Sample records for actuarial local control

  1. Local Control After Stereotactic Body Radiation Therapy for Liver Tumors.

    PubMed

    Ohri, Nitin; Tomé, Wolfgang A; Méndez Romero, Alejandra; Miften, Moyed; Ten Haken, Randall K; Dawson, Laura A; Grimm, Jimm; Yorke, Ellen; Jackson, Andrew

    2018-01-06

    To quantitatively evaluate published experiences with hepatic stereotactic body radiation therapy (SBRT), to determine local control rates after treatment of primary and metastatic liver tumors and to examine whether outcomes are affected by SBRT dosing regimen. We identified published articles that reported local control rates after SBRT for primary or metastatic liver tumors. Biologically effective doses (BEDs) were calculated for each dosing regimen using the linear-quadratic equation. We excluded series in which a wide range of BEDs was used. Individual lesion data for local control were extracted from actuarial survival curves, and data were aggregated to form a single dataset. Actuarial local control curves were generated using the Kaplan-Meier method after grouping lesions by disease type and BED (<100 Gy 10 vs >100 Gy 10 ). Comparisons were made using log-rank testing. Thirteen articles met all inclusion criteria and formed the dataset for this analysis. The 1-, 2-, and 3-year actuarial local control rates after SBRT for primary liver tumors (n = 431) were 93%, 89%, and 86%, respectively. Lower 1- (90%), 2- (79%), and 3-year (76%) actuarial local control rates were observed for liver metastases (n = 290, log-rank P = .011). Among patients treated with SBRT for primary liver tumors, there was no evidence that local control is influenced by BED within the range of schedules used. For liver metastases, on the other hand, outcomes were significantly better for lesions treated with BEDs exceeding 100 Gy 10 (3-year local control 93%) than for those treated with BEDs of ≤100 Gy 10 (3-year local control 65%, P < .001). Stereotactic body radiation therapy for primary liver tumors provides high rates of durable local control, with no clear evidence for a dose-response relationship among commonly utilized schedules. Excellent local control rates are also seen after SBRT for liver metastases when BEDs of >100 Gy 10 are utilized. Copyright © 2018

  2. The Casualty Actuarial Society: Helping Universities Train Future Actuaries

    ERIC Educational Resources Information Center

    Boa, J. Michael; Gorvett, Rick

    2014-01-01

    The Casualty Actuarial Society (CAS) believes that the most effective way to advance the actuarial profession is to work in partnership with universities. The CAS stands ready to assist universities in creating or enhancing courses and curricula associated with property/casualty actuarial science. CAS resources for university actuarial science…

  3. Actuarial Valuation.

    ERIC Educational Resources Information Center

    Teachers Retirement System of Louisiana, Baton Rouge.

    This report presents the results of the actuarial valuation of assets and liabilities as well as funding requirements for the Teachers Retirement System of Louisiana as of June 30, 1996. Data reported include current funding, actuarial assets and valuation assets. These include the Louisiana State University Agriculture and Extension Service Fund,…

  4. Clinical versus actuarial judgment.

    PubMed

    Dawes, R M; Faust, D; Meehl, P E

    1989-03-31

    Professionals are frequently consulted to diagnose and predict human behavior; optimal treatment and planning often hinge on the consultant's judgmental accuracy. The consultant may rely on one of two contrasting approaches to decision-making--the clinical and actuarial methods. Research comparing these two approaches shows the actuarial method to be superior. Factors underlying the greater accuracy of actuarial methods, sources of resistance to the scientific findings, and the benefits of increased reliance on actuarial approaches are discussed.

  5. The case for an actuary.

    PubMed

    Renaud, Patrick N

    2002-12-01

    The author describes the role of the actuary, the need for qualified actuaries and how to find them. Qualified actuarial help, in the form of a Fellow of the Society of Actuaries (FSA), is necessary to ensure the best outcome when setting annual premium rates and realistic budgets for self-funded group benefit plans.

  6. Underlying theory of actuarial analyses.

    PubMed

    Benjamin, B

    1985-05-01

    The developments in theory governing the calculation of mortality rates for use in survival measurements working through the initial basic concept of exposure to risk to the later introduction of stochastic elements are reviewed. I have indicated the way in which actuaries and statisticians who work closely with those in the fields of medicine and biology have, by the exchange of methodologic ideas, come to an identity of approach. Recent new actuarial work and likely future developments in actuarial interests are reviewed.

  7. Actually, What Is an Actuary?

    ERIC Educational Resources Information Center

    Oudshoorn, Susan; Finkelstein, Gary

    1991-01-01

    The actuarial profession is described to provide secondary school mathematics teachers insights into how actuaries use mathematics in solving real life problems. Examples are provided involving compound interest, the probability of dying, and inflation with computer modeling. (MDH)

  8. Improved local and regional control with radiotherapy for Merkel cell carcinoma of the head and neck.

    PubMed

    Strom, Tobin; Naghavi, Arash O; Messina, Jane L; Kim, Sungjune; Torres-Roca, Javier F; Russell, Jeffery; Sondak, Vernon K; Padhya, Tapan A; Trotti, Andy M; Caudell, Jimmy J; Harrison, Louis B

    2017-01-01

    We hypothesized that radiotherapy (RT) would improve both local and regional control with Merkel cell carcinoma of the head and neck. A single-institution institutional review board-approved study was performed including 113 patients with nonmetastatic Merkel cell carcinoma of the head and neck. Postoperative RT was delivered to the primary tumor bed (71.7% cases) ± draining lymphatics (33.3% RT cases). Postoperative local RT was associated with improved local control (3-year actuarial local control 89.4% vs 68.1%; p = .005; Cox hazard ratio [HR] 0.18; 95% confidence interval [CI] = 0.06-0.55; p = .002). Similarly, regional RT was associated with improved regional control (3-year actuarial regional control 95.0% vs 66.7%; p = .008; Cox HR = 0.09; 95% CI = 0.01-0.69; p = .02). Regional RT played an important role for both clinical node-negative patients (3-year regional control 100% vs 44.7%; p = .03) and clinical/pathological node-positive patients (3-year regional control 90.9% vs 55.6%; p = .047). Local RT was beneficial for all patients with Merkel cell carcinoma of the head and neck, whereas regional RT was beneficial for clinical node-negative and clinical/pathological node-positive patients. © 2016 Wiley Periodicals, Inc. Head Neck 39: 48-55, 2017. © 2016 Wiley Periodicals, Inc.

  9. Are we selecting the right patients for treatment of localized prostate cancer? Results of an actuarial analysis.

    PubMed

    Koch, M O; Miller, D A; Butler, R; Lebos, L; Collings, D; Smith, J A

    1998-02-01

    To determine our accuracy in selecting patients with at least a 10-year life expectancy for aggressive treatment of localized prostate cancer. The medical records of 261 consecutive patients who underwent radical retropubic prostatectomy were submitted to the actuarial division of American General Life and Accident Insurance Company (AGLA) for estimation of life expectancy, excluding the diagnosis of prostate cancer. Survival curves were generated from predicted individual survivals. In patients with less than a 10-year life expectancy, AGLA provided us with the basis for assigning suboptimal survival rates. The mean life expectancy for the group was 15.2 years. Two hundred ten men (80%) were projected to have a life expectancy of more than 10 years, including 27 of 55 (49%) and 4 of 8 (50%) men who were older than or equal to 70 and 75 years of age, respectively. Coronary artery disease and diabetes mellitus were the most common coexisting medical conditions that adversely affected risk as single disease entities. Although clinicians do not estimate life expectancy with the scientific exactitude of an actuary, the ability to assess the patient in person and assimilate pertinent medical information in a less rigid format yields similar results. Selection of men for definitive treatment of localized prostate cancer should be based on the inherent aggressiveness of the disease and the health of the individual and should not be limited by specific age cutoffs. Populations of men undergoing radical prostatectomy are younger and healthier than those in reported series of watchful waiting for prostate cancer.

  10. A look inside the actuarial black box.

    PubMed

    Math, S E; Youngerman, H

    1992-12-01

    Hospital executives often rely on actuaries (and their "black boxes") to determine self-insurance program liabilities and funding contributions. Typically, the hospital supplies the actuary with a myriad of statistics, and eventually the hospital receives a liability estimate and recommended funding level. The mysterious actuarial calculations that occur in between data reporting and receipt of the actuary's report are akin to a black box--a complicated device whose internal mechanism is hidden from or mysterious to the user.

  11. 42 CFR 403.258 - Statement of actuarial opinion.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions used... policy experience, if any, and reasonable expectations. (b) Qualified actuary means— (1) A member in good standing of the American Academy of Actuaries; or (2) A person who has otherwise demonstrated his or her...

  12. 42 CFR 403.258 - Statement of actuarial opinion.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions used... policy experience, if any, and reasonable expectations. (b) Qualified actuary means— (1) A member in good standing of the American Academy of Actuaries; or (2) A person who has otherwise demonstrated his or her...

  13. 42 CFR 403.258 - Statement of actuarial opinion.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions used... policy experience, if any, and reasonable expectations. (b) Qualified actuary means— (1) A member in good standing of the American Academy of Actuaries; or (2) A person who has otherwise demonstrated his or her...

  14. 42 CFR 403.258 - Statement of actuarial opinion.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions used... policy experience, if any, and reasonable expectations. (b) Qualified actuary means— (1) A member in good standing of the American Academy of Actuaries; or (2) A person who has otherwise demonstrated his or her...

  15. 42 CFR 403.258 - Statement of actuarial opinion.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions used... policy experience, if any, and reasonable expectations. (b) Qualified actuary means— (1) A member in good standing of the American Academy of Actuaries; or (2) A person who has otherwise demonstrated his or her...

  16. 20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries are selected. (b) Carrier actuary. One member of the Actuarial Advisory Committee shall be selected by... railroad mileage within the United States. (c) Railway labor actuary. The other member of the Actuarial...

  17. 20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries are selected. (b) Carrier actuary. One member of the Actuarial Advisory Committee shall be selected by... railroad mileage within the United States. (c) Railway labor actuary. The other member of the Actuarial...

  18. 20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries are selected. (b) Carrier actuary. One member of the Actuarial Advisory Committee shall be selected by... railroad mileage within the United States. (c) Railway labor actuary. The other member of the Actuarial...

  19. 20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries are selected. (b) Carrier actuary. One member of the Actuarial Advisory Committee shall be selected by... railroad mileage within the United States. (c) Railway labor actuary. The other member of the Actuarial...

  20. Actuarial Science.

    ERIC Educational Resources Information Center

    Warren, Bette

    1982-01-01

    Details are provided of a program on actuarial training developed at the State University of New York (SUNY) at Binghamton through the Department of Mathematical Sciences. An outline of its operation, including a few statistics on students in the program, is included. (MP)

  1. 20 CFR 901.2 - Eligibility to perform actuarial services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .... 901.2 Section 901.2 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS.... (a) Enrolled actuary. Subject to the standards of performance set forth in subpart C of this part, any individual who is an enrolled actuary as defined in § 901.1(g) may perform actuarial services...

  2. 20 CFR 901.2 - Eligibility to perform actuarial services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .... 901.2 Section 901.2 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS.... (a) Enrolled actuary. Subject to the standards of performance set forth in subpart C of this part, any individual who is an enrolled actuary as defined in § 901.1(g) may perform actuarial services...

  3. 20 CFR 901.2 - Eligibility to perform actuarial services.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... 901.2 Section 901.2 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS.... (a) Enrolled actuary. Subject to the standards of performance set forth in subpart C of this part, any individual who is an enrolled actuary as defined in § 901.1(g) may perform actuarial services...

  4. 20 CFR 901.2 - Eligibility to perform actuarial services.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .... 901.2 Section 901.2 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS.... (a) Enrolled actuary. Subject to the standards of performance set forth in subpart C of this part, any individual who is an enrolled actuary as defined in § 901.1(g) may perform actuarial services...

  5. 20 CFR 901.2 - Eligibility to perform actuarial services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... 901.2 Section 901.2 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS.... (a) Enrolled actuary. Subject to the standards of performance set forth in subpart C of this part, any individual who is an enrolled actuary as defined in § 901.1(g) may perform actuarial services...

  6. Insights into managed care--operational, legal and actuarial.

    PubMed

    Melek, S P; Johnson, B A; Schryver, D

    1997-01-01

    Understanding the operational, legal and actuarial dimensions of managed care is essential to developing managed care contracts between managed care organizations and individual health care providers or groups such as provider-sponsored organizations or independent practice associations. Operationally, it is important to understand managed care and its trends, emphasizing business issues, knowing your practice and defining acceptable levels of reimbursement and risk. Legally, there are a number of common themes or issues relevant to all managed care contracts, including primary care vs. specialist contracts, services offered, program policies and procedures, utilization review, physician reimbursement and compensation, payment schedule, terms and conditions, term and termination, continuation of care requirements, indemnification, amendment of contract and program policies, and stop-loss insurance. Actuarial issues include membership, geography, age-gender distribution, degree of health care management, local managed care utilization levels, historical utilization levels, health plan benefit design, among others.

  7. 26 CFR 301.6059-1 - Periodic report of actuary.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Periodic report of actuary. 301.6059-1 Section...-1 Periodic report of actuary. (a) In general. The actuarial report described in this section must be... funding deficiency (as defined in section 412(a)) to zero, (4) A statement by the enrolled actuary signing...

  8. 26 CFR 301.6059-1 - Periodic report of actuary.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Periodic report of actuary. 301.6059-1 Section...-1 Periodic report of actuary. (a) In general. The actuarial report described in this section must be... funding deficiency (as defined in section 412(a)) to zero, (4) A statement by the enrolled actuary signing...

  9. 26 CFR 301.6059-1 - Periodic report of actuary.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Periodic report of actuary. 301.6059-1 Section...-1 Periodic report of actuary. (a) In general. The actuarial report described in this section must be... funding deficiency (as defined in section 412(a)) to zero, (4) A statement by the enrolled actuary signing...

  10. 26 CFR 301.6059-1 - Periodic report of actuary.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Periodic report of actuary. 301.6059-1 Section...-1 Periodic report of actuary. (a) In general. The actuarial report described in this section must be... funding deficiency (as defined in section 412(a)) to zero, (4) A statement by the enrolled actuary signing...

  11. 26 CFR 301.6059-1 - Periodic report of actuary.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Periodic report of actuary. 301.6059-1 Section...-1 Periodic report of actuary. (a) In general. The actuarial report described in this section must be... funding deficiency (as defined in section 412(a)) to zero, (4) A statement by the enrolled actuary signing...

  12. 75 FR 63505 - Renewal of Advisory Committee on Actuarial Examinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ... actuarial mathematics and methodology. The Joint Board administers such examinations in discharging its... JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES Renewal of Advisory Committee on Actuarial... Committee on Actuarial Examinations. FOR FURTHER INFORMATION CONTACT: Patrick W. McDonough, 202-622-8225...

  13. 42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...— (1) By an individual who is a member of the American Academy of Actuaries; (2) Using generally accepted actuarial principles and methodologies of the American Academy of Actuaries; (3) Using a... coverage. (c) The actuary who prepares the opinion must select and specify the standardized set and...

  14. 20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

  15. 20 CFR 901.20 - Standards of performance of actuarial services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... services. 901.20 Section 901.20 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services. In the discharge of duties required by ERISA of enrolled actuaries with respect to any plan to which the...

  16. 20 CFR 901.20 - Standards of performance of actuarial services.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... services. 901.20 Section 901.20 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services. In the discharge of duties required by ERISA of enrolled actuaries with respect to any plan to which the...

  17. 20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

  18. 20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

  19. 20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

  20. 20 CFR 901.20 - Standards of performance of actuarial services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... services. 901.20 Section 901.20 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services. In the discharge of duties required by ERISA of enrolled actuaries with respect to any plan to which the...

  1. 20 CFR 901.20 - Standards of performance of actuarial services.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... services. 901.20 Section 901.20 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services. In the discharge of duties required by ERISA of enrolled actuaries with respect to any plan to which the...

  2. 20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

  3. 26 CFR 300.7 - Enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

  4. 26 CFR 300.7 - Enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

  5. 26 CFR 300.7 - Enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

  6. 26 CFR 300.7 - Enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

  7. 26 CFR 300.7 - Enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Enrollment of enrolled actuary fee. 300.7... AND ADMINISTRATION USER FEES § 300.7 Enrollment of enrolled actuary fee. (a) Applicability. This section applies to the initial enrollment of enrolled actuaries with the Joint Board for the Enrollment of...

  8. Actuarial considerations of medical malpractice evaluations in M&As.

    PubMed

    Frese, Richard C

    2014-11-01

    To best project an actuarial estimate for medical malpractice exposure for a merger and acquisition, a organization's leaders should consider the following factors, among others: How to support an unbiased actuarial estimation. Experience of the actuary. The full picture of the organization's malpractice coverage. The potential for future loss development. Frequency and severity trends.

  9. 29 CFR 4231.10 - Actuarial calculations and assumptions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date of...

  10. 29 CFR 4231.10 - Actuarial calculations and assumptions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date of...

  11. 29 CFR 4231.10 - Actuarial calculations and assumptions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date of...

  12. 29 CFR 4231.10 - Actuarial calculations and assumptions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date of...

  13. 29 CFR 4231.10 - Actuarial calculations and assumptions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date of...

  14. Developing an Actuarial Track Utilizing Existing Resources

    ERIC Educational Resources Information Center

    Rodgers, Kathy V.; Sarol, Yalçin

    2014-01-01

    Students earning a degree in mathematics often seek information on how to apply their mathematical knowledge. One option is to follow a curriculum with an actuarial emphasis designed to prepare students as an applied mathematician in the actuarial field. By developing only two new courses and utilizing existing courses for Validation by…

  15. 20 CFR 901.20 - Standards of performance of actuarial services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... explanation relative to any report signed or certified by such enrolled actuary. (d) Conflicts of interest. In any situation in which the enrolled actuary has a conflict of interest with respect to the performance... not of a distinctive nature. (h) Notification. An enrolled actuary shall provide written notification...

  16. The Undergraduate Statistics Major--A Prelude to Actuarial Science Training.

    ERIC Educational Resources Information Center

    Ratliff, Michael I.; Williams, Raymond E.

    Recently there has been increased interest related to the Actuarial Science field. An actuary is a business professional who uses mathematical skills to define, analyze, and solve financial and social problems. This paper examines: (1) the interface between Statistical and Actuarial Science training; (2) statistical courses corresponding to…

  17. 77 FR 63337 - Renewal of Charter of Advisory Committee on Actuarial Examinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-16

    ... examinations in actuarial mathematics and methodology. The Joint Board administers such examinations in... JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES Renewal of Charter of Advisory Committee on Actuarial... the Advisory Committee on Actuarial Examinations. FOR FURTHER INFORMATION CONTACT: Patrick McDonough...

  18. Different actuarial risk measures produce different risk rankings for sexual offenders.

    PubMed

    Barbaree, Howard E; Langton, Calvin M; Peacock, Edward J

    2006-10-01

    Percentile ranks were computed for N=262 sex offenders using each of 5 actuarial risk instruments commonly used with adult sex offenders (RRASOR, Static-99, VRAG, SORAG, and MnSOST-R). Mean differences between percentile ranks obtained by different actuarial measures were found to vary inversely with the correlation between the actuarial scores. Following studies of factor analyses of actuarial items, we argue that the discrepancies among actuarial instruments can be substantially accounted for by the way in which the factor Antisocial Behavior and various factors reflecting sexual deviance are represented among the items contained in each instrument. In the discussion, we provide guidance to clinicians in resolving discrepancies between instruments and we discuss implications for future developments in sex offender risk assessment.

  19. 26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

  20. 26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

  1. 26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

  2. 26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

  3. 26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

  4. Strategic Curricular Decisions in Butler University's Actuarial Science Major

    ERIC Educational Resources Information Center

    Wilson, Christopher James

    2014-01-01

    We describe specific curricular decisions employed at Butler University that have resulted in student achievement in the actuarial science major. The paper includes a discussion of how these decisions might be applied in the context of a new actuarial program.

  5. 42 CFR 440.340 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... individual who is a member of the American Academy of Actuaries (AAA). (2) Using generally accepted actuarial principles and methodologies of the AAA. (3) Using a standardized set of utilization and price factors. (4...

  6. Actuarial risk assessment: commentary on Berlin et al.

    PubMed

    Hart, Stephen D

    2003-10-01

    F. S. Berlin, N. W. Galbreath, B. Geary, and G. McGlone (this issue) have raised some important questions regarding the use of acturial risk assessment instruments in sex offender civil commitment proceedings, also known as sexually violent predator or SVP proceedings. Their primary point is that interpreting the findings of existing actuarial risk assessment instruments is a tricky business because it is not certain whether the extent to which probability estimates derived from group data can be applied to individual cases. I agree completely with Berlin et al. on this point, but disagree with them concerning the extent to which probability estimates--and, therefore, actuarial instruments--are legally relevant in SVP proceedings. I outline some potential problems with respect to the legal admissibility of actuarial instruments, including their legal relevance.

  7. 75 FR 22754 - Federal Advisory Committee; Department of Defense Board of Actuaries; Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ... Board of Actuaries; Charter Renewal AGENCY: Department of Defense (DoD). ACTION: Renewal of Federal... Department of Defense Board of Actuaries (hereafter referred to as the Board). FOR FURTHER INFORMATION... qualified professional actuaries who are members of the Society of Actuaries. Board members shall be...

  8. 26 CFR 301.6692-1 - Failure to file actuarial report.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... enrolled actuary (see § 301.6059-1(d)) is considered a material item of information. Further, for any report filed for a plan year ending after January 25, 1982, if the actuary seeks to materially qualify a...

  9. 26 CFR 301.6692-1 - Failure to file actuarial report.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... enrolled actuary (see § 301.6059-1(d)) is considered a material item of information. Further, for any report filed for a plan year ending after January 25, 1982, if the actuary seeks to materially qualify a...

  10. 26 CFR 301.6692-1 - Failure to file actuarial report.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... enrolled actuary (see § 301.6059-1(d)) is considered a material item of information. Further, for any report filed for a plan year ending after January 25, 1982, if the actuary seeks to materially qualify a...

  11. 26 CFR 301.6692-1 - Failure to file actuarial report.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... enrolled actuary (see § 301.6059-1(d)) is considered a material item of information. Further, for any report filed for a plan year ending after January 25, 1982, if the actuary seeks to materially qualify a...

  12. 26 CFR 301.6692-1 - Failure to file actuarial report.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... enrolled actuary (see § 301.6059-1(d)) is considered a material item of information. Further, for any report filed for a plan year ending after January 25, 1982, if the actuary seeks to materially qualify a...

  13. 20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Selection of members of Actuarial Advisory Committee. 200.9 Section 200.9 Employees' Benefits RAILROAD RETIREMENT BOARD GENERAL ADMINISTRATION GENERAL... railroad subject to the Interstate Commerce Act which own or control more than 50 percent of the total...

  14. 75 FR 6359 - Federal Advisory Committee; DoD Board of Actuaries; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-09

    ... DEPARTMENT OF DEFENSE Office of the Secretary Federal Advisory Committee; DoD Board of Actuaries... the DoD Board of Actuaries will meet on July 22 and 23, 2010. Subject to the availability of space...D Office of the Actuary, 4040 N. Fairfax Drive, Suite 308, Arlington, VA 22203; phone 703-696-7413...

  15. Development of an Actuarial Science Program at Salisbury University

    ERIC Educational Resources Information Center

    Wainwright, Barbara A.

    2014-01-01

    This paper focuses on the development of an actuarial science track for the mathematics major at Salisbury University (SU). A timeline from the initial investigation into such a program through the proposal and approval processes is shared for those who might be interested in developing a new actuarial program. It is wise to start small and take…

  16. 5 CFR 839.1115 - What is an actuarial reduction?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...? An actuarial reduction allows you to receive benefits without having to pay an amount due in a lump sum. OPM reduces your annuity in a way that, on average, allows the Fund to recover the amount of the... have to pay at that time. To compute an actuarial reduction, OPM divides the lump sum amount by the...

  17. 5 CFR 839.1115 - What is an actuarial reduction?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...? An actuarial reduction allows you to receive benefits without having to pay an amount due in a lump sum. OPM reduces your annuity in a way that, on average, allows the Fund to recover the amount of the... have to pay at that time. To compute an actuarial reduction, OPM divides the lump sum amount by the...

  18. The Role of an Actuarial Director in the Development of an Introductory Program

    ERIC Educational Resources Information Center

    Staples, Susan G.

    2014-01-01

    We describe the roles and duties of a director in developing an introductory actuarial program. Degree plan design, specialized exam courses, internship classes, coordination of efforts with Economics and Finance Departments, opportunities for creating a minor in actuarial mathematics, actuarial clubs, career advice, and interaction with actuarial…

  19. An Overview of the Society of Actuaries and Its Education Programs

    ERIC Educational Resources Information Center

    Klugman, Stuart; Long, Gena

    2014-01-01

    The Society of Actuaries (SOA) is the world's largest actuarial organization. This article describes the SOA with particular attention paid to its education and qualification processes and resources available for university and college programs.

  20. Including an Exam P/1 Prep Course in a Growing Actuarial Science Program

    ERIC Educational Resources Information Center

    Wakefield, Thomas P.

    2014-01-01

    The purpose of this article is to describe the actuarial science program at our university and the development of a course to enhance students' problem solving skills while preparing them for Exam P/1 of the Society of Actuaries (SOA) and the Casualty Actuary Society (CAS). The Exam P/1 prep course, formally titled Mathematical Foundations of…

  1. Connecting clinical and actuarial prediction with rule-based methods.

    PubMed

    Fokkema, Marjolein; Smits, Niels; Kelderman, Henk; Penninx, Brenda W J H

    2015-06-01

    Meta-analyses comparing the accuracy of clinical versus actuarial prediction have shown actuarial methods to outperform clinical methods, on average. However, actuarial methods are still not widely used in clinical practice, and there has been a call for the development of actuarial prediction methods for clinical practice. We argue that rule-based methods may be more useful than the linear main effect models usually employed in prediction studies, from a data and decision analytic as well as a practical perspective. In addition, decision rules derived with rule-based methods can be represented as fast and frugal trees, which, unlike main effects models, can be used in a sequential fashion, reducing the number of cues that have to be evaluated before making a prediction. We illustrate the usability of rule-based methods by applying RuleFit, an algorithm for deriving decision rules for classification and regression problems, to a dataset on prediction of the course of depressive and anxiety disorders from Penninx et al. (2011). The RuleFit algorithm provided a model consisting of 2 simple decision rules, requiring evaluation of only 2 to 4 cues. Predictive accuracy of the 2-rule model was very similar to that of a logistic regression model incorporating 20 predictor variables, originally applied to the dataset. In addition, the 2-rule model required, on average, evaluation of only 3 cues. Therefore, the RuleFit algorithm appears to be a promising method for creating decision tools that are less time consuming and easier to apply in psychological practice, and with accuracy comparable to traditional actuarial methods. (c) 2015 APA, all rights reserved).

  2. Population projections for AIDS using an actuarial model.

    PubMed

    Wilkie, A D

    1989-09-05

    This paper gives details of a model for forecasting AIDS, developed for actuarial purposes, but used also for population projections. The model is only appropriate for homosexual transmission, but it is age-specific, and it allows variation in the transition intensities by age, duration in certain states and calendar year. The differential equations controlling transitions between states are defined, the method of numerical solution is outlined, and the parameters used in five different Bases of projection are given in detail. Numerical results for the population of England and Wales are shown.

  3. 75 FR 47650 - Actuarial Advisory Committee With Respect to the Railroad Retirement Account; Notice of Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... Chief Actuary of the U.S. Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois, on the... sent by the Chief Actuary to the Committee before the meeting. The meeting will be open to the public... communications or notices to the RRB Actuarial Advisory Committee, c/o Chief Actuary, U.S. Railroad Retirement...

  4. 78 FR 9890 - DoD Board of Actuaries; Notice of Federal Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ... DEPARTMENT OF DEFENSE Office of the Secretary DoD Board of Actuaries; Notice of Federal Advisory... Advisory Committee meeting of the DoD Board of Actuaries will take place. DATES: July 18, 2013, from 1:00 p... Defense Human Resource Activity, DoD Office of the Actuary, 4800 Mark Center Drive, STE 06J25-01...

  5. Impact of actuarial assumptions on pension costs: A simulation analysis

    NASA Astrophysics Data System (ADS)

    Yusof, Shaira; Ibrahim, Rose Irnawaty

    2013-04-01

    This study investigates the sensitivity of pension costs to changes in the underlying assumptions of a hypothetical pension plan in order to gain a perspective on the relative importance of the various actuarial assumptions via a simulation analysis. Simulation analyses are used to examine the impact of actuarial assumptions on pension costs. There are two actuarial assumptions will be considered in this study which are mortality rates and interest rates. To calculate pension costs, Accrued Benefit Cost Method, constant amount (CA) modification, constant percentage of salary (CS) modification are used in the study. The mortality assumptions and the implied mortality experience of the plan can potentially have a significant impact on pension costs. While for interest rate assumptions, it is inversely related to the pension costs. Results of the study have important implications for analyst of pension costs.

  6. 76 FR 81362 - Regulations Governing the Performance of Actuarial Services Under the Employee Retirement Income...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-28

    ... JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES 20 CFR Part 901 [TD 9517] RIN 1545-BC82 Regulations...; Correction AGENCY: Joint Board for the Enrollment of Actuaries. ACTION: Correction to final regulations... Federal Register on Thursday, March 31, 2011 (76 FR 17762) relating to the enrollment of actuaries. DATES...

  7. 77 FR 12577 - Department of Defense (DoD) Board of Actuaries; Federal Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... DEPARTMENT OF DEFENSE Office of the Secretary Department of Defense (DoD) Board of Actuaries... that the following Federal advisory committee meeting of the DoD Board of Actuaries will take place... Actuaries meeting or make an oral presentation or submit a written statement for consideration at the...

  8. Recruiting and Advising Challenges in Actuarial Science

    ERIC Educational Resources Information Center

    Case, Bettye Anne; Guan, Yuanying Michelle; Paris, Stephen

    2014-01-01

    Some challenges to increasing actuarial science program size through recruiting broadly among potential students are identified. Possible solutions depend on the structures and culture of the school. Up to three student cohorts may result from partition of potential students by the levels of academic progress before program entry: students…

  9. 77 FR 12577 - Department of Defense (DoD) Medicare-Eligible Retiree Health Care Board of Actuaries; Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... Retiree Health Care Board of Actuaries; Federal Advisory Committee Meeting AGENCY: DoD. ACTION: Meeting... DoD Medicare-Eligible Retiree Health Care Board of Actuaries will take place. DATES: Friday, August 3... Contact: Persons desiring to attend the DoD Medicare- Eligible Retiree Health Care Board of Actuaries...

  10. Choosing the 'best' plan in a health insurance exchange: actuarial value tells only part of the story.

    PubMed

    Lore, Ryan; Gabel, Jon R; McDevitt, Roland; Slover, Michael

    2012-08-01

    In the health insurance exchanges that will come online in 2014, consumers will be able to compare health plans with respect to actuarial value, or the percentage of health care costs that a plan would pay for a standard population. This analysis illustrates the out-of-pocket costs that might result from plans with various plan designs and actuarial values. We find that average out-of-pocket expense declines as actuarial values rise, but two plans with similar actuarial values can produce very different outcomes for a given person. The overall affordability of a plan also will be influenced by age rating, income-related premium subsidies, and out-of-pocket subsidies. Actuarial value is a useful starting point for selecting a plan, but it does not pinpoint which plan will produce the best overall value for a particular person.

  11. Prognosis of patients after open mitral commissurotomy. Actuarial analysis of late results in 100 patients.

    PubMed

    Housman, L B; Bonchek, L; Lambert, L; Grunkemeier, G; Starr, A

    1977-05-01

    The continuing controversy between proponents of open and closed commissurotomy might be clarified by analysis of late follow-up with modern actuarial techniques that provide a true perspective of patient risk. We have used open mitral commissurotomy exclusively for 15 years in 100 patients. There was one operative death from pancreatitis and one late death from cancer; the actuarially projected survival rate (+/- the standard error) at 10 years is 97 per cent (+/- 2). Thirteen patients had preoperative emboli, 6 of whom were in sinus rhythm and 7 in atrial fibrillation. Two patients had postoperative emboli, both in sinus rhythm. The actuarial chance of remaining free of embolism at 10 years is 97 per cent (+/- 2). Sixteen patients required reoperation on the mitral valve for functional deterioration. The remaining survivors were in Class I or II when last seen. The actuarial chance of not requiring a reoperation after 5 years is 91 per cent (+/- 4) and at 10 years, 38 per cent(+/- 16). Results in different centers are difficult to compare for many reasons, but imprecise statistical methods further obscure such comparisons. The use of actuarial techniques may help to define the role of open mitral commissurotomy.

  12. Marketplace Plans Provide Risk Protection, But Actuarial Values Overstate Realized Coverage For Most Enrollees.

    PubMed

    Polyakova, Maria; Hua, Lynn Mei; Bundorf, M Kate

    2017-12-01

    The Affordable Care Act (ACA) has increased the number of Americans with health insurance. Yet many policy makers and consumers have questioned the value of Marketplace plan coverage because of the generally high levels of cost sharing. We simulated out-of-pocket spending for bronze, silver, or gold Marketplace plans (those having actuarial values of 60 percent, 70 percent, and 80 percent, respectively). We found that for the vast majority of consumers, the proportion of covered spending paid by the plans is likely to be far less than their actuarial values, the metric commonly used to convey plan generosity. Indeed, only when annual health care spending exceeds $16,500 for bronze plans, $19,500 for silver plans, and $21,500 for gold plans do plans in these metal tiers cover the proportion of costs matching their actuarial values. While Marketplace plans substantially reduce consumers' exposure to financial risk relative to being uninsured, the use of actuarial values to communicate plan generosity is likely to be misleading to consumers.

  13. 77 FR 24233 - Actuarial Advisory Committee With Respect to the Railroad Retirement Account; Notice of Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-23

    ... Actuary of the U.S. Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois, on the conduct of... Actuary, U.S. Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois 60611-2092. Dated: April...

  14. Actuarial senescence in a long-lived orchid challenges our current understanding of ageing

    PubMed Central

    Colchero, Fernando; Jones, Owen R.; Øien, Dag-Inge; Moen, Asbjørn; Sletvold, Nina

    2016-01-01

    The dominant evolutionary theory of actuarial senescence—an increase in death rate with advancing age—is based on the concept of a germ cell line that is separated from the somatic cells early in life. However, such a separation is not clear in all organisms. This has been suggested to explain the paucity of evidence for actuarial senescence in plants. We used a 32 year study of Dactylorhiza lapponica that replaces its organs each growing season, to test whether individuals of this tuberous orchid senesce. We performed a Bayesian survival trajectory analysis accounting for reproductive investment, for individuals under two types of land use, in two climatic regions. The mortality trajectory was best approximated by a Weibull model, showing clear actuarial senescence. Rates of senescence in this model declined with advancing age, but were slightly higher in mown plots and in the more benign climatic region. At older ages, senescence was evident only when accounting for a positive effect of reproductive investment on mortality. Our results demonstrate actuarial senescence as well as a survival–reproduction trade-off in plants, and indicate that environmental context may influence senescence rates. This knowledge is crucial for understanding the evolution of demographic senescence and for models of plant population dynamics. PMID:27852801

  15. Actuarial senescence in a long-lived orchid challenges our current understanding of ageing.

    PubMed

    Dahlgren, Johan Petter; Colchero, Fernando; Jones, Owen R; Øien, Dag-Inge; Moen, Asbjørn; Sletvold, Nina

    2016-11-16

    The dominant evolutionary theory of actuarial senescence-an increase in death rate with advancing age-is based on the concept of a germ cell line that is separated from the somatic cells early in life. However, such a separation is not clear in all organisms. This has been suggested to explain the paucity of evidence for actuarial senescence in plants. We used a 32 year study of Dactylorhiza lapponica that replaces its organs each growing season, to test whether individuals of this tuberous orchid senesce. We performed a Bayesian survival trajectory analysis accounting for reproductive investment, for individuals under two types of land use, in two climatic regions. The mortality trajectory was best approximated by a Weibull model, showing clear actuarial senescence. Rates of senescence in this model declined with advancing age, but were slightly higher in mown plots and in the more benign climatic region. At older ages, senescence was evident only when accounting for a positive effect of reproductive investment on mortality. Our results demonstrate actuarial senescence as well as a survival-reproduction trade-off in plants, and indicate that environmental context may influence senescence rates. This knowledge is crucial for understanding the evolution of demographic senescence and for models of plant population dynamics. © 2016 The Author(s).

  16. An analysis of possible applications of fuzzy set theory to the actuarial credibility theory

    NASA Technical Reports Server (NTRS)

    Ostaszewski, Krzysztof; Karwowski, Waldemar

    1992-01-01

    In this work, we review the basic concepts of actuarial credibility theory from the point of view of introducing applications of the fuzzy set-theoretic method. We show how the concept of actuarial credibility can be modeled through the fuzzy set membership functions and how fuzzy set methods, especially fuzzy pattern recognition, can provide an alternative tool for estimating credibility.

  17. Excellent Local Control Rates and Distinctive Patterns of Failure in Myxoid Liposarcoma Treated With Conservation Surgery and Radiotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Guadagnolo, B. Ashleigh; Zagars, Gunar K.; Ballo, Matthew T.

    2008-03-01

    Purpose: To evaluate the local control rates and patterns of metastatic relapse in patients with localized myxoid liposarcoma treated with conservation surgery and radiotherapy (RT). Patients and Methods: Between 1960 and 2003, 127 patients with non-metastatic myxoid liposarcoma were treated with conservation surgery and RT at our institution. The median patient age was 39 years (range, 14-79 years). Of the 127 patients, 46% underwent preoperative RT (median dose, 50 Gy) and 54% underwent postoperative RT (median dose, 60 Gy). Also, 28% received doxorubicin-based chemotherapy as a part of their treatment. Results: The median follow-up was 9.1 years. The overall survivalmore » rate at 5 and 10 years was 87% and 79%, respectively. The corresponding disease-free survival rates were 81% and 73%. The local control rate at {>=}5 years was 97%. The actuarial rate of distant metastases at 5 and 10 years was 15% and 24%, respectively. Of the 27 patients who developed distant metastases, 48% did so in the retroperitoneum, 22% in other extrapulmonary soft tissues, 22% in the lung, 15% in bone, and 4% in the liver. Conclusion: The results of our study have shown that RT and conservation surgery for localized myxoid liposarcoma provide excellent local control. Distant metastatic relapse tended to occur in the retroperitoneum and other nonpulmonary soft tissues. Therefore, staging and surveillance imaging should include the abdomen and pelvis, as well as the thorax, for patients with localized myxoid liposarcoma.« less

  18. Actuarial Science at One Four-Year Comprehensive University

    ERIC Educational Resources Information Center

    Charlwood, Kevin E.

    2014-01-01

    Building an Actuarial Science program designated as advanced requires dedicated faculty, support from the administration, and a core group of strong students. Washburn University may serve as a model for those wishing to start or enhance such a program at their institution. We face three main ongoing challenges: first, the hiring and retention of…

  19. A Comparison of Logistic Regression, Neural Networks, and Classification Trees Predicting Success of Actuarial Students

    ERIC Educational Resources Information Center

    Schumacher, Phyllis; Olinsky, Alan; Quinn, John; Smith, Richard

    2010-01-01

    The authors extended previous research by 2 of the authors who conducted a study designed to predict the successful completion of students enrolled in an actuarial program. They used logistic regression to determine the probability of an actuarial student graduating in the major or dropping out. They compared the results of this study with those…

  20. 75 FR 68790 - Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-09

    ... 0938-AP81 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual... (SMI) program beginning January 1, 2011. In addition, this notice announces the monthly premium for... beneficiaries with modified adjusted gross income above certain threshold amounts. The monthly actuarial rates...

  1. 76 FR 67572 - Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... 0938-AQ16 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual... (SMI) program beginning January 1, 2012. In addition, this notice announces the monthly premium for... beneficiaries with modified adjusted gross income above certain threshold amounts. The monthly actuarial rates...

  2. 78 FR 64943 - Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... 0938-AR58 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual... (SMI) program beginning January 1, 2014. In addition, this notice announces the monthly premium for... beneficiaries with modified adjusted gross income above certain threshold amounts. The monthly actuarial rates...

  3. Local Failure in Resected N1 Lung Cancer: Implications for Adjuvant Therapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Higgins, Kristin A., E-mail: kristin.higgins@duke.edu; Chino, Junzo P.; Berry, Mark

    2012-06-01

    Purpose: To evaluate actuarial rates of local failure in patients with pathologic N1 non-small-cell lung cancer and to identify clinical and pathologic factors associated with an increased risk of local failure after resection. Methods and Materials: All patients who underwent surgery for non-small-cell lung cancer with pathologically confirmed N1 disease at Duke University Medical Center from 1995-2008 were identified. Patients receiving any preoperative therapy or postoperative radiotherapy or with positive surgical margins were excluded. Local failure was defined as disease recurrence within the ipsilateral hilum, mediastinum, or bronchial stump/staple line. Actuarial rates of local failure were calculated with the Kaplan-Meiermore » method. A Cox multivariate analysis was used to identify factors independently associated with a higher risk of local recurrence. Results: Among 1,559 patients who underwent surgery during the time interval, 198 met the inclusion criteria. Of these patients, 50 (25%) received adjuvant chemotherapy. Actuarial (5-year) rates of local failure, distant failure, and overall survival were 40%, 55%, and 33%, respectively. On multivariate analysis, factors associated with an increased risk of local failure included a video-assisted thoracoscopic surgery approach (hazard ratio [HR], 2.5; p = 0.01), visceral pleural invasion (HR, 2.1; p = 0.04), and increasing number of positive N1 lymph nodes (HR, 1.3 per involved lymph node; p = 0.02). Chemotherapy was associated with a trend toward decreased risk of local failure that was not statistically significant (HR, 0.61; p = 0.2). Conclusions: Actuarial rates of local failure in pN1 disease are high. Further investigation of conformal postoperative radiotherapy may be warranted.« less

  4. Development of a clinical prediction model to calculate patient life expectancy: the measure of actuarial life expectancy (MALE).

    PubMed

    Clarke, M G; Kennedy, K P; MacDonagh, R P

    2009-01-01

    To develop a clinical prediction model enabling the calculation of an individual patient's life expectancy (LE) and survival probability based on age, sex, and comorbidity for use in the joint decision-making process regarding medical treatment. A computer software program was developed with a team of 3 clinicians, 2 professional actuaries, and 2 professional computer programmers. This incorporated statistical spreadsheet and database access design methods. Data sources included life insurance industry actuarial rating factor tables (public and private domain), Government Actuary Department UK life tables, professional actuarial sources, and evidence-based medical literature. The main outcome measures were numerical and graphical display of comorbidity-adjusted LE; 5-, 10-, and 15-year survival probability; in addition to generic UK population LE. Nineteen medical conditions, which impacted significantly on LE in actuarial terms and were commonly encountered in clinical practice, were incorporated in the final model. Numerical and graphical representations of statistical predictions of LE and survival probability were successfully generated for patients with either no comorbidity or a combination of the 19 medical conditions included. Validation and testing, including actuarial peer review, confirmed consistency with the data sources utilized. The evidence-based actuarial data utilized in this computer program design represent a valuable resource for use in the clinical decision-making process, where an accurate objective assessment of patient LE can so often make the difference between patients being offered or denied medical and surgical treatment. Ongoing development to incorporate additional comorbidities and enable Web-based access will enhance its use further.

  5. Conversations with your actuary: getting to the right number.

    PubMed

    Frese, Richard C

    2013-05-01

    A healthcare finance leader can guarantee recognition of his or her organization's insurance program and better manage the program's liability by discussing changes in the following areas with an actuary: Claims management. Exposure. Coverage or retention Financial reporting of losses. Management goals. Other insurance and operational matters.

  6. 75 FR 6360 - Federal Advisory Committee; DoD Medicare-Eligible Retiree Health Care Board of Actuaries

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-09

    ... Retiree Health Care Board of Actuaries AGENCY: Department of Defense (DoD). ACTION: Meeting notice..., the Department of Defense announces that the DoD Medicare-Eligible Retiree Health Care Board of... actuarial methods and assumptions to be used in the valuation of benefits under DoD retiree health care...

  7. Predicting Success for Actuarial Students in Undergraduate Mathematics Courses

    ERIC Educational Resources Information Center

    Smith, Richard Manning; Schumacher, Phyllis A.

    2005-01-01

    A study of undergraduate actuarial graduates found that math SAT scores, verbal SAT scores, percentile rank in high school graduating class, and percentage score on a college mathematics placement exam had some relevance to forecasting the students' grade point averages in their major. For both males and females, percentile rank in high school…

  8. Deductibles in health insurance: can the actuarially fair premium reduction exceed the deductible?

    PubMed

    Bakker, F M; van Vliet, R C; van de Ven, W P

    2000-09-01

    The actuarially fair premium reduction in case of a deductible relative to full insurance is affected by: (1) out-of-pocket payments, (2) moral hazard, (3) administrative costs, and, in case of a voluntary deductible, (4) adverse selection. Both the partial effects and the total effect of these factors are analyzed. Moral hazard and adverse selection appear to have a substantial effect on the expected health care costs above a deductible but a small effect on the expected out-of-pocket expenditure. A premium model indicates that for a broad range of deductible amounts the actuarially fair premium reduction exceeds the deductible.

  9. Actuarial assessment of violence risk in hospital-based partner assault clinics.

    PubMed

    Hilton, N Zoe; Harris, Grant T; Holder, Norah

    2008-12-01

    Hospital-based partner assault clinics are a relatively recent addition to the community response to partner violence. In this study, 66% of 111 women attending hospital clinics for partner assault were physically injured and 43% reported death threats. Few concurrently used other services (shelters or police) and most relied on female friends and relatives for help. Many participants who currently lived with the perpetrator were contemplating leaving but only a third had made plans to do so. Participants faced an unusually high risk of future assault, according to both victim interview using the ODARA actuarial risk assessment and their own perceptions. Findings imply an important role for partner assault clinics and the feasibility of the victim service sector's using the same actuarial risk assessments as the criminal justice system.

  10. Psychotherapy: theory, experience, and personalized actuarial tables.

    PubMed

    Leventhal, D B; Shemberg, K M

    1977-12-01

    This paper addresses the issue of the role of theory in the actual application of psychotherapeutic operations. Within the present framework, psychotherapeutic effectiveness is seen as an empirical, actuarial process which occurs in an interpersonal setting separate from theoretical considerations. The role of theory is discussed and a rationale for the coexistence of equally 'effective' contradictory theories is presented. Suggestions for future research in the area of behaviour change are made and an argument for the eventual development of a 'therapeutic cookbook' is presented.

  11. Starting an Actuarial Science Major at a Liberal Arts College

    ERIC Educational Resources Information Center

    Mills, Mark A.

    2014-01-01

    The article provides details of the process of starting an actuarial science major at a small, liberal arts college. Some critique of the major is included, as well as some challenges that may be faced by others wanting to start such a major at their institution.

  12. An actuarial approach to retrofit savings in buildings

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Subbarao, Krishnappa; Etingov, Pavel V.; Reddy, T. A.

    An actuarial method has been developed for determining energy savings from retrofits from energy use data for a number of buildings. This method should be contrasted with the traditional method of using pre- and post-retrofit data on the same building. This method supports the U.S. Department of Energy Building Performance Database of real building performance data and related tools that enable engineering and financial practitioners to evaluate retrofits. The actuarial approach derives, from the database, probability density functions (PDFs) for energy savings from retrofits by creating peer groups for the user’s pre post buildings. From the energy use distribution ofmore » the two groups, the savings PDF is derived. This provides the basis for engineering analysis as well as financial risk analysis leading to investment decisions. Several technical issues are addressed: The savings PDF is obtained from the pre- and post-PDF through a convolution. Smoothing using kernel density estimation is applied to make the PDF more realistic. The low data density problem can be mitigated through a neighborhood methodology. Correlations between pre and post buildings are addressed to improve the savings PDF. Sample size effects are addressed through the Kolmogorov--Smirnov tests and quantile-quantile plots.« less

  13. Long-Term Post-CABG Survival: Performance of Clinical Risk Models Versus Actuarial Predictions.

    PubMed

    Carr, Brendan M; Romeiser, Jamie; Ruan, Joyce; Gupta, Sandeep; Seifert, Frank C; Zhu, Wei; Shroyer, A Laurie

    2016-01-01

    Clinical risk models are commonly used to predict short-term coronary artery bypass grafting (CABG) mortality but are less commonly used to predict long-term mortality. The added value of long-term mortality clinical risk models over traditional actuarial models has not been evaluated. To address this, the predictive performance of a long-term clinical risk model was compared with that of an actuarial model to identify the clinical variable(s) most responsible for any differences observed. Long-term mortality for 1028 CABG patients was estimated using the Hannan New York State clinical risk model and an actuarial model (based on age, gender, and race/ethnicity). Vital status was assessed using the Social Security Death Index. Observed/expected (O/E) ratios were calculated, and the models' predictive performances were compared using a nested c-index approach. Linear regression analyses identified the subgroup of risk factors driving the differences observed. Mortality rates were 3%, 9%, and 17% at one-, three-, and five years, respectively (median follow-up: five years). The clinical risk model provided more accurate predictions. Greater divergence between model estimates occurred with increasing long-term mortality risk, with baseline renal dysfunction identified as a particularly important driver of these differences. Long-term mortality clinical risk models provide enhanced predictive power compared to actuarial models. Using the Hannan risk model, a patient's long-term mortality risk can be accurately assessed and subgroups of higher-risk patients can be identified for enhanced follow-up care. More research appears warranted to refine long-term CABG clinical risk models. © 2015 The Authors. Journal of Cardiac Surgery Published by Wiley Periodicals, Inc.

  14. Long‐Term Post‐CABG Survival: Performance of Clinical Risk Models Versus Actuarial Predictions

    PubMed Central

    Carr, Brendan M.; Romeiser, Jamie; Ruan, Joyce; Gupta, Sandeep; Seifert, Frank C.; Zhu, Wei

    2015-01-01

    Abstract Background/aim Clinical risk models are commonly used to predict short‐term coronary artery bypass grafting (CABG) mortality but are less commonly used to predict long‐term mortality. The added value of long‐term mortality clinical risk models over traditional actuarial models has not been evaluated. To address this, the predictive performance of a long‐term clinical risk model was compared with that of an actuarial model to identify the clinical variable(s) most responsible for any differences observed. Methods Long‐term mortality for 1028 CABG patients was estimated using the Hannan New York State clinical risk model and an actuarial model (based on age, gender, and race/ethnicity). Vital status was assessed using the Social Security Death Index. Observed/expected (O/E) ratios were calculated, and the models' predictive performances were compared using a nested c‐index approach. Linear regression analyses identified the subgroup of risk factors driving the differences observed. Results Mortality rates were 3%, 9%, and 17% at one‐, three‐, and five years, respectively (median follow‐up: five years). The clinical risk model provided more accurate predictions. Greater divergence between model estimates occurred with increasing long‐term mortality risk, with baseline renal dysfunction identified as a particularly important driver of these differences. Conclusions Long‐term mortality clinical risk models provide enhanced predictive power compared to actuarial models. Using the Hannan risk model, a patient's long‐term mortality risk can be accurately assessed and subgroups of higher‐risk patients can be identified for enhanced follow‐up care. More research appears warranted to refine long‐term CABG clinical risk models. doi: 10.1111/jocs.12665 (J Card Surg 2016;31:23–30) PMID:26543019

  15. An application of actuarial methods in psychiatric diagnosis.

    PubMed

    Overall, J E; Higgins, C W

    1977-10-01

    An actuarial program for psychiatric diagnosis is evaluated for agreement with final clinical diagnosis in a series of 288 patients. The acturial program provides a probability differential diagnosis based on an analysis of history and background data, symptom rating profiles, and MMPI clinical scale profiles. The observed agreement with final clinical diagnosis is approximately 50% higher than previously reported for psychological testing in this same setting. The results emphasize the importance for psychologists of clinical interview and observation skills.

  16. Actuarial calculation for PSAK-24 purposes post-employment benefit using market-consistent approach

    NASA Astrophysics Data System (ADS)

    Effendie, Adhitya Ronnie

    2015-12-01

    In this paper we use a market-consistent approach to calculate present value of obligation of a companies' post-employment benefit in accordance with PSAK-24 (the Indonesian accounting standard). We set some actuarial assumption such as Indonesian TMI 2011 mortality tables for mortality assumptions, accumulated salary function for wages assumption, a scaled (to mortality) disability assumption and a pre-defined turnover rate for termination assumption. For economic assumption, we use binomial tree method with estimated discount rate as its average movement. In accordance with PSAK-24, the Projected Unit Credit method has been adapted to determine the present value of obligation (actuarial liability), so we use this method with a modification in its discount function.

  17. Throwing the baby out with the bath water: is it time for clinical judgment to supplement actuarial risk assessment?

    PubMed

    Abbott, Brian R

    2011-01-01

    The assessment of the potential for sexual violence is one of three prongs that must be met to satisfy the requirements for civil confinement of dangerous sex offenders in the 21 U.S. jurisdictions that have these laws. In a recent issue of The Journal, Sreenivasan et al. argued that, because of a host of methodological problems, actuarial risk assessment methods in general and the Static-99 and its progeny in particular are insufficient for accurate assessment of risk for dangerous sex offenders. They propose using a combination of clinical judgment with actuarial science as a solution. This analysis and review of Sreenivasan et al. reveals and corrects flaws in the arguments they employed to support their position and shows how the combination of actuarial science with clinical judgment is more error prone than the actuarial approach only, and cannot be forensically defended in court. Recommendations on reporting Static-99R data in expert testimony are provided, taking into account the limitations of the instrument.

  18. Of pacemakers and statistics: the actuarial method extended.

    PubMed

    Dussel, J; Wolbarst, A B; Scott-Millar, R N; Obel, I W

    1980-01-01

    Pacemakers cease functioning because of either natural battery exhaustion (nbe) or component failure (cf). A study of four series of pacemakers shows that a simple extension of the actuarial method, so as to incorporate Normal statistics, makes possible a quantitative differentiation between the two modes of failure. This involves the separation of the overall failure probability density function PDF(t) into constituent parts pdfnbe(t) and pdfcf(t). The approach should allow a meaningful comparison of the characteristics of different pacemaker types.

  19. Preliminary experience in treatment of papillary and macular retinoblastoma: evaluation of local control and local complications after treatment with linear accelerator-based stereotactic radiotherapy with micromultileaf collimator as second-line or salvage treatment after chemotherapy.

    PubMed

    Pica, Alessia; Moeckli, Raphael; Balmer, Aubin; Beck-Popovic, Maja; Chollet-Rivier, Madeleine; Do, Huu-Phuoc; Weber, Damien C; Munier, Francis L

    2011-12-01

    To determine the local control and complication rates for children with papillary and/or macular retinoblastoma progressing after chemotherapy and undergoing stereotactic radiotherapy (SRT) with a micromultileaf collimator. Between 2004 and 2008, 11 children (15 eyes) with macular and/or papillary retinoblastoma were treated with SRT. The mean age was 19 months (range, 2-111). Of the 15 eyes, 7, 6, and 2 were classified as International Classification of Intraocular Retinoblastoma Group B, C, and E, respectively. The delivered dose of SRT was 50.4 Gy in 28 fractions using a dedicated micromultileaf collimator linear accelerator. The median follow-up was 20 months (range, 13-39). Local control was achieved in 13 eyes (87%). The actuarial 1- and 2-year local control rates were both 82%. SRT was well tolerated. Late adverse events were reported in 4 patients. Of the 4 patients, 2 had developed focal microangiopathy 20 months after SRT; 1 had developed a transient recurrence of retinal detachment; and 1 had developed bilateral cataracts. No optic neuropathy was observed. Linear accelerator-based SRT for papillary and/or macular retinoblastoma in children resulted in excellent tumor control rates with acceptable toxicity. Additional research regarding SRT and its intrinsic organ-at-risk sparing capability is justified in the framework of prospective trials. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Preliminary Experience in Treatment of Papillary and Macular Retinoblastoma: Evaluation of Local Control and Local Complications After Treatment With Linear Accelerator-Based Stereotactic Radiotherapy With Micromultileaf Collimator as Second-Line or Salvage Treatment After Chemotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pica, Alessia, E-mail: Alessia.Pica@chuv.ch; Moeckli, Raphael; Balmer, Aubin

    2011-12-01

    Purpose: To determine the local control and complication rates for children with papillary and/or macular retinoblastoma progressing after chemotherapy and undergoing stereotactic radiotherapy (SRT) with a micromultileaf collimator. Methods and Materials: Between 2004 and 2008, 11 children (15 eyes) with macular and/or papillary retinoblastoma were treated with SRT. The mean age was 19 months (range, 2-111). Of the 15 eyes, 7, 6, and 2 were classified as International Classification of Intraocular Retinoblastoma Group B, C, and E, respectively. The delivered dose of SRT was 50.4 Gy in 28 fractions using a dedicated micromultileaf collimator linear accelerator. Results: The median follow-upmore » was 20 months (range, 13-39). Local control was achieved in 13 eyes (87%). The actuarial 1- and 2-year local control rates were both 82%. SRT was well tolerated. Late adverse events were reported in 4 patients. Of the 4 patients, 2 had developed focal microangiopathy 20 months after SRT; 1 had developed a transient recurrence of retinal detachment; and 1 had developed bilateral cataracts. No optic neuropathy was observed. Conclusions: Linear accelerator-based SRT for papillary and/or macular retinoblastoma in children resulted in excellent tumor control rates with acceptable toxicity. Additional research regarding SRT and its intrinsic organ-at-risk sparing capability is justified in the framework of prospective trials.« less

  1. Predictors of Local Control After Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Greco, Carlo; Zelefsky, Michael J., E-mail: zelefskm@mskcc.or; Lovelock, Michael

    2011-03-15

    Purpose: To report tumor local control after treatment with single-dose image-guided intensity-modulated radiotherapy (SD-IGRT) to extracranial metastatic sites. Methods and Materials: A total of 126 metastases in 103 patients were treated with SD-IGRT to prescription doses of 18-24 Gy (median, 24 Gy) between 2004 and 2007. Results: The overall actuarial local relapse-free survival (LRFS) rate was 64% at a median follow-up of 18 months (range, 2-45 months). The median time to failure was 9.6 months (range, 1-23 months). On univariate analysis, LRFS was significantly correlated with prescription dose (p = 0.029). Stratification by dose into high (23 to 24 Gy),more » intermediate (21 to 22 Gy), and low (18 to 20 Gy) dose levels revealed highly significant differences in LRFS between high (82%) and low doses (25%) (p < 0.0001). Overall, histology had no significant effect on LRFS (p = 0.16). Renal cell histology displayed a profound dose-response effect, with 80% LRFS at the high dose level (23 to 24 Gy) vs. 37% with low doses ({<=}22 Gy) (p = 0.04). However, for patients who received the high dose level, histology was not a statistically significant predictor of LRFS (p = 0.90). Target organ (bone vs. lymph node vs. soft tissues) (p = 0.5) and planning target volume size (p = 0.55) were not found to be associated with long-term LRFS probability. Multivariate Cox regression analysis confirmed prescription dose to be a significant predictor of LRFS (p = 0.003). Conclusion: High-dose SD-IGRT is a noninvasive procedure resulting in high probability of local tumor control. Single-dose IGRT may be effectively used to locally control metastatic deposits regardless of histology and target organ, provided sufficiently high doses (> 22 Gy) of radiation are delivered.« less

  2. Sexual Reconviction Rates in the United Kingdom and Actuarial Risk Estimates

    ERIC Educational Resources Information Center

    Craig, Leam A.; Browne, Kevin D.; Stringer, Ian; Hogue, Todd E.

    2008-01-01

    Objective: Assessing the risk of further offending behavior by adult sexual perpetrators of children is highly relevant and important to professionals involved in child protection. Recent progress in assessing risk in sexual offenders has established the validity of actuarial measures, although there continues to be some debate about the…

  3. 5 CFR 839.1114 - Will OPM actuarially reduce my benefit if I elect to change my retirement coverage under these...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Will OPM actuarially reduce my benefit if... General Provisions § 839.1114 Will OPM actuarially reduce my benefit if I elect to change my retirement... Basic Employee Death Benefit (see § 839.1121). ...

  4. Fast Neutron Radiotherapy for Locally Advanced Prostate Cancer: Update of a Past Trial and Future Research Directions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Krieger, John N.; Krall, John M.; Laramore, George E.

    1987-01-01

    Between June, 1977 and April, 1983 the Radiation Therapy Oncology Group (RTOG) sponsored a Phase III study comparing fast neutron radiotherapy as part of a mixed beam (neutron/photon) regimen with conventional photon (x-ray) radiotherapy for patients with locally advanced (stages C and o1 ) adenocarcinoma of the prostate. A total of 91 analyzable patients were entered into the study with -the two treatment groups being balanced in regard to all major prognostic variables. The current analysis is for a median follow-up of 6.7 years (range 3.4-9.0). Actuarial curves are presented for local/regional control, overall survival and "determinantal" survival. The resultsmore » are statistically significant in favor of the mixed beam group for all of the above parameters. At 5 years the local control rate is 81% on the mixed beam arm compared to 60% on the photon arm. Histologic evidence of residual prostatic carcinoma was documented in six patients with no clinical evidence of disease on both treatment arms. The actuarial overall survival rate at S years is 70% on the mixed beam compared to 56% on the photon arm. The determinantal survival at 5 years was 82%. on the mixed beam arm compared to 61% on the photon arm. The type of therapy appeared to be the most important predictor of both local tumor control and patient survival in a step-wise Cox analysis. There was no difference in the treatment related morbidity for the two patient groups. Mixed beam therapy may be superior to standard photon radiotherapy for treatment of locally advanced prostate cancer.« less

  5. 78 FR 773 - Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-04

    ...., Commercial/ Actuarial/Information Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford... financial reporting. The group develops databases for creating reports for corporate, regulatory, and... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-81,815] Hartford Financial...

  6. Should Actuarial Risk Assessments Be Used with Sex Offenders Who Are Intellectually Disabled?

    ERIC Educational Resources Information Center

    Harris, Andrew J. R.; Tough, Susan

    2004-01-01

    Background: Objective actuarial assessments are critical for making risk decisions, determining the necessary level of supervision and intensity of treatment ( Andrews & Bonta 2003). This paper reviews the history of organized risk assessment and discusses some issues in current attitudes towards sexual offenders with intellectual disabilities.…

  7. 78 FR 8596 - Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ... Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford, Connecticut (The Hartford-IDS... technology applications for corporate, regulatory, and financial reporting. Pursuant to 29 CFR 90.18(c...., Commercial/Actuarial/Information Delivery Services (IDS)/ Corporate & Financial Reporting group, Hartford...

  8. Post-operative radiation therapy for advanced-stage oropharyngeal cancer.

    PubMed

    Hansen, Eric; Panwala, Kathryn; Holland, John

    2002-11-01

    Between 1985 and 1999, 43 patients with locally-advanced, resectable oropharyngeal cancer were treated with combined surgery and post-operative radiation therapy (RT) at Oregon Health and Science University. Five patients (12 per cent) had Stage III disease and 38 patients (88 per cent) had Stage IV disease. All patients had gross total resections of the primary tumour. Thirty-seven patients had neck dissections for regional disease. RT consisted of a mean tumour-bed dose of 63.0 Gy delivered in 1.8-2.0 Gy fractions over a mean of 49 days. At three- and five-years, the actuarial local control was 96 per cent and the actuarial local/regional control was 80 per cent. The three- and five-year actuarial rates of distant metastases were 41 per cent and 46 per cent, respectively. The actuarial overall survival at three- and five-years was 41 per cent and 34 per cent, respectively. The actuarial rates of progression-free survival were 49 per cent at three-years and 45 per cent at five years. Combined surgery and post-operative RT for advanced-stage oropharyngeal cancer results in excellent local/regional control. This particular group of patients experienced a high-rate of developing distant metastases.

  9. An Actuarial Model for Selecting Participants for a Special Medical Education Program.

    ERIC Educational Resources Information Center

    Walker-Bartnick, Leslie; And Others

    An actuarial model applied to the selection process of a special medical school program at the University of Maryland School of Medicine was tested. The 77 students in the study sample were admitted to the university's Fifth Pathway Program, which is designed for U.S. citizens who completed their medical school training, except for internship and…

  10. Applying a Forensic Actuarial Assessment (the Violence Risk Appraisal Guide) to Nonforensic Patients

    ERIC Educational Resources Information Center

    Harris, Grant T.; Rice, Marnie E.; Camilleri, Joseph A..

    2004-01-01

    The actuarial Violence Risk Appraisal Guide (VRAG) was developed for male offenders where it has shown excellent replicability in many new forensic samples using officially recorded outcomes. Clinicians also make decisions, however, about the risk of interpersonal violence posed by nonforensic psychiatric patients of both sexes. Could an actuarial…

  11. Stereotactic radiotherapy of vestibular schwannoma : Hearing preservation, vestibular function, and local control following primary and salvage radiotherapy.

    PubMed

    Putz, Florian; Müller, Jan; Wimmer, Caterina; Goerig, Nicole; Knippen, Stefan; Iro, Heinrich; Grundtner, Philipp; Eyüpoglu, Ilker; Rössler, Karl; Semrau, Sabine; Fietkau, Rainer; Lettmaier, Sebastian

    2017-03-01

    The aim of this publication is to present long-term data on functional outcomes and tumor control in a cohort of 107 patients treated with stereotactic radiotherapy (RT) for vestibular schwannoma. Included were 107 patients with vestibular schwannoma (primary or recurrent following resection) treated with stereotactic RT (either fractioned or single-dose radiosurgery) between October 2002 and December 2013. Local control and functional outcomes were determined. Analysis of hearing preservation was limited to a subgroup of patients with complete audiometric data collected before treatment and during follow-up. Vestibular function test (FVT) results could be analyzed in a subset of patients and were compared to patient-reported dizziness. After a mean follow-up of 46.3 months, actuarial local control for the whole cohort was 100% after 2, 97.6% after 5, and 94.1% after 10 years. In patients with primary RT, serviceable hearing was preserved in 72%. Predictors for preservation of serviceable hearing in multivariate analysis were time of follow-up (odds ratio, OR = 0.93 per month; p = 0.021) and pre-RT tumor size (Koos stage I-IIa vs. IIb-IV; OR = 0.15; p = 0.031). Worsening of FVT results was recorded in 17.6% (N = 3). Profound discrepancy of patient-reported dizziness and FVT results was observed after RT. In patients with primary RT, worsening of facial nerve function occurred in 1.7% (N = 1). Stereotactic RT of vestibular schwannoma provides good functional outcomes and high control rates. Dependence of hearing preservation on time of follow-up and initial tumor stage has to be considered.

  12. [Survival functions and life tables at the origins of actuarial mathematics].

    PubMed

    Spelta, D

    1997-01-01

    "In the determination of death probabilities of an insured subject one can use either statistical data or a mathematical function. In this paper a survey of the relationship between mortality tables and survival functions from the origins until the first half of the nineteenth century is presented. The author has tried to find the methodological grounds which have induced the actuaries to prefer either of these tools." (EXCERPT)

  13. [Actuarial analysis of time-failure data and its rrelevance for interpretation of results. Audit of the journal "Strahlentherapie und Onkologie" (Radiotherapy and Oncology)].

    PubMed

    Dubben, H H; Beck-Bornholdt, H P

    2000-12-01

    The statistical quality of the contributions to "Strahlentherapie und Onkologie" is assessed, aiming for improvement of the journal and consequently its impact factor. All 181 articles published during 1998 and 1999 in the categories "review", "original contribution", and "short communication" were analyzed concerning actuarial analysis of time-failure data. One hundred and twenty-three publications without time-failure data were excluded from analysis. Forty-five of the remaining 58 publications with time-failure data were evaluated actuarially. This corresponds to 78% (95% confidence interval: 64 to 88%) of papers, in which data were adequately analyzed. Complications were reported in 16 of 58 papers, but in only 3 cases actuarially. The number of patients at risk during the course of follow-up was documented adequately in 22 of the 45 publications with actuarial analysis. Authors, peer reviewers, and editors could contribute to improve the quality of the journal by setting value on acturial analysis of time-failure data.

  14. Has actuarial aging “slowed” over the past 250 years? A comparison of small-scale subsistence populations and European cohorts

    PubMed Central

    Gurven, Michael; Fenelon, Andrew

    2012-01-01

    G.C. Williams’ 1957 hypothesis famously argues that higher age-independent, or “extrinsic”, mortality should select for faster rates of senescence. Long-lived species should therefore show relatively few deaths from extrinsic causes such as predation and starvation. Theoretical explorations and empirical tests of Williams’ hypothesis have flourished in the past decade but it has not yet been tested empirically among humans. We test Williams’ hypothesis using mortality data from subsistence populations and from historical cohorts from Sweden and England/Wales, and examine whether rates of actuarial aging declined over the past two centuries. We employ three aging measures: mortality rate doubling time (MRDT), Ricklef’s ω, and the slope of mortality hazard from ages sixty to seventy, m’60–70, and model mortality using both Weibull and Gompertz-Makeham hazard models. We find that (1) actuarial aging in subsistence societies is similar to that of early Europe, (2) actuarial senescence has slowed in later European cohorts, (3) reductions in extrinsic mortality associate with slower actuarial aging in longitudinal samples, and (4) men senesce more rapidly than women, especially in later cohorts. To interpret these results, we attempt to bridge population-based evolutionary analysis with individual-level proximate mechanisms. PMID:19220451

  15. High-dose-rate interstitial brachytherapy for the treatment of high-volume locally recurrent endometrial carcinoma.

    PubMed

    Huang, Kitty; D'Souza, David; Patil, Nikhilesh; Velker, Vikram; Leung, Eric; Stitt, Larry; Whiston, Frances; Sugimoto, Akira; McGee, Jacob; Prefontaine, Michel

    2016-01-01

    Limited therapeutic options are available for the treatment of locally recurrent endometrial carcinoma. Our objective was to report an institutional experience using interstitial brachytherapy (IBT) to treat significant recurrent endometrial carcinoma, including previously irradiated disease. Between December 2004 and September 2012, 40 patients with high-volume locally recurrent endometrial cancer were treated by high-dose-rate IBT (± external beam radiation therapy EBRT). Sixteen patients had prior radiotherapy: EBRT alone (n = 5), intracavitary brachytherapy alone (n = 3), or EBRT with intracavitary brachytherapy boost (n = 8). Actuarial outcome rates were calculated using the Kaplan-Meier method and compared using the log-rank test. Median followup interval was 18 months. Median disease-free interval was 61 months. Actuarial local control, progression-free survival (PFS), and overall survival were 74% and 60%, 70% and 51%, and 83% and 72% at 12 and 24 months, respectively. p-Values for local control, progression-free survival, and overall survival between patient who had prior RT (n = 16) to no prior RT (n = 24) were p = 0.38, 0.32, and 0.90, respectively. Acute toxicities include Grade 1-2 pain (5%), genitourinary (7%), gastrointestinal (12%), soft tissue (5%), and dermatologic (12%). Four patients observed late Grade 3-4 toxicities, including rectal bleeding/fistula and soft tissue necrosis. High-dose-rate IBT is an effective treatment for locally recurrent endometrial carcinoma with an acceptable toxicity profile. Outcomes are similar between previously irradiated and nonirradiated patients. In women who have received prior radiotherapy and are often considered for palliative treatment, interstitial brachytherapy is a potentially curative option. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  16. Validation of a systems-actuarial computer process for multidimensional classification of child psychopathology.

    PubMed

    McDermott, P A; Hale, R L

    1982-07-01

    Tested diagnostic classifications of child psychopathology produced by a computerized technique known as multidimensional actuarial classification (MAC) against the criterion of expert psychological opinion. The MAC program applies series of statistical decision rules to assess the importance of and relationships among several dimensions of classification, i.e., intellectual functioning, academic achievement, adaptive behavior, and social and behavioral adjustment, to perform differential diagnosis of children's mental retardation, specific learning disabilities, behavioral and emotional disturbance, possible communication or perceptual-motor impairment, and academic under- and overachievement in reading and mathematics. Classifications rendered by MAC are compared to those offered by two expert child psychologists for cases of 73 children referred for psychological services. Experts' agreement with MAC was significant for all classification areas, as was MAC's agreement with the experts held as a conjoint reference standard. Whereas the experts' agreement with MAC averaged 86.0% above chance, their agreement with one another averaged 76.5% above chance. Implications of the findings are explored and potential advantages of the systems-actuarial approach are discussed.

  17. 29 CFR 2520.104-42 - Waiver of certain actuarial information in the annual report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ERISA that the annual report include as part of the actuarial statement (Schedule B) 1 the present value of all of the plan's liabilities for nonforfeitable pension benefits allocated by termination... report. 2520.104-42 Section 2520.104-42 Labor Regulations Relating to Labor (Continued) EMPLOYEE BENEFITS...

  18. Human actuarial aging increases faster when back ground death rates are lower: a consequence of differential heterogeneity?

    PubMed Central

    Hawkes, Kristen; Smith, Ken R.; Blevins, James K.

    2014-01-01

    Many analyses of human populations have found that age-specific mortality rates increase faster across most of adulthood when overall mortality levels decline. This contradicts the relationship often expected from Williams′ classic hypothesis about the effects of natural selection on the evolution of senescence. More likely, much of the within-species difference in actuarial aging is not due to variation in senescence, but to the strength of filters on the heterogeneity of frailty in older survivors. A challenge to this differential frailty hypothesis was recently posed by an analysis of life tables from historical European populations and traditional societies that reported variation in actuarial aging consistent with Williams′ hypothesis after all. To investigate the challenge, we reconsidered those cases and aging measures. Here we show that the discrepancy depends on Ricklefs′ aging rate measure,ω, which decreases as mortality levels drop because it is an index of mortality level itself, not the rate of increase in mortality with age. We also show unappreciated correspondence among the parameters of Gompertz–Makeham and Weibull survival models. Finally, we compare the relationships among mortality parameters of the traditional societies and the historical series, providing further suggestive evidence that differential heterogeneity has strong effects on actuarial aging. PMID:22220868

  19. 77 FR 69850 - Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-21

    ... percent reserve has been the normal target used to calculate the Part B premium. In view of the strong... 0938-AR16 Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual...

  20. Treatment of Locally Advanced Adenoid Cystic Carcinoma of the Trachea With Neutron Radiotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bittner, Nathan; Koh, W.-J.; Laramore, George E.

    2008-10-01

    Purpose: To examine the efficacy of fast neutron radiotherapy in the treatment of locally advanced adenoid cystic carcinoma (ACC) of the trachea and to compare outcomes with and without high-dose-rate (HDR) endobronchial brachytherapy boost. Methods and Materials: Between 1989 and 2005, a total of 20 patients with ACC of the trachea were treated with fast neutron radiotherapy at University of Washington. Of these 20 patients, 19 were treated with curative intent. Neutron doses ranged from 10.7 to 19.95 Gy (median, 19.2 Gy). Six of these patients received an endobronchial brachytherapy boost using an HDR {sup 192}Ir source (3.5 Gy xmore » 2 fractions). Median duration of follow-up was 46 months (range, 10-121 months). Results: The 5-year actuarial overall survival rate and median overall survival for the entire cohort were 89.4%, and 97 months, respectively. Overall survival was not statistically different among those patients receiving an endobronchial boost compared with those receiving neutron radiotherapy alone (100% vs. 68%, p = 0.36). The 5-year actuarial locoregional control rate for the entire cohort was 54.1%. The locoregional control rate was not statistically different among patients who received an endobronchial boost compared with those who received neutron radiotherapy alone (40% vs. 58%, p 0.94). There were no cases of Grade {>=}3 acute toxicity. There were 2 cases of Grade 3/4 chronic toxicity. Conclusions: Fast neutron radiotherapy is an effective treatment for locally advanced adenoid cystic carcinoma of the trachea, with acceptable treatment-related toxicity.« less

  1. A mathematical proof and example that Bayes's Theorem is fundamental to actuarial estimates of sexual recidivism risk.

    PubMed

    Donaldson, Theodore; Wollert, Richard

    2008-06-01

    Expert witnesses in sexually violent predator (SVP) cases often rely on actuarial instruments to make risk determinations. Many questions surround their use, however. Bayes's Theorem holds much promise for addressing these questions. Some experts nonetheless claim that Bayesian analyses are inadmissible in SVP cases because they are not accepted by the relevant scientific community. This position is illogical because Bayes's Theorem is simply a probabilistic restatement of the way that frequency data are combined to arrive at whatever recidivism rates are paired with each test score in an actuarial table. This article presents a mathematical proof and example validating this assertion. The advantages and implications of a logic model that combines Bayes's Theorem and the null hypothesis are also discussed.

  2. Current Dosing Paradigm for Stereotactic Radiosurgery Alone After Surgical Resection of Brain Metastases Needs to Be Optimized for Improved Local Control

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Prabhu, Roshan; Shu, Hui-Kuo; Winship Cancer Institute, Emory University, Atlanta, GA

    2012-05-01

    Purpose: To describe the use of radiosurgery (RS) alone to the resection cavity after resection of brain metastases as an alternative to adjuvant whole-brain radiotherapy (WBRT). Methods and Materials: Sixty-two patients with 64 cavities were treated with linear accelerator-based RS alone to the resection cavity after surgical removal of brain metastases between March 2007 and August 2010. Fifty-two patients (81%) had a gross total resection. Median cavity volume was 8.5 cm{sup 3}. Forty-four patients (71%) had a single metastasis. Median marginal and maximum doses were 18 Gy and 20.4 Gy, respectively. Sixty-one cavities (95%) had gross tumor volume to planningmore » target volume expansion of {>=}1 mm. Results: Six-month and 1-year actuarial local recurrence rates were 14% and 22%, respectively, with a median follow-up period of 9.7 months. Six-month and 1-year actuarial distant brain recurrence, total intracranial recurrence, and freedom from WBRT rates were 31% and 51%, 41% and 63%, and 91% and 74%, respectively. The symptomatic cavity radiation necrosis rate was 8%, with 2 patients (3%) undergoing surgery. Of the 11 local failures, 8 were in-field, 1 was marginal, and 2 were both (defined as in-field if {>=}90% of recurrence within the prescription isodose and marginal if {>=}90% outside of the prescription isodose). Conclusions: The high rate of in-field cavity failure suggests that geographic misses with highly conformal RS are not a major contributor to local recurrence. The current dosing regimen derived from Radiation Therapy Oncology Group protocol 90-05 should be optimized in this patient population before any direct comparison with WBRT.« less

  3. Two-Tiered Violence Risk Estimates: a validation study of an integrated-actuarial risk assessment instrument.

    PubMed

    Mills, Jeremy F; Gray, Andrew L

    2013-11-01

    This study is an initial validation study of the Two-Tiered Violence Risk Estimates instrument (TTV), a violence risk appraisal instrument designed to support an integrated-actuarial approach to violence risk assessment. The TTV was scored retrospectively from file information on a sample of violent offenders. Construct validity was examined by comparing the TTV with instruments that have shown utility to predict violence that were prospectively scored: The Historical-Clinical-Risk Management-20 (HCR-20) and Lifestyle Criminality Screening Form (LCSF). Predictive validity was examined through a long-term follow-up of 12.4 years with a sample of 78 incarcerated offenders. Results show the TTV to be highly correlated with the HCR-20 and LCSF. The base rate for violence over the follow-up period was 47.4%, and the TTV was equally predictive of violent recidivism relative to the HCR-20 and LCSF. Discussion centers on the advantages of an integrated-actuarial approach to the assessment of violence risk.

  4. 76 FR 81362 - Regulations Governing the Performance of Actuarial Services Under the Employee Retirement Income...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-28

    ... Governing the Performance of Actuarial Services Under the Employee Retirement Income Security Act of 1974... regulations (TD 9517) that are the subject of this correction are under section 3042 of the Employee... EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 0 Paragraph 1. The authority citation for part 901...

  5. The Actuarial Society of South Africa AIDS model.

    PubMed

    1997-01-01

    The AIDS Committee of the Actuarial Society of South Africa has developed a demographic model to allow researchers to project the impact of HIV and AIDS in South Africa. The model is available for use as a projection tool rather than to endorse a given projected scenario as being representative. It is very flexible and can be adapted to suit different purposes by anyone with a working knowledge of Microsoft Excel. The need for a model, calibration of the model, the lack of allowance in the model for racial and cultural heterogeneity in the underlying population, and default scenario projections are discussed. The model is available free of charge via E-mail and on the worldwide web at the following respective addresses: awhitelo@oldmutual.com and http://www.und.ac.za/und/eco/eru/eru.htm.

  6. 'Boomerang' technique: an improved method for conformal treatment of locally advanced nasopharyngeal cancer.

    PubMed

    Corry, June; Hornby, Colin; Fisher, Richard; D'Costa, Ieta; Porceddu, Sandro; Rischin, Danny; Peters, Lester J

    2004-06-01

    The primary aim of the present study was to assess radiation dosimetry and subsequent clinical outcomes in patients with locally advanced nasopharyngeal cancer using a novel radiation technique termed the 'Boomerang'. Dosimetric comparisons were made with both conventional and intensity modulated radiation therapy (IMRT) techniques. This is a study of 22 patients treated with this technique from June 1995 to October 1998. The technique used entailed delivery of 36 Gy in 18 fractions via parallel opposed fields, then 24 Gy in 12 fractions via asymmetric rotating arc fields for a total of 60 Gy in 30 fractions. Patients also received induction and concurrent chemotherapy. The radiation dosimetry was excellent. Dose-volume histograms showed that with the arc fields, 90% of the planning target volume received 94% of the prescribed dose. Relative to other conventional radiation therapy off-cord techniques, the Boomerang technique results in a 27% greater proportion of the prescribed dose being received by 90% of the planning target volume. This translates into an overall 10% greater dose received for the same prescribed dose. At 3 years, the actuarial loco-regional control rate, the failure-free survival rate and the overall survival rate were 91, 75 and 91%, respectively. At 5 years, the actuarial loco-regional control rate, the failure-free survival rate and the overall survival rate were 74, 62 and 71%, respectively. The Boomerang technique provided excellent radiation dosimetry with correspondingly good loco-regional control rates (in conjunction with chemotherapy) and very acceptable acute and late toxicity profiles. Because treatment can be delivered with conventional standard treatment planning and delivery systems, it is a validated treatment option for centres that do not have the capability or capacity for IMRT. A derivative of the Boomerang technique, excluding the parallel opposed component, is now our standard for patients with locally advanced

  7. Are psychological measures and actuarial data equally effective in discriminating among the prison population? Analysis by crimes

    PubMed Central

    Burneo-Garcés, Carlos; Marín-Morales, Agar; Pérez-García, Miguel

    2018-01-01

    The ability of a wide range of psychological and actuarial measures to characterize crimes in the prison population has not yet been compared in a single study. Our main objective was to determine if the discriminant capacity of psychological measures (PM) and actuarial data (AD) varies according to the crime. An Ecuadorian sample of 576 men convicted of Robbery, Murder, Rape and Drug Possession crimes was evaluated through an ad hoc questionnaire, prison files and the Spanish adaptation of the Personality Assessment Inventory. Discriminant analysis was used to establish, for each crime, the discriminant capacity and the classification accuracy of a model composed of AD (socio-demographic and judicial measures) and a second model incorporating PM. The AD showed a superior discriminant capacity, whilst the contribution of both types of measures varied according to the crime. The PM generated some increase in the correct classification percentages for Murder, Rape and Drug Possession, but their contribution was zero for the crime of Robbery. Specific profiles of each crime were obtained from the strongest significant correlations between the value of each explanatory variable and the probability of belonging to the crime. The AD model is more robust when these four crimes are characterized. The contribution of AD and PM depends on the crime, and the inclusion of PM in actuarial models moderately optimizes the classification accuracy of Murder, Rape, and Drug Possession crimes. PMID:29874264

  8. 26 CFR 1.412(c)(2)-1 - Valuation of plan assets; reasonable actuarial valuation methods.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... market value by making use of the— (i) Fair market value (determined under paragraph (c) of this section... requirements of section 412(c)(2)(A) solely on the basis of their fair market value (under paragraph (c) of... reasonble actuarial valuation methods designed to mitigate short-run changes in the fair market value of...

  9. Stereotactic radiotherapy for locally recurrent nasopharyngeal carcinoma.

    PubMed

    Leung, To-Wai; Wong, Victy Y W; Tung, Stewart Y

    2009-11-01

    To study the treatment outcome in patients with locally recurrent nasopharyngeal carcinoma (NPC) who were treated with stereotactic radiotherapy (SRT). Thirty patients with non-metastatic, locally recurrent NPC who were treated with curative intent between 1998 and 2002 were retrospectively analyzed. The International Union Against Cancer T-stage distribution at recurrence (rT) was as follows: rT1-14, rT2-7, rT3-3, and rT4-6. All patients were treated with SRT with a daily fractional dose of 2.5-4.5 Gy (median, 3 Gy) in 8-22 fractions (median, 18 fractions). Total equivalent dose (TED) was calculated by the linear-quadratic formula without a time factor correction. The 5-year actuarial overall survival rate, disease-specific survival rate, and local failure-free survival (LFFS) rate for the whole group were 40%, 41.4%, and 56.8%, respectively. The 3-year LFFS rates of rT1-2 and rT3-4 diseases were 65% and 66.7%, respectively. Seven of nine patients who received a TED <55 Gy recurred locally compared with 4 of 21 patients who received > or =55 Gy. Their corresponding 5-year LFFS rates were 22.2% and 75.8% (p = 0.005). The TED was the only factor significant in affecting the local control on univariate analyses. SRT is an effective treatment for locally recurrent NPC. TED > or =55 Gy should be given to secure a higher local control rate. The late complication rates were acceptable for patients with rT1-2 disease. For patients with rT3-4 disease, more works need to be done to further decrease the late complications.

  10. Long-term actuarial survivorship analysis of an interspinous stabilization system

    PubMed Central

    Sénégas, Jacques; Pointillart, Vincent; Mangione, Paolo

    2007-01-01

    In 1986, an interspinous dynamic stabilization system (the prototype of the current Wallis implant) was designed to stiffen unstable operated degenerate lumbar segments with a hard interspinous blocker to limit extension and a tension band around the spinous processes to secure the implant and limit flexion. Restoring physiological mechanical conditions to the treated level(s) while preserving some intervertebral mobility was intended to treat low-back pain related to degenerative instability without increasing stress forces in the adjacent segments. The procedure was easily reversible. If low back pain persisted or recurred, the device was removed and stability was achieved using fusion. The intermediate-term results were promising, but the long-term safety and efficacy of this dynamic interspinous stabilization device has not been previously documented. We retrospectively reviewed the hospital files of all the patients (n = 241) who had this dynamic stabilization system implanted between 1987 and 1995, contacting as many as possible to determine the actuarial survivorship of the system. In this manner, 142 of the 241 patients (58.9%) were contacted by telephone. The endpoints used for the survivorship analysis were ‘any subsequent lumbar operation’ and ‘implant removal’. At 14 years follow-up, values of actuarial survivorship with 95% confidence interval were 75.9 ± 8.3 and 81.3 ± 6.8% for the endpoints ‘any subsequent lumbar operation’ and ‘implant removal’, respectively. There was no difference in survivorship of multiple-level implants with respect to single-level devices. Although the conclusions of the present study must be tempered by the 41% attrition rate, these findings support the long-term safety of this system, and possibly long-term protective action against adjacent-level degeneration by motion preservation. Outcomes at least equivalent to those of fusion were observed without the primary drawbacks of fusion. PMID:17426988

  11. Policies, Local Control, and Other Antiquities.

    ERIC Educational Resources Information Center

    Davies, Daniel R.; And Others

    1988-01-01

    This bulletin focuses on the views of four authors. The first, Daniel R. Davies, describes the rise and fall of local control and local school board policies and predicts how the vacuum will be filled. Specifically, he analyzes the concomitant waning of local control and school board policymaking power and forecasts stages in the transition from…

  12. Academic Attributes of College Freshmen that Lead to Success in Actuarial Studies in a Business College

    ERIC Educational Resources Information Center

    Smith, Richard Manning; Schumacher, Phyllis

    2006-01-01

    The authors studied beginning undergraduate actuarial concentrators in a business college. They identified four variables (math Scholastic Aptitude Test [SAT] score, verbal SAT score, percentile rank in high school graduating class, and percentage score on a college mathematics placement exam) that were available for entering college students that…

  13. 5 CFR 839.1121 - What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... will be the amount of the BEDB divided by the present value factor for your age at the time of the... Basic Employee Death Benefit (BEDB)? 839.1121 Section 839.1121 Administrative Personnel OFFICE OF... Benefits § 839.1121 What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)? If you...

  14. Treatment of salivary gland neoplasms with fast neutron radiotherapy.

    PubMed

    Douglas, James G; Koh, Wui-jin; Austin-Seymour, Mary; Laramore, George E

    2003-09-01

    To evaluate the efficacy of fast neutron radiotherapy for the treatment of salivary gland neoplasms. Retrospective analysis. University of Washington Cancer Center, Neutron Facility, Seattle. The medical records of 279 patients treated with curative intent using fast neutron radiotherapy at the University of Washington Cancer Center were reviewed. Of the 279 patients, 263 had evidence of gross residual disease at the time of treatment (16 had no evidence of gross residual disease), 141 had tumors of a major salivary gland, and 138 had tumors of minor salivary glands. The median follow-up period was 36 months (range, 1-142 months). Local-regional control, cause-specific survival, and freedom from metastasis. The 6-year actuarial cause-specific survival rate was 67%. Multivariate analysis revealed that low group stage (I-II) disease, minor salivary sites, lack of skull base invasion, and primary disease were associated with a statistically significant improvement in cause-specific survival. The 6-year actuarial local-regional control rate was 59%. Multivariate analysis revealed size 4 cm or smaller, lack of base of skull invasion, prior surgical resection, and no previous radiotherapy to have a statistically significant improved local-regional control. Sixteen patients without evidence of gross residual disease had a 100% 6-year actuarial local-regional control. The 6-year actuarial freedom from metastasis rate was 64%. Factors associated with decreased development of systemic metastases included negative lymph nodes at the time of treatment and lack of base of skull involvement. The 6-year actuarial rate of development of grade 3 or 4 long-term toxicity (using the Radiation Therapy Oncology Group and European Organization for Research on the Treatment of Cancer criteria) was 10%. No patient experienced grade 5 toxic effects. Neuron radiotherapy is an effective treatment for patients with salivary gland neoplasms who have gross residual disease and achieves excellent

  15. A Brief Actuarial Assessment for the Prediction of Wife Assault Recidivism: The Ontario Domestic Assault Risk Assessment

    ERIC Educational Resources Information Center

    Hilton, N. Zoe; Harris, Grant T.; Rice, Marnie E.; Lang, Carol; Cormier, Catherine A.; Lines, Kathryn J.

    2004-01-01

    An actuarial assessment to predict male-to-female marital violence was constructed from a pool of potential predictors in a sample of 589 offenders identified in police records and followed up for an average of almost 5 years. Archival information in several domains (offender characteristics, domestic violence history, nondomestic criminal…

  16. If You Build It, Will They Come? Tales of Developing a New Degree Program in Actuarial Science

    ERIC Educational Resources Information Center

    Marano, Lisa E.

    2014-01-01

    In 2007, the B.S. in Applied Mathematics program consisting of five concentrations, including Actuarial Science, began at West Chester University of Pennsylvania, and we graduated our first class (of one) that December. We describe our program, some ideas to consider when planning your own program, and share some of the successes of our program…

  17. 78 FR 9890 - DoD Medicare-Eligible Retiree Health Care Board of Actuaries; Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ... DEPARTMENT OF DEFENSE Office of the Secretary DoD Medicare-Eligible Retiree Health Care Board of... Retiree Health Care Board of Actuaries will take place. DATES: Friday, August 2, 2013, from 10:00 a.m. to... assumptions to be used in the valuation of benefits under DoD retiree health care programs for Medicare...

  18. The factor structure of static actuarial items: its relation to prediction.

    PubMed

    Barbaree, Howard E; Langton, Calvin M; Peacock, Edward J

    2006-04-01

    Principal components analysis was conducted on items contained in actuarial instruments used with adult sex offenders, including: the Rapid Assessment of Sex Offender Risk for Recidivism (RASORR), the Static-99, the Violence Risk Appraisal Guide (VRAG), the Sex Offender Risk Appraisal Guide (SORAG), and the Minnesota Sex Offender Screening Tool-Revised (MnSOST-R). In a data set that included child molesters and rapists (N = 311), six interpretable components were identified: Antisocial Behavior, Child Sexual Abuse, Persistence, Detached Predatory Behavior, Young and Single, and Male Victim(s). The RRASOR was highly correlated with Persistence, and the VRAG and SORAG were highly correlated with Antisocial Behavior. Antisocial Behavior was a significant predictor of violent recidivism, while Persistence and Child Sexual Abuse were significant predictors of sexual recidivism.

  19. Local Control--Myth or Reality

    ERIC Educational Resources Information Center

    Campbell, Ronald

    1978-01-01

    Questions whether community colleges really exercise any meaningful degree of local control by examining bills passed in Michigan which place new forms of regulatory control on community colleges by the governor's office, legislature, state licensing agencies, labor organizations, federal agencies, or the attorney general's office. (TP)

  20. American Schools and the Future of Local Control.

    ERIC Educational Resources Information Center

    Doyle, Denis P.; Finn, Chester E., Jr.

    1984-01-01

    Analyzes the concept of local control against a background of rising state control. Focuses on school funding, equity, the excellence movement, and diversity and proposes a statewide educational voucher system. Concludes that the traditional conception of local control must be updated, but that school-level control is essential to improving…

  1. Actuarial Models for Assessing Prison Violence Risk: Revisions and Extensions of the Risk Assessment Scale for Prison (RASP)

    ERIC Educational Resources Information Center

    Cunningham, Mark D.; Sorensen, Jon R.

    2006-01-01

    An investigation and extension of the Risk Assessment Scale for Prison (RASP-Potosi), an actuarially derived scale for the assessment of prison violence, was undertaken through a retrospective review of the disciplinary records of the first 12 months of confinement of a cohort of inmates entering the Florida Department of Corrections in 2002 and…

  2. Light ion irradiation for unfavorable soft tissue sarcoma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Linstadt, D.; Castro, J.R.; Phillips, T.L.

    1990-09-01

    Between 1978 and 1989, 32 patients with unfavorable soft tissue sarcoma underwent light ion (helium, neon) irradiation with curative intent at Lawrence Berkeley Laboratory. The tumors were located in the trunk in 22 patients and head and neck in 10. Macroscopic tumor was present in 22 at the time of irradiation. Two patients had tumors apparently induced by previous therapeutic irradiation. Follow-up times for surviving patients ranged from 4 to 121 months (median 27 months). The overall 3-year actuarial local control rate was 62%; the corresponding survival rate was 50%. The 3-year actuarial control rate for patients irradiated with macroscopicmore » tumors was 48%, while none of the patients with microscopic disease developed local recurrence (100%). The corresponding 3-year actuarial survival rates were 40% (macroscopic) and 78% (microscopic). Patients with retroperitoneal sarcoma did notably well; the local control rate and survival rate were 64% and 62%, respectively. Complications were acceptable; there were no radiation related deaths, while two patients (6%) required operations to correct significant radiation-related injuries. These results appear promising compared to those achieved by low -LET irradiation, and suggest that this technique merits further investigation.« less

  3. Toxicity and outcome of a phase II trial of taxane-based neoadjuvant chemotherapy and 3-dimensional, conformal, accelerated radiotherapy in locally advanced nonsmall cell lung cancer.

    PubMed

    Rojas, Ana M; Lyn, Basil E; Wilson, Elena M; Williams, Frances J; Shah, Nihal; Dickson, Jeanette; Saunders, Michele I

    2006-09-15

    The objective of this study was to evaluate prospectively the acute and late adverse effects of taxane/carboplatin neoadjuvant chemotherapy and 3-dimensional, conformal radiotherapy in patients with locally advanced nonsmall cell lung cancer (NSCLC). Forty-two patients were entered into a nonrandomized Phase II study of continuous, hyperfractionated, accelerated radiotherapy (CHART) week-end less (CHARTWEL) to a dose of 60 grays (Gy). Three cycles of chemotherapy were given over 9 weeks before radiotherapy. Dose escalation with paclitaxel was from 150 mg/m2 to 225 mg/m2. Systemic toxicity to chemotherapy was monitored throughout. Radiation-induced, early, adverse effects were assessed during the first 9 weeks from the start of radiotherapy, and late effects were assessed from 3 months onward. Overall survival, disease-free survival, and locoregional tumor control also were monitored. Twenty percent of patients failed to receive chemotherapy as planned, primarily because of neutropenia. The incidence of Dische Dictionary Grade >or=2 and Grade >or=3 dysphagia was 57.5% and 10%, respectively, with an average duration of 1.2 weeks and 1.5 days, respectively. By 9 weeks, <3% of patients were symptomatic; and, eventually, all acute reactions were healed, and there has been no evidence of consequential damage. At 6 months, the actuarial incidence of moderate-to-severe pneumonitis was 10%. During this time, all patients were free of severe pulmonary complications. Actuarial estimates of Grade >or=2 late lung dysfunction were 3% at 1 year, 10% at 2 years, and remained at this level thereafter. The actuarial 3-year locoregional control and overall survival rates were 54% and 45%, respectively. Neoadjuvant chemotherapy followed by 3-dimensional, conformal CHARTWEL 60-Gy radiotherapy in patients with advanced NSCLC was feasible and was tolerated well. Historic comparisons indicated that locoregional tumor control is not compromised by the use of conformal techniques. (c) 2006

  4. Local position control: A new concept for control of manipulators

    NASA Technical Reports Server (NTRS)

    Kelly, Frederick A.

    1988-01-01

    Resolved motion rate control is currently one of the most frequently used methods of manipulator control. It is currently used in the Space Shuttle remote manipulator system (RMS) and in prosthetic devices. Position control is predominately used in locating the end-effector of an industrial manipulator along a path with prescribed timing. In industrial applications, resolved motion rate control is inappropriate since position error accumulates. This is due to velocity being the control variable. In some applications this property is an advantage rather than a disadvantage. It may be more important for motion to end as soon as the input command is removed rather than reduce the position error to zero. Local position control is a new concept for manipulator control which retains the important properties of resolved motion rate control, but reduces the drift. Local position control can be considered to be a generalization of resolved position and resolved rate control. It places both control schemes on a common mathematical basis.

  5. Enabling Controlling Complex Networks with Local Topological Information.

    PubMed

    Li, Guoqi; Deng, Lei; Xiao, Gaoxi; Tang, Pei; Wen, Changyun; Hu, Wuhua; Pei, Jing; Shi, Luping; Stanley, H Eugene

    2018-03-15

    Complex networks characterize the nature of internal/external interactions in real-world systems including social, economic, biological, ecological, and technological networks. Two issues keep as obstacles to fulfilling control of large-scale networks: structural controllability which describes the ability to guide a dynamical system from any initial state to any desired final state in finite time, with a suitable choice of inputs; and optimal control, which is a typical control approach to minimize the cost for driving the network to a predefined state with a given number of control inputs. For large complex networks without global information of network topology, both problems remain essentially open. Here we combine graph theory and control theory for tackling the two problems in one go, using only local network topology information. For the structural controllability problem, a distributed local-game matching method is proposed, where every node plays a simple Bayesian game with local information and local interactions with adjacent nodes, ensuring a suboptimal solution at a linear complexity. Starring from any structural controllability solution, a minimizing longest control path method can efficiently reach a good solution for the optimal control in large networks. Our results provide solutions for distributed complex network control and demonstrate a way to link the structural controllability and optimal control together.

  6. Knowledge-based control for robot self-localization

    NASA Technical Reports Server (NTRS)

    Bennett, Bonnie Kathleen Holte

    1993-01-01

    Autonomous robot systems are being proposed for a variety of missions including the Mars rover/sample return mission. Prior to any other mission objectives being met, an autonomous robot must be able to determine its own location. This will be especially challenging because location sensors like GPS, which are available on Earth, will not be useful, nor will INS sensors because their drift is too large. Another approach to self-localization is required. In this paper, we describe a novel approach to localization by applying a problem solving methodology. The term 'problem solving' implies a computational technique based on logical representational and control steps. In this research, these steps are derived from observing experts solving localization problems. The objective is not specifically to simulate human expertise but rather to apply its techniques where appropriate for computational systems. In doing this, we describe a model for solving the problem and a system built on that model, called localization control and logic expert (LOCALE), which is a demonstration of concept for the approach and the model. The results of this work represent the first successful solution to high-level control aspects of the localization problem.

  7. Local feedback control of light honeycomb panels.

    PubMed

    Hong, Chinsuk; Elliott, Stephen J

    2007-01-01

    This paper summarizes theoretical and experimental work on the feedback control of sound radiation from honeycomb panels using piezoceramic actuators. It is motivated by the problem of sound transmission in aircraft, specifically the active control of trim panels. Trim panels are generally honeycomb structures designed to meet the design requirement of low weight and high stiffness. They are resiliently mounted to the fuselage for the passive reduction of noise transmission. Local coupling of the closely spaced sensor and actuator was observed experimentally and modeled using a single degree of freedom system. The effect of the local coupling was to roll off the response between the actuator and sensor at high frequencies, so that a feedback control system can have high gain margins. Unfortunately, only relatively poor global performance is then achieved because of localization of reduction around the actuator. This localization prompts the investigation of a multichannel active control system. Globalized reduction was predicted using a model of 12-channel direct velocity feedback control. The multichannel system, however, does not appear to yield a significant improvement in the performance because of decreased gain margin.

  8. State Aid, Voter Power and Local Control in Education.

    ERIC Educational Resources Information Center

    Zak, Itai; Glasman, Naftaly S.

    1979-01-01

    Not only did voter power contribute meaningfully to local control behavior regardless of the exact shape of the relations between state aid and local control, but the hypothesized inverse relationship between state aid and local control did not receive support. Journal availability: see EA 511 898. (Author/IRT)

  9. Remote Control of Gene Function by Local Translation

    PubMed Central

    Jung, Hosung; Gkogkas, Christos G.; Sonenberg, Nahum; Holt, Christine E.

    2014-01-01

    The subcellular position of a protein is a key determinant of its function. Mounting evidence indicates that RNA localization, where specific mRNAs are transported subcellularly and subsequently translated in response to localized signals, is an evolutionarily conserved mechanism to control protein localization. On-site synthesis confers novel signaling properties to a protein and helps to maintain local proteome homeostasis. Local translation plays particularly important roles in distal neuronal compartments, and dysregulated RNA localization and translation cause defects in neuronal wiring and survival. Here, we discuss key findings in this area and possible implications of this adaptable and swift mechanism for spatial control of gene function. PMID:24679524

  10. Competence in Mathematics and Academic Achievement: An Analysis of Enrollees in the Bachelor of Science in Actuarial Science Program

    ERIC Educational Resources Information Center

    Wamala, Robert; Maswere, Dyson W.; Mwanga, Yeko

    2013-01-01

    This study investigates the role of prior grounding attained in mathematics in predicting the academic achievement of enrollees in Bachelor of Science in Actuarial Science (BSAS). The investigation is based on administrative records of 240 BSAS enrollees at Makerere University, School of Statistics and Planning in the 2007-2009 cohorts. Students'…

  11. Limits of localized control in extended nonlinear systems

    NASA Astrophysics Data System (ADS)

    Handel, Andreas

    We investigate the limits of localized linear control in spatially extended, nonlinear systems. Spatially extended, nonlinear systems can be found in virtually every field of engineering and science. An important category of such systems are fluid flows. Fluid flows play an important role in many commercial applications, for instance in the chemical, pharmaceutical and food-processing industries. Other important fluid flows include air- or water flows around cars, planes or ships. In all these systems, it is highly desirable to control the flow of the respective fluid. For instance control of the air flow around an airplane or car leads to better fuel-economy and reduced noise production. Usually, it is impossible to apply control everywhere. Consider an airplane: It would not be feasibly to cover the whole body of the plane with control units. Instead, one can place the control units at localized regions, such as points along the edge of the wings, spaced as far apart from each other as possible. These considerations lead to an important question: For a given system, what is the minimum number of localized controllers that still ensures successful control? Too few controllers will not achieve control, while using too many leads to unnecessary expenses and wastes resources. To answer this question, we study localized control in a class of model equations. These model equations are good representations of many real fluid flows. Using these equations, we show how one can design localized control that renders the system stable. We study the properties of the control and derive several expressions that allow us to determine the limits of successful control. We show how the number of controllers that are needed for successful control depends on the size and type of the system, as well as the way control is implemented. We find that especially the nonlinearities and the amount of noise present in the system play a crucial role. This analysis allows us to determine under

  12. Interval between surgery and radiotherapy: effect on local control of soft tissue sarcoma.

    PubMed

    Ballo, Matthew T; Zagars, Gunar K; Cormier, Janice N; Hunt, Kelly K; Feig, Barry W; Patel, Shreyaskumar R; Pisters, Peter W T

    2004-04-01

    To evaluate the clinical significance of the interval between surgery and postoperative radiotherapy (RT) for patients with soft tissue sarcoma. The records of 799 patients who underwent postoperative RT for soft tissue sarcoma between 1960 and 2000 were retrospectively reviewed. Univariate and multivariate analyses were used to evaluate the potential impact of the timing of postoperative RT on the rate of local control (LC). The actuarial overall LC rate was 79% at 10 years and 78% at 15 years. Univariate analysis indicated that the factors associated with an inferior 10-year LC rate were positive resection margins (p <0.0001); treatment for recurrent disease (p <0.0001); primary location in the head and neck or deep trunk (p <0.0001); age >64 years (p <0.0001); histopathologic subtype of malignant fibrous histiocytoma, neurogenic sarcoma, or epithelioid sarcoma (p = 0.01); tumor size >10 cm (p = 0.02); postoperative radiation dose <64 Gy (p = 0.03); and high histologic grade (p = 0.05). On multivariate analysis, all these factors remained statistically significant, except for high histologic grade and large size. A delay between surgery and the start of RT of >30 days was associated with a decreased 10-year LC rate, but this association was not statistically significant (76% vs. 83%, p = 0.07). The potential association between RT delay and inferior LC could be explained by an imbalance in the distribution of other prognostic factors. The interval between surgery and RT did not significantly impact the 10-year LC rate. These findings indicate that an RT delay should not be viewed as an independent adverse factor for LC and that treatment intensification may not be necessary for patients in whom a treatment delay has already occurred.

  13. 29 CFR 4010.15 - OMB control number.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false OMB control number. 4010.15 Section 4010.15 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.15 OMB control number... Management and Budget under OMB control number 1212-0049. [61 FR 34022, July 1, 1996. Redesignated at 74 FR...

  14. 29 CFR 4010.15 - OMB control number.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false OMB control number. 4010.15 Section 4010.15 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.15 OMB control number... Management and Budget under OMB control number 1212-0049. [61 FR 34022, July 1, 1996. Redesignated at 74 FR...

  15. 29 CFR 4010.15 - OMB control number.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false OMB control number. 4010.15 Section 4010.15 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.15 OMB control number... Management and Budget under OMB control number 1212-0049. [61 FR 34022, July 1, 1996. Redesignated at 74 FR...

  16. 29 CFR 4010.15 - OMB control number.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false OMB control number. 4010.15 Section 4010.15 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.15 OMB control number... Management and Budget under OMB control number 1212-0049. [61 FR 34022, July 1, 1996. Redesignated at 74 FR...

  17. [Long term results of exclusive chemotherapy for glottic squamous cell carcinoma complete clinical responders after induction chemotherapy].

    PubMed

    Vachin, F; Hans, S; Atlan, D; Brasnu, D; Menard, M; Laccourreye, O

    2004-06-01

    To evaluate the long-term results of exclusive chemotherapy for T1-T3N0M0 glottic squamous cell carcinoma complete clinical responders after induction chemotherapy. Between 1985 and 2000, 69 patients with glottic squamous cell carcinoma complete clinical responders after induction chemotherapy were managed with exclusive chemotherapy at our department. Chemotherapy associated platinum and fluorouracil. This retrospective analysis evaluated actuarial survival, treatment morbidity, oncologic events and laryngeal preservation. Various independent factors were tested for potential correlation with survival and local recurrence. The 5-year Kaplan-Meier actuarial survival, local control, lymph node control estimate were 83,6%, 64,8%, 98,6% respectively. Chemotherapy never resulted in death. The 10-year actuarial metachronous second primary tumors estimate was 32%. The overall laryngeal preservation rate was 98,6%. Altogether our data and the review of the literature suggest that in patients achieving a complete clinical response after and induction based chemotherapy regimen, the completion of an exclusive chemotherapy regimen appears to be a valid alternative to the conventional use of radiotherapy or chemo-radiation protocols.

  18. RNA Transport and Local Control of Translation

    PubMed Central

    Kindler, Stefan; Wang, Huidong; Richter, Dietmar; Tiedge, Henri

    2007-01-01

    In eukaryotes, the entwined pathways of RNA transport and local translational regulation are key determinants in the spatio-temporal articulation of gene expression. One of the main advantages of this mechanism over transcriptional control in the nucleus lies in the fact that it endows local sites with independent decision-making authority, a consideration that is of particular relevance in cells with complex cellular architecture such as neurons. Localized RNAs typically contain codes, expressed within cis-acting elements, that specify subcellular targeting. Such codes are recognized by trans-acting factors, adaptors that mediate translocation along cytoskeletal elements by molecular motors. Most transported mRNAs are assumed translationally dormant while en route. In some cell types, especially in neurons, it is considered crucial that translation remains repressed after arrival at the destination site (e.g., a postsynaptic microdomain) until an appropriate activation signal is received. Several candidate mechanisms have been suggested to participate in the local implementation of translational repression and activation, and such mechanisms may target translation at the level of initiation and/or elongation. Recent data indicate that untranslated RNAs may play important roles in the local control of translation. PMID:16212494

  19. Projections of health care expenditures as a share of the GDP: actuarial and macroeconomic approaches.

    PubMed Central

    Warshawsky, M J

    1994-01-01

    STUDY QUESTION. Can the steady increases in health care expenditures as a share of GDP projected by widely cited actuarial models be rationalized by a macroeconomic model with sensible parameters and specification? DATA SOURCES. National Income and Product Accounts, and Social Security and Health Care Financing Administration are the data sources used in parameters estimates. STUDY DESIGN. Health care expenditures as a share of gross domestic product (GDP) are projected using two methodological approaches--actuarial and macroeconomic--and under various assumptions. The general equilibrium macroeconomic approach has the advantage of allowing an investigation of the causes of growth in the health care sector and its consequences for the overall economy. DATA COLLECTION METHODS. Simulations are used. PRINCIPAL FINDINGS. Both models unanimously project a continued increase in the ratio of health care expenditures to GDP. Under the most conservative assumptions, that is, robust economic growth, improved demographic trends, or a significant moderation in the rate of health care price inflation, the health care sector will consume more than a quarter of national output by 2065. Under other (perhaps more realistic) assumptions, including a continuation of current trends, both approaches predict that health care expenditures will comprise between a third and a half of national output. In the macroeconomic model, the increasing use of capital goods in the health care sector explains the observed rise in relative prices. Moreover, this "capital deepening" implies that a relatively modest fraction of the labor force is employed in health care and that the rest of the economy is increasingly starved for capital, resulting in a declining standard of living. PMID:8063567

  20. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Murphy, Colin; Anderson, Penny R.; Li Tianyu

    Purpose: We examined the impact of radiation tumor bed boost parameters in early-stage breast cancer on local control and cosmetic outcomes. Methods and Materials: A total of 3,186 women underwent postlumpectomy whole-breast radiation with a tumor bed boost for Tis to T2 breast cancer from 1970 to 2008. Boost parameters analyzed included size, energy, dose, and technique. Endpoints were local control, cosmesis, and fibrosis. The Kaplan-Meier method was used to estimate actuarial incidence, and a Cox proportional hazard model was used to determine independent predictors of outcomes on multivariate analysis (MVA). The median follow-up was 78 months (range, 1-305 months).more » Results: The crude cosmetic results were excellent in 54%, good in 41%, and fair/poor in 5% of patients. The 10-year estimate of an excellent cosmesis was 66%. On MVA, independent predictors for excellent cosmesis were use of electron boost, lower electron energy, adjuvant systemic therapy, and whole-breast IMRT. Fibrosis was reported in 8.4% of patients. The actuarial incidence of fibrosis was 11% at 5 years and 17% at 10 years. On MVA, independent predictors of fibrosis were larger cup size and higher boost energy. The 10-year actuarial local failure was 6.3%. There was no significant difference in local control by boost method, cut-out size, dose, or energy. Conclusions: Likelihood of excellent cosmesis or fibrosis are associated with boost technique, electron energy, and cup size. However, because of high local control and rare incidence of fair/poor cosmesis with a boost, the anatomy of the patient and tumor cavity should ultimately determine the necessary boost parameters.« less

  1. Substance abuse among high-risk sexual offenders: do measures of lifetime history of substance abuse add to the prediction of recidivism over actuarial risk assessment instruments?

    PubMed

    Looman, Jan; Abracen, Jeffrey

    2011-03-01

    There has been relatively little research on the degree to which measures of lifetime history of substance abuse add to the prediction of risk based on actuarial measures alone among sexual offenders. This issue is of relevance in that a history of substance abuse is related to relapse to substance using behavior. Furthermore, substance use has been found to be related to recidivism among sexual offenders. To investigate whether lifetime history of substance abuse adds to prediction over and above actuarial instruments alone, several measures of substance abuse were administered in conjunction with the Sex Offender Risk Appraisal Guide (SORAG). The SORAG was found to be the most accurate actuarial instrument for the prediction of serious recidivism (i.e., sexual or violent) among the sample included in the present investigation. Complete information, including follow-up data, were available for 250 offenders who attended the Regional Treatment Centre Sex Offender Treatment Program (RTCSOTP). The Michigan Alcohol Screening Test (MAST) and the Drug Abuse Screening Test (DAST) were used to assess lifetime history of substance abuse. The results of logistic regression procedures indicated that both the SORAG and the MAST independently added to the prediction of serious recidivism. The DAST did not add to prediction over the use of the SORAG alone. Implications for both the assessment and treatment of sexual offenders are discussed.

  2. Pelvis Ewing sarcoma: Local control and survival in the modern era.

    PubMed

    Ahmed, Safia K; Robinson, Steven I; Arndt, Carola A S; Petersen, Ivy A; Haddock, Michael G; Rose, Peter S; Issa Laack, Nadia N

    2017-09-01

    Local control for Ewing sarcoma (ES) has improved in modern studies. However, it is unclear if these gains have also been achieved for pelvis tumors. The purpose of this study is to evaluate local control and survival in pelvis ES patients treated in the modern era. All pelvis ES patients diagnosed from 1990 to 2012 and seen at Mayo Clinic were identified. Factors relevant to survival and local control were analyzed. The cohort consisted of 48 patients. Fifty-two percent had metastatic disease at diagnosis. The 5-year overall survival and event-free survival was 73% and 65%, respectively, for localized disease. The 5-year cumulative incidence of local recurrence was 19%, with a 26% incidence for radiation, 13% for surgery, and 0% for surgery + radiation (P = 0.54). All local failures occurred in-field. Sacral involvement by tumor trended toward a higher incidence of local recurrence (hazard ratio 3.06, P = 0.09). Patients treated with definitive radiation doses ≥5,600 cGy had a lower incidence of local recurrence (17% vs. 28%, P = 0.61). Our study demonstrates excellent survival for localized tumors in the modern era. Anatomical localization within the pelvis likely correlates with outcomes. Local control remains problematic, especially for patients treated with definitive radiation. Though statistically not significant, surgery + radiation and definitive radiation dose ≥5,600 cGy were associated with the lowest incidence of local failure, suggesting treatment intensification may improve local control for pelvis ES. © 2017 Wiley Periodicals, Inc.

  3. Supporting tobacco control: stimulating local newspaper coverage with a technical assistance website for local coalitions.

    PubMed

    Buller, David B; Bettinghaus, Erwin P; Helme, Donald; Young, Walter F; Borland, Ron; Maloy, Julie A; Cutter, Gary R; Andersen, Peter A; Walther, Joseph B

    2011-11-01

    A large and growing literature confirms that well-designed web-based programs can be effective in preventing or treating several chronic diseases. This study examined how the Internet can deliver information and train community activists and specifically tested the effects of web-based technical assistance on local tobacco control coalitions' efforts to use media advocacy to advance their agendas. The authors compared a highly interactive, Enhanced website (intervention) to a noninteractive, Basic text-based website (comparison) in Colorado communities. A total of 24 tobacco control coalitions led by local county health departments and nursing services were enrolled in the project and randomly assigned to use either the intervention or comparison website. A total of 73 local daily and weekly newspapers were identified in the service areas of 23 of the 24 coalitions. A posttest assessment of newspaper coverage was conducted to locate all newspaper articles with tobacco control information published between January 1 and April 9, 2004, the last 3 months of the intervention. Although there was no evidence of a treatment effect on the frequency of newspaper articles on tobacco-related issues, there was, however, evidence that newspapers in counties where the coalition had access to the Enhanced website printed more stories focused on local/regional issues and more anti-tobacco local/regional stories than in the counties where coalitions had access to the Basic website. Coalitions can improve their influence on local media for community tobacco control when high-quality online technical assistance, training, and resources are available to them.

  4. Medulloblastoma. The identification of prognostic subgroups and implications for multimodality management

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kopelson, G.; Linggood, R.M.; Kleinman, G.M.

    1983-01-15

    For 43 medulloblatoma patients who had five-and ten-year actuarial survival rates of 56%, prognostic factors of statistical significance included: T-stage, M-stage and histopathologic tumor score. Posterior fossa local control rates were also function of T-stage and TS. Combining TS with T-stage, patients fell into three prognostic and local control groups, which may have different future management implications: Small (T1,2) tumors of favorable (TS less than or equal to 5) histology had a 92% ten-year actuarial survival rate with 100% (8/8) local control; no change from current management is suggested. For the intermediate prognosis group, increasing the irradiation dose alone maymore » improve survival because these tumors exhibited an irradiation dose-response relationship. However, it is the poor prognosis group which might be suitable for future adjuvant chemotherapy or radiosensitizer trials since there is no evidence that higher irradiation doses improve local control. This article identifies prognostic subgroups based on histologic type and TM staging in medulloblastoma patients which potentially may be utilized to improve therapeutic results, and confirms the value of staging patients with central nervous system malignancies.« less

  5. Positron Emission Tomography for Assessing Local Failure After Stereotactic Body Radiotherapy for Non-Small-Cell Lung Cancer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhang Xu; Liu Hui; Balter, Peter

    2012-08-01

    Purpose: We analyzed whether positron emission tomography (PET)/computed tomography standardized uptake values (SUVs) after stereotactic body radiotherapy (SBRT) could predict local recurrence (LR) in non-small-cell lung cancer (NSCLC). Methods and Materials: This study comprised 128 patients with Stage I (n = 68) or isolated recurrent/secondary parenchymal (n = 60) NSCLC treated with image-guided SBRT to 50 Gy over 4 consecutive days; prior radiotherapy was allowed. PET/computed tomography scans were obtained before therapy and at 1 to 6 months after therapy, as well as subsequently as clinically indicated. Continuous variables were analyzed with Kruskal-Wallis tests and categorical variables with Pearson chi-squaremore » or Fisher exact tests. Actuarial local failure rates were calculated with the Kaplan-Meier method. Results: At a median follow-up of 31 months (range, 6-71 months), the actuarial 1-, 2-, and 3-year local control rates were 100%, 98.5%, and 98.5%, respectively, in the Stage I group and 95.8%, 87.6%, and 85.8%, respectively, in the recurrent group. The cumulative rates of regional nodal recurrence and distant metastasis were 8.8% (6 of 68) and 14.7% (10 of 68), respectively, for the Stage I group and 11.7% (7 of 60) and 16.7% (10 of 60), respectively, for the recurrent group. Univariate analysis showed that SUVs obtained 12.1 to 24 months after treatment for the Stage I group (p = 0.007) and 6.1 to 12 months and 12.1 to 24 months after treatment for the recurrent group were associated with LR (p < 0.001 for both). Of the 128 patients, 17 (13.3%) had ipsilateral consolidation after SBRT but no elevated metabolic activity on PET; none had LR. The cutoff maximum SUV of 5 was found to have 100% sensitivity, 91% specificity, a 50% positive predictive value, and a 100% negative predictive value for predicting LR. Conclusions: PET was helpful for distinguishing SBRT-induced consolidation from LR. SUVs obtained more than 6 months after SBRT for NSCLC

  6. Highly tunable local gate controlled complementary graphene device performing as inverter and voltage controlled resistor.

    PubMed

    Kim, Wonjae; Riikonen, Juha; Li, Changfeng; Chen, Ya; Lipsanen, Harri

    2013-10-04

    Using single-layer CVD graphene, a complementary field effect transistor (FET) device is fabricated on the top of separated back-gates. The local back-gate control of the transistors, which operate with low bias at room temperature, enables highly tunable device characteristics due to separate control over electrostatic doping of the channels. Local back-gating allows control of the doping level independently of the supply voltage, which enables device operation with very low VDD. Controllable characteristics also allow the compensation of variation in the unintentional doping typically observed in CVD graphene. Moreover, both p-n and n-p configurations of FETs can be achieved by electrostatic doping using the local back-gate. Therefore, the device operation can also be switched from inverter to voltage controlled resistor, opening new possibilities in using graphene in logic circuitry.

  7. Barriers to adopting and implementing local-level tobacco control policies.

    PubMed

    Satterlund, Travis D; Cassady, Diana; Treiber, Jeanette; Lemp, Cathy

    2011-08-01

    Although California communities have been relatively successful in adopting and implementing a wide range of local tobacco control policies, the process has not been without its setbacks and barriers. Little is known about local policy adoption, and this paper examines these processes related to adopting and implementing outdoor smoke-free policies, focusing on the major barriers faced by local-level tobacco control organizations in this process. Ninety-six projects funded by the California Tobacco Control Program submitted final evaluation reports pertaining to an outdoor smoking objective, and the reports from these projects were analyzed. The barriers were grouped in three primary areas: politically polarizing barriers, organizational barriers, and local political orientation. The barriers identified in this study underscore the need for an organized action plan in adopting local tobacco policy. The authors also suggest potential strategies to offset the barriers, including: (1) having a "champion" who helps to carry an objective forward; (2) tapping into a pool of youth volunteers; (3) collecting and using local data as a persuasive tool; (4) educating the community in smoke-free policy efforts; (5) working strategically within the local political climate; and (6) demonstrating to policymakers the constituent support for proposed policy.

  8. Youth Actuarial Risk Assessment Tool (Y-ARAT): The development of an actuarial risk assessment instrument for predicting general offense recidivism on the basis of police records.

    PubMed

    van der Put, Claudia E

    2014-06-01

    Estimating the risk for recidivism is important for many areas of the criminal justice system. In the present study, the Youth Actuarial Risk Assessment Tool (Y-ARAT) was developed for juvenile offenders based solely on police records, with the aim to estimate the risk of general recidivism among large groups of juvenile offenders by police officers without clinical expertise. On the basis of the Y-ARAT, juvenile offenders are classified into five risk groups based on (combinations of) 10 variables including different types of incidents in which the juvenile was a suspect, total number of incidents in which the juvenile was a suspect, total number of other incidents, total number of incidents in which co-occupants at the youth's address were suspects, gender, and age at first incident. The Y-ARAT was developed on a sample of 2,501 juvenile offenders and validated on another sample of 2,499 juvenile offenders, showing moderate predictive accuracy (area under the receiver-operating-characteristic curve = .73), with little variation between the construction and validation sample. The predictive accuracy of the Y-ARAT was considered sufficient to justify its use as a screening instrument for the police. © The Author(s) 2013.

  9. Active local control of propeller-aircraft run-up noise.

    PubMed

    Hodgson, Murray; Guo, Jingnan; Germain, Pierre

    2003-12-01

    Engine run-ups are part of the regular maintenance schedule at Vancouver International Airport. The noise generated by the run-ups propagates into neighboring communities, disturbing the residents. Active noise control is a potentially cost-effective alternative to passive methods, such as enclosures. Propeller aircraft generate low-frequency tonal noise that is highly compatible with active control. This paper presents a preliminary investigation of the feasibility and effectiveness of controlling run-up noise from propeller aircraft using local active control. Computer simulations for different configurations of multi-channel active-noise-control systems, aimed at reducing run-up noise in adjacent residential areas using a local-control strategy, were performed. These were based on an optimal configuration of a single-channel control system studied previously. The variations of the attenuation and amplification zones with the number of control channels, and with source/control-system geometry, were studied. Here, the aircraft was modeled using one or two sources, with monopole or multipole radiation patterns. Both free-field and half-space conditions were considered: for the configurations studied, results were similar in the two cases. In both cases, large triangular quiet zones, with local attenuations of 10 dB or more, were obtained when nine or more control channels were used. Increases of noise were predicted outside of these areas, but these were minimized as more control channels were employed. By combining predicted attenuations with measured noise spectra, noise levels after implementation of an active control system were estimated.

  10. A fuzzy controller with nonlinear control rules is the sum of a global nonlinear controller and a local nonlinear PI-like controller

    NASA Technical Reports Server (NTRS)

    Ying, Hao

    1993-01-01

    The fuzzy controllers studied in this paper are the ones that employ N trapezoidal-shaped members for input fuzzy sets, Zadeh fuzzy logic and a centroid defuzzification algorithm for output fuzzy set. The author analytically proves that the structure of the fuzzy controllers is the sum of a global nonlinear controller and a local nonlinear proportional-integral-like controller. If N approaches infinity, the global controller becomes a nonlinear controller while the local controller disappears. If linear control rules are used, the global controller becomes a global two-dimensional multilevel relay which approaches a global linear proportional-integral (PI) controller as N approaches infinity.

  11. Tailoring many-body entanglement through local control

    NASA Astrophysics Data System (ADS)

    Lucas, Felix; Mintert, Florian; Buchleitner, Andreas

    2013-09-01

    We construct optimal time-local control pulses based on a multipartite entanglement measure as target functional. The underlying control Hamiltonians are derived in a purely algebraic fashion, and the resulting pulses drive a composite quantum system rapidly into that highly entangled state which can be created most efficiently for a given interaction mechanism, and which bears entanglement that is robust against decoherence. Moreover, it is shown that the control scheme is insensitive to experimental imperfections in first order.

  12. Computer-controlled local anesthetic delivery for painless anesthesia: a literature review

    PubMed Central

    Kwak, Eun-Jung; Pang, Nan-Sim; Cho, Jin-Hyung; Jung, Bock-Young; Kim, Kee-Deog

    2016-01-01

    Local anesthesia is administered to reduce pain during dental treatments, but may itself cause pain and contribute to increased dental fear. Computer-controlled local anesthetic delivery (CCLAD) is one the method to reduce patient pain during local anesthesia; it is a device that slowly administers anesthetics by using a computerized device to control the injection speed. This literature review aims to provide an objective assessment of the usefulness of CCLAD for controlling pain by reviewing papers published to date that have used CCLAD. PMID:28879299

  13. Electronically controllable spoof localized surface plasmons

    NASA Astrophysics Data System (ADS)

    Zhou, Yong Jin; Zhang, Chao; Yang, Liu; Xun Xiao, Qian

    2017-10-01

    Electronically controllable multipolar spoof localized surface plasmons (LSPs) are experimentally demonstrated in the microwave frequencies. It has been shown that half integer order LSPs modes exist on the corrugated ring loaded with a slit, which actually arise from the Fabry-Perot-like resonances. By mounting active components across the slit in the corrugated rings, electronic switchability and tunability of spoof LSPs modes have been accomplished. Both simulated and measured results demonstrate efficient dynamic control of the spoof LSPs. These elements may form the basis of highly integrated programmable plasmonic circuits in microwave and terahertz regimes.

  14. Blockage-induced condensation controlled by a local reaction

    NASA Astrophysics Data System (ADS)

    Cirillo, Emilio N. M.; Colangeli, Matteo; Muntean, Adrian

    2016-10-01

    We consider the setup of stationary zero range models and discuss the onset of condensation induced by a local blockage on the lattice. We show that the introduction of a local feedback on the hopping rates allows us to control the particle fraction in the condensed phase. This phenomenon results in a current versus blockage parameter curve characterized by two nonanalyticity points.

  15. Patient Protection and Affordable Care Act; standards related to essential health benefits, actuarial value and accreditation. Final rule.

    PubMed

    2013-02-25

    This final rule sets forth standards for health insurance issuers consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Specifically, this final rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value. This rule also finalizes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and amends regulations providing an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans.

  16. Local Failure in Parameningeal Rhabdomyosarcoma Correlates With Poor Response to Induction Chemotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ladra, Matthew M.; Mandeville, Henry C.; Niemierko, Andrzej

    2015-06-01

    Background: Local control remains a challenge in pediatric parameningeal rhabdomyosarcoma (PM-RMS), and survival after local failure (LF) is poor. Identifying patients with a high risk of LF is of great interest to clinicians. In this study, we examined whether tumor response to induction chemotherapy (CT) could predict LF in embryonal PM-RMS. Methods: We identified 24 patients with embryonal PM-RMS, age 2 to 18 years, with complete magnetic resonance imaging and gross residual disease after surgical resection. All patients received proton radiation therapy (RT), median dose 50.4 Gy{sub RBE} (50.4-55.8 Gy{sub RBE}). Tumor size was measured before initial CT and before RT. Results:more » With a median follow-up time of 4.1 years for survivors, LF was seen in 9 patients (37.5%). The median time from the initiation of CT to the start of RT was 4.8 weeks. Patients with LF had a similar initial (pre-CT) tumor volume compared with patients with local controlled (LC) (54 cm{sup 3} vs 43 cm{sup 3}, P=.9) but a greater median volume before RT (pre-RT) (40 cm{sup 3} vs 7 cm{sup 3}, P=.009) and a smaller median relative percent volume reduction (RPVR) in tumor size (0.4% vs 78%, P<.001). Older age (P=.05), larger pre-RT tumor volume (P=.03), and smaller RPVR (P=.003) were significantly associated with actuarial LF on univariate Cox analysis. Conclusions: Poor response to induction CT appears to be associated with an increased risk of LF in pediatric embryonal PM-RMS.« less

  17. Local Control With 21-Gy Radiation Therapy for High-Risk Neuroblastoma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Casey, Dana L.; Kushner, Brian H.; Cheung, Nai-Kong V.

    2016-10-01

    Purpose: To evaluate local control after 21-Gy radiation therapy (RT) to the primary site in patients with high-risk neuroblastoma. Methods and Materials: After receiving dose-intensive chemotherapy and gross total resection (GTR), 246 patients (aged 1.2-17.9 years, median 4.0 years) with high-risk neuroblastoma underwent RT to the primary site at Memorial Sloan Kettering from 2000 to 2014. Radiation therapy consisted of 21 Gy in twice-daily fractions of 1.5 Gy each. Local failure (LF) was correlated with biologic prognostic factors and clinical findings at the time of diagnosis and start of RT. Results: Median follow-up of surviving patients was 6.4 years. Cumulative incidence of LF was 7.1%more » at 2 years after RT and 9.8% at 5 years after RT. The isolated LF rate was 3.0%. Eighty-six percent of all local failures were within the RT field. Local control was worse in patients who required more than 1 surgical resection to achieve GTR (22.4% vs 8.3%, P=.01). There was also a trend toward inferior local control with MYCN-amplified tumors or serum lactate dehydrogenase ≥1500 U/L (P=.09 and P=.06, respectively). Conclusion: After intensive chemotherapy and maximal surgical debulking, hyperfractionated RT with 21 Gy in high-risk neuroblastoma results in excellent local control. Given the young patient age, concern for late effects, and local control >90%, dose reduction may be appropriate for patients without MYCN amplification who achieve GTR.« less

  18. Local gate control in carbon nanotube quantum devices

    NASA Astrophysics Data System (ADS)

    Biercuk, Michael Jordan

    This thesis presents transport measurements of carbon nanotube electronic devices operated in the quantum regime. Nanotubes are contacted by source and drain electrodes, and multiple lithographically-patterned electrostatic gates are aligned to each device. Transport measurements of device conductance or current as a function of local gate voltages reveal that local gates couple primarily to the proximal section of the nanotube, hence providing spatially localized control over carrier density along the nanotube length. Further, using several different techniques we are able to produce local depletion regions along the length of a tube. This phenomenon is explored in detail for different contact metals to the nanotube. We utilize local gating techniques to study multiple quantum dots in carbon nanotubes produced both by naturally occurring defects, and by the controlled application of voltages to depletion gates. We study double quantum dots in detail, where transport measurements reveal honeycomb charge stability diagrams. We extract values of energy-level spacings, capacitances, and interaction energies for this system, and demonstrate independent control over all relevant tunneling rates. We report rf-reflectometry measurements of gate-defined carbon nanotube quantum dots with integrated charge sensors. Aluminum rf-SETs are electrostatically coupled to carbon nanotube devices and detect single electron charging phenomena in the Coulomb blockade regime. Simultaneous correlated measurements of single electron charging are made using reflected rf power from the nanotube itself and from the rf-SET on microsecond time scales. We map charge stability diagrams for the nanotube quantum dot via charge sensing, observing Coulomb charging diamonds beyond the first order. Conductance measurements of carbon nanotubes containing gated local depletion regions exhibit plateaus as a function of gate voltage, spaced by approximately 1e2/h, the quantum of conductance for a single

  19. Thailand Momentum on Policy and Practice in Local Legislation on Dengue Vector Control

    PubMed Central

    Bhumiratana, Adisak; Intarapuk, Apiradee; Chujun, Suriyo; Kaewwaen, Wuthichai; Sorosjinda-Nunthawarasilp, Prapa; Koyadun, Surachart

    2014-01-01

    Over a past decade, an administrative decentralization model, adopted for local administration development in Thailand, is replacing the prior centralized (top-down) command system. The change offers challenges to local governmental agencies and other public health agencies at all the ministerial, regional, and provincial levels. A public health regulatory and legislative framework for dengue vector control by local governmental agencies is a national topic of interest because dengue control program has been integrated into healthcare services at the provincial level and also has been given priority in health plans of local governmental agencies. The enabling environments of local administrations are unique, so this critical review focuses on the authority of local governmental agencies responsible for disease prevention and control and on the functioning of local legislation with respect to dengue vector control and practices. PMID:24799896

  20. Interstitial and external radiotherapy in carcinoma of the soft palate and uvula

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Esche, B.A.; Haie, C.M.; Gerbaulet, A.P.

    1988-09-01

    Forty-three patients, all male, with limited epidermoid carcinoma of the soft palate and uvula were treated by interstitial implant usually associated with external radiotherapy. Most patients received 50 Gy external irradiation to the oropharynx and neck followed by 20-35 Gy by interstitial iridium-192 wires using either guide gutters or a plastic tube technique. Twelve primary tumors and two recurrences after external irradiation alone had implant only for 65-75 Gy. Total actuarial local control is 92% with no local failures in 34 T1 primary tumors. Only one serious complication was seen. Overall actuarial survival was 60% at 3 years and 37%more » at 5 years but cause-specific survivals were 81% and 64%. The leading cause of death was other aerodigestive cancer, with an actuarial rate of occurrence of 10% per year after treatment of a soft palate cancer. Interstitital brachytherapy alone or combined with external irradiation is safe, effective management for early carcinoma of the soft palate and uvula but second malignancy is a serious problem.« less

  1. Controlling the delocalization-localization transition of light via electromagnetically induced transparency

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cheng Jing; Huang Guoxiang; State Key Laboratory of Precision Spectroscopy, East China Normal University, Shanghai 200062

    2011-05-15

    We propose a scheme to realize a transition from delocalization to localization of light waves via electromagnetically induced transparency. The system we suggested is a resonant cold atomic ensemble having N configuration, with a control field consisting of two pairs of laser beams with different cross angles, which produce an electromagnetically induced quasiperiodic waveguide (EIQPW) for the propagation of a signal field. By appropriately tuning the incommensurate rate or relative modulation strength between the two pairs of control-field components, the signal field can exhibit the delocalization-localization transition as it transports inside the atomic ensemble. The delocalization-localization transition point is determinedmore » and the propagation property of the signal field is studied in detail. Our work provides a way of realizing wave localization via atomic coherence, which is quite different from the conventional, off-resonant mechanism-based Aubry-Andre model, and the great controllability of the EIQPW also allows an easy manipulation of the delocalization-localization transition.« less

  2. 24 CFR 1000.139 - What are the standards for insurance entities owned and controlled by recipients?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Governmental Risk Pools and conducted by an independent property or casualty actuary who is a member of a recognized professional actuarial organization, such as the American Academy of Actuaries. The report issued and submitted to HUD must include the actuary's written opinion on any over- or under-reserving and...

  3. An Analysis of Tower (Local) Controller - Pilot Voice Communications

    DOT National Transportation Integrated Search

    1994-06-01

    The purposes of this analysis were to examine current pilot-controller communication practices in the terminal environment. Forty-nine hours of voice tapes from local positions in ten Air Traffic Control Towers (ATCTs) were examined. There were 8,444...

  4. 18 years' experience with high dose rate strontium-90 brachytherapy of small to medium sized posterior uveal melanoma.

    PubMed

    van Ginderdeuren, R; van Limbergen, E; Spileers, W

    2005-10-01

    To analyse local tumour control, radiation related complications, visual acuity, enucleation rate, and survival after brachytherapy of small to medium sized choroidal melanoma (CM) with a high dose rate (HDR) strontium-90 (Sr-90) applicator. From 1983 until 2000, 98 eyes with CM were treated with Sr-90 brachytherapy. The main outcome measures were actuarial rates of the patients' survival, ocular conservation rate, tumour regression, complication rates, and preservation of visual acuity. End point rates were estimated using Kaplan-Meier analysis. The median follow up time was 6.7 years (0.5-18.8 years). Actuarial melanoma free patient survival rate was 85% (SE 4.8%) after 18 years. Actuarial rate of ocular conservation and complete tumour regression was 90% (SE 3.8%) after 15 years. In 93% local tumour control was achieved, 88% showed a stable scar. Recurrence of the tumour on the border caused enucleation of six eyes (7%). In three cases (4%) retinal detachment was the end point. No cases of optic atrophy or of sight impairing retinopathy outside the treated area were found. Actuarial rate of preservation of visual acuity of 1/10 was 65% at 5 years and 45% at 15 years of follow up (SE 5.9% and 8.8%). Sr-90 brachytherapy is as effective as iodine or ruthenium brachytherapy for small to medium sized CM but causes fewer complications. The preservation of vision is better than with all other described radioisotopes. HDR Sr-90 brachytherapy can therefore safely be recommended for small to medium sized CM.

  5. 18 Years’ experience with high dose rate strontium-90 brachytherapy of small to medium sized posterior uveal melanoma

    PubMed Central

    van Ginderdeuren, R; van Limbergen, E; Spileers, W

    2005-01-01

    Aim: To analyse local tumour control, radiation related complications, visual acuity, enucleation rate, and survival after brachytherapy of small to medium sized choroidal melanoma (CM) with a high dose rate (HDR) strontium-90 (Sr-90) applicator. Methods: From 1983 until 2000, 98 eyes with CM were treated with Sr-90 brachytherapy. The main outcome measures were actuarial rates of the patients’ survival, ocular conservation rate, tumour regression, complication rates, and preservation of visual acuity. End point rates were estimated using Kaplan-Meier analysis. Results: The median follow up time was 6.7 years (0.5–18.8 years). Actuarial melanoma free patient survival rate was 85% (SE 4.8%) after 18 years. Actuarial rate of ocular conservation and complete tumour regression was 90% (SE 3.8%) after 15 years. In 93% local tumour control was achieved, 88% showed a stable scar. Recurrence of the tumour on the border caused enucleation of six eyes (7%). In three cases (4%) retinal detachment was the end point. No cases of optic atrophy or of sight impairing retinopathy outside the treated area were found. Actuarial rate of preservation of visual acuity of 1/10 was 65% at 5 years and 45% at 15 years of follow up (SE 5.9% and 8.8%). Conclusions: Sr-90 brachytherapy is as effective as iodine or ruthenium brachytherapy for small to medium sized CM but causes fewer complications. The preservation of vision is better than with all other described radioisotopes. HDR Sr-90 brachytherapy can therefore safely be recommended for small to medium sized CM. PMID:16170122

  6. Racial Isolation, Poverty, and the Limits of Local Control in Oakland

    ERIC Educational Resources Information Center

    Noguera, Pedro A.

    2004-01-01

    Historically, schools in the United States have been governed at the local level by elected school boards, and finances have been raised primarily through local property taxes. While local control theoretically allows for greater responsiveness to local concerns, it does not take into account the vast inequality among and between communities in…

  7. Technologies for Controlled, Local Delivery of siRNA

    PubMed Central

    Sarett, Samantha M.; Nelson, Christopher E.; Duvall, Craig L.

    2015-01-01

    The discovery of RNAi in the late 1990s unlocked a new realm of therapeutic possibilities by enabling potent and specific silencing of theoretically any desired genetic target. Better elucidation of the mechanism of action, the impact of chemical modifications that stabilize and reduce nonspecific effects of siRNA molecules, and the key design considerations for effective delivery systems has spurred progress toward developing clinically-successful siRNA therapies. A logical aim for initial siRNA translation is local therapies, as delivering siRNA directly to its site of action helps to ensure that a sufficient dose reaches the target tissue, lessens the potential for off-target side effects, and circumvents the substantial systemic delivery barriers. While topical siRNA delivery has progressed into numerous clinical trials, an enormous opportunity also exists to develop sustained-release, local delivery systems that enable both spatial and temporal control of gene silencing. This review focuses on material platforms that establish both localized and controlled gene silencing, with emphasis on the systems that show most promise for clinical translation. PMID:26476177

  8. Telerobot local-remote control architecture for space flight program applications

    NASA Technical Reports Server (NTRS)

    Zimmerman, Wayne; Backes, Paul; Steele, Robert; Long, Mark; Bon, Bruce; Beahan, John

    1993-01-01

    The JPL Supervisory Telerobotics (STELER) Laboratory has developed and demonstrated a unique local-remote robot control architecture which enables management of intermittent communication bus latencies and delays such as those expected for ground-remote operation of Space Station robotic systems via the Tracking and Data Relay Satellite System (TDRSS) communication platform. The current work at JPL in this area has focused on enhancing the technologies and transferring the control architecture to hardware and software environments which are more compatible with projected ground and space operational environments. At the local site, the operator updates the remote worksite model using stereo video and a model overlay/fitting algorithm which outputs the location and orientation of the object in free space. That information is relayed to the robot User Macro Interface (UMI) to enable programming of the robot control macros. This capability runs on a single Silicon Graphics Inc. machine. The operator can employ either manual teleoperation, shared control, or supervised autonomous control to manipulate the intended object. The remote site controller, called the Modular Telerobot Task Execution System (MOTES), runs in a multi-processor VME environment and performs the task sequencing, task execution, trajectory generation, closed loop force/torque control, task parameter monitoring, and reflex action. This paper describes the new STELER architecture implementation, and also documents the results of the recent autonomous docking task execution using the local site and MOTES.

  9. Local navigation and fuzzy control realization for autonomous guided vehicle

    NASA Astrophysics Data System (ADS)

    El-Konyaly, El-Sayed H.; Saraya, Sabry F.; Shehata, Raef S.

    1996-10-01

    This paper addresses the problem of local navigation for an autonomous guided vehicle (AGV) in a structured environment that contains static and dynamic obstacles. Information about the environment is obtained via a CCD camera. The problem is formulated as a dynamic feedback control problem in which speed and steering decisions are made on the fly while the AGV is moving. A decision element (DE) that uses local information is proposed. The DE guides the vehicle in the environment by producing appropriate navigation decisions. Dynamic models of a three-wheeled vehicle for driving and steering mechanisms are derived. The interaction between them is performed via the local feedback DE. A controller, based on fuzzy logic, is designed to drive the vehicle safely in an intelligent and human-like manner. The effectiveness of the navigation and control strategies in driving the AGV is illustrated and evaluated.

  10. Five-year Local Control in a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost for Early Stage Breast Cancer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Freedman, Gary M., E-mail: Gary.Freedman@uphs.upenn.edu; Anderson, Penny R.; Bleicher, Richard J.

    Purpose: Conventional radiation fractionation of 1.8-2 Gy per day for early stage breast cancer requires daily treatment for 6-7 weeks. We report the 5-year results of a phase II study of intensity modulated radiation therapy (IMRT), hypofractionation, and incorporated boost that shortened treatment time to 4 weeks. Methods and Materials: The study design was phase II with a planned accrual of 75 patients. Eligibility included patients aged {>=}18 years, Tis-T2, stage 0-II, and breast conservation. Photon IMRT and an incorporated boost was used, and the whole breast received 2.25 Gy per fraction for a total of 45 Gy, and themore » tumor bed received 2.8 Gy per fraction for a total of 56 Gy in 20 treatments over 4 weeks. Patients were followed every 6 months for 5 years. Results: Seventy-five patients were treated from December 2003 to November 2005. The median follow-up was 69 months. Median age was 52 years (range, 31-81). Median tumor size was 1.4 cm (range, 0.1-3.5). Eighty percent of tumors were node negative; 93% of patients had negative margins, and 7% of patients had close (>0 and <2 mm) margins; 76% of cancers were invasive ductal type: 15% were ductal carcinoma in situ, 5% were lobular, and 4% were other histology types. Twenty-nine percent of patients 29% had grade 3 carcinoma, and 20% of patients had extensive in situ carcinoma; 11% of patients received chemotherapy, 36% received endocrine therapy, 33% received both, and 20% received neither. There were 3 instances of local recurrence for a 5-year actuarial rate of 2.7%. Conclusions: This 4-week course of hypofractionated radiation with incorporated boost was associated with excellent local control, comparable to historical results of 6-7 weeks of conventional whole-breast fractionation with sequential boost.« less

  11. Olivocochlear Efferent Control in Sound Localization and Experience-Dependent Learning

    PubMed Central

    Irving, Samuel; Moore, David R.; Liberman, M. Charles; Sumner, Christian J.

    2012-01-01

    Efferent auditory pathways have been implicated in sound localization and its plasticity. We examined the role of the olivocochlear system (OC) in horizontal sound localization by the ferret and in localization learning following unilateral earplugging. Under anesthesia, adult ferrets underwent olivocochlear bundle section at the floor of the fourth ventricle, either at the midline or laterally (left). Lesioned and control animals were trained to localize 1 s and 40ms amplitude-roved broadband noise stimuli from one of 12 loudspeakers. Neither type of lesion affected normal localization accuracy. All ferrets then received a left earplug and were tested and trained over 10 d. The plug profoundly disrupted localization. Ferrets in the control and lateral lesion groups improved significantly during subsequent training on the 1 s stimulus. No improvement (learning) occurred in the midline lesion group. Markedly poorer performance and failure to learn was observed with the 40 ms stimulus in all groups. Plug removal resulted in a rapid resumption of normal localization in all animals. Insertion of a subsequent plug in the right ear produced similar results to left earplugging. Learning in the lateral lesion group was independent of the side of the lesion relative to the earplug. Lesions in all reported cases were verified histologically. The results suggest the OC system is not needed for accurate localization, but that it is involved in relearning localization during unilateral conductive hearing loss. PMID:21325517

  12. Substance Abuse among High-Risk Sexual Offenders: Do Measures of Lifetime History of Substance Abuse Add to the Prediction of Recidivism over Actuarial Risk Assessment Instruments?

    ERIC Educational Resources Information Center

    Looman, Jan; Abracen, Jeffrey

    2011-01-01

    There has been relatively little research on the degree to which measures of lifetime history of substance abuse add to the prediction of risk based on actuarial measures alone among sexual offenders. This issue is of relevance in that a history of substance abuse is related to relapse to substance using behavior. Furthermore, substance use has…

  13. Outcomes of Proton Radiation Therapy for Peripapillary Choroidal Melanoma at the BC Cancer Agency

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tran, Eric, E-mail: etran2@bccancer.bc.ca; Ma, Roy; Paton, Katherine

    2012-08-01

    Purpose: To report toxicity, local control, enucleation, and survival rates for patients with peripapillary choroidal melanoma treated with proton therapy in Canada. Methods and Materials: We performed a retrospective analysis of patients with peripapillary choroidal melanoma ({<=}2 mm from optic disc) treated between 1995 and 2007 at the only Canadian proton therapy facility. A prospective database was updated for follow-up information from a chart review. Descriptive and actuarial data are presented. Results: In total, 59 patients were treated. The median age was 59 years. According to the 2010 American Joint Committee on Cancer TNM classification, there were 20 T1 tumorsmore » (34%), 28 T2 tumors (48%), and 11 T3 tumors (19%). The median tumor diameter was 11.4 mm, and the median thickness was 3.5 mm. Median follow-up was 63 months. Nineteen patients received 54 cobalt gray equivalents (CGE) and forty patients received 60 CGE, each in 4 fractions. The 5-year actuarial local control rate was 91% (T1, 100%; T2, 93%; and T3, 59%) (p = 0.038). There was a suggestive relationship between local control and dose. The local control rate was 97% with 60 CGE and 83% with 54 CGE (p = 0.106). The metastasis-free survival rate was 82% and related to T stage (T1, 94%; T2, 84%; and T3, 47%) (p < 0.001). Twelve patients died, including eleven with metastases. The 5-year actuarial rate of neovascular glaucoma was 31% (23% for T1-T2 and 68% for T3, p < 0.001), and that of enucleation was 0% for T1, 14% for T2, and 72% for T3 (p < 0.001). Radiation retinopathy (74%) and optic neuropathy (64%) were common within-field effects. Conclusions: Proton therapy provides excellent local control with acceptable toxicity while conserving the globe in 80% of cases. These results are consistent with other single-institution series using proton radiotherapy, and toxicity rates were acceptable. T3 tumors carry a higher rate of both local recurrence and metastasis.« less

  14. Outcomes for Spine Stereotactic Body Radiation Therapy and an Analysis of Predictors of Local Recurrence

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bishop, Andrew J.; Tao, Randa; Rebueno, Neal C.

    Purpose: To investigate local control, survival outcomes, and predictors of local relapse for patients treated with spine stereotactic body radiation therapy. Methods and Materials: We reviewed the records of 332 spinal metastases consecutively treated with stereotactic body radiation therapy between 2002 and 2012. The median follow-up for all living patients was 33 months (range, 0-111 months). Endpoints were overall survival and local control (LC); recurrences were classified as either in-field or marginal. Results: The 1-year actuarial LC and overall survival rates were 88% and 64%, respectively. Patients with local relapses had poorer dosimetric coverage of the gross tumor volume (GTV) compared withmore » patients without recurrence (minimum dose [Dmin] biologically equivalent dose [BED] 23.9 vs 35.1 Gy, P<.001; D98 BED 41.8 vs 48.1 Gy, P=.001; D95 BED 47.2 vs 50.5 Gy, P=.004). Furthermore, patients with marginal recurrences had poorer prescription coverage of the GTV (86% vs 93%, P=.01) compared with those with in-field recurrences, potentially because of more upfront spinal canal disease (78% vs 24%, P=.001). Using a Cox regression univariate analysis, patients with a GTV BED Dmin ≥33.4 Gy (median dose) (equivalent to 14 Gy in 1 fraction) had a significantly higher 1-year LC rate (94% vs 80%, P=.001) compared with patients with a lower GTV BED Dmin; this factor was the only significant variable on multivariate Cox analysis associated with LC (P=.001, hazard ratio 0.29, 95% confidence interval 0.14-0.60) and also was the only variable significant in a separate competing risk multivariate model (P=.001, hazard ratio 0.30, 95% confidence interval 0.15-0.62). Conclusions: Stereotactic body radiation therapy offers durable control for spinal metastases, but there is a subset of patients that recur locally. Patients with local relapse had significantly poorer tumor coverage, which was likely attributable to treatment planning directives that prioritized

  15. Evidence-based diabetes prevention and control programs and policies in local health departments

    PubMed Central

    Zwald, Marissa; Elliott, Lindsay; Brownson, Ross C.; Skala, Mahree

    2016-01-01

    Purpose The purpose of this study is to: (1) assess implementation of evidence-based programs and policies (EBPPs) related to diabetes prevention and control in local health departments; (2) assess feasibility of non-implemented diabetes prevention and control EBPPs; and (3) examine individual- and organizational-level factors associated with implementation of diabetes prevention and control EBPPs. Methods An online survey was administered in January 2015 to key representatives of all local health departments in Missouri. Descriptive statistics were used to describe implementation and perceived feasibility of 20 diabetes prevention and control EBPPs. Logistic regression was used to examine the association between individual and organizational factors and diabetes prevention and control EBPP implementation. Results One hundred local health departments participated (89% response rate) in the online survey. Most frequently implemented diabetes-related EBPPs in local health departments included: nutrition education for agency or community members; increased fruit and vegetable access in community settings; and community-wide campaigns to promote physical activity. Increased encouragement to others in the department to use evidence-based decision making and agency incentives to help employees use evidence-based decision making were positively associated with implementation of diabetes prevention and control EBPPs. Conclusions Local health departments are the “front line” of public health and this study demonstrates the important role these organizations play in implementing diabetes prevention and control EBPPs. Potential leverage points for more widespread adoption of diabetes-related EBPPs in local health departments include education about and encouragement of evidence-based decision making and organizational incentives for employees to integrate evidence-based decision making into their diabetes prevention and control activities. PMID:26297714

  16. Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments.

    PubMed

    Zwald, Marissa; Elliott, Lindsay; Brownson, Ross C; Skala, Mahree

    2015-12-01

    The purpose of this study is to: (1) assess implementation of evidence-based programs and policies (EBPPs) related to diabetes prevention and control in local health departments, (2) assess feasibility of non-implemented diabetes prevention and control EBPPs, and (3) examine individual- and organizational-level factors associated with implementation of diabetes prevention and control EBPPs. An online survey was administered in January 2015 to key representatives of all local health departments in Missouri. Descriptive statistics were used to describe implementation and perceived feasibility of 20 diabetes prevention and control EBPPs. Logistic regression was used to examine the association between individual and organizational factors and diabetes prevention and control EBPP implementation. One hundred local health departments participated (89% response rate) in the online survey. Most frequently implemented diabetes-related EBPPs in local health departments included: nutrition education for agency or community members, increased fruit and vegetable access in community settings, and community-wide campaigns to promote physical activity. Increased encouragement to others in the department to use evidence-based decision making and agency incentives to help employees use evidence-based decision making were positively associated with implementation of diabetes prevention and control EBPPs. Local health departments are on the "front line" of public health, and this study demonstrates the important role these organizations play in implementing diabetes prevention and control EBPPs. Potential leverage points for more widespread adoption of diabetes-related EBPPs in local health departments include education about and encouragement of evidence-based decision making and organizational incentives for employees to integrate evidence-based decision making into their diabetes prevention and control activities. © 2015 The Author(s).

  17. 76 FR 77270 - Proposed Submission of Information Collection for OMB Review; Comment Request; Annual Financial...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-12

    ...; Comment Request; Annual Financial and Actuarial Information Reporting AGENCY: Pension Benefit Guaranty... financial and actuarial information reporting under 29 CFR Part 4010 (OMB control number 1212- 0049; expires... controlled group to submit financial and actuarial information to PBGC under certain circumstances. PBGC's...

  18. Participatory health impact assessment for the development of local government regulation on hazard control

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Inmuong, Uraiwan, E-mail: uraiwan@kku.ac.t; Faculty of Public Health, Khon Kaen University, Thailand 123 Mittrapharb Road, Khon Kaen 40002; Rithmak, Panee, E-mail: panrit@kku.ac.t

    The Thai Public Health Act 1992 required the Thai local governments to issue respective regulations to take control of any possible health-hazard related activities, both from commercial and noncommercial sources. Since 1999, there has been centrally decentralized of power to a new form of local government establishment, namely Sub-district Administrative Organization (SAO). The SAO is asmall-scale local governing structure while its legitimate function is for community services, including control of health impact related activities. Most elected SAO administrators and officers are new and less experience with any of public health code of practice, particularly on health-hazard control. This action researchmore » attempted to introduce and apply a participatory health impact assessment (HIA) tool for the development of SAO health-hazard control regulation. The study sites were at Ban Meang and Kok See SAOs, Khon Kaen Province, Thailand, while all intervention activities conducted during May 2005-April 2006. A set of cooperative activities between researchers and community representatives were planned and organized by; surveying and identifying place and service base locally causing local environmental health problems, organizing community participatory workshops for drafting and proposing the health-hazard control regulation, and appropriate practices for health-hazard controlling measures. This action research eventually could successfully enable the SAO administrators and officers understanding of local environmental-related health problem, as well as development of imposed health-hazard control regulation for local community.« less

  19. Tree hazard control on recreation sites...estimating local budgets

    Treesearch

    Lee A. Paine

    1967-01-01

    Tree hazard control efforts on recreation sites are subject to budget and administrative restrictions. To make the most effective use of available control funds, priorities should be assigned to various classes of tree defects and a budget set up. With the method provided, local priorities are based on cost effectiveness. Some guide lines and a worksheet for planning a...

  20. A brief actuarial assessment for the prediction of wife assault recidivism: the Ontario domestic assault risk assessment.

    PubMed

    Hilton, N Zoe; Harris, Grant T; Rice, Marnie E; Lang, Carol; Cormier, Catherine A; Lines, Kathryn J

    2004-09-01

    An actuarial assessment to predict male-to-female marital violence was constructed from a pool of potential predictors in a sample of 589 offenders identified in police records and followed up for an average of almost 5 years. Archival information in several domains (offender characteristics, domestic violence history, nondomestic criminal history, relationship characteristics, victim characteristics, index offense) and recidivism were subjected to setwise and stepwise logistic regression. The resulting 13-item scale, the Ontario Domestic Assault Risk Assessment (ODARA), showed a large effect size in predicting new assaults against legal or common-law wives or ex-wives (Cohen's d = 1.1, relative operating characteristic area =.77) and was associated with number and severity of new assaults and time until recidivism. Cross-validation and comparisons with other instruments are also reported.

  1. Dynamic subcellular localization of a respiratory complex controls bacterial respiration

    PubMed Central

    Alberge, François; Espinosa, Leon; Seduk, Farida; Sylvi, Léa; Toci, René; Walburger, Anne; Magalon, Axel

    2015-01-01

    Respiration, an essential process for most organisms, has to optimally respond to changes in the metabolic demand or the environmental conditions. The branched character of their respiratory chains allows bacteria to do so by providing a great metabolic and regulatory flexibility. Here, we show that the native localization of the nitrate reductase, a major respiratory complex under anaerobiosis in Escherichia coli, is submitted to tight spatiotemporal regulation in response to metabolic conditions via a mechanism using the transmembrane proton gradient as a cue for polar localization. These dynamics are critical for controlling the activity of nitrate reductase, as the formation of polar assemblies potentiates the electron flux through the complex. Thus, dynamic subcellular localization emerges as a critical factor in the control of respiration in bacteria. DOI: http://dx.doi.org/10.7554/eLife.05357.001 PMID:26077726

  2. Quantum thermodynamics with local control

    NASA Astrophysics Data System (ADS)

    Lekscha, J.; Wilming, H.; Eisert, J.; Gallego, R.

    2018-02-01

    We investigate the limitations that emerge in thermodynamic tasks as a result of having local control only over the components of a thermal machine. These limitations are particularly relevant for devices composed of interacting many-body systems. Specifically, we study protocols of work extraction that employ a many-body system as a working medium whose evolution can be driven by tuning the on-site Hamiltonian terms. This provides a restricted set of thermodynamic operations, giving rise to alternative bounds for the performance of engines. Our findings show that those limitations in control render it, in general, impossible to reach Carnot efficiency; in its extreme ramification it can even forbid to reach a finite efficiency or finite work per particle. We focus on the one-dimensional Ising model in the thermodynamic limit as a case study. We show that in the limit of strong interactions the ferromagnetic case becomes useless for work extraction, while the antiferromagnetic case improves its performance with the strength of the couplings, reaching Carnot in the limit of arbitrary strong interactions. Our results provide a promising connection between the study of quantum control and thermodynamics and introduce a more realistic set of physical operations well suited to capture current experimental scenarios.

  3. Assessing local health department performance in diabetes prevention and control--North Carolina, 2005.

    PubMed

    Porterfield, Deborah S; Reaves, Janet; Konrad, Thomas R; Weiner, Bryan J; Garrett, Joanne M; Davis, Mary; Dickson, Curtis W; Plescia, Marcus; Alexander, Janet; Baker, Edward L

    2009-07-01

    To improve the public health system's ability to prevent and control chronic diseases, we must first understand current practice and develop appropriate strategies for measuring performance. The objectives of this study were to measure capacity and performance of local health departments in diabetes prevention and control and to investigate characteristics associated with performance. In 2005, we conducted a cross-sectional mailed survey of all 85 North Carolina local health departments to assess capacity and performance in diabetes prevention and control based on the 10 Essential Public Health Services and adapted from the Local Public Health System Performance Assessment Instrument. We linked survey responses to county-level data, including data from a national survey of local health departments. Local health departments reported a median of 0.05 full-time equivalent employees in diabetes prevention and 0.1 in control. Performance varied across the 10 Essential Services; activities most commonly reported included providing information to the public and to policy makers (76%), providing diabetes education (58%), and screening (74%). The mean score on a 10-point performance index was 3.5. Characteristics associated with performance were population size, health department size and accreditation status, and diabetes-specific external funding. Performance was not better in localities where the prevalence of diabetes was high or availability of primary care was low. Most North Carolina local health departments had limited capacity to conduct diabetes prevention or control programs in their communities. Diabetes is a major cause of illness and death, yet it is neglected in public health practice. These findings suggest opportunities to enhance local public health practice, particularly through targeted funding and technical assistance.

  4. Which is the optimal risk stratification system for surgically treated localized primary GIST? Comparison of three contemporary prognostic criteria in 171 tumors and a proposal for a modified Armed Forces Institute of Pathology risk criteria.

    PubMed

    Goh, Brian K P; Chow, Pierce K H; Yap, Wai-Ming; Kesavan, Sittampalam M; Song, In-Chin; Paul, Pradeep G; Ooi, Boon-Swee; Chung, Yaw-Fui A; Wong, Wai-Keong

    2008-08-01

    This study aims to validate and compare the performance of the National Institute of Health (NIH) criteria, Huang modified NIH criteria, and Armed Forces Institute of Pathology (AFIP) risk criteria for gastrointestinal stromal tumors (GISTs) in a large series of localized primary GISTs surgically treated at a single institution to determine the ideal risk stratification system for GIST. The clinicopathological features of 171 consecutive patients who underwent surgical resection for GISTs were retrospectively reviewed. Statistical analyses were performed to compare the prognostic value of the three risk criteria by analyzing the discriminatory ability linear trend, homogeneity, monotonicity of gradients, and Akaike information criteria. The median actuarial recurrence-free survival (RFS) for all 171 patients was 70%. On multivariate analyses, size >10 cm, mitotic count >5/50 high-power field, tumor necrosis, and serosal involvement were independent prognostic factors of RFS. All three risk criteria demonstrated a statistically significant difference in the recurrence rate, median actuarial RFS, actuarial 5-year RFS, and tumor-specific death across the different stages. Comparison of the various risk-stratification systems demonstrated that our proposed modified AFIP criteria had the best independent predictive value of RFS when compared with the other systems. The NIH, modified NIH, and AFIP criteria are useful in the prognostication of GIST, and the AFIP risk criteria provided the best prognostication among the three systems for primary localized GIST. However, remarkable prognostic heterogeneity exists in the AFIP high-risk category, and with our proposed modification, this system provides the most accurate prognostic information.

  5. SPM local oxidation nanolithography with active control of cantilever dynamics

    NASA Astrophysics Data System (ADS)

    Nishimura, S.; Takemura, Y.; Shirakashi, J.

    2007-04-01

    Local oxidation nanolithography using scanning probe microscope (SPM) has enabled us to fabricate nanometer-scale oxide wires on material surfaces. Here, we study tapping mode SPM local oxidation experiments for silicon by controlling the dynamic properties of the cantilever. Dependence of feature size of fabricated oxide wires on the amplitude of the cantilever was precisely investigated. The quality factor (Q) was fixed at a natural value of ~500. By enhancing the amplitude of the cantilever, both width and height of fabricated Si oxide wires were decreased. With the variation of the amplitude of the cantilever from 0.5 V to 3.0 V (DC voltage = 22.5 V, scanning speed = 20 nm/s), the feature size of Si oxide wires was well controlled, ranging from 40 nm to 18 nm in width and 2.3 nm to 0.6 nm in height. Standard deviation of width on Si oxide wires formed by tapping mode SPM is around 2.0 nm, which is smaller than that of contact mode Si oxide wires. Furthermore, the variation of the oscillation amplitude of the cantilever does not affect the size uniformity of the wires. These results imply that the SPM local oxidation nanolithography with active control of cantilever dynamics is a useful technique for producing higher controllability on the nanometer-scale fabrication of Si oxide wires.

  6. Investigation of spherical loudspeaker arrays for local active control of sound.

    PubMed

    Peleg, Tomer; Rafaely, Boaz

    2011-10-01

    Active control of sound can be employed globally to reduce noise levels in an entire enclosure, or locally around a listener's head. Recently, spherical loudspeaker arrays have been studied as multiple-channel sources for local active control of sound, presenting the fundamental theory and several active control configurations. In this paper, important aspects of using a spherical loudspeaker array for local active control of sound are further investigated. First, the feasibility of creating sphere-shaped quiet zones away from the source is studied both theoretically and numerically, showing that these quiet zones are associated with sound amplification and poor system robustness. To mitigate the latter, the design of shell-shaped quiet zones around the source is investigated. A combination of two spherical sources is then studied with the aim of enlarging the quiet zone. The two sources are employed to generate quiet zones that surround a rigid sphere, investigating the application of active control around a listener's head. A significant improvement in performance is demonstrated in this case over a conventional headrest-type system that uses two monopole secondary sources. Finally, several simulations are presented to support the theoretical work and to demonstrate the performance and limitations of the system. © 2011 Acoustical Society of America

  7. The Local Control Funding Formula: An Opportunity for Early Childhood & Low-Income Students. Increasing Resources for Early Childhood through the Local Control Funding Formula: A Guide for Early Childhood Advocates

    ERIC Educational Resources Information Center

    Children Now, 2016

    2016-01-01

    According to the new Local Control Funding Formula (LCFF) law, most school districts in the state are responsible for using LCFF funds to improve outcomes for low-income students. Each district has created a Local Control Accountability Plan (LCAP), the funding plan for LCFF. The LCAP is reviewed and revised annually by each district. Early…

  8. The Local Control Funding Formula: An Opportunity for Early Childhood & Dual Language Learners. Increasing Resources for Early Childhood through the Local Control Funding Formula: A Guide for Early Childhood Advocates

    ERIC Educational Resources Information Center

    Children Now, 2016

    2016-01-01

    According to the new Local Control Funding Formula (LCFF) law, most school districts in the state are responsible for using LCFF funds to improve outcomes for English language learners, also known as dual language learners. Each district has created a Local Control Accountability Plan (LCAP), the funding plan for LCFF. The LCAP is reviewed and…

  9. Hypofractionated Proton Boost Combined with External Beam Radiotherapy for Treatment of Localized Prostate Cancer

    PubMed Central

    Johansson, Silvia; Åström, Lennart; Sandin, Fredrik; Isacsson, Ulf; Montelius, Anders; Turesson, Ingela

    2012-01-01

    Proton boost of 20 Gy in daily 5 Gy fractions followed by external beam radiotherapy (EBRT) of 50 Gy in daily 2 Gy fractions were given to 278 patients with prostate cancer with T1b to T4N0M0 disease. Fifty-three percent of the patients received neoadjuvant androgen deprivation therapy (N-ADT). The medium followup was 57 months. The 5-year PSA progression-free survival was 100%, 95%, and 74% for low-, intermediate-, and high-risk patients, respectively. The toxicity evaluation was supported by a patient-reported questionnaire before every consultant visit. Cumulative probability and actuarial prevalence of genitourinary (GU) and gastrointestinal (GI) toxicities are presented according to the RTOG classification. N-ADT did not influence curability. Mild pretreatment GU-symptoms were found to be a strong predictive factor for GU-toxicity attributable to treatment. The actuarial prevalence declined over 3 to 5 years for both GU and GI toxicities, indicating slow resolution of epithelial damage to the genitourinary and gastrointestinal tract. Bladder toxicities rather than gastrointestinal toxicities seem to be dose limiting. More than 5-year followup is necessary to reveal any sign of true progressive late side effects of the given treatment. Hypofractionated proton-boost combined with EBRT is associated with excellent curability of localized PC and acceptable frequencies of treatment toxicity. PMID:22848840

  10. A neo-strategic planning approach to enhance local tobacco control programs.

    PubMed

    Douglas, Malinda R; Carter, Sara Sally R; Wilson, Andrew P; Chan, Andie

    2015-01-01

    Research in tobacco control demonstrating best practices is widely disseminated; however, application at the local level is often difficult. Translating research into practice requires a concerted effort to develop an understanding of the evidence and how it can be applied within diverse contexts. A strategic planning infrastructure was developed to support the translation of evidence-based interventions into community practice. This paper highlights the strategic process of turning "know-what" into "know-how" to facilitate the strategic planning and implementation of tobacco control best practices at the local level. The purpose, people, process, and product strategies of knowledge management and translation provided a framework for the strategic planning infrastructure. The knowledge translation concepts of audience, motivations, and mechanisms were synergized in the neo-strategic planning component design. The participants were 20 community coalitions funded to implement local tobacco control programs. From 2004 to 2011, the strategic planners facilitated a cyclical process to translate research into practice using a trio of integrated tools, skill-building workshops on strategic planning, and grantee-driven technical assistance and consultation. In the short term, the usefulness of the strategic planning components to the programs was measured. The intermediate outcome was the successful movement of the community programs from the planning stage to the implementation stage. The achievement of community-level changes in planned tobacco control efforts was the overall outcome measure for the success of the local coalitions. Seventeen of 20 communities that began the planning process implemented strategic plans. All 17 of the programs implemented evidence-based practices, resulting in numerous tobacco-free policies, increased cessation, and increased support from the media and community. Bridging the gap between research and practice can enhance the practicality

  11. Local knowledge, science, and institutional change: the case of desertification control in Northern China.

    PubMed

    Yang, Lihua

    2015-03-01

    This article studies the influence of local knowledge on the impact of science on institutional change in ecological and environmental management. Based on an empirical study on desertification control in 12 counties in north China, the study found the following major results: (1) although there was a cubic relationship between the extent and effect of local knowledge, local knowledge significantly influenced the impact of science on institutional change; (2) local knowledge took effect mainly through affecting formal laws and regulations, major actors, and methods of desertification control in institutional change but had no significant impact on the types of property rights; and (3) local knowledge enhanced the impact of science on the results of desertification control through affecting the impact of science on institutional change. These findings provide a reference for researchers, policy makers, and practitioners, both in China and in other regions of the world, to further explore the influence of local knowledge on the impact of science on institutional change and the roles of local knowledge or knowledge in institutional change and governance.

  12. Thermal Dose is Related to Duration of Local Control in Canine Sarcomas Undergoing Thermoradiotherapy

    PubMed Central

    Thrall, Donald E.; LaRue, Susan M.; Yu, Daohai; Samulski, Thaddeus; Sanders, Linda; Case, Beth; Rosner, Gary; Azuma, Chieko; Poulson, Jeannie; Pruitt, Amy F.; Stanley, Wilma; Hauck, Marlene L.; Williams, Laurel; Hess, Paul; Dewhirst, Mark W.

    2009-01-01

    Purpose To test that prospective delivery of higher thermal dose is associated with longer tumor control duration. Experimental Design 122 dogs with a heatable soft tissue sarcoma were randomized to receive a low (2–5 CEM43°CT90) or high (20–50 CEM43°CT90) thermal dose in combination with radiotherapy. Most dogs (90%) received 4–6 hyperthermia treatments over 5 weeks. Results In the primary analysis, median (95% CI) duration of local control in the low dose group was 1.2 (0.7–2.1) years versus 1.9 (1.4–3.2) years in the high dose group (logrank p=0.28). The probability (95% CI) of tumor control at one year in the low vs. high dose groups was 0.57 (0.43–0.70) vs. 0.74 (0.62–0.86), respectively. Using multivariable procedure, thermal dose group (p=0.023), total duration of heating (p=0.008), tumor volume (p=0.041) and tumor grade (p=0.027) were significantly related to duration of local tumor control. When correcting for volume, grade and duration of heating, dogs in the low dose group were 2.3 times as likely to experience local failure. Conclusions Thermal dose is directly related to local control duration in irradiated canine sarcomas. Longer heating being associated with shorter local tumor control was unexpected. However, the effect of thermal dose on tumor control was stronger than for heating duration. The heating duration effect is possibly mediated through deleterious effects on tumor oxygenation. These results are the first to show the value of prospectively controlled thermal dose in achieving local tumor control with thermoradiotherapy, and they establish a paradigm for prescribing thermoradiotherapy and writing a thermal prescription. PMID:16033838

  13. Distributed model predictive control for constrained nonlinear systems with decoupled local dynamics.

    PubMed

    Zhao, Meng; Ding, Baocang

    2015-03-01

    This paper considers the distributed model predictive control (MPC) of nonlinear large-scale systems with dynamically decoupled subsystems. According to the coupled state in the overall cost function of centralized MPC, the neighbors are confirmed and fixed for each subsystem, and the overall objective function is disassembled into each local optimization. In order to guarantee the closed-loop stability of distributed MPC algorithm, the overall compatibility constraint for centralized MPC algorithm is decomposed into each local controller. The communication between each subsystem and its neighbors is relatively low, only the current states before optimization and the optimized input variables after optimization are being transferred. For each local controller, the quasi-infinite horizon MPC algorithm is adopted, and the global closed-loop system is proven to be exponentially stable. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

  14. The Local Control Funding Formula: An Opportunity for Early Childhood & Children in Foster Care. Increasing Resources for Early Childhood through the Local Control Funding Formula: A Guide for Early Childhood Advocates

    ERIC Educational Resources Information Center

    Children Now, 2016

    2016-01-01

    According to the new Local Control Funding Formula (LCFF) law, most school districts in California are responsible for using LCFF funds to improve outcomes for children in the foster care system. Each district has created a Local Control Accountability Plan (LCAP), the expenditure plan for LCFF. The LCAP is reviewed and revised annually by each…

  15. The ethical implications of Paul Meehl's work on comparing clinical versus actuarial prediction methods.

    PubMed

    Dawes, Robyn M

    2005-10-01

    Paul E. Meehl's work comparing statistical versus actuarial prediction-and the large body of research that followed by others on the same topic-was mainly theoretical and empirical. Meehl also suggested that this work led to a "practical" conclusion, which was quite strong. The author argues that, in addition, it leads to an ethical conclusion, equally strong. Whether the scientific findings are combined with an overarching ethical principle that the best predictions possible should be made for clients, or whether these findings are framed as delineating what can be done for clients-and that clinicians ought not to attempt to do what they cannot-the conclusion is the same. Whenever statistical prediction rules (SPR's) are available for making a relevant prediction, they should be used in preference to intuition. Any modification of these rules should be systematic and subject to the same type of evaluation originally used to assess the SPR's themselves. It is even possible to develop near-optimal rules in new situations. Providing service that assumes that clinicians "can do better" simply based on self-confidence or plausibility in the absence of evidence that they can actually do so is simply unethical. 2005 Wiley Periodicals, Inc.

  16. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Edwards-Bennett, Sophia M., E-mail: edwards2@mskcc.org; Jacks, Lindsay M.; McCormick, Beryl

    Purpose: Population-based studies have reported that as many of 35% of black women do not undergo radiotherapy (RT) after breast conservation surgery (BCS). The objective of the present study was to determine whether this trend persisted at a large multidisciplinary cancer center, and to identify the factors that predict for noncompliance with RT and determine the outcomes for this subset of patients. Methods and Materials: Between January 2002 and December 2007, 83 black women underwent BCS at Memorial Sloan-Kettering Cancer Center and were therefore eligible for the present study. Of the 83 women, 38 (46%) had Stage I, 38 (46%)more » Stage II, and 7 (8%) Stage III disease. Of the study cohort, 31 (37%) had triple hormone receptor-negative tumors. RT was recommended for 81 (98%) of the 83 patients (median dose, 60 Gy). Results: Of the 81 women, 12 (15%) did not receive the recommended adjuvant breast RT. Nonreceipt of chemotherapy (p = .003) and older age (p = .009) were associated with nonreceipt of RT. With a median follow-up of 70 months, the 3-year local control, locoregional control, recurrence-free survival, disease-free survival, and overall survival rate was 99% (actuarial 5-year rate, 97%), 96% (actuarial 5-year rate, 93%), 95% (actuarial 5-year rate, 92%), 92% (actuarial 5-year rate, 89%), and 95% (actuarial 5-year rate, 91%), respectively. Conclusion: We found a greater rate of utilization adjuvant breast RT (85%) among black women after BCS than has been reported in recent studies, indicating that excellent outcomes are attainable for black women after BCS when care is administered in a multidisciplinary cancer center.« less

  17. Supervisory autonomous local-remote control system design: Near-term and far-term applications

    NASA Technical Reports Server (NTRS)

    Zimmerman, Wayne; Backes, Paul

    1993-01-01

    The JPL Supervisory Telerobotics Laboratory (STELER) has developed a unique local-remote robot control architecture which enables management of intermittent bus latencies and communication delays such as those expected for ground-remote operation of Space Station robotic systems via the TDRSS communication platform. At the local site, the operator updates the work site world model using stereo video feedback and a model overlay/fitting algorithm which outputs the location and orientation of the object in free space. That information is relayed to the robot User Macro Interface (UMI) to enable programming of the robot control macros. The operator can then employ either manual teleoperation, shared control, or supervised autonomous control to manipulate the object under any degree of time-delay. The remote site performs the closed loop force/torque control, task monitoring, and reflex action. This paper describes the STELER local-remote robot control system, and further describes the near-term planned Space Station applications, along with potential far-term applications such as telescience, autonomous docking, and Lunar/Mars rovers.

  18. Controlling Androgen receptor nuclear localization by dendrimer conjugates

    NASA Astrophysics Data System (ADS)

    Wang, Haoyu

    Androgen Receptor (AR) antagonists, such as bicalutamide and flutamide have been used widely in the treatment of prostate cancer. Although initial treatment is effective, prostate cancer cells often acquire antiandrogen resistance with prolonged treatment. AR over-expression and AR mutations contribute to the development of antiandrogen resistant cancer. Second generation antiandrogens such as enzalutamide are more effective and show reduced AR nuclear localization. In this study, derivatives of PAN52, a small molecule antiandrogen previously developed in our lab, were conjugated to the surface of generation 4 and generation 6 PAMAM dendrimers to obtain antiandrogen PAMAM dendrimer conjugates (APDC). APDCs readily enter cells and associate with AR in the cytoplasm. Due to their large size and positive charge, they can not enter the nucleus, thus retaining AR in the cytoplasm. In addition, APDCs are effective in decreasing AR mediated transcription and cell proliferation. APDC is the first AR antagonists that inhibit DHT-induced nuclear localization of AR. By inhibiting AR nuclear localization, APDC represents a new class of antiandrogens that offer an alternative approach to addressing antiandrogen-resistant prostate cancer. Lysine post-translational modification of AR Nuclear Localization Sequence (NLS) has great impact on AR cellular localization. It is of interest to understand which modifications modulate AR translocation into the nucleus. In this study, we prepared dendrimer-based acetyltransferase mimetic (DATM), DATM is able to catalytically acetylate AR in CWR22Rv1 cells, which will be a useful tool for studying AR modification effect on AR cellular localization. Derivatives of DATM, which transfer other chemical groups to AR, can be prepared similarly, and with more dendrimer based AR modification tools prepared in future, we will be able to understand and control AR cellular localization through AR modification.

  19. Local Voltage Control in Distribution Networks: A Game-Theoretic Perspective

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhou, Xinyang; Tian, Jie; Chen, Lijun

    Inverter-based voltage regulation is gaining importance to alleviate emerging reliability and power-quality concerns related to distribution systems with high penetration of photovoltaic (PV) systems. This paper seeks contribution in the domain of reactive power compensation by establishing stability of local Volt/VAr controllers. In lieu of the approximate linear surrogate used in the existing work, the paper establishes existence and uniqueness of an equilibrium point using nonlinear AC power flow model. Key to this end is to consider a nonlinear dynamical system with non-incremental local Volt/VAr control, cast the Volt/VAr dynamics as a game, and leverage the fixed-point theorem as wellmore » as pertinent contraction mapping argument. Numerical examples are provided to complement the analytical results.« less

  20. Containing the Damage: Quality Control of Local Data Production.

    ERIC Educational Resources Information Center

    Blair, Norman A.

    1983-01-01

    The ability of operating departments of an institution to mechanically gather, summarize, and report "local" data is discussed. Problems are outlined that arise when departments have the ability to produce data and do so with rigorous quality control by the institution's central information management organization. (MLW)

  1. Histology-Stratified Tumor Control and Patient Survival After Stereotactic Radiosurgery for Pineal Region Tumors: A Report From the International Gamma Knife Research Foundation.

    PubMed

    Iorio-Morin, Christian; Kano, Hideyuki; Huang, Marshall; Lunsford, L Dade; Simonová, Gabriela; Liscak, Roman; Cohen-Inbar, Or; Sheehan, Jason; Lee, Cheng-Chia; Wu, Hsiu-Mei; Mathieu, David

    2017-11-01

    Pineal region tumors represent a rare and histologically diverse group of lesions. Few studies are available to guide management and the outcomes after stereotactic radiosurgery (SRS). Patients who underwent SRS for a pineal region tumor and for whom at least 6 months of imaging follow-up was available were retrospectively assessed in 5 centers. Data were collected from the medical record and histology level analyses were performed, including actuarial tumor control and survival analyses. A total of 70 patients were treated between 1989 and 2014 with a median follow-up of 47 months. Diagnoses were pineocytoma (37%), pineoblastoma (19%), pineal parenchymal tumor of intermediate differentiation (10%), papillary tumor of the pineal region (9%), germinoma (7%), teratoma (3%), embryonal carcinoma (1%), and unknown (14%). Median prescription dose was 15 Gy at the 50% isodose line. Actuarial local control and survival rates were 81% and 76% at 20 years for pineocytoma, 50% and 56% at 5 years for pineal parenchymal tumor of intermediate differentiation, 27% and 48% at 5 years for pineoblastoma, 33% and 100% at 5 years for papillary tumor of the pineal region, 80% and 80% at 20 years for germinoma, and 61% and 67% at 5 years for tumors of unknown histology. New focal neurological deficit, Parinaud syndrome, and hydrocephalus occurred in 9%, 7%, and 3% of cases, respectively. SRS is a safe modality for the management of pineal region tumors. Its specific role is highly dependent on tumor histology. As such, all efforts should be made to obtain a reliable histologic diagnosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Predictors of Individual Tumor Local Control After Stereotactic Radiosurgery for Non-Small Cell Lung Cancer Brain Metastases

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Garsa, Adam A.; Badiyan, Shahed N.; DeWees, Todd

    2014-10-01

    Purpose: To evaluate local control rates and predictors of individual tumor local control for brain metastases from non-small cell lung cancer (NSCLC) treated with stereotactic radiosurgery (SRS). Methods and Materials: Between June 1998 and May 2011, 401 brain metastases in 228 patients were treated with Gamma Knife single-fraction SRS. Local failure was defined as an increase in lesion size after SRS. Local control was estimated using the Kaplan-Meier method. The Cox proportional hazards model was used for univariate and multivariate analysis. Receiver operating characteristic analysis was used to identify an optimal cutpoint for conformality index relative to local control. Amore » P value <.05 was considered statistically significant. Results: Median age was 60 years (range, 27-84 years). There were 66 cerebellar metastases (16%) and 335 supratentorial metastases (84%). The median prescription dose was 20 Gy (range, 14-24 Gy). Median overall survival from time of SRS was 12.1 months. The estimated local control at 12 months was 74%. On multivariate analysis, cerebellar location (hazard ratio [HR] 1.94, P=.009), larger tumor volume (HR 1.09, P<.001), and lower conformality (HR 0.700, P=.044) were significant independent predictors of local failure. Conformality index cutpoints of 1.4-1.9 were predictive of local control, whereas a cutpoint of 1.75 was the most predictive (P=.001). The adjusted Kaplan-Meier 1-year local control for conformality index ≥1.75 was 84% versus 69% for conformality index <1.75, controlling for tumor volume and location. The 1-year adjusted local control for cerebellar lesions was 60%, compared with 77% for supratentorial lesions, controlling for tumor volume and conformality index. Conclusions: Cerebellar tumor location, lower conformality index, and larger tumor volume were significant independent predictors of local failure after SRS for brain metastases from NSCLC. These results warrant further investigation in a

  3. News focus: Report on state and local air toxics regulatory strategies published by STAPPA/ALAPCO (State and Territorial Air Pollution Program Administrators/Association of Local Air Pollution Control Officials)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1989-12-01

    The report is entitled Toxic Air Pollutants: State and Local Regulatory Strategies - 1989. The 364-page report is the result of a survey of state and local air pollution control agencies, which solicited information on their programs to control air toxics. According to the survey, every state currently has a program to address emissions of air toxics. Additionally, 27 of the 40 local agencies that responded to the survey have, or are developing, air toxics programs. The strategies employed by state and local agencies vary widely, including control technology requirements, risk assessment, acceptable ambient guidelines, or a combination of thesemore » approaches. This is a report summarizing the air toxics control programs currently implemented (or under development) by state and local air pollution control agencies throughout the US. The report is based upon a survey of all 50 states and 220 local air pollution control agencies conducted by the State and Territorial Air Pollution Program Administrators (STAPPA) and the Association of Local Air Pollution Control Officials (ALAPCO). This survey updates one published five years earlier.« less

  4. The Effect of Local Violence on Children’s Attention and Impulse Control

    PubMed Central

    Tirado-Strayer, Nicole; Papachristos, Andrew V.; Raver, C. Cybele

    2012-01-01

    Objectives. We examined whether the burden of violence in a child’s community environment alters the child’s behavior and functioning in the classroom setting. Methods. To identify the effects of local violence, we exploited variation in the timing of local homicides, based on data from the Chicago Police Department, relative to the timing of interview assessments conducted as part of a randomized controlled trial conducted with preschoolers in Head Start programs from 2004–2006, the Chicago School Readiness Project. We compared children’s scores when exposed to recent local violence with scores when no recent violence had occurred to identify causal effects. Results. When children were assessed within a week of a homicide that occurred near their home, they exhibited lower levels of attention and impulse control and lower preacademic skills. The analysis showed strong positive effects of local violence on parental distress, providing suggestive evidence that parental responses may be a likely pathway by which local violence affects young children. Conclusions. Exposure to homicide generates acute psychological distress among caregivers and impairs children’s self-regulatory behavior and cognitive functioning. PMID:23078491

  5. Electric-field control of local ferromagnetism using a magnetoelectric multiferroic.

    PubMed

    Chu, Ying-Hao; Martin, Lane W; Holcomb, Mikel B; Gajek, Martin; Han, Shu-Jen; He, Qing; Balke, Nina; Yang, Chan-Ho; Lee, Donkoun; Hu, Wei; Zhan, Qian; Yang, Pei-Ling; Fraile-Rodríguez, Arantxa; Scholl, Andreas; Wang, Shan X; Ramesh, R

    2008-06-01

    Multiferroics are of interest for memory and logic device applications, as the coupling between ferroelectric and magnetic properties enables the dynamic interaction between these order parameters. Here, we report an approach to control and switch local ferromagnetism with an electric field using multiferroics. We use two types of electromagnetic coupling phenomenon that are manifested in heterostructures consisting of a ferromagnet in intimate contact with the multiferroic BiFeO(3). The first is an internal, magnetoelectric coupling between antiferromagnetism and ferroelectricity in the BiFeO(3) film that leads to electric-field control of the antiferromagnetic order. The second is based on exchange interactions at the interface between a ferromagnet (Co(0.9)Fe(0.1)) and the antiferromagnet. We have discovered a one-to-one mapping of the ferroelectric and ferromagnetic domains, mediated by the colinear coupling between the magnetization in the ferromagnet and the projection of the antiferromagnetic order in the multiferroic. Our preliminary experiments reveal the possibility to locally control ferromagnetism with an electric field.

  6. Electric-field control of local ferromagnetism using a magnetoelectric multiferroic

    NASA Astrophysics Data System (ADS)

    Chu, Ying-Hao; Martin, Lane W.; Holcomb, Mikel B.; Gajek, Martin; Han, Shu-Jen; He, Qing; Balke, Nina; Yang, Chan-Ho; Lee, Donkoun; Hu, Wei; Zhan, Qian; Yang, Pei-Ling; Fraile-Rodríguez, Arantxa; Scholl, Andreas; Wang, Shan X.; Ramesh, R.

    2008-06-01

    Multiferroics are of interest for memory and logic device applications, as the coupling between ferroelectric and magnetic properties enables the dynamic interaction between these order parameters. Here, we report an approach to control and switch local ferromagnetism with an electric field using multiferroics. We use two types of electromagnetic coupling phenomenon that are manifested in heterostructures consisting of a ferromagnet in intimate contact with the multiferroic BiFeO3. The first is an internal, magnetoelectric coupling between antiferromagnetism and ferroelectricity in the BiFeO3 film that leads to electric-field control of the antiferromagnetic order. The second is based on exchange interactions at the interface between a ferromagnet (Co0.9Fe0.1) and the antiferromagnet. We have discovered a one-to-one mapping of the ferroelectric and ferromagnetic domains, mediated by the colinear coupling between the magnetization in the ferromagnet and the projection of the antiferromagnetic order in the multiferroic. Our preliminary experiments reveal the possibility to locally control ferromagnetism with an electric field.

  7. Local Control and Self-Determination: The San Juan Case.

    ERIC Educational Resources Information Center

    Garman, Keats; Jack, Donald

    Rapidly increasing Navajo enrollment in San Juan County, Utah, public schools in the 1960's forced the rural school district to improve educational services to a sizable Navajo population while attempting to preserve local control in the face of changing Indian self-determination policy. The district implemented a Curriculum Development Center, a…

  8. 42 CFR 70.2 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... control. Whenever the Director of the Centers for Disease Control and Prevention determines that the... 42 Public Health 1 2013-10-01 2013-10-01 false Measures in the event of inadequate local control...) are insufficient to prevent the spread of any of the communicable diseases from such State or...

  9. 42 CFR 70.2 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... control. Whenever the Director of the Centers for Disease Control and Prevention determines that the... 42 Public Health 1 2010-10-01 2010-10-01 false Measures in the event of inadequate local control...) are insufficient to prevent the spread of any of the communicable diseases from such State or...

  10. 42 CFR 70.2 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... control. Whenever the Director of the Centers for Disease Control and Prevention determines that the... 42 Public Health 1 2011-10-01 2011-10-01 false Measures in the event of inadequate local control...) are insufficient to prevent the spread of any of the communicable diseases from such State or...

  11. 42 CFR 70.2 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... control. Whenever the Director of the Centers for Disease Control and Prevention determines that the... 42 Public Health 1 2012-10-01 2012-10-01 false Measures in the event of inadequate local control...) are insufficient to prevent the spread of any of the communicable diseases from such State or...

  12. 42 CFR 70.2 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... control. Whenever the Director of the Centers for Disease Control and Prevention determines that the... 42 Public Health 1 2014-10-01 2014-10-01 false Measures in the event of inadequate local control...) are insufficient to prevent the spread of any of the communicable diseases from such State or...

  13. Temporary traffic control handbook for local agencies : tech transfer summary.

    DOT National Transportation Integrated Search

    2016-03-01

    The updated handbook provides local agencies with uniform standards for temporary traffic control. The handbook includes sample layouts that can be used on various projects. Having sample layouts will provide a cost savings to agencies because the de...

  14. 77 FR 10786 - Submission of Information Collection for OMB Review; Comment Request; Annual Financial and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ... Request; Annual Financial and Actuarial Information Reporting AGENCY: Pension Benefit Guaranty Corporation..., of its collection of information for annual financial and actuarial information reporting under 29... Act of 1974 (ERISA) requires each member of a controlled group to submit financial and actuarial...

  15. Should Aggressive Surgical Local Control Be Attempted in All Patients with Metastatic or Pelvic Ewing's Sarcoma?

    PubMed Central

    Thorpe, Steven W.; Weiss, Kurt R.; Goodman, Mark A.; Heyl, Alma E.; McGough, Richard L.

    2012-01-01

    In previous reports, patients with Ewing's sarcoma received radiation therapy (XRT) for definitive local control because metastatic disease and pelvic location were thought to preclude aggressive local treatment. We sought to determine if single-site metastatic disease should be treated differently from multicentric-metastatic disease. We also wanted to reinvestigate the impact of XRT, pelvic location, and local recurrence on outcomes. Our results demonstrated a significant difference in overall survival (OS) between patients with either localized disease or a single-metastatic site and patients with multicentric-metastatic disease (P = 0.004). Local control was also found to be an independent predictor of outcomes as demonstrated by a significant difference in OS between those with and without local recurrence (P = 0.001). Axial and pelvic location did not predict a decreased OS. Based on these results, we concluded that pelvic location and the diagnosis of metastatic disease at diagnosis should not preclude aggressive local control, except in cases of multicentric-metastatic disease. PMID:22550427

  16. Exeresis and Brachytherapy as Salvage Treatment for Local Recurrence After Conservative Treatment for Breast Cancer: Results of a Ten-Year Pilot Study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Guix, Benjamin, E-mail: bguix@imor.or; Lejarcegui, Jose Antonio; Tello, Jose Ignacio

    2010-11-01

    Purpose: To analyze the long-term results of a pilot study assessing excision and brachytherapy as salvage treatment for local recurrence after conservative treatment of breast cancer. Methods and Materials: Between December 1990 and March 2001, 36 patients with breast-only recurrence less than 3 cm in diameter after conservative treatment for Stage I or II breast carcinoma were treated with local excision followed by high-dose rate brachytherapy implants (30 Gy in 12 fractions over a period of 5 days). No patient was lost to follow-up. Special attention was paid to local, regional, or distant recurrences; survival; cosmesis; and early and latemore » side effects. Results: All patients completed treatment. During follow-up (range, 1-13 years), 8 patients presented metastases (2 regional and 6 distant) as their first site of failure, 1 had a differed local recurrence, and 1 died of the disease. Actuarial results at 10 years were as follows: local control, 89.4%; disease-free survival, 64.4%; and survival, 96.7%. Cosmetic results were satisfactory in 90.4%. No patient had Grade 3 or 4 early or late complications. Of the 11 patients followed up for at least 10 years, all but 1 still had their breast in place at the 10-year stage. Conclusions: High-dose rate brachytherapy is a safe, effective treatment for small-size, low-risk local recurrence after local excision in conservatively treated patients. The dose of 30 Gy of high-dose rate brachytherapy (12 fractions over a period of 5 days twice daily) was well tolerated. The excellent results support the use of breast preservation as salvage treatment in selected patients with local recurrence after conservative treatment for breast cancer.« less

  17. A clinical study of 407 cases of nasopharyngeal carcinoma in Hong Kong

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Teo, P.; Tsao, S.Y.; Shiu, W.

    Four hundred and seven cases of nasopharyngeal carcinoma were analyzed retrospectively; 403/407 were evaluable for recurrence and survival. Parapharyngeal boost significantly decreased local recurrences in parapharyngeal diseases without base of skull involvement (T2p), but not with base of skull involvement (T3p). Enhanced local control of T2p with boost was significant without neoadjuvant chemotherapy. Tumors localized within the nasopharynx (T1) and tumors with nasal involvement (T2n) suffering from local persistences after external radiation therapy were treated with an intracavitary afterloading method. They had survival and recurrence rates comparable to complete responders to external radiation therapy. Patients with bulky cervical nodes (maximalmore » diameter greater than or equal to 4 cm, N1-N3), treated with neoadjuvant chemotherapy with cis-diamminedichloroplatinum II and 5-fluorouracil, had a regional failure rate, distant metastasis rate, actuarial survival rate, and disease-free survival rate comparable to those with smaller nodes treated with external radiation therapy alone. A simple modification of the Ho's classification by regrouping the T-stages into 'early T-stages' and 'advanced T-stages' and by combining the N1 and the N2 has greatly increased the power of the system in predicting local recurrence and distant metastasis, respectively. There was an overall improvement of the actuarial survival rate and disease-free survival rate over the historical control, and its significance is discussed.« less

  18. Prototyping the E-ELT M1 local control system communication infrastructure

    NASA Astrophysics Data System (ADS)

    Argomedo, J.; Kornweibel, N.; Grudzien, T.; Dimmler, M.; Andolfato, L.; Barriga, P.

    2016-08-01

    The primary mirror of the E-ELT is composed of 798 hexagonal segments of about 1.45 meters across. Each segment can be moved in piston and tip-tilt using three position actuators. Inductive edge sensors are used to provide feedback for global reconstruction of the mirror shape. The E-ELT M1 Local Control System will provide a deterministic infrastructure for collecting edge sensor and actuators readings and distribute the new position actuators references while at the same time providing failure detection, isolation and notification, synchronization, monitoring and configuration management. The present paper describes the prototyping activities carried out to verify the feasibility of the E-ELT M1 local control system communication architecture design and assess its performance and potential limitations.

  19. Local Voltage Control in Distribution Networks: A Game-Theoretic Perspective: Preprint

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhou, Xinyang; Tian, Jie; Chen, Lijun

    Inverter-based voltage regulation is gaining importance to alleviate emerging reliability and power-quality concerns related to distribution systems with high penetration of photovoltaic (PV) systems. This paper seeks contribution in the domain of reactive power compensation by establishing stability of local Volt/VAr controllers. In lieu of the approximate linear surrogate used in the existing work, the paper establishes existence and uniqueness of an equilibrium point using nonlinear AC power flow model. Key to this end is to consider a nonlinear dynamical system with non-incremental local Volt/VAr control, cast the Volt/VAr dynamics as a game, and leverage the fixed-point theorem as wellmore » as pertinent contraction mapping argument. Numerical examples are provided to complement the analytical results.« less

  20. Assessing local planning to control groundwater depletion: California as a microcosm of global issues

    NASA Astrophysics Data System (ADS)

    Nelson, Rebecca L.

    2012-01-01

    Groundwater pumping has caused excessive groundwater depletion around the world, yet regulating pumping remains a profound challenge. California uses more groundwater than any other U.S. state, and serves as a microcosm of the adverse effects of pumping felt worldwide—land subsidence, impaired water quality, and damaged ecosystems, all against the looming threat of climate change. The state largely entrusts the control of depletion to the local level. This study uses internationally accepted water resources planning theories systematically to investigate three key aspects of controlling groundwater depletion in California, with an emphasis on local-level action: (a) making decisions and engaging stakeholders; (b) monitoring groundwater; and (c) using mandatory, fee-based and voluntary approaches to control groundwater depletion (e.g., pumping restrictions, pumping fees, and education about water conservation, respectively). The methodology used is the social science-derived technique of content analysis, which involves using a coding scheme to record these three elements in local rules and plans, and State legislation, then analyzing patterns and trends. The study finds that Californian local groundwater managers rarely use, or plan to use, mandatory and fee-based measures to control groundwater depletion. Most use only voluntary approaches or infrastructure to attempt to reduce depletion, regardless of whether they have more severe groundwater problems, or problems which are more likely to have irreversible adverse effects. The study suggests legal reforms to the local groundwater planning system, drawing upon its empirical findings. Considering the content of these recommendations may also benefit other jurisdictions that use a local groundwater management planning paradigm.

  1. Stereotactic Fractionated Radiotherapy in the Treatment of Juxtapapillary Choroidal Melanoma: The McGill University Experience

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Al-Wassia, Rolina; Dal Pra, Alan; Shun, Kitty

    2011-11-15

    Purpose: To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma. Methods and Materials: We performed a retrospective review of 50 consecutive patients diagnosed with juxtapapillary choroidal melanoma and treated with linear accelerator-based stereotactic fractionated radiotherapy between April 2003 and December 2009. Patients with small to medium sized lesions (Collaborative Ocular Melanoma Study classification) located within 2 mm of the optic disc were included. The prescribed radiation dose was 60 Gy in 10 fractions. The primary endpoints included local control, enucleation-free survival, and complication rates. Results: The median follow-up was 29 months (range,more » 1-77 months). There were 31 males and 29 females, with a median age of 69 years (range, 30-92 years). Eighty-four percent of the patients had medium sized lesions, and 16% of patients had small sized lesions. There were four cases of local progression (8%) and three enucleations (6%). Actuarial local control rates at 2 and 5 years were 93% and 86%, respectively. Actuarial enucleation-free survival rates at 2 and 5 years were 94% and 84%, respectively. Actuarial complication rates at 2 and 5 years were 33% and 88%, respectively, for radiation-induced retinopathy; 9.3% and 46.9%, respectively, for dry eye; 12% and 53%, respectively, for cataract; 30% and 90%, respectively, for visual loss [Snellen acuity (decimal equivalent), <0.1]; 11% and 54%, respectively, for optic neuropathy; and 18% and 38%, respectively, for neovascular glaucoma. Conclusions: Linear accelerator-based stereotactic fractionated radiotherapy using 60 Gy in 10 fractions is safe and has an acceptable toxicity profile. It has been shown to be an effective noninvasive treatment for juxtapapillary choroidal melanomas.« less

  2. Local Control of Aldosterone Production and Primary Aldosteronism.

    PubMed

    Lalli, Enzo; Barhanin, Jacques; Zennaro, Maria-Christina; Warth, Richard

    2016-03-01

    Primary aldosteronism (PA) is caused by excessive production of aldosterone by the adrenal cortex and is determined by a benign aldosterone-producing adenoma (APA) in a significant proportion of cases. Local mechanisms, as opposed to circulatory ones, that control aldosterone production in the adrenal cortex are particularly relevant in the physiopathological setting and in the pathogenesis of PA. A breakthrough in our understanding of the pathogenetic mechanisms in APA has been the identification of somatic mutations in genes controlling membrane potential and intracellular calcium concentrations. However, recent data show that the processes of nodule formation and aldosterone hypersecretion can be dissociated in pathological adrenals and suggest a model envisaging different molecular events for the pathogenesis of APA. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Strategies implemented by 20 local tobacco control agencies to promote smoke-free recreation areas, California, 2004-2007.

    PubMed

    Satterlund, Travis D; Cassady, Diana; Treiber, Jeanette; Lemp, Cathy

    2011-09-01

    Since 2000, local jurisdictions in California have enacted hundreds of policies and ordinances in an effort to protect their citizens from the harmful effects of secondhand smoke. We evaluated strategies used by state-funded local tobacco control programs to enact local smoke-free policies involving outdoor recreational spaces. The Tobacco Control Evaluation Center analyzed 23 final evaluation reports that discussed adopting local smoke-free policies in outdoor recreational facilities in California. These reports were submitted for the 2004 through 2007 funding period by local tobacco control organizations to the California Department of Public Health, Tobacco Control Program. We used a comparative technique whereby we coded passages and compared them by locale and case, focusing on strategies that led to the enactment of smoke-free policies. Our analysis found the following 6 strategies to be the most effective: 1) having a "champion" who helps to carry an objective forward, 2) tapping into a pool of potential youth volunteers, 3) collecting and using local data as a persuasive tool, 4) educating the community in smoke-free policy efforts, 5) working strategically in the local political climate, and 6) framing the policy appropriately. These strategies proved effective regardless of whether policies were voluntary, administrative, or legislative. Successful policy enactment required a strong foundation of agency funding and an experienced and committed staff. These results should be relevant to other tobacco control organizations that are attempting to secure local smoke-free policy.

  4. Real-Time Local Volt/VAR Control Under External Disturbances with High PV Penetration

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Singhal, A.; Ajjarapu, V.; Fuller, Jason C.

    Volt/var control (VVC) of smart PV inverter is becoming one of the most popular solutions to address the voltage challenges associated with high PV penetration. This work focuses on the local droop VVC recommended by the grid integration standards IEEE1547, rule21 and addresses their major challenges i.e. appropriate parameters selection under changing conditions, and the control being vulnerable to instability (or voltage oscillations) and significant steady state error (SSE). This is achieved by proposing a two-layer local real-time adaptive VVC that has two major features i.e. a) it is able to ensure both low SSE and control stability simultaneously withoutmore » compromising either; and b) it dynamically adapts its parameters to ensure good performance in a wide range of external disturbances such as sudden cloud cover, cloud intermittency, and substation voltage changes. A theoretical analysis and convergence proof of the proposed control is also discussed. The proposed control is implementation friendly as it fits well within the integration standard framework and depends only on the local bus information. Furthermore, the performance is compared with the existing droop VVC methods in several scenarios on a large unbalanced 3-phase feeder with detailed secondary side modeling.« less

  5. Real-Time Local Volt/VAR Control Under External Disturbances with High PV Penetration

    DOE PAGES

    Singhal, A.; Ajjarapu, V.; Fuller, Jason C.; ...

    2018-05-28

    Volt/var control (VVC) of smart PV inverter is becoming one of the most popular solutions to address the voltage challenges associated with high PV penetration. This work focuses on the local droop VVC recommended by the grid integration standards IEEE1547, rule21 and addresses their major challenges i.e. appropriate parameters selection under changing conditions, and the control being vulnerable to instability (or voltage oscillations) and significant steady state error (SSE). This is achieved by proposing a two-layer local real-time adaptive VVC that has two major features i.e. a) it is able to ensure both low SSE and control stability simultaneously withoutmore » compromising either; and b) it dynamically adapts its parameters to ensure good performance in a wide range of external disturbances such as sudden cloud cover, cloud intermittency, and substation voltage changes. A theoretical analysis and convergence proof of the proposed control is also discussed. The proposed control is implementation friendly as it fits well within the integration standard framework and depends only on the local bus information. Furthermore, the performance is compared with the existing droop VVC methods in several scenarios on a large unbalanced 3-phase feeder with detailed secondary side modeling.« less

  6. Cryoablation of Bone Metastases from Renal Cell Carcinoma for Local Tumor Control.

    PubMed

    Gardner, Carly S; Ensor, Joe E; Ahrar, Kamran; Huang, Steven Y; Sabir, Sharjeel H; Tannir, Nizar M; Lewis, Valerae O; Tam, Alda L

    2017-11-15

    Patients with bone metastases from renal cell carcinoma often are not surgical candidates and have a poor prognosis. There are limited data on the use of cryoablation as a locoregional therapy for bone metastases. Our objective was to assess the local tumor-control rate following cryoablation of bone metastases in the setting of renal cell carcinoma. We retrospectively reviewed the medical records of patients with metastatic renal cell carcinoma who underwent cryoablation for bone metastases between 2007 and 2014. We excluded patients if the intent of treatment was for pain palliation only, if cryoablation was performed without an attempt for complete tumor control (cytoreduction), or if the patient had no further follow-up beyond the cryoablation procedure. We recorded patient demographics, procedural variables, and complications. Cross-sectional imaging and clinical follow-up were reviewed to determine disease recurrence. The median overall survival and recurrence-free survival were determined using the Kaplan-Meier method. Forty patients (30 male and 10 female) with 50 bone metastases were included for analysis. The mean patient age was 62 years (range, 47 to 82 years). The median follow-up was 35 months (95% confidence interval [CI], 22.7 to 74.4 months). Twenty-five (62.5%) of the 40 patients had oligometastatic disease, defined as ≤5 metastases at the time of ablation. The mean tumor size was 3.4 ± 1.5 cm. Metastases in the pelvic region represented 68% of the treated tumors (34 of 50). The overall local tumor-control rate per lesion was 82% (41 of 50). Patients with oligometastatic disease experienced better local tumor control (96% [24 of 25]) compared with patients who had >5 metastases (53.3% [8 of 15]) (p = 0.001). The local tumor-control rate was better for lesions for which a larger mean difference between maximum ice-ball diameter and maximum lesion diameter was achieved (2.2 ± 0.9 cm for those without recurrence versus 1.35 ± 1.2 cm for those

  7. Optimal control to modelling motorcycle rider steering: local versus global coordinate systems in rider preview

    NASA Astrophysics Data System (ADS)

    Rowell, S.; Popov, A. A.; Meijaard, J. P.

    2010-04-01

    The response of a motorcycle is heavily dependent on the rider's control actions, and consequently a means of replicating the rider's behaviour provides an important extension to motorcycle dynamics. The primary objective here is to develop effective path-following simulations and to understand how riders control motorcycles. Optimal control theory is applied to the tracking of roadway by a motorcycle, using a non-linear motorcycle model operating in free control by steering torque input. A path-following controller with road preview is designed by minimising tracking errors and control effort. Tight controls with high weightings on performance and loose controls with high weightings on control power are defined. Special attention is paid to the modelling of multipoint preview in local and global coordinate systems. The controller model is simulated over a standard single lane-change manoeuvre. It is argued that the local coordinates point of view is more representative of the way that a human rider operates and interprets information. The simulations suggest that for accurate path following, using optimal control, the problem must be solved by the local coordinates approach in order to achieve accurate results with short preview horizons. Furthermore, some weaknesses of the optimal control approach are highlighted here.

  8. The influence of diabetic peripheral neuropathy on local postural muscle and central sensory feedback balance control.

    PubMed

    Toosizadeh, Nima; Mohler, Jane; Armstrong, David G; Talal, Talal K; Najafi, Bijan

    2015-01-01

    Poor balance control and increased fall risk have been reported in people with diabetic peripheral neuropathy (DPN). Traditional body sway measures are unable to describe underlying postural control mechanism. In the current study, we used stabilogram diffusion analysis to examine the mechanism under which balance is altered in DPN patients under local-control (postural muscle control) and central-control (postural control using sensory cueing). DPN patients and healthy age-matched adults over 55 years performed two 15-second Romberg balance trials. Center of gravity sway was measured using a motion tracker system based on wearable inertial sensors, and used to derive body sway and local/central control balance parameters. Eighteen DPN patients (age = 65.4±7.6 years; BMI = 29.3±5.3 kg/m2) and 18 age-matched healthy controls (age = 69.8±2.9; BMI = 27.0±4.1 kg/m2) with no major mobility disorder were recruited. The rate of sway within local-control was significantly higher in the DPN group by 49% (healthy local-controlslope = 1.23±1.06×10-2 cm2/sec, P<0.01), which suggests a compromised local-control balance behavior in DPN patients. Unlike local-control, the rate of sway within central-control was 60% smaller in the DPN group (healthy central-controlslope-Log = 0.39±0.23, P<0.02), which suggests an adaptation mechanism to reduce the overall body sway in DPN patients. Interestingly, significant negative correlations were observed between central-control rate of sway with neuropathy severity (rPearson = 0.65-085, P<0.05) and the history of diabetes (rPearson = 0.58-071, P<0.05). Results suggest that in the lack of sensory feedback cueing, DPN participants were highly unstable compared to controls. However, as soon as they perceived the magnitude of sway using sensory feedback, they chose a high rigid postural control strategy, probably due to high concerns for fall, which may increase the energy cost during extended period of standing; the adaptation mechanism

  9. The influence of mechanical vibration on local and central balance control.

    PubMed

    Ehsani, Hossein; Mohler, Jane; Marlinski, Vladimir; Rashedi, Ehsan; Toosizadeh, Nima

    2018-04-11

    Fall prevention has an indispensable role in enhancing life expectancy and quality of life among older adults. The first step to prevent falls is to devise reliable methods to identify individuals at high fall risk. The purpose of the current study was to assess alterations in local postural muscle and central sensory balance control mechanisms due to low-frequency externally applied vibration among elders at high fall risk, in comparison with healthy controls, as a potential tool for assessing fall risk. Three groups of participants were recruited: healthy young (n = 10; age = 23 ± 2 years), healthy elders (n = 10; age = 73 ± 3 years), and elders at high fall risk (n = 10; age = 84 ± 9 years). Eyes-open and eyes-closed upright standing balance performance was measured with no vibration, 30 Hz, and 40 Hz vibration of Gastrocnemius muscles. When vibratory stimulation was applied, changes in local-control performance manifested significant differences among the groups (p < 0.01). On average between conditions, we observed 97% and 92% less change among high fall risk participants when compared to healthy young and older adults, respectively. On the other hand, vibration-induced changes in the central-control performance were not significant between groups (p ≥ 0.19). Results suggest that local-control deficits are responsible for balance behavior alterations among elders at high fall risk and healthy individuals. This observation may be attributable to deterioration of short-latency reflexive loop in elders at high fall risk. On the other hand, we could not ascribe the balance alterations to problems related to central nervous system performance or long-latency responses. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. An integrative model of the cardiac ventricular myocyte incorporating local control of Ca2+ release.

    PubMed Central

    Greenstein, Joseph L; Winslow, Raimond L

    2002-01-01

    The local control theory of excitation-contraction (EC) coupling in cardiac muscle asserts that L-type Ca(2+) current tightly controls Ca(2+) release from the sarcoplasmic reticulum (SR) via local interaction of closely apposed L-type Ca(2+) channels (LCCs) and ryanodine receptors (RyRs). These local interactions give rise to smoothly graded Ca(2+)-induced Ca(2+) release (CICR), which exhibits high gain. In this study we present a biophysically detailed model of the normal canine ventricular myocyte that conforms to local control theory. The model formulation incorporates details of microscopic EC coupling properties in the form of Ca(2+) release units (CaRUs) in which individual sarcolemmal LCCs interact in a stochastic manner with nearby RyRs in localized regions where junctional SR membrane and transverse-tubular membrane are in close proximity. The CaRUs are embedded within and interact with the global systems of the myocyte describing ionic and membrane pump/exchanger currents, SR Ca(2+) uptake, and time-varying cytosolic ion concentrations to form a model of the cardiac action potential (AP). The model can reproduce both the detailed properties of EC coupling, such as variable gain and graded SR Ca(2+) release, and whole-cell phenomena, such as modulation of AP duration by SR Ca(2+) release. Simulations indicate that the local control paradigm predicts stable APs when the L-type Ca(2+) current is adjusted in accord with the balance between voltage- and Ca(2+)-dependent inactivation processes as measured experimentally, a scenario where common pool models become unstable. The local control myocyte model provides a means for studying the interrelationship between microscopic and macroscopic behaviors in a manner that would not be possible in experiments. PMID:12496068

  11. Adaptive and Optimal Control of Stochastic Dynamical Systems

    DTIC Science & Technology

    2015-09-14

    Advances in Statistics, Probability and Actuarial Sciences , Vol. 1, World Scientific, 2012, 451- 463. [4] T. E. Duncan and B. Pasik-Duncan, A...S. N. Cohen, T. K. Siu and H. Yang) Advances in Statistics, Probability and Actuarial Sciences , Vol. 1, World Scientific, 2012, 451-463. 4. T. E...games with gen- eral noise processes, Models and Methods in Economics and Management Science : Essays in Honor of Charles S. Tapiero, (eds. F. El

  12. Radiation Therapy for Control of Soft-Tissue Sarcomas Resected With Positive Margins

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    DeLaney, Thomas F.; Kepka, Lucyna; Goldberg, Saveli I.

    Purpose: Positive margins (PM) remain after surgery in some soft-tissue sarcoma (STS) patients. We investigated the efficacy of radiation therapy (RT) in STS patients with PM. Methods and Materials: A retrospective chart review was performed on 154 patients with STS at various anatomic sites with PM, defined as tumor on ink, who underwent RT with curative intent between 1970 and 2001. Local control (LC), disease-free survival (DFS), and overall survival (OS) rates were evaluated by univariate (log-rank) and multivariate analysis of prognostic and treatment factors. Results: At 5 years, actuarial LC, DFS, and OS rates were: 76%, 46.7%, and 65.2%,more » respectively. LC was highest with extremity lesions (p < 0.01), radiation dose >64 Gy (p < 0.05), microscopically (vs. grossly visible) positive margin (p = 0.03), and superficial lesions (p = 0.05). Patients receiving >64 Gy had higher 5-year LC, DFS, and OS rates of 85%, 52.1%, and 67.8% vs. 66.1%, 41.8%, and 62.9% if {<=}64 Gy, p < 0.04. OS was worse in patients with G2/G3 tumors with local failure (LF), p < 0.001. Other known prognostic factors, including grade, stage, size, and age (>50), also significantly influenced OS. By multivariate analysis, the best predictors of LC were site (extremity vs. other), p < 0.01 and dose (>64 vs. {<=}64 Gy), p < 0.05; the best predictors for OS were size, p < 0.001, gross vs. microscopic PM, p < 0.05, and LF, p < 0.01. Conclusion: Local control is achieved in most PM STS patients undergoing RT. Doses >64 Gy, superficial location, and extremity site are associated with improved LC. OS is worse in patients with tumors with lesions >5 cm, grossly positive margins, and after local failure.« less

  13. Stereotactic radiotherapy following surgery for brain metastasis: Predictive factors for local control and radionecrosis.

    PubMed

    Doré, M; Martin, S; Delpon, G; Clément, K; Campion, L; Thillays, F

    2017-02-01

    To evaluate local control and adverse effects after postoperative hypofractionated stereotactic radiosurgery in patients with brain metastasis. We reviewed patients who had hypofractionated stereotactic radiosurgery (7.7Gy×3 prescribed to the 70% isodose line, with 2mm planning target volume margin) following resection from March 2008 to January 2014. The primary endpoint was local failure defined as recurrence within the surgical cavity. Secondary endpoints were distant failure rates and the occurrence of radionecrosis. Out of 95 patients, 39.2% had metastatic lesions from a non-small cell lung cancer primary tumour. The median Graded Prognostic Assessment score was 3 (48% of patients). One-year local control rates were 84%. Factors associated with improved local control were no cavity enhancement on pre-radiation MRI (P<0.00001), planning target volume less than 12cm 3 (P=0.005), Graded Prognostic Assessment score 2 or above (P=0.009). One-year distant cerebral control rates were 56%. Thirty-three percent of patients received whole brain radiation therapy. Histologically proven radionecrosis of brain tissue occurred in 7.2% of cases. The size of the preoperative lesion and the volume of healthy brain tissue receiving 21Gy (V 21 ) were both predictive of the incidence of radionecrosis (P=0.010 and 0.036, respectively). Adjuvant hypofractionated stereotactic radiosurgery to the postoperative cavity in patients with brain metastases results in excellent local control in selected patients, helps delay the use of whole brain radiation, and is associated with a relatively low risk of radionecrosis. Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  14. Seizing the Moment for Transformation: California's Local Control Funding Formula

    ERIC Educational Resources Information Center

    Miles, Karen Hawley; Feinberg, Randi

    2014-01-01

    In 2013 California adopted a new funding formula that includes a significant reinvestment in public education after years of budget cuts. The new law allocates funds differently, directing more resources to students with higher needs and providing more local control and greater transparency. This revolutionary change presents California districts…

  15. A Preliminary Analysis of California's New Local Control Funding Formula

    ERIC Educational Resources Information Center

    Wolf, Rebecca; Sands, Janelle

    2016-01-01

    California recently overhauled its K-12 public education finance system. Enacted in 2013, the Local Control Funding Formula (LCFF) replaced California's 40-year-old funding formula. The LCFF increases district officials' fiscal flexibility; provides more resources to districts serving larger proportions of low-income, English learner (EL), and…

  16. Tumor Control Outcomes After Hypofractionated and Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases From Renal Cell Carcinoma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zelefsky, Michael J., E-mail: zelefskm@mskcc.org; Greco, Carlo; Motzer, Robert

    2012-04-01

    Purpose: To report tumor local progression-free outcomes after treatment with single-dose, image-guided, intensity-modulated radiotherapy and hypofractionated regimens for extracranial metastases from renal cell primary tumors. Patients and Methods: Between 2004 and 2010, 105 lesions from renal cell carcinoma were treated with either single-dose, image-guided, intensity-modulated radiotherapy to a prescription dose of 18-24 Gy (median, 24) or hypofractionation (three or five fractions) with a prescription dose of 20-30 Gy. The median follow-up was 12 months (range, 1-48). Results: The overall 3-year actuarial local progression-free survival for all lesions was 44%. The 3-year local progression-free survival for those who received a highmore » single-dose (24 Gy; n = 45), a low single-dose (<24 Gy; n = 14), or hypofractionation regimens (n = 46) was 88%, 21%, and 17%, respectively (high single dose vs. low single dose, p = .001; high single dose vs. hypofractionation, p < .001). Multivariate analysis revealed the following variables were significant predictors of improved local progression-free survival: 24 Gy dose compared with a lower dose (p = .009) and a single dose vs. hypofractionation (p = .008). Conclusion: High single-dose, image-guided, intensity-modulated radiotherapy is a noninvasive procedure resulting in high probability of local tumor control for metastatic renal cell cancer generally considered radioresistant according to the classic radiobiologic ranking.« less

  17. Pro-Inflammatory cytokines increases hepatocellular carcinoma cells thermotolerance: Evidence of how local inflammation may negatively impact radiofrequency ablation local control rates

    PubMed Central

    Douglas, Wade G.; Wang, Yangping; Gibbs, John F.; Tracy, Erin; Kuvshinoff, Boris; Huntoon, Kristin; Baumann, Heinz

    2008-01-01

    Background Hepatocellular carcinomas (HCC) associated with inflammation that undergo radiofrequency ablation (RFA) appear to have poorer local control rates. Little is known of how mediators of inflammation influence HCC cellular thermotolerance which in part is mediated by heat shock protein 70 (HSP 70). This study determines how inflammatory mediators effect cellular thermotolerance and provides insight into how associated inflammation may impact HCC RFA local control rates. Methods HepG2 cell lines were cultured in control medium (CM) or CM containing conditioned medium of endotoxin-activated macrophage (CMM). Serial dilutions of CMM established microenvironments approximating low, medium and high CMM. All groups underwent a heat shock challenge (HSC) at 45° C for 10 minutes. Western blot, northern blot, densometric analysis, along with Thymidine and clonagenic assays determined how inflammation influenced multiple biologic endpoints. Results Cells cultured in low CMM, expressed significantly more HSP 70 RNA and protein compared to control cells after HSC. The cells also had a higher proliferative and survival rate after HSC compared to control cells. Medium CMM cultured cells had no significant difference in HSP 70 RNA and protein production or proliferation and survival rates after HSC, compared to CM cultured cells. AT high CMM the inhibitory effects of inflammatory mediators prevailed, all the measured endpoints were significantly less compared to CM cultured cells. Conclusions This study demonstrates that inflammation can alter the responsiveness of HCC cells to a HSC in a dose dependent manner. This study supports the clinical observation that HCC associated with chronic inflammation have worse RFA local control rates. PMID:18262552

  18. Long-Term Outcome and Morbidity After Treatment With Accelerated Radiotherapy and Weekly Cisplatin for Locally Advanced Head-and-Neck Cancer: Results of a Multidisciplinary Late Morbidity Clinic

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ruetten, Heidi, E-mail: h.rutten@rther.umcn.nl; Pop, Lucas A.M.; Janssens, Geert O.R.J.

    2011-11-15

    Purpose: To evaluate the long-term outcome and morbidity after intensified treatment for locally advanced head-and-neck cancer. Methods and Materials: Between May 2003 and December 2007, 77 patients with Stage III to IV head-and-neck cancer were treated with curative intent. Treatment consisted of accelerated radiotherapy to a dose of 68 Gy and concurrent cisplatin. Long-term survivors were invited to a multidisciplinary outpatient clinic for a comprehensive assessment of late morbidity with special emphasis on dysphagia, including radiological evaluation of swallowing function in all patients. Results: Compliance with the treatment protocol was high, with 87% of the patients receiving at least fivemore » cycles of cisplatin and all but 1 patient completing the radiotherapy as planned. The 5-year actuarial disease-free survival and overall survival rates were 40% and 47%, respectively. Locoregional recurrence-free survival at 5 years was 61%. The 5-year actuarial rates of overall late Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) Grade 3 and Grade 4 toxicity were 52% and 25% respectively. Radiologic evaluation after a median follow-up of 44 months demonstrated impaired swallowing in 57% of the patients, including 23% with silent aspiration. Subjective assessment using a systematic scoring system indicated normalcy of diet in only 15.6% of the patients. Conclusion: This regimen of accelerated radiotherapy with weekly cisplatin produced favorable tumor control rates and survival rates while compliance was high. However, comprehensive assessment by a multidisciplinary team of medical and paramedical specialists revealed significant long-term morbidity in the majority of the patients, with dysphagia being a major concern.« less

  19. Induced seismicity closed-form traffic light system for actuarial decision-making during deep fluid injections.

    PubMed

    Mignan, A; Broccardo, M; Wiemer, S; Giardini, D

    2017-10-19

    The rise in the frequency of anthropogenic earthquakes due to deep fluid injections is posing serious economic, societal, and legal challenges to many geo-energy and waste-disposal projects. Existing tools to assess such problems are still inherently heuristic and mostly based on expert elicitation (so-called clinical judgment). We propose, as a complementary approach, an adaptive traffic light system (ATLS) that is function of a statistical model of induced seismicity. It offers an actuarial judgement of the risk, which is based on a mapping between earthquake magnitude and risk. Using data from six underground reservoir stimulation experiments, mostly from Enhanced Geothermal Systems, we illustrate how such a data-driven adaptive forecasting system could guarantee a risk-based safety target. The proposed model, which includes a linear relationship between seismicity rate and flow rate, as well as a normal diffusion process for post-injection, is first confirmed to be representative of the data. Being integrable, the model yields a closed-form ATLS solution that is both transparent and robust. Although simulations verify that the safety target is consistently ensured when the ATLS is applied, the model from which simulations are generated is validated on a limited dataset, hence still requiring further tests in additional fluid injection environments.

  20. Quantification of local and global benefits from air pollution control in Mexico City.

    PubMed

    Mckinley, Galen; Zuk, Miriam; Höjer, Morten; Avalos, Montserrat; González, Isabel; Iniestra, Rodolfo; Laguna, Israel; Martínez, Miguel A; Osnaya, Patricia; Reynales, Luz M; Valdés, Raydel; Martínez, Julia

    2005-04-01

    Complex sociopolitical, economic, and geographical realities cause the 20 million residents of Mexico City to suffer from some of the worst air pollution conditions in the world. Greenhouse gas emissions from the city are also substantial, and opportunities for joint local-global air pollution control are being sought. Although a plethora of measures to improve local air quality and reduce greenhouse gas emissions have been proposed for Mexico City, resources are not available for implementation of all proposed controls and thus prioritization must occur. Yet policy makers often do not conduct comprehensive quantitative analyses to inform these decisions. We reanalyze a subset of currently proposed control measures, and derive cost and health benefit estimates that are directly comparable. This study illustrates that improved quantitative analysis can change implementation prioritization for air pollution and greenhouse gas control measures in Mexico City.

  1. Interaction Between Strategic and Local Traffic Flow Controls

    NASA Technical Reports Server (NTRS)

    Grabbe, Son; Sridhar, Banavar; Mukherjee, Avijit; Morando, Alexander

    2010-01-01

    The loosely coordinated sets of traffic flow management initiatives that are operationally implemented at the national- and local-levels have the potential to under, over, and inconsistently control flights. This study is designed to explore these interactions through fast-time simulations with an emphasis on identifying inequitable situations in which flights receive multiple uncoordinated delays. Two operationally derived scenarios were considered in which flights arriving into the Dallas/Fort Worth International Airport were first controlled at the national-level, either with a Ground Delay Program or a playbook reroute. These flights were subsequently controlled at the local level. The Traffic Management Advisor assigned them arrival scheduling delays. For the Ground Delay Program scenarios, between 51% and 53% of all arrivals experience both pre-departure delays from the Ground Delay Program and arrival scheduling delays from the Traffic Management Advisor. Of the subset of flights that received multiple delays, between 5.7% and 6.4% of the internal departures were first assigned a pre-departure delay by the Ground Delay Program, followed by a second pre-departure delay as a result of the arrival scheduling. For the playbook reroute scenario, Dallas/Fort Worth International Airport arrivals were first assigned pre-departure reroutes based on the MW_2_DALLAS playbook plan, and were subsequently assigned arrival scheduling delays by the Traffic Management Advisor. Since the airport was operating well below capacity when the playbook reroute was in effect, only 7% of the arrivals were observed to receive both rerouting and arrival scheduling delays. Findings from these initial experiments confirm field observations that Ground Delay Programs operated in conjunction with arrival scheduling can result in inequitable situations in which flights receive multiple uncoordinated delays.

  2. 21 CFR 1240.30 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Measures in the event of inadequate local control. 1240.30 Section 1240.30 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... CONTROL OF COMMUNICABLE DISEASES Administrative Procedures § 1240.30 Measures in the event of inadequate...

  3. 21 CFR 1240.30 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Measures in the event of inadequate local control. 1240.30 Section 1240.30 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... CONTROL OF COMMUNICABLE DISEASES Administrative Procedures § 1240.30 Measures in the event of inadequate...

  4. 21 CFR 1240.30 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Measures in the event of inadequate local control. 1240.30 Section 1240.30 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... CONTROL OF COMMUNICABLE DISEASES Administrative Procedures § 1240.30 Measures in the event of inadequate...

  5. 21 CFR 1240.30 - Measures in the event of inadequate local control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Measures in the event of inadequate local control. 1240.30 Section 1240.30 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... CONTROL OF COMMUNICABLE DISEASES Administrative Procedures § 1240.30 Measures in the event of inadequate...

  6. Anderson localization of a Tonks-Girardeau gas in potentials with controlled disorder

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Radic, J.; Bacic, V.; Jukic, D.

    We theoretically demonstrate features of Anderson localization in a Tonks-Girardeau gas confined in one-dimensional potentials with controlled disorder. That is, we investigate the evolution of the single-particle density and correlations of a Tonks-Girardeau wave packet in such disordered potentials. The wave packet is initially trapped, the trap is suddenly turned off, and after some time the system evolves into a localized steady state due to Anderson localization. The density tails of the steady state decay exponentially, while the coherence in these tails increases. The latter phenomenon corresponds to the same effect found in incoherent optical solitons.

  7. Localized temperature and chemical reaction control in nanoscale space by nanowire array.

    PubMed

    Jin, C Yan; Li, Zhiyong; Williams, R Stanley; Lee, K-Cheol; Park, Inkyu

    2011-11-09

    We introduce a novel method for chemical reaction control with nanoscale spatial resolution based on localized heating by using a well-aligned nanowire array. Numerical and experimental analysis shows that each individual nanowire could be selectively and rapidly Joule heated for local and ultrafast temperature modulation in nanoscale space (e.g., maximum temperature gradient 2.2 K/nm at the nanowire edge; heating/cooling time < 2 μs). By taking advantage of this capability, several nanoscale chemical reactions such as polymer decomposition/cross-linking and direct and localized hydrothermal synthesis of metal oxide nanowires were demonstrated.

  8. Local problems, local solutions: improving tuberculosis control at the district level in Malawi.

    PubMed Central

    Kelly, P. M.

    2001-01-01

    OBJECTIVE: To examine the causes of a low cure rate at the district level of a tuberculosis (TB) control programme and to formulate, implement, and evaluate an intervention to improve the situation. METHODS: The study setting was Mzuzu (population 60,000), where the annual smear-positive pulmonary TB incidence was 160 per 100,000 and the human immunodeficiency virus (HIV) seroprevalence was 67% among TB patients. There is one TB treatment unit, but several other organizations are involved with TB control. An examination of case-holding activities was carried out, potential areas for improvement were identified, and interventions performed. FINDINGS: In 1990-91, the cure rate was 24% among smear-positive cases (29% among survivors to end of treatment). Problems identified included a fragmented TB control programme; inadequate training and supervision; suboptimal recording of patients' addresses; and nonadherence to national TB control programme protocols. These problems were addressed, and in 1992-93 the cure rate rose to 68% (relative risk (RR) = 2.85 (95% confidence interval (CI) = 1.63, 4.96)) and to 92% among survivors to the end of treatment (RR = 3.12 (95% CI = 1.84, 5.29)). High cure rates are therefore achievable despite high HIV prevalence. CONCLUSIONS: Simple, inexpensive, local programmatic interventions can dramatically improve TB case holding. This study demonstrates the need for evaluation, training, and supervision at all levels of the programme. PMID:11242817

  9. Local control after intensity-modulated radiotherapy for head-and-neck rhabdomyosarcoma.

    PubMed

    Curtis, Amarinthia E; Okcu, M Fatih; Chintagumpala, Murali; Teh, Bin S; Paulino, Arnold C

    2009-01-01

    To examine the patterns of failure in patients treated with intensity-modulated radiotherapy (IMRT) for head-and-neck rhabdomyosarcoma (RMS). Between 1998 and 2005, 19 patients with a diagnosis of head-and-neck RMS received IMRT at The Methodist Hospital. There were 11 male and 8 female patients, with a median age of 6 years at time of irradiation. Tumor location was parameningeal in 7, orbital in 6, and other head-and-neck RMS in 6. Chemotherapy was given to all patients, with vincristine, actinomycin D, and cyclophosphamide being the most common regimen (n = 18). The median prescribed dose was 5040 cGy. The clinical target volume included the gross tumor volume with a 1.5-cm margin. The median duration of follow-up for surviving patients was 56 months. The 4-year overall survival and local control rates were 76% and 92.9%, respectively. One patient developed a local failure in the high-dose region of the radiation field; there were no marginal failures. Distant metastasis was seen in 4 patients. Overall survival was 42.9% for parameningeal sites and 100% for other sites (p < 0.01). Late toxicities were seen in 7 patients. Two secondary malignancies occurred in 1 child with embryonal RMS of the face and a p53 mutation. Local control was excellent in patients receiving IMRT for head-and-neck RMS. Patterns of local failure reveal no marginal failures in this group of patients.

  10. Spot-Scanning Proton Radiation Therapy for Pediatric Chordoma and Chondrosarcoma: Clinical Outcome of 26 Patients Treated at Paul Scherrer Institute

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rombi, Barbara; ATreP; Ares, Carmen, E-mail: carmen.ares@psi.ch

    Purpose: To evaluate the clinical results of fractionated spot-scanning proton radiation therapy (PT) in 26 pediatric patients treated at Paul Scherrer Institute for chordoma (CH) or chondrosarcoma (CS) of the skull base or axial skeleton. Methods and Materials: Between June 2000 and June 2010, 19 CH and 7 CS patients with tumors originating from the skull base (17) and the axial skeleton (9) were treated with PT. Mean age at the time of PT was 13.2 years. The mean prescribed dose was 74 Gy (relative biological effectiveness [RBE]) for CH and 66 Gy (RBE) for CS, at a dose ofmore » 1.8-2.0 Gy (RBE) per fraction. Results: Mean follow-up was 46 months. Actuarial 5-year local control (LC) rates were 81% for CH and 80% for CS. Actuarial 5-year overall survival (OS) was 89% for CH and 75% for CS. Two CH patients had local failures: one is alive with evidence of disease, while the other patient succumbed to local recurrence in the surgical pathway. One CS patient died of local progression of the disease. No high-grade late toxicities were observed. Conclusions: Spot-scanning PT for pediatric CH and CS patients resulted in excellent clinical outcomes with acceptable rates of late toxicity. Longer follow-up time and larger cohort are needed to fully assess tumor control and late effects of treatment.« less

  11. Open Air Silicon Deposition by Atmospheric Pressure Plasma under Local Ambient Gas Control

    NASA Astrophysics Data System (ADS)

    Naito, Teruki; Konno, Nobuaki; Yoshida, Yukihisa

    2015-09-01

    In this paper, we report open air silicon (Si) deposition by combining a silane free Si deposition technology and a newly developed local ambient gas control technology. Recently, material processing in open air has been investigated intensively. While a variety of materials have been deposited, there were only few reports on Si deposition due to the susceptibility to contamination and the hazardous nature of source materials. Since Si deposition is one of the most important processes in device fabrication, we have developed open air silicon deposition technologies in BEANS project. For a clean and safe process, a local ambient gas control head was designed. Process gas leakage was prevented by local evacuation, and air contamination was shut out by inert curtain gas. By numerical and experimental investigations, a safe and clean process condition with air contamination less than 10 ppm was achieved. Si film was deposited in open air by atmospheric pressure plasma enhanced chemical transport under the local ambient gas control. The film was microcrystalline Si with the crystallite size of 17 nm, and the Hall mobility was 2.3 cm2/V .s. These properties were comparable to those of Si films deposited in a vacuum chamber. This research has been conducted as one of the research items of New Energy and Industrial Technology Development Organization ``BEANS'' project.

  12. A Feedforward Control Approach to the Local Navigation Problem for Autonomous Vehicles

    DTIC Science & Technology

    1994-05-02

    AD-A282 787 " A Feedforward Control Approach to the Local Navigation Problem for Autonomous Vehicles Alonzo Kelly CMU-RI-TR-94-17 The Robotics...follow, or a direction to prefer, it cannot generate its own strategic goals. Therefore, it solves the local planning problem for autonomous vehicles . The... autonomous vehicles . It is intelligent because it uses range images that are generated from either a laser rangefinder or a stereo triangulation

  13. Controlling the Localization of Liquid Droplets in Polymer Matrices by Evaporative Lithography.

    PubMed

    Zhao, Huaixia; Xu, Jiajia; Jing, Guangyin; Prieto-López, Lizbeth Ofelia; Deng, Xu; Cui, Jiaxi

    2016-08-26

    Localized inclusions of liquids provide solid materials with many functions, such as self-healing, secretion, and tunable mechanical properties, in a spatially controlled mode. However, a strategy to control the distribution of liquid droplets in solid matrices directly obtained from a homogeneous solution has not been reported thus far. Herein, we describe an approach to selectively localize liquid droplets in a supramolecular gel directly obtained from its solution by using evaporative lithography. In this process, the formation of droplet-embedded domains occurs in regions of free evaporation where the non-volatile liquid is concentrated and undergoes a phase separation to create liquid droplets prior to gelation, while a homogeneous gel matrix is formed in the regions of hindered evaporation. The different regions of a coating with droplet embedment patterns display different secretion abilities, enabling the control of the directional movement of water droplets. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Synaptic control of local translation: the plot thickens with new characters.

    PubMed

    Thomas, María Gabriela; Pascual, Malena Lucía; Maschi, Darío; Luchelli, Luciana; Boccaccio, Graciela Lidia

    2014-06-01

    The production of proteins from mRNAs localized at the synapse ultimately controls the strength of synaptic transmission, thereby affecting behavior and cognitive functions. The regulated transcription, processing, and transport of mRNAs provide dynamic control of the dendritic transcriptome, which includes thousands of messengers encoding multiple cellular functions. Translation is locally modulated by synaptic activity through a complex network of RNA-binding proteins (RBPs) and various types of non-coding RNAs (ncRNAs) including BC-RNAs, microRNAs, piwi-interacting RNAs, and small interference RNAs. The RBPs FMRP and CPEB play a well-established role in synaptic translation, and additional regulatory factors are emerging. The mRNA repressors Smaug, Nanos, and Pumilio define a novel pathway for local translational control that affects dendritic branching and spines in both flies and mammals. Recent findings support a role for processing bodies and related synaptic mRNA-silencing foci (SyAS-foci) in the modulation of synaptic plasticity and memory formation. The SyAS-foci respond to different stimuli with changes in their integrity thus enabling regulated mRNA release followed by translation. CPEB, Pumilio, TDP-43, and FUS/TLS form multimers through low-complexity regions related to prion domains or polyQ expansions. The oligomerization of these repressor RBPs is mechanistically linked to the aggregation of abnormal proteins commonly associated with neurodegeneration. Here, we summarize the current knowledge on how specificity in mRNA translation is achieved through the concerted action of multiple pathways that involve regulatory ncRNAs and RBPs, the modification of translation factors, and mRNA-silencing foci dynamics.

  15. Developing cancer control capacity in state and local public health agencies.

    PubMed

    Meissner, H I; Bergner, L; Marconi, K M

    1992-01-01

    In 1986, the National Cancer Institute began a major grant program to enhance the technical capabilities of public health departments in cancer prevention and control. This effort, commonly referred to as "capacity building" for cancer control, provided funding to support eight State and one local health department. The program focused on developing the knowledge and skills of health department personnel to implement intervention programs in such areas as smoking cessation, diet modification, and breast and cervical cancer screening. The grants ranged from 2 to 5 years in length, with funding of $125,000 to $1.6 million per grant. The total for the program was $7.4 million. While the priorities set for these grants were nominally similar, their capacity building activities in cancer prevention and control evolved into unique interventions reflecting the individual needs and priorities of each State or locality. Their experiences illustrate that technical development for planning, implementing, and evaluating cancer prevention and control programs is a complex process that must occur at multiple levels, regardless of overall approach. Factors found to contribute to successful implementation of technical development programs include* commitment of the organization's leadership to provide adequate support for staff and activities and to keep cancer prevention and control on the organizational agenda,* the existence of appropriate data to monitor and evaluate programs,* appropriately trained staff,* building linkages with State and community agencies and coalitions to guide community action,* an established plan or process for achieving cancer control objectives,* access to the advice of and participation of individual cancer and health experts,* an informed State legislature,* diffusion of cancer prevention and control efforts,and* the ability to obtain funds needed for future activities.

  16. A framework for mobilizing communities to advance local tobacco control policy: the Los Angeles County experience.

    PubMed

    Weber, Mark D; Simon, Paul; Messex, Monty; Aragon, Linda; Kuo, Tony; Fielding, Jonathan E

    2012-05-01

    The Los Angeles County Tobacco Control and Prevention Program was significantly restructured in 2004 to improve capacity for local policy adoption. Restructuring included creating a fully staffed and trained policy unit; partnering with state-funded tobacco control organizations to provide high-quality, continuous technical assistance and training; implementing a highly structured policy adoption approach; expanding community capacity building; and establishing local coalitions to mobilize communities. Over the ensuing 6 years (2004-2010), 97 tobacco control policies were enacted in the county's 88 cities and unincorporated area, including 79 that were attributable to the program. By comparison, only 15 policies were enacted from 1998 to 2003. Expanding policy adoption capacity through program restructuring may be achievable in other local jurisdictions.

  17. Typing Local Control and State Using Flow Analysis

    NASA Astrophysics Data System (ADS)

    Guha, Arjun; Saftoiu, Claudiu; Krishnamurthi, Shriram

    Programs written in scripting languages employ idioms that confound conventional type systems. In this paper, we highlight one important set of related idioms: the use of local control and state to reason informally about types. To address these idioms, we formalize run-time tags and their relationship to types, and use these to present a novel strategy to integrate typing with flow analysis in a modular way. We demonstrate that in our separation of typing and flow analysis, each component remains conventional, their composition is simple, but the result can handle these idioms better than either one alone.

  18. An acute bout of localized resistance exercise can rapidly improve inhibitory control

    PubMed Central

    Tsukamoto, Hayato; Suga, Tadashi; Takenaka, Saki; Takeuchi, Tatsuya; Tanaka, Daichi; Hamaoka, Takafumi; Hashimoto, Takeshi; Isaka, Tadao

    2017-01-01

    The positive effect of acute resistance exercise on executive function, such as inhibitory control (IC), is poorly understood. Several previous studies have demonstrated this effect using whole-body resistance exercise. However, it remains unclear whether localized resistance exercise performed using only limited muscle groups could also acutely improve IC. Thus, the present study examined the effect of an acute bout of localized resistance exercise on IC. Twelve healthy men performed a color-word Stroop task (CWST) before and immediately after the experimental conditions, which consisted of 2 resistance exercises and a resting control (CON). Bilateral knee extension was used to create 2 resistance exercise conditions: light-intensity resistance exercise (LRE) and high-intensity resistance exercise (HRE) conditions, which were 40% and 80% of one-repetition maximum, respectively. The resistance exercise session was programmed for 6 sets with 10 repetitions per set. The CWST-measured IC was significantly improved immediately after both LRE and HRE, but it did not improve immediately after CON. However, the improved IC was significantly greater in HRE than in LRE. The present findings showed that IC could be rapidly improved by an acute bout of localized resistance exercise, especially with high-intensity. Therefore, we suggest that in addition to whole-body resistance exercise, localized resistance exercise performed using limited muscle groups may be sufficient for improving IC. PMID:28877232

  19. Local Government Planning Tool to Calculate Institutional and Engineering Control Costs for Brownfield Properties

    EPA Pesticide Factsheets

    This cost calculator is designed as a guide for municipal or local governments to assist in calculating their expected costs of implementing and conducting long-term stewardship of institutional controls and engineering controls at brownfield properties.

  20. Postoperative hypofractionated stereotactic brain radiation (HSRT) for resected brain metastases: improved local control with higher BED10.

    PubMed

    Kumar, Aryavarta M S; Miller, Jonathan; Hoffer, Seth A; Mansur, David B; Coffey, Michael; Lo, Simon S; Sloan, Andrew E; Machtay, Mitchell

    2018-05-10

    HSRT directed to large surgical beds in patients with resected brain metastases improves local control while sparing patients the toxicity associated with whole brain radiation. We review our institutional series to determine factors predictive of local failure. In a total of 39 consecutive patients with brain metastases treated from August 2011 to August 2016, 43 surgical beds were treated with HSRT in three or five fractions. All treatments were completed on a robotic radiosurgery platform using the 6D Skull tracking system. Volumetric MRIs from before and after surgery were used for radiation planning. A 2-mm PTV margin was used around the contoured surgical bed and resection margins; these were reviewed by the radiation oncologist and neurosurgeon. Lower total doses were prescribed based on proximity to critical structures or if prior radiation treatments were given. Local control in this study is defined as no volumetric MRI evidence of recurrence of tumor within the high dose radiation volume. Statistics were calculated using JMP Pro v13. Of the 43 surgical beds analyzed, 23 were from NSCLC, 5 were from breast, 4 from melanoma, 5 from esophagus, and 1 each from SCLC, sarcoma, colon, renal, rectal, and unknown primary. Ten were treated with three fractions with median dose 24 Gy and 33 were treated with five fractions with median dose 27.5 Gy using an every other day fractionation. There were no reported grade 3 or higher toxicities. Median follow up was 212 days after completion of radiation. 10 (23%) surgical beds developed local failure with a median time to failure of 148 days. All but three patients developed new brain metastases outside of the treated field and were treated with stereotactic radiosurgery, whole brain radiation and/or chemotherapy. Five patients (13%) developed leptomeningeal disease. With a median follow up of 226 days, 30 Gy/5 fx was associated with the best local control (93%) with only 1 local failure. A lower total dose in

  1. Accuracy of actuarial procedures for assessment of sexual offender recidivism risk may vary across ethnicity.

    PubMed

    Långström, Niklas

    2004-04-01

    Little is known about whether the accuracy of tools for assessment of sexual offender recidivism risk holds across ethnic minority offenders. I investigated the predictive validity across ethnicity for the RRASOR and the Static-99 actuarial risk assessment procedures in a national cohort of all adult male sex offenders released from prison in Sweden 1993-1997. Subjects ordered out of Sweden upon release from prison were excluded and remaining subjects (N = 1303) divided into three subgroups based on citizenship. Eighty-three percent of the subjects were of Nordic ethnicity, and non-Nordic citizens were either of non-Nordic European (n = 49, hereafter called European) or African Asian descent (n = 128). The two tools were equally accurate among Nordic and European sexual offenders for the prediction of any sexual and any violent nonsexual recidivism. In contrast, neither measure could differentiate African Asian sexual or violent recidivists from nonrecidivists. Compared to European offenders, AfricanAsian offenders had more often sexually victimized a nonrelative or stranger, had higher Static-99 scores, were younger, more often single, and more often homeless. The results require replication, but suggest that the promising predictive validity seen with some risk assessment tools may not generalize across offender ethnicity or migration status. More speculatively, different risk factors or causal chains might be involved in the development or persistence of offending among minority or immigrant sexual abusers.

  2. Mosquito politics: local vector control policies and the spread of West Nile Virus in the Chicago region.

    PubMed

    Tedesco, Carmen; Ruiz, Marilyn; McLafferty, Sara

    2010-11-01

    Differences in mosquito control practices at the local level involve the interplay of place, scale and politics. During the Chicago West Nile Virus (WNV) outbreak of 2002, mosquito abatement districts represent distinct suburban clusters of human WNV cases, independent of characteristics of the local population, housing and physical environment. We examine how the contrasting actions of four districts reveal a distinct local politics of mosquito control that may have contributed to local-scale geographic differences in WNV incidence. This politics is rooted in political, economic and philosophical differences within and between administrative boundaries. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Quadratic obstructions to small-time local controllability for scalar-input systems

    NASA Astrophysics Data System (ADS)

    Beauchard, Karine; Marbach, Frédéric

    2018-03-01

    We consider nonlinear finite-dimensional scalar-input control systems in the vicinity of an equilibrium. When the linearized system is controllable, the nonlinear system is smoothly small-time locally controllable: whatever m > 0 and T > 0, the state can reach a whole neighborhood of the equilibrium at time T with controls arbitrary small in Cm-norm. When the linearized system is not controllable, we prove that: either the state is constrained to live within a smooth strict manifold, up to a cubic residual, or the quadratic order adds a signed drift with respect to it. This drift holds along a Lie bracket of length (2 k + 1), is quantified in terms of an H-k-norm of the control, holds for controls small in W 2 k , ∞-norm and these spaces are optimal. Our proof requires only C3 regularity of the vector field. This work underlines the importance of the norm used in the smallness assumption on the control, even in finite dimension.

  4. Investigating local controls on soil moisture temporal stability using an inverse modeling approach

    NASA Astrophysics Data System (ADS)

    Bogena, Heye; Qu, Wei; Huisman, Sander; Vereecken, Harry

    2013-04-01

    A better understanding of the temporal stability of soil moisture and its relation to local and nonlocal controls is a major challenge in modern hydrology. Both local controls, such as soil and vegetation properties, and non-local controls, such as topography and climate variability, affect soil moisture dynamics. Wireless sensor networks are becoming more readily available, which opens up opportunities to investigate spatial and temporal variability of soil moisture with unprecedented resolution. In this study, we employed the wireless sensor network SoilNet developed by the Forschungszentrum Jülich to investigate soil moisture variability of a grassland headwater catchment in Western Germany within the framework of the TERENO initiative. In particular, we investigated the effect of soil hydraulic parameters on the temporal stability of soil moisture. For this, the HYDRUS-1D code coupled with a global optimizer (DREAM) was used to inversely estimate Mualem-van Genuchten parameters from soil moisture observations at three depths under natural (transient) boundary conditions for 83 locations in the headwater catchment. On the basis of the optimized parameter sets, we then evaluated to which extent the variability in soil hydraulic conductivity, pore size distribution, air entry suction and soil depth between these 83 locations controlled the temporal stability of soil moisture, which was independently determined from the observed soil moisture data. It was found that the saturated hydraulic conductivity (Ks) was the most significant attribute to explain temporal stability of soil moisture as expressed by the mean relative difference (MRD).

  5. Tracking Control of Mobile Robots Localized via Chained Fusion of Discrete and Continuous Epipolar Geometry, IMU and Odometry.

    PubMed

    Tick, David; Satici, Aykut C; Shen, Jinglin; Gans, Nicholas

    2013-08-01

    This paper presents a novel navigation and control system for autonomous mobile robots that includes path planning, localization, and control. A unique vision-based pose and velocity estimation scheme utilizing both the continuous and discrete forms of the Euclidean homography matrix is fused with inertial and optical encoder measurements to estimate the pose, orientation, and velocity of the robot and ensure accurate localization and control signals. A depth estimation system is integrated in order to overcome the loss of scale inherent in vision-based estimation. A path following control system is introduced that is capable of guiding the robot along a designated curve. Stability analysis is provided for the control system and experimental results are presented that prove the combined localization and control system performs with high accuracy.

  6. Local tumor control probability modeling of primary and secondary lung tumors in stereotactic body radiotherapy.

    PubMed

    Guckenberger, Matthias; Klement, Rainer J; Allgäuer, Michael; Andratschke, Nicolaus; Blanck, Oliver; Boda-Heggemann, Judit; Dieckmann, Karin; Duma, Marciana; Ernst, Iris; Ganswindt, Ute; Hass, Peter; Henkenberens, Christoph; Holy, Richard; Imhoff, Detlef; Kahl, Henning K; Krempien, Robert; Lohaus, Fabian; Nestle, Ursula; Nevinny-Stickel, Meinhard; Petersen, Cordula; Semrau, Sabine; Streblow, Jan; Wendt, Thomas G; Wittig, Andrea; Flentje, Michael; Sterzing, Florian

    2016-03-01

    To evaluate whether local tumor control probability (TCP) in stereotactic body radiotherapy (SBRT) varies between lung metastases of different primary cancer sites and between primary non-small cell lung cancer (NSCLC) and secondary lung tumors. A retrospective multi-institutional (n=22) database of 399 patients with stage I NSCLC and 397 patients with 525 lung metastases was analyzed. Irradiation doses were converted to biologically effective doses (BED). Logistic regression was used for local tumor control probability (TCP) modeling and the second-order bias corrected Akaike Information Criterion was used for model comparison. After median follow-up of 19 months and 16 months (n.s.), local tumor control was observed in 87.7% and 86.7% of the primary and secondary lung tumors (n.s.), respectively. A strong dose-response relationship was observed in the primary NSCLC and metastatic cohort but dose-response relationships were not significantly different: the TCD90 (dose to achieve 90% TCP; BED of maximum planning target volume dose) estimates were 176 Gy (151-223) and 160 Gy (123-237) (n.s.), respectively. The dose-response relationship was not influenced by the primary cancer site within the metastatic cohort. Dose-response relationships for local tumor control in SBRT were not different between lung metastases of various primary cancer sites and between primary NSCLC and lung metastases. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Enhancement of Local Piezoresponse in Polymer Ferroelectrics via Nanoscale Control of Microstructure

    DOE PAGES

    Choi, Yoon-Young; Sharma, Pankaj; Phatak, Charudatta; ...

    2015-02-01

    Polymer ferroelectrics are flexible and lightweight electromechanical materials that are widely studied due to their potential application as sensors, actuators, and energy harvesters. However, one of the biggest challenges is their low piezoelectric coefficient. Here, we report a mechanical annealing effect based on local pressure induced by a nanoscale tip that enhances the local piezoresponse. This process can control the nanoscale material properties over a microscale area at room temperature. We attribute this improvement to the formation and growth of beta-phase extended chain crystals via sliding diffusion and crystal alignment along the scan axis under high mechanical stress. We believemore » that this technique can be useful for local enhancement of piezoresponse in ferroelectric polymer thin films.« less

  8. Stereotactic Radiation Therapy can Safely and Durably Control Sites of Extra-Central Nervous System Oligoprogressive Disease in Anaplastic Lymphoma Kinase-Positive Lung Cancer Patients Receiving Crizotinib

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gan, Gregory N., E-mail: gregory.gan@ucdenver.edu; Weickhardt, Andrew J.; Scheier, Benjamin

    Purpose: To analyze the durability and toxicity of radiotherapeutic local ablative therapy (LAT) applied to extra-central nervous system (eCNS) disease progression in anaplastic lymphoma kinase-positive non-small cell lung cancer (NSCLC) patients. Methods and Materials: Anaplastic lymphoma kinase-positive NSCLC patients receiving crizotinib and manifesting ≤4 discrete sites of eCNS progression were classified as having oligoprogressive disease (OPD). If subsequent progression met OPD criteria, additional courses of LAT were considered. Crizotinib was continued until eCNS progression was beyond OPD criteria or otherwise not suitable for further LAT. Results: Of 38 patients, 33 progressed while taking crizotinib. Of these, 14 had eCNS progressionmore » meeting OPD criteria suitable for radiotherapeutic LAT. Patients with eCNS OPD received 1-3 courses of LAT with radiation therapy. The 6- and 12-month actuarial local lesion control rates with radiation therapy were 100% and 86%, respectively. The 12-month local lesion control rate with single-fraction equivalent dose >25 Gy versus ≤25 Gy was 100% versus 60% (P=.01). No acute or late grade >2 radiation therapy-related toxicities were observed. Median overall time taking crizotinib among those treated with LAT versus those who progressed but were not suitable for LAT was 28 versus 10.1 months, respectively. Patients continuing to take crizotinib for >12 months versus ≤12 months had a 2-year overall survival rate of 72% versus 12%, respectively (P<.0001). Conclusions: Local ablative therapy safely and durably eradicated sites of individual lesion progression in anaplastic lymphoma kinase-positive NSCLC patients receiving crizotinib. A dose–response relationship for local lesion control was observed. The suppression of OPD by LAT in patients taking crizotinib allowed an extended duration of exposure to crizotinib, which was associated with longer overall survival.« less

  9. Nonparametric method for failures detection and localization in the actuating subsystem of aircraft control system

    NASA Astrophysics Data System (ADS)

    Karpenko, S. S.; Zybin, E. Yu; Kosyanchuk, V. V.

    2018-02-01

    In this paper we design a nonparametric method for failures detection and localization in the aircraft control system that uses the measurements of the control signals and the aircraft states only. It doesn’t require a priori information of the aircraft model parameters, training or statistical calculations, and is based on algebraic solvability conditions for the aircraft model identification problem. This makes it possible to significantly increase the efficiency of detection and localization problem solution by completely eliminating errors, associated with aircraft model uncertainties.

  10. Localized modelling and feedback control of linear instabilities in 2-D wall bounded shear flows

    NASA Astrophysics Data System (ADS)

    Tol, Henry; Kotsonis, Marios; de Visser, Coen

    2016-11-01

    A new approach is presented for control of instabilities in 2-D wall bounded shear flows described by the linearized Navier-Stokes equations (LNSE). The control design accounts both for spatially localized actuators/sensors and the dominant perturbation dynamics in an optimal control framework. An inflow disturbance model is proposed for streamwise instabilities that drive laminar-turbulent transition. The perturbation modes that contribute to the transition process can be selected and are included in the control design. A reduced order model is derived from the LNSE that captures the input-output behavior and the dominant perturbation dynamics. This model is used to design an optimal controller for suppressing the instability growth. A 2-D channel flow and a 2-D boundary layer flow over a flat plate are considered as application cases. Disturbances are generated upstream of the control domain and the resulting flow perturbations are estimated/controlled using wall shear measurements and localized unsteady blowing and suction at the wall. It will be shown that the controller is able to cancel the perturbations and is robust to unmodelled disturbances.

  11. Local control of brain metastases by stereotactic radiosurgery in relation to dose to the tumor margin.

    PubMed

    Vogelbaum, Michael A; Angelov, Lilyana; Lee, Shih-Yuan; Li, Liang; Barnett, Gene H; Suh, John H

    2006-06-01

    The maximal tolerated dose (MTD) for stereotactic radiosurgery (SRS) for brain tumors was established by the Radiation Therapy Oncology Group (RTOG) in protocol 90-05, which defined three dose groups based on the maximal tumor diameter. The goal in this retrospective study was to determine whether differences in doses to the margins of brain metastases affect the ability of SRS to achieve local control. Between 1997 and 2003, 202 patients harboring 375 tumors that met study entry criteria underwent SRS for treatment of one or multiple brain metastases. The median overall follow-up duration was 10.7 months (range 3-83 months). A dose of 24 Gy to the tumor margin had a significantly lower risk of local failure than 15 or 18 Gy (p = 0.0005; hazard ratio 0.277, confidence interval [CI] 0.134-0.573), whereas the 15- and 18-Gy groups were not significantly different from each other (p = 0.82) in this regard. The 1-year local control rate was 85% (95% CI 78-92%) in tumors treated with 24 Gy, compared with 49% (CI 30-68%) in tumors treated with 18 Gy and 45% (CI 23-67%) in tumors treated with 15 Gy. Overall patient survival was independent of dose to the tumor margin. Use of the RTOG 90-05 dosing scheme for brain metastases is associated with a variable local control rate. Tumors larger than 2 cm are less effectively controlled than smaller lesions, which can be safely treated with 24 Gy. Prospective evaluations of the relationship between dose to the tumor margin and local control should be performed to confirm these observations.

  12. Acoustofluidic waveguides for localized control of acoustic wavefront in microfluidics

    PubMed Central

    Bian, Yusheng; Guo, Feng; Yang, Shujie; Mao, Zhangming; Bachman, Hunter; Tang, Shi-Yang; Ren, Liqiang; Zhang, Bin; Gong, Jianying; Guo, Xiasheng

    2017-01-01

    The precise manipulation of acoustic fields in microfluidics is of critical importance for the realization of many biomedical applications. Despite the tremendous efforts devoted to the field of acoustofluidics during recent years, dexterous control, with an arbitrary and complex acoustic wavefront, in a prescribed, microscale region is still out of reach. Here, we introduce the concept of acoustofluidic waveguide, a three-dimensional compact configuration that is capable of locally guiding acoustic waves into a fluidic environment. Through comprehensive numerical simulations, we revealed the possibility of forming complex field patterns with defined pressure nodes within a highly localized, pre-determined region inside the microfluidic chamber. We also demonstrated the tunability of the acoustic field profile through controlling the size and shape of the waveguide geometry, as well as the operational frequency of the acoustic wave. The feasibility of the waveguide concept was experimentally verified via microparticle trapping and patterning. Our acoustofluidic waveguiding structures can be readily integrated with other microfluidic configurations and can be further designed into more complex types of passive acoustofluidic devices. The waveguide platform provides a promising alternative to current acoustic manipulation techniques and is useful in many applications such as single-cell analysis, point-of-care diagnostics, and studies of cell–cell interactions. PMID:29358901

  13. The role of palliative radiation therapy in symptomatic locally advanced gastric cancer

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tey, Jeremy; Back, Michael F.; Department of Radiation Oncology, Cancer Institute, Tan Tock Seng Hospital

    2007-02-01

    Purpose: To review the outcome of palliative radiotherapy (RT) alone in patients with symptomatic locally advanced or recurrent gastric cancer. Methods and Materials: Patients with symptomatic locally advanced or recurrent gastric cancer who were managed palliatively with RT at Cancer Institute, Singapore were retrospectively reviewed. Study end points included symptom response, median survival, and treatment toxicity (retrospectively scored using the Common Toxicity Criteria v3.0 [CTC]). Results: Between November 1999 and December 2004, 33 patients with locally advanced or recurrent gastric cancer were managed with palliative intent using RT alone. Median age was 76 years (range, 38-90 years). Twenty-one (64%) patientsmore » had known distant metastatic disease at time of treatment. Key index symptoms were bleeding (24 patients), obstruction (8 patients), and pain (8 patients). The majority of patients received 30 Gy/10 fractions (17 patients). Dose fractionation regimen ranged from an 8-Gy single fraction to 40 Gy in 16 fractions. Median survival was 145 days, actuarial 12-month survival 8%. A total of 54.3% of patients (13/24) with bleeding responded (median duration of response of 140 days), 25% of patients (2/8) with obstruction responded (median duration of response of 102 days), and 25% of patients (2/8) with pain responded (median duration of response of 105 days). No obvious dose-response was evident. One Grade 3 CTC equivalent toxicity was recorded. Conclusion: External beam RT alone is an effective and well tolerated modality in the local palliation of gastric cancer, with palliation lasting the majority of patients' lives.« less

  14. Spherical loudspeaker array for local active control of sound.

    PubMed

    Rafaely, Boaz

    2009-05-01

    Active control of sound has been employed to reduce noise levels around listeners' head using destructive interference from noise-canceling sound sources. Recently, spherical loudspeaker arrays have been studied as multiple-channel sound sources, capable of generating sound fields with high complexity. In this paper, the potential use of a spherical loudspeaker array for local active control of sound is investigated. A theoretical analysis of the primary and secondary sound fields around a spherical sound source reveals that the natural quiet zones for the spherical source have a shell-shape. Using numerical optimization, quiet zones with other shapes are designed, showing potential for quiet zones with extents that are significantly larger than the well-known limit of a tenth of a wavelength for monopole sources. The paper presents several simulation examples showing quiet zones in various configurations.

  15. Autologous whole blood versus corticosteroid local injection in treatment of plantar fasciitis: A randomized, controlled multicenter clinical trial.

    PubMed

    Karimzadeh, Afshin; Raeissadat, Seyed Ahmad; Erfani Fam, Saleh; Sedighipour, Leyla; Babaei-Ghazani, Arash

    2017-03-01

    Plantar fasciitis is the most common cause of heel pain. Local injection modalities are among treatment options in patients with resistant pain. The aim of the present study was to evaluate the effect of local autologous whole blood compared with corticosteroid local injection in treatment of plantar fasciitis. In this randomized controlled multicenter study, 36 patients with chronic plantar fasciitis were recruited. Patients were allocated randomly into three treatment groups: local autologous blood, local corticosteroid injection, and control groups receiving no injection. Patients were assessed with visual analog scale (VAS), pressure pain threshold (PPT), and plantar fasciitis pain/disability scale (PFPS) before treatment, as well as 4 and 12 weeks post therapy. Variables of pain and function improved significantly in both corticosteroid and autologous blood groups compared to control group. At 4 weeks following treatment, patients in corticosteroid group had significantly lower levels of pain than patients in autologous blood and control groups (higher PPT level, lower PFPS, and VAS). After 12 weeks of treatment, both corticosteroid and autologous blood groups had lower average levels of pain than control group. The corticosteroid group showed an early sharp and then more gradual improvement in pain scores, but autologous blood group had a steady gradual drop in pain. Autologous whole blood and corticosteroid local injection can both be considered as effective methods in the treatment of chronic plantar fasciitis. These treatments decrease pain and significantly improve function compared to no treatment.

  16. Curative Treatment of Stage I Non-Small-Cell Lung Cancer in Patients With Severe COPD: Stereotactic Radiotherapy Outcomes and Systematic Review

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Palma, David, E-mail: david.palma@uwo.ca; Division of Radiation Oncology, London Regional Cancer Program, London, Ontario; Lagerwaard, Frank

    2012-03-01

    Objectives: Patients with severe chronic obstructive pulmonary disease (COPD) have a high risk of lung cancer and of postsurgical complications. We studied outcomes after stereotactic body radiotherapy (SBRT) in patients with severe COPD, as defined by Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, and performed a systematic review of the literature on outcomes after SBRT or surgery in these patients. Methods: A single-institution cohort of 176 patients with COPD GOLD III-IV and Stage I non-small-cell lung cancer (NSCLC) treated with SBRT was evaluated. A systematic review identified studies reporting outcomes after SBRT or surgery for Stage I NSCLCmore » in patients with GOLD III-IV or a predicted postoperative forced expiratory volume in 1 second (FEV1) of {<=}40%. Results: In the single-institution cohort, median follow-up was 21 months and median overall survival (OS) was 32 months. Actuarial 3-year local control was 89%, and 1- and 3-year OS were 79% and 47%, respectively. COPD severity correlated with OS (p = 0.01). The systematic review identified four other studies (two surgical, two SBRT, n = 196 patients). SBRT studies were published more recently and included older patients than surgical studies. Mean 30-day mortality was 0% post-SBRT and 10% after surgery. Local or locoregional control was high ({>=}89%) after both treatments. Post-SBRT, actuarial OS was 79-95% at 1 year and 43-70% at 3 years. Postsurgical actuarial OS was 45-86% at 1 year and 31-66% at 3 years. Conclusions: SBRT and surgery differ in risk of 30-day mortality in patients with severe COPD. Despite the negative selection of SBRT patients, survival at 1 and 3 years is comparable between the two treatments.« less

  17. Performance Evaluation of Multichannel Adaptive Algorithms for Local Active Noise Control

    NASA Astrophysics Data System (ADS)

    DE DIEGO, M.; GONZALEZ, A.

    2001-07-01

    This paper deals with the development of a multichannel active noise control (ANC) system inside an enclosed space. The purpose is to design a real practical system which works well in local ANC applications. Moreover, the algorithm implemented in the adaptive controller should be robust, of low computational complexity and it should manage to generate a uniform useful-size zone of quite in order to allow the head motion of a person seated on a seat inside a car. Experiments were carried out under semi-anechoic and listening room conditions to verify the successful implementation of the multichannel system. The developed prototype consists of an array of up to four microphones used as error sensors mounted on the headrest of a seat place inside the enclosure. One loudspeaker was used as single primary source and two secondary sources were placed facing the seat. The aim of this multichannel system is to reduce the sound pressure levels in an area around the error sensors, following a local control strategy. When using this technique, the cancellation points are not only the error sensor positions but an area around them, which is measured by using a monitoring microphone. Different multichannel adaptive algorithms for ANC have been analyzed and their performance verified. Multiple error algorithms are used in order to cancel out different types of primary noise (engine noise and random noise) with several configurations (up to four channels system). As an alternative to the multiple error LMS algorithm (multichannel version of the filtered-X LMS algorithm, MELMS), the least maximum mean squares (LMMS) and the scanning error-LMS algorithm have been developed in this work in order to reduce computational complexity and achieve a more uniform residual field. The ANC algorithms were programmed on a digital signal processing board equipped with a TMS320C40 floating point DSP processor. Measurements concerning real-time experiments on local noise reduction in two

  18. Local tumour control and eye preservation after gamma-knife radiosurgery of choroidal melanomas.

    PubMed

    Wackernagel, Werner; Holl, Etienne; Tarmann, Lisa; Mayer, Christoph; Avian, Alexander; Schneider, Mona; Kapp, Karin S; Langmann, Gerald

    2014-02-01

    To report on local tumour control and eye preservation after gamma knife radiosurgery (GK-RS) to treat choroidal melanomas. A total of 189 patients with choroidal melanoma were treated with GK-RS, with treatment doses between 25 and 80 Grays. The main outcome measures of our retrospective analysis were local tumour control, time to recurrence, eye retention rate and the reason for and time to secondary enucleation. Patient-associated, tumour-associated and treatment-associated parameters were evaluated as potential risk factors. Local tumour control was achieved in 94.4% of patients. The estimated tumour control rates were 97.6% at 1 year, 94.2% at 5 years and 92.4% at 10 years after treatment. Recurrence was observed between 3.1 months and 60.7 months post-treatment (median: 13.5 months). Advanced tumour stage (Tumour, Node, Metastasis (TNM) 3-4) was the most important risk factor for recurrence (Fine-Gray model; subhazard ratio, SHR: 3.3; p=0.079). The treatment dose was not related to tumour recurrence. The eye preservation rate was 81.6% at 5 years after treatment, remaining stable thereafter. Twenty-five eyes (14.1%) had to be enucleated at between 17 days and 68.0 months (median: 13.9 months) after GK-RS, and advanced tumour stage (Cox model; p=0.005), treatment dose (p=0.048), pretreatment visual acuity (p=0.016), and retinal detachment (p=0.027) were risk factors for requiring enucleation. GK-RS achieved a high tumour control rate, comparable to linear accelerator-based radiotherapy. Advanced TNM stage was a predictive risk factor for tumour recurrence and for secondary enucleation after GK-RS. Lower treatment doses were unrelated to tumour recurrence, although they were associated with an improved eye retention rate.

  19. Local Support for Alcohol Control Policies and Perceptions of Neighborhood Issues in Two College Communities

    PubMed Central

    Fairlie, Anne M.; DeJong, William; Wood, Mark D.

    2014-01-01

    Background Although valuable, national opinion surveys on alcohol policy may be less informative for policy development at the local level. Using samples of adult residents in two college communities, the present study: 1) measured public support for local alcohol control policies to stem underage drinking and alcohol over-service in on-premise outlets; 2) assessed residents' opinions regarding neighborhood problems; and 3) identified factors associated with strong policy support. Methods We administered random-sample telephone surveys to residents ages 21 years and older in college communities located in Community 1 (N = 501; mean age = 57.4 years, SD = 14.7) and Community 2 (N = 505; mean age = 56.0 years, SD = 15.2). The response rates were typical of telephone surveys (Community 1: 33.5%; Community 2: 29.9%). We assessed support for 16 alcohol control policies and the occurrence of specific types of neighborhood incidents (e.g., witnessing intoxicated people). We used multiple regression analyses to determine factors associated with policy support. Results Residents in Community 1 reported significantly higher weekly alcohol use, a greater number of witnessed neighborhood incidents, and a higher level of perceived neighborhood problems than did residents in Community 2. Residents in Community 1 perceived local alcohol control policies and their enforcement to be significantly stricter. Overall, policy support was high and did not differ between the communities. In both communities, higher policy support was significantly associated with being female, being older, less weekly alcohol use, and lower perceived strictness of alcohol control policies and enforcement. Conclusions It is important for campus officials and community leaders to be aware of and publicize favorable public opinion when advocating for policy change, especially at the local level. Information on residents' perceptions of the neighborhood issues they face can also inform local policy and

  20. Stretching and Controlled Motion of Single-Stranded DNA in Locally-Heated Solid-State Nanopores

    PubMed Central

    Belkin, Maxim; Maffeo, Christopher; Wells, David B.

    2013-01-01

    Practical applications of solid-state nanopores for DNA detection and sequencing require the electrophoretic motion of DNA through the nanopores to be precisely controlled. Controlling the motion of single-stranded DNA presents a particular challenge, in part because of the multitude of conformations that a DNA strand can adopt in a nanopore. Through continuum, coarse-grained and atomistic modeling, we demonstrate that local heating of the nanopore volume can be used to alter the electrophoretic mobility and conformation of single-stranded DNA. In the nanopore systems considered, the temperature near the nanopore is modulated via a nanometer-size heater element that can be radiatively switched on and off. The local enhancement of temperature produces considerable stretching of the DNA fragment confined within the nanopore. Such stretching is reversible, so that the conformation of DNA can be toggled between compact (local heating is off) and extended (local heating is on) states. The effective thermophoretic force acting on single-stranded DNA in the vicinity of the nanopore is found to be sufficiently large (4–8 pN) to affect such changes in the DNA conformation. The local heating of the nanopore volume is observed to promote single-file translocation of DNA strands at transmembrane biases as low as 10 mV, which opens new avenues for using solid-state nanopores for detection and sequencing of DNA. PMID:23876013

  1. Local cellular neighborhood controls proliferation in cell competition

    PubMed Central

    Bove, Anna; Gradeci, Daniel; Fujita, Yasuyuki; Banerjee, Shiladitya; Charras, Guillaume; Lowe, Alan R.

    2017-01-01

    Cell competition is a quality-control mechanism through which tissues eliminate unfit cells. Cell competition can result from short-range biochemical inductions or long-range mechanical cues. However, little is known about how cell-scale interactions give rise to population shifts in tissues, due to the lack of experimental and computational tools to efficiently characterize interactions at the single-cell level. Here, we address these challenges by combining long-term automated microscopy with deep-learning image analysis to decipher how single-cell behavior determines tissue makeup during competition. Using our high-throughput analysis pipeline, we show that competitive interactions between MDCK wild-type cells and cells depleted of the polarity protein scribble are governed by differential sensitivity to local density and the cell type of each cell’s neighbors. We find that local density has a dramatic effect on the rate of division and apoptosis under competitive conditions. Strikingly, our analysis reveals that proliferation of the winner cells is up-regulated in neighborhoods mostly populated by loser cells. These data suggest that tissue-scale population shifts are strongly affected by cellular-scale tissue organization. We present a quantitative mathematical model that demonstrates the effect of neighbor cell–type dependence of apoptosis and division in determining the fitness of competing cell lines. PMID:28931601

  2. Fostering Innovation: How User-Centered Design Can Help Us Get the Local Control Funding Formula Right. Policy and Practice Brief

    ERIC Educational Resources Information Center

    Knudson, Joel; Ramanathan, Arun; Carter, Allison; O'Day, Jennifer

    2017-01-01

    The Local Control Funding Formula (LCFF) has introduced positive and much-needed change to California's approach to K-12 education funding by allocating resources according to student need and freeing districts to make decisions that address local priorities. For all of LCFF's advantages, however, the Local Control Accountability Plans (LCAPs) in…

  3. Outcomes of Node-positive Breast Cancer Patients Treated With Accelerated Partial Breast Irradiation Via Multicatheter Interstitial Brachytherapy: The Pooled Registry of Multicatheter Interstitial Sites (PROMIS) Experience.

    PubMed

    Kamrava, Mitchell; Kuske, Robert R; Anderson, Bethany; Chen, Peter; Hayes, John; Quiet, Coral; Wang, Pin-Chieh; Veruttipong, Darlene; Snyder, Margaret; Demanes, David J

    2018-06-01

    To report outcomes for breast-conserving therapy using adjuvant accelerated partial breast irradiation (APBI) with interstitial multicatheter brachytherapy in node-positive compared with node-negative patients. From 1992 to 2013, 1351 patients (1369 breast cancers) were treated with breast-conserving surgery and adjuvant APBI using interstitial multicatheter brachytherapy. A total of 907 patients (835 node negative, 59 N1a, and 13 N1mic) had >1 year of data available and nodal status information and are the subject of this analysis. Median age (range) was 59 years old (22 to 90 y). T stage was 90% T1 and ER/PR/Her2 was positive in 87%, 71%, and 7%. Mean number of axillary nodes removed was 12 (SD, 6). Cox multivariate analysis for local/regional control was performed using age, nodal stage, ER/PR/Her2 receptor status, tumor size, grade, margin, and adjuvant chemotherapy/antiestrogen therapy. The mean (SD) follow-up was 7.5 years (4.6). The 5-year actuarial local control (95% confidence interval) in node-negative versus node-positive patients was 96.3% (94.5-97.5) versus 95.8% (87.6-98.6) (P=0.62). The 5-year actuarial regional control in node-negative versus node-positive patients was 98.5% (97.3-99.2) versus 96.7% (87.4-99.2) (P=0.33). The 5-year actuarial freedom from distant metastasis and cause-specific survival were significantly lower in node-positive versus node-negative patients at 92.3% (82.4-96.7) versus 97.8% (96.3-98.7) (P=0.006) and 91.3% (80.2-96.3) versus 98.7% (97.3-99.3) (P=0.0001). Overall survival was not significantly different. On multivariate analysis age 50 years and below, Her2 positive, positive margin status, and not receiving chemotherapy or antiestrogen therapy were associated with a higher risk of local/regional recurrence. Patients who have had an axillary lymph node dissection and limited node-positive disease may be candidates for treatment with APBI. Further research is ultimately needed to better define specific criteria for APBI

  4. Spatial control of chemical processes on nanostructures through nano-localized water heating.

    PubMed

    Jack, Calum; Karimullah, Affar S; Tullius, Ryan; Khorashad, Larousse Khosravi; Rodier, Marion; Fitzpatrick, Brian; Barron, Laurence D; Gadegaard, Nikolaj; Lapthorn, Adrian J; Rotello, Vincent M; Cooke, Graeme; Govorov, Alexander O; Kadodwala, Malcolm

    2016-03-10

    Optimal performance of nanophotonic devices, including sensors and solar cells, requires maximizing the interaction between light and matter. This efficiency is optimized when active moieties are localized in areas where electromagnetic (EM) fields are confined. Confinement of matter in these 'hotspots' has previously been accomplished through inefficient 'top-down' methods. Here we report a rapid 'bottom-up' approach to functionalize selective regions of plasmonic nanostructures that uses nano-localized heating of the surrounding water induced by pulsed laser irradiation. This localized heating is exploited in a chemical protection/deprotection strategy to allow selective regions of a nanostructure to be chemically modified. As an exemplar, we use the strategy to enhance the biosensing capabilities of a chiral plasmonic substrate. This novel spatially selective functionalization strategy provides new opportunities for efficient high-throughput control of chemistry on the nanoscale over macroscopic areas for device fabrication.

  5. Definitive Radiotherapy for Ewing Tumors of Extremities and Pelvis: Long-Term Disease Control, Limb Function, and Treatment Toxicity

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Indelicato, Daniel J.; Keole, Sameer R.; Shahlaee, Amir H.

    2008-11-01

    Purpose: More than 70% of Ewing tumors occur in the extremities and pelvis. This study identified factors influencing local control and functional outcomes after management with definitive radiotherapy (RT). Patients and Methods: A total of 75 patients with a localized Ewing tumor of the extremity or pelvis were treated with definitive RT at the University of Florida between 1970 and 2006 (lower extremity tumors in 30, pelvic tumors in 26, and upper extremity tumors in 19). RT was performed on a once-daily (40%) or twice-daily (60%) basis. The median dose was 55.2 Gy in 1.8-Gy daily fractions or 55.0 Gymore » in 1.2-Gy twice-daily fractions. The median observed follow-up was 4.7 years. Functional outcome was assessed using the Toronto Extremity Salvage Score. Results: The 10-year actuarial overall survival, cause-specific survival, freedom from relapse, and local control rate was 48%, 48%, 42%, and 71%, respectively. Of the 72 patients, 3 required salvage amputation. Inferior cause-specific survival was associated with larger tumors (81% for tumors <8 cm vs. 39% for tumors {>=}8 cm, p <0.05). No patient characteristics or treatment variables were predictive of local failure. No fractures occurred in patients treated with hyperfractionation or with tumors of the distal extremities. Severe late complications were more frequently associated with use of <8-MV photons and fields encompassing the entire bone or hemipelvis. A significantly better Toronto Extremity Salvage Score was associated with a late-effect biologically effective dose of <91.7 Gy{sub 3}. Conclusions: Limb preservation was effectively achieved through definitive RT. Treating limited field sizes with hyperfractionated high-energy RT could minimize long-term complications and provides superior functional outcomes.« less

  6. Tectonic control on sea-floor relief and the localization of Lower Mississippian Waulsortian mounds, New Mexico

    NASA Astrophysics Data System (ADS)

    Jeffery, David L.

    1997-11-01

    Lower Mississippian carbonate mud-rich bioherms, generally referred to as Waulsortian mounds, are commonly associated with low-paleolatitude carbonate ramp settings and have recently been recognized as important hydrocarbon reservoirs. The factors controlling localization of Waulsortian mounds have heretofore been poorly understood. Stratal relations exposed in the Alamogordo Member of the Lake Valley Formation in the Sacramento Mountains of New Mexico illustrate the effects of tectonism on carbonate sedimentation prior to, during, and after mound growth. They indicate that mound initiation and localization were strongly controlled by tectonically generated, intraramp, sea-floor topography. These observations bear strongly on understanding the controls on localization and growth of mud mounds in general. Stratal geometries observed in the underlying Andrecito Member indicate that this topography was modified by erosional and depositional processes prior to mound initiation. Mounds formed on the surfaces and margins of the intraramp topography as the result of aggradational, in situ accumulation of biogenic sediment. Differences in growth geometry of stratal units within individual mounds and differences between mounds are correlated with position of the mound on the ramp and the deformation occurring immediately prior to mound growth. It is probable that local tectonism continued during mound growth, and that local differences in the amount of relative uplift resulted in different amounts of space for growth of individual mounds, and thus determined differences in mound size and geometry.

  7. Controlling a microdisk laser by local refractive index perturbation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Liew, Seng Fatt; Redding, Brandon; Cao, Hui, E-mail: hui.cao@yale.edu

    2016-02-01

    We demonstrate a simple yet effective approach of controlling lasing in a semiconductor microdisk by photo-thermal effect. A continuous wave green laser beam, focused onto the microdisk perimeter, can enhance or suppress lasing in different cavity modes, depending on the position of the focused beam. Its main effect is a local modification of the refractive index of the disk, which results in an increase in the power slope of some lasing modes and a decrease of others. The boundary roughness breaks the rotational symmetry of a circular disk, allowing the lasing process to be tuned by varying the green beammore » position. Using the same approach, we can also fine tune the relative intensity of a quasi-degenerate pair of lasing modes. Such post-fabrication control, enabled by an additional laser beam, is flexible and reversible, thus enhancing the functionality of semiconductor microdisk lasers.« less

  8. Transition from global to local control of dayside reconnection from ionospheric-sourced mass loading

    NASA Astrophysics Data System (ADS)

    Zhang, B.; Brambles, O. J.; Cassak, P. A.; Ouellette, J. E.; Wiltberger, M.; Lotko, W.; Lyon, J. G.

    2017-09-01

    We have conducted a series of controlled numerical simulations to investigate the response of dayside reconnection to idealized, ionosphere-sourced mass loading processes to determine whether they affect the integrated dayside reconnection rate. Our simulation results show that the coupled solar wind-magnetosphere system may exhibit both local and global control behaviors depending on the amount of mass loading. With a small amount of mass loading, the changes in local reconnection rate affects magnetosheath properties only weakly and the geoeffective length in the upstream solar wind is essentially unchanged, resulting in the same integrated dayside reconnection rate. With a large amount of mass loading, however, the magnetosheath properties and the geoeffective length are significantly affected by slowing down the local reconnection rate, resulting in an increase of the magnetic pressure in the magnetosheath, with a significant reduction in the geoeffective length in the upstream solar wind and in the integrated dayside reconnection rate. In this controlled simulation setup, the behavior of dayside reconnection potential is determined by the role of the enhanced magnetic pressure in the magnetospheath due to magnetospheric mass loading. The reconnection potential starts to decrease significantly when the enhanced magnetic pressure alters the thickness of the magnetosheath.

  9. [Radiotherapy of squamous cell carcinomas of the tongue--a statistical review].

    PubMed

    Kubo, K; Furukawa, S; Fuchihata, H; Nakamura, M; Shimizutani, K; Nishiyama, K; Ikeda, H; Masaki, N

    1989-01-01

    The cases of 36 patients referred for radiotherapy of the tongue after an excisional biopsy or after an inadequate excision of the tongue cancer have been reviewed. In 32 patients treated by radiotherapy, the actuarial survival rate at five years was 86%, and the local rate control, was 82%. The local control rate for those treated by interstitial radiotherapy (Int. RT) was successful in 12 out of 13 cases, and the rates for those treated by external radiotherapy (Ext. RT) followed by Int. RT, or by the intraoral cone technique with electron beams (Elec.), or by Ext. RT, or by Elec. followed by Int. RT, or by no additional therapy were 7 out of 9, 4 out of 5, 2 out of 4, 1 out of 1, and 2 out of 4, respectively. For such cases of cancer, subsequent interstitial radiotherapy is advisable to maintain local control.

  10. Tumor Control Outcomes Following Hypofractionated and Single-Dose Stereotactic Image-Guided Intensity-Modulated Radiotherapy for Extracranial Metastases from Renal Cell Carcinoma

    PubMed Central

    Zelefsky, Michael J; Greco, Carlo; Motzer, Robert; Magsanoc, Juan Martin; Pei, Xin; Lovelock, Michael; Mechalakos, Jim; Zatcky, Joan; Fuks, Zvi; Yamada, Yoshiya

    2014-01-01

    Purpose To report tumor local progression-free outcomes following treatment with single-dose image-guided intensity-modulated radiotherapy (SD-IGRT) and hypofractionated regimens for extracranial metastases from renal cell primary tumors. Methods and Materials Between 2004 and 2010, a total of 105 lesions from renal cell carcinomas were treated with either SD-IGRT to prescription doses of 18–24 Gy (median, 24 Gy) or hypofractionation (3 or 5 fractions) with prescription doses ranging between 20 and 30 Gy. The median follow-up was 12 months (range, 1–48 months). Results The overall 3-year actuarial local progression-free survival (LPFS) for all lesions was 44%. The 3-year LPFS for those who received high single-dose (24 Gy; n = 45), low single-dose (< 24 Gy; n = 14), and hypofractionation regimens (n = 46) were 88%, 21%, and 17%, respectively (high single dose versus low single dose, p = 0.001; high single dose versus hypofractionation, p < 0.001). Multivariate analysis revealed the following variables as significant predictors of improved LPFS: dose of 24 Gy compared with lower dose (p = 0.009), and single dose versus hypofractionation (p = 0.008). Conclusion High-dose SD-IGRT is a non-invasive procedure resulting in high probability of local tumor control for metastatic renal cell cancers, generally considered radioresistant according to classical radiobiological ranking. PMID:21596489

  11. Controlling the Local Electronic Properties of Si(553)-Au through Hydrogen Doping

    NASA Astrophysics Data System (ADS)

    Hogan, C.; Speiser, E.; Chandola, S.; Suchkova, S.; Aulbach, J.; Schäfer, J.; Meyer, S.; Claessen, R.; Esser, N.

    2018-04-01

    We propose a quantitative and reversible method for tuning the charge localization of Au-stabilized stepped Si surfaces by site-specific hydrogenation. This is demonstrated for Si(553)-Au as a model system by combining density functional theory simulations and reflectance anisotropy spectroscopy experiments. We find that controlled H passivation is a two-step process: step-edge adsorption drives excess charge into the conducting metal chain "reservoir" and renders it insulating, while surplus H recovers metallic behavior. Our approach illustrates a route towards microscopic manipulation of the local surface charge distribution and establishes a reversible switch of site-specific chemical reactivity and magnetic properties on vicinal surfaces.

  12. Design of parallel transmission pulses for simultaneous multislice with explicit control for peak power and local specific absorption rate.

    PubMed

    Guérin, Bastien; Setsompop, Kawin; Ye, Huihui; Poser, Benedikt A; Stenger, Andrew V; Wald, Lawrence L

    2015-05-01

    To design parallel transmit (pTx) simultaneous multislice (SMS) spokes pulses with explicit control for peak power and local and global specific absorption rate (SAR). We design SMS pTx least-squares and magnitude least squares spokes pulses while constraining local SAR using the virtual observation points (VOPs) compression of SAR matrices. We evaluate our approach in simulations of a head (7T) and a body (3T) coil with eight channels arranged in two z-rows. For many of our simulations, control of average power by Tikhonov regularization of the SMS pTx spokes pulse design yielded pulses that violated hardware and SAR safety limits. On the other hand, control of peak power alone yielded pulses that violated local SAR limits. Pulses optimized with control of both local SAR and peak power satisfied all constraints and therefore had the best excitation performance under limited power and SAR constraints. These results extend our previous results for single slice pTx excitations but are more pronounced because of the large power demands and SAR of SMS pulses. Explicit control of local SAR and peak power is required to generate optimal SMS pTx excitations satisfying both the system's hardware limits and regulatory safety limits. © 2014 Wiley Periodicals, Inc.

  13. Surgical smoke control with local exhaust ventilation: Experimental study.

    PubMed

    Lee, Taekhee; Soo, Jhy-Charm; LeBouf, Ryan F; Burns, Dru; Schwegler-Berry, Diane; Kashon, Michael; Bowers, Jay; Harper, Martin

    2018-04-01

    This experimental study aimed to evaluate airborne particulates and volatile organic compounds (VOCs) from surgical smoke when a local exhaust ventilation (LEV) system is in place. Surgical smoke was generated from human tissue in an unoccupied operating room using an electrocautery surgical device for 15 min with 3 different test settings: (1) without LEV control; (2) control with a wall irrigation suction unit with an in-line ultra-low penetration air filter; and (3) control with a smoke evacuation system. Flow rate of LEVs was approximately 35 L/min and suction was maintained within 5 cm of electrocautery interaction site. A total of 6 experiments were conducted. Particle number and mass concentrations were measured using direct reading instruments including a condensation particle counter (CPC), a light-scattering laser photometer (DustTrak DRX), a scanning mobility particle sizer (SMPS), an aerodynamic particle sizer (APS), and a viable particle counter. Selected VOCs were collected using evacuated canisters using grab, personal and area sampling techniques. The largest average particle and VOCs concentrations were found in the absence of LEV control followed by LEV controls. Average ratios of LEV controls to without LEV control ranged 0.24-0.33 (CPC), 0.28-0.39 (SMPS), 0.14-0.31 (DustTrak DRX), and 0.26-0.55 (APS). Ethanol and isopropyl alcohol were dominant in the canister samples. Acetaldehyde, acetone, acetonitrile, benzene, hexane, styrene, and toluene were detected but at lower concentrations (<500 μg/m 3 ) and concentrations of the VOCs were much less than the National Institute for Occupational Safety and Health recommended exposure limit values. Utilization of the LEVs for surgical smoke control can significantly reduce but not completely eliminate airborne particles and VOCs.

  14. Local Control: Fear or Fantasy. A Report of the New Jersey Education Reform Project.

    ERIC Educational Resources Information Center

    Fuhrman, Susan H.

    Today local control over education seems to face the most serious challenge in its history. The movement to reform school finance raises the specter of the State assuming its formal consitutional powers and removing autonomy from the communities. Hence, it is argued, as the State takes over control of taxation and expenditures it will want to…

  15. Local governments’ dependence on tobacco tax revenue: a deterrent to tobacco control in the Republic of Korea

    PubMed Central

    Park, Kidong

    2009-01-01

    Abstract Objective To investigate, in the Republic of Korea, whether local governments’ participation in an anti-smoking programme supported by the National Health Promotion Fund in 2002–2003 was related to the percentage of local tax revenue comprised by the tobacco consumption tax (TCT). Methods Using financial and administrative data on 163 municipalities, the authors estimated logit models of local governments’ participation in the anti-smoking programme as a function of the proportion of local tax revenue that came from the TCT and a set of control variables, namely local socioeconomic characteristics and the size of the staff in the local public health centre (PHC). Findings Local governments that derived a greater percentage of their local tax revenue from the TCT, particularly those that ranked in the upper fourth in terms of this percentage, were less likely to participate in the anti-smoking programme. Insufficient staff in the PHC was also found to be associated with lower participation in the anti-smoking programme. Conclusion Local governments’ dependence on revenue from the TCT may be a deterrent to tobacco control in the Republic of Korea. PMID:19784449

  16. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial.

    PubMed

    Lewis, S C; Warlow, C P; Bodenham, A R; Colam, B; Rothwell, P M; Torgerson, D; Dellagrammaticas, D; Horrocks, M; Liapis, C; Banning, A P; Gough, M; Gough, M J

    2008-12-20

    The effect of carotid endarterectomy in lowering the risk of stroke ipsilateral to severe atherosclerotic carotid-artery stenosis is offset by complications during or soon after surgery. We compared surgery under general anaesthesia with that under local anaesthesia because prediction and avoidance of perioperative strokes might be easier under local anaesthesia than under general anaesthesia. We undertook a parallel group, multicentre, randomised controlled trial of 3526 patients with symptomatic or asymptomatic carotid stenosis from 95 centres in 24 countries. Participants were randomly assigned to surgery under general (n=1753) or local (n=1773) anaesthesia between June, 1999 and October, 2007. The primary outcome was the proportion of patients with stroke (including retinal infarction), myocardial infarction, or death between randomisation and 30 days after surgery. Analysis was by intention to treat. The trial is registered with Current Control Trials number ISRCTN00525237. A primary outcome occurred in 84 (4.8%) patients assigned to surgery under general anaesthesia and 80 (4.5%) of those assigned to surgery under local anaesthesia; three events per 1000 treated were prevented with local anaesthesia (95% CI -11 to 17; risk ratio [RR] 0.94 [95% CI 0.70 to 1.27]). The two groups did not significantly differ for quality of life, length of hospital stay, or the primary outcome in the prespecified subgroups of age, contralateral carotid occlusion, and baseline surgical risk. We have not shown a definite difference in outcomes between general and local anaesthesia for carotid surgery. The anaesthetist and surgeon, in consultation with the patient, should decide which anaesthetic technique to use on an individual basis. The Health Foundation (UK) and European Society of Vascular Surgery.

  17. Defining local-regional control and its importance in locally advanced non-small cell lung carcinoma.

    PubMed

    Machtay, Mitchell; Paulus, Rebecca; Moughan, Jennifer; Komaki, Ritsuko; Bradley, J Effrey; Choy, Hak; Albain, Kathy; Movsas, Benjamin; Sause, William T; Curran, Walter J

    2012-04-01

    Local-regional control (LRC) rates for non-small cell lung cancer after chemoradiotherapy were studied (using two different definitions of LRC) for the association between LRC and survival. Seven legacy Radiation Therapy Ooncology Group trials of chemoradiotherapy for locally advanced non-small cell lung cancer were analyzed. Two different definitions of LRC were studied: (1) freedom from local progression (FFLP-LRC), the traditional Radiation Therapy Oncology Group methodology, in which a failure is intrathoracic tumor progression by World Health Oorganization criteria; and (2) response-mandatory (strict-LRC), in which any patient not achieving at least partial response was considered to have failure at day 0. Testing for associations between LRC and survival was performed using a Cox multivariate model that included other potential predictive factors. A total of 1390 patients were analyzed. The LRC rate at 3 years was 38% based on the FFLP-LRC definition and 14% based on the strict-LRC definition. Performance status, concurrent chemotherapy, and radiotherapy dose intensity (biologically equivalent dose) were associated with better LRC (using either definition). With the strict-LRC definition (but not FFLP-LRC), age was also important. There was a powerful association between LRC and overall survival (p, 0.0001) on univariate and multivariate analyses. Age, performance status, chemotherapy sequencing, and biologically equivalent dose were also significantly associated with survival. Histology and gender were also significant if the strict-LRC model was used. LRC is associated with survival. The definition of LRC affects the results of these analyses. A consensus definition of LRC, incorporating functional imaging and/or central review, is needed, with the possibility of using LRC as a surrogate end point in future trials.

  18. Local Nordic tobacco interests collaborated with multinational companies to maintain a united front and undermine tobacco control policies.

    PubMed

    Hiilamo, Heikki; Glantz, Stanton A

    2013-03-01

    To analyse how local tobacco companies in the Nordic countries, individually and through National Manufacturers' Associations, cooperated with British American Tobacco and Philip Morris in denying the health hazards of smoking and undermining tobacco control. Analysis of tobacco control policies in the Nordic countries and tobacco industry documents. Nordic countries were early adopters of tobacco control policies. The multinational tobacco companies recognised this fact and mobilised to oppose these policies, in part because of fear that they would set unfavourable precedents. Since at least 1972, the Nordic tobacco companies were well informed about and willing to participate in the multinational companies activities to obscure the health dangers of smoking and secondhand smoke and to oppose tobacco control policies. Cooperation between multinational companies, Nordic national manufacturer associations and local companies ensured a united front on smoking and health issues in the Nordic area that was consistent with the positions that the multinational companies were taking. This cooperation delayed smoke-free laws and undermined other tobacco control measures. Local tobacco companies worked with multinational companies to undermine tobacco control in distant and small Nordic markets because of concern that pioneering policies initiated in Nordic countries would spread to bigger market areas. Claims by the local Nordic companies that they were not actively involved with the multinationals are not supported by the facts. These results also demonstrate that the industry appreciates the global importance of both positive and negative public health precedents in tobacco control.

  19. Pain and efficacy rating of a microprocessor-controlled metered injection system for local anaesthesia in minor hand surgery.

    PubMed

    Nimigan, André S; Gan, Bing Siang

    2011-01-01

    Purpose. Little attention has been given to syringe design and local anaesthetic administration methods. A microprocessor-controlled anaesthetic delivery device has become available that may minimize discomfort during injection. The purpose of this study was to document the pain experience associated with the use of this system and to compare it with use of a conventional syringe. Methods. A prospective, randomized clinical trial was designed. 40 patients undergoing carpal tunnel release were block randomized according to sex into a two groups: a traditional syringe group and a microprocessor-controlled device group. The primary outcome measure was surgical pain and local anaesthetic administration pain. Secondary outcomes included volume of anaesthetic used and injection time. Results. Analysis showed that equivalent anaesthesia was achieved in the microprocessor-controlled group despite using a significantly lower volume of local anaesthetic (P = .0002). This same group, however, has significantly longer injection times (P < .0001). Pain during the injection process or during surgery was not different between the two groups. Conclusions. This RCT comparing traditional and microprocessor controlled methods of administering local anaesthetic showed similar levels of discomfort in both groups. While the microprocessor-controlled group used less volume, the total time for the administration was significantly greater.

  20. Local and synoptic controls on rapid supraglacial lake drainage in West Greenland

    NASA Astrophysics Data System (ADS)

    Williamson, Andrew; Banwell, Alison; Arnold, Neil; Willis, Ian

    2016-04-01

    Many supraglacial lakes within the ablation zone of the Greenland Ice Sheet (GrIS) are known to drain rapidly (in <1 day) in the mid- to late melt season, delivering large meltwater pulses to the subglacial drainage system, thus affecting basal water pressures and ice-sheet dynamics. Although it is now generally recognised that rapid lake drainage is caused by hydrofracture, the precise controls on hydrofracture initiation remain poorly understood: they may be linked to a local critical water-volume threshold, or they may be associated with synoptic-scale factors, such as ice thickness, driving stresses, ice velocities and strain rates. A combination of the local water-volume threshold and one or more synoptic-scale factors may explain the overall patterns of rapid lake drainage, but this requires verification using targeted field- and remotely-based studies that cover large areas of the GrIS and span long timescales. Here, we investigate a range of potential controls on rapid supraglacial lake drainage in the land-terminating Paakitsoq region of the ice sheet, northeast of Jakobshavn Isbræ, for the 2014 melt season. We have analysed daily 250-m Moderate Resolution Imaging Spectroradiometer (MODIS) imagery in order to calculate lake areas, depths and volumes, and have developed an automatic lake-tracking algorithm to determine the dates on which all rapid lake drainage events occur. For each rapidly draining lake, the water volumes immediately prior to drainage are compared with other local factors, notably lake-filling rate and ice thickness, and with a variety of synoptic-scale features, such as slope angles, driving stresses, surface velocities, surface strain rates and the incidence of nearby lake-drainage events. We present the outcomes of our statistical analysis to elicit the statistically significant controls on hydrofracture beneath supraglacial lakes.

  1. Enhanced Control for Local Helicity Injection on the Pegasus ST

    NASA Astrophysics Data System (ADS)

    Pierren, C.; Bongard, M. W.; Fonck, R. J.; Lewicki, B. T.; Perry, J. M.

    2017-10-01

    Local helicity injection (LHI) experiments on Pegasus rely upon programmable control of a 250 MVA modular power supply system that drives the electromagnets and helicity injection systems. Precise control of the central solenoid is critical to experimental campaigns that test the LHI Taylor relaxation limit and the coupling efficiency of LHI-produced plasmas to Ohmic current drive. Enhancement and expansion of the present control system is underway using field programmable gate array (FPGA) technology for digital logic and control, coupled to new 10 MHz optical-to-digital transceivers for semiconductor level device communication. The system accepts optical command signals from existing analog feedback controllers, transmits them to multiple devices in parallel H-bridges, and aggregates their status signals for fault detection. Present device-level multiplexing/de-multiplexing and protection logic is extended to include bridge-level protections with the FPGA. An input command filter protects against erroneous and/or spurious noise generated commands that could otherwise cause device failures. Fault registration and response times with the FPGA system are 25 ns. Initial system testing indicates an increased immunity to power supply induced noise, enabling plasma operations at higher working capacitor bank voltage. This can increase the applied helicity injection drive voltage, enable longer pulse lengths and improve Ohmic loop voltage control. Work supported by US DOE Grant DE-FG02-96ER54375.

  2. Local Circuit Inhibition in the Cerebral Cortex as the source of Gain Control and Untuned Suppression

    PubMed Central

    Shapley, Robert M.; Xing, Dajun

    2012-01-01

    Theoretical considerations have led to the concept that the cerebral cortex is operating in a balanced state in which synaptic excitation is approximately balanced by synaptic inhibition from the local cortical circuit. This paper is about the functional consequences of the balanced state in sensory cortex. One consequence is gain control: there is experimental evidence and theoretical support for the idea that local circuit inhibition acts as a local automatic gain control throughout the cortex. Second, inhibition increases cortical feature selectivity: many studies of different sensory cortical areas have reported that suppressive mechanisms contribute to feature selectivity. Synaptic inhibition from the local microcircuit should be untuned (or broadly tuned) for stimulus features because of the microarchitecture of the cortical microcircuit. Untuned inhibition probably is the source of Untuned Suppression that enhances feature selectivity. We studied inhibition’s function in our experiments, guided by a neuronal network model, on orientation selectivity in the primary visual cortex, V1, of the Macaque monkey. Our results revealed that Untuned Suppression, generated by local circuit inhibition, is crucial for the generation of highly orientation-selective cells in V1 cortex. PMID:23036513

  3. Controlling disasters: Local emergency management perceptions about Federal Emergency Management and Homeland Security actions after September 11, 2001.

    PubMed

    Hildebrand, Sean

    This article examines local emergency manager's beliefs regarding control over tasks during various stages of the hazard cycle since federal policies went into effect following the September 11 attacks. The study considers whether a disparity exists between the actions of local officials during each phase of the "hazard cycle" and the policy expectations of the federal government, which call for greater federal control over activities in emergency management and homeland security. To do so, hypothesis testing investigates the jurisdiction's use of comprehensive emergency management (CEM) practices, the perceived "clarity" of the federal policy demands, and if the local actors feel coerced to comply with federal policy demands so that grant funding is not compromised. Using a model developed from "third-generation" policy implementation research, the results show that the odds of local officials citing federal control over these actions have very limited statistical significance. This signals that the perceived lack of local input into the development of these federal policies and the policies' limited use of traditional CEM measures may not be in concert with what local actors perform in the field. Simply put, the respondents claim to understand the federal policy demands, support the concept of federal control as the policies describe, yet follow their own plans or traditional CEM principles, even if such actions do not support the federal policy demands. These results align with pre-existing research in the emergency management field that show issues with efforts to centralize policies under the Department of Homeland Security and Federal Emergency Management Agency.

  4. Effect of family history on outcomes in patients treated with definitive brachytherapy for clinically localized prostate cancer.

    PubMed

    Peters, Christopher A; Stock, Richard G; Blacksburg, Seth R; Stone, Nelson N

    2009-01-01

    To determine the impact familial prostate cancer has on prognosis in men treated with brachytherapy for clinically localized prostate cancer. A total of 1,738 consecutive patients with prostate cancer (cT1-3, N0/X, M0) received low-dose-rate brachytherapy alone or in combination with external beam radiation therapy or hormone ablation from 1992 to 2005. The primary end-point was freedom from biochemical failure (FFBF) using the Phoenix definition. Minimum follow-up was 2 years and the median follow-up was 60 months (range, 24-197 months). A total of 187 of 1,738 men (11%) had a family history of prostate cancer in a first-degree relative. For the low-risk patients, both groups had similar actuarial 5-year FFBF (97.2% vs. 95.5%, p = 0.516). For intermediate-risk patients, there was a trend toward improved biochemical control in men positive for family history (5-yr FFBF 100% vs. 93.6%, p = 0.076). For the high-risk patients, men with a positive family history had similar 5-year FFBF (92.8% vs. 85.2%, p = 0.124). On multivariate analysis, family history was not significant; use of hormones, high biologic effective dose, initial prostate-specific antigen value, and Gleason score were the significant variables predicting biochemical control. This is the first study to examine the relationship of familial prostate cancer and outcomed in men treated with brachytherapy alone or in combination therapy. Men with a positive family history have clinicopathologic characteristics and biochemical outcomes similar to those with sporadic disease.

  5. Changes in Gene Expression Predicting Local Control in Cervical Cancer: Results from Radiation Therapy Oncology Group 0128

    PubMed Central

    Weidhaas, Joanne B.; Li, Shu-Xia; Winter, Kathryn; Ryu, Janice; Jhingran, Anuja; Miller, Bridgette; Dicker, Adam P.; Gaffney, David

    2009-01-01

    Purpose To evaluate the potential of gene expression signatures to predict response to treatment in locally advanced cervical cancer treated with definitive chemotherapy and radiation. Experimental Design Tissue biopsies were collected from patients participating in Radiation Therapy Oncology Group (RTOG) 0128, a phase II trial evaluating the benefit of celecoxib in addition to cisplatin chemotherapy and radiation for locally advanced cervical cancer. Gene expression profiling was done and signatures of pretreatment, mid-treatment (before the first implant), and “changed” gene expression patterns between pre- and mid-treatment samples were determined. The ability of the gene signatures to predict local control versus local failure was evaluated. Two-group t test was done to identify the initial gene set separating these end points. Supervised classification methods were used to enrich the gene sets. The results were further validated by leave-one-out and 2-fold cross-validation. Results Twenty-two patients had suitable material from pretreatment samples for analysis, and 13 paired pre- and mid-treatment samples were obtained. The changed gene expression signatures between the pre- and mid-treatment biopsies predicted response to treatment, separating patients with local failures from those who achieved local control with a seven-gene signature. The in-sample prediction rate, leave-one-out prediction rate, and 2-fold prediction rate are 100% for this seven-gene signature. This signature was enriched for cell cycle genes. Conclusions Changed gene expression signatures during therapy in cervical cancer can predict outcome as measured by local control. After further validation, such findings could be applied to direct additional therapy for cervical cancer patients treated with chemotherapy and radiation. PMID:19509178

  6. Puzzling Plans and Budgets: Making Sense of California's Second Year Local Control and Accountability Plans

    ERIC Educational Resources Information Center

    Chen, Theresa

    2016-01-01

    On July 1, 2013, Gov. Jerry Brown signed California's landmark Local Control Funding Formula (LCFF) into law. In addition to providing districts with greater control over how to spend funds, LCFF marked a tremendous opportunity for educational equity. The new funding law gave districts additional resources, called supplemental and concentration…

  7. Control of defect localization in crystalline wrinkling by curvature and topology

    NASA Astrophysics Data System (ADS)

    Lopez Jimenez, Francisco

    We investigate the influence of curvature and topology on crystalline wrinkling patterns in generic elastic bilayers. Our numerical analysis predicts that the total number of defects created by adiabatic compression exhibits universal quadratic scaling for spherical, ellipsoidal and toroidal surfaces over a wide range of system sizes. However, both the localization of individual defects and the orientation of defect chains depend strongly on the local Gaussian curvature and its gradients across a surface. Our results imply that curvature and topology can be utilized to pattern defects in elastic materials, thus promising improved control over hierarchical bending, buckling or folding processes. Generally, this study suggests that bilayer systems provide an inexpensive yet valuable experimental test-bed for exploring the effects of geometrically induced forces on assemblies of topological charges. Joint work with Norbert Stoop, Romain Lagrange, Jorn Dunkel and Pedro M. Reis.

  8. Estimating the Impacts of Local Policy Innovation: The Synthetic Control Method Applied to Tropical Deforestation

    PubMed Central

    Sills, Erin O.; Herrera, Diego; Kirkpatrick, A. Justin; Brandão, Amintas; Dickson, Rebecca; Hall, Simon; Pattanayak, Subhrendu; Shoch, David; Vedoveto, Mariana; Young, Luisa; Pfaff, Alexander

    2015-01-01

    Quasi-experimental methods increasingly are used to evaluate the impacts of conservation interventions by generating credible estimates of counterfactual baselines. These methods generally require large samples for statistical comparisons, presenting a challenge for evaluating innovative policies implemented within a few pioneering jurisdictions. Single jurisdictions often are studied using comparative methods, which rely on analysts’ selection of best case comparisons. The synthetic control method (SCM) offers one systematic and transparent way to select cases for comparison, from a sizeable pool, by focusing upon similarity in outcomes before the intervention. We explain SCM, then apply it to one local initiative to limit deforestation in the Brazilian Amazon. The municipality of Paragominas launched a multi-pronged local initiative in 2008 to maintain low deforestation while restoring economic production. This was a response to having been placed, due to high deforestation, on a federal “blacklist” that increased enforcement of forest regulations and restricted access to credit and output markets. The local initiative included mapping and monitoring of rural land plus promotion of economic alternatives compatible with low deforestation. The key motivation for the program may have been to reduce the costs of blacklisting. However its stated purpose was to limit deforestation, and thus we apply SCM to estimate what deforestation would have been in a (counterfactual) scenario of no local initiative. We obtain a plausible estimate, in that deforestation patterns before the intervention were similar in Paragominas and the synthetic control, which suggests that after several years, the initiative did lower deforestation (significantly below the synthetic control in 2012). This demonstrates that SCM can yield helpful land-use counterfactuals for single units, with opportunities to integrate local and expert knowledge and to test innovations and permutations on

  9. Estimating the Impacts of Local Policy Innovation: The Synthetic Control Method Applied to Tropical Deforestation.

    PubMed

    Sills, Erin O; Herrera, Diego; Kirkpatrick, A Justin; Brandão, Amintas; Dickson, Rebecca; Hall, Simon; Pattanayak, Subhrendu; Shoch, David; Vedoveto, Mariana; Young, Luisa; Pfaff, Alexander

    2015-01-01

    Quasi-experimental methods increasingly are used to evaluate the impacts of conservation interventions by generating credible estimates of counterfactual baselines. These methods generally require large samples for statistical comparisons, presenting a challenge for evaluating innovative policies implemented within a few pioneering jurisdictions. Single jurisdictions often are studied using comparative methods, which rely on analysts' selection of best case comparisons. The synthetic control method (SCM) offers one systematic and transparent way to select cases for comparison, from a sizeable pool, by focusing upon similarity in outcomes before the intervention. We explain SCM, then apply it to one local initiative to limit deforestation in the Brazilian Amazon. The municipality of Paragominas launched a multi-pronged local initiative in 2008 to maintain low deforestation while restoring economic production. This was a response to having been placed, due to high deforestation, on a federal "blacklist" that increased enforcement of forest regulations and restricted access to credit and output markets. The local initiative included mapping and monitoring of rural land plus promotion of economic alternatives compatible with low deforestation. The key motivation for the program may have been to reduce the costs of blacklisting. However its stated purpose was to limit deforestation, and thus we apply SCM to estimate what deforestation would have been in a (counterfactual) scenario of no local initiative. We obtain a plausible estimate, in that deforestation patterns before the intervention were similar in Paragominas and the synthetic control, which suggests that after several years, the initiative did lower deforestation (significantly below the synthetic control in 2012). This demonstrates that SCM can yield helpful land-use counterfactuals for single units, with opportunities to integrate local and expert knowledge and to test innovations and permutations on policies

  10. Vision-Based Steering Control, Speed Assistance and Localization for Inner-City Vehicles

    PubMed Central

    Olivares-Mendez, Miguel Angel; Sanchez-Lopez, Jose Luis; Jimenez, Felipe; Campoy, Pascual; Sajadi-Alamdari, Seyed Amin; Voos, Holger

    2016-01-01

    Autonomous route following with road vehicles has gained popularity in the last few decades. In order to provide highly automated driver assistance systems, different types and combinations of sensors have been presented in the literature. However, most of these approaches apply quite sophisticated and expensive sensors, and hence, the development of a cost-efficient solution still remains a challenging problem. This work proposes the use of a single monocular camera sensor for an automatic steering control, speed assistance for the driver and localization of the vehicle on a road. Herein, we assume that the vehicle is mainly traveling along a predefined path, such as in public transport. A computer vision approach is presented to detect a line painted on the road, which defines the path to follow. Visual markers with a special design painted on the road provide information to localize the vehicle and to assist in its speed control. Furthermore, a vision-based control system, which keeps the vehicle on the predefined path under inner-city speed constraints, is also presented. Real driving tests with a commercial car on a closed circuit finally prove the applicability of the derived approach. In these tests, the car reached a maximum speed of 48 km/h and successfully traveled a distance of 7 km without the intervention of a human driver and any interruption. PMID:26978365

  11. Vision-Based Steering Control, Speed Assistance and Localization for Inner-City Vehicles.

    PubMed

    Olivares-Mendez, Miguel Angel; Sanchez-Lopez, Jose Luis; Jimenez, Felipe; Campoy, Pascual; Sajadi-Alamdari, Seyed Amin; Voos, Holger

    2016-03-11

    Autonomous route following with road vehicles has gained popularity in the last few decades. In order to provide highly automated driver assistance systems, different types and combinations of sensors have been presented in the literature. However, most of these approaches apply quite sophisticated and expensive sensors, and hence, the development of a cost-efficient solution still remains a challenging problem. This work proposes the use of a single monocular camera sensor for an automatic steering control, speed assistance for the driver and localization of the vehicle on a road. Herein, we assume that the vehicle is mainly traveling along a predefined path, such as in public transport. A computer vision approach is presented to detect a line painted on the road, which defines the path to follow. Visual markers with a special design painted on the road provide information to localize the vehicle and to assist in its speed control. Furthermore, a vision-based control system, which keeps the vehicle on the predefined path under inner-city speed constraints, is also presented. Real driving tests with a commercial car on a closed circuit finally prove the applicability of the derived approach. In these tests, the car reached a maximum speed of 48 km/h and successfully traveled a distance of 7 km without the intervention of a human driver and any interruption.

  12. Inflammatory breast cancer: enhanced local control with hyperfractionated radiotherapy and infusional vincristine, ifosfamide and epirubicin.

    PubMed

    Gurney, H; Harnett, P; Kefford, R; Boyages, J

    1998-06-01

    Local control rate for inflammatory breast cancer (IBC) is < 50% with standard chemotherapy-radiotherapy regimen. Nineteen women (age range 40-65, median 50 years) with IBC (18 patients) or with a primary tumour of > 10 cm (one patient) received a novel treatment comprising hyperfractionated radiotherapy (HFRT) sandwiched between two cycles of infusional chemotherapy using vincristine, ifosfamide and epirubicin (VIE). The primary endpoint was local control. VIE was continuously infused for six weeks via a Hickman's line using a Deltec CADD-1 ambulatory pump. Ifosfamide (3 gm/m2) mixed with equi-dose mesna was infused for seven days and alternated every week with an infusion of epirubicin (50 mg/m2) mixed with vincristine (1.5 mg/m2). HFRT consisted of 1.5 Gy twice daily for 34 frct (51 Gy) followed by a boost of 15 Gy in 10 frct. The total treatment time was less than 22 weeks. Median follow-up was 37 months. Local control rate was 58%. Three patients failed to respond initially and five relapsed in the breast at a median time of 36.8 months. Median overall and disease-free survival was 18 and 25.3 months respectively. Toxicity from VIE was minimal (WHO gd 3 emesis--two patients, gd 3 mucositis--one patient, neutropenic sepsis--three patients). Radiotherapy caused moist desquamation in 17/19 patients. Twenty-four central lines were complicated by seven line infections, three thromboses, and one extravasation. The local control rate of 58% with VIE + HFRT appears similar to reported chemoradiotherapy regimen, although the treatment time of 22 weeks is much shorter than other regimens which take up to 12 months. Toxicity is acceptable. Hickman-related complications need to be reduced. The study is ongoing.

  13. Local Nordic tobacco interests collaborated with multinational companies to maintain a united front and undermine tobacco control policies

    PubMed Central

    Hiilamo, Heikki; Glantz, Stanton A

    2012-01-01

    Objective To analyse how local tobacco companies in the Nordic countries, individually and through National Manufacturers’ Associations, cooperated with British American Tobacco and Philip Morris in denying the health hazards of smoking and undermining tobacco control. Methods Analysis of tobacco control policies in the Nordic countries and tobacco industry documents. Results Nordic countries were early adopters of tobacco control policies. The multinational tobacco companies recognised this fact and mobilised to oppose these policies, in part because of fear that they would set unfavourable precedents. Since at least 1972, the Nordic tobacco companies were well informed about and willing to participate in the multinational companies activities to obscure the health dangers of smoking and secondhand smoke and to oppose tobacco control policies. Cooperation between multinational companies, Nordic national manufacturer associations and local companies ensured a united front on smoking and health issues in the Nordic area that was consistent with the positions that the multinational companies were taking. This cooperation delayed smoke-free laws and undermined other tobacco control measures. Conclusions Local tobacco companies worked with multinational companies to undermine tobacco control in distant and small Nordic markets because of concern that pioneering policies initiated in Nordic countries would spread to bigger market areas. Claims by the local Nordic companies that they were not actively involved with the multinationals are not supported by the facts. These results also demonstrate that the industry appreciates the global importance of both positive and negative public health precedents in tobacco control. PMID:22199013

  14. Predictive factors of tumor control and survival after radiosurgery for local failures of nasopharyngeal carcinoma.

    PubMed

    Chua, Daniel T T; Sham, Jonathan S T; Hung, Kwan-Ngai; Leung, Lucullus H T; Au, Gordon K H

    2006-12-01

    Stereotactic radiosurgery has been employed as a salvage treatment of local failures of nasopharyngeal carcinoma (NPC). To identify patients that would benefit from radiosurgery, we reviewed our data with emphasis on factors that predicted treatment outcome. A total of 48 patients with local failures of NPC were treated by stereotactic radiosurgery between March 1996 and February 2005. Radiosurgery was administered using a modified linear accelerator with single or multiple isocenters to deliver a median dose of 12.5 Gy to the target periphery. Median follow-up was 54 months. Five-year local failure-free probability after radiosurgery was 47.2% and 5-year overall survival rate was 46.9%. Neuroendocrine complications occurred in 27% of patients but there were no treatment-related deaths. Time interval from primary radiotherapy, retreatment T stage, prior local failures and tumor volume were significant predictive factors of local control and/or survival whereas age was of marginal significance in predicting survival. A radiosurgery prognostic scoring system was designed based on these predictive factors. Five-year local failure-free probabilities in patients with good, intermediate and poor prognostic scores were 100%, 42.5%, and 9.6%. The corresponding five-year overall survival rates were 100%, 51.1%, and 0%. Important factors that predicted tumor control and survival after radiosurgery were identified. Patients with good prognostic score should be treated by radiosurgery in view of the excellent results. Patients with intermediate prognostic score may also be treated by radiosurgery but those with poor prognostic score should receive other salvage treatments.

  15. Comorbidity, Use of Common Medications, and Risk of Early Death in Patients with Localized or Locally Advanced Prostate Cancer

    PubMed Central

    Nieder, Carsten; Dalhaug, Astrid; Pawinski, Adam; Aandahl, Gro; Norum, Jan

    2011-01-01

    In this paper, we analyze predictive factors for early death from comorbidity (defined as death within 3 years from diagnosis and unrelated to prostate cancer) in patients with localized or locally advanced prostate cancer. Such information may guide individually tailored treatment or observation strategies, and help to avoid overtreatment. We retrospectively analyzed baseline parameters including information on comorbidity and medication use among 177 patients (median age at diagnosis 70 years). Actuarial survival analyses were performed. During the first 3 years, two patients (1.1%) died from progressive prostate cancer after they had developed distant metastases. The risk of dying from other causes (3.4%) was numerically higher, although not to a statistically significant degree. Six patients who died from other causes had age-adjusted Charlson comorbidity index (CCI) scores ≥5 (CCI is a sum score where each comorbid condition is assigned with a score depending on the risk of dying associated with this condition). The main comorbidity was cardiovascular disease. The two statistically significant predictive factors were medication use and age-adjusted CCI score ≥5 (univariate analysis). However, medication use was not an independent factor as all patients with age-adjusted CCI score ≥5 also used at least one class of medication. Median survival was 30 months in patients with age-adjusted CCI score ≥5. Prediction of non-prostate cancer death may be important to prevent overtreatment in patients who are more threatened by comorbidity. Our data suggest that simple parameters such as use of medications vs. none, or presence of serious cardiac disease vs. none, are not sufficient, and that age-adjusted CCI scores outperform the other factors included in our analysis. PMID:21666987

  16. Acupuncture at local and distal points for chronic shoulder pain: study protocol for a randomized controlled trial.

    PubMed

    Fu, Qing-Nan; Shi, Guang-Xia; Li, Qian-Qian; He, Tian; Liu, Bao-Zhen; Sun, San-Feng; Wang, Jun; Tan, Cheng; Yang, Bo-Feng; Liu, Cun-Zhi

    2014-04-17

    Chronic shoulder pain (CSP) is the third most common type of musculoskeletal pain. It has a major impact on health-related quality of life. In Chinese medicine, CSP is considered one of the conditions most amenable to treatment with acupuncture. The purpose of this study is to evaluate the efficacy of local acupoints in combination with distal acupoints in pain relief and shoulder function improvement in CSP patients. This is a multicenter, single blind, factorial randomized controlled clinical trial. A total of 164 participants will be randomly allocated to four different groups: Group A will receive acupuncture at local acupoints in combination with distal acupoint. Group B will receive acupuncture at local acupoints in combination with distal non-acupoint. Group C will receive acupuncture at local non-acupoints in combination with distal acupoint. Group D will receive acupuncture at local non-acupoints in combination with distal non-acupoint. Each group will receive 12 treatments of acupuncture one to three times per week for six weeks in total. The primary outcome is shoulder pain intensity, which is graded using a 100 -mm Visual Analogue Scale. The assessment is at baseline (before treatment initiation), 6 weeks after the first acupuncture, 10 weeks after the first acupuncture and 18 weeks after the first acupuncture. This trial will be helpful in identifying whether acupuncture at local acupoints in combination with distal acupoints may be more effective than needling points separately. International Standard Randomized Controlled Trial Number Register: ISRCTN61861069 (http://www.controlled-trials.com).

  17. Plan View Pattern Control for Steel Plates through Constrained Locally Weighted Regression

    NASA Astrophysics Data System (ADS)

    Shigemori, Hiroyasu; Nambu, Koji; Nagao, Ryo; Araki, Tadashi; Mizushima, Narihito; Kano, Manabu; Hasebe, Shinji

    A technique for performing parameter identification in a locally weighted regression model using foresight information on the physical properties of the object of interest as constraints was proposed. This method was applied to plan view pattern control of steel plates, and a reduction of shape nonconformity (crop) at the plate head end was confirmed by computer simulation based on real operation data.

  18. Industry/Government Teleconference on Pollution Control. Proceedings National Telecast and Local Panel Sessions.

    ERIC Educational Resources Information Center

    National Association of Manufacturers, New York, NY.

    Proceedings of the closed-circuit Teleconference on Pollution Control conducted by the National Association of Manufacturers on May 26, 1971 are supplied in this compendium. Edited transcripts are provided for the national programs and local panel sessions. Seeking to bring business and government together for cooperative problem solving, the…

  19. Flutter of wings involving a locally distributed flexible control surface

    NASA Astrophysics Data System (ADS)

    Mozaffari-Jovin, S.; Firouz-Abadi, R. D.; Roshanian, J.

    2015-11-01

    This paper undertakes to facilitate appraisal of aeroelastic interaction of a locally distributed, flap-type control surface with aircraft wings operating in a subsonic potential flow field. The extended Hamilton's principle serves as a framework to ascertain the Euler-Lagrange equations for coupled bending-torsional-flap vibration. An analytical solution to this boundary-value problem is then accomplished by assumed modes and the extended Galerkin's method. The developed aeroelastic model considers both the inherent flexibility of the control surface displaced on the wing and the inertial coupling between these two flexible bodies. The structural deformations also obey the Euler-Bernoulli beam theory, along with the Kelvin-Voigt viscoelastic constitutive law. Meanwhile, the unsteady thin-airfoil and strip theories are the tools of producing the three-dimensional airloads. The origin of aerodynamic instability undergoes analysis in light of the oscillatory loads as well as the loads owing to arbitrary motions. After successful verification of the model, a systematic flutter survey was conducted on the theoretical effects of various control surface parameters. The results obtained demonstrate that the flapping modes and parameters of the control surface can significantly impact the flutter characteristics of the wings, which leads to a series of pertinent conclusions.

  20. Solid-state nanopore localization by controlled breakdown of selectively thinned membranes

    NASA Astrophysics Data System (ADS)

    Carlsen, Autumn T.; Briggs, Kyle; Hall, Adam R.; Tabard-Cossa, Vincent

    2017-02-01

    We demonstrate precise positioning of nanopores fabricated by controlled breakdown (CBD) on solid-state membranes by spatially varying the electric field strength with localized membrane thinning. We show 100 × 100 nm2 precision in standard SiN x membranes (30-100 nm thick) after selective thinning by as little as 25% with a helium ion beam. Control over nanopore position is achieved through the strong dependence of the electric field-driven CBD mechanism on membrane thickness. Confinement of pore formation to the thinned region of the membrane is confirmed by TEM imaging and by analysis of DNA translocations. These results enhance the functionality of CBD as a fabrication approach and enable the production of advanced nanopore devices for single-molecule sensing applications.

  1. Global, local and focused geographic clustering for case-control data with residential histories

    PubMed Central

    Jacquez, Geoffrey M; Kaufmann, Andy; Meliker, Jaymie; Goovaerts, Pierre; AvRuskin, Gillian; Nriagu, Jerome

    2005-01-01

    Background This paper introduces a new approach for evaluating clustering in case-control data that accounts for residential histories. Although many statistics have been proposed for assessing local, focused and global clustering in health outcomes, few, if any, exist for evaluating clusters when individuals are mobile. Methods Local, global and focused tests for residential histories are developed based on sets of matrices of nearest neighbor relationships that reflect the changing topology of cases and controls. Exposure traces are defined that account for the latency between exposure and disease manifestation, and that use exposure windows whose duration may vary. Several of the methods so derived are applied to evaluate clustering of residential histories in a case-control study of bladder cancer in south eastern Michigan. These data are still being collected and the analysis is conducted for demonstration purposes only. Results Statistically significant clustering of residential histories of cases was found but is likely due to delayed reporting of cases by one of the hospitals participating in the study. Conclusion Data with residential histories are preferable when causative exposures and disease latencies occur on a long enough time span that human mobility matters. To analyze such data, methods are needed that take residential histories into account. PMID:15784151

  2. Localizing Effects of Leptin on Upper Airway and Respiratory Control during Sleep.

    PubMed

    Yao, Qiaoling; Pho, Huy; Kirkness, Jason; Ladenheim, Ellen E; Bi, Sheng; Moran, Timothy H; Fuller, David D; Schwartz, Alan R; Polotsky, Vsevolod Y

    2016-05-01

    Obesity hypoventilation and obstructive sleep apnea are common complications of obesity linked to defects in respiratory pump and upper airway neural control. Leptin-deficient ob/ob mice have impaired ventilatory control and inspiratory flow limitation during sleep, which are both reversed with leptin. We aimed to localize central nervous system (CNS) site(s) of leptin action on respiratory and upper airway neuroventilatory control. We localized the effect of leptin to medulla versus hypothalamus by administering intracerbroventricular leptin (10 μg/2 μL) versus vehicle to the lateral (n = 14) versus fourth ventricle (n = 11) of ob/ob mice followed by polysomnographic recording. Analyses were stratified for effects on respiratory (nonflow-limited breaths) and upper airway (inspiratory flow limitation) functions. CNS loci were identified by (1) leptin-induced signal transducer and activator of transcription 3 (STAT3) phosphorylation and (2) projections of respiratory and upper airway motoneurons with a retrograde transsynaptic tracer (pseudorabies virus). Both routes of leptin administration increased minute ventilation during nonflow-limited breathing in sleep. Phrenic motoneurons were synaptically coupled to the nucleus of the solitary tract, which also showed STAT3 phosphorylation, but not to the hypothalamus. Inspiratory flow limitation and obstructive hypopneas were attenuated by leptin administration to the lateral but not to the fourth cerebral ventricle. Upper airway motoneurons were synaptically coupled with the dorsomedial hypothalamus, which exhibited STAT3 phosphorylation. Leptin relieves upper airway obstruction in sleep apnea by activating the forebrain, possibly in the dorsomedial hypothalamus. In contrast, leptin upregulates ventilatory control through hindbrain sites of action, possibly in the nucleus of the solitary tract. © 2016 Associated Professional Sleep Societies, LLC.

  3. Intraflagellar transport protein 122 antagonizes Sonic Hedgehog signaling and controls ciliary localization of pathway components.

    PubMed

    Qin, Jian; Lin, Yulian; Norman, Ryan X; Ko, Hyuk W; Eggenschwiler, Jonathan T

    2011-01-25

    Primary cilia are required for proper Sonic Hedgehog (Shh) signaling in mammals. However, their role in the signal transduction process remains unclear. We have identified sister of open brain (sopb), a null allele of mouse Intraflagellar transport protein 122 (Ift122). IFT122 negatively regulates the Shh pathway in the cilium at a step downstream of the Shh ligand and the transmembrane protein Smoothened, but upstream of the Gli2 transcription factor. Ift122(sopb) mutants generate primary cilia, but they show features of defective retrograde intraflagellar transport. IFT122 controls the ciliary localization of Shh pathway regulators in different ways. Disruption of IFT122 leads to accumulation of Gli2 and Gli3 at cilia tips while blocking the ciliary localization of the antagonist TULP3. Suppressor of Fused and Smoothened localize to the cilium through an IFT122-independent mechanism. We propose that the balance between positive and negative regulators of the Shh pathway at the cilium tip controls the output of the pathway and that Shh signaling regulates this balance through intraflagellar transport.

  4. Immunohistochemical localization of translationally controlled tumor protein in the mouse digestive system

    PubMed Central

    Sheverdin, Vadim; Jung, Jiwon; Lee, Kyunglim

    2013-01-01

    Translationally controlled tumor protein (TCTP) is a housekeeping protein, highly conserved among various species. It plays a major role in cell differentiation, growth, proliferation, apoptosis and carcinogenesis. Studies reported so far on TCTP expression in different digestive organs have not led to any understanding of the role of TCTP in digestion, so we localized TCTP in organs of the mouse digestive system employing immunohistochemical techniques. Translationally controlled tumor protein was found expressed in all organs studied: tongue, salivary glands, esophagus, stomach, small and large intestines, liver and pancreas. The expression of TCTP was found to be predominant in epithelia and neurons of myenteric nerve ganglia; high in serous glands (parotid, submandibular, gastric, intestinal crypts, pancreatic acini) and in neurons of myenteric nerve ganglia, and moderate to low in epithelia. In epithelia, expression of TCTP varied depending on its type and location. In enteric neurons, TCTP was predominantly expressed in the processes. Translationally controlled tumor protein expression in the liver followed porto-central gradient with higher expression in pericentral hepatocytes. In the pancreas, TCTP was expressed in both acini and islet cells. Our finding of nearly universal localization and expression of TCTP in mouse digestive organs points to the hitherto unrecognized functional importance of TCTP in the digestive system and suggests the need for further studies of the possible role of TCTP in the proliferation, secretion, absorption and neural regulation of the digestive process and its importance in the physiology and pathology of digestive process. PMID:23834399

  5. 'A potential fifth column': conflicts and struggles for control in the context of local NHS privatization.

    PubMed

    Aldred, Rachel

    2009-09-01

    This article uses case study data to discuss how a new procurement policy (Local Improvement Finance Trust, or LIFT) in English primary care may affect general practitioners' control over their work. LIFT, a series of 51 public-private partnerships, will enable over the medium term a shift towards the corporate ownership of surgeries and the creation of polyclinics or 'onestop-shops'. In this article, I explore the struggles over work autonomy and control within these new LIFT structures, as expressed by clinicians and managers in meetings and in research interviews. More generally, I consider how the findings inform debates over the changing position of professionals within increasingly financialized 'local health economies'.

  6. Local Control of Blood Flow

    ERIC Educational Resources Information Center

    Clifford, Philip S.

    2011-01-01

    Organ blood flow is determined by perfusion pressure and vasomotor tone in the resistance vessels of the organ. Local factors that regulate vasomotor tone include myogenic and metabolic autoregulation, flow-mediated and conducted responses, and vasoactive substances released from red blood cells. The relative importance of each of these factors…

  7. Effect of localizer radiograph on radiation dose associated with automatic exposure control: human cadaver and patient study.

    PubMed

    Singh, Sarabjeet; Petrovic, Dean; Jamnik, Ethen; Aran, Shima; Pourjabbar, Sarvenaz; Kave, Maggie L; Bradley, Stephen E; Choy, Garry; Kalra, Mannudeep K

    2014-01-01

    To evaluate the effect of localizing radiograph on computed tomography (CT) radiation dose associated with automatic exposure control with a human cadaver and patient study. Institutional review board approved the study with a waiver of informed consent. Two chest CT image series with fixed tube current and combined longitudinal-angular automatic exposure control (AEC) were acquired in a human cadaver (64-year-old man) after each of the 8 combinations of localizer radiographs (anteroposterior [AP], AP lateral, AP-posteroanterior [PA], lateral AP, lateral PA, PA, PA-AP, and PA lateral). Applied effective milliampere second, volume CT dose index (CTDIvol) and image noise were recorded for all 24-image series. Volume CT dose indexes were also recorded in 20 patients undergoing chest and abdominal CT after PA and PA-lateral radiographs with the use of AEC. Data were analyzed using analysis of variance and linear correlation tests. With AEC, the CTDIvol fluctuates with the number and projection of localizer radiographs (P < 0.0001). Lowest CTDIvol values are seen when 2 orthogonal localizer radiographs are acquired, whereas highest values are seen when single PA or AP-PA projection localizer radiographs are acquired for planning (P < 0.0001). In 20 patients, CT scanning with AEC after acquisition of 2 orthogonal projection localizer radiographs was associated with significant reduction in radiation dose compared to PA projection radiographs alone (P < 0.0001). When scanning with AEC, acquisition of 2 orthogonal localizer radiographs is associated with lower CTDIvol compared to a single localizer radiograph.

  8. Impulse-induced localized control of chaos in starlike networks.

    PubMed

    Chacón, Ricardo; Palmero, Faustino; Cuevas-Maraver, Jesús

    2016-06-01

    Locally decreasing the impulse transmitted by periodic pulses is shown to be a reliable method of taming chaos in starlike networks of dissipative nonlinear oscillators, leading to both synchronous periodic states and equilibria (oscillation death). Specifically, the paradigmatic model of damped kicked rotators is studied in which it is assumed that when the rotators are driven synchronously, i.e., all driving pulses transmit the same impulse, the networks display chaotic dynamics. It is found that the taming effect of decreasing the impulse transmitted by the pulses acting on particular nodes strongly depends on their number and degree of connectivity. A theoretical analysis is given explaining the basic physical mechanism as well as the main features of the chaos-control scenario.

  9. Phase II Study Evaluating the Addition of Cetuximab to the Concurrent Delivery of Weekly Carboplatin, Paclitaxel, and Daily Radiotherapy for Patients With Locally Advanced Squamous Cell Carcinomas of the Head and Neck

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Suntharalingam, Mohan, E-mail: msuntha@umm.edu; Kwok, Young; Goloubeva, Olga

    Purpose: To report the mature data of a prospective Phase II trial designed to evaluate the efficacy of an epidermal growth factor receptor inhibitor cetuximab (CTX) added to the concurrent therapy of weekly paclitaxel/carboplatin (PC) and daily radiation therapy (RT). Methods and Materials: From 2005 to 2009, a total of 43 patients were enrolled in the study. The median follow-up was 31 months (range, 9-59 months). All patients had Stage III/IV disease at presentation, and 67% had oropharyngeal primaries. The weekly IV dose schedules were CTX 250 mg/m{sup 2} (400 mg/m{sup 2} IV loading dose 1 week before RT), paclitaxelmore » 40 mg/m{sup 2}, and carboplatin AUC 2. RT was given at 1.8 Gy per day to 70.2 Gy. Intensity-modulated RTwas used in 70% of cases. Results: All patients completed the planned RT dose, 74% without any treatment breaks. The planned CTX and PC cycles were completed in 70% (91% with at least seven of planned nine cycles) and 56% (93% with at least seven of planned eight cycles) of patients, respectively. Toxicity included Grade 3 mucositis (79%), rash (9%), leucopenia (19%), neutropenia (19%), and RT dermatitis (16%). The complete response (CR) rate at the completion of therapy was 84%. The estimated 3-year local regional control rate was 72%. Six patients with an initial CR subsequently experienced a local recurrence, 10 patients experienced distant progression. The median overall survival and disease-free survivals have not been reached. The 3-year actuarial overall survival and disease-free survival were 59% and 58%, respectively. Conclusions: The addition of CTX to weekly PC and daily RT was well tolerated and resulted in encouraging local control and survival rates.« less

  10. Local optical control of ferromagnetism and chemical potential in a topological insulator

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yeats, Andrew L.; Mintun, Peter J.; Pan, Yu

    Many proposed experiments involving topological insulators (TIs) require spatial control over time-reversal symmetry and chemical potential. We demonstrate reconfigurable micron-scale optical control of both magnetization (which breaks time-reversal symmetry) and chemical potential in ferromagnetic thin films of Cr-(Bi,Sb) 2Te 3 grown on SrTiO 3. By optically modulating the coercivity of the films, we write and erase arbitrary patterns in their remanent magnetization, which we then image with Kerr microscopy. Additionally, by optically manipulating a space charge layer in the underlying SrTiO 3 substrates, we control the local chemical potential of the films. This optical gating effect allows us to writemore » and erase p-n junctions in the films, which we study with photocurrent microscopy. Both effects are persistent and may be patterned and imaged independently on a few-micron scale. As a result, dynamic optical control over both magnetization and chemical potential of a TI may be useful in efforts to understand and control the edge states predicted at magnetic domain walls in quantum anomalous Hall insulators.« less

  11. Local optical control of ferromagnetism and chemical potential in a topological insulator

    DOE PAGES

    Yeats, Andrew L.; Mintun, Peter J.; Pan, Yu; ...

    2017-09-12

    Many proposed experiments involving topological insulators (TIs) require spatial control over time-reversal symmetry and chemical potential. We demonstrate reconfigurable micron-scale optical control of both magnetization (which breaks time-reversal symmetry) and chemical potential in ferromagnetic thin films of Cr-(Bi,Sb) 2Te 3 grown on SrTiO 3. By optically modulating the coercivity of the films, we write and erase arbitrary patterns in their remanent magnetization, which we then image with Kerr microscopy. Additionally, by optically manipulating a space charge layer in the underlying SrTiO 3 substrates, we control the local chemical potential of the films. This optical gating effect allows us to writemore » and erase p-n junctions in the films, which we study with photocurrent microscopy. Both effects are persistent and may be patterned and imaged independently on a few-micron scale. As a result, dynamic optical control over both magnetization and chemical potential of a TI may be useful in efforts to understand and control the edge states predicted at magnetic domain walls in quantum anomalous Hall insulators.« less

  12. Local control of brain metastases after stereotactic radiosurgery: the impact of whole brain radiotherapy and treatment paradigm

    PubMed Central

    Black, Paul J.; Page, Brandi R.; Lucas, John T.; Qasem, Shadi A.; Watabe, Kounosuke; Ruiz, Jimmy; Laxton, Adrian W.; Tatter, Stephen B.; Debinski, Waldemar; Chan, Michael D.

    2016-01-01

    Purpose We investigate clinical, pathologic, and treatment paradigm-related factors affecting local control of brain metastases after stereotactic radiosurgery (SRS) with or without whole brain radiotherapy (WBRT). Methods and materials Patients with brain metastases treated with SRS alone, before or after WBRT were considered to determine predictors of local failure (LF), time to failure and survival. Results Among 137 patients, 411 brain metastases were analyzed. 23% of patients received SRS alone, 51% received WBRT prior to SRS, and 26% received SRS followed by WBRT. LF occurred in 125 metastases: 63% after SRS alone, 20% after WBRT then SRS, and 22% after SRS then WBRT. Median time to local failure was significantly less after SRS alone compared to WBRT then SRS (12.1 v. 22.7 months, p=0.003). Tumor volume was significantly associated with LF (HR:5.2, p<0.001, 95% CI:3.4-7.8). Conclusions WBRT+SRS results in reduced LF. Local control was not significantly different after SRS as salvage therapy versus upfront SRS. PMID:29296433

  13. An adaptive PID like controller using mix locally recurrent neural network for robotic manipulator with variable payload.

    PubMed

    Sharma, Richa; Kumar, Vikas; Gaur, Prerna; Mittal, A P

    2016-05-01

    Being complex, non-linear and coupled system, the robotic manipulator cannot be effectively controlled using classical proportional-integral-derivative (PID) controller. To enhance the effectiveness of the conventional PID controller for the nonlinear and uncertain systems, gains of the PID controller should be conservatively tuned and should adapt to the process parameter variations. In this work, a mix locally recurrent neural network (MLRNN) architecture is investigated to mimic a conventional PID controller which consists of at most three hidden nodes which act as proportional, integral and derivative node. The gains of the mix locally recurrent neural network based PID (MLRNNPID) controller scheme are initialized with a newly developed cuckoo search algorithm (CSA) based optimization method rather than assuming randomly. A sequential learning based least square algorithm is then investigated for the on-line adaptation of the gains of MLRNNPID controller. The performance of the proposed controller scheme is tested against the plant parameters uncertainties and external disturbances for both links of the two link robotic manipulator with variable payload (TL-RMWVP). The stability of the proposed controller is analyzed using Lyapunov stability criteria. A performance comparison is carried out among MLRNNPID controller, CSA optimized NNPID (OPTNNPID) controller and CSA optimized conventional PID (OPTPID) controller in order to establish the effectiveness of the MLRNNPID controller. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

  14. Timing is everything: Rac1 controls Net1A localization to regulate cell adhesion.

    PubMed

    Carr, Heather S; Frost, Jeffrey A

    2013-01-01

    Cell adhesion to the extracellular matrix elicits a temporal reorganization of the actin cytoskeleton that is regulated first by Rac1 and later by RhoA. The signaling mechanisms controlling late stage RhoA activation are incompletely understood. Net1A is a RhoA/RhoB-specific guanine nucleotide exchange factor that is required for cancer cell motility. The ability of Net1A to stimulate RhoA activation is negatively regulated by nuclear sequestration. However, mechanisms controlling the plasma membrane localization of Net1A had not previously been reported. Recently we have shown that Rac1 activation stimulates plasma membrane relocalization and activation of Net1A. Net1A relocalization is independent of its catalytic activity and does not require its C-terminal pleckstrin homology or PDZ interacting domains. Rac1 activation during cell adhesion stimulates a transient relocalization of Net1A that is terminated by proteasomal degradation of Net1A. Importantly, plasma membrane localization of Net1A is required for efficient myosin light chain phosphorylation, focal adhesion maturation, and cell spreading. These data show for the first time a physiological mechanism controlling Net1A relocalization from the nucleus. They also demonstrate a previously unrecognized role for Net1A in controlling actomyosin contractility and focal adhesion dynamics during cell adhesion.

  15. Immunohistochemical localization of translationally controlled tumor protein in the mouse digestive system.

    PubMed

    Sheverdin, Vadim; Jung, Jiwon; Lee, Kyunglim

    2013-09-01

    Translationally controlled tumor protein (TCTP) is a housekeeping protein, highly conserved among various species. It plays a major role in cell differentiation, growth, proliferation, apoptosis and carcinogenesis. Studies reported so far on TCTP expression in different digestive organs have not led to any understanding of the role of TCTP in digestion, so we localized TCTP in organs of the mouse digestive system employing immunohistochemical techniques. Translationally controlled tumor protein was found expressed in all organs studied: tongue, salivary glands, esophagus, stomach, small and large intestines, liver and pancreas. The expression of TCTP was found to be predominant in epithelia and neurons of myenteric nerve ganglia; high in serous glands (parotid, submandibular, gastric, intestinal crypts, pancreatic acini) and in neurons of myenteric nerve ganglia, and moderate to low in epithelia. In epithelia, expression of TCTP varied depending on its type and location. In enteric neurons, TCTP was predominantly expressed in the processes. Translationally controlled tumor protein expression in the liver followed porto-central gradient with higher expression in pericentral hepatocytes. In the pancreas, TCTP was expressed in both acini and islet cells. Our finding of nearly universal localization and expression of TCTP in mouse digestive organs points to the hitherto unrecognized functional importance of TCTP in the digestive system and suggests the need for further studies of the possible role of TCTP in the proliferation, secretion, absorption and neural regulation of the digestive process and its importance in the physiology and pathology of digestive process. © 2013 Anatomical Society.

  16. Time-delayed feedback control of breathing localized structures in a three-component reaction-diffusion system.

    PubMed

    Gurevich, Svetlana V

    2014-10-28

    The dynamics of a single breathing localized structure in a three-component reaction-diffusion system subjected to time-delayed feedback is investigated. It is shown that variation of the delay time and the feedback strength can lead either to stabilization of the breathing or to delay-induced periodic or quasi-periodic oscillations of the localized structure. A bifurcation analysis of the system in question is provided and an order parameter equation is derived that describes the dynamics of the localized structure in the vicinity of the Andronov-Hopf bifurcation. With the aid of this equation, the boundaries of the stabilization domains as well as the dependence of the oscillation radius on delay parameters can be explicitly derived, providing a robust mechanism to control the behaviour of the breathing localized structure in a straightforward manner. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

  17. Optochemical Control of Protein Localization and Activity within Cell-like Compartments.

    PubMed

    Caldwell, Reese M; Bermudez, Jessica G; Thai, David; Aonbangkhen, Chanat; Schuster, Benjamin S; Courtney, Taylor; Deiters, Alexander; Hammer, Daniel A; Chenoweth, David M; Good, Matthew C

    2018-05-08

    We report inducible dimerization strategies for controlling protein positioning, enzymatic activity, and organelle assembly inside synthetic cell-like compartments upon photostimulation. Using a photocaged TMP-Haloligand compound, we demonstrate small molecule and light-induced dimerization of DHFR and Haloenzyme to localize proteins to a compartment boundary and reconstitute tripartite sfGFP assembly. Using photocaged rapamycin and fragments of split TEV protease fused to FRB and FKBP, we establish optical triggering of protease activity inside cell-size compartments. We apply light-inducible protease activation to initiate assembly of membraneless organelles, demonstrating the applicability of these tools for characterizing cell biological processes in vitro. This modular toolkit, which affords spatial and temporal control of protein function in a minimal cell-like system, represents a critical step toward the reconstitution of a tunable synthetic cell, built from the bottom up.

  18. Local Control in the Era of Accountability: A Case Study of Wisconsin PreK

    ERIC Educational Resources Information Center

    Graue, M. Elizabeth; Wilinski, Bethany; Nocera, Amato

    2016-01-01

    The opposing principles of local control and increased standardization are a prominent tension in the United States' education system. Since at least the early 1990s, this tension has taken shape around the accountability movement, defined by educational reforms that hold schools, teachers, and students accountable for performance on new…

  19. Clinical Outcomes of 130 Patients with Primary and Secondary Lung Tumors treated with Cyberknife Robotic Stereotactic Body Radiotherapy

    PubMed Central

    Jansen, Nicolas; Baart, Veronique; Devillers, Magali; Dechambre, David; Lenaerts, Eric; Seidel, Laurence; Barthelemy, Nicole; Berkovic, Patrick; Gulyban, Akos; Lakosi, Ferenc; Horvath, Zsolt; Coucke, Philippe A.

    2017-01-01

    Abstract Background Authors report clinical outcomes of patients treated with robotic stereotactic body radiotherapy (SBRT) for primary, recurrent and metastatic lung lesions. Patients and methods 130 patients with 160 lesions were treated with Cyberknife SBRT, including T1-3 primary lung cancers (54%), recurrent tumors (22%) and pulmonary metastases (24%). The mean biologically equivalent dose (BED10Gy) was 151 Gy (72–180 Gy). Median prescribed dose for peripheral and central lesions was 3×20 Gy and 3×15 Gy, respectively. Local control (LC), overall survival (OS), and cause-specific survival (CSS) rates, early and late toxicities are reported. Statistical analysis was performed to identify factors influencing local tumor control. Results Median follow-up time was 21 months. In univariate analysis, higher dose was associated with better LC and a cut-off value was detected at BED10Gy ≤ 112.5 Gy, resulting in 1-, 2-, and 3-year actuarial LC rates of 93%, vs 73%, 80% vs 61%, and 63% vs 54%, for the high and low dose groups, respectively (p = 0.0061, HR = 0.384). In multivariate analysis, metastatic origin, histological confirmation and larger Planning Target Volume (PTV) were associated with higher risk of local failure. Actuarial OS and CSS rates at 1, 2, and 3 years were 85%, 74% and 62%, and 93%, 89% and 80%, respectively. Acute and late toxicities ≥ Gr 3 were observed in 3 (2%) and 6 patients (5%), respectively. Conclusions Our favorable LC and survival rates after robotic SBRT, with low rates of severe toxicities, are coherent with the literature data in this mixed, non-selected study population. PMID:28740453

  20. Elective Inguinal Node Irradiation in Early-Stage T2N0 Anal Cancer: Prognostic Impact on Locoregional Control

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zilli, Thomas, E-mail: Thomas.Zilli@hcuge.ch; Betz, Michael; Radiation Oncology Institute, Hirslanden Lausanne, Lausanne

    2013-09-01

    Purpose: To evaluate the influence of elective inguinal node radiation therapy (INRT) on locoregional control (LRC) in patients with early-stage T2N0 anal cancer treated conservatively with primary RT. Methods and Materials: Between 1976 and 2008, 116 patients with T2 node-negative anal cancer were treated curatively with RT alone (n=48) or by combined chemoradiation therapy (CRT) (n=68) incorporating mitomycin C and 5-fluorouracil. Sixty-four percent of the patients (n=74) received elective INRT. Results: Over a median follow-up of 69 months (range, 4-243 months), 97 (84%) and 95 patients (82%) were locally and locoregionally controlled, respectively. Rates for 5-year actuarial local control, LRC,more » cancer-specific, and overall survival for the entire population were 81.7% ± 3.8%, 79.2% ± 4.1%, 91.1% ± 3.0%, and 72.1% ± 4.5%, respectively. The overall 5-year inguinal relapse-free survival was 92.3% ± 2.9%. Isolated inguinal recurrence occurred in 2 patients (4.7%) treated without INRT, whereas no groin relapse was observed in those treated with INRT. The 5-year LRC rates for patients treated with and without INRT and with RT alone versus combined CRT were 80.1% ± 5.0% versus 77.8% ± 7.0% (P=.967) and 71.0% ± 7.2% versus 85.4% ± 4.5% (P=.147), respectively. A trend toward a higher rate of grade ≥3 acute toxicity was observed in patients treated with INRT (53% vs 31%, P=.076). Conclusions: In cases of node-negative T2 anal cancer, the inguinal relapse rate remains relatively low with or without INRT. The role of INRT in the treatment of early-stage anal carcinoma needs to be investigated in future prospective trials.« less

  1. Proton beam radiosurgery for vestibular schwannoma: tumor control and cranial nerve toxicity.

    PubMed

    Weber, Damien C; Chan, Annie W; Bussiere, Marc R; Harsh, Griffith R; Ancukiewicz, Marek; Barker, Fred G; Thornton, Allan T; Martuza, Robert L; Nadol, Joseph B; Chapman, Paul H; Loeffler, Jay S

    2003-09-01

    We sought to determine the tumor control rate and cranial nerve function outcomes in patients with vestibular schwannomas who were treated with proton beam stereotactic radiosurgery. Between November 1992 and August 2000, 88 patients with vestibular schwannomas were treated at the Harvard Cyclotron Laboratory with proton beam stereotactic radiosurgery in which two to four convergent fixed beams of 160-MeV protons were applied. The median transverse diameter was 16 mm (range, 2.5-35 mm), and the median tumor volume was 1.4 cm(3) (range, 0.1-15.9 cm(3)). Surgical resection had been performed previously in 15 patients (17%). Facial nerve function (House-Brackmann Grade 1) and trigeminal nerve function were normal in 79 patients (89.8%). Eight patients (9%) had good or excellent hearing (Gardner-Robertson [GR] Grade 1), and 13 patients (15%) had serviceable hearing (GR Grade 2). A median dose of 12 cobalt Gray equivalents (range, 10-18 cobalt Gray equivalents) was prescribed to the 70 to 108% isodose lines (median, 70%). The median follow-up period was 38.7 months (range, 12-102.6 mo). The actuarial 2- and 5-year tumor control rates were 95.3% (95% confidence interval [CI], 90.9-99.9%) and 93.6% (95% CI, 88.3-99.3%). Salvage radiosurgery was performed in one patient 32.5 months after treatment, and a craniotomy was required 19.1 months after treatment in another patient with hemorrhage in the vicinity of a stable tumor. Three patients (3.4%) underwent shunting for hydrocephalus, and a subsequent partial resection was performed in one of these patients. The actuarial 5-year cumulative radiological reduction rate was 94.7% (95% CI, 81.2-98.3%). Of the 21 patients (24%) with functional hearing (GR Grade 1 or 2), 7 (33.3%) retained serviceable hearing ability (GR Grade 2). Actuarial 5-year normal facial and trigeminal nerve function preservation rates were 91.1% (95% CI, 85-97.6%) and 89.4% (95% CI, 82-96.7%). Univariate analysis revealed that prescribed dose (P = 0

  2. Dynamic mechanical control of local vacancies in NiO thin films

    NASA Astrophysics Data System (ADS)

    Seol, Daehee; Yang, Sang Mo; Jesse, Stephen; Choi, Minseok; Hwang, Inrok; Choi, Taekjib; Park, Bae Ho; Kalinin, Sergei V.; Kim, Yunseok

    2018-07-01

    The manipulation of local ionic behavior via external stimuli in oxide systems is of great interest because it can help in directly tuning material properties. Among external stimuli, mechanical force has attracted intriguing attention as novel stimulus for ionic modulation. Even though effectiveness of mechanical force on local ionic modulation has been validated in terms of static effect, its real-time i.e., dynamic, behavior under an application of the force is barely investigated in spite of its crucial impact on device performance such as force or pressure sensors. In this study, we explore dynamic ionic behavior modulated by mechanical force in NiO thin films using electrochemical strain microscopy (ESM). Ionically mediated ESM hysteresis loops were significantly varied under an application of mechanical force. Based on these results, we were able to investigate relative relationship between the force and voltage effects on ionic motion and, further, control effectively ionic behavior through combination of mechanical and electrical stimuli. Our results can provide comprehensive information on the effect of mechanical forces on ionic dynamics in ionic systems.

  3. Dynamic mechanical control of local vacancies in NiO thin films.

    PubMed

    Seol, Daehee; Yang, Sang Mo; Jesse, Stephen; Choi, Minseok; Hwang, Inrok; Choi, Taekjib; Park, Bae Ho; Kalinin, Sergei V; Kim, Yunseok

    2018-07-06

    The manipulation of local ionic behavior via external stimuli in oxide systems is of great interest because it can help in directly tuning material properties. Among external stimuli, mechanical force has attracted intriguing attention as novel stimulus for ionic modulation. Even though effectiveness of mechanical force on local ionic modulation has been validated in terms of static effect, its real-time i.e., dynamic, behavior under an application of the force is barely investigated in spite of its crucial impact on device performance such as force or pressure sensors. In this study, we explore dynamic ionic behavior modulated by mechanical force in NiO thin films using electrochemical strain microscopy (ESM). Ionically mediated ESM hysteresis loops were significantly varied under an application of mechanical force. Based on these results, we were able to investigate relative relationship between the force and voltage effects on ionic motion and, further, control effectively ionic behavior through combination of mechanical and electrical stimuli. Our results can provide comprehensive information on the effect of mechanical forces on ionic dynamics in ionic systems.

  4. High-Dose-Rate Monotherapy for Localized Prostate Cancer: 10-Year Results

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hauswald, Henrik; Kamrava, Mitchell R.; Fallon, Julia M.

    2016-03-15

    Purpose: High-dose-rate (HDR) brachytherapy was originally used with external beam radiation therapy (EBRT) to increase the dose to the prostate without injuring the bladder or rectum. Numerous studies have reported HDR brachytherapy is safe and effective. We adapted it for use without EBRT for cases not requiring lymph node treatment. Patients and Methods: We entered the patient demographics, disease characteristics, and treatment parameters into a prospective registry and serially added follow-up data for 448 men with low-risk (n=288) and intermediate-risk (n=160) prostate cancer treated from 1996 to 2009. Their median age was 64 years (range 42-90). The median prostate-specific antigen (PSA)more » level was 6.0 ng/mL (range 0.2-18.2). The Gleason score was ≤6 in 76% and 7 in 24%. The median dose was 43.5 Gy in 6 fractions. The clinical and biochemical disease control and survival rates were calculated. Adverse events were graded according to the Common Toxicity Criteria of Adverse Events. Results: The median follow-up period was 6.5 years (range 0.3-15.3). The actuarial 6- and 10-year PSA progression-free survival was 98.6% (95% confidence interval [CI] 96.9%-99.4%) and 97.8% (95% CI 95.5%-98.9%). Overall survival at 10 years was 76.7% (95% CI 69.9%-82.2%). The local control, distant metastasis-free survival, and cause-specific survival were 99.7% (95% CI 97.9%-99.9%), 98.9% (95% CI 96.3%-99.7%), and 99.1% (95% CI 95.8%-99.8%). T stage, initial PSA level, Gleason score, National Comprehensive Cancer Network risk group, patient age, and androgen deprivation therapy did not significantly correlate with disease control or survival. No late grade 3 to 4 rectal toxicities developed. Late grade 3 to 4 genitourinary toxicity occurred in 4.9% (grade 3 in 4.7%). Conclusions: HDR monotherapy is a safe and highly effective treatment of low- and intermediate-risk prostate cancer.« less

  5. On the Impact of Localization and Density Control Algorithms in Target Tracking Applications for Wireless Sensor Networks

    PubMed Central

    Campos, Andre N.; Souza, Efren L.; Nakamura, Fabiola G.; Nakamura, Eduardo F.; Rodrigues, Joel J. P. C.

    2012-01-01

    Target tracking is an important application of wireless sensor networks. The networks' ability to locate and track an object is directed linked to the nodes' ability to locate themselves. Consequently, localization systems are essential for target tracking applications. In addition, sensor networks are often deployed in remote or hostile environments. Therefore, density control algorithms are used to increase network lifetime while maintaining its sensing capabilities. In this work, we analyze the impact of localization algorithms (RPE and DPE) and density control algorithms (GAF, A3 and OGDC) on target tracking applications. We adapt the density control algorithms to address the k-coverage problem. In addition, we analyze the impact of network density, residual integration with density control, and k-coverage on both target tracking accuracy and network lifetime. Our results show that DPE is a better choice for target tracking applications than RPE. Moreover, among the evaluated density control algorithms, OGDC is the best option among the three. Although the choice of the density control algorithm has little impact on the tracking precision, OGDC outperforms GAF and A3 in terms of tracking time. PMID:22969329

  6. Controlling effect of geometrically defined local structural changes on chaotic Hamiltonian systems.

    PubMed

    Ben Zion, Yossi; Horwitz, Lawrence

    2010-04-01

    An effective characterization of chaotic conservative Hamiltonian systems in terms of the curvature associated with a Riemannian metric tensor derived from the structure of the Hamiltonian has been extended to a wide class of potential models of standard form through definition of a conformal metric. The geodesic equations reproduce the Hamilton equations of the original potential model through an inverse map in the tangent space. The second covariant derivative of the geodesic deviation in this space generates a dynamical curvature, resulting in (energy-dependent) criteria for unstable behavior different from the usual Lyapunov criteria. We show here that this criterion can be constructively used to modify locally the potential of a chaotic Hamiltonian model in such a way that stable motion is achieved. Since our criterion for instability is local in coordinate space, these results provide a minimal method for achieving control of a chaotic system.

  7. Simultaneous control of emission localization and two-photon absorption efficiency in dissymmetrical chromophores

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tretiak, Sergei

    2009-01-01

    The aim of the present work is to demonstrate that combined spectral tuning of fluorescence and two-photon absorption (TPA) properties of multipolar chromophores can be achieved by introduction of slight electronic chemical dissymmetry. In that perspective, two novel series of structurally related chromophores have been designed and studied: a first series based on rod-like quadrupolar chromophores bearing different electron-donating (D) end groups and a second series based on three-branched octupolar chromophores built from a trigonal donating moiety and bearing various acceptor (A) peripheral groups. The influence of the electronic dissymmetry is investigated by combined experimental and theoretical studies of themore » linear and nonlinear optical properties of dissymmetric chromophores compared to their symmetrical counterparts. In both types of systems (i.e. quadrupoles and octupoles) experiments and theory reveal that excitation is essentially delocalized and that excitation involves synchronized charge redistribution between the different D and A moieties within the multipolar structure (i.e. concerted intramolecular charge transfer). In contrast, the emission stems only from a particular dipolar subunit bearing the strongest D or A moieties due to fast excitation localization after excitation prior to emission. Hence control of emission characteristics (polarization and emission spectrum) in addition to localization can be achieved by controlled introduction of electronic dissymmetry (i.e. replacement of one of the D or A end-groups by a slightly stronger D{prime} or A{prime} units). Interestingly dissymmetrical functionalization of both quadrupolar and octupolar compounds does not lead to significant loss in TPA responses and can even be beneficial due to the spectral broadening and peak position tuning that it allows. This study thus reveals an original molecular engineering route strategy allowing major TPA enhancement in multipolar structures due to

  8. Localization of an Underwater Control Network Based on Quasi-Stable Adjustment.

    PubMed

    Zhao, Jianhu; Chen, Xinhua; Zhang, Hongmei; Feng, Jie

    2018-03-23

    There exists a common problem in the localization of underwater control networks that the precision of the absolute coordinates of known points obtained by marine absolute measurement is poor, and it seriously affects the precision of the whole network in traditional constraint adjustment. Therefore, considering that the precision of underwater baselines is good, we use it to carry out quasi-stable adjustment to amend known points before constraint adjustment so that the points fit the network shape better. In addition, we add unconstrained adjustment for quality control of underwater baselines, the observations of quasi-stable adjustment and constrained adjustment, to eliminate the unqualified baselines and improve the results' accuracy of the two adjustments. Finally, the modified method is applied to a practical LBL (Long Baseline) experiment and obtains a mean point location precision of 0.08 m, which improves by 38% compared with the traditional method.

  9. Localization of an Underwater Control Network Based on Quasi-Stable Adjustment

    PubMed Central

    Chen, Xinhua; Zhang, Hongmei; Feng, Jie

    2018-01-01

    There exists a common problem in the localization of underwater control networks that the precision of the absolute coordinates of known points obtained by marine absolute measurement is poor, and it seriously affects the precision of the whole network in traditional constraint adjustment. Therefore, considering that the precision of underwater baselines is good, we use it to carry out quasi-stable adjustment to amend known points before constraint adjustment so that the points fit the network shape better. In addition, we add unconstrained adjustment for quality control of underwater baselines, the observations of quasi-stable adjustment and constrained adjustment, to eliminate the unqualified baselines and improve the results’ accuracy of the two adjustments. Finally, the modified method is applied to a practical LBL (Long Baseline) experiment and obtains a mean point location precision of 0.08 m, which improves by 38% compared with the traditional method. PMID:29570627

  10. Extended (5-year) Outcomes of Accelerated Partial Breast Irradiation Using MammoSite Balloon Brachytherapy: Patterns of Failure, Patient Selection, and Dosimetric Correlates for Late Toxicity

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vargo, John A.; Verma, Vivek; Kim, Hayeon

    2014-02-01

    Purpose: Accelerated partial breast irradiation (APBI) with balloon and catheter-based brachytherapy has gained increasing popularity in recent years and is the subject of ongoing phase III trials. Initial data suggest promising local control and cosmetic results in appropriately selected patients. Long-term data continue to evolve but are limited outside of the context of the American Society of Breast Surgeons Registry Trial. Methods and Materials: A retrospective review of 157 patients completing APBI after breast-conserving surgery and axillary staging via high-dose-rate {sup 192}Ir brachytherapy from June 2002 to December 2007 was made. APBI was delivered with a single-lumen MammoSite balloon-based applicatormore » to a median dose of 34 Gy in 10 fractions over a 5-day period. Tumor coverage and critical organ dosimetry were retrospectively collected on the basis of computed tomography completed for conformance and symmetry. Results: At a median follow-up time of 5.5 years (range, 0-10.0 years), the 5-year and 7-year actuarial incidences of ipsilateral breast control were 98%/98%, of nodal control 99%/98%, and of distant control 99%/99%, respectively. The crude rate of ipsilateral breast recurrence was 2.5% (n=4); of nodal failure, 1.9% (n=3); and of distant failure, 0.6% (n=1). The 5-year and 7-year actuarial overall survival rates were 89%/86%, with breast cancer–specific survival of 100%/99%, respectively. Good to excellent cosmetic outcomes were achieved in 93.4% of patients. Telangiectasia developed in 27% of patients, with 1-year, 3-year, and 5-year actuarial incidence of 7%/24%/33%; skin dose >100% significantly predicted for the development of telangiectasia (50% vs 14%, P<.0001). Conclusions: Long-term single-institution outcomes suggest excellent tumor control, breast cosmesis, and minimal late toxicity. Skin toxicity is a function of skin dose, which may be ameliorated with dosimetric optimization afforded by newer multicatheter brachytherapy

  11. Electronically controlled spoof localized surface plasmons on the corrugated ring with a shorting pin

    NASA Astrophysics Data System (ADS)

    Zhang, Chao; Zhou, Yong Jin

    2018-07-01

    We have demonstrated that spoof localized surface plasmons (LSPs) can be controlled by loading a shorting pin into the corrugated ring resonator in the microwave and terahertz (THz) frequencies. Electronical switchability and tunability of spoof LSPs have been achieved by mounting Schottky barrier diodes and varactor diodes across the slit around the shorting pin in the ground plane. An electronically tunable band-pass filter has been demostrated in the microwave frequencies. Such electronically controlled spoof LSPs devices can find more applications for highly integrated plasmonic circuits in microwave and THz frequencies.

  12. Local Recurrence After Complete Clinical Response and Watch and Wait in Rectal Cancer After Neoadjuvant Chemoradiation: Impact of Salvage Therapy on Local Disease Control

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Habr-Gama, Angelita, E-mail: gamange@uol.com.br; University of São Paulo School of Medicine, São Paulo; Gama-Rodrigues, Joaquim

    Purpose: To review the risk of local recurrence and impact of salvage therapy after Watch and Wait for rectal cancer with complete clinical response (cCR) after chemoradiation therapy (CRT). Methods and Materials: Patients with cT2-4N0-2M0 distal rectal cancer treated with CRT (50.4-54 Gy + 5-fluorouracil-based chemotherapy) and cCR at 8 weeks were included. Patients with cCR were enrolled in a strict follow-up program with no immediate surgery (Watch and Wait). Local recurrence-free survival was compared while taking into account Watch and Wait strategy alone and Watch and Wait plus salvage. Results: 90 of 183 patients experienced cCR at initial assessment after CRT (49%). Whenmore » early tumor regrowths (up to and including the initial 12 months of follow-up) and late recurrences were considered together, 28 patients (31%) experienced local recurrence (median follow-up time, 60 months). Of those, 26 patients underwent salvage therapy, and 2 patients were not amenable to salvage. In 4 patients, local re-recurrence developed after Watch and Wait plus salvage. The overall salvage rate for local recurrence was 93%. Local recurrence-free survival at 5 years was 69% (all local recurrences) and 94% (after salvage procedures). Thirteen patients (14%) experienced systemic recurrence. The 5-year cancer-specific overall survival and disease-free survival for all patients (including all recurrences) were 91% and 68%, respectively. Conclusions: Local recurrence may develop in 31% of patients with initial cCR when early regrowths (≤12 months) and late recurrences are grouped together. More than half of these recurrences develop within 12 months of follow-up. Salvage therapy is possible in ≥90% of recurrences, leading to 94% local disease control, with 78% organ preservation.« less

  13. Short-term outcomes of local infiltration anaesthetic in total knee arthroplasty: a randomized controlled double-blinded controlled trial.

    PubMed

    Mulford, Jonathan S; Watson, Anna; Broe, David; Solomon, Michael; Loefler, Andreas; Harris, Ian

    2016-03-01

    The primary objective of the study was to determine if local infiltration anaesthetic (LIA) reduced total length of hospital stay in total knee arthroplasty (TKA) patients. The study also examined whether LIA improves early pain management, patient satisfaction and range of motion in TKA patients. We conducted a randomized controlled double-blinded study. Fifty patients undergoing TKA were randomized to receive either placebo or LIA at the time of surgery and on the first day post-operatively. Pain scores, level of satisfaction and range of motion were recorded preoperatively and post-operatively. There was no statistical difference between the groups for length of stay, post-operative pain scores, satisfaction scores or range of motion 6 weeks post-operatively. This randomized double-blinded trial did not demonstrate a decrease in pain or reduction of length of stay due to local infiltration analgesia. © 2015 Royal Australasian College of Surgeons.

  14. Radiographic Local Tumor Control and Pain Palliation of Sarcoma Metastases within the Musculoskeletal System with Percutaneous Thermal Ablation.

    PubMed

    Vaswani, Devin; Wallace, Adam N; Eiswirth, Preston S; Madaelil, Thomas P; Chang, Randy O; Tomasian, Anderanik; Jennings, Jack W

    2018-03-14

    To evaluate the effectiveness of percutaneous image-guided thermal ablation in achieving local tumor control and pain palliation of sarcoma metastases within the musculoskeletal system. Retrospective review of 64 sarcoma metastases within the musculoskeletal system in 26 women and 15 men (total = 41) treated with ablation between December 2011 and August 2016 was performed. Mean age of the cohort was 42.9 years ± 16.0 years. Two subgroups were treated: oligometastatic disease (n = 13) and widely metastatic disease (n = 51). A variety of sarcoma histologies were treated with average tumor volume of 42.5 cm 3 (range 0.1-484.7 cm 3 ). Pain scores were recorded before and 4 weeks after therapy for 59% (38/64) of treated lesions. Follow-up imaging was evaluated for local control and to monitor sites of untreated disease as an internal control. Fifty-eight percent (37/64) were lost to imaging follow-up at varying time points over a year. Complication rate was 5% (3/64; one minor and two major events). One-year local tumor control rates were 70% (19/27) in all patients, 67% (12/18) in the setting of progression of untreated metastases, and 100% (10/10) in the setting of oligometastatic disease. Median pain scores decreased from 8 (interquartile range 5.0-9.0) to 3 (interquartile range 0.1-4.0) 1 month after the procedure (P < 0.001). Image-guided percutaneous ablation is an effective option for local tumor control and pain palliation of metastatic sarcomas within the musculoskeletal system. Treatment in the setting of oligometastatic disease offers potential for remission. Level 4, Retrospective Review.

  15. Variation in Delivery of the 10 Essential Public Health Services by Local Health Departments for Obesity Control in 2005 and 2008

    PubMed Central

    Luo, Huabin; Sotnikov, Sergey; Shah, Gulzar; Galuska, Deborah A.; Zhang, Xinzhi

    2016-01-01

    Objectives To describe and compare the capacity of local health departments (LHDs) to perform 10 essential public health services (EPHS) for obesity control in 2005 and 2008, and explore factors associated with provision of these services. Methods The data for this study were drawn from the 2005 and 2008 National Profile of Local Health Department surveys, conducted by the National Association of County and City Health Officials. Data were analyzed in SAS version 9.1 (SAS Institute Inc, Cary, North Carolina). Results The proportion of LHDs that reported that they do not provide any of the EPHS for obesity control decreased from 27.9% in 2005 to 17.0% in 2008. In both 2005 and 2008, the 2 most frequently provided EPHS for obesity control by LHDs were informing, educating, and empowering the people (EPHS 3) and linking people to needed personal health services (EPHS 7). The 2 least frequently provided services were enforcing laws and regulations (EPHS 6) and conducting research (EPHS 10). On average, LHDs provided 3.05 EPHS in 2005 and 3.69 EPHS in 2008. Multiple logistic regression results show that LHDs with larger jurisdiction population, with a local governance, and those that have completed a community health improvement plan were more likely to provide more of the EPHS for obesity (P < .05). Conclusions The provision of the 10 EPHS for obesity control by LHDs remains low. Local health departments need more assistance and resources to expand performance of EPHS for obesity control. Future studies are needed to evaluate and promote LHD capacity to deliver evidence-based strategies for obesity control in local communities. PMID:23169404

  16. Tele-Autonomous control involving contact. Final Report Thesis; [object localization

    NASA Technical Reports Server (NTRS)

    Shao, Lejun; Volz, Richard A.; Conway, Lynn; Walker, Michael W.

    1990-01-01

    Object localization and its application in tele-autonomous systems are studied. Two object localization algorithms are presented together with the methods of extracting several important types of object features. The first algorithm is based on line-segment to line-segment matching. Line range sensors are used to extract line-segment features from an object. The extracted features are matched to corresponding model features to compute the location of the object. The inputs of the second algorithm are not limited only to the line features. Featured points (point to point matching) and featured unit direction vectors (vector to vector matching) can also be used as the inputs of the algorithm, and there is no upper limit on the number of the features inputed. The algorithm will allow the use of redundant features to find a better solution. The algorithm uses dual number quaternions to represent the position and orientation of an object and uses the least squares optimization method to find an optimal solution for the object's location. The advantage of using this representation is that the method solves for the location estimation by minimizing a single cost function associated with the sum of the orientation and position errors and thus has a better performance on the estimation, both in accuracy and speed, than that of other similar algorithms. The difficulties when the operator is controlling a remote robot to perform manipulation tasks are also discussed. The main problems facing the operator are time delays on the signal transmission and the uncertainties of the remote environment. How object localization techniques can be used together with other techniques such as predictor display and time desynchronization to help to overcome these difficulties are then discussed.

  17. Stereotactic body radiation therapy for abdominal oligometastases: a biological and clinical review

    PubMed Central

    2012-01-01

    Advances in imaging and biological targeting have led to the development of stereotactic body radiation therapy (SBRT) as an alternative treatment of extracranial oligometastases. New radiobiological concepts, such as ceramide-induced endothelial apoptosis after hypofractionated high-dose SBRT, and the identification of patients with oligometastatic disease by microRNA expression may yet lead to further developments. Key factors in SBRT are delivery of a high dose per fraction, proper patient positioning, target localisation, and management of breathing–related motion. Our review addresses the radiation doses and schedules used to treat liver, abdominal lymph node (LN) and adrenal gland oligometastases and treatment outcomes. Reported local control (LC) rates for liver and abdominal LN oligometastases are high (median 2-year actuarial LC: 61 -100% for liver oligometastases; 4-year actuarial LC: 68% in a study of abdominal LN oligometastases). Early toxicity is low-to-moderate; late adverse effects are rare. SBRT of adrenal gland oligometastases shows promising results in the case of isolated lesions. In conclusion, properly conducted SBRT procedures are a safe and effective treatment option for abdominal oligometastases. PMID:22852764

  18. Interface Shape Control Using Localized Heating during Bridgman Growth

    NASA Technical Reports Server (NTRS)

    Volz, M. P.; Mazuruk, K.; Aggarwal, M. D.; Croll, A.

    2008-01-01

    Numerical calculations were performed to assess the effect of localized radial heating on the melt-crystal interface shape during vertical Bridgman growth. System parameters examined include the ampoule, melt and crystal thermal conductivities, the magnitude and width of localized heating, and the latent heat of crystallization. Concave interface shapes, typical of semiconductor systems, could be flattened or made convex with localized heating. Although localized heating caused shallower thermal gradients ahead of the interface, the magnitude of the localized heating required for convexity was less than that which resulted in a thermal inversion ahead of the interface. A convex interface shape was most readily achieved with ampoules of lower thermal conductivity. Increasing melt convection tended to flatten the interface, but the amount of radial heating required to achieve a convex interface was essentially independent of the convection intensity.

  19. A tether tension control law for tethered subsatellites deployed along local vertical. [space shuttle orbiters - satellite control/towed bodies

    NASA Technical Reports Server (NTRS)

    Rupp, C. C.

    1975-01-01

    A tethered subsatellite deployed along the local vertical is in stable equilibrium. This applies equally to subsatellites deployed in the direction towards the earth from the main spacecraft or away from the earth. Momentary perturbations from this stable equilibrium will result in a swinging motion, which decays very slowly if passive means are relied upon to provide damping. A control law is described which actively damps the swinging motion by employing a reel, or other mechanism, to apply appropriate tension as a function of tetherline length, rate of change of length, and desired length. The same control law is shown to be useful for deployment and retrieval of tethered subsatellites in addition to damping to steady state.

  20. Deciding the Fate of Local Control.

    ERIC Educational Resources Information Center

    Schlechty, Phillip C.

    1992-01-01

    The fundamental job of school board members is to view themselves as moral and cultural leaders and to transform the needs of groups to a higher and more noble framework. Lists the National School Boards Association's statement on the governance role of the local school board. (MLF)

  1. Favorable Local Control From Consolidative Radiation Therapy in High-Risk Neuroblastoma Despite Gross Residual Disease, Positive Margins, or Nodal Involvement

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ferris, Matthew J., E-mail: mjferri@emory.edu; Winship Cancer Institute, Emory University, Atlanta, Georgia; Danish, Hasan

    Purpose: To report the influence of radiation therapy (RT) dose and surgical pathology variables on disease control and overall survival (OS) in patients treated for high-risk neuroblastoma at a single institution. Methods and Materials: We conducted a retrospective study of 67 high-risk neuroblastoma patients who received RT as part of definitive management from January 2003 until May 2014. Results: At a median follow-up of 4.5 years, 26 patients (38.8%) failed distantly; 4 of these patients also failed locally. One patient progressed locally without distant failure. Local control was 92.5%, and total disease control was 59.5%. No benefit was demonstrated for RT doses over 21.6 Gymore » with respect to local relapse–free survival (P=.55), disease-free survival (P=.22), or OS (P=.72). With respect to local relapse–free survival, disease-free survival, and OS, no disadvantage was seen for positive lymph nodes on surgical pathology, positive surgical margins, or gross residual disease. Of the patients with gross residual disease, 75% (6 of 8) went on to have no evidence of disease at time of last follow-up, and the 2 patients who failed did so distantly. Conclusions: Patients with high-risk neuroblastoma in this series maintained excellent local control, with no benefit demonstrated for radiation doses over 21.6 Gy, and no disadvantage demonstrated for gross residual disease after surgery, positive surgical margins, or pathologic lymph node positivity. Though the limitations of a retrospective review for an uncommon disease must be kept in mind, with small numbers in some of the subgroups, it seems that dose escalation should be considered only in exceptional circumstances.« less

  2. Effect of Facilitation of Local Maternal-and-Newborn Stakeholder Groups on Neonatal Mortality: Cluster-Randomized Controlled Trial

    PubMed Central

    Persson, Lars Åke; Nga, Nguyen T.; Målqvist, Mats; Thi Phuong Hoa, Dinh; Eriksson, Leif; Wallin, Lars; Selling, Katarina; Huy, Tran Q.; Duc, Duong M.; Tiep, Tran V.; Thi Thu Thuy, Vu; Ewald, Uwe

    2013-01-01

    Background Facilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. We hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve maternal, delivery, and newborn care indicators (secondary outcomes) in Quang Ninh province, Vietnam. Methods and Findings In a cluster-randomized design 44 communes were allocated to intervention and 46 to control. Laywomen facilitated monthly meetings during 3 years in groups composed of health care staff and key persons in the communes. A problem-solving approach was employed. Births and neonatal deaths were monitored, and interviews were performed in households of neonatal deaths and of randomly selected surviving infants. A latent period before effect is expected in this type of intervention, but this timeframe was not pre-specified. Neonatal mortality rate (NMR) from July 2008 to June 2011 was 16.5/1,000 (195 deaths per 11,818 live births) in the intervention communes and 18.4/1,000 (194 per 10,559 live births) in control communes (adjusted odds ratio [OR] 0.96 [95% CI 0.73–1.25]). There was a significant downward time trend of NMR in intervention communes (p = 0.003) but not in control communes (p = 0.184). No significant difference in NMR was observed during the first two years (July 2008 to June 2010) while the third year (July 2010 to June 2011) had significantly lower NMR in intervention arm: adjusted OR 0.51 (95% CI 0.30–0.89). Women in intervention communes more frequently attended antenatal care (adjusted OR 2.27 [95% CI 1.07–4.8]). Conclusions A randomized facilitation intervention with local stakeholder groups composed of primary care staff and local politicians working for three years with a perinatal problem-solving approach resulted in increased attendance to antenatal care and reduced neonatal

  3. X11/Mint Genes Control Polarized Localization of Axonal Membrane Proteins in Vivo

    PubMed Central

    Gross, Garrett G.; Lone, G. Mohiddin; Leung, Lok Kwan; Hartenstein, Volker

    2013-01-01

    Mislocalization of axonal proteins can result in misassembly and/or miswiring of neural circuits, causing disease. To date, only a handful of genes that control polarized localization of axonal membrane proteins have been identified. Here we report that Drosophila X11/Mint proteins are required for targeting several proteins, including human amyloid precursor protein (APP) and Drosophila APP-like protein (APPL), to axonal membranes and for their exclusion from dendrites of the mushroom body in Drosophila, a brain structure involved in learning and memory. Axonal localization of APP is mediated by an endocytic motif, and loss of X11/Mint results in a dramatic increase in cell-surface levels of APPL, especially on dendrites. Mutations in genes required for endocytosis show similar mislocalization of these proteins to dendrites, and strongly enhance defects seen in X11/Mint mutants. These results suggest that X11/Mint-dependent endocytosis in dendrites may serve to promote the axonal localization of membrane proteins. Since X11/Mint binds to APP, and abnormal trafficking of APP contributes to Alzheimer's disease, deregulation of X11/Mint may be important for Alzheimer's disease pathogenesis. PMID:23658195

  4. Local control of globally competing patterns in coupled Swift-Hohenberg equations

    NASA Astrophysics Data System (ADS)

    Becker, Maximilian; Frenzel, Thomas; Niedermayer, Thomas; Reichelt, Sina; Mielke, Alexander; Bär, Markus

    2018-04-01

    We present analytical and numerical investigations of two anti-symmetrically coupled 1D Swift-Hohenberg equations (SHEs) with cubic nonlinearities. The SHE provides a generic formulation for pattern formation at a characteristic length scale. A linear stability analysis of the homogeneous state reveals a wave instability in addition to the usual Turing instability of uncoupled SHEs. We performed weakly nonlinear analysis in the vicinity of the codimension-two point of the Turing-wave instability, resulting in a set of coupled amplitude equations for the Turing pattern as well as left- and right-traveling waves. In particular, these complex Ginzburg-Landau-type equations predict two major things: there exists a parameter regime where multiple different patterns are stable with respect to each other and that the amplitudes of different patterns interact by local mutual suppression. In consequence, different patterns can coexist in distinct spatial regions, separated by localized interfaces. We identified specific mechanisms for controlling the position of these interfaces, which distinguish what kinds of patterns the interface connects and thus allow for global pattern selection. Extensive simulations of the original SHEs confirm our results.

  5. Stereotactic Radiosurgery for the Treatment of Primary and Metastatic Spinal Sarcomas

    PubMed Central

    Balagamwala, Ehsan H.; Angelov, Lilyana; Suh, John H.; Djemil, Toufik; Magnelli, Anthony; Qi, Peng; Zhuang, Tingliang; Godley, Andrew

    2016-01-01

    Purpose: Despite advancements in local and systemic therapy, metastasis remains common in the natural history of sarcomas. Unfortunately, such metastases are the most significant source of morbidity and mortality in this heterogeneous disease. As a classically radioresistant histology, stereotactic radiosurgery has emerged to control spinal sarcomas and provide palliation. However, there is a lack of data regarding pain relief and relapse following stereotactic radiosurgery. Methods: We queried a retrospective institutional database of patients who underwent spine stereotactic radiosurgery for primary and metastatic sarcomas. The primary outcome was pain relief following stereotactic radiosurgery. Secondary outcomes included progression of pain, radiographic failure, and development of toxicities following treatment. Results: Forty treatment sites were eligible for inclusion; the median prescription dose was 16 Gy in a single fraction. Median time to radiographic failure was 14 months. At 6 and 12 months, radiographic control was 63% and 51%, respectively. Among patients presenting with pain, median time to pain relief was 1 month. Actuarial pain relief at 6 months was 82%. Median time to pain progression was 10 months; at 12 months, actuarial pain progression was 51%. Following multivariate analysis, presence of neurologic deficit at consult (hazard ratio: 2.48, P < .01) and presence of extraspinal bone metastases (hazard ratio: 2.83, P < .01) were associated with pain relief. Greater pain at consult (hazard ratio: 1.92, P < .01), prior radiotherapy (hazard ratio: 4.65, P = .02), and greater number of irradiated vertebral levels were associated with pain progression. Conclusions: Local treatment of spinal sarcomas has remained a challenge for decades, with poor rates of local control and limited pain relief following conventional radiotherapy. In this series, pain relief was achieved in 82% of treatments at 6 months, with half of patients experiencing pain

  6. Local Stable and Unstable Manifolds and Their Control in Nonautonomous Finite-Time Flows

    NASA Astrophysics Data System (ADS)

    Balasuriya, Sanjeeva

    2016-08-01

    It is well known that stable and unstable manifolds strongly influence fluid motion in unsteady flows. These emanate from hyperbolic trajectories, with the structures moving nonautonomously in time. The local directions of emanation at each instance in time is the focus of this article. Within a nearly autonomous setting, it is shown that these time-varying directions can be characterised through the accumulated effect of velocity shear. Connections to Oseledets spaces and projection operators in exponential dichotomies are established. Availability of data for both infinite- and finite-time intervals is considered. With microfluidic flow control in mind, a methodology for manipulating these directions in any prescribed time-varying fashion by applying a local velocity shear is developed. The results are verified for both smoothly and discontinuously time-varying directions using finite-time Lyapunov exponent fields, and excellent agreement is obtained.

  7. Local rollback for fault-tolerance in parallel computing systems

    DOEpatents

    Blumrich, Matthias A [Yorktown Heights, NY; Chen, Dong [Yorktown Heights, NY; Gara, Alan [Yorktown Heights, NY; Giampapa, Mark E [Yorktown Heights, NY; Heidelberger, Philip [Yorktown Heights, NY; Ohmacht, Martin [Yorktown Heights, NY; Steinmacher-Burow, Burkhard [Boeblingen, DE; Sugavanam, Krishnan [Yorktown Heights, NY

    2012-01-24

    A control logic device performs a local rollback in a parallel super computing system. The super computing system includes at least one cache memory device. The control logic device determines a local rollback interval. The control logic device runs at least one instruction in the local rollback interval. The control logic device evaluates whether an unrecoverable condition occurs while running the at least one instruction during the local rollback interval. The control logic device checks whether an error occurs during the local rollback. The control logic device restarts the local rollback interval if the error occurs and the unrecoverable condition does not occur during the local rollback interval.

  8. What is the effect of local controls on the temporal stability of soil water contents?

    NASA Astrophysics Data System (ADS)

    Martinez, G.; Pachepsky, Y. A.; Vereecken, H.; Vanderlinden, K.; Hardelauf, H.; Herbst, M.

    2012-04-01

    Temporal stability of soil water content (TS SWC) reflects the spatio-temporal organization of SWC. Factors and their interactions that control this organization, are not completely understood and have not been quantified yet. It is understood that these factors should be classified into groups of local and non-local controls. This work is a first attempt to evaluate the effects of soil properties at a certain location as local controls Time series of SWC were generated by running water flow simulations with the HYDRUS6 code. Bare and grassed sandy loam, loam and clay soils were represented by sets of 100 independent soil columns. Within each set, values of saturated hydraulic conductivity (Ks) were generated randomly assuming for the standard deviation of the scaling factor of ln Ks a value ranging from 0.1 to 1.0. Weather conditions were the same for all of the soil columns. SWC at depths of 0.05 and 0.60 m, and the average water content of the top 1 m were analyzed. The temporal stability was characterized by calculating the mean relative differences (MRD) of soil water content. MRD distributions from simulations, developed from the log-normal distribution of Ks, agreed well with the experimental studies found in the literature. Generally, Ks was the leading variable to define the MRD rank for a specific location. Higher MRD corresponded to the lowest values of Ks when a single textural class was considered. Higher MRD were found in the finer texture when mixtures of textural classes were considered and similar values of Ks were compared. The relationships between the spread of the MRD distributions and the scaling factor of ln Ks were nonlinear. Variation in MRD was higher in coarser textures than in finer ones and more variability was seen in the topsoil than in the subsoil. Established vegetation decreased variability of MRD in the root zone and increased variability below. The dependence of MRD on Ks opens the possibility of using SWC sensor networks to

  9. Local infiltration analgesia followed by continuous infusion of local anesthetic solution for total hip arthroplasty: a prospective, randomized, double-blind, placebo-controlled study.

    PubMed

    Solovyova, Olga; Lewis, Courtland G; Abrams, Jonathan H; Grady-Benson, John; Joyce, Michael E; Schutzer, Steven F; Arumugam, Sivasenthil; Caminiti, Stephanie; Sinha, Sanjay K

    2013-11-06

    We studied the efficacy of local infiltration analgesia in surgical wounds with 0.2% ropivacaine (50 mL), ketorolac (15 mg), and adrenaline (0.5 mg) compared with that of local infiltration analgesia combined with continuous infusion of 0.2% ropivacaine as a method of pain control after total hip arthroplasty. We hypothesized that as a component of multimodal analgesia, local infiltration analgesia followed by continuous infusion of ropivacaine would result in reduced postoperative opioid consumption and lower pain scores compared with infiltration alone, and that both of these techniques would be superior to placebo. In this prospective, double-blind, placebo-controlled study, 105 patients were randomized into three groups: Group I, in which patients received infiltration with ropivacaine, ketorolac, and adrenaline followed by continuous infusion of 0.2% ropivacaine at 5 mL/hr; Group II, in which patients received infiltration with ropivacaine, ketorolac, and adrenaline followed by continuous infusion of saline solution at 5 mL/hr; and Group III, in which patients received infiltration with saline solution followed by continuous infusion of saline solution at 5 mL/hr.All patients received celecoxib, pregabalin, and acetaminophen perioperatively and patient-controlled analgesia; surgery was performed under general anesthesia. Before wound closure, the tissues and periarticular space were infiltrated with ropivacaine, ketorolac, and adrenaline or saline solution and a fenestrated catheter was placed. The catheter was attached to a pump prefilled with either 0.2% ropivacaine or saline solution set to infuse at 5 mL/hr.The primary outcome measure was postoperative opioid consumption and the secondary outcome measures were pain scores, adverse side effects, and patient satisfaction. There were no differences between groups in the administration of opioids in the operating room, in the recovery room, or on the surgical floor. The pain scores on recovery room admission

  10. Local control theory using trajectory surface hopping and linear-response time-dependent density functional theory.

    PubMed

    Curchod, Basile F E; Penfold, Thomas J; Rothlisberger, Ursula; Tavernelli, Ivano

    2013-01-01

    The implementation of local control theory using nonadiabatic molecular dynamics within the framework of linear-response time-dependent density functional theory is discussed. The method is applied to study the photoexcitation of lithium fluoride, for which we demonstrate that this approach can efficiently generate a pulse, on-the-fly, able to control the population transfer between two selected electronic states. Analysis of the computed control pulse yields insights into the photophysics of the process identifying the relevant frequencies associated to the curvature of the initial and final state potential energy curves and their energy differences. The limitations inherent to the use of the trajectory surface hopping approach are also discussed.

  11. Community-Based School Finance and Accountability: A New Era for Local Control in Education Policy?

    ERIC Educational Resources Information Center

    Vasquez Heilig, Julian; Ward, Derrick R.; Weisman, Eric; Cole, Heather

    2014-01-01

    Top-down accountability policies have arguably had very limited impact over the past 20 years. Education stakeholders are now contemplating new forms of bottom-up accountability. In 2013, policymakers in California enacted a community-based approach that creates the Local Control Funding Formula (LCFF) process for school finance to increase…

  12. Ultralow-power local laser control of the dimer density in alkali-metal vapors through photodesorption

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jha, Pankaj K.; Scully, Marlan O.; Princeton University, Princeton, New Jersey 08544

    2012-08-27

    Ultralow-power diode-laser radiation is employed to induce photodesorption of cesium from a partially transparent thin-film cesium adsorbate on a solid surface. Using resonant Raman spectroscopy, we demonstrate that this photodesorption process enables an accurate local optical control of the density of dimer molecules in alkali-metal vapors.

  13. The impact of histology and delivered dose on local control of spinal metastases treated with stereotactic radiosurgery.

    PubMed

    Yamada, Yoshiya; Katsoulakis, Evangelia; Laufer, Ilya; Lovelock, Michael; Barzilai, Ori; McLaughlin, Lily A; Zhang, Zhigang; Schmitt, Adam M; Higginson, Daniel S; Lis, Eric; Zelefsky, Michael J; Mechalakos, James; Bilsky, Mark H

    2017-01-01

    OBJECTIVE An analysis of factors contributing to durable radiographic control of spinal metastases was undertaken, drawing from a large single-institution database in an attempt to elucidate indications and dose requirements for successful treatment. METHODS All patients treated at a single institution with stereotactic radiosurgery (SRS) of the spine as first-line therapy were assessed for local progression of the treated site, defined as radiographic enlargement of the treated tumor and/or biopsy-proven evidence of active tumor cells. All patients were followed with CT, PET, or MR imaging every 3-6 months until death. Treatment decisions were made by a multidisciplinary team of radiation oncologists, neurosurgeons, and neuroradiologists. Target volumes were defined according to the international consensus guidelines and were reviewed in a multidisciplinary conference. Image-guided techniques and intensity modulation were used for every case. The tumor's histological type, gross tumor volume (GTV), dose that covers 95% of the GTV (GTV D95), percentage of GTV covered by 95% of the prescribed dose (GTV V95), planning target volume (PTV), dose that covers 95% of the PTV (PTV D95), and percentage of PTV covered by 95% of the prescribed dose (PTV V95) were analyzed for significance in relation to local control, based on time to local progression. RESULTS A total of 811 lesions were treated in 657 patients between 2003 and 2015 at a single institution. The mean follow-up and overall survival for the entire cohort was 26.9 months (range 2-141 months). A total of 28 lesions progressed and the mean time to failure was 26 months (range 9.7-57 months). The median prescribed dose was 2400 cGy (range 1600-2600 cGy). Both GTV D95 and PTV D95 were highly significantly associated with local failure in univariate analysis, but GTV and PTV and histological type did not reach statistical significance. The median GTV D95 for the cohort equal to or above the GTV D95 1830 cGy cut point

  14. The impact of histology and delivered dose on local control of spinal metastases treated with stereotactic radiosurgery

    PubMed Central

    Yamada, Yoshiya; Katsoulakis, Evangelia; Laufer, Ilya; Lovelock, Michael; Barzilai, Ori; McLaughlin, Lily A.; Zhang, Zhigang; Schmitt, Adam M.; Higginson, Daniel S.; Lis, Eric; Zelefsky, Michael J.; Mechalakos, James; Bilsky, Mark H.

    2017-01-01

    Objective An analysis of factors contributing to durable radiographic control of spinal metastases was undertaken, drawing from a large single-institution database in an attempt to elucidate indications and dose requirements for successful treatment. Methods All patients treated at a single institution with stereotactic radiosurgery (SRS) of the spine as first-line therapy were assessed for local progression of the treated site, defined as radiographic enlargement of the treated tumor and/or biopsy-proven evidence of active tumor cells. All patients were followed with CT, PET, or MR imaging every 3–6 months until death. Treatment decisions were made by a multidisciplinary team of radiation oncologists, neurosurgeons, and neuroradiologists. Target volumes were defined according to the international consensus guidelines and were reviewed in a multidisciplinary conference. Image-guided techniques and intensity modulation were used for every case. The tumor’s histological type, gross tumor volume (GTV), dose that covers 95% of the GTV (GTV D95), percentage of GTV covered by 95% of the prescribed dose (GTV V95), planning target volume (PTV), dose that covers 95% of the PTV (PTV D95), and percentage of PTV covered by 95% of the prescribed dose (PTV V95) were analyzed for significance in relation to local control, based on time to local progression. Results A total of 811 lesions were treated in 657 patients between 2003 and 2015 at a single institution. The mean follow-up and overall survival for the entire cohort was 26.9 months (range 2–141 months). A total of 28 lesions progressed and the mean time to failure was 26 months (range 9.7–57 months). The median prescribed dose was 2400 cGy (range 1600–2600 cGy). Both GTV D95 and PTV D95 were highly significantly associated with local failure in univariate analysis, but GTV and PTV and histological type did not reach statistical significance. The median GTV D95 for the cohort equal to or above the GTV D95 1830 c

  15. Intra-operatively customized implant coating strategies for local and controlled drug delivery to bone.

    PubMed

    Trajkovski, Branko; Petersen, Ansgar; Strube, Patrick; Mehta, Manav; Duda, Georg N

    2012-09-01

    Bone is one of the few tissues in the human body with high endogenous healing capacity. However, failure of the healing process presents a significant clinical challenge; it is a tremendous burden for the individual and has related health and economic consequences. To overcome such healing deficits, various concepts for a local drug delivery to bone have been developed during the last decades. However, in many cases these concepts do not meet the specific requirements of either surgeons who must use these strategies or individual patients who might benefit from them. We describe currently available methods for local drug delivery and their limitations in therapy. Various solutions for drug delivery to bone focusing on clinical applications and intra-operative constraints are discussed and drug delivery by implant coating is highlighted. Finally, a new set of design and performance requirements for intra-operatively customized implant coatings for controlled drug delivery is proposed. In the future, these requirements may improve approaches for local and intra-operative treatment of patients. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. Manifestation Pattern of Early-Late Vaginal Morbidity After Definitive Radiation (Chemo)Therapy and Image-Guided Adaptive Brachytherapy for Locally Advanced Cervical Cancer: An Analysis From the EMBRACE Study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kirchheiner, Kathrin, E-mail: kathrin.kirchheiner@meduniwien.ac.at; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna; Nout, Remi A.

    2014-05-01

    Background and Purpose: Brachytherapy in the treatment of locally advanced cervical cancer has changed substantially because of the introduction of combined intracavitary/interstitial applicators and an adaptive target concept, which is the focus of the prospective, multi-institutional EMBRACE study ( (www.embracestudy.dk)) on image-guided adaptive brachytherapy (IGABT). So far, little has been reported about the development of early to late vaginal morbidity in the frame of IGABT. Therefore, the aim of the present EMBRACE analysis was to evaluate the manifestation pattern of vaginal morbidity during the first 2 years of follow-up. Methods and Materials: In total, 588 patients with a median follow-up timemore » of 15 months and information on vaginal morbidity were included. Morbidity was prospectively assessed at baseline, every 3 months during the first year, and every 6 months in the second year according to the Common Terminology Criteria for Adverse Events, version 3, regarding vaginal stenosis, dryness, mucositis, bleeding, fistula, and other symptoms. Crude incidence rates, actuarial probabilities, and prevalence rates were analyzed. Results: At 2 years, the actuarial probability of severe vaginal morbidity (grade ≥3) was 3.6%. However, mild and moderate vaginal symptoms were still pronounced (grade ≥1, 89%; grade ≥2, 29%), of which the majority developed within 6 months. Stenosis was most frequently observed, followed by vaginal dryness. Vaginal bleeding and mucositis were mainly mild and infrequently reported. Conclusion: Severe vaginal morbidity within the first 2 years after definitive radiation (chemo)therapy including IGABT with intracavitary/interstitial techniques for locally advanced cervical cancer is limited and is significantly less than has been reported from earlier studies. Thus, the new adaptive target concept seems to be a safe treatment with regard to the vagina being an organ at risk. However, mild to moderate vaginal

  17. Laserthermia: a new computer-controlled contact Nd: YAG system for interstitial local hyperthermia.

    PubMed

    Daikuzono, N; Suzuki, S; Tajiri, H; Tsunekawa, H; Ohyama, M; Joffe, S N

    1988-01-01

    Contact Nd:YAG laser surgery is assuming a greater importance in endoscopic and open surgery, allowing coagulation, cutting, and vaporization with greater precision and safety. A new contact probe allows a wider angle of irradiation and diffusion of low-power laser energy (less than 5 watts), using the interstitial technique for producing local hyperthermia. Temperature sensors that monitor continuously can be placed directly into the surrounding tissue or tumor. Using a computer program interfaced with the laser and sensors, a controlled and stable temperature (e.g., 42 degrees C) can be produced in a known volume of tissue over a prolonged period of time (e.g., 20-40 min). This new laserthermia system, using a single low-power Nd:YAG laser for interstitial local hyperthermia, may offer many new advantages in the experimental treatment and clinical management of carcinoma. A multiple system is now being developed.

  18. Effect of External Boost Volume in Breast-Conserving Therapy on Local Control With Long-Term Follow-Up

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jobsen, Jan J.; Palen, Job van der; Ong, Francisca

    2008-05-01

    Purpose: To determine the effects of boost volume (BV) in relation to margin status and tumor size on the development of local recurrence with breast-conserving therapy. Methods and Materials: Between 1983 and 1995, 1,073 patients with invasive breast cancer underwent 1,101 breast-conserving therapies. Of these 1,101 BCTs, 967 were eligible for analysis. The BV was categorized into tertiles: <66 cm{sup 3} (n = 330), 66-98 cm{sup 3} (n = 326), and >98 cm{sup 3} (n = 311). The median follow-up was 141 months. Separate analyses were done for women {<=}40 years and >40 years. Results: No significant difference in localmore » recurrence was shown between the tertiles and the recurrence site. The 15-year local recurrence-free survival rate was 87.9% for the first tertile, 88.7% for the second, and 89% for the third. For women {<=}40 years old, the corresponding 15-year local recurrence-free survival rate was 80%, 74.5%, and 69.2%. For women >40 years old, the corresponding rate was 88.7%, 89.5%, and 90.9%. At 5 years, women >40 years old had significantly more local failures in the first tertile; this difference disappeared with time. A test for trend showed significance at 5 years (p = 0.0105) for positive margins for ductal carcinoma in situ in women >40 years of age. Conclusion: The results of this study have shown that the size of the external BV has no major impact on local control. For women >40 years old, positive margins for ductal carcinoma in situ showed a trend with respect to BV at 5 years. The BV had no influence on local control in the case of positive margins for invasive carcinoma.« less

  19. Local infiltration anesthesia with steroids in total knee arthroplasty: A systematic review of randomized control trials.

    PubMed

    Tran, Jonathan; Schwarzkopf, Ran

    2015-10-01

    Local infiltration anesthesia (LIA) with anesthetics, steroids, NSAIDS, and epinephrine has been shown to be effective in reducing total knee arthroplasty (TKA) postoperative pain. This systematic review explores the functional outcomes of randomized control trials that have compared the use of LIA with and without steroids during TKA. Five studies with 412 patients met the inclusion criteria, 228 received local infiltration anesthesia with steroids (LIAS) and 184 received local infiltration anesthesia without steroids (LIAWS). The use of LIAS in management of postoperative TKA pain has been shown to decrease the length of hospital stay, time required to achieve straight leg raise, and pro-inflammatory signals in patients. Although there is no overwhelming data to suggest LIAS improves postoperative TKA pain, current literature does support its effectiveness in producing other favorable surgical outcomes.

  20. Response of pest control by generalist predators to local-scale plant diversity: a meta-analysis.

    PubMed

    Dassou, Anicet Gbèblonoudo; Tixier, Philippe

    2016-02-01

    Disentangling the effects of plant diversity on the control of herbivores is important for understanding agricultural sustainability. Recent studies have investigated the relationships between plant diversity and arthropod communities at the landscape scale, but few have done so at the local scale. We conducted a meta-analysis of 32 papers containing 175 independent measures of the relationship between plant diversity and arthropod communities. We found that generalist predators had a strong positive response to plant diversity, that is, their abundance increased as plant diversity increased. Herbivores, in contrast, had an overall weak and negative response to plant diversity. However, specialist and generalist herbivores differed in their response to plant diversity, that is, the response was negative for specialists and not significant for generalists. While the effects of scale remain unclear, the response to plant diversity tended to increase for specialist herbivores, but decrease for generalist herbivores as the scale increased. There was no clear effect of scale on the response of generalist predators to plant diversity. Our results suggest that the response of herbivores to plant diversity at the local scale is a balance between habitat and trophic effects that vary according to arthropod specialization and habitat type. Synthesis and applications. Positive effects of plant diversity on generalist predators confirm that, at the local scale, plant diversification of agroecosystems is a credible and promising option for increasing pest regulation. Results from our meta-analysis suggest that natural control in plant-diversified systems is more likely to occur for specialist than for generalist herbivores. In terms of pest management, our results indicate that small-scale plant diversification (via the planting of cover crops or intercrops and reduced weed management) is likely to increase the control of specialist herbivores by generalist predators.

  1. Paving the Way to Equity and Coherence? The Local Control Funding Formula in Year 3

    ERIC Educational Resources Information Center

    Humphrey, Daniel; Koppich, Julia; Lavadenz, Magaly; Marsh, Julie; O'Day, Jennifer; Plank, David; Stokes, Laura; Hall, Michelle

    2017-01-01

    This report is the third in a series by the Local Control Funding Formula Research Collaborative (LCFFRC). This research seeks to help policymakers and others better understand ways in which the LCFF is changing fundamental aspects of resource allocation and governance and how these changes might lead to improved student outcomes. The work is…

  2. [The activity of local health units in agriculture: promotion, prevention, control].

    PubMed

    Angotzi, G; Ariano, E; Quercia, A

    2010-01-01

    Agriculture shows an high proportion of injuries, mostly by machineries and instruments, and the highest proportion between fatal and total injuries. The Conference of Regions has adopted the National Agriculture and Forestry Prevention Plan, in application of the "Pact for health and safety in workplaces". The plan gives priority to actions improving the safety of agricultural machines, specially if more frequently involved in serious and fatal injuries. Goal is to achieve an homogenous intervention standard all over in the country, composed by a mix of information, support and control, addressed to farms and agricultural machines traders. Public prevention organizations of Local Health Units moreover will record homogenously the happen modality of fatal and serious accidents, will collaborate in joining prevention objectives with Rural Develop Plans and in drawing up good practices. At another level in some regions have been developed prevention activities for other risk factors: definition of exposition profiles of pesticides, development of professionally exposed workers formation, control of buildings and cattle breeding, medical and epidemiological periodic survey of employees.

  3. Perceived control among migrant live-in and local live-out home care workers in Israel.

    PubMed

    Shinan-Altman, Shiri; Ayalon, Liat

    2017-11-20

    To examine perceived control among live-in and live-out home care workers and to identify factors that contribute to perceived control among both types of caregiving. 338 migrant live-in home care workers and 185 local live-out home care workers were asked to report their perceived control. Burnout, satisfaction with the relationship with the care recipient and the care recipient's family, and satisfaction with social relationship were also gathered. Both types of caregivers reported high levels of perceived control, although live-in home care workers expressed more perceived control. Higher age, higher levels of satisfaction with the relationship with the care recipient and the care recipient's family and lower levels of burnout, predicted perceived control. Satisfaction with social relationship was a stronger predictor of one's perceived control among live-in home care workers. Promoting social relationships outside the home care context by allowing migrant live-in home care workers to take part in social gatherings is recommended as this can strengthen their sense of perceived control.

  4. Intraperitoneal local anaesthetic instillation versus no intraperitoneal local anaesthetic instillation for laparoscopic cholecystectomy.

    PubMed

    Gurusamy, Kurinchi Selvan; Nagendran, Myura; Guerrini, Gian Piero; Toon, Clare D; Zinnuroglu, Murat; Davidson, Brian R

    2014-03-13

    While laparoscopic cholecystectomy is generally considered less painful than open surgery, pain is one of the important reasons for delayed discharge after day surgery and overnight stay laparoscopic cholecystectomy. The safety and effectiveness of intraperitoneal local anaesthetic instillation in people undergoing laparoscopic cholecystectomy is unknown. To assess the benefits and harms of intraperitoneal instillation of local anaesthetic agents in people undergoing laparoscopic cholecystectomy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and Science Citation Index Expanded to March 2013 to identify randomised clinical trials of relevance to this review. We considered only randomised clinical trials (irrespective of language, blinding, or publication status) comparing local anaesthetic intraperitoneal instillation versus placebo, no intervention, or inactive control during laparoscopic cholecystectomy for the review with regards to benefits while we considered quasi-randomised studies and non-randomised studies for treatment-related harms. Two review authors collected the data independently. We analysed the data with both fixed-effect and random-effects models using Review Manager 5 analysis. For each outcome, we calculated the risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CI). We included 58 trials, of which 48 trials with 2849 participants randomised to intraperitoneal local anaesthetic instillation (1558 participants) versus control (1291 participants) contributed data to one or more of the outcomes. All the trials except one trial with 30 participants were at high risk of bias. Most trials included only low anaesthetic risk people undergoing elective laparoscopic cholecystectomy. Various intraperitoneal local anaesthetic agents were used but bupivacaine in the liquid form was the most common local anaesthetic used. There were considerable differences in the methods of local anaesthetic

  5. Controlling electron localization in H2 + by intense plasmon-enhanced laser fields

    NASA Astrophysics Data System (ADS)

    Yavuz, I.; Ciappina, M. F.; Chacón, A.; Altun, Z.; Kling, M. F.; Lewenstein, M.

    2016-03-01

    We present a theoretical study of the H2 + molecular ion wave-packet dynamics in plasmon-enhanced laser fields. These fields may be produced, for instance, when metallic nanostructures are illuminated by a laser pulse of moderated intensity. Their main property is that they vary in space on a nanometric scale. We demonstrate that the spatial inhomogeneous character of the plasmonic fields leads to an enhancement of electron localization (EL), an instrumental phenomenon to control molecular fragmentation. We suggest that the charge imbalance induced by the surface-plasmon resonance near the metallic nanostructure is the origin of the increase in the EL.

  6. Relief of Injection Pain During Delivery of Local Anesthesia by Computer-Controlled Anesthetic Delivery System for Periodontal Surgery: Randomized Clinical Controlled Trial.

    PubMed

    Chang, Hyeyoon; Noh, Jiyoung; Lee, Jungwon; Kim, Sungtae; Koo, Ki-Tae; Kim, Tae-Il; Seol, Yang-Jo; Lee, Yong-Moo; Ku, Young; Rhyu, In-Chul

    2016-07-01

    Pain from local anesthetic injection makes patients anxious when visiting a dental clinic. This study aims to determine differences in pain according to types of local anesthetizing methods and to identify the possible contributing factors (e.g., dental anxiety, stress, and sex). Thirty-one patients who underwent open-flap debridement in maxillary premolar and molar areas during treatment for chronic periodontitis were evaluated for this study. A randomized, split-mouth, single-masked clinical trial was implemented. The dental anxiety scale (DAS) and perceived stress scale (PSS) were administered before surgery. Two lidocaine ampules for each patient were used for local infiltration anesthesia (supraperiosteal injection). Injection pain was measured immediately after local infiltration anesthesia using the visual analog pain scale (VAS) questionnaire. Results from the questionnaire were used to assess degree of pain patients feel when a conventional local anesthetic technique (CNV) is used compared with a computer-controlled anesthetic delivery system (CNR). DAS and PSS did not correlate to injection pain. VAS scores were lower for CNR than for CNV regardless of the order in which anesthetic procedures were applied. VAS score did not differ significantly with sex. Pearson coefficient for correlation between VAS scores for the two procedures was 0.80, also indicating a strong correlation. Within the limitations of the present study, relief from injection pain is observed using CNR.

  7. Split-course, high-dose palliative pelvic radiotherapy for locally progressive hormone-refractory prostate cancer.

    PubMed

    Gogna, Nirdosh Kumar; Baxi, Siddhartha; Hickey, Brigid; Baumann, Kathryn; Burmeister, Elizabeth; Holt, Tanya

    2012-06-01

    Local progression, in patients with hormone-refractory prostate cancer, often causes significant morbidity. Pelvic radiotherapy (RT) provides effective palliation in this setting, with most published studies supporting the use of high-dose regimens. The aim of the present study was to examine the role of split-course hypofractionated RT used at our institution in treating this group of patients. A total of 34 men with locoregionally progressive hormone-refractory prostate cancer, treated with a split course of pelvic RT (45-60 Gy in 18-24 fractions) between 2000 and 2008 were analyzed. The primary endpoints were the response rate and actuarial locoregional progression-free survival. Secondary endpoints included overall survival, compliance, and acute and late toxicity. The median age was 71 years (range, 53-88). Treatment resulted in an overall initial response rate of 91%, a median locoregional progression-free survival of 43 months, and median overall survival of 28 months. Compliance was excellent and no significant late toxicity was reported. The split course pelvic RT described has an acceptable toxicity profile, is effective, and compares well with other high-dose palliative regimens that have been previously reported. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Locally optimal control under unknown dynamics with learnt cost function: application to industrial robot positioning

    NASA Astrophysics Data System (ADS)

    Guérin, Joris; Gibaru, Olivier; Thiery, Stéphane; Nyiri, Eric

    2017-01-01

    Recent methods of Reinforcement Learning have enabled to solve difficult, high dimensional, robotic tasks under unknown dynamics using iterative Linear Quadratic Gaussian control theory. These algorithms are based on building a local time-varying linear model of the dynamics from data gathered through interaction with the environment. In such tasks, the cost function is often expressed directly in terms of the state and control variables so that it can be locally quadratized to run the algorithm. If the cost is expressed in terms of other variables, a model is required to compute the cost function from the variables manipulated. We propose a method to learn the cost function directly from the data, in the same way as for the dynamics. This way, the cost function can be defined in terms of any measurable quantity and thus can be chosen more appropriately for the task to be carried out. With our method, any sensor information can be used to design the cost function. We demonstrate the efficiency of this method through simulating, with the V-REP software, the learning of a Cartesian positioning task on several industrial robots with different characteristics. The robots are controlled in joint space and no model is provided a priori. Our results are compared with another model free technique, consisting in writing the cost function as a state variable.

  9. Global frameworks, local strategies: Women's rights, health, and the tobacco control movement in Argentina.

    PubMed

    Muñoz Martínez, Hepzibah; Pederson, Ann

    2018-02-23

    The article examines how civil society organisations in Argentina used the United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) to frame the country's failure to enact strong national tobacco control legislation as a violation of women's rights in the late 2000s. We analyze this case study through the politics of scale, namely the social processes that produce, reproduce, and contest the boundaries of policies and socio-economic relations. This approach understands how multiple scales overlap and connect to obstruct or enhance the right to health in Latin America. In Argentina, the global organisation of tobacco companies, the reach of international financial institutions and the national dynamics of economic austerity and export-orientation promoted the local production and use of tobacco (leaf and cigarettes) and reproduced health inequalities in the country throughout the 1990s and the early 2000s. Yet, the visible legacy of local and national human rights struggles in the adoption of international human rights treaties into Argentina's national constitution allowed the tobacco control movement to link the scale of women's bodies to the right to health through the use of CEDAW to change national legislation, tackling the social determinants of the tobacco epidemic.

  10. Long-term local control rates of patients with adenoid cystic carcinoma of the head and neck managed by surgery and postoperative radiation.

    PubMed

    Ali, Safina; Palmer, Frank L; Katabi, Nora; Lee, Nancy; Shah, Jatin P; Patel, Snehal G; Ganly, Ian

    2017-10-01

    To report long-term local control in patients with adenoid cystic cancer (ACC) of the head and neck managed by surgery and identify factors predictive for local failure. Single-institution retrospective cohort study. Eighty-seven patients who had surgery for ACC between 1985 and 2009 were identified. Patient, tumor, and treatment characteristics were recorded. Local recurrence-free survival (LRFS) was recorded by the Kaplan-Meier method. Predictors of local control were identified. The median age was 54 years. Seventy-two (83%) patients had perineural invasion, 61 (70%) had close/positive margins, and 58 (67%) had pT 1T2. Fifty-nine (68%) patients had postoperative radiation therapy (PORT). With a median follow-up of 85 months, the 10-year LRFS was 78.7%. There were 14 local recurrences. On multivariable analysis, pathological tumor (T)3T4 stage and no PORT were independent predictors for local failure. Patients with no PORT had a 13-fold increased risk of local failure compared to patients treated with PORT (P = 0.003) after adjusting for stage. After adjusting for T stage, patients who do not get PORT are more likely to have local recurrence. 4. Laryngoscope, 127:2265-2269, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Compact vibration isolation and suspension for Australian International Gravitational Observatory: Local control system

    NASA Astrophysics Data System (ADS)

    Dumas, Jean-Charles; Barriga, Pablo; Zhao, Chunnong; Ju, Li; Blair, David G.

    2009-11-01

    High performance vibration isolators are required for ground based gravitational wave detectors. To attain very high performance at low frequencies we have developed multistage isolators for the proposed Australian International Gravitational Observatory detector in Australia. New concepts in vibration isolation including self-damping, Euler springs, LaCoste springs, Roberts linkages, and double preisolation require novel sensors and actuators. Double preisolation enables internal feedback to be used to suppress low frequency seismic noise. Multidegree of freedom control systems are required to attain high performance. Here we describe the control components and control systems used to control all degrees of freedom. Feedback forces are injected at the preisolation stages and at the penultimate suspension stage. There is no direct actuation on test masses. A digital local control system hosted on a digital signal processor maintains alignment and position, corrects drifts, and damps the low frequency linear and torsional modes without exciting the very high Q-factor test mass suspension. The control system maintains an optical cavity locked to a laser with a high duty cycle even in the absence of an autoalignment system. An accompanying paper presents the mechanics of the system, and the optical cavity used to determine isolation performance. A feedback method is presented, which is expected to improve the residual motion at 1 Hz by more than one order of magnitude.

  12. Compact vibration isolation and suspension for Australian International Gravitational Observatory: local control system.

    PubMed

    Dumas, Jean-Charles; Barriga, Pablo; Zhao, Chunnong; Ju, Li; Blair, David G

    2009-11-01

    High performance vibration isolators are required for ground based gravitational wave detectors. To attain very high performance at low frequencies we have developed multistage isolators for the proposed Australian International Gravitational Observatory detector in Australia. New concepts in vibration isolation including self-damping, Euler springs, LaCoste springs, Roberts linkages, and double preisolation require novel sensors and actuators. Double preisolation enables internal feedback to be used to suppress low frequency seismic noise. Multidegree of freedom control systems are required to attain high performance. Here we describe the control components and control systems used to control all degrees of freedom. Feedback forces are injected at the preisolation stages and at the penultimate suspension stage. There is no direct actuation on test masses. A digital local control system hosted on a digital signal processor maintains alignment and position, corrects drifts, and damps the low frequency linear and torsional modes without exciting the very high Q-factor test mass suspension. The control system maintains an optical cavity locked to a laser with a high duty cycle even in the absence of an autoalignment system. An accompanying paper presents the mechanics of the system, and the optical cavity used to determine isolation performance. A feedback method is presented, which is expected to improve the residual motion at 1 Hz by more than one order of magnitude.

  13. Controlling chaos with localized heterogeneous forces in oscillator chains.

    PubMed

    Chacón, Ricardo

    2006-10-01

    The effects of decreasing the impulse transmitted by localized periodic pulses on the chaotic behavior of homogeneous chains of coupled nonlinear oscillators are studied. It is assumed that when the oscillators are driven synchronously, i.e., all driving pulses transmit the same impulse, the chains display chaotic dynamics. It is shown that decreasing the impulse transmitted by the pulses of the two free end oscillators results in regularization with the whole array exhibiting frequency synchronization, irrespective of the chain size. A maximum level of amplitude desynchrony as the pulses of the two end oscillators narrow is typically found, which is explained as the result of two competing universal mechanisms: desynchronization induced by localized heterogeneous pulses and oscillation death of the complete chain induced by drastic decreasing of the impulse transmitted by such localized pulses. These findings demonstrate that decreasing the impulse transmitted by localized external forces can suppress chaos and lead to frequency-locked states in networks of dissipative systems.

  14. 20 CFR 901.1 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... during which the actuary spent a substantial amount of time in responsible actuarial experience. (d... month during which the actuary spent a substantial amount of time in responsible pension actuarial...

  15. 20 CFR 901.1 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... during which the actuary spent a substantial amount of time in responsible actuarial experience. (d... month during which the actuary spent a substantial amount of time in responsible pension actuarial...

  16. 20 CFR 901.1 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... during which the actuary spent a substantial amount of time in responsible actuarial experience. (d... month during which the actuary spent a substantial amount of time in responsible pension actuarial...

  17. Controlling the layer localization of gapless states in bilayer graphene with a gate voltage

    NASA Astrophysics Data System (ADS)

    Jaskólski, W.; Pelc, M.; Bryant, Garnett W.; Chico, Leonor; Ayuela, A.

    2018-04-01

    Experiments in gated bilayer graphene with stacking domain walls present topological gapless states protected by no-valley mixing. Here we research these states under gate voltages using atomistic models, which allow us to elucidate their origin. We find that the gate potential controls the layer localization of the two states, which switches non-trivially between layers depending on the applied gate voltage magnitude. We also show how these bilayer gapless states arise from bands of single-layer graphene by analyzing the formation of carbon bonds between layers. Based on this analysis we provide a model Hamiltonian with analytical solutions, which explains the layer localization as a function of the ratio between the applied potential and interlayer hopping. Our results open a route for the manipulation of gapless states in electronic devices, analogous to the proposed writing and reading memories in topological insulators.

  18. Local Control Funding Formula in California: How to Monitor Progress and Learn from a Grand Experiment

    ERIC Educational Resources Information Center

    Fuller, Bruce; Tobben, Laura

    2014-01-01

    The Local Control Funding Formula (LCFF) was enacted by the California legislature in June 2013 and fundamentally changes the distribution of education dollars to districts. The legislation simplifies the formula for sending money to districts and now takes into account the higher costs of educating certain groups of students, specifically those…

  19. Bone Balance within a Cortical BMU: Local Controls of Bone Resorption and Formation

    PubMed Central

    Smith, David W.; Gardiner, Bruce S.; Dunstan, Colin

    2012-01-01

    Maintaining bone volume during bone turnover by a BMU is known as bone balance. Balance is required to maintain structural integrity of the bone and is often dysregulated in disease. Consequently, understanding how a BMU controls bone balance is of considerable interest. This paper develops a methodology for identifying potential balance controls within a single cortical BMU. The theoretical framework developed offers the possibility of a directed search for biological processes compatible with the constraints of balance control. We first derive general control constraint equations and then introduce constitutive equations to identify potential control processes that link key variables that describe the state of the BMU. The paper describes specific local bone volume balance controls that may be associated with bone resorption and bone formation. Because bone resorption and formation both involve averaging over time, short-term fluctuations in the environment are removed, leaving the control systems to manage deviations in longer-term trends back towards their desired values. The length of time for averaging is much greater for bone formation than for bone resorption, which enables more filtering of variability in the bone formation environment. Remarkably, the duration for averaging of bone formation may also grow to control deviations in long-term trends of bone formation. Providing there is sufficient bone formation capacity by osteoblasts, this leads to an extraordinarily robust control mechanism that is independent of either osteoblast number or the cellular osteoid formation rate. A complex picture begins to emerge for the control of bone volume. Different control relationships may achieve the same objective, and the ‘integration of information’ occurring within a BMU may be interpreted as different sets of BMU control systems coming to the fore as different information is supplied to the BMU, which in turn leads to different observable BMU behaviors

  20. Localization, Localization, Localization

    NASA Technical Reports Server (NTRS)

    Parker, T.; Malin, M.; Golombek, M.; Duxbury, T.; Johnson, A.; Guinn, J.; McElrath, T.; Kirk, R.; Archinal, B.; Soderblom, L.

    2004-01-01

    Localization of the two Mars Exploration Rovers involved three independent approaches to place the landers with respect to the surface of Mars and to refine the location of those points on the surface with the Mars control net: 1) Track the spacecraft through entry, descent, and landing, then refine the final roll stop position by radio tracking and comparison to images taken during descent; 2) Locate features on the horizon imaged by the two rovers and compare them to the MOC and THEMIS VIS images, and the DIMES images on the two MER landers; and 3) 'Check' and refine locations by acquisition of MOC 1.5 meter and 50 cm/pixel images.

  1. Stabilization and localization of Xist RNA are controlled by separate mechanisms and are not sufficient for X inactivation.

    PubMed

    Clemson, C M; Chow, J C; Brown, C J; Lawrence, J B

    1998-07-13

    These studies address whether XIST RNA is properly localized to the X chromosome in somatic cells where human XIST expression is reactivated, but fails to result in X inactivation (Tinker, A.V., and C.J. Brown. 1998. Nucl. Acids Res. 26:2935-2940). Despite a nuclear RNA accumulation of normal abundance and stability, XIST RNA does not localize in reactivants or in naturally inactive human X chromosomes in mouse/ human hybrid cells. The XIST transcripts are fully stabilized despite their inability to localize, and hence XIST RNA localization can be uncoupled from stabilization, indicating that these are separate steps controlled by distinct mechanisms. Mouse Xist RNA tightly localized to an active X chromosome, demonstrating for the first time that the active X chromosome in somatic cells is competent to associate with Xist RNA. These results imply that species-specific factors, present even in mature, somatic cells that do not normally express Xist, are necessary for localization. When Xist RNA is properly localized to an active mouse X chromosome, X inactivation does not result. Therefore, there is not a strict correlation between Xist localization and chromatin inactivation. Moreover, expression, stabilization, and localization of Xist RNA are not sufficient for X inactivation. We hypothesize that chromosomal association of XIST RNA may initiate subsequent developmental events required to enact transcriptional silencing.

  2. California's First Year with Local Control Finance and Accountability

    ERIC Educational Resources Information Center

    Menefee-Libey, David J.; Kerchner, Charles Taylor

    2015-01-01

    In 2013, Governor Jerry Brown and the California legislature radically restructured the state's school funding system and accountability systems with a weighted student formula and a mandated local planning process in each district. The new law substitutes local politics and grassroots agency for state-driven mandates and compliance reviews. While…

  3. A tip-localized RhoGAP controls cell polarity by globally inhibiting Rho GTPase at the cell apex.

    PubMed

    Hwang, Jae-Ung; Vernoud, Vanessa; Szumlanski, Amy; Nielsen, Erik; Yang, Zhenbiao

    2008-12-23

    Highly elongated eukaryotic cells (e.g., neuronal axons, fungal hyphae, and pollen tubes) are generated through continuous apically restricted growth (tip growth), which universally requires tip-localized Rho GTPases. We used the oscillating pollen tube as a model system to determine the function and regulation of Rho GTPases in tip growth. Our previous work showed that the spatiotemporal dynamics of the apical cap of the activated Rho-like GTPase from Plant 1 (ROP1) are critical for tip growth in pollen tubes. However, the underlying mechanism for the generation and maintenance of this dynamic apical cap is poorly understood. A screen for mutations that enhance ROP1-overexpression-induced depolarization of pollen-tube growth identified REN1 (ROP1 enhancer 1) in Arabidopsis, whose null mutations turn elongated pollen tubes into bulbous cells. REN1 encodes a novel Rho GTPase-activating protein (RhoGAP) required for restricting the ROP1 activity to the pollen-tube tip. REN1 was localized to exocytic vesicles accumulated in the pollen-tube apex, as well as to the apical plasma membrane at the site of ROP1 activation. The apical localization of REN1 and its function in controlling growth polarity was compromised by disruption of ROP1-dependent F-actin and vesicular trafficking, which indicates that REN1 targeting and function is regulated by ROP1 downstream signaling. Our findings suggest that the REN1 RhoGAP controls a negative-feedback-based global inhibition of ROP1. This function provides a critical self-organizing mechanism, by which ROP signaling is spatially limited to the growth site and temporally oscillates during continuous tip growth. Similar spatiotemporal control of Rho GTPase signaling may also play an important role in cell-polarity control in other systems, including tip growth in fungi and cell movement in animals.

  4. Continued benefits of a technical assistance web site to local tobacco control coalitions during a state budget shortfall.

    PubMed

    Buller, David B; Young, Walter F; Bettinghaus, Erwin P; Borland, Ron; Walther, Joseph B; Helme, Donald; Andersen, Peter A; Cutter, Gary R; Maloy, Julie A

    2011-01-01

    A state budget shortfall defunded 10 local tobacco coalitions during a randomized trial but defunded coalitions continued to have access to 2 technical assistance Web sites. To test the ability of Web-based technology to provide technical assistance to local tobacco control coalitions. Randomized 2-group trial with local tobacco control coalitions as the unit of randomization. Local communities (ie, counties) within the State of Colorado. Leaders and members in 34 local tobacco control coalitions funded by the state health department in Colorado. Two technical assistance Web sites: A Basic Web site with text-based information and a multimedia Enhanced Web site containing learning modules, resources, and communication features. Use of the Web sites in minutes, pages, and session and evaluations of coalition functioning on coalition development, conflict resolution, leadership satisfaction, decision-making satisfaction, shared mission, personal involvement, and organization involvement in survey of leaders and members. Coalitions that were defunded but had access to the multimedia Enhanced Web site during the Fully Funded period and after defunding continued to use it (treatment group × funding status × period, F(3,714) = 3.18, P = .0234). Coalitions with access to the Basic Web site had low Web site use throughout and use by defunded coalitions was nearly zero when funding ceased. Members in defunded Basic Web site coalitions reported that their coalitions functioned worse than defunded Enhanced Web site coalitions (coalition development: group × status, F(1,360) = 4.81, P = .029; conflict resolution: group × status, F(1,306) = 5.69, P = .018; leadership satisfaction: group × status, F(1,342) = 5.69, P = .023). The Enhanced Web site may have had a protective effect on defunded coalitions. Defunded coalitions may have increased their capacity by using the Enhanced Web site when fully funded or by continuing to use the available online resources after defunding

  5. 42 CFR 422.254 - Submission of bids.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... accepted actuarial principles. (i) A qualified actuary must certify the plan's actuarial valuation (which may be prepared by others under his or her direction or review). (ii) To be deemed a qualified actuary, the actuary must be a member of the American Academy of Actuaries. (iii) Applicants may use qualified...

  6. 42 CFR 422.254 - Submission of bids.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... principles. (i) A qualified actuary must certify the plan's actuarial valuation (which may be prepared by others under his or her direction or review). (ii) To be deemed a qualified actuary, the actuary must be a member of the American Academy of Actuaries. (iii) Applicants may use qualified outside actuaries...

  7. Combination of a fusogenic glycoprotein, prodrug activation, and oncolytic herpes simplex virus for enhanced local tumor control.

    PubMed

    Simpson, Guy R; Han, Ziqun; Liu, Binlei; Wang, Yibing; Campbell, Gregor; Coffin, Robert S

    2006-05-01

    We have previously developed an oncolytic herpes simplex virus-1 based on a clinical virus isolate, which was deleted for ICP34.5 to provide tumor selected replication and ICP47 to increase antigen presentation as well as tumor selective virus replication. A phase I/II clinical trial using a version of this virus expressing granulocyte macrophage colony-stimulating factor has shown promising results. The work reported here aimed to develop a version of this virus in which local tumor control was further increased through the combined expression of a highly potent prodrug activating gene [yeast cytosine deaminase/uracil phospho-ribosyltransferase fusion (Fcy::Fur)] and the fusogenic glycoprotein from gibbon ape leukemia virus (GALV), which it was hoped would aid the spread of the activated prodrug through the tumor. Viruses expressing the two genes individually or in combination were constructed and tested, showing (a) GALV and/or Fcy::Fur expression did not affect virus growth; (b) GALV expression causes cell fusion and increases the tumor cell killing at least 30-fold in vitro and tumor shrinkage 5- to 10-fold in vivo; (c) additional expression of Fcy::Fur combined with 5-fluorocytosine administration improves tumor shrinkage further. These results indicate, therefore, that the combined expression of the GALV protein and Fcy::Fur provides a highly potent oncolytic virus with improved capabilities for local tumor control. It is intended to enter the GALV/Fcy::Fur expressing virus into clinical development for the treatment of tumor types, such as pancreatic or lung cancer, where local control would be anticipated to be clinically advantageous.

  8. IMRT for Sinonasal Tumors Minimizes Severe Late Ocular Toxicity and Preserves Disease Control and Survival

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Duprez, Frederic, E-mail: frederic.duprez@ugent.be; Madani, Indira; Morbee, Lieve

    2012-05-01

    Purpose: To report late ocular (primary endpoint) and other toxicity, disease control, and survival (secondary endpoints) after intensity-modulated radiotherapy (IMRT) for sinonasal tumors. Methods and Materials: Between 1998 and 2009, 130 patients with nonmetastatic sinonasal tumors were treated with IMRT at Ghent University Hospital. Prescription doses were 70 Gy (n = 117) and 60-66 Gy (n = 13) at 2 Gy per fraction over 6-7 weeks. Most patients had adenocarcinoma (n = 82) and squamous cell carcinoma (n = 23). One hundred and one (101) patients were treated postoperatively. Of 17 patients with recurrent tumors, 9 were reirradiated. T-stages weremore » T1-2 (n = 39), T3 (n = 21), T4a (n = 38), and T4b (n = 22). Esthesioneuroblastoma was staged as Kadish A, B, and C in 1, 3, and 6 cases, respectively. Results: Median follow-up was 52, range 15-121 months. There was no radiation-induced blindness in 86 patients available for late toxicity assessment ({>=}6 month follow-up). We observed late Grade 3 tearing in 10 patients, which reduced to Grade 1-2 in 5 patients and Grade 3 visual impairment because of radiation-induced ipsilateral retinopathy and neovascular glaucoma in 1 patient. There was no severe dry eye syndrome. The worst grade of late ocular toxicity was Grade 3 (n = 11), Grade 2 (n = 31), Grade 1 (n = 33), and Grade 0 (n = 11). Brain necrosis and osteoradionecrosis occurred in 6 and 1 patients, respectively. Actuarial 5-year local control and overall survival were 59% and 52%, respectively. On multivariate analysis local control was negatively affected by cribriform plate and brain invasion (p = 0.044 and 0.029, respectively) and absence of surgery (p = 0.009); overall survival was negatively affected by cribriform plate and orbit invasion (p = 0.04 and <0.001, respectively) and absence of surgery (p = 0.001). Conclusions: IMRT for sinonasal tumors allowed delivering high doses to targets at minimized ocular toxicity, while maintaining disease control and

  9. Selection with inbreeding control in simulated young bull schemes for local dairy cattle breeds.

    PubMed

    Gandini, G; Stella, A; Del Corvo, M; Jansen, G B

    2014-03-01

    Local breeds are rarely subject to modern selection techniques; however, selection programs will be required if local breeds are to remain a viable livelihood option for farmers. Selection in small populations needs to take into account accurate inbreeding control. Optimum contribution selection (OCS) is efficient in controlling inbreeding and maximizes genetic gain. The current paper investigates genetic progress in simulated dairy cattle populations from 500 to 6,000 cows undergoing young bull selection schemes with OCS compared with truncation selection (TS) at an annual inbreeding rate of 0.003. Selection is carried out for a dairy trait with a base heritability of 0.3. A young bull selection scheme was used because of its simplicity in implementation. With TS, annual genetic gain from 0.111 standard deviation units with 500 cows increases rapidly to 0.145 standard deviation units with 4,000 cows. Then, genetic gain increases more slowly up to 6,000 cows. At the same inbreeding rate, OCS produces higher genetic progress than TS. Differences in genetic gain between OCS and TS vary from to 2 to 6.3%. Genetic gain is also improved by increasing the number of years that males can be used as sires of sires. When comparing OCS versus TS at different heritabilities, we observe an advantage of OCS only at high heritability, up to 8% with heritability of 0.9. By increasing the constraint on inbreeding, the difference of genetic gain between the 2 selection methods increases in favor of OCS, and the advantage at the inbreeding rate of 0.001 per generation is 6 times more than at the inbreeding rate of 0.003. Opportunities exist for selection even in dairy cattle populations of a few hundred females. In any case, selection in local breeds will most often require specific investments in infrastructure and manpower, including systems for accurate data recording and selection skills and the presence of artificial insemination and breeders organizations. A cost

  10. Periostin in Mature Stage Localized Scleroderma.

    PubMed

    Kim, Min-Woo; Park, Jung Tae; Kim, Jung Ho; Koh, Seong-Joon; Yoon, Hyun-Sun; Cho, Soyun; Park, Hyun-Sun

    2017-06-01

    Periostin is a novel matricellular protein expressed in many tissues, including bone, periodontal ligament, and skin. Although its expression is prominent in various fibrotic conditions, studies of periostin in localized scleroderma are rare. To investigate the expression of periostin and other molecules in localized scleroderma. A retrospective study of 14 patients with confirmed mature stage localized scleroderma was undertaken. Fourteen age-matched and biopsy site-matched subjects with normal skin were included as controls. Collagen fiber deposition, periostin, procollagen, transforming growth factor-β, and matrix metalloproteinase (MMP)-1 expression were assessed and compared between the two groups. Co-localization of α-smooth muscle actin and periostin was evaluated using confocal microscopy. Periostin was predominantly expressed along the dermo-epidermal junction in the controls. Conversely, patients with localized scleroderma demonstrated increased collagen fiber deposition and periostin expression that was more widely distributed along the entire dermis. MMP-1 staining showed increased expression in the epidermis and dermis of patients compared to scanty expression in the controls. A semi-quantitative evaluation showed a higher proportion of excessive collagen bundle deposition (57.1% vs. 7.1%, p =0.013), diffuse periostin positivity (42.9% vs. 0%, p =0.016), and moderate MMP-1 positivity (71.4% vs. 7.1%, p =0.001) in patients than in the controls. Compared to the controls, patients with localized scleroderma had enhanced periostin expression corresponding to increased collagen fiber deposition and unexpected overexpression of MMP-1. The results of this human in vivo study may implicate the pathogenesis of localized scleroderma.

  11. Periostin in Mature Stage Localized Scleroderma

    PubMed Central

    Kim, Min-Woo; Park, Jung Tae; Kim, Jung Ho; Koh, Seong-Joon; Yoon, Hyun-Sun; Cho, Soyun

    2017-01-01

    Background Periostin is a novel matricellular protein expressed in many tissues, including bone, periodontal ligament, and skin. Although its expression is prominent in various fibrotic conditions, studies of periostin in localized scleroderma are rare. Objective To investigate the expression of periostin and other molecules in localized scleroderma. Methods A retrospective study of 14 patients with confirmed mature stage localized scleroderma was undertaken. Fourteen age-matched and biopsy site-matched subjects with normal skin were included as controls. Collagen fiber deposition, periostin, procollagen, transforming growth factor-β, and matrix metalloproteinase (MMP)-1 expression were assessed and compared between the two groups. Co-localization of α-smooth muscle actin and periostin was evaluated using confocal microscopy. Results Periostin was predominantly expressed along the dermo-epidermal junction in the controls. Conversely, patients with localized scleroderma demonstrated increased collagen fiber deposition and periostin expression that was more widely distributed along the entire dermis. MMP-1 staining showed increased expression in the epidermis and dermis of patients compared to scanty expression in the controls. A semi-quantitative evaluation showed a higher proportion of excessive collagen bundle deposition (57.1% vs. 7.1%, p=0.013), diffuse periostin positivity (42.9% vs. 0%, p=0.016), and moderate MMP-1 positivity (71.4% vs. 7.1%, p=0.001) in patients than in the controls. Conclusion Compared to the controls, patients with localized scleroderma had enhanced periostin expression corresponding to increased collagen fiber deposition and unexpected overexpression of MMP-1. The results of this human in vivo study may implicate the pathogenesis of localized scleroderma. PMID:28566901

  12. High Dose Rate Brachytherapy in Two 9 Gy Fractions in the Treatment of Locally Advanced Cervical Cancer - a South Indian Institutional Experience.

    PubMed

    Ghosh, Saptarshi; Rao, Pamidimukkala Bramhananda; Kotne, Sivasankar

    2015-01-01

    Although 3D image based brachytherapy is currently the standard of treatment in cervical cancer, most of the centres in developing countries still practice orthogonal intracavitary brachytherapy due to financial constraints. The quest for optimum dose and fractionation schedule in high dose rate (HDR) intracavitary brachytherapy (ICBT) is still ongoing. While the American Brachytherapy Society recommends four to eight fractions of each less than 7.5 Gy, there are some studies demonstrating similar efficacy and comparable toxicity with higher doses per fraction. To assess the treatment efficacy and late complications of HDR ICBT with 9 Gy per fraction in two fractions. This is a prospective institutional study in Southern India carried on from 1st June 2012 to 31st July 2014. In this period, 76 patients of cervical cancer satisfying our inclusion criteria were treated with concurrent chemo-radiation following ICBT with 9 Gy per fraction in two fractions, five to seven days apart. The median follow-up period in the study was 24 months (range 10.6 - 31.2 months). The 2 year actuarial local control rate, disease-free survival and overall survival were 88.1%, 84.2% and 81.8% respectively. Although 38.2% patients suffered from late toxicity, only 3 patients had grade III late toxicity. In our experience, HDR brachytherapy with 9 Gy per fraction in two fractions is an effective dose fractionation for the treatment of cervical cancer with acceptable toxicity.

  13. Climate Controls AM Fungal Distributions from Global to Local Scales

    NASA Astrophysics Data System (ADS)

    Kivlin, S. N.; Hawkes, C.; Muscarella, R.; Treseder, K. K.; Kazenel, M.; Lynn, J.; Rudgers, J.

    2016-12-01

    Arbuscular mycorrhizal (AM) fungi have key functions in terrestrial biogeochemical processes; thus, determining the relative importance of climate, edaphic factors, and plant community composition on their geographic distributions can improve predictions of their sensitivity to global change. Local adaptation by AM fungi to plant hosts, soil nutrients, and climate suggests that all of these factors may control fungal geographic distributions, but their relative importance is unknown. We created species distribution models for 142 AM fungal taxa at the global scale with data from GenBank. We compared climate variables (BioClim and soil moisture), edaphic variables (phosphorus, carbon, pH, and clay content), and plant variables using model selection on models with (1) all variables, (2) climatic variables only (including soil moisture) and (3) resource-related variables only (all other soil parameters and NPP) using the MaxEnt algorithm evaluated with ENMEval. We also evaluated whether drivers of AM fungal distributions were phylogenetically conserved. To test whether global correlates of AM fungal distributions were reflected at local scales, we then surveyed AM fungi in nine plant hosts along three elevation gradients in the Upper Gunnison Basin, Colorado, USA. At the global scale, the distributions of 55% of AM fungal taxa were affected by both climate and soil resources, whereas 16% were only affected by climate and 29% were only affected by soil resources. Even for AM fungi that were affected by both climate and resources, the effects of climatic variables nearly always outweighed those of resources. Soil moisture and isothermality were the main climatic and NPP and soil carbon the main resource related factors influencing AM fungal distributions. Distributions of closely related AM fungal taxa were similarly affected by climate, but not by resources. Local scale surveys of AM fungi across elevations confirmed that climate was a key driver of AM fungal

  14. Local Control With Reduced-Dose Radiotherapy for Low-Risk Rhabdomyosarcoma: A Report From the Children's Oncology Group D9602 Study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Breneman, John, E-mail: john.breneman@uchealth.com; Meza, Jane; Donaldson, Sarah S.

    2012-06-01

    Purpose: To analyze the effect of reduced-dose radiotherapy on local control in children with low-risk rhabdomyosarcoma (RMS) treated in the Children's Oncology Group D9602 study. Methods and Materials: Patients with low-risk RMS were nonrandomly assigned to receive radiotherapy doses dependent on the completeness of surgical resection of the primary tumor (clinical group) and the presence of involved regional lymph nodes. After resection, most patients with microscopic residual and uninvolved nodes received 36 Gy, those with involved nodes received 41.4 to 50.4 Gy, and those with orbital primary tumors received 45 Gy. All patients received vincristine and dactinomycin, with cyclophosphamide addedmore » for patient subsets with a higher risk of relapse in Intergroup Rhabdomyosarcoma Study Group III and IV studies. Results: Three hundred forty-two patients were eligible for analysis; 172 received radiotherapy as part of their treatment. The cumulative incidence of local/regional failure was 15% in patients with microscopic involved margins when cyclophosphamide was not part of the treatment regimen and 0% when cyclophosphamide was included. The cumulative incidence of local/regional failure was 14% in patients with orbital tumors. Protocol-specified omission of radiotherapy in girls with Group IIA vaginal tumors (n = 5) resulted in three failures for this group. Conclusions: In comparison with Intergroup Rhabdomyosarcoma Study Group III and IV results, reduced-dose radiotherapy does not compromise local control for patients with microscopic tumor after surgical resection or with orbital primary tumors when cyclophosphamide is added to the treatment program. Girls with unresected nonbladder genitourinary tumors require radiotherapy for postsurgical residual tumor for optimal local control to be achieved.« less

  15. Local Control in Action: Learning from the CORE Districts' Focus on Measurement, Capacity Building, and Shared Accountability. Policy Brief 16-4

    ERIC Educational Resources Information Center

    Marsh, Julie; Bush-Mecenas, Susan; Hough, Heather

    2016-01-01

    California and the nation are at the crossroads of a major shift in school accountability policy. At the state level, California's Local Control and Accountability Plan (LCAP) encourages the use of multiple measures of school performance used locally to support continuous improvement and strategic resource allocation. Similarly, the federal Every…

  16. Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft-Tissue Sarcomas After Preoperative Concurrent Chemoradiotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    MacDermed, Dhara M.; Miller, Luke L.; Peabody, Terrance D.

    Purpose: Various neoadjuvant approaches have been evaluated for the treatment of locally advanced soft-tissue sarcomas. This retrospective study describes a uniquely modified version of the Eilber regimen developed at the University of Chicago. Methods and Materials: We treated 34 patients (28 Stage III and 6 Stage IV) with locally advanced soft-tissue sarcomas of an extremity between 1995 and 2008. All patients received preoperative therapy including ifosfamide (2.5 g/m2 per day for 5 days) with concurrent radiation (28 Gy in 3.5-Gy daily fractions), sandwiched between various chemotherapy regimens. Postoperatively, 47% received further adjuvant chemotherapy. Results: Most tumors (94%) were Grade 3,more » and all were T2b, with a median size of 10.3 cm. Wide excision was performed in 29 patients (85%), and 5 required amputation. Of the resected tumor specimens, 50% exhibited high (>=90%) treatment-induced necrosis and 11.8% had a complete pathologic response. Surgical margins were negative in all patients. The 5-year survival rate was 42.3% for all patients and 45.2% for Stage III patients. For limb-preservation patients, the 5-year local control rate was 89.0% and reoperation was required for wound complications in 17.2%. The 5-year freedom-from-distant metastasis rate was 53.4% (Stage IV patients excluded), and freedom from distant metastasis was superior if treatment-induced tumor necrosis was 90% or greater (84.6% vs. 19.9%, p = 0.02). Conclusions: This well-tolerated concurrent chemoradiotherapy approach yields excellent rates of limb preservation and local control. The resulting treatment-induced necrosis rates are predictive of subsequent metastatic risk, and this information may provide an opportunity to guide postoperative systemic therapies.« less

  17. Cognitive Control Acts Locally

    ERIC Educational Resources Information Center

    Notebaert, Wim; Verguts, Tom

    2008-01-01

    Cognitive control adjusts information processing to momentary needs and task requirements. We investigated conflict adaptation when participants are performing two tasks, a Simon task and a SNARC task. The results indicated that one congruency effect (e.g., Simon) was reduced after conflict in the other task (e.g., SNARC), but only when both tasks…

  18. Parafoveal Target Detectability Reversal Predicted by Local Luminance and Contrast Gain Control

    NASA Technical Reports Server (NTRS)

    Ahumada, Albert J., Jr.; Beard, Bettina L.; Null, Cynthia H. (Technical Monitor)

    1996-01-01

    This project is part of a program to develop image discrimination models for the prediction of the detectability of objects in a range of backgrounds. We wanted to see if the models could predict parafoveal object detection as well as they predict detection in foveal vision. We also wanted to make our simplified models more general by local computation of luminance and contrast gain control. A signal image (0.78 x 0.17 deg) was made by subtracting a simulated airport runway scene background image (2.7 deg square) from the same scene containing an obstructing aircraft. Signal visibility contrast thresholds were measured in a fully crossed factorial design with three factors: eccentricity (0 deg or 4 deg), background (uniform or runway scene background), and fixed-pattern white noise contrast (0%, 5%, or 10%). Three experienced observers responded to three repetitions of 60 2IFC trials in each condition and thresholds were estimated by maximum likelihood probit analysis. In the fovea the average detection contrast threshold was 4 dB lower for the runway background than for the uniform background, but in the parafovea, the average threshold was 6 dB higher for the runway background than for the uniform background. This interaction was similar across the different noise levels and for all three observers. A likely reason for the runway background giving a lower threshold in the fovea is the low luminance near the signal in that scene. In our model, the local luminance computation is controlled by a spatial spread parameter. When this parameter and a corresponding parameter for the spatial spread of contrast gain were increased for the parafoveal predictions, the model predicts the interaction of background with eccentricity.

  19. Propensity score matching for selection of local areas as controls for evaluation of effects of alcohol policies in case series and quasi case-control designs.

    PubMed

    de Vocht, F; Campbell, R; Brennan, A; Mooney, J; Angus, C; Hickman, M

    2016-03-01

    Area-level public health interventions can be difficult to evaluate using natural experiments. We describe the use of propensity score matching (PSM) to select control local authority areas (LAU) to evaluate the public health impact of alcohol policies for (1) prospective evaluation of alcohol policies using area-level data, and (2) a novel two-stage quasi case-control design. Ecological. Alcohol-related indicator data (Local Alcohol Profiles for England, PHE Health Profiles and ONS data) were linked at LAU level. Six LAUs (Blackpool, Bradford, Bristol, Ipswich, Islington, and Newcastle-upon-Tyne) as sample intervention or case areas were matched to two control LAUs each using PSM. For the quasi case-control study a second stage was added aimed at obtaining maximum contrast in outcomes based on propensity scores. Matching was evaluated based on average standardized absolute mean differences (ASAM) and variable-specific P-values after matching. The six LAUs were matched to suitable control areas (with ASAM < 0.20, P-values >0.05 indicating good matching) for a prospective evaluation study that sought areas that were similar at baseline in order to assess whether a change in intervention exposure led to a change in the outcome (alcohol related harm). PSM also generated appropriate matches for a quasi case-control study--whereby the contrast in health outcomes between cases and control areas needed to be optimized in order to assess retrospectively whether differences in intervention exposure were associated with the outcome. The use of PSM for area-level alcohol policy evaluation, but also for other public health interventions, will improve the value of these evaluations by objective and quantitative selection of the most appropriate control areas. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Acetylation of the RhoA GEF Net1A controls its subcellular localization and activity

    PubMed Central

    Song, Eun Hyeon; Oh, Wonkyung; Ulu, Arzu; Carr, Heather S.; Zuo, Yan; Frost, Jeffrey A.

    2015-01-01

    ABSTRACT Net1 isoform A (Net1A) is a RhoA GEF that is required for cell motility and invasion in multiple cancers. Nuclear localization of Net1A negatively regulates its activity, and we have recently shown that Rac1 stimulates Net1A relocalization to the plasma membrane to promote RhoA activation and cytoskeletal reorganization. However, mechanisms controlling the subcellular localization of Net1A are not well understood. Here, we show that Net1A contains two nuclear localization signal (NLS) sequences within its N-terminus and that residues surrounding the second NLS sequence are acetylated. Treatment of cells with deacetylase inhibitors or expression of active Rac1 promotes Net1A acetylation. Deacetylase inhibition is sufficient for Net1A relocalization outside the nucleus, and replacement of the N-terminal acetylation sites with arginine residues prevents cytoplasmic accumulation of Net1A caused by deacetylase inhibition or EGF stimulation. By contrast, replacement of these sites with glutamine residues is sufficient for Net1A relocalization, RhoA activation and downstream signaling. Moreover, the N-terminal acetylation sites are required for rescue of F-actin accumulation and focal adhesion maturation in Net1 knockout MEFs. These data indicate that Net1A acetylation regulates its subcellular localization to impact on RhoA activity and actin cytoskeletal organization. PMID:25588829

  1. Intraoperative biopsy of the major cranial nerves in the surgical strategy for adenoid cystic carcinoma close to the skull base.

    PubMed

    Tarsitano, Achille; Pizzigallo, Angelo; Gessaroli, Manlio; Sturiale, Carmelo; Marchetti, Claudio

    2012-02-01

    Adenoid cystic carcinoma of the salivary glands has a propensity for perineural invasion, which could favor spread along the major cranial nerves, sometimes to the skull base and through the foramina to the brain parenchyma. This study evaluated the relationship between neural spread and relapse in the skull base. During surgery, we performed multiple biopsies with extemporaneous examination of the major nerves close to the tumor to guide the surgical resection. The percentage of actuarial local control at 5 years for patients with a positive named nerve and skull base infiltration was 12.5%, compared with 90.0% in patients who were named nerve-negative and without infiltration of the skull base (P = .001). Our study shows that local control of disease for patients who are named nerve-positive with skull base infiltration is significantly more complex compared with patients who are named nerve-negative without infiltration of the skull base. Copyright © 2012. Published by Mosby, Inc.

  2. Cerebellar medulloblastoma: the importance of posterior fossa dose to survival and patterns of failure

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Silverman, C.L.; Simpson, J.R.

    1982-11-01

    Fifty patients with biopsy-proven cerebellar medulloblastoma were retrospectively analyzed for prognostic factors, survival and patterns of failure. Five- and ten-year actuarial survivals for the entire group were 51% and 42%. Survival and local control were significantly better for the 21 patients who received doses greater than 5000 rad to the posterior fossa (85% and 80% respectively) than for the remaining patients (38% and 38%, respectively). Significant prognostic factors included achievement of local control in the posterior fossa (p = .0001) and dose to the posterior fossa (p = .0005). Sex, age, duration of symptoms, extent of surgery and initial T-stagemore » of disease were not significant. Posterior fossa was the predominant site of failure (71% of failures), but 10% of patients failed in the cerebrum and 12% outside the CNS. This experience confirms that survival rates of 70-80% are achievable with current treatment policies but accurate and consistent dose delivery to the posterior fossa is essential.« less

  3. Cerebellar medulloblastoma: the importance of posterior fossa dose to survival and patterns of failure

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Silverman, C.L.; Simpson, J.R.

    1982-11-01

    Fifty patients with biopsy-proven cerebellar medulloblastoma were retrospectively analyzed for prognostic factors, survival and patterns of failure. Five- and ten-year actuarial survivals for the entire group were 51% and 42%. Survival and local control were significantly better for the 21 patients who received doses greater that 5000 rad to the posterior fossa (85% and 80% respectively) than for the remaining patients (38% and 38%, respectively). Significant prognostic factors included achievement of local control in the posterior fossa (p = .0001) and dose to the posterior fossa (p = .0005). Sex, age, duration of symptoms, extent of surgery and initial T-stagemore » of disease were not significant. Posterior fossa was the predominant site of failure (71% of failures), but 10% of patients failed in the cerebrum and 12% outside the CNS. This experience confirms that survival rates of 70-80% are achievable with current treatment policies but accurate and consistent dose delivery to the posterior fossa is essential.« less

  4. Localized Control of Curie Temperature in Perovskite Oxide Film by Capping-Layer-Induced Octahedral Distortion.

    PubMed

    Thomas, S; Kuiper, B; Hu, J; Smit, J; Liao, Z; Zhong, Z; Rijnders, G; Vailionis, A; Wu, R; Koster, G; Xia, J

    2017-10-27

    With reduced dimensionality, it is often easier to modify the properties of ultrathin films than their bulk counterparts. Strain engineering, usually achieved by choosing appropriate substrates, has been proven effective in controlling the properties of perovskite oxide films. An emerging alternative route for developing new multifunctional perovskite is by modification of the oxygen octahedral structure. Here we report the control of structural oxygen octahedral rotation in ultrathin perovskite SrRuO_{3} films by the deposition of a SrTiO_{3} capping layer, which can be lithographically patterned to achieve local control. Using a scanning Sagnac magnetic microscope, we show an increase in the Curie temperature of SrRuO_{3} due to the suppression octahedral rotations revealed by the synchrotron x-ray diffraction. This capping-layer-based technique may open new possibilities for developing functional oxide materials.

  5. Local Controlled Release of Polyphenol Conjugated with Gelatin Facilitates Bone Formation

    PubMed Central

    Honda, Yoshitomo; Tanaka, Tomonari; Tokuda, Tomoko; Kashiwagi, Takahiro; Kaida, Koji; Hieda, Ayato; Umezaki, Yasuyuki; Hashimoto, Yoshiya; Imai, Koichi; Matsumoto, Naoyuki; Baba, Shunsuke; Shimizutani, Kimishige

    2015-01-01

    Catechins are extensively used in health care treatments. Nevertheless, there is scarce information about the feasibility of local administration with polyphenols for bone regeneration therapy, possibly due to lack of effective delivery systems. Here we demonstrated that the epigallocatechin-3-gallate-conjugated gelatin (EGCG/Gel) prepared by an aqueous chemical synthesis using 4-(4,6-dimethoxy-1,3,5-triazin-2-yl)-4-morpholinium chloride (DMT-MM) gradually disintegrated with time and facilitated bone formation in a critical size defect of a mouse calvaria. Conjugation of EGCG with the Gel generated cross-linking between the two molecules, thereby leading to a retardation of the degradation of the EGCG/Gel and to a delayed release of EGCG. The prepared EGCG/Gels represented significant osteogenic capability compared with that of the uncross-linked Gel and the cross-linked Gel with uncombined-EGCG. In vitro experiments disclosed that the EGCG/Gel induced osteoblastogenesis of a mouse mesenchymal stem cell line (D1 cells) within 14 days. Using fluorescently-labeled EGCG/Gel, we found that the fraction of EGCG/Gel adsorbed onto the cell membrane of the D1 cells possibly via a Gel-cell interaction. The interaction might confer the long-term effects of EGCG on the cells, resulting in a potent osteogenic capability of the EGCG/Gel in vivo. These results should provide insight into local controlled release of polyphenols for bone therapy. PMID:26110386

  6. Intraluminal low-dose-rate 192Ir brachytherapy combined with external beam radiotherapy and biliary stenting for unresectable extrahepatic bile duct carcinoma.

    PubMed

    Takamura, Akio; Saito, Hiroya; Kamada, Tadashi; Hiramatsu, Kazuhide; Takeuchi, Shuhei; Hasegawa, Masakazu; Miyamoto, Noriyuki

    2003-12-01

    To evaluate the results of combined-modality therapy, including external beam radiotherapy, intraluminal (192)Ir, and biliary stenting for extrahepatic bile duct carcinoma. Between 1988 and 1998, 93 patients with unresectable extrahepatic bile duct carcinoma underwent definitive radiotherapy. The dose of external beam radiotherapy was 50 Gy in 25 fractions. Low-dose-rate (192)Ir was delivered at a dose of 27-50 Gy (mean 39.2) at 0.5 cm from the source. An expandable metallic endoprosthesis was used to establish an internal bile passage. The median survival was 12 months, with a 1-, 3-, and 5-year actuarial survival rate of 50%, 10%, and 4%, respectively. Tumor length, hepatic invasion, and distant metastasis significantly affected survival. Ninety-six percent of patients could successfully remove external drainage catheters. The actuarial biliary patency rate for these patients at 1, 3, and 5 years was 52%, 29%, and 18%, respectively. Tumor length, tumor diameter and T stage were significantly associated with the patency rate. Mild-to-severe gastroduodenal complications were observed in 32 patients and were significantly associated with the active length of (192)Ir and linear source activity. Eight patients had treatment-related biliary fistula. Our combined-modality therapy provided reasonable local control and improved the quality of life of patients with extrahepatic bile duct carcinoma. Because none of the treatment characteristics had any impact on survival or biliary patency, lower dose levels and/or a localized target volume are recommended to minimize morbidity.

  7. Cryotherapy with concurrent CpG oligonucleotide treatment controls local tumor recurrence and modulates HER2/neu immunity.

    PubMed

    Veenstra, Jesse J; Gibson, Heather M; Littrup, Peter J; Reyes, Joyce D; Cher, Michael L; Takashima, Akira; Wei, Wei-Zen

    2014-10-01

    Percutaneous cryoablation is a minimally invasive procedure for tumor destruction, which can potentially initiate or amplify antitumor immunity through the release of tumor-associated antigens. However, clinically efficacious immunity is lacking and regional recurrences are a limiting factor relative to surgical excision. To understand the mechanism of immune activation by cryoablation, comprehensive analyses of innate immunity and HER2/neu humoral and cellular immunity following cryoablation with or without peritumoral CpG injection were conducted using two HER2/neu(+) tumor systems in wild-type (WT), neu-tolerant, and SCID mice. Cryoablation of neu(+) TUBO tumor in BALB/c mice resulted in systemic immune priming, but not in neu-tolerant BALB NeuT mice. Cryoablation of human HER2(+) D2F2/E2 tumor enabled the functionality of tumor-induced immunity, but secondary tumors were refractory to antitumor immunity if rechallenge occurred during the resolution phase of the cryoablated tumor. A step-wise increase in local recurrence was observed in WT, neu-tolerant, and SCID mice, indicating a role of adaptive immunity in controlling residual tumor foci. Importantly, local recurrences were eliminated or greatly reduced in WT, neu tolerant, and SCID mice when CpG was incorporated in the cryoablation regimen, showing significant local control by innate immunity. For long-term protection, however, adaptive immunity was required because most SCID mice eventually succumbed to local tumor recurrence even with combined cryoablation and CpG treatment. This improved understanding of the mechanisms by which cryoablation affects innate and adaptive immunity will help guide appropriate combination of therapeutic interventions to improve treatment outcomes. ©2014 American Association for Cancer Research.

  8. Failure to Achieve a PSA Level {<=}1 ng/mL After Neoadjuvant LHRHA Therapy Predicts for Lower Biochemical Control Rate and Overall Survival in Localized Prostate Cancer Treated With Radiotherapy

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mitchell, Darren M.; McAleese, Jonathan; Park, Richard M.

    2007-12-01

    Purpose: To investigate whether failure to suppress the prostate-specific antigen (PSA) level to {<=}1 ng/mL after {>=}2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy in patients scheduled to undergo external beam radiotherapy for localized prostate carcinoma is associated with reduced biochemical failure-free survival. Methods and Materials: A retrospective case note review of consecutive patients with intermediate- or high-risk localized prostate cancer treated between January 2001 and December 2002 with neoadjuvant hormonal deprivation therapy, followed by concurrent hormonal therapy and radiotherapy was performed. Patient data were divided for analysis according to whether the PSA level in Week 1 of radiotherapymore » was {<=}1.0 ng/mL. Biochemical failure was determined using the American Society for Therapeutic Radiology and Oncology (Phoenix) definition. Results: A total of 119 patients were identified. The PSA level after neoadjuvant hormonal deprivation therapy was {<=}1 ng/mL in 67 patients and >1 ng/mL in 52. At a median follow-up of 49 months, the 4-year actuarial biochemical failure-free survival rate was 84% vs. 60% (p = 0.0016) in favor of the patients with a PSA level after neoadjuvant hormonal deprivation therapy of {<=}1 ng/mL. The overall survival rate was 94% vs. 77.5% (p = 0.0045), and the disease-specific survival rate at 4 years was 98.5% vs. 82.5%. Conclusions: The results of our study have shown that patients with a PSA level >1 ng/mL at the beginning of external beam radiotherapy after {>=}2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy have a significantly greater rate of biochemical failure and lower survival rate compared with those with a PSA level of {<=}1 ng/mL. Patients without adequate PSA suppression should be considered a higher risk group and considered for dose escalation or the use of novel treatments.« less

  9. Global aspirations, local realities: the role of social science research in controlling neglected tropical diseases.

    PubMed

    Bardosh, Kevin

    2014-01-01

    Neglected Tropical Diseases (NTDs) are both drivers and manifestations of poverty and social inequality. Increased advocacy efforts since the mid-2000s have led to ambitious new control and elimination targets set for 2020 by the World Health Organisation. While these global aspirations represent significant policy momentum, there are multifaceted challenges in controlling infectious diseases in resource-poor local contexts that need to be acknowledged, understood and engaged. However a number of recent publications have emphasised the "neglected" status of applied social science research on NTDs. In light of the 2020 targets, this paper explores the social science/NTD literature and unpacks some of the ways in which social inquiry can help support effective and sustainable interventions. Five priority areas are discussed, including on policy processes, health systems capacity, compliance and resistance to interventions, education and behaviour change, and community participation. The paper shows that despite the multifaceted value of having anthropological and sociological perspectives integrated into NTD programmes, contemporary efforts underutilise this potential. This is reflective of the dominance of top-down information flows and technocratic approaches in global health. To counter this tendency, social research needs to be more than an afterthought; integrating social inquiry into the planning, monitoring and evaluating process will help ensure that flexibility and adaptability to local realities are built into interventions. More emphasis on social science perspectives can also help link NTD control to broader social determinants of health, especially important given the major social and economic inequalities that continue to underpin transmission in endemic countries.

  10. Robotics and local fusion

    NASA Astrophysics Data System (ADS)

    Emmerman, Philip J.

    2005-05-01

    Teams of robots or mixed teams of warfighters and robots on reconnaissance and other missions can benefit greatly from a local fusion station. A local fusion station is defined here as a small mobile processor with interfaces to enable the ingestion of multiple heterogeneous sensor data and information streams, including blue force tracking data. These data streams are fused and integrated with contextual information (terrain features, weather, maps, dynamic background features, etc.), and displayed or processed to provide real time situational awareness to the robot controller or to the robots themselves. These blue and red force fusion applications remove redundancies, lessen ambiguities, correlate, aggregate, and integrate sensor information with context such as high resolution terrain. Applications such as safety, team behavior, asset control, training, pattern analysis, etc. can be generated or enhanced by these fusion stations. This local fusion station should also enable the interaction between these local units and a global information world.

  11. 20 CFR 901.70 - Records.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... Joint Board for the Enrollment of Actuaries a roster of all persons enrolled to perform actuarial... applicable disclosure and privacy statutes. (b) Disciplinary procedures. A request by an enrolled actuary...

  12. On the effect of local barrier height in scanning tunneling microscopy: Measurement methods and control implications

    NASA Astrophysics Data System (ADS)

    Tajaddodianfar, Farid; Moheimani, S. O. Reza; Owen, James; Randall, John N.

    2018-01-01

    A common cause of tip-sample crashes in a Scanning Tunneling Microscope (STM) operating in constant current mode is the poor performance of its feedback control system. We show that there is a direct link between the Local Barrier Height (LBH) and robustness of the feedback control loop. A method known as the "gap modulation method" was proposed in the early STM studies for estimating the LBH. We show that the obtained measurements are affected by controller parameters and propose an alternative method which we prove to produce LBH measurements independent of the controller dynamics. We use the obtained LBH estimation to continuously update the gains of a STM proportional-integral (PI) controller and show that while tuning the PI gains, the closed-loop system tolerates larger variations of LBH without experiencing instability. We report experimental results, conducted on two STM scanners, to establish the efficiency of the proposed PI tuning approach. Improved feedback stability is believed to help in avoiding the tip/sample crash in STMs.

  13. Control of electron excitation and localization in the dissociation of H2(+) and its isotopes using two sequential ultrashort laser pulses.

    PubMed

    He, Feng; Ruiz, Camilo; Becker, Andreas

    2007-08-24

    We study the control of dissociation of the hydrogen molecular ion and its isotopes exposed to two ultrashort laser pulses by solving the time-dependent Schrödinger equation. While the first ultraviolet pulse is used to excite the electron wave packet on the dissociative 2psigma{u} state, a second time-delayed near-infrared pulse steers the electron between the nuclei. Our results show that by adjusting the time delay between the pulses and the carrier-envelope phase of the near-infrared pulse, a high degree of control over the electron localization on one of the dissociating nuclei can be achieved (in about 85% of all fragmentation events). The results demonstrate that current (sub-)femtosecond technology can provide a control over both electron excitation and localization in the fragmentation of molecules.

  14. 20 CFR 901.0 - Scope.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... perform actuarial services; subpart B of this part sets forth rules governing the enrollment of actuaries; subpart C of this part sets forth standards of performance to which enrolled actuaries must adhere...

  15. 20 CFR 901.0 - Scope.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... perform actuarial services; subpart B of this part sets forth rules governing the enrollment of actuaries; subpart C of this part sets forth standards of performance to which enrolled actuaries must adhere...

  16. 20 CFR 901.0 - Scope.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... perform actuarial services; subpart B of this part sets forth rules governing the enrollment of actuaries; subpart C of this part sets forth standards of performance to which enrolled actuaries must adhere...

  17. 20 CFR 901.0 - Scope.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... perform actuarial services; subpart B of this part sets forth rules governing the enrollment of actuaries; subpart C of this part sets forth standards of performance to which enrolled actuaries must adhere...

  18. 20 CFR 901.0 - Scope.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL... perform actuarial services; subpart B of this part sets forth rules governing the enrollment of actuaries; subpart C of this part sets forth standards of performance to which enrolled actuaries must adhere...

  19. Improving electrical power systems reliability through locally controlled distributed curtailable load

    NASA Astrophysics Data System (ADS)

    Dehbozorgi, Mohammad Reza

    2000-10-01

    Improvements in power system reliability have always been of interest to both power companies and customers. Since there are no sizable electrical energy storage elements in electrical power systems, the generated power should match the load demand at any given time. Failure to meet this balance may cause severe system problems, including loss of generation and system blackouts. This thesis proposes a methodology which can respond to either loss of generation or loss of load. It is based on switching of electric water heaters using power system frequency as the controlling signal. The proposed methodology encounters, and the thesis has addressed, the following associated problems. The controller must be interfaced with the existing thermostat control. When necessary to switch on loads, the water in the tank should not be overheated. Rapid switching of blocks of load, or chattering, has been considered. The contributions of the thesis are: (A) A system has been proposed which makes a significant portion of the distributed loads connected to a power system to behave in a predetermined manner to improve the power system response during disturbances. (B) The action of the proposed system is transparent to the customers. (C) The thesis proposes a simple analysis for determining the amount of such loads which might be switched and relates this amount to the size of the disturbances which can occur in the utility. (D) The proposed system acts without any formal communication links, solely using the embedded information present system-wide. (E) The methodology of the thesis proposes switching of water heater loads based on a simple, localized frequency set-point controller. The thesis has identified the consequent problem of rapid switching of distributed loads, which is referred to as chattering. (F) Two approaches have been proposed to reduce chattering to tolerable levels. (G) A frequency controller has been designed and built according to the specifications required to

  20. Intensity Modulated Radiation Therapy With Dose Painting to Treat Rhabdomyosarcoma

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yang, Joanna C.; Dharmarajan, Kavita V.; Wexler, Leonard H.

    Purpose: To examine local control and patterns of failure in rhabdomyosarcoma patients treated with intensity modulated radiation therapy (RT) with dose painting (DP-IMRT). Patients and Methods: A total of 41 patients underwent DP-IMRT with chemotherapy for definitive treatment. Nineteen also underwent surgery with or without intraoperative RT. Fifty-six percent had alveolar histologic features. The median interval from beginning chemotherapy to RT was 17 weeks (range, 4-25). Very young children who underwent second-look procedures with or without intraoperative RT received reduced doses of 24-36 Gy in 1.4-1.8-Gy fractions. Young adults received 50.4 Gy to the primary tumor and lower doses ofmore » 36 Gy in 1.8-Gy fractions to at-risk lymph node chains. Results: With 22 months of median follow-up, the actuarial local control rate was 90%. Patients aged {<=}7 years who received reduced overall and fractional doses had 100% local control, and young adults had 79% (P=.07) local control. Three local failures were identified in young adults whose primary target volumes had received 50.4 Gy in 1.8-Gy fractions. Conclusions: DP-IMRT with lower fractional and cumulative doses is feasible for very young children after second-look procedures with or without intraoperative RT. DP-IMRT is also feasible in adolescents and young adults with aggressive disease who would benefit from prophylactic RT to high-risk lymph node chains, although dose escalation might be warranted for improved local control. With limited follow-up, it appears that DP-IMRT produces local control rates comparable to those of sequential IMRT in patients with rhabdomyosarcoma.« less

  1. The design of the local monitor and control system of SKA dishes

    NASA Astrophysics Data System (ADS)

    Schillirò, F.; Baldini, V.; Becciani, U.; Cirami, R.; Costa, A.; Ingallinera, A.; Marassi, A.; Nicotra, G.; Nocita, C.; Riggi, S.; Trigilio, C.

    2016-08-01

    The Square Kilometer Array (SKA) project aims at building the world's largest radio observatory to observe the sky with unprecedented sensitivity and collecting area. In the first phase of the project (SKA1), an array of dishes, SKA1-MID, will be built in South Africa. It will consist of 133 15m-dishes, which will include the MeerKAT array, for the 0.350-20 GHz frequency band observations. Each antenna will be provided with a local monitor and control system (LMC), enabling operations both to the Telescope Manager remote system, and to the engineers and maintenance staff; it provides different environment for the telescope control (positioning, pointing, observational bands), metadata collection for monitoring and database storaging, operational modes and functional states management for all the telescope capabilities. In this paper we present the LMC software architecture designed for the detailed design phase (DD), where we describe functional and physical interfaces with monitored and controlled sub-elements, and highlight the data flow between each LMC modules and its sub-element controllers from one side, and Telescope Manager on the other side. We also describe the complete Product Breakdown Structure (PBS) created in order to optimize resources allocation in terms of calculus and memory, able to perform required task for each element according to the proper requirements. Among them, time response and system reliability are the most important, considering the complexity of SKA dish network and its isolated placement. Performances obtained by software implementation using TANGO framework will be discussed, matching them with technical requirements derived by SKA science drivers.

  2. Local corticosteroid injection in iliotibial band friction syndrome in runners: a randomised controlled trial

    PubMed Central

    Gunter, P; Schwellnus, M; Fuller, P

    2004-01-01

    Objective: To establish whether a local injection of methylprednisolone acetate (40 mg) is effective in decreasing pain during running in runners with recent onset (less than two weeks) iliotibial band friction syndrome (ITBFS). Methods: Eighteen runners with at least grade 2 ITBFS underwent baseline investigations including a treadmill running test during which pain was recorded on a visual analogue scale every minute. The runners were then randomly assigned to either the experimental (EXP; nine) or a placebo control (CON; nine) group. The EXP group was infiltrated in the area where the iliotibial band crosses the lateral femoral condyle with 40 mg methylprednisolone acetate mixed with a short acting local anaesthetic, and the CON group with short acting local anaesthetic only. The same laboratory based running test was repeated after seven and 14 days. The main measure of outcome was total pain during running (calculated as the area under the pain versus time graph for each running test). Results: There was a tendency (p = 0.07) for a greater decrease in total pain (mean (SEM)) during the treadmill running in the EXP group than the CON group tests from day 0 (EXP = 222 (71), CON = 197 (31)) to day 7 (EXP = 140 (87), CON = 178 (76)), but there was a significant decrease in total pain during running (p = 0.01) from day 7 (EXP = 140 (87), CON = 178 (76)) to day 14 (EXP = 103 (89), CON = 157 (109)) in the EXP group compared with the CON group. Conclusion: Local corticosteroid infiltration effectively decreases pain during running in the first two weeks of treatment in patients with recent onset ITBFS. PMID:15155424

  3. New horizons in local anesthesia.

    PubMed

    Lackey, A D

    1998-08-01

    The computer-controlled local anesthesia system and the TEA system present 21st-century alternatives to the traditional syringe. The TEA system is a non-invasive form of anesthesia that blocks pain electronically, using the same cellular mechanism as local chemical anesthesia. Targeted electronic anesthesia provides pain control for restorative dental procedures without the use of needles or postoperative discomfort, numbness, and swelling. The computer-assisted system outperforms syringes for traditional injections. This new system generates a precisely controlled anesthetic flow rate that eliminates the need for the operator to use thumb pressure to administer the injection. The lightweight pen-grasp handle results in greater tactile feedback, precision, operator ease, and patient comfort. The greatest advantage may be in the new techniques that it makes available. With these techniques, a dentist can target the teeth to achieve profound pulpal anesthesia, often without the annoying side effects of facial numbness. With this new advanced system in the maxillary arch, the AMSA injection offers clinical advantages over traditional anesthesia techniques, according to Dr. Mark Friedman, whom I consulted with earlier this year. In the mandibular arch, a safe and predictable PDL injection technique may replace the need for an inferior alveolar block in numerous clinical situations. The use of these modified injection techniques can have a positive influence on patient safety, patient comfort, and office productivity. Both of these systems take the fear and anxiety out of dental injections. They offer exciting advanced technology for local pain control. Significantly, if patient stress and anxiety are reduced, the operator immediately benefits. New horizons in local anesthesia offer improved opportunities for patient comfort using computer-controlled local anesthetic systems and TEA.

  4. Local Control Model of Excitation–Contraction Coupling in Skeletal Muscle

    PubMed Central

    Stern, Michael D.; Pizarro, Gonzalo; Ríos, Eduardo

    1997-01-01

    This is a quantitative model of control of Ca2+ release from the sarcoplasmic reticulum in skeletal muscle, based on dual control of release channels (ryanodine receptors), primarily by voltage, secondarily by Ca2+ (Ríos, E., and G. Pizarro. 1988. NIPS. 3:223–227). Channels are positioned in a double row array of between 10 and 60 channels, where exactly half face voltage sensors (dihydropyridine receptors) in the transverse (t) tubule membrane (Block, B.A., T. Imagawa, K.P. Campbell, and C. Franzini-Armstrong. 1988. J. Cell Biol. 107:2587–2600). We calculate the flux of Ca2+ release upon different patterns of pulsed t-tubule depolarization by explicit stochastic simulation of the states of all channels in the array. Channels are initially opened by voltage sensors, according to an allosteric prescription (Ríos, E., M. Karhanek, J. Ma, A. González. 1993. J. Gen. Physiol. 102:449–482). Ca2+ permeating the open channels, diffusing in the junctional gap space, and interacting with fixed and mobile buffers produces defined and changing distributions of Ca2+ concentration. These concentrations interact with activating and inactivating channel sites to determine the propagation of activation and inactivation within the array. The model satisfactorily simulates several whole-cell observations, including kinetics and voltage dependence of release flux, the “paradox of control,” whereby Ca2+-activated release remains under voltage control, and, most surprisingly, the “quantal” aspects of activation and inactivation (Pizarro, G., N. Shirokova, A. Tsugorka, and E. Ríos. 1997. J. Physiol. 501:289–303). Additionally, the model produces discrete events of activation that resemble Ca2+ sparks (Cheng, H., M.B. Cannell, and W.J. Lederer. 1993. Science (Wash. DC). 262:740–744). All these properties result from the intersection of stochastic channel properties, control by local Ca2+, and, most importantly, the one dimensional geometry of the array and its

  5. Local control of metastatic lung tumors treated with SBRT of 48 Gy in four fractions: in comparison with primary lung cancer.

    PubMed

    Hamamoto, Yasushi; Kataoka, Masaaki; Yamashita, Motohiro; Shinkai, Tetsu; Kubo, Yoshiro; Sugawara, Yoshifumi; Inoue, Takeshi; Sakai, Shinya; Aono, Shoji; Takahashi, Tadaaki; Semba, Takatoshi; Uwatsu, Kotaro

    2010-02-01

    The optimal dose of stereotactic body radiotherapy (SBRT) for metastatic lung tumors has not been clarified. Local control rates of metastatic lung tumors treated with SBRT of 48 Gy in four fractions, which is one of the common dose schedules for Stage I primary lung cancer in Japan, were examined. Between 2006 and 2008, 12 metastatic lung tumors (colorectal cancer, 7; others, 5) in 10 patients and 56 lesions of Stage I primary lung cancer (T1, 43; T2, 13) in 52 patients were treated with SBRT of 48 Gy in four fractions at the isocenter. Two-year overall survival rates were 86% for patients with metastatic lung tumors and 96% for patients with Stage I primary lung cancer (P = 0.4773). One- and 2-year local control rates were 48% and 25% for metastatic lung tumors, and 91% and 88% for Stage I primary lung cancer, respectively (P < 0.0001). The local control rates after SBRT of 48 Gy in four fractions were significantly worse in metastatic lung tumors compared with Stage I primary lung cancer. In SBRT, metastatic lung tumors should be clearly differentiated from primary lung cancer and should be given higher doses.

  6. Localized Control of Curie Temperature in Perovskite Oxide Film by Capping-Layer-Induced Octahedral Distortion

    DOE PAGES

    Thomas, S.; Kuiper, B.; Hu, J.; ...

    2017-10-27

    With reduced dimensionality, it is often easier to modify the properties of ultrathin films than their bulk counterparts. Strain engineering, usually achieved by choosing appropriate substrates, has been proven effective in controlling the properties of perovskite oxide films. An emerging alternative route for developing new multifunctional perovskite is by modification of the oxygen octahedral structure. Here we report the control of structural oxygen octahedral rotation in ultrathin perovskite SrRuO 3 films by the deposition of a SrTiO 3 capping layer, which can be lithographically patterned to achieve local control. Here, using a scanning Sagnac magnetic microscope, we show an increasemore » in the Curie temperature of SrRuO 3 due to the suppression octahedral rotations revealed by the synchrotron x-ray diffraction. Lastly, this capping-layer-based technique may open new possibilities for developing functional oxide materials.« less

  7. Composite polymer systems with control of local substrate elasticity and their effect on cytoskeletal and morphological characteristics of adherent cells.

    PubMed

    Chou, Szu-Yuan; Cheng, Chao-Min; LeDuc, Philip R

    2009-06-01

    At the interface between extracellular substrates and biological materials, substrate elasticity strongly influences cell morphology and function. The associated biological ramifications comprise a diversity of critical responses including apoptosis, differentiation, and motility, which can affect medical devices such as stents. The interactions of the extracellular environment with the substrate are also affected by local properties wherein cells sense and respond to different physical inputs. To investigate the effects of having localized elasticity control of substrate microenvironments on cell response, we have developed a method to control material interface interactions with cells by dictating local substrate elasticity. This system is created by generating a composite material system with alternating, linear regions of polymers that have distinct stiffness characteristics. This approach was used to examine cytoskeletal and morphological changes in NIH 3T3 fibroblasts with emphasis on both local and global properties, noting that cells sense and respond to distinct material elasticities. Isolated cells sense and respond to these local differences in substrate elasticity by extending processes along the interface. Also, cells grown on softer elastic regions at higher densities (in contact with each other) have a higher projected area than isolated cells. Furthermore, when using chemical agents such as cytochalasin-D to disrupt the actin cytoskeleton, there is a significant increase in projected area for cells cultured on softer elastic regions This method has the potential to promote understanding of biomaterial-affected responses in a diversity of areas including morphogenesis, mechanotransduction, stents, and stem cell differentiation.

  8. The Effect of Local Anesthetic Infiltration Around Nephrostomy Tract on Postoperative Pain Control after Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis.

    PubMed

    Wang, Jiawu; Zhang, Chengyao; Tan, Dan; Tan, Guangzhong; Yang, Bo; Chen, Wenkai; Tang, Guoqiang

    2016-01-01

    To assess the safety and efficacy of local anesthetic infiltration around nephrostomy tract on postoperative pain control after percutaneous nephrolithotomy. This systematic review was performed based on randomized clinic trials about local anesthetic infiltration around nephrostomy tract on postoperative pain control. The weighted mean difference (WMD), with their corresponding 95% CI, was calculated to compare continuous variables. Our results showed that the consumption of analgesic was less in the experimental group than in the control group (WMD -25.32, 95% CI -48.09 to -2.55, p = 0.003). There was no significant difference between the mean Visual Analog Scale (VAS) in the experimental group than the control group after 6 h while significantly lower after 24 h. The time of first analgesic demand was significantly longer in the experimental group (WMD 2.19, 95% CI 0.98-3.41). There was no significant difference between 2 groups in terms of operation time, hemoglobin (Hb) alteration, and hospital stay. Local anesthetic infiltration around nephrostomy tract had similar efficacy in the control group in terms of operation time, Hb alteration, and hospital stay, but offers some potential advantages in terms of analgesia requirement, the time of first analgesic demand, and VAS-24 h. However, good quality and large studies with long-term follow-up are warranted for further research. © 2016 S. Karger AG, Basel.

  9. Identifying localized and scale-specific multivariate controls of soil organic matter variations using multiple wavelet coherence.

    PubMed

    Zhao, Ruiying; Biswas, Asim; Zhou, Yin; Zhou, Yue; Shi, Zhou; Li, Hongyi

    2018-06-23

    Environmental factors have shown localized and scale-dependent controls over soil organic matter (SOM) distribution in the landscape. Previous studies have explored the relationships between SOM and individual controlling factors; however, few studies have indicated the combined control from multiple environmental factors. In this study, we compared the localized and scale-dependent univariate and multivariate controls of SOM along two long transects (northeast, NE transect and north, N transect) from China. Bivariate wavelet coherence (BWC) between SOM and individual factors and multiple wavelet coherence (MWC) between SOM and factor combinations were calculated. Average wavelet coherence (AWC) and percent area of significant coherence (PASC) were used to assess the relative dominance of individual and a combination of factors to explain SOM variations at different scales and locations. The results showed that (in BWC analysis) mean annual temperature (MAT) with the largest AWC (0.39) and PASC (16.23%) was the dominant factor in explaining SOM variations along the NE transect. The topographic wetness index (TWI) was the dominant factor (AWC = 0.39 and PASC = 20.80%) along the N transect. MWC identified the combination of Slope, net primary production (NPP) and mean annual precipitation (MAP) as the most important combination in explaining SOM variations along the NE transect with a significant increase in AWC and PASC at different scales and locations (e.g. AWC = 0.91 and PASC = 58.03% at all scales). The combination of TWI, NPP and normalized difference vegetation index (NDVI) was the most influential along the N transect (AWC = 0.83 and PASC = 32.68% at all scales). The results indicated that the combined controls of environmental factors on SOM variations at different scales and locations in a large area can be identified by MWC. This is promising for a better understanding of the multivariate controls in SOM variations at larger spatial

  10. 75 FR 35093 - Civil Service Retirement System; Present Value Factors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ... present value factors to changes in demographic factors adopted by the Board of Actuaries of the Civil... actuarial assumptions and data to the Board of Actuaries, care of Gregory Kissel, Actuary, Office of... 1986, Public Law 99- 335, based on changed demographic factors adopted by the Board of Actuaries of the...

  11. Dissipative stability analysis and control of two-dimensional Fornasini-Marchesini local state-space model

    NASA Astrophysics Data System (ADS)

    Wang, Lanning; Chen, Weimin; Li, Lizhen

    2017-06-01

    This paper is concerned with the problems of dissipative stability analysis and control of the two-dimensional (2-D) Fornasini-Marchesini local state-space (FM LSS) model. Based on the characteristics of the system model, a novel definition of 2-D FM LSS (Q, S, R)-α-dissipativity is given first, and then a sufficient condition in terms of linear matrix inequality (LMI) is proposed to guarantee the asymptotical stability and 2-D (Q, S, R)-α-dissipativity of the systems. As its special cases, 2-D passivity performance and 2-D H∞ performance are also discussed. Furthermore, by use of this dissipative stability condition and projection lemma technique, 2-D (Q, S, R)-α-dissipative state-feedback control problem is solved as well. Finally, a numerical example is given to illustrate the effectiveness of the proposed method.

  12. Industry Speed Bumps on Local Tobacco Control in Japan? The Case of Hyogo.

    PubMed

    Yamada, Keiko; Mori, Nagisa; Kashiwabara, Mina; Yasuda, Sakiko; Horie, Rumi; Yamato, Hiroshi; Garçon, Loic; Armada, Francisco

    2015-01-01

    Despite being a signatory since 2004, Japan has not yet fully implemented Article 8 of the World Health Organization's Framework Convention on Tobacco Control regarding 100% protection against exposure to second-hand smoke (SHS). The Japanese government still recognizes designated smoking rooms (DSRs) in public space as a valid control measure. Furthermore, subnational initiatives for tobacco control in Japan are of limited effectiveness. Through an analysis of the Hyogo initiative in 2012, we identified key barriers to the achievement of a smoke-free environment. Using a descriptive case-study approach, we analyzed the smoke-free policy development process. The information was obtained from meeting minutes and other gray literature, such as public records, well as key informant interviews. Hyogo Prefecture established a committee to propose measures against SHS, and most committee members agreed with establishing completely smoke-free environments. However, the hospitality sector representatives opposed regulation, and tobacco companies were allowed to make a presentation to the committee. Further, political power shifted against completely smoke-free environments in the context of upcoming local elections, which was an obvious barrier to effective regulation. Throughout the approving process, advocacy by civil society for stronger regulation was weak. Eventually, the ordinance approved by the Prefectural Assembly was even weaker than the committee proposal and included wide exemptions. The analysis of Hyogo's SHS control initiative shed light on three factors that present challenges to implementing tobacco control regulations in Japan, from which other countries can also draw lessons: incomplete national legislation, the weakness of advocacy by the civil society, and the interference of the tobacco industry.

  13. Local variability in long-term care services: local autonomy, exogenous influences and policy spillovers.

    PubMed

    Fernandez, José-Luis; Forder, Julien

    2015-03-01

    In many countries, public responsibility over the funding and provision of long-term care services is held at the local level. In such systems, long-term care provision is often characterised by significant local variability. Using a panel dataset of local authorities over the period 2002-2012, the paper investigates the underlying causes of variation in gross social care expenditure for older people in England. The analysis distinguishes between factors outside the direct control of policy makers, local preferences and local policy spillovers. The results indicate that local demand and supply factors, and to a much lesser extent local political preferences and spatial policy spillovers, explain a large majority of the observed variation in expenditure. Copyright © 2015 John Wiley & Sons, Ltd.

  14. Topography printing to locally control wettability.

    PubMed

    Zheng, Zijian; Azzaroni, Omar; Zhou, Feng; Huck, Wilhelm T S

    2006-06-21

    This paper reports a new patterning method, which utilizes NaOH to facilitate the irreversible binding between the PDMS stamp and substrates and subsequent cohesive mechanical failure to transfer the PDMS patterns. Our method shows high substrate tolerance and can be used to "print" various PDMS geometries on a wide range of surfaces, including Si100, glass, gold, polymers, and patterned SU8 photoresist. Using this technique, we are able to locally change the wettability of substrate surfaces by printing well-defined PDMS architectures on the patterned SU8 photoresist. It is possible to generate differential wetting and dewetting properties in microchannels and in the PDMS printed area, respectively.

  15. SIMULATING LOCAL DENSE AREAS USING PMMA TO ASSESS AUTOMATIC EXPOSURE CONTROL IN DIGITAL MAMMOGRAPHY.

    PubMed

    Bouwman, R W; Binst, J; Dance, D R; Young, K C; Broeders, M J M; den Heeten, G J; Veldkamp, W J H; Bosmans, H; van Engen, R E

    2016-06-01

    Current digital mammography (DM) X-ray systems are equipped with advanced automatic exposure control (AEC) systems, which determine the exposure factors depending on breast composition. In the supplement of the European guidelines for quality assurance in breast cancer screening and diagnosis, a phantom-based test is included to evaluate the AEC response to local dense areas in terms of signal-to-noise ratio (SNR). This study evaluates the proposed test in terms of SNR and dose for four DM systems. The glandular fraction represented by the local dense area was assessed by analytic calculations. It was found that the proposed test simulates adipose to fully glandular breast compositions in attenuation. The doses associated with the phantoms were found to match well with the patient dose distribution. In conclusion, after some small adaptations, the test is valuable for the assessment of the AEC performance in terms of both SNR and dose. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. High Accuracy Passive Magnetic Field-Based Localization for Feedback Control Using Principal Component Analysis.

    PubMed

    Foong, Shaohui; Sun, Zhenglong

    2016-08-12

    In this paper, a novel magnetic field-based sensing system employing statistically optimized concurrent multiple sensor outputs for precise field-position association and localization is presented. This method capitalizes on the independence between simultaneous spatial field measurements at multiple locations to induce unique correspondences between field and position. This single-source-multi-sensor configuration is able to achieve accurate and precise localization and tracking of translational motion without contact over large travel distances for feedback control. Principal component analysis (PCA) is used as a pseudo-linear filter to optimally reduce the dimensions of the multi-sensor output space for computationally efficient field-position mapping with artificial neural networks (ANNs). Numerical simulations are employed to investigate the effects of geometric parameters and Gaussian noise corruption on PCA assisted ANN mapping performance. Using a 9-sensor network, the sensing accuracy and closed-loop tracking performance of the proposed optimal field-based sensing system is experimentally evaluated on a linear actuator with a significantly more expensive optical encoder as a comparison.

  17. The comparative effectiveness of mail order pharmacy use vs. local pharmacy use on LDL-C control in new statin users.

    PubMed

    Schmittdiel, Julie A; Karter, Andrew J; Dyer, Wendy; Parker, Melissa; Uratsu, Connie; Chan, James; Duru, O Kenrik

    2011-12-01

    Mail order pharmacies are commonly used to deliver CVD risk factor medications. Previous studies have shown that mail order pharmacy use is associated with greater medication adherence; however, no studies have examined whether mail order pharmacy use is related to improved CVD risk factor outcomes. To examine the comparative effectiveness of mail order pharmacy vs. local pharmacy use on LDL-C control in new statin users. Observational cohort study. 100,298 adult Kaiser Permanente Northern California (KPNC) members who were new users of statins between January 1, 2005 and December 31, 2007. The main outcome measure was LDL-C control in the 3-15 month period after statin therapy was initiated. After adjustment for patient, clinical, and census-block characteristics, and for potential unmeasured differences between mail order and local KPNC pharmacy users with instrumental variables analysis, 85.0% of patients who used the mail order pharmacy to deliver their statin at any time achieved target LDL-C levels compared with 74.2% of patients who only used the local KPNC pharmacy to dispense the statin (p < 0.001). Greater adjusted rates of LDL-C control in mail order pharmacy users were seen across all gender and race/ethnicity subgroups. Mail order pharmacy use was positively associated with LDL-C control in new statin users. Future research should continue to explore the relationship between mail order pharmacy use and outcomes, and address how to appropriately target mail order services to patients most likely to benefit without compromising patient choice, care, and safety.

  18. Exact controllability for a Thermodiffusion System with locally distributed controls

    NASA Astrophysics Data System (ADS)

    de Moraes, F. G.; Schulz, R. A.; Soriano, J. A.

    2018-03-01

    In this work we establish a exact controllability result for a thermodiffusion system, modeled by Cattaneo's law, posed in a one-dimensional domain. In the present model the control mechanisms are effective in a small subinterval of the domain. To obtain the desired results, we prove an observability inequality for the adjoint system which, together with the multiplier methods and the Hilbert Uniqueness Method (HUM) developed by J.L. Lions, gives the controllability.

  19. Enhancement of ultracold molecule formation by local control in the nanosecond regime

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Carini, J. L.; Kallush, S.; Kosloff, R.

    2015-02-01

    We describe quantum simulations of ultracold 87Rb 2 molecule formation using photoassociation (PA) with nanosecond-time-scale pulses of frequency chirped light. In particular, we compare the case of a linear chirp to one where the frequency evolution is optimized by local control (LC) of the phase, and find that LC can provide a significant enhancement. The resulting optimal frequency evolution corresponds to a rapid jump from the PA absorption resonance to a downward transition to a bound level of the lowest triplet state. We also consider the case of two frequencies and investigate interference effects. The assumed chirp parameters should bemore » achievable with nanosecond pulse shaping techniques and are predicted to provide a significant enhancement over recent experiments with linear chirps.« less

  20. Spinal and Paraspinal Ewing Tumors

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Indelicato, Daniel J., E-mail: dindelicato@floridaproton.or; University of Florida Proton Therapy Institute, Jacksonville, FL; Keole, Sameer R.

    Purpose: To perform a review of the 40-year University of Florida experience treating spinal and paraspinal Ewing tumors. Patients and Methods: A total of 27 patients were treated between 1965 and 2007. For local management, 21 patients were treated with radiotherapy (RT) alone and 6 with surgery plus RT. All patients with metastatic disease were treated with RT alone. The risk profiles of each group were otherwise similar. The median age was 17 years, and the most frequent subsite was the sacral spine (n = 9). The median potential follow-up was 16 years. Results: The 5-year actuarial overall survival, cause-specificmore » survival, and local control rate was 62%, 62%, and 90%, respectively. For the nonmetastatic subset (n = 22), the 5-year overall survival, cause-specific survival, and local control rate was 71%, 71%, and 89%, respectively. The local control rate was 84% for patients treated with RT alone vs. 100% for those treated with surgery plus RT. Patients who were >14 years old and those who were treated with intensive therapy demonstrated superior local control. Of 9 patients in our series with Frankel C or greater neurologic deficits at presentation, 7 experienced a full recovery with treatment. Of the 27 patients, 37% experienced Common Toxicity Criteria Grade 3 or greater toxicity, including 2 deaths from sepsis. Conclusion: Aggressive management of spinal and paraspinal Ewing tumors with RT with or without surgery results in high toxicity but excellent local control and neurologic outcomes. Efforts should be focused on identifying disease amenable to combined modality local therapy and improving RT techniques.« less