Sample records for catheterization indications techniques

  1. Catheterization.

    ERIC Educational Resources Information Center

    Lewis, Mary Bell; Moseley, James L.

    This module is designed to teach the fundamentals of clean intermittent urinary catheterization for the disabled child, particularly in the school setting. The text includes information on proper hand washing techniques, the supplies needed, suggested settings, and the preparations required before and after the catheter is inserted into the…

  2. Percutaneous Treatment of a Primary Pancreatic Hydatid Cyst Using a Catheterization Technique

    PubMed Central

    Karaman, Bulent; Ustunsoz, Bahri; Ugurel, Mehmet Sahin

    2012-01-01

    Primary pancreatic hydatid cysts are rare and its percutaneous treatment and catheterization technique has, to the best of our knowledge, not been published in literature. A 33-year-old male patient who presented with abdominal pain was evaluated by ultrasonography (US) and computed tomography examinations. Both examinations revealed a cyst in the neck of the pancreas. After the administration of albendazole chemoprophylaxis, the patient underwent diagnostic puncture showing high pressure spring water which harbored the scoleces and was treated percutaneously by the catheterization technique. In this technique, first the cyst was punctured, the fluid content aspirated, the radiocontrast material injected to see possible fistulisation, and then re-aspirated. The 20% hypertonic saline solution was injected and re-aspiration was performed to the best of our abilities, followed by the insertion of a catheter for drainage of the remaining non-aspiratable fluid content. At follow-up examination, the cyst was not visible on US after 6 months. There was no evidence of cyst recurrence or dissemination after 18 months at serologic and imaging follow-up. PMID:22438691

  3. Technical note: a technique for ear vein catheterization in group-housed sows.

    PubMed

    Phillips, C E; Li, Y Z; Johnston, L J; Goplen, A E; Shurson, G C

    2012-02-01

    No methods have been published for repeated blood sampling via an ear vein in group-housed sows. Therefore, the objective of this study was to develop a minimally invasive technique for the insertion of an ear vein catheter for repeated blood sampling in group-housed peripartum sows while minimizing any impact on production performance. Thirty-three multiparous pregnant sows were used including 18 catheterized sows and 15 control sows. In a group-farrowing barn, sows (8/room) shared a communal area and farrowed in individual, free-access pens. Treatment sows were anesthetized, and 1 ear was prepared aseptically 2 to 4 d before their expected farrowing date. A sterile needle was inserted into the largest and straightest portion of the vein, and the catheter, which was medical-grade microbore tubing, was inserted through the needle at least 24 cm. The needle was withdrawn, and the catheter was fixed into position and sutured to the ear. A blunt-end probe point cannula was glued onto the distal end of the catheter, and an adaptor injection cap with male Luer lock was placed on the end. The catheter was coiled and placed in a protective purse, which was cemented directly to the skin on the back of the shoulders. The catheter was flushed with heparinized saline to ensure patency. Once sows were able to stand, an elastic bandage was wrapped around the neck and upper body of the sow to hold the protective purse and exposed catheter in position. Blood samples were collected every 24 h, and catheters were flushed with heparinized saline after each collection. Fourteen of the 18 insertions were successful, and 11 of those remained functional for 4 d or more. Differences were not observed in reproductive performance between catheterized and noncatheterized sows. PMID:21926321

  4. Augmentation cystoplasty: Contemporary indications, techniques and complications

    PubMed Central

    Veeratterapillay, Rajan; Thorpe, Andrew C.; Harding, Chris

    2013-01-01

    Augmentation cystoplasty (AC) has traditionally been used in the treatment of the low capacity, poorly compliant or refractory overactive bladder (OAB). The use of intravesical botulinum toxin and sacral neuromodulation in detrusor overactivity has reduced the number of AC performed for this indication. However, AC remains important in the pediatric and renal transplant setting and still remains a viable option for refractory OAB. Advances in surgical technique have seen the development of both laparoscopic and robotic augmentation cystoplasty. A variety of intestinal segments can be used although ileocystoplasty remains the most common performed procedure. Early complications include thromboembolism and mortality, whereas long-term problems include metabolic disturbance, bacteriuria, urinary tract stones, incontinence, perforation, the need for intermittent self-catheterization and carcinoma. This article examines the contemporary indications, published results and possible future directions for augmentation cystoplasty. PMID:24235795

  5. Videourodynamics: indications and technique.

    PubMed

    Marks, Brian K; Goldman, Howard B

    2014-08-01

    Videourodynamics combines fluoroscopic voiding cystourethrography with multichannel urodynamics to better evaluate lower urinary tract symptoms. This article reviews current literature and guidelines outlining the indications for obtaining this specialized study as well as technique. Appropriate and judicious use of fluoro-urodynamics lends to improved diagnostic acumen in a well-selected patient population; however, clinicians must be mindful of the added cost, safety concerns, and limitations of its use. PMID:25063594

  6. Cardiac Catheterization

    MedlinePLUS

    ... done during a cardiac catheterization include: closing small holes inside the heart repairing leaky or narrow heart ... bandage. It's normal for the site to be black and blue, red, or slightly swollen for a ...

  7. Viscosupplementation: techniques, indications, results.

    PubMed

    Legré-Boyer, V

    2015-02-01

    Viscosupplementation by hyaluronic acid (HA) injections is frequently used for local treatment of osteoarthritis (OA), due to ease of use and good tolerance. A profusion of linear or reticulated HA derivates are marketed, with varied characters and levels of evidence. Viscosupplementation has demonstrated moderate but significant efficacy (20%) versus placebo in terms of pain and function, with a high rate of responders (60-70%) in knee osteoarthritis. It allows reduced administration of opioid analgesics and NSAIDs, with improved risk/benefit ratio, and may delay joint replacement. Cartilage protection remains to be proven. Clinical efficacy shows 1-4 weeks' later onset than corticosteroids, but is maintained for 6 or even 12 months. Systematic association of corticosteroid and HA injection is not justified, and an interval has to be left before undertaking arthroplasty. Intra-articular injection of HA requires a skilled specialist, and may be difficult in a non-swollen joint; some tips and tricks may be helpful. In other joints than the knee, radiologic or ultrasound guidance is recommended. The efficacy of viscosupplementation is a matter of ongoing debate, after discordant findings in some meta-analyses. Some poor results may be due to inappropriate use of HA injections, poorly adapted to the patient's OA phenotype. Viscosupplementation is a treatment for chronic moderate symptomatic OA, and not for flares with joint swelling. Application in sport-related chondropathy has yet to be properly assessed. The optimal response profile remains to be determined. The ideal indication in the knee seems to be moderate femorotibial OA without swelling. Results have been generally disappointing in hip osteoarthritis but promising in OA of the ankle and shoulder (with and without rotator cuff tear). Further studies are needed to determine response profile and optimal treatment schedule, according to the joint. PMID:25596987

  8. Glidewire-assisted Foley catheter placement: a simple and safe technique for difficult male catheterization

    PubMed Central

    Chiou, Rei K.; Aggarwal, Himanshu; Chen, Wen

    2009-01-01

    Difficulty in Foley catheter placement is a frequently encountered problem. We describe a simple and safe technique for this condition. Rather than using force, which may lead to the formation of a false passage, one should place a glidewire into the bladder through the area of resistance, followed by the placement of a Foley catheter over the glidewire. This is a very easy procedure and can be taught to nurses and nurse practitioners to avoid an unnecessary call for a urologist in the emergency department. PMID:19543460

  9. Radial Artery Catheterization

    MedlinePLUS

    ... Name Password Sign In Cardiology Patient Page Radial Artery Catheterization Nicholas R. Balaji , MD ; Pinak B. Shah , ... procedures. Previous Section Next Section Advantages of Radial Artery Catheterization Any catheter placement into a blood vessel ...

  10. Curiethérapie endobronchique : technique et indications

    Microsoft Academic Search

    C Hennequin; O Bleichner; J Trédaniel; C Maylin

    2003-01-01

    The endobronchial brachytherapy procedure involves the insertion of an afterloading catheter into bronchus in close proximity to an endoluminal lesion, and to perform limited irradiation sparing as much as possible normal health tissues. The catheter is inserted during a classical flexible bronchoscopy. Three types of indications have been discussed: (i) palliative treatment of lung carcinoma, with or without laser desobstruction:

  11. [Endobronchial brachytherapy: technique and indications].

    PubMed

    Hennequin, C; Bleichner, O; Trédaniel, J; Maylin, C

    2003-02-01

    The endobronchial brachytherapy procedure involves the insertion of an afterloading catheter into bronchus in close proximity to an endoluminal lesion, and to perform limited irradiation sparing as much as possible normal health tissues. The catheter is inserted during a classical flexible bronchoscopy. Three types of indications have been discussed: (i) palliative treatment of lung carcinoma, with or without laser desobstruction: an improvement in respiratory symptoms was observed in 60 to 80% of the cases; (ii) curative treatment for localised endobronchial carcinomas, in previously irradiated patients, or in case of contraindication of surgery or external beam irradiation; local control rate range from 60 to 70% at 2 years; (iii) combination of external irradiation and brachytherapy in the first line treatment of lung cancers. Two randomised trials did not show any improvement in survival for this approach; however, they have included advanced diseases. In the opposite, this association seems very effective for early stage lung carcinomas. Two major complications were regularly reported, haemoptysis and radiation bronchitis. Predictive factors for these toxicities are actually better known: haemoptysis could be due to a progressive disease more often than to brachytherapy itself; technical factors (dose, volume, fractionation), however, could explain a number of radiation bronchitis, and their incidence could decrease in the future. PMID:12648715

  12. Cardiac catheterization and angiography, 3d Ed

    SciTech Connect

    Grossman, W.

    1986-01-01

    This textbook was first published in 1974 and subsequently revised in 1980. The current edition, in seven parts and 33 chapters, has been extensively rewritten, and new chapters have been added that present recently developed techniques. The references have been updated to 1985. The purpose of this work is to provide a concise description of the major techniques employed in cardiac catheterization and angiography. Part 1 deals with the history, general principles, and practice of cardiac catheterization and angiography. In part 2, various techniques of cardiac catheterization are discussed and compared. In part 3, techniques for the determination of cardiac output, pressure, resistance, valve area, and shunt flow are described. Part 4 deals briefly with coronary angiography, cardiac ventriculography, pulmonary angiography, and aortography. In part 5, techniques for evaluating cardiac function and intracardiac electrophysiology are presented. The characteristic hemodynamic and angiographic abnormalities in specific disorders are described in part 6. Part 7 deals with special catheter techniques.

  13. Bladder catheterization, male (image)

    MedlinePLUS

    ... kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.

  14. Left heart catheterization

    MedlinePLUS

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye will be injected into your ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  15. Review of radiation safety in the cardiac catheterization laboratory

    SciTech Connect

    Johnson, L.W.; Moore, R.J.; Balter, S. (St. Joseph's Hospital Health Center, Syracuse, NY (United States))

    1992-03-01

    With the increasing use of coronary arteriography and interventional procedures, radiation exposure to patients and personnel working in cardiac catheterization laboratories has increased. Proper technique to minimize both patient and operator exposure is necessary. A practical approach to radiation safety in the cardiac catheterization laboratory is presented. This discussion should be useful to facilities with well-established radiation safety programs as well as facilities that require restructuring to cope with the radiation environment in a modern cardiac catheterization laboratory.

  16. Multicenter long-term validation of a minicourse in radiation-reducing techniques in the catheterization laboratory.

    PubMed

    Kuon, Eberhard; Weitmann, Kerstin; Hoffmann, Wolfgang; Dörr, Marcus; Hummel, Astrid; Riad, Alexander; Busch, Mathias C; Felix, Stephan B; Empen, Klaus

    2015-02-01

    Patient radiation exposure in invasive cardiology is considerable. We aimed to investigate, in a multicenter field study, the long-term efficacy of an educational 90-minute workshop in cardiac invasive techniques with reduced irradiation. Before and at a median period of 2.5 months and 2.0 years after the minicourse (periods I, II, and III, respectively) at 5 German cardiac centers, 18 interventionalists documented various radiation parameters for 10 coronary angiographies. The median patient dose area product (DAP) for periods I, II, and III amounted to 26.6, 12.2, and 9.6 Gy × cm(2), respectively. The short-term and long-term effects were related to shorter median fluoroscopy times (180, 138, and 114 seconds), fewer radiographic frames (745, 553, and 417) because of fewer (11, 11, and 10) and shorter (64, 52, and 44 frames/run) runs, consistent collimation, and restriction to an adequate image quality; both radiographic DAP/frame (27.7, 17.3, and 18.4 mGy × cm(2)) and fluoroscopic DAP/second (26.6, 12.9, and 14.9 mGy × cm(2)) decreased significantly. Multivariate analysis over time indicated increasing efficacy of the minicourse itself (-55% and -64%) and minor influence of interventionist experience (-4% and -3% per 1,000 coronary angiographies, performed lifelong until the minicourse and until period III). In conclusion, autonomous self-surveillance of various dose parameters and feedback on individual radiation safety efforts supported the efficacy of a 90-minute course program toward long-lasting and ongoing patient dose reduction. PMID:25579886

  17. Routine preoperative cardiac catheterization necessary before repair of secundum and sinus venosus atrial septal defects

    SciTech Connect

    Freed, M.D.; Nadas, A.S.; Norwood, W.I.; Castaneda, A.R.

    1984-08-01

    Between January 1976 and July 1983, 217 patients with atrial septal defect underwent surgical repair at Children's Hospital. Thirty with a primum atrial septal defect and 26 who underwent cardiac catheterization elsewhere before being seen were excluded from analysis. Of the 161 remaining patients, 52 (31%) underwent preoperative cardiac catheterization, 38 because the physical examination was considered atypical for a secundum atrial septal defect and 14 because of a preexisting routine indication. One hundred nine (69%) underwent surgery without catheterization, with the attending cardiologist relying on clinical examination alone in 5, additional technetium radionuclide angiocardiography in 5, M-mode echocardiography in 13 and two-dimensional echocardiography in 43; both M-mode echocardiography and radionuclide angiography were performed in 24 and two-dimensional echocardiography and radionuclide angiography in 19. Since 1976, there has been a trend toward a reduction in the use of catheterization and use of one rather than two noninvasive or semiinvasive techniques for the detection of atrial defects. Of the 52 patients who underwent catheterization, the correct anatomic diagnosis was made before catheterization in 47 (90%). Two patients with a sinus venosus defect and one each with a sinus venosus defect plus partial anomalous pulmonary venous connection, partial anomalous pulmonary venous connection without an atrial septal defect and a sinoseptal defect were missed. Of 109 patients without catheterization, a correct morphologic diagnosis was made before surgery in 92 (84%). Nine patients with a sinus venosus defect, three with sinus venous defect and partial anomolous pulmonary venous connection, four with partial anomalous pulmonary venous return without an atrial septal defect and one with a secundum defect were incorrectly diagnosed.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Midface-lifting: evolution, indications, and technique.

    PubMed

    Hachach-Haram, Nadine; Kirkpatrick, W Niall A

    2013-08-01

    The youthful face is often defined by malar and lateral cheek fullness with associated submalar concavity, giving a smooth contour between the different subunits coupled with an aesthetically pleasing convex lower eyelid-cheek continuum. This article reviews the key anatomical concepts of midfacial aging, the evolution of midface-lifting techniques, and indications and contraindications for their use. PMID:23884850

  19. Current Trends in the Management of Difficult Urinary Catheterizations

    PubMed Central

    Willette, Paul A.; Coffield, Scott

    2012-01-01

    Routine urinary catheter placement may cause trauma and poses a risk of infection. Male catheterization, in particular, can be difficult, especially in patients with enlarged prostate glands or other potentially obstructive conditions in the lower urinary tract. Solutions to problematic urinary catheterization are not well known and when difficult catheterization occurs, the risk of failed catheterization and concomitant complications increase. Repeated and unsuccessful attempts at urinary catheterization induce stress and pain for the patient, injury to the urethra, potential urethral stricture requiring surgical reconstruction, and problematic subsequent catheterization. Improper insertion of catheters also can significantly increase healthcare costs due to added days of hospitalization, increased interventions, and increased complexity of follow-up evaluations. Improved techniques for catheter placement are essential for all healthcare personnel involved in the management of the patient with acute urinary retention, including attending emergency physicians who often are the first physicians to encounter such patients. Best practice methods for blind catheter placement are summarized in this review. In addition, for progressive clinical practice, an algorithm for the management of difficult urinary catheterizations that incorporates technology enabling direct visualization of the urethra during catheter insertion is presented. This algorithm will aid healthcare personnel in decision making and has the potential to improve quality of care of patients. PMID:23359117

  20. Outpatient cardiac catheterization and arteriography: Twenty-month experience at the Arizona Heart Institute

    PubMed Central

    Diethrich, Edward B.; Kinard, Sam A.; Pierce, Stephen A.; Koopot, Ravi

    1981-01-01

    Arteriographic examination of the coronary, cerebral, and peripheral circulatory systems is the ultimate diagnostic technique for the identification and quantification of atherosclerotic occlusive disease. In the past, hospitalization has been required for this invasive procedure. Recently, however, the concept of outpatient catheterization and arteriography has become a reality. To investigate the integrity, safety, and cost-effectiveness of our outpatient invasive procedures laboratory, we analyzed our experience with 254 cardiac catheterizations and 174 peripheral arteriograms performed during a 20-month period. There were no deaths or major complications. Minor complications (11%) included bleeding from the cutdown site, nausea, numbness, and allergic reactions. Two patients with arrhythmias required cardioversion. Nine patients (2%) were transferred to the hospital for observation or immediate surgery due to the nature of their atherosclerotic lesions. This study reveals (1) the technical quality, safety, indications, and contraindications for outpatient catheterization and arteriography; (2) the enthusiastic patient acceptance of outpatient invasive diagnostic studies; (3) the economic impact of these procedures on escalating health-care costs; and (4) the potential for outpatient catheterization and arteriography on a broad scale. PMID:15216207

  1. Hystérectomie cœlioscopique : technique, indications

    Microsoft Academic Search

    V. Thoma; M. Salvatores; L. Mereu; I. Chua; A. Wattiez

    2007-01-01

    Today, hysterectomy is, after caesarean section, the most frequent surgical intervention performed in fertile women. Introduced in 1989, laparoscopic hysterectomy remains poorly diffused: today, less than 5% of all hysterectomies remain done by laparoscopy. Nevertheless after a correct learning curve, laparoscopic hysterectomy finds perfect indications in benign and even some malignant indications. In these conditions, the complication rate is similar

  2. Gluteal augmentation: technique, indications, and implant selection.

    PubMed

    Aboudib, Jose Horacio; Serra, Fernando; de Castro, Claudio Cardoso

    2012-10-01

    Silicone implants have been used for gluteal augmentation for the past 40 years. Several techniques have been described for cosmetic purposes, but many plastic surgeons do not feel that performing the operation is safe. In this article, a technique is described to reduce the complication rate, improve the final results, and develop an easy way of understanding and learning this procedure. Based on surgical simulation involving 10 fresh cadavers, the authors have determined the goals for making the operation simpler and safer. One hundred three patients have undergone the operation performed by the staff or by the plastic surgery resident under supervision. There was seroma in 3.88 percent, dehiscence of the sutures in 5.8 percent, infection and removal of the implant in one case (0.97 percent), and no hematoma. The patient satisfaction rate was high. Anatomical dissections allowed the authors to gain experience and confidence regarding the plane of undermining, avoiding damage to the sciatic nerve, and the placement of the prosthesis, keeping it in place. The technique is easy to understand and learn. PMID:23018702

  3. Indications and techniques for anterior cervical plating.

    PubMed

    Rhee, John M; Park, Jong-Beom; Yang, Jun-Young; Riew, Daniel K

    2005-12-01

    Anterior cervical plating is commonly performed to stabilize anterior cervical fusions. Modern plating options include dynamic plates, with screws that can either toggle within fixed holes or translate within slotted holes. Regardless of the plating system used, paramount to success and avoidance of complications with plated anterior cervical fusions are meticulous plating techniques, exacting graft carpentry, and understanding the biomechanical limitations of plating in certain situations, such as multilevel corpectomies reconstructed with a single-strut graft. In order to prevent graft-related complications associated with long-strut grafts, additional posterior fixation and fusion, or alternative corpectomy constructs, such as multilevel anterior cervical discectomy and fusion, corpectomy-discectomy, and corpectomy-corpectomy, should be considered instead if the pattern of stenosis allows. PMID:16565534

  4. Nonocclusive chronic vascular catheterization of conscious unrestrained baboons.

    PubMed

    Phippard, A F; Garner, M G; Thompson, J F; Maclean, J M; Fletcher, P J; Horvath, J S; Duggin, G G; Tiller, D J

    1986-11-01

    A surgical technique is described for chronic arterial and venous catheterization of unrestrained adult baboons. Vascular access was achieved through a small (5 cm) abdominal incision and an extraperitoneal approach to the iliac vessels, which minimizes postoperative morbidity, discomfort, and restriction of movement. The method permits secure but nonocclusive catheterization, confirmed by angiography. Catheters were removed without further surgery, leaving the baboons intact for reuse. Catheters placed in the distal common or proximal external iliac vessels were all patent when removed at 46-61 days. The results demonstrate arterial pressure, pulse rates, drug administration, blood sampling, and plasma volume measurement as examples of the technique's application in conscious unrestrained baboons. PMID:3096951

  5. Current approaches to pediatric heart catheterizations

    PubMed Central

    Bernard, Philip A.; Ballard, Hubert; Schneider, Douglas

    2011-01-01

    Sedation for pediatric cardiac catheterization is a common requirement in many institutions. As the field of cardiac catheterization has evolved, the provision of sedation for these procedures has been varied. Increasingly the demand is for dedicated personnel focused on monitoring and delivery of sedation while in the catheterization suite. This article describes the considerations one must use when undertaking these cases. PMID:22053267

  6. Combined cardiac catheterization for uncomplicated ischemic heart disease in a medicare population 1 1 The analyses upon which this publication is based were performed under contract number 500-96-P708, entitled, “Utilization and Quality Peer Review Organization for the Commonwealth of Pennsylvania,” sponsored by the Health Care Financing Administration, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government. The authors assume full responsibility for the accuracy and completeness of ideas presented

    Microsoft Academic Search

    Christine Laine; Laura Venditti; Russell Localio; Leona Wickenheiser; D. Lynn Morris

    1998-01-01

    PURPOSE: Experts recommend left heart catheterization alone to evaluate uncomplicated ischemic heart disease, reserving right heart catheterization for specific indications. Yet some centers routinely perform combined cardiac catheterization (left heart catheterization and right heart catheterization together).SUBJECTS AND METHODS: Using 1992–1993 Pennsylvania Medicare claims for cardiac catheterizations (n = 41,180), we examined rates of combined cardiac catheterization for patients with uncomplicated

  7. A practical approach to difficult urinary catheterizations.

    PubMed

    Ghaffary, Cameron; Yohannes, Amanuel; Villanueva, Carlos; Leslie, Stephen W

    2013-12-01

    Routine placement of transurethral catheters can be challenging in some situations, such as urethral strictures, severe phimosis and false passages. Intravaginal retraction of the urethral meatus can complicate Foley placement in postmenopausal females. In men, blind urethral procedures with mechanical or metal sounds without visual guidance or guidewire assistance are now discouraged due to the increased risk of urethral trauma and false passages. Newer techniques of urethral catheterization including guidewires, directed hydrophilic mechanical dilators, urethral balloon dilation, and direct vision endoscopic catheter systems are discussed, along with the new standardized protocol for difficult transurethral catheter insertions. Suprapubic catheter placement techniques, including percutaneous trocars and the use of the curved Lowsley tractor for initial suprapubic catheter insertion, are reviewed. Prevention and management of common catheter-related problems such as encrustation, leakage, Foley malposition, balloon cuffing and frequent blockages are discussed. PMID:23959835

  8. Complications associated with pediatric cardiac catheterization

    Microsoft Academic Search

    Renato Vitiello; Brian W McCrindle; David Nykanen; Robert M Freedom; Lee N Benson

    1998-01-01

    Objectives. The aim of this study was to determine the relative risks of pediatric diagnostic, interventional and electrophysiologic catheterizations.Background. The role of the pediatric catheterization laboratory has evolved in the last decade as a therapeutic modality, although remaining an important tool for anatomic and hemodynamic diagnosis.Methods. A study of 4,952 consecutive pediatric catheterization procedures was undertaken.Results. Patient ages ranged from

  9. Spectral analysis techniques for estimating power quality indices

    Microsoft Academic Search

    R. Zolfaghari; Y. Shrivastava; V. G. Agelidis

    2010-01-01

    This paper presents the theory, design and implementation of a real time virtual instrument to measure the power quality indices such as power factor, voltage harmonic distortion and current harmonic distortion as given by the IEEE standard. Windowing techniques offer an adjustable mechanism to detect low or high power harmonics as they have different leakage characteristics. Cross spectral density is

  10. Full Endoscopic Spinal Surgery Techniques: Advancements, Indications, and Outcomes

    PubMed Central

    Yue, James J.; Long, William

    2015-01-01

    Advancements in both surgical instrumentation and full endoscopic spine techniques have resulted in positive clinical outcomes in the treatment of cervical, thoracic, and lumbar spine pathologies. Endoscopic techniques impart minimal approach related disruption of non-pathologic spinal anatomy and function while concurrently maximizing functional visualization and correction of pathological tissues. An advanced understanding of the applicable functional neuroanatomy, in particular the neuroforamen, is essential for successful outcomes. Additionally, an understanding of the varying types of disc prolapse pathology in relation to the neuroforamen will result in more optimal surgical outcomes. Indications for lumbar endoscopic spine surgery include disc herniations, spinal stenosis, infections, medial branch rhizotomy, and interbody fusion. Limitations are based on both non spine and spine related findings. A high riding iliac wing, a more posteriorly located retroperitoneal cavity, an overly distal or proximally migrated herniated disc are all relative contra-indications to lumbar endoscopic spinal surgery techniques. Modifications in scope size and visual field of view angulation have enabled both anterior and posterior cervical decompression. Endoscopic burrs, electrocautery, and focused laser technology allow for the least invasive spinal surgical techniques in all age groups and across varying body habitus. Complications include among others, dural tears, dysesthsia, nerve injury, and infection.

  11. Dynamic multiplanar real time ultrasound guided infraclavicular subclavian vein catheterization.

    PubMed

    Zhong, Xin; Hamill, Mark; Collier, Bryan; Bradburn, Eric; Ferrara, John

    2015-06-01

    Ultrasound guided vascular access has been well-characterized as a safe and effective technique for internal jugular and femoral vein catheterization. However, there is limited experience with the use of ultrasound to access the infraclavicular subclavian vein. Multiple ultrasound techniques do exist to identify the subclavian vein, but real time access is limited by vessel identification in a single planar view. To overcome this limitation, a novel technique of ultrasound guided infraclavicular subclavian vein catheterization using a real time multiplanar approach has been developed. The initial experience with this approach is described. A single surgeon used combined oblique, transverse, and longitudinal views along with Doppler color flow images to both define the infraclavicular anatomy and to obtain subclavian vein access in 42 adult patients (20 M/22 F and 22 L/20 R) with a mean body mass index of 29.2 (range = 18.9-55.4). Chest x-ray was obtained to confirm position and to rule out pneumothorax. Subclavian vein cannulation was achieved in 100 per cent of patients; subsequent catheterization was successful in 92.9 per cent. The number of attempts required for cannulation averaged 1.3 (range = 1-5), and decreased after a five patient learning curve. No patient developed a pneumothorax, hematoma, or cannula malposition. Ultrasound guided multiplanar infraclavicular subclavian vein access appears to be a safe and effective adjunct for central line placement. PMID:26031277

  12. [Aseptic precautions in epidural catheterization for surgery].

    PubMed

    Haraga, Isao; Shono, Shinjiro; Abe, Shintarou; Higa, Kazuo

    2010-05-01

    We describe aseptic precautions in epidural catheterization for surgery. Every patient has to be checked for immunodeficiency, atopic dermatitis, preoperative use of antibiotics, and local infection of the epidural puncture site. Physicians who perform epidural catheterization should wear a mask and a cap and take off a wrist watch and rings on the fingers before an epidural kit is opened. Fingers and hands should be disinfected before wearing surgical gloves. The skin for epidural puncture site should be disinfected with 0.5% chlorhexidine in 80% ethanol. A micropore filter should be used when epidural catheterization is expected to remain over 24 hours. PMID:20486569

  13. Continuous use of intermittent bladder catheterization - can social support contribute?

    PubMed Central

    Lopes, Marjoyre Anne Lindozo; Lima, Elenice Dias Ribeiro de Paula

    2014-01-01

    Objective to investigate the factors affecting the adequate continuous use of intermittent catheterization and its relation with social support. Method sectional, descriptive and correlational study involving 49 patients with neuropathic bladder caused by spinal cord injury. Results almost all (92%) participants continued the intermittent catheterization, but 46.9% made some changes in the technique. The complications (28.6% of the sample) were mainly infection and vesicolithiasis. There were high scores for social support in relation to people that were part of the patient's social support. Conclusion All of them noticed great support from the family, but not from the society in general. The difficulties were related to the lack of equipment and inadequate infrastructure, leading to changes that increased urologic complications. PMID:25029058

  14. Intrathecal pain pumps: indications, patient selection, techniques, and outcomes.

    PubMed

    Bolash, Robert; Mekhail, Nagy

    2014-10-01

    Intrathecal drug delivery represents an advanced modality for refractory chronic pain patients as well as intractable spasticity. This article reviews the advantages and indications for intrathecal therapy, as well as recommendations for proper patient selection using a multidisciplinary team to provide a global assessment of the impact of chronic pain on the patient's well-being. The goals and expectations of trialing are discussed alongside advantages and disadvantages of several trialing techniques. A discussion of outcomes is presented for patients with chronic pain due to both malignant and nonmalignant causes. PMID:25240660

  15. [Indications and technique of partial arthrodesis of the carpus].

    PubMed

    Martini, A K

    1992-01-01

    Partial arthrodesis of the carpus has again become a topical method. The technique has been improved and the range of indications has been extended. Fusion of certain areas has indeed been propagated as first-line therapy, for example in lunatum necrosis or as an important additional operation in substitution plastic surgery. Partial arthrodesis of the carpus is intended to eliminate mechanisms which has become pathological whilst preserving the best possible mobility. Partial arthrodesis alters the movement pattern of the individual ossae carpi. Moreover, the pressure in the adjacent joints also rises. The risk of a new pathological process is considerable. Recent publications report on a rapid development of impingement and symptoms. The most frequent partial arthrodeses are discussed. The indications and the direct consequences are critically analysed and explained with reference to examples. Technical details and potential dangers are described. An STT-arthrodesis is indicated for osteoarthritis of these bones. The radio-lunar arthrodesis is recommended for ulnar drifting of the carpus in cases of rheumatoid arthritis. Reconstruction of the central axis with arthrodesis of the capitate-lunate is indicated for pseudarthrosis of the scaphoid with carpal collapse. Other combinations are possible, they cause however greater functional deficits. We recommend a critical analysis of the function of the entire carpus before the operation. Caution is called for when an incipient arthrosis is present in the adjacent joint. Partial arthrodesis of the carpus is rather a temporary solution, since it enables time to be gained. Total arthrodesis is the ultimate resort. PMID:1642031

  16. Outcomes of pediatric patients undergoing cardiac catheterization while on extracorporeal membrane oxygenation.

    PubMed

    Callahan, Ryan; Trucco, Sara M; Wearden, Peter D; Beerman, Lee B; Arora, Gaurav; Kreutzer, Jacqueline

    2015-03-01

    The aim of the study is to explore the indications for cardiac catheterization while on extracorporeal membrane oxygenation (ECMO) and the various catheter interventions performed as well as assess the safety profile and determine the short- and intermediate-term survival. ECMO is a lifesaving intervention for pediatric patients with respiratory and/or cardiovascular failure. There is limited recent literature discussing the survival and outcomes of patients undergoing cardiac catheterization while on ECMO. A retrospective review of consecutive patients undergoing catheterization while on ECMO from 2004 to 2013 was performed. Thirty-six patients who underwent 40 cardiac catheterizations were identified. Indications for catheterization included hemodynamic/anatomic assessment of postoperative (16) and non-operative patients (7), planned catheter interventions (CI) (12), and cardiomyopathy assessment (5). CI were performed during 18 (45 %) catheterizations, including stenting of vessels/surgical shunts (9), balloon atrial septostomy (4), device closure of septal defects/vessels (3), thrombolysis of vessels (2), endomyocardial biopsy (2), and temporary pacer wire placement (1). Unexpected diagnostic information was found in 21 (52 %), and 13 patients were referred for surgical intervention. Successful decannulation was achieved in 86 % of patients. Survival to discharge was 72 % and intermediate survival was 69 % (median = 29 months). Survival was 88 % (15/17) among patients who underwent CI. There were six procedural complications (15 %); five vascular and one non-vascular. There were no complications related to patient transport. Cardiac catheterization and interventions while on ECMO are safe, with a survival to discharge of 72 %. Diagnostic information obtained from catheterization leads to management decisions which may impact survival. PMID:25381624

  17. Percutaneous endoscopic gastrostomy: Indications, technique, complications and management

    PubMed Central

    Rahnemai-Azar, Ata A; Rahnemaiazar, Amir A; Naghshizadian, Rozhin; Kurtz, Amparo; Farkas, Daniel T

    2014-01-01

    Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the “pull” technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues. Despite the mentioned PEG tube placement complications, this procedure has gained worldwide popularity as a safe enteral access for nutrition in patients with a functional gastrointestinal system. PMID:24976711

  18. Internal jugular versus subclavian vein catheterization for central venous catheterization in orthotopic liver transplantation.

    PubMed

    Torgay, A; Pirat, A; Candan, S; Zeyneloglu, P; Arslan, G; Haberal, M

    2005-09-01

    The aim of this study was to compare incidence rates of mechanical and infectious complications associated with central venous catheterization via the internal jugular vein (IJV) versus the subclavian vein (SV) among 45 consecutive patients undergoing orthotopic liver transplantation (OLT) between January 2000 and June 2004. The subjects were divided into two groups according to the site of central venous catheterization (IJV or SV). We recorded each patient's physical characteristics, international normalized ratio (INR), partial thromboplastin time, platelet levels, number of puncture attempts, success/failure of central venous catheterization, duration of catheter placement, occurrence of catheter tip misplacement, arterial puncture, incidence of hematoma or pneumothorax, catheter-related infection, or bacterial colonization of the catheter. Senior staff anesthesiologists performed 22 SV and 23 IJV catheterizations for the 45 OLT procedures. The SV and IVJ groups both had minor coagulation abnormalities with slightly increased INR values at the time of catheterization. There were no significant differences between the groups with respect to success of central venous catheterization (100% for both), numbers of attempted punctures, duration of catheter placement, and incidence rates of mechanical and infectious complications. Both groups showed high frequencies of catheter tip misplacement, with right atrium as the site of misplacement in all cases. Two patients in the IJV group (8.7%) developed hematomas after accidental carotid artery puncture. The results suggest that, when performed by experienced anesthesiologists, central venous catheterization via the SV is an acceptable alternative to IJV catheterization for patients undergoing OLT. PMID:16213340

  19. Interventional ultrasonography of the chest: Techniques and indications

    PubMed Central

    Almolla, J.; Balconi, G.

    2011-01-01

    Thoracic ultrasonography can be used for diagnostic purposes as well as a guide for diagnostic and therapeutic interventions. When the lesion or fluid collection has been located and the patient properly positioned, the angle of the needle is identified with respect to the transducer. The insertion tract should transgress the smallest possible area of aerated parenchyma. The needle can be introduced with a free-hand technique or with the aid of a needle guide. Correct planning of the procedure reduces intervention time and decreases the risk of complications. The main indications are superficial masses that require biopsy, pleural and parenchymal lesions formerly biopsied with CT or fluoroscopic guidance, and fluid collections that need to be drained. Ultrasound, thanks to its widespread use, simple execution, and low costs, represents a safe, manageable guide for thoracic interventions. PMID:23396954

  20. Per-oral endoscopic myotomy: emerging indications and evolving techniques.

    PubMed

    Minami, Hitomi; Inoue, Haruhiro; Haji, Amyn; Isomoto, Hajime; Urabe, Shigetoshi; Hashiguchi, Keiichi; Matsushima, Kayoko; Akazawa, Yuko; Yamaguchi, Naoyuki; Ohnita, Ken; Takeshima, Fuminao; Nakao, Kazuhiko

    2015-01-01

    Esophageal achalasia is a benign esophageal motility disorder resulting from an impaired relaxation of the lower esophageal sphincter. The principles of treatment involve disruption of the sphincter at the esophagogastric junction. Treatment techniques include balloon dilatation, botulinum toxin injection, and surgical myotomy. In 2008, per-oral endoscopic myotomy (POEM) was introduced by Inoue et?al. as an endoscopic myotomy with no skin incision. The procedure has been well accepted and widely applied owing to its minimal invasiveness and high cure rates. Moreover, there have been discussions on wider indications for POEM and new technical developments have been reported. The present article reviews the historical background and present status of POEM, as well as future prospects for its application in the treatment of esophageal achalasia. PMID:25040806

  1. Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes.

    PubMed

    Lopez, Anthony James

    2015-08-01

    Until recently, the main indication for pelvic vein embolization (PVE) in women was to treat pelvic venous congestion syndrome (PVC) but increasingly, patients with refluxing pelvic veins associated with leg varicosities are also being treated. A more unusual reason for PVE is to treat pelvic venous malformations, although such lesions may be treated with sclerotherapy alone. Embolotherapy for treating PVC has been performed for many years with several published studies included in this review, whilst an emerging indication for PVE is to treat lower limb varicosities associated with pelvic vein reflux. Neither group, however, has been subjected to an adequate randomized, controlled trial. Consequently, some of the information presented in this review should be considered anecdotal (level III evidence) at this stage, and a satisfactory 'proof' of clinical efficacy remains deficient until higher-level evidence is presented. Furthermore, a wide range of techniques not accepted by all are used, and some standardization will be required based on future mandatory prospective studies. Large studies have also clearly shown an unacceptably high recurrence rate of leg varicose veins following venous surgery. Furthermore, minimally or non-invasive imaging is now revealing that there is a refluxing pelvic venous source in a significant percentage of women with de novo leg varicose veins, and many more with recurrent varicosities. Considering that just over half the world's population is female and a significant number of women not only have pelvic venous reflux, but also have associated leg varicosities, minimally invasive treatment of pelvic venous incompetence will become a common procedure. PMID:25804635

  2. Family presence in the congenital catheterization laboratory.

    PubMed

    Heitschmidt, Mary

    2015-01-01

    Evidence suggests that family presence as an option during invasive procedures may provide a comforting presence to the patient and may not be notable disruptive to the health care team. Little research has explored family presence during cardiac procedures. This is the first documented report of family presence in the congenital cardiac catheterization lab (CCCL). The purpose of this article is to review the course for implementing a family presence program in the CCCL. The Iowa Model of Evidence-Based practice guided this process which included the development of a written policy of family presence in the CCCL at two academic medical centers. Successful family presence in the catheterization lab must include: written guidelines, involvement of all staff, family presence offered as an option, and preparation of the patient and family for the catheterization experience as well as emergency procedures. PMID:25766042

  3. Percutaneous Extraluminal (Subintimal) Recanalization of a Brachial Artery Occlusion Following Cardiac Catheterization

    SciTech Connect

    Bolia, Amman [Department of Radiology, Clinical Sciences Building, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX (United Kingdom); Nasim, Akhtar; Bell, Peter R.F. [Department of Surgery, Clinical Sciences Building, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX (United Kingdom)

    1996-05-15

    A 47-year-old woman presented with disabling right arm claudication 10 weeks after Sones cardiac catheterization via a brachial artery cut-down. A technique of extraluminal recanalization of the brachial artery occlusion, used to treat this patient, is described.

  4. Infection control guidelines for the cardiac catheterization laboratory: society guidelines revisited.

    PubMed

    Chambers, Charles E; Eisenhauer, Michael D; McNicol, Lynn B; Block, Peter C; Phillips, William J; Dehmer, Gregory J; Heupler, Frederick A; Blankenship, James C

    2006-01-01

    In the early years of diagnostic cardiac catheterization, strict sterile precautions were required for cutdown procedures. Thirteen years ago, when the original guidelines were written, the brachial arteriotomy was still frequently utilized, femoral closure devices were uncommon, "implantables," such as intracoronary stents and PFO/ASD closure devices, were in their infancy, and percutaneous valve replacement was not a consideration. In 2005, the cardiac catheterization laboratory is a complex interventional suite with percutaneous access routine and device implantation standard. Despite frequent device implantation, strict sterile precautions are often not observed. Reasons for this include a decline in brachial artery cutdown, limited postprocedure follow-up with few reported infections, limited use of hats and masks in televised cases, and lack of current guidelines. Proper sterile technique has the potential to decrease the patient infection rate. Hand washing remains the most important procedure for preventing infections. Caps, masks, gowns, and gloves help to protect the patient by maintaining a sterile field. Protection of personnel may be accomplished by proper gowning, gloving, and eye wear, disposal of contaminated equipment, and prevention and care of puncture wounds and lacerations. With the potential for acquired disease from blood-borne pathogens, the need for protective measures is as essential in the cardiac catheterization laboratory as is the standard Universal Precautions, which are applied throughout the hospital. All personnel should strongly consider vaccination for hepatitis B. Maintenance of the cardiac catheterization laboratory environment includes appropriate cleaning, limitation of traffic, and adequate ventilation. In an SCAI survey, members recommended an update on guidelines for infection control in the cardiac catheterization laboratory. The following revision of the original 1992 guidelines is written specifically to address the increased utilization of the catheterization laboratory as an interventional suite with device implantation. In this update, infection protection is divided into sections on the patient, the laboratory personnel, and the laboratory environment. Additionally, specific CDC recommendation sections highlight recommendations from other published guidelines. PMID:16331649

  5. Radiation exposure and protection in cardiac catheterization laboratories

    Microsoft Academic Search

    Stephen W. Miller; Frank P. Castronovo Jr.

    1985-01-01

    Cardiac catheterization with angiography can deliver the greatest dose of x-radiation of any diagnostic medical examination. The physicians and technologists in the angiography room receive low-level scattered radiation over a period of months to decades. Although the radiobiology is complex, the physicians who perform cardiac catheterization should be familiar with the potential genetic and somatic effects of radiation and with

  6. CathSim: an intravascular catheterization simulator on a PC.

    PubMed

    Ursino, M; Tasto, J L; Nguyen, B H; Cunningham, R; Merril, G L

    1999-01-01

    The development of a medical simulator that incorporates substantial training value and realism into an affordable product has been a huge challenge for the simulation community. A large hurdle to making an inexpensive simulator has been the high cost of the computers needed for adequate realism. We have met this challenge by developing CathSim, a low-cost medical simulator that integrates force feedback, multimedia, and 3D graphics simulation technology on an industry standard PC. This product is commercially available and is currently being used by numerous training institutions and hospitals. The CathSim system includes software and a force feedback interface device. The platform and device can be used to train health care providers to perform needle-stick medical procedures. Our first module teaches users the techniques of peripheral intravenous (i.v.) catheterization. Other training modules that will be added to the CathSim platform include central venous catheter (CVC) insertion and peripherally inserted central catheter (PICC) placement. This paper discusses the challenges of this project and the trade-offs and solutions that we developed to overcome them. We describe our process of analyzing and prioritizing the medical tasks necessary to correctly perform peripheral intravenous catheterization. This analysis and prioritization was used to decide which tasks would be included in the simulator and how the included tasks would be replicated. We discuss the method by which we obtained the needed realism in the 3D graphics rendering and in the tactile feedback of the input device. We illustrate how we blended together simulation and multimedia technology to ensure adequate immersion and training efficacy, while keeping the system cost to a minimum. PMID:10538388

  7. Ureteral Cannulation as a Complication of Urethral Catheterization

    PubMed Central

    Greenlund, Andrew C.

    2014-01-01

    Urinary catheterization is a common procedure, particularly among patients with neurogenic bladder secondary to spinal cord injury. Urethral catheterization is associated with the well-recognized complications of catheter-associated urinary tract infections and limited genitourinary trauma. Unintentional ureteral cannulation represents a rare complication of urethral catheterization and has been previously described in only eight cases within the literature. We describe two cases of aberrant ureteral cannulation involving two patients with quadriplegia. These cases along with prior reports identify the spastic, insensate bladder and altered pelvic sensorium found in upper motor neuron syndromes as major risk factors for ureteral cannulation with a urinary catheter. PMID:25405021

  8. Use of structured personality survey techniques to indicate operator response to stressful situations

    SciTech Connect

    Waller, M.A.

    1990-01-01

    Under given circumstances, a person will tend to operate in one of four dominant orientations: (1) to perform tasks; (2) to achieve consensus; (3) to achieve understanding, or (4) to maintain structure. Historically, personality survey techniques, such as the Myers-Briggs type indicator, have been used to determine these tendencies. While these techniques can accurately reflect a person's orientation under normal social situations, under different sets of conditions, the same person may exhibit other tendencies, displaying a similar or entirely different orientation. While most do not exhibit extreme tendencies or changes of orientation, the shift in personality from normal to stressful conditions can be rather dramatic, depending on the individual. Structured personality survey techniques have been used to indicate operator response to stressful situations. These techniques have been extended to indicate the balance between orientations that the control room team has through the various levels of cognizance.

  9. Superciliary Keyhole Approach for Unruptured Anterior Circulation Aneurysms: Surgical Technique, Indications, and Contraindications

    PubMed Central

    2014-01-01

    Neurosurgeons have been trying to reduce surgical invasiveness by applying minimally invasive keyhole approaches. Therefore, this paper clarifies the detailed surgical technique, its limitations, proper indications, and contraindications for a superciliary keyhole approach as a minimally invasive modification of a pterional approach. Successful superciliary keyhole surgery for unruptured aneurysms requires an understanding of the limitations and the use of special surgical techniques. Essentially, this means the effective selection of surgical indications, usage of the appropriate surgical instruments with a tubular shaft, and refined surgical techniques, including straightforward access to the aneurysm, clean surgical dissection, and the application of clips with an appropriate configuration. A superciliary keyhole approach allows unruptured anterior circulation aneurysms to be clipped safely, rapidly, and less invasively on the basis of appropriate surgical indications. PMID:25535512

  10. Enoxaparin Treatment of Spontaneous Deep Vein Thrombosis in a Chronically Catheterized Rhesus Macaque (Macaca mulatta)

    PubMed Central

    Wathen, Asheley B; Myers, Daniel D; Zajkowski, Paul; Flory, Graham; Hankenson, F Claire

    2009-01-01

    A chronically catheterized 14-y-old male rhesus macaque (Macaca mulatta) was reported for recurrent scrotal swelling. The scrotum was enlarged and warm to touch, and associated skin was noted to be lichenified on physical examination. The penis could not be extruded due to preputial swelling. Results from the following diagnostic tests were all unremarkable or within normal limits: scrotal aspirate, hematology, serum biochemistries, urinalysis, and radiography of the thorax, scrotum, and abdomen. Ultrasonography of lower extremities identified thrombi in bilateral iliac veins and left femoral vein. Collateral circulation surrounding the left femoral vein permitted some compensatory venous return. The left femoral vein of this animal had been catheterized approximately 2 mo before initial presentation. A coagulation panel revealed a positive D-dimer test, indicative of elevated levels of fibrin degradation products due to active thrombus breakdown. Enoxaparin sodium, a low-molecular-weight heparin for human use, was administered at 20 mg subcutaneously once daily for 10 d to treat occlusive venous thrombi. After enoxaparin treatment, the edema was greatly decreased. To achieve complete resolution, a second course of enoxaparin was administered 2 months after the first. Ultrasonography of the pelvic vasculature 6 mo after completion of therapy showed marked thrombus resolution, allowing for bilateral patency in the iliac and femoral veins. Follow-up evaluation revealed that D-dimer values were negative as well. This case demonstrates the novel application of the human medication enoxaparin to treat clinical signs of deep vein thrombosis in a chronically catheterized rhesus macaque. PMID:19807974

  11. Cardiac catheterization in children with pulmonary hypertensive vascular disease.

    PubMed

    Bobhate, Prashant; Guo, Long; Jain, Shreepal; Haugen, Richard; Coe, James Y; Cave, Dominic; Rutledge, Jennifer; Adatia, Ian

    2015-04-01

    The risks associated with cardiac catheterization in children with pulmonary hypertension (PH) are increased compared with adults. We reviewed retrospectively all clinical data in children with PH [mean pulmonary artery pressure (mean PAp) ?25 mmHg and pulmonary vascular resistance index (PVRI) ?3 Wood units m(2)] undergoing cardiac catheterization between 2009 and 2014. Our strategy included a team approach, minimal catheter manipulation and sildenafil administration prior to extubation. Adverse events occurring within 48 h were noted. Seventy-five patients (36 males), median age 4 years (0.3-17) and median weight 14.6 kg (2.6-77 kg), underwent 97 cardiac catheterizations. Diagnoses included idiopathic or heritable pulmonary arterial hypertension (PAH) (29 %), PAH associated with congenital heart disease (52 %), left heart disease (5 %) and lung disease (14 %). Mean PAp was 43 ± 19 mmHg; mean PVRI was 9.7 ± 6 Wood units m(2). There were no deaths or serious arrhythmias. No patient required cardiac massage. Three patients who suffered adverse events had suprasystemic PAp (3/3), heritable PAH (2/3), decreased right ventricular function (3/3), and pulmonary artery capacitance index <1 ml/mmHg/m(2) (3/3) and were treatment naïve (3/3). No patient undergoing follow-up cardiac catheterization suffered a complication. In 45 % of cases, the data acquired from the follow-up cardiac catheterization resulted in an alteration of therapy. Three percent of children with PH undergoing cardiac catheterization suffered adverse events. However, there were no intra or post procedural deaths and no one required cardiac massage or cardioversion. Follow-up cardiac catheterization in patients receiving pulmonary hypertensive targeted therapy is safe and provides useful information. PMID:25577228

  12. Indication.

    PubMed

    Pust, Ronald E

    2012-01-01

    Should the indications for therapies differ from one nation to the next? What are the reasons behind controversial therapeutic variations? What roles do cultural history and authoritarian conflict among clinicians play in the adoption of therapies? When I worked at a rural hospital in Kenya, a woman experiencing obstructed labor made me ponder many questions-but only after our emergency ended in the death of her newborn son. In recounting and learning from this episode, I listened to the disparate Kenyan voices of the patient, the hospital's director, the consultant obstetrician, and to the even more controversial voices of evidence-based medicine. In reflecting on this process, I have learned at least 3 lessons-about the transmissibility of arrogance, the role of guests in other countries, and the nature of science. PMID:22230834

  13. Indication

    PubMed Central

    Pust, Ronald E.

    2012-01-01

    Should the indications for therapies differ from one nation to the next? What are the reasons behind controversial therapeutic variations? What roles do cultural history and authoritarian conflict among clinicians play in the adoption of therapies? When I worked at a rural hospital in Kenya, a woman experiencing obstructed labor made me ponder many questions—but only after our emergency ended in the death of her newborn son. In recounting and learning from this episode, I listened to the disparate Kenyan voices of the patient, the hospital’s director, the consultant obstetrician, and to the even more controversial voices of evidence-based medicine. In reflecting on this process, I have learned at least 3 lessons—about the transmissibility of arrogance, the role of guests in other countries, and the nature of science. PMID:22230834

  14. Spectral analysis techniques with Kalman filtering for estimating power quality indices

    Microsoft Academic Search

    R. Zolfaghari; Y. Shrivastava; V. G. Agelidis; G. M. L. Chu

    2010-01-01

    This paper presents the theory, design and implementation of two real time virtual instruments to measure the power quality indices such as current harmonic distortion, voltage harmonic distortion and power factor as given by the IEEE standard. Different windowing techniques are explored in the estimation of the spectra. Cross spectral analysis is used for the measurement of phase angles in

  15. Techniques, indications et résultats précoces de la conservation splénique dans les exérèses pancréatiques gauches

    Microsoft Academic Search

    P Bernard; E Letessier; F Denimal; O Armstrong; J. C Le Néel

    2002-01-01

    Study aim. Splenic preservation is rarely performed during left pancreatectomy. We compared retrospectively the early results of left pancreatectomy with and without splenic preservation to define the place of this procedure.Patients and methods. From 1979 to 1997, among 54 left pancreatectomies for another indication than adenocarcinoma, 13 were performed with and 41 without splenic preservation. The technique used for splenic

  16. Endovascular Aortic Aneurysm Repair with Chimney and Snorkel Grafts: Indications, Techniques and Results

    SciTech Connect

    Patel, Rakesh P., E-mail: rpatel9@nhs.net [Northwick Park Hospital, Department of Vascular Radiology (United Kingdom); Katsargyris, Athanasios, E-mail: kthanassos@yahoo.com; Verhoeven, Eric L. G., E-mail: Eric.Verhoeven@klinikum-nuernberg.de [Klinikum Nuernberg, Department of Vascular and Endovascular Surgery (Germany)] [Klinikum Nuernberg, Department of Vascular and Endovascular Surgery (Germany); Adam, Donald J., E-mail: donald.adam@tiscali.co.uk [Heartlands Hospital, Department of Vascular Surgery (United Kingdom); Hardman, John A., E-mail: johnhardman@doctors.org.uk [Royal United Hospital Bath, Department of Vascular Radiology (United Kingdom)

    2013-12-15

    The chimney technique in endovascular aortic aneurysm repair (Ch-EVAR) involves placement of a stent or stent-graft parallel to the main aortic stent-graft to extend the proximal or distal sealing zone while maintaining side branch patency. Ch-EVAR can facilitate endovascular repair of juxtarenal and aortic arch pathology using available standard aortic stent-grafts, therefore, eliminating the manufacturing delays required for customised fenestrated and branched stent-grafts. Several case series have demonstrated the feasibility of Ch-EVAR both in acute and elective cases with good early results. This review discusses indications, technique, and the current available clinical data on Ch-EVAR.

  17. Combined Hip Arthroscopy and Periacetabular Osteotomy: Indications, Advantages, Technique, and Complications

    PubMed Central

    Domb, Benjamin; LaReau, Justin; Redmond, John M.

    2014-01-01

    Evaluation and treatment of concomitant intra-articular pathology may be beneficial before periacetabular osteotomy (PAO) is performed. Hip arthroscopy before PAO allows the surgeon to perform full inspection of the hip joint and can be used to treat hip pathology before osteotomy. The indications for hip arthroscopy before PAO are presented in this article. The combined surgical procedure is described, along with potential complications. The advantages and disadvantages of this technique are outlined. PMID:24843847

  18. Teaching Self-Catheterization Skills to a Child with Myelomeningocele in a Preschool Setting.

    ERIC Educational Resources Information Center

    Robertson, Jo; And Others

    1992-01-01

    Simulation training and a prompt hierarchy were found to facilitate acquisition of clean intermittent self-catheterization skills by a four-year-old male with myelomeningocele. The child was first taught to perform catheterization on a doll, then on himself. Skills were clustered into three tasks of diapering, cleansing, and catheterization.…

  19. Indwelling versus Intermittent Urinary Catheterization following Total Joint Arthroplasty: A Systematic Review and Meta-Analysis

    PubMed Central

    Xue, Deting; Li, Chao; Zhang, Kai; Ma, Honghai; Yan, Shigui; Pan, Zhijun

    2015-01-01

    Objective The purpose of this study is to compare the rates of urinary tract infection (UTI) and postoperative urinary retention (POUR) in patients undergoing lower limb arthroplasty after either indwelling urinary catheterization or intermittent urinary catheterization. Methods We conducted a meta-analysis of relevant randomized controlled trials (RCT) to compare the rates of UTI and POUR in patients undergoing total joint arthroplasty after either indwelling urinary catheterization or intermittent urinary catheterization. A comprehensive search was carried out to identify RCTs. Study-specific risk ratios (RR) with 95% confidence intervals (CI) were pooled. Additionally, a meta-regression analysis, as well as a sensitivity analysis, was performed to evaluate the heterogeneity. Results Nine RCTs with 1771 patients were included in this meta-analysis. The results showed that there was no significant difference in the rate of UTIs between indwelling catheterization and intermittent catheterization groups (P>0.05). Moreover, indwelling catheterization reduced the risk of POUR, versus intermittent catheterization, in total joint surgery (P<0.01). Conclusions Based on the results of the meta-analysis, indwelling urinary catheterization, removed 24-48 h postoperatively, was superior to intermittent catheterization in preventing POUR. Furthermore, indwelling urinary catheterization with removal 24 to 48 hours postoperatively did not increase the risk of UTI. In patients with multiple risk factors for POUR undergoing total joint arthroplasty of lower limb, the preferred option should be indwelling urinary catheterization removed 24-48 h postoperatively. Level of Evidence Level I. PMID:26146830

  20. Intercostal bleeding that developed during thoracic epidural catheterization

    Microsoft Academic Search

    Sumio Amagasa; Ayuko Igarashi; Noriko Yokoo; Masayoshi Sato

    2008-01-01

    To the editor: Various complications related to thoracic epidural catheterization have been reported, including epidural hematoma or abscess, dural puncture, nerve injuries, intrapleural catheter placement, and pneumothorax (1,2). However, to our knowledge, intercostal bleeding has not been reported; this complication may be rare. We report a case of intercostal bleeding associated with hemothorax and a hematoma external to the parietal

  1. Managing Inadvertent Arterial Catheterization During Central Venous Access Procedures

    SciTech Connect

    Nicholson, Tony, E-mail: Tony.Nicholson@leedsth.nhs.uk; Ettles, Duncan; Robinson, Graham [Hull and EastYorkshire Hospitals Trust, Anlaby Road, Hull HU3 2JZ, Department of Vascular Radiology (United Kingdom)

    2004-01-15

    Purpose: Approximately 200,000 central venous catheterizations are carried out annually in the National Health Service in the United Kingdom. Inadvertent arterial puncture occurs in up to 3.7%. Significant morbidity and death has been reported. We report on our experience in the endovascular treatment of this iatrogenic complication. Methods: Retrospective analysis was carried out of 9 cases referred for endovascular treatment of inadvertent arterial puncture during central venous catheterization over a 5 year period. Results: It was not possible to obtain accurate figures on the numbers of central venous catheterizations carried out during the time period. Five patients were referred with carotid or subclavian pseudoaneurysms and hemothorax following inadvertent arterial catheter insertion and subsequent removal. These patients all underwent percutaneous balloon tamponade and/or stent-graft insertion. More recently 4 patients were referred with the catheter still in situ and were successfully treated with a percutaneous closure device. Conclusion: If inadvertent arterial catheterization during central venous access procedures is recognized and catheters removed, sequelae can be treated percutaneously. However, once the complication is recognized it is better to leave the catheter in situ and seal the artery percutaneously with a closure device.

  2. Renal hemodynamics during pregnancy in chronically catheterized, conscious rats

    Microsoft Academic Search

    Kirk P Conrad

    1984-01-01

    Renal hemodynamics during pregnancy in chronically catheterized, conscious rats. Two types of experiments were performed, cross-sectional and longitudinal. In the cross-sectional studies, rats were mated, later prepared surgically, and then 5 or more days after surgery, each examined twice during days 11 to 15 or days 18 to 20 of gestation. Nonpregnant rats matched for age and prepregnant weight served

  3. Arthroscopy and endoscopy of the foot and ankle: indications for new techniques.

    PubMed

    Lui, Tun Hing

    2007-08-01

    The scope of arthroscopy and endoscopy of the foot and ankle is expanding. New techniques are emerging to deal with diverse ankle pathology. Some of the conditions that can be dealt with arthroscopically are as follows: hallux valgus deformity, lesser toe deformity, first metatarsophalangeal instability, cock-up deformity of the big toe, peroneal tendon instability, lateral ankle and subtalar instability, hindfoot deformity or arthrosis, first metatarsocuneiform hypermobility, Lisfranc joint arthrosis, various stages of posterior tibial tendon insufficiency, foot and ankle arthrofibrosis, late complications after calcaneal fracture, acute and chronic Achilles tendon rupture, insertional Achilles tendinopathy, entrapment of the first branch of the lateral plantar nerve, Freiberg's infarction, flexor digitorum longus tenosynovitis, flexor hallucis longus pathology, calcaneonavicular coalition or "too-long" anterior process of the calcaneus, and ganglions. With sound knowledge regarding the indications, merits, and potential risks of new techniques, they will be powerful tools in foot and ankle surgery. PMID:17681212

  4. Optical fibre techniques for use within tamper indicating enclosures designed for arms control verification purposes

    NASA Astrophysics Data System (ADS)

    Dyer, Thomas C.; Thompson, Alexander W. J.; Wynn, Paul; White, Helen

    2014-10-01

    Ensuring that a future nuclear arms control agreement can be verified is a complex technical challenge. Tamper Indicating Enclosures (TIEs) are likely to be deployed as part of a chain of custody regime, providing an indication of an unauthorised attempt to access an item within the agreement. This paper focuses on the assessment of optical fibre techniques for ensuring boundary control as part of a TIE design. The results of optical fibre damage, subsequent repair attempts, enclosure construction considerations and unique identification features have been evaluated for a selection of fused-silica optical fibres. This paper focuses on detecting a fibre repair attempt, presents a method for increasing repair resistance and a method for uniquely identifying an enclosure using the optical signature from the embedded optical fibre.

  5. Reflections of six years of lead extraction: influence on indications and technique

    PubMed Central

    Bracke, F.A.; Meijer, A.; van Gelder, B.

    2004-01-01

    Background Endovascular techniques have become the standard approach for extraction of pacemaker and ICD leads. However, with experience, the indications and technical approach have evolved. Indications In a population referred for lead extraction, we could not found a relation between the number of leads implanted and the incidence of occlusion of the access vein. Moreover, there is evidence that the lead extraction itself is accompanied with an increased risk of post-procedural venous occlusion. Electrical interference can be avoided in most cases, even in ICD patients. As complications of extraction have to be taken into account as well, it is therefore not in the patient's interest to extract chronically implanted non-functional superfluous leads. In contrast, lead extraction is a most effective way to cure pacemaker or ICD related infections, even if previous conservative therapy has failed. However, in patients at high risk, extraction might be deferred to attempt device saving therapy first. Technique Although leads can be removed with traction for almost all implant times, after six months additional tools are increasingly necessary to safely and completely extract them. No single technique suffices for all procedures: powered sheaths — as the laser sheath — and a femoral workstation with retrievers should be available when extraction is attempted. Complications Venous or myocardial perforation is a life-threatening complication of lead extraction. In these circumstances, time lacks to safely transfer a patient for emergency surgery and therefore the only safe environment to perform lead extraction is the operating theatre with cardiosurgical standby. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9 PMID:25696305

  6. Internal Jugular Vein Cannulation: An Ultrasound-Guided Technique Versus a Landmark-Guided Technique

    PubMed Central

    Turker, Gurkan; Kaya, Fatma Nur; Gurbet, Alp; Aksu, Hale; Erdogan, Cuneyt; Atlas, Ahmet

    2009-01-01

    OBJECTIVES To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p < 0.01). Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p < 0.05). The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p < 0.05 and p < 0.01, respectively). Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications. PMID:19841706

  7. Cystoscopic Confirmation of Inadvertent Ureteral Catheterization during Cystometry

    Microsoft Academic Search

    E. J. Gill; C. M. Nichols

    2002-01-01

    :   A patient in whom the right ureter was inadvertently catheterized at the time of cystometry is described. Upon filling, the\\u000a patient immediately developed severe colicky right flank pain and the vesical pressure of 150 cmH2O triggered the pump’s automatic shut-off mechanism. Cystoscopy was performed and confirmed the inadvertent placement of the\\u000a microtip catheter in the right ureteral orifice. After

  8. Ultrasound-guided arterial catheterization: a narrative review

    Microsoft Academic Search

    Ariel L. Shiloh; Lewis A. Eisen

    2010-01-01

    Arterial catheterization is the second most common invasive procedure performed in the intensive care unit. Despite the ubiquity\\u000a of the procedure, complications including failure to place the catheter occur. While many clinicians are familiar with the\\u000a use of ultrasound (US) guidance to decrease complication rates of central venous catheter insertion, fewer are familiar with\\u000a the use of ultrasound to guide

  9. Effect of pulsed progressive fluoroscopy on reduction of radiation dose in the cardiac catheterization laboratory

    SciTech Connect

    Holmes, D.R. Jr.; Wondrow, M.A.; Gray, J.E.; Vetter, R.J.; Fellows, J.L.; Julsrud, P.R. (Mayo Clinic, Rochester, MN (USA))

    1990-01-01

    The increased application of therapeutic interventional cardiology procedures is associated with increased radiation exposure to physicians, patients and technical personnel. New advances in imaging techniques have the potential for reducing radiation exposure. A progressive scanning video system with a standard vascular phantom has been shown to decrease entrance radiation exposure. The effect of this system on reducing actual radiation exposure to physicians and technicians was assessed from 1984 through 1987. During this time, progressive fluoroscopy was added sequentially to all four adult catheterization laboratories; no changes in shielding procedures were made. During this time, the case load per physician increased by 63% and the number of percutaneous transluminal coronary angioplasty procedures (a high radiation procedure) increased by 244%. Despite these increases in both case load and higher radiation procedures, the average radiation exposure per physician declined by 37%. During the same time, the radiation exposure for technicians decreased by 35%. Pulsed progressive fluoroscopy is effective for reducing radiation exposure to catheterization laboratory physicians and technical staff.

  10. Impact of patient characteristics, complications, and facility volume on the costs and time of cardiac catheterization and coronary angioplasty in 70 catheterization laboratories

    Microsoft Academic Search

    David J Cohen; Edmund R Becker; Steven D Culler; Stephen Ellis; LuAnn M Green; Robert N Schnitzler; April W Simon; William S Weintraub

    2000-01-01

    Although over 1 million procedures are performed in cardiac catheterization laboratories (CCLs) annually, little comparative data exist on costs or resource use in these settings. In this study, data from 70 CCLs were used to profile CCL times and total direct costs for 2 high-volume procedures: left heart catheterization (LHC) and percutaneous transluminal coronary angioplasty (PTCA) with or without stent

  11. Cholesterol emboli syndrome--a rare complication of cardiac catheterization.

    PubMed

    Shaikh, Ayaz Hussain; Hanif, Bashir; Hasan, Khursheed; Malik, Faiza

    2010-06-01

    We are reporting the case of a 57 years old male, hypertensive, diabetic, dyslipidaemic who presented with exertional angina. He had a coronary artery bypass surgery, one year ago. He underwent left heart catheterization with graft study which showed critical native triple vessel disease with patent arterial graft to left anterior descending and occluded venous grafts to obtuse marginal and right coronary artery. The procedure was complicated by catheter induced dissection of the ascending aorta. Three days later he developed cholesterol emboli syndrome, that was treated symptomatically. PMID:20527652

  12. Uncertainty and sensitivity analysis techniques as tools for the quality assessment of composite indicators

    Microsoft Academic Search

    M. Saisana; A. Saltelli; S. Tarantola

    2005-01-01

    Composite indicators are increasingly used for bench-marking countries' performances. Yet doubts are often raised about the robustness of the resulting countries' rankings and about the significance of the associated policy message. We propose the use of uncertainty analysis and sensitivity analysis to gain useful insights during the process of building composite indicators, including a contribution to the indicators' definition of

  13. Stents in paediatric and adult congenital interventional cardiac catheterization.

    PubMed

    Hascoët, Sebastien; Baruteau, Alban; Jalal, Zakaria; Mauri, Lucia; Acar, Philippe; Elbaz, Meyer; Boudjemline, Younes; Fraisse, Alain

    2014-01-01

    A 'stent' is a tubular meshed endoprosthesis that has contributed to the development of interventional catheterization over the past 30 years. In congenital heart diseases, stents have offered new solutions to the treatment of congenital vessel stenosis or postsurgical lesions, to maintain or close shunt patency, and to allow transcatheter valve replacement. First, stents were made of bare metal. Then, stent frameworks evolved to achieve a better compromise between radial strength and flexibility. However, almost all stents used currently in children have not been approved for vascular lesions in children and are therefore used 'off-label'. Furthermore, the inability of stents to follow natural vessel growth still limits their use in low-weight children and infants. Recently, bioresorbable stents have been manufactured and may overcome this issue; they are made from materials that may dissolve or be absorbed in the body. In this review, we aim to describe the history of stent development, the technical characteristics of stents used currently, the clinical applications and results, and the latest technological developments and perspectives in paediatric and adult congenital cardiac catheterization. PMID:25128078

  14. Intermittent Self-Catheterization by Quadriplegic Patients Via a Catheterizable Mitrofanoff Channel

    Microsoft Academic Search

    James A. Sylora; Ricardo Gonzalez; Mary Vaughn; Yuri Reinberg

    1997-01-01

    PurposeNeurogenic bladder due to cervical spinal cord injury is often best managed by clean intermittent catheterization. Limited upper extremity function makes patients with quadriplegia dependent on caregivers for clean intermittent catheterization. The Mitrofanoff umbilical appendicovesicostomy provides easy access to the bladder in patients with all types of access difficulty. We evaluated the Mitrofanoff umbilical appendicovesicostomy in 7 patients with quadriplegia.

  15. Urinary Catheterization May Not Adversely Impact Quality of Life in Multiple Sclerosis Patients

    PubMed Central

    Frasure, Heidi E.; Mahajan, Sangeeta T.

    2014-01-01

    Background. Multiple sclerosis (MS) healthcare providers (HCP) have undergone considerable educational efforts regarding the importance of evaluating and treating pelvic floor disorders, specifically, urinary dysfunction. However, limited data are available to determine the impact of catheterization on patient quality of life (QoL). Objectives. To describe the use of urinary catheterization among MS patients and determine the differences between those who report positive versus negative impact of this treatment on QoL. Methods. Patients were queried as part of the 2010 North American Research Committee On Multiple Sclerosis survey; topics included 1) urinary/bladder, bowel, or sexual problems; 2) current urine leakage; 3) current catheter use; 4) catheterizing and QoL. Results. Respondents with current urine leakage were 5143 (54.7%), of which 1201 reported current catheter use (12.8%). The types of catheters (intermittent self-catheterization and Foley catheter (indwelling and suprapubic)) did not differ significantly. Of the current catheter users, 304 (25.35%) respondents reported catheterization negatively impacting QoL, 629 (52.4%) reported a positive impact on QoL, and 223 (18.6%) reported neutral QoL. Conclusions. A large proportion of catheterized MS patients report negative or positive changes in QoL associated with urinary catheterization. Urinary catheterization does not appear to have a universally negative impact on patient QoL. PMID:25006498

  16. Pulmonary hypertension in sickle cell disease: cardiac catheterization results and survival

    Microsoft Academic Search

    Oswaldo Castro; Mohammed Hoque; Bernice D. Brown

    2002-01-01

    Few results on cardiac catheterization have been published for patients with sickle cell disease (SCD) with pulmonary hypertension (PHTN). Their survival once this complication develops is unknown. We analyzed hemodynamic data in 34 adult patients with SCD at right-sided cardiac catheterization and determined the relationship of PHTN to patient sur- vival. In 20 patients with PHTN the aver- age systolic,

  17. Diagnostic pediatric cardiac catheterization: Experience of a tertiary care pediatric cardiac centre

    PubMed Central

    Kumar, Prabhat; Joshi, Vidya Sagar; Madhu, P.V.

    2013-01-01

    Background Cardiac catheterization was considered gold standard for confirmation of diagnosis and analyzing various management issues in congenital heart diseases. In spite of development of various non invasive tools for investigation of cardiac disorders diagnostic catheterization still holds an important place in pediatric patients. Methods 300 consecutive diagnostic cardiac catheterization performed since April 2007 were included in this study. The study was undertaken to evaluate the profile of patients undergoing diagnostic cardiac catheterization, its results, assess its safety and its contribution toward solving various management issues. Result & Conclusion Children who underwent cardiac catheterization ranged in weight from 1.6 kg to 35 kg, with their age range 0 day–12 years. The information obtained was of great importance for further management in over 90% cases. The procedure of cardiac cath is invasive, still it was proved to be quite safe even in smallest baby. PMID:24623940

  18. Clinical experiences with cartilage repair techniques: outcomes, indications, contraindications and rehabilitation.

    PubMed

    Berta, Á; Duska, Zsofia; Tóth, Ferenc; Hangody, Laszlo

    2015-08-01

    Untreated articular cartilage defects may lead to chronic joint degeneration and functional disability. In the past decade, several cartilage repair techniques have emerged for the treatment of cartilage lesions. Among these techniques, mosaicplasty was introduced by the senior author into the clinical practice in 1992. This article does not intend to give a review or a comparison of currently existing surgical techniques which aim to repair symptomatic focal defects; however, it focuses on the procedures used in the everyday practice in the authors' institute, namely microfracture, mosaicplasty, autologous chondrocyte implantation (ACI), osteochondral allograft transplantation and biodegradable osteochondral scaffolds. It gives a brief summary of these well-described techniques, summarizes the authors' clinical experience and available data on the clinical outcome, and the rehabilitation protocol following different procedures, with a special emphasis on mosaicplasty. PMID:26165712

  19. Tubal sterilization by selective catheterization in an animal model.

    PubMed

    Maubon, A; Rouanet, J P; Laurent, A; Joujoux, J M; Cover, S; Courtieu, C; Wassef, M; Godlewski, G; Honiger, J; Lopez, F M

    1994-02-01

    Unilateral selective salpingography was performed in 3 groups of 6 rabbits. 4-6 month old, virgin New Zealand White female rabbits were used with a mean weight of 4.4 kg. The fallopian tubes were embolized with ethanol (group 1); a viscous radiopaque solution which solidifies rapidly after injection to produce a biocompatible and inert hydrogel (group 2); or an occluding emulsion (a radiopaque heterogeneous alcoholic solution of zein, poppy seed oil, propylene glycol, and sodium amidotrizoate from Ethibloc, Laboratoire Princeps, Neuilly sur Seine, France) (group 3). Animals were killed 2 days or 30 days after the procedure, according to randomization; and tubal patency and histologic modifications were evaluated. Selective tubal catheterization was possible in all 18 cases, in 12 cases on the right side (66%), in 6 cases on the left side (33%); in 11 cases with a 5F catheter (61%), in 7 cases with a 2.5F catheter (39%). In group 1, no satisfactory occlusion was obtained; in group 2, 65% of the tubes were occluded with little histologic damage; and in group 3, 80% of the tubes were occluded, but significant inflammation and tissue necrosis were noted. The fallopian tubes were selectively catheterized over variable lengths: over 10 mm in 5 rabbits (28%), between 5 and 10 mm in 4 rabbits (22%), and between 1 and 5 mm in 9 rabbits (50%). Before injection of the occluding materials, all the catheterized tubes were patent. Mean volume of occluding material injected was 0.36 mL in group 1, 0.30 mL in group 2, and 0.83 mL in group 3. The ethanol injected reached the peritoneum in all 6 rabbits. The gel was injected an average length of 11 mm in the tube, while the emulsion opacified all the volume of the tubes with a peritoneal spill of emulsion in 3 of 6 cases. Reflux of occluding material into the uterus was noted in 1 of 6 rabbits in group 1, in 4 of 6 rabbits in group 2, in 3 of 6 rabbits in group 3. Selective salpingography proved a suitable method and allowed selective injection of occluding materials. PMID:8169090

  20. Incidence and Risk Factors of Cerebrovascular Events Following Cardiac Catheterization

    PubMed Central

    Korn?Lubetzki, Isabelle; Farkash, Rivka; Pachino, Rachel M.; Almagor, Yaron; Tzivoni, Dan; Meerkin, David

    2013-01-01

    Background One of the most daunting complications of cardiac catheterization is a cerebrovascular event (CVE). We aimed to assess the real?life incidence, etiology, and risk factors of cardiac catheterization?related acute CVEs in a large cohort of patients treated in a single center. Methods and Results We undertook a retrospective analysis of 43 350 coronary procedures performed on 30 907 procedure days over the period 1992?2011 and compared patient and procedural characteristics of procedures complicated by CVEs with the remaining cohort. CVEs occurred in 47 cases: 43 were ischemic, 3 intracerebral hemorrhages, and 1 undetermined. The overall CVE rate was 0.15%, with percutaneous coronary intervention (PCI) and diagnostic coronary angiography rates 0.23% and 0.09%, respectively. Using a forward stepwise multivariate logistic regression model including patient demographic and procedural characteristics, a total of 5 significant predictors were defined: prior stroke (OR=15.09, 95% CI [8.11 to 28.08], P<0.0001), presence of coronary arterial thrombus (OR=2.79, 95% CI [1.25 to 6.22], P=0.012), age >75 years (OR=3.33, 95% CI [1.79 to 6.19], P<0.0001), triple vessel disease (OR=2.24, 95% CI [1.20 to 4.18], P=0.011), and performance of intervention (OR=2.21, 95% CI [1.12 to 4.33], P=0.021). An additional analysis excluded any temporal change of CVE rates but demonstrated a significant increase of all high?risk patient features. Conclusion In a single?center, retrospective assessment over nearly 20 years, cardiac catheterization?related CVEs were very rare and nearly exclusively ischemic. The independent predictors for these events were found to be the performance of an intervention and those associated with increased atherosclerotic burden, specifically older age, triple vessel disease, and prior stroke. The presence of intracoronary thrombus appears also to raise the risk of procedure?related CVE. PMID:24231658

  1. Residents learning ultrasound-guided catheterization are not sufficiently skilled to use landmarks

    PubMed Central

    2014-01-01

    Introduction Ultrasound-guided (UG) technique is the recommended procedure for central venous catheterization (CVC). However, as ultrasound may not be available in emergency situations, guidelines also propose that physicians remain skilled in landmark (LM) placement. We conducted this prospective observational study to determine the learning curve of the LM technique in residents only learning the UG technique. Methods During the first three months of their rotation in our ICU, residents inexperienced in CVC used only the real-time UG technique. During the following three months, residents were allowed to place CVC by means of the LM technique when authorized by the attending physician. Results A total of 172 procedures (84 UG and 88 LM) were performed by the inexperienced residents during the study. The success rate was lower (72% versus 84%; P?=?0.05) and the complication rate was higher (22% versus 10%; P?=?0.04) for LM compared to UG procedures. Comparison between the five last UG procedures and the first five LM procedures performed demonstrated that the transition between the two techniques was associated with a marked decrease of the success rate (65% versus 93%; P?=?0.01) and an increase of the complication rate (33% versus 8%; P?=?0.01). After 10 LM procedures, residents achieved a success rate and a complication rate of 81% and 6%, respectively. Conclusions Residents who only learn the UG technique will not be immediately able to perform the LM technique, but require specific training based on at least 10 LM procedures. The question of whether or not the LM technique should still be taught when an ultrasound device is not available must therefore be addressed. PMID:24559179

  2. Radiation safety program for the cardiac catheterization laboratory.

    PubMed

    Chambers, Charles E; Fetterly, Kenneth A; Holzer, Ralf; Lin, Pei-Jan Paul; Blankenship, James C; Balter, Stephen; Laskey, Warren K

    2011-03-01

    The Society of Cardiovascular Angiography and Interventions present a practical approach to assist cardiac catheterization laboratories in establishing a radiation safety program. The importance of this program is emphasized by the appropriate concerns for the increasing use of ionizing radiation in medical imaging, and its potential adverse effects. An overview of the assessment of radiation dose is provided with a review of basic terminology for dose management. The components of a radiation safety program include essential personnel, radiation monitoring, protective shielding, imaging equipment, and training/education. A procedure based review of radiation dose management is described including pre-procedure, procedure and post-procedure best practice recommendations. Specific radiation safety considerations are discussed including women and fluoroscopic procedures as well as patients with congenital and structural heart disease. PMID:21254324

  3. COMPLEMENTARY IMAGING OF GRANULAR CoAg FILMS WITH MAGNETOOPTICAL INDICATOR FILM TECHNIQUE AND MAGNETIC

    E-print Network

    Donahue, Michael J.

    of the magnetization processes of magnetic Co90Ag10 granular films. It is shown that the magnetization reversal characterization of magnetic multilayered and clustered systems is of great interest [3--6]. In this paper we granular films. The MOIF technique was initially developed for investigation of magnetization processes

  4. HYPERSPECTRAL TECHNIQUE AS AN INDICATOR OF EUTROPHICATION AND SEDIMENT LOAD FOR DEEP RIVERS

    EPA Science Inventory

    Remote sensing techniques were used to characterize and quantify spatial and temporal variation in water quality of the Great Miami River in Ohio. An initial feasibility study was conducted in the summer of 1999 using a non-imaging hand-held spectroradiometer to ascertain the pre...

  5. Autologous and Alloplastic Breast Reconstruction – Overview of Techniques, Indications and Results

    Microsoft Academic Search

    Mahdi Rezai; Maren Darsow; Sherko Kümmel; Stefan Krämer

    2008-01-01

    It is important for any woman undergoing mastectomy to make an informed decision about reconstruction and to be provided with information about the technique, advantages and disadvantages. There is a high degree of patient satisfaction with breast reconstruction, but high levels of preoperative information and psychological support are necessary. Close collaboration between oncological and reconstructive surgeons or management by an

  6. INDICATOR OF EUTROPHICATION AND SEDIMENT LOAD: HYPERSPECTRAL TECHNIQUE FOR CONTINUOUS COVERAGE OF DEEP RIVERS

    EPA Science Inventory

    Remote sensing techniques were used to characterize and quantify spatial and temporal variation in water quality of the Great Miami River in Ohio. An initial feasibility study was conducted in the summer of 1999 using a non-imaging hand-held spectroradiometer to ascertain the pr...

  7. Log-Linear Techniques for the Analysis of Categorical Data: A Demonstration with the Myers-Briggs Type Indicator.

    ERIC Educational Resources Information Center

    Salter, Daniel W.

    2003-01-01

    Log-linear analysis (LLA) techniques for categorical variables are demonstrated and evaluated using data from the Myers-Briggs Type Indicator. Symmetrical LLA and asymmetrical LLA address questions of association and inference, respectively. Configural frequency analysis is examined as a strategy for whole types research. LLA approaches seem…

  8. Indication and Technique of Transnasal Microscopic Orbital Decompression for Endocrine Ophthalmopathy

    Microsoft Academic Search

    A. May; U. Fries; C. von Ilberg; A. Weber

    2000-01-01

    If endocrine ophthalmopathy progresses despite conservative treatment then indications for surgical decompression are: loss of visual acuity, increasing strabism, and severe keratopathy. Endonasal microsurgery ensures a binocular view onto the intranasal landmarks of the orbital walls and allows simultaneous decompression of the medial and inferior wall as well as a good relief of pressure at the orbital apex. Surgical decompressions

  9. IMMUNOLOGICAL AND BIOSENSOR TECHNIQUES FOR DETECTING NON-MICROBIAL INDICATORS OF HUMAN FECAL POLLUTION

    EPA Science Inventory

    Limitations exist in applying the conventional microbial methods to the detection of human fecal contamination in water. Recently, there has been an increased interest in developing supplemental and/or alternate indicators of human contamination to better define water quality an...

  10. Performance of central venous catheterization by medical students: a retrospective study of students’ logbooks

    PubMed Central

    2014-01-01

    Background Medical students often learn the skills necessary to perform a central venous catheterization in the operating room after simulator training. We examined the performance of central venous catheterization by medical students from the logbooks during their rotation in department of anesthesiology. Methods From the logbooks of medical students rotating in our department between January 2011 and June 2012, we obtained the kind and the number of central venous catheterization students had done, the results of the procedures whether they were success or failed, the reasons of the failures, complications, and the student self-reported confidence and satisfaction of their performance. Results There were 93 medical students performed 875 central venous catheterizations with landmark guidance on patients in the operating theater, and the mean number of catheterizations performed per student was 9.4?±?2.0, with a success rate of 67.3%. Adjusted for age, sex, body mass index, surgical category, ASA score and insertion site, the odds of successful catherization improved with cumulative practice (odds ratio 1.10 per additional central venous catheterization performed; 95% confidence interval 1.05–1.15). The major challenge students encountered during the procedure was the difficulty of finding the central veins, which led to 185 catheterizations failed. The complication rate of central venous catheterization by the students was 7.8%, while the most common complication was puncture of artery. The satisfaction and confidence of students regarding their performance increased with each additional procedure and decreased significantly if failure or complications had occurred. Conclusion A student logbook is a useful tool for recording the actual procedural performance of students. From the logbooks, we could see the students’ performance, challenges, satisfaction and confidence of central venous catheterization were improved through cumulative clinical practice of the procedure. PMID:25123826

  11. [Eyelid approach and pediatric orbital tumors: indications and surgical technique. About three children].

    PubMed

    Marandat, S; Geronimo, M; Pech-Gourg, G; Degardin, N; Lena, G; Scavarda, D

    2012-08-01

    Interdisciplinary collaboration can offer unusual approaches for the treatment of orbital pathologies. The authors report their experience with the eyelid incision in treating three children with epidural orbitary hematoma, dermoid cyst of the upper outer quadrant and a dermoid cyst of the internal inferior quadrant. For all the children, removal was complete and cosmetic results satisfying. The authors discuss the indications and complications of this surgical approach. PMID:22425582

  12. Have advances in extracorporeal removal techniques changed the indications for their use in poisonings?

    PubMed

    Garlich, Fiona M; Goldfarb, David S

    2011-05-01

    During the past 25 years, numerous changes have taken place in the use of hemodialysis as a therapeutic modality. Advances in technologies and a progression in our collective understanding of the pharmacokinetics of certain xenobiotics have resulted in alterations in the indications, effectiveness, and safety of hemodialysis. However, these changes have not necessarily been reflected in the current published data regarding treatment of intoxications. Reported clearance rates often reflect what was achievable in the 1970s and 1980s, and more recent reports are frequently lacking. Our goal in this review is to summarize the changes in hemodialysis and in other extracorporeal removal technologies and highlight the effects of these changes on the current indications for hemodialysis of the poisoned patient. Changes in dialysis performance that are reviewed in this article include the use of high-efficiency and high-flux dialysis membranes, improved hemodynamic stability because of ultrafiltration control, and the use of bicarbonate as a source of base. We review the indications for hemodialysis for removal of specific toxins, including vancomycin, methotrexate, carbamazepine, and valproic acid. PMID:21531323

  13. Supporting 64-bit global indices in Epetra and other Trilinos packages : techniques used and lessons learned.

    SciTech Connect

    Jhurani, Chetan; Austin, Travis M.; Heroux, Michael Allen; Willenbring, James Michael

    2013-06-01

    The Trilinos Project is an effort to facilitate the design, development, integration and ongoing support of mathematical software libraries within an object-oriented framework. It is intended for large-scale, complex multiphysics engineering and scientific applications [2, 4, 3]. Epetra is one of its basic packages. It provides serial and parallel linear algebra capabilities. Before Trilinos version 11.0, released in 2012, Epetra used the C++ int data-type for storing global and local indices for degrees of freedom (DOFs). Since int is typically 32-bit, this limited the largest problem size to be smaller than approximately two billion DOFs. This was true even if a distributed memory machine could handle larger problems. We have added optional support for C++ long long data-type, which is at least 64-bit wide, for global indices. To save memory, maintain the speed of memory-bound operations, and reduce further changes to the code, the local indices are still 32-bit. We document the changes required to achieve this feature and how the new functionality can be used. We also report on the lessons learned in modifying a mature and popular package from various perspectives - design goals, backward compatibility, engineering decisions, C++ language features, effects on existing users and other packages, and build integration.

  14. Free function muscle transfers for upper extremity reconstruction: a review of indications, techniques, and outcomes.

    PubMed

    Fischer, John P; Elliott, River M; Kozin, Scott H; Levin, L Scott

    2013-12-01

    Free functional muscle transfer (FFMT) replaces destroyed, denervated, or resected skeletal muscle units in the upper extremity with functioning skeletal muscle from other locations in the body. Common indications for FFMT include brachial plexus injuries, ischemic contracture, tumor resection, and extensive direct muscle trauma. Recent studies have focused on improving patient outcomes through refinements in muscle flap harvest and inset, donor nerve selection, and postoperative management. In this review, we assess and summarize the current literature on FFMT, with emphasis on etiopathogenesis, diagnosis, treatment, postoperative management, and clinical outcomes. PMID:24210720

  15. Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications

    PubMed Central

    Marquez, Yvette; Tuchman, Alexander; Zada, Gabriel

    2012-01-01

    Among multimodality treatments for acromegaly, the goals of surgical intervention are to balance maximal tumor resection while preserving normal pituitary function and maintaining patient safety. The resection of growth hormone-(GH-) secreting pituitary adenomas in the hands of experienced surgeons results in hormonal remission in 50–70% of patients. Acromegalic patients often have medical comorbidities and anatomical variations complicating anesthesia and surgical management. Despite these challenges, complications such as CSF leak or new hypopituitarism following surgery remain uncommon. Over the past decade, endoscopic approaches to pituitary tumors have improved visualization and facilitated identification of additional tumor using angled telescopes. Patients with persistent acromegaly following surgery require continued medical and/or radiation-based interventions. The adjunctive use of stereotactic radiosurgery offers hormonal remission in 40–50% of patients. In this article, the current preoperative evaluation, indications for surgery, surgical approaches, role of radiosurgery, complications, and remission criteria following operative resection of GH adenomas are reviewed. PMID:22518121

  16. Computational learning techniques for intraday FX trading using popular technical indicators.

    PubMed

    Dempster, M H; Payne, T W; Romahi, Y; Thompson, G P

    2001-01-01

    We consider strategies which use a collection of popular technical indicators as input and seek a profitable trading rule defined in terms of them. We consider two popular computational learning approaches, reinforcement learning and genetic programming, and compare them to a pair of simpler methods: the exact solution of an appropriate Markov decision problem, and a simple heuristic. We find that although all methods are able to generate significant in-sample and out-of-sample profits when transaction costs are zero, the genetic algorithm approach is superior for non-zero transaction costs, although none of the methods produce significant profits at realistic transaction costs. We also find that there is a substantial danger of overfitting if in-sample learning is not constrained. PMID:18249910

  17. Performance analysis of spatial interpolation techniques for daily precipitation amount and further precipitation indices for a data sparse region

    NASA Astrophysics Data System (ADS)

    Bliefernicht, Jan; Laux, Patrick; Waongo, Moussa; Annor, Thompson; Harald, Kunstmann

    2014-05-01

    Many hydrological applications need precipitation information at locations where measurements are often not available. To overcome this basic problem, the simplest way is to use spatial interpolation techniques for transferring the information from measurement sites to a location of interest. Since the performance of a spatial interpolation technique strongly depends on the availability of measurements, the technique might fail for a data sparse region. To address this question in more detail, we analyze the performance of various interpolation techniques ranging from a nearest neighbor approach to more sophisticated kriging techniques for the Volta basin in West Africa. This study region is characterized by a low station density, precipitation time series with long data gaps and less reliable measurements, high precipitation variability on different spatiotemporal scales and a strong demand of reliable techniques for providing spatially distributed precipitation data sets in a fine resolution. The target variables are the annual, monthly and daily precipitation amount and further daily precipitation indices e.g. the precipitation probability and transition probabilities. An interpolation of the latter variables is of interest e.g. as input information for a stochastic generation of daily precipitation time series at arbitrary (e.g. gridded) locations. The database is an archive of daily observations ranging from 1970 and 2010 collected at more than 200 sites. This precipitation archive is probably the most comprehensive data set with daily measurements for this region. The performance of the interpolation technique is determined based on a leave-one out cross-validation using sophisticated performance measures such as the linear error in probability space. The target variables are interpolated on a regular grid with a resolution of 5 km covering the Volta basin to provide this information for subsequent studies in this region. The outcomes of this study indicate that the selected kriging techniques slightly outperform the other techniques in many situations and seem to provide valuable information for many sites. However, the performance of an interpolation technique strongly depends on the spatial variability of the interpolation variable and is therefore low for an interpolation of the daily precipitation amount. In future, the gridded precipitation data sets are transferred to an online database to provide this information for hydrological and non-hydrological studies.

  18. Primary hyperparathyroidism in a child. Use of jugular venous catheterization in diagnosis.

    PubMed Central

    Gluckman, P D; Ferguson, R S; Osborne, D; Evans, M

    1977-01-01

    A 10-year-old boy with a parathyroid ademona is reported. Parathyroid hormone estimations of samples obtained by selective jugular venous catheterization were useful in diagnosis and for localizing the tumour before operation. PMID:879837

  19. Primary hyperparathyroidism in a child. Use of jugular venous catheterization in diagnosis.

    PubMed

    Gluckman, P D; Ferguson, R S; Osborne, D; Evans, M

    1977-06-01

    A 10-year-old boy with a parathyroid ademona is reported. Parathyroid hormone estimations of samples obtained by selective jugular venous catheterization were useful in diagnosis and for localizing the tumour before operation. PMID:879837

  20. The effects of music intervention on anxiety in the patient waiting for cardiac catheterization

    Microsoft Academic Search

    Wallace J. Hamel

    2001-01-01

    Background: Hospitalization causes anxiety for many patients. It increases when patients anticipate their turn for cardiac catheterization. Music therapy reduces the psychophysiologic effects of anxiety and stress through the relaxation response.Aim: To determine the effects of music therapy an anxiety, heart rate and arterial blood pressure in patients waiting for their scheduled cardiac catheterization.Methods: In a quasi-experimental, pretest-posttest design, 101

  1. Pharmacotherapy in the cardiac catheterization laboratory: evolution and recent developments

    PubMed Central

    Thind, Guramrinder S; Parida, Raunak; Gupta, Nishant

    2014-01-01

    Many recent innovations have been made in developing new antiplatelet and anticoagulant drugs in the last few years, with a total of nine new antithrombotic drugs approved by the Food and Drug Administration after the year 2000. This has revolutionized the medical therapy given to manage acute coronary syndrome and support cardiac catheterization. The concept of dual antiplatelet therapy has been emphasized, and clopidogrel has emerged as the most-popular second antiplatelet drug after aspirin. Newer P2Y12 inhibitors like prasugrel and ticagrelor have been extensively studied and compared to clopidogrel. The role of glycoprotein (Gp) IIb/IIIa inhibitors is being redefined. Other alternatives to unfractionated heparin have become available, of which enoxaparin and bivalirudin have been studied the most. Apart from these, many more drugs with novel therapeutic targets are being studied and are currently under development. In this review, current evidence on these drugs is presented and analyzed in a way that would facilitate decision making for the clinician. For this analysis, various high-impact clinical trials, pharmacological studies, meta-analyses, and reviews were accessed through the MEDLINE database. Adopting a unique interdisciplinary approach, an attempt has been made to integrate pharmacological and clinical evidence to better understand and appreciate the pros and cons of each of these classes of drugs. PMID:25364258

  2. Left atrial appendage closure-indications, techniques, and outcomes: results of the European Heart Rhythm Association Survey.

    PubMed

    Pison, Laurent; Potpara, Tatjana S; Chen, Jian; Larsen, Torben B; Bongiorni, Maria Grazia; Blomström-Lundqvist, Carina

    2015-04-01

    The purpose of this EP Wire was to assess the indications, techniques, and outcomes of left atrial appendage occlusion (LAAO) in Europe. Thirty-three European centres, all members of the European Heart Rhythm Association electrophysiology (EP) research network, responded to this survey by completing the questionnaire. The major indication for LAAO (94%) was the prevention of stroke in patients at high thrombo-embolic risk (CHA2DS2-VASc ? 2) and contraindications to oral anticoagulants (OACs). Twenty-one (64%) of the responding centres perform LAAO in their own institution and 80% implanted 30 or less LAAO devices in 2014. Two-dimensional transoesophageal echocardiography was the preferred imaging technique to visualize LAA before, during, and after LAAO in 79, 58, and 62% of the participating centres, respectively. Following LAAO, 49% of the centres prescribe vitamin K antagonists or novel OACs. Twenty-five per cent of the centres combine LAAO with pulmonary vein isolation. The periprocedural complications included death (range, 0-3%), ischaemic or haemorrhagic stroke (0-25%), tamponade (0-25%), and device embolization (0-20%). In conclusion, this EP Wire has demonstrated that LAAO is most commonly employed in patients at high thrombo-embolic risk in whom OAC is contraindicated. The technique is not yet very widespread and the complication rates remain significant. PMID:25833883

  3. A peculiar complication of suprapubic catheterization: Recurrent ureteral obstruction and hydronephrosis

    PubMed Central

    Adeyemo, Bamidele; Makovitch, Steven; Foo, Dominic

    2013-01-01

    Context Suprapubic cystostomy (SPC) catheterization is a common and important technique for the management of vesicular drainage, especially in patients with neurogenic bladder. Some serious complications include bowel perforation and obstruction. Findings A 55-year-old man with C6 American Spinal Injury Association B tetraplegia and a urethral stricture requiring a chronic SPC was admitted for recurrent urosepsis. Computed tomography (CT) of the abdomen revealed severe right hydronephrosis and hydroureter due to obstruction of the right distal ureter by the SPC tip. The SPC (30 French/10-mm silicone catheter with a 10-ml balloon) was removed and replaced with a similar suprapubic catheter (30 French/10-mm silicone catheter with an 8-ml balloon). Symptoms recurred 2 months later and he was readmitted for urosepsis. CT of the abdomen again revealed severe right hydronephrosis and hydroureter due to obstruction of the right distal ureter by the SPC tip. The SPC was removed, and the patient was given a 14 French/4.67-mm urethral silicone catheter with a 5-ml balloon. Follow-up CT of the abdomen 2 months later showed complete resolution of the hydronephrosis and hydroureter. Of note, urodynamic studies 2 years earlier revealed an extremely small bladder with a capacity less than 20 ml. Conclusion This case illustrates that obstruction of the ureter by the tip of an SPC can be a cause of recurrent hydronephrosis and urosepsis. PMID:23809534

  4. Ultrasound-guided supraclavicular central venous catheterization in patients with malignant hematologic diseases.

    PubMed

    Yamauchi, Masanori; Sasaki, Hideaki; Yoshida, Tsukasa; Niiya, Tomohisa; Mizuno, Eri; Narimatsu, Eichi; Yamakage, Michiaki

    2012-10-01

    We present two cases of central venous catheterization (CVC) in which an ultrasound-guided in-plane approach was used. Case 1 was a 60-year-old man with acute myelogenous leukemia in whom a right supraclavicular CVC was performed. He had pancytopenia (leukocytes 2,000/?L; erythrocytes 350 × 10(4)/?L; platelets 5.6 × 10(4)/?L), and abnormal coagulability (prothrombin time-international normalized ratio 1.35). A linear array transducer was positioned cephalad to the right clavicle and rotated 30° clockwise. The 21-gauge needle was manipulated from outside of the transducer. A CV catheter (CV legaforce EX(®); Terumo Co., Japan) was placed and stitched near the right clavicle. The patient felt no discomfort caused by the catheter. Case 2 was a 64-year-old women with malignant lymphoma whose right internal jugular vein was surrounded by abnormally enlarged lymph nodes. CVC was performed by the in-plane supraclavicular approach, avoiding puncture of the lymph node. This novel CVC technique is useful to minimize the risk of complications and patient discomfort by indwelling catheter. PMID:22547165

  5. Developing a visualized patient-centered, flow-based and objective-oriented care path of cardiac catheterization examination.

    PubMed

    Kuo, Ming Chuan; Chang, Polun

    2009-01-01

    It has been known that visualization is a user-preferred and more meaningful interface of information systems. To reduce the anxiety and uncertainty of patients, we transformed the sophisticated process of cardiac catheterization into visualized information. The Microsoft Visio 2003 and Excel 2003 with the VBA automation tool were used to design a process flow of Cardiac Catheterization. The results show the technical feasibility and potentials helpful for patient to realize the nursing process of cardiac catheterization. PMID:19593031

  6. Comparison of Ultrasonography-Guided Central Venous Catheterization Between Adult and Pediatric Populations

    SciTech Connect

    Tercan, Fahri [Baskent Universitesi, Adana Arastirma ve Uygulama Merkezi (Turkey)], E-mail: ftercan@yahoo.com; Oguzkurt, Levent; Ozkan, Ugur [Baskent University Faculty of Medicine, Department of Radiology (Turkey); Eker, Hatice Evren [Baskent University Faculty of Medicine, Department of Anesthesiology (Turkey)

    2008-05-15

    The purpose of this study was to compare the technical success and complication rates of ultrasonography-guided central venous catheterization between adult and pediatric patients which have not been reported previously. In a 4-year period, 859 ultrasonography-guided central vein catheterizations in 688 adult patients and 247 catheterizations in 156 pediatric patients were retrospectively evaluated. Mean age was 56.3 years (range, 18 to 95 years) for adults and 3.3 years (range, 0.1 to 16.3 years) for children. The preferred catheterization site was internal jugular vein in 97% of adults and 85% of children. The technical success rate, mean number of punctures, and rate of single wall puncture were 99.4%, 1.04 (range, 1-3), and 83% for adults and 90.3%, 1.25 (range, 1-5), and 49% for children, respectively. All the differences were statistically significant (p < 0.05). Complication rates were 2.3% and 2.4% for adults and children, respectively (p > 0.05). Major complications such as pneumothorax and hemothorax were not seen in any group. In conclusion, ultrasonography-guided central venous catheterization has a high technical success rate, lower puncture attempt rate, and higher single wall puncture rate in adults compared to children. Complication rates are comparable in the two groups.

  7. Procedural costs of digital vs. analog archiving of diagnostic cardiac catheterizations.

    PubMed

    Oetgen, M E; New, G; Moussa, I; Balter, S; Collins, M; Iyer, S; Roubin, G; Colombo, A; Moses, J W

    2000-03-01

    The use of digital technology in the cardiac catheterization laboratory is expanding at a rapid pace. The cost-effectiveness of this new technology is yet to be proven. The aims of this study were to determine the direct cost differences of digital versus analog media (CDs) for the storage of diagnostic cardiac catheterizations and to explore the factors influencing these differences. Procedural costs of all diagnostic angiograms (n = 109), from three physicians, performed in an analog catheterization laboratory (room A) and a digital catheterization laboratory (room C) were compared during a 9-month period. The mean procedural cost was higher in room A than in room C ($1,102 vs. $1,087, P < 0.001). This cost difference was eliminated when recording media costs were excluded from analysis ($1,079 vs. $1,080, P = 0.931). Therefore, we conclude there is a procedural cost savings in a cardiac catheterization room that uses digital CDs versus cineangiogram film as the archival media. Cathet. Cardiovasc. Intervent. 49:246-250, 2000. PMID:10700050

  8. Reduction of femoral arterial bleeding post catheterization using percutaneous application of fibrin sealant.

    PubMed

    Ismail, S; Combs, M J; Goodman, N C; Teotia, S S; Teates, C D; Abbott, R D; Fechner, R E; Nolan, S P; Powers, E R; Spotnitz, W D

    1995-01-01

    The number of cardiac catheterizations performed yearly is growing with correspondingly increasing amounts of morbidity, complications, and hospital costs. This study suggests that fibrin sealant instillation via an arterial sheath at the completion of femoral catheterization may improve hemostasis. Results using fibrin sealant in 12 unheparinized dogs documented significant reductions (McNemar's exact test) versus control for groin ecchymoses (1 versus 8, P = .008) and radiolabeled hematoma formation (0 versus 7, P = .016). Also swelling was less in the fibrin sealant treated groins when compared to control groins (1 versus 6, P = .125), but failed to reach statistical significance. Results in eight heparinized dogs (activated clotting time 374 +/- 22, mean +/- SEM) revealed a statistically significant reduction in signs of gross bleeding in the fibrin sealant-treated groins (1 versus 8, P = .016). This method may contribute to reduced morbidity, complications, and length of hospitalization. It may also allow for earlier patient mobilization after cardiac catheterization. PMID:7728863

  9. Implementation of multivariate techniques for the selection of volatile compounds as indicators of sensory quality of raw beef.

    PubMed

    Saraiva, Cristina; Oliveira, I; Silva, J A; Martins, C; Ventanas, J; García, C

    2015-06-01

    This study was performed in order to select volatile compounds to predict the off-odour and overall assessment of raw beef's freshness Maronesa breed, using multivariate analysis. M. longissimus dorsi packed in vacuum and MAP (70 % O2/20 % CO2/10 % N2) stored at 4?ºC were examined for off-odour perception as well as the overall assessment of freshness at 10 and 21 days post mortem. The results achieved in this study demonstrated that the selected volatile compounds could be considered as volatile indicators of beef spoilage, enclosing information for discrimination of Maronesa beef samples in sensory classes of odour corresponding to unspoiled and spoiled levels. Fifty-four volatile compounds were detected. A significant increase of aldehydes, ketones and alcohols were observed during storage in MAP. 2 and 3-methylbutanal, 2 and 3-methylbutanol, 1-pentanol, 1-hexanol, 2,3-octanedione, 3,5-octanedione, octanal and nonanal were suggested as indicators of beef spoilage. 3-methylpentane was considered as a marker in the first stages of spoilage in beef, decreasing during storage. Data were examined using PCR and PLSR models for different optimal subsets of volatile compounds. The simplicity and usefulness of the technique in using 0/1 data in preserving high levels of accuracy was also prevalent. The powerful analytical methodologies for reducing variables and the choice of optimal subsets could be advantageous in both basic research and the routine quality control of chilled beef. PMID:26028774

  10. Resection and reconstruction of the carotid bifurcation with polytetrafluoroethylene grafts; operative technique. Preliminary results in 25 procedures and indications.

    PubMed

    Castellani, L; Benhamou, A C; Angel, F; Garces, D; al Kassar, T

    1991-01-01

    Although carotid endarterectomy is the standard procedure, the purpose of this paper is to describe a new surgical technique and indicate its role in the surgery of cervical cerebrovascular disease. The technique consists of resection of the pathologic carotid artery bifurcation followed by its total replacement with a bifurcated thin-wall polytetrafluoroethylene (PTFE) graft constructed by the surgeon. Prosthetic graft reconstruction of the carotid bifurcation (PGRCB) was performed in 21 patients (25 procedures) from November 1984 to May 1987. Many patients were over 70 years old. The indications for surgery were transient ischemic attacks (TIA)'s in 10 patients (high-grade stenosis), established stroke with mild deficit in 3 patients (high-grade stenosis). Eight patients (high-grade stenosis) were asymptomatic and 4 had vertebro-basilar symptoms. In 11 procedures the indications were the same as for standard carotid endarterectomy (significant stenosis and/or ulcerated plaque). In 14 cases, the procedure was justified by extensive lesions involving a long segment of the internal carotid artery (2 restenoses, 12 calcified lesions). In the perioperative period, there were no deaths and no TIA's. The 25 procedures were assessed one month postoperatively by ultrasonic imaging and venous substraction angiography. All the grafts were patent with perfect restoration of the carotid bifurcation anatomy. Systematic follow-up study was carried out in 1987. Three patients had died of non-neurologic causes and one was lost to study. The remaining 19 procedures were evaluated with an average follow-up of 19 months (range 7 to 32 months). The patients were asymptomatic and all the grafts remained patent including one stenosis (greater than 50%) at the common carotid artery anastomosis. Because recent studies have documented a much higher rate of technical defects or recurrent stenosis after carotid endarterectomy, we believe that PGRCB merits consideration, particularly in difficult endarterectomies, and in recurrent carotid stenosis. Furthermore it seems acceptable to advocate PGRCB in aneurysms of the internal carotid artery and in post-irradiation arteritis. PMID:1864868

  11. Can the Anesthesiologist Use the Radial Artery for Monitoring After Transradial Artery Catheterization?

    PubMed

    Awad, Hamdy; Quevedo, Eduardo; Abas, Motaz; Brown, Michelle; Satiani, Bhagwan; Capers, Quinn; Starr, Jean E

    2015-06-15

    The use of transradial coronary angiography and intervention is growing because of its advantages over the femoral approach. However, the small size of the radial artery can contribute to complications. We present a case of an in situ access complication of transradial coronary artery catheterization. It is important for the anesthesiologist to know about the short-term and long-term consequences of this intervention, which could lead to narrowing of the artery even beyond the site of puncture. Understanding these changes could help anesthesiologists make better decisions about using the radial artery for monitoring after transradial coronary artery catheterization procedures. PMID:26050247

  12. Determining geographic areas and populations with timely access to cardiac catheterization facilities for acute myocardial infarction care in Alberta, Canada

    Microsoft Academic Search

    Alka B Patel; Nigel M Waters; William A Ghali

    2007-01-01

    BACKGROUND: This study uses geographic information systems (GIS) as a tool to evaluate and visualize the general accessibility of areas within the province of Alberta (Canada) to cardiac catheterization facilities. Current American and European guidelines suggest performing catheterization within 90 minutes of the first medical contact. For this reason, this study evaluates the populated places that are within a 90

  13. [Long-term catheterization of the central venous system in children].

    PubMed

    Spatenka, J; Smelhaus, V; Spicáková, V; Janda, J; Cerný, K; Starý, J; Lochman, O; Hon?k, T

    1990-08-01

    The authors explain the principle of central venous catheters (CVC) for long-term use, indicators for insertion, mode of insertion and principles of care of children with these special CVC. The authors inserted since 1982 42 CVC of the Broviac-Hickmann type in 32 children (age 22 days--15 years; body weight 2.4-17 kg). Since 1987 they inserted 16 CVC for long-term use with a subcutaneous capsule to 16 children and adolescents (age 1 years-17 years; body weight 11.5-73.5 kg). These CVC were inserted under general anaesthesia, in catheterization theatre. There were no technical complications. The authors treated and followed under standard protocol a group of 14 children with 20 CVC of the Broviac type (age at onset of treatment 22-715 days; body weight 2.4-10 kg) as well as the above described group of 16 children and adolescents with CVC for long-term use with a subcutaneous capsule. During treatment of children with Broviac catheters five technical complications were observed (mechanical damage of the CVC); in children with CVC with a subcutaneous capsule one technical complication was recorded (damage of the chamber of the Chemoport Vygon system, by incorrect puncture). The authors searched for thromboembolic and infectious complications. In four of 20 children with Broviac catheters purulent phlebitis of the cannulated veins was found (all died)--one thromboembolic complication developed on average after 234 days of use of Broviac catheters.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2078871

  14. Role of cardiac catheterization and percutaneous coronary intervention in the preoperative assessment and management of patients before orthotopic liver transplantation.

    PubMed

    Maddur, Haripriya; Bourdillon, Patrick D; Liangpunsakul, Suthat; Joseph Tector, A; Fridell, Jonathan A; Ghabril, Marwan; Lacerda, Marco A; Bourdillon, Charlotte; Shen, Changyu; Kwo, Paul Y

    2014-06-01

    Limited data regarding the optimal risk assessment strategy for evaluating candidates for orthotopic liver transplantation (OLT) exist. Our center has adopted a policy of performing cardiac catheterization (CATH) in patients with predefined risk factors, and this is followed by percutaneous coronary intervention (PCI) when it is indicated, even in the presence of negative stress test findings. The aim of this single-center, retrospective study of all patients who underwent OLT between 2000 and 2010 was to assess the effect of our policy on cardiovascular (CV) complications and survival rates after OLT. Data, including 1-year all-cause and CV mortality, postoperative myocardial infarctions (MIs), and frequencies of CATH and PCI, were abstracted. The study was divided into 3 subperiods to reflect the changes in policy over this period: (A) 2000-2004, (B) 2005-2008, and (C) 2009-2010. One thousand two hundred twenty-one patients underwent OLT between 2000 and 2010. The rate of catheterization increased during the 3 time periods (P?

  15. Oral Ketamine\\/Midazolam Is Superior to Intramuscular Meperidine, Promethazine, and Chlorpromazine for Pediatric Cardiac Catheterization

    Microsoft Academic Search

    Steve M. Auden; Walter L. Sobczyk; Robert E. Solinger; L. Jane Goldsmith

    2000-01-01

    An IM combination of meperidine, promethazine, and chlorpromazine (DPT) has been given as sedation for pe- diatric procedures for more than 40 years. We compared this IM combination to oral (PO) ketamine\\/midazolam in children having cardiac catheterization. A total of 51 chil- dren, ages 9 mo to 10 yr, were enrolled and randomized in this double-blinded study. All children received

  16. Subclavian artery pseudoaneurysm: a rare and serious complication of central venous catheterization in an infant

    Microsoft Academic Search

    Esad Koklu; Hakan Poyrazoglu; Ali Yikilmaz; Mehmet Canpolat; Bahadir Konuskan

    2008-01-01

    Serious complications of central venous access occur in 0.4–9.9% of patients undergoing attempted central venepuncture. We\\u000a report an unusual case of an 18-month-old infant in whom a right subclavian artery pseudoaneurysm developed rapidly after\\u000a attempted subclavian vein catheterization without US guidance failed.

  17. Application of the Mitrofanoff principle for intermittent self-catheterization in quadriplegic patients

    Microsoft Academic Search

    Oliver W Hakenberg; Johann Ebermayer; Andreas Manseck; Manfred P Wirth

    2001-01-01

    Objectives. Patients with cervical spinal cord lesions have impaired hand function, which often prohibits clean intermittent self-catheterization (CIC), especially in female patients. Enabling these patients to perform CIC gives them control of their bladder management and can improve their quality of life considerably. We have used an appendicovesicostomy to provide easy access for CIC in such patients.Methods. Five patients (4

  18. Increasing accuracy and decreasing latency during clean intermittent self-catheterization procedures with young children.

    PubMed Central

    McComas, J J; Lalli, J S; Benavides, C

    1999-01-01

    We examined the effects of simulation training on performance of clean intermittent self-catheterization procedures with 2 young girls. Simulation training was conducted, after which independent performance was assessed within a multiple baseline design. The training resulted in increased accuracy and decreased latency for both girls. PMID:10396774

  19. Using a Robotic Arm for Echocardiography to X-ray Image Registration during Cardiac Catheterization

    E-print Network

    Boyer, Edmond

    Using a Robotic Arm for Echocardiography to X-ray Image Registration during Cardiac Catheterization C-arm, we are able to register the 3D echo images with live 2D X-ray images. In addition, we can fluoroscopic guidance. Pure X-ray guidance has a number of disadvantages. Firstly, X-ray images are two

  20. [Catheterization of the Eustachian tube in the combined treatment of exudative otitis].

    PubMed

    Magomedov, M M; Levina, Iu V; Nikitin, A Iu; Bardina, E A; Magomedov, G M; Ibragimov, Sh I; Maksimova, M A

    2013-01-01

    The objective of the present study was to determine the amount of a medicinal agent entering the tympanic cavity during catheterization of the Eustachian tube in 26 patients presenting with exudative otitis and admitted for its treatment to N.I. Pirogov Clinical Hospital No 1, Moscow. The patients were managed by combined therapy in conjunction with catheterization of the Eustachian tube using radiocontrast matter (the iodine containing (76%) preparation trazograf having viscosity identical with that of dexamethasone). The administration of trazograf was followed by multispiral CT of the temporal bones. It was shown that trazograf penetrated into the tympanic cavity during catheterization of the Eustachian tube and accumulated inside it in 19.2% and 77% of the cases respectively. This finding suggests that the therapeutic effect in the patients presenting with exudative otitis is due not only to the direct action of the pharmaceutical product being used on the site of inflammation but also to the restoration of the draining and aerating functions of the course of Eustachian tube catheterization. PMID:24429856

  1. MRI-Compatible Fiber-Optic Force Sensors for Catheterization Procedures

    Microsoft Academic Search

    Panagiotis Polygerinos; Dinusha Zbyszewski; Tobias Schaeffter; Reza Razavi; Lakmal D. Seneviratne; Kaspar Althoefer

    2010-01-01

    Cardiac catheterization is an interventional procedure that is usually carried out without the use of force sensors. During such procedures the physician mainly relies on visual feedback provided by an imaging modality, like X-ray fluoroscopy, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). Hence, the physician it is not always able to predict the forces between the catheter and blood

  2. Direct measurement of a patient's entrance skin dose during pediatric cardiac catheterization

    PubMed Central

    Sun, Lue; Mizuno, Yusuke; Iwamoto, Mari; Goto, Takahisa; Koguchi, Yasuhiro; Miyamoto, Yuka; Tsuboi, Koji; Chida, Koichi; Moritake, Takashi

    2014-01-01

    Children with complex congenital heart diseases often require repeated cardiac catheterization; however, children are more radiosensitive than adults. Therefore, radiation-induced carcinogenesis is an important consideration for children who undergo those procedures. We measured entrance skin doses (ESDs) using radio-photoluminescence dosimeter (RPLD) chips during cardiac catheterization for 15 pediatric patients (median age, 1.92 years; males, n = 9; females, n = 6) with cardiac diseases. Four RPLD chips were placed on the patient's posterior and right side of the chest. Correlations between maximum ESD and dose–area products (DAP), total number of frames, total fluoroscopic time, number of cine runs, cumulative dose at the interventional reference point (IRP), body weight, chest thickness, and height were analyzed. The maximum ESD was 80 ± 59 (mean ± standard deviation) mGy. Maximum ESD closely correlated with both DAP (r = 0.78) and cumulative dose at the IRP (r = 0.82). Maximum ESD for coiling and ballooning tended to be higher than that for ablation, balloon atrial septostomy, and diagnostic procedures. In conclusion, we directly measured ESD using RPLD chips and found that maximum ESD could be estimated in real-time using angiographic parameters, such as DAP and cumulative dose at the IRP. Children requiring repeated catheterizations would be exposed to high radiation levels throughout their lives, although treatment influences radiation dose. Therefore, the radiation dose associated with individual cardiac catheterizations should be analyzed, and the effects of radiation throughout the lives of such patients should be followed. PMID:24968708

  3. Acute embolic carotid occlusion after cardiac catheterization: effect of local intra-arterial urokinase thrombolysis.

    PubMed

    Sztajzel, J; Rüfenacht, D; Megret, M; Sztajzel, R; Burgan, S; Rutishauser, W

    1995-12-01

    A 64-year-old woman developed a severe embolic cerebral attack with total left hemiplegia approximately 30 hours after cardiac catheterization for mitral stenosis. She underwent intra-arterial thrombolysis of the right internal carotid artery four and one-half hours after the onset of neurologic deficit with subsequent recanalization of the occluded vessel and near complete neurologic recovery. PMID:10158381

  4. Infection control guidelines for the cardiac catheterization laboratory: Society guidelines revisited

    Microsoft Academic Search

    Charles E. Chambers; Michael D. Eisenhauer; Lynn B. McNicol; Peter C. Block; William J. Phillips; Gregory J. Dehmer; Frederick A. Heupler; James C. Blankenship

    2006-01-01

    In the early years of diagnostic cardiac catheterization, strict sterile precautions were required for cutdown procedures. Thirteen years ago, when the original guidelines were written, the brachial arteriotomy was still frequently utilized, femoral closure devi- ces were uncommon, ''implantables,'' such as intracoronary stents and PFO\\/ASD clo- sure devices, were in their infancy, and percutaneous valve replacement was not a consideration.

  5. Predictors of Mortality in Acute Respiratory Distress Syndrome Focus on the Role of Right Heart Catheterization

    Microsoft Academic Search

    ANTOINE VIEILLARD-BARON; EMMANUELLE GIROU; ELISABETH VALENTE; CHRISTIAN BRUN-BUISSON; FRANÇOIS JARDIN; FRANÇOIS LEMAIRE; LAURENT BROCHARD

    Right heart catheterization (RHC) has been suspected of increas- ing mortality. The acute respiratory distress syndrome (ARDS) is a frequent reason for RHC. We designed a retrospective cohort study of 119 consecutive ARDS patients admitted to two medical intensive care units of tertiary care hospitals in which two differ- ent approaches are used for hemodynamic monitoring: RHC on demand (Henri

  6. History of Right Heart Catheterization: 100 Years of Experimentation and Methodology Development

    PubMed Central

    Nossaman, Bobby D.; Scruggs, Brittni A.; Nossaman, Vaughn E.; Murthy, Subramanyam N.; Kadowitz, Philip J.

    2010-01-01

    The development of right heart catheterization has provided the clinician the ability to diagnose patients with congenital and acquired right heart disease, and to monitor patients in the ICU with significant cardiovascular illnesses. The development of bedside pulmonary artery catheterization has become a standard of care for the critically ill patient since its introduction into the ICU almost 40 years ago. However, adoption of this procedure into the mainstream of clinical practice occurred without prior evaluation or demonstration of its clinical or cost-effectiveness. Moreover, current randomized, controlled trials provide little evidence in support of the clinical utility of pulmonary artery catheterization in the management of critically ill patients. Nevertheless, the right heart catheter is an important diagnostic tool to assist the clinician in the diagnosis of congenital heart disease and acquired right heart disease, and moreover, when catheter placement is proximal to the right auricle (atria), this catheter provides an important and safe route for administration of fluids, medications, and parenteral nutrition. The purpose of this manuscript is to review the development of right heart catheterization that led to the ability to conduct physiologic studies in cardiovascular dynamics in normal individuals and in patients with cardiovascular diseases, and to review current controversies of the extension of the right heart catheter, the pulmonary artery catheter. PMID:20160536

  7. A multi-region assessment of population rates of cardiac catheterization and yield of high-risk coronary artery disease

    PubMed Central

    2011-01-01

    Background There is variation in cardiac catheterization utilization across jurisdictions. Previous work from Alberta, Canada, showed no evidence of a plateau in the yield of high-risk disease at cardiac catheterization rates as high as 600 per 100,000 population suggesting that the optimal rate is higher. This work aims 1) To determine if a previously demonstrated linear relationship between the yield of high-risk coronary disease and cardiac catheterization rates persists with contemporary data and 2) to explore whether the linear relationship exists in other jurisdictions. Methods Detailed clinical information on all patients undergoing cardiac catheterization in 3 Canadian provinces was available through the Alberta Provincial Project for Outcomes Assessment in Coronary Heart (APPROACH) disease and partner initiatives in British Columbia and Nova Scotia. Population rates of catheterization and high-risk coronary disease detection for each health region in these three provinces, and age-adjusted rates produced using direct standardization. A mixed effects regression analysis was performed to assess the relationship between catheterization rate and high-risk coronary disease detection. Results In the contemporary Alberta data, we found a linear relationship between the population catheterization rate and the high-risk yield. Although the yield was slightly less in time period 2 (2002-2006) than in time period 1(1995-2001), there was no statistical evidence of a plateau. The linear relationship between catheterization rate and high-risk yield was similarly demonstrated in British Columbia and Nova Scotia and appears to extend, without a plateau in yield, to rates over 800 procedures per 100,000 population. Conclusions Our study demonstrates a consistent finding, over time and across jurisdictions, of linearly increasing detection of high-risk CAD as population rates of cardiac catheterization increase. This internationally-relevant finding can inform country-level planning of invasive cardiac care services. PMID:22115358

  8. Impact of patient characteristics, complications, and facility volume on the costs and time of cardiac catheterization and coronary angioplasty in 70 catheterization laboratories.

    PubMed

    Cohen, D J; Becker, E R; Culler, S D; Ellis, S; Green, L M; Schnitzler, R N; Simon, A W; Weintraub, W S

    2000-09-15

    Although over 1 million procedures are performed in cardiac catheterization laboratories (CCLs) annually, little comparative data exist on costs or resource use in these settings. In this study, data from 70 CCLs were used to profile CCL times and total direct costs for 2 high-volume procedures: left heart catheterization (LHC) and percutaneous transluminal coronary angioplasty (PTCA) with or without stent placement. In total, 70,677 consecutive patient examinations for a 12-month period from January 1, 1998 to December 31, 1998 were analyzed. For LHC mean total direct costs averaged $306, whereas for PTCA catheterization laboratory costs averaged $3,172. The average total times for these procedures were 63 and 108 minutes, respectively. Seventy-two percent of the PTCA patients underwent coronary stenting with an associated incremental cost of $1,244. By multivariate linear regression, baseline patient characteristics such as age, gender, and clinical factors had little impact on total time and total costs. The major determinants of CCL time and cost were procedural factors (e.g., number and type of interventions) and in-lab complications, including profound hypotension, abrupt vessel closure, and emergency bypass surgery. Using facility procedure volume as a proxy for potential economies of scale, we found no relation between CCL volume and total direct CCL costs. There did appear to be a significant inverse relation between facility volume and total procedural time with CCLs that performed the highest volumes of LHC and PTCA procedures saving an average of 5 to 9 minutes per procedure. These findings may be useful in defining specific time and cost benchmarks for these commonly performed procedures and serve to underscore the critical role of reducing complications in both quality improvement and cost-saving efforts. PMID:10980207

  9. Differences in heart transplant physiology according to surgical technique

    Microsoft Academic Search

    Jesus Peteiro; Francisco Redondo; Ramon Calviño; Jose Cuenca; Gonzalo Pradas; Alfonso Castro Beiras

    1996-01-01

    A new cardiac transplantation technique that preserves the shape of the left atrium and leaves the right atrium intact has been introduced. To compare the new and the standard techniques, we studied cardiac physiology with Doppler echocardiography and catheterization in 26 patients who underwent operation with the standard technique (group A) and 11 who underwent operation with the new technique

  10. Comparison of silicone and polyurethane catheters for the catheterization of small vessels in mice.

    PubMed

    Teilmann, Anne Charlotte; Falkenberg, Malene Kari; Hau, Jann; Abelson, Klas Stig Peter

    2014-11-01

    Vascular catheterization is increasingly carried out in laboratory mice, but the long-term patency of catheters implanted in mice is limited owing to their small size. The authors compared mice that were catheterized in their right common carotid artery either with a silicone catheter with a polyurethane tip or with a 100% polyurethane catheter to determine which catheter type was better suited for long-term studies in mice. The catheters were inspected daily and were flushed if blood was visible in the catheters; if no blood was visible, they were flushed every 3 d. Silicone catheters were patent for a shorter period of time than polyurethane catheters, which were patent for a median of 6 d and up to 25 d. The authors identify the principal causes of catheter failure and discuss how they can be prevented. PMID:25333592

  11. Emergent cesarean section in the catheterization laboratory for spontaneous coronary artery dissection.

    PubMed

    Sundaram, Varun; Chaudhry, Sunit-Preet; Reddy, Yogesh N V; Longenecker, Chris T; Fang, James C

    2015-06-15

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome in pregnant women. Delay in the diagnosis might lead to substantial maternal and fetal morbidity and mortality. Although there have been reports of SCAD in pregnancy, to our knowledge, there have been no reports of maternal and fetal hemodynamic compromise related to SCAD leading to emergent delivery of fetus in the cardiac catheterization laboratory. PMID:25888300

  12. Pulse oximetry during cardiac catheterization in children with congenital heart disease

    Microsoft Academic Search

    Anne M. Lynn; Adrian Bosenberg

    1986-01-01

    One hundred and five children with congenital heart disease were monitored by pulse oximetry during cardiac catheterization.\\u000a Excellent correlation (r = 0.95) was found between oxygen saturation values obtained with pulse oximetry and those obtained\\u000a from arterial blood in 133 data pairs. This correlation was described by the regression equation y = 0.91 x + 8.1. The correlation\\u000a was also

  13. Argument identification for arterial branching predications asserted in cardiac catheterization reports.

    PubMed Central

    Rindflesch, T. C.; Bean, C. A.; Sneiderman, C. A.

    2000-01-01

    The language describing coronary vasculature provides a suitable paradigm for research in semantic interpretation of anatomical text. As a pilot project we investigate the possibility of highly accurate retrieval of arterial branching relationships asserted in cardiac catheterization reports. Our methodology relies on the cooperation of underspecified linguistic analysis and structured domain knowledge. The satisfactory results of formal evaluation on both a training and testing set support the promise of this approach. PMID:11079975

  14. Predictors of Conversion from Radial Into Femoral Access in Cardiac Catheterization

    PubMed Central

    Carvalho, Maria Salomé; Calé, Rita; Gonçalves, Pedro de Araújo; Vinhas, Hugo; Raposo, Luís; Teles, Rui; Martins, Cristina; Gabriel, Henrique Mesquita; Pereira, Helder; Almeida, Manuel

    2015-01-01

    Background Fewer bleeding complications and early ambulation make radial access a privileged route for cardiac catheterization. However, transradial (TR) approach is not always successful, requiring its conversion into femoral access. Objectives To evaluate the rate of conversion from radial into femoral access in cardiac catheterization and to identify its predictors. Methods Prospective dual-center registry, including 7632 consecutive patients undergoing catheterization via the radial access between Jan/2009 and Oct/2012. We evaluated the incidence of conversion into femoral access and its predictors by logistic regression analysis. Results The patients’ mean age was 66 ± 11 years, and 32% were women. A total of 2969 procedures (38.4%) were percutaneous coronary interventions (PCI), and the most used first intention arterial access was the right radial artery (97.6%). Radial access failure rate was 5.8%. Independent predictors of conversion from radial into femoral access were the use of short introducer sheaths (OR 3.047, CI: 2.380-3.902; p < 0.001), PCI (OR 1.729, CI: 1.375-2.173; p < 0.001), female sex (OR 1.569, CI: 1.234-1.996; p < 0.001), multivessel disease (OR 1.457, CI: 1.167-1.819; p = 0.001), body surface area (BSA) ? 1.938 (OR 1.448, CI: 1.120-1.871; p = 0.005) and age > 66 years (OR 1.354, CI: 1.088-1.684; p = 0.007). Conclusion Transradial approach for cardiac catheterization has a high success rate and the need for its conversion into femoral access in this cohort was low. Female sex, older age, smaller BSA, the use of short introducer sheaths, multivessel disease and PCI were independent predictors of conversion into femoral access. PMID:25789883

  15. Modeling and simulation of right ventricular volume measurement system during right heart catheterization

    Microsoft Academic Search

    Petros Toumpaniaris; Ilias Skalkidis; Ioannis Nikolakopoulos; Nikolaos Kelekis; Gerasimos Filippatos; Dimitrios Koutsouris

    Haemodynamic monitoring is necessary for the effective management of critically ill cardiac patients. Pulmonary artery catheterization\\u000a has been used for monitoring the circulation, for measurement of intracardiac pressures and to estimate preload and afterload.\\u000a However, pressures may not be accurate reflection of the circulation and simultaneous measurement of volumes would improve\\u000a patient treatment. However, measurement of cardiac volumes especially of

  16. The composition of fluid collected by micropuncture and catheterization from the seminiferous tubules and rete testis of rats

    Microsoft Academic Search

    R. R. Tuck; B. P. Setchell; G. M. H. Waites; J. A. Young

    1970-01-01

    Fluid and electrolyte secretion in the rat testis has been studied by micropuncture and catheterization. Three fluids have been collected and analyzed:1.Rete-testis fluid, obtained by catheterization of the rete testis.2.Free-flow fluid, obtained by micropuncture of seminiferous tubules.3.Primary fluid, also obtained by micropuncture but after first filling a tubule segment with oil and allowing new secretion to form and break up

  17. A prospective observational study of the outcome of central venous catheterization in 100 patients

    PubMed Central

    Kumar, Arun H. D.; Srinivasan, Nataraj M.; Thakkar, Jayashree M.; Mathew, Shaji

    2013-01-01

    Context: To Study the outcome following central vein catheterization in patients receiving chemotherapy. Aims: To Study the outcome of central venous catheterization in terms of difficulty during insertion, duration, incidence of infections and other complications and reasons for removal. Settings and Designs: Prospective observational study conducted in 100 patients attending to Gujarat Cancer and Research Institute. Materials and Methods: Both onco-medical and onco-surgical patients who required insertion of central venous catheters were enrolled after ethical approval from June 2008 to November 2010. The study comprised 100 patients. Statistical Analysis Used: Mean and percentage. Results: Mean duration of the indwelling catheter was 109 days for Hickman catheter, 39 days for cavafix and 59 days for certofix. Difficulty in insertion and arrhythmias were common complications. There were no incidences of major life threatening complications. Catheter related infection was 30%. The commonest reason for catheter removal was treatment completion 72%. The next frequent cause was catheter infection 14% and patient death 6%. Conclusions: Even though central venous catheterization is associated with acceptable complications, they serve a useful aid in management of patients on chemotherapy. PMID:25885724

  18. [Multicenter pediatric therapeutic interventional heart catheterization 1996-1998].

    PubMed

    Dinarevi?, S; Mesihovi?, H; Terzi?, R; Cengi?, H; Lojpur, V; Begi?, Z

    1999-01-01

    The aim of the study is to evaluate choice, efficacy and safety of transcatheter therapy in patients (pts) with congenital heart disease which has been performed in Europe on pts from the Paediatric Clinic of Sarajevo. From January 1996 to August 1998 out of 20 transcatheter therapeutic interventions, 5 have been done in pts whose congenital heart lesions: ductus arteriosus persistence (DAP), atrial septal defect (ASD), pulmonary artery valve stenosis (PS), aortic valve stenosis (AS), were diagnosed in first year of life. Pts were followed 11 months post interventions (the longest period of follow-up 19 months). All pts are well and asymptomatic. DAP closure has been done using "coil" devices in 2 pts (in Italy and Monaco) age 5 and 7.5 years. Duct diameter was 3.5 mm and 4 mm with percent of success within 24 hrs of 100%. With PW Doppler no residual ductual shunt has been proven. Transcatheter closure of ASD type secundum diameter 9 mm, using the "amplatz" device has been performed in Germany. No residual shunt has been proven by echocardiography. Balloon pulmonary valvuloplasty successfully was done in 1 pt in Austria age 3/12 with normal flow of right ventricle outflow tract post intervention. Balloon aortic valvuloplasty was performed in Sweden in neonate with decrease of pressure gradient of AS for 70%. Using Pencil Doppler, 8/12 post intervention in that pt restenosis occurred. The therapeutic catheterizational technique has been successful in alternating surgical approach to resolve congenital heart disease. With further development of catheter systems, techniques and longer periods of follow-up, possibilities of simpler, faster, safer and more efficient solvation of cardiac lesions will brightening up the future of paediatric interventional catheterisation. PMID:10758753

  19. COMPLEMENTARY IMAGING OF GRANULAR Co-Ag FILMS WITH MAGNETO-OPTICAL INDICATOR FILM TECHNIQUE AND MAGNETIC

    E-print Network

    Donahue, Michael J.

    of the magnetization processes of magnetic Co90Ag10 granular films. It is shown that the magnetization reversal characterization of magnetic multilayered and clustered systems is of great interest [3­6]. In this paper we granular films. The MOIF technique was initially developed for investigation of magnetization processes

  20. Spectrophotometric Determination of the Dissociation Constant of an Acid-Base Indicator Using a Mathematical Deconvolution Technique

    ERIC Educational Resources Information Center

    Alter, Krystyn P.; Molloy, John L.; Niemeyer, Emily D.

    2005-01-01

    A laboratory experiment reinforces the concept of acid-base equilibria while introducing a common application of spectrophotometry and can easily be completed within a standard four-hour laboratory period. It provides students with an opportunity to use advanced data analysis techniques like data smoothing and spectral deconvolution to…

  1. 22/06/2014 Toutes les informations donnes sur cette page sont indicatives et n'ont pas de valeur contractuelle LICENCE SCIENCES ET TECHNIQUES DES

    E-print Network

    Di Girolami, Cristina

    22/06/2014 Toutes les informations données sur cette page sont indicatives et n'ont pas de valeur contractuelle Page 1 / 9 LICENCE SCIENCES ET TECHNIQUES DES ACTIVITÉS PHYSIQUES ET SPORTIVES, SP. ACTIVITÉS PHYSIQUES ADAPTÉES ET SANTÉ Domaine ministériel : SCIENCES, TECHNOLOGIES, SANTÉ Mention : SCIENCES ET

  2. 15/6/2014 Toutes les informations donnes sur cette page sont indicatives et n'ont pas de valeur contractuelle LICENCE PROFESSIONNELLE ACTIVITES ET TECHNIQUES

    E-print Network

    Pravda-Starov, Karel

    infographie Traitement vidéo et animation multimédia Techniques de réalisation d'un site Web Animations et, montage vidéo, animation, site Web) ainsi que la méthodologie et les outils nécessaires à l'élaboration d Cut pro et Flash CS4 ; #12;15/6/2014 Toutes les informations données sur cette page sont indicatives

  3. A comparison of displaced phase centre antenna and along-track interferometry techniques for RADARSAT-2 ground moving target indication

    Microsoft Academic Search

    Shen Chiu; Chuck Livingstone

    2005-01-01

    Canada's RADARSAT-2 commercial synthetic aperture radar (SAR) satellite will have an experimental mode that will permit ground moving target indication (GMTI) measurements to be made. In this mode of operation, the radar antenna is partitioned into two subapertures that sequentially observe the scene of interest from the same point in space. Two of the GMTI processing approaches currently being explored

  4. Temporary Percutaneous Gastric Electrical Stimulation: A Novel Technique Tested in Patients with Non-Established Indications for Gastric Electrical Stimulation

    Microsoft Academic Search

    S. Andersson; G. Ringström; A. Elfvin; M. Simrén; H. Lönroth; H. Abrahamsson

    2011-01-01

    Aim: To test temporary percutaneous gastric electrical stimulation (TPGES) in patients with drug-refractory nausea\\/vomiting and nonestablished indications for GES. Methods: 27 patients (2–81 years) underwent TPGES with electrodes implanted at gastroscopy and received stimulation for 7–21 days with low current settings (5–7 mA) either as open stimulation (n = 14) or randomized to double-blind crossover stimulation (n = 13; ON

  5. Stability-indicating micellar electrokinetic chromatography technique for simultaneous measurement of delapril and manidipine from a combination drug formulation.

    PubMed

    Todeschini, Vítor; Sangoi, Maximiliano da Silva; Meira, Alianise da Silva; Miron, Diogo; Lange, Alini Dall Cortivo; Volpato, Nadia Maria

    2014-01-01

    A stability-indicating micellar electrokinetic chromatography (MEKC) method was developed and validated for simultaneous analysis of delapril (DEL) and manidipine (MAN) using salicylic acid as an internal standard. The MEKC method was performed using a fused-silica capillary (effective length of 72 cm) with 50 mM of borate buffer and 5 mM of anionic surfactant sodium dodecylsulfate at pH 9.0 as the background electrolyte. The separation was achieved at 25 kV applied voltage and 35 degrees C. The injection was performed at 50 mbar for 5 s, with detection at 208 nm. The method was linear in the range of 15-150 microg/mL (r2 = 0.9966) for DEL and 5-50 microg/mL (r2 = 0.9985) for MAN with adequate results for the precision (< or = 1.87%) and accuracy (98.94% for DEL and 100.65% for MAN). The specificity of the method and its stability-indicating capability was demonstrated through forced degradation studies, which showed that there was no interference from the excipients. The Plackett-Burman experimental design was used for robustness evaluation, giving results within the acceptable range. The method was successfully applied for analysis of the drugs, and the results were compared to an LC method, resulting in nonsignificant differences (P = 0.78 and 0.84 for DEL and MAN, respectively). PMID:24672867

  6. Effects of oral premedication on cognitive status of elderly patients undergoing cardiac catheterization

    PubMed Central

    Ashraf, Javed M; Schweiger, Marc; Vallurupalli, Neelima; Bellantonio, Sandra; Cook, James R

    2015-01-01

    Background Sedatives and analgesics are often administered to achieve conscious sedation for diagnostic and therapeutic procedures. Appropriate concerns have been raised regarding post procedure delirium related to peri-procedural medication in the elderly. The objective of this study was to investigate the effect of premedication on new onset delirium and procedural care in elderly patients. Methods Patients ? 70 years old and scheduled for elective cardiac catheterization were randomly assigned to receive either oral diphenhydramine and diazepam (25 mg/5 mg) or no premedication. All patients underwent a mini mental state exam and delirium assessment using confusion assessment method prior to the procedure and repeated at 4 h after the procedure and prior to discharge. Patients' cooperation during the procedure and ease of post-procedure were measured using Visual Analog Scale (VAS). The degree of alertness was assessed immediately on arrival to the floor, and twice hourly afterwards using Observer's Assessment of Alertness/Sedation Scale (OAA/S). Results A total of 93 patients were enrolled. The mean age was 77 years, and 47 patients received premedication prior to the procedure. None of the patients in either group developed delirium. Patients' cooperation and the ease of procedure was greater and pain medication requirement less both during and after the procedure in the pre-medicated group (P < 0.05 for both). Nurses reported an improvement with patient management in the pre-medicated group (P = 0.08). Conclusions In conclusion, premedication did not cause delirium in elderly patients undergoing cardiac catheterization. The reduced pain medication requirement, perceived procedural ease and post procedure management favors premedication in elderly patients undergoing cardiac catheterization.

  7. Subclavian artery- internal jugular vein fistula and heart failure: complication of internal jugular vein catheterization.

    PubMed

    Prakash, Jai; Takhellambam, Brojen; Ghosh, Biplab; Choudhury, Tauhidul Alam; Singh, Shivendra; Sharma, Om Prakash

    2013-02-01

    Hemodialysis in patients with end-stage renal disease (ESRD) requires vascular access which can be either temporary or permanent. However, these procedures are not without complications. Arterial puncture is the most common immediate complication and pseudoaneurysm formation is the most common late sequel of internal jugular venous catheterization (IJVC). However, arterio-venous fistula (AVF) formatiorn following IJVC is rare. We are reporting a case of AVF formation between subclavian artery (SCA) and internal jugular vein (IJV) following IJVC which later on leads to the development of cardiac failure. PMID:24471256

  8. A Segmentation Algorithm for X-ray 3D Angiography and Vessel Catheterization

    SciTech Connect

    Franchi, Danilo; Rosa, Luigi; Placidi, Giuseppe [Department of Science and Biomedical Technologies, University of L'Aquila, Via Vetoio 10, 67100 Coppito, L'Aquila (Italy)

    2008-11-06

    Vessel Catheterization is a clinical procedure usually performed by a specialist by means of X-ray fluoroscopic guide with contrast-media. In the present paper, we present a simple and efficient algorithm for vessel segmentation which allows vessel separation and extraction from the background (noise and signal coming from other organs). This would reduce the number of projections (X-ray scans) to reconstruct a complete and accurate 3D vascular model and the radiological risk, in particular for the patient. In what follows, the algorithm is described and some preliminary experimental results are reported illustrating the behaviour of the proposed method.

  9. Cardiac catheterization

    MedlinePLUS

    ... management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the ...

  10. Tubal sterilization by means of selective catheterization: comparison of a hydrogel and a collagen glue.

    PubMed

    Maubon, A J; Thurmond, A S; Laurent, A; Machan, L S; Scanlan, R M; Nikolchev, J; Rouanet, J P

    1996-01-01

    The purpose of this study was to test, in an animal model, two potentially suitable materials for nonsurgical selective tubal sterilization. A hydrogel that forms an in situ plug by phase inversion of a polymer solution was placed in four rabbit fallopian tubes, and a proprietary collagen glue was placed into three rabbit fallopian tubes by means of transvaginal fluoroscopic fallopian tube catheterization. As controls, 11 tubes were catheterized without sterilization material injection. The rabbits were bred, and the presence of embryos was confirmed with palpation and at autopsy. Histologic analysis was performed. The short-term contraception rate was 100% in the hydrogel group, 33% in the collagen glue group, and 0% in the control group (P .001 hydrogel group, P not significant in collagen group). Inflammation was minimal in the three groups (P not significant). The collagen glue had an insufficient contraceptive effect and should be abandoned. The hydrogel used proved effective and biocompatible, and long-term studies of this compound are warranted. PMID:8897343

  11. Comparison Of Povodine-Iodine Versus Savlon For Pre Catheterization Cleansing And The Association Of Bacteriuria With Its Antibiotic Susceptibility In Catheterised Patients Of The Surgical Ward

    Microsoft Academic Search

    SHOBHA K. L; RAMACHANDRA L

    Background: Urinary tract infection is one of the most common nosocomial infections, and urinary catheterization is the most frequent predisposing factor. Nosocomial infections associated with urinary catheters may increase the mortality rate upto three times. These infections also pose a considerable financial burden. Different methods for urinary tract infection prophylaxis have been proposed for patients who undergo continuous catheterization. This

  12. [Antireflux operations: indications and techniques].

    PubMed

    Feussner, H; Wilhelm, D

    2013-04-01

    In severe gastroesophageal reflux disease fundoplication is a sound therapeutic alternative if long-term treatment with proton pump inhibitors is not a viable option. However, careful patient selection is mandatory and reflux disease has to be proven objectively. Patients who are particularly prone to develop postoperative functional side effects should be excluded.For surgical treatment either a 360° wrap (Nissen) or a 270° wrap (Toupet) can be performed with more or less equivalent results. The common technical denominators are to achieve a loose, short wrap. In both instances the cuff has to be fixed securely with non-absorbable sutures and any damage to the vagal innervation has to be avoided.Long-term reflux prevention is excellent and superior to medical treatment; nonetheless, functional side effects still occur and to keep the incidence as low as possible preoperative selection of patients is essential. PMID:23532487

  13. Comparison of role of early (less than six hours) to later (more than six hours) or no cardiac catheterization after resuscitation from out-of-hospital cardiac arrest.

    PubMed

    Strote, Justin A; Maynard, Charles; Olsufka, Michele; Nichol, Graham; Copass, Michael K; Cobb, Leonard A; Kim, Francis

    2012-02-15

    Despite reports of patients with resuscitated sudden cardiac arrest (rSCA) receiving acute cardiac catheterization, the efficacy of this strategy is largely unknown. We hypothesized that acute cardiac catheterization of patients with rSCA would improve survival to hospital discharge. A retrospective cohort of 240 patients with out-of-hospital rSCA caused by ventricular tachycardia or fibrillation was identified from 11 institutions in Seattle, Washington from 1999 through 2002. Patients were grouped into those receiving acute catheterization within 6 hours (?6-hour group, n = 61) and those with deferred catheterization at >6 hours or no catheterization during the index hospitalization (>6-hour group, n = 179). Attention was directed to survival to hospital discharge, neurologic status, extent of coronary artery disease, presenting electrocardiographic findings, and symptoms before arrest. Propensity-score methods were used to adjust for the likelihood of receiving acute catheterization. Survival was greater in patients who underwent acute catheterization (72% in the ?6-hour group vs 49% in the >6-hour group, p = 0.001). Percutaneous coronary intervention was performed in 38 of 61 patients (62%) in the ?6-hour group and 13 of 170 patients (7%) in the >6-hour group (p <0.0001). Neurologic status was similar in the 2 groups. A significantly larger percentage of patients in the acute catheterization group had symptoms before cardiac arrest and had ST-segment elevation on electrocardiogram after resuscitation. Age, bystander cardiopulmonary resuscitation, daytime presentation, history of percutaneous coronary intervention or stroke, and acute ST-segment elevation were positively associated with receiving cardiac catheterization. In conclusion, in this series of patients who sustained out-of-hospital cardiac arrest, acute catheterization (<6 hours of presentation) was associated with improved survival. PMID:22100026

  14. Catheterization during adrenal vein sampling for primary aldosteronism: failure to use (1-24) ACTH may increase apparent failure rate.

    PubMed

    Kline, Gregory A; So, Benny; Dias, Valerian C; Harvey, Adrian; Pasieka, Janice L

    2013-07-01

    "Successful" adrenal vein catheterization in primary aldosteronism (PA) is often defined by a ratio of >3:1 of cortisol in the adrenal vein vs the inferior vena cava. Non-use of corticotropin (ACTH) during sampling may increase the apparent failure rate of adrenal vein catheterization due to lower cortisol levels. A retrospective study was performed on all patients with confirmed unilateral PA between June 2005 and August 2011. Adrenal vein sampling (AVS) included simultaneous bilateral baseline samples with repeat sampling 15 minutes after intravenous infusion of 250 ?g of Cortrosyn (ACTH-S). Successful catheter placement was judged as adrenal cortisol:IVC cortisol of >3:1, applied to both baseline and ACTH-S samples and lateralization of aldosteronism was judged as normalized aldosterone/cortisol (A/C) ratio >3 times the contralateral A/C ratio. In ACTH-S samples, 94% of right-sided catheterizations were biochemically successful with 100% success on the left. Among baseline samples, only 47% of right- and 44% of left-sided samples met the 3:1 cortisol criteria. However, 95% of apparent "failed" baseline cortisol sets still showed lateralization of A/C ratios that matched the ultimate pathology. Non-ACTH-stimulated samples may be incorrectly judged as failed catheter placement when a 3:1 ratio is used. ACTH-stimulated sampling is the preferred means to confirm catheterization during AVS. PMID:23815536

  15. Indications and Outcomes of the Components Separation Technique in the Repair of Complex Abdominal Wall Hernias: Experience From the Cambridge Plastic Surgery Department

    PubMed Central

    Adekunle, Shola; Pantelides, Nicholas M.; Hall, Nigel R.; Praseedom, Raaj; Malata, Charles M.

    2013-01-01

    Objectives: The components separation technique (CST) is a widely described abdominal wall reconstructive technique. There have, however, been no UK reports of its use, prompting the present review. Methods: Between 2008 and 2012, 13 patients who underwent this procedure by a single plastic surgeon (C.M.M.) were retrospectively evaluated. The indications, operative details, and clinical outcomes were recorded. Results: There were 7 women and 6 men in the series with a mean age of 53 years (range: 30-80). Patients were referred from a variety of specialties, often as a last resort. The commonest indication for CST was herniation following abdominal surgery. All operations except 1 were jointly performed with general surgeons (for bowel resection, stoma reversal, and hernia dissection). The operations lasted a mean of 5 hours (range: 3-8 hours). There were no major intra- and postoperative problems, except in 1 patient who developed intra-abdominal compartment syndrome, secondary to massive hemorrhage. All patients were satisfied with the cosmetic improvement in their abdominal contours. None of the patients have developed a clinical recurrence after a mean follow-up of 16 months (range: 3-38 months). Conclusions: The components separation technique is an effective method of treating large recalcitrant hernias but appears to be underutilized in the United Kingdom. The management of large abdominal wall defects requires a multidisciplinary approach, with input across a variety of specialities. Liaison with plastic surgery teams should be encouraged at an early stage and the CST should be more widely considered when presented with seemingly intractable abdominal wall defects. PMID:24058718

  16. Radiation exposure to the pediatric patient during cardiac catheterization and angiocardiography. Emphasis on the thyroid gland

    SciTech Connect

    Martin, E.C.; Olson, A.P.; Steeg, C.N.; Casarella, W.J.

    1981-07-01

    Thermoluminescent dosimetry was used to measure the radiation exposure to the skin, thyroid and gonads in 50 consecutive pediatric patients undergoing cardiac catheterization and angiocariography using cine photofluorography. Average exposures were 17.1 R to the skin, 2.3 R to the thyroid and 0.1 R to the gonads. Fluoroscopy accounted for approximately 80% of the skin and thyroid exposure and cine photofluorography for 20 to 25%. Occasional primary-beam irradiation was the major contributor to gonad exposure. Internal scatter of the incident x-ray beam was primarily responsible for thyroid exposure, so that infants received relatively high exposures; one receiving 7.3 R. The thyroid was not frequently in the primary beam. The significance of high radiation exposure to the thyroid, and in particular its relationship to thyroid carcinoma, are discussed. The results are compared with other series in the literature and relative exposures of cine photofluorography and serial filming are contrasted.

  17. [Nursing diagnoses in patients after heart catheterization--contribution of Orem].

    PubMed

    de Lima, Luciano Ramos; Pereira, Sandra Valéria Martins; Chianca, Tânia Couto Machado

    2006-01-01

    Sectional study of multiple cases involving 30 patients after heart catheterization aiming to establish the nursing diagnoges according to the North American Nursing Diagnoses Association (NANDA). The method of data collection was the Nursing Process based on the Self-care Deficit Theory. Twenty-five different nursing diagnoses had been established. All patients presented Impaired tissue integrity, Risk of infection, Pain incisive in the area inguinal, Injured physical mobility, Self-care deficit related to personal hygiene, and Risk of organic renal lesion. It has been concluded that the Self-care Deficit theory allowed the classification of all nursing diagnoses according to NANDA. It contributed to the nursing assistance individualization, humanization, and qualification. Beyond advance self-knowledge, self-control and patient participation on his/her self-car. PMID:17175715

  18. [Estimation of radiation exposure and radiation risk for employees of a heart catheterization laboratory].

    PubMed

    Folkerts, K H; Münz, A; Jung, S

    1997-04-01

    The staff at interventional radiological procedures is exposed to high levels of ionizing radiation. This applies especially to measures at cardiac catheterization laboratories. In this study the annual radiation exposure to the staff was estimated by measuring the dose rate under characteristic conditions. It could be shown that the resulting radiation exposure was strongly dependent on the radiation protection measures and is also dependent on the operation conditions of the x-ray-tube. The effective dose for the physician wearing a lead apron and thyroid shield was determined to about 1.7 mSv/a. Without a thyroid shield an effective dose of about 3.5 mSv/a resulted. This corresponds to approximately the natural background radiation of about 2.4 mSv/a in the Federal Republic of Germany. From the number of procedures performed we could derive an effective dose of approximately 1-2 microSv per application for the physician, averaged over all types of procedures. Further, it could be shown that the readings of the film badges, usually worn by the staff, underestimate the effective dose by approximately a factor of two. This is because the film badges do not include the contribution of the unshielded parts of the body to effective dose. From the estimated annual effective dose, a lifetime dose of 68 mSv was estimated for a 40-year working career. The corresponding lifetime risk for induced fatal cancer due to radiation exposure was determined to 0.3% applying the ICRP risk factor of 4 x 10(-2) Sv-1. Considering the NCRP recommendations for a safe occupation, working in a cardiac catheterization laboratory can be considered as safe when applying all radiation protection measures. However, changing the protection measures and modifying the parameters of the x-ray-tube can lead to strong changes of the radiation exposure and the resulting risk estimation. PMID:9235797

  19. Intermittent self-catheterization and the risk of squamous cell cancer of the bladder: An emerging clinical entity?

    PubMed Central

    Casey, Rowan G.; Cullen, Ivor M.; Crotty, Tom; Quinlan, David M.

    2009-01-01

    There are only 7 cases reported in the literature of squamous cell cancer of the bladder in patients performing intermittent self-catheterization (ISC). We report on an eighth case, and the first case described in a patient with a Mitrofanoff continent appendicovesicostomy. A description of the case and review of the literature are presented. Risk factors for squamous cell cancer include recurrent urinary tract infections, keratinising squamous metaplasia (leukoplakia) and local mucosal trauma from intermittent self-catheterization. There is no recognized or validated monitoring program for patients performing ISC who may also have these risk factors. Reasonable protocols may include regular urinary cytology and cystoscopy with random or targeted bladder biopsies. Squamous cell cancer may present late in this cohort of patients and is associated with a dismal prognosis. PMID:19829719

  20. A national clinical quality program for Veterans Affairs catheterization laboratories (from the Veterans Affairs clinical assessment, reporting, and tracking program).

    PubMed

    Maddox, Thomas M; Plomondon, Mary E; Petrich, Megan; Tsai, Thomas T; Gethoffer, Hans; Noonan, Gregory; Gillespie, Brian; Box, Tamara; Fihn, Stephen D; Jesse, Robert L; Rumsfeld, John S

    2014-12-01

    A "learning health care system", as outlined in a recent Institute of Medicine report, harnesses real-time clinical data to continuously measure and improve clinical care. However, most current efforts to understand and improve the quality of care rely on retrospective chart abstractions complied long after the provision of clinical care. To align more closely with the goals of a learning health care system, we present the novel design and initial results of the Veterans Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) program-a national clinical quality program for VA cardiac catheterization laboratories that harnesses real-time clinical data to support clinical care and quality-monitoring efforts. Integrated within the VA electronic health record, the CART program uses a specialized software platform to collect real-time patient and procedural data for all VA patients undergoing coronary procedures in VA catheterization laboratories. The program began in 2005 and currently contains data on 434,967 catheterization laboratory procedures, including 272,097 coronary angiograms and 86,481 percutaneous coronary interventions, performed by 801 clinicians on 246,967 patients. We present the initial data from the CART program and describe 3 quality-monitoring programs that use its unique characteristics-procedural and complications feedback to individual labs, coronary device surveillance, and major adverse event peer review. The VA CART program is a novel approach to electronic health record design that supports clinical care, quality, and safety in VA catheterization laboratories. Its approach holds promise in achieving the goals of a learning health care system. PMID:25439452

  1. Administration of dexmedetomidine alone during diagnostic cardiac catheterization in adults with congenital heart disease: two case reports

    Microsoft Academic Search

    Takayuki KunisawaAtsushi Kurosawa; Atsushi Kurosawa; Dai Hayashi; Keiya Takahashi; Mai Kishi; Hiroshi Iwasaki

    2011-01-01

    We report the clinical management of 2 adults with mental retardation because of trisomy 21 who were sedated with high-dose\\u000a dexmedetomidine (DEX) alone during diagnostic cardiac catheterization (DCC). The first patient was a 25-year-old man with\\u000a aortic regurgitation and ventricular septal defect. DEX increased his Ramsay sedation score; however, a high dose and bolus\\u000a injection of DEX were required to

  2. Three-dimensional magnetic resonance imaging overlay to assist with percutaneous transhepatic access at the time of cardiac catheterization

    PubMed Central

    Whiteside, Wendy; Christensen, Jason; Zampi, Jeffrey D

    2015-01-01

    Multimodality image overlay is increasingly used for complex interventional procedures in the cardiac catheterization lab. We report a case in which three-dimensional magnetic resonance imaging (3D MRI) overlay onto live fluoroscopic imaging was utilized to safely obtain transhepatic access in a 12-year-old patient with prune belly syndrome, complex and distorted abdominal anatomy, and a vascular mass within the liver.

  3. ARFI Ultrasound for In Vivo Hemostasis Assessment Postcardiac Catheterization, Part II: Pilot Clinical Results

    PubMed Central

    Behler, Russell H.; Scola, Mallory R.; Nichols, Timothy C.; Caughey, Melissa C.; Fisher, Melrose W.; Zhu, Hongtu; Gallippi, Caterina M.

    2010-01-01

    In this second of a two part series, we present pilot clinical data demonstrating Acoustic Radiation Force Impulse (ARFI) ultrasound for monitoring the onset of subcutaneous hemostasis at femoral artery puncture sites (arteriotomies), in vivo. We conducted a randomized, reader-blinded investigation of 20 patient volunteers who underwent diagnostic percutaneous coronary catheterization. After sheath removal (6 French), patients were randomized to treatment with either standard of care manual compression alone or, to expedite hemostasis, manual compression augmented with a p-GlcNAc fiber-based hemostatic dressing (Marine Polymer Technologies, Danvers MA). Concurrent with manual compression, serial ARFI imaging began at the time of sheath removal and continued every minute for 15 min. Serial data sets were processed with custom software to (1) estimate the time of hemostasis onset, and (2) render hybrid ARFI/B-Mode images to highlight displacements considered to correspond to extravasted blood. Images were read by an observer blinded to the treatment groups. Average estimated times to hemostasis in patient volunteers treated with manual compression alone (n = 10) and manual compression augmented by hemostatic dressing (n = 9) were, respectively, 13.00 ± 1.56 and 9.44 ± 3.09 min, which are statistically significantly different (p = 0.0065, Wilcoxon two-sample test). Example images are shown for three selected patient volunteers. These pilot data suggest that ARFI ultrasound is relevant to monitoring subcutaneous bleeding from femoral arteriotomies clinically and that time to hemostasis was significantly reduced by use of the hemostatic dressing. PMID:19771959

  4. Physician liability for procedure related injury: Focused on central venous catheterization.

    PubMed

    Lee, Seok-Bae; Bae, Hyuna; Kim, Sung Eun

    2015-07-01

    Central venous catheterization (CVC) is one of essential procedures in critical care medicine. CVC is relatively safe when performed by experienced physicians. Complications may occur due to various risk factors. Although the incidence of CVC-related complications is not high, a serious risk may ensue in cases of such complications. Procedure related complications could lead to civil and criminal lawsuits. This study reviewed the occurrence patterns and rulings of the courts related to CVC in South Korea and tried to find pitfalls that medical professionals should keep in mind before, during and after medical procedures. Various patterns of CVC-related lawsuits have been raised. During the procedure, physicians should perform their duty considering risk factors such as patients' underlying diseases and age. In addition, before the procedure, physicians must obtain written consent for CVC from patients or their legal guardians including explanation of rare complications that could be lethal. After the completion of CVC, surveillance of anticipated complications including chest radiographs should be conducted for the immediate management of any possible complications. PMID:26048491

  5. Delayed sudden radial artery rupture after left transradial coronary catheterization: a case report.

    PubMed

    Indolfi, Ciro; Passafaro, Francesco; Mongiardo, Annalisa; Spaccarotella, Carmen; Torella, Daniele; Sorrentino, Sabato; Polimeni, Alberto; Emanuele, Vittorio; Curcio, Antonio; De Rosa, Salvatore

    2015-03-01

    Local complications at the radial access site are not frequent, hence its large diffusion as the preferred access route for endovascular procedures. However, in a time of fast widespreading, better comprehension of all potential complications becomes critical to facilitate their early recognition and the most appropriate treatment. In this case report, we present for the first time a case of sudden massive bleeding at the left wrist, due to spontaneous gross rupture of the left radial artery bleeding 15 days after an endovascular procedure through a left radial arterial access. The patient had been readmitted to the hospital after evidence of local infection at the left wrist with loss of substance. The radial artery was patent with no evidence of pseudoaneurysm. After sudden radial artery rupture, with massive bleeding and suspicion that the local infection could have reached the arterial wall, surgical hemostasis with artery ligation was obtained. Healing of the large wound was then efficiently speeded up using a negative pressure wound therapy. This is the first case of macroscopic radial artery rupture associated with local wrist infection after arterial catheterization. After prompt surgical hemostasis, negative pressure wound therapy was very helpful in favoring healing of the large and deep wound. PMID:25761194

  6. Microcomputer-assisted filing system of cardiac catheterization records using a relational database management system.

    PubMed

    Mohri, M; Kikuchi, Y; Sagara, T; Sugihara, M

    1988-03-01

    To efficiently store and retrieve cardiac catheterization records, we have developed a computer-assisted database, which comprises a 16-bit microcomputer with dual floppy disk drives, a 20 MB random-access memory, hard disk drive, and a line printer. All programmings were accomplished using a relational database management system (R:base 5000, Microrim, Inc.). Data inquiry procedures could be performed with direct operational commands of the system as well as with preprogrammed command files, and final results of searches were printed out with a line printer. The major advantages of the present system described in this report include: (1) the relatively easy and rapid creation of the database, (2) ease of modification of the database structures even after the system design is finished, (3) operational commands in combination with conditional operator(s) are flexible and powerful enough to allow the end user to retrieve data based on various kinds of criteria, (4) a high-level programming language provided by the R:base automates a series of database procedures with relative ease, (5) relational capabilities of the database management system can enhance the possibility of reconstruction of a new data file from a single or several preexisting data files, and (6) the system can be realized at reasonable cost. PMID:3258556

  7. Ultrasound or near-infrared vascular imaging to guide peripheral intravenous catheterization in children: a pragmatic randomized controlled trial

    PubMed Central

    Curtis, Sarah J.; Craig, William R.; Logue, Erin; Vandermeer, Ben; Hanson, Amanda; Klassen, Terry

    2015-01-01

    Background: Peripheral intravenous catheterization in children is challenging, and success rates vary greatly. We conducted a pragmatic randomized controlled trial to determine whether the use of ultrasound or near-infrared vascular imaging to guide catheterization would be more effective than the standard approach in achieving successful catheter placement on the first attempt. Methods: We enrolled a convenience sample of 418 children in a pediatric emergency department who required peripheral intravenous catheterization between June 2010 to August 2012. We stratified them by age (? 3 yr and > 3 yr) and randomly assigned them to undergo the procedure with the standard approach, or with the help of either ultrasound or near-infrared vascular imaging. The primary outcome was the proportion of patients who had successful placement of a catheter on the first attempt. Results: The rate of successful first attempts did not differ significantly between either of the 2 intervention groups and the standard approach group (differences in proportions ?3.9%, 95% confidence interval [CI] ?14.2% to 6.5%, for ultrasound imaging; ?8.7%, 95% CI ?19.4% to 1.9%, for near-infrared imaging). Among children 3 years and younger, the difference in success rates relative to standard care was also not significant for ultrasound imaging (?9.6%, 95% CI ?29.8% to 10.6%), but it was significantly worse for near-infrared imaging (?20.1%, 95% CI ?40.1% to ?0.2%). Among children older than 3 years, the differences in success rates relative to standard care were smaller but not significant (?2.3%, 95% CI ?13.6% to 9.0%, for ultrasound imaging; ?4.1%, 95% CI ?15.7% to 7.5%, for near-infrared imaging). None of the pairwise comparisons were statistically significant in any of the outcomes. Interpretation: Neither technology improved first-attempt success rates of peripheral intravenous catheterization in children, even in the younger group. These findings do not support investment in these technologies for routine peripheral intravenous catheterization in children. Trial registration: ClinicalTrials.gov, no. NCT01133652. PMID:25897047

  8. ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: American College of Cardiology Foundation Appropriate Use Criteria Task Force Society for Cardiovascular Angiography and Interventions American Association for Thoracic Surgery American Heart Association, American Society of Echocardiography American Society of Nuclear Cardiology Heart Failure Society of America Heart Rhythm Society, Society of Critical Care Medicine Society of Cardiovascular Computed Tomography Society for Cardiovascular Magnetic Resonance Society of Thoracic Surgeons.

    PubMed

    Patel, Manesh R; Bailey, Steven R; Bonow, Robert O; Chambers, Charles E; Chan, Paul S; Dehmer, Gregory J; Kirtane, Ajay J; Wann, L Samuel; Ward, R Parker; Douglas, Pamela S; Patel, Manesh R; Bailey, Steven R; Altus, Philip; Barnard, Denise D; Blankenship, James C; Casey, Donald E; Dean, Larry S; Fazel, Reza; Gilchrist, Ian C; Kavinsky, Clifford J; Lakoski, Susan G; Le, D Elizabeth; Lesser, John R; Levine, Glenn N; Mehran, Roxana; Russo, Andrea M; Sorrentino, Matthew J; Williams, Mathew R; Wong, John B; Wolk, Michael J; Bailey, Steven R; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Shaw, Leslee; Stainback, Raymond F; Allen, Joseph M

    2012-09-01

    The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. © 2012 Wiley Periodicals, Inc. PMID:22678595

  9. Modeling groundwater quality over a humid subtropical region using numerical indices, earth observation datasets, and X-ray diffraction technique: a case study of Allahabad district, India.

    PubMed

    Singh, Sudhir Kumar; Srivastava, Prashant K; Singh, Dharmveer; Han, Dawei; Gautam, Sandeep Kumar; Pandey, A C

    2015-02-01

    Water is undoubtedly the vital commodity for all living creatures and required for well-being of the human society. The present work is based on the surveys and chemical analyses performed on the collected groundwater samples in a part of the Ganga basin in order to understand the sources and evolution of the water quality in the region. The two standard indices such as water quality index and synthetic pollution index for the classification of water in the region are computed. The soil and sediment analysis are carried out with the help of X-ray diffractometer (XRD) for the identification of possible source of ions in water from rock and soil weathering. The dominant minerals which include quartz, muscovite, plagioclase, and orthoclase are reported in the area. The study further utilizes the multivariate statistical techniques for handling large and complex datasets in order to get better information about the groundwater quality. The following statistical methods such as cluster analysis (CA), factor analysis (FA), and principal component analysis (PCA) are applied to handle the large datasets and to understand the latent structure of the data. Through FA/PCAs, we have identified a total of 3 factors in pre-monsoon and 4 factors in post-monsoon season, which are responsible for the whole data structure. These factors explain 77.62 and 82.39% of the total variance of the pre- and post-monsoon datasets. On the other hand, CA depicted the regions that have similar pollutants origin. The average value of synthetic pollution index of groundwater during pre-monsoon is 9.27, while during post-monsoon, it has been recorded as 8.74. On the other hand, the average values of water quality index of groundwater during pre-monsoon and post-monsoon seasons are found as 217.59 and 233.02, respectively. The study indicates that there occurs an extensive urbanization with gradual vast development of various small- and large-scale industries, which is responsible for degradation in water quality. The overall analysis reveals that the agricultural runoff, waste disposal, leaching, and irrigation with wastewater are the main causes of groundwater pollution followed by some degree of pollution from geogenic sources such as rock and soil weathering, confirmed through XRD analysis. PMID:25086613

  10. Emergency Central Venous Catheterization during Trauma Resuscitation: A Safety Analysis by Site.

    PubMed

    Choron, Rachel L; Wang, Andrew; Van Orden, Kathryn; Capano-Wehrle, Lisa; Seamon, Mark J

    2015-05-01

    Central venous catheterization (CVC) is often necessary during initial trauma resuscitations, but may cause complications including catheter-related blood stream infection (CRBSI), deep venous thrombosis (DVT), pulmonary emboli (PE), arterial injury, or pneumothoraces. Our primary objective compared subclavian versus femoral CVC complications during initial trauma resuscitations. A retrospective review (2010-2011) at an urban, Level-I Trauma Center reviewed CVCs during initial trauma resuscitations. Demographics, clinical characteristics, and complications including: CRBSIs, DVTs, arterial injuries, pneumothoraces, and PEs were analyzed. Fisher's exact test and Student's t test were used; P ? 0.05 was considered statistically significant. Overall, 504 CVCs were placed (subclavian, n = 259; femoral, n = 245). No difference in age (47 ± 22 vs 45 ± 23 years) or body mass index (28 ± 6 vs 29 ± 16 kg/m(2)) was detected (P > 0.05) in subclavian vs femoral CVC, but subclavian CVCs had more blunt injuries (81% vs 69%), greater systolic blood pressure (95 ± 55 vs 83 ± 43 mmHg), greater Glasgow Coma Scale (10 ± 5 vs 9 ± 5), and less introducers (49% vs 73%) than femoral CVCs (all P < 0.05). Catheter related arterial injuries, PEs, and CRBSIs were similar in subclavian and femoral groups (3% vs 2%, 0% vs 1%, and 3% vs 3%; all P > 0.05). Catheter-related DVTs occurred in 2 per cent of subclavian and 9 per cent of femoral CVCs (P < 0.001). There was a 3 per cent occurrence of pneumothorax in the subclavian CVC population. In conclusion, both subclavian and femoral CVCs caused significant complications. Subclavian catheter-related pneumothoraces occurred more commonly and femoral CRBSIs less commonly than expected compared with prior literature in nonemergent scenarios. This suggests that femoral CVC may be safer than subclavian CVC during initial trauma resuscitations. PMID:25975341

  11. Referrals in Acute Coronary Events for CARdiac Catheterization: The RACE CAR trial

    PubMed Central

    Kreatsoulas, Catherine; Sloane, Debi; Pogue, Janice; Velianou, James L; Anand, Sonia S

    2010-01-01

    BACKGROUND: Women with acute coronary syndromes have lower rates of cardiac catheterization (CC) than men. OBJECTIVE: To determine whether sex/gender, age, risk level and patient preference influence physician decision making to refer patients for CC. METHODS: Twelve clinical scenarios controlling for sex/gender, age (55 or 75 years of age), Thrombolysis in Myocardial Infarction risk score (low, moderate or high) and patient preference for CC (agreeable or refused/no preference expressed) were designed. Scenarios were administered to specialists across Canada using a web-based computerized survey instrument. Questions were standardized using a five-point Likert scale ranging from 1 (very unlikely to benefit from CC) to 5 (very likely to benefit from CC). Outcomes were assessed using a two-tailed mixed linear regression model. RESULTS: Of 237 scenarios, physicians rated men as more likely to benefit from CC than women (mean [± SE] 4.44±0.07 versus 4.25±0.07, P=0.03), adjusted for age, risk and patient preference. Low-risk men were perceived to benefit more than low-risk women (4.20±0.13 versus 3.54±0.14, P<0.01), and low-risk younger patients were perceived to benefit more than low-risk older patients (4.52±0.17 versus 3.22±0.16, P<0.01). Regardless of risk, patients who agreed to CC were perceived as more likely to benefit from CC than patients who were disagreeable or made no comment at all (5.0±0.23, 3.67±0.21, 2.95±0.14, respectively, P<0.01). CONCLUSION: Canadian specialists’ decisions to refer patients for CC appear to be influenced by sex/gender, age and patient preference in clinical scenarios in which cardiac risk is held constant. Future investigation of possible age and sex/gender biases as proxies for risk is warranted. PMID:20931097

  12. Balloon valvuloplasty as destination therapy in elderly with severe aortic stenosis: a cardiac catheterization study

    PubMed Central

    Kamperidis, Vasileios; Hadjimiltiades, Stavros; Ziakas, Antonios; Sianos, Georgios; Kazinakis, Georgios; Giannakoulas, George; Mouratoglou, Sophia-Anastasia; Sarafidou, Athanasia; Ventoulis, Ioannis; Efthimiadis, Georgios K; Parcharidis, Georgios; Karvounis, Haralambos

    2015-01-01

    Background In the current era of transcatheter aortic valve replacement, there is renewed interest in balloon aortic valvuloplasty (BAV) and invasive hemodynamic evaluation of aortic stenosis (AS). The current report aimed to study the invasive hemodynamics of severe AS patients treated with BAV as destination therapy and to identify factors associated with better hemodynamic outcome and prognosis. Methods From 2009 to 2012, 63 high risk elderly patients were treated with BAV as destination therapy for symptomatic severe AS and were all prospectively included in the study. Their hemodynamics were invasively evaluated during catheterization, pre- and post-BAV at the same session. All Post-BAV patients were regularly followed-up. Results The patients (82 ± 6 years, 52% male) had post-BAV aortic valve area index (AVAi) significantly increased and mean pressure gradient (MPG) significantly reduced. During the follow-up of 0.9 (maximum 3.3) years, those with post-BAV AVAi < 0.6 cm2/m2 compared with the AVAi ? 0.6 cm2/m2 group had significantly higher mortality (60% vs. 28%, log-rank P = 0.02), even after adjusting for age, gender, atrial fibrillation, chronic kidney disease, diabetes mellitus, coronary artery disease and EuroSCORE [HR: 5.58, 95% confidence interval (CI): 1.62?19.20, P = 0.006]. The only independent predictor of moderate AS post-BAV was the pre-BAV AVAi increase by 0.1cm2/m2 (OR: 3.81, 95% CI: 1.33?10.89, P = 0.01). Pre-BAV AVAi ? 0.39 cm2/m2 could predict with sensitivity 84% and specificity 70% the post-BAV hemodynamic outcome. Conclusions BAV as destination therapy for severe AS offered immediate and significant hemodynamic improvement. The survival was significantly better when a moderate degree of AS was present.

  13. A micro blood sampling system for catheterized neonates and pediatrics in intensive care unit.

    PubMed

    Jung, Wooseok; Ahn, Chong H

    2013-04-01

    A new micro blood sampling system has been designed, fabricated, and characterized to reduce iatrogenic blood loss from the catheterized neonates and pediatrics in intensive care unit by providing micro-volume of blood to analytical biomedical microdevices which can do point-of-care testing for their critical care. The system can not only save enormous iatrogenic blood loss through 1 to 10 ?L of blood sampling and re-infusion of 1 to 5 mL of discard blood but also reduce the infection risk through the closed structure while satisfying the key criteria of the blood sampler. The sampled blood preserved its quality without rupturing of red blood cells verified by blood potassium concentrations of 3.86 ± 0.07 mM on the sampled blood which is similar to 3.81 ± 0.04 mM measured from the blood which did not go through the system. The sampling volume among the sampling channels showed consistency with the relative standard deviation of 1.41 %. In addition to the micro blood sampling capability, the sampling system showed negligible sample cross-contamination. The analyte-free samples collected after aspirating 7,500 times higher signal sample showed the same output signal as blank. The system was also demonstrated not to cause air-embolism by having no bubble generation during flushing procedure and the system was verified as leak-free since there was no fluid leakage under 30 times higher pressure than central venous pressure for 24 h. PMID:23150205

  14. Urinary tract infections in children with myelodysplasia in whom clean intermittent catheterization was administered

    PubMed Central

    Y?ld?z, Zuhal Albayrak; Candan, Cengiz; Arga, Mustafa; Turhan, P?nar; ??güven, P?nar; Ergüven, Müferet

    2014-01-01

    Aim: In this study, it was aimed to evaluate the frequency of significant bacteriuria and antibiotic resistance characteristics in children with myelodysplasia in whom clean intermittent catheterization was administered. Material and Methods: The study group was composed of 71 patients with myelodysplasia who were found to have significant bacteriuria (age: 8.20±4.57 years; 39 girls) and the control groups was composed of 49 children who were diagnosed with community-acquired urinary tract infection (age: 7.94±4.17 years; 29 girls). The patient and control groups were evaluated in terms of the microorganisms grown in urinary cultures and antibiotic resistance characteristics. The study approved by the ethics committe (14/02/2012-19/E). Results: Growth of Escherichia coli (E. coli) was found with the highest rate in myelodysplasic patients. However, when compared with the control group in terms of microorganism types, an increase in the growth rates of the microorganisms excluding E. coli was observed in the patients with myelodysplasia which was close to the significance limit (p=0.055). When antibiotic resistance properties were examined, a significantly increased resistance against cotrimaxazole was found in the patient group compared to the control group (p=0.001). 84.5% of the patients were using prophylactic antibiotic including mainly co-trimoxazole. A significantly increased co-trimoxazole resistance was also found in the patients who were using prophylactic antibiotic compared to the patients who were not using prophylactic antibiotic (p=0.025). The rate of symptomatic UTI was found to be 21% in the patients with myelodysplasia and a significant increase was found in the complaints of abdominal/side pain and nausea/vomiting as well as fever in these patients compared to the patients with asymptomatic bacteriuria (p=0.029 and p=0.032, respectively). Conclusion: Our results show that UTI is still a significant problem in patients with myelodysplasia. In addition, they show that use of prophylactic antibiotic may increase the frequency of development of resistance and co-trimoxazole used for this objective is not a good option..

  15. [Radiation exposure of health personnel and patients in the heart catheterization laboratory in during vascular brachytherapy].

    PubMed

    Folkerts, K H; Franz, A; Kiefer, A; Hennersdorf, G

    2002-06-01

    Interventional radiological measures can lead to high radiation exposures for medical staff. In order to determine the radiation exposure to staff and patients, the resulting radiation exposures were directly measured for 52 measures at an cardiac catheterization laboratory with a new dosimetry system DIS (Direct Ion Storage). Beside the measurement of body dose behind the lead apron, measurements of radiation doses were performed in front of the lead apron and at the wrist of the physician. These measurements were taken as an approximation of the radiation exposure of the non-shielded body parts. The patients dose was estimated by placing a dosemeter close to the head of the patient and from the dose-area product. The mean value of body dose from 52 measurements for the physician behind the lead apron was 1.9 microSv per procedure with a range of 0-9 microSv. In front of the lead apron, a mean value of 53.9 microSv (3-233 microSv) per procedure was obtained. The mean value of partial body dose at the physician's wrist was determined to be 163.2 microSv (12-603 microSv) per procedure. It could be shown that measures combined with interventions lead to higher exposures compared with measures without interventions. For the medical technician, the mean value behind the lead apron was 3.9 microSv (0-58 microSv) per procedure. For the patient, a mean value of 800 microSv (119-8642 microSv) was measured close to the head. The mean dose to the skin of the patient at radiation entrance was determined to be 307 mGy (70-1190 mGy). From this data, the radiation dose per year for the physician performing 1000 measures, was determined to be 1.9 mSv/year. This is below the new dose limit of 20 mSv/year. Also the estimations for the dose to the eye lens and the hands of the physician show no conflicts with actual dose limits when obeying all radiation regulations. The results for vascular brachytherapy did not show significantly higher exposures, compared with conventional measures including interventions. PMID:12219698

  16. Reducing the burden of regular indwelling urinary catheter changes in the catheter clinics: the opinion of patients and relatives on the practice of self-catheterization

    PubMed Central

    Nnabugwu, Ikenna I; Udeh, Emeka I; Enivwenae, Oghenekaro A; Ugwumba, Fred O; Ozoemena, Oyiogu F

    2014-01-01

    Background Clean intermittent self-catheterization is accepted worldwide as a standard of care for patients with long-standing need for urinary bladder decompression. Evidence of its routine practice in our low-resource setting is lacking, leading to increasing number of patients with a long-standing indwelling urinary catheter. Objective To seek the opinion of patients already using indwelling catheters regarding the practice of self-catheterization. Patients and methods Over a 4-month period, the opinion of every patient and patient’s relative that attended the regular urinary catheter clinic was sought using an intern-administered questionnaire. The data was analyzed using SPSS version 20. Results A total of 108 patients completed the questionnaire. Age range was 16–100 years with a mean of 62.2±15.5 years. Only 30.5% of the patients had formal education beyond the primary level. The median cost for change of the indwelling catheter was 1,325 naira ($8.28 US) with a range of 500–4,000 naira ($3.13–$25 USD). Analysis showed that: 70.8% of patients aged under 60 years/60.6% of those with formal education beyond primary level/61.9% of those wearing catheters for <3 months would give consent for training in self-catheterization. Higher cost of catheter change did not influence the decision to consider self-catheterization. Of the 59 patient relatives who completed the questionnaire, 63% of those younger than 50 years old and 69.2% of those with tertiary education would be willing to undertake training to administer self-catheterization. Conclusion A select group of patients and accompanying relatives in our low-resource setting are willing to learn and practice self-catheterization. PMID:25214771

  17. Stenting as a Rescue Treatment of a Pulmonary Artery False Aneurysm Caused by Swan-Ganz Catheterization

    PubMed Central

    Keymel, Stefanie; Merx, Marc W.; Zeus, Tobias; Kelm, Malte; Steiner, Stephan

    2014-01-01

    Pulmonary vascular injury is a rare but life-threatening complication of Swan-Ganz catheterization. We report an 82-year old patient who underwent right heart catheterization by a balloon-tipped catheter because of suspected pulmonary hypertension. After deflation of the catheter in the wedge position, hemoptoe appeared associated with acute respiratory insufficiency requiring respiratory support by intubation and mechanical ventilation. Pulmonary angiography showed the formation of a false aneurysm of a segment artery of the left lower lobe. Immediate interventional therapy was performed by the implantation of two coated coronary stent grafts into the injured pulmonary artery thereby excluding the false aneurysm. Bleeding was stopped by this interventional approach while antegrade blood flow was maintained. Long term follow-up after 3 months showed an effective treatment with a completely thrombotic false aneurysm. However, despite oral anticoagulation and dual antiplatelet therapy, graft patency could not be achieved after 3 months. In summary, implantation of coated stents is a feasible and safe approach for the acute and long term treatment of potentially life-threatening condition of a pulmonary artery false aneurysm while treatment to achieve long term patency of the affected vessel still remains an issue to be resolved. PMID:25610693

  18. Environmental Indicators

    NSDL National Science Digital Library

    Environment Canada has developed a set of environmental indicators that are easily measurable and provide useful clues on the state of the environment. This Web site provides a listing of those indicators that Environment Canada monitors. For each indicator, there is a detailed description of the environmental indicator, how it relates to larger environmental problems, and what is being done to reduce the threat. A number of Web links are provided for further information on each indicator.

  19. Resource Utilisation Performance Indicators in the Public Sector of Higher Education, or Never Mind the Technique Feel the Structure. Coombe Lodge Information Bank Number 1450.

    ERIC Educational Resources Information Center

    Birch, Derek W.; Cuthbert, R. E.

    A discussion is presented of the process of resource allocation and the use of performance indicators in public sector higher education in Britain. First, background is presented on the method of providing resources to institutions of advanced further education (AFE) and non-advanced further education (NAFE) on the basis of pooled recurrent…

  20. ECOLOGICAL INDICATORS

    EPA Science Inventory

    An international symposium on ecological indicators was developed to explore both the potential of ecological indicators and the issues surrounding their development and implementation. his symposium presented state-of-the-science information on the identification, application re...

  1. Combined Hepatic Vein, Umbilicoportal Vein, and Superior Mesenteric Artery Catheterization in Portal Hypertension: Estimation of the Portal Fraction of Total Hepatic Blood Flow in Cirrhotic Patients 1

    PubMed Central

    Huet, P. M.; Lavoie, P.; Legare, A.; Viallet, A.

    1975-01-01

    Hemodynamic data were obtained in 13 cirrhotic patients with severe portal hypertension, undergoing combined hepatic vein, umbilicoportal vein, and superior mesenteric artery catheterization. The relative clearance of indocyanine green, the portohepatic gradient (difference between the free portal venous pressure and the free hepatic venous pressure), and the estimated hepatic blood flow were measured. The portal fraction (PF) of total hepatic blood flow was calculated in all patients using indicator dilution curves obtained from the portal bifurcation, a right hepatic vein, and when possible a left hepatic vein (six cases) after injection of 51Cr-labeled red blood cells (51Cr RBC) into the superior mesenteric artery. Flows were overestimated because of loss of indicator through spontaneous portosystemic shunts; however, the ratio between hepatic and portal indicator dilution curves can be used to calculate the portal fraction of total hepatic blood flow since no extrahepatic shunts existed after the bifurcation of the portal vein (as shown on portography). In 10 patients, 15 series of curves were calculable and the PF varied between 30.1 and 100% (mean ± SE: 71.1 ± 6.2%). In the three other patients, only delayed activity from recirculation was detected from portal and hepatic vein samples and PF was 0%; in these three cases, portography and arteriography revealed spontaneous portacaval shunting with reverse and/or stagnant circulation in the portal vein. In the 13 patients, no correlation existed between PF and the relative clearance of indocyanine green or the portohepatic gradient, parameters generally used as indices of severity in cirrhosis. In 10 patients, no correlation was found between PF and the estimated hepatic blood flow. These data indicate that 51Cr RBC dilution curves can be used for the estimation of the portal fraction of total hepatic blood flow in conscious cirrhotic patients before portacaval shunts. Using this methodology, it could be assessed whether any critical level of portal fraction exists above which poor clinical results occur after portacaval shunting. This measurement could eventually be helpful in determining the appropriate surgical procedure to be applied in individual cases. ImagesFIG. 4FIG. 5aFIG. 5bFIG. 5c PMID:1130101

  2. An evaluation of single-site statistical downscaling techniques in terms of indices of climate extremes for the Midwest of Iran

    NASA Astrophysics Data System (ADS)

    Farajzadeh, M.; Oji, R.; Cannon, A. J.; Ghavidel, Y.; Massah Bavani, A.

    2015-04-01

    Seven single-site statistical downscaling methods for daily temperature and precipitation, including four deterministic algorithms [analog model (ANM), quantile mapping with delta method extrapolation (QMD), cumulative distribution function transform (CDFt), and model-based recursive partitioning (MOB)] and three stochastic algorithms [generalized linear model (GLM), Conditional Density Estimation Network Creation and Evaluation (CaDENCE), and Statistical Downscaling Model-Decision Centric (SDSM-DC] are evaluated at nine stations located in the mountainous region of Iran's Midwest. The methods are of widely varying complexity, with input requirements that range from single-point predictors of temperature and precipitation to multivariate synoptic-scale fields. The period 1981-2000 is used for model calibration and 2001-2010 for validation, with performance assessed in terms of 27 Climate Extremes Indices (CLIMDEX). The sensitivity of the methods to large-scale anomalies and their ability to replicate the observed data distribution in the validation period are separately tested for each index by Pearson correlation and Kolmogorov-Smirnov (KS) tests, respectively. Combined tests are used to assess overall model performances. MOB performed best, passing 14.5 % (49.6 %) of the combined (single) tests, respectively, followed by SDSM, CaDENCE, and GLM [14.5 % (46.5 %), 13.2 % (47.1 %), and 12.8 % (43.2 %), respectively], and then by QMD, CDFt, and ANM [7 % (45.7 %), 4.9 % (45.3 %), and 1.6 % (37.9 %), respectively]. Correlation tests were passed less frequently than KS tests. All methods downscaled temperature indices better than precipitation indices. Some indices, notably R20, R25, SDII, CWD, and TNx, were not successfully simulated by any of the methods. Model performance varied widely across the study region.

  3. ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Patel, Manesh R; Bailey, Steven R; Bonow, Robert O; Chambers, Charles E; Chan, Paul S; Dehmer, Gregory J; Kirtane, Ajay J; Wann, L Samuel; Ward, R Parker

    2012-05-29

    The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. PMID:22578925

  4. Sensitivity analysis of standard toxicity tests, rapid bioassays and in-situ techniques to indicate effluent toxicity in Gulf of Mexico estuaries

    SciTech Connect

    Lewis, M.; Weber, D. [Environmental Protection Agency, Gulf Breeze, FL (United States)

    1995-12-31

    The toxicities of eight industrial and municipal effluents discharged into the Pensacola Bay System (Florida) were evaluated for two years. Standard chronic toxicity tests with algae, invertebrates and fish were determined, as were effects monitored by Mutatox{reg_sign} and Microtox{reg_sign}. Sediment toxicity in the receiving water to four test species, in-situ effects on colonized periphyton and oyster tissue analysis were determined to assess environmental relevance of single-species toxicity tests. Overall, chronic toxicity to fish and Microtox effects were rarely observed; whereas, Mutatox effects and chronic toxicity to invertebrates were more common. Phytotoxicity (inhibition) of the effluents and sediment in the receiving water was not usually observed; however, significant stimulation of plant growth was common. Biomass and chlorophyll content of periphyton in the receiving water were greater than those in control areas, reflecting the stimulatory effect on growth observed in the laboratory phytotoxicity tests. Overall, toxicity was observed for all effluents by at least one diagnostic technique. There was no most sensitive test since effects were effluent-specific. Consequently, since there was no single effective test, the scientific and regulatory communities need to decide the significance of the various effluent assessment techniques and the ramifications of this issue on the NPDES permitting process.

  5. Stability-indicating spectrophotometric methods for determination of tazarotene in the presence of its alkaline degradation product by derivative spectrophotometric techniques.

    PubMed

    Badawy, Amr M; El-Alim, Abd El-Aziz B Abd; Saad, Ahmed S

    2010-03-01

    The stability of tazarotene (TZ) was investigated and two stability-indicating methods-namely, first derivative and a derivative ratio spectrophotometric method-were used to determine tazarotene in the presence of its alkaline degradation product (HD) using methanol as a solvent. A linear relationship was obtained in the range 1-10 µg ml?¹ for both methods. By applying the proposed methods, it was possible to determine tazarotene in its pure powdered from with accuracy 99.35 ± 1.410 (n = 10) for the first derivative method and 99.45 ± 1.053 (n = 10) for the derivative ratio method. First derivative and derivative ratio methods were used for the analysis of laboratory-prepared mixtures containing different ratios of tazarotene and its degradation product and they were valid in the presence of up to 70% and 80% degradation product, respectively. The proposed methods were validated and found to be suitable as stability-indicating assay methods for tazarotene in pharmaceutical formulations. PMID:20878894

  6. Subclavian artery pseudoaneurysm complicating central venous catheterization: endovascular treatment with Amplatzer Vascular Plug 4 and covered stent.

    PubMed

    Rossi, Umberto G; Petrocelli, Francesco; Ferro, Carlo

    2013-12-01

    Central venous catheterization is a routine vascular access procedure; however, it may be associated with life-threatening complications such as arterial puncture, leading to pseudoaneurysm formation. We report a case of a 41-year-old female that developed an iatrogenic left subclavian pseudoaneurysm complicating the attempt of left internal jugular vein cannulation for temporary hemodialysis therapy. The patient underwent urgent endovascular treatment with deployment of covered stent into the left subclavian artery (SCA) after embolization of the origin of the left internal mammary artery with Amplatzer Vascular Plug 4. The patient's recovery was unremarkable. Follow-up till 24 months reveals total exclusion of the pseudoaneurysm of the left SCA with patency of the distal branches. PMID:23359531

  7. Transcatheter aortic valve replacement: establishing a comprehensive program model for hybrid cardiac catheterization laboratories in the Department of Veterans Affairs.

    PubMed

    Speiser, Bernadette; Dutra-Brice, Cynthia

    2014-01-01

    Aortic valve disease, especially aortic stenosis, becomes progressively debilitating and carries a high mortality risk if it is categorized as severe and symptomatic (J Thorac Cardiovas Surg. 2012;144(3):e29-e84). In the past, the only treatment for aortic stenosis was surgical aortic valve replacement. Surgical treatment may require several hours of cardioplegia, and if the patient has comorbidities, such as renal failure or chronic obstructive pulmonary disease, their operative mortality percentage increases.In 2011, the US Food and Drug Administration approved the use of a transcatheter aortic valve replacement (TAVR) procedure for patients who were deemed high risk or inoperative for the routine surgical aortic valve replacement surgery. More than 20,?000 TAVRs have been performed in patients worldwide since 2002 when Dr Alain Cribier performed the first-in-man TAVR (Arch Cardiovasc Dis. 2012;105(3):145-152). The Edwards Lifesciences SAPIEN XT valve and the Medtronic CoreValve are commercially available.The clinical findings and economic statistic have supported the expansion of the TAVR procedure. However, there has been considerable controversy over where the procedure is to occur and who is directly responsible for directing the TAVR care. This debate has identified barriers to the implementation of a TAVR program. The operating rooms and a cardiac catheterization laboratory are underprepared for the hybrid valve replacement therapy. Because of the barriers identified, the Department of Veterans Affairs determined a need for a systematic approach to review the programs that applied for this structural heart disease program. A centralized team was developed to ensure room readiness and staff competency. The use of the Health Failure Mode and Effects Analysis can define high-risk clinical processes and conduct a hazard analysis. Worksheets can show potential failure modes and their probabilities, along with actions and outcome measures, team collaboration, extensive screening, and selection process. The TAVR program begins implementation with data entry with each case into CART-CL (Cardiovascular Assessment, Reporting and Tracking System for Cath Labs, Veteran Administration database for interventional cardiology procedures). If an untoward event occurs, within 24 hours the CART-CL Quality Assessment Team is activated to begin the review process. This provides real-time review and feedback to the local facility in an expeditious manner. Cardiac catheterization laboratories have been inundated with rapidly changing technological advances in the past decade. The era for structural heart repair is rapidly mobilizing from a surgical/operating room setting to a transcatheter/hybrid catheterization laboratory suite. The use of the new hybrid catheterization laboratories will continue to expand as the approval of future transcatheter therapies evolve. Editor's note: Due to the volume of important information presented in each table, only the first table is included in the print version of the article, however, all tables may be viewed in their entirety free of charge on the online version of this article: http://journals.lww.com/dccnjournal/pages/default.aspx. PMID:25144213

  8. GIS modelling of seismic vulnerability of residential fabrics considering geotechnical, structural, social and physical distance indicators in Tehran city using multi-criteria decision-making (MCDM) techniques

    NASA Astrophysics Data System (ADS)

    Rezaie, F.; Panahi, M.

    2014-09-01

    The main issue in determining the seismic vulnerability is having a comprehensive view to all probable damages related to earthquake occurrence. Therefore, taking factors such as peak ground acceleration (PGA) in the time of earthquake occurrence, the type of structures, population distribution among different age groups, level of education, the physical distance to a hospitals (or medical care centers), etc. into account and categorized under four indicators of geotechnical, structural, social and physical distance to needed facilities and distance from dangerous ones will provide us with a better and more exact outcome. To this end in this paper using analytic hierarchy process (AHP), the amount of importance of criteria or alternatives are determined and using geographical information system (GIS), the vulnerability of Tehran metropolitan as a result of an earthquake, is studied. This study focuses on the fact that Tehran is surrounded by three active and major faults of the Mosha, North Tehran and Rey. In order to comprehensively determine the vulnerability, three scenarios are developed. In each scenario, seismic vulnerability of different areas in Tehran city is analysed and classified into four levels including high, medium, low and safe. The results show that regarding seismic vulnerability, the faults of Mosha, North Tehran and Rey respectively make 6, 16 and 10% of Tehran area highly vulnerable and also 34, 14 and 27% are safe.

  9. Total Pancreatectomy and Islet Auto-Transplantation in Children for Chronic Pancreatitis. Indication, Surgical Techniques, Post Operative Management and Long-Term Outcomes

    PubMed Central

    Chinnakotla, Srinath; Bellin, Melena D.; Schwarzenberg, Sarah J.; Radosevich, David M.; Cook, Marie; Dunn, Ty B.; Beilman, Gregory J.; Freeman, Martin L.; Balamurugan, A.N.; Wilhelm, Josh; Bland, Barbara; Jimenez-Vega, Jose M; Hering, Bernhard J.; Vickers, Selwyn M.; Pruett, Timothy L.; Sutherland, David E.R.

    2014-01-01

    Objective Describe the surgical technique, complications and long term outcomes of total pancreatectomy and islet auto transplantation (TP-IAT) in a large series of pediatric patients. Summary Background Data Surgical management of childhood pancreatitis is not clear; partial resection or drainage procedures often provide transient pain relief, but long term recurrence is common due to the diffuse involvement of the pancreas. Total pancreatectomy (TP) removes the source of the pain, while islet auto transplantation (IAT) potentially can prevent or minimize TP-related diabetes. Methods Retrospective review of 75 children undergoing TP-IAT for chronic pancreatitis who had failed medical, endoscopic or surgical treatment between 1989–2012. Results Pancreatitis pain and the severity of pain statistically improved in 90% of patients after TP-IAT (p =<0.001). The relief from narcotics was sustained. Of the 75 patients undergoing TP-IAT, 31 (41.3%) achieved insulin independence. Younger age (p=0.032), lack of prior Puestow (p=0.018), lower body surface area (p=0.048), IEQ per Kg Body Weight (p=0.001) and total IEQ (100,000) (0.004) were associated with insulin independence. By multivariate analysis, 3 factors were associated with insulin independence after TP-IAT:(1) male gender, (2) lower body surface area and the (3) higher total IEQ per kilogram body weight. Total IEQ (100,000) was the single factor most strongly associated with insulin independence (OR = 2.62; p value < 0.001). Conclusions TP-IAT provides sustained pain relief and improved quality of life. The ? cell function is dependent on islet yield. TP-IAT is an effective therapy for children with painful pancreatitis that fail medical and or endoscopic management PMID:24509206

  10. RBC indices

    MedlinePLUS

    ... corpuscular hemoglobin concentration (MCHC); Mean corpuscular volume (MCV); Red blood cell indices ... and hemoglobin. The MCV reflects the size of red blood cells. The MCH and MCHC reflect the ...

  11. Determination of cytoplasmic calcium concentration in Dryopteris spores: a developmentally non-disruptive technique for loading of the calcium indicator fura-2

    NASA Technical Reports Server (NTRS)

    Scheuerlein, R.; Schmidt, K.; Poenie, M.; Roux, S. J.

    1991-01-01

    Germination of Dryopteris spores is mediated by the physiologically active, far-red-absorbing form of phytochrome, Pfr, and external Ca2+ is necessary for the transduction of the light signal. Because knowledge about the cytoplasmic calcium ion concentration, [Ca2+]i, is of great importance for understanding the role of calcium during signal transduction, this value was measured using fura-2 in fern spores undergoing the normal developmental progression into germination. Fura-2 was loaded into the spores by electroporation, which does not disrupt the normal process of germination. The intensity of the fluorescence emission of the loaded fura-2 was analysed by a microspectrophotometric assay of single spores, and successful loading could be obtained by the application of ten electrical pulses (field strength 7.5 kV cm-1, half-life (time constant) 230 microseconds). Fura-2 was alternately excited by light of wavelengths 355 and 385 nm through an inverted fluorescence microscope, and the emitted fura-2 fluorescence was collected by a silicon-intensified video camera. The cytoplasmic calcium ion concentration was calculated from the ratio of the camera output obtained for both wavelengths and displayed by a pseudo-color technique. Spores responded to changes of the extracellular Ca2+ concentration, and this observation is considered as evidence that fura-2 is loaded into the cytoplasm. The substitution of a low external [Ca2+] (1 mM ethyleneglycol-bis(2-aminoethylether)-N,N,N',N'-tetraacetic acid (EGTA)) by 1 mM CaCl2 caused a fast increase of [Ca2+]i from approx. 50 nM to above 500 nM. In contrast, the subsequent substitution of CaCl2 by EGTA decreased [Ca2+]i again below 100 nM within 0.5 h. Furthermore, the application of ionomycin could initiate a change in [Ca2+]i according to the Ca2+ gradient established between the extracellular medium and cytoplasm. In spores sown on a Ca(2+) -free medium, [Ca2+]i, analysed in a buffer containing EGTA, was found to be around 50 nM during the first days of cultivation, independent of the irradiation protocol. However, if spores were grown in darkness on a Ca(2+) -containing medium and analysed in EGTA, [Ca2+]i was significantly higher (> or = 500 nM). In red-light-irradiated spores, [Ca2+]i was found to decrease with increasing time after irradiation, and was determined to be less than 100 nM when analysis was done 44 h after germination was initiated by the light treatment.

  12. Position indicator

    DOEpatents

    Tanner, David E. (Poway, CA)

    1981-01-01

    A nuclear reactor system is described in which a position indicator is provided for detecting and indicating the position of a movable element inside a pressure vessel. The movable element may be a valve element or similar device which moves about an axis. Light from a light source is transmitted from a source outside the pressure vessel to a first region inside the pressure vessel in alignment with the axis of the movable element. The light is redirected by a reflector prism to a second region displaced radially from the first region. The reflector prism moves in response to movement of the movable element about its axis such that the second region moves arcuately with respect to the first region. Sensors are arrayed in an arc corresponding to the arc of movement of the second region and signals are transmitted from the sensors to the exterior of the reactor vessel to provide indication of the position of the movable element.

  13. Chemical Indicators.

    ERIC Educational Resources Information Center

    Prombain, Dorothy R.; And Others

    This science sourcebook was written for intermediate grade teachers to provide guidance in teaching a specially developed unit on chemical indicators. Directions and suggestions for guiding student science activities are given. Some of the activities concern soil testing, crystals, and household powders such as sugar and salt. A list of necessary…

  14. Acute Hemodynamic Changes After Rapid Intravenous Bolus Dosing of Dexmedetomidine in Pediatric Heart Transplant Patients Undergoing Routine Cardiac Catheterization

    PubMed Central

    Jooste, EH; Muhly, WT; Ibinson, JW; Suresh, T; Damian, D; Phadke, A; Callahan, P; Miller, S; Feingold, B; Lichtenstein, SE; Cain, JG; Chrysostomou, C; Davis, PJ

    2011-01-01

    Introduction Dexmedetomidine is a highly selective ?2-adrenoceptor agonist with sedative, anxiolytic and analgesic properties that has minimal effects on respiratory drive. Its sedative and hypotensive effects are mediated via central ?2A and imidazoline type 1 receptors while activation of peripheral ?2B–adrenoceptors result in an increase in arterial blood pressure and systemic vascular resistance (SVR). In this randomized, prospective, clinical study we attempted to quantify the short-term hemodynamic effects resulting from a rapid IV bolus administration of dexmedetomidine in pediatric cardiac transplant patients. Methods Twelve patients, aged ?10 years of age, weighing ?40kg, presenting for routine surveillance of right and left heart cardiac catheterization after cardiac transplantation were enrolled. After an inhaled or IV induction, the tracheas were intubated and anesthesia was maintained with 1 minimum alveolar concentration of isoflurane in room air, fentanyl (1mcg/kg) and rocuronium (1mg/kg). At the completion of the planned cardiac catheterization, 100% oxygen was administered. After recording a set of baseline values that included heart rate (HR), systolic blood pressure, diastolic blood pressure, central venous pressure, systolic pulmonary artery pressure, diastolic pulmonary artery pressure, pulmonary artery wedge pressure and thermodilution-based cardiac output, a rapid IV dexmedetomidine bolus of either 0.25mcg/kg or 0.5mcg/kg was administered over 5 seconds. The hemodynamic measurements were repeated at 1 min and 5 mins. Results There were 6 patients in each group. Investigation suggested that systolic blood pressure, diastolic blood pressure, systolic pulmonary artery pressure, diastolic pulmonary artery pressure, pulmonary artery wedge pressure and systemic vascular resistance all increased at 1 minute after rapid IV bolus for both doses, and decreased significantly to near baseline for both doses by 5 minutes. The transient increase in pressures was more pronounced in the systemic system than in the pulmonary system. In the systemic system there was a larger percent increase in the diastolic pressures than the systolic pressures. Cardiac output, CVP and pulmonary vascular resistance did not change significantly. HR decreased at 1 min for both doses and was, within the 0.5 mcg/kg group, the only hemodynamic variable still changed from baseline at the 5 min time point Conclusion Rapid IV bolus administration of dexmedetomidine in this small sample of children having undergone heart transplants was clinically well tolerated, although it resulted in a transient but significant increase in systemic and pulmonary pressure and a decrease in HR. In the systemic system there is a larger percent increase in the diastolic pressures than the systolic pressures, and furthermore these transient increases in pressures were more pronounced in the systemic system than in the pulmonary system. PMID:21059743

  15. Social Indicators

    NSDL National Science Digital Library

    Bolton, Paul.

    The House of Commons Library Research Papers are published for the benefit of Parliament members, but this one should be of interest to both researchers and general readers wanting to learn more about contemporary British social issues. Social Indicators is the first paper in a new series that will be published three times a year. The 71-page paper includes a wide range of topic pages that present social statistics on a variety of issues, from the prison population to defense expenses to agricultural outputs. Each Social Indicator paper will also offer feature articles that give a closer look at specific subjects (in this instance,, election turnout and adult literacy) and an article on statistical sources for a particular issue (in this paper, social security statistics). The last few pages are devoted to a list of important, recent governmental statistical publications.

  16. Supramalleolar Osteotomy: Indications and Surgical Techniques.

    PubMed

    Mulhern, Jennifer L; Protzman, Nicole M; Brigido, Stephen A; Deol, Premjit Pete S

    2015-07-01

    Supramalleolar osteotomies are a surgical treatment option for asymmetric varus or valgus ankle arthritis where at least 50% of the joint surface is spared. Procedure selection requires significant preoperative planning for appropriate execution. Thus, the surgeon must be familiar with the principles of deformity correction. With appropriate patient selection and proper preoperative planning, the procedure has been shown to yield excellent results, redistributing forces more evenly across the ankle joint by restoring the mechanical axis of the lower leg with minimal complications. PMID:26117578

  17. Pediatric Islet Autotransplantation: Indication, Technique, and Outcome

    Microsoft Academic Search

    Melena D. Bellin; David E. R. Sutherland

    2010-01-01

    Chronic pancreatitis is a rare disease in childhood. However, when severe, a total pancreatectomy may be the only option to\\u000a relieve pain and restore quality of life. An islet autotransplant performed at the time of pancreatectomy can prevent or minimize\\u000a the postsurgical diabetes that would otherwise result from pancreatectomy alone. In this procedure, the resected pancreas\\u000a is mechanically disrupted and

  18. Laparoscopic adrenalectomy—indications and technique

    Microsoft Academic Search

    Geeta Lal; Quan-Yang Duh

    2003-01-01

    Laparoscopic adrenalectomy has become the procedure of choice for the surgical management of most adrenal tumors, including functional and non-functional lesions. The role of laparoscopic adrenalectomy in the management of malignant adrenal tumors is controversial and most adrenocortical cancers are generally treated by open adrenalectomy. Laparoscopic adrenalectomy can be performed by both the anterior or lateral trans-abdominal approach and by

  19. Superiority of quantitative exercise thallium-201 variables in determining long-term prognosis in ambulatory patients with chest pain: a comparison with cardiac catheterization

    SciTech Connect

    Kaul, S.; Finkelstein, D.M.; Homma, S.; Leavitt, M.; Okada, R.D.; Boucher, C.A.

    1988-07-01

    The purpose of this study was to determine the prognostic utility of quantitative exercise thallium-201 imaging and compare it with that of cardiac catheterization in ambulatory patients. Accordingly, long-term (4 to 9 years) follow-up was obtained in 293 patients who underwent both tests for the evaluation of chest pain: 89 had undergone coronary artery bypass graft surgery within 3 months of testing and were excluded from analysis, 119 experienced no cardiac events and 91 had an event (death in 20, nonfatal myocardial infarction in 21 and coronary artery bypass operations performed greater than 3 months after cardiac catheterization in 50). When all variables were analyzed using Cox regression analysis, the quantitatively assessed lung/heart ratio of thallium-201 activity was the most important predictor of a future cardiac event (chi 2 = 40.21). Other significant predictors were the number of diseased vessels (chi 2 = 17.11), patient gender (chi 2 = 9.43) and change in heart rate from rest to exercise (chi 2 = 4.19). Whereas the number of diseased vessels was an important independent predictor of cardiac events, it did not add significantly to the overall ability of the exercise thallium-201 test to predict events. Furthermore, information obtained from thallium-201 imaging alone was marginally superior to that obtained from cardiac catheterization alone (p = 0.04) and significantly superior to that obtained from exercise testing alone (p = 0.02) in determining the occurrence of events. In addition, unlike the exercise thallium-201 test, which could predict the occurrence of all categories of events, catheterization data were not able to predict the occurrence of nonfatal myocardial infarction. The exclusion of bypass surgery and previous myocardial infarction did not alter the results.

  20. Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

    PubMed Central

    Jelin, Eric B.; Schecter, Samuel C.; Gonzales, Kelly D.; Hirose, Shinjiro; Lee, Hanmin; Machin, Geoffrey A.; Rand, Larry; Feldstein, Vickie A.

    2011-01-01

    Monochorionic (MC) twin pregnancies are associated with significantly higher morbidity and mortality rates than dichorionic twins. Approximately 50% of MC twin pregnancies develop complications arising from the shared placenta and associated vascular connections1. Severe twin-to-twin syndrome (TTTS) is reported to account for approximately 20% of these complications2,3. Inter-twin vascular connections occur in almost all MC placentas and are related to the prognosis and outcome of these high-risk twin pregnancies. The number, size and type of connections have been implicated in the development of TTTS and other MC twin conditions. Three types of inter-twin vascular connections occur: 1) artery to vein connections (AVs) in which a branch artery carrying deoxygenated blood from one twin courses along the fetal surface of the placenta and dives into a placental cotyledon. Blood flows via a deep intraparenchymal capillary network into a draining vein that emerges at the fetal surface of the placenta and brings oxygenated blood toward the other twin. There is unidirectional flow from the twin supplying the afferent artery toward the twin receiving the efferent vein; 2) artery to artery connections (AAs) in which a branch artery from each twin meets directly on the superficial placental surface resulting in a vessel with pulsatile bidirectional flow, and 3) vein to vein connections (VVs) in which a branch vein from each twin meets directly on the superficial placental surface allowing low pressure bidirectional flow. In utero obstetric sonography with targeted Doppler interrogation has been used to identify the presence of AV and AA connections4. Prenatally detected AAs that have been confirmed by postnatal placental injection studies have been shown to be associated with an improved prognosis for both twins5. Furthermore, fetoscopic laser ablation of inter-twin vascular connections on the fetal surface of the shared placenta is now the preferred treatment for early, severe TTTS. Postnatal placental injection studies provide a valuable method to confirm the accuracy of prenatal Doppler ultrasound findings and the efficacy of fetal laser therapy6. Using colored dyes separately hand-injected into the arterial and venous circulations of each twin, the technique highlights and delineates AVs, AAs, and VVs. This definitive demonstration of MC placental vascular anatomy may then be correlated with Doppler ultrasound findings and neonatal outcome to enhance our understanding of the pathophysiology of MC twinning and its sequelae. Here we demonstrate our placental injection technique. PMID:21912372

  1. Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease

    PubMed Central

    DiStefano, Youmna E.; Lazar, Michael D.

    2015-01-01

    Peripheral nerve blockade (PNB) is superior to neuraxial anesthesia and/or opioid therapy for perioperative analgesia in total knee replacement (TKR). Evidence on the safety of PNB in patients with coagulopathy is lacking. We describe the first documented account of continuous femoral PNB for perioperative analgesia in a patient with Von Willebrand Disease (vWD). Given her history of opioid tolerance and after an informative discussion, a continuous femoral PNB was planned for in this 34-year-old female undergoing TKR. A Humate-P intravenous infusion was started and the patient was positioned supinely. Using sterile technique with ultrasound guidance, a Contiplex 18 Gauge Tuohy needle was advanced in plane through the fascia iliaca towards the femoral nerve. A nerve catheter was threaded through the needle and secured without complications. Postoperatively, a levobupivacaine femoral catheter infusion was maintained, and twice daily Humate-P intravenous infusions were administered for 48 hours; enoxaparin thromboprophylaxis was initiated thereafter. The patient was discharged uneventfully on postoperative day 4. Given documentation of delayed, unheralded bleeding from PNB in coagulopathic patients, we recommend individualized PNB in vWD patients. Multidisciplinary team involvement is required to guide factor supplementation and thromboprophylaxis, as is close follow-up to elicit signs of bleeding throughout the delayed postoperative period. PMID:26113995

  2. Gross and histopathological observations of long-term catheterized vessels in experimental sheep.

    PubMed

    Barraza, M L; Strickland, J R; Zepeda, H; Taylor, J B; Krehbiel, C R; Bell, G S; Klotz, J L

    2006-06-01

    Chronic indwelling central vessel catheters provide vascular access for compartmental infusion or sampling. However, complications with catheter patency during the postoperative and/or experimental period often arise. In order to identify physiological occurrences common with such complications, 10 multicatheterized sheep (61.8 +/- 7.8 kg BW), obtained from a previous nutrient flux study were used for gross and histopathological investigation. Catheters had been surgically placed in a hepatic portal vein (PVC), a hepatic vein (HVC), a distal mesenteric vein (MVC) and a mesenteric artery (MAC). In the previous study, catheters (PVC, HVC and MAC) were used to collect blood samples or infuse (MVC) p-aminohippurate. Catheters were maintained for a total of 58 days prior to necropsy. Histopathological findings indicated that catheter failures were associated with the following tissue responses: (i) thromboses with frequent focal vasculitis; (ii) euplastic tissues associated with extensive fibrosis; (iii) granulomas; (iv) neo-vascularization of the media; (v) calcification processes; and (vi) micro-abscesses. Additional studies are needed that address and incorporate improvement of catheter design and placement to minimize irritation of endothelium, improvement of catheter treatments and therapeutic regimes, and development and use of alternative anti-coagulants. A greater understanding of the mechanisms leading to failure will help researchers improve catheter performance and patency. PMID:16737512

  3. Validation of the Use of Nonnaive Surgically Catheterized Rats for Pharmacokinetics Studies

    PubMed Central

    Deshmukh, Sujal V; Durston, Jessica; Shomer, Nirah H

    2008-01-01

    Although large animals, such as dogs and nonhuman primates, often are used for more than 1 pharmacokinetics study, common practice is to use only naive rodents for pharmacokinetics studies. We undertook a series of studies to validate whether surgically cannulated nonnaive rats could be used again after a 7-d washout. When vascular catheters are cared for appropriately, we find that they remain patent for more than 2 wk, with negligible drug carryover. Hematocrit decreased approximately 11% after pharmacokinetics studies but rebounded to prestudy levels after a 7-d washout. We empirically tested whether drugs known to alter drug disposition (1-aminobenzotriazole and quinidine) had residual effects on drug disposition after a 7-d washout and found that they did not. This finding suggests that after a 7-d washout, nonnaive rats likely would produce pharmacokinetics data similar to those of naive rats. We also tested reference compounds in naive and nonnaive rats and found no difference in pharmacokinetics parameters. Using surgically cannulated rats for a second study was feasible because of the relatively noninvasive nature of pharmacokinetics sampling (unrestrained rats attached to automated blood samplers). In addition, reusing surgically altered animals yields considerable cost savings. Our studies indicate that pharmacokinetics parameters did not differ significantly between naive and nonnaive rats. Cost–benefit analysis, monetary considerations, and validation studies support using rats for a second study after a 7-d washout period. PMID:19049252

  4. Fast catheter segmentation from echocardiographic sequences based on segmentation from corresponding X-ray fluoroscopy for cardiac catheterization interventions.

    PubMed

    Wu, Xianliang; Housden, James; Ma, YingLiang; Razavi, Benjamin; Rhode, Kawal; Rueckert, Daniel

    2015-04-01

    Echocardiography is a potential alternative to X-ray fluoroscopy in cardiac catheterization given its richness in soft tissue information and its lack of ionizing radiation. However, its small field of view and acoustic artifacts make direct automatic segmentation of the catheters very challenging. In this study, a fast catheter segmentation framework for echocardiographic imaging guided by the segmentation of corresponding X-ray fluoroscopic imaging is proposed. The complete framework consists of: 1) catheter initialization in the first X-ray frame; 2) catheter tracking in the rest of the X-ray sequence; 3) fast registration of corresponding X-ray and ultrasound frames; and 4) catheter segmentation in ultrasound images guided by the results of both X-ray tracking and fast registration. The main contributions include: 1) a Kalman filter-based growing strategy with more clinical data evalution; 2) a SURF detector applied in a constrained search space for catheter segmentation in ultrasound images; 3) a two layer hierarchical graph model to integrate and smooth catheter fragments into a complete catheter; and 4) the integration of these components into a system for clinical applications. This framework is evaluated on five sequences of porcine data and four sequences of patient data comprising more than 3000 X-ray frames and more than 1000 ultrasound frames. The results show that our algorithm is able to track the catheter in ultrasound images at 1.3 s per frame, with an error of less than 2 mm. However, although this may satisfy the accuracy for visualization purposes and is also fast, the algorithm still needs to be further accelerated for real-time clinical applications. PMID:25291790

  5. Right ventricular reverse remodeling after pulmonary endarterectomy: magnetic resonance imaging and clinical and right heart catheterization assessment.

    PubMed

    Berman, Marius; Gopalan, Deepa; Sharples, Linda; Screaton, Nick; Maccan, Caroline; Sheares, Karen; Pepke-Zaba, Joanna; Dunning, John; Tsui, Steven; Jenkins, David P

    2014-03-01

    The objective of this study was to assess the effect of pulmonary endarterectomy (PEA) on right ventricular (RV) reverse remodeling using magnetic resonance imaging (MRI) and to correlate MRI findings with clinical and hemodynamic outcomes postsurgery. We performed a retrospective analysis in 72 patients undergoing PEA surgery in whom MRI and right heart catheterization (RHC) were performed preoperation and 3 months postoperation. RV volumes and mass were assessed by MRI. Continuous variables were expressed as means, changes were compared with a paired t test, and associations between the variables were explored using Pearson correlation coefficients. The mean age was 57 years, and 51% were male. Both RV end-diastolic volume (EDV; 176-117 mL; P < 0.001) and RV end-systolic volume (ESV; 129-64 mL; P < 0.001) reduced significantly following PEA. Preoperative pulmonary artery pressure (PAP) correlated moderately with ESV (r = 0.46, P < 0.001). Postoperatively, PAP correlated with EDV (r = 0.45, P < 0.001) and ESV (r = 0.44, P < 0.001). Moderate correlation was present between hemodynamic parameters: PAP, pulmonary vascular resistance, and right atrial pressure with pre- and postoperation end-systolic and end-diastolic RV mass (P < 0.001). RHC and MRI measurements of cardiac output and RV volumes were significantly different (P < 0.001). In conclusion, RV reverse remodeling, as measured by improvement in RV volumes and mass by MRI, was observed for 3 months in patients who underwent PEA surgery. This is the largest series of patients with pre- and post-PEA MRI assessment so far reported. MRI detects changes in parameters reflecting cardiac remodeling and pulmonary clearance, but measurements are significantly different from those of RHC. PMID:25006419

  6. Right ventricular reverse remodeling after pulmonary endarterectomy: magnetic resonance imaging and clinical and right heart catheterization assessment

    PubMed Central

    2014-01-01

    Abstract The objective of this study was to assess the effect of pulmonary endarterectomy (PEA) on right ventricular (RV) reverse remodeling using magnetic resonance imaging (MRI) and to correlate MRI findings with clinical and hemodynamic outcomes postsurgery. We performed a retrospective analysis in 72 patients undergoing PEA surgery in whom MRI and right heart catheterization (RHC) were performed preoperation and 3 months postoperation. RV volumes and mass were assessed by MRI. Continuous variables were expressed as means, changes were compared with a paired t test, and associations between the variables were explored using Pearson correlation coefficients. The mean age was 57 years, and 51% were male. Both RV end-diastolic volume (EDV; 176–117 mL; P < 0.001) and RV end-systolic volume (ESV; 129–64 mL; P < 0.001) reduced significantly following PEA. Preoperative pulmonary artery pressure (PAP) correlated moderately with ESV (r = 0.46, P < 0.001). Postoperatively, PAP correlated with EDV (r = 0.45, P < 0.001) and ESV (r = 0.44, P < 0.001). Moderate correlation was present between hemodynamic parameters: PAP, pulmonary vascular resistance, and right atrial pressure with pre- and postoperation end-systolic and end-diastolic RV mass (P < 0.001). RHC and MRI measurements of cardiac output and RV volumes were significantly different (P < 0.001). In conclusion, RV reverse remodeling, as measured by improvement in RV volumes and mass by MRI, was observed for 3 months in patients who underwent PEA surgery. This is the largest series of patients with pre- and post-PEA MRI assessment so far reported. MRI detects changes in parameters reflecting cardiac remodeling and pulmonary clearance, but measurements are significantly different from those of RHC. PMID:25006419

  7. Medical iPad use in the cardiac catheterization and echo laboratories.

    PubMed

    Lavi, Ifat; Malki, Guy; Kornowski, Ran

    2014-02-01

    The present study aims to describe a dedicated cardiac imaging application on a tablet and to assess the accuracy and reproducibility of this novel application for measurement on angiography and echocardiography data sets. Tablet devices have recently been used in radiological image interpretation and enable transfer of images. It allows the clinician to look up clinical information, search the Internet and communicate with colleagues and family. The study group consisted of 30 patients who had both echocardiographic and angiographic examinations. For each patient, a few measurements (i.e. length, area and angle) were performed using the iPad, and compared to the McKesson workstation, which is routinely used in the hospital. In order to show the equivalence between these two methods, a linear regression was fitted and the distribution of differences between measurements was examined. In addition, the variability of the measurements was compared between two different reviewers (inter-observer test) and between the measurements of the same reviewer at two different time settings (intra-observer test) by calculating the intraclass correlation coefficient (ICC). In all comparisons, the linear regression showed high correlation coefficient (r > 0.9), and the distribution of differences was around zero, implying that the two methods lead to equivalent results. The absolute mean difference between the two different observers demonstrated high agreement between the two observers' repeated measurements. The same conclusions can be deduced from the same observer's repeated measurements. The ICC indicates the resemblance between the two sets, and could be considered almost perfect (ICC > 0.968 for all cases). The newly developed cardiology iPad application offers the opportunity to accurately present the cardiac procedure in a visual, clear and professional manner. PMID:24337922

  8. Late MitraClip procedure after left atrial appendage occlusion: indication and procedure description.

    PubMed

    Cammalleri, Valeria; Scandura, Salvatore; Tamburino, Corrado; Ussia, Gian Paolo

    2014-02-01

    We report the first human case of percutaneous edge-to-edge mitral valve repair using MitraClip System (Abbott Vascular, Abbott Park, IL) in a patient, who previously underwent left atrial appendage closure with PLAATO™ System (ev3. Inc., Plymouth, MN). The procedure was successfully performed using the standard MitraClip technique, in the catheterization laboratory, with transesophageal echocardiographic and fluoroscopic guidance. We showed that a double percutaneous procedure for stroke prevention and mitral regurgitation treatment might be a valid approach in selected patients ineligible for chronic anticoagulation therapy and at high risk for conventional cardiac surgery. PMID:23436381

  9. Characteristics and outcomes of patients with heart failure and discordant findings by right-sided heart catheterization and cardiopulmonary exercise testing.

    PubMed

    Patel, Chetan B; DeVore, Adam D; Felker, G Michael; Wojdyla, Daniel M; Hernandez, Adrian F; Milano, Carmelo A; O'Connor, Christopher M; Rogers, Joseph G

    2014-10-01

    There are limited data integrating findings on right-sided cardiac catheterization and cardiopulmonary exercise testing in ambulatory patients with heart failure. In this study, 187 outpatients with HF referred to the Duke Medical Center for consideration of advanced HF therapies were retrospectively evaluated. All patients had undergone right-sided cardiac catheterization and cardiopulmonary exercise testing; the median cardiac index (CI) was 2.0 L/min/m2 (interquartile range 1.7 to 2.3), and the median peak oxygen consumption was 11.3 ml/kg/min (interquartile range 9.2 to 13.8). Despite aggressive medical therapy, medical management had failed in 97 patients (52%) at 18 months, defined as left ventricular assist device implantation, cardiac transplantation, or death. After multivariate adjustment, factors associated with failure of optimal medical management included percentage achieved of predicted peak oxygen consumption, low CI (i.e., <2 L/min/m2), left ventricular size, and exercise time. Patients with discordant findings on right-sided cardiac catheterization and cardiopulmonary exercise testing were common, occurring in 88 patients (47%). The most common profile was preserved CI but reduced functional capacity, and these patients remained at high risk for requiring advanced therapies, whereas patients with reduced CIs but preserved exercise capacity were uncommon. In conclusion, low CI was independently associated with higher rates of death, transplantation, and left ventricular assist device implantation in this study. Also, patients with preserved CIs at rest but poor functional capacity, so-called cardiac insufficiency, were commonly encountered and had poor outcomes with medical management. PMID:25212547

  10. Pulmonary alveolar hemorrhage from a pulmonary artery false aneurysm after Swan-Ganz catheterization in a thoracic aortic aneurysm patient: a case report

    PubMed Central

    Ikeno, Shigeo; Tsuchihashi, Tetsuya; Yokota, Shigeru; Ina, Hiroaki; Kono, Tetsuya; Yamashita, Kunihiko; Kawamata, Mikito

    2014-01-01

    Pulmonary artery (PA) rupture caused by a PA Swan-Ganz catheter is a rare complication but remains fatal in almost 50% of cases. False aneurysm of the PA is a rare presentation of PA rupture and should be considered as a possible diagnosis in a patient with a new lung mass after PA catheterization. We present a case of sudden-onset pulmonary alveolar hemorrhage during cardiovascular surgery due to a traumatic PA false aneurysm. The Swan-Ganz catheter might have been displaced by the thoracic aortic aneurysm with displacement of the catheter causing the false aneurysm and bleeding. PMID:25473465

  11. Self catheterization - male

    MedlinePLUS

    ... these steps to insert your catheter: Wash your hands well with soap and water. Collect your supplies, including your catheter (open and ready to be used), a towelette or other cleaning wipe, lubricant, and a container to collect the urine ...

  12. Self catheterization - female

    MedlinePLUS

    ... flushing to prevent germs from spreading. Wash your hands with soap and water. ... wall, and floor). Follow these steps: Wash your hands well. Rinse ... warm water and soap. The catheter does not need to be sterile, ...

  13. [Comparison of continuous wave Doppler and heart catheterization in the determination of the mean transvalvular gradient in mitral stenosis. A simultaneous beat to beat analysis].

    PubMed

    Moro, E; Pignoni, P; Caprioglio, F; Nicolosi, G L; D'Angelo, G; Pavan, D; Dall'Aglio, V; Burelli, C; Zanuttini, D

    1988-04-01

    Continuous wave Doppler echocardiography (CWD) is widely used in the assessment of pressure gradients in patients with valvular heart disease, utilizing the simplified Bernoulli equation. However determination of non-simultaneous mean pressure gradient (MG) in mitral stenosis (MS) from CWD recordings has often been described as being unsatisfactory. Therefore, the purpose of this study was to compare the estimates of trans-mitral MG derived from CWD with gradients measured simultaneously at cardiac catheterization (beat to beat analysis). We studied 3 patients (pts) with MS (1 man and 2 women, aged 55, 55 and 62 years respectively); one patient (pt) was in sinus rhythm and 2 were in atrial fibrillation. In each pt the trans-mitral flow velocity curve was obtained simultaneously with trans-mitral gradient measured directly at cardiac catheterization (cath). In this way it was possible to obtain a beat to beat correlation between Doppler and cath in 181 beats taken from the 3 pts. These beats were selected from a total number of 321 beats because of their excellent quality for analysis (74 beats were obtained from the first pt, 38 from the second pt and 69 from the third pt). Mean diastolic velocity, defined as the mean of maximal velocities throughout diastole, was obtained for each beat by planimetring the envelope of the spectral velocity profile. MG was calculated from mean velocity by applying the simplified Bernoulli equation (delta P = 4V2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3181658

  14. The Effects of Ranitidine and Hydrocortisone on the Complications of Femoral Artery Obstruction Treated by Streptokinase Following Cardiac Catheterization in Pediatric Patients with Congenital Heart Diseases

    PubMed Central

    Noori, Noormohammad; Miri Aliabad, Ghasem; Mohammadi, Mehdi; Mahjoubifard, Maziar; Jahangiri Fard, Alireza

    2013-01-01

    Background: The most important complication following cardiac catheterization required urgent therapeutic management is vessel obstruction and arterial thrombosis. The morbidity following this complication can be decreased by surgery intervention and/or thrombolytic drugs. Objectives: In this study we evaluated the effects of ranitidine and hydrocortisone on pediatric patients with congenital heart diseases who suffered from femoral artery obstruction following cardiac catheterization on decreasing the events after streptokinase administration. Materials and Methods: This semi experimental study was conducted on 47 patients among 600 cases who underwent cardiac catheterization from April 2002 to December 2011.The patients suffered from distal vessel obstruction following cardiac catheterization with no response to surgery intervention, were enrolled and divided in two groups. Streptokinase was administrated in both groups. Patients in group 2 (25 cases), received ranitidine and hydrocortisone before streptokinase administration. In group 1 (22 cases), the loading dose of streptokinase was 2000IU/kg/ in 20-30 minutes/ infusion and thereafter streptokinase was administrated 1000 IU /kg/hour. In group 2, the loading dose was 3000IU/kg in 20-30 minutes /infusion and 1500 IU/kg/hour as maintenance dose. The infusion dose of streptokinase was decreased and then terminated in 2-3 hours by the time arterial pulse was detected by pulse oximetry. Results: There were 13 (59, 1%) male and 9 (40.9%) female patients in group 1. In group 2, there were 15 (60%) male and 10 (40%) female cases (P = 0.949). Patients in both groups were matched well regarding age, body weight, height and the duration of streptokinase infusion (P < 0.05). The incidence of hematoma was higher in group 1 than group 2 (P = 0.032). the patients of Group 1 required more blood transfusion than group 2 because the incidence of bleeding was more in the first group (P = 0.042). 12 patients in group 1 required fresh frozen plasma transfusion versus 4 patients in group 2 (P = 0.049). Local oozing was detected more in group 1 (P = 0.042). Significant bleeding was occurred in 6 cases in group 1; however this event did not occurrin any patients in group 2 (P = 0.007). Although 4 patients in group 1 suffered from anaphylactic shock after streptokinase administration but no patients in group 2 did. (P = 0.041). Conclusions: Based on the results of this study, we concluded that streptokinase was able to remove the vessel thrombosis at the site of cardiac catheterization and ranitidine and hydrocortisone administration before streptokinase may be effective in order to reduce the complications related to thrombolytic drugs; however the experience of the performer is an issue of concern in this matter. PMID:24693416

  15. Coronary arteriography and angioplasty

    SciTech Connect

    King, S.B.; Douglas, J.S.

    1985-01-01

    This book explores biomedical radiography of the heart. Topics considered include six bench marks in the history of cardiac catheterization; normal coronary anatomy; anomalies of the coronary arteries; pathoanotomy of the coronary arteries and complications; indications, limitations, and risks of coronary arteriography and left ventriculography; catheterization techniques in coronary arteriography and left ventriculography: the Sones technique; catheterization techniques in coronary arteriography and left ventriculography: the Judkins technique; modification of Judkins catheters; catheterization techniques in coronary arteriography and left ventriculography multipurpose technique; new views in coronary arteriography; quantitative evaluation of left ventricular function; complications of coronary arteriography: management during and following the procedure; interpretation of coronary arteriograms and left ventriculograms; prevalence and distribution of disease in patients catheterized for suspected coronary disease at Emory University Hospital; the Cardiac Catheterization Laboratory; selection for surgery or percutaneous transluminal coronary angioplasty; intracoronary thrombolysis; and percutaneous transluminal coronary angioplasty.

  16. A novel technique for simultaneous whole-body and multi-organ decellularization: umbilical artery catheterization as a perfusion-based method in a sheep foetus model.

    PubMed

    Kajbafzadeh, Abdol-Mohammad; Khorramirouz, Reza; Akbarzadeh, Aram; Sabetkish, Shabnam; Sabetkish, Nastaran; Saadat, Paria; Tehrani, Mona

    2015-04-01

    The aim of this study was to develop a method to generate multi-organ acellular matrices. Using a foetal sheep model have developed a method of systemic pulsatile perfusion via the umbilical artery which allows for simultaneous multi-organ decellularization. Twenty sheep foetuses were systemically perfused with Triton X-100 and sodium dodecyl sulphate. Following completion of the whole-body decellularization, multiple biopsy samples were taken from different parts of 21 organs to ascertain complete cell component removal in the preserved extracellular matrices. Both the natural and decellularized organs were subjected to several examinations. The samples were obtained from the skin, eye, ear, nose, throat, cardiovascular, respiratory, gastrointestinal, urinary, musculoskeletal, central nervous and peripheral nervous systems. The histological results depicted well-preserved extracellular matrix (ECM) integrity and intact vascular structures, without any evidence of residual cellular materials, in all decellularized bioscaffolds. Scanning electron microscope (SEM) and biochemical properties remained intact, similar to their age-matched native counterparts. Preservation of the collagen structure was evaluated by a hydroxyproline assay. Dense organs such as bone and muscle were also completely decellularized, with a preserved ECM structure. Thus, as shown in this study, several organs and different tissues were decellularized using a perfusion-based method, which has not been previously accomplished. Given the technical challenges that exist for the efficient generation of biological scaffolds, the current results may pave the way for obtaining a variety of decellularized scaffolds from a single donor. In this study, there have been unique responses to the single acellularization protocol in foetuses, which may reflect the homogeneity of tissues and organs in the developing foetal body. PMID:26031202

  17. A new technique for early detection of portal vein and arterial thromboses. Indwelling mesenteric venous catheterization and relevance to small bowel transplantation.

    PubMed

    Yamataka, A; Kawamoto, S; Ishikawa, M; Lancaster, J F; Miyano, T; Lynch, S V

    1993-09-01

    The aim of this study was to ascertain whether, in an animal model, continuous monitoring of mesenteric venous pressure (MVP) via an indwelling mesenteric venous catheter could assist in early detection of thrombosis of the portal vein (PVT) and superior mesenteric artery (SMAT). The role of portography via the catheter was also studied in confirming these complications. An animal model of PVT and SMAT was developed in pigs. At laparotomy, a 20-cm jejunal loop was isolated and a heparin-coated catheter was inserted into a mesenteric vein of the isolated jejunum and connected to a pressure transducer. Conditions of PVT were simulated by progressive occlusion of the portal vein (PV) using a silastic tourniquet and those of SMAT by superior mesenteric artery (SMA) clamping. MVPs (mm Hg) were found to significantly increase with all degrees of PV occlusion (P < 0.01, Student's t test) and to significantly decrease after SMA occlusion (P < 0.01). Portography clearly demonstrated all degrees of PV stenosis after PV occlusion and stasis of contrast medium during SMA occlusion. The authors feel that this method enables rapid diagnosis of PVT and SMAT and may be useful in the monitoring of the therapy for these complications after small bowel transplantation. PMID:8212141

  18. Biological Indicators of Watershed Health

    NSDL National Science Digital Library

    This recently launched site on biological indicators, from the Environmental Protection Agency, is a gem, offering basic yet critical information on the what, where, why, and how of biological indicators. Presented in straightforward language, the site sets out to educate viewers about the importance of biological indicators -- those organisms that, because of their sensitivity to changes in the environment, "can provide accurate information about the health of a specific river, stream, lake, wetland, or estuary." The site is organized into seven main sections: Why use Indicators?, Key Concepts, Learn About State Programs, Biocriteria Resources, Fish as Indicators, Invertebrates as Indicators, and Periphyton as Indicators. In each section, a series of brief statements (with accompanying color photographs) leads the viewer through the logic, techniques, and methods used to assess watershed health. A collection of links rounds out the site.

  19. Hydrologic indices for nontidal wetlands

    USGS Publications Warehouse

    Lent, R.M.; Weiskel, P.K.; Lyford, F.P.; Armstrong, D.S.

    1997-01-01

    Two sets of hydrologic indices were developed to characterize the water-budget components of nontidal wetlands. The first set consisted of six water-budget indices for input and output variables, and the second set consisted of two hydrologic interaction indices derived from the water-budget indices. The indices then were applied to 19 wetlands with previously published water-budget data. Two trilinear diagrams for each wetland were constructed, one for the three input indices and another for the three output indices. These two trilinear diagrams then were combined with a central quadrangle to form a Piper-type diagram, with data points from the trilinear diagrams projected onto the quadrangle. The quadrangle then was divided into nine fields that summarized the water-budget information. Two quantitative "interaction indices" were calculated from two of the six water-budget indices (precipitation and evapotranspiration). They also were obtained graphically from the water-budget indices, which were first projected to the central quadrangle of a Piper-type diagram from the flanking trilinear plots. The first interaction index (l) defines the strength of interaction between a wetland and the surrounding ground- and surface-water system. The second interaction index (S) defines the nature of the interaction between the wetland and the surrounding ground- and surface-water system (source versus sink). Evaluation of these indices using published wetland water-budget data illustrates the usefulness of the technique.

  20. Dynamic Process Capability Indices

    Microsoft Academic Search

    Jing Sun

    2002-01-01

    Process capability indices as an important kind of indices are intended to provide single-number assessments of the inherent process capability to meet specification limits on quality characteristic(s) of interest. In this paper the condition for the application of process capability indices is analyzed. On the basis of process capability indices, dynamic process capability indices as a new kind of indices

  1. Terrestrial Indicators and Measurements

    E-print Network

    jurisdictions. General Approach. Indicators were selected through a five-step participatory process involving in at least one national monitoring program, was used for the core indicators. Core Indicators and/or vegetation trend monitoring: (1)

  2. ECOLOGICAL PERFORMANCE INDICATORS

    EPA Science Inventory

    EMAP has traditionally relied on indicators of ecological condition to report on the extent to which coastal waters are impaired. Correlations between biological indicators and physical or chemical indicators may generate hypotheses about potential causes of impairment but are n...

  3. A fatal case of fungal endocarditis of the tricuspid valve associated with long-term venous catheterization and treatment with antibiotics in a patient with a history of alcohol abuse

    Microsoft Academic Search

    Takaaki Ohmori; Kazuhide Iwakawa; Yasushi Matsumoto; Norimasa Arita; Kazuyo Okada

    1997-01-01

    We report a fatal case of fungal (candidal) endocarditis of the tricuspid valve with clinico-pathologically interesting findings\\u000a following and associated with candidal pneumonia during long-term central venous catheterization (CVC) for intravenous therapy\\u000a and long-term treatment with antibiotics for bacterial and fungal infection in a patient with a history of alcohol abuse.\\u000a We review the literature on fungal cardiac infection related

  4. Technology and indications.

    PubMed

    Sunada, Keijiro; Yamamoto, Hironori

    2009-07-01

    Double-balloon endoscopy (DBE) was developed based on the principle of preventing stretching of the intestinal tract by anchoring the convoluted intestinal tract with an endoscope and overtube fitted with inflatable balloons. The DBE system includes the main body of the endoscope with a built-in air channel, a balloon attached to the tip of the endoscope, an overtube with a hydrophilic coating equipped with an inflatable balloon, and a balloon controller that safely inflates/deflates the two balloons. At present, there are three different types of endoscopes for DBE. The indications for DBE include the diagnosis or treatment of various small intestinal conditions such as obscure gastrointestinal bleeding, Crohn's disease, and benign and malignant tumors. In addition, DBE can be used to approach the surgically modified intestinal tract; conventional endoscopes have difficulty in that situation. DBE can be used for colonoscopy in cases in which it is difficult to insert a conventional colonoscope. In the future, DBE will have the potential for wider use in routine colonoscopy because the insertion technique is easy and reliable. PMID:19647642

  5. The Comparison of Pain Caused by Suprapubic Aspiration and Transurethral Catheterization Methods for Sterile Urine Collection in Neonates: A Randomized Controlled Study

    PubMed Central

    Ghaffari, Vajihe; Fattahi, Saeed; Taheri, Mohsen; Khademloo, Mohammad; Farhadi, Roya

    2014-01-01

    This study was performed to compare the levels of pain experienced by young infants undergoing either suprapubic aspiration (SPA) or transurethral catheterization (TUC) for the collection of sterile urine samples. This prospective randomized clinical trial was conducted in hospitalized neonates in a university-affiliated hospital. Patients who required urine cultures were randomly assigned into one of two groups, the SPA or TUC group. The infants' faces were videotaped, and the changes in the facial expression and physiological parameters during the procedure were scored using the Premature Infant Pain Profile (PIPP) in a blind manner. The primary outcome was the severity of the pain experienced during each procedure, and the secondary outcomes were the success rate, the duration, and the complications of each procedure. Ninety-four percent of male infants in the TUC group and 77.3% in the SPA group were uncircumcised (P = 0.1). The mean (SD) of the PIPP pain scores did not differ between groups (9.95 ± 3.7 in SPA and 9.64 ± 3.2 in TUC, P = 0.6). The duration of TUC was longer. Both methods can be used to collect urine from neonates, but the difficulty of performing TUC on females and uncircumcised males should be considered. PMID:24587764

  6. Single-blind and Double-blind Randomized Controlled Trials of Palmtherapy®, an Alternative Medical Approach, for Anxiety before Cardiac Catheterization

    PubMed Central

    Jafari, Jamal; Podberezsky, Anna; David, Tamar; Reizin, Leonardo; Benjamin, Jonathan

    2008-01-01

    Alternative medicine is widely used, but lacks consensus regarding its amenability to scientific investigation. Anxiety increases morbidity and mortality in ischemic heart disease. We performed two studies of Palmtherapy®, an alternative treatment, for anxiety before cardiac catheterization. In the first study, patients were randomized to receive pressure at particular points on the palm, or at incorrect locations, for about 50?min, while the therapist conversed with them. In the second study, the conversation was conducted by a second, ‘blind’ investigator. In both studies, patients and nurses, all blind to treatment assignment, completed visual analog scale and National Institute of Mental Health measures of anxiety, respectively. Twenty-three subjects completed study 1, and 17 completed study 2. In study 1, palm therapy was superior to sham therapy for both outcome measures. In study 2, palm therapy was superior for self-reported anxiety, but not for nurses’ assessments of anxiety. Future studies should attempt to separate possible mechanistic effects of Palmtherapy® from therapist-related variables. Whether alternative medicine deserves to be studied at all remains controversial. Palmtherapy® may offer anxiolytic benefit without the harm attributable to drugs. PMID:18317556

  7. Virtual-Reality Simulator System for Double Interventional Cardiac Catheterization Using Fractional-Order Vascular Access Tracker and Haptic Force Producer

    PubMed Central

    Chen, Guan-Chun; Lin, Chia-Hung; Li, Chien-Ming; Hsieh, Kai-Sheng; Du, Yi-Chun; Chen, Tainsong

    2015-01-01

    This study proposes virtual-reality (VR) simulator system for double interventional cardiac catheterization (ICC) using fractional-order vascular access tracker and haptic force producer. An endoscope or a catheter for diagnosis and surgery of cardiovascular disease has been commonly used in minimally invasive surgery. It needs specific skills and experiences for young surgeons or postgraduate year (PGY) students to operate a Berman catheter and a pigtail catheter in the inside of the human body and requires avoiding damaging vessels. To improve the training in inserting catheters, a double-catheter mechanism is designed for the ICC procedures. A fractional-order vascular access tracker is used to trace the senior surgeons' consoled trajectories and transmit the frictional feedback and visual feedback during the insertion of catheters. Based on the clinical feeling through the aortic arch, vein into the ventricle, or tortuous blood vessels, haptic force producer is used to mock the elasticity of the vessel wall using voice coil motors (VCMs). The VR establishment with surgeons' consoled vessel trajectories and hand feeling is achieved, and the experimental results show the effectiveness for the double ICC procedures. PMID:26171419

  8. Aerodynamic measurement techniques. [laser based diagnostic techniques

    NASA Technical Reports Server (NTRS)

    Hunter, W. W., Jr.

    1976-01-01

    Laser characteristics of intensity, monochromatic, spatial coherence, and temporal coherence were developed to advance laser based diagnostic techniques for aerodynamic related research. Two broad categories of visualization and optical measurements were considered, and three techniques received significant attention. These are holography, laser velocimetry, and Raman scattering. Examples of the quantitative laser velocimeter and Raman scattering measurements of velocity, temperature, and density indicated the potential of these nonintrusive techniques.

  9. [Performance indicators: INCA (cardiovascular indicators) project].

    PubMed

    Gillespie, F; Orsi, G B; Caracci, G; Scanzano, P; Casertano, L; Duranti, G; Cardo, S; Barone, A P; Tozzi, Q; Ammirati, F

    2007-01-01

    The objective of INCA project was the development and implementation of Acute Myocardial Infarction (AMI type ST elevation) process and outcome indicators for the regional cardiology units, testing the possibility of using regional healthcare information data to evaluate the quality of provided healthcare within the regional healthcare accreditation process. The project is introduced by an overview of major concepts of evaluating and managing quality of healthcare. We performed a literature review of structure, process and outcome indicators in cardiology and of accreditation standards for cardiology at national and international level. Through consensus procedures and according to international evidence based literature a set of 18 process and outcome indicators for AMI was defined. A specific procedure for data collection has been developed. Education and training of participants on procedures, quality and accreditation was achieved. Expected verifiable end-points have been achieved over a three months period of data collecting throughout 21 cardiology units, differentiated for level of complexity and location, for a total of 409 clinical observed cases of AMI. Analysis of data was followed by the diffusion of results. Successful data collection of clinical performance indicators on a regional basis was achieved. Participants have been trained to quality sciences. Results will be useful to evaluate and design implementation strategies of regional accreditation of health care services within a shared framework. Benchmarking within Regional hospital cardiology care services will be developed following self evaluation and continuous quality improvement cycle activities. PMID:17405513

  10. Environmental Treaties and Indicators Resource Indicators

    NSDL National Science Digital Library

    ENTRI is an international, collaborative effort hosted by the Consortium for International Earth Science Information Network (CIESIN) charged with providing "information about environmental treaties and national resource indicators." These treaties are organized into nine issue areas which cover land use change and desertification, transboundary air pollution, and trade and the environment, among others. Treaties can be searched or browsed. Free text searching of the treaties and treaty summaries is also available.

  11. Method for recording electrical activity of the sinoatrial node and automatic atrial foci during cardiac catheterization in human subjects.

    PubMed

    Hariman, R J; Krongrad, E; Boxer, R A; Weiss, M B; Steeg, C N; Hoffman, B F

    1980-04-01

    A method for recording electrical activity of the sinoatrial (S-A) node and automatic atrial foci in human subjects is described. To record S-A nodal electrograms, an electrode catheter was inserted percutaneously into the femoral vein and advanced under fluoroscopic control to the superior vena caval-right atrial junction. The distal terminal of the catheter was placed in the area of the S-A node and the proximal terminal on the free right atrial wall or in the right atrial lumen. Polarity was reversed from the conventional electrocardiographic recording; high amplification (about 100 microV/cm) and selective filters (0.1 to 20 hertz) were used. S-A nodal electrograms recorded with this method in human subjects were similar to electrograms obtained previously from the dog and rabbit and revealed negatively directed diastolic and upstroke slopes preceding the P wave of the electrocardiogram. Sinoatrial conduction time measured from the S-A nodal electrograms in 15 cases was 34.9 +/- 2.1 ms(mean +/- standard error of the mean) for a sinus cycle length of 736.4 +/- 38.6 ms. The coronary sinus electrograms in a patient with coronary sinus rhythm were recorded by the same technique except that the distal terminal of the catheter was placed at the coronary sinus ostium. A negatively directed diastolic slope preceding the P wave was consistently recorded. This method for recording electrograms of the S-A node and ectopic automatic atrial foci should prove useful in (1) assessment of both normal and abnormal S-A nodal function, (2) direct determination of conduction time from the S-A nodal pacemaker to the atrium, and (3) localization of automatic atrial foci. PMID:7361668

  12. Calculation of enviromental indices

    SciTech Connect

    NONE

    1995-10-01

    This portion of the Energy Vision 2020 draft report discusses the development of environmental indices. These indices were developed to be a quantitative measure of characterizing how TVA power system operations and alternative energy strategies might affect the environment. All indices were calculated relative to the reference strategy, and for the environmental review, the reference strategy was `no action`.

  13. Understanding Process Capability Indices

    Microsoft Academic Search

    Stefan Steiner; Bovas Abraham; Jock MacKay

    this article is answer such questions by providing an illustration of theimportant issues related to capability indices. In addition, this article makes suggestions regardingthe process information necessary to make appropriate use of capability indices. In the nextsection, the question of which capability index to use is addressed by contrasting the variouscommon indices. It is shown that the index P pk

  14. Science Indicators, 1974.

    ERIC Educational Resources Information Center

    National Science Foundation, Washington, DC. National Science Board.

    In this report the National Science Board presents the second step in the process begun with Science Indicators--1972 of developing indicators of the state of science in the United States. The goal of this effort is a periodical series of indices of the strengths and weaknesses of science and technology in the United States and the changing…

  15. Prognostic value of angiographic lesion complexity in patients with acute coronary syndromes undergoing percutaneous coronary intervention (from the acute catheterization and urgent intervention triage strategy trial).

    PubMed

    Goto, Kenji; Lansky, Alexandra J; Ng, Vivian G; Pietras, Cody; Nargileci, Erol; Mehran, Roxana; Parise, Helen; Feit, Frederick; Ohman, E Magnus; White, Harvey D; Bertrand, Michel E; Desmet, Walter; Hamon, Martial; Stone, Gregg W

    2014-12-01

    Although lesion complexity is predictive of outcomes after balloon angioplasty, it is unclear whether complex lesions continue to portend a worse prognosis in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) with contemporary interventional therapies. We sought to assess the impact of angiographic lesion complexity, defined by the modified American College of Cardiology/American Heart Association classification, on clinical outcomes after PCI in patients with ACS and to determine whether an interaction exists between lesion complexity and antithrombin regimen outcomes after PCI. Among the 3,661 patients who underwent PCI in the Acute Catheterization and Urgent Intervention Triage strategy study, patients with type C lesions (n = 1,654 [45%]) had higher 30-day rates of mortality (1.2% vs 0.6%, p = 0.049), myocardial infarction (9.2% vs 6.3%, p = 0.0006), and unplanned revascularization (4.3% vs 3.1%, p = 0.04) compared with those without type C lesions. In multivariate analysis, type C lesions were independently associated with myocardial infarction (odds ratio [95% confidence interval] = 1.37 [1.04 to 1.80], p = 0.02) and composite ischemia (odds ratio [95% confidence interval] = 1.49 [1.17 to 1.88], p = 0.001) at 30 days. Bivalirudin monotherapy compared with heparin plus a glycoprotein IIb/IIIa inhibitor reduced major bleeding complications with similar rates of composite ischemic events, regardless of the presence of type C lesions. There were no interactions between antithrombotic regimens and lesion complexity in terms of composite ischemia and major bleeding (p [interaction] = 0.91 and 0.80, respectively). In conclusion, patients with ACS with type C lesion characteristics undergoing PCI have an adverse short-term prognosis. Treatment with bivalirudin monotherapy reduces major hemorrhagic complications irrespective of lesion complexity with comparable suppression of adverse ischemic events as heparin plus glycoprotein IIb/IIIa inhibitor. PMID:25312637

  16. Fuse status indicator system

    NASA Astrophysics Data System (ADS)

    Middlebrooks, H.

    1984-09-01

    An on-line indicator connected to each fuse of an electrical circuit includes an LED which becomes illuminated if its protected fuse blows. Groups of these on-line indicators can be connected via on OR gate to a single master fuse status indicator which also includes an LED which becomes illuminated if any of the on-line indicators connected thereto has its LED illuminated. The circuitry can accommodate power supplies of different voltages of either polarity. Opto-isolators can be used to reduce stand-by current drain and to isolate the on-line indicators from each other.

  17. A process capability indicator

    Microsoft Academic Search

    Lai K. Chan; T. K. Mak

    1993-01-01

    A new measure of process capability, called process capability indicator and denoted by C1is proposed. It is of the form C1=deviation indicator (DI)+w×variation indicator (VI), where DI and VI, are, respectively, measures of the deviation of the process mean from the target value and the process variation, and both are relative to the tolerance. The weight factor w is used

  18. Marine Organisms as Indicators

    NASA Astrophysics Data System (ADS)

    Weston, Donald P.

    The term “indicator organism” can have a variety of meanings. In its narrowest and perhaps most often used sense, an indicator organism is a single species whose abundance, physiological state, or reproductive success gives the investigator information about the environmental conditions to which it has been exposed. The indicator concept has been employed traditionally by regulatory agencies to assess the consequence of anthropogenic activity, using the indicator species as a surrogate for the ecosystem as a whole. The concept of a single-indicator species useful for such purposes is, however, as one of the editors points out, “illusory as the search for alchemist's gold,” and if the reader expects that this volume contains only a review of the use of indicator organisms in pollution monitoring, he or she will be greatly surprised. The editors have instead chosen a broad definition of indicator organisms and applications. The result is that the “indicator organism” may not be an organism at all (e.g., the paper by G. S. Kleppel on pigments as trophodynamic indicators), and the environmental information conveyed, such as climatic changes or the presence of mesoscale oceanic features, is most often unrelated to man's activities.

  19. Bayesian Model Selection for Human Development Indicators

    Microsoft Academic Search

    Nitin Sawhney

    In this paper, we explore the use of Bayesian estimation techniques towards modeling indicators related to Human Development, in particular Gender-related measures. The main emphasis and contribution of this work is demonstrating the use of Bayesian approaches towards modeling development indicators, rather than interpreting the validity of specific models obtained from the current limited dataset. Future work will seek to

  20. Flow characteristics of the proximal pulmonary arteries and vena cava in patients with chronic thromboembolic pulmonary hypertension: correlation between 3.0 T phase-contrast MRI and right heart catheterization

    PubMed Central

    Guo, Xiaojuan; Liu, Min; Ma, Zhanhong; Wang, Shuangkun; Yang, Yuanhua; Zhai, Zhenguo; Wang, Chen; Zhai, Renyou

    2014-01-01

    PURPOSE We aimed to determine the correlation between flow characteristics of the proximal pulmonary arteries and vena cava obtained by 3.0 T phase-contrast magnetic resonance imaging (MRI) and hemodynamic characteristics by right heart catheterization in patients with chronic thromboembolic pulmonary hypertension. MATERIALS AND METHODS Twenty consecutive patients with chronic thromboembolic pulmonary hypertension and 20 sex- and age-matched healthy volunteers were included prospectively. All patients and controls underwent phase-contrast MRI to determine the flow characteristics including peak velocity, mean velocity, and mean blood flow of the proximal pulmonary artery and vena cava. All patients underwent right heart catheterization to determine the hemodynamics. RESULTS Peak velocity and mean velocity of the proximal pulmonary artery were significantly lower in the patient group. In patients, both peak velocity and mean blood flow were sequentially decreased in the main pulmonary artery, left and right pulmonary arteries, and left and right interlobar pulmonary arteries. Inferior vena cava had higher peak velocity, mean velocity, and mean blood flow than superior vena cava. Peak velocity of the main pulmonary artery correlated with mean and diastolic pulmonary artery pressure. Peak velocity of both inferior and superior vena cava strongly correlated with the pulmonary vascular resistance index (PVRI) (r=?0.68, P < 0.001 and r=?0.74, P < 0.001, respectively). Mean velocity of the main pulmonary artery and right pulmonary artery strongly correlated with PVRI and mean pulmonary artery pressure. Mean velocity of the superior vena cava and mean blood flow of the main pulmonary artery strongly correlated with PVRI and right cardiac work index. CONCLUSION Blood flow in the proximal pulmonary artery and vena cava evaluated by phase-contrast MRI correlate with hemodynamic parameters of right heart catheterization and can be used to noninvasively evaluate the severity of chronic thromboembolic pulmonary hypertension and, potentially, to follow up the treatment response. PMID:25163757

  1. Power quality indicators

    Microsoft Academic Search

    X. Mamo; J. Javerzac

    2001-01-01

    The paper describes individual (relative to a particular disturbance) and global quality indicators designed to assist the French power transmission system operator as far as quality of supply is concerned. These indicators have been defined to be easily understood and manipulated by operators. As they are based on the \\

  2. Rehabilitation Indicators: An Overview.

    ERIC Educational Resources Information Center

    Brown, Margaret M.; And Others

    The purpose of the Rehabilitation Indicators Project is to develop a method, rehabilitation indicators (RI's), for defining multi-dimensionally the benefits that accrue to rehabilitation clients. RI's are presented as descriptors of observable elements of the rehabilitation client's life space with each descriptor inherently meaningful to client…

  3. Indicators of Quality.

    ERIC Educational Resources Information Center

    Cleary, Thomas S.

    2001-01-01

    Surveyed students, faculty, administrative staff, governing board, and employers affiliated with a public two-year college to determine their perceptions of various quality indicators and congruence between the groups. Found that all groups placed importance on indicators of customer satisfaction and skill development; beyond that, considerable…

  4. Robust process capability indices

    Microsoft Academic Search

    Sameer Prasad; Tom Bramorski

    1998-01-01

    Many organizations are mandating the use of process capability indices to measure and reduce variability. Managers may find the use of such indices as unreliable when the interaction of the dependency structure and outliers mask potential assignable causes of variation. A monitoring procedure is proposed that effectively classifies a series' variability into three components: (1) the underlying correlation structure, (2)

  5. Cobb's Red Cabbage Indicator.

    ERIC Educational Resources Information Center

    Cobb, Vicki

    1998-01-01

    Describes the use of an indicator made from the pigment in red cabbage. Cabbage is grated then soaked in water. When the water is a strong red, the cabbage is strained out. The cabbage-juice indicator is then used to test for acids and bases. Includes a list of good foods to test for acidity and alkalinity. (PVD)

  6. Chronic Disease Indicators

    NSDL National Science Digital Library

    Center for Disease Control

    The Chronic Disease Indicators (CDI) is a cross-cutting set of 97 indicators that were developed by consensus and that allows states and territories and large metropolitan areas to uniformly define, collect, and report chronic disease data that are important to public health practice and available for states, territories and large metropolitan areas. 

  7. Retractable Visual Indicator Assembly

    NASA Technical Reports Server (NTRS)

    Hackler, George R. (Inventor); Gamboa, Ronald J. (Inventor); Dominquez, Victor (Inventor)

    1998-01-01

    A retractable indicator assembly may be mounted on a container which transmits air through the container and removes deleterious gases with an activated charcoal medium in the container. The assembly includes: an elongate indicator housing has a chamber therein; a male adaptor with an external threads is used for sealing engagement with the container; a plug located at the upper end of the housing; a housing that includes a transparent wall portion for viewing at least a portion of the chamber; a litmus indicator, moveable by a retractable rod from a retracted position within the container to an extended position within the chamber of the housing; and an outer housing that is secured to the upper end of the rod, and protects the indicator housing while the litmus indicator is in its normally retracted position. The assembly may be manually manipulated between its extended position wherein the litmus indicator may be viewed through the transparent wall of the indicator housing, and a retracted position wherein the outer housing encloses the indicator housing and engages the exterior of the container.

  8. Effect of anemia on frequency of short- and long-term clinical events in acute coronary syndromes (from the Acute Catheterization and Urgent Intervention Triage Strategy Trial).

    PubMed

    Kunadian, Vijay; Mehran, Roxana; Lincoff, A Michael; Feit, Frederick; Manoukian, Steven V; Hamon, Martial; Cox, David A; Dangas, George D; Stone, Gregg W

    2014-12-15

    There are limited data on the impact of anemia on clinical outcomes in unstable angina and non-ST-segment elevation myocardial infarction treated with an early invasive strategy. We sought to determine the short- and long-term clinical events among patients with and without anemia enrolled in the Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trial. Anemia was defined as baseline hemoglobin of <13 g/dl for men and <12 g/dl for women. The primary end points were composite ischemia (death, myocardial infarction, or unplanned revascularization for ischemia) and major bleeding assessed in-hospital, at 1 month, and at 1 year. Among the 13,819 patients in the ACUITY trial, information regarding anemia was available in 13,032 (94.3%), 2,199 of whom (16.9%) had anemia. Patients with anemia compared with those without anemia had significantly increased adverse event rates in-hospital (composite ischemia 6.6% vs 4.8%, p = 0.0004; major bleeding 7.3% vs 3.3%, p <0.0001), at 1 month (composite ischemia 10% vs 7.2%, p <0.0001, major bleeding 8.8% vs 3.9%, p <0.0001), and 1 year (composite ischemia 21.7% vs 15.3%, p <0.0001). Anemia was an independent predictor of death at 1 year (hazard ratio 1.77, 95% confidence interval [CI] 1.29 to 2.44, p = 0.0005). Composite ischemia was significantly more common among patients who developed in-hospital non-coronary artery bypass surgery major bleeding compared with those who did not (anemic patients 1-year relative risk 2.19, 95% CI 1.67 to 2.88, p <0.0001; nonanemic patients relative risk 2.16, 95% CI 1.76 to 2.65, p <0.0001). In conclusion, in the ACUITY trial, baseline anemia was strongly associated with adverse early and late clinical events, especially in those who developed major bleeding. PMID:25438908

  9. Cabbage Juice Indicator

    NSDL National Science Digital Library

    The Science House

    2014-01-28

    In this chemistry activity, learners make indicator solution from red cabbage. Then, learners test everyday foods and household substances using the cabbage juice indicator. Learners will record the color change, approximate pH (using the pH scale), and identify if it is an acid or base. As an extension, learners can make pH paper strips to conduct an "at home" pH test of other household items. The indicator solution can be frozen in ice trays and when mixed with alcohol, can last for months. For safety reasons, adult supervision is recommended.

  10. Surgical technique: new advancements for expanding indications and safety

    Microsoft Academic Search

    Guido Torzilli

    2010-01-01

    The technical issues discussed herein represent part of the panorama of innovative approaches proposed for the surgical treatment\\u000a of hepatocellular carcinoma (HCC); in particular, the attention is focused on the recent advances in the field of planning\\u000a the surgical strategy and performing liver dissection via ultrasound guidance. It is described how recent technical \\u000a advances have allowed the range of scenarios

  11. Health expectancy indicators.

    PubMed Central

    Robine, J. M.; Romieu, I.; Cambois, E.

    1999-01-01

    An outline is presented of progress in the development of health expectancy indicators, which are growing in importance as a means of assessing the health status of populations and determining public health priorities. PMID:10083720

  12. ENVIRONMENTAL PUBLIC HEALTH INDICATORS

    EPA Science Inventory

    Environmental Public Health Indicators (EPHIs), quantitative measures of health factors and environmental influences tracked over time, can be used to identify specific areas and populations for intervention and prevention efforts and to evaluate the outcomes of implemented polic...

  13. Industrial energy use indices 

    E-print Network

    Hanegan, Andrew Aaron

    2008-10-10

    Energy use index (EUI) is an important measure of energy use which normalizes energy use by dividing by building area. Energy use indices and associated coefficients of variation are computed for major industry categories ...

  14. Industrial energy use indices 

    E-print Network

    Hanegan, Andrew Aaron

    2009-05-15

    Energy use index (EUI) is an important measure of energy use which normalizes energy use by dividing by building area. Energy use indices and associated coefficients of variation are computed for major industry categories ...

  15. World Development Indicators

    NSDL National Science Digital Library

    Published by the World Bank Group, World Development Indicators is an annual report containing statistical data on global topics such as people, environment, the economy, and states and markets. The Website for World Development Indicators provides all of the text of the report, but it only contains a small selection of the tables offered in the actual report, which is available on CD ROM for purchasing.

  16. Internationally Comparable Health Indices

    PubMed Central

    Meijer, Erik; Kapteyn, Arie; Andreyeva, Tatiana

    2013-01-01

    One of the most intractable problems in international health research is the lack of comparability of health measures across countries or cultures. We develop a cross-country measurement model for health in which functional limitations, self-reports of health, and a physical measure are interrelated to construct health indices. To establish comparability across countries, we define the measurement scales by the physical measure while other parameters vary by country to reflect cultural and linguistic differences in response patterns. We find significant cross-country variation in response styles of health reports along with variability in genuine health that is related to differences in national income. Our health indices achieve satisfactory reliability of about 80% and their gradients by age, income, and wealth for the most part show the expected patterns. Moreover, the health indices correlate much more strongly with income and net worth than self reported health measures. PMID:20572201

  17. Treatment of High-Flow Vascular Malformations by Venous Embolization Aided by Flow Occlusion Techniques

    SciTech Connect

    Jackson, James E. [Department of Diagnostic Radiology, Royal Postgraduate Medical School, Hammersmith Hospital, Du Cane Road, London W12 OHS (United Kingdom); Mansfield, Averil O. [Department of Surgery, St. Mary's Hospital, Praed Street, London W2 (United Kingdom); Allison, David J. [Department of Diagnostic Radiology, Royal Postgraduate Medical School, Hammersmith Hospital, Du Cane Road, London W12 OHS (United Kingdom)

    1996-09-15

    Purpose: Transvenous embolization techniques may be helpful as alternatives to the arterial route when treating high-flow vascular malformations. We present our experience using these techniques in four patients. Methods: In one patient the venous portion of the arteriovenous malformation (AVM) was punctured directly; in the other three patients it was catheterized via a retrograde venous approach. Flow occlusion techniques were utilized in all patients during embolization, which was performed with absolute alcohol or N-butyl-2-cyanoacrylate.Results: Excellent clinical and angiographic results were obtained, with obliteration of arteriovenous shunting in all patients. There were no complications.Conclusion: The embolization of certain AVMs using a venous approach is a safe and effective treatment.

  18. LEADING WITH LEADING INDICATORS

    Microsoft Academic Search

    2005-01-01

    This paper documents Fluor Hanford's use of Leading Indicators, management leadership, and statistical methodology in order to improve safe performance of work. By applying these methods, Fluor Hanford achieved a significant reduction in injury rates in 2003 and 2004, and the improvement continues today. The integration of data, leadership, and teamwork pays off with improved safety performance and credibility with

  19. Indicators of Reading Education.

    ERIC Educational Resources Information Center

    Guthrie, John T.

    Monitoring the effectiveness of reading education is central to the appraisal of the productivity of schooling, yet most measures currently being used do not take into account the full range of processes which lead to successful reading education. A model of indicators relevant to reading education (outcome, process, and input) can be used to…

  20. Universal Indicator Rainbow Trout

    NSDL National Science Digital Library

    2013-07-08

    In this activity on page 2 of the PDF, learners discover how color changes can help scientists distinguish between acids and bases. Learners create colorful rainbow trout artwork using universal indicator solution and various household liquids. Safety note: learners must wear safety goggles.

  1. Slickenside kinematic indicators

    Microsoft Academic Search

    Miguel Doblas; Consejo Superior de Investigaciones; JoseGutierrez Abascal

    1998-01-01

    A new classification of slickenside kinematic indicators is presented based on 61 criteria. These slickensides have been subdivided into eleven major groups: `V' or crescentic markings, steps, fractures, trains of inclined planar structures, trailed material, asymmetric elevations, deformed elements, mineralogical\\/crystallographic orientations, asymmetric plan-view features, asymmetric cavities, and asymmetric folds. This classification constitutes a useful tool for geologists interested in the

  2. Indications for Fetal Echocardiography

    Microsoft Academic Search

    M. Small; J. A. Copel

    2004-01-01

    Congenital heart disease is one of the most common congenital malformations diagnosed in liveborns. As more women undergo prenatal diagnosis, the need for screening fetal echocadiography increases. The fetal, maternal, and familial indications for fetal echocadiography are outlined in order to improve the identification of women in greatest need for this screening modality.

  3. PARTICLE ASSOCIATION EFFECTS ON MICROBIAL INDICATOR CONCENTRATIONS AND CSO DISINFECTION

    EPA Science Inventory

    Combined sewer overflow (CSO) and wastewater disinfection effectiveness are evaluated by measuring microbial indicator concentrations before and after disinfection. The standard techniques for quantifying indicators are membrane filtration and multiple-tube fermentation/most pro...

  4. LEADING WITH LEADING INDICATORS

    SciTech Connect

    PREVETTE, S.S.

    2005-01-27

    This paper documents Fluor Hanford's use of Leading Indicators, management leadership, and statistical methodology in order to improve safe performance of work. By applying these methods, Fluor Hanford achieved a significant reduction in injury rates in 2003 and 2004, and the improvement continues today. The integration of data, leadership, and teamwork pays off with improved safety performance and credibility with the customer. The use of Statistical Process Control, Pareto Charts, and Systems Thinking and their effect on management decisions and employee involvement are discussed. Included are practical examples of choosing leading indicators. A statistically based color coded dashboard presentation system methodology is provided. These tools, management theories and methods, coupled with involved leadership and employee efforts, directly led to significant improvements in worker safety and health, and environmental protection and restoration at one of the nation's largest nuclear cleanup sites.

  5. THE VIOLOGEN INDICATORS

    PubMed Central

    Michaelis, L.; Hill, Edgar S.

    1933-01-01

    The tabulation gives the normal potentials of the various indicators at 30°C.; referred to the normal hydrogen electrode, the accuracy is estimated to be ±0.002 volt. Normal potentials of the viologens at 30°C.: Methyl viologen –0.446 volts Ethyl viologen –0.449 volts Betaine viologen –0.444 volts Benzyl viologen –0.359 volts Supposing some solution brings about a coloration of one of these indicators to the extent of A per cent of the maximum color, the oxidation-reduction potential of this solution is E = Eo – 0.06 log See PDF for Equation where Eo is the normal potential according to the above tabulation. This normal potential is independent of pH. PMID:19872744

  6. Tamper-indicating seal

    DOEpatents

    Fiarman, Sidney (Port Jefferson, NY); Degen, Michael F. (Patchogue, NY); Peters, Henry F. (Brookhaven, NY)

    1985-01-01

    There is disclosed a tamper-indicating seal that permits in the field inspection and detection of tampering. Said seal comprises a shrinkable tube having a visible pattern of markings which is shrunk over the item to be sealed, and a second transparent tube, having a second visible marking pattern, which is shrunk over the item and the first tube. The relationship between the first and second set of markings produces a pattern so that the seal may not be removed without detection.

  7. Indicators for Inquiry

    NSDL National Science Digital Library

    Jeffery Townsend

    2006-02-01

    Fifth-grade students use homemade plant-based acid/base indicators to learn about matter at an age-appropriate level and develop process skills. As a result of completing this lesson sequence the students should be able to perform many tasks using process skills such as observing chemical changes; identifying acids and bases by performing tests; classifying common household substances as acidic, basic (alkaline), or neutral; and developing a scheme for solving a performance-based scenario.

  8. Evaluation of electromagnetic load influence on induction motor quality indices

    Microsoft Academic Search

    D. M. Glukhov

    2001-01-01

    Nowadays important problems of modern electrical machines are relative mass decrease, dimensions decrease and energetic indices increase. Traditional technique is impractical in this case. Therefore, it is necessary to find a new way of decreasing induction motor mass-overall indices. The aim of the investigation is evaluation of electromagnetic load influence on quality indices and mass-overall indices of induction motors. Mathematical

  9. Posterior triangle approach for lateral in-plane technique during hemodialysis catheter insertion via the internal jugular vein

    PubMed Central

    Song, Dan; Cho, Sungwoo

    2015-01-01

    A recent widespread concept is that ultrasound-guided central venous catheter insertion is a mandatory method. Some techniques have been introduced for ultrasound-guided central venous catheterization. Among them, short-axis lateral in-plane technique is considered to be the most useful technique for internal jugular vein access. Therefore, we used this technique for the insertion of a large-bore cuffed tunneled dual-lumen catheter for hemodialysis. Additionally, a lesser number of catheter angulations may lead to good flow rates and catheter function; we recommend that skin puncture site in the neck at the posterior triangle is better than the Sedillot's triangle. Using this approach, we can reduce the possible complications of pinching and kinking of the catheter. PMID:25692124

  10. Tamper-indicating seal

    DOEpatents

    Fiarman, S.; Degen, M.F.; Peters, H.F.

    1982-08-13

    There is disclosed a tamper-indicating seal that permits in the field inspection and detection of tampering. Said seal comprises a shrinkable tube having a visible pattern of markings which is shrunk over th item to be sealed, and a second transparent tube, having a second visible marking pattern, which is shrunk over the item and the first tube. The relationship between the first and second set of markings produces a pattern so that the seal may not be removed without detection. The seal is particularly applicable to UF/sub 6/ cylinder valves.

  11. Slickenside kinematic indicators

    NASA Astrophysics Data System (ADS)

    Doblas, Miguel

    1998-09-01

    A new classification of slickenside kinematic indicators is presented based on 61 criteria. These slickensides have been subdivided into eleven major groups: `V' or crescentic markings, steps, fractures, trains of inclined planar structures, trailed material, asymmetric elevations, deformed elements, mineralogical/crystallographic orientations, asymmetric plan-view features, asymmetric cavities, and asymmetric folds. This classification constitutes a useful tool for geologists interested in the determination of the shear sense in fault surfaces bearing slickensides. Examples of application of this classification to natural fault surfaces at different scales are presented.

  12. Pleurodesis: indications and radiologic appearance.

    PubMed

    Sonoda, Akinaga; Jeudy, Jean; White, Charles S; Kligerman, Seth J; Nitta, Norihisa; Lempel, Jason; Frazier, Aletta Ann

    2015-05-01

    Pleurodesis is frequently performed to prevent recurrence of pneumothorax or recurrent pleural effusion in benign or malignant conditions. In essence, it involves producing an area of adhesion between the parietal and the visceral layers of the pleura. The approach to this procedure can be divided into chemical and mechanical methods. Chemical pleurodesis is performed by introducing various substances such as talc, bleomycin, povidone iodine or other chemicals into the pleural space typically using a pleural catheter. The instilled substances cause inflammation of the parietal and the visceral layers of the pleura and leads to adhesion of the pleural surfaces, preventing further fluid or air accumulation. Mechanical pleurodesis, which is performed with thoracotomy or thoracoscopy, involves mechanical irritation of the pleura or removal of parietal pleura. It is important for the radiologist to develop an understanding of the clinical indications for pleurodesis, methods for the procedure and post-procedure imaging appearance so the radiologist can provide a correct interpretation and avoid misdiagnosis of the radiologic appearance as chronic infection, tumor or other entities with a similar appearance. Thus, the aim of this article is to review the indications, techniques and post-procedural appearances of pleurodesis from an imaging perspective. PMID:25791777

  13. Tamper indicating packaging

    SciTech Connect

    Baumann, M.J.; Bartberger, J.C.; Welch, T.D.

    1994-08-01

    Protecting sensitive items from undetected tampering in an unattended environment is crucial to the success of non-proliferation efforts relying on the verification of critical activities. Tamper Indicating Packaging (TIP) technologies are applied to containers, packages, and equipment that require an indication of a tamper attempt. Examples include: the transportation and storage of nuclear material, the operation and shipment of surveillance equipment and monitoring sensors, and the retail storage of medicine and food products. The spectrum of adversarial tampering ranges from attempted concealment of a pin-hole sized penetration to the complete container replacement, which would involve counterfeiting efforts of various degrees. Sandia National Laboratories (SNL) has developed a technology base for advanced TIP materials, sensors, designs, and processes which can be adapted to various future monitoring systems. The purpose of this technology base is to investigate potential new technologies, and to perform basic research of advanced technologies. This paper will describe the theory of TIP technologies and recent investigations of TIP technologies at SNL.

  14. Breathiness in Indic languages

    NASA Astrophysics Data System (ADS)

    Esposito, Christina; Khan, Sameeruddowla; Hurst, Alex

    2005-04-01

    Previous work on breathiness in Indic languages has focused on the acoustic properties of breathy oral stops in languages like Hindi ([bal] hair versus [bhal] forehead) or Bengali ([baSa] house versus [bhaSa] language). However, breathiness in Indic languages often extends to nasals (e.g., Marathi ([maar] beat versus [mhaar] a caste). It is unclear if languages such as Hindi and Bengali have breathy nasals in addition to breathy oral stops. This study addresses the following questions: (1) Are breathy nasals (Nh) acoustically different from N+h sequences, both in languages where they are phonemic and ones where they are not? (2) In sequences of a breathy stop and a modal nasal (e.g., Hindi [udhmi] naughty) where is the breathiness realized, if at all? To answer these questions, audio, aerodynamic, and electroglottographic recordings will be made of Hindi, Bengali, and Marathi speakers. It is hypothesized that acoustically breathy nasals in Hindi and Bengali will not be distinct from sequences of N+ h. We believe that this will also be true for the oral stops. In addition, it is believed that in sequences of breathy oral stop followed by a modal nasal (e.g., ChN), the breathiness will be produced on the nasal.

  15. Molecular Models of Indicators

    NSDL National Science Digital Library

    The article by Nicholas C. Thomas and Stephen Faulk on "Colorful Chemical Fountains" (1) reminds us that color—the colors of acid–base indicators or of metal complexes—is responsible for many of us developing an interest in chemistry. The featured molecules this month are the acid and base forms of three common indicators–phenolphthalein, methyl orange, and methyl red. These three substances display interesting structural features as the pH-induced transformation from one form to another takes place in three different ways. In the case of phenolphthalein, the lactam ring is cleaved on deprotonation to produce a carboxyl group with the concomitant removal of a proton from a phenolic group. In methyl orange, one of the nitrogen atoms is protonated in the acid form, and that proton is lost in the base form. In methyl red, a carboxylic acid function is deprotonated. There are many other interesting aspects of acid–base indicators. Since most plants and fruits contain pigments that show a color change in some pH range, it is difficult to state with any degree of certainty when these changes were first put to use in a systematic fashion. The Spanish alchemist Arnaldus de Villa Nova (Arnold of Villanova) is purported to have used litmus in the early 14th century. In general systematic use of indicators is traced to the latter half of the nineteenth century with the development of the three synthetic indicators described above. Many students will be familiar with the use of phenolphthalein to identify blood—often shown on the various forensic chemistry TV dramas by dropping some solution on a cotton swab that has been used to pick up some of the sample in question. If the swab turns red we frequently hear "It's blood". The reality of using phenolphthalein in this way is more complicated. The test is presumptive for the presence of blood, but not conclusive. It is not an acid–base reaction but rather, in the presence of hydrogen peroxide, relies on hemoglobin to catalyze the oxidation of phenolphthalein. An interesting assignment for students in a high-school or non-majors course would be to have them explore the details of this Kastle–Meyers test to see just what is involved in the correct application of the test, and what factors complicate the process. For example, would tomato juice infused with asparagus juice give a positive Kastle–Meyers test? Historically phenolphthalein was used in a variety of laxatives. Recently that usage has been discontinued due to concern about the carcinogenic nature of the substance. A review of the history of the controversy surrounding the use of phenolphthalein in laxatives would make a good research paper at the high-school level. Lastly, students with some practice building structures and performing calculations might wish to explore the structures of two other forms of phenolphthalein—one found in very acidic solutions, having an orange color, and one found in very basic solutions that is colorless.

  16. [Minilaparoscopic appendectomy: which indications?].

    PubMed

    Ciardo, Luigi Francesco; Agresta, Ferdinando; Michelet, Ivan; Bedin, Natalino

    2003-01-01

    Laparoscopy has gained widespread acceptance in common surgical practice as a diagnostic and therapeutic tool. Suspected appendicitis is still a diagnostic challenge to the general surgeon. A correct diagnosis is crucial because of the various diseases that may be responsible for the same symptoms, in order to plan the appropriate procedure or avoid an unnecessary laparotomy. Laparoscopy is the only minimally invasive technique to allow at the same time for adequate diagnosis, appropriate treatment and the best abdominal approach. Minilaparoscopy would appear to be a natural further step in the development of this technique. The aim of the present work was to illustrate retrospectively the results of an initial case-control study of minilaparoscopy vs. laparoscopy carried out at our institution. Between January and December 2002 a total of 86 patients underwent emergency and/or urgent appendectomy. Among them, 68 (79%) were operated on laparoscopically (37 [54.4%] with a minilaparoscopic approach and 31 with conventional laparoscopy), while 18 (21%) were treated by laparotomy, as performed by a well-trained surgical team. In the minilaparoscop group we registered no conversions to laparotomy and only one major postoperative complication (intra-abdominal abscess treated laparoscopically). As regards the postoperative period, generally speaking, the patients' conditions (analgesic treatment, flatus, diet, hospital discharge) were broadly the same as in the laparoscopic group. Though limited by its initial retrospective character, the present study shows that minilaparoscopic appendectomy is as safe and effective as classical laparoscopic surgery, and seems to be associated with less trauma and a more rapid postoperative recovery. Such features make minilaparoscopy a challenging alternative to conventional laparoscopy (and, of course, laparotomy) in patients referred for urgent abdominal and/or pelvic surgery. PMID:14587115

  17. Endovascular extraction techniques

    PubMed Central

    Bracke, F.A.; Meijer, A.; van Gelder, B.

    2001-01-01

    The use of lead extraction is expanding with the introduction of new endovascular extraction techniques. Indications for extraction of chronically implanted pacemaker leads have been classified as mandatory, necessary or discretionary, but their rationale is often based on clinical judgement without corresponding support from the literature. We reviewed the literature of pacemaker lead-related complications as a starting point for discussing the indications for lead extraction. ImagesFigure 1Figure 2Figure 3 PMID:25696699

  18. Percutaneous Nephrostomy: Technical Aspects and Indications

    PubMed Central

    Dagli, Mandeep; Ramchandani, Parvati

    2011-01-01

    First described in 1955 by Goodwin et al as a minimally invasive treatment for urinary obstruction causing marked hydronephrosis, percutaneous nephrostomy (PCN) placement quickly found use in a wide variety of clinical indications in both dilated and nondilated systems. Although the advancement of modern endourological techniques has led to a decline in the indications for primary nephrostomy placement, PCNs still play an important role in the treatment of multiple urologic conditions. In this article, the indications, placement, and postprocedure management of percutaneous nephrostomy drainage are described. PMID:23204641

  19. National Neighborhood Indicators Partnership

    NSDL National Science Digital Library

    The National Neighborhood Indicators Partnership works "to build local capacity" through a range of activities, including the creation of apps, outreach projects, and much more. Visitors can look over the Partnershipâ??s Featured area to get a sense of its recent initiatives which include the creation of integrated data systems and neighborhood centers. The Activities area includes Issue Areas which feature publications and presentations on matters that include absenteeism, affordable housing, children, and community development. The Library includes online guides on local data sharing, a user conference directory, and short stories from partners on their own work. The site is rounded out by the Data & Tech section with summary information on the local neighborhood-level data held by numerous community partners throughout the United States.

  20. The masticatory normative indicator.

    PubMed

    Woda, A; Nicolas, E; Mishellany-Dutour, A; Hennequin, M; Mazille, M-N; Veyrune, J-L; Peyron, M-A

    2010-03-01

    There is no established quantitative, objective method to differentiate individuals with good masticatory function from those lacking this attribute. The aim of this study was to specify a normal range of median particle size values for masticated raw carrots collected just before being swallowed. The masticatory normative indicator (MNI) value thus obtained was based on seven studies carried out by different investigators using different methods for measuring particle size in carrot boluses. A simple mathematical transformation of variables and the choice of an interval of +/-1.96 times the standard deviation gave 4.0 mm as the upper limit of normal median particle size for carrots in a population of young persons with good oral health. This value identifies boluses that may be considered as resulting from impaired mastication, as illustrated in healthy individuals with experimentally hampered mastication, denture wearers, and individuals presenting with obesity or Down syndrome. PMID:20118433

  1. Enhanced tamper indicator

    DOEpatents

    Garcia, Anthony R.; Johnston, Roger G.

    2003-07-08

    The present invention provides an apparatus and method whereby the reliability and tamper-resistance of tamper indicators can be improved. A flexible connector may be routed through a latch for an enclosure such as a door or container, and the free ends of the flexible connector may be passed through a first locking member and firmly attached to an insert through the use of one or more attachment members such as set screws. A second locking member may then be assembled in interlocking relation with the first locking member to form an interlocked assembly around the insert. The insert may have one or more sharp projections extending toward the first or second locking member so that any compressive force applied in an attempt to disassemble the interlocked assembly results in permanent, visible damage to the first or second locking member.

  2. International energy indicators

    NASA Astrophysics Data System (ADS)

    Rossi, E., Jr.

    1981-12-01

    Data on international energy indicators were tabulated and graphically represented. The following data are presented: world crude oil production, 1974 to October 1981; OPEC crude oil productive capacity; world crude oil and refined product inventory levels, 1975 to October, 1981; oil consumption in OECD countries, 1975 to October 1981; USSR crude oil production and exports, 1975 to October 1981; free world and US nuclear electricity generation, 1973 to December, 1981 and current capacity. Specific US data presented are: US domestic oil supply, 1977 to June, 1981; US gross imports of crude oil and products, 1973 to October, 1981; landed cost of Saudi crude current and 1974 dollars; US coal trade, 1975 to September, 1981; US natural gas trade, 1981; and energy/GNP ratio.

  3. Precipitation Indices Low Countries

    NASA Astrophysics Data System (ADS)

    van Engelen, A. F. V.; Ynsen, F.; Buisman, J.; van der Schrier, G.

    2009-09-01

    Since 1995, KNMI published a series of books(1), presenting an annual reconstruction of weather and climate in the Low Countries, covering the period AD 763-present, or roughly, the last millennium. The reconstructions are based on the interpretation of documentary sources predominantly and comparison with other proxies and instrumental observations. The series also comprises a number of classifications. Amongst them annual classifications for winter and summer temperature and for winter and summer dryness-wetness. The classification of temperature have been reworked into peer reviewed (2) series (AD 1000-present) of seasonal temperatures and temperature indices, the so called LCT (Low Countries Temperature) series, now incorporated in the Millennium databases. Recently we started a study to convert the dryness-wetness classifications into a series of precipitation; the so called LCP (Low Countries Precipitation) series. A brief outline is given here of the applied methodology and preliminary results. The WMO definition for meteorological drought has been followed being that a period is called wet respectively dry when the amount of precipitation is considerable more respectively less than usual (normal). To gain a more quantitative insight for four locations, geographically spread over the Low Countries area (De Bilt, Vlissingen, Maastricht and Uccle), we analysed the statistics of daily precipitation series, covering the period 1900-present. This brought us to the following definition, valid for the Low Countries: A period is considered as (very) dry respectively (very) wet if over a continuous period of at least 60 days (~two months) cq 90 days (~three months) on at least two out of the four locations 50% less resp. 50% more than the normal amount for the location (based on the 1961-1990 normal period) has been measured. This results into the following classification into five drought classes hat could be applied to non instrumental observations: Very wet period (+2): Wide scale river flooding, marshy acres and meadows.-Farmers cope with poor harvests of hay, grains, fruit etc. resulting in famines.-Late grape harvests, poor yield quantity and quality of wine. Wet period (+1): High water levels cq discharges of major rivers, tributaries and brooks, local river floodings, marshy acres and meadows in the low lying areas.-Wearisome and hampered agriculture. Normal (0) Dry period (-1): Low water levels cq discharges of major rivers, tributaries and brooks. Some brooks may dry up.-Summer half year: local short of yield of grass, hay and other forage.-Summer half year: moor-, peat- and forest fires. Very dry period (-2): Very low water levels cq discharges of major rivers and tributaries. Brooks and wells dry up. Serious shortage of drinking water; especially in summer.-Major agricultural damage, shortage of water, mortality stock of cattle. Shortage of grain. Flour can not be produced due to water mills running out of water, shortage of bread, bread riots, famines.-Large scale forest and peat areas, resulting in serious air pollution. Town fires. By verifying the historical evidence on these criterions, a series of 5 step indices ranging from very dry to very wet for summer and winter half year of the Low Countries was obtained. Subsequently these indices series were compared with the instrumentally observed seasonal precipitation sums for De Bilt (1735-2008), which is considered to be representative for the Central Netherlands. For winter (Oct-March) and summer half year (Apr.-Sept.) the accumulated precipitation amounts are calculated; these amounts are approximately normally distributed. Based on this distribution, the cumulative frequency distribution is calculated. By tabulating the number of summers in the pre-instrumental period 1201-1750 for each of the drought classes, a distribution is calculated which is then related to the modern accumulated precipitation distribution. Assuming that the accumulated precipitation amount has not been below (above) the mean precipitation minus (plus) three standard deviations for

  4. Analysis techniques

    NASA Technical Reports Server (NTRS)

    Chelton, D.

    1983-01-01

    Analysis techniques for the sea surface temperature (SST) intercomparison were discussed. Systematic differences between various measurement techniques were identified and examined. This in turn might reveal areas for needed improvement in the SST retrieval algorithms or, at the very least, a clearer understanding of the limitations of each sensor.

  5. Ergodicity of financial indices

    NASA Astrophysics Data System (ADS)

    Kolesnikov, A. V.; Rühl, T.

    2010-05-01

    We introduce the concept of the ensemble averaging for financial markets. We address the question of equality of ensemble and time averaging in their sequence and investigate if these averagings are equivalent for large amount of equity indices and branches. We start with the model of Gaussian-distributed returns, equal-weighted stocks in each index and absence of correlations within a single day and show that even this oversimplified model captures already the run of the corresponding index reasonably well due to its self-averaging properties. We introduce the concept of the instant cross-sectional volatility and discuss its relation to the ordinary time-resolved counterpart. The role of the cross-sectional volatility for the description of the corresponding index as well as the role of correlations between the single stocks and the role of non-Gaussianity of stock distributions is briefly discussed. Our model reveals quickly and efficiently some anomalies or bubbles in a particular financial market and gives an estimate of how large these effects can be and how quickly they disappear.

  6. Cepheids as Distance Indicators

    E-print Network

    N. R. Tanvir

    1996-11-04

    We review the use of Cepheids as distance indicators with particular emphasis on the methods which have been applied to HST observations of Cepheids. The calibration of the period-luminosity relations is examined in detail and we identify possible problems with the existing calibrations. New V- and I-band period luminosity relations are presented based on a sample of 53 Cepheids in the LMC with photometry drawn from the literature. These revised PL relations result in a systematic decrease of approx 0.1 magnitudes in distance moduli derived using the standard method of extinction correction. Hence estimates of the Hubble constant based on such distances should be increased by $\\sim5%$. Other aspects of Cepheid distance determination, specifically incompleteness bias, metallicity dependence, the effects of crowding and contamination of samples by non-Cepheids are also discussed. We conclude that current HST distance estimates to individual galaxies are probably good to about 10%, but that much of this error is systematic. Efforts to reduce the systematics, therefore, for example by improving the photometric calibration, refining the distance to the LMC, and reobserving the Cepheid galaxies in the infrared with NICMOS, will give large returns.

  7. Should researchers use single indicators, best indicators, or multiple indicators in structural equation models?

    PubMed Central

    2012-01-01

    Background Structural equation modeling developed as a statistical melding of path analysis and factor analysis that obscured a fundamental tension between a factor preference for multiple indicators and path modeling’s openness to fewer indicators. Discussion Multiple indicators hamper theory by unnecessarily restricting the number of modeled latents. Using the few best indicators – possibly even the single best indicator of each latent – encourages development of theoretically sophisticated models. Additional latent variables permit stronger statistical control of potential confounders, and encourage detailed investigation of mediating causal mechanisms. Summary We recommend the use of the few best indicators. One or two indicators are often sufficient, but three indicators may occasionally be helpful. More than three indicators are rarely warranted because additional redundant indicators provide less research benefit than single indicators of additional latent variables. Scales created from multiple indicators can introduce additional problems, and are prone to being less desirable than either single or multiple indicators. PMID:23088287

  8. Illustrating Chemiluminescence with Siloxene Indicator.

    ERIC Educational Resources Information Center

    Hoff, Ray

    1981-01-01

    Discusses the nature of light-producing reactions and provides a procedure for demonstrating chemical luminescence using siloxene indicator. Indicates source of this chemical and safety precautions. (SK)

  9. Indications and limitations of splints and casts.

    PubMed

    Mulon, Pierre-Yves; Desrochers, André

    2014-03-01

    Long bone fractures are relatively common in cattle, whether they result from a self-inflicted trauma or from external actors (herd mate or farm machinery). Various advanced orthopedic techniques have been described to stabilize and treat fractures in cattle with success. Unfortunately the use of most of those techniques remains unrealistic in a field setting, rendering the realization of splints and casts still accurate for the treatment of long bone fracture in cattle. This article refers to the use of all external coaptation and their specific indications as well as their limitations. PMID:24534659

  10. Anterior ankle arthroscopy: indications, pitfalls, and complications.

    PubMed

    Epstein, David M; Black, Brandee S; Sherman, Seth L

    2015-03-01

    Anterior ankle arthroscopy is a useful, minimally invasive technique for diagnosing and treating ankle conditions. Arthroscopic treatment offers the benefit of decreased surgical morbidity, less postoperative pain, and earlier return to activities. Indications for anterior ankle arthroscopy continue to expand, including ankle instability, impingement, management of osteochondritis dissecans, synovectomy, and loose body removal. Anterior ankle arthroscopy has its own set of inherent risks and complications. Surgeons can decrease the risk of complications through mastery of ankle anatomy and biomechanics, and by careful preoperative planning and meticulous surgical technique. PMID:25726482

  11. Decomposition techniques

    USGS Publications Warehouse

    Chao, T.T.; Sanzolone, R.F.

    1992-01-01

    Sample decomposition is a fundamental and integral step in the procedure of geochemical analysis. It is often the limiting factor to sample throughput, especially with the recent application of the fast and modern multi-element measurement instrumentation. The complexity of geological materials makes it necessary to choose the sample decomposition technique that is compatible with the specific objective of the analysis. When selecting a decomposition technique, consideration should be given to the chemical and mineralogical characteristics of the sample, elements to be determined, precision and accuracy requirements, sample throughput, technical capability of personnel, and time constraints. This paper addresses these concerns and discusses the attributes and limitations of many techniques of sample decomposition along with examples of their application to geochemical analysis. The chemical properties of reagents as to their function as decomposition agents are also reviewed. The section on acid dissolution techniques addresses the various inorganic acids that are used individually or in combination in both open and closed systems. Fluxes used in sample fusion are discussed. The promising microwave-oven technology and the emerging field of automation are also examined. A section on applications highlights the use of decomposition techniques for the determination of Au, platinum group elements (PGEs), Hg, U, hydride-forming elements, rare earth elements (REEs), and multi-elements in geological materials. Partial dissolution techniques used for geochemical exploration which have been treated in detail elsewhere are not discussed here; nor are fire-assaying for noble metals and decomposition techniques for X-ray fluorescence or nuclear methods be discussed. ?? 1992.

  12. Calibration of a universal indicated turbulence system

    NASA Technical Reports Server (NTRS)

    Chapin, W. G.

    1977-01-01

    Theoretical and experimental work on a Universal Indicated Turbulence Meter is described. A mathematical transfer function from turbulence input to output indication was developed. A random ergodic process and a Gaussian turbulence distribution were assumed. A calibration technique based on this transfer function was developed. The computer contains a variable gain amplifier to make the system output independent of average velocity. The range over which this independence holds was determined. An optimum dynamic response was obtained for the tubulation between the system pitot tube and pressure transducer by making dynamic response measurements for orifices of various lengths and diameters at the source end.

  13. GMM Repeat Sales Price Indices

    Microsoft Academic Search

    Liang Peng

    2002-01-01

    Illiquid assets are widely spread within the economy but their indices are difficult to measure. This paper proposes a Generalized Method of Moment (GMM) repeat sales regression for estimating illiquid asset price indices. This method has estimators that are arithmetic averages of individual asset returns. This method is able to estimate custom-weighted indices, including equal- and value-weighted indices. It can

  14. Relationship of echocardiographic indices to pulmonary capillary wedge pressures in healthy volunteers

    NASA Technical Reports Server (NTRS)

    Firstenberg, M. S.; Levine, B. D.; Garcia, M. J.; Greenberg, N. L.; Cardon, L.; Morehead, A. J.; Zuckerman, J.; Thomas, J. D.

    2000-01-01

    OBJECTIVES: We sought to determine the relationship between different echocardiographic indices and pulmonary capillary wedge pressures (PCWP) in normal volunteers. BACKGROUND: Indices based on tissue Doppler (TDE) and color M-mode (CMM) echocardiography have been proposed to reflect left (LV) ventricular filling pressures. These include the ratio of early diastolic transmitral velocity (E) to early myocardial velocity measured by TDE (E') and the ratio of E to the wave propagation velocity (Vp) measured from CMM images. These indices, however, have not been validated in normal individuals. METHODS: We studied seven volunteers during two phases of preload altering maneuvers, baseline, with two stages of lower body negative pressure, and repeat baseline with two stages of volume loading. The PCWP obtained from right heart catheterization was compared with diastolic indices using pulsed Doppler, TDE and CMM echocardiography. RESULTS: The PCWP ranged from 2.2 to 23.5 mm Hg. During preload alterations, significant changes in E and septal E' (both p < 0.05) but not lateral E' or Vp were observed. Furthermore, E, septal E' and E/Vp correlated with PCWP (all r > 0.80) but not combined E and TDE indices (both r < 0.15). Within individuals, a similar linear relationship was observed among E/Vp, E and septal E' (average r > 0.80). CONCLUSIONS: In subjects without heart disease, E, septal E' and E/Vp correlate with PCWP. Because the influence of ventricular relaxation is minimized, the ratio E/Vp may be the best overall index of LV filling pressures.

  15. Combined contrast echocardiographic and radionuclide diagnosis of atrial septal defect: accuracy of the technique and analysis of erroneous diagnoses.

    PubMed

    Ginzton, L E; French, W; Mena, I

    1984-06-01

    The utility of combined peripheral vein contrast 2-dimensional echocardiography (2-D echo) and radionuclide shunt detection was evaluated in 25 patients with suspected atrial septal defect (ASD) in whom the diagnosis was confirmed at cardiac catheterization: 14 patients had ASD and 11 had no intracardiac shunt. Contrast 2-D echo correctly diagnosed 13 of 14 patients with ASD, but there were 2 false-positive diagnoses in the 11 patients without ASD. Radionuclide shunt studies correctly identified all 14 patients with ASD, but yielded 5 false-positives results among the 11 without ASD. After altering the radionuclide processing technique, there were only 2 of 11 false-positive shunt studies, and the correlation of radionuclide shunt magnitude with cardiac catheterization improved (r = 0.49, p less than 0.025 to r = 0.75, p less than 0.001). Thus, the improved processing method improved both the qualitative and quantitative accuracy of radionuclide shunt detection. The combination of contrast 2-D echo and radionuclide shunt detection led to a proper diagnostic and therapeutic decision in 24 of 25 patients. Therefore, these combined modalities are clinically useful in the evaluation of patients with suspected ASD. PMID:6731309

  16. Statistical Indicators for Religious Studies: Indicators of Level and Structure

    ERIC Educational Resources Information Center

    Herteliu, Claudiu; Isaic-Maniu, Alexandru

    2009-01-01

    Using statistic indicators as vectors of information relative to the operational status of a phenomenon, including a religious one, is unanimously accepted. By introducing a system of statistic indicators we can also analyze the interfacing areas of a phenomenon. In this context, we have elaborated a system of statistic indicators specific to the…

  17. CONFIDENTIAL INDICATOR/NO PRINT INDICATOR Georgia Institute of Technology

    E-print Network

    Weber, Rodney

    CONFIDENTIAL INDICATOR/NO PRINT INDICATOR Georgia Institute of Technology Registrar's Office, Atlanta GA 30332-0315 Fax 404-894-0167 "CONFIDENTIAL" INDICATOR ­ (Option A) Checking the "Confidential records are "confidential" each time your record is viewed. Your name and associated information

  18. Hacking Techniques

    Microsoft Academic Search

    Richard Barber

    2001-01-01

    With tales of hacked networks and websites being reported by the media daily, people assume that hacking must be easy. But, in truth, the tools and techniques employed by hackers are extremely complex, utilizing a broad range of technologies. The number of mechanisms for breaking into systems, whatever the objective, is on the increase with new tools emerging continuously. This

  19. Non-invasive evaluation of hemodynamics in pulmonary hypertension by a Septal angle measured by computed tomography pulmonary angiography: Comparison with right-heart catheterization and association with N-terminal pro-B-type natriuretic peptide.

    PubMed

    Tang, Qiang; Liu, Min; Ma, Zhanhong; Guo, Xiaojuan; Kuang, Tuguang; Yang, Yuanhua

    2013-12-01

    The septal angle, an angle between the interventricular septum and the line connecting the sternum midpoint and thoracic vertebral spinous process, as measured by computed tomographic pulmonary angiography (CTPA), has been observed to be increased in patients with pulmonary hypertension (PH), but its meaning remains unclear. The aim of this study was to investigate the potential role of the septal angle in evaluating hemodynamics and its association with N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with PH. Patients with PH (n=106), including 76 with chronic thromboembolic pulmonary hypertension (CTEPH) and 30 with pulmonary artery hypertension (PAH), were retrospectively reviewed. The patients underwent CTPA prior to right-heart catheterization. The septal angle was measured on transversal CTPA images. Hemodynamic parameters were evaluated by right-heart catheterization. The level of plasma NT-proBNP was measured by enzyme-linked sandwich immunoassay. The septal angle had a moderate correlation with cardiac output (CO; r=-0.535, P=0.000) and a high correlation with pulmonary vascular resistance (PVR; r=0.642, P=0.000). The mean level of NT-proBNP in PH was 1,716.09±1,498.30 pg/ml, which correlated with the septal angle (r=0.693, P=0.000). In a stepwise forward regression analysis, the Septal angle was entered into the final equation for predicting PVR, leading to the following equation: PVR = 28.256 × Septal angle - 728.72. In CTEPH, the Septal angle strongly correlated with NT-proBNP (r=0.668, P=0.000) and PVR (r=0.676, P=0.000). In PAH, the Septal angle strongly correlated with NT-proBNP (r=0.616, P=0.003) and PVR (r=0.623, P=0.000). The CTPA-derived Septal angle is a superior predictor for evaluating and monitoring the level of NT-proBNP and PVR in patients with PH. PMID:24255661

  20. Physiologic and Clinical Principles behind Noninvasive Resuscitation Techniques and Cardiac Output Monitoring

    PubMed Central

    Napoli, Anthony M.

    2012-01-01

    Clinical assessment and vital signs are poor predictors of the overall hemodynamic state. Optimal measurement of the response to fluid resuscitation and hemodynamics has previously required invasive measurement with radial and pulmonary artery catheterization. Newer noninvasive resuscitation technology offers the hope of more accurately and safely monitoring a broader range of critically ill patients while using fewer resources. Fluid responsiveness, the cardiac response to volume loading, represents a dynamic method of improving upon the assessment of preload when compared to static measures like central venous pressure. Multiple new hemodynamic monitors now exist that can noninvasively report cardiac output and oxygen delivery in a continuous manner. Proper assessment of the potential future role of these techniques in resuscitation requires understanding the underlying physiologic and clinical principles, reviewing the most recent literature examining their clinical validity, and evaluating their respective advantages and limitations. PMID:21860802

  1. Physiologic and Clinical Principles behind Noninvasive Resuscitation Techniques and Cardiac Output Monitoring.

    PubMed

    Napoli, Anthony M

    2012-01-01

    Clinical assessment and vital signs are poor predictors of the overall hemodynamic state. Optimal measurement of the response to fluid resuscitation and hemodynamics has previously required invasive measurement with radial and pulmonary artery catheterization. Newer noninvasive resuscitation technology offers the hope of more accurately and safely monitoring a broader range of critically ill patients while using fewer resources. Fluid responsiveness, the cardiac response to volume loading, represents a dynamic method of improving upon the assessment of preload when compared to static measures like central venous pressure. Multiple new hemodynamic monitors now exist that can noninvasively report cardiac output and oxygen delivery in a continuous manner. Proper assessment of the potential future role of these techniques in resuscitation requires understanding the underlying physiologic and clinical principles, reviewing the most recent literature examining their clinical validity, and evaluating their respective advantages and limitations. PMID:21860802

  2. Smart Indicators on Learning Interactions

    Microsoft Academic Search

    Christian Glahn; Marcus Specht; Rob Koper

    2007-01-01

    Indicators help actors to organise, orientate and navigate through complex environments by providing contextual information relevant for the performance of learning tasks. In this article we analyse the requirements, present a model and an initial prototype of a software system that uses smart indicators to support learners to be more engaged in the learning process. We argue that indicators need

  3. Fecal Indicator Bacteria and Environmental Observations: Validation of Virtual Beach

    EPA Science Inventory

    Contamination of recreational waters by fecal material is often assessed using indicator bacteria such as enterococci. Enumeration based on culturing methods can take up to 48 hours to complete, limiting the accuracy of water quality evaluations. Molecular microbial techniques em...

  4. Nanofabrication Techniques

    NSDL National Science Digital Library

    This page from Foothill-De Anza Community College describes a course on nanoscience for those who need an introduction to the subject. This course is the fifth in a five course series that leads to a certificate in nanoscience, nanotechnology, and nanomaterials engineering. Students will obtain a survey of fabrication techniques as well as "hands-on experience creating thin film materials, and quality control 'shadowing' in a clean energy technology fabrication facility." The projects required by the class are also described.

  5. Densitometry Techniques

    Microsoft Academic Search

    Sydney Lou Bonnick; RADIOGRAPHIC ABSORPTIOMETRY

    \\u000a Clinical densitometry is relatively new but densitometry itself is actually quite old. It was first described over 100 years\\u000a ago in the field of dental radiology as dentists attempted to quantify the bone density in the mandible(1,2). With today’s\\u000a techniques bone density can be quantified in almost every region of the skeleton. The extraordinary technical advances in\\u000a recent years have

  6. Electrochemical Techniques

    SciTech Connect

    Chen, Gang; Lin, Yuehe

    2008-07-20

    Sensitive and selective detection techniques are of crucial importance for capillary electrophoresis (CE), microfluidic chips, and other microfluidic systems. Electrochemical detectors have attracted considerable interest for microfluidic systems with features that include high sensitivity, inherent miniaturization of both the detection and control instrumentation, low cost and power demands, and high compatibility with microfabrication technology. The commonly used electrochemical detectors can be classified into three general modes: conductimetry, potentiometry, and amperometry.

  7. Measurement techniques

    SciTech Connect

    Willis, W.L.

    1980-10-01

    The discussion will be restricted to measurements of voltage and current. Also, although the measurements themselves should be as quantitative as possible, the discussion is rather nonquantitative. Emphasis is on types of instruments, how they may be used, and the inherent advantages and limitations of a given technique. A great deal of information can be obtained from good, clean voltage and current data. Power and impedance are obviously inherent if the proper time relationships are preserved. Often an associated, difficult-to-determine, physical event can be evaluated from the V-I data, such as a time-varying load characteristic, or the time of light emission, etc. The lack of active high voltage devices, such as 50-kV operational amplifiers, restricts measurement devices to passive elements, primarily R and C. There are a few more exotic techniques that are still passive in nature. There are several well-developed techniques for voltage measurements. These include: spark gaps; electrostatic meters; capacitive dividers; mixed RC dividers; and the electro-optic effect. Current is measured by either direct measurement of charge flow or by measuring the resulting magnetic field.

  8. Bifurcated Aortoiliac Endograft Limb Occlusion during Deployment and Its Bailout Conversion Using the External Iliac Artery to Internal Iliac Artery Endograft Technique.

    PubMed

    Kehagias, Elias; Kontopodis, Nikolaos; Tsetis, Dimitrios; Ioannou, Christos V

    2015-07-01

    Endovascular aneurysm repair has become the preferred method to treat abdominal aortic aneurysms (AAAs). The Ovation TriVascular Stent-Graft system introduces a unique concept of separation of the metal (stent) and fabric (graft) portion of the endograft's main body to facilitate delivery through ultra-low profile 14F devices. In the setting of a narrow distal aneurysmal lumen, usually due to the presence of thrombus, deployment of this endograft may be complicated by folding and collapse of the (unsupported by a stent) aortic body or limbs, making catheterization and ballooning impossible. We present a case of Ovation endograft contralateral limb collapse in a tight AAA lumen due to thrombus deposition, which led to folding and total occlusion of the limb and made limb catheterization impossible. This is a real-life example of how the external iliac artery to internal iliac artery endograft technique may be used as a bailout procedure, converting the procedure into an aortouni-iliac graft. To our knowledge, this is the first reported bailout use of this technique in English literature which may be used in selected cases. PMID:25770386

  9. Quantitative evaluation of left ventricular systolic function by Doppler echocardiographic techniques.

    PubMed

    Loutfi, H; Nishimura, R A

    1994-05-01

    Doppler echocardiography provides the ability to measure blood flow velocities noinvasively. These blood flow velocities can be used to obtain powerful hemodynamic information about systolic contractility of the left ventricle, which in the past could only be determined from invasive cardiac catheterization or cumbersome pulse recordings. Volumetric flow rates can be measured using the hydraulic principle of flow through a rigid tube, providing a measurement of stroke volume and cardiac output. The rate of the left ventricular pressure rise derived from a mitral regurgitation velocity curve provides a nonejection phase index of systolic contractility. Acceleration time can be obtained from an ascending aortic velocity and is an indicator of maximum myocardial force. Systolic time intervals can now be quickly and accurately obtained from the standard Doppler tracings. These quantitative measurements of the status of the left ventricular are accurate, reproducible, and should be incorporated into the routine noninvasive assessment of patients with cardiac disease. PMID:10150566

  10. The role of the ECG in diagnosis, risk estimation, and catheterization laboratory activation in patients with acute coronary syndromes: a consensus document.

    PubMed

    Birnbaum, Yochai; Nikus, Kjell; Kligfield, Paul; Fiol, Miguel; Barrabés, Jose Antonio; Sionis, Alessandro; Pahlm, Olle; Niebla, J Garcia; de Luna, Antonio Bayès

    2014-09-01

    The electrocardiogram (ECG) is the most widely used imaging tool helping in diagnosis and initial management of patients presenting with symptoms compatible with acute coronary syndrome. Acute ischemia affects the configuration of the QRS complexes, the ST segments and the T waves. The ECG should be read along with the clinical assessment of the patient. ST segment elevation (and ST depression in leads V1 -V3 ) in patients with active symptoms usually indicates acute occlusion of an epicardial artery with ongoing transmural ischemia. These patients should be triaged for emergent reperfusion therapy per current guidelines. However, many patients have ST segment elevation secondary to nonischemic causes. ST depression in leads other than V1 -V3 usually are indicative of subendocardial ischemia secondary to subocclusion of the epicardial artery, distal embolization to small arteries or spasm supply/demand mismatch. ST depression may also be secondary to nonischemic etiologies, such as left ventricular hypertrophy, cardiomyopathies, etc. Knowing the clinical scenario, comparison to previous ECG and subsequent ECGs (in cases that there are changes in the quality or severity of symptoms) may add in the diagnosis and interpretation in difficult cases. This review addresses the different ECG patterns, typically seen in patients with active symptoms, after resolution of symptoms and the significance of such changes when seen in asymptomatic patients. PMID:25262661

  11. Indicators for Transboundary River Management

    Microsoft Academic Search

    CAROLIN M. LORENZ; ALISON J. GILBERT; WIM P. COFINO

    2001-01-01

    The aim of this paper is to analyze the potential of indicators for integrated river basin management and to develop a set\\u000a of indicators for the management of transboundary river basins. An indicator, comprising a variable or some aggregation of\\u000a variables, describes a system or process such that it has significance beyond the face value of its components. Integrated\\u000a river

  12. Emergent Median Sternotomy for Mediastinal Hematoma: A Rare Complication following Internal Jugular Vein Catheterization for Chemoport Insertion—A Case Report and Review of Relevant Literature

    PubMed Central

    Biswas, Saptarshi

    2014-01-01

    Mediastinal hematoma is a rare complication following insertion of a central venous catheter with only few cases reported in the English literature. We report a case of a 71-year-old female who was admitted for elective chemoport placement. USG guided right internal jugular access was attempted using the Seldinger technique. Resistance was met while threading the guidewire. USG showed a chronic clot burden in the RIJ. A microvascular access was established under fluoroscopic guidance. Rest of the procedure was completed without any further issues. Following extubation, the patient complained of right-sided chest pain radiating to the back. Chest X-ray revealed a contained white out in the right upper lung field. She became hemodynamically unstable. Repeated X-ray showed progression of the hematoma. Median Sternotomy showed posterior mediastinal hematoma tracking into right pleural cavity. Active bleeding from the puncture site at RIJ-SCL junction was repaired. Patient had an uneventful recovery. Injury to the central venous system is the result of either penetrating trauma or iatrogenic causes as in our case. A possible explanation of our complication may be attributed to the forced manipulation of the dilator or guidewire against resistance. Clavicle and sternum offer bony protection to the underlying vital venous structures and injuries often need sternotomy with or without neck extension. Division of the clavicle and disarticulation of the sternoclavicular joint may be required for optimum exposure. Meticulous surgical technique, knowledge of the possible complications, and close monitoring in the postprocedural period are of utmost importance. Chest X-ray showed to be routinely done to detect any complication early. PMID:24592335

  13. Indexing human development in India : Indicators, scaling and composition

    Microsoft Academic Search

    Amitabh Khundu; Abusaleh Shariff; P. K. Ghosh

    2002-01-01

    The paper analyses methodological issues concerning selection of indicators, making them scale-free and construction of composite indices within the framework of measuring human development. It reviews the existing literature in the area and highlights the key areas of concern from the viewpoint of methodology of aggregation. It discusses the implications of the assumptions underlying different techniques, currently being used in

  14. Identifying Quality Indicators of SAE and FFA: A Delphi Approach

    ERIC Educational Resources Information Center

    Jenkins, Charles Cordell, III; Kitchel, Tracy

    2009-01-01

    The purpose of this study was to determine quality indicators for SAE and FFA according to 36 experts across the United States. This is a part of a larger study looking at all components of the traditional three-circle model. The study utilized the Delphi technique to garner expert opinion about quality indicators in Agricultural Education. For…

  15. Using windowed ESPRIT spectral estimation for measuring power quality indices

    Microsoft Academic Search

    R. Zolfaghari; Y. Shrivastava; V. G. Agelidis; G. M. L. Chu

    2010-01-01

    This paper presents the theory, design and implementation of a virtual instrument based on a new method to measure the power quality indices such as current harmonic distortion, voltage harmonic distortion and power factor as given by the IEEE standard. A modern spectral estimation technique (ESPRIT) is used to estimate the power quality indices. Simulation results followed by experimental results

  16. Quality Indicators for Learning Analytics

    ERIC Educational Resources Information Center

    Scheffel, Maren; Drachsler, Hendrik; Stoyanov, Slavi; Specht, Marcus

    2014-01-01

    This article proposes a framework of quality indicators for learning analytics that aims to standardise the evaluation of learning analytics tools and to provide a mean to capture evidence for the impact of learning analytics on educational practices in a standardised manner. The criteria of the framework and its quality indicators are based on…

  17. Quality Indicators of Online Programs

    Microsoft Academic Search

    Leo Hirner; Thomas Kochtanek

    2012-01-01

    The continued growth of online programs in higher education has resulted in concerns about how institutions monitor the quality of their online programs. These concerns indicate a need for a process by which online programs may be evaluated and compared. They provided the impetus for this study, the goals of which were to identify quality indicators specific to community college

  18. Fit Indices Versus Test Statistics

    ERIC Educational Resources Information Center

    Yuan, Ke-Hai

    2005-01-01

    Model evaluation is one of the most important aspects of structural equation modeling (SEM). Many model fit indices have been developed. It is not an exaggeration to say that nearly every publication using the SEM methodology has reported at least one fit index. Most fit indices are defined through test statistics. Studies and interpretation of…

  19. Indicator Variables for Optimal Policy

    Microsoft Academic Search

    Lars E. O. Svensson; Michael Woodford

    1999-01-01

    The optimal weights on indicators in models with partial information about the state of the economy and forward-looking variables are derived and interpreted, both for equilibria under discretion and under commitment. An example of optimal monetary policy with a partially observable potential output and a forward-looking indicator is examined. The optimal response to the optimal estimate of potential output displays

  20. Deriving indicators of sustainable development

    Microsoft Academic Search

    Hartmut Bossel

    1996-01-01

    Assessments of current and future development paths require comprehensive sets of indicators covering all essential aspects. From a holistic systems point of view, most currently proposed indicator sets are incomplete and deficient. Assessments of sustainable development require a full representation of the satisfaction states of the “basic orientors” (=fundamental interests) of constituent sector systems, and of their contribution to basic

  1. Some Indices of Lake Productivity

    Microsoft Academic Search

    John B. Moyle

    1949-01-01

    In an attempt to evaluate lake-survey procedures some of the chemical, physical, and biological measurements that have been considered possible indices of lake productivity have been examined in the light of 11 years of lake surveys and 6 years of pond rearing of yellow pikeperch. In Minnesota waters total alkalinity and total phosphorus appear to be the most valuable indices.

  2. Passive Tamper Indicating Enclosures Incorporating Embedded Optical Fibre

    SciTech Connect

    Wynn, Paul; White, Helen; Allen, Keir; Simmons, Kevin L.; Sliva, Paul; Benz, Jacob M.; Tanner, Jennifer E.

    2011-08-14

    AWE and PNNL are engaged in a technical collaboration investigating techniques to enhance continuity of knowledge over Accountable Items within a verified nuclear weapons dismantlement process. Tamper Indicating Enclosures (TIE) will likely be deployed as part of a chain of custody regime to indicate an unauthorised attempt to access an Accountable Item. This paper looks at the use of passive TIEs incorporating embedded optical fibre; concepts relating to deployment, tamper indication and unique identification will be discussed.

  3. Indicator-based and indicator-free magnetic assays connected with disposable electrochemical nucleic acid sensor system

    Microsoft Academic Search

    Hakan Karadeniz; Arzum Erdem; Filiz Kuralay; Frantisek Jelen

    2009-01-01

    An indicator-based and indicator-free magnetic assays connected with a disposable pencil graphite electrode (PGE) were successfully developed, and also compared for the electrochemical detection of DNA hybridization. The oxidation signals of echinomycin (ECHI) and electroactive DNA bases, guanine and adenine, respectively were monitored in the presence of DNA hybridization by using differential pulse voltammetry (DPV) technique. The biotinylated probe was

  4. Catheterization of the carotid artery and jugular vein to perform hemodynamic measures, infusions and blood sampling in a conscious rat model.

    PubMed

    Feng, Jing; Fitz, Yvonne; Li, Yan; Fernandez, Melinda; Cortes Puch, Irene; Wang, Dong; Pazniokas, Stephanie; Bucher, Brandon; Cui, Xizhong; Solomon, Steven B

    2015-01-01

    The success of a small animal model to study critical illness is, in part, dependent on the ability of the model to simulate the human condition. Intra-tracheal inoculation of a known amount of bacteria has been successfully used to reproduce the pathogenesis of pneumonia which then develops into sepsis. Monitoring hemodynamic parameters and providing standard clinical treatment including infusion of antibiotics, fluids and drugs to maintain blood pressure is critical to simulate routine supportive care in this model but to do so requires both arterial and venous vascular access. The video details the surgical technique for implanting carotid artery and common jugular vein catheters in an anesthetized rat. Following a 72 hr recovery period, the animals will be re-anesthetized and connected to a tether and swivel setup attached to the rodent housing which connects the implanted catheters to the hemodynamic monitoring system. This setup allows free movement of the rat during the study while continuously monitoring pressures, infusing fluids and drugs (antibiotics, vasopressors) and performing blood sampling. PMID:25741606

  5. Catheterization of the Carotid Artery and Jugular Vein to Perform Hemodynamic Measures, Infusions and Blood Sampling in a Conscious Rat Model

    PubMed Central

    Feng, Jing; Fitz, Yvonne; Li, Yan; Fernandez, Melinda; Cortes Puch, Irene; Wang, Dong; Pazniokas, Stephanie; Bucher, Brandon; Cui, Xizhong; Solomon, Steven B.

    2015-01-01

    The success of a small animal model to study critical illness is, in part, dependent on the ability of the model to simulate the human condition. Intra-tracheal inoculation of a known amount of bacteria has been successfully used to reproduce the pathogenesis of pneumonia which then develops into sepsis. Monitoring hemodynamic parameters and providing standard clinical treatment including infusion of antibiotics, fluids and drugs to maintain blood pressure is critical to simulate routine supportive care in this model but to do so requires both arterial and venous vascular access. The video details the surgical technique for implanting carotid artery and common jugular vein catheters in an anesthetized rat. Following a 72 hr recovery period, the animals will be re-anesthetized and connected to a tether and swivel setup attached to the rodent housing which connects the implanted catheters to the hemodynamic monitoring system. This setup allows free movement of the rat during the study while continuously monitoring pressures, infusing fluids and drugs (antibiotics, vasopressors) and performing blood sampling. PMID:25741606

  6. Analyzing Crisis in Global Financial Indices

    NASA Astrophysics Data System (ADS)

    Kumar, Sunil; Deo, Nivedita

    We apply the Random Matrix Theory and complex network techniques to 20 global financial indices and study the correlation and network properties before and during the financial crisis of 2008 respectively. We find that the largest eigenvalue deviate significantly from the upper bound which shows a strong correlation between financial indices. By using a sliding window of 25 days we find that largest eigenvalue represent the collective information about the correlation between global financial indices and its trend indicate the market conditions. It is confirmed that eigenvectors corresponding to second largest eigenvalue gives useful information about the sector formation in the global financial indices. We find that these clusters are formed on the basis of the geographical location. The correlation network is constructed using threshold method for different values of threshold ? in the range 0 to 0.9, at ?=0.2 the network is fully connected. At ?=0.6, the Americas, Europe and Asia/Pacific form different clusters before the crisis but during the crisis Americas and Europe are strongly linked. If we further increase the threshold to 0.9 we find that European countries France, Germany and UK consistently constitute the most tightly linked markets before and during the crisis. We find that the structure of Minimum Spanning Tree before the crisis is more star like whereas during the crisis it changes to be more chain like. Using the multifractal analysis, we find that Hurst exponents of financial indices increases during the period of crisis as compared to the period before the crisis. The empirical results verify the validity of measures, and this has led to a better understanding of complex financial markets.

  7. Developing indicators for European birds

    PubMed Central

    Gregory, Richard D; van Strien, Arco; Vorisek, Petr; Gmelig Meyling, Adriaan W; Noble, David G; Foppen, Ruud P.B; Gibbons, David W

    2005-01-01

    The global pledge to deliver ‘a significant reduction in the current rate of biodiversity loss by 2010’ is echoed in a number of regional and national level targets. There is broad consensus, however, that in the absence of conservation action, biodiversity will continue to be lost at a rate unprecedented in the recent era. Remarkably, we lack a basic system to measure progress towards these targets and, in particular, we lack standard measures of biodiversity and procedures to construct and assess summary statistics. Here, we develop a simple classification of biodiversity indicators to assist their development and clarify purpose. We use European birds, as example taxa, to show how robust indicators can be constructed and how they can be interpreted. We have developed statistical methods to calculate supranational, multi-species indices using population data from national annual breeding bird surveys in Europe. Skilled volunteers using standardized field methods undertake data collection where methods and survey designs differ slightly across countries. Survey plots tend to be widely distributed at a national level, covering many bird species and habitats with reasonable representation. National species' indices are calculated using log-linear regression, which allows for plot turnover. Supranational species' indices are constructed by combining the national species' indices weighted by national population sizes of each species. Supranational, multi-species indicators are calculated by averaging the resulting indices. We show that common farmland birds in Europe have declined steeply over the last two decades, whereas woodland birds have not. Evidence elsewhere shows that the main driver of farmland bird declines is increased agricultural intensification. We argue that the farmland bird indicator is a useful surrogate for trends in other elements of biodiversity in this habitat. PMID:15814345

  8. Communication Indicators. I. Communication Indicators and Indicators of Socio-Economic Development. Communication and Society 3.

    ERIC Educational Resources Information Center

    O'Brien, Rita Cruise; And Others

    This report summarizes a Unesco-sponsored study of indicators of international communication and socioeconomic development. Following a brief description of the background, purpose, and methodology of the study, the report discusses its findings in the following areas: (1) communication and social indicators; (2) communications and the growth of…

  9. Refinement of microwave vegetation indices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Previous investigations have established the basis for a new type of vegetation index based on passive microwave satellite observations. These microwave vegetation indices (MVIs) have been qualitatively evaluated by examining global spatial and seasonal temporal features. Limited quantitative studie...

  10. Global Climate Change Key Indicators

    NSDL National Science Digital Library

    This website charts measurement of key indicators of global climate change. Simple explanations and "What Does This Mean?" sections accompany each area of sea level, carbon dioxide concentration, global surface temperature, Arctic sea ice and land ice.

  11. Community Health Status Indicators Project

    E-print Network

    conditions for health in order to eliminate health disparities #12;Challenges · Acquire resources to addCommunity Health Status Indicators Project National Center for Environmental Health Environmental Health Tracking Branch Marilyn Metzler National Center for Chronic Disease Prevention and Health

  12. EVALUATION GUIDELINES FOR ECOLOGICAL INDICATORS

    EPA Science Inventory

    This document presents fifteen technical guidelines to evaluate the suitability of an ecological indicator for a particular monitoring program. The guidelines are organized within four evaluation phrases: conceptual relevance, feasibility of implementation, response variability...

  13. Impact of chronic catheterization and automated blood sampling (Accusampler) on serum corticosterone and fecal immunoreactive corticosterone metabolites and immunoglobulin A in male rats.

    PubMed

    Royo, F; Björk, N; Carlsson, H-E; Mayo, S; Hau, J

    2004-01-01

    Jugular catheters were inserted in nine male rats under general isofluorane anesthesia and the catheters were connected to a commercially available computerized blood sampling device (Accusampler). Blood samples (150 microl) were collected every 4 h during the first 24 h after surgery and every 12 h during the following 72 h until 94 h after surgery, when the animals were killed. All fecal pellets were collected at blood sampling. Serum corticosterone and fecal concentrations of immunoreactive corticosterone metabolites and immunoglobulin A (IgA) were quantified by ELISAs. In blood, high corticosterone concentrations (>200 ng/ml) were recorded in the first samples obtained after surgery, but the concentrations decreased steadily during the day and became cyclical, showing a diurnal variation with high levels during evenings and low levels in the mornings. The automatic blood sampling itself did not result in recordable increases in serum corticosterone concentrations. The time delay between the presence of elevated corticosterone levels in blood and in feces was approximately 12 h. Fecal immunoreactive corticosterone metabolite levels remained elevated during the 94 h study period after surgery. The fecal concentrations of IgA showed substantial between-animal variation and decreased non-significantly after the surgery. Like serum corticosterone, fecal IgA showed a diurnal variation in amounts excreted, in this case with high values in the morning and low values in the evening. The concentrations of fecal corticosterone and IgA were negatively correlated in samples obtained before surgery but no correlation existed after surgery. This indicates that fecal immunoreactive corticosterone metabolites, but not IgA, constitute a good marker of acute stress. For immunoreactive corticosterone metabolites as well as for IgA, the concentration in feces correlated well with total excretion, making single fecal samplings usable as a measure of total secretion. PMID:14709153

  14. Environmental indices in irrigation management.

    PubMed

    Manoliadis, O G

    2001-10-01

    Irrigation management calls for objective criteria capable of representing the economy, reliability, and productivity of irrigation systems. These criteria must be compatible with long-term sustainability and conservation goals. The criteria representing the above goals are the economic effect of management on yield reduction, economic effect, and reliability referring to plant growth and operation of the network. In this study environmental indices are introduced to express the above criteria in quantitative terms. The inclusion of these indices at the farm and network level create a multicriteria framework for decision-making based on composite programming. An experimental study was conducted during the irrigation periods of 1989 and 1990 in Chania, Greece, concerning water delivered to 40 experimental plots, soil moisture content at the rootzone, and irrigation system operational failures. The data collected in real time were used for the calculation of the corresponding environmental indices. The variation in time and space is high and resulted in up to 62% of yield loss and low system performance (up to 7% of system temporal reliability). The study indicated that environmental indices could be incorporated to select alternatives and also to develop policies on water delivery. The final decision involves a trade-off analysis between cost of application and desired system performance. Measures of both primary objectives can be obtained using environmental indices that represent system operation aggregation at its basic levels (on farm and network). PMID:11494068

  15. Transurethral plasmakinetic resection of the prostate is a reliable minimal invasive technique for benign prostate hyperplasia: a meta-analysis of randomized controlled trials

    PubMed Central

    Wang, Kai; Li, Yao; Teng, Jing-Fei; Zhou, Hai-Yong; Xu, Dan-Feng; Fan, Yi

    2015-01-01

    To evaluate the efficacy and safety of plasmakinetic resection of the prostate (PKRP) versus transurethral resection of the prostate (TURP) for the treatment of patients with benign prostate hyperplasia (BPH), a meta-analysis of randomized controlled trials was carried out. We searched PubMed, Embase, Web of Science and the Cochrane Library. The pooled estimates of maximum flow rate, International Prostate Symptom Score, operation time, catheterization time, irrigated volume, hospital stay, transurethral resection syndrome, transfusion, clot retention, urinary retention and urinary stricture were assessed. There was no notable difference in International Prostate Symptom Score between TURP and PKRP groups during the 1-month, 3 months, 6 months and 12 months follow-up period, while the pooled Qmax at 1-month favored PKRP group. PKRP group was related to a lower risk rate of transurethral resection syndrome, transfusion and clot retention, and the catheterization time and operation time were also shorter than that of TURP. The irrigated volume, length of hospital stay, urinary retention and urinary stricture rate were similar between groups. In conclusion, our study suggests that the PKRP is a reliable minimal invasive technique and may anticipatorily prove to be an alternative electrosurgical procedure for the treatment of BPH. PMID:25337839

  16. Novel tamper-indicating protective devices

    SciTech Connect

    DeVolpi, A.

    1995-07-01

    Several novel tamper-indicating devices, originally developed under DOE auspices for arms control applications, might be useful in nonproliferation. Some devices that have reached the laboratory prototype stage could provide specialized alternatives to established seals. As locks and cables, the following might be useful: (1) a brittle ceramic lock--impervious to toxic, radiation, and thermal extremes--interrogated for identification and continuity by ultrasonic means, (2) a flexible ceramic-fiber seal that also tolerates severe environments, (3) an ultrasonic smart-material strip seal, and (4) an RF-resonant coaxial cable, verified by radio frequency and microwave signals. To validate the identity of secured surfaces, joints, welds, and fasteners--two techniques are applicable: (1) the scanning electron microscope, which examines three- dimensional micron-level topography, and (2) the plastic-casting fingerprint, a simple low-cost technique, analogous to human fingerprinting. The techniques mentioned above have one or more of the potential advantages of low cost, immediate availability, security for large-area enclosures, application to hazardous environments, usability in the FSU, or suitability for covert use.

  17. Scaling drug indication curation through crowdsourcing

    PubMed Central

    Khare, Ritu; Burger, John D.; Aberdeen, John S.; Tresner-Kirsch, David W.; Corrales, Theodore J.; Hirchman, Lynette; Lu, Zhiyong

    2015-01-01

    Motivated by the high cost of human curation of biological databases, there is an increasing interest in using computational approaches to assist human curators and accelerate the manual curation process. Towards the goal of cataloging drug indications from FDA drug labels, we recently developed LabeledIn, a human-curated drug indication resource for 250 clinical drugs. Its development required over 40?h of human effort across 20 weeks, despite using well-defined annotation guidelines. In this study, we aim to investigate the feasibility of scaling drug indication annotation through a crowdsourcing technique where an unknown network of workers can be recruited through the technical environment of Amazon Mechanical Turk (MTurk). To translate the expert-curation task of cataloging indications into human intelligence tasks (HITs) suitable for the average workers on MTurk, we first simplify the complex task such that each HIT only involves a worker making a binary judgment of whether a highlighted disease, in context of a given drug label, is an indication. In addition, this study is novel in the crowdsourcing interface design where the annotation guidelines are encoded into user options. For evaluation, we assess the ability of our proposed method to achieve high-quality annotations in a time-efficient and cost-effective manner. We posted over 3000 HITs drawn from 706 drug labels on MTurk. Within 8?h of posting, we collected 18 775 judgments from 74 workers, and achieved an aggregated accuracy of 96% on 450 control HITs (where gold-standard answers are known), at a cost of $1.75 per drug label. On the basis of these results, we conclude that our crowdsourcing approach not only results in significant cost and time saving, but also leads to accuracy comparable to that of domain experts. Database URL: ftp://ftp.ncbi.nlm.nih.gov/pub/lu/LabeledIn/Crowdsourcing/. PMID:25797061

  18. prognostic indicators of aggressive PCa.

    E-print Network

    Jiang, Wen

    techniques for the radiolabeling of small biomolecules, (3) evaluation of cationic metal complexes and metastatic tumors. Liu's group has clearly demonstrated that multimerization of cyclic RGD peptides enhances) select the patients who will benefit most from a specific therapeutic regiment, and (4) optimize the dose

  19. Leading indicators of trophic cascades.

    PubMed

    Carpenter, S R; Brock, W A; Cole, J J; Kitchell, J F; Pace, M L

    2008-02-01

    Regime shifts are large, long-lasting changes in ecosystems. They are often hard to predict but may have leading indicators which are detectable in advance. Potential leading indicators include wider swings in dynamics of key ecosystem variables, slower return rates after perturbation and shift of variance towards lower frequencies. We evaluated these indicators using a food web model calibrated to long-term whole-lake experiments. We investigated whether impending regime shifts driven by gradual increase in exploitation of the top predator can create signals that cascade through food webs and be discerned in phytoplankton. Substantial changes in standard deviations, return rates and spectra occurred near the switch point, even two trophic levels removed from the regime shift in fishes. Signals of regime shift can be detected well in advance, if the driver of the regime shift changes much more slowly than the dynamics of key ecosystem variables which can be sampled frequently enough to measure the indicators. However, the regime shift may occur long after the driver has passed the critical point, because of very slow transient dynamics near the critical point. Thus, the ecosystem can be poised for regime shift by the time the signal is discernible. Field tests are needed to evaluate these indicators. PMID:18021242

  20. Autographic Indicator for Tension Tests

    E-print Network

    Hood, George J.

    1902-01-01

    by Adolf Martens, two volumes* In the second class, the indicators, being fastened securely to the test piece9 show more accurate res Its. One of the best of this type is the Henning Pocket Indicator, described in A*S*M*E* Records Vol* XX, Page... into the threads of lead screw L* When one pen has traveled across the drum the next pen is fed into the lead screw by the feeders P^and sliding rod J . The lead serew L has 80 threads per inch and hence must make one revolution per 250 pounds increase...

  1. Image compression technique

    DOEpatents

    Fu, C.Y.; Petrich, L.I.

    1997-03-25

    An image is compressed by identifying edge pixels of the image; creating a filled edge array of pixels each of the pixels in the filled edge array which corresponds to an edge pixel having a value equal to the value of a pixel of the image array selected in response to the edge pixel, and each of the pixels in the filled edge array which does not correspond to an edge pixel having a value which is a weighted average of the values of surrounding pixels in the filled edge array which do correspond to edge pixels; and subtracting the filled edge array from the image array to create a difference array. The edge file and the difference array are then separately compressed and transmitted or stored. The original image is later reconstructed by creating a preliminary array in response to the received edge file, and adding the preliminary array to the received difference array. Filling is accomplished by solving Laplace`s equation using a multi-grid technique. Contour and difference file coding techniques also are described. The techniques can be used in a method for processing a plurality of images by selecting a respective compression approach for each image, compressing each of the images according to the compression approach selected, and transmitting each of the images as compressed, in correspondence with an indication of the approach selected for the image. 16 figs.

  2. Aircraft Control-Position Indicator

    NASA Technical Reports Server (NTRS)

    Dennis, D. V.

    1985-01-01

    Aircraft control-position indicator cockpit-mounted instrument that displays positions of elevator and ailerons to pilot. Display is cruciform array of lights: horizontal row of amber lights and vertical row of green lights representing aileron and elevator positions, respectively. Display used extensively in spin testing and has been trouble-free, with no maintenance required after about 30 hours of operation.

  3. Gain function and hydrocarbon indicators

    Microsoft Academic Search

    De-hua Han; Michael Batzle

    1999-01-01

    Summary We have derived the gain function for porous rock based on the Gassmann's equation. We study property of the gain function for consolidated sandstone and poor consolidated sands from deep-water, Gulf of Mexico. We apply the gain function to derive pore fluid modulus as a hydrocarbon indicator from log data.

  4. Geochemical indicators of intrinsic bioremediation

    Microsoft Academic Search

    Robert C. Borden; Carlos A. Gomez; Mark T. Becker

    1995-01-01

    A detailed field investigation has been completed at a gasoline-contaminated aquifer near Rocky Point, NC, to examine possible indicators of intrinsic bioremediation and identify factors that may significantly influence the rae and extent of bioremediation. The dissolved plume of benzene, toluene, ethylbenzene, and xylene (BTEX) in ground water is naturally degrading. Toluene and o-xylene are most rapidly degraded followed by

  5. Quality Indicators of Online Programs

    ERIC Educational Resources Information Center

    Hirner, Leo; Kochtanek, Thomas

    2012-01-01

    The continued growth of online programs in higher education has resulted in concerns about how institutions monitor the quality of their online programs. These concerns indicate a need for a process by which online programs may be evaluated and compared. They provided the impetus for this study, the goals of which were to identify quality…

  6. International Comparisons of Unemployment Indicators.

    ERIC Educational Resources Information Center

    Sorrentino, Constance

    1993-01-01

    Comparison of seven indicators (long-term unemployment, job losers, adult unemployment, full-time unemployment, conventional unemployment, part-time work for economic reasons, and discouraged workers) in North America, Europe, and Japan show that Sweden and Japan have the largest unemployment increase. Long-term joblessness prevailed in Europe;…

  7. Graph Theoretical Indicators and Refactoring

    Microsoft Academic Search

    J. Adrian Zimmer

    2003-01-01

    \\u000a Metrics of software quality grow stale after a while and there is always a need for new ones. Graph theory can be a fruitful\\u000a source. We discuss how. Before that we discuss what metrics do and we suggest the word “indicator” better describes that function\\u000a than the word “metric”.

  8. Brazing Alloys Indicate Turbomachinery Temperatures

    NASA Technical Reports Server (NTRS)

    Schlaff, J. W.

    1985-01-01

    Foils serve as consumable thermometers. Stainless-steel tab with circular window holds brazing-foil sample in place. Tab tacked to object to be tested with capacitive-discharge spot welder operating in range 10 + 1 joules. After measurements, tabs and samples chiseled off, leaving tested object fairly well intact. Technique used on objects made of alloys with iron, nickel, or cobalt as principal ingredients.

  9. Development of an indicator to monitor mediterranean wetlands.

    PubMed

    Sanchez, Antonio; Abdul Malak, Dania; Guelmami, Anis; Perennou, Christian

    2015-01-01

    Wetlands are sensitive ecosystems that are increasingly subjected to threats from anthropogenic factors. In the last decades, coastal Mediterranean wetlands have been suffering considerable pressures from land use change, intensification of urban growth, increasing tourism infrastructure and intensification of agricultural practices. Remote sensing (RS) and Geographic Information Systems (GIS) techniques are efficient tools that can support monitoring Mediterranean coastal wetlands on large scales and over long periods of time. The study aims at developing a wetland indicator to support monitoring Mediterranean coastal wetlands using these techniques. The indicator makes use of multi-temporal Landsat images, land use reference layers, a 50m numerical model of the territory (NMT) and Corine Land Cover (CLC) for the identification and mapping of wetlands. The approach combines supervised image classification techniques making use of vegetation indices and decision tree analysis to identify the surface covered by wetlands at a given date. A validation process is put in place to compare outcomes with existing local wetland inventories to check the results reliability. The indicator´s results demonstrate an improvement in the level of precision of change detection methods achieved by traditional tools providing reliability up to 95% in main wetland areas. The results confirm that the use of RS techniques improves the precision of wetland detection compared to the use of CLC for wetland monitoring and stress the strong relation between the level of wetland detection and the nature of the wetland areas and the monitoring scale considered. PMID:25826210

  10. Chapter A7. Biological Indicators

    USGS Publications Warehouse

    Myers, Donna N.; Wilde, Franceska D.

    2003-01-01

    The National Field Manual for the Collection of Water-Quality Data (National Field Manual) provides guidelines and standard procedures for U.S. Geological Survey (USGS) personnel who collect data used to assess the quality of the Nation's surface-water and ground-water resources. This chapter of the manual includes procedures for the (1) determination of biochemical oxygen demand using a 5-day bioassay test; (2) collection, identification, and enumeration of fecal indicator bacteria; (3) collection of samples and information on two laboratory methods for fecal indicator viruses (coliphages); and (4) collection of samples for protozoan pathogens. Each chapter of the National Field Manual is published separately and revised periodically. Newly published and revised chapters are posted on the World Wide Web on the USGS page 'National Field Manual for the Collection of Water-Quality Data.' The URL for this page is http://pubs.water.usgs.gov/twri9A/ (accessed November 25, 2003).

  11. Microbial indicators of soil quality

    SciTech Connect

    Turco, R.F.; Kennedy, A.C.; Jawson, M.

    1992-01-01

    Soil quality is an elusive term; however, the quality of a soil can greatly impact land use, sustainability, and productivity. Soil microbial processes are an integral part of soil quality and a better understanding of these processes and microbial community structure is needed. Microbial biomass, respiration, and labile nutrient pool size have generally been used as intrinsic parameters of a soil's microbial status. These analyses may not fully identify inherent differences in soil quality, especially if environmental conditions or manmade pertubations alter microbial community structure. Assessment of microbial community structure is necessary to determine the long-term effects of stress on soil quality. Measurement of microbial diversity should include nucleic acid and fatty acid phospholipid profiles as well as substrate utilization patterns. Microbial indicators will allow us to characterize the ecological status of the soil microbial community. For soil quality indicators to be successful, integration with other soil parameters is essential.

  12. Stress Indicators Quiz Never Always

    E-print Network

    Wang, Hai

    Stress Indicators Quiz Never Always 0 1 2 3 4 5 How Often 1. Do you get sick? 2. Do you get burnout! Commit to making a big change! SSS T R E S ST R E S ST R E S S STRESS © University of Southern or tired · Be able to focus only on the stressful situation (i.e. work or family) · Feel irritable

  13. Thermodynamic indicators for environmental certification.

    PubMed

    Panzieri, Margherita; Porcelli, Marcello; Pulselli, Federico Maria

    2002-09-01

    The Earth is an open thermodynamic system, that remains in a steady state far from the equilibrium, through energy and matter exchanges with the surrounding environment. These natural constraints, which prevent the system from maximizing its entropy, are threatened by human action and our ecosystem needs urgent protection. In this viewpoint the environmental certification was born, according to international standards ISO 14001, ISO 14040, and European Regulation EMAS. These are voluntary adhesions to a program of environmental protection by companies, administrations and organizations which, starting from the respect of the existing environmental laws and regulations, decide to further improve their environmental performance. To obtain and maintain certification of a system is necessary to apply some indicators to evaluate its environmental performance and to demonstrate its progressive improvement. Here we propose to use for this purpose the thermodynamic indicators produced from energy analysis by Odum. The case study is Montalcino city (Italy) and energy indicators are used to evaluate environmental performance of this system where exist different activities, from agricultural productions, to tourism. Results show that energy analysis could become a valid standard monitoring method for environmental certification, especially in consideration of its wide application field. PMID:12407910

  14. Segregation indices for disease clustering.

    PubMed

    Ceyhan, Elvan

    2014-05-10

    Spatial clustering has important implications in various fields. In particular, disease clustering is of major public concern in epidemiology. In this article, we propose the use of two distance-based segregation indices to test the significance of disease clustering among subjects whose locations are from a homogeneous or an inhomogeneous population. We derive the asymptotic distributions of the segregation indices and compare them with other distance-based disease clustering tests in terms of empirical size and power by extensive Monte Carlo simulations. The null pattern we consider is the random labeling (RL) of cases and controls to the given locations. Along this line, we investigate the sensitivity of the size of these tests to the underlying background pattern (e.g., clustered or homogenous) on which the RL is applied, the level of clustering and number of clusters, or to differences in relative abundances of the classes. We demonstrate that differences in relative abundances have the highest influence on the empirical sizes of the tests. We also propose various non-RL patterns as alternatives to the RL pattern and assess the empirical power performances of the tests under these alternatives. We observe that the empirical size of one of the indices is more robust to the differences in relative abundances, and this index performs comparable with the best performers in literature in terms of power. We illustrate the methods on two real-life examples from epidemiology. PMID:24307306

  15. DOE performance indicators guidance document

    SciTech Connect

    Not Available

    1992-12-01

    SEN-29-91 directed that a Department-wide uniform process for trending and analysis of operational data be established for DOE facilities. This Performance Indicator (PI) Program establishes a uniform system for trending and analyzing operational data providing an important tool to help assess and support progress in improving performance and strengthening both DOE and contractor line management control of operations. DOE, similar to the commercial nuclear industry, considers that facilities with good performance, as measured by an overall set of performance indicators, are well-managed facilities. The Performance Indicator Program established by SEN-29-91 is but one of several initiatives undertaken by DOE to instill a new DOE and DOE contractor line management culture committed to achieving a rising standard of acceptable performance. Line management trending and analysis of data depicting the performance of their facilities is an essential element in creating this culture of ``continuous improvement,`` where performance gains achieved are maintained and early identification of deteriorating environmental, safety, and health conditions is accomplished.

  16. Disposition of feedwater nozzle UT indications in a BWR

    SciTech Connect

    Leshnoff, S.D.; Orski, M.A.

    1989-01-01

    A technical logic is developed, which justifies the disposition of feedwater nozzle ultrasonic testing (UT) indications in order to return to operation without visual inspection of the vessel inside surface. Present regulatory guidance is to inspect the inside surface from the inside if a reportable indication is found. A highly sensitive, tomographic UT technique, developed by Kraftwerk Union, is used to detect and size machined notches in the blend radius and bore regions of a full-sized feedwater nozzle mock-up.

  17. Metacarpophalangeal joint arthroscopy: indications revisited.

    PubMed

    Choi, Alexander K Y; Chow, Esther C S; Ho, P C; Chow, Y Y

    2011-08-01

    Arthroscopic surgery has become the gold standard for the diagnosis and treatment of major joint disorders. With advancement in arthroscopic technique, arthroscopy has become feasible in most human joints, even those as small as the finger joints. The metacarpophalangeal joint (MCPJ) can become spacious with simple traction, the intra-articular anatomy is simple, and its major structures can be easily visualized and identified. However, MCPJ arthroscopy has never been popular. This article describes our experience with MCPJ arthroscopy and seeks to establish its role in clinical practice. PMID:21871361

  18. Thyrocervical trunk pseudoaneurysm following central venous catheterization.

    PubMed

    Mazzei, Valerio; Benvenuto, Domenico; Gagliardi, Massimo; Guarracini, Stefano; Di Mauro, Michele

    2011-11-01

    A 71-year-old female developed a painless neck mass three months following an aortic valve replacement, mitral commissurotomy, and coronary artery bypass. A cervical trunk angio revealed a pseudoaneurysm supplied from a branch of the thyrocervical trunk, which was successfully excised. PMID:21929740

  19. Construction and demolition waste indicators.

    PubMed

    Mália, Miguel; de Brito, Jorge; Pinheiro, Manuel Duarte; Bravo, Miguel

    2013-03-01

    The construction industry is one of the biggest and most active sectors of the European Union (EU), consuming more raw materials and energy than any other economic activity. Furthermore, construction waste is the commonest waste produced in the EU. Current EU legislation sets out to implement construction and demolition waste (CDW) prevention and recycling measures. However it lacks tools to accelerate the development of a sector as bound by tradition as the building industry. The main objective of the present study was to determine indicators to estimate the amount of CDW generated on site both globally and by waste stream. CDW generation was estimated for six specific sectors: new residential construction, new non-residential construction, residential demolition, non-residential demolition, residential refurbishment, and non-residential refurbishment. The data needed to develop the indicators was collected through an exhaustive survey of previous international studies. The indicators determined suggest that the average composition of waste generated on site is mostly concrete and ceramic materials. Specifically for new residential and new non-residential construction the production of concrete waste in buildings with a reinforced concrete structure lies between 17.8 and 32.9 kg m(-2) and between 18.3 and 40.1 kg m(-2), respectively. For the residential and non-residential demolition sectors the production of this waste stream in buildings with a reinforced concrete structure varies from 492 to 840 kg m(-2) and from 401 to 768 kg/m(-2), respectively. For the residential and non-residential refurbishment sectors the production of concrete waste in buildings lies between 18.9 and 45.9 kg/m(-2) and between 18.9 and 191.2 kg/m(-2), respectively. PMID:23315370

  20. Space Weathering: An Ultraviolet Indicator

    NASA Technical Reports Server (NTRS)

    Hendrix, A. R.; Vilas, F.

    2004-01-01

    We present evidence suggesting that the spectral slope of airless bodies in the UV-visible wavelength range can be used as an indicator of exposure to space weathering. While space weathering generally produces a reddening of spectra in the visible-NIR spectral regions, it tends to result in a bluing of the UV-visible portion of the spectrum, and may in some cases produce a spectral reversal. The bluing effect may be detectable with smaller amounts of weathering than are necessary to detect the longer-wavelength weathering effects.

  1. Space Weathering: An Ultraviolet Indicator

    NASA Technical Reports Server (NTRS)

    Hendrix, A. R.; Vilas, F.

    2003-01-01

    We present evidence suggesting that the spectral slope of airless bodies in the UV-visible wavelength range can be used as an indicator of exposure to space weathering. While space weathering generally produces a reddening of spectra in the visible-NIR spectral regions, it tends to result in a bluing of the UV-visible portion of the spectrum, and may in some cases produce a spectral reversal. The bluing effect may be detectable with smaller amounts of weathering than are necessary to detect the longer-wavelength weathering effects.

  2. Optical indices of lithiated electrochromic oxides

    SciTech Connect

    Rubin, M.; Rottkay, K. von; Wen, S.J.; Ozer, N.; Slack, J.

    1996-09-01

    Optical indices have been determined for thin films of several electrochromic oxide materials. One of the most important materials in electrochromic devices, WO{sub 3}, was thoroughly characterized for a range of electrochromic states by sequential injection of Li ions. Another promising material, Li{sub 0.5}Ni{sub 0.5}O, was also studied in detail. Less detailed results are presented for three other common lithium-intercalating electrochromic electrode materials: V{sub 2}O{sub 5}, LiCoO{sub 2}, and CeO{sub 2}-TiO{sub 2}. The films were grown by sputtering, pulsed laser deposition (PLD) and sol-gel techniques. Measurements were made using a combination of variable-angle spectroscopy ellipsometry and spectroradiometry. The optical constants were then extracted using physical and spectral models appropriate to each material. Optical indices of the underlying transparent conductors, determined in separate studies, were fixed in the models of this work. The optical models frequently agree well with independent physical measurements of film structure, particularly surface roughness by atomic force microscopy. Inhomogeneity due to surface roughness, gradient composition, and phase separation are common in both the transparent conductors and electrochromics, resulting sometimes in particularly complex models for these materials. Complete sets of data are presented over the entire solar spectrum for a range of colored states. This data is suitable for prediction of additional optical properties such as oblique transmittance and design of complete electrochromic devices.

  3. Low latency counter event indication

    DOEpatents

    Gara, Alan G. (Mount Kisco, NY); Salapura, Valentina (Chappaqua, NY)

    2010-08-24

    A hybrid counter array device for counting events with interrupt indication includes a first counter portion comprising N counter devices, each for counting signals representing event occurrences and providing a first count value representing lower order bits. An overflow bit device associated with each respective counter device is additionally set in response to an overflow condition. The hybrid counter array includes a second counter portion comprising a memory array device having N addressable memory locations in correspondence with the N counter devices, each addressable memory location for storing a second count value representing higher order bits. An operatively coupled control device monitors each associated overflow bit device and initiates incrementing a second count value stored at a corresponding memory location in response to a respective overflow bit being set. The incremented second count value is compared to an interrupt threshold value stored in a threshold register, and, when the second counter value is equal to the interrupt threshold value, a corresponding "interrupt arm" bit is set to enable a fast interrupt indication. On a subsequent roll-over of the lower bits of that counter, the interrupt will be fired.

  4. Some Teaching Techniques for High School Economics

    ERIC Educational Resources Information Center

    Morton, John S.; Rezny, Ronald R.

    1971-01-01

    Use of a variety of student groupings and teaching techniques in a course designed by the authors has led to high student interest and accomplishment, as indicated by attitudinal and subject-matter tests. (IM)

  5. Evaluating canopy temperature-based indices for irrigation scheduling

    Microsoft Academic Search

    Claudio O. Stockle; William A. Dugas

    1992-01-01

    Since the development of commercial versions of infrared sensors, they have been increasingly used to determine canopy temperature and schedule irrigations. However, some shortcomings of the technique have been identified, among them the sensitivity of canopy temperature measurements to weather fluctuations. Based on field and computer simulated data, an analysis of the suitability of crop water stress indices (CWSI's) developed

  6. The accuracy of real estate indices: Repeat sale estimators

    Microsoft Academic Search

    William Nelson Goetzmann

    1992-01-01

    Simulation techniques allow us to examine the behavior and accuracy of several repeat sales regression estimators used to construct real estate return indices. We show that the generalized least squares (GLS) method is the maximum likelihood estimator, and we show how estimation accuracy can be significantly improved through a Baysian approach. In addition, we introduce a biased estimation procedure based

  7. Construct Validity of the Myers-Briggs Type Indicator

    Microsoft Academic Search

    Bruce Thompson; Gloria M. Borrello

    1986-01-01

    The Myers-Briggs Type Indicator (MBTI) is widely recognized as an important measure of normal or non-pathological variations in personality. However, the construct validity of the measure has not been clearly established using factor analytic techniques. The present study investigated the structure and item performance of the instrument using data from 359 college students. Factor analysis was applied to the 95

  8. Research Performance Evaluation: Some Critical Thoughts on Standard Bibliometric Indicators

    ERIC Educational Resources Information Center

    Anninos, Loukas N.

    2014-01-01

    The bibliometric methodology is an established technique for research evaluation as it offers an objective determination and comparison of research performance. This paper aims to critically assess some standard bibliometric indicators commonly used (based on publication and citation counts) to evaluate academic units, and examine whether there…

  9. Efficacy of Intra-Arterial Infusion Chemotherapy for Head and Neck Cancers Using Coaxial Catheter Technique: Initial Experience

    SciTech Connect

    Tsurumaru, Daisuke, E-mail: tsuru-d@radiol.med.kyushu-u.ac.jp; Kuroiwa, Toshiro; Yabuuchi, Hidetake; Hirata, Hideki [National Kyushu Cancer Center, Department of Radiology (Japan); Higaki, Yuichiro; Tomita, Kichinobu [National Kyushu Cancer Center, Department of Head and Neck Surgery (Japan)

    2007-04-15

    The aim of this study was to evaluate the efficacy of intra-arterial infusion chemotherapy for head and neck cancers using a coaxial catheter technique: the superficial temporal artery (STA)-coaxial catheter method. Thirty-one patients (21 males and 10 females; 37-83 years of age) with squamous cell carcinoma of the head and neck (maxilla, 2; epipharynx, 4; mesopharynx, 8; oral floor, 4; tongue, 10; lower gingiva, 1; buccal mucosa, 2) were treated by intra-arterial infusion chemotherapy. Four patients were excluded from the tumor-response evaluation because of a previous operation or impossibility of treatment due to catheter trouble. Forty-eight sessions of catheterization were performed. A guiding catheter was inserted into the STA and a microcatheter was advanced into the tumor-feeding artery via the guiding catheter under angiographic guidance. When the location of the tumor or its feeding artery was uncertain on angiography, computed tomographic angiography was performed. The anticancer agent carboplatin (CBDCA) was continuously injected for 24 h through the microcatheter from a portable infusion pump attached to the patient's waist. The total administration dose was 300-1300 mg per body. External radiotherapy was administered during intra-arterial chemotherapy at a total dose of 21-70.5 Gy.The initial response was complete response in 15 patients, partial response in 7 patients, and no change in 5 patients; the overall response rate was 81.5% (22/27). Complication-related catheter maintenance was observed in 15 of 48 sessions of catheterization. Injury and dislocation of the microcatheter occurred 10 times in 7 patients. Catheter infection was observed three times in each of two patients, and catheter occlusion and vasculitis occurred in two patients. Intra-arterial infusion chemotherapy via the STA-coaxial catheter method could have potential as a favorable treatment for head and neck tumors.

  10. Internet Economy Indicators: January 2001 Internet Economy Indicators

    NSDL National Science Digital Library

    2001-01-01

    Internet Economy Indicators published in January the third of its biannual reports on the state of the Internet economy (for information on the June 2000 report, see the September 7, 2000 Scout Report for Business & Economics). The latest report finds that "the addition of 612,375 jobs in the Internet Economy in the first six months of 2000 was nearly as much as all of 1999 (when 650,000 jobs were added)." These data apparently belie more dire recent predictions concerning the state of the Internet economy. The report offers data and analysis of employment, revenues, types of jobs, comparison of Internet employment growth to the rest of the economy, comparison of Internet employment growth to revenue growth, and more. Funded by Cisco systems, the report was conducted by the University of Texas. Questions about the influence of corporate sponsors aside, the information here serves as a counterbalance to concerns about dot.com crashes (the report points out that dot.coms make up less than ten percent of the Internet's economy). The full report is offered in .pdf format with an executive summary, key findings, an overview, and selected data also posted on-site in HTML. The site also features an extensive report entitled Dot Coms and Productivity in the Internet Economy as well as an archive of previous biannual reports.

  11. Country Indicators for Foreign Policy

    NSDL National Science Digital Library

    Created and maintained by the Department of Foreign Affairs and International Trade and Norman Paterson School of International Affairs, Country Indicators for Foreign Policy (CIFP) "represents an on-going effort to identify and assemble statistical information conveying the key features of the economic, political, social and cultural environments of countries around the world." Started in 1997, this flexible database project is intended to serve the needs of NGOs, government departments, and the private sector, and can potentially be used to aid in strategic decision-making, for risk analysis, and to monitor countries for possible "peacebuilding intervention." The database may be searched by region, regional and global organization, or by issue area. New users will want to visit the Users Guide, which offers detailed instructions for searching the database. Registration by email is required, and a user name and password will be emailed within two days.

  12. [Ketamine: psychiatric indications and misuses].

    PubMed

    Delimbeuf, N; Petit, A; Karila, L; Lejoyeux, M

    2014-01-01

    Ketamine or -ketamine hydrochloride- is used as an anesthesic and a painkiller. It may also, in some indications, be prescribed in psychiatry and addictology. A literature review was conducted from 2003 to 2013, in PubMed, Google Scholar, Embase, and Psyclnfo, using the following key words (alone or combined): "ketamine", "abuse", "addiction", "dependence" and "misuse". Various studies have shown the benefit of kétamine in some psychiatric conditions such as major depressive episodes and electroconvulsive therapy. Others have demonstrated beneficial effects in alcohol or opiate abstinence maintenance. Ketamine seems to be a promising molecule in psychiatry and in the treatment of addictions, despite the absence of marketing approval for those specific uses. Being a strong psycho-stimulant, ketamine can be the source of abuse and dependence with somatic, psychiatric and cognitive complications. PMID:25158385

  13. [Indications for neuroleptics in children].

    PubMed

    Mouren-Siméoni, M C; Bouvard, M P

    1990-01-01

    The purpose of this article is to summarize those main indications where neuroleptics have been proven efficient in children. In some types of pathology (hyperactivity, conduct disorders, mental retardation with agressiveness...), their impact is purely symptomatic, generally sedative. In other cases (Tourette's syndrome, stuttering) they seem to have a more specific effect. Whichever may be the case, neuroleptics seem to be irremplaceable, whenever the symptoms become incapacitating such as when they hinder the person's social functioning and learning abilities. On a practical level, one has to avoid "poorly justified" prescriptions, including low-dose prescriptions. In children and adolescents, therapy cannot be considered for one angle only: the administration of neuroleptics has to be integrated into a general treatment plan which involves other therapeutic approaches which are not mutually exclusive. PMID:1693559

  14. Bootstrap lower confidence limits for the process capability indices Cp, Cpk and Cpm

    Microsoft Academic Search

    S. Balamurali; M. Kalyanasundaram

    2002-01-01

    The capability indices are widely used by quality professionals as an estimate of process capability. Many process indices have been proposed and developed with Cp, Cpk and Cpm among the most widely used. More recently, techniques have been developed to construct lower 95 percent confidence limits for each index. These techniques are based on the assumption that the underlying process

  15. Range indices of geomagnetic activity

    USGS Publications Warehouse

    Stuart, W.F.; Green, A.W., Jr.

    1988-01-01

    The simplest index of geomagnetic activity is the range in nT from maximum to minimum value of the field in a given time interval. The hourly range R was recommended by IAGA for use at observatories at latitudes greater than 65??, but was superceded by AE. The most used geomagnetic index K is based on the range of activity in a 3 h interval corrected for the regular daily variation. In order to take advantage of real time data processing, now available at many observatories, it is proposed to introduce a 1 h range index and also a 3 h range index. Both will be computed hourly, i.e. each will have a series of 24 per day, the 3 h values overlapping. The new data will be available as the range (R) of activity in nT and also as a logarithmic index (I) of the range. The exponent relating index to range in nT is based closely on the scale used for computing K values. The new ranges and range indices are available, from June 1987, to users in real time and can be accessed by telephone connection or computer network. Their first year of production is regarded as a trial period during which their value to the scientific and commercial communities will be assessed, together with their potential as indicators of regional and global disturbances' and in which trials will be conducted into ways of eliminating excessive bias at quiet times due to the rate of change of the daily variation field. ?? 1988.

  16. Psychometric Evaluation of Lexical Diversity Indices: Assessing Length Effects

    PubMed Central

    Fergadiotis, Gerasimos; Wright, Heather Harris; Green, Samuel B.

    2015-01-01

    Purpose Several novel techniques have been developed recently to assess the breadth of speaker’s vocabulary exhibited in a language sample. The specific aim of this study was to increase our understanding of the validity of the scores generated by different lexical diversity (LD) estimation techniques. Four techniques were explored: D, Maas, Measure of Textual Lexical Diversity (MTLD), and the Moving Average Type Token Ratio (MATTR). Method Four LD indices were estimated for language samples on four discourse tasks (procedures, eventcasts, story retell, and recounts) from 442 neurologically intact adults. The resulting data were analyzed using structural equation modeling. Results The scores on the MATTR and MTLD estimation techniques were stronger indicators of the LD of the language samples. The results for the other two techniques were consistent with the presence of method factors representing construct-irrelevant sources. Conclusions These findings offer a deeper understanding of the relative validity of the four estimation techniques and should assist clinicians and researchers in the selection of LD measures of language samples that minimize construct-irrelevant sources. PMID:25766139

  17. [Laparoscopic partial nephrectomy: technique and outcomes].

    PubMed

    Colombo, J R; Gill, I S

    2006-05-01

    The indication of laparoscopic partial nephrectomy (LPN) has evolved considerably, and the technique is approaching established status at our institution. Over the past 5 years, the senior author has performed more than 450 laparoscopic partial nephrectomies at the Cleveland Clinic. Herein we present our current technique, review contemporary data and oncological outcomes of LPN. PMID:16884101

  18. A Technique for Assessing Postural Discomfort

    Microsoft Academic Search

    E. N. CORLETT; R. P. BISHOP

    1976-01-01

    A technique is described which enables the distribution of discomfort in the body, and its change during the work poriod, to he recorded. The recorded data indicate points of inadequate man-machine compatibility as well as permitting the evaluation of the effectiveness of machine designs. When used in conjunction with moasures of production performance the technique provides direct evidence of the

  19. Tamper-indicating barcode and method

    DOEpatents

    Cummings, Eric B.; Even, Jr., William R.; Simmons, Blake A.; Dentinger, Paul Michael

    2005-03-22

    A novel tamper-indicating barcode methodology is disclosed that allows for detection of alteration to the barcode. The tamper-indicating methodology makes use of a tamper-indicating means that may be comprised of a particulate indicator, an optical indicator, a deformable substrate, and/or may be an integrated aspect of the barcode itself. This tamper-indicating information provides greater security for the contents of containers sealed with the tamper-indicating barcodes.

  20. Indicating anthropogenic effectson urban water system - indicators and extension

    NASA Astrophysics Data System (ADS)

    Strauch, G.; Ufz-Team

    2003-04-01

    Urban water systems are polluted by diffusive and direct contribution of anthropogenic activities. Besides industrial contaminants like aromatic and chlorinated HC and other persistent organic compounds, the urban aquatic environment is increasingly polluted by low concentrated but high eco-toxic compounds as pharmaceuticals, fragrances, plasticizers which most have disrupt endocrine functions, and trace elements carried in by surface and sub-surface waste water and seeping processes. This contamination could have a longtime impact on the urban ecosystem and on the human health. The interdisciplinary project on risk assessment of water pollution was initiated to explore new methodologies for assessing human activities on the urban water system and processes among urban watersheds. In a first assumption we used a flow model concept with in- and output and surface water transport represented by the city of Halle, Germany, and the river Saale. The river Saale acts as surface water system collecting waste water inputs along the city traverse. We investigated the anthropogenic effect on the urban water system using the indicators hydrological parameters, compound specific pattern of complex organic substances and trace elements, isotopic signatures of water (H, O) and dissolved substances (sulfate, DIC, nitrate), pathogens, and microbiota. A first balance modeling showed that main ions are not very sensitive concerning the direct urban input into the river. Depending on the discharge of the river in high and low flood stages the load of dissolved matter has no specific urban effect. However, the concentration pattern of fragrances (tonalid, galaxolid) and endocrine disrupters (t-nonylphenol) point to a different pollution along the city traverse: downstream of the sewage plant a higher load was observed in comparison to the upstream passage. Furthermore, a degradation ability of fungi and bacteria occurred in the bank sediments could be detected in lab experiments concerning the fragrances, and endocrine disrupters (t-nonylphenol, phthalate). The Saale water samples contain components able to eco-toxic and immunomodulated effects as measured on the vitality and cytokine-secretion profile of human peripheral blood mononuclear cells (PBMC). Even fragrances caused such effects which are unknown so far. The study of assessing urban effects onto the water system is still under investigation.

  1. Optically broadcasting wind direction indicator

    NASA Astrophysics Data System (ADS)

    Zysko, Jan A.

    1994-10-01

    An optically broadcasting wind direction indicator generates flashes of light which are separated by a time interval that is directly proportional to the angle of the wind direction relative to a fixed direction, such as north. An angle/voltage transducer generates a voltage that is proportional to the wind direction relative to the fixed direction, and this voltage is employed by timing circuitry or a microprocessor that generates pulses for actuating a light source trigger circuit first at the start of the time interval, and then at the end of the time interval. To aid an observer in distinguishing between the beginning and end of the interval, two stop flashes can be provided in quick succession. The time scale is preferably chosen so that each second of the time interval corresponds to 30 deg of direction relative to north. In this manner, an observer can easily correlate the measured time interval to the wind direction by visualizing the numbers on a conventional clock face, each of which correspond to one second of time and 30 deg of angle.

  2. Plugging and sealing technique by Onyx to prevent type II endoleak in ruptured abdominal aortic aneurysm.

    PubMed

    Larzon, Thomas; Hörer, Tal

    2013-04-01

    Control of back bleeding from the hypogastric artery into the aneurysm after endovascular aneurysm repair (EVAR) of a ruptured aorto-iliac aneurysm may be necessary in order to avoid a type II endoleak. It is an emergency situation and selective catheterization and embolization of the hypogastric artery may be time-consuming and more importantly, it has to be performed before complete exclusion of the aneurysm has been established. We describe a plugging and sealing technique that embolizes the hypogastric artery after the exclusion of a ruptured aorto-iliac aneurysm using the embolizing agent Onyx. The mortality rate of the 16 patients treated in our institute with this technique was 25% (4/16) at 30-day and 31% (5/16) at 90-day follow up. One patient had a type II endoleak at one-year follow-up. The EVAR procedure can focus completely on controlling the acute life-threatening situation, with the embolization performed at the end of the procedure. PMID:23508383

  3. Community Health Status Indicators Project

    NSDL National Science Digital Library

    The Health Resources and Services Administration (HRSA) of the Department of Health and Human Services (DHHS), in collaboration with the Association of State and Territorial Health Officials, the National Association of County and City Health Officials, and the Public Health Foundation, has recently unveiled a new Website that makes available health data for all 3,082 US counties. The Community Health Status Indicators (CHSI) Project has compiled pre-existing data from a variety of sources (no new data were collected) and created a report for each county. The reports offer data on a variety of topics, among them Population Characteristics, Leading Causes of Death, Vulnerable Populations, Environmental Health, and Access to Care. To access reports, users can either enter a county, or they can search for a county by selecting a state and/or a population range; searches can also be limited to those counties with the highest percentage of non-white or Hispanic inhabitants. Once a county is selected, reports can be downloaded in a viewable or printable form (both .pdf format). In addition, the data can be compared to that of "peer" counties, which share similar demographics. The site provides supplemental material to make the reports more understandable and usable, including a FAQ; a document on data sources, definitions, and notes; and a guide to using the reports. While the CHSI reports were created with public health professionals in mind, because the site is easy to navigate and the reports are readable, anyone with an interest in community health issues should find this a useful resource.

  4. The Indicating FTA Elute Cartridge

    PubMed Central

    de Bie, Roosmarie P.; Schmeink, Channa E.; Bakkers, Judith M.J.E.; Snijders, Peter J.F.; Quint, Wim G.V.; Massuger, Leon F.A.G.; Bekkers, Ruud L.M.; Melchers, Willem J.G.

    2011-01-01

    The clinically validated high-risk human papillomavirus (hrHPV) Hybrid Capture 2 (HC2) and GP5+/6+-PCR assays were analyzed on an Indicating FTA Elute cartridge (FTA cartridge). The FTA cartridge is a solid dry carrier that allows safe transport of cervical samples. FTA cartridge samples were compared with liquid-based samples for hrHPV and high-grade cervical intraepithelial neoplasia (CIN) detection. One cervical sample was collected in a liquid-based medium, and one was applied to the FTA cartridge. DNA was eluted directly from the FTA cartridge by a simple elution step. HC2 and GP5+/6+-PCR assays were performed on both the liquid-based and the FTA-eluted DNA of 88 women. Overall agreement between FTA and liquid-based samples for the presence of hrHPV was 90.9% with GP5+/6+-PCR and 77.3% with HC2. The sensitivity for high-grade CIN of hrHPV testing on the FTA cartridges was 84.6% with GP5+/6+-PCR and only 53.8% with HC2. By comparison, these sensitivities on liquid-based samples were 92.3% and 100% for GP5+/6+-PCR and HC2, respectively. Therefore, the FTA cartridge shows reasonably good overall agreement for hrHPV detection with liquid-based media when using GP5+/6+-PCR but not HC2 testing. Even with GP5+/6+-PCR, the FTA cartridge is not yet capable of detecting all high-grade CIN lesions. PMID:21704269

  5. Three New Multivariate Process Capability Indices

    Microsoft Academic Search

    Mohammad R. Niavarani; Rassoul Noorossana; Babak Abbasi

    2012-01-01

    Different multivariate process capability indices are developed by researchers to evaluate process capability when vectors of quality characteristics are considered in a study. This article presents three indices referred to as NCpM, MCpM, and NMCPM in order to evaluate process capability in multivariate environment. The performance of the proposed indices is investigated numerically. Simulation results indicate that the proposed indices

  6. 49 CFR 176.704 - Requirements relating to transport indices and criticality safety indices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... false Requirements relating to transport indices and criticality safety indices...176.704 Requirements relating to transport indices and criticality safety indices. (a) The sum of the transport indices (TI's) for all...

  7. 49 CFR 176.704 - Requirements relating to transport indices and criticality safety indices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... false Requirements relating to transport indices and criticality safety indices...176.704 Requirements relating to transport indices and criticality safety indices. (a) The sum of the transport indices (TI's) for all...

  8. 49 CFR 176.704 - Requirements relating to transport indices and criticality safety indices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... false Requirements relating to transport indices and criticality safety indices...176.704 Requirements relating to transport indices and criticality safety indices. (a) The sum of the transport indices (TI's) for all...

  9. 49 CFR 176.704 - Requirements relating to transport indices and criticality safety indices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... false Requirements relating to transport indices and criticality safety indices...176.704 Requirements relating to transport indices and criticality safety indices. (a) The sum of the transport indices (TI's) for all...

  10. 49 CFR 176.704 - Requirements relating to transport indices and criticality safety indices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... false Requirements relating to transport indices and criticality safety indices...176.704 Requirements relating to transport indices and criticality safety indices. (a) The sum of the transport indices (TI's) for all...

  11. 30 CFR 57.19009 - Position indicator.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Position indicator. 57.19009 Section 57.19009 Mineral...Hoisting Hoists § 57.19009 Position indicator. An accurate and reliable indicator of the position of the cage, skip,...

  12. 30 CFR 56.19009 - Position indicator.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Position indicator. 56.19009 Section 56.19009 Mineral...Hoisting Hoists § 56.19009 Position indicator. An accurate and reliable indicator of the position of the cage, skip,...

  13. 14 CFR 29.1545 - Airspeed indicator.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...2010-01-01 2010-01-01 false Airspeed indicator. 29.1545 Section 29.1545 Aeronautics...Markings and Placards § 29.1545 Airspeed indicator. (a) Each airspeed indicator must be marked as specified in...

  14. 49 CFR 230.68 - Speed indicators.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 2010-10-01 false Speed indicators. 230.68 Section 230.68 Transportation...STANDARDS Steam Locomotives and Tenders Speed Indicators § 230.68 Speed indicators. Steam locomotives that operate at...

  15. 14 CFR 27.1545 - Airspeed indicator.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...2010-01-01 2010-01-01 false Airspeed indicator. 27.1545 Section 27.1545 Aeronautics...Markings and Placards § 27.1545 Airspeed indicator. (a) Each airspeed indicator must be marked as specified in...

  16. PROGRAMME GROUP RESEARCH UPDATE: Biodiversity indicators &

    E-print Network

    1 PROGRAMME GROUP RESEARCH UPDATE: Biodiversity indicators & knowledge management programme group Introduction Duncan Ray The programme group Biodiversity Indicators and Knowledge Management (BIKM) was established by the merger of the Biodiversity Indicators & Evaluation Programme and the Decision Support

  17. Rangeland health attributes and indicators for qualitative assessment

    USGS Publications Warehouse

    Pyke, David A.; Herrick, J.E.; Pellant, Mike

    2002-01-01

    Panels of experts from the Society for Range Management and the National Research Council proposed that status of rangeland ecosystems could be ascertained by evaluating an ecological site's potential to conserve soil resources and by a series of indicators for ecosystem processes and site stability. Using these recommendations as a starting point, we developed a rapid, qualitative method for assessing a moment-in-time status of rangelands. Evaluators rate 17 indicators to assess 3 ecosystem attributes (soil and site stability, hydrologic function, and biotic integrity) for a given location. Indicators include rills, water flow patterns, pedestals and terracettes, bare ground, gullies, wind scour and depositional areas, litter movement, soil resistance to erosion, soil surface loss or degradation, plant composition relative to infiltration, soil compaction, plant functional/structural groups, plant mortality, litter amount, annual production, invasive plants, and reproductive capability. In this paper, we detail the development and evolution of the technique and introduce a modified ecological reference worksheet that documents the expected presence and amount of each indicator on the ecological site. In addition, we review the intended applications for this technique and clarify the differences between assessment and monitoring that lead us to recommend this technique be used for moment-in-time assessments and not be used for temporal monitoring of rangeland status. Lastly, we propose a mechanism for adapting and modifying this technique to reflect improvements in understanding of ecosystem processes. We support the need for quantitative measures for monitoring rangeland health and propose some measures that we believe may address some of the 17 indicators.

  18. PROCESS YIELD AND CAPABILITY INDICES DANIEL GRAU

    E-print Network

    Paris-Sud XI, Université de

    . An application on high-tech paint is also presented. KEYWORDS Asymmetric tolerances, Process capability indices, Process centering, Process yield 1. INTRODUCTION Process capability indices are widely used

  19. Orientationally invariant indices of axon diameter and density from diffusion MRI

    Microsoft Academic Search

    Daniel C. Alexander; Penny L. Hubbard; Matt G. Hall; Elizabeth A. Moore; Maurice Ptito; Geoff J. M. Parker; Tim B. Dyrby

    2010-01-01

    This paper proposes and tests a technique for imaging orientationally invariant indices of axon diameter and density in white matter using diffusion magnetic resonance imaging. Such indices potentially provide more specific markers of white matter microstructure than standard indices from diffusion tensor imaging. Orientational invariance allows for combination with tractography and presents new opportunities for mapping brain connectivity and quantifying

  20. Field Indicators of Hydric Soils in the United States: Version 4.0, March 1998

    NSDL National Science Digital Library

    A collaborative report by the US Department of Agriculture, Natural Resources Conservation Service, Wetland Science Institute Soil Survey Division, and National Technical Committee for Hydric Soils, this report describes field indicators of hydric soils in the US. In addition to descriptive text, the report includes several color photographs illustrating techniques and soil types, a glossary, and tables of field indicators and indicator correlations.

  1. Indicator bacteria at five swimming beaches—analysis using random forests

    Microsoft Academic Search

    David F. Parkhurst; Kristen P. Brenner; Alfred P. Dufour; Larry J. Wymer

    2005-01-01

    “Random forests,” an extension of tree regression, provide a relatively new technique for exploring relationships of a response variable like the density of indicator bacteria in water to numerous potential explanatory variables. We used this tool to study relationships of indicator density at five beaches to numerous other variables and found that day of the week, indicator density 24h earlier,

  2. Spatial Cluster Analysis of Hydrological Drought Indicator in an Oasis Ecosystem

    Microsoft Academic Search

    Meng-Lung Lin; Chien-Min Chu

    2009-01-01

    The objective of this study was to identify the spatial extent of high drought risk areas using remotely sensed drought indices in arid environments. Using remote sensing and geographic information system techniques, this study spatially quantified drought risk using hydrological drought indices derived from satellite data in Ejin Oasis, western China. All indices were computed from the MODIS data in

  3. Use of thermodynamic indices as ecological indicators of the development state of lake ecosystems. 1. Entropy production indices

    Microsoft Academic Search

    Alessandro Ludovisi; Antonio Poletti

    2003-01-01

    The effectiveness of Aoki's entropy production indices as ecological indicators of the trophic state is tested here under the changing hydrological conditions of Lake Trasimeno, a shallow freshwater lake in Italy. The analysis leads to a review of Aoki's indices and a definition of a new set of eutrophication indices (c, d, d?) based on the entropy production per surface

  4. STATE OF CALIFORNIA CHARGE INDICATOR DISPLAY (CID)

    E-print Network

    STATE OF CALIFORNIA CHARGE INDICATOR DISPLAY (CID) CEC-CF-6R-MECH-24-HERS (Revised 03/10) CALIFORNIA ENERGY COMMISSION INSTALLATION CERTIFICATE CF-6R-MECH-24-HERS Charge Indicator Display (CID) (Page 2010 CHARGE INDICATOR DISPLAY (CID) Charge Indicator Display (CID) specifications are available

  5. Basic Process Capability Indices: An Expository Review

    Microsoft Academic Search

    Mohammed Z. Anis

    2008-01-01

    A review of the four basic process capability indices has been made. The interrelationship among these indices has been highlighted. Attention has been drawn to their drawbacks. The relation of these indices to the proportion nonconforming has been dwelt upon and the requirement of the adequate sample size has been emphasized. Cautionary remarks on the use of these indices in

  6. DC KIDS COUNT e-Databook Indicators

    ERIC Educational Resources Information Center

    DC Action for Children, 2012

    2012-01-01

    This report presents indicators that are included in DC Action for Children's 2012 KIDS COUNT e-databook, their definitions and sources and the rationale for their selection. The indicators for DC KIDS COUNT represent a mix of traditional KIDS COUNT indicators of child well-being, such as the number of children living in poverty, and indicators of…

  7. The communion bridge to Six Sigma and process capability indices

    Microsoft Academic Search

    K. S. Chen; L. Y. Ouyang; C. H. Hsu; C. C. Wu

    2009-01-01

    Six Sigma has already become an efficient improvement technique adopted by a great number of enterprises. Numbers of Sigma\\u000a has become a tool of measuring process capability in some enterprises. But some of enterprises still use process capability\\u000a indices (PCIs) to measure the process capability. So numbers of Sigma and PCIs both can be used to measure the process capability.

  8. A Comparison of Moderated Regression Techniques Considering Strength of Effect.

    ERIC Educational Resources Information Center

    Darrow, Arthur L.; Kahl, Douglas R.

    1982-01-01

    Compared the traditional moderated regression technique with a technique designed to increase the probability of indication of a moderator variable. Results indicated that detection of moderator variables is dependent on their strength. A higher probability of detecting a moderator exists if the interaction is entered into the regression first.…

  9. The radiocarbon hydroxyl technique

    NASA Technical Reports Server (NTRS)

    Campbell, Malcolm J.; Sheppard, John C.

    1994-01-01

    The Radiocarbon Technique depends upon measuring the rate of oxidation of CO in an essentially unperturbed sample of air. The airborne technique is slightly different. Hydroxyl concentrations can be calculated directly; peroxyl concentrations can be obtained by NO doping.

  10. Seals and Sealing Techniques

    NASA Technical Reports Server (NTRS)

    1972-01-01

    Developments by the aerospace industry in seals and sealing techniques are announced for possible use in other areas. The announcements presented are grouped as: sealing techniques for cryogenic fluids, high pressure applications, and modification for improved performance.

  11. Nondestructive evaluation technique guide

    NASA Technical Reports Server (NTRS)

    Vary, A.

    1973-01-01

    A total of 70 individual nondestructive evaluation (NDE) techniques are described. Information is presented that permits ease of comparison of the merits and limitations of each technique with respect to various NDE problems. An NDE technique classification system is presented. It is based on the system that was adopted by the National Materials Advisory Board (NMAB). The classification system presented follows the NMAB system closely with the exception of additional categories that have been added to cover more advanced techniques presently in use. The rationale of the technique is explained. The format provides for a concise description of each technique, the physical principles involved, objectives of interrogation, example applications, limitations of each technique, a schematic illustration, and key reference material. Cross-index tabulations are also provided so that particular NDE problems can be referred to appropriate techniques.

  12. Evaluation of Mesoscale Model Phenomenological Verification Techniques

    NASA Technical Reports Server (NTRS)

    Lambert, Winifred

    2006-01-01

    Forecasters at the Spaceflight Meteorology Group, 45th Weather Squadron, and National Weather Service in Melbourne, FL use mesoscale numerical weather prediction model output in creating their operational forecasts. These models aid in forecasting weather phenomena that could compromise the safety of launch, landing, and daily ground operations and must produce reasonable weather forecasts in order for their output to be useful in operations. Considering the importance of model forecasts to operations, their accuracy in forecasting critical weather phenomena must be verified to determine their usefulness. The currently-used traditional verification techniques involve an objective point-by-point comparison of model output and observations valid at the same time and location. The resulting statistics can unfairly penalize high-resolution models that make realistic forecasts of a certain phenomena, but are offset from the observations in small time and/or space increments. Manual subjective verification can provide a more valid representation of model performance, but is time-consuming and prone to personal biases. An objective technique that verifies specific meteorological phenomena, much in the way a human would in a subjective evaluation, would likely produce a more realistic assessment of model performance. Such techniques are being developed in the research community. The Applied Meteorology Unit (AMU) was tasked to conduct a literature search to identify phenomenological verification techniques being developed, determine if any are ready to use operationally, and outline the steps needed to implement any operationally-ready techniques into the Advanced Weather Information Processing System (AWIPS). The AMU conducted a search of all literature on the topic of phenomenological-based mesoscale model verification techniques and found 10 different techniques in various stages of development. Six of the techniques were developed to verify precipitation forecasts, one to verify sea breeze forecasts, and three were capable of verifying several phenomena. The AMU also determined the feasibility of transitioning each technique into operations and rated the operational capability of each technique on a subjective 1-10 scale: (1) 1 indicates that the technique is only in the initial stages of development, (2) 2-5 indicates that the technique is still undergoing modifications and is not ready for operations, (3) 6-8 indicates a higher probability of integrating the technique into AWIPS with code modifications, and (4) 9-10 indicates that the technique was created for AWIPS and is ready for implementation. Eight of the techniques were assigned a rating of 5 or below. The other two received ratings of 6 and 7, and none of the techniques a rating of 9-10. At the current time, there are no phenomenological model verification techniques ready for operational use. However, several of the techniques described in this report may become viable techniques in the future and should be monitored for updates in the literature. The desire to use a phenomenological verification technique is widespread in the modeling community, and it is likely that other techniques besides those described herein are being developed, but the work has not yet been published. Therefore, the AMIU recommends that the literature continue to be monitored for updates to the techniques described in this report and for new techniques being developed whose results have not yet been published. 111

  13. Petrosal sinus sampling: technique and rationale.

    PubMed

    Miller, D L; Doppman, J L

    1991-01-01

    Bilateral simultaneous sampling of the inferior petrosal sinuses is an extremely sensitive, specific, and accurate test for diagnosing Cushing disease and distinguishing between that entity and the ectopic ACTH syndrome. It is also valuable for lateralizing small hormone-producing adenomas within the pituitary gland. The inferior petrosal sinuses connect the cavernous sinuses with the ipsilateral internal jugular veins. The anatomy of the anastomoses between the inferior petrosal sinus, the internal jugular vein, and the venous plexuses at the base of the skull varies, but it is almost always possible to catheterize the inferior petrosal sinus. In addition, variations in size and anatomy are often present between the two inferior petrosal sinuses in a patient. Advance preparation is required for petrosal sinus sampling. Teamwork is a critical element, and each member of the staff should know what he or she will be doing during the procedure. The samples must be properly labeled, processed, and stored. Specific needles, guide wires, and catheters are recommended for this procedure. The procedure is performed with specific attention to the three areas of potential technical difficulty: catheterization of the common femoral veins, crossing the valve at the base of the left internal jugular vein, and selective catheterization of the inferior petrosal sinuses. There are specific methods for dealing with each of these areas. The sine qua non of correct catheter position in the inferior petrosal sinus is demonstration of reflux of contrast material into the ipsilateral cavernous sinus. Images must always be obtained to document correct catheter position. Special attention must be paid to two points to prevent potential complications: The patient must be given an adequate dose of heparin, and injection of contrast material into the inferior petrosal sinuses and surrounding veins must be done gently and carefully. When the procedure is performed as outlined, both inferior petrosal sinuses can be catheterized in more than 98% of patients. The complication rate is low, and the theoretical risk of major morbidity or death is less than 1% (neither has yet occurred, to our knowledge). The most common complication is groin hematoma. PMID:1845785

  14. Advances in electronic pressure indication and resulting drilling application breakthroughs

    SciTech Connect

    Condon, W.S. [Houston Digital Instruments, Inc., Houston, TX (United States); Quentin, K.M. [Well Control and Systems Design, Inc., Houston, TX (United States)

    1995-12-31

    Pressure is the core process variable of all drilling programs. This paper expounds on technological advances achieved over the past four years in the design of electronic pressure indication instrumentation and several prominent drilling application breakthroughs resulting from these design enhancements. Currently, industry focus on pressure indication is impeded by reliance on older, hydraulic technology with its attendant linearity and maintenance/downtime problems. Limited accuracy and poor linearity stifles creative conception of pressure management techniques that could result in greater drilling optimization. Utilizing electronic pressure indication instruments can be justified on either well specific or overall operating considerations for all but the most rudimentary drilling programs. Importantly, enhancements have evolved without the high costs normally associated with new technology.

  15. Laplacian Estrada and normalized Laplacian Estrada indices of evolving graphs.

    PubMed

    Shang, Yilun

    2015-01-01

    Large-scale time-evolving networks have been generated by many natural and technological applications, posing challenges for computation and modeling. Thus, it is of theoretical and practical significance to probe mathematical tools tailored for evolving networks. In this paper, on top of the dynamic Estrada index, we study the dynamic Laplacian Estrada index and the dynamic normalized Laplacian Estrada index of evolving graphs. Using linear algebra techniques, we established general upper and lower bounds for these graph-spectrum-based invariants through a couple of intuitive graph-theoretic measures, including the number of vertices or edges. Synthetic random evolving small-world networks are employed to show the relevance of the proposed dynamic Estrada indices. It is found that neither the static snapshot graphs nor the aggregated graph can approximate the evolving graph itself, indicating the fundamental difference between the static and dynamic Estrada indices. PMID:25822506

  16. Developments in functional neuroimaging techniques

    SciTech Connect

    Aine, C.J. [Los Alamos National Lab., NM (United States). Biophysics Group

    1995-03-01

    A recent review of neuroimaging techniques indicates that new developments have primarily occurred in the area of data acquisition hardware/software technology. For example, new pulse sequences on standard clinical imagers and high-powered, rapidly oscillating magnetic field gradients used in echo planar imaging (EPI) have advanced MRI into the functional imaging arena. Significant developments in tomograph design have also been achieved for monitoring the distribution of positron-emitting radioactive tracers in the body (PET). Detector sizes, which pose a limit on spatial resolution, have become smaller (e.g., 3--5 mm wide) and a new emphasis on volumetric imaging has emerged which affords greater sensitivity for determining locations of positron annihilations and permits smaller doses to be utilized. Electromagnetic techniques have also witnessed growth in the ability to acquire data from the whole head simultaneously. EEG techniques have increased their electrode coverage (e.g., 128 channels rather than 16 or 32) and new whole-head systems are now in use for MEG. But the real challenge now is in the design and implementation of more sophisticated analyses to effectively handle the tremendous amount of physiological/anatomical data that can be acquired. Furthermore, such analyses will be necessary for integrating data across techniques in order to provide a truly comprehensive understanding of the functional organization of the human brain.

  17. Trading indicators with information-gap uncertainty

    E-print Network

    Guttman, Tony

    1 Trading indicators with information-gap uncertainty Colin J. Thompson ARC Centre of Excellence. Practical implications ­ An additional technical trading tool for applying Information ­ Gap theory trading indicators, Information gaps, Uncertainty, Robustness, Financial modelling Paper type Research

  18. [Improvement of selection indices for animals].

    PubMed

    Riabko, V M; Gorlov, A I; Gerasimenko, T G

    1991-01-01

    Selection indices should be used taking into account their correlations with the selected characters. The method of relative values to determine selection indices gives a more reliable evaluation of boars. PMID:1796513

  19. Process capability indices and product reliability

    Microsoft Academic Search

    Bharatwaj Ramakrishnan; Peter Sandborn; Michael G. Pecht

    2001-01-01

    This paper discusses process capability indices—Cp and Cpk, their underlying assumptions, and the relationships between process capability indices and product reliability. An actual case is presented to demonstrate this relationship.

  20. Performance indicator report for operation surety

    SciTech Connect

    NONE

    1991-05-01

    This report for the month of May, 1991, summarizes performance indicators which are being monitored at the Pinellas Plant. These indicators range over maintenance related items, radiation incidents, overtime hours, hazardous spills, discharges of gases and liquids, etc.

  1. A LEVEL INDICATOR FOR LIQUEFIED GASES

    Microsoft Academic Search

    A. L. Burke; L. H. Jr. Cook

    1960-01-01

    A capacitance instrument is described that indicates the level of ;\\u000a liquefied gas in a closed container. The instrument has been used to indicate ;\\u000a and control the level of liquid nitrogen, hydrogen, and methane. (auth)

  2. The Current Status of Primary Distance Indicators

    E-print Network

    Michael Feast

    2004-05-22

    A review is given of the current status of the primary distance indicators. The relevance of these indicators for determining the local expansion rate and the age of globular clusters is briefly outlined.

  3. Indicators of hawala operations and criminal abuse

    Microsoft Academic Search

    Nikos Passas

    2004-01-01

    Indicates the importance of the Informal Value Transfer System (IVTS) and hawala in particular as a means whereby immigrant workers can send remittances to their home countries, and the reasons for suspecting that these systems can be used to transfer funds which support terrorist activities. Lists the indicators of IVTS activity. Lists and discusses the possible indicators of criminal abuse:

  4. Ecological Indicators for the Nation (2000)

    NSDL National Science Digital Library

    National Research Council (U.S.). Board on Atmospheric Sciences and Climate.

    The National Academy Press (of the National Academies) has posted this Open Book (for browsing only), from the Committee to Evaluate Indicators for Monitoring Aquatic and Terrestrial Environments (National Research Council). The text provides criteria and methodologies for selecting and developing ecological indicators; proposes several ecological indicators and relevant data sources; and suggests ways to gather, store, interpret, and communicate information from ecological monitoring.

  5. Educational Indicators: Monitoring the State of Education.

    ERIC Educational Resources Information Center

    Educational Testing Service, Princeton, NJ.

    The l975 Educational Testing Service (ETS) Invitational Conference provided an overview of the social indicators movement, and the relationship between schooling and quality of life. The concept of educational indicators was discussed. Educational indicators are defined as statistics used to provide information regarding the status of particular…

  6. 49 CFR 229.117 - Speed indicators.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 2010-10-01 false Speed indicators. 229.117 Section 229.117 ...Cab Equipment § 229.117 Speed indicators. (a) After December 31, 1980...per hour shall be equipped with a speed indicator which is— (1) Accurate...

  7. Early Reading Proficiency. Leading Indicator Spotlight

    ERIC Educational Resources Information Center

    Musen, Lindsey

    2010-01-01

    In "Beyond Test Scores: Leading Indicators for Education," Foley and colleagues (2008) define leading indicators as those that "provide early signals of progress toward academic achievement" (p. 1) and stress that educators "need leading indicators to help them see the direction their efforts are going in and to take corrective action as soon as…

  8. Facilities Performance Indicators Report, 2008-09

    ERIC Educational Resources Information Center

    Hills, Christina, Ed.

    2010-01-01

    This paper features another expanded Web-based Facilities Performance Indicators Report (FPI). The purpose of APPA's Facilities Performance Indicators is to provide a representative set of statistics about facilities in educational institutions. The 2008-09 iteration of the Web-based Facilities Performance Indicators Survey was posted and…

  9. 49 CFR 236.513 - Audible indicator.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...2010-10-01 2010-10-01 false Audible indicator. 236.513 Section 236.513 Transportation...Systems Standards § 236.513 Audible indicator. (a) The automatic cab signal...more restrictive aspect, an audible indicator will sound continuously until...

  10. Informing security indicator design in web browsers

    Microsoft Academic Search

    Pan Shi; Heng Xu

    2011-01-01

    In this paper, we aim at providing conceptual and empirical insights to the design of security indicators in web browsers. In examining why security indicators in web browsers fail to warn users about web frauds, we propose affordance-based principles for our new design of web authentication indicators. Following these principles, we present a new design for Extended Validation (EV) certificate

  11. Choosing Aggregation Rules for Composite Indicators

    ERIC Educational Resources Information Center

    Munda, Giuseppe

    2012-01-01

    From a formal point of view, a composite indicator is an aggregate of all dimensions, objectives, individual indicators and variables used for its construction. This implies that what defines a composite indicator is the set of properties underlying its mathematical aggregation convention. In this article, I try to revise the theoretical debate on…

  12. Indicator Models of Core Inflation for Canada

    Microsoft Academic Search

    Richard Dion

    1999-01-01

    When there is uncertainty about estimates of the margin of unused capacity in the economy, examining a range of inflation indicators may help in assessing the balance of risks regarding the outlook for inflation. This paper tests a wide range of observable variables for their leading-indicator properties with respect to core inflation, including: commodity prices, cost indicators, measures of capacity

  13. Laboratory Indices of Nutritional Status in Pregnancy.

    ERIC Educational Resources Information Center

    National Academy of Sciences-National Research Council, Washington, DC. Food and Nutrition Board.

    This report reviews the current state of knowledge regarding laboratory indices of nutritional and metabolic status during normal pregnancy in order to provide normative data with respect to such indices in healthy pregnant women. The report contains seven chapters: Physiologic Adjustments in General; Hematologic Indices; Electrolytes in Normal…

  14. Key Performance Indicators for Primary Schools.

    ERIC Educational Resources Information Center

    Strand, Steve

    Focusing mostly on their application for primary schools, this document describes the educational key performance indicators (KPI) employed by the Wendsworth, England, Local Educational Authority (LEA). Indicators are divided into 3 areas, educational context, resource development, and outcomes. Contextual indicators include pupil mobility, home…

  15. Robot-assisted transaxillary thyroidectomy: Surgical technique.

    PubMed

    Abramovici, Laurent; Cartier, César; Pierre, Guillemette; Garrel, Renaud

    2015-06-01

    Robot-assisted transaxillary thyroid surgery avoids the need for a neck incision. It consists of thyroid lobectomy and isthmectomy for moderately large unilateral benign nodules. The surgical imperatives are the same as for conventional surgery, but with differences in terms of patient positioning, surgical incision, equipment, surgical technique and indications. The purpose of this article is to describe the equipment, patient positioning and surgical technique of exclusive robot-assisted transaxillary total thyroid lobectomy and isthmectomy. PMID:25980627

  16. Proper Injection Techniques in Dairy Cattle 

    E-print Network

    Villarino, Mario A.

    2009-05-04

    E-567 05-09 Proper Injection Techniques in Dairy Cattle I t is very important to administer medications to dairy cattle in the proper way. That means using the correct drug, dosage and injection technique; handling animals... labeled for use in dairy ? cattle. Refer to the vaccine label for this information. Using a vaccine in an animal species for which it is not labeled is illegal. Give the proper dosage as indicated on the label. ? Always give an injection in the body...

  17. Renal artery stenosis treated with stent deployment: Indications, technique, and outcome for 108 patients

    Microsoft Academic Search

    Julio A. Rodriguez-Lopez; Alan Werner; Lance I. Ray; Christos Verikokos; Luis J. Torruella; Edward Martinez; Edward B. Diethrich

    1999-01-01

    From January 1993 to May 1996, 108 patients (64 men, 44 women; mean age, 72 years; age range, 37 to 87 years) underwent 125 percutaneous transluminal angioplasties and stent implantations primarily for atherosclerotic lesions of the renal artery. Sixty-four patients underwent treatment for renovascular hypertension (two antihypertensive medications or more), 32 patients underwent treatment for a combination of hypertension and

  18. Different Stability-Indicating Chromatographic Techniques for the Determination of Netobimin

    PubMed Central

    Ramadan, Nesrin K.; Mohamed, Afaf O.; Shawky, Sara E.; Salem, Maissa Y.

    2012-01-01

    Two simple, accurate, and sensitive methods were developed for the determination of netobimin in the presence of its degradation product. Method (A) was an HPLC method, performed on C18 column using acetonitrile/methanol/0.01?M potassium dihydrogen phosphate (56?:?14?:?30 by volume) as a mobile phase with a flow rate of 0.5?mL/min. Detection was performed at 254?nm. Method (B) was a TLC method, using silica gel 60 F254 plates; the optimized mobile phase was toluene/methanol/chloroform/ammonium hydroxide (5?:?4?:?6?:?0.1 by volume). The spots were scanned densitometrically at 346?nm. Linearity ranges were 1–10??g/mL for method (A) and 0.5–5??g/band for method (B), and the mean percentage recoveries were 99.3 ± 0.7% and 99.7 ± 0.7% for methods (A) and (B), respectively. The proposed methods were found to be specific for netobimin in the presence of up to 90% of its degradation product. Statistical comparison between the results obtained by these methods and the manufacturer method was done, and no significance difference was obtained. PMID:22567566

  19. Bi-unicompartmental and combined uni plus patellofemoral replacement: indications and surgical technique

    PubMed Central

    ROMAGNOLI, SERGIO; MARULLO, MATTEO; MASSARO, MICHELE; RUSTEMI, ENIS; D’AMARIO, FEDERICO; CORBELLA, MICHELE

    2015-01-01

    The anatomy and orientation of the condyles and the trochlea are not standard, but related to morphotype, gender and race. Consequently, the extreme variability in their dimension, and in the distance and angle between the axis of the condyles and of the trochlea, often necessitates a “custom-made” replacement. This may be achieved through the use of small implants. Bicompartmental osteoarthritis with intact ligaments should be addressed with bi-unicompartmental (bi-UKR) or UKR plus patellofemoral replacement (PFR). These options allow selective replacement of the worn compartments and a customised fit of the small implants to the native knee anatomy. Clinical consequences are restoration of the native knee kinematics and overall better function.

  20. The Gore-tex sling procedure for female sphincteric incontinence: indications, technique, and results

    Microsoft Academic Search

    David R. Staskin; Jong M. Choe; David S. Breslin

    1997-01-01

    We constructed a pubovaginal sling using the Gore-tex Soft Tissue Patch and 2-0 polytetrafluoroethlene (PTFE) suspension suture and placed it in 122 consecutive incontinent women with urethral hypermobility and\\/or intrinsic sphincter deficiency. We performed a retrospective outcome analysis using a questionnaire-based telephone survey. The mean follow-up period was 24.4 months. Stress incontinence was cured in 88% of patients (equally effective

  1. The Transcervical Approach for Parapharyngeal Space Pleomorphic Adenomas: Indications and Technique

    PubMed Central

    Horowitz, Gilad; Ben-Ari, Oded; Wasserzug, Oshri; Weizman, Noam; Yehuda, Moshe; Fliss, Dan M.

    2014-01-01

    Background Head and Neck Parapharyngeal space tumors are rare. Pleomorphic Adenomas are the most common Parapharyngeal space tumors. The purpose of this study was to define preoperative criteria for enabling full extirpation of parapharyngeal space pleomorphic adenomas via the transcervical approach while minimizing functional and cosmetic morbidity. Methods The surgical records and medical charts of 19 females and 10 males with parapharyngeal space pleomorphic adenomas operated between 1993 and 2012 were reviewed. Results Fifteen patients were operated by a simple transcervical approach, 13 by a transparotid transcervical approach, and one by a transmandibular transcervical approach. Complications included facial nerve paralysis, infection, hemorrhage and first bite syndrome. There were three recurrences, but neither recurrence nor complications were associated with the type of surgical approach. Conclusion A simple transcervical approach is preferred for parapharyngeal space pleomorphic adenomas with narrow attachments to the deep lobe of the parotid gland and for pleomorphic adenomas originating in a minor salivary gland within the parapharyngeal space. PMID:24587286

  2. DEVELOPMENT OF BIOLOGICAL INDICATORS, METHODS AND ASSESSMENT TECHNIQUES FOR USE IN HEADWATER INTERMITTENT STREAMS

    EPA Science Inventory

    Despite representing the most abundant and widespread of our nation's surface waters, regions, states and tribes have received little guidance specific to headwater intermittent streams from the U.S. EPA. Headwater streams lie at the terrestrial-aquatic interface both spatially,...

  3. Sustainable Development Indicators 353 In the Mineral Industries, Milos 2003, Greece

    E-print Network

    Sustainable Development Indicators 353 In the Mineral Industries, Milos 2003, Greece Sustainable development of mineral resources: Improving communications using visualization techniques S. Schafrik and M technologies in the sustainable development of mineral resources. 1. INTRODUCTION The design of surface mineral

  4. Remote indicator for a laser alignment system

    SciTech Connect

    Poling, M.E.

    1987-03-31

    A remote indicator is described for the main receiver of a laser alignment system the combination comprising: connecting means between the main receiver and the remote indicator. The connecting means is operable to supply power to the remote indicator and to transmit to the remote indicator alignment data indicative of the relative alignment detected by the main receiver; an LCD in the remote indicator coupled to the connecting means and operable to provide a visual indication of the alignment data; illuminating means located in back of the LCD operable when turned on to make the LCD visible under conditions of reduced ambient light; and switching means connected to the illuminating means and the connecting means and being operable to turn the illuminating means on if the alignment data is present and to turn the illuminating means off if the alignment data is not present.

  5. Three Cs in Measurement Models: Causal Indicators, Composite Indicators, and Covariates

    ERIC Educational Resources Information Center

    Bollen, Kenneth A.; Bauldry, Shawn

    2011-01-01

    In the last 2 decades attention to causal (and formative) indicators has grown. Accompanying this growth has been the belief that one can classify indicators into 2 categories: effect (reflective) indicators and causal (formative) indicators. We argue that the dichotomous view is too simple. Instead, there are effect indicators and 3 types of…

  6. Analysis of Citric Acid in Beverages: Use of an Indicator Displacement Assay

    ERIC Educational Resources Information Center

    Umali, Alona P.; Anslyn, Eric V.; Wright, Aaron T.; Blieden, Clifford R.; Smith, Carolyne K.; Tian, Tian; Truong, Jennifer A.; Crumm, Caitlin E.; Garcia, Jorge E.; Lee, Soal; Mosier, Meredith; Nguyen, Chester P.

    2010-01-01

    The use of an indicator displacement assay permits the visualization of binding events between host and guest molecules. An undergraduate laboratory experiment is described to demonstrate the technique in the determination of citric acid content in commercially available beverages such as soda pop and fruit juices. Through the technique, students…

  7. Interferometric Methods of Measuring Refractive Indices and Double-Refraction of Fibres.

    ERIC Educational Resources Information Center

    Hamza, A. A.; El-Kader, H. I. Abd

    1986-01-01

    Presents two methods used to measure the refractive indices and double-refraction of fibers. Experiments are described, with one involving the use of Pluta microscope in the double-beam interference technique, the other employing the multiple-beam technique. Immersion liquids are discussed that can be used in the experiments. (TW)

  8. Discovering Indicators of Successful Collaboration Using Tense: Automated Extraction of Patterns in Discourse

    ERIC Educational Resources Information Center

    Thompson, Kate; Kennedy-Clark, Shannon; Wheeler, Penny; Kelly, Nick

    2014-01-01

    This paper describes a technique for locating indicators of success within the data collected from complex learning environments, proposing an application of e-research to access learner processes and measure and track group progress. The technique combines automated extraction of tense and modality via parts-of-speech tagging with a visualisation…

  9. Which is the easiest and safest technique for central venous access? A retrospective survey of more than 5,400 cases.

    PubMed

    Pittiruti, M; Malerba, M; Carriero, C; Tazza, L; Gui, D

    2000-01-01

    There is an ongoing debate on the technique for central venous catheterization associated with the lowest complication rate and the highest success rate. In an attempt to better define the easiest and safest venous approach, we have reviewed our 7-year experience with 5479 central venous percutaneous punctures (by Seldinger's technique) for the insertion of short-term (n=2109), medium/long-term (n=2627) catheters, as well as double-lumen, large-bore catheters for hemodialysis and/or hemapheresis (n=743). We have analyzed the incidence of the most frequent in-sertion-related complications by comparing seven different venous approaches: jugular vein, low lateral approach; jugular vein, high lateral approach; jugular vein, low axial approach; subclavian vein, infraclavicular approach; subclavian vein, supraclavicular approach; external jugular vein; femoral vein. The results of our retrospective study suggest that the 'low lateral' approach to the internal jugular vein, as described by Jernigan and modified according to our protocol, appears to be the easiest and safest technique for percutaneous insertion of central venous access, being characterized by the lowest incidence of accidental arte-rial puncture (1.2%) and malposition (0.8%), no pneumothorax, and an extremely low rate of repeated attempts (i.e. more than two punctures before successful cannulation) (3.3%). We advocate the 'low lateral' approach to the internal jugular vein as first-choice technique for venipuncture in both adults and children, for both short-term and long-term central venous percutaneous cannulation. PMID:17638235

  10. Glassy spectral gas sensors based on the immobilized indicators

    NASA Astrophysics Data System (ADS)

    Novikov, Alexander F.; Zemskii, Vladimir I.

    1995-09-01

    A number of color absorption and luminescence indicators being dispersed within a porous matrix have been investigated by means of spectral techniques. As a support for the indicator molecules served a mesoporous silica glass of Vycor type (pore size of 7.5 nm) which was transparent to the light and permeable to the ambient gases and vapors. The selected immobilized indicators have revealed the well-defined spectral sensitivity to certain components of an atmosphere or other gas mixture. After a proper chemical and thermal treatment these indicators have gained high selectivity of spectral response on an individual gas appearing in the ambients, the observed spectral changes have demonstrated its reversibility. The indicators immobilized within the porous glass turned out to be mostly advantageous as applied in the colorimetric sensors and anlyzyers, sepcifically in the automated remote air monitoring systems. Some of the essential parameters of the developed portable individual gas analyzers and remote multicomponent monitoring systems with use of fiber optic guides are reported.

  11. Optical Techniques Nanomicroscopy

    E-print Network

    Fischer, Wolfgang

    Optical Techniques Nanomicroscopy Drug Development Medicinal Plants Sessions Nanomicroscopy Medical Biophysics Structure and Mechanics of F nction Medicinal Plants Nano Medicine Drug Encapsulation and Deli er

  12. The evolution of tooth wear indices

    PubMed Central

    2008-01-01

    Tooth wear—attrition, erosion and abrasion—is perceived internationally as an ever-increasing problem. Clinical and epidemiological studies, however, are difficult to interpret and compare due to differences in terminology and the large number of indices that have been developed for diagnosing, grading and monitoring dental hard tissue loss. These indices have been designed to identify increasing severity and are usually numerical. Some record lesions on an aetiological basis (e.g. erosion indices), others record lesions irrespective of aetiology (tooth wear indices); none have universal acceptance, complicating the evaluation of the true increase in prevalence reported. This article considers the ideal requirements for an erosion index. It reviews the literature to consider how current indices have evolved and discusses if these indices meet the clinical and research needs of the dental profession. PMID:17701430

  13. Energy conservation indicators. 1982 annual report

    SciTech Connect

    Belzer, D.B.

    1982-09-01

    A series of Energy Conservation Indicators were developed for the Department of Energy to assist in the evaluation of current and proposed conservation strategies. As descriptive statistics that signify current conditions and trends related to efficiency of energy use, indicators provide a way of measuring, monitoring, or inferring actual responses by consumers in markets for energy services. Related sets of indicators are presented in some 40 one-page indicator summaries. Indicators are shown graphically, followed by several paragraphs that explain their derivation and highlight key findings. Indicators are classified according to broad end-use sectors: Aggregate (economy), Residential, Commercial, Industrial, Transportation and Electric Utilities. In most cases annual time series information is presented covering the period 1960 through 1981.

  14. Techniques for transvenous leads extraction.

    PubMed

    Bongiorni, M G; Soldati, E; De Lucia, R; Marzilli, M

    2007-12-01

    The number of implanted cardiac pacing and defibrillating devices is currently increasing, leading to an increasing number of device-related complications, due to either malfunction or infection. Removal of the whole system, including the leads, was proven to be the most effective therapy. At present the importance of transvenous lead extraction is consequently increased. In order to remove pacing and implantable cardioverter defibrillators (ICD) leads, they have to be made free from any binding site from the entry in the vein to the tip. Different techniques, including mechanical dilation, powered dilation and intravascular approaches have been developed over the last years and are currently available. Results reported in the literature show a significant success rate (ranging between 90% and 98% of the leads) and a reduced incidence of serious complications (1% to 3% in different series) in selected centres. The extraction procedures are complex and life-threatening complications may always occur, suggesting the need of trained and experienced operators as well as the availability of a surgical standby. At present indications to removal are restricted to infection or to damage of the leads inducing serious risk for the patients; the availability of a more effective and safe technique will probably spread indications to most of abandoned leads. PMID:18091645

  15. The stochastic control of process capability indices

    Microsoft Academic Search

    Nozer D. Singpurwalla; G. Box; D. R. Cox; D. K. Dey; A. Fries; J. K. Ghosh; M. A. Gómez-Villegas; T. Z. Irony; W. Kliemann; S. Kotz; D. V. Lindley; M. F. McGrath; D. Peña

    1998-01-01

    In manufacturing science, process capability indices play a role analogous to economic indices in government statistics. The\\u000a existing capability indices are passive devices whose main role is to retroactively monitor process capability. The have been\\u000a developed under the restrictive assumption of process stability, and the procedures for using them are based on ad hoc rules.\\u000a Using the normative point of

  16. United Nations Statistics Division: Social Indicators

    NSDL National Science Digital Library

    The UNSD continually updates its social indicators page. Data is available on population, human settlements, water supply, housing, health, education, literacy, unemployment, income, and child-bearing.

  17. An efficient compression scheme for bitmap indices

    SciTech Connect

    Wu, Kesheng; Otoo, Ekow J.; Shoshani, Arie

    2004-04-13

    When using an out-of-core indexing method to answer a query, it is generally assumed that the I/O cost dominates the overall query response time. Because of this, most research on indexing methods concentrate on reducing the sizes of indices. For bitmap indices, compression has been used for this purpose. However, in most cases, operations on these compressed bitmaps, mostly bitwise logical operations such as AND, OR, and NOT, spend more time in CPU than in I/O. To speedup these operations, a number of specialized bitmap compression schemes have been developed; the best known of which is the byte-aligned bitmap code (BBC). They are usually faster in performing logical operations than the general purpose compression schemes, but, the time spent in CPU still dominates the total query response time. To reduce the query response time, we designed a CPU-friendly scheme named the word-aligned hybrid (WAH) code. In this paper, we prove that the sizes of WAH compressed bitmap indices are about two words per row for large range of attributes. This size is smaller than typical sizes of commonly used indices, such as a B-tree. Therefore, WAH compressed indices are not only appropriate for low cardinality attributes but also for high cardinality attributes.In the worst case, the time to operate on compressed bitmaps is proportional to the total size of the bitmaps involved. The total size of the bitmaps required to answer a query on one attribute is proportional to the number of hits. These indicate that WAH compressed bitmap indices are optimal. To verify their effectiveness, we generated bitmap indices for four different datasets and measured the response time of many range queries. Tests confirm that sizes of compressed bitmap indices are indeed smaller than B-tree indices, and query processing with WAH compressed indices is much faster than with BBC compressed indices, projection indices and B-tree indices. In addition, we also verified that the average query response time is proportional to the index size. This indicates that the compressed bitmap indices are efficient for very large datasets.

  18. Passive tamper-indicating secure container

    SciTech Connect

    Bartberger, J.C.

    1993-07-01

    This paper describes a passive tamper-indicating secure container that has been designed to demonstrate concepts, features, and materials that can be used in passive container applications. (In a passive security system, physical phenomena provide visual indication of tampering.) The basic container {open_quotes}volume within a volume{close_quotes} assembly consists of a transparent plastic outer container and an aluminum inner container. Both containers incorporate passive, fingerprinted layers as part of the tamper-indicating container system. Many of the tamper-indicating features can be visually inspected without disassembling the container. The status of container development and potential applications for the container are addressed.

  19. ISIM3D: AN ANSI-C THREE-DIMENSIONAL MULTIPLE INDICATOR CONDITIONAL SIMULATION PROGRAM

    EPA Science Inventory

    The indicator conditional simulation technique provides stochastic simulations of a variable that (i) honor the initial data and (ii) can feature a richer family of spatial structures not limited by Gaussianity. he data are encoded into a series of indicators which then are used ...

  20. Quality indicators in higher education - comparing Hong Kong and China’s students

    Microsoft Academic Search

    Paula Y. K. Kwan; Paul W. K. Ng

    1999-01-01

    There is growing concern in college management about the quality of education in tertiary institutions. For related studies, people normally encounter the problems of developing measurement indicators and identifying components of quality education. Some people use SERVQUAL, a technique making use of the gap between customers’ expectations and perceived experience as indicators of service quality, to measure quality of services

  1. A separated representation of an error indicator for the mesh refinement process under the proper generalized decomposition framework

    NASA Astrophysics Data System (ADS)

    Nadal, E.; Leygue, A.; Chinesta, F.; Beringhier, M.; Ródenas, J. J.; Fuenmayor, F. J.

    2015-02-01

    Today industries do not only require fast simulation techniques but also verification techniques for the simulations. The proper generalized decomposition (PGD) has been situated as a suitable tool for fast simulation for many physical phenomena. However, so far, verification tools for the PGD are under development. The PGD approximation error mainly comes from two different sources. The first one is related with the truncation of the PGD approximation and the second one is related with the discretization error of the underlying numerical technique. In this work we propose a fast error indicator technique based on recovery techniques, for the discretization error of the numerical technique used by the PGD technique, for refinement purposes.

  2. Hysterectomy—Current Methods and Alternatives for Benign Indications

    PubMed Central

    Papadopoulos, Michail S.; Tolikas, Athanasios C.; Miliaras, Dimosthenis E.

    2010-01-01

    Hysterectomy is the commonest gynecologic operation performed not only for malignant disease but also for many benign conditions such as fibroids, endometrial hyperplasia, adenomyosis, uterine prolapse, dysfunctional uterine bleeding, and cervical intraepithelial neoplasia. There are many approaches to hysterectomy for benign disease: abdominal hysterectomy, vaginal hysterectomy, laparoscopic assisted vaginal hysterectomy (LAVH) where a vaginal hysterectomy is assisted by laparoscopic procedures that do not include uterine artery ligation, total laparoscopic hysterectomy (TLH) where the laparoscopic procedures include uterine artery ligation, and subtotal laparoscopic hysterectomy (STLH) where there is no vaginal component and the uterine body is removed using a morcelator. In the last decades, many new techniques, alternative to hysterectomy with conservation of the uterus have been developed. They use modern technologies and their results are promising and in many cases comparable with hysterectomy. This paper is a review of all the existing hysterectomy techniques and the alternative methods for benign indications. PMID:20798870

  3. Power Amplifier Linearization Techniques

    E-print Network

    Dawson, Joel

    Power Amplifier Linearization Techniques: An Overview Workshop on RF Circuits for 2.5G and 3G(x))) is a linear function of the input variable x. x (Power amplifier) #12;Technique II estimation. · Depends on having a good power amplifier model. · Complexity: incurs power overhead of a DSP

  4. Classroom Assessment Techniques

    NSDL National Science Digital Library

    This is a short, but easy to read matrix of assessment techniques, outlining descriptions, what to do with the data, and the time required for each type of assessment. The techniques included are the minute paper, chain notes, memory matrix, directed paraphrasing, one sentence summary, exam evaluations, application cards, and student-generated test questions.

  5. Delphi Technique: Expanding Applications.

    ERIC Educational Resources Information Center

    Brooks, Kenneth W.

    1979-01-01

    Describes the Delphi Technique, an approach to elicit and refine the opinions of a group of people. Outlines the steps in the process and provides illustrations of the applications of the technique for schools and colleges in determining future research needs, assessing staff development needs, and identifying problems confronting administrators.…

  6. Contamination Control Techniques

    SciTech Connect

    EBY, J.L.

    2000-05-16

    Welcome to a workshop on contamination Control techniques. This work shop is designed for about two hours. Attendee participation is encouraged during the workshop. We will address different topics within contamination control techniques; present processes, products and equipment used here at Hanford and then open the floor to you, the attendees for your input on the topics.

  7. UIAGM Ropehandling Techniques.

    ERIC Educational Resources Information Center

    Cloutier, K. Ross

    The Union Internationale des Associations des Guides de Montagne's (UIAGM) rope handling techniques are intended to form the standard for guiding ropework worldwide. These techniques have become the legal standard for instructional institutions and commercial guiding organizations in UIAGM member countries: Austria, Canada, France, Germany, Great…

  8. Efficient digital comparison technique for logic circuits

    NASA Technical Reports Server (NTRS)

    Mccarthy, C. E.

    1971-01-01

    Tolerance compare technique indicates discompare only when numerical difference value exceeds prescribed limit. Algorithm involving binary number properties is defined, in lieu of arithmetic operation which requires relatively complex circuitry. Extension of algorithm may be made to encompass tolerances other than one unit.

  9. Classroom Assessment Techniques

    NASA Astrophysics Data System (ADS)

    Narayanan, M.

    2003-12-01

    Provost David L. Potter of George Mason University chaired a joint task force and presented a report entitled ``Powerful Partnerships : A Shared Responsibility for Learnin'' in June 1998. The main goal is to make a difference in the quality of student learning. Further, it is important to assess this difference and document it. Clifford O. Young, Sr., & Laura Howzell Young of California State University, San Bernardino argue that a new paradigm for assessment, a learning paradigm, must be constructed to measure the success of new kinds of educational practices. Using two survey instruments, the Instruction Model Learning Model Questionnaire (IMLMQ) and the Student Evaluation of Teaching Effectiveness (SETE), they compared students' responses to the course when taught with traditional methods and with interactive methods. The results suggest that neither instrument effectively measures the kinds of learning promoted under the new paradigm. Linn, Baker, & Dunbar recommend that these newer assessment practices should be more authentic, that is, to involve students in the actual or simulated performance of a task or the documentation of the desired competency in a portfolio. Cerbin says that one of the most unfortunate consequences of a summative emphasis is that it inhibits open and productive discussions about teaching; in essence, it marginalizes the types of activity that could lead to better teaching (Cerbin, 1992). William Cerbin, who is the Director of the Center for Effective Teaching and learning, University Assessment Coordinator, and Professor of Psychology at the University of Wisconsin-LaCrosse is a recognized expert in the areas of cognition, language, and development. Edgerton, Hutchings, & Quinlan indicate that Teaching Portfolios may contain evidence of students' learning, but such information is optional, and when included, it may be only one of many pieces of material. Seldin, also supports this and stresses that the interplay between the instructor and the learner should be carefully observed and monitored. Forrest says that Student Portfolios, which document learning in more detail, seldom reveal how teaching contributes to students' progress. Cerbin further indicates that a course portfolio is essentially, a like a manuscript of scholarly work in progress. In this example, it is a work that explains what, how, and why students learn or do not learn in a course. In this paper, the author reports on a dozen techniques that could perhaps be used to document assessment of student learning. References : Cerbin, W. (1993). Fostering a culture of teaching as scholarship. The Teaching Professor, 7(3), 1-2. Edgerton, R., Hutchings, P., & Quinlan, P. (1991). The teaching portfolio: Capturing the scholarship in teaching. Washington, DC: American Association for Higher Education. Forrest, A. (1990). Time will tell: Portfolio-assisted assessment of general education. Washington, DC: American Association for Higher Education. Linn, R., Baker, E., & Dunbar, S. (1991). Complex, Performance-based Assessment: Expectations and Validation Criteria. Educational Researcher, 20 (8), 15-21. Narayanan, M. (2003). Assessment in Higher Education: Partnerships in Learning. Paper presented at the 23rd Annual Lilly Conference on College Teaching, Miami University, Oxford, OH. Seldin, P. (1991). The teaching portfolio. Bolton, MA: Anker. Young, C. O., Sr., & Young, L. H. (1999). Assessing Learning in Interactive Courses. Journal on Excellence in College Teaching, 10 (1), 63-76.

  10. Modeling and analysis of distribution reliability indices

    Microsoft Academic Search

    Nagaraj Balijepalli; Subrahmanyam S. Venkata; Richard D. Christie

    2004-01-01

    Assessment of customer power supply reliability is an important part of distribution system operation and planning. Monte Carlo simulations can be used to find the statistical distribution of the reliability indices, along with their mean and standard deviation. The standard deviation of the reliability indices provides distribution engineers with information on the expected range of the annual values. However, the

  11. Quality measurement indicators for Iranian Health Centers

    PubMed Central

    Moslehi, Shandiz; Atefi Manesh, Pezhman; Sarabi Asiabar, Ali

    2015-01-01

    Background: Recently, quality is a serious concern in development of organizations. There are various indicators to assess quality and the purpose of this study was to identify the main indicators for quality measurement of Iranian health centers. Methods: This qualitative study was conducted in three stages: first, review of the literature was performed to identify different indicators for quality measurement in health centers; second, a tworound Delphi process was used with participation of 18 experts in both rounds; third, Analytical Hierarchy Process (AHP) method was applied to give weights to each indicator. Results: Twenty-seven indicators were identified from the literature review stage. The Delphi method reduced the list to 4 indicators. Developing a quality plan in the health center had the highest weight (38%) and percentage of followed complaints the lowest (12%). The consistency rate was 7.2% indicating appropriateness of the data. Conclusion: This list of indicators can be used as a template for measuring quality of health centers in Iran and possibly in other developing countries.

  12. Lipoprotein Metabolism Indicators Improve Cardiovascular Risk Prediction

    PubMed Central

    van Schalkwijk, Daniël B.; de Graaf, Albert A.; Tsivtsivadze, Evgeni; Parnell, Laurence D.; van der Werff-van der Vat, Bianca J. C.; van Ommen, Ben; van der Greef, Jan; Ordovás, José M.

    2014-01-01

    Background Cardiovascular disease risk increases when lipoprotein metabolism is dysfunctional. We have developed a computational model able to derive indicators of lipoprotein production, lipolysis, and uptake processes from a single lipoprotein profile measurement. This is the first study to investigate whether lipoprotein metabolism indicators can improve cardiovascular risk prediction and therapy management. Methods and Results We calculated lipoprotein metabolism indicators for 1981 subjects (145 cases, 1836 controls) from the Framingham Heart Study offspring cohort in which NMR lipoprotein profiles were measured. We applied a statistical learning algorithm using a support vector machine to select conventional risk factors and lipoprotein metabolism indicators that contributed to predicting risk for general cardiovascular disease. Risk prediction was quantified by the change in the Area-Under-the-ROC-Curve (?AUC) and by risk reclassification (Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI)). Two VLDL lipoprotein metabolism indicators (VLDLE and VLDLH) improved cardiovascular risk prediction. We added these indicators to a multivariate model with the best performing conventional risk markers. Our method significantly improved both CVD prediction and risk reclassification. Conclusions Two calculated VLDL metabolism indicators significantly improved cardiovascular risk prediction. These indicators may help to reduce prescription of unnecessary cholesterol-lowering medication, reducing costs and possible side-effects. For clinical application, further validation is required. PMID:24667559

  13. Causal Indicator Models: Identification, Estimation, and Testing

    ERIC Educational Resources Information Center

    Bollen, Kenneth A.; Davis, Walter R.

    2009-01-01

    We discuss the identification, estimation, and testing of structural equation models that have causal indicators. We first provide 2 rules of identification that are particularly helpful in models with causal indicators--the 2C emitted paths rule and the exogenous X rule. We demonstrate how these rules can help us distinguish identified from…

  14. 33 CFR 159.83 - Level indicator.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Waters 2 2010-07-01 2010-07-01 false Level indicator. 159.83 Section 159.83 Navigation and Navigable... Design, Construction, and Testing § 159.83 Level indicator. Each sewage retention device must have a means of...

  15. INDICATORS OF ECOSYSTEM INTEGRITY FOR ESTUARIES

    EPA Science Inventory

    Jordan, Stephen J. and Lisa M. Smith. In press. Indicators of Ecosystem Integrity for Estuaries. In: Proceedings of the Estuarine Indicators Workshop, 29-31 October 2003, Sanibel Island, FL. Sanibel-Captiva Conservation Foundation, Sanibel, FL. 23 p. (ERL,GB 1194). Ideal ...

  16. Development and Testing of Drought Indicators

    Microsoft Academic Search

    A. R. RAO; T. L. VOELLER

    1997-01-01

    Numerous definitions of droughts which are based on different climatological time series have been in use. In this paper, the development of drought indicators by using different time series is described. These drought indicators were developed for use by the Department of Natural Resources in the State of Indiana, U.S.A. The second part of the study deals with an analysis

  17. Future Development of Nursing Home Quality Indicators

    ERIC Educational Resources Information Center

    Arling, Greg; Kane, Robert L.; Lewis, Teresa; Mueller, Christine

    2005-01-01

    Nursing home quality indicators have been developed over the past 10 years to quantify nursing home quality and to draw systematic comparisons between facilities. Although these indicators have been applied widely for nursing home regulation, quality improvement, and public reporting, researchers and stakeholders have raised concerns about their…

  18. Eco-innovation indicators European Environment Agency

    E-print Network

    Eco-innovation indicators European Environment Agency Copenhagen, February 2006 #12;Page 2 Contents Acknowledgements Executive summary 1. Background 2. Key considerations in developing eco-innovation indicators 3. Eco-innovation setting up a frame 4. Existing main methods and experiences of analyzing eco

  19. Multiple Indicator Stationary Time Series Models.

    ERIC Educational Resources Information Center

    Sivo, Stephen A.

    2001-01-01

    Discusses the propriety and practical advantages of specifying multivariate time series models in the context of structural equation modeling for time series and longitudinal panel data. For time series data, the multiple indicator model specification improves on classical time series analysis. For panel data, the multiple indicator model…

  20. Approximating Power Indices --Theoretical and Empirical Analysis

    E-print Network

    Rosenschein, Jeff

    Approximating Power Indices -- Theoretical and Empirical Analysis Yoram Bachrach School power indices. This version contains new empirical analysis of the performance of these methods of these domains, agents are unequal in their power to affect the outcome of the game. Prior research on weighted

  1. Myers-Briggs Type Indicator Career Report

    E-print Network

    Peak, Derek

    Myers-Briggs Type Indicator® Career Report Developed by Allen L. Hammer Report prepared for JANE SAMPLE May 8, 2008 CPP, Inc. | 800-624-1765 | www.cpp.com Myers-Briggs Type Indicator® Career Report Copyright 1992, 1998, 2004 by Peter B. Myers and Katharine D. Myers. All rights reserved. Myers-Briggs Type

  2. Science and Engineering Indicators, 2002. Volume 1.

    ERIC Educational Resources Information Center

    National Science Foundation, Arlington, VA. National Science Board.

    This publication is the fifteenth in the series of biennial Science Indicators reports. The Science Indicators series was designed to provide a broad base of quantitative information about U.S. science, engineering, and technology for use by public and private policymakers. Because of the spread of scientific and technological capabilities around…

  3. Environmental performance indicators of organic spreading machines

    E-print Network

    Paris-Sud XI, Université de

    aims to evaluate environmental effects of organic product spreading according to several ways of environmental protection. It explains test methods and calculation to obtain indicators for each machine1 Environmental performance indicators of organic spreading machines M. Rousselet1 *, J. C. Roux1

  4. Rotifers as indicators of water quality

    Microsoft Academic Search

    Vladimír Sláde?ek

    1983-01-01

    Six hundred and twenty species and lower taxonomical units of Rotatoria found in Czechoslovakia and surrounding countries are listed alphabetically and classified according to water quality. The numerical characteristics include the saprobic valence in 10 balls, the indicative weight of species, Ii, and the individual saprobic index, Si. Rotifers are considered to be good indicators and some of them are

  5. Community Interests and Indicator System Success

    ERIC Educational Resources Information Center

    Holden, Meg

    2009-01-01

    Testing the validity of indicator systems is a task almost always left to the scientific community, in standard practice and in keeping with the quest for objectivity prevalent in politics and in society as a whole. This paper calls for a reinvigorated agenda within indicators research to question this practice and develop alternative…

  6. Life Potential as a Basic Demographic Indicator

    ERIC Educational Resources Information Center

    Goerlich, Francisco J.; Soler, Angel

    2013-01-01

    This paper proposes an indicator that integrates life expectancy with the demographic structure of the population for a given society. By doing this, we have a simple indicator of mortality and aging combined, which could be very useful for developed societies. As is widely known, life expectancy at birth is independent of the demographic…

  7. Thermal comfort and the heat stress indices.

    PubMed

    Epstein, Yoram; Moran, Daniel S

    2006-07-01

    Thermal stress is an important factor in many industrial situations, athletic events and military scenarios. It can seriously affect the productivity and the health of the individual and diminish tolerance to other environmental hazards. However, the assessment of the thermal stress and the translation of the stress in terms of physiological and psychological strain is complex. For over a century attempts have been made to construct an index, which will describe heat stress satisfactorily. The many indices that have been suggested can be categorized into one of three groups: "rational indices", "empirical indices", or "direct indices". The first 2 groups are sophisticated indices, which integrate environmental and physiological variables; they are difficult to calculate and are not feasible for daily use. The latter group comprises of simple indices, which are based on the measurement of basic environmental variables. In this group 2 indices are in use for over four decades: the "wet-bulb globe temperature" (WBGT) index and the "discomfort index" (DI). The following review summarizes the current knowledge on thermal indices and their correlates to thermal sensation and comfort. With the present knowledge it is suggested to adopt the DI as a universal heat stress index. PMID:16922182

  8. Developing Rural Knowledge Indicators Prepared for

    E-print Network

    Levinson, David M.

    Developing Rural Knowledge Indicators Prepared for U.S. Department of Agriculture, Cooperative State Research, Education, and Extension Service (CSREES) Fund for Rural America July 2003 Impresa of possible indicators of the presence of knowledge workers and knowledge-based industry clusters in rural

  9. Indicators of School Crime and Safety, 1999.

    ERIC Educational Resources Information Center

    Kaufman, Phillip; Chen, Xianglei; Choy, Susan P.; Ruddy, Sally A.; Miller, Amanda K.; Chandler, Kathryn A.; Chapman, Christopher D.; Rand, Michael R.; Klaus, Patsy

    This report provides detailed statistical information on crime in schools. It is a companion document to the "Annual Report on School Safety: 1999," which offers an overview of the nature and scope of school crime. This report is organized as a series of indicators, with each indicator presenting data on a different aspect of school crime and…

  10. Indicators of School Crime and Safety, 2000.

    ERIC Educational Resources Information Center

    Kaufman, Phillip; Chen, Xianglei; Choy, Susan P.; Ruddy, Sally A.; Miller, Amanda K.; Fleury, Jill K.; Chandler, Kathryn A.; Rand, Michael R.; Klaus, Patsy; Planty, Michael G.

    This report contains the most recent available data on school crime and safety drawn from a number of statistical series supported by the federal government. It is organized as a series of indicators, with each indicator presenting data on a different aspect of school crime and safety. There are five sections to the report: Violent Deaths at…

  11. America's Children in Brief: Key National Indicators

    E-print Network

    Rau, Don C.

    Statistics #12;America's Children in Brief: Key National Indicators of Well-Being, 20122 This year's AmericaAmerica's Children in Brief: Key National Indicators of Well-Being, 2012 #12;#12;America's Children and Budget Introduction Each year since 1997, the Federal Interagency Forum on Child and Family Statistics

  12. Selection of the Argentine indicator region

    NASA Technical Reports Server (NTRS)

    Ramirez, C. J.; Reed, C. R. (principal investigators)

    1982-01-01

    Determined from available Argentine crop statistics, selection of the Indicator Region was based on the highest wheat, corn, and soybean producing provinces, which were: Buenos Aires, Cordoba, Entre Rios, and Santa Fe. Each province in Argentina was examined for the availability of LANDSAT data; area, yield and production statistics; crop calendars; and other ancillary data. The Argentine Indicator Region is described.

  13. Financial Indicators for Critical Access Hospitals

    ERIC Educational Resources Information Center

    Pink, George H.; Holmes, G. Mark; D'Alpe, Cameron; Strunk, Lindsay A.; McGee, Patrick; Slifkin, Rebecca T.

    2006-01-01

    Context: There is a growing recognition of the need to measure and report hospital financial performance. However, there exists little comparative financial indicator data specifically for critical access hospitals (CAHs). CAHs differ from other hospitals on a number of dimensions that might affect appropriate indicators of performance, including…

  14. Climate Change Indicators for the United States

    EPA Science Inventory

    EPA?s publishes the Climate Change Indicators for the United States report to communicate information about the science and impacts of climate change, track trends in environmental quality, and inform de¬cision-making. This report presents a set of key indicators to help readers ...

  15. Institutional repositories: proposed indicators of success

    Microsoft Academic Search

    Mary Westell

    2006-01-01

    Purpose – This paper proposes indicators for measuring the success of institutional repositories based on their demonstrated integration with other research initiatives and provides a snapshot of the current state of selected institutional repositories in Canada through a review of their web presence and their integration with university library and research pages. Design\\/methodology\\/approach – Using the proposed indicators, an examination

  16. SENSITIVITY OF ZOOPLANKTON INDICATORS IN REGIONAL MONITORING

    EPA Science Inventory

    This study describes an approach for assessing and selecting ecological indicators for regional monitoring of northeastern US lakes. We analyze the components of variance for indicators of zooplankton richness and abundance in the context of the spatial and temporal sampling des...

  17. Are performance indicators generic? The international experience of the Quality Indicator Project

    Microsoft Academic Search

    Vahé A. Kazandjian

    Performance indicators for healthcare organizations represent a strategy for accountability worldwide. A universal approach to either the design for indicators or their applicability to local needs remains a work in progress. The Maryland Hospital Association's Quality Indicator Project® (QIP) is the only indicator-based performance measurement system used world- wide. This paper presents, for the first time in QIP's 17 years

  18. Dynamic Well-Being: Connecting Indicators of what People Anticipate with Indicators of what they Experience

    ERIC Educational Resources Information Center

    Dolan, Paul; White, Mathew

    2006-01-01

    There are many indicators of a person's well-being that could be used for policy purposes. Few would argue that any single indicator of well-being is appropriate in all contexts and, increasingly, social scientists are attempting to integrate the various indicators. Further successful integration depends on understanding how the various indicators

  19. Electrical termination techniques

    NASA Technical Reports Server (NTRS)

    Oakey, W. E.; Schleicher, R. R.

    1976-01-01

    A technical review of high reliability electrical terminations for electronic equipment was made. Seven techniques were selected from this review for further investigation, experimental work, and preliminary testing. From the preliminary test results, four techniques were selected for final testing and evaluation. These four were: (1) induction soldering, (2) wire wrap, (3) percussive arc welding, and (4) resistance welding. Of these four, induction soldering was selected as the best technique in terms of minimizing operator errors, controlling temperature and time, minimizing joint contamination, and ultimately producing a reliable, uniform, and reusable electrical termination.

  20. Techniques of vasectomy.

    PubMed

    Art, Kevin S; Nangia, Ajay K

    2009-08-01

    Vasectomy remains a safe and effective method of contraception for men. Many variations in surgical technique currently are used by surgeons in the United States, each with its own benefits and drawbacks. Regardless of the surgical method used, the most important factor for successful vasectomy remains the experience and skill of the surgeon. The amount of evidence-based literature on the rationale for the different techniques for vasectomy remains limited. Careful study and innovation of vasectomy techniques will ensure that the most commonly performed urologic surgical procedure remain an excellent form of contraception in the future. PMID:19643233