Worst-Case Scenario Tsunami Hazard Assessment in Two Historically and Economically Important Districts in Eastern Sicily (Italy)

NASA Astrophysics Data System (ADS)

Armigliato, A.; Tinti, S.; Pagnoni, G.; Zaniboni, F.; Paparo, M. A.

2015-12-01

The portion of the eastern Sicily coastline (southern Italy), ranging from the southern part of the Catania Gulf (to the north) down to the southern-eastern end of the island, represents a very important geographical domain from the industrial, commercial, military, historical and cultural points of view. Here the two major cities of Augusta and Siracusa are found. In particular, the Augusta bay hosts one of the largest petrochemical poles in the Mediterranean, and Siracusa is listed among the UNESCO World Heritage Sites since 2005. This area was hit by at least seven tsunamis in the approximate time interval from 1600 BC to present, the most famous being the 365, 1169, 1693 and 1908 tsunamis. The choice of this area as one of the sites for the testing of innovative methods for tsunami hazard, vulnerability and risk assessment and reduction is then fully justified. This is being developed in the frame of the EU Project called ASTARTE - Assessment, STrategy And Risk Reduction for Tsunamis in Europe (Grant 603839, 7th FP, ENV.2013.6.4-3). We assess the tsunami hazard for the Augusta-Siracusa area through the worst-case credible scenario technique, which can be schematically divided into the following steps: 1) Selection of five main source areas, both in the near- and in the far-field (Hyblaean-Malta escarpment, Messina Straits, Ionian subduction zone, Calabria offshore, western Hellenic Trench); 2) Choice of potential and credible tsunamigenic faults in each area: 38 faults were selected, with properly assigned magnitude, geometry and focal mechanism; 3) Computation of the maximum tsunami wave elevations along the eastern Sicily coast on a coarse grid (by means of the in-house code UBO-TSUFD) and extraction of the 9 scenarios that produce the largest effects in the target areas of Augusta and Siracusa; 4) For each of the 9 scenarios we run numerical UBO-TSUFD simulations over a set of five nested grids, with grid cells size decreasing from 3 km in the open Ionian

Impacts of fertilization on water quality of a drained pine plantation: a worst case scenario.

PubMed

Beltran, Bray J; Amatya, Devendra M; Youssef, Mohamed; Jones, Martin; Callahan, Timothy J; Skaggs, R Wayne; Nettles, Jami E

2010-01-01

Intensive plantation forestry will be increasingly important in the next 50 yr to meet the high demand for domestic wood in the United States. However, forest management practices can substantially influence downstream water quality and ecology. This study analyses, the effect of fertilization on effluent water quality of a low gradient drained coastal pine plantation in Carteret County, North Carolina using a paired watershed approach. The plantation consists of three watersheds, two mature (31-yr) and one young (8-yr) (age at treatment). One of the mature watersheds was commercially thinned in 2002. The mature unthinned watershed was designated as the control. The young and mature-thinned watersheds were fertilized at different rates with Arborite (Encee Chemical Sales, Inc., Bridgeton, NC), and boron. The outflow rates and nutrient concentrations in water drained from each of the watersheds were measured. Nutrient concentrations and loadings were analyzed using general linear models (GLM). Three large storm events occurred within 47 d of fertilization, which provided a worst case scenario for nutrient export from these watersheds to the receiving surface waters. Results showed that average nutrient concentrations soon after fertilization were significantly (alpha = 0.05) higher on both treatment watersheds than during any other period during the study. This increase in nutrient export was short lived and nutrient concentrations and loadings were back to prefertilization levels as soon as 3 mo after fertilization. Additionally, the mature-thinned watershed presented higher average nutrient concentrations and loadings when compared to the young watershed, which received a reduced fertilizer rate than the mature-thinned watershed.

Worst case analysis: Earth sensor assembly for the tropical rainfall measuring mission observatory

NASA Technical Reports Server (NTRS)

Conley, Michael P.

1993-01-01

This worst case analysis verifies that the TRMMESA electronic design is capable of maintaining performance requirements when subjected to worst case circuit conditions. The TRMMESA design is a proven heritage design and capable of withstanding the most worst case and adverse of circuit conditions. Changes made to the baseline DMSP design are relatively minor and do not adversely effect the worst case analysis of the TRMMESA electrical design.

Less than severe worst case accidents

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

Sanders, G.A.

1996-08-01

Many systems can provide tremendous benefit if operating correctly, produce only an inconvenience if they fail to operate, but have extreme consequences if they are only partially disabled such that they operate erratically or prematurely. In order to assure safety, systems are often tested against the most severe environments and accidents that are considered possible to ensure either safe operation or safe failure. However, it is often the less severe environments which result in the ``worst case accident`` since these are the conditions in which part of the system may be exposed or rendered unpredictable prior to total system failure.more » Some examples of less severe mechanical, thermal, and electrical environments which may actually be worst case are described as cautions for others in industries with high consequence operations or products.« less

SU-E-T-551: PTV Is the Worst-Case of CTV in Photon Therapy

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

Harrington, D; Liu, W; Park, P

2014-06-01

Purpose: To examine the supposition of the static dose cloud and adequacy of the planning target volume (PTV) dose distribution as the worst-case representation of clinical target volume (CTV) dose distribution for photon therapy in head and neck (H and N) plans. Methods: Five diverse H and N plans clinically delivered at our institution were selected. Isocenter for each plan was shifted positively and negatively in the three cardinal directions by a displacement equal to the PTV expansion on the CTV (3 mm) for a total of six shifted plans per original plan. The perturbed plan dose was recalculated inmore » Eclipse (AAA v11.0.30) using the same, fixed fluence map as the original plan. The dose distributions for all plans were exported from the treatment planning system to determine the worst-case CTV dose distributions for each nominal plan. Two worst-case distributions, cold and hot, were defined by selecting the minimum or maximum dose per voxel from all the perturbed plans. The resulting dose volume histograms (DVH) were examined to evaluate the worst-case CTV and nominal PTV dose distributions. Results: Inspection demonstrates that the CTV DVH in the nominal dose distribution is indeed bounded by the CTV DVHs in the worst-case dose distributions. Furthermore, comparison of the D95% for the worst-case (cold) CTV and nominal PTV distributions by Pearson's chi-square test shows excellent agreement for all plans. Conclusion: The assumption that the nominal dose distribution for PTV represents the worst-case dose distribution for CTV appears valid for the five plans under examination. Although the worst-case dose distributions are unphysical since the dose per voxel is chosen independently, the cold worst-case distribution serves as a lower bound for the worst-case possible CTV coverage. Minor discrepancies between the nominal PTV dose distribution and worst-case CTV dose distribution are expected since the dose cloud is not strictly static. This research was

Defining the worst case scenario for the Makran Subduction Zone: the 1008 AD tsunami

NASA Astrophysics Data System (ADS)

Hoffmann, Goesta

2016-04-01

correlated to the 1008 AD earthquake and tsunami inundation. The boulder deposits as well as the archaeological remains testify for a maximum tsunami runup of 15m, exceeding by far the inundation as observed in 1945. We define this as the worst case scenario for the Makran Subduction Zone. However, the return period is rather large (>500 years).

Worst-Case Flutter Margins from F/A-18 Aircraft Aeroelastic Data

NASA Technical Reports Server (NTRS)

Lind, Rick; Brenner, Marty

1997-01-01

An approach for computing worst-case flutter margins has been formulated in a robust stability framework. Uncertainty operators are included with a linear model to describe modeling errors and flight variations. The structured singular value, micron, computes a stability margin which directly accounts for these uncertainties. This approach introduces a new method of computing flutter margins and an associated new parameter for describing these margins. The micron margins are robust margins which indicate worst-case stability estimates with respect to the defined uncertainty. Worst-case flutter margins are computed for the F/A-18 SRA using uncertainty sets generated by flight data analysis. The robust margins demonstrate flight conditions for flutter may lie closer to the flight envelope than previously estimated by p-k analysis.

Evacuation planning for plausible worst case inundation scenarios in Honolulu, Hawaii.

PubMed

Kim, Karl; Pant, Pradip; Yamashita, Eric

2015-01-01

Honolulu is susceptible to coastal flooding hazards. Like other coastal cities, Honolulu&s long-term economic viability and sustainability depends on how well it can adapt to changes in the natural and built environment. While there is a disagreement over the magnitude and extent of localized impacts associated with climate change, it is widely accepted that by 2100 there will be at least a meter in sea level rise (SLR) and an increase in extreme weather events. Increased exposure and vulnerabilities associated with urbanization and location of human activities in coastal areas warrants serious consideration by planners and policy makers. This article has three objectives. First, flooding due to the combined effects of SLR and episodic hydro-meteorological and geophysical events in Honolulu are investigated and the risks to the community are quantified. Second, the risks and vulnerabilities of critical infrastructure and the surface transportation system are described. Third, using the travel demand software, travel distances and travel times for evacuation from inundated areas are modeled. Data from three inundation models were used. The first model simulated storm surge from a category 4 hurricane similar to Hurricane Iniki which devastated the island of Kauai in 1992. The second model estimates inundation based on five tsunamis that struck Hawaii. A 1-m increase in sea level was included in both the hurricane storm surge and tsunami flooding models. The third model used in this article generated a 500-year flood event due to riverine flooding. Using a uniform grid cell structure, the three inundation maps were used to assess the worst case flooding scenario. Based on the flood depths, the ruling hazard (hurricane, tsunami, or riverine flooding) for each grid cell was determined. The hazard layer was analyzed with socioeconomic data layers to determine the impact on vulnerable populations, economic activity, and critical infrastructure. The analysis focused both

Selection of Thermal Worst-Case Orbits via Modified Efficient Global Optimization

NASA Technical Reports Server (NTRS)

Moeller, Timothy M.; Wilhite, Alan W.; Liles, Kaitlin A.

2014-01-01

Efficient Global Optimization (EGO) was used to select orbits with worst-case hot and cold thermal environments for the Stratospheric Aerosol and Gas Experiment (SAGE) III. The SAGE III system thermal model changed substantially since the previous selection of worst-case orbits (which did not use the EGO method), so the selections were revised to ensure the worst cases are being captured. The EGO method consists of first conducting an initial set of parametric runs, generated with a space-filling Design of Experiments (DoE) method, then fitting a surrogate model to the data and searching for points of maximum Expected Improvement (EI) to conduct additional runs. The general EGO method was modified by using a multi-start optimizer to identify multiple new test points at each iteration. This modification facilitates parallel computing and decreases the burden of user interaction when the optimizer code is not integrated with the model. Thermal worst-case orbits for SAGE III were successfully identified and shown by direct comparison to be more severe than those identified in the previous selection. The EGO method is a useful tool for this application and can result in computational savings if the initial Design of Experiments (DoE) is selected appropriately.

A Framework to Improve Surgeon Communication in High-Stakes Surgical Decisions: Best Case/Worst Case.

PubMed

Taylor, Lauren J; Nabozny, Michael J; Steffens, Nicole M; Tucholka, Jennifer L; Brasel, Karen J; Johnson, Sara K; Zelenski, Amy; Rathouz, Paul J; Zhao, Qianqian; Kwekkeboom, Kristine L; Campbell, Toby C; Schwarze, Margaret L

2017-06-01

Although many older adults prefer to avoid burdensome interventions with limited ability to preserve their functional status, aggressive treatments, including surgery, are common near the end of life. Shared decision making is critical to achieve value-concordant treatment decisions and minimize unwanted care. However, communication in the acute inpatient setting is challenging. To evaluate the proof of concept of an intervention to teach surgeons to use the Best Case/Worst Case framework as a strategy to change surgeon communication and promote shared decision making during high-stakes surgical decisions. Our prospective pre-post study was conducted from June 2014 to August 2015, and data were analyzed using a mixed methods approach. The data were drawn from decision-making conversations between 32 older inpatients with an acute nonemergent surgical problem, 30 family members, and 25 surgeons at 1 tertiary care hospital in Madison, Wisconsin. A 2-hour training session to teach each study-enrolled surgeon to use the Best Case/Worst Case communication framework. We scored conversation transcripts using OPTION 5, an observer measure of shared decision making, and used qualitative content analysis to characterize patterns in conversation structure, description of outcomes, and deliberation over treatment alternatives. The study participants were patients aged 68 to 95 years (n = 32), 44% of whom had 5 or more comorbid conditions; family members of patients (n = 30); and surgeons (n = 17). The median OPTION 5 score improved from 41 preintervention (interquartile range, 26-66) to 74 after Best Case/Worst Case training (interquartile range, 60-81). Before training, surgeons described the patient's problem in conjunction with an operative solution, directed deliberation over options, listed discrete procedural risks, and did not integrate preferences into a treatment recommendation. After training, surgeons using Best Case/Worst Case clearly presented a choice between

The Avellino 3780-yr-B.P. catastrophe as a worst-case scenario for a future eruption at Vesuvius

PubMed Central

Mastrolorenzo, Giuseppe; Petrone, Pierpaolo; Pappalardo, Lucia; Sheridan, Michael F.

2006-01-01

A volcanic catastrophe even more devastating than the famous anno Domini 79 Pompeii eruption occurred during the Old Bronze Age at Vesuvius. The 3780-yr-B.P. Avellino plinian eruption produced an early violent pumice fallout and a late pyroclastic surge sequence that covered the volcano surroundings as far as 25 km away, burying land and villages. Here we present the reconstruction of this prehistoric catastrophe and its impact on the Bronze Age culture in Campania, drawn from an interdisciplinary volcanological and archaeoanthropological study. Evidence shows that a sudden, en masse evacuation of thousands of people occurred at the beginning of the eruption, before the last destructive plinian column collapse. Most of the fugitives likely survived, but the desertification of the total habitat due to the huge eruption size caused a social–demographic collapse and the abandonment of the entire area for centuries. Because an event of this scale is capable of devastating a broad territory that includes the present metropolitan district of Naples, it should be considered as a reference for the worst eruptive scenario at Vesuvius. PMID:16537390

Worst case estimation of homology design by convex analysis

NASA Technical Reports Server (NTRS)

Yoshikawa, N.; Elishakoff, Isaac; Nakagiri, S.

1998-01-01

The methodology of homology design is investigated for optimum design of advanced structures. for which the achievement of delicate tasks by the aid of active control system is demanded. The proposed formulation of homology design, based on the finite element sensitivity analysis, necessarily requires the specification of external loadings. The formulation to evaluate the worst case for homology design caused by uncertain fluctuation of loadings is presented by means of the convex model of uncertainty, in which uncertainty variables are assigned to discretized nodal forces and are confined within a conceivable convex hull given as a hyperellipse. The worst case of the distortion from objective homologous deformation is estimated by the Lagrange multiplier method searching the point to maximize the error index on the boundary of the convex hull. The validity of the proposed method is demonstrated in a numerical example using the eleven-bar truss structure.

40 CFR 300.324 - Response to worst case discharges.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 28 2011-07-01 2011-07-01 false Response to worst case discharges. 300.324 Section 300.324 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS NATIONAL OIL AND HAZARDOUS SUBSTANCES POLLUTION...

40 CFR 300.324 - Response to worst case discharges.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 29 2012-07-01 2012-07-01 false Response to worst case discharges. 300.324 Section 300.324 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS NATIONAL OIL AND HAZARDOUS SUBSTANCES POLLUTION...

40 CFR 300.324 - Response to worst case discharges.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 29 2013-07-01 2013-07-01 false Response to worst case discharges. 300.324 Section 300.324 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS NATIONAL OIL AND HAZARDOUS SUBSTANCES POLLUTION...

40 CFR 300.324 - Response to worst case discharges.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 28 2014-07-01 2014-07-01 false Response to worst case discharges. 300.324 Section 300.324 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS NATIONAL OIL AND HAZARDOUS SUBSTANCES POLLUTION...

The Worst-Case Weighted Multi-Objective Game with an Application to Supply Chain Competitions.

PubMed

Qu, Shaojian; Ji, Ying

2016-01-01

In this paper, we propose a worst-case weighted approach to the multi-objective n-person non-zero sum game model where each player has more than one competing objective. Our "worst-case weighted multi-objective game" model supposes that each player has a set of weights to its objectives and wishes to minimize its maximum weighted sum objectives where the maximization is with respect to the set of weights. This new model gives rise to a new Pareto Nash equilibrium concept, which we call "robust-weighted Nash equilibrium". We prove that the robust-weighted Nash equilibria are guaranteed to exist even when the weight sets are unbounded. For the worst-case weighted multi-objective game with the weight sets of players all given as polytope, we show that a robust-weighted Nash equilibrium can be obtained by solving a mathematical program with equilibrium constraints (MPEC). For an application, we illustrate the usefulness of the worst-case weighted multi-objective game to a supply chain risk management problem under demand uncertainty. By the comparison with the existed weighted approach, we show that our method is more robust and can be more efficiently used for the real-world applications.

Estimation of human damage and economic loss of buildings for the worst-credible scenario of tsunami inundation in the city of Augusta, Italy

NASA Astrophysics Data System (ADS)

Pagnoni, Gianluca; Tinti, Stefano

2017-04-01

The city of Augusta is located in the southern part of the eastern coast of Sicily. Italian tsunami catalogue and paleo-tsunami surveys indicate that at least 7 events of tsunami affected the bay of Augusta in the last 4,000 years, two of which are associated with earthquakes (1169 and 1693) that destroyed the city. For these reasons Augusta has been chosen in the project ASTARTE as a test site for the study of issues related to tsunami hazard and risk. In last two years we studied hazard through the approach of the worst-case credible scenario and carried out vulnerability and damage analysis for buildings. In this work, we integrate that research, and estimate the damage to people and the economic loss of buildings due to structural damage. As regards inundation, we assume both uniform inundation levels (bath-tub hypothesis) and inundation data resulting from the worst-case scenario elaborated for the area by Armigliato et al. (2015). Human damage is calculated in three steps using the method introduced by Pagnoni et al. (2016) following the work by Terrier et al. (2012) and by Koshimura et al. (2009). First, we use census data to estimate the number of people present in each residential building affected by inundation; second, based on water column depth and building type, we evaluate the level of damage to people; third, we provide an estimate of fatalities. The economic loss is computed for two types of buildings (residential and trade-industrial) by using data on inundation and data from the real estate market. This study was funded by the EU Project ASTARTE - "Assessment, STrategy And Risk Reduction for Tsunamis in Europe", Grant 603839, 7th FP (ENV.2013.6.4-3)

30 CFR 553.14 - How do I determine the worst case oil-spill discharge volume?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 2 2012-07-01 2012-07-01 false How do I determine the worst case oil-spill... THE INTERIOR OFFSHORE OIL SPILL FINANCIAL RESPONSIBILITY FOR OFFSHORE FACILITIES Applicability and Amount of OSFR § 553.14 How do I determine the worst case oil-spill discharge volume? (a) To calculate...

30 CFR 253.14 - How do I determine the worst case oil-spill discharge volume?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How do I determine the worst case oil-spill... INTERIOR OFFSHORE OIL SPILL FINANCIAL RESPONSIBILITY FOR OFFSHORE FACILITIES Applicability and Amount of OSFR § 253.14 How do I determine the worst case oil-spill discharge volume? (a) To calculate the amount...

30 CFR 553.14 - How do I determine the worst case oil-spill discharge volume?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 2 2013-07-01 2013-07-01 false How do I determine the worst case oil-spill... THE INTERIOR OFFSHORE OIL SPILL FINANCIAL RESPONSIBILITY FOR OFFSHORE FACILITIES Applicability and Amount of OSFR § 553.14 How do I determine the worst case oil-spill discharge volume? (a) To calculate...

30 CFR 553.14 - How do I determine the worst case oil-spill discharge volume?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 2 2014-07-01 2014-07-01 false How do I determine the worst case oil-spill... THE INTERIOR OFFSHORE OIL SPILL FINANCIAL RESPONSIBILITY FOR OFFSHORE FACILITIES Applicability and Amount of OSFR § 553.14 How do I determine the worst case oil-spill discharge volume? (a) To calculate...

30 CFR 253.14 - How do I determine the worst case oil-spill discharge volume?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 2 2011-07-01 2011-07-01 false How do I determine the worst case oil-spill... ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL SPILL FINANCIAL RESPONSIBILITY FOR OFFSHORE FACILITIES Applicability and Amount of OSFR § 253.14 How do I determine the worst case oil-spill discharge volume? (a) To...

Sensitivity of worst-case strom surge considering influence of climate change

NASA Astrophysics Data System (ADS)

Takayabu, Izuru; Hibino, Kenshi; Sasaki, Hidetaka; Shiogama, Hideo; Mori, Nobuhito; Shibutani, Yoko; Takemi, Tetsuya

2016-04-01

There are two standpoints when assessing risk caused by climate change. One is how to prevent disaster. For this purpose, we get probabilistic information of meteorological elements, from enough number of ensemble simulations. Another one is to consider disaster mitigation. For this purpose, we have to use very high resolution sophisticated model to represent a worst case event in detail. If we could use enough computer resources to drive many ensemble runs with very high resolution model, we can handle these all themes in one time. However resources are unfortunately limited in most cases, and we have to select the resolution or the number of simulations if we design the experiment. Applying PGWD (Pseudo Global Warming Downscaling) method is one solution to analyze a worst case event in detail. Here we introduce an example to find climate change influence on the worst case storm-surge, by applying PGWD to a super typhoon Haiyan (Takayabu et al, 2015). 1 km grid WRF model could represent both the intensity and structure of a super typhoon. By adopting PGWD method, we can only estimate the influence of climate change on the development process of the Typhoon. Instead, the changes in genesis could not be estimated. Finally, we drove SU-WAT model (which includes shallow water equation model) to get the signal of storm surge height. The result indicates that the height of the storm surge increased up to 20% owing to these 150 years climate change.

The worst case scenario: Locomotor and collision demands of the longest periods of gameplay in professional rugby union.

PubMed

Reardon, Cillian; Tobin, Daniel P; Tierney, Peter; Delahunt, Eamonn

2017-01-01

A number of studies have used global positioning systems (GPS) to report on positional differences in the physical game demands of rugby union both on an average and singular bout basis. However, the ability of these studies to report quantitative data is limited by a lack of validation of certain aspects of measurement by GPS micro-technology. Furthermore no study has analyzed the positional physical demands of the longest bouts of ball-in-play time in rugby union. The aim of the present study is to compare the demands of the single longest period of ball-in-play, termed "worst case scenario" (WCS) between positional groups, which have previously been reported to have distinguishable game demands. The results of this study indicate that WCS periods follow a similar sporadic pattern as average demands but are played at a far higher pace than previously reported for average game demands with average meters per minute of 116.8 m. The positional differences in running and collision activity previously reported are perpetuated within WCS periods. Backs covered greater total distances than forwards (318 m vs 289 m), carried out more high-speed running (11.1 m·min-1 vs 5.5 m·min-1) and achieved higher maximum velocities (MaxVel). Outside Backs achieved the highest MaxVel values (6.84 m·sec-1). Tight Five and Back Row forwards underwent significantly more collisions than Inside Back and Outside Backs (0.73 & 0.89 collisions·min-1 vs 0.28 & 0.41 collisions·min-1 respectively). The results of the present study provide information on the positional physical requirements of performance in prolonged periods involving multiple high intensity bursts of effort. Although the current state of GPS micro-technology as a measurement tool does not permit reporting of collision intensity or acceleration data, the combined use of video and GPS provides valuable information to the practitioner. This can be used to match and replicate game demands in training.

The Worst-Case Weighted Multi-Objective Game with an Application to Supply Chain Competitions

PubMed Central

Qu, Shaojian; Ji, Ying

2016-01-01

In this paper, we propose a worst-case weighted approach to the multi-objective n-person non-zero sum game model where each player has more than one competing objective. Our “worst-case weighted multi-objective game” model supposes that each player has a set of weights to its objectives and wishes to minimize its maximum weighted sum objectives where the maximization is with respect to the set of weights. This new model gives rise to a new Pareto Nash equilibrium concept, which we call “robust-weighted Nash equilibrium”. We prove that the robust-weighted Nash equilibria are guaranteed to exist even when the weight sets are unbounded. For the worst-case weighted multi-objective game with the weight sets of players all given as polytope, we show that a robust-weighted Nash equilibrium can be obtained by solving a mathematical program with equilibrium constraints (MPEC). For an application, we illustrate the usefulness of the worst-case weighted multi-objective game to a supply chain risk management problem under demand uncertainty. By the comparison with the existed weighted approach, we show that our method is more robust and can be more efficiently used for the real-world applications. PMID:26820512

Comparison of linear and nonlinear programming approaches for "worst case dose" and "minmax" robust optimization of intensity-modulated proton therapy dose distributions.

PubMed

Zaghian, Maryam; Cao, Wenhua; Liu, Wei; Kardar, Laleh; Randeniya, Sharmalee; Mohan, Radhe; Lim, Gino

2017-03-01

Robust optimization of intensity-modulated proton therapy (IMPT) takes uncertainties into account during spot weight optimization and leads to dose distributions that are resilient to uncertainties. Previous studies demonstrated benefits of linear programming (LP) for IMPT in terms of delivery efficiency by considerably reducing the number of spots required for the same quality of plans. However, a reduction in the number of spots may lead to loss of robustness. The purpose of this study was to evaluate and compare the performance in terms of plan quality and robustness of two robust optimization approaches using LP and nonlinear programming (NLP) models. The so-called "worst case dose" and "minmax" robust optimization approaches and conventional planning target volume (PTV)-based optimization approach were applied to designing IMPT plans for five patients: two with prostate cancer, one with skull-based cancer, and two with head and neck cancer. For each approach, both LP and NLP models were used. Thus, for each case, six sets of IMPT plans were generated and assessed: LP-PTV-based, NLP-PTV-based, LP-worst case dose, NLP-worst case dose, LP-minmax, and NLP-minmax. The four robust optimization methods behaved differently from patient to patient, and no method emerged as superior to the others in terms of nominal plan quality and robustness against uncertainties. The plans generated using LP-based robust optimization were more robust regarding patient setup and range uncertainties than were those generated using NLP-based robust optimization for the prostate cancer patients. However, the robustness of plans generated using NLP-based methods was superior for the skull-based and head and neck cancer patients. Overall, LP-based methods were suitable for the less challenging cancer cases in which all uncertainty scenarios were able to satisfy tight dose constraints, while NLP performed better in more difficult cases in which most uncertainty scenarios were hard to meet

Preliminary Analysis of Aircraft Loss of Control Accidents: Worst Case Precursor Combinations and Temporal Sequencing

NASA Technical Reports Server (NTRS)

Belcastro, Christine M.; Groff, Loren; Newman, Richard L.; Foster, John V.; Crider, Dennis H.; Klyde, David H.; Huston, A. McCall

2014-01-01

Aircraft loss of control (LOC) is a leading cause of fatal accidents across all transport airplane and operational classes, and can result from a wide spectrum of hazards, often occurring in combination. Technologies developed for LOC prevention and recovery must therefore be effective under a wide variety of conditions and uncertainties, including multiple hazards, and their validation must provide a means of assessing system effectiveness and coverage of these hazards. This requires the definition of a comprehensive set of LOC test scenarios based on accident and incident data as well as future risks. This paper defines a comprehensive set of accidents and incidents over a recent 15 year period, and presents preliminary analysis results to identify worst-case combinations of causal and contributing factors (i.e., accident precursors) and how they sequence in time. Such analyses can provide insight in developing effective solutions for LOC, and form the basis for developing test scenarios that can be used in evaluating them. Preliminary findings based on the results of this paper indicate that system failures or malfunctions, crew actions or inactions, vehicle impairment conditions, and vehicle upsets contributed the most to accidents and fatalities, followed by inclement weather or atmospheric disturbances and poor visibility. Follow-on research will include finalizing the analysis through a team consensus process, defining future risks, and developing a comprehensive set of test scenarios with correlation to the accidents, incidents, and future risks. Since enhanced engineering simulations are required for batch and piloted evaluations under realistic LOC precursor conditions, these test scenarios can also serve as a high-level requirement for defining the engineering simulation enhancements needed for generating them.

Scalene Myofascial Pain Syndrome Mimicking Cervical Disc Prolapse: A Report of Two Cases

PubMed Central

Abd Jalil, Nizar; Awang, Mohammad Saufi; Omar, Mahamarowi

2010-01-01

Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over the neck area and radiates down to the arm. This condition may present as primary or secondary to underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial pain syndrome mimics cervical radiculopathy, this condition often leads to mismanagement, which can, in turn, result in persistent pain and suffering. In the worst-case scenarios, patients may be subjected to unjustifiable surgical intervention. Because the clinical findings in scalene myofascial pain syndrome are “pathognomonic”, clinicians should be aware of ways to recognize this disorder and be able to differentiate it from other conditions that present with neck pain and rediculopathy. We present two cases of unilateral scalene myofascial pain syndrome that significantly impaired the patients’ functioning and quality of life. This case report serves to create awareness about the existence of the syndrome and to highlight the potential morbidity due to clinical misdiagnosis. PMID:22135529

Addison's Disease Mimicking as Acute Pancreatitis: A Case Report.

PubMed

Chaudhuri, Sayani; Rao, Karthik N; Patil, Navin; Ommurugan, Balaji; Varghese, George

2017-04-01

Over past two decades there has been significant improvement in medical field in elucidating the underlying pathophysiology and genetics of Addison's disease. Adrenal insufficiency (Addison's disease) is a rare disease with an incidence of 0.8/100,000 cases. The diagnosis may be delayed if the clinical presentation mimics a gastrointestinal disorder or psychiatric illness. We report a case of Addison's disease presenting as acute pain in abdomen mimicking clinical presentation of acute pancreatitis.

Conceptual modeling for identification of worst case conditions in environmental risk assessment of nanomaterials using nZVI and C60 as case studies.

PubMed

Grieger, Khara D; Hansen, Steffen F; Sørensen, Peter B; Baun, Anders

2011-09-01

Conducting environmental risk assessment of engineered nanomaterials has been an extremely challenging endeavor thus far. Moreover, recent findings from the nano-risk scientific community indicate that it is unlikely that many of these challenges will be easily resolved in the near future, especially given the vast variety and complexity of nanomaterials and their applications. As an approach to help optimize environmental risk assessments of nanomaterials, we apply the Worst-Case Definition (WCD) model to identify best estimates for worst-case conditions of environmental risks of two case studies which use engineered nanoparticles, namely nZVI in soil and groundwater remediation and C(60) in an engine oil lubricant. Results generated from this analysis may ultimately help prioritize research areas for environmental risk assessments of nZVI and C(60) in these applications as well as demonstrate the use of worst-case conditions to optimize future research efforts for other nanomaterials. Through the application of the WCD model, we find that the most probable worst-case conditions for both case studies include i) active uptake mechanisms, ii) accumulation in organisms, iii) ecotoxicological response mechanisms such as reactive oxygen species (ROS) production and cell membrane damage or disruption, iv) surface properties of nZVI and C(60), and v) acute exposure tolerance of organisms. Additional estimates of worst-case conditions for C(60) also include the physical location of C(60) in the environment from surface run-off, cellular exposure routes for heterotrophic organisms, and the presence of light to amplify adverse effects. Based on results of this analysis, we recommend the prioritization of research for the selected applications within the following areas: organism active uptake ability of nZVI and C(60) and ecotoxicological response end-points and response mechanisms including ROS production and cell membrane damage, full nanomaterial characterization taking

Ileal Entrapment within a Paracaecal Hernia Mimicking Acute Appendicitis

PubMed Central

Birchley, David

2009-01-01

Presented is a case of incarcerated paracaecal hernia mimicking acute appendicitis. The clinical scenario highlights the need for a high index of suspicion in the management of patients with localised peritonism even in the absence of obstructive symptoms and the presence of normal laboratory markers of inflammation.Whilst computed tomography might offer a pre-operative diagnosis, in such a low-risk patient laparoscopy offers the combined advantages of immediate diagnosis and definitive treatment of acute pathology. PMID:19317924

Tension pneumocephalus mimicking septic shock: a case report.

PubMed

Miranda, Caroline; Mahta, Ali; Wheeler, Lee Adam; Tsiouris, A John; Kamel, Hooman

2018-02-01

Tension pneumocephalus can lead to rapid neurologic deterioration. We report for the first time its association with aseptic systemic inflammatory response syndrome mimicking septic shock and the efficacy of prompt neurosurgical intervention and critical care support in treating this condition. A 64-year-old man underwent 2-stage olfactory groove meningioma resection. The patient developed altered mental status and gait instability on postoperative day 6. Imaging showed significant pneumocephalus. The patient subsequently developed worsening mental status, respiratory failure, and profound shock requiring multiple vasopressors. Bedside needle decompression, identification and repair of the cranial fossa defect, and critical care support led to improved mental status and reversal of shock and multiorgan dysfunction. Thorough evaluation revealed no evidence of an underlying infection. In this case, tension pneumocephalus incited an aseptic systemic inflammatory response syndrome mimicking septic shock. Prompt neurosurgical correction of pneumocephalus and critical care support not only improved neurologic status, but also reversed shock. Such a complication indicates the importance of close monitoring of patients with progressive pneumocephalus.

The Undergraduate Curriculum: The Best and the Worst.

ERIC Educational Resources Information Center

Woloshin, David J.

1983-01-01

Reviews various aspects of the undergraduate foreign language curriculum over the past decade and identifies the strengths and weaknesses of that curriculum. Outlines the best and worst scenarios which could occur during the next 10 years and suggests means which can assure that undergraduate foreign language education will meet future needs. (EKN)

A case of imported tungiasis in Scotland initially mimicking verrucae vulgaris.

PubMed

Wardhaugh, A D; Norris, J F

1994-10-01

A case is described of Tunga penetrans infection in the feet of a tourist returning from South America to Scotland. The condition had initially mimicked verrucae vulgaris, but microscopic examination of the lesions together with the travel history allowed the diagnosis of tungiasis to be made. This is the first case reported in Scotland.

Worst-case space radiation environments for geocentric missions

NASA Technical Reports Server (NTRS)

Stassinopoulos, E. G.; Seltzer, S. M.

1976-01-01

Worst-case possible annual radiation fluences of energetic charged particles in the terrestrial space environment, and the resultant depth-dose distributions in aluminum, were calculated in order to establish absolute upper limits to the radiation exposure of spacecraft in geocentric orbits. The results are a concise set of data intended to aid in the determination of the feasibility of a particular mission. The data may further serve as guidelines in the evaluation of standard spacecraft components. Calculations were performed for each significant particle species populating or visiting the magnetosphere, on the basis of volume occupied by or accessible to the respective species. Thus, magnetospheric space was divided into five distinct regions using the magnetic shell parameter L, which gives the approximate geocentric distance (in earth radii) of a field line's equatorial intersect.

Dedifferentiated Liposarcoma Mimicking a Primary Colon Mass.

PubMed

Hollowoa, Blake; Lamps, Laura W; Mizell, Jason S; English, George W; Bridge, Julia A; Ram, Roopa; Gardner, Jerad M

2018-04-01

Dedifferentiated liposarcoma is typically a nonlipogenic high-grade sarcoma that arises from well-differentiated liposarcoma. It most commonly presents as a large mass in the retroperitoneum. Significant involvement of the gastrointestinal tract by dedifferentiated liposarcoma is uncommon. We present a unique case of dedifferentiated liposarcoma radiographically mimicking a primary colon mass with resulting intussusception; stranding of the adjacent adipose tissue was presumed to be a secondary reactive change. On histopathologic analysis of the hemicolectomy specimen, a high-grade sarcoma was seen growing through the colonic wall, and the majority of the surrounding pericolonic adipose tissue was actually composed of well-differentiated liposarcoma with characteristic fibrous bands rather than benign fat with reactive fibrosis. This case raises awareness that well-differentiated liposarcoma and dedifferentiated liposarcoma can rarely present as a primary intestinal mass mimicking colon cancer or other more common entities. When radiographic examination shows a perigastrointestinal or retroperitoneal fatty mass and/or stranding of the fat adjacent to a solid gastrointestinal mass, this unusual scenario should be considered in the radiologic differential diagnosis. Pathologists should keep dedifferentiated liposarcoma in the initial histologic differential diagnosis for any high-grade spindle cell tumor of the retroperitoneum or intra-abdominal visceral organs.

A rare case of primary bone lymphoma mimicking a pelvic abscess

PubMed Central

Al Wattar, BH; Mohanty, K

2011-01-01

Primary bone lymphoma (PBL) is a rare, malignant, neoplastic disorder of the skeleton that accounts for less than 5% of all primary bone tumours. We present an extremely rare case of PBL mimicking a pelvic abscess around the sacroiliac joint, which has never been reported in the medical literature, and discuss learning points highlighted from this case. PMID:22004625

Optimal Analyses for 3×n AB Games in the Worst Case

NASA Astrophysics Data System (ADS)

Huang, Li-Te; Lin, Shun-Shii

The past decades have witnessed a growing interest in research on deductive games such as Mastermind and AB game. Because of the complicated behavior of deductive games, tree-search approaches are often adopted to find their optimal strategies. In this paper, a generalized version of deductive games, called 3×n AB games, is introduced. However, traditional tree-search approaches are not appropriate for solving this problem since it can only solve instances with smaller n. For larger values of n, a systematic approach is necessary. Therefore, intensive analyses of playing 3×n AB games in the worst case optimally are conducted and a sophisticated method, called structural reduction, which aims at explaining the worst situation in this game is developed in the study. Furthermore, a worthwhile formula for calculating the optimal numbers of guesses required for arbitrary values of n is derived and proven to be final.

A Worst-Case Approach for On-Line Flutter Prediction

NASA Technical Reports Server (NTRS)

Lind, Rick C.; Brenner, Martin J.

1998-01-01

Worst-case flutter margins may be computed for a linear model with respect to a set of uncertainty operators using the structured singular value. This paper considers an on-line implementation to compute these robust margins in a flight test program. Uncertainty descriptions are updated at test points to account for unmodeled time-varying dynamics of the airplane by ensuring the robust model is not invalidated by measured flight data. Robust margins computed with respect to this uncertainty remain conservative to the changing dynamics throughout the flight. A simulation clearly demonstrates this method can improve the efficiency of flight testing by accurately predicting the flutter margin to improve safety while reducing the necessary flight time.

Discussions On Worst-Case Test Condition For Single Event Burnout

NASA Astrophysics Data System (ADS)

Liu, Sandra; Zafrani, Max; Sherman, Phillip

2011-10-01

This paper discusses the failure characteristics of single- event burnout (SEB) on power MOSFETs based on analyzing the quasi-stationary avalanche simulation curves. The analyses show the worst-case test condition for SEB would be using the ion that has the highest mass that would result in the highest transient current due to charge deposition and displacement damage. The analyses also show it is possible to build power MOSFETs that will not exhibit SEB even when tested with the heaviest ion, which have been verified by heavy ion test data on SEB sensitive and SEB immune devices.

Addison’s Disease Mimicking as Acute Pancreatitis: A Case Report

PubMed Central

Chaudhuri, Sayani; Rao, Karthik N; Ommurugan, Balaji; Varghese, George

2017-01-01

Over past two decades there has been significant improvement in medical field in elucidating the underlying pathophysiology and genetics of Addison’s disease. Adrenal insufficiency (Addison’s disease) is a rare disease with an incidence of 0.8/100,000 cases. The diagnosis may be delayed if the clinical presentation mimics a gastrointestinal disorder or psychiatric illness. We report a case of Addison’s disease presenting as acute pain in abdomen mimicking clinical presentation of acute pancreatitis. PMID:28571196

Phylogenetic diversity, functional trait diversity and extinction: avoiding tipping points and worst-case losses.

PubMed

Faith, Daniel P

2015-02-19

The phylogenetic diversity measure, ('PD'), measures the relative feature diversity of different subsets of taxa from a phylogeny. At the level of feature diversity, PD supports the broad goal of biodiversity conservation to maintain living variation and option values. PD calculations at the level of lineages and features include those integrating probabilities of extinction, providing estimates of expected PD. This approach has known advantages over the evolutionarily distinct and globally endangered (EDGE) methods. Expected PD methods also have limitations. An alternative notion of expected diversity, expected functional trait diversity, relies on an alternative non-phylogenetic model and allows inferences of diversity at the level of functional traits. Expected PD also faces challenges in helping to address phylogenetic tipping points and worst-case PD losses. Expected PD may not choose conservation options that best avoid worst-case losses of long branches from the tree of life. We can expand the range of useful calculations based on expected PD, including methods for identifying phylogenetic key biodiversity areas. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Phylogenetic diversity, functional trait diversity and extinction: avoiding tipping points and worst-case losses

PubMed Central

Faith, Daniel P.

2015-01-01

The phylogenetic diversity measure, (‘PD’), measures the relative feature diversity of different subsets of taxa from a phylogeny. At the level of feature diversity, PD supports the broad goal of biodiversity conservation to maintain living variation and option values. PD calculations at the level of lineages and features include those integrating probabilities of extinction, providing estimates of expected PD. This approach has known advantages over the evolutionarily distinct and globally endangered (EDGE) methods. Expected PD methods also have limitations. An alternative notion of expected diversity, expected functional trait diversity, relies on an alternative non-phylogenetic model and allows inferences of diversity at the level of functional traits. Expected PD also faces challenges in helping to address phylogenetic tipping points and worst-case PD losses. Expected PD may not choose conservation options that best avoid worst-case losses of long branches from the tree of life. We can expand the range of useful calculations based on expected PD, including methods for identifying phylogenetic key biodiversity areas. PMID:25561672

Case report: vertebral foreign body granuloma mimicking a skeletal metastasis.

PubMed

Vossen, Josephina A; Bathaii, Seyed M; Hatfield, Bryce; Hayes, Curtis W

2018-06-01

Intraosseous foreign body granuloma formation related to migrated surgical material is a rarely reported condition with variable imaging appearance. In this case report, we describe a foreign body granuloma that occurred in a lumbar vertebral body one level above a prior surgical fusion. The lytic appearance mimicked a skeletal metastasis in a 65-year-old patient with recently diagnosed renal cell carcinoma. To the best of our knowledge, this is the first reported case of a lumbar vertebral foreign body granuloma occurring distant from the site of surgery, indistinguishable from skeletal metastasis on radiologic examination.

40 CFR Appendix D to Part 112 - Determination of a Worst Case Discharge Planning Volume

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 23 2013-07-01 2013-07-01 false Determination of a Worst Case Discharge Planning Volume D Appendix D to Part 112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Pt. 112, App. D Appendix D to Part 112—Determination of a...

40 CFR Appendix D to Part 112 - Determination of a Worst Case Discharge Planning Volume

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Determination of a Worst Case Discharge Planning Volume D Appendix D to Part 112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Pt. 112, App. D Appendix D to Part 112—Determination of a...

40 CFR Appendix D to Part 112 - Determination of a Worst Case Discharge Planning Volume

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 22 2014-07-01 2013-07-01 true Determination of a Worst Case Discharge Planning Volume D Appendix D to Part 112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Pt. 112, App. D Appendix D to Part 112—Determination of a...

40 CFR Appendix D to Part 112 - Determination of a Worst Case Discharge Planning Volume

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Determination of a Worst Case Discharge Planning Volume D Appendix D to Part 112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Pt. 112, App. D Appendix D to Part 112—Determination of a...

40 CFR Appendix D to Part 112 - Determination of a Worst Case Discharge Planning Volume

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Determination of a Worst Case Discharge Planning Volume D Appendix D to Part 112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL POLLUTION PREVENTION Pt. 112, App. D Appendix D to Part 112—Determination of a...

Scenario planning.

PubMed

Enzmann, Dieter R; Beauchamp, Norman J; Norbash, Alexander

2011-03-01

In facing future developments in health care, scenario planning offers a complementary approach to traditional strategic planning. Whereas traditional strategic planning typically consists of predicting the future at a single point on a chosen time horizon and mapping the preferred plans to address such a future, scenario planning creates stories about multiple likely potential futures on a given time horizon and maps the preferred plans to address the multiple described potential futures. Each scenario is purposefully different and specifically not a consensus worst-case, average, or best-case forecast; nor is scenario planning a process in probabilistic prediction. Scenario planning focuses on high-impact, uncertain driving forces that in the authors' example affect the field of radiology. Uncertainty is the key concept as these forces are mapped onto axes of uncertainty, the poles of which have opposed effects on radiology. One chosen axis was "market focus," with poles of centralized health care (government control) vs a decentralized private market. Another axis was "radiology's business model," with one pole being a unified, single specialty vs a splintered, disaggregated subspecialty. The third axis was "technology and science," with one pole representing technology enabling to radiology vs technology threatening to radiology. Selected poles of these axes were then combined to create 3 scenarios. One scenario, termed "entrepreneurialism," consisted of a decentralized private market, a disaggregated business model, and threatening technology and science. A second scenario, termed "socialized medicine," had a centralized market focus, a unified specialty business model, and enabling technology and science. A third scenario, termed "freefall," had a centralized market focus, a disaggregated business model, and threatening technology and science. These scenarios provide a range of futures that ultimately allow the identification of defined "signposts" that can

Space Environment Effects: Model for Emission of Solar Protons (ESP): Cumulative and Worst Case Event Fluences

NASA Technical Reports Server (NTRS)

Xapsos, M. A.; Barth, J. L.; Stassinopoulos, E. G.; Burke, E. A.; Gee, G. B.

1999-01-01

The effects that solar proton events have on microelectronics and solar arrays are important considerations for spacecraft in geostationary and polar orbits and for interplanetary missions. Designers of spacecraft and mission planners are required to assess the performance of microelectronic systems under a variety of conditions. A number of useful approaches exist for predicting information about solar proton event fluences and, to a lesser extent, peak fluxes. This includes the cumulative fluence over the course of a mission, the fluence of a worst-case event during a mission, the frequency distribution of event fluences, and the frequency distribution of large peak fluxes. Naval Research Laboratory (NRL) and NASA Goddard Space Flight Center, under the sponsorship of NASA's Space Environments and Effects (SEE) Program, have developed a new model for predicting cumulative solar proton fluences and worst-case solar proton events as functions of mission duration and user confidence level. This model is called the Emission of Solar Protons (ESP) model.

Space Environment Effects: Model for Emission of Solar Protons (ESP)--Cumulative and Worst-Case Event Fluences

NASA Technical Reports Server (NTRS)

Xapsos, M. A.; Barth, J. L.; Stassinopoulos, E. G.; Burke, Edward A.; Gee, G. B.

1999-01-01

The effects that solar proton events have on microelectronics and solar arrays are important considerations for spacecraft in geostationary and polar orbits and for interplanetary missions. Designers of spacecraft and mission planners are required to assess the performance of microelectronic systems under a variety of conditions. A number of useful approaches exist for predicting information about solar proton event fluences and, to a lesser extent, peak fluxes. This includes the cumulative fluence over the course of a mission, the fluence of a worst-case event during a mission, the frequency distribution of event fluences, and the frequency distribution of large peak fluxes. Naval Research Laboratory (NRL) and NASA Goddard Space Flight Center, under the sponsorship of NASA's Space Environments and Effects (SEE) Program, have developed a new model for predicting cumulative solar proton fluences and worst-case solar proton events as functions of mission duration and user confidence level. This model is called the Emission of Solar Protons (ESP) model.

Visceral leishmaniasis mimicking systemic lupus erythematosus: Case series and a systematic literature review.

PubMed

Santana, Iuri Usêda; Dias, Blenda; Nunes, Eduardo Araújo Santana; Rocha, Francisco Airton Castro da; Silva, Francisco Saraiva; Santiago, Mittermayer Barreto

2015-06-01

Systemic lupus erythematosus (SLE) is an autoimmune disease that may present manifestations that resemble other diseases. Visceral leishmaniasis (VL) is a parasitic infection whose hallmarks may mimic SLE symptoms. Here, we report a case series and evaluate the published, scientific evidence of the relationship between SLE and VL infection. To assess original studies reporting cases of VL-infected patients presenting manifestations that are capable of leading to inappropriate suspicions of SLE or mimicking an SLE flare, we performed an extensive search in several scientific databases (MEDLINE, LILACS, SciELO, and Scopus). Two authors independently screened all citations and abstracts identified by the search strategy to identify eligible studies. Secondary references were additionally obtained from the selected articles. The literature search identified 53 eligible studies, but only 17 articles met our criteria. Among these, 10 lupus patients with VL mimicking an SLE flare and 18 cases of VL leading to unappropriated suspicions of SLE were described. The most common manifestations in patients infected with VL were intermittent fever, pancytopenia, visceromegaly, and increased serum level of acute phase reactants. The most frequent autoantibodies were antinuclear antibodies, rheumatoid factor, and direct Coombs' test. In endemic areas for VL, the diagnosis of SLE or its exacerbation may be a clinical dilemma. Hepatosplenomegaly or isolated splenomegaly was identified in the majority of the reported cases where VL occurred, leading to unappropriated suspicions of SLE or mimicking an SLE flare. Furthermore, the lack of response to steroids, the normal levels of complement proteins C3 and C4, and the increased level of transaminases suggest a possible infectious origin. Copyright © 2015 Elsevier Inc. All rights reserved.

Fibromatosis of the breast mimicking an abscess: case report of unusual sonographic features.

PubMed

Lee, So Min; Lee, Ji Young; Lee, Byung Hoon; Kim, Su Young; Joo, Mee; Kim, Jae Il

2015-01-01

Fibromatosis of the breast, also known as a desmoid tumor, is extremely rare and most often appears as an aggressive lesion mimicking breast carcinoma. It lacks metastatic potential but can grow aggressively in a localized area. Ultrasonography often shows an irregular spiculated hypoechoic mass with posterior acoustic shadowing. We discuss a case of breast fibromatosis that presented as a painful palpable breast mass in a 32-year-old woman and mimicked an abscess in the sonogram. We found that this lesion displayed atypical sonographic features such as a heterogeneous echoic mass with an internal anechoic area. Copyright © 2015 Elsevier Inc. All rights reserved.

Worst-Case Energy Efficiency Maximization in a 5G Massive MIMO-NOMA System.

PubMed

Chinnadurai, Sunil; Selvaprabhu, Poongundran; Jeong, Yongchae; Jiang, Xueqin; Lee, Moon Ho

2017-09-18

In this paper, we examine the robust beamforming design to tackle the energy efficiency (EE) maximization problem in a 5G massive multiple-input multiple-output (MIMO)-non-orthogonal multiple access (NOMA) downlink system with imperfect channel state information (CSI) at the base station. A novel joint user pairing and dynamic power allocation (JUPDPA) algorithm is proposed to minimize the inter user interference and also to enhance the fairness between the users. This work assumes imperfect CSI by adding uncertainties to channel matrices with worst-case model, i.e., ellipsoidal uncertainty model (EUM). A fractional non-convex optimization problem is formulated to maximize the EE subject to the transmit power constraints and the minimum rate requirement for the cell edge user. The designed problem is difficult to solve due to its nonlinear fractional objective function. We firstly employ the properties of fractional programming to transform the non-convex problem into its equivalent parametric form. Then, an efficient iterative algorithm is proposed established on the constrained concave-convex procedure (CCCP) that solves and achieves convergence to a stationary point of the above problem. Finally, Dinkelbach's algorithm is employed to determine the maximum energy efficiency. Comprehensive numerical results illustrate that the proposed scheme attains higher worst-case energy efficiency as compared with the existing NOMA schemes and the conventional orthogonal multiple access (OMA) scheme.

Worst-Case Energy Efficiency Maximization in a 5G Massive MIMO-NOMA System

PubMed Central

Jeong, Yongchae; Jiang, Xueqin; Lee, Moon Ho

2017-01-01

In this paper, we examine the robust beamforming design to tackle the energy efficiency (EE) maximization problem in a 5G massive multiple-input multiple-output (MIMO)-non-orthogonal multiple access (NOMA) downlink system with imperfect channel state information (CSI) at the base station. A novel joint user pairing and dynamic power allocation (JUPDPA) algorithm is proposed to minimize the inter user interference and also to enhance the fairness between the users. This work assumes imperfect CSI by adding uncertainties to channel matrices with worst-case model, i.e., ellipsoidal uncertainty model (EUM). A fractional non-convex optimization problem is formulated to maximize the EE subject to the transmit power constraints and the minimum rate requirement for the cell edge user. The designed problem is difficult to solve due to its nonlinear fractional objective function. We firstly employ the properties of fractional programming to transform the non-convex problem into its equivalent parametric form. Then, an efficient iterative algorithm is proposed established on the constrained concave-convex procedure (CCCP) that solves and achieves convergence to a stationary point of the above problem. Finally, Dinkelbach’s algorithm is employed to determine the maximum energy efficiency. Comprehensive numerical results illustrate that the proposed scheme attains higher worst-case energy efficiency as compared with the existing NOMA schemes and the conventional orthogonal multiple access (OMA) scheme. PMID:28927019

Dental technician pneumoconiosis mimicking pulmonary tuberculosis: a case report.

PubMed

Tan, Han Loong; Faisal, Mohamed; Soo, Chun Ian; Ban, Andrea Y L; Manap, Roslina Abdul; Hassan, Tidi M

2016-09-07

Dental laboratory technicians are at risk of developing occupational respiratory diseases due to exposure to various potentially toxic substances in their working environment. Since 1939, few cases of silicosis among dental technician have been reported. We illustrate a 38 year-old female, who worked in a dental laboratory for 20 years, initially treated as pulmonary tuberculosis and chronic necrotising aspergillosis without much improvement. Computed tomography guided lung biopsy and bronchoscopic transbronchial lung biopsy were performed. Lung tissue biopsies showed presence of refractile dental materials within the areas of histiocyte proliferation. The diagnosis of dental technician pneumoconiosis was obtained and our patient underwent pulmonary rehabilitation. This case highlights the importance of obtaining a detailed occupational history in tuberculosis endemic area, as pulmonary tuberculosis is a great mimicker of other respiratory diseases.

An unusual case of lumbar paravertebral miositis ossificans mimicking muscular skeletal tumor.

PubMed

Zoccali, C; Chichierchia, G; Covello, R

2013-12-01

Several lesions have clinical and radiological characteristics mimicking muscular skeletal tumor. Myositis ossificans usually presents a typical pattern making biopsy unnecessary; nevertheless, in rare cases, neoplasm must be ruled out. Biopsy is often sufficient to allow a diagnosis and a correct related treatment, but, unfortunately, sometimes it may lead to erroneous treatment. We report an unusual case of a lumbar paravertebral mass that had an MRI aspect similar to a chondrosarcoma, a histology pattern based on biopsy compatible with neurinoma and a definitive diagnosis of myosistis ossificans.

The worst case scenario: Locomotor and collision demands of the longest periods of gameplay in professional rugby union

PubMed Central

Reardon, Cillian; Tobin, Daniel P.; Tierney, Peter; Delahunt, Eamonn

2017-01-01

A number of studies have used global positioning systems (GPS) to report on positional differences in the physical game demands of rugby union both on an average and singular bout basis. However, the ability of these studies to report quantitative data is limited by a lack of validation of certain aspects of measurement by GPS micro-technology. Furthermore no study has analyzed the positional physical demands of the longest bouts of ball-in-play time in rugby union. The aim of the present study is to compare the demands of the single longest period of ball-in-play, termed “worst case scenario” (WCS) between positional groups, which have previously been reported to have distinguishable game demands. The results of this study indicate that WCS periods follow a similar sporadic pattern as average demands but are played at a far higher pace than previously reported for average game demands with average meters per minute of 116.8 m. The positional differences in running and collision activity previously reported are perpetuated within WCS periods. Backs covered greater total distances than forwards (318 m vs 289 m), carried out more high-speed running (11.1 m·min-1 vs 5.5 m·min-1) and achieved higher maximum velocities (MaxVel). Outside Backs achieved the highest MaxVel values (6.84 m·sec-1). Tight Five and Back Row forwards underwent significantly more collisions than Inside Back and Outside Backs (0.73 & 0.89 collisions·min-1 vs 0.28 & 0.41 collisions·min-1 respectively). The results of the present study provide information on the positional physical requirements of performance in prolonged periods involving multiple high intensity bursts of effort. Although the current state of GPS micro-technology as a measurement tool does not permit reporting of collision intensity or acceleration data, the combined use of video and GPS provides valuable information to the practitioner. This can be used to match and replicate game demands in training. PMID:28510582

Unusual Case of Overt Aortic Dissection Mimicking Aortic Intramural Hematoma

PubMed Central

Disha, Kushtrim; Kuntze, Thomas; Girdauskas, Evaldas

2016-01-01

We report an interesting case in which overt aortic dissection mimicked two episodes of aortic intramural hematoma (IMH) (Stanford A, DeBakey I). This took place over the course of four days and had a major influence on the surgical treatment strategy. The first episode of IMH regressed completely within 15 hours after it was clinically diagnosed and verified using imaging techniques. The recurrence of IMH was detected three days thereafter, resulting in an urgent surgical intervention. Overt aortic dissection with evidence of an intimal tear was diagnosed intraoperatively. PMID:27066437

Testicular Schistosomiasis Mimicking Malignancy in a Child: A Case Report.

PubMed

Ekenze, Sebastian O; Modekwe, Victor O; Nzegwu, Martin A; Ekpemo, Samuel C; Ezomike, Uchechukwu O

2015-08-01

Schistosomiasis is an important communicable disease in the developing world. However, testicular schistosomiasis is an extremely rare condition. We report a case of testicular schistosomiasis mimicking testicular tumour in a 13 year old who presented with huge unilateral testicular mass. The dilemma encountered in the diagnosis and treatment of this child is presented to highlight the need for high index of suspicion of this pathology in children with testicular mass presenting from schistosomiasis-endemic areas. © The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A rare case of unilateral discoid lupus erythematosus mimicking lupus vulgaris.

PubMed

Verma, Parul; Pathania, Sucheta; Kubba, Asha

2017-11-08

Discoidlupus erythematosus (DLE) is a chronic type of cutaneous lupus erythematosus which can present in various morphologies, and the diagnosis can be rather confounding. Prompt evaluation and treatment is necessary to prevent disfigurement and systemic involvement associated with DLE. The following case presented a diagnostic dilemma as the lesion mimicked lupus vulgaris. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Subcutaneous Emphysema Mimicking Gas Gangrene Following Perforation of the Rectum: A Case Report

PubMed Central

Moon, Eun-Sun; Jung, Sung-Taek; Seo, Hyoung-Yeon

2004-01-01

We report a case of extensive subcutaneous emphysema of the lower extremity mimicking gas gangrene following perforation of the rectum in a 38-yr-old man. Subcutaneous emphysema of the leg may rarely occur secondary to perforation of the gastrointestinal tract and has often created serious diagnostic problems and high mortality rates. Therefore, prompt diagnosis and aggressive treatment is imperative. PMID:15483358

A large epidermoid cyst of breast mimicking carcinoma: A case report and review of literature

PubMed Central

Debnath, Debasish; Taribagil, Savita; Al-Janabi, Khalid J.S.; Inwang, Reggie

2012-01-01

INTRODUCTION Triple assessment of a suspicious breast lesion may not always provide a definite diagnosis. We report a case of epidermoid cyst of breast, which caused diagnostic dilemma in spite of a thorough triple assessment and entailed mastectomy. PRESENTATION OF CASE A 69-year-old woman presented with a large painful retroareolar left breast mass. Clinical examination, ultrasound and mammography were highly suspicious of malignancy. However, core biopsy suggested a benign lesion. Due to size of the lesion and diagnostic uncertainty, various options were discussed with the patient. She opted for a simple mastectomy. The histology confirmed a large epidermoid cyst. DISCUSSION It is rare for an epidermoid cyst to present as such an advanced lesion, mimicking carcinoma. Excision of such a large retroareolar ‘benign’ lesion, however, may sometime entail mastectomy. This is the first reported case of an epidermoid cyst of breast necessitating mastectomy. CONCLUSION Diagnostic dilemma while dealing with a suspected breast cancer is not rare. Involvement of multidisciplinary team as well as patient is important in the decision-making. The report illustrates a rare presentation of a deep seated large epidermoid cyst of breast, which mimicked carcinoma, caused diagnostic confusion and entailed mastectomy. We strongly advocate the option of breast reconstruction in such cases. PMID:22705938

Clear cell carcinoma of the ovary mimicking struma ovarii and carcinoid tumor.

PubMed

Alduaij, Ahmad; Quddus, M Ruhul

2011-04-01

Clear cell carcinomas are considered as high-grade tumor often with poor prognosis. We describe 2 cases of clear cell carcinomas of the ovary mimicking benign or less aggressive tumors encountered in the female genital track. The first case is mimicking a benign monodermal teratoma, the so-called struma ovarii, and the second mimicking a carcinoid tumor. Copyright © 2011 Elsevier Inc. All rights reserved.

Housing for the "Worst of the Worst" Inmates: Public Support for Supermax Prisons

ERIC Educational Resources Information Center

Mears, Daniel P.; Mancini, Christina; Beaver, Kevin M.; Gertz, Marc

2013-01-01

Despite concerns whether supermaximum security prisons violate human rights or prove effective, these facilities have proliferated in America over the past 25 years. This punishment--aimed at the "worst of the worst" inmates and involving 23-hr-per-day single-cell confinement with few privileges or services--has emerged despite little…

Melorheostosis mimicking synovial osteochondromatosis.

PubMed

Wadhwa, Vibhor; Chhabra, Avneesh; Samet, Jonathan D

2014-01-01

Melorheostosis is an uncommon, sporadic, sclerosing bone lesion that may affect the adjacent soft tissues. It has been associated with many entities such as osteopoikilosis, soft tissue vascular malformations, bone and soft tissue tumors, nephrotic syndrome, segmental limb contractures, osteosarcoma, desmoid tumor, and mesenteric fibromatosis. Synovial osteochondromatosis is a benign neoplasia of the hyaline cartilage presenting as nodules in the subsynovial tissue of a joint or tendon sheath. The intra-articular extension of melorheostosis mimicking synovial osteochondromatosis has not been reported before. In this article, the authors describe an unusual case mimicking synovial chondromatosis arising as a result of melorheostosis and their characteristic imaging findings.

Modelling the long-term evolution of worst-case Arctic oil spills.

PubMed

Blanken, Hauke; Tremblay, Louis Bruno; Gaskin, Susan; Slavin, Alexander

2017-03-15

We present worst-case assessments of contamination in sea ice and surface waters resulting from hypothetical well blowout oil spills at ten sites in the Arctic Ocean basin. Spill extents are estimated by considering Eulerian passive tracers in the surface ocean of the MITgcm (a hydrostatic, coupled ice-ocean model). Oil in sea ice, and contamination resulting from melting of oiled ice, is tracked using an offline Lagrangian scheme. Spills are initialized on November 1st 1980-2010 and tracked for one year. An average spill was transported 1100km and potentially affected 1.1 million km 2 . The direction and magnitude of simulated oil trajectories are consistent with known large-scale current and sea ice circulation patterns, and trajectories frequently cross international boundaries. The simulated trajectories of oil in sea ice match observed ice drift trajectories well. During the winter oil transport by drifting sea ice is more significant than transport with surface currents. Copyright © 2017 Elsevier Ltd. All rights reserved.

Linear immunoglobulin A dermatosis mimicking toxic epidermal necrolysis: a case report of etanercept treatment.

PubMed

Prieto-Barrios, M; Velasco-Tamariz, V; Tous-Romero, F; Burillo-Martinez, S; Zarco-Olivo, C; Rodriguez-Peralto, J L; Ortiz-Romero, P L

2018-03-01

A 65-year-old pluripathological woman attended our hospital with a cutaneous eruption of sudden appearance after vancomycin treatment. She presented targetoid lesions affecting approximately 25-30% of her body surface, large erosions with mucosal lesions and positive Nikolsky sign. Under the initial clinical suspicion of toxic epidermal necrolysis (TEN), and considering the recent literature of successful use of etanercept in these cases, she was treated with a single dose of this antitumour necrosis factor (anti-TNF) agent. Subsequently, the exanthema progression stopped and resolution of the lesions happened in a few days. Later on, histopathology revealed a subepidermal blister with dense neutrophilic infiltrate and linear deposits of immunoglobulin A (IgA) on the dermoepidermal junction, allowing us to establish the diagnosis of drug-induced linear IgA dermatosis mimicking TEN. Linear IgA dermatosis can have severe clinical manifestations, even mimicking TEN, and can have high mortality, especially in drug-induced cases. We have not found any other report of linear IgA dermatosis treated with etanercept in the English literature. Anti-TNF medications could represent useful therapeutic alternatives in this dermatosis. © 2017 British Association of Dermatologists.

A case of a large Chiari network mimicking a right atrial thrombus.

PubMed

Erdogan, Sevinc Bayer; Akansel, Serdar; Sargın, Murat; Mete, Muge Evren Tasdemir; Arslanhan, Gokhan; Aka, Serap Aykut

2017-01-01

The Chiari network is described as a reticulated network of fibers connected to the Eustachian valve identified as the embryological remnant of the right valve of the sinus venosus. It is an incidental finding without any significant pathophysiological consequences. However, the presence of the Chiari network in the right atrium obliges the physician to differentiate from other right atrial pathologies. We present a case of a large Chiari network mimicking a right atrial thrombus with incidental finding in a 76-year-old man undergoing coronary artery bypass surgery.

Nasopalatine duct cyst mimicking an endodontic periapical lesion: a case report.

PubMed

Bains, Rhythm; Verma, Promila; Chandra, Anil; Tikku, A P; Singh, Nimisha

2016-01-01

Lesions of nonendodontic origin, such as nasopalatine or globulomaxillary cysts, may mimic periapical radiolucencies associated with pulpal pathosis, and incorrect diagnosis may lead to unnecessary endodontic treatment. Horizontal root fractures most commonly affect the maxillary central and lateral incisors. Prognosis depends largely on the level of fracture; fractures in the apical third have the best prognosis, and those in the cervical third have the worst. This case report discusses surgical and restorative management of a patient who had a nasopalatine cyst that had been misdiagnosed and treated as an endodontic lesion of the maxillary right central incisor as well as a midroot horizontal fracture of the adjacent lateral incisor.

Assessing worst case scenarios in movement demands derived from global positioning systems during international rugby union matches: Rolling averages versus fixed length epochs

PubMed Central

Cunningham, Daniel J.; Shearer, David A.; Carter, Neil; Drawer, Scott; Pollard, Ben; Bennett, Mark; Eager, Robin; Cook, Christian J.; Farrell, John; Russell, Mark

2018-01-01

significantly different to FR. For relative distance covered all other position groups were greater than the FR (p < 0.05). The FIXED method underestimated both relative distance (~11%) and HSR values (up to ~20%) compared to the ROLL method. These differences were exaggerated for the HSR variable in the backs position who covered the greatest HSR distance; highlighting important consideration for those implementing the FIXED method of analysis. The data provides coaches with a worst-case scenario reference on the running demands required for periods of 60–300 s in length. This information offers novel insight into game demands and can be used to inform the design of training games to increase specificity of preparation for the most demanding phases of matches. PMID:29621279

Assessing worst case scenarios in movement demands derived from global positioning systems during international rugby union matches: Rolling averages versus fixed length epochs.

PubMed

Cunningham, Daniel J; Shearer, David A; Carter, Neil; Drawer, Scott; Pollard, Ben; Bennett, Mark; Eager, Robin; Cook, Christian J; Farrell, John; Russell, Mark; Kilduff, Liam P

2018-01-01

significantly different to FR. For relative distance covered all other position groups were greater than the FR (p < 0.05). The FIXED method underestimated both relative distance (~11%) and HSR values (up to ~20%) compared to the ROLL method. These differences were exaggerated for the HSR variable in the backs position who covered the greatest HSR distance; highlighting important consideration for those implementing the FIXED method of analysis. The data provides coaches with a worst-case scenario reference on the running demands required for periods of 60-300 s in length. This information offers novel insight into game demands and can be used to inform the design of training games to increase specificity of preparation for the most demanding phases of matches.

Ethoprophos fate on soil-water interface and effects on non-target terrestrial and aquatic biota under Mediterranean crop-based scenarios.

PubMed

Leitão, Sara; Moreira-Santos, Matilde; Van den Brink, Paul J; Ribeiro, Rui; José Cerejeira, M; Sousa, José Paulo

2014-05-01

The present study aimed to assess the environmental fate of the insecticide and nematicide ethoprophos in the soil-water interface following the pesticide application in simulated maize and potato crops under Mediterranean agricultural conditions, particularly of irrigation. Focus was given to the soil-water transfer pathways (leaching and runoff), to the pesticide transport in soil between pesticide application (crop row) and non-application areas (between crop rows), as well as to toxic effects of the various matrices on terrestrial and aquatic biota. A semi-field methodology mimicking a "worst-case" ethoprophos application (twice the recommended dosage for maize and potato crops: 100% concentration v/v) in agricultural field situations was used, in order to mimic a possible misuse by the farmer under realistic conditions. A rainfall was simulated under a slope of 20° for both crop-based scenarios. Soil and water samples were collected for the analysis of pesticide residues. Ecotoxicity of soil and aquatic samples was assessed by performing lethal and sublethal bioassays with organisms from different trophic levels: the collembolan Folsomia candida, the earthworm Eisenia andrei and the cladoceran Daphnia magna. Although the majority of ethoprophos sorbed to the soil application area, pesticide concentrations were detected in all water matrices illustrating pesticide transfer pathways of water contamination between environmental compartments. Leaching to groundwater proved to be an important transfer pathway of ethoprophos under both crop-based scenarios, as it resulted in high pesticide concentration in leachates from Maize (130µgL(-1)) and Potato (630µgL(-1)) crop scenarios, respectively. Ethoprophos application at the Potato crop scenario caused more toxic effects on terrestrial and aquatic biota than at the Maize scenario at the recommended dosage and lower concentrations. In both crop-based scenarios, ethoprophos moved with the irrigation water flow to the

40 CFR 68.25 - Worst-case release scenario analysis.

Code of Federal Regulations, 2013 CFR

2013-07-01

... used is based on TNT equivalent methods. (1) For regulated flammable substances that are normally gases... shall be used to determine the distance to the explosion endpoint if the model used is based on TNT...

40 CFR 68.25 - Worst-case release scenario analysis.

Code of Federal Regulations, 2011 CFR

2011-07-01

... used is based on TNT equivalent methods. (1) For regulated flammable substances that are normally gases... shall be used to determine the distance to the explosion endpoint if the model used is based on TNT...

40 CFR 68.25 - Worst-case release scenario analysis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... used is based on TNT equivalent methods. (1) For regulated flammable substances that are normally gases... shall be used to determine the distance to the explosion endpoint if the model used is based on TNT...

40 CFR 68.25 - Worst-case release scenario analysis.

Code of Federal Regulations, 2012 CFR

2012-07-01

... used is based on TNT equivalent methods. (1) For regulated flammable substances that are normally gases... shall be used to determine the distance to the explosion endpoint if the model used is based on TNT...

40 CFR 68.25 - Worst-case release scenario analysis.

Code of Federal Regulations, 2014 CFR

2014-07-01

... used is based on TNT equivalent methods. (1) For regulated flammable substances that are normally gases... shall be used to determine the distance to the explosion endpoint if the model used is based on TNT...

How can health systems research reach the worst-off? A conceptual exploration.

PubMed

Pratt, Bridget; Hyder, Adnan A

2016-11-15

Health systems research is increasingly being conducted in low and middle-income countries (LMICs). Such research should aim to reduce health disparities between and within countries as a matter of global justice. For such research to do so, ethical guidance that is consistent with egalitarian theories of social justice proposes it ought to (amongst other things) focus on worst-off countries and research populations. Yet who constitutes the worst-off is not well-defined. By applying existing work on disadvantage from political philosophy, the paper demonstrates that (at least) two options exist for how to define the worst-off upon whom equity-oriented health systems research should focus: those who are worst-off in terms of health or those who are systematically disadvantaged. The paper describes in detail how both concepts can be understood and what metrics can be relied upon to identify worst-off countries and research populations at the sub-national level (groups, communities). To demonstrate how each can be used, the paper considers two real-world cases of health systems research and whether their choice of country (Uganda, India) and research population in 2011 would have been classified as amongst the worst-off according to the proposed concepts. The two proposed concepts can classify different countries and sub-national populations as worst-off. It is recommended that health researchers (or other actors) should use the concept that best reflects their moral commitments-namely, to perform research focused on reducing health inequalities or systematic disadvantage more broadly. If addressing the latter, it is recommended that they rely on the multidimensional poverty approach rather than the income approach to identify worst-off populations.

Florid cemento-osseous dysplasia mimicking apical periodontitis: A case report.

PubMed

Rekabi, Ali Reza; Ashouri, Rezvan; Torabi, Molok; Parirokh, Masoud; Abbott, Paul V

2013-12-01

Cemento-osseous dysplasia may present as a focal, periapical or florid lesion in the mandible or maxilla. The lesion may sometimes appear similar to peri-radicular lesions on a periapical radiograph. This report presents a case with irreversible pulpitis and root resorption as well as a mixed radiolucent/radiopaque lesion around a mandibular molar tooth root. Root canal treatment was performed and because of the radiographic signs of root resorption and the patient's fear of having a malignant disease, periapical surgery was also performed. The histopathology report confirmed the presence of florid cement-osseous dysplasia which was mimicking apical periodontitis. Follow-up radiography 12 months after the surgery illustrated complete healing of the radiolucent area. © 2011 The Authors. Australian Endodontic Journal © 2011 Australian Society of Endodontology.

Natural Hazards Risk Reduction and the ARkStorm Scenario

NASA Astrophysics Data System (ADS)

Cox, D. A.; Dettinger, M. D.; Ralph, F. M.

2016-12-01

The ARkStorm Scenario project began in 2008, led by the USGS Multi-Hazards Demonstration Project (now Science Application for Risk Reduction) in an effort to innovate the application of science to reduce natural-hazard risk associated with large atmospheric-river (AR) storms on the West Coast of the US. The effort involved contributions from many federal, state and academic organizations including NOAA's Environmental Systems Laboratory. The ARkStorm project used new understanding of atmospheric river physics, combined with downscaled meteorological data from two recent ARs (in 1969 and 1986), to describe and model a prolonged sequence of back-to-back storms similar to those that bankrupted California in 1862. With this scientifically plausible (but not worst-case) scenario, the ARkStorm team engaged flood and levee experts to identify plausible flooding extents and durations, created a coastal-storm inundation model (CoSMoS), and California's first landslide susceptibility map, to better understand secondary meteorological and geophysical hazards (flood, wind, landslide, coastal erosion and inundation) across California. Physical damages to homes, infrastructure, agriculture, and the environment were then estimated to calculate the likely social and economic impact to California and the nation. Across California, property damage from the ARkStorm scenario was estimated to exceed 300 billion, mostly from flooding. Including damage and losses, lifeline damages and business interruptions, the total cost of an ARkStorm-sized series of storms came to nearly 725 billion, nearly three times the losses estimated from another SAFRR scenario describing a M7.8 earthquake in southern California. Thus, atmospheric rivers have the potential to be California's other "Big One." Since its creation, the ARkStorm scenario has been used in preparedness exercises by NASA, the US Navy, the State of California, the County of Ventura, and cities and counties in the Tahoe Basin and

'Worst case' methodology for the initial assessment of societal risk from proposed major accident installations.

PubMed

Carter, D A; Hirst, I L

2000-01-07

This paper considers the application of one of the weighted risk indicators used by the Major Hazards Assessment Unit (MHAU) of the Health and Safety Executive (HSE) in formulating advice to local planning authorities on the siting of new major accident hazard installations. In such cases the primary consideration is to ensure that the proposed installation would not be incompatible with existing developments in the vicinity, as identified by the categorisation of the existing developments and the estimation of individual risk values at those developments. In addition a simple methodology, described here, based on MHAU's "Risk Integral" and a single "worst case" even analysis, is used to enable the societal risk aspects of the hazardous installation to be considered at an early stage of the proposal, and to determine the degree of analysis that will be necessary to enable HSE to give appropriate advice.

[A case of pulmonary malignant melanoma mimicking lung abscess].

PubMed

Mochizuki, Hideaki; Chikui, Emiko; Tokumaru, Aya; Kato, Takayuki; Arai, Tomio; Takahashi, Hideki

2011-06-01

An 84-year-old man was admitted with paresis of the right lower limb. Hemorrhagic lesions were demonstrated in the left frontoparietal lobe and cerebellum by cranial computed tomography (CT) and magnetic resonance imaging (MRI). Chest CT revealed an ill-defined mass measuring 4 x 6 cm in the left lower lobe of the lung, although bronchoscopic examination failed to obtain pathological diagnosis. Clinical diagnosis of primary lung cancer with multiple brain metastases was made, and he underwent whole brain radiotherapy. The pulmonary and cerebral lesions mimicked abscesses during his clinical course, and he died of respiratory failure due to bilateral pneumonia three months after admission. Autopsy revealed that both the pulmonary and brain lesions were malignant melanomas, but no other melanoma lesions could be identified despite meticulous investigation. Although malignant melanoma with an unknown primary site is rare in Japan, careful evaluation of the CT and MRI findings might be the key to correct diagnosis in this case.

Klatskin-mimicking lesions--a case series and literature review.

PubMed

Dumitrascu, Traian; Ionescu, Mihnea; Ciurea, Silviu; Herlea, Vlad; Lupescu, Ioana; Popescu, Irinel

2010-01-01

Obstruction of the hepatic hilum in patients without prior surgery is generally due to hilar adenocarcinoma (Klatskin tumor). However, not all the hilar strictures are malignant. Although uncommon, benign strictures of the proximal bile duct should be taken into consideration in differential diagnosis of Klatskin tumors, since the incidence could reach up to 25% of patients with presumed Klatskin tumor diagnosis. This group of benign proximal bile duct strictures (Klatskin-mimicking lesions) is usually represented by segmental fibrosis and non-specific chronic inflammation. The clinical and imaging features can not differentiate between benign and malignant strictures. Herein, we present a case series of three patients with benign proximal bile duct strictures (representing 4.1% of 73 patients resected with presumptive preoperative diagnosis of Klatskin tumor) and literature review. There are presented the clinical and biochemical features, imaging preoperative workup, surgical treatment and histological analysis of the specimen, along with postoperative outcome. For benign strictures of the hilum limited resections are curative. However, despite new diagnosis tools developed in the last years, patients with hilar obstructions still require unnecessary extensive resections due to impossibility of excluding the malignancy. In all cases of proximal bile duct obstruction presumed malignant, they should be managed accordingly, even with the risk of over-treatment for some benign lesions.

Malignant mesenchymal neoplasms of the dermis and subcutis mimicking benign lesions: a case-based review.

PubMed

Mentzel, Thomas; Brenn, Thomas

2017-11-01

In this short review, malignant mesenchymal neoplasms of the dermis and subcutis mimicking benign lesions and their differential diagnoses are discussed. These include plaque-like dermatofibrosarcoma protuberans, superficial low-grade fibromyxoid sarcoma, low-grade superficial malignant peripheral nerve sheath tumour, epithelioid sarcoma, pseudomyogenic haemangioendothelioma, Kaposi sarcoma mimicking cavernous haemangioma and benign lymphangioendothelioma, and rare forms of angiosarcoma mimicking a benign vascular lesion.

SU-F-T-433: Evaluation of a New Dose Mimicking Application for Clinical Flexibility and Reliability

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

Hoffman, D; Nair, C Kumaran; Wright, C

2016-06-15

Purpose: Clinical workflow and machine down time occasionally require patients to be temporarily treated on a system other than the initial treatment machine. A new commercial dose mimicking application provides automated cross-platform treatment planning to expedite this clinical flexibility. The aim of this work is to evaluate the feasibility of automatic plan creation and establish a robust clinical workflow for prostate and pelvis patients. Methods: Five prostate and five pelvis patients treated with helical plans were selected for re-planning with the dose mimicking application, covering both simple and complex scenarios. Two-arc VMAT and 7- and 9-field IMRT plans were generatedmore » for each case, with the objective function of achieving similar dose volume histogram from the initial helical plans. Dosimetric comparisons include target volumes and organs at risk (OARs) (rectum, bladder, small bowel, femoral heads, etc.). Dose mimicked plans were evaluated by a radiation oncologist, and patient-specific QAs were performed to validate delivery. Results: Overall plan generation and transfer required around 30 minutes of dosimetrist’s time once the dose-mimicking protocol is setup for each site. The resulting VMAT and 7- and 9-field IMRT plans achieved equivalent PTV coverage and homogeneity (D99/DRx = 97.3%, 97.2%, 97.2% and HI = 6.0, 5.8, and 5.9, respectively), compared to helical plans (97.6% and 4.6). The OAR dose discrepancies were up to 6% in rectum Dmean, but generally lower in bladder, femoral heads, bowel and penile bulb. In the context of 1–5 fractions, the radiation oncologist evaluated the dosimetric changes as not clinically significant. All delivery QAs achieved >90% pass with a 3%/3mm gamma criteria. Conclusion: The automated dose-mimicking workflow offers a strategy to avoid missing treatment fractions due to machine down time with non-clinically significant changes in dosimetry. Future work will further optimize dose mimicking plans and

Atmospheric transport of radioactive debris to Norway in case of a hypothetical accident related to the recovery of the Russian submarine K-27.

PubMed

Bartnicki, Jerzy; Amundsen, Ingar; Brown, Justin; Hosseini, Ali; Hov, Øystein; Haakenstad, Hilde; Klein, Heiko; Lind, Ole Christian; Salbu, Brit; Szacinski Wendel, Cato C; Ytre-Eide, Martin Album

2016-01-01

The Russian nuclear submarine K-27 suffered a loss of coolant accident in 1968 and with nuclear fuel in both reactors it was scuttled in 1981 in the outer part of Stepovogo Bay located on the eastern coast of Novaya Zemlya. The inventory of spent nuclear fuel on board the submarine is of concern because it represents a potential source of radioactive contamination of the Kara Sea and a criticality accident with potential for long-range atmospheric transport of radioactive particles cannot be ruled out. To address these concerns and to provide a better basis for evaluating possible radiological impacts of potential releases in case a salvage operation is initiated, we assessed the atmospheric transport of radionuclides and deposition in Norway from a hypothetical criticality accident on board the K-27. To achieve this, a long term (33 years) meteorological database has been prepared and used for selection of the worst case meteorological scenarios for each of three selected locations of the potential accident. Next, the dispersion model SNAP was run with the source term for the worst-case accident scenario and selected meteorological scenarios. The results showed predictions to be very sensitive to the estimation of the source term for the worst-case accident and especially to the sizes and densities of released radioactive particles. The results indicated that a large area of Norway could be affected, but that the deposition in Northern Norway would be considerably higher than in other areas of the country. The simulations showed that deposition from the worst-case scenario of a hypothetical K-27 accident would be at least two orders of magnitude lower than the deposition observed in Norway following the Chernobyl accident. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Primary omental gangrene mimicking appendicular perforation peritonitis-A case report.

PubMed

Kumar, A; Shah, J; Vaidya, P

2016-01-01

Primary omental torsion is a rare cause of acute abdomen in adults and presents with variable signs and symptoms. Establishing a preoperative diagnosis may be difficult in the emergency setting. It is rarely diagnosed preoperatively as it mimics common surgical emergencies such as acute appendicitis, appendicular perforation, acute cholecystitis and perforated peptic ulcers and can lead to the clinical deterioration of patient if missed A 47 years old male was taken to the operating room with a diagnosis of appendicular perforation peritonitis and during surgery was found to have a primary omental gangrene with pyoperitoneum, for which omentectomy and peritoneal lavage was performed. Torsion of the omentum is a condition in which the organ twists on its long axis to such an extent that its vascularity is compromised. Omental torsion can be primary (idiopathic) or secondary, depending on an underlying cause. Primary omental torsion was first described by Eitel in 1899. However, very few cases have been reported. Our case was a rare case presenting with omental gangrene with pyoperitoneum mimicking appendicular perforation peritonitis. Primary omental torsion is a rare diagnosis. A high index of clinical suspicion is required for a preoperative diagnosis. In doubtful cases a CT scan may be helpful. Surgical excision of the omentum remains the treatment of choice; however, conservative management may be attempted in an uncomplicated omental torsion. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Mesalamine treatment mimicking relapse in a child with ulcerative colitis.

PubMed

Hojsak, Iva; Pavić, Ana M; Kolaček, Sanja

2014-11-01

There are reports on mesalamine-induced bloody diarrhea mimicking ulcerative colitis (UC) relapse, mostly in adults. Herein we present a case of a child with UC who developed relapse of hemorrhagic colitis related to mesalamine. A 10-year-old girl developed severe symptoms mimicking UC relapse 3 weeks after introduction of mesalamine therapy. After mesalamine was withdrawn, her symptoms improved, but deteriorated again during the challenge of mesalamine despite concomitant use of corticosteroids. This is the first case report on such a young child during the concomitant use of corticosteroids.

Abdominal Wall Endometriosis Mimicking Metastases.

PubMed

Nambiar, Rakul; Anoop, T M; Mony, Rari P

2018-06-01

Abdominal wall lesions can be broadly divided into nontumorous and tumorous conditions. Nontumorous lesions include congenital lesion, abdominal wall hernia, inflammation and infection, vascular lesions, and miscellaneous conditions like hematoma. Tumorous lesions include benign and malignant neoplasms. Here, we report an unusual case of abdominal wall endometriosis mimicking metastases in a patient with breast carcinoma.

Developing ecological scenarios for the prospective aquatic risk assessment of pesticides.

PubMed

Rico, Andreu; Van den Brink, Paul J; Gylstra, Ronald; Focks, Andreas; Brock, Theo Cm

2016-07-01

The prospective aquatic environmental risk assessment (ERA) of pesticides is generally based on the comparison of predicted environmental concentrations in edge-of-field surface waters with regulatory acceptable concentrations derived from laboratory and/or model ecosystem experiments with aquatic organisms. New improvements in mechanistic effect modeling have allowed a better characterization of the ecological risks of pesticides through the incorporation of biological trait information and landscape parameters to assess individual, population and/or community-level effects and recovery. Similarly to exposure models, ecological models require scenarios that describe the environmental context in which they are applied. In this article, we propose a conceptual framework for the development of ecological scenarios that, when merged with exposure scenarios, will constitute environmental scenarios for prospective aquatic ERA. These "unified" environmental scenarios are defined as the combination of the biotic and abiotic parameters that are required to characterize exposure, (direct and indirect) effects, and recovery of aquatic nontarget species under realistic worst-case conditions. Ideally, environmental scenarios aim to avoid a potential mismatch between the parameter values and the spatial-temporal scales currently used in aquatic exposure and effect modeling. This requires a deeper understanding of the ecological entities we intend to protect, which can be preliminarily addressed by the formulation of ecological scenarios. In this article we present a methodological approach for the development of ecological scenarios and illustrate this approach by a case-study for Dutch agricultural ditches and the example focal species Sialis lutaria. Finally, we discuss the applicability of ecological scenarios in ERA and propose research needs and recommendations for their development and integration with exposure scenarios. Integr Environ Assess Manag 2016;12:510-521. �

Primary pulmonary lymphoma mimicking a refractory lung abscess: A case report.

PubMed

Matsumoto, Takeshi; Otsuka, Kojiro; Funayama, Yuki; Imai, Yukihiro; Tomii, Keisuke

2015-04-01

The current study presents a case of primary pulmonary lymphoma (PPL) mimicking refractory lung abscess that was diagnosed at autopsy. An 80-year-old male with clinically inapparent aspiration presented with a large cavitated mass and pleural effusion. A lung abscess and empyema was diagnosed, therefore, antibiotics were administered and the pleural effusion was drained. Various examinations, including a biopsy, yielded no specific diagnosis. The lesion was considered inoperable due to the poor general condition of the patient. Subsequently, the mass that had been diagnosed as a refractory lung abscess became enlarged and a repeat biopsy resulted in a diagnosis of diffuse large B-cell lymphoma. The patient succumbed to sudden respiratory failure, and the final diagnosis of PPL was confirmed at autopsy. PPL is a rare disease that accounts for 0.45% of all pulmonary malignant tumors and is difficult to diagnose in inoperable cases. Therefore, patients with PPL who do not undergo surgery can be misdiagnosed and consequently treated inappropriately. PPL should therefore be considered in the differential diagnosis of a refractory lung abscess.

Hepatitis Aand E Co-Infection with Worst Outcome.

PubMed

Saeed, Anjum; Cheema, Huma Arshad; Assiri, Asaad

2016-06-01

Infections are still a major problem in the developing countries like Pakistan because of poor sewage disposal and economic restraints. Acute viral hepatitis like Aand E are not uncommon in pediatric age group because of unhygienic food handling and poor sewage disposal, but majority recovers well without any complications. Co-infections are rare occurrences and physicians need to be well aware while managing such conditions to avoid worst outcome. Co-infection with hepatitis Aand E is reported occasionally in the literature, however, other concurrent infections such as hepatitis A with Salmonellaand hepatotropic viruses like viral hepatitis B and C are present in the literature. Co-infections should be kept in consideration when someone presents with atypical symptoms or unusual disease course like this presented case. We report here a girl child who had acute hepatitis A and E concurrent infections and presented with hepatic encephalopathy and had worst outcome, despite all the supportive measures being taken.

Electrocardiogram artifact caused by rigors mimicking narrow complex tachycardia: a case report.

PubMed

Matthias, Anne Thushara; Indrakumar, Jegarajah

2014-02-04

The electrocardiogram (ECG) is useful in the diagnosis of cardiac and non-cardiac conditions. Rigors due to shivering can cause electrocardiogram artifacts mimicking various cardiac rhythm abnormalities. We describe an 80-year-old Sri Lankan man with an abnormal electrocardiogram mimicking narrow complex tachycardia during the immediate post-operative period. Electrocardiogram changes caused by muscle tremor during rigors could mimic a narrow complex tachycardia. Identification of muscle tremor as a cause of electrocardiogram artifact can avoid unnecessary pharmacological and non-pharmacological intervention to prevent arrhythmias.

Reducing the worst case running times of a family of RNA and CFG problems, using Valiant's approach.

PubMed

Zakov, Shay; Tsur, Dekel; Ziv-Ukelson, Michal

2011-08-18

RNA secondary structure prediction is a mainstream bioinformatic domain, and is key to computational analysis of functional RNA. In more than 30 years, much research has been devoted to defining different variants of RNA structure prediction problems, and to developing techniques for improving prediction quality. Nevertheless, most of the algorithms in this field follow a similar dynamic programming approach as that presented by Nussinov and Jacobson in the late 70's, which typically yields cubic worst case running time algorithms. Recently, some algorithmic approaches were applied to improve the complexity of these algorithms, motivated by new discoveries in the RNA domain and by the need to efficiently analyze the increasing amount of accumulated genome-wide data. We study Valiant's classical algorithm for Context Free Grammar recognition in sub-cubic time, and extract features that are common to problems on which Valiant's approach can be applied. Based on this, we describe several problem templates, and formulate generic algorithms that use Valiant's technique and can be applied to all problems which abide by these templates, including many problems within the world of RNA Secondary Structures and Context Free Grammars. The algorithms presented in this paper improve the theoretical asymptotic worst case running time bounds for a large family of important problems. It is also possible that the suggested techniques could be applied to yield a practical speedup for these problems. For some of the problems (such as computing the RNA partition function and base-pair binding probabilities), the presented techniques are the only ones which are currently known for reducing the asymptotic running time bounds of the standard algorithms.

Reducing the worst case running times of a family of RNA and CFG problems, using Valiant's approach

PubMed Central

2011-01-01

Background RNA secondary structure prediction is a mainstream bioinformatic domain, and is key to computational analysis of functional RNA. In more than 30 years, much research has been devoted to defining different variants of RNA structure prediction problems, and to developing techniques for improving prediction quality. Nevertheless, most of the algorithms in this field follow a similar dynamic programming approach as that presented by Nussinov and Jacobson in the late 70's, which typically yields cubic worst case running time algorithms. Recently, some algorithmic approaches were applied to improve the complexity of these algorithms, motivated by new discoveries in the RNA domain and by the need to efficiently analyze the increasing amount of accumulated genome-wide data. Results We study Valiant's classical algorithm for Context Free Grammar recognition in sub-cubic time, and extract features that are common to problems on which Valiant's approach can be applied. Based on this, we describe several problem templates, and formulate generic algorithms that use Valiant's technique and can be applied to all problems which abide by these templates, including many problems within the world of RNA Secondary Structures and Context Free Grammars. Conclusions The algorithms presented in this paper improve the theoretical asymptotic worst case running time bounds for a large family of important problems. It is also possible that the suggested techniques could be applied to yield a practical speedup for these problems. For some of the problems (such as computing the RNA partition function and base-pair binding probabilities), the presented techniques are the only ones which are currently known for reducing the asymptotic running time bounds of the standard algorithms. PMID:21851589

New trends in transportation and land use scenario planning : five case studies of regional and local scenario planning efforts

DOT National Transportation Integrated Search

2010-04-01

This report summarizes important findings from a literature review on scenario planning processes and a scan of stakeholders. It also presents case studies on innovative, next generation scenario planning efforts. The project team defined next ...

Scoring best-worst data in unbalanced many-item designs, with applications to crowdsourcing semantic judgments.

PubMed

Hollis, Geoff

2018-04-01

Best-worst scaling is a judgment format in which participants are presented with a set of items and have to choose the superior and inferior items in the set. Best-worst scaling generates a large quantity of information per judgment because each judgment allows for inferences about the rank value of all unjudged items. This property of best-worst scaling makes it a promising judgment format for research in psychology and natural language processing concerned with estimating the semantic properties of tens of thousands of words. A variety of different scoring algorithms have been devised in the previous literature on best-worst scaling. However, due to problems of computational efficiency, these scoring algorithms cannot be applied efficiently to cases in which thousands of items need to be scored. New algorithms are presented here for converting responses from best-worst scaling into item scores for thousands of items (many-item scoring problems). These scoring algorithms are validated through simulation and empirical experiments, and considerations related to noise, the underlying distribution of true values, and trial design are identified that can affect the relative quality of the derived item scores. The newly introduced scoring algorithms consistently outperformed scoring algorithms used in the previous literature on scoring many-item best-worst data.

Hypercementosis and odontogenic epithelial hyperplasia associated with a tooth root remnant mimicking a neoplasm. A case report.

PubMed

Zustin, J; Friedrich, R E

2010-01-01

Hypercementosis presents as painless, single or multiple non-neoplastic cementum formation beyond the physiological limits of the tooth. It often occurs in the apical area of the involved tooth following infection, chemical or mechanical trauma. We report on radiographic and histopathological findings in a single case of late intraosseous hypercementosis and odontogenic epithelial hyperplasia associated with a minute apical tooth root remnant years after its extraction, mimicking a tumour.

Zero-moment point determination of worst-case manoeuvres leading to vehicle wheel lift

NASA Astrophysics Data System (ADS)

Lapapong, S.; Brown, A. A.; Swanson, K. S.; Brennan, S. N.

2012-01-01

This paper proposes a method to evaluate vehicle rollover propensity based on a frequency-domain representation of the zero-moment point (ZMP). Unlike other rollover metrics such as the static stability factor, which is based on the steady-state behaviour, and the load transfer ratio, which requires the calculation of tyre forces, the ZMP is based on a simplified kinematic model of the vehicle and the analysis of the contact point of the vehicle relative to the edge of the support polygon. Previous work has validated the use of the ZMP experimentally in its ability to predict wheel lift in the time domain. This work explores the use of the ZMP in the frequency domain to allow a chassis designer to understand how operating conditions and vehicle parameters affect rollover propensity. The ZMP analysis is then extended to calculate worst-case sinusoidal manoeuvres that lead to untripped wheel lift, and the analysis is tested across several vehicle configurations and compared with that of the standard Toyota J manoeuvre.

A case of positive 68Ga-DOTATOC-PET/CT pancreatic heterotopia mimicking an intestinal neuroendocrine tumor.

PubMed

Zilli, Alessandra; Fanetti, Ilaria; Conte, Dario; Massironi, Sara

Gallium-68 DOTA-peptide positron emission tomography/computed tomography ( 68 Ga-PET/CT) has emerged as a promising tool for the diagnosis and staging of gastro-entero-pancreatic neoplasms, thanks to its high sensitivity and specificity. Heterotopic pancreas, which is relatively rare, has never been reported as a possible cause of false positives of 68 Ga-PET/CT. We report on the first case of a heterotopic pancreas showing pathological uptake at 68 Ga-PET/CT, thus mimicking an intestinal neuroendocrine tumor. The present case suggests that heterotopic pancreas should be included among the possible causes of false positives at 68 Ga PET. Copyright © 2018 Elsevier Inc. All rights reserved.

Adrenal cortical oncocytoma mimicking pheochromocytoma.

PubMed

Kiriakopoulos, Andreas; Papaioannou, Dimitrios; Linos, Dimitrios

2011-01-01

Adrenal tumors present with clinical features and signs unique to their specific hormonal hypersecretion. However, there have been cases in which the clinical expression has been in conflict with the histologic features of the tumor. In this communication we report an unusual clinical presentation of an adrenal cortical tumor with histologic features of an oncocytoma that clinically mimicked a pheochromocytoma. A 49-year old man was referred to our Unit due to type B aortic dissection and a mass of the left adrenal gland. Computed tomography and magnetic resonance imaging confirmed the presence of aortic dissection extending from the left subclavian artery to both iliac arteries and also revealed a 6 cm tumor on the left adrenal gland. Preoperative endocrine evaluation showed a near tenfold increase of urinary vanillylmandelic acid (VMA) and metanephrine values. Transperitoneal laparoscopic adrenalectomy was successfully performed. The adrenal tumor proved to be an adrenal cortical neoplasm with histologic features of oncocytoma. Although the case of an adrenal cortical adenoma clinically mimicking a pheochromocytoma has been described in the literature, to the best of our knowledge, there has been no previous report of an adrenal cortical neoplasm with predominant features of oncocytoma.

Experimental measurement of preferences in health and healthcare using best-worst scaling: an overview.

PubMed

Mühlbacher, Axel C; Kaczynski, Anika; Zweifel, Peter; Johnson, F Reed

2016-12-01

Best-worst scaling (BWS), also known as maximum-difference scaling, is a multiattribute approach to measuring preferences. BWS aims at the analysis of preferences regarding a set of attributes, their levels or alternatives. It is a stated-preference method based on the assumption that respondents are capable of making judgments regarding the best and the worst (or the most and least important, respectively) out of three or more elements of a choice-set. As is true of discrete choice experiments (DCE) generally, BWS avoids the known weaknesses of rating and ranking scales while holding the promise of generating additional information by making respondents choose twice, namely the best as well as the worst criteria. A systematic literature review found 53 BWS applications in health and healthcare. This article expounds possibilities of application, the underlying theoretical concepts and the implementation of BWS in its three variants: 'object case', 'profile case', 'multiprofile case'. This paper contains a survey of BWS methods and revolves around study design, experimental design, and data analysis. Moreover the article discusses the strengths and weaknesses of the three types of BWS distinguished and offered an outlook. A companion paper focuses on special issues of theory and statistical inference confronting BWS in preference measurement.

Adhesive strength of total knee endoprostheses to bone cement - analysis of metallic and ceramic femoral components under worst-case conditions.

PubMed

Bergschmidt, Philipp; Dammer, Rebecca; Zietz, Carmen; Finze, Susanne; Mittelmeier, Wolfram; Bader, Rainer

2016-06-01

Evaluation of the adhesive strength of femoral components to the bone cement is a relevant parameter for predicting implant safety. In the present experimental study, three types of cemented femoral components (metallic, ceramic and silica/silane-layered ceramic) of the bicondylar Multigen Plus knee system, implanted on composite femora were analysed. A pull-off test with the femoral components was performed after different load and several cementing conditions (four groups and n=3 components of each metallic, ceramic and silica/silane-layered ceramic in each group). Pull-off forces were comparable for the metallic and the silica/silane-layered ceramic femoral components (mean 4769 N and 4298 N) under standard test condition, whereas uncoated ceramic femoral components showed reduced pull-off forces (mean 2322 N). Loading under worst-case conditions led to decreased adhesive strength by loosening of the interface implant and bone cement using uncoated metallic and ceramic femoral components, respectively. Silica/silane-coated ceramic components were stably fixed even under worst-case conditions. Loading under high flexion angles can induce interfacial tensile stress, which could promote early implant loosening. In conclusion, a silica/silane-coating layer on the femoral component increased their adhesive strength to bone cement. Thicker cement mantles (>2 mm) reduce adhesive strength of the femoral component and can increase the risk of cement break-off.

[A CASE OF DEXTRANOMER-HYALURONIC ACID COPOLYMER (Deflux®) IMPLANTS CALCIFICATION MIMICKING DISTAL URETERAL CALCULI].

PubMed

Matsumoto, Fumi; Matsui, Futoshi; Yazawa, Koji; Shimada, Kenji

2017-01-01

Since 2011, endoscopic correction of vesicoureteral reflux using dextranomer-hyaluronic acid copolymer (Deflux ® ) has been widely accepted in Japan due to its safety and minimally invasive nature. However, long-term complications are unknown. We present a case of Deflux ® implants calcification mimicking distal ureteral calculi in a 12-year-old boy with a history of Deflux ® injection performed at three years of age for primary VUR. We should be aware of this complication to avoid misdiagnosis and unnecessary invasive examination such as radiological imaging or endoscopy.

Anticipating and training for the worst-case metabolic scenario: a comment on Del Vecchio, Hirata, and Franchini (2011).

PubMed

Amtmann, John

2012-02-01

Del Vecchio, Hirata, and Franchini (2011) studied the effort: pause ratio of mixed martial arts by analyzing 26 bouts in two separate mixed martial arts events in Sao Paulo, Brazil. They referenced research identifying effort:pause ratios from other combat sports ranging from 10:1 (Brazilian Jiu Jitsu), 2:1 (judo and wrestling), and 1:3/1:4 (taekwondo). The authors identified an effort:pause ratio ranging from 1:2 to 1:4 in the bouts they analyzed, and suggested and described training programs that resemble this ratio. It is important for coaches to anticipate the most challenging metabolic mixed martial arts scenario and to create training programs that mimic that profile. Del Vecchio and associates' research is an important first step in gathering information which can help enhance training programs for injury prevention and performance enhancement.

Dermatophyte infections mimicking other skin diseases: a 154-person case survey of tinea atypica in the district of Cagliari (Italy).

PubMed

Atzori, Laura; Pau, Monica; Aste, Natalia; Aste, Nicola

2012-04-01

Although usually simple, the diagnosis of dermatophyte infection is sometimes neglected. An observational study has been realized to evaluate the role of corticosteroid exposure (tinea incognito) and of other primary characteristics of the dermatophytosis that from onset mimic other diseases and mislead an unexperienced physician. Between 1990 and 2009, all cases of atypical dermatophytosis mimicking other skin diseases were collected from the more general number of dermatophyte infections diagnosed at the Dermatology Department of Cagliari University, Italy. One-hundred and fifty-four cases (71 male/83 female, 2-81 years old) were studied, with a median of 7 cases/year. The most observed clinical forms were those mimicking impetigo, eczematous dermatitis, lupus erythematosus, polymorphous light eruption, psoriasis, and rosacea. The identified dermatophytes were: Microsporum canis (70 cases), Trichophyton rubrum (43 cases), Trichophyton mentagrophytes var. mentagrophytes (29 cases), Trichophyton mentagrophytes var. interdigitale (six cases), Microsporum gypseum (three cases), Epidermophyton floccosum (two cases), and Trichophyton verrucosum (one case). Diagnostic difficulties are discussed, with special attention to the origin of the pathomorphosis. In our experience, clinical atypia is not a mere consequence of corticosteroid therapy but present at the very onset of the illness, due to the variable dermatophyte invasive capacity, the site of invasion, physiological individual, and/or acquired condition, such as excessive washing or sun exposure. Therefore, we suggest using the term "tinea atypica" rather than "tinea incognito" to include all forms of dermatophytosis that do not present the classic features for both primary and secondary pathomorphosis. © 2012 The International Society of Dermatology.

Scenario based approach for multiple source Tsunami Hazard assessment for Sines, Portugal

NASA Astrophysics Data System (ADS)

Wronna, M.; Omira, R.; Baptista, M. A.

2015-08-01

In this paper, we present a scenario-based approach for tsunami hazard assessment for the city and harbour of Sines - Portugal, one of the test-sites of project ASTARTE. Sines holds one of the most important deep-water ports which contains oil-bearing, petrochemical, liquid bulk, coal and container terminals. The port and its industrial infrastructures are facing the ocean southwest towards the main seismogenic sources. This work considers two different seismic zones: the Southwest Iberian Margin and the Gloria Fault. Within these two regions, we selected a total of six scenarios to assess the tsunami impact at the test site. The tsunami simulations are computed using NSWING a Non-linear Shallow Water Model With Nested Grids. In this study, the static effect of tides is analysed for three different tidal stages MLLW (mean lower low water), MSL (mean sea level) and MHHW (mean higher high water). For each scenario, inundation is described by maximum values of wave height, flow depth, drawback, runup and inundation distance. Synthetic waveforms are computed at virtual tide gauges at specific locations outside and inside the harbour. The final results describe the impact at Sines test site considering the single scenarios at mean sea level, the aggregate scenario and the influence of the tide on the aggregate scenario. The results confirm the composite of Horseshoe and Marques Pombal fault as the worst case scenario. It governs the aggregate scenario with about 60 % and inundates an area of 3.5 km2.

Worst-error analysis of batch filter and sequential filter in navigation problems. [in spacecraft trajectory estimation

NASA Technical Reports Server (NTRS)

Nishimura, T.

1975-01-01

This paper proposes a worst-error analysis for dealing with problems of estimation of spacecraft trajectories in deep space missions. Navigation filters in use assume either constant or stochastic (Markov) models for their estimated parameters. When the actual behavior of these parameters does not follow the pattern of the assumed model, the filters sometimes result in very poor performance. To prepare for such pathological cases, the worst errors of both batch and sequential filters are investigated based on the incremental sensitivity studies of these filters. By finding critical switching instances of non-gravitational accelerations, intensive tracking can be carried out around those instances. Also the worst errors in the target plane provide a measure in assignment of the propellant budget for trajectory corrections. Thus the worst-error study presents useful information as well as practical criteria in establishing the maneuver and tracking strategy of spacecraft's missions.

Case series: Two cases of eyeball tattoos with short-term complications.

PubMed

Duarte, Gonzalo; Cheja, Rashel; Pachón, Diana; Ramírez, Carolina; Arellanes, Lourdes

2017-04-01

To report two cases of eyeball tattoos with short-term post procedural complications. Case 1 is a 26-year-old Mexican man that developed orbital cellulitis and posterior scleritis 2 h after an eyeball tattoo. Patient responded satisfactorily to systemic antibiotic and corticosteroid treatment. Case 2 is a 17-year-old Mexican man that developed two sub-episcleral nodules in the ink injection sites immediately after the procedure. Eyeball tattoos are performed by non-ophthalmic trained personnel. There are a substantial number of short-term risks associated with this procedure. Long-term effects on the eyes and vision are still unknown, but in a worst case scenario could include loss of vision or permanent damage to the eyes.

"Best Case/Worst Case": Qualitative Evaluation of a Novel Communication Tool for Difficult in-the-Moment Surgical Decisions.

PubMed

Kruser, Jacqueline M; Nabozny, Michael J; Steffens, Nicole M; Brasel, Karen J; Campbell, Toby C; Gaines, Martha E; Schwarze, Margaret L

2015-09-01

To evaluate a communication tool called "Best Case/Worst Case" (BC/WC) based on an established conceptual model of shared decision-making. Focus group study. Older adults (four focus groups) and surgeons (two focus groups) using modified questions from the Decision Aid Acceptability Scale and the Decisional Conflict Scale to evaluate and revise the communication tool. Individuals aged 60 and older recruited from senior centers (n = 37) and surgeons from academic and private practices in Wisconsin (n = 17). Qualitative content analysis was used to explore themes and concepts that focus group respondents identified. Seniors and surgeons praised the tool for the unambiguous illustration of multiple treatment options and the clarity gained from presentation of an array of treatment outcomes. Participants noted that the tool provides an opportunity for in-the-moment, preference-based deliberation about options and a platform for further discussion with other clinicians and loved ones. Older adults worried that the format of the tool was not universally accessible for people with different educational backgrounds, and surgeons had concerns that the tool was vulnerable to physicians' subjective biases. The BC/WC tool is a novel decision support intervention that may help facilitate difficult decision-making for older adults and their physicians when considering invasive, acute medical treatments such as surgery. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Morphologic mimickers of Cryptococcus occurring within inflammatory infiltrates in the setting of neutrophilic dermatitis: a series of three cases highlighting clinical dilemmas associated with a novel histopathologic pitfall.

PubMed

Ko, Jennifer S; Fernandez, Anthony P; Anderson, Kyle A; Burdick, Laura M; Billings, Steven D; Procop, Gary W; McMahon, James T; Bergfeld, Wilma F; Piliang, Melissa P

2013-01-01

A neutrophil-predominant inflammatory infiltrate in a cutaneous biopsy can be associated with a broad spectrum of diseases. Here we describe three cases showing a neutrophil-predominant dermal infiltrate admixed with abundant acellular bodies surrounded by capsule-like vacuolated spaces, which strikingly mimicked Cryptococcus. Two cases occurred within the settings of underlying hematologic malignancies; the third case was associated with immune dysregulation. Two patients were acutely ill in the medical intensive care unit. Fungal work-up, including cultures and multiple stains were negative. Because of clinical deterioration in these patients, transmission electron microscopy was pursued to definitively rule out fungal infection. In both cases, characteristics most compatible with autolysing human cells, not Cryptococcus, were identified. Chemotherapy and high-dose steroids were given, but both patients eventually succumbed to their diseases. To the best of our knowledge, these represent the first reported cases of autolysing human cells mimicking Cryptococcus organisms within neutrophilic infiltrates. They highlight the therapeutic dilemmas arising with histopathologic mimics, as well as the importance of thorough investigation to distinguish mimickers from true infectious organisms. We believe recognition of this microscopic pitfall will be useful to dermatopathologists faced with similar findings in the future, and may prevent unnecessary delay of appropriate therapy in acutely ill patients. Copyright © 2012 John Wiley & Sons A/S.

Vaginal foreign body mimicking cervical cancer in postmenopausal woman - case study.

PubMed

Ciebiera, Michał; Słabuszewska-Jóźwiak, Aneta; Ledowicz, Witold; Jakiel, Grzegorz

2015-09-01

We present a case report of a 73-year-old, postmenopausal woman with detailed history of breast cancer and oncology treatment including tamoxifen therapy. She presented at the clinic of gynecology and obstetrics with recurrent inflammation of the urinary and genital tract and suspicion of a cervical mass. She also presented occasional abdominal complaints and malodorous vaginal discharge. These symptoms were observed in the patient for several years. Before hospitalization she received many kinds of empirical, antimicrobial treatment such as chlorquinaldol, metronidazole, nifuratel, and nystatin. She did not receive further guidance from doctors about the causes of ailments and further diagnostic and treatment capabilities. In our clinic a detailed diagnostic process including ultrasound transvaginal examination and a minisurgical procedure revealed the presence of a vaginal foreign body (which turned out to be a plastic, shampoo bottle cap) surrounded by a mass of inflamed tissue mimicking a cervical tumor. All symptoms and complaints subsided after surgical removal of the foreign body and antibacterial therapy with metronidazole and cefuroxime. Our study draws attention to the need of thorough gynecological care including prophylaxis, especially in the case of complaints of an intimate nature. Even trivial, frequently occurring disorders can be dangerous and require proper and responsible doctor's supervision and management through the healing process.

Comparison of temporal realistic telecommunication base station exposure with worst-case estimation in two countries.

PubMed

Mahfouz, Zaher; Verloock, Leen; Joseph, Wout; Tanghe, Emmeric; Gati, Azeddine; Wiart, Joe; Lautru, David; Hanna, Victor Fouad; Martens, Luc

2013-12-01

The influence of temporal daily exposure to global system for mobile communications (GSM) and universal mobile telecommunications systems and high speed downlink packet access (UMTS-HSDPA) is investigated using spectrum analyser measurements in two countries, France and Belgium. Temporal variations and traffic distributions are investigated. Three different methods to estimate maximal electric-field exposure are compared. The maximal realistic (99 %) and the maximal theoretical extrapolation factor used to extrapolate the measured broadcast control channel (BCCH) for GSM and the common pilot channel (CPICH) for UMTS are presented and compared for the first time in the two countries. Similar conclusions are found in the two countries for both urban and rural areas: worst-case exposure assessment overestimates realistic maximal exposure up to 5.7 dB for the considered example. In France, the values are the highest, because of the higher population density. The results for the maximal realistic extrapolation factor at the weekdays are similar to those from weekend days.

Control-oriented modelization of a satellite with large flexible appendages and use of worst-case analysis to verify robustness to model uncertainties of attitude control

NASA Astrophysics Data System (ADS)

Gasbarri, Paolo; Monti, Riccardo; Campolo, Giovanni; Toglia, Chiara

2012-12-01

lengthy and expensive: difficulty and cost do increase because of the overall system dimension that depends on the number of uncertainties. Uncertain parameters have to be parametrically investigated to determine robust performance of the control laws via gridding approaches. In particular in this paper we propose to consider two methods: (i) a conventional Monte Carlo analysis, and (ii) a worst-case analysis, i.e., an optimization process to find an estimation of the true worst-case behaviour. Both techniques allow to verify that the design is robust enough to meet the system performance specification in case of uncertainties.

EPA worst case water microcosms for testing phage biocontrol of Salmonella.

PubMed

McLaughlin, Michael R; Brooks, John P

2008-01-01

A microplate method was developed as a tool to test phages for their ability to control Salmonella in aqueous environments. The method used EPA (U.S. Environmental Protection Agency) worst case water (WCW) in 96-well plates. The WCW provided a consistent and relatively simple defined turbid aqueous matrix, high in total organic carbon (TOC) and total dissolved salts (TDS), to simulate swine lagoon effluent, without the inconvenience of malodor and confounding effects from other biological factors. The WCW was originally defined to simulate high turbidity and organic matter in water for testing point-of-use filtration devices. Use of WCW to simulate lagoon effluent for phage testing is a new and innovative application of this matrix. Control of physical and chemical parameters (TOC, TDS, turbidity, temperature, and pH) allowed precise evaluation of microbiological parameters (Salmonella and phages). In a typical application, wells containing WCW were loaded with Salmonella enterica susp. enterica serovar Typhimurium (ATCC14028) and treated with phages alone and in cocktail combinations. Mean Salmonella inactivation rates (k, where the lower the value, the greater the inactivation) of phage treatments ranged from -0.32 to -1.60 versus -0.004 for Salmonella controls. Mean log(10) reductions (the lower the value, the greater the reduction) of Salmonella phage treatments were -1.60 for phage PR04-1, -2.14 for phage PR37-96, and -2.14 for both phages in a sequential cocktail, versus -0.08 for Salmonella controls. The WCW microcosm system was an effective tool for evaluating the biocontrol potential of Salmonella phages.

When is best-worst best? A comparison of best-worst scaling, numeric estimation, and rating scales for collection of semantic norms.

PubMed

Hollis, Geoff; Westbury, Chris

2018-02-01

Large-scale semantic norms have become both prevalent and influential in recent psycholinguistic research. However, little attention has been directed towards understanding the methodological best practices of such norm collection efforts. We compared the quality of semantic norms obtained through rating scales, numeric estimation, and a less commonly used judgment format called best-worst scaling. We found that best-worst scaling usually produces norms with higher predictive validities than other response formats, and does so requiring less data to be collected overall. We also found evidence that the various response formats may be producing qualitatively, rather than just quantitatively, different data. This raises the issue of potential response format bias, which has not been addressed by previous efforts to collect semantic norms, likely because of previous reliance on a single type of response format for a single type of semantic judgment. We have made available software for creating best-worst stimuli and scoring best-worst data. We also made available new norms for age of acquisition, valence, arousal, and concreteness collected using best-worst scaling. These norms include entries for 1,040 words, of which 1,034 are also contained in the ANEW norms (Bradley & Lang, Affective norms for English words (ANEW): Instruction manual and affective ratings (pp. 1-45). Technical report C-1, the center for research in psychophysiology, University of Florida, 1999).

Characteristics of worst hour rainfall rate for radio wave propagation modelling in Nigeria

NASA Astrophysics Data System (ADS)

Osita, Ibe; Nymphas, E. F.

2017-10-01

Radio waves especially at the millimeter-wave band are known to be attenuated by rain. Radio engineers and designers need to be able to predict the time of the day when radio signal will be attenuated so as to provide measures to mitigate this effect. This is achieved by characterizing the rainfall intensity for a particular region of interest into worst month and worst hour of the day. This paper characterized rainfall in Nigeria into worst year, worst month, and worst hour. It is shown that for the period of study, 2008 and 2009 are the worst years, while September is the most frequent worst month in most of the stations. The evening time (LT) is the worst hours of the day in virtually all the stations.

Crohn's disease-associated interstitial lung disease mimicking sarcoidosis: a case report and review of the literature.

PubMed

Thao, Choua; Lagstein, Amir; Allen, Tadashi; Dincer, Huseyin Erhan; Kim, Hyun Joo

2016-10-07

Respiratory involvement in Crohn's disease (CD) is a rare manifestation known to involve the large and small airways, lung parenchyma, and pleura. The clinical presentation is nonspecific, and diagnostic tests can mimic other pulmonary diseases, posing a diagnostic challenge and delay in treatment. We report a case of a 60-year-old female with a history of CD and psoriatic arthritis who presented with dyspnea, fever, and cough with abnormal radiological findings. Diagnostic testing revealed an elevated CD4:CD8 ratio in the bronchoalveolar lavage fluid, and cryoprobe lung biopsy results showed non-necrotizing granulomatous inflammation. We describe here the second reported case of pulmonary involvement mimicking sarcoidosis in Crohn's disease and a review of the literature on the approaches to making a diagnosis of CD-associated interstitial lung disease.

Worst theft losses are for Mercedes model; 2 of 3 worst are for acura

DOT National Transportation Integrated Search

2000-05-13

The Highway Loss Data Institute's annual list of vehicles with worst theft losses has Mercedes S class heading the list of passenger vehicles with the highest insurance losses for theft. Overall losses for this car are 10 times higher than the averag...

Internet Posting of Chemical Worst Case Scenarios: A Roadmap for Terrorists

DTIC Science & Technology

1999-02-10

with homework and connect with friends. As a parent, the greatest concern I used to have about the Internet was porn and the other things that sickos...slightest risk with the lives of their husbands, wives, parents, children , or grandchildren.’’ Let me stress that no one here, including those in law...make sure our standards cover the uncommon person who would be more sus- ceptible. This not only includes children , but also groups or individuals

Considering the worst-case metabolic scenario, but training to the typical-case competitive scenario: response to Amtmann (2012).

PubMed

Del Vecchio, Fabrício Boscolo; Franchini, Emerson

2013-08-01

This response to Amtmann's letter emphasizes that the knowledge of the typical time structure, as well as its variation, together with the main goal of the mixed martial arts athletes--to win by knock out or submission--need to be properly considered during the training sessions. Example with other combat sports are given and discussed, especially concerning the importance of adapting the physical conditioning workouts to the technical-tactical profile of the athlete and not the opposite.

Gouty involvement of the patella and extensor mechanism of the knee mimicking aggressive neoplasm. A case series.

PubMed

Kester, Christopher; Wallace, Matthew T; Jelinek, James; Aboulafia, Albert

2018-06-01

Gout is a common inflammatory crystal deposition disease that occurs in many joints throughout the body. Active gout is most often associated with painful synovitis causing searing joint pains, but gout can also produce large masses of space-occupying deposits called tophi. Tophi are most frequently seen in juxta-articular locations with or without bony erosion and are often misdiagnosed as degenerative joint disease. Soft tissue deposits and tendon involvement are also known manifestations of gout, but can present with indeterminate and alarming findings on imaging. We present three cases of tophaceous gout mimicking aggressive neoplasms in the extensor mechanism of the knee. All cases presented as extensor tendon masses eroding into the patella, with imaging findings initially concerning for primary musculoskeletal malignancy.

Vaginal foreign body mimicking cervical cancer in postmenopausal woman – case study

PubMed Central

Słabuszewska-Jóźwiak, Aneta; Ledowicz, Witold; Jakiel, Grzegorz

2015-01-01

We present a case report of a 73-year-old, postmenopausal woman with detailed history of breast cancer and oncology treatment including tamoxifen therapy. She presented at the clinic of gynecology and obstetrics with recurrent inflammation of the urinary and genital tract and suspicion of a cervical mass. She also presented occasional abdominal complaints and malodorous vaginal discharge. These symptoms were observed in the patient for several years. Before hospitalization she received many kinds of empirical, antimicrobial treatment such as chlorquinaldol, metronidazole, nifuratel, and nystatin. She did not receive further guidance from doctors about the causes of ailments and further diagnostic and treatment capabilities. In our clinic a detailed diagnostic process including ultrasound transvaginal examination and a minisurgical procedure revealed the presence of a vaginal foreign body (which turned out to be a plastic, shampoo bottle cap) surrounded by a mass of inflamed tissue mimicking a cervical tumor. All symptoms and complaints subsided after surgical removal of the foreign body and antibacterial therapy with metronidazole and cefuroxime. Our study draws attention to the need of thorough gynecological care including prophylaxis, especially in the case of complaints of an intimate nature. Even trivial, frequently occurring disorders can be dangerous and require proper and responsible doctor's supervision and management through the healing process. PMID:26528112

A High-Grade Chondrosarcoma of Calcaneum Mimicking as a Benign Pathology: Delayed Diagnosis and Management.

PubMed

Baba, Muzamil Ahmad; Nazir, Naila; Shabeer, Maajid; Mir, Bashir Ahmed; Kawoosa, Altaf Ahmad

2016-10-01

This case is presented to highlight a rare case of chondrosarcoma of calcaneum in a young adult mimicking as a benign pathology and to highlight the diagnosis and early management of such cases to prevent complications and even death. Chondrosarcoma constitutes less than 10% of all primary malignancies of bone and occurs mostly in proximal locations such as pelvis, proximal femur, and proximal humerus. We present a case of high-grade chondrosarcoma at a very rare site, calcaneum of a 40-year-old male that was mimicking as a benign pathology. This case report highlights the importance of proper clinical examination, evaluation, and suspicion for benign occurring lesions to prevent complications related to a delay in diagnosis. Therapeutic, Level IV: Case study. © 2016 The Author(s).

Conscious worst case definition for risk assessment, part I: a knowledge mapping approach for defining most critical risk factors in integrative risk management of chemicals and nanomaterials.

PubMed

Sørensen, Peter B; Thomsen, Marianne; Assmuth, Timo; Grieger, Khara D; Baun, Anders

2010-08-15

This paper helps bridge the gap between scientists and other stakeholders in the areas of human and environmental risk management of chemicals and engineered nanomaterials. This connection is needed due to the evolution of stakeholder awareness and scientific progress related to human and environmental health which involves complex methodological demands on risk management. At the same time, the available scientific knowledge is also becoming more scattered across multiple scientific disciplines. Hence, the understanding of potentially risky situations is increasingly multifaceted, which again challenges risk assessors in terms of giving the 'right' relative priority to the multitude of contributing risk factors. A critical issue is therefore to develop procedures that can identify and evaluate worst case risk conditions which may be input to risk level predictions. Therefore, this paper suggests a conceptual modelling procedure that is able to define appropriate worst case conditions in complex risk management. The result of the analysis is an assembly of system models, denoted the Worst Case Definition (WCD) model, to set up and evaluate the conditions of multi-dimensional risk identification and risk quantification. The model can help optimize risk assessment planning by initial screening level analyses and guiding quantitative assessment in relation to knowledge needs for better decision support concerning environmental and human health protection or risk reduction. The WCD model facilitates the evaluation of fundamental uncertainty using knowledge mapping principles and techniques in a way that can improve a complete uncertainty analysis. Ultimately, the WCD is applicable for describing risk contributing factors in relation to many different types of risk management problems since it transparently and effectively handles assumptions and definitions and allows the integration of different forms of knowledge, thereby supporting the inclusion of multifaceted risk

Scenarios of large mammal loss in Europe for the 21st century.

PubMed

Rondinini, Carlo; Visconti, Piero

2015-08-01

Distributions and populations of large mammals are declining globally, leading to an increase in their extinction risk. We forecasted the distribution of extant European large mammals (17 carnivores and 10 ungulates) based on 2 Rio+20 scenarios of socioeconomic development: business as usual and reduced impact through changes in human consumption of natural resources. These scenarios are linked to scenarios of land-use change and climate change through the spatial allocation of land conversion up to 2050. We used a hierarchical framework to forecast the extent and distribution of mammal habitat based on species' habitat preferences (as described in the International Union for Conservation of Nature Red List database) within a suitable climatic space fitted to the species' current geographic range. We analyzed the geographic and taxonomic variation of habitat loss for large mammals and the potential effect of the reduced impact policy on loss mitigation. Averaging across scenarios, European large mammals were predicted to lose 10% of their habitat by 2050 (25% in the worst-case scenario). Predicted loss was much higher for species in northwestern Europe, where habitat is expected to be lost due to climate and land-use change. Change in human consumption patterns was predicted to substantially improve the conservation of habitat for European large mammals, but not enough to reduce extinction risk if species cannot adapt locally to climate change or disperse. © 2015 Society for Conservation Biology.

Acute corneal hydrops mimicking full thickness perforation.

PubMed

Ch'ng, S W; Pillai, M B; Aazeem, S; Tu, K L

2012-05-11

A 26-year-old Caucasian female with keratoconus presented with an acutely painful and red left eye. Visual acuity on presentation was 3/60. Slit lamp examination revealed localised Descemet's membrane break with iris partially plugging it. There was a bulging stromal cyst which would intermittently flatten and reform. The appearance when the cyst was flattened mimicked a full thickness corneal perforation. However, no obvious overlying epithelial defect was detected and an intermittent leakage through micro-perforations in the corneal epithelium was the probable cause of the variable appearance. The anterior chamber reformed and iris plug freed following an insertion of a bandage contact lens and taped eyelid. On follow-up, the Descement's membrane had healed with visual acuity improving to 6/18. Our case illustrates the importance of identifying corneal hydrops mimicking a full thickness perforation as conservative management has a greater chance of recovery.

A General Safety Assessment for Purified Food Ingredients Derived From Biotechnology Crops: Case Study of Brazilian Sugar and Beverages Produced From Insect-Protected Sugarcane.

PubMed

Kennedy, Reese D; Cheavegatti-Gianotto, Adriana; de Oliveira, Wladecir S; Lirette, Ronald P; Hjelle, Jerry J

2018-01-01

Insect-protected sugarcane that expresses Cry1Ab has been developed in Brazil. Analysis of trade information has shown that effectively all the sugarcane-derived Brazilian exports are raw or refined sugar and ethanol. The fact that raw and refined sugar are highly purified food ingredients, with no detectable transgenic protein, provides an interesting case study of a generalized safety assessment approach. In this study, both the theoretical protein intakes and safety assessments of Cry1Ab, Cry1Ac, NPTII, and Bar proteins used in insect-protected biotechnology crops were examined. The potential consumption of these proteins was examined using local market research data of average added sugar intakes in eight diverse and representative Brazilian raw and refined sugar export markets (Brazil, Canada, China, Indonesia, India, Japan, Russia, and the USA). The average sugar intakes, which ranged from 5.1 g of added sugar/person/day (India) to 126 g sugar/p/day (USA) were used to calculated possible human exposure. The theoretical protein intake estimates were carried out in the "Worst-case" scenario, assumed that 1 μg of newly-expressed protein is detected/g of raw or refined sugar; and the "Reasonable-case" scenario assumed 1 ng protein/g sugar. The "Worst-case" scenario was based on results of detailed studies of sugarcane processing in Brazil that showed that refined sugar contains less than 1 μg of total plant protein /g refined sugar. The "Reasonable-case" scenario was based on assumption that the expression levels in stalk of newly-expressed proteins were less than 0.1% of total stalk protein. Using these calculated protein intake values from the consumption of sugar, along with the accepted NOAEL levels of the four representative proteins we concluded that safety margins for the "Worst-case" scenario ranged from 6.9 × 10 5 to 5.9 × 10 7 and for the "Reasonable-case" scenario ranged from 6.9 × 10 8 to 5.9 × 10 10 . These safety margins are very high due to

Two cases of childhood narcolepsy mimicking epileptic seizures in video-EEG/EMG.

PubMed

Yanagishita, Tomoe; Ito, Susumu; Ohtani, Yui; Eto, Kaoru; Kanbayashi, Takashi; Oguni, Hirokazu; Nagata, Satoru

2018-06-06

Narcolepsy is characterized by excessive sleepiness, hypnagogic hallucinations, and sleep paralysis, and can occur with or without cataplexy. Here, we report two children with narcolepsy presenting with cataplexy mimicking epileptic seizures as determined by long-term video-electroencephalography (EEG) and electromyography (EMG) monitoring. Case 1 was a 15-year-old girl presenting with recurrent episodes of "convulsions" and loss of consciousness, who was referred to our hospital with a diagnosis of epilepsy showing "convulsions" and "complex partial seizures". The long-term video-polygraph showed a clonic attack lasting for 15 s, which corresponded to 1-2 Hz with interruption of mentalis EMG discharges lasting for 70-300 ms without any EEG changes. Narcolepsy was suspected due to the attack induced by hearty laughs and the presence of sleep attacks, and confirmed by low orexin levels in cerebrospinal fluid (CSF). Case 2 was an 11-year-old girl presenting with recurrent episodes of myoclonic attacks simultaneously with dropping objects immediately after hearty laughs, in addition to sleep attacks, hypnagogic hallucinations, and sleep paralysis. The long-term video-polygraph showed a subtle attack, characterized by dropping chopsticks from her hand, which corresponded to an interruption of ongoing deltoid EMG discharges lasting 140 ms without any EEG changes. A diagnosis of narcolepsy was confirmed by the low orexin levels in CSF. These cases demonstrate that children with narcolepsy may have attacks of cataplexy that resemble clonic or myoclonic seizures. Copyright © 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

SU-F-T-192: Study of Robustness Analysis Method of Multiple Field Optimized IMPT Plans for Head & Neck Patients

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

Li, Y; Wang, X; Li, H

Purpose: Proton therapy is more sensitive to uncertainties than photon treatments due to protons’ finite range depending on the tissue density. Worst case scenario (WCS) method originally proposed by Lomax has been adopted in our institute for robustness analysis of IMPT plans. This work demonstrates that WCS method is sufficient enough to take into account of the uncertainties which could be encountered during daily clinical treatment. Methods: A fast and approximate dose calculation method is developed to calculate the dose for the IMPT plan under different setup and range uncertainties. Effects of two factors, inversed square factor and range uncertainty,more » are explored. WCS robustness analysis method was evaluated using this fast dose calculation method. The worst-case dose distribution was generated by shifting isocenter by 3 mm along x,y and z directions and modifying stopping power ratios by ±3.5%. 1000 randomly perturbed cases in proton range and x, yz directions were created and the corresponding dose distributions were calculated using this approximated method. DVH and dosimetric indexes of all 1000 perturbed cases were calculated and compared with the result using worst case scenario method. Results: The distributions of dosimetric indexes of 1000 perturbed cases were generated and compared with the results using worst case scenario. For D95 of CTVs, at least 97% of 1000 perturbed cases show higher values than the one of worst case scenario. For D5 of CTVs, at least 98% of perturbed cases have lower values than worst case scenario. Conclusion: By extensively calculating the dose distributions under random uncertainties, WCS method was verified to be reliable in evaluating the robustness level of MFO IMPT plans of H&N patients. The extensively sampling approach using fast approximated method could be used in evaluating the effects of different factors on the robustness level of IMPT plans in the future.« less

Adefovir-Induced Hypophosphatemic Osteomalacia Mimicking Bone Metastases From Primary Hepatocarcinoma.

PubMed

Wei, Wei-Jun; Sun, Zhen-Kui; Shen, Chen-Tian; Qiu, Zhong-Ling; Luo, Quan-Yong

2017-09-01

Adefovir-induced hypophosphatemic osteomalacia in the context of hepatocarcinoma is rare and needs to be differentiated from metastatic hepatocarcinoma. We here report a case of severe osteomalacia whose focal uptakes of radiotracer on the Tc-MDP SPECT/CT images mimicked that of metastatic hepatocarcinoma.

Central nervous system borreliosis mimicking a pontine tumour.

PubMed

Latsch, Kirsten; Tappe, Dennis; Warmuth-Metz, Monika; Hebestreit, Helge

2006-11-01

In childhood, facial nerve palsy and headache are typical symptoms of second and third stage neuroborreliosis. While focal demyelination is occasionally observed on MRI scans, the appearance of a tumorous lesion is extremely rare. The case of a 10-year-old girl with neuroborreliosis mimicking a space-occupying lesion in the brainstem, without any previously recognized manifestations of borreliosis, is reported.

The "Best Worst" Field Optimization and Focusing

NASA Technical Reports Server (NTRS)

Vaughnn, David; Moore, Ken; Bock, Noah; Zhou, Wei; Ming, Liang; Wilson, Mark

2008-01-01

A simple algorithm for optimizing and focusing lens designs is presented. The goal of the algorithm is to simultaneously create the best and most uniform image quality over the field of view. Rather than relatively weighting multiple field points, only the image quality from the worst field point is considered. When optimizing a lens design, iterations are made to make this worst field point better until such a time as a different field point becomes worse. The same technique is used to determine focus position. The algorithm works with all the various image quality metrics. It works with both symmetrical and asymmetrical systems. It works with theoretical models and real hardware.

Don’t get caught out! A rare case of a calcified urachal remnant mimicking a bladder calculus

PubMed Central

Rodrigues, Jonathan Carl Luis; Gandhi, Sanjay

2013-01-01

Computer tomography through the kidneys, ureters and bladder (CT KUB) is the mainstay investigation of suspected renal tract calculi. However, several pathologies other than renal tract calculi can cause apparent urinary bladder calcification. We describe the case of a 45 year old man who presented with left sided renal colic. Prone CT KUB performed on admission revealed a calcified urachal remnant mimicking a urinary bladder calculus in the dependent portion of the urinary bladder, confirmed by reviewing the multi-planar reformatted images. This is the first reported case in the literature of this phenomenon. We discuss the importance of using multi-planar reformatted images (MPR) and maximum intensity projection images (MIP), as well as careful review of previous imaging, in making the correct diagnosis. We also discuss the differential diagnoses that should be considered when presented with urinary bladder calcification. PMID:23705044

Rare extraskeletal Ewing's sarcoma mimicking as adenocarcinoma of the sigmoid.

PubMed

Mertens, Michelle; Haenen, Filip W N; Siozopoulou, Vasiliki; Van Cleemput, Marc

2017-06-01

Extraskeletal Ewing's sarcoma (EES) is a rare finding in comparison with Ewing's sarcoma of bone and usually manifests in young patients. However, even in older patients, one must consider the diagnosis. In this case, we describe a 52-year-old woman diagnosed with EES, mimicking as adenocarcinoma of the sigmoid. The tumor was not visualized by a multi-slice spiral computed tomography of the abdomen and pelvis with intravenous contrast, and eventually the diagnosis was made by positive immunohistochemical staining for CD99 and by molecular testing for EWSR1 translocation. This combination of the patient's age and the localization of the tumor mimicking an adenocarcinoma of the sigmoid has never been described before.

Orthokeratinised odontogenic cyst mimicking periapical cyst

PubMed Central

Rajalakshmi, R; Sreeja, C; Vijayalakshmi, D; Leelarani, V

2013-01-01

Orthokeratinised odontogenic cyst (OOC) denotes the odontogenic cyst that microscopically has an orthokeratinised epithelial lining. OOC is characterised by a less-aggressive behaviour and a low rate of recurrence. This report describes a case of OOC involving posterior part of the mandible that mimicked periapical cyst in a 14-year-old boy. The initial clinical diagnosis was given as periapical cyst based on the clinical and radiographical features. Enucleation of the cyst was performed and the specimen was sent for histopathological examination. A definite diagnosis of OOC was made by histopathological examination of the biopsy specimen. This case emphases on including OOC in the differential diagnosis of radiolucencies occurring in the periapical region of non-vital tooth. PMID:24099763

Orthokeratinised odontogenic cyst mimicking periapical cyst.

PubMed

Rajalakshmi, R; Sreeja, C; Vijayalakshmi, D; Leelarani, V

2013-10-07

Orthokeratinised odontogenic cyst (OOC) denotes the odontogenic cyst that microscopically has an orthokeratinised epithelial lining. OOC is characterised by a less-aggressive behaviour and a low rate of recurrence. This report describes a case of OOC involving posterior part of the mandible that mimicked periapical cyst in a 14-year-old boy. The initial clinical diagnosis was given as periapical cyst based on the clinical and radiographical features. Enucleation of the cyst was performed and the specimen was sent for histopathological examination. A definite diagnosis of OOC was made by histopathological examination of the biopsy specimen. This case emphases on including OOC in the differential diagnosis of radiolucencies occurring in the periapical region of non-vital tooth.

An Empirical Comparison of Discrete Choice Experiment and Best-Worst Scaling to Estimate Stakeholders' Risk Tolerance for Hip Replacement Surgery.

PubMed

van Dijk, Joris D; Groothuis-Oudshoorn, Catharina G M; Marshall, Deborah A; IJzerman, Maarten J

2016-06-01

Previous studies have been inconclusive regarding the validity and reliability of preference elicitation methods. The aim of this study was to compare the metrics obtained from a discrete choice experiment (DCE) and profile-case best-worst scaling (BWS) with respect to hip replacement. We surveyed the general US population of men aged 45 to 65 years, and potentially eligible for hip replacement surgery. The survey included sociodemographic questions, eight DCE questions, and twelve BWS questions. Attributes were the probability of a first and second revision, pain relief, ability to participate in sports and perform daily activities, and length of hospital stay. Conditional logit analysis was used to estimate attribute weights, level preferences, and the maximum acceptable risk (MAR) for undergoing revision surgery in six hypothetical treatment scenarios with different attribute levels. A total of 429 (96%) respondents were included. Comparable attribute weights and level preferences were found for both BWS and DCE. Preferences were greatest for hip replacement surgery with high pain relief and the ability to participate in sports and perform daily activities. Although the estimated MARs for revision surgery followed the same trend, the MARs were systematically higher in five of the six scenarios using DCE. This study confirms previous findings that BWS or DCEs are comparable in estimating attribute weights and level preferences. However, the risk tolerance threshold based on the estimation of MAR differs between these methods, possibly leading to inconsistency in comparing treatment scenarios. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Posterior Epidural Migration of an Extruded Lumbar Disc Mimicking a Facet Cyst: A Case Report

PubMed Central

Yoo, Young Sun; Ju, Chang Il; Kim, Dong Min

2015-01-01

Dorsal extradural migration of extruded disc material is clinically uncommon. We report a rare case of posterior epidural migration of an extruded lumbar disc mimicking a facet cyst. A 32-year-old man was admitted to our institute with a 2-week history of severe low back pain and radiating pain in the left leg. The magnetic resonance (MR) images revealed a dorsally located, left-sided extradural cystic mass at the L2-3 level. The initial diagnosis was an epidural facet cyst because of the high signal intensity on MR images and its location adjacent to the facet joint. Intraoperatively, an encapsulated mass of soft tissue adherent to the dural sac was observed and excised. The pathological diagnosis was degenerated disc material. After surgery, the patient experienced complete relief from leg pain. PMID:25883662

Cryptococcoma mimicking a brain tumor in an immunocompetent patient: case report of an extremely rare presentation.

PubMed

Paiva, Aline Lariessy Campos; Aguiar, Guilherme Brasileiro de; Lovato, Renan Maximilian; Zanetti, Arthus Vilar Deolindo; Panagopoulos, Alexandros Theodoros; Veiga, José Carlos Esteves

2017-11-06

Central nervous system (CNS) infectious diseases have high prevalence in developing countries and their proper diagnosis and treatment are very important for public health planning. Cryptococcus neoformans is a fungus that may cause several CNS manifestations, especially in immunocompromised patients. Cryptococcal meningitis is the most common type of involvement. Mass-effect lesions are uncommon: they are described as cryptococcomas and their prevalence is even lower among immunocompetent patients. The aim here was to report an extremely rare case of cryptococcoma causing a mass effect and mimicking a brain tumor in an immunocompetent patient. The literature on CNS cryptococcal infections was reviewed with emphasis on cryptococcomas. Clinical, surgical and radiological data on a female patient with this rare presentation of cryptococcoma mimicking a brain tumor are described. A 54-year-old female patient presented to the emergency department with a rapid-onset progressive history of confusion and completely dependency for basic activities. Neuroimaging showed a left occipital lesion and neurosurgical treatment was proposed. From histopathological evaluation, a diagnosis of cryptococcoma was established. She received clinical support with antifungals, but despite optimal clinical treatment, her condition evolved to death. Cryptococcal infections have several forms of presentation and, in immunocompetent patients, their manifestation may be even more different. Cryptococcoma is an extremely rare presentation in which proper surgical and clinical treatment should be instituted as quickly as possible, but even so, there is a high mortality rate.

Primary Papillary Mucinous Adenocarcinoma of the Ureter Mimicking Genitourinary Tuberculosis

PubMed Central

Gulwani, Hanni; Jain, Aruna

2010-01-01

Primary adenocarcinomas of the renal pelvis and ureter are rare and account for less than 1% of all malignancies at this site. We report a case of primary papillary mucinous adenocarcinoma of the ureter that clinically mimicked genitourinary tuberculosis. Early diagnosis is important for the better outcome. PMID:21151719

A case of pulmonary Serratia marcescens granuloma radiologically mimicking metastatic malignancy and tuberculosis infection.

PubMed

Das, Joyutpal; Layton, Benjamin; Lamb, Harriet; Sinnott, Nicola; Leahy, Bernard C

2015-11-01

Serratia marcescens is a saprophytic gram-negative bacillus capable of causing a wide range of infections. A 57-year-old female was admitted to our hospital for four weeks with community acquired pneumonia. A chest x-ray, six weeks after discharge, demonstrated multiple, bilateral 'cannon ball'-like opacities and mediastinal lymphadenopathy which were highly suspicious of disseminated malignancy or tuberculosis. The only symptom that this patient had was a productive cough. She had multiple commodities, but no specific immunodeficiency disorder. Interestingly, her sputum and bronchial washing samples grew S. marcescens. The computed tomography-guided lung biopsy demonstrated necrotic granulomatous changes. There was no pathological evidence of tuberculosis or fungal infection, malignancy or vasculitis. There are only a handful of reported cases of Serratia granulomas. Thus, we are reporting a rare instance of pulmonary Serratia marcescens granuloma radiologically mimicking metastatic malignancy and tuberculosis infection. © The Author(s) 2015.

"Best Case/Worst Case": Training Surgeons to Use a Novel Communication Tool for High-Risk Acute Surgical Problems.

PubMed

Kruser, Jacqueline M; Taylor, Lauren J; Campbell, Toby C; Zelenski, Amy; Johnson, Sara K; Nabozny, Michael J; Steffens, Nicole M; Tucholka, Jennifer L; Kwekkeboom, Kris L; Schwarze, Margaret L

2017-04-01

Older adults often have surgery in the months preceding death, which can initiate postoperative treatments inconsistent with end-of-life values. "Best Case/Worst Case" (BC/WC) is a communication tool designed to promote goal-concordant care during discussions about high-risk surgery. The objective of this study was to evaluate a structured training program designed to teach surgeons how to use BC/WC. Twenty-five surgeons from one tertiary care hospital completed a two-hour training session followed by individual coaching. We audio-recorded surgeons using BC/WC with standardized patients and 20 hospitalized patients. Hospitalized patients and their families participated in an open-ended interview 30 to 120 days after enrollment. We used a checklist of 11 BC/WC elements to measure tool fidelity and surgeons completed the Practitioner Opinion Survey to measure acceptability of the tool. We used qualitative analysis to evaluate variability in tool content and to characterize patient and family perceptions of the tool. Surgeons completed a median of 10 of 11 BC/WC elements with both standardized and hospitalized patients (range 5-11). We found moderate variability in presentation of treatment options and description of outcomes. Three months after training, 79% of surgeons reported BC/WC is better than their usual approach and 71% endorsed active use of BC/WC in clinical practice. Patients and families found that BC/WC established expectations, provided clarity, and facilitated deliberation. Surgeons can learn to use BC/WC with older patients considering acute high-risk surgical interventions. Surgeons, patients, and family members endorse BC/WC as a strategy to support complex decision making. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Sensitivity of the global submarine hydrate inventory to scenarios of future climate change

NASA Astrophysics Data System (ADS)

Hunter, S. J.; Goldobin, D. S.; Haywood, A. M.; Ridgwell, A.; Rees, J. G.

2013-04-01

The global submarine inventory of methane hydrate is thought to be considerable. The stability of marine hydrates is sensitive to changes in temperature and pressure and once destabilised, hydrates release methane into sediments and ocean and potentially into the atmosphere, creating a positive feedback with climate change. Here we present results from a multi-model study investigating how the methane hydrate inventory dynamically responds to different scenarios of future climate and sea level change. The results indicate that a warming-induced reduction is dominant even when assuming rather extreme rates of sea level rise (up to 20 mm yr-1) under moderate warming scenarios (RCP 4.5). Over the next century modelled hydrate dissociation is focussed in the top ˜100m of Arctic and Subarctic sediments beneath <500m water depth. Predicted dissociation rates are particularly sensitive to the modelled vertical hydrate distribution within sediments. Under the worst case business-as-usual scenario (RCP 8.5), upper estimates of resulting global sea-floor methane fluxes could exceed estimates of natural global fluxes by 2100 (>30-50TgCH4yr-1), although subsequent oxidation in the water column could reduce peak atmospheric release rates to 0.75-1.4 Tg CH4 yr-1.

The Use of a Multiplanar, Multi-Axis External Fixator to Achieve Knee Arthrodesis in a Worst Case Scenario: A Case Series

PubMed Central

Raskolnikov, Dima; Slover, James D.; Egol, Kenneth A.

2013-01-01

Background One of the most catastrophic outcomes following total knee arthroplasty (TKA) is a chronic periprosthetic infection with concomitant failure of the knee extensor mechanism. This study retrospectively reviewed the clinical records of 7 patients who were treated with a 6 axis circular external fixation frame (Taylor Spatial Frame (TSF)) for this condition. Fusion was achieved in 5 of 7 patients (71%) at an average of 8.4 months after surgery. Complications occurred in the treatment of 5 of 7 patients (71%). Infection was controlled in all cases. The TSF presents another valuable tool, which the orthopaedic surgeon should consider when treating these difficult cases. Purpose To evaluate the use of the Taylor Spatial Frame (TSF) to achieve knee arthrodesis in patients with chronically infected total knee arthroplasties (TKAs) with concomitant failure of the knee extensor mechanism. Methods We retrospectively evaluated the clinical records of 7 patients who were referred to our tertiary care orthopaedic medical center with multiple failed knee arthroplasties, chronic draining infection and complete loss of the extensor mechanism. All patients were treated with a similar protocol including, debridement and bony stabilization with an adjustable, 6 axis circular external fixation frame (TSF). Hospital charts were reviewed for sociodemographic information, surgical details, hospital course and complications. Radiographs were reviewed for healing and alignment. Follow up included clinical examination and radiographs. Results The mean age of the patients was 70.9 years (range, 59 – 83 years) at the time of application of the TSF. There were 3 men and 4 women. The average time between TKA and diagnosis of infection was 30.7 months (range, 2.6 – 67.0 months). The 7 patients had undergone an average of 3.3 prior surgical procedures (range, 2-4 procedures) on the ipsilateral extremity. Fusion was achieved in 5 of 7 patients (71%) at an average of 8.4 months after

Cost-efficacy of biologic therapies for psoriatic arthritis from the perspective of the Taiwanese healthcare system.

PubMed

Yang, Tsong-Shing; Chi, Ching-Chi; Wang, Shu-Hui; Lin, Jing-Chi; Lin, Ko-Ming

2016-10-01

Biologic therapies are more effective but more costly than conventional therapies in treating psoriatic arthritis. To evaluate the cost-efficacy of etanercept, adalimumab and golimumab therapies in treating active psoriatic arthritis in a Taiwanese setting. We conducted a meta-analysis of randomized placebo-controlled trials to calculate the incremental efficacy of etanercept, adalimumab and golimumab, respectively, in achieving Psoriatic Arthritis Response Criteria (PsARC) and a 20% improvement in the American College of Rheumatology score (ACR20). The base, best, and worst case incremental cost-effectiveness ratios (ICERs) for one subject to achieve PsARC and ACR20 were calculated. The annual ICER per PsARC responder were US$27 047 (best scenario US$16 619; worst scenario US$31 350), US$39 339 (best scenario US$31 846; worst scenario US$53 501) and US$27 085 (best scenario US$22 716; worst scenario US$33 534) for etanercept, adalimumab and golimumab, respectively. The annual ICER per ACR20 responder were US$27 588 (best scenario US$20 900; worst scenario US$41 800), US$39 339 (best scenario US$25 236; worst scenario US$83 595) and US$33 534 (best scenario US$27 616; worst scenario US$44 013) for etanercept, adalimumab and golimumab, respectively. In a Taiwanese setting, etanercept had the lowest annual costs per PsARC and ACR20 responder, while adalimumab had the highest annual costs per PsARC and ACR responder. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Hydrological and water quality impact assessment of a Mediterranean limno-reservoir under climate change and land use management scenarios

NASA Astrophysics Data System (ADS)

Molina-Navarro, Eugenio; Trolle, Dennis; Martínez-Pérez, Silvia; Sastre-Merlín, Antonio; Jeppesen, Erik

2014-02-01

Water scarcity and water pollution constitute a big challenge for water managers in the Mediterranean region today and will exacerbate in a projected future warmer world, making a holistic approach for water resources management at the catchment scale essential. We expanded the Soil and Water Assessment Tool (SWAT) model developed for a small Mediterranean catchment to quantify the potential effects of various climate and land use change scenarios on catchment hydrology as well as the trophic state of a new kind of waterbody, a limno-reservoir (Pareja Limno-reservoir), created for environmental and recreational purposes. We also checked for the possible synergistic effects of changes in climate and land use on water flow and nutrient exports from the catchment. Simulations showed a noticeable impact of climate change in the river flow regime and consequently the water level of the limno-reservoir, especially during summer, complicating the fulfillment of its purposes. Most of the scenarios also predicted a deterioration of trophic conditions in the limno-reservoir. Fertilization and soil erosion were the main factors affecting nitrate and total phosphorus concentrations. Combined climate and land use change scenarios showed noticeable synergistic effects on nutrients exports, relative to running the scenarios individually. While the impact of fertilization on nitrate export is projected to be reduced with warming in most cases, an additional 13% increase in the total phosphorus export is expected in the worst-case combined scenario compared to the sum of individual scenarios. Our model framework may help water managers to assess and manage how these multiple environmental stressors interact and ultimately affect aquatic ecosystems.

Calculations of the skyshine gamma-ray dose rates from independent spent fuel storage installations (ISFSI) under worst case accident conditions

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

Pace, J.V. III; Cramer, S.N.; Knight, J.R.

1980-09-01

Calculations of the skyshine gamma-ray dose rates from three spent fuel storage pools under worst case accident conditions have been made using the discrete ordinates code DOT-IV and the Monte Carlo code MORSE and have been compared to those of two previous methods. The DNA 37N-21G group cross-section library was utilized in the calculations, together with the Claiborne-Trubey gamma-ray dose factors taken from the same library. Plots of all results are presented. It was found that the dose was a strong function of the iron thickness over the fuel assemblies, the initial angular distribution of the emitted radiation, and themore » photon source near the top of the assemblies. 16 refs., 11 figs., 7 tabs.« less

Effects of alternative outcome scenarios and structured outcome evaluation on case-based ethics instruction.

PubMed

Peacock, Juandre; Harkrider, Lauren N; Bagdasarov, Zhanna; Connelly, Shane; Johnson, James F; Thiel, Chase E; Macdougall, Alexandra E; Mumford, Michael D; Devenport, Lynn D

2013-09-01

Case-based instruction has been regarded by many as a viable alternative to traditional lecture-based education and training. However, little is known about how case-based training techniques impact training effectiveness. This study examined the effects of two such techniques: (a) presentation of alternative outcome scenarios to a case, and (b) conducting a structured outcome evaluation. Consistent with the hypotheses, results indicate that presentation of alternative outcome scenarios reduced knowledge acquisition, reduced sensemaking and ethical decision-making strategy use, and reduced decision ethicality. Conducting a structured outcome evaluation had no impact on these outcomes. Results indicate that those who use case-based instruction should take care to use clear, less complex cases with only a singular outcome if they are seeking these types of outcomes.

A case series of verrucae vulgares mimicking hyperkeratosis in individuals with diabetic foot ulcers.

PubMed

Quast, D R; Nauck, M A; Bechara, F G; Meier, J J

2017-08-01

Diabetic foot ulcers are a common complication in the advanced stages of diabetes mellitus. Certain lesions may be refractory to usual treatments with prolonged healing. In these cases, differential diagnoses to classical ulcers should be considered. Although plantar warts are a common and easy-to-diagnose finding in the general population, diagnosis can be challenging in people with diabetic foot ulcers, as they mimic hyperkeratosis in these people. We report seven cases of people with diabetic foot ulcers and verrucae vulgares mimicking treatment-refractory hyperkeratosis, presenting to our centre between 2014 and 2016. Diagnosis was aided by the clinical presentation, followed by dermoscopy and punch biopsy. Treatment included topical application of 5-fluoruracil and salicylic acid (four people), cryotherapy (three people) and surgical excision (three people), all in combination with local pressure offloading. In five people, the verrucae were completely removed after a mean treatment period of 9.4 months; two individuals were lost to follow-up. Verrucae may be more common in people with diabetic foot lesions and polyneuropathy than generally assumed. Typical findings include small, pinhead-sized bleedings within and surrounding hyperkeratous lesions. These findings should alert the clinician for the potential presence of a verruca. In such cases, biopsy should be performed to enable specific diagnosis and treatment. © 2017 Diabetes UK.

Chronic active Epstein-Barr virus infection mimicking Henoch-Schönlein purpura.

PubMed

Guissa, Vanessa R; Aragão, Paula A; Marques, Heloisa H; Jacob, Cristina M; Silva, Clovis A

2010-01-01

Chronic active Epstein-Barr virus (CAEBV) infection is characterized by chronic or recurrent symptoms for at least 3 months, such as fever, hepatosplenomegaly and lymphadenopathy. The diagnosis is established due to the presence of anti-EBV antibodies or isolation of this infectious agent in affected tissues. Three cases of CAEBV infection mimicking Henoch-Schönlein purpura (HSP) were described. CASE 1: Female 3-year old patient with cervical adenomegaly, anemia and fever developed palpable purpura, haematuria and arthritis. CAEBV infection was established by serology test. She received methylprednisolone and acyclovir. She had generalized lymphadenopathy, hepatomegaly, splenomegaly, disseminated intravascular coagulation and deceased. CASE 2: Male 12-year old patient with persistent anemia, lymphadenopathy, hepatomegaly and splenomegaly had CAEBV infection diagnosis by serology test. He developed purpura and arthritis and received methylprednisolone. CASE 3: Male 13-year old patient had purpura, abdominal pain, haematuria, hepatomegaly, splenomegaly, lymphadenopathy, anemia and elevated liver enzymes. The cervical lymph node biopsy was positive to EBV infection. He received methylprednisolone and acyclovir, developing acute fulminant hepatitis and death. CAEBV infection mimicking HSP was rarely observed in our population.

Epidermal cyst mimicking incision line metastasis.

PubMed

Gündoğdu, Ramazan; Ayhan, Erhan; Çolak, Tahsin

2017-01-01

Epidermal cysts are cystic tumors lined with keratinized squamous layer and filled with keratin debris. Epidermal cysts may develop by implantation of surface epidermal layer into the dermis or subcutaneous tissue after trauma or surgical procedures. Cervix cancer spreads either directly or via the vascular and lymphatic systems. Distant skin metastasis of endometrium or cervix cancer is very rare. In this case report, a patient who had a history of cervix cancer operation 11 years ago and presented with a mass that mimicked incision line metastasis and was histopathologically diagnosed with epidermal cyst is presented.

Inflammatory Myofibroblastic Tumor Mimicking Apical Periodontitis.

PubMed

Adachi, Makoto; Kiho, Kazuki; Sekine, Genta; Ohta, Takahisa; Matsubara, Makoto; Yoshida, Takakazu; Katsumata, Akitoshi; Tanuma, Jun-ichi; Sumitomo, Shinichiro

2015-12-01

Inflammatory myofibroblastic tumors (IMTs) are rare. IMTs of the head and neck occur in all age groups, from neonates to old age, with the highest incidence occurring in childhood and early adulthood. An IMT has been defined as a histologically distinctive lesion of uncertain behavior. This article describes an unusual case of IMT mimicking apical periodontitis in the mandible of a 42-year-old man. At first presentation, the patient showed spontaneous pain and percussion pain at teeth #28 to 30, which continued after initial endodontic treatment. Panoramic radiography revealed a radiolucent lesion at the site. Cone-beam computed tomographic imaging showed osteolytic lesions, suggesting an aggressive neoplasm requiring incisional biopsy. Histopathological examination indicated an IMT. The lesion was removed en bloc under general anesthesia, and the patient manifested no clinical evidence of recurrence for 24 months. Lesions of nonendodontic origin should be included in the differential diagnosis of apical periodontitis. Every available diagnostic tool should be used to confirm the diagnosis. Cone-beam computed tomographic imaging is very helpful for differential diagnosis in IMTs mimicking apical periodontitis. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Ecthyma gangrenosum mimicking acute invasive fungal sinusitis in an immunocompromised patient.

PubMed

Hekiert, Adrianna M; Cohen, Michael B; Montone, Kathleen T; Palmer, James N; Govindaraj, Satish

2010-06-01

Ecthyma gangrenosum is a rare necrotizing cutaneous infection usually caused by Pseudomonas aeruginosa. We report a case of ecthyma gangrenosum presenting as a sinonasal eschar and mimicking acute invasive fungal sinusitis in an immunocompromised 39-year-old man with a hematologic malignancy. To the best of our knowledge, this represents the first case of ecthyma gangrenosum affecting the sinonasal mucosa to be reported in the literature.

Bone tumor mimickers: A pictorial essay

PubMed Central

Mhuircheartaigh, Jennifer Ni; Lin, Yu-Ching; Wu, Jim S

2014-01-01

Focal lesions in bone are very common and many of these lesions are not bone tumors. These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes. Many of these tumor mimickers can be left alone, while others can be due to a significant disease process. It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup. Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety. PMID:25114385

Oropharyngeal trauma mimicking a first branchial cleft anomaly.

PubMed

Larem, Aisha; Sheikh, Rashid; Al Qahtani, Abdulsalam; Khais, Frat; Ganesan, Shanmugam; Haidar, Hassan

2016-06-01

We present a unique and challenging case of a remnant foreign body that presented to us in a child disguised as a strongly suspected congenital branchial cleft anomaly. This case entailed oropharyngeal trauma, with a delayed presentation as a retroauricular cyst accompanied by otorrhea that mimicked the classic presentation of an infected first branchial cleft anomaly. During surgical excision of the presumed branchial anomaly, a large wooden stick was found in the tract. The diagnostic and therapeutic obstacles in the management of such cases are highlighted. In addition to exploring the existing literature, we retrospectively analyzed a plausible explanation of the findings of this case. Laryngoscope, 126:E224-E226, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Demodex folliculitis mimicking acute graft-vs-host disease.

PubMed

Cotliar, Jonathan; Frankfurt, Olga

2013-12-01

Acute graft-vs-host disease (GVHD) typically requires high-dose systemic steroids as first-line treatment. Like drug eruptions, viral exanthema, and toxic erythema of chemotherapy, Demodex folliculitis is a clinical mimicker of acute GVHD and requires nonimmunosuppressive therapy. This case of Demodex folliculitis mimicking acute GVHD highlights the need for skin biopsy in patients who have undergone a stem cell transplant with eruptions on the head and neck. A 46-year-old white woman with a history of Fms-like tyrosine kinase 3 acute myeloid leukemia presented to the dermatology clinic with a 5-day history of a nonpruritic eruption on her face and neck 28 days after undergoing a double umbilical cord blood hematopoietic stem cell transplant (HSCT). Findings from the skin biopsy demonstrated a deep dermal lymphocytic infiltrate adjacent to follicular units along with an abundance of Demodex mites noted within the hair follicles consistent with Demodex folliculitis. Oral ivermectin, 12 mg, was given, and the eruption cleared within 24 hours. To our knowledge, this is only the fifth reported case of Demodex folliculitis following HSCT, but the first ever reported to be successfully treated with oral ivermectin. Demodex folliculitis should be added to the differential diagnosis of skin eruptions that arise after HSCT.

Granulomatous mastitis caused by histoplasma and mimicking inflammatory breast carcinoma.

PubMed

Osborne, B M

1989-01-01

Two cases of a lobular, necrotizing granulomatous process causing a unilateral painful breast mass mimicking carcinoma are presented for comparison. While the morphologic appearance in each case was that of lobular granulomatous mastitis, the etiologic agent in one case appeared to be Histoplasma capsulatum, based on Grocott methenamine silver staining, and represents the second reported case of histoplasmosis involving only breast parenchyma. Awareness of the rare entity, granulomatous mastitis, is important for the pathologist because the definitive diagnosis is made microscopically. Thorough evaluation of the breast tissue is essential for its management and should eventually contribute to the clarification of its etiology.

Cordylobia rodhaini infestation of the breast: Report of a case mimicking a breast abscess.

PubMed

Grassi, Veronica; Butterworth, James William; Latiffi, Layloma

2016-01-01

Myiasis, parasitic infestation of the body by fly larvae, caused by the Cordylobia rodhaini is very rare with only fourteen cases published since 1970. We present a rare case of myiasis mimicking a breast abscess. A 17-year-old female presented with a nodular ulcerative lesion in her left breast 14days following a trip to Ghana. She had been initially unsuccessfully treated with the antibiotic flucloxacillin following a misdiagnosis of a breast abscess. Following application of Vaseline to the breast wound, covering the wound for 2h and gentle manipulation the larvae was removed successfully and the patient made a good recovery. Presenting as an inflammatory papule with central opening oozing serosanguinous fluid myiasis secondary to C. rodhaini can easily be mistaken for a breast abscess, often avoiding detection by unsuspecting surgeons on initial assessment. In turn ineffective antibiotic treatment is often prescribed leading to further disease progression and associated morbidity. Myiasis secondary to C. rodhaini is a rare but important differential surgeons should consider in women presenting with an inflammatory breast lesion with a recent history of foreign travel to ensure timely diagnosis and treatment. Ultrasound imaging can be useful in confirming diagnosis and avoiding treatment delays. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

SU-F-BRA-01: A Procedure for the Fast Semi-Automatic Localization of Catheters Using An Electromagnetic Tracker (EMT) for Image-Guided Brachytherapy

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

Damato, A; Viswanathan, A; Cormack, R

2015-06-15

Purpose: To evaluate the feasibility of brachytherapy catheter localization through use of an EMT and 3D image set. Methods: A 15-catheter phantom mimicking an interstitial implantation was built and CT-scanned. Baseline catheter reconstruction was performed manually. An EMT was used to acquire the catheter coordinates in the EMT frame of reference. N user-identified catheter tips, without catheter number associations, were used to establish registration with the CT frame of reference. Two algorithms were investigated: brute-force registration (BFR), in which all possible permutation of N identified tips with the EMT tips were evaluated; and signature-based registration (SBR), in which a distancemore » matrix was used to generate a list of matching signatures describing possible N-point matches with the registration points. Digitization error (average of the distance between corresponding EMT and baseline dwell positions; average, standard deviation, and worst-case scenario over all possible registration-point selections) and algorithm inefficiency (maximum number of rigid registrations required to find the matching fusion for all possible selections of registration points) were calculated. Results: Digitization errors on average <2 mm were observed for N ≥5, with standard deviation <2 mm for N ≥6, and worst-case scenario error <2 mm for N ≥11. Algorithm inefficiencies were: N = 5, 32,760 (BFR) and 9900 (SBR); N = 6, 360,360 (BFR) and 21,660 (SBR); N = 11, 5.45*1010 (BFR) and 12 (SBR). Conclusion: A procedure was proposed for catheter reconstruction using EMT and only requiring user identification of catheter tips without catheter localization. Digitization errors <2 mm were observed on average with 5 or more registration points, and in any scenario with 11 or more points. Inefficiency for N = 11 was 9 orders of magnitude lower for SBR than for BFR. Funding: Kaye Family Award.« less

Autoimmune pancreatitis associated with renal lesions mimicking metastatic tumours

PubMed Central

Rudmik, Lucas; Trpkov, Kiril; Nash, Carla; Kinnear, Susan; Falck, Vincent; Dushinski, John; Dixon, Elijah

2006-01-01

Autoimmune pancreatitis is a chronic inflammatory disorder that is often misdiagnosed as pancreatic cancer. Since autoimmune pancreatitis is benign and responds to steroid management, it is important to diagnose it to avoid unnecessary surgical intervention. We describe a novel case of IgG4-associated autoimmune pancreatitis presenting with tubulointerstitial nephritis as renal lesions mimicking metastatic tumours but with no change in renal function. PMID:16908897

Epidermal cyst mimicking incision line metastasis

PubMed Central

Gündoğdu, Ramazan; Ayhan, Erhan; Çolak, Tahsin

2017-01-01

Epidermal cysts are cystic tumors lined with keratinized squamous layer and filled with keratin debris. Epidermal cysts may develop by implantation of surface epidermal layer into the dermis or subcutaneous tissue after trauma or surgical procedures. Cervix cancer spreads either directly or via the vascular and lymphatic systems. Distant skin metastasis of endometrium or cervix cancer is very rare. In this case report, a patient who had a history of cervix cancer operation 11 years ago and presented with a mass that mimicked incision line metastasis and was histopathologically diagnosed with epidermal cyst is presented. PMID:28740968

Neglected foreign body aspiration mimicking bronchial carcinoma.

PubMed

Afghani, Reza; Khandashpour Ghomi, Mahmoud; Khandoozi, Seyed Reza; Yari, Behrouz

2016-07-01

Foreign body aspiration can occur in any age group, but it is more commonly seen in children. In adults, there is usually a predisposing condition that poses a risk of aspiration. If aspiration occurs, prompt diagnosis and extraction of the foreign body is needed to prevent early and late complications. We report a rare case of neglected foreign body aspiration in a 45-year-old schizophrenic opium addicted patient, which resulted in an occlusive lesion in the bronchus, mimicking bronchial carcinoma. © The Author(s) 2016.

Reticulated acanthoma with sebaceous differentiation mimicking melanoma

PubMed Central

Ribeiro, Felipe; Leocadia, Elizabeth; Macarenco, Ricardo S.; Lapins, Jan; Huet, Pascale; Akay, Bengu Nisa; Steiner, Denise

2017-01-01

Reticulated acanthoma with sebaceous differentiation (RASD) is a rare, benign cutaneous tumor with peculiar histopathologic characteristics [1]. RASD had been described under various synonyms such as superficial epithelioma with sebaceous differentiation, sebocrine adenoma, poroma with sebaceous differentiation, and seborrheic keratosis with sebaceous differentiation [2]. Clinical differential diagnosis of RASD includes cutaneous superficial epithelial neoplasia such as Bowen’s disease, superficial basal cell carcinoma (BCC) and intraepidermal eccrine poroma [1]. We report the first case of RASD mimicking both clinically and dermoscopically a melanoma. PMID:29085717

Borrelia Lymphocytoma Mimicking Butterfly Rash in a Pediatric Patient.

PubMed

Llamas-Velasco, Mar; Paredes, Bruno Emilio

2018-03-01

A 5-year-old girl presented with a facial butterfly rash that persisted for 5 months without arthralgia, fever, malaise, photosensitivity, or other symptoms. Lupus erythematosus was clinically suspected. All blood tests were negative or within normal values. Skin biopsy showed a dense nodular superficial and deep inflammatory infiltrate of lymphocytes that reaches subcutaneous tissue. The most striking histopathological finding was plasma cells with some perifollicular accentuation. Borrelia polymerase chain reaction assay of the tissue was positive, and we made the diagnoses of borrelia lymphocytoma mimicking butterfly rash of lupus erythematosus. The lesions disappeared with amoxicillin followed by cefuroxime for 28 days. In children, a variety of diseases including lupus erythematous may lead to a butterfly rash that is usually short lasting and commonly associated with systemic symptoms. Borreliosis may be related with long-lasting facial erythema in children and may mimic lupus and present high titers of antinuclear antibodies. In any case, borrelial lymphocytoma has not been previously reported as a cause of butterfly rash, thus mimicking acute lupus in a child, as in our case. From a histopathological point of view, the presence of plasma cells in a pseudolymphomatous infiltrate is a clue for the right diagnosis. Therefore, we suggest that borrelia serology should be done in children with butterfly rash lasting more than a month and empirical antibiotic treatment should be tried even in cases with negative serology.

Vogt Koyanagi Harada Syndrome mimicking multiple sclerosis: A case report and review of the literature.

PubMed

Algahtani, Hussein; Shirah, Bader; Algahtani, Raghad; Alkahtani, Abdulah; Alwadie, Saeed

2017-02-01

Vogt Koyanagi Harada (VKH) Syndrome, also called uveomeningioencephalitis, is a chronic disorder characterized by inflammation of the uvea, meninges, auditory system, and integumentary system. The association between VKH syndrome and multiple sclerosis (MS) has been reported only once in the literature in a patient who developed VKH syndrome after two years of the diagnosis of MS. In this article, we report a case who was misdiagnosed and treated as MS until she was proven to have VKH syndrome, and a diagnosis of MS was excluded. VKH syndrome is a systemic disorder that may present with clinical and/or radiological features mimicking MS. Applying diagnostic criteria is extremely important for confirming or excluding the diagnosis. Detailed history and physical examination are of paramount importance to score the final diagnosis. Rigorous search for red flags for both conditions is very helpful. Copyright © 2017 Elsevier B.V. All rights reserved.

Herpes zoster sciatica mimicking lumbar canal stenosis: a case report.

PubMed

Koda, Masao; Mannoji, Chikato; Oikawa, Makiko; Murakami, Masazumi; Okamoto, Yuzuru; Kon, Tamiyo; Okawa, Akihiko; Ikeda, Osamu; Yamazaki, Masashi; Furuya, Takeo

2015-07-29

Symptom of herpes zoster is sometimes difficult to distinguish from sciatica induced by spinal diseases, including lumbar disc herniation and spinal canal stenosis. Here we report a case of sciatica mimicking lumbar canal stenosis. A 74-year-old Chinese male patient visited our hospital for left-sided sciatic pain upon standing or walking for 5 min of approximately 1 month's duration. At the first visit to our hospital, there were no skin lesions. A magnetic resonance imaging showed spinal canal stenosis between the 4th and 5th lumbar spine. Thus, we diagnosed the patient with sciatica induced by spinal canal stenosis. We considered decompression surgery for the stenosis of 4th and 5th lumbar spine because conservative therapy failed to relieve the patient's symptom. At that time, the patient complained of a skin rash involving his left foot for several days. A vesicular rash and erythema were observed on the dorsal and plantar surfaces of the great toe and lateral malleolus. The patient was diagnosed with herpes zoster in the left 5th lumbar spinal nerve area based on clinical findings, including the characteristics of the pain and vesicular rash and erythema in the 5th lumbar spinal dermatome. The patient was treated with famciclovir (1,500 mg/day) and non-steroidal anti-inflammatory drugs. After 1 week of medication, the skin rash resolved and pain relief was obtained. In conclusion, spinal surgeons should keep in mind herpes zoster infection as one of the possible differential diagnoses of sciatica, even if there is no typical skin rash.

Worst-Case Cooperative Jamming for Secure Communications in CIoT Networks.

PubMed

Li, Zhen; Jing, Tao; Ma, Liran; Huo, Yan; Qian, Jin

2016-03-07

The Internet of Things (IoT) is a significant branch of the ongoing advances in the Internet and mobile communications. The use of a large number of IoT devices makes the spectrum scarcity problem even more serious. The usable spectrum resources are almost entirely occupied, and thus, the increasing radio access demands of IoT devices cannot be met. To tackle this problem, the Cognitive Internet of Things (CIoT) has been proposed. In a CIoT network, secondary users, i.e., sensors and actuators, can access the licensed spectrum bands provided by licensed primary users (such as telephones). Security is a major concern in CIoT networks. However, the traditional encryption method at upper layers (such as symmetric cryptography and asymmetric cryptography) may be compromised in CIoT networks, since these types of networks are heterogeneous. In this paper, we address the security issue in spectrum-leasing-based CIoT networks using physical layer methods. Considering that the CIoT networks are cooperative networks, we propose to employ cooperative jamming to achieve secrecy transmission. In the cooperative jamming scheme, a certain secondary user is employed as the helper to harvest energy transmitted by the source and then uses the harvested energy to generate an artificial noise that jams the eavesdropper without interfering with the legitimate receivers. The goal is to minimize the signal to interference plus noise ratio (SINR) at the eavesdropper subject to the quality of service (QoS) constraints of the primary traffic and the secondary traffic. We formulate the considered minimization problem into a two-stage robust optimization problem based on the worst-case Channel State Information of the Eavesdropper. By using semi-definite programming (SDP), the optimal solutions of the transmit covariance matrices can be obtained. Moreover, in order to build an incentive mechanism for the secondary users, we propose an auction framework based on the cooperative jamming scheme

Statistical analysis of environmental monitoring data: does a worst case time for monitoring clean rooms exist?

PubMed

Cundell, A M; Bean, R; Massimore, L; Maier, C

1998-01-01

To determine the relationship between the sampling time of the environmental monitoring, i.e., viable counts, in aseptic filling areas and the microbial count and frequency of alerts for air, surface and personnel microbial monitoring, statistical analyses were conducted on 1) the frequency of alerts versus the time of day for routine environmental sampling conducted in calendar year 1994, and 2) environmental monitoring data collected at 30-minute intervals during routine aseptic filling operations over two separate days in four different clean rooms with multiple shifts and equipment set-ups at a parenteral manufacturing facility. Statistical analyses showed, except for one floor location that had significantly higher number of counts but no alert or action level samplings in the first two hours of operation, there was no relationship between the number of counts and the time of sampling. Further studies over a 30-day period at the floor location showed no relationship between time of sampling and microbial counts. The conclusion reached in the study was that there is no worst case time for environmental monitoring at that facility and that sampling any time during the aseptic filling operation will give a satisfactory measure of the microbial cleanliness in the clean room during the set-up and aseptic filling operation.

Pneumopyopericardium mimicking an inferior ST elevation myocardial infarction with regional electrocardiogram changes: a case report.

PubMed

Ratnayake, Eranda Chamara; Premaratne, Sandamali; Lokunarangoda, Niroshan; Fernando, Sanduni; Fernando, Nilanthi; Ponnamperuma, Chandrike; Santharaj, W Samuel

2015-04-30

Pneumopyopericardium is a rare disease with poor prognosis. The usual presentation is with fever, shortness of breath and haemodynamic compromise. The Electrocardiogram changes associated with this disease entity would be similar to pericarditis such as concave shaped ST elevations in all leads with PR sagging. Pneumopyopericardium mimicking an acute ST Elevation Myocardial Infarction, with regional Electrocardiogram changes has hitherto not been described in world literature. We describe the case of a 48 year old native Sri Lankan man, presenting with chest pain and Electrocardiogram changes compatible with an Acute ST Elevation Myocardial Infarction, subsequently found to have Pneumopyopericardium secondary to an oesophageal tear. Retrospective history revealed repetitive vomiting due to heavy alcohol consumption, prior to presentation. It unfortunately led to a fatal outcome. Pneumopyopericardium may mimic an acute ST elevation myocardial infarction with associated regional Electrocardiogram changes. A high degree of suspicion should be maintained and an adequate history should always be obtained prior to any intervention in all ST Elevation Myocardial Infarction patients.

Cartilage Delamination Flap Mimicking a Torn Medial Meniscus

PubMed Central

Bin Abd Razak, Hamid Rahmatullah; Amit Kanta, Mitra

2016-01-01

We report a case of a chondral delamination lesion due to medial parapatellar plica friction syndrome involving the medial femoral condyle. This mimicked a torn medial meniscus in clinical and radiological presentation. Arthroscopy revealed a chondral delamination flap, which was debrided. Diagnosis of chondral lesions in the knee can be challenging. Clinical examination and MRI have good accuracy for diagnosis and should be used in tandem. Early diagnosis and treatment of chondral lesions are important to prevent progression to early osteoarthritis. PMID:28070434

Endometriosis after surgical menopause mimicking pelvic malignancy: surgeons' predicament.

PubMed

Bhat, Rani A; Teo, Melissa; Bhat, Akhil Krishnanand

2014-05-01

Prevalence of persistent endometriosis in women after menopause without any hormonal replacement therapy is very rare. This is a case of a woman with previous history of total hysterectomy and bilateral salpingo-oophorectomy for endometriosis who presented with hemoperitoneum, vaginal bleeding, pelvic mass, and pulmonary thromboembolism mimicking as rectovaginal septum carcinoma. This is the first case report with a unique mode of presentation wherein the patient presented with hemoperitoneum requiring emergency embolization of the vessel to stabilize the patient. She underwent en bloc resection of the tumor with high anterior resection of the rectum. Histopathology confirmed endometriosis.

Endometriosis After Surgical Menopause Mimicking Pelvic Malignancy: Surgeons’ Predicament

PubMed Central

Bhat, Rani A.; Teo, Melissa; Bhat, Akhil Krishnanand

2014-01-01

Prevalence of persistent endometriosis in women after menopause without any hormonal replacement therapy is very rare. This is a case of a woman with previous history of total hysterectomy and bilateral salpingo-oophorectomy for endometriosis who presented with hemoperitoneum, vaginal bleeding, pelvic mass, and pulmonary thromboembolism mimicking as rectovaginal septum carcinoma. This is the first case report with a unique mode of presentation wherein the patient presented with hemoperitoneum requiring emergency embolization of the vessel to stabilize the patient. She underwent en bloc resection of the tumor with high anterior resection of the rectum. Histopathology confirmed endometriosis. PMID:24936277

Post-pancreatitis Fat Necrosis Mimicking Carcinomatosis.

PubMed

Smith, Joshua P; Arnoletti, J Pablo; Varadarajulu, Shyam; Morgan, Desiree E

2008-01-01

Acute pancreatitis can result in retroperitoneal fat necrosis, typically occurring in the peripancreatic region, with extension into the transverse mesocolon, omentum and mesenteric root. When evaluated with contrast enhanced computed tomography (CECT), acute peripancreatic post necrotic collections typically become lower in attenuation over time, and often appear as homogeneous fluid collections. Saponification as a complication of fat necrosis in patients with acute pancreatitis is a well recognized clinical entity. While retroperitonal fat necrosis is commonly seen on CECT, saponification is not a prominent imaging feature. We present a case of acute pancreatitis complicated by extensive saponification of fat throughout the retroperitoneum and peritoneal lining, mimicking carcinomatosis.

Cogan's syndrome mimicking acute Lyme arthritis.

PubMed

Schwegmann, J P; Enzenauer, R J

1995-05-01

A pediatric case of Cogan's syndrome mimicking acute Lyme arthritis is described. A 12-year-old black boy was admitted to the pediatric service for presumed right knee septic arthritis. Symptoms included acute pain and swelling with decreased range-of-motion. Although the patient's right knee symptoms and positive Lyme serology were consistent with a diagnosis of Lyme arthritis, the presence of sensorineural hearing loss and interstitial keratitis with inflammatory arthritis suggested a diagnosis of Cogan's syndrome. Subsequent Western blot analysis was negative for Borrelia burgdorferi antigens. The patient had dramatic clinical improvement of musculoskeletal and ophthalmologic complaints shortly after receiving high-dose corticosteroids, although residual sensorineural hearing loss persisted.

Specific exercises reduce brace prescription in adolescent idiopathic scoliosis: a prospective controlled cohort study with worst-case analysis.

PubMed

Negrini, Stefano; Zaina, Fabio; Romano, Michele; Negrini, Alessandra; Parzini, Silvana

2008-06-01

To compare the effect of Scientific Exercises Approach to Scoliosis (SEAS) exercises with "usual care" rehabilitation programmes in terms of the avoidance of brace prescription and prevention of curve progression in adolescent idiopathic scoliosis. Prospective controlled cohort observational study. Seventy-four consecutive outpatients with adolescent idiopathic scoliosis, mean 15 degrees (standard deviation 6) Cobb angle, 12.4 (standard deviation 2.2) years old, at risk of bracing who had not been treated previously. Thirty-five patients were included in the SEAS exercises group and 39 in the usual physiotherapy group. The primary outcome included the number of braced patients, Cobb angle and the angle of trunk rotation. There were 6.1% braced patients in the SEAS exercises group vs 25.0% in the usual physiotherapy group. Failures of treatment in the worst-case analysis were 11.5% and 30.8%, respectively. In both cases the differences were statistically significant. Cobb angle improved in the SEAS exercises group, but worsened in the usual physiotherapy group. In the SEAS exercises group, 23.5% of patients improved and 11.8% worsened, while in the usual physiotherapy group 11.1% improved and 13.9% worsened. These data confirm the effectiveness of exercises in patients with scoliosis who are at high risk of progression. Compared with non-adapted exercises, a specific and personalized treatment (SEAS) appears to be more effective.

Demons-meigs pseudosyndrome mimicking the symptoms of pregnancy: a case report.

PubMed

Nohuz, Erdogan; Alaboud, Maher; El-Drayi, Bilal; Tamburro, Stefano; Kachkach, Said; Varga, Janos

2014-10-01

The Demons-Meigs syndrome should usually be evoked in case of presence of a typical triad: abdominopelvic mass, ascites and hydrothorax. Its diagnosis appears crucial to prevent the realization of unnecessary surgical procedures. A 32-year-old woman presented in April 2012 to the emergency department of our maternity unit (General Hospital, Thiers, France) with an abdominal distension mimicking the symptoms of a pregnancy at term. Physical examination revealed a voluminous painful abdominopelvic mass, extended from the pelvis to the upper abdomen with a large right pleural effusion. Ultrasound and computed tomography showed it was a tumor measuring more than 300 mm in diameter with a right hydrothorax. Serum CA-125 level was 289 U/ml. Cytologic analysis of the pleural effusion didn't show any malignant cells. In this study, Demons-Meigs syndrome was recognized. A laparoscopico-laparotomic management permitted an aspiration of 23 liters of a brownish liquid and an unilateral adnexectomy after pleural paracentesis was performed. Frozen section demonstrated benign mucinous cystadenoma. The final histologic findings objectified intracystic intestinal type ovarian mucinous borderline tumor. After multidisciplinary consultation, the patient was re-operated one month later. The exploration didn't reveal any suspected lesions and appendectomy and omentectomy were performed. The postoperative course was uneventful. Serum CA-125 level was normal at the time of the reoperation and 24 months after the initial surgery. The preoperative recognition of a Demons-Meigs syndrome or a Demons' pseudosyndrome is essential to avoid useless surgical procedures.

[Graft-versus-host disease as the cause of symptoms mimicking Sjögren's syndrome].

PubMed

Tuchocka-Piotrowska, Aleksandra; Puszczewicz, Mariusz; Kołczewska, Aleksandra; Majewski, Dominik

2006-01-01

A case of chronic graft-versus-host disease (chronic GvHD) mimicking symptoms associated with idiopathic Sjögren's syndrome is presented. Hypotheses on the pathophysiological origin of clinical syndromes associated with graft-versus-host disease are discussed.

An Unusual Foreign Body in the Urinary Bladder Mimicking a Parasitic Worm

PubMed Central

Schmitt, Bryan H.; Feder, Marc T.; Rokke, Denise L.; Moyer, Thomas P.

2012-01-01

We report an unusual case of a foreign body removed from the urinary bladder of a 63-year-old male which mimicked a parasitic worm. The foreign body was identified as an artificial fishing worm by morphological comparison to a similar commercially produced product and by infrared spectrum analysis. PMID:22535991

A multinational randomised study comparing didactic lectures with case scenario in a severe sepsis medical simulation course.

PubMed

Li, Chih-Huang; Kuan, Win-Sen; Mahadevan, Malcolm; Daniel-Underwood, Lynda; Chiu, Te-Fa; Nguyen, H Bryant

2012-07-01

Medical simulation has been used to teach critical illness in a variety of settings. This study examined the effect of didactic lectures compared with simulated case scenario in a medical simulation course on the early management of severe sepsis. A prospective multicentre randomised study was performed enrolling resident physicians in emergency medicine from four hospitals in Asia. Participants were randomly assigned to a course that included didactic lectures followed by a skills workshop and simulated case scenario (lecture-first) or to a course that included a skills workshop and simulated case scenario followed by didactic lectures (simulation-first). A pre-test was given to the participants at the beginning of the course, post-test 1 was given after the didactic lectures or simulated case scenario depending on the study group assignment, then a final post-test 2 was given at the end of the course. Performance on the simulated case scenario was evaluated with a performance task checklist. 98 participants were enrolled in the study. Post-test 2 scores were significantly higher than pre-test scores in all participants (80.8 ± 12.0% vs 65.4 ± 12.2%, p<0.01). There was no difference in pre-test scores between the two study groups. The lecture-first group had significantly higher post-test 1 scores than the simulation-first group (78.8 ± 10.6% vs 71.6 ± 12.6%, p<0.01). There was no difference in post-test 2 scores between the two groups. The simulated case scenario task performance completion was 90.8% (95% CI 86.6% to 95.0%) in the lecture-first group compared with 83.8% (95% CI 79.5% to 88.1%) in the simulation-first group (p=0.02). A medical simulation course can improve resident physician knowledge in the early management of severe sepsis. Such a course should include a comprehensive curriculum that includes didactic lectures followed by simulation experience.

Mesenteric fibromatosis with intestinal involvement mimicking a gastrointestinal stromal tumour

PubMed Central

Wronski, Marek; Ziarkiewicz-Wroblewska, Bogna; Slodkowski, Maciej; Cebulski, Wlodzimierz; Gornicka, Barbara; Krasnodebski, Ireneusz W.

2011-01-01

Introduction Mesenteric fibromatosis or intra-abdominal desmoid tumour is a rare proliferative disease affecting the mesentery. It is a locally aggressive tumour that lacks metastatic potential, but the local recurrence is common. Mesenteric fibromatosis with the intestinal involvement can be easily confused with other primary gastrointestinal tumours, especially with that of the mesenchymal origin. Case report We report a case of a 44-year-old female who presented with an abdominal mass that radiologically and pathologically mimicked a gastrointestinal stromal tumour. Conclusions The diagnosis of mesenteric fibromatosis should always be considered in the case of mesenchymal tumours apparently originating from the bowel wall that diffusely infiltrate the mesentery. PMID:22933936

Floating retained root lesion mimicking apical periodontitis.

PubMed

Chung, Ming-Pang; Chen, Chih-Ping; Shieh, Yi-Shing

2009-10-01

A case of a retained root tip simulating apical periodontitis on radiographic examination is described. The retained root tip, originating from the left lower first molar, floated under the left lower second premolar apical region mimicking apical periodontitis. It appeared as an ill-defined periapical radiolucency containing a smaller radiodense mass on radiograph. The differential diagnosis included focal sclerosing osteomyelitis (condensing osteitis) and ossifying fibroma. Upon exicisional biopsy, a retained root associated with granulation tissue was found. After 1-year follow-up, the patient was asymptomatic and the periradicular lesion was healing. Meanwhile, the associated tooth showed a normal response to stimulation testing.

Performance of a normalized energy metric without jammer state information for an FH/MFSK system in worst case partial band jamming

NASA Technical Reports Server (NTRS)

Lee, P. J.

1985-01-01

For a frequency-hopped noncoherent MFSK communication system without jammer state information (JSI) in a worst case partial band jamming environment, it is well known that the use of a conventional unquantized metric results in very poor performance. In this paper, a 'normalized' unquantized energy metric is suggested for such a system. It is shown that with this metric, one can save 2-3 dB in required signal energy over the system with hard decision metric without JSI for the same desired performance. When this very robust metric is compared to the conventional unquantized energy metric with JSI, the loss in required signal energy is shown to be small. Thus, the use of this normalized metric provides performance comparable to systems for which JSI is known. Cutoff rate and bit error rate with dual-k coding are used for the performance measures.

Ileal inflammatory fibroid polyp causing chronic ileocolic intussusception and mimicking cecal carcinoma

PubMed Central

Gara, Naveen; Falzarano, John S; Limm, Whitney ML; Namiki, Thomas S; Tom, Laurie KS

2009-01-01

Inflammatory fibroid polyp (IFP) is a rare, idiopathic pseudotumorous lesion of the gastrointestinal tract. While mostly reported as solitary gastric lesions, multiple cases of small bowel IFPs are also reported. It is a documented cause of intussusception in adults. In the case reports of ileal inflammatory fibroid polyps with intussusception, an emergent presentation with small bowel obstruction has been most often described. Here we depict a case of ileal inflammatory fibroid polyp presenting with chronic intermittent ileocolic intussusception, anemia and weight loss with an endoscopic appearance mimicking necrotic cecal carcinoma. PMID:21160780

Modeling post-fire sediment yield based on two burn scenarios at the Sooke Lake Reservoir, BC, Canada

NASA Astrophysics Data System (ADS)

Dobre, Mariana; Elliot, William J.; Brooks, Erin S.; Smith, Tim

2016-04-01

Wildfires can have major adverse effects on municipal water sources. Local governments need methods to evaluate fire risk and to develop mitigation procedures. The Sooke Lake Reservoir is the primary source of water for the city of Victoria, BC and the concern is that sediment delivered from upland burned areas could have a detrimental impact on the reservoir and the water supply. We conducted a sediment delivery modeling pilot study on a portion of the Sooke Lake Reservoir (specifically, the Trestle Creek Management Unit (TCMU)) to evaluate the potential impacts of wildfire on sediment delivery from hillslopes and sub-catchments. We used a process-based hydrologic and soil erosion model called Water Erosion Prediction Project geospatial interface, GeoWEPP, to predict the sediment delivery from specific return period design storms for two burn severity scenarios: real (low-intensity burn severity) and worst (high-intensity burn severity) case scenarios. The GeoWEPP model allows users to simulate streamflow and erosion from hillslope polygons within a watershed. The model requires information on the topographic, soil and vegetative characteristics for each hillslope and a weather file. WEPP default values and several assumptions were necessary to apply the model where data were missing. Based on a 10-m DEM we delineated 16 watersheds within the TCMU area. A long term 100-year daily climate file was generated for this analysis using the CLIGEN model based on the historical observations recorded at Concrete, WA in United States, and adjusted for observed monthly precipitation observed in the Sooke Basin. We ran 100-year simulations and calculated yearly and event-based return periods (for 2, 5, 10, 20, 25, and 50 years) for each of the 16 watersheds. Overall, WEPP simulations indicate that the storms that are most likely to produce the greatest runoff and sediment load in these coastal, maritime climates with relatively low rainfall intensities are likely to occur in

Pesticide exposure assessment for surface waters in the EU. Part 2: Determination of statistically based run-off and drainage scenarios for Germany.

PubMed

Bach, Martin; Diesner, Mirjam; Großmann, Dietlinde; Guerniche, Djamal; Hommen, Udo; Klein, Michael; Kubiak, Roland; Müller, Alexandra; Preuss, Thomas G; Priegnitz, Jan; Reichenberger, Stefan; Thomas, Kai; Trapp, Matthias

2017-05-01

In order to assess surface water exposure to active substances of plant protection products (PPPs) in the European Union (EU), the FOCUS (FOrum for the Co-ordination of pesticide fate models and their USe) surface water workgroup introduced four run-off and six drainage scenarios for Step 3 of the tiered FOCUSsw approach. These scenarios may not necessarily represent realistic worst-case situations for the different Member States of the EU. Hence, the suitability of the scenarios for risk assessment in the national authorisation procedures is not known. Using Germany as an example, the paper illustrates how national soil-climate scenarios can be developed to model entries of active substances into surface waters from run-off and erosion (using the model PRZM) and from drainage (using the model MACRO). In the authorisation procedure for PPPs on Member State level, such soil-climate scenarios can be used to determine exposure endpoints with a defined overall percentile. The approach allows the development of national specific soil-climate scenarios and to calculate percentile-based exposure endpoints. The scenarios have been integrated into a software tool analogous to FOCUS-SWASH which can be used in the future to assess surface water exposure in authorisation procedures of PPPs in Germany. © 2017 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry. © 2017 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Primary scattered multifocal melanocytomas in spinal canal mimicking neurofibromatosis.

PubMed

Yang, Chenlong; Fang, Jingyi; Li, Guang; Yang, Jun; Xu, Yulun

2016-08-01

Meningeal melanocytoma is an extremely rare pigmented tumor derived from leptomeningeal melanocytes. By and large, it is considered to be a well-differentiated and slow-growing benign lesion. Generally, meningeal melanocytomas are solitary lesions, and the occurrence of the primary multifocal form in the central nervous system is exceedingly rare; it has been previously reported in only six cases. The present report illustrates a 41-year-old woman with primary multifocal meningeal melanocytoma in the spinal canal. Contrary to earlier reports, the tumors presented with a scattered appearance mimicking neurofibromatosis. This study is a case report and review of literature. On admission, the cerebral magnetic resonance images of the patient were normal, whereas the spinal magnetic resonance images showed scattered multifocal nodules mimicking neurofibromatosis. Surgical resection of the responsible lesions was scheduled. In addition to this case presentation, relevant previous reports were reviewed, and the challenging diagnosis, management, and prognosis of meningeal melanocytoma are discussed. Gross total resection of the two largest lesions was achieved, and histopathological examinations confirmed the diagnosis. Despite the benign histopathological findings, the patient had an aggressive clinical course. On follow-up at 18 months after surgery, she succumbed to the disease. Clinicians should be alert to a potential aggressive clinical course of meningeal melanocytoma, despite its benign histopathological nature. Of particular note is multifocality and diffuse leptomeningeal hyperpigmentation, which may suggest a poor prognosis. A combined treatment including surgical resection and adjuvant radiotherapy should be considered, and long-term close follow-up is necessary. Copyright © 2016. Published by Elsevier Inc.

Scenario Based Approach for Multiple Source Tsunami Hazard Assessment for Sines, Portugal

NASA Astrophysics Data System (ADS)

Wronna, Martin; Omira, Rachid; Baptista, Maria Ana

2015-04-01

In this paper, we present a scenario-based approach for tsunami hazard assessment for the city and harbour of Sines, Portugal one the test-sites of project ASTARTE. Sines holds one of the most important deep-water ports which contains oil-bearing, petrochemical, liquid bulk, coal and container terminals. The port and its industrial infrastructures are facing the ocean to the southwest facing the main seismogenic sources. This work considers two different seismic zones: the Southwest Iberian Margin and the Gloria Fault. Within these two regions, a total of five scenarios were selected to assess tsunami impact at the test site. These scenarios correspond to the worst-case credible scenario approach based upon the largest events of the historical and paleo tsunami catalogues. The tsunami simulations from the source area towards the coast is carried out using NSWING a Non-linear Shallow Water Model With Nested Grids. The code solves the non-linear shallow water equations using the discretization and explicit leap-frog finite difference scheme, in a Cartesian or Spherical frame. The initial sea surface displacement is assumed to be equal to the sea bottom deformation that is computed by Okada equations. Both uniform and non-uniform slip conditions are used. The presented results correspond to the models using non-uniform slip conditions. In this study, the static effect of tides is analysed for three different tidal stages MLLW (mean lower low water) MSL (mean sea level) and MHHW (mean higher high water). For each scenario, inundation is described by maximum values of wave height, flow depth, drawdown, run-up and inundation distance. Synthetic waveforms are computed at virtual tide gages at specific locations outside and inside the harbour. The final results consist of Aggregate Scenario Maps presented for the different inundation parameters. This work is funded by ASTARTE - Assessment, Strategy And Risk Reduction for Tsunamis in Europe - FP7-ENV2013 6.4-3, Grant 603839

A Case-Based Scenario with Interdisciplinary Guided-Inquiry in Chemistry and Biology: Experiences of First Year Forensic Science Students

ERIC Educational Resources Information Center

Cresswell, Sarah L.; Loughlin, Wendy A.

2017-01-01

In this paper, insight into forensic science students' experiences of a case-based scenario with an interdisciplinary guided-inquiry experience in chemistry and biology is presented. Evaluation of student experiences and interest showed that the students were engaged with all aspects of the case-based scenario, including the curriculum theory…

Nephropathic Cystinosis Mimicking Bartter Syndrome: a Novel Mutation.

PubMed

Bastug, Funda; Nalcacioglu, Hulya; Ozaltin, Fatih; Korkmaz, Emine; Yel, Sibel

2018-01-01

Cystinosis is a rare autosomal recessive disorder resulting from defective lysosomal transport of cystine due to mutations in the cystinosin lysosomal cystine transporter (CTNS) gene. The clinical phenotype of nephropathic cystinosis is characterized by renal tubular Fanconi syndrome and development of end-stage renal disease during the first decade. Although metabolic acidosis is the classically prominent finding of the disease, a few cases may present with hypokalemic metabolic alkalosis mimicking Bartter syndrome. Bartter-like presentation may lead to delay in diagnosis and initiation of specific treatment for cystinosis. We report a case of a 6-year-old girl initially presenting with the features of Bartter syndrome that was diagnosed 2 years later with nephropathic cystinosis and a novel CTNS mutation.

High-altitude cerebral oedema mimicking stroke.

PubMed

Yanamandra, Uday; Gupta, Amul; Patyal, Sagarika; Varma, Prem Prakash

2014-03-26

High-altitude cerebral oedema (HACO) is the most fatal high-altitude illness seen by rural physicians practising in high-altitude areas. HACO presents clinically with cerebellar ataxia, features of raised intracranial pressure (ICP) and coma. Early identification is important as delay in diagnosis can be fatal. We present two cases of HACO presenting with focal deficits mimicking stroke. The first patient presented with left-sided hemiplegia associated with the rapid deterioration in the sensorium. Neuroimaging revealed features suggestive of vasogenic oedema. The second patient presented with monoplegia of the lower limb. Neuroimaging revealed perfusion deficit in anterior cerebral artery territory. Both patients were managed with dexamethasone and they improved dramatically. Clinical picture and neuroimaging closely resembled acute ischaemic stroke in both cases. Thrombolysis in these patients would have been disastrous. Recent travel to high altitude, young age, absence of atherosclerotic risk factors and features of raised ICP concomitantly directed the diagnosis to HACO.

Generating local scale land use/cover change scenarios: case studies of high-risk mountain areas

NASA Astrophysics Data System (ADS)

Malek, Žiga; Glade, Thomas; Boerboom, Luc

2014-05-01

The relationship between land use/cover changes and consequences to human well-being is well acknowledged and has led to higher interest of both researchers and decision makers in driving forces and consequences of such changes. For example, removal of natural vegetation cover or urban expansion resulting in new elements at risk can increase hydro-meteorological risk. This is why it is necessary to study how the land use/cover could evolve in the future. Emphasis should especially be given to areas experiencing, or expecting, high rates of socio-economic change. A suitable approach to address these changes is scenario development; it offers exploring possible futures and the corresponding environmental consequences, and aids decision-making, as it enables to analyse possible options. Scenarios provide a creative methodology to depict possible futures, resulting from existing decisions, based on different assumptions of future socio-economic development. They have been used in various disciplines and on various scales, such as flood risk and soil erosion. Several studies have simulated future scenarios of land use/cover changes at a very high success rate, however usually these approaches are tailor made for specific case study areas and fit to available data. This study presents a multi-step scenario generation framework, which can be transferable to other local scale case study areas, taking into account the case study specific consequences of land use/cover changes. Through the use of experts' and decision-makers' knowledge, we aimed to develop a framework with the following characteristics: (1) it enables development of scenarios that are plausible, (2) it can overcome data inaccessibility, (3) it can address intangible and external driving forces of land use/cover change, and (4) it ensures transferability to other local scale case study areas with different land use/cover change processes and consequences. To achieve this, a set of different methods is applied

A semi-quantitative World Health Organization grading scheme evaluating worst tumor differentiation predicts disease-free survival in oral squamous carcinoma patients.

PubMed

Jain, Dhruv; Tikku, Gargi; Bhadana, Pallavi; Dravid, Chandrashekhar; Grover, Rajesh Kumar

2017-08-01

We investigated World Health Organization (WHO) grading and pattern of invasion based histological schemes as independent predictors of disease-free survival, in oral squamous carcinoma patients. Tumor resection slides of eighty-seven oral squamous carcinoma patients [pTNM: I&II/III&IV-32/55] were evaluated. Besides examining various patterns of invasion, invasive front grade, predominant and worst (highest) WHO grade were recorded. For worst WHO grading, poor-undifferentiated component was estimated semi-quantitatively at advancing tumor edge (invasive growth front) in histology sections. Tumor recurrence was observed in 31 (35.6%) cases. The 2-year disease-free survival was 47% [Median: 656; follow-up: 14-1450] days. Using receiver operating characteristic curves, we defined poor-undifferentiated component exceeding 5% of tumor as the cutoff to assign an oral squamous carcinoma as grade-3, when following worst WHO grading. Kaplan-Meier curves for disease-free survival revealed prognostic association with nodal involvement, tumor size, worst WHO grading; most common pattern of invasion and invasive pattern grading score (sum of two most predominant patterns of invasion). In further multivariate analysis, tumor size (>2.5cm) and worst WHO grading (grade-3 tumors) independently predicted reduced disease-free survival [HR, 2.85; P=0.028 and HR, 3.37; P=0.031 respectively]. The inter-observer agreement was moderate for observers who semi-quantitatively estimated percentage of poor-undifferentiated morphology in oral squamous carcinomas. Our results support the value of semi-quantitative method to assign tumors as grade-3 with worst WHO grading for predicting reduced disease-free survival. Despite limitations, of the various histological tumor stratification schemes, WHO grading holds adjunctive value for its prognostic role, ease and universal familiarity. Copyright © 2017 Elsevier Inc. All rights reserved.

Metastatic carcinoma to the mandible that mimicked pulpal/periodontal disease.

PubMed

Selden, H S; Manhoff, D T; Hatges, N A; Michel, R C

1998-04-01

An oral cavity metastasis from a poorly differentiated carcinoma, presumed to have originated in the pancreas, mimicked a dental abscess. An additional metastasis to the lung caused a postobstructive lobar pneumonia that masked the lesion, thereby delaying the diagnosis of malignancy. This case report illustrates how the clinical manifestations of a widely disseminated neoplasm led to initial medical confusion and subsequent dental misdiagnosis, and serves to caution of a possible pitfall in the dental evaluation of endodontic lesions.

Spontaneous ovarian hyperstimulation syndrome and pituitary hyperplasia mimicking macroadenoma associated with primary hypothyroidism

PubMed Central

Kanza, Rene Epunza; Gagnon, Sylvain; Villeneuve, Helene; Laverdiere, David; Rousseau, Isabelle; Bordeleau, Edith; Berube, Michel

2013-01-01

We report an unusual case of spontaneous ovarian hyperstimulation syndrome and pituitary hyperplasia mimicking macroadenoma in an adult, non-pregnant woman. Her condition was triggered by unrecognized primary hypothyroidism, which regressed after thyroid hormone replacement therapy. This case highlights the need for clinicians and radiologists to familiarize themselves with the clinical and imaging features detected in case of these complications of primary hypothyroidism, which are not well known in the medical and radiological profession. Such improved knowledge will help avoid delays in diagnosis, progression to life-threatening complications, and unnecessary surgery. PMID:23494012

Fibroadenoma in Axillary Ectopic Breast Tissue Mimicking Lymphadenopathy

PubMed Central

Maheshwari, Ujwala M

2017-01-01

Swellings in the axilla especially in women are always viewed with suspicion owing to a large number of these being associated with breast carcinoma presenting as nodal metastasis. In a country like India, tuberculous lymphadenopathy is also amongst the first differentials. We present a case of a woman with right sided axillary swelling mimicking lymphadenopathy which on Fine Needle Aspiration Cytology (FNAC) turned out to be fibroadenoma of the ectopic breast tissue. This condition is a rare occurrence in Ectopic Breast Tissue (EBT) as opposed to that in the normal breast, the most common pathology affecting ectopic breast being carcinomas. PMID:28511397

Simple bone cyst of mandible mimicking periapical cyst.

PubMed

Hs, Charan Babu; Rai, Bhagawan Das; Nair, Manju A; Astekar, Madhusudan S

2012-05-29

Simple bone cysts (SBC) are pseudocysts occurring less commonly in the maxillofacial region. The uncertain and unclear etiopathogenesis led to numerous synonyms to refer this particular cyst. These cysts are devoid of an epithelial lining and are usually empty or contain blood or straw-colored fluid. In jaws initially it mimics a periapical cyst and later can lead to cortical bone expansion warranting for radical approach, which is seldom required. SBC is predominantly diagnosed in first two decades of life. Here we report a case of solitary bone cyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient.

Tinea capitis caused by Trichophyton rubrum mimicking favus.

PubMed

Boyd, Alan S

2016-12-01

Favus is an uncommon form of tinea capitis (TC) currently seen in geographic areas with poor sanitation and limited access to health care such as emerging nations. Several variants of this condition have been described including one exhibiting a plaque composed of parchmentlike material. The makeup of this plaque has not been described. Tinea capitis is rare in adults, particularly when the infectious agent is Trichophyton rubrum , and affected patients often exhibit comorbidities associated with diminished immune surveillance. This case report describes an elderly woman with TC due to T rubrum mimicking a rare form of favus.

Determining access to assisted reproductive technology: reactions of clinic directors to ethically complex case scenarios.

PubMed

Stern, J E; Cramer, C P; Green, R M; Garrod, A; DeVries, K O

2003-06-01

Our aim was to increase understanding of how patient selection is handled by assisted reproductive technology (ART) clinicians. Ethically complex case scenarios were evaluated by the directors of USA ART clinics. Scenarios included using a son as sperm donor for his father, sex selection without associated disease, treatment of morally irresponsible couples, and a dispute over embryo disposition. Respondents reviewed eight scenarios and gave their opinions on whether to offer treatment. Reasons given for these decisions were placed into one of 13 categories. Survey response rate was 57%. Between 3 and 50% of respondents would treat in each case. Of reasons given, 'conditional' responses (requiring counselling, blood tests or agreement to other 'conditions') were common (31.4%). Non-maleficence (risk) accounted for 29.4% of responses, philosophy of medicine 18.9%, respect for patient autonomy 5.9% and legal concerns 4.6%. Discrimination and threats were each significant in one case. Reasons evoking absolutist beliefs, personal discomfort, commitment to justice, religion and ethical relativism were rare. Clinicians felt conflict between a desire to respect patient autonomy and their discomfort over the risk associated with the procedure. They raised concerns about misuse of medical technology. Attempts to resolve complex issues through negotiation and compromise were common.

Sarcoidosis of the cauda equina mimicking Guillain-Barré syndrome.

PubMed

Shah, Jagdish R; Lewis, Richard A

2003-04-15

Neurosarcoidosis is a great mimicker. It is often difficult to diagnose particularly when there is no prior history of systemic sarcoidosis. Although certain sites of the neuraxis are more commonly involved than others, any site of the central or peripheral nervous system can be affected. We report a case of sarcoidosis involving the cauda equina in a 38-year-old African American male without prior history of systemic disease. Initial clinical presentation was suggestive of Guillian-Barré syndrome, but the evaluation proved this case to be neurosarcoidosis involving the cauda equina. We have followed this patient for 8 years, and he remains clinically stable on prednisone 5 mg/day.

Tissue mimicking materials for dental ultrasound

PubMed Central

Singh, Rahul S.; Culjat, Martin O.; Grundfest, Warren S.; Brown, Elliott R.; White, Shane N.

2008-01-01

While acoustic tissue mimicking materials have been explored for a variety of soft and hard biological tissues, no dental hard tissue mimicking materials have been characterized. Tooth phantoms are necessary to better understand acoustic phenomenology within the tooth environment and to accelerate the advancement of dental ultrasound imaging systems. In this study, soda lime glass and dental composite were explored as surrogates for human enamel and dentin, respectively, in terms of compressional velocity, attenuation, and acoustic impedance. The results suggest that a tooth phantom consisting of glass and composite can effectively mimic the acoustic behavior of a natural human tooth. PMID:18396919

Metastatic gastric carcinoma from breast cancer mimicking primary linitis plastica: A case report.

PubMed

Yagi, Yasumichi; Sasaki, Shozo; Yoshikawa, Akemi; Tsukioka, Yuji; Fukushima, Wataru; Fujimura, Takashi; Hirosawa, Hisashi; Izumi, Ryohei; Saito, Katsuhiko

2015-12-01

Metastases to the gastrointestinal tract rarely occur in breast cancer except in invasive lobular carcinoma. The present study reports a rare case of metastatic gastric cancer from invasive ductal carcinoma (IDC) of the breast mimicking primary gastric linitis plastica. A 51-year-old premenopausal female, who had a history of partial mastectomy for right breast cancer at the age of 40, was referred to Toyama City Hospital (Toyoma, Japan) for an endoscopic diagnosis of gastric linitis plastica. Abdominal computed tomography (CT) revealed left hydronephrosis, while peritoneal metastasis and malignant ascites were not detected. Chest CT detected a left lung tumor, which had invaded the left upper bronchus. Biopsy specimens were obtained and the histopathological findings on both the gastric tumor and lung tumor demonstrated poorly differentiated adenocarcinoma, whereas the histology of the original breast cancer was IDC with a solid-tubular type. Immunohistochemistry revealed that the biopsied specimens of the gastric and lung tumors were positive for estrogen receptor (ER), progesterone receptor (PgR) and negative for human epithelial growth factor receptor-2 (HER2). These molecular characteristics indicated the case was metastatic gastric carcinoma from the breast cancer with lung metastasis, since the statuses of ER, PgR and HER2 were concordant with those of the original breast cancer. However, the possibility of primary gastric cancer could not be completely ruled out. Therefore, a total gastrectomy was performed for the purpose of both diagnosis and treatment. Pathological examination of the resected specimen provided a definite diagnosis of multiple metastatic gastric carcinomas from the breast. To the best of our knowledge, metastatic gastric cancer derived from the breast presenting as linitis plastica 11 years following the surgical removal of IDC has not been described previously.

Pneumatosis cystoides intestinalis associated with massive free air mimicking perforated diffuse peritonitis.

PubMed

Sakurai, Yoichi; Hikichi, Masahiro; Isogaki, Jun; Furuta, Shinpei; Sunagawa, Risaburo; Inaba, Kazuki; Komori, Yoshiyuki; Uyama, Ichiro

2008-11-21

While pneumatosis cystoides intestinalis (PCI) is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical importance of PCI that mimics perforated peritonitis, which requires emergency surgery. Preoperative imaging modalities and diagnostic laparoscopy are useful to make an accurate diagnosis.

Intramuscular Dirofilariasis Mimicking an Orbital Metastasis in a Patient with Breast Cancer

PubMed Central

Henderson, Brett M.; Hunt, Christopher H.; Eckel, Laurence J.; Schwartz, Kara M.; Diehn, Felix E.; Pritt, Bobbi S.; Schembri Wismayer, David J.; Garrity, James A.

2012-01-01

We present the unusual case of a 74 year-old female with a history of breast cancer who presented with acute painless orbital swelling and vertical diplopia. MRI revealed a focal enhancing mass within the superior rectus muscle. As the concern for metastatic disease was high, surgical biopsy was performed and revealed an unusual mimicker of metastatic disease, the parasitic infection dirofilariasis. PMID:23008795

RMP Guidance for Warehouses - Chapter 4: Offsite Consequence Analysis

EPA Pesticide Factsheets

Offsite consequence analysis (OCA) informs government and the public about potential consequences of an accidental toxic or flammable chemical release at your facility, and consists of a worst-case release scenario and alternative release scenarios.

RMP Guidance for Chemical Distributors - Chapter 4: Offsite Consequence Analysis

EPA Pesticide Factsheets

How to perform the OCA for regulated substances, informing the government and the public about potential consequences of an accidental chemical release at your facility. Includes calculations for worst-case scenario, alternative scenarios, and endpoints.

78 FR 49831 - Endangered and Threatened Wildlife and Plants; Proposed Designation of Critical Habitat for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-15

... Service (NPS) for the Florida leafwing and the pine rockland ecosystem, in general. Sea Level Rise... habitat. In the best case scenario, which assumes low sea level rise, high financial resources, proactive... human population. In the worst case scenario, which assumes high sea level rise, low financial resources...

Engineering and environmental remediation scenarios due to leakage from the Gulf War oil spill using 3-D numerical contaminant modellings

NASA Astrophysics Data System (ADS)

Yihdego, Yohannes; Al-Weshah, Radwan A.

2017-11-01

The transport groundwater modelling has been undertaken to assess potential remediation scenarios and provide an optimal remediation options for consideration. The purpose of the study was to allow 50 years of predictive remediation simulation time. The results depict the likely total petroleum hydrocarbon migration pattern in the area under the worst-case scenario. The remediation scenario simulations indicate that do nothing approach will likely not achieve the target water quality within 50 years. Similarly, complete source removal approach will also likely not achieve the target water quality within 50 years. Partial source removal could be expected to remove a significant portion of the contaminant mass, but would increase the rate of contaminant recharge in the short to medium term. The pump-treat-reinject simulation indicates that the option appears feasible and could achieve a reduction in the area of the 0.01 mg/L TPH contour area for both Raudhatain and Umm Al-Aish by 35 and 30%, respectively, within 50 years. The rate of improvement and the completion date would depend on a range of factors such as bore field arrangements, pumping rates, reinjection water quality and additional volumes being introduced and require further optimisation and field pilot trials.

A Case of Eosinophilic Gastroenteritis Forming a Rigid Chamber Mimicking Giant Duodenal Ulcer on Computed Tomography Imaging.

PubMed

Shimamoto, Yoko; Harima, Yohei

2016-04-18

The clinical manifestations of eosinophilic gastroenteritis are nonspecific and vary depending on which layer of the gastrointestinal tract is involved. Computed tomography (CT) is valuable for detecting and characterizing gastrointestinal wall abnormalities. We report a case of eosinophilic gastroenteritis that formed a chamber in the rigid duodenal wall of a 67-year-old woman. Abdominal CT showed symmetrical wall thickening of the gastric antrum and duodenal bulb, and the bowel walls consisted of 2 continuous, symmetrically stratified layers. There was a chamber mimicking a giant ulcer at the orifice of the descending duodenum. Eosinophilic inflammation was present through this rigid wall of the descending duodenum, accompanied by perienteric inflammation, which infiltrated the anterior pararenal space, gall bladder, and right colic flexure. Gastrointestinal endoscopy showed spotty erosions and reddish mucosa, with the edematous gastric antrum and duodenal bulb narrowed at their lumens. Just beyond the supraduodenal angle at the orifice of the descending duodenum, there was a chamber with only minor mucosal changes, and it was not a duodenal ulcer. Endoscopic biopsy of the duodenum showed intramucosal eosinophilic infiltration. Treatment with prednisolone resulted in normalization of radiologic and endoscopic abnormalities. We present a case of eosinophilic gastroenteritis with both mucosal and muscular involvement. CT imaging and endoscopic examination confirmed the diagnosis.

Estimates of radiological risk from depleted uranium weapons in war scenarios.

PubMed

Durante, Marco; Pugliese, Mariagabriella

2002-01-01

Several weapons used during the recent conflict in Yugoslavia contain depleted uranium, including missiles and armor-piercing incendiary rounds. Health concern is related to the use of these weapons, because of the heavy-metal toxicity and radioactivity of uranium. Although chemical toxicity is considered the more important source of health risk related to uranium, radiation exposure has been allegedly related to cancers among veterans of the Balkan conflict, and uranium munitions are a possible source of contamination in the environment. Actual measurements of radioactive contamination are needed to assess the risk. In this paper, a computer simulation is proposed to estimate radiological risk related to different exposure scenarios. Dose caused by inhalation of radioactive aerosols and ground contamination induced by Tomahawk missile impact are simulated using a Gaussian plume model (HOTSPOT code). Environmental contamination and committed dose to the population resident in contaminated areas are predicted by a food-web model (RESRAD code). Small values of committed effective dose equivalent appear to be associated with missile impacts (50-y CEDE < 5 mSv), or population exposure by water-independent pathways (50-y CEDE < 80 mSv). The greatest hazard is related to the water contamination in conditions of effective leaching of uranium in the groundwater (50-y CEDE < 400 mSv). Even in this worst case scenario, the chemical toxicity largely predominates over radiological risk. These computer simulations suggest that little radiological risk is associated to the use of depleted uranium weapons.

Assessments of direct human exposure: the approach of EU risk assessments compared to scenario-based risk assessment.

PubMed

Wormuth, Matthias; Demou, Evangelia; Scheringer, Martin; Hungerbühler, Konrad

2007-08-01

The awareness of potential risks emerging from the use of chemicals in all parts of daily life has increased the need for risk assessments that are able to cover a high number of exposure situations and thereby ensure the safety of workers and consumers. In the European Union (EU), the practice of risk assessments for chemicals is laid down in a Technical Guidance Document; it is designed to consider environmental and human occupational and residential exposure. Almost 70 EU risk assessment reports (RARs) have been finalized for high-production-volume chemicals during the last decade. In the present study, we analyze the assessment of occupational and consumer exposure to trichloroethylene and phthalates presented in six EU RARs. Exposure scenarios in these six RARs were compared to scenarios used in applications of the scenario-based risk assessment approach to the same set of chemicals. We find that scenarios used in the selected EU RARs to represent typical exposure situations in occupational or private use of chemicals and products do not necessarily represent worst-case conditions. This can be due to the use of outdated information on technical equipment and conditions in workplaces or omission of pathways that can cause consumer exposure. Considering the need for exposure and risk assessments under the new chemicals legislation of the EU, we suggest that a transparent process of collecting data on exposure situations and of generating representative exposure scenarios is implemented to improve the accuracy of risk assessments. Also, the data sets used to assess human exposure should be harmonized, summarized in a transparent fashion, and made accessible for all risk assessors and the public.

RMP Guidance for Offsite Consequence Analysis

EPA Pesticide Factsheets

Offsite consequence analysis (OCA) consists of a worst-case release scenario and alternative release scenarios. OCA is required from facilities with chemicals above threshold quantities. RMP*Comp software can be used to perform calculations described here.

Scenario management and automated scenario generation

NASA Astrophysics Data System (ADS)

McKeever, William; Gilmour, Duane; Lehman, Lynn; Stirtzinger, Anthony; Krause, Lee

2006-05-01

The military planning process utilizes simulation to determine the appropriate course of action (COA) that will achieve a campaign end state. However, due to the difficulty in developing and generating simulation level COAs, only a few COAs are simulated. This may have been appropriate for traditional conflicts but the evolution of warfare from attrition based to effects based strategies, as well as the complexities of 4 th generation warfare and asymmetric adversaries have placed additional demands on military planners and simulation. To keep pace with this dynamic, changing environment, planners must be able to perform continuous, multiple, "what-if" COA analysis. Scenario management and generation are critical elements to achieving this goal. An effects based scenario generation research project demonstrated the feasibility of automated scenario generation techniques which support multiple stove-pipe and emerging broad scope simulations. This paper will discuss a case study in which the scenario generation capability was employed to support COA simulations to identify plan effectiveness. The study demonstrated the effectiveness of using multiple simulation runs to evaluate the effectiveness of alternate COAs in achieving the overall campaign (metrics-based) objectives. The paper will discuss how scenario generation technology can be employed to allow military commanders and mission planning staff to understand the impact of command decisions on the battlespace of tomorrow.

Simple bone cyst of mandible mimicking periapical cyst

PubMed Central

HS, Charan Babu; Rai, Bhagawan Das; Nair, Manju A.; Astekar, Madhusudan S.

2012-01-01

Simple bone cysts (SBC) are pseudocysts occurring less commonly in the maxillofacial region. The uncertain and unclear etiopathogenesis led to numerous synonyms to refer this particular cyst. These cysts are devoid of an epithelial lining and are usually empty or contain blood or straw-colored fluid. In jaws initially it mimics a periapical cyst and later can lead to cortical bone expansion warranting for radical approach, which is seldom required. SBC is predominantly diagnosed in first two decades of life. Here we report a case of solitary bone cyst mimicking a periapical cyst of a mandibular molar in a 37-year-old patient. PMID:24765458

Extraventricular neurocytoma in a child mimicking oligodendroglioma: a diagnostic pitfall.

PubMed

Limaiem, F; Bellil, S; Chelly, I; Mekni, A; Bellil, K; Jemel, H; Haouet, S; Zitouna, M; Kchir, N

2009-04-01

Extraventricular neurocytomas are rare neuronal tumours that have been included in the 2007 WHO classification as a variant of central neurocytoma. They arise outside the ventricles, usually within the cerebral hemisphere,s but also in other regions throughout the neuraxis. The morphological overlap of these tumours with oligodendroglioma often poses diagnostic difficulty. Herein, a case of extraventricular neurocytoma in a 4-year-old girl is reported that mimicked histologically oligodendroglioma. The authors describe the clinicopathological features of this rare entity with special emphasis on differential diagnosis.

Ecological scenarios analyzed and evaluated by a shallow lake model.

PubMed

Kardaetz, Sascha; Strube, Torsten; Brüggemann, Rainer; Nützmann, Gunnar

2008-07-01

We applied the complex ecosystem model EMMO, which was adopted to the shallow lake Müggelsee (Germany), in order to evaluate a large set of ecological scenarios. By means of EMMO, 33 scenarios and 17 indicators were defined to characterize their effects on the lake ecosystem. The indicators were based on model outputs of EMMO and can be separated into biological indicators, such as chlorophyll-a and cyanobacteria, and hydro-chemical indicators, such as phosphorus. The question to be solved was, what is the ranking of the scenarios based on their characterization by these 17 indicators? And how can we handle high quantities of complex data within evaluation procedures? The scenario evaluation was performed by partial order theory which, however, did not provide a clear result. By subsequently applying the hierarchical cluster analysis (complete linkage) it was possible to reduce the data matrix to indicator and scenario representatives. Even though this step implies losses of information, it simplifies the application of partial order theory and the post processing by METEOR. METEOR is derived from partial order theory and allows the stepwise aggregation of indicators, which subsequently leads to a distinct and clear decision. In the final evaluation result the best scenario was the one which defines a minimum nutrient input and no phosphorus release from the sediment while the worst scenario is characterized by a maximum nutrient input and extensive phosphorus release from the sediment. The reasonable and comprehensive results show that the combination of partial order, cluster analysis and METEOR can handle big amounts of data in a very clear and transparent way, and therefore is ideal in the context of complex ecosystem models, like that we applied.

Assessing Orchestrated Simulation Through Modeling to Quantify the Benefits of Unmanned-Teaming in a Tactical ASW Scenario

DTIC Science & Technology

2018-03-01

Results are compared to a previous study using a similar design of experiments but different simulation software. The baseline scenario for exploring the...behaviors are mimicked in this research, enabling Solem’s MANA results to be compared to our LITMUS’ results. By design , the principal difference...missions when using the second order NOLH, and compares favorably with the over six million in the full factorial design . 3. Advantages of Cluster

Mimicking Nonequilibrium Steady States with Time-Periodic Driving

NASA Astrophysics Data System (ADS)

Raz, O.; Subaşı, Y.; Jarzynski, C.

2016-04-01

Under static conditions, a system satisfying detailed balance generically relaxes to an equilibrium state in which there are no currents. To generate persistent currents, either detailed balance must be broken or the system must be driven in a time-dependent manner. A stationary system that violates detailed balance evolves to a nonequilibrium steady state (NESS) characterized by fixed currents. Conversely, a system that satisfies instantaneous detailed balance but is driven by the time-periodic variation of external parameters—also known as a stochastic pump (SP)—reaches a periodic state with nonvanishing currents. In both cases, these currents are maintained at the cost of entropy production. Are these two paradigmatic scenarios effectively equivalent? For discrete-state systems, we establish a mapping between nonequilibrium stationary states and stochastic pumps. Given a NESS characterized by a particular set of stationary probabilities, currents, and entropy production rates, we show how to construct a SP with exactly the same (time-averaged) values. The mapping works in the opposite direction as well. These results establish a proof of principle: They show that stochastic pumps are able to mimic the behavior of nonequilibrium steady states, and vice versa, within the theoretical framework of discrete-state stochastic thermodynamics. Nonequilibrium steady states and stochastic pumps are often used to model, respectively, biomolecular motors driven by chemical reactions and artificial molecular machines steered by the variation of external, macroscopic parameters. Our results loosely suggest that anything a biomolecular machine can do, an artificial molecular machine can do equally well. We illustrate this principle by showing that kinetic proofreading, a NESS mechanism that explains the low error rates in biochemical reactions, can be effectively mimicked by a constrained periodic driving.

Disaster Preparedness: Anticipating the Worst Case Scenario Issue Paper Volume 05-05, March 2005

DTIC Science & Technology

2005-03-01

PROFESSOR B.E GRIFFARD, COL (RET.) ART BRAD4sAW; AND DR. KENT HUGnES BUTTs "Volcanic arcs and oceanic trenches partly encircling the Pacific Basin ...2004 Tsunami, triggered by a magnitude 9.0 earth- assists international organizations and other northern Sumatra . countries in sizing appropriate...Kathmandu, the United States Central Command, and the United States Army War College Center for Strategic Leadership. The conference focused on

Preparing for the Worst-Case Scenario--Planning Pays Off with First-Ever Stadium Evacuation

ERIC Educational Resources Information Center

Bradley, Carol C.

2012-01-01

It's Saturday, September 3, Notre Dame vs. South Florida--the first home game of the season--and nearing halftime. The only person feeling more pressure than Head Coach Brian Kelly is Mike Seamon, associate vice president for campus safety and director of game day operations. Bad weather is on the way, and he's about to make the call to evacuate…

Subaortic membrane mimicking hypertrophic cardiomyopathy.

PubMed

Anderson, Mark Joseph; Arruda-Olson, Adelaide; Gersh, Bernard; Geske, Jeffrey

2015-11-04

A 34-year-old man was referred for progressive angina and exertional dyspnoea refractory to medical therapy, with a presumptive diagnosis of hypertrophic cardiomyopathy (HCM). Transthoracic echocardiography (TTE) revealed asymmetric septal hypertrophy without systolic anterior motion of the mitral valve leaflet and with no dynamic left ventricular outflow tract (LVOT) obstruction. However, the LVOT velocity was elevated at rest as well as with provocation, without the characteristic late peaking obstruction seen in HCM. Focused TTE to evaluate for suspected fixed obstruction demonstrated a subaortic membrane 2.2 cm below the aortic valve. Coronary CT angiography confirmed the presence of the subaortic membrane and was negative for concomitant coronary artery disease. Surgical resection of the subaortic membrane and septal myectomy resulted in significant symptomatic relief and lower LVOT velocities on postoperative TTE. This case reminds the clinician to carefully evaluate for alternative causes of LVOT obstruction, especially subaortic membrane, as a cause of symptoms mimicking HCM. 2015 BMJ Publishing Group Ltd.

Subaortic membrane mimicking hypertrophic cardiomyopathy

PubMed Central

Anderson, Mark Joseph; Arruda-Olson, Adelaide; Gersh, Bernard; Geske, Jeffrey

2015-01-01

A 34-year-old man was referred for progressive angina and exertional dyspnoea refractory to medical therapy, with a presumptive diagnosis of hypertrophic cardiomyopathy (HCM). Transthoracic echocardiography (TTE) revealed asymmetric septal hypertrophy without systolic anterior motion of the mitral valve leaflet and with no dynamic left ventricular outflow tract (LVOT) obstruction. However, the LVOT velocity was elevated at rest as well as with provocation, without the characteristic late peaking obstruction seen in HCM. Focused TTE to evaluate for suspected fixed obstruction demonstrated a subaortic membrane 2.2 cm below the aortic valve. Coronary CT angiography confirmed the presence of the subaortic membrane and was negative for concomitant coronary artery disease. Surgical resection of the subaortic membrane and septal myectomy resulted in significant symptomatic relief and lower LVOT velocities on postoperative TTE. This case reminds the clinician to carefully evaluate for alternative causes of LVOT obstruction, especially subaortic membrane, as a cause of symptoms mimicking HCM. PMID:26538250

Primary adnexial hydatid cyst mimicking ovarian tumor

PubMed Central

Görgen, Hüsnü; Api, Murat; Çetin, Ahmet

2009-01-01

We report here the rare case of a 28-year-old woman with a large hydatid cyst in her left lower pelvis with an unusual sonographic presentation mimicking a multicystic ovarian tumor. Laparoscopic evaluation revealed normal uterus and ovaries with a swelling in the left retropritoneal area. We decided to reach this tumour by the vaginal route and multiple scolex, daughter cysts were removed via a left lateral vaginal wall incision. The pericystic cavity was thoroughly washed. The patient was discharged on the first postoperative day. Mebendazole (100 mg twice daily) was administered for 4 months. This parasite should be kept in mind and considered when making the differential diagnosis of pelvic cystic masses, particularly if the patient is from an endemic area. PMID:24591878

Reenacted Case Scenarios for Undergraduate Healthcare Students to Illustrate Person-Centered Care in Dementia

ERIC Educational Resources Information Center

Bradley, Sandra L.; De Bellis, Anita; Guerin, Pauline; Walters, Bonnie; Wotherspoon, Alison; Cecchin, Maggie; Paterson, Jan

2010-01-01

Healthcare practitioners have suggested that interpreting person-centered care for people who have dementia to undergraduate students requires guidance in practical application. This article describes the production of a written and digital interdisciplinary educational resource for tertiary students. It uses real-life case scenarios provided by…

Heparin-Mimicking Polymers: Synthesis and Biological Applications

PubMed Central

2016-01-01

Heparin is a naturally occurring, highly sulfated polysaccharide that plays a critical role in a range of different biological processes. Therapeutically, it is mostly commonly used as an injectable solution as an anticoagulant for a variety of indications, although it has also been employed in other forms such as coatings on various biomedical devices. Due to the diverse functions of this polysaccharide in the body, including anticoagulation, tissue regeneration, anti-inflammation, and protein stabilization, and drawbacks of its use, analogous heparin-mimicking materials are also widely studied for therapeutic applications. This review focuses on one type of these materials, namely, synthetic heparin-mimicking polymers. Utilization of these polymers provides significant benefits compared to heparin, including enhancing therapeutic efficacy and reducing side effects as a result of fine-tuning heparin-binding motifs and other molecular characteristics. The major types of the various polymers are summarized, as well as their applications. Because development of a broader range of heparin-mimicking materials would further expand the impact of these polymers in the treatment of various diseases, future directions are also discussed. PMID:27739666

Heparin-Mimicking Polymers: Synthesis and Biological Applications.

PubMed

Paluck, Samantha J; Nguyen, Thi H; Maynard, Heather D

2016-11-14

Heparin is a naturally occurring, highly sulfated polysaccharide that plays a critical role in a range of different biological processes. Therapeutically, it is mostly commonly used as an injectable solution as an anticoagulant for a variety of indications, although it has also been employed in other forms such as coatings on various biomedical devices. Due to the diverse functions of this polysaccharide in the body, including anticoagulation, tissue regeneration, anti-inflammation, and protein stabilization, and drawbacks of its use, analogous heparin-mimicking materials are also widely studied for therapeutic applications. This review focuses on one type of these materials, namely, synthetic heparin-mimicking polymers. Utilization of these polymers provides significant benefits compared to heparin, including enhancing therapeutic efficacy and reducing side effects as a result of fine-tuning heparin-binding motifs and other molecular characteristics. The major types of the various polymers are summarized, as well as their applications. Because development of a broader range of heparin-mimicking materials would further expand the impact of these polymers in the treatment of various diseases, future directions are also discussed.

Thalamic Amnesia Mimicking Transient Global Amnesia.

PubMed

Giannantoni, Nadia M; Lacidogna, Giordano; Broccolini, Aldobrando; Pilato, Fabio; Profice, Paolo; Morosetti, Roberta; Caliandro, Pietro; Gambassi, Giovanni; Della Marca, Giacomo; Frisullo, Giovanni

2015-06-01

Transient global amnesia is a benign syndrome and one of the most frequent discharges from the emergency department that can hardly be distinguished from other mimicking diseases. No consensus in the evaluation of transient global amnesia has yet been found in the emergency setting. We describe a 69-year-old woman who presented to our emergency department with an abrupt onset of anterograde amnesia, preceded by a similar amnesic episode misinterpreted as transient global amnesia. Neuroradiologic, neuropsychological, and neurophysiological evaluations supported the diagnosis of vascular thalamic amnesia. We report a patient who clinically fulfilled transient global amnesia's criteria and in whom nevertheless was disclosed a thalamic ischemic lesion on neuroimaging.This case report highlights the importance of performing neuroradiologic screening in the emergency department even when clinical history and physical findings are highly suggestive for transient global amnesia.

Subdural Hematoma Mimickers: A Systematic Review.

PubMed

Catana, Dragos; Koziarz, Alex; Cenic, Aleksa; Nath, Siddharth; Singh, Sheila; Almenawer, Saleh A; Kachur, Edward

2016-09-01

A variety of subdural pathologies that may mimic hematomas are reported in the literature. We aimed to identify the atypical clinical and radiologic presentations of subdural masses that may mimic subdural hematomas. A systematic review of MEDLINE and Embase was conducted independently by 2 reviewers to identify articles describing subdural hematoma mimickers. We also present a patient from our institution with a subdural pathology mimicking a subdural hematoma. We analyzed patient clinical presentations, underlying pathologies, radiologic findings, and clinical outcomes. We included 43 articles totaling 48 patients. The mean ± SD patient age was 55.7 ± 16.8 years. Of the 45 cases describing patient history, 13 patients (27%) had a history of trauma. The underlying pathologies of the 48 subdural collections were 10 metastasis (21%), 14 lymphoma (29%), 7 sarcoma (15%), 4 infectious (8%), 4 autoimmune (8%), and 9 miscellaneous (19%). Findings on computed tomography (CT) scan were 18 hyperdense (41%), 11 hypodense (25%), 9 isodense (20%), 3 isodense/hyperdense (7%), and 3 hypodense/isodense (7%). Thirty-four patients (71%) were treated surgically; among these patients, 65% had symptom resolution. Neither the pathology (P = 0.337) nor the management strategy (P = 0.671) was correlated with improved functional outcomes. Identification of atypical history and radiologic features should prompt further diagnostic tests, including magnetic resonance imaging (MRI), to elucidate the proper diagnosis, given that certain pathologies may be managed nonsurgically. A subdural collection that is hyperdense on CT scan and hyperintense on T2-weighted MRI, along with a history of progressive headache with no trauma, may raise the suspicion of an atypical subdural pathology. Copyright © 2016 Elsevier Inc. All rights reserved.

RMP*Comp

EPA Pesticide Factsheets

You can use this free software program to complete the Off-site Consequence Analyses (both worst case scenarios and alternative scenarios) required under the Risk Management Program rule, so that you don't have to do calculations by hand.

Traumatic head injury mimicking acute encephalopathy with biphasic seizures and late reduced diffusion.

PubMed

Inoue, Hirofumi; Hasegawa, Shunji; Kajimoto, Madoka; Matsushige, Takeshi; Ichiyama, Takashi

2014-10-01

Many studies have reported acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) associated with viral infection at onset, but few studies have reported AESD without infection. We report the case of a 9-month-old boy who had a clinical course mimicking AESD after a traffic accident. The traffic accident caused a mild subdural hematoma without neurological abnormalities on admission. The boy became unconscious on the second day, and he was diagnosed with non-convulsive status epilepticus on the third day. Diffusion-weighted imaging showed reduced water diffusion in the subcortical white matter. On laboratory analysis interleukin (IL)-6 was elevated in the cerebrospinal fluid (CSF), but not in the serum. He had severe neurological sequelae with mental retardation, spastic tetraplegia, and epilepsy. We suggest that brain damage mimicking AESD was caused by the traffic accident and the prolonged seizure during infancy. © 2014 Japan Pediatric Society.

Assessing the robustness of passive scattering proton therapy with regard to local recurrence in stage III non-small cell lung cancer: a secondary analysis of a phase II trial.

PubMed

Zhu, Zhengfei; Liu, Wei; Gillin, Michael; Gomez, Daniel R; Komaki, Ritsuko; Cox, James D; Mohan, Radhe; Chang, Joe Y

2014-05-06

We assessed the robustness of passive scattering proton therapy (PSPT) plans for patients in a phase II trial of PSPT for stage III non-small cell lung cancer (NSCLC) by using the worst-case scenario method, and compared the worst-case dose distributions with the appearance of locally recurrent lesions. Worst-case dose distributions were generated for each of 9 patients who experienced recurrence after concurrent chemotherapy and PSPT to 74 Gy(RBE) for stage III NSCLC by simulating and incorporating uncertainties associated with set-up, respiration-induced organ motion, and proton range in the planning process. The worst-case CT scans were then fused with the positron emission tomography (PET) scans to locate the recurrence. Although the volumes enclosed by the prescription isodose lines in the worst-case dose distributions were consistently smaller than enclosed volumes in the nominal plans, the target dose coverage was not significantly affected: only one patient had a recurrence outside the prescription isodose lines in the worst-case plan. PSPT is a relatively robust technique. Local recurrence was not associated with target underdosage resulting from estimated uncertainties in 8 of 9 cases.

Calvarial sarcoid mimicking metastatic disease.

PubMed

Bodie, B F; Kheir, S M; Omura, E F

1980-10-01

A 61-year-old white woman presented with localized cutaneous Boeck's sarcoid and multiple lytic skull lesions mimicking metastatic carcinoma. Complete workup revealed no neoplastic process; biopsy of the skull lesions showed noncaseating granulomas consistent with sarcoid. Although rare, calvarial sarcoid can occur.

A Diffusion Model Explanation of the Worst Performance Rule for Reaction Time and IQ

ERIC Educational Resources Information Center

Ratcliff, Roger; Schmiedek, Florian; McKoon, Gail

2008-01-01

The worst performance rule for cognitive tasks [Coyle, T.R. (2003). IQ, the worst performance rule, and Spearman's law: A reanalysis and extension. "Intelligence," 31, 567-587] in which reaction time is measured is the result that IQ scores correlate better with longer (i.e., 0.7 and 0.9 quantile) reaction times than shorter (i.e., 0.1 and 0.3…

Experimental Evaluation of PV Inverter Anti-Islanding with Grid Support Functions in Multi-Inverter Island Scenarios

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

Hoke, Anderson; Nelson, Austin; Miller, Brian

load based anti-islanding tests to determine the worst-case configuration of grid support functions for each inverter. A grid support function is a function an inverter performs to help stabilize the grid or drive the grid back towards its nominal operating point. The four grid support functions examined here were voltage ride-through, frequency ride-through, Volt-VAr control, and frequency-Watt control. The worst-case grid support configuration was defined as the configuration that led to the maximum island duration (or run-on time, ROT) out of 50 tests of each inverter. For each of the three inverters, it was observed that maximum ROT increased when voltage and frequency ride-through were activated. No conclusive evidence was found that Volt-VAr control or frequency-Watt control increased maximum ROT. Over all single-inverter test cases, the maximum ROT was 711 ms, well below the two-second limit currently imposed by IEEE Standard 1547-2003. A subsequent series of 244 experiments tested all three inverters simultaneously in the same island. These tests again used a procedure based on the IEEE 1547.1 unintentional islanding test to create a difficult-to-detect island condition. For these tests, which used the two worst-case grid support function configurations from the single-inverter tests, the inverters were connected to a variety of island circuit topologies designed to represent the variety of multiple-inverter islands that may occur on real distribution circuits. The interconnecting circuits and the resonant island load itself were represented in the real-time PHIL model. PHIL techniques similar to those employed here have been previously used and validated for anti-islanding tests, and the PHIL resonant load model used in this test was successfully validated by comparing single-inverter PHIL tests to conventional tests using an RLC load bank.« less

Tsunamigenic scenarios for southern Peru and northern Chile seismic gap: Deterministic and probabilistic hybrid approach for hazard assessment

NASA Astrophysics Data System (ADS)

González-Carrasco, J. F.; Gonzalez, G.; Aránguiz, R.; Yanez, G. A.; Melgar, D.; Salazar, P.; Shrivastava, M. N.; Das, R.; Catalan, P. A.; Cienfuegos, R.

2017-12-01

Plausible worst-case tsunamigenic scenarios definition plays a relevant role in tsunami hazard assessment focused in emergency preparedness and evacuation planning for coastal communities. During the last decade, the occurrence of major and moderate tsunamigenic earthquakes along worldwide subduction zones has given clues about critical parameters involved in near-field tsunami inundation processes, i.e. slip spatial distribution, shelf resonance of edge waves and local geomorphology effects. To analyze the effects of these seismic and hydrodynamic variables over the epistemic uncertainty of coastal inundation, we implement a combined methodology using deterministic and probabilistic approaches to construct 420 tsunamigenic scenarios in a mature seismic gap of southern Peru and northern Chile, extended from 17ºS to 24ºS. The deterministic scenarios are calculated using a regional distribution of trench-parallel gravity anomaly (TPGA) and trench-parallel topography anomaly (TPTA), three-dimensional Slab 1.0 worldwide subduction zones geometry model and published interseismic coupling (ISC) distributions. As result, we find four higher slip deficit zones interpreted as major seismic asperities of the gap, used in a hierarchical tree scheme to generate ten tsunamigenic scenarios with seismic magnitudes fluctuates between Mw 8.4 to Mw 8.9. Additionally, we construct ten homogeneous slip scenarios as inundation baseline. For the probabilistic approach, we implement a Karhunen - Loève expansion to generate 400 stochastic tsunamigenic scenarios over the maximum extension of the gap, with the same magnitude range of the deterministic sources. All the scenarios are simulated through a non-hydrostatic tsunami model Neowave 2D, using a classical nesting scheme, for five coastal major cities in northern Chile (Arica, Iquique, Tocopilla, Mejillones and Antofagasta) obtaining high resolution data of inundation depth, runup, coastal currents and sea level elevation. The

Estimated cost of universal public coverage of prescription drugs in Canada

PubMed Central

Morgan, Steven G.; Law, Michael; Daw, Jamie R.; Abraham, Liza; Martin, Danielle

2015-01-01

Background: With the exception of Canada, all countries with universal health insurance systems provide universal coverage of prescription drugs. Progress toward universal public drug coverage in Canada has been slow, in part because of concerns about the potential costs. We sought to estimate the cost of implementing universal public coverage of prescription drugs in Canada. Methods: We used published data on prescribing patterns and costs by drug type, as well as source of funding (i.e., private drug plans, public drug plans and out-of-pocket expenses), in each province to estimate the cost of universal public coverage of prescription drugs from the perspectives of government, private payers and society as a whole. We estimated the cost of universal public drug coverage based on its anticipated effects on the volume of prescriptions filled, products selected and prices paid. We selected these parameters based on current policies and practices seen either in a Canadian province or in an international comparator. Results: Universal public drug coverage would reduce total spending on prescription drugs in Canada by $7.3 billion (worst-case scenario $4.2 billion, best-case scenario $9.4 billion). The private sector would save $8.2 billion (worst-case scenario $6.6 billion, best-case scenario $9.6 billion), whereas costs to government would increase by about $1.0 billion (worst-case scenario $5.4 billion net increase, best-case scenario $2.9 billion net savings). Most of the projected increase in government costs would arise from a small number of drug classes. Interpretation: The long-term barrier to the implementation of universal pharmacare owing to its perceived costs appears to be unjustified. Universal public drug coverage would likely yield substantial savings to the private sector with comparatively little increase in costs to government. PMID:25780047

Estimated cost of universal public coverage of prescription drugs in Canada.

PubMed

Morgan, Steven G; Law, Michael; Daw, Jamie R; Abraham, Liza; Martin, Danielle

2015-04-21

With the exception of Canada, all countries with universal health insurance systems provide universal coverage of prescription drugs. Progress toward universal public drug coverage in Canada has been slow, in part because of concerns about the potential costs. We sought to estimate the cost of implementing universal public coverage of prescription drugs in Canada. We used published data on prescribing patterns and costs by drug type, as well as source of funding (i.e., private drug plans, public drug plans and out-of-pocket expenses), in each province to estimate the cost of universal public coverage of prescription drugs from the perspectives of government, private payers and society as a whole. We estimated the cost of universal public drug coverage based on its anticipated effects on the volume of prescriptions filled, products selected and prices paid. We selected these parameters based on current policies and practices seen either in a Canadian province or in an international comparator. Universal public drug coverage would reduce total spending on prescription drugs in Canada by $7.3 billion (worst-case scenario $4.2 billion, best-case scenario $9.4 billion). The private sector would save $8.2 billion (worst-case scenario $6.6 billion, best-case scenario $9.6 billion), whereas costs to government would increase by about $1.0 billion (worst-case scenario $5.4 billion net increase, best-case scenario $2.9 billion net savings). Most of the projected increase in government costs would arise from a small number of drug classes. The long-term barrier to the implementation of universal pharmacare owing to its perceived costs appears to be unjustified. Universal public drug coverage would likely yield substantial savings to the private sector with comparatively little increase in costs to government. © 2015 Canadian Medical Association or its licensors.

Differential diagnosis and treatment of periodontitis-mimicking actinomycosis.

PubMed

Kim, Nam Ryang; Park, Jun-Beom; Ko, Youngkyung

2012-12-01

Actinomycosis is an uncommon chronic granulomatous disease that presents as a slowly progressive, indolent, indurated infiltration with multiple abscesses, fistulas, and sinuses. The purpose of this article is to report on a case of actinomycosis with clinical findings similar to periodontitis. A 46-year-old female presented with recurrent throbbing pain on the right first and second molar of the mandible three weeks after root planing. Exploratory flap surgery was performed, and the bluish-gray tissue fragment found in the interproximal area between the two molars was sent for histopathology. The diagnosis from the biopsy was actinomycosis. The clinical and radiographic manifestations of this case were clinically indistinguishable from periodontitis. The patient did not report any symptoms, and she is scheduled for a follow-up visit. The present study has identified periodontitis-mimicking actinomycosis. Actinomycosis should be included in the differential diagnosis in cases with periodontal pain and inflammation that do not respond to nonsurgical treatment for periodontitis. More routine submissions of tissue removed from the oral cavity for biopsies may be beneficial for differential diagnosis.

Enterobiasis in Ectopic Locations Mimicking Tumor-Like Lesions

PubMed Central

Pampiglione, Silvio; Rivasi, Francesco

2009-01-01

Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on this subject, lamenting the scarce importance given to this parasitosis in university courses of medical schools and in medical textbooks as it is incorrectly considered “out-of-fashion.” PMID:20016678

Non-harmful insertion of data mimicking computer network attacks

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

Neil, Joshua Charles; Kent, Alexander; Hash, Jr, Curtis Lee

Non-harmful data mimicking computer network attacks may be inserted in a computer network. Anomalous real network connections may be generated between a plurality of computing systems in the network. Data mimicking an attack may also be generated. The generated data may be transmitted between the plurality of computing systems using the real network connections and measured to determine whether an attack is detected.

Polymerization of a divalent/tetravalent metal-storing atom-mimicking dendrimer.

PubMed

Albrecht, Ken; Hirabayashi, Yuki; Otake, Masaya; Mendori, Shin; Tobari, Yuta; Azuma, Yasuo; Majima, Yutaka; Yamamoto, Kimihisa

2016-12-01

The phenylazomethine dendrimer (DPA) has a layer-by-layer electron density gradient that is an analog of the Bohr atom (atom mimicry). In combination with electron pair mimicry, the polymerization of this atom-mimicking dendrimer was achieved. The valency of the mimicked atom was controlled by changing the chemical structure of the dendrimer. By mimicking a divalent atom, a one-dimensional (1D) polymer was obtained, and by using a planar tetravalent atom mimic, a 2D polymer was obtained. These poly(dendrimer) polymers could store Lewis acids (SnCl 2 ) in their unoccupied orbitals, thus indicating that these poly(dendrimer) polymers consist of a series of nanocontainers.

Oncocytic Type Intraductal Papillary Mucinous Neoplasm of the Pancreas with Unusually Low Mucin Production Mimicking Intraductal Tubulopapillary Neoplasm: A Report of a Case Diagnosed by a Preoperative Endoscopic Biopsy

PubMed Central

Yoshida, Yukinari; Endo, Takao; Tanaka, Eiichi; Kikuchi, Takefumi; Akino, Kimishige; Mita, Hiroaki; Adachi, Yasuyo; Nakamura, Masahiro; Adachi, Yasushi; Ishii, Yoshifumi; Matsumoto, Joe; Hirano, Satoshi; Nitta, Takeo; Mitsuhashi, Tomoko; Kato, Yasuo

2017-01-01

We herein report the case of a 78-year-old woman with an intraductal tumor with scant mucin production in a moderately dilated main pancreatic duct that resembled an intraductal tubulopapillary neoplasm (ITPN) on imaging. An endoscopic transpapillary forceps biopsy enabled an accurate preoperative diagnosis of the tumor as an oncocytic type intraductal papillary mucinous neoplasm (IPMN) of the pancreas microscopically showing papillary growth consisting of oncocytic cells with a typical mucin expression profile, although with few intraepithelial lumina containing mucin. This is the first case of an oncocytic type IPMN mimicking an ITPN that was able to be diagnosed preoperatively. PMID:29021473

Elementary Social Studies in 2005: Danger or Opportunity?--A Response to Jeff Passe

ERIC Educational Resources Information Center

Libresco, Andrea S.

2006-01-01

From the emphasis on lower-level test-prep materials to the disappearance of the subject altogether, elementary social studies is, in the best case scenario, being tested and, thus, taught with a heavy emphasis on recall; and, in the worst-case scenario, not being taught at all. In this article, the author responds to Jeff Passe's views on…

Analysis of Glenoid Fixation with Anatomic Total Shoulder Arthroplasty in an Extreme Cyclic Loading Scenario.

PubMed

Roche, Christopher P; Staunch, Cameron; Hahn, William; Grey, Sean G; Flurin, Pierre-Henri; Wright, Thomas W; Zuckerman, Joseph D

2015-12-01

ASTM F2028-14 was adopted to recom mend a cyclic eccentric glenoid edge loading test that simulates the rocking horse loading mechanism beleived to cause aTSA glenoid loosening. While this method accurately simulates that failure mechanism, the recommended 750 N load may not be sufficient to simulate worst-case loading magnitudes, and the recommended 100,000 cycles may not be sufficient to simulate device fatigue-related failure modes. Finally, if greater loading magnitude or a larger number of cycles is performed, the recommended substrate density may not be sufficiently strong to support the elevated loads and cycles. To this end, a new test method is proposed to supplement ASTM F2028-14. A series of cyclic tests were performed to evaluate the long-term fixation strength of two different hybrid glenoid designs in both low (15 pcf) and high (30 pcf) density polyurethane blocks at elevated loads relative to ASTM F2028-14. To simulate a worst case clinical condition in which the humeral head is superiorly migrated, a cyclic load was applied to the superior glenoid rim to induce a maximum torque on the fixation pegs for three different cyclic loading tests: 1. 1,250 N load for 0.75 M cycles in a 15 pcf block, 2. 1,250 N load for 1.5 M cycles in a 30 pcf block, and 3. 2,000 N load for 0.65 M cycles in a 30 pcf block. All devices completed cyclic loading without failure, fracture, or loss of fixation regardless of glenoid design, polyurethane density, loading magnitude, or cycle length. No significant difference in post-cyclic displacement was noted between designs in any of the three tests. Post-cyclic radiographs demonstrated that each device maintained fixa - tion with the metal pegs within the bone-substitute blocks with no fatigue related failures. These results demonstrate that both cemented hybrid glenoids maintained fixation when tested according to each cyclic loading scenario, with no difference in post-cyclic displacement observed between designs. The lack

Primary central nervous system vasculitis and its mimicking diseases - clinical features, outcome, comorbidities and diagnostic results - A case control study.

PubMed

Becker, J; Horn, P A; Keyvani, K; Metz, I; Wegner, C; Brück, W; Heinemann, F M; Schwitalla, J C; Berlit, P; Kraemer, M

2017-05-01

To compare clinical features and outcome, imaging characteristics, biopsy results and laboratory findings in a cohort of 69 patients with suspected or diagnosed primary central nervous system vasculitis (PCNSV) in adults; to identify risk factors and predictive features for PCNSV. We performed a case-control-study including 69 patients referred with suspected PCNSV from whom 25 were confirmed by predetermined diagnostic criteria based on biopsy (72%) or angiography (28%). Forty-four patients turned out to have 15 distinct other diagnoses. Clinical and diagnostic data were compared between PCNSV and Non-PCNSV cohorts. Clinical presentation was not able to discriminate between PCNSV and its differential diagnoses. However, a worse clinical outcome was associated with PCNSV (p=0.005). Biopsy (p=0.004), contrast enhancement (p=0.000) or tumour-like mass lesion (p=0.008) in magnetic resonance imaging (MRI), intrathecal IgG increase (p=0.020), normal Duplex findings of cerebral arteries (p=0.022) and conventional angiography (p 0.010) were able to distinguish between the two cohorts. In a cohort of 69 patients with suspected PCNSV, a large number (64%) was misdiagnosed and partly received treatment, since mimicking diseases are very difficult to discriminate. Clinical presentation at manifestation does not help to differentiate PCNSV from its mimicking diseases. MRI and cerebrospinal fluid analysis are unlikely to be normal in PCNSV, though unspecific if pathological. Cerebral angiography and biopsy must complement other diagnostics when establishing the diagnosis in order to avoid misdiagnosis and mistreatment. German clinical trials register: http://drks-neu.uniklinik-freiburg.de/drks_web/, Unique identifier: DRKS00005347. Copyright © 2017 Elsevier B.V. All rights reserved.

Focal Nodulary Hyperplasia of the Liver Due to Congenital Portosystemic Shunt: A Rare Condition Mimicking Hepatocellulary Carcinoma.

PubMed

Yazal Erdem, Arzu; Emir, Suna; Demir, Haci A; Özyörük, Derya; Çetin, İlker; Turan, Aynur; Karakuş, Esra

2017-01-01

Congenital portosystemic shunts are rare vascular malformations that lead to several complications including liver tumors, pulmonary hypertension, and metabolic encephalopathy. We describe a rare case of a 17-year-old girl with an extrahepatic portosystemic shunt presenting recurrent syncope episodes and a liver mass mimicking hepatocellulary carcinoma.

Alternative Geothermal Power Production Scenarios

DOE Data Explorer

Sullivan, John

2014-03-14

The information given in this file pertains to Argonne LCAs of the plant cycle stage for a set of ten new geothermal scenario pairs, each comprised of a reference and improved case. These analyses were conducted to compare environmental performances among the scenarios and cases. The types of plants evaluated are hydrothermal binary and flash and Enhanced Geothermal Systems (EGS) binary and flash plants. Each scenario pair was developed by the LCOE group using GETEM as a way to identify plant operational and resource combinations that could reduce geothermal power plant LCOE values. Based on the specified plant and well field characteristics (plant type, capacity, capacity factor and lifetime, and well numbers and depths) for each case of each pair, Argonne generated a corresponding set of material to power ratios (MPRs) and greenhouse gas and fossil energy ratios.

Polyarteritis nodosa clinically mimicking nonocclusive mesenteric ischemia

PubMed Central

Shirai, Tsuyoshi; Fujii, Hiroshi; Saito, Shinichiro; Ishii, Tomonori; Yamaya, Hideyuki; Miyagi, Shigehito; Sekiguchi, Satoshi; Kawagishi, Naoki; Nose, Masato; Harigae, Hideo

2013-01-01

Here, we present the case of a 74-year-old Japanese man with segmental intestinal necrosis, which developed after treatment with pulsed methylprednisolone for mononeuritis multiplex. The patient was weakly positive for myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA). Computed tomography and surgical findings were compatible with nonocclusive mesenteric ischemia (NOMI). He underwent small intestinal resection by emergency surgery and an intestinal fistula was made. Pathologically, necrotizing vasculitis with fibrinoid necrosis was present in medium to small-sized arteries, which was equivalent to Arkin’s classification II-IV. Most of the arteries had fibrous intimal thickening, which was considered to obstruct the arteries and thus cause segmental intestinal necrosis. A diagnosis of polyarteritis nodosa (PAN) was made, and intravenous cyclophosphamide pulse therapy was added to the therapeutic regimen. This patient was successfully treated with these multidisciplinary therapies and his stoma was finally closed. This is a very rare and indicative case of PAN weakly positive for MPO-ANCA and clinically mimicking NOMI, which occurred even after treatment with pulsed methylprednisolone. PMID:23801874

Spinal cord compression in a patient with a pain pump for failed back syndrome: a chalk-like precipitate mimicking a spinal cord neoplasm: case report.

PubMed

Wadhwa, Rishi K; Shaya, Mark R; Nanda, Anil

2006-02-01

The use of intrathecal morphine has been effective with few complications for chronic intractable pain of both benign and malignant origins. A rare but serious problem that exists is the formation of an inflammatory mass at the catheter tip of the pain pump. We report the case of a 67-year-old female patient with failed back syndrome who presented with sensory complaints and back pain. Magnetic resonance imaging revealed impingement on the thoracic cord by a mass. The mass was originally thought to be a spinal cord tumor; however, operation and chemical analysis of the mass showed that it was a bupivacaine precipitate at the tip of the catheter of the pain pump. This is the first such case, to our knowledge, of a bupivacaine precipitate mimicking a spinal cord tumor.

A Review of Current Evidence of Olmesartan Medoxomil Mimicking Symptoms of Celiac Disease.

PubMed

Sanford, Michele L; Nagel, Angela K

2015-04-01

Objective:To review the evidence of an association between olmesartan medoxomil and symptoms mimicking celiac disease.Data Sources:Literature was searched in PubMed (1965-November 2013) using the key words or MeSH terms olmesartan, enteropathy, celiac disease, sprue, and diarrhea. References from the Food and Drug Administration (FDA) and Dipiro's Pharmacotherapy eighth edition textbook were also reviewed.Data Synthesis:There have been recent implications of olmesartan medoxomil being linked to symptoms mimicking celiac disease. Investigators first identified the association in 22 patients who presented with presumed refractory celiac disease. Upon further evaluation, it was discovered that these symptoms improved when olmesartan was discontinued. In response to this report, additional case studies have been published. DeGaetani et al also further analyzed patients with seronegative villous atrophy from the Celiac Disease Center and found that olmesartan accounted for 22% of previously unclassified sprue cases. Conversely, the authors of the ROADMAP trial, which compared olmesartan to placebo, found no significant differences in the incidence of gastrointestinal adverse effects.Conclusions:There is growing evidence supporting the association between olmesartan and sprue-like symptoms; however, further research is warranted. These symptoms can be life threatening and clinicians should be aware of the potential association.

Enzyme-mimicking polymer brush-functionalized surface for combating biomaterial-associated infections

NASA Astrophysics Data System (ADS)

Jiang, Rujian; Xin, Zhirong; Xu, Shiai; Shi, Hengchong; Yang, Huawei; Song, Lingjie; Yan, Shunjie; Luan, Shifang; Yin, Jinghua; Khan, Ather Farooq; Li, Yonggang

2017-11-01

Biomaterial-associated infections critically compromise the functionality and performance of the medical devices, and pose a serious threat to human healthcare. Recently, natural DNase enzyme has been recognized as a potent material to prevent bacterial adhesion and biofilm formation. However, the vulnerability of DNase dramatically limits its long-term performance in antibacterial applications. In this work, DNase-mimicking polymer brushes were constructed to mimic the DNA-cleavage activity as well as the macromolecular scaffold of the natural DNase. The bacteria repellent efficacy of DNase-mimicking polymer brush-functionalized surface was comparable to that of the DNase-functionalized surface. More importantly, due to their inherent stability, DNase-mimicking polymer brushes presented the much better performance in inhibiting bacterial biofilm development for prolonged periods of time, as compared to the natural DNase. The as-developed DNase-mimicking polymer brush-functionalized surface presents a promising approach to combat biomaterial-associated infections.

Scenario-based and scenario-neutral assessment of climate change impacts on operational performance of a multipurpose reservoir

Treesearch

Allison G. Danner; Mohammad Safeeq; Gordon E. Grant; Charlotte Wickham; Desirée Tullos; Mary V. Santelmann

2017-01-01

Scenario-based and scenario-neutral impacts assessment approaches provide complementary information about how climate change-driven effects on streamflow may change the operational performance of multipurpose dams. Examining a case study of Cougar Dam in Oregon, United States, we simulated current reservoir operations under scenarios of plausible future hydrology....

Uveal Melanoma Mimicking Advanced Coats' Disease in a Young Patient.

PubMed

Gupta, Naina; Terrell, William; Schoenfield, Lynn; Kirsch, Claudia; Cebulla, Colleen M

2016-04-01

To report a case and the unique histopathology of a necrotic uveal melanoma mimicking advanced Coats' disease in a young adult. A 26-year-old male presented with a blind, painful eye, total exudative retinal detachment, and bulbous aneurysms consistent with Coats' disease. No masses were visualized on ultrasound or CT scan, and the patient underwent enucleation of the eye. Histopathology of the involved eye confirmed a necrotic uveal melanoma with persistent spindle cells forming a collar around residual tumor vessels. Careful consideration is needed in approaching any patient with a blind, painful eye and opaque media, even in younger populations.

The ShakeOut Earthquake Scenario - A Story That Southern Californians Are Writing

USGS Publications Warehouse

Perry, Suzanne; Cox, Dale; Jones, Lucile; Bernknopf, Richard; Goltz, James; Hudnut, Kenneth; Mileti, Dennis; Ponti, Daniel; Porter, Keith; Reichle, Michael; Seligson, Hope; Shoaf, Kimberley; Treiman, Jerry; Wein, Anne

2008-01-01

resulting losses are one realistic outcome, deliberately not a worst-case scenario, rather one worth preparing for and mitigating against. Decades of improving the life-safety requirements in building codes have greatly reduced the risk of death in earthquakes, yet southern California's economic and social systems are still vulnerable to large-scale disruptions. Because of this, the ShakeOut Scenario earthquake would dramatically alter the nature of the southern California community. Fortunately, steps can be taken now that can change that outcome and repay any costs many times over. The ShakeOut Scenario is the first public product of the USGS Multi-Hazards Demonstration Project, created to show how hazards science can increase a community's resiliency to natural disasters through improved planning, mitigation, and response.

Scenarios and methods that induce protruding or released CNTs after degradation of nanocomposite materials.

PubMed

Hirth, Sabine; Cena, Lorenzo; Cox, Gerhard; Tomović, Zeljko; Peters, Thomas; Wohlleben, Wendel

2013-04-01

Nanocomposite materials may be considered as a low-risk application of nanotechnology, if the nanofillers remain embedded throughout the life-cycle of the products in which they are embedded. We hypothesize that release of free CNTs occurs by a combination of mechanical stress and chemical degradation of the polymer matrix. We experimentally address limiting cases: Mechanically released fragments may show tubular protrusions on their surface. Here we identify these protrusions unambiguously as naked CNTs by chemically resolved microscopy and a suitable preparation protocol. By size-selective quantification of fragments we establish as a lower limit that at least 95 % of the CNTs remain embedded. Contrary to classical fiber composite approaches, we link this phenomenon to matrix materials with only a few percent elongation at break, predicting which materials should still cover their CNT nanofillers after machining. Protruding networks of CNTs remain after photochemical degradation of the matrix, and we show that it takes the worst case combinations of weathering plus high-shear wear to release free CNTs in the order of mg/m 2 /year. Synergy of chemical degradation and mechanical energy input is identified as the priority scenario of CNT release, but its lab simulation by combined methods is still far from real-world validation.

Postpolypectomy Electrocoagulation Syndrome: A Mimicker of Colonic Perforation

PubMed Central

Benson, Brian C.; Myers, Jonathan J.; Laczek, Jeffrey T.

2013-01-01

Postpolypectomy electrocoagulation syndrome is a rare complication of polypectomy with electrocautery and is characterized by a transmural burn of the colon wall. Patients typically present within 12 hours after the procedure with symptoms mimicking colonic perforation. Presented is the case of a 56-year-old man who developed abdominal pain six hours after colonoscopy during which polypectomy was performed using snare cautery. CT imaging of the abdomen revealed circumferential thickening of the wall of the transverse colon without evidence of free air. The patient was treated conservatively as an outpatient and had resolution of his pain over the following four days. Recognition of the diagnosis and understanding of the treatment are important to avoid unnecessary exploratory laparotomy or hospitalization. PMID:23956889

Idelalisib-induced colitis and skin eruption mimicking graft-versus-host disease.

PubMed

Hammami, Muhammad Bader; Al-Taee, Ahmad; Meeks, Marshall; Fesler, Mark; Hurley, M Yadira; Cao, Dengfeng; Lai, Jin-Ping

2017-04-01

Idelalisib is a selective inhibitor of the delta isoform of phosphatidylinositol 3-kinase which was approved by the United States Federal Drug Administration in 2014 for the treatment of relapsed chronic lymphocytic leukemia and indolent non-Hodgkin lymphoma. Drug-induced injury of the gastrointestinal tract is a relatively frequent but usually under-recognized disease entity. We report the case of a 56-year-old male with a history of relapsed follicular lymphoma status post allogenic bone marrow transplant who developed severe diarrhea with a skin eruption mimicking graft-versus-host disease (GVHD) 6 months after starting idelalisib. He underwent a colonoscopy demonstrating a grossly normal-appearing colon and terminal ileum. Biopsies taken during the procedure revealed mild active ileitis, colitis, and proctitis with frequent epithelial apoptosis, and focal intra-epithelial lymphocytosis. Skin biopsies revealed sub-acute spongiotic dermatitis suggestive of either contact dermatitis or an eczematous drug reaction. Symptoms were attributed to idelalisib given their resolution with withdrawal of the drug in conjunction with the skin and colonic biopsies. High clinical suspicion and awareness of the histological features of idelalisib-associated colitis is important to distinguish it from potential mimickers such as GVHD and infectious colitis.

P-HPB-21: Isolated pancreatic tuberculosis mimicking inoperable pancreatic cancer

PubMed Central

Sahu, Manoj Kumar; Singh, Ayashkanta; Behera, Debasmita; Behera, Manas; Narayan, Jimmy

2017-01-01

Background: Pancreatic tuberculosis is an uncommon disease, presenting as hypoechoic mass on imaging mimicking malignancy. Consequently, it represents a diagnostic challenge necessitating a tissue diagnosis. Case Report: A 75-year-old female presented with progressive jaundice and weight loss; imaging with computed tomography (CT) showed a large (5.8 cm × 4.6 cm) pancreatic head mass with encasement of portal and superior mesenteric veins, peripancreatic nodes, atrophic pancreatic parenchyma, and dilated main pancreatic duct. Cancer antigen 19-9 was moderately elevated. With a diagnosis of inoperable pancreatic malignancy, she was planned for tissue diagnosis and palliative chemotherapy. Endoscopic ultrasonography (EUS) showed a heterogeneous mass with vascular invasion as in the CT. Fine needle aspiration (FNA) and biliary decompression with a plastic stent performed in the same sitting. Cytology demonstrated granuloma with caseous necrosis and presence of acid-fast bacilli. Antituberculosis treatment was started, and repeat CT after 6 months showed resolution of the mass. Discussion and Conclusion: A diagnosis of isolated pancreatic tuberculosis is rare and is difficult by clinical presentation alone; in India, it should be considered as a differential diagnosis of a pancreatic tumor. Benign lesions can also present with vascular invasions mimicking inoperable malignancy. EUS FNA is a very useful tool in accurate diagnosis of pancreatic head mass avoiding unnecessary surgeries.

Thinking and Doing the Best Things in the Worst Times.

ERIC Educational Resources Information Center

Marty, Martin E.

1994-01-01

Several danger signals reflect our cultural disarray. Schools reflect larger societal breakdown and absence of common culture to support learning, discourse, conversation, or argument. In the "worst times," best educators preserve whatever transcends mere relativism, promote whatever survives of subcommunities that generate character,…

Assessing Seismic Hazards - Algorithms, Maps, and Emergency Scenarios

NASA Astrophysics Data System (ADS)

Ferriz, H.

2007-05-01

Public officials in charge of building codes, land use planning, and emergency response need sound estimates of seismic hazards. Sources may be well defined (e.g., active faults that have a surface trace) or diffuse (e.g., a subduction zone or a blind-thrust belt), but in both cases one can use a deterministic or worst-case scenario approach. For each scenario, a design earthquake is selected based on historic data or the known length of Holocene ruptures (as determined by geologic mapping). Horizontal ground accelerations (HGAs) can then be estimated at different distances from the earthquake epicenter using published attenuation relations (e.g., Seismological Res. Letters, v. 68, 1997) and estimates of the elastic properties of the substrate materials. No good algorithms are available to take into account reflection of elastic waves across other fault planes (e.g., a common effect in California, where there are many strands of the San Andreas fault), or amplification of waves in water-saturated alluvial and lacustrine basins (e.g., the Mexico City basin), but empirical relations can be developed by correlating historic damage patterns with predicted HGAs. The ultimate result is a map of HGAs. With this map, and with additional data on depth to groundwater and geotechnical properties of local soils, a liquefaction susceptibility map can be prepared, using published algorithms (e.g., J. of Geotech. Geoenv. Eng., v. 127, p. 817-833, 2001; Eng. Geology Practice in N. California, p. 579-594, 2001). Finally, the HGA estimates, digital elevation models, geologic structural data, and geotechnical properties of local geologic units can be used to prepare a slope failure susceptibility map (e.g., Eng. Geology Practice in N. California, p. 77-94, 2001). Seismic hazard maps are used by: (1) Building officials to determine areas of the city where special construction codes have to be implemented, and where existing buildings may need to be retrofitted. (2) Planning officials

A Case Report of Heel Pain Mimicking Plantar Fasciitis and Osteosarcoma: A Unique Presentation of a Nora's Lesion.

PubMed

Rushing, Calvin J; Rogers, Diana E; Spinner, Steven M; Gajzer, David C

Bizarre parosteal osteochondromatous proliferation, otherwise known as "Nora's lesion," is a rare benign neoplasm first described by Nora in 1983. The exact etiology of this neoplasm remains unknown, and its presentation in the lower extremity presents a diagnostic challenge, as both clinical and radiologic features cannot fully differentiate it from other neoplasms. We present the case of a 48-year-old female with plantar heel pain secondary to Nora's lesion mimicking plantar fasciitis and periosteal osteosarcoma. Following bone biopsy for histopathologic analysis, the patient's symptoms spontaneously resolved, and she returned to activity with complete resolution of symptoms 18 months post biopsy. Bizarre parosteal osteochondromatous proliferation as an etiology for plantar heel pain has not been previously described in the literature. Although rare, it should be considered in the differential diagnosis for patients presenting with plantar heel pain, especially after failed conservative treatment. Following diagnostic confirmation by histopathology, complete surgical excision is the treatment of choice. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Scenario-neutral Food Security Risk Assessment: A livestock Heat Stress Case Study

NASA Astrophysics Data System (ADS)

Broman, D.; Rajagopalan, B.; Hopson, T. M.

2015-12-01

Food security risk assessments can provide decision-makers with actionable information to identify critical system limitations, and alternatives to mitigate the impacts of future conditions. The majority of current risk assessments have been scenario-led and results are limited by the scenarios - selected future states of the world's climate system and socioeconomic factors. A generic scenario-neutral framework for food security risk assessments is presented here that uses plausible states of the world without initially assigning likelihoods. Measures of system vulnerabilities are identified and system risk is assessed for these states. This framework has benefited greatly by research in the water and natural resource fields to adapt their planning to provide better risk assessments. To illustrate the utility of this framework we develop a case study using livestock heat stress risk within the pastoral system of West Africa. Heat stress can have a major impact not only on livestock owners, but on the greater food production system, decreasing livestock growth, milk production, and reproduction, and in severe cases, death. A heat stress index calculated from daily weather is used as a vulnerability measure and is computed from historic daily weather data at several locations in the study region. To generate plausible states, a stochastic weather generator is developed to generate synthetic weather sequences at each location, consistent with the seasonal climate. A spatial model of monthly and seasonal heat stress provide projections of current and future livestock heat stress measures across the study region, and can incorporate in seasonal climate and other external covariates. These models, when linked with empirical thresholds of heat stress risk for specific breeds offer decision-makers with actionable information for use in near-term warning systems as well as for future planning. Future assessment can indicate under which states livestock are at greatest risk

57. Aerial view looking northwest; Botany Worsted Mills at center, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

57. Aerial view looking northwest; Botany Worsted Mills at center, Dundee Canal at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

Saving Time, Saving Money: The Economics of Unclogging America's Worst Bottlenecks

DOT National Transportation Integrated Search

2000-01-01

A 1999 study by the American Highway Users Alliance entitled "Unclogging America's Arteries: Prescriptions for Healthier Highways" identified the 166 worst bottlenecks in the country and evaluated the benefits of removing them. By assigning monetary ...

ARAMIS project: a comprehensive methodology for the identification of reference accident scenarios in process industries.

PubMed

Delvosalle, Christian; Fievez, Cécile; Pipart, Aurore; Debray, Bruno

2006-03-31

In the frame of the Accidental Risk Assessment Methodology for Industries (ARAMIS) project, this paper aims at presenting the work carried out in the part of the project devoted to the definition of accident scenarios. This topic is a key-point in risk assessment and serves as basis for the whole risk quantification. The first result of the work is the building of a methodology for the identification of major accident hazards (MIMAH), which is carried out with the development of generic fault and event trees based on a typology of equipment and substances. The term "major accidents" must be understood as the worst accidents likely to occur on the equipment, assuming that no safety systems are installed. A second methodology, called methodology for the identification of reference accident scenarios (MIRAS) takes into account the influence of safety systems on both the frequencies and possible consequences of accidents. This methodology leads to identify more realistic accident scenarios. The reference accident scenarios are chosen with the help of a tool called "risk matrix", crossing the frequency and the consequences of accidents. This paper presents both methodologies and an application on an ethylene oxide storage.

A case of scrotal swelling mimicking testicular torsion preceding Henoch-Schönlein vasculitis.

PubMed

Akgun, C

2012-01-01

Henoch-Schönlein purpura, is one of the most common types of multisystemic vasculitis seen in childhood. The major clinical manifestations are cutaneous purpura, arthritis, abdominal pain, gastrointestinal bleeding, and nephritis. Isolated central nervous system vasculitis, seizures, coma and hemorrhage, Guillan--Barré syndrome, ataxia and central and peripheral neuropathy, ocular involvement, orchitis, epididymitis or testicular torsion are medical or surgical complications. In this study, we report a 7-year-old boy with scrotal swelling mimicking testicular torsion with ultrasonographic and clinical findings that the typical clinical features of Henoch-Schönlein purpura including rashes and arthritis were developed after one week of surgery (Ref. 15).

28. View looking north; Botany Worsted Mills building No. 15 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

28. View looking north; Botany Worsted Mills building No. 15 at left, Dundee Canal at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

36. View of Botany Worsted Mills looking north; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

36. View of Botany Worsted Mills looking north; building No. 35 at left, Dundee Canal at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

Rheumatic mitral valve stenosis mimicking advanced lung cancer.

PubMed

von Lueder, Thomas; Steine, Kjetil; Nerdrum, Tone; Steen, Torkel; Bay, Dag; Humerfelt, Sjur; Atar, Dan

2007-09-01

This report describes a patient with a perihilar mass and mediastinal lymphadenopathy mimicking advanced lung cancer. The patient, a 45-year old regular smoker, was admitted to hospital for dyspnea and tachyarrhythmia, and during hospitalization he was diagnosed with severe rheumatic mitral valve stenosis (MVS) and aortic regurgitation as well as pulmonary venous hypertension. Surgical valve replacement and removal of an atrial thrombus was delayed considerably by diagnostic work-up for suspected malignancy. After cardiac surgery had been performed, recovery was uneventful. On follow-up 1 year later, echocardiography showed well-functioning prosthetic mitral and aortic valves, and normal findings on chest X-ray. Perihilar masses and mediastinal lymphadenopathy presented in this case constitute infrequent yet established findings in MVS, resulting from pulmonary venous congestion and hypertension, and focal lymphedema.

Managing risk in a challenging financial environment.

PubMed

Kaufman, Kenneth

2008-08-01

Five strategies can help hospital financial leaders balance their organizations' financial and risk positions: Understand the hospital's financial condition; Determine the desired level of risk; Consider total risk; Use a portfolio approach; Explore best-case/worst-case scenarios to measure risk.

39. View of Botany Worsted Mills looking southeast; buildings No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

39. View of Botany Worsted Mills looking southeast; buildings No. 39 and 38 at right, Dundee Canal at left - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

38. View looking west toward Botany Worsted Mills; railroad bridge ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

38. View looking west toward Botany Worsted Mills; railroad bridge (No.39A) at right, Dundee Canal at center - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

37. View of Botany Worsted Mills looking north; buildings No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

37. View of Botany Worsted Mills looking north; buildings No. 38 and 39 at left, Dundee Canal at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

Scenarios for gluino coannihilation

DOE PAGES

Ellis, John; Evans, Jason L.; Luo, Feng; ...

2016-02-11

In this article, we study supersymmetric scenarios in which the gluino is the next-to-lightest supersymmetric particle (NLSP), with a mass sufficiently close to that of the lightest supersymmetric particle (LSP) that gluino coannihilation becomes important. One of these scenarios is the MSSM with soft supersymmetry-breaking squark and slepton masses that are universal at an input GUT renormalization scale, but with non-universal gaugino masses. The other scenario is an extension of the MSSM to include vector-like supermultiplets. In both scenarios, we identify the regions of parameter space where gluino coannihilation is important, and discuss their relations to other regions of parametermore » space where other mechanisms bring the dark matter density into the range allowed by cosmology. In the case of the non-universal MSSM scenario, we find that the allowed range of parameter space is constrained by the requirement of electroweak symmetry breaking, the avoidance of a charged LSP and the measured mass of the Higgs boson, in particular, as well as the appearance of other dark matter (co)annihilation processes. Nevertheless, LSP masses m X ≲ 8TeV with the correct dark matter density are quite possible. In the case of pure gravity mediation with additional vector-like supermultiplets, changes to the anomaly-mediated gluino mass and the threshold effects associated with these states can make the gluino almost degenerate with the LSP, and we find a similar upper bound.« less

Scenario-based tsunami risk assessment using a static flooding approach and high-resolution digital elevation data: An example from Muscat in Oman

NASA Astrophysics Data System (ADS)

Schneider, Bastian; Hoffmann, Gösta; Reicherter, Klaus

2016-04-01

Knowledge of tsunami risk and vulnerability is essential to establish a well-adapted Multi Hazard Early Warning System, land-use planning and emergency management. As the tsunami risk for the coastline of Oman is still under discussion and remains enigmatic, various scenarios based on historical tsunamis were created. The suggested inundation and run-up heights were projected onto the modern infrastructural setting of the Muscat Capital Area. Furthermore, possible impacts of the worst-case tsunami event for Muscat are discussed. The approved Papathoma Tsunami Vulnerability Assessment Model was used to model the structural vulnerability of the infrastructure for a 2 m tsunami scenario, depicting the 1945 tsunami and a 5 m tsunami in Muscat. Considering structural vulnerability, the results suggest a minor tsunami risk for the 2 m tsunami scenario as the flooding is mainly confined to beaches and wadis. Especially traditional brick buildings, still predominant in numerous rural suburbs, and a prevalently coast-parallel road network lead to an increased tsunami risk. In contrast, the 5 m tsunami scenario reveals extensively inundated areas and with up to 48% of the buildings flooded, and therefore consequently a significantly higher tsunami risk. We expect up to 60000 damaged buildings and up to 380000 residents directly affected in the Muscat Capital Area, accompanied with a significant loss of life and damage to vital infrastructure. The rapid urbanization processes in the Muscat Capital Area, predominantly in areas along the coast, in combination with infrastructural, demographic and economic growth will additionally increase the tsunami risk and therefore emphasizes the importance of tsunami risk assessment in Oman.

Unusual presentation of anaplastic large cell lymphoma with clinical course mimicking fever of unknown origin and sepsis: autopsy study of five cases.

PubMed

Mosunjac, Marina B; Sundstrom, J Bruce; Mosunjac, Mario I

2008-10-01

To describe a subset of cases with the unusual clinical and histomorphological presentation of anaplastic large cell lymphoma (ALCL) mimicking fever of unknown origin (FUO) and sepsis. A pathology database was searched using full term Systematized Nomenclature of Medicine codes for ALCL to identify 23ALCL cases from the period 1999-2006. Of those, five cases that did not have a correct premortem diagnosis were further analyzed to elucidate the reasons for delayed and incorrect pre-mortem diagnosis. The analyzed data included clinical presentation, duration of symptoms, duration of hospital stay, premortem presumed cause of death, white blood cell count, platelet count, anion gap and blood pH, liver enzymes (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, alkaline phosphatase), lactate, coagulation tests (prothrombin time, partial thromboplastin time, fibrinogen, D-dimers), microbiology cultures, and radiology and surgical pathology reports. Autopsy reports were reviewed for description of major gross findings, initial clinical diagnosis, and cause of death. Five fatal and pre-mortem unrecognized ALCL cases were characterized by rapid decline, with histologic findings showing predominantly extranodal involvement, intravascular lymphomatosis, and hemophagocytosis. The cases were also characterized by unusual clinical manifestations including a FUO, sepsis, and disseminated intravascular coagulation-like picture, lactic acidosis, hepatosplenomegaly, and absence of significant peripheral adenopathy. There is a distinct group of ALCLs with unique and specific clinical, gross autopsy, and histopathologic findings. Recognition of this clinical variant may facilitate early detection and potentially timely diagnosis and therapy.

40. View of Botany Worsted Mills looking southeast; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

40. View of Botany Worsted Mills looking southeast; building No. 39 at right, building No. 38 behind, Dundee Canal at left - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

29. View looking north; Botany Worsted Mills building No. 13 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

29. View looking north; Botany Worsted Mills building No. 13 at left and building No. 14 rising behind, Dundee Canal at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

Mechanical Implantation of Urothelium Into Periureteral Soft Tissue: A Series of 4 Cases Mimicking High-stage Urothelial Carcinoma.

PubMed

Wobker, Sara E; Aron, Manju; Epstein, Jonathan I

2016-11-01

In the upper genitourinary tract of the ureter and renal pelvis, any invasion of urothelial carcinoma (UC) beyond the thin muscularis is considered pT3 disease, which may prompt adjuvant chemotherapy. Ureteroscopy is commonly used in the workup of these lesions to obtain tissue biopsies and cytology specimens, or to place stents for the relief of obstructive symptoms. The current study describes 4 cases in which the presence of small nests of urothelium in periureteral and peripelvic soft tissue was noted after ureteroscopic instrumentation, mimicking high-stage UC. All 4 cases had a history of ureteral instrumentation with biopsy of the suspected UC. The diagnostic biopsies showed low-grade noninvasive papillary UC (n=2), papillary urothelial neoplasm of uncertain malignant potential (n=1), and benign inverted urothelial papilloma (n=1). In the definitive resection specimens, small nests of bland urothelium were present in the periureteral or peripelvic soft tissue, raising the possibility of pT3 UC. We interpreted these displaced small nests to be the result of mechanical implantation occurring during the ureteroscopic procedure on the basis of the finding of associated linear fibrosis, inflammation, hemorrhage, and foreign body giant cells. In the setting of low-grade or benign urothelial neoplasms in the upper urinary tract, caution is warranted when cytologically bland nests of the urothelium are identified beyond the muscularis that could represent mechanically induced implants as opposed to invasive UC extending into peripelvic or periureteral soft tissue.

Osteomalacia mimicking spondyloarthropathy: a case report.

PubMed

Garip, Y; Dedeoglu, M; Bodur, H

2014-07-01

Osteomalacia is a metabolic bone disorder characterized by impaired mineralization of bone matrix. Symptoms of osteomalacia can be confused with other conditions such as spondyloarthropathy, polymyalgia rheumatica, polymyositis, and fibromyalgia. In this case, we report a patient with axial osteomalacia who developed low back pain, morning stiffness, and "grade 3 sacroiliitis" in pelvis X-ray, leading to the misdiagnosis as seronegative spondyloarthropathy. Serum biochemical studies revealed low serum phosphorus, low 25-hydroxy vitamin D3, normal calcium, elevated parathyroid hormone, and alkaline phosphatase levels. Her symptoms were relieved with vitamin D and calcium therapy. The diagnosis of osteomalacia should be considered in case of sacroiliitis and spondylitis.

Hypothetical Case and Scenario Description for International Transportation of Spent Nuclear Fuel.

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

Williams, Adam David; Osborn, Douglas; Jones, Katherine A.

To support more rigorous analysis on global security issues at Sandia National Laboratories (SNL), there is a need to develop realistic data sets without using "real" data or identifying "real" vulnerabilities, hazards or geopolitically embarrassing shortcomings. In response, an interdisciplinary team led by subject matter experts in SNL's Center for Global Security and Cooperation (CGSC) developed a hypothetical case description. This hypothetical case description assigns various attributes related to international SNF transportation that are representative, illustrative and indicative of "real" characteristics of "real" countries. There is no intent to identify any particular country and any similarity with specific real-world eventsmore » is purely coincidental. To support the goal of this report to provide a case description (and set of scenarios of concern) for international SNF transportation inclusive of as much "real-world" complexity as possible -- without crossing over into politically sensitive or classified information -- this SAND report provides a subject matter expert-validated (and detailed) description of both technical and political influences on the international transportation of spent nuclear fuel. [PAGE INTENTIONALLY LEFT BLANK]« less

Accident epidemiology and the U.S. chemical industry: accident history and worst-case data from RMP*Info.

PubMed

Kleindorfer, Paul R; Belke, James C; Elliott, Michael R; Lee, Kiwan; Lowe, Robert A; Feldman, Harold I

2003-10-01

This article reports on the data collected on one of the most ambitious government-sponsored environmental data acquisition projects of all time, the Risk Management Plan (RMP) data collected under section 112(r) of the Clean Air Act Amendments of 1990. This RMP Rule 112(r) was triggered by the Bhopal accident in 1984 and led to the requirement that each qualifying facility develop and file with the U.S. Environmental Protection Agency a Risk Management Plan (RMP) as well as accident history data for the five-year period preceding the filing of the RMP. These data were collected in 1999-2001 on more than 15,000 facilities in the United States that store or use listed toxic or flammable chemicals believed to be a hazard to the environment or to human health of facility employees or off-site residents of host communities. The resulting database, RMP*Info, has become a key resource for regulators and researchers concerned with the frequency and severity of accidents, and the underlying facility-specific factors that are statistically associated with accident and injury rates. This article analyzes which facilities actually filed under the Rule and presents results on accident frequencies and severities available from the RMP*Info database. This article also presents summaries of related results from RMP*Info on Offsite Consequence Analysis (OCA), an analytical estimate of the potential consequences of hypothetical worst-case and alternative accidental releases on the public and environment around the facility. The OCA data have become a key input in the evaluation of site security assessment and mitigation policies for both government planners as well as facility managers and their insurers. Following the survey of the RMP*Info data, we discuss the rich set of policy decisions that may be informed by research based on these data.

Subarachnoid Hemorrhage due to Spinal Cord Schwannoma Presenting Findings Mimicking Meningitis.

PubMed

Zhang, Hong-Mei; Zhang, Yin-Xi; Zhang, Qing; Song, Shui-Jiang; Liu, Zhi-Rong

2016-08-01

Subarachnoid hemorrhage (SAH) of spinal origin is uncommon in clinical practice, and spinal schwannomas associated with SAH are even more rarely reported. We report an unusual case of spinal SAH mimicking meningitis with normal brain computed tomography (CT)/magnetic resonance imaging (MRI) and negative CT angiography. Cerebrospinal fluid examination results were consistent with the manifestation of SAH. Spinal MRI performed subsequently showed an intradural extramedullary mass. The patient received surgery and was finally diagnosed with spinal cord schwannoma. A retrospective chart review of the patient was performed. We describe a case of SAH due to spinal cord schwannoma. Our case highlights the importance of careful history taking and complete evaluation. We emphasize that spinal causes should always be ruled out in patients with angionegative SAH and that schwannoma should be considered in the differential diagnosis of SAH etiologies even though rare. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

48. View of Botany Worsted Mills looking east; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

48. View of Botany Worsted Mills looking east; building No. 23 at left, building No. 17 at right, building No. 26 in center distance - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

35. View of Botany Worsted Mills looking east; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

35. View of Botany Worsted Mills looking east; building No. 24 at left, building No. 35 across center, Dundee Canal and pipe in foreground - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

34. View of Botany Worsted Mills looking north; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

34. View of Botany Worsted Mills looking north; building No. 14 at left, building No. 18 at left background, Dundee Canal at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

33. View of Botany Worsted Mills looking northwest; footbridge (No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

33. View of Botany Worsted Mills looking northwest; footbridge (No. 14A) at center, building No. 18 at left center, Dundee Canal in foreground - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

58. Aerial view looking east; Botany Worsted Mills at front, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

58. Aerial view looking east; Botany Worsted Mills at front, Andrew McLean Company Textile Mill at upper right, Passaic River at rear - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

42. View of Botany Worsted Mills looking northeast along Sherman ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

42. View of Botany Worsted Mills looking northeast along Sherman Street; site of 95-97 Dayton Avenue in right distance, at end of Sherman Street - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

27. View looking east; Botany Worsted Mills building No. 13 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

27. View looking east; Botany Worsted Mills building No. 13 at left, Dundee Canal at center, Andrew McLean Company Textile Mill at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

32. View looking south; Botany Worsted Mills building No. 15 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

32. View looking south; Botany Worsted Mills building No. 15 at right, Dundee Canal at center, Andrew McLean Company Textile Mill at left - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

46. View of Botany Worsted Mills looking northeast; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

46. View of Botany Worsted Mills looking northeast; building No. 68-69 at left, Mattimore Street houses (No. 66-67 through No. 54-55) at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

49. View of Botany Worsted Mills looking southeast; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

49. View of Botany Worsted Mills looking southeast; building No. 26 at left, building No. 18 at center, addition to building No. 17 at right foreground - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

Retinal pigmentary changes in chronic uveitis mimicking retinitis pigmentosa.

PubMed

Sevgi, D Damla; Davoudi, Samaneh; Comander, Jason; Sobrin, Lucia

2017-09-01

To present retinal pigmentary changes mimicking retinitis pigmentosa (RP) as a finding of advanced uveitis. We retrospectively reviewed charts of patients without a family history of inherited retinal degenerations who presented with retinal pigment changes and signs of past or present intraocular inflammation. Comprehensive eye examination including best-corrected visual acuity, slit-lamp examination and dilated fundus examination was performed on all patients in addition to color fundus photography, optical coherence tomography, fluorescein angiography (FA), and full-field electroretinogram testing. We identified five patients with ages ranging from 33 to 66 years, who presented with RP-like retinal pigmentary changes which were eventually attributed to longstanding uveitis. The changes were bilateral in three cases and unilateral in two cases. Four of five cases presented with active inflammation, and the remaining case showed evidence of active intraocular inflammation during follow-up. This study highlights the overlapping features of advanced uveitis and RP including the extensive pigmentary changes. Careful review of possible past uveitis history, detailed examination of signs of past or present inflammation and ancillary testing, with FA often being most helpful, are required for the correct diagnosis. This is important, because intervention can prevent further damage if the cause of the pigmentary changes is destructive inflammation.

Vulnerability and impact assessment of extreme climatic event: A case study of southern Punjab, Pakistan.

PubMed

Aslam, Abdul Qayyum; Ahmad, Sajid R; Ahmad, Iftikhar; Hussain, Yawar; Hussain, Muhammad Sameem

2017-02-15

Understanding of frequency, severity, damages and adaptation costs of climate extremes is crucial to manage their aftermath. Evaluation of PRECIS RCM modelled data under IPCC scenarios in Southern Punjab reveals that monthly mean temperature is 30°C under A2 scenario, 2.4°C higher than A1B which is 27.6°C in defined time lapses. Monthly mean precipitation under A2 scenario ranges from 12 to 15mm and for A1B scenario it ranges from 15 to 19mm. Frequency modelling of floods and droughts via poisson distribution shows increasing trend in upcoming decades posing serious impacts on agriculture and livestock, food security, water resources, public health and economic status. Cumulative loss projected for frequent floods without adaptation will be in the range of USD 66.8-79.3 billion in time lapse of 40years from 2010 base case. Drought damage function @ 18% for A2 scenario and @ 13.5% for A1B scenario was calculated; drought losses on agriculture and livestock sectors were modelled. Cumulative loss projected for frequent droughts without adaptation under A2 scenario will be in the range of USD 7.5-8.5 billion while under A1B scenario it will be in the range of USD 3.5-4.2 billion for time lapse of 60years from base case 1998-2002. Severity analysis of extreme events shows that situation get worse if adaptations are not only included in the policy but also in the integrated development framework with required allocation of funds. This evaluation also highlights the result of cost benefit analysis, benefits of the adaptation options (mean & worst case) for floods and droughts in Southern Punjab. Additionally the research highlights the role of integrated extreme events impact assessment methodology in performing the vulnerability assessments and to support the adaptation decisions. This paper is an effort to highlight importance of bottom up approaches to deal with climate change. Copyright © 2016 Elsevier B.V. All rights reserved.

Oral desmoplastic melanoma mimicking inflammatory hyperplasia.

PubMed

Jou, Adriana; Miranda, Fábio V; Oliveira, Márcia G; Martins, Manoela D; Rados, Pantelis V; Filho, Manoel S

2012-06-01

Desmoplastic melanoma (DM) arising in the oral cavity is a rare neoplasm that may be confused with a variety of non-melanocytic benign or malignant lesions. To present a case of DM in the oral mucosa mimicking fibrous inflammatory hyperplasia, discusses the difficulties involved in the diagnosis and offers a literature review on the clinicopathologic and immunohistochemincal aspects of this neoplasm. A 62-year-old white male, smoker, was referred with a chief complaint of pain and swelling in the palate. The oral examination revealed multiple brown-to-black patches and a non-pigmented sessile nodule located on the mucosa of the hard palate. The clinical diagnosis of the pigmented lesions was either oral melanosis or melanoma. The nodular lesion was clinically diagnosed as fibrous inflammatory hyperplasia. Incisional biopsy was performed on the pigmented lesion and the microscopic sections revealed a melanotic macule. The nodular lesions histologically revealed an amelanotic desmoplastic melanoma. Reactive lesions close to a pigmented area should be investigated with great care. © 2010 The Gerodontology Society and John Wiley & Sons A/S.

Low-grade appendiceal mucinous neoplasm mimicking an adnexal mass.

PubMed

Cristian, Daniel Alin; Grama, Florin Andrei; Becheanu, Gabriel; Pop, Anamaria; Popa, Ileana; Şurlin, Valeriu; Stănilescu, Sorin; Bratu, Ana Magdalena; Burcoş, Traean

2015-01-01

We present a rare case of malignant epithelial neoplasm of the appendix, an uncommon disorder encountered in clinical practice, which poses a variety of diagnostic and therapeutic challenges. We report a particular case in which the appendix was abnormally located in the pelvis, mimicking an adnexal mass. Therefore, it was difficult to make the preoperative diagnosis on clinical examination, imaging studies and laboratory tests and we discovered the lesion during the diagnostic laparoscopy. No lymphadenopathy or mucinous ascites were found. The case was completely handled via the laparoscopic approach keeping the appendix intact during the operation. The frozen section, the detailed histopathology overview as well as multiple immunostaining with a complex panel of markers report diagnosed a low-grade appendiceal mucinous neoplasm (LAMN) with no invasion of the wall. No adjuvant therapy was considered needed. At a one-year follow-up oncological assessment, the patient was free of disease. In women with cystic mass in the right iliac fossa an appendiceal mucocele should be considered in the differential diagnosis. Laparoscopic appendectomy can represent an adequate operation for the appendiceal mucinous neoplasm if the histological report is clear and surgical precautionary measures are taken.

Hiatal hernia uptake of iodine-131 mimicking mediastinal metastasis of papillary thyroid carcinoma.

PubMed

Haghighatafshar, Mahdi; Khajehrahimi, Farnaz

2015-01-01

There are a few case reports of hiatal hernia demonstrating thoracic uptake on I-131 scintigraphy. In this case, high thyroglobulin levels in combination with misinterpretation of I-131 uptake in the mediastinum, leaded to mismanagement of the patient. Here we present a case of focal I-131 uptake within a hiatal hernia initially mimicking an isolated mediastinal metastasis. There are many potential causes of false-positive I-131 scan result. In this case, adjunctive chest computed tomography and gastroesophageal barium study helped to elucidate the true nature of this I-131 uptake. False-positive findings may be caused by a wide variety of nonthyroidal carcinomas, which can concentrate radioiodine or from skin contamination. Several organs, such as the gastric, salivary glands, renal cyst, pericardial effusion, and ovarian can accumulate I-131. It should be borne in mind as a potential source of false-positive whole-body I-131 imaging.

Great Plains Project: at worst a $1. 7 billion squeeze

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

Maize, K.

1983-04-11

On January 29, 1982, seeking a loan guarantee for its coal-to-gas synfuels project, Great Plains Gasification Associates told the Department of Energy that they expected to reap $1.2 billion in net income to the partnership during the first 10 years of the venture. On March 31, 1983, Great Plains treasurer Rodney Boulanger had a different projection: a horrific loss of $773 million in the first decade. The Great Plains project, with construction 50% complete, is being built near Beulah, ND. The project has a design capacity of 137.5 million cubic feet a day of SNG. Great Plains' analysis assumes thatmore » the plant will operate at 70% of design capacity in 1985, 77% in 1986, 84% in 1987 and 91% thereafter. The company projects the total project cost at $2.1 billion, consisting of plant costs of $1.9 billion and coal mine costs of $156 million. In originally projecting a cumulative net income of better than $1 billion, the partners anticipated running losses in only three of the first 10 years, and cash distributions from the project of $893 million during the first decade. Under the new projections, even in the best case, the first four years would show losses and there would be no distribution to the partners. In the worst case, the project would run in the red every year for the first 10 years.« less

SERENITY in e-Business and Smart Item Scenarios

NASA Astrophysics Data System (ADS)

Benameur, Azzedine; Khoury, Paul El; Seguran, Magali; Sinha, Smriti Kumar

SERENITY Artefacts, like Class, Patterns, Implementations and Executable Components for Security & Dependability (S&D) in addition to Serenity Runtime Framework (SRF) are discussed in previous chapters. How to integrate these artefacts with applications in Serenity approach is discussed here with two scenarios. The e-Business scenario is a standard loan origination process in a bank. The Smart Item scenario is an Ambient intelligence case study where we take advantage of Smart Items to provide an electronic healthcare infrastructure for remote healthcare assistance. In both cases, we detail how the prototype implementations of the scenarios select proper executable components through Serenity Runtime Framework and then demonstrate how these executable components of the S&D Patterns are deployed.

Toxoplasma lymphadenitis mimicking malign axillary lymphadenopathy of a left breast mass.

PubMed

Yildirim, Ali Cihat; Bostanci, Hasan; Yilmaz, Engin Deniz; Kutluer, Nizamettin; Kargici, Hulagu

2013-06-01

Toxoplasmosis is an infection caused by the intracellular parasite, Toxoplasma gondii. Immunocompetent persons with primary infection are usually asymptomatic, but latent infection can persist for the life of the host. There is a risk of reactivating infection at a later time should the individual become immunocompromised, even if infection was asymptomatic or only mildly symptomatic initially. Axillary lymph nodes receive 85% of the lymphatic drainage from the breast. Lymph node metastases are relatively common even with invasive breast cancers ≤1 cm in size. Here, we report a case of toxoplasma lymphadenitis in a female adult patient mimicking a malign breast lymphadenopathy of a left breast mass.

41. View of Botany Worsted Mills looking southeast from site ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

41. View of Botany Worsted Mills looking southeast from site of former Forstmann and Huffman textile mill; water tank (No. 43A) at center, Dundee Canal to left - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

45. View of Botany Worsted Mills looking east; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

45. View of Botany Worsted Mills looking east; building No. 4 at left, building No. 68-69 at right, chimney of Andrew McLean Company Textile Mill at center distance - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

51. View of Botany Worsted Mills looking east; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

51. View of Botany Worsted Mills looking east; building No. 43 at left, building No. 41 at center, building No. 40 at right, building No. 31 rising at right background - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

50. View of Botany Worsted Mills looking northwest; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

50. View of Botany Worsted Mills looking northwest; building No. 43 at left center, building No. 42 at right center, water tank (No. 43A) at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

Giant hydronephrosis mimicking progressive malignancy

PubMed Central

Schrader, Andres Jan; Anderer, Georgia; von Knobloch, Rolf; Heidenreich, Axel; Hofmann, Rainer

2003-01-01

Background Cases of giant hydronephroses are rare and usually contain no more than 1–2 litres of fluid in the collecting system. We report a remarkable case of giant hydronephrosis mimicking a progressive malignant abdominal tumour. Case presentation A 78-year-old cachectic woman presented with an enormous abdominal tumour, which, according to the patient, had slowly increased in diameter. Medical history was unremarkable except for a hysterectomy >30 years before. A CT scan revealed a giant cystic tumour filling almost the entire abdominal cavity. It was analysed by two independent radiologists who suspected a tumour originating from the right kidney and additionally a cystic ovarian neoplasm. Subsequently, a diagnostic and therapeutic laparotomy was performed: the tumour presented as a cystic, 35 × 30 × 25 cm expansive structure adhesive to adjacent organs without definite signs of invasive growth. The right renal hilar vessels could finally be identified at its basis. After extirpation another tumourous structure emerged in the pelvis originating from the genital organs and was also resected. The histopathological examination revealed a >15 kg hydronephrotic right kidney, lacking hardly any residual renal cortex parenchyma. The second specimen was identified as an ovary with regressive changes and a large partially calcified cyst. There was no evidence of malignant growth. Conclusion Although both clinical symptoms and the enormous size of the tumour indicated malignant growth, it turned out to be a giant hydronephrosis. Presumably, a chronic obstruction of the distal ureter had caused this extraordinary hydronephrosis. As demonstrated in our case, an accurate diagnosis of giant hydronephrosis remains challenging due to the atrophy of the renal parenchyma associated with chronic obstruction. Therefore, any abdominal cystic mass even in the absence of other evident pathologies should include the differential diagnosis of a possible hydronephrosis. Diagnostic

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

Strauss, Henry

This research was mostly concerned with asymmetric vertical displacement event (AVDE) disruptions, which are the worst case scenario for producing a large asymmetric wall force. This is potentially a serious problem in ITER.

Glutaric Aciduria Type I: A Rare Metabolic Disorder Mimicking as Choreoathetoid Cerebral Palsy

PubMed Central

Sarangi, Pradosh Kumar; Sahoo, Lulup Kumar; Mallick, Ashok Kumar; Dash, Prafulla Kumar

2017-01-01

Glutaric aciduria type I (GA I) is an autosomal recessive inborn error of metabolism caused by a deficiency of the enzyme glutaryl-CoA dehydrogenase. This disorder is characterized by progressive dystonia, choreoathetosis, and dyskinesia. It is often misdiagnosed as athetoid cerebral palsy. Laboratory evaluation usually demonstrates increased urinary excretion of gluataric acid and 3-hydroxyglutaric acid. We report a case of a 7-year-old boy presenting with choreoathetosis and dystonia, mimicking as choreoathetoid cerebral palsy. The presence of characteristic neuroimaging and biochemical studies led to the diagnosis of GA I. PMID:28553392

Glutaric Aciduria Type I: A Rare Metabolic Disorder Mimicking as Choreoathetoid Cerebral Palsy.

PubMed

Sarangi, Pradosh Kumar; Sahoo, Lulup Kumar; Mallick, Ashok Kumar; Dash, Prafulla Kumar

2017-01-01

Glutaric aciduria type I (GA I) is an autosomal recessive inborn error of metabolism caused by a deficiency of the enzyme glutaryl-CoA dehydrogenase. This disorder is characterized by progressive dystonia, choreoathetosis, and dyskinesia. It is often misdiagnosed as athetoid cerebral palsy. Laboratory evaluation usually demonstrates increased urinary excretion of gluataric acid and 3-hydroxyglutaric acid. We report a case of a 7-year-old boy presenting with choreoathetosis and dystonia, mimicking as choreoathetoid cerebral palsy. The presence of characteristic neuroimaging and biochemical studies led to the diagnosis of GA I.

Model of the Phase Transition Mimicking the Pasta Phase in Cold and Dense Quark-Hadron Matter

NASA Astrophysics Data System (ADS)

Ayriyan, Alexander; Grigorian, Hovik

2018-02-01

A simple mixed phase model mimicking so-called "pasta" phases in the quarkhadron phase transition is developed and applied to static neutron stars for the case of DD2 type hadronic and NJL type quark matter models. The influence of the mixed phase on the mass-radius relation of the compact stars is investigated. Model parameters are chosen such that the results are in agreement with the mass-radius constraints.

Investigations on the emission of fragrance allergens from scented toys by means of headspace solid-phase microextraction gas chromatography-mass spectrometry.

PubMed

Masuck, Ines; Hutzler, Christoph; Luch, Andreas

2010-04-30

In the revised European toy safety directive 2009/48/EC the application of fragrance allergens in children's toys is restricted. The focus of the present work lies on the instrumental analytics of 13 banned fragrance allergens, as well as on 11 fragrance allergens that require declaration when concentrations surpass 100 microg per gram material. Applying a mixture of ethyl acetate and toluene solid/liquid extraction was performed prior to quantitative analysis of mass contents of fragrances in scented toys. In addition, an easy-to-perform method for the determination of emitted fragrances at 23 degrees C (handling conditions) or at 40 degrees C (worst case scenario) has been worked out to allow for the evaluation of potential risks originating from inhalation of these compounds during handling of or playing with toys. For this purpose a headspace solid-phase microextraction (HS-SPME) technique was developed and coupled to subsequent gas chromatography-mass spectrometry (GC-MS) analysis. Fragrance allergens were adsorbed (extracted) from the gas phase onto an 85 microm polyacrylate fiber while incubating pieces of the scented toys in sealed headspace vials at 23 degrees C and 40 degrees C. Quantification of compounds was performed via external calibration. The newly developed headspace method was subsequently applied to five perfumed toys. As expected, the emission of fragrance allergens from scented toys depends on the temperature and on the content of fragrance allergens present in those samples. In particular at conditions mimicking worst case (40 degrees C), fragrance allergens in toys may pose a risk to children since considerable amounts of compound might be absorbed by lung tissue via breathing of contaminated air. 2010 Elsevier B.V. All rights reserved.

The role of ultraviolet colour in the assessment of mimetic accuracy between Batesian mimics and their models: a case study using ant-mimicking spiders

NASA Astrophysics Data System (ADS)

Corcobado, Guadalupe; Herberstein, Marie E.; Pekár, Stano

2016-12-01

The use of ultraviolet (UV) cues for intra- and inter-specific communication is common in many animal species. Still, the role of UV signals under some predator-prey contexts, such as Batesian mimicry, is not clear. Batesian mimicry is a defensive strategy by which a palatable species (the mimic) resembles an unpalatable or noxious species (the model) to avoid predation. This strategy has evolved independently in many different taxa that are predated by species capable of UV perception. Moreover, there is considerable variation in how accurately Batesian mimics resemble their models across species. Our aim was to investigate how UV colour contributed to mimetic accuracy using several ant-mimicking spider species as a case study. We measured the reflectance spectrum (300-700 nm) for several species of mimics and models, and we tested whether they differ in visible and UV colour. We modelled whether two different predators could discriminate between mimics and models using colour information. We found that generally, ant-mimicking spiders differed significantly from their ant models in UV colour and that information from the visible range of light cannot be extrapolated into the UV. Our modelling suggested that wasps should be able to discriminate between mimics and models combining information from visible and the UV light, whereas birds may not discriminate between them. Thus, we show that UV colour can influence mimic accuracy and we discuss its potential role in Batesian mimicry. We conclude that colour, especially in the UV range, should be taken into account when measuring mimetic accuracy.

Topical Backgrounder: Evaluating Chemical Hazards in the Community: Using RMP's Offsite Consequence Analysis

EPA Pesticide Factsheets

Part of a May 1999 series on the Risk Management Program Rule and issues related to chemical emergency management. Explains hazard versus risk, worst-case and alternative release scenarios, flammable endpoints and toxic endpoints.

Stochastic Robust Mathematical Programming Model for Power System Optimization

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

Liu, Cong; Changhyeok, Lee; Haoyong, Chen

2016-01-01

This paper presents a stochastic robust framework for two-stage power system optimization problems with uncertainty. The model optimizes the probabilistic expectation of different worst-case scenarios with ifferent uncertainty sets. A case study of unit commitment shows the effectiveness of the proposed model and algorithms.

An Integrated Scenario Ensemble-Based Framework for Hurricane Evacuation Modeling: Part 2-Hazard Modeling.

PubMed

Blanton, Brian; Dresback, Kendra; Colle, Brian; Kolar, Randy; Vergara, Humberto; Hong, Yang; Leonardo, Nicholas; Davidson, Rachel; Nozick, Linda; Wachtendorf, Tricia

2018-04-25

Hurricane track and intensity can change rapidly in unexpected ways, thus making predictions of hurricanes and related hazards uncertain. This inherent uncertainty often translates into suboptimal decision-making outcomes, such as unnecessary evacuation. Representing this uncertainty is thus critical in evacuation planning and related activities. We describe a physics-based hazard modeling approach that (1) dynamically accounts for the physical interactions among hazard components and (2) captures hurricane evolution uncertainty using an ensemble method. This loosely coupled model system provides a framework for probabilistic water inundation and wind speed levels for a new, risk-based approach to evacuation modeling, described in a companion article in this issue. It combines the Weather Research and Forecasting (WRF) meteorological model, the Coupled Routing and Excess STorage (CREST) hydrologic model, and the ADvanced CIRCulation (ADCIRC) storm surge, tide, and wind-wave model to compute inundation levels and wind speeds for an ensemble of hurricane predictions. Perturbations to WRF's initial and boundary conditions and different model physics/parameterizations generate an ensemble of storm solutions, which are then used to drive the coupled hydrologic + hydrodynamic models. Hurricane Isabel (2003) is used as a case study to illustrate the ensemble-based approach. The inundation, river runoff, and wind hazard results are strongly dependent on the accuracy of the mesoscale meteorological simulations, which improves with decreasing lead time to hurricane landfall. The ensemble envelope brackets the observed behavior while providing "best-case" and "worst-case" scenarios for the subsequent risk-based evacuation model. © 2018 Society for Risk Analysis.

Environmental performance of construction waste: Comparing three scenarios from a case study in Catalonia, Spain.

PubMed

Ortiz, O; Pasqualino, J C; Castells, F

2010-04-01

The main objective of this paper is to evaluate environmental impacts of construction wastes in terms of the LIFE 98 ENV/E/351 project. Construction wastes are classified in accordance with the Life Program Environment Directive of the European Commission. Three different scenarios to current waste management from a case study in Catalonia (Spain) have been compared: landfilling, recycling and incineration, and these scenarios were evaluated by means of Life Cycle Assessment. The recommendations of the Catalan Waste Catalogue and the European Waste Catalogue have been taken into account. Also, the influence of transport has been evaluated. Results show that in terms of the Global Warming Potential, the most environmentally friendly treatment was recycling, followed by incineration and lastly landfilling. According to the influence of treatment plants location on the GWP indicator, we observe that incineration and recycling of construction wastes are better than landfilling, even for long distances from the building site to the plants. This is true for most wastes except for the stony types, than should be recycled close to the building site. In summary, data from construction waste of a Catalan case study was evaluated using the well established method of LCA to determine the environmental impacts. Copyright 2009 Elsevier Ltd. All rights reserved.

Environmental performance of construction waste: Comparing three scenarios from a case study in Catalonia, Spain

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

Ortiz, O., E-mail: oscarortiz@unipamplona.edu.c; University of Pamplona, Department of Industrial Engineering, Km 1 Via Bucaramanga, Pamplona, N de S; Pasqualino, J.C.

2010-04-15

The main objective of this paper is to evaluate environmental impacts of construction wastes in terms of the LIFE 98 ENV/E/351 project. Construction wastes are classified in accordance with the Life Program Environment Directive of the European Commission. Three different scenarios to current waste management from a case study in Catalonia (Spain) have been compared: landfilling, recycling and incineration, and these scenarios were evaluated by means of Life Cycle Assessment. The recommendations of the Catalan Waste Catalogue and the European Waste Catalogue have been taken into account. Also, the influence of transport has been evaluated. Results show that in termsmore » of the Global Warming Potential, the most environmentally friendly treatment was recycling, followed by incineration and lastly landfilling. According to the influence of treatment plants location on the GWP indicator, we observe that incineration and recycling of construction wastes are better than landfilling, even for long distances from the building site to the plants. This is true for most wastes except for the stony types, than should be recycled close to the building site. In summary, data from construction waste of a Catalan case study was evaluated using the well established method of LCA to determine the environmental impacts.« less

Tongue metastasis mimicking an abscess.

PubMed

Mavili, Ertuğrul; Oztürk, Mustafa; Yücel, Tuba; Yüce, Imdat; Cağli, Sedat

2010-03-01

Primary tumors metastasizing to the oral cavity are extremely rare. Lung is one of the most common primary sources of metastases to the tongue. Although the incidence of lung cancer is increasing, tongue metastasis as the initial presentation of the tumor remains uncommon. Due to the rarity of tongue metastasis, little is known about its imaging findings. Herein we report the magnetic resonance imaging and clinical findings of a lingual metastasis, mimicking an abscess, from a primary lung cancer.

47. View of Botany Worsted Mills looking east; building No. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

47. View of Botany Worsted Mills looking east; building No. 16 at left, chimney (No. 17A) at left center, building No. 18 behind, building No. 7 at right center, building No. 1 at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

Assessment of the Incentives Created by Public Disclosure of Off-Site Consequence Analysis Information for Reduction in the Risk of Accidental Releases

EPA Pesticide Factsheets

The off-site consequence analysis (OCA) evaluates the potential for worst-case and alternative accidental release scenarios to harm the public and environment around the facility. Public disclosure would likely reduce the number/severity of incidents.

Invasive Pulmonary Aspergillosis-mimicking Tuberculosis.

PubMed

Kim, Sung-Han; Kim, Mi Young; Hong, Sun In; Jung, Jiwon; Lee, Hyun Joo; Yun, Sung-Cheol; Lee, Sang-Oh; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee

2015-07-01

Pulmonary tuberculosis is occasionally confused with invasive pulmonary aspergillosis (IPA) in transplant recipients, since clinical suspicion and early diagnosis of pulmonary tuberculosis and IPA rely heavily on imaging modes such as computed tomography (CT). We therefore investigated IPA-mimicking tuberculosis in transplant recipients. All adult transplant recipients who developed tuberculosis or IPA at a tertiary hospital in an intermediate tuberculosis-burden country during a 6-year period were enrolled. First, we tested whether experienced radiologists could differentiate pulmonary tuberculosis from IPA. Second, we determined which radiologic findings could help us differentiate them. During the study period, 28 transplant recipients developed pulmonary tuberculosis after transplantation, and 80 patients developed IPA after transplantation. Two experienced radiologists scored blindly 28 tuberculosis and 50 randomly selected IPA cases. The sensitivities of radiologists A and B for IPA were 78% and 68%, respectively (poor agreement, kappa value = 0.25). The sensitivities of radiologists A and B for tuberculosis were 64% and 61%, respectively (excellent agreement, kappa value = 0.77). We then compared the CT findings of the 28 patients with tuberculosis and 80 patients with IPA. Infarct-shaped consolidations and smooth bronchial wall thickening were more frequent in IPA, and mass-shaped consolidations and centrilobular nodules (<10 mm, clustered) were more frequent in tuberculosis. Certain CT findings appear to be helpful in differentiating between IPA and tuberculosis. Nevertheless, the CT findings of about one-third of pulmonary tuberculosis cases in transplant recipients are very close to those of IPA. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Acute dystonic reaction leading to lingual hematoma mimicking angioedema

PubMed Central

Sezer, Özgür; Aydin, Ali Attila; Bilge, Sedat; Arslan, Fatih; Arslan, Hasan

2017-01-01

Lingual hematoma is a severe situation, which is rare and endangers the airway. It can develop due to trauma, vascular abnormalities, and coagulopathy. Due to its sudden development, it can be clinically confused with angioedema. In patients who applied to the doctor with complaints of a swollen tongue, lingual hematoma can be confused with angioedema, in particular, at the beginning if the symptoms occurred after drug use. It should especially be considered that dystonia in the jaw can present as drug-induced hyperkinetic movement disorder. Early recognition of this rare clinical condition and taking precautions for providing airway patency are essential. In this case report, we will discuss mimicking angioedema and caused by a bite due to dystonia and separation of the tongue from the base of the mouth developing concurrently with lingual hematoma. PMID:29326495

Base-Case 1% Yield Increase (BC1), All Energy Crops scenario of the 2016 Billion Ton Report

DOE Data Explorer

Davis, Maggie R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)] (ORCID:0000000181319328); Hellwinkel, Chad [University of Tennessee] (ORCID:0000000173085058); Eaton, Laurence [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)] (ORCID:0000000312709626); Langholtz, Matthew H. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)] (ORCID:0000000281537154); Turhollow, Anthony [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)] (ORCID:0000000228159350); Brandt, Craig [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)] (ORCID:0000000214707379); Myers, Aaron (ORCID:0000000320373827)

2016-07-13

Scientific reason for data generation: to serve as the base-case scenario for the BT16 volume 1 agricultural scenarios to compare these projections of potential biomass supplies against a reference case (agricultural baseline 10.11578/1337885). The simulation runs from 2015 through 2040; a starting year of 2014 is used but not reported. How each parameter was produced (methods), format, and relationship to other data in the data set: This exogenous price simulations (also referred to as “specified-price” simulations) introduces a farmgate price, and POLYSYS solves for biomass supplies that may be brought to market in response to these prices. In specified-price scenarios, a specified farmgate price is offered constantly in all counties over all years of the simulation. This simulation begins in 2015 with an offered farmgate price for primary crop residues only between 2015 and 2018 and long-term contracts for dedicated crops beginning in 2019. Expected mature energy crop yield grows at a compounding rate of 1% beginning in 2016. The yield growth assumptions are fixed after crops are planted such that yield gains do not apply to crops already planted, but new plantings do take advantage of the gains in expected yield growth. Instruments used: Policy Analysis System –POLYSYS (version POLYS2015_V10_alt_JAN22B), an agricultural policy modeling system of U.S. agriculture (crops and livestock), supplied by the University of Tennessee Institute of Agriculture, Agricultural Policy Analysis Center.

An Adolescent Case of Citrin Deficiency With Severe Anorexia Mimicking Anorexia Nervosa.

PubMed

Takeuchi, Satsuki; Yazaki, Masahide; Yamada, Shinji; Fukuyama, Tetsuhiro; Inui, Akio; Iwasaki, Yasushi; Ikeda, Shu-ichi

2015-08-01

We report a 12-year-old female citrin-deficient patient presenting with severe anorexia and body weight loss, mimicking the restricting type of anorexia nervosa (AN). She showed normal development until age 10 years when she started to play volleyball at school. She then became gradually anorexic, and her growth was stunted. At age 12, she was admitted to hospital because of severe anorexia and thinness. She was first thought to have AN, and drip infusion of glucose solution and high-calorie drinks were given, but her condition deteriorated further. She had a history of neonatal hepatitis and was therefore suspected to have citrin deficiency (CD). Genetic analysis of SLC25A13 revealed that she was compound heterozygous for 851del4 and IVS16ins3kb, and a diagnosis of CD was made. A low-carbohydrate diet with oral intake of arginine and ursodeoxycholic acid was started, and her condition gradually improved. The clinical features in our patient were similar to those of AN, and therefore AN may also be an important clinical sign in adolescent patients with CD. Copyright © 2015 by the American Academy of Pediatrics.

Scenarios and decisionmaking for complex environmental systems

Treesearch

Stephen R. Carpenter; Adena R. Rissman

2012-01-01

Scenarios are used for expanding the scope of imaginable outcomes considered by assessments, planning exercises, or research projects on social-ecological systems. We discuss a global case study, the Millennium Ecosystem Assessment, and a regional project for an urbanizing agricultural watershed. Qualitative and quantitative aspects of scenarios are complementary....

Retroperitoneal Pseudoaneurysm Mimicking Ureteral Calculus: Pitfalls in Diagnosis.

PubMed

Kalabin, Aleksandr; Mani, Vishnu R; Dinesh, Anant; Landa, Marina; Davis-Joseph, Brian

2017-10-08

Arterial aneurysms (AA) can be classified as true aneurysms, characterized by the persistence of all three layers of the arterial wall with progressive dilation and wall thinning; arterial pseudoaneurysms (APAs) are characterized by a tear in the vessel wall and a periarterial hematoma formation. They could occur due to a visceral, retroperitoneal, or peripheral origin. Most AA/APA are usually found incidentally, and it is imperative to be vigilant in order to diagnose and manage them due to their potentially life-threatening complications. We present a case of a 35-year-old woman presenting with right-sided abdominal pain mimicking renal colic with an initial misdiagnosis of ureteral calculus. Post-cystoscopy, a misdiagnosis was confirmed, and subsequently, the patient had a right retroperitoneal mass excision. The histopathology report concluded the calcified retroperitoneal mass to be pseudoaneurysm. Such pitfalls in diagnosis are essential to be shared with the larger medical community for increased vigilance and optimal management of pseudoaneurysms.

43. View of Botany Worsted Mills looking north along Dayton ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

43. View of Botany Worsted Mills looking north along Dayton Avenue; building No. 1 at right, building No. 53 at center, building No. 19 rising behind; chimney (No. 46A) at center distance, buildings No. 52, 51, and 50 at left - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

Assessment of the water supply:demand ratios in a Mediterranean basin under different global change scenarios and mitigation alternatives.

PubMed

Boithias, Laurie; Acuña, Vicenç; Vergoñós, Laura; Ziv, Guy; Marcé, Rafael; Sabater, Sergi

2014-02-01

Spatial differences in the supply and demand of ecosystem services such as water provisioning often imply that the demand for ecosystem services cannot be fulfilled at the local scale, but it can be fulfilled at larger scales (regional, continental). Differences in the supply:demand (S:D) ratio for a given service result in different values, and these differences might be assessed with monetary or non-monetary metrics. Water scarcity occurs where and when water resources are not enough to meet all the demands, and this affects equally the service of water provisioning and the ecosystem needs. In this study we assess the value of water in a Mediterranean basin under different global change (i.e. both climate and anthropogenic changes) and mitigation scenarios, with a non-monetary metric: the S:D ratio. We computed water balances across the Ebro basin (North-East Spain) with the spatially explicit InVEST model. We highlight the spatial and temporal mismatches existing across a single hydrological basin regarding water provisioning and its consumption, considering or not, the environmental demand (environmental flow). The study shows that water scarcity is commonly a local issue (sub-basin to region), but that all demands are met at the largest considered spatial scale (basin). This was not the case in the worst-case scenario (increasing demands and decreasing supply), as the S:D ratio at the basin scale was near 1, indicating that serious problems of water scarcity might occur in the near future even at the basin scale. The analysis of possible mitigation scenarios reveals that the impact of global change may be counteracted by the decrease of irrigated areas. Furthermore, the comparison between a non-monetary (S:D ratio) and a monetary (water price) valuation metrics reveals that the S:D ratio provides similar values and might be therefore used as a spatially explicit metric to valuate the ecosystem service water provisioning. © 2013.

Urban Growth Scenarios of a Future MEGA City: Case Study Ahmedabad

NASA Astrophysics Data System (ADS)

Lehner, A.; Kraus, V.; Steinnocher, K.

2016-06-01

The study of urban areas and their development focuses on cities, their physical and demographic expansion and the tensions and impacts that go along with urban growth. Especially in developing countries and emerging national economies like India, consistent and up to date information or other planning relevant data all too often is not available. With its Smart Cities Mission, the Indian government places great importance on the future developments of Indian urban areas and pays tribute to the large-scale rural to urban migration. The potentials of urban remote sensing and its contribution to urban planning are discussed and related to the Indian Smart Cities Mission. A case study is presented showing urban remote sensing based information products for the city of Ahmedabad. Resulting urban growth scenarios are presented, hotspots identified and future action alternatives proposed.

Treatment of hypogonadotropic male hypogonadism: Case-based scenarios

PubMed Central

Crosnoe-Shipley, Lindsey E; Elkelany, Osama O; Rahnema, Cyrus D; Kim, Edward D

2015-01-01

The aim of this study is to review four case-based scenarios regarding the treatment of symptomatic hypogonadism in men. The article is designed as a review of published literature. We conducted a PubMed literature search for the time period of 1989-2014, concentrating on 26 studies investigating the efficacy of various therapeutic options on semen analysis, pregnancy outcomes, time to recovery of spermatogenesis, as well as serum and intratesticular testosterone levels. Our results demonstrated that exogenous testosterone suppresses intratesticular testosterone production, which is an absolute prerequisite for normal spermatogenesis. Cessation of exogenous testosterone should be recommended for men desiring to maintain their fertility. Therapies that protect the testis involve human chorionic gonadotropin (hCG) therapy or selective estrogen receptor modulators (SERMs), but may also include low dose hCG with exogenous testosterone. Off-label use of SERMs, such as clomiphene citrate, are effective for maintaining testosterone production long-term and offer the convenience of representing a safe, oral therapy. At present, routine use of aromatase inhibitors is not recommended based on a lack of long-term data. We concluded that exogenous testosterone supplementation decreases sperm production. It was determined that clomiphene citrate is a safe and effective therapy for men who desire to maintain fertility. Although less frequently used in the general population, hCG therapy with or without testosterone supplementation represents an alternative treatment. PMID:25949938

Deep Granuloma Annulare Mimicking Inflamed Cysts in a Teenager.

PubMed

Guo, Emily L; Degesys, Catherine A; Jahan-Tigh, Richard; Chan, Audrey

2017-07-01

We describe deep granuloma annulare (DGA) of the forehead mimicking inflamed cysts. Reactive inflammation and sterile purulent drainage may be an underrecognized feature of DGA. © 2017 Wiley Periodicals, Inc.

General RMP Guidance - Chapter 4: Offsite Consequence Analysis

EPA Pesticide Factsheets

This chapter provides basic compliance information, not modeling methodologies, for people who plan to do their own air dispersion modeling. OCA is a required part of the risk management program, and involves worst-case and alternative release scenarios.

HDR syndrome with a novel mutation in GATA3 mimicking a congenital X-linked stapes gusher: a case report.

PubMed

Yang, Aram; Kim, Jinsup; Ki, Chang-Seok; Hong, Sung Hwa; Cho, Sung Yoon; Jin, Dong-Kyu

2017-10-26

Hypoparathyroidism, sensorineural hearing loss, and renal disease (HDR) syndrome, also known as Barakat syndrome, is a rare genetic disorder with high phenotypic heterogeneity caused by haploinsufficiency of the GATA3 gene on chromosome 10p14-p15. For these reasons, the diagnosis of HDR syndrome is challenging and requires a high index of suspicion as well as genetic analysis. A 14-month-old boy, with sensorineural hearing loss in both ears, showed typical radiological features of X-linked stapes gusher on preoperative temporal bone computed tomography (CT) for cochlear implantations. Then after his discharge from hospital, he suffered a hypocalcemic seizure and we discovered a renal cyst during investigation of hypocalcemia. He was finally diagnosed with HDR syndrome by clinical findings, which were confirmed by molecular genetic testing. Direct sequencing of the GATA3 gene showed a heterozygous 2-bp deletion (c.1201_1202delAT), which is predicted to cause a frameshift of the reading frame (p.Met401Valfs*106). To our knowledge, this is the first case of HDR syndrome with a novel de novo variant mimicking a congenital X-linked stapes gusher syndrome. Novel mutations and the diversity of clinical manifestations expand the genotypic and phenotypic spectrum of HDR syndrome. Diagnosis of HDR syndrome is still challenging, but clinicians should consider it in their differential diagnosis for children with a wide range of clinical manifestations including hypocalcemia induced seizures and deafness. We hope that this case will contribute to further understanding and studies of HDR-associated GATA3 mutations.

An Extracranial Metastasis of Glioblastoma Mimicking Mucoepidermoid Carcinoma.

PubMed

Jie, Wei-Ping; Bai, Jia-Ying; Li, Bin-Bin

2018-05-28

Glioblastoma (GBM) is the most common and aggressive primary malignant tumor of the brain and central nervous system. Extracranial metastases of GBM are very rare, with few case reports published to date. The tumor cells of GBM show strong immunopositivity for glial fibrillary acid protein (GFAP). A 47-year-old man without comorbidities presented with a 1-year history of an augmenting right parotid lump. A right total parotidectomy with selective neck dissection was performed. The hematoxylin-eosin stained slice of a parotid lymph node collected intraoperatively revealed destruction of normal lymph node structure by medium-sized pleomorphic cells scattered in groups; their cytoplasm was lightly stained and pale. There were abundant myxoid stroma in the interstitial tissue. This characteristic mimicked mucoepidermoid carcinoma (MEC). Immunohistochemistry test demonstrated that the cells were positive for GFAP. A diagnosis of extracranial metastasis of GBM was made after confirmation with postoperative pathological examination of the intracranial resection specimen. We believe that this is the first reported case of extracranial metastasis of GBM resembling MEC in the microscope features. Pathologists and clinicians should be alert to this rare lesion and consider this differential diagnosis after excluding other common parotid lesions. Copyright © 2018 Elsevier Inc. All rights reserved.

Chloroquine cardiotoxicity mimicking connective tissue disease heart involvement.

PubMed

Vereckei, András; Fazakas, Adám; Baló, Timea; Fekete, Béla; Molnár, Mária Judit; Karádi, István

2013-04-01

The authors report a case of rare chloroquine cardiotoxicity mimicking connective tissue disease heart involvement in a 56-year-old woman with mixed connective tissue disease (MCTD) manifested suddenly as third degree A-V block with QT(c) interval prolongation and short torsade de pointes runs ultimately degenerating into ventricular fibrillation. Immunological tests suggested an MCTD flare, implying that cardiac arrest had resulted from myocardial involvement by MCTD. However, QT(c) prolongation is not a characteristic of cardiomyopathy caused by connective tissue disease, unless anti-Ro/SSA positivity is present, but that was not the case. Therefore, looking for another cause of QT(c) prolongation the possibility of chloroquine cardiotoxicity emerged, which the patient had been receiving for almost two years in supramaximal doses. Biopsy of the deltoid muscle was performed, because in chloroquine toxicity, specific lesions are present both in the skeletal muscle and in the myocardium, and electron microscopy revealed the accumulation of cytoplasmic curvilinear bodies, which are specific to antimalarial-induced myocyte damage and are absent in all other muscle diseases, except neuronal ceroid lipofuscinosis. Thus, the diagnosis of chloroquine cardiotoxicity was established. It might be advisable to supplement the periodic ophthalmological examination, which is currently the only recommendation for patients on long-term chloroquine therapy, with ECG screening.

Analysis of Future Streamflow Regimes under Global Change Scenarios in Central Chile for Ecosystem Sustainability

NASA Astrophysics Data System (ADS)

Henriquez Dole, L. E.; Gironas, J. A.; Vicuna, S.

2015-12-01

Given the critical role of the streamflow regime for ecosystem sustainability, modeling long term effects of climate change and land use change on streamflow is important to predict possible impacts in stream ecosystems. Because flow duration curves are largely used to characterize the streamflow regime and define indices of ecosystem health, they were used to represent and analyze in this study the stream regime in the Maipo River Basin in Central Chile. Water and Environmental Assessment and Planning (WEAP) model and the Plant Growth Model (PGM) were used to simulate water distribution, consumption in rural areas and stream flows on a weekly basis. Historical data (1990-2014), future land use scenarios (2030/2050) and climate change scenarios were included in the process. Historical data show a declining trend in flows mainly by unprecedented climatic conditions, increasing interest among users on future streamflow scenarios. In the future, under an expected decline in water availability coupled with changes in crop water demand, water users will be forced to adapt by changing water allocation rules. Such adaptation actions would in turns affect the streamflow regime. Future scenarios for streamflow regime show dramatic changes in water availability and temporal distribution. Annual weekly mean flows can reduce in 19% in the worst scenario and increase in 3.3% in the best of them, and variability in streamflow increases nearly 90% in all scenarios under evaluation. The occurrence of maximum and minimum monthly flows changes, as June instead of July becomes the driest month, and December instead of January becomes the month with maximum flows. Overall, results show that under future scenarios streamflow is affected and altered by water allocation rules to satisfy water demands, and thus decisions will need to consider the streamflow regime (and habitat) in order to be sustainable.

44. View of Botany Worsted Mills looking southeast along Dayton ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

44. View of Botany Worsted Mills looking southeast along Dayton Avenue; building No. 2 at left, building No. 4 rising at center, building No. 68-69 at end of avenue; site of 95-97 Dayton Avenue and other former Botany buildings at right - Dundee Canal Industrial Historic District, Beginning at George Street in Passaic & extending north along Dundee Canal approximately 1.2 miles to Canal headgates opposite East Clifton Avenue in Clifton, Passaic, Passaic County, NJ

Climate Change Scenarios in the Yucatan Peninsula to the year 2020

NASA Astrophysics Data System (ADS)

Orellana, R.; Espadas, C.; Conde, C.; Gay, C.

2010-03-01

A topic that has not been sufficiently analyzed is that the global warming is already affecting, and that it will have worst consequences in those regions with transitional climates, which have more sensibility to changes. This is the case of the Yucatan Peninsula which is semi-arid in their northern portion, and toward the south is subhumid, with a tendency to be more rainy toward the south. To have an estimation of what could happen in the future, the Intergovernmental Panel of Climatic Change (IPCC) has promoted the use of General Circulation Models (GCM), as well as the construction of possible emission scenarios that integrate different global and regional socioeconomic and demographic conditions, which project then a possible increase of emissions of greenhouse gases. These conditions are recognized as the decisive forces that will determine the variations of temperature and of precipitation. These projections are useful for the analysis of climatic change, and in particular for the assessments of the possible impacts and of the initiatives of adaptation and of mitigation that should be implemented in every country or region. In Mexico, most of those evaluations of climate change have been carried out generally at country level. For that reason, it is necessary to direct the research at regional level. In this work, we evaluated the potential climatic changes on the Yucatan Peninsula, considering the different changes of temperature and precipitation as a consequence for different emission scenarios and for the horizon 2020. To project the environmental responses of the region, we used as a base scenario the available temperature and precipitation information of the period 1961-1990, registered in 85 meteorological stations of the peninsula. With these data, we generated climate change scenarios using the outputs of four General Circulation Models: HADLEY, ECHAM, GFDL and CGCM, and the emission scenarios A1FI, A2, B1 and B2. The outputs of these models were

Australian Public Preferences for the Funding of New Health Technologies: A Comparison of Discrete Choice and Profile Case Best-Worst Scaling Methods.

PubMed

Whitty, Jennifer A; Ratcliffe, Julie; Chen, Gang; Scuffham, Paul A

2014-07-01

Ethical, economic, political, and legitimacy arguments support the consideration of public preferences in health technology decision making. The objective was to assess public preferences for funding new health technologies and to compare a profile case best-worst scaling (BWS) and traditional discrete choice experiment (DCE) method. An online survey consisting of a DCE and BWS task was completed by 930 adults recruited via an Internet panel. Respondents traded between 7 technology attributes. Participation quotas broadly reflected the population of Queensland, Australia, by gender and age. Choice data were analyzed using a generalized multinomial logit model. The findings from both the BWS and DCE were generally consistent in that respondents exhibited stronger preferences for technologies offering prevention or early diagnosis over other benefit types. Respondents also prioritized technologies that benefit younger people, larger numbers of people, those in rural areas, or indigenous Australians; that provide value for money; that have no available alternative; or that upgrade an existing technology. However, the relative preference weights and consequent preference orderings differed between the DCE and BWS models. Further, poor correlation between the DCE and BWS weights was observed. While only a minority of respondents reported difficulty completing either task (22.2% DCE, 31.9% BWS), the majority (72.6%) preferred the DCE over BWS task. This study provides reassurance that many criteria routinely used for technology decision making are considered to be relevant by the public. The findings clearly indicate the perceived importance of prevention and early diagnosis. The dissimilarity observed between DCE and profile case BWS weights is contrary to the findings of previous comparisons and raises uncertainty regarding the comparative merits of these stated preference methods in a priority-setting context. © The Author(s) 2014.

Multi-modality gellan gum-based tissue-mimicking phantom with targeted mechanical, electrical, and thermal properties.

PubMed

Chen, Roland K; Shih, A J

2013-08-21

This study develops a new class of gellan gum-based tissue-mimicking phantom material and a model to predict and control the elastic modulus, thermal conductivity, and electrical conductivity by adjusting the mass fractions of gellan gum, propylene glycol, and sodium chloride, respectively. One of the advantages of gellan gum is its gelling efficiency allowing highly regulable mechanical properties (elastic modulus, toughness, etc). An experiment was performed on 16 gellan gum-based tissue-mimicking phantoms and a regression model was fit to quantitatively predict three material properties (elastic modulus, thermal conductivity, and electrical conductivity) based on the phantom material's composition. Based on these material properties and the regression model developed, tissue-mimicking phantoms of porcine spinal cord and liver were formulated. These gellan gum tissue-mimicking phantoms have the mechanical, thermal, and electrical properties approximately equivalent to those of the spinal cord and the liver.

Tsunami Hazard in La Réunion Island (SW Indian Ocean): Scenario-Based Numerical Modelling on Vulnerable Coastal Sites

NASA Astrophysics Data System (ADS)

Allgeyer, S.; Quentel, É.; Hébert, H.; Gailler, A.; Loevenbruck, A.

2017-08-01

Several major tsunamis have affected the southwest Indian Ocean area since the 2004 Sumatra event, and some of them (2005, 2006, 2007 and 2010) have hit La Réunion Island in the southwest Indian Ocean. However, tsunami hazard is not well defined for La Réunion Island where vulnerable coastlines can be exposed. This study offers a first tsunami hazard assesment for La Réunion Island. We first review the historical tsunami observations made on the coastlines, where high tsunami waves (2-3 m) have been reported on the western coast, especially during the 2004 Indian Ocean tsunami. Numerical models of historical scenarios yield results consistent with available observations on the coastal sites (the harbours of La Pointe des Galets and Saint-Paul). The 1833 Pagai earthquake and tsunami can be considered as the worst-case historical scenario for this area. In a second step, we assess the tsunami exposure by covering the major subduction zones with syntethic events of constant magnitude (8.7, 9.0 and 9.3). The aggregation of magnitude 8.7 scenarios all generate strong currents in the harbours (3-7 m s^{-1}) and about 2 m of tsunami maximum height without significant inundation. The analysis of the magnitude 9.0 events confirms that the main commercial harbour (Port Est) is more vulnerable than Port Ouest and that flooding in Saint-Paul is limited to the beach area and the river mouth. Finally, the magnitude 9.3 scenarios show limited inundations close to the beach and in the riverbed in Saint-Paul. More generally, the results confirm that for La Runion, the Sumatra subduction zone is the most threatening non-local source area for tsunami generation. This study also shows that far-field coastal sites should be prepared for tsunami hazard and that further work is needed to improve operational warning procedures. Forecast methods should be developed to provide tools to enable the authorities to anticipate the local effects of tsunamis and to evacuate the harbours in

Building Data and Information Capacity in Environmental Public Health: A Best-Worst Scaling Experiment.

PubMed

Wallar, Lauren E; Sargeant, Jan M; McEwen, Scott A; Mercer, Nicola J; Papadopoulos, Andrew

Environmental public health practitioners rely on information technology (IT) to maintain and improve environmental health. However, current systems have limited capacity. A better understanding of the importance of IT features is needed to enhance data and information capacity. (1) Rank IT features according to the percentage of respondents who rated them as essential to an information management system and (2) quantify the relative importance of a subset of these features using best-worst scaling. Information technology features were initially identified from a previously published systematic review of software evaluation criteria and a list of software options from a private corporation specializing in inspection software. Duplicates and features unrelated to environmental public health were removed. The condensed list was refined by a working group of environmental public health management to a final list of 57 IT features. The essentialness of features was electronically rated by environmental public health managers. Features where 50% to 80% of respondents rated them as essential (n = 26) were subsequently evaluated using best-worst scaling. Ontario, Canada. Environmental public health professionals in local public health. Importance scores of IT features. The majority of IT features (47/57) were considered essential to an information management system by at least half of the respondents (n = 52). The highest-rated features were delivery to printer, software encryption capability, and software maintenance services. Of the 26 features evaluated in the best-worst scaling exercise, the most important features were orientation to all practice areas, off-line capability, and ability to view past inspection reports and results. The development of a single, unified environmental public health information management system that fulfills the reporting and functionality needs of system users is recommended. This system should be implemented by all public health units

Compression in the Superintendent Ranks

ERIC Educational Resources Information Center

Saron, Bradford G.; Birchbauer, Louis J.

2011-01-01

Sadly, the fiscal condition of school systems now not only is troublesome, but in some cases has surpassed all expectations for the worst-case scenario. Among the states, one common response is to drop funding for public education to inadequate levels, leading to permanent program cuts, school closures, staff layoffs, district dissolutions and…

Global climate change: The quantifiable sustainability challenge

EPA Science Inventory

Population growth and the pressures spawned by increasing demands for energy and resource-intensive goods, foods and services are driving unsustainable growth in greenhouse gas (GHG) emissions. Recent GHG emission trends are consistent with worst-case scenarios of the previous de...

A series of parapharyngeal glial heterotopia mimicking lymphatic malformation.

PubMed

Haloob, Nora; Pepper, Christopher; Hartley, Benjamin

2015-12-01

Otolaryngologists will most frequently encounter extra-cranial glial tissue within the nasal cavity, where it is known as a 'nasal glioma', and may communicate with the dura. However, glial tissue can also present extra-nasally in the form of a neck mass with no intracranial connection. In these rare cases, they can present soon after birth as an enlarging neck mass, causing compressive symptoms with airway obstruction and feeding difficulties. In this way, it is often initially misdiagnosed as a more common lesion such as a lymphatic malformation, teratoma, branchial anomaly or vascular malformation. As with many congenital head and neck masses, offering the most the appropriate management relies heavily on radiological imaging and, where possible, histopathology from a diagnostic biopsy. Once the diagnosis of extra-nasal glial heterotopia has been confirmed, the gold standard management is complete surgical excision. We review three cases of extra-nasal glial heterotopia presenting to our institution over an eleven year period as a large neck mass, which mimicked other congenital neck lumps, and discuss them in the context of those in the literature. We highlight how their clinical and radiological features can easily be confused with lymphatic malformations, and the potential implications of misdiagnosis. Raising awareness of this diagnostic confusion will highlight the need for management of these cases within an appropriate paediatric multidisciplinary setting. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Tail mean and related robust solution concepts

NASA Astrophysics Data System (ADS)

Ogryczak, Włodzimierz

2014-01-01

Robust optimisation might be viewed as a multicriteria optimisation problem where objectives correspond to the scenarios although their probabilities are unknown or imprecise. The simplest robust solution concept represents a conservative approach focused on the worst-case scenario results optimisation. A softer concept allows one to optimise the tail mean thus combining performances under multiple worst scenarios. We show that while considering robust models allowing the probabilities to vary only within given intervals, the tail mean represents the robust solution for only upper bounded probabilities. For any arbitrary intervals of probabilities the corresponding robust solution may be expressed by the optimisation of appropriately combined mean and tail mean criteria thus remaining easily implementable with auxiliary linear inequalities. Moreover, we use the tail mean concept to develope linear programming implementable robust solution concepts related to risk averse optimisation criteria.

Lung Metastases from Bile Duct Adenocarcinoma Mimicking Chronic Airway Infection and Causing Diagnostic Difficulty.

PubMed

Sato, Mitsuo; Okachi, Shotaro; Fukihara, Jun; Shimoyama, Yoshie; Wakahara, Keiko; Sakakibara, Toshihiro; Hase, Tetsunari; Onishi, Yasuharu; Ogura, Yasuhiro; Maeda, Osamu; Hasegawa, Yoshinori

2018-05-15

We herein report a case of lung metastases with unusual radiological appearances that mimicked those of chronic airway infection, causing diagnostic difficulty. A 60-year-old woman who underwent liver transplantation from a living donor was incidentally diagnosed with bile duct adenocarcinoma after a histopathological analysis of her explanted liver. Six months later, chest computed tomography (CT) revealed bilateral bronchogenic dissemination that had gradually worsened, suggesting chronic airway infection. A biopsy with bronchoscopy from a mass lesion beyond a segmental bronchus revealed adenocarcinoma identical to that of her bile duct adenocarcinoma, leading to the diagnosis of multiple lung metastases from bile duct adenocarcinoma.

The use of scenarios for long-range planning by investor-owned electric utilities in the Pacific Northwest

NASA Astrophysics Data System (ADS)

Lyons, John V.

Scenario planning is a method of organizing and understanding large amounts of quantitative and qualitative data for leaders to make better strategic decisions. There is a lack of academic research about scenario planning with a subsequent shortage of definitions and theories. This study utilized a case study methodology to analyze scenario planning by investor-owned electric utilities in the Pacific Northwest in their integrated resource planning (IRP) process. The cases include Avista Corporation, Idaho Power, PacifiCorp, Portland General Electric, and Puget Sound Energy. This study sought to determine how scenario planning was used, what scenario approach was used, the scenario outcomes, and the similarities and differences in the scenario planning processes. The literature review of this study covered the development of scenario planning, common definitions and theories, approaches to scenario development, and scenario outcomes. A research methodology was developed to classify the scenario development approach into intuitive, hybrid, or quantitative approaches; and scenario outcomes of changed thinking, stories of plausible futures, improved decision making, and enhanced organizational learning. The study found all three forms of scenario planning in the IRPs. All of the cases used a similar approach to IRP development. All of the cases had at least improved decision making as an outcome of scenario planning. Only one case demonstrated all four scenario outcomes. A critical finding was a correlation between the use of the intuitive approach and the use of all scenario outcomes. Another major finding was the unique use of predetermined elements, which are normally consistent across scenarios, but became critical uncertainties in some of the scenarios in the cases for this study. This finding will need to be confirmed by future research as unique to the industry or an aberration. An unusually high number of scenarios were found for cases using the hybrid approach

Modelling regional climate change and urban planning scenarios and their impacts on the urban environment in two cities with WRF-ACASA

NASA Astrophysics Data System (ADS)

Falk, M.; Pyles, R. D.; Marras, S.; Spano, D.; Paw U, K. T.

2011-12-01

The number of urban metabolism studies has increased in recent years, due to the important impact that energy, water and carbon exchange over urban areas have on climate change. Urban modeling is therefore crucial in the future design and management of cities. This study presents the ACASA model coupled to the Weather Research and Forecasting (WRF-ARW) mesoscale model to simulate urban fluxes at a horizontal resolution of 200 meters for urban areas of roughly 100 km^2. As part of the European Project "BRIDGE", these regional simulations were used in combination with remotely sensed data to provide constraints on the land surface types and the exchange of carbon and energy fluxes from urban centers. Surface-atmosphere exchanges of mass and energy were simulated using the Advanced Canopy Atmosphere Soil Algorithm (ACASA). ACASA is a multi-layer high-order closure model, recently modified to work over natural, agricultural as well as urban environments. In particular, improvements were made to account for the anthropogenic contribution to heat and carbon production. For two cities four climate change and four urban planning scenarios were simulated: The climate change scenarios include a base scenario (Sc0: 2008 Commit in IPCC), a medium emission scenario (Sc1: IPCC A2), a worst case emission scenario (Sce2: IPCC A1F1) and finally a best case emission scenario (Sce3: IPCC B1). The urban planning scenarios include different development scenarios such as smart growth. The two cities are a high latitude city, Helsinki (Finland) and an historic city, Florence (Italy). Helsinki is characterized by recent, rapid urbanization that requires a substantial amount of energy for heating, while Florence is representative of cities in lower latitudes, with substantial cultural heritage and a comparatively constant architectural footprint over time. In general, simulated fluxes matched the point observations well and showed consistent improvement in the energy partitioning over

Cerebello-cortical network fingerprints differ between essential, Parkinson's and mimicked tremors.

PubMed

Muthuraman, Muthuraman; Raethjen, Jan; Koirala, Nabin; Anwar, Abdul Rauf; Mideksa, Kidist G; Elble, Rodger; Groppa, Sergiu; Deuschl, Günter

2018-06-01

Cerebello-thalamo-cortical loops play a major role in the emergence of pathological tremors and voluntary rhythmic movements. It is unclear whether these loops differ anatomically or functionally in different types of tremor. We compared age- and sex-matched groups of patients with Parkinson's disease or essential tremor and healthy controls (n = 34 per group). High-density 256-channel EEG and multi-channel EMG from extensor and flexor muscles of both wrists were recorded simultaneously while extending the hands against gravity with the forearms supported. Tremor was thereby recorded from patients, and voluntarily mimicked tremor was recorded from healthy controls. Tomographic maps of EEG-EMG coherence were constructed using a beamformer algorithm coherent source analysis. The direction and strength of information flow between different coherent sources were estimated using time-resolved partial-directed coherence analyses. Tremor severity and motor performance measures were correlated with connection strengths between coherent sources. The topography of oscillatory coherent sources in the cerebellum differed significantly among the three groups, but the cortical sources in the primary sensorimotor region and premotor cortex were not significantly different. The cerebellar and cortical source combinations matched well with known cerebello-thalamo-cortical connections derived from functional MRI resting state analyses according to the Buckner-atlas. The cerebellar sources for Parkinson's tremor and essential tremor mapped primarily to primary sensorimotor cortex, but the cerebellar source for mimicked tremor mapped primarily to premotor cortex. Time-resolved partial-directed coherence analyses revealed activity flow mainly from cerebellum to sensorimotor cortex in Parkinson's tremor and essential tremor and mainly from cerebral cortex to cerebellum in mimicked tremor. EMG oscillation flowed mainly to the cerebellum in mimicked tremor, but oscillation flowed mainly

Most Probable Fire Scenarios in Spacecraft and Extraterrestrial Habitats: Why NASA's Current Test 1 Might Not Always be Conservative

NASA Technical Reports Server (NTRS)

Olson, S. L.

2004-01-01

NASA's current method of material screening determines fire resistance under conditions representing a worst-case for normal gravity flammability - the Upward Flame Propagation Test (Test 1). Its simple pass-fail criteria eliminates materials that burn for more than 12 inches from a standardized ignition source. In addition, if a material drips burning pieces that ignite a flammable fabric below, it fails. The applicability of Test 1 to fires in microgravity and extraterrestrial environments, however, is uncertain because the relationship between this buoyancy-dominated test and actual extraterrestrial fire hazards is not understood. There is compelling evidence that the Test 1 may not be the worst case for spacecraft fires, and we don t have enough information to assess if it is adequate at Lunar or Martian gravity levels.

Most Probable Fire Scenarios in Spacecraft and Extraterrestrial Habitats: Why NASA's Current Test 1 Might Not Always Be Conservative

NASA Technical Reports Server (NTRS)

Olson, S. L.

2004-01-01

NASA s current method of material screening determines fire resistance under conditions representing a worst-case for normal gravity flammability - the Upward Flame Propagation Test (Test 1[1]). Its simple pass-fail criteria eliminates materials that burn for more than 12 inches from a standardized ignition source. In addition, if a material drips burning pieces that ignite a flammable fabric below, it fails. The applicability of Test 1 to fires in microgravity and extraterrestrial environments, however, is uncertain because the relationship between this buoyancy-dominated test and actual extraterrestrial fire hazards is not understood. There is compelling evidence that the Test 1 may not be the worst case for spacecraft fires, and we don t have enough information to assess if it is adequate at Lunar or Martian gravity levels.

Severe anaemia associated with Plasmodium falciparum infection in children: consequences for additional blood sampling for research.

PubMed

Kuijpers, Laura Maria Francisca; Maltha, Jessica; Guiraud, Issa; Kaboré, Bérenger; Lompo, Palpouguini; Devlieger, Hugo; Van Geet, Chris; Tinto, Halidou; Jacobs, Jan

2016-06-02

Plasmodium falciparum infection may cause severe anaemia, particularly in children. When planning a diagnostic study on children suspected of severe malaria in sub-Saharan Africa, it was questioned how much blood could be safely sampled; intended blood volumes (blood cultures and EDTA blood) were 6 mL (children aged <6 years) and 10 mL (6-12 years). A previous review [Bull World Health Organ. 89: 46-53. 2011] recommended not to exceed 3.8 % of total blood volume (TBV). In a simulation exercise using data of children previously enrolled in a study about severe malaria and bacteraemia in Burkina Faso, the impact of this 3.8 % safety guideline was evaluated. For a total of 666 children aged >2 months to <12 years, data of age, weight and haemoglobin value (Hb) were available. For each child, the estimated TBV (TBVe) (mL) was calculated by multiplying the body weight (kg) by the factor 80 (ml/kg). Next, TBVe was corrected for the degree of anaemia to obtain the functional TBV (TBVf). The correction factor consisted of the rate 'Hb of the child divided by the reference Hb'; both the lowest ('best case') and highest ('worst case') reference Hb values were used. Next, the exact volume that a 3.8 % proportion of this TBVf would present was calculated and this volume was compared to the blood volumes that were intended to be sampled. When applied to the Burkina Faso cohort, the simulation exercise pointed out that in 5.3 % (best case) and 11.4 % (worst case) of children the blood volume intended to be sampled would exceed the volume as defined by the 3.8 % safety guideline. Highest proportions would be in the age groups 2-6 months (19.0 %; worst scenario) and 6 months-2 years (15.7 %; worst case scenario). A positive rapid diagnostic test for P. falciparum was associated with an increased risk of violating the safety guideline in the worst case scenario (p = 0.016). Blood sampling in children for research in P. falciparum endemic settings may easily violate

Pathology informatics fellowship retreats: The use of interactive scenarios and case studies as pathology informatics teaching tools.

PubMed

Lee, Roy E; McClintock, David S; Balis, Ulysses J; Baron, Jason M; Becich, Michael J; Beckwith, Bruce A; Brodsky, Victor B; Carter, Alexis B; Dighe, Anand S; Haghighi, Mehrvash; Hipp, Jason D; Henricks, Walter H; Kim, Jiyeon Y; Klepseis, Veronica E; Kuo, Frank C; Lane, William J; Levy, Bruce P; Onozato, Maristela L; Park, Seung L; Sinard, John H; Tuthill, Mark J; Gilbertson, John R

2012-01-01

Last year, our pathology informatics fellowship added informatics-based interactive case studies to its existing educational platform of operational and research rotations, clinical conferences, a common core curriculum with an accompanying didactic course, and national meetings. The structure of the informatics case studies was based on the traditional business school case study format. Three different formats were used, varying in length from short, 15-minute scenarios to more formal multiple hour-long case studies. Case studies were presented over the course of three retreats (Fall 2011, Winter 2012, and Spring 2012) and involved both local and visiting faculty and fellows. Both faculty and fellows found the case studies and the retreats educational, valuable, and enjoyable. From this positive feedback, we plan to incorporate the retreats in future academic years as an educational component of our fellowship program. Interactive case studies appear to be valuable in teaching several aspects of pathology informatics that are difficult to teach in more traditional venues (rotations and didactic class sessions). Case studies have become an important component of our fellowship's educational platform.

Closed Environment Module - Modularization and extension of the Virtual Habitat

NASA Astrophysics Data System (ADS)

Plötner, Peter; Czupalla, Markus; Zhukov, Anton

2013-12-01

The Virtual Habitat (V-HAB), is a Life Support System (LSS) simulation, created to perform dynamic simulation of LSS's for future human spaceflight missions. It allows the testing of LSS robustness by means of computer simulations, e.g. of worst case scenarios.

Imaging findings of mimickers of hepatocellular carcinoma

PubMed Central

Lee, Eunchae; Jang, Hyun-Jung

2015-01-01

Radiological imaging plays a crucial role in the diagnosis of hepatocellular carcinoma (HCC) as the noninvasive diagnosis of HCC in high-risk patients by typical imaging findings alone is widely adopted in major practice guidelines for HCC. While imaging techniques have markedly improved in detecting small liver lesions, they often detect incidental benign liver lesions and non-hepatocellular malignancy that can be misdiagnosed as HCC. The most common mimicker of HCC in cirrhotic liver is nontumorous arterioportal shunts that are seen as focal hypervascular liver lesions on dynamic contrast-enhanced cross-sectional imaging. Rapidly enhancing hemangiomas can be easily misdiagnosed as HCC especially on MR imaging with liver-specific contrast agent. Focal inflammatory liver lesions mimic HCC by demonstrating arterial-phase hypervascularity and subsequent washout on dynamic contrast-enhanced imaging. It is important to recognize the suggestive imaging findings for intrahepatic cholangiocarcinoma (CC) as the management of CC is largely different from that of HCC. There are other benign mimickers of HCC such as angiomyolipomas and focal nodular hyperplasia-like nodules. Recognition of their typical imaging findings can reduce false-positive HCC diagnosis. PMID:26770920

Best-worst scaling to assess the most important barriers and facilitators for the use of health technology assessment in Austria.

PubMed

Feig, Chiara; Cheung, Kei Long; Hiligsmann, Mickaël; Evers, Silvia M A A; Simon, Judit; Mayer, Susanne

2018-04-01

Although Health Technology Assessment (HTA) is increasingly used to support evidence-based decision-making in health care, several barriers and facilitators for the use of HTA have been identified. This best-worst scaling (BWS) study aims to assess the relative importance of selected barriers and facilitators of the uptake of HTA studies in Austria. A BWS object case survey was conducted among 37 experts in Austria to assess the relative importance of HTA barriers and facilitators. Hierarchical Bayes estimation was applied, with the best-worst count analysis as sensitivity analysis. Subgroup analyses were also performed on professional role and HTA experience. The most important barriers were 'lack of transparency in the decision-making process', 'fragmentation', 'absence of appropriate incentives', 'no explicit framework for decision-making process', and 'insufficient legal support'. The most important facilitators were 'transparency in the decision-making process', 'availability of relevant HTA research for policy makers', 'availability of explicit framework for decision-making process', 'sufficient legal support', and 'appropriate incentives'. This study suggests that HTA barriers and facilitators related to the context of decision makers, especially 'policy characteristics' and 'organization and resources' are the most important in Austria. A transparent and participatory decision-making process could improve the adoption of HTA evidence.

Acute Exposure to Worst-Case Concentrations of Amitraz Does Not Affect Honey Bee Learning, Short-Term Memory, or Hemolymph Octopamine Levels.

PubMed

Rix, Rachel R; Christopher Cutler, G

2017-02-01

Amitraz, an acaricide used to treat Varroa destructor Anderson & Trueman, is one of the most commonly detected pesticides in honey bee (Apis mellifera L.) hives. Acaricides sometimes negatively impact honey bee cognition, but potential effects of amitraz on honey bee learning have been rarely studied. We topically exposed foragers to 95th percentile field-relevant levels of amitraz and, 24 h later, tested the ability of bees to associate a sucrose reward with a conditioned odor (learning response) using the proboscis extension response (PER). We then tested the ability of the bees to retain this memory 1 h and 2 h post-conditioning. Because amitraz is thought to affect octopamine metabolism in honey bees, and because octopamine is directly related to honey bee learning and memory, we also examined effects of exposure to amitraz on octopamine levels in honey bee hemolymph. We found that acute exposure to 95th percentile doses of amitraz had no impact on honey bee learning or short-term memory as measured by PER. Concentrations of octopamine in hemolymph from our low amitraz treatment were 1.4-fold higher than control levels, but other treatments had no effect. Our results from worst-case acute exposure experiments with worker bees in the laboratory suggest that typical field-relevant (within hive) exposures to amitraz probably have little effect on honey bee learning and memory. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Orbital compressed air and petroleum injury mimicking necrotizing fasciitis.

PubMed

Mellington, Faye E; Bacon, Annette S; Abu-Bakra, Mohammed A J; Martinez-Devesa, Pablo; Norris, Jonathan H

2014-09-01

Orbital injury secondary to petroleum-based products is rare. We report the first case, to our knowledge, of a combined compressed air and chemical orbital injury, which mimicked necrotizing fasciitis. A 58-year-old man was repairing his motorcycle engine when a piston inadvertently fired, discharging compressed air and petroleum-based carburetor cleaner into his left eye. He developed surgical emphysema, skin necrosis, and a chemical cellulitis, causing an orbital compartment syndrome. He was treated initially with antibiotics and subsequently with intravenous steroid and orbital decompression surgery. There was almost complete recovery by 4 weeks postsurgery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Petroleum-based products can cause severe skin irritation and necrosis. Compressed air injury can cause surgical emphysema. When these two mechanisms of injury are combined, the resulting orbitopathy and skin necrosis can mimic necrotizing fasciitis and cause diagnostic confusion. A favorable outcome is achievable with aggressive timely management. Copyright © 2014 Elsevier Inc. All rights reserved.

Peroxidase-Mimicking Nanozyme with Enhanced Activity and High Stability Based on Metal-Support Interactions.

PubMed

Li, Zhihao; Yang, Xiangdong; Yang, Yanbing; Tan, Yaning; He, Yue; Liu, Meng; Liu, Xinwen; Yuan, Quan

2018-01-09

Peroxidase-mimicking nanozymes offer unique advantages in terms of high stability and low cost over natural peroxidase for applications in bioanalysis, biomedicine, and the treatment of pollution. However, the design of high-efficiency peroxidase-mimicking nanozymes remains a great challenge. In this study, we adopted a structural-design approach through hybridization of cube-CeO 2 and Pt nanoparticles to create a new peroxidase-mimicking nanozyme with high efficiency and excellent stability. Relative to pure cube-CeO 2 and Pt nanoparticles, the as-hybridized Pt/cube-CeO 2 nanocomposites display much improved activities because of the strong metal-support interaction. Meanwhile, the nanocomposites also maintain high catalytic activity after long-term storage and multiple recycling. Based on their excellent properties, Pt/cube-CeO 2 nanocomposites were used to construct high-performance colorimetric biosensors for the sensitive detection of metabolites, including H 2 O 2 and glucose. Our findings highlight opportunities for the development of high-efficiency peroxidase-mimicking nanozymes with potential applications such as diagnostics, biomedicine, and the treatment of pollution. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Gadolinium-Based Contrast Agent Extravasation Mimicking Subarachnoid Hemorrhage After Electroconvulsive Therapy.

PubMed

Taydas, Onur; Ogul, Hayri; Ozcan, Halil; Kantarci, Mecit

2018-06-01

Electroconvulsive therapy (ECT) is a safe method that has been applied for many years in medical treatment-resistant depression treatment. In this case report, contrast extravasation due to deterioration of the blood-brain barrier after ECT mimicking subarachnoid hemorrhage (SAH) on magnetic resonance imaging (MRI) is discussed. A 70-year-old male patient who underwent ECT presented with sulcal hyperintensities suggesting subarachnoid hemorrhage on fluid-attenuated inversion recovery sequence of MRI obtained after ECT. However, there was no evidence to suggest SAH on nonenhanced brain computed tomography. It should be kept in mind that patients may have contrast extravasation due to deterioration of the blood-brain barrier after ECT, and other alternative methods should be used for the diagnosis of SAH in these patients, not MRI. Copyright © 2018 Elsevier Inc. All rights reserved.

Pelvic Hydatidosis Mimicking a Malignant Multicystic Ovarian Tumor

PubMed Central

Mushtaq, Deeba; Verma, Neetu; Mahajan, N. C.

2010-01-01

Echinococcosis is a multisystem disease and has propensity to involve any organ, an unusual anatomical site, and can mimic any disease process. Primary peritoneal echinococcosis is known to occur secondary to hepatic involvement but occasional cases of primary peritoneal hydatid disease including pelvic involvement have also been reported. We report here 1 such case of primary pelvic hydatidosis mimicking a malignant multicystic ovarian tumor where there was no evidence of involvement of the liver or spleen. Our patient, a 27-year-old female, was detected to have a large right cystic adnexal mass on per vaginal examination which was confirmed by ultrasonography. Her biochemical parameters were normal and CA-125 levels, though mildly raised, were below the cut off point. She underwent surgery and on exploratory laparotomy, another cystic mass was found attached to the mesentery of the small gut. The resected cysts were processed histopathologically. On cut sections both large cysts revealed numerous daughter cysts. Microscopic examination of fluid from the cysts revealed free scolices with hooklets and the cyst wall had a typical laminated membrane with inner germinal layer containing degenerated protoplasmic mass. The diagnosis of pelvic hydatid disease was confirmed and patient was managed accordingly. Hydatid disease must be considered while making the differential diagnosis of pelvic cystic masses, especially in endemic areas. PMID:20877508

Moderately nonlinear ultrasound propagation in blood-mimicking fluid.

PubMed

Kharin, Nikolay A; Vince, D Geoffrey

2004-04-01

In medical diagnostic ultrasound (US), higher than-in-water nonlinearity of body fluids and tissue usually does not produce strong nonlinearly distorted waves because of the high absorption. The relative influence of absorption and nonlinearity can be characterized by the Gol'dberg number Gamma. There are two limiting cases in nonlinear acoustics: weak waves (Gamma < 1) or strong waves (Gamma > 1). However, at diagnostic frequencies in tissue and body fluids, the nonlinear effects and effects of absorption more likely are comparable (Gol'dberg number Gamma approximately 1). The aim of this work was to study the nonlinear propagation of a moderately nonlinear US second harmonic signal in a blood-mimicking fluid. Quasilinear solutions to the KZK equation are presented, assuming radiation from a flat and geometrically focused circular Gaussian source. The solutions are expressed in a new simplified closed form and are in very good agreement with those of previous studies measuring and modeling Gaussian beams. The solutions also show good agreement with the measurements of the beams produced by commercially available transducers, even without special Gaussian shading.

Esophageal adenosquamous carcinoma mimicking acantholytic squamous cell carcinoma

PubMed Central

Matsukuma, Susumu; Takahashi, Oh; Utsumi, Yoshitaka; Tsuda, Masaki; Miyai, Kosuke; Okada, Kenji; Takeo, Hiroaki

2017-01-01

Herein is described a unique case of esophageal cancer mimicking acantholytic squamous cell carcinoma (SCC). The patient succumbed to the disease within one month of diagnosis. Autopsy revealed a 10-cm esophageal tumor, characterized by prominent acantholysis-like areas composed of discohesive cancer cells, along with nested growth of SCC. These discohesive cancer cells focally exhibited pagetoid extension into adjacent esophageal epithelium, comprised ~60% of the esophageal tumor volume and had widely metastasized to the lungs, chest wall, liver, spleen, right adrenal gland, bones and lymph nodes. No metastases of SCC were observed. SCC cells were immunohistochemically positive for keratin 5/6 and E-cadherin and were negative for mucin and carcinoembryonic antigen (CEA). However, the discohesive cancer cells exhibited negativity for keratin 5/6, positivity for mucin and CEA, and diminished or no immunostaining for E-cadherin. Thus, these discohesive cells represented true adenocarcinomatous differentiation rather than acantholytic SCC cells. It was concluded that this tumor was an esophageal adenosquamous carcinoma with ‘pseudo’-acantholytic adenocarcinoma components, which should be considered as a rare but distinctive type of aggressive cancer. PMID:29085501

Retroperitoneal Pseudoaneurysm Mimicking Ureteral Calculus: Pitfalls in Diagnosis

PubMed Central

Kalabin, Aleksandr; Dinesh, Anant; Landa, Marina; Davis-Joseph, Brian

2017-01-01

Arterial aneurysms (AA) can be classified as true aneurysms, characterized by the persistence of all three layers of the arterial wall with progressive dilation and wall thinning; arterial pseudoaneurysms (APAs) are characterized by a tear in the vessel wall and a periarterial hematoma formation. They could occur due to a visceral, retroperitoneal, or peripheral origin. Most AA/APA are usually found incidentally, and it is imperative to be vigilant in order to diagnose and manage them due to their potentially life-threatening complications. We present a case of a 35-year-old woman presenting with right-sided abdominal pain mimicking renal colic with an initial misdiagnosis of ureteral calculus. Post-cystoscopy, a misdiagnosis was confirmed, and subsequently, the patient had a right retroperitoneal mass excision. The histopathology report concluded the calcified retroperitoneal mass to be pseudoaneurysm. Such pitfalls in diagnosis are essential to be shared with the larger medical community for increased vigilance and optimal management of pseudoaneurysms. PMID:29226048

A stochastic approach for quantifying immigrant integration: the Spanish test case

NASA Astrophysics Data System (ADS)

Agliari, Elena; Barra, Adriano; Contucci, Pierluigi; Sandell, Richard; Vernia, Cecilia

2014-10-01

We apply stochastic process theory to the analysis of immigrant integration. Using a unique and detailed data set from Spain, we study the relationship between local immigrant density and two social and two economic immigration quantifiers for the period 1999-2010. As opposed to the classic time-series approach, by letting immigrant density play the role of ‘time’ and the quantifier the role of ‘space,’ it becomes possible to analyse the behavior of the quantifiers by means of continuous time random walks. Two classes of results are then obtained. First, we show that social integration quantifiers evolve following diffusion law, while the evolution of economic quantifiers exhibits ballistic dynamics. Second, we make predictions of best- and worst-case scenarios taking into account large local fluctuations. Our stochastic process approach to integration lends itself to interesting forecasting scenarios which, in the hands of policy makers, have the potential to improve political responses to integration problems. For instance, estimating the standard first-passage time and maximum-span walk reveals local differences in integration performance for different immigration scenarios. Thus, by recognizing the importance of local fluctuations around national means, this research constitutes an important tool to assess the impact of immigration phenomena on municipal budgets and to set up solid multi-ethnic plans at the municipal level as immigration pressures build.

AeroMACS Interference Simulations for Global Airports

NASA Technical Reports Server (NTRS)

Wilson, Jeffrey D.; Apaza, Rafael D.

2012-01-01

Ran 18 scenarios with Visualyse Professional interference software (presented 2 most realistic scenarios). Scenario A: 85 large airports can transmit 1650 mW on each of 11 channels. 173 medium airports can transmit 825 mW on each of 6 channels. 5951 small airports can transmit 275 mW on one channel. Reducing power allowed for small airports in Scenario B increases allowable power for large and medium airports, but should not be necessary as Scenario A levels are more than adequate. These power limitations are conservative because we are assuming worst case with 100% duty.

Progressive external ophthalmoplegia (PEO) due to a mutation in the C10orf2 (PEO1) gene mimicking a myasthenic crisis.

PubMed

Gonzalez-Moron, Dolores; Bueri, Jose; Kauffman, Marcelo Andres

2013-09-07

We described a case of a patient with autosomal dominant progressive external ophthalmoplegia (PEO) who presented with the acute onset dysphagia, quadriparesis, ptosis and respiratory insufficiency following a cardiac procedure and mimicking a myasthenic crisis. A pathogenic mutation in the C10orf2 (PEO1) gene was confirmed. The unusual presentation of our patient contributes to expand the clinical phenotype of PEO1 mutations and reinforces the need to consider mitochondrial myopathy as differential diagnosis of myasthenia gravis even in the case of acute onset symptoms.

Modeling and Composing Scenario-Based Requirements with Aspects

NASA Technical Reports Server (NTRS)

Araujo, Joao; Whittle, Jon; Ki, Dae-Kyoo

2004-01-01

There has been significant recent interest, within the Aspect-Oriented Software Development (AOSD) community, in representing crosscutting concerns at various stages of the software lifecycle. However, most of these efforts have concentrated on the design and implementation phases. We focus in this paper on representing aspects during use case modeling. In particular, we focus on scenario-based requirements and show how to compose aspectual and non-aspectual scenarios so that they can be simulated as a whole. Non-aspectual scenarios are modeled as UML sequence diagram. Aspectual scenarios are modeled as Interaction Pattern Specifications (IPS). In order to simulate them, the scenarios are transformed into a set of executable state machines using an existing state machine synthesis algorithm. Previous work composed aspectual and non-aspectual scenarios at the sequence diagram level. In this paper, the composition is done at the state machine level.

A modified blade element theory for estimation of forces generated by a beetle-mimicking flapping wing system.

PubMed

Truong, Q T; Nguyen, Q V; Truong, V T; Park, H C; Byun, D Y; Goo, N S

2011-09-01

We present an unsteady blade element theory (BET) model to estimate the aerodynamic forces produced by a freely flying beetle and a beetle-mimicking flapping wing system. Added mass and rotational forces are included to accommodate the unsteady force. In addition to the aerodynamic forces needed to accurately estimate the time history of the forces, the inertial forces of the wings are also calculated. All of the force components are considered based on the full three-dimensional (3D) motion of the wing. The result obtained by the present BET model is validated with the data which were presented in a reference paper. The difference between the averages of the estimated forces (lift and drag) and the measured forces in the reference is about 5.7%. The BET model is also used to estimate the force produced by a freely flying beetle and a beetle-mimicking flapping wing system. The wing kinematics used in the BET calculation of a real beetle and the flapping wing system are captured using high-speed cameras. The results show that the average estimated vertical force of the beetle is reasonably close to the weight of the beetle, and the average estimated thrust of the beetle-mimicking flapping wing system is in good agreement with the measured value. Our results show that the unsteady lift and drag coefficients measured by Dickinson et al are still useful for relatively higher Reynolds number cases, and the proposed BET can be a good way to estimate the force produced by a flapping wing system.

An Alaskan Theater Airlift Model.

DTIC Science & Technology

1982-02-19

overt attack on American soil . In any case, such a reaotion represents the worst-case scenario In that theater forces would be denied the advantages of...NNSETNTAFE,SS(l06), USL (100), 7 TNET,THOV,1X(100) REAL A,CHKTIN INTEGER ORIC,DEST,ISCTMP,WXFLG,ALLW,T(RT,ZPTR,ZONE, * FTNFLG.WX,ZONLST(150) DATA ZNSI

Thyroid Ultrasound Pitfalls: Esophageal Fibrovascular Polyp Mimicking Thyroid Nodule

PubMed Central

Brigante, G.; Madeo, B.

2016-01-01

Background. Ultrasound (US) is the most accurate tool in the diagnosis of thyroid nodules if performed by expert physician. Misdiagnosis due to extrathyroidal lesions mimicking thyroid nodules is reported in literature. We describe the first case of an esophageal fibrovascular polyp misdiagnosed as a thyroid nodule on US examination. Patient Findings. A 54-year-old woman presented to emergency department for headache and underwent carotid Doppler extended to neck ultrasound with incidental finding of a nodule in the posterior side of the left thyroid lobe. A following thyroid US performed by an endocrinologist allowed the characterization of the lesion as an esophageal pathology, considering the extrathyroidal position, the typical peripheral hyperechoic spots and hypoechoic rim, the connection to the esophagus, and the swallowing connected movement. The patient was addressed to further investigations and finally to anterior pharyngotomy with histological diagnosis of esophageal fibrovascular polyp. Summary. Differential diagnosis between thyroid nodules and other neck lesions is important to prevent an unnecessary fine needle aspiration biopsy and to treat the extrathyroidal pathology. In this case, an US performed by an expert endocrinologist allowed detecting an esophageal fibrovascular polyp requiring surgical removal. In conclusion, the possibility of an esophageal pathology, and even fibrovascular polyp, should be considered during US thyroid examination. PMID:27022492

Bronchoalveolar carcinoma (adenocarcinoma) mimicking recurrent bacterial community-acquired pneumonia (CAP).

PubMed

Cunha, Burke A; Syed, Uzma; Mikail, Nardeen

2012-01-01

Depending on the community-acquired pneumonia (CAP) pathogen, host factors, and immune status, CAPs resolve on chest x-rays at different rates. CAPs that resolve more slowly than expected, or not at all, are termed "slowly or non-resolving CAPs." In contrast, recurrent CAPs may be due to host defense defects (eg, multiple myelomas) or post-obstructive bronchogenic carcinomas. There are a variety of noninfectious disorders that may mimic CAPs on chest x-ray: alveolar hemorrhage, pulmonary drug reactions, radiation pneumonitis, Wegener's granulomatosis, bronchiolitis obliterans organizing pneumonia, bronchogenic carcinomas, and lymphomas. Noninfectious mimics of recurrent CAPs include congestive heart failure, pulmonary emboli, infarctions, sarcoidosis, and systemic lupus erythematosus pneumonitis. We present the case of a middle-aged man who presented with recurrent right middle lobe and right lower lobe CAPs. Diagnostic bronchoscopy showed no bronchial obstruction, but open lung biopsy showed bronchoalveolar carcinoma (well-differentiated adenocarcinoma). Bronchoalveolar carcinomas presenting as post-obstructive or recurrent CAPs are rare because the spread is along tissue planes and not endobronchially. The case described demonstrates a rare cause of bronchogenic carcinoma mimicking recurrent CAP. Copyright © 2012 Elsevier Inc. All rights reserved.

Worst error performance of continuous Kalman filters. [for deep space navigation and maneuvers

NASA Technical Reports Server (NTRS)

Nishimura, T.

1975-01-01

The worst error performance of estimation filters is investigated for continuous systems in this paper. The pathological performance study, without assuming any dynamical model such as Markov processes for perturbations, except for its bounded amplitude, will give practical and dependable criteria in establishing the navigation and maneuver strategy in deep space missions.

Successful treatment of a primary gastric plasmacytoma mimicking intractable gastric ulcer by using high-dose dexamethasone therapy: a case report.

PubMed

Kang, Da-yeong; Kim, Gee-Bum; Choi, Byung-Seok; Seo, Jun-won; Lim, Hyun-Jong; Hong, Ran; Park, Sang-Gon

2016-03-31

Extramedullary plasmacytoma is a plasma cell neoplasm that presents as a solitary lesion in soft tissue. Most extramedullary plasmacytomas involve the nasopharynx or upper respiratory tract. Primary plasmacytoma of the stomach is extremely rare. A 78-year-old Korean woman presented with epigastric pain for 3 months. She had a history of an intractable gastric ulcer despite repeated endoscopic biopsies and appropriate medical therapy for the ulcer. She underwent another endoscopy and a biopsy was performed for multiple large and deep specimens. Ultimately, primary gastric plasmacytoma was confirmed. However, she and her attendant refused standard local radiotherapy or surgical resection. She came to our emergency room 3 months later with hematemesis due to a large gastric ulcer, despite management with medication for over 3 months at a local clinic. We again recommended local radiation or surgical resection. However, as she was willing to undergo only medical therapy, she was prescribed high-dose dexamethasone. Surprisingly, her ulcer completely regressed and remission was maintained for over 1 year. We report successful treatment of a rare primary gastric plasmacytoma mimicking intractable ulcer by using high-dose dexamethasone. To the best of our knowledge, this is the first reported case successfully treated with only high-dose dexamethasone.

Do women and providers value the same features of contraceptive products? Results of a best-worst stated preference experiment.

PubMed

Weisberg, Edith; Bateson, Deborah; Knox, Stephanie; Haas, Marion; Viney, Rosalie; Street, Deborah; Fiebig, Denzil

2013-06-01

To determine how women and physicians rate individual characteristics of contraceptives. Discrete choice experiments are used in health economics to elicit preferences for healthcare products. A choice experiment uses hypothetical scenarios to determine which individual factors influence choice. Women and general practitioners (GPs) were shown individual characteristics of contraceptives, not always matching existing methods, and chose the best and worst features. Two hundred women, mean age 36, 71% using contraception, were presented with descriptions of 16 possible methods and asked to indicate their preference for individual characteristics. One hundred and sixty-two GPs, mostly women, also completed 16 descriptions. Longer duration of action was most favoured by both, followed by lighter periods with less pain or amenorrhoea. The least attractive features for women were heavier and more painful periods, high cost, irregular periods, low efficacy (10% failure) and weight gain of 3 kg. GPs ranked a 10% pregnancy rate as least attractive followed by heavy painful periods and a 5% failure rate. Women and GPs differed in their ranking of contraceptive characteristics. Long duration of use, high efficacy, minimal or no bleeding without pain, were preferred by both. Very undesirable were heavy periods especially with pain, and low efficacy.

Lung Metastases from Bile Duct Adenocarcinoma Mimicking Chronic Airway Infection and Causing Diagnostic Difficulty

PubMed Central

Sato, Mitsuo; Okachi, Shotaro; Fukihara, Jun; Shimoyama, Yoshie; Wakahara, Keiko; Sakakibara, Toshihiro; Hase, Tetsunari; Onishi, Yasuharu; Ogura, Yasuhiro; Maeda, Osamu; Hasegawa, Yoshinori

2017-01-01

We herein report a case of lung metastases with unusual radiological appearances that mimicked those of chronic airway infection, causing diagnostic difficulty. A 60-year-old woman who underwent liver transplantation from a living donor was incidentally diagnosed with bile duct adenocarcinoma after a histopathological analysis of her explanted liver. Six months later, chest computed tomography (CT) revealed bilateral bronchogenic dissemination that had gradually worsened, suggesting chronic airway infection. A biopsy with bronchoscopy from a mass lesion beyond a segmental bronchus revealed adenocarcinoma identical to that of her bile duct adenocarcinoma, leading to the diagnosis of multiple lung metastases from bile duct adenocarcinoma. PMID:29279503

Accuracy of the cosmic-ray soil water content probe in humid forest ecosystems: The worst case scenario

NASA Astrophysics Data System (ADS)

Bogena, H. R.; Huisman, J. A.; Baatz, R.; Hendricks Franssen, H.-J.; Vereecken, H.

2013-09-01

Soil water content is one of the key state variables in the soil-vegetation-atmosphere continuum due to its important role in the exchange of water and energy at the soil surface. A new promising method to measure integral soil water content at the field or small catchment scale is the cosmic-ray probe (CRP). Recent studies of CRP measurements have mainly presented results from test sites located in very dry areas and from agricultural fields with sandy soils. In this study, distributed continuous soil water content measurements from a wireless sensor network (SoilNet) were used to investigate the accuracy of CRP measurements for soil water content determination in a humid forest ecosystem. Such ecosystems are less favorable for CRP applications due to the presence of a litter layer. In addition, lattice water and carbohydrates of soil organic matter and belowground biomass reduce the effective sensor depth and thus were accounted for in the calibration of the CRP. The hydrogen located in the biomass decreased the level of neutron count rates and thus also decreased the sensitivity of the cosmic-ray probe, which in turn resulted in an increase of the measurement uncertainty. This uncertainty was compensated by using longer integration times (e.g., 24 h). For the Wüstebach forest site, the cosmic-ray probe enabled the assessment of integral daily soil water content dynamics with a RMSE of about 0.03 cm3/cm3 without explicitly considering the litter layer. By including simulated water contents of the litter layer in the calibration, a better accuracy could be achieved.

Cystic Benign Metastasizing Leiomyoma of the Lung Mimicking Hydatid Cyst.

PubMed

Alimi, Faouzi; El Hadj Sidi, Chighali; Ghannouchi, Chams

2016-12-01

A 60-year-old woman, with history of a resected uterine benign leiomyoma, is operated for a cystic lesion in the left lung, mimicking an hydatid cyst, and confirmed histologically as Cystic Benign Metastasizing Leiomyoma.

Clinical and Histologic Mimickers of Celiac Disease.

PubMed

Kamboj, Amrit K; Oxentenko, Amy S

2017-08-17

Celiac disease is an autoimmune disorder of the small bowel, classically associated with diarrhea, abdominal pain, and malabsorption. The diagnosis of celiac disease is made when there are compatible clinical features, supportive serologic markers, representative histology from the small bowel, and response to a gluten-free diet. Histologic findings associated with celiac disease include intraepithelial lymphocytosis, crypt hyperplasia, villous atrophy, and a chronic inflammatory cell infiltrate in the lamina propria. It is important to recognize and diagnose celiac disease, as strict adherence to a gluten-free diet can lead to resolution of clinical and histologic manifestations of the disease. However, many other entities can present with clinical and/or histologic features of celiac disease. In this review article, we highlight key clinical and histologic mimickers of celiac disease. The evaluation of a patient with serologically negative enteropathy necessitates a carefully elicited history and detailed review by a pathologist. Medications can mimic celiac disease and should be considered in all patients with a serologically negative enteropathy. Many mimickers of celiac disease have clues to the underlying diagnosis, and many have a targeted therapy. It is necessary to provide patients with a correct diagnosis rather than subject them to a lifetime of an unnecessary gluten-free diet.

Implications for future survival of delta smelt from four climate change scenarios for the Sacramento–San Joaquin Delta, California

USGS Publications Warehouse

Brown, Larry R.; Bennett, William A.; Wagner, R. Wayne; Morgan-King, Tara; Knowles, Noah; Feyrer, Frederick; Schoellhamer, David H.; Stacey, Mark T.; Dettinger, Mike

2013-01-01

Changes in the position of the low salinity zone, a habitat suitability index, turbidity, and water temperature modeled from four 100-year scenarios of climate change were evaluated for possible effects on delta smelt Hypomesus transpacificus, which is endemic to the Sacramento–San Joaquin Delta. The persistence of delta smelt in much of its current habitat into the next century appears uncertain. By mid-century, the position of the low salinity zone in the fall and the habitat suitability index converged on values only observed during the worst droughts of the baseline period (1969–2000). Projected higher water temperatures would render waters historically inhabited by delta smelt near the confluence of the Sacramento and San Joaquin rivers largely uninhabitable. However, the scenarios of climate change are based on assumptions that require caution in the interpretation of the results. Projections like these provide managers with a useful tool for anticipating long-term challenges to managing fish populations and possibly adapting water management to ameliorate those challenges.

EVA Suit Microbial Leakage Investigation Project

NASA Technical Reports Server (NTRS)

Falker, Jay; Baker, Christopher; Clayton, Ronald; Rucker, Michelle

2016-01-01

The objective of this project is to collect microbial samples from various EVA suits to determine how much microbial contamination is typically released during simulated planetary exploration activities. Data will be released to the planetary protection and science communities, and advanced EVA system designers. In the best case scenario, we will discover that very little microbial contamination leaks from our current or prototype suit designs, in the worst case scenario, we will identify leak paths, learn more about what affects leakage--and we'll have a new, flight-certified swab tool for our EVA toolbox.

Rational Design of Pathogen-Mimicking Amphiphilic Materials as Nanoadjuvants

NASA Astrophysics Data System (ADS)

Ulery, Bret D.; Petersen, Latrisha K.; Phanse, Yashdeep; Kong, Chang Sun; Broderick, Scott R.; Kumar, Devender; Ramer-Tait, Amanda E.; Carrillo-Conde, Brenda; Rajan, Krishna; Wannemuehler, Michael J.; Bellaire, Bryan H.; Metzger, Dennis W.; Narasimhan, Balaji

2011-12-01

An opportunity exists today for cross-cutting research utilizing advances in materials science, immunology, microbial pathogenesis, and computational analysis to effectively design the next generation of adjuvants and vaccines. This study integrates these advances into a bottom-up approach for the molecular design of nanoadjuvants capable of mimicking the immune response induced by a natural infection but without the toxic side effects. Biodegradable amphiphilic polyanhydrides possess the unique ability to mimic pathogens and pathogen associated molecular patterns with respect to persisting within and activating immune cells, respectively. The molecular properties responsible for the pathogen-mimicking abilities of these materials have been identified. The value of using polyanhydride nanovaccines was demonstrated by the induction of long-lived protection against a lethal challenge of Yersinia pestis following a single administration ten months earlier. This approach has the tantalizing potential to catalyze the development of next generation vaccines against diseases caused by emerging and re-emerging pathogens.

Role of Cone Beam Computed Tomography in Evaluation of Radicular Cyst mimicking Dentigerous Cyst in a 7-year-old Child: A Case Report and Literature Review.

PubMed

Mahesh, B S; P Shastry, Shilpa; S Murthy, Padmashree; Jyotsna, T R

2017-01-01

To report a rare case of large radicular cyst-associated deciduous tooth and to discuss the importance of cone beam computed tomography (CBCT) in diagnosing the condition. Radicular cyst is the most common cyst affecting the permanent teeth, but its occurrence in deciduous teeth is rare. Most of the radicular cysts are asymptomatic and are discovered accidentally when radiographs are taken. Conventional radiographs show two-dimensional images of three-dimensional objects. Cone beam computed tomography provides undistorted three-dimensional information of hard tissues and gives adequate spatial resolution. A 7-year-old child, with a complaint of swelling in the maxillary anterior region, was diagnosed with radicular cyst in relation to primary maxillary right central incisor based on CBCT and histopathological features. Early diagnosis and prompt treatment of radicular cyst in primary dentition is important to prevent damage to permanent tooth. Mahesh BS, Shastry SP, Murthy PS, Jyotsna TR. Role of Cone Beam Computed Tomography in Evaluation of Radicular Cyst mimicking Dentigerous Cyst in a 7-year-old Child: A Case Report and Literature Review. Int J Clin Pediatr Dent 2017;10(2):213-216.

30 CFR 254.21 - How must I format my response plan?

Code of Federal Regulations, 2010 CFR

2010-07-01

... divide your response plan for OCS facilities into the sections specified in paragraph (b) and explained in the other sections of this subpart. The plan must have an easily found marker identifying each.... (ii) Contractual agreements. (iii) Worst case discharge scenario. (iv) Dispersant use plan. (v) In...

Dynamic safety assessment of natural gas stations using Bayesian network.

PubMed

Zarei, Esmaeil; Azadeh, Ali; Khakzad, Nima; Aliabadi, Mostafa Mirzaei; Mohammadfam, Iraj

2017-01-05

Pipelines are one of the most popular and effective ways of transporting hazardous materials, especially natural gas. However, the rapid development of gas pipelines and stations in urban areas has introduced a serious threat to public safety and assets. Although different methods have been developed for risk analysis of gas transportation systems, a comprehensive methodology for risk analysis is still lacking, especially in natural gas stations. The present work is aimed at developing a dynamic and comprehensive quantitative risk analysis (DCQRA) approach for accident scenario and risk modeling of natural gas stations. In this approach, a FMEA is used for hazard analysis while a Bow-tie diagram and Bayesian network are employed to model the worst-case accident scenario and to assess the risks. The results have indicated that the failure of the regulator system was the worst-case accident scenario with the human error as the most contributing factor. Thus, in risk management plan of natural gas stations, priority should be given to the most probable root events and main contribution factors, which have identified in the present study, in order to reduce the occurrence probability of the accident scenarios and thus alleviate the risks. Copyright © 2016 Elsevier B.V. All rights reserved.

What emergency physicians should know about informed consent: legal scenarios, cases, and caveats.

PubMed

Moore, Gregory P; Moffett, Peter M; Fider, Cyril; Moore, Malia J

2014-08-01

The basic concept of obtaining informed consent is familiar to emergency physicians, and many consider themselves well versed on the topic; however, lack of obtaining proper informed consent is a frequent source of lawsuits. The legal definitions and nuances of informed consent might surprise even the most experienced physician. This article will detail the historical legal evolution of the concept of informed consent. It will also report defining and recent court cases that illustrate the current medical-legal status of informed consent. Special scenarios, caveats, and documentation recommendations are discussed. After reading this article the emergency physician will know how to practice and document the appropriate aspects of informed consent in emergency medicine, as well as understand available legal defenses if a lawsuit should arise. © 2014 by the Society for Academic Emergency Medicine.

The scenario-based generalization of radiation therapy margins.

PubMed

Fredriksson, Albin; Bokrantz, Rasmus

2016-03-07

We give a scenario-based treatment plan optimization formulation that is equivalent to planning with geometric margins if the scenario doses are calculated using the static dose cloud approximation. If the scenario doses are instead calculated more accurately, then our formulation provides a novel robust planning method that overcomes many of the difficulties associated with previous scenario-based robust planning methods. In particular, our method protects only against uncertainties that can occur in practice, it gives a sharp dose fall-off outside high dose regions, and it avoids underdosage of the target in 'easy' scenarios. The method shares the benefits of the previous scenario-based robust planning methods over geometric margins for applications where the static dose cloud approximation is inaccurate, such as irradiation with few fields and irradiation with ion beams. These properties are demonstrated on a suite of phantom cases planned for treatment with scanned proton beams subject to systematic setup uncertainty.

Thermal-hydraulic analysis of N Reactor graphite and shield cooling system performance

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

Low, J.O.; Schmitt, B.E.

1988-02-01

A series of bounding (worst-case) calculations were performed using a detailed hydrodynamic RELAP5 model of the N Reactor graphite and shield cooling system (GSCS). These calculations were specifically aimed to answer issues raised by the Westinghouse Independent Safety Review (WISR) committee. These questions address the operability of the GSCS during a worst-case degraded-core accident that requires the GDCS to mitigate the consequences of the accident. An accident scenario previously developed was designed as the hydrogen-mitigation design-basis accident (HMDBA). Previous HMDBA heat transfer analysis,, using the TRUMP-BD code, was used to define the thermal boundary conditions that the GSDS may bemore » exposed to. These TRUMP/HMDBA analysis results were used to define the bounding operating conditions of the GSCS during the course of an HMDBA transient. Nominal and degraded GSCS scenarios were investigated using RELAP5 within or at the bounds of the HMDBA transient. 10 refs., 42 figs., 10 tabs.« less

Zika virus in French Polynesia 2013-14: anatomy of a completed outbreak.

PubMed

Musso, Didier; Bossin, Hervé; Mallet, Henri Pierre; Besnard, Marianne; Broult, Julien; Baudouin, Laure; Levi, José Eduardo; Sabino, Ester C; Ghawche, Frederic; Lanteri, Marion C; Baud, David

2018-05-01

The Zika virus crisis exemplified the risk associated with emerging pathogens and was a reminder that preparedness for the worst-case scenario, although challenging, is needed. Herein, we review all data reported during the unexpected emergence of Zika virus in French Polynesia in late 2013. We focus on the new findings reported during this outbreak, especially the first description of severe neurological complications in adults and the retrospective description of CNS malformations in neonates, the isolation of Zika virus in semen, the potential for blood-transfusion transmission, mother-to-child transmission, and the development of new diagnostic assays. We describe the effect of this outbreak on health systems, the implementation of vector-borne control strategies, and the line of communication used to alert the international community of the new risk associated with Zika virus. This outbreak highlighted the need for careful monitoring of all unexpected events that occur during an emergence, to implement surveillance and research programmes in parallel to management of cases, and to be prepared to the worst-case scenario. Copyright © 2018 Elsevier Ltd. All rights reserved.

Subependymal Heterotopia Mimicking Mass in Conventional Magnetic Resonance Imaging: Demonstration With 3T Advanced Neuroimages.

PubMed

Aktas, Filiz; Ogul, Hayri

2017-10-01

The authors reported a rare patient with large subependymal heterotopia mimicking cerebral neoplasia. A 22-year-old female was admitted with a history of right-sided paresthesia accompanied by progressive headache. Cerebral magnetic resonance (MR) imaging showed a large solid lesion in the left frontal lobe. Advanced MR images proved that the lesion was compatible with subependymal heterotopia. Large subependymal heterotopia may mimick cerebral neoplasia.

Misrepresentation of the IPCC CO2 emission scenarios

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

Manning, Martin; Edmonds, James A.; Emori, S.

2010-06-01

Estimates of recent fossil fuel CO2 emissions have been compared with the IPCC SRES (Special Report on Emission Scenarios) emission scenarios that had been developed for analysis of future climate change, impacts and mitigation. In some cases this comparison uses averages across subgroups of SRES scenarios and for one category of greenhouse gases (industrial sources of CO2). That approach can be misleading and cause confusion as it is inconsistent with many of the papers on future climate change projections that are based on a specific subset of closely scrutinized SRES scenarios, known as illustrative marker scenarios. Here, we show thatmore » comparison between recent estimates of fossil fuel emissions trends and the SRES illustrative marker scenarios leads to the conclusion that recent trends are not outside the SRES range. Furthermore, the recent economic downturn appears to have brought actual emission back toward the middle of the SRES illustrative marker scenarios. We also note that SRES emission scenarios are designed to reflect potential alternative long-term trends in a world without climate policy intervention and the trend in the resulting climate change is not sensitive to short-term fluctuations.« less

Scenario-Based Tsunami Hazard Assessment from Earthquake and Landslide Sources for Eastern Sicily, Italy

NASA Astrophysics Data System (ADS)

Tinti, S.; Armigliato, A.; Pagnoni, G.; Paparo, M. A.; Zaniboni, F.

2016-12-01

Eastern Sicily was theatre of the most damaging tsunamis that ever struck Italy, such as the 11 January 1693 and the 28 December 1908 tsunamis. Tectonic studies and paleotsunami investigations extended historical records of tsunami occurrence back of several thousands of years. Tsunami sources relevant for eastern Sicily are both local and remote, the latter being located in the Ionian Greece and in the Western Hellenic Arc. Here in 365 A.D. a large earthquake generated a tsunami that was seen in the whole eastern and central Mediterranean including the Sicilian coasts. The objective of this study is the evaluation of tsunami hazard along the coast of eastern Sicily, central Mediterranean, Italy via a scenario-based technique, which has been preferred to the PTHA approach because, when dealing with tsunamis induced by landslides, uncertainties are usually so large to undermine the PTHA results. Tsunamis of earthquake and landslide origin are taken into account for the entire coast of Sicily, from the Messina to the Siracusa provinces. Landslides are essentially local sources and can occur underwater along the unstable flanks of the Messina Straits or along the steep slopes of the Hyblaean-Malta escarpment. The method is based on a two-step procedure. After a preliminary step where very many earthquake and landslide sources are taken into account and tsunamis are computed on a low-resolution grid, the worst-case scenarios are selected and tsunamis are simulated on a finer-resolution grid allowing for a better calculation of coastal wave height and tsunami penetration. The final result of our study is given in the form of aggregate fields computed from individual scenarios. Also interesting is the contribution of the various tsunami sources in different localities along the coast. It is found that the places with the highest level of hazard are the low lands of La Playa south of Catania and of the Bay of Augusta, which is in agreement also with historical

Human herpesvirus 8-associated lymphoma mimicking cutaneous anaplastic large T-cell lymphoma in a patient with human immunodeficiency virus infection.

PubMed

Li, Meng-Fang; Hsiao, Cheng-Hsiang; Chen, Yi-Lin; Huang, Wen-Ya; Lee, Yi-Hsuan; Huang, Hsien-Neng; Lien, Huang-Chun

2012-02-01

Primary effusion lymphoma, a human herpesvirus 8 (HHV8)-associated lymphoma, is uncommon, and it is usually seen in human immunodeficiency virus (HIV)-infected patients. It presents as a body cavity-based lymphomatous effusion, but several cases of the so-called solid primary effusion lymphoma presenting as solid tumors without associated lymphomatous effusion have been reported. They have similar clinical, histopathological and immunophenotypical features. Most of them have a B-cell genotype. This suggests the solid variant may represent a clinicopathological spectrum of primary effusion lymphoma. We report a case of HHV8-associated lymphoma histopathologically and immunophenotypically mimicking cutaneous anaplastic large cell lymphoma. The patient was a 31-year-old HIV-seropositive man presenting with skin nodules over his right thigh. Biopsy of the nodules showed anaplastic large cells infiltrating the dermis. These malignant cells strongly expressed CD3, CD30 and CD43. Cutaneous anaplastic large T-cell lymphoma was initially diagnosed, but further tests, including immunoreactivity for HHV8 protein and clonal rearrangements of immunoglobulin genes, confirmed the diagnosis of HHV8-associated B-cell lymphoma with aberrant T-cell marker expression. This case provides an example of solid primary effusion lymphoma mimicking cutaneous anaplastic large T-cell lymphoma and highlights the importance of HHV8 immunohistochemistry and molecular tests in the diagnosis of HHV8-associated lymphoma with a cutaneous presentation. Copyright © 2011 John Wiley & Sons A/S.

Friedreich's ataxia mimicking hereditary motor and sensory neuropathy.

PubMed

Panas, Marios; Kalfakis, Nikolaos; Karadima, Georgia; Davaki, Panagiota; Vassilopoulos, Demetris

2002-11-01

Four patients from three unrelated families, with clinical and electrophysiological findings compatible with the diagnosis of hereditary motor and sensory neuropathy, are presented. The molecular analysis showed that the affected individuals were homozygous for the mutation in the X25 gene, characteristic of Friedreich's ataxia. These patients seem to represent a form of Friedreich's ataxia mimicking Charcot-Marie-Tooth disease.

Combination of Face Regions in Forensic Scenarios.

PubMed

Tome, Pedro; Fierrez, Julian; Vera-Rodriguez, Ruben; Ortega-Garcia, Javier

2015-07-01

This article presents an experimental analysis of the combination of different regions of the human face on various forensic scenarios to generate scientific knowledge useful for the forensic experts. Three scenarios of interest at different distances are considered comparing mugshot and CCTV face images using MORPH and SC face databases. One of the main findings is that inner facial regions combine better in mugshot and close CCTV scenarios and outer facial regions combine better in far CCTV scenarios. This means, that depending of the acquisition distance, the discriminative power of the facial regions change, having in some cases better performance than the full face. This effect can be exploited by considering the fusion of facial regions which results in a very significant improvement of the discriminative performance compared to just using the full face. © 2015 American Academy of Forensic Sciences.

Deep Invasive Fungal Infection of the Hand in a Child Mimicking a Local Gigantism.

PubMed

Chatterjee, Anirban; Chatterjee, Shamita

2018-04-01

Subcutaneous and deep fungal infections in the hand are rare among children. These are usually found in immunocompromised adults or in persons engaged in soil handling activities, due to direct exposure, especially in the tropics. Delay in diagnosis is usual because pyogenic and other granulomatous infections are considered first. The authors present the case of a healthy, immunocompetent 2½-year-old child who presented with progressive swelling of the right hand mimicking a localized gigantism of the entire hand. Multiple operative drainage procedures done previously had failed to resolve the condition. A biopsy established the presence of fungal hyphae, thus confirming the diagnosis of deep fungal infection of the hand and guided proper therapeutic intervention. A strong index of suspicion needs to be maintained in cases not responding to conventional antibacterial therapy, and both microbiologic and histopathologic samples need to be obtained to establish the diagnosis.

A generalized land-use scenario generator: a case study for the Congo basin.

NASA Astrophysics Data System (ADS)

Caporaso, Luca; Tompkins, Adrian Mark; Biondi, Riccardo; Bell, Jean Pierre

2014-05-01

The impact of deforestation on climate is often studied using highly idealized "instant deforestation" experiments due to the lack of generalized deforestation scenario generators coupled to climate model land-surface schemes. A new deforestation scenario generator has been therefore developed to fulfill this role known as the deforestation ScenArio GEnerator, or FOREST-SAGE. The model produces distributed maps of deforestation rates that account for local factors such as proximity to transport networks, distance weighted population density, forest fragmentation and presence of protected areas and logging concessions. The integrated deforestation risk is scaled to give the deforestation rate as specified by macro-region scenarios such as "business as usual" or "increased protection legislation" which are a function of future time. FOREST-SAGE was initialized and validated using the MODerate Resolution Imaging Spectroradiometer Vegetation Continuous Field data. Despite the high cloud coverage of Congo Basin over the year, we were able to validate the results with high confidence from 2001 to 2010 in a large forested area. Furthermore a set of scenarios has been used to provide a range of possible pathways for the evolution of land-use change over the Congo Basin for the period 2010-2030.

Climate change and socio-economic scenarios, land use modelling implications on water resources in an inner alpine area, Switzerland

NASA Astrophysics Data System (ADS)

Rey, Emmanuel; Schneider, Flurina; Liniger, Hanspeter; Weingartner, Rolf; Herweg, Karl

2014-05-01

The MontanAqua project aims to study the water resources management in the region Sierre-Montana (Valais, Switzerland). Land use is known to have an influence on the water resources (soil moisture dynamic, soil sealing, surface runoff and deep percolation). Thus land use modelling is of importance for the water resources management. An actual land use map was produced using infrared imagery (Niklaus 2012, Fig.1). Land use changes are known to be mainly drived by socio-economic factors as well as climatic factors (Dolman et al. 2003). Potential future Land uses was separatly predicted according to 1-. socio-economic and 2-. climatic/abiotic drivers : 1. 4 socio-economic scenarios were developped with stakeholders (Schneider et al. 2013) between 2010 and 2012. We modeled those socio-economic scenarios into a GIS application using Python programming (ModelBuilder in ArcGIS 10) to get a cartographic transcription of the wishes of the stakeholders for their region in 2050. 2. Uncorrelated climatic and abiotic drivers were used in a BIOMOD2 (Georges et al. 2013) framework. 4 models were used: Maximum Entropy (MAXENT), Multiple Adaptive Regression Splines (MARS), Classification Tree Analysis (CTA) and the Flexible Discriminant Analysis (FDA) to predict grassland, alpine pasture, vineyards and forest in our study region. Climatic scenarios were then introduced into the models to predict potential land use in 2050 driven only by climatic and abiotic factors The comparison of all the outputs demonstrates that the socio-economic drivers will have a more important impact in the region than the climatic drivers (e.g. -70% grassland surface for the worst socio-economic scenario vs. -40% of grassland surface for the worst climatic models). Further analysis also brings out the sensitivity of the grassland/alpine pasture system to the climate change and to socio-economic changes. Future work will be to cross the different land use maps obtained by the two model types and to use

Medium-Term Prospects for the Mexican Economy: Some Modeling Results

DTIC Science & Technology

1990-07-01

Mexican prospects. A base case scenario illustrates that without a net inflow of foreign capital, the peso cannot be sustained at current real levels... peso and no decline in real income. The model can also produce a pessimistic scenario that suggests the worst that might happen to the Mexican economy...net inflow of foreign capital (in the form of either lending or direct investment) the peso cannot be sustained at current real levels (assuming that

Optimization of a secondary VOI protocol for lung imaging in a clinical CT scanner.

PubMed

Larsen, Thomas C; Gopalakrishnan, Vissagan; Yao, Jianhua; Nguyen, Catherine P; Chen, Marcus Y; Moss, Joel; Wen, Han

2018-05-21

We present a solution to meet an unmet clinical need of an in-situ "close look" at a pulmonary nodule or at the margins of a pulmonary cyst revealed by a primary (screening) chest CT while the patient is still in the scanner. We first evaluated options available on current whole-body CT scanners for high resolution screening scans, including ROI reconstruction of the primary scan data and HRCT, but found them to have insufficient SNR in lung tissue or discontinuous slice coverage. Within the capabilities of current clinical CT systems, we opted for the solution of a secondary, volume-of-interest (VOI) protocol where the radiation dose is focused into a short-beam axial scan at the z position of interest, combined with a small-FOV reconstruction at the xy position of interest. The objective of this work was to design a VOI protocol that is optimized for targeted lung imaging in a clinical whole-body CT system. Using a chest phantom containing a lung-mimicking foam insert with a simulated cyst, we identified the appropriate scan mode and optimized both the scan and recon parameters. The VOI protocol yielded 3.2 times the texture amplitude-to-noise ratio in the lung-mimicking foam when compared to the standard chest CT, and 8.4 times the texture difference between the lung mimicking and reference foams. It improved details of the wall of the simulated cyst and better resolution in a line-pair insert. The Effective Dose of the secondary VOI protocol was 42% on average and up to 100% in the worst-case scenario of VOI positioning relative to the standard chest CT. The optimized protocol will be used to obtain detailed CT textures of pulmonary lesions, which are biomarkers for the type and stage of lung diseases. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Autoimmunity to Tropomyosin-Specific Peptides Induced by Mycobacterium leprae in Leprosy Patients: Identification of Mimicking Proteins.

PubMed

Singh, Itu; Yadav, Asha Ram; Mohanty, Keshar Kunja; Katoch, Kiran; Sharma, Prashant; Pathak, Vinay Kumar; Bisht, Deepa; Gupta, Umesh D; Sengupta, Utpal

2018-01-01

It has been shown earlier that there is a rise in the levels of autoantibodies and T cell response to cytoskeletal proteins in leprosy. Our group recently demonstrated a rise in both T and B cell responses to keratin and myelin basic protein in all types of leprosy patients and their associations in type 1 reaction (T1R) group of leprosy. In this study, we investigated the association of levels of autoantibodies and lymphoproliferation against myosin in leprosy patients across the spectrum and tried to find out the mimicking proteins or epitopes between host protein and protein/s of Mycobacterium leprae . One hundred and sixty-nine leprosy patients and 55 healthy controls (HC) were enrolled in the present study. Levels of anti-myosin antibodies and T-cell responses against myosin were measured by ELISA and lymphoproliferation assay, respectively. Using 2-D gel electrophoresis, western blot and MALDI-TOF/TOF antibody-reactive spots were identified. Three-dimensional structure of mimicking proteins was modeled by online server. B cell epitopes of the proteins were predicted by BCPREDS server 1.0 followed by identification of mimicking epitopes. Mice of inbred BALB/c strain were hyperimmunized with M. leprae soluble antigen (MLSA) and splenocytes and lymph node cells of these animals were adoptively transferred to naïve mice. Highest level of anti-myosin antibodies was noted in sera of T1R leprosy patients. We observed significantly higher levels of lymphoproliferative response ( p  < 0.05) with myosin in all types of leprosy patients compared to HC. Further, hyperimmunization of inbred BALB/c strain of female mice and rabbit with MLSA revealed that both hyperimmunized rabbit and mice evoked heightened levels of antibodies against myosin and this autoimmune response could be adoptively transferred from hyperimmunized to naïve mice. Tropomyosin was found to be mimicking with ATP-dependent Clp protease ATP-binding subunit of M. leprae . We found four mimicking

Web Based Tool for Mission Operations Scenarios

NASA Technical Reports Server (NTRS)

Boyles, Carole A.; Bindschadler, Duane L.

2008-01-01

A conventional practice for spaceflight projects is to document scenarios in a monolithic Operations Concept document. Such documents can be hundreds of pages long and may require laborious updates. Software development practice utilizes scenarios in the form of smaller, individual use cases, which are often structured and managed using UML. We have developed a process and a web-based scenario tool that utilizes a similar philosophy of smaller, more compact scenarios (but avoids the formality of UML). The need for a scenario process and tool became apparent during the authors' work on a large astrophysics mission. It was noted that every phase of the Mission (e.g., formulation, design, verification and validation, and operations) looked back to scenarios to assess completeness of requirements and design. It was also noted that terminology needed to be clarified and structured to assure communication across all levels of the project. Attempts to manage, communicate, and evolve scenarios at all levels of a project using conventional tools (e.g., Excel) and methods (Scenario Working Group meetings) were not effective given limitations on budget and staffing. The objective of this paper is to document the scenario process and tool created to offer projects a low-cost capability to create, communicate, manage, and evolve scenarios throughout project development. The process and tool have the further benefit of allowing the association of requirements with particular scenarios, establishing and viewing relationships between higher- and lower-level scenarios, and the ability to place all scenarios in a shared context. The resulting structured set of scenarios is widely visible (using a web browser), easily updated, and can be searched according to various criteria including the level (e.g., Project, System, and Team) and Mission Phase. Scenarios are maintained in a web-accessible environment that provides a structured set of scenario fields and allows for maximum

Effect of Impact Location on the Response of Shuttle Wing Leading Edge Panel 9

NASA Technical Reports Server (NTRS)

Lyle, Karen H.; Spellman, Regina L.; Hardy, Robin C.; Fasanella, Edwin L.; Jackson, Karen E.

2005-01-01

The objective of this paper is to compare the results of several simulations performed to determine the worst-case location for a foam impact on the Space Shuttle wing leading edge. The simulations were performed using the commercial non-linear transient dynamic finite element code, LS-DYNA. These simulations represent the first in a series of parametric studies performed to support the selection of the worst-case impact scenario. Panel 9 was selected for this study to enable comparisons with previous simulations performed during the Columbia Accident Investigation. The projectile for this study is a 5.5-in cube of typical external tank foam weighing 0.23 lb. Seven locations spanning the panel surface were impacted with the foam cube. For each of these cases, the foam was traveling at 1000 ft/s directly aft, along the orbiter X-axis. Results compared from the parametric studies included strains, contact forces, and material energies for various simulations. The results show that the worst case impact location was on the top surface, near the apex.

The effect of acutely administered MDMA on subjective and BOLD-fMRI responses to favourite and worst autobiographical memories.

PubMed

Carhart-Harris, R L; Wall, M B; Erritzoe, D; Kaelen, M; Ferguson, B; De Meer, I; Tanner, M; Bloomfield, M; Williams, T M; Bolstridge, M; Stewart, L; Morgan, C J; Newbould, R D; Feilding, A; Curran, H V; Nutt, D J

2014-04-01

3,4-methylenedioxymethamphetamine (MDMA) is a potent monoamine-releaser that is widely used as a recreational drug. Preliminary work has supported the potential of MDMA in psychotherapy for post-traumatic stress disorder (PTSD). The neurobiological mechanisms underlying its putative efficacy are, however, poorly understood. Psychotherapy for PTSD usually requires that patients revisit traumatic memories, and it has been argued that this is easier to do under MDMA. Functional magnetic resonance imaging (fMRI) was used to investigate the effect of MDMA on recollection of favourite and worst autobiographical memories (AMs). Nineteen participants (five females) with previous experience with MDMA performed a blocked AM recollection (AMR) paradigm after ingestion of 100 mg of MDMA-HCl or ascorbic acid (placebo) in a double-blind, repeated-measures design. Memory cues describing participants' AMs were read by them in the scanner. Favourite memories were rated as significantly more vivid, emotionally intense and positive after MDMA than placebo and worst memories were rated as less negative. Functional MRI data from 17 participants showed robust activations to AMs in regions known to be involved in AMR. There was also a significant effect of memory valence: hippocampal regions showed preferential activations to favourite memories and executive regions to worst memories. MDMA augmented activations to favourite memories in the bilateral fusiform gyrus and somatosensory cortex and attenuated activations to worst memories in the left anterior temporal cortex. These findings are consistent with a positive emotional-bias likely mediated by MDMA's pro-monoaminergic pharmacology.

Health risk impacts analysis of fugitive aromatic compounds emissions from the working face of a municipal solid waste landfill in China.

PubMed

Liu, Yanjun; Liu, Yanting; Li, Hao; Fu, Xindi; Guo, Hanwen; Meng, Ruihong; Lu, Wenjing; Zhao, Ming; Wang, Hongtao

2016-12-01

Aromatic compounds (ACs) emitted from landfills have attracted a lot of attention of the public due to their adverse impacts on the environment and human health. This study assessed the health risk impacts of the fugitive ACs emitted from the working face of a municipal solid waste (MSW) landfill in China. The emission data was acquired by long-term in-situ samplings using a modified wind tunnel system. The uncertainty of aromatic emissions is determined by means of statistics and the emission factors were thus developed. Two scenarios, i.e. 'normal-case' and 'worst-case', were presented to evaluate the potential health risk in different weather conditions. For this typical large anaerobic landfill, toluene was the dominant species owing to its highest releasing rate (3.40±3.79g·m -2 ·d -1 ). Despite being of negligible non-carcinogenic risk, the ACs might bring carcinogenic risks to human in the nearby area. Ethylbenzene was the major health threat substance. The cumulative carcinogenic risk impact area is as far as ~1.5km at downwind direction for the normal-case scenario, and even nearly 4km for the worst-case scenario. Health risks of fugitive ACs emissions from active landfills should be concerned, especially for landfills which still receiving mixed MSW. Copyright © 2016 Elsevier Ltd. All rights reserved.

Vulnerability assessment of the impact of sea-level rise and flooding on the Moroccan coast: The case of the Mediterranean eastern zone

NASA Astrophysics Data System (ADS)

Snoussi, Maria; Ouchani, Tachfine; Niazi, Saïda

2008-04-01

The eastern part of the Mediterranean coast of Morocco is physically and socio-economically vulnerable to accelerated sea-level rise, due to its low topography and its high ecological and touristic value. Assessment of the potential land loss by inundation has been based on empirical approaches using a minimum inundation level of 2 m and a maximum inundation level of 7 m, where scenarios for future sea-level rise range from 200 to 860 mm, with a 'best estimate' of 490 mm. The socio-economic impacts have been based on two possible alternative futures: (1) a 'worst-case' scenario, obtained by combining the 'economic development first' scenario with the maximum inundation level; and (2) a 'best-case' scenario, by combining the 'sustainability first' scenario with the minimum inundation level. Inundation analysis, based on Geographical Information Systems and a modelling approach to erosion, has identified both locations and the socioeconomic sectors that are most at risk to accelerated sea-level rise. Results indicate that 24% and 59% of the area will be lost by flooding at minimum and maximum inundation levels, respectively. The most severely impacted sectors are expected to be the residential and recreational areas, agricultural land, and the natural ecosystem. Shoreline erosion will affect 50% and 70% of the total area in 2050 and 2100, respectively. Potential strategies to ameliorate the impact of seawater inundation include: wetland preservation; beach nourishment at tourist resorts; and the afforestation of dunes. As this coast is planned to become one of the most developed tourist resorts in Morocco by 2010, measures such as building regulation, urban growth planning and development of an Integrated Coastal Zone Management Plan, are recommended for the region.

When Food Is a Foe.

ERIC Educational Resources Information Center

Fitzgerald, Patricia L.

1998-01-01

Although only 5% of the population has severe food allergies, school business officials must be prepared for the worst-case scenario. Banning foods and segregating allergic children are harmful practices. Education and sensible behavior are the best medicine when food allergies and intolerances are involved. Resources are listed. (MLH)

Bronchogenic adenocarcinoma metastatic tumor mimicking a dentoalveolar abscess in the maxilla.

PubMed

Salarić, Ivan; Miloš, Mate; Brajdić, Davor; Manojlović, Spomenka; Trutin Ostović, Karmen; Macan, Darko

2016-01-01

Intraosseous metastatic tumors (IOM) in maxilla are less frequent than the soft tissue metastatic tumors. Lung and bronchogenic metastatic tumors are uncommon in the maxilla. We present a maxillary bronchogenic metastasis with a rare clinical appearance. IOM was misdiagnosed as a dentoalveolar abscess and treated with antibiotics for 3 weeks. After not responding to antibiotics, the patient's general dental practitioner forwarded the patient to the Department of Oral and Maxillofacial Surgery. The associated tooth was extracted and the patient was recalled 1 week later. No signs of improvement were observed, and cytology, biopsy, and radiology diagnostics were performed. Cytologic results and biopsy could not differentiate a metastatic tumor from a salivary duct carcinoma. Ultimately, negative androgen receptors immunohistochemistry supported the diagnosis of bronchogenic metastatic adenocarcinoma. This case report stresses the importance of taking a thorough medical history. To our knowledge, this is the third bronchogenic IOM to the maxilla reported, mimicking a dentoalveolar abscess. General dental practitioners are among the first in contact with oral metastatic tumors and it is therefore important to report unusual clinical cases, as they present a diagnostic challenge for both the clinician and the pathologist.

Indoor exposure to toluene from printed matter matters: complementary views from life cycle assessment and risk assessment.

PubMed

Walser, Tobias; Juraske, Ronnie; Demou, Evangelia; Hellweg, Stefanie

2014-01-01

A pronounced presence of toluene from rotogravure printed matter has been frequently observed indoors. However, its consequences to human health in the life cycle of magazines are poorly known. Therefore, we quantified human-health risks in indoor environments with Risk Assessment (RA) and impacts relative to the total impact of toxic releases occurring in the life cycle of a magazine with Life Cycle Assessment (LCA). We used a one-box indoor model to estimate toluene concentrations in printing facilities, newsstands, and residences in a best, average, and worst-case scenario. The modeled concentrations are in the range of the values measured in on-site campaigns. Toluene concentrations can be close or even surpass the occupational legal thresholds in printing facilities in realistic worst-case scenarios. The concentrations in homes can surpass the US EPA reference dose (69 μg/kg/day) in worst-case scenarios, but are still at least 1 order of magnitude lower than in press rooms or newsstands. However, toluene inhaled at home becomes the dominant contribution to the total potential human toxicity impacts of toluene from printed matter when assessed with LCA, using the USEtox method complemented with indoor characterization factors for toluene. The significant contribution (44%) of toluene exposure in production, retail, and use in households, to the total life cycle impact of a magazine in the category of human toxicity, demonstrates that the indoor compartment requires particular attention in LCA. While RA works with threshold levels, LCA assumes that every toxic emission causes an incremental change to the total impact. Here, the combination of the two paradigms provides valuable information on the life cycle stages of printed matter.

Toxoplasmosis presenting as a swelling in the axillary tail of the breast and a palpable axillary lymph node mimicking malignancy: a case report

PubMed Central

2011-01-01

Introduction Lymphadenopathy is a common finding in toxoplasmosis. A breast mass due to toxoplasmosis is very rare, and only a few cases have been reported. We present a case of toxoplasmosis that presented as a swelling in the axillary tail of the breast with a palpable axillary lymph node which mimicked breast cancer. Case presentation A 45-year-old otherwise healthy Caucasian woman presented with a lump on the lateral aspect of her left breast. Her mother had breast cancer that was diagnosed at the age of 66 years. During an examination, we discovered that our patient had a discrete, firm lump in the axillary tail of her left breast and an enlarged, palpable lymph node in her left axilla. Her right breast and axilla were normal. The clinical diagnosis was malignancy in the left breast. Ultrasound and mammographic examinations of her breast suggested a pathological process but were not conclusive. She had targeted fine-needle aspiration cytology (FNAC) and core biopsy of the lesions. FNAC was indeterminate (C3) but suggested a possibility of toxoplasmosis. The core biopsy was not suggestive of malignancy but showed granulomatous inflammation. She had a wide local excision of the breast lump and an axillary lymph node biopsy. Histopathology and immunohistochemical studies excluded carcinoma or lymphoma but suggested the possibility of intramammary and axillary toxoplasmic lymphadenopathy. The results of Toxoplasma gondii IgM and IgG serology tests were positive, supporting a diagnosis of toxoplasmosis. Conclusions Toxoplasmosis rarely presents as a pseudotumor of the breast. FNAC and histology are valuable tools for a diagnosis of toxoplasmosis, and serology is an important adjunct for confirmation. PMID:21816047

Quantifying policy options for reducing future coronary heart disease mortality in England: a modelling study.

PubMed

Scholes, Shaun; Bajekal, Madhavi; Norman, Paul; O'Flaherty, Martin; Hawkins, Nathaniel; Kivimäki, Mika; Capewell, Simon; Raine, Rosalind

2013-01-01

To estimate the number of coronary heart disease (CHD) deaths potentially preventable in England in 2020 comparing four risk factor change scenarios. Using 2007 as baseline, the IMPACTSEC model was extended to estimate the potential number of CHD deaths preventable in England in 2020 by age, gender and Index of Multiple Deprivation 2007 quintiles given four risk factor change scenarios: (a) assuming recent trends will continue; (b) assuming optimal but feasible levels already achieved elsewhere; (c) an intermediate point, halfway between current and optimal levels; and (d) assuming plateauing or worsening levels, the worst case scenario. These four scenarios were compared to the baseline scenario with both risk factors and CHD mortality rates remaining at 2007 levels. This would result in approximately 97,000 CHD deaths in 2020. Assuming recent trends will continue would avert approximately 22,640 deaths (95% uncertainty interval: 20,390-24,980). There would be some 39,720 (37,120-41,900) fewer deaths in 2020 with optimal risk factor levels and 22,330 fewer (19,850-24,300) in the intermediate scenario. In the worst case scenario, 16,170 additional deaths (13,880-18,420) would occur. If optimal risk factor levels were achieved, the gap in CHD rates between the most and least deprived areas would halve with falls in systolic blood pressure, physical inactivity and total cholesterol providing the largest contributions to mortality gains. CHD mortality reductions of up to 45%, accompanied by significant reductions in area deprivation mortality disparities, would be possible by implementing optimal preventive policies.

Quantifying Policy Options for Reducing Future Coronary Heart Disease Mortality in England: A Modelling Study

PubMed Central

Scholes, Shaun; Bajekal, Madhavi; Norman, Paul; O’Flaherty, Martin; Hawkins, Nathaniel; Kivimäki, Mika; Capewell, Simon; Raine, Rosalind

2013-01-01

Aims To estimate the number of coronary heart disease (CHD) deaths potentially preventable in England in 2020 comparing four risk factor change scenarios. Methods and Results Using 2007 as baseline, the IMPACTSEC model was extended to estimate the potential number of CHD deaths preventable in England in 2020 by age, gender and Index of Multiple Deprivation 2007 quintiles given four risk factor change scenarios: (a) assuming recent trends will continue; (b) assuming optimal but feasible levels already achieved elsewhere; (c) an intermediate point, halfway between current and optimal levels; and (d) assuming plateauing or worsening levels, the worst case scenario. These four scenarios were compared to the baseline scenario with both risk factors and CHD mortality rates remaining at 2007 levels. This would result in approximately 97,000 CHD deaths in 2020. Assuming recent trends will continue would avert approximately 22,640 deaths (95% uncertainty interval: 20,390-24,980). There would be some 39,720 (37,120-41,900) fewer deaths in 2020 with optimal risk factor levels and 22,330 fewer (19,850-24,300) in the intermediate scenario. In the worst case scenario, 16,170 additional deaths (13,880-18,420) would occur. If optimal risk factor levels were achieved, the gap in CHD rates between the most and least deprived areas would halve with falls in systolic blood pressure, physical inactivity and total cholesterol providing the largest contributions to mortality gains. Conclusions CHD mortality reductions of up to 45%, accompanied by significant reductions in area deprivation mortality disparities, would be possible by implementing optimal preventive policies. PMID:23936122

Impacts of Mega-droughts on Water and Food Security in the Indo-Gangetic Plains: A Paleoclimate Scenario Analysis

NASA Astrophysics Data System (ADS)

Zhu, T.; Pitois, G.; Ringler, C.; Wang, D.; Rosegrant, M. W.

2014-12-01

Spanning over Pakistan, northern India, Nepal, and Bangladesh, the Indo-Gangetic Plains (IGP) is the home of several hundred million people and the "bread basket" for much of South Asia. The flat terrain, fertile soils, and favorable climate of the IGP make it agriculturally productive. However prolonged droughts caused by consecutive monsoon failures can seriously affect crop production and social wellbeing, in particular for the eastern part of the plains where agriculture remains largely rain-fed. Severe droughts were observed in the IGP historically, and recent paleoclimate studies reveal that more severe and long-lasting "mega-droughts" had happened in the distant past. Agricultural losses from major droughts can dramatically affect food systems and increase the vulnerability of resource-poor people given the delicate balance between food supply and demand under growing natural resource scarcity. To estimate the potential impacts of "mega-droughts" on the water and food systems in the IGP, we develop worst-case drought scenarios through inverse modeling of tree-ring-based PDSI reconstruction that covers the period 1300-1899 (A.D.), and analyze these historic mega-drought scenarios using IFPRI's IMPACT global water and food projections model. The base year of the IMPACT model is parameterized using socioeconomic and engineering data that reflect today's water management and infrastructure, agricultural technologies, population, income, and market institutions. The base year simulation is validated against observations to ensure model fidelity. Anticipated changes of the above factors in the future out to 2050 are specified using demographic and economic growth projections and literature data. Model simulation results represent the consequences of mega-droughts in the IGP given technological and socioeconomic conditions of today and in the future. We also explore policy options for increasing the resilience of water and food systems in the IGP, through scenario

Contrasting SWAT predictions of watershed-level streamflow and nutrient loss resulting from static versus dynamic atmospheric CO2 inputs

USDA-ARS?s Scientific Manuscript database

Past climate observations have indicated a rapid increase in global atmospheric CO2 concentration during late 20th century (13 ppm/decade), and models project further rise throughout the 21st century (24 ppm/decade and 69 ppm/decade in the best and worst case scenario, respectively). We modified SWA...

A Comparison of Learning Technologies for Teaching Spacecraft Software Development

ERIC Educational Resources Information Center

Straub, Jeremy

2014-01-01

The development of software for spacecraft represents a particular challenge and is, in many ways, a worst case scenario from a design perspective. Spacecraft software must be "bulletproof" and operate for extended periods of time without user intervention. If the software fails, it cannot be manually serviced. Software failure may…

Metastatic breast cancer to the liver with hepatoid features and Hep Par 1 antibody positive mimicking hepatocellular carcinoma.

PubMed

Affleck, Authur; Lyman, William B; Jacobs, W Carl; Livasy, Chad A; Martinie, John B; Iannitti, David A; Vrochides, Dionisios

2018-05-09

The hepatocyte paraffin 1 antibody (Hep Par 1) has a high positive predictive value for differentiating hepatocellular carcinoma from cholangiocarcinoma and metastatic carcinoma. 1 We report a case of metastatic breast cancer to the liver with hepatoid histology and strong positive staining for Hep Par 1 mimicking hepatocellular carcinoma. To our knowledge, primary breast carcinoma staining Hep Par 1 positive has not been reported in the setting of hepatic metastasis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Acute Fulminant Uremic Neuropathy Following Coronary Angiography Mimicking Guillain-Barre Syndrome.

PubMed

Priti, Kumari; Ranwa, Bhanwar

2017-01-01

A 55-year-old diabetic woman suffered a posterior wall ST-elevation myocardial infarction. She developed contrast-induced nephropathy following coronary angiography. Acute fulminant uremic neuropathy was precipitated which initially mimicked Guillan-Barre Syndrome, hence reported.

Moraxella bacteremia. Report of a case resembling gonococcemia with cutaneous manifestations.

PubMed

Lasser, A E; Goldman, E J

1978-05-01

A case of a Moraxella osloensis bacteremia mimicking a case of gonococcemia, complete with cutaneous manifestations, is presented. The importance of confirming all positive smears with inhibitory and noninhibitory culture media is stressed.

Heparin-mimicking multilayer coating on polymeric membrane via LbL assembly of cyclodextrin-based supramolecules.

PubMed

Deng, Jie; Liu, Xinyue; Ma, Lang; Cheng, Chong; Shi, Wenbin; Nie, Chuanxiong; Zhao, Changsheng

2014-12-10

In this study, multifunctional and heparin-mimicking star-shaped supramolecules-deposited 3D porous multilayer films with improved biocompatibility were fabricated via a layer-by-layer (LbL) self-assembly method on polymeric membrane substrates. Star-shaped heparin-mimicking polyanions (including poly(styrenesulfonate-co-sodium acrylate; Star-PSS-AANa) and poly(styrenesulfonate-co-poly(ethylene glycol)methyl ether methacrylate; Star-PSS-EGMA)) and polycations (poly(methyl chloride-quaternized 2-(dimethylamino)ethyl methacrylate; Star-PMeDMA) were first synthesized by atom transfer radical polymerization (ATRP) from β-cyclodextrin (β-CD) based cores. Then assembly of 3D porous multilayers onto polymeric membrane surfaces was carried out by alternating deposition of the polyanions and polycations via electrostatic interaction. The surface morphology and composition, water contact angle, blood activation, and thrombotic potential as well as cell viability for the coated heparin-mimicking films were systematically investigated. The results of surface ATR-FTIR spectra and XPS spectra verified successful deposition of the star-shaped supramolecules onto the biomedical membrane surfaces; scanning electron microscopy (SEM) and atomic force microscopy (AFM) observations revealed that the modified substrate had 3D porous surface morphology, which might have a great biological influence on the biointerface. Furthermore, systematic in vitro investigation of protein adsorption, platelet adhesion, human platelet factor 4 (PF4, indicates platelet activation), activate partial thromboplastin time (APTT), thrombin time (TT), coagulation activation (thrombin-antithrombin III complex (TAT, indicates blood coagulant)), and blood-related complement activation (C3a and C5a, indicates inflammation potential) confirmed that the heparin-mimicking multilayer coated membranes exhibited ultralow blood component activations and excellent hemocompatibility. Meanwhile, after surface coating

Using Multi-Scenario Tsunami Modelling Results combined with Probabilistic Analyses to provide Hazard Information for the South-WestCoast of Indonesia

NASA Astrophysics Data System (ADS)

Zosseder, K.; Post, J.; Steinmetz, T.; Wegscheider, S.; Strunz, G.

2009-04-01

Indonesia is located at one of the most active geological subduction zones in the world. Following the most recent seaquakes and their subsequent tsunamis in December 2004 and July 2006 it is expected that also in the near future tsunamis are likely to occur due to increased tectonic tensions leading to abrupt vertical seafloor alterations after a century of relative tectonic silence. To face this devastating threat tsunami hazard maps are very important as base for evacuation planning and mitigation strategies. In terms of a tsunami impact the hazard assessment is mostly covered by numerical modelling because the model results normally offer the most precise database for a hazard analysis as they include spatially distributed data and their influence to the hydraulic dynamics. Generally a model result gives a probability for the intensity distribution of a tsunami at the coast (or run up) and the spatial distribution of the maximum inundation area depending on the location and magnitude of the tsunami source used. The boundary condition of the source used for the model is mostly chosen by a worst case approach. Hence the location and magnitude which are likely to occur and which are assumed to generate the worst impact are used to predict the impact at a specific area. But for a tsunami hazard assessment covering a large coastal area, as it is demanded in the GITEWS (German Indonesian Tsunami Early Warning System) project in which the present work is embedded, this approach is not practicable because a lot of tsunami sources can cause an impact at the coast and must be considered. Thus a multi-scenario tsunami model approach is developed to provide a reliable hazard assessment covering large areas. For the Indonesian Early Warning System many tsunami scenarios were modelled by the Alfred Wegener Institute (AWI) at different probable tsunami sources and with different magnitudes along the Sunda Trench. Every modelled scenario delivers the spatial distribution of

Dark scenarios

NASA Astrophysics Data System (ADS)

Ahonen, Pasi; Alahuhta, Petteri; Daskala, Barbara; Delaitre, Sabine; Hert, Paul De; Lindner, Ralf; Maghiros, Ioannis; Moscibroda, Anna; Schreurs, Wim; Verlinden, Michiel

In this chapter, we present four "dark scenarios" that highlight the key socio-economic, legal, technological and ethical risks to privacy, identity, trust, security and inclusiveness posed by new AmI technologies. We call them dark scenarios, because they show things that could go wrong in an AmI world, because they present visions of the future that we do not want to become reality. The scenarios expose threats and vulnerabilities as a way to inform policy-makers and planners about issues they need to take into account in developing new policies or updating existing legislation. Before presenting the four scenarios and our analysis of each, we describe the process of how we created the scenarios as well as the elements in our methodology for analysing the scenarios.

Cervical Epidural Abscess Mimicking as Stroke - Report of Two Cases

PubMed Central

Velpula, Jagan Mohana Reddy; Gakhar, Harinder; Sigamoney, Kohilavani; Bommireddy, Rajendra

2014-01-01

Background: Stroke is a common provisional diagnosis in patients presenting to the emergency department (ED) with unilateral neurological deficit. Cervical epidural abscess (CEA) may also present clinically with a unilateral neurological deficit. Objects: To highlight the inherent problems with diagnosing cervical epidural abscess and possible consequences of delay in diagnosis. Case Report: We would like to highlight two cases provisionally diagnosed as stroke. Both cases turned out to be cervical epidural abscesses. The delay in diagnosis and treatment led to suboptimal outcome in both cases. Summary: Cases with suspected stroke who deteriorate while under treatment or whose diagnosis is doubtful should have MRI whole spine in order to avoid potential complications. PMID:24551026

Factors influencing care seeking for a self-defined worst panic attack.

PubMed

Katerndahl, David A

2002-04-01

Only 60 percent of persons who experience panic attacks seek treatment for them, many at the emergency department. The author documented care-seeking behaviors among persons living in the community who had experienced panic attacks and studied determinants of care seeking. In-depth structured interviews were conducted with 97 randomly selected community-dwelling adults who met DSM-III-R criteria for panic attacks. Participants were asked whether they had contemplated using or had actually used medical, alternative, and family sources of care when they had experienced their worst attack. Seventy-seven participants (79 percent) had considered using a general medical or mental health site when they experienced their worst attack. Of these, 50 (52 percent) had actually used such a site. General medical sites were contemplated more often (72 percent of participants) than mental health sites (27 percent), particularly emergency departments (43 percent) and family physicians' offices (34 percent). Other sources, such as friends or family members, alternative sites, and self-treatment, were contemplated less often. Once contemplated, certain sources were readily used, such as ambulances, family members, and self-treatment. Several factors were significantly associated with whether a person contemplated seeking care: access or barriers to treatment, perception of symptoms and of the reasons for the panic attack, and family-related variables. Contemplation and use of a mental health site after a panic attack was rare among the participants in this study. Further study of determinants of care seeking may help explain why persons who experience panic attacks fail to seek treatment or seek treatment from non-mental health sources.

Acute Fulminant Uremic Neuropathy Following Coronary Angiography Mimicking Guillain–Barre Syndrome

PubMed Central

Priti, Kumari; Ranwa, Bhanwar

2017-01-01

A 55-year-old diabetic woman suffered a posterior wall ST-elevation myocardial infarction. She developed contrast-induced nephropathy following coronary angiography. Acute fulminant uremic neuropathy was precipitated which initially mimicked Guillan–Barre Syndrome, hence reported. PMID:28706599

Imaging of Posttraumatic Arthritis, Avascular Necrosis, Septic Arthritis, Complex Regional Pain Syndrome, and Cancer Mimicking Arthritis.

PubMed

Rupasov, Andrey; Cain, Usa; Montoya, Simone; Blickman, Johan G

2017-09-01

This article focuses on the imaging of 5 discrete entities with a common end result of disability: posttraumatic arthritis, a common form of secondary osteoarthritis that results from a prior insult to the joint; avascular necrosis, a disease of impaired osseous blood flow, leading to cellular death and subsequent osseous collapse; septic arthritis, an infectious process leading to destructive changes within the joint; complex regional pain syndrome, a chronic limb-confined painful condition arising after injury; and cases of cancer mimicking arthritis, in which the initial findings seem to represent arthritis, despite a more insidious cause. Copyright © 2017 Elsevier Inc. All rights reserved.

Imbibition dynamics on surfaces of legs of a small animal and on artificial surfaces mimicking them

NASA Astrophysics Data System (ADS)

Tani, Marie; Ishii, Daisuke; Ito, Shuto; Hariyama, Takahiko; Shimomura, Masatsugu; Okumura, Ko

2014-03-01

Recently, imbibition of textured surfaces covered with homogeneous micro-pillar arrays has been actively studied partly because of the potential for transport of a small amount of liquids. In most cases, the dynamics is described by the Washburn law, in which the imbibition distance scales with the square root of elapsed time, while a different scaling law has been recently found. In this study, we studied imbibition on legs of a small animal that absorbs water via its legs to find yet another scaling law. Furthermore, imbibition of artificial surfaces mimicking the leg surface was found to be described well by a composite theory.

Analysis of JT-60SA operational scenarios

NASA Astrophysics Data System (ADS)

Garzotti, L.; Barbato, E.; Garcia, J.; Hayashi, N.; Voitsekhovitch, I.; Giruzzi, G.; Maget, P.; Romanelli, M.; Saarelma, S.; Stankiewitz, R.; Yoshida, M.; Zagórski, R.

2018-02-01

Reference scenarios for the JT-60SA tokamak have been simulated with one-dimensional transport codes to assess the stationary state of the flat-top phase and provide a profile database for further physics studies (e.g. MHD stability, gyrokinetic analysis) and diagnostics design. The types of scenario considered vary from pulsed standard H-mode to advanced non-inductive steady-state plasmas. In this paper we present the results obtained with the ASTRA, CRONOS, JINTRAC and TOPICS codes equipped with the Bohm/gyro-Bohm, CDBM and GLF23 transport models. The scenarios analysed here are: a standard ELMy H-mode, a hybrid scenario and a non-inductive steady state plasma, with operational parameters from the JT-60SA research plan. Several simulations of the scenarios under consideration have been performed with the above mentioned codes and transport models. The results from the different codes are in broad agreement and the main plasma parameters generally agree well with the zero dimensional estimates reported previously. The sensitivity of the results to different transport models and, in some cases, to the ELM/pedestal model has been investigated.

Neoplastic stomach lesions and their mimickers: spectrum of imaging manifestations

PubMed Central

Virmani, Vivek; Sethi, Vineeta; Fraser-Hill, Margret; Fasih, Najla; Kielar, Ania

2012-01-01

Abstract This review illustrates a wide spectrum of gastric neoplasms with emphasis on imaging findings helpful in characterizing various gastric neoplasms. Both the malignant and benign neoplasms along with focal gastric masses mimicking tumour are illustrated. Moreover, imaging clues to reach an accurate diagnosis are emphasized. PMID:22935192

Facilitating Interdisciplinary Work: Using Quality Assessment to Create Common Ground

ERIC Educational Resources Information Center

Oberg, Gunilla

2009-01-01

Newcomers often underestimate the challenges of interdisciplinary work and, as a rule, do not spend sufficient time to allow them to overcome differences and create common ground, which in turn leads to frustration, unresolved conflicts, and, in the worst case scenario, discontinued work. The key to successful collaboration is to facilitate the…

The Value of CCS under Current Policy Scenarios: NDCs and Beyond

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

Davidson, Casie L.; Dahowski, Robert T.; McJeon, Haewon C.

This paper describes preliminary results of analysis using the Global Change Assessment Model (GCAM) to evaluate the potential role of CCS in addressing emissions reduction targets. Scenarios are modelled using the Paris-Increased Ambition (PIA) case developed by Fawcett et al. (2015), and a more aggressive Paris Two-Degree Ambition (P2A) case. Both cases are based upon nationally determined contributions (NDCs) agreed to at the UNFCCC Conference of Parties (COP-21) in December 2015, coupled with additional mitigation effort beyond the 2030 Paris timeframe, through the end of the century. Analysis of CCS deployment and abatement costs under both policy scenarios suggests that,more » as modelled, having CCS in the technological portfolio could reduce the global cost of addressing emissions reduction targets specified under the policy scenario by trillions of dollars, primarily by enabling a smoother and lower-cost transition to next-generation technologies. Through the end of the century, total global abatement costs associated with the PIA case – with five percent annual reduction in emission intensity and reaching 2.2 degrees by 2100 – are reduced by $15 trillion USD in the scenario where CCS is available to deploy by 2025 and remains available through 2100, reflecting a 47 percent savings in the cost of climate change abatement. Under the more ambitious P2A case, with 8 percent annual reduction in emission intensity and reaching 1.9 degrees by 2100, the availability of CCS reduces global abatement costs by $22 trillion USD through the end of the century, again nearly halving the costs of addressing the policy, relative to achieving the same target using an energy portfolio that does not include CCS. PIA and P2A scenarios with CCS result in 1,250 and 1,580 GtCO2 of global geologic storage by the end of the century, respectively.« less

Theoretical assessment of the maximum obtainable power in wireless power transfer constrained by human body exposure limits in a typical room scenario.

PubMed

Chen, Xi Lin; De Santis, Valerio; Umenei, Aghuinyue Esai

2014-07-07

In this study, the maximum received power obtainable through wireless power transfer (WPT) by a small receiver (Rx) coil from a relatively large transmitter (Tx) coil is numerically estimated in the frequency range from 100 kHz to 10 MHz based on human body exposure limits. Analytical calculations were first conducted to determine the worst-case coupling between a homogeneous cylindrical phantom with a radius of 0.65 m and a Tx coil positioned 0.1 m away with the radius ranging from 0.25 to 2.5 m. Subsequently, three high-resolution anatomical models were employed to compute the peak induced field intensities with respect to various Tx coil locations and dimensions. Based on the computational results, scaling factors which correlate the cylindrical phantom and anatomical model results were derived. Next, the optimal operating frequency, at which the highest transmitter source power can be utilized without exceeding the exposure limits, is found to be around 2 MHz. Finally, a formulation is proposed to estimate the maximum obtainable power of WPT in a typical room scenario while adhering to the human body exposure compliance mandates.

Theoretical assessment of the maximum obtainable power in wireless power transfer constrained by human body exposure limits in a typical room scenario

NASA Astrophysics Data System (ADS)

Chen, Xi Lin; De Santis, Valerio; Esai Umenei, Aghuinyue

2014-07-01

In this study, the maximum received power obtainable through wireless power transfer (WPT) by a small receiver (Rx) coil from a relatively large transmitter (Tx) coil is numerically estimated in the frequency range from 100 kHz to 10 MHz based on human body exposure limits. Analytical calculations were first conducted to determine the worst-case coupling between a homogeneous cylindrical phantom with a radius of 0.65 m and a Tx coil positioned 0.1 m away with the radius ranging from 0.25 to 2.5 m. Subsequently, three high-resolution anatomical models were employed to compute the peak induced field intensities with respect to various Tx coil locations and dimensions. Based on the computational results, scaling factors which correlate the cylindrical phantom and anatomical model results were derived. Next, the optimal operating frequency, at which the highest transmitter source power can be utilized without exceeding the exposure limits, is found to be around 2 MHz. Finally, a formulation is proposed to estimate the maximum obtainable power of WPT in a typical room scenario while adhering to the human body exposure compliance mandates.

DENTAL CARE PROFESSIONALS AND CHILD PROTECTION: CASE SCENARIOS AND DISCUSSIONS.

PubMed

Park, Christine

2015-11-01

Any concerns about paediatric patients in general dental practice can be stressful for all involved. Barriers to the reporting of concerns by dental teams are known to exist. Anything that can help ease those situations can only be beneficial. In this article we look at three scenarios that could arise which I am often asked about during teaching and training sessions on safeguarding and child protection for dental teams. They can be discussed at team meetings and training, so that if they are ever to happen for real, everyone will know exactly what to do. This article cannot be completely prescriptive as there will be local variations, but it gives general guidance on issues raised by the scenarios. If you already have a child protection policy in your practice, make sure you know what it says; and if you don't this article will point the way to further resources for developing one.

A multivariate copula-based framework for dealing with hazard scenarios and failure probabilities

NASA Astrophysics Data System (ADS)

Salvadori, G.; Durante, F.; De Michele, C.; Bernardi, M.; Petrella, L.

2016-05-01

This paper is of methodological nature, and deals with the foundations of Risk Assessment. Several international guidelines have recently recommended to select appropriate/relevant Hazard Scenarios in order to tame the consequences of (extreme) natural phenomena. In particular, the scenarios should be multivariate, i.e., they should take into account the fact that several variables, generally not independent, may be of interest. In this work, it is shown how a Hazard Scenario can be identified in terms of (i) a specific geometry and (ii) a suitable probability level. Several scenarios, as well as a Structural approach, are presented, and due comparisons are carried out. In addition, it is shown how the Hazard Scenario approach illustrated here is well suited to cope with the notion of Failure Probability, a tool traditionally used for design and risk assessment in engineering practice. All the results outlined throughout the work are based on the Copula Theory, which turns out to be a fundamental theoretical apparatus for doing multivariate risk assessment: formulas for the calculation of the probability of Hazard Scenarios in the general multidimensional case (d≥2) are derived, and worthy analytical relationships among the probabilities of occurrence of Hazard Scenarios are presented. In addition, the Extreme Value and Archimedean special cases are dealt with, relationships between dependence ordering and scenario levels are studied, and a counter-example concerning Tail Dependence is shown. Suitable indications for the practical application of the techniques outlined in the work are given, and two case studies illustrate the procedures discussed in the paper.

A scenario-planning approach to human resources for health: the case of community pharmacists in Portugal.

PubMed

Gregório, João; Cavaco, Afonso; Velez Lapão, Luís

2014-10-13

Health workforce planning is especially important in a setting of political, social, and economic uncertainty. Portuguese community pharmacists are experiencing such conditions as well as increasing patient empowerment, shortage of primary care physicians, and primary health care reforms. This study aims to design three future scenarios for Portuguese community pharmacists, recognizing the changing environment as an opportunity to develop the role that community pharmacists may play in the Portuguese health system. The community pharmacist scenario design followed a three-stage approach. The first stage comprised thinking of relevant questions to be addressed and definition of the scenarios horizon. The second stage comprised two face-to-face, scenario-building workshops, for which 10 experts from practice and academic settings were invited. Academic and professional experience was the main selection criteria. The first workshop was meant for context analysis and design of draft scenarios, while the second was aimed at scenario analysis and validation. The final scenarios were built merging workshops' information with data collected from scientific literature followed by team consensus. The final stage involved scenario development carried by the authors alone, developing the narratives behind each scenario. Analysis allowed the identification of critical factors expected to have particular influence in 2020 for Portuguese community pharmacists, leading to two critical uncertainties: the "Legislative environment" and "Ability to innovate and develop services". Three final scenarios were built, namely "Pharmacy-Mall", "e-Pharmacist", and "Reorganize or Die". These scenarios provide possible trends for market needs, pharmacist workforce numbers, and expected qualifications to be developed by future professionals. In all scenarios it is clear that the future advance of Portuguese community pharmacists will depend on pharmaceutical services provision beyond medicine

Being Mimicked Increases Prosocial Behavior in 18-Month-Old Infants

ERIC Educational Resources Information Center

Carpenter, Malinda; Uebel, Johanna; Tomasello, Michael

2013-01-01

Most previous research on imitation in infancy has focused on infants' learning of instrumental actions on objects. This study focused instead on the more social side of imitation, testing whether being mimicked increases prosocial behavior in infants, as it does in adults (van Baaren, Holland, Kawakami, & van Knippenberg, 2004).…

A resected case of medullary carcinoma of the ascending colon followed by infarction of the greater omentum mimicking anastomotic leakage.

PubMed

Wakasugi, Masaki; Kono, Hiroshi; Yasuhara, Yumiko; Tsujimura, Naoto; Nakahara, Yujiro; Matsumoto, Takashi; Takemoto, Hiroyoshi; Takachi, Ko; Nishioka, Kiyonori; Yoshida, Kyotaro; Oshima, Satoshi

2017-01-01

Medullary carcinoma is a rare type of colorectal adenocarcinoma, and omental infarction is a rare cause of acute abdomen. A 72-year-old woman underwent single-incision laparoscopic right hemicolectomy for ascending colon cancer. Pathological examination showed a medullary carcinoma (MC) of T4aN0M0 Stage IIB. Her postoperative course was uneventful, and she was discharged on postoperative day (POD) 6. From POD 7, she suffered from fever, and she returned to the hospital on POD 9. Plain computed tomography showed free air beside the anastomotic site around the elevated density of fat tissue and gallbladder wall thickening with a gallstone. Suspecting anastomotic leakage with acute cholecystitis, probe laparotomy was performed. Intraoperative observation confirmed omental infarction with acute cholecystitis, and no leakage was found at the anastomotic site. Therefore, the necrotic part of the greater omentum was resected, and cholecystectomy was performed. She has remained well, with no evidence of recurrent cancer during the 12 months of follow-up without chemotherapy after the surgery for MC of the ascending colon. MC should be distinguished from other more aggressive, non-glandular tumors of the colon because MC appears to have a better survival outcome than undifferentiated colon adenocarcinoma. Omental infarction should be considered in the differential diagnosis of acute abdomen after surgery. A rare case of medullary carcinoma of the ascending colon followed by infarction of the greater omentum mimicking anastomotic leakage is presented.

Mimicking the Moon

NASA Image and Video Library

2014-11-03

When Galileo first observed Venus displaying a crescent phase, he excitedly wrote to Kepler (in anagram) of Venus mimicking the moon-goddess. He would have been delirious with joy to see Saturn and Titan, seen in this image, doing the same thing. More than just pretty pictures, high-phase observations -- taken looking generally toward the Sun, as in this image -- are very powerful scientifically since the way atmospheres and rings transmit sunlight is often diagnostic of compositions and physical states. In this example, Titan's crescent nearly encircles its disk due to the small haze particles high in its atmosphere refracting the incoming light of the distant Sun. This view looks toward the sunlit side of the rings from about 3 degrees above the ringplane. The image was taken in violet light with the Cassini spacecraft wide-angle camera on Aug. 11, 2013. The view was obtained at a distance of approximately 1.1 million miles (1.7 million kilometers) from Saturn and at a Sun-Saturn-spacecraft, or phase, angle of 154 degrees. Image scale is 64 miles (103 kilometers) per pixel. http://photojournal.jpl.nasa.gov/catalog/PIA18291

ASTM F1717 standard for the preclinical evaluation of posterior spinal fixators: can we improve it?

PubMed

La Barbera, Luigi; Galbusera, Fabio; Villa, Tomaso; Costa, Francesco; Wilke, Hans-Joachim

2014-10-01

Preclinical evaluation of spinal implants is a necessary step to ensure their reliability and safety before implantation. The American Society for Testing and Materials reapproved F1717 standard for the assessment of mechanical properties of posterior spinal fixators, which simulates a vertebrectomy model and recommends mimicking vertebral bodies using polyethylene blocks. This set-up should represent the clinical use, but available data in the literature are few. Anatomical parameters depending on the spinal level were compared to published data or measurements on biplanar stereoradiography on 13 patients. Other mechanical variables, describing implant design were considered, and all parameters were investigated using a numerical parametric finite element model. Stress values were calculated by considering either the combination of the average values for each parameter or their worst-case combination depending on the spinal level. The standard set-up represents quite well the anatomy of an instrumented average thoracolumbar segment. The stress on the pedicular screw is significantly influenced by the lever arm of the applied load, the unsupported screw length, the position of the centre of rotation of the functional spine unit and the pedicular inclination with respect to the sagittal plane. The worst-case combination of parameters demonstrates that devices implanted below T5 could potentially undergo higher stresses than those described in the standard suggestions (maximum increase of 22.2% at L1). We propose to revise F1717 in order to describe the anatomical worst case condition we found at L1 level: this will guarantee higher safety of the implant for a wider population of patients. © IMechE 2014.

Cervical Lymphadenopathy Mimicking Angioimmunoblastic T-Cell Lymphoma after Dapsone-Induced Hypersensitivity Syndrome

PubMed Central

Rim, Min Young; Hong, Junshik; Yo, Inku; Park, Hyeonsu; Chung, Dong Hae; Ahn, Jeong Yeal; Park, Jinny; Kim, Yun Soo; Lee, Jae Hoon

2012-01-01

A 36-year-old woman presented with erythematous confluent macules on her whole body with fever and chills associated with jaundice after 8 months of dapsone therapy. Her symptoms had developed progressively, and a physical examination revealed bilateral cervical lymphadenopathy and splenomegaly. Excisional biopsy of a cervical lymph node showed effacement of the normal architecture with atypical lymphoid hyperplasia and proliferation of high endothelial venules compatible with angioimmunoblastic T-cell lymphoma. However, it was assumed that the cervical lymphadenopathy was a clinical manifestation of a systemic hypersensitivity reaction because her clinical course was reminiscent of dapsone-induced hypersensitivity syndrome. A liver biopsy revealed drug-induced hepatitis with no evidence of lymphomatous involvement. Intravenous glucocorticoid was immediately initiated and her symptoms and clinical disease dramatically improved. The authors present an unusual case of cervical lymphadenopathy mimicking angioimmunoblastic T-cell lymphoma as an adverse reaction to dapsone. PMID:23323115

Space Based Intelligence, Surveillance, and Reconnaissance Contribution to Global Strike in 2035

DTIC Science & Technology

2012-02-15

include using high altitude air platforms and airships as a short-term solution, and small satellites with an Operationally Responsive Space (ORS) launch...irreversible threats, along with a worst case scenario. Section IV provides greater detail of the high altitude air platform, airship , and commercial space...Resultantly, the U.S. could use high altitude air platforms, airships , and cyber to complement its space systems in case of denial, degradation, or

The cutaneous manifestations and common mimickers of physical child abuse.

PubMed

Mudd, Shawna S; Findlay, Jeanne S

2004-01-01

The cutaneous manifestations of physical child abuse are some of the most common and easily recognized forms of injury. To make an accurate assessment and diagnosis, it is important to differentiate between inflicted cutaneous injuries and mimickers of physical abuse. Likewise, an understanding of reporting guidelines helps guide practitioners in their decision making.

Ageing of Insensitive DNAN Based Melt-Cast Explosives

DTIC Science & Technology

2014-08-01

diurnal cycle (representative of the MEAO climate). Analysis of the ingredient composition, sensitiveness, mechanical and thermal properties was...first test condition was chosen to provide a worst-case scenario. Analysis of the ingredient composition, theoretical maximum density, sensitiveness...5 4.1.1 ARX-4027 Ingredient Analysis .............................................................. 5 4.1.2 ARX-4028 Ingredient Analysis

Numerical modelling of vehicular pollution dispersion: The application of computational fluid dynamics techniques, a case study

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

Vanderheyden, M.D.; Dajka, S.C.; Sinclair, R.

1997-12-31

Numerical modelling of vehicular emissions using the United States Environmental Protection Agency`s CALINE4 and CAL3QHC dispersion models to predict air quality impacts in the vicinity of roadways is a widely accepted means of evaluating vehicular emissions impacts. The numerical models account for atmospheric dispersion in both open or suburban terrains. When assessing roadways in urban areas with numerous large buildings, however, the models are unable to account for the complex airflows and therefore do not provide satisfactory estimates of pollutant concentrations. Either Wind Tunnel Modelling or Computational Fluid Dynamics (CFD) techniques can be used to assess the impact of vehiclemore » emissions in an urban core. This paper presents a case study where CFD is used to predict worst-case air quality impacts for two development configurations: an existing roadway configuration and a proposed configuration with an elevated pedestrian walkway. In assessing these configurations, worst-case meteorology and traffic conditions are modeled to allow for the prediction of pollutant concentrations due to vehicular emissions on two major streets in Hong Kong. The CFD modelling domain is divided up into thousands of control volumes. Each of these control volumes has a central point called a node where velocities, pollutant concentration and other auxiliary variables are calculated. The region of interest, the pedestrian link and its immediate surroundings, has a denser distribution of nodes in order to give a better resolution of local flow details. Separate CFD modelling runs were undertaken for each development configuration for wind direction increments of 15 degrees. For comparison of the development scenarios, pollutant concentrations (carbon monoxide, nitrogen dioxide and particulate matter) are predicted at up to 99 receptor nodes representing sensitive locations.« less

Scenario-based projections of future urban inundation within a coupled hydrodynamic model framework: A case study in Dongguan City, China

NASA Astrophysics Data System (ADS)

Wu, Xushu; Wang, Zhaoli; Guo, Shenglian; Liao, Weilin; Zeng, Zhaoyang; Chen, Xiaohong

2017-04-01

One major threat to cities at present is the increased inundation hazards owing to changes in climate and accelerated human activity. Future evolution of urban inundation is still an unsolved issue, given large uncertainties in future environmental conditions within urbanized areas. Developing model techniques and urban inundation projections are essential for inundation management. In this paper, we proposed a 2D hydrodynamic inundation model by coupling SWMM and LISFLOOD-FP models, and revealed how future urban inundation would evolve for different storms, sea level rise and subsidence scenarios based on the developed model. The Shiqiao Creek District (SCD) in Dongguan City was used as the case study. The model ability was validated against the June 13th, 2008 inundation event, which occurred in SCD, and proved capable of simulating dynamic urban inundation. Scenario analyses revealed a high degree of consistency in the inundation patterns among different storms, with larger magnitudes corresponding to greater return periods. Inundations across SCD generally vary as a function of storm intensity, but for lowlands or regions without drainage facilities inundations tend to aggravate over time. In riverfronts, inundations would exacerbate with sea level rise or subsidence; however, the inland inundations are seemingly insensitive to both factors. For the combined scenario of 100-yr storm, 0.5 m subsidence and 0.7 m sea level rise, the riverside inundations would occur much in advance, whilst catastrophic inundations sweep across SCD. Furthermore, the optimal low-impact development found for this case study includes 0.2 km2 of permeable pavements, 0.1 km2 of rain barrels and 0.7 km2 of green roofs.

Open Scenario Study: IDA Open Scenario Repository User’s Manual

DTIC Science & Technology

2010-01-01

Thomason, Study Co-Lead Zachary S. Rabold, Sub-Task Lead Ylli Bajraktari Rachel D. Dubin Mary Catherine Flythe Open Scenario Study: IDA Open Scenario... Bajraktari Rachel D. Dubin Mary Catherine Flythe Open Scenario Study: IDA Open Scenario Repository User’s Manual iii Preface This document reports the...vii Appendices A. Identifying Scenario Components...........................................................A-1 B . Acronyms

[Accidental ingestion of dental prostheses; 2 scenarios in the management and outcome. Case reports].

PubMed

Santander-Flores, Selene Artemisa; Mata-Quintero, Carlos Javier; O'Farrill-Anzures, Ricardo; González-Villegas, Paloma; Calvo-Vázquez, Iván; Campos-Serna, Esteban Israel

Foreign body ingestion is the second cause of endoscopic emergency in the elderly, and dentures are the most frequent accidently ingested objects. Once in the stomach, their expulsion can be expected in 4 to 6 days. The treatment is wait and see in asymptomatic patients, but preventive endoscopic removal can also be performed. To present 2 scenarios of the outcome and treatment in patients with foreign body ingestion. Patient under study due to weight loss, with a denture detected by abdominal x-ray, ingested inadvertently a year ago. A laparotomy was required as extraction by colonoscopy failed, due to excessive inflammation. The second case, of 24-hour onset, was due to the ingestion of a partial denture. As duodenal endoscopy extraction was unsuccessful, the patient was kept under observation. When it did not pass the caecum, it was extracted by colonoscopy, with no further complications and shorter hospital stay. Follow-up can be by simple abdominal x-ray, with endoscopic management if there is insufficient progress. In one of our cases, the outcome was unfavourable due to time of ingestion, and endoscopic management was not possible, whereas in the second case colonoscopy was performed early with success. Proper diagnostic and timely treatment mark the difference in the progression and outcome of the ingestion of foreign bodies. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Collective doses to man from dumping of radioactive waste in the Arctic Seas.

PubMed

Nielsen, S P; Iosjpe, M; Strand, P

1997-08-25

A box model for the dispersion of radionuclides in the marine environment covering the Arctic Ocean and the North Atlantic Ocean has been constructed. Collective doses from ingestion pathways have been calculated from unit releases of the radionuclides 3H, 60Co, 63Ni, 90Sr, 129I, 137Cs, 239Pu and 241Am into a fjord on the east coast of NovayaZemlya. The results show that doses for the shorter-lived radionuclides (e.g. 137Cs) are derived mainly from seafood production in the Barents Sea. Doses from the longer-lived radionuclides (e.g. 239Pu) are delivered through marine produce further away from the Arctic Ocean. Collective doses were calculated for two release scenarios, both of which are based on information of the dumping of radioactive waste in the Barents and Kara Seas by the former Soviet Union and on preliminary information from the International Arctic Sea Assessment Programme. A worst-case scenario was assumed according to which all radionuclides in liquid and solid radioactive waste were available for dispersion in the marine environment at the time of dumping. Release of radionuclides from spent nuclear fuel was assumed to take place by direct corrosion of the fuel ignoring the barriers that prevent direct contact between the fuel and the seawater. The second scenario selected assumed that releases of radionuclides from spent nuclear fuel do not occur until after failure of the protective barriers. All other liquid and solid radioactive waste was assumed to be available for dispersion at the time of discharge in both scenarios. The estimated collective dose for the worst-case scenario was about 9 manSv and that for the second scenario was about 3 manSv. In both cases, 137Cs is the radionuclide predicted to dominate the collective doses as well as the peak collective dose rates.

Groundwater contaminations and health perspectives in developing world case study: Gaza Strip.

PubMed

Shomar, B

2011-04-01

Groundwater is the only source of water in the Gaza Strip. The results of a 10-year monitoring program revealed that more than 90% of the available water is not suitable for drinking purposes as a result of elevated chemical contaminants as well as microbiological organisms. The archives of the local hospitals showed catastrophic records on diseases caused by water directly and indirectly. Methemoglobinemia and dental fluorosis are well-known diseases caused by elevated nitrate and fluoride, respectively. Water-borne diseases are currently high and will increase if water, sanitation, and food-control services are not restored, or are allowed to deteriorate further. Heavy use and misuse of banned and prohibited pesticides may show other hard diseases in the near future. Geography, politics, and war combine to make the Gaza Strip a worst-case scenario for water-resource planners. Urgent alternative water resources should be secured and the human health should be given the highest priority.

Scenario-Based Case Study Method and the Functionality of the Section Called "From Production to Consumption" from the Perspective of Primary School Students

ERIC Educational Resources Information Center

Taneri, Ahu

2018-01-01

In this research, the aim was showing the evaluation of students on scenario-based case study method and showing the functionality of the studied section called "from production to consumption". Qualitative research method and content analysis were used to reveal participants' experiences and reveal meaningful relations regarding…

Herniated Thoracic Spleen Mimicking Lung Metastasis on 68Ga-Labeled Prostate-Specific Membrane Antigen PET/CT in a Patient With Prostate Cancer.

PubMed

Malik, Dharmender; Basher, Rajender K; Sood, Apurva; Devana, Sudheer Kumar; Bhattacharya, Anish; Mittal, Bhagwant Rai

2017-06-01

We report a case of clinically asymptomatic patient of prostate cancer who was previously subjected to radical prostatectomy presenting with a rising serum prostate-specific antigen level of 6.6 ng/mL. Whole-body PET/CT with Ga-labeled prostate-specific membrane antigen ligand was performed to assess for disease recurrence, which revealed an intense tracer uptake in a soft tissue mass in left hemithorax mimicking lung metastasis; which later turned out to be splenic tissue.

Programmable Control in Extracellular Matrix-mimicking Polymer Hydrogels.

PubMed

Hof, Kevin S; Bastings, Maartje M C

2017-06-28

The extracellular matrix (ECM) and cells have a reciprocal relationship, one shapes the other and vice versa. One of the main challenges of synthetic material systems for developmental cell culturing, organoid and stem cell work includes the implementation of this reciprocal nature. The largest hurdle to achieve true cell-instructive materials in biomaterials engineering is a lack of spatial and temporal control over material properties and the display of bioactive signals compared to the natural cell environment. ECM-mimicking hydrogels have been developed using a wide range of polymers, assembly and cross-linking strategies. While our synthetic toolbox is larger than nature, often our systems underperform when compared to ECM systems with natural components like Matrigel. Material properties and three-dimensional structure ill-represent the three-dimensional ECM reciprocal nature and ligand presentation is an oversimplified version of the complexity found in nature. We hypothesize that the lack of programmable control in properties and ligand presentation forms the basis of this mismatch in performance and analyze the presence of control in current state of the art ECM-mimicking systems based on covalent, supramolecular and recombinant polymers. We conclude that through combining the dynamics of supramolecular materials, robustness from covalent systems and the programmable spatial control of bio-activation in recombinant ECM materials, the optimal synthetic artificial ECM could be assembled.

Antimicrobial Peptide Mimicking Primary Amine and Guanidine Containing Methacrylamide Copolymers Prepared by Raft Polymerization

PubMed Central

Exley, Sarah E.; Paslay, Lea C.; Sahukhal, Gyan S.; Abel, Brooks A.; Brown, Tyler D.; McCormick, Charles L.; Heinhorst, Sabine; Koul, Veena; Choudhary, Veena; Elasri, Mohamed O.; Morgan, Sarah E.

2016-01-01

Naturally occurring antimicrobial peptides (AMPs) display the ability to eliminate a wide variety of bacteria, without toxicity to the host eukaryotic cells. Synthetic polymers containing moieties mimicking lysine and arginine components found in AMPs have been reported to show effectiveness against specific bacteria, with the mechanism of activity purported to depend on the nature of the amino acid mimic. In an attempt to incorporate the antimicrobial activity of both amino acids into a single water-soluble copolymer, a series of copolymers containing lysine mimicking aminopropyl methacrylamide (APMA) and arginine mimicking guanadinopropyl methacrylamide (GPMA) were prepared via aqueous RAFT polymerization. Copolymers were prepared with varying ratios of the comonomers, with degree of polymerization of 35–40 and narrow molecular weight distribution to simulate naturally occurring AMPs. Antimicrobial activity was determined against Gram-negative and Gram-positive bacteria under conditions with varying salt concentration. Toxicity to mammalian cells was assessed by hemolysis of red blood cells and MTT assays of MCF-7 cells. Antimicrobial activity was observed for APMA homopolymer and copolymers with low concentrations of GPMA against all bacteria tested, with low toxicity toward mammalian cells. PMID:26558609

Adaptive scenarios: a training model for today's public health workforce.

PubMed

Uden-Holman, Tanya; Bedet, Jennifer; Walkner, Laurie; Abd-Hamid, Nor Hashidah

2014-01-01

With the current economic climate, money for training is scarce. In addition, time is a major barrier to participation in trainings. To meet the public health workforce's rising demand for training, while struggling with less time and fewer resources, the Upper Midwest Preparedness and Emergency Response Learning Center has developed a model of online training that provides the public health workforce with individually customized, needs-based training experiences. Adaptive scenarios are rooted in case-based reasoning, a learning approach that focuses on the specific knowledge needed to solve a problem. Proponents of case-based reasoning argue that learners benefit from being able to remember previous similar situations and reusing information and knowledge from that situation. Adaptive scenarios based on true-to-life job performance provide an opportunity to assess skills by presenting the user with choices to make in a problem-solving context. A team approach was used to develop the adaptive scenarios. Storylines were developed that incorporated situations aligning with the knowledge, skills, and attitudes outlined in the Public Health Preparedness and Response Core Competency Model. This article examines 2 adaptive scenarios: "Ready or Not? A Family Preparedness Scenario" and "Responding to a Crisis: Managing Emotions and Stress Scenario." The scenarios are available on Upper Midwest Preparedness and Emergency Response Learning Center's Learning Management System, the Training Source (http://training-source.org). Evaluation data indicate that users' experiences have been positive. Integrating the assessment and training elements of the scenarios so that the training experience is uniquely adaptive to each user is one of the most efficient ways to provide training. The opportunity to provide individualized, needs-based training without having to administer separate assessments has the potential to save time and resources. These adaptive scenarios continue to be

Sports Competition--Integrated or Segregated? Which Is Better for Your Child?

ERIC Educational Resources Information Center

Grosse, Susan J.

2008-01-01

Selecting competitive sports opportunities for a child is a challenging process. Parents have to make the right choices so that their young athletes will have many years of healthy, happy, active experiences. If parents make the wrong choices, their son or daughter will have, at the very least, a few unhappy hours, and worst-case scenario, could…

Designing, Developing and Implementing a Software Tool for Scenario Based Learning

ERIC Educational Resources Information Center

Norton, Geoff; Taylor, Mathew; Stewart, Terry; Blackburn, Greg; Jinks, Audrey; Razdar, Bahareh; Holmes, Paul; Marastoni, Enrique

2012-01-01

The pedagogical value of problem-based and inquiry-based learning activities has led to increased use of this approach in many courses. While scenarios or case studies were initially presented to learners as text-based material, the development of modern software technology provides the opportunity to deliver scenarios as e-learning modules,…

Case Study: Influences of Uncertainties and Traffic Scenario Difficulties in a Human-in-the-Loop Simulation

NASA Technical Reports Server (NTRS)

Bienert, Nancy; Mercer, Joey; Homola, Jeffrey; Morey, Susan; Prevot, Thomas

2014-01-01

This paper presents a case study of how factors such as wind prediction errors and metering delays can influence controller performance and workload in Human-In-The-Loop simulations. Retired air traffic controllers worked two arrival sectors adjacent to the terminal area. The main tasks were to provide safe air traffic operations and deliver the aircraft to the metering fix within +/- 25 seconds of the scheduled arrival time with the help of provided decision support tools. Analyses explore the potential impact of metering delays and system uncertainties on controller workload and performance. The results suggest that trajectory prediction uncertainties impact safety performance, while metering fix accuracy and workload appear subject to the scenario difficulty.

Restless legs syndrome mimicking S1 radiculopathy.

PubMed

Zambelis, Th; Wolgamuth, B R; Papoutsi, S N; Economou, N T

2016-01-01

Α case of a chronic idiopathic form of a severe type of Restless Legs Syndrome (RLS), which developed during pregnancy and persisted after this, misdiagnosed for 34 years as radiculopathy S1, is reported. In spite of the thorough clinical and laboratory investigation, in addition to constant changes of the therapeutic approach, the diagnosis of S1 radiculopathy could not be confirmed, resulting in a chronic clinical course; the latter was characterized by relapses and remissions not attributed or linked in any way to the treatment (various types of). In fact, it was due to a routine workup in a sleep clinic, where the patient was referred because of a coincident chronic insomnia (Restless Legs Syndrome is a known and important cause of insomnia/chronic insomnia), which resulted in a proper diagnosis and treatment of this case. With the use of Restless Legs Syndrome appropriate treatment (Pramipexole 0.18 mg taken at bedtime, a dopaminergic agent and Level A recommended drug for Restless Legs Syndrome) an excellent response and immediate elimination of symptoms was achieved. Restless Legs Syndrome may present with a variety of symptoms (with the most prominent shortly being reported with the acronym URGE: Urge to move the legs usually associated with unpleasant leg sensations, Rest induces symptoms, Getting active brings relief, Evening and night deteriorate symptoms); given the fact that Restless Legs Syndrome presents with a great variety and heterogeneity of symptoms (mostly pain, dysesthesia and paresthesia), which may occur in several other diseases (the so called "RLS mimics"), proper diagnosis of Restless Legs Syndrome usually fails. Restless Legs Syndrome misinterpreted as S1 radiculopathy, to the best of our knowledge, has not been reported yet in the literature. Here, case history, clinical course and common RLS mimics are presented. Different forms of Restless Legs Syndrome manifestations, which are commonly -as in this case- misinterpreted due to their

Does extreme precipitation intensity depend on the emissions scenario?

NASA Astrophysics Data System (ADS)

Pendergrass, Angeline; Lehner, Flavio; Sanderson, Benjamin; Xu, Yangyang

2016-04-01

The rate of increase of global-mean precipitation per degree surface temperature increase differs for greenhouse gas and aerosol forcings, and therefore depends on the change in composition of the emissions scenario used to drive climate model simulations for the remainder of the century. We investigate whether or not this is also the case for extreme precipitation simulated by a multi-model ensemble driven by four realistic emissions scenarios. In most models, the rate of increase of maximum annual daily rainfall per degree global warming in the multi-model ensemble is statistically indistinguishable across the four scenarios, whether this extreme precipitation is calculated globally, over all land, or over extra-tropical land. These results indicate that, in most models, extreme precipitation depends on the total amount of warming and does not depend on emissions scenario, in contrast to mean precipitation.

Finite volume analysis of temperature effects induced by active MRI implants: 2. Defects on active MRI implants causing hot spots.

PubMed

Busch, Martin H J; Vollmann, Wolfgang; Grönemeyer, Dietrich H W

2006-05-26

Active magnetic resonance imaging implants, for example stents, stent grafts or vena cava filters, are constructed as wireless inductively coupled transmit and receive coils. They are built as a resonator tuned to the Larmor frequency of a magnetic resonance system. The resonator can be added to or incorporated within the implant. This technology can counteract the shielding caused by eddy currents inside the metallic implant structure. This may allow getting diagnostic information of the implant lumen (in stent stenosis or thrombosis for example). The electro magnetic rf-pulses during magnetic resonance imaging induce a current in the circuit path of the resonator. A by material fatigue provoked partial rupture of the circuit path or a broken wire with touching surfaces can set up a relatively high resistance on a very short distance, which may behave as a point-like power source, a hot spot, inside the body part the resonator is implanted to. This local power loss inside a small volume can reach (1/4) of the total power loss of the intact resonating circuit, which itself is proportional to the product of the resonator volume and the quality factor and depends as well from the orientation of the resonator with respect to the main magnetic field and the imaging sequence the resonator is exposed to. First an analytical solution of a hot spot for thermal equilibrium is described. This analytical solution with a definite hot spot power loss represents the worst case scenario for thermal equilibrium inside a homogeneous medium without cooling effects. Starting with this worst case assumptions additional conditions are considered in a numerical simulation, which are more realistic and may make the results less critical. The analytical solution as well as the numerical simulations use the experimental experience of the maximum hot spot power loss of implanted resonators with a definite volume during magnetic resonance imaging investigations. The finite volume analysis

Finite volume analysis of temperature effects induced by active MRI implants: 2. Defects on active MRI implants causing hot spots

PubMed Central

Busch, Martin HJ; Vollmann, Wolfgang; Grönemeyer, Dietrich HW

2006-01-01

Background Active magnetic resonance imaging implants, for example stents, stent grafts or vena cava filters, are constructed as wireless inductively coupled transmit and receive coils. They are built as a resonator tuned to the Larmor frequency of a magnetic resonance system. The resonator can be added to or incorporated within the implant. This technology can counteract the shielding caused by eddy currents inside the metallic implant structure. This may allow getting diagnostic information of the implant lumen (in stent stenosis or thrombosis for example). The electro magnetic rf-pulses during magnetic resonance imaging induce a current in the circuit path of the resonator. A by material fatigue provoked partial rupture of the circuit path or a broken wire with touching surfaces can set up a relatively high resistance on a very short distance, which may behave as a point-like power source, a hot spot, inside the body part the resonator is implanted to. This local power loss inside a small volume can reach ¼ of the total power loss of the intact resonating circuit, which itself is proportional to the product of the resonator volume and the quality factor and depends as well from the orientation of the resonator with respect to the main magnetic field and the imaging sequence the resonator is exposed to. Methods First an analytical solution of a hot spot for thermal equilibrium is described. This analytical solution with a definite hot spot power loss represents the worst case scenario for thermal equilibrium inside a homogeneous medium without cooling effects. Starting with this worst case assumptions additional conditions are considered in a numerical simulation, which are more realistic and may make the results less critical. The analytical solution as well as the numerical simulations use the experimental experience of the maximum hot spot power loss of implanted resonators with a definite volume during magnetic resonance imaging investigations. The finite

The Scenario Model Intercomparison Project (ScenarioMIP) for CMIP6

DOE PAGES

O'Neill, Brian C.; Tebaldi, Claudia; van Vuuren, Detlef P.; ...

2016-09-28

Projections of future climate change play a fundamental role in improving understanding of the climate system as well as characterizing societal risks and response options. The Scenario Model Intercomparison Project (ScenarioMIP) is the primary activity within Phase 6 of the Coupled Model Intercomparison Project (CMIP6) that will provide multi-model climate projections based on alternative scenarios of future emissions and land use changes produced with integrated assessment models. Here, we describe ScenarioMIP's objectives, experimental design, and its relation to other activities within CMIP6. The ScenarioMIP design is one component of a larger scenario process that aims to facilitate a wide rangemore » of integrated studies across the climate science, integrated assessment modeling, and impacts, adaptation, and vulnerability communities, and will form an important part of the evidence base in the forthcoming Intergovernmental Panel on Climate Change (IPCC) assessments. Furthermore, it will provide the basis for investigating a number of targeted science and policy questions that are especially relevant to scenario-based analysis, including the role of specific forcings such as land use and aerosols, the effect of a peak and decline in forcing, the consequences of scenarios that limit warming to below 2°C, the relative contributions to uncertainty from scenarios, climate models, and internal variability, and long-term climate system outcomes beyond the 21st century. In order to serve this wide range of scientific communities and address these questions, a design has been identified consisting of eight alternative 21st century scenarios plus one large initial condition ensemble and a set of long-term extensions, divided into two tiers defined by relative priority. Some of these scenarios will also provide a basis for variants planned to be run in other CMIP6-Endorsed MIPs to investigate questions related to specific forcings. Harmonized, spatially explicit

The Scenario Model Intercomparison Project (ScenarioMIP) for CMIP6

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

O'Neill, Brian C.; Tebaldi, Claudia; van Vuuren, Detlef P.

2016-01-01

Projections of future climate change play a fundamental role in improving understanding of the climate system as well as characterizing societal risks and response options. The Scenario Model Intercomparison Project (ScenarioMIP) is the primary activity within Phase 6 of the Coupled Model Intercomparison Project (CMIP6) that will provide multi-model climate projections based on alternative scenarios of future emissions and land use changes produced with integrated assessment models. In this paper, we describe ScenarioMIP's objectives, experimental design, and its relation to other activities within CMIP6. The ScenarioMIP design is one component of a larger scenario process that aims to facilitate amore » wide range of integrated studies across the climate science, integrated assessment modeling, and impacts, adaptation, and vulnerability communities, and will form an important part of the evidence base in the forthcoming Intergovernmental Panel on Climate Change (IPCC) assessments. At the same time, it will provide the basis for investigating a number of targeted science and policy questions that are especially relevant to scenario-based analysis, including the role of specific forcings such as land use and aerosols, the effect of a peak and decline in forcing, the consequences of scenarios that limit warming to below 2 °C, the relative contributions to uncertainty from scenarios, climate models, and internal variability, and long-term climate system outcomes beyond the 21st century. To serve this wide range of scientific communities and address these questions, a design has been identified consisting of eight alternative 21st century scenarios plus one large initial condition ensemble and a set of long-term extensions, divided into two tiers defined by relative priority. Some of these scenarios will also provide a basis for variants planned to be run in other CMIP6-Endorsed MIPs to investigate questions related to specific forcings. Harmonized, spatially

The Scenario Model Intercomparison Project (ScenarioMIP) for CMIP6

NASA Astrophysics Data System (ADS)

O'Neill, Brian C.; Tebaldi, Claudia; van Vuuren, Detlef P.; Eyring, Veronika; Friedlingstein, Pierre; Hurtt, George; Knutti, Reto; Kriegler, Elmar; Lamarque, Jean-Francois; Lowe, Jason; Meehl, Gerald A.; Moss, Richard; Riahi, Keywan; Sanderson, Benjamin M.

2016-09-01

Projections of future climate change play a fundamental role in improving understanding of the climate system as well as characterizing societal risks and response options. The Scenario Model Intercomparison Project (ScenarioMIP) is the primary activity within Phase 6 of the Coupled Model Intercomparison Project (CMIP6) that will provide multi-model climate projections based on alternative scenarios of future emissions and land use changes produced with integrated assessment models. In this paper, we describe ScenarioMIP's objectives, experimental design, and its relation to other activities within CMIP6. The ScenarioMIP design is one component of a larger scenario process that aims to facilitate a wide range of integrated studies across the climate science, integrated assessment modeling, and impacts, adaptation, and vulnerability communities, and will form an important part of the evidence base in the forthcoming Intergovernmental Panel on Climate Change (IPCC) assessments. At the same time, it will provide the basis for investigating a number of targeted science and policy questions that are especially relevant to scenario-based analysis, including the role of specific forcings such as land use and aerosols, the effect of a peak and decline in forcing, the consequences of scenarios that limit warming to below 2 °C, the relative contributions to uncertainty from scenarios, climate models, and internal variability, and long-term climate system outcomes beyond the 21st century. To serve this wide range of scientific communities and address these questions, a design has been identified consisting of eight alternative 21st century scenarios plus one large initial condition ensemble and a set of long-term extensions, divided into two tiers defined by relative priority. Some of these scenarios will also provide a basis for variants planned to be run in other CMIP6-Endorsed MIPs to investigate questions related to specific forcings. Harmonized, spatially explicit

Lymphocytic mastopathy mimicking breast malignancy: a case report*

PubMed Central

Campos, Gabriela Couto Possati; Castro, Melissa Vieira Koch e; de Mattos, Viviane Ferreira Esteves; Pinto, Laura Zaiden Ferreira e; Boechat, Marcia Cristina Bastos; dos Santos, Alair Augusto Sarmet Moreira Damas

2014-01-01

Lymphocytic mastopathy affects both young and middle-aged women and is frequently associated with autoimmune diseases. Diagnosis is done by associating clinical (breast tissue thickening or hardened breast lump), radiological (increased breast density, presence of mass and calcifications), sonographic (nodule with posterior acoustic shadowing), histopathological (fibrosis and lymphocytic infiltrate) and immunohistochemical findings. Lymphocytic mastopathy is a benign entity that may mimic carcinoma. The authors report the case of a patient with lymphocytic mastopathy. PMID:25741094

Willingness to pay for midwife-endorsed product: An Australian best-worst study.

PubMed

Lahtinen, Ville; Rundle-Thiele, Sharyn; Adamsen, Jannie Mia

2016-01-01

This article examined the impact of midwife endorsement on stated choice preferences in one of the highest volume baby care product categories, diapers. An online survey was conducted testing 12 alternatives of which six were midwife endorsed. A total of 215 responses were analyzed using best-worst and multinomial logit modeling. Results indicate that package size, price, and brand are more sensitive predictors of stated choice preferences than midwife endorsement. Respondents were willing to pay 2.3% more for a diaper that was endorsed by midwives. These findings suggest that midwife endorsement should be pursued by health marketers.

Changes in land cover and carbon emissions to 2050 from African tropical forests using policy scenarios

NASA Astrophysics Data System (ADS)

Laporte, N.; Galford, G. L.; Soares Filho, B. S.

2011-12-01

Africa has the second largest block of rainforest in the world, next to the Amazon basin, with the majority of the carbon being stored in the dense humid forests of the Democratic Republic of the Congo (DRC). Historically, political instability in the DRC kept development and deforestation low, with primary forest uses being extensive logging and small scale agriculture. In the last decade, political stability has opened the country to foreign investment in forested areas, largely for industrial-scale oil palm plantations and more recently to rice production. The DRC ranks worst on the IFPRI global hunger index, scoring "extremely serious" based on the proportion of undernourished population, prevalence of underweight in children under 5 and the mortality rates of children under 5. In fact, DRC saw its hunger score increase (worsen) from 1990 to 2010, with a 66% gain compared to the other 8 worsening countries increasing only 21% or less. This is a critical time for policy in the DRC, where business-as-usual (relatively low deforestation rates) is unlikely to continue given today's relative political stability and economic stabilization compared to the 1990s. The country must examine options for forest conservation in balance with foreign investment for use of forest resources, national development of rural livelihoods and domestic production of food. Here we present deforestation trajectories simulated through the year 2050 under a set of scenarios. The scenarios consider the relative carbon emissions from business-as-usual (no new policy), conservation (policy favoring protection and enforcement for forest areas), and a food security scenario (favoring clearing for industrial agriculture, extractive timber resources and development of new agricultural areas). Carbon emissions for each scenario are estimated with a coupled bookkeeping model. These scenarios are not predictive of the future, rather, they are meant to provide an understanding of the outcomes of

Systemic lupus erythematosus (SLE) pneumonitis mimicking swine influenza pneumonia during the swine influenza (H1N1) pandemic.

PubMed

Cunha, Burke A; Syed, Uzma; Mickail, Nardeen

2011-01-01

We present a young woman with a negative medical history who presented with acute systemic lupus erythematosus (SLE) pneumonitis mimicking swine influenza (H1N1) pneumonia. Because this case occurred during the H1N1 pandemic, the initial diagnostic impression was of H1N1 pneumonia. Although her clinical and laboratory findings were consistent with the diagnosis of H1N1 pneumonia, e.g., fever, sore throat, dry cough, arthralgias, myalgias, thrombocytopenia, relative lymphopenia, and elevated serum transaminases, some findings suggested an alternate diagnosis, e.g., leukopenia, a highly elevated erythrocyte sedimentation rate, highly elevated serum ferritin levels, elevated antinuclear antibody (ANA) levels, and double-stranded (DS) DNA titers. Her chest x-ray showed an accentuation of basilar lung markings, with a small pleural effusion similar to the chest x-ray findings of early H1N1 pneumonia. Initially, her headaches were thought to be related to central nervous system manifestations of H1N1. After laboratory test results demonstrated elevated ANA and anti-DS DNA titers, she was diagnosed with acute SLE pneumonitis. The take-home lesson for clinicians is that other infectious diseases, e.g., human parainfluenza virus or Legionnaires' disease, can mimic H1N1 pneumonia during an influenza pandemic. Excluding asthma, congestive heart failure, exacerbations of acute bronchitis, chronic obstructive pulmonary disorder, and pulmonary interstitial disease, noninfectious mimics of H1N1 are extremely rare. To the best of our knowledge, this is the first reported case of de novo SLE pneumonitis mimicking H1N1 pneumonia during the swine influenza pandemic. Copyright © 2011 Elsevier Inc. All rights reserved.

Toxoplasmosis presenting as a swelling in the axillary tail of the breast and a palpable axillary lymph node mimicking malignancy: a case report.

PubMed

Siriwardana, Hp Priyantha; Teare, Louise; Kamel, Dia; Inwang, E Reggie

2011-08-04

Lymphadenopathy is a common finding in toxoplasmosis. A breast mass due to toxoplasmosis is very rare, and only a few cases have been reported. We present a case of toxoplasmosis that presented as a swelling in the axillary tail of the breast with a palpable axillary lymph node which mimicked breast cancer. A 45-year-old otherwise healthy Caucasian woman presented with a lump on the lateral aspect of her left breast. Her mother had breast cancer that was diagnosed at the age of 66 years. During an examination, we discovered that our patient had a discrete, firm lump in the axillary tail of her left breast and an enlarged, palpable lymph node in her left axilla. Her right breast and axilla were normal. The clinical diagnosis was malignancy in the left breast. Ultrasound and mammographic examinations of her breast suggested a pathological process but were not conclusive. She had targeted fine-needle aspiration cytology (FNAC) and core biopsy of the lesions. FNAC was indeterminate (C3) but suggested a possibility of toxoplasmosis. The core biopsy was not suggestive of malignancy but showed granulomatous inflammation. She had a wide local excision of the breast lump and an axillary lymph node biopsy. Histopathology and immunohistochemical studies excluded carcinoma or lymphoma but suggested the possibility of intramammary and axillary toxoplasmic lymphadenopathy. The results of Toxoplasma gondii IgM and IgG serology tests were positive, supporting a diagnosis of toxoplasmosis. Toxoplasmosis rarely presents as a pseudotumor of the breast. FNAC and histology are valuable tools for a diagnosis of toxoplasmosis, and serology is an important adjunct for confirmation.

The Effectiveness of Remotely Piloted Aircraft in a Permissive Hunter-Killer Scenario

DTIC Science & Technology

2014-01-01

APY -8, Lynx Block 20. 20 Specific Scenario In our scenario, prior intelligence has indicated that the target is likely to emerge from hiding...an additional 5 sec. must be taken to transfer (digitally) the target geolocation data to the strike platform. (Unlike in Case 1, it was not

Mr. Ngao's proposal: introducing client fees. Case scenarios for training and group discussion.

PubMed

1992-01-01

In this supplement to the issue of "The Family Planning Manager" devoted to fees, a hypothetical case scenario is presented to illustrate the introduction of client fees to a family planning program. Managers are instructed to prepare a plan that includes the necessary information for deciding what to charge for, who to charge, and how much to charge; identifies the administrative changes involved in charging fees; and outlines steps that clinic managers should take before introducing client fees. Decisions should be based on factors such as the objectives of fee charging, client willingness and ability to pay, client perception of the quality of current services, services for which clients would be most willing to pay, estimated cost of providing services, and the cost of new administrative procedures inherent in a fee-for-service approach. Administrative procedures for collecting, handling, and accounting for cash; reporting income and expenses; and implementing a fair and flexible system of waivers and exemptions must be defined. Clients should be informed well in advance of fee introduction, and staff trained to manage potential client complaints.

What's good and bad about contraceptive products?: a best-worst attribute experiment comparing the values of women consumers and GPs.

PubMed

Knox, Stephanie A; Viney, Rosalie C; Street, Deborah J; Haas, Marion R; Fiebig, Denzil G; Weisberg, Edith; Bateson, Deborah

2012-12-01

In the past decade, the range of contraceptives available has increased dramatically. There are limited data on the factors that determine women's choices on contraceptive alternatives or what factors providers consider most important when recommending contraceptive products to women. Our objectives were to compare women's (consumers') preferences and GPs' (providers') views in relation to existing and new contraceptive methods, and particularly to examine what factors increase the acceptability of different contraceptive products. A best-worst attribute stated-choice experiment was completed online. Participants (Australian women of reproductive age and Australian GPs) completed questions on 16 contraceptive profiles. 200 women of reproductive age were recruited through a commercial panel. GPs from all states of Australia were randomly sampled and approached by phone; 162 GPs agreed to participate. Participants chose the best and worst attribute levels of hypothetical but realistic prescribed contraceptive products. Best and worst choices were modelled using multinomial logit and product features were ranked from best to worst according to the size of model coefficients. The most attractive feature of the contraceptive products for both GPs and women consumers were an administration frequency of longer than 1 year and light or no bleeding. Women indicated that the hormonal vaginal ring was the least attractive mode of administration. Women and GPs agree that longer-acting methods with less bleeding are important features in preferred methods of contraception; however, women are also attracted to products involving less invasive modes of administration. While the vaginal ring may fill the niche in Australia for a relatively non-invasive, moderately long-acting and effective contraceptive, the results of this study indicate that GPs will need to promote the benefits of the vaginal ring to overcome negative perceptions about this method among women who may benefit

Dying scenarios improve recall as much as survival scenarios.

PubMed

Burns, Daniel J; Hart, Joshua; Kramer, Melanie E

2014-01-01

Merely contemplating one's death improves retention for entirely unrelated material learned subsequently. This "dying to remember" effect seems conceptually related to the survival processing effect, whereby processing items for their relevance to being stranded in the grasslands leads to recall superior to that of other deep processing control conditions. The present experiments directly compared survival processing scenarios with "death processing" scenarios. Results showed that when the survival and dying scenarios are closely matched on key dimensions, and possible congruency effects are controlled, the dying and survival scenarios produced equivalently high recall levels. We conclude that the available evidence (cf. Bell, Roer, & Buchner, 2013; Klein, 2012), while not definitive, is consistent with the possibility of overlapping mechanisms.

Structure-Based Design of Inhibitors of Protein–Protein Interactions: Mimicking Peptide Binding Epitopes

PubMed Central

Pelay-Gimeno, Marta; Glas, Adrian; Koch, Oliver; Grossmann, Tom N

2015-01-01

Protein–protein interactions (PPIs) are involved at all levels of cellular organization, thus making the development of PPI inhibitors extremely valuable. The identification of selective inhibitors is challenging because of the shallow and extended nature of PPI interfaces. Inhibitors can be obtained by mimicking peptide binding epitopes in their bioactive conformation. For this purpose, several strategies have been evolved to enable a projection of side chain functionalities in analogy to peptide secondary structures, thereby yielding molecules that are generally referred to as peptidomimetics. Herein, we introduce a new classification of peptidomimetics (classes A–D) that enables a clear assignment of available approaches. Based on this classification, the Review summarizes strategies that have been applied for the structure-based design of PPI inhibitors through stabilizing or mimicking turns, β-sheets, and helices. PMID:26119925

Evidence and future scenarios of a low-carbon energy transition in Central America: a case study in Nicaragua

NASA Astrophysics Data System (ADS)

Barido, Diego Ponce de Leon; Johnston, Josiah; Moncada, Maria V.; Callaway, Duncan; Kammen, Daniel M.

2015-10-01

The global carbon emissions budget over the next decades depends critically on the choices made by fast-growing emerging economies. Few studies exist, however, that develop country-specific energy system integration insights that can inform emerging economies in this decision-making process. High spatial- and temporal-resolution power system planning is central to evaluating decarbonization scenarios, but obtaining the required data and models can be cost prohibitive, especially for researchers in low, lower-middle income economies. Here, we use Nicaragua as a case study to highlight the importance of high-resolution open access data and modeling platforms to evaluate fuel-switching strategies and their resulting cost of power under realistic technology, policy, and cost scenarios (2014-2030). Our results suggest that Nicaragua could cost-effectively achieve a low-carbon grid (≥80%, based on non-large hydro renewable energy generation) by 2030 while also pursuing multiple development objectives. Regional cooperation (balancing) enables the highest wind and solar generation (18% and 3% by 2030, respectively), at the least cost (US127 MWh-1). Potentially risky resources (geothermal and hydropower) raise system costs but do not significantly hinder decarbonization. Oil price sensitivity scenarios suggest renewable energy to be a more cost-effective long-term investment than fuel oil, even under the assumption of prevailing cheap oil prices. Nicaragua’s options illustrate the opportunities and challenges of power system decarbonization for emerging economies, and the key role that open access data and modeling platforms can play in helping develop low-carbon transition pathways.

Spontaneous motor entrainment to music in multiple vocal mimicking species.

PubMed

Schachner, Adena; Brady, Timothy F; Pepperberg, Irene M; Hauser, Marc D

2009-05-26

The human capacity for music consists of certain core phenomena, including the tendency to entrain, or align movement, to an external auditory pulse [1-3]. This ability, fundamental both for music production and for coordinated dance, has been repeatedly highlighted as uniquely human [4-11]. However, it has recently been hypothesized that entrainment evolved as a by-product of vocal mimicry, generating the strong prediction that only vocal mimicking animals may be able to entrain [12, 13]. Here we provide comparative data demonstrating the existence of two proficient vocal mimicking nonhuman animals (parrots) that entrain to music, spontaneously producing synchronized movements resembling human dance. We also provide an extensive comparative data set from a global video database systematically analyzed for evidence of entrainment in hundreds of species both capable and incapable of vocal mimicry. Despite the higher representation of vocal nonmimics in the database and comparable exposure of mimics and nonmimics to humans and music, only vocal mimics showed evidence of entrainment. We conclude that entrainment is not unique to humans and that the distribution of entrainment across species supports the hypothesis that entrainment evolved as a by-product of selection for vocal mimicry.