Science.gov

Sample records for primary system loca

  1. System code requirements for SBWR LOCA predictions

    SciTech Connect

    Rohatgi, U.S.; Slovik, G.; Kroeger, P.

    1994-12-31

    The simplified boiling water reactor (SBWR) is the latest design in the family of boiling water reactors (BWRs) from General Electric. The concept is based on many innovative, passive, safety systems that rely on naturally occurring phenomena, such as natural circulation, gravity flows, and condensation. Reliability has been improved by eliminating active systems such as pumps and valves. The reactor pressure vessel (RPV) is connected to heat exchangers submerged in individual water tanks, which are open to atmosphere. These heat exchanger, or isolation condensers (ICs), provide a heat sink to reduce the RPV pressure when isolated. The RPV is also connected to three elevated tanks of water called the gravity-driven cooling system (GDCS). During a loss-of-coolant accident (LOCA), the RPV is depressurized by the automatic depressurization system (ADS), allowing the gravity-driven flow from the GDCS tanks. The containment pressure is controlled by a passive containment cooling system (PCCS) and suppression pool. Similarly, there are new plant protection systems in the SBWR, such as fine-motion control rod drive, passive standby liquid control system, and the automatic feedwater runback system. These safety and plant protection systems respond to phenomena that are different from previous BWR designs. System codes must be upgraded to include models for the phenomena expected during transients for the SBWR.

  2. The LOCA performance of the AP600 passive safety systems

    SciTech Connect

    Kemper, R.M.; Hochreiter, L.E.; Takeuchi, K.; Garner, D.C.; Nguyen, S.B.; Cunningham, J.P. ); Lee, S.N.K.; Tehrani, A.A.K.; Yang, H.; Bratby, P.A.W. )

    1992-01-01

    The AP600 is an advanced passive safeguards pressurized water reactor (PWR) that is being developed jointly by Westinghouse Electric Corporation, the U.S. Department of Energy, and the Electrical Power Research Institute. The plant has a thermal rating of 1940 MW (thermal) [600 MW(electric)] and has been designed with passive safeguard systems that utilize gravity feed injection rather than safety-grade active pumps and equipment. Calculations performed for a range of break sizes used locations to find the worst set of conditions for depressurizing the reactor coolant system. The main criterion was system inventory such that the core remained covered. The resulting break spectrum study indicates only that the double-ended guillotine shear of the direct vessel injection line (a .68-in. line that feeds the emergency core coolant flow into the vessel) resulted in a momentary core uncover. For all other small-break cases, the core remained covered as the reactor coolant system depressurized. The passive safety systems provided sufficient mass flow to the reactor vessel such that even under the more conservative Appendix K assumptions, the core remained covered and in a coolable state. The LOCA analysis performed for the AP600 confirms that passive safety systems can provide the core cooling necessary to meet the requirements of 10CFR50.46 with ample margin.

  3. Code System for Supercritical Water Cooled Reactor LOCA Analysis.

    Energy Science and Technology Software Center (ESTSC)

    1999-10-13

    Version 00 The new SCRELA code was developed to analyze the LOCA of the supercritical water cooled reactor. Since the currently available LWR codes for LOCA analysis could not analyze the significant differences in reactor characteristics between the supercritical-water cooled reactor and the current LWR, the first objective of this code development was to analyze the uniqueness of this reactor. The behavior of the supercritical water in the blowdown phase and the reflood phase ismore » modeled.« less

  4. K-Reactor emergency core coolant system response during a double-ended guillotine break LOCA

    SciTech Connect

    Rodriguez, S.B. )

    1990-01-01

    This paper describes the modeling and benchmarking of the Savannah River Site K-Reactor emergency core coolant system (ECCS), using the Transient Reactor Analysis Code (TRAC). The ECCS model was benchmarked against plant data obtained from various ECCS configurations. Next, the benchmarked model was used to simulate various loss-of-coolant accidents (LOCAs). The adequacy of the model's behavior during the LOCAs was then analyzed. The K-Reactor ECCS model can adequately simulate a wide variety of system configurations. The TRAC output compared favorably with the plant data for the different ECCS configurations. The results of the plenum-inlet double-ended guillotine break LOCA simulation showed the ECCS protected the core.

  5. User's guide for the PWR LOCA analysis capability of the WRAP-EM system

    SciTech Connect

    Beranek, F; Gregory, M V

    1980-02-01

    The Water Reactor Analysis Package (WRAP) has been expanded to provide the capability to analyze loss-of-coolant accidents (LOCAs) in both pressurized water reactors (PWRs) and boiling water reactors (BWRs) by using evaluation models (EMs). The input specifications for modules in the WRAP-EM system are presented in this document along with the JOSHUA input templates. This document, along with the WRAP user's guide, provides a step-by-step procedure for setting up a PWR data base for the WRAP-EM system. 12 refs.

  6. Continuation and bifurcation analysis of large-scale dynamical systems with LOCA.

    SciTech Connect

    Salinger, Andrew Gerhard; Phipps, Eric Todd; Pawlowski, Roger Patrick

    2010-06-01

    Dynamical systems theory provides a powerful framework for understanding the behavior of complex evolving systems. However applying these ideas to large-scale dynamical systems such as discretizations of multi-dimensional PDEs is challenging. Such systems can easily give rise to problems with billions of dynamical variables, requiring specialized numerical algorithms implemented on high performance computing architectures with thousands of processors. This talk will describe LOCA, the Library of Continuation Algorithms, a suite of scalable continuation and bifurcation tools optimized for these types of systems that is part of the Trilinos software collection. In particular, we will describe continuation and bifurcation analysis techniques designed for large-scale dynamical systems that are based on specialized parallel linear algebra methods for solving augmented linear systems. We will also discuss several other Trilinos tools providing nonlinear solvers (NOX), eigensolvers (Anasazi), iterative linear solvers (AztecOO and Belos), preconditioners (Ifpack, ML, Amesos) and parallel linear algebra data structures (Epetra and Tpetra) that LOCA can leverage for efficient and scalable analysis of large-scale dynamical systems.

  7. Large Break LOCA Safety Injection Sensitivity for a CE/ABB System 80+ PWR

    SciTech Connect

    Pottorf, J.; Bajorek, S.M.

    2002-07-01

    A WCOBRA/TRAC model of an evolutionary pressurized water reactor with direct vessel injection was constructed using publicly available information and a hypothetical double-ended guillotine break of a cold leg pipe was simulated. The model is an approximation of a ABB/Combustion Engineering System 80+ pressurized water reactor (PWR). WCOBRA/TRAC is the thermal-hydraulics code approved by the U.S. Nuclear Regulatory Commission for use in realistic large break LOCA analyses of Westinghouse 3- and 4-loop PWRs and the AP600 passive design. The AP600 design uses direct vessel injection, and the applicability of WCOBRA/TRAC to such designs is supported by comparisons to appropriate test data. This study extends the application of WCOBRA/TRAC to the investigation of the predicted behavior of direct vessel injection in an evolutionary design. A series of large break LOCA simulations were performed assuming a core power of 3914 MWt, and Technical Specification limits of 2.5 on total peaking factor and 1.7 on hot channel enthalpy rise factor. Two cladding temperature peaks were predicted during reflood, one following bottom of core recovery and a second caused by saturated boiling of water in the downcomer. This behavior is consistent with prior WCOBRA/TRAC calculations for some Westinghouse PWRs. The simulation results are described, and the sensitivity to failure assumptions for the safety injection system is presented. (authors)

  8. Interfacing systems LOCA (loss-of-coolant accidents): Pressurized water reactors

    SciTech Connect

    Bozoki, G.; Kohut, P.; Fitzpatrick, R.

    1989-02-01

    This report summarizes a study performed by Brookhaven National Laboratory for the Office of Nuclear Regulatory Research, Reactor and Plant Safety Issues Branch, Division of Reactor and Plant Systems, US Nuclear Regulatory Commission. This study was requested by the NRC in order to provide a technical basis for the resolution of Generic Issue 105 ''Interfacing LOCA at LWRs.'' This report deals with pressurized water reactors (PWRs). A parallel report was also accomplished for boiling water reactors. This study focuses on three representative PWRs and extrapolates the plant-specific findings for their generic applicability. In addition, a generic analysis was performed to investigate the cost-benefit aspects of imposing a testing program that would require some minimum level of leak testing of the pressure isolation valves on plants that presently have no such requirements. 28 refs., 31 figs., 64 tabs.

  9. Code System for Best-Estimate Analysis of LOCA in BWR.

    Energy Science and Technology Software Center (ESTSC)

    2001-07-23

    Version 00 TRAC-BD1 performs best estimate analyses of loss-of-coolant accidents (LOCA) and other transients in boiling water reactors (BWRs). The program provides LOCA analysis capability for BWRs and for many BWR-related thermal-hydraulic experimental facilities. The program features a three-dimensional treatment of the BWR pressure vessel, a detailed model of a BWR fuel bundle including multi-rod, multi-bundle, radiation heat transfer, and leakage path modeling capability; flow-regime-dependent constitutive equation treatment; reflood tracking capability both for falling filmsmore » and bottom flood quench fronts; and consistent treatment of the entire accident sequence. Dump/restart capabilities are also provided.« less

  10. Geochemical and Hydrologic Controls of Copper-Rich Surface Waters in the Yerba Loca-Mapocho System

    NASA Astrophysics Data System (ADS)

    Pasten, P.; Montecinos, M.; Coquery, M.; Pizarro, G. E.; Abarca, M. I.; Arce, G. J.

    2015-12-01

    Andean watersheds in Northern and Central Chile are naturally enriched with metals, many of them associated to sulfide mineralizations related to copper mining districts. The natural and anthropogenic influx of toxic metals into drinking water sources pose a sustainability challenge for cities that need to provide safe water with the smallest footprint. This work presents our study of the transformations of copper in the Yerba Loca-Mapocho system. Our sampling campaign started from the headwaters at La Paloma Glacier and continues to the inlet of the San Enrique drinking water treatment plant, a system feeding municipalities in the Eastern area of Santiago, Chile. Depending on the season, total copper concentrations go as high as 22 mg/L for the upper sections, which become diluted to <5 mg/L downstream. pH ranged from 3 to 5.6 while suspended solids ranged from <10 to 100 mg/L. We used Geochemist Workbench to assess copper speciation and to evaluate the thermodynamic controls for the formation and dissolution of solid phases. A sediment trap was used to concentrate suspended particulate matter, which was analyzed with ICP-MS, TXRF (total reflection X ray fluorescence) and XRD (X-ray diffraction). Major elements detected in the precipitates were Al (200 g/kg), S (60 g/kg), and Cu (6 g/kg). Likely solid phases include hydrous amorphous phases of aluminum hydroxides and sulfates, and copper hydroxides/carbonates. Efforts are undergoing to find the optimal mixing ratios between the acidic stream and more alkaline streams to maximize attenuation of dissolved copper. The results of this research could be used for enhancing in-stream natural attenuation of copper and reducing treatment needs at the drinking water facility. Acknowledgements to Fondecyt 1130936 and Conicyt Fondap 15110020

  11. Preliminary LOCA analysis of the westinghouse small modular reactor using the WCOBRA/TRAC-TF2 thermal-hydraulics code

    SciTech Connect

    Liao, J.; Kucukboyaci, V. N.; Nguyen, L.; Frepoli, C.

    2012-07-01

    The Westinghouse Small Modular Reactor (SMR) is an 800 MWt (> 225 MWe) integral pressurized water reactor (iPWR) with all primary components, including the steam generator and the pressurizer located inside the reactor vessel. The reactor core is based on a partial-height 17x17 fuel assembly design used in the AP1000{sup R} reactor core. The Westinghouse SMR utilizes passive safety systems and proven components from the AP1000 plant design with a compact containment that houses the integral reactor vessel and the passive safety systems. A preliminary loss of coolant accident (LOCA) analysis of the Westinghouse SMR has been performed using the WCOBRA/TRAC-TF2 code, simulating a transient caused by a double ended guillotine (DEG) break in the direct vessel injection (DVI) line. WCOBRA/TRAC-TF2 is a new generation Westinghouse LOCA thermal-hydraulics code evolving from the US NRC licensed WCOBRA/TRAC code. It is designed to simulate PWR LOCA events from the smallest break size to the largest break size (DEG cold leg). A significant number of fluid dynamics models and heat transfer models were developed or improved in WCOBRA/TRAC-TF2. A large number of separate effects and integral effects tests were performed for a rigorous code assessment and validation. WCOBRA/TRAC-TF2 was introduced into the Westinghouse SMR design phase to assist a quick and robust passive cooling system design and to identify thermal-hydraulic phenomena for the development of the SMR Phenomena Identification Ranking Table (PIRT). The LOCA analysis of the Westinghouse SMR demonstrates that the DEG DVI break LOCA is mitigated by the injection and venting from the Westinghouse SMR passive safety systems without core heat up, achieving long term core cooling. (authors)

  12. The behavior of ANGRA 2 nuclear power plant core for a small break LOCA simulated with RELAP5 code

    NASA Astrophysics Data System (ADS)

    Sabundjian, Gaianê; Andrade, Delvonei A.; Belchior, Antonio, Jr.; da Silva Rocha, Marcelo; Conti, Thadeu N.; Torres, Walmir M.; Macedo, Luiz A.; Umbehaun, Pedro E.; Mesquita, Roberto N.; Masotti, Paulo H. F.; de Souza Lima, Ana Cecília

    2013-05-01

    This work discusses the behavior of Angra 2 nuclear power plant core, for a postulate Loss of Coolant Accident (LOCA) in the primary circuit for Small Break Loss Of Coolant Accident (SBLOCA). A pipe break of the hot leg Emergency Core Cooling System (ECCS) was simulated with RELAP 5 code. The considered rupture area is 380 cm2, which represents 100% of the ECCS pipe flow area. Results showed that the cooling is enough to guarantee the integrity of the reactor core.

  13. Small Break LOCA Analysis of ACR-700 NPP

    SciTech Connect

    Limin Zheng; Sen Shen; Wright, David

    2006-07-01

    A small break loss of coolant accident (SB-LOCA) analysis to assess a preliminary conceptual design of the ACR-700 PHWR nuclear power plant (NPP) developed by AECL has been performed with CATHENA MOD 3.5d, a PHWR system thermal-hydraulic analysis code. The limiting break size has been found by performing a sensitivity study for three different break locations [i.e. reactor inlet header (RIH), HTS pump suction (PS) pipe and reactor outlet head (ROH)] under the limiting case (i.e. SB-LOCA with subsequent loss of class IV power with all safety systems available). The analysis results indicate that the SB-LOCA acceptance criteria are satisfied. (authors)

  14. [Purpura: primary systemic amyloidosis manifestation].

    PubMed

    Lestre, Sara; Gonçalves, Andreia; João, Alexandre; Ferreira, Ana; Apetato, Margarida

    2009-01-01

    Primary Systemic Amyloidosis (AL) is the most frequent form of systemic amyloidosis and its morbilility is associated with immunoglobulin light chains deposition in vital organs. The mucocutaneous manifestations occur in about 30-40% of the cases and are important in diagnostic suspicion, once they appear in early stages of disease. We report a 71-years-old female patient, with disseminated purpura and cutaneous fragility with 6 months of evolution, accompanied by recent complaints of dysphagy. The first laboratory evaluation didn't show any alterations. The histological and immunohistochemical study of subcutaneous abdominal fat and skin biopsy showed lambda type amyloid protein. In the systemic work-up, we highlight a proteinúria > 1g/24h with Bence Jones proteins and the presence of monoclonal immunoglobulin light chain (lambda type) in serum immunoelectrophoresis. With the diagnosis of primary systemic amyloidosis, treatment with prednisolone and melphalan was started. PMID:19686633

  15. Viking orbiter system primary mission

    NASA Technical Reports Server (NTRS)

    Goudy, J. R.

    1977-01-01

    An overview of Viking Orbiter (VO) system and subsystem performances during the primary mission (the time period from VO-1 launch on August 20, 1975, through November 15, 1976) is presented. Brief descriptions, key design requirements, pertinent historical information, unique applications or situations, and predicted versus actual performances are included for all VO-1 and VO-2 subsystems, both individually and as an integrated system.

  16. APT Blanket System Loss-of-Coolant Accident (LOCA) Based on Initial Conceptual Design - Case 2: with Beam Shutdown Only

    SciTech Connect

    Hamm, L.L.

    1998-10-07

    This report is one of a series of reports that document normal operation and accident simulations for the Accelerator Production of Tritium (APT) blanket heat removal system. These simulations were performed for the Preliminary Safety Analysis Report. This report documents the results of simulations of a Loss-of-Flow Accident (LOFA) where power is lost to all of the pumps that circulate water in the blanket region, the accelerator beam is shut off and neither the residual heat removal nor cavity flood systems operate.

  17. Primary Atomic Clock Reference System

    NASA Technical Reports Server (NTRS)

    2001-01-01

    An artist's concept of the Primary Atomic Clock Reference System (PARCS) plarned to fly on the International Space Station (ISS). PARCS will make even more accurate atomic time available to everyone, from physicists testing Einstein's Theory of Relativity, to hikers using the Global Positioning System to find their way. In ground-based atomic clocks, lasers are used to cool and nearly stop atoms of cesium whose vibrations are used as the time base. The microgravity of space will allow the atoms to be suspended in the clock rather than circulated in an atomic fountain, as required on Earth. PARCS is being developed by the Jet Propulsion Laboratory with principal investigators at the National Institutes of Standards and Technology and the University of Colorado, Boulder. See also No. 0103191

  18. Primary Atomic Clock Reference System

    NASA Technical Reports Server (NTRS)

    2001-01-01

    An artist's concept of the Primary Atomic Clock Reference System (PARCS) plarned to fly on the International Space Station (ISS). PARCS will make even more accurate atomic time available to everyone, from physicists testing Einstein's Theory of Relativity, to hikers using the Global Positioning System to find their way. In ground-based atomic clocks, lasers are used to cool and nearly stop atoms of cesium whose vibrations are used as the time base. The microgravity of space will allow the atoms to be suspended in the clock rather than circulated in an atomic fountain, as required on Earth. PARCS is being developed by the Jet Propulsion Laboratory with principal investigators at the National Institutes of Standards and Technology and the University of Colorado, Boulder. See also No. 0100120.

  19. [Primary central nervous system vasculitis].

    PubMed

    Schuster, S; Magnus, T

    2015-12-01

    Primary angiitis of the central nervous system (PACNS) is a rare disorder. However, it is often considered in the differential diagnosis of vascular or inflammatory CNS diseases. Diagnosis is challenging, as specific biomarkers are lacking and the clinical presentation can be variable. A definitive diagnosis can only be established by biopsy of the inflammatory changes in the vascular wall. Alternatively, the diagnosis of PACNS can also be based on the synopsis of clinical, radiological, and laboratory findings. Different subtypes of PACNS have been described in recent years, depending on the size of the affected vessels or histopathological patterns. Based on selective literature research in the database PubMed on the subject of CNS vasculitis, this article reviews the diagnostic characteristics and differential diagnosis of the condition. We suggest a diagnostic algorithm customized to the size of the affected vessels. Lastly, therapeutic options and the outcome of PACNS are briefly outlined. PMID:26589203

  20. Analysis of LOCA Scenarios in the NIST Research Reactor Before and After Fuel Conversion

    SciTech Connect

    Baek, J. S.; Cheng, L. Y.; Diamond, D.

    2015-08-30

    An analysis has been done of hypothetical loss-of-coolant-accidents (LOCAs) in the research reactor (NBSR) at the National Institute of Standards and Technology (NIST). The purpose of the analysis is to determine if the peak clad temperature remains below the Safety Limit, which is the blister temperature for the fuel. The configuration of the NBSR considered in the analysis is that projected for the future when changes will be made so that shutdown pumps do not operate when a LOCA signal is detected. The analysis was done for the present core with high-enriched uranium (HEU) fuel and with the proposed low-enriched uranium (LEU) fuel that would be used when the NBSR is converted from one to the other. The analysis consists of two parts. The first examines how the water would drain from the primary system following a break and the possibility for the loss of coolant from within the fuel element flow channels. This work is performed using the TRACE system thermal-hydraulic code. The second looks at the fuel clad temperature as a function of time given that the water may have drained from many of the flow channels and the water in the vessel is in a quasi-equilibrium state. The temperature behavior is investigated using the three-dimensional heat conduction code HEATING7.3. The results in all scenarios considered for both HEU and LEU fuel show that the peak clad temperature remains below the blister temperature.

  1. The behavior of ANGRA 2 nuclear power plant core for a small break LOCA simulated with RELAP5 code

    SciTech Connect

    Sabundjian, Gaiane; Andrade, Delvonei A.; Belchior, Antonio Jr.; Silva Rocha, Marcelo da; Conti, Thadeu N.; Torres, Walmir M.; Macedo, Luiz A.; Umbehaun, Pedro E.; Mesquita, Roberto N.; Masotti, Paulo H. F.; Souza Lima, Ana Cecilia de

    2013-05-06

    This work discusses the behavior of Angra 2 nuclear power plant core, for a postulate Loss of Coolant Accident (LOCA) in the primary circuit for Small Break Loss Of Coolant Accident (SBLOCA). A pipe break of the hot leg Emergency Core Cooling System (ECCS) was simulated with RELAP 5 code. The considered rupture area is 380 cm{sup 2}, which represents 100% of the ECCS pipe flow area. Results showed that the cooling is enough to guarantee the integrity of the reactor core.

  2. Fuel behavior during a LOCA: LOFT experiments

    SciTech Connect

    Russell, M.L.

    1980-11-01

    The LOFT experiments have provided the following fuel behavior information which appears to be valuable for improving the safety of PWR operation and resolving PWR licensing issues: (1) A generic unassisted core cooling event occurs during large-break LOCAs that dominates the cooling of the core before ECC reflood commences and potentially eliminates the possibility of flow channel blockage from prepressurized fuel rod swelling. (2) The large-break LOCA decompression forces do not disturb the normal control rod gravity drop and may not structually damage the fuel assemblies. (3) Large-break LOCA core cooling may also be enhanced by spacer grid and core counter flow delay of liquid escape from the core boundaries and liquid fallback from the upper plenum into the core region. (4) Lower fuel rod prepressurization may be possible in PWR fuel rods which would reduce flow channel blockage complications during LOCA's. (5) Uniform fuel rod cladding temperature indications during the large break LOCA's do not confirm expectations for the fuel rod cladding temperature variations that would inhibit development of flow channel blockages by ballooning of prepressurized fuel rods.

  3. Preoperational test report, primary ventilation system

    SciTech Connect

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Primary Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space filtered venting of tanks AY101, AY102, AZ101, AZ102. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  4. Television Distribution System for Primary Schools.

    ERIC Educational Resources Information Center

    South Australia Education Dept., Adelaide.

    This report covers a 12-month study and actual trial of a video distribution system for a primary school. It consisted of a main aerial distribution into a distribution junction box which also took video cassette recorders. The whole system was designed to distribute both in RF and video frequencies. Some ways of using the system have also been…

  5. Spatializing Sexuality in Jaime Hernandez's "Locas"

    ERIC Educational Resources Information Center

    Jones, Jessica E.

    2009-01-01

    Focusing on Jaime Hernandez's "Locas: The Maggie and Hopey Stories," part of the "Love and Rockets" comic series, I argue that the graphic landscape of this understudied comic offers an illustration of the theories of space in relation to race, gender, and sexuality that have been critical to understandings of Chicana sexuality. Set in a barrio…

  6. Boric acid precipitation following a cold-leg LOCA

    SciTech Connect

    Twogood, F.J. ); Strong, B.R. ); Lew, B.S. ); Kramer, C. )

    1993-01-01

    For a postulated cold-leg loss-of-coolant accident (LOCA) in a pressurized water reactor, borated water from the safety injection and recirculation systems is predicted to flow preferentially around the reactor pressure vessel (RPV) downcomer and out the rupture, bypassing the core. Flow to the core may therefore be limited to just the flow that is required to make up for boil-off in the core and to maintain an equal static head between the downcomer and core regions. Lacking any mixing of dilute injection water in the core, this would result in the accumulation of boron in the core region until saturation concentrations are reached and boric acid begins to precipitate out of solution. Boric acid precipitation is undesirable because it may interfere with long-term core cooling. Without a reliable estimate of reflux condensation, this time to precipitation establishes the minimum time for the initiation of hot-leg recirculation to flush the core and terminate boric acid concentration. This analysis estimates the boric acid concentration over time for the postulated conditions of a cold-leg LOCA in San Onofre nuclear generating station unit 1, including the explicit incorporation of the stored heat release from the RPV and structures discussed in a companion paper. Earlier analyses assumed that the RPV stored energy was released during the safety injection phase immediately after the LOCA. Recent analyses showed that a significant portion of this stored energy is released into the coolant after core safety injection and needs to be explicitly addressed.

  7. Primary propulsion/large space system interactions

    NASA Technical Reports Server (NTRS)

    Dergance, R. H.

    1980-01-01

    Three generic types of structural concepts and nonstructural surface densities were selected and combined to represent potential LSS applications. The design characteristics of various classes of large space systems that are impacted by primary propulsion thrust required to effect orbit transfer were identified. The effects of propulsion system thrust-to-mass ratio, thrust transients, and performance on the mass, area, and orbit transfer characteristics of large space systems were determined.

  8. Large LOCA-earthquake event combination probability assessment - Load Combination Program Project I summary report

    SciTech Connect

    Lu, S.; Streit, R.D.; Chou, C.K.

    1980-12-10

    This report summarizes work performed to establish a technical basis for the NRC to use in reassessing its requirement that earthquake and large loss-of-coolant accident (LOCA) loads be combined in the design of nucelar power plants. A systematic probabilistic approach is used to treat the random nature of earthquake and transient loading to estimate the probability of large LOCAs that are directly and indirectly induced by earthquakes. A large LOCA is defined in this report as a double-ended guillotine break of the primary reactor coolant loop piping (the hot leg, cold leg, and crossover) of a pressurized water reactor (PWR). Unit 1 of the Zion Nuclear Power Plant, a four-loop PWR-1, is used for this study. To estimate the probability of a large LOCA directly induced by earthquakes, only fatigue crack growth resulting from the combined effects of thermal, pressure, seismic, and other cyclic loads is considered. Fatigue crack growth is simulated with a deterministic fracture mechanics model that incorporates stochastic inputs of initial crack size distribution, material properties, stress histories, and leak detection probability. Results of the simulation indicate that the probability of a double-ended guillotine break, either with or without an earthquake, is very small (on the order of 10/sup -12/). The probability of a leak was found to be several orders of magnitude greater than that of a complete pipe rupture.

  9. Project Design Concept Primary Ventilation System

    SciTech Connect

    MCGREW, D.L.

    2000-10-02

    Tank Farm Restoration and Safe Operation (TFRSO), Project W-3 14 was established to provide upgrades that would improve the reliability and extend the system life of portions of the waste transfer, electrical, ventilation, instrumentation and control systems for the Hanford Site Tank Farms. An assessment of the tank farm system was conducted and the results are documented in system assessment reports. Based on the deficiencies identified in the tank farm system assessment reports, and additional requirements analysis performed in support of the River Protection Project (RPP), an approved scope for the TFRSO effort was developed and documented in the Upgrade Scope Summary Report (USSR), WHC-SD-W314-RPT-003, Rev. 4. The USSR establishes the need for the upgrades and identifies the specific equipment to be addressed by this project. This Project Design Concept (PDC) is in support of the Phase 2 upgrades and provides an overall description of the operations concept for the W-314 Primary Ventilation Systems. Actual specifications, test requirements, and procedures are not included in this PDC. The PDC is a ''living'' document, which will be updated throughout the design development process to provide a progressively more detailed description of the W-314 Primary Ventilation Systems design. The Phase 2 upgrades to the Primary Ventilation Systems shall ensure that the applicable current requirements are met for: Regulatory Compliance; Safety; Mission Requirements; Reliability; and Operational Requirements.

  10. Overview of the M5{sup R} Alloy behavior under RIA and LOCA Conditions

    SciTech Connect

    Mardon, J.P.; Dunn, B.

    2007-07-01

    Experience from irradiation in PWRs has confirmed the M5{sup R} possesses all the properties required for upgraded operation including new fuel management approaches and high duty reactor operation. In this paper accident behavior is demonstrated through a comparison of M5{sup R} and Zircaloy-4 cladding behavior under RIA (Reactivity Insertion Accident) and LOCA (Loss Of Coolant Accident) conditions. AREVA NP supports a significant experimental program of analytical and full -scale tests along with comprehensive analyses on both M5{sup R} and SRA low-tin Zircaloy-4. A key presumption in the conduct of such tests is that, for all Zirconium alloys, the primary effects of high burn-up on cladding thermal-mechanical properties arise from the accumulation of hydrogen within the cladding during operation. This hypothesis is supported through a summarisation of the results of the main RIA and LOCA tests performed on virgin, pre-hydrided, and irradiated M5{sup R} and SRA low-tin Zircaloy-4 cladding. The first part of the paper presents the results of recent Room Temperature (RT) and High Temperature High Pressure (HTHP) integral RIA tests, mainly from the NSRR and CABRI programs, and separate effects mechanical properties tests on high burn-up M5{sup R} and Zircaloy- 4 irradiated claddings. In the second part of this paper, studies of cladding performance under LOCA conditions are presented.. The discussion includes high temperature oxidation kinetics, quench behaviour and post quenched mechanical behaviour of virgin, pre-hydrided and irradiated M5{sup R} and Zircaloy-4 cladding tubes after oxidation at LOCA temperatures and various quenching scenarios. The hydrogen concentrations studied are alloy dependent. Included are mechanical tests and in-depth metallurgical investigations developed to understand the failure mechanisms with the differing alloys and hydrogen concentrations. The result is a confirmation that the effect of hydrogen uptake dominates on the RIA and LOCA

  11. Systemic malignancies presenting as primary osteolytic lesion.

    PubMed

    Sirelkhatim, A; Kaiserova, E; Kolenova, A; Puskacova, J; Subova, Z; Petrzalkova, D; Banikova, K; Suvada, J; Sejnova, D

    2009-01-01

    The tumor formation may be the earliest manifestation preceeding other symptoms, signs and bone marrow evidence of systemic malignancy - leukemia/lymphoma. Here we present three cases of systemic malignancy in which bone lesions were the first manifested signs of the disease. All three cases were thought to be orthopedic cases and had been treated as so without genuing improvement. We would like to draw an attention to children who present with multifocal musculoskeletal pain and the importance of whole-body scaning. We describe interesting cases of diffuse large cell lymphoma and leukemia that initially presented as primary osteolytic bone lesion and discuss the differential diagnosis, literature review of non-Hodgkin's lymphoma arising in bone as the primary site (Tab. 1, Fig. 3, Ref. 18). Full Text (Free, PDF) www.bmj.sk. PMID:20017455

  12. Aging and loss-of-coolant accident (LOCA) testing of electrical connections

    SciTech Connect

    Nelson, C.F.

    1998-01-01

    This report presents the results of an experimental program to determine the aging and loss-of-coolant accident (LOCA) behavior of electrical connections in order to obtain an initial scoping of their performance. Ten types of connections commonly used in nuclear power plants were tested. These included 3 types of conduit seals, 2 types of cable-to-device connectors, 3 types of cable-to-cable connectors, and 2 types of in-line splices. The connections were aged for 6 months under simultaneous thermal (99 C) and radiation (46 Gy/hr) conditions. A simulated LOCA consisting of sequential high dose-rate irradiation (3 kGy/hr) and high-temperature steam exposures followed the aging. Connection functionality was monitored using insulation resistance measurements during the aging and LOCA exposures. Because only 5 of the 10 connection types passed a post-LOCA, submerged dielectric withstand test, further detailed investigation of electrical connections and the effects of cable jacket integrity on the cable-connection system is warranted.

  13. APT Blanket System Loss-of-Coolant Accident (LOCA) Based on Initial Conceptual Design - Case 4: External Pressurizer Surge Line Break Near Inlet Header

    SciTech Connect

    Hamm, L.L.

    1998-10-07

    This report is one of a series of reports documenting accident scenario simulations for the Accelerator Production of Tritium (APT) blanket heat removal systems. The simulations were performed in support of the Preliminary Safety Analysis Report (PSAR) for the APT.

  14. APT Blanket System Loss-of-Coolant Accident (LOCA) Analysis Based on Initial Conceptual Design - Case 3: External HR Break at Pump Outlet without Pump Trip

    SciTech Connect

    Hamm, L.L.

    1998-10-07

    This report is one of a series of reports that document normal operation and accident simulations for the Accelerator Production of Tritium (APT) blanket heat removal (HR) system. These simulations were performed for the Preliminary Safety Analysis Report.

  15. APT Blanket System Loss-of-Coolant Accident (LOCA) Based on Initial Conceptual Design - Case 1: External HR Break Near Inlet Header

    SciTech Connect

    Hamm, L.L.

    1998-10-07

    The APT blanket system has about 57 MW of thermal energy deposited within the blanket region under normal operating conditions from the release of neutrons and the interaction of the High energy particles with the blanket materials. This corresponds to about 48 percent of total thermal energy deposited in the APT target/blanket system. The deposited thermal energy under normal operation conditions is an important input parameter used in the thermal-hydraulic design and accident analysis.

  16. Effect of spray parameter on containment depressurization during LOCA in KAPP 3 and 4, 700 MWE IPHWR

    SciTech Connect

    Sharma, S. K.; Bhartia, D. K.; Mohan, N.; Malhotra, P. K.; Ghadge, S. G.

    2012-07-01

    KAPP 3 and 4 is an Indian Pressurized Heavy Water Reactor (IPHWR) of 700 MWe capacities. It is a pressure tube type reactor with heavy water as moderator and coolant and natural Uranium Dioxide as fuel. It consists of 392 horizontal fuel channel assemblies and surrounded by three separate water systems i.e. primary coolant, moderator and calandria vault water system. Containment of Indian PHWR is an ultimate barrier, which is designed to envelope whole reactor systems, to prevent the spread of active air-borne fission products in accident condition. Containment Spray System has been provided for energy as well as activity removal from the Containment system. This paper discusses about the studies done to assess the effect of spray parameters such as spray flow rate, droplets diameter and height of fall on containment peak pressure and temperature, long term containment depressurization and energy removal from the containment during Loss of Coolant Accident (LOCA). The spray flow rate and droplets diameter play an important role in removing residual energy from containment atmosphere, which influences depressurization of containment. It is obvious that faster depressurization of containment during postulated LOCA helps in limiting radiological consequences. From radiological considerations, droplets diameter is required to be kept to the lowest practically possible value and flow rate of spray should be high. Spray water droplets fall height governs the exposure time of droplets, which is the direct indication of energy removal rate. However, it is observed from the sensitivity studies that for a height of spray droplet fall more than 16.5 m, for the range of spray water flow rate and droplets sizes considered in the analyses, there is no significant change in heat removal. (authors)

  17. REPOSITORY SURFACE FACILITIES PRIMARY SYSTEM CRANE DATA

    SciTech Connect

    K. Schwartztrauber

    2005-03-14

    The purpose of this calculation is to compile crane design data for the mechanical primary structures, systems, and components (SSCs) required for the repository Waste Handling Building (WHB) and Carrier Preparation Building (CPB). The work presented in this document has been prepared in accordance with Office of Civilian Radioactive Waste Management approved program document AP-3.12Q, Calculations. This calculation has been developed to supplement information previously prepared using the development plan for ''WHB/WTB Space Program Analysis for Site Recommendation'' (Reference 5), which concentrates on the primary, primary support, facility support, and miscellaneous building support areas located in the WHB and Waste Treatment Building (WTB). The development plan was completed in accordance with AP-2.13Q, ''Technical Product Development Planning''. The work in this calculation is a continuance of the work described in the previous development plan; therefore, in accordance with AP-2.21Q, ''Quality Determinations and Planning for Scientific, Engineering, and Regulatory Compliance Activities'', a new Technical Work Plan is not required.

  18. Catastrophic primary central nervous system vasculitis.

    PubMed

    Salvarani, Carlo; Brown, Robert D; Morris, Jonathan M; Huston, John; Hunder, Gene G

    2014-01-01

    Primary central nervous system vasculitis (PCNSV) is an uncommon condition that affects the brain and the spinal cord. It is heterogeneous in presenting characteristics and outcomes. We report a patient with a catastrophic rapidly progressive course refractory to intensive treatment with pulses of methylprednisolone and iv cyclophosphamide. The condition rapidly deteriorated and the patient died 6 weeks after presentation. Rapidly progressive PCNSV represents the worst end of the clinical spectrum of PCNSV. These patients are characterised by bilateral, multiple, large cerebral vessel lesions on angiograms and multiple bilateral cerebral infarctions. PMID:24854370

  19. Primary helium heater for propellant pressurization systems

    NASA Technical Reports Server (NTRS)

    Reichmuth, D. M.; Nguyen, T. V.; Pieper, J. L.

    1991-01-01

    The primary helium heater is a unique design that provides direct heating of pressurant gas for large pressure fed propulsion systems. It has been conceptually designed to supply a heated (800-1000 R) pressurization gas to both a liquid oxygen and an RP-1 propellant tank. This pressurization gas is generated within the heater by mixing super critical helium (40-300 R and 3000-1600 psi) with an appropriate amount of combustion products from a 4:1 throttling stoichiometric LO2/LH2 combustor. This simple, low cost and reliable mixer utilizes the large quantity of helium to provide stoichiometric combustor cooling, extend the throttling limits and enhance the combustion stability margin. Preliminary combustion, thermal, and CFD analyses confirm that this low-pressure-drop direct helium heater can provide the constant-temperature pressurant suitable for tank pressurization of both fuel and oxidizer tanks of large pressure fed vehicles.

  20. Advances in Primary Central Nervous System Lymphoma.

    PubMed

    Patrick, Lauren B; Mohile, Nimish A

    2015-12-01

    Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma that is limited to the CNS. Although novel imaging techniques aid in discriminating lymphoma from other brain tumors, definitive diagnosis requires brain biopsy, vitreoretinal biopsy, or cerebrospinal fluid analysis. Survival rates in clinical studies have improved over the past 20 years due to the addition of high-dose methotrexate-based chemotherapy regimens to whole-brain radiotherapy. Long-term survival, however, is complicated by clinically devastating delayed neurotoxicity. Newer regimens are attempting to reduce or eliminate radiotherapy from first-line treatment with chemotherapy dose intensification. Significant advances have also been made in the fields of pathobiology and treatment, with more targeted treatments on the horizon. The rarity of the disease makes conducting of prospective clinical trials challenging, requiring collaborative efforts between institutions. This review highlights recent advances in the biology, detection, and treatment of PCNSL in immunocompetent patients. PMID:26475775

  1. Primary reflector for solar energy collection systems

    NASA Technical Reports Server (NTRS)

    Miller, C. G. (Inventor); Stephens, J. B.

    1978-01-01

    A fixed, linear, ground-based primary reflector is disclosed which has an extended curved sawtooth-contoured surface covered with a metalized polymeric reflecting material. The device reflects solar energy to a movably supported collector that is kept at the concentrated line focus of the reflector primary. The primary reflector may be constructed by a process utilizing well-known freeway paving machinery.

  2. 47 CFR 11.14 - Primary Entry Point (PEP) System.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Primary Entry Point (PEP) System. 11.14 Section 11.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) General § 11.14 Primary Entry Point (PEP) System. The PEP system is a nationwide network of...

  3. 47 CFR 11.14 - Primary Entry Point (PEP) System.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Primary Entry Point (PEP) System. 11.14 Section 11.14 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS) General § 11.14 Primary Entry Point (PEP) System. The PEP system is a nationwide network of...

  4. A sustainable primary care system: lessons from the Netherlands.

    PubMed

    Faber, Marjan J; Burgers, Jako S; Westert, Gert P

    2012-01-01

    The Dutch primary care system has drawn international attention, because of its high performance at low cost. Primary care practices are easily accessible during office hours and collaborate in a unique out-of-hours system. After the reforms in 2006, there are no copayments for patients receiving care in the primary care practice in which they are registered. Financial incentives support the transfer of care from hospital specialists to primary care physicians, and task delegation from primary care physicians to practice nurses. Regional collaborative care groups of primary care practices offer disease management programs. The quality assessment system and the electronic medical record system are predominantly driven by health care professionals. Bottom-up and top-down activities contributed to a successful Dutch primary care system. PMID:22668606

  5. Teachers' Performance Motivation System in Thai Primary Schools

    ERIC Educational Resources Information Center

    Pasathang, Sarojn; Tesaputa, Kowat; Sataphonwong, Pattananusron

    2016-01-01

    This research aims to: 1) study the present conditions and desirable condition of the motivation systems as well as how to find methods for motivating the performance of teachers in primary schools, 2) develop a motivation system for the performance of teachers in primary schools, 3) study the effects of using the motivation system for compliance…

  6. Pediatric Primary Care as a Component of Systems of Care

    ERIC Educational Resources Information Center

    Brown, Jonathan D.

    2010-01-01

    Systems of care should be defined in a manner that includes primary care. The current definition of systems of care shares several attributes with the definition of primary care: both are defined as community-based services that are accessible, accountable, comprehensive, coordinated, culturally competent, and family focused. However, systems of…

  7. TRANSPORT CHARACTERISTICS OF SELECTED PWR LOCA GENERATED DEBRIS.

    SciTech Connect

    A. K. MAJI; B. MARSHALL; ET AL

    2000-10-01

    In the unlikely event of a Loss of Coolant Accident (LOCA) in a pressurized water reactor (PWR), break jet impingement would dislodge thermal insulation from nearby piping, as well as other materials within the containment, such as paint chips, concrete dust, and fire barrier materials. Steam/water flows induced by the break and by the containment sprays would transport debris to the containment floor. Subsequently, debris would likely transport to and accumulate on the suction sump screens of the emergency core cooling system (ECCS) pumps, thereby potentially degrading ECCS performance and possibly even failing the ECCS. In 1998, the U. S. Nuclear Regulatory Commission (NRC) initiated a generic study (Generic Safety Issue-191) to evaluate the potential for the accumulation of LOCA related debris on the PWR sump screen and the consequent loss of ECCS pump net positive suction head (NPSH). Los Alamos National Laboratory (LANL), supporting the resolution of GSI-191, was tasked with developing a method for estimating debris transport in PWR containments to estimate the quantity of debris that would accumulate on the sump screen for use in plant specific evaluations. The analytical method proposed by LANL, to predict debris transport within the water that would accumulate on the containment floor, is to use computational fluid dynamics (CFD) combined with experimental debris transport data to predict debris transport and accumulation on the screen. CFD simulations of actual plant containment designs would provide flow data for a postulated accident in that plant, e.g., three-dimensional patterns of flow velocities and flow turbulence. Small-scale experiments would determine parameters defining the debris transport characteristics for each type of debris. The containment floor transport methodology will merge debris transport characteristics with CFD results to provide a reasonable and conservative estimate of debris transport within the containment floor pool and

  8. The primary glomerulonephritides: a systems biology approach

    PubMed Central

    Jiang, Song; Chuang, Peter Y.; Liu, Zhi-Hong; He, John C.

    2014-01-01

    Our understanding of the pathogenesis of most primary glomerular diseases, including IgA nephropathy, membranous nephropathy and focal segmental glomerulosclerosis, is limited. Advances in molecular technology now permit genome-wide, high-throughput characterization of genes and gene products from biological samples. Comprehensive examinations of the genome, transcriptome, proteome and metabolome (collectively known as omics analyses), have been applied to the study of IgA nephropathy, membranous nephropathy and focal segmental glomerulosclerosis in both animal models and human patients. However, most omics studies of primary glomerular diseases, with the exception of large genomic studies, have been limited by inadequate sample sizes and the lack of kidney-specific data sets derived from kidney biopsy samples. Collaborative efforts to develop a standardized approach for prospective recruitment of patients, scheduled monitoring of clinical outcomes, and protocols for sampling of kidney tissues will be instrumental in uncovering the mechanisms that drive these diseases. Integration of molecular data sets with the results of clinical and histopathological studies will ultimately enable these diseases to be characterized in a comprehensive and systematic manner, and is expected to improve the diagnosis and treatment of these diseases. PMID:23856995

  9. School Management Information Systems in Primary Schools

    ERIC Educational Resources Information Center

    Demir, Kamile

    2006-01-01

    Developments in information technologies have been impacting upon educational organizations. Principals have been using management information systems to improve the efficiency of administrative services. The aim of this research is to explore principals' perceptions about management information systems and how school management information…

  10. Primary care training and the evolving healthcare system.

    PubMed

    Peccoralo, Lauren A; Callahan, Kathryn; Stark, Rachel; DeCherrie, Linda V

    2012-01-01

    With growing numbers of patient-centered medical homes and accountable care organizations, and the potential implementation of the Patient Protection and Affordable Care Act, the provision of primary care in the United States is expanding and changing. Therefore, there is an urgent need to create more primary-care physicians and to train physicians to practice in this environment. In this article, we review the impact that the changing US healthcare system has on trainees, strategies to recruit and retain medical students and residents into primary-care internal medicine, and the preparation of trainees to work in the changing healthcare system. Recruitment methods for medical students include early preclinical exposure to patients in the primary-care setting, enhanced longitudinal patient experiences in clinical clerkships, and primary-care tracks. Recruitment methods for residents include enhanced ambulatory-care training and primary-care programs. Financial-incentive programs such as loan forgiveness may encourage trainees to enter primary care. Retaining residents in primary-care careers may be encouraged via focused postgraduate fellowships or continuing medical education to prepare primary-care physicians as both teachers and practitioners in the changing environment. Finally, to prepare primary-care trainees to effectively and efficiently practice within the changing system, educators should consider shifting ambulatory training to community-based practices, encouraging resident participation in team-based care, providing interprofessional educational experiences, and involving trainees in quality-improvement initiatives. Medical educators in primary care must think innovatively and collaboratively to effectively recruit and train the future generation of primary-care physicians. PMID:22786734

  11. Application of Total Quality Management System in Thai Primary Schools

    ERIC Educational Resources Information Center

    Prueangphitchayathon, Setthiya; Tesaputa, Kowat; Somprach, Kanokorn

    2015-01-01

    The present study seeks to develop a total quality management (TQM) system that can be applied to primary schools. The approach focuses on customer orientation, total involvement of all constituencies and continuous improvement. TQM principles were studied and synthesized according to case studies of the best practices in 3 primary schools (small,…

  12. Uncertainty analysis for K-reactor flow instability LOCA limits

    SciTech Connect

    Hardy, B.J. )

    1992-01-01

    A postulated accident scenario for the Savannah River Site (SRS) K reactor is a double-ended guillotine break loss-of-coolant accident (DEGB/LOCA) caused by a coolant pipe break at the plenum inlet. The DEBG/LOCA consists of two parts, the first of which applies to the first few seconds of the transient. The first part of the DEGB/LOCA is addressed in this paper. In the first few seconds after the pipe break, there is a rapid depressurization of the plenum, which results in a rapid reduction in the core flow rate. Safety rod insertion is not assumed to begin until 1 s after the pipe break, and the rods are assumed not to be fully inserted until {approximately} 2 s after the break. The resulting flow-power mismatch results in coolant heating and possible flow disruption via a Ledinegg-type flow instability. It is assumed that assembly integrity will be compromised if flow disruption occurs. Because Ledinegg flow instability is the limiting phenomenon for the initial phase of the DEGB/LOCA transient, this part of the transient is called the flow instability (FI) phase.

  13. Primary Health Care in Canada: Systems in Motion

    PubMed Central

    Hutchison, Brian; Levesque, Jean-Frederic; Strumpf, Erin; Coyle, Natalie

    2011-01-01

    Context: During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged. Methods: This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada. Findings: Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support. Conclusions: Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert. PMID:21676023

  14. SPACE code simulation of cold leg small break LOCA in the ATLAS integral test

    SciTech Connect

    Kim, B. J.; Kim, H. T.; Kim, J.; Kim, K. D.

    2012-07-01

    SPACE code is a system analysis code for pressurized water reactors. This code uses a two-fluid and three-field model. For a few years, intensive validations have been performed to secure the prediction accuracy of models and correlations for two-phase flow and heat transfer. Recently, the code version 1.0 was released. This study is to see how well SPACE code predicts thermal hydraulic phenomena of an integral effect test. The target experiment is a cold leg small break LOCA in the ATLAS facility, which has the same two-loop features as APR1400. Predicted parameters were compared with experimental observations. (authors)

  15. MELCOR code analysis of a severe accident LOCA at Peach Bottom Plant

    SciTech Connect

    Carbajo, J.J. )

    1993-01-01

    A design-basis loss-of-coolant accident (LOCA) concurrent with complete loss of the emergency core cooling systems (ECCSs) has been analyzed for the Peach Bottom atomic station unit 2 using the MELCOR code, version 1.8.1. The purpose of this analysis is to calculate best-estimate times for the important events of this accident sequence and best-estimate source terms. Calculated pressures and temperatures at the beginning of the transient have been compared to results from the Peach Bottom final safety analysis report (FSAR). MELCOR-calculated source terms have been compared to source terms reported in the NUREG-1465 draft.

  16. Dynamics and Seismic Issues in primary and secondary systems

    SciTech Connect

    Karim-Panahi, K. ); Derkivreghian, A. )

    1986-01-01

    his book contains the papers presented at the conference held in Pittsburgh, on the subject of pressure vessels and piping systems. Topics discussed were: dynamics of MDF secondary systems; impacting effects of seismic loading in feeder pipes of PHWR plants; random vibration methods for the seismic qualification of secondary systems; interaction in primary-secondary systems; and system response through novel applications of transfer function.

  17. Estimate of LOCA-FI plenum pressure uncertainty for a five-ring RELAP5 production reactor model

    SciTech Connect

    Griggs, D.P.

    1993-03-01

    The RELAP5/MOD2.5 code (RELAP5) is used to perform best-estimate analyses of certain postulated Design Basis Accidents (DBAs) in SRS production reactors. Currently, the most limiting DBA in terms of reactor power level is an instantaneous double-ended guillotine break (DEGB) loss of coolant accident (LOCA). A six-loop RELAP5 K Reactor model is used to analyze the reactor system behavior dozing the Flow Instability (FI) phase of the LOCA, which comprises only the first 5 seconds following the DEGB. The RELAP5 K Reactor model includes tank and plenum nodalizations having five radial rings and six azimuthal sectors. The reactor system analysis provides time-dependent plenum and tank bottom pressures for use as boundary conditions in the FLOWTRAN code, which models a single fuel assembly in detail. RELAP5 also performs the system analysis for the latter phase of the LOCA, denoted the Emergency Cooling System (ECS) phase. Results from the RELAP analysis are used to provide boundary conditions to the FLOWTRAN-TF code, which is an advanced two-phase version of FLOWTRAN. The RELAP5 K Reactor model has been tested for LOCA-FI and Loss-of-Pumping Accident analyses and the results compared with equivalent analyses performed with the TRAC-PF1/MOD1 code (TRAC). An equivalent RELAP5 six-loop, five-ring, six-sector L Reactor model has been benchmarked against qualified single-phase system data from the 1989 L-Area In-Reactor Test Program. The RELAP5 K and L Reactor models have also been subjected to an independent Quality Assurance verification.

  18. Seismic Response and Sensitivity of Primary-Secondary Systems

    NASA Astrophysics Data System (ADS)

    Huang, Changdian

    Seismic performance of light secondary systems anchored or attached to primary structures is crucial to their integrity and serviceability under severe earthquakes. Damage to secondary systems could be just as disastrous as damage to the primary structure itself. The goals of this study are to better understand the dynamic characteristics of secondary systems mounted on the elastic and inelastic primary structure in a seismic environment, and to provide practical considerations of secondary system seismic design based on the selection of optimum structural parameters. Sensitivity analysis is one of the important tools which provides engineers with methods for investigating or minimizing the effects of parameter deviations. This investigation starts with introduction of a stochastic response sensitivity measure to primary-secondary systems in the time domain, and decoupling methods are proposed to deal with the high dimensionality associated with moment equations by partitioning them into several sub-equations. It is shown that this sensitivity measure can be used for a quantitative assessment of secondary system response in the elastic and inelastic primary structure. Under severe earthquakes, most structures are designed to yield, while many secondary systems are designed to remain essentially linear to ensure functionality during earthquakes. Based on this consideration, the stochastic response and reliability of a single-degree-of-freedom secondary system attached to single- or multi-degree-of -freedom yielding primary structures are considered by using equivalent linearization and digital simulation. A detailed analysis which includes mean-square response, coefficient of excess, reliability, response probability density and nonlinear modes of the secondary system is carried out under white and filtered white noise excitations. Some useful results are presented, and application of these results to design is commented upon.

  19. Viking 75 project: Viking lander system primary mission performance report

    NASA Technical Reports Server (NTRS)

    Cooley, C. G.

    1977-01-01

    Viking Lander hardware performance during launch, interplanetary cruise, Mars orbit insertion, preseparation, separation through landing, and the primary landed mission, with primary emphasis on Lander engineering and science hardware operations, the as-flown mission are described with respect to Lander system performance and anomalies during the various mission phases. The extended mission and predicted Lander performance is discussed along with a summary of Viking goals, mission plans, and description of the Lander, and its subsystem definitions.

  20. Transient deformation properties of Zircaloy for LOCA simulation. Final report

    SciTech Connect

    Hann, C. R.; Mohr, C. L.; Busness, K. M.; Olson, N. J.; Reich, F. R.; Stewart, K. B.

    1980-05-01

    This experimental data report is Volume 4 of a series of 5 volumes describing the oxidation and deformation rate behavior of Zircaloy cladding under simulated LOCA conditions. It contains listings of strain versus stress, time, and temperature evaluated from the numerical constitutive relationships and the original data used to develop them. This volume also contains listings of the ramp load, pressure, and temperature test data from both current and previous phases of the series, as well as material describing applications of the data.

  1. Zircoloy Cladding Oxidation Simulation for LWR under LOCA Conditions

    Energy Science and Technology Software Center (ESTSC)

    2003-04-25

    PRECIP-2 simulates zircaloy cladding oxidation under LOCA conditions of LWR’s. The code calculates oxygen concentration distribution across the cladding wall by solving the diffusion equation with moving boundary conditions, taking into account the structure change of the beta— phase, i.e. alpha precipitation during the cooling period. The code also predicts total oxygen uptake, thicknesses of alpha, beta and oxide layers.

  2. THE CONTRIBUTIONS OF PHYSICIAN ASSISTANTS IN PRIMARY CARE SYSTEMS

    PubMed Central

    Hooker, Roderick S.; Everett, Christine M.

    2013-01-01

    Shortages of primary care doctors are occurring globally; one means of meeting this demand has been the use of physician assistants (PAs). Introduced in the United States in the late 1960s to address doctor shortages, the PA movement has grown to over 75,000 providers in 2011 and spread to Australia, Canada, Great Britain, The Netherlands, Germany, Ghana, and South Africa. A purposeful literature review was undertaken to assess the contribution of PAs to primary care systems. Contemporary studies suggest that PAs can contribute to the successful attainment of primary care functions, particularly the provision of comprehensive care, accessibility, and accountability. Employing PAs seems a reasonable strategy for providing primary care for diverse populations. PMID:21851446

  3. Hydrogen motion in Zircaloy-4 cladding during a LOCA transient

    NASA Astrophysics Data System (ADS)

    Elodie, T.; Jean, D.; Séverine, G.; M-Christine, B.; Michel, C.; Berger, P.; Martine, B.; Antoine, A.

    2016-04-01

    Hydrogen and oxygen are key elements influencing the embrittlement of zirconium-based nuclear fuel cladding during the quench phase following a Loss Of Coolant Accident (LOCA). The understanding of the mechanisms influencing the motion of these two chemical elements in the metal is required to fully describe the material embrittlement. High temperature steam oxidation tests were performed on pre-hydrided Zircaloy-4 samples with hydrogen contents ranging between 11 and 400 wppm prior to LOCA transient. Thanks to the use of both Electron Probe Micro-Analysis (EPMA) and Elastic Recoil Detection Analysis (μ-ERDA), the chemical elements partitioning has been systematically quantified inside the prior-β phase. Image analysis and metallographic examinations were combined to provide an average oxygen profile as well as hydrogen profile within the cladding thickness after LOCA transient. The measured hydrogen profile is far from homogeneous. Experimental distributions are compared to those predicted numerically using calculations derived from a finite difference thermo-diffusion code (DIFFOX) developed at IRSN.

  4. The 747 primary flight control systems reliability and maintenance study

    NASA Technical Reports Server (NTRS)

    1979-01-01

    The major operational characteristics of the 747 Primary Flight Control Systems (PFCS) are described. Results of reliability analysis for separate control functions are presented. The analysis makes use of a NASA computer program which calculates reliability of redundant systems. Costs for maintaining the 747 PFCS in airline service are assessed. The reliabilities and cost will provide a baseline for use in trade studies of future flight control system design.

  5. 78 FR 28896 - Design Limits and Loading Combinations for Metal Primary Reactor Containment System Components

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... COMMISSION Design Limits and Loading Combinations for Metal Primary Reactor Containment System Components... Combinations for Metal Primary Reactor Containment System Components,'' in which there are no substantive... loading combinations for metal primary reactor containment system components. ADDRESSES: Please refer...

  6. French investigations of high burnup effect on LOCA thermomechanical behavior: Part 1. Experimental programmes in support of LOCA design methodologies

    SciTech Connect

    Waeckel, N.; Cauvin, R.; Lebuffe, C.

    1997-01-01

    Within the framework of Burn-Up extension request, EDF, FRAMATOME, CEA and IPSN have carried out experimental programmes in order to provide the design of fuel rods under LOCA conditions with relevant data. The design methods used in France for LOCA are based on standard Appendix K methodology updated to take into account some penalties related to the actual conditions of the Nuclear Power Plant. Best-Estimate assessments are used as well. Experimental programmes concern plastic deformation and burst behavior of advanced claddings (EDGAR) and thermal shock quenching behavior of highly irradiated claddings (TAGCIR). The former reveals the important role played by the {alpha}/{beta} transformation kinetics related to advanced alloys (Niobium alloys) and the latter the significative impact of hydrogen charged during in-reactor corrosion on oxidation kinetics and failure behavior in terms of cooling rates.

  7. Primary electric power generation systems for advanced-technology engines

    NASA Technical Reports Server (NTRS)

    Cronin, M. J.

    1983-01-01

    The advantages of the all electric airplane are discussed. In the all electric airplane the generator is the sole source of electric power; it powers the primary and secondary flight controls, the environmentals, and the landing gear. Five candidates for all electric power systems are discussed and compared. Cost benefits of the all electric airplane are discussed.

  8. Peroneal nerve involvement as initial manifestation of primary systemic vasculitis

    PubMed Central

    Ripellino, Paolo; Varrasi, Claudia; Maldi, Elena; Cantello, Roberto

    2014-01-01

    We report a case of two patients with foot drop due to peroneal nerve infarct as early sign of two different forms of primary systemic vasculitides: a predominantly small-vessel p-antineutrophil cytoplasmic antibody-positive vasculitis (microscopic polyangiitis) and a predominantly medium-vessel vasculitis (polyarteritis nodosa). PMID:24686810

  9. Oral purpura as the first manifestation of primary systemic amyloidosis.

    PubMed

    McCormick, Robert Stuart; Sloan, Philip; Farr, David; Carrozzo, Marco

    2016-07-01

    Oral blood blisters and purpura are rare features of primary systemic amyloidosis (amyloid light-chain (AL) amyloidosis). We report a case in which these unusual presentations led to a diagnosis of amyloidosis, which enabled effective treatment before organ failure. PMID:26708800

  10. An Exploratory Study on How Primary Pupils Approach Systems

    ERIC Educational Resources Information Center

    Koski, Marja-Ilona; de Vries, Marc

    2013-01-01

    This paper presents a study of systems thinking among 27 primary pupils (8-10 years old) and their teacher. The study included a pre-test for the teacher and the pupils, lesson planning, the actual lesson and a post-test for the pupils. The research focused on finding an answer to three questions: (1) do pupils see a system as a structure…

  11. Targetable genetic features of primary testicular and primary central nervous system lymphomas.

    PubMed

    Chapuy, Bjoern; Roemer, Margaretha G M; Stewart, Chip; Tan, Yuxiang; Abo, Ryan P; Zhang, Liye; Dunford, Andrew J; Meredith, David M; Thorner, Aaron R; Jordanova, Ekaterina S; Liu, Gang; Feuerhake, Friedrich; Ducar, Matthew D; Illerhaus, Gerald; Gusenleitner, Daniel; Linden, Erica A; Sun, Heather H; Homer, Heather; Aono, Miyuki; Pinkus, Geraldine S; Ligon, Azra H; Ligon, Keith L; Ferry, Judith A; Freeman, Gordon J; van Hummelen, Paul; Golub, Todd R; Getz, Gad; Rodig, Scott J; de Jong, Daphne; Monti, Stefano; Shipp, Margaret A

    2016-02-18

    Primary central nervous system lymphomas (PCNSLs) and primary testicular lymphomas (PTLs) are extranodal large B-cell lymphomas (LBCLs) with inferior responses to current empiric treatment regimens. To identify targetable genetic features of PCNSL and PTL, we characterized their recurrent somatic mutations, chromosomal rearrangements, copy number alterations (CNAs), and associated driver genes, and compared these comprehensive genetic signatures to those of diffuse LBCL and primary mediastinal large B-cell lymphoma (PMBL). These studies identify unique combinations of genetic alterations in discrete LBCL subtypes and subtype-selective bases for targeted therapy. PCNSLs and PTLs frequently exhibit genomic instability, and near-uniform, often biallelic, CDKN2A loss with rare TP53 mutations. PCNSLs and PTLs also use multiple genetic mechanisms to target key genes and pathways and exhibit near-uniform oncogenic Toll-like receptor signaling as a result of MYD88 mutation and/or NFKBIZ amplification, frequent concurrent B-cell receptor pathway activation, and deregulation of BCL6. Of great interest, PCNSLs and PTLs also have frequent 9p24.1/PD-L1/PD-L2 CNAs and additional translocations of these loci, structural bases of immune evasion that are shared with PMBL. PMID:26702065

  12. Primary Vitreoretinal Lymphoma: A Report from an International Primary Central Nervous System Lymphoma Collaborative Group Symposium

    PubMed Central

    Rubenstein, James L.; Coupland, Sarah E.; Davis, Janet L.; Harbour, J. William; Johnston, Patrick B.; Cassoux, Nathalie; Touitou, Valerie; Smith, Justine R.; Batchelor, Tracy T.; Pulido, Jose S.

    2011-01-01

    Primary vitreoretinal lymphoma (PVRL), also known as primary intraocular lymphoma, is a rare malignancy typically classified as a diffuse large B-cell lymphoma and most frequently develops in elderly populations. PVRL commonly masquerades as posterior uveitis and has a unique tropism for the retina and central nervous system (CNS). Over 15% of primary CNS lymphoma patients develop intraocular lymphoma, usually occurring in the retina and/or vitreous. Conversely, 65%–90% of PVRL patients develop CNS lymphoma. Consequently, PVRL is often fatal because of ultimate CNS association. Current PVRL animal models are limited and require further development. Typical clinical findings include vitreous cellular infiltration (lymphoma and inflammatory cells) and subretinal tumor infiltration as determined using dilated fundoscopy, fluorescent angiography, and optical coherent tomography. Currently, PVRL is most often diagnosed using both histology to identify lymphoma cells in the vitreous or retina and immunohistochemistry to indicate monoclonality. Additional adjuncts in diagnosing PVRL exist, including elevation of interleukin-10 levels in ocular fluids and detection of IgH or T-cell receptor gene rearrangements in malignant cells. The optimal therapy for PVRL is not defined and requires the combined effort of oncologists and ophthalmologists. PVRL is sensitive to radiation therapy and exhibits high responsiveness to intravitreal methotrexate or rituximab. Although systemic chemotherapy alone can result in high response rates in patients with PVRL, there is a high relapse rate. Because of the disease rarity, international, multicenter, collaborative efforts are required to better understand the biology and pathogenesis of PVRL as well as to define both diagnostic markers and optimal therapies. PMID:22045784

  13. System seismic analysis of an innovative primary system for a large pool type LMFBR plant

    SciTech Connect

    Pan, Y.C.; Wu, T.S.; Cha, B.K.; Burelbach, J.; Seidensticker, R.

    1984-01-01

    The system seismic analysis of an innovative primary system for a large pool type liquid metal fast breeder reactor (LMFBR) plant is presented. In this primary system, the reactor core is supported in a way which differs significantly from that used in previous designs. The analytical model developed for this study is a three-dimensional finite element model including one-half of the primary system cut along the plane of symmetry. The model includes the deck and deck mounted components,the reactor vessel, the core support structure, the core barrel, the radial neutron shield, the redan, and the conical support skirt. The sodium contained in the primary system is treated as a lumped mass appropriately distributed among various components. The significant seismic behavior as well as the advantages of this primary system design are discussed in detail.

  14. Primary systemic amyloidosis: A rare cause for pleural effusion.

    PubMed

    George, Sunny; Ravindran, M; Anandan, P T; Kiran, V N

    2014-01-01

    Pleural effusion is a common problem dealt by most of the practicing clinicians. Some causes for pleural effusion are less often considered as a differential diagnosis owing to its rarity. Here we report a case of renal amyloidosis on alternate day haemodialysis for about two months time presenting with left sided pleural effusion. On evaluation this turned out to be a case of amyloidosis on thoracoscopic pleural biopsy suggesting the possibility of Primary systemic amyloidosis. PMID:26029558

  15. Preoperational test report, primary ventilation condenser cooling system

    SciTech Connect

    Clifton, F.T.

    1997-10-29

    This represents the preoperational test report for the Primary Ventilation Condenser Cooling System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system uses a closed chilled water piping loop to provide offgas effluent cooling for tanks AY101, AY102, AZ1O1, AZ102; the offgas is cooled from a nominal 100 F to 40 F. Resulting condensation removes tritiated vapor from the exhaust stack stream. The piping system includes a package outdoor air-cooled water chiller with parallel redundant circulating pumps; the condenser coil is located inside a shielded ventilation equipment cell. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  16. RELAP5 MODEL OF THE DIVERTOR PRIMARY HEAT TRANSFER SYSTEM

    SciTech Connect

    Popov, Emilian L; Yoder Jr, Graydon L; Kim, Seokho H

    2010-08-01

    This report describes the RELAP5 model that has been developed for the divertor primary heat transfer system (PHTS). The model is intended to be used to examine the transient performance of the divertor PHTS and evaluate control schemes necessary to maintain parameters within acceptable limits during transients. Some preliminary results are presented to show the maturity of the model and examine general divertor PHTS transient behavior. The model can be used as a starting point for developing transient modeling capability, including control system modeling, safety evaluations, etc., and is not intended to represent the final divertor PHTS design. Preliminary calculations using the models indicate that during normal pulsed operation, present pressurizer controls may not be sufficient to keep system pressures within their desired range. Additional divertor PHTS and control system design efforts may be required to ensure system pressure fluctuation during normal operation remains within specified limits.

  17. Best-Estimate Analysis PWR LOCA.

    Energy Science and Technology Software Center (ESTSC)

    2005-11-11

    Version: 00 TRAC‑PF1 performs best estimate analyses of loss of coolant accidents and other transients in pressurized light water reactors. The program can also be used to model a wide range of thermal hydraulic experiments in reduced scale facilities. Models employed include reflood, multi‑dimensional two‑phase flow, nonequilibrium thermodynamics, generalized heat transfer, and reactor kinetics. Automatic steady‑state and dump/restart capabilities are provided. The changes reported in TRACNEWS issues through Number 7 are incorporated in this release.more » TRAC-PF1 was developed on a CDC computer at Los Alamos National Laboratory. The PC version of TRAC‑PF1 was converted at CNEN in 1989 and has not been updated since that time. The NRC no longer supports the TRAC codes. They currently develop and maintain the TRACE code system, which is the TRAC/RELAP Advanced Computational Engine. TRACE is a modernized thermal-hydraulics code designed to consolidate the capabilities of NRC's 3 legacy safety codes - TRAC-P, TRAC-B and RELAP. This is NRC's flagship thermal-hydraulics analysis tool. See the website for more information http://www.nrccodes.com/.« less

  18. Best-Estimate Analysis PWR LOCA.

    SciTech Connect

    MAHAFFY, J. H.

    2005-11-11

    Version: 00 TRAC‑PF1 performs best estimate analyses of loss of coolant accidents and other transients in pressurized light water reactors. The program can also be used to model a wide range of thermal hydraulic experiments in reduced scale facilities. Models employed include reflood, multi‑dimensional two‑phase flow, nonequilibrium thermodynamics, generalized heat transfer, and reactor kinetics. Automatic steady‑state and dump/restart capabilities are provided. The changes reported in TRACNEWS issues through Number 7 are incorporated in this release. TRAC-PF1 was developed on a CDC computer at Los Alamos National Laboratory. The PC version of TRAC‑PF1 was converted at CNEN in 1989 and has not been updated since that time. The NRC no longer supports the TRAC codes. They currently develop and maintain the TRACE code system, which is the TRAC/RELAP Advanced Computational Engine. TRACE is a modernized thermal-hydraulics code designed to consolidate the capabilities of NRC's 3 legacy safety codes - TRAC-P, TRAC-B and RELAP. This is NRC's flagship thermal-hydraulics analysis tool. See the website for more information http://www.nrccodes.com/.

  19. Use of Fuzzy Logic Systems for Assessment of Primary Faults

    NASA Astrophysics Data System (ADS)

    Petrović, Ivica; Jozsa, Lajos; Baus, Zoran

    2015-09-01

    In electric power systems, grid elements are often subjected to very complex and demanding disturbances or dangerous operating conditions. Determining initial fault or cause of those states is a difficult task. When fault occurs, often it is an imperative to disconnect affected grid element from the grid. This paper contains an overview of possibilities for using fuzzy logic in an assessment of primary faults in the transmission grid. The tool for this task is SCADA system, which is based on information of currents, voltages, events of protection devices and status of circuit breakers in the grid. The function model described with the membership function and fuzzy logic systems will be presented in the paper. For input data, diagnostics system uses information of protection devices tripping, states of circuit breakers and measurements of currents and voltages before and after faults.

  20. Apollo experience report guidance and control systems: Primary guidance, navigation, and control system development

    NASA Technical Reports Server (NTRS)

    Holley, M. D.; Swingle, W. L.; Bachman, S. L.; Leblanc, C. J.; Howard, H. T.; Biggs, H. M.

    1976-01-01

    The primary guidance, navigation, and control systems for both the lunar module and the command module are described. Development of the Apollo primary guidance systems is traced from adaptation of the Polaris Mark II system through evolution from Block I to Block II configurations; the discussion includes design concepts used, test and qualification programs performed, and major problems encountered. The major subsystems (inertial, computer, and optical) are covered. Separate sections on the inertial components (gyroscopes and accelerometers) are presented because these components represent a major contribution to the success of the primary guidance, navigation, and control system.

  1. LSST primary/tertiary mirror thermal control system

    NASA Astrophysics Data System (ADS)

    Neill, Douglas R.

    2010-07-01

    The Large Synoptic Survey Telescope (LSST) primary/tertiary monolithic mirror will be fabricated as a single cast borosilicate substrate that requires an extensive thermal control system. The relatively large coefficient of thermal expansion (CTE) of borosilicate glass requires the thermal system maintain differences throughout the mirror to below 0.1C. The thermal control system is also required to take full advantage of the relatively thin glass sections for good tracking of ambient temperatures. A modified version of the thermal control system utilized on the Magellan telescope primary mirror will provide adequate cooling. This type of system supplies coolant to multiple on-board blowers in the mirror cell. Each blower contains a fan and a heat exchanger supplying conditioned and mildly pressurized air to the mirror cell. The mirror cell then acts as an air plenum which distributes the air through individual nozzles to each honeycomb cell of the mirror. Unlike previous systems, each LSST blower assembly will incorporate individual air temperature and air flow control systems. Since air can be more accurately heated than cooled, the air will be initially slightly overcooled and then reheated electrically to match the ambient air temperature. Based on thermal sensors in the mirror, the optimum cooling air flow rate to balance mirror thermal distortion and mirror seeing will be determined and enforced by the variable speed fans on the blower assemblies. To further equalize the cooling throughout the mirror, the coolant flow system has also been designed to provide inherently equal coolant flow to each blower assembly.

  2. Near misdiagnosis of glioblastoma as primary central nervous system lymphoma.

    PubMed

    Bhatt, Vijaya Raj; Shrestha, Rajesh; Shonka, Nicole; Bociek, R Gregory

    2014-08-01

    Primary central nervous system (CNS) lymphoma, most frequently a diffuse large B-cell lymphoma, is a rare aggressive lymphoma confined to the CNS, thus requiring differentiation from other brain malignancies such as glioblastoma. Although stereotactic biopsy can confirm the diagnosis, this is invasive, not always feasible and can be inconclusive after steroid use. Hence, cranial magnetic resonance imaging (MRI) with contrast and cerebrospinal fluid analysis are frequently used to make a prompt diagnosis. We report a case of a woman with two brain masses who presented unique diagnostic challenge. PMID:24883157

  3. Near Misdiagnosis of Glioblastoma as Primary Central Nervous System Lymphoma

    PubMed Central

    Bhatt, Vijaya Raj; Shrestha, Rajesh; Shonka, Nicole; Bociek, R. Gregory

    2014-01-01

    Primary central nervous system (CNS) lymphoma, most frequently a diffuse large B-cell lymphoma, is a rare aggressive lymphoma confined to the CNS, thus requiring differentiation from other brain malignancies such as glioblastoma. Although stereotactic biopsy can confirm the diagnosis, this is invasive, not always feasible and can be inconclusive after steroid use. Hence, cranial magnetic resonance imaging (MRI) with contrast and cerebrospinal fluid analysis are frequently used to make a prompt diagnosis. We report a case of a woman with two brain masses who presented unique diagnostic challenge. PMID:24883157

  4. EVALUATION OF THE TEMPORARY TENT COVER TRUSS SYSTEM AP PRIMARY VENT SYSTEM

    SciTech Connect

    HAQ MA

    2009-12-31

    The purpose of this calculation is to evaluate a temporary ten cover truss system. This system will be used to provide weather protection to the workers during replacement of the filter for the Primary Ventilation System in AP Tank Farm. The truss system has been fabricated utilizing tubes and couplers, which are normally used for scaffoldings.

  5. Primary propulsion/large space system interaction study

    NASA Technical Reports Server (NTRS)

    Coyner, J. V.; Dergance, R. H.; Robertson, R. I.; Wiggins, J. V.

    1981-01-01

    An interaction study was conducted between propulsion systems and large space structures to determine the effect of low thrust primary propulsion system characteristics on the mass, area, and orbit transfer characteristics of large space systems (LSS). The LSS which were considered would be deployed from the space shuttle orbiter bay in low Earth orbit, then transferred to geosynchronous equatorial orbit by their own propulsion systems. The types of structures studied were the expandable box truss, hoop and column, and wrap radial rib each with various surface mesh densities. The impact of the acceleration forces on system sizing was determined and the effects of single point, multipoint, and transient thrust applications were examined. Orbit transfer strategies were analyzed to determine the required velocity increment, burn time, trip time, and payload capability over a range of final acceleration levels. Variables considered were number of perigee burns, delivered specific impulse, and constant thrust and constant acceleration modes of propulsion. Propulsion stages were sized for four propellant combinations; oxygen/hydrogen, oxygen/methane, oxygen/kerosene, and nitrogen tetroxide/monomethylhydrazine, for pump fed and pressure fed engine systems. Two types of tankage configurations were evaluated, minimum length to maximize available payload volume and maximum performance to maximize available payload mass.

  6. Fiber optic signal collection system for primary flight control applications

    NASA Astrophysics Data System (ADS)

    Harper, Sandy L.

    1994-10-01

    The FOPMN is a fiber-optic signal collection system for primary flight control applications. An avionics bay protected electro-optic interface unit transmits light down fiber optic cable to an optical sensor housed in the harsh environment of a hydraulic actuator. The interface unit also receives the sensor's reflected pattern and calculates independent positions from the multiplexed signals. This paper discusses the FOPMN method for fiber-optically sensing and multiplexing two channels of position of a TEF actuator's main ram cylinder. Currently installed in NASA Dryden's SRA F/A-18, the FOPMN has accumulated approximately 15 hours of flight time. A performance comparison is made between the FOPMN positions and the flight control computer's feedback mechanism (the actuator LVDTs). Included is a discussion of some of the lessons learned as a result of testing the FOPMN in the lab and in flight. The FOPMN is well on its way to proving itself as a robust fiber optic system with the ability to multiplex numerous optical sensors for primary flight control. The success of the FOPMN leads to the second phase of the project--optical loop closure. Our goal for this phase is to have four FOPMN sensor channels on the main ram and/or the main control valve of the actuator to serve as the quad redundant feedback mechanism for flight control.

  7. Fission Product Migration in Primary System and Containment

    Energy Science and Technology Software Center (ESTSC)

    2015-04-01

    Version 00 ART MOD2 aims at a comprehensive analysis for the FP behaviour in primary system and in containment during severe accidents and therefore the code considers the removal of radio-nuclides of up to 60 materials including chemical compounds by natural deposition and by the engineered safety features (ESF) such as spray systems. As for the natural deposition of radio-nuclides, the code can consider the phenomena such as gravitational settling, thermophoresis, diffusiophoresis, Brownian diffusion, diffusionmore » under laminar or turbulent flows, resuspension, condensation, chemisorption and revaporization. The code also models the aerosol growth by agglomeration of aerosols and condensation/evaporation of volatile material at the aerosol surface. Recently, the models for iodine chemistry in containment sump water was incorporated into ART MOD2 ART MOD2 was modified in January 2015 to correct coding errors and improve the vibration of the calculation result of water (H2O) vapor.« less

  8. Primary Central Nervous System Vasculitis With Optic Nerve Involvement.

    PubMed

    Benson, Christy E; Knezevic, Alexander; Lynch, Shannon C

    2016-06-01

    A 20-year-old woman presented with headache, decreased vision, eye pain, and urinary retention. During her clinical course, visual acuity declined to 20/800, right eye, and 20/50, left eye, associated with bilateral optic disc edema. Brain magnetic resonance imaging revealed enhancement of the leptomeninges, right optic nerve, and right side of the optic chiasm. Extensive evaluation of the central nervous system (CNS) for an infectious cause was negative. Brain biopsy showed a pattern consistent with vasculitis. The patient was treated with prednisone and cyclophosphamide, resulting in improvement of her vision and systemic symptoms. Primary CNS vasculitis is a rare condition that may affect the anterior visual pathways. PMID:26693942

  9. Fission Product Migration in Primary System and Containment

    SciTech Connect

    2015-04-01

    Version 00 ART MOD2 aims at a comprehensive analysis for the FP behaviour in primary system and in containment during severe accidents and therefore the code considers the removal of radio-nuclides of up to 60 materials including chemical compounds by natural deposition and by the engineered safety features (ESF) such as spray systems. As for the natural deposition of radio-nuclides, the code can consider the phenomena such as gravitational settling, thermophoresis, diffusiophoresis, Brownian diffusion, diffusion under laminar or turbulent flows, resuspension, condensation, chemisorption and revaporization. The code also models the aerosol growth by agglomeration of aerosols and condensation/evaporation of volatile material at the aerosol surface. Recently, the models for iodine chemistry in containment sump water was incorporated into ART MOD2 ART MOD2 was modified in January 2015 to correct coding errors and improve the vibration of the calculation result of water (H2O) vapor.

  10. Optimized Battery-Type Reactor Primary System Design Utilizing Lead

    SciTech Connect

    Yu, Yong H.; Son, Hyoung M.; Lee, Il S.; Suh, Kune Y.

    2006-07-01

    A number of small and medium size reactors are being developed worldwide as well as large electricity generation reactors for co-generation, district heating or desalination. The Seoul National University has started to develop 23 MWth BORIS (Battery Optimized Reactor Integral System) as a multi-purpose reactor. BORIS is an integral-type optimized fast reactor with an ultra long life core. BORIS is being designed to meet the Generation IV nuclear energy system goals of sustainability, safety, reliability and economics. Major features of BORIS include 20 consecutive years of operation without refueling; elimination of an intermediate heat transport loop and main coolant pump; open core without individual subassemblies; inherent negative reactivity feedback; and inherent load following capability. Its one mission is to provide incremental electricity generation to match the needs of developing nations and especially remote communities without major electrical grid connections. BORIS consists of a reactor module, heat exchanger, coolant module, guard vessel, reactor vessel auxiliary cooling system (RVACS), secondary system, containment and the seismic isolation. BORIS is designed to generate 10 MWe with the resulting thermal efficiency of 45 %. BORIS uses lead as the primary system coolant because of the inherent safety of the material. BORIS is coupled with a supercritical carbon dioxide Brayton cycle as the secondary system to gain a high cycle efficiency in the range of 45 %. The reference core consists of 757 fuel rods without assembly with an active core height of 0.8 m. The BORIS core consists of single enrichment zone composed of a Pu-MA (minor actinides)-U-N fuel and a ferritic-martensitic stainless steel clad. This study is intended to set up appropriate reactor vessel geometry by performing thermal hydraulic analysis on RVACS using computational fluid dynamics codes; to examine the liquid metal coolant behavior along the subchannels; to find out whether the

  11. Radiative transfer during the reflooding step of a LOCA

    NASA Astrophysics Data System (ADS)

    Gérardin, J.; Seiler, N.; Ruyer, P.; Boulet, P.

    2013-10-01

    Within the evaluation of the heat transfer downstream a quench front during the reflood phase of a Loss of Coolant Accident (LOCA) in a nuclear power plant, a numerical study has been conducted on radiative transfer through a vapor-droplet medium. The non-grey behavior of the medium is obvious since it can be optically thin or thick depending on the wavelength. A six wide bands model has been tested, providing a satisfactory accuracy for the description of the radiative properties. Once the radiative properties of the medium computed, they have been introduced in a model solving the radiative heat transfer based on the Improved Differential Approximation. The fluxes and the flux divergence have been computed on a geometry characteristic of the reactor core showing that radiative transfer plays a relevant role, quite as important as convective heat transfer.

  12. Biology and Treatment of Primary Central Nervous System Lymphoma

    PubMed Central

    Algazi, Alain P.; Kadoch, Cigall; Rubenstein, James L.

    2016-01-01

    Summary Primary central nervous system lymphoma (PCNSL) is a rare variant of extranodal non-Hodgkin lymphoma that is restricted in distribution to the brain, leptomeninges, spinal cord and intraocular compartments. While PCNSL shares overlapping features of systemic lymphoma, recent studies also reveal a unique pattern of gene and protein expression in PCNSL. These findings have yielded new insights into the pathophysiology of the disease as well as the identification of novel prognostic biomarkers. Immune system compromise such as that seen in the acquired immune deficiency syndrome is the best established known risk factor for PCNSL. Like other lesions of the brain, meninges, and eye, the presenting symptoms associated with PCNSL typically include focal neurological deficits related to the site of disease or more global consequences of increased intracranial pressure. Diagnosis of PCNSL typically includes gadolinium-enhanced magnetic resonance imaging and pathological tissue analysis as well as additional studies aimed at excluding concurrent systemic disease. PCNSL is typically associated with a worse overall prognosis than systemic lymphoma. High dose chemotherapy, particularly with methotrexate-based regimens, is the backbone of therapy for most patients and chemotherapy is associated with much lower rates of treatment-related morbidity and mortality than whole brain irradiation. Autologous stem cell transplantation is an emerging treatment modality, particularly in younger patients with relapsed disease, but high rates of treatment related mortality are observed in older patients. Immunotherapy, including treatment with intrathecal rituximab, is another area of active research that may have promise in refractory or relapsed disease. Treatment options for intraocular lymphoma parallel those for PCNSL elsewhere in the brain and they included systemic chemotherapy, radiation, and local delivery of cytotoxic and immunologically-active agents such as anti-CD20

  13. Measurement of convectional heat transfer coefficients in a primary containment vessel with outer pool

    SciTech Connect

    Fukui, Toru; Kataoka, Yoshiyuki; Hatamiya, Shigeo

    1990-01-01

    New concepts with passive safety systems that use no active compounds, such as pumps, have been recently developed for next-generation nuclear power plants. In these concepts, several ideas and their combination of passive components were adopted for emergency core cooling and residual heat removal systems. For the residual heat removal system, utilization of natural circulation heat transfer in water pools was proposed as a passive containment cooling system (PCCS), which removes decay heat from the primary containment vessel (PCV) during loss-of-coolant accidents (LOCAs). This system consists of a suppression pool (S/P) and an outer pool (O/P), which are set adjacently inside and outside of the steel PCV wall. The core decay heat during LOCA is released through a break as steam and is led into the S/P. The injected steam condenses there, resulting a pool temperature rise. The adsorbed heat in the S/P is transferred to the O/P by convection in both pools and thermal conduction through the steel PCV wall. The heat transferred to the O/P is finally released to the atmosphere by vaporization of the O/P water. Estimation of the convectional heat transfer coefficients in both pools is necessary to predict the heat removal capability in this system precisely. The heat transfer coefficients measured in this study are useful for the design of the next-generation nuclear reactor as the fundamental thermal-hydraulic data in the primary containment vessel with the outer pool.

  14. Chemotherapy in newly diagnosed primary central nervous system lymphoma

    PubMed Central

    Hashemi-Sadraei, Nooshin; Peereboom, David M.

    2010-01-01

    Primary central nervous system lymphoma (PCNSL) accounts for only 3% of brain tumors. It can involve the brain parenchyma, leptomeninges, eyes and the spinal cord. Unlike systemic lymphoma, durable remissions remain uncommon. Although phase III trials in this rare disease are difficult to perform, many phase II trials have attempted to define standards of care. Treatment modalities for patients with newly diagnosed PCNSL include radiation and/or chemotherapy. While the role of radiation therapy for initial management of PCNSL is controversial, clinical trials will attempt to improve the therapeutic index of this modality. Routes of chemotherapy administration include intravenous, intraocular, intraventricular or intra-arterial. Multiple trials have outlined different methotrexate-based chemotherapy regimens and have used local techniques to improve drug delivery. A major challenge in the management of patients with PCNSL remains the delivery of aggressive treatment with preservation of neurocognitive function. Because PCNSL is rare, it is important to perform multicenter clinical trials and to incorporate detailed measurements of long-term toxicities. In this review we focus on different chemotherapeutic approaches for immunocompetent patients with newly diagnosed PCNSL and discuss the role of local drug delivery in addition to systemic therapy. We also address the neurocognitive toxicity of treatment. PMID:21789140

  15. The Australian experiment: how primary health care organizations supported the evolution of a primary health care system.

    PubMed

    Nicholson, Caroline; Jackson, Claire L; Marley, John E; Wells, Robert

    2012-03-01

    Primary health care in Australia has undergone 2 decades of change. Starting with a vision for a national health strategy with general practice at its core, Australia established local meso-level primary health care organizations--Divisions of General Practice--moving from focus on individual practitioners to a professional collective local voice. The article identifies how these meso-level organizations have helped the Australian primary health care system evolve by supporting the roll-out of initiatives including national practice accreditation, a focus on quality improvement, expansion of multidisciplinary teams into general practice, regional integration, information technology adoption, and improved access to care. Nevertheless, there are still challenges to ensuring equitable access and the supply and distribution of a primary care workforce, addressing the increasing rates of chronic disease and obesity, and overcoming the fragmentation of funding and accountability in the Australian system. PMID:22403246

  16. Evaluation of prompt nucleation of bubbles in annular fuel elements during the initial depressurization transient of a DEGB LOCA

    SciTech Connect

    Smith, A.C.

    1997-06-01

    In the first moments following the pipe break, of a DEGB LOCA, the depressurization wave is postulated to propagate rapidly through the system, in the manner of an acoustic or water hammer wave. this is immediately followed by a (reflected) repressurization wave, as the flow of coolant through the break is established. The pressure history is then dictated by the flow from the break and the ability of the pressurizer, pumps and accumulators to supply coolant. The initial sudden drop in pressure may result in the system pressure falling below the saturation pressure of the coolant. This could, in turn, result in bubble formation. Such immediate vapor formation (prompt nucleation of bubbles), in the period before the repressurization wave restores the system pressure to a level above the saturation pressure might initiate flow instability. Such an interruption in flow would allow the fuel tube clad temperature to increase rapidly. Depending on the duration of the flow interruption, the reactor might not be able to survive the initial moments of DEGB LOCA. It has generally been that this phenomenon would not actually occur in an operating reactor. The purpose of this investigation is to evaluate the possibility of occurrence of bubble formation as a result of initial depressurization. 7 refs., 6 figs.

  17. Genomic characterization of primary central nervous system lymphoma.

    PubMed

    Fukumura, Kazutaka; Kawazu, Masahito; Kojima, Shinya; Ueno, Toshihide; Sai, Eirin; Soda, Manabu; Ueda, Hiroki; Yasuda, Takahiko; Yamaguchi, Hiroyuki; Lee, Jeunghun; Shishido-Hara, Yukiko; Sasaki, Atsushi; Shirahata, Mitsuaki; Mishima, Kazuhiko; Ichimura, Koichi; Mukasa, Akitake; Narita, Yoshitaka; Saito, Nobuhito; Aburatani, Hiroyuki; Nishikawa, Ryo; Nagane, Motoo; Mano, Hiroyuki

    2016-06-01

    Primary central nervous system lymphoma (PCNSL) is a rare malignancy confined to the central nervous system (CNS), and majority of PCNSL is pathologically classified as diffuse large B-cell lymphoma (DLBCL). We have now performed whole-exome sequencing for 41 tumor tissues of DLBCL-type PCNSL and paired normal specimens and also RNA-sequencing for 30 tumors, revealing a very high frequency of nonsynonymous somatic mutations in PIM1 (100 %), BTG2 (92.7 %), and MYD88 (85.4 %). Many genes in the NF-κB pathway are concurrently mutated within the same tumors. Further, focal deletion or somatic mutations in the HLA genes are associated with poor prognosis. Copy number amplification and overexpression of genes at chromosome 7q35 were both found to predict short progression-free survival as well. Oncogenic mutations in GRB2 were also detected, the effects of which in cultured cells were attenuated by inhibitors of the downstream kinases MAP2K1 and MAP2K2. Individuals with tumors positive for MYD88 mutations also harbored the same mutations at a low frequency in peripheral blood mononuclear cells, suggesting that MYD88 mutation-positive precancerous cells originate outside of the CNS and develop into lymphoma after additional genetic hits that confer adaptation to the CNS environment. PMID:26757737

  18. [Primary central nervous system post-transplant lymphoproliferative disorders].

    PubMed

    Honda, Masaya; Koga, Michiaki; Kanda, Takashi

    2014-08-01

    The post-transplant lymphoproliferative disorders (PTLD) are a heterogeneous disease entity of lymphoid and plasmacytic proliferations that can occur after solid organ and bone marrow/stem cell transplantation. PTLD sometimes involves the central nervous system (CNS), but primary occurrence in central nervous system (PCNS-PTLD) is rare. The Epstein-Barr virus (EBV) plays a causative role, and up to 90% of the tumors are associated with this virus. Diagnosing PCNS-PTLD is often challenging based solely on computed tomography, magnetic resonance imaging, and physical findings; therefore, direct biopsy of the lesion is usually necessary to make a definitive diagnosis. The optimal therapy for PCNS-PTLD remains unknown. Dose reduction or discontinuation of immunosuppressive agents is effective for approximately half of PTLD patients, but not for most patients with PCNS-PTLD. It has been noted that CNS involvement is a poor prognostic factor, but early diagnosis and initiation of chemotherapy or radiotherapy seem critical for maximizing the likelihood of a favorable outcome. PMID:25082316

  19. Leptomeningeal metastasis of primary central nervous system (CNS) neoplasms.

    PubMed

    Engelhard, Herbert H; Corsten, Luke A

    2005-01-01

    Leptomeningeal dissemination of primary CNS tumors varies widely by histologic subtype. In certain tumors including medulloblastoma, ependymoma, germ cell tumors, and primary CNS lymphoma, seeding of the cerebrospinal fluid space is a critical factor in determining stage, prognosis and appropriate therapy. Other tumor types, such as glioma, may have radiographic evidence of leptomeningeal metastases without clear impact on prognosis or therapy. PMID:16211884

  20. New approaches in primary central nervous system lymphoma

    PubMed Central

    Fraser, Eleanor; Gruenberg, Katherine; Rubenstein, James L.

    2016-01-01

    Primary central nervous system lymphoma (PCNSL) has long been associated with an inferior prognosis compared to other aggressive non-Hodgkin’s lymphomas (NHLs). However, during the past 10 years an accumulation of clinical experience has demonstrated that long-term progression-free survival (PFS) can be attained in a major proportion of PCNSL patients who receive dose-intensive consolidation chemotherapy and avoid whole brain radiotherapy. One recent approach that has reproducibly demonstrated efficacy for newly diagnosed PCNSL patients is an immunochemotherapy combination regimen used during induction that consists of methotrexate, temozolomide, and rituximab followed by consolidative infusional etoposide plus high-dose cytarabine (EA), administered in first complete remission (CR). Other high-dose chemotherapy-based consolidative regimens have shown efficacy as well. Our goal in this review is to update principles of diagnosis and management as well as data regarding the molecular pathogenesis of PCNSL, information that may constitute a basis for development of more effective therapies required to make additional advances in this phenotype of aggressive NHL. PMID:25841718

  1. Primary immunodeficiency diseases: dissectors of the immune system.

    PubMed

    Buckley, Rebecca H

    2002-07-01

    The past 50 years have seen enormous progress in this field. An unknown concept until 1952, there are now more than 100 different primary immunodeficiency syndromes in the world's literature. Each novel syndrome has shed new insight into the workings of the immune system, dissecting its multiple parts into unique functioning components. This has been especially true over the past decade, as the molecular bases of approximately 40 of these diseases have been identified in rapid succession. Advances in the treatment of these diseases have also been impressive. Antibody replacement has been improved greatly by the development of human immunoglobulin preparations that can be safely administered by the intravenous route, and cytokine and humanized anticytokine therapies are now possible through recombinant technologies. The ability to achieve life-saving immune reconstitution of patients with lethal severe combined immunodeficiency by administering rigorously T-cell-depleted allogeneic related haploidentical bone marrow stem cells has extended this option to virtually all such infants, if diagnosed before untreatable infections develop. Finally, the past 3 years have witnessed the first truly successful gene therapy. The impressive results in X-linked severe combined immunodeficiency offer hope that this approach can be extended to many more diseases in the future. PMID:12190932

  2. Reversible Ammonia Sorption for the Primary Life Support System (PLSS)

    NASA Technical Reports Server (NTRS)

    Wojtowicz, Marek A.; Cosgrove, Joseph E.; Serio, Michael A.; Jennings, Mallory A.

    2012-01-01

    Results are presented on the development of regenerable trace-contaminant (TC) sorbent for use in Extravehicular Activities (EVAs), and more specifically in the Primary Life Support System (PLSS). Since ammonia is the most important TC to be captured, data presented in this paper are limited to ammonia sorption, with results relevant to other TCs to be reported at a later time. The currently available TC-control technology involves the use of a packed bed of acid-impregnated granular charcoal. The sorbent is non-regenerable, and its use is associated with appreciable pressure drop, i.e. power consumption. The objective of this work is to demonstrate the feasibility of using vacuum-regenerable sorbents for PLSS application. In this study, several carbon sorbent monoliths were fabricated and tested. Multiple adsorption/vacuum-regeneration cycles were demonstrated at room temperature, as well as carbon surface conditioning that enhances ammonia sorption without impairing sorbent regeneration. Depending on sorbent monolith geometry, the reduction in pressure drop with respect to granular sorbent was found to be between 50% and two orders of magnitude. Resistive heating of the carbon sorbent monolith was demonstrated by applying voltage to the opposite ends of the monolith.

  3. Radiation Therapy for Primary Carcinoma of the Extrahepatic Biliary System

    PubMed Central

    Flickinger, John C.; Epstein, Alan H.; Iwatsuki, Shunzaburo; Carr, Brian I.; Starzl, Thomas E.

    2010-01-01

    From 1976 to 1988, 63 patients received radiation therapy for primary cancers of the extrahepatic biliary system (eight gallbladder and 55 extrahepatic biliary duct). Twelve patients underwent orthotopic liver transplantation. Chemotherapy was administered to 13 patients. Three patients underwent intraluminal brachytherapy alone (range, 28 to 55 Gy). Sixty patients received megavoltage external-beam radiation therapy (range, 5.4 to 61.6 Gy; median, 45 Gy), of whom nine received additional intraluminal brachytherapy (range, 14 to 45 Gy; median, 30 Gy). The median survival of all patients was 7 months. Sixty patients died, all within 39 months of radiation therapy. One patient is alive 11 months after irradiation without surgical resection, and two are alive 50 months after liver transplantation and irradiation. Symptomatic duodenal ulcers developed after radiation therapy in seven patients but were not significantly related to any clinical variable tested. Extrahepatic biliary duct cancers, the absence of metastases, increasing calendar year of treatment, and liver transplantation with postoperative radiation therapy were factors significantly associated with improved survival. PMID:2070327

  4. Clinical epidemiology for childhood primary central nervous system tumors.

    PubMed

    Bauchet, Luc; Rigau, Valérie; Mathieu-Daudé, Hélène; Fabbro-Peray, Pascale; Palenzuela, Gilles; Figarella-Branger, Dominique; Moritz, Jorge; Puget, Stéphanie; Bauchet, Fabienne; Pallusseau, Lorelei; Duffau, Hugues; Coubes, Philippe; Trétarre, Brigitte; Labrousse, François; Dhellemmes, Patrick

    2009-03-01

    This work was conducted by the French Brain Tumor Data Bank (FBTDB) and aims to prospectively record all primary central nervous system tumors (PCNST), in France, for which histological diagnosis is available. Results concerning children are presented. This study analyzes the childhood cases (0-19 years) of newly diagnosed and histologically confirmed PCNST (during the years 2004-2006) which have been recorded by the FBTDB. All French neuropathology and neurosurgery departments participated in this program. Neurosurgeons and neuropathologists completed a data file containing socio-demographic, clinical, radiologic and anatomopathologic information. The Tumor Registry from Herault was authorized to compile the data files with personal identifiers. About 1,017 cases (533 boys and 484 girls) of newly diagnosed childhood PCNST have been recorded (gliomas: 52%, all other neuroepithelial tumors: 31%, craniopharyngioma: 5%, germ cell tumors, meningioma and neurinoma: approximately 3% each, all histological subtypes have been detailed). Tumor resections were performed in 83.3%, and biopsies in 16.7%. The distributions by histology, cryopreservation of the samples, age, sex, tumor site and surgery have been detailed. To our knowledge, this work is the first databank in Europe dedicated to PCNST that includes the collection of clinical, radiological and histological data (including cryopreservation of the specimen). The long term goals of the FBTDB are to create a national registry and a network to perform epidemiological studies, to implement clinical and basic research protocols, and to evaluate and harmonize the healthcare of children and adult patients affected by PCNST. PMID:19020806

  5. Development of Effective Academic Affairs Administration System in Thai Primary Schools

    ERIC Educational Resources Information Center

    Thongnoi, Niratchakorn; Srisa-ard, Boonchom; Sri-ampai, Anan

    2013-01-01

    This research aimed to: 1) study current situations and problems of academic affairs administration system in Primary Schools. 2) develop an effective academic affairs administration system, and 3) evaluate the implementation of the developed system in the primary school, Thailand. Research and Development (R&D) was employed which consisted of…

  6. ACHILLES: Heat Transfer in PWR Core During LOCA Reflood Phase

    SciTech Connect

    2013-11-01

    1. NAME AND TITLE OF DATA LIBRARY ACHILLES -Heat Transfer in PWR Core During LOCA Reflood Phase. 2. NAME AND TITLE OF DATA RETRIEVAL PROGRAMS N/A 3. CONTRIBUTOR AEA Technology, Winfrith Technology Centre, Dorchester DT2 8DH United Kingdom through the OECD Nuclear Energy Agency Data Bank, Issy-les-Moulineaux, France. 4. DESCRIPTION OF TEST FACILITY The most important features of the Achilles rig were the shroud vessel, which contained the test section, and the downcomer. These may be thought of as representing the core barrel and the annular downcomer in the reactor pressure vessel. The test section comprises a cluster of 69 rods in a square array within a circular shroud vessel. The rod diameter and pitch (9.5 mm and 12.6 mm) were typical of PWR dimensions. The internal diameter of the shroud vessel was 128 mm. Each rod was electrically heated over a length of 3.66 m, which is typical of the nuclear heated length in a PWR fuel rod, and each contained 6 internal thermocouples. These were arranged in one of 8 groupings which concentrated the thermocouples in different axial zones. The spacer grids were at prototypic PWR locations. Each grid had two thermocouples attached to its trailing edge at radial locations. The axial power profile along the rods was an 11 step approximation to a "chopped cosine". The shroud vessel had 5 heating zones whose power could be independently controlled. 5. DESCRIPTION OF TESTS The Achilles experiments investigated the heat transfer in the core of a Pressurized Water Reactor during the re-flood phase of a postulated large break loss of coolant accident. The results provided data to validate codes and to improve modeling. Different types of experiments were carried out which included single phase cooling, re-flood under low flow conditions, level swell and re-flood under high flow conditions. Three series of experiments were performed. The first and the third used the same test section but the second used another test section, similar in

  7. ACHILLES: Heat Transfer in PWR Core During LOCA Reflood Phase

    Energy Science and Technology Software Center (ESTSC)

    2013-11-01

    1. NAME AND TITLE OF DATA LIBRARY ACHILLES -Heat Transfer in PWR Core During LOCA Reflood Phase. 2. NAME AND TITLE OF DATA RETRIEVAL PROGRAMS N/A 3. CONTRIBUTOR AEA Technology, Winfrith Technology Centre, Dorchester DT2 8DH United Kingdom through the OECD Nuclear Energy Agency Data Bank, Issy-les-Moulineaux, France. 4. DESCRIPTION OF TEST FACILITY The most important features of the Achilles rig were the shroud vessel, which contained the test section, and the downcomer. These maymore » be thought of as representing the core barrel and the annular downcomer in the reactor pressure vessel. The test section comprises a cluster of 69 rods in a square array within a circular shroud vessel. The rod diameter and pitch (9.5 mm and 12.6 mm) were typical of PWR dimensions. The internal diameter of the shroud vessel was 128 mm. Each rod was electrically heated over a length of 3.66 m, which is typical of the nuclear heated length in a PWR fuel rod, and each contained 6 internal thermocouples. These were arranged in one of 8 groupings which concentrated the thermocouples in different axial zones. The spacer grids were at prototypic PWR locations. Each grid had two thermocouples attached to its trailing edge at radial locations. The axial power profile along the rods was an 11 step approximation to a "chopped cosine". The shroud vessel had 5 heating zones whose power could be independently controlled. 5. DESCRIPTION OF TESTS The Achilles experiments investigated the heat transfer in the core of a Pressurized Water Reactor during the re-flood phase of a postulated large break loss of coolant accident. The results provided data to validate codes and to improve modeling. Different types of experiments were carried out which included single phase cooling, re-flood under low flow conditions, level swell and re-flood under high flow conditions. Three series of experiments were performed. The first and the third used the same test section but the second used another test section

  8. Considerations for Probabilistic Analyses to Assess Potential Changes to Large-Break LOCA Definition for ECCS Requirements

    SciTech Connect

    Wilkowski, G.; Rudland, D.; Wolterman, R.; Krishnaswamy, P.; Scott, P.; Rahman, S.; Fairbanks, C.

    2002-07-01

    The U.S.NRC has undertaken a study to explore changes to the body of Part 50 of the U.S. Federal Code of Regulations, to incorporate risk-informed attributes. One of the regulations selected for this study is 10 CFR 50.46, {sup A}cceptance Criteria for Emergency Core Cooling Systems for Light-Water Nuclear Power Reactors{sup .} These changes will potentially enhance safety and reduce unnecessary burden on utilities. Specific attention is being paid to redefining the maximum pipe break size for LB-LOCA by determining the spectrum of pipe diameter (or equivalent opening area) versus failure probabilities. In this regard, it is necessary to ensure that all contributors to probabilistic failures are accounted for when redefining ECCS requirements. This paper describes initial efforts being conducted for the U.S.NRC on redefining the LB-LOCA requirements. Consideration of the major contributors to probabilistic failure, and deterministic aspects for modeling them, are being addressed. At this time three major contributors to probabilistic failures are being considered. These include: (1) Analyses of the failure probability from cracking mechanisms that could involve rupture or large opening areas from either through-wall or surface flaws, whether the pipe system was approved for leak-before-break (LBB) or not. (2) Future degradation mechanisms, such as recent occurrence of PWSCC in PWR piping need to be included. This degradation mechanism was not recognized as being an issue when LBB was approved for many plants or when the initial risk-informed inspection plans were developed. (3) Other indirect causes of loss of pressure-boundary integrity than from cracks in the pipe system also should be included. The failure probability from probabilistic fracture mechanics will not account for these other indirect causes that could result in a large opening in the pressure boundary: i.e., failure of bolts on a steam generator manway, flanges, and valves; outside force damage from

  9. Primary Nocturnal Enuresis: A Structural and Strategic Family Systems Approach.

    ERIC Educational Resources Information Center

    Fletcher, Teresa B.

    2000-01-01

    Exploration of the literature regarding primary nocturnal enuresis suggests there are various causes including genetic, biological, physiological, and psychological explanations. Treatments typically consist of medication and behavioral intervention. However, it was believed that this enuretic case was caused by psychological trauma. A series of…

  10. Cobalt-60 simulation of LOCA (loss of coolant accident) radiation effects

    SciTech Connect

    Buckalew, W.H.

    1989-07-01

    The consequences of simulating nuclear reactor loss of coolant accident (LOCA) radiation effects with Cobalt-60 gamma ray irradiators have been investigated. Based on radiation induced damage in polymer base materials, it was demonstrated that electron/photon induced radiation damage could be related on the basis of average absorbed radiation dose. This result was used to estimate the relative effectiveness of the mixed beta/gamma LOCA and Cobalt-60 radiation environments to damage both bare and jacketed polymer base electrical insulation materials. From the results obtained, it is concluded that present simulation techniques are a conservative method for simulating LOCA radiation effects and that the practices have probably substantially overstressed both bare and jacketed materials during qualification testing. 9 refs., 8 figs., 5 tabs.

  11. DEGB LOCA ECS power limit recommendation for the K-14. 1 subcycle

    SciTech Connect

    Smith, F.G. III; Aleman, S.E.

    1991-04-01

    This report documents assembly deposited power limits and the corresponding effluent temperature limits recommended for operating the K-14.1 subcycle to ensure sufficient cooling of reactor assemblies during the ECS phase of a Double Ended Guillotine Break (DEGSS) Loss of Coolant Accident (LOCA). The ECS LOCA effluent temperature limits are computed for each flowzone of the K-14.1 charge. The recommended overall DEGB LOCA ECS power limit is 1515 MW or about 63.1% of the historical full reactor power limit (assumed to be 2400-MW) for Mark 22 assemblies. The design basis accident is a break in the plenum inlet line where the AC pump motors not tripped.

  12. DEGB LOCA ECS power limit recommendation for the K-14.1 subcycle. Revision 1

    SciTech Connect

    Smith, F.G. III; Aleman, S.E.

    1991-04-01

    This report documents assembly deposited power limits and the corresponding effluent temperature limits recommended for operating the K-14.1 subcycle to ensure sufficient cooling of reactor assemblies during the ECS phase of a Double Ended Guillotine Break (DEGSS) Loss of Coolant Accident (LOCA). The ECS LOCA effluent temperature limits are computed for each flowzone of the K-14.1 charge. The recommended overall DEGB LOCA ECS power limit is 1515 MW or about 63.1% of the historical full reactor power limit (assumed to be 2400-MW) for Mark 22 assemblies. The design basis accident is a break in the plenum inlet line where the AC pump motors not tripped.

  13. Iraqi primary care system in Kurdistan region: providers’ perspectives on problems and opportunities for improvement

    PubMed Central

    2012-01-01

    Background As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers’ perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system. Methods A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement. The discussions were fully transcribed and the qualitative data was analyzed by content analysis, followed by a thematic analysis. Results Problems facing the primary care system included inappropriate health service delivery (irrational use of health services, irrational treatment, poor referral system, poor infrastructure and poor hygiene), health workforce challenges (high number of specialists, uneven distribution of the health workforce, rapid turnover, lack of training and educational opportunities and discrepancies in the salary system), shortage in resources (shortage and low quality of medical supplies and shortage in financing), poor information technology and poor leadership/governance. The greatest emphasis was placed on poor organization of health services delivery, particularly the irrational use of health services and the related overcrowding and overload on primary care providers and health facilities. Suggestions for improving the system included application of a family medicine approach and ensuring effective planning and monitoring. Conclusions This study has provided a comprehensive understanding of the factors that negatively affect the primary care system in Iraq’s Kurdistan region from the perspective of primary care providers. From their experience, primary care providers

  14. Distributed information system architecture for Primary Health Care.

    PubMed

    Grammatikou, M; Stamatelopoulos, F; Maglaris, B

    2000-01-01

    We present a distributed architectural framework for Primary Health Care (PHC) Centres. Distribution is handled through the introduction of the Roaming Electronic Health Care Record (R-EHCR) and the use of local caching and incremental update of a global index. The proposed architecture is designed to accommodate a specific PHC workflow model. Finally, we discuss a pilot implementation in progress, which is based on CORBA and web-based user interfaces. However, the conceptual architecture is generic and open to other middleware approaches like the DHE or HL7. PMID:11187702

  15. Design and analysis of large spaceborne light-weighted primary mirror and its support system

    NASA Astrophysics Data System (ADS)

    Yan, Yong; Jin, Guang; Yang, Hong-bo

    2007-12-01

    With the development of the resolution of spaceborne remote sensor, the diameter of the primary mirror of spaceborne telescope becomes larger and larger. The distortion of primary mirror which is influenced by the mirror material, structure, self-weight, support system and temperature environment affects optical image quality finally. In this paper, an on-axis TMA high-resolution Cassegrain optical payload with a primary mirror whose diameter is φ 650mm was designed and the effects of the influence factors of the distortion acts on the on-axis TMA optical system primary mirror had been analyzed by means of Finite Element Analysis. During work, the technology of the primary mirror design had been summarized and general consideration of the primary mirror design technology also had been described at the same time. Considering the telescope manufacture and work station, a reasonable and optimal structure of the primary mirror sub-assembly is taken finally. In the end, the distortion of the primary mirror during its fabrication station and work station had been analyzed by integrated Finite Element Analysis Method. The results implicated the synthesis profile error (P-V value) for the primary mirror is less than λ/10 and all the indexes of the primary mirror satisfy the requirements of the optical system.

  16. Intermediate-break LOCA analyses for the AP600 design

    SciTech Connect

    Boyack, B.E.; Lime, J.F.

    1995-07-01

    A postulated double-ended guillotine break of a direct-vessel-injection line in an AP600 plant has been analyzed. This event is characterized as an intermediate break loss-of-coolant accident (IBLOCA). Most of the insights regarding the response of the AP600 safety systems to the postulated accident are derived from calculations performed with the TRAC-PFl/MOD2 code. However, complementary insights derived from a scaled experiment conducted in the ROSA facility, as well as insights based upon calculations by other codes, are also presented. The key processes occurring in an AP600 during a IBLOCA are primary coolant system depressurization, inventory depletion, inventory replacement via emergency core coolant injection, continuous core cooling, and long-term decay heat rejection to the atmosphere. Based upon the calculated and experimental results, the AP600 will not experience a core heat up and will reach a safe shutdown state using only safety-class equipment. Only the early part of the long-term cooling period initiated by In-containment Refueling Water Storage Tank injection was evaluated Thus, the observation that the core is continuously cooled should be verified for the latter phase of the long-term cooling period, the interval when sump injection and containment cooling processes are important.

  17. The W. M. Keck Telescope segmented primary mirror active control system

    SciTech Connect

    Jared, R.C.; Arthur, A.A.; Andreae, S.; Biocca, A.; Cohen, R.W.; Fuertes, J.M.; Franck, J.; Gabor, G.; Llacer, J.; Mast, T.; Meng, J.; Merrick, T.; Minor, R.; Nelson, J.; Orayani, M.; Salz, P.; Schaefer, B.; Witebsky, C.

    1989-07-01

    The ten meter diameter primary mirror of the W. M. Keck Telescope is a mosaic of thirty-six hexagonal mirrors. An active control system stabilizes the primary mirror. The active control system uses 168 measurements of the relative positions of adjacent mirror segments and 3 measurements of the primary mirror position in the telescope structure to control the 108 degrees of freedom needed to stabilize the figure and position of the primary mirror. The components of the active control system are relative position sensors, electronics, computers, actuators that position the mirrors, and software. The software algorithms control the primary mirror, perform star image stacking, emulate the segments, store and fit calibration data, and locate hardware defects. We give an overview of the active control system, its functional requirements and test measurements. 12 refs.

  18. Description of the primary flight display and flight guidance system logic in the NASA B-737 transport systems research vehicle

    NASA Technical Reports Server (NTRS)

    Knox, Charles E.

    1990-01-01

    A primary flight display format was integrated with the flight guidance and control system logic in support of various flight tests conducted with the NASA Transport Systems Research Vehicle B-737-100 airplane. The functional operation of the flight guidance mode control panel and the corresponding primary flight display formats are presented.

  19. Control System Modeling for the Thirty Meter Telescope Primary Mirror

    NASA Technical Reports Server (NTRS)

    MacMynowski, Douglas G.; Thompson, Peter M.; Shelton, J. Chris; Roberts, Lewis C., Jr.; Colavita, M. Mark; Sirota, Mark J.

    2011-01-01

    The Thirty Meter Telescope primary mirror is composed of 492 segments that are controlled to high precision in the presence of wind and vibration disturbances, despite the interaction with structural dynamics. The higher bandwidth and larger number of segments compared with the Keck telescopes requires greater attention to modeling to ensure success. We focus here on the development and validation of a suite of quasi-static and dynamic modeling tools required to support the design process, including robustness verification, performance estimation, and requirements flowdown. Models are used to predict the dynamic response due to wind and vibration disturbances, estimate achievable bandwidth in the presence of control-structure-interaction (CSI) and uncertainty in the interaction matrix, and simulate and analyze control algorithms and strategies, e.g. for control of focus-mode, and sensor calibration. Representative results illustrate TMT performance scaling with parameters, but the emphasis is on the modeling framework itself.

  20. Contribution of polymers to classical primary insulation of distribution system

    SciTech Connect

    Shwehdi, M.H.; Al-Rawi, A.

    1996-12-31

    Insulation composites used on present distribution lines frequently consist of several types of materials such as wood, porcelain, polymers and fiberglass reinforced plastics (FRP) connected in series. A study included the laboratory determination of the critical flashover voltage (CFO) of 17 single component and 90 combinations of two components were conducted. The acquired data were used to develop methods of predicting CFO levels of various multiple series electrical insulations. This paper illustrates the results and analyses of the classical primary insulation (porcelain), and of the modern-day insulation of polymers. It also presents the result of whether polymers may add or supplement insulation strength to the two dielectric combination using statistical methods. The paper also presents advantages and guidelines for the use of polymers to either replace or complement porcelain. This may help optimize the choice of dielectrics on distribution lines.

  1. Uncertainties in TRAC plenum pressures for the FI phase of a DEGB LOCA

    SciTech Connect

    Griggs, D.P.

    1991-05-01

    The TRAC-PF1/MOD1 code (TRAC) is used to perform best-estimate analyses of certain postulated Design Basis Accidents (DBAs) in SRS production reactors. Currently, the most limiting DBA in terms of reactor power level is an instantaneous double-ended guillotine break (DEGB) loss of coolant accident (LOCA). For this accident, TRAC is used to analyze only the first 5 seconds following the DEGB, which encompasses the Flow Instability (FI) phase of the DBA. The TRAC analysis provides time-dependent plenum and tank bottom pressures for use as boundary conditions in the FLOWTRAN code. The quantification of uncertainty is an important element of determining safe operating power levels for SRS reactors. A detailed methodology for the determination of uncertainty for the FI phase of a DEGB LOCA has been developed. This report presents estimates of the uncertainty in the time-dependent plenum pressures for the DEGB LOCA calculated by TRAC. The plenum pressure uncertainty was estimated by means of comparing TRAC results with steady-state data measured in L Reactor, and confirmed by comparisons with transient LOCA results calculated by an independent group with the RELAP5 code. An overview of the limits methodology is given and discusses the L Reactor data. The methodology for estimating the plenum pressure uncertainty is presented along with the results.

  2. Uncertainty analysis for the K-reactor FI-LOCA limits

    SciTech Connect

    Hardy, B.J.

    1991-12-31

    A postulated accident scenario for the Savannah River Site (SRS) K-reactor is a Double Ended Guillotine Break Loss of Coolant Accident (DEGB/LOCA) due to a coolant pipe break at the plenum inlet. The DEGB/LOCA consists of two parts, the first of which applies to the first few seconds of the transient. The first part of the DEGB/LOCA is addressed in this paper. In the first few seconds after the pipe break there is a rapid depressurization of the plenum, which results in a rapid reduction in the core flowrate. Safety rod insertion is not assumed to begin until 1 second after the pipe break and the rods are assumed not to be fully inserted until approximately 2 seconds after the break. The resulting flow-power mismatch results in coolant heating and possible flow disruption via a Lendinegg type flow instability. For this reason, the initial phase of the DEGB/LOCA transient is called the Flow Instability (FI) phase.

  3. Uncertainty analysis for the K-reactor FI-LOCA limits

    SciTech Connect

    Hardy, B.J.

    1991-01-01

    A postulated accident scenario for the Savannah River Site (SRS) K-reactor is a Double Ended Guillotine Break Loss of Coolant Accident (DEGB/LOCA) due to a coolant pipe break at the plenum inlet. The DEGB/LOCA consists of two parts, the first of which applies to the first few seconds of the transient. The first part of the DEGB/LOCA is addressed in this paper. In the first few seconds after the pipe break there is a rapid depressurization of the plenum, which results in a rapid reduction in the core flowrate. Safety rod insertion is not assumed to begin until 1 second after the pipe break and the rods are assumed not to be fully inserted until approximately 2 seconds after the break. The resulting flow-power mismatch results in coolant heating and possible flow disruption via a Lendinegg type flow instability. For this reason, the initial phase of the DEGB/LOCA transient is called the Flow Instability (FI) phase.

  4. Downscaling humidity with Localized Constructed Analogs (LOCA) over the conterminous United States

    NASA Astrophysics Data System (ADS)

    Pierce, D. W.; Cayan, D. R.

    2015-09-01

    Humidity is important to climate impacts in hydrology, agriculture, ecology, energy demand, and human health and comfort. Nonetheless humidity is not available in some widely-used archives of statistically downscaled climate projections for the western U.S. In this work the Localized Constructed Analogs (LOCA) statistical downscaling method is used to downscale specific humidity to a 1°/16° grid over the conterminous U.S. and the results compared to observations. LOCA reproduces observed monthly climatological values with a mean error of ~0.5 % and RMS error of ~2 %. Extreme (1-day in 1- and 20-years) maximum values (relevant to human health and energy demand) are within ~5 % of observed, while extreme minimum values (relevant to agriculture and wildfire) are within ~15 %. The asymmetry between extreme maximum and minimum errors is largely due to residual errors in the bias correction of extreme minimum values. The temporal standard deviations of downscaled daily specific humidity values have a mean error of ~1 % and RMS error of ~3 %. LOCA increases spatial coherence in the final downscaled field by ~13 %, but the downscaled coherence depends on the spatial coherence in the data being downscaled, which is not addressed by bias correction. Temporal correlations between daily, monthly, and annual time series of the original and downscaled data typically yield values >0.98. LOCA captures the observed correlations between temperature and specific humidity even when the two are downscaled independently.

  5. Downscaling humidity with Localized Constructed Analogs (LOCA) over the conterminous United States

    NASA Astrophysics Data System (ADS)

    Pierce, D. W.; Cayan, D. R.

    2016-07-01

    Humidity is important to climate impacts in hydrology, agriculture, ecology, energy demand, and human health and comfort. Nonetheless humidity is not available in some widely-used archives of statistically downscaled climate projections for the western U.S. In this work the Localized Constructed Analogs (LOCA) statistical downscaling method is used to downscale specific humidity to a 1°/16° grid over the conterminous U.S. and the results compared to observations. LOCA reproduces observed monthly climatological values with a mean error of ~0.5 % and RMS error of ~2 %. Extreme (1-day in 1- and 20-years) maximum values (relevant to human health and energy demand) are within ~5 % of observed, while extreme minimum values (relevant to agriculture and wildfire) are within ~15 %. The asymmetry between extreme maximum and minimum errors is largely due to residual errors in the bias correction of extreme minimum values. The temporal standard deviations of downscaled daily specific humidity values have a mean error of ~1 % and RMS error of ~3 %. LOCA increases spatial coherence in the final downscaled field by ~13 %, but the downscaled coherence depends on the spatial coherence in the data being downscaled, which is not addressed by bias correction. Temporal correlations between daily, monthly, and annual time series of the original and downscaled data typically yield values >0.98. LOCA captures the observed correlations between temperature and specific humidity even when the two are downscaled independently.

  6. [Differences and similarities of primary care in the German and Spanish health care systems].

    PubMed

    Salvador Comino, María Rosa; Krane, Sibylla; Schelling, Jörg; Regife García, Víctor

    2016-02-01

    An efficient primary care is of particular importance for any countries' health care system. Many differences exist on how distinctive countries try to obtain the goal of an efficient, cost-effective primary care for its population. In this article we conducted a selective literature review, which includes both scientific and socio-political publications. The findings are complemented with the experience of a Spanish physician from Seville in her last year of training in family medicine, who completed a four months long rotation in the German health care system. We highlighted different features by comparing both countries, including their health care expenditure, the relation between primary and secondary care, the organization in the academic field and the training of future primary care physicians. It is clear that primary care in both countries plays a central role, have to deal with shortcomings, and in some points one system can learn from the other. PMID:26363955

  7. Current Management of Primary Central Nervous System Lymphoma

    SciTech Connect

    Schultz, Christopher J.; Bovi, Joseph

    2010-03-01

    Primary central nervous cell lymphoma (PCNSL) is an uncommon neoplasm of the brain, leptomeninges, and rarely the spinal cord. Initially thought to be characteristically associated with congenital, iatrogenic, or acquired immunosuppression, PCNSL is now recognized with increasing frequency in immunocompetent individuals. The role of surgery is limited to establishing diagnosis, as PCNSL is often multifocal with a propensity to involve the subarachnoid space. A whole-brain radiation volume has empirically been used to adequately address the multifocal tumor frequently encountered at the time of PCNSL diagnosis. Despite high rates of response after whole-brain radiotherapy (WBRT), rapid recurrence is common and long-term survival is the exception. Chemotherapy alone or in combination with WBRT has more recently become the treatment of choice. Most effective regimens contain high-dose methotrexate and or other agents that are capable of penetrating the blood-brain barrier. High response rates and improved survival with the use of chemotherapy has led to treatment strategies that defer or eliminate WBRT in hopes of lessening the risk of neurotoxicity attributed to WBRT. Unfortunately, elimination of WBRT is also associated with a higher rate of relapse. Combined chemotherapy and WBRT regimens are now being explored that use lower total doses of radiation and altered fractionation schedules with the aim of maintaining high rates of tumor control while minimizing neurotoxicity. Pretreatment, multifactor prognostic indices have recently been described that may allow selection of treatment regimens that strike an appropriate balance of risk and benefit for the individual PCNSL patient.

  8. Reproductive health in India's primary health care system.

    PubMed

    Rao, M

    1997-01-01

    India's family planning program having reached a dead end, the government of India appointed an expert group to develop a new population policy for the country. While the group's report, submitted in May 1994, proclaimed a new orientation described as pro-poor, pro-nature, and pro-women, the recommendations of the report were criticized as not being serious about gender equity. The government of India, describing a new reproductive health care approach, envisions a paradigm shift in the family planning program strategy. Reproductive health is defined as a state in which people can reproduce and regulate their fertility, women are able to go through pregnancy and childbirth safely, the outcome of pregnancy is successful with regard to maternal and infant survival and well-being, and couples are able to have sexual relations free of the fear of pregnancy and of contracting disease. To further the discussion on the newly initiated reproductive health care approach, the faculty of the Center of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, New Delhi, organized a workshop for November 4-5, 1996, on the place of reproductive health in India's primary health care. The workshop brought together public health persons, clinicians, and health and women's rights activists. The author outlines the content of papers presented at the workshop. PMID:9230606

  9. Systemic Lupus Erythematosus: Primary Care Approach to Diagnosis and Management.

    PubMed

    Lam, Nguyet-Cam Vu; Ghetu, Maria V; Bieniek, Marzena L

    2016-08-15

    Systemic lupus erythematosus is an autoimmune disease that affects many systems, including the skin, musculoskeletal, renal, neuropsychiatric, hematologic, cardiovascular, pulmonary, and reproductive systems. Family physicians should be familiar with the manifestations of lupus to aid in early diagnosis, monitoring patients with mild disease, recognizing warning signs that require referral to a rheumatologist, and helping to monitor disease activity and treatment in patients with moderate to severe disease. The American College of Rheumatology has 11 classification criteria for lupus. If a patient meets at least four criteria, lupus can be diagnosed with 95% specificity and 85% sensitivity. All patients with lupus should receive education, counseling, and support. Hydroxychloroquine is the cornerstone of treatment because it reduces disease flares and other constitutional symptoms. Low-dose glucocorticoids can be used to treat most manifestations of lupus. The use of immunosuppressive and cytotoxic agents depends on the body systems affected. Patients with mild disease that does not involve major organ systems can be monitored by their family physician. Patients with increased disease activity, complications, or adverse effects from treatment should be referred to a rheumatologist. To optimize treatment, it is important that a rheumatologist coordinate closely with the patient's family physician to improve chronic care as well as preventive health services. PMID:27548593

  10. Innate immune cells in the pathogenesis of primary systemic vasculitis.

    PubMed

    Misra, Durga Prasanna; Agarwal, Vikas

    2016-02-01

    Innate immune system forms the first line of defense against foreign substances. Neutrophils, eosinophils, erythrocytes, platelets, monocytes, macrophages, dendritic cells, γδ T cells, natural killer and natural killer T cells comprise the innate immune system. Genetic polymorphisms influencing the activation of innate immune cells predispose to development of vasculitis and influence its severity. Abnormally activated innate immune cells cross-talk with other cells of the innate immune system, present antigens more efficiently and activate T and B lymphocytes and cause tissue destruction via cell-mediated cytotoxicity and release of pro-inflammatory cytokines. These secreted cytokines further recruit other cells to the sites of vascular injury. They are involved in both the initiation as well as the perpetuation of vasculitis. Evidences suggest reversal of aberrant activation of immune cells in response to therapy. Understanding the role of innate immune cells in vasculitis helps understand the potential of therapeutic modulation of their activation to treat vasculitis. PMID:26403285

  11. Assessing & Developing Primary Care for Children: Reforms in Health Systems.

    ERIC Educational Resources Information Center

    Grason, Holly Allen, Ed.; Guyer, Bernard, Ed.

    This publication is a compilation of papers presented at an April 1994 workshop sponsored by the National Center for Education in Maternal and Child Health and the Bureau-funded Johns Hopkins Child and Adolescent Health Policy Center (CAHPC). The papers are as follows: (1) "Defining the Issues and Planning for Change: Health Care Systems, Primary…

  12. Measuring primary care practice performance within an integrated delivery system: a case study.

    PubMed

    Stewart, Louis J; Greisler, David

    2002-01-01

    This article examines the use of an integrated performance measurement system to plan and control primary care service delivery within an integrated delivery system. We review a growing body of literature that focuses on the development and implementation of management reporting systems among healthcare providers. Our study extends the existing literature by examining the use of performance information generated by an integrated performance measurement system within a healthcare organization. We conduct our examination through a case study of the WMG Primary Care Medicine Group, the primary care medical group practice of WellSpan Health System. WellSpan Health System is an integrated delivery system that serves south central Pennsylvania and northern Maryland. Our study examines the linkage between WellSpan Health's strategic objectives and its primary care medicine group's integrated performance measurement system. The conceptual design of this integrated performance measurement system combines financial metrics with practice management and clinical operating metrics to provide a more complete picture of medical group performance. Our findings demonstrate that WellSpan Health was able to achieve superior financial results despite a weak linkage between its integrated performance measurement system and its strategic objectives. WellSpan Health achieved this objective for its primary care medicine group by linking clinical performance information to physician compensation and reporting practice management performance through the use of statistical process charts. They found that the combined mechanisms of integrated performance measurement and statistical process control charts improved organizational learning and communications between organizational stakeholders. PMID:12221746

  13. 49 CFR 214.529 - In-service failure of primary braking system.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY On-Track Roadway Maintenance Machines and Hi-Rail Vehicles § 214.529 In-service failure of primary braking system. (a) In...

  14. 49 CFR 214.529 - In-service failure of primary braking system.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY On-Track Roadway Maintenance Machines and Hi-Rail Vehicles § 214.529 In-service failure of primary braking system. (a) In...

  15. 49 CFR 214.529 - In-service failure of primary braking system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY On-Track Roadway Maintenance Machines and Hi-Rail Vehicles § 214.529 In-service failure of primary braking system. (a) In...

  16. The development process for the space shuttle primary avionics software system

    NASA Technical Reports Server (NTRS)

    Keller, T. W.

    1987-01-01

    Primary avionics software system; software development approach; user support and problem diagnosis; software releases and configuration; quality/productivity programs; and software development/production facilities are addressed. Also examined are the external evaluations of the IBM process.

  17. An illustrative case of primary angiitis of the central nervous system

    PubMed Central

    Zagami, Alessandro S

    2014-01-01

    Primary angiitis of the central nervous system is a rare idiopathic vasculitis affecting small- and medium-sized vessels, isolated to the brain, leptomeninges and spinal cord. We report a case of biopsy-proven primary angiitis of the central nervous system, displaying some atypical features. This case highlights several key diagnostic and management issues of the disorder as well as its potential heterogeneity. PMID:27489666

  18. Generic Safety Issue (GSI) 171 -- Engineered Safety Feature (ESF) failure from a loop subsequent to LOCA: Assessment of plant vulnerability and CDF contributions

    SciTech Connect

    Martinez-Guridi, G.; Samanta, P.; Chu, L.; Yang, J.

    1998-03-01

    Generic Safety Issue 171 (GSI-171), Engineered Safety Feature (ESF) from a Loss Of Offsite Power (LOOP) subsequent to a Loss Of Coolant Accident (LOCA), deals with an accident sequence in which a LOCA is followed by a LOOP. This issue was later broadened to include a LOOP followed by a LOCA. Plants are designed to handle a simultaneous LOCA and LOOP. In this paper, the authors address the unique issues that are involved i LOCA with delayed LOOP (LOCA/LOOP) and LOOP with delayed LOCA (LOOP/LOCA) accident sequences. LOCA/LOOP accidents are analyzed further by developing event-tree/fault-tree models to quantify their contributions to core-damage frequency (CDF) in a pressurized water reactor and a boiling water reactor (PWR and a BWR). Engineering evaluation and judgments are used during quantification to estimate the unique conditions that arise in a LOCA/LOOP accident. The results show that the CDF contribution of such an accident can be a dominant contributor to plant risk, although BWRs are less vulnerable than PWRs.

  19. Evaluation of primary stability of innovated orthodontic miniscrew system (STS): An ex-vivo study

    PubMed Central

    Seifi, Massoud

    2016-01-01

    Background Stability is determined as one of the requirements in use of Temporary Anchorage Devices (TAD) in orthodontics. Miniscrew has been a widely used Bone Anchor. Compared with mini-implant that necessitates osseointegration; mechanical retention is a determining factor for primary stability of miniscrew. Studies investigated various ways to increase primary stability. The aim of this study is to introduce a new configuration of miniscrew system which is believed to obtain more primary stability. Material and Methods Freshly ovine mandibles were cut in blocks. Twenty-seven miniscrews (diameter 1.6 × 8 mm; G2, Dual Top Anchor System, Jeil Medical, Seoul, Korea) were inserted in the blocks and divided in 2 experimental groups: single miniscrew and the innovated design “Seifi Twin Screw (STS)”. Primary stability was evaluated by Periotest “M”® device. Results Independent t-test showed a significant difference between 2 experimental groups in periotest evaluation (p< 0.05). STS demonstrated higher primary stability due to its mechanical configuration and design. Conclusions The STS provides higher primary stability and was found to be effective in increased success rate of miniscrew systems from the standpoint of primary stability. Key words:Anchorage procedures, anchorage techniques, orthodontic anchorage procedures, miniscrews, temporary anchorage device. PMID:27398174

  20. Reliability model of fault-tolerant data processing system with primary and backup nodes

    NASA Astrophysics Data System (ADS)

    Rahman, P. A.; Bobkova, E. Yu

    2016-04-01

    This paper deals with the fault-tolerant data processing systems, which are widely used in modern world of information technologies and have acceptable overhead expenses in hardware implementation. A simplified reliability model for duplex systems and the offered by authors advanced model for data processing systems with primary and backup nodes based on a three-state model of recoverable elements, which takes into consideration different failure rates of passive and active nodes and finite time of node activation, are also given. A calculation formula for the availability factor of the dual-node data processing system with primary and backup nodes and calculation examples are also provided.

  1. Space Shuttle Program Primary Avionics Software System (PASS) Success Legacy - Quality and Reliability Date

    NASA Technical Reports Server (NTRS)

    Orr, James K.; Peltier, Daryl

    2010-01-01

    Thsi slide presentation reviews the avionics software system on board the space shuttle, with particular emphasis on the quality and reliability. The Primary Avionics Software System (PASS) provides automatic and fly-by-wire control of critical shuttle systems which executes in redundant computers. Charts given show the number of space shuttle flights vs time, PASS's development history, and other charts that point to the reliability of the system's development. The reliability of the system is also compared to predicted reliability.

  2. 40 CFR 141.544 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.544 Section 141.544 Protection of Environment... Benchmark § 141.544 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone or chlorine dioxide for primary disinfection your system...

  3. 40 CFR 141.544 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.544 Section 141.544 Protection of Environment... Benchmark § 141.544 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone or chlorine dioxide for primary disinfection your system...

  4. 40 CFR 141.544 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.544 Section 141.544 Protection of Environment... Benchmark § 141.544 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone or chlorine dioxide for primary disinfection your system...

  5. Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

    PubMed Central

    2013-01-01

    Background The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective. Methods A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework. Results Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care. Conclusion Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices

  6. Optimal gamut volume design for three primary and multiprimary display systems

    NASA Astrophysics Data System (ADS)

    Rodríguez-Pardo, Carlos Eduardo; Sharma, Gaurav; Feng, Xiao-Fan; Speigle, Jon; Sezan, Ibrahim

    2012-01-01

    Primary selection plays a fundamental role in display design. Primaries affect not only the gamut of colors the systems is able to reproduce, but also, they have an impact on the power consumption and other cost related variables. Using more than the traditional three primaries has been shown to be a versatile way of extending the color gamut, widening the angle view of LCD screens and improving power consumption of displays systems. Adequate selection of primaries requires a trade-off between the multiple benefits the system offers, the costs and the complexity it implies, among other design parameters. The purpose of this work is to present a methodology for optimal design for three primary and multiprimary display systems. We consider the gamut in perceptual spaces, which offer the advantage of an evaluation that correlates with human perception, and determine a design that maximize the gamut volume, constrained to a certain power budget, and analyze the benefits of increasing number of primaries, and their effect on other variables of performance like gamut coverage.

  7. Assessment of CONTAIN and MELCOR for performing LOCA and LOVA analyses in ITER

    SciTech Connect

    Merrill, B.J.; Hagrman, D.L.; Gaeta, M.J.; Petti, D.A.

    1994-09-01

    This report describes the results of an assessment of the CONTAIN and MELCOR computer codes for ITER LOCA and LOVA applications. As part of the assessment, the results of running a test problem that describes an ITER LOCA are presented. It is concluded that the MELCOR code should be the preferred code for ITER severe accident thermal hydraulic analyses. This code will require the least modification to be appropriate for calculating thermal hydraulic behavior in ITER relevant conditions that include vacuum, cryogenics, ITER temperatures, and the presence of a liquid metal test module. The assessment of the aerosol transport models in these codes concludes that several modifications would have to be made to CONTAIN and/or MELCOR to make them applicable to the aerosol transport part of severe accident analysis in ITER.

  8. Embrittlement of pre-hydrided Zircaloy-4 by steam oxidation under simulated LOCA transients

    NASA Astrophysics Data System (ADS)

    Desquines, J.; Drouan, D.; Guilbert, S.; Lacote, P.

    2016-02-01

    During a Loss Of Coolant Accident (LOCA), the mechanical behavior of high temperature steam oxidized fuel rods is an important issue. In this study, as-received and pre-hydrided axial tensile samples were steam oxidized in a vertical furnace and water quenched in order to simulate a LOCA transient. The samples were then subjected to a mechanical test to determine the failure conditions. Two different rupture modes were evidenced; the first one associated to linear elastic fracture mechanics and the second one is associated to sample failure without applied load. The oxidized cladding fracture toughness was determined relying on intensive metallographic analysis. The sample failure conditions were then back predicted confirming that the main rupture parameters are well captured.

  9. The Place of Creativity in Pakistani Primary Education System: An Investigation into the Factors Enhancing and Inhibiting Primary School Children's Creativity

    ERIC Educational Resources Information Center

    Shaheen, Robina

    2011-01-01

    The study presented in this book provides a baseline analysis of the extent to which the primary education system in Pakistan is capable of enhancing or inhibiting children's creativity. It involved 1008 primary schools who participated in a survey, 154 children who took the Torrance Tests of Creative Thinking, and classroom observation in 16…

  10. Group D Adenoviruses Infect Primary Central Nervous System Cells More Efficiently than Those from Group C

    PubMed Central

    Chillon, Miguel; Bosch, Assumpció; Zabner, Joseph; Law, Lane; Armentano, Donna; Welsh, Michael J.; Davidson, Beverly L.

    1999-01-01

    Group C adenovirus-mediated gene transfer to central nervous system cells is inefficient. We found that wild-type group D viruses, or recombinant adenovirus type 2 (Ad2) (group C) modified to contain Ad17 (group D) fiber, were more efficient in infecting primary cultures of neurons. Together with studies on primary vascular endothelial cells and tissue culture cell lines, our results indicate that there is not a universally applicable adenovirus serotype for use as a gene transfer vector. PMID:9971839

  11. Preparation of gaseous CRMs from the primary system for (222)Rn activity measurement.

    PubMed

    Kim, B J; Kim, B C; Lee, K B; Lee, J M; Park, T S

    2016-03-01

    For disseminating the gaseous radon standard traceable to the KRISS primary system based on the defined solid angle counting method, two kinds of radon CRM (a glass ampule type and a stainless steel cylinder type) were developed. The activity of the CRM was certified by subtracting a residual activity from the measured activity by the primary system. After certification, the ampule CRM was used to calibrate a radon-monitoring instrument and the cylinder CRM to calibrate an HPGe system. We also improved the measurement procedure of the radon primary system. In a typical radon energy spectrum, the radon peak overlaps with the polonium peak. For more reliable and accurate measurement of radon activity, a fitting method was adopted for the evaluation of radon area in the alpha energy spectrum. The result of radon activity evaluated by using the fitting method is in good agreement with that by the previous integration method. PMID:26778761

  12. Primary Mirror Figure Maintenance of the Hobby-Eberly Telescope using the Segment Alignment Maintenance System

    NASA Technical Reports Server (NTRS)

    Rakoczy, John; Hall, Drew; Howard, Ricky; Ly, William; Weir, John; Montgomery, Edward; Brantley, Lott W. (Technical Monitor)

    2002-01-01

    The Segment Alignment Maintenance System (SAMs) was installed on McDonald Observatory's Hobby-Eberly Telescope (HET) in August 2001. The SAMs became fully operational in October 2001. The SAMs uses a system of 480 inductive edge sensors to correct misalignments of the HET's 91 primary mirror segments when the segments are perturbed from their aligned reference positions. A special observer estimated and corrects for the global radius of curvature (GroC) mode, a mode unobservable by the edge sensors. The SAMs edge sensor system and (GroC) estimator are able to maintain HET's primary figure for much longer durations than previously had been observed. Telescope image quality has improved, and the amount of overhead time required from primary mirror alignment has been reduced. This paper gives a functional description of the SAMs control system and presents performance verification data. This paper also describes how the SAMs has improved the operational efficiency of the HET.

  13. Circulation within the primary system at TMI-2 with lowered coolant level and at atmospheric conditions

    SciTech Connect

    Baston, V.F.; Hofstetter, K.J.; Malinauskas, A.P.

    1985-06-01

    Experiments were performed with the Three Mile Island reactor coolant system open to the atmosphere and the coolant lowered to a level above the fuel (a condition required for defueling) to ascertain the extent of coolant mixing. A principal concern for coolant decontamination during defueling is the radionuclides released and their distribution within the primary system. Analyses of radionuclide, temperature, and dissolved oxygen data taken during these experiments confirm mixing in the primary system under forced coolant flow conditions with only minimal mixing occurring during static periods.

  14. Long-term aging and loss-of-coolant accident (LOCA) testing of electrical cables

    SciTech Connect

    Nelson, C.F.; Gauthier, G.; Carlin, F.

    1996-10-01

    Experiments were performed to assess the aging degradation and loss-of-coolant accident (LOCA) behavior of electrical cables subjected to long-term aging exposures. Four different cable types were tested in both the U.S. and France: (1) U.S. 2 conductor with ethylene propylene rubber (EPR) insulation and a Hypalon jacket. (2) U.S. 3 conductor with cross-linked polyethylene (XLPE) insulation and a Hypalon jacket. (3) French 3 conductor with EPR insulation and a Hypalon jacket. (4) French coaxial with polyethylene (PE) insulation and a PE jacket. The data represent up to 5 years of simultaneous aging where the cables were exposed to identical aging radiation doses at either 40{degrees}C or 70{degrees}C; however, the dose rate used for the aging irradiation was varied over a wide range (2-100 Gy/hr). Aging was followed by exposure to simulated French LOCA conditions. Several mechanical, electrical, and physical-chemical condition monitoring techniques were used to investigate the degradation behavior of the cables. All the cables, except for the French PE cable, performed acceptably during the aging and LOCA simulations. In general, cable degradation at a given dose was highest for the lowest dose rate, and the amount of degradation decreased as the dose rate was increased.

  15. Experimental investigation on the causes for pellet fragmentation under LOCA conditions

    NASA Astrophysics Data System (ADS)

    Bianco, A.; Vitanza, C.; Seidl, M.; Wensauer, A.; Faber, W.; Macián-Juan, R.

    2015-10-01

    This paper addresses a separate effect experiment performed with irradiated fuel to study fuel fragmentation and fission gas release during a loss of coolant accident (LOCA). The paper presents a qualitative and quantitative investigation of the effects of the removal of the geometrical constraint provided by the cladding and the removal of the constraint given by the rod internal pressure in determining the extent of fuel fragmentation and fission gas release during a LOCA for fuel segments with a burnup of approximately 52 MWd/kgU. A review of previous LOCA tests was the starting point for the identification of these constraints and for the selection of the fuel rod burnup, the experiment's procedure and the boundary conditions. An out-of-pile test was considered representative for the scope, and the experiment was performed at the Halden Reactor Project hot cell in Kjeller (Norway) with heat provided by an electric oven. Three fuel rod segments were studied: 1) a fuel segment that experienced only ballooning without burst, 2) a fuel segment that experienced ballooning and burst and 3) a fuel segment that experienced neither ballooning nor burst. The neutron radiography and fuel fragment sifting showed that both cladding constraint and internal pressure play a role in the formation of fuel cracks and fragmentation, and the study of the fission gas release during the transient showed that removing the cladding constraint or the internal pressure increased the amount of fission gas release.

  16. Experimental investigation of sedimentation of LOCA - generated fibrous debris and sludge in BWR suppression pools

    SciTech Connect

    Souto, F.J.; Rao, D.V.

    1995-12-01

    Several tests were conducted in a 1:2.4 scale model of a Mark I suppression pool to investigate the behavior of fibrous insulation and sludge debris under LOCA conditions. NUKON{trademark} shreds, manually cut and tore up in a leaf shredder, and iron oxide particles were used to simulate fibrous and sludge debris, respectively. The suppression pool model included four downcomers fitted with pistons to simulate the steam-water oscillations during chugging expected during a LOCA. The study was conducted to provide debris settling velocity data for the models used in the BLOCKAGE computer code, developed to estimate the ECCS pump head loss due to clogging of the strainers with LOCA generated debris. The tests showed that the debris, both fibrous and particulate, remains fully mixed during chugging; they also showed that, during chugging, the fibrous debris underwent fragmentation into smaller sizes, including individual fibers. Measured concentrations showed that fibrous debris settled slower than the sludge, and that the settling behavior of each material is independent of the presence of the other material. Finally, these tests showed that the assumption of considering uniform debris concentration during strainer calculations is reasonable. The tests did not consider the effects of the operation of the ECCS on the transport of debris in the suppression pool.

  17. 49 CFR 214.529 - In-service failure of primary braking system.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Maintenance Machines and Hi-Rail Vehicles § 214.529 In-service failure of primary braking system. (a) In the... machine may be operated for the remainder of its tour of duty with the use of a secondary braking system or by coupling to another machine, if such operations may be done safely. (b) If the total...

  18. Gender Differences in the Primary Representational System according to Neurolinguistic Programming.

    ERIC Educational Resources Information Center

    Cassiere, M. F.; And Others

    Neurolinguistic Programming (NLP) is a currently popular therapeutic modality in which individuals organize information through three basic sensory systems, one of which is the Primary Representational System (PRS). This study was designed to investigate gender differences in PRS according to the predicate preference method. It was expected that…

  19. Relationships between Digestive, Circulatory, and Urinary Systems in Portuguese Primary Textbooks

    ERIC Educational Resources Information Center

    Carvalho, Graça S.; Clèment, Pierre

    2007-01-01

    In this study, 63 Portuguese primary schoolbooks (1920-2005) were analyzed. The analysis focused on text information (reference to blood absorption and association of the digestive system to other human systems) and on information from images (presence or absence of image "confusion" (when the sequence of the digestive tract is not…

  20. Primary central nervous system lymphomas and related diseases: Pathological characteristics and discussion of the differential diagnosis.

    PubMed

    Sugita, Yasuo; Muta, Hiroko; Ohshima, Koichi; Morioka, Motohiro; Tsukamoto, Yoshihiro; Takahashi, Hitoshi; Kakita, Akiyoshi

    2016-08-01

    Although primary diffuse large B-cell lymphomas of the CNS are designated as primary CNS lymphomas according to the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissue in 2008, a variety of other lymphomas (Burkitt lymphomas, EBV-positive diffuse large B-cell lymphoma of the elderly) and related diseases (lymphomatoid granulomatosis) that are also found in the CNS have been spotlighted in recent years. The histopathology of primary CNS Burkitt lymphomas mimics that of primary diffuse large B-cell lymphomas of the CNS after steroid administration. Therefore, for correct diagnosis of the involved lymphoma, comprehensive fluorescent in situ hybridization analysis for c-MYC and BCL2 is recommended in all primary CNS lymphoma cases with aggressive clinical course, multifocal involvement of the CNS, and a high proliferation index. The pathological characteristics of primary CNS EBV-positive diffuse large B-cell lymphoma of the elderly have similarities with those of the latency phenotype III, EBV lymphoproliferative disorders that arise in the setting of immunodeficiency. These age-related lymphomas usually occur in elderly immunocompetent patients, and the incidence of this disease was estimated to range from 4.0% to 13.6% of all primary CNS lymphomas. Shorter overall survival has been reported for patients with this disease. Lymphomatoid granulomatosis (LYG) is a systemic, EBV-driven, angiocentric and angiodestructive lymphoproliferative disorder. Primary LYG that shows distinct clinicopathological features compared with systemic LYG was recently reported. Finally, this review focuses on the relationship between primary CNS lymphomas and demyelinating diseases, and the concomitant use of intraoperative cytology and frozen sections that are helpful in rapid intraoperative diagnosis. PMID:26607855

  1. Thermodynamics of greenhouse systems for the northern latitudes: analysis, evaluation and prospects for primary energy saving.

    PubMed

    Bronchart, Filip; De Paepe, Michel; Dewulf, Jo; Schrevens, Eddie; Demeyer, Peter

    2013-04-15

    In Flanders and the Netherlands greenhouse production systems produce economically important quantities of vegetables, fruit and ornamentals. Indoor environmental control has resulted in high primary energy use. Until now, the research on saving primary energy in greenhouse systems has been mainly based on analysis of energy balances. However, according to the thermodynamic theory, an analysis based on the concept of exergy (free energy) and energy can result in new insights and primary energy savings. Therefore in this paper, we analyse the exergy and energy of various processes, inputs and outputs of a general greenhouse system. Also a total system analysis is then performed by linking the exergy analysis with a dynamic greenhouse climate growth simulation model. The exergy analysis indicates that some processes ("Sources") lie at the origin of several other processes, both destroying the exergy of primary energy inputs. The exergy destruction of these Sources is caused primarily by heat and vapour loss. Their impact can be compensated by exergy input from heating, solar radiation, or both. If the exergy destruction of these Sources is reduced, the necessary compensation can also be reduced. This can be accomplished through insulating the greenhouse and making the building more airtight. Other necessary Sources, namely transpiration and loss of CO2, have a low exergy destruction compared to the other Sources. They are therefore the best candidate for "pump" technologies ("vapour heat pump" and "CO2 pump") designed to have a low primary energy use. The combination of these proposed technologies results in an exergy efficient greenhouse with the highest primary energy savings. It can be concluded that exergy analyses add additional information compared to only energy analyses and it supports the development of primary energy efficient greenhouse systems. PMID:23474336

  2. The role of a reaction-diffusion system in the initiation of primary hair follicles.

    PubMed

    Nagorcka, B N; Mooney, J R

    1985-05-21

    A mechanism based on a reaction-diffusion system is proposed for the initiation of hair follicles in the epidermis during fetal development. It is demonstrated that initiation of primary follicles in a series of waves, within the proposed mechanism, is a consequence of the size and shape dependent properties of the reaction-diffusion system without the need for the propagation of signals through the skin. The observed trio grouping of follicles and variation of primary follicle density per unit skin area during development are also correctly predicted. An explanation, based on the reaction-diffusion system and the variation of its characteristic spatial wavelength with time during development, is suggested for the termination of both primary and secondary follicle initiation as well as follicle neogenesis. The proposed initiation mechanism is basically the same as that used to explain various spatial patterns observed in hair fibre formation (Nagorcka & Mooney, 1982). PMID:4033155

  3. 40 CFR 141.535 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.535 Section 141.535 Protection of Environment... § 141.535 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone, or chlorine dioxide for primary disinfection, you must...

  4. 40 CFR 141.535 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.535 Section 141.535 Protection of Environment... § 141.535 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone, or chlorine dioxide for primary disinfection, you must...

  5. 40 CFR 141.535 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., ozone, or chlorine dioxide for primary disinfection? 141.535 Section 141.535 Protection of Environment... § 141.535 What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? If your system uses chloramines, ozone, or chlorine dioxide for primary disinfection, you must...

  6. A primary culture system of mouse thick ascending limb cells with preserved function and uromodulin processing.

    PubMed

    Glaudemans, Bob; Terryn, Sara; Gölz, Nadine; Brunati, Martina; Cattaneo, Angela; Bachi, Angela; Al-Qusairi, Lama; Ziegler, Urs; Staub, Olivier; Rampoldi, Luca; Devuyst, Olivier

    2014-02-01

    The epithelial cells lining the thick ascending limb (TAL) of the loop of Henle perform essential transport processes and secrete uromodulin, the most abundant protein in normal urine. The lack of differentiated cell culture systems has hampered studies of TAL functions. Here, we report a method to generate differentiated primary cultures of TAL cells, developed from microdissected tubules obtained in mouse kidneys. The TAL tubules cultured on permeable filters formed polarized confluent monolayers in ∼12 days. The TAL cells remain differentiated and express functional markers such as uromodulin, NKCC2, and ROMK at the apical membrane. Electrophysiological measurements on primary TAL monolayers showed a lumen-positive transepithelial potential (+9.4 ± 0.8 mV/cm(2)) and transepithelial resistance similar to that recorded in vivo. The transepithelial potential is abolished by apical bumetanide and in primary cultures obtained from ROMK knockout mice. The processing, maturation and apical secretion of uromodulin by primary TAL cells is identical to that observed in vivo. The primary TAL cells respond appropriately to hypoxia, hypertonicity, and stimulation by desmopressin, and they can be transfected. The establishment of this primary culture system will allow the investigation of TAL cells obtained from genetically modified mouse models, providing a critical tool for understanding the role of that segment in health and disease. PMID:23887378

  7. Primary Systemic Amyloidosis with Unusual Dermatological Manifestations: A Rare Case Report

    PubMed Central

    Vyas, Kapil; Morgaonkar, Manjaree; Gupta, Savera; Jain, Suresh Kumar

    2016-01-01

    Amyloidosis is a group of heterogeneous diseases characterized by pathological deposition of proteinaceous substance extracellularly in various tissues. The clinical presentation depends on the site of amyloid deposition, with predominant involvement of mesenchymal elements and cutaneous findings in 30–40% of patients in case of primary systemic amyloidosis. We present a case of idiopathic primary systemic amyloidosis presenting with an unusual finding of nodulo-ulcerative lesion over tongue along with multiple skin-colored nodules, mimicking squamous cell carcinoma of tongue with secondary cutaneous metastasis, as well as lacking the classical presentation of purpura, macroglossia, waxy papules, and plaques. PMID:27057028

  8. Primary Systemic Amyloidosis and High Levels of Angiotensin-Converting Enzyme: Two Case Reports

    PubMed Central

    Praena-Segovia, J.; Sanchez-Gastaldo, A.; Bernabeu-Wittel, M.; Ocete-Pérez, R.; Ávila-Polo, R.; Martino, M. L.

    2013-01-01

    Infiltrative heart diseases are caused by a heterogeneous group of disorders; amyloidosis and sarcoidosis are two frequent causes of myocardial infiltration, which differ in clinical and biological outcome and treatment issues. The presence of high levels of angiotensin-converting enzyme (ACE) in a patient with infiltrative heart disease may increase suspicion of sarcoidosis. Nevertheless, no mention about increased ACE levels in extracerebral primary systemic amyloidosis is available. We present two cases of primary systemic amyloidosis, which are cardiac involvement and elevated ACE levels. PMID:24826302

  9. Comparison of Carbon and Hi-Z Primary Collimators for the LHC Phase II Collimation System

    SciTech Connect

    Keller, Lewis; Markiewicz, Thomas; Smith, Jeffrey; Assmann, Ralph; Bracco, Chiara; Weiler, Thomas; /Karlsruhe, Inst. Technol.

    2011-10-31

    A current issue with the LHC collimation system is single-diffractive, off-energy protons from the primary collimators that pass completely through the secondary collimation system and are absorbed immediately downbeam in the cold magnets of the dispersion suppressor section. Simulations suggest that the high impact rate could result in quenching of these magnets. We have studied replacing the 60 cm primary graphite collimators, which remove halo mainly by inelastic strong interactions, with 5.25 mm tungsten, which remove halo mainly by multiple coulomb scattering and thereby reduce the rate of single-diffractive interactions that cause losses in the dispersion suppressor.

  10. Gaps In Primary Care And Health System Performance In Six Latin American And Caribbean Countries.

    PubMed

    Macinko, James; Guanais, Frederico C; Mullachery, Pricila; Jimenez, Geronimo

    2016-08-01

    The rapid demographic and epidemiological transitions occurring in Latin America and the Caribbean have led to high levels of noncommunicable diseases in the region. In addition to reduced risk factors for chronic conditions, a strong health system for managing chronic conditions is vital. This study assessed the extent to which populations in six Latin American and Caribbean countries receive high-quality primary care, and it examined the relationship between experiences with care and perceptions of health system performance. We applied a validated survey on access, use, and satisfaction with health care services to nationally representative samples of the populations of Brazil, Colombia, El Salvador, Jamaica, Mexico, and Panama. Respondents reported considerable gaps in the ways in which primary care is organized, financed, and delivered. Nearly half reported using the emergency department for a condition they considered treatable in a primary care setting. Reports of more primary care problems were associated with worse perceptions of health system performance and quality and less receipt of preventive care. Urgent attention to primary care performance is required as the region's population continues to age at an unprecedented rate. PMID:27503978

  11. Primary Care Behavioral Health Provider Training: Systematic Development and Implementation in a Large Medical System.

    PubMed

    Dobmeyer, Anne C; Hunter, Christopher L; Corso, Meghan L; Nielsen, Matthew K; Corso, Kent A; Polizzi, Nicholas C; Earles, Jay E

    2016-09-01

    The expansion of integrated, collaborative, behavioral health services in primary care requires a trained behavioral health workforce with specific competencies to deliver effective, evidence-informed, team-based care. Most behavioral health providers do not have training or experience working as primary care behavioral health consultants (BHCs), and require structured training to function effectively in this role. This article discusses one such training program developed to meet the needs of a large healthcare system initiating widespread implementation of the primary care behavioral health model of service delivery. It details the Department of Defense's experience in developing its extensive BHC training program, including challenges of addressing personnel selection and hiring issues, selecting a model for training, developing and implementing a phased training curriculum, and improving the training over time to address identified gaps. Future directions for training improvements and lessons learned in a large healthcare system are discussed. PMID:27484777

  12. Dimensions and equilibrium structures of the primary component of the nonsynchronous binary systems

    NASA Astrophysics Data System (ADS)

    Pathania, A.; Medupe, T.

    2014-01-01

    Rotating stars and stars in the synchronous binaries have been extensively studied in literature. However, there are only few studies that have investigated the problems of the nonsynchronous binaries. In the present paper, we have made an attempt to study the various dimensions and equilibrium structures of the primary component of the nonsynchronous binaries. We have used the first approximation theory of Limber (1963) along with the methodology as that proposed by Mohan and Saxena (1983) for the present study. The objective of this paper is to check the effect of nonsynchronism on the various dimensions and equilibrium structures of the primary components of the binary systems. The results of the present study shows that there is change in the dimensions and equilibrium structures of the primary component of the binary systems due to nonsynchronism, and this change is more appreciable when the difference between the angular velocities of rotation and revolution is large.

  13. Vapor/Mist Used to Lubricate Gears After Loss of Primary Lubrication System

    NASA Technical Reports Server (NTRS)

    Handschuh, Robert F.; Morales, Wilfredo

    2001-01-01

    Loss of lubrication in rotorcraft drive systems is a demanding requirement placed on drive system manufacturers. The drive system must operate for at least 30 minutes once the primary lubrication system has failed. This test is a military requirement that must be passed prior to certification of the aircraft. As new aircraft engines, operating at higher speeds, are fielded, the requirements for the drive system become increasingly more difficult. Also, the drive system must be lightweight, which minimizes the opportunity to use the gear bodies to absorb the tremendous amount of heating that takes place. In many cases, the amount of heat generated because of the high speed and load requires an emergency lubrication system that negatively impacts the aircraft's weight, complexity, and cost. A single mesh spur gear test rig is being used at the NASA Glenn Research Center to investigate possible emergency lubrication system improvements that will minimize the impact of having these systems onboard rotorcraft. A technique currently being investigated uses a vapor/mist system to lubricate the contacting surfaces after the primary lubrication system has been shut down. A number of tests were conducted in which the vapor/mist used the same lubricant as the primary system, but at a greatly reduced flow rate. Each test was initiated with the primary lubrication system operational and at steady-state conditions for a given speed and load. Then the primary lubrication system was shut down, and the vapor/mist lubrication system was initiated. An example of the tests conducted is shown in the figures. These preliminary tests have uncovered a mechanism that provides a lubricious, carbonaceous solid on the surface that actually reduces the surface temperature of the meshing gear teeth during operation. Surface analysis of the carbonaceous solid revealed it was graphitic. This mechanism is the synthetic lubricant "coking" on the active profile of the gears, which reduces the

  14. Mammaglobin-A immunohistochemistry in primary central nervous system neoplasms and intracranial metastatic breast carcinoma.

    PubMed

    Cimino, Patrick J; Perrin, Richard J

    2014-07-01

    Metastases represent the most common type of intracranial neoplasm. In women, 30% of such tumors derive from breast carcinoma. In neurosurgical cases with ambiguous cellular morphology and/or limited biopsy material, immunohistochemistry (IHC) is often performed to distinguish metastases from primary central nervous system (CNS) neoplasms. IHC for mammaglobin-A (MGA), a protein expressed in a majority of breast carcinomas, is commonly applied in this setting, but its utility for distinguishing primary CNS neoplasms from metastatic breast carcinoma is unknown; the reactivity of MGA in primary and metastatic CNS neoplasms has never been described. Here, we describe the frequency and patterns of IHC reactivity for MGA in metastatic and primary CNS neoplasms from patients with well-documented histories of breast carcinoma. Following a published protocol previously applied to non-CNS neoplasms, MGA staining of moderate to strong intensity within 5% or more of a neoplasm was considered positive. On the basis of these criteria, 3 of 12 (25.0%) glioblastomas, 1 of 10 (10.0%) meningiomas, and 47 of 95 (49.5%) metastases were positive. Importantly, the cytoarchitectural staining characteristics among all 4 MGA-positive primary CNS neoplasms (cytoplasmic and nuclear) differed from those of the metastases (cytoplasmic and membranous). These findings suggest that MGA IHC staining intensity and distribution can distinguish metastases from primary CNS neoplasms (P=0.0086) in women with a history of breast carcinoma but also indicate that cytologic staining patterns must be interpreted for more accurate tumor classification. PMID:23958549

  15. Primary healthcare in transition – a qualitative study of how managers perceived a system change

    PubMed Central

    2013-01-01

    Background Primary healthcare in Sweden has undergone widespread reforms in recent years, including freedom of choice regarding provider, freedom of establishment and increased privatisation. The key aims of the reforms were to strengthen the role of the patient and improve performance in terms of access and responsiveness. The aim of this study was to explore how managers at publicly owned primary healthcare centres perceived the transition of the primary healthcare system and the impact it has had on their work. Methods In this qualitative study, 24 managers of publicly owned primary healthcare centres in the metropolitan region of Gothenburg were recruited. Semi-structured interviews were conducted and data were analysed using content analysis inspired by Silverman. Results The analysis revealed two core themes: The transition is perceived as a rapid change, enforced mainly through financial incentives and Prioritisation conflicts arise between patient groups with different needs, demands and levels of empowerment. The transition has produced powerful and rapid effects that were considered to be both positive and negative. While the new financial incentives were seen as a driving force and a tool for change, they also became a stress factor due to uncertainty, competition with other primary healthcare centres and negative feelings associated with staff cutbacks. The shift in power towards the patient improved access and service but also led to more patients with unreasonable demands. Managers found it difficult to prioritise correctly between patient groups with different needs, demands and levels of empowerment and they were concerned about potentially negative effects on less empowered patients, e.g. multi-morbid patients. Managers also experienced shortcomings in their change management skills. Conclusions This qualitative study shows the complexity of the system change and describes the different effects and perceptions of the transition from a manager

  16. Numerical simulation of PWR response to a small break LOCA (loss-of-coolant accident) with reactor coolant pumps operating

    SciTech Connect

    Adams, J.P.; Dobbe, C.A.; Bayless, P.D.

    1986-01-01

    Calculations have been made of the response of pressurized water reactors (PWRs) during a small-break, loss-of-coolant accident with the reactor coolant pumps (RCPs) operating. This study was conducted, as part of a comprehensive project, to assess the relationship between measurable RCP parameters, such as motor power or current, and fluid density, both local (at the RCP inlet) and global (average reactor coolant system). Additionally, the efficacy of using these RCP parameters, together with fluid temperature, to identify an off-nominal transient as either a LOCA, a heatup transient, or a cooldown transient and to follow recovery from the transient was assessed. The RELAP4 and RELAP5 computer codes were used with three independent sets of RCP, two-phase degradation multipliers. These multipliers were based on data obtained in two-phase flow conditions for the Semiscale, LOFT, and Creare/Combustion Engineering (CE)/Electric Power Research Institute (EPRI) pumps, respectively. Two reference PWRs were used in this study: Zion, a four-loop, 1100-MWe, Westinghouse plant operated by Commonwealth Edison Co. in Zion, Illinois and Bellefonte, a two-by-four loop, 1213 MWe, Babcock and Wilcox designed plant being built by the Tennessee Valley Authority in Scottsboro, Alabama. The results from this study showed that RCP operation resulted in an approximately homogeneous reactor coolant system and that this result was independent of reference plant, computer code, or two-phase RCP head degradation multiplier used in the calculation.

  17. Fission product plateout and liftoff in the MHTGR primary system: A review

    SciTech Connect

    Wichner, R.P. )

    1991-04-01

    A review is presented of the technical basis for predicting radioactivity release resulting from depressurization of an MHTGR primary system. Consideration is restricted to so called dry events with no involvement of the steam system. The various types of deposition mechanisms effective for iodine, cesium, strontium, and silver are discussed in terms of their chemical characteristics and the nature of the materials in the primary system. Emphasis is given to iodine behavior, including means for estimating the quantity available for release, the types of plateout locations in the primary system, and the effect of dust on distribution and release. The behavior of fission products cesium, strontium, and silver in such accidents is presented qualitatively. A major part of the review deals with expected dust levels, types, and transport. Available information on the level and nature of dust in the HTGR primary system is reviewed. A summary is presented of dust deposition and liftoff mechanisms. It was concluded that recent approaches to dust liftoff modeling, based on turbulent burst concepts for removal from surfaces, probably offer advantages over the current shear ratio approach. This study concludes that iodine releases from dry depressurization events are likely to be extremely low, on the order of millicuries, due to a predictably low degree of chemical desorption, a low degree of dust liftoff, and a low involvement of iodine with dust. It was also concluded that deposition mechanisms controlling the distribution of fission product material in the primary system, and hence also controlling the degree of liftoff, depend strongly on the chemical nature of the individual elements. Therefore contrary to the current practice, both plateout and liftoff models should reflect those unique chemical and physical properties. 56 refs., 16 figs., 23 tabs.

  18. Development of Quality Assurance System in Culture and Nation Character Education in Primary Education in Indonesia

    ERIC Educational Resources Information Center

    Susilana, Rudi; Asra

    2013-01-01

    The purpose of national education is to develop skills and build dignified national character and civilization in educating nation life (Act No. 20, 2003). The paper describes a system of quality assurance in culture and character education in primary education. This study employs the six sigma model which consists of the formula DMAIC (Define,…

  19. Office Systems and Their Influence on Mammography Use in Rural and Urban Primary Care

    ERIC Educational Resources Information Center

    Engelman, Kimberly K.; Ellerbeck, Edward F.; Perpich, Denise; Nazir, Niaman; McCarter, Kevin; Ahluwalia, Jasjit S.

    2004-01-01

    Breast cancer screening rates are lower in rural communities. Although studies have addressed barriers to mammography for rural residents, physician practice barriers have received less attention. Purpose: Controlled clinical trials have shown that the use of office reminder systems in primary care practices is related to increased clinical care…

  20. Using a Learning Management System to Personalise Learning for Primary School Students

    ERIC Educational Resources Information Center

    Edmunds, Bronwyn; Hartnett, Maggie

    2014-01-01

    This paper reports on one aspect of a descriptive multiple-case study which set out to explore the role of a learning management system (LMS) in personalising learning for students from the perspective of three teachers in one primary school in New Zealand. The intention was to provide insight into the role the LMS could play in classrooms when…

  1. Space shuttle/food system study. Volume 2, Appendix F: Flight food and primary packaging

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The analysis and selection of food items and primary packaging, the development of menus, the nutritional analysis of diet, and the analyses of alternate food mixes and contingency foods is reported in terms of the overall food system design for space shuttle flight. Stowage weights and cubic volumes associated with each alternate mix were also evaluated.

  2. Assessment of Primary Representational Systems with Neurolinguistic Programming: Examination of Preliminary Literature.

    ERIC Educational Resources Information Center

    Dorn, Fred J.; And Others

    1983-01-01

    Reviews the inconsistent findings of studies on neurolinguistic programing and recommends some areas that should be examined to verify various claims. Discusses methods of assessing client's primary representational systems, including predicate usage and eye movements, and suggests that more reliable methods of assessing PRS must be found. (JAC)

  3. Assessing Primary Representational System (PRS) Preference for Neurolinguistic Programming (NLP) Using Three Methods.

    ERIC Educational Resources Information Center

    Dorn, Fred J.

    1983-01-01

    Considered three methods of identifying Primary Representational System (PRS)--an interview, a word list, and a self-report--in a study of 120 college students. Results suggested the three methods offer little to counselors either collectively or individually. Results did not validate the PRS construct, suggesting the need for further research.…

  4. Job Realities of Primary School Principals in Greece: Similarities and Variations in a Highly Centralized System

    ERIC Educational Resources Information Center

    Dimopoulos, Kostas; Dalkavouki, Katerina; Koulaidis, Vasilis

    2015-01-01

    This study aims at investigating primary school principals' work on a daily basis in order to understand the ways in which the centralized educational system affects their practices. Four typical cases of principals were selected and asked to keep daily records for a period of four months. Data from logs were complemented with data collected…

  5. Investigating Nigerian Primary School Teachers' Preparedness to Adopt Personal Response System in ESL Classroom

    ERIC Educational Resources Information Center

    Agbatogun, Alaba Olaoluwakotansibe

    2012-01-01

    This study investigated the extent to which computer literacy dimensions (computer general knowledge, documents and documentations, communication and surfing as well as data inquiry), computer use and academic qualification as independent variables predicted primary school teachers' attitude towards the integration of Personal Response System in…

  6. Primary central nervous system T-cell lymphoma mimicking meningoencephalomyelitis in a cat

    PubMed Central

    Guil-Luna, Silvia; Carrasco, Librado; Gómez-Laguna, Jaime; Hilbe, Monika; Mínguez, Juan J.; Köhler, Kernt; de las Mulas, Juana Martín

    2013-01-01

    A cat was presented with right head tilt and circling. The lack of expression of virus antigens did not support the postmortem diagnosis of encephalomyelitis pointing to a diffuse primary central nervous system T-cell lymphoma on the basis of CD3 and CD45R co-expression with absence of CD79α staining. PMID:24155454

  7. Primary central nervous system T-cell lymphoma mimicking meningoencephalomyelitis in a cat.

    PubMed

    Guil-Luna, Silvia; Carrasco, Librado; Gómez-Laguna, Jaime; Hilbe, Monika; Mínguez, Juan J; Köhler, Kernt; de las Mulas, Juana Martín

    2013-06-01

    A cat was presented with right head tilt and circling. The lack of expression of virus antigens did not support the postmortem diagnosis of encephalomyelitis pointing to a diffuse primary central nervous system T-cell lymphoma on the basis of CD3 and CD45R co-expression with absence of CD79α staining. PMID:24155454

  8. Hedgehog signaling regulates myelination in the peripheral nervous system through primary cilia.

    PubMed

    Yoshimura, Kentaro; Takeda, Sen

    2012-02-01

    Myelination is an essential prerequisite for the nervous system to transmit an impulse efficiently by a saltatory conduction. In the peripheral nervous system (PNS), Schwann cells (SCs) engage in myelination. However, a detailed molecular mechanism underlying myelination still remains unclear. In this study, we hypothesized that the primary cilia of SCs are the regulators of Hedgehog (Hh) signaling-mediated myelination. To confirm our hypothesis, we used mouse dorsal root ganglion (DRG)/SC co-cultures, wherein the behavior of SCs could be analyzed by maintaining the interaction of SCs with DRG neurons. Under these conditions, SCs had primary cilia, and Hh signaling molecules accumulated on the primary cilia. When the SCs were stimulated by the addition of desert hedgehog or smoothened agonist, formation of myelin segments on the DRG axons was facilitated. On the contrary, upon administration of cyclopamine, an inhibitor of Hh signaling, myelin segments became comparable to those of controls. Of note, the ratio of SCs harboring primary cilium reached the highest point during the early phase of myelination. Furthermore, the strongest effects of Hh on myelination were encountered during the same stage. These results collectively indicate that Hh signaling regulates myelin formation through primary cilia in the PNS. PMID:22101064

  9. RY Aquarius a Binary System with Pulsating delta-scuti Primary Component

    NASA Astrophysics Data System (ADS)

    Manzoori, Davood; Salar, Abbasvand

    2016-07-01

    We present simultaneous new BVI light curves along with radial velocity curve analysis of the RY Aqr system, using the PHysics Of Eclipsing BinariEs code. The analysis indicates that while the primary is completely inside its Roche critical surface, the secondary has filled out its Roche surface. In addition, the positions of the system components on M–R, H–R diagrams are specified, which show that the primary is a main-sequence or nearly main-sequence star while the secondary is an evolved subgiant. In addition, analysis of the period and luminosity variations of the system were carried out. Fourier frequency analysis of light variation indicates that the primary is a pulsating, δ-scuti variable star. Moreover, O–C curve analysis shows that the period of the system is secularly decreasing with a rate of dp/dt = 0.074 s yr‑1. This decrease in the orbital period variations was attributed to a mass and angular momentum loss from the system with a rate of 2.57× {10}-10{M}ȯ {{yr}}-1. Apart from the secular period decreases, the orbital period of the system is modulated by a cyclic period of 72.69 year, which was attributed to a third body orbiting around the barycenter of the system.

  10. A safety incident reporting system for primary care. A systematic literature review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care

    PubMed Central

    Klemp, Kerstin; Zwart, Dorien; Hansen, Jørgen; Hellebek, Torben; Luettel, Dagmar; Verstappen, Wim; Beyer, Martin; Gerlach, Ferdin M.; Hoffmann, Barbara; Esmail, Aneez

    2015-01-01

    Background: Incident reporting is widely used in both patient safety improvement programmes, and in research on patient safety. Objective: To identify the key requirements for incident reporting systems in primary care; to develop an Internet-based incident reporting and learning system for primary care. Methods: A literature review looking at the purpose, design and requirements of an incident reporting system (IRS) was used to update an existing incident reporting system, widely used in Germany. Then, an international expert panel with knowledge on IRS developed the criteria for the design of a new web-based incident reporting system for European primary care. A small demonstration project was used to create a web-based reporting system, to be made freely available for practitioners and researchers. The expert group compiled recommendations regarding the desirable features of an incident reporting system for European primary care. These features covered the purpose of reporting, who should be involved in reporting, the mode of reporting, design considerations, feedback mechanisms and preconditions necessary for the implementation of an IRS. Results: A freely available web-based reporting form was developed, based on these criteria. It can be modified for local contexts. Practitioners and researchers can use this system as a means of recording patient safety incidents in their locality and use it as a basis for learning from errors. Conclusion: The LINNEAUS collaboration has provided a freely available incident reporting system that can be modified for a local context and used throughout Europe. PMID:26339835

  11. A new primary care rostering and capitation system in Norway: Lessons for Canada?

    PubMed Central

    Ostbye, T; Hunskaar, S

    1997-01-01

    Providing every patient with a personal primary care physician or, from the physician's perspective, establishing a stable roster or list of patients is currently being actively debated in Canada. Norway's system of primary care medicine, similar to Canada's, faces many of the same problems. In 1992 a trial rostering system with blended funding (capitation, fee-for-service and user fees) was established in 4 Norwegian municipalities. After 3 years of close monitoring, the results of system evaluations have attracted strong interest. This article reports on the benefits and problems encountered with the new rostering system in Norway. If Canada is moving in the same direction, some of the lessons learned may be helpful. PMID:9220943

  12. French investigations of high burnup effect on LOCA thermomecanical behavior. Part two. Oxidation and quenching experiments under simulated LOCA conditions with high burnup clad material

    SciTech Connect

    GrandJean, C.; Cauvin, R.; Lebuffe, C.

    1997-01-01

    In the frame of the high burnup fuel studies to support a possible extension of the current discharge burnup limit, experimental programs have been undertaken, jointly by EDF and IPSN in order to study the thermal-shock behavior of high burnup fuel claddings under typical LOCA conditions. The TAGUS program used unirradiated cladding samples, bare or bearing a pre-corrosion state simulating the end-of-life state of high burnup fuel claddings: the TAGCIR program used actually irradiated cladding samples taken from high burnup rods irradiated over 5 cycles in a commercial EDF PWR and having reached a rod burnup close to 60 GWd/tU. The thermal-shock failure tests consisted in oxidizing the cladding samples under steam flow, on both inner and outer faces or on the outer face alone, and subjecting them to a final water quench. The heating was provided by an inductive furnace the power of which being regulated through monitoring of the sample surface temperature with use of a single-wave optical pyrometer. Analysis of the irradiated tests (TAGCIR series) evidenced an increased oxidation rate as compared to similar tests on unirradiated samples. Results of the quenching tests series on unirradiated and irradiated samples are plotted under the usual presentation of failure maps relative to the oxidation parameters ECR (equivalent cladding reacted) or e{sub {beta}} (thickness of the remaining beta phase layer) as a function of the oxidation temperature. Comparison of the failure limits for irradiated specimens to those for unirradiated specimens indicates a lower brittleness under two side oxidation and possibly the opposite under one-side oxidation. The tentative analysis of the oxidation and quenching tests results on irradiated samples reveals the important role played by the hydrogen charged during in-reactor corrosion on the oxidation kinetics and the failure bearing capability of the cladding under LOCA transient conditions.

  13. Structural and Contextual Dimensions of Iranian Primary Health Care System at Local Level

    PubMed Central

    Zanganeh Baygi, Mehdi; Seyedin, Hesam; Salehi, Masoud; Jafari Sirizi, Mehdi

    2014-01-01

    Background: In recent years, family physician plan was established as the main strategy of health system in Iran, while organizational structure of the primary health care system has remained the same as thirty years ago. Objectives: This study was performed to illustrate structural and contextual dimensions of organizational structure and relationship between them in Iranian primary health care system at local level. Materials and Methods: A cross-sectional quantitative study was conducted from January to June 2013, during which 121 questionnaires were distributed among senior and junior managers of city health centers at Medical Sciences universities in Iran. Validity of the questionnaire was confirmed by experts (CVI = 0.089 and CVR more than 0.85) and Cronbach α was utilized for reliability (α = 0.904). We used multistage sampling method in this study and analysis of the data was performed by SPSS software using different tests. Results: Local level of primary health care system in Iran had mechanical structure, but in contextual dimensions the results showed different types. There was a significant relationship between structural and contextual dimensions (r = 0.642, P value < 0.001). Goals and culture dimensions had strongest effects on structural dimensions. Conclusions: Because of the changes in goals and strategies of Iranian health system in recent years, it is urgently recommended to reform the current structure to increase efficiency and effectiveness of the system. PMID:25763257

  14. Post-transplantation primary central nervous system lymphoma in a patient with systemic lupus erythematosus and prolonged use of immunosuppressant.

    PubMed

    Tse, Teresa P K; Chan, Allan N L; Chan, Tony K T; Po, Y C

    2014-12-01

    Post-transplantation primary central nervous system lymphoma is an uncommon and fatal post-transplant lymphoproliferative disorder. Such lymphomas have been described in only a few case series in the literature. The incidence of this condition is rising with improved survival after organ transplantation. A case of post-transplantation primary central nervous system lymphoma in a young Chinese woman with systemic lupus erythematosus is described here. She presented with right-sided weakness and memory loss after tooth extraction 2 weeks before admission. Contrast computed tomography of the brain demonstrated a contrast rim-enhancing lesion over the left frontal lobe. With a history of recent dental procedure, long-term immunosuppressive therapy and computed tomography findings, cerebral abscess was highly suspected. Emergency operation was performed. Histopathology showed post-transplantation primary central nervous system lymphoma, with cells positive for B-cell marker CD20. Immunosuppressant was stopped and she was treated with radiotherapy and rituximab (anti-CD20 monoclonal antibody). She remained disease-free at 16 months. Post-transplantation primary central nervous system lymphoma is rare with variable presentation and radiological features. We believe rituximab may have a role in the treatment of such lymphomas. PMID:25488034

  15. Simple system of aberration correction for very large spherical primary mirrors

    NASA Astrophysics Data System (ADS)

    Beach, David A.

    2000-10-01

    Several large telescopes are now being proposed that would benefit from the cost reduction due to the use of spherical primary mirror. However, structural cost constraints require compact formats that tend to impose very high speeds, e.g. f/1.5, which renders difficult the correction of the resulting very large spherical aberration. A technique is described here in which a spherical concentric Cassegrain-like primary-secondary combination is followed by a simple catadioptric focal modifier. The spherical primary is 9m diameter, f/1.5, and the final focus is f/5 with a sub-arcsecond resolution over a 5 arcminute angular field for a passband of 480-850nm. Primary- secondary separation is only 11m and central obscuration is only 11% of pupil area. The two relatively small corrector components provide the functions of concentric meniscus and zonal corrector plate and are made from the same single glass- BK7 is the example given, but silica or any other preferred glass is possible. The relatively small zonal corrector is the only aspheric surface in the entire system. A related system is described elsewhere in which a 30 arcminute angular field can be achieved with a similar resolution, but with more complex glass requirements. However, supply of such exotic glasses may be difficult in large diameters, and the system presented here may find a place in some specialized applications.

  16. A PCA3 gene-based transcriptional amplification system targeting primary prostate cancer

    PubMed Central

    Têtu, Bernard; Wu, Lily; Fradet, Yves; Pouliot, Frédéric

    2016-01-01

    Targeting specifically primary prostate cancer (PCa) cells for immune therapy, gene therapy or molecular imaging is of high importance. The PCA3 long non-coding RNA is a unique PCa biomarker and oncogene that has been widely studied. This gene has been mainly exploited as an accurate diagnostic urine biomarker for PCa detection. In this study, the PCA3 promoter was introduced into a new transcriptional amplification system named the 3-Step Transcriptional Amplification System (PCA3-3STA) and cloned into type 5 adenovirus. PCA3-3STA activity was highly specific for PCa cells, ranging between 98.7- and 108.0-fold higher than that for benign primary prostate epithelial or non-PCa cells, respectively. In human PCa xenografts, PCA3-3STA displayed robust bioluminescent signals at levels that are sufficient to translate to positron emission tomography (PET)-based reporter imaging. Remarkably, when freshly isolated benign or cancerous prostate biopsies were infected with PCA3-3STA, the optical signal produced from primary PCa biopsies was significantly higher than from benign prostate biopsies (4.4-fold, p < 0.0001). PCA3-3STA therefore represents a PCa-specific expression system with the potential to target, with high accuracy, primary or metastatic PCa epithelial cells for imaging, vaccines, or gene therapy. PMID:26594800

  17. Development of a handheld computer documentation system to enhance an integrated primary care clerkship.

    PubMed

    Pipas, Catherine F; Carney, Patricia A; Eliassen, M Scottie; Mengshol, Sarah C; Fall, Leslie H; Olson, Ardis L; Schifferdecker, Karen E; Russell, Margaret T; Peltier, Deborah A; Nierenberg, David W

    2002-07-01

    Documentation systems are used by medical schools and residency programs to record the clinical experiences of their learners. The authors developed a system for their school's (Dartmouth's) multidisciplinary primary care clerkship (family medicine, internal medicine, pediatrics) that documents students' clinical and educational experiences and provides feedback designed to enhance clinical training utilizing a timely data-reporting system. The five critical components of the system are (1) a valid, reliable and feasible data-collection instrument; (2) orientation of and ongoing support for student and faculty users; (3) generation and distribution of timely feedback reports to students, preceptors, and clerkship directors; (4) adequate financial and technical support; and (5) a database design that allows for overall evaluation of educational outcomes. The system, whose development began in 1997, generated and distributed approximately 150 peer-comparison reports of clinical teaching experiences to students, preceptors, and course directors during 2001, in formats that are easy to interpret and use to individualize learning. The authors present report formats and annual cost estimate comparisons of paper- and computer-based system development and maintenance, which range from $35,935 to $53,780 for the paper-based system and from $46,820 to $109,308 for the computer-based system. They mention ongoing challenges in components of the system. They conclude that a comprehensive documentation and feedback system provides an essential infrastructure for the evaluation and enhancement of community-based teaching and learning in primary care ambulatory clerkships, whether separate or integrated. PMID:12114137

  18. Implementing a gatekeeper system to strengthen primary care in Egypt: pilot study.

    PubMed

    Ward, T R

    2010-06-01

    Overuse of hospital outpatient clinics in Egypt, due to lack of an effective gatekeeper system, has threatened the sustainability of improved primary care services. In this pilot project in Menoufia in the Nile delta region, the price of direct hospital outpatient visits was increased, encouraging patients to attend primary care clinics first. As a result, direct hospital outpatient utilization decreased by 63% in the project area compared with a 4% increase in a control district. The majority of this reduction was accounted for by patients attending either public primary care clinics or private clinics. Increasing the price of direct hospital outpatient visits was an effective way to establish a gatekeeper role for family health clinics. PMID:20799599

  19. Advising potential recipients on the use of organs from donors with primary central nervous system tumors.

    PubMed

    Warrens, Anthony N; Birch, Rhiannon; Collett, David; Daraktchiev, Maren; Dark, John H; Galea, George; Gronow, Katie; Neuberger, James; Hilton, David; Whittle, Ian R; Watson, Christopher J E

    2012-02-27

    Deciding to use an organ from a donor with a primary central nervous system (CNS) tumor necessitates offsetting the risk of tumor transmission with the chances of survival if the patient waits for another offer of a transplant. Published data vary in the quoted risk of tumor transmission. We used data obtained by reviewing 246 UK recipients of organs taken from donors with CNS tumors and found no evidence of a difference in overall patient mortality for recipients of a kidney, liver, or cardiothoracic organ, compared with recipients of organs from donors without a CNS tumor. Recent publication of the UK experience of transplanting organs from CNS tumor donors found no transmission in 448 recipients of organs from 177 donors with a primary CNS tumor (Watson et al., Am J Transplant 2010; 10: 1437). This 0% transmission rate is associated with an upper 95% confidence interval limit of 1.5%. Using a series of assumptions of risk, we compared the risks of dying as a result of the transmission of a primary brain tumor with the risks of dying if not transplanted. On this basis, the use of kidneys from a donor with a primary CNS tumor provides a further 8 years of life over someone who waited for a donor who did not have a primary CNS tumor, in addition to the life years gained by the transplant itself. The benefits for the recipients of livers and cardiothoracic organs were less, but there was no disadvantage in the impact on life expectancy. PMID:22258288

  20. Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study

    PubMed Central

    Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim

    2015-01-01

    Objectives To examine the effectiveness of the quality management programme—European Practice Assessment—in primary care in Switzerland. Design Longitudinal study with three points of measurement. Setting Primary care practices in Switzerland. Participants In total, 45 of 91 primary care practices completed European Practice Assessment three times. Outcomes The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: ‘infrastructure’, ‘information’, ‘finance’, and ‘quality and safety’ to examine changes over time. Results Significant improvements were found in three of four domains: ‘quality and safety’ (F=22.81, p<0.01), ‘information’ (F=27.901, p<0.01) and ‘finance’ (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). Conclusions The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care. PMID:25900466

  1. Primary and specialist diabetes care three years after introduction of health care system reform in Poland.

    PubMed

    Mardarowicz, Grazyna; Łopatyński, Jerzy

    2002-01-01

    The authors discuss epidemics of diabetes in the world and in Poland. In the Lublin region (eastern Poland), for instance, they found type 2 diabetes (DM 2) in 15.6% of the examined aged over 35 (according to the WHO criteria of 1985). The health care system reform in Poland has made more difficult the access of the diabetic to a specialist that treats this disease. Therefore doctors and nurses of primary health care have become more responsible for diabcare than before. The authors believe that the systematic education of primary health care doctors by specialists so that they can treat patients according to the modern standards of practical diabetology as well as sharing of tasks and responsibilities between primary and specialist diabetologic care, are very important. Primary health care would be in charge of prevention and early diagnosis of DM 2 as well as prevention and early diagnosis of concomitant complications of the disease. Specialists would have consultation on the patients at the moment of diagnosis and then at least once a year. They would also take care of search for and diagnosis of remote diabetes complications. Primary health care doctors would still treat most of diabetics with DM 2; specialist centres doctors would treat most of diabetics with DM type 1, patients with complications and from special risk groups (e.g. women with gestational diabetes). PMID:12898974

  2. Importance of thermal nonequilibrium considerations for the simulation of nuclear reactor LOCA transients. [PWR

    SciTech Connect

    Fischer, S.R.; Nelson, R.A.; Sullivan, L.H.

    1980-01-01

    The purpose of this paper is to show the importance of considering thermal nonequilibrium effects in computer simulations of the refill and reflood portions of pressurized water reactor (PWR) loss-of-coolnat accident (LOCA) transients. Although RELAP4 assumes thermodynamic equilibrium between phases, models that account for the nonequilibrium phenomena associated with the mixing of subcooled emergency cooling water with steam and the superheating of vapor in the presence of liquid droplets have recently been incorporated into the code. Code calculated results, both with and without these new models, have been compared with experimental test data to assess the importance of including thermal nonequilibrium phenomena in computer code simulations.

  3. Probabilistic based design rules for intersystem LOCAS in ABWR piping

    SciTech Connect

    Ware, A.G.; Wesley, D.A.

    1993-05-01

    A methodology has been developed for probability-based standards for low-pressure piping systems that are attached to the reactor coolant loops of advanced light water reactors (ALWRs) which could experience reactor coolant loop temperatures and pressures because of multiple isolation valve failures. This accident condition is called an intersystem loss-of-coolant accident (ISLOCA). The methodology was applied to various sizes of carbon and stainless steel piping designed to advanced boiling water reactor (ABWR) temperatures and pressures.

  4. A novel mechanical lung assist system sustains primary bidirectional cavopulmonary shunt circulation in pigs.

    PubMed

    Honjo, Osami; Merklinger, Sandra L; Poe, John; Guerguerian, Anne-Marie; Alghamdi, Abdullah A; Takatani, Setsuo; Van Arsdell, Glen S

    2007-01-01

    Primary creation of a bidirectional cavopulmonary shunt (BCPS), which provides a stable in-series circulation, might improve survival in patients with hypoplastic left heart syndrome. However, pulmonary vascular immaturity and high pulmonary vascular resistance must be overcome to achieve a successful primary neonatal BCPS. This study tested the hypothesis that a novel mechanical lung assist (MLA) system would permit a primary BCPS in juvenile pigs. A BCPS (1(1/2) ventricle repair physiology) was created in nine 4-5-week-old pigs (mean weight 17.9 kg), followed by MLA with a miniature centrifugal pump and a hand-made double-lumen cannula for 2 hours. Systemic and cerebral hemodynamic and metabolic data were evaluated. A mean BCPS flow of 331 +/- 56 ml/min was obtained with a mean pump speed of 3899 +/- 306 rpm at 30 minutes after MLA initiation. Adequate oxygenation, ventilation, and hemodynamics were maintained. Transcranial Doppler ultrasound demonstrated consistent pre- and postoperative peak systolic and diastolic velocities of the middle cerebral artery, indicating sustained cerebral perfusion pressure. This study demonstrated that the MLA is able to sustain a high-resistance BCPS and provides a strategy or rationale for developing a primary neonatal cavopulmonary connection in appropriately selected neonates with congenital heart disease. PMID:18043155

  5. Health policy and the policymaking system: A case study of primary care in Ireland.

    PubMed

    Kelly, Niall; Garvey, John; Palcic, Dónal

    2016-08-01

    In 2001 the Irish government published a reforming policy intended to modernise and expand the delivery of primary care in Ireland. Fifteen years later, the Irish health system remains beset by problems indicative of a fragmented and underdeveloped primary care system. This case study examines the formation and implementation of the 2001 primary care policy and identifies key risk categories within the policymaking process itself that inhibited the timely achievement of policy objectives. Our methodology includes a directed content analysis of the policy formation and implementation documents and the influencing academic literature, as well as semi-structured interviews with key personnel involved in the process. We identify three broad risk categories - power, resources and capability - within the policymaking process that strongly influenced policy formation and implementation. We additionally show that the disjoint between policy formation and policy implementation was a contested issue among those involved in the policy process and provided space for these risks to critically undermine Ireland's primary care policy. PMID:27342835

  6. Safety characteristics of lithium primary and secondary battery systems. Formulation of a lithium battery safety matrix

    NASA Astrophysics Data System (ADS)

    Bis, R. F.; Barnes, James A.; Zajac, William V.; Davis, Patrick B.; Murphy, Robert M.

    1986-07-01

    A study was conducted to assess the safety characteristics for both primary and secondary lithium electrochemical systems. Of particular interest is the behavior of specific cell designs of these systems when subjected to the electrical and thermal abuse test procedures prescribed in NAVSEANOTE 9310. These abusive tests include short circuit, forced overdischarge, charge, and incineration. The main intent of the report is the formulation of a lithium battery safety matrix wherein certain electrochemical system, cell designs, or cell types which have exhibited exceptionally safe characteristics under abusive conditions may be exempt from some or all of the NAVSEANOTE 9310 test procedures.

  7. Combined heat and power systems for commercial buildings: investigating cost, emissions, and primary energy reduction based on system components

    NASA Astrophysics Data System (ADS)

    Smith, Amanda D.

    Combined heat and power (CHP) systems produce electricity and useful heat from fuel. When power is produced near a building which consumes power, transmission losses are averted, and heat which is a byproduct of power production may be useful to the building. That thermal energy can be used for hot water or space heating, among other applications. This dissertation focuses on CHP systems using natural gas, a common fuel, and systems serving commercial buildings in the United States. First, the necessary price difference between purchased electricity and purchased fuel is analyzed in terms of the efficiencies of system components by comparing CHP with a conventional separate heat and power (SHP) configuration, where power is purchased from the electrical grid and heat is provided by a gas boiler. Similarly, the relationship between CDE due to electricity purchases and due to fuel purchases is analyzed as well as the relationship between primary energy conversion factors for electricity and fuel. The primary energy conversion factor indicates the quantity of source energy necessary to produce the energy purchased at the site. Next, greenhouse gas emissions are investigated for a variety of commercial buildings using CHP or SHP. The relationship between the magnitude of the reduction in emissions and the parameters of the CHP system is explored. The cost savings and reduction in primary energy consumption are evaluated for the same buildings. Finally, a CHP system is analyzed with the addition of a thermal energy storage (TES) component, which can store excess thermal energy and deliver it later if necessary. The potential for CHP with TES to reduce cost, emissions, and primary energy consumption is investigated for a variety of buildings. A case study is developed for one building for which TES does provide additional benefits over a CHP system alone, and the requirements for a water tank TES device are examined.

  8. Primary health care and public health: foundations of universal health systems.

    PubMed

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable. PMID:25591411

  9. Intravascular Lymphomatosis Mimicking Primary Central Nervous System Lymphoma: A Case Report and Literature Review

    PubMed Central

    Oomura, Masahiro; Sakakibara, Noriyuki; Suzuki, Shugo; Wakita, Atsushi; Mori, Yuji; Kamimoto, Kaoru

    2014-01-01

    We herein report a 75-year-old female patient with intravascular lymphomatosis (IVL) who presented with fever of unknown origin. Examination, including contrast-enhanced CT and 67Ga scintigraphy, failed to show any lesions. Her blood levels of lactate dehydrogenase and soluble interleukin-2 receptors were high, suggesting a lymphomatous tumor. A bone marrow puncture was negative, and a random skin biopsy revealed a monoclonal proliferation of naked, large lymphocytes in the vascular space of the subcutaneous tissue, confirming the diagnosis of IVL. MRI, performed 7 weeks after admission, showed a brain mass mimicking primary central nervous system lymphoma. The mass was considered to be a collection of malignant lymphocyte cells invading from the vessels. Without the random skin biopsy, this case may have been misdiagnosed as primary central nervous system lymphoma. PMID:24761147

  10. A rare case of nonenhancing primary central nervous system lymphoma mimic multiple sclerosis

    PubMed Central

    Chen, Hai; Dong, Huiqing

    2015-01-01

    Primary central nervous system lymphoma (PCNSL) is reported to have increased in the last decades. Early diagnosis is crucial for proper management of this tumor. We report a case of a 48-year-old man who was initially diagnosed with multiple sclerosis. Magnetic resonance imaging of the brain revealed multiple lesions with hypersignals in the bilateral basal ganglia and brain stem in T2-weighted image and non-enhancement, while positron emission tomography showed a low uptake of 18F-fluorodeoxyglucose in the affected brain, indicative of demyelination. However, this individual was correctly diagnosed with PCNSL after biopsy and further histological analysis. Primary central nervous system lymphoma must be considered even when nonenhancing, diffuse lesions are seen on MRI. A visible tumor on imaging is essential to ensure an early brain biopsy and histological diagnosis. PMID:26492120

  11. INTEGRATED DRILLING SYSTEM USING MUD ACTUATED DOWN HOLE HAMMER AS PRIMARY ENGINE

    SciTech Connect

    John V. Fernandez; David S. Pixton

    2005-12-01

    A history and project summary of the development of an integrated drilling system using a mud-actuated down-hole hammer as its primary engine are given. The summary includes laboratory test results, including atmospheric tests of component parts and simulated borehole tests of the hammer system. Several remaining technical hurdles are enumerated. A brief explanation of commercialization potential is included. The primary conclusion for this work is that a mud actuated hammer can yield substantial improvements to drilling rate in overbalanced, hard rock formations. A secondary conclusion is that the down-hole mud actuated hammer can serve to provide other useful down-hole functions including generation of high pressure mud jets, generation of seismic and sonic signals, and generation of diagnostic information based on hammer velocity profiles.

  12. [Legislation on primary care in Brazilian Unified National Health System: document analysis].

    PubMed

    Domingos, Carolina Milena; Nunes, Elisabete de Fátima Polo de Almeida; Carvalho, Brígida Gimenez; Mendonça, Fernanda de Freitas

    2016-03-01

    A reflection on Brazil's legislation for primary care helps understand the way health policy is implemented in the country. This study focuses on the legal provisions aimed at strengthening primary care, drawing on an analysis of documents from the Ministry of Health's priority actions, programs, and strategies. A total of 224 provisions were identified, in two groups of documents, so-called instituting provisions and complementary provisions. The former include the principles and guidelines of the Brazilian Unified National Health System (SUS) and also involve the expansion of actions. Financing was a quantitatively central theme, especially in the complementary provisions. The analysis led to reflection on the extent to which these strategies can induce linkage between health system managers and civil society in building a political project resulting in improvements and meeting the population's health needs. PMID:27027459

  13. Primary reaction control system/remote manipulator system interaction with loaded arm. Space shuttle engineering and operations support

    NASA Technical Reports Server (NTRS)

    Taylor, E. C.; Davis, J. D.

    1978-01-01

    A study of the interaction between the orbiter primary reaction control system (PRCS) and the remote manipulator system (RMS) with a loaded arm is documented. This analysis was performed with the Payload Deployment and Retrieval Systems Simulation (PDRSS) program with the passive arm bending option. The passive-arm model simulates the arm as massless elastic links with locked joints. The study was divided into two parts. The first part was the evaluation of the response of the arm to step inputs (i.e. constant jet torques) about each of the orbiter body axes. The second part of the study was the evaluation of the response of the arm to minimum impulse primary RCS jet firings with both single pulse and pulse train inputs.

  14. Aging, Loss-of-Coolant Accident (LOCA), and high potential testing of damaged cables

    SciTech Connect

    Vigil, R.A.; Jacobus, M.J.

    1994-04-01

    Experiments were conducted to assess the effects of high potential testing of cables and to assess the survivability of aged and damaged cables under Loss-of-Coolant Accident (LOCA) conditions. High potential testing at 240 Vdc/mil on undamaged cables suggested that no damage was incurred on the selected virgin cables. During aging and LOCA testing, Okonite ethylene propylene rubber (EPR) cables with a bonded jacket experienced unexpected failures. The failures appear to be primarily related to the level of thermal aging and the presence of a bonded jacket that ages more rapidly than the insulation. For Brand Rex crosslinked polyolefin (XLPO) cables, the results suggest that 7 mils of insulation remaining should give the cables a high probability of surviving accident exposure following aging. The voltage necessary to detect when 7 mils of insulation remain on unaged Brand Rex cables is approximately 35 kVdc. This voltage level would almost certainly be unacceptable to a utility for use as a damage assessment tool. However, additional tests indicated that a 35 kvdc voltage application would not damage virgin Brand Rex cables when tested in water. Although two damaged Rockbestos silicone rubber cables also failed during the accident test, no correlation between failures and level of damage was apparent.

  15. Potential for boron dilution during small-break LOCAs in PWRs

    SciTech Connect

    Nourbakhsh, H.P.; Cheng, Z.

    1995-11-01

    This paper documents the results of a scoping study of boron dilution and mixing phenomena during small break loss of coolant accidents (LOCAs) in pressurized water reactors (PWRs). Boron free condensate can accumulate in the cold leg loop seals when the reactor is operating in a reflux/boiler condenser mode. A problem may occur when the subsequent change in flow conditions such as loop seal clearing or re-establishment of natural circulation flow drive the diluted water in the loop seals into the reactor core without sufficient mixing with the highly borated water in the reactor downcomer and lower plenum. The resulting low boron concentration coolant entering the core may cause a power excursion leading to fuel failure. The mixing processes associated with a slow moving stream of diluted water through the loop seal to the core were examined in this report. A bounding evaluation of the range of boron concentration entering the core during a small break LOCA in a typical Westinghouse-designed, four-loop plant is also presented in this report.

  16. Systemically administered PEDF against primary and secondary tumours in a clinically relevant osteosarcoma model

    PubMed Central

    Broadhead, M L; Dass, C R; Choong, P F M

    2011-01-01

    Background: Pigment epithelium-derived factor (PEDF) is an endogenous glycoprotein with a potential role as a therapeutic for osteosarcoma. Animal studies have demonstrated the biological effects of PEDF on osteosarcoma; however, these results are difficult to extrapolate for human use due to the chosen study design and drug delivery methods. Methods: In this study we have attempted to replicate the human presentation and treatment of osteosarcoma using a murine orthotopic model of osteosarcoma. The effects of PEDF on osteosarcoma cell lines were evaluated in vitro prior to animal experimentation. Orthotopic tumours were induced by intra-tibial injection of SaOS-2 osteosarcoma cells. Treatment with PEDF was delayed until after the macroscopic appearance of primary tumours. Pigment epithelium-derived factor was administered systemically via an implanted intraperitoneal micro-osmotic pump. Results: In vitro, PEDF inhibited proliferation, induced apoptosis and inhibited cell cycling of osteosarcoma cells. Pigment epithelium-derived factor promoted adhesion to Collagen I and inhibited invasion through Collagen I. In vivo, treatment with PEDF caused a reduction in both primary tumour volume and burden of pulmonary metastases. Systemic administration of PEDF did not cause toxic effects on normal tissues. Conclusion: Systemically delivered PEDF is effective in suppressing the size of primary and secondary tumours in an orthotopic murine model of osteosarcoma. PMID:21979423

  17. Deployment and validation of a smart system for screening of language disorders in primary care.

    PubMed

    Martín-Ruiz, María Luisa; Duboy, Miguel Ángel Valero; de la Cruz, Iván Pau

    2013-01-01

    Neuro-evolutive development from birth until the age of six years is a decisive factor in a child's quality of life. Early detection of development disorders in early childhood can facilitate necessary diagnosis and/or treatment. Primary-care pediatricians play a key role in its detection as they can undertake the preventive and therapeutic actions requested to promote a child's optimal development. However, the lack of time and little specific knowledge at primary-care avoid to applying continuous early-detection anomalies procedures. This research paper focuses on the deployment and evaluation of a smart system that enhances the screening of language disorders in primary care. Pediatricians get support to proceed with early referral of language disorders. The proposed model provides them with a decision-support tool for referral actions to trigger essential diagnostic and/or therapeutic actions for a comprehensive individual development. The research was conducted by starting from a sample of 60 cases of children with language disorders. Validation was carried out through two complementary steps: first, by including a team of seven experts from the fields of neonatology, pediatrics, neurology and language therapy, and, second, through the evaluation of 21 more previously diagnosed cases. The results obtained show that therapist positively accepted the system proposal in 18 cases (86%) and suggested system redesign for single referral to a speech therapist in three remaining cases. PMID:23752564

  18. Analysis of N-16 concentration in primary cooling system of AP1000 power reactor

    NASA Astrophysics Data System (ADS)

    Rohanda, Anis; Waris, Abdul

    2015-04-01

    Nitrogen-16 (N-16) is one of the radiation safety parameter on the primary reactor system. The activation product, N-16, is the predominant contributor to the activity in the reactor coolant system during reactor operation. N-16 is activation product derived from activation of O-16 with fast neutron based on 16O(n,p)16N reaction. Thus study is needed and it performs to determine N-16 concentration in reactor coolant (primary coolant) in supporting radiation safety. One of the way is using analytical methode based on activation and redecay princip to obtain N-16 concentration. The analysis was performed on the configuration basis and operational of Westinghouse AP1000 power reactor in several monitoring points at coolant reactor system. The results of the calculation of N-16 concentration at the core outlet, reactor vessel outlet, pressurizer line, inlet and outlet of steam generators, primary pumps, reactor vessels inlet and core inlet are: 281, 257, 255, 250, 145, 142, 129 and 112 µCi/gram respectively. The results of analysis compared with AP1000 design control document as standard values. The verification showed very high accuracy comparation between analytical results and standard values.

  19. Deployment and Validation of a Smart System for Screening of Language Disorders in Primary Care

    PubMed Central

    Martín-Ruiz, María Luisa; Duboy, Miguel Ángel Valero; de la Cruz, Iván Pau

    2013-01-01

    Neuro-evolutive development from birth until the age of six years is a decisive factor in a child's quality of life. Early detection of development disorders in early childhood can facilitate necessary diagnosis and/or treatment. Primary-care pediatricians play a key role in its detection as they can undertake the preventive and therapeutic actions requested to promote a child's optimal development. However, the lack of time and little specific knowledge at primary-care avoid to applying continuous early-detection anomalies procedures. This research paper focuses on the deployment and evaluation of a smart system that enhances the screening of language disorders in primary care. Pediatricians get support to proceed with early referral of language disorders. The proposed model provides them with a decision-support tool for referral actions to trigger essential diagnostic and/or therapeutic actions for a comprehensive individual development. The research was conducted by starting from a sample of 60 cases of children with language disorders. Validation was carried out through two complementary steps: first, by including a team of seven experts from the fields of neonatology, pediatrics, neurology and language therapy, and, second, through the evaluation of 21 more previously diagnosed cases. The results obtained show that therapist positively accepted the system proposal in 18 cases (86%) and suggested system redesign for single referral to a speech therapist in three remaining cases. PMID:23752564

  20. Analysis of N-16 concentration in primary cooling system of AP1000 power reactor

    SciTech Connect

    Rohanda, Anis; Waris, Abdul

    2015-04-16

    Nitrogen-16 (N-16) is one of the radiation safety parameter on the primary reactor system. The activation product, N-16, is the predominant contributor to the activity in the reactor coolant system during reactor operation. N-16 is activation product derived from activation of O-16 with fast neutron based on {sup 16}O(n,p){sup 16}N reaction. Thus study is needed and it performs to determine N-16 concentration in reactor coolant (primary coolant) in supporting radiation safety. One of the way is using analytical methode based on activation and redecay princip to obtain N-16 concentration. The analysis was performed on the configuration basis and operational of Westinghouse AP1000 power reactor in several monitoring points at coolant reactor system. The results of the calculation of N-16 concentration at the core outlet, reactor vessel outlet, pressurizer line, inlet and outlet of steam generators, primary pumps, reactor vessels inlet and core inlet are: 281, 257, 255, 250, 145, 142, 129 and 112 µCi/gram respectively. The results of analysis compared with AP1000 design control document as standard values. The verification showed very high accuracy comparation between analytical results and standard values.

  1. Breast cancer brain metastases responding to lapatinib plus capecitabine as second-line primary systemic therapy.

    PubMed

    Bergen, Elisabeth S; Berghoff, Anna S; Rudas, Margaretha; Preusser, Matthias; Bartsch, Rupert

    2015-06-01

    Brain metastases (BM) are diagnosed in up to 40% of HER2-positive breast cancer patients. Standard treatment includes local approaches such as whole-brain radiotherapy (WBRT), radiosurgery, and neurosurgery. The landscape trial established primary systemic therapy as an effective and safe alternative to WBRT in selected patients with Her2-positive BM. We aim to further focus on the role of systemic therapy in oligosymptomatic patients by presenting this case report. We report on a 50-year-old patient diagnosed with multiple BM 5 years after early breast cancer diagnosis. As the patient was asymptomatic and had a favorable diagnosis-specific GPA score, she received primary systemic treatment with T-DM1. She achieved partial remission within the brain for eight treatment cycles and then progressed despite stable extracranial disease. As the patient remained asymptomatic and refused WBRT, we decided upon trastuzumab, lapatinib plus capecitabine as second-line therapy. Another partial remission of BM was observed; to date, she has received 11 treatment cycles without any sign of disease progression. In this case, WBRT was delayed by at least 14 months, again indicating the activity of systemic treatment in BM. Apparently, in selected patients, BM can be controlled with multiple lines of systemic therapy similar to extracranial disease. Further investigation of systemic treatment approaches is therefore warranted. PMID:25714248

  2. Cooperative Research and Development of Primary Surface Recuperator for Advanced Microturbine Systems

    SciTech Connect

    Escola, George

    2007-01-17

    Recuperators have been identified as key components of advanced gas turbines systems that achieve a measure of improvement in operating efficiency and lead the field in achieving very low emissions. Every gas turbine manufacturer that is studying, developing, or commercializing advanced recuperated gas turbine cycles requests that recuperators operate at higher temperature without a reduction in design life and must cost less. The Solar Cooperative Research and Development of Primary Surface Recuperator for Advanced Microturbine Systems Program is directed towards meeting the future requirements of advanced gas turbine systems by the following: (1) The development of advanced alloys that will allow recuperator inlet exhaust gas temperatures to increase without significant cost increase. (2) Further characterization of the creep and oxidation (dry and humid air) properties of nickel alloy foils (less than 0.13 mm thick) to allow the economical use of these materials. (3) Increasing the use of advanced robotic systems and advanced in-process statistical measurement systems.

  3. Microtensile and Microshear Bond Strength of an Antibacterial Self-Etching System to Primary Tooth Dentin

    PubMed Central

    Yildirim, Sibel; Tosun, Gül; Koyutürk, Alp Erdin; Şener, Yaḡmur; Şengün, Abdulkadir; Özer, Füsun; Imazato, Satoshi

    2008-01-01

    Objectives The aim of this study was to test the hypothesis that the bonding ability of antibacterial bonding system to primary dentin was not different from the parental material which did not contain any antibacterial component. Methods Extracted human non-carious primary molars were ground to expose the coronal dentin, and then randomly divided into two experimental groups: treatment with Clearfil Protect Bond or with Clearfil SE Bond (Kuraray Medical Inc.). Composite-dentin sticks with a cross-sectional area of approximately 0.90 mm2 were prepared and subsequently subjected to microtensile bond strength (μTBS) and microshear bond strength (μSBS) tests. For the μTBS tests, specimens were attached to an Instron testing machine with a cyanoacrylate adhesive. For μSBS testing, the sticks were mechanically fixed to the μSBS testing apparatus. The bonds were stressed in shear or tension at a crosshead speed of 1mm/min until failure occurred. Resin-dentin interfaces produced by each system were examined using SEM. The data were analyzed with Mann-Whitney’s U test. Results The μTBS and μSBS of Clearfil Protect Bond were 30.69±9.71 and 9.94±3.78 MPa, respectively. Clearfil SE Bond showed significantly greater values of 37.31±9.57 and 12.83±3.15 MPa, respectively. SEM analysis demonstrated similar micro-morphological features including the thickness of the hybrid layer for both materials. Conclusions It was showed that antibacterial self-etching system Clearfil Protect Bond showed lower bond strength values compared to primary dentin than that of to Clearfil SE Bond on primary dentin. (Eur J Dent 2008;2:11–17) PMID:19212503

  4. Dynamics of the Establishment of Systemic Potyvirus Infection: Independent yet Cumulative Action of Primary Infection Sites

    PubMed Central

    Lafforgue, Guillaume; Tromas, Nicolas; Elena, Santiago F.

    2012-01-01

    In the clinic, farm, or field, for many viruses there is a high prevalence of mixed-genotype infections, indicating that multiple virions have initiated infection and that there can be multiple sites of primary infection within the same host. The dynamic process by which multiple primary infection sites interact with each other and the host is poorly understood, undoubtedly due to its high complexity. In this study, we attempted to unravel the basic interactions underlying this process using a plant RNA virus, as removing the inoculated leaf can instantly and rigorously eliminate all primary infection sites. Effective population size in the inoculated leaf and time of removal of the inoculated leaf were varied in experiments, and it was found that both factors positively influenced if the plant became systemically infected and what proportion of cells in the systemic tissue were infected, as measured by flow cytometry. Fitting of probabilistic models of infection to our data demonstrated that a null model in which the action of each focus is independent of the presence of other foci was better supported than a dependent-action model. The cumulative effect of independently acting foci therefore determined when plants became infected and how many individual cells were infected. There was no evidence for interference between primary infection sites, which is surprising given the planar structure of leaves. By showing that a simple null model is supported, we experimentally confirmed—to our knowledge for the first time—the minimal components that dictate interactions of a conspecific virus population establishing systemic infection. PMID:22993154

  5. Oil-air mist lubrication as an emergency system and as a primary lubrication system. [for helicopter engines

    NASA Technical Reports Server (NTRS)

    Loomis, W. R.

    1976-01-01

    The feasibility of an emergency aspirator once-through lubrication system was demonstrated as a viable survivability concept for Army helicopter mainshaft engine bearings for periods as long as 30 minutes. It was also shown in an experimental study using a 46-mm bore bearing test machine that an oil-air mist once-through system with auxiliary air cooling is an effective primary lubrication system at speeds up to 2,500,000 DN for extended operating periods of at least 50 hours.

  6. Primary propulsion of electrothermal, ion, and chemical systems for space-based radar orbit transfer

    NASA Technical Reports Server (NTRS)

    Wang, S.-Y.; Staiger, P. J.

    1985-01-01

    An orbit transfer mission concept has been studied for a Space-Based Radar (SBR) where 40 kW required for radar operation is assumed available for orbit transfer propulsion. Arcjet, pulsed electrothermal (PET), ion, and storable chemical systems are considered for the primary propulsion. Transferring two SBR per shuttle flight to 1112 km/60 deg using eiectrical propulsion systems offers an increased payload at the expense of increased trip time, up to 2000 kg each, which may be critical for survivability. Trade offs between payload mass, transfer time, launch site, inclination, and height of parking orbits are presented.

  7. Primary propulsion of electrothermal, ion and chemical systems for space-based radar orbit transfer

    NASA Technical Reports Server (NTRS)

    Wang, S. Y.; Staiger, P. J.

    1985-01-01

    An orbit transfer mission concept has been studied for a Space-Based Radar (SBR) where 40 kW required for radar operation is assumed available for orbit transfer propulsion. Arcjet, pulsed electrothermal (PET), ion, and storable chemical systems are considered for the primary propulsion. Transferring two SBR per shuttle flight to 1112 km/60 deg using electrical propulsion systems offers an increased payload at the expense of increased trip time, up to 2000 kg each, which may be critical for survivability. Trade offs between payload mass, transfer time, launch site, inclination, and height of parking orbits are presented.

  8. Primary calibration system for vibration transducers from 0.4 Hz to 160 Hz

    NASA Astrophysics Data System (ADS)

    Ferreira, C. D.; Ripper, G. P.; Dias, R. S.; Teixeira, D. B.

    2015-01-01

    This paper presents a system developed at the Vibration Laboratory of Inmetro, which is used for primary calibration of vibration transducers by the fringe counting method. This system includes a vibration exciter, a Michelson interferometer, a data acquisition board, a band-pass filter, a universal counter and a software for measurement automation. It allows the laboratory to perform calibrations in accordance with the international standard ISO 16063-11 in the frequency range from 0.4 Hz to 160 Hz. Some experimental results are presented herein.

  9. The Development and Evaluation of an Integrated Electronic Prescribing and Drug Management System for Primary Care

    PubMed Central

    Tamblyn, Robyn; Huang, Allen; Kawasumi, Yuko; Bartlett, Gillian; Grad, Roland; Jacques, André; Dawes, Martin; Abrahamowicz, Michal; Perreault, Robert; Taylor, Laurel; Winslade, Nancy; Poissant, Lise; Pinsonneault, Alain

    2006-01-01

    Objective: To develop and evaluate the acceptability and use of an integrated electronic prescribing and drug management system (MOXXI) for primary care physicians. Design: A 20-month follow-up study of MOXXI (Medical Office of the XXIst Century) implementation in 28 primary care physicians and 13,515 consenting patients. Measurement: MOXXI was developed to enhance patient safety by integrating patient demographics, retrieving active drugs from pharmacy systems, generating an automated problem list, and providing electronic prescription, stop order, automated prescribing problem alerts, and compliance monitoring functions. Evaluation of technical performance, acceptability, and use was conducted using audit trails, questionnaires, standardized tasks, and information from comprehensive health insurance databases. Results: Perceived improvements in continuity of care and professional autonomy were associated with physicians' expected use of MOXXI. Physician speed in using MOXXI improved substantially in the first three months; however, only the represcribing function was faster using MOXXI than by handwritten prescription. Physicians wrote electronic prescriptions in 36.9 per 100 visits and reviewed the patient's drug profile in 12.6 per 100 visits. Physicians rated printed prescriptions, the current drug list, and the represcribing function as the most beneficial aspects of the system. Physicians were more likely to use the drug profile for patients who used more medication, made more emergency department visits, had more prescribing physicians, and lower continuity of care. Conclusion: Primary care physicians believed an integrated electronic prescribing and drug management system would improve continuity of care, and they were more likely to use the system for patients with more complex, fragmented care. PMID:16357357

  10. Design of the primary mirror segment support system for the E-ELT

    NASA Astrophysics Data System (ADS)

    Cavaller, Lluis; Marrero, Juan; Castro, Javier; Morante, Esteban; Ronquillo, Mariano; Hernández, Elvio

    2008-07-01

    The European Extremely Large Telescope (E-ELT) is a 42-m class optical telescope with a segmented primary mirror composed of 984 segments which is currently being studied by ESO (European Southern Observatory). The segment support system combines a series of mechanical whiffletrees for the axial support, a central diaphragm for lateral support and a torsional constrainer. These elements are fixed to a common moving frame which is actively moved by means of three actuators in piston and tip-tilt in order to keep the whole primary mirror in phase. The moving frame is fixed to the segments subcells, which properly attach the segments to the cell structure, by means of special flexures, allowing large axial alignment capability combined with high lateral stiffness. This paper describes the development of the support system for the primary mirror segments of the E-ELT, which has been specified for a high stiffness and eigenfrequencies, 60Hz for axial modes and 40Hz for lateral ones.

  11. Lab on a chip-based hepatic sinusoidal system simulator for optimal primary hepatocyte culture.

    PubMed

    Choi, Yoon Young; Kim, Jaehyung; Lee, Sang-Hoon; Kim, Dong-Sik

    2016-08-01

    Primary hepatocyte cultures have been used in studies on liver disease, physiology, and pharmacology. While they are an important tool for in vitro liver studies, maintaining liver-specific characteristics of hepatocytes in vitro is difficult, as these cells rapidly lose their unique characteristics and functions. Portal flow is an important condition to preserve primary hepatocyte functions and liver regeneration in vivo. We have developed a microfluidic chip that does not require bulky peripheral devices or an external power source to investigate the relationship between hepatocyte functional maintenance and flow rates. In our culture system, two types of microfluidic devices were used as scaffolds: a monolayer- and a concave chamber-based device. Under flow conditions, our chips improved albumin and urea secretion rates after 13 days compared to that of the static chips. Reverse transcription polymerase chain reaction demonstrated that hepatocyte-specific gene expression was significantly higher at 13 days under flow conditions than when using static chips. For both two-dimensional and three-dimensional culture on the chips, flow resulted in the best performance of the hepatocyte culture in vitro. We demonstrated that flow improves the viability and efficiency of long-term culture of primary hepatocytes and plays a key role in hepatocyte function. These results suggest that this flow system has the potential for long-term hepatocyte cultures as well as a technique for three-dimensional culture. PMID:27334878

  12. A microfluidic system to study cytoadhesion of Plasmodium falciparum infected erythrocytes to primary brain microvascularendothelial cells.

    PubMed

    Herricks, Thurston; Seydel, Karl B; Turner, George; Molyneux, Malcolm; Heyderman, Robert; Taylor, Terrie; Rathod, Pradipsinh K

    2011-09-01

    The cellular events leading to severe and complicated malaria in some Plasmodium falciparum infections are poorly understood. Additional tools are required to better understand the pathogenesis of this disease. In this technical report, we describe a microfluidic culture system and image processing algorithms that were developed to observe cytoadhesion interactions of P. falciparum parasitized erythrocytes rolling on primary brain microvascularendothelial cells. We isolated and cultured human primary microvascular brain endothelial cells in a closed loop microfluidic culture system where a peristaltic pump and media reservoirs were integrated onto a microscope stage insert. We developed image processing methods to enhance contrast of rolling parasitized erythrocytes on endothelial cells and to estimate the local wall shear stress. The velocity of parasitized erythrocytes rolling on primary brain microvascularendothelial cells was then measured under physiologically relevant wall shear stresses. Finally, we deployed this method successfully at a field site in Blantyre, Malawi. The method is a promising new tool for the investigation of the pathogenesis of severe malaria. PMID:21743938

  13. Environmental standards for primary and secondary containment systems and transfer stations

    SciTech Connect

    Maguire, D.M.

    1995-04-01

    Environmental Standards for Primary and Secondary Containment Systems and Transfer Stations will supersede all previous requirements for design of dikes, storage tanks, and transfer stations in order to maintain consistency throughout the Y-12 Plant. This document is organized into six distinct sections, each with a specific purpose. Section I outlines the objectives of the document along with its applications and limitations; this section should be of interest to all readers for essential background information. Section II lists all definitions and is consistent with definitions outlined by environmental regulations. Section III discusses primary containment standards. Section IV outlines secondary containment standards; this section contains the actual standards for the diking of storage tanks and storage containers. Section V discusses transfer station standards. Section VI of this document outlines how exemptions may be granted for specific cases.

  14. Colon Targeted Drug Delivery Systems: A Review on Primary and Novel Approaches

    PubMed Central

    Philip, Anil K.; Philip, Betty

    2010-01-01

    The colon is a site where both local and systemic delivery of drugs can take place. Local delivery allows topical treatment of inflammatory bowel disease. However, treatment can be made effective if the drugs can be targeted directly into the colon, thereby reducing the systemic side effects. This review, mainly compares the primary approaches for CDDS (Colon Specific Drug Delivery) namely prodrugs, pH and time dependent systems, and microbially triggered systems, which achieved limited success and had limitations as compared with newer CDDS namely pressure controlled colonic delivery capsules, CODESTM, and osmotic controlled drug delivery which are unique in terms of achieving in vivo site specificity, and feasibility of manufacturing process. PMID:22125706

  15. Design and testing of the U.S. Space Station Freedom primary propulsion system

    NASA Astrophysics Data System (ADS)

    Morano, Joseph S.; Delventhal, Rex A.; Chilcot, Kimberly J.

    1992-07-01

    The primary propulsion system (PPS) for the Space Station Freedom is discussed in terms of salient design characteristics and key testing procedures. The rocket engine modules contain reboost and attitude control thrusters, and their designs are illustrated showing the mounting structures, thruster solenoid valves, and thrust chambers. The propellant tank assembly for storing gaseous N pressurant and hydrazine propellant is described as are the system avionics, thruster solenoid valves, and latching isolation valves. PPS testing conducted on the development systems includes the use of a propulsion-module development unit, a development test article, and system qualification testing. Specific test articles include functional heaters, mass/thermal simulated components, flight-quality structures, and software control operations.

  16. Treatment of a primary intracranial germ cell tumor with systemic chemotherapy

    SciTech Connect

    Kirshner, J.J.; Ginsberg, S.J.; Fitzpatrick, A.V.; Comis, R.L.

    1981-01-01

    Primary germ cell neoplasms of the central nervous system (CNS) are rare tumors which generally respond to radiotherapy. Experience is limited in managing the refractory patient. We report a patient whose suprasellar dysgerminoma responded completely to 5,000 rad. Seven years later, disease recurrence was refractory to an additional 4,000 rad. Theorizing that the ''blood-brain barrier'' was no longer intact after extensive radiotherapy and tumor involvement of the ventricular system, the patient was treated with systemic bleomycin, cisplatin, and vinblastine. Pharmacokinetic studies revealed that the bleomycin and cisplatin entered the cerebrospinal fluid. Serial CT scans and CSF levels of beta-HCG confirmed the clinical impression of a partial remission. Subsequent tumor progression was refractory to therapy with intraventricular bleomycin. It is concluded that systemic chemotherapy may be beneficial in certain cases of CNS germ cell neoplasms.

  17. A concept of JAERI passive safety light water reactor system (JPSR)

    SciTech Connect

    Murao, Y.; Araya, F.; Iwamura, T.

    1995-09-01

    The Japan Atomic Energy Research Institute (JAERI) proposed a passive safety reactor system concept, JPSR, which was developed for reducing manpower in operation and maintenance and influence of human errors on reactor safety. In the concept the system was extremely simplified. The inherent matching nature of core generation and heat removal rate within a small volume change of the primary coolant is introduced by eliminating chemical shim and adopting in-vessel control rod drive mechanism units, a low power density core and once-through steam generators. In order to simplify the system, a large pressurizer, canned pumps, passive engineered-safety-features-system (residual heat removal system and coolant injection system) are adopted and the total system can be significantly simplified. The residual heat removal system is completely passively actuated in non-LOCAs and is also used for depressurization of the primary coolant system to actuate accumulators in small break LOCAs and reactor shutdown cooling system in normal operation. All of systems for nuclear steam supply system are built in the containment except for the air coolers as a the final heat sink of the passive residual heat removal system. Accordingly the reliability of the safety system and the normal operation system is improved, since most of residual heat removal system is always working and a heat sink for normal operation system is {open_quotes}safety class{close_quotes}. In the passive coolant injection system, depressurization of the primary cooling system by residual heat removal system initiates injection from accumulators designed for the MS-600 in medium pressure and initiates injection from the gravity driven coolant injection pool at low pressure. Analysis with RETRAN-02/MOD3 code demonstrated the capability of passive load-following, self-power-controllability, cooling and depressurization.

  18. Predicting length of stay from an electronic patient record system: a primary total knee replacement example

    PubMed Central

    2014-01-01

    Background To investigate whether factors can be identified that significantly affect hospital length of stay from those available in an electronic patient record system, using primary total knee replacements as an example. To investigate whether a model can be produced to predict the length of stay based on these factors to help resource planning and patient expectations on their length of stay. Methods Data were extracted from the electronic patient record system for discharges from primary total knee operations from January 2007 to December 2011 (n = 2,130) at one UK hospital and analysed for their effect on length of stay using Mann-Whitney and Kruskal-Wallis tests for discrete data and Spearman’s correlation coefficient for continuous data. Models for predicting length of stay for primary total knee replacements were tested using the Poisson regression and the negative binomial modelling techniques. Results Factors found to have a significant effect on length of stay were age, gender, consultant, discharge destination, deprivation and ethnicity. Applying a negative binomial model to these variables was successful. The model predicted the length of stay of those patients who stayed 4–6 days (~50% of admissions) with 75% accuracy within 2 days (model data). Overall, the model predicted the total days stayed over 5 years to be only 88 days more than actual, a 6.9% uplift (test data). Conclusions Valuable information can be found about length of stay from the analysis of variables easily extracted from an electronic patient record system. Models can be successfully created to help improve resource planning and from which a simple decision support system can be produced to help patient expectation on their length of stay. PMID:24708853

  19. Characteristics of physical activity programs in the Brazilian primary health care system.

    PubMed

    Gomes, Grace Angélica de Oliveira; Kokubun, Eduardo; Mieke, Grégore Iven; Ramos, Luiz Roberto; Pratt, Michael; Parra, Diana C; Simões, Eduardo; Florindo, Alex A; Bracco, Mario; Cruz, Danielle; Malta, Deborah; Lobelo, Felipe; Hallal, Pedro C

    2014-10-01

    The aim of this study was to describe the characteristics of programs that promote physical activity in the public primary care system by region of Brazil, subject to the presence or absence of multidisciplinary primary care teams (NASF). We conducted a cross sectional and population-based telephone survey of the health unit coordinators from 1,251 health care units. Coordinators were asked about the presence and characteristics of physical activity programs. Four out of ten health units reported having a physical activity intervention program, the most common involving walking groups. Most of the activities were performed in the morning, once or twice a week, and in sessions of 30 minutes or more. Physical education professionals were primarily responsible for directing the activities. Interventions occurred in the health unit itself or in adjacent community spaces. In general, these characteristics were similar between units with or without NASF, but varied substantially across regions. These findings will guide future physical activity policies and programs within primary care in Brazil. PMID:25388318

  20. Regional systems-of-care for primary percutaneous coronary intervention in ST-elevation myocardial infarction.

    PubMed

    Sørensen, Jacob Thorsted; Maeng, Michael

    2015-12-01

    ST-elevation myocardial infarction (STEMI) is a critical, time-dependent condition requiring immediate reperfusion of the coronary arteries to minimize mortality and morbidity. The preferred method of revascularization is a primary percutaneous coronary intervention (PCI) if this can be performed in a timely manner. This requires an effective and well-organized setup from symptom onset to revascularization. Such regional networks for the diagnosis and treatment of STEMI patients have been proven to be very effective in achieving the treatment goals stipulated by the international guidelines. Several trials have provided evidence that prehospital ECG recording and early diagnosis combined with direct referral to a primary PCI center reduces treatment delay considerably. In-hospital awareness with early notification of the PCI operator and technicians and admission directly to the catheterization laboratory also reduces time to treatment. There is solid evidence that the reduction in treatment delay achieved by dedicated STEMI networks is associated with a lower mortality and morbidity. Regional STEMI networks are now implemented in many countries with highly varying geographical challenges and healthcare systems, allowing patients everywhere to receive optimal treatment with primary PCI. PMID:26230884

  1. Intravitreal injection of anti-VEGF and diagnosis of primary intraocular central nervous system lymphoma.

    PubMed

    Gambrelle, J; Missotten, G; Delhoum, S; Desjardins, L

    2013-05-01

    We report a case of primary intraocular central nervous system (CNS) lymphoma in a patient previously treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections for age-related macular degeneration (AMD). An 88-year-old woman, with past medical history significant for bilateral age-related macular degeneration (AMD) treated with intravitreal ranibizumab injections for 1 year, was referred to our department for bilateral vitritis diagnosed 10 days after the last anti-VEGF injection. A complete uveitis work-up including aqueous humour analysis, brain MRI and vitreous biopsy enabled us to confirm the diagnosis of primary intraocular CNS lymphoma. To the best of our knowledge, this is the first report of the diagnosis of primary intraocular CNS lymphoma in a patient treated with anti-VEGF for AMD. The differential diagnosis of vitritis in elderly patients is relatively broad. Endophthalmitis and uveitis have been described after anti-VEGF injections. In such a situation, there is actually a risk of missing the diagnosis of intraocular lymphoma in the mistaken belief that the observed vitritis may be a reaction to administered anti-VEGFs. If no direct time-relationship with the anti-VEGF injections can be found, a classic vitritis work-up should be performed. Our observation suggests that ranibizumab, at the dosage used for AMD, does not impede the spread of CNS lymphoma in the eye nor interfere with cytological diagnosis. PMID:23306179

  2. Factors influencing the role of primary care providers as gatekeepers in the Malaysian public healthcare system.

    PubMed

    Ang, K T; Ho, B K; Mimi, O; Salmah, N; Salmiah, M S; Noridah, M S

    2014-01-01

    Primary care providers play an important gatekeeping role in ensuring appropriate referrals to secondary care facilities. This cross-sectional study aimed to determine the level, pattern and rate of referrals from health clinics to hospitals in the public sector, and whether the placement of resident family medicine specialist (FMS) had made a significant difference. The study was carried out between March and April in 2012, involving 28 public primary care clinics. It showed that the average referral rate was 1.56% for clinics with resident FMS and 1.94% for those without resident FMS, but it was not statistically significant. Majority of referred cases were considered appropriate (96.1%). Results of the multivariate analysis showed that no prior consultation with senior healthcare provider and illnesses that were not severe and complex were independently associated with inappropriate referrals. Severity, complexity or uncertain diagnosis of patients' illness or injury significantly contributed to unavoidable referrals. Adequate facilities or having more experienced doctors could have avoided 14.5% of the referrals. The low referral rate and very high level of appropriate referrals could indicate that primary care providers in the public sector played an effective role as gatekeepers in the Malaysian public healthcare system. PMID:26425299

  3. An innovative sludge management system based on separation of primary and secondary sludge treatment.

    PubMed

    Mininni, G; Braguglia, C M; Ramadori, R; Tomei, M C

    2004-01-01

    An innovative sludge management system based on separation of treatment and disposal of primary and secondary sludge is discussed with reference to a sewage treatment plant of 500,000 equivalent person capacity. Secondary sludge, if treated separately from primary sludge, can be recovered in agriculture considering its relatively high content of nitrogen and phosphorus and negligible presence of pathogens and micropollutants. One typical outlet for primary sludge is still incineration which can be optimised by rendering the process auto thermal and significantly reducing the size of the incineration plant units (dryer, fluidised bed furnace, boiler and units for exhaust gas treatment) in comparison with those required for mixed sludge incineration. Biogas produced in anaerobic digestion is totally available for energy conversion when sludge treatment separation is performed, while in the other case a large proportion may be used as fuel in incineration, thus reducing the net electric energy conversion from 0.85-0.9 to 0.35-0.4 MW for the plant considered. PMID:15581006

  4. Primary central nervous system gamma delta cytotoxic T-cell lymphoma.

    PubMed

    Mooney, Kelly L; Choy, Winward; Woodard, Joslyn; Xian, Rena R; Deal, Taylor M; Kendle, Ryan F; Said, Jonathan; Grody, Wayne; Yang, Isaac

    2016-04-01

    Primary T-cell lymphomas of the central nervous system (CNS) are uncommon, but aggressive and increasing in incidence. We describe a rare case of T-cell lymphoma in a cerebellar location, to our knowledge the first reported case demonstrating gamma/delta receptor expression. Additionally, we elaborate on key diagnostic features and review all nine patients with primary CNS lymphoma of cytotoxic T-cell phenotype reported in the literature. A 26-year-old female medical student presented with a 6week history of nausea, vomiting and dizziness. MRI revealed a 2cm cerebellar mass. The tumor was subtotally resected, and pathologic examination of a subtotal resection specimen demonstrated peripheral T-cell lymphoma, not otherwise specified, with a gamma/delta cytotoxic T-cell phenotype. She subsequently started high dose methotrexate and cytarabine. We report a unique case of primary CNS gamma delta CD8+ T-cell lymphoma lineage in a young female patient. While these are rare entities, it is an important differential diagnosis to consider. Therapy should be tailored to the patient, and involves resection with adjuvant chemotherapy, radiotherapy or autologous stem-cell based treatments. PMID:26804925

  5. EVALUATION OF BEST AVAILABLE CONTROL TECHNOLOGY FOR TOXICS -TBACT- DOUBLE SHELL TANK FARMS PRIMARY VENTILATION SYSTEMS SUPPORTING WASTE TRANSFER OPERATIONS

    SciTech Connect

    HAAS CC; KOVACH JL; KELLY SE; TURNER DA

    2010-06-24

    This report is an evaluation of Best Available Control Technology for Toxics (tBACT) for installation and operation of the Hanford double shell (DST) tank primary ventilation systems. The DST primary ventilation systems are being modified to support Hanford's waste retrieval, mixing, and delivery of single shell tank (SST) and DST waste through the DST storage system to the Waste Treatment and Immobilizaiton Plant (WTP).

  6. EVALUATION OF BEST AVAILABLE CONTROL TECHNOLOGY FOR TOXICS (TBACT) DOUBLE SHELL TANK FARMS PRIMARY VENTILATION SYSTEM SUPPORTING WASTE TRANSFER OPERATIONS

    SciTech Connect

    KELLY SE; HAASS CC; KOVACH JL; TURNER DA

    2010-06-03

    This report is an evaluation of Best Available Control Technology for Toxics (tBACT) for installation and operation of the Hanford double shell (DST) tank primary ventilation systems. The DST primary ventilation systems are being modified to support Hanford's waste retrieval, mixing, and delivery of single shell tank (SST) and DST waste throught the DST storage system to the Waste Treatment and Immobilization Plant (WTP).

  7. EHR systems in the Spanish Public Health National System: the lack of interoperability between primary and specialty care.

    PubMed

    de la Torre-Díez, Isabel; González, Sandra; López-Coronado, Miguel

    2013-02-01

    One of the problems of the Spanish Public Health National System is the lack of interoperability in the implemented Electronic Health Records (EHRs) systems in primary and specialty care. There is a deficiency in the electronic health systems that store the data of primary care patients, so one of the basic problems that prevent that every hospital and health center working on the same method is that deficiency. In this paper we research on this problem and to give expression to a series of solutions to it. Bibliographic material in this work has been obtained mainly from MEDLINE source. Additionally, due to the lack of information and privacy about the different EHRs systems, we have resorted to making direct contact with the organizations that have implemented those systems and technological providers. Two solutions have been propounded given several aspects for a feasibility study. The first solution is based upon in the execution of backups in different EHRs databases, which implies a huge economical and infrastructure development. The second of these solutions so that due to the creation of protocols by means of Cloud Computing Technologies. It is crucial the need to reach a homogeneity concerning to the storage of patients clinical data. On the results achieved we can emphasize that maybe the main problems are not the economical handicaps or the large technological development needed, but, as for Health each Region manages its own competences, each one governs with independent policies and decisions. PMID:23321962

  8. System facilitators and barriers to discussing older driver safety in primary care settings

    PubMed Central

    Betz, Marian E.; Jones, Jacqueline; Carr, David B.

    2015-01-01

    Background Primary care physicians play a leading role in counseling older drivers, but discussions often do not occur until safety concerns arise. Prior work suggests that routine questioning about driving might facilitate these difficult conversations. Objective To explore system-level factors affecting driving discussions in primary care settings, in order to inform the design and implementation of a program supporting routine conversations. Methods This qualitative descriptive study used iterative interviews with providers (physicians, nurses, medical assistants, social workers, and administrative staff) working at two clinics (one geriatric, one general internal medicine) at a tertiary-care teaching hospital. General inductive techniques in transcript analysis were used to identify stakeholder-perceived system-level barriers and facilitators to routine conversations with older drivers. Results From fifteen interviews, four themes emerged: (1) complexity of defined provider roles within primary care setting (which can both support team work and hamper efficiency); (2) inadequate resources to support providers (including clinical prompts, local guides, and access to social workers and driving specialists); (3) gaps in education of providers and patients about discussing driving; and (4) suggested models to enhance provider conversations with older drivers (including following successful examples and using defined pathways integrated into the electronic medical record). A fifth theme was that participants characterized their experiences in terms of current and ideal states. Conclusions Physicians have been tasked with assessing older driver safety and guiding older patients through the process of “driving retirement.” Attention to system-level factors such as provider roles, resources, and training can support them in this process. PMID:25617342

  9. Characterization of a primary brown adipocyte culture system derived from human fetal interscapular fat

    PubMed Central

    Seiler, Sarah E; Xu, Dan; Ho, Jia-Pei; Lo, Kinyui Alice; Buehrer, Benjamin M; Ludlow, Y John W; Kovalik, Jean-Paul; Sun, Lei

    2015-01-01

    Brown fat has gained widespread attention as a potential therapeutic target to treat obesity and associated metabolic disorders. Indeed, the anti-obesity potential of multiple targets to stimulate both brown adipocyte differentiation and recruitment have been verified in rodent models. However, their therapeutic potential in humans is unknown due to the lack of a human primary brown adipocyte cell culture system. Likewise, the lack of a well-characterized human model has limited the discovery of novel targets for the activation of human brown fat. To address this current need, we aimed to identify and describe the first primary brown adipocyte cell culture system from human fetal interscapular brown adipose tissue. Pre-adipocytes isolated from non-viable human fetal interscapular tissue were expanded and cryopreserved. Cells were then thawed and plated alongside adult human subcutaneous and omental pre-adipocytes for subsequent differentiation and phenotypic characterization. Interscapular pre-adipocytes in cell culture differentiated into mature adipocytes that were morphologically indistinguishable from the adult white depots. Throughout differentiation, cultured human fetal interscapular adipocytes demonstrated increased expression of classical brown fat markers compared to subcutaneous and omental cells. Further, functional analysis revealed an elevation in fatty acid oxidation as well as maximal and uncoupled oxygen consumption in interscapular brown adipocytes compared to white control cells. These data collectively identify the brown phenotype of these cells. Thus, our primary cell culture system derived from non-viable human fetal interscapular brown adipose tissue provides a valuable tool for the study of human brown adipocyte biology and for the development of anti-obesity therapeutics. PMID:26451287

  10. [Examination of the Cases Given Primary Tumor Resection after Systemic Therapy for Metastatic Breast Cancer].

    PubMed

    Hara, Yukiko; Sakurai, Kenichi; Adachi, Keita; Fujiwara, Asako; Ono, Youko; Nagashima, Saki; Suzuki, Shuhei; Waga, Eiko; Hirano, Tomohiro; Enomoto, Katsuhisa; Amano, Sadao

    2015-11-01

    We examined the records of patients with stage Ⅳ breast cancer who underwent primary tumor resection after systemic therapy. In our department, in 2013, there were 8 such cases. The average local tumor diameter was 59 mm. There was 1 case of metastases to the liver, 2 cases to the lung, 3 cases to the bone, and 1 case to the kidney. Three cases had lymph node metastases. Two cases were treated with hormonal therapy, and 6 cases received chemotherapy as preoperative systemic therapy. All cases underwent Bt plus Ax. Approximately 2 years after the surgery, 5 of the 8 patients were alive. The postoperative local control was good and we were able to continue systemic treatment for the distant metastases in all cases. We think that resection of the primary tumor improved the quality of life of the patients. However, for 1 fatal case, a brain metastasis was detected shortly after surgery. Therefore, we need to consider the patient's condition carefully before we operate. PMID:26805078

  11. Thermal Analysis of the Divertor Primary Heat Transfer System Piping During the Gas Baking Process

    SciTech Connect

    Yoder Jr, Graydon L; Harvey, Karen; Ferrada, Juan J

    2011-02-01

    A preliminary analysis has been performed examining the temperature distribution in the Divertor Primary Heat Transfer System (PHTS) piping and the divertor itself during the gas baking process. During gas baking, it is required that the divertor reach a temperature of 350 C. Thermal losses in the piping and from the divertor itself require that the gas supply temperature be maintained above that temperature in order to ensure that all of the divertor components reach the required temperature. The analysis described in this report was conducted in order to estimate the required supply temperature from the gas heater.

  12. Meeting report: primary central nervous system lymphoma: standards of care and future perspectives.

    PubMed

    Herrlinger, Ulrich; Korfel, Agnieszka; Hebart, Holger; Schlegel, Uwe; Plasswilm, Ludwig; Illerhaus, Gerald; Finke, Jürgen; Krüger, William; Montemurro, Michael; Wolf, Timo; Thiel, Eckhart; Bamberg, Michael; Weller, Michael; Kanz, Lothar

    2005-02-01

    A standard of care for patients with primary central nervous system lymphoma (PCNSL) has not been defined. Current controversies concern, amongst others, the role, dose and timing of radiotherapy, the role of intrathecal chemotherapy and the delineation of age-specific standards of care. Given the strong clinical trial activities for PCNSL in Germany, the PCNSL conference held in Tubingen aimed at comparing the diverging trial strategies in Germany and at exploring the options for joint activities of the various PCNSL study groups in the near future. PMID:15692223

  13. A Wireless, Handheld Decision Support System To Promote Smoking Cessation in Primary Care

    PubMed Central

    Michel, George; Marcy, Theodore; Shiffman, Richard N.

    2005-01-01

    Tobacco use remains a relatively unaddressed cause of disease and death in the daily care of patients by physicians. To overcome the barriers that physicians face in addressing tobacco use and its treatment in the primary care setting, we have developed a clinical decision support system that is readily accessible through the use of familiar wireless handheld devices and supportive of treatment through the implementation of the Tobacco Use and Dependence Treatment Guideline recommendations. We adopted the Information Management Services model to ensure that the application would effectively implement the guideline. The techniques used here are readily adaptable to implementing a broad range of clinical guidelines. PMID:16779096

  14. Primary central nervous system T-cell lymphoma in a common dolphin (Delphinus delphis).

    PubMed

    Arbelo, M; Espinosa de los Monteros, A; Herráez, P; Suárez-Bonnet, A; Andrada, M; Rivero, M; Grau-Bassas, E R; Fernández, A

    2014-01-01

    This report describes the pathological findings in an adult female short-beaked common dolphin (Delphinus delphis) stranded alive in the Canary Islands. Necropsy examination revealed the presence of a nodular neoplastic growth in the central nervous system (CNS) at the level of the thalamus. Microscopical examination revealed the mass to be a lymphoma and immunohistochemical labelling demonstrated a T-cell origin. No significant lesions were observed in other organs, including lymphoid organs. This is the first report of a primary T-cell lymphoma in the CNS in cetaceans. PMID:24650893

  15. Value of anti-infective chemoprophylaxis in primary systemic vasculitis: what is the evidence?

    PubMed Central

    2009-01-01

    Although infections are a major concern in patients with primary systemic vasculitis, actual knowledge about risk factors and evidence concerning the use of anti-infective prophylaxis from clinical trials are scarce. The use of high dose glucocorticoids and cyclophosphamide pose a definite risk for infections. Bacterial infections are among the most frequent causes of death, with Staphylococcus aureus being the most common isolate. Concerning viral infections, cytomegalovirus and varicella-zoster virus reactivation represent the most frequent complications. The only prophylactic measure that is widely accepted is trimethoprim/sulfamethoxazole to avoid Pneumocystis jiroveci pneumonia in small vessel vasculitis patients with generalised disease receiving therapy for induction of remission. PMID:19886977

  16. A Patient-Centered Understanding of the Referral System in Ethiopian Primary Health Care Units

    PubMed Central

    Abrahim, Orit; Linnander, Erika; Mohammed, Halima; Fetene, Netsanet; Bradley, Elizabeth

    2015-01-01

    Background Primary healthcare systems in sub-Saharan Africa have undergone substantial development in an effort to expand access to appropriate facilities through a well-functioning referral system. The objective of this study was to evaluate the current patterns of seeking prior care before arriving at a health center or a hospital as a key aspect of the referral system of the primary health care unit (PHCU) in three regions in Ethiopia. We examined what percentage of patients had either sought prior care or had been referred to the present facility and identified demographic and clinical factors associated with having sought prior care or having been referred. Methods and Findings We conducted a cross-sectional study using face-to-face interviews in the local language with 796 people (99% response rate) seeking outpatient care in three primary health care units serving approximately 100,000 people each and reflecting regional and ethnic diversity; 53% (N = 418) of the sample was seeking care at hospital outpatient departments, and 47% of the sample was seeking care at health centers (N = 378). We used unadjusted and adjusted logistic regression to identify factors associated with having been referred or sought prior care. Our findings indicated that only 10% of all patients interviewed had been referred to their current place of care. Among those in the hospital population, 14% had been referred; among those in the health center population, only 6% had been referred. Of those who had been referred to the hospital, most (74%) had been referred by a health center. Among those who were referred to the health center, the plurality portion (32%) came from a nearby hospital (most commonly for continued HIV treatment or early childhood vaccinations); only 18% had come from a health post. Among patients who had not been formally referred, an additional 25% in the hospital sample and 10% in the health center sample had accessed some prior source of care for their present

  17. Embedding effective depression care: using theory for primary care organisational and systems change

    PubMed Central

    2010-01-01

    agreement is reached about how care is organised; and reflexive monitoring, which proposes that depression work requires agreement about how depression work will be monitored at the patient and practice level. We describe how these constructs can be used to guide the design and implementation of effective depression care in a way that can take account of contextual differences. Conclusions Ideas about what is required for an effective model and system of depression care in primary care need to be accompanied by theoretically informed frameworks that consider how these can be implemented. The conceptual framework we have presented can be used to guide organisational and system change to develop common language around each construct between policy makers, service users, professionals, and researchers. This shared understanding across groups is fundamental to the effective implementation of change in primary care for depression. PMID:20687962

  18. Envisioning a Learning Health Care System: The Electronic Primary Care Research Network, A Case Study

    PubMed Central

    Delaney, Brendan C.; Peterson, Kevin A.; Speedie, Stuart; Taweel, Adel; Arvanitis, Theodoros N.; Hobbs, F. D. Richard

    2012-01-01

    PURPOSE The learning health care system refers to the cycle of turning health care data into knowledge, translating that knowledge into practice, and creating new data by means of advanced information technology. The electronic Primary Care Research Network (ePCRN) was a project, funded by the US National Institutes of Health, with the aim to facilitate clinical research using primary care electronic health records (EHRs). METHODS We identified the requirements necessary to deliver clinical studies via a distributed electronic network linked to EHRs. After we explored a variety of informatics solutions, we constructed a functional prototype of the software. We then explored the barriers to adoption of the prototype software within US practice-based research networks. RESULTS We developed a system to assist in the identification of eligible cohorts from EHR data. To preserve privacy, counts and flagging were performed remotely, and no data were transferred out of the EHR. A lack of batch export facilities from EHR systems and ambiguities in the coding of clinical data, such as blood pressure, have so far prevented a full-scale deployment. We created an international consortium and a model for sharing further ePCRN development across a variety of ongoing projects in the United States and Europe. CONCLUSIONS A means of accessing health care data for research is not sufficient in itself to deliver a learning health care system. EHR systems need to use sophisticated tools to capture and preserve rich clinical context in coded data, and business models need to be developed that incentivize all stakeholders from clinicians to vendors to participate in the system. PMID:22230831

  19. Oxidation of SiC cladding under Loss of Coolant Accident (LOCA) conditions in LWRs

    SciTech Connect

    Lee, Y.; Yue, C.; Arnold, R. P.; McKrell, T. J.; Kazimi, M. S.

    2012-07-01

    An experimental assessment of Silicon Carbide (SiC) cladding oxidation rate in steam under conditions representative of Loss of Coolant Accidents (LOCA) in light water reactors (LWRs) was conducted. SiC oxidation tests were performed with monolithic alpha phase tubular samples in a vertical quartz tube at a steam temperature of 1140 deg. C and steam velocity range of 1 to 10 m/sec, at atmospheric pressure. Linear weight loss of SiC samples due to boundary layer controlled reaction of silica scale (SiO{sub 2} volatilization) was experimentally observed. The weight loss rate increased with increasing steam flow rate. Over the range of test conditions, SiC oxidation rates were shown to be about 3 orders of magnitude lower than the oxidation rates of zircaloy 4. A SiC volatilization correlation for developing laminar flow in a vertical channel is formulated. (authors)

  20. The BWR lower head response during a large-break LOCA with core damage

    SciTech Connect

    Alammar, M.A.

    1996-12-31

    Some of the important issues in severe accident management guidelines development deal with estimating the time to lower head vessel failure after core damage and the time window available for water injection that would prevent vessel failure. These issues are obviously scenario dependent, but bounding estimates are needed. The scenario chosen for this purpose was a design-basis accident (DBA) loss-of-coolant accident (LOCA) because it was one of the contributors to the Oyster Creek containment failure frequency. Oyster Creek is a 1930-MW(thermal) boiling water reactor (BWR)-2. The lower head response models have improved since the Three Mile Island unit 2 (TMI-2) vessel investigation project (VIP) results became known, specifically the addition of rapid- and slow-cooling models. These mechanisms were found to have taken place in the TMI-2 lower head during debris cooldown and were important contributors in preventing vessel failure.

  1. Modeling of Zr alloy burst cladding internal oxidation and secondary hydriding under LOCA conditions

    NASA Astrophysics Data System (ADS)

    Veshchunov, M. S.; Shestak, V. E.

    2015-06-01

    The recently developed mechanistic model for Zr alloy cladding hydriding has been implemented in the single-rod SVECHA/QUENCH (S/Q) code. The mass transfer in a fuel rod after ballooning and burst opening have been modeled in the modified code that allowed calculating hydrogen and oxygen pickup by the cladding inner-metal surface. The code predicts with a good accuracy the typical distributions of oxygen and hydrogen in the Zr alloy cladding that were observed in the JAERI (Japan Atomic Energy Research Institute) and ANL (Argonne National Laboratory) single-rod tests and KIT (Karlsruhe Institute of Technology) bundle tests under postulated loss-of-coolant accident (LOCA) conditions.

  2. LOCA simulation in NRU program: data report for the fourth materials experiment (MT-4)

    SciTech Connect

    Wilson, C.L.; Mohr, C.L.; Hesson, G.M.; Wildung, N.J.; Russcher, G.E.; Webb, B.J.; Freshley, M.D.

    1983-07-01

    A series of in-reactor experiments were conducted using full-length 32-rod pressurized water reactor (PWR) fuel bundles as part of the Loss-of-Coolant Accident (LOCA) Simulation Program by Pacific Northwest Laboratory (PNL). This experiment (MT-4) was funded by the US Nuclear Regulatory Commission (NRC) to evaluate ballooning and rupture during adiabatic heatup in the temperature range of 1033 to 1200K (1400 to 1700/sup 0/F). The 12 rest rods in the center of the 32-rod bundle were initially pressurized to 4.62 MPa (670 psia) to insure rupture in the correct temperature range. All 12 test rods ruptured with an average strain of 43.7% at the maximum flow blockage elevation of 2.68 m (105.4 in.). Experimental data for the MT-4 transient experiment and post-test measurements and photographs of the fuel are presented in this report.

  3. Effect of bundle size on cladding deformation in LOCA simulation tests. [PWR; BWR

    SciTech Connect

    Chapman, R.H.; Crowley, J.L.; Longest, A.W.

    1982-01-01

    Two LOCA simulation tests were conducted to investigate the effects of temperature uniformity and radial restraint boundary conditions on Zircaloy cladding deformation. In one of the tests (B-5), boundary conditions typical of a large array were imposed on an inner 4 x 4 square array by two concentric rings of interacting guard fuel pin simulators. In the other test (B-3), the boundary conditions were imposed on a 4 x 4 square array by a non-interacting heated shroud. Test parameters conducive to large deformation were selected in order to favor rod-to-rod interactions. The tests showed that rod-to-rod interactions play an important role in the deformation process.

  4. [Primary care pediatrics in the public health system of the twenty-first century. SESPAS report 2012].

    PubMed

    Domínguez Aurrecoechea, Begoña; Valdivia Jiménez, Carlos

    2012-03-01

    Today in our country, the primary care pediatrician is the first contact between children and adolescents with the health system, being also a highly resolving specialist that addresses over 90% of the health needs of this population, monitors growth and development and participates in all activities of prevention, health promotion and health education within primary care teams with nurses and family doctors. Witnessing rapid and profound demographic, social, cultural, scientific and technological changes as well as the demands and expectations of health care for citizens, which should enhance the value and response capacity of primary care. These changes also affect infant morbidity and health care priorities in child and adolescent, posing new challenges for primary care practice and reinforce the role of the pediatrician in primary care. Primary care is not only the gateway to the health system. Primary care teams have to take responsibility for the care of people assigned to coordinate the necessary resources and advising citizens on their health problems and his itinerary care by the health system. It identifies the need to foster teamwork within the health department involved nursing staff to take care activities in this age group. It aims to foster a model based on cooperation and complementarity. A recent systematic review recommended maintaining the figure of the pediatrician in primary care teams and strengthen their specific role as first point of contact with the child's health care system, found significant benefits for children. PMID:22196036

  5. 40 CFR 141.535 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 23 2011-07-01 2011-07-01 false What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? 141.535 Section 141.535 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration...

  6. 40 CFR 141.535 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? 141.535 Section 141.535 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING...

  7. 40 CFR 141.544 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? 141.544 Section 141.544 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING...

  8. 40 CFR 141.544 - What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 23 2011-07-01 2011-07-01 false What if my system uses chloramines, ozone, or chlorine dioxide for primary disinfection? 141.544 Section 141.544 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration...

  9. PROMIS in Primary Care: Demonstration of a Computerized Problem-Oriented Medical Information System in Primary Care

    PubMed Central

    Powell, H.; Davis, E.; Wolf, L.

    1981-01-01

    This paper describes the implementation of a computerized PROMIS (Problem Oriented Medical Information System) at the Champlain Islands Health Center, a Rural Health Initiative Project, in Grand Isle County, Vermont. The goal of the contract with the National Center for Health Services Research was to develop a well defined, computerized and coordinated system of care that would provide a mid-level provider staff with guidance, as they practice health care in a rural, isolated county. The conceptualization of this technology as a method to meet the needs of rural health care, a brief description of POMR (Problem Oriented Medical Records) and the technological aspects of the system will all be addressed in this paper.

  10. Evaluation of computerized health management information system for primary health care in rural India

    PubMed Central

    2010-01-01

    Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors) and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR) 1674,217 (USD 35,622). Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213). The annual savings is around INR 894,283 (USD 11,924). Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision. PMID:21078203

  11. Development of a computerised decisions support system for renal risk drugs targeting primary healthcare

    PubMed Central

    Helldén, Anders; Al-Aieshy, Fadiea; Bastholm-Rahmner, Pia; Bergman, Ulf; Gustafsson, Lars L; Höök, Hans; Sjöviker, Susanne; Söderström, Anders; Odar-Cederlöf, Ingegerd

    2015-01-01

    Objectives To assess general practitioners (GPs) experience from the implementation and use of a renal computerised decision support system (CDSS) for drug dosing, developed for primary healthcare, integrated into the patient’s electronic health record (EHR), and building on estimation of the patient's creatinine clearance (ClCG). Design Qualitative research design by a questionnaire and a focus group discussion. Setting and participants Eight GPs at two primary healthcare centres (PHCs). Interventions The GP at PHC 1, and the project group, developed and tested the technical solution of the CDSS. Proof-of-concept was tested by seven GPs at PHC 2. They also participated in a group discussion and answered a questionnaire. A web window in the EHR gave drug and dosage in relation to ClCG. Each advice was according to three principles: If? Why? Because. Outcome measures (1) The GPs’ experience of ‘easiness to use’ and ‘perceived usefulness’ at PHC 2, based on loggings of use, answers from a questionnaire using a 5-point Likert scale, and answers from a focus group discussion. (2) The number of patients aged 65 years and older with an estimation of ClCG before and after the implementation of the CDSS. Results The GPs found the CDSS fast, simple and easy to use. They appreciated the automatic presentation of the CICG status on opening the medication list, and the ability to actively look up specific drug recommendations in two steps. The CDSS scored high on the Likert scale. All GPs wanted to continue the use of the CDSS and to recommend it to others. The number of patients with an estimated ClCG increased 1.6-fold. Conclusions Acceptance of the simple graphical interface of this push and pull renal CDSS was high among the primary care physicians evaluating this proof of concept. The graphical model should be useful for further development of renal decision support systems. PMID:26150141

  12. Educational potential of a virtual patient system for caring for traumatized patients in primary care

    PubMed Central

    2013-01-01

    Background Virtual Patients (VPs) have been used in undergraduate healthcare education for many years. This project is focused on using VPs for training professionals to care for highly vulnerable patient populations. The aim of the study was to evaluate if Refugee Trauma VPs was perceived as an effective and engaging learning tool by primary care professionals (PCPs) in a Primary Health Care Centre (PHC). Methods A VP system was designed to create realistic and engaging VP cases for Refugee Trauma for training refugee patient interview, use of established trauma and mental health instruments as well as to give feedback to the learners. The patient interview section was based on video clips with a Bosnian actor with a trauma story and mental health problems. The video clips were recorded in Bosnian language to further increase the realism, but also subtitled in English. The system was evaluated by 11 volunteering primary health clinicians at the Lynn Community Health Centre, Lynn, Massachusetts, USA. The participants were invited to provide insights/feedback about the system’s usefulness and educational value. A mixed methodological approach was used, generating both quantitative and qualitative data. Results Self-reported dimensions of clinical care, pre and post questionnaire questions on the PCPs clinical worldview, motivation to use the VP, and IT Proficiency. Construct items used in these questionnaires had previously demonstrated high face and construct validity. The participants ranked the mental status examination more positively after the simulation exercise compared to before the simulation. Follow up interviews supported the results. Conclusions Even though virtual clinical encounters are quite a new paradigm in PHC, the participants in the present study considered our VP case to be a relevant and promising educational tool. Next phase of our project will be a RCT study including comparison with specially prepared paper-cases and determinative input on

  13. Recent Clinical Characteristics of Labors Using Three Japanese Systems of Midwife-Led Primary Delivery Care

    PubMed Central

    Suzuki, Shunji

    2016-01-01

    Objective. The objective of this study was to describe the recent clinical characteristics of labor using 3 systems of Japanese midwife-led primary delivery care, as follows: (1) those intending to give birth at home managed by midwives who do not belong to our hospital, (2) those planning to give birth in our hospital managed by the same midwives, and (3) those planning to give birth managed by midwives who belong to our hospital. Methods. A retrospective cohort study was performed. Results. There were no significant differences in the obstetric or neonatal outcomes among the 3 groups. The rate of transfers during labor with the system involving midwives belonging to our hospital was higher than those with the other 2 systems. In addition, the timing of transfers in the system with the midwives belonging to our hospital was earlier than with the other 2 systems. Among the 3 groups, there were no significant differences in the rate of the main 2 indications for transfers: fetal heart rate abnormality and failure to progress. Conclusion. There were no significant differences in perinatal outcomes among the 3 systems; however, there were some differences in the status of transfers to obstetric shared care. PMID:27034827

  14. Validation of the Chinese Handwriting Analysis System (CHAS) for primary school students in Hong Kong.

    PubMed

    Li-Tsang, Cecilia W P; Wong, Agnes S K; Leung, Howard W H; Cheng, Joyce S; Chiu, Billy H W; Tse, Linda F L; Chung, Raymond C K

    2013-09-01

    There are more children diagnosed with specific learning difficulties in recent years as people are more aware of these conditions. Diagnostic tool has been validated to screen out this condition from the population (SpLD test for Hong Kong children). However, for specific assessment on handwriting problem, there seems a lack of standardized and objective evaluation tool to look into the problems. The objective of this study was to validate the Chinese Handwriting Analysis System (CHAS), which is designed to measure both the process and production of handwriting. The construct validity, convergent validity, internal consistency and test-retest reliability of CHAS was analyzed using the data from 734 grade 1-6 students from 6 primary schools in Hong Kong. Principal Component Analysis revealed that measurements of CHAS loaded into 4 components which accounted for 77.73% of the variance. The correlation between the handwriting accuracy obtained from HAS and eyeballing was r=.73. Cronbach's alpha of all measurement items was .65. Except SD of writing time per character, all the measurement items regarding handwriting speed, handwriting accuracy and pen pressure showed good to excellent test-retest reliability (r=.72-.96), while measurement on the numbers of characters which exceeded grid showed moderate reliability (r=.48). Although there are still ergonomic, biomechanical or unspecified aspects which may not be determined by the system, the CHAS can definitely assist therapists in identifying primary school students with handwriting problems and implement interventions accordingly. PMID:23816625

  15. Effect of Fluoride and Simplified Adhesive Systems on the Bond Strength of Primary Molars and Incisors.

    PubMed

    Firoozmand, Leily Macedo; Noleto, Lawanne Ellen Carvalho; Gomes, Isabella Azevedo; Bauer, José Roberto de Oliveira; Ferreira, Meire Coelho

    2015-01-01

    The aim of this study was evaluate in vitro the influence of simplified adhesive systems (etch-and-rinse and self-etching) and 1.23% acidulated phosphate fluoride (APF) on the microshear bond strength (μ-SBS) of composite resins on primary molars and incisors. Forty primary molars and forty incisors vestibular enamel was treated with either the self-etching Clearfil SE Bond (CSE, Kuraray) or etch-and-rinse Adper Single Bond 2 (SB2, 3M/ESPE) adhesive system. Each group was subdivided based on the prior treatment of the enamel with or without the topical application of 1.23% APF. Thereafter, matrices were positioned and filled with composite resin and light cured. After storage in distilled water at 37 ± 1°C for 24 h, the specimens were submitted to μ-SBS in a universal testing machine. Kruskal-Wallis and Mann-Whitney tests (p < 0.05) showed that the prior application of 1.23% APF led to a significant reduction in bond strength. The type of adhesive exerted no significant influence bond strength. In the inter-group analysis, however, significantly bond strength reduction was found for the incisors when CSE was employed with APF. Adhesive failure was the most common type of fracture. The bond strength was affected by the prior application of 1.23% APF and type of tooth. PMID:26312974

  16. Frequency response properties of primary afferent neurons in the posterior lateral line system of larval zebrafish.

    PubMed

    Levi, Rafael; Akanyeti, Otar; Ballo, Aleksander; Liao, James C

    2015-01-15

    The ability of fishes to detect water flow with the neuromasts of their lateral line system depends on the physiology of afferent neurons as well as the hydrodynamic environment. Using larval zebrafish (Danio rerio), we measured the basic response properties of primary afferent neurons to mechanical deflections of individual superficial neuromasts. We used two types of stimulation protocols. First, we used sine wave stimulation to characterize the response properties of the afferent neurons. The average frequency-response curve was flat across stimulation frequencies between 0 and 100 Hz, matching the filtering properties of a displacement detector. Spike rate increased asymptotically with frequency, and phase locking was maximal between 10 and 60 Hz. Second, we used pulse train stimulation to analyze the maximum spike rate capabilities. We found that afferent neurons could generate up to 80 spikes/s and could follow a pulse train stimulation rate of up to 40 pulses/s in a reliable and precise manner. Both sine wave and pulse stimulation protocols indicate that an afferent neuron can maintain their evoked activity for longer durations at low stimulation frequencies than at high frequencies. We found one type of afferent neuron based on spontaneous activity patterns and discovered a correlation between the level of spontaneous and evoked activity. Overall, our results establish the baseline response properties of lateral line primary afferent neurons in larval zebrafish, which is a crucial step in understanding how vertebrate mechanoreceptive systems sense and subsequently process information from the environment. PMID:25355959

  17. The relationship between office system tools and evidence-based care in primary care physician practice.

    PubMed

    Davis, Mark A; Pavur, Robert J

    2011-08-01

    A number of office system tools have been developed to improve the rates of preventive services and enhance the quality of medical care in practice settings. New approaches to measuring physician adherence to evidence-based standards of treatment, offer a unique opportunity to examine the link between the use of office system tools and evidence-based practices in primary care. Using episode-based profiling measures of adherence as the criterion, results from this investigation suggest that the application of simple physician reminders can be an effective technique for promoting evidence-based treatment. The data also reveal that the influence of health information technology (HIT) resources on adherence was not exclusively positive. Specifically, adherence to evidence-based standards was higher for primary care practices that employed HIT resources judiciously. In contrast, extensive use of personal digital assistants was negatively associated with adherence. Despite concerns directed towards the new generation of episode-based profiling measures, results from this research indicate that the measures behave similarly to traditional measures of quality. PMID:21840895

  18. Frequency response properties of primary afferent neurons in the posterior lateral line system of larval zebrafish

    PubMed Central

    Levi, Rafael; Akanyeti, Otar; Ballo, Aleksander

    2014-01-01

    The ability of fishes to detect water flow with the neuromasts of their lateral line system depends on the physiology of afferent neurons as well as the hydrodynamic environment. Using larval zebrafish (Danio rerio), we measured the basic response properties of primary afferent neurons to mechanical deflections of individual superficial neuromasts. We used two types of stimulation protocols. First, we used sine wave stimulation to characterize the response properties of the afferent neurons. The average frequency-response curve was flat across stimulation frequencies between 0 and 100 Hz, matching the filtering properties of a displacement detector. Spike rate increased asymptotically with frequency, and phase locking was maximal between 10 and 60 Hz. Second, we used pulse train stimulation to analyze the maximum spike rate capabilities. We found that afferent neurons could generate up to 80 spikes/s and could follow a pulse train stimulation rate of up to 40 pulses/s in a reliable and precise manner. Both sine wave and pulse stimulation protocols indicate that an afferent neuron can maintain their evoked activity for longer durations at low stimulation frequencies than at high frequencies. We found one type of afferent neuron based on spontaneous activity patterns and discovered a correlation between the level of spontaneous and evoked activity. Overall, our results establish the baseline response properties of lateral line primary afferent neurons in larval zebrafish, which is a crucial step in understanding how vertebrate mechanoreceptive systems sense and subsequently process information from the environment. PMID:25355959

  19. [Two cases of breast cancer responding to primary systemic chemotherapy containing trastuzumab without surgery].

    PubMed

    Konishi, Kazuya; Hasegawa, Naoto; Kaneko, Hiroyuki; Iimura, Yasuaki; Shoji, Yasuhito; Kawabata, Makoto

    2010-01-01

    The first case was a 40-year-old woman who was referred to our hospital with a complaint of left breast tumor. She was diagnosed as invasive ductal carcinoma (T2N0M0, Stage IIA). The tumor was ER-negative, PR-negative and HER2-positive. After primary systemic chemotherapy with 6 courses of 5-fluorouracil+epirubicin+cyclophosphamide(FEC)and 3 courses of weekly paclitaxel (PTX)+trastuzumab, the efficacy of chemotherapy was judged as a complete response (CR). After chemotherapy, radiotherapy for her left breast was performed without surgery. At 21 months after CR, local efficacy was judged as CR, but liver and bone metastases appeared, and were treated by capecitabine and trastuzumab. The efficacy of chemotherapy was judged as a partial response (PR). The second case was a 26-year-old woman referred to our hospital with a complaint of right breast tumor. She was diagnosed as invasive lobular carcinoma (T2N0M0, Stage IIA). The tumor was ER-positive, PR-negative and HER2-positive. After primary systemic chemotherapy with 4 courses of FEC and 6 courses of docetaxel+trastuzumab, the efficacy of chemotherapy was judged as CR. Then, 4 courses of weekly PTX+trastuzumab were performed. After chemotherapy, radiotherapy for her right breast was performed without surgery. The efficacy of treatment was judged as CR for 15 months. PMID:20087043

  20. Primary angiitis of central nervous system: The story of a great masquerader.

    PubMed

    Bajaj, Bhupender Kumar; Pandey, Shweta; Ramanujam, Bhargavi; Wadhwa, Ankur

    2015-01-01

    Primary angiitis of central nervous system (PACNS) is characterized by non-caseating granulomatous angiitis restricted to CNS. The condition often masquerades as migraine, stroke, epilepsy, dementia, demyelinating disorder and CNS infection. The protean manifestations frequently lead to misdiagnoses. We present a case of a young male from rural background that remained undiagnosed for years as the possibility of PACNS was not considered. He had history suggestive of migraine-like headaches followed by seizures. Subsequently, he developed rapidly progressive dementia and two episodes of hemorrhagic strokes over a short period. The diagnosis was finally clinched by the absence of evidence of systemic vasculitis and the presence of characteristic non-caseating granuloma around vessels of duramater and cerebral parenchyma on brain biopsy. He was started on pulse therapy with intravenous cyclophosphamide and methylprednisolone. The current literature about the condition and its management is reviewed in this report. PMID:26167025

  1. Highly practical copper(I)/TEMPO catalyst system for chemoselective aerobic oxidation of primary alcohols.

    PubMed

    Hoover, Jessica M; Stahl, Shannon S

    2011-10-26

    Aerobic oxidation reactions have been the focus of considerable attention, but their use in mainstream organic chemistry has been constrained by limitations in their synthetic scope and by practical factors, such as the use of pure O(2) as the oxidant or complex catalyst synthesis. Here, we report a new (bpy)Cu(I)/TEMPO catalyst system that enables efficient and selective aerobic oxidation of a broad range of primary alcohols, including allylic, benzylic, and aliphatic derivatives, to the corresponding aldehydes using readily available reagents, at room temperature with ambient air as the oxidant. The catalyst system is compatible with a wide range of functional groups and the high selectivity for 1° alcohols enables selective oxidation of diols that lack protecting groups. PMID:21861488

  2. Distributed Hierarchical Control of Multi-Area Power Systems with Improved Primary Frequency Regulation

    SciTech Connect

    Lian, Jianming; Marinovici, Laurentiu D.; Kalsi, Karanjit; Du, Pengwei; Elizondo, Marcelo A.

    2012-12-12

    The conventional distributed hierarchical control architecture for multi-area power systems is revisited. In this paper, a new distributed hierarchical control architecture is proposed. In the proposed architecture, pilot generators are selected in each area to be equipped with decentralized robust control as a supplementary to the conventional droop speed control. With the improved primary frequency control, the system frequency can be restored to the nominal value without the help of secondary frequency control, which reduces the burden of the automatic generation control for frequency restoration. Moreover, the low frequency inter-area electromechanical oscillations can also be effectively damped. The effectiveness of the proposed distributed hierarchical control architecture is validated through detailed simulations.

  3. WWER Expert System for Fuel Failure Analysis Using Data on Primary Coolant Activity

    SciTech Connect

    Likhanskii, V.V.; Evdokimov, I.A.; Sorokin, A.A.; Khromov, A.G.; Kanukova, V.D.; Apollonova, O.V.; Ugryumov, A.V.

    2007-07-01

    The computer expert system for fuel failure analysis of WWER during operation is presented. The diagnostics is based on the measurement of specific activity of reference nuclides in reactor primary coolant and application of a computer code for the data interpretation. The data analysis includes an evaluation of tramp uranium mass in reactor core, detection of failures by iodine and caesium spikes, evaluation of burnup of defective fuel. Evaluation of defective fuel burnup was carried out by applying the relation of caesium nuclides activity in spikes and relations of activities of gaseous fission products for steady state operational conditions. The method of burnup evaluation of defective fuel by use of fission gas activity is presented in detail. The neural-network analysis is performed for determination of failed fuel rod number and defect size. Results of the expert system application are illustrated for several fuel campaigns on operating WWER NPPs. (authors)

  4. [Management problems of improving the quality and efficiency of primary health care system of Georgia].

    PubMed

    Dzhakeli, I V; Edzhibadze, O I; Gerzmava, O Kh

    2009-01-01

    Improving the quality and efficiency of primary health care system is a key challenge. In this regard, problems that have accumulated in the system over the past decade - a weak material base of outpatient-polyclinic institutions, especially in rural areas; a surplus of medical personnel; lack of control by local, regional and central authorities--still remain as serious obstacle. The issue of financing the provided health services, is also particularly important, given the fact that a significant portion of the cost of medical services is covered by the patient directly. And as a consequence, the low level of applications for outpatient-polyclinic assistance due to declining affordability of medical services. In connection with the foregoing, the authors of the paper raise the question of implementing strict, multi-component system of quality control of medical care for patients. In particular, they propose: to base modern organization works on improving the quality of primary health care system on the principles of general management theory; Modern management of service quality should be clearly oriented towards the needs of the population in health care, its structure and dynamics; accessibility, incentives, determined by economic and technological competition characteristic to the market; Modern quality management, regardless of ownership and scale of outpatient-polyclinic establishment should optimally combine the actions, methods and tools that provide, on the one hand--the organization of diagnostic and therapeutic-prophylactic processes meeting the needs of the people, and on the other--the introduction of new methods and means to ensure the modern level of medical care; Schematic diagram of quality control mechanism organically interacts with the market research and includes a block of policy development in terms of quality. PMID:19644201

  5. Development of an inducible gene expression system for primary murine keratinocytes

    PubMed Central

    Nagarajan, Priyadharsini

    2008-01-01

    Background The tetracycline (Tet) responsive system is a valuable tool that is routinely used in a wide variety of mammalian cells for regulatable expression of gene products. However, technical difficulties such as harsh selection conditions and extensive screening processes to identify suitably responsive clones limit the generation of stable cell lines. Hence, application of this system in mammalian cells with relatively slow growth rates and / or the capacity to undergo terminal differentiation such as primary mouse keratinocytes is particularly challenging. Objective To our knowledge, no Tet-responsive stable cell lines have been generated from mouse keratinocytes, presumably due to their sensitivity to selection conditions. Our goal was to utilize a modified and robust Tet-expression system to generate a stable primary mouse keratinocyte cell line. These cells could be then utilized for conditional expression of potentially toxic proteins in an inducible fashion. Methods We utilized a eukaryotic promoter instead of a viral promoter to express a modified reverse tetracycline transactivator in mouse keratinocytes and optimized the selection process for generating stable cell lines. Results Here, we report the generation of a stable mouse keratinocyte cell line for Tet-regulated gene expression with minimal leakiness and high degree of Tet responsivity. This mouse keratinocyte cell line was further engineered for generation of a double stable cell line, which expresses the transcription factor AP-2α in an inducible manner. Importantly, the selected cells retain their inherent keratinocyte morphology, respond to differentiation signals and exhibit a persistent and highly tunable Tet inducibility upon continuous culturing. Conclusion We have generated a tetracycline inducible gene expression model system in mouse epidermal keratinocytes. Such inducible cell lines will serve as valuable in vitro models for future gain-of-function and loss-of-function studies. PMID

  6. How Can Primary Health Care System and Community-Based Participatory Research Be Complementary?

    PubMed Central

    Sheikhattari, Payam; Kamangar, Farin

    2010-01-01

    Health statistics leave little doubt that the current health system in Iran, which is mainly based on primary health care (PHC), is a functioning one, and that health in Iran has improved far beyond where it was 40 years ago. However, this system has its limitations too. While PHC is very effective in reducing morbidity and mortality from infectious diseases and other acute conditions, it is far less effective in addressing chronic and multifactorial conditions which are now emerging in Iran. In this article, we review some of the salient features of the current health system in Iran, its strengths and limitations, and then introduce community-based participatory research (CBPR) as a method that could potentially fill some of the gaps in the system. We will discuss the definition and steps needed to implement CBPR, provide some important references, and discuss how this approach may not only improve the health system but it could also lead to improvement in other fields in the society too. PMID:21677760

  7. The utility of body FDG PET in staging primary central nervous system lymphoma

    PubMed Central

    Mohile, Nimish A.; DeAngelis, Lisa M.; Abrey, Lauren E.

    2008-01-01

    18F-Fluorodeoxyglucose (FDG) PET has become an important tool in the management of non-Hodgkin’s lymphoma (NHL), but its role in the evaluation of primary CNS lymphoma (PCNSL) has not been established. We investigated the ability of body FDG PET to detect systemic disease in the staging and restaging of PCNSL. The records of 166 PCNSL patients seen at Memorial Sloan-Kettering Cancer Center were examined. Forty-nine patients who underwent body FDG PET for staging of PCNSL were identified. Clinical data were reviewed to determine FDG PET results and their influence on therapy. Body FDG PET disclosed a systemic site of malignancy in 15% of patients. NHL was found in 11% of all patients, 7% of patients at diagnosis, and 27% of patients at CNS relapse. Four percent had a second systemic neoplasm. Workup with conventional staging did not reveal systemic disease, and in 8% of patients, body FDG PET was the only abnormal diagnostic exam suggestive of lymphoma. FDG PET findings altered patient treatment and resulted in additional chemotherapy, surgery, or radiotherapy. Our findings suggest that FDG PET may be more sensitive than conventional body staging and may disclose higher rates of concomitant systemic disease at PCNSL diagnosis. Body FDG PET may be an important noninvasive adjunct to conventional PCNSL staging, and its utility should be evaluated prospectively. PMID:18287338

  8. Genome-wide analysis uncovers novel recurrent alterations in primary central nervous system lymphomas

    PubMed Central

    Braggio, Esteban; Van Wier, Scott; Ojha, Juhi; McPhail, Ellen; Asmann, Yan W.; Egan, Jan; da Silva, Jackline Ayres; Schiff, David; Lopes, M Beatriz; Decker, Paul A; Valdez, Riccardo; Tibes, Raoul; Eckloff, Bruce; Witzig, Thomas E.; Stewart, A Keith; Fonseca, Rafael; O’Neill, Brian Patrick

    2015-01-01

    Purpose Primary central nervous system lymphoma (PCNSL) is an aggressive non-Hodgkin lymphoma confined to the CNS. Whether there is a PCNSL-specific genomic signature and, if so, how it differs from systemic diffuse large B-cell lymphoma (DLBCL) is uncertain. Experimental design We performed a comprehensive genomic study of tumor samples from 19 immunocompetent PCNSL patients. Testing comprised array-comparative genomic hybridization and whole exome sequencing. Results Biallelic inactivation of TOX and PRKCD were recurrently found in PCNSL but not in systemic DLBCL, suggesting a specific role in PCNSL pathogenesis. Additionally, we found a high prevalence of MYD88 mutations (79%) and CDKN2A biallelic loss (60%). Several genes recurrently affected in PCNSL were common with systemic DLBCL, including loss of TNFAIP3, PRDM1, GNA13, TMEM30A, TBL1XR1, B2M, CD58, activating mutations of CD79B, CARD11 and translocations IgH-BCL6. Overall, BCR/TLR/NF-κB pathways were altered in >90% of PNCSL, highlighting its value for targeted therapeutic approaches. Furthermore, integrated analysis showed enrichment of pathways associated with immune response, proliferation, apoptosis, and lymphocyte differentiation. Conclusions In summary, genome-wide analysis uncovered novel recurrent alterations, including TOX and PRKCD, helping to differentiate PCNSL from systemic DLBCL and related lymphomas. PMID:25991819

  9. Bronchial Artery and Systemic Artery Embolization in the Management of Primary Lung Cancer Patients with Hemoptysis

    SciTech Connect

    Park, Hong Suk Kim, Young Il; Kim, Hyae Young; Zo, Jae-Ill; Lee, Joo Hyuk; Lee, Jin Soo

    2007-07-15

    Purpose. To assess the safety and effectiveness of arterial embolization in lung cancer patients with hemoptysis. Methods. Nineteen primary lung cancer patients with hemoptysis underwent bronchial artery and systemic artery embolization from April 2002 to March 2005. There were 17 men and 2 women, with a mean age of 59 years. Histologic analysis revealed squamous cell carcinoma in 10 patients and poorly differentiated adenocarcinoma in 9 patients. The amount of hemoptysis was bleeding of 25-50 ml within 24 hr in 8 patients, recurrent blood-tinged sputum in 6, and bleeding of 100 ml or more per 24 hr in 5. Embolization was done with a superselective technique using a microcatheter and polyvinyl alcohol particles to occlude the affected vessels. Results. Arterial embolization was technically successful in all patients and clinically successful in 15 patients (79%). The average number of arteries embolized was 1.2. Bronchial arteriography revealed staining (all patients), dilatation of the artery or hypervascularity (10 patients), and bronchopulmonary shunt (6 patients). The recurrence rate was 33% (5/15) and 11 patients were alive with a mean follow-up time of 148 days (30-349 days). Conclusion. Arterial embolotherapy for hemoptysis in patients with primary lung cancer is an effective, safe therapeutic modality despite the fact the vascular changes are subtle on angiography.

  10. Primary activity measurements with a 4πβ-4πγ coincidence counting system.

    PubMed

    Nedjadi, Youcef; Bailat, Claude J; Bochud, François O

    2012-01-01

    The radioactive concentrations of (166m)Ho, (134)Cs and (133)Ba solutions have been standardised using a 4πβ-4πγ coincidence counting system we have recently set up. The detection in the beta channel is performed using various geometries of a UPS-89 plastic scintillator optically coupled to a selected low-noise 1in. diameter photomultiplier tube. The light-tight thin capsule that encloses this beta detector is housed within the well of a 5in.×5in. NaI(Tl) monocrystal detector. The beta detection efficiency can be varied either by optical filtering or electronic discrimination when the electrons loose all their energy in the plastic scintillator. This 4πβ-4πγ coincidence system improves on our 4πβ(PC)-γ system in that its sample preparation is less labour intensive, it yields larger beta- and gamma-counting efficiencies thus enabling the standardisation of low activity sources with good statistics in reasonable time, and it makes standardising short-lived radionuclides easier. The resulting radioactive concentrations of (166m)Ho, (134)Cs and (133)Ba are found to agree with those measured with other primary measurement methods thus validating our 4πβ-4πγ coincidence counting system. PMID:21840220

  11. Applying Quality Improvement into Systems-based Learning to Improve Diabetes Outcomes in Primary Care.

    PubMed

    Moreo, Kathleen; Sapir, Tamar; Greene, Laurence

    2015-01-01

    In the U.S., where the prevalence of type 2 diabetes has reached epidemic proportions, many patients with this disease are treated by primary care physicians in community-based systems, including accountable care organisations (ACOs). To address gaps in the quality of diabetes care, national quality measures have been established, including patient-centered measures adopted by the Centers for Medicare and Medicaid Services for its Shared Savings Program for ACOs. From a patient-centered perspective, high-quality diabetes care depends on effective communication between clinicians and patients, along with patient education and counseling about medications and lifestyle. We designed and implemented a quality improvement (QI) program for 30 primary care physicians treating patients with type 2 diabetes in three structurally similar but geographically diverse ACOs. Retrospective chart audits were conducted before (n = 300) and after (n = 300) each physician participated in accredited continuing medical education (CME) courses that focused on QI strategies. Randomly selected charts were audited to measurably assess essential interventions for improved outcomes in type 2 diabetes including the physicians' documentation of patient counseling and assessment of side effects, and patients' medication adherence status and changes in hemoglobin A1C (A1C) and body mass index (BMI). Paced educational interventions included a private performance improvement Internet live course conducted for each physician, small-group Internet live courses involving peer discussion, and a set of enduring materials, which were also multi-accredited for all clinicians in the physician's practice. Continual improvement cycles were guided by analysis of the baseline chart audits, quantitative survey data, and qualitative feedback offered by participants. To extend the benefit of the education, the enduring materials were offered to the interprofessional team of clinicians throughout the U.S. who did

  12. Applying Quality Improvement into Systems-based Learning to Improve Diabetes Outcomes in Primary Care

    PubMed Central

    Moreo, Kathleen; Sapir, Tamar; Greene, Laurence

    2015-01-01

    In the U.S., where the prevalence of type 2 diabetes has reached epidemic proportions, many patients with this disease are treated by primary care physicians in community-based systems, including accountable care organisations (ACOs). To address gaps in the quality of diabetes care, national quality measures have been established, including patient-centered measures adopted by the Centers for Medicare and Medicaid Services for its Shared Savings Program for ACOs. From a patient-centered perspective, high-quality diabetes care depends on effective communication between clinicians and patients, along with patient education and counseling about medications and lifestyle. We designed and implemented a quality improvement (QI) program for 30 primary care physicians treating patients with type 2 diabetes in three structurally similar but geographically diverse ACOs. Retrospective chart audits were conducted before (n = 300) and after (n = 300) each physician participated in accredited continuing medical education (CME) courses that focused on QI strategies. Randomly selected charts were audited to measurably assess essential interventions for improved outcomes in type 2 diabetes including the physicians’ documentation of patient counseling and assessment of side effects, and patients’ medication adherence status and changes in hemoglobin A1C (A1C) and body mass index (BMI). Paced educational interventions included a private performance improvement Internet live course conducted for each physician, small-group Internet live courses involving peer discussion, and a set of enduring materials, which were also multi-accredited for all clinicians in the physician's practice. Continual improvement cycles were guided by analysis of the baseline chart audits, quantitative survey data, and qualitative feedback offered by participants. To extend the benefit of the education, the enduring materials were offered to the interprofessional team of clinicians throughout the U.S. who

  13. Effect of the Keck telescope`s segmented primary on the performance on the Keck adaptive optics system

    SciTech Connect

    Gavel, D.

    1997-06-01

    The 349 degree of freedom Keck adaptive optics system will be mapped on to the 36 segment Keck primary mirror. Each telescope segment is independently controlled in piston and tilt by an active control system and each segment also has its own set of aberrations. This presents a unique set of problems for the Keck adaptive optics system, not encountered with continuous primaries. To a certain extent the low order segment aberrations, beginning with focus, can be corrected statically by the adaptive optic system. However, the discontinuous surface at the segment edges present special problems in sensing and correcting wavefront with laser guide stars or natural guide stars.

  14. A Systems Model for Ursodeoxycholic Acid Metabolism in Healthy and Patients With Primary Biliary Cirrhosis

    PubMed Central

    Dobbins, RL; O'Connor‐Semmes, RL; Young, MA

    2016-01-01

    A systems model was developed to describe the metabolism and disposition of ursodeoxycholic acid (UDCA) and its conjugates in healthy subjects based on pharmacokinetic (PK) data from published studies in order to study the distribution of oral UDCA and potential interactions influencing therapeutic effects upon interruption of its enterohepatic recirculation. The base model was empirically adapted to patients with primary biliary cirrhosis (PBC) based on current understanding of disease pathophysiology and clinical measurements. Simulations were performed for patients with PBC under two competing hypotheses: one for inhibition of ileal absorption of both UDCA and conjugates and the other only of conjugates. The simulations predicted distinctly different bile acid distribution patterns in plasma and bile. The UDCA model adapted to patients with PBC provides a platform to investigate a complex therapeutic drug interaction among UDCA, UDCA conjugates, and inhibition of ileal bile acid transport in this rare disease population. PMID:27537780

  15. Primary central nervous system lymphoma: implication of high-dose chemotherapy followed by auto-SCT

    PubMed Central

    Reddy, N; Savani, BN

    2016-01-01

    Primary central nervous system lymphoma is a rare and distinct subtype of non-Hodgkin's lymphoma that is sensitive to radiation and chemotherapy. Decisions regarding the initial therapeutic approach are influenced by age and risk of therapy-related neurotoxicity. Despite several albeit small phase II studies, and the acknowledged need for larger prospective trials, there is supporting evidence to consider auto-SCT following induction chemotherapy in patients with good performance status. The international extranodal lymphoma study group is conducting a randomized phase II study comparing consolidative radiation therapy to high-dose therapy. Novel therapeutic options including early aggressive approach with upfront auto-SCT and strategies to prevent relapse following transplantation is an area of focus. PMID:22002486

  16. Astrocytes As the Main Players in Primary Degenerative Disorders of the Human Central Nervous System

    PubMed Central

    Capani, Francisco; Quarracino, Cecilia; Caccuri, Roberto; Sica, Roberto E. P.

    2016-01-01

    Along the last years it has been demonstrated that non-neural cells play a major role in the pathogenesis of the primary degenerative disorders (PDDs) of the human central nervous system. Among them, astrocytes coordinate and participate in many different and complex metabolic processes, in close interaction with neurons. Moreover, increasing experimental evidence hints an early astrocytic dysfunction in these diseases. In this mini review we summarize the astrocytic behavior in PDDs, with special consideration to the experimental observations where astrocytic pathology precedes the development of neuronal dysfunction. We also suggest a different approach that could be consider in human investigations in Alzheimer’s and Parkinson’s disease. We believe that the study of PDDs with human brain samples may hold the key of a paradigmatic physiopathological process in which astrocytes might be the main players. PMID:26973519

  17. Astrocytes As the Main Players in Primary Degenerative Disorders of the Human Central Nervous System.

    PubMed

    Capani, Francisco; Quarracino, Cecilia; Caccuri, Roberto; Sica, Roberto E P

    2016-01-01

    Along the last years it has been demonstrated that non-neural cells play a major role in the pathogenesis of the primary degenerative disorders (PDDs) of the human central nervous system. Among them, astrocytes coordinate and participate in many different and complex metabolic processes, in close interaction with neurons. Moreover, increasing experimental evidence hints an early astrocytic dysfunction in these diseases. In this mini review we summarize the astrocytic behavior in PDDs, with special consideration to the experimental observations where astrocytic pathology precedes the development of neuronal dysfunction. We also suggest a different approach that could be consider in human investigations in Alzheimer's and Parkinson's disease. We believe that the study of PDDs with human brain samples may hold the key of a paradigmatic physiopathological process in which astrocytes might be the main players. PMID:26973519

  18. The Systemic Changes to Improve Efficiency in Polish Primary Health Care

    PubMed Central

    Holecki, Tomasz; Romaniuk, Piotr; Woźniak-Holecka, Joanna

    2016-01-01

    Primary health care is an important part of any health care system. In highly developed countries it secures the population's most elementary health needs, with particular emphasis on preventive care and early intervention. Polish PHC model is currently undergoing a thorough transformation, associated with the need to adapt to standards designated based on the WHO's criteria, and with reference to the experience of other European countries. The paper describes the process of changes being carried out, in the context of previous experiences of reform relating to the sphere of organization, processes and efficiency. A review and systematization has been made, with regard to the undertaken activities in the field of deregulation and change of legal provisions, which are aimed at achieving the improvement of the efficiency of treatment and resource allocation. A set of recommendations based on expert's discourse have also been provided, with respect to future directions of Polish PHC transformation. PMID:27468269

  19. The Systemic Changes to Improve Efficiency in Polish Primary Health Care.

    PubMed

    Holecki, Tomasz; Romaniuk, Piotr; Woźniak-Holecka, Joanna

    2016-01-01

    Primary health care is an important part of any health care system. In highly developed countries it secures the population's most elementary health needs, with particular emphasis on preventive care and early intervention. Polish PHC model is currently undergoing a thorough transformation, associated with the need to adapt to standards designated based on the WHO's criteria, and with reference to the experience of other European countries. The paper describes the process of changes being carried out, in the context of previous experiences of reform relating to the sphere of organization, processes and efficiency. A review and systematization has been made, with regard to the undertaken activities in the field of deregulation and change of legal provisions, which are aimed at achieving the improvement of the efficiency of treatment and resource allocation. A set of recommendations based on expert's discourse have also been provided, with respect to future directions of Polish PHC transformation. PMID:27468269

  20. Implementation of non-condensable gases condensation suppression model into the WCOBRA/TRAC-TF2 LOCA safety evaluation code

    SciTech Connect

    Liao, J.; Cao, L.; Ohkawa, K.; Frepoli, C.

    2012-07-01

    The non-condensable gases condensation suppression model is important for a realistic LOCA safety analysis code. A condensation suppression model for direct contact condensation was previously developed by Westinghouse using first principles. The model is believed to be an accurate description of the direct contact condensation process in the presence of non-condensable gases. The Westinghouse condensation suppression model is further revised by applying a more physical model. The revised condensation suppression model is thus implemented into the WCOBRA/TRAC-TF2 LOCA safety evaluation code for both 3-D module (COBRA-TF) and 1-D module (TRAC-PF1). Parametric study using the revised Westinghouse condensation suppression model is conducted. Additionally, the performance of non-condensable gases condensation suppression model is examined in the ACHILLES (ISP-25) separate effects test and LOFT L2-5 (ISP-13) integral effects test. (authors)

  1. Primary reflector for solar energy collection systems and method of making same

    NASA Technical Reports Server (NTRS)

    Miller, C. G.; Stephens, J. B. (Inventor)

    1979-01-01

    Solar energy is reflected to a movably supported collector that is kept at the concentrated line focus of the reflector primary by a fixed, linear, ground-based primary reflector having an extended curved sawtooth contoured surface covered with a metalized polymeric reflecting material. The primary reflector was constructed by a process utilizing well-known freeway paving machinery.

  2. Parametric study of the potential for BWR ECCS strainer blockage due to LOCA generated debris. Final report

    SciTech Connect

    Zigler, G.; Brideau, J.; Rao, D.V.; Shaffer, C.; Souto, F.; Thomas, W.

    1995-10-01

    This report documents a plant-specific study for a BWR/4 with a Mark I containment that evaluated the potential for LOCA generated debris and the probability of losing long term recirculation capability due ECCS pump suction strainer blockage. The major elements of this study were: (1) acquisition of detailed piping layouts and installed insulation details for a reference BWR; (2) analysis of plant specific piping weld failure probabilities to estimate the LOCA frequency; (3) development of an insulation and other debris generation and drywell transport models for the reference BWR; (4) modeling of debris transport in the suppression pool; (5) development of strainer blockage head loss models for estimating loss of NPSH margin; (6) estimation of core damage frequency attributable to loss of ECCS recirculation capability following a LOCA. Elements 2 through 5 were combined into a computer code, BLOCKAGE 2.3. A point estimate of overall DEGB pipe break frequency (per Rx-year) of 1.59E-04 was calculated for the reference plant, with a corresponding overall ECCS loss of NPSH frequency (per Rx-year) of 1.58E-04. The calculated point estimate of core damage frequency (per Rx-year) due to blockage related accident sequences for the reference BWR ranged from 4.2E-06 to 2.5E-05. The results of this study show that unacceptable strainer blockage and loss of NPSH margin can occur within the first few minutes after ECCS pumps achieve maximum flows when the ECCS strainers are exposed to LOCA generated fibrous debris in the presence of particulates (sludge, paint chips, concrete dust). Generic or unconditional extrapolation of these reference plant calculated results should not be undertaken.

  3. Advancement of the segment support system for the Thirty Meter Telescope primary mirror

    NASA Astrophysics Data System (ADS)

    Williams, Eric C.; Baffes, Curtis; Mast, Terry; Nelson, Jerry; Platt, Benjamin; Ponchione, R. J.; Ponslet, Eric; Setoodeh, Shahriar; Sirota, Mark; Stephens, Vince; Stepp, Larry; Tubb, Alan

    2008-07-01

    This paper presents refinements to the design of the TMT primary mirror segment passive-support system that are effective in reducing gravity print-through and thermal distortion effects. First, a novel analytical method is presented for tuning the axial and lateral support systems in a manner that results in improved optical performance when subject to varying gravity fields. The method utilizes counterweights attached to the whiffletrees to cancel astigmatic and comatic errors normally resulting when the lateral support system resists transverse loads induced by gravity. Secondly, several central diaphragm designs are presented and analyzed to assess lateral-gravity and thermal distortion performance: 1) a simple flat diaphragm, 2) a stress-relieving diaphragm having a slotted outer rim and a circumferential convolution near the outside diameter, and 3) a flat diaphragm having a slotted outer rim. The latter design is chosen based on results from analytical studies which show it to have better overall optical performance in the presence of gravity and thermal environments.

  4. Revitalising primary healthcare requires an equitable global economic system - now more than ever.

    PubMed

    Sanders, David; Baum, Fran E; Benos, Alexis; Legge, David

    2011-08-01

    The promised revitalisation of primary healthcare (PHC) is happening at a time when the contradictions and unfairness of the global economic system have become clear, suggesting that the current system is unsustainable. In the past two decades, one of the most significant impediments to the implementation of comprehensive PHC has been neoliberal economic policies and their imposition globally. This article questions what will be required for PHC to flourish. PHC incorporates five key principles: equitable provision of services, comprehensive care, intersectoral action, community involvement and appropriate technology. This article considers intersectoral action and comprehensiveness and their potential to be implemented in the current global environment. It highlights the constraints to intersectoral action through a case study of nutrition in the context of globalisation of the food chain. It also explores the challenges to implementing a comprehensive approach to health that are posed by neoliberal health sector reforms and donor practices. The paper concludes that even well-designed health systems based on PHC have little influence over the broader economic forces that shape their operation and their ability to improve health. Reforming these economic forces will require greater regulation of the national and global economic environment to emphasise people's health rather than private profit, and action to address climate change. Revitalisation of PHC and progress towards health equity are unlikely without strong regulation of the market. The further development and strengthening of social movements for health will be key to successful advocacy action. PMID:19955097

  5. Modeling and Analysis of Alternative Concept of ITER Vacuum Vessel Primary Heat Transfer System

    SciTech Connect

    Carbajo, Juan J; Yoder Jr, Graydon L; Dell'Orco, Giovanni; Curd, Warren; Kim, Seokho H

    2010-01-01

    A RELAP5-3D model of the ITER (Latin for the way ) vacuum vessel (VV) primary heat transfer system has been developed to evaluate a proposed design change that relocates the heat exchangers (HXs) from the exterior of the tokamak building to the interior. This alternative design protects the HXs from external hazards such as wind, tornado, and aircraft crash. The proposed design integrates the VV HXs into a VV pressure suppression system (VVPSS) tank that contains water to condense vapour in case of a leak into the plasma chamber. The proposal is to also use this water as the ultimate sink when removing decay heat from the VV system. The RELAP5-3D model has been run under normal operating and abnormal (decay heat) conditions. Results indicate that this alternative design is feasible, with no effects on the VVPSS tank under normal operation and with tank temperature and pressure increasing under decay heat conditions resulting in a requirement to remove steam generated if the VVPSS tank low pressure must be maintained.

  6. Mechanism for the primary transformation of acetaminophen in a soil/water system.

    PubMed

    Liang, Chuanzhou; Lan, Zhonghui; Zhang, Xu; Liu, Yingbao

    2016-07-01

    The transformation of acetaminophen (APAP) in a soil/water system was systematically investigated by a combination of kinetic studies and a quantitative analysis of the reaction intermediates. Biotransformation was the predominant pathway for the elimination of APAP, whereas hydrolysis or other chemical transformation, and adsorption processes made almost no contribution to the transformation under a dark incubation. Bacillus aryabhattai strain 1-Sj-5-2-5-M, Klebsiella pneumoniae strain S001, and Bacillus subtilis strain HJ5 were the main bacteria identified in the biotransformation of APAP. The soil-to-water ratio and soil preincubation were able to alter the transformation kinetic pattern. Light irradiation promoted the overall transformation kinetics through enhanced biotransformation and extra photosensitized chemical reactions. The transformation pathways were strongly dependent on the initial concentration of APAP. The main primary transformation products were APAP oligomers and p-aminophenol, with the initial addition of 26.5 and 530 μM APAP, respectively. APAP oligomers accounted for more than 95% of transformed APAP, indicating that almost no bound residues were generated through the transformation of APAP in the soil/water system. The potential environmental risks of APAP could increase following the transformation of APAP in the soil/water system because of the higher toxicity of the transformation intermediates. PMID:27107139

  7. Assessment of Primary Production of Horticultural Safety Management Systems of Mushroom Farms in South Africa.

    PubMed

    Dzingirayi, Garikayi; Korsten, Lise

    2016-07-01

    Growing global consumer concern over food safety in the fresh produce industry requires producers to implement necessary quality assurance systems. Varying effectiveness has been noted in how countries and food companies interpret and implement food safety standards. A diagnostic instrument (DI) for global fresh produce industries was developed to measure the compliancy of companies with implemented food safety standards. The DI is made up of indicators and descriptive grids for context factors and control and assurance activities to measure food safety output. The instrument can be used in primary production to assess food safety performance. This study applied the DI to measure food safety standard compliancy of mushroom farming in South Africa. Ten farms representing almost half of the industry farms and more than 80% of production were independently assessed for their horticultural safety management system (HSMS) compliance via in-depth interviews with each farm's quality assurance personnel. The data were processed using Microsoft Office Excel 2010 and are represented in frequency tables. The diagnosis revealed that the mushroom farming industry had an average food safety output. The farms were implementing an average-toadvanced HSMS and operating in a medium-risk context. Insufficient performance areas in HSMSs included inadequate hazard analysis and analysis of control points, low specificity of pesticide assessment, and inadequate control of suppliers and incoming materials. Recommendations to the industry and current shortcomings are suggested for realization of an improved industry-wide food safety assurance system. PMID:27357039

  8. Hybrid EANN-EA System for the Primary Estimation of Cardiometabolic Risk.

    PubMed

    Kupusinac, Aleksandar; Stokić, Edita; Kovaćevic, Ilija

    2016-06-01

    The most important part of the early prevention of atherosclerosis and cardiovascular diseases is the estimation of the cardiometabolic risk (CMR). The CMR estimation can be divided into two phases. The first phase is called primary estimation of CMR (PE-CMR) and includes solely diagnostic methods that are non-invasive, easily-obtained, and low-cost. Since cardiovascular diseases are among the main causes of death in the world, it would be significant for regional health strategies to develop an intelligent software system for PE-CMR that would save time and money by extracting the persons with potentially higher CMR and conducting complete tests only on them. The development of such a software system has few limitations - dataset can be very large, data can not be collected at the same time and the same place (eg. data can be collected at different health institutions) and data of some other region are not applicable since every population has own features. This paper presents a MATLAB solution for PE-CMR based on the ensemble of well-learned artificial neural networks guided by evolutionary algorithm or shortly EANN-EA system. Our solution is suitable for research of CMR in population of some region and its accuracy is above 90 %. PMID:27106582

  9. Patients’ perceptions of the triage system in a primary healthcare facility, Cape Town, South Africa

    PubMed Central

    Adeniji, Adeloye Amoo

    2016-01-01

    Background In public healthcare facilities, where the patient numbers and the available resources are often disproportionate, triage is used to prioritise when patients are seen. Patients may not understand the triage process and have strong views on how to improve their experience. Aim This study explored the views of patients who had undergone triage in the emergency centre of a primary care facility. Setting Gugulethu Community Health Centre, Cape Town. Methods A purposive sample consisted of five women (one coded green, three orange, one yellow) and four men (one coded green and three yellow). A semi-structured qualitative interview was conducted in either Xhosa or English and the transcripts analysed using the framework method. Results All of the respondents complained of a lack of information and poor understanding of the triage process. Those coded green experienced the process as biased and unfair and reported that the triage nurse was rude and unprofessional. By contrast, those coded yellow or orange found the triage nurse to be helpful and professional. Most patients turned to support staff (e.g. security staff or cleaners) for assistance in dealing with the triage system. Most patients waited longer than the guidelines recommend and the green-coded patients complained about this issue. Conclusion Patients did not have a good experience of the triage system. Managers of the triage system need to design better strategies to improve patient acceptance and share information. The important role of support staff needs to be recognised and strengthened. PMID:27380788

  10. Neurologic complications after intrathecal liposomal cytarabine in combination with systemic polychemotherapy in primary CNS lymphoma.

    PubMed

    Ostermann, Kathrin; Pels, Hendrik; Kowoll, Annika; Kuhnhenn, Jan; Schlegel, Uwe

    2011-07-01

    Intrathecal application of liposomal cytarabine (Ara-C) (DepoCyte(®)) has been associated with neurotoxicity when applied as part of a polychemotherapy regimen. Patients with primary central nervous system lymphoma treated with high-dose systemic methotrexate (MTX)- and Ara-C-based polychemotherapy including six cycles of liposomal Ara-C (50 mg intrathecally every 3 weeks) were prospectively monitored for neurotoxic side-effects. Between November 2005 and February 2009, 149 intrathecal applications of liposomal cytarabine (DepoCyte(®)) were carried out in 33 patients, 7 (21%) of whom developed an incomplete conus medullaris/cauda equina syndrome with incontinence for bladder (6) and bowel function (3) or lumbosacral polyradicular paresis (1), resolving only incompletely over a follow-up period of 9-30 months. In six of these seven patients, lumbosacral magnetic resonance imaging (MRI) was negative for leptomeningeal infiltration or arachnoiditis. Cerebrospinal fluid (CSF) analysis performed in six of these seven patients showed normal cell count in all and increased total protein in four of them. One patient among these seven suffered a seizure without other identifiable causes. Conus/cauda syndrome has to be considered as a serious potential neurotoxic side-effect in patients receiving liposomal Ara-C as part of a multimodal regimen including high-dose systemic MTX and Ara-C. PMID:20953896

  11. An updated T-series thermocouple measurement system for high-accuracy temperature measurements of the MMT primary mirror

    NASA Astrophysics Data System (ADS)

    Clark, D.; Gibson, J. D.

    2012-09-01

    Starting in 2009, MMTO began design and installation of a new set of electronics to measure a set of radiallydistributed type T thermocouples installed after the primary mirror polishing was completed. These thermocouples are arranged in both single measurement points and as thermopiles for differential temperature sensing. Since the goal of the primary mirror temperature control system is to minimize mirror seeing and mirror figure errors induced by temperature variation across the primary mirror, it depends on excellent accuracy from the temperature sensing system. The new electronics encompass on-board cold-junction compensation, real-time ITS-90 curve fitting, and Ethernet connectivity to the data servers running in the MMTO software infrastructure. We describe the hardware design, system wiring, and software used in this system.

  12. Pressure suppression system

    DOEpatents

    Gluntz, D.M.

    1994-10-04

    A pressure suppression system includes a containment vessel surrounding a reactor pressure vessel and defining a drywell therein containing a non-condensable gas. An enclosed wetwell pool is disposed inside the containment vessel, and an enclosed gravity driven cooling system (GDCS) pool is disposed above the wetwell pool in the containment vessel. The GDCS pool includes a plenum for receiving through an inlet the non-condensable gas carried with steam from the drywell following a loss-of-coolant accident (LOCA). A condenser is disposed in the GDCS plenum for condensing the steam channeled therein and to trap the non-condensable gas therein. A method of operation includes draining the GDCS pool following the LOCA and channeling steam released into the drywell following the LOCA into the GDCS plenum for cooling along with the non-condensable gas carried therewith for trapping the gas therein. 3 figs.

  13. Pressure suppression containment system

    DOEpatents

    Gluntz, Douglas M.; Townsend, Harold E.

    1994-03-15

    A pressure suppression containment system includes a containment vessel surrounding a reactor pressure vessel and defining a drywell therein containing a non-condensable gas. An enclosed wetwell pool is disposed inside the containment vessel, and a gravity driven cooling system (GDCS) pool is disposed above the wetwell pool in the containment vessel. The wetwell pool includes a plenum for receiving the non-condensable gas carried with steam from the drywell following a loss-of coolant-accident (LOCA). The wetwell plenum is vented to a plenum above the GDCS pool following the LOCA for suppressing pressure rise within the containment vessel. A method of operation includes channeling steam released into the drywell following the LOCA into the wetwell pool for cooling along with the non-condensable gas carried therewith. The GDCS pool is then drained by gravity, and the wetwell plenum is vented into the GDCS plenum for channeling the non-condensable gas thereto.

  14. Pressure suppression system

    DOEpatents

    Gluntz, Douglas M.

    1994-01-01

    A pressure suppression system includes a containment vessel surrounding a reactor pressure vessel and defining a drywell therein containing a non-condensable gas. An enclosed wetwell pool is disposed inside the containment vessel, and an enclosed gravity driven cooling system (GDCS) pool is disposed above the wetwell pool in the containment vessel. The GDCS pool includes a plenum for receiving through an inlet the non-condensable gas carried with steam from the drywell following a loss-of-coolant accident (LOCA). A condenser is disposed in the GDCS plenum for condensing the steam channeled therein and to trap the non-condensable gas therein. A method of operation includes draining the GDCS pool following the LOCA and channeling steam released into the drywell following the LOCA into the GDCS plenum for cooling along with the non-condensable gas carried therewith for trapping the gas therein.

  15. Pressure suppression containment system

    DOEpatents

    Gluntz, D.M.; Townsend, H.E.

    1994-03-15

    A pressure suppression containment system includes a containment vessel surrounding a reactor pressure vessel and defining a drywell therein containing a non-condensable gas. An enclosed wetwell pool is disposed inside the containment vessel, and a gravity driven cooling system (GDCS) pool is disposed above the wetwell pool in the containment vessel. The wetwell pool includes a plenum for receiving the non-condensable gas carried with steam from the drywell following a loss-of-coolant-accident (LOCA). The wetwell plenum is vented to a plenum above the GDCS pool following the LOCA for suppressing pressure rise within the containment vessel. A method of operation includes channeling steam released into the drywell following the LOCA into the wetwell pool for cooling along with the non-condensable gas carried therewith. The GDCS pool is then drained by gravity, and the wetwell plenum is vented into the GDCS plenum for channeling the non-condensable gas thereto. 6 figures.

  16. Analysis of cell identity, morphology, apoptosis and mitotic activity in a primary neural cell culture system in Drosophila

    PubMed Central

    2012-01-01

    In Drosophila, most neurogenetic research is carried out in vivo. Mammalian research demonstrates that primary cell culture techniques provide a powerful model to address cell autonomous and non-autonomous processes outside their endogenous environment. We developed a cell culture system in Drosophila using wildtype and genetically manipulated primary neural tissue for long-term observations. We assessed the molecular identity of distinct neural cell types by immunolabeling and genetically expressed fluorescent cell markers. We monitored mitotic activity of cell cultures derived from wildtype and tumorous larval brains. Our system provides a powerful approach to unveil developmental processes in the nervous system and to complement studies in vivo. PMID:22554060

  17. Primary paranasal sinus lymphoma: natural history and improved outcome with central nervous system chemoprophylaxis.

    PubMed

    Laskin, Janessa J; Savage, Kerry J; Voss, Nicholas; Gascoyne, Randy D; Connors, Joseph M

    2005-12-01

    Non-Hodgkin's lymphoma of the paranasal sinus is an uncommon presentation of extranodal lymphoma. Its natural history, treatment and prognosis have been infrequently characterized in the medical literature; however, a tendency to involve the central nervous system (CNS) has been noted. In British Columbia (population 4 million), a central database for lymphomas has allowed us to accurately track cases of paranasal sinus lymphoma diagnosed since 1980. A retrospective review was performed on the 44 patients who presented with primary paranasal sinus lymphoma (stage I or II) between 1980 and 1999. Histologic features were identified and immunophenotypic classification performed. Complete diagnostic and follow-up data including stage, treatment, response rates, sites of relapse and survival data were available for all patients. There were 26 men and 18 women. The types of lymphoma found were: diffuse large B cell (including immunoblastic), n = 37 (84%); T/NK nasal type, n = 3 (8%); peripheral T cell, not otherwise classified, n = 2 (4%); and others, n = 2 (4%). The median age at presentation was 66 years (range 27-97 years). The median follow-up for living patients was 114 months. For all 44 patients, the 5- and 10-year overall survivals were 48% and 41% and the disease-specific survivals 62% and 62%, respectively. Beginning in May 1985, intrathecal chemotherapy was added to our standard treatment plan of multi-agent chemotherapy and local irradiation. Before 1985, 2 of 5 patients developed leptomeningeal metastasis. Following the institution of intrathecal chemotherapy, only 8% (3 of 39) of patients have developed CNS disease. Introduction of intrathecal chemoprophylaxis was also associated with an improvement in overall survival from 20% to 51% and disease-specific survival from 40% to 65%. Primary paranasal sinus lymphoma is an uncommon presentation of lymphoma that carries the potential risk of spreading to the leptomeninges. Treatment with combined modality

  18. RELAP5 Model of the First Wall/Blanket Primary Heat Transfer System

    SciTech Connect

    Popov, Emilian L; Yoder Jr, Graydon L; Kim, Seokho H

    2010-06-01

    ITER inductive power operation is modeled and simulated using a system level computer code to evaluate the behavior of the Primary Heat Transfer System (PHTS) and predict parameter operational ranges. The control algorithm strategy and derivation are summarized in this report as well. A major feature of ITER is pulsed operation. The plasma does not burn continuously, but the power is pulsed with large periods of zero power between pulses. This feature requires active temperature control to maintain a constant blanket inlet temperature and requires accommodation of coolant thermal expansion during the pulse. In view of the transient nature of the power (plasma) operation state a transient system thermal-hydraulics code was selected: RELAP5. The code has a well-documented history for nuclear reactor transient analyses, it has been benchmarked against numerous experiments, and a large user database of commonly accepted modeling practices exists. The process of heat deposition and transfer in the blanket modules is multi-dimensional and cannot be accurately captured by a one-dimensional code such as RELAP5. To resolve this, a separate CFD calculation of blanket thermal power evolution was performed using the 3-D SC/Tetra thermofluid code. A 1D-3D co-simulation more realistically models FW/blanket internal time-dependent thermal inertia while eliminating uncertainties in the time constant assumed in a 1-D system code. Blanket water outlet temperature and heat release histories for any given ITER pulse operation scenario are calculated. These results provide the basis for developing time dependent power forcing functions which are used as input in the RELAP5 calculations.

  19. Creating an optical spectroscopy system for use in a primary care clinical setting (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Eshein, Adam; Nguyen, The-Quyen; Radosevich, Andrew J.; Gould, Bradley; Wu, Wenli; Konda, Vani; Yang, Leslie W.; Koons, Ann; Feder, Seth; Valuckaite, Vesta; Roy, Hemant K.; Backman, Vadim

    2016-03-01

    While there are a plethora of in-vivo spectroscopic techniques that have demonstrated the ability to detect a number of diseases in research trials, very few techniques have successfully become a fully realized clinical technology. This is primarily due to the stringent demands on a clinical device for widespread implementation. Some of these demands include: simple operation requiring minimal or no training, safe for in-vivo patient use, no disruption to normal clinic workflow, tracking of system performance, warning for measurement abnormality, and meeting all FDA guidelines for medical use. Previously, our group developed a fiber optic probe-based optical sensing technique known as low-coherence enhanced backscattering spectroscopy (LEBS) to quantify tissue ultrastructure in-vivo. Now we have developed this technique for the application of prescreening patients for colonoscopy in a primary care (PC) clinical setting. To meet the stringent requirements for a viable medical device used in a PC clinical setting, we developed several novel components including an automated calibration tool, optical contact sensor for signal acquisition, and a contamination sensor to identify measurements which have been affected by debris. The end result is a state-of-the-art medical device that can be realistically used by a PC physician to assess a person's risk for harboring colorectal precancerous lesions. The pilot study of this system shows great promise with excellent stability and accuracy in identifying high-risk patients. While this system has been designed and optimized for our specific application, the system and design concepts are universal to most in-vivo fiber optic based spectroscopic techniques.

  20. Enhanced Control of PWR Primary Coolant Water Chemistry Using Selective Separation Systems for Recovery and Recycle of Enriched Boric Acid

    SciTech Connect

    Ken Czerwinski; Charels Yeamans; Don Olander; Kenneth Raymond; Norman Schroeder; Thomas Robison; Bryan Carlson; Barbara Smit; Pat Robinson

    2006-02-28

    The objective of this project is to develop systems that will allow for increased nuclear energy production through the use of enriched fuels. The developed systems will allow for the efficient and selective recover of selected isotopes that are additives to power water reactors' primary coolant chemistry for suppression of corrosion attack on reactor materials.

  1. Primary Care Physicians’ Use of an Electronic Medical Record System: A Cognitive Task Analysis

    PubMed Central

    Hadas-Dayagi, Michal; Ziv, Amitai; Reis, Shmuel

    2009-01-01

    OBJECTIVE To describe physicians’ patterns of using an Electronic Medical Record (EMR) system; to reveal the underlying cognitive elements involved in EMR use, possible resulting errors, and influences on patient–doctor communication; to gain insight into the role of expertise in incorporating EMRs into clinical practice in general and communicative behavior in particular. DESIGN Cognitive task analysis using semi-structured interviews and field observations. PARTICIPANTS Twenty-five primary care physicians from the northern district of the largest health maintenance organization (HMO) in Israel. RESULTS The comprehensiveness, organization, and readability of data in the EMR system reduced physicians’ need to recall information from memory and the difficulty of reading handwriting. Physicians perceived EMR use as reducing the cognitive load associated with clinical tasks. Automaticity of EMR use contributed to efficiency, but sometimes resulted in errors, such as the selection of incorrect medication or the input of data into the wrong patient’s chart. EMR use interfered with patient–doctor communication. The main strategy for overcoming this problem involved separating EMR use from time spent communicating with patients. Computer mastery and enhanced physicians’ communication skills also helped. CONCLUSIONS There is a fine balance between the benefits and risks of EMR use. Automaticity, especially in combination with interruptions, emerged as the main cognitive factor contributing to errors. EMR use had a negative influence on communication, a problem that can be partially addressed by improving the spatial organization of physicians’ offices and by enhancing physicians’ computer and communication skills. PMID:19130148

  2. How stratification changes affect primary production in the California Current System.

    NASA Astrophysics Data System (ADS)

    Kim, H.; Miller, A. J.

    2006-12-01

    Warming of the California Current for the recent several decades was observed and buoyancy frequency increased by the warming, which might alter the upwelling cell and nutrient supply in the California Current System (CCS). Coastal upwelling plays an important role in bringing nutrients into euphotic zone for photosynthesis in the CCS. It is well known that bottom stress plays a significant role for the coastal upwelling. However, Lentz and Chapman (2004) proposed a new theory that nonlinear cross-shelf momentum flux can be more important than the bottom stress so onshore returning flow in the bottom boundary layer is less than interior cross-shelf momentum flux. The importance of interior flow depends on Burger number, which is a function of buoyancy frequency. Thus, we hypothesized that intensified stratification observed in the CCS, consequently increased Burger number can result in stronger interior return flow, which has less nutrient than bottom boundary return flow, and presumably less primary production and zooplankton biomass. To address this hypothesis modeling effort has been conducted using Regional Ocean Modeling System (ROMS) with biological tracers.

  3. Partial decoupling of primary productivity from upwelling in the California Current system

    NASA Astrophysics Data System (ADS)

    Renault, Lionel; Deutsch, Curtis; McWilliams, James C.; Frenzel, Hartmut; Liang, Jun-Hong; Colas, François

    2016-07-01

    Coastal winds and upwelling of deep nutrient-rich water along subtropical eastern boundaries yield some of the ocean's most productive ecosystems. Simple indices of coastal wind strength have been extensively used to estimate the timing and magnitude of biological productivity on seasonal and interannual timescales and underlie the prediction that anthropogenic climate warming will increase the productivity by making coastal winds stronger. The effect of wind patterns on regional net primary productivity is not captured by such indices and is poorly understood. Here we present evidence, using a realistic model of the California Current system and satellite measurements, that the observed slackening of the winds near the coast has little effect on near-shore phytoplankton productivity despite a large reduction in upwelling velocity. On the regional scale the wind drop-off leads to substantially higher production even when the total upwelling rate remains the same. This partial decoupling of productivity from upwelling results from the impact of wind patterns on alongshore currents and the eddies they generate. Our results imply that productivity in eastern boundary upwelling systems will be better predicted from indices of the coastal wind that account for its offshore structure.

  4. A Defined, Controlled Culture System for Primary Bovine Chromaffin Progenitors Reveals Novel Biomarkers and Modulators

    PubMed Central

    Masjkur, Jimmy; Levenfus, Ian; Lange, Sven; Arps-Forker, Carina; Poser, Steve; Qin, Nan; Vukicevic, Vladimir; Chavakis, Triantafyllos; Eisenhofer, Graeme; Bornstein, Stefan R.; Ehrhart-Bornstein, Monika

    2014-01-01

    We present a method to efficiently culture primary chromaffin progenitors from the adult bovine adrenal medulla in a defined, serum-free monolayer system. Tissue is dissociated and plated for expansion under support by the mitogen basic fibroblast growth factor (bFGF). The cultures, although not homogenous, contain a subpopulation of cells expressing the neural stem cell marker Hes3 that also propagate. In addition, Hes3 is also expressed in the adult adrenal medulla from where the tissue is taken. Differentiation is induced by bFGF withdrawal and switching to Neurobasal medium containing B27. Following differentiation, Hes3 expression is lost, and cells acquire morphologies and biomarker expression patterns of chromaffin cells and dopaminergic neurons. We tested the effect of different treatments that we previously showed regulate Hes3 expression and cell number in cultures of fetal and adult rodent neural stem cells. Treatment of the cultures with a combination of Delta4, Angiopoietin2, and a Janus kinase inhibitor increases cell number during the expansion phase without significantly affecting catecholamine content levels. Treatment with cholera toxin does not significantly affect cell number but reduces the ratio of epinephrine to norepinephrine content and increases the dopamine content relative to total catecholamines. These data suggest that this defined culture system can be used for target identification in drug discovery programs and that the transcription factor Hes3 may serve as a new biomarker of putative adrenomedullary chromaffin progenitor cells. PMID:24855275

  5. A Conceptual Framework for Evaluation of Public Health and Primary Care System Performance in Iran

    PubMed Central

    Jahanmehr, Nader; Rashidian, Arash; Khosravi, Ardeshir; Farzadfar, Farshad; Shariati, Mohammad; Majdzadeh, Reza; Sari, Ali Akbari; Mesdaghinia, Alireza

    2015-01-01

    Introduction: The main objective of this study was to design a conceptual framework, according to the policies and priorities of the ministry of health to evaluate provincial public health and primary care performance and to assess their share in the overall health impacts of the community. Methods: We used several tools and techniques, including system thinking, literature review to identify relevant attributes of health system performance framework and interview with the key stakeholders. The PubMed, Scopus, web of science, Google Scholar and two specialized databases of Persian language literature (IranMedex and SID) were searched using main terms and keywords. Following decision-making and collective agreement among the different stakeholders, 51 core indicators were chosen from among 602 obtained indicators in a four stage process, for monitoring and evaluation of Health Deputies. Results: We proposed a conceptual framework by identifying the performance area for Health Deputies between other determinants of health, as well as introducing a chain of results, for performance, consisting of Input, Process, Output and Outcome indicators. We also proposed 5 dimensions for measuring the performance of Health Deputies, consisting of efficiency, effectiveness, equity, access and improvement of health status. Conclusion: The proposed Conceptual Framework illustrates clearly the Health Deputies success in achieving best results and consequences of health in the country. Having the relative commitment of the ministry of health and Health Deputies at the University of Medical Sciences is essential for full implementation of this framework and providing the annual performance report. PMID:25946937

  6. Performance Enhancement of Multi-Cyclic Detector for Cognitive Radios with an OFDM Primary System

    NASA Astrophysics Data System (ADS)

    Kim, Minseok; Po, Kimtho; Takada, Jun-Ichi

    Spectrum sensing, a key technical challenge in cognitive radios (CR) technology, is a technique that enables the spectrum of licensed systems to be accessed without causing undue interference. It is well known that cyclostationarity detectors have great advantages over energy detectors in terms of the robustness to noise uncertainty that significantly degrades the performance as well as the capability to distinguish the signal of interest from the other interferences and noise. The generalized likelihood ratio test (GLRT) is a recognized sensing technique that utilizes the inherent cyclostationarity of the signal and has been intensively studied. However, no comprehensive evaluation on its performance enhancement has been published to date. Moreover high computational complexity is still a significant problem for its realization. This paper proposes a maximum ratio combining multi-cyclic detector which uses multiple cyclic frequencies for performance enhancement with reduced computational complexity. An orthogonal frequency-division multiplexing (OFDM) signal based on the ISDB-T (integrated services digital broadcasting terrestrial), a Japanese digital television broadcasting standard, was used in the evaluation assuming this as a primary system in WRAN (wireless regional area network) applications like IEEE 802.22.

  7. Non-condensable gas effects in ROSA/AP600 small-break LOCA experiments

    SciTech Connect

    Nakamura, Hideo; Kukita, Yutaka; Shaw, R.A.; Schultz, R.R.

    1996-06-01

    Integral experiments simulating the postulated accidents in the Westinghouse AP600 reactor have been conducted using the ROSA-V Large Scale Test Facility (LSTF). These experiments allowed the N{sub 2} gas for the pressurization of accumulator tanks to enter the primary system after the depletion of the tank water inventory. The gas migrated into the Passive Residual Heat Removal (PRHR) system heat exchanger tubes and into the Core Makeup Tanks (CMTs), and influenced the performance of these components which are unique to the AP600 reactor. Specifically, the PRHR was disabled soon after the N{sub 2} gas discharge in most of the experiments, although the core decay power was removed well by the steam discharge through the Automatic Depressurization System (ADS) after the PRHR was disabled. The N{sub 2} gas ingress into the CMTs occurred in the experiments with relatively large breaks ({ge} 2 inch in equivalent diameter), and contributed to a smooth draindown of the CMT inventory into the primary system.

  8. Metabolic Profiling of Systemic Lupus Erythematosus and Comparison with Primary Sjögren’s Syndrome and Systemic Sclerosis

    PubMed Central

    Bengtsson, Anders A.; Trygg, Johan; Wuttge, Dirk M.; Sturfelt, Gunnar; Theander, Elke; Donten, Magdalena; Moritz, Thomas; Sennbro, Carl-Johan; Torell, Frida; Lood, Christian; Surowiec, Izabella; Rännar, Stefan; Lundstedt, Torbjörn

    2016-01-01

    Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease which can affect most organ systems including skin, joints and the kidney. Clinically, SLE is a heterogeneous disease and shares features of several other rheumatic diseases, in particular primary Sjögrens syndrome (pSS) and systemic sclerosis (SSc), why it is difficult to diagnose The pathogenesis of SLE is not completely understood, partly due to the heterogeneity of the disease. This study demonstrates that metabolomics can be used as a tool for improved diagnosis of SLE compared to other similar autoimmune diseases. We observed differences in metabolic profiles with a classification specificity above 67% in the comparison of SLE with pSS, SSc and a matched group of healthy individuals. Selected metabolites were also significantly different between studied diseases. Biochemical pathway analysis was conducted to gain understanding of underlying pathways involved in the SLE pathogenesis. We found an increased oxidative activity in SLE, supported by increased xanthine oxidase activity and an increased turnover in the urea cycle. The most discriminatory metabolite observed was tryptophan, with decreased levels in SLE patients compared to control groups. Changes of tryptophan levels were related to changes in the activity of the aromatic amino acid decarboxylase (AADC) and/or to activation of the kynurenine pathway. PMID:27441838

  9. HD 35502: a hierarchical triple system with a magnetic B5IVpe primary

    NASA Astrophysics Data System (ADS)

    Sikora, J.; Wade, G. A.; Bohlender, D. A.; Shultz, M.; Adelman, S. J.; Alecian, E.; Hanes, D.; Monin, D.; Neiner, C.; MiMeS Collaboration; BinaMIcS Collaboration

    2016-08-01

    We present our analysis of HD 35502 based on high- and medium-resolution spectropolarimetric observations. Our results indicate that the magnetic B5IVsnp star is the primary component of a spectroscopic triple system and that it has an effective temperature of 18.4 ± 0.6 kK, a mass of 5.7 ± 0.6 M⊙, and a polar radius of 3.0^{+1.1}_{-0.5} R_{⊙}. The two secondary components are found to be essentially identical A-type stars for which we derive effective temperatures (8.9 ± 0.3 kK), masses (2.1 ± 0.2 M⊙), and radii (2.1 ± 0.4 R⊙). We infer a hierarchical orbital configuration for the system in which the secondary components form a tight binary with an orbital period of 5.668 66(6) d that orbits the primary component with a period of over 40 yr. Least-Squares Deconvolution profiles reveal Zeeman signatures in Stokes V indicative of a longitudinal magnetic field produced by the B star ranging from approximately -4 to 0 kG with a median uncertainty of 0.4 kG. These measurements, along with the line variability produced by strong emission in Hα, are used to derive a rotational period of 0.853 807(3) d. We find that the measured v sin i = 75 ± 5 km s-1 of the B star then implies an inclination angle of the star's rotation axis to the line of sight of 24^{+6}_{-10}°. Assuming the Oblique Rotator Model, we derive the magnetic field strength of the B star's dipolar component (14^{+9}_{-3} kG) and its obliquity (63± 13°). Furthermore, we demonstrate that the calculated Alfvén radius (41^{+17}_{-6}R_ast) and Kepler radius (2.1^{+0.4}_{-0.7}R_ast) place HD 35502's central B star well within the regime of centrifugal magnetosphere-hosting stars.

  10. HD 35502: a hierarchical triple system with a magnetic B5IVpe primary

    NASA Astrophysics Data System (ADS)

    Sikora, J.; Wade, G. A.; Bohlender, D. A.; Shultz, M.; Adelman, S. J.; Alecian, E.; Hanes, D.; Monin, D.; Neiner, C.; MiMeS Collaboration; BinaMIcS Collaboration

    2016-08-01

    We present our analysis of HD 35502 based on high- and medium-resolution spectropolarimetric observations. Our results indicate that the magnetic B5IVsnp star is the primary component of a spectroscopic triple system and that it has an effective temperature of 18.4 ± 0.6 kK, a mass of 5.7 ± 0.6 M⊙, and a polar radius of 3.0^{+1.1}_{-0.5} R_{odot }. The two secondary components are found to be essentially identical A-type stars for which we derive effective temperatures (8.9 ± 0.3 kK), masses (2.1 ± 0.2 M⊙), and radii (2.1 ± 0.4 R⊙). We infer a hierarchical orbital configuration for the system in which the secondary components form a tight binary with an orbital period of 5.668 66(6) d that orbits the primary component with a period of over 40 yr. Least-Squares Deconvolution profiles reveal Zeeman signatures in Stokes V indicative of a longitudinal magnetic field produced by the B star ranging from approximately -4 to 0 kG with a median uncertainty of 0.4 kG. These measurements, along with the line variability produced by strong emission in Hα, are used to derive a rotational period of 0.853 807(3) d. We find that the measured v sin i = 75 ± 5 km s-1 of the B star then implies an inclination angle of the star's rotation axis to the line of sight of 24^{+6}_{-10}{}^circ. Assuming the Oblique Rotator Model, we derive the magnetic field strength of the B star's dipolar component (14^{+9}_{-3} kG) and its obliquity (63± 13deg). Furthermore, we demonstrate that the calculated Alfvén radius (41^{+17}_{-6}R_ast) and Kepler radius (2.1^{+0.4}_{-0.7}R_ast) place HD 35502's central B star well within the regime of centrifugal magnetosphere-hosting stars.

  11. Sleep misperception, EEG characteristics and autonomic nervous system activity in primary insomnia: a retrospective study on polysomnographic data.

    PubMed

    Maes, J; Verbraecken, J; Willemen, M; De Volder, I; van Gastel, A; Michiels, N; Verbeek, I; Vandekerckhove, M; Wuyts, J; Haex, B; Willemen, T; Exadaktylos, V; Bulckaert, A; Cluydts, R

    2014-03-01

    Misperception of Sleep Onset Latency, often found in Primary Insomnia, has been cited to be influenced by hyperarousal, reflected in EEG- and ECG-related indices. The aim of this retrospective study was to examine the association between Central Nervous System (i.e. EEG) and Autonomic Nervous System activity in the Sleep Onset Period and the first NREM sleep cycle in Primary Insomnia (n=17) and healthy controls (n=11). Furthermore, the study examined the influence of elevated EEG and Autonomic Nervous System activity on Stage2 sleep-protective mechanisms (K-complexes and sleep spindles). Confirming previous findings, the Primary Insomnia-group overestimated Sleep Onset Latency and this overestimation was correlated with elevated EEG activity. A higher amount of beta EEG activity during the Sleep Onset Period was correlated with the appearance of K-complexes immediately followed by a sleep spindle in the Primary Insomnia-group. This can be interpreted as an extra attempt to protect sleep continuity or as a failure of the sleep-protective role of the K-complex by fast EEG frequencies following within one second. The strong association found between K-alpha (K-complex within one second followed by 8-12 Hz EEG activity) in Stage2 sleep and a lower parasympathetic Autonomic Nervous System dominance (less high frequency HR) in Slow-wave sleep, further assumes a state of hyperarousal continuing through sleep in Primary Insomnia. PMID:24177246

  12. Intraoperative 5-aminolevulinic acid-induced fluorescence in primary central nervous system lymphoma.

    PubMed

    Grossman, Rachel; Nossek, Erez; Shimony, Nir; Raz, Michal; Ram, Zvi

    2014-01-01

    The authors report a case of primary CNS lymphoma located in the floor of the fourth ventricle that showed intense fluorescence after preoperative administration of 5-aminolevulinic acid. The authors believe that this is the first demonstration of a 5-aminolevulinic acid-induced fluorescence pattern in primary CNS lymphoma. PMID:24138204

  13. Meckel-Gruber syndrome and the role of primary cilia in kidney, skeleton, and central nervous system development

    PubMed Central

    Barker, Amy R; Thomas, Rhys; Dawe, Helen R

    2014-01-01

    The ciliopathies are a group of related inherited diseases characterized by malformations in organ development. The diseases affect multiple organ systems, with kidney, skeleton, and brain malformations frequently observed. Research over the last decade has revealed that these diseases are due to defects in primary cilia, essential sensory organelles found on most cells in the human body. Here we discuss the genetic and cell biological basis of one of the most severe ciliopathies, Meckel-Gruber syndrome, and explain how primary cilia contribute to the development of the affected organ systems. PMID:24322779

  14. 18F-FDG PET in the Diagnosis and Treatment of Primary Central Nervous System Lymphoma

    PubMed Central

    Yamamoto, Yuka; Nishiyama, Yoshihiro; Tamiya, Takashi

    2013-01-01

    This paper summarizes the usefulness and limitation of positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) in the diagnosis and treatment of primary central nervous system lymphoma (PCNSL). The 18F-FDG uptake in typical PCNSL is about 2.5 times higher than that in the normal gray matter, and the tumor can usually be identified visually. The 18F-FDG uptake pattern and value provide useful information for differentiating PCNSL from other enhancing malignant brain tumors especially glioblastoma (GB). The 18F-FDG uptake in typical PCNSL is usually homogenous, and the uptake value is significantly higher than that in GB. However, 18F-FDG PET often fails to show the presence of tumor in the brain as 18F-FDG uptake is faint in atypical PCNSL such as disseminated or nonenhancing lesions. 18F-FDG PET is also useful for evaluating the treatment response at a very early stage after the initial treatment. Pretreatment and posttreatment 18F-FDG uptake values may have a prognostic value in patients with PCNSL. In conclusion, 18F-FDG PET is very useful in the diagnosis of typical PCNSL and can differentiate PCNSL from other malignant brain tumors. However, the usefulness of 18F-FDG PET is limited in the diagnosis of atypical PCNSL. PMID:23844359

  15. Radiation therapy for primary carcinoma of the extrahepatic biliary system. An analysis of 63 cases

    SciTech Connect

    Flickinger, J.C.; Epstein, A.H.; Iwatsuki, S.; Carr, B.I.; Starzl, T.E. )

    1991-07-15

    From 1976 to 1988, 63 patients received radiation therapy for primary cancers of the extrahepatic biliary system (eight gallbladder and 55 extrahepatic biliary duct). Twelve patients underwent orthotopic liver transplantation. Chemotherapy was administered to 13 patients. Three patients underwent intraluminal brachytherapy alone (range, 28 to 55 Gy). Sixty patients received megavoltage external-beam radiation therapy (range, 5.4 to 61.6 Gy; median, 45 Gy), of whom nine received additional intraluminal brachytherapy (range, 14 to 45 Gy; median, 30 Gy). The median survival of all patients was 7 months. Sixty patients died, all within 39 months of radiation therapy. One patient is alive 11 months after irradiation without surgical resection, and two are alive 50 months after liver transplantation and irradiation. Symptomatic duodenal ulcers developed after radiation therapy in seven patients but were not significantly related to any clinical variable tested. Extrahepatic biliary duct cancers, the absence of metastases, increasing calendar year of treatment, and liver transplantation with postoperative radiation therapy were factors significantly associated with improved survival.

  16. Hyperosmolar and methotrexate therapy avoiding surgery in the acute presentation of primary central nervous system lymphoma

    PubMed Central

    Lee, Bryan S.; Juthani, Rupa G.; Healy, Andrew T.; Peereboom, David M.; Recinos, Violette M.

    2014-01-01

    Background: Primary central nervous system lymphoma (PCNSL) is an aggressive type of extra-nodal non-Hodgkin lymphoma. Without treatment, PCNSL is associated with significant morbidity and mortality, including rapid neurological deterioration. In contrast to other high-grade intracranial neoplasms, PCNSL is considered to have a high response rate to conventional medical therapy, especially in younger patients, and therefore warrants particular attention in terms of nonsurgical treatment. Case Description: We report a case of the medical management of acute deterioration due to rapidly growing PCNSL with mass effect to highlight the efficacy of temporization with hyperosmolar therapy while awaiting the known rapid effects of dexamethasone and methotrexate (MTX) treatment. Surgical intervention was avoided, and tumor response was rapid. The patient had corresponding clinical resolution of symptoms of elevated intracranial pressure with return to neurologic baseline. Conclusions: Despite the evidence that PCNSL responds well to steroids and MTX, the rapidity of onset with which this occurs can vary. In patients presenting with mass effect and rapid neurologic decline, there is little evidence to support medical over surgical intervention. Herein we present an illustrative case of a large PCNSL lesion presenting with rapid decline. With clinical improvement in one day and a 50% reduction in tumor volume over less than seven days, the authors present the specific time frame with which PCNSL responds to medical therapy and a safe strategy for medical temporization. PMID:25184099

  17. Primary Biliary Cirrhosis Associated with Systemic Sclerosis: Diagnostic and Clinical Challenges

    PubMed Central

    Rigamonti, Cristina; Bogdanos, Dimitrios P.; Mytilinaiou, Maria G.; Smyk, Daniel S.; Rigopoulou, Eirini I.; Burroughs, Andrew K.

    2011-01-01

    Patients with primary biliary cirrhosis (PBC) often have concurrent limited systemic sclerosis (SSc). Conversely, up to one-fourth of SSc patients are positive for PBC-specific antimitochondrial antibodies (AMA). The mechanisms responsible for the co-occurrence of these diseases are largely unknown. Genetic, epigenetic, environmental, and infectious factors appear to be important for the pathogenesis of the disease, but the hierarchy of events are not well defined. Patients with SSc and PBC have an increased morbidity and mortality compared with the general population, but whether the presence of both diseases in an affected individual worsens the prognosis and/or outcome of either disease is not clear. Some case reports suggested that the presence of SSc in PBC patents is associated with a more favorable prognosis of the liver disease, whereas others report an increased mortality in patients with PBC and SSc compared to patients with PBC alone. This paper discusses the features of patients with PBC-associated SSc. Our aims are to clarify some of the pathogenetic, diagnostic, and clinical challenges that are currently faced in the routine management of these patients. We also intend to provide some practical hints for practitioners that will assist in the early identification of patients with PBC-associated SSc. PMID:22187566

  18. mTORC1 signaling in primary central nervous system lymphoma

    PubMed Central

    Nitta, Naoki; Nakasu, Satoshi; Shima, Ayako; Nozaki, Kazuhiko

    2016-01-01

    Background: Mammalian target of rapamycin (mTOR) complex 1 (mTORC1) acts as a downstream effector of phosphatidyl-inositol-3 kinase, which is frequently hyperactivated in glioblastoma multiforme and links to cell signaling in cellular proliferation, differentiation, metabolism, and survival. Although many studies have suggested the importance of mTORC1 in tumorigenesis, its role remains unclear in brain tumors other than glioblastoma. Methods: In the present study, we evaluated the activation of mTORC1 in 24 cases of primary central nervous system lymphoma (PCNSL). Results: Immunohistochemical analysis showed overexpression of Rheb, which is immediately upstream of mTORC1, in 20 cases of PCNSL. Immunohistochemical analysis also showed overexpression of phospho-4E-BP1 (Thr37/46) and phospho-S6 (Ser235/236), which are increased after mTORC1 activation as mTORC1 downstream effectors in 17 and 21 cases, respectively. Conclusion: Our data suggest that abnormal activation of the mTORC1 signaling pathway may cause tumor growth in patients with PCNSL. PMID:27512609

  19. A case of primary central nervous system vasculitis diagnosed by second brain biopsy and treated successfully.

    PubMed

    Mizuno, Yuri; Shigeto, Hiroshi; Yamada, Takeshi; Maeda, Norihisa; Suzuki, Satoshi O; Kira, Jun-Ichi

    2016-03-30

    We report a case of primary central nervous system vasculitis (PCNSV) diagnosed by second brain biopsy. A 53-year-old man initially presented with left lateral gaze diplopia. Brain MRI revealed multiple enhanced lesions in the bilateral frontal lobe, bilateral basal ganglia, left cerebellum and brainstem. An initial brain biopsy of the right frontal lobe suggested immune-related encephalitis with angiocentric accumulation of chronic inflammatory cells, while malignant lymphoma could not be completely ruled out. The patient deteriorated despite being treated with repeated methylprednisolone pulse therapy, cyclophosphamide, and plasmapheresis. A second brain biopsy of the right temporal lobe was then performed. The biopsied specimens showed vascular wall disruption and fibrinoid necrosis with perivascular inflammatory infiltrates, mainly composed of CD8-positive T cells, and PCNSV was diagnosed. He was treated with high dose corticosteroids, in combination with methotrexate (8 mg/week), which reduced the brain lesions. As brain biopsy is an essential investigation for the histological diagnosis of PCNSV; subsequent biopsies may be required when a histopathological diagnosis has not been obtained by the first biopsy, and further aggressive therapy is being considered. PMID:26960271

  20. Review of Failure Probability Calculations for HFIR Primary Coolant System Piping

    SciTech Connect

    Simonen, Fredric A.

    2001-10-31

    During July 2001, Pacific Northwest National Laboratory was requested by the U.S. Department of Energy, Office of Nuclear Facilities Management, Office of Nuclear Energy, Science and Technology, Germantown, Maryland, to review calculations of piping failure probabilities for the High Flux Test Reactor (HFIR) located at and operated by the Oak Ridge National Laboratory (ORNL). The objective of the failure probability calculations was to estimate the probabilities of large leaks (>1500 gpm) that are of sufficient size to disable the primary coolant system of HFIR to the extent that there is a potential for core damage. PNNL reviewed the computational methods and the inputs to the calculations along with an evaluation of potential failure mechanisms not explicitly addressed by the ORNL calculations. The review concluded that the calculated failure probabilities even with consideration of uncertainties in the calculations and of other potential failure mechanisms provide a high level of confidence that failure frequencies are less than the stated goal of 10-6 piping failures per year.

  1. Navigated revision knee arthroplasty using a system designed for primary surgery.

    PubMed

    Massin, Philippe; Boyer, Patrick; Pernin, Jerome; Jeanrot, Cecile

    2008-07-01

    While navigation is now recognized as an efficient tool for improving femoro-tibial alignment of primary knee prostheses, its use in revision surgery has not yet been fully evaluated. We describe a procedure based on a bone morphing acquisition performed on the surface of the original implants, followed by a dependant bone cut sequence (tibia first). Using the current system, a preoperative CT-scan measurement of the original femoral component was required. Knee balancing was achieved using spacer blocks, with the trial tibial component and the original femoral component still in place. Preliminary experience from 19 cases, some with severe bone loss requiring reconstruction, is reported. A retrospective comparison to 10 non-navigated revision cases performed concomitantly by the same operating surgeon was carried out. Although there was no significant difference in the number of outliers for the two series, navigation appeared to be a valuable aid in reconstructing both bone extremities, while controlling the level of the joint line. However, definitive validation requires further prospective and comparative investigations in larger series. PMID:18622792

  2. Neuroarthropathy of the foot revealing primary systemic amyloidosis: case report and literature review.

    PubMed

    Andrei, Irina Adriana; Kuntzer, Thierry; Lobrinus, Johannes Alexander; Jaccard, Arnaud; Zufferey, Pascal

    2016-02-01

    The aims of this review were to describe the case of a patient with debilitating neuroarthropathy of the ankles and feet and reveal a primary systemic (amyloid light chain, AL) amyloidosis and to review the relevant literature concerning the peripheral neuropathy and neuroarthropathy due to amyloidosis. We will emphasize the diagnostic pitfalls and discuss prognosis and treatments of both the peripheral neuropathy and the arthropathy related to AL amyloidosis. This is a descriptive case report of a patient with neuroarthropathy of the lower limbs due to AL amyloidosis. A review and discussion of relevant literature were conducted, based on a PubMed search from 1973 to December 2013. A 51-year-old female was diagnosed with AL amyloidosis after 20 months of investigation of small painful deformities of the feet. Chronic peripheral neuropathy occurs as a manifestation of AL amyloidosis in 25 % of cases. It may exceptionally be complicated by neuroarthropathy. In this case, the paucity of clinical and electrophysiological signs of the neuropathy delayed the diagnosis, leading to a severe arthropathy. The massive destruction of the joints dominated the clinical and the poor functional outcome. Diagnosis of AL amyloidosis should be considered in the presence of a mild peripheral neuropathy and a distal destructive and painless arthropathy. The two key diagnostic procedures are serum protein electrophoresis and nerve biopsy. Delay in treatment worsens the prognosis. PMID:25227773

  3. Neuro-glial and systemic mechanisms of pathological responses in rat models of primary blast overpressure compared to "composite" blast.

    PubMed

    Svetlov, Stanislav I; Prima, Victor; Glushakova, Olena; Svetlov, Artem; Kirk, Daniel R; Gutierrez, Hector; Serebruany, Victor L; Curley, Kenneth C; Wang, Kevin K W; Hayes, Ronald L

    2012-01-01

    A number of experimental models of blast brain injury have been implemented in rodents and larger animals. However, the variety of blast sources and the complexity of blast wave biophysics have made data on injury mechanisms and biomarkers difficult to analyze and compare. Recently, we showed the importance of rat position toward blast generated by an external shock tube. In this study, we further characterized blast producing moderate traumatic brain injury and defined "composite" blast and primary blast exposure set-ups. Schlieren optics visualized interaction between the head and a shock wave generated by external shock tube, revealing strong head acceleration upon positioning the rat on-axis with the shock tube (composite blast), but negligible skull movement upon peak overpressure exposure off-axis (primary blast). Brain injury signatures of a primary blast hitting the frontal head were assessed and compared to damage produced by composite blast. Low to negligible levels of neurodegeneration were found following primary blast compared to composite blast by silver staining. However, persistent gliosis in hippocampus and accumulation of GFAP/CNPase in circulation was detected after both primary and composite blast. Also, markers of vascular/endothelial inflammation integrin alpha/beta, soluble intercellular adhesion molecule-1, and L-selectin along with neurotrophic factor nerve growth factor-beta were increased in serum within 6 h post-blasts and persisted for 7 days thereafter. In contrast, systemic IL-1, IL-10, fractalkine, neuroendocrine peptide Orexin A, and VEGF receptor Neuropilin-2 (NRP-2) were raised predominantly after primary blast exposure. In conclusion, biomarkers of major pathological pathways were elevated at all blast set-ups. The most significant and persistent changes in neuro-glial markers were found after composite blast, while primary blast instigated prominent systemic cytokine/chemokine, Orexin A, and Neuropilin-2 release

  4. [Case of primary central nervous system lymphoma after open head injury].

    PubMed

    Honma, Mari; Ota, Mamoru; Sato, Naoki; Ogawa, Kazuei; Sugino, Takashi; Yamamoto, Teiji

    2012-01-01

    A 65-year-old man had suffered contusion of the left frontal lobe of the brain with a skull base fracture, pneumocephalus, and cerebrospinal fluid (CSF) leakage. He was treated with ceftriaxone 4 g/day for 14 days, but after 1 month he developed multiple cranial nerve palsies (bilateral III-X). CSF contained increased levels of protein (96 mg/dl) and mononuclear cells (72 cells/mm³), and low glucose levels (40 mg/dl, blood sugar 120 mg/dl), but no malignant cells were detected. Magnetic resonance imaging (MRI) disclosed swelling in multiple cranial nerves with Gd enhancement. Anti-biotic and antifungal therapy remitted the facial, glossopharyngeal, and vagus nerve palsies and reduced the Gd-enhancement lesion, as detected by MRI. However, the eyes were bilaterally dilated and medially fixed, and hearing impairments persisted. After 3 months, follow-up MRIs revealed the presence of Gd-enhanced small masses at the ventral pontine base, medulla, and cervicomedullary junctions despite a lack of change in neurological symptoms. Those lesions subsided favorably upon treatment with intravenous and oral corticosteroids. After 1 year and 9 months, Gd-enhanced small cystic masses appeared on the medulla and cerebellum. An open biopsy of the cerebellar tonsillar lesions revealed diffuse large B cell lymphoma. Although the development of primary central nervous system lymphoma after open head injury and infection has not been reported to date, central nervous system lymphomas may mimic diverse neurological diseases. Brain biopsy remains the only definitive diagnosis, and thus should be pursued if blood and CSF markers appear normal. PMID:22688112

  5. Subthalamic Nucleus Stimulation Increases Brain Derived Neurotrophic Factor in the Nigrostriatal System and Primary Motor Cortex

    PubMed Central

    Spieles-Engemann, Anne L.; Steece-Collier, Kathy; Behbehani, Michael M.; Collier, Timothy J.; Wohlgenant, Susan L.; Kemp, Christopher J.; Cole-Strauss, Allyson; Levine, Nathan D.; Gombash, Sara E.; Thompson, Valerie B.; Lipton, Jack W.; Sortwell, Caryl E.

    2011-01-01

    The mechanisms underlying the effects of long-term deep brain stimulation of the subthalamic nucleus (STN DBS) as a therapy for Parkinson’s disease (PD) remain poorly understood. The present study examined whether functionally effective, long-term STN DBS modulates glial cell line-derived neurotrophic factor (GDNF) and/or brain-derived neurotrophic factor (BDNF) in both unlesioned and unilateral 6-hydroxydopamine lesioned rats. Lesioned rats that received two weeks of continuous unilateral STN DBS exhibited significant improvements in parkinsonian motor behaviors in tests of forelimb akinesia and rearing activity. Unilateral STN DBS did not increase GDNF in the nigrostriatal system, primary motor cortex (M1), or hippocampus of unlesioned rats. In contrast, unilateral STN DBS increased BDNF protein 2–3 fold bilaterally in the nigrostriatal system with the location (substantia nigra vs. striatum) dependent upon lesion status. Further, BDNF protein was bilaterally increased in M1 cortex by as much as 2 fold regardless of lesion status. STN DBS did not impact cortical regions that receive less input from the STN. STN DBS also was associated with bilateral increases in BDNF mRNA in the substantia nigra (SN) and internal globus pallidus (GPi). The increase observed in GPi was completely blocked by pretreatment with 5-Methyl-10,11-dihydro-5 H-dibenzo[a,d]cyclohepten-5,10-imine (MK-801), suggesting that the activation of N-methyl-D-aspartate (NMDA) receptors was involved in this phenomenon. The upregulation of BDNF associated with long term STN DBS suggest that this therapy may exert pronounced and underappreciated effects on plasticity in the basal ganglia circuitry that may play a role in the symptomatic effects of this therapy as well as support the neuroprotective effect of stimulation documented in this rat model. PMID:22328911

  6. Treating asthma by the guidelines: developing a medication management information system for use in primary care.

    PubMed

    Twiggs, Joan E; Fifield, J; Jackson, E; Cushman, R; Apter, A

    2004-01-01

    The aim of this study was to develop, implement, and assess an automated asthma medication management information system (MMIS) that provides patient-specific evaluative guidance based on 1997 NAEPP clinical consensus guidelines. MMIS was developed and implemented in primary care settings within a pediatric asthma disease management program. MMIS infrastructure featured a centralized database with Internet access. MMIS collects detailed patient asthma medication data, evaluates pharmacotherapy relative to practitioner-reported disease severity, symptom control and model of guideline-recommended severity-appropriate medications and produces a patient-specific "curbside consult" feedback report. A system algorithm translates actual detailed medication data into actual severity-specific medication-class combinations. A table-driven computer program compares actual medication-class combinations to a guideline-based medication-class combinations model. Methodology determines whether the patient was prescribed a "severity-appropriate" amount or an amount "more" or "less" medication than indicated for patient's reported severity. Feedback messages comment on comparison. Missing data, unrecognized amounts of controller medication or unrecognized medication combinations create error cases. Post hoc review analyzed error cases to determine prevalence of non-guideline medicating practices among these practitioners. Proportion of valid and error cases across two clinical visits before and after post hoc clinical review were measured, as well as proportion of severity-appropriate, out-of-severity and non-guideline medications. MMIS produced a valid feedback report for 83% of patient visits. Missing data accounted for 60% of error cases. Practitioners used severity-appropriate medications for 60% of cases. When non-severity-appropriate medications were used they tended to be "too much" rather than "too little" (22%, 5%), suggesting appropriate use of guideline-recommended "step

  7. Peripheral Neuropathy in Primary HIV Infection Associates with Systemic and CNS Immune Activation

    PubMed Central

    Wang, Samantha XY; Ho, Emily L.; Grill, Marie; Lee, Evelyn; Peterson, Julia; Robertson, Kevin; Fuchs, Dietmar; Sinclair, Elizabeth; Price, Richard W.; Spudich, Serena

    2014-01-01

    Background Peripheral neuropathy (PN) is a frequent complication of chronic HIV infection. We prospectively studied individuals with primary HIV infection (PHI, <1 year after transmission) to assess the presence of and laboratory associations with PN in this early stage. Methods Standardized examination and analysis of blood and cerebrospinal fluid (CSF) was performed in participants with laboratory-confirmed PHI. PN was defined as ≥1 of the following unilateral or bilateral signs: decreased distal limb position, vibration, or temperature sense, or hyporeflexia; symptomatic PN (SPN) as presence of these signs with symptoms. Analysis employed nonparametric statistics. Results 20/58 (35%) antiretroviral-naïve male subjects without diabetes evaluated at a median 107 days post HIV transmission (dpt) met criteria for PN. 13/20 (65%) of PN subjects met criteria for SPN; 6/20 (30%) had bilateral findings. PN subjects and no PN subjects (NPN) did not differ in median age, dpt, blood CD4 or CD8 counts, CSF or plasma HIV RNA levels, CSF white blood cell counts, or CSF:blood albumin ratio. PN and SPN subjects had elevated CSF neopterin (p=0.003 and p=0.0005), CSF MCP-1 (p=0.006 and p=0.01) and blood neopterin (p=0.006 and p=0.009) compared to NPN. PN subjects had a higher percentage of activated phenotype CSF CD8+ T lymphocytes than NPN subjects (p=0.009). Conclusions Signs of PN were detected by detailed neurologic exam in 35% of men enrolled in a neurological study at a median 3.5 months after HIV transmission. PN during this early period may be mediated by systemic and nervous system immune responses to HIV. PMID:24732871

  8. Cell Communication in a Coculture System Consisting of Outgrowth Endothelial Cells and Primary Osteoblasts

    PubMed Central

    Herzog, David Paul Eric; Dohle, Eva; Bischoff, Iris; Kirkpatrick, Charles James

    2014-01-01

    Bone tissue is a highly vascularized and dynamic system with a complex construction. In order to develop a construct for implant purposes in bone tissue engineering, a proper understanding of the complex dependencies between different cells and cell types would provide further insight into the highly regulated processes during bone repair, namely, angiogenesis and osteogenesis, and might result in sufficiently equipped constructs to be beneficial to patients and thereby accomplish their task. This study is based on an in vitro coculture model consisting of outgrowth endothelial cells and primary osteoblasts and is currently being used in different studies of bone repair processes with special regard to angiogenesis and osteogenesis. Coculture systems of OECs and pOBs positively influence the angiogenic potential of endothelial cells by inducing the formation of angiogenic structures in long-term cultures. Although many studies have focused on cell communication, there are still numerous aspects which remain poorly understood. Therefore, the aim of this study is to investigate certain growth factors and cell communication molecules that are important during bone repair processes. Selected growth factors like VEGF, angiopoietins, BMPs, and IGFs were investigated during angiogenesis and osteogenesis and their expression in the cultures was observed and compared after one and four weeks of cultivation. In addition, to gain a better understanding on the origin of different growth factors, both direct and indirect coculture strategies were employed. Another important focus of this study was to investigate the role of “gap junctions,” small protein pores which connect adjacent cells. With these bridges cells are able to exchange signal molecules, growth factors, and other important mediators. It could be shown that connexins, the gap junction proteins, were located around cell nuclei, where they await their transport to the cell membrane. In addition, areas in which

  9. A clinicopathological study of primary central nervous system lymphomas & their association with Epstein-Barr virus

    PubMed Central

    Sharma, Mehar Chand; Gupta, Rakesh Kumar; Kaushal, Seema; Suri, Vaishali; Sarkar, Chitra; Singh, Manmohan; Kale, S.S.; Sahoo, Ranjit K.; Kumar, Lalit; Raina, Vinod

    2016-01-01

    Background & objectives: Primary central nervous system lymphomas (PCNSLs) are relatively uncommon, accounting for 2-3 per cent of primary brain tumours. Majority of these are diffuse large B cell lymphomas (DLBCL) occurring both in immunocompromised and immunocompetent patients. We undertook this study to classify PCNSL into germinal centre (GC) and non-germinal centre (NGC) type based on Hans classification and to find the role of Epstein-Barr virus (EBV) in pathogenesis both by conventional immunohistochemistry (IHC) and chromogenic in situ hybridization (CISH). Methods: The consecutive cases of PCNSL during a 10 years period were analysed by IHC for CD45, CD20, CD3, B-cell lymphoma 2 and 6 (Bcl-2 and Bcl-6), B-cell specific octamer binding protein-1 (BOB-1), multiple myeloma oncogene-1 (MUM-1), EBV latent-membrane protein 1 (LMP-1), cyclin-D1, CD10, CD5 and CD23, as well as by CISH for EBV. Results: During a period of 10 years, 65 PCNSL were diagnosed which comprised 0.69 per cent (65/9476) of all intracranial tumours. The mean age of presentation was 49 yr with sex ratio (M:F) of 1.4:1. Most common location was supratentorial region with predominant involvement of frontal lobe. Single lesions were seen in 38 (58.4%) and multifocal lesions in 27 (41.5%) patients. None of the patients were immunocompromised. All cases were B cell immunophenotype and were DLBCL except one case of follicular lymphoma. According to Hans classification, majority of them were NGC (n=51, 79.6%) and 13 (20.3%) were GC type. Bcl-2 expression was noted in 34 (52.3%) tumours. EBV was positive in three (4.6%) cases; two were detected both by IHC and CISH and one case by CISH only. Interpretation & conclusions: In Indian population, PCNSL occurs mainly in immunocompetent patients, and a decade earlier than in western population. Immunophenotyping revealed that all cases were DLBCL with predominance of NGC type. No prognostic difference was seen between GC and NGC DLBCL. Association of EBV

  10. Reducing diagnostic errors in primary care. A systematic meta-review of computerized diagnostic decision support systems by the LINNEAUS collaboration on patient safety in primary care

    PubMed Central

    Nurek, Martine; Kostopoulou, Olga; Delaney, Brendan C; Esmail, Aneez

    2015-01-01

    ABSTRACT Background: Computerized diagnostic decision support systems (CDDSS) have the potential to support the cognitive task of diagnosis, which is one of the areas where general practitioners have greatest difficulty and which accounts for a significant proportion of adverse events recorded in the primary care setting. Objective: To determine the extent to which CDDSS may meet the requirements of supporting the cognitive task of diagnosis, and the currently perceived barriers that prevent the integration of CDDSS with electronic health record (EHR) systems. Methods: We conducted a meta-review of existing systematic reviews published in English, searching MEDLINE, Embase, PsycINFO and Web of Knowledge for articles on the features and effectiveness of CDDSS for medical diagnosis published since 2004. Eligibility criteria included systematic reviews where individual clinicians were primary end users. Outcomes we were interested in were the effectiveness and identification of specific features of CDDSS on diagnostic performance. Results: We identified 1970 studies and excluded 1938 because they did not fit our inclusion criteria. A total of 45 articles were identified and 12 were found suitable for meta-review. Extraction of high-level requirements identified that a more standardized computable approach is needed to knowledge representation, one that can be readily updated as new knowledge is gained. In addition, a deep integration with the EHR is needed in order to trigger at appropriate points in cognitive workflow. Conclusion: Developing a CDDSS that is able to utilize dynamic vocabulary tools to quickly capture and code relevant diagnostic findings, and coupling these with individualized diagnostic suggestions based on the best-available evidence has the potential to improve diagnostic accuracy, but requires evaluation. PMID:26339829

  11. Design and Testing of the Primary and Secondary Oxygen Regulators for the Flexible Portable Life Support System (FlexPLSS)

    NASA Technical Reports Server (NTRS)

    Campbell, Colin; Hepworth, Mark

    2010-01-01

    The next generation space suit requires additional capabilities for controlling and adjusting internal pressure compared to that of historical designs. Although the general configuration of the oxygen systems for the next generation space suit is similar or derived from the Apollo and Shuttle Extravehicular Mobility Unit (EMU) with Primary closed loop life support operation and Secondary sourced open loop life support operations, nearly everything else has evolved with new available technologies. For the case of the primary and secondary regulators, the design has gone away from purely mechanical systems actuated with pull-cords or "bicycle cables" to electro-mechanical hybrids that provide the best of both worlds with respect to power draw, reliability, and versatility. This paper discusses the development and testing of a Secondary Oxygen Regulator bench-top prototype along with comparisons of operation with the various prototypes for the Primary Oxygen Regulator.

  12. Quantifying Human Appropriated Net Primary Productivity (HANPP) in a Ghanaian Cocoa System

    NASA Astrophysics Data System (ADS)

    Morel, A.; Adu-Bredu, S.; Adu Sasu, M.; Ashley Asare, R.; Boyd, E.; Hirons, M. A.; Malhi, Y.; Mason, J.; Norris, K.; Robinson, E. J. Z.; McDermott, C. L.

    2015-12-01

    Ghana is the second largest producer of cocoa (Theobroma cacoa), exporting approximately 18 percent of global volumes. These cocoa farms are predominantly small-scale, ranging in size from 2-4 hectares (ha). Traditionally, the model of cocoa expansion in Ghana relied on clearing new areas of forest and establishing a farm under remnant forest trees. This is increasingly less practical due to few unprotected forest areas remaining and management practices favoring close to full sun cocoa to maximize short-term yields. This study is part of a larger project, ECOLMITS, which is an interdisciplinary, ESPA-funded[1] initiative exploring the ecological limits of ecosystem system services (ESS) for alleviating poverty in small-scale agroforestry systems. The ecological study plots are situated within and around the Kakum National Forest, a well-protected, moist-evergreen forest of the Lower Guinea Forest region. Net primary productivity (NPP) is a measure of the rate at which carbon dioxide (CO2) is incorporated into plant tissues (e.g. canopy, stem and root). For this study, NPP was monitored in situ using methods developed by the Global Environmental Monitoring Network (GEM, http://gem.tropicalforests.ox.ac.uk/). By comparing NPP measured in intact forest and farms, the human appropriated NPP (HANPP) of this system can be estimated. The forest measures provide the "potential" NPP of the region, and then the reduction in NPP for farm plots is calculated for both land-cover change (HANPPLUC) and cocoa harvesting (HANPPHARV). The results presented are of the first year of NPP measurements across the cocoa landscape, including measurements from intact forest, logged forest and cocoa farms across a shade gradient and located at varying distances from the forest edge (e.g. 100 m, 500 m, 1 km and 5 km). These measures will have implications for carbon sequestration potential over the region and long-term sustainability of the Ghanaian cocoa sector. [1] Ecosystem Services for

  13. A primary neuron culture system for the study of herpes simplex virus latency and reactivation.

    PubMed

    Kobayashi, Mariko; Kim, Ju-Youn; Camarena, Vladimir; Roehm, Pamela C; Chao, Moses V; Wilson, Angus C; Mohr, Ian

    2012-01-01

    Herpes simplex virus type-1 (HSV-1) establishes a life-long latent infection in peripheral neurons. This latent reservoir is the source of recurrent reactivation events that ensure transmission and contribute to clinical disease. Current antivirals do not impact the latent reservoir and there are no vaccines. While the molecular details of lytic replication are well-characterized, mechanisms controlling latency in neurons remain elusive. Our present understanding of latency is derived from in vivo studies using small animal models, which have been indispensable for defining viral gene requirements and the role of immune responses. However, it is impossible to distinguish specific effects on the virus-neuron relationship from more general consequences of infection mediated by immune or non-neuronal support cells in live animals. In addition, animal experimentation is costly, time-consuming, and limited in terms of available options for manipulating host processes. To overcome these limitations, a neuron-only system is desperately needed that reproduces the in vivo characteristics of latency and reactivation but offers the benefits of tissue culture in terms of homogeneity and accessibility. Here we present an in vitro model utilizing cultured primary sympathetic neurons from rat superior cervical ganglia (SCG) (Figure 1) to study HSV-1 latency and reactivation that fits most if not all of the desired criteria. After eliminating non-neuronal cells, near-homogeneous TrkA(+) neuron cultures are infected with HSV-1 in the presence of acyclovir (ACV) to suppress lytic replication. Following ACV removal, non-productive HSV-1 infections that faithfully exhibit accepted hallmarks of latency are efficiently established. Notably, lytic mRNAs, proteins, and infectious virus become undetectable, even in the absence of selection, but latency-associated transcript (LAT) expression persists in neuronal nuclei. Viral genomes are maintained at an average copy number of 25 per neuron

  14. A Primary Neuron Culture System for the Study of Herpes Simplex Virus Latency and Reactivation

    PubMed Central

    Kobayashi, Mariko; Kim, Ju-Youn; Camarena, Vladimir; Roehm, Pamela C.; Chao, Moses V.; Wilson, Angus C.; Mohr, Ian

    2012-01-01

    Herpes simplex virus type-1 (HSV-1) establishes a life-long latent infection in peripheral neurons. This latent reservoir is the source of recurrent reactivation events that ensure transmission and contribute to clinical disease. Current antivirals do not impact the latent reservoir and there are no vaccines. While the molecular details of lytic replication are well-characterized, mechanisms controlling latency in neurons remain elusive. Our present understanding of latency is derived from in vivo studies using small animal models, which have been indispensable for defining viral gene requirements and the role of immune responses. However, it is impossible to distinguish specific effects on the virus-neuron relationship from more general consequences of infection mediated by immune or non-neuronal support cells in live animals. In addition, animal experimentation is costly, time-consuming, and limited in terms of available options for manipulating host processes. To overcome these limitations, a neuron-only system is desperately needed that reproduces the in vivo characteristics of latency and reactivation but offers the benefits of tissue culture in terms of homogeneity and accessibility. Here we present an in vitro model utilizing cultured primary sympathetic neurons from rat superior cervical ganglia (SCG) (Figure 1) to study HSV-1 latency and reactivation that fits most if not all of the desired criteria. After eliminating non-neuronal cells, near-homogeneous TrkA+ neuron cultures are infected with HSV-1 in the presence of acyclovir (ACV) to suppress lytic replication. Following ACV removal, non-productive HSV-1 infections that faithfully exhibit accepted hallmarks of latency are efficiently established. Notably, lytic mRNAs, proteins, and infectious virus become undetectable, even in the absence of selection, but latency-associated transcript (LAT) expression persists in neuronal nuclei. Viral genomes are maintained at an average copy number of 25 per neuron

  15. Role of primary substrate composition and concentration on attenuation of trace organic chemicals in managed aquifer recharge systems.

    PubMed

    Alidina, Mazahirali; Li, Dong; Ouf, Mohamed; Drewes, Jörg E

    2014-11-01

    This study was undertaken to investigate the role of primary substrate composition and concentration on the attenuation of biodegradable emerging trace organic chemicals (TOrCs) in simulated managed aquifer recharge (MAR) systems. Four sets of soil columns were established in the laboratory, each receiving synthetic feed solutions comprising different ratios and concentrations of peptone-yeast and humic acid as the primary substrate to investigate the effect on removal of six TOrCs (atenolol, caffeine, diclofenac, gemfibrozil, primidone, and trimethoprim). Based on abiotic control experiments, adsorption was not identified as a significant attenuation mechanism for primidone, gemfibrozil and diclofenac. Caffeine, atenolol and trimethoprim displayed initial adsorptive losses, however, adsorption coefficients derived from batch tests confirmed that adsorption was limited and in the long-term experiment, biodegradation was the dominant attenuation process. Within a travel time of 16 h, caffeine - an easily degradable compound exhibited removal exceeding 75% regardless of composition or concentration of the primary substrate. Primidone - a poorly degradable compound, showed no removal in any column regardless of the nature of the primary substrate. The composition and concentration of the primary substrate, however, had an effect on attenuation of moderately degradable TOrCs, such as atenolol, gemfibrozil and diclofenac, with the primary substrate composition seeming to have a larger impact on TOrC attenuation than its concentration. When the primary substrate consisted mainly of refractory substrate (humic acid), higher removal of the moderately degradable TOrCs was observed. The microbial communities in the columns receiving more refractory carbon, were noted to be more diverse and hence likely able to express a wider range of enzymes, which were more suitable for TOrC transformation. The effect of the primary substrate on microbial community composition, diversity

  16. At a Crossroad between Memory and Thinking: The Case of Primary History Education in the Greek Cypriot Educational System

    ERIC Educational Resources Information Center

    Perikleous, Lukas

    2010-01-01

    At the moment primary history education in the Greek Cypriot educational system is mainly about providing substantive knowledge and promoting Greek national identity and other social goals. Debates about history education are mostly about the kind of the past that should conveyed to the students and the social aims which should be promoted through…

  17. An Analysis of Two Beginning Reading Programs: Scott Foresman's "Reading Unlimited" and Pittsburgh LRDC's "New Primary Grades Reading Systems."

    ERIC Educational Resources Information Center

    Popp, Helen Mitchell

    The two reading programs discussed in this paper, "Reading Unlimited" (RU) published by Scott Foresman and "New Primary Grades Reading Systems" (RS) by the University of Pittsburgh Learning Research and Development Center, provide maximal contrasts in materials and teaching strategies. The instructional strategies in RU are analytic and inductive,…

  18. Profiling Bioactivity of the ToxCast Chemical Library Using BioMAP Primary Human Cell Systems

    EPA Science Inventory

    The complexity of human biology has made prediction of health effects as a consequence of exposure to environmental chemicals especially challenging. Complex cell systems, such as the Biologically Multiplexed Activity Profiling (BioMAP) primary, human, cell-based disease models, ...

  19. Effect of 5E Instructional Model in Student Success in Primary School 6th Year Circulatory System Topic

    ERIC Educational Resources Information Center

    Cardak, Osman; Dikmenli, Musa; Saritas, Ozge

    2008-01-01

    The aim of this study is to research the effect of the 5E instructional model on primary (sixth grade) student success during the circulatory system unit. This study was conducted with 38 students in two different classes by the same researcher in 2006-2007. One of the classes was assigned as the control group and the other as the experimental…

  20. FFTF primary system transition to natural circulation from low reactor power

    SciTech Connect

    Bouchey, G.D.; Additon, S.L.; Nutt, W.T.

    1980-01-01

    Plans for reactor and primary loop natural circulation testing in the Fast Flux Test Facility (FFTF) are summarized. Detailed pretest planning with an emphasis on understanding the implications of process noise and model uncertainties for model verification and test acceptance are discussed for a transition to natural circulation in the reactor core and primary heat transport loops from initial conditions of 5% of rated reactor power and 75% of full flow.

  1. Neurocognitive Features Distinguishing Primary Central Nervous System Lymphoma from Other Possible Causes of Rapidly Progressive Dementia

    PubMed Central

    Deutsch, Mariel B.; Mendez, Mario F.

    2015-01-01

    Objective Define the neurocognitive features of primary central nervous system lymphoma (PCNSL) presenting with dementia, and compare with other causes of rapidly progressive dementia (RPD). Background PCNSL can present as an RPD. Differentiating PCNSL from other RPDs is critical because lymphomatous dementia may be reversible, and untreated PCNSL is fatal. Methods We performed a meta-analysis of case reports of dementia from PCNSL (between 1950 and 2013); 20 patients (14 with lymphomatosis cerebri) met our criteria. We compared these patients to a case series of patients with RPD from Creutzfeldt-Jakob disease and other non-PCNSL etiologies (Sala et al, 2012. Alzheimer Dis Assoc Disord. 26:267–271). Results Median age was 66 (range 41–81); 70% were men. Time from symptom onset to evaluation was < 6 months in 65%. No patients had seizures; 5% had headaches; 45% had non-aphasic speech difficulty. There was significantly more memory impairment in patients with PCNSL than other RPDs and significantly less myoclonus and parkinsonism. Behavioral changes and cerebellar signs were not significantly different. Significantly more patients with PCNSL than other RPDs had white matter changes; significantly fewer had atrophy. Elevated CSF protein and pleocytosis were more frequent in PCNSL; patients with other RPDs tended to have normal CSF ± 14-3-3 protein. Conclusions Unlike patients with RPD from other causes, those with PCNSL commonly present with impaired memory, apathy, and abnormal speech and gait, without headache, seizure, or myoclonus. White-matter changes and CSF abnormalities predominate. Improved clinical awareness of PCNSL can prompt earlier diagnosis and treatment. PMID:25812125

  2. Efficacy of Procarbazine, Lomustine, and Vincristine Chemotherapy for Recurrent Primary Central Nervous System Lymphomas

    PubMed Central

    Kim, Young-Joo; Choe, Jai-ho; Park, Jae-Hyun

    2015-01-01

    Background Optimal treatment for recurrent primary central nervous system lymphomas (PCNSLs) has not been defined yet and there is no general consensus about the salvage chemotherapy after high-dose methotrexate (HD-MTX)-based chemotherapy. The purpose of the present study was to evaluate the efficacy and safety of procarbazine, lomustine, and vincristine (PCV) chemotherapy for recurrent PCNSLs. Methods We reviewed eight immunocompetent patients (five males/three females, mean age: 56 years) who received salvage PCV chemotherapy (procarbazine 60 mg/m2, days 8 through 21: CCNU 110 mg/m2, day 1: vincristine 2 mg, days 8 and 28) for recurrent PCNSL and two patients switched to PCV chemotherapy due to severe adverse effects of HD-MTX chemotherapy. Radiologic responses, survival, and adverse effects were analyzed. Results Of the eight recurrent PCNSLs, three patients (37.5%) showed radiologic complete response, one patient (12.5%) showed partial response, and four patients (50%) showed progressive disease after PCV chemotherapy. Median progression free survival (PFS) from the first administration of PCV to relapse or last follow-up was 7 months (range 5-32 months) and median overall survival was 8 months (range 2-41 months). The two patients who switched to PCV chemotherapy showed PFS of 9 and 5 months from the beginning of PCV to relapse. The common side effects were thrombocytopenia, neutropenia, and peripheral neuropathy. There were 4 grade III or IV myelo-suppression, but no fatal complications, including severe hemorrhage or infection, were observed. Conclusion Salvage PCV chemotherapy has a moderate anti-lymphoma activity for recurrent PCNSLs after the HD-MTX-based chemotherapy with tolerable toxicity. PMID:26605261

  3. Antiglutamate Receptor Antibodies and Cognitive Impairment in Primary Antiphospholipid Syndrome and Systemic Lupus Erythematosus

    PubMed Central

    Gerosa, Maria; Poletti, Barbara; Pregnolato, Francesca; Castellino, Gabriella; Lafronza, Annalisa; Silani, Vincenzo; Riboldi, Piersandro; Meroni, Pier Luigi; Merrill, Joan T.

    2016-01-01

    Systemic lupus erythematosus (SLE) and antiphospholipid syndrome have an increased risk to develop cognitive impairment. A possible role for antiphospholipid antibodies (aPL) and antiglutamate receptor (anti-NMDA) antibodies in the pathogenesis of neurological manifestations of these two conditions, have been suggested. In particular, the role of anti-NMDA antibodies in the pathogenesis of neuropsychiatric SLE is supported by several experimental studies in animal models and by the finding of a correlation between anti-NMDA positivity in cerebrospinal fluid and neurological manifestations of SLE. However, data from the literature are controversial, as several studies have reported a correlation of these antibodies with mild cognitive impairment in SLE, but more recent studies have not confirmed this finding. The synergism between anti-NMDA and other concomitant autoantibodies, such as aPL, can be hypothesized to play a role in inducing the tissue damage and eventually the functional abnormalities. In line with this hypothesis, we have found a high incidence of at least one impaired cognitive domain in a small cohort of patients with primary APS (PAPS) and SLE. Interestingly, aPL were associated with low scoring for language ability and attention while anti-NMDA titers and mini-mental state examination scoring were inversely correlated. However, when patients were stratified according to the presence/absence of aPL, the correlation was confirmed in aPL positive patients only. Should those findings be confirmed, the etiology of the prevalent defects found in PAPS patients as well as the synergism between aPL and anti-NMDA antibodies would need to be explored. PMID:26870034

  4. Racial differences in primary central nervous system lymphoma incidence and survival rates.

    PubMed

    Pulido, Jose S; Vierkant, Robert A; Olson, Janet E; Abrey, Lauren; Schiff, David; O'Neill, Brian Patrick

    2009-06-01

    To determine racial and ethnic differences in incidence and survival in patients with primary central nervous system lymphoma (PCNSL), NCI Surveillance, Epidemiology, and End Results (SEER) program data from 1992 to 2002 were queried. Data were substratified by age (20-49 years vs. 50 or above) and race (White, Black, Asian/Pacific Islander [A/PI], American Indian/Alaskan Native [AI/AN]). Incidence of PCNSL and survival were calculated by SEER(*)Stat software. The incidence rates were 0.94 per 100,000 per year (95% confidence interval [CI] 0.90-0.98) for Whites, 1.10 (95% CI 0.98-1.22) for Blacks, 0.51 (95% CI 0.28-0.74) for AI/AN, and 0.64 (95% CI 0.56-0.72) for A/PI. In patients aged 20-49 years the rates were 0.72 (95% CI 0.68-0.76) for Whites, 1.43 (95% CI 1.27-1.59) for Blacks, 0.58 (95% CI 0.30-0.86) for AI/AN, and 0.21 (CI 0.15-0.27) for A/PI. In patients over 49 years, the rates were 1.30 (95% CI 1.22-1.38) for Whites, 0.56 (95% CI 0.40-0.72) for Blacks, 0.34 (95% CI 0-0.70) for AI/AN, and 1.31 (95% CI 1.00-1.53) for A/PI. PCNSL incidence for ages 20-49 years for Black patients was twice that for Whites. Incidence for ages over 49 years for Whites was twice that for Blacks. Survival at 12 months, 24 months, and 60 months was higher among Whites than Blacks. Research is needed to determine the origin of these differences. PMID:19273630

  5. Environmental monitoring of urban streams using a primary fish gill cell culture system (FIGCS).

    PubMed

    Schnell, Sabine; Bawa-Allah, Kafilat; Otitoloju, Adebayo; Hogstrand, Christer; Miller, Thomas H; Barron, Leon P; Bury, Nic R

    2015-10-01

    The primary fish gill cell culture system (FIGCS) is an in vitro technique which has the potential to replace animals in whole effluent toxicity tests. In the current study FIGCS were transported into the field and exposed to filtered (0.2μm) river water for 24h from 4 sites, on 2 different sampling dates. Sites 1 and 2 are situated in an urban catchment (River Wandle, London, UK) with site 1 downstream of a sewage treatment work; site 3 is located in a suburban park (River Cray, Kent, UK), and site 4 is more rural (River Darent, Kent, UK). The change in transepithelial electrical resistance (TER), the expression of the metal responsive genes metallothionein A (mta) and B (mtb), cytochrome P450 1A1 (cyp1a1) and 3A27 (cyp3a27), involved in phase 1 metabolism, were assessed following exposure to sample water for 24h. TER was comparable between FIGCS exposed to 0.2μm filtered river water and those exposed to synthetic moderately soft water for 24h. During the first sampling time, there was an increase in mta, cyp1a1 and cyp3a27 gene expression in epithelium exposed to water from sites 1 and 2, and during the second sampling period an increase in cyp3a27 gene expression at sites 1 and 4. Urban river water is a complex mixture of contaminants (e.g., metals, pesticides, pharmaceuticals and polyaromatic hydrocarbons) and the increase in the expression of genes encoding mta, cyp1a1 and cyp3a27 in FIGCS is indicative of the presence of biologically active pollutants. PMID:26093110

  6. Trends in primary central nervous system lymphoma incidence and survival in the U.S.

    PubMed

    Shiels, Meredith S; Pfeiffer, Ruth M; Besson, Caroline; Clarke, Christina A; Morton, Lindsay M; Nogueira, Leticia; Pawlish, Karen; Yanik, Elizabeth L; Suneja, Gita; Engels, Eric A

    2016-08-01

    It is suspected that primary central nervous system lymphoma (PCNSL) rates are increasing among immunocompetent people. We estimated PCNSL trends in incidence and survival among immunocompetent persons by excluding cases among human immunodeficiency virus (HIV)-infected persons and transplant recipients. PCNSL data were derived from 10 Surveillance, Epidemiology and End Results (SEER) cancer registries (1992-2011). HIV-infected cases had reported HIV infection or death due to HIV. Transplant recipient cases were estimated from the Transplant Cancer Match Study. We estimated PCNSL trends overall and among immunocompetent individuals, and survival by HIV status. A total of 4158 PCNSLs were diagnosed (36% HIV-infected; 0·9% transplant recipients). HIV prevalence in PCNSL cases declined from 64·1% (1992-1996) to 12·7% (2007-2011), while the prevalence of transplant recipients remained low. General population PCNSL rates were strongly influenced by immunosuppressed cases, particularly in 20-39 year-old men. Among immunocompetent people, PCNSL rates in men and women aged 65+ years increased significantly (1·7% and 1·6%/year), but remained stable in other age groups. Five-year survival was poor, particularly among HIV-infected cases (9·0%). Among HIV-uninfected cases, 5-year survival increased from 19·1% (1992-1994) to 30·1% (2004-2006). In summary, PCNSL rates have increased among immunocompetent elderly adults, but not in younger individuals. Survival remains poor for both HIV-infected and HIV-uninfected PCNSL patients. PMID:27018254

  7. Randomized clinical trial comparing systemic interferon with diathermocoagulation in primary multiple and widespread anogenital condyloma.

    PubMed

    Benedetti Panici, P; Scambia, G; Baiocchi, G; Perrone, L; Pintus, C; Mancuso, S

    1989-09-01

    Two hundred three patients (median age 26 years; range 18-45) with untreated multiple and widespread anogenital condyloma were randomly assigned to one of four study arms in order to compare the efficacy, toxicity, and tolerability of recombinant interferon alpha-2b with those of diathermocoagulation. Of 200 evaluable patients, 51 were treated intramuscularly (IM) with 3 x 10(6) U (3 MU)/m2 daily for 3 weeks (total dose 63 MU/m2), 50 received subcutaneous thrice-weekly injections of 3 MU/m2 for 4 weeks (total dose 36 MU/m2), 51 underwent diathermocoagulation, and 48 were not treated and were used as a control group. Six months after the end of treatment, the overall response rate (complete and partial responses) was 70%: 57 and 82% for patients receiving interferon alpha-2b (IM and subcutaneously) and diathermocoagulation, respectively, and 8% for the control group. After 6 months from therapy, no significant differences in complete response were found among the different types of treatment: 20, 20, and 35% for the two interferon groups and the diathermocoagulation group, respectively. Fifteen and two complete responders in the cauterization and interferon groups, respectively, experienced disease recurrence (P less than .01). All patients given interferon therapy complained of flu-like symptoms, which declined progressively after the first week of treatment. Fatigue, lasting as long as patients received interferon, was the most prevalent chronic side effect. We conclude that systemic recombinant interferon alpha-2b is active in treating patients with primary condyloma lesions and does so as well as cauterization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2761917

  8. Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

    PubMed Central

    2011-01-01

    Background There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden. Methods This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System®). Results The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix. Conclusions Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain. PMID:21645335

  9. Evaluation of a carp primary hepatocyte culture system for screening chemicals for oestrogenic activity.

    PubMed

    Bickley, L K; Lange, A; Winter, M J; Tyler, C R

    2009-09-14

    variation observed in the vitellogenic response between different cultures, data from the different donor fish could be compared by standardising responses relative to the maximum VTG induction in each culture following exposure to E2. Adopting this approach in the future will allow for data from different hepatocyte cultures and from donor fish of different sexes, age and stage of maturity to be compared with greater consistency. Measurement of vtg mRNA expression was relatively more sensitive to the oestrogenic effects of E2 exposure than measurement of VTG protein (the LOEC at the transcriptome level was 10-fold lower [0.01 microM E2] than at the protein level [0.1 microM E2]) and changes in vtg mRNA expression showed less variation between individual hepatocyte isolations. Measurement of vtg mRNA in the hepatocyte culture system therefore may offer the most sensitive and consistent option for the screening of chemicals with oestrogenic activity in fish primary hepatocyte cultures. PMID:19695720

  10. Systemic primary carnitine deficiency: an overview of clinical manifestations, diagnosis, and management.

    PubMed

    Magoulas, Pilar L; El-Hattab, Ayman W

    2012-01-01

    Systemic primary carnitine deficiency (CDSP) is an autosomal recessive disorder of carnitine transportation. The clinical manifestations of CDSP can vary widely with respect to age of onset, organ involvement, and severity of symptoms, but are typically characterized by episodes of hypoketotic hypoglycemia, hepatomegaly, elevated transaminases, and hyperammonemia in infants; skeletal myopathy, elevated creatine kinase (CK), and cardiomyopathy in childhood; or cardiomyopathy, arrhythmias, or fatigability in adulthood. The diagnosis can be suspected on newborn screening, but is established by demonstration of low plasma free carnitine concentration (<5 μM, normal 25-50 μM), reduced fibroblast carnitine transport (<10% of controls), and molecular testing of the SLC22A5 gene. The incidence of CDSP varies depending on ethnicity; however the frequency in the United States is estimated to be approximately 1 in 50,000 individuals based on newborn screening data. CDSP is caused by recessive mutations in the SLC22A5 gene. This gene encodes organic cation transporter type 2 (OCTN2) which transport carnitine across cell membranes. Over 100 mutations have been reported in this gene with the c.136C > T (p.P46S) mutation being the most frequent mutation identified. CDSP should be differentiated from secondary causes of carnitine deficiency such as various organic acidemias and fatty acid oxidation defects. CDSP is an autosomal recessive condition; therefore the recurrence risk in each pregnancy is 25%. Carrier screening for at-risk individuals and family members should be obtained by performing targeted mutation analysis of the SLC22A5 gene since plasma carnitine analysis is not a sufficient methodology for determining carrier status. Antenatal diagnosis for pregnancies at increased risk of CDSP is possible by molecular genetic testing of extracted DNA from chorionic villus sampling or amniocentesis if both mutations in SLC22A5 gene are known. Once the diagnosis of CDSP is

  11. Degradation and Failure Characteristics of NPP Containment Protective Coating Systems

    SciTech Connect

    Sindelar, R.L.

    2001-04-10

    Nuclear power plants (NPPs) must ensure that the emergency core cooling system (ECCS) or safety-related containment spray system (CSS) remains capable of performing its design safety function throughout the life of the plant. This requires ensuring that long-term core cooling can be maintained following a postulated loss-of-coolant accident (LOCA). Adequate safety operation can be impaired if the protective coatings which have been applied to the concrete and steel structures within the primary containment fail, producing transportable debris which could then accumulate on BWR ECCS suction strainers or PWR ECCS sump debris screens located within the containment. This document will present the data collected during the investigation of coating specimens from plants.

  12. Primary diffuse large B-cell lymphoma of the central nervous system: A case report and literature review

    PubMed Central

    CHEN, DAWEI; GU, WEIHONG; LI, WENZHONG; LIU, XIAOLIANG; YANG, XIAOYU

    2016-01-01

    The present study reports the clinical diagnosis and management of a patient with primary diffuse large B-cell lymphoma (Bcl) of the central nervous system (CNS). Making an early diagnosis of primary diffuse large Bcl is challenging due to the variable and complicated clinical manifestations of the disease. The relevant literature was reviewed, and high-dose methotrexate, whole brain radiotherapy and highly active antiretroviral therapy was recommended for the patient. The present study elucidates the role of positron emission tomography-computed tomography scans for the diagnosis and management of primary diffuse large Bcl of the CNS, and demonstrates the importance of resection surgery in the management of the disease. Specifically, the present study proposes that resection surgery may be applied in the early stages of disease for patients with a single occupied lesion and increased intracranial pressure. PMID:27123068

  13. The energetic contributions of aquatic primary producers to terrestrial food webs in a mid-size river system.

    PubMed

    Kautza, Adam; Mazeika, S; Sullivan, P

    2016-03-01

    Rivers are increasingly recognized as providing nutritional subsidies (i.e., energy and nutrients) to adjacent terrestrial food webs via depredation of aquatic organisms (e.g., emergent aquatic insects, crayfish, fish) by terrestrial consumers. However, because these prey organisms assimilate energy from both aquatic (e.g., benthic algae, phytoplankton, aquatic macrophytes) and terrestrial (e.g., riparian leaf detritus) primary producers, river subsidies to terrestrial consumers represent a combination of aquatically and terrestrially derived energy. To date, the explicit contribution of energy derived from aquatic primary producers to terrestrial consumers has not been fully explored yet might be expected to be quantitatively important to terrestrial food webs. At 12 reaches along a 185-km segment of the sixth-order Scioto River system (Ohio, USA), we quantified the relative contribution of energy derived from aquatic primary producers to a suite of terrestrial riparian consumers that integrate the adjacent landscape across multiple spatial scales through their foraging activities (tetragnathid spiders, rove beetles, adult coenagrionid damselflies, riparian swallows, and raccoons). We used naturally abundant stable isotopes (13C and 15N) of periphyton, phytoplankton, macrophytes, and terrestrial vegetation to evaluate the energetic contribution of aquatic primary producers to terrestrial food webs. Shoreline tetragnathid spiders were most reliant on aquatic primary producers (50%), followed by wider-ranging raccoons (48%), damselflies (44%), and riparian swallows (41%). Of the primary producers, phytoplankton (19%) provisioned the greatest nutritional contribution to terrestrial consumers (considered collectively), followed by periphyton (14%) and macrophytes (11%). Our findings provide empirical evidence that aquatic primary producers of large streams and rivers can be a critical nutritional resource for terrestrial food webs. We also show that aquatically

  14. Design and simulation of the active support system for a 1.2m meniscus primary mirror

    NASA Astrophysics Data System (ADS)

    Liu, Haitao; Fan, Bin; Zeng, Zhige; Li, Xiaojin; Wang, Hongqiao; Liu, Rong

    2015-07-01

    Thin meniscus primary mirrors with active support have been used successfully in many large telescopes, and also draw attention of many optical fabricators. Because the active support system can correct the low order figure errors, such as astigmatism, coma, trefoil 3rd astigmatism, the optical fabricators can just focus on to remove high order figure errors. This will shorten the fabrication time. In this paper, we present an active support system for a 1.2m meniscus parabolic primary mirror. It contains 37 axial push-pull force supports, 3 axial fixed points, and 4 lateral restraints. Some basic performance of the active support system is analyzed and the figure error correction capability is also studied based on Zernike modes.

  15. Central nervous system tuberculosis masquerading as primary dementia: a case report.

    PubMed

    Sethi, Nitin K; Sethi, Prahlad K; Torgovnick, Josh; Arsura, Edward

    2011-01-01

    Primary dementias are the most common cause of memory impairment in patients above the age of 60. Hypothyroidism, depression, vitamin B12 deficiency and infectious diseases such as syphilis at times may present with memory impairment mimicking primary dementias in their clinical presentation. We present here a 64-year-old female who presented with complaints of forgetfulness, confusion, memory loss and impaired concentration for the past 3 months. Neuroimaging and computed tomography of the chest were suggestive of active tuberculosis. Anti-tubercular therapy led to resolution of enhancing lesions in the brain and abatement of memory deficits. PMID:22127948

  16. Comparison of computer codes (CE-THERM, FRAP-T5, GT3-FLECHT, and TRUMP-FLECHT) with data from the NRU-LOCA thermal hydraulic tests

    SciTech Connect

    Mohr, C.L.; Rausch, W.N.; Hesson, G.M.

    1981-07-01

    The LOCA Simulation Program in the NRU reactor is the first set of experiments to provide data on the behavior of full-length, nuclear-heated PWR fuel bundles during the heatup, reflood, and quench phases of a loss-of-coolant accident (LOCA). This paper compares the temperature time histories of 4 experimental test cases with 4 computer codes: CE-THERM, FRAP-T5, GT3-FLECHT, and TRUMP-FLECHT. The preliminary comparisons between prediction and experiment show that the state-of-the art fuel codes have large uncertainties and are not necessarily conservative in predicting peak temperatures, turn around times, and bundle quench times.

  17. An Update of the Mayo Clinic Cohort of Patients With Adult Primary Central Nervous System Vasculitis

    PubMed Central

    Salvarani, Carlo; Brown, Robert D.; Christianson, Teresa; Miller, Dylan V.; Giannini, Caterina; Huston, John; Hunder, Gene G.

    2015-01-01

    Abstract Primary central nervous system vasculitis (PCNSV) is an uncommon condition in which lesions are limited to vessels of the brain and spinal cord. Because the clinical manifestations are not specific, the diagnosis is often difficult, and permanent disability and death are frequent outcomes. This study is based on a cohort of 163 consecutive patients with PCNSV who were examined at the Mayo Clinic over a 29-year period from 1983 to 2011. The aim of the study was to define the characteristics of these patients, which represents the largest series in adults reported to date. A total of 105 patients were diagnosed by angiographic findings and 58 by biopsy results. The patients diagnosed by biopsy more frequently had at presentation cognitive dysfunction, greater cerebrospinal fluid total protein concentrations, less frequent cerebral infarcts, and more frequent leptomeningeal gadolinium-enhanced lesions on magnetic resonance imaging (MRI), along with less mortality and disability at last follow-up. The patients diagnosed by angiograms more frequently had at presentation hemiparesis or a persistent neurologic deficit or stroke, more frequent infarcts on MRI and an increased mortality. These differences were mainly related to the different size of the vessels involved in the 2 groups. Although most patients responded to therapy with glucocorticoids alone or in conjunction with cyclophosphamide and tended to improve during the follow-up period, an overall increased mortality rate was observed. Relapses occurred in one-quarter of the patients and were less frequent in patients treated with prednisone and cyclophosphamide compared with those treated with prednisone alone. The mortality rate and degree of disability at last follow-up were greater in those with increasing age, cerebral infarctions on MRI, angiographic large vessel involvement, and diagnosis made by angiography alone, but were lower in those with gadolinium-enhanced lesions on MRI and in those with

  18. Experimental treatment of Epstein-Barr virus-associated primary central nervous system lymphoma.

    PubMed

    Roychowdhury, Sameek; Peng, Ruoqi; Baiocchi, Robert A; Bhatt, Darshna; Vourganti, Srinivas; Grecula, John; Gupta, Nilendu; Eisenbeis, Charles F; Nuovo, Gerard J; Yang, Weilian; Schmalbrock, Petra; Ferketich, Amy; Moeschberger, Melvin; Porcu, Pierluigi; Barth, Rolf F; Caligiuri, Michael A

    2003-03-01

    Primary central nervous system lymphoma (PCNSL) that arises in immune-deficient patients is an aggressive B-cell neoplasm that is universally associated with the EBV. Patients with EBV(+) PCNSL face a particularly poor prognosis with median survival times of 2-12 months despite aggressive management with radiation therapy. We have developed a preclinical model of EBV(+) PCNSL to explore strategies that specifically target EBV-infected B lymphoblasts in vivo. Stereotactic implantation of EBV-transformed human lymphoblastoid B-cell lines into the caudate nucleus of the nude rat resulted in lethal CNS tumor burden manifested by the onset of focal neurological symptoms within 21 days. Histological evaluation at autopsy revealed a multifocal, perivascular human EBV(+) lymphoblastic B-cell infiltrate that displayed a latency type III EBV gene expression profile similar to PCNSL that develops in some immune-deficient patients. Radiation (1600 cGy) of lymphoblastoid B-cell lines resulted in up-regulation of the EBV thymidine kinase (EBV-TK) transcript and sensitization of these cells to drug-induced apoptosis using nucleoside analogs. Enhanced expression of EBV-TK mRNA in EBV(+) PCNSL tumors by radiation therapy occurred in a dose-dependent fashion. In vivo trials using the nude rat PCNSL model demonstrated significantly improved mean survival time (MST) with single fraction whole-brain radiotherapy (WBRT) and antiviral therapy consisting of zidovudine (AZT) and ganciclovir (GCV; MST 41.3 +/- 3.3 days; P = 0.05), compared with either antiviral therapy (MST 32.1 +/- 1.1 days) or WBRT alone (MST 22 +/- 0.8 days). We found constitutive and abundant EBV-TK mRNA expression in a stereotactic core biopsy specimen from a solid organ transplant patient with EBV(+) PCNSL. Withdrawal of immunosuppression did not result in disease regression. This patient achieved a complete response after therapy with high-dose AZT and GCV in the absence of WBRT, and remains in remission on oral

  19. Design and evaluation of a primary/secondary pumping system for a heat pump assisted solar thermal loop

    NASA Astrophysics Data System (ADS)

    Krockenberger, Kyle G.

    A heat pump assisted solar thermal system was designed, commissioned, tested and analyzed over a period of two years. The unique system uses solar energy whenever it is available, but switches to heat pump mode at night or whenever there is a lack of solar energy. The solar thermal energy is added by a variety of flat plat solar collectors and an evacuated tube heat pipe solar collector. The working medium in the entire system is a 50% mixture of propylene glycol and water for freeze protection. During the design and evaluation the primary / secondary pumping system was the focus of the evaluation. Testing within this research focused on the operation modes, pump stability, and system efficiency. It was found that the system was in full operation, the pumps were stable and that the efficiency factor of the system was 1.95.

  20. Structures and Systems and Bodies and Things: Historical Research on Primary Schooling and Its Professional Relevance

    ERIC Educational Resources Information Center

    Cunningham, Peter

    2012-01-01

    Recalling its origins as a research journal addressing educationists this article seeks to understand historical research published in "History of Education" as aimed at a professional audience. Primary schooling provides a significant focus as the study of education history was fostered especially in the training of elementary teachers.1 In that…

  1. Construing Systems of Management among Primary Headteachers: Moving Forward from Work Activity Studies.

    ERIC Educational Resources Information Center

    Jones, Norah; Connolly, Michael

    2001-01-01

    A study used a Personal Construct Theory/Repertory Grid approach to examine the work of 12 Welsh primary headteachers. Analysis of thematic work-activity grids suggests principals have a more coherent view of their work (as centered on children and education) than Henry Mintzberg's observational studies portrayed. (Contains 36 references.) (MLH)

  2. State Liability for Abuse in Primary Schools: Systemic Failure and "O'Keeffe" v. "Hickey"

    ERIC Educational Resources Information Center

    O'Mahony, Conor

    2009-01-01

    Due to the historical arrangement between Church and State, the Irish State has always discharged its duty to provide for free primary education exclusively through the provision of funding to privately owned and managed schools. Consequently, in "O'Keeffe" v. "Hickey," where a woman sued the State in respect of sex abuse she suffered when in…

  3. Uneven Distribution of Novice Teachers in the Chilean Primary School System

    ERIC Educational Resources Information Center

    Meckes, Lorena; Bascope, Martin

    2012-01-01

    This study examines the allocation of novice primary teachers in Chilean schools, looking at their characteristics and at the attributes of the schools at which they are hired after having completed their initial teacher training. The study reveals that in Chile, more qualified novice teachers are more prone to get jobs in socio-economically…

  4. Primary systemic amyloidosis as a real diagnostic challenge – case study

    PubMed Central

    Jerzykowska, Sonia; Gil, Lidia A.; Balcerzak, Andrzej; Pupek-Musialik, Danuta; Komarnicki, Mieczysław A.

    2014-01-01

    Primary amyloidosis (AL) is a rare variety of plasma cell dyscrasia, the diagnosis of which is often difficult to establish. Pathogenesis of amyloidosis involves extracellular deposition of insoluble protein fibrils in tissues, leading to insufficiency of affected organs. According to various sources, mean survival rate of patients with primary amyloidosis ranges from 12 to 24 months, making primary amyloidosis a disease with a very poor prognosis. Survival rate is significantly lowered in case of cardiac manifestation of amyloidosis (about 6 months survival in untreated patients). In recent years a considerable progress in AL treatment has been observed. Nowadays we are able not only to delay progression of amyloidosis, but also to improve the function of the affected organs. Unfortunately as first signs and symptoms of AL are usually nonspecific, the diagnosis of AL is often delayed, resulting in late introduction of optimal therapy. There are many diagnostic tests which can be used in diagnostic process of amyloidosis, i.e. electrophoresis, serum and urine immunofixation or affected organs and bone marrow biopsy. On establishing the diagnosis in a patient with suspected amyloidosis it should be remembered that particular diagnostic methods vary considerably in sensitivity. The aim of this paper is to present a case report of a 27-year-old patient with primary amyloidosis focusing on diagnostic aspect of this condition. On the basis of this case, the authors would like to emphasize the value of precise diagnostic process, with immunological techniques playing undoubtedly a crucial role. PMID:26155101

  5. Student Transition from Primary to Lower Secondary School in Cambodia: Narrative Insights into Complex Systems

    ERIC Educational Resources Information Center

    Edwards, D. Brent, Jr.; Zimmermann, Thomas; Sitha, Chhinh; Williams, James H.; Kitamura, Yuto

    2014-01-01

    This article has three purposes. First, it presents findings from a study of student retention and dropout in Cambodia, as pupils transition from primary to lower secondary school. Second, it aims to understand from an in-depth, emic perspective the dynamics of this process and the challenges that individual families and their students face around…

  6. Final report spent nuclear fuel retrieval system primary cleaning development testing

    SciTech Connect

    Ketner, G.L.; Meeuwsen, P.V.

    1997-09-01

    Developmental testing of the primary cleaning station for spent nuclear fuel (SNF) and canisters is reported. A primary clean machine will be used to remove the gross sludge from canisters and fuel while maintaining water quality in the downstream process area. To facilitate SNF separation from canisters and minimize the impact to water quality, all canisters will be subjected to mechanical agitation and flushing with the Primary Clean Station. The Primary Clean Station consists of an outer containment box with an internally mounted, perforated wash basket. A single canister containing up to 14 fuel assemblies will be loaded into the wash basket, the confinement box lid closed, and the wash basket rotated for a fixed cycle time. During this cycle, basin water will be flushed through the wash basket and containment box to remove and entrain the sludge and carry it out of the box. Primary cleaning tests were performed to provide information concerning the removal of sludge from the fuel assemblies while in the basin canisters. The testing was also used to determine if additional fuel cleaning is required outside of the fuel canisters. Hydraulic performance and water demand requirements of the cleaning station were also evaluated. Thirty tests are reported in this document. Tests demonstrated that sludge can be dislodged and suspended sufficiently to remove it from the canister. Examination of fuel elements after cleaning suggested that more than 95% of the exposed fuel surfaces were cleaned so that no visual evidence of remained. As a result of testing, recommendations are made for the cleaning cycle. 3 refs., 16 figs., 4 tabs.

  7. Mixed-oxide fuel decay heat analysis for BWR LOCA safety evaluation

    SciTech Connect

    Chiang, R. T.

    2013-07-01

    The mixed-oxide (MOX) fuel decay heat behavior is analyzed for Boiling Water Reactor (BWR) Loss of Coolant Accident (LOCA) safety evaluation. The physical reasoning on why the decay heat power fractions of MOX fuel fission product (FP) are significantly lower than the corresponding decay heat power fractions of uranium-oxide (UOX) fuel FP is illustrated. This is primarily due to the following physical phenomena. -The recoverable energies per fission of plutonium (Pu)-239 and Pu-241 are significantly higher than those of uranium (U)-235 and U-238. Consequently, the fission rate required to produce the same amount of power in MOX fuel is significantly lower than that in UOX fuel, which leads to lower subsequent FP generation rate and associated decay heat power in MOX fuel than those in UOX fuel. - The effective FP decay energy per fission of Pu-239 is significantly lower than the corresponding effective FP decay energy per fission of U-235, e.g., Pu-239's 10.63 Mega-electron-Volt (MeV) vs. U-235's 12.81 MeV at the cooling time 0.2 second. This also leads to lower decay heat power in MOX fuel than that in UOX fuel. The FP decay heat is shown to account for more than 90% of the total decay heat immediately after shutdown. The FP decay heat results based on the American National Standard Institute (ANSI)/American Nuclear Society (ANS)-5.1-1979 standard method are shown very close to the corresponding FP decay heat results based on the ANSI/ANS-5.1-2005 standard method. The FP decay heat results based on the ANSI/ANS-5.1-1979 simplified method are shown very close to but mostly slightly lower than the corresponding FP decay heat results based on the ANSI/ANS-5.1-1971 method. The FP decay heat results based on the ANSI/ANS-5.1-1979 simplified method or the ANSI/ANS-5.1-1971 method are shown significantly larger than the corresponding FP decay heat results based on the ANSI/ANS-5.1-1979 standard method or the ANSI/ANS-5.1-2005 standard method. (authors)

  8. Mixing phenomena of interest to boron dilution during small break LOCAs in PWRs. Revision 7/95

    SciTech Connect

    Nourbakhsh, H.P.; Cheng, Z.

    1995-07-01

    This paper presents the results of a study of mixing phenomena related to boron dilution during small break loss of coolant accidents (LOCAs) in pressurized water reactors (PWRs). Boron free condensate can accumulate in the cold leg loop seals when the reactor is operating in a reflux/boiler-condenser mode. A problem may occur when subsequent change in flow conditions such as loop seal clearing or re-establishment of natural circulation flow drive the diluted water in the loop seals into the reactor core without sufficient mixing with the highly borated water in the reactor downcomer and lower plenum. The resulting low boron concentration coolant entering the core may cause a power excursion leading to fuel failure. The mixing processes associated with a slow moving stream of diluted water through the loop seal to the core are examined in this paper. Bounding calculations for boron concentration of coolant entering the core during a small break LOCA in a typical Westinghouse-designed four-loop plant are also presented.

  9. Medication incidents in primary care medicine: protocol of a study by the Swiss Federal Sentinel Reporting System

    PubMed Central

    Gnädinger, Markus; Ceschi, Alessandro; Conen, Dieter; Herzig, Lilli; Puhan, Milo; Staehelin, Alfred; Zoller, Marco

    2015-01-01

    Background/rationale Patient safety is a major concern in healthcare systems worldwide. Although most safety research has been conducted in the inpatient setting, evidence indicates that medical errors and adverse events are a threat to patients in the primary care setting as well. Since information about the frequency and outcomes of safety incidents in primary care is required, the goals of this study are to describe the type, frequency, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate possible risk factors for medication incidents. Methods and analysis Study design and setting: We will conduct a prospective surveillance study to identify cases of medication incidents among primary care patients in Switzerland over the course of the year 2015. Participants: Patients undergoing drug treatment by 167 general practitioners or paediatricians reporting to the Swiss Federal Sentinel Reporting System. Inclusion criteria: Any erroneous event, as defined by the physician, related to the medication process and interfering with normal treatment course. Exclusion criteria: Lack of treatment effect, adverse drug reactions or drug–drug or drug–disease interactions without detectable treatment error. Primary outcome: Medication incidents. Risk factors: Age, gender, polymedication, morbidity, care dependency, hospitalisation. Statistical Analysis: Descriptive statistics to assess type, frequency, seasonal and regional distribution of medication incidents and logistic regression to assess their association with potential risk factors. Estimated sample size: 500 medication incidents. Limitations: We will take into account under-reporting and selective reporting among others as potential sources of bias or imprecision when interpreting the results. Ethics and dissemination No formal request was necessary because of fully anonymised data. The results will be published in a peer-reviewed journal. Trial registration number

  10. Angiography-negative primary angiitis of the central nervous system in childhood.

    PubMed

    Park, Michael S; Marlin, Arthur E; Gaskill, Sarah J

    2014-01-01

    Childhood primary angiitis of the CNS is a recently characterized, potentially reversible disease process. A favorable outcome requires early diagnosis and appropriate treatment. The histological findings of childhood primary angiitis of the CNS are characterized by a lymphocytic, nongranulomatous vasculitis. This disorder can lead to neurological deficits, seizures, and strokes. Laboratory and radiographic investigation are part of the evaluation, but are often nonspecific. Conventional angiography can fail to show any abnormality, and biopsy may ultimately be required for diagnosis. Although there can be significant rates of morbidity and mortality if untreated, patients who receive appropriate therapy can experience excellent outcomes, and in many cases will demonstrate near-complete or total clinical and radiographic resolution. The case of a previously healthy 13-year-old girl with new-onset generalized tonic-clonic seizures is presented, with a review of the literature. PMID:24160668

  11. Common Infections in Patients Prescribed Systemic Glucocorticoids in Primary Care: A Population-Based Cohort Study

    PubMed Central

    Fardet, Laurence; Petersen, Irene; Nazareth, Irwin

    2016-01-01

    Background Little is known about the relative risk of common bacterial, viral, fungal, and parasitic infections in the general population of individuals exposed to systemic glucocorticoids, or about the impact of glucocorticoid exposure duration and predisposing factors on this risk. Methods and Findings The hazard ratios of various common infections were assessed in 275,072 adults prescribed glucocorticoids orally for ≥15 d (women: 57.8%, median age: 63 [interquartile range 48–73] y) in comparison to those not prescribed glucocorticoids. For each infection, incidence rate ratios were calculated for five durations of exposure (ranging from 15–30 d to >12 mo), and risk factors were assessed. Data were extracted from The Health Improvement Network (THIN) primary care database. When compared to those with the same underlying disease but not exposed to glucocorticoids, the adjusted hazard ratios for infections with significantly higher risk in the glucocorticoid-exposed population ranged from 2.01 (95% CI 1.83–2.19; p < 0.001) for cutaneous cellulitis to 5.84 (95% CI 5.61–6.08; p < 0.001) for lower respiratory tract infection (LRTI). There was no difference in the risk of scabies, dermatophytosis and varicella. The relative increase in risk was stable over the durations of exposure, except for LRTI and local candidiasis, for which it was much higher during the first weeks of exposure. The risks of infection increased with age and were higher in those with diabetes, in those prescribed higher glucocorticoid doses, and in those with lower plasma albumin level. Most associations were also dependent on the underlying disease. A sensitivity analysis conducted on all individuals except those with asthma or chronic obstructive pulmonary disease produced similar results. Another sensitivity analysis assessing the impact of potential unmeasured confounders such as disease severity or concomitant prescription of chemotherapy suggested that it was unlikely that

  12. A Systems Biology Study on NFκB Signaling in Primary Mouse Hepatocytes

    PubMed Central

    Pinna, Federico; Sahle, Sven; Beuke, Katharina; Bissinger, Michaela; Tuncay, Selcan; D’Alessandro, Lorenza A.; Gauges, Ralph; Raue, Andreas; Timmer, Jens; Klingmüller, Ursula; Schirmacher, Peter; Kummer, Ursula; Breuhahn, Kai

    2012-01-01

    The cytokine tumor necrosis factor-alpha (TNFα) is one of the key factors during the priming phase of liver regeneration as well as in hepatocarcinogenesis. TNFα activates the nuclear factor κ-light-chain-enhancer of activated B cells (NFκB) signaling pathway and contributes to the conversion of quiescent hepatocytes to activated hepatocytes that are able to proliferate in response to growth factor stimulation. Different mathematical models have been previously established for TNFα/NFκB signaling in the context of tumor cells. Combining these mathematical models with time-resolved measurements of expression and phosphorylation of TNFα/NFκB pathway constituents in primary mouse hepatocytes revealed that an additional phosphorylation step of the NFκB isoform p65 has to be considered in the mathematical model in order to sufficiently describe the dynamics of pathway activation in the primary cells. Also, we addressed the role of basal protein turnover by experimentally measuring the degradation rate of pivotal players in the absence of TNFα and including this information in the model. To elucidate the impact of variations in the protein degradation rates on TNFα/NFκB signaling on the overall dynamic behavior we used global sensitivity analysis that accounts for parameter uncertainties and showed that degradation and translation of p65 had a major impact on the amplitude and the integral of p65 phosphorylation. Finally, our mathematical model of TNFα/NFκB signaling was able to predict the time-course of the complex formation of p65 and of the inhibitor of NFκB (IκB) in primary mouse hepatocytes, which was experimentally verified. Hence, we here present a mathematical model for TNFα/NFκB signaling in primary mouse hepatocytes that provides an important basis to quantitatively disentangle the complex interplay of multiple factors in liver regeneration and tumorigenesis. PMID:23293603

  13. Gene Mutation Profiles in Primary Diffuse Large B Cell Lymphoma of Central Nervous System: Next Generation Sequencing Analyses

    PubMed Central

    Todorovic Balint, Milena; Jelicic, Jelena; Mihaljevic, Biljana; Kostic, Jelena; Stanic, Bojana; Balint, Bela; Pejanovic, Nadja; Lucic, Bojana; Tosic, Natasa; Marjanovic, Irena; Stojiljkovic, Maja; Karan-Djurasevic, Teodora; Perisic, Ognjen; Rakocevic, Goran; Popovic, Milos; Raicevic, Sava; Bila, Jelena; Antic, Darko; Andjelic, Bosko; Pavlovic, Sonja

    2016-01-01

    The existence of a potential primary central nervous system lymphoma-specific genomic signature that differs from the systemic form of diffuse large B cell lymphoma (DLBCL) has been suggested, but is still controversial. We investigated 19 patients with primary DLBCL of central nervous system (DLBCL CNS) using the TruSeq Amplicon Cancer Panel (TSACP) for 48 cancer-related genes. Next generation sequencing (NGS) analyses have revealed that over 80% of potentially protein-changing mutations were located in eight genes (CTNNB1, PIK3CA, PTEN, ATM, KRAS, PTPN11, TP53 and JAK3), pointing to the potential role of these genes in lymphomagenesis. TP53 was the only gene harboring mutations in all 19 patients. In addition, the presence of mutated TP53 and ATM genes correlated with a higher total number of mutations in other analyzed genes. Furthermore, the presence of mutated ATM correlated with poorer event-free survival (EFS) (p = 0.036). The presence of the mutated SMO gene correlated with earlier disease relapse (p = 0.023), inferior event-free survival (p = 0.011) and overall survival (OS) (p = 0.017), while mutations in the PTEN gene were associated with inferior OS (p = 0.048). Our findings suggest that the TP53 and ATM genes could be involved in the molecular pathophysiology of primary DLBCL CNS, whereas mutations in the PTEN and SMO genes could affect survival regardless of the initial treatment approach. PMID:27164089

  14. A station blackout simulation for the Advanced Neutron Source Reactor using the integrated primary and secondary system model

    SciTech Connect

    Schneider, E.A.

    1994-06-01

    The Advanced Neutron Source Reactor (ANSR) is a research reactor to be built at Oak Ridge National Laboratory. This paper deals with thermal-hydraulic analysis of ANSR`s cooling systems during nominal and transient conditions, with the major effort focusing upon the construction and testing of computer models of the reactor`s primary, secondary and reflector vessel cooling systems. The code RELAP5 was used to simulate transients, such as loss of coolant accidents and loss of off-site power, as well as to model the behavior of the reactor in steady state. Three stages are involved in constructing and using a RELAP5 model: (1) construction and encoding of the desired model, (2) testing and adjustment of the model until a satisfactory steady state is achieved, and (3) running actual transients using the steady-state results obtained earlier as initial conditions. By use of the ANSR design specifications, a model of the reactor`s primary and secondary cooling systems has been constructed to run a transient simulating a loss of off-site power. This incident assumes a pump coastdown in both the primary and secondary loops. The results determine whether the reactor can survive the transition from forced convection to natural circulation.

  15. Gene Mutation Profiles in Primary Diffuse Large B Cell Lymphoma of Central Nervous System: Next Generation Sequencing Analyses.

    PubMed

    Todorovic Balint, Milena; Jelicic, Jelena; Mihaljevic, Biljana; Kostic, Jelena; Stanic, Bojana; Balint, Bela; Pejanovic, Nadja; Lucic, Bojana; Tosic, Natasa; Marjanovic, Irena; Stojiljkovic, Maja; Karan-Djurasevic, Teodora; Perisic, Ognjen; Rakocevic, Goran; Popovic, Milos; Raicevic, Sava; Bila, Jelena; Antic, Darko; Andjelic, Bosko; Pavlovic, Sonja

    2016-01-01

    The existence of a potential primary central nervous system lymphoma-specific genomic signature that differs from the systemic form of diffuse large B cell lymphoma (DLBCL) has been suggested, but is still controversial. We investigated 19 patients with primary DLBCL of central nervous system (DLBCL CNS) using the TruSeq Amplicon Cancer Panel (TSACP) for 48 cancer-related genes. Next generation sequencing (NGS) analyses have revealed that over 80% of potentially protein-changing mutations were located in eight genes (CTNNB1, PIK3CA, PTEN, ATM, KRAS, PTPN11, TP53 and JAK3), pointing to the potential role of these genes in lymphomagenesis. TP53 was the only gene harboring mutations in all 19 patients. In addition, the presence of mutated TP53 and ATM genes correlated with a higher total number of mutations in other analyzed genes. Furthermore, the presence of mutated ATM correlated with poorer event-free survival (EFS) (p = 0.036). The presence of the mutated SMO gene correlated with earlier disease relapse (p = 0.023), inferior event-free survival (p = 0.011) and overall survival (OS) (p = 0.017), while mutations in the PTEN gene were associated with inferior OS (p = 0.048). Our findings suggest that the TP53 and ATM genes could be involved in the molecular pathophysiology of primary DLBCL CNS, whereas mutations in the PTEN and SMO genes could affect survival regardless of the initial treatment approach. PMID:27164089

  16. Belgian experience in applying the {open_quotes}leak-before-break{close_quotes} concept to the primary loop piping

    SciTech Connect

    Gerard, R.; Malekian, C.; Meessen, O.

    1997-04-01

    The Leak Before Break (LBB) concept allows to eliminate from the design basis the double-ended guillotine break of the primary loop piping, provided it can be demonstrated by a fracture mechanics analysis that a through-wall flaw, of a size giving rise to a leakage still well detectable by the plant leak detection systems, remains stable even under accident conditions (including the Safe Shutdown Earthquake (SSE)). This concept was successfully applied to the primary loop piping of several Belgian Pressurized Water Reactor (PWR) units, operated by the Utility Electrabel. One of the main benefits is to permit justification of supports in the primary loop and justification of the integrity of the reactor pressure vessel and internals in case of a Loss Of Coolant Accident (LOCA) in stretch-out conditions. For two of the Belgian PWR units, the LBB approach also made it possible to reduce the number of large hydraulic snubbers installed on the primary coolant pumps. Last but not least, the LBB concept also facilitates the steam generator replacement operations, by eliminating the need for some pipe whip restraints located close to the steam generator. In addition to the U.S. regulatory requirements, the Belgian safety authorities impose additional requirements which are described in details in a separate paper. An novel aspect of the studies performed in Belgium is the way in which residual loads in the primary loop are taken into account. Such loads may result from displacements imposed to close the primary loop in a steam generator replacement operation, especially when it is performed using the {open_quote}two cuts{close_quotes} technique. The influence of such residual loads on the LBB margins is discussed in details and typical results are presented.

  17. Primary lymphoma of the brain

    MedlinePlus

    Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; Lymphoma - brain ... The cause of primary brain lymphoma is not known. Patients who have a weakened immune system are at high risk of primary lymphoma of the ...

  18. Primary lymphoma of the brain

    MedlinePlus

    Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; Lymphoma - brain ... The cause of primary brain lymphoma is not known. People with a weakened immune system are at high risk for primary lymphoma of the brain. ...

  19. Using Principles of Complex Adaptive Systems to Implement Secondary Prevention of Coronary Heart Disease in Primary Care

    PubMed Central

    Kottke, Thomas E; Huebsch, Jacquelyn A; McGinnis, Paul; Nichols, Jolleen M; Parker, Emily D; Tillema, Juliana O; Maciosek, Michael V

    2016-01-01

    Context: Primary care practice. Objective: To test whether the principles of complex adaptive systems are applicable to implementation of team-based primary care. Design: We used complex adaptive system principles to implement team-based care in a private, five-clinic primary care practice. We compared randomly selected samples of patients with coronary heart disease (CHD) and diabetes before system implementation (March 1, 2009, to February 28, 2010) and after system implementation (December 1, 2011, to March 31, 2013). Main Outcome Measures: Rates of patients meeting the composite goals for CHD (blood pressure < 140/90 mmHg, low-density lipoprotein cholesterol level < 100 mg/dL, tobacco-free, and using aspirin unless contraindicated) and diabetes (CHD goal plus hemoglobin A1c concentration < 8%) before and after the intervention. We also measured provider and patient satisfaction with preventive services. Results: The proportion of patients with CHD who met the composite goal increased from 40.3% to 59.9% (p < 0.0001) because documented aspirin use increased (65.2%–97.5%, p < 0.0001) and attainment of the cholesterol goal increased (77.0%–83.9%, p = 0.0041). The proportion of diabetic patients meeting the composite goal rose from 24.5% to 45.4% (p < 0.0001) because aspirin use increased (58.6%–97.6%, p < 0.0001). Increased percentages of patients meeting the CHD and diabetes composite goals were not significantly different (p = 0.2319). Provider satisfaction with preventive services delivery increased significantly (p = 0.0017). Patient satisfaction improved but not significantly. Conclusion: Principles of complex adaptive systems can be used to implement team-based care systems for patients with CHD and possibly diabetic patients. PMID:26784851

  20. System Factors Affect the Recognition and Management of Post-Traumatic Stress Disorder by Primary Care Clinicians

    PubMed Central

    Meredith, Lisa S; Eisenman, David P; Green, Bonnie L; Basurto-Dávila, Ricardo; Cassells, Andrea; Tobin, Jonathan

    2009-01-01

    Background Post-traumatic stress disorder (PTSD) is common with an estimated prevalence of 8% in the general population and up to 17% in primary care patients. Yet, little is known about what determines primary care clinician’s (PCC) provision of PTSD care. Objective To describe PCC’s reported recognition and management of PTSD and identify how system factors affect the likelihood of performing clinical actions with regard to patients with PTSD or “PTSD treatment proclivity.” Design Linked cross-sectional surveys of medical directors and PCCs. Participants Forty-six medical directors and 154 PCCs in community health centers (CHCs) within a practice-based research network in New York and New Jersey. Measurements Two system factors (degree of integration between primary care and mental health services, and existence of linkages with other community, social, and legal services) as reported by medical directors, and PCC reports of self-confidence, perceived barriers, and PTSD treatment proclivity. Results Surveys from 47 (of 58) medical directors (81% response rate) and 154 PCCs (86% response rate). PCCs from CHCs with better mental health integration reported greater confidence, fewer barriers, and higher PTSD treatment proclivity (all p<.05). PCCs in CHCs with better community linkages reported greater confidence, fewer barriers, higher PTSD treatment proclivity, and lower proclivity to refer patients to mental health specialists or to use a “watch and wait” approach (all p<.05). Conclusion System factors play an important role in PCC PTSD management. Interventions are needed that restructure primary care practices by making mental health services more integrated and community linkages stronger. PMID:19433999

  1. Space Shuttle Program Primary Avionics Software System (PASS) Success Legacy - Major Accomplishments and Lessons Learned Detail Historical Timeline Analysis

    NASA Technical Reports Server (NTRS)

    Orr, James K.

    2010-01-01

    This presentation focuses on the Space Shuttle Primary Avionics Software System (PASS) and the people who developed and maintained this system. One theme is to provide quantitative data on software quality and reliability over a 30 year period. Consistent data relates to code break discrepancies. Requirements were supplied from external sources. Requirement inspections and measurements not implemented until later, beginning in 1985. Second theme is to focus on the people and organization of PASS. Many individuals have supported the PASS project over the entire period while transitioning from company to company and contract to contract. Major events and transitions have impacted morale (both positively and negatively) across the life of the project.

  2. Performance of the Primary Mirror Center-of-Curvature Optical Metrology System during Cryogenic Testing of the JWST Pathfinder Telescope

    NASA Technical Reports Server (NTRS)

    Hadaway, James B.; Wells, Conrad; Olczak, Gene; Waldman, Mark; Whitman, Tony; Cosentino, Joseph; Connolly, Mark; Chaney, David; Telfer, Randal

    2016-01-01

    The JWST primary mirror consists of 18 1.5 m hexagonal segments, each with 6-DoF and RoC adjustment. The telescope will be tested at its cryogenic operating temperature at Johnson Space Center. The testing will include center-of-curvature measurements of the PM, using the Center-of-Curvature Optical Assembly (COCOA) and the Absolute Distance Meter Assembly (ADMA). The performance of these metrology systems, including hardware, software, procedures, was assessed during two cryogenic tests at JSC, using the JWST Pathfinder telescope. This paper describes the test setup, the testing performed, and the resulting metrology system performance.

  3. Intrinsic subtypes and genomic signatures of primary breast cancer and prognosis after systemic relapse.

    PubMed

    Falato, Claudette; Tobin, Nicholas P; Lorent, Julie; Lindström, Linda S; Bergh, Jonas; Foukakis, Theodoros

    2016-04-01

    Molecular subtypes and gene expression signatures are widely used in early breast cancer but their role in metastatic disease is less explored. Two hundred-twenty patients diagnosed with primary breast cancer and subsequent relapse in Stockholm, Sweden between 1997 and 2006 were identified and their primary tumor was assessed for immunohistochemistry (IHC)- and PAM50-based subtypes, risk of recurrence (ROR-S) score, 21-gene and 70-gene signatures using research-based microarray expression profiles. Clinical and pathological data were retrospectively collected. Post-relapse survival within intrinsic subtypes and genomic signatures was investigated by Kaplan-Meier and Cox regression methods. ROR weighted for proliferation index (ROR-P) was explored and the prognostic contribution provided when combined to a clinical model estimated as change in LR- χ(2). IHC classified 27%, 24%, 36% and 13% of the tumors as luminal A, luminal B, HER2+ and triple negative, respectively. PAM50 categorized 22%, 24%, 26%, 22%, 6% of the tumors as luminal A, luminal B, HER2-enriched, basal-like and normal-like. Triple negative and basal tumors had a significantly shorter median post-relapse survival in comparison with luminal. Overall, neither IHC nor PAM50 subtypes, 21- and 70- gene profiles were prognostic in multivariable models. Low and medium ROR-S had a longer survival compared with the high-risk group (23 vs 10 months; p = 0.04). ROR-P independently correlated with post-relapse survival (p = 0.002) and provided the most significant prognostic information when added to a clinical model. ROR score from primary tumor represents an independent prognostic factor of post-relapse survival beyond classical clinical and pathological variables. PMID:26651914

  4. The Effect of Cinnamon on Menstrual Bleeding and Systemic Symptoms With Primary Dysmenorrhea

    PubMed Central

    Jaafarpour, Molouk; Hatefi, Masoud; Najafi, Fatemeh; Khajavikhan, Javaher; Khani, Ali

    2015-01-01

    Background: Primary dysmenorrhea with interferes in daily activities can have adverse effects on quality of life of women. Objectives: Regarding the use of herbal medicine, the aim of this study was to assess the effect of cinnamon on primary dysmenorrhea in a sample of Iranian female college students from Ilam University of Medical Sciences (west of Iran) during 2013-2014. Patients and Methods: In a randomized double-blind trial, 76 female student received placebo (n = 38, capsules containing starch, three times a day (TDS)) or cinnamon (n = 38, capsules containing 420 mg cinnamon, TDS) in 24 hours. Visual analogue scale (VAS) was used to determine the severity of pain and nausea. Vomiting and menstrual bleeding were assessed by counting the number of saturated pads. The parameters were recorded in the group during the first 72 hours of the cycle. Results: The mean amount of menstrual bleeding in the cinnamon group was significantly lower than the placebo group (P < 0.05 and P < 0.001, respectively). The mean pain severity score in the cinnamon group was less than the placebo group at various intervals (4.1 ± 0.5 vs. 6.1 ± 0.4 at 24 hours, 3.2 ± 0.6 vs. 6.1 ± 0.4 at 48 hours, and 1.8 ± 0.4 vs. 4.0 ± 0.3 at 72 hours, respectively) (P < 0.001). The mean severity of nausea and the frequencies of vomiting significantly decreased in the cinnamon group compared with the placebo group at various intervals (P < 0.001, P < 0.05). Conclusions: Regarding the significant effect of cinnamon on reduction of pain, menstrual bleeding, nausea and vomiting with primary dysmenorrhea without side effects, it can be regarded as a safe and effective treatment for dysmenorrhea in young women. PMID:26023350

  5. Development of a Primary Standard for Calibration of [18F]FDG Activity Measurement Systems

    NASA Astrophysics Data System (ADS)

    Capogni, M.; DeFelice, P.; Fazio, A.; Simonelli, F.; D'Ursi, V.; Pecorale, A.; Giliberti, C.; Abbas, K.

    2006-05-01

    The 18F national primary standard was developed by the INMRI-ENEA using the 4πβ Liquid Scintillation Spectrometry Method with 3H-Standard Efficiency Tracing. Measurements were performed at JRCIspra under a scientific collaboration between the Institute for Health and Consumer Production, the Amersham Health and the National Institute for Occupational Safety and Prevention (ISPESL). The goal of the work was to calibrate, with minimum uncertainty, the INMRI-ENEA transfer standard portable well-type ionisation chamber as well as other JRC-Ispra and Amersham Health reference Ionising Chambers used for FDG activity measurement.

  6. Unusual relapse of primary central nervous system lymphoma at site of lumbar puncture.

    PubMed

    Ahmed, Zartaj; Ramanathan, Ramesh K; Ram, Sunil; Newell, James; Halepota, Maqbool

    2014-01-01

    Primary CNS lymphoma (PCNSL) is a rare non-Hodgkin's lymphoma confined to the CNS. Local relapse of this disease is common, but extracranial or subcutaneous metastasis is rare with only a few cases being reported in literature. We report a 63-year-old male patient, who responded well to treatment for PCNSL but relapsed two and half years later with a lumbosacral nodule at the site of a previous lumbar puncture due to microscopic tumor seeding. Clinicians treating patients with PCNSL must remain alert to the possibility of extracranial solitary relapse even after the resolution of initial disease because prompt treatment can result in a good outcome. PMID:25093130

  7. Unusual Relapse of Primary Central Nervous System Lymphoma at Site of Lumbar Puncture

    PubMed Central

    Ramanathan, Ramesh K.; Ram, Sunil; Halepota, Maqbool

    2014-01-01

    Primary CNS lymphoma (PCNSL) is a rare non-Hodgkin's lymphoma confined to the CNS. Local relapse of this disease is common, but extracranial or subcutaneous metastasis is rare with only a few cases being reported in literature. We report a 63-year-old male patient, who responded well to treatment for PCNSL but relapsed two and half years later with a lumbosacral nodule at the site of a previous lumbar puncture due to microscopic tumor seeding. Clinicians treating patients with PCNSL must remain alert to the possibility of extracranial solitary relapse even after the resolution of initial disease because prompt treatment can result in a good outcome. PMID:25093130

  8. The design of an active support control system for a thin 1.2m primary mirror

    NASA Astrophysics Data System (ADS)

    Liu, Rong; Li, Xiaojin; Liu, Haitao; Wang, Hongqiao

    2014-09-01

    Active support system is a low-frequency wavefront error correction system, which is often used to correct the mirror deformation resulting from gravity, temperature, wind load, manufacture, installation and other factors. In addition, the active support technology can improve the efficiency of grinding and polishing by adjusting the surface shape in the process of manufacturing large mirrors. This article describes the design of an active support control system for a thin 1.2m primary mirror. The support system consists of 37 axial pneumatic actuators. And in order to change the shape of thin primary mirror we need to precisely control the 37 pneumatic actuators. These 37 pneumatic actuators are divided into six regions. Each region is designed with a control circuit board to realize force closed-loop control for the pneumatic actuators, and all control panels are connected to the PC by CAN bus. The control panels have to support: receive commands from the host PC; control the actuators; periodically return result of control. The whole control system is composed by hardware and control algorithm and communication program.

  9. Mineralized human primary osteoblast matrices as a model system to analyse interactions of prostate cancer cells with the bone microenvironment.

    PubMed

    Reichert, Johannes C; Quent, Verena M C; Burke, Leslie J; Stansfield, Scott H; Clements, Judith A; Hutmacher, Dietmar W

    2010-11-01

    Prostate cancer metastasis is reliant on the reciprocal interactions between cancer cells and the bone niche/micro-environment. The production of suitable matrices to study metastasis, carcinogenesis and in particular prostate cancer/bone micro-environment interaction has been limited to specific protein matrices or matrix secreted by immortalised cell lines that may have undergone transformation processes altering signaling pathways and modifying gene or receptor expression. We hypothesize that matrices produced by primary human osteoblasts are a suitable means to develop an in vitro model system for bone metastasis research mimicking in vivo conditions. We have used a decellularized matrix secreted from primary human osteoblasts as a model for prostate cancer function in the bone micro-environment. We show that this collagen I rich matrix is of fibrillar appearance, highly mineralized, and contains proteins, such as osteocalcin, osteonectin and osteopontin, and growth factors characteristic of bone extracellular matrix (ECM). LNCaP and PC3 cells grown on this matrix, adhere strongly, proliferate, and express markers consistent with a loss of epithelial phenotype. Moreover, growth of these cells on the matrix is accompanied by the induction of genes associated with attachment, migration, increased invasive potential, Ca(2+) signaling and osteolysis. In summary, we show that growth of prostate cancer cells on matrices produced by primary human osteoblasts mimics key features of prostate cancer bone metastases and thus is a suitable model system to study the tumor/bone micro-environment interaction in this disease. PMID:20688384

  10. How protein targeting to primary plastids via the endomembrane system could have evolved? A new hypothesis based on phylogenetic studies

    PubMed Central

    2013-01-01

    Background It is commonly assumed that a heterotrophic ancestor of the supergroup Archaeplastida/Plantae engulfed a cyanobacterium that was transformed into a primary plastid; however, it is still unclear how nuclear-encoded proteins initially were imported into the new organelle. Most proteins targeted to primary plastids carry a transit peptide and are transported post-translationally using Toc and Tic translocons. There are, however, several proteins with N-terminal signal peptides that are directed to higher plant plastids in vesicles derived from the endomembrane system (ES). The existence of these proteins inspired a hypothesis that all nuclear-encoded, plastid-targeted proteins initially carried signal peptides and were targeted to the ancestral primary plastid via the host ES. Results We present the first phylogenetic analyses of Arabidopsis thaliana α-carbonic anhydrase (CAH1), Oryza sativa nucleotide pyrophosphatase/phosphodiesterase (NPP1), and two O. sativa α-amylases (αAmy3, αAmy7), proteins that are directed to higher plant primary plastids via the ES. We also investigated protein disulfide isomerase (RB60) from the green alga Chlamydomonas reinhardtii because of its peculiar dual post- and co-translational targeting to both the plastid and ES. Our analyses show that these proteins all are of eukaryotic rather than cyanobacterial origin, and that their non-plastid homologs are equipped with signal peptides responsible for co-translational import into the host ES. Our results indicate that vesicular trafficking of proteins to primary plastids evolved long after the cyanobacterial endosymbiosis (possibly only in higher plants) to permit their glycosylation and/or transport to more than one cellular compartment. Conclusions The proteins we analyzed are not relics of ES-mediated protein targeting to the ancestral primary plastid. Available data indicate that Toc- and Tic-based translocation dominated protein import into primary plastids from the

  11. Development of Alternative Reductant Application in Pressurized Water Reactor Primary Systems

    NASA Astrophysics Data System (ADS)

    Domae, Masafumi; Kawamura, Hirotaka; Ohira, Taku

    In primary coolant of pressurized water reactors, high concentration dissolved hydrogen (DH) has been added, to prevent generation of oxidizing species through radiolysis of the coolant. Recently, number of ageing plants is increasing and utilities are concerned about primary water stress corrosion cracking (PWSCC). Some researchers consider that occurrence of PWSCC and crack propagation rate are affected by the DH concentration. The authors consider that one of possible mitigation methods toward PWSCC is use of alternative reductant in place of hydrogen. Because from the radiation chemical aspect aliphatic alcohols are typical scavengers of the oxidizing radical generated through the radiolysis of water, they are promising candidates of the alternative reductant. In the present work, possible alternatives of hydrogen were screened, and methanol was selected as the best candidate. Corrosion tests of type 304 stainless steels were carried out in high temperature water at 320°C without irradiation under two conditions: (1) DH 1.5 ppm (part per million) and (2) methanol 2.9 ppm. Electrochemical corrosion potential of the stainless steel specimens was measured during the immersion tests. After the immersion tests for 1500 h, surface morphology of the stainless steel specimens was observed by scanning probe microscope. Major component of the oxide film formed on the stainless steel specimens was analyzed by X-ray diffraction. From comparison of the test results, it is concluded that addition of 2.9 ppm methanol has almost the same effect on corrosion environment as DH 1.5 ppm addition.

  12. Whole slide images for primary diagnostics of urinary system pathology: a feasibility study

    PubMed Central

    Al-Janabi, Shaimaa; Huisman, André; Jonges, Geertruida N.; ten Kate, Fiebo J.W.; Goldschmeding, Roel; van Diest, Paul J.

    2014-01-01

    Introduction: During the last decade, whole slide images (WSI) have been used in many areas of pathology such as teaching, research, digital archiving, teleconsultation and quality assurance testing. However, WSI have as yet not much been used for upfront diagnostics because of the lack of validation studies. Objectives: The aim of this study was to test the feasibility of WSI for primary diagnosis of urinary tract pathology. Materials and Methods: 100 consecutive urinary tract biopsies and resections which had been diagnosed conventionally between the years 2008-2009 were scanned at 20× magnification, and rediagnosed by two pathologists on WSI, having the original clinical information available, but blinded to the original diagnoses. Original and WSI diagnoses were compared and classified as concordant, slightly discordant (without clinical consequences) and discordant. Results: Original and WSI based rediagnosis were concordant in 87% of the cases. Original and WSI diagnosis were slightly discordant in 8% of cases. Major discrepancies with clinical or prognostic implications were founded in only 5 cases. However, for 6 out of the 13 discrepancies, WSI based diagnoses were considered to be better than the original diagnoses. Conclusion: Primary diagnostics of urinary tract specimens can be reliably done on WSI. Further improvements of image resolution may help to increase diagnostic accuracy and WSI acceptance in routine pathology. PMID:25610886

  13. Designing for Risk Assessment Systems for Patient Triage in Primary Health Care: A Literature Review

    PubMed Central

    Carvalho, Paulo Victor Rodrigues

    2016-01-01

    Background This literature review covers original journal papers published between 2011 and 2015. These papers review the current status of research on the application of human factors and ergonomics in risk assessment systems’ design to cope with the complexity, singularity, and danger in patient triage in primary health care. Objective This paper presents a systematic literature review that aims to identify, analyze, and interpret the application of available evidence from human factors and ergonomics to the design of tools, devices, and work processes to support risk assessment in the context of health care. Methods Electronic search was performed on 7 bibliographic databases of health sciences, engineering, and computer sciences disciplines. The quality and suitability of primary studies were evaluated, and selected papers were classified according to 4 classes of outcomes. Results A total of 1845 papers were retrieved by the initial search, culminating in 16 selected for data extraction after the application of inclusion and exclusion criteria and quality and suitability evaluation. Conclusions Results point out that the study of the implications of the lack of understanding about real work performance in designing for risk assessment in health care is very specific, little explored, and mostly focused on the development of tools. PMID:27528543

  14. Task overlap among primary care team members: an opportunity for system redesign?

    PubMed

    Best, Richard G; Hysong, Sylvia J; Pugh, Jacqueline A; Ghosh, Suvro; Moore, Frank I

    2006-01-01

    This article presents the results of research on a systematic approach to the assignment of primary care work in the Veterans Health Administration. Based on a functional job analysis protocol, the study identified overlap in the performance of primary care tasks among multiple occupational groups as prima facie evidence of opportunities to reallocate work responsibilities. Results show that registered nurses, physicians, advanced practitioners, and licensed vocational nurses reported performing 60 percent to 97 percent of the same tasks, while clerks and health technicians appeared to be underutilized. The frequency and duration with which occupational groups performed each task were also examined, providing additional evidence to be used in improving clinic efficiency. The management of healthcare personnel can be improved through systematic analysis of the work, the worker, and the work organization and through more informed decisions about the appropriateness of task assignment (or reassignment). This article presents an evidence-based approach to personnel management with important implications for clinic efficiency. The approach can be used to guide strategic planning and staffing decisions by identifying not only who currently does the work but, more importantly, who should be doing the work given the full array of data. PMID:17039689

  15. Experimental investigation on circumferential and axial temperature gradient over fuel channel under LOCA

    NASA Astrophysics Data System (ADS)

    Yadav, Ashwini Kumar; kumar, Ravi; Gupta, Akhilesh; Chatterjee, Barun; Mukhopadhyay, Deb; Lele, H. G.

    2014-06-01

    In a nuclear reactor temperature rises drastically in fuel channels under loss of coolant accident due to failure of primary heat transportation system. Present investigation has been carried out to capture circumferential and axial temperature gradients during fully and partially voiding conditions in a fuel channel using 19 pin fuel element simulator. A series of experiments were carried out by supplying power to outer, middle and center rods of 19 pin fuel simulator in ratio of 1.4:1.1:1. The temperature at upper periphery of pressure tube (PT) was slightly higher than at bottom due to increase in local equivalent thermal conductivity from top to bottom of PT. To simulate fully voided conditions PT was pressurized at 2.0 MPa pressure with 17.5 kW power injection. Ballooning initiated from center and then propagates towards the ends and hence axial temperature difference has been observed along the length of PT. For asymmetric heating, upper eight rods of fuel simulator were activated and temperature difference up-to 250 °C has been observed from top to bottom periphery of PT. Such situation creates steep circumferential temperature gradient over PT and could lead to breaching of PT under high pressure.

  16. Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria

    PubMed Central

    Garg, Lalit; Eze, Godson

    2016-01-01

    Background Nigeria contributes only 2% to the world’s population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. Objective The purpose of this study was to document costs associated with a mobile technology–supported, community-based health insurance scheme. Methods This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. Results All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (P<.001). This indicates that average out-of-pocket cost of services at private health care facilities is significantly

  17. EULAR Sjogren's syndrome disease activity index: development of a consensus systemic disease activity index for primary Sjogren's syndrome

    PubMed Central

    Seror, Raphaèle; Ravaud, Philippe; Bowman, Simon; Baron, Gabriel; Tzioufas, Athanasios; Theander, Elke; Gottenberg, Jacques-Eric; Bootsma, Hendrika; Mariette, Xavier; Vitali, Claudio

    2010-01-01

    Objective To develop a disease activity index for patients with primary Sjögren’s syndrome (SS): the European League Against Rheumatism (EULAR) Sjögren’s Syndrome Disease Activity Index (ESSDAI). Methods Thirty-nine SS experts participated in an international collaboration, promoted by EULAR, to develop the ESSDAI. Experts identified 12 organ-specific “domains” contributing to disease activity. For each domain, features of disease activity were classified in 3 or 4 levels according to their severity. Data abstracted from 96 patients with systemic complications of primary SS were used to generate 702 realistic vignettes for which all possible systemic complications were represented. Using the 0–10 physician global assessment (PhGA) scale, each expert scored the disease activity of 5 patient profiles and 20 realistic vignettes. Multiple regression modelling, with PhGA used as the dependent variable, was used to estimate the weight of each domain. Results All 12 domains were significantly associated with disease activity in the multivariate model, domain weights ranged from 1 to 6. The ESSDAI scores varied from 2 to 47 and were significantly correlated with PhGA for both real patient profiles and realistic vignettes (r=0.61 and r=0.58, respectively, p<0.0001). Compared to 57 (59.4%) of the real patient profiles, 468 (66.7%) of the realistic vignettes were considered likely or very likely to be true. Conclusion The ESSDAI is a clinical index designed to measure disease activity in patients with primary SS. Once validated, such a standardized evaluation of primary SS should facilitate clinical research and should be helpful as an outcome measure in clinical trials. PMID:19561361

  18. Physician user satisfaction with an electronic medical records system in primary healthcare centres in Al Ain: a qualitative study

    PubMed Central

    Al Alawi, Shamma; Al Dhaheri, Aysha; Al Baloushi, Durra; Al Dhaheri, Mouza; Prinsloo, Engela A M

    2014-01-01

    Objectives To explore physician satisfaction with an electronic medical records (EMR) system, to identify and explore the main limitations of the system and finally to submit recommendations to address these limitations. Design A descriptive qualitative study that entailed three focus group interviews was performed among physicians using open-ended questions. The interviews were audiotaped, documented and transcribed verbatim. The themes were explored and analysed in different categories. Setting The study was conducted in primary healthcare centres (PHC) in Al Ain, United Arab Emirates (UAE). Participants A total of 23 physicians, all using the same EMR system, attended one of three focus groups held in PHC in Al Ain Medical District. Each focus group consisted of 7–9 physicians working in PHC as family medicine specialists, residents or general practitioners. Primary outcome measure Physician satisfaction with the EMR system. Results Key themes emerged and were categorised as physician-dependent, patient-related and system-related factors. In general, physicians were satisfied with the EMR system in spite of initial difficulties with implementation. Most participants identified that the long time required to do the documentation affected their practice and patient communication. Many physicians expressed satisfaction with the orders and results of laboratory and radiology functions and they emphasised that this was the strongest point in the EMR. They were also satisfied with the electronic prescription function, stating that it reduced errors and saved time. Conclusions Physicians are satisfied with the EMR and have a positive perception regarding the application of the system. Several themes emerged during this study that need to be considered to enhance the EMR system. Further studies need to be conducted among other healthcare practitioners and patients to explore their attitude and perception about the EMR. PMID:25377010

  19. National healthcare information system in Croatian primary care: the foundation for improvement of quality and efficiency in patient care.

    PubMed

    Gvozdanović, Darko; Koncar, Miroslav; Kojundzić, Vinko; Jezidzić, Hrvoje

    2007-01-01

    In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1) to provide efficient healthcare-related data management in support of decision-making processes; (2) to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS) on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories) into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution. PMID:18005567

  20. A contemporary look at the sedimentary system of the coastal sabkha of Abu Dhabi (UAE): Primary deposition vs. early diagenesis

    NASA Astrophysics Data System (ADS)

    Paul, Andreas; Wang, Jiayi; Court, Wesley; Lokier, Stephen

    2016-04-01

    More than half a century ago, the Abu Dhabi coastline was subject to intensive research efforts by institutions from all over the world. This activity was mostly related to the onset of oil exploration in the region and the hypothesis that the modern Abu Dhabi Sabkha provides a direct analogue to the ancient deposits of the hydrocarbon-bearing Arab Formation. While research initially concentrated on a characterisation of the bulk depositional system, focus has recently shifted to answer more specific questions such as the role of microbial mats in the formation of dolomite. Through this shift to a smaller scale, the remainder of the sabkha, including its microbial mats, was neglected and little further activity was undertaken to characterise the coastal sabkha using modern, state-of-the-art, research tools and methods. This paper will not attempt to reinvent the wheel with respect to the work of the early researchers; we will instead present an updated model of the sedimentary system of the coastal sabkha of Abu Dhabi. This model will focus on establishing the relationship and controlling factors between primary deposits of the carbonate ramp system and secondary early diagenetic precipitates. Initial results show that primary deposits of the UAE's carbonate ramp are equivalent to carbonate mudstones, packstones, grainstones, and occasional rudstones with a packstone matrix, that form above a Holocene to Recent hardground. These deposits occur mostly in a subtidal to lower intertidal setting, landward of which they are gradually being covered by a green cyanobacterial layer that binds the primarily unconsolidated sediment. Further landward, in the middle and upper intertidal zones, these cyanobacterial layers grade into more complex microbial mat layers of potentially highly diverse bacterial and algal faunal composition. Microbial mat layers in the upper intertidal and the lower supratidal zones are increasingly interspersed with gypsum crystals and white

  1. Primary traits of Eysenck's P-E-N system: three- and five-factor solutions.

    PubMed

    Costa, P T; McCrae, R R

    1995-08-01

    The Eysenck Personality Profiler (EPP), a set of 21 scales measuring primary traits hypothesized to be definers of Neuroticism, Extraversion, and Psychoticism factors, was administered to 229 adults together with the Eysenck Personality Questionnaire--Revised (H. J. Eysenck & S. B. G. Eysenck, 1991) and the Revised NEO Personality Inventory (NEO-PI-R; P. T. Costa & R. R. McCrae, 1992b). Correlations of EPP scales with NEO-PI-R facet scales provided preliminary evidence supporting the convergent and discriminant validity of the EPP scales. However, varimax and targeted validimax factor analyses suggested that some EPP scales were misclassified and that EPP scales could better be understood in terms of the 5-factor model than the intended 3-factor model. PMID:7643307

  2. Constraining geochemistry and biological primary productivity in hydrothermal systems via in situ mass spectrometric geochemical mapping

    NASA Astrophysics Data System (ADS)

    Vidoudez, Charles; Marcon, Yann; Bach, Wolfgang; Lebris, Nadine; Dubilier, Nicole; Girguis, Peter

    2014-05-01

    Hydrothermal vent ecosystems are biological hot spots, supported by chemoautotrophic primary productivity and achieving densities comparable to rainforests. Nevertheless, our understanding of the geochemical factors that govern the distribution of animals and microbes within vents is limited. It is well known that vent endemic organisms are found in specific vent "microenvironments", and that these microenvironments are distributed -coarsely speaking- in predictable patterns within a vent field. However, the relative differences in activity among these faunal patches, and their role in influencing geochemical flux remains largely unknown due to historical limitations in our ability to sample and quantify geochemical constituents with fine spatial resolution. In particular, the distribution of biologically important volatiles around vent fields is poorly constrained, as is the degree to which their distribution influences the destiny and distribution of organisms. To characterize the relationship between the distribution of volatiles, chemosynthetic microbes, and chemosynthetic symbioses, we generated detailed geo-referenced maps of methane, hydrogen sulfide, carbon dioxide and oxygen (four of the key volatiles that are both vent- and seawater derived) using an in situ mass spectrometer (ISMS). We characterized these concentrations in over 130 spots across three vent sites associated with the mid-Atlantic ridge in the Menez Gwen vent field. We quantified gases in sites ranging from hot fluids to mussel beds, and found notable relationships between the distribution and consumption of hydrogen sulfide and methane and the animal and microbial communities. Finally, we also developed a metabolic energy "map", which enables us to constrain both the potential energy that is available to these communities as well as the extent to which it is being used, and places constraints on the extent of primary production that can be supported by the realized use of these volatiles.

  3. Non-categorical problem lists in a primary-care information system.

    PubMed Central

    Wilton, R.

    1991-01-01

    An ambulatory-care patient-tracking system has been implemented that records non-categorical problem descriptions in the outpatient problem list. The system does not restrict physicians to the use of predefined diagnostic categories. Instead, the system stores patient problems in a database as free-text records. Subsequent diagnostic categorization and coding is accomplished through prompted free-text input and appropriate reference databases. This system design allows an outpatient problem-list summary to reflect non-categorical health-status information in addition to coded medical diagnoses. PMID:1807721

  4. Primary healthcare information system--the cornerstone for the next generation healthcare sector in Republic of Croatia.

    PubMed

    Koncar, Miroslav; Gvozdanović, Darko

    2006-01-01

    At no time in the history of medicine has the growth in knowledge and technologies been so profound [Crossing the Quality Chasm: A New Health System for the 21st Century, Institute of Medicine (IOM), 2001. ISBN 0-309-07280-8]. However, healthcare delivery systems today are not able to keep up with the pace. Studies have shown that it takes an average of about 17 years for new knowledge generated by randomized trials to be incorporated into practice [B. Andrew, S. Boren, Managing clinical knowledge for health care improvement, in: Yearbook of Medical Informatics, National Library of Medicine, Bethesda, MD, 2000, pp. 65-70]. It is safe to say that today healthcare systems "have the data, but not information". In order to provide highest quality patient care, Republic of Croatia has started the process of introducing enterprise information systems to support business processes in the healthcare domain. Two major requirements are in focus: to provide efficient healthcare related data management in support of decision-making processes; and to support continuous process of healthcare resources spending optimization. The first initiated project refers to Primary Healthcare Information System (PHCIS) that provides domain of primary care with state-of-the-art enterprise information system that connects General Practitioners, Pediatricians and Gynecologists offices with the Croatian Institute for Health Insurance and Public Health Institute. In the years to come, PHCIS will serve as the main integration platform for connecting all other stakeholders and levels of healthcare (e.g. hospitals, pharmacies, laboratories) into single enterprise healthcare network. This article gives an overview of PHCIS, explains challenges that were faced in designing and implementing the system, and elaborates PHCIS role as the cornerstone for the next generation healthcare provisioning in Republic of Croatia. PMID:16213189

  5. Two-phase performance of scale models of a primary coolant pump. Final report

    SciTech Connect

    Kamath, P.S.; Swift, W.L.

    1982-09-01

    Scale models of PWR primary coolant pumps were tested in steady and transient two-phase flows in order to generate a data base to aid in the development and assessment of pump performance models for use in computer codes for the analysis of postulated Loss-of-Coolant Accidents (LOCA). This report summarizes and unifies the single and two-phase air/water and steam/water performance data on the relatively high specific speed pumps (4200 rpm (US gpm) /sup 1/2//ft /sup 3/4/) tested in these programs. These data are compared with those acquired from tests on the lower specific speed Semiscale pump (926 rpm (US gpm)/sup 1/2//ft/sup 3/4/) to better understand the mechanism of performance degradation with increasing void fraction. The study revealed that scaling down the size of the pump while maintaining the same design specific speed produces very similar performance characteristics both in single and two-phase flows. Effects due to size and operating speed were not discernible within the range of test conditions and within experimental uncertainties. System pressure appears to affect the rate of degradation as a function of void fraction. The report includes a survey of the existing two-phase pump performance correlations. A correlation synthesized from the B and W, C-E and Creare two-phase data is also presented.

  6. Towards a Healthy District: Organizing and Managing District Health Systems Based on Primary Health Care.

    ERIC Educational Resources Information Center

    Tarimo, E.

    This book is concerned with orienting health care workers in district health systems in developing countries to ways and means of overcoming problems, and describes briefly how district health systems can be improved. The book is organized around nine issues in nine chapters, each of which is an integral part of a district planning cycle. The…

  7. DEVELOPMENT OF A TOXICITY TEST SYSTEM USING PRIMARY RAT LIVER CELLS

    EPA Science Inventory

    A model in vitro rat liver parenchymal cellular toxicity system employing cells obtained by the in situ collagenase perfusion technique has been developed to detect potential liver toxicants. The initial evaluation of this test system was accomplished using cadmium chloride, chro...

  8. Sex Determination in the Fly Megaselia Scalaris, a Model System for Primary Steps of Sex Chromosome Evolution

    PubMed Central

    Traut, W.

    1994-01-01

    The fly Megaselia scalaris Loew possesses three homomorphic chromosome pairs; 2 is the sex chromosome pair in two wild-type laboratory stocks of different geographic origin (designated ``original'' sex chromosome pair in this paper). The primary male-determining function moves at a very low rate to other chromosomes, thereby creating new Y chromosomes. Random amplified polymorphic DNA markers obtained by polymerase chain reaction with single decamer primers and a few available phenotypic markers were used in testcrosses to localize the sex-determining loci and to define the new sex chromosomes. Four cases are presented in which the primary male-determining function had been transferred from the original Y chromosome to a new locus either on one of the autosomes or on the original X chromosome, presumably by transposition. In these cases, the sex-determining function had moved to a different locus without an obvious cotransfer of other Y chromosome markers. Thus, with Megaselia we are afforded an experimental system to study the otherwise hypothetical primary stages of sex chromosome evolution. An initial molecular differentiation is apparent even in the new sex chromosomes. Molecular differences between the original X and Y chromosomes illustrate a slightly more advanced stage of sex chromosome evolution. PMID:8005417

  9. The Role of Nature and Nurture for Individual Differences in Primary Emotional Systems: Evidence from a Twin Study.

    PubMed

    Montag, Christian; Hahn, Elisabeth; Reuter, Martin; Spinath, Frank M; Davis, Ken; Panksepp, Jaak

    2016-01-01

    The present study investigated for the first time the relative importance of genetics and environment on individual differences in primary emotionality as measured with the Affective Neuroscience Personality Scales (ANPS) by means of a twin-sibling study design. In N = 795 participants (n = 303 monozygotic twins, n = 172 dizygotic twins and n = 267 non-twin full siblings), moderate to strong influences of genetics on individual differences in these emotional systems are observed. Lowest heritability estimates are presented for the SEEKING system (33%) and highest for the PLAY system (69%). Further, multivariate genetic modeling was applied to the data showing that associations among the six ANPS scales were influences by both, a genetic as well as an environmental overlap between them. In sum, the study underlines the usefulness of the ANPS for biologically oriented personality psychology research. PMID:26999649

  10. Biotechnological reduction of sulfide in an industrial primary wastewater treatment system: A sustainable and successful case study

    SciTech Connect

    Rajamani, S.

    1996-12-31

    The leather industry is an important export-oriented industry in India, with more than 3,000 tanneries located in different clusters. Sodium sulfide, a toxic chemical, is used in large quantities to remove hair and excess flesh from hides and skins. Most of the sodium sulfide used in the process is discharged as waste in the effluent, which causes serious environmental problems. Reduction of sulfide in the effluent is generally achieved by means of chemicals in the pretreatment system, which involves aerobic mixing using large amounts of chemicals and high energy, and generating large volumes of sludge. A simple biotechnological system that uses the residual biosludge from the secondary settling tank was developed, and the commercial-scale application established that more than 90% of the sulfide could be reduced in the primary treatment system. In addition to the reduction of sulfide, foul smells, BOD and COD are reduced to a considerable level. 3 refs., 2 figs., 1 tab.

  11. A portable system for identifying urinary tract infection in primary care using a PC-based chromatic technique.

    PubMed

    Deakin, A G; Jones, G R; Spencer, J W; Bongard, E J; Gal, M; Sufian, A T; Butler, C C

    2014-05-01

    An approach is described for monitoring urine samples using a portable system based on chromatic techniques and for predicting urinary tract infection (UTI) from the results. The system uses a webcam-computer combination with the screen of a computer visual display unit as a tuneable illumination source. It is shown that the system can operate in a robust manner under ambient lighting conditions and with potential for use as a point of care test in primary care. The present approach combines information on urine liquid concentration and turbidity. Its performance in an exploratory study is compared with microbiological culture of 200 urine samples, of which 79 had bacterial growth >10(5) colony forming unit/millilitre (cfu ml(-1)) indicative of UTI. It is shown that both sensitivity and negative predictive value of 0.92 could be achieved. PMID:24682226

  12. The Role of Nature and Nurture for Individual Differences in Primary Emotional Systems: Evidence from a Twin Study

    PubMed Central

    Reuter, Martin; Spinath, Frank M.; Davis, Ken; Panksepp, Jaak

    2016-01-01

    The present study investigated for the first time the relative importance of genetics and environment on individual differences in primary emotionality as measured with the Affective Neuroscience Personality Scales (ANPS) by means of a twin-sibling study design. In N = 795 participants (n = 303 monozygotic twins, n = 172 dizygotic twins and n = 267 non-twin full siblings), moderate to strong influences of genetics on individual differences in these emotional systems are observed. Lowest heritability estimates are presented for the SEEKING system (33%) and highest for the PLAY system (69%). Further, multivariate genetic modeling was applied to the data showing that associations among the six ANPS scales were influences by both, a genetic as well as an environmental overlap between them. In sum, the study underlines the usefulness of the ANPS for biologically oriented personality psychology research. PMID:26999649

  13. Epstein-Barr and human immunodeficiency viruses in acquired immunodeficiency syndrome-related primary central nervous system lymphoma.

    PubMed Central

    Morgello, S.

    1992-01-01

    The prevalence of Epstein-Barr virus (EBV) and human immunodeficiency virus (HIV) in acquired immunodeficiency syndrome (AIDS)-related primary central nervous system (CNS) lymphoma was examined. Deoxyribonucleic acid (DNA) extracted from 12 formalin-fixed, paraffin-embedded tumors was used as substrate for the polymerase chain reaction (PCR). Targets for amplification were the EBNA-1 region of EBV, the gag region of HIV, and a single copy cellular sequence as a control. The cases studied were autopsy and surgical specimens collected between the years 1985 and 1989. By the working formulation for non-Hodgkin's lymphomas, five had large cell, four had mixed large and small cleaved cell, two had small cleaved cell, and one had an unclassified histology. Epstein-Barr virus was detected in 6 of 12 tumors studied. Human immunodeficiency virus was not detected in any of the tumors. The presence of EBV was not correlated with any particular histologic tumor type. It is concluded that EBV, not HIV, can be detected in a large percentage (50%) of AIDS-related primary central nervous system (CNS) lymphomas. This viral association may be significant in light of the demonstrated ability of EBV to induce lymphoid tumors in experimental mammalian systems. Images Figure 1 Figure 2 PMID:1323221

  14. Profiling bioactivity of the ToxCast chemical library using BioMAP primary human cell systems.

    PubMed

    Houck, Keith A; Dix, David J; Judson, Richard S; Kavlock, Robert J; Yang, Jian; Berg, Ellen L

    2009-10-01

    The complexity of human biology has made prediction of health effects as a consequence of exposure to environmental chemicals especially challenging. Complex cell systems, such as the Biologically Multiplexed Activity Profiling (BioMAP) primary, human, cell-based disease models, leverage cellular regulatory networks to detect and distinguish chemicals with a broad range of target mechanisms and biological processes relevant to human toxicity. Here the authors use the BioMAP human cell systems to characterize effects relevant to human tissue and inflammatory disease biology following exposure to the 320 environmental chemicals in the Environmental Protection Agency's (EPA's) ToxCast phase I library. The ToxCast chemicals were assayed at 4 concentrations in 8 BioMAP cell systems, with a total of 87 assay endpoints resulting in more than 100,000 data points. Within the context of the BioMAP database, ToxCast compounds could be classified based on their ability to cause overt cytotoxicity in primary human cell types or according to toxicity mechanism class derived from comparisons to activity profiles of BioMAP reference compounds. ToxCast chemicals with similarity to inducers of mitochondrial dysfunction, cAMP elevators, inhibitors of tubulin function, inducers of endoplasmic reticulum stress, or NFkappaB pathway inhibitors were identified based on this BioMAP analysis. This data set is being combined with additional ToxCast data sets for development of predictive toxicity models at the EPA. PMID:19773588

  15. SURFACE ARTHROPLASTY FOR TREATING PRIMARY AND/OR SECONDARY SHOULDER OSTEOARTHROSIS BY MEANS OF THE HEMICAP-ARTHROSURFACE® SYSTEM

    PubMed Central

    Visco, Adalberto; Vieira, Luis Alfredo Gómez; Gonçalves, Felipe Borges; Fernandes, Luis Filipe Daneu; dos Santos, Murilo Cunha Rafael; Filho, Nivaldo Souza Cardozo; Cordero, Nicolas Gerardo Gómez

    2015-01-01

    Objective: To present the surgical technique for the He-miCAP-Arthrosurface® system and evaluate our results from this technique for treating primary and/or secondary shoulder osteoarthrosis. Method: Between June 2007 and June 2009, 10 shoulders of 10 patients (nine with primary osteoarthrosis and one with avascular necrosis of the humeral head) underwent surface arthroplasty using the HemiCAP-Arthrosurface® system to correct the problem. The follow-up time ranged from six to 29 months (mean of 17 months). The patients’ ages ranged from 62 to 73 years (mean of 67.5 years). Six patients were female and four patients were male. The patients were followed up weekly for the first month after the surgical procedure and every three months thereafter. The clinic evaluation was done using the criteria of the University of California at Los Angeles (UCLA) and a visual analogue pain scale. Results: All the patients said that they were satisfied with the results from the surgical treatment, with a mean UCLA score of 30 points and a mean analogue pain score of two points. Conclusion: The HemiCAP-Arthrosurface® system for shoulder surgery for a specific group of patients is a technique that preserves the bone stock with good functional and antalgic results. PMID:27047820

  16. Reversible cerebral vasoconstriction syndromes and primary angiitis of the central nervous system: clinical, imaging, and angiographic comparison.

    PubMed

    Singhal, Aneesh B; Topcuoglu, Mehmet A; Fok, Joshua W; Kursun, Oguzhan; Nogueira, Raul G; Frosch, Matthew P; Caviness, Verne S

    2016-06-01

    Reversible cerebral vasoconstriction syndromes (RCVS) and primary angiitis of the central nervous system (PACNS) are invariably considered in the differential diagnosis of new cerebral arteriopathies. However, prompt and accurate diagnosis remains challenging. Here we compared the features of 159 RCVS to 47 PACNS patients and developed criteria for prompt bedside diagnosis. Recurrent thunderclap headache (TCH), and single TCH combined with either normal neuroimaging, border zone infarcts, or vasogenic edema, have 100% positive predictive value for diagnosing RCVS or RCVS-spectrum disorders. In patients without TCH and positive angiography, neuroimaging can discriminate RCVS (no lesion) from PACNS (deep/brainstem infarcts). Ann Neurol 2016;79:882-894. PMID:27043703

  17. Structural Arrangement Trade Study. Volume 1: Reusable Hydrogen Composite Tank System (RHCTS) and Graphite Composite Primary Structures (GCPS). Executive summary

    NASA Technical Reports Server (NTRS)

    1995-01-01

    This volume is the first of a three volume set that discusses the structural arrangement trade study plan that will identify the most suitable configuration for an SSTO winged vehicle capable of delivering 25,000 lbs to a 220 nm circular orbit at 51.6 deg inclination. The Reusable Hydrogen Composite Tank System (RHCTS), and Graphite Composite Primary Structures most suitable for intertank, wing and thrust structures are identified. This executive summary presents the trade study process, the selection process, requirements used, analysis performed and data generated. Conclusions and recommendations are also presented.

  18. Presence of Systemic Inflammatory Response Syndrome Predicts a Poor Clinical Outcome in Dogs with a Primary Hepatitis.

    PubMed

    Kilpatrick, Scott; Dreistadt, Margaret; Frowde, Polly; Powell, Roger; Milne, Elspeth; Smith, Sionagh; Morrison, Linda; Gow, Adam G; Handel, Ian; Mellanby, Richard J

    2016-01-01

    Primary hepatopathies are a common cause of morbidity and mortality in dogs. The underlying aetiology of most cases of canine hepatitis is unknown. Consequently, treatments are typically palliative and it is difficult to provide accurate prognostic information to owners. In human hepatology there is accumulating data which indicates that the presence of systemic inflammatory response syndrome (SIRS) is a common and debilitating event in patients with liver diseases. For example, the presence of SIRS has been linked to the development of complications such as hepatic encephalopathy (HE) and is associated with a poor clinical outcome in humans with liver diseases. In contrast, the relationship between SIRS and clinical outcome in dogs with a primary hepatitis is unknown. Seventy dogs with histologically confirmed primary hepatitis were enrolled into the study. Additional clinical and clinicopathological information including respiratory rate, heart rate, temperature, white blood cell count, sodium, potassium, sex, presence of ascites, HE score, alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin and red blood cell concentration were available in all cases. The median survival of dogs with a SIRS score of 0 or 1 (SIRS low) was 231 days compared to a median survival of 7 days for dogs with a SIRS score of 2, 3 or 4 (SIRS high) (p<0.001). A Cox proportional hazard model, which included all other co-variables, revealed that a SIRS high score was an independent predictor of a poor clinical outcome. The effect of modulating inflammation on treatment outcomes in dogs with a primary hepatitis is deserving of further study. PMID:26808672

  19. Integrated system to automatize information collecting for the primary health care at home.

    PubMed

    Oliveira, Edson N; Cainelli, Jean; Pinto, Maria Eugênia B; Cazella, Silvio C; Dahmer, Alessandra

    2013-01-01

    Data collected in a consistent manner is the basis for any decision making. This article presents a system that automates data collection by community-based health workers during their visits to the residences of users of the Brazilian Health Care System (Sistema Único de Saúde - SUS) The automated process will reduce the possibility of mistakes in the transcription of visit information and make information readily available to the Ministry of Health. Furthermore, the analysis of the information provided via this system can be useful in the implementation of health campaigns and in the control of outbreaks of epidemiological diseases. PMID:23920593

  20. Integrated guidance, navigation and control verification plan primary flight system. [space shuttle avionics integration

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The verification process and requirements for the ascent guidance interfaces and the ascent integrated guidance, navigation and control system for the space shuttle orbiter are defined as well as portions of supporting systems which directly interface with the system. The ascent phase of verification covers the normal and ATO ascent through the final OMS-2 circularization burn (all of OPS-1), the AOA ascent through the OMS-1 burn, and the RTLS ascent through ET separation (all of MM 601). In addition, OPS translation verification is defined. Verification trees and roadmaps are given.

  1. Primary care and reform of health systems: a framework for the analysis of Latin American experiences.

    PubMed

    Frenk, J; González-Block, M A

    1992-03-01

    The article first proposes a framework within which to assess the potential of health sector reforms in Latin America for primary health care (PHC). Two dimensions are recognized: the scope of the reforms, content, and the means of participation that are put into play. This framework is then complemented through a critique of the often-sought but little-analyzed PHC reform strategies of decentralization and health sector integration. The analytical framework is next directed to the financing of health services, a chief aspect of any reform aiming toward PHC. Two facets of health service finance are first distinguished: its formal aspect as a means for economic subsistence and growth, and its substantive aspect as a means to promote the rational use of services and thus improvement of health. Once finance is understood in this microeconomic perspective, the focus shifts to the analysis of health care reforms at the macro, health policy level. The article concludes by positing that PHC is in essence a new health care paradigm, oriented by the values of universality, redistribution, integration, plurality, quality, and efficiency. PMID:10118440

  2. A fully automated primary screening system for the discovery of therapeutic antibodies directly from B cells.

    PubMed

    Tickle, Simon; Howells, Louise; O'Dowd, Victoria; Starkie, Dale; Whale, Kevin; Saunders, Mark; Lee, David; Lightwood, Daniel

    2015-04-01

    For a therapeutic antibody to succeed, it must meet a range of potency, stability, and specificity criteria. Many of these characteristics are conferred by the amino acid sequence of the heavy and light chain variable regions and, for this reason, can be screened for during antibody selection. However, it is important to consider that antibodies satisfying all these criteria may be of low frequency in an immunized animal; for this reason, it is essential to have a mechanism that allows for efficient sampling of the immune repertoire. UCB's core antibody discovery platform combines high-throughput B cell culture screening and the identification and isolation of single, antigen-specific IgG-secreting B cells through a proprietary technique called the "fluorescent foci" method. Using state-of-the-art automation to facilitate primary screening, extremely efficient interrogation of the natural antibody repertoire is made possible; more than 1 billion immune B cells can now be screened to provide a useful starting point from which to identify the rare therapeutic antibody. This article will describe the design, construction, and commissioning of a bespoke automated screening platform and two examples of how it was used to screen for antibodies against two targets. PMID:25548140

  3. An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells.

    PubMed

    Silva, Ariosto; Jacobson, Timothy; Meads, Mark; Distler, Allison; Shain, Kenneth

    2015-01-01

    In this work we describe a novel approach that combines ex vivo drug sensitivity assays and digital image analysis to estimate chemosensitivity and heterogeneity of patient-derived multiple myeloma (MM) cells. This approach consists in seeding primary MM cells freshly extracted from bone marrow aspirates into microfluidic chambers implemented in multi-well plates, each consisting of a reconstruction of the bone marrow microenvironment, including extracellular matrix (collagen or basement membrane matrix) and stroma (patient-derived mesenchymal stem cells) or human-derived endothelial cells (HUVECs). The chambers are drugged with different agents and concentrations, and are imaged sequentially for 96 hr through bright field microscopy, in a motorized microscope equipped with a digital camera. Digital image analysis software detects live and dead cells from presence or absence of membrane motion, and generates curves of change in viability as a function of drug concentration and exposure time. We use a computational model to determine the parameters of chemosensitivity of the tumor population to each drug, as well as the number of sub-populations present as a measure of tumor heterogeneity. These patient-tailored models can then be used to simulate therapeutic regimens and estimate clinical response. PMID:26274375

  4. Primary Central Nervous System (CNS) Lymphoma B Cell Receptors Recognize CNS Proteins.

    PubMed

    Montesinos-Rongen, Manuel; Purschke, Frauke G; Brunn, Anna; May, Caroline; Nordhoff, Eckhard; Marcus, Katrin; Deckert, Martina

    2015-08-01

    Primary lymphoma of the CNS (PCNSL) is a diffuse large B cell lymphoma confined to the CNS. To elucidate its peculiar organ tropism, we generated recombinant Abs (recAbs) identical to the BCR of 23 PCNSLs from immunocompetent patients. Although none of the recAbs showed self-reactivity upon testing with common autoantigens, they recognized 1547 proteins present on a large-scale protein microarray, indicating polyreactivity. Interestingly, proteins (GRINL1A, centaurin-α, BAIAP2) recognized by the recAbs are physiologically expressed by CNS neurons. Furthermore, 87% (20/23) of the recAbs, including all Abs derived from IGHV4-34 using PCNSL, recognized galectin-3, which was upregulated on microglia/macrophages, astrocytes, and cerebral endothelial cells upon CNS invasion by PCNSL. Thus, PCNSL Ig may recognize CNS proteins as self-Ags. Their interaction may contribute to BCR signaling with sustained NF-κB activation and, ultimately, may foster tumor cell proliferation and survival. These data may also explain, at least in part, the affinity of PCNSL cells for the CNS. PMID:26116512

  5. Effects of Wheat Germ Extract on the Severity and Systemic Symptoms of Primary Dysmenorrhea: A Randomized Controlled Clinical Trial

    PubMed Central

    Atallahi, Maryam; Amir Ali Akbari, Sedigheh; Mojab, Faraz; Alavi Majd, Hamid

    2014-01-01

    Background: Primary dysmenorrhea is one of the most common disorders in women and the main cause of absenteeism from work and school. Objectives: Considering the anti-inflammatory properties of wheat germ, the present study examined the effects of wheat germ extract on the severity and systemic symptoms of primary dysmenorrhea. Patients and Methods: This triple-blinded clinical trial was performed on 80 employed women in hospitals affiliated with Hamadan University of Medical Sciences (Hamadan, IR Iran). Subjects were allocated to two groups of 45 patients. Three 400-mg capsules of wheat germ extract or placebo were used daily٫ between the 16th day of the menstrual cycle to the fifth day of the next menstrual cycle for two consecutive months. Pain intensity was measured by a visual analogue scale thrice a day and a four-point verbal rating scale was employed to assess systemic symptoms. Results: Pain severity decreased only in the wheat germ extract group (P < 0.001) and there was no statistically significant change in the placebo group. In the wheat germ extract group, the pain severity decreased from 4.701 at baseline to 1.120 at the second cycle. The reduction in total scores of systemic symptoms of dysmenorrhea was statistically significant only in the wheat germ extract group (P < 0.001) and there was not a statistically significant change in the placebo group. It revealed statistically significant differences in systemic symptoms associated with dysmenorrhea including fatigue, headache, and mood swings in experimental group. Conclusions: Wheat germ extract seems to be an effective treatment for dysmenorrhea and its systemic symptoms, probably because of its anti-inflammatory effects. PMID:25389490

  6. NLTE spectral analysis of the sdOB primary of the eclipsing binary system LB 3459 (AA Dor)

    NASA Astrophysics Data System (ADS)

    Rauch, T.

    2000-04-01

    We present a spectral analysis of the sdOB primary star of the binary system LB 3459 based on high-resolution high-S/N optical and UV spectra. The metal abundances are determined by means of state-of-the-art NLTE model atmospheres. We determined Teffw42 and log gw{5.2} within very small error limits. The He (1/125 solar), C (1/265), N (1/33), O (1/12), and Si (1/5) abundances appear strongly depleted while that of Fe and Ni are roughly solar and Mg is strongly enriched by a factor of 6. The spectroscopic distance to LB 3459 is d = 396 pc. The mass of the primary component of LB 3459 is 0.330 M_sun derived from comparisons with theoretical models for sdO stars in the log T_eff - \\log g plane. The mass of the secondary is then 0.066 M_sun derived from the mass function. There remains some disagreement between the radius derived from log g and the above mass, and that derived from analysis of the radial-velocity curve and the eclipse curves. LB 3459 is a close binary system which had experienced a common envelope (CE) phase during its evolution. It fits in the ``low mass case B'' scenario of Iben & Livio (1993) and the secondary is a brown dwarf. The spectroscopically determined rotational velocity of the primary is v_rot = 34 ± 10 km* sec-1. Thus even bound rotation (v_rot = 45.7 km* sec-1) cannot be ruled out. Based on observations collected at the European Southern Observatory, La Silla, Chile (proposals 55.D-0319, 56.C-0165) and on data retrieved from the International Ultraviolet Explorer (IUE) Final Archive.

  7. The primary test of measuremental system for the actual emittance of relativistic electron beams

    SciTech Connect

    Liang Fu; Tai-bin Du; Xin Chen

    1995-12-31

    Recent, a new measuremental system has been established basically in Tsinghua University PRA. This system is able to measure the lower emittance of the electron beams from the RF accelerators for the FEL. It consists of a scanning magnetic field, a slit, a fluorescent screen, and a TV camera, an image processing system, a CAD 386 computer. Using it an actual phase diagram is obtained for 4-10 Mev electron beams, The principle and structure of the facility were reported in the Proceeding of the 15th FEL Conference. This paper describes the performance of the main components and the results of first measurement for the electron gun and 4Mev standing wave LINAC, Some new suggests are related too.

  8. Primary Care Clinicians’ Perspectives on Reducing Low-Value Care in an Integrated Delivery System

    PubMed Central

    Buist, Diana SM; Chang, Eva; Handley, Matt; Pardee, Roy; Gundersen, Gabrielle; Cheadle, Allen; Reid, Robert J

    2016-01-01

    Context: Perceptions about low-value care (eg, medical tests and procedures that may be unnecessary and/or harmful) among clinicians with capitated salaries are unknown. Objective: Explore clinicians’ perceived use of and responsibility for reducing low-value care by focusing on barriers to use, awareness of the Choosing Wisely campaign, and response to reports of peer-comparison resource use and practice patterns. Methods: Electronic, cross-sectional survey, distributed in 2013, to 304 salaried primary care physicians and physician assistants at Group Health Cooperative. Main Outcome Measures: Attitudes, awareness, and barriers of low-value care strategies and initiatives. Results: A total of 189 clinicians responded (62% response rate). More than 90% believe cost is important to various stakeholders and believe it is fair to ask clinicians to be cost-conscious. Most found peer-comparison resource-use reports useful for understanding practice patterns and prompting peer discussions. Two-thirds of clinicians were aware of the Choosing Wisely campaign; among them, 97% considered it a legitimate information source. Although 88% reported being comfortable discussing low-value care with patients, 80% reported they would order tests or procedures when a patient insisted. As key barriers in reducing low-value care, clinicians identified time constraints (45%), overcoming patient preferences/values (44%), community standards (43%), fear of patients’ dissatisfaction (41%), patients’ knowledge about the harms of low-value care (38%), and availability of tools to support shared decision making (37%). Conclusions: Salaried clinicians are aware of rising health care costs and want to be stewards of limited health care resources. Evidence-based initiatives such as the Choosing Wisely campaign may help motivate clinicians to be conscientious stewards of limited health care resources. PMID:26562308

  9. Patient use and compliance with medical advice delivered by a web-based triage system in primary care.

    PubMed

    Nijland, Nicol; Cranen, Karlijn; Boer, Henk; van Gemert-Pijnen, Julia E W C; Seydel, Erwin R

    2010-01-01

    We studied a web-based triage system which was accessible to the general public in the Netherlands. In a retrospective analysis we investigated the type of complaints that were submitted and the kind of advice provided. Over a period of 15 months, 13,133 different people began using the web-based triage system and 3812 patients went right through the triage process to the end. The most frequent complaints were common cold symptoms, such as cough and a sore throat (22%), itch problems (13%), urinary complaints (12%), diarrhoea (10%), headache (8%) and lower back pain (8%). Most commonly, the system generated the advice to contact a doctor (85%) and in 15% of the cases the system provided fully automated, problem-tailored, self-care advice. A total of 192 patients participated in a prospective study and completed an online survey immediately after the delivery of advice. A follow-up questionnaire on actual compliance was completed by 35 patients. Among these, 20 (57%) had actually complied with the advice provided by the system. A regression analysis revealed that intention to comply was strongly related to actual compliance. In turn, intention to comply was strongly related to attitude towards the advice (P < 0.001). Web-based triage can contribute to a more efficient primary care system, because it facilitates the gatekeeper function. PMID:20086260

  10. Design, analysis, and control of large transport aircraft utilizing engine thrust as a backup system for the primary flight controls

    NASA Technical Reports Server (NTRS)

    Gerren, Donna S.

    1993-01-01

    A review of accidents that involved the loss of hydraulic flight control systems serves as an introduction to this project. In each of the accidents--involving transport aircraft such as the DC-10, the C-5A, the L-1011, and the Boeing 747--the flight crew attempted to control the aircraft by means of thrust control. Although these incidents had tragic endings, in the absence of control power due to primary control system failure, control power generated by selective application of engine thrust has proven to be a viable alternative. NASA Dryden has demonstrated the feasibility of controlling an aircraft during level flight, approach, and landing conditions using an augmented throttles-only control system. This system has been successfully flown in the flight test simulator for the B-720 passenger transport and the F-15 air superiority fighter and in actual flight tests for the F-15 aircraft. The Douglas Aircraft Company is developing a similar system for the MD-11 aircraft. The project's ultimate goal is to provide data for the development of thrust control systems for mega-transports (600+ passengers).

  11. Rare case of a primary non-dural central nervous system low grade B-cell lymphoma and literature review

    PubMed Central

    Papanicolau-Sengos, Antonios; Wang-Rodriguez, Jessica; Wang, Huan-You; Lee, Roland R; Wong, Anna; Hansen, Lawrence A; Mahooti, Sepi; Rashidi, Hooman H

    2012-01-01

    We present a case of a 70-year-old HIV negative man with a five-year history of progressive dysnomia and new onset right extremity numbness, dysarthria, and blurry vision. On magnetic resonance imaging (MRI), an infiltrative enhancing tumor was noted. Follow up brain biopsy results revealed a small lymphocytic infiltrate with scattered plasma cells in a predominantly perivascular growth pattern. Flow-cytometric findings revealed a lambda monotypic B-cell population. The morphology and the flow cytometric findings were consistent with involvement by a low grade B-cell lymphoma. Subsequent positron emission tomography (PET) studies along with bone marrow biopsy and serum protein electrophoresis showed no evidence of systemic disease. The above findings are consistent with involvement by a non-dural extranodal marginal zone B-cell lymphoma (MZBCL) primary to the central nervous system (CNS). This is the first reported case of a primary CNS MZBCL with flow cytometric analysis. A review of literature on this rare entity is also included. PMID:22295152

  12. Primary central nervous system vasculitis preceded by granulomatous hypophysitis: Case report with a review of the literature

    PubMed Central

    Huang, Meng; Steele, William J.; Baskin, David S.

    2015-01-01

    Background: Primary central nervous system (CNS) vasculitis is an idiopathic inflammatory process that selectively affects CNS vasculature without a systemic inflammatory response, and causes luminal obstruction with resultant ischemia of recipient tissue. Its varying clinical symptoms and signs depend on the caliber of vessels involved and distribution and location of the affected structures. Granulomatous hypophysitis (GH) is an autoimmune inflammatory process typically affecting women, and usually presents with hypopituitarism, and at times, diabetes insipidus, and/or visual loss. Both entities are rare CNS diseases, which, to our knowledge, have never been previously reported in the same patient. Case Description: We present a unique case of chronic progressive primary CNS vasculitis causing limbic encephalopathy in a 30-year-old male with only a history of medication-controlled hypertension. He initially presented 4 months prior with nonspecific neurological complaints and was found to have a homogenously enhancing and enlarged pituitary, which was biopsy proven to be GH. Conclusion: This rather unique presentation highlights the need to maintain a high index of suspicion for underlying PCNS vasculitis in a patient who does not fit the typical demographic for isolated GH. PMID:26539311

  13. Dependency of global primary bioenergy crop potentials in 2050 on food systems, yields, biodiversity conservation and political stability

    PubMed Central

    Erb, Karl-Heinz; Haberl, Helmut; Plutzar, Christoph

    2012-01-01

    The future bioenergy crop potential depends on (1) changes in the food system (food demand, agricultural technology), (2) political stability and investment security, (3) biodiversity conservation, (4) avoidance of long carbon payback times from deforestation, and (5) energy crop yields. Using a biophysical biomass-balance model, we analyze how these factors affect global primary bioenergy potentials in 2050. The model calculates biomass supply and demand balances for eleven world regions, eleven food categories, seven food crop types and two livestock categories, integrating agricultural forecasts and scenarios with a consistent global land use and NPP database. The TREND scenario results in a global primary bioenergy potential of 77 EJ/yr, alternative assumptions on food-system changes result in a range of 26–141 EJ/yr. Exclusion of areas for biodiversity conservation and inaccessible land in failed states reduces the bioenergy potential by up to 45%. Optimistic assumptions on future energy crop yields increase the potential by up to 48%, while pessimistic assumptions lower the potential by 26%. We conclude that the design of sustainable bioenergy crop production policies needs to resolve difficult trade-offs such as food vs. energy supply, renewable energy vs. biodiversity conservation or yield growth vs. reduction of environmental problems of intensive agriculture. PMID:23576836

  14. Advancing the application of systems thinking in health: South African examples of a leadership of sensemaking for primary health care

    PubMed Central

    2014-01-01

    Background New forms of leadership are required to bring about the fundamental health system changes demanded by primary health care (PHC). Using theory about complex adaptive systems and policy implementation, this paper considers how actors’ sensemaking and the exercise of discretionary power currently combine to challenge PHC re-orientation in the South African health system; and provides examples of leadership practices that promote sensemaking and power use in support of PHC. Methods The paper draws on observational, interview, and reflective data collected as part of the District Innovation and Action Learning for Health Systems Development (DIALHS) project being implemented in Cape Town, South Africa. Undertaken collaboratively between health managers and researchers, the project is implemented through cycles of action-learning, including systematic reflection and synthesis. It includes a particular focus on how local health managers can better support front line facility managers in strengthening PHC. Results The results illuminate how the collective understandings of staff working at the primary level - of their working environment and changes within it – act as a barrier to centrally-led initiatives to strengthen PHC. Staff often fail to take ownership of such initiatives and experience them as disempowering. Local area managers, located between the centre and the service frontline, have a vital role to play in providing a leadership of sensemaking to mediate these challenges. Founded on personal values, such leadership entails, for example, efforts to nurture PHC-aligned values and mind-sets among staff; build relationships and support the development of shared meanings about change; instil a culture of collective inquiry and mutual accountability; and role-model management practices, including using language to signal meaning. Conclusions PHC will only become a lived reality within the South African health system when frontline staff are able to

  15. The Integration of Pedagogical Aspects in Environmental Management Systems in Selected South African Primary Schools

    ERIC Educational Resources Information Center

    Kanyimba, Alex; Richter, Barry; Raath, Schalk

    2015-01-01

    Environmental management systems implemented in schools are regarded by many as a mechanism for the integration of environmental matters in all the operational functions of the school. The links, however, between environmental management and curriculum practice have not been adequately addressed in the literature. This article reports on the…

  16. Efficacy of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP) Primary Version

    ERIC Educational Resources Information Center

    DiPerna, James Clyde; Lei, Puiwa; Bellinger, Jillian; Cheng, Weiyi

    2015-01-01

    A multisite cluster randomized trial was conducted to examine the effects of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP; Elliott & Gresham, 2007) on students' classroom social behavior. The final sample included 432 students across 38 second grade classrooms. Social skills and problem behaviors were measured…

  17. One vs two primary LOX feedline configuration study for the National Launch System

    NASA Technical Reports Server (NTRS)

    Dill, K.; Davis, D.; Bates, R.; Tarwater, R.

    1992-01-01

    Six single LOX feedline designs were evaluated for use on the National Launch Vehicle. A single feedline design, designated the 'Spider', was chosen and compared to the baseline system. The baseline configuration employs two 20-inch I.D. lines, each supplying LOX to three 650,000 lbf thrust Space Transportation Main Engines. Five single feedline diameters were examined for the spider configuration; 22, 24, 26, 28, and 30-inch I.D. System dry weights and LOX residuals were estimated. These parameters, along with calculated staged mass for the different single line and baseline configurations, were used to calculate the payload mass to orbit. For the cases where LOX is drained to minimum NPSP conditions, none of the single lines performed as well as the dual line system, although the 22-inch diameter single line compared well. However, for the cases where LOX is drained to operating levels (LOX level at the booster and spider manifolds for the dual and single line configurations, respectively), the 22 - 26-inch I.D. single line systems show a greater payload capability.

  18. The Interplay of Context and Concepts in Primary School Children's Systems Thinking

    ERIC Educational Resources Information Center

    Hipkins, Rosemary; Bull, Ally; Joyce, Chris

    2008-01-01

    There is growing recognition of the importance of helping children to develop an ability to think about biological and environmental issues in terms of systems interactions and impacts. Several progressions have been published that suggest how their conceptual understandings may develop over time. However these are not necessarily as informative…

  19. Primary Angiitis of the Central Nervous System: A Report of Three Cases from a Single Colombian Center

    PubMed Central

    Coronel-Restrepo, Nicolás; Bonilla-Abadía, Fabio; Cortes, Omar A.; Izquierdo, Jorge H.; Shinchi, Alberto M.; Bravo, Juan C.; Tobón, Gabriel J.; Cañas, Carlos A.

    2013-01-01

    The primary angiitis of the central nervous system (PACNS) is an entity with a very low incidence and prevalence. It is not clear why the inflammatory process of this entity is limited to the cerebral vasculature without systemic manifestations. Its clinical manifestations are very heterogeneous and make clinical diagnosis difficult. In most cases, a brain biopsy is required. Only the clinical suspicion and the ability to recognize the possible clinical and imagenological patterns of presentation make an accurate diagnosis possible. The vast majority of the treatment recommendations are given by series of case reports. The following paper described the clinical, imagenological, and histopathological characteristics of three Colombian patients with PACNS. The strategic therapeutic used in shown. PMID:23738167

  20. Comparing ICD-9-CM and ICD-10 classification systems in a primary health care setting: some initial observations.

    PubMed

    Walker, S; Wood, M; Wilks, J; Nicol, J

    1995-01-01

    The ICD-10 is due to be introduced into Australia during the late 1990s, superseding the current and widely used ICD-9-CM. Improvements in areas such as number of codes, an expanded external cause framework, and more context to injuries are expected to make the ICD-10 a more streamlined system for practitioners. The present study examined both classification formats using data from 1183 presentations to primary health clinics at island tourist resorts. Some initial observations are made about differences in the two systems, highlighting the greater coding detail provided by the ICD-10, particularly in the area of injuries. It is recommended that further empirical testing be undertaken using the ICD-10 in a variety of settings so as to identify benefits in the coding of both medical conditions and injuries. PMID:10163113

  1. Tracking and data system support for the Mariner Mars 1971 mission. Volume 3: Orbit insertion through end of primary mission

    NASA Technical Reports Server (NTRS)

    Barnum, P. W.; Renzetti, N. A.; Textor, G. P.; Kelly, L. B.

    1973-01-01

    The Tracking and Data System (TDS) Support for the Mariner Mars 1971 Mission final report contains the deep space tracking and data acquisition activities in support of orbital operations. During this period a major NASA objective was accomplished: completion of the 180th revolution and 90th day of data gathering with the spacecraft about the planet Mars. Included are presentations of the TDS flight support pass chronology data for each of the Deep Space Stations used, and performance evaluation for the Deep Space Network Telemetry, Tracking, Command, and Monitor Systems. With the loss of Mariner 8 at launch, Mariner 9 assumed the mission plan of Mariner 8, which included the TV mapping cycles and a 12-hr orbital period. The mission plan was modified as a result of a severe dust storm on the surface of Mars, which delayed the start of the TV mapping cycles. Thus, the end of primary mission date was extended to complete the TV mapping cycles.

  2. The Primary Care Physician in the Early Diagnosis of Systemic Sclerosis: the Cornerstone of Recognition and Hope

    PubMed Central

    Saketkoo, Lesley Ann; Magnus, Jeanette H.; Doyle, Mittie K.

    2013-01-01

    Systemic sclerosis (SSc) is a disease of unknown etiology that manifests as a heterogeneous group of multi-organ system manifestations and is characterized by vasculopathy and fibrosis of the skin and internal organs, with mortality related to pulmonary, cardiac, renal or gastrointestinal involvement. The prevalence of SSc may be underestimated in the general population. Cases are often undiagnosed or misdiagnosed, particularly cases with mild or no skin manifestations. Due to late referrals to rheumatologic care, many moderate-to-severe cases progress to irreversible end-organ damage that might have been prevented by early diagnosis. Early diagnosis of SSc with initiation of appropriate treatment is essential, with great impact on morbidity and mortality. This review examines presenting features, ensuing complications and treatment providing a focus on SSc as a treatable disease. Primary care providers play a pivotal role in recognizing initial symptoms associated with SSc and securing early diagnosis through early referral to specialists. PMID:24366221

  3. Leaf chlorophyll constraint on model simulated gross primary productivity in agricultural systems

    NASA Astrophysics Data System (ADS)

    Houborg, Rasmus; F. McCabe, Matthew; Cescatti, Alessandro; A. Gitelson, Anatoly

    2015-12-01

    Leaf chlorophyll content (Chll) may serve as an observational proxy for the maximum rate of carboxylation (Vmax), which describes leaf photosynthetic capacity and represents the single most important control on modeled leaf photosynthesis within most Terrestrial Biosphere Models (TBMs). The parameterization of Vmax is associated with great uncertainty as it can vary significantly between plants and in response to changes in leaf nitrogen (N) availability, plant phenology and environmental conditions. Houborg et al. (2013) outlined a semi-mechanistic relationship between Vmax25 (Vmax normalized to 25 °C) and Chll based on inter-linkages between Vmax25, Rubisco enzyme kinetics, N and Chll. Here, these relationships are parameterized for a wider range of important agricultural crops and embedded within the leaf photosynthesis-conductance scheme of the Community Land Model (CLM), bypassing the questionable use of temporally invariant and broadly defined plant functional type (PFT) specific Vmax25 values. In this study, the new Chll constrained version of CLM is refined with an updated parameterization scheme for specific application to soybean and maize. The benefit of using in-situ measured and satellite retrieved Chll for constraining model simulations of Gross Primary Productivity (GPP) is evaluated over fields in central Nebraska, U.S.A between 2001 and 2005. Landsat-based Chll time-series records derived from the Regularized Canopy Reflectance model (REGFLEC) are used as forcing to the CLM. Validation of simulated GPP against 15 site-years of flux tower observations demonstrate the utility of Chll as a model constraint, with the coefficient of efficiency increasing from 0.91 to 0.94 and from 0.87 to 0.91 for maize and soybean, respectively. Model performances particularly improve during the late reproductive and senescence stage, where the largest temporal variations in Chll (averaging 35-55 μg cm-2 for maize and 20-35 μg cm-2 for soybean) are observed. While

  4. Identifying patients with asthma in primary care electronic medical record systems

    PubMed Central

    Xi, Nancy; Wallace, Rebecca; Agarwal, Gina; Chan, David; Gershon, Andrea; Gupta, Samir

    2015-01-01

    Objective To develop and test a variety of electronic medical record (EMR) search algorithms to allow clinicians to accurately identify their patients with asthma in order to enable improved care. Design A retrospective chart analysis identified 5 relevant unique EMR information fields (electronic disease registry, cumulative patient profile, billing diagnostic code, medications, and chart notes); asthma-related search terms were designated for each field. The accuracy of each term was tested for its ability to identify the asthma patients among all patients whose charts were reviewed. Increasingly sophisticated search algorithms were then designed and evaluated by serially combining individual searches with Boolean operators. Setting Two large academic primary care clinics in Hamilton, Ont. Participants Charts for 600 randomly selected patients aged 16 years and older identified in an initial EMR search as likely having asthma (n = 150), chronic obstructive pulmonary disease (n = 150), other respiratory conditions (n = 150), or nonrespiratory conditions (n = 150) were reviewed until 100 patients per category were identified (or until all available names were exhausted). A total of 398 charts were reviewed in full and included. Main outcome measures Sensitivity and specificity of each search for asthma diagnosis (against the reference standard of a physician chart review–based diagnosis). Results Two physicians reviewed the charts identified in the initial EMR search using a standardized data collection form and ascribed the following diagnoses in 398 patients: 112 (28.1%) had asthma, 81 (20.4%) had chronic obstructive pulmonary disease, 104 (26.1%) had other respiratory conditions, and 101 (25.4%) had nonrespiratory conditions. Concordance between reviewers in chart abstraction diagnosis was high (κ = 0.89, 95% CI 0.80 to 0.97). Overall, the algorithm searching for patients who had asthma in their cumulative patient profiles or for whom an asthma billing code

  5. The spectrum of primary blastomycotic meningitis: a review of central nervous system blastomycosis.

    PubMed

    Gonyea, E F

    1978-01-01

    Three cases of meningitis with initial and exclusive neurological involvement prompted a review of the clinical, cerebrospinal fluid, and pathological findings in an additional 78 patients with central nervous system blastomycosis. The first patient of the 3 had progressive cerebellar dysfunction as the result of chronic basilar meningitis. The second had a C8-T1 radiculopathy without other evidence of superior sulcus syndrome, and subsequent acute fatal meningitis. The third had aseptic, benign, self-limited meningitis followed by clinically obvious systemic blastomycosis. Diagnosis is difficult, and it is likely that other cases have been presumptively treated for tuberculous meningitis. A more aggressive approach to diagnosis is proposed that takes into account the condition of the patient, the likelihood of dissemination at necropsy, and the frequent meningeal infections that are negative on culture of lumbar CSF. PMID:655652

  6. Solid Waste Processing Center Primary Opening Cells Systems, Equipment and Tools

    SciTech Connect

    Bailey, Sharon A.; Baker, Carl P.; Mullen, O Dennis; Valdez, Patrick LJ

    2006-04-17

    This document addresses the remote systems and design integration aspects of the development of the Solid Waste Processing Center (SWPC), a facility to remotely open, sort, size reduce, and repackage mixed low-level waste (MLLW) and transuranic (TRU)/TRU mixed waste that is either contact-handled (CH) waste in large containers or remote-handled (RH) waste in various-sized packages.

  7. Alternatives generation and analysis for double-shell tank primary ventilation systems emissions control and monitoring

    SciTech Connect

    SEDERBURG, J.P.

    1999-09-30

    This AGA addresses the question: ''What equipment upgrades, operational changes, and/or other actions are required relative to the DST tanks farms' ventilation systems to support retrieval, staging (including feed sampling), and delivery of tank waste to the Phase I private contractor?'' Issues and options for the various components within the ventilation subsystem affect each other. Recommended design requirements are presented and the preferred alternatives are detailed.

  8. Primary and secondary electrical space power based on advanced PEM systems

    NASA Technical Reports Server (NTRS)

    Vanderborgh, N. E.; Hedstrom, J. C.; Stroh, K. R.; Huff, J. R.

    1993-01-01

    For new space ventures, power continues to be a pacing function for mission planning and experiment endurance. Although electrochemical power is a well demonstrated space power technology, current hardware limitations impact future mission viability. In order to document and augment electrochemical technology, a series of experiments for the National Aeronautics and Space Administration Lewis Research Center (NASA LeRC) are underway at the Los Alamos National Laboratory that define operational parameters on contemporary proton exchange membrane (PEM) hardware operating with hydrogen and oxygen reactants. Because of the high efficiency possible for water electrolysis, this hardware is also thought part of a secondary battery design built around stored reactants - the so-called regenerative fuel cell. An overview of stack testing at Los Alamos and of analyses related to regenerative fuel cell systems are provided in this paper. Finally, this paper describes work looking at innovative concepts that remove complexity from stack hardware with the specific intent of higher system reliability. This new concept offers the potential for unprecedented electrochemical power system energy densities.

  9. Technical Information on the Carbonation of the EBR-II Reactor, Summary Report Part 2: Application to EBR-II Primary Sodium System and Related Systems

    SciTech Connect

    Steven R. Sherman; Collin J. Knight

    2006-03-01

    Residual sodium is defined as sodium metal that remains behind in pipes, vessels, and tanks after the bulk sodium metal has been melted and drained from such components. The residual sodium has the same chemical properties as bulk sodium, and differs from bulk sodium only in the thickness of the sodium deposit. Typically, sodium is considered residual when the thickness of the deposit is less than 5-6 cm. This residual sodium must be removed or deactivated when a pipe, vessel, system, or entire reactor is permanently taken out of service, in order to make the component or system safer and/or to comply with decontamination and decomissioning regulations. As an alternative to the established residual sodium deactivation techniques (steam-and-nitrogen, wet vapor nitrogen, etc.), a technique involving the use of moisture and carbon dioxide has been developed. With this technique, sodium metal is converted into sodium bicarbonate by reacting it with humid carbon dioxide. Hydrogen is emitted as a by-product. This technique was first developed in the laboratory by exposing sodium samples to humidifed carbon dioxide under controlled conditions, and then demonstrated on a larger scale by treating residual sodium within the Experimental Breeder Reactor II (EBR-II) secondary cooling system, followed by the primary cooling system, respectively. The EBR-II facility is located at the Idaho National Laboratory (INL) in southeastern Idaho, USA. This report is Part 2 of a two-part report. This second report provides a supplement to the first report and describes the application of the humdidified carbon dioxide technique ("carbonation") to the EBR-II primary tank, primary cover gas systems, and the intermediate heat exchanger. Future treatment plans are also provided.

  10. Development of a 12-Thrust Chamber Kerosene /Oxygen Primary Rocket Sub-System for an Early (1964) Air-Augmented Rocket Ground-Test System

    NASA Technical Reports Server (NTRS)

    Pryor, D.; Hyde, E. H.; Escher, W. J. D.

    1999-01-01

    Airbreathing/Rocket combined-cycle, and specifically rocket-based combined- cycle (RBCC), propulsion systems, typically employ an internal engine flow-path installed primary rocket subsystem. To achieve acceptably short mixing lengths in effecting the "air augmentation" process, a large rocket-exhaust/air interfacial mixing surface is needed. This leads, in some engine design concepts, to a "cluster" of small rocket units, suitably arrayed in the flowpath. To support an early (1964) subscale ground-test of a specific RBCC concept, such a 12-rocket cluster was developed by NASA's Marshall Space Flight Center (MSFC). The small primary rockets used in the cluster assembly were modified versions of an existing small kerosene/oxygen water-cooled rocket engine unit routinely tested at MSFC. Following individual thrust-chamber tests and overall subsystem qualification testing, the cluster assembly was installed at the U. S. Air Force's Arnold Engineering Development Center (AEDC) for RBCC systems testing. (The results of the special air-augmented rocket testing are not covered here.) While this project was eventually successfully completed, a number of hardware integration problems were met, leading to catastrophic thrust chamber failures. The principal "lessons learned" in conducting this early primary rocket subsystem experimental effort are documented here as a basic knowledge-base contribution for the benefit of today's RBCC research and development community.

  11. Antenatal screening for haemoglobinopathies in primary care: a whole system participatory action research project

    PubMed Central

    Thomas, Paul; Oni, Lola; Alli, Mabel; St Hilaire, Judith; Smith, Alma; Leavey, Conan; Banarsee, Ricky

    2005-01-01

    Background The usual system for antenatal screening for haemoglobinopathies permits termination only late in the second trimester of pregnancy. Aim To evaluate a system where pregnant women are screened in general practice, and to develop a model of care pathway or whole system research able to bring into view unexpected effects of health service innovation. Design of study A whole system participatory action research approach was used. Six purposefully chosen general practices screened women who attended with a new pregnancy. Data of gestational age of screening were compared with two control groups. Qualitative data were gathered through workshops, interviews and feedback to the project steering group. At facilitated annual workshops participants from all parts of the care pathway produced a consensus about the meaning of the data as a whole. Setting Six general practices in north London. Method A whole system participatory action research approach allowed stakeholders from throughout the care pathway to pilot the innovation and reflect on the meaning and significance of quantitative and qualitative data. Results The gestational age of screening in general practice was 4.1 weeks earlier (95% confidence interval (CI) = 3.41 to 4.68) than in hospital clinics (P<0.001), and 2.9 weeks earlier (95% CI = 2.07 to 3.65) than in community midwife clinics (P<0.001). However, only 35% of pregnant women in the study were screened in the practices. Changes required throughout the whole care pathway make wider implementation more difficult than at first realised. The cost within general practice is greater than initially appreciated owing to a perceived need to provide counselling about other issues at the same time. Practitioners considered that other ways of early screening should be explored, including preconceptual screening. The research approach was able to bring into view unexpected effects of the innovation, but health workers were unfamiliar with the participatory

  12. Probability of pipe fracture in the primary coolant loop of a PWR plant. Volume 1. Summary, Load Combination Program. Project I final report

    SciTech Connect

    Lu, S.; Streit, R.D.; Chou, C.K.

    1981-06-01

    This report summarizes work performed to establish a technical basis for the NRC to use in reassessing its requirement that earthquake and large loss-of-coolant accident (LOCA) loads be combined in the design of nuclear power plants. A systematic probabilistic approach is used to treat the random nature of earthquake and transient loading and to estimate the probability of large LOCAs that are directly and indirectly induced by earthquakes. A large LOCA is defined in this report as a double-ended guillotine break of the primary reactor coolant loop piping (the hot leg, cold leg, and crossover) of a pressurized water reactor (PWR). Unit 1 of the Zion Nuclear Power Plant, a four-loop PWR, is the demonstration plant used in this study. To estimate the probability of a large LOCA directly induced by earthquakes, only fatigue crack growth resulting from the combined effects of thermal, pressure, seismic, and other cyclic loads is considered. Fatigue crack growth is simulated by a deterministic fracture mechanics model with stochastic inputs of initial crack size distribution, material properties, stress histories, and leak detection probability. Results of the simulation indicate that the probability of a double-ended guillotine break, either with or without earthquake, is very small (on the order of 10/sup -12/). The probability of a leak was found to be several orders of magnitude greater than that of a large LOCA, complete pipe rupture. A limited investigation involving engineering judgment of a double-ended guillotine break indirectly induced by an earthquake is also reported.

  13. Spatial complexity of character-based writing systems and arithmetic in primary school: a longitudinal study

    PubMed Central

    Rodic, Maja; Tikhomirova, Tatiana; Kolienko, Tatiana; Malykh, Sergey; Bogdanova, Olga; Zueva, Dina Y.; Gynku, Elena I.; Wan, Sirui; Zhou, Xinlin; Kovas, Yulia

    2015-01-01

    Previous research has consistently found an association between spatial and mathematical abilities. We hypothesized that this link may partially explain the consistently observed advantage in mathematics demonstrated by East Asian children. Spatial complexity of the character-based writing systems may reflect or lead to a cognitive advantage relevant to mathematics. Seven hundered and twenty one 6–9-year old children from the UK and Russia were assessed on a battery of cognitive skills and arithmetic. The Russian children were recruited from specialist linguistic schools and divided into four different language groups, based on the second language they were learning (i.e., English, Spanish, Chinese, and Japanese). The UK children attended regular schools and were not learning any second language. The testing took place twice across the school year, once at the beginning, before the start of the second language acquisition, and once at the end of the year. The study had two aims: (1) to test whether spatial ability predicts mathematical ability in 7–9 year-old children across the samples; (2) to test whether acquisition and usage of a character-based writing system leads to an advantage in performance in arithmetic and related cognitive tasks. The longitudinal link from spatial ability to mathematics was found only in the Russian sample. The effect of second language acquisition on mathematics or other cognitive skills was negligible, although some effect of Chinese language on mathematical reasoning was suggested. Overall, the findings suggest that although spatial ability is related to mathematics at this age, one academic year of exposure to spatially complex writing systems is not enough to provide a mathematical advantage. Other educational and socio-cultural factors might play a greater role in explaining individual and cross-cultural differences in arithmetic at this age. PMID:25859235

  14. Primary Analysis on the Interplanetary Cause of Geomagnetically Induced Current and Its Effects on Power System

    NASA Astrophysics Data System (ADS)

    Wang, K. R.; Liu, L. G.; Li, Y.

    2014-09-01

    In this paper, we use the measured data of geomagnetically induced current (GIC) in Ling'ao nuclear power plant from 2004 to 2005 to analyze its solar driving source and interplanetary solar wind structure, focus on the interplanetary cause and its effects on power system, and apply the wavelet analysis to the greatest GIC event. We conclude that: (1) Most GIC events were driven by halo coronal mass ejections, and the sheath, the magnetic cloud, and the multiple interplanetary solar structure are the interplanetary cause of GIC events. (2) Based on the strongest event on 2004 November 9, we find that the fluctuation of GIC in the earlier stage was related to the magnetic cloud boundary layer, and the variation of GIC intensity in the later stage was caused by magnetic cloud itself. (3) Compared to the frequency of the power system (50 Hz), the GIC can be equivalent to the quasi direct current. The energy of the GIC is embodied in the two time intervals within the wavelet power spectrum: the first interval is shown as the pulse type and with a weaker intensity, and the second one is stronger. Regarding to the cumulative time of the transformer temperature rise caused by GIC, the second interval has a longer duration than the first one. So during the second interval, it is more harmful to the power system and the equipments. (4) The correlations of SYM-H, and dBx/dt to GIC are significantly closer than those of other geomagnetic indices to GIC.

  15. Viral transduction of primary Schwann cells using a Cre-lox system to regulate GDNF expression.

    PubMed

    Wu-Fienberg, Yuewei; Moore, Amy M; Marquardt, Laura M; Newton, Piyaraj; Johnson, Philip J; Mackinnon, Susan E; Sakiyama-Elbert, Shelly E; Wood, Matthew D

    2014-09-01

    Glial cell-line-derived neurotrophic factor (GDNF) is a potent neurotrophic factor known to enhance motor nerve regeneration following its delivery. However, recent studies have determined that extended GDNF delivery to regenerating axons can entrap motor axons at the site of GDNF delivery. This entrapment leads to reduced motor axons available to reinnervate muscle. To address this issue, we designed a cell-based GDNF expression system that can temporally regulate protein expression using an inducible gene excision mechanism to prevent entrapment at the site of expression. To design this system for regulation of GDNF expression, we transduced two lentiviral vectors, one containing a constitutively active GDNF transgene flanked by two loxP sites, and the other containing a tetracycline-inducible cre transgene along with its constitutively active transactivator, into Schwann cells (SCs). These SCs over-express GDNF, but expression can be suppressed through the administration of tetracycline family antibiotics, such as doxycycline. The engineered SCs produced significantly more GDNF as compared to untransduced controls, as measured by enzyme-linked immunosorbent assay (ELISA). Following doxycycline treatment, these SCs produced significantly lower levels of GDNF and induced less neurite extension as compared to untreated SCs. Engineered SCs treated with doxycycline showed a marked increase in Cre recombinase expression, as visualized by immunohistochemistry (IHC), providing evidence of a mechanism for the observed changes in GDNF expression levels and biological activity. This cell-based GDNF expression system could have potential for future in vivo studies to provide a temporally controlled GDNF source to promote axon growth. PMID:24728940

  16. Spatial complexity of character-based writing systems and arithmetic in primary school: a longitudinal study.

    PubMed

    Rodic, Maja; Tikhomirova, Tatiana; Kolienko, Tatiana; Malykh, Sergey; Bogdanova, Olga; Zueva, Dina Y; Gynku, Elena I; Wan, Sirui; Zhou, Xinlin; Kovas, Yulia

    2015-01-01

    Previous research has consistently found an association between spatial and mathematical abilities. We hypothesized that this link may partially explain the consistently observed advantage in mathematics demonstrated by East Asian children. Spatial complexity of the character-based writing systems may reflect or lead to a cognitive advantage relevant to mathematics. Seven hundered and twenty one 6-9-year old children from the UK and Russia were assessed on a battery of cognitive skills and arithmetic. The Russian children were recruited from specialist linguistic schools and divided into four different language groups, based on the second language they were learning (i.e., English, Spanish, Chinese, and Japanese). The UK children attended regular schools and were not learning any second language. The testing took place twice across the school year, once at the beginning, before the start of the second language acquisition, and once at the end of the year. The study had two aims: (1) to test whether spatial ability predicts mathematical ability in 7-9 year-old children across the samples; (2) to test whether acquisition and usage of a character-based writing system leads to an advantage in performance in arithmetic and related cognitive tasks. The longitudinal link from spatial ability to mathematics was found only in the Russian sample. The effect of second language acquisition on mathematics or other cognitive skills was negligible, although some effect of Chinese language on mathematical reasoning was suggested. Overall, the findings suggest that although spatial ability is related to mathematics at this age, one academic year of exposure to spatially complex writing systems is not enough to provide a mathematical advantage. Other educational and socio-cultural factors might play a greater role in explaining individual and cross-cultural differences in arithmetic at this age. PMID:25859235

  17. Viral transduction of primary Schwann cells using a Cre-lox system to regulate GDNF expression

    PubMed Central

    Wu-Fienberg, Yuewei; Moore, Amy M.; Marquardt, Laura M.; Newton, Piyaraj; Johnson, Philip J.; Mackinnon, Susan E.; Sakiyama-Elbert, Shelly E.; Wood, Matthew D.

    2014-01-01

    Glial cell-line-derived neurotrophic factor (GDNF) is a potent neurotrophic factor known to enhance motor nerve regeneration following its delivery. However, recent studies have determined that extended GDNF delivery to regenerating axons can entrap motor axons at the site of GDNF delivery. This entrapment leads to reduced motor axons available to reinnervate muscle. To address this issue, we designed a cell-based GDNF expression system that can temporally regulate protein expression using an inducible gene excision mechanism to prevent entrapment at the site of expression. To design this system for regulation of GDNF expression, we transduced two lentiviral vectors, one containing a constitutively active GDNF transgene flanked by two loxP sites, and the other containing a tetracycline-inducible cre transgene along with its constitutively active transactivator, into Schwann cells (SCs). These SCs over-express GDNF, but expression can be suppressed through the administration of tetracycline family antibiotics, such as doxycycline. The engineered SCs produced significantly more GDNF as compared to untransduced controls, as measured by enzyme-linked immunosorbent assay (ELISA). Following doxycycline treatment, these SCs produced significantly lower levels of GDNF and induced less neurite extension as compared to untreated SCs. Engineered SCs treated with doxycycline showed a marked increase in Cre recombinase expression, as visualized by immunohistochemistry (IHC), providing evidence of a mechanism for the observed changes in GDNF expression levels and biological activity. This cell-based GDNF expression system could have potential for future in vivo studies to provide a temporally-controlled GDNF source to promote axon growth. PMID:24728940

  18. The Waveform Correlation Event Detection System project, Phase II: Testing with the IDC primary network

    SciTech Connect

    Young, C.J.; Beiriger, J.I.; Moore, S.G.

    1998-04-01

    Further improvements to the Waveform Correlation Event Detection System (WCEDS) developed by Sandia Laboratory have made it possible to test the system on the accepted Comprehensive Test Ban Treaty (CTBT) seismic monitoring network. For our test interval we selected a 24-hour period from December 1996, and chose to use the Reviewed Event Bulletin (REB) produced by the Prototype International Data Center (PIDC) as ground truth for evaluating the results. The network is heterogeneous, consisting of array and three-component sites, and as a result requires more flexible waveform processing algorithms than were available in the first version of the system. For simplicity and superior performance, we opted to use the spatial coherency algorithm of Wagner and Owens (1996) for both types of sites. Preliminary tests indicated that the existing version of WCEDS, which ignored directional information, could not achieve satisfactory detection or location performance for many of the smaller events in the REB, particularly those in the south Pacific where the network coverage is unusually sparse. To achieve an acceptable level of performance, we made modifications to include directional consistency checks for the correlations, making the regions of high correlation much less ambiguous. These checks require the production of continuous azimuth and slowness streams for each station, which is accomplished by means of FK processing for the arrays and power polarization processing for the three-component sites. In addition, we added the capability to use multiple frequency-banded data streams for each site to increase sensitivity to phases whose frequency content changes as a function of distance.

  19. CATHARE2 calculation of SPE-3 test small break loca on PMK facility

    SciTech Connect

    Laugier, E.; Radet, J.

    1995-09-01

    Bind and post test calculations with CATHARE2 have been performed concerning the SPE-4 exercise organized under the auspices of IAEA on the hungarian PMK-2 facility, a one loop scaled model of VVER 440/213 Nuclear Power Plant. The SPE-4 test is a cold leg SBLOCA associated to a {open_quotes}bleed and feed{close_quotes} procedure applied in the secondary circuit. The present paper is devoted to the analysis of the post test calculation. For the first part of the transient (until the end of the SIT activations), the primary and secondary pressures are rather well predicted, leading to a good agreement with the experimental trips, as scram, flow coast down, SIT beginning and end of activation. Nevertheless, some discrepancy with the experiment may be due to an over prediction of the thermal exchanges from the primary to the secondary circuits. For the second part of the transient, the predicted primary circuit repressurization is shifted after the SITs are off, while in the experiment this event immediately follows the end of SIT activation. The delay in the calculation leads to underpredict primary and secondary pressures, thus anticipating the timing of events, such as LPIS and emergency feedwater activation.

  20. Dynamic Tunnel Usability Study: Format Recommendations for Synthetic Vision System Primary Flight Displays

    NASA Technical Reports Server (NTRS)

    Arthur, Jarvis J., III; Prinzel, Lawrence J., III; Kramer, Lynda J.; Bailey, Randall E.

    2006-01-01

    A usability study evaluating dynamic tunnel concepts has been completed under the Aviation Safety and Security Program, Synthetic Vision Systems Project. The usability study was conducted in the Visual Imaging Simulator for Transport Aircraft Systems (VISTAS) III simulator in the form of questionnaires and pilot-in-the-loop simulation sessions. Twelve commercial pilots participated in the study to determine their preferences via paired comparisons and subjective rankings regarding the color, line thickness and sensitivity of the dynamic tunnel. The results of the study showed that color was not significant in pilot preference paired comparisons or in pilot rankings. Line thickness was significant for both pilot preference paired comparisons and in pilot rankings. The preferred line/halo thickness combination was a line width of 3 pixels and a halo of 4 pixels. Finally, pilots were asked their preference for the current dynamic tunnel compared to a less sensitive dynamic tunnel. The current dynamic tunnel constantly gives feedback to the pilot with regard to path error while the less sensitive tunnel only changes as the path error approaches the edges of the tunnel. The tunnel sensitivity comparison results were not statistically significant.

  1. Developmental analysis reveals labial and subradular ganglia and the primary framework of the nervous system in nudibranch gastropods.

    PubMed

    Page, L R

    1993-11-01

    Previous ultrastructural observations on late stage larvae of dorid nudibranchs (Gastropoda, Opisthobranchia) revealed two pairs of ganglia within the base of the foot that do not have obvious counterparts in existing descriptions of other gastropod larvae [Chia and Koss (1989). Cell Tiss. Res. 256:17-26.] One of these ganglionic pairs has been implicated in the initiation of settlement preceding metamorphosis [Arkett et al. (1989). Biol. Bull. 176:155-160.] By examining neurogenesis in sequential larval stages, I have found that the pattern of connectives and commissures associated with these enigmatic ganglia is comparable to patterns found in less consolidated adult nervous systems of chitons, monoplacophorans, and archaeogastropods. These comparative data suggest that the two pairs of ganglia in dorid nudibranch larvae are homologues of labial and subradular ganglia. The labial ganglia become incorporated into the cerebral ganglia at metamorphosis. In an attempt to integrate anatomical and developmental observations with behavioral and neurophysiological results, I suggest that receptor cells of the larval labial ganglia may become postmetamorphic primary mechanoreceptors of the oral tube, which have central cell bodies within the "cerebral" ganglia and which help coordinate feeding. Results of this study also address a larger evolutionary issue by questioning the traditional model of an ancestral molluscan nervous system that consists of four longitudinal nerve cords that arise from separate sites along a circumesophageal nerve ring. This pattern results from secondary connections in nudibranchs and possibly other molluscs. The primary condition of a single axon bundle emerging from each cerebral ganglion is more similar to the developing nervous system in polychaete annelids than what has been recognized previously. PMID:8283184

  2. Instrumentation Needs for Integral Primary System Reactors (IPSRs) - Task 1 Final Report

    SciTech Connect

    Gary D. Storrick; Bojan Petrovic; Luca Oriani; Lawrence E. Conway; Diego Conti

    2005-09-30

    This report presents the results of the Westinghouse work performed under Task 1 of this Financial Assistance Award and satisfies a Level 2 Milestone for the project. While most of the signals required for control of IPSRs are typical of other PWRs, the integral configuration poses some new challenges in the design or deployment of the sensors/instrumentation and, in some cases, requires completely new approaches. In response to this consideration, the overall objective of Task 1 was to establish the instrumentation needs for integral reactors, provide a review of the existing solutions where available, and, identify research and development needs to be addressed to enable successful deployment of IPSRs. The starting point for this study was to review and synthesize general characteristics of integral reactors, and then to focus on a specific design. Due to the maturity of its design and availability of design information to Westinghouse, IRIS (International Reactor Innovative and Secure) was selected for this purpose. The report is organized as follows. Section 1 is an overview. Section 2 provides background information on several representative IPSRs, including IRIS. A review of the IRIS safety features and its protection and control systems is used as a mechanism to ensure that all critical safety-related instrumentation needs are addressed in this study. Additionally, IRIS systems are compared against those of current advanced PWRs. The scope of this study is then limited to those systems where differences exist, since, otherwise, the current technology already provides an acceptable solution. Section 3 provides a detailed discussion on instrumentation needs for the representative IPSR (IRIS) with detailed qualitative and quantitative requirements summarized in the exhaustive table included as Appendix A. Section 3 also provides an evaluation of the current technology and the instrumentation used for measurement of required parameters in current PWRs. Section 4

  3. Localization of Physical Activity in Primary School Children Using Accelerometry and Global Positioning System

    PubMed Central

    Bürgi, Rahel; Tomatis, Laura; Murer, Kurt; de Bruin, Eling D.

    2015-01-01

    Background Ecological approaches have highlighted the importance of the built environment as a factor affecting physical activity. However, knowledge on children’s activity patterns is still incomplete. Particularly, data on the spatial context of physical activity is limited, which limits the potential to design location-based interventions effectively. Using global positioning system (GPS) and accelerometry, this study aimed to identify locations where children engage in moderate-vigorous physical activity (MVPA). Methods Participants included 119 children (11–14 years, 57% girls) from public schools in Winterthur, Switzerland. During a regular school week between February and April 2013, children wore an accelerometer and GPS sensor for seven consecutive days. Time-matched accelerometer and GPS data was mapped with a geographic information system and each data point was assigned to one of seven defined activity settings. Both the absolute amount of MVPA and proportion of time in MVPA were calculated for every setting. Multilevel analyses accounting for the hierarchical structure of the data were conducted to investigate any gender differences. Results Children achieved most MVPA on streets (34.5%) and on school grounds (33.4%). The proportion children spent in MVPA was highest in recreational facilities (19.4%), at other schools (19.2%) and on streets (18.6%). Boys accumulated significantly more MVPA overall and on other school grounds (p < 0.05) and showed a significantly higher proportion of time in MVPA at own school and outside of Winterthur (p < 0.05). Conclusions The results indicate the importance of streets and school grounds as activity-promoting environments. The high use of streets may be an indicator for active transportation, which appears to contribute to an active lifestyle in both genders. In contrast, the school setting is more likely to encourage physical activity in boys. Recreational facilities seem to be conducive for MVPA among both

  4. Activated neu oncogene sequences in primary tumors of the peripheral nervous system induced in rats by transplacental exposure to ethylnitrosourea

    SciTech Connect

    Perantoni, A.O.; Rice, J.M.; Reed, C.D.; Watatani, M.; Wenk, M.L.

    1987-09-01

    Neurogenic tumors were selectively induced in high incidence in F344 rats by a single transplacental exposure to the direct-acting alkylating agent N-ethyl-N-nitrosourea (EtNU). The authors prepared DNA for transfection of NIH 3T3 cells from primary glial tumors of the brain and form schwannomas of the cranial and spinal nerves that developed in the transplacentally exposed offspring between 20 and 40 weeks after birth. DNA preparations from 6 of 13 schwannomas, but not from normal liver, kidney, or intestine of tumor-bearing rats, transformed NIH 3T3 cells. NIH 3T3 clones transformed by schwannoma DNA contained rat repetitive DNA sequences, and all isolates contained rat neu oncogene sequences. A point mutation in the transmembrane region of the putative protein product of neu was identified in all six transformants and in the primary tumors from which they were derived as well as in 5 of 6 schwannomas tested that did not transform NIH 3T3 cells. Of 59 gliomas, only one yielded transforming DNA, and an activated N-ras oncogen was identified. The normal cellular neu sequence for the transmembrane region, but not the mutated sequence, was identified in DNA from all 11 gliomas surveyed by oligonucleotide hybridization. Activation of the neu oncogene, originally identified in cultured cell lines derived from EtNU-induced neurogenic tumors appears specifically associated with tumors of the peripheral nervous system in the F344 inbred strain.

  5. Primary Diffuse Large B-Cell Lymphoma of Central Nervous System: Is Still Surgery an Unorthodox Treatment?

    PubMed

    Siasios, Ioannis; Fotiadou, Aggeliki; Fotakopoulos, George; Ioannou, Maria; Anagnostopoulos, Vassilios; Fountas, Konstantinos

    2015-12-01

    Primary central nervous system lymphoma (PCNSL) is characterized as an extra-nodal non-Hodgkin lymphoma which develops from the neuraxis. The purpose was to report a case of a patient with a supra-tentorial tumor who underwent subtotal resection of his tumor as his biopsy was not indicative of a PCNSL tumor and had uneventful recovery until his last follow-up. A 42-year-old man was admitted to our department for generalized epileptic seizures. CT and MRI examinations revealed a tumor in his right parietal-occipital lobe that was surrounded by edema and was enhancing after gadolinium administration. The patient underwent a navigation-assisted parieto-occipital craniotomy and posterior parietal transcortical approach for tumor biopsy which was not indicative of PCNSL tumor. The surgical team decided to remove the tumor on site. Histological analysis of the resected specimen showed primary diffuse large B-cell lymphoma. Combined chemotherapy and radiation therapy was applied to the patient, and at his last follow-up (16 months), he is tumor free. In our case as in several other studies during the last decade, the outcome after the surgical resection of a PCNSL tumor in combination to radiation and chemotherapy was unexpectedly good. The role of surgery probably should be reconsidered for single lesion PCNSL tumors. PMID:26566417

  6. Performance of the Primary Mirror Center-of-curvature Optical Metrology System During Cryogenic Testing of the JWST Pathfinder Telescope

    NASA Technical Reports Server (NTRS)

    Hadaway, James B.; Wells, Conrad; Olczak, Gene; Waldman, Mark; Whitman, Tony; Cosentino, Joseph; Connolly, Mark; Chaney, David; Telfer, Randal

    2016-01-01

    The James Webb Space Telescope (JWST) primary mirror (PM) is 6.6 m in diameter and consists of 18 hexagonal segments, each 1.5 m point-to-point. Each segment has a six degree-of-freedom hexapod actuation system and a radius-of-curvature (RoC) actuation system. The full telescope will be tested at its cryogenic operating temperature at Johnson Space Center. This testing will include center-of-curvature measurements of the PM, using the Center-of-Curvature Optical Assembly (COCOA) and the Absolute Distance Meter Assembly (ADMA). The COCOA includes an interferometer, a reflective null, an interferometer-null calibration system, coarse & fine alignment systems, and two displacement measuring interferometer systems. A multiple-wavelength interferometer (MWIF) is used for alignment & phasing of the PM segments. The ADMA is used to measure, and set, the spacing between the PM and the focus of the COCOA null (i.e. the PM center-of-curvature) for determination of the ROC. The performance of these metrology systems was assessed during two cryogenic tests at JSC. This testing was performed using the JWST Pathfinder telescope, consisting mostly of engineering development & spare hardware. The Pathfinder PM consists of two spare segments. These tests provided the opportunity to assess how well the center-of-curvature optical metrology hardware, along with the software & procedures, performed using real JWST telescope hardware. This paper will describe the test setup, the testing performed, and the resulting metrology system performance. The knowledge gained and the lessons learned during this testing will be of great benefit to the accurate & efficient cryogenic testing of the JWST flight telescope.

  7. Characterization of primary human hepatocyte spheroids as a model system for drug-induced liver injury, liver function and disease.

    PubMed

    Bell, Catherine C; Hendriks, Delilah F G; Moro, Sabrina M L; Ellis, Ewa; Walsh, Joanne; Renblom, Anna; Fredriksson Puigvert, Lisa; Dankers, Anita C A; Jacobs, Frank; Snoeys, Jan; Sison-Young, Rowena L; Jenkins, Rosalind E; Nordling, Åsa; Mkrtchian, Souren; Park, B Kevin; Kitteringham, Neil R; Goldring, Christopher E P; Lauschke, Volker M; Ingelman-Sundberg, Magnus

    2016-01-01

    Liver biology and function, drug-induced liver injury (DILI) and liver diseases are difficult to study using current in vitro models such as primary human hepatocyte (PHH) monolayer cultures, as their rapid de-differentiation restricts their usefulness substantially. Thus, we have developed and extensively characterized an easily scalable 3D PHH spheroid system in chemically-defined, serum-free conditions. Using whole proteome analyses, we found that PHH spheroids cultured this way were similar to the liver in vivo and even retained their inter-individual variability. Furthermore, PHH spheroids remained phenotypically stable and retained morphology, viability, and hepatocyte-specific functions for culture periods of at least 5 weeks. We show that under chronic exposure, the sensitivity of the hepatocytes drastically increased and toxicity of a set of hepatotoxins was detected at clinically relevant concentrations. An interesting example was the chronic toxicity of fialuridine for which hepatotoxicity was mimicked after repeated-dosing in the PHH spheroid model, not possible to detect using previous in vitro systems. Additionally, we provide proof-of-principle that PHH spheroids can reflect liver pathologies such as cholestasis, steatosis and viral hepatitis. Combined, our results demonstrate that the PHH spheroid system presented here constitutes a versatile and promising in vitro system to study liver function, liver diseases, drug targets and long-term DILI. PMID:27143246

  8. Characterization of primary human hepatocyte spheroids as a model system for drug-induced liver injury, liver function and disease

    PubMed Central

    Bell, Catherine C.; Hendriks, Delilah F. G.; Moro, Sabrina M. L.; Ellis, Ewa; Walsh, Joanne; Renblom, Anna; Fredriksson Puigvert, Lisa; Dankers, Anita C. A.; Jacobs, Frank; Snoeys, Jan; Sison-Young, Rowena L.; Jenkins, Rosalind E.; Nordling, Åsa; Mkrtchian, Souren; Park, B. Kevin; Kitteringham, Neil R.; Goldring, Christopher E. P.; Lauschke, Volker M.; Ingelman-Sundberg, Magnus

    2016-01-01

    Liver biology and function, drug-induced liver injury (DILI) and liver diseases are difficult to study using current in vitro models such as primary human hepatocyte (PHH) monolayer cultures, as their rapid de-differentiation restricts their usefulness substantially. Thus, we have developed and extensively characterized an easily scalable 3D PHH spheroid system in chemically-defined, serum-free conditions. Using whole proteome analyses, we found that PHH spheroids cultured this way were similar to the liver in vivo and even retained their inter-individual variability. Furthermore, PHH spheroids remained phenotypically stable and retained morphology, viability, and hepatocyte-specific functions for culture periods of at least 5 weeks. We show that under chronic exposure, the sensitivity of the hepatocytes drastically increased and toxicity of a set of hepatotoxins was detected at clinically relevant concentrations. An interesting example was the chronic toxicity of fialuridine for which hepatotoxicity was mimicked after repeated-dosing in the PHH spheroid model, not possible to detect using previous in vitro systems. Additionally, we provide proof-of-principle that PHH spheroids can reflect liver pathologies such as cholestasis, steatosis and viral hepatitis. Combined, our results demonstrate that the PHH spheroid system presented here constitutes a versatile and promising in vitro system to study liver function, liver diseases, drug targets and long-term DILI. PMID:27143246

  9. [Effect of the storage method on microleakage of primary teeth restored with different bonding systems: in vitro study].

    PubMed

    Ghersel, E L; Guedes-Pinto, A C; Ciamponi, A L

    2001-01-01

    The influence of the method of storage of teeth and the effect of two kinds of dentin-bonding agents on the microleakage at the axial and cervical walls of composite restorations, in primary second molars, were evaluated. The samples were divided in three groups: Dehydrated, Hydrated and Frozen. The Dehydrated group was kept dry, the Hydrated group was stored in physiological saline solution under refrigeration, and the Frozen group was kept in the freezer, also immersed in physiological solution. The samples received two vertical slot preparations: a mesio-occlusal and a disto-occlusal one. In the mesio-occlusal cavities, Scotchbond Multi-Use adhesive system was used, whereas in the disto-occlusal cavities Prime & Bond 2.1 system was used, and all cavities were filled with Solitaire composite resin. The groups were then thermocycled and immersed in silver nitrate solution. Microleakage was measured by means of a digitized image system and the values were submitted to statistical analysis. The results showed that the method of storage had no statistically significant influence on marginal microleakage. Microleakage at the cervical wall was significantly greater than that at the axial wall, with 99.9% of certainty. The adhesive systems did not show significant influence on microleakage, in the studied methods of storage. However, there was statistical difference in the Dehydrated group samples, with the use of Prime & Bond 2.1 adhesive, when considering the margins of the restoration (axial and cervical). PMID:11705313

  10. The Five Planets in the Kepler-296 Binary System All Orbit the Primary: An Application of Importance Sampling

    NASA Astrophysics Data System (ADS)

    Barclay, Thomas; Quintana, Elisa; Adams, Fred; Ciardi, David; Huber, Daniel; Foreman-Mackey, Daniel; Montet, Benjamin Tyler; Caldwell, Douglas

    2015-08-01

    Kepler-296 is a binary star system with two M-dwarf components separated by 0.2 arcsec. Five transiting planets have been confirmed to be associated with the Kepler-296 system; given the evidence to date, however, the planets could in principle orbit either star. This ambiguity has made it difficult to constrain both the orbital and physical properties of the planets. Using both statistical and analytical arguments, this paper shows that all five planets are highly likely to orbit the primary star in this system. We performed a Markov-Chain Monte Carlo simulation using a five transiting planet model, leaving the stellar density and dilution with uniform priors. Using importance sampling, we compared the model probabilities under the priors of the planets orbiting either the brighter or the fainter component of the binary. A model where the planets orbit the brighter component, Kepler-296A, is strongly preferred by the data. Combined with our assertion that all five planets orbit the same star, the two outer planets in the system, Kepler-296 Ae and Kepler-296 Af, have radii of 1.53 ± 0.26 and 1.80 ± 0.31 R⊕, respectively, and receive incident stellar fluxes of 1.40 ± 0.23 and 0.62 ± 0.10 times the incident flux the Earth receives from the Sun. This level of irradiation places both planets within or close to the circumstellar habitable zone of their parent star.

  11. The Five Planets in the Kepler-296 Binary System All Orbit the Primary: A Statistical and Analytical Analysis

    NASA Astrophysics Data System (ADS)

    Barclay, Thomas; Quintana, Elisa V.; Adams, Fred C.; Ciardi, David R.; Huber, Daniel; Foreman-Mackey, Daniel; Montet, Benjamin T.; Caldwell, Douglas

    2015-08-01

    Kepler-296 is a binary star system with two M-dwarf components separated by 0.″2. Five transiting planets have been confirmed to be associated with the Kepler-296 system; given the evidence to date, however, the planets could in principle orbit either star. This ambiguity has made it difficult to constrain both the orbital and physical properties of the planets. Using both statistical and analytical arguments, this paper shows that all five planets are highly likely to orbit the primary star in this system. We performed a Markov-Chain Monte Carlo simulation using a five transiting planet model, leaving the stellar density and dilution with uniform priors. Using importance sampling, we compared the model probabilities under the priors of the planets orbiting either the brighter or the fainter component of the binary. A model where the planets orbit the brighter component, Kepler-296A, is strongly preferred by the data. Combined with our assertion that all five planets orbit the same star, the two outer planets in the system, Kepler-296 Ae and Kepler-296 Af, have radii of 1.53 ± 0.26 and 1.80 ± 0.31 {R}\\oplus , respectively, and receive incident stellar fluxes of 1.40 ± 0.23 and 0.62 ± 0.10 times the incident flux the Earth receives from the Sun. This level of irradiation places both planets within or close to the circumstellar habitable zone of their parent star.

  12. Determination of the bias in LOFT fuel peak cladding temperature data from the blowdown phase of large-break LOCA experiments

    SciTech Connect

    Berta, V.T.; Hanson, R.G.; Johnsen, G.W.; Schultz, R.R.

    1993-05-01

    Data from the Loss-of-Fluid Test (LOFT) Program help quantify the margin of safety inherent in pressurized water reactors during postulated loss-of-coolant accidents (LOCAs). As early as 1979, questions arose concerning the accuracy of LOFT fuel rod cladding temperature data during several large-break LOCA experiments. This report analyzes how well externally-mounted fuel rod cladding thermocouples in LOFT accurately reflected actual cladding surface temperature during large-break LOCA experiments. In particular, the validity of the apparent core-wide fuel rod cladding quench exhibited during blowdown in LOFT Experiments L2-2 and L2-3 is studied. Also addressed is the question of whether the externally-mounted thermocouples might have influenced cladding temperature. The analysis makes use of data and information from several sources, including later, similar LOFT Experiments in which fuel centerline temperature measurements were made, experiments in other facilities, and results from a detailed FRAP-T6 model of the LOFT fuel rod. The analysis shows that there can be a significant difference (referred to as bias) between the surface-mounted thermocouple reading and the actual cladding temperature, and that the magnitude of this bias depends on the rate of heat transfer between the fuel rod cladding and coolant. The results of the analysis demonstrate clearly that a core-wide cladding quench did occur in Experiments L2-2 and L2-3. Further, it is shown that, in terms of peak cladding temperature recording during LOFT large-break LOCA experiments, the mean bias is 11.4 {plus_minus} 16.2K (20.5 {plus_minus} 29.2{degrees} F). The best-estimate value of peak cladding temperature for LOFT LP-02-6 is 1,104.8 K. The best-estimate peak cladding temperature for LOFT LP-LB-1 is 1284.0 K.

  13. A Coded Structured Light System Based on Primary Color Stripe Projection and Monochrome Imaging

    PubMed Central

    Barone, Sandro; Paoli, Alessandro; Razionale, Armando Viviano

    2013-01-01

    Coded Structured Light techniques represent one of the most attractive research areas within the field of optical metrology. The coding procedures are typically based on projecting either a single pattern or a temporal sequence of patterns to provide 3D surface data. In this context, multi-slit or stripe colored patterns may be used with the aim of reducing the number of projected images. However, color imaging sensors require the use of calibration procedures to address crosstalk effects between different channels and to reduce the chromatic aberrations. In this paper, a Coded Structured Light system has been developed by integrating a color stripe projector and a monochrome camera. A discrete coding method, which combines spatial and temporal information, is generated by sequentially projecting and acquiring a small set of fringe patterns. The method allows the concurrent measurement of geometrical and chromatic data by exploiting the benefits of using a monochrome camera. The proposed methodology has been validated by measuring nominal primitive geometries and free-form shapes. The experimental results have been compared with those obtained by using a time-multiplexing gray code strategy. PMID:24129018

  14. Descriptive epidemiology and risk factors of primary central nervous system tumors: Current knowledge.

    PubMed

    Pouchieu, C; Baldi, I; Gruber, A; Berteaud, E; Carles, C; Loiseau, H

    2016-01-01

    Although comparisons are difficult due to differences in methodologies, the annual incidence rates of central nervous system (CNS) tumors range from 8.5 to 21.4/100,000 population according to cancer registries, with a predominance of neuroepithelial tumors in men and meningiomas in women. An increase in the incidence of CNS tumors has been observed during the past decades in several countries. It has been suggested that this trend could be due to aging of the population, and improvements in diagnostic imaging and healthcare access, but these factors do not explain differences in incidence by gender and histological subtypes. Several etiological hypotheses related to intrinsic (sociodemographic, anthropometric, hormonal, immunological, genetic) and exogenous (ionizing radiation, electromagnetic fields, diet, infections, pesticides, drugs) risk factors have led to analytical epidemiological studies to establish relationships with CNS tumors. The only established environmental risk factor for CNS tumors is ionizing radiation exposure. However, for other risk factors, studies have been inconsistent and inconclusive due to systematic differences in study design and difficulties in accurately measuring exposures. Thus, the etiology of CNS tumors is complex and may involve several genetic and/or environmental factors that may act differently according to histological subtype. PMID:26708326

  15. LOFA (loss of flow accident) and LOCA (loss of coolant accident) in the TIBER-II engineering test reactor: Appendix A-4

    SciTech Connect

    Sviatoslavsky, I.N.; Attaya, H.M.; Corradini, M.L.; Lomperski, S.

    1987-01-01

    This paper describes the preliminary analysis of LOFA (loss of flow accident) and LOCA (loss of coolant accident) in the TIBER-II engineering test reactor breeding shield. TIBER-II is a compact reactor with a major radius of 3 m and thus requires a thin, high efficiency shield on the inboard side. The use of tungsten in the inboard shield implies a rather high rate of afterheat upon plasma shutdown, which must be dissipated in a controlled manner to avoid the possibility of radioactivity release or threatening the investment. Because the shield is cooled with an aqueous solution, LOFA does not pose a problem as long as natural convection can be established. LOCA, however, has more serious consequences, particularly on the inboard side. Circulation of air by natural convection is proposed as a means for dissipating the inboard shield decay heat. The safety and environmental implications of such a scheme are evaluated. It is shown that the inboard shield temperature never exceeds 510/sup 0/C following LOCA posing no hazard to reactor personnel and not threatening the investment. 7 refs., 6 figs.

  16. The team approach to home-based primary care: restructuring care to meet individual, program, and system needs.

    PubMed

    Reckrey, Jennifer M; Soriano, Theresa A; Hernandez, Cameron R; DeCherrie, Linda V; Chavez, Silvia; Zhang, Meng; Ornstein, Katherine

    2015-02-01

    Team-based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address individual, program, and system needs, a portion of a large, physician-led academic home-based primary care practice was restructured into a team-based model. With support from an office-based nurse practitioner, a dedicated social worker, and a dedicated administrative assistant, physicians were able to care for a larger number of patients. Hospitalizations, readmissions, and patient satisfaction remained the same while physician panel size increased and physician satisfaction improved. The Team Approach is an innovative way to improve interdisciplinary, team-based care through practice restructuring and serves as an example of how other practices can approach the complex task of caring for the homebound. PMID:25645568

  17. The Team Approach to Home-Based Primary Care: Restructuring Care to Meet Patient, Program, and System Needs

    PubMed Central

    Reckrey, Jennifer M.; Soriano, Theresa A.; Hernandez, Cameron R.; DeCherrie, Linda V.; Chavez, Silvia; Zhang, Meng; Ornstein, Katherine

    2016-01-01

    Team-based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address patient, program, and system needs, we restructured a portion of our large, physician-led academic home-based primary care practice into a team-based model. With support from an office-based nurse practitioner, a dedicated social worker, and a dedicated administrative assistant, physicians were able to care for a larger number of patients. Hospitalizations, readmissions, and patient satisfaction remained the same while physician panel size increased and physician satisfaction improved. Our Team Approach is an innovative way to improve interdisciplinary, team-based care though practice restructuring and serves as an example of how other practices can approach the complex task of caring for the homebound. PMID:25645568

  18. T-Cell/Histiocyte-Rich Large B-Cell Lymphoma Presenting as a Primary Central Nervous System Lymphoma

    PubMed Central

    Advani, Pooja; Starr, Jason; Swaika, Abhisek; Jiang, Liuyan; Qiu, Yushi; Li, Zhimin

    2015-01-01

    Primary central nervous system (PCNSL) lymphoma is an aggressive extranodal non-Hodgkin lymphoma, and most cases are classified as diffuse large B-cell lymphoma (DLBCL) by histology. T-cell/histiocyte-rich large B-cell lymphoma (TCRLBCL) represents a distinct subtype of diffuse large B-cell lymphoma and is characterized by the presence of scattered large neoplastic B-cells in a background of abundant T-cells and histiocytes. This is in contrast to the dense perivascular cuffing of neoplastic B-cells in classic DLBCL. T-cell/histiocyte-rich large B-cell lymphoma should be considered in PCNSL cases in which neoplastic B-cells are sparse and scattered. Immunohistochemistry will help identify the B-cells and surrounding infiltrate rich in Tlymphocytes and histiocytes. Future studies exploring the biology of TCRLBCL and the crosstalk between the neoplastic cells and the surrounding inflammatory infiltrate may provide exciting prospects for future therapies for TCRLBCL. PMID:26788280

  19. Therapeutic management of refractory or relapsed primary central nervous system lymphomas.

    PubMed

    Reni, M; Ferreri, A J

    2001-01-01

    Despite the high rate of complete remission achieved with first-line therapy, 10-15% of immunocompetent PCNSL patients are treatment refractory while 35-60% relapse and die of lymphoma within a few months. In many cases, salvage therapy produces a second complete remission with consequent symptomatic and survival improvement. Due to the heterogeneity of both first and second line therapies employed, the optimal schedule for salvage therapy can not be identified. Nevertheless, some therapeutic guidelines could be suggested. Radiotherapy is an effective option for both previously irradiated and radiotherapy naïve patients. Some authors have been able to minimize the incidence of actinic toxicity by using chemotherapy alone at failure. In patients that have relapsed after receiving high-dose methotrexate (HD-MTX), the same drug again has been successfully employed while HD-cytarabine has been the most widely used cytostatic. Ocular recurrence can be treated with cytarabine or focal radiotherapy. Meningeal relapse can be treated with spinal cord irradiation, intrathecal and/or systemic chemotherapy. Salvage therapy, beyond improving survival, constitutes the selection ground for testing active agents. The addition of other cytostatics to HD-MTX has been empirically based and without a clear survival benefit, but with a higher toxicity. Intriguing preliminary results from small pilot studies are now available with topotecan, rituximab, temozolomide, PCV regimen and HD-chemotherapy supported by autologous or allogeneic peripheral blood stem cells transplantation. Considering its positive effect on survival and the potential improvement in neurological symptoms and quality of life, salvage therapy seems to be a valuable treatment in PCNSL patients. Finally, the inclusion of relapsing or progressive PCNSL patients into second-line prospective clinical trials for testing therapeutic agents should be strongly encouraged. PMID:11757691

  20. TNF-α stimulates System A amino acid transport in primary human trophoblast cells mediated by p38 MAPK signaling

    PubMed Central

    Aye, Irving L M H; Jansson, Thomas; Powell, Theresa L

    2015-01-01

    Maternal obesity and gestational diabetes mellitus (GDM) increase the risk of delivering infants that are large for gestational age with greater adiposity, who are prone to the development of metabolic disease in childhood and beyond. These maternal conditions are also associated with increased levels of the proinflammatory cytokine TNF-α in maternal tissues and the placenta. Recent evidence suggests that changes in placental amino acid transport contribute to altered fetal growth. TNF-α was previously shown to stimulate System A amino acid transport in primary human trophoblasts (PHTs), however the molecular mechanisms remain unknown. In this study, we tested the hypothesis that TNF-α regulates amino acid uptake in cultured PHTs by a mitogen-activated protein kinase (MAPK)-dependent mechanism. Treatment of PHTs with TNF-α significantly increased System A amino acid transport, as well as Erk and p38 MAPK signaling. Pharmacological antagonism of p38, but not Erk MAPK activity, inhibited TNF-α stimulated System A activity. Silencing of p38 MAPK using siRNA transfections prevented TNF-α stimulated System A transport in PHTs. TNF-α significantly increased the protein expression of System A transporters SNAT1 and SNAT2, but did not affect their mRNA expression. The effects of TNF-α on SNAT1 and SNAT2 protein expression were reversed by p38 MAPK siRNA silencing. In conclusion, TNF-α regulates System A activity through increased SNAT1 and SNAT2 transporter protein expression in PHTs. These findings suggest that p38 MAPK may represent a critical mechanistic link between elevated proinflammatory cytokines and increased placental amino acid transport in obese and GDM pregnancies associated with fetal overgrowth. PMID:26508738