Hydrogeologic Case Studies (Seattle, WA)

EPA Science Inventory

Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

HYDROGEOLOGIC CASE STUDIES (CHICAGO, IL)

EPA Science Inventory

Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

Clinical Research Methodology 2: Observational Clinical Research.

PubMed

Sessler, Daniel I; Imrey, Peter B

2015-10-01

Case-control and cohort studies are invaluable research tools and provide the strongest feasible research designs for addressing some questions. Case-control studies usually involve retrospective data collection. Cohort studies can involve retrospective, ambidirectional, or prospective data collection. Observational studies are subject to errors attributable to selection bias, confounding, measurement bias, and reverse causation-in addition to errors of chance. Confounding can be statistically controlled to the extent that potential factors are known and accurately measured, but, in practice, bias and unknown confounders usually remain additional potential sources of error, often of unknown magnitude and clinical impact. Causality-the most clinically useful relation between exposure and outcome-can rarely be definitively determined from observational studies because intentional, controlled manipulations of exposures are not involved. In this article, we review several types of observational clinical research: case series, comparative case-control and cohort studies, and hybrid designs in which case-control analyses are performed on selected members of cohorts. We also discuss the analytic issues that arise when groups to be compared in an observational study, such as patients receiving different therapies, are not comparable in other respects.

The challenges to gender integration in the career fire services: a comparative case study of men in nursing

DTIC Science & Technology

2017-03-01

GENDER INTEGRATION IN THE CAREER FIRE SERVICES: A COMPARATIVE CASE STUDY OF MEN IN NURSING by Anna L. Schermerhorn-Collins March 2017...IN THE CAREER FIRE SERVICES: A COMPARATIVE CASE STUDY OF MEN IN NURSING 5. FUNDING NUMBERS 6. AUTHOR(S) Anna L. Schermerhorn-Collins 7... comparative case study of men in nursing. Research is based in academic and historical accounts, in addition to the use of participant-observation

A Case Study in Design Thinking Applied Through Aviation Mission Support Tactical Advancements for the Next Generation (TANG)

DTIC Science & Technology

2017-12-01

This is an examination of the research, execution, and follow- on developments supporting the Design Thinking event explored through Case Study ...research, execution, and follow- on developments supporting the Design Thinking event explored through case study methods. Additionally, the lenses of...total there have been two Naval Postgraduate School (NPS) case study theses on U.S. Navy innovation events as well as other works examining the

Testing the effectiveness of family therapeutic assessment: a case study using a time-series design.

PubMed

Smith, Justin D; Wolf, Nicole J; Handler, Leonard; Nash, Michael R

2009-11-01

We describe a family Therapeutic Assessment (TA) case study employing 2 assessors, 2 assessment rooms, and a video link. In the study, we employed a daily measures time-series design with a pretreatment baseline and follow-up period to examine the family TA treatment model. In addition to being an illustrative addition to a number of clinical reports suggesting the efficacy of family TA, this study is the first to apply a case-based time-series design to test whether family TA leads to clinical improvement and also illustrates when that improvement occurs. Results support the trajectory of change proposed by Finn (2007), the TA model's creator, who posits that benefits continue beyond the formal treatment itself.

Involvement of a Case Manager in Palliative Care Reduces Hospitalisations at the End of Life in Cancer Patients; A Mortality Follow-Back Study in Primary Care

PubMed Central

van der Plas, Annicka G. M.; Vissers, Kris C.; Francke, Anneke L.; Donker, Gé A.; Jansen, Wim J. J.; Deliens, Luc; Onwuteaka-Philipsen, Bregje D.

2015-01-01

Background Case managers have been introduced in primary palliative care in the Netherlands; these are nurses with expertise in palliative care who offer support to patients and informal carers in addition to the care provided by the general practitioner (GP) and home-care nurse. Objectives To compare cancer patients with and without additional support from a case manager on: 1) the patients’ general characteristics, 2) characteristics of care and support given by the GP, 3) palliative care outcomes. Methods This article is based on questionnaire data provided by GPs participating in two different studies: the Sentimelc study (280 cancer patients) and the Capalca study (167 cancer patients). The Sentimelc study is a mortality follow-back study amongst a representative sample of GPs that monitors the care provided via GPs to a general population of end-of-life patients. Data from 2011 and 2012 were analysed. The Capalca study is a prospective study investigating the implementation and outcome of the support provided by case managers in primary palliative care. Data were gathered between March 2011 and December 2013. Results The GP is more likely to know the preferred place of death (OR 7.06; CI 3.47-14.36), the place of death is more likely to be at the home (OR 2.16; CI 1.33-3.51) and less likely to be the hospital (OR 0.26; CI 0.13-0.52), and there are fewer hospitalisations in the last 30 days of life (none: OR 1.99; CI 1.12-3.56 and one: OR 0.54; CI 0.30-0.96), when cancer patients receive additional support from a case manager compared with patients receiving the standard GP care. Conclusions Involvement of a case manager has added value in addition to palliative care provided by the GP, even though the role of the case manager is ‘only’ advisory and he or she does not provide hands-on care or prescribe medication. PMID:26208099

Involvement of a Case Manager in Palliative Care Reduces Hospitalisations at the End of Life in Cancer Patients; A Mortality Follow-Back Study in Primary Care.

PubMed

van der Plas, Annicka G M; Vissers, Kris C; Francke, Anneke L; Donker, Gé A; Jansen, Wim J J; Deliens, Luc; Onwuteaka-Philipsen, Bregje D

2015-01-01

Case managers have been introduced in primary palliative care in the Netherlands; these are nurses with expertise in palliative care who offer support to patients and informal carers in addition to the care provided by the general practitioner (GP) and home-care nurse. To compare cancer patients with and without additional support from a case manager on: 1) the patients' general characteristics, 2) characteristics of care and support given by the GP, 3) palliative care outcomes. This article is based on questionnaire data provided by GPs participating in two different studies: the Sentimelc study (280 cancer patients) and the Capalca study (167 cancer patients). The Sentimelc study is a mortality follow-back study amongst a representative sample of GPs that monitors the care provided via GPs to a general population of end-of-life patients. Data from 2011 and 2012 were analysed. The Capalca study is a prospective study investigating the implementation and outcome of the support provided by case managers in primary palliative care. Data were gathered between March 2011 and December 2013. The GP is more likely to know the preferred place of death (OR 7.06; CI 3.47-14.36), the place of death is more likely to be at the home (OR 2.16; CI 1.33-3.51) and less likely to be the hospital (OR 0.26; CI 0.13-0.52), and there are fewer hospitalisations in the last 30 days of life (none: OR 1.99; CI 1.12-3.56 and one: OR 0.54; CI 0.30-0.96), when cancer patients receive additional support from a case manager compared with patients receiving the standard GP care. Involvement of a case manager has added value in addition to palliative care provided by the GP, even though the role of the case manager is 'only' advisory and he or she does not provide hands-on care or prescribe medication.

Lung Cancer Risk from Occupational and Environmental Radon and Role of Smoking in Two Czech Nested Case-Control Studies

PubMed Central

Tomasek, Ladislav

2013-01-01

The aim of the present study was to evaluate the risk of lung cancer from combined exposure to radon and smoking. Methodologically, it is based on case-control studies nested within two Czech cohort studies of nearly 11,000 miners followed-up for mortality in 1952–2010 and nearly 12,000 inhabitants exposed to high levels of radon in homes, with mortality follow-up in 1960–2010. In addition to recorded radon exposure, these studies use information on smoking collected from the subjects or their relatives. A total of 1,029 and 370 cases with smoking information have been observed in the occupational and environmental (residential) studies, respectively. Three or four control subjects have been individually matched to cases according to sex, year of birth, and age. The combined effect from radon and smoking is analyzed in terms of geometric mixture models of which the additive and multiplicative models are special cases. The resulting models are relatively close to the additive interaction (mixing parameter 0.2 and 0.3 in the occupational and residential studies, respectively). The impact of the resulting model in the residential radon study is illustrated by estimates of lifetime risk in hypothetical populations of smokers and non-smokers. In comparison to the multiplicative risk model, the lifetime risk from the best geometric mixture model is considerably higher, particularly in the non-smoking population. PMID:23470882

Changes in frequency of recall recommendations of examinations depicting cancer with the availability of either priors or digital breast tomosynthesis

NASA Astrophysics Data System (ADS)

Hakim, Christiane M.; Bandos, Andriy I.; Ganott, Marie A.; Catullo, Victor J.; Chough, Denise M.; Kelly, Amy E.; Shinde, Dilip D.; Sumkin, Jules H.; Wallace, Luisa P.; Nishikawa, Robert M.; Gur, David

2016-03-01

Performance changes in a binary environment when using additional information is affected only when changes in recommendations are made due to the additional information in question. In a recent study, we have shown that, contrary to general expectation, introducing prior examinations improved recall rates, but not sensitivity. In this study, we assessed cancer detection differences when prior examinations and/or digital breast tomosynthesis (DBT) were made available to the radiologist. We identified a subset of 21 cancer cases with differences in the number of radiologists who recalled these cases after reviewing either a prior examination or DBT. For the cases with differences in recommendations after viewing either priors or DBT, separately, we evaluated the total number of readers that changed their recommendations, regardless of the specific radiologist in question. Confidence intervals for the number of readers and a test for the hypothesis of no difference was performed using the non-parameteric bootstrap approach addressing both case and reader-related sources of variability by resampling cases and readers. With the addition of priors, there were 14 cancer cases (out of 15) where the number of "recalling radiologists" decreased. With the addition of DBT, the number of "recalling radiologists" decreased in only five cases (out of 15) while increasing in the remaining 9 cases. Unlike most new approaches to breast imaging DBT seems to improve both recall rates and cancer detection rates. Changes in recommendations were noted by all radiologists for all cancers by type, size, and breast density.

Thomas Midgley, Jr., and the Development of New Substances: A Case Study for Chemical Educators

ERIC Educational Resources Information Center

Viana, Hélio Elael Bonini; Porto, Paulo Alves

2013-01-01

This paper presents a history of chemistry case study focusing on selected aspects of the work of American engineer Thomas Midgley, Jr. (1889-1944): the development of tetraethyl lead as an antiknock gasoline additive and of chlorofluorocarbons (CFCs) as fluids for refrigeration devices. One general aim of this case study is to display the complex…

HYDROGEOLOGIC CASE STUDIE(PRESENTATION FOR MNA WORKSHOP)

EPA Science Inventory

Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

Team effectiveness in academic medical libraries: a multiple case study*

PubMed Central

Russo Martin, Elaine

2006-01-01

Objectives: The objective of this study is to apply J. Richard Hackman's framework on team effectiveness to academic medical library settings. Methods: The study uses a qualitative, multiple case study design, employing interviews and focus groups to examine team effectiveness in three academic medical libraries. Another site was selected as a pilot to validate the research design, field procedures, and methods to be used with the cases. In all, three interviews and twelve focus groups, with approximately seventy-five participants, were conducted at the case study libraries. Findings: Hackman identified five conditions leading to team effectiveness and three outcomes dimensions that defined effectiveness. The participants in this study identified additional characteristics of effectiveness that focused on enhanced communication, leadership personality and behavior, and relationship building. The study also revealed an additional outcome dimension related to the evolution of teams. Conclusions: Introducing teams into an organization is not a trivial matter. Hackman's model of effectiveness has implications for designing successful library teams. PMID:16888659

Satellites for Commonwealth Education: Some Policy Issues. Case Studies: AUSSAT, Australia; Knowledge Network, Canada; INSAT, India; University of the South Pacific; University of the West Indies.

ERIC Educational Resources Information Center

Bates, A. W.

This report presents case studies on the use of satellites for education in five Commonwealth countries: Australia, Canada, India, Fiji, and Jamaica. Information provided in each of the case studies includes geography, production, the distribution system, regulation and management, and costs. Additional information given for the Australian…

A Case Study of Engineering Ethics

NASA Astrophysics Data System (ADS)

Shimizu, Kazuo

In Engineering Ethics Class at Shizuoka University, the Code of Ethics and Cases for Electrical Engineers by IEEJ Ethics committee is used to promote for high education effect to correspond large number of students (140students). In this paper, a case study in the class, and survey results for ethics value of students are presented. In addition, some comments for role playing act on the case of virtual experiences by students are described.

A note on the uniqueness of 2D elastostatic problems formulated by different types of potential functions

NASA Astrophysics Data System (ADS)

Guerrero, José Luis Morales; Vidal, Manuel Cánovas; Nicolás, José Andrés Moreno; López, Francisco Alhama

2018-05-01

New additional conditions required for the uniqueness of the 2D elastostatic problems formulated in terms of potential functions for the derived Papkovich-Neuber representations, are studied. Two cases are considered, each of them formulated by the scalar potential function plus one of the rectangular non-zero components of the vector potential function. For these formulations, in addition to the original (physical) boundary conditions, two new additional conditions are required. In addition, for the complete Papkovich-Neuber formulation, expressed by the scalar potential plus two components of the vector potential, the additional conditions established previously for the three-dimensional case in z-convex domain can be applied. To show the usefulness of these new conditions in a numerical scheme two applications are numerically solved by the network method for the three cases of potential formulations.

Addition of aripiprazole to the clozapine may be useful in reducing anxiety in treatment-resistant schizophrenia.

PubMed

Chanachev, Aleksandar; Ansermot, Nicolas; Crettol Wavre, Séverine; Nowotka, Ute; Stamatopoulou, Maria-Eleni; Conus, Philippe; Eap, Chin B

2011-01-01

There exist many case reports and studies on the antipsychotic augmentation by aripirazole in partial responders to clozapine, the most seem to be finding a slight difference in the PANSS and CGI scores after the aripirazole addition. The results of our report are compatible with those of other studies but, we have found a considerable antianxiety action in both of the cases. The 5HT1A agonism of aripirazole could be hypothesized as mechanism contributing to this effect.

New-onset asthma after exposure to the steam system additive 2-diethylaminoethanol. A descriptive study.

PubMed

Gadon, M E; Melius, J M; McDonald, G J; Orgel, D

1994-06-01

Through a leak in the steam heating system, the anticorrosive agent 2-diethylaminoethanol was released into the air of a large office building. Irritative symptoms were experienced by most of the 2500 employees, and 14 workers developed asthma within 3 months of exposure. This study was undertaken to review clinical characteristics of these asthmatics. Environmental exposure monitoring data and medical records were reviewed. Seven of 14 cases were defined as "confirmed" and 7 of 14 as "suspect," using the National Institute for Occupational Safety and Health surveillance case definition of occupational asthma. Spirometry was positive in 4 of 14 of the cases and peak flow testing in 10 of 14. Three cases were diagnosed on the basis of work-related symptoms and physical examination alone. The study suggests that acute exposure to the irritating steam additive 2-diethylaminoethanol was a contributing factor in the development of clinical asthma in this population.

[Dandy-Walker complex: a clinicopathologic study of 9 cases].

PubMed

Zhang, Xiao-bo; Gu, Yi-qun; Sun, Xiao-fei; Wang, Ying-nan; Wang, Ai-chun

2013-12-01

To investigate the etiology, pathogenesis, clinicopathologic characteristics, clinical prognosis and treatment of Dandy-Walker syndrome. Nine cases of Dandy-Walker syndrome were included in the study. The autopsy findings and clinical history were evaluated along with review of the literature. The causes, pathogenetic mechanism, pathologic features and prognosis of Dandy-Walker syndrome were analyzed. Among 9 Dandy-Walker syndrome cases, six patients presented with variants of Dandy-Walker complex and 3 cases had classic Dandy-Walker malformation. In addition, 4 patients presented with combined lateral ventricle expansion and multiple malformations were seen in 7 cases. Combined umbilical cord abnormality was noted in 4 patients with variant of Dandy-Walker complex and combined placental abnormality was seen in one classic Dandy-Walker syndrome. Dandy-Walker syndrome is a rare disease. In addition to complex pathogenesis with possible genetic and environmental antigenic etiologies, placental and umbilical cord abnormality may be also related to its development.

Alternative Fuels Data Center: Idle Reduction

Science.gov Websites

Cities Annual Petroleum Savings Clean Cities Annual Petroleum Savings Incentive and Law Additions by Fuel /Technology Type Incentive and Law Additions by Fuel/Technology Type Incentive Additions by Policy Type Incentive Additions by Policy Type More Idle Reduction Data | All Maps & Data Case Studies Massachusetts

Giftedness, Trauma, and Development: A Qualitative, Longitudinal Case Study

ERIC Educational Resources Information Center

Peterson, Jean Sunde

2014-01-01

A qualitative, longitudinal, phenomenological case study explored how a gifted female experienced various life events and aspects of development during adolescence and young adulthood (ages 15-30 years), particularly as related to multiple traumatic experiences, which were revealed late in the first year of the study. Additional experiences, well…

Successful Student Goal Completion: A Community College Case Study

ERIC Educational Resources Information Center

Cady, Sara C.

2013-01-01

Research studies have shown that one half of all students who begin college fail to realize their goals. This case study of one community college provided a comprehensive examination of best practices developed over several years through strategic enrollment planning. Additionally, this dissertation examined the decision-making processes that…

Virtual Surgical Planning for Inferior Alveolar Nerve Reconstruction.

PubMed

Miloro, Michael; Markiewicz, Michael R

2017-11-01

The purpose of this study was to assess the outcomes after preoperative virtual surgical planning (VSP) for inferior alveolar nerve (IAN) reconstruction in ablative mandibular surgery. We performed a retrospective evaluation of consecutive surgical cases using standard VSP for hard tissue resection and reconstructive surgery in addition to IAN VSP performed simultaneously during surgery. Cases were assessed regarding the planning time, additional costs involved, surgeon's subjective impression of the process, accuracy of the prediction during surgery, and operative time during surgery compared with cases performed without VSP. The study sample was composed of 5 cases of mandibular resection for benign disease, with bony, soft tissue, and neural reconstruction with the use of VSP. The addition of IAN reconstruction to the VSP session added no additional expense to the planning session but resulted in an additional 22.5 minutes (±7.5 minutes) for the webinar session. From a subjective standpoint, IAN VSP provided the surgeon with a discreet plan for surgery. From an objective standpoint, IAN VSP provided the exact length and diameter of nerve graft required for surgery, facilitated the surgeon's ability to visualize the actual nerve graft procedure, and limited the additional time required for simultaneous nerve reconstruction. Despite perceived prejudice against simultaneous IAN reconstruction with complex mandibular resection and reconstruction, the use of IAN VSP may facilitate the actual surgical procedure and result in considerably improved patient outcomes without considerable additional time or cost associated with this protocol. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Parameters and pitfalls to consider in the conduct of food additive research, Carrageenan as a case study.

PubMed

Weiner, Myra L

2016-01-01

This paper provides guidance on the conduct of new in vivo and in vitro studies on high molecular weight food additives, with carrageenan, the widely used food additive, as a case study. It is important to understand the physical/chemical properties and to verify the identity/purity, molecular weight and homogeneity/stability of the additive in the vehicle for oral delivery. The strong binding of CGN to protein in rodent chow or infant formula results in no gastrointestinal tract exposure to free CGN. It is recommended that doses of high Mw non-caloric, non-nutritive additives not exceed 5% by weight of total solid diet to avoid potential nutritional effects. Addition of some high Mw additives at high concentrations to liquid nutritional supplements increases viscosity and may affect palatability, caloric intake and body weight gain. In in vitro studies, the use of well-characterized, relevant cell types and the appropriate composition of the culture media are necessary for proper conduct and interpretation. CGN is bound to media protein and not freely accessible to cells in vitro. Interpretation of new studies on food additives should consider the interaction of food additives with the vehicle components and the appropriateness of the animal or cell model and dose-response. Copyright © 2015 FMC Corporation. Published by Elsevier Ltd.. All rights reserved.

Geothermal Case Studies

DOE Data Explorer

Young, Katherine

2014-09-30

database.) In fiscal year 2015, NREL is working with universities to populate additional case studies on OpenEI. The goal is to provide a large enough dataset to start conducting analyses of exploration programs to identify correlations between successful exploration plans for areas with similar geologic occurrence models.

Investigating Approaches to Achieve Modularity Benefits in the Acquisition Ecosystem

DTIC Science & Technology

2017-06-09

actions and that of others, and how the assessments are affected by their actions. • Case study approach based on best practices, tacit knowledge... case study -derived exemplars, and items requiring further research on identifying additional enablers and useful knowledge constructs. All of these... case studies that document the effective use of modularity in system design for some or all of innovation, competition, cost, technology and

Fas/APO-1 (CD95) expression in myelodysplastic syndromes.

PubMed

Lepelley, P; Grardel, N; Erny, O; Iaru, T; Obein, V; Cosson, A; Fenaux, P

1998-07-01

Increased apoptosis of myeloid precursors appears to contribute to the pathophysiology of cytopenias in myelodysplastic syndromes (MDS). Fas /APO-1(CD95) is a cell surface protein inducing an apoptotic signal after its binding to Fas ligand or to a functional anti-Fas antibody. Here we studied Fas expression by immunocytochemistry on marrow slides from 30 cases of MDS. Increased Fas expression in erythroblasts and/or immature granulocytes, compared to controls, was seen in 12 (40%) of the cases. In addition, in 16 of the 18 cases with > or = 5% marrow blasts, a variable proportion of blasts expressed Fas. Increased apoptosis was found by morphological analysis and/or TUNEL technique in marrow cells from 8 of the 26 cases analyzed (31%) The ability of Fas antigen to trigger apoptosis was studied after addition of a functional anti Fas antibody in 5 of the patients with Fas overexpression. Addition of this antibody, however, only lead to mild increase of apoptosis in immature granulocytes (but not other myeloid cells) in 2 of the 5 cases. Thus, increased Fas expression is seen in myeloid and/or blast cells in the majority of MDS cases. However, the relationship between this finding and increased apoptosis in MDS still remains to be established.

A Case Study of Educational Computer Game Design by Middle School Students

ERIC Educational Resources Information Center

An, Yun-Jo

2016-01-01

Only a limited number of research studies have investigated how students design educational computer games and its impact on student learning. In addition, most studies on educational game design by students were conducted in the areas of mathematics and science. Using the qualitative case study approach, this study explored how seventh graders…

Reproducibility in Natural Language Processing: A Case Study of Two R Libraries for Mining PubMed/MEDLINE.

PubMed

Cohen, K Bretonnel; Xia, Jingbo; Roeder, Christophe; Hunter, Lawrence E

2016-05-01

There is currently a crisis in science related to highly publicized failures to reproduce large numbers of published studies. The current work proposes, by way of case studies, a methodology for moving the study of reproducibility in computational work to a full stage beyond that of earlier work. Specifically, it presents a case study in attempting to reproduce the reports of two R libraries for doing text mining of the PubMed/MEDLINE repository of scientific publications. The main findings are that a rational paradigm for reproduction of natural language processing papers can be established; the advertised functionality was difficult, but not impossible, to reproduce; and reproducibility studies can produce additional insights into the functioning of the published system. Additionally, the work on reproducibility lead to the production of novel user-centered documentation that has been accessed 260 times since its publication-an average of once a day per library.

Real life juvenile toxicity case studies: the good, the bad and the ugly.

PubMed

De Schaepdrijver, Luc; Rouan, Marie-Claude; Raoof, Araz; Bailey, Graham P; De Zwart, Loeckie; Monbaliu, Johan; Coogan, Timothy P; Lammens, Lieve; Coussement, Werner

2008-09-01

With the growing experience in the conduct of juvenile toxicity studies for multiple classes of compound, the 'case-by-case' approach has become under much more pressure. Instead, a general screen or 'standard design' is now commonly expected by regulatory authorities with more routine inclusion of neurological and reproductive assessments. Minor modifications or additions can be made to the design to address specific questions according to the class of drug or intended clinical use. This drift from a 'case-by-case' approach to a 'standard design' approach is present within certain reviewing divisions of the FDA, often requesting by default a rodent and non-rodent juvenile animal study. However, juvenile animal studies should be designed thoughtfully to fulfil a purpose based on scientific rationale, with each endpoint carefully considered in terms of practicality and interpretability of data generated. Only when using the appropriate strategy and design may juvenile studies add value by (1) identifying potential safety or pharmacokinetic issues for drugs intended for paediatric use, (2) suggesting additional clinical endpoints and (3) adding new information to the product label. As the knowledge from juvenile animal studies in various species grows, a better understanding of the significance/relevance of findings will be achieved.

A case study on topology optimized design for additive manufacturing

NASA Astrophysics Data System (ADS)

Gebisa, A. W.; Lemu, H. G.

2017-12-01

Topology optimization is an optimization method that employs mathematical tools to optimize material distribution in a part to be designed. Earlier developments of topology optimization considered conventional manufacturing techniques that have limitations in producing complex geometries. This has hindered the topology optimization efforts not to fully be realized. With the emergence of additive manufacturing (AM) technologies, the technology that builds a part layer upon a layer directly from three dimensional (3D) model data of the part, however, producing complex shape geometry is no longer an issue. Realization of topology optimization through AM provides full design freedom for the design engineers. The article focuses on topologically optimized design approach for additive manufacturing with a case study on lightweight design of jet engine bracket. The study result shows that topology optimization is a powerful design technique to reduce the weight of a product while maintaining the design requirements if additive manufacturing is considered.

Baby Boomers and Community College: A Study of Motivations

ERIC Educational Resources Information Center

Cunningham, DiAnne H.

2009-01-01

Scope and method of study. This descriptive case study was designed to describe the critical issues surrounding Baby Boomers and their motivations to attend community college, in addition to their perceptions of learning and curriculum needs. Additionally the study explored what these Baby Boomers plan to do after completing their courses and…

CONTROL FUNCTION ASSISTED IPW ESTIMATION WITH A SECONDARY OUTCOME IN CASE-CONTROL STUDIES.

PubMed

Sofer, Tamar; Cornelis, Marilyn C; Kraft, Peter; Tchetgen Tchetgen, Eric J

2017-04-01

Case-control studies are designed towards studying associations between risk factors and a single, primary outcome. Information about additional, secondary outcomes is also collected, but association studies targeting such secondary outcomes should account for the case-control sampling scheme, or otherwise results may be biased. Often, one uses inverse probability weighted (IPW) estimators to estimate population effects in such studies. IPW estimators are robust, as they only require correct specification of the mean regression model of the secondary outcome on covariates, and knowledge of the disease prevalence. However, IPW estimators are inefficient relative to estimators that make additional assumptions about the data generating mechanism. We propose a class of estimators for the effect of risk factors on a secondary outcome in case-control studies that combine IPW with an additional modeling assumption: specification of the disease outcome probability model. We incorporate this model via a mean zero control function. We derive the class of all regular and asymptotically linear estimators corresponding to our modeling assumption, when the secondary outcome mean is modeled using either the identity or the log link. We find the efficient estimator in our class of estimators and show that it reduces to standard IPW when the model for the primary disease outcome is unrestricted, and is more efficient than standard IPW when the model is either parametric or semiparametric.

Supporting Student Athletes with Disabilities: A Case Study

ERIC Educational Resources Information Center

Weiss, Margaret P.

2011-01-01

Students with disabilities face tremendous change when transitioning to postsecondary education. Student athletes with disabilities face additional time and academic demands. Many universities have developed academic support programs for these student athletes. This article describes a case study of a Learning Assistance Program developed to…

Identification of seven new prostate cancer susceptibility loci through a genome-wide association study.

PubMed

Eeles, Rosalind A; Kote-Jarai, Zsofia; Al Olama, Ali Amin; Giles, Graham G; Guy, Michelle; Severi, Gianluca; Muir, Kenneth; Hopper, John L; Henderson, Brian E; Haiman, Christopher A; Schleutker, Johanna; Hamdy, Freddie C; Neal, David E; Donovan, Jenny L; Stanford, Janet L; Ostrander, Elaine A; Ingles, Sue A; John, Esther M; Thibodeau, Stephen N; Schaid, Daniel; Park, Jong Y; Spurdle, Amanda; Clements, Judith; Dickinson, Joanne L; Maier, Christiane; Vogel, Walther; Dörk, Thilo; Rebbeck, Timothy R; Cooney, Kathleen A; Cannon-Albright, Lisa; Chappuis, Pierre O; Hutter, Pierre; Zeegers, Maurice; Kaneva, Radka; Zhang, Hong-Wei; Lu, Yong-Jie; Foulkes, William D; English, Dallas R; Leongamornlert, Daniel A; Tymrakiewicz, Malgorzata; Morrison, Jonathan; Ardern-Jones, Audrey T; Hall, Amanda L; O'Brien, Lynne T; Wilkinson, Rosemary A; Saunders, Edward J; Page, Elizabeth C; Sawyer, Emma J; Edwards, Stephen M; Dearnaley, David P; Horwich, Alan; Huddart, Robert A; Khoo, Vincent S; Parker, Christopher C; Van As, Nicholas; Woodhouse, Christopher J; Thompson, Alan; Christmas, Tim; Ogden, Chris; Cooper, Colin S; Southey, Melissa C; Lophatananon, Artitaya; Liu, Jo-Fen; Kolonel, Laurence N; Le Marchand, Loic; Wahlfors, Tiina; Tammela, Teuvo L; Auvinen, Anssi; Lewis, Sarah J; Cox, Angela; FitzGerald, Liesel M; Koopmeiners, Joseph S; Karyadi, Danielle M; Kwon, Erika M; Stern, Mariana C; Corral, Roman; Joshi, Amit D; Shahabi, Ahva; McDonnell, Shannon K; Sellers, Thomas A; Pow-Sang, Julio; Chambers, Suzanne; Aitken, Joanne; Gardiner, R A Frank; Batra, Jyotsna; Kedda, Mary Anne; Lose, Felicity; Polanowski, Andrea; Patterson, Briony; Serth, Jürgen; Meyer, Andreas; Luedeke, Manuel; Stefflova, Klara; Ray, Anna M; Lange, Ethan M; Farnham, Jim; Khan, Humera; Slavov, Chavdar; Mitkova, Atanaska; Cao, Guangwen; Easton, Douglas F

2009-10-01

Prostate cancer (PrCa) is the most frequently diagnosed cancer in males in developed countries. To identify common PrCa susceptibility alleles, we previously conducted a genome-wide association study in which 541,129 SNPs were genotyped in 1,854 PrCa cases with clinically detected disease and in 1,894 controls. We have now extended the study to evaluate promising associations in a second stage in which we genotyped 43,671 SNPs in 3,650 PrCa cases and 3,940 controls and in a third stage involving an additional 16,229 cases and 14,821 controls from 21 studies. In addition to replicating previous associations, we identified seven new prostate cancer susceptibility loci on chromosomes 2, 4, 8, 11 and 22 (with P = 1.6 x 10(-8) to P = 2.7 x 10(-33)).

Improving Assistive Technology Service by Using 3D Printing: Three Case Studies.

PubMed

Watanabe, Takashi; Hatakeyama, Takuro; Tomiita, Mitsuru

2015-01-01

Assistive technology services are essential for adapting assistive devices to the individual needs of users with disabilities. In this study, we attempted to apply three-dimensional (3D) printing technology to three actual cases, and to study its use, effectiveness, and future applications. We assessed the usefulness of 3D printing technology by categorizing its utilization after reviewing the outcomes of these case studies. In future work, we aim to gather additional case studies and derive information on using 3D printing technology that will enable its effective application in the process of assistive technology services.

Revisiting Approaches to Learning in Science and Engineering: A Case Study

ERIC Educational Resources Information Center

Gynnild, V.; Myrhaug, D.

2012-01-01

Several studies have applied the dichotomy of deep and surface approaches to learning in a range of disciplinary contexts. Existing questionnaires have largely assumed the existence of these constructs; however, in a recent study Case and Marshall (2004) described two additional context-specific approaches to learning in engineering. The current…

Case-Control Genome-Wide Association Study of Attention-Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Neale, Benjamin M.; Medland, Sarah; Ripke, Stephan; Anney, Richard J. L.; Asherson, Philip; Buitelaar, Jan; Franke, Barbara; Gill, Michael; Kent, Lindsey; Holmans, Peter; Middleton, Frank; Thapar, Anita; Lesch, Klaus-Peter; Faraone, Stephen V.; Daly, Mark; Nguyen, Thuy Trang; Schafer, Helmut; Steinhausen, Hans-Christoph; Reif, Andreas; Renner, Tobias J.; Romanos, Marcel; Romanos, Jasmin; Warnke, Andreas; Walitza, Susanne; Freitag, Christine; Meyer, Jobst; Palmason, Haukur; Rothenberger, Aribert; Hawi, Ziarih; Sergeant, Joseph; Roeyers, Herbert; Mick, Eric; Biederman, Joseph

2010-01-01

Objective: Although twin and family studies have shown attention-deficit/hyperactivity disorder (ADHD) to be highly heritable, genetic variants influencing the trait at a genome-wide significant level have yet to be identified. Thus additional genome-wide association studies (GWAS) are needed. Method: We used case-control analyses of 896 cases…

An Exploratory Analysis of Projected Navy Officer Inventory Strength Using Data Farming

DTIC Science & Technology

2016-09-01

model’s run-time. 3. Base Case In addition to the experimental design, this study includes a base case scenario to serve as a baseline for comparison...47 3. SWO Operating Strength Deviation-Base Case One objective of this study is to determine the risk in operating strength deviation presented by...ANSWERS TO RESEARCH QUESTIONS ................................... 71  B.  RECOMMENDATIONS FOR FUTURE STUDIES ......................... 73  1.  Continuous

The FIDELIS initiative: innovative strategies for increased case finding.

PubMed

Hinderaker, S G; Rusen, I D; Chiang, C-Y; Yan, L; Heldal, E; Enarson, D A

2011-01-01

Low-income, high tuberculosis (TB) burden countries. To compare case finding of new smear-positive pulmonary TB patients in projects funded to apply innovative approaches. Prospective application of innovative approaches to case finding within routine services to determine the numbers of additional cases detected and the cost per additional case detected, according to the type of approach applied. Between 2003 and 2007, 51 FIDELIS projects were implemented in 18 countries; 273,239 cases were reported, of which 85,267 were additional to the number reported in the previous year. The median cost per additional case was US$103. The interventions employed were: 1) social mobilisation and information, education and communication; 2) engagement of the private sector; 3) innovative approaches for microscopy services; 4) enhanced or semi-active case finding; 5) health systems strengthening; and 6) use of incentives. None of these was significantly more likely to detect additional cases or to have a lower cost per additional case than any of the others. While there was a substantial increase in cases detected, at a moderate cost per additional case, we were unable to show that any single intervention had an advantage over the others.

Addition of Aripiprazole to the Clozapine May Be Useful in Reducing Anxiety in Treatment-Resistant Schizophrenia

PubMed Central

Chanachev, Aleksandar; Ansermot, Nicolas; Crettol Wavre, Séverine; Nowotka, Ute; Stamatopoulou, Maria-Eleni; Conus, Philippe; Eap, Chin B.

2011-01-01

There exist many case reports and studies on the antipsychotic augmentation by aripirazole in partial responders to clozapine, the most seem to be finding a slight difference in the PANSS and CGI scores after the aripirazole addition. The results of our report are compatible with those of other studies but, we have found a considerable antianxiety action in both of the cases. The 5HT1A agonism of aripirazole could be hypothesized as mechanism contributing to this effect. PMID:22937411

75 FR 42296 - Safe, Efficient Use and Preservation of the Navigable Airspace

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... facilitates the aeronautical study process and has reduced the overall processing time for these cases. The... cases to be processed, particularly if additional information, via public comment period, was necessary... the permit application is not necessary. There are cases where circulating the proposal for public...

Unit Hydrograph Peaking Analysis for Goose Creek Watershed in Virginia: A Case Study

DTIC Science & Technology

2017-05-01

ER D C/ CH L TR -1 7- 6 Unit Hydrograph Peaking Analysis for Goose Creek Watershed in Virginia: A Case Study Co as ta l a nd H yd ra...default. ERDC/CHL TR-17-6 May 2017 Unit Hydrograph Peaking Analysis for Goose Creek Watershed in Virginia: A Case Study Nawa Raj Pradhan and...confidence interval precipitation depths to the watershed in addition to the 50% value. This study concluded that a design event with a return period greater

Making intelligent systems team players: Additional case studies

NASA Technical Reports Server (NTRS)

Malin, Jane T.; Schreckenghost, Debra L.; Rhoads, Ron W.

1993-01-01

Observations from a case study of intelligent systems are reported as part of a multi-year interdisciplinary effort to provide guidance and assistance for designers of intelligent systems and their user interfaces. A series of studies were conducted to investigate issues in designing intelligent fault management systems in aerospace applications for effective human-computer interaction. The results of the initial study are documented in two NASA technical memoranda: TM 104738 Making Intelligent Systems Team Players: Case Studies and Design Issues, Volumes 1 and 2; and TM 104751, Making Intelligent Systems Team Players: Overview for Designers. The objective of this additional study was to broaden the investigation of human-computer interaction design issues beyond the focus on monitoring and fault detection in the initial study. The results of this second study are documented which is intended as a supplement to the original design guidance documents. These results should be of interest to designers of intelligent systems for use in real-time operations, and to researchers in the areas of human-computer interaction and artificial intelligence.

Schools Where Parents Make A Difference.

ERIC Educational Resources Information Center

Davies, Don, Ed.

This book presents 11 case studies that demonstrate successful efforts to improve education through building new relationships between schools and communities. In addition to presenting the case studies, the book also contains an introductory chapter that discusses the potentials and pitfalls of local efforts at participatory democracy, as well as…

The Regional Accreditation Process at Community Colleges: A Case Study of Effectiveness

ERIC Educational Resources Information Center

Young, Alissa L.

2013-01-01

This companion dissertation reports the findings of applied case study research on four community college organizational units that consistently meet or exceed standard performance measures. In addition, prior ample evidence confirms that performance extended significantly beyond what might be explained by available tangible resources alone. The…

Exploring the role of the internet in juvenile prostitution cases coming to the attention of law enforcement.

PubMed

Wells, Melissa; Mitchell, Kimberly J; Ji, Kai

2012-01-01

This exploratory analysis examines the role of the Internet in juvenile prostitution cases coming to the attention of law enforcement. The National Juvenile Prostitution Study (N-JPS) collected information from a national sample of law enforcement agencies about the characteristics of juvenile prostitution cases. In comparison to non-Internet juvenile prostitution cases, Internet juvenile prostitution cases involved younger juveniles and police were more likely to treat juveniles as victims rather than offenders. In addition, these cases were significantly more likely to involve a family or acquaintance exploiter. This analysis suggests that the role of the Internet may impact legal and social service response to juveniles involved in prostitution. In addition, it highlights the need for interventions that acknowledge the vulnerabilities of youth involved in this type of commercial sexual exploitation.

Phosphate analysis of natural sausage casings preserved in brines with phosphate additives as inactivating agent - Method validation.

PubMed

Wijnker, J J; Tjeerdsma-van Bokhoven, J L M; Veldhuizen, E J A

2009-01-01

Certain phosphates have been identified as suitable additives for the improvement of the microbial and mechanical properties of processed natural sausage casings. When mixed with NaCl (sodium chloride) and used under specific treatment and storage conditions, these phosphates are found to prevent the spread of foot-and-mouth disease and classical swine fever via treated casings. The commercially available Quantichrom™ phosphate assay kit has been evaluated as to whether it can serve as a reliable and low-tech method for routine analysis of casings treated with phosphate. The outcome of this study indicates that this particular assay kit has sufficient sensitivity to qualitatively determine the presence of phosphate in treated casings without interference of naturally occurring phosphate in salt used for brines in which casings are preserved.

Systems Engineering Technical Leadership Development Program

DTIC Science & Technology

2012-02-01

leading others in creative problem solving, complexity, and why projects fail . These topics were additionally supported by case studies designed to...Your Core Values Dominick Wed 12:30-1:30 Lunch Wed 1:30-2:45 Case Study: Why Projects Fail Pennotti Wed 2:45-3:00 Break Wed 3:00-4:30 Project...Case Study: When Good Wasn’t Good Enough 11. Technical Value-5: Group Project: AR2D2 RFP 12. Customer Expectation-1: Lecture: Why Systems Fail

Exploring Campus Response to State Mandated Change: A Case Study of the Implementation of Legislation Allowing Guns on Campus

ERIC Educational Resources Information Center

Grantham, Ashley Erin

2016-01-01

This case study examines the implementation of a state legislative mandate to allow guns on campus at a public higher education institution in the southeastern United States. This study explores the process that one campus underwent to implement an externally mandated change. Additionally, this study examined whether Newcombe and Conrad's (1981)…

Explicit Instruction of Graphic Organizers as an Informational Text Reading Comprehension Strategy: Third-Grade Students' Strategies and Perceptions

ERIC Educational Resources Information Center

Fealy, Erin Marie

2010-01-01

The purpose of this case study research was to explore the effects of explicit instruction of graphic organizers to support students' understandings of informational text. An additional purpose was to investigate students' perceptions of using graphic organizers as a comprehension strategy. Using case study methodology, this study occurred…

Teaching Students about Plagiarism: What It Looks Like and How It Is Measured

ERIC Educational Resources Information Center

Stout, Diana

2013-01-01

This case study examines how full-time faculty, adjunct instructors, and graduate teaching assistants teach students how to avoid plagiarism. Additionally, this case study includes a cross-section of teachers who encounter plagiarism in writing assignments across the curriculum. While many studies in the past have focused on students, this study…

Identification of seven new prostate cancer susceptibility loci through a genome-wide association study

PubMed Central

Eeles, Rosalind A.; Kote-Jarai, Zsofia; Olama, Ali Amin Al; Giles, Graham G.; Guy, Michelle; Severi, Gianluca; Muir, Kenneth; Hopper, John L.; Henderson, Brian E.; Haiman, Christopher A.; Schleutker, Johanna; Hamdy, Freddie C.; Neal, David E.; Donovan, Jenny L.; Stanford, Janet L.; Ostrander, Elaine A.; Ingles, Sue A.; John, Esther M.; Thibodeau, Stephen N.; Schaid, Daniel; Park, Jong Y.; Spurdle, Amanda; Clements, Judith; Dickinson, Joanne L.; Maier, Christiane; Vogel, Walther; Dörk, Thilo; Rebbeck, Timothy R.; Cooney, Kathleen A.; Cannon-Albright, Lisa; Chappuis, Pierre O.; Hutter, Pierre; Zeegers, Maurice; Kaneva, Radka; Zhang, Hong-Wei; Lu, Yong-Jie; Foulkes, William D.; English, Dallas R.; Leongamornlert, Daniel A.; Tymrakiewicz, Malgorzata; Morrison, Jonathan; Ardern-Jones, Audrey T.; Hall, Amanda L.; O’Brien, Lynne T.; Wilkinson, Rosemary A.; Saunders, Edward J.; Page, Elizabeth C.; Sawyer, Emma J.; Edwards, Stephen M.; Dearnaley, David P.; Horwich, Alan; Huddart, Robert A.; Khoo, Vincent S.; Parker, Christopher C.; Van As, Nicholas; Woodhouse, Christopher J.; Thompson, Alan; Christmas, Tim; Ogden, Chris; Cooper, Colin S.; Southey, Melissa C.; Lophatananon, Artitaya; Liu, Jo-Fen; Kolonel, Laurence N.; Le Marchand, Loic; Wahlfors, Tiina; Tammela, Teuvo L.; Auvinen, Anssi; Lewis, Sarah J.; Cox, Angela; FitzGerald, Liesel M.; Koopmeiners, Joseph S.; Karyadi, Danielle M.; Kwon, Erika M.; Stern, Mariana C.; Corral, Roman; Joshi, Amit D.; Shahabi, Ahva; McDonnell, Shannon K.; Sellers, Thomas A; Pow-Sang, Julio; Chambers, Suzanne; Aitken, Joanne; Gardiner, R.A. (Frank); Batra, Jyotsna; Kedda, Mary Anne; Lose, Felicity; Polanowski, Andrea; Patterson, Briony; Serth, Jürgen; Meyer, Andreas; Luedeke, Manuel; Stefflova, Klara; Ray, Anna M.; Lange, Ethan M.; Farnham, Jim; Khan, Humera; Slavov, Chavdar; Mitkova, Atanaska; Cao, Guangwen; Easton, Douglas F.

2010-01-01

Prostate cancer (PrCa) is the most frequently diagnosed male cancer in developed countries. To identify common PrCa susceptibility alleles, we have previously conducted a genome-wide association study in which 541, 129 SNPs were genotyped in 1,854 PrCa cases with clinically detected disease and 1,894 controls. We have now evaluated promising associations in a second stage, in which we genotyped 43,671 SNPs in 3,650 PrCa cases and 3,940 controls, and a third stage, involving an additional 16,229 cases and 14,821 controls from 21 studies. In addition to previously identified loci, we identified a further seven new prostate cancer susceptibility loci on chromosomes 2, 4, 8, 11, and 22 (P=1.6×10−8 to P=2.7×10−33). PMID:19767753

[The Hospital Information System of the Brazilian National Unified Health System: a preliminary evaluation of performance in monitoring RhD hemolytic disease of the newborn].

PubMed

Lobato, Gustavo; Reichenheim, Michael Eduardo; Coeli, Claudia Medina

2008-03-01

This study aimed to evaluate the adequacy of the Hospital Information System of the National Unified Health System (SIH-SUS) in identifying cases of RhD hemolytic disease of the newborn (HDN) at the Fernandes Figueira Institute (IFF/FIOCRUZ) from 1998 to 2003. Neonatal records, data from the Medical Archives, and AIH (Hospital Admissions Authorization Form) data consolidated in the SIH-SUS were analyzed. Cases were identified according to the following fields: principal diagnosis, secondary diagnosis, and procedure performed. During the period studied, 194 cases of HDN were diagnosed. The Medical Archives registered 148 newborns with HDN, however only 147 AIHs were issued and 145 consolidated in the SIH-SUS. Among these 145 cases, 84 cited HDN as the principal diagnosis, while secondary diagnosis identified 38 additional cases and the procedures performed failed to identify any further cases. Thus, the SIH-SUS identified only 122 (62.9%) of the 194 cases of HDN treated at the IFF/FIOCRUZ. Although it is necessary to evaluate other units, the SIH-SUS does not appear to be reliable for monitoring HDN. Additional studies are essential for employing secondary administrative data in the context of epidemiological surveillance.

The clinical relevance and prognostic significance of adenosine triphosphate ATP-binding cassette (ABCB5) and multidrug resistance (MDR1) genes expression in acute leukemia: an Egyptian study.

PubMed

Farawela, Hala M; Khorshied, Mervat M; Kassem, Neemat M; Kassem, Heba A; Zawam, Hamdy M

2014-08-01

Multidrug resistance (MDR1) represents a major obstacle in the chemotherapeutic treatment of acute leukemia (AL). Adenosine triphosphate ATP-binding cassette (ABCB5) and MDR1 genes are integral membrane proteins belonging to ATP-binding cassette transporters superfamily. The present work aimed to investigate the impact of ABCB5 and MDR1 genes expression on the response to chemotherapy in a cohort of Egyptian AL patients. The study included 90 patients: 53 AML cases and 37 ALL cases in addition to 20 healthy volunteers as controls. Quantitative assessment of MDR1 and ABCB5 genes expression was performed by quantitative real-time polymerase chain reaction. Additional prognostic molecular markers were determined as internal tandem duplications of the FLT3 gene (FLT3-ITD) and nucleophosmin gene mutation (NPM1) for AML cases, and mbcr-abl fusion transcript for B-ALL cases. In AML patients, ABCB5 and MDR1 expression levels did not differ significantly between de novo and relapsed cases and did not correlate with the overall survival or disease-free survival. AML patients were stratified according to the studied genetic markers, and complete remission rate was found to be more prominent in patients having low expression of MDR1 and ABCB5 genes together with mutated NPM1 gene. In ALL patients, ABCB5 gene expression level was significantly higher in relapsed cases and MDR1 gene expression was significantly higher in patients with resistant disease. In conclusion, the results obtained by the current study provide additional evidence of the role played by these genes as predictive factors for resistance of leukemic cells to chemotherapy and hence treatment outcome.

Endomyocardial fibrosis in Sudan: clinical and echocardiographic features

PubMed Central

Khalil, Siddiq Ibrahim; Khalil, Suha; El Tigani, Salma; Saad, Hanan A

2017-01-01

Summary Objective: Endomyocardial fibrosis (EMF) is a rare disease and is often an underdiagnosed and forgotten cardiomyopathy. The objective of this study was to document the current frequency of EMF in Sudan by defining and selecting cases from patients attending the echocardiography laboratory. Additionally we aimed to create an EMF registry for Sudan. Methods: The study started in January 2007 and is on-going. All the patients attending our echocardiography clinics in four different hospitals in Khartoum, Sudan, were included. Transthoracic echocardiography was used as the main diagnostic and selection tool. The diagnosis of EMF was based on predefined criteria and definitions, and was further supported by additional clinical, ECG, laboratory and chest X-ray findings. Results: Out of 4 332 cases studied, 23 (0.5%) were found to have features of EMF. Females constituted 52% and the age range was 24 to 67 years. All patients presented with dyspnoea grades III–IV. Advanced heart failure with gross fluid overload was seen in 54% of cases and ascites was seen in 30%. EMF was biventricular in 53%, left ventricular in 29% and right ventricular in 18% of cases. Apical and ventricular wall fibrosis was found in all cases, followed by atrial enlargement, atrioventricular valve incompetence, ventricular cavity obliteration, restrictive flow pattern and pericardial effusion. Additional echocardiographic features are defined and discussed. Conclusion: Although a rare disease, cases of EMF can be identified in Sudan if a high index of suspicion is observed. New echocardiographic features of ventricular wall layering, endocardial fibrous shelf and endomyocardiopericarial fibrosis were identified and are discussed. PMID:28906536

Reproducibility in Natural Language Processing: A Case Study of Two R Libraries for Mining PubMed/MEDLINE

PubMed Central

Cohen, K. Bretonnel; Xia, Jingbo; Roeder, Christophe; Hunter, Lawrence E.

2018-01-01

There is currently a crisis in science related to highly publicized failures to reproduce large numbers of published studies. The current work proposes, by way of case studies, a methodology for moving the study of reproducibility in computational work to a full stage beyond that of earlier work. Specifically, it presents a case study in attempting to reproduce the reports of two R libraries for doing text mining of the PubMed/MEDLINE repository of scientific publications. The main findings are that a rational paradigm for reproduction of natural language processing papers can be established; the advertised functionality was difficult, but not impossible, to reproduce; and reproducibility studies can produce additional insights into the functioning of the published system. Additionally, the work on reproducibility lead to the production of novel user-centered documentation that has been accessed 260 times since its publication—an average of once a day per library. PMID:29568821

Autism Spectrum Disorder and New Jersey Administrative Law Decisions: An Analysis of Case Law Involving Public School Students

ERIC Educational Resources Information Center

Barcadepone, Michael J.

2012-01-01

The purpose of this case study was to investigate existing New Jersey case law for the special education population classified as Autism Spectrum Disorder (ASD) and analyze New Jersey Administrative Law Judge (ALJ) decisions to identify why districts win or lose cases, adding to the limited body of research in New Jersey. In addition, the purpose…

Case studies for GSHP demonstration projects in the US

DOE PAGES

Liu, Xiaobing; Malhotra, Mini; Im, Piljae

2015-07-01

Under the American Recovery and Reinvestment Act , twenty-six ground source heat pump (GSHP) projects were competitively selected and carried out to demonstrate the benefits of GSHP systems and innovative technologies for cost reduction and/or performance improvement. This article gives an overview of the case studies for six of the systems. These case studies evaluated efficiencies, energy savings, and costs of the demonstrated systems. In addition, it was found that more energy savings could be achieved if controls of GSHP system are improved.

The impact of use of an intraoperative margin assessment device on re-excision rates.

PubMed

Sebastian, Molly; Akbari, Stephanie; Anglin, Beth; Lin, Erin H; Police, Alice M

2015-01-01

Historically there has been a high rate of surgical interventions to obtain clear margins for breast cancer patients undergoing breast conserving local therapy. An intraoperative margin assessment tool (MarginProbe) has been approved for use in the US since 2013. This study is the first compilation of data from routine use of the device, to assess the impact of device utilization on re-excision rates. We present a retrospective, observational, review from groups of consecutive patients, before and after the implementation of intraoperative use of the device during lumpectomy procedures. Lesions were localized by standard methods. The intraoperative margin assessment device was used on all circumferential margins of the main specimen, but not on any additional shavings. A positive reading by the device led to an additional shaving of the corresponding cavity location. Specimens were also, when feasible, imaged intra-operatively by X-ray, and additional shavings were taken if needed based on clinical assessment. For each surgeon, historical re-excision rates were established based on a consecutive set of patients from a time period proximal to initiation of use of the device. From March 2013 to April 2014 the device was routinely used by 4 surgeons in 3 centers. In total, 165 cases lumpectomy cases were performed. Positive margins resulted in additional re-excision procedures in 9.7% (16/165) of the cases. The corresponding historical set from 2012 and 2013 consisted of 186 Lumpectomy cases, in which additional re-excision procedures were performed in 25.8% (48/186) of the cases. The reduction in the rate of re-excision procedures was significant 62% (P < 0.0001). Use of an intraoperative margin assessment device contributes to achieving clear margins and reducing re-excision procedures. As in some cases positive margins were found on shavings, future studies of interest may include an analysis of the effect of using the device on the shavings intra-operatively.

Perceptions of ESL Program Management in Canadian Higher Education: A Qualitative Case Study

ERIC Educational Resources Information Center

Eaton, Sarah Elaine

2017-01-01

ESL programs at post-secondary institutions must often generate revenue in addition to teaching students English. Institutions often impose explicit expectations on these programs to generate profit, creating unique challenges for those who administer them. This qualitative case study investigated challenges faced by ESL program directors at one…

Meta-Analysis of Interventions for Basic Mathematics Computation in Single-Case Research

ERIC Educational Resources Information Center

Methe, Scott A.; Kilgus, Stephen P.; Neiman, Cheryl; Riley-Tillman, T. Chris

2012-01-01

This study examined interventions for addition and subtraction that were implemented through single-case design (SCD) research studies. We attempted to extend prior SCD meta-analyses by examining differences in effect sizes across several moderating variables and by including a novel index of effect, improvement rate difference (IRD). We also…

Problem Solving by 5-6 Years Old Kindergarten Children in a Computer Programming Environment: A Case Study

ERIC Educational Resources Information Center

Fessakis, G.; Gouli, E.; Mavroudi, E.

2013-01-01

Computer programming is considered an important competence for the development of higher-order thinking in addition to algorithmic problem solving skills. Its horizontal integration throughout all educational levels is considered worthwhile and attracts the attention of researchers. Towards this direction, an exploratory case study is presented…

Home Education in the Post-Communist Countries: Case Study of the Czech Republic

ERIC Educational Resources Information Center

Kostelecká, Yvona

2010-01-01

The paper analyzes the emergence of home education in European post-communist countries after 1989. The case of the Czech Republic representing the development and characteristic features of home education in the whole region is studied in detail. Additional information about homeschooling in other post-communist countries are provided wherever…

Peer Learning Group among College Voice Majors: Collaborative Inquiry Case Study

ERIC Educational Resources Information Center

Jung, Joo Yeon

2013-01-01

This collaborative inquiry case study investigated a pre-existing peer learning group composed of five Korean college voice students and a non-musician facilitator. The group was chosen for this research to understand the implications of a diversified learning context in addition to the typical master-apprenticeship context of higher music…

A Case Study of Dual Language Program Administrators: The Teachers We Need

ERIC Educational Resources Information Center

Lachance, Joan R.

2017-01-01

In support of growing numbers of dual language programs nation-wide, dual language school administrators seek to find teachers who are specifically prepared to work with dual language learners for additive biliteracy. For this research the author utilized a case study design to explore practicing dual language administrators' perspectives…

Parent-Implemented Hanen Program "More than Words" in Angelman Syndrome: A Case Study

ERIC Educational Resources Information Center

de Carlos Isla, Mercedes; Fortea, Inmaculada Baixauli

2016-01-01

Children with Angelman syndrome (AS) exhibit significant social, communicative and cognitive difficulties. The aim of this case study was to describe the profile of communicative abilities of a child with AS, before and after the implementation of the Hanen program "More than Words" (MTW). Additionally, changes on the language directed…

Applying Emax model and bivariate thin plate splines to assess drug interactions

PubMed Central

Kong, Maiying; Lee, J. Jack

2014-01-01

We review the semiparametric approach previously proposed by Kong and Lee and extend it to a case in which the dose-effect curves follow the Emax model instead of the median effect equation. When the maximum effects for the investigated drugs are different, we provide a procedure to obtain the additive effect based on the Loewe additivity model. Then, we apply a bivariate thin plate spline approach to estimate the effect beyond additivity along with its 95% point-wise confidence interval as well as its 95% simultaneous confidence interval for any combination dose. Thus, synergy, additivity, and antagonism can be identified. The advantages of the method are that it provides an overall assessment of the combination effect on the entire two-dimensional dose space spanned by the experimental doses, and it enables us to identify complex patterns of drug interaction in combination studies. In addition, this approach is robust to outliers. To illustrate this procedure, we analyzed data from two case studies. PMID:20036878

Applying Emax model and bivariate thin plate splines to assess drug interactions.

PubMed

Kong, Maiying; Lee, J Jack

2010-01-01

We review the semiparametric approach previously proposed by Kong and Lee and extend it to a case in which the dose-effect curves follow the Emax model instead of the median effect equation. When the maximum effects for the investigated drugs are different, we provide a procedure to obtain the additive effect based on the Loewe additivity model. Then, we apply a bivariate thin plate spline approach to estimate the effect beyond additivity along with its 95 per cent point-wise confidence interval as well as its 95 per cent simultaneous confidence interval for any combination dose. Thus, synergy, additivity, and antagonism can be identified. The advantages of the method are that it provides an overall assessment of the combination effect on the entire two-dimensional dose space spanned by the experimental doses, and it enables us to identify complex patterns of drug interaction in combination studies. In addition, this approach is robust to outliers. To illustrate this procedure, we analyzed data from two case studies.

Management of Sacral Tumors Requiring Spino-Pelvic Reconstruction with Different Histopathologic Diagnosis: Evaluation with Four Cases

PubMed Central

Togral, Guray; Hasturk, Askin Esen; Kekec, Fevzi; Parpucu, Murat; Gungor, Safak

2015-01-01

In this retrospective study, surgical results of four patients with sacral tumors having disparate pathologic diagnoses, who were treated with partial or total sacrectomy and lumbopelvic stabilization were abstracted. Two patients were treated with partial sacral resection and two patients were treated with total sacrectomy and spinopelvic fixation. Fixation methods included spinopelvic fixation with rods and screws in two cases, reconstruction plate in one case, and fresh frozen allografts in two cases. Fibular allografts used for reconstruction accelerated bony union and enhanced the stability in two cases. Addition of polymethyl methacrylate in the cavity in the case of a giant cell tumor had a positive stabilizing effect on fixation. As a result, we can conclude that mechanical instability after sacral resection can be stabilized securely with lumbopelvic fixation and polymethyl methacrylate application or addition of fresh frozen allografts between the rods can augment the stability of the reconstruction. PMID:26713133

Management of Sacral Tumors Requiring Spino-Pelvic Reconstruction with Different Histopathologic Diagnosis: Evaluation with Four Cases.

PubMed

Arıkan, Murat; Togral, Guray; Hasturk, Askin Esen; Kekec, Fevzi; Parpucu, Murat; Gungor, Safak

2015-12-01

In this retrospective study, surgical results of four patients with sacral tumors having disparate pathologic diagnoses, who were treated with partial or total sacrectomy and lumbopelvic stabilization were abstracted. Two patients were treated with partial sacral resection and two patients were treated with total sacrectomy and spinopelvic fixation. Fixation methods included spinopelvic fixation with rods and screws in two cases, reconstruction plate in one case, and fresh frozen allografts in two cases. Fibular allografts used for reconstruction accelerated bony union and enhanced the stability in two cases. Addition of polymethyl methacrylate in the cavity in the case of a giant cell tumor had a positive stabilizing effect on fixation. As a result, we can conclude that mechanical instability after sacral resection can be stabilized securely with lumbopelvic fixation and polymethyl methacrylate application or addition of fresh frozen allografts between the rods can augment the stability of the reconstruction.

Costs incurred by applying computer-aided design/computer-aided manufacturing techniques for the reconstruction of maxillofacial defects.

PubMed

Rustemeyer, Jan; Melenberg, Alex; Sari-Rieger, Aynur

2014-12-01

This study aims to evaluate the additional costs incurred by using a computer-aided design/computer-aided manufacturing (CAD/CAM) technique for reconstructing maxillofacial defects by analyzing typical cases. The medical charts of 11 consecutive patients who were subjected to the CAD/CAM technique were considered, and invoices from the companies providing the CAD/CAM devices were reviewed for every case. The number of devices used was significantly correlated with cost (r = 0.880; p < 0.001). Significant differences in mean costs were found between cases in which prebent reconstruction plates were used (€3346.00 ± €29.00) and cases in which they were not (€2534.22 ± €264.48; p < 0.001). Significant differences were also obtained between the costs of two, three and four devices, even when ignoring the cost of reconstruction plates. Additional fees provided by statutory health insurance covered a mean of 171.5% ± 25.6% of the cost of the CAD/CAM devices. Since the additional fees provide financial compensation, we believe that the CAD/CAM technique is suited for wide application and not restricted to complex cases. Where additional fees/funds are not available, the CAD/CAM technique might be unprofitable, so the decision whether or not to use it remains a case-to-case decision with respect to cost versus benefit. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Nutrition and Its Effects on the Hyperkinetic Child's Behavior and Learning: A Case Study.

ERIC Educational Resources Information Center

Noonan, Roberta L.

This case study reviews the literature related to diet, behavior and learning and describes procedures and results of a change in the diet of an adolescent girl who had an extensive history of problems at home and at school. Studies of nutritional deficiency, nutritional imbalance, allergies, and synthetic food additives are briefly overviewed.…

Insights into Inclusive Education through a Small Finnish Case Study of an Inclusive School Context

ERIC Educational Resources Information Center

Tarr, Jane Mary; Tsokova, Diana; Takkunen, Ulla-Maija

2012-01-01

This study seeks to present data and discussion arising from a case study of a school in Finland renowned for its practice in the inclusion of learners with additional support requirements due to cognitive and physical disabilities. It aims to establish how the school staff understand their practice with inclusion through day-to-day professional…

Distribution of maternal age and birth order groups in cases with unclassified multiple congenital abnormalities according to the number of component abnormalities: a national population-based case-control study.

PubMed

Csermely, Gyula; Czeizel, Andrew E; Veszprémi, Béla

2015-02-01

Multiple congenital abnormalities are caused by chromosomal aberrations, mutant major genes and teratogens. A minor proportion of these patients are identified as syndromes but the major part belonging to the group of unclassified multiple CAs (UMCAs). The main objective of this study was to evaluate the maternal age and birth order in pregnant women who had offspring affected with UMCA. The strong association between numerical chromosomal aberrations, e.g., Down syndrome and advanced maternal age is well-known and tested here. The Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980 to 1996, yielded a large population-based national data set with 22,843 malformed newborns or fetuses ("informative cases") included 1349 UMCA cases with their 2407 matched controls. Case-control comparison of maternal age and birth order was made for cases with UMCA, stratified by component numbers and their controls. In addition, 834 cases with Down syndrome were compared to 1432 matched controls. The well-known advanced maternal age with the higher risk for Down syndrome was confirmed. The findings of the study suggest that the young age of mothers associates with the higher risk of UMCA, in addition birth order 4 or more associates with the higher risk for UMCA with 2 and 3 component CAs. This study was the first to analyze the possible maternal and birth order effect for cases with UMCA, and the young age and higher birth order associated with a higher risk for UMCA. © 2014 Wiley Periodicals, Inc.

The first Korean case report of anti-Gerbich.

PubMed

Jeon, You La; Park, Tae Sung; Cho, Sun Young; Oh, Seung Hwan; Kim, Myeong Hee; Kang, So Young; Lee, Woo-In

2012-11-01

In this study, we report the first Korean case of an anti-Gerbich (Ge) alloantibody to a high-incidence antigen that belongs to the Ge blood group system. The alloantibody was detected in a middle-aged Korean woman who did not have a history of transfusion. Her blood type was B+, and findings from the antibody screening test revealed 1+ reactivity in all panels except the autocontrol. The cross-matching test showed incompatible results with all 5 packed red blood cells. Additional blood type antigen and antibody tests confirmed the anti-Ge alloantibody. While rare, cases of hemolytic transfusion reaction or hemolytic disease in newborns due to anti-Ge have been recently reported in the literature. Therefore, additional further studies on alloantibodies to high-incidence antigens, including anti-Ge, are necessary in the future.

The Use of Interrupted Case Studies to Enhance Critical Thinking Skills in Biology

PubMed Central

White, Tracy K.; Whitaker, Paul; Gonya, Terri; Hein, Richard; Kroening, Dubear; Lee, Kevin; Lee, Laura; Lukowiak, Andrea; Hayes, Elizabeth

2009-01-01

There has been a dramatic increase in the availability of case studies for use in the biology classroom, and perceptions of the effectiveness of case-study-based learning are overwhelmingly positive. Here we report the results of a study in which we evaluated the ability of interrupted case studies to improve critical thinking in the context of experimental design and the conventions of data interpretation. Students were assessed using further case studies designed to evaluate their ability to recognize and articulate problematic approaches to these elements of experimentation. Our work reveals that case studies have broad utility in the classroom. In addition to demonstrating a small but statistically significant increase in the number of students capable of critically evaluating selected aspects of experimental design, we also observed increased student engagement and documented widespread misconceptions regarding the conventions of data acquisition and analysis. PMID:23653687

A Real-Life Case Study of Audit Interactions--Resolving Messy, Complex Problems

ERIC Educational Resources Information Center

Beattie, Vivien; Fearnley, Stella; Hines, Tony

2012-01-01

Real-life accounting and auditing problems are often complex and messy, requiring the synthesis of technical knowledge in addition to the application of generic skills. To help students acquire the necessary skills to deal with these problems effectively, educators have called for the use of case-based methods. Cases based on real situations (such…

Older paternal age and fresh gene mutation: data on additional disorders.

PubMed

Jones, K L; Smith, D W; Harvey, M A; Hall, B D; Quan, L

1975-01-01

Older paternal age has previously been documented as a factor in sporadic fresh mutational cases of several autosomal dominant disorders. In this collaborative study, an older mean paternal age has been documented in sporadic cases of at least five additional dominantly inheritable disorders; the basal cell nevus syndrome, the Waardenburg syndrome, the Crouzon syndrome, the oculo-dental-digital sysdrome, and the Treacher-Collins syndrome. It was also found to be a factor in acrodysostosis and progeria, suggesting a fresh mutant gene etiology for these two conditions in which virtually all cases have been sporadic and the mode of genetic etiology has been unknown.

Dating human skeletal remains using 90Sr and 210Pb: case studies.

PubMed

Schrag, Bettina; Uldin, Tanya; Mangin, Patrice; Bochud, François; Froidevaux, Pascal

2014-01-01

In legal medicine, the post mortem interval (PMI) of interest covers the last 50 years. When only human skeletal remains are found, determining the PMI currently relies mostly on the experience of the forensic anthropologist, with few techniques available to help. Recently, several radiometric methods have been proposed to reveal PMI. For instance, (14)C and (90)Sr bomb pulse dating covers the last 60 years and give reliable PMI when teeth or bones are available. (232)Th series dating has also been proposed but requires a large amount of bones. In addition, (210)Pb dating is promising but is submitted to diagenesis and individual habits like smoking that must be handled carefully. Here we determine PMI on 29 cases of forensic interest using (90)Sr bomb pulse. In 12 cases, (210)Pb dating was added to narrow the PMI interval. In addition, anthropological investigations were carried out on 15 cases to confront anthropological expertise to the radiometric method. Results show that 10 of the 29 cases can be discarded as having no forensic interest (PMI>50 years) based only on the (90)Sr bomb pulse dating. For 10 other cases, the additional (210)Pb dating restricts the PMI uncertainty to a few years. In 15 cases, anthropological investigations corroborate the radiometric PMI. This study also shows that diagenesis and inter-individual difference in radionuclide uptake represent the main sources of uncertainty in the PMI determination using radiometric methods. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Time-resolved XAFS spectroscopic studies of B-H and N-H oxidative addition to transition metal catalysts relevant to hydrogen storage

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

Bitterwolf, Thomas E.

2014-12-09

Successful catalytic dehydrogenation of aminoborane, H 3NBH 3, prompted questions as to the potential role of N-H oxidative addition in the mechanisms of these processes. N-H oxidative addition reactions are rare, and in all cases appear to involve initial dative bonding to the metal by the amine lone pairs followed by transfer of a proton to the basic metal. Aminoborane and its trimethylborane derivative block this mechanism and, in principle, should permit authentic N-H oxidative attrition to occur. Extensive experimental work failed to confirm this hypothesis. In all cases either B-H complexation or oxidative addition of solvent C-H bonds dominatemore » the chemistry.« less

The efficacy of hydroxychloroquine for obstetrical outcome in anti-phospholipid syndrome: Data from a European multicenter retrospective study.

PubMed

Mekinian, Arsène; Lazzaroni, Maria Grazia; Kuzenko, Anna; Alijotas-Reig, Jaume; Ruffatti, Amelia; Levy, Pierre; Canti, Valentina; Bremme, Katarina; Bezanahary, Holy; Bertero, Tiziana; Dhote, Robin; Maurier, Francois; Andreoli, Laura; Benbara, Amélie; Tigazin, Ahmed; Carbillon, Lionel; Nicaise-Roland, Pascale; Tincani, Angela; Fain, Olivier

2015-06-01

In European multicenter study, we aimed to describe the real-life hydroxychloroquine use in APS patients during pregnancy and determine its benefit in refractory obstetrical APS. We analyzed the outcome of pregnancies treated by hydroxychloroquine in patients with APS or asymptomatic antiphospholipid (aPL) antibodies carriers. Thirty patients with APS with 35 pregnancies treated by hydroxychloroquine were analyzed. Comparing the outcome of pregnancies treated by the addition of hydroxychloroquine to previous pregnancies under the conventional treatment, pregnancy losses decreased from 81% to 19% (p<0.05), without differences in the associated treatments. The univariate analysis showed that the previous intrauterine deaths and higher hydroxychloroquine amount (400mg per day) were the factors associated with pregnancy outcome. Considering 14 patients with previous refractory obstetrical APS (n=5 with obstetrical and thrombotic primary APS and n=9 with purely obstetrical APS), all with previous pregnancy losses under treatment (aspirin with LMWH in 11 cases and LMWH in 3 cases), the addition of hydroxychloroquine resulted in live born babies in 11/14 (78%) cases (p<0.05). Our study shows the benefit of hydroxychloroquine addition in patients with refractory obstetrical APS and raises the need of prospective studies to confirm our preliminary study. Copyright © 2015 Elsevier B.V. All rights reserved.

Solar Array and Auroral Charging Studies of DMSP Spacecraft

NASA Technical Reports Server (NTRS)

Matias, Kelwin

2013-01-01

The SSJ electrostatic analyzers and the SSIES plasma instruments on the DMSP spacecraft in low Earth polar orbit can be used to conduct case studies of auroral and solar array charging. We will use a program written in the Interactive Data Language (IDL) to evaluate questionable charging events in the SSJ records by comparing charging signatures in SSJ and SSIES data. In addition, we will assemble a number of case studies of solar array charging showing the signatures from the SSJ data and compare to the SSIES charging signatures. In addition we will use Satellite Tool Kit (STK) to propagate orbits, obtain solar intensity, and use to verify onset of charging with sunrise.

Removal of biofilm from contact lens storage cases.

PubMed

Wu, Yvonne T; Zhu, Hua; Willcox, Mark; Stapleton, Fiona

2010-12-01

Lens case hygiene practices are important in maintaining safe contact lens wear. However, the effectiveness of various lens case cleaning practices have not been evaluated and compared. This in vitro study aimed to evaluate and compare the efficacy of cleaning practices that are most commonly carried out by lens wearers and recommended by practitioners. Pseudomonas aeruginosa 122, Serratia marcescens ATCC 13880, and Staphylococcus aureus ATCC 6538 were the challenge bacteria for biofilm formation on unused lens cases from two different manufacturers. After establishment of the biofilm, each lens case was subjected to one of the six cleaning regimens: "rinsed," "rubbed and rinsed," "air-dried," "soaked in a multipurpose contact lens solution," "tissue-wiped," and "lids recapped." The level of residual biofilm was quantified at the end of each cleaning regimen. The efficacy of each cleaning regimen was then compared. Mechanical rubbing and wiping of lens cases were the most effective cleaning regimen tested in reducing biofilm. Soaking lenses in disinfecting solution for 6 hours removed the majority of biofilm from lens cases. Rinsing lens cases alone provided only minimal efficacy in reducing biofilm. Air-drying or recapping the cases with the lid without any other additional cleaning methods were the least efficient at removing biofilm. Based on this study, digital rubbing and rinsing and/or wiping the lens cases with tissue is recommended. Air-drying or recapping the lens case lids after use without any additional cleaning methods should be discouraged with non-antimicrobial lens cases.

Pedagogy and Process: A Case Study of Writing in a Hybrid Learning Model

ERIC Educational Resources Information Center

Keiner, Jason F.

2017-01-01

This qualitative case study explored the perceived experiences and outcomes of writing in a hybrid model of instruction in a large suburban high school. In particular, the impact of a hybrid model on the writing process and on future writing performance were examined. In addition, teacher expectation and teacher attitude and their impact upon…

Should the Dead Sea Be Sustainable?: Investigating Environmental Issues Using a Case Study

ERIC Educational Resources Information Center

Saunders, Cheston Andrew

2016-01-01

Many students leave the environmental science classroom with misconceptions centered on the availability of natural resources such as water. This article presents a case study where students assume the roles of various stakeholders and articulate their position on whether or not to pipe water from the Red Sea to the Dead Sea. Additionally,…

Planning Intervention Using Dynamic Assessments: A Case Study

ERIC Educational Resources Information Center

Hasson, Natalie; Dodd, Barbara

2014-01-01

Dynamic assessments (DA) of language have been shown to be a useful addition to the battery of tests used to diagnose language impairments in children, and to evaluate their skills. The current article explores the value of the information gained from a DA in planning intervention for a child with language impairment. A single case study was used…

Racism in Interracial Dating: A Case Study in Southern Culture and Fundamentalism

ERIC Educational Resources Information Center

Rose, Stephanie Firebaugh; Firmin, Michael W.

2016-01-01

This article presents a case study of Bob Jones University (BJU), a fundamentalist Christian institution located in South Carolina that is known within the context of U.S. higher education for its conservatism on multiple levels. Our analysis traces the beliefs of the institution's founder and subsequent leaders, in addition to particular…

Bowland Maths: Problem Solving in Key Stage 3

ERIC Educational Resources Information Center

Lane, Peter; Lister, Adelaide; Onion, Alice; Wintle, Karen

2008-01-01

A project has been developed for KS3 maths, funded by the Bowland Trust (www.bowlandmaths.org.uk) with additional support from the DCSF. It consists of a teaching resource of about 20 case-study problems aimed at developing thinking, reasoning and problem-solving skills and has been distributed to all UK secondary schools. Each case study includes…

SIMPLE MEASURES ARE AS EFFECTIVE AS INVASIVE TECHNIQUES IN THE DIAGNOSIS OF PULMONARY TUBERCULOSIS IN MALAWI

PubMed Central

Bell, David J; Dacombe, Russell; Graham, Stephen M; Hicks, Alexander; Cohen, Danielle; Chikaonda, Tarsizio; French, Neil; Molyneux, Malcolm E; Zijlstra, Ed E; Squire, S Bertel; Gordon, Stephen B

2010-01-01

Setting Detection of smear-positive pulmonary tuberculosis (PTB) cases is vital for tuberculosis control. Methods to augment sputum collection are available but their additional benefit is uncertain in resource-limited settings. Objective To compare the diagnostic yields using five methods to obtain sputum from adults diagnosed with smear-negative PTB in Malawi. Design Self-expectorated sputum was collected under supervision for microscopy and mycobacterial culture in the study laboratory. Confirmed smear-negative patients, provided physiotherapy-assisted sputum and induced sputum followed, the next morning, by gastric washing and bronchoalveolar-lavage samples. Results 150 patients, diagnosed with smear-negative PTB by the hospital service, were screened. 39 (26%) were smear-positive from supervised self-expectorated sputum examined in the study laboratory. The remaining 111 confirmed smear-negative patients were enrolled; 89% were HIV positive. Seven additional smear-positive cases were diagnosed using the augmented sputum collection techniques. No differences were observed in the numbers of cases detected using the different methods. 44 (95.6%) of the 46 smear-positive cases could be detected from self-expectorated and physiotherapy-assisted samples Conclusions For countries like Malawi, the best use of limited resources to detect smear-positive PTB cases would be to improve the quality of self-expectorated sputum collection and microscopy. The additional diagnostic yield using bronchoalveolar-lavage after induced sputum is limited. PMID:19105886

Geothermal Exploration Case Studies on OpenEI (Presentation)

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

Young, K.; Bennett, M.; Atkins, D.

2014-03-01

The U.S. Geological Survey (USGS) resource assessment (Williams et al., 2008) outlined a mean 30 GWe of undiscovered hydrothermal resource in the western United States. One goal of the U.S. Department of Energy's (DOE) Geothermal Technology Office (GTO) is to accelerate the development of this undiscovered resource. DOE has focused efforts on helping industry identify hidden geothermal resources to increase geothermal capacity in the near term. Increased exploration activity will produce more prospects, more discoveries, and more readily developable resources. Detailed exploration case studies akin to those found in oil and gas (e.g. Beaumont and Foster, 1990-1992) will give developersmore » central location for information gives models for identifying new geothermal areas, and guide efficient exploration and development of these areas. To support this effort, the National Renewable Energy Laboratory (NREL) has been working with GTO to develop a template for geothermal case studies on the Geothermal Gateway on OpenEI. In 2012, the template was developed and tested with two case studies: Raft River Geothermal Area (http://en.openei.org/wiki/Raft_River_Geothermal_Area) and Coso Geothermal Area (http://en.openei.org/wiki/Coso_Geothermal_Area). In 2013, ten additional case studies were completed, and Semantic MediaWiki features were developed to allow for more data and the direct citations of these data. These case studies are now in the process of external peer review. In 2014, NREL is working with universities and industry partners to populate additional case studies on OpenEI. The goal is to provide a large enough data set to start conducting analyses of exploration programs to identify correlations between successful exploration plans for areas with similar geologic occurrence models.« less

Ulnar nerve injury associated with trampoline injuries.

PubMed

Maclin, Melvin M; Novak, Christine B; Mackinnon, Susan E

2004-08-01

This study reports three cases of ulnar neuropathy after trampoline injuries in children. A chart review was performed on children who sustained an ulnar nerve injury from a trampoline accident. In all cases, surgical intervention was required. Injuries included upper-extremity fractures in two cases and an upper-extremity laceration in one case. All cases required surgical exploration with internal neurolysis and ulnar nerve transposition. Nerve grafts were used in two cases and an additional nerve transfer was used in one case. All patients had return of intrinsic hand function and sensation after surgery. Children should be followed for evolution of ulnar nerve neuropathy after upper-extremity injury with consideration for electrical studies and surgical exploration if there is no improvement after 3 months.

Facial fractures caused by less-lethal rubber bullet weapons: case series report and literature review.

PubMed

Amaral, Marcio Bruno Figueiredo; Bueno, Sebastião Cristian; Abdala, Icaro Buchholz; da Silveira, Roger Lanes

2017-09-01

The present study aims to describe three cases of patients inflicted by rubber bullets with severe facial fractures. In addition, a review of English-language literature involving facial fractures by rubber bullets from 1975 to 2016 was performed. This current study demonstrated that the use of the LLRBW is unsafety even when applied by police enforcements exclusively. Management of facial fractures caused by LLRBW is done in a usual manner with closed or open reduction associated with bone mini-plates or reconstruction plates when indicated. Special initial wound care should be done to avoid secondary infection and additional procedures.

A review of published research on adult dissociative identity disorder: 2000-2010.

PubMed

Boysen, Guy A; VanBergen, Alexandra

2013-01-01

The purpose of this study was to assess the scientific and etiological status of dissociative identity disorder (DID) by examining cases published from 2000 to 2010. In terms of scientific status, DID is a small but ongoing field of study. The review yielded 21 case studies and 80 empirical studies, presenting data on 1171 new cases of DID. A mean of 9 articles, each containing a mean of 17 new cases of DID, emerged each year. In terms of etiological status, many of the central criticisms of the disorder's validity remain unaddressed. Most cases of DID emerged from a small number of countries and clinicians. In addition, documented cases occurring outside treatment were almost nonexistent. Finally, people simulating DID in the laboratory were mostly indistinguishable from individuals with DID. Overall, DID is still a topic of study, but the research lacks the productivity and focus needed to resolve ongoing controversies surrounding the disorder.

The First Korean Case Report of Anti-Gerbich

PubMed Central

Jeon, You La; Park, Tae Sung; Cho, Sun Young; Oh, Seung Hwan; Kim, Myeong Hee; Kang, So Young

2012-01-01

In this study, we report the first Korean case of an anti-Gerbich (Ge) alloantibody to a high-incidence antigen that belongs to the Ge blood group system. The alloantibody was detected in a middle-aged Korean woman who did not have a history of transfusion. Her blood type was B+, and findings from the antibody screening test revealed 1+ reactivity in all panels except the autocontrol. The cross-matching test showed incompatible results with all 5 packed red blood cells. Additional blood type antigen and antibody tests confirmed the anti-Ge alloantibody. While rare, cases of hemolytic transfusion reaction or hemolytic disease in newborns due to anti-Ge have been recently reported in the literature. Therefore, additional further studies on alloantibodies to high-incidence antigens, including anti-Ge, are necessary in the future. PMID:23130346

Maxillary gap at 11-13 weeks' gestation: marker of cleft lip and palate.

PubMed

Chaoui, R; Orosz, G; Heling, K S; Sarut-Lopez, A; Nicolaides, K H

2015-12-01

To describe a new sign of cleft lip and palate (CLP), the maxillary gap, which is visible in the mid-sagittal plane of the fetal face used routinely for measurement of nuchal translucency thickness. This was a retrospective study of stored images of the mid-sagittal view of the fetal face at 11-13 weeks' gestation in 86 cases of CLP and 86 normal controls. The images were examined to determine if a maxillary gap was present, in which case its size was measured. In 37 (43.0%) cases of CLP the defect was isolated and in 49 (57.0%) there were additional fetal defects. In the isolated CLP group, the diagnosis of facial cleft was made in the first trimester in nine (24.3%) cases and in the second trimester in 28 (75.7%). In the group with additional defects, the diagnosis of facial cleft was made in the first trimester in 46 (93.9%) cases and in the second trimester in three (6.1%). A maxillary gap was observed in 96% of cases of CLP with additional defects, in 65% of those with isolated CLP and in 7% of normal fetuses. There was a large gap (>1.5 mm) or complete absence of signals from the maxilla in the midline in 69% of cases of CLP with additional defects, in 35% of those with isolated CLP and in none of the normal controls. The maxillary gap is a new simple marker of possible CLP, which could increase the detection rate of CLP, especially in isolated cases. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

International outbreak investigation of Salmonella Heidelberg associated with in-flight catering.

PubMed

Rebolledo, J; Garvey, P; Ryan, A; O'Donnell, J; Cormican, M; Jackson, S; Cloak, F; Cullen, L; Swaan, C M; Schimmer, B; Appels, R W; Nygard, K; Finley, R; Sreenivasan, N; Lenglet, A; Gossner, C; McKeown, P

2014-04-01

Rapid and wide dispersal of passengers after flights makes investigation of flight-related outbreaks challenging. An outbreak of Salmonella Heidelberg was identified in a group of Irish travellers returning from Tanzania. Additional international cases sharing the same flight were identified. Our aim was to determine the source and potential vehicles of infection. Case-finding utilized information exchange using experts' communication networks and national surveillance systems. Demographic, clinical and food history information was collected. Twenty-five additional cases were identified from Ireland, The Netherlands, Norway, USA and Canada. We conducted a case-control study which indicated a significant association between illness and consumption of milk tart (OR 10.2) and an egg dish (OR 6) served on-board the flight. No food consumed before the flight was associated with illness. Cases from countries other than Ireland provided supplementary information that facilitated the identification of likely vehicles of infection. Timely, committed international collaboration is vital in such investigations.

Comparative risk for cardiovascular diseases of dipeptidyl peptidase-4 inhibitors vs. sulfonylureas in combination with metformin: Results of a two-phase study.

PubMed

Enders, Dirk; Kollhorst, Bianca; Engel, Susanne; Linder, Roland; Verheyen, Frank; Pigeot, Iris

2016-01-01

The aim was to assess whether the use of additional data from the Disease Management Program (DMP) diabetes mellitus type 2 to minimize the potential for residual confounding will alter the estimated risk of either myocardial infarction, ischemic stroke or heart failure in patients with type 2 diabetes using sulfonylureas compared to dipeptidyl peptidase-4 (DPP-4) inhibitors in addition to metformin based on routine health care data. We conducted a nested two-phase case-control study using claims data of one German health insurance from 2004 to 2013 (phase 1) and data of the DMP from 2010 to 2013 (phase 2). Adjusted odds ratios (ORs) for the combined cardiovascular event myocardial infarction, ischemic stroke or heart failure were calculated using a two-phase logistic regression. Phase 1 comprised 3179 patients (289 cases; 2890 controls) and phase 2 comprised 1968 patients (168 cases; 1800 controls). We observed an adjusted OR of 0.83 for the combined cardiovascular event (95% CI: 0.61-1.13). We observed a non-significantly reduced risk for cardiovascular diseases in patients using DPP-4 inhibitors compared to sulfonylureas in addition to metformin. This finding was not altered by the inclusion of additional information of the DMP in the analysis. However, due to the low power of this study, further studies are needed to reproduce our findings. Copyright © 2016 Elsevier Inc. All rights reserved.

40 CFR 260.40 - Additional regulation of certain hazardous waste recycling activities on a case-by-case basis.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Additional regulation of certain hazardous waste recycling activities on a case-by-case basis. 260.40 Section 260.40 Protection of... SYSTEM: GENERAL Rulemaking Petitions § 260.40 Additional regulation of certain hazardous waste recycling...

40 CFR 260.40 - Additional regulation of certain hazardous waste recycling activities on a case-by-case basis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Additional regulation of certain hazardous waste recycling activities on a case-by-case basis. 260.40 Section 260.40 Protection of... SYSTEM: GENERAL Rulemaking Petitions § 260.40 Additional regulation of certain hazardous waste recycling...

40 CFR 260.40 - Additional regulation of certain hazardous waste recycling activities on a case-by-case basis.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Additional regulation of certain hazardous waste recycling activities on a case-by-case basis. 260.40 Section 260.40 Protection of... SYSTEM: GENERAL Rulemaking Petitions § 260.40 Additional regulation of certain hazardous waste recycling...

40 CFR 260.40 - Additional regulation of certain hazardous waste recycling activities on a case-by-case basis.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Additional regulation of certain hazardous waste recycling activities on a case-by-case basis. 260.40 Section 260.40 Protection of... SYSTEM: GENERAL Rulemaking Petitions § 260.40 Additional regulation of certain hazardous waste recycling...

40 CFR 260.40 - Additional regulation of certain hazardous waste recycling activities on a case-by-case basis.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Additional regulation of certain hazardous waste recycling activities on a case-by-case basis. 260.40 Section 260.40 Protection of... SYSTEM: GENERAL Rulemaking Petitions § 260.40 Additional regulation of certain hazardous waste recycling...

Is Mistletoe Treatment Beneficial in Invasive Breast Cancer? A New Approach to an Unresolved Problem.

PubMed

Fritz, Peter; Dippon, Jürgen; Müller, Simon; Goletz, Sven; Trautmann, Christian; Pappas, Xenophon; Ott, German; Brauch, Hiltrud; Schwab, Matthias; Winter, Stefan; Mürdter, Thomas; Brinkmann, Friedhelm; Faisst, Simone; Rössle, Susanne; Gerteis, Andreas; Friedel, Godehard

2018-03-01

In this retrospective study, we compared breast cancer patients treated with and without mistletoe lectin I (ML-I) in addition to standard breast cancer treatment in order to determine a possible effect of this complementary treatment. This study included 18,528 patients with invasive breast cancer. Data on additional ML-I treatments were reported for 164 patients. We developed a "similar case" method with a distance measure retrieved from the beta variable in Cox regression to compare these patients, after stage adjustment, with their non-ML-1 treated counterparts in order to answer three hypotheses concerning overall survival, recurrence free survival and life quality. Raw data analysis of an additional ML-I treatment yielded a worse outcome (p=0.02) for patients with ML treatment, possibly due to a bias inherent in the ML-I-treated patients. Using the "similar case" method (a case-based reasoning approach) we could not confirm this harm for patients using ML-I. Analysis of life quality data did not demonstrate reliable differences between patients treated with ML-I treatment and those without proven ML-I treatment. Based on a "similar case" model we did not observe any differences in the overall survival (OS), recurrence-free survival (RFS), and quality of life data between breast cancer patients with standard treatment and those who in addition to standard treatment received ML-I treatment. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Reliable harvest of a dorsal scapular artery perforator flap by augmenting its perfusion.

PubMed

Kim, So-Young; Lee, Kyeong-Tae; Mun, Goo-Hyun

2016-02-01

Despite confirmation of a reliable perforasome in the dorsal scapular artery in an anatomic study, a true perforator flap has not been recommended in previous clinical studies because of concerns regarding insufficient perfusion in the distal region. In this report, we present two cases of reconstruction for occipital defects caused by tumor extirpation using pedicled dorsal scapular artery perforator flaps without a muscle component. To secure the perfusion of the dorsal scapular artery perforator flap, inclusion of an additional perforator was attempted for perfusion augmentation. The second dorsal scapular artery perforator was harvested in one case. In an additional case, the sixth dorsal intercostal artery perforator with a branch that directly connected with the dorsal scapular artery within the trapezius muscle was additionally harvested. The flaps survived without any perfusion-related complications, including tip necrosis, and no donor site morbidities were observed. We suggest that a perfusion augmented dorsal scapular artery perforator flap by harvesting multiple perforators could be a safe and useful alternative for reconstructive surgery of head and neck defects. © 2014 Wiley Periodicals, Inc.

Teaching as Coaching: A Case Study of Awareness and Learning in Engineering Education

ERIC Educational Resources Information Center

Gynnild, Vidar; Holstad, Anders; Myrhaug, Dag

2007-01-01

This paper presents a number of case studies in Oceanography, an optional module in the third/fourth year of a Master of Science programme at Norwegian University of Science and Technology. The main objective was to gain more thorough insights into student learning by examining two sets of individual oral examinations. In addition, all students…

Design-Grounded Assessment: A Framework and a Case Study of Web 2.0 Practices in Higher Education

ERIC Educational Resources Information Center

Ching, Yu-Hui; Hsu, Yu-Chang

2011-01-01

This paper synthesis's three theoretical perspectives, including sociocultural theory, distributed cognition, and situated cognition, into a framework to guide the design and assessment of Web 2.0 practices in higher education. In addition, this paper presents a case study of Web 2.0 practices. Thirty-seven online graduate students participated in…

An Exploratory Investigation of Online Forum Mediated Collaborative Learning of Speech Writing: A Case Study

ERIC Educational Resources Information Center

Lata, Pushp; Luhach, Suman

2014-01-01

Learning Management Systems (LMS) are being integrated in the curriculum by many educational institutions to extend teaching and learning beyond classroom. This paper is based on a case study exploring the integration of LMS Nalanda created on Moodle in Effective Public Speaking (EPS) classroom to give students an additional platform to practice,…

Exploring Young Children's Understanding about the Concept of Volume through Engineering Design in a STEM Activity: A Case Study

ERIC Educational Resources Information Center

Park, Do-Yong; Park, Mi-Hwa; Bates, Alan B.

2018-01-01

This case study explores young children's understanding and application of the concept of volume through the practices of engineering design in a STEM activity. STEM stands for science, technology, engineering, and mathematics. However, engineering stands out as a challenging area to implement. In addition, most early engineering education…

Case Studies of Postponement in the Supply Chain

DTIC Science & Technology

2006-06-14

postponement it is still an underutilized strategy across manufacturing. Costs and benefits are sometimes hard to quantify. However, successful case studies...savings in inventory because the value of the product increases through the addition of each successive component. Manufacturing postponement usually...the instrument during the shipment process. Shortly after achieving successful packaging operations, DB initiated another post- ponement strategy in

Conceptualization of American English Native Speaker Norms: A Case Study of an English Language Classroom in South Korea

ERIC Educational Resources Information Center

Ahn, Kyungja

2011-01-01

This case study aims to reveal how conceptualization of native speakership was constructed and reinforced in a South Korean university classroom of English as a foreign language (EFL). In addition, it examines how this conceptualization positions native speakers, a non-native EFL teacher, and learners, and what learning opportunities were provided…

Te Rita Papesch: Case Study of an Exemplary Learner of Maori as an Additional Language

ERIC Educational Resources Information Center

Ratima, Matiu Tai; Papesch, Te Rita

2014-01-01

This paper presents a case study of the life experiences of one exemplar adult second language Maori learner--Te Rita Papesch. Te Rita was one of 17 participants who were interviewed as a part of the first author's PhD study which sought to answer the question: what factors lead to the development of proficiency in te reo Maori amongst adult…

Primary Intraosseous Adenoid Cystic Carcinoma of the Mandible: A Comprehensive Review With Analysis of 2 Additional Cases.

PubMed

Hu, Hong Ying; Liu, Yuan Yuan; Wang, Hu; Jiang, Meng

2017-08-01

Primary intraosseous adenoid cystic carcinoma (IACC) of the mandible is poorly understood because of its rarity. This study performed a comprehensive literature review on IACC of the mandible. Forty-five cases of IACC reported in the literature and 2 additional cases in the authors' hospital were reviewed. IACC of the mandible generally occurred in the fourth to sixth decades, with no meaningful gender predilection. Pain and swelling were the most common clinical manifestations. Radical surgery combined with postsurgical radiotherapy was recommended as the best treatment. The diagnosis of IACC should be based on clinical, radiologic, and pathologic examinations. Radical surgery combined with postsurgical radiotherapy seems to be the best treatment. In addition, the histologic subtype of the tumor is an important prognostic factor in patients with IACC. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Epidemiology of atlas fractures--a national registry-based cohort study of 1,537 cases.

PubMed

Matthiessen, Christian; Robinson, Yohan

2015-11-01

The epidemiology of fractures of the first cervical vertebra-the atlas-has not been well documented. Previous studies concerning atlas fractures focus on treatment and form a weak platform for epidemiologic study. This study aims to provide reliable epidemiologic data on atlas fractures. This was a national registry-based cohort study. A total of 1,537 cases of atlas fractures between 1997 and 2011 from the Swedish National Patient Registry (NPR). The outcome measures were annual incidence and mortality. Data from the NPR and the Swedish Cause of Death Registry were extracted, including age, gender, diagnosis, comorbidity, treatment codes, and date of death. The Charlson Comorbidity Index was calculated and a survival analysis performed. A total of 869 (56.5%) cases were men, and 668 (43.5%) were women. The mean age of the entire population was 64 years. The proportion of atlas fractures of all registered cervical fractures was 10.6%. In 19% of all cases, there was an additional fracture of the axis, and 7% of all cases had additional subaxial cervical fractures. Patients with fractures of the axis were older than patients with isolated atlas fractures. The annual incidence almost doubled during the study period, and in 2011, it was 17 per million inhabitants. The greatest increase in incidence occurred in the elderly population. Atlas fractures occurred predominantly in the elderly population. Further study is needed to determine the cause of the increasing incidence. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Psoas abscess and chronic Q fever: a contiguous or hematogenous complication? A case report and literature review.

PubMed

Galy, Adrien; Decousser, Jean Winoc; El-Anbassi, Sarra; Nebbad, Biba; Belzunce, Carine; Cochennec, Frédéric; Deforges, Lionel; Lepeule, Raphaël

2016-08-01

Few cases of psoas abscesses (PA) during chronic Q fever have been reported, and the route of transmission remains unknown. Here, we report a new case and have performed a systematic literature review to determinate the spreading route of this complication. Medline, EMBASE and Web of Science were searched. Local spreading was supported by endocarditis exclusion, evidence of vascular infection and absence of distantly infected sites. Among 275 retrieved references, 179 were initially rejected, and 85 additional references were rejected after full-text review. A total of 11 studies, reporting 13 cases, were included. Additionally, we reported one new case. A total of 14/14 cases reached Q fever vascular infection diagnostic criteria, and 7/14 provided adequate evidence supporting a causal relationship between Q fever vascular infection and PA. All patients presented aorta defects. In conclusion, Q fever PA results from the spreading of a local infection and occurs specifically in patients presenting a vascular graft or an abdominal aortic aneurysm.

Evaluation of an internet-based e-learning module to introduce nuclear medicine to medical students: a feasibility study.

PubMed

Diessl, Stefanie; Verburg, Frederik A; Hoernlein, Alexander; Schumann, Martin; Luster, Markus; Reiners, Christoph

2010-12-01

The advent of electronic learning, the so-called e-learning, offers new possibilities for instruction in addition to the traditional face-to-face teaching in the education of medical students. To evaluate the additional educational value of a voluntary e-learning module in a nuclear medicine course for third-year medical students. Twenty exemplary nuclear medicine patient cases from our department were developed for e-learning purposes and presented on the internet using the web-based training program ‘CaseTrain’. Subsequently, three selected test cases were handled and evaluated by an unselected population of third-year medical students. One hundred and twenty-eight students studied the three patient cases and filled out the evaluation questionnaire completely. The most important result is that both the interest in and the subjective feeling of the knowledge level regarding the specialized field of nuclear medicine had increased significantly after working through the three e-learning cases. Ninety-seven percent of the evaluating students considered the use of computer-based learning useful. The subjective grading of the content of the cases and the handling of the software were graded with high marks by the participants, 1.9 and 2.0, respectively, on a linear scale with 1 being the best and 6 being the worst. The addition of e-learning to face-to-face teaching as a form of ‘blended learning’ is highly appreciated by medical students, and will provide an effective medium for bringing better understanding of nuclear medicine to future colleagues.

A balanced perspective: using nonfinancial measures to assess financial performance.

PubMed

Watkins, Ann L

2003-11-01

Assessments of hospitals' financial performance have traditionally been based exclusively on analysis of a concise set of key financial ratios. One study, however, demonstrates that analysis of a hospital's financial condition can be significantly enhanced with the addition of several nonfinancial measures, including case-mix adjusted admissions, case-mix adjusted admissions per full-time equivalent, and case-mix adjusted admissions per beds in service.

Lightning forecasting studies using LDAR, LLP, field mill, surface mesonet, and Doppler radar data

NASA Technical Reports Server (NTRS)

Forbes, Gregory S.; Hoffert, Steven G.

1995-01-01

The ultimate goal of this research is to develop rules, algorithms, display software, and training materials that can be used by the operational forecasters who issue weather advisories for daily ground operations and launches by NASA and the United States Air Force to improve real-time forecasts of lightning. Doppler radar, Lightning Detection and Ranging (LDAR), Lightning Location and Protection (LLP), field mill (Launch Pad Lightning Warning System -- LPLWS), wind tower (surface mesonet) and additional data sets have been utilized in 10 case studies of thunderstorms in the vicinity of KSC during the summers of 1994 and 1995. These case studies reveal many intriguing aspects of cloud-to-ground, cloud-to-cloud, in-cloud, and cloud-to-air lightning discharges in relation to radar thunderstorm structure and evolution. They also enable the formulation of some preliminary working rules of potential use in the forecasting of initial and final ground strike threat. In addition, LDAR and LLP data sets from 1993 have been used to quantify the lightning threat relative to the center and edges of LDAR discharge patterns. Software has been written to overlay and display the various data sets as color imagery. However, human intervention is required to configure the data sets for proper intercomparison. Future efforts will involve additional software development to automate the data set intercomparisons, to display multiple overlay combinations in a windows format, and to allow for animation of the imagery. The software package will then be used as a tool to examine more fully the current cases and to explore additional cases in a timely manner. This will enable the formulation of more general and reliable forecasting guidelines and rules.

Case Studies in Exercise and Sport Sciences: A Powerful Tool to Bridge the Science-Practice Gap.

PubMed

Halperin, Israel

2018-03-27

Despite the progress made by the scientific exercise community in collaborating and communicating with non-scientist coaches, there is room for improvement. Coaches find research difficult to understand, feel that their interests are not being addressed by exercise research, and rely on peer-discussion to further their coaching knowledge base while consuming little peer-reviewed articles. One useful strategy to bridge the science-practice gap is with case-studies. In addition to furthering our understanding of the physiology, psychology, and training schedules of elite athletes, case studies can serve 1) as a useful communication channel with coaches if presented as narratives and 2) to establish and strengthen relationships between scientists and coaches leading to fruitful research collaborations. The purpose of this invited commentary is to discuss these two less-recognized benefits of case-studies, and propose a way to incorporate case-studies more frequently alongside group-based studies.

Case Studies in Exercise and Sport Sciences: A Powerful Tool to Bridge the Science-Practice Gap.

PubMed

Halperin, Israel

2018-06-21

Despite the progress made by the scientific exercise community in collaborating and communicating with nonscientist coaches, there is room for improvement. Coaches find research difficult to understand, feel that their interests are not being addressed by exercise research, and rely on peer discussion to further their coaching knowledge base while consuming few peer-reviewed articles. One useful strategy to bridge the science-practice gap is with case studies. In addition to furthering our understanding of the physiology, psychology, and training schedules of elite athletes, case studies can serve (1) as a useful communication channel with coaches if presented as narratives and (2) to establish and strengthen relationships between scientists and coaches, leading to fruitful research collaborations. The purpose of this invited commentary is to discuss these 2 less-recognized benefits of case studies and propose a way to incorporate case studies more frequently alongside group-based studies.

Raising Achievement of English as Additional Language Pupils in Schools: Implications for Policy and Practice

ERIC Educational Resources Information Center

Demie, Feyisa; Lewis, Kirstin

2018-01-01

This study looks at schools that serve English as an additional language (EAL) pupils and examines the factors behind their successful achievement. A complementary methodological approach of case studies and focus groups was used to explore performance and the views of teachers, governors, parents and pupils, and to evaluate and gather evidence on…

Attitudes and Perception Towards Eye Donation in Patients with Corneal Disease: A Case-controlled Population-based Study.

PubMed

Noopur, Gupta; Praveen, Vashist; Radhika, Tandon; Sanjeev K, Gupta; Mani, Kalaivani; Deepak, Kumar

2018-06-01

To assess awareness, barriers, and misconceptions related to eye donation in people with corneal disease as compared to controls in a population setting. A population-based study was conducted in 25 randomly selected clusters of Rural Gurgaon, Haryana, India, as part of the CORE (Cornea Opacity Rural Epidemiological) study. In addition to ophthalmic examination, knowledge and perceptions regarding eye donation were assessed through a validated questionnaire. The questionnaire captured the sociodemographic factors influencing awareness regarding eye donation in participants with corneal disease and twice the number of age- and gender-matched controls recruited from the same study clusters. Descriptive statistics were computed along with multivariable logistic regression analysis to determine associated factors for awareness of eye donation. In the CORE study, 452 participants had corneal opacities on ocular examination. Of these, 442 were assessed for eye donation awareness. Additionally, 884 age- and gender-matched controls were recruited. The mean age of cases and controls was 60.9 ± 15.5 and 59.6 ± 14.3 years, respectively. Awareness of eye donation in cases and controls was 46.4% (n = 205 of 442) and 52.3% (n = 462 of 884), respectively (P = 0.044). Educational status was an important factor determining knowledge about eye donation in both cases and controls (P = < 0.001). Major barriers reported for not pledging eyes were lack of willingness (36.7%) and ignorance (15.3%). Common misconceptions like eyes could be donated before death or even after 24 h of death and that any type of blindness could be treated with corneal transplantation were prevalent. The study demonstrated that although there is substantial awareness about eye donation, there are numerous barriers in this population that need to be resolved to improve donation rates. Additional efforts are needed to translate this awareness into actual eye donation in both cases with corneal disease and controls.

The Pericles Space Case: Preserving Earth Observation Data for the Future

NASA Astrophysics Data System (ADS)

Muller, C.; Pandey, P.; Pericles Consortium

2016-08-01

PERICLES (Promoting and Enhancing the Reuse of Information throughout the Content Lifecycle exploiting Evolving Semantics) is an FP7 project started on February 2013. It aims at preserving by design large and complex data sets. PERICLES is coordinated by King's College London, UK and its partners are University of Borås (Sweden), CERT (Greece), DotSoft(Greece), GeorgAugustUniversität, Göttingen (Germany), University of Liverpool (UK), Space Application Services (Belgium), XEROX France and University of Edinburgh (UK). Two additional partners provide the case studies: Tate Gallery (UK) brings the digital art and media case study and B.USOC (Belgian Users Support and Operations Centre) brings the space science case study.

Enhancing Leadership in Colleges and Universities: A Case Approach

ERIC Educational Resources Information Center

Sandeen, Arthur

2011-01-01

In view of the serious challenges facing college and university administrators, it is encouraging to note the increased interest in improving leadership knowledge and skills. This book presents an additional option to college and university administrators in their efforts to enhance their leadership skills. The case study approach to improving…

Acoustic Studies of Ocean Surface Processes in SWAPP

DTIC Science & Technology

1992-02-05

detected with an accelerometer and tiltmeters , and corrections are made in the data analysis where appropriate. Additional sensors , which are not discussed...electronics case battery case compass depth sensor submersible floats ballast weight acoustic release Figure 1. dW CN CC) Q!) CN (w UL C e Figure 2. -r

Information needs of case managers caring for persons living with HIV.

PubMed

Schnall, Rebecca; Cimino, James J; Currie, Leanne M; Bakken, Suzanne

2011-05-01

The goals of this study were to explore the information needs of case managers who provide services to persons living with HIV (PLWH) and to assess the applicability of the Information Needs Event Taxonomy in a new population. The study design was observational with data collection via an online survey. Responses to open-ended survey questions about the information needs of case managers (n=94) related to PLWH of three levels of care complexity were categorized using the Information Needs Event Taxonomy. The most frequently identified needs were related to patient education resources (33%), patient data (23%), and referral resources (22%) accounting for 79% of all (N=282) information needs. Study limitations include selection bias, recall bias, and a relatively narrow focus of the study on case-manager information needs in the context of caring for PLWH. The study findings contribute to the evidence base regarding information needs in the context of patient interactions by: (1) supporting the applicability of the Information Needs Event Taxonomy and extending it through addition of a new generic question; (2) providing a foundation for the addition of context-specific links to external information resources within information systems; (3) applying a new approach for elicitation of information needs; and (4) expanding the literature regarding addressing information needs in community-based settings for HIV services.

Dyslexia and dyscalculia: two learning disorders with different cognitive profiles.

PubMed

Landerl, Karin; Fussenegger, Barbara; Moll, Kristina; Willburger, Edith

2009-07-01

This study tests the hypothesis that dyslexia and dyscalculia are associated with two largely independent cognitive deficits, namely a phonological deficit in the case of dyslexia and a deficit in the number module in the case of dyscalculia. In four groups of 8- to 10-year-olds (42 control, 21 dyslexic, 20 dyscalculic, and 26 dyslexic/dyscalculic), phonological awareness, phonological and visual-spatial short-term and working memory, naming speed, and basic number processing skills were assessed. A phonological deficit was found for both dyslexic groups, irrespective of additional arithmetic deficits, but not for the dyscalculia-only group. In contrast, deficits in processing of symbolic and nonsymbolic magnitudes were observed in both groups of dyscalculic children, irrespective of additional reading difficulties, but not in the dyslexia-only group. Cognitive deficits in the comorbid dyslexia/dyscalculia group were additive; that is, they resulted from the combination of two learning disorders. These findings suggest that dyslexia and dyscalculia have separable cognitive profiles, namely a phonological deficit in the case of dyslexia and a deficient number module in the case of dyscalculia.

Preferential elimination of chromosome 1D from homoeologous group-1 alien addition lines in hexaploid wheat.

PubMed

Garg, Monika; Elamein, Hala M M; Tanaka, Hiroyuki; Tsujimoto, Hisashi

2007-10-01

Alien chromosome addition lines are useful genetic material for studying the effect of an individual chromosome in the same genetic background. However, addition lines are sometimes unstable and tend to lose the alien chromosome in subsequent generations. In this study, we report preferential removal of chromosome 1D rather than the alien chromosome from homoeologous group-1 addition lines. The Agropyron intermedium chromosome 1Agi (1E) addition line, created in the background of 'Vilmorin 27', showed loss of a part of chromosome 1D, thereby losing its HMW glutenin locus. Even in the case of Aegilops longissima and Ae. peregrina, the genomes of which are closer to the B genome than D genome, chromosome 1D was lost from chromosome 1Sl and 1Sv addition lines in cv. 'Chinese Spring' rather than chromosome 1B during transfer from one generation to another. A similar observation was also observed in the case of a chromosome 1E disomic addition line of Ag. elongatum and alloplasmic common wheat line with Ag. intermedium ssp. trichophorum cytoplasm. The reason for this strange observation is thought to lie in the history of wheat evolution, the size of chromosome 1D compared to 1A and 1B, or differing pollen competition abilities.

Genome-wide association studies in dogs and humans identify ADAMTS20 as a risk variant for cleft lip and palate.

PubMed

Wolf, Zena T; Brand, Harrison A; Shaffer, John R; Leslie, Elizabeth J; Arzi, Boaz; Willet, Cali E; Cox, Timothy C; McHenry, Toby; Narayan, Nicole; Feingold, Eleanor; Wang, Xioajing; Sliskovic, Saundra; Karmi, Nili; Safra, Noa; Sanchez, Carla; Deleyiannis, Frederic W B; Murray, Jeffrey C; Wade, Claire M; Marazita, Mary L; Bannasch, Danika L

2015-03-01

Cleft lip with or without cleft palate (CL/P) is the most commonly occurring craniofacial birth defect. We provide insight into the genetic etiology of this birth defect by performing genome-wide association studies in two species: dogs and humans. In the dog, a genome-wide association study of 7 CL/P cases and 112 controls from the Nova Scotia Duck Tolling Retriever (NSDTR) breed identified a significantly associated region on canine chromosome 27 (unadjusted p=1.1 x 10(-13); adjusted p= 2.2 x 10(-3)). Further analysis in NSDTR families and additional full sibling cases identified a 1.44 Mb homozygous haplotype (chromosome 27: 9.29 - 10.73 Mb) segregating with a more complex phenotype of cleft lip, cleft palate, and syndactyly (CLPS) in 13 cases. Whole-genome sequencing of 3 CLPS cases and 4 controls at 15X coverage led to the discovery of a frameshift mutation within ADAMTS20 (c.1360_1361delAA (p.Lys453Ilefs*3)), which segregated concordant with the phenotype. In a parallel study in humans, a family-based association analysis (DFAM) of 125 CL/P cases, 420 unaffected relatives, and 392 controls from a Guatemalan cohort, identified a suggestive association (rs10785430; p =2.67 x 10-6) with the same gene, ADAMTS20. Sequencing of cases from the Guatemalan cohort was unable to identify a causative mutation within the coding region of ADAMTS20, but four coding variants were found in additional cases of CL/P. In summary, this study provides genetic evidence for a role of ADAMTS20 in CL/P development in dogs and as a candidate gene for CL/P development in humans.

The Science Manager's Guide to Case Studies

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

Branch, Kristi M.; Peffers, Melissa S.; Ruegg, Rosalie T.

2001-09-24

This guide takes the science manager through the steps of planning, implementing, validating, communicating, and using case studies. It outlines the major methods of analysis, describing their relative merits and applicability while providing relevant examples and sources of additional information. Well-designed case studies can provide a combination of rich qualitative and quantitative information, offering valuable insights into the nature, outputs, and longer-term impacts of the research. An objective, systematic, and credible approach to the evaluation of U.S. Department of Energy Office of Science programs adds value to the research process and is the subject of this guide.

Female polysomy-X and systemic lupus erythematosus.

PubMed

Slae, Mordechai; Heshin-Bekenstein, Merav; Simckes, Ari; Heimer, Gali; Engelhard, Dan; Eisenstein, Eli M

2014-02-01

Systemic lupus erythematosus (SLE) occurs more commonly in females than in males. Recent evidence suggests that genetic factors transmitted by the X-chromosome may confer increased risk for autoimmune disease in general, and for SLE in particular. It is therefore possible that X-chromosome polysomy might confer further increased risk for lupus. In addition to describing the clinical and immunologic features of a young woman with polysomy-X and SLE, we sought to review all other published cases associating female or male polysomy-X with SLE or other forms of autoimmunity. We report a case of a prepubertal girl with polysomy-X and SLE. We performed a systemic literature review for cases of polysomy-X and SLE and summarize previously published cases. In addition, we reviewed reports concerning the possible association between SLE and other connective tissue diseases and male polysomy-X. An 11-year-old girl with tetrasomy-X (48 XXXX karyotype) presented with prolonged fever. Workup led to the diagnosis of SLE, and subsequent renal biopsy revealed mild diffuse mesangial proliferative glomerulonephritis. Two additional cases of SLE in women with 47 XXX and one of 48 XXXX karyotype were found in a literature review and compared to the present case. We identified studies that found X-chromosome polysomy to be over-represented in male patients with SLE and case descriptions of connective tissue diseases occurring in patients with polysomy-X. No consistent pattern of disease was observed in female polysomy patients with SLE. Taken together with the data concerning the frequency of polysomy-X among males with SLE, our findings provide additional support for the hypothesis that X-chromosome polysomy may confer increased susceptibility to SLE. Molecular mechanisms that might account for this phenomenon are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

Characterization of non-typable strains of Staphylococcus aureus from cases of hospital infection.

PubMed Central

Vindel, A.; Martín-Bourgon, C.; Saez-Nieto, J. A.

1987-01-01

A high percentage of non-typable (NT) Staphylococcus aureus strains was isolated in Spanish hospitals during 1984 and 1985. Several alternative methods of typing were employed to study these isolates. These were: phage-typing at 1000 X RTD, phage-typing after heat-treatment (48 degrees C), thermal shock (56 degrees C), reverse-typing and induction of additional phages. Using these methods the number of NT isolates was reduced by 60%. Best results were obtained with heat-treatment. Additional phages and reverse-typing were also useful. A scheme for the study of outbreaks and sporadic cases caused by NT strains is proposed using the methods described. PMID:3609172

Massive localized lymphedema of the male external genitalia: a clinicopathologic study of 6 cases.

PubMed

Lee, Stephen; Han, Jeong S; Ross, Hillary M; Epstein, Jonathan I

2013-02-01

Massive localized lymphedema is a reactive pseudotumor strongly associated with obesity. The tumor most commonly presents as pendulous masses in the lower limbs with only 3 reported cases involving external male genitalia. In this study, we report an additional 6 cases localized to the external male genitalia. The cases were retrospectively identified from the surgical pathology database of the Johns Hopkins Hospital. All 6 patients were obese (5 presented with diffuse scrotal edema and 1 with a penile mass). In all cases, the clinical impression was of a benign chronic process developing over 3 months to 1 year. All 3 cases from outside institutions were referred with benign pathologic diagnoses. The lesions ranged in size from 4 to 55 cm. Microscopically, all cases exhibited stromal fibrosis and edema, multinucleated stromal cells, perivascular chronic inflammation, and lymphangiectasia. Entrapped fat was a minor feature and seen in only 3 cases. Variable hyperplasia and hypertrophy of dartos muscle were noted in 6 lesions. Three cases showed prominent microvascular proliferation around the edge of individual dartos muscle bundles. In summary, diagnosis of massive localized lymphedema requires appropriate correlation between clinical and microscopic findings. Lesions in the male external genitalia share many microscopic findings with massive localized lymphedema at other sites, although entrapped adipose tissue is not prominent. Additional, although not specific, findings include variably hyperplastic and hypertrophic dartos muscle and capillary neoangiogenesis at the interface between smooth muscle bundles and stroma. Copyright © 2013 Elsevier Inc. All rights reserved.

Dreams Do Come True: The Creation and Growth of a Recreational Dance Program for Children and Young Adults with Additional Needs

ERIC Educational Resources Information Center

Reinders, Nicole; Fletcher, Paula; Bryden, Pam

2015-01-01

There are many benefits to dance, both for typically developing individuals and for individuals with additional needs. The purpose of this narrative case study was to analyse a dance program for children and young adults with additional needs from the perspective of the program creator and primary dance instructor. Data collection occurred at two…

Quantitative Relationships Involving Additive Differences: Numerical Resilience

ERIC Educational Resources Information Center

Ramful, Ajay; Ho, Siew Yin

2014-01-01

This case study describes the ways in which problems involving additive differences with unknown starting quantities, constrain the problem solver in articulating the inherent quantitative relationship. It gives empirical evidence to show how numerical reasoning takes over as a Grade 6 student instantiates the quantitative relation by resorting to…

Computer model for refinery operations with emphasis on jet fuel production. Volume 1: Program description

NASA Technical Reports Server (NTRS)

Dunbar, D. N.; Tunnah, B. G.

1978-01-01

A FORTRAN computer program is described for predicting the flow streams and material, energy, and economic balances of a typical petroleum refinery, with particular emphasis on production of aviation turbine fuel of varying end point and hydrogen content specifications. The program has provision for shale oil and coal oil in addition to petroleum crudes. A case study feature permits dependent cases to be run for parametric or optimization studies by input of only the variables which are changed from the base case.

Computer model for refinery operations with emphasis on jet fuel production. Volume 3: Detailed systems and programming documentation

NASA Technical Reports Server (NTRS)

Dunbar, D. N.; Tunnah, B. G.

1978-01-01

The FORTRAN computing program predicts flow streams and material, energy, and economic balances of a typical petroleum refinery, with particular emphasis on production of aviation turbine fuels of varying end point and hydrogen content specifications. The program has a provision for shale oil and coal oil in addition to petroleum crudes. A case study feature permits dependent cases to be run for parametric or optimization studies by input of only the variables which are changed from the base case.

Comparing health outcomes and costs of general vaccination with pneumococcal conjugate vaccines in Sweden: a Markov model.

PubMed

By, Asa; Sobocki, Patrik; Forsgren, Arne; Silfverdal, Sven-Arne

2012-01-01

Two new pneumococcal conjugate vaccines were licensed to immunize infants and young children against pneumococcal disease. The objective of this study was to estimate the expected health benefits, costs, and incremental cost-effectiveness of routine vaccination with the 10-valent pneumococcal nontypeable hemophilus influenza protein-D conjugate vaccine (PHiD-CV) compared with the 13-valent pneumococcal conjugate vaccine (PCV13) in Sweden. A Markov cohort model was used to estimate the effect of vaccination at vaccine steady state, taking a societal perspective and using a 2+1 vaccination schedule. Price parity was assumed between the vaccines. Outcomes were measured by reduction in disease burden, costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratio. The results predicted that PCV13 would prevent 3 additional cases of invasive pneumococcal disease and 34 additional cases of pneumonia, whereas PHiD-CV would avoid 3 additional cases of mastoiditis, 1010 tube insertions, and 10,420 cases of ambulatory acute otitis media compared with PCV13. By combining morbidity and mortality benefits of all clinical outcomes, PHiD-CV would generate 45.3 additional QALYs compared with PCV13 and generate savings of an estimated 62 million Swedish kronors. The present study predicted lower costs and better health outcome (QALYs) gained by introducing PHiD-CV compared with PCV13 in routine vaccination. Our results indicated that PHiD-CV is cost-effective compared with PCV13 in Sweden. Copyright © 2012 Elsevier HS Journals, Inc. All rights reserved.

THE COMMAND OF THE TREND: SOCIAL MEDIA AS A WEAPON IN THE INFORMATION AGE

DTIC Science & Technology

2017-06-01

and a bot network) based on the analysis within this case study . Table 3. ISIS Case Study Analysis Propaganda Narratives 1. ISIS is strong...get started with an interview and included me in a cyber think-tank for the study of ISIS activity on social media. Additionally, I am still... study demonstrates how social media is a tool for modern warfare in the information age. The report builds on analysis of three distinct topics

Non-Malignant Respiratory Disease Among Workers in Industries Using Styrene—A Review of the Evidence

PubMed Central

Nett, Randall J.; Cox-Ganser, Jean M.; Hubbs, Ann F.; Ruder, Avima M.; Cummings, Kristin J.; Huang, Yuh-Chin T.; Kreiss, Kathleen

2017-01-01

Background Asthma and obliterative bronchiolitis (OB) cases have occurred among styrene-exposed workers. We aimed to investigate styrene as a risk factor for non-malignant respiratory disease (NMRD). Methods From a literature review, we identified case reports and assessed cross-sectional and mortality studies for strength of evidence of positive association (i.e., strong, intermediate, suggestive, none) between styrene exposure and NMRD-related morbidity and mortality. Results We analyzed 55 articles and two unpublished case reports. Ten OB cases and eight asthma cases were identified. Six (75%) asthma cases had abnormal styrene inhalation challenges. Thirteen (87%) of 15 cross-sectional studies and 12 (50%) of 24 mortality studies provided at least suggestive evidence that styrene was associated with NMRD-related morbidity or mortality. Six (66%) of nine mortality studies assessing chronic obstructive pulmonary disease-related mortality indicated excess mortality. Conclusions Available evidence suggests styrene exposure is a potential risk factor for NMRD. Additional studies of styrene-exposed workers are warranted. PMID:28079275

An outbreak investigation of congenital rubella syndrome in Solomon Islands, 2013

PubMed Central

Durski, Kara N; Tituli, Carol; Ogaoga, Divi; Joshua, Cynthia; Dofai, Alfred; Leydon, Jennie; Nilles, Eric

2016-01-01

Introduction During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. Methods Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS. Results A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy. Discussion Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well planned and funded vaccination activities can prevent future CRS cases. PMID:27757248

An outbreak investigation of congenital rubella syndrome in Solomon Islands, 2013.

PubMed

Durski, Kara N; Tituli, Carol; Ogaoga, Divi; Musto, Jennie; Joshua, Cynthia; Dofai, Alfred; Leydon, Jennie; Nilles, Eric

2016-01-01

During May 2012, a rubella outbreak was declared in Solomon Islands. A suspected case of congenital rubella syndrome (CRS) was reported from one hospital 11 months later in 2013. This report describes the subsequent CRS investigation, findings and measures implemented. Prospective CRS surveillance was conducted at the newborn nursery, paediatric and post-natal wards, and the paediatric cardiology and ophthalmology clinics of the study hospital from April to July 2013. Retrospective case finding by reviewing medical records was also undertaken to identify additional cases born between January and March 2013 for the same wards and clinics. Cases were identified using established World Health Organization case definitions for CRS. A total of 13 CRS cases were identified, including two laboratory-confirmed, four clinically confirmed and seven suspected cases. Five CRS cases were retrospectively identified, including four suspected and one clinically confirmed case. There was no geospatial clustering of residences. The mothers of the cases were aged between 20 and 36 years. Three of the six mothers available for interview recalled an acute illness with rash during the first trimester of pregnancy. Additional CRS cases not captured in this investigation are likely. Caring for CRS cases is a challenge in resource-poor settings. Rubella vaccination is safe and effective and can prevent the serious consequences of CRS. Well planned and funded vaccination activities can prevent future CRS cases.

Chromosome abnormalities additional to the Philadelphia chromosome at the diagnosis of chronic myelogenous leukemia: pathogenetic and prognostic implications.

PubMed

Zaccaria, Alfonso; Testoni, Nicoletta; Valenti, Anna Maria; Luatti, Simona; Tonelli, Michela; Marzocchi, Giulia; Cipriani, Raffaella; Baldazzi, Carmen; Giannini, Barbara; Stacchini, Monica; Gamberini, Carla; Castagnetti, Fausto; Rosti, Gianantonio; Azzena, Annalisa; Cavazzini, Francesco; Cianciulli, Anna Maria; Dalsass, Alessia; Donti, Emilio; Giugliano, Emilia; Gozzetti, Alessandro; Grimoldi, Maria Grazia; Ronconi, Sonia; Santoro, Alessandra; Spedicato, Francesco; Zanatta, Lucia; Baccarani, Michele

2010-06-01

Additional chromosome abnormalities (ACAs) occur in less than 10% of cases at diagnosis of Philadelphia chromosome (Ph)-positive chronic myelogenous leukemia (CML). In some cases, on the basis of the persistence of the ACAs in Ph-negative cells after response to imatinib, a secondary origin of the Ph chromosome has been demonstrated. In this study, the possible prognostic value of this phenomenon was evaluated. Thirty-six Ph-positive CML patients were included in the study. In six patients, ACAs persisted after the disappearance of the Ph. A complete cytogenetic response (CCR) was obtained in five of these six patients, and five of six also had a high Sokal score. In all the other cases, ACAs disappeared together (in cases of response to therapy with imatinib) or persisted with the Ph (in cases of no response to imatinib). In the former cases, the primary origin of the Ph was demonstrated. CCR was obtained in 22 cases (17 with low to intermediate Sokal scores), while no response was observed in 8 patients (5 with a high Sokal score). Sokal score seems to maintain its prognostic value for patients in whom the Ph occurs as a primary event, but not in those in whom it occurs as a secondary one. Copyright 2010 Elsevier Inc. All rights reserved.

An Analysis of Earth Science Data Analytics Use Cases

NASA Technical Reports Server (NTRS)

Shie, Chung-Lin; Kempler, Steve

2014-01-01

The increase in the number and volume, and sources, of globally available Earth science data measurements and datasets have afforded Earth scientists and applications researchers unprecedented opportunities to study our Earth in ever more sophisticated ways. In fact, the NASA Earth Observing System Data Information System (EOSDIS) archives have doubled from 2007 to 2014, to 9.1 PB (Ramapriyan, 2009; and https:earthdata.nasa.govaboutsystem-- performance). In addition, other US agency, international programs, field experiments, ground stations, and citizen scientists provide a plethora of additional sources for studying Earth. Co--analyzing huge amounts of heterogeneous data to glean out unobvious information is a daunting task. Earth science data analytics (ESDA) is the process of examining large amounts of data of a variety of types to uncover hidden patterns, unknown correlations and other useful information. It can include Data Preparation, Data Reduction, and Data Analysis. Through work associated with the Earth Science Information Partners (ESIP) Federation, a collection of Earth science data analytics use cases have been collected and analyzed for the purpose of extracting the types of Earth science data analytics employed, and requirements for data analytics tools and techniques yet to be implemented, based on use case needs. ESIP generated use case template, ESDA use cases, use case types, and preliminary use case analysis (this is a work in progress) will be presented.

The Toxic Effects of Cigarette Additives. Philip Morris' Project Mix Reconsidered: An Analysis of Documents Released through Litigation

PubMed Central

Wertz, Marcia S.; Kyriss, Thomas; Paranjape, Suman; Glantz, Stanton A.

2011-01-01

Background In 2009, the promulgation of US Food and Drug Administration (FDA) tobacco regulation focused attention on cigarette flavor additives. The tobacco industry had prepared for this eventuality by initiating a research program focusing on additive toxicity. The objective of this study was to analyze Philip Morris' Project MIX as a case study of tobacco industry scientific research being positioned strategically to prevent anticipated tobacco control regulations. Methods and Findings We analyzed previously secret tobacco industry documents to identify internal strategies for research on cigarette additives and reanalyzed tobacco industry peer-reviewed published results of this research. We focused on the key group of studies conducted by Phillip Morris in a coordinated effort known as “Project MIX.” Documents showed that Project MIX subsumed the study of various combinations of 333 cigarette additives. In addition to multiple internal reports, this work also led to four peer-reviewed publications (published in 2001). These papers concluded that there was no evidence of substantial toxicity attributable to the cigarette additives studied. Internal documents revealed post hoc changes in analytical protocols after initial statistical findings indicated an additive-associated increase in cigarette toxicity as well as increased total particulate matter (TPM) concentrations in additive-modified cigarette smoke. By expressing the data adjusted by TPM concentration, the published papers obscured this underlying toxicity and particulate increase. The animal toxicology results were based on a small number of rats in each experiment, raising the possibility that the failure to detect statistically significant changes in the end points was due to underpowering the experiments rather than lack of a real effect. Conclusion The case study of Project MIX shows tobacco industry scientific research on the use of cigarette additives cannot be taken at face value. The results demonstrate that toxins in cigarette smoke increase substantially when additives are put in cigarettes, including the level of TPM. In particular, regulatory authorities, including the FDA and similar agencies elsewhere, could use the Project MIX data to eliminate the use of these 333 additives (including menthol) from cigarettes. Please see later in the article for the Editors' Summary PMID:22205885

The case-control design in veterinary sciences: A survey.

PubMed

Cullen, Jonah N; Sargeant, Jan M; Makielski, Kelly M; O'Connor, Annette M

2016-11-01

The case-control study design is deceptively simple. However, many design considerations influence the estimated effect measure. An investigation of case-control studies in the human health literature suggested that some of these considerations are not described in reports of case-control studies. Our hypothesis was that the majority of veterinary studies labeled as case-controls would be incident density designs, and many would not interpret the effect measure obtained from those studies as the rate ratio rather than the odds ratio. Reference databases were searched for author-designated case-control studies. A survey of 100 randomly selected studies was conducted to examine the different design options described and estimated effect measures. Of the 100 author-identified case-control studies, 83 assessed an exposure-outcome association and, of those, only 54 (65.1%) sampled the study population based on an outcome and would thus be considered case-control designs. Twelve studies were incidence density designs but none used this terminology. Of the studies that reported an odds ratio as the effect measure, none reported on additional considerations that would have enabled a more interpretable result. This survey indicated many case-control-labeled studies were not case-control designs and among case-control studies, key design aspects were not often described. The absence of information about study design elements and underlying assumptions in case-control studies limits the ability to establish the effect measured by the study and the evidentiary value of the study might be underestimated. Copyright © 2016 Elsevier B.V. All rights reserved.

Tasks that May Occasion Mathematical Creativity: Teachers' Choices

ERIC Educational Resources Information Center

Levenson, Esther

2013-01-01

Promoting mathematical creativity is one of the aims of mathematics education. This study investigates the tasks teachers chose when their aim was to occasion mathematical creativity in the classroom. Five cases are described in depth, and general trends found among these cases as well as in additional data are discussed. Findings indicated that…

Impact of Case-Based Instruction on Student Teachers' Reflection on Facilitating Children's Learning

ERIC Educational Resources Information Center

Rosen, Dina

2008-01-01

The purpose of this original quasi-experimental research was to investigate the potential for using case-based instruction during the student teaching seminar as a means for promoting practicum student teachers' critical reflection about facilitating children's learning. In addition, the study explored the impact of varied modes for delivering…

Issues in Developing Programmes to Support Teachers of Philology in Using Information and Communications Technologies in Greek Schools: A Case Study

ERIC Educational Resources Information Center

Fragkouli, Elpiniki; Hammond, Michael

2007-01-01

This paper reports on a case study of an in-service teacher-training programme for Greek philology teachers, from 2002 to 2003, which was designed to develop the use of information and communications technologies in their teaching. It draws on questionnaires and interviews with 34 teachers who took part in the training. In addition, the three…

A Case Example of the Implementation of Schoolwide Positive Behavior Support in a High School Setting Using Change Point Test Analysis

ERIC Educational Resources Information Center

Bohanon, Hank; Fenning, Pamela; Hicks, Kira; Weber, Stacey; Thier, Kimberly; Aikins, Brigit; Morrissey, Kelly; Briggs, Alissa; Bartucci, Gina; McArdle, Lauren; Hoeper, Lisa; Irvin, Larry

2012-01-01

The purpose of this case study was to expand the literature base regarding the application of high school schoolwide positive behavior support in an urban setting for practitioners and policymakers to address behavior issues. In addition, the study describes the use of the Change Point Test as a method for analyzing time series data that are…

Satisfactory surgical option for cartilage graft absorption in microtia reconstruction.

PubMed

Han, So-Eun; Oh, Kap Sung

2016-04-01

We routinely perform auricular elevation at least 6 months after implantation of framework in microtia reconstruction using costal cartilage. However, in a few cases, cartilage graft absorption has occurred, which has led to contour irregularity with unfavorable long-term results. In the present study, we recount the details of using additional rib cartilage augmentation to achieve an accentuated contour in cartilage graft absorption cases. The cartilage graft absorption was defined as contour irregularity or cartilage graft deformation as evaluated by the surgeon and patient. Depending on the extent of cartilage graft absorption, another rib cartilage framework was added to the previously implanted framework, targeting the absorption area. We used banked cartilage or harvested new cartilage based on three-dimensional rib computed tomography. Additional recontouring of framework was conducted in eight patients who were examined for cartilage graft absorption from 1.5 to 5 years after implantation of the framework. Four patients received additional rib cartilage augmentation and tissue expander insertion simultaneously prior to auricular elevation. Two patients underwent auricular elevation simultaneously. In another two patients, additional rib cartilage augmentation was performed before auricular elevation. The mean follow-up period was 18 months, and in all cases reconstructive results were acceptable. Although further follow-up evaluation is required, additional rib cartilage augmentation is an attractive surgical option for cartilage graft absorption cases. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Recruitment strategies for a hand dermatitis prevention programme in the food industry.

PubMed

Kaatz, Martin; Ladermann, Regina; Stadeler, Martina; Fluhr, Joachim Wilhelm; Elsner, Peter; Bauer, Andrea

2008-09-01

An interdisciplinary 'Skin Disease Prevention Programme (SDPP) in the baking, hotel, and catering industries' was established. However, only 30% of the eligible employees suffering from occupational hand dermatitis (OHD) participated in the programme. The aim of the present study was to increase the participation rate in the SDPP from 30% to 50% by specific recruitment strategies. Two hundred and twenty five baker and catering trade employees suffering from OHD were included in a prospective controlled intervention study. The employees were invited to take part in the SDPP using (i) a standard invitation letter (n = 40), (ii) a newly developed, personalized, and targeted invitation letter (n = 52), (iii) the new invitation letter and a case report (n = 75), and (iv) the new invitation letter, the case report, and the additional information (n = 58). The commitment of the employees to join the SDPP increased significantly from 30% to 54% (P < 0.02) in the group receiving the new personalized targeted invitation letter. Neither the additional case report nor the supplementation with additional information concerning the SDPP did further increase the recruitment. The strategy to personalize and target the new invitation letter was successful to influence the employees' commitment to participate in the SDPP.

Role of survivor bias in pancreatic cancer case-control studies.

PubMed

Hu, Zhen-Huan; Connett, John E; Yuan, Jian-Min; Anderson, Kristin E

2016-01-01

The purpose of this study was to evaluate the impact of survivor bias on pancreatic cancer case-control studies. The authors constructed five case-loss scenarios based on the Iowa Women's Health Study cohort to reflect how case recruitment in population-based studies varies by case survival time. Risk factors for disease incidence included smoking, body mass index (BMI), waist circumference, diabetes, and alcohol consumption. Odds ratios (ORs) were estimated by conditional logistic regression and quantitatively compared by the interactions between risk factors and 3-month survival time. Additionally, Kaplan-Meier estimates for overall survival were compared within the subset cohort of pancreatic cancer cases. BMI and waist circumference showed a significant inverse relationship with survival time. Decreasing trends in ORs for BMI and waist circumference were observed with increasing case survival time. The interaction between BMI and survival time based on a cutpoint of 3 months was significant (P < .01) as was the interaction between waist circumference and survival time (P < .01). The findings suggested that case losses could result in survivor bias causing underestimated odds ratios for both BMI and waist circumference, whereas other risk factors were not significantly affected by case losses. Copyright © 2016 Elsevier Inc. All rights reserved.

Component Release and Mechanical Properties of Endodontic Sealers following Incorporation of Antimicrobial Agents.

PubMed

Gjorgievska, Elizabeta S; Nicholson, John W; Coleman, Nichola J; Booth, Samantha; Dimkov, Aleksandar; Hurt, Andrew

2017-01-01

Root canal sealers with antimicrobial activity are highly beneficial; therefore, their antimicrobial properties could be improved by incorporation of antimicrobial agents. In the present study, the release of the quaternary ammonium compounds from endodontic sealers admixed with either benzalkonium chloride (BC) or cetylpyridinium chloride (CPC) at loadings of 2% wt was monitored. The effect of these additives on the compressive strengths and their release from the sealers was determined after 1 and 4 weeks. All of the materials studied were found to be capable of releasing antimicrobial additive in useful quantities. The release of CPC occurred to a statistically significant greater extent than BC for all materials. The addition of both BC and CPC generally decreased the compressive strength of all the endodontic sealers, with the exception of CPC in AH Plus, where the compressive strength was significantly increased. This suggests that, for these endodontic sealers, the antimicrobial additives alter the setting chemistry. AH Plus is an epoxy-based material cured with an amine, and in this case the increase in compressive strength with CPC is attributed to an enhanced cure reaction with this system. In all other cases, the additive inhibited the cure reaction to a greater or lesser extent.

Acoustic cavitation studies

NASA Astrophysics Data System (ADS)

Crum, L. A.

1981-09-01

The primary thrust of this study was toward a more complete understanding of general aspects of acoustic cavitation. The effect of long-chain polymer additives on the cavitation threshold was investigated to determine if they reduced the acoustic cavitation threshold in a similar manner to the observed reduction in the cavitation index in hydrodynamic cavitation. Measurements were made of the acoustic cavitation threshold as a function of polymer concentration for additives such as guar gum and polyethelene oxide. The measurements were also made as a function of dissolved gas concentration, surface tension and viscosity. It was determined that there was a significant increase in the acoustic cavitation threshold for increased concentrations of the polymer additives (measurable effects could be obtained for concentrations as low as a few parts per million). One would normally expect that an additive that reduces surface tension to decrease the pressure required to cause a cavity to grow and thus these additives, at first thought, should reduce the threshold. However, even in the hydrodynamic case, the threshold was increased. In both of the hydrodynamic cases considered, the explanation for the increased threshold was given in terms of changed fluid dynamics rather than changed physical properties of the fluid.

Device-independent quantum key distribution

NASA Astrophysics Data System (ADS)

Hänggi, Esther

2010-12-01

In this thesis, we study two approaches to achieve device-independent quantum key distribution: in the first approach, the adversary can distribute any system to the honest parties that cannot be used to communicate between the three of them, i.e., it must be non-signalling. In the second approach, we limit the adversary to strategies which can be implemented using quantum physics. For both approaches, we show how device-independent quantum key distribution can be achieved when imposing an additional condition. In the non-signalling case this additional requirement is that communication is impossible between all pairwise subsystems of the honest parties, while, in the quantum case, we demand that measurements on different subsystems must commute. We give a generic security proof for device-independent quantum key distribution in these cases and apply it to an existing quantum key distribution protocol, thus proving its security even in this setting. We also show that, without any additional such restriction there always exists a successful joint attack by a non-signalling adversary.

The population ecology of infectious diseases: pertussis in Thailand as a case study.

PubMed

Blackwood, J C; Cummings, D A T; Broutin, H; Iamsirithaworn, S; Rohani, P

2012-12-01

Many of the fundamental concepts in studying infectious diseases are rooted in population ecology. We describe the importance of population ecology in exploring central issues in infectious disease research including identifying the drivers and dynamics of host-pathogen interactions and pathogen persistence, and evaluating the success of public health policies. The use of ecological concepts in infectious disease research is demonstrated with simple theoretical examples in addition to an analysis of case notification data of pertussis, a childhood respiratory disease, in Thailand as a case study. We stress that further integration of these fields will have significant impacts in infectious diseases research.

Benefits of additional courses of systemic azithromycin in periodontal disease case report.

PubMed

Schmidt, Edgard F; Bretz, Walter A

2007-01-01

The strong association of subgingival anaerobic bacteria, such as Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia, with destructive periodontal disease has been well documented in the literature. Several double-blind studies have also shown the beneficial use of systemic antimicrobials that are active against these microorganisms in conjunction with conventional periodontal treatment, especially when periodontal abscesses and/or suppuration upon probing are present. Four cases with periodontal abscesses were treated with scaling/root planing in conjunction with systemic azithromycin. Partial improvement led to retreatment with two additional courses of azithromycin. Bone formation was noted on periapical radiographs after the patients took additional courses of azithromycin. In view of the benefits of using additional courses of azithromycin in the treatment of destructive periodontal disease, we conclude that the single course of systemic antimicrobials currently used in periodontal therapy may be insufficient to reach necessary therapeutic levels in infected sites.

The Economics of Big Area Addtiive Manufacturing

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

Post, Brian; Lloyd, Peter D; Lindahl, John

Case studies on the economics of Additive Manufacturing (AM) suggest that processing time is the dominant cost in manufacturing. Most additive processes have similar performance metrics: small part sizes, low production rates and expensive feedstocks. Big Area Additive Manufacturing is based on transitioning polymer extrusion technology from a wire to a pellet feedstock. Utilizing pellets significantly increases deposition speed and lowers material cost by utilizing low cost injection molding feedstock. The use of carbon fiber reinforced polymers eliminates the need for a heated chamber, significantly reducing machine power requirements and size constraints. We hypothesize that the increase in productivity coupledmore » with decrease in feedstock and energy costs will enable AM to become more competitive with conventional manufacturing processes for many applications. As a test case, we compare the cost of using traditional fused deposition modeling (FDM) with BAAM for additively manufacturing composite tooling.« less

Assessing the effect, on animal model, of mixture of food additives, on the water balance.

PubMed

Friedrich, Mariola; Kuchlewska, Magdalena

2013-01-01

The purpose of this study was to determine, on the animal model, the effect of modification of diet composition and administration of selected food additives on water balance in the body. The study was conducted with 48 males and 48 females (separately for each sex) of Wistar strain rats divided into four groups. For drinking, the animals from groups I and III were receiving water, whereas the animals from groups II and IV were administered 5 ml of a solution of selected food additives (potassium nitrate - E 252, sodium nitrite - E 250, benzoic acid - E 210, sorbic acid - E 200, and monosodium glutamate - E 621). Doses of the administered food additives were computed taking into account the average intake by men, expressed per body mass unit. Having drunk the solution, the animals were provided water for drinking. The mixture of selected food additives applied in the experiment was found to facilitate water retention in the body both in the case of both male and female rats, and differences observed between the volume of ingested fluids and the volume of excreted urine were statistically significant in the animals fed the basal diet. The type of feed mixture provided to the animals affected the site of water retention - in the case of animals receiving the basal diet analyses demonstrated a significant increase in water content in the liver tissue, whereas in the animals fed the modified diet water was observed to accumulate in the vascular bed. Taking into account the fact of water retention in the vascular bed, the effects of food additives intake may be more adverse in the case of females.

Evolution of design considerations in complex craniofacial reconstruction using patient-specific implants.

PubMed

Peel, Sean; Bhatia, Satyajeet; Eggbeer, Dominic; Morris, Daniel S; Hayhurst, Caroline

2017-06-01

Previously published evidence has established major clinical benefits from using computer-aided design, computer-aided manufacturing, and additive manufacturing to produce patient-specific devices. These include cutting guides, drilling guides, positioning guides, and implants. However, custom devices produced using these methods are still not in routine use, particularly by the UK National Health Service. Oft-cited reasons for this slow uptake include the following: a higher up-front cost than conventionally fabricated devices, material-choice uncertainty, and a lack of long-term follow-up due to their relatively recent introduction. This article identifies a further gap in current knowledge - that of design rules, or key specification considerations for complex computer-aided design/computer-aided manufacturing/additive manufacturing devices. This research begins to address the gap by combining a detailed review of the literature with first-hand experience of interdisciplinary collaboration on five craniofacial patient case studies. In each patient case, bony lesions in the orbito-temporal region were segmented, excised, and reconstructed in the virtual environment. Three cases translated these digital plans into theatre via polymer surgical guides. Four cases utilised additive manufacturing to fabricate titanium implants. One implant was machined from polyether ether ketone. From the literature, articles with relevant abstracts were analysed to extract design considerations. In all, 19 frequently recurring design considerations were extracted from previous publications. Nine new design considerations were extracted from the case studies - on the basis of subjective clinical evaluation. These were synthesised to produce a design considerations framework to assist clinicians with prescribing and design engineers with modelling. Promising avenues for further research are proposed.

Xpert(®) MTB/RIF for improved case detection of extra-pulmonary TB in a tertiary care setting in urban India.

PubMed

Nataraj, G; Kanade, S; Mehta, P

2016-07-01

Department of microbiology at a tertiary care hospital, Mumbai, India. To determine 1) the sensitivity and specificity of the Xpert(®) MTB/RIF assay in comparison with microscopy and culture in extra-pulmonary tuberculosis (EPTB), and 2) the number of additional cases of EPTB and rifampicin (RMP) resistance detected using this assay. The study was conducted from July 2013 to April 2015. All consecutive patients with clinically suspected EPTB referred for microscopic examination to the Department of Microbiology that were sufficient in specimen volume were included in the study. Of the 728 specimens included in the study, respectively 5.5%, 23.5% and 20.9% were positive on smear, culture and Xpert. Compared to culture, Xpert had a sensitivity of 84.2% (95%CI 81.4-86.6) and specificity of 98.2% (95%CI 90-104). All specimens with high and medium load on assay were positive on culture; 28 (18.4%) specimens were RMP-resistant and 124 (81.6%) were Xpert-susceptible. No additional RMP-resistant cases were detected using Xpert as compared to phenotypic drug susceptibility testing. The ability of the Xpert assay to rapidly detect a significantly greater number of bacteriologically confirmed EPTB cases, including RMP-resistant cases, makes it an important diagnostic tool in a TB-endemic country.

Performable Case Studies in Ethics Education.

PubMed

Robeson, Richard; King, Nancy M P

2017-09-12

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry-the creation and performance of short case studies designed specifically to raise bioethics issues for discussion-represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio.

Performable Case Studies in Ethics Education

PubMed Central

Robeson, Richard; King, Nancy M. P.

2017-01-01

Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry—the creation and performance of short case studies designed specifically to raise bioethics issues for discussion—represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio. PMID:28895903

Ultrasound analysis of mental artery flow in elderly patients: a case-control study.

PubMed

Baladi, Marina G; Tucunduva Neto, Raul R C M; Cortes, Arthur R G; Aoki, Eduardo M; Arita, Emiko S; Freitas, Claudio F

2015-01-01

Mental artery flow decreases with age and may have an aetiological role in alveolar ridge atrophy. The aim of this study was to identify factors associated with alterations of mental artery flow, assessed by ultrasonography. This case-control study was conducted on elderly patients (aged above 60 years) at the beginning of dental treatment. Intraoral B-mode Doppler ultrasonography was used to assess mental artery flow. The cases were defined as patients with a weak/absent ultrasound signal, whereas the controls presented a strong ultrasound signal. Demographics and radiographic findings (low bone mineral density on dual-energy X-ray absorptiometry and mandibular cortical index on panoramic radiographs) were analysed as risk factors for weak/absent ultrasound signal and were calculated as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) using conditional logistic regression. In addition, the Student's t-test was used to compare the mean alveolar bone height of the analysed groups. A p-value <0.05 was considered statistically significant. A total of 30 ultrasound examinations (12 cases and 18 controls) were analysed. A weak/absent mental artery pulse strength was significantly associated with edentulism (AOR = 3.67; 95% CI = 0.86-15.63; p = 0.046). In addition, there was a significant difference in alveolar bone height between edentulous cases and controls (p = 0.036). Within the limitations of this study, the present results indicate that edentulism is associated with diminished mental artery flow, which, in turn, affects alveolar bone height.

From job training to green jobs: a case study for a young adult employment program centered on environmental restoration in New York City, USA

Treesearch

Nancy Falxa-Raymond; Erika Svendsen; Lindsay K. Campbell

2013-01-01

The demand for a well-trained green-collar labor force will increase as many cities implement sustainability and green infrastructure plans. Additionally, many green jobs training programs are intended to provide pathways out of poverty for low-skilled workers. In this case study, we analyze the experiences of graduates from a New York City, USA green jobs training...

[Method to calculate the additional hospital stay in patients with cross infection].

PubMed

Angeles-Garay, Ulises; Velázquez-Chávez, Yesenia; Molinar-Ramos, Fernando; Anaya-Flores, Verónica E; Uribe-Márquez, Samuel E

2009-01-01

To calculate additional hospital stay due to specific cross infection. Cases and controls study; matched by age +/- 2 years, sex, specialty in which were taken care, diagnosis, surgical procedure and hospitalization stay, between July 2005-June 2006. t test, chi(2) to calculate death risk, Kaplan-Meier analysis to calculate survival, Hosmer-Lemeshow test to know the contribution of cross infection for additional hospital stay due to cross infection (AHSDCI). We identified 851 patients with 1347 cross infection in 16 528 discharges. We could match 677. The cases stayed 25.42 days and the controls 13.29 (p < 0.01). The death risk for the cases was 5.8 (CI 95 % = 3.7-8.6, p < 0.01), four weeks survival 55.3 % for cases and 79.2 % for the controls. The AHSDCI for pneumonia was 10.39 days, urinary-tract-infection 6.28, bacteremia 8.92, vascular-catheter-related infection 3.31, surgical site infections 7.42, and skin and soft-tissue-infection 3.31 (p < 0.05). We used a multivariate model fitted to patient's gravity and complexity to extract the proportion days of AHSDCI of each cross infection.

Short Text Messages (SMS) as an Additional Tool for Notifying Medical Staff in Case of a Hospital Mass Casualty Incident.

PubMed

Timler, Dariusz; Bogusiak, Katarzyna; Kasielska-Trojan, Anna; Neskoromna-Jędrzejczak, Aneta; Gałązkowski, Robert; Szarpak, Łukasz

2016-02-01

The aim of the study was to verify the effectiveness of short text messages (short message service, or SMS) as an additional notification tool in case of fire or a mass casualty incident in a hospital. A total of 2242 SMS text messages were sent to 59 hospital workers divided into 3 groups (n=21, n=19, n=19). Messages were sent from a Samsung GT-S8500 Wave cell phone and Orange Poland was chosen as the telecommunication provider. During a 3-month trial period, messages were sent between 3:35 PM and midnight with no regular pattern. Employees were asked to respond by telling how much time it would take them to reach the hospital in case of a mass casualty incident. The mean reaction time (SMS reply) was 36.41 minutes. The mean declared time of arrival to the hospital was 100.5 minutes. After excluding 10% of extreme values for declared arrival time, the mean arrival time was estimated as 38.35 minutes. Short text messages (SMS) can be considered an additional tool for notifying medical staff in case of a mass casualty incident.

Case studies approach for an undergraduate astrobiology course

NASA Astrophysics Data System (ADS)

Burko, Lior M.; Enger, Sandra

2013-04-01

Case studies is a well known and widely used method in law schools, medical schools, and business schools, but relatively little used in physics or astronomy courses. We developed an astrobiology course based strongly on the case studies approach, and after teaching it first at the University of Alabama in Huntsville, we have adapted it and are now teaching it at Alabama A&M University, a HBCU. The case studies approach uses several well tested and successful teaching methods - including group work, peer instruction, current interest topics, just-in-time teaching, &c. We have found that certain styles of cases are more popular among students than other styles, and will revise our cases to reflect such student preferences. We chose astrobiology -- an inherently multidisciplinary field -- because of the popularity of the subject matter, its frequent appearance in the popular media (news stories about searches for life in the universe, the discovery of Earth-like exoplanets, etc, in addition to SciFi movies and novels), and the rapid current progress in the field. In this talk we review briefly the case studies method, the styles of cases used in our astrobiology course, and student response to the course as found in our assessment analysis.

Targeting Terrorist Leaders: A Case Study

DTIC Science & Technology

2011-03-01

PRESSURE .................................38 IV. STATISTICAL ANALYSIS ON ISRAELI LEADERSHIP TARGETING ...43 V. CONCLUSION: HAVE ISRAELI ATTEMPTS TO...organization. D. POTENTIAL WEAKNESSES The use of one case to evaluate the efficacy of the terrorist-leadership targeting model is problematic...times who was in charge. In addition, the literature on Hamas is widely split on the role that inspirational leaders had on operational matters

Hepatobiliary fascioliasis: a case with unusual radiological features.

PubMed

Yeşildağ, Ahmet; Senol, Altuğ; Köroğlu, Mert; Koçkar, Cem; Oyar, Orhan; Işler, Mehmet

2010-12-01

We report a case of hepatobiliary fascioliasis presenting with unusual radiological findings that have not been reported previously. Imaging studies revealed hepatic cystic pouches communicating with intrahepatic bile ducts. Snail-like, oval shaped and conglomerated echogenic particles with no acoustic shadowing, suggesting F. hepatica, were detected in these cystic pouches. In addition, secondary sclerosing cholangitis developed after fascioliasis.

The dilemma of allergy to food additives.

PubMed

Bahna, Sami L; Burkhardt, Joshua G

2018-01-01

To provide a brief summary on food additives and to outline a practical approach for evaluating subjects suspected of having reactions to food additives. Information was derived from selected reviews and original articles published in peer-reviewed journals, supplemented by the clinical experience of the authors. Priority was given to studies that used blinded, placebo controlled, oral challenges to confirm adverse reactions to food additives. In addition, selected, appropriately evaluated case reports were included. A large number of food additives are widely used in the food industry. Allergic reactions to additives seem to be rare but are very likely underdiagnosed, primarily due to a low index of suspicion. A wide variety of symptoms to food additives have been reported, but a cause-and-effect relationship has not been well documented in the majority of cases. Reactions to food additives should be suspected in patients who report symptoms related to multiple foods or to a certain food when commercially prepared but not when home made. It is also prudent to investigate food additives in subjects considered to have "idiopathic" reactions. Except for a limited number of natural additives, there is a small role for skin tests or in vitro testing. Oral challenge, in stages, with commonly used additives is the definitive procedure for detecting the offending agent. Once the specific additive is identified, management is strict avoidance, which can be difficult.

[Evaluation of fetomaternal hemorrhage in postpartum patients with indication for administration of anti-D immunoglobulin].

PubMed

Baiochi, Eduardo; Camano, Luiz; Bordin, José Orlando

2005-01-01

This study evaluated fetomaternal hemorrhage (FMH) in 343 postpartum patients who required prophylaxis of Rh alloimmunization with anti-D immunoglobulin. The rosette test was applied to screen for patients needing quantitative determination of fetal blood transferred from the maternal circulation, which was then measured by the Kleihauer-Betke test (K-B). The rosette test was positive in 22 cases (6.4%). In five of these cases, K-B did not show fetomaternal hemorrhage (a 1.45% false-positive rate for the rosette test), and in one case the test was inconclusive. There were 8 cases with FMH < 10 ml (2.3%), 6 cases with FMH from 10 to 30 ml (1.7%), and two cases with FMH > 30 ml (0.58%), requiring a supplementary dose of anti-D. The study concludes that following the rosette test, additional evaluation of FMH using a quantitative test was unnecessary in 93.6% of the cases.

Sialolipoma of salivary glands: Two case reports and review of the literature

PubMed Central

Khazaeni, Kamran; Jafarian, Amir Hosein; Khajehahmadi, Saeedeh; Rahpeyma, Amin; Asadi, Ladan

2013-01-01

Sialolipoma is a rare neoplasm of salivary glands, described as a distinct entity by Nagao et al. in 2001. Thirty-six cases of sialolipoma in minor and major salivary glands have been reported thus far in addition to the two new cases of sialolipoma arising in the major salivary glands in this study. Thirty-six cases of sialolipoma published in English language reports were analyzed considering gender, age, location, size, duration of symptoms, treatment mode, follow-up, and histologic findings. Congenital sialolipomas were considered in this study. The first case occurred in a 45-year-old female and presented as a localized swelling in right parotid area. The second case occurred in an 18-year-old female as a swelling in the left parotid region. On histopathological examination, these lesions were diagnosed as sialolipoma. PMID:23878570

Dedifferentiated liposarcoma of the oral floor: A case study and literature review of 50 cases of head and neck neoplasm.

PubMed

Nimura, Fumikazu; Nakasone, Toshiyuki; Matsumoto, Hirofumi; Maruyama, Tessho; Matayoshi, Akira; Maruyama, Nobuyuki; Yoshimi, Naoki; Arasaki, Akira; Nishihara, Kazuhide

2018-05-01

Dedifferentiated liposarcoma (DDLS) has a relatively poor prognosis, however this neoplasm rarely occurs in the head and neck. To date, no definite protocol has been established for the diagnosis and treatment of head and neck DDLS. The present study reports the case of a 69-year-old male patient with DDLS of the oral floor. To the best of our knowledge, this is the first documented case of oral floor DDLS. In addition, this is the first reported case with the development of a second primary malignancy following the treatment of head and neck DDLS. A literature review of 50 cases of head and neck DDLS revealed that preoperative biopsy is not reliable for the diagnosis of these tumors and an accurate pathological diagnosis with total resection is preferred.

Dedifferentiated liposarcoma of the oral floor: A case study and literature review of 50 cases of head and neck neoplasm

PubMed Central

Nimura, Fumikazu; Nakasone, Toshiyuki; Matsumoto, Hirofumi; Maruyama, Tessho; Matayoshi, Akira; Maruyama, Nobuyuki; Yoshimi, Naoki; Arasaki, Akira; Nishihara, Kazuhide

2018-01-01

Dedifferentiated liposarcoma (DDLS) has a relatively poor prognosis, however this neoplasm rarely occurs in the head and neck. To date, no definite protocol has been established for the diagnosis and treatment of head and neck DDLS. The present study reports the case of a 69-year-old male patient with DDLS of the oral floor. To the best of our knowledge, this is the first documented case of oral floor DDLS. In addition, this is the first reported case with the development of a second primary malignancy following the treatment of head and neck DDLS. A literature review of 50 cases of head and neck DDLS revealed that preoperative biopsy is not reliable for the diagnosis of these tumors and an accurate pathological diagnosis with total resection is preferred. PMID:29740489

Computer model for refinery operations with emphasis on jet fuel production. Volume 2: Data and technical bases

NASA Technical Reports Server (NTRS)

Dunbar, D. N.; Tunnah, B. G.

1978-01-01

The FORTRAN computing program predicts the flow streams and material, energy, and economic balances of a typical petroleum refinery, with particular emphasis on production of aviation turbine fuel of varying end point and hydrogen content specifications. The program has provision for shale oil and coal oil in addition to petroleum crudes. A case study feature permits dependent cases to be run for parametric or optimization studies by input of only the variables which are changed from the base case. The report has sufficient detail for the information of most readers.

Rate laws of the self-induced aggregation kinetics of Brownian particles

NASA Astrophysics Data System (ADS)

Mondal, Shrabani; Sen, Monoj Kumar; Baura, Alendu; Bag, Bidhan Chandra

2016-03-01

In this paper we have studied the self induced aggregation kinetics of Brownian particles in the presence of both multiplicative and additive noises. In addition to the drift due to the self aggregation process, the environment may induce a drift term in the presence of a multiplicative noise. Then there would be an interplay between the two drift terms. It may account qualitatively the appearance of the different laws of aggregation process. At low strength of white multiplicative noise, the cluster number decreases as a Gaussian function of time. If the noise strength becomes appreciably large then the variation of cluster number with time is fitted well by the mono exponentially decaying function of time. For additive noise driven case, the decrease of cluster number can be described by the power law. But in case of multiplicative colored driven process, cluster number decays multi exponentially. However, we have explored how the rate constant (in the mono exponentially cluster number decaying case) depends on strength of interference of the noises and their intensity. We have also explored how the structure factor at long time depends on the strength of the cross correlation (CC) between the additive and the multiplicative noises.

Analysis of the origin of the extra chromosome in trisomy 8 in 4 cases of spontaneous abortions.

PubMed

Nicolaidis, P; von Beust, G; Bugge, M; Karadima, G; Vassilopoulos, D; Brøndum-Nielsen, K; Petersen, M B

1998-01-01

To determine the origin of the extra chromosome in trisomy 8 in spontaneous abortions. We analyzed 4 cases of nonmosaic trisomy 8 in 1st-trimester spontaneous abortions and their parents with DNA polymorphism analysis using microsatellite DNA markers. In 3 cases the extra chromosome was maternal in origin and in 1 case paternal in origin. In 2 of the cases the nondisjunction had occurred in maternal meiosis, while the other 2 cases were consistent with a postzygotic (mitotic) origin of the additional chromosome. Although a small number of cases studied, these results suggest differences from the common autosomal trisomies 21, 18, 16, and 13 where the vast majority of cases are due to errors in maternal meiosis.

The prevalence of ADHD in a population-based sample

PubMed Central

Rowland, Andrew S.; Skipper, Betty J.; Umbach, David M.; Rabiner, David L.; Campbell, Richard A.; Naftel, A. Jack; Sandler, Dale P.

2014-01-01

Objective Few studies of ADHD prevalence have used population-based samples, multiple informants, and DSM-IV criteria. In addition, children who are asymptomatic while receiving ADHD mediction often have been misclassified. Therefore, we conducted a population-based study to estimate the prevalence of ADHD in elementary school children using DSM-IV critera. Methods We screened 7587 children for ADHD. Teachers of 81% of the children completed a DSM-IV checklist. We then interviewed parents using a structured interview (DISC). Of these, 72% participated. Parent and teacher ratings were combined to determine ADHD status. We also estimated the proportion of cases attributable to other conditions. Results Overall, 15.5% of our sample (95% confidence interval (C.I.) 14.6%-16.4%) met DSM-IV-TR criteria for ADHD. Over 40% of cases reported no previous diagnosis. With additional information, other conditions explained about 9% of cases. Conclusions The prevalence of ADHD in this population-based sample was higher than the 3-7% commonly reported. To compare study results, the methods used to implement the DSM criteria need to be standardized. PMID:24336124

Using Case Studies as a Semester-Long Tool to Teach Neuroanatomy and Structure-Function Relationships to Undergraduates

PubMed Central

Kennedy, Susan

2013-01-01

In addition to being inherently interesting to students, case studies can serve as useful tools to teach neuroanatomy and demonstrate important relationships between brain structure and function. In most undergraduate courses, however, neuroanatomy is presented to students as a “unit” or chapter, much like other topics (e.g., receptors, pharmacology) covered in the course, over a period of a week or two. In this article, a relatively simple model of teaching neuroanatomy is described in which students are actively engaged in the presentation and discussion of case studies throughout the semester, following a general introduction to the structure of the nervous system. In this way, the teaching of neuroanatomy is “distributed” throughout the semester and put into a more user-friendly context for students as additional topics are introduced. Generally, students report enjoying learning brain structure using this method, and commented positively on the class activities associated with learning brain anatomy. Advantages and disadvantages of such a model are presented, as are suggestions for implementing similar models of undergraduate neuroanatomy education. PMID:24319386

Acquired immunodeficiency syndrome in a patient with no known risk factors: a pathological study.

PubMed

Burt, A D; Scott, G; Shiach, C R; Isles, C G

1984-04-01

We present the pathological findings in a case of acquired immunodeficiency syndrome (AIDS) in a patient with no known risk factor. Postmortem examination showed klebsiella lung abscess, generalised cytomegalovirus infection, cerebral toxoplasmosis, and a primary cerebral lymphoma. An additional feature was the presence of dilatation of the intrahepatic large bile ducts in association with an atypical distribution of cytomegalovirus. The relation between this case and previously reported cases of AIDS is discussed.

Strangulation and Its Role in Multiple Causes of Death.

PubMed

Hlavaty, Leigh; Sung, LokMan

2017-12-01

Forensic pathologists have a duty to determine the cause and manner of death and are bound by international guidelines in the completion of the death certificate. Sometimes, there are complex circumstances surrounding a death that cannot be captured in the structure of the death certificate and its requirement of listing only 1 cause of death per line. Cases may have multiple causes of death with comorbid medical conditions or inflicted injuries that equally contribute to the ultimate demise. Compared with other forms of homicide, autopsy evidence of strangulation will often be found with other life-threatening traumatic injuries. The Wayne County Medical Examiner's Office conducted a retrospective study of strangulation cases that came into the office from mid-2007 to the end of 2016. The purpose of the study was to examine patterns of injuries in strangulation cases and identify those with additional traumatic injuries of commensurate extent that required incorporation into the cause of death. A total of 43 strangulation cases were found, of which there were equal numbers of ligature and manual strangulations (19 each) and 5 cases in which the method was not specified, and decedents were divided: 63% female and 37% male. Fourteen of these cases were recognized to have multiple causes of death, where blunt force trauma was the most common additional cause, and the sex distribution weighed heavily toward the female (approximately 79%).

Effects of pay-for-performance system on tuberculosis default cases control and treatment in Taiwan.

PubMed

Tsai, Wen-Chen; Kung, Pei-Tseng; Khan, Mahmud; Campbell, Claudia; Yang, Wen-Ta; Lee, Tsuey-Fong; Li, Ya-Hsin

2010-09-01

In order to make tuberculosis (TB) treatment more effective and to lower the default rate of the disease, the Bureau of National Health Insurance (BNHI) in Taiwan implemented the "pay-for-performance on Tuberculosis" program (P4P on TB) in 2004. The purpose of this study is to investigate the effectiveness of the P4P system in terms of default rate. This is a retrospective study. National Health Insurance Research Datasets in Taiwan from 2002 to 2005 has been used for the study. The study compared the differences of TB default rate before and after the implementation of P4P program, between participating and non-participating hospitals, and between P4P hospitals with and without case managers. Furthermore, logistic regression analysis was conducted to explore the related factors influencing TB patients default treatment after TB detected. The treatment default rate after "P4P on TB" was 11.37% compared with the 15.56% before "P4P on TB" implementation. The treatment default rate in P4P hospitals was 10.67% compared to 12.7% in non-P4P hospitals. In addition, the default rate was 10.4% in hospitals with case managers compared with 12.68% in hospitals without case managers. The results of the study showed that "P4P on TB" program improved the treatment default rate for TB patients. In addition, case managers improved the treatment outcome in controlling patients' default rate. Copyright 2010 The British Infection Society. Published by Elsevier Ltd. All rights reserved.

Characterizing mammographic images by using generic texture features

PubMed Central

2012-01-01

Introduction Although mammographic density is an established risk factor for breast cancer, its use is limited in clinical practice because of a lack of automated and standardized measurement methods. The aims of this study were to evaluate a variety of automated texture features in mammograms as risk factors for breast cancer and to compare them with the percentage mammographic density (PMD) by using a case-control study design. Methods A case-control study including 864 cases and 418 controls was analyzed automatically. Four hundred seventy features were explored as possible risk factors for breast cancer. These included statistical features, moment-based features, spectral-energy features, and form-based features. An elaborate variable selection process using logistic regression analyses was performed to identify those features that were associated with case-control status. In addition, PMD was assessed and included in the regression model. Results Of the 470 image-analysis features explored, 46 remained in the final logistic regression model. An area under the curve of 0.79, with an odds ratio per standard deviation change of 2.88 (95% CI, 2.28 to 3.65), was obtained with validation data. Adding the PMD did not improve the final model. Conclusions Using texture features to predict the risk of breast cancer appears feasible. PMD did not show any additional value in this study. With regard to the features assessed, most of the analysis tools appeared to reflect mammographic density, although some features did not correlate with PMD. It remains to be investigated in larger case-control studies whether these features can contribute to increased prediction accuracy. PMID:22490545

A d-statistic for single-case designs that is equivalent to the usual between-groups d-statistic.

PubMed

Shadish, William R; Hedges, Larry V; Pustejovsky, James E; Boyajian, Jonathan G; Sullivan, Kristynn J; Andrade, Alma; Barrientos, Jeannette L

2014-01-01

We describe a standardised mean difference statistic (d) for single-case designs that is equivalent to the usual d in between-groups experiments. We show how it can be used to summarise treatment effects over cases within a study, to do power analyses in planning new studies and grant proposals, and to meta-analyse effects across studies of the same question. We discuss limitations of this d-statistic, and possible remedies to them. Even so, this d-statistic is better founded statistically than other effect size measures for single-case design, and unlike many general linear model approaches such as multilevel modelling or generalised additive models, it produces a standardised effect size that can be integrated over studies with different outcome measures. SPSS macros for both effect size computation and power analysis are available.

Shuttle Case Study Collection Website Development

NASA Technical Reports Server (NTRS)

Ransom, Khadijah S.; Johnson, Grace K.

2012-01-01

As a continuation from summer 2012, the Shuttle Case Study Collection has been developed using lessons learned documented by NASA engineers, analysts, and contractors. Decades of information related to processing and launching the Space Shuttle is gathered into a single database to provide educators with an alternative means to teach real-world engineering processes. The goal is to provide additional engineering materials that enhance critical thinking, decision making, and problem solving skills. During this second phase of the project, the Shuttle Case Study Collection website was developed. Extensive HTML coding to link downloadable documents, videos, and images was required, as was training to learn NASA's Content Management System (CMS) for website design. As the final stage of the collection development, the website is designed to allow for distribution of information to the public as well as for case study report submissions from other educators online.

Inter-observer variability in the classification of ovarian cancer cell type using microscopy: a pilot study

NASA Astrophysics Data System (ADS)

Gavrielides, Marios A.; Ronnett, Brigitte M.; Vang, Russell; Seidman, Jeffrey D.

2015-03-01

Studies have shown that different cell types of ovarian carcinoma have different molecular profiles, exhibit different behavior, and that patients could benefit from typespecific treatment. Different cell types display different histopathology features, and different criteria are used for each cell type classification. Inter-observer variability for the task of classifying ovarian cancer cell types is an under-examined area of research. This study served as a pilot study to quantify observer variability related to the classification of ovarian cancer cell types and to extract valuable data for designing a validation study of digital pathology (DP) for this task. Three observers with expertise in gynecologic pathology reviewed 114 cases of ovarian cancer with optical microscopy, with specific guidelines for classifications into distinct cell types. For 93 cases all 3 pathologists agreed on the same cell type, for 18 cases 2 out of 3 agreed, and for 3 cases there was no agreement. Across cell types with a minimum sample size of 10 cases, agreement between all three observers was {91.1%, 80.0%, 90.0%, 78.6%, 100.0%, 61.5%} for the high grade serous carcinoma, low grade serous carcinoma, endometrioid, mucinous, clear cell, and carcinosarcoma cell types respectively. These results indicate that unanimous agreement varied over a fairly wide range. However, additional research is needed to determine the importance of these differences in comparison studies. These results will be used to aid in the design and sizing of such a study comparing optical and digital pathology. In addition, the results will help in understanding the potential role computer-aided diagnosis has in helping to improve the agreement of pathologists for this task.

Intra-arterial intervention chemotherapy for sarcoma and cancerous ulcer via an implanted pump.

PubMed

Liu, Cheng; Cui, Qiu; Guo, Jun; Li, Dingfeng; Zeng, Yanjun

2014-04-01

To observe the efficacy of intra-arterial chemotherapy with subcutaneously implanted pump for soft tissue sarcoma in extremities and cancerous ulcer. 31 patients with ulcerative skin squamous cell carcinoma or sarcoma in extremities who received treatment during the period from July 2003 to November 2011 at our hospital were recruited, including 15 male and 16 female patients, aging between 14 and 83 with average age of 49 years old. 10 patients had tumor in upper extremities and 21 patients in lower extremities. The pathological types of studied cases include 9 cases with skin squamous cell carcinoma, 6 cases with synovial sarcoma, 5 cases with malignant fibrous histiocytoma, 3 cases with liposarcoma, 3 cases with osteosarcoma, 2 cases with malignant melanoma, 2 cases with epidermoid sarcoma, and 1 case with protuberans. The main symptoms of cancerous ulcer were pain, infection and hemorrhage; All the studied patients were administrated with cisplatin and doxorubicin by intra-arterial chemotherapy pump, and the patients with squamous cell carcinoma were additionally applied with bleomycin and patients with malignant melanoma were additionally applied with dacarbazine. The chemotherapy efficiency was observed after at 3 cycles of intra-arterial chemotherapy. The total remission rate of pain (RR) was 87 %, and total remission rate of ulcer cicatrization (RR) was 71 %, with ulcer cicatrizing spontaneously in 9 cases and obvious homeostasis in 5 cases with bleeding ulcers. 19 patients underwent surgery after chemotherapy, in which 16 cases had limb-salvage surgery and 3 cases underwent lower leg amputation after chemotherapy, and 3 patients out of 16 cases had local recurrence (19 %). The subcutaneous intra-arterial targeting chemotherapy could be applied to treat refractory sarcoma and cancerous ulcer in extremities to significantly increase the chemotherapeutic concentration at tumor area so as to effectively constrain the tumor rupture induced main symptoms including pain, infection and bleeding, which would help to make a decreased blood supplied and well defined tumor boundary to finally decrease the recurrence rate.

Should sputum-negative presumptive TB patients be actively followed to identify missing cases in India?

PubMed

Waikar, S; Pathak, A; Ghule, V; Kapoor, A; Sagili, K; Babu, E R; Chadha, S

2017-12-21

Setting: Sputum smear microscopy, the primary diagnostic tool used for diagnosis of tuberculosis (TB) in India's Revised National TB Control Programme (RNTCP), has low sensitivity, resulting in a significant number of TB cases reported as sputum-negative. As the revised guidelines pose challenges in implementation, sputum-negative presumptive TB (SNPT) patients are subjected to 2 weeks of antibiotics, followed by chest X-ray (CXR), resulting in significant loss to care among these cases. Objective: To determine whether reducing delays in CXR would yield additional TB cases and reduce initial loss to follow-up for diagnosis among SNPT cases. Methods: In an ongoing intervention in five districts of Maharashtra, SNPT patients were offered upfront CXR. Results: Of 119 male and 116 female SNPT patients with a mean age of 45 years who were tested by CXR, 32 (14%) were reported with CXR suggestive of TB. Administering upfront CXR in SNPT patients yielded twice as many additional cases, doubling the proportion of cases detected among all those tested as against administering CXR 2 weeks after smear examination. Conclusion: Our interventional study showed that the yield of TB cases was significantly greater when upfront CXR examination was undertaken without waiting for a 2-week antibiotic trial.

26 CFR 1.6654-2T - Exceptions to imposition of the addition to the tax in the case of individuals (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Additions to the Tax, Additional Amounts, and Assessable Penalties § 1.6654-2T Exceptions to imposition of the addition to the tax in the case of individuals (temporary). (a) In general. The addition to the tax under...

Authorization and Toxicity of Veterinary Drugs and Plant Protection Products: Residues of the Active Ingredients in Food and Feed and Toxicity Problems Related to Adjuvants

PubMed Central

Klátyik, Szandra; Bohus, Péter; Darvas, Béla; Székács, András

2017-01-01

Chemical substances applied in animal husbandry or veterinary medicine and in crop protection represent substantial environmental loads, and their residues occur in food and feed products. Product approval is governed differently in these two sectors in the European Union (EU), and the occurrence of veterinary drug (VD) and pesticide residues indicated by contamination notification cases in the Rapid Alert System for Food and Feed of the EU also show characteristic differences. While the initial high numbers of VD residues reported in 2002 were successfully suppressed to less than 100 cases annually by 2006 and on, the number of notification cases for pesticide residues showed a gradual increase from a low (approximately 50 cases annually) initial level until 2005 to more than 250 cases annually after 2009, with a halt occurring only in 2016. Main notifiers of VD residues include Germany, Belgium, the UK, and Italy (63, 59, 42, and 31 notifications announced, respectively), and main consigning countries of non-compliances are Vietnam, India, China, and Brazil (88, 50, 34, and 23 notifications, respectively). Thus, countries of South and Southeast Asia are considered a vulnerable point with regard to VD residues entering the EU market. Unintended side effects of VDs and plant protection products may be caused not only by the active ingredients but also by various additives in these preparations. Adjuvants (e.g., surfactants) and other co-formulants used in therapeutic agents and feed additives, as well as in pesticide formulations have long been considered as inactive ingredients in the aspects of the required main biological effect of the pharmaceutical or pesticide, and in turn, legal regulations of the approval and marketing of these additives specified significantly less stringent risk assessment requirements, than those specified for the active ingredients. However, numerous studies have shown additive, synergistic, or antagonistic side effects between the active ingredients and their additives in formulated products; moreover, toxicity has been evidenced for various additives. Therefore, toxicological evaluation of surfactants and other additives is essential for proper environmental risk assessment of formulations used in agriculture including animal husbandry and plant protection. PMID:28929103

Authorization and Toxicity of Veterinary Drugs and Plant Protection Products: Residues of the Active Ingredients in Food and Feed and Toxicity Problems Related to Adjuvants.

PubMed

Klátyik, Szandra; Bohus, Péter; Darvas, Béla; Székács, András

2017-01-01

Chemical substances applied in animal husbandry or veterinary medicine and in crop protection represent substantial environmental loads, and their residues occur in food and feed products. Product approval is governed differently in these two sectors in the European Union (EU), and the occurrence of veterinary drug (VD) and pesticide residues indicated by contamination notification cases in the Rapid Alert System for Food and Feed of the EU also show characteristic differences. While the initial high numbers of VD residues reported in 2002 were successfully suppressed to less than 100 cases annually by 2006 and on, the number of notification cases for pesticide residues showed a gradual increase from a low (approximately 50 cases annually) initial level until 2005 to more than 250 cases annually after 2009, with a halt occurring only in 2016. Main notifiers of VD residues include Germany, Belgium, the UK, and Italy (63, 59, 42, and 31 notifications announced, respectively), and main consigning countries of non-compliances are Vietnam, India, China, and Brazil (88, 50, 34, and 23 notifications, respectively). Thus, countries of South and Southeast Asia are considered a vulnerable point with regard to VD residues entering the EU market. Unintended side effects of VDs and plant protection products may be caused not only by the active ingredients but also by various additives in these preparations. Adjuvants (e.g., surfactants) and other co-formulants used in therapeutic agents and feed additives, as well as in pesticide formulations have long been considered as inactive ingredients in the aspects of the required main biological effect of the pharmaceutical or pesticide, and in turn, legal regulations of the approval and marketing of these additives specified significantly less stringent risk assessment requirements, than those specified for the active ingredients. However, numerous studies have shown additive, synergistic, or antagonistic side effects between the active ingredients and their additives in formulated products; moreover, toxicity has been evidenced for various additives. Therefore, toxicological evaluation of surfactants and other additives is essential for proper environmental risk assessment of formulations used in agriculture including animal husbandry and plant protection.

Literacy in the Early Years and English as an Additional Language: The Case of a British International School

ERIC Educational Resources Information Center

Englezou, Eliana; Fragkouli, Elpiniki

2014-01-01

The study upon which this article is based investigates teachers' literacy development methods used in nursery and reception classrooms of a British international school, and focuses specifically on children having English as an additional language (EAL). Findings from teaching observations and from interviews with teachers present the techniques…

Molecular Study of Three Lebanese and Syrian Patients with Waardenburg Syndrome and Report of Novel Mutations in the EDNRB and MITF Genes.

PubMed

Haddad, N M; Ente, D; Chouery, E; Jalkh, N; Mehawej, C; Khoueir, Z; Pingault, V; Mégarbané, A

2011-01-01

Waardenburg syndrome (WS) is a genetic disorder characterized primarily by depigmentation of the skin and hair, heterochromia of the irides, sensorineural deafness, and sometimes by dystopia canthorum, and Hirschsprung disease. WS presents a large clinical and genetic heterogeneity. Four different types have been individualized and linked to 5 different genes. We report 2 cases of WS type II and 1 case of WS type IV from Lebanon and Syria. The genetic studies revealed 2 novel mutations in the MITF gene of the WS type II cases and 1 novel homozygous mutation in the EDNRB gene of the WS type IV case. This is the first molecular study of patients from the Arab world. Additional cases will enable a more detailed description of the clinical spectrum of Waardenburg syndrome in this region.

Molecular Study of Three Lebanese and Syrian Patients with Waardenburg Syndrome and Report of Novel Mutations in the EDNRB and MITF Genes

PubMed Central

Haddad, N.M.; Ente, D.; Chouery, E.; Jalkh, N.; Mehawej, C.; Khoueir, Z.; Pingault, V.; Mégarbané, A.

2011-01-01

Waardenburg syndrome (WS) is a genetic disorder characterized primarily by depigmentation of the skin and hair, heterochromia of the irides, sensorineural deafness, and sometimes by dystopia canthorum, and Hirschsprung disease. WS presents a large clinical and genetic heterogeneity. Four different types have been individualized and linked to 5 different genes. We report 2 cases of WS type II and 1 case of WS type IV from Lebanon and Syria. The genetic studies revealed 2 novel mutations in the MITF gene of the WS type II cases and 1 novel homozygous mutation in the EDNRB gene of the WS type IV case. This is the first molecular study of patients from the Arab world. Additional cases will enable a more detailed description of the clinical spectrum of Waardenburg syndrome in this region. PMID:21373256

Robust Tests for Additive Gene-Environment Interaction in Case-Control Studies Using Gene-Environment Independence.

PubMed

Liu, Gang; Mukherjee, Bhramar; Lee, Seunggeun; Lee, Alice W; Wu, Anna H; Bandera, Elisa V; Jensen, Allan; Rossing, Mary Anne; Moysich, Kirsten B; Chang-Claude, Jenny; Doherty, Jennifer A; Gentry-Maharaj, Aleksandra; Kiemeney, Lambertus; Gayther, Simon A; Modugno, Francesmary; Massuger, Leon; Goode, Ellen L; Fridley, Brooke L; Terry, Kathryn L; Cramer, Daniel W; Ramus, Susan J; Anton-Culver, Hoda; Ziogas, Argyrios; Tyrer, Jonathan P; Schildkraut, Joellen M; Kjaer, Susanne K; Webb, Penelope M; Ness, Roberta B; Menon, Usha; Berchuck, Andrew; Pharoah, Paul D; Risch, Harvey; Pearce, Celeste Leigh

2018-02-01

There have been recent proposals advocating the use of additive gene-environment interaction instead of the widely used multiplicative scale, as a more relevant public health measure. Using gene-environment independence enhances statistical power for testing multiplicative interaction in case-control studies. However, under departure from this assumption, substantial bias in the estimates and inflated type I error in the corresponding tests can occur. In this paper, we extend the empirical Bayes (EB) approach previously developed for multiplicative interaction, which trades off between bias and efficiency in a data-adaptive way, to the additive scale. An EB estimator of the relative excess risk due to interaction is derived, and the corresponding Wald test is proposed with a general regression setting under a retrospective likelihood framework. We study the impact of gene-environment association on the resultant test with case-control data. Our simulation studies suggest that the EB approach uses the gene-environment independence assumption in a data-adaptive way and provides a gain in power compared with the standard logistic regression analysis and better control of type I error when compared with the analysis assuming gene-environment independence. We illustrate the methods with data from the Ovarian Cancer Association Consortium. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Framework for the Evaluation of the Cost and Benefits of Microgrids

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

Morris, Greg Young; Abbey, Chad; Joos, Geza

2011-07-15

A Microgrid is recognized as an innovative technology to help integrate renewables into distribution systems and to provide additional benefits to a variety of stakeholders, such as offsetting infrastructure investments and improving the reliability of the local system. However, these systems require additional investments for control infrastructure, and as such, additional costs and the anticipated benefits need to be quantified in order to determine whether the investment is economically feasible. This paper proposes a methodology for systematizing and representing benefits and their interrelationships based on the UML Use Case paradigm, which allows complex systems to be represented in a concise,more » elegant format. This methodology is demonstrated by determining the economic feasibility of a Microgrid and Distributed Generation installed on a typical Canadian rural distribution system model as a case study. The study attempts to minimize the cost of energy served to the community, considering the fixed costs associated with Microgrids and Distributed Generation, and suggests benefits to a variety of stakeholders.« less

The financial impact of heparin-induced thrombocytopenia.

PubMed

Smythe, Maureen A; Koerber, John M; Fitzgerald, Maureen; Mattson, Joan C

2008-09-01

Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction that increases patient morbidity and mortality. The financial impact of HIT to an institution is thought to be significant. The objective of this study was to evaluate the financial impact of HIT. A case-control study was employed. Case patients were identified as newly diagnosed HIT patients. Control subjects were matched by diagnosis-related group, primary diagnosis code, primary procedure code, and hospital admission date. The financial/decision support database of the hospital was queried to identify the matched control subjects, total cost, and reimbursement. The determination of financial impact included the total profit or (total loss) and the backfill effect (ie, the lost operating margin resulting from increased length of stay). Length of stay and mortality were compared. Data from 22 case patients and 255 control subjects were analyzed. On average, HIT case patients incurred a financial loss of $14,387 per patient and an increase in length of stay of 14.5 days. When confining the analysis to only Medicare case patients (n = 17) and Medicare control subjects, case patients incurred a financial loss of $20,170 per case and an increase in length of stay of 15.8 days. Depending on the occupancy rate of the institution, additional financial loss could result from the backfill effect. Mortality was not significantly affected. For an institution that sees 50 new cases of HIT per year, the projected annual financial impact ranges from approximately $700,000 to $1 million. Institutions with high bed occupancy rates may see an additional loss from the backfill effect.

Lessons from a Dominican Republic Field Study

ERIC Educational Resources Information Center

Gunter, Michael M., Jr.

2010-01-01

Utilizing student-centered pedagogy, this case study explores an increasingly prominent and instructive addition to traditional academic coursework--the field study experience. This is particularly true in the arena of environmental education where students learn best by experiencing environmental problems first-hand and then interacting with…

Characterizing Treatable Causes of Small-Fiber Polyneuropathy in Gulf War Veterans

DTIC Science & Technology

2017-10-01

this study Global experts participated in additional rounds of a Delphi process to determine the most reliable markers for SFPN ( Case Definition). We...We supplemented the pertinent information on SFPN and added a link to this study as a recruitment tool. The public portion of the website may be...propose as part of the Case Definition. The database currently contains data on 3,495 subjects consisting of 3,087 patients and 408 healthy controls

Control selection and confounding factors: A lesson from a Japanese case-control study to examine acellular pertussis vaccine effectiveness.

PubMed

Ohfuji, Satoko; Okada, Kenji; Nakano, Takashi; Ito, Hiroaki; Hara, Megumi; Kuroki, Haruo; Hirota, Yoshio

2017-08-24

When using a case-control study design to examine vaccine effectiveness, both the selection of control subjects and the consideration of potential confounders must be the important issues to ensure accurate results. In this report, we described our experience from a case-control study conducted to evaluate the effectiveness of acellular pertussis vaccine combined with diphtheria-tetanus toxoids (DTaP vaccine). Newly diagnosed pertussis cases and age- and sex-matched friend-controls were enrolled, and the history of DTaP vaccination was compared between groups. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of vaccination for development of pertussis. After adjustment for potential confounders, four doses of DTaP vaccination showed a lower OR for pediatrician-diagnosed pertussis (OR=0.11, 95% CI, 0.01-0.99). In addition, the decreasing OR of four doses vaccination was more pronounced for laboratory-confirmed pertussis (OR=0.07, 95%CI, 0.01-0.82). Besides, positive association with pertussis was observed in subjects with a history of steroid treatment (OR=5.67) and those with a recent contact with a lasting cough (OR=4.12). When using a case-control study to evaluate the effectiveness of vaccines, particularly those for uncommon infectious diseases such as pertussis, the use of friend-controls may be optimal due to the fact that they shared a similar experience for exposure to the pathogen as the cases. In addition, to assess vaccine effectiveness as accurately as possible, the effects of confounding should be adequately controlled with a matching or analysis technique. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Factors associated with divorce in intrafamily child sexual abuse cases.

PubMed

Sirles, E A; Lofberg, C E

1990-01-01

This study analyzes factors related to the decision to divorce in intrafamilial sexual abuse cases. Data was collected on 128 cases of incest in St. Louis, Missouri, through the Washington University Child Guidance Center. Examination of multiple variables revealed there are differences between child sexual abuse cases that elect to stay together vs. those that divorce subsequent to the discovery of abuse. Families that broke up were more likely to have young child victims and have additional problems with domestic violence. The child was more likely to have revealed the abuse to the mother and have been believed by her in divorcing cases.

Association of rs1344706 in the ZNF804A gene with schizophrenia in a case/control sample from Indonesia.

PubMed

Schwab, Sibylle G; Kusumawardhani, Agung A A A; Dai, Nan; Qin, WenWen; Wildenauer, Mutiara D B; Agiananda, Feranindhya; Amir, Nurmiati; Antoni, Ronald; Arsianti, Tiana; Asmarahadi, Asmarahadi; Diatri, Hervita; Djatmiko, Prianto; Irmansyah, Irmansyah; Khalimah, Siti; Kusumadewi, Irmia; Kusumaningrum, Profitasari; Lukman, Petrin R; Mustar, Lukman; Nasrun, Martina W; Naswati, Safyuni; Prasetiyawan, Prasetiyawan; Semen, Gerald M; Siste, Kristiana; Tobing, Heriani; Widiasih, Natalia; Wiguna, Tjhin; Wulandari, Widayanti Dewi; Benyamin, Beben; Wildenauer, Dieter B

2013-06-01

Association of rs1344706 in the ZNF804A gene (2q32.1) with schizophrenia was first reported in a genome wide scan conducted in a sample of 479 cases and replicated in 6666 cases. Subsequently, evidence by replication was obtained in several samples with European- and Asian ancestral background. We report ascertainment, clinical characterization, quality control, and determination of ancestral background of a case control sample from Indonesia, comprising 1067 cases and 1111 ancestry matched controls. Genotyping was performed using a fluorescence-based allelic discrimination assay (TaqMan SNP genotyping assay) and a newly designed PCR-RFLP assay for confirmation of rs1344706 genotypes. We confirmed association of the T-allele of rs1344706 with schizophrenia in a newly ascertained sample from Indonesia with Southeast Asian ancestral background (P=0.019, OR=1.155, 95%, CI 1.025-1.301). In addition, we studied several SNPs in the vicinity of rs1344706, for which nominally significant results had been reported. None of the association P values of the additional SNPs exceeded that of rs1344706. We provide additional evidence for association of the ZNF804A gene with schizophrenia. We conclude that rs1344706 or a yet unknown polymorphism in linkage disequilibrium is also involved in conferring susceptibility to schizophrenia in samples with different (Asian) ancestral backgrounds. Copyright © 2013 Elsevier B.V. All rights reserved.

Experimental Evaluation of Oxide Nanoparticles as Friction and Wear Improvement Additives in Motor Oil

DOE PAGES

Demas, Nicholaos G.; Erck, Robert A.; Lorenzo-Martin, Cinta; ...

2017-01-30

The effect of two nanoparticle oxides on friction and wear was studied under laboratory test conditions using a reciprocating test machine and two test configurations. The addition of these nanoparticles in base stock oil under certain conditions reduced the coefficient of friction and improved wear, but that depended on the test configuration. Examination of the rubbed surfaces showed the pronounced formation of a tribofilm in some cases, while polishing on the surface was also observed in other cases. Contact configuration is important when oxide nanoparticles are being evaluated and the conclusions about their efficacy can be vastly different.

CHEK2, MGMT, SULT1E1 and SULT1A1 polymorphisms and endometrial cancer risk.

PubMed

O'Mara, Tracy A; Ferguson, Kaltin; Fahey, Paul; Marquart, Louise; Yang, Hannah P; Lissowska, Jolanta; Chanock, Stephen; Garcia-Closas, Montserrat; Thompson, Deborah J; Healey, Catherine S; Dunning, Alison M; Easton, Douglas F; Webb, Penelope M; Spurdle, Amanda B

2011-08-01

Several single nucleotide polymorphisms (SNPs) in candidate genes of DNA repair and hormone pathways have been reported to be associated with endometrial cancer risk. We sought to confirm these associations in two endometrial cancer case-control sample sets and used additional data from an existing genome-wide association study to prioritize an additional SNP for further study. Five SNPs from the CHEK2, MGMT, SULT1E1 and SULT1A1 genes, genotyped in a total of 1597 cases and 1507 controls from two case-control studies, the Australian National Endometrial Cancer Study and the Polish Endometrial Cancer Study, were assessed for association with endometrial cancer risk using logistic regression analysis. Imputed data was drawn for CHEK2 rs8135424 for 666 cases from the Study of Epidemiology and Risk factors in Cancer Heredity study and 5190 controls from the Wellcome Trust Case Control Consortium. We observed no association between SNPs in the MGMT, SULT1E1 and SULT1A1 genes and endometrial cancer risk. The A allele of the rs8135424 CHEK2 SNP was associated with decreased risk of endometrial cancer (adjusted per-allele OR 0.83; 95%CI 0.70-0.98; p = .03) however this finding was opposite to that previously published. Imputed data for CHEK2 rs8135424 supported the direction of effect reported in this study (OR 0.85; 95% CI 0.65-1.10). Previously reported endometrial cancer risk associations with SNPs from in genes involved in estrogen metabolism and DNA repair were not replicated in our larger study population. This study highlights the need for replication of candidate gene SNP studies using large sample groups, to confirm risk associations and better prioritize downstream studies to assess the causal relationship between genetic variants and cancer risk. Our findings suggest that the CHEK2 SNP rs8135424 be prioritized for further study as a genetic factor associated with risk of endometrial cancer.

If SWORD Is the Answer, What Is the Question?: Use of the Simple Web-Service Offering Repository Deposit Protocol

ERIC Educational Resources Information Center

Lewis, Stuart; Hayes, Leonie; Newton-Wade, Vanessa; Corfield, Antony; Davis, Richard; Donohue, Tim; Wilson, Scott

2009-01-01

Purpose: The purpose of this paper is to describe the repository deposit protocol, Simple Web-service Offering Repository Deposit (SWORD), its development iteration, and some of its potential use cases. In addition, seven case studies of institutional use of SWORD are provided. Design/methodology/approach: The paper describes the recent…

The Misspecification of the Covariance Structures in Multilevel Models for Single-Case Data: A Monte Carlo Simulation Study

ERIC Educational Resources Information Center

Moeyaert, Mariola; Ugille, Maaike; Ferron, John M.; Beretvas, S. Natasha; Van den Noortgate, Wim

2016-01-01

The impact of misspecifying covariance matrices at the second and third levels of the three-level model is evaluated. Results indicate that ignoring existing covariance has no effect on the treatment effect estimate. In addition, the between-case variance estimates are unbiased when covariance is either modeled or ignored. If the research interest…

Financing Facilities in Rural School Districts: Variations among the States and the Case of Arkansas.

ERIC Educational Resources Information Center

Hughes, Mary F.

This chapter examines the main challenges that rural school districts face in school facilities funding and illustrates these problems with a case study of Arkansas. Most rural school districts serve only a small number of students, which tends to limit the funds available for construction or renovation. In addition, rural districts are likely to…

The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study.

PubMed

Coyne, Karin S; Sexton, Chris C; Irwin, Debra E; Kopp, Zoe S; Kelleher, Con J; Milsom, Ian

2008-06-01

To examine the effect overactive bladder (OAB) and other lower urinary tract symptoms (LUTS) on health-related quality of life (HRQoL) in a population sample, as OAB often occurs in conjunction with many other LUTS. A nested case-control analysis was performed on men and women with (cases) and without (controls) OAB, from the EPIC study. OAB was assessed using 2002 International Continence Society definitions. Based on their responses to questions about LUTS, cases were classified into five groups; continent OAB, OAB with incontinence, OAB + postmicturition, OAB + voiding, and OAB + postmicturition + voiding. Both cases and controls were asked questions about symptom bother (OAB-q), generic QoL (EQ-5D), work productivity (Work Productivity and Activity Impairment, WPAI), depressive symptoms (Center for Epidemiologic Studies Depression Scale), sexual satisfaction, and erectile dysfunction (men only) using the Massachusetts Male Aging Study. Cases answered additional condition-specific questions HRQoL (OAB-q short form), Patient Perception of Bladder Condition and work productivity related to a specific health problem (WPAI-SHP). General linear models were used to evaluate group differences. Of the EPIC participants, 1434 identified OAB cases were matched by age, gender and country, with 1434 participants designated as controls. Cases and controls were primarily Caucasian (96.2% and 96.7%, respectively), and most (65%) were female; the mean age was 53.8 and 53.7 years, respectively. Comorbid conditions differed significantly by case/control status, with cases reporting significantly greater rates of chronic constipation, asthma, diabetes, high blood pressure, bladder or prostate cancer, neurological conditions and depression. There were significant differences between the cases and controls in all reported LUTS. The OAB + postmicturition + voiding group reported significantly greater symptom bother, worse HRQoL, higher rates of depression and decreased enjoyment of sexual activity, than the other subgroups. OAB has a substantial, multidimensional impact on patients; OAB with additional LUTS has a greater impact. The diagnosis and treatment of OAB should be considered in conjunction with other LUTS, to maximize treatment options and optimize patient outcomes.

Hepatic venous connection to a persistent inferior caval vein in left isomerism.

PubMed

Guenthard, J; Carvalho, J S; Anderson, R H; Rigby, M L

1990-09-01

In 22 cases of left atrial isomerism studied at the Brompton Hospital, four cases were found to have an unusual arrangement of the abdominal vessels. There was persistence of an inferior caval vein, partially anomalous hepatic venous connection and additional continuation of part of the venous return from the lower body through the azygos venous system. This venous pattern had surgical implications in our index case, since redirection of the inferior caval venous return was necessary.

Component Release and Mechanical Properties of Endodontic Sealers following Incorporation of Antimicrobial Agents

PubMed Central

Nicholson, John W.; Coleman, Nichola J.; Booth, Samantha; Dimkov, Aleksandar

2017-01-01

Root canal sealers with antimicrobial activity are highly beneficial; therefore, their antimicrobial properties could be improved by incorporation of antimicrobial agents. In the present study, the release of the quaternary ammonium compounds from endodontic sealers admixed with either benzalkonium chloride (BC) or cetylpyridinium chloride (CPC) at loadings of 2% wt was monitored. The effect of these additives on the compressive strengths and their release from the sealers was determined after 1 and 4 weeks. All of the materials studied were found to be capable of releasing antimicrobial additive in useful quantities. The release of CPC occurred to a statistically significant greater extent than BC for all materials. The addition of both BC and CPC generally decreased the compressive strength of all the endodontic sealers, with the exception of CPC in AH Plus, where the compressive strength was significantly increased. This suggests that, for these endodontic sealers, the antimicrobial additives alter the setting chemistry. AH Plus is an epoxy-based material cured with an amine, and in this case the increase in compressive strength with CPC is attributed to an enhanced cure reaction with this system. In all other cases, the additive inhibited the cure reaction to a greater or lesser extent. PMID:28620615

The Added Value of a Single-photon Emission Computed Tomography-Computed Tomography in Sentinel Lymph Node Mapping in Patients with Breast Cancer and Malignant Melanoma.

PubMed

Bennie, George; Vorster, Mariza; Buscombe, John; Sathekge, Mike

2015-01-01

Single-photon emission computed tomography-computed tomography (SPECT-CT) allows for physiological and anatomical co-registration in sentinel lymph node (SLN) mapping and offers additional benefits over conventional planar imaging. However, the clinical relevance when considering added costs and radiation burden of these reported benefits remains somewhat uncertain. This study aimed to evaluate the possible added value of SPECT-CT and intra-operative gamma-probe use over planar imaging alone in the South African setting. 80 patients with breast cancer or malignant melanoma underwent both planar and SPECT-CT imaging for SLN mapping. We assessed and compared the number of nodes detected on each study, false positive and negative findings, changes in surgical approach and or patient management. In all cases where a sentinel node was identified, SPECT-CT was more accurate anatomically. There was a significant change in surgical approach in 30 cases - breast cancer (n = 13; P 0.001) and malignant melanoma (n = 17; P 0.0002). In 4 cases a node not identified on planar imaging was seen on SPECT-CT. In 16 cases additional echelon nodes were identified. False positives were excluded by SPECT-CT in 12 cases. The addition of SPECT-CT and use of intra-operative gamma-probe to planar imaging offers important benefits in patients who present with breast cancer and melanoma. These benefits include increased nodal detection, elimination of false positives and negatives and improved anatomical localization that ultimately aids and expedites surgical management. This has been demonstrated in the context of industrialized country previously and has now also been confirmed in the setting of a emerging-market nation.

Atypical Ewing sarcoma breakpoint region 1 fluorescence in-situ hybridization signal patterns in bone and soft tissue tumours: diagnostic experience with 135 cases.

PubMed

Vargas, A Cristina; Selinger, Christina I; Satgunaseelan, Laveniya; Cooper, Wendy A; Gupta, Ruta; Stalley, Paul; Brown, Wendy; Soper, Judy; Schatz, Julie; Boyle, Richard; Thomas, David M; Tattersall, Martin H N; Bhadri, Vivek A; Maclean, Fiona; Bonar, S Fiona; Scolyer, Richard A; Karim, Rooshdiya Z; McCarthy, Stanley W; Mahar, Annabelle; O'Toole, Sandra A

2016-12-01

Recurrent Ewing sarcoma breakpoint region 1 (EWSR1) gene rearrangements characterize a select group of bone and soft tissue tumours. In our routine diagnostic practice with fluorescence in-situ hybridization (FISH), we have occasionally observed EWSR1 gene rearrangements in tumours not associated classically with EWSR1 translocations. This study aimed to review our institutional experience of this phenomenon and also to highlight the occurrence of unusual EWSR1 FISH signals (i.e. 5' centromeric region or 3' telomeric region signals) that do not fulfil the published diagnostic criteria for rearrangements. Using an EWSR1 break-apart probe, we performed FISH assays on formalin-fixed paraffin-embedded tissue sections from 135 bone and soft tissue specimens as part of their routine diagnostic work-up. EWSR1 gene rearrangements were identified in 51% of cases, 56% of which also showed an abnormal FISH signal pattern (in addition to classically rearranged signals). However, atypical FISH signals were present in 45% of the non-rearranged cases. In addition, we observed tumours unrelated to those described classically as EWSR1-associated that were technically EWSR1-rearranged in 6% of cases. Borderline levels of rearrangement (affecting 10-30% of lesional cells) were present in an additional 17% of these cases. While our study confirmed that FISH is a sensitive and specific tool in the diagnosis of EWSR1-associated tumours, atypical FISH signals and classical rearrangement in entities other than EWSR1-associated tumours can occur. Therefore, it is essential that the FISH result not be used as an isolated test, but must be evaluated in the context of clinical features, imaging, pathological and immunohistochemical findings. © 2016 John Wiley & Sons Ltd.

Association of Bacterial Vaginosis With Chlamydia and Gonorrhea Among Women in the U.S. Army.

PubMed

Bautista, Christian T; Wurapa, Eyako K; Sateren, Warren B; Morris, Sara M; Hollingsworth, Bruce P; Sanchez, Jose L

2017-05-01

Bacterial vaginosis (BV) is a common vaginal condition in women of reproductive age, which has been associated with Chlamydia trachomatis and Neisseria gonorrhoeae among commercial sex workers and women attending sexually transmitted infection clinics. Pathogen-specific associations between BV and other sexually transmitted infections among U.S. military women have not been investigated. A population-based, nested case-control study was conducted of all incident chlamydia and gonorrhea cases reported to the Defense Medical Surveillance System during 2006-2012. Using a density sampling approach, for each chlamydia or gonorrhea case, 10 age-matched (±1 year) controls were randomly selected from those women who were never diagnosed with these infections. Incidence rate ratios were estimated using conditional logistic regression. Statistical analysis was carried out in December 2015. A total of 37,149 chlamydia cases and 4,987 gonorrhea cases were identified during the study period. Antecedent BV was associated with an increased risk of subsequent chlamydia (adjusted incidence rate ratio=1.51; 95% CI=1.47, 1.55) and gonorrhea (adjusted incidence rate ratio=2.42; 95% CI=2.27, 2.57) infections. For every one additional episode of BV, the risk of acquiring chlamydia and gonorrhea infections increased by 13% and 26%, respectively. A monotonic dose-response relationship was also noted between antecedent BV and subsequent chlamydia and gonorrhea infection. In addition, an effect modification on the additive scale was found between BV and African-American race for gonorrhea, but not for chlamydia. Among U.S. Army women, antecedent BV is associated with an increased risk of subsequent chlamydia and gonorrhea infection. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

Pulley lesions in rotator cuff tears: prevalence, etiology, and concomitant pathologies.

PubMed

Hawi, Nael; Liodakis, Emmanouil; Garving, Christina; Habermeyer, Peter; Tauber, Mark

2017-08-01

This study aimed to demonstrate the prevalence of lesions in the biceps pulley complex in a representative, consecutive series of rotator cuff tears and rotator cuff interval treatments. We also analyzed associated tear pattern of rotator cuff injuries and superior labrum anterior-posterior (SLAP) lesions. We evaluated the relationships of these lesions to traumatic genesis and the prevalence of pulley lesions in revision cases. This retrospective study analyzed all pre- and intra-operative documentation on arthroscopic rotator cuff reconstructions and isolated pulley lesion treatments performed by a single surgeon over 2 consecutive years. According to Habermeyer et al., we classified cases into four groups, based on the presence of additional or related complete or partial rotator cuff tears, SLAP lesions, trauma, and primary or revision surgery. Among 382 patients with rotator cuff tears, 345 (90.3%) had an injured pulley system; 151 (43.8%) had partial tears of the rotator cuff; out of these, 106 (30.6%) were articular-sided. All of these articular-sided partial tears showed extension into the pulley complex. In 154 cases (44.6%), history of shoulder trauma was associated with the beginning of symptoms. In addition, concomitant SLAP lesions occurred in 25-62% of pulley lesions, correlating with the severity of pulley lesions. Among the 345 cases, there have been 32 (9.3%) revision cases where a pulley lesion was intra-operatively identified and addressed. Pulley complex lesions are present in 90.3% of surgically treated rotator cuff lesions, particularly in articular-sided injuries. In addition, we found a significant relationship between the incidence of SLAP lesions and the severity of pulley lesions. It seems reasonable to assume an important role of pulley system injuries in the pathogenesis of rotator cuff lesions.

Aspergillus spondylodiscitis: successful conservative treatment in 9 cases.

PubMed

Cortet, B; Richard, R; Deprez, X; Lucet, L; Flipo, R M; Le Loët, X; Duquesnoy, B; Delcambre, B

1994-07-01

To assess the effectiveness of medical treatment by clinical, radiological, and biological analysis of outcome in 9 patients with aspergillus spondylodiscitis. Retrospective study including 9 patients with aspergillus discitis, in which 7 were immunosuppressed; 3 were heart transplant patients, 2 had acute lymphoblastic leukemia, 1 hairy cell leukemia and one was receiving prednisone for bronchial asthma. Four patients had isolated spinal aspergillosis infection. In 4 cases, disc space infection occurred after pulmonary aspergillosis. In the last case the spondylodiscitis occurred after aspergillus endocarditis and mycotic limb embolism. In all cases a percutaneous needle biopsy of the intervertebral disc was performed; the subsequent culture produced Aspergillus fumigatus in 8 cases and Aspergillus flavus in 1. Itraconazole was given to all patients (mean dose: 350 mg/day); it was given alone in 2 cases, in addition to 5 flucytosine and amphotericin B in 6 cases, and in addition to amphotericin B in the last case. Improvement was obtained in the 9 cases, with full recovery in the absence of any surgical debridement after a mean treatment duration of 5.5 months and a mean followup delay of 16 months. Early recognition of aspergillus spondylodiscitis in immunocompromised hosts is important. Itraconazole alone or in combination is an effective therapy. There may be an increased incidence of aspergillus discitis due to the increasing frequency of immunosuppression associated conditions including organ transplantation, chemotherapy, or acquired immune deficiency syndrome.

Genome-wide association study identifies a novel locus contributing to type 2 diabetes susceptibility in Sikhs of Punjabi origin from India.

PubMed

Saxena, Richa; Saleheen, Danish; Been, Latonya F; Garavito, Martha L; Braun, Timothy; Bjonnes, Andrew; Young, Robin; Ho, Weang Kee; Rasheed, Asif; Frossard, Philippe; Sim, Xueling; Hassanali, Neelam; Radha, Venkatesan; Chidambaram, Manickam; Liju, Samuel; Rees, Simon D; Ng, Daniel Peng-Keat; Wong, Tien-Yin; Yamauchi, Toshimasa; Hara, Kazuo; Tanaka, Yasushi; Hirose, Hiroshi; McCarthy, Mark I; Morris, Andrew P; Basit, Abdul; Barnett, Anthony H; Katulanda, Prasad; Matthews, David; Mohan, Viswanathan; Wander, Gurpreet S; Singh, Jai Rup; Mehra, Narinder K; Ralhan, Sarju; Kamboh, M Ilyas; Mulvihill, John J; Maegawa, Hiroshi; Tobe, Kazuyuki; Maeda, Shiro; Cho, Yoon S; Tai, E Shyong; Kelly, M Ann; Chambers, John C; Kooner, Jaspal S; Kadowaki, Takashi; Deloukas, Panos; Rader, Daniel J; Danesh, John; Sanghera, Dharambir K

2013-05-01

We performed a genome-wide association study (GWAS) and a multistage meta-analysis of type 2 diabetes (T2D) in Punjabi Sikhs from India. Our discovery GWAS in 1,616 individuals (842 case subjects) was followed by in silico replication of the top 513 independent single nucleotide polymorphisms (SNPs) (P < 10⁻³) in Punjabi Sikhs (n = 2,819; 801 case subjects). We further replicated 66 SNPs (P < 10⁻⁴) through genotyping in a Punjabi Sikh sample (n = 2,894; 1,711 case subjects). On combined meta-analysis in Sikh populations (n = 7,329; 3,354 case subjects), we identified a novel locus in association with T2D at 13q12 represented by a directly genotyped intronic SNP (rs9552911, P = 1.82 × 10⁻⁸) in the SGCG gene. Next, we undertook in silico replication (stage 2b) of the top 513 signals (P < 10⁻³) in 29,157 non-Sikh South Asians (10,971 case subjects) and de novo genotyping of up to 31 top signals (P < 10⁻⁴) in 10,817 South Asians (5,157 case subjects) (stage 3b). In combined South Asian meta-analysis, we observed six suggestive associations (P < 10⁻⁵ to < 10⁻⁷), including SNPs at HMG1L1/CTCFL, PLXNA4, SCAP, and chr5p11. Further evaluation of 31 top SNPs in 33,707 East Asians (16,746 case subjects) (stage 3c) and 47,117 Europeans (8,130 case subjects) (stage 3d), and joint meta-analysis of 128,127 individuals (44,358 case subjects) from 27 multiethnic studies, did not reveal any additional loci nor was there any evidence of replication for the new variant. Our findings provide new evidence on the presence of a population-specific signal in relation to T2D, which may provide additional insights into T2D pathogenesis.

Importance of relationship context in HIV transmission: results from a qualitative case-control study in Rakai, Uganda.

PubMed

Higgins, Jenny A; Mathur, Sanyukta; Eckel, Elizabeth; Kelley, Laura; Kelly, Laura; Nakyanjo, Neema; Sekamwa, Richard; Namatovu, Josephine; Ddaaki, William; Nakubulwa, Rosette; Namakula, Sylvia; Nalugoda, Fred; Santelli, John S

2014-04-01

We present results from life history interviews with 60 young adults from southern Uganda. Using a novel qualitative case-control design, we compared newly HIV-positive cases with HIV-negative controls matched on age, gender, marital status, and place of residence. Relationship context was the most salient theme differentiating cases from controls. Compared with HIV-negative respondents, recent seroconverters described relationships marked by poorer communication, greater suspicion and mistrust, and larger and more transitory sexual networks. Results highlight the importance of dyadic approaches to HIV and possibly of couple-based interventions. Using HIV-matched pairs allowed additional understanding of the factors influencing transmission. This hybrid methodological approach holds promise for future studies of sexual health.

Importance of Relationship Context in HIV Transmission: Results From a Qualitative Case-Control Study in Rakai, Uganda

PubMed Central

Mathur, Sanyukta; Eckel, Elizabeth; Kelly, Laura; Nakyanjo, Neema; Sekamwa, Richard; Namatovu, Josephine; Ddaaki, William; Nakubulwa, Rosette; Namakula, Sylvia; Nalugoda, Fred; Santelli, John S.

2014-01-01

We present results from life history interviews with 60 young adults from southern Uganda. Using a novel qualitative case-control design, we compared newly HIV-positive cases with HIV-negative controls matched on age, gender, marital status, and place of residence. Relationship context was the most salient theme differentiating cases from controls. Compared with HIV-negative respondents, recent seroconverters described relationships marked by poorer communication, greater suspicion and mistrust, and larger and more transitory sexual networks. Results highlight the importance of dyadic approaches to HIV and possibly of couple-based interventions. Using HIV-matched pairs allowed additional understanding of the factors influencing transmission. This hybrid methodological approach holds promise for future studies of sexual health. PMID:24524490

Polymer translocation under time-dependent driving forces: resonant activation induced by attractive polymer-pore interactions.

PubMed

Ikonen, Timo; Shin, Jaeoh; Sung, Wokyung; Ala-Nissila, Tapio

2012-05-28

We study the driven translocation of polymers under time-dependent driving forces using N-particle Langevin dynamics simulations. We consider the force to be either sinusoidally oscillating in time or dichotomic noise with exponential correlation time, to mimic both plausible experimental setups and naturally occurring biological conditions. In addition, we consider both the case of purely repulsive polymer-pore interactions and the case with additional attractive polymer-pore interactions, typically occurring inside biological pores. We find that the nature of the interaction fundamentally affects the translocation dynamics. For the non-attractive pore, the translocation time crosses over to a fast translocation regime as the frequency of the driving force decreases. In the attractive pore case, because of a free energy well induced inside the pore, the translocation time can be a minimum at the optimal frequency of the force, the so-called resonant activation. In the latter case, we examine the effect of various physical parameters on the resonant activation, and explain our observations using simple theoretical arguments.

Systematic review and meta-analysis of isolated posterior fossa malformations on prenatal ultrasound imaging (part 1): nomenclature, diagnostic accuracy and associated anomalies.

PubMed

D'Antonio, F; Khalil, A; Garel, C; Pilu, G; Rizzo, G; Lerman-Sagie, T; Bhide, A; Thilaganathan, B; Manzoli, L; Papageorghiou, A T

2016-06-01

To explore the outcome in fetuses with prenatal diagnosis of posterior fossa anomalies apparently isolated on ultrasound imaging. MEDLINE and EMBASE were searched electronically utilizing combinations of relevant medical subject headings for 'posterior fossa' and 'outcome'. The posterior fossa anomalies analyzed were Dandy-Walker malformation (DWM), mega cisterna magna (MCM), Blake's pouch cyst (BPC) and vermian hypoplasia (VH). The outcomes observed were rate of chromosomal abnormalities, additional anomalies detected at prenatal magnetic resonance imaging (MRI), additional anomalies detected at postnatal imaging and concordance between prenatal and postnatal diagnoses. Only isolated cases of posterior fossa anomalies - defined as having no cerebral or extracerebral additional anomalies detected on ultrasound examination - were included in the analysis. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale for cohort studies. We used meta-analyses of proportions to combine data and fixed- or random-effects models according to the heterogeneity of the results. Twenty-two studies including 531 fetuses with posterior fossa anomalies were included in this systematic review. The prevalence of chromosomal abnormalities in fetuses with isolated DWM was 16.3% (95% CI, 8.7-25.7%). The prevalence of additional central nervous system (CNS) abnormalities that were missed at ultrasound examination and detected only at prenatal MRI was 13.7% (95% CI, 0.2-42.6%), and the prevalence of additional CNS anomalies that were missed at prenatal imaging and detected only after birth was 18.2% (95% CI, 6.2-34.6%). Prenatal diagnosis was not confirmed after birth in 28.2% (95% CI, 8.5-53.9%) of cases. MCM was not significantly associated with additional anomalies detected at prenatal MRI or detected after birth. Prenatal diagnosis was not confirmed postnatally in 7.1% (95% CI, 2.3-14.5%) of cases. The rate of chromosomal anomalies in fetuses with isolated BPC was 5.2% (95% CI, 0.9-12.7%) and there was no associated CNS anomaly detected at prenatal MRI or only after birth. Prenatal diagnosis of BPC was not confirmed after birth in 9.8% (95% CI, 2.9-20.1%) of cases. The rate of chromosomal anomalies in fetuses with isolated VH was 6.5% (95% CI, 0.8-17.1%) and there were no additional anomalies detected at prenatal MRI (0% (95% CI, 0.0-45.9%)). The proportions of cerebral anomalies detected only after birth was 14.2% (95% CI, 2.9-31.9%). Prenatal diagnosis was not confirmed after birth in 32.4% (95% CI, 18.3-48.4%) of cases. DWM apparently isolated on ultrasound imaging is a condition with a high risk for chromosomal and associated structural anomalies. Isolated MCM and BPC have a low risk for aneuploidy or associated structural anomalies. The small number of cases with isolated VH prevents robust conclusions regarding their management from being drawn. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

High expression of SALL4 and fascin, and loss of E-cadherin expression in undifferentiated/dedifferentiated carcinomas of the endometrium

PubMed Central

Onder, Semen; Taskin, Orhun Cig; Sen, Fatma; Topuz, Samet; Kucucuk, Seden; Sozen, Hamdullah; Ilhan, Ridvan; Tuzlali, Sitki; Yavuz, Ekrem

2017-01-01

Abstract Undifferentiated/dedifferentiated endometrial carcinomas (UCE/DCEs) of the endometrium are rare tumors with poor prognosis. There are few clinicopathologic studies with detailed immunohistochemical analysis regarding UCE/DCEs. We evaluated the diagnostic value of a selected tumor stem-cell marker and epithelial-mesenchymal transition (EMT) markers, in addition to previously studied markers in identifying UCE/DCEs from other types of high-grade endometrial carcinomas. Eleven cases of UCE/DCEs with complete clinical follow-up that were diagnosed between 2006 and 2015 were included in the study. For immunohistochemical comparison, 11 clinically matched cases for each type of other high-grade endometrial carcinomas (high-grade endometrioid (F3-EC), serous [SC], and clear cell carcinoma [CCC]) were used as a control group. An immunohistochemical analysis including fascin, SALL4, E-cadherin, and β-catenin, in addition to epithelial and neuroendocrine markers was performed in each case. The majority of UCE/DCEs displayed diffuse expression of fascin (81.9%) and loss of E-cadherin expression (54.5%). SALL4 expression was detected in 36.3% of the UCE/DCE cases. SALL4 expression was significantly more frequent in UCE/DCEs than all other high-grade carcinomas (P < 0.001). Loss of E-cadherin and fascin expression was significantly more frequent in UCE/DCEs than high-grade endometrioid and clear cell adenocarcinomas (P = 0.012, 0.014 and P = 0.01, 0.003, respectively). We suggest that loss of E-cadherin expression together with fascin and SALL4 immunopositivity in addition to morphologic features have an impact in differential diagnosis of UCE/DCEs from other high-grade endometrial carcinomas. PMID:28272224

Interleukin 12B (IL12B) Genetic Variation and Pulmonary Tuberculosis: A Study of Cohorts from The Gambia, Guinea-Bissau, United States and Argentina

PubMed Central

Hill, Philip C.; Wejse, Christian; Bisseye, Cyrille; Olesen, Rikke; Edwards, Todd L.; Gilbert, John R.; Myers, Jamie L.; Stryjewski, Martin E.; Abbate, Eduardo; Estevan, Rosa; Hamilton, Carol D.; Tacconelli, Alessandra; Novelli, Giuseppe; Brunetti, Ercole; Aaby, Peter; Sodemann, Morten; Østergaard, Lars; Adegbola, Richard; Williams, Scott M.; Scott, William K.; Sirugo, Giorgio

2011-01-01

We examined whether polymorphisms in interleukin-12B (IL12B) associate with susceptibility to pulmonary tuberculosis (PTB) in two West African populations (from The Gambia and Guinea-Bissau) and in two independent populations from North and South America. Nine polymorphisms (seven SNPs, one insertion/deletion, one microsatellite) were analyzed in 321 PTB cases and 346 controls from Guinea-Bissau and 280 PTB cases and 286 controls from The Gambia. For replication we studied 281 case and 179 control African-American samples and 221 cases and 144 controls of European ancestry from the US and Argentina. First-stage single locus analyses revealed signals of association at IL12B 3′ UTR SNP rs3212227 (unadjusted allelic p = 0.04; additive genotypic p = 0.05, OR = 0.78, 95% CI [0.61–0.99]) in Guinea-Bissau and rs11574790 (unadjusted allelic p = 0.05; additive genotypic p = 0.05, OR = 0.76, 95% CI [0.58–1.00]) in The Gambia. Association of rs3212227 was then replicated in African-Americans (rs3212227 allelic p = 0.002; additive genotypic p = 0.05, OR = 0.78, 95% CI [0.61–1.00]); most importantly, in the African-American cohort, multiple significant signals of association (seven of the nine polymorphisms tested) were detected throughout the gene. These data suggest that genetic variation in IL12B, a highly relevant candidate gene, is a risk factor for PTB in populations of African ancestry, although further studies will be required to confirm this association and identify the precise mechanism underlying it. PMID:21339808

Case study report.

DOT National Transportation Integrated Search

2012-04-19

The Michigan Department of Transportation (MDOT) desired to explore the impact that recently completed roadway projects had on automobile, pedestrian, and bicycle safety. Additionally, MDOT wanted to determine to what extent these improvements also i...

A Case Study of Minority and Low-SES Gifted Students' Perceptions of the Effects of a Gifted Resource Specialist

ERIC Educational Resources Information Center

Samples, Sherry L.

2010-01-01

This research explores the experiences of 9 minority and low socioeconomic status [low-SES] gifted high school graduates from a district which provided additional support beyond a counselor for its high school gifted students. The additional support was a Gifted Resource Specialist at each school; their interactions with the graduates from a…

Gravel addition as a habitat restoration technique for tailwaters

Treesearch

Ryan McManamay; D. Orth; Charles Dolloff; Mark Cantrell

2010-01-01

We assessed the efficacy of passive gravel addition at forming catostomid spawning habitat under various flow regimes in the Cheoah River, a high-gradient tailwater river in North Carolina. The purpose was to provide a case study that included recommendations for future applications. A total of 76.3 m3 (162 tons) of washed gravel (10-50 mm) was passively dumped down...

Evaluating the effect of metronidazole plus amoxicillin-clavulanate versus amoxicillin-clavulanate alone in canine haemorrhagic diarrhoea: a randomised controlled trial in primary care practice.

PubMed

Ortiz, V; Klein, L; Channell, S; Simpson, B; Wright, B; Edwards, C; Gilbert, R; Day, R; Caddy, S L

2018-06-07

To investigate the benefit of supplementing amoxicillin-clavulanic acid therapy with metronidazole in dogs presenting to a primary care veterinary practice with severe haemorrhagic diarrhoea. Prospective randomised blinded trial on dogs presenting with haemorrhagic diarrhoea of less than 3 days duration to a primary care veterinary hospital and also requiring intravenous fluid therapy. Cases were randomised to receive either metronidazole or saline, in addition to standard supportive therapy consisting of amoxicillin-clavulanic acid, intravenous fluid therapy, buprenorphine and omeprazole. Treatment efficacy was measured by duration of hospitalisation and daily scoring of disease severity. Thirty-four cases successfully completed the trial. There was no significant difference in hospitalisation time between treatment groups (mean for dogs receiving metronidazole was 29.6 hours and for controls was 26.3 hours) nor in daily clinical scores. This study strongly suggests that addition of metronidazole is not an essential addition to amoxicillin-clavulanic acid therapy for treatment of severe cases of haemorrhagic diarrhoea in dogs. © 2018 British Small Animal Veterinary Association.

Case study of landfill leachate recirculation using small-diameter vertical wells.

PubMed

Jain, Pradeep; Ko, Jae Hac; Kumar, Dinesh; Powell, Jon; Kim, Hwidong; Maldonado, Lizmarie; Townsend, Timothy; Reinhart, Debra R

2014-11-01

A case study of landfill liquids addition using small diameter (5 cm) vertical wells is reported. More than 25,000 m(3) of leachate was added via 134 vertical wells installed 3 m, 12 m, and 18 m deep over five years in a landfill in Florida, US. Liquids addition performance (flow rate per unit screen length per unit liquid head) ranged from 5.6×10(-8) to 3.6×10(-6) m(3) s(-1) per m screen length per m liquid head. The estimated radial hydraulic conductivity ranged from 3.5×10(-6) to 4.2×10(-4) m s(-1). The extent of lateral moisture movement ranged from 8 to 10 m based on the responses of moisture sensors installed around vertical well clusters, and surface seeps were found to limit the achievable liquids addition rates, despite the use of concrete collars under a pressurized liquids addition scenario. The average moisture content before (51 samples) and after (272 samples) the recirculation experiments were 23% (wet weight basis) and 45% (wet weight basis), respectively, and biochemical methane potential measurements of excavated waste indicated significant (p<0.025) decomposition. Copyright © 2014 Elsevier Ltd. All rights reserved.

Automated Cellient(™) cytoblocks: better, stronger, faster?

PubMed

Prendeville, S; Brosnan, T; Browne, T J; McCarthy, J

2014-12-01

Cytoblocks (CBs), or cell blocks, provide additional morphological detail and a platform for immunocytochemistry (ICC) in cytopathology. The Cellient(™) system produces CBs in 45 minutes using methanol fixation, compared with traditional CBs, which require overnight formalin fixation. This study compares Cellient and traditional CB methods in terms of cellularity, morphology and immunoreactivity, evaluates the potential to add formalin fixation to the Cellient method for ICC studies and determines the optimal sectioning depth for maximal cellularity in Cellient CBs. One hundred and sixty CBs were prepared from 40 cytology samples (32 malignant, eight benign) using four processing methods: (A) traditional; (B) Cellient (methanol fixation); (C) Cellient using additional formalin fixation for 30 minutes; (D) Cellient using additional formalin fixation for 60 minutes. Haematoxylin and eosin-stained sections were assessed for cellularity and morphology. ICC was assessed on 14 cases with a panel of antibodies. Three additional Cellient samples were serially sectioned to determine the optimal sectioning depth. Scoring was performed by two independent, blinded reviewers. For malignant cases, morphology was superior with Cellient relative to traditional CBs (P < 0.001). Cellularity was comparable across all methods. ICC was excellent in all groups and the addition of formalin at any stage during the Cellient process did not influence the staining quality. Serial sectioning through Cellient CBs showed optimum cellularity at 30-40 μm with at least 27 sections obtainable. Cellient CBs provide superior morphology to traditional CBs and, if required, formalin fixation may be added to the Cellient process for ICC. Optimal Cellient CB cellularity is achieved at 30-40 μm, which will impact on the handling of cases in daily practice. © 2014 John Wiley & Sons Ltd.

Birth weight and later life adherence to unhealthy lifestyles in predicting type 2 diabetes: prospective cohort study.

PubMed

Li, Yanping; Ley, Sylvia H; Tobias, Deirdre K; Chiuve, Stephanie E; VanderWeele, Tyler J; Rich-Edwards, Janet W; Curhan, Gary C; Willett, Walter C; Manson, JoAnn E; Hu, Frank B; Qi, Lu

2015-07-21

To prospectively assess the joint association of birth weight and established lifestyle risk factors in adulthood with incident type 2 diabetes and to quantitatively decompose the attributing effects to birth weight only, to adulthood lifestyle only, and to their interaction. Prospective cohort study. Health Professionals Follow-up Study (1986-2010), Nurses' Health Study (1980-2010), and Nurses' Health Study II (1991-2011). 149,794 men and women without diabetes, cardiovascular disease, or cancer at baseline. Incident cases of type 2 diabetes, identified through self report and validated by a supplementary questionnaire. Unhealthy lifestyle was defined on the basis of body mass index, smoking, physical activity, alcohol consumption, and the alternate healthy eating index. During 20-30 years of follow-up, 11,709 new cases of type 2 diabetes were documented. The multivariate adjusted relative risk of type 2 diabetes was 1.45 (95% confidence interval 1.32 to 1.59) per kg lower birth weight and 2.10 (1.71 to 2.58) per unhealthy lifestyle factor. The relative risk of type 2 diabetes associated with a combination of per kg lower birth weight and per unhealthy lifestyle factor was 2.86 (2.26 to 3.63), which was more than the addition of the risk associated with each individual factor, indicating a significant interaction on an additive scale (P for interaction < 0.001). The attributable proportions of joint effect were 22% (95% confidence interval 18.3% to 26.4%) to lower birth weight alone, 59% (57.1% to 61.5%) to unhealthy lifestyle alone, and 18% (13.9% to 21.3%) to their interaction. Most cases of type 2 diabetes could be prevented by the adoption of a healthier lifestyle, but simultaneous improvement of both prenatal and postnatal factors could further prevent additional cases. © Li et al 2015.

Birth weight and later life adherence to unhealthy lifestyles in predicting type 2 diabetes: prospective cohort study

PubMed Central

Ley, Sylvia H; Tobias, Deirdre K; Chiuve, Stephanie E; VanderWeele, Tyler J; Rich-Edwards, Janet W; Curhan, Gary C; Willett, Walter C; Manson, JoAnn E; Hu, Frank B

2015-01-01

Objectives To prospectively assess the joint association of birth weight and established lifestyle risk factors in adulthood with incident type 2 diabetes and to quantitatively decompose the attributing effects to birth weight only, to adulthood lifestyle only, and to their interaction. Design Prospective cohort study. Setting Health Professionals Follow-up Study (1986-2010), Nurses’ Health Study (1980-2010), and Nurses’ Health Study II (1991-2011). Participants 149 794 men and women without diabetes, cardiovascular disease, or cancer at baseline. Main outcome measure Incident cases of type 2 diabetes, identified through self report and validated by a supplementary questionnaire. Unhealthy lifestyle was defined on the basis of body mass index, smoking, physical activity, alcohol consumption, and the alternate healthy eating index. Results During 20-30 years of follow-up, 11 709 new cases of type 2 diabetes were documented. The multivariate adjusted relative risk of type 2 diabetes was 1.45 (95% confidence interval 1.32 to 1.59) per kg lower birth weight and 2.10 (1.71 to 2.58) per unhealthy lifestyle factor. The relative risk of type 2 diabetes associated with a combination of per kg lower birth weight and per unhealthy lifestyle factor was 2.86 (2.26 to 3.63), which was more than the addition of the risk associated with each individual factor, indicating a significant interaction on an additive scale (P for interaction<0.001). The attributable proportions of joint effect were 22% (95% confidence interval 18.3% to 26.4%) to lower birth weight alone, 59% (57.1% to 61.5%) to unhealthy lifestyle alone, and 18% (13.9% to 21.3%) to their interaction. Conclusion Most cases of type 2 diabetes could be prevented by the adoption of a healthier lifestyle, but simultaneous improvement of both prenatal and postnatal factors could further prevent additional cases. PMID:26199273

Landslides and engineering geology of the Seattle, Washington, area

USGS Publications Warehouse

Baum, Rex L.; Godt, Jonathan W.; Highland, Lynn M.

2008-01-01

This volume brings together case studies and summary papers describing the application of state-of-the-art engineering geologic methods to landslide hazard analysis for the Seattle, Washington, area. An introductory chapter provides a thorough description of the Quaternary and bedrock geology of Seattle. Nine additional chapters review the history of landslide mapping in Seattle, present case studies of individual landslides, describe the results of spatial assessments of landslide hazard, discuss hydrologic controls on landsliding, and outline an early warning system for rainfall-induced landslides.

The exponentiated Hencky energy: anisotropic extension and case studies

NASA Astrophysics Data System (ADS)

Schröder, Jörg; von Hoegen, Markus; Neff, Patrizio

2017-10-01

In this paper we propose an anisotropic extension of the isotropic exponentiated Hencky energy, based on logarithmic strain invariants. Unlike other elastic formulations, the isotropic exponentiated Hencky elastic energy has been derived solely on differential geometric grounds, involving the geodesic distance of the deformation gradient \\varvec{F} to the group of rotations. We formally extend this approach towards anisotropy by defining additional anisotropic logarithmic strain invariants with the help of suitable structural tensors and consider our findings for selected case studies.

3-D CSEM data inversion algorithm based on simultaneously active multiple transmitters concept

NASA Astrophysics Data System (ADS)

Dehiya, Rahul; Singh, Arun; Gupta, Pravin Kumar; Israil, Mohammad

2017-05-01

We present an algorithm for efficient 3-D inversion of marine controlled-source electromagnetic data. The efficiency is achieved by exploiting the redundancy in data. The data redundancy is reduced by compressing the data through stacking of the response of transmitters which are in close proximity. This stacking is equivalent to synthesizing the data as if the multiple transmitters are simultaneously active. The redundancy in data, arising due to close transmitter spacing, has been studied through singular value analysis of the Jacobian formed in 1-D inversion. This study reveals that the transmitter spacing of 100 m, typically used in marine data acquisition, does result in redundancy in the data. In the proposed algorithm, the data are compressed through stacking which leads to both computational advantage and reduction in noise. The performance of the algorithm for noisy data is demonstrated through the studies on two types of noise, viz., uncorrelated additive noise and correlated non-additive noise. It is observed that in case of uncorrelated additive noise, up to a moderately high (10 percent) noise level the algorithm addresses the noise as effectively as the traditional full data inversion. However, when the noise level in the data is high (20 percent), the algorithm outperforms the traditional full data inversion in terms of data misfit. Similar results are obtained in case of correlated non-additive noise and the algorithm performs better if the level of noise is high. The inversion results of a real field data set are also presented to demonstrate the robustness of the algorithm. The significant computational advantage in all cases presented makes this algorithm a better choice.

Utility of additional tissue sections in dermatopathology: diagnostic, clinical and financial implications.

PubMed

Stuart, Lauren N; Rodriguez, Adrianna S; Gardner, Jerad M; Foster, Toby E; MacKelfresh, Jamie; Parker, Douglas C; Chen, Suephy C; Stoff, Benjamin K

2014-02-01

As histopathologic assessment is subject to sampling error, some institutions 'preorder' deeper sections on some or all cases (hereafter referred to as prospective deeper sections), while others order additional sections only when needed (hereafter referred to as retrospective deeper sections). We investigated how often additional sections changed a diagnosis and/or clinical management. Given the recent decrease in reimbursement for CPT-code 88305, we also considered the financial implications of ordering additional sections. Cases (n = 204) were assigned a preliminary diagnosis, based on review of the initial slide, and a final diagnosis, after reviewing additional sections. Cases with discordant diagnoses were assessed by two dermatologists, who indicated whether the change in diagnosis altered clinical management. Expenses were estimated for three scenarios: (a) no additional sections, (b) prospective deeper sections and (c) retrospective deeper sections. Diagnoses were modified in 9% of cases, which changed clinical management in 56% of these cases. Lesions obtained by punch-biopsy and inflammatory lesions were disproportionately overrepresented amongst cases with changed diagnoses (p < 0.001, p = 0.12, respectively). The cost of prospective deeper sections and retrospective deeper sections represented a 56% and 115% increase over base costs, respectively. Labor costs, particularly the cost of dermatopathologist evaluation, were the most significant cost-drivers. While additional sections improve diagnostic accuracy, they delay turn-around-time and increase expenditures. In our practice, prospective deeper sections are cost effective, however, this may vary by institution. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Use of Music Therapy During the Treatment of Cancer Patients: A Collection of Evidence

PubMed Central

Boyde, Constance; Linden, Ulrike; Boehm, Katja

2012-01-01

Background: Music therapy is one of the oldest forms of creative art therapy and has been shown to have effects in different clinical and therapeutic settings, such as schizophrenia, pain, cardiovascular parameters, and dementia. This article provides an overview of some of the recent findings in this field and also reports two single case vignettes that offer insight into day-to-day applications of clinical music therapy. Material and Methods: For the collection of clinical studies of music therapy in oncology, the databases AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX were searched with the terms “Study OR Trial” AND “Music Therapy” AND “Cancer OR Oncolog$.” Studies were analyzed with respect to their design, setting and interventions, indications, patients, and outcomes. In addition, two case vignettes present the application of music therapy for a child with leukemia and an adult patient with breast cancer. Results: We found a total of 12 clinical studies conducted between 2001 and 2011 comprised of a total of 922 patients. Eight studies had a randomized controlled design, and four studies were conducted in the field of pediatric oncology. Studies reported heterogeneous results on short-term improvements in patients' mood and relaxation and reduced exhaustion and anxiety as well as in coping with the disease and cancer-related pain. Case descriptions showed similar effects in expressing emotions, opening up new goals, and turning the mind toward a healthy process and away form a disease-centered focus. Conclusion: The use of music therapy in the integrative treatment of cancer patients is a therapeutic option whose salutogenetic potential is shown in many case studies such as those presented here. Study results, however, did not draw a conclusive picture of the overall effect of music therapy. In addition to further clinical trials, the evidence mosaic should be complemented with qualitative studies, single case descriptions, and basic research. PMID:27257528

Contaminant Leach Testing of Hanford Tank 241-C-104 Residual Waste

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

Cantrell, Kirk J.; Snyder, Michelle M.V.; Wang, Guohui

2015-07-01

Leach testing of Tank C-104 residual waste was completed using batch and column experiments. Tank C-104 residual waste contains exceptionally high concentrations of uranium (i.e., as high as 115 mg/g or 11.5 wt.%). This study was conducted to provide data to develop contaminant release models for Tank C-104 residual waste and Tank C-104 residual waste that has been treated with lime to transform uranium in the waste to a highly insoluble calcium uranate (CaUO4) or similar phase. Three column leaching cases were investigated. In the first case, C-104 residual waste was leached with deionized water. In the second case, crushedmore » grout was added to the column so that deionized water contacted the grout prior to contacting the waste. In the third case, lime was mixed in with the grout. Results of the column experiments demonstrate that addition of lime dramatically reduces the leachability of uranium from Tank C-104 residual waste. Initial indications suggest that CaUO4 or a similar highly insoluble calcium rich uranium phase forms as a result of the lime addition. Additional work is needed to definitively identify the uranium phases that occur in the as received waste and the waste after the lime treatment.« less

Blood alcohol analysis alone versus comprehensive toxicological analysis - Systematic investigation of missed co-ingested other drugs in suspected alcohol-impaired drivers.

PubMed

Steuer, Andrea E; Eisenbeiss, Lisa; Kraemer, Thomas

2016-10-01

Driving under the influence of alcohol and/or drugs (DUID) is a safety issue of increasing public concern. When a police officer has reasonable grounds to classify a driver as impaired, he may arrange for a blood sample to be taken. In many countries, alcohol analysis only is ordered if impairment is suspected to be exclusively due to alcohol while comprehensive toxicological screening will be performed if additional suspicion for other illegal drugs of abuse (DoA) or medicinal drugs is on hand. The aim of the present study was firstly to evaluate whether signs of impairment can be differentiated to be caused by alcohol alone or a combination of alcohol and other driving-impairing drugs and secondly to which extent additional drugs are missed in suspected alcohol-impaired drivers. A total of 293 DUID cases (negative n=41; alcohol positive only, n=131; alcohol+active drug positive, n=121) analyzed in 2015 in the Canton of Zurich were evaluated for their documented impairment symptoms by translating these into a severity score and comparing them applying principle component analysis (PCA). Additional 500 cases suspected for alcohol-impaired driving only were reanalyzed using comprehensive LC-MS/MS screening methods covering about 1500 compounds. Drugs detected were classified for severity of driving impairment using the classification system established in the DRUID study of the European Commission. As partly expected from the pharmacological and toxicological point of view, PCA analysis revealed no differences between signs of impairment caused by alcohol alone and those caused by alcohol plus at least one active drug. Breaking it down to different blood alcohol concentration ranges, only between 0.3 and 0.5g/kg trends could be observed in terms of more severe impairment for combined alcohol and drug intake. In the 500 blood samples retrospectively analyzed in this study, a total of 330 additional drugs could be detected; in some cases up to 9 co-ingested ones. In total, 37% of all cases were positive for additional drugs, thereby 15% of classic DoAs and further 9% of prescription drugs with a severe risk to cause driving impairment based on the DRUID classification system. A decision whether signs of impairment are related to alcohol alone or to the combination of alcohol and other drugs is impossible. Taking into consideration the high rate of missed drugs in DUI cases, police should think about increasing the number of DUID cases in countries were sanctioning differs between alcohol and alcohol plus drug impaired driving. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A multicase study of the impact of perceived gender roles on the career decisions of women in science-related careers

NASA Astrophysics Data System (ADS)

Hren, Stephen Frank

The purpose of this study was to determine how perceived gender roles developed throughout childhood and early adulthood impacted the career decisions of women in science-related career fields. An additional purpose was to determine if my experiences as I analyzed the data and the propositions discovered in the study would become a transformative agent for me. A multicase framework was utilized so that within and between case analyses could be achieved. Four women who showed early promise in science were chosen as the case study participants. The relationship of gender roles to the career decisions made by the four cases were arbitrated through three areas: (a) supports, which came from parents, immediate family members, spouses, teachers, mentors, and collaborators; (b) opportunities, which were separated into family experiences and opportunities, school and community opportunities, and postsecondary/current opportunities; and (c) postmodern feminism, which was the lens that grounded this study and fit well with the lives of the cases. As seen through a postmodern feminist lens, the cases' social class, their lived experiences tied to their opportunities and supports, and the culture of growing up in a small rural community helped them develop personas for the professions they chose even where those professions did not necessarily follow from the early promise shown for a science-related career. In addition, as related to my transformation as a male researcher, being a male conducting research in a realm most often shared by women, I was able to gain greater empathy and understanding of what it takes for women to be successful in a career and at the same time maintain a fruitful family life.

Cyclin D1 G870A polymorphism and breast cancer risk: a meta-analysis comprising 9,911 cases and 11,171 controls.

PubMed

Sergentanis, Theodoros N; Economopoulos, Konstantinos P

2011-11-01

Cyclin D1 represents a key molecule in the regulation of cell cycle. CCND1 G870A (rs603965) polymorphism has drawn considerable attention as the A allele may generate a variant splice product with possible oncogenic actions. A meta-analysis examining the association between CCND1 G870A polymorphism and breast cancer risk was performed. Separate analyses on Caucasian and Chinese populations were also implemented. Eligible articles were identified for the period up to July 2010. Pooled odds ratios (OR) were appropriately derived from fixed-effects or random-effects models. Sensitivity analysis excluding studies whose genotype frequencies in controls significantly deviated from Hardy-Weinberg Equilibrium (HWE) was performed. Nine case-control studies on Caucasians (7,304 cases and 8,149 controls) and four case-control studies on Chinese (2,607 cases and 3,022 controls) were eligible. At the overall analysis the A allele seemed to be associated with elevated breast cancer risk; the effect seemed to be confined to homozygous carriers (pooled OR = 1.091, 95% CI: 1.008-1.179, P = 0.030, fixed effects) as heterozygous carriers did not exhibit significantly elevated breast cancer risk. No statistically significant associations were demonstrated in Caucasians. On the other hand, Chinese AA carriers exhibited marginally elevated breast cancer risk (pooled OR = 1.144, 95% CI: 0.984-1.329, P = 0.080, fixed effects). Nevertheless, the controls in two out of the four Chinese studies deviated from HWE. In conclusion, this meta-analysis suggests that the A allele of the CCND1 G870A polymorphism may confer additional breast cancer risk when it comes to homozygosity and Chinese populations. The need for additional, methodologically sound studies on Chinese populations seems warranted.

A multimedia case based approach to the study of office ergonomics.

PubMed

August-Dalfen, Sharon; Snider, Laurie

2003-01-01

Multimedia technology has the capacity to provide students with an interactive approach to problem based learning and to bridge the gap between theoretical knowledge and clinical practice. The present paper describes the design and development of the program ErgoROM, a CD which presents a case study to assist occupational therapy students in their studies of office ergonomics. A pilot study showed that overall, 91% of respondents rated the ErgoROM as either "Excellent" or "Very Good". Additionally they reported that ErgoROM had a positive impact on active learning and critical thinking.

Implementation of Complexity Analyzing Based on Additional Effect

NASA Astrophysics Data System (ADS)

Zhang, Peng; Li, Na; Liang, Yanhong; Liu, Fang

According to the Complexity Theory, there is complexity in the system when the functional requirement is not be satisfied. There are several study performances for Complexity Theory based on Axiomatic Design. However, they focus on reducing the complexity in their study and no one focus on method of analyzing the complexity in the system. Therefore, this paper put forth a method of analyzing the complexity which is sought to make up the deficiency of the researches. In order to discussing the method of analyzing the complexity based on additional effect, this paper put forth two concepts which are ideal effect and additional effect. The method of analyzing complexity based on additional effect combines Complexity Theory with Theory of Inventive Problem Solving (TRIZ). It is helpful for designers to analyze the complexity by using additional effect. A case study shows the application of the process.

Full-Thickness Macular Hole Formation in the Postoperative Period After Initial Vitrectomy for Rhegmatogenous Retinal Detachment.

PubMed

Takashina, Hirotsugu; Watanabe, Akira; Tsuneoka, Hiroshi

2017-01-01

To evaluate full-thickness macular hole (MH) formation in the postoperative period after initial vitrectomy for rhegmatogenous retinal detachment (rRD). We retrospectively reviewed the medical records of 4 consecutive eyes that required additional vitrectomy for full-thickness MH between April 2013 and March 2016 after undergoing an initial vitrectomy for rRD. Epiretinal membrane (ERM) was identified by preoperative optical coherence tomography or intraoperative dye staining in each case. Photocoagulation of retinal breaks prior to initial vitrectomy was performed in Cases 1, 2, and 3 (4-16 days), with yttrium-aluminum-garnet capsulotomy after cataract extraction also performed prior to the retinal break formation in Case 3. At the initial vitrectomy, there was a superior retinal break which crossed the equator in Case 2, and an intentional hole was created in Cases 1 and 4. The mean interval from the initial vitrectomy until MH formation was 27.5 ± 15.8 months. As with Case 2, the intervals in Cases 1 and 4, in which an intentional hole was created, were clearly shorter than in those in Case 3. Finally, MH closure was achieved after an additional vitrectomy (removal of the internal limiting membrane with ERM and gas tamponade) and best-corrected visual acuity improved in each case. ERM was identified in the cases examined in our study. The presence of an intentional hole might shorten the interval of MH formation after vitrectomy for rRD.

Immunocytochemical characterization of lung tumors in fine-needle aspiration. The use of cytokeratin monoclonal antibodies for the differential diagnosis of squamous cell carcinoma and adenocarcinoma.

PubMed

Bruderman, I; Cohen, R; Leitner, O; Ronah, R; Guber, A; Griffel, B; Geiger, B

1990-10-15

In the current study, immunocytochemical typing of intermediate filaments was used for a differential diagnosis of human lung tumors from transthoracic fine-needle aspiration biopsies (TFNAB). The authors have compared the cytologic diagnosis of 53 lung cancer cases with the immunofluorescence patterns obtained using a panel of monoclonal antibodies, five of which (KG 8.13, KM 4.62, Ks B.17, KS 8.12, KK 8.60) react with specific cytokeratin polypeptides and one with vimentin (VIM 13.2). Only in six of 23 samples cytologically diagnosed as squamous cell carcinoma did the immunocytochemical typing of cytokeratins (ICTC) confirm the cytologic diagnosis. In seven cases some of the tumor cells stained positively with antibody Ks B.17 specific for simple epithelial keratin (No: 18), suggesting the presence of some cells of glandular origin. In ten additional cases the ICTC was in conflict with the cytologic diagnosis of squamous cell carcinoma (i.e., antibodies Ks 8.12 and KK 8.60 were negative, and antibody Ks B.17, positive) supporting a diagnosis of adenocarcinoma. In 14 of 18 cases cytologically diagnosed as adenocarcinoma, the ICTC confirmed the diagnosis whereas in four cases additional presence of some squamous cells was noticed. The ICTC labeling of cases cytologically diagnosed as undifferentiated and large cell carcinomas was similar to that of the group of adenocarcinomas. Thus, the application of cytokeratin typing for TFNAB samples seems to provide a vital complementation to routine cytologic study, especially for cases cytologically diagnosed as squamous carcinoma.

Review of ear, nose and throat foreign bodies in Sarawak General Hospital. A five year experience.

PubMed

Chiun, Kian Chai; Tang, Ing Ping; Tan, Tee Yong; Jong, Doris Evelyn Yah Hui

2012-02-01

Ear, nose and throat foreign bodies are common in ENT clinical practice. This study was designed to establish the local data of otorhinolaryngeal foreign bodies in term of prevalence among paediatric and adult groups, the clinical features, types of foreign body at different sites, and laterality of foreign bodies. This study was carried out at ENT department, Sarawak General Hospital, Malaysia, from 1st January 2005 to 31st December 2009. A total of 1084 cases were included and statistically analyzed. Ear foreign bodies showed the highest incidence which was consisted of 480 (44.3%) cases, followed by nose in 270 (24.9%) cases, pharynx in 251 (23.2%) cases, esophagus in 57 (5.3%) cases and laryngo-tracheobronchial tree in 26 (2.4%) cases. Otorhinolaryngeal foreign bodies occurred more frequently in 0-10 year old age group which constituted 651 (60.1%) cases. The descending order of frequency for foreign body sites in adult was pharynx (17.2%), ear (12.8%), esophagus (3.1%), nose (1.7%) and laryngo-tracheobronchial tree (1.1%). The type of foreign bodies varies with age group and site of foreign body lodgement. In general, common foreign bodies in both adult and children were food related, with the additional of small objects such as plastic toy in paediatric group. Otorhinolaryngeal foreign bodies were found more frequently in children. The types of foreign body were different from age group and sites of foreign body lodgement. The local food constituted the highest incidence of ear, nose, and throat foreign bodies with additional of plastic toys in paediatric group.

Meta-Leadership in a Mega Disaster: A Case Study of Governor Haley Barbour’s Leadership During Hurricane Katrina

DTIC Science & Technology

2014-12-01

bales of cotton were destroyed by Katrina with a market value of over $108 million.119 In addition , crops as far north as the Mississippi Delta were...killed 6.2 million birds valued at over $15 million. Additionally , the storm destroyed 2,400 poultry barns with a replacement cost of over $6 million...existing leadership literature assumed a hierarchical leadership structure.1 Additionally , the authors discovered that many leadership theories dealt with

Noncoding RNA Shows Context-Dependent Function | Center for Cancer Research

Cancer.gov

In addition to well-studied protein coding sequences, it is known that the genomes of higher organisms produce numerous noncoding RNAs (ncRNAs). Important roles for some ncRNAs in cell function have been demonstrated, though usually on a case-by-case basis, leading some scientists to argue that the majority of ncRNA production is just “noise” that results from the imperfect

5 CFR 890.1025 - Cases where additional fact-finding is not required.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional fact..., suspension, restriction, or nonrenewal by a State licensing authority; (2) Debarment, exclusion, suspension... additional fact-finding proceeding is not required when: (a) Prior adjudication. The proposed debarment is...

Using Supercomputers to Speed Execution of the CAISO/PLEXOS 33% RPS Study

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

Meyers, C; Streitz, F; Yao, Y

2011-09-19

The study's official title is 'ISO Study of Operational Requirements and Market Impacts at 33% Renewable Portfolio Standard (RPS).' The stated objectives are twofold: (1) identifying operational requirements and resource options to reliably operate the ISO-controlled grid under a 33% RPS in 2020; and (2) inform market, planning, and policy/regulatory decisions by the ISO, state agencies, market participants, and other stakeholders. The first of these objectives requires the hourly estimates of integration requirements, measured in terms of operational ramp, load following and regulation capacity and ramp rates, as well as additional capacity to resolve operational violations. It also involves considerationmore » of other variables that affect the results, such as the impact of different mixes of renewable technologies, and the impact of forecasting error and variability. The second objective entails supporting the CPUC to identify long-term procurement planning needs, costs, and options, as well as informing other decisions made by the CPUC and state agencies. For the ISO itself this includes informing state-wide transmission planning needs for renewables up to a 33% RPS, and informing design of wholesale markets for energy and ancillary services to facilitate provision of integration capacities. The study is designed in two phases. The first (current) phase is focused on operational requirements and addressing these requirements with existing and new conventional fossil generation; for instance, gas turbines and/or combined cycle units. The second (planned) phase will address the same operational requirements with a combination of conventional fossil generation resources, new non-generation resources, and a renewable resource dispatch. There are seven different scenarios considered in the current phase: a 20% RPS reference case; four 33% RPS cases (a reference case, a high out-of-state case, a high distributed generation case, and a low load case); an alternative 27.5% RPS case; and an all-gas case (no new renewables after 2008). In addition, the CPUC is planning a new set of cases that will alter the anticipated sets of runs.« less

The Effect of Detonation Wave Incidence Angle on the Acceleration of Flyers by Explosives Heavily Laden with Inert Additives

NASA Astrophysics Data System (ADS)

Loiseau, Jason; Georges, William; Frost, David; Higgins, Andrew

2015-06-01

The incidence angle of a detonation wave is often assumed to weakly influence the terminal velocity of an explosively driven flyer. For explosives heavily loaded with dense additives, this may not be true due to differences in momentum and energy transfer between detonation products, additive particles, and the flyer. For tangential incidence the particles are first accelerated against the flyer via an expansion fan, whereas they are first accelerated by the detonation wave in the normal case. In the current study we evaluate the effect of normal versus tangential incidence on the acceleration of flyers by nitromethane heavily loaded with a variety of additives. Normal detonation was initiated via an explosively driven slapper. Flyer acceleration was measured with heterodyne laser interferometry (PDV). The influence of wave angle is evaluated by comparing the terminal velocity in the two cases (i.e., normal and grazing) for the heavily loaded mixtures. The decrement in flyer velocity correlated primarily with additive volume fraction and had a weak dependence on additive density or particle size. The Gurney energy of the heterogeneous explosive was observed to increase with flyer mass, presumably due to the timescale over which impinging particles could transfer momentum.

Hyperbaric oxygen therapy (HBOT) in case of hemorrhagic cystitis after radiotherapy

PubMed Central

Klejnotowska, Alicja; Matuszewski, Marcin; Sicko, Zdzislaw; Markuszewski, Marcin; Krajka, Kazimierz

2012-01-01

Introduction We present the effect of hyperbaric oxygen therapy (HBOT) after radiotherapy for cancer in the pelvic cavity resulting in hematuria. Increasing the pressure of oxygen (PO2) in ischemic tissues favors the formation of new blood vessels and increases the secretion of collagen. Material and methods We evaluated 10 patients who were treated with HBOT from October 2006 to December 2010 due to persistent radiation damage to the lining of the bladder leading to recurrent hematuria. The study group was comprised of seven men and three women. In the case of cervical and endometrial cancers, 30 Gy of brachytherapy with 45-50 Gy of teleradiotherapy were used. In prostate cancer (PCa), we applied 50 Gy of teleradiotherapy with an additional dose of 20-24 Gy, and in the case of bladder cancer (BCa), 50 Gy of teleradiotherapy was applied with an additional dose of 16 Gy. HBOT consisted of 60 HBO2 treatments, in which patients were administered 100% oxygen at a pressure of 2.5 atm. Results The group effect of total or partial resolution was observed in six patients. In one case, treatment was discontinued due to an increase in hematuria and the consequent suspicion of bladder tumor recurrence. While in and additional three cases, the treatment did not produce the desired result. Conclusions Treatment of hemorrhagic cystitis is a difficult therapeutic challenge. One possible method is the implementation of HBOT. In very difficult cases, HBO2 treatment appears to be effective in giving more than half of patients a chance of getting better. PMID:24578962

Pre-surgical road map for thyroid cancer and large goiters: Practical benefits of detailed radiological evaluation by surgeon.

PubMed

Panchangam, Ramakanth Bhargav; Guntupalli, Satyam; Seetharamaiah, Thotakura; Kumbhar, Uday Shamrao

2015-01-01

Pre-surgical radiological evaluation of neck is often mandatory for surgical planning in high risk thyroid cancer and large goiters. Frequently, surgeons are overdependent on radiologist's report. In this context, we analysed the practical benefits of surgeon's independent radiological evaluation in our institutional experience. This prospective study was conducted in Endocrine Surgery department of a teaching hospital in South India. Cases operated between January 2011 and June 2012 (18 months) were included. Films of cross-sectional imaging were read in detail by primary and assistant surgeons in correlation with stepwise operative planning and documented. Cases with additional radiological signs on surgeon's evaluation, which were missing in radiologist's report are discussed in detail. F: M ratio is 67:24. Mean age was 45.3 ± 9.8 years (37 - 76). Forty-seven cases of thyroid cancer and 44 cases of large goiters were analysed. Surgeon read additional signs such as obliterated fat plane between goiter and subcutaneous plane; level I lymph nodes; bilateral cervical lymphadenopathy, internal jugular vein thrombus, and pharyngeal invasion helped in pre-operatively planned modification of operative steps for optimal R0 resection and total thyroidectomy. A mean of 1.42 ± 0.83 (1 - 6), additional signs were detected on surgeon's radiological evaluation compared to radiologist's report in 41.7% of cases. These findings modified the pre-operative plan, facilitating better surgical outcome in 28.6% of cases. In high-risk thyroid cancer and large goiters, detailed radiological evaluation by surgeon facilitates optimal surgical resection and superior outcome compared to radiologist report-guided surgery.

Methaemoglobinaemia following ingestion of a commonly available food additive.

PubMed

Maric, Peter; Ali, Sayed S; Heron, Leon G; Rosenfeld, David; Greenwood, Matthew

2008-02-04

Five cases of methaemoglobinaemia after ingestion of sodium nitrite occurred in two clusters in Sydney in 2006. All cases were unintentional poisonings following use in cooking of an imported compound sold as a food additive. In all cases, methaemoglobinaemia was recognised early and treated promptly, with all patients making a full recovery. These cases highlight the importance of accurate food labelling and surveillance of imported goods.

A Systematic Review and Aggregated Analysis on the Impact of Amyloid PET Brain Imaging on the Diagnosis, Diagnostic Confidence, and Management of Patients being Evaluated for Alzheimer's Disease.

PubMed

Fantoni, Enrico R; Chalkidou, Anastasia; O' Brien, John T; Farrar, Gill; Hammers, Alexander

2018-01-01

Amyloid PET (aPET) imaging could improve patient outcomes in clinical practice, but the extent of impact needs quantification. To provide an aggregated quantitative analysis of the value added by aPET in cognitively impaired subjects. Systematic literature searches were performed in Embase and Medline until January 2017. 1,531 cases over 12 studies were included (1,142 cases over seven studies in the primary analysis where aPET was the key biomarker; the remaining cases included as defined groups in the secondary analysis). Data was abstracted by consensus among two observers and assessed for bias. Clinical utility was measured by diagnostic change, diagnostic confidence, and patient management before and after aPET. Three groups were further analyzed: control patients for whom feedback of aPET scan results was delayed; aPET Appropriate Use Criteria (AUC+) cases; and patients undergoing additional FDG/CSF testing. For 1,142 cases with only aPET, 31.3% of diagnoses were revised, whereas 3.2% of diagnoses changed in the delayed aPET control group (p < 0.0001). Increased diagnostic confidence following aPET was found for 62.1% of 870 patients. Management changes with aPET were found in 72.2% of 740 cases and in 55.5% of 299 cases in the control group (p < 0.0001). The diagnostic value of aPET in AUC+ patients or when FDG/CSF were additionally available did not substantially differ from the value of aPET alone in the wider population. Amyloid PET contributed to diagnostic revision in almost a third of cases and demonstrated value in increasing diagnostic confidence and refining management plans.

Case-control study of genus-beta human papillomaviruses in plucked eyebrow hairs and cutaneous squamous cell carcinoma.

PubMed

Iannacone, Michelle R; Gheit, Tarik; Pfister, Herbert; Giuliano, Anna R; Messina, Jane L; Fenske, Neil A; Cherpelis, Basil S; Sondak, Vernon K; Roetzheim, Richard G; Silling, Steffi; Pawlita, Michael; Tommasino, Massimo; Rollison, Dana E

2014-05-01

Cutaneous human papillomaviruses (HPV) have been reported in cutaneous squamous cell carcinoma (SCC). We conducted a clinic-based case-control study to investigate the association between genus-beta HPV DNA in eyebrow hairs (EBH) and SCC. EBH from 168 SCC cases and 290 controls were genotyped for genus-beta HPV DNA. SCC tumors from a subset of cases (n = 142) were also genotyped. Viral load was determined in a subset of specimens positive for a single HPV type. Associations with SCC were estimated by odds ratios (OR) and 95% confidence intervals (CI) adjusted for age and sex using logistic regression. Statistical tests were two-sided. EBH DNA prevalence was greater in cases (87%) than controls (73%) (p < 0.05), and the association with SCC increased with the number of HPV types present, (≥ 4 types vs. HPV-negative: OR = 2.02, 95% CI = 1.07-3.80; p(trend) = 0.02). Type-specific associations were observed between SCC and DNA in EBH for HPV23 (OR = 1.90, 95% CI = 1.10-3.30) and HPV38 (OR = 1.84, 95% CI = 1.04-3.24). Additionally, when compared with the controls, the DNA prevalence in EBH was significantly higher among cases for 11 of the 25 genus-beta types tested, when accounting for DNA for the same HPV type in the tumor (ORs = 3.44-76.50). Compared to controls, the mean viral DNA load in EBH among the selected cases was greater for HPV5, HPV8 and HPV24, but lower for HPV38. SCC cases were more likely than controls to have HPV DNA+ EBH for single and multiple HPV types, providing additional support for the potential role of genus-beta HPV infections in SCC development. © 2013 UICC.

A Systematic Review and Aggregated Analysis on the Impact of Amyloid PET Brain Imaging on the Diagnosis, Diagnostic Confidence, and Management of Patients being Evaluated for Alzheimer’s Disease

PubMed Central

Fantoni, Enrico R.; Chalkidou, Anastasia; O’ Brien, John T.; Farrar, Gill; Hammers, Alexander

2018-01-01

Background: Amyloid PET (aPET) imaging could improve patient outcomes in clinical practice, but the extent of impact needs quantification. Objective: To provide an aggregated quantitative analysis of the value added by aPET in cognitively impaired subjects. Methods: Systematic literature searches were performed in Embase and Medline until January 2017. 1,531 cases over 12 studies were included (1,142 cases over seven studies in the primary analysis where aPET was the key biomarker; the remaining cases included as defined groups in the secondary analysis). Data was abstracted by consensus among two observers and assessed for bias. Clinical utility was measured by diagnostic change, diagnostic confidence, and patient management before and after aPET. Three groups were further analyzed: control patients for whom feedback of aPET scan results was delayed; aPET Appropriate Use Criteria (AUC+) cases; and patients undergoing additional FDG/CSF testing. Results: For 1,142 cases with only aPET, 31.3% of diagnoses were revised, whereas 3.2% of diagnoses changed in the delayed aPET control group (p < 0.0001). Increased diagnostic confidence following aPET was found for 62.1% of 870 patients. Management changes with aPET were found in 72.2% of 740 cases and in 55.5% of 299 cases in the control group (p < 0.0001). The diagnostic value of aPET in AUC+ patients or when FDG/CSF were additionally available did not substantially differ from the value of aPET alone in the wider population. Conclusions: Amyloid PET contributed to diagnostic revision in almost a third of cases and demonstrated value in increasing diagnostic confidence and refining management plans. PMID:29689725

ALLERGENIC RELATIONSHIP OF THE POLLENS OF DWARF AND GIANT RAGWEED TO SEVERAL OF THEIR BOTANIC RELATIVES.

PubMed

Simon, F A

1943-02-01

Thirty-eight of forty patients, allergic to the pollen of dwarf and giant ragweed, were found to be allergic also to the pollen of botanically related species. There was definite variation in the degree of reactivity to the various pollens in different patients. One additional patient reacted to dwarf ragweed but not to giant ragweed or to four other composites. Antibody neutralization studies in six cases indicated that (a) in four cases dwarf ragweed could have been the only sensitizing allergen. (b) In one case either dwarf or giant ragweed could have been the only sensitizing allergen. (c) In one case cosmos plus either of the ragweeds or some undetermined pollen could have been the sensitizing allergen, (d) In none of the six cases studied could cosmos, sunflower, goldenrod, or dandelion have been the only sensitizing allergens. The evidence presented supports the following concepts: (1) Hypersensitiveness of this type develops as the result of allergenic stimulation. (2) The pollens of the ragweeds and their botanic relatives contain, in addition to species-specific allergens, multiple common allergenic determinants which vary in their distribution among related species. (3) A person exposed simultaneously to a group of allergens may become sensitized to certain members of the group and not to others, while another person, exposed to the same group of allergens, may become sensitized to different members of the group.

Constructed Wetlands for Wastewater Treatment and Wildlife Habitat: 17 Case Studies

EPA Pesticide Factsheets

This document provides brief descriptions of 17 wetland treatment systems from across the country that are providing significant water quality benefits while demonstrating additional benefits such as wildlife habitat.

Optimized model tuning in medical systems.

PubMed

Kléma, Jirí; Kubalík, Jirí; Lhotská, Lenka

2005-12-01

In medical systems it is often advantageous to utilize specific problem situations (cases) in addition to or instead of a general model. Decisions are then based on relevant past cases retrieved from a case memory. The reliability of such decisions depends directly on the ability to identify cases of practical relevance to the current situation. This paper discusses issues of automated tuning in order to obtain a proper definition of mutual case similarity in a specific medical domain. The main focus is on a reasonably time-consuming optimization of the parameters that determine case retrieval and further utilization in decision making/ prediction. The two case studies - mortality prediction after cardiological intervention, and resource allocation at a spa - document that the optimization process is influenced by various characteristics of the problem domain.

Gene-environment interactions between smoking and a haplotype of RAI, ASE-1 and ERCC1 polymorphisms among women in relation to risk of lung cancer in a population-based study.

PubMed

Vogel, Ulla; Sørensen, Mette; Hansen, Rikke Dalgaard; Tjønneland, Anne; Overvad, Kim; Wallin, Håkan; Nexø, Bjørn A; Raaschou-Nielsen, Ole

2007-03-08

Homozygous carriers of a haplotype consisting of ERCC1 Asn118Asn(A), ASE-1 G-21A(G), RAI IVS1 A4364G(A) are at increased risk of lung cancer especially among women. Here, we analyse for gene-environment interactions with the predefined haplotype in a case cohort study including 428 lung cancer cases and a comparison group of 800 persons, all from the prospective Diet, Cancer and Health cohort of 57,000 Danes. At high smoking intensity (>20g tobacco/day), there was only additional risk of smoking intensity among women who were homozygous carriers of the haplotype (IRR=2.03; 95% CI: 1.10-3.73 per 5 additional g tobacco/day).

Genotype-Based Association Mapping of Complex Diseases: Gene-Environment Interactions with Multiple Genetic Markers and Measurement Error in Environmental Exposures

PubMed Central

Lobach, Irvna; Fan, Ruzone; Carroll, Raymond T.

2011-01-01

With the advent of dense single nucleotide polymorphism genotyping, population-based association studies have become the major tools for identifying human disease genes and for fine gene mapping of complex traits. We develop a genotype-based approach for association analysis of case-control studies of gene-environment interactions in the case when environmental factors are measured with error and genotype data are available on multiple genetic markers. To directly use the observed genotype data, we propose two genotype-based models: genotype effect and additive effect models. Our approach offers several advantages. First, the proposed risk functions can directly incorporate the observed genotype data while modeling the linkage disequihbrium information in the regression coefficients, thus eliminating the need to infer haplotype phase. Compared with the haplotype-based approach, an estimating procedure based on the proposed methods can be much simpler and significantly faster. In addition, there is no potential risk due to haplotype phase estimation. Further, by fitting the proposed models, it is possible to analyze the risk alleles/variants of complex diseases, including their dominant or additive effects. To model measurement error, we adopt the pseudo-likelihood method by Lobach et al. [2008]. Performance of the proposed method is examined using simulation experiments. An application of our method is illustrated using a population-based case-control study of association between calcium intake with the risk of colorectal adenoma development. PMID:21031455

Attrition Bias Related to Missing Outcome Data: A Longitudinal Simulation Study.

PubMed

Lewin, Antoine; Brondeel, Ruben; Benmarhnia, Tarik; Thomas, Frédérique; Chaix, Basile

2018-01-01

Most longitudinal studies do not address potential selection biases due to selective attrition. Using empirical data and simulating additional attrition, we investigated the effectiveness of common approaches to handle missing outcome data from attrition in the association between individual education level and change in body mass index (BMI). Using data from the two waves of the French RECORD Cohort Study (N = 7,172), we first examined how inverse probability weighting (IPW) and multiple imputation handled missing outcome data from attrition in the observed data (stage 1). Second, simulating additional missing data in BMI at follow-up under various missing-at-random scenarios, we quantified the impact of attrition and assessed how multiple imputation performed compared to complete case analysis and to a perfectly specified IPW model as a gold standard (stage 2). With the observed data in stage 1, we found an inverse association between individual education and change in BMI, with complete case analysis, as well as with IPW and multiple imputation. When we simulated additional attrition under a missing-at-random pattern (stage 2), the bias increased with the magnitude of selective attrition, and multiple imputation was useless to address it. Our simulations revealed that selective attrition in the outcome heavily biased the association of interest. The present article contributes to raising awareness that for missing outcome data, multiple imputation does not do better than complete case analysis. More effort is thus needed during the design phase to understand attrition mechanisms by collecting information on the reasons for dropout.

Questionnaire-based assessment of executive functioning: Case studies.

PubMed

Kronenberger, William G; Castellanos, Irina; Pisoni, David B

2018-01-01

Delays in the development of executive functioning skills are frequently observed in pediatric neuropsychology populations and can have a broad and significant impact on quality of life. As a result, assessment of executive functioning is often relevant for the development of formulations and recommendations in pediatric neuropsychology clinical work. Questionnaire-based measures of executive functioning behaviors in everyday life have unique advantages and complement traditional neuropsychological measures of executive functioning. Two case studies of children with spina bifida are presented to illustrate the clinical use of a new questionnaire measure of executive and learning-related functioning, the Learning, Executive, and Attention Functioning Scale (LEAF). The LEAF emphasizes clinical utility in assessment by incorporating four characteristics: brevity in administration, breadth of additional relevant content, efficiency of scoring and interpretation, and ease of availability for use. LEAF results were consistent with another executive functioning checklist in documenting everyday behavior problems related to working memory, planning, and organization while offering additional breadth of assessment of domains such as attention, processing speed, and novel problem-solving. These case study results demonstrate the clinical utility of questionnaire-based measurement of executive functioning in pediatric neuropsychology and provide a new measure for accomplishing this goal.

Pediatric thymomas: report of two cases and comprehensive review of the literature.

PubMed

Fonseca, Annabelle L; Ozgediz, Doruk E; Christison-Lagay, Emily R; Detterbeck, Frank C; Caty, Michael G

2014-03-01

Thymomas are rare pediatric malignancies with indolent behavior. There are fewer than 50 reported cases and no comprehensive review. We sought to evaluate our recent experience with pediatric thymomas, and comprehensively review the extant literature. A systematic search of the PubMed database was performed using keywords: "thymoma", "pediatric", "juvenile", "childhood", and "child". Additional studies were identified by a manual search of the reference list. We report two patients with thymomas. We identified 22 case reports or series that described 48 patients; 62 % were male, 15 % presented with myasthenia gravis. Fifty percent were Masaoka Stage I, 15 % were Stage II, 13 % were Stage III, and 23 % were Stage IV. Four patients with early stage (I or II) disease were treated with adjuvant therapies in addition to surgical excision, while five patients with late stage (III or IV) disease treated with surgical excision alone. Of studies reporting at least 2-year follow-up, survival was 71 %. Pediatric thymomas are rare tumors with a slight male predominance. Wide variations were observed in the treatment of thymomas across all stages. Our review indicates a need for large database and multi-institutional studies to clearly elucidate clinical course, prognostic factors and outcome.

A parametric shell analysis of the shuttle 51-L SRB AFT field joint

NASA Technical Reports Server (NTRS)

Davis, Randall C.; Bowman, Lynn M.; Hughes, Robert M., IV; Jackson, Brian J.

1990-01-01

Following the Shuttle 51-L accident, an investigation was conducted to determine the cause of the failure. Investigators at the Langley Research Center focused attention on the structural behavior of the field joints with O-ring seals in the steel solid rocket booster (SRB) cases. The shell-of-revolution computer program BOSOR4 was used to model the aft field joint of the solid rocket booster case. The shell model consisted of the SRB wall and joint geometry present during the Shuttle 51-L flight. A parametric study of the joint was performed on the geometry, including joint clearances, contact between the joint components, and on the loads, induced and applied. In addition combinations of geometry and loads were evaluated. The analytical results from the parametric study showed that contact between the joint components was a primary contributor to allowing hot gases to blow by the O-rings. Based upon understanding the original joint behavior, various proposed joint modifications are shown and analyzed in order to provide additional insight and information. Finally, experimental results from a hydro-static pressurization of a test rocket booster case to study joint motion are presented and verified analytically.

Interstitial insertion of RARα gene into PML gene in a patient with acute promyelocytic leukemia (APL) lacking the classic t(15;17).

PubMed

Goldschmidt, Neta; Yehuda-Gafni, Orly; Abeliovich, Deborah; Slyusarevsky, Elena; Rund, Deborah

2010-10-01

The diagnosis of APL is based on clinical and morphological tests though the final diagnosis is at the molecular level. An accurate diagnosis is important as it mandates targeted therapy to improve survival. We report a case of APL without t(15;17) in conventional cytogenetic study and with initially negative fluorescence in situ hybridization (FISH) study on cells in interphase. Reverse transcription polymerase chain reaction (RT-PCR) for the promyelocytic/retinoic acid receptor alpha gene (PML/RARα) fusion oncogene proved the clinical diagnosis as well as FISH study on cells in metaphase. The cause was a cryptic translocation of the RARα gene into PML. We reviewed 36 additional cases of APL diagnosed in our hospital since 1992. This was the only case that failed to show t(15;17) in cytogenetics. However, three cases with t(15;17) in cytogenetics had negative RT-PCR for PML/RARα. Our case emphasizes that cytogenetics, FISH and RT-PCR studies are complementary studies for the molecular diagnosis of APL.

Mitochondrial dysfunction in Gulf War illness revealed by 31Phosphorus Magnetic Resonance Spectroscopy: a case-control study.

PubMed

Koslik, Hayley J; Hamilton, Gavin; Golomb, Beatrice A

2014-01-01

Approximately 1/3 of 1990-1 Gulf War veterans developed chronic multisymptom health problems. Implicated exposures bear mechanisms that adversely affect mitochondria. Symptoms emphasize fatigue, cognition and muscle (brain and muscle are aerobically demanding); with protean additional domains affected, compatible with mitochondrial impairment. Recent evidence supports treatments targeting cell bioenergetics (coenzyme10) to benefit Gulf War illness symptoms. However, no evidence has directly documented mitochondrial or bioenergetic impairment in Gulf War illness. We sought to objectively assess for mitochondrial dysfunction, examining post-exercise phosphocreatine-recovery time constant (PCr-R) using (31)Phosphorus Magnetic Resonance Spectroscopy ((31)P-MRS), in Gulf War veterans with Gulf War illness compared to matched healthy controls. PCr-R has been described as a "robust and practical" index of mitochondrial status. Case-control study from 2012-2013. Fourteen community-dwelling Gulf War veterans and matched controls from the San Diego area comprised 7 men meeting CDC and Kansas criteria for Gulf War illness, and 7 non-deployed healthy controls matched 1:1 to cases on age, sex, and ethnicity. Calf muscle phosphocreatine was evaluated by (31)P-MRS at rest, through 5 minutes of foot pedal depression exercise, and in recovery, to assess PCr-R. Paired t-tests compared cases to matched controls. PCr-R was significantly prolonged in Gulf War illness cases vs their matched controls: control values, mean ± SD, 29.0 ± 8.7 seconds; case values 46.1 ± 18.0 seconds; difference 17.1 ± 14.9 seconds; p = 0.023. PCr-R was longer for cases relative to their matched controls for all but one pair; moreover while values clustered under 31 seconds for all but one control, they exceeded 35 seconds (with a spread up to 70 seconds) for all but one case. These data provide the first direct evidence supporting mitochondrial dysfunction in Gulf War illness. Findings merit replication in a larger study and/or corroboration with additional mitochondrial assessment tools.

Epidemiology of chronic obstructive pulmonary disease: a population-based study in Krasnoyarsk region, Russia.

PubMed

Artyukhov, Ivan P; Arshukova, Irina L; Dobretsova, Elena A; Dugina, Tatyana A; Shulmin, Andrey V; Demko, Irina V

2015-01-01

Krasnoyarsk region is a territory with the widespread risk factors for chronic obstructive pulmonary disease (COPD) such as tobacco smoke, air pollution, and occupational exposure. An assessment of COPD prevalence based on medical diagnosis statistics underestimates the true COPD prevalence. This study aims to evaluate how medical examinations may increase the accuracy of estimates of COPD prevalence. True COPD prevalence was estimated as a number of patients with the established disease diagnosis supplemented by the additional disease cases detected during medical examinations per 1,000 inhabitants of the region. Official medical statistics data and the data collected from the Global Alliance against Chronic Respiratory Diseases program 2011 among 15,000 inhabitants of the region aged 18 years and older were analyzed. This study revealed the COPD cases without official medical diagnosis. The true prevalence of COPD is estimated to be two times higher than the prevalence estimates based on medical diagnosis statistics. Undiagnosed and untreated cases of COPD result in severe COPD forms as well as addition of severe comorbidities. Because of this, there is an increase in the index of potential years of life lost. Conducting special medical examinations may increase the number of COPD cases detected at the early stages of the disease. This, in turn, may reduce the overall burden of the disease for the population of the region.

Socioscientific Issues in Science Education: The Case of Turkey

ERIC Educational Resources Information Center

Topcu, Mustafa Sami; Mugaloglu, Ebru Zeynep; Guven, Devrim

2014-01-01

The purpose of this study is to identify the foci and results of studies on socioscientific issues (SSI) conducted in Turkey. Additionally, the study aimed to compare the results of this study with ones conducted internationally. For this aim, a literary review of empirical studies related to SSI conducted in Turkey was carried out. Four criteria…

Dynamic Course of Serratia marcescens Pulmonic Valve Endocarditis Resulting in Submassive PE and Valve Replacement.

PubMed

Meyer, Chloe Grace; Vacek, Thomas Paul; Bansal, Amit; Gurujal, Ravi; Parikh, Analkumar

2018-01-01

This report illustrates a case of a 42-year-old male with a history of intravenous drug abuse who presented with septic shock. Diagnostic studies, including a transthoracic echocardiogram, chest computed tomography angiography, transesophageal echocardiogram, and blood cultures ultimately revealed Serratia marcescens pulmonic valve infective endocarditis that was treated with intravenous antibiotics. In addition to the rare form of endocarditis and bacterium involved, this case brings into awareness the dynamic nature of the hospital course that requires vigilance in responding to hypotensive episodes for consideration of pulmonary embolism. Surgical valve replacement was opted for due to such a complication in addition to the large size of the vegetation, 2.5 cm.

The role of natural color additives in food allergy.

PubMed

Lucas, C D; Hallagan, J B; Taylor, S L

2001-01-01

A critical evaluation of the available information demonstrates that reactions to natural color additives are rare. Studies of turmeric and carotenoid pigments administered in mixtures with other food colorings failed to definitely identify reactions to either color additive. For carotenoids, the one case report of an adverse reaction was not conclusive. An anaphylactic reaction to saffron does suggest an IgE-mediated reaction, but the high use of saffron as compared with this single report of an adverse reaction suggests that sensitivity to saffron is extremely rare. Numerous reports of reactions to grapes or grape products have been reported in the literature, but no reports of sensitivities to grape skin extract or grape color extract were found. In rare cases, annatto dye may provoke a severe, adverse reaction in individuals with an uncommon hypersensitivity, and may aggravate the symptoms of patients suffering from recurrent urticaria. In its long history of use, there has been only one reported case of anaphylaxis resulting from the ingestion of annatto. Studies designed to investigate the role of annatto in recurrent urticaria sufferers were limited due to the absence of double-blind challenge and placebo controls. A number of cases of adverse reactions to carmine following ingestion have been reported in the literature. These adverse reactions suggest an IgE-mediated hypersensitivity. In many of the reported cases, the cause of sensitization to carmine was topical exposure from the use of carmine-containing cosmetics or occupational exposure to carmine and not from ingestion of carmine-containing foods and beverages. Following sensitization, affected individuals would be sensitive to carmine and the amounts present in foods and beverages could elicit allergic reactions. It is not known whether all individuals with carmine sensitivity induced through topical use are sensitive to the ingestion of carmine in foods. However, reactions to carmine solely because of ingestion are likely to be exceedingly rare due to the low use levels of carmine in foods and beverages. Despite their widespread use in food products, few reports of allergic reactions following ingestion have been reported for the majority of natural color additives. It is concluded that the ingestion of natural color additives presents a very low risk of provoking adverse reactions.

An approach to checking case-crossover analyses based on equivalence with time-series methods.

PubMed

Lu, Yun; Symons, James Morel; Geyh, Alison S; Zeger, Scott L

2008-03-01

The case-crossover design has been increasingly applied to epidemiologic investigations of acute adverse health effects associated with ambient air pollution. The correspondence of the design to that of matched case-control studies makes it inferentially appealing for epidemiologic studies. Case-crossover analyses generally use conditional logistic regression modeling. This technique is equivalent to time-series log-linear regression models when there is a common exposure across individuals, as in air pollution studies. Previous methods for obtaining unbiased estimates for case-crossover analyses have assumed that time-varying risk factors are constant within reference windows. In this paper, we rely on the connection between case-crossover and time-series methods to illustrate model-checking procedures from log-linear model diagnostics for time-stratified case-crossover analyses. Additionally, we compare the relative performance of the time-stratified case-crossover approach to time-series methods under 3 simulated scenarios representing different temporal patterns of daily mortality associated with air pollution in Chicago, Illinois, during 1995 and 1996. Whenever a model-be it time-series or case-crossover-fails to account appropriately for fluctuations in time that confound the exposure, the effect estimate will be biased. It is therefore important to perform model-checking in time-stratified case-crossover analyses rather than assume the estimator is unbiased.

Retrospective Study of Histomoniasis (Blackhead) in California Turkey Flocks, 2000-2014.

PubMed

Hauck, R; Stoute, S; Chin, R P; Sentíes-Cué, C G; Shivaprasad, H L

2018-03-01

The flagellate parasite Histomonas meleagridis causes a severe disease in turkeys. Since nitarsone, the last antiflagellate feed additive, was withdrawn from the market, H. meleagridis has gained increasing clinical and economic importance, and frequently entire turkey flocks are lost to the disease. Even before the antiflagellate market withdrawal, H. meleagridis has been recognized as a noteworthy disease in commercial turkeys. The aim of this study was to compile and analyze data on histomoniasis outbreaks diagnosed by the California Animal Health and Food Safety System in the years 2000 through 2014 while nitarsone was still available. Sixty-two cases were included in the study. In all cases, the parasite was detected by histopathology. Five cases were from breeder flocks, 44 from commercial meat turkey flocks, and 13 from other flocks such as backyard flocks or pet turkeys. There were between one and eight cases each year with no clear trend over time. Most cases occurred in the warmer months between April and October with a clear peak in August. Turkeys in the flocks with the disease were aged between 2 wk and 15 mo, with a median age of 9 wk. In cases for which mortality was reported, daily mortality ranged between 0.04% and 2% with an average of 0.34% and a median of 0.15%. Five-week mortality in infected houses on three infected ranches was between 1.3% and 68%. In 12 cases, the parasite was observed in organs other than ceca and liver. These included spleen, kidney, bursa of Fabricius, proventriculus, lung, pancreas, and crop. In 58 cases, histomoniasis was considered the most significant and primary diagnosis; in four cases histomoniasis was regarded as an incidental finding. In 14 other outbreaks, detailed information was available. In 11 cases, more than one house on the ranch was affected; in five cases the disease spread to all houses. Total mortality in turkeys from affected flocks ranged between 12% and 65%. In eight flocks, the birds were marketed with a weight that was considered too light. In conclusion, the present study shows that even with nitarsone available as antiflagellate feed, additive histomoniasis was a serious disease of turkeys in the United States with an epidemiology similar to that observed in Europe.

Diabetic retinopathy screening with pharmacy-based teleophthalmology in a semiurban setting: a cost-effectiveness analysis.

PubMed

Coronado, Andrea C; Zaric, Gregory S; Martin, Janet; Malvankar-Mehta, Monali; Si, Francie F; Hodge, William G

2016-01-01

Diabetic eye complications are the leading cause of visual loss among working-aged people. Pharmacy-based teleophthalmology has emerged as a possible alternative to in-person examination that may facilitate compliance with evidence-based recommendations and reduce barriers to specialized eye care. The objective of this study was to estimate the cost-effectiveness of mobile teleophthalmology screening compared with in-person examination (primary care) for the diabetic population residing in semiurban areas of southwestern Ontario. A decision tree was constructed to compare in-person examination (comparator program) versus pharmacy-based teleophthalmology (intervention program). The economic model was designed to identify patients with more than minimal diabetic retinopathy, manifested by at least 1 microaneurysm at examination (modified Airlie House classification grade of ≥ 20). Cost-effectiveness was assessed as cost per case detected (true-positive result) and cost per case correctly diagnosed (including true-positive and true-negative results). The cost per case detected was $510 with in-person examination and $478 with teleophthalmology, and the cost per case correctly diagnosed was $107 and $102 respectively. The incremental cost-effectiveness ratio was $314 per additional case detected and $73 per additional case correctly diagnosed. Use of pharmacologic dilation and health care specialists' fees were the most important cost drivers. The study showed that a compound teleophthalmology program in a semiurban community would be more effective but more costly than in-person examination. The findings raise the question of whether the benefits of pharmacy-based teleophthalmology in semiurban areas, where in-person examination is still available, are equivalent to those observed in remote communities. Further study is needed to investigate the impact of this program on the prevention of severe vision loss and quality of life in a semiurban setting.

Absence of Association between Cord Specific Antibody Levels and Severe Respiratory Syncytial Virus (RSV) Disease in Early Infants: A Case Control Study from Coastal Kenya.

PubMed

Nyiro, Joyce Uchi; Sande, Charles Jumba; Mutunga, Martin; Kiyuka, Patience Kerubo; Munywoki, Patrick Kioo; Scott, John Anthony G; Nokes, David James

2016-01-01

The target group for severe respiratory syncytial virus (RSV) disease prevention is infants under 6 months of age. Vaccine boosting of antibody titres in pregnant mothers could protect these young infants from severe respiratory syncytial virus (RSV) associated disease. Quantifying protective levels of RSV-specific maternal antibody at birth would inform vaccine development. A case control study nested in a birth cohort (2002-07) was conducted in Kilifi, Kenya; where 30 hospitalised cases of RSV-associated severe disease were matched to 60 controls. Participants had a cord blood and 2 subsequent 3-monthly blood samples assayed for RSV-specific neutralising antibody by the plaque reduction neutralisation test (PRNT). Two sample paired t test and conditional logistic regression were used in analyses of log2PRNT titres. The mean RSV log2PRNT titre at birth for cases and controls were not significantly different (P = 0.4) and remained so on age-stratification. Cord blood PRNT titres showed considerable overlap between cases and controls. The odds of RSV disease decreased with increase in log2PRNT cord blood titre. There was a 30% reduction in RSV disease per unit increase in log2PRNT titre (<3months age group) but not significant (P = 0.3). From this study, there is no strong evidence of protection by maternal RSV specific antibodies from severe RSV disease. Cord antibody levels show wide variation with considerable overlap between cases and controls. It is likely that, there are additional factors to specific PRNT antibody levels which determine susceptibility to severe RSV disease. In addition, higher levels of neutralizing antibody beyond the normal range may be required for protection; which it is hoped can be achieved by a maternal RSV vaccine.

Genetic Association and Gene-Gene Interaction Analyses in African American Dialysis Patients With Nondiabetic Nephropathy

PubMed Central

Bostrom, Meredith A.; Kao, W.H. Linda; Li, Man; Abboud, Hanna E.; Adler, Sharon G.; Iyengar, Sudha K.; Kimmel, Paul L.; Hanson, Robert L.; Nicholas, Susanne B.; Rasooly, Rebekah S.; Sedor, John R.; Coresh, Josef; Kohn, Orly F.; Leehey, David J.; Thornley-Brown, Denyse; Bottinger, Erwin P.; Lipkowitz, Michael S.; Meoni, Lucy A.; Klag, Michael J.; Lu, Lingyi; Hicks, Pamela J.; Langefeld, Carl D.; Parekh, Rulan S.; Bowden, Donald W.; Freedman, Barry I.

2011-01-01

Background African Americans (AAs) have increased susceptibility to non-diabetic nephropathy relative to European Americans. Study Design Follow-up of a pooled genome-wide association study (GWAS) in AA dialysis patients with nondiabetic nephropathy; novel gene-gene interaction analyses. Setting & Participants Wake Forest sample: 962 AA nondiabetic nephropathy cases; 931 non-nephropathy controls. Replication sample: 668 Family Investigation of Nephropathy and Diabetes (FIND) AA nondiabetic nephropathy cases; 804 non-nephropathy controls. Predictors Individual genotyping of top 1420 pooled GWAS-associated single nucleotide polymorphisms (SNPs) and 54 SNPs in six nephropathy susceptibility genes. Outcomes APOL1 genetic association and additional candidate susceptibility loci interacting with, or independently from, APOL1. Results The strongest GWAS associations included two non-coding APOL1 SNPs, rs2239785 (odds ratio [OR], 0.33; dominant; p = 5.9 × 10−24) and rs136148 (OR, 0.54; additive; p = 1.1 × 10−7) with replication in FIND (p = 5.0 × 10−21 and 1.9 × 10−05, respectively). Rs2239785 remained significantly associated after controlling for the APOL1 G1 and G2 coding variants. Additional top hits included a CFH SNP(OR from meta-analysis in above 3367 AA cases and controls, 0.81; additive; p = 6.8 × 10−4). The 1420 SNPs were tested for interaction with APOL1 G1 and G2 variants. Several interactive SNPs were detected, the most significant was rs16854341 in the podocin gene (NPHS2) (p = 0.0001). Limitations Non-pooled GWAS have not been performed in AA nondiabetic nephropathy. Conclusions This follow-up of a pooled GWAS provides additional and independent evidence that APOL1 variants contribute to nondiabetic nephropathy in AAs and identified additional associated and interactive non-diabetic nephropathy susceptibility genes. PMID:22119407

[Detection of heterogeneity and evolution of subclones in t(8;21) AML by QM-FISH].

PubMed

Wang, Ying-chan; Hu, Lin-ping; Lin, Dong; Li, Cheng-wen; Yuan, Tian; Jia, Yu-jiao; Tian, Zheng; Tang, Ke-jing; Wang, Min; Wang, Jian-xiang

2013-10-01

To explore the heterogeneous subclones in acute myeloid leukemia (AML) with t(8;21) by quantitative multicolor- fluorescence in situ hybridization (QM-FISH), and to figure out whether there is putative ancestral relationship among different subclones. Bacterial artificial chromosomes (BAC) clones that contain the targeted genes including AML1, ETO, WT1, p27 and c-kit were searched in the data base UCSC Genome Bioinformatics. Multicolor FISH probes were prepared by linking fluorescein labeled dUTP or dCTP to targeted genes by nick translation. Bone marrow mononuclear cells from t (8;21) AML patients are dropped on to the wet surface of glass slides after hypotonic treatment and fixation. After hybridization, the fluorescence signals were captured by Zeiss fluorescence microscope. The copy number of AML1, ETO, WT1, p27, c- kit and the AML1-ETO fusion gene in AML1-ETO positive cells was counted. The cells with same signals were defined as a subclone. Various subclones were recorded and their proportions were calculated, and their evolutionary relationship was deduced. The subclones in matched primary and relapsed samples were compared, the evolution of dominant clones were figured out and the genomic abnormality that is associated with relapse and drug resistance were speculated. In this study, 36 primary AML with t(8;21) cases and 1 relapsed case paired with the primary case were detected. In these 36 primary cases, 4 cases (11.1%) acquired additional AML1-ETO fusion signal, 3(8.3%) had additional AML1 signal, 4(11.1%) had additional ETO signal, 20(55.6%) had additional WT1 signal, 15(41.7%) had additional p27 signal and 14(38.9%) had additional c-kit signal. In addition, 10(27.8%) displayed AML1 signal deletion, and such an aberration represents statistic significance in male patients. It seems that male patients usually accompany AML1 signal deletion. Of 36 cases, 28(77.8 %) harbored at least 2 subclones (ranged from 2 to 10). According to the genetic signature of subclones, we can assemble a putative ancestral tree, and the genetic architecture is linear or branching. In particular, the clonal architecture of the relapsed sample exhibited significant clonal evolution compared to its paired sample at diagnosis, including proportion changes in dominant clone, subclone disappearance and appearance of new dominant clones. Genomic abnormality is very diverse in t(8;21) AML. Subclones have linear or complex branching evolutionary histories, and clonal architecture is dynamic.

Hospitalization Costs of Total Knee Arthroplasty With a Continuous Femoral Nerve Block Provided Only in the Hospital Versus on an Ambulatory Basis: A Retrospective, Case-Control, Cost-Minimization Analysis

PubMed Central

Ilfeld, Brian M.; Mariano, Edward R.; Williams, Brian A.; Woodard, Jennifer N.; Macario, Alex

2007-01-01

Background and Objectives Following total knee arthroplasty (TKA), hospitalization may be shortened by allowing patients to return home with a continuous femoral nerve block (CFNB). This study quantified the hospitalization costs for 10 TKA patients receiving ambulatory CFNB versus a matched cohort of 10 patients who received CFNB only during hospitalization. Methods We examined the medical records (n=125) of patients who underwent a unilateral, primary, tricompartment TKA with a postoperative CFNB by one surgeon at one institution in an 18-month period beginning January 2004. Each of the ten patients discharged home with an ambulatory CFNB (cases) was matched with a patient with a hospital-only CFNB (controls) for age, gender, body mass index, and health status. Financial data were extracted from the hospital micro-costing database. Results Nine patients with ambulatory CFNB (cases) were discharged home on postoperative day (POD) 1, and one on POD 4. Of the controls, 3 were discharged home on POD 3, 6 on POD 4, and 1 on POD 5. The median (range) costs of hospitalization (excluding implant and professional fees) was $5,292 (4,326 – 7,929) for ambulatory cases, compared with $7,974 (6,931 – 9,979) for inpatient controls (difference=$2,682, 34% decrease, P<0.001). The total charges for hospitalization, the implant, and professional fees was $33,646 (31,816 – 38,468) for cases, compared with $39,100 (36,096 – 44,098) for controls (difference=$5,454, 14% decrease, P<0.001). Conclusions This study provides evidence that ambulatory CFNB for selected patients undergoing TKA has the potential to reduce hospital length-of-stay and associated costs and charges. However, the current study has significant inherent limitations based on the study design. Additional research is required to replicate these results in a prospective, randomized, controlled trial and to determine whether any savings exceed additional CFNB costs such as from complications, having caregivers provide care at home, and additional hospital/health-care provider visits. PMID:17196492

Association of daily asthma emergency department visits and hospital admissions with ambient air pollutants among the pediatric Medicaid population in Detroit: time-series and time-stratified case-crossover analyses with threshold effects.

PubMed

Li, Shi; Batterman, Stuart; Wasilevich, Elizabeth; Wahl, Robert; Wirth, Julie; Su, Feng-Chiao; Mukherjee, Bhramar

2011-11-01

Asthma morbidity has been associated with ambient air pollutants in time-series and case-crossover studies. In such study designs, threshold effects of air pollutants on asthma outcomes have been relatively unexplored, which are of potential interest for exploring concentration-response relationships. This study analyzes daily data on the asthma morbidity experienced by the pediatric Medicaid population (ages 2-18 years) of Detroit, Michigan and concentrations of pollutants fine particles (PM2.5), CO, NO2 and SO2 for the 2004-2006 period, using both time-series and case-crossover designs. We use a simple, testable and readily implementable profile likelihood-based approach to estimate threshold parameters in both designs. Evidence of significant increases in daily acute asthma events was found for SO2 and PM2.5, and a significant threshold effect was estimated for PM2.5 at 13 and 11 μg m(-3) using generalized additive models and conditional logistic regression models, respectively. Stronger effect sizes above the threshold were typically noted compared to standard linear relationship, e.g., in the time series analysis, an interquartile range increase (9.2 μg m(-3)) in PM2.5 (5-day-moving average) had a risk ratio of 1.030 (95% CI: 1.001, 1.061) in the generalized additive models, and 1.066 (95% CI: 1.031, 1.102) in the threshold generalized additive models. The corresponding estimates for the case-crossover design were 1.039 (95% CI: 1.013, 1.066) in the conditional logistic regression, and 1.054 (95% CI: 1.023, 1.086) in the threshold conditional logistic regression. This study indicates that the associations of SO2 and PM2.5 concentrations with asthma emergency department visits and hospitalizations, as well as the estimated PM2.5 threshold were fairly consistent across time-series and case-crossover analyses, and suggests that effect estimates based on linear models (without thresholds) may underestimate the true risk. Copyright © 2011 Elsevier Inc. All rights reserved.

Postmortem audit in a paediatric cardiology unit.

PubMed Central

Russell, G A; Berry, P J

1989-01-01

Postmortem examinations performed on 76 children with a clinical diagnosis of congenital heart disease were reviewed retrospectively and compared with the findings before death. Both operated and unoperated cases were studied over a three year period. Despite intensive investigation during life, there was a high rate of unsuspected abnormalities at necropsy (80%): 29 cases had undiagnosed additional cardiac anomalies or surgical flaws, which contributed to death in 13 cases. Defects in surgery were uncommon but permitted modification in surgical technique to avoid recurrence. Myocardial necrosis and pulmonary foreign body embolism were common findings, the importance of which is uncertain and requires further study for their prevention. Even in the most thoroughly investigated cases postmortem examination has a high yield of clinically important pathology which is undetected during life. Images PMID:2794078

Evidence-Based Design for Project-Based Learning: A Case Study for a 50,000 SF Addition Dedicated to the New Tech Curriculum

ERIC Educational Resources Information Center

Moretti, Richard D.; Conte, Philip R.

2012-01-01

The Seaford School District, Seaford, Delaware, determined that a component of their "reinvention" of Seaford High School would be the creation of a New Tech Academy, affiliated with the New Tech Network and housed in an addition to that building. The New Tech Network, headquartered in Napa, California, is a rapidly growing association…

5 CFR 890.1039 - Cases where additional fact-finding is required.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Suspension § 890.1039 Cases where additional fact-finding is...

Surgical team proficiency in minimally invasive esophagectomy is related to case volume and improves patient outcomes.

PubMed

Okamura, Akihiko; Watanabe, Masayuki; Fukudome, Ian; Yamashita, Kotaro; Yuda, Masami; Hayami, Masaru; Imamura, Yu; Mine, Shinji

2018-04-01

Minimally invasive esophagectomy (MIE) is being increasingly performed; however, it is still associated with high morbidity and mortality. The correlation between surgical team proficiency and patient load lacks clarity. This study evaluates surgical outcomes during the first 3-year period after establishment of a new surgical team. A new surgical team was established in September 2013 by two expert surgeons having experience of performing more than 100 MIEs. We assessed 237 consecutive patients who underwent MIE for esophageal cancer and evaluated the impact of surgical team proficiency on postoperative outcomes, as well as the team learning curve. In the cumulative sum analysis, a point of downward inflection for operative time and blood loss was observed in case 175. After 175 cases, both operative time and blood loss significantly decreased (P < 0.001 and P < 0.001, respectively), and postoperative incidence of pneumonia significantly decreased from 18.9 to 6.5% (P = 0.024). Median postoperative hospital stay also decreased from 20 to 18 days (P = 0.022). Additionally, serum CRP levels on postoperative day 1 showed a significant, but weak inverse association with the number of cases (P = 0.024). After 175 cases, both operative time and blood loss significantly decreased. In addition, the incidence of pneumonia decreased significantly. Additionally, surgical team proficiency may decrease serum CRP levels immediately after MIE. Surgical team proficiency based on team experience had beneficial effects on patients undergoing MIE.

Lessons learned from additional research analyses of unsolved clinical exome cases.

PubMed

Eldomery, Mohammad K; Coban-Akdemir, Zeynep; Harel, Tamar; Rosenfeld, Jill A; Gambin, Tomasz; Stray-Pedersen, Asbjørg; Küry, Sébastien; Mercier, Sandra; Lessel, Davor; Denecke, Jonas; Wiszniewski, Wojciech; Penney, Samantha; Liu, Pengfei; Bi, Weimin; Lalani, Seema R; Schaaf, Christian P; Wangler, Michael F; Bacino, Carlos A; Lewis, Richard Alan; Potocki, Lorraine; Graham, Brett H; Belmont, John W; Scaglia, Fernando; Orange, Jordan S; Jhangiani, Shalini N; Chiang, Theodore; Doddapaneni, Harsha; Hu, Jianhong; Muzny, Donna M; Xia, Fan; Beaudet, Arthur L; Boerwinkle, Eric; Eng, Christine M; Plon, Sharon E; Sutton, V Reid; Gibbs, Richard A; Posey, Jennifer E; Yang, Yaping; Lupski, James R

2017-03-21

Given the rarity of most single-gene Mendelian disorders, concerted efforts of data exchange between clinical and scientific communities are critical to optimize molecular diagnosis and novel disease gene discovery. We designed and implemented protocols for the study of cases for which a plausible molecular diagnosis was not achieved in a clinical genomics diagnostic laboratory (i.e. unsolved clinical exomes). Such cases were recruited to a research laboratory for further analyses, in order to potentially: (1) accelerate novel disease gene discovery; (2) increase the molecular diagnostic yield of whole exome sequencing (WES); and (3) gain insight into the genetic mechanisms of disease. Pilot project data included 74 families, consisting mostly of parent-offspring trios. Analyses performed on a research basis employed both WES from additional family members and complementary bioinformatics approaches and protocols. Analysis of all possible modes of Mendelian inheritance, focusing on both single nucleotide variants (SNV) and copy number variant (CNV) alleles, yielded a likely contributory variant in 36% (27/74) of cases. If one includes candidate genes with variants identified within a single family, a potential contributory variant was identified in a total of ~51% (38/74) of cases enrolled in this pilot study. The molecular diagnosis was achieved in 30/63 trios (47.6%). Besides this, the analysis workflow yielded evidence for pathogenic variants in disease-associated genes in 4/6 singleton cases (66.6%), 1/1 multiplex family involving three affected siblings, and 3/4 (75%) quartet families. Both the analytical pipeline and the collaborative efforts between the diagnostic and research laboratories provided insights that allowed recent disease gene discoveries (PURA, TANGO2, EMC1, GNB5, ATAD3A, and MIPEP) and increased the number of novel genes, defined in this study as genes identified in more than one family (DHX30 and EBF3). An efficient genomics pipeline in which clinical sequencing in a diagnostic laboratory is followed by the detailed reanalysis of unsolved cases in a research environment, supplemented with WES data from additional family members, and subject to adjuvant bioinformatics analyses including relaxed variant filtering parameters in informatics pipelines, can enhance the molecular diagnostic yield and provide mechanistic insights into Mendelian disorders. Implementing these approaches requires collaborative clinical molecular diagnostic and research efforts.

A systematic review of occupational safety and health business cases.

PubMed

Verbeek, Jos; Pulliainen, Marjo; Kankaanpää, Eila

2009-12-01

Business cases are commonly developed as means to rationalize investment. We systematically reviewed 26 reported cases on occupational safety and health (OSH) interventions to assess if health and productivity arguments make a good business case. To be included in the review, studies had to analyze the costs and benefits, including productivity, of an OSH intervention at the enterprise level. We searched Medline and Embase for studies and used Google search in addition. Two reviewers independently selected studies and extracted data. The intervention profitability was calculated in euros (euro in 2008) as the first year's benefits minus the total intervention costs per worker. The payback period was calculated as the intervention costs divided by the first year's benefits. We found three ex-ante and 23 ex-post cases. In 20 cases, the study design was a before-after comparison without a control group. Generally a 100% reduction of injuries or sickness absence was assumed. In two cases, productivity and quality increases were very large. The main benefit was avoided sick leave. Depreciation or discounting was applied only in a minority of cases. The intervention profitability was negative in seven studies, up to euro 500 per employee in 12 studies and more than euro 500 per employee in seven studies. The payback period was less than half a year for 19 studies. Only a few studies included sensitivity analyses. Few ex-ante business cases for management decisions on OSH are reported. Guidelines for reporting and evaluation are needed. Business cases need more sound assumptions on the effectiveness of interventions and should incorporate greater uncertainty into their design. Ex-post evaluation should be based preferably on study designs that control for trends at a time different from that of the intervention.

Clinicopathologic analysis of 370 cases of vulvar intraepithelial neoplasia. Italian Study Group on Vulvar Disease.

PubMed

1996-09-01

To investigate epidemiologic, clinical and pathologic aspects of various grades of vulvar intraepithelial neoplasia (VIN). A retrospective, multicenter study of 370 cases of vulvar intraepithelial neoplasia (VIN) was performed by the Italian Study Group on Vulvar Disease. Of the 370 cases, 148 were VIN 1 (40.0%, 53 were VIN 2 (14.3%), and 169 were VIN 3 (45.7%). The mean age of the patients was 52.6 years. During the study period an increase in the rate of human papillomavirus-associated VIN was observed. In addition, while VIN 1 and 2 were associated mostly with squamous cell hyperplasia, VIN 3 was almost equally associated with lichen sclerosus and squamous cell hyperplasia; the difference was statistically significant. Intraepithelial or invasive squamous neoplasia of the lower genital tract was associated in 22% of the cases (82/370). The results of the investigation, although not allowing firm conclusions due to the retrospective and multicentered nature of the study, demonstrate the extreme heterogeneity of VIN lesions.

Maximum likelihood estimation for Cox's regression model under nested case-control sampling.

PubMed

Scheike, Thomas H; Juul, Anders

2004-04-01

Nested case-control sampling is designed to reduce the costs of large cohort studies. It is important to estimate the parameters of interest as efficiently as possible. We present a new maximum likelihood estimator (MLE) for nested case-control sampling in the context of Cox's proportional hazards model. The MLE is computed by the EM-algorithm, which is easy to implement in the proportional hazards setting. Standard errors are estimated by a numerical profile likelihood approach based on EM aided differentiation. The work was motivated by a nested case-control study that hypothesized that insulin-like growth factor I was associated with ischemic heart disease. The study was based on a population of 3784 Danes and 231 cases of ischemic heart disease where controls were matched on age and gender. We illustrate the use of the MLE for these data and show how the maximum likelihood framework can be used to obtain information additional to the relative risk estimates of covariates.

An 'inflammatory' variant of solar purpura: a simulant of leukocytoclastic vasculitis and neutrophilic dermatoses.

PubMed

Wood, Benjamin A; LeBoit, Philip E

2013-08-01

To study the clinical and pathological features of cases of apparent solar purpura, with attention to the recently described phenomenon of inflammatory changes within otherwise typical lesions. We studied 95 cases diagnosed as solar purpura and identified 10 cases (10.5%) in which significant neutrophilic inflammation was present, potentially simulating a leukocytoclastic vasculitis or neutrophilic dermatosis. An additional three cases were identified in subsequent routine practice. The clinical features, including follow-up for subsequent development of vasculitis and histological features were studied. In all cases the histological features were typical of solar purpura, with the exception of inflammatory changes, typically associated with clefting of elastotic stroma. Clinical follow-up information was available for all patients and none developed subsequent evidence of a cutaneous or systemic vasculitis or neutrophilic dermatosis. Inflammatory changes appear to be more frequent in solar purpura than is generally recognised. Awareness of this histological variation and correlation with the clinical findings and evolution is important in avoiding misdiagnosis.

The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) Study Protocol

PubMed Central

Woo, Daniel; Rosand, Jonathan; Kidwell, Chelsea; McCauley, Jacob L.; Osborne, Jennifer; Brown, Mark W.; West, Sandra E.; Rademacher, Eric W.; Waddy, Salina; Roberts, Jamie N.; Koch, Sebastian; Gonzales, Nicole R.; Sung, Gene; Kittner, Steven J.; Birnbaum, Lee; Frankel, Michael; Daniel Testai, Fernando; Hall, Christiana E.; Elkind, Mitchell S. V.; Flaherty, Matthew; Coull, Bruce; Chong, Ji Y.; Warwick, Tanya; Malkoff, Marc; James, Michael L.; Ali, Latisha K.; Worrall, Bradford B.; Jones, Floyd; Watson, Tiffany; Leonard, Anne; Martinez, Rebecca; Sacco, Ralph I; Langefeld, Carl D.

2013-01-01

Background and Purpose Epidemiologic studies of intracerebral hemorrhage (ICH) have consistently demonstrated variation in incidence, location, age at presentation, and outcomes among non-Hispanic white, black, and Hispanic populations. We report here the design and methods for this large, prospective, multi-center case-control study of ICH. Methods The ERICH study is a multi-center, prospective case-control study of ICH. Cases are identified by hot-pursuit and enrolled using standard phenotype and risk factor information and include neuroimaging and blood sample collection. Controls are centrally identified by random digit dialing to match cases by age (+/−5 years), race, ethnicity, gender and metropolitan region. Results As of March 22, 2013, 1,655 cases of ICH had been recruited into the study which is 101.5% of the target for that date and 851 controls had been recruited which is 67.2% of the target for that date (1,267 controls) for a total of 2,506 subjects which is 86.5% of the target for that date (2,897 subjects). Of the 1,655 cases enrolled, 1,640 cases had the case interview entered into the database of which 628 (38%) were non-Hispanic black, 458 (28%) were non-Hispanic white and 554 (34%) were Hispanic. Of the 1,197 cases with imaging submitted, 876 (73.2%) had a 24 hour follow-up CT available In addition to CT imaging, 607 cases have had MRI evaluation. Conclusion The ERICH study is a large, case-control study of ICH with particular emphasis on recruitment of minority populations for the identification of genetic and epidemiologic risk factors for ICH and outcomes after ICH. PMID:24021679

Systematic review of general thoracic surgery articles to identify predictors of operating room case durations.

PubMed

Dexter, Franklin; Dexter, Elisabeth U; Masursky, Danielle; Nussmeier, Nancy A

2008-04-01

Previous studies of operating room (OR) information systems data over the past two decades have shown how to predict case durations using the combination of scheduled procedure(s), individual surgeon and assistant(s), and type of anesthetic(s). We hypothesized that the accuracy of case duration prediction could be improved by the use of other electronic medical record data (e.g., patient weight or surgeon notes using standardized vocabularies). General thoracic surgery was used as a model specialty because much of its workload is elective (scheduled) and many of its cases are long. PubMed was searched for thoracic surgery papers reporting operative time, surgical time, etc. The systematic literature review identified 48 papers reporting statistically significant differences in perioperative times. There were multiple reports of differences in OR times based on the procedure(s), perioperative team including primary surgeon, and type of anesthetic, in that sequence of importance. All such detail may not be known when the case is originally scheduled and thus may require an updated duration the day before surgery. Although the use of these categorical data from OR systems can result in few historical data for estimating each case's duration, bias and imprecision of case duration estimates are unlikely to be affected. There was a report of a difference in case duration based on additional information. However, the incidence of the procedure for the diagnosis was so uncommon as to be unlikely to affect OR management. Matching findings of prior studies using OR information system data, multiple case series show that it is important to rely on the precise procedure(s), surgical team, and type of anesthetic when estimating case durations. OR information systems need to incorporate the statistical methods designed for small numbers of prior surgical cases. Future research should focus on the most effective methods to update the prediction of each case's duration as these data become available. The case series did not reveal additional data which could be cost-effectively integrated with OR information systems data to improve the accuracy of predicted durations for general thoracic surgery cases.

[Lack of association between MMR vaccination and the incidence of autism in children: a case-control study].

PubMed

Mrozek-Budzyn, Dorota; Kiełtyka, Agnieszka; Majewska, Renata

2009-01-01

The matched case-control study has been undertook to investigate whether measles, mumps, and rubella (MMR) vaccine may be casually associated with autism in children. Cases were children to 14-year old with diagnosis of core autism or atypical autism. Controls were matched on age, sex and general practice. The 96 cases and 192 controls were included. The study provides strong evidence against association of autism with both MMR and a single measles individual vaccine. Additionally children vaccinated with MMR, regardless of age of vaccination (to 18th, 24th and 36th month of life), had risk equal half of that of single measles vaccinated (for vaccinated to 18th month OR=0.41 95%PU: 0.20-0.85). Our findings confirm that MMR vaccination is not associated with an increased risk of autism in children.

A Simple Case Study of a Grid Performance System

NASA Technical Reports Server (NTRS)

Aydt, Ruth; Gunter, Dan; Quesnel, Darcy; Smith, Warren; Taylor, Valerie; Biegel, Bryan (Technical Monitor)

2001-01-01

This document presents a simple case study of a Grid performance system based on the Grid Monitoring Architecture (GMA) being developed by the Grid Forum Performance Working Group. It describes how the various system components would interact for a very basic monitoring scenario, and is intended to introduce people to the terminology and concepts presented in greater detail in other Working Group documents. We believe that by focusing on the simple case first, working group members can familiarize themselves with terminology and concepts, and productively join in the ongoing discussions of the group. In addition, prototype implementations of this basic scenario can be built to explore the feasibility of the proposed architecture and to expose possible shortcomings. Once the simple case is understood and agreed upon, complexities can be added incrementally as warranted by cases not addressed in the most basic implementation described here. Following the basic performance monitoring scenario discussion, unresolved issues are introduced for future discussion.

CHARACTERIZING SITE HYDROLOGY (REGION 5)

EPA Science Inventory

Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

Using Case Studies to Promote Student Engagement in Primary Literature Data Analysis and Evaluation

PubMed Central

Cook-Snyder, Denise R.

2017-01-01

Analyzing and evaluating primary literature data is a common learning objective in undergraduate neuroscience courses. However, students with more clinically focused career goals often dismiss the relevance of evaluating basic neuroscience literature. Here, we describe using case studies to promote student engagement in primary literature in a cellular and molecular neuroscience course. Two example literature-based case studies are provided: Untwisting Pretzel Syndrome, a neurodevelopment case exploring synapse formation in a pretzel syndrome patient, and The Trials of ALS, a neurodegeneration case exploring axon degeneration and repair in an amyotrophic lateral sclerosis patient. These cases were assigned after neurodevelopment and neurodegeneration lectures covering key concepts. Both cases begin by introducing the patient and hypothesizing symptoms and diagnoses, followed by scenes incorporating primary data to illustrate disease pathogenesis and treatments. Students complete questions embedded in these cases as homework, and class time is used to discuss their answers. Discussion emphasizes that there can be multiple “correct” answers, and the best answers are accurate and well-supported. Accordingly, students edit their answers in class, and these annotations are factored into a pass/fail grade on the case. Additional scenes and questions from the same case studies are used on the course’s take-home exams, thereby allowing students to practice primary data analysis and evaluation before a graded assignment. Student evaluations support literature-based case studies as an effective learning tool, with students identifying cases as the most valuable aspect of the course, and reporting increased confidence in understanding cellular and molecular neuroscience. PMID:29371850

Using Case Studies to Promote Student Engagement in Primary Literature Data Analysis and Evaluation.

PubMed

Cook-Snyder, Denise R

2017-01-01

Analyzing and evaluating primary literature data is a common learning objective in undergraduate neuroscience courses. However, students with more clinically focused career goals often dismiss the relevance of evaluating basic neuroscience literature. Here, we describe using case studies to promote student engagement in primary literature in a cellular and molecular neuroscience course. Two example literature-based case studies are provided: Untwisting Pretzel Syndrome, a neurodevelopment case exploring synapse formation in a pretzel syndrome patient, and The Trials of ALS, a neurodegeneration case exploring axon degeneration and repair in an amyotrophic lateral sclerosis patient. These cases were assigned after neurodevelopment and neurodegeneration lectures covering key concepts. Both cases begin by introducing the patient and hypothesizing symptoms and diagnoses, followed by scenes incorporating primary data to illustrate disease pathogenesis and treatments. Students complete questions embedded in these cases as homework, and class time is used to discuss their answers. Discussion emphasizes that there can be multiple "correct" answers, and the best answers are accurate and well-supported. Accordingly, students edit their answers in class, and these annotations are factored into a pass/fail grade on the case. Additional scenes and questions from the same case studies are used on the course's take-home exams, thereby allowing students to practice primary data analysis and evaluation before a graded assignment. Student evaluations support literature-based case studies as an effective learning tool, with students identifying cases as the most valuable aspect of the course, and reporting increased confidence in understanding cellular and molecular neuroscience.

The effects of Medicaid reimbursement method and ownership on nursing home costs, case mix, and staffing.

PubMed

Cohen, J W; Dubay, L C

1990-01-01

In this study we analyze the effects of ownership and Medicaid cost containment initiatives on nursing home costs, payer mix, case mix, and staffing, using 1981 Medicare cost reports and Medicare/Medicaid Automated Certification files. As Medicaid cost containment incentives become stronger, nursing homes respond by decreasing case mix and commensurately decreasing staffing. When these incentives are especially strong, staffing is reduced beyond the apparently appropriate level, given the case mix. In addition, while chain facilities have lower costs than other types of facilities, these lower costs do not appear to come from either increased cream-skimming or reduced staffing levels.

Changes in enzyme activity and functional diversity in soil induced by Cd and glucose addition

NASA Astrophysics Data System (ADS)

Gilmullina, A. R.; Galitskaya, P. Yu; Selivanovskaya, S. Yu

2018-01-01

Toxic heavy metal (HM) contamination is a major global issue as it may have an indirect effect on the health of soil, plants, animals and, consequently, on human health. Agricultural soils’ fertilization is one of the reported sources of HM pollution in the world. In this case simultaneous input of stimulating and inhibiting agents into soil takes place, and effects of the combined influence of these agents is hardly predictable. In this study, a simultaneous inhibiting and stimulating effect of Cd and glucose on soil microbes was studied in a model experiment. Enzyme activities (phosphatase, β-glucosidase and cellobiohydrolase) and functional diversity (BIOLOG®EcoPlates ™) were assessed as a test functions. Cd (300 μg Cd g-1 ) amendment had a negative effect only on phosphatase activity. Glucose (3 mg C g-1) addition inhibited β-glucosidase activity and stimulated functional diversity. In joint addition of Cd and Glucose the leading effect belonged to that agent which had the greatest effect in case when it was added separately.

NATO’s Preparedness for Cyberwar

DTIC Science & Technology

2016-09-01

ARTS IN SECURITY STUDIES EUROPE AND EURASIA from the NAVAL POSTGRADUATE SCHOOL September 2016 Approved by: David Yost, Ph.D...CYBER CASE STUDIES : CYBER ATTACKS AGAINST NATO ALLIES AND PARTNERS .................................................................................33...to thank Dr. Wade Huntley for first stimulating my interest in the academic study of NATO’s cyberwarfare capabilities and readiness. In addition, I

Meta-Analysis of Behavioral Self-Management Interventions in Single-Case Research

ERIC Educational Resources Information Center

Briesch, Amy M.; Briesch, Jacquelyn M.

2016-01-01

The current study meta-analyzed 47 single-subject studies of behavioral self-management interventions that were published between 1971 and 2011. In addition to obtaining an overall measure of effect across all self-management studies (f = 0.93), analyses were conducted to assess whether treatment effectiveness was moderated by factors such as…

Writing Projects and Writing Instruction: A Study of Teacher Change.

ERIC Educational Resources Information Center

Wilson, David E.

To examine the ways in which participation in the Iowa Writing Project influenced secondary English language arts teachers, a study surveyed and interviewed teachers who participated in the 1982 and 1985 Iowa Writing Project about their beliefs and practices concerning writing instruction. In addition, case studies and over 70 hours of classroom…

Australian Institute of Aboriginal Studies; Catalogue of Tape Archive No. 7.

ERIC Educational Resources Information Center

Australian Inst. of Aboriginal Studies, Canberra.

Entries in this aboriginal studies catalogue are listed under language/tribe and subject indexes, and include linguistic studies, myths and stories, songs and dances, songs and music, and speech. Language/tribe headings are from the Institute's Preliminary Tribal Index. Summaries are brief, but in most cases, additional information is available…

Whole exome sequencing identifies genetic variants in inherited thrombocytopenia with secondary qualitative function defects

PubMed Central

Johnson, Ben; Lowe, Gillian C.; Futterer, Jane; Lordkipanidzé, Marie; MacDonald, David; Simpson, Michael A.; Sanchez-Guiú, Isabel; Drake, Sian; Bem, Danai; Leo, Vincenzo; Fletcher, Sarah J.; Dawood, Ban; Rivera, José; Allsup, David; Biss, Tina; Bolton-Maggs, Paula HB; Collins, Peter; Curry, Nicola; Grimley, Charlotte; James, Beki; Makris, Mike; Motwani, Jayashree; Pavord, Sue; Talks, Katherine; Thachil, Jecko; Wilde, Jonathan; Williams, Mike; Harrison, Paul; Gissen, Paul; Mundell, Stuart; Mumford, Andrew; Daly, Martina E.; Watson, Steve P.; Morgan, Neil V.

2016-01-01

Inherited thrombocytopenias are a heterogeneous group of disorders characterized by abnormally low platelet counts which can be associated with abnormal bleeding. Next-generation sequencing has previously been employed in these disorders for the confirmation of suspected genetic abnormalities, and more recently in the discovery of novel disease-causing genes. However its full potential has not yet been exploited. Over the past 6 years we have sequenced the exomes from 55 patients, including 37 index cases and 18 additional family members, all of whom were recruited to the UK Genotyping and Phenotyping of Platelets study. All patients had inherited or sustained thrombocytopenia of unknown etiology with platelet counts varying from 11×109/L to 186×109/L. Of the 51 patients phenotypically tested, 37 (73%), had an additional secondary qualitative platelet defect. Using whole exome sequencing analysis we have identified “pathogenic” or “likely pathogenic” variants in 46% (17/37) of our index patients with thrombocytopenia. In addition, we report variants of uncertain significance in 12 index cases, including novel candidate genetic variants in previously unreported genes in four index cases. These results demonstrate that whole exome sequencing is an efficient method for elucidating potential pathogenic genetic variants in inherited thrombocytopenia. Whole exome sequencing also has the added benefit of discovering potentially pathogenic genetic variants for further study in novel genes not previously implicated in inherited thrombocytopenia. PMID:27479822

Evaluation of ALK rearrangement in Chinese non-small cell lung cancer using FISH, immunohistochemistry, and real-time quantitative RT- PCR on paraffin-embedded tissues.

PubMed

Zhang, Yun-Gang; Jin, Mu-Lan; Li, Li; Zhao, Hong-Ying; Zeng, Xuan; Jiang, Lei; Wei, Ping; Diao, Xiao-Li; Li, Xue; Cao, Qing; Tian, Xin-Xia

2013-01-01

Patients with ALK gene rearrangements often manifest dramatic responses to crizotinib, an ALK inhibitor. Accurate identification of patients with ALK-positive non-small cell lung cancer (NSCLC) is essential for the clinical application of ALK-targeted therapy. However, assessing EML4-ALK rearrangement in NSCLC remains challenging in routine pathology practice. The aim of this study was to compare the diagnostic accuracy of FISH, immunohistochemistry (IHC), and real-time quantitative RT-PCR (QPCR) methodologies for detection of EML4-ALK rearrangement in NSCLC and to appraise immunohistochemistry as a pre-screening tool. In this study, a total of 473 paraffin-embedded NSCLC samples from surgical resections and biopsies were analyzed by IHC with ALK antibody. ALK rearrangement was further confirmed by FISH and QPCR. ALK protein expression was detected in twenty patients (20/473, 4.2%). Of the 20 ALK-positive cases by IHC, 15 cases were further confirmed as ALK rearrangement by FISH, and 5 cases were not interpretable. Also, we evaluated 13 out of the 20 IHC-positive tissues by QPCR in additional to FISH, and found that 9 cases were positive and 2 cases were equivocal, whereas 2 cases were negative although they were positive by both IHC and FISH. The ALK status was concordant in 5 out of 8 cases that were interpretable by three methods. Additionally, none of the 110 IHC-negative cases with adenocarcinoma histology showed ALK rearrangements by FISH. Histologically, almost all the ALK-rearranged cases were adenocarcinoma, except that one case was sarcomatoid carcinoma. A solid signet-ring cell pattern or mucinous cribriform pattern was presented at least focally in all ALK-positive tumors. In conclusion, our findings suggested that ALK rearrangement was associated with ALK protein expression. The conventional IHC assay is a valuable tool for the pre-screening of patients with ALK rearrangement in clinical practice and a combination of FISH and QPCR is required for further confirmation.

On estimation of time-dependent attributable fraction from population-based case-control studies.

PubMed

Zhao, Wei; Chen, Ying Qing; Hsu, Li

2017-09-01

Population attributable fraction (PAF) is widely used to quantify the disease burden associated with a modifiable exposure in a population. It has been extended to a time-varying measure that provides additional information on when and how the exposure's impact varies over time for cohort studies. However, there is no estimation procedure for PAF using data that are collected from population-based case-control studies, which, because of time and cost efficiency, are commonly used for studying genetic and environmental risk factors of disease incidences. In this article, we show that time-varying PAF is identifiable from a case-control study and develop a novel estimator of PAF. Our estimator combines odds ratio estimates from logistic regression models and density estimates of the risk factor distribution conditional on failure times in cases from a kernel smoother. The proposed estimator is shown to be consistent and asymptotically normal with asymptotic variance that can be estimated empirically from the data. Simulation studies demonstrate that the proposed estimator performs well in finite sample sizes. Finally, the method is illustrated by a population-based case-control study of colorectal cancer. © 2017, The International Biometric Society.

Association between rs3087243 and rs231775 polymorphism within the cytotoxic T-lymphocyte antigen 4 gene and Graves' disease: a case/control study combined with meta-analyses

PubMed Central

Dai, Yu; Zeng, Tianshu; Xiao, Fei; Chen, Lulu; Kong, Wen

2017-01-01

We conducted a case/control study to assess the impact of SNP rs3087243 and rs231775 within the CTLA4 gene, on the susceptibility to Graves' disease (GD) in a Chinese Han dataset (271 cases and 298 controls). The frequency of G allele for rs3087243 and rs231775 was observed to be significantly higher in subjects with GD than in control subjects (p = 0.005 and p = 0.000, respectively). After logistic regression analysis, a significant association was detected between SNP rs3087243 and GD in the additive and recessive models. Similarly, association for the SNP rs231775 could also be detected in the additive model, dominant model and recessive model. A meta-analysis, including 27 published datasets along with the current dataset, was performed to further confirm the association. Consistent with our case/control results, rs3087243 and rs231775 showed a significant association with GD in all genetic models. Of note, ethnic stratification revealed that these two SNPs were associated with susceptibility to GD in populations of both Asian and European descent. In conclusion, our data support that the rs3087243 and rs231775 polymorphisms within the CTLA4 gene confer genetic susceptibility to GD. PMID:29299173

Awareness and uptake of direct-to-consumer genetic testing among cancer cases, their relatives, and controls: the Northwest Cancer Genetics Network.

PubMed

Hall, Taryn O; Renz, Anne D; Snapinn, Katherine W; Bowen, Deborah J; Edwards, Karen L

2012-07-01

To determine if awareness of, interest in, and use of direct-to-consumer (DTC) genetic testing is greater in a sample of high-risk individuals (cancer cases and their relatives), compared to controls. Participants were recruited from the Northwest Cancer Genetics Network. A follow-up survey was mailed to participants to assess DTC genetic testing awareness, interest, and use. One thousand two hundred sixty-seven participants responded to the survey. Forty-nine percent of respondents were aware of DTC genetic testing. Of those aware, 19% indicated interest in obtaining and <1% reported having used DTC genetic testing. Additional information supplied by respondents who reported use of DTC genetic tests indicated that 55% of these respondents likely engaged in clinical genetic testing, rather than DTC genetic testing. Awareness of DTC genetic testing was greater in our sample of high-risk individuals than in controls and population-based studies. Although interest in and use of these tests among cases in our sample were equivalent to other population-based studies, interest in testing was higher among relatives and people who self-referred for a registry focused on cancer than among cases and controls. Additionally, our results suggest that there may be some confusion about what constitutes DTC genetic testing.

Posterior fossa anomalies diagnosed with fetal MRI: associated anomalies and neurodevelopmental outcomes.

PubMed

Patek, Kyla J; Kline-Fath, Beth M; Hopkin, Robert J; Pilipenko, Valentina V; Crombleholme, Timothy M; Spaeth, Christine G

2012-01-01

The purpose of this study was to describe the relationship between intracranial and extracranial anomalies and neurodevelopmental outcome for fetuses diagnosed with a posterior fossa anomaly (PFA) on fetal MRI. Cases of Dandy-Walker malformation, vermian hypogenesis/hypoplasia, and mega cisterna magna (MCM) were identified through the Fetal Care Center of Cincinnati between January 2004 and December 2010. Parental interview and retrospective chart review were used to assess neurodevelopmental outcome. Posterior fossa anomalies were identified in 59 fetuses; 9 with Dandy-Walker malformation, 36 with vermian hypogenesis/hypoplasia, and 14 with MCM. Cases with isolated PFAs (14/59) had better outcomes than those with additional anomalies (p = 0.00016), with isolated cases of MCM all being neurodevelopmentally normal. Cases with additional intracranial anomalies had a worse outcome than those without intracranial anomalies (p = 0.00017). The presence of extracranial anomalies increased the likelihood of having a poor outcome (p = 0.00014) as did the identification of an abnormal brainstem (p = 0.00018). Intracranial and extracranial anomalies were good predictors of neurodevelopmental outcome in this study. The prognosis was poor for individuals with an abnormal brainstem, whereas those with isolated MCM had normal neurodevelopmental outcome. © 2012 John Wiley & Sons, Ltd.

Office of Exploration: Exploration studies technical report. Volume 2: Studies approach and results

NASA Technical Reports Server (NTRS)

Roberts, Barney B.; Bland, Dan

1988-01-01

The NASA Office of Exploration has been tasked with defining and recommending alternatives for an early 1990's national decision on a focused program of human exploration of the solar system. The Mission Analysis and System Engineering (MASE) group, which is managed by the Exploration Studies Office at the Johnson Space Center, is responsible for coordinating the technical studies necessary for accomplishing such a task. This technical report describes the process that has been developed in a case study approach. The four case studies that were developed in FY88 include: (1) human expedition to Phobos; (2) human expeditions to Mars; (3) lunar observatory; and (4) lunar outpost to early Mars evolution. The final outcome of this effort is a set of programmatic and technical conclusions and recommendations for the following year's work. Volume 2 describes the case study process, the technical results of each of the case studies, and opportunities for additional study. Included in the discussion of each case study is a description of the mission key features and profile. Mission definition and manifesting are detailed, followed by a description of the mission architecture and infrastructure. Systems concepts for the required orbital nodes, transportation systems, and planetary surface systems are discussed. Prerequisite implementation plans resulting from the synthesized case studies are described and in-depth assessments are presented.

The impact of FDG-PET/CT in the management of patients with vulvar and vaginal cancer.

PubMed

Robertson, N L; Hricak, H; Sonoda, Y; Sosa, R E; Benz, M; Lyons, G; Abu-Rustum, N R; Sala, E; Vargas, H A

2016-03-01

To evaluate the changes in prognostic impression and patient management following PET/CT in patients with vulvar and vaginal carcinoma; and to compare PET/CT findings with those of conventional imaging modalities. We summarized prospectively and retrospectively collected data for 50 consecutive patients from our institution that enrolled in the National Oncologic PET Registry and underwent FDG-PET/CT for a suspected or known primary or recurrent vulvar/vaginal cancer. 54/83 (65%) studies included had a diagnosis of vulvar cancer, and the remaining 29/83 (35%), a diagnosis of vaginal cancer. Following FDG-PET/CT, the physician's prognostic impression changed in 51% of cases. A change in patient management, defined as a change to/from a non-interventional strategy (observation or additional imaging), to/from an interventional strategy (biopsy or treatment), was documented in 36% of studies. The electronic records demonstrated that 95% of the management strategies recorded in the physician questionnaires were implemented as planned. MRI and/or CT were performed within one month of the FDG-PET/CT in 20/83 (24%) and 28/83 (34%) cases, respectively. FDG-PET/CT detected nodes suspicious for metastases on 29/83 (35%) studies performed. MRI and CT detected positive nodes on 6 and 11 studies respectively. Distant metastases were identified in 10 cases imaged with FDG-PET and 5 cases that had additional conventional CT imaging. All suspicious lesions seen on CT were positively identified on PET/CT. In 4 cases, an abnormality identified on PET/CT, was not seen on diagnostic CT. FDG-PET/CT may play an important role in the management of vulvar and vaginal carcinoma. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparison of exposure assessment methods in a lung cancer case-control study: performance of a lifelong task-based questionnaire for asbestos and PAHs.

PubMed

Bourgkard, Eve; Wild, Pascal; Gonzalez, Maria; Févotte, Joëlle; Penven, Emmanuelle; Paris, Christophe

2013-12-01

To describe the performance of a lifelong task-based questionnaire (TBQ) in estimating exposures compared with other approaches in the context of a case-control study. A sample of 93 subjects was randomly selected from a lung cancer case-control study corresponding to 497 jobs. For each job, exposure assessments for asbestos and polycyclic aromatic hydrocarbons (PAHs) were obtained by expertise (TBQ expertise) and by algorithm using the TBQ (TBQ algorithm) as well as by expert appraisals based on all available occupational data (REFERENCE expertise) considered to be the gold standard. Additionally, a Job Exposure Matrix (JEM)-based evaluation for asbestos was also obtained. On the 497 jobs, the various evaluations were contrasted using Cohen's κ coefficient of agreement. Additionally, on the total case-control population, the asbestos dose-response relationship based on the TBQ algorithm was compared with the JEM-based assessment. Regarding asbestos, the TBQ-exposure estimates agreed well with the REFERENCE estimate (TBQ expertise: level-weighted κ (lwk)=0.68; TBQ algorithm: lwk=0.61) but less so with the JEM estimate (TBQ expertise: lwk=0.31; TBQ algorithm: lwk=0.26). Regarding PAHs, the agreements between REFERENCE expertise and TBQ were less good (TBQ expertise: lwk=0.43; TBQ algorithm: lwk=0.36). In the case-control study analysis, the dose-response relationship between lung cancer and cumulative asbestos based on the JEM is less steep than with the TBQ-algorithm exposure assessment and statistically non-significant. Asbestos-exposure estimates based on the TBQ were consistent with the REFERENCE expertise and yielded a steeper dose-response relationship than the JEM. For PAHs, results were less clear.

5 CFR 890.1027 - Cases where an additional fact-finding proceeding is required.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1027 Cases where an additional...

5 CFR 890.1037 - Cases where additional fact-finding is not required.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Suspension § 890.1037 Cases where additional fact-finding is...

26 CFR 1.612-2 - Allowable capital additions in case of mines.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 7 2011-04-01 2009-04-01 true Allowable capital additions in case of mines. 1.612-2 Section 1.612-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Natural Resources § 1.612-2 Allowable capital additions...

A Case Study of the Impact of Guided Reading Groups in Second Grade on Comprehension Improvement

ERIC Educational Resources Information Center

Lorent Deegan, Chanin E.

2010-01-01

This study combined both qualitative and quantitative research to determine the impact of instructional practices on comprehension improvement in second grade Guided Reading groups. Four second grade teachers and their 73 students ages seven through eight years old participated in this study. Additionally, the study examined the effects of Guided…

Measles: effect of a two-dose vaccination programme in Catalonia, Spain.

PubMed Central

Godoy, P.; Domínguez, A.; Salleras, L.

1999-01-01

The study reports incidences of measles in Catalonia, Spain, as detected by surveillance, and analyses the specific characteristics of the outbreaks reported for the period 1986-95. Incidences per 100,000 inhabitants were calculated for the period 1971-95. The following variables were studied: year of presentation, number of cases, median age, transmission setting, cases with a record of vaccination and preventable cases. Associations between variables were determined using odds ratios (OR). The incidence of measles declined from 306.3 cases in 1971 to 30.9 in 1995. A total of 50 outbreaks were investigated. The outbreaks that occurred in the last two years of the study had a higher likelihood of having a transmission setting other than primary school (OR = 3.9); a median case age > 10 years (OR = 7.2); and fewer than 6 cases (OR = 2.3). The characteristics of recent outbreaks, marked by a rise both in transmission outside the primary-school setting and in median age, indicate the need for the introduction of a specific vaccination programme at the end of adolescence in addition to control of school-related outbreaks. PMID:10083711

Histological features associated with diagnostic agreement in atypical ductal hyperplasia of the breast: illustrative cases from the B-Path study.

PubMed

Allison, Kimberly H; Rendi, Mara H; Peacock, Sue; Morgan, Tom; Elmore, Joann G; Weaver, Donald L

2016-12-01

This study examined the case-specific characteristics associated with interobserver diagnostic agreement in atypical ductal hyperplasia (ADH) of the breast. Seventy-two test set cases with a consensus diagnosis of ADH from the B-Path study were evaluated. Cases were scored for 17 histological features, which were then correlated with the participant agreement with the consensus ADH diagnosis. Participating pathologists' perceptions of case difficulty, borderline features or whether they would obtain a second opinion were also examined for associations with agreement. Of the 2070 participant interpretations of the 72 consensus ADH cases, 48% were scored by participants as difficult and 45% as borderline between two diagnoses; the presence of both of these features was significantly associated with increased agreement (P < 0.001). A second opinion would have been obtained in 80% of interpretations, and this was associated with increased agreement (P < 0.001). Diagnostic agreement ranged from 10% to 89% on a case-by-case basis. Cases with papillary lesions, cribriform architecture and obvious cytological monotony were associated with higher agreement. Lower agreement rates were associated with solid or micropapillary architecture, borderline cytological monotony, or cases without a diagnostic area that was obvious on low power. The results of this study suggest that pathologists frequently recognize the challenge of ADH cases, with some cases being more prone to diagnostic variability. In addition, there are specific histological features associated with diagnostic agreement on ADH cases. Multiple example images from cases in this test set are provided to serve as educational illustrations of these challenges. © 2016 John Wiley & Sons Ltd.

Outline of cost-benefit analysis and a case study

NASA Technical Reports Server (NTRS)

Kellizy, A.

1978-01-01

The methodology of cost-benefit analysis is reviewed and a case study involving solar cell technology is presented. Emphasis is placed on simplifying the technique in order to permit a technical person not trained in economics to undertake a cost-benefit study comparing alternative approaches to a given problem. The role of economic analysis in management decision making is discussed. In simplifying the methodology it was necessary to restrict the scope and applicability of this report. Additional considerations and constraints are outlined. Examples are worked out to demonstrate the principles. A computer program which performs the computational aspects appears in the appendix.

Symptomatic Meckel's diverticulum in newborn: two interesting additional cases and review of literature.

PubMed

Bertozzi, Mirko; Melissa, Berardino; Radicioni, Maurizio; Magrini, Elisa; Appignani, Antonino

2013-09-01

This study aimed to review the literature about symptomatic Meckel's diverticulum (MD) in the neonatal period with 2 additional uncommon cases. The authors describe 2 interesting neonatal cases of symptomatic MD and analyze the literature on this topic, with particular reference to the prevalence of sex, age at presentation, most common signs and symptoms, treatment, histology, associated anomalies, and outcome. The first patient was a term newborn with bowel obstruction by a pseudocystic MD. The second patient was a preterm infant with double perforation of the MD and ileum. Literature search for published case reports and case series on this topic reveals only 18 cases of neonatal symptomatic MD. Males are more frequently involved than females, and even preterm infants may be affected. Bowel obstruction (58.3%) and pneumoperitoneum (33.3%) are the most frequent clinical manifestation. Acute inflammation of the MD is the prominent histopathological finding (75%), although it does not seem to be related with the presence of heterotopic tissue within the MD. Surgical treatment is essential. The association of neonatal symptomatic MD with other anomalies is exceptional but is otherwise life threatening despite surgery. Bowel obstruction and pneumoperitoneum are the most frequent clinical manifestations of symptomatic MD in the newborn. Surgery is required for a definitive diagnosis and successful outcome.

Renoprotective effects of thiazides combined with loop diuretics in patients with type 2 diabetic kidney disease.

PubMed

Hoshino, Taro; Ookawara, Susumu; Miyazawa, Haruhisa; Ito, Kiyonori; Ueda, Yuichiro; Kaku, Yoshio; Hirai, Keiji; Mori, Honami; Yoshida, Izumi; Tabei, Kaoru

2015-04-01

Type 2 diabetic kidney disease (DKD) is frequently accompanied by uncontrollable hypertension due to the sodium sensitivity inherent in DKD and to diuretic-resistant edema. In general, diuretics are effective in treating this condition, but thiazide diuretics are thought to be innocuous in advanced chronic kidney disease (CKD). We examined the renoprotective effects of combination therapy with thiazides and loop diuretics in type 2 DKD patients with CKD stage G4 or G5. This study included 11 patients with type 2 DKD and an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m(2) who were suffering from severe edema even with loop diuretics. Each patient received additional hydrochlorothiazide (HCTZ) therapy, which was continued for more than 12 months. We examined clinical parameters including blood pressure (BP), proteinuria, and eGFR before and after the addition of HCTZ. Patients received a 13.6 ± 3.8 mg/day dose of HCTZ in addition to loop diuretics (azosemide: 120 mg/day in 6 cases, 60 mg/day in 3 cases and furosemide: 80 mg/day in 1 case, 120 mg/day in 1 case). Side effects of HCTZ were not observed in all patients. After the addition of HCTZ therapy, systolic and diastolic blood pressures (S-BP, D-BP) as well as proteinuria significantly decreased (S-BP: at 6 months, p < 0.05 and 12 months, p < 0.01 vs. 0 month, D-BP: at 12 months, p < 0.05 vs. 0 month, proteinuria: at 6 months, p < 0.05 and 12 months, p < 0.01 vs. 0 month). The annual decline in eGFR was not significantly different before and after HCTZ therapy (-7.7 ± 8.5 and -8.4 ± 4.8 mL/min/1.73 m(2)/year, respectively). Our findings suggest that the combination of HCTZ and loop diuretics improves BP levels, and decreases proteinuria even in advanced stage type 2 DKD patients with severe edema. The addition of HCTZ therapy was not found to negatively affect the change in eGFR in the present study.

Modelling Long Term Disability following Injury: Comparison of Three Approaches for Handling Multiple Injuries

PubMed Central

Gabbe, Belinda J.; Harrison, James E.; Lyons, Ronan A.; Jolley, Damien

2011-01-01

Background Injury is a leading cause of the global burden of disease (GBD). Estimates of non-fatal injury burden have been limited by a paucity of empirical outcomes data. This study aimed to (i) establish the 12-month disability associated with each GBD 2010 injury health state, and (ii) compare approaches to modelling the impact of multiple injury health states on disability as measured by the Glasgow Outcome Scale – Extended (GOS-E). Methods 12-month functional outcomes for 11,337 survivors to hospital discharge were drawn from the Victorian State Trauma Registry and the Victorian Orthopaedic Trauma Outcomes Registry. ICD-10 diagnosis codes were mapped to the GBD 2010 injury health states. Cases with a GOS-E score >6 were defined as “recovered.” A split dataset approach was used. Cases were randomly assigned to development or test datasets. Probability of recovery for each health state was calculated using the development dataset. Three logistic regression models were evaluated: a) additive, multivariable; b) “worst injury;” and c) multiplicative. Models were adjusted for age and comorbidity and investigated for discrimination and calibration. Findings A single injury health state was recorded for 46% of cases (1–16 health states per case). The additive (C-statistic 0.70, 95% CI: 0.69, 0.71) and “worst injury” (C-statistic 0.70; 95% CI: 0.68, 0.71) models demonstrated higher discrimination than the multiplicative (C-statistic 0.68; 95% CI: 0.67, 0.70) model. The additive and “worst injury” models demonstrated acceptable calibration. Conclusions The majority of patients survived with persisting disability at 12-months, highlighting the importance of improving estimates of non-fatal injury burden. Additive and “worst” injury models performed similarly. GBD 2010 injury states were moderately predictive of recovery 1-year post-injury. Further evaluation using additional measures of health status and functioning and comparison with the GBD 2010 disability weights will be needed to optimise injury states for future GBD studies. PMID:21984951

Quality assurance study of caries risk assessment performance by clinical faculty members in a school of dentistry.

PubMed

Rechmann, Peter; Featherstone, John D B

2014-09-01

The goal of this quality assurance study was to explore the decision making of clinical faculty members at the University of California, San Francisco School of Dentistry predoctoral dental clinic in terms of caries risk level assignment using the caries risk assessment (CRA) as part of the Caries Management by Risk Assessment (CAMBRA) concept. This research was done in part to determine if additional training and calibration were needed for these faculty members. The study tested the reliability and reproducibility of the caries risk levels assigned by different clinical teachers who completed CRA forms for simulated patients. In the first step, five clinical teachers assigned caries risk levels for thirteen simulated patients. Six months later, the same five plus an additional nine faculty members assigned caries risk levels to the same thirteen simulated and nine additional cases. While the intra-examiner reliability with weighted kappa strength of agreement was very high, the inter-examiner agreements with a gold standard were on average only moderate. In total, 20 percent of the presented high caries risk cases were underestimated at caries levels too low, even when obvious caries disease indicators were present. This study suggests that more consistent training and calibration of clinical faculty members as well as students are needed.

Secondary School Students' Understanding of Science and Their Socioscientific Reasoning

NASA Astrophysics Data System (ADS)

Karahan, Engin; Roehrig, Gillian

2017-08-01

Research in socioscientific issue (SSI)-based interventions is relatively new (Sadler in Journal of Research in Science Teaching 41:513-536, 2004; Zeidler et al. in Journal of Research in Science Teaching 46:74-101, 2009), and there is a need for understanding more about the effects of SSI-based learning environments (Sadler in Journal of Research in Science Teaching 41:513-536, 2004). Lee and Witz (International Journal of Science Education 31:931-960, 2009) highlighted the need for detailed case studies that would focus on how students respond to teachers' practices of teaching SSI. This study presents case studies that investigated the development of secondary school students' science understanding and their socioscientific reasoning within SSI-based learning environments. A multiple case study with embedded units of analysis was implemented for this research because of the contextual differences for each case. The findings of the study revealed that students' understanding of science, including scientific method, social and cultural influences on science, and scientific bias, was strongly influenced by their experiences in SSI-based learning environments. Furthermore, multidimensional SSI-based science classes resulted in students having multiple reasoning modes, such as ethical and economic reasoning, compared to data-driven SSI-based science classes. In addition to portraying how participants presented complexity, perspectives, inquiry, and skepticism as aspects of socioscientific reasoning (Sadler et al. in Research in Science Education 37:371-391, 2007), this study proposes the inclusion of three additional aspects for the socioscientific reasoning theoretical construct: (1) identification of social domains affecting the SSI, (2) using cost and benefit analysis for evaluation of claims, and (3) understanding that SSIs and scientific studies around them are context-bound.

Polymerase chain reaction-based clonality testing in tissue samples with reactive lymphoproliferations: usefulness and pitfalls. A report of the BIOMED-2 Concerted Action BMH4-CT98-3936.

PubMed

Langerak, A W; Molina, T J; Lavender, F L; Pearson, D; Flohr, T; Sambade, C; Schuuring, E; Al Saati, T; van Dongen, J J M; van Krieken, J H J M

2007-02-01

Lymphoproliferations are generally diagnosed via histomorphology and immunohistochemistry. Although mostly conclusive, occasionally the differential diagnosis between reactive lesions and malignant lymphomas is difficult. In such cases molecular clonality studies of immunoglobulin (Ig)/T-cell receptor (TCR) rearrangements can be useful. Here we address the issue of clonality assessment in 106 histologically defined reactive lesions, using the standardized BIOMED-2 Ig/TCR multiplex polymerase chain reaction (PCR) heteroduplex and GeneScan assays. Samples were reviewed nationally, except 10% random cases and cases with clonal results selected for additional international panel review. In total 75% (79/106) only showed polyclonal Ig/TCR targets (type I), whereas another 15% (16/106) represent probably polyclonal cases, with weak Ig/TCR (oligo)clonality in an otherwise polyclonal background (type II). Interestingly, in 10% (11/106) clear monoclonal Ig/TCR products were observed (types III/IV), which prompted further pathological review. Clonal cases included two missed lymphomas in national review and nine cases that could be explained as diagnostically difficult cases or probable lymphomas upon additional review. Our data show that the BIOMED-2 Ig/TCR multiplex PCR assays are very helpful in confirming the polyclonal character in the vast majority of reactive lesions. However, clonality detection in a minority should lead to detailed pathological review, including close interaction between pathologist and molecular biologist.

Risk Factors Profile of Shoulder Dystocia in Oman: A Case Control Study

PubMed Central

Al-Khaduri, Maha M.; Abudraz, Rania Mohammed; Al-Farsi, Yahya M.

2014-01-01

Objective This study aimed to assess the risk factor profile of shoulder dystocia and associated neonatal complications in Oman, a developing Arab country. Methods A retrospective case-control study was conducted among 111 cases with dystocia and 111 controls, identified during 1994-2006 period in a tertiary care hospital in Oman. Controls were randomly selected among women who did not have dystocia, and were matched to cases on the day of delivery. Data related to potential risk factors, delivery, and obstetric complications were collected. Results Dystocia was significantly associated with older maternal age, higher parity, larger BMI, diabetes, and previous record of dystocia. In addition, dystocia was associated more with vacuum and forceps deliveries. Routine traction (51%) was the most used manoeuvre. Among dystocia cases, 13% were associated with fetal complications of which Erb’s Palsy was the most prevalent (79%). Conclusion Our finding of significant associations with risk factors lays out the ground to develop a predictability index for shoulder dystocia, which would help in making it preventable. Further p rospective studies are required to confirm the obtained results. PMID:25337307

Drugs & the Brain: Case-based Instruction for an Undergraduate Neuropharmacology Course.

PubMed

Nagel, Anastasia; Nicholas, Andrea

2017-01-01

In order to transform a traditional large non-majors general education (GE) neurobiology lecture (Drugs & the Brain) into an active learning course, we developed a series of directed mini-cases targeting major drug classes. Humorous and captivating case-based situations were used to better engage and motivate students to solve problems related to neuropharmacology and physiology. Here we provide directed cases, questions and learning outcomes for our opiates mini-cases. In addition, we describe how case studies were incorporated into our course and assessed using peer review and online quizzing. An in-depth analysis of the overall course transformation on student exam performance, opinions and instructor evaluations can be found in the JUNE article Don't Believe the Gripe! Increasing Course Structure in a Large Non-majors Neuroscience Course.

Correlation of bone defect dimensions with healing outcome one year after apical surgery.

PubMed

von Arx, Thomas; Hänni, Stefan; Jensen, Simon Storgård

2007-09-01

This clinical study prospectively evaluated the healing outcome 1 year after apical surgery in relation to bony crypt dimensions measured intraoperatively. The study cohort included 183 teeth in an equal number of patients. For statistical analysis, results were dichotomized (healed versus non-healed cases). The overall success rate was 83% (healed cases). Healing outcome was not significantly related to the level and height of the facial bone plate. In contrast, a significant difference was found for the mean size of the bony crypt when healed cases (395 mm(3)) were compared with non-healed cases (554 mm(3)). In addition, healed cases had a significantly shorter mean distance (4.30 mm) from the facial bone surface to the root canal (horizontal access) compared with non-healed cases (5.13 mm). With logistic regression, however, the only parameter found to be significantly related to healing outcome was the length of the access window to the bony crypt.

Actinomyces israelii in osteoradionecrosis of the jaws. Histopathologic and immunocytochemical study of five cases

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

Happonen, R.P.; Viander, M.; Pelliniemi, L.

1983-06-01

Five surgically treated patients with osteoradionecrosis of the jaws are presented. The clinical history of the disease varied from 3 to 17 years. In three cases the progression of the disease was enhanced by surgical procedures performed in the irradiated area causing exfoliation of the premaxillary area in one case and spontaneous mandibular fracture in two cases. Actinomyces israelii was demonstrated in tissue sections of all five cases by using FITC-labeled specific antiserum and additionally with peroxidase-antiperoxidase method in one case. Candida was found in histologic sections of three cases. Radiation damage in the oral soft tissues and jawbones makesmore » the atmosphere favorable for anaerobic microorganisms. The present results indicate that the role of A. israelii in the pathogenesis of osteoradionecrosis of the jaws has not been fully appreciated.« less

Comparison of time series models for predicting campylobacteriosis risk in New Zealand.

PubMed

Al-Sakkaf, A; Jones, G

2014-05-01

Predicting campylobacteriosis cases is a matter of considerable concern in New Zealand, after the number of the notified cases was the highest among the developed countries in 2006. Thus, there is a need to develop a model or a tool to predict accurately the number of campylobacteriosis cases as the Microbial Risk Assessment Model used to predict the number of campylobacteriosis cases failed to predict accurately the number of actual cases. We explore the appropriateness of classical time series modelling approaches for predicting campylobacteriosis. Finding the most appropriate time series model for New Zealand data has additional practical considerations given a possible structural change, that is, a specific and sudden change in response to the implemented interventions. A univariate methodological approach was used to predict monthly disease cases using New Zealand surveillance data of campylobacteriosis incidence from 1998 to 2009. The data from the years 1998 to 2008 were used to model the time series with the year 2009 held out of the data set for model validation. The best two models were then fitted to the full 1998-2009 data and used to predict for each month of 2010. The Holt-Winters (multiplicative) and ARIMA (additive) intervention models were considered the best models for predicting campylobacteriosis in New Zealand. It was noticed that the prediction by an additive ARIMA with intervention was slightly better than the prediction by a Holt-Winter multiplicative method for the annual total in year 2010, the former predicting only 23 cases less than the actual reported cases. It is confirmed that classical time series techniques such as ARIMA with intervention and Holt-Winters can provide a good prediction performance for campylobacteriosis risk in New Zealand. The results reported by this study are useful to the New Zealand Health and Safety Authority's efforts in addressing the problem of the campylobacteriosis epidemic. © 2013 Blackwell Verlag GmbH.

Following a natural experiment of guideline adaptation and early implementation: a mixed-methods study of facilitation

PubMed Central

2012-01-01

Background Facilitation is emerging as an important strategy in the uptake of evidence. However, it is not entirely clear from a practical perspective how facilitation occurs to help move research evidence into nursing practice. The Canadian Partnership Against Cancer, also known as the 'Partnership,' is a Pan-Canadian initiative supporting knowledge translation activity for improved care through guideline use. In this case-series study, five self-identified groups volunteered to use a systematic methodology to adapt existing clinical practice guidelines for Canadian use. With 'Partnership' support, local and external facilitators provided assistance for groups to begin the process by adapting the guidelines and planning for implementation. Methods To gain a more comprehensive understanding of the nature of facilitation, we conducted a mixed-methods study. Specifically, we examined the role and skills of individuals actively engaged in facilitation as well as the actual facilitation activities occurring within the 'Partnership.' The study was driven by and builds upon a focused literature review published in 2010 that examined facilitation as a role and process in achieving evidence-based practice in nursing. An audit tool outlining 46 discrete facilitation activities based on results of this review was used to examine the facilitation noted in the documents (emails, meeting minutes, field notes) of three nursing-related cases participating in the 'Partnership' case-series study. To further examine the concept, six facilitators were interviewed about their practical experiences. The case-audit data were analyzed through a simple content analysis and triangulated with participant responses from the focus group interview to understand what occurred as these cases undertook guideline adaptation. Results The analysis of the three cases revealed that almost all of the 46 discrete, practical facilitation activities from the literature were evidenced. Additionally, case documents exposed five other facilitation-related activities, and a combination of external and local facilitation was apparent. Individuals who were involved in the case or group adapting the guideline(s) also performed facilitation activities, both formally and informally, in conjunction with or in addition to appointed external and local facilitators. Conclusions Facilitation of evidence-based practice is a multifaceted process and a team effort. Communication and relationship-building are key components. The practical aspects of facilitation explicated in this study validate what has been previously noted in the literature and expand what is known about facilitation process and activity. PMID:22309743

Evaluating the cost effectiveness of environmental projects: Case studies in aerospace and defense

NASA Technical Reports Server (NTRS)

Shunk, James F.

1995-01-01

Using the replacement technology of high pressure waterjet decoating systems as an example, a simple methodology is presented for developing a cost effectiveness model. The model uses a four-step process to formulate an economic justification designed for presentation to decision makers as an assessment of the value of the replacement technology over conventional methods. Three case studies from major U.S. and international airlines are used to illustrate the methodology and resulting model. Tax and depreciation impacts are also presented as potential additions to the model.

26 CFR 1.612-2 - Allowable capital additions in case of mines.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Allowable capital additions in case of mines. 1... in case of mines. (a) In general. Expenditures for improvements and for replacements, not including... the recession of the working faces of the mine and which: (1) Do not increase the value of the mine...

How many published cases of serious adverse events after yellow fever vaccination meet Brighton Collaboration diagnostic criteria?

PubMed

Thomas, Roger E; Spragins, Wendy; Lorenzetti, Diane L

2013-12-16

To perform a systematic review of all serious adverse events (SAEs) after yellow fever vaccination and to assess them according to Brighton Collaboration criteria. Nine electronic databases were searched with the terms "yellow fever vaccine" and "adverse events" to 10 July 2013 (no language/date limits). Two reviewers independently assessed studies, entered data, and assessed cases with Brighton Collaboration criteria. One hundred and thirty-one cases met Brighton Collaboration criteria: 32 anaphylaxis, 41 neurologic (one death), 56 viscerotropic (24 deaths), and 2 both neurologic and viscerotropic criteria. All SAEs occurred following first yellow fever (YF) vaccination. Two additional cases which met Brighton Collaboration criteria were proven due to wild virus. An additional 345 cases were presented with insufficient detail to meet Brighton Collaboration criteria:173 neurological, 68 viscerotropic (24 deaths), 67 anaphylaxis, and 34 cases from a UK database and 3 from a Swiss database described as "serious adverse events" but not further classified into neurologic or viscerotropic. A further 253 cases were excluded as presenting insufficient data to be regarded as yellow fever vaccine (YFV) related SAEs. One hundred and thirty-one cases met Brighton Collaboration criteria for serious adverse events after yellow fever vaccination. Another 345 cases did not meet Brighton criteria and 253 were excluded as presenting insufficient data to be regarded as serious adverse events after YFV. There are likely to be cases in areas that are remote or with insufficient diagnostic resources that are neither correctly assessed nor not published. Copyright © 2013 Elsevier Ltd. All rights reserved.

The role of IgG4 (+) plasma cells in the association of Hashimoto's thyroiditis with papillary carcinoma.

PubMed

Taşli, Funda; Ozkök, Güliz; Argon, Asuman; Ersöz, Didem; Yağci, Ayşe; Uslu, Adam; Erkan, Nazif; Salman, Tarik; Vardar, Enver

2014-12-01

Hashimoto's thyroiditis (HT) is considered to be a risk factor for the formation of papillary carcinoma. The association of IgG4-related sclerosing disease with tumor is reported to be as sporadic cases in many organs. In this study, it was intended to re-classify the HT diagnosed cases on the basis of the existence of IgG4 (+) plasma cells; to investigate the clinicopathologic and histopathologic features of the both groups; and in addition, to evaluate the papillary carcinoma prevalence in IgG4 (+) and IgG4 (-) HT cases as well as the prognostic parameters between these groups. Totally 59 cases between the years 2008-2013, 29 of which contain Hashimoto thyroiditis diagnosis in total thyroidectomy materials, and 30 of which contain the diagnosis of HT+papillary carcinoma, were included in the study. The materials were immunohistochemically applied IgG and IgG4; and the cases were classified in two groups as IgG4-positive HT and IgG4-negative HT containing cases, on the basis of IgG4/IgG rate. All histopathologic and clinicopathologic parameters between these two groups, as well as their association with papillary carcinoma were investigated. Thirty eight (64.4%) of total 59 cases were NonIgG4 thyroiditis, and 21 (35.5%) were IgG4 thyroiditis. Tumors were detected in 14 (36.8%) of the NonIgG4 thyroiditis cases, and in 16 (76.1%) of the IgG4 thyroiditis cases. The association of IgG4 thyroiditis with tumor is statistically significant (p < 0.004). Multifocality was found to be at a higher rate in IgG4 thyroiditis cases. Perithyroidal extension was detected in six of the cases with tumor, and five of the six cases were IgG4 thyroiditis cases. The association of IgG4 (+) HT cases with increased papillary carcinoma prevalence is suggestive of that IgG4 (+) plasma cells can play a role in carcinogenesis in papillary carcinomas developed in HTs, without a chronic sclerosing ground. In addition, although the number of cases is limited, the high-association of IgG4 (+) plasma cells with adverse prognostic parameters such as multifocality and extrathyroidal extension is attention-grabbing. To render these possibilities evaluable, studies to be carried out with larger case series are needed. © 2014 APMIS. Published by John Wiley & Sons Ltd.

Methodology for determining economic impacts of raised medians : data collection for additional case studies

DOT National Transportation Integrated Search

1998-10-01

The objective of this four-year resaerch effort is to develop and test a methodology to estimate the economic impact of median design. This report summarizes the work performed in the second year. The secnd year of this study included collecting data...

A Case Study of the Impact of PBIS at Smith Elementary

ERIC Educational Resources Information Center

Halliburton, Amber

2015-01-01

This dissertation was designed to examine and assess the impact of a Positive Behavior Intervention and Supports (PBIS) program on student behaviors, academic environment, and the total school environment. The study examined and assessed the impact of PBIS on student suspensions, student attendance, and student interactions. Additionally, this…

Arizona Conserve Water Educators Guide

ERIC Educational Resources Information Center

Project WET Foundation, 2007

2007-01-01

This award-winning, 350-page, full-color book provides a thorough study of Arizona water resources from a water conservation perspective. Its background section contains maps, graphs, diagrams and photos that facilitate the teaching of 15 interactive, multi-disciplinary lessons to K-12 students. In addition, 10 Arizona case studies are highlighted…

Common variant at 16p11.2 conferring risk of psychosis.

PubMed

Steinberg, S; de Jong, S; Mattheisen, M; Costas, J; Demontis, D; Jamain, S; Pietiläinen, O P H; Lin, K; Papiol, S; Huttenlocher, J; Sigurdsson, E; Vassos, E; Giegling, I; Breuer, R; Fraser, G; Walker, N; Melle, I; Djurovic, S; Agartz, I; Tuulio-Henriksson, A; Suvisaari, J; Lönnqvist, J; Paunio, T; Olsen, L; Hansen, T; Ingason, A; Pirinen, M; Strengman, E; Hougaard, D M; Orntoft, T; Didriksen, M; Hollegaard, M V; Nordentoft, M; Abramova, L; Kaleda, V; Arrojo, M; Sanjuán, J; Arango, C; Etain, B; Bellivier, F; Méary, A; Schürhoff, F; Szoke, A; Ribolsi, M; Magni, V; Siracusano, A; Sperling, S; Rossner, M; Christiansen, C; Kiemeney, L A; Franke, B; van den Berg, L H; Veldink, J; Curran, S; Bolton, P; Poot, M; Staal, W; Rehnstrom, K; Kilpinen, H; Freitag, C M; Meyer, J; Magnusson, P; Saemundsen, E; Martsenkovsky, I; Bikshaieva, I; Martsenkovska, I; Vashchenko, O; Raleva, M; Paketchieva, K; Stefanovski, B; Durmishi, N; Pejovic Milovancevic, M; Lecic Tosevski, D; Silagadze, T; Naneishvili, N; Mikeladze, N; Surguladze, S; Vincent, J B; Farmer, A; Mitchell, P B; Wright, A; Schofield, P R; Fullerton, J M; Montgomery, G W; Martin, N G; Rubino, I A; van Winkel, R; Kenis, G; De Hert, M; Réthelyi, J M; Bitter, I; Terenius, L; Jönsson, E G; Bakker, S; van Os, J; Jablensky, A; Leboyer, M; Bramon, E; Powell, J; Murray, R; Corvin, A; Gill, M; Morris, D; O'Neill, F A; Kendler, K; Riley, B; Craddock, N; Owen, M J; O'Donovan, M C; Thorsteinsdottir, U; Kong, A; Ehrenreich, H; Carracedo, A; Golimbet, V; Andreassen, O A; Børglum, A D; Mors, O; Mortensen, P B; Werge, T; Ophoff, R A; Nöthen, M M; Rietschel, M; Cichon, S; Ruggeri, M; Tosato, S; Palotie, A; St Clair, D; Rujescu, D; Collier, D A; Stefansson, H; Stefansson, K

2014-01-01

Epidemiological and genetic data support the notion that schizophrenia and bipolar disorder share genetic risk factors. In our previous genome-wide association study, meta-analysis and follow-up (totaling as many as 18 206 cases and 42 536 controls), we identified four loci showing genome-wide significant association with schizophrenia. Here we consider a mixed schizophrenia and bipolar disorder (psychosis) phenotype (addition of 7469 bipolar disorder cases, 1535 schizophrenia cases, 333 other psychosis cases, 808 unaffected family members and 46 160 controls). Combined analysis reveals a novel variant at 16p11.2 showing genome-wide significant association (rs4583255[T]; odds ratio=1.08; P=6.6 × 10(-11)). The new variant is located within a 593-kb region that substantially increases risk of psychosis when duplicated. In line with the association of the duplication with reduced body mass index (BMI), rs4583255[T] is also associated with lower BMI (P=0.0039 in the public GIANT consortium data set; P=0.00047 in 22 651 additional Icelanders).

CHARACTERIZING SITE HYDROLOGY (WORKSHOP MSA PRESENTATION)

EPA Science Inventory

Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

Characterizing Site Hydrology (Region 10, Seattle, WA)

EPA Science Inventory

Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

CHARACTERIZING SITE HYDROLOGY (REGION 8 WORKSHOP)

EPA Science Inventory

Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

Information Management for the Watershed Approach in the Pacific Northwest

EPA Pesticide Factsheets

A collection of interviews with leaders and key participants in the statewide watershed approach activities in the State of Washington. Additionally, there are reviews of Washington’s statewide watershed activities in a case study fashion.

Case Study Teaching Method Improves Student Performance and Perceptions of Learning Gains†

PubMed Central

Bonney, Kevin M.

2015-01-01

Following years of widespread use in business and medical education, the case study teaching method is becoming an increasingly common teaching strategy in science education. However, the current body of research provides limited evidence that the use of published case studies effectively promotes the fulfillment of specific learning objectives integral to many biology courses. This study tested the hypothesis that case studies are more effective than classroom discussions and textbook reading at promoting learning of key biological concepts, development of written and oral communication skills, and comprehension of the relevance of biological concepts to everyday life. This study also tested the hypothesis that case studies produced by the instructor of a course are more effective at promoting learning than those produced by unaffiliated instructors. Additionally, performance on quantitative learning assessments and student perceptions of learning gains were analyzed to determine whether reported perceptions of learning gains accurately reflect academic performance. The results reported here suggest that case studies, regardless of the source, are significantly more effective than other methods of content delivery at increasing performance on examination questions related to chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication. This finding was positively correlated to increased student perceptions of learning gains associated with oral and written communication skills and the ability to recognize connections between biological concepts and other aspects of life. Based on these findings, case studies should be considered as a preferred method for teaching about a variety of concepts in science courses. PMID:25949753

Case study teaching method improves student performance and perceptions of learning gains.

PubMed

Bonney, Kevin M

2015-05-01

Following years of widespread use in business and medical education, the case study teaching method is becoming an increasingly common teaching strategy in science education. However, the current body of research provides limited evidence that the use of published case studies effectively promotes the fulfillment of specific learning objectives integral to many biology courses. This study tested the hypothesis that case studies are more effective than classroom discussions and textbook reading at promoting learning of key biological concepts, development of written and oral communication skills, and comprehension of the relevance of biological concepts to everyday life. This study also tested the hypothesis that case studies produced by the instructor of a course are more effective at promoting learning than those produced by unaffiliated instructors. Additionally, performance on quantitative learning assessments and student perceptions of learning gains were analyzed to determine whether reported perceptions of learning gains accurately reflect academic performance. The results reported here suggest that case studies, regardless of the source, are significantly more effective than other methods of content delivery at increasing performance on examination questions related to chemical bonds, osmosis and diffusion, mitosis and meiosis, and DNA structure and replication. This finding was positively correlated to increased student perceptions of learning gains associated with oral and written communication skills and the ability to recognize connections between biological concepts and other aspects of life. Based on these findings, case studies should be considered as a preferred method for teaching about a variety of concepts in science courses.

The Origin of the EUV Late Phase: A Case Study of the C8.8 Flare on 2010 May 5

NASA Technical Reports Server (NTRS)

Hock, R. A.; Woods, T. N.; Klimchuk, J. A.; Eparvier, F. G.; Jones, A. R.

2012-01-01

Since the launch of NASA's Solar Dynamics Observatory on 2010 February 11, the Extreme ultraviolet Variability Experiment (EVE) has observed numerous flares. One interesting feature observed by EVE is that a subset of flares exhibit an additional enhancement of the 2-3 million K emission several hours after the flares soft X-ray emission. From the Atmospheric Imaging Assembly (AIA) images, we observe that this secondary emission, dubbed the EUV late phase, occurs in the same active region as the flare but not in the same coronal loops. Here, we examine the C8.8 flare that occurred on 2010 May 5 as a case study of EUV late phase flares. In addition to presenting detailed observations from both AIA and EVE, we develop a physical model of this flare and test it using the Enthalpy Based Thermal Evolution of Loops (EBTEL) model.

Obsolete Laws: Economic and Moral Aspects, Case Study-Composting Standards.

PubMed

Vochozka, Marek; Maroušková, Anna; Šuleř, Petr

2017-12-01

From the early days of philosophy, ethics and justice, there is wide consensus that the constancy of the laws establishes the legal system. On the other hand, the rate at which we accumulate knowledge is gaining speed like never before. Due to the recently increased attention of academics to climate change and other environmental issues, a lot of new knowledge has been obtained about carbon management, its role in nature and mechanisms regarding the formation and degradation of organic matter. A multidisciplinary techno-economic assessment of current composting standards and laws that took into account the current state of knowledge about carbon management was carried out as a case study. Economic and environmental damage caused by outdated laws was revealed. In addition, it was found that the introduction of the best composts into the market is permitted, causing additional negative environmental as well as economic impacts.

Clinicopathological study of 81 cases of localized and systemic scleroderma.

PubMed

Succaria, F; Kurban, M; Kibbi, A-G; Abbas, O

2013-02-01

Scleroderma is a connective tissue disease that includes localized and systemic forms. Our recent encounter with a morphea case exhibiting prominent perineural inflammation microscopically prompted us to assess the features of all patients diagnosed with morphea/scleroderma at our institution. To describe the clinicopathological features of all patients diagnosed with morphea/scleroderma at American University of Beirut Medical Center (AUB-MC) between 1999 and 2010, and compare our findings with those published in the literature. A total of 81 cases (63 women and 18 men) were identified, of which 73 were localized (morphea) and eight were systemic scleroderma. Clinically, plaque type morphea was the most common variant both in adults and children, and seven (9%) cases of morphea were associated with lichen sclerosis et atrophicus (LSA). Histopathologically, perineural inflammation was observed in 49% of cases, and may serve, in addition to other features including lichen sclerosis-like changes (observed in exclusively nine cases of morphea), more diffuse dermal and less subcutaneous sclerosis, and intense inflammation, as clues favouring diagnosis of morphea over systemic sclerosis. The features of morphea/scleroderma patients in this study are generally comparable to those published in the literature, with few differences. Clinically, plaque type morphea was the most common variant both in adults and children and LSA was a frequent association. Histopathologically, perineural inflammation was commonly observed and may serve in addition to lichen sclerosis-like changes and intense inflammation as clues favouring diagnosis of morphea over systemic sclerosis. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

Bacterial Coaggregation and Cohesion Among Isolates From Contact Lens Cases.

PubMed

Datta, Ananya; Stapleton, Fiona; Willcox, Mark D P

2018-06-01

The aim of this study was to examine cohesion, coaggregation, and coculture between bacteria commonly isolated from contact lens cases. Staphylococcus epidermidis, Staphylococcus haemolyticus, Micrococcus luteus, and Acinetobacter radioresistens (two strains each) isolated from contact lens cases of two asymptomatic wearers were used in this study. In the cohesion assay, bacteria were grown, washed, and examined by incubating lens cases with two different types of bacteria sequentially and assessing the number of adhered cells of each isolate. The ability of isolates to interfere with the growth of other isolates was tested by growing strains in cocultures for 24 hours and determining the numbers of cells of individual strains. For coaggregation, equal proportions of two bacterial suspensions were mixed and allowed to coaggregate for 24 hours. Inhibition of coaggregation was tested by the addition of lactose (0.06 M) or sucrose (0.06 M) or pronase. The initial adhesion of M. luteus or A. radioresistens significantly (P < 0.05) enhanced the subsequent adhesion of the staphylococci. The addition of A. radioresistens in liquid media significantly (P < 0.05) enhanced the growth of staphylococci. S. epidermidis or S. haemolyticus coaggregated with M. luteus or A. radioresistens. The degree of coaggregation varied between 30% and 54%. The highest coaggregation (54% ± 5%) was seen between A. radioresistens 22-1 and S. epidermidis 22-1, isolated from the same lens case. Only lactose or sucrose treatment of staphylococci could partly inhibit coaggregation of some pairs. Coaggregation, cohesion, and growth promotion may facilitate the process of bacterial colonization of contact lens cases.

[Preliminary investigation on the safety and efficacy of Trabectome].

PubMed

Huang, Ping; Wang, Huaizhou; Wu, Huijuan; Sun, Yanran; Wang, Minshu; Cui, Ying; Qiu, Weiqiang; Yang, Yiquan; Ren, Zeqin; Zhang, Chun; Wang, Ningli

2015-02-01

To evaluate the safety and efficacy of ab interno trabeculectomy (Trabectome) surgery in Chinese open angle glaucoma patients. Prospective non-comparative case series study. A total of 41 cases (34 primary open angle glaucoma patients, 3 developmental glaucoma patients and 4 pigmentary glaucoma patients) were included in the study. All the cases underwent Trabectome, including 9 cases combined with phacoemulsification cataract extraction. Major outcomes include intraocular pressure (IOP), number of glaucoma medications, secondary glaucoma surgery and postoperative complications. Criteria for successful operation were defined as IOP ≤ 21 mmHg (1 mmHg = 0.133 kPa), at least 20% IOP reduction in any two consecutive visits after 3 months with or without IOP-lowering drugs and no additional glaucoma surgery. IOP and number of glaucoma medications were compared to baseline using Wilcoxon signed-rank test with Bonferroni correction. Kaplan-Meier analysis was performed to analyze the success rate of surgery. In the all 41 patients, 21 cases (51.2%) were followed up for up to 12 months. IOP was reduced from (22.5 ± 8.1) mmHg to (17.6 ± 6.4) mmHg (P = 0.02), meanwhile number of glaucoma medications was reduced from 2.0 ± 0.9 to 1.2 ± 0.9 (P = 0.02) at 12 months. The success rate at one year was 85% and 4 cases required additional glaucoma surgery. Trabectome has many advantages, such as shorter surgery time, simple post-operative care, less intraoperative and postoperative complications and clear IOP-lowering effect. But it slong-term efficacy is still need a large sample, long-term follow-up to verify.

[Teaching of clinical reasoning to medical students using prototypical clinical cases].

PubMed

Montaldo L, Gustavo; Herskovic L, Pedro

2013-07-01

Clinical reasoning is the most important competente in the training process of a physician. To develop a method for teaching clinical reasoning based on prototypes of clinical cases. The study was conducted on sixty-four third year medical students. The study and control groups attended lectures and tutorial sessions with patients. The study group attended additionally discussion seminars of prototypical clinical cases. A clinical reasoning test was applied at the start and end of the learning period to both groups. At the end of the study, the opinions of students of the study group were collected in a focus group. After the learning period, both groups significantly increased their clinical reasoning skills. However, the improvement in the study group was more than double than that of the control group. The absolute improvement in the study group was 30.9%. Students interviewed in the focus group were unanimous in expressing their satisfaction in each and every aspect discussed. The teaching of clinical reasoning to third year medical students by means of pattern recognition in seminars with clinical cases improved significantly their skills.

Childhood headache attributed to airplane travel: a case report.

PubMed

Rogers, Kirsty; Rafiq, Nadia; Prabhakar, Prab; Ahmed, Mas

2015-05-01

Headache attributed to airplane flights is a rare form of headache disorder. This case study describes an 11-year-old girl with recurrent, severe, frontal headaches occurring during airplane travel. The episodes were associated with dizziness and facial pallor but no additional symptoms and showed spontaneous resolution on landing. Blood tests and imaging revealed no abnormalities. The present case fulfils the criteria for airplane headache recently included in the revised edition of the International Classification of Headache Disorders (ICHD-III Beta). Only a few cases of airplane headache have been reported in children. To our knowledge, this is the fourth case. We review the current literature on this rare syndrome and discuss various proposed pathophysiological mechanisms. © The Author(s) 2014.

Feasibility of a multi-component additive for efficient control of activated sludge filamentous bulking.

PubMed

Seka, A M; Van De Wiele, T; Verstraete, W

2001-08-01

Instantaneous improvement of the settling of bulking filamentous activated sludge can be achieved by the addition of a polymer or a large amount (up to 100% of the MLSS concentration) of talc powder to the sludge. Long-term improvement relies on repeated additions, as these additives have no adverse effects on the causative filaments. A multi-component additive was compared to the traditional additives in lab-scale activated sludge units using three highly filamentous sludges from different industrial treatment plants. The study demonstrated that the multi-component additive was superior to the traditional remedies. It was shown that, in the case of severe filamentous bulking, a single addition of the new additive immediately improved sludge settling and exerted a destructive effect on the causative filamentous bacteria. Thus, the latter additive also ensured a long-term sludge sedimentation improvement. The traditional additives exhibited an immediate and short-term effect. The novel additive also retarded sludge rising due to denitrification and it improved sludge dewaterability. The study revealed Nostocoido limicola II, with slightly hydrophobic cell wall, to be somewhat resistant to the quaternary ammonium salt present as biocide in the additive.

Synchronization of an optomechanical system to an external drive

NASA Astrophysics Data System (ADS)

Amitai, Ehud; Lörch, Niels; Nunnenkamp, Andreas; Walter, Stefan; Bruder, Christoph

2017-05-01

Optomechanical systems driven by an effective blue-detuned laser can exhibit self-sustained oscillations of the mechanical oscillator. These self-oscillations are a prerequisite for the observation of synchronization. Here, we study the synchronization of the mechanical oscillations to an external reference drive. We study two cases of reference drives: (1) an additional laser applied to the optical cavity; (2) a mechanical drive applied directly to the mechanical oscillator. Starting from a master equation description, we derive a microscopic Adler equation for both cases, valid in the classical regime in which the quantum shot noise of the mechanical self-oscillator does not play a role. Furthermore, we numerically show that, in both cases, synchronization arises also in the quantum regime. The optomechanical system is therefore a good candidate for the study of quantum synchronization.

Association between biomass fuel and pulmonary tuberculosis: a nested case-control study.

PubMed

Kolappan, C; Subramani, R

2009-08-01

To quantify the association between biomass fuel usage and sputum-positive pulmonary tuberculosis. A tuberculosis prevalence survey was conducted in a random sample of 50 rural units (villages) and three urban units in the Tiruvallur district of Tamilnadu, India during the period 2001-2003. Additional data regarding exposure to tobacco smoking, alcohol consumption, biomass fuel usage and Standard of Living Index (SLI) were also collected from the study participants. A nested case-control study was carried out in this population. Cases are defined as bacteriological-positive cases diagnosed by either sputum smear or culture examination. For each case, five age- (within +/-5 years of age) and sex-matched controls were selected randomly from the non-cases residing in the same village/unit. Thus, 255 cases and 1275 controls were included in this study. The unadjusted OR measured from univariate analysis for biomass fuel is 2.9 (95% CI 1.8 to 4.7). The adjusted OR measured from multivariate analysis using Cox regression is 1.7 (95% CI 1.0 to 2.9). Thirty-six percent of cases are attributable to biomass fuel usage. The findings from this case-control study add to the evidence for an independent association between biomass smoke and pulmonary tuberculosis. Improvement in standards of living brought about by economic development will lead to more people using cleaner fuels for cooking than biomass fuel which in turn will lead to a reduction in the occurrence of pulmonary tuberculosis in the community.

Characterizing dense suspensions: two case studies from the pharmaceutical industry

NASA Astrophysics Data System (ADS)

Goldfarb, David J.; Khawaja, Nazia; Kazakevich, Irina; Bhattacharjee, Himanshu; Heslinga, Michael; Dalton, Chad

2015-11-01

Liquid suspensions of Active Pharmaceutical Ingredient powders are present as pharmaceutical dosage forms in the form of oral suspensions and injectables. We present two case studies, both dense (~ 30-40%) suspensions, in which the physical characterization of the product, specifically, particle size & shape and rheology were key to understanding the key product attributes as pertaining to the manufacturing process and to patient administration. For the one case study, an oral suspension, identifying variations in particle morphology during the wet milling of the product was key to the product understanding necessary to modify the milling process. Rheological measurements were applied as well. For the second case study, an injectable, results from different particle size measurement techniques and rheological measurements indicated the possibility of flocculation in a formulation. Additionally, measurements were obtained to assess the ``injectability'' of the product via rheometer and texture analyzer measurements and Poiseuille flow modeling. As a result, the relevant shear rate regime for this drug product administration was identified.

Hypnotherapy of a pain disorder: a clinical case study.

PubMed

Artimon, Henrieta Mihaela

2015-01-01

Hypnotherapy's effectiveness in improving and controlling chronic pain of various etiologies has been demonstrated by studies; the mechanism by which hypnosis does this is more complex than a simple induction of muscle relaxation. This study reveals, in addition to this mechanism, a deeper dimension of hypnotherapy from the vantage of a patient with a medical-surgical background, diagnosed with a pain disorder and major severe depressive disorder in addition to incurable painful symptoms, through treatment associated with hypnoanalysis. Following psychotherapy, which included some elements of cognitive-behavioral therapy, a complete remission of the anxious-depressive mood and the painful symptoms was achieved.

Meta-analysis identifies 29 additional ulcerative colitis risk loci, increasing the number of confirmed associations to 47.

PubMed

Anderson, Carl A; Boucher, Gabrielle; Lees, Charlie W; Franke, Andre; D'Amato, Mauro; Taylor, Kent D; Lee, James C; Goyette, Philippe; Imielinski, Marcin; Latiano, Anna; Lagacé, Caroline; Scott, Regan; Amininejad, Leila; Bumpstead, Suzannah; Baidoo, Leonard; Baldassano, Robert N; Barclay, Murray; Bayless, Theodore M; Brand, Stephan; Büning, Carsten; Colombel, Jean-Frédéric; Denson, Lee A; De Vos, Martine; Dubinsky, Marla; Edwards, Cathryn; Ellinghaus, David; Fehrmann, Rudolf S N; Floyd, James A B; Florin, Timothy; Franchimont, Denis; Franke, Lude; Georges, Michel; Glas, Jürgen; Glazer, Nicole L; Guthery, Stephen L; Haritunians, Talin; Hayward, Nicholas K; Hugot, Jean-Pierre; Jobin, Gilles; Laukens, Debby; Lawrance, Ian; Lémann, Marc; Levine, Arie; Libioulle, Cecile; Louis, Edouard; McGovern, Dermot P; Milla, Monica; Montgomery, Grant W; Morley, Katherine I; Mowat, Craig; Ng, Aylwin; Newman, William; Ophoff, Roel A; Papi, Laura; Palmieri, Orazio; Peyrin-Biroulet, Laurent; Panés, Julián; Phillips, Anne; Prescott, Natalie J; Proctor, Deborah D; Roberts, Rebecca; Russell, Richard; Rutgeerts, Paul; Sanderson, Jeremy; Sans, Miquel; Schumm, Philip; Seibold, Frank; Sharma, Yashoda; Simms, Lisa A; Seielstad, Mark; Steinhart, A Hillary; Targan, Stephan R; van den Berg, Leonard H; Vatn, Morten; Verspaget, Hein; Walters, Thomas; Wijmenga, Cisca; Wilson, David C; Westra, Harm-Jan; Xavier, Ramnik J; Zhao, Zhen Z; Ponsioen, Cyriel Y; Andersen, Vibeke; Torkvist, Leif; Gazouli, Maria; Anagnou, Nicholas P; Karlsen, Tom H; Kupcinskas, Limas; Sventoraityte, Jurgita; Mansfield, John C; Kugathasan, Subra; Silverberg, Mark S; Halfvarson, Jonas; Rotter, Jerome I; Mathew, Christopher G; Griffiths, Anne M; Gearry, Richard; Ahmad, Tariq; Brant, Steven R; Chamaillard, Mathias; Satsangi, Jack; Cho, Judy H; Schreiber, Stefan; Daly, Mark J; Barrett, Jeffrey C; Parkes, Miles; Annese, Vito; Hakonarson, Hakon; Radford-Smith, Graham; Duerr, Richard H; Vermeire, Séverine; Weersma, Rinse K; Rioux, John D

2011-03-01

Genome-wide association studies and candidate gene studies in ulcerative colitis have identified 18 susceptibility loci. We conducted a meta-analysis of six ulcerative colitis genome-wide association study datasets, comprising 6,687 cases and 19,718 controls, and followed up the top association signals in 9,628 cases and 12,917 controls. We identified 29 additional risk loci (P < 5 × 10(-8)), increasing the number of ulcerative colitis-associated loci to 47. After annotating associated regions using GRAIL, expression quantitative trait loci data and correlations with non-synonymous SNPs, we identified many candidate genes that provide potentially important insights into disease pathogenesis, including IL1R2, IL8RA-IL8RB, IL7R, IL12B, DAP, PRDM1, JAK2, IRF5, GNA12 and LSP1. The total number of confirmed inflammatory bowel disease risk loci is now 99, including a minimum of 28 shared association signals between Crohn's disease and ulcerative colitis.

A prospective study on the role of octreotide in management of chyle fistula neck.

PubMed

Jain, Avani; Singh, Shashank Nath; Singhal, Pawan; Sharma, Man Prakash; Grover, Mohnish

2015-07-01

To study the effectiveness of octreotide in managing chyle fistula neck and its effect on duration of hospitalization. Prospective study. A total of 19 patients with chyle fistula following neck dissection over a period of 10 years were included in the study. All the patients first underwent conservative management of the chyle leak, including suction drainage, pressure dressings, bed rest, and nutritional modifications. In all of the cases, chyle leak persisted despite conservative management. Octreotide was started in a dose of 100 µg subcutaneously every 8 hours for 5 days in cases with low-output leaks and for 7 days in cases with high-output leaks. In all of the cases, the duration of chyle leak after starting treatment with octreotide and the duration of hospitalization was recorded. Chyle leak stopped in all the cases using octreotide. The mean duration of hospitalization was 13.8 days. Chyle leak stopped within 5 days of starting octreotide in the low-output cases and within 7 days in the high-output cases. This permitted early resumption of a regular oral diet and reduced morbidity associated with chyle fistula. The rapid response and minimal side effect profile make octreotide a promising addition to the medical management of a chyle fistula. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Evaluation of direct and indirect additive manufacture of maxillofacial prostheses.

PubMed

Eggbeer, Dominic; Bibb, Richard; Evans, Peter; Ji, Lu

2012-09-01

The efficacy of computer-aided technologies in the design and manufacture of maxillofacial prostheses has not been fully proven. This paper presents research into the evaluation of direct and indirect additive manufacture of a maxillofacial prosthesis against conventional laboratory-based techniques. An implant/magnet-retained nasal prosthesis case from a UK maxillofacial unit was selected as a case study. A benchmark prosthesis was fabricated using conventional laboratory-based techniques for comparison against additive manufactured prostheses. For the computer-aided workflow, photogrammetry, computer-aided design and additive manufacture (AM) methods were evaluated in direct prosthesis body fabrication and indirect production using an additively manufactured mould. Qualitative analysis of position, shape, colour and edge quality was undertaken. Mechanical testing to ISO standards was also used to compare the silicone rubber used in the conventional prosthesis with the AM material. Critical evaluation has shown that utilising a computer-aided work-flow can produce a prosthesis body that is comparable to that produced using existing best practice. Technical limitations currently prevent the direct fabrication method demonstrated in this paper from being clinically viable. This research helps prosthesis providers understand the application of a computer-aided approach and guides technology developers and researchers to address the limitations identified.

Case definition and classification of leukodystrophies and leukoencephalopathies.

PubMed

Vanderver, Adeline; Prust, Morgan; Tonduti, Davide; Mochel, Fanny; Hussey, Heather M; Helman, Guy; Garbern, James; Eichler, Florian; Labauge, Pierre; Aubourg, Patrick; Rodriguez, Diana; Patterson, Marc C; Van Hove, Johan L K; Schmidt, Johanna; Wolf, Nicole I; Boespflug-Tanguy, Odile; Schiffmann, Raphael; van der Knaap, Marjo S

2015-04-01

An approved definition of the term leukodystrophy does not currently exist. The lack of a precise case definition hampers efforts to study the epidemiology and the relevance of genetic white matter disorders to public health. Thirteen experts at multiple institutions participated in iterative consensus building surveys to achieve definition and classification of disorders as leukodystrophies using a modified Delphi approach. A case definition for the leukodystrophies was achieved, and a total of 30 disorders were classified under this definition. In addition, a separate set of disorders with heritable white matter abnormalities but not meeting criteria for leukodystrophy, due to presumed primary neuronal involvement and prominent systemic manifestations, was classified as genetic leukoencephalopathies (gLE). A case definition of leukodystrophies and classification of heritable white matter disorders will permit more detailed epidemiologic studies of these disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

Translational manipulation under anesthesia for patients with frozen shoulder: a case series study with five-year health care utilization and post-manipulative arthroscopic findings.

PubMed

Hando, Ben R; Rhon, Daniel I; Boyles, Robert E; Whitman, Julie M; English, Jenny L

2017-12-01

Case series study. Although there have been no reported complications from translational manipulation under anesthesia (tMUA) for individuals with adhesive capsulitis (AC) there are no cases reporting surgical findings post tMUA. Also, there are no studies evaluating health care utilization following tMUA. The purpose of this study was to: (1) report clinical outcomes following tMUA, (2) describe relevant health care costs and utilization following tMUA, and (3) summarize findings from two cases receiving joint arthroscopy following tMUA. Fourteen Individuals with AC underwent tMUA. Range of motion (ROM) and Shoulder Pain and Disability Index (SPADI) values were collected at baseline and six weeks follow-up. Shoulder-related health care cost and utilization were analyzed for a five-year period following tMUA. Two additional patients with AC underwent tMUA followed by arthroscopic assessment for evidence of iatrogenic injury. Thirteen patients completed the six-week follow-up. Mean change scores for ROM and SPADI values were flexion; +38.5°, abduction; +71.1°, external rotation (shoulder abducted); +49.8°, internal rotation (shoulder abducted); +26.6°, SPADI scores; +44.4. 13 patient records were analyzed for health care utilization. Ten of the 13 patients utilized no additional shoulder-related health care. Surgical evaluation revealed no evidence of iatrogenic injury. Clinical outcomes were similar to previous studies. Utilization data indicated that for the majority of patients, little shoulder-related health care was utilized. Surgical evaluation provided further evidence that tMUA performed by a physical therapist is safe. Future research will be required to establish a causal relationship between tMUA and the results observed in this study. Therapy, Level 4.

Triticale crisp bread enriched with selected bioactive additives: volatile profile, physical characteristics, sensory and nutritional properties.

PubMed

Makowska, Agnieszka; Majcher, Małgorzata; Mildner-Szkudlarz, Sylwia; Jedrusek-Golinska, Anna; Przygoński, Krzysztof

2017-09-01

The effect of selected plant additives (couch grass, artichoke, kale, nettle, ground buckwheat husks, broad beans, fenugreek seeds, and extracts of yellow tea and mulberry leaf) on the volatile compounds, color, texture, sensory attributes, polyphenols, and antioxidant properties of triticale crisp bread was studied. The volatile profile of control bread was dominated by lipid oxidation products with hexanal and (E)-2-nonenal predominant. The additives strongly modified the volatile profile of the extruded crisp bread. The greatest differences were recorded in the case of products with artichoke and kale additions, which had respectively about 12 and 8 times higher levels of total volatile compounds than the control crisp bread. The samples containing kale, buckwheat, and fenugreek as well as yellow tea extract characterized high levels of sulfur compounds, with methanethiol predominant. The additives, especially kale, nettle, and artichoke affected the color of the crisp breads, in most cases making them darker. In terms of texture only the crisp bread with addition of buckwheat husk was significantly harder than the control sample. On the basis of sensory evaluation it was stated that among all the additives, the artichoke and fenugreek resulted in dramatic deterioration in the extruded product taste. The used additives also affected the antioxidant properties of triticale crisp bread. The greatest content of total phenolic compounds and the highest antioxidant activity were observed for the bread with yellow tea extract addition (3.5- and 6.5-fold higher, respectively, than in control sample).

Craniofacial duplication (diprosopus): CT, MR imaging, and MR angiography findings case report.

PubMed

Hähnel, Stefan; Schramm, Peter; Hassfeld, Stefan; Steiner, Hans H; Seitz, Angelika

2003-01-01

Diprosopus is one of the rarest malformations in humans. In addition to the facial structures, the cerebral frontal lobes were duplicated in this case. Three pairs of anterior cerebral arteries were detected, and the rostral parts of the superior sagittal sinus were duplicated. Computed tomography, magnetic resonance (MR) imaging, and MR angiography allowed study of the degree of duplicative changes in diprosopus, especially for planning cosmetic correction. Copyright RSNA, 2002

Molecular Biology and Prevention of Endometrial Cancer

DTIC Science & Technology

2006-07-01

adenocarcinoma cases from the International DES Registry (IDESR) was analyzed for MSI 3) A case-control study of the CASH database was performed to...that have arisen in women exposed to DES in- utero , for methylation and mutation of PTEN and MLH1 in order to determine if estrogen induces genetic...and analyzed, which would most likely take an additional 3-6 months after enrollment. Aim 2: To analyze vaginal and cervical adenocarcinomas

Biomass production in agroforestry and forestry systems on salt-affected soils in South Asia: exploration of the GHG balance and economic performance of three case studies.

PubMed

Wicke, Birka; Smeets, Edward M W; Akanda, Razzaque; Stille, Leon; Singh, Ranjay K; Awan, Abdul Rasul; Mahmood, Khalid; Faaij, Andre P C

2013-09-30

This study explores the greenhouse gas balance and the economic performance (i.e. net present value (NPV) and production costs) of agroforestry and forestry systems on salt-affected soils (biosaline (agro)forestry) based on three case studies in South Asia. The economic impact of trading carbon credits generated by biosaline (agro)forestry is also assessed as a potential additional source of income. The greenhouse gas balance shows carbon sequestration over the plantation lifetime of 24 Mg CO2-eq. ha(-1) in a rice-Eucalyptus camaldulensis agroforestry system on moderately saline soils in coastal Bangladesh (case study 1), 6 Mg CO2-eq. ha(-1) in the rice-wheat- Eucalyptus tereticornis agroforestry system on sodic/saline-sodic soils in Haryana state, India (case study 2), and 96 Mg CO2-eq. ha(-1) in the compact tree (Acacia nilotica) plantation on saline-sodic soils in Punjab province of Pakistan. The NPV at a discount rate of 10% is 1.1 k€ ha(-1) for case study 1, 4.8 k€ ha(-1) for case study 2, and 2.8 k€ ha(-1) for case study 3. Carbon sequestration translates into economic values that increase the NPV by 1-12% in case study 1, 0.1-1% in case study 2, and 2-24% in case study 3 depending on the carbon credit price (1-15 € Mg(-1) CO2-eq.). The analysis of the three cases indicates that the economic performance strongly depends on the type and severity of salt-affectedness (which affect the type and setup of the agroforestry system, the tree species and the biomass yield), markets for wood products, possibility of trading carbon credits, and discount rate. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparative Study on High-Order Positivity-preserving WENO Schemes

NASA Technical Reports Server (NTRS)

Kotov, Dmitry V.; Yee, Helen M.; Sjogreen, Bjorn Axel

2013-01-01

The goal of this study is to compare the results obtained by non-positivity-preserving methods with the recently developed positivity-preserving schemes for representative test cases. In particular the more di cult 3D Noh and Sedov problems are considered. These test cases are chosen because of the negative pressure/density most often exhibited by standard high-order shock-capturing schemes. The simulation of a hypersonic nonequilibrium viscous shock tube that is related to the NASA Electric Arc Shock Tube (EAST) is also included. EAST is a high-temperature and high Mach number viscous nonequilibrium ow consisting of 13 species. In addition, as most common shock-capturing schemes have been developed for problems without source terms, when applied to problems with nonlinear and/or sti source terms these methods can result in spurious solutions, even when solving a conservative system of equations with a conservative scheme. This kind of behavior can be observed even for a scalar case (LeVeque & Yee 1990) as well as for the case consisting of two species and one reaction (Wang et al. 2012). For further information concerning this issue see (LeVeque & Yee 1990; Griffiths et al. 1992; Lafon & Yee 1996; Yee et al. 2012). This EAST example indicated that standard high-order shock-capturing methods exhibit instability of density/pressure in addition to grid-dependent discontinuity locations with insufficient grid points. The evaluation of these test cases is based on the stability of the numerical schemes together with the accuracy of the obtained solutions.

Revision surgery due to magnet dislocation in cochlear implant patients: an emerging complication.

PubMed

Hassepass, Frederike; Stabenau, Vanessa; Maier, Wolfgang; Arndt, Susan; Laszig, Roland; Beck, Rainer; Aschendorff, Antje

2014-01-01

To analyze the cause and effect of magnet dislocation in cochlear implant (CI) recipients requiring magnet revision surgery for treatment. Retrospective study. Tertiary referral center. Case reports from 1,706 CI recipients consecutively implanted from January 2000 to December 2011 were reviewed. The number of cases requiring magnet revision surgery was assessed. Revision surgery involving magnet removal or replacement was indicated in 1.23% (21/1,706), of all CI recipients. Magnet dislocation occurring during magnetic resonance tomography (MRI), at 1.5 Tesla (T), with the magnet in place and with the application of compression bandaging around the head, was the main cause for revision surgery in 47.62% (10/21) of the affected cases. All 10 cases were implanted with Cochlear Nucleus cochlear implants. These events occurred, despite adherence to current recommendations of the manufacturer. The present study underlines that MRI examination is the main cause of magnet dislocation. The use of compressive bandaging when using 1.5-T MRI does not eliminate the risk of magnet dislocation. Additional cautionary measures are for required for conditional MRI. We recommend X-ray examination after MRI to determine magnet dislocation and avoid major complications in all cases reporting pain during or after MRI. Additional research regarding silicon magnet pocket design for added retention is needed. Effective communication of guidelines for precautionary measures during MRI examination in CI patients is mandatory for all clinicians involved. MRI in CI recipients should be indicated with caution.

Feline leprosy due to Candidatus 'Mycobacterium lepraefelis': Further clinical and molecular characterisation of eight previously reported cases and an additional 30 cases.

PubMed

O'Brien, Carolyn R; Malik, Richard; Globan, Maria; Reppas, George; McCowan, Christina; Fyfe, Janet A

2017-09-01

This paper, the last in a series of three on 'feline leprosy', provides a detailed description of disease referable to the previously unnamed species, Candidatus 'Mycobacterium lepraefelis', a close relative of the human pathogens Mycobacterium leprae and Mycobacterium lepromatosis. Cases were sourced retrospectively and prospectively for this observational study, describing clinical, geographical and molecular microbiological data for cats definitively diagnosed with Candidatus 'M lepraefelis' infection. A total of 145 cases of feline leprosy were scrutinised; 114 'new' cases were sourced from the Victorian Infectious Diseases Reference Laboratory (VIDRL) records, veterinary pathology laboratories or veterinarians, and 31 cases were derived from six published studies. Thirty-eight cats were definitively diagnosed with Candidatus 'M lepraefelis' infection. Typically, cats tended to be middle-aged or older when first infected, with a male predilection. Affected cats typically had widespread cutaneous lesions, in some cases after initially localised disease. Advanced cases were often systemically unwell. All cats had outdoor access. The histological picture was lepromatous in the majority of patients, although two cases had tuberculoid disease. In one case that underwent necropsy, lesions were evident in the liver, spleen and lungs. Treatment was varied, although most cats received a combination of oral clarithromycin and rifampicin. Prognosis for recovery was variable, but typically poor. Candidatus 'M lepraefelis' typically causes high bacterial index (lepromatous) feline leprosy that in some cases progresses to systemic mycobacteriosis. The disease has a variable clinical course and prognosis. Many cases either died or were euthanased due to the infection. Multilocus sequence analysis reveals a heterogeneous picture and further analysis of draft genome sequencing may give clues to the taxonomy and epidemiology of this organism. Prospective treatment trials and/or additional drug susceptibility testing in specialised systems would further inform treatment recommendations. Comparative aspects: This paper finishes with a discussion of comparative aspects of infection caused by the three feline leproid disease agents that have been the subject of this series: Candidatus 'Mycobacterium tarwinense', Mycobacterium lepraemurium and Candidatus 'M lepraefelis'.

Attracting Youth to Agriculture: The Career Interests of Young Farmers Club Members in Uganda

ERIC Educational Resources Information Center

Mukembo, Stephen C.; Edwards, M. Craig; Ramsey, Jon W.; Henneberry, Shida R.

2014-01-01

This embedded, quantitative case study included 102 participants who were members of Young Farmers Clubs (YFCs) from two secondary schools in eastern Uganda. The study's multifold purpose was to describe YFC members' personal characteristics and their reasons for joining the clubs. In addition, the study sought to determine the career…

Persistence of chromosomal abnormalities additional to the Philadelphia chromosome after Philadelphia chromosome disappearance during imatinib therapy for chronic myeloid leukemia.

PubMed

Zaccaria, Alfonso; Valenti, Anna Maria; Donti, Emilio; Gozzetti, Alessandro; Ronconi, Sonia; Spedicato, Francesco

2007-04-01

Five Philadelphia chromosome positive (Ph+) chronic myeloid leukemia (CML) patients with additional chromosome abnormalities at diagnosis have been followed during Imatinib therapy. In all, the Ph chromosome disappeared, while the 5 cases, additional abnormalities [dup(1); del(5), +8 (2 patients) and +14] persisted in the subsequent studies, performed over a period of 11 to 49 months, either alone or together with a karyotypically normal cell population. This finding is consistent with a secondary origin of the Ph chromosome in these patients. It is still to early to evaluate the possible prognostic value of these additional abnormalities.

ESP Needs Analysis of Iranian MA Students: A Case Study of the University of Isfahan

ERIC Educational Resources Information Center

Moslemi, Fatemeh; Moinzadeh, Ahmad; Dabaghi, Azizollah

2011-01-01

The aim of this study was to investigate the foreign language learning needs of Iranian MA students, in particular those who were majoring in biology, psychology, physical training, accounting and west philosophy. A total of 80 students from five MA majors studying at university of Isfahan participated in the study. Additionally, twenty-five…

The Impact of Multilocus Variable-Number Tandem-Repeat Analysis on PulseNet Canada Escherichia coli O157:H7 Laboratory Surveillance and Outbreak Support, 2008-2012.

PubMed

Rumore, Jillian Leigh; Tschetter, Lorelee; Nadon, Celine

2016-05-01

The lack of pattern diversity among pulsed-field gel electrophoresis (PFGE) profiles for Escherichia coli O157:H7 in Canada does not consistently provide optimal discrimination, and therefore, differentiating temporally and/or geographically associated sporadic cases from potential outbreak cases can at times impede investigations. To address this limitation, DNA sequence-based methods such as multilocus variable-number tandem-repeat analysis (MLVA) have been explored. To assess the performance of MLVA as a supplemental method to PFGE from the Canadian perspective, a retrospective analysis of all E. coli O157:H7 isolated in Canada from January 2008 to December 2012 (inclusive) was conducted. A total of 2285 E. coli O157:H7 isolates and 63 clusters of cases (by PFGE) were selected for the study. Based on the qualitative analysis, the addition of MLVA improved the categorization of cases for 60% of clusters and no change was observed for ∼40% of clusters investigated. In such situations, MLVA serves to confirm PFGE results, but may not add further information per se. The findings of this study demonstrate that MLVA data, when used in combination with PFGE-based analyses, provide additional resolution to the detection of clusters lacking PFGE diversity as well as demonstrate good epidemiological concordance. In addition, MLVA is able to identify cluster-associated isolates with variant PFGE pattern combinations that may have been previously missed by PFGE alone. Optimal laboratory surveillance in Canada is achieved with the application of PFGE and MLVA in tandem for routine surveillance, cluster detection, and outbreak response.

RISK COMMUNICATION IN ACTION: CASE STUDIES IN FISH ADVISORIES

EPA Science Inventory

This Handbook provides both general and specific information on how to enhance mercury risk communication activities and their associated outreach efforts. Additionally, it provides information on how to facilitate communication in areas where information is not available. Chapte...

Risk factors for cardiomyopathy syndrome (CMS) in Norwegian salmon farming.

PubMed

Bang Jensen, Britt; Brun, Edgar; Fineid, Birgitte; Larssen, Rolf Bjerke; Kristoffersen, Anja B

2013-12-12

Cardiomyopathy syndrome (CMS) has been an economically important disease in Norwegian aquaculture since the 1990s. In this study, data on monthly production characteristics and case registrations were combined in a cohort study and supplemented with a questionnaire-based case-control survey on management factors in order to identify risk factors for CMS. The cohort study included cases and controls from 2005 to 2012. From this dataset differences between all cases and controls were analyzed by a mixed effect multivariate logistic regression. From this we found that the probability of CMS increased with increasing time in the sea, infection pressure, and cohort size, and that cohorts which had previously been diagnosed with heart and skeletal muscle inflammation or which were in farms with a history of CMS in previous cohorts had double the odds of developing CMS. The model was then used to calculate the predicted value for each cohort from which additional data were obtained via the questionnaire-based survey and used as offset for calculating the probability of CMS in a semi-univariate analysis of additional risk factors. Finally, the model was used to calculate the probability of developing CMS in 100 different scenarios in which the cohorts were subject to increasingly worse conditions with regards to the risk factors from the dataset. We believe that this exercise is a good way of communicating the findings to farmers, so they can make informed decisions when trying to avoid CMS in their fish cohorts.

Pilot clinical observations between food and drug seeking derived from fifty cases attending an eating disorder clinic.

PubMed

Beitscher-Campbell, Harriet; Blum, Kenneth; Febo, Marcelo; Madigan, Margaret A; Giordano, John; Badgaiyan, Rajendra D; Braverman, Eric R; Dushaj, Kristina; Li, Mona; Gold, Mark S

2016-09-01

Background The reward deficiency syndrome hypothesis posits that genes are responsible for reward dependence and related behaviors. There is evidence that both bulimia and anorexia nervosa, especially in women, have been linked to a lifetime history of substance use disorder (SUD). There are difficulties in accepting food as an addiction similar to drugs; however, increasingly neuroimaging studies favor such an assertion. Case presentations We are reporting the evidence of comorbidity of eating disorders with SUD found within these case presentations. We show 50 case reports derived from two independent treatment centers in Florida that suggest the commonality between food and drug addictions. In an attempt to provide data from this cohort, many participants did not adequately respond to our questionnaire. Discussion We propose that dopamine agonist therapy may be of common benefit. Failure in the past may reside in too powerful D2 agonist activity leading to D2 receptor downregulation, while the new methodology may cause a reduction of "dopamine resistance" by inducing "dopamine homeostasis." While this is not a definitive study, it does provide some additional clinical evidence that these two addictions are not mutually exclusive. Conclusion Certainly, it is our position that there is an overlap between food- and drug-seeking behavior. We propose that the studies focused on an effort to produce natural activation of dopaminergic reward circuitry as a type of common therapy may certainly be reasonable. Additional research is warranted.

[Patient-related complexity in nursing care - Collective case studies in the acute care hospital].

PubMed

Gurtner, Caroline; Spirig, Rebecca; Staudacher, Diana; Huber, Evelyn

2018-06-04

Patient-related complexity in nursing care - Collective case studies in the acute care hospital Abstract. Patient-related complexity of nursing is defined by the three characteristics "instability", "uncertainty", and "variability". Complexity increased in the past years, due to reduced hospital length of stay and a growing number of patients with chronic and multiple diseases. We investigated the phenomenon of patient-related complexity from the point of view of nurses and clinical nurse specialists in an acute care hospital. In the context of a collective case study design, nurses and clinical nurse specialists assessed the complexity of nursing situations with a questionnaire. Subsequently, we interviewed nurses and clinical nurse specialists about their evaluation of patient-related complexity. In a within-case-analysis we summarized data inductively to create case narratives. By means of a cross-case-analysis we compared the cases with regard to deductively derived characteristics. The four cases exemplarily showed that the degree of complexity depends on the controllability and predictability of clinical problems. Additionally, complexity increases or decreases, according to patients' individual resources. Complex patient situations demand professional expertise, experience, communicative competencies and the ability for reflection. Beginner nurses would benefit from support and advice by experienced nurses to develop these skills.

Leadership and organisational effectiveness--lessons to be drawn from education?

PubMed

Joyce, Pauline

2009-05-01

The aim of this paper is to present findings of a case study on organisational effectiveness in an education setting and draw similarities with a healthcare setting, focusing on the school principal and nurse leader. The study was carried out in a primary school setting and focuses on a principal (as leader). The school, which will be named St Senan's for the case study, is a typical tall structure, has a staff of 30 (teachers and special needs' assistants) and a student number of 117. A case study methodology was used. Data was collected by interviewing the principal, two teachers, two students and a parent, in this order. In addition, a Parents' Council meeting was observed and document analysis was carried out on measurements which reflected some critical success factors for the school. Interviews from students and teachers in addition to observation notes indicate that the principal's leadership impacts on organisational effectiveness in the school. The findings are located in the context of education with similarities being drawn from nursing. It is how the leader leads in the context of the organisation setting which is paramount. In other words it is not possible to take a set of general critical success factors for a school or healthcare setting and apply these widely. The paper concludes by proposing the use of a quality framework to contextualise the findings of the case and promote further discussion in the context of nurse leaders. The paper suggests that comparisons can be made between school principals and nurse leaders.

Observational evidence and strength of evidence domains: case examples

PubMed Central

2014-01-01

Background Systematic reviews of healthcare interventions most often focus on randomized controlled trials (RCTs). However, certain circumstances warrant consideration of observational evidence, and such studies are increasingly being included as evidence in systematic reviews. Methods To illustrate the use of observational evidence, we present case examples of systematic reviews in which observational evidence was considered as well as case examples of individual observational studies, and how they demonstrate various strength of evidence domains in accordance with current Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) methods guidance. Results In the presented examples, observational evidence is used when RCTs are infeasible or raise ethical concerns, lack generalizability, or provide insufficient data. Individual study case examples highlight how observational evidence may fulfill required strength of evidence domains, such as study limitations (reduced risk of selection, detection, performance, and attrition); directness; consistency; precision; and reporting bias (publication, selective outcome reporting, and selective analysis reporting), as well as additional domains of dose-response association, plausible confounding that would decrease the observed effect, and strength of association (magnitude of effect). Conclusions The cases highlighted in this paper demonstrate how observational studies may provide moderate to (rarely) high strength evidence in systematic reviews. PMID:24758494

Hematological malignancies with t(9;11)(p21-22;q23)--a laboratory and clinical study of 125 cases. European 11q23 Workshop participants.

PubMed

Swansbury, G J; Slater, R; Bain, B J; Moorman, A V; Secker-Walker, L M

1998-05-01

This paper reports clinical and cytogenetic data from 125 cases with t(9;11)(p21-22;q32) which were accepted for a European Union Concerted Action Workshop on 11q23. This chromosome abnormality is known to occur predominantly in acute myeloid leukemia (AML) FAB type M5a and less often in AML M4; in this series it was also found to occur, uncommonly, in other AML FAB types, in childhood acute lymphoblastic leukemia (ALL) (nine cases), in relatively young patients with myelodysplastic syndrome (MDS) (five cases), acute biphenotypic leukemia (two cases), and acute undifferentiated leukemia (one case). All age groups were represented but 50% of the patients were aged less than 15 years. The t(9;11) was the sole abnormality in 57 cases with AML; trisomy 8 was the most common additional abnormality (23 cases, including seven with further abnormalities), and 28 cases had other additional abnormalities. Among the t(9;11)+ve patients with AML, the white cell count (WBC) and age group were significant predictors of event-free survival; central nervous system (CNS) involvement or karyotype class (sole, with trisomy 8, or with other), also contributed to prognosis although our data could not show these to be independent factors. The best outcome was for patients aged 1-9 years, with low WBC, and with absence of CNS disease or presence of trisomy 8. For patients aged less than 15 years, the event-free survival for ALL patients was not significantly worse than that of AML patients.

Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: A Case Study and Review of the Literature

PubMed Central

Acikalin, Arbil; Zeren, Handan; Gonlusen, Gulfılız; Zorludemir, Suzan; Izol, Volkan

2014-01-01

Well-differentiated papillary mesothelioma is an uncommon tumor of the testes that usually presents as a hydrocele. Here, we present the case of one patient who did not have a history of asbestos exposure. The tumor was localized in the tunica vaginalis and was composed of three pedunculated masses macroscopically. Microscopically, branching papillary structures with focal coagulative necrosis were present. In addition to immunohistochemistry, simian virus 40 DNA was also tested by polymerase chain reaction. This report presents one case of this rare entity, its clinical and macroscopic features, and follow-up results. PMID:25013421

Applications of the Ultrasonic Serial Number Restoration Technique to Guns and Typical Stolen Articles

NASA Technical Reports Server (NTRS)

Young, S. G.

1976-01-01

An ultrasonic cavitation method for restoring obliterated serial numbers has been further explored by application to articles involved in police cases. The method was applied successfully to gun parts. In one case portions of numbers were restored after prior failure by other laboratories using chemical etching techniques. The ultrasonic method was not successful on a heavily obliterated and restamped automobile engine block, but it was partially successful on a motorcycle gear-case housing. Additional studies were made on the effect of a larger diameter ultrasonic probe, and on the method's ability to restore numbers obliterated by peening.

Characterization of a novel founder MSH6 mutation causing Lynch syndrome in the French Canadian population.

PubMed

Castellsagué, E; Liu, J; Volenik, A; Giroux, S; Gagné, R; Maranda, B; Roussel-Jobin, A; Latreille, J; Laframboise, R; Palma, L; Kasprzak, L; Marcus, V A; Breguet, M; Nolet, S; El-Haffaf, Z; Australie, K; Gologan, A; Aleynikova, O; Oros-Klein, K; Greenwood, C; Mes-Masson, A M; Provencher, D; Tischkowitz, M; Chong, G; Rousseau, F; Foulkes, W D

2015-06-01

We identified an MSH6 mutation (c.10C>T, p.Gln4*) causing Lynch syndrome (LS) in 11 French Canadian (FC) families from the Canadian province of Quebec. We aimed to investigate the molecular and clinical implications of this mutation among FC carriers and to assess its putative founder origin. We studied 11 probands and 27 family members. Additionally 6433 newborns, 187 colorectal cancer (CRC) cases, 381 endometrial cancer (EC) cases and 179 additional controls, all of them from Quebec, were used. Found in approximately 1 of 400 newborns, the mutation is one of the most common LS mutations described. We have found that this mutation confers a greater risk for EC than for CRC, both in the 11 studied families and in the unselected cases: EC [odds ratio (OR) = 7.5, p < 0.0001] and CRC (OR = 2.2, p = 0.46). Haplotype analyses showed that the mutation arose in a common ancestor, probably around 430-656 years ago, coinciding with the arrival of the first French settlers. Application of the results of this study could significantly improve the molecular testing and clinical management of LS families in Quebec. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

In-111-labeled leukocytes in the diagnosis of rejection and cytomegalovirus infection in renal transplant patients

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

Forstrom, L.A.; Loken, M.K.; Cook, A.

1981-04-01

Indium-111-labeled (In-111) leukocytes have been shown to be useful in the localization of inflammatory processes, including renal transplant rejection. Using previously reported labeling methods, 63 studies with this agent have been performed in 53 renal transplant patients. Indications for study included suspected rejection or cytomegalovirus (CMV) infection. Studies were performed in 33 men and 20 women, with ages ranging from 6 to 68 years. Autologous cells were normally used for labeling, although leukocytes obtained from ABO-compatible donors were used in three subjects. Rectilinear scanner and/or scintillation camera images were obtained at 24 hours after intravenous administration of 0.1 to 0.6more » mCi of In-111-leukocytes. There was abnormal uptake of In-111-leukocytes in the transplanted kidney in 11 of 15 cases of rejection. In three additional cases of increased transplant uptake, CMV infection was present in two. Abnormal lung uptake was present in 13 of 14 patients with CMV infection. In four additional cases, increased lung uptake was associated with other pulmonary inflammatory disease. Increased lung activity was not seen in patients with uncomplicated transplant rejection. These results suggest that In-111-leukocyte imaging may be useful in the differential diagnosis of rejection versus CMV infection in renal transplant patients.« less

In-111-labeled leukocytes in the diagnosis of rejection and cytomegalovirus infection in renal transplant patients

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

Forstrom, L.A.; Loken, M.K.; Cook, A.

1981-04-01

Indium-111-labelled (In-111) leukocytes have been shown to be useful in the localization of inflammatory processes, including renal transplant rejection. Using previously reported labelling methods, 63 studies with this agent have been performed in 53 renal transplant patients. Indications for study included suspected rejection or cytomegalovirus (CMV) infection. Studies were performed in 33 men and 20 women, with ages ranging from 6 to 68 years. Autologous cells were normally used for labeling, although leukocytes obtained from ABO-compatible donors were used in three subjects. Rectilinear scanner and/or scintillation camera images were obtained at 24 hours after intravenous administration of 0.1 to 0.6more » mCi of In-111 leukocytes. There was abnormal uptake of In-111-leukocytes in the transplanted kidney in 11 of 15 cases of rejection. In three additional cases of increased transplant uptake, CMV infection was present in two. Abnormal lung uptake was present in 13 of 14 patients with CMV infection. In four additional cases, increased lung uptake was associated with other pulmonary inflammatory disease. Increased lung activity was not seen in patients with uncomplicated transplant rejection. These results suggest that In-111-leukocyte imaging may be useful in the differential diagnosis of rejection versus CMV infection in renal transplant patients.« less

Approaches to the safety assessment of engineered nanomaterials (ENM) in food.

PubMed

Cockburn, Andrew; Bradford, Roberta; Buck, Neil; Constable, Anne; Edwards, Gareth; Haber, Bernd; Hepburn, Paul; Howlett, John; Kampers, Frans; Klein, Christoph; Radomski, Marek; Stamm, Hermann; Wijnhoven, Susan; Wildemann, Tanja

2012-06-01

A systematic, tiered approach to assess the safety of engineered nanomaterials (ENMs) in foods is presented. The ENM is first compared to its non-nano form counterpart to determine if ENM-specific assessment is required. Of highest concern from a toxicological perspective are ENMs which have potential for systemic translocation, are insoluble or only partially soluble over time or are particulate and bio-persistent. Where ENM-specific assessment is triggered, Tier 1 screening considers the potential for translocation across biological barriers, cytotoxicity, generation of reactive oxygen species, inflammatory response, genotoxicity and general toxicity. In silico and in vitro studies, together with a sub-acute repeat-dose rodent study, could be considered for this phase. Tier 2 hazard characterisation is based on a sentinel 90-day rodent study with an extended range of endpoints, additional parameters being investigated case-by-case. Physicochemical characterisation should be performed in a range of food and biological matrices. A default assumption of 100% bioavailability of the ENM provides a 'worst case' exposure scenario, which could be refined as additional data become available. The safety testing strategy is considered applicable to variations in ENM size within the nanoscale and to new generations of ENM. Copyright © 2012 Elsevier Ltd. All rights reserved.

Public private mix model in enhancing tuberculosis case detection in District Thatta, Sindh, Pakistan.

PubMed

Ahmed, Jameel; Ahmed, Mubashir; Laghari, A; Lohana, Wasdev; Ali, Sajid; Fatmi, Zafar

2009-02-01

To enhance the TB case detection through Public Private Mix (PPM) model by involving private practitioners in collaboration with National TB Control Program, (NTP) in district Thatta. Private practitioners (PPs) of district Thatta involved in treatment of TB cases were requested to participate in the study. All consenting physicians were provided with training on Directly Observed Treatment Short course (DOTS) module. In addition to routine cases, TB cases diagnosed by private practitioners through sputum microscopy were also registered with the district TB control program and medicines were provided by NTP. After intervention of PPM-DOTS change in Case Detection Rate (CDR) were estimated. An increased number of sputum smear positive cases were found in the intervention period--the third quarter of 2007, from 188 to 211 and CDR from 69% to 77%. The improvement in case detection rate was significant as this moderately added to the total number of cases detected from the whole of the district Thatta during the study period. Public private mix (PPM) model was effective in increasing the CDR of TB cases in district Thatta. It is recommended that the public private partnership model in Tuberculosis case detection needs to be taken on a larger scale so as to reduce the heavy TB burden in the country.

The Impact of Peritumoral Retraction Clefting & Intratumoral Eosinophils on Overall Survival in Oral Squamous Carcinoma Patients.

PubMed

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

2017-10-18

This retrospective study aimed to investigate the impact of peritumoral retraction clefts (RC) and tumor-associated tissue eosinophilia (TATE) as predictors of overall survival (OS) in oral squamous cell carcinoma (OSCC) patients. Their relationships with tumor-factors were also examined. Eighty-seven OSCC cases (pTNM: I + II/III + IV; 32/55), post-curative surgery, comprised the study cohort. Three observers independently estimated the percent RC semi-quantitatively in the selected tumor sections. Additionally, stromal eosinophils were counted in ten consecutive high-power fields of intratumoral and peritumoral regions to evaluate the corresponding TATE. The percent RC ranged between 0% -90% (Mean ± SD: 16 ± 24%; Median: 5%). The stromal eosinophils were greater in peritumoral as compared to intratumoral region. The events of death and tumor recurrence were reached in 16 (18.4%) and 36 (41%) cases respectively. The 3-years OS was 69% [Median OS: 1880 days; Mean follow up: 471(Range; 36-1880) days]. Increased percent RC exhibited relationship with pathologic stage (pTNM III&IV), primary tumor (pT III&IV), tumor depth > 4 mm and categorical tumor recurrence. Additionally, peritumoral eosinophilic infiltrates increased with increasing tumor depths and muscle invasion. Kaplan-Meier curves revealed significantly reduced OS in OSCC cases exhibiting: increased percent RC (>2.5%), mild -moderate/absent intratumoral TATE (versus intense TATE) or categorical tumor recurrence. In subsequent multivariate tests, all the three variables retained significance. Additionally, intraclass correlation coefficient demonstrated acceptable internal consistency for the observers who estimated percent RC. In conclusion, RC and intratumoral TATE proved to be independent predictors of OS in our OSCC cohort. Additionally, increased percent RC pointed towards aggressive tumor behaviour.

Characterization of Forested Landscapes From Remotely Sensed Data Using Fractals and Spatial Autocorrelation

NASA Technical Reports Server (NTRS)

Al-Hamdan, Mohammad Z.; Cruise, James F.; Rickman, Douglas L.; Quattrochi, Dale A.

2007-01-01

The characterization of forested areas is frequently required in resource management practice. Passive remotely sensed data, which are much more accessible and cost effective than are active data, have rarely, if ever, been used to characterize forest structure directly, but rather they usually focus on the estimation of indirect measurement of biomass or canopy coverage. In this study, some spatial analysis techniques are presented that might be employed with Landsat TM data to analyze forest structure characteristics. A case study is presented wherein fractal dimensions, along with a simple spatial autocorrelation technique (Moran s I), were related to stand density parameters of the Oakmulgee National Forest located in the southeastern United States (Alabama). The results of the case study presented herein have shown that as the percentage of smaller diameter trees becomes greater, and particularly if it exceeds 50%, then the canopy image obtained from Landsat TM data becomes sufficiently homogeneous so that the spatial indices reach their lower limits and thus are no longer determinative. It also appears, at least for the Oakmulgee forest, that the relationships between the spatial indices and forest class percentages within the boundaries can reasonably be considered linear. The linear relationship is much more pronounced in the sawtimber and saplings cases than in samples dominated by medium sized trees (poletimber). In addition, it also appears that, at least for the Oakmulgee forest, the relationships between the spatial indices and forest species groups (Hardwood and Softwood) percentages can reasonably be considered linear. The linear relationship is more pronounced in the forest species groups cases than in the forest classes cases. These results appear to indicate that both fractal dimensions and spatial autocorrelation indices hold promise as means of estimating forest stand characteristics from remotely sensed images. However, additional work is needed to confirm that the boundaries identified for Oakmulgee forest and the linear nature of the relationship between image complexity indices and forest characteristics are generally evident in other forests. In addition, the effects of other parameters such ,as topographic relief and image distortion due to sun angle and cloud cover, for example, need to be examined.

Which groups of patients benefit from helicopter evacuation?

PubMed

Hotvedt, R; Kristiansen, I S; Førde, O H; Thoner, J; Almdahl, S M; Bjørsvik, G; Berge, L; Magnus, A C; Mamen, K; Sparr, T; Ytre-Arne, K

1996-05-18

The evacuation of emergency cases by air, usually by helicopter, is controversial because of the cost of the programme, the possibility of an accident (especially in an urban area), and unproven benefit. But such evacuations cannot be studied by a random intervention (eg, air versus ground ambulance). We used an expert-panel approach to estimate the health outcome for patients transferred by emergency helicopter compared with the potential outcome if they had gone by surface ambulance. The helicopter programme is based at the University Hospital of Tromsø in northern Norway. 370 case-reports of helicopter evacuation from rural areas were screened by anaesthetists for routine and case-specific data. Two expert panels assessed the cases for potential additional health benefit arising from the fact of helicopter evacuation. The panels used a modified Delphi technique to reach consensus in life-years gained. One panel met for cases aged under 15 and pregnant women, the other for older cases. 240 of the 370 cases were male (65%); the age range for both sexes was 0-86 years. The most common diagnosis for the 55 cases aged under 15 was infection (49%); in older patients, cardiovascular disease dominated (50%). Trauma accounted for just under a fifth of cases in both groups. On average, the patients arrived 69 min (range 0-615) earlier in hospital than if they had gone by ground transport. For 283 cases, the initial screening by the anaesthetists indicated no additional benefit compared with that obtainable by ground-ambulance transport. The main reason was that no treatment was given during the flight or early on in hospital that could not have been given otherwise. 90 cases entered the expert panel system. Of these 90, 49 cases were judged to have received no additional benefit. This left 41 (11% of the total of 370 evacuated) who were judged to have benefited, gaining 290.6 life-years. 96% of the total number of life-years gained was achieved in nine patients, six of whom were aged below 7 (four were aged 0-7 months). The life-year-gain per adult patient with cardiovascular disease was 0.54. We conclude that an emergency helicopter service can provide considerable health benefits for selected patients, at least in this rural setting. Given the costs and risks of such a service, the benefits for most patients are small.

Heterogeneous Risk Perceptions: The Case of Poultry Meat Purchase Intentions in Finland

PubMed Central

Heikkilä, Jaakko; Pouta, Eija; Forsman-Hugg, Sari; Mäkelä, Johanna

2013-01-01

This study focused on the heterogeneity of consumer reactions, measured through poultry meat purchase intentions, when facing three cases of risk. The heterogeneity was analysed by latent class logistic regression that included all three risk cases. Approximately 60% of the respondents belonged to the group of production risk avoiders, in which the intention to purchase risk food was significantly lower than in the second group of risk neutrals. In addition to socio-demographic variables, the purchase intentions were statistically associated with several attitude-based variables. We highlighted some policy implications of the heterogeneity. Overall, the study demonstrated that risk matters to consumers, not all risk is equal, and consumer types react somewhat differently to different types of risk. PMID:24157513

q-Gaussian distributions and multiplicative stochastic processes for analysis of multiple financial time series

NASA Astrophysics Data System (ADS)

Sato, Aki-Hiro

2010-12-01

This study considers q-Gaussian distributions and stochastic differential equations with both multiplicative and additive noises. In the M-dimensional case a q-Gaussian distribution can be theoretically derived as a stationary probability distribution of the multiplicative stochastic differential equation with both mutually independent multiplicative and additive noises. By using the proposed stochastic differential equation a method to evaluate a default probability under a given risk buffer is proposed.

Analytical Study of Cockpit Information Requirements.

DTIC Science & Technology

1981-04-01

monitoring and control of engine case heating and cooling . Generally, the crew will be buffered from these changes by the increasingly more...advantages of color for prioritization, data separation and added dimensionality should apply equally well here as with conventional EADI and EHSI formats...addition of position/time control to a 3-D RNAV system converts it into a 4-D system. A 3-D system requires the addition of a time source plus software

Spatial Distribution of the Risk of Dengue and the Entomological Indicators in Sumaré, State of São Paulo, Brazil

PubMed Central

Barbosa, Gerson Laurindo; Donalísio, Maria Rita; Stephan, Celso; Lourenço, Roberto Wagner; Andrade, Valmir Roberto; Arduino, Marylene de Brito; de Lima, Virgilia Luna Castor

2014-01-01

Dengue fever is a major public health problem worldwide, caused by any of four virus (DENV-1, DENV-2, DENV-3 and DENV-4; Flaviviridae: Flavivirus), transmitted by Aedes aegypti mosquito. Reducing the levels of infestation by A. aegypti is one of the few current strategies to control dengue fever. Entomological indicators are used by dengue national control program to measure the infestation of A. aegypti, but little is known about predictive power of these indicators to measure dengue risk. In this spatial case-control study, we analyzed the spatial distribution of the risk of dengue and the influence of entomological indicators of A. aegypti in its egg, larva-pupa and adult stages occurring in a mid-size city in the state of São Paulo. The dengue cases were those confirmed by the city's epidemiological surveillance system and the controls were obtained through random selection of points within the perimeter of the inhabited area. The values of the entomological indicators were extrapolated for the entire study area through the geostatistical ordinary kriging technique. For each case and control, the respective indicator values were obtained, according with its geographical coordinates and analyzed by using a generalized additive model. Dengue incidence demonstrated a seasonal behavior, as well as the entomological indicators of all mosquito's evolutionary stages. The infestation did not present a significant variation in intensity and was not a limiting or determining factor of the occurrence of cases in the municipality. The risk maps of the disease from crude and adjusted generalized additive models did not present differences, suggesting that areas with the highest values of entomological indicators were not associated with the incidence of dengue. The inclusion of other variables in the generalized additive models may reveal the modulatory effect for the risk of the disease, which is not found in this study. PMID:24831806

Spatial distribution of the risk of dengue and the entomological indicators in Sumaré, state of São Paulo, Brazil.

PubMed

Barbosa, Gerson Laurindo; Donalísio, Maria Rita; Stephan, Celso; Lourenço, Roberto Wagner; Andrade, Valmir Roberto; Arduino, Marylene de Brito; de Lima, Virgilia Luna Castor

2014-05-01

Dengue fever is a major public health problem worldwide, caused by any of four virus (DENV-1, DENV-2, DENV-3 and DENV-4; Flaviviridae: Flavivirus), transmitted by Aedes aegypti mosquito. Reducing the levels of infestation by A. aegypti is one of the few current strategies to control dengue fever. Entomological indicators are used by dengue national control program to measure the infestation of A. aegypti, but little is known about predictive power of these indicators to measure dengue risk. In this spatial case-control study, we analyzed the spatial distribution of the risk of dengue and the influence of entomological indicators of A. aegypti in its egg, larva-pupa and adult stages occurring in a mid-size city in the state of São Paulo. The dengue cases were those confirmed by the city's epidemiological surveillance system and the controls were obtained through random selection of points within the perimeter of the inhabited area. The values of the entomological indicators were extrapolated for the entire study area through the geostatistical ordinary kriging technique. For each case and control, the respective indicator values were obtained, according with its geographical coordinates and analyzed by using a generalized additive model. Dengue incidence demonstrated a seasonal behavior, as well as the entomological indicators of all mosquito's evolutionary stages. The infestation did not present a significant variation in intensity and was not a limiting or determining factor of the occurrence of cases in the municipality. The risk maps of the disease from crude and adjusted generalized additive models did not present differences, suggesting that areas with the highest values of entomological indicators were not associated with the incidence of dengue. The inclusion of other variables in the generalized additive models may reveal the modulatory effect for the risk of the disease, which is not found in this study.

Emergency department injury surveillance and aetiological research: bridging the gap with the two-stage case-control study design.

PubMed

Hagel, Brent E

2011-04-01

To provide an overview of the two-stage case-control study design and its potential application to ED injury surveillance data and to apply this approach to published ED data on the relation between brain injury and bicycle helmet use. Relevant background is presented on injury aetiology and case-control methodology with extension to the two-stage case-control design in the context of ED injury surveillance. The design is then applied to data from a published case-control study of the relation between brain injury and bicycle helmet use with motor vehicle involvement considered as a potential confounder. Taking into account the additional sampling at the second stage, the adjusted and corrected odds ratio and 95% confidence interval for the brain injury-helmet use relation is presented and compared with the estimate from the entire original dataset. Contexts where the two-stage case-control study design might be most appropriately applied to ED injury surveillance data are suggested. The adjusted odds ratio for the relation between brain injury and bicycle helmet use based on all data (n = 2833) from the original study was 0.34 (95% CI 0.25 to 0.46) compared with an estimate from a two-stage case-control design of 0.35 (95% CI 0.25 to 0.48) using only a fraction of the original subjects (n = 480). Application of the two-stage case-control study design to ED injury surveillance data has the potential to dramatically reduce study time and resource costs with acceptable losses in statistical efficiency.

Epstein-Barr Virus and Gastric Cancer Risk: A Meta-analysis With Meta-regression of Case-control Studies.

PubMed

Bae, Jong-Myon; Kim, Eun Hee

2016-03-01

Research on how the risk of gastric cancer increases with Epstein-Barr virus (EBV) infection is lacking. In a systematic review that investigated studies published until September 2014, the authors did not calculate the summary odds ratio (SOR) due to heterogeneity across studies. Therefore, we include here additional studies published until October 2015 and conduct a meta-analysis with meta-regression that controls for the heterogeneity among studies. Using the studies selected in the previously published systematic review, we formulated lists of references, cited articles, and related articles provided by PubMed. From the lists, only case-control studies that detected EBV in tissue samples were selected. In order to control for the heterogeneity among studies, subgroup analysis and meta-regression were performed. In the 33 case-control results with adjacent non-cancer tissue, the total number of test samples in the case and control groups was 5280 and 4962, respectively. In the 14 case-control results with normal tissue, the total number of test samples in case and control groups was 1393 and 945, respectively. Upon meta-regression, the type of control tissue was found to be a statistically significant variable with regard to heterogeneity. When the control tissue was normal tissue of healthy individuals, the SOR was 3.41 (95% CI, 1.78 to 6.51; I-squared, 65.5%). The results of the present study support the argument that EBV infection increases the risk of gastric cancer. In the future, age-matched and sex-matched case-control studies should be conducted.

Teachers' Attitudes toward Information and Communication Technologies: The Case of Syrian EFL Teachers

ERIC Educational Resources Information Center

Albirini, Abdulkafi

2006-01-01

Based on the new technology initiative in Syrian education, this study explored the attitudes of high school English as a Foreign Language (EFL) teachers in Syria toward ICT. In addition, the study investigated the relationship between computer attitudes and five independent variables: computer attributes, cultural perceptions, computer…

Procedural and Conceptual Changes in Young Children's Problem Solving

ERIC Educational Resources Information Center

Voutsina, Chronoula

2012-01-01

This study analysed the different types of arithmetic knowledge that young children utilise when solving a multiple-step addition task. The focus of the research was on the procedural and conceptual changes that occur as children develop their overall problem solving approach. Combining qualitative case study with a micro-genetic approach,…

Merit Aid in North Carolina: A Case Study of a "Nonevent"

ERIC Educational Resources Information Center

Ness, Erik C.; Mistretta, Molly A.

2010-01-01

Since the adoption of Georgia's HOPE (Helping Outstanding Pupils Educationally) scholarship program, seven additional Southeastern states have adopted similar merit-based financial aid programs, most of which are also funded by state lotteries. This study examines why North Carolina after adopting a state lottery in 2005 did not allocate its…

The Impact of Self-Regulatory Skills Training for Reducing in School Suspension Placement: A Case Study

ERIC Educational Resources Information Center

Schilling-Dickey, Gwen

2013-01-01

Researchers have been looking for solutions to disciplinary problems within the school setting. Many studies have been conducted to assess the impact of a variety of intervention strategies with research indicating that strategies involving self-regulatory control of behavioral responses can benefit students. Additionally, positive behavioral…

Testing the Intervention Effect in Single-Case Experiments: A Monte Carlo Simulation Study

ERIC Educational Resources Information Center

Heyvaert, Mieke; Moeyaert, Mariola; Verkempynck, Paul; Van den Noortgate, Wim; Vervloet, Marlies; Ugille, Maaike; Onghena, Patrick

2017-01-01

This article reports on a Monte Carlo simulation study, evaluating two approaches for testing the intervention effect in replicated randomized AB designs: two-level hierarchical linear modeling (HLM) and using the additive method to combine randomization test "p" values (RTcombiP). Four factors were manipulated: mean intervention effect,…

Mentored Research in a Tribal College Setting: The Northern Cheyenne Case

ERIC Educational Resources Information Center

Ward, Carol; Jones, Kacey Widdison; Coles, Ryan; Rich, Loren; Knapp, Stan; Madsen, Robert

2014-01-01

The current study, which focuses on mentored research experiences of freshmen and sophomores at the tribal college of the Northern Cheyenne Nation, responds to the call by Ovink and Veazey (2011) for additional study of effective strategies for providing both mentoring and research experiences for minority undergraduates. We use qualitative…

Listening to the Reactions of People in the Midst of Change

ERIC Educational Resources Information Center

Friestad-Tate, Jill; McCoy, Craig

2012-01-01

The purpose of the study was to listen to reactions of key stakeholders experiencing profound organizational change. A case study was used to gather data from participants' interview responses. Data analysis identified research-supported reactions; in addition, two unique themes were identified: constructive critique and ill-effects of good…

Genome-wide association study of colorectal cancer identifies six new susceptibility loci.

PubMed

Schumacher, Fredrick R; Schmit, Stephanie L; Jiao, Shuo; Edlund, Christopher K; Wang, Hansong; Zhang, Ben; Hsu, Li; Huang, Shu-Chen; Fischer, Christopher P; Harju, John F; Idos, Gregory E; Lejbkowicz, Flavio; Manion, Frank J; McDonnell, Kevin; McNeil, Caroline E; Melas, Marilena; Rennert, Hedy S; Shi, Wei; Thomas, Duncan C; Van Den Berg, David J; Hutter, Carolyn M; Aragaki, Aaron K; Butterbach, Katja; Caan, Bette J; Carlson, Christopher S; Chanock, Stephen J; Curtis, Keith R; Fuchs, Charles S; Gala, Manish; Giovannucc, Edward L; Giocannucci, Edward L; Gogarten, Stephanie M; Hayes, Richard B; Henderson, Brian; Hunter, David J; Jackson, Rebecca D; Kolonel, Laurence N; Kooperberg, Charles; Küry, Sébastien; Kury, Sebastian; LaCroix, Andrea; Laurie, Cathy C; Laurie, Cecelia A; Lemire, Mathieu; Lemire, Mathiew; Levine, David; Ma, Jing; Makar, Karen W; Qu, Conghui; Taverna, Darin; Ulrich, Cornelia M; Wu, Kana; Kono, Suminori; West, Dee W; Berndt, Sonja I; Bezieau, Stéphane; Brenner, Hermann; Campbell, Peter T; Chan, Andrew T; Chang-Claude, Jenny; Coetzee, Gerhard A; Conti, David V; Duggan, David; Figueiredo, Jane C; Fortini, Barbara K; Gallinger, Steven J; Gauderman, W James; Giles, Graham; Green, Roger; Haile, Robert; Harrison, Tabitha A; Hoffmeister, Michael; Hopper, John L; Hudson, Thomas J; Jacobs, Eric; Iwasaki, Motoki; Jee, Sun Ha; Jenkins, Mark; Jia, Wei-Hua; Joshi, Amit; Li, Li; Lindor, Noralene M; Matsuo, Keitaro; Moreno, Victor; Mukherjee, Bhramar; Newcomb, Polly A; Potter, John D; Raskin, Leon; Rennert, Gad; Rosse, Stephanie; Severi, Gianluca; Schoen, Robert E; Seminara, Daniela; Shu, Xiao-Ou; Slattery, Martha L; Tsugane, Shoichiro; White, Emily; Xiang, Yong-Bing; Zanke, Brent W; Zheng, Wei; Le Marchand, Loic; Casey, Graham; Gruber, Stephen B; Peters, Ulrike

2015-07-07

Genetic susceptibility to colorectal cancer is caused by rare pathogenic mutations and common genetic variants that contribute to familial risk. Here we report the results of a two-stage association study with 18,299 cases of colorectal cancer and 19,656 controls, with follow-up of the most statistically significant genetic loci in 4,725 cases and 9,969 controls from two Asian consortia. We describe six new susceptibility loci reaching a genome-wide threshold of P<5.0E-08. These findings provide additional insight into the underlying biological mechanisms of colorectal cancer and demonstrate the scientific value of large consortia-based genetic epidemiology studies.

Quantifying the impact of community quarantine on SARS transmission in Ontario: estimation of secondary case count difference and number needed to quarantine.

PubMed

Bondy, Susan J; Russell, Margaret L; Laflèche, Julie Ml; Rea, Elizabeth

2009-12-24

Community quarantine is controversial, and the decision to use and prepare for it should be informed by specific quantitative evidence of benefit. Case-study reports on 2002-2004 SARS outbreaks have discussed the role of quarantine in the community in transmission. However, this literature has not yielded quantitative estimates of the reduction in secondary cases attributable to quarantine as would be seen in other areas of health policy and cost-effectiveness analysis. Using data from the 2003 Ontario, Canada, SARS outbreak, two novel expressions for the impact of quarantine are presented. Secondary Case Count Difference (SCCD) reflects reduction in the average number of transmissions arising from a SARS case in quarantine, relative to not in quarantine, at onset of symptoms. SCCD was estimated using Poisson and negative binomial regression models (with identity link function) comparing the number of secondary cases to each index case for quarantine relative to non-quarantined index cases. The inverse of this statistic is proposed as the number needed to quarantine (NNQ) to prevent one additional secondary transmission. Our estimated SCCD was 0.133 fewer secondary cases per quarantined versus non-quarantined index case; and a NNQ of 7.5 exposed individuals to be placed in community quarantine to prevent one additional case of transmission in the community. This analysis suggests quarantine can be an effective preventive measure, although these estimates lack statistical precision. Relative to other health policy areas, literature on quarantine tends to lack in quantitative expressions of effectiveness, or agreement on how best to report differences in outcomes attributable to control measure. We hope to further this discussion through presentation of means to calculate and express the impact of population control measures. The study of quarantine effectiveness presents several methodological and statistical challenges. Further research and discussion are needed to understand the costs and benefits of enacting quarantine, and this includes a discussion of how quantitative benefit should be communicated to decision-makers and the public, and evaluated.

Quantifying the impact of community quarantine on SARS transmission in Ontario: estimation of secondary case count difference and number needed to quarantine

PubMed Central

2009-01-01

Background Community quarantine is controversial, and the decision to use and prepare for it should be informed by specific quantitative evidence of benefit. Case-study reports on 2002-2004 SARS outbreaks have discussed the role of quarantine in the community in transmission. However, this literature has not yielded quantitative estimates of the reduction in secondary cases attributable to quarantine as would be seen in other areas of health policy and cost-effectiveness analysis. Methods Using data from the 2003 Ontario, Canada, SARS outbreak, two novel expressions for the impact of quarantine are presented. Secondary Case Count Difference (SCCD) reflects reduction in the average number of transmissions arising from a SARS case in quarantine, relative to not in quarantine, at onset of symptoms. SCCD was estimated using Poisson and negative binomial regression models (with identity link function) comparing the number of secondary cases to each index case for quarantine relative to non-quarantined index cases. The inverse of this statistic is proposed as the number needed to quarantine (NNQ) to prevent one additional secondary transmission. Results Our estimated SCCD was 0.133 fewer secondary cases per quarantined versus non-quarantined index case; and a NNQ of 7.5 exposed individuals to be placed in community quarantine to prevent one additional case of transmission in the community. This analysis suggests quarantine can be an effective preventive measure, although these estimates lack statistical precision. Conclusions Relative to other health policy areas, literature on quarantine tends to lack in quantitative expressions of effectiveness, or agreement on how best to report differences in outcomes attributable to control measure. We hope to further this discussion through presentation of means to calculate and express the impact of population control measures. The study of quarantine effectiveness presents several methodological and statistical challenges. Further research and discussion are needed to understand the costs and benefits of enacting quarantine, and this includes a discussion of how quantitative benefit should be communicated to decision-makers and the public, and evaluated. PMID:20034405

A power comparison of generalized additive models and the spatial scan statistic in a case-control setting.

PubMed

Young, Robin L; Weinberg, Janice; Vieira, Verónica; Ozonoff, Al; Webster, Thomas F

2010-07-19

A common, important problem in spatial epidemiology is measuring and identifying variation in disease risk across a study region. In application of statistical methods, the problem has two parts. First, spatial variation in risk must be detected across the study region and, second, areas of increased or decreased risk must be correctly identified. The location of such areas may give clues to environmental sources of exposure and disease etiology. One statistical method applicable in spatial epidemiologic settings is a generalized additive model (GAM) which can be applied with a bivariate LOESS smoother to account for geographic location as a possible predictor of disease status. A natural hypothesis when applying this method is whether residential location of subjects is associated with the outcome, i.e. is the smoothing term necessary? Permutation tests are a reasonable hypothesis testing method and provide adequate power under a simple alternative hypothesis. These tests have yet to be compared to other spatial statistics. This research uses simulated point data generated under three alternative hypotheses to evaluate the properties of the permutation methods and compare them to the popular spatial scan statistic in a case-control setting. Case 1 was a single circular cluster centered in a circular study region. The spatial scan statistic had the highest power though the GAM method estimates did not fall far behind. Case 2 was a single point source located at the center of a circular cluster and Case 3 was a line source at the center of the horizontal axis of a square study region. Each had linearly decreasing logodds with distance from the point. The GAM methods outperformed the scan statistic in Cases 2 and 3. Comparing sensitivity, measured as the proportion of the exposure source correctly identified as high or low risk, the GAM methods outperformed the scan statistic in all three Cases. The GAM permutation testing methods provide a regression-based alternative to the spatial scan statistic. Across all hypotheses examined in this research, the GAM methods had competing or greater power estimates and sensitivities exceeding that of the spatial scan statistic.

A power comparison of generalized additive models and the spatial scan statistic in a case-control setting

PubMed Central

2010-01-01

Background A common, important problem in spatial epidemiology is measuring and identifying variation in disease risk across a study region. In application of statistical methods, the problem has two parts. First, spatial variation in risk must be detected across the study region and, second, areas of increased or decreased risk must be correctly identified. The location of such areas may give clues to environmental sources of exposure and disease etiology. One statistical method applicable in spatial epidemiologic settings is a generalized additive model (GAM) which can be applied with a bivariate LOESS smoother to account for geographic location as a possible predictor of disease status. A natural hypothesis when applying this method is whether residential location of subjects is associated with the outcome, i.e. is the smoothing term necessary? Permutation tests are a reasonable hypothesis testing method and provide adequate power under a simple alternative hypothesis. These tests have yet to be compared to other spatial statistics. Results This research uses simulated point data generated under three alternative hypotheses to evaluate the properties of the permutation methods and compare them to the popular spatial scan statistic in a case-control setting. Case 1 was a single circular cluster centered in a circular study region. The spatial scan statistic had the highest power though the GAM method estimates did not fall far behind. Case 2 was a single point source located at the center of a circular cluster and Case 3 was a line source at the center of the horizontal axis of a square study region. Each had linearly decreasing logodds with distance from the point. The GAM methods outperformed the scan statistic in Cases 2 and 3. Comparing sensitivity, measured as the proportion of the exposure source correctly identified as high or low risk, the GAM methods outperformed the scan statistic in all three Cases. Conclusions The GAM permutation testing methods provide a regression-based alternative to the spatial scan statistic. Across all hypotheses examined in this research, the GAM methods had competing or greater power estimates and sensitivities exceeding that of the spatial scan statistic. PMID:20642827

Histologic Features associated with Diagnostic Agreement in Atypical Ductal Hyperplasia of the Breast: Illustrative Cases from the B-Path Study

PubMed Central

Allison, Kimberly H.; Rendi, Mara H.; Peacock, Sue; Morgan, Tom; Elmore, Joann G.; Weaver, Donald L.

2016-01-01

Background Case specific characteristics associated with interobserver diagnostic agreement in atypical ductal hyperplasia (ADH) of the breast are poorly understood. Methods Seventy-two test set cases with a consensus diagnosis of ADH from the B-Path study were evaluated. Cases were scored for 17 histologic features which were then correlated with the participant agreement with the consensus ADH diagnosis. Participating pathologists’ perceptions of case difficulty, borderline features, or if they would obtain a second opinion were also examined for associations with agreement. Results Of the 2,070 participant interpretations on the 72 consensus ADH cases, 48% were scored by participants as difficult and 45% as borderline between two diagnoses; the presence of both of these features was significantly associated with increased agreement (p < 0.001). A second opinion would have been obtained in 80% of interpretations, and this was associated with increased agreement (p < 0.001). Diagnostic agreement ranged from 10–89% on a case-by-case basis. Cases with papillary lesions, cribriform architecture and obvious cytologic monotony were associated with higher agreement. Lower agreement rates were associated with solid or micro-papillary architecture, borderline cytologic monotony or cases without a diagnostic area that was obvious on low power. Conclusions The results of this study suggest that pathologists frequently recognize the challenge of ADH cases with some cases more prone to diagnostic variability. In addition, there are specific histologic features associated with diagnostic agreement on ADH cases. Multiple example images from cases in this test set are provided to serve as educational illustrations of these challenges. PMID:27398812

Advancing the role of the pharmacy technician: A systematic review.

PubMed

Mattingly, Ashlee N; Mattingly, T Joseph

To summarize the findings of a literature search on advancing the role of pharmacy technicians, including the types of training identified and the potential costs and benefits to both the technician and the pharmacy. A literature search of Scopus, Embase, and Medline was conducted on January 11, 2017. Original research, research reports, case studies, or association reports were included for review. Articles were considered to be relevant based on identification of an advanced pharmacy technician role or addressing additional training/education for technician functions. A standard data extraction form was used to collect study authors, article title, year published, journal title, study design, brief description of methods, primary outcome measures, advanced technician roles identified, additional education or training addressed, and additional costs and benefits identified in each article. A total of 33 articles were included for full review and data extraction. Study design varied, with 17 (52%) quantitative, 1 (3%) qualitative, 5 (15%) mixed-method, and 10 (30%) case study designs. Seventeen (52%) of the studies included were published after 2006. The mechanism of training was primarily through supervised on-the-job training, allowing technicians to assume administrative-based positions that facilitated a pharmacist-led clinical service, with either the pharmacist or the pharmacy receiving the greatest benefits. Although the literature supports technicians performing advanced roles in the pharmacy, resulting in either improved patient outcomes or opportunities for pharmacists to engage in additional clinical services, the benefits to the technician were primarily indirect, such as an increase in job satisfaction or a more desirable work schedule. If a technician is to take on additional roles that require completion of a formalized training or educational program, benefits that are more tangible may help to inspire technicians to pursue these roles. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Infectious encephalitis: utility of a rational approach to aetiological diagnosis in daily clinical practice.

PubMed

López-Sánchez, C; Sulleiro, E; Bocanegra, C; Romero, S; Codina, G; Sanz, I; Esperalba, J; Serra, J; Pigrau, C; Burgos, J; Almirante, B; Falcó, V

2017-04-01

In this study we attempt to assess the utility of a simplified step-wise diagnostic algorithm to determinate the aetiology of encephalitis in daily clinical practice and to describe the main causes in our setting. This was a prospective cohort study of all consecutive cases of encephalitis in adult patients diagnosed between January 2010 and March 2015 at the University Hospital Vall d'Hebron in Barcelona, Spain. The aetiological study was carried out following the proposed step-wise algorithm. The proportion of aetiological diagnoses achieved in each step was analysed. Data from 97 patients with encephalitis were assessed. Following a simplified step-wise algorithm, a definite diagnosis was made in the first step in 53 patients (55 %) and in 12 additional cases (12 %) in the second step. Overall, a definite or probable aetiological diagnosis was achieved in 78 % of the cases. Herpes virus, L. monocytogenes and M. tuberculosis were the leading causative agents demonstrated, whereas less frequent aetiologies were observed, mainly in immunosuppressed patients. The overall related mortality was 13.4 %. According to our experience, the leading and treatable causes of encephalitis can be identified in a first diagnostic step with limited microbiological studies. L. monocytogenes treatment should be considered on arrival in some patients. Additional diagnostic effort should be made in immunosuppressed patients.

The implementation of problem-based learning in collaborative groups in a chiropractic program in Malaysia.

PubMed

Win, Ni Ni; Nadarajah, Vishna Devi V; Win, Daw Khin

2015-01-01

Problem-based learning (PBL) is usually conducted in small-group learning sessions with approximately eight students per facilitator. In this study, we implemented a modified version of PBL involving collaborative groups in an undergraduate chiropractic program and assessed its pedagogical effectiveness. This study was conducted at the International Medical University, Kuala Lumpur, Malaysia, and involved the 2012 chiropractic student cohort. Six PBL cases were provided to chiropractic students, consisting of three PBL cases for which learning resources were provided and another three PBL cases for which learning resources were not provided. Group discussions were not continuously supervised, since only one facilitator was present. The students' perceptions of PBL in collaborative groups were assessed with a questionnaire that was divided into three domains: motivation, cognitive skills, and perceived pressure to work. Thirty of the 31 students (97%) participated in the study. PBL in collaborative groups was significantly associated with positive responses regarding students' motivation, cognitive skills, and perceived pressure to work (P<0.05). The students felt that PBL with learning resources increased motivation and cognitive skills (P<0.001). The new PBL implementation described in this study does not require additional instructors or any additional funding. When implemented in a classroom setting, it has pedagogical benefits equivalent to those of small-group sessions. Our findings also suggest that students rely significantly on available learning resources.

Bayesian Inference for the Stereotype Regression Model: Application to a Case-control Study of Prostate Cancer

PubMed Central

Ahn, Jaeil; Mukherjee, Bhramar; Banerjee, Mousumi; Cooney, Kathleen A.

2011-01-01

Summary The stereotype regression model for categorical outcomes, proposed by Anderson (1984) is nested between the baseline category logits and adjacent category logits model with proportional odds structure. The stereotype model is more parsimonious than the ordinary baseline-category (or multinomial logistic) model due to a product representation of the log odds-ratios in terms of a common parameter corresponding to each predictor and category specific scores. The model could be used for both ordered and unordered outcomes. For ordered outcomes, the stereotype model allows more flexibility than the popular proportional odds model in capturing highly subjective ordinal scaling which does not result from categorization of a single latent variable, but are inherently multidimensional in nature. As pointed out by Greenland (1994), an additional advantage of the stereotype model is that it provides unbiased and valid inference under outcome-stratified sampling as in case-control studies. In addition, for matched case-control studies, the stereotype model is amenable to classical conditional likelihood principle, whereas there is no reduction due to sufficiency under the proportional odds model. In spite of these attractive features, the model has been applied less, as there are issues with maximum likelihood estimation and likelihood based testing approaches due to non-linearity and lack of identifiability of the parameters. We present comprehensive Bayesian inference and model comparison procedure for this class of models as an alternative to the classical frequentist approach. We illustrate our methodology by analyzing data from The Flint Men’s Health Study, a case-control study of prostate cancer in African-American men aged 40 to 79 years. We use clinical staging of prostate cancer in terms of Tumors, Nodes and Metastatsis (TNM) as the categorical response of interest. PMID:19731262

Probing the mechanism for Deep Submarine Groundwater Discharge using a Case Study in the Levant Basin (Achziv Canyon)

NASA Astrophysics Data System (ADS)

Paldor, A.; Aharonov, E.; Katz, O.

2017-12-01

Deep Submarine Groundwater Discharge (DSGD) is a ubiquitous and highly significant phenomenon, yet it remains poorly understood. Here we use numerical modeling (FEFLOW) to investigate a case study of DSGD offshore northern Israel, aiming to unravel the main features and mechanics of steady-state DSGD: the hydrology that enables its formation, the controls on rates and salinity of seepage, and the residence time of fluid underground. In addition, we investigate the geometry of the fresh-salt water interface within the seeping offshore aquifer. The first part of this work constructs a large scale (70 km) geologic cross-section of our case-study region. The mapping suggests outcropping of confined aquifer strata (Upper Cenomanian Judea Group) on the continental shelf break, 5-15 km offshore. The second part consists of hydrological simulations of DSGD from a confined aquifer similar to the case-study aquifer. The main findings are thus: steady-state DSGD from a confined aquifer occurs far offshore even under moderate heads. It is accompanied by a circulation cell that forms around an intrinsic freshwater-seawater interface. Circulation consists of seawater entering the confined aquifer at the exposed section offshore, mixing with terrestrial groundwater within the aquifer, and seeping saline water out the upper part of the exposed section. In addition, the simulated confined aquifer displays a very flat fresh-salt water interface extending far offshore, as observed in natural offshore aquifers. Preliminary results of a hydrographic survey in the area of study suggest a low-salinity anomaly close to the seafloor, implying seepage of brines in that area, as expected from the model. These new insights have potentially important implications for coastal hydrology, seawater chemistry, biogeochemistry, and submarine slope instability.

Modernization of the International Volcanic Ash Website - a global resource for ashfall preparedness and impact guidance.

NASA Astrophysics Data System (ADS)

Wallace, K.; Leonard, G.; Stewart, C.; Wilson, T. M.; Randall, M.; Stovall, W. K.

2015-12-01

The internationally collaborative volcanic ash website (http://volcanoes.usgs.gov/ash/) has been an important global information resource for ashfall preparedness and impact guidance since 2004. Recent volcanic ashfalls with significant local, regional, and global impacts highlighted the need to improve the website to make it more accessible and pertinent to users worldwide. Recently, the Volcanic Ash Impacts Working Group (Cities and Volcanoes Commission of IAVCEI) redesigned and modernized the website. Improvements include 1) a database-driven back end, 2) reorganized menu navigation, 3) language translation, 4) increased downloadable content, 5) addition of ash-impact case studies, 7) expanded and updated references , 8) an image database, and 9) inclusion of cooperating organization's logos. The database-driven platform makes the website more dynamic and efficient to operate and update. New menus provide information about specific impact topics (buildings, transportation, power, health, agriculture, water and waste water, equipment and communications, clean up) and updated content has been added throughout all topics. A new "for scientists" menu includes information on ash collection and analysis. Website translation using Google translate will significantly increase user base. Printable resources (e.g. checklists, pamphlets, posters) provide information to people without Internet access. Ash impact studies are used to improve mitigation measures during future eruptions, and links to case studies will assist communities' preparation and response plans. The Case Studies menu is intended to be a living topic area, growing as new case studies are published. A database of all images from the website allows users to access larger resolution images and additional descriptive details. Logos clarify linkages among key contributors and assure users that the site is authoritative and science-based.

The effects of the addition of a pediatric surgery fellow on the operative experience of the general surgery resident.

PubMed

Raines, Alexander; Garwe, Tabitha; Adeseye, Ademola; Ruiz-Elizalde, Alejandro; Churchill, Warren; Tuggle, David; Mantor, Cameron; Lees, Jason

2015-06-01

Adding fellows to surgical departments with residency programs can affect resident education. Our specific aim was to evaluate the effect of adding a pediatric surgery (PS) fellow on the number of index PS cases logged by the general surgery (GS) residents. At a single institution with both PS and GS programs, we examined the number of logged cases for the fellows and residents over 10 years [5 years before (Time 1) and 5 years after (Time 2) the addition of a PS fellow]. Additionally, the procedure related relative value units (RVUs) recorded by the faculty were evaluated. The fellows averaged 752 and 703 cases during Times 1 and 2, respectively, decreasing by 49 (P = 0.2303). The residents averaged 172 and 161 cases annually during Time 1 and Time 2, respectively, decreasing by 11 (P = 0.7340). The total number of procedure related RVUs was 4627 and 6000 during Times 1 and 2, respectively. The number of cases logged by the PS fellows and GS residents decreased after the addition of a PS fellow; however, the decrease was not significant. Programs can reasonably add an additional PS fellow, but care should be taken especially in programs that are otherwise static in size.

An approach to peer review in forensic pathology.

PubMed

Sims, D Noel; Langlois, Neil E I; Byard, Roger W

2013-07-01

Peer review in forensic pathology has been a long time in evolution but may provide a very useful mechanism to check for, and to correct, errors, in addition to establishing an important educative vehicle for pathologists. A process is reported that has been established at our institution that involves both informal peer review in the mortuary and formal auditing of a set number of cases. Every autopsy case is discussed at a daily meeting of pathologists before a provisional cause of death is released. In addition, one in ten cases including all homicides, deaths in custody, suspicious and paediatric cases, and randomly selected additional cases undergo formal auditing by a second pathologist. Finally, administrative staff check the completed report. This formalized process, in a jurisdiction where autopsies are usually performed by only one pathologist, has been extremely useful in standardizing autopsy reports and in enabling pathologists to discuss cases and associated issues on a regular basis. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

A pharmacometric case study regarding the sensitivity of structural model parameter estimation to error in patient reported dosing times.

PubMed

Knights, Jonathan; Rohatagi, Shashank

2015-12-01

Although there is a body of literature focused on minimizing the effect of dosing inaccuracies on pharmacokinetic (PK) parameter estimation, most of the work centers on missing doses. No attempt has been made to specifically characterize the effect of error in reported dosing times. Additionally, existing work has largely dealt with cases in which the compound of interest is dosed at an interval no less than its terminal half-life. This work provides a case study investigating how error in patient reported dosing times might affect the accuracy of structural model parameter estimation under sparse sampling conditions when the dosing interval is less than the terminal half-life of the compound, and the underlying kinetics are monoexponential. Additional effects due to noncompliance with dosing events are not explored and it is assumed that the structural model and reasonable initial estimates of the model parameters are known. Under the conditions of our simulations, with structural model CV % ranging from ~20 to 60 %, parameter estimation inaccuracy derived from error in reported dosing times was largely controlled around 10 % on average. Given that no observed dosing was included in the design and sparse sampling was utilized, we believe these error results represent a practical ceiling given the variability and parameter estimates for the one-compartment model. The findings suggest additional investigations may be of interest and are noteworthy given the inability of current PK software platforms to accommodate error in dosing times.

Transcranial Magnetic Stimulation as an Additional Diagnostic Tool in Children with Acute Inflammatory Demyelinating Polyneuropathy.

PubMed

Voitenkov, Voitenkov Vladislav; Andrey, Klimkin; Natalia, Skripchenko; Anastasia, Aksenova

2017-01-01

The diagnosis of polyneuropathy may be challenging at the early stages of the disease. Despite electromyography (EMG) efficacy in the establishment of polyneuropathy diagnosis, in some cases, results are dubious and neurophysiologists may implement additional techniques to ensure that conduction is affected. The aim of the study was to evaluate motor-evoked potential (MEP) characteristics in children with acute inflammatory demyelinating polyneuropathy (AIDP). The study was conducted at a pediatric research and clinical center for infectious diseases. Twenty healthy children (7-14 years old) without signs of neurological disorders were enrolled as controls. Thirty-seven patients (8-13 years old) with AIDP were enrolled as the main group. EMG and transcranial magnetic stimulation (TMS) were performed on the 3 rd -7 th days from the onset of the first symptoms. Descriptive statistics and Student's t -test were used. Bonferroni method was applied to implement appropriate corrections for multiple comparisons. Significant differences between children with AIDP and controls on latencies of both cortical and lumbar MEPs were registered. Cortical MEP shapes were disperse in 100% of the cases and lumbar MEPs were disperse in 57% of the cases. Diagnostic TMS on the early stage of the AIDP in children may be implemented as the additional tool. The main finding in this population is lengthening of the latency of cortical and lumbar MEPs. Disperse shape of the lumbar MEPs may be used as the early sign of the acute demyelization.

Octylisothiazolinone, an additional cause of allergic contact dermatitis caused by leather: case series and potential implications for the study of cross-reactivity with methylisothiazolinone.

PubMed

Aerts, Olivier; Meert, Hans; Romaen, Elien; Leysen, Julie; Matthieu, Lucretia; Apers, Sandra; Lambert, Julien; Goossens, An

2016-11-01

Octylisothiazolinone (OIT) is used as an antifungal agent by the leather industry. To show sensitization to OIT from leather, and to highlight the potential implications when cross-reactivity between OIT and methylisothiazolinone (MI) is studied. Two patients with allergic contact dermatitis caused by a leather belt and shoes, respectively, were patch tested with methylchloroisothiazolinone (MCI)/MI, MI, MCI, OIT, and benzisothiazolinone (BIT). High-performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect isothiazolinone derivatives in leather goods. Additionally, files of OIT-sensitized patients, observed at the KU Leuven department during the period 1990-2015, were retrospectively analysed. Both patients had been primarily sensitized to OIT, but the diagnosis in one of them could be achieved only when a higher patch test concentration of OIT (1000 ppm pet.) was used. HPLC-UV confirmed the presence of OIT in their leather goods. Non-relevant sensitization to MI was noted in both cases. Four additional cases of OIT sensitization from leather could be retrieved from the KU Leuven database. Non-occupational sensitization to OIT from leather may occur. Patch test concentrations of >250 ppm pet. may be necessary for diagnosis, and to show cross-reactivity with MI. Safer use limits for OIT in the leather industry may be needed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Whole exome sequencing identifies genetic variants in inherited thrombocytopenia with secondary qualitative function defects.

PubMed

Johnson, Ben; Lowe, Gillian C; Futterer, Jane; Lordkipanidzé, Marie; MacDonald, David; Simpson, Michael A; Sanchez-Guiú, Isabel; Drake, Sian; Bem, Danai; Leo, Vincenzo; Fletcher, Sarah J; Dawood, Ban; Rivera, José; Allsup, David; Biss, Tina; Bolton-Maggs, Paula Hb; Collins, Peter; Curry, Nicola; Grimley, Charlotte; James, Beki; Makris, Mike; Motwani, Jayashree; Pavord, Sue; Talks, Katherine; Thachil, Jecko; Wilde, Jonathan; Williams, Mike; Harrison, Paul; Gissen, Paul; Mundell, Stuart; Mumford, Andrew; Daly, Martina E; Watson, Steve P; Morgan, Neil V

2016-10-01

Inherited thrombocytopenias are a heterogeneous group of disorders characterized by abnormally low platelet counts which can be associated with abnormal bleeding. Next-generation sequencing has previously been employed in these disorders for the confirmation of suspected genetic abnormalities, and more recently in the discovery of novel disease-causing genes. However its full potential has not yet been exploited. Over the past 6 years we have sequenced the exomes from 55 patients, including 37 index cases and 18 additional family members, all of whom were recruited to the UK Genotyping and Phenotyping of Platelets study. All patients had inherited or sustained thrombocytopenia of unknown etiology with platelet counts varying from 11×10 9 /L to 186×10 9 /L. Of the 51 patients phenotypically tested, 37 (73%), had an additional secondary qualitative platelet defect. Using whole exome sequencing analysis we have identified "pathogenic" or "likely pathogenic" variants in 46% (17/37) of our index patients with thrombocytopenia. In addition, we report variants of uncertain significance in 12 index cases, including novel candidate genetic variants in previously unreported genes in four index cases. These results demonstrate that whole exome sequencing is an efficient method for elucidating potential pathogenic genetic variants in inherited thrombocytopenia. Whole exome sequencing also has the added benefit of discovering potentially pathogenic genetic variants for further study in novel genes not previously implicated in inherited thrombocytopenia. Copyright© Ferrata Storti Foundation.

Temporal bone changes in patients with Goldenhar syndrome with special emphasis on inner ear abnormalities.

PubMed

Hennersdorf, Florian; Friese, Natascha; Löwenheim, Hubert; Tropitzsch, Anke; Ernemann, Ulrike; Bisdas, Sotirios

2014-06-01

Goldenhar syndrome is a developmental disorder presenting with orofacial and vertebral anomalies, which are also accompanied by abnormalities in other organs. We examined temporal bone changes with special emphasis on inner ear abnormalities in these patients. A retrospective review of 7 new cases in addition to a previously published series of 14 cases with clinically diagnosed Goldenhar syndrome was carried out to search for inner ear anomalies. In addition, temporal bone imaging studies from the literature were summarized and compared with our results. Departments of Neuroradiology and Otorhinolaryngology at a university hospital. In addition to the previous series of 14 patients, 7 new patients with Goldenhar syndrome were identified. Patients underwent otologic examination, audiometric studies, and high-resolution computed tomography (CT) or magnetic resonance imaging (MRI) of the temporal bone. Temporal bone changes and specifically inner ear malformations. Nineteen of 21 patients showed changes of the external and middle ear correlating with the literature. Seven of 21 patients showed inner ear abnormalities constituting one-third of all patients. These ranged from mild such as vestibular enlargement to severe defects such as cochlear hypoplasia and common cavity. Inner ear abnormalities were present in one-third of patients. Although in some cases, these might not be of clinical significance, some patients show severe defects of the inner ear requiring more complex hearing loss therapy. Therefore, imaging of the temporal bone structures is important in the care of these patients.

15 CFR 50.5 - Fee structure for age search and citizenship information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Foreign Trade BUREAU OF THE CENSUS, DEPARTMENT OF COMMERCE SPECIAL SERVICES AND STUDIES BY THE BUREAU OF... to the $65.00 transcript fee. Note: An additional charge of $20.00 per case is charged for expedited...

Music therapy in the treatment of multiple sclerosis: a comprehensive literature review.

PubMed

Ostermann, Thomas; Schmid, Wolfgang

2006-04-01

Coping with multiple sclerosis symptoms still remains a challenge for each patient suffering from this chronic inflammatory disease. Therefore, patients often turn to using complementary and alternative medicine (CAM). In this review, the authors aimed to investigate the current state of literature of music therapy in the treatment of multiple sclerosis (MS). Medline, PubMed, Embase, AMED, CAMbase and the Music Therapy World Journal Index were searched for the terms MS and 'music therapy'. In addition, an internet search using Google Scholar was performed. The authors found seven case-reports/series and seven studies on music therapy for MS-patients. Both the case reports and studies presented here are pioneer work. Most of the studies are naturally predominated by the use of qualitative and uncontrolled research designs. Nevertheless, the results of the studies as well as the case reports demonstrate patients' improvement in the domains of self-acceptance, anxiety and depression. The results of the studies as well as the case reports define a sufficient basis for further music therapeutical work as they show a variety of psychosocial and emotional benefits for MS patients.

Fractions division knowledge of elementary school student: The case of Lala

NASA Astrophysics Data System (ADS)

Purnomo, Yoppy Wahyu; Widowati, Chairunnisa; Aziz, Tian Abdul; Pramudiani, Puri

2017-08-01

Division of fractions is often acknowledged by mysterious rule which is not based on conceptual knowledge. The purpose of the study was to explore elementary school student's knowledge of division fractions. For this purpose, a case study was conducted. The participant of the study was Lala (pseudonym) who enrolled at one elementary school in East Jakarta. The data were collected by administering written test and semi-structured interview respectively. The findings of the study indicated that Lala was able to describe strategy of division fractions as inverse of repeated addition flexibly. She also had basic understanding of fractions division concept as equal sharing, but when she was challenged with advance problems, she performed poorly. Lala also encountered difficulty when dealing with dividing fraction by fraction problem in which she interpreted it as subtraction problem. In this case, her procedural knowledge was likely to be more salient than her conceptual knowledge.

Low-cost and no-cost practice to achieve energy efficiency of government office buildings: A case study in federal territory of Malaysia

NASA Astrophysics Data System (ADS)

Tahir, Mohamad Zamhari; Nawi, Mohd Nasrun Mohd; Ibrahim, Amlus

2016-08-01

This paper presents the findings of a case study to achieve energy-efficient performance of conventional office buildings in Malaysia. Two multi-storey office buildings in Federal Territory of Malaysia have been selected. The aim is to study building energy saving potential then to highlight the appropriate measures that can be implemented. Data was collected using benchmarking method by comparing the measured consumption to other similar office buildings and a series of preliminary audit which involves interviews, a brief review of utility and operating data as well as a walkthrough in the buildings. Additionally, in order to get a better understanding of major energy consumption in the selected buildings, general audit have been conducted to collect more detailed information about building operation. In the end, this study emphasized low-cost and no-cost practice to achieve energy efficiency with significant results in some cases.

Association Between Four Polymorphisms in lncRNA and Risk of Lung Cancer in a Chinese Never-Smoking Female Population.

PubMed

Gao, Min; Li, Hang; Lv, Xiaoting; Zhou, Baosen; Yin, Zhihua

2018-06-07

Long noncoding RNAs (lncRNAs) play important roles in the development of human cancers. This is the first case-control study of the association between specific polymorphisms in lncRNA genes and the risk of lung cancer, as well as the gene-environment interaction between the polymorphisms and cooking oil fume exposure in Chinese never-smoking females. A hospital-based case-control study was carried out in Shenyang, Liaoning province. The study included 395 cases and 556 controls. The polymorphisms of rs4785367, rs3803662, rs10750417, and rs1814343 in lncRNA genes were analyzed. The gene-environment interactions were explored on both additive and multiplicative scale. In addition, the results were listed as follows: for rs3803662, compared with the individuals carrying homozygous TT genotype, those with homozygous CC genotype had the decreased risk of lung cancer (adjusted odds ratio [OR] = 0.61, 95% confidence interval [CI] = 0.40-0.92, p = 0.018). As for rs4785367, compared with homozygous TT, homozygous CC could lessen the risk of lung cancer (adjusted OR = 0.54, 95% CI = 0.33-0.89, p = 0.016). The recessive models of rs3803662 and rs4785367 showed significant association (adjusted OR = 0.65, 95% CIs = 0.44-0.97, p = 0.033; adjusted OR = 0.54, 95% CIs = 0.33-0.88, p = 0.014). The C allele of rs3803662 was suggested to be protective allele of lung cancer (adjusted OR = 0.80, 95% CI = 0.66-0.97, p = 0.023). However, rs10750417 and rs1814343 polymorphisms were not significantly associated with lung cancer risks. The measures of additive interaction and logistic models suggested that the gene-environment interactions were not statistically significant on both additive and multiplicative scales.

Development of Next Generation Energy Audit Protocols for the Rapid and Advanced Analysis of Building Energy Use

NASA Astrophysics Data System (ADS)

Hartley, Christopher Ahlvin

Current building energy auditing techniques are outdated and lack targeted, actionable information. These analyses only use one year's worth of monthly electricity and gas bills to define energy conservation and efficiency measures. These limited data sets cannot provide robust, directed energy reduction recommendations. The need is apparent for an overhaul of existing energy audit protocols to utilize all data that is available from the building's utility provider, installed energy management system (EMS), and sub-metering devices. This thesis analyzed the current state-of-the-art in energy audits, generated a next generation energy audit protocol, and conducted both audits types on four case study buildings to find out what additional information can be obtained from additional data sources and increased data gathering resolutions. Energy data from each case study building were collected using a variety of means including utility meters, whole building energy meters, EMS systems, and sub-metering devices. In addition to conducting an energy analysis for each case study building using the current and next generation energy audit protocols, two building energy models were created using the programs eQuest and EnergyPlus. The current and next generation energy audit protocol results were compared to one another upon completion. The results show that using the current audit protocols, only variations in season are apparent. Results from the developed next generation energy audit protocols show that in addition to seasonal variations, building heating, ventilation and air conditioning (HVAC) schedules, occupancy schedules, baseline and peak energy demand levels, and malfunctioning equipment can be found. This new protocol may also be used to quickly generate accurate building models because of the increased resolution that yields scheduling information. The developed next generation energy auditing protocol is scalable and can work for many building types across the United States, and perhaps the world.

Influenza-Associated Parotitis During the 2014-2015 Influenza Season in the United States.

PubMed

Rolfes, Melissa A; Millman, Alexander J; Talley, Pamela; Elbadawi, Lina I; Kramer, Natalie A; Barnes, John R; Blanton, Lenee; Davis, Jeffrey P; Cole, Stefanie; Dreisig, John J; Garten, Rebecca; Haupt, Thomas; Jackson, Mary Anne; Kocharian, Anna; Leifer, Daniel; Lynfield, Ruth; Martin, Karen; McHugh, Lisa; Robinson, Sara; Turabelidze, George; Webber, Lori A; Pearce Weinberg, Meghan; Wentworth, David E; Finelli, Lyn; Jhung, Michael A

2018-03-30

During the 2014-2015 influenza season in the United States, 256 cases of influenza-associated parotitis were reported from 27 states. We conducted a case-control study and laboratory investigation to further describe this rare clinical manifestation of influenza. During February 2015-April 2015, we interviewed 50 cases (with parotitis) and 124 ill controls (without parotitis) with laboratory-confirmed influenza; participants resided in 11 states and were matched by age, state, hospital admission status, and specimen collection date. Influenza viruses were characterized using real-time polymerase chain reaction and next-generation sequencing. We compared cases and controls using conditional logistic regression. Specimens from additional reported cases were also analyzed. Cases, 73% of whom were aged <20 years, experienced painful (86%), unilateral (68%) parotitis a median of 4 (range, 0-16) days after onset of systemic or respiratory symptoms. Cases were more likely than controls to be male (76% vs 51%; P = .005). We detected influenza A(H3N2) viruses, genetic group 3C.2a, in 100% (32/32) of case and 92% (105/108) of control specimens sequenced (P = .22). Influenza B and A(H3N2) 3C.3 and 3C.3b genetic group virus infections were detected in specimens from additional cases. Influenza-associated parotitis, as reported here and in prior sporadic case reports, seems to occur primarily with influenza A(H3N2) virus infection. Because of the different clinical and infection control considerations for mumps and influenza virus infections, we recommend clinicians consider influenza in the differential diagnoses among patients with acute parotitis during the influenza season.

The cost-effectiveness of iodine 131 scintigraphy, ultrasonography, and fine-needle aspiration biopsy in the initial diagnosis of solitary thyroid nodules.

PubMed

Khalid, Ayesha N; Hollenbeak, Christopher S; Quraishi, Sadeq A; Fan, Chris Y; Stack, Brendan C

2006-03-01

To compare the cost-effectiveness of fine-needle aspiration biopsy, iodine 131 scintigraphy, and ultrasonography for the initial diagnostic workup of a solitary palpable thyroid nodule. A deterministic cost-effectiveness analysis was conducted using a decision tree to model the diagnostic strategies. A single, mid-Atlantic academic medical center. Expected costs, expected number of cases correctly diagnosed, and incremental cost per additional case correctly diagnosed. Relative to the routine use of fine-needle aspiration biopsy, the incremental cost per case correctly diagnosed is 24,554 dollars for the iodine 131 scintigraphy strategy and 1212 dollars for the ultrasound strategy. A diagnostic strategy using initial fine-needle aspiration biopsy for palpable thyroid nodules was found to be cost-effective compared with the other approaches as long as a payor's willingness to pay for an additional correct diagnosis is less than 1212 dollars. Prospective studies are needed to validate these finding in clinical practice.

Characterization of Effect of Support Structures in Laser Additive Manufacturing of Stainless Steel

NASA Astrophysics Data System (ADS)

Järvinen, Jukka-Pekka; Matilainen, Ville; Li, Xiaoyun; Piili, Heidi; Salminen, Antti; Mäkelä, Ismo; Nyrhilä, Olli

Laser additive manufacturing (LAM) of stainless steel is a layer wisetechnology for fabricating 3D parts from metal powder via selectively melting powder with laser beam. Support structures play a significant role in LAM process as they help to remove heat away from the process and on the other hand hold the work piece in its place. A successful design of support structures can help to achievea building process fast and inexpensive with high quality. Aimof this study was to characterize the usability of two types of support structures: web and tube supports. Purpose of this studywas also to analyze how suitable they are in two industrial application cases: case for dental application and case for jewelry application. It was concluded that the removability of web supports was much better than tube supports. It was noticed that support structures are an important part of LAM process and they strongly affect the manufacturability and the end quality of the part.

Common genetic variation in ETV6 is associated with colorectal cancer susceptibility

PubMed Central

Wang, Meilin; Gu, Dongying; Du, Mulong; Xu, Zhi; Zhang, Suzhan; Zhu, Lingjun; Lu, Jiachun; Zhang, Rui; Xing, Jinliang; Miao, Xiaoping; Chu, Haiyan; Hu, Zhibin; Yang, Lei; Tang, Cuiju; Pan, Lei; Du, Haina; Zhao, Jian; Du, Jiangbo; Tong, Na; Sun, Jielin; Shen, Hongbing; Xu, Jianfeng; Zhang, Zhengdong; Chen, Jinfei

2016-01-01

Genome-wide association studies (GWASs) have identified multiple susceptibility loci for colorectal cancer, but much of heritability remains unexplained. To identify additional susceptibility loci for colorectal cancer, here we perform a GWAS in 1,023 cases and 1,306 controls and replicate the findings in seven independent samples from China, comprising 5,317 cases and 6,887 controls. We find a variant at 12p13.2 associated with colorectal cancer risk (rs2238126 in ETV6, P=2.67 × 10−10). We replicate this association in an additional 1,046 cases and 1,076 controls of European ancestry (P=0.034). The G allele of rs2238126 confers earlier age at onset of colorectal cancer (P=1.98 × 10−6) and reduces the binding affinity of transcriptional enhancer MAX. The mRNA level of ETV6 is significantly lower in colorectal tumours than in paired normal tissues. Our findings highlight the potential importance of genetic variation in ETV6 conferring susceptibility to colorectal cancer. PMID:27145994

Integration of intensive care treatment and neurorehabilitation in patients with disorders of consciousness: a program description and case report.

PubMed

Eifert, Bernd; Maurer-Karattup, Petra; Schorl, Martin

2013-10-01

Severe brain injuries frequently result in disorders of consciousness, requiring intensive care unit treatment. We present a rehabilitative system that integrates neurorehabilitation into intensive care treatment. The system will be described using the case report of a young man who was in a vegetative state after a severe traumatic brain injury that resulted in major medical problems and complications. Despite these challenges, interdisciplinary therapies can be applied throughout the rehabilitative process. The patient in our case report showed significant improvements and functional gains during the course of treatment. Additional data from other patients support the feasibility of this system and show that integrating neurorehabilitation into intensive care treatment is possible and can lead to improved outcomes in this patient population. We will discuss the advantages, special features, and limitations of the system. Additional studies are needed to further demonstrate the efficacy of this approach compared with standard treatment. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Novel mutations in the SOX10 gene in the first two Chinese cases of type IV Waardenburg syndrome.

PubMed

Jiang, Lu; Chen, Hongsheng; Jiang, Wen; Hu, Zhengmao; Mei, Lingyun; Xue, Jingjie; He, Chufeng; Liu, Yalan; Xia, Kun; Feng, Yong

2011-05-20

We analyzed the clinical features and family-related gene mutations for the first two Chinese cases of type IV Waardenburg syndrome (WS4). Two families were analyzed in this study. The analysis included a medical history, clinical analysis, a hearing test and a physical examination. In addition, the EDNRB, EDN3 and SOX10 genes were sequenced in order to identify the pathogenic mutation responsible for the WS4 observed in these patients. The two WS4 cases presented with high phenotypic variability. Two novel heterozygous mutations (c.254G>A and c.698-2A>T) in the SOX10 gene were detected. The mutations identified in the patients were not found in unaffected family members or in 200 unrelated control subjects. This is the first report of WS4 in Chinese patients. In addition, two novel mutations in SOX10 gene have been identified. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

Preeclampsia does not share common risk alleles in 9p21 with coronary artery disease and type 2 diabetes.

PubMed

Kaartokallio, Tea; Lokki, A Inkeri; Peterson, Hanna; Kivinen, Katja; Hiltunen, Leena; Salmela, Elina; Lappalainen, Tuuli; Maanselkä, Paula; Heino, Sanna; Knuutila, Sakari; Sayed, Ayat; Poston, Lucilla; Brennecke, Shaun P; Johnson, Matthew P; Morgan, Linda; Moses, Eric K; Kere, Juha; Laivuori, Hannele

2016-08-01

Preeclampsia is a common and partially genetic pregnancy complication characterized by hypertension and proteinuria. Association with cardiovascular disease and type 2 diabetes has been reported in 9p21 by several genome-wide association studies. It has been hypothesized that cardiometabolic diseases may share common etiology with preeclampsia. We tested association with the 9p21 region to preeclampsia in the Finnish population by genotyping 23 tagging single nucleotide polymorphisms (SNPs) in 15 extended preeclampsia families and in a nationwide cohort consisting of 281 cases and 349 matched controls. Replication was conducted in additional datasets. Four SNPs (rs7044859, rs496892, rs564398 and rs7865618) showed nominal association (p ≤ 0.024 uncorrected) with preeclampsia in the case-control cohort. To increase power, we genotyped two SNPs in additional 388 cases and 341 controls from the Finnish Genetics of Preeclampsia Consortium (FINNPEC) cohort. Partial replication was also attempted in a UK cohort (237 cases and 199 controls) and in 74 preeclamptic families from Australia/New Zealand. We were unable to replicate the initial association in the extended Finnish dataset or in the two international cohorts. Our study did not find evidence for the involvement of the 9p21 region in the risk of preeclampsia. Key Message Chromosome 9p21 is not associated with preeclampsia.

Polygenic dissection of diagnosis and clinical dimensions of bipolar disorder and schizophrenia.

PubMed

Ruderfer, Douglas M; Fanous, Ayman H; Ripke, Stephan; McQuillin, Andrew; Amdur, Richard L; Gejman, Pablo V; O'Donovan, Michael C; Andreassen, Ole A; Djurovic, Srdjan; Hultman, Christina M; Kelsoe, John R; Jamain, Stephane; Landén, Mikael; Leboyer, Marion; Nimgaonkar, Vishwajit; Nurnberger, John; Smoller, Jordan W; Craddock, Nick; Corvin, Aiden; Sullivan, Patrick F; Holmans, Peter; Sklar, Pamela; Kendler, Kenneth S

2014-09-01

Bipolar disorder and schizophrenia are two often severe disorders with high heritabilities. Recent studies have demonstrated a large overlap of genetic risk loci between these disorders but diagnostic and molecular distinctions still remain. Here, we perform a combined genome-wide association study (GWAS) of 19 779 bipolar disorder (BP) and schizophrenia (SCZ) cases versus 19 423 controls, in addition to a direct comparison GWAS of 7129 SCZ cases versus 9252 BP cases. In our case-control analysis, we identify five previously identified regions reaching genome-wide significance (CACNA1C, IFI44L, MHC, TRANK1 and MAD1L1) and a novel locus near PIK3C2A. We create a polygenic risk score that is significantly different between BP and SCZ and show a significant correlation between a BP polygenic risk score and the clinical dimension of mania in SCZ patients. Our results indicate that first, combining diseases with similar genetic risk profiles improves power to detect shared risk loci and second, that future direct comparisons of BP and SCZ are likely to identify loci with significant differential effects. Identifying these loci should aid in the fundamental understanding of how these diseases differ biologically. These findings also indicate that combining clinical symptom dimensions and polygenic signatures could provide additional information that may someday be used clinically.

Phrase Lengths and the Perceived Informativeness of Prosodic Cues in Turkish.

PubMed

Dinçtopal Deniz, Nazik; Fodor, Janet Dean

2017-12-01

It is known from previous studies that in many cases (though not all) the prosodic properties of a spoken utterance reflect aspects of its syntactic structure, and also that in many cases (though not all) listeners can benefit from these prosodic cues. A novel contribution to this literature is the Rational Speaker Hypothesis (RSH), proposed by Clifton, Carlson and Frazier. The RSH maintains that listeners are sensitive to possible reasons for why a speaker might introduce a prosodic break: "listeners treat a prosodic boundary as more informative about the syntax when it flanks short constituents than when it flanks longer constituents," because in the latter case the speaker might have been motivated solely by consideration of optimal phrase lengths. This would effectively reduce the cue value of an appropriately placed prosodic boundary. We present additional evidence for the RSH from Turkish, a language typologically different from English. In addition, our study shows for the first time that the RSH also applies to a prosodic break which conflicts with the syntactic structure, reducing its perceived cue strength if it might have been motivated by length considerations. In this case, the RSH effect is beneficial. Finally, the Turkish data show that prosody-based explanations for parsing preferences such as the RSH do not take the place of traditional syntax-sensitive parsing strategies such as Late Closure. The two sources of guidance co-exist; both are used when available.

Factors determining disease duration in Alzheimer's disease: a postmortem study of 103 cases using the Kaplan-Meier estimator and Cox regression.

PubMed

Armstrong, R A

2014-01-01

Factors associated with duration of dementia in a consecutive series of 103 Alzheimer's disease (AD) cases were studied using the Kaplan-Meier estimator and Cox regression analysis (proportional hazard model). Mean disease duration was 7.1 years (range: 6 weeks-30 years, standard deviation = 5.18); 25% of cases died within four years, 50% within 6.9 years, and 75% within 10 years. Familial AD cases (FAD) had a longer duration than sporadic cases (SAD), especially cases linked to presenilin (PSEN) genes. No significant differences in duration were associated with age, sex, or apolipoprotein E (Apo E) genotype. Duration was reduced in cases with arterial hypertension. Cox regression analysis suggested longer duration was associated with an earlier disease onset and increased senile plaque (SP) and neurofibrillary tangle (NFT) pathology in the orbital gyrus (OrG), CA1 sector of the hippocampus, and nucleus basalis of Meynert (NBM). The data suggest shorter disease duration in SAD and in cases with hypertensive comorbidity. In addition, degree of neuropathology did not influence survival, but spread of SP/NFT pathology into the frontal lobe, hippocampus, and basal forebrain was associated with longer disease duration.

Trans-ethnic genome-wide association study of colorectal cancer identifies a new susceptibility locus in VTI1A

PubMed Central

Wang, Hansong; Burnett, Terrilea; Kono, Suminori; Haiman, Christopher A.; Iwasaki, Motoki; Wilkens, Lynne R.; Loo, Lenora W.M.; Berg, David Van Den; Kolonel, Laurence N.; Henderson, Brian E.; Keku, Temitope O.; Sandler, Robert S.; Signorello, Lisa B.; Blot, William J.; Newcomb, Polly A.; Pande, Mala; Amos, Christopher I.; West, Dee W.; Bézieau, Stéphane; Berndt, Sonja I.; Zanke, Brent W.; Hsu, Li; Lindor, Noralane M.; Haile, Robert W.; Hopper, John L.; Jenkins, Mark A.; Gallinger, Steven; Casey, Graham; Stenzel, Stephanie L.; Schumacher, Fredrick R.; Peters, Ulrike; Gruber, Stephen B.; Tsugane, Shoichiro; Stram, Daniel O.; Marchand, Loïc Le

2014-01-01

The genetic basis of sporadic colorectal cancer (CRC) is not well explained by known risk polymorphisms. Here we perform a meta-analysis of two genome-wide association studies in 2,627 cases and 3,797 controls of Japanese ancestry and 1,894 cases and 4,703 controls of African ancestry, to identify genetic variants that contribute to CRC susceptibility. We replicate genome-wide statistically significant associations (P < 5×10−8) in 16,823 cases and 18,211 controls of European ancestry. This study reveals a new pan-ethnic CRC risk locus at 10q25 (rs12241008, intronic to VTI1A; P=1.4×10−9), providing additional insight into the etiology of CRC and highlighting the value of association mapping in diverse populations. PMID:25105248

Trans-ethnic genome-wide association study of colorectal cancer identifies a new susceptibility locus in VTI1A.

PubMed

Wang, Hansong; Burnett, Terrilea; Kono, Suminori; Haiman, Christopher A; Iwasaki, Motoki; Wilkens, Lynne R; Loo, Lenora W M; Van Den Berg, David; Kolonel, Laurence N; Henderson, Brian E; Keku, Temitope O; Sandler, Robert S; Signorello, Lisa B; Blot, William J; Newcomb, Polly A; Pande, Mala; Amos, Christopher I; West, Dee W; Bézieau, Stéphane; Berndt, Sonja I; Zanke, Brent W; Hsu, Li; Lindor, Noralane M; Haile, Robert W; Hopper, John L; Jenkins, Mark A; Gallinger, Steven; Casey, Graham; Stenzel, Stephanie L; Schumacher, Fredrick R; Peters, Ulrike; Gruber, Stephen B; Tsugane, Shoichiro; Stram, Daniel O; Le Marchand, Loïc

2014-08-08

The genetic basis of sporadic colorectal cancer (CRC) is not well explained by known risk polymorphisms. Here we perform a meta-analysis of two genome-wide association studies in 2,627 cases and 3,797 controls of Japanese ancestry and 1,894 cases and 4,703 controls of African ancestry, to identify genetic variants that contribute to CRC susceptibility. We replicate genome-wide statistically significant associations (P<5 × 10(-8)) in 16,823 cases and 18,211 controls of European ancestry. This study reveals a new pan-ethnic CRC risk locus at 10q25 (rs12241008, intronic to VTI1A; P=1.4 × 10(-9)), providing additional insight into the aetiology of CRC and highlighting the value of association mapping in diverse populations.

Fusarium species causing eumycetoma: Report of two cases and comprehensive review of the literature.

PubMed

Al-Hatmi, Abdullah M S; Bonifaz, Alexandro; Tirado-Sánchez, Andrés; Meis, Jacques F; de Hoog, G Sybren; Ahmed, Sarah A

2017-03-01

Recently, mycetoma was added to the World Health Organization's list of neglected tropical disease priorities. Fusarium as a genus has been reported to cause eumycetoma, but little is known about the species involved in this infection and their identification. In this study, molecular tools were applied to identify Fusarium agents from human eumycetoma cases. The partial translation elongation factor 1-alpha (TEF-1α) gene was used as diagnostic parameter. Two additional cases of eumycetoma, due to F. keratoplasticum and F. pseudensiforme, respectively, are presented. A systematic literature review was performed to assess general features, identification, treatment and outcome of eumycetoma infections due to Fusarium species. Of the 20 reviewed patients, the majority (75%) were male. Most agents belonged to the F. solani species complex, ie F. keratoplasticum, F. pseudensiforme, and an undescribed lineage of F. solani. In addition, F. thapsinum, a member of Fusarium fujikuroi species complex was encountered. The main antifungal drugs used were itraconazole, ketoconazole and amphotericin B, but cure rates were low (15%). Partial response or relapse was observed in some cases, and a case ended in amputation. Clinical management of eumycetoma due to Fusarium is complex and combination therapy might be required to increase cure rates. © 2016 Blackwell Verlag GmbH.

Helicobacter Species Identified in Captive Sooty Mangabeys (Cercocebus atys) with Metastatic Gastric Adenocarcinoma

PubMed Central

Esmail, Michael Y.; Bacon, Rebecca; Swennes, Alton G.; Feng, Yan; Shen, Zeli; Garcia, AnaPatricia; Sharma, Prachi; Cohen, Joyce; Fox, James G.

2016-01-01

Background Of all human cancers, gastric carcinoma is the one of the leading causes of death. Helicobacter pylori is considered a major etiologic agent of this disease. Spontaneously occurring gastric carcinoma is a rare diagnosis in nonhuman primates. A 2011 case report documented a high incidence of gastric adenocarcinoma in a closed colony of captive sooty mangabeys (Cercebus atys). However, H. pylori infection was not detected in these animals. Materials and Methods In this study, using archived formalin-fixed, paraffin-embedded stomach sections of these animals alternative methodologies were used to identify H. pylori and other non-H. pylori Helicobacter species. In addition, two additional cases of sooty mangabeys with metastatic gastric carcinoma are characterized. Results Using fluorescent in situ hybridization, we identified gastric H. suis in 75% of archived and new gastric carcinoma cases. In the two newly reported cases, H. suis and a novel Helicobacter species were detected via PCR and sequence analysis of the 16S rRNA gene. H. pylori was not identified in any of the gastric carcinoma cases via FISH and/or PCR and sequence analysis of Helicobacter spp. in DNA from of available tissues. Conclusions This report is the first to characterize Helicobacter species infection in spontaneous gastric carcinoma with metastatic potential in nonhuman primates. PMID:26477442

Malpractice in otology.

PubMed

Blake, Danielle M; Svider, Peter F; Carniol, Eric T; Mauro, Andrew C; Eloy, Jean Anderson; Jyung, Robert W

2013-10-01

(1) Analyze otologic procedural malpractice litigation in the United States of America. (2) Discuss ways to prevent future malpractice litigation. Case series with record review. The study is a case series with review of court records pertaining to otologic procedures using the Westlaw legal database. The phrase medical malpractice was searched with terms related to otology and neurotology obtained from the AAO-HNS website. Of the 47 claims that met inclusion criteria, 63.8% were decided in the physician's favor, 25.5% were decided in the plaintiff's favor (average payment $446,697), and 10.6% were settled out of court (average payment $372,607). Cerumen removal was the most common procedure leading to complaint (21.3%) and the most likely procedure to lead to payment (50.0%). Hearing loss was the most common injury claimed among all cases (53.2%) and resulted in a high proportion of cases that led to payment (40.0%). Other common alleged injuries were facial nerve injury (27.7%), tympanic membrane perforation (23.4%), need for additional surgery (42.6%), and lack of informed consent (31.9%). In addition, cases resulting from acoustic neuroma or stapedectomy resulted in higher payments to the plaintiffs (average $3,498,597 and $2,733,000, respectively). Malpractice trials were resolved in the defendant's favor in the majority of cases. Cerumen removal was the most common procedure leading to complaint and the procedure most likely to result in payment. Hearing loss was the most common injury cited. Payment was highest in acoustic neuroma and stapedectomy cases.

Clinical differences between nasal and extranasal natural killer/T-cell lymphoma: a study of 136 cases from the International Peripheral T-Cell Lymphoma Project.

PubMed

Au, Wing-yan; Weisenburger, Dennis D; Intragumtornchai, Tanin; Nakamura, Shigeo; Kim, Won-Seog; Sng, Ivy; Vose, Julie; Armitage, James O; Liang, Raymond

2009-04-23

Among 1153 new adult cases of peripheral/T-cell lymphoma from 1990-2002 at 22 centers in 13 countries, 136 cases (11.8%) of extranodal natural killer (NK)/T-cell lymphoma were identified (nasal 68%, extranasal 26%, aggressive/unclassifiable 6%). The disease frequency was higher in Asian than in Western countries and in Continental Asia than in Japan. There were no differences in age, sex, ethnicity, or immunophenotypic profile between the nasal and extranasal cases, but the latter had more adverse clinical features. The median overall survival (OS) was better in nasal compared with the extranasal cases in early- (2.96 vs 0.36 years, P < .001) and late-stage disease (0.8 vs 0.28 years, P = .031). The addition of radiotherapy for early-stage nasal cases yielded survival benefit (P = .045). Among nasal cases, both the International Prognostic Index (P = .006) and Korean NK/T-cell Prognostic Index (P < .001) were prognostic. In addition, Ki67 proliferation greater than 50%, transformed tumor cells greater than 40%, elevated C-reactive protein level (CRP), anemia (< 11 g/dL) and thrombocytopenia (< 150 x 10(9)/L) predicts poorer OS for nasal disease. No histologic or clinical feature was predictive in extranasal disease. We conclude that the clinical features and treatment response of extranasal NK/T-cell lymphoma are different from of those of nasal lymphoma. However, the underlying features responsible for these differences remain to be defined.

[A study of otitis externa associated with Malassezia].

PubMed

Shiota, Ryoko; Kaneko, Takamasa; Yano, Hiroaki; Takeshita, Kimiko; Nishioka, Keiko; Makimura, Koichi

2009-01-01

Malassezia-positive smears can be recognized from otitis externa, however, there are few references in the literature to the relation between Malassezia and otitis externa. Therefore, the bacterial and clinical characteristics of 72 cases (63 patients) with otitis externa were investigated at the Department of Otorhinolaryngology, Takinomiya General Hospital to analyze this. Thirty-seven cases were bacterial otitis externa, 20 cases were fungal otitis externa, and 15 cases were etiological agents unknown in this study. The causative organisms in fungal otitis externa were the genera Aspergillus (10 cases), Malassezia (5) and Candida (5), respectively. We suspected that 5 cases were caused by Malassezia because Malassezia cell counts were greater than 10 per field (x 400), and a large number of Malassezia were isolated from all cases. In these cases, many squamous epithelial cells were observed by direct examination, and cells from the middle or basal layer of the ear canal were also recognized in three cases. Therefore, accelerated turnover of epidermal cells of the ear canal was suggested. The main symptoms were itching and fullness in the ear, with observations of redness and erosion in objective deterioration, and we felt that these conditions were similar to seborrheic dermatitis (SD). In addition, these five cases were confirmed as fungus-related otitis externa by their improvement with antifungal agents.

Virtual patients: the influence of case design and teamwork on students' perception and knowledge - a pilot study.

PubMed

Jäger, Frederik; Riemer, Martin; Abendroth, Martin; Sehner, Susanne; Harendza, Sigrid

2014-07-08

Virtual patient (VP) cases are an effective teaching method, although little is known about how to design and implement them for maximum effectiveness. The aim of this study was to explore the effect of case design and teamwork on students' learning outcome. One hundred forty-six undergraduate medical students participated in a mandatory medical computer science course consisting of five seminars. At the end of each seminar, they worked on one VP case, either in teams of two or individually. Each student filled out an introductory and a final survey and a feedback sheet after completing each case. Additionally, there was a surprise multiple choice (MC) test after the last seminar with three questions regarding each case. Students with more clinical experience and students who had worked in a team performed significantly better on MC questions. Students with less clinical experience more frequently used information which had been positioned less prominently on the case material. Certain aspects of case design were rated more positively by students who had an interest in e-learning. In general, students preferred to work on cases for less than 15 minutes. Clinically more advanced students and students working with a partner seem to benefit most from short VP cases with prominently presented information.

Effect of the 16-hour work limit on general surgery intern operative case volume: a multi-institutional study.

PubMed

Schwartz, Samuel I; Galante, Joseph; Kaji, Amy; Dolich, Matthew; Easter, David; Melcher, Marc L; Patel, Kevin; Reeves, Mark E; Salim, Ali; Senagore, Anthony J; Takanishi, Danny M; de Virgilio, Christian

2013-09-01

The 80-hour work-week limit for all residents was instituted in 2003 and studies looking at its effect have been mixed. Since the advent of the 16-hour mandate for postgraduate year 1 residents in July 2011, no data have been published regarding the effect of this additional work-hour restriction. To determine whether the 16-hour intern work limit, implemented in July 2011, has adversely affected operative experience. A retrospective review of categorical postgraduate year 1 Accreditation Council for Graduate Medical Education case logs from the intern class (N = 52) (with 16-hour work limit) compared with the 4 preceding years (2007-2010; N = 197) (without 16-hour work limit). A total of 249 categorical general surgery interns from 10 general surgery residency programs in the western United States were included. Total, major, first-assistant, and defined-category case totals. As compared with the preceding 4 years, the 2011-2012 interns recorded a 25.8% decrease in total operative cases (65.9 vs 88.8, P = .005), a 31.8% decrease in major cases (54.9 vs 80.5, P < .001), and a 46.3% decrease in first-assistant cases (11.1 vs 20.7, P = .008). There were statistically significant decreases in cases within the defined categories of abdomen, endocrine, head and neck, basic laparoscopy, complex laparoscopy, pediatrics, thoracic, and soft tissue/breast surgery in the 16-hour shift intern era, whereas there was no decrease in trauma, vascular, alimentary, endoscopy, liver, and pancreas cases. The 16-hour work limit for interns, implemented in July 2011, is associated with a significant decrease in categorical intern operative experience. If the 16-hour shift were to be extended to all postgraduate year levels, one can anticipate that additional years of training will be needed to maintain the same operative volume.

Experimental design and statistical analysis for three-drug combination studies.

PubMed

Fang, Hong-Bin; Chen, Xuerong; Pei, Xin-Yan; Grant, Steven; Tan, Ming

2017-06-01

Drug combination is a critically important therapeutic approach for complex diseases such as cancer and HIV due to its potential for efficacy at lower, less toxic doses and the need to move new therapies rapidly into clinical trials. One of the key issues is to identify which combinations are additive, synergistic, or antagonistic. While the value of multidrug combinations has been well recognized in the cancer research community, to our best knowledge, all existing experimental studies rely on fixing the dose of one drug to reduce the dimensionality, e.g. looking at pairwise two-drug combinations, a suboptimal design. Hence, there is an urgent need to develop experimental design and analysis methods for studying multidrug combinations directly. Because the complexity of the problem increases exponentially with the number of constituent drugs, there has been little progress in the development of methods for the design and analysis of high-dimensional drug combinations. In fact, contrary to common mathematical reasoning, the case of three-drug combinations is fundamentally more difficult than two-drug combinations. Apparently, finding doses of the combination, number of combinations, and replicates needed to detect departures from additivity depends on dose-response shapes of individual constituent drugs. Thus, different classes of drugs of different dose-response shapes need to be treated as a separate case. Our application and case studies develop dose finding and sample size method for detecting departures from additivity with several common (linear and log-linear) classes of single dose-response curves. Furthermore, utilizing the geometric features of the interaction index, we propose a nonparametric model to estimate the interaction index surface by B-spine approximation and derive its asymptotic properties. Utilizing the method, we designed and analyzed a combination study of three anticancer drugs, PD184, HA14-1, and CEP3891 inhibiting myeloma H929 cell line. To our best knowledge, this is the first ever three drug combinations study performed based on the original 4D dose-response surface formed by dose ranges of three drugs.

Inorganic bromine in organic molecular crystals: Database survey and four case studies

NASA Astrophysics Data System (ADS)

Nemec, Vinko; Lisac, Katarina; Stilinović, Vladimir; Cinčić, Dominik

2017-01-01

We present a Cambridge Structural Database and experimental study of multicomponent molecular crystals containing bromine. The CSD study covers supramolecular behaviour of bromide and tribromide anions as well as halogen bonded dibromine molecules in crystal structures of organic salts and cocrystals, and a study of the geometries and complexities in polybromide anion systems. In addition, we present four case studies of organic structures with bromide, tribromide and polybromide anions as well as the neutral dibromine molecule. These include the first observed crystal with diprotonated phenazine, a double salt of phenazinium bromide and tribromide, a cocrystal of 4-methoxypyridine with the neutral dibromine molecule as a halogen bond donor, as well as bis(4-methoxypyridine)bromonium polybromide. Structural features of the four case studies are in the most part consistent with the statistically prevalent behaviour indicated by the CSD study for given bromine species, although they do exhibit some unorthodox structural features and in that indicate possible supramolecular causes for aberrations from the statistically most abundant (and presumably most favourable) geometries.

Spinal cord ischemia following elective endovascular repair of infrarenal aortic aneurysms: A systematic review.

PubMed

Moulakakis, Konstantinos G; Alexiou, Vangelis G; Karaolanis, Georgios; Sfyroeras, George S; Theoharopoulos, George; Lazaris, Andreas; Kakisis, John; Geroulakos, George

2018-06-06

Spinal cord ischemia (SCI) following endovascular abdominal aortic aneurysm (AAA) repair (EVAR) is a rare but devastating complication. The mechanism underlying the occurrence of SCI following EVAR seems to be multifactorial and is underreported and not fully elucidated. The aim of the study was to investigate the clinical outcomes in patients with this serious complication. A systematic review of the current literature, as per PRISMA statement guidelines, to evaluate the incidence of SCI following elective EVAR was performed. PubMed and Scopus databases were systematically searched. Studies reporting on thoracic endovascular aneurysm repair, open repair of AAAs, and symptomatic or ruptured AAAs were excluded. In total, 18 articles reporting 25 cases were included. The mean age was 74.6 ± 7.6 (range: 60-90) years. The mean diameter of AAAs was 5.96 ± 1.0 cm (range: 4.7-8.3). Six cases also had aneurysms in the common iliac arteries. Seventy-one percent of AAAs had characteristics that made EVAR difficult and technically demanding. The mean operative time was prolonged, 254 ± 104.6 minutes, and associated with extensive intravascular handling. In 41.6% of cases, additional procedures were performed because of the difficult anatomy. Thirty-two percent of the cases had 1 internal iliac artery (IIA) embolized with coils or covered with the stent graft and 14% had both IIAs compromised. In most of the cases, SCI symptoms presented immediately after the operation, and in 14.8% of patients the symptoms had late presentation. Almost all cases had motor loss in the form of paraparesis or paraplegia, 54% of the cases also had diminished sensation, and 29.1% of the cases had urinary and/or fecal incontinence. Heterogeneity was observed regarding the management of the disease; in 6 of the cases cerebrospinal fluid (CSF) drainage was performed, steroids were administered in 5, and in the other cases an expectant strategy was selected. In 50% of the cases, only small improvement was seen at follow-up. In 25% of the cases no improvement was seen, and 25% had almost complete recovery. Our study identified a common pattern among patients who present SCI following EVAR: difficult anatomy, prolonged operative time, additional procedures, and extensive intravascular handling that may have led to embolization. Patency of pelvic circulation preoperatively is also of importance. Regarding outcomes, only 25% of patients recovered, and in certain cases CSF drainage may have significantly improved chances for recovery. Copyright © 2018. Published by Elsevier Inc.

Alcohol drinking and esophageal cancer risk: an evaluation based on a systematic review of epidemiologic evidence among the Japanese population.

PubMed

Oze, Isao; Matsuo, Keitaro; Wakai, Kenji; Nagata, Chisato; Mizoue, Tetsuya; Tanaka, Keitaro; Tsuji, Ichiro; Sasazuki, Shizuka; Inoue, Manami; Tsugane, Shoichiro

2011-05-01

Although alcohol drinking is considered as an important risk factor for esophageal cancer, the magnitude of the association might be varied among geographic areas. Therefore, we reviewed epidemiologic studies on the association between alcohol drinking and esophageal cancer among the Japanese population. Original data were obtained from MEDLINE, searched using PubMed or from searches of the Ichushi database, complemented with manual searches. Evaluation of associations was based on the strength of evidence ('convincing', 'probable', 'possible' or 'insufficient') and the magnitude of association ('strong', 'moderate', 'weak' or 'no association'), together with biological plausibility as previously evaluated by the International Agency of Research on Cancer. We identified four cohort studies and nine case-control studies. All cohort studies and case-control studies showed strong positive associations between esophageal cancer and alcohol drinking. All cohort studies and six case-control studies showed that alcohol drinking had the dose- or frequency-response relationships with esophageal cancer. In addition, four case-control studies showed that acetaldehyde dehydrogenase Glu504Lys polymorphism had strong effect modification with alcohol drinking. We conclude that there is convincing evidence that alcohol drinking increases the risk of esophageal cancer in the Japanese population.

Narrative research methods in palliative care contexts: two case studies.

PubMed

Thomas, Carol; Reeve, Joanne; Bingley, Amanda; Brown, Janice; Payne, Sheila; Lynch, Tom

2009-05-01

Narrative methods have played a minor role in research with dying patients to date, and deserve to be more widely understood. This article illustrates the utility and value of these methods through the narrative analysis of semi-structured interview data gathered in a series of interviews with two terminally ill cancer patients and their spouses. The methods and findings associated with these two case studies are outlined and discussed. The authors' contention is that an analytical focus on the naturalistic storytelling of patients and informal carers can throw new light on individuals' perceived illness states and symptoms, care-related needs, behaviors, and desires. In addition, the juxtaposition of two cases that share a number of markers of risk and need at the end of life illustrates how the narrative analysis of patients' experiential accounts can assist in uncovering important distinctions between cases that are of relevance to care management.

[Based on the incidence of Creutzfeldt-Jakob disease in the Lanzarote healthcare area. Description of two definitive cases].

PubMed

Hernández-Ramos, F J; Martínez Martín, M; Esteban Robayna, M; Jensen Toll, F; Palacios Llopis, S

2005-01-01

We present two cases who have been diagnosed of definitive Creutzfeldt-Jakob disease in the health area of Lanzarote in the period January 2002 to January 2004. The two cases are presented with clinical description, complementary tests -- including electroencephalogram, 14-3-3 protein determination -- study of the prionic protein gene, and histopathologic findings. In this article, we try to show the importance of trying to reach a definitive diagnosis with the histopathologic study once there is clinical suspicion (a diagnosis that is probable or possible). In addition our cases show that communication between the clinical and the epidemiological coordinator of the regional community and the National Center of Epidemiology is very important. We refer to the clear growth in the incidence of the disease in the population of Lanzarote in the period above mentioned. Finally, we discuss whether this growth is or is not an isolated event.

The Teachers' Research Self-Efficacy and Attitudes towards Scientific Research Based on Different Parameters: A Case Study of Agri Province

ERIC Educational Resources Information Center

Kurt, Murat

2015-01-01

The purpose of this study is to develop competencies of teachers, the coordination of the education, learning activities; in having access to innovations, developments and scientific studies in the literature. In addition, the purpose is to determine how teachers' scientific research self-efficacy and attitude towards the scientific research…

School Leaders' Problem Framing: A Sense-Making Approach to Problem-Solving Processes of Beginning School Leaders

ERIC Educational Resources Information Center

Sleegers, Peter; Wassink, Hartger; van Veen, Klaas; Imants, Jeroen

2009-01-01

In addition to cognitive research on school leaders' problem solving, this study focuses on the situated and personal nature of problem framing by combining insights from cognitive research on problem solving and sense-making theory. The study reports the results of a case study of two school leaders solving problems in their daily context by…

Muscle dysmorphia symptomatology and extreme drive for muscularity in a 23-year-old woman: a case study.

PubMed

Leone, James E

2009-05-01

We describe a 23-year-old woman with muscle dysmorphia symptomatology and extreme drive for muscularity. In addition to structured case study interviews, 3 questionnaires and a series of semistructured interview questions were administered for elaboration on key issues. The case studies allowed for triangulation of data garnered from the questionnaires. Responses revealed high scores for drive for muscularity, moderate scores for the Adonis complex, and high scores for symptoms of muscle dysmorphia. Muscle dysmorphia and drive for muscularity are more prevalent in men; however, unique cases such as this need to be further explored both empirically and theoretically. Cross-cultural references are needed to assess the overall impact of global social influences. Instruments measuring muscle dysmorphia need to be devised and validated for women as well as men. The strength and conditioning professional needs to be both aware and vigilant in helping people affected with psychosomatic disorders such as muscle dysmorphia or exercise addiction.

Aircraft-Assisted Pilot Suicides: Lessons to be Learned.

PubMed

Vuorio, Alpo; Laukkala, Tanja; Navathe, Pooshan; Budowle, Bruce; Eyre, Anne; Sajantila, Antti

2014-08-01

Aircraft assisted suicides were studied in the United States, United Kingdom, Germany, and Finland during 1956-2012 by means of literature search and accident case analysis. According to our study the frequency varied slightly between the studies. Overall, the new estimate of aircraft assisted suicides in the United States in a 20-yr period (1993-2012) is 0.33% (95% CI 0.21-0.49) (24/7244). In the detailed accident case analysis, it was found that in five out of the eight cases from the United States, someone knew of prior suicidal ideation before the aircraft assisted fatality. The caveats of standard medico-legal autopsy and accident investigation methods in investigation of suspected aircraft assisted suicides are discussed. It is suggested that a psychological autopsy should be performed in all such cases. Also the social context and possibilities of the prevention of aviation-related suicides were analyzed. In addition, some recent aircraft assisted suicides carried out using commercial aircraft during scheduled services and causing many casualties are discussed.

Polymorphisms of genes coding for ghrelin and its receptor in relation to colorectal cancer risk: a two-step gene-wide case-control study

PubMed Central

2010-01-01

Background Ghrelin, an endogenous ligand for the growth hormone secretagogue receptor (GHSR), has two major functions: the stimulation of the growth hormone production and the stimulation of food intake. Accumulating evidence also indicates a role of ghrelin in cancer development. Methods We conducted a case-control study to examine the association of common genetic variants in the genes coding for ghrelin (GHRL) and its receptor (GHSR) with colorectal cancer risk. Pairwise tagging was used to select the 11 polymorphisms included in the study. The selected polymorphisms were genotyped in 680 cases and 593 controls from the Czech Republic. Results We found two SNPs associated with lower risk of colorectal cancer, namely SNPs rs27647 and rs35683. We replicated the two hits, in additional 569 cases and 726 controls from Germany. Conclusion A joint analysis of the two populations indicated that the T allele of rs27647 SNP exerted a protective borderline effect (Ptrend = 0.004). PMID:20920174

Polymorphisms of genes coding for ghrelin and its receptor in relation to colorectal cancer risk: a two-step gene-wide case-control study.

PubMed

Campa, Daniele; Pardini, Barbara; Naccarati, Alessio; Vodickova, Ludmila; Novotny, Jan; Steinke, Verena; Rahner, Nils; Holinski-Feder, Elke; Morak, Monika; Schackert, Hans K; Görgens, Heike; Kötting, Judith; Betz, Beate; Kloor, Matthias; Engel, Christoph; Büttner, Reinhard; Propping, Peter; Försti, Asta; Hemminki, Kari; Barale, Roberto; Vodicka, Pavel; Canzian, Federico

2010-09-28

Ghrelin, an endogenous ligand for the growth hormone secretagogue receptor (GHSR), has two major functions: the stimulation of the growth hormone production and the stimulation of food intake. Accumulating evidence also indicates a role of ghrelin in cancer development. We conducted a case-control study to examine the association of common genetic variants in the genes coding for ghrelin (GHRL) and its receptor (GHSR) with colorectal cancer risk. Pairwise tagging was used to select the 11 polymorphisms included in the study. The selected polymorphisms were genotyped in 680 cases and 593 controls from the Czech Republic. We found two SNPs associated with lower risk of colorectal cancer, namely SNPs rs27647 and rs35683. We replicated the two hits, in additional 569 cases and 726 controls from Germany. A joint analysis of the two populations indicated that the T allele of rs27647 SNP exerted a protective borderline effect (Ptrend = 0.004).

Recovery from severe novel coronavirus infection.

PubMed

Albarrak, Ali M; Stephens, Gwen M; Hewson, Roger; Memish, Ziad A

2012-12-01

We describe the third confirmed case of novel coronavirus infection in a resident of the Arabian Peninsula. Our patient presented, as did 2 prior cases, with severe pneumonia and renal dysfunction requiring intensive care support including assisted ventilation. However, unlike the earlier cases, and despite underlying chronic disease and a single kidney, he survived his infection and has been discharged home. The Ministry of Health continues active surveillance for additional cases. As this case report goes to press, 2 additional confirmed cases have been identified in Riyadh, Saudi Arabia. Contact investigations are in progress. Future work will focus not only on the origin of the virus and mechanisms of transmission, but also the host factors that influence pathogenesis and prognosis.

Locating People Diagnosed With HIV for Public Health Action: Utility of HIV Case Surveillance and Other Data Sources.

PubMed

Padilla, Mabel; Mattson, Christine L; Scheer, Susan; Udeagu, Chi-Chi N; Buskin, Susan E; Hughes, Alison J; Jaenicke, Thomas; Wohl, Amy Rock; Prejean, Joseph; Wei, Stanley C

Human immunodeficiency virus (HIV) case surveillance and other health care databases are increasingly being used for public health action, which has the potential to optimize the health outcomes of people living with HIV (PLWH). However, often PLWH cannot be located based on the contact information available in these data sources. We assessed the accuracy of contact information for PLWH in HIV case surveillance and additional data sources and whether time since diagnosis was associated with accurate contact information in HIV case surveillance and successful contact. The Case Surveillance-Based Sampling (CSBS) project was a pilot HIV surveillance system that selected a random population-based sample of people diagnosed with HIV from HIV case surveillance registries in 5 state and metropolitan areas. From November 2012 through June 2014, CSBS staff members attempted to locate and interview 1800 sampled people and used 22 data sources to search for contact information. Among 1063 contacted PLWH, HIV case surveillance data provided accurate telephone number, address, or HIV care facility information for 239 (22%), 412 (39%), and 827 (78%) sampled people, respectively. CSBS staff members used additional data sources, such as support services and commercial people-search databases, to locate and contact PLWH with insufficient contact information in HIV case surveillance. PLWH diagnosed <1 year ago were more likely to have accurate contact information in HIV case surveillance than were PLWH diagnosed ≥1 year ago ( P = .002), and the benefit from using additional data sources was greater for PLWH with more longstanding HIV infection ( P < .001). When HIV case surveillance cannot provide accurate contact information, health departments can prioritize searching additional data sources, especially for people with more longstanding HIV infection.

Genomic analysis of the origins and evolution of multicentric diffuse lower-grade gliomas.

PubMed

Hayes, Josie; Yu, Yao; Jalbert, Llewellyn E; Mazor, Tali; Jones, Lindsey E; Wood, Matthew D; Walsh, Kyle M; Bengtsson, Henrik; Hong, Chibo; Oberndorfer, Stefan; Roetzer, Thomas; Smirnov, Ivan V; Clarke, Jennifer L; Aghi, Manish K; Chang, Susan M; Nelson, Sarah J; Woehrer, Adelheid; Phillips, Joanna J; Solomon, David A; Costello, Joseph F

2018-04-09

Rare multicentric lower-grade gliomas (LGGs) represent a unique opportunity to study the heterogeneity among distinct tumor foci in a single patient and to infer their origins and parallel patterns of evolution. In this study, we integrate clinical features, histology, and immunohistochemistry for 4 patients with multicentric LGG, arising both synchronously and metachronously. For 3 patients we analyze the phylogeny of the lesions using exome sequencing, including one case with a total of 8 samples from the 2 lesions. One patient was diagnosed with multicentric isocitrate dehydrogenase 1 (IDH1) mutated diffuse astrocytomas harboring distinct IDH1 mutations, R132H and R132C; the latter mutation has been associated with Li-Fraumeni syndrome, which was subsequently confirmed in the patient's germline DNA and shown in additional cases with The Cancer Genome Atlas data. In another patient, phylogenetic analysis of synchronously arising grade II and grade III diffuse astrocytomas demonstrated a single shared mutation, IDH1 R132H, and revealed convergent evolution via non-overlapping mutations in ATRX and TP53. In 2 cases, there was divergent evolution of IDH1-mutated and 1p/19q-codeleted oligodendroglioma and IDH1-mutated and 1p/19q-intact diffuse astrocytoma, occurring synchronously in one case and metachronously in a second. Each tumor in multicentric LGG cases may arise independently or may diverge very early in their development, presenting as genetically and histologically distinct tumors. Comprehensive sampling of these lesions can therefore significantly alter diagnosis and management. Additionally, somatic IDH1 R132C mutation in either multicentric or solitary LGG identifies unsuspected germline TP53 mutation, validating the limited number of published cases.

Learning Curve Analysis and Surgical Outcomes of Single-port Laparoscopic Myomectomy.

PubMed

Lee, Hee Jun; Kim, Ju Yeong; Kim, Seul Ki; Lee, Jung Ryeol; Suh, Chang Suk; Kim, Seok Hyun

2015-01-01

To identify learning curves for single-port laparoscopic myomectomy (SPLM) and evaluate surgical outcomes according to the sequence of operation. A retrospective study. A university-based hospital (Canadian Task Force classification II-2). The medical records from 205 patients who had undergone SPLM from October 2009 to May 2013 were reviewed. Because the myomectomy time was significantly affected by the size and number of myomas removed by SPLM, cases in which 2 or more of the myomas removed were >7 cm in diameter were excluded. Furthermore, cases involving additional operations performed simultaneously (e.g., ovarian or hysteroscopic surgery) were also excluded. A total of 161 cases of SPLM were included. None. We assessed the SPLM learning curve via a graph based on operation time versus sequence of cases. Patients were chronologically arranged according to their surgery dates and were then placed into 1 of 4 groups according to their operation sequence. SPLM was completed successfully in 160 of 161 cases (99.4%). One case was converted to multiport surgery. Basal characteristics of the patients between the 4 groups did not differ. The median operation times for the 4 groups were 112.0, 92.8, 83.7, and 90.0 minutes, respectively. Operation time decreased significantly in the second, third, and fourth groups compared with that in the first group (p < .001). Proficiency, which is the point at which the slope of the learning curve became less steep, was evident after about 45 operations. Results from the current study suggested that proficiency for SPLM was achieved after about 45 operations. Additionally, operation time decreased with experience without an increase in complication rate. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

[Is DRG Coding too Important to be Left to Physicians? - Evaluation of Economic Efficiency by Health Economists in a University Medical Centre].

PubMed

Burger, F; Walgenbach, M; Göbel, P; Parbs, S; Neugebauer, E

2017-04-01

Background: We investigated and evaluated the cost effectiveness of coding by health care economists in a centre for orthopaedics and trauma surgery in Germany, by quantifying and comparing the financial efficiency of physicians with basic knowledge of the DRG-system with the results of healthcare economists with in-depth knowledge (M.Sc.). In addition, a hospital survey was performed to establish how DRG-coding is being performed and the identity of the persons involved. Material and Methods: In a prospective and controlled study, 200 in-patients were coded by a healthcare economist (study group). Prior to that, the same cases were coded by physicians with basic training in the DRG-system, who made up the control group. All cases were picked randomly and blinded without informing the physicians coding the controls, in order to avoid any Hawthorne effect. We evaluated and measured the effective weighting within the G-DRG, the DRG returns per patient, the overall DRG return, and the additional time needed. For the survey, questionnaires were sent to 1200 German hospitals. The completed questionnaire was analysed using a statistical program. Results: The return difference per patient between controls and the study group was significantly greater (2472 ± 337 €; p < 0.05); the overall return was raised by 494,500 €. The mean additional time needed was 11.32 ± 0.8 min per case, resulting in an increase in proceeds of 218 ± 38 € per minute. 2.5 % of all cases had to be devaluated by the health economist after the initial coding by the control group. Returned sheets of 60 hospitals were evaluated. The median level of DRG case reports was 1277 (2500-62,300). Coding was performed in 69 % of cases by doctors, 19 % by skilled specialists for DRG coding and in 8 % together. Overall satisfaction with the DRG was described by 61 % of respondents as good or excellent. Conclusion: Our prospective and controlled study quantifies the cost efficiency of health economists in a centre of orthopaedics and trauma surgery in Germany for the first time. We provide some initial evidence that health economists can enhance the CMI, the resulting DRG return per patient as well as the overall DRG return. Data from the survey shows that in many hospitals there is great reluctance to leave the coding to specialists only. Georg Thieme Verlag KG Stuttgart · New York.

Development, Characterization, and Resultant Properties of a Carbon, Boron, and Chromium Ternary Diffusion System

NASA Astrophysics Data System (ADS)

Domec, Brennan S.

In today's industry, engineering materials are continuously pushed to the limits. Often, the application only demands high-specification properties in a narrowly-defined region of the material, such as the outermost surface. This, in combination with the economic benefits, makes case hardening an attractive solution to meet industry demands. While case hardening has been in use for decades, applications demanding high hardness, deep case depth, and high corrosion resistance are often under-served by this process. Instead, new solutions are required. The goal of this study is to develop and characterize a new borochromizing process applied to a pre-carburized AISI 8620 alloy steel. The process was successfully developed using a combination of computational simulations, calculations, and experimental testing. Process kinetics were studied by fitting case depth measurement data to Fick's Second Law of Diffusion and an Arrhenius equation. Results indicate that the kinetics of the co-diffusion method are unaffected by the addition of chromium to the powder pack. The results also show that significant structural degradation of the case occurs when chromizing is applied sequentially to an existing boronized case. The amount of degradation is proportional to the chromizing parameters. Microstructural evolution was studied using metallographic methods, simulation and computational calculations, and analytical techniques. While the co-diffusion process failed to enrich the substrate with chromium, significant enrichment is obtained with the sequential diffusion process. The amount of enrichment is directly proportional to the chromizing parameters with higher parameters resulting in more enrichment. The case consists of M7C3 and M23C6 carbides nearest the surface, minor amounts of CrB, and a balance of M2B. Corrosion resistance was measured with salt spray and electrochemical methods. These methods confirm the benefit of surface enrichment by chromium in the sequential diffusion method with corrosion resistance increasing directly with chromium concentration. The results also confirm the deleterious effect of surface-breaking case defects and the need to reduce or eliminate them. The best combination of microstructural integrity, mean surface hardness, effective case depth, and corrosion resistance is obtained in samples sequentially boronized and chromized at 870°C for 6hrs. Additional work is required to further optimize process parameters and case properties.

Cerebral malaria and sequelar epilepsy: first matched case-control study in Gabon.

PubMed

Ngoungou, Edgard Brice; Koko, Jean; Druet-Cabanac, Michel; Assengone-Zeh-Nguema, Yvonne; Launay, Marylène Ndong; Engohang, Edouard; Moubeka-Mounguengui, Martine; Kouna-Ndouongo, Philomène; Loembe, Paul-Marie; Preux, Pierre-Marie; Kombila, Maryvonne

2006-12-01

Cerebral malaria (CM) is suspected to be a potential cause of epilepsy in tropical areas. The purpose of this article was to evaluate the relationship between CM and epilepsy in Gabon. A matched case-control study was carried out on a sample of subjects aged six months to 25 years and hospitalized between 1990 and 2004 in three hospitals in Libreville, Gabon. Cases were defined as patients suffering from epilepsy and confirmed by a neurologist. Controls were defined as patients without epilepsy. The exposure of interest was CM according to WHO criteria. In total, 296 cases and 296 controls were included. Of these, 36 (26 cases and 10 controls) had a CM history. The adjusted odds ratio (aOR) to develop epilepsy after CM was 3.9 [95% CI: 1.7-8.9], p<0.001. Additional risk factors were identified: family history of epilepsy: aOR=6.0 [95% CI: 2.6-14.1], p<0.0001, and febrile convulsions: aOR=9.2 [95% CI 4.0-21.1], p<0.0001. This first case-control study on that issue suggests that epilepsy-related CM is an underrecognized problem. It emphasizes the need for further studies to better evaluate the role of convulsions during CM.

Epidemiology of acute promyelocytic leukemia.

PubMed

Mele, A; Stazi, M A; Pulsoni, A; Visani, G; Monarca, B; Castelli, G; Rocchi, L; Avvisati, G; Mandelli, F

1995-01-01

The estimated incidence of acute promyelocytic leukemia (APL) is approximately 6 cases per 10 million people per year with no apparent differences between sexes. The age of APL cases is younger than that of other acute myeloid leukemias (AML). Spatial and temporal clusters of APL have been reported. These observations suggest a possible selective role for environmental and/or occupational factors in APL development. A multicenter case-control study was carried out on risk factors for acute leukemias and preleukemias. In this report data related to APL are selectively analyzed from the larger study to identify specific risk factors. The case-control study on 38 cases of APL showed a strong association with shoemaking (odds ration 6.3, 95% confidence interval 1.3-31.1). A moderate leukemogenic effect from living in houses built with tuff, a polous building material containing gamma-emitting radionuclides and having a high radon concentration, and from using hair dyes was also suggested. These data, together with the reported spatial and temporal clustering of APL, support the hypothesis of specific environmental and/or occupational risk factors for APL among other AML subtypes and indicate the need for additional ad hoc multicenter studies.

Impact of case type, length of stay, institution type, and comorbidities on Medicare diagnosis-related group reimbursement for adult spinal deformity surgery.

PubMed

Nunley, Pierce D; Mundis, Gregory M; Fessler, Richard G; Park, Paul; Zavatsky, Joseph M; Uribe, Juan S; Eastlack, Robert K; Chou, Dean; Wang, Michael Y; Anand, Neel; Frank, Kelly A; Stone, Marcus B; Kanter, Adam S; Shaffrey, Christopher I; Mummaneni, Praveen V

2017-12-01

OBJECTIVE The aim of this study was to educate medical professionals about potential financial impacts of improper diagnosis-related group (DRG) coding in adult spinal deformity (ASD) surgery. METHODS Medicare's Inpatient Prospective Payment System PC Pricer database was used to collect 2015 reimbursement data for ASD procedures from 12 hospitals. Case type, hospital type/location, number of operative levels, proper coding, length of stay, and complications/comorbidities (CCs) were analyzed for effects on reimbursement. DRGs were used to categorize cases into 3 types: 1) anterior or posterior only fusion, 2) anterior fusion with posterior percutaneous fixation with no dorsal fusion, and 3) combined anterior and posterior fixation and fusion. RESULTS Pooling institutions, cases were reimbursed the same for single-level and multilevel ASD surgery. Longer stay, from 3 to 8 days, resulted in an additional $1400 per stay. Posterior fusion was an additional $6588, while CCs increased reimbursement by approximately $13,000. Academic institutions received higher reimbursement than private institutions, i.e., approximately $14,000 (Case Types 1 and 2) and approximately $16,000 (Case Type 3). Urban institutions received higher reimbursement than suburban institutions, i.e., approximately $3000 (Case Types 1 and 2) and approximately $3500 (Case Type 3). Longer stay, from 3 to 8 days, increased reimbursement between $208 and $494 for private institutions and between $1397 and $1879 for academic institutions per stay. CONCLUSIONS Reimbursement is based on many factors not controlled by surgeons or hospitals, but proper DRG coding can significantly impact the financial health of hospitals and availability of quality patient care.

Epidemiologic study of residential proximity to transmission lines and childhood cancer in California: description of design, epidemiologic methods and study population

PubMed Central

Kheifets, Leeka; Crespi, Catherine M; Hooper, Chris; Oksuzyan, Sona; Cockburn, Myles; Ly, Thomas; Mezei, Gabor

2015-01-01

We conducted a large epidemiologic case-control study in California to examine the association between childhood cancer risk and distance from the home address at birth to the nearest high-voltage overhead transmission line as a replication of the study of Draper et al. in the United Kingdom. We present a detailed description of the study design, methods of case ascertainment, control selection, exposure assessment and data analysis plan. A total of 5788 childhood leukemia cases and 3308 childhood central nervous system cancer cases (included for comparison) and matched controls were available for analysis. Birth and diagnosis addresses of cases and birth addresses of controls were geocoded. Distance from the home to nearby overhead transmission lines was ascertained on the basis of the electric power companies’ geographic information system (GIS) databases, additional Google Earth aerial evaluation and site visits to selected residences. We evaluated distances to power lines up to 2000 m and included consideration of lower voltages (60–69 kV). Distance measures based on GIS and Google Earth evaluation showed close agreement (Pearson correlation >0.99). Our three-tiered approach to exposure assessment allowed us to achieve high specificity, which is crucial for studies of rare diseases with low exposure prevalence. PMID:24045429

Sequential karyotyping in Burkitt lymphoma reveals a linear clonal evolution with increase in karyotype complexity and a high frequency of recurrent secondary aberrations.

PubMed

Aukema, Sietse M; Theil, Laura; Rohde, Marius; Bauer, Benedikt; Bradtke, Jutta; Burkhardt, Birgit; Bonn, Bettina R; Claviez, Alexander; Gattenlöhner, Stefan; Makarova, Olga; Nagel, Inga; Oschlies, Ilske; Pott, Christiane; Szczepanowski, Monika; Traulsen, Arne; Kluin, Philip M; Klapper, Wolfram; Siebert, Reiner; Murga Penas, Eva M

2015-09-01

Typical Burkitt lymphoma is characterized by an IG-MYC translocation and overall low genomic complexity. Clinically, Burkitt lymphoma has a favourable prognosis with very few relapses. However, the few patients experiencing disease progression and/or relapse have a dismal outcome. Here we report cytogenetic findings of seven cases of Burkitt lymphoma in which sequential karyotyping was performed at time of diagnosis and/or disease progression/relapse(s). After case selection, karyotype re-review and additional molecular analyses were performed in six paediatric cases, treated in Berlin-Frankfurt-Münster-Non-Hodgkin lymphoma study group trials, and one additional adult patient. Moreover, we analysed 18 cases of Burkitt lymphoma from the Mitelman database in which sequential karyotyping was performed. Our findings show secondary karyotypes to have a significant increase in load of cytogenetic aberrations with a mean number of 2, 5 and 8 aberrations for primary, secondary and third investigations. Importantly, this increase in karyotype complexity seemed to result from recurrent secondary chromosomal changes involving mainly trisomy 21, gains of 1q and 7q, losses of 6q, 11q, 13q, and 17p. In addition, our findings indicate a linear clonal evolution to be the predominant manner of cytogenetic evolution. Our data may provide a biological framework for the dismal outcome of progressive and relapsing Burkitt lymphoma. © 2015 John Wiley & Sons Ltd.

Behaviour of I/Br/Cl-THMs and their projected toxicities under simulated cooking conditions: Effects of heating, table salt and residual chlorine.

PubMed

Yan, Mingquan; Li, Mingyang; Han, Xuze

2016-08-15

This study examined the effects of heating, residual chlorine and concentration of table salt on the generation of iodine-, bromine- and chlorine-containing trihalomethanes (THMs) under simulated cooking conditions. In the case of addition of either KI- or KIO3-fortified salt, total I-THM concentrations increased with increasing iodine concentration, while total Cl/Br-THM concentrations decreased. CHCl2I, CHBrClI, CHBrI2, CHBr2I and CHI3 were formed in the presence of KI salt, while only CHCl2I was formed in the presence of KIO3 salt. CHCl2I was unstable under cooking conditions, and >90% of this DBP was removed during heating, which in some cases increased the concentrations of the other I-THMs. The calculated cytotoxicity increased with addition of KI- or KIO3-fortified salt due to the generation of I-THMs, whose impact on the cytotoxicity at room temperature was equal to or five times higher, respectively, than the cytotoxicity of the simultaneously formed Cl/Br-THMs for the cases of salts. Heating decreased the cytotoxicity, except for the case of addition of KI salt, in which the calculated cytotoxicity of I-THMs increased above 150% as the temperature was increased up to 100°C. The reported results may have important implications for epidemiologic exposure assessments and, ultimately, for public health protection. Copyright © 2016 Elsevier B.V. All rights reserved.

MICROWAVE-INDUCED, SOLVENT-FREE TRANSFORMATIONS OF BENZOHETERACYCLANONES BY HTIB (KOSER'S REAGENT)

EPA Science Inventory

The microwave-activated reaction of [hydroxy(tosyloxy)iodo]benzene (HTIB) with various chromanones, thiochromanones and dihydroquinolones under solvent-free conditions has been studied. In addition to the common dehydrogenation, 2,3-migration has also been observed in the case of...

Prostate Can Men: The Effect of Body Habitus and Physical Activity

DTIC Science & Technology

2006-02-01

throughout the active phase of the study and 35 men had died of prostate cancer by 1980 . An additional 88 prostate cancer deaths 7 between 1981...prostate cancer by 1980 . An additional 88 prostate cancer deaths between 1981 and 2002 were ascertained using passive follow-up by matching participants...6(4):865- 70. (3) Jain MG, Hislop GT, Howe GR, Ghadirian P. Plant foods, antioxidants, and prostate cancer risk: findings from case-control

A Relative Ranking Approach for Nano-Enabled Applications to Improve Risk-Based Decision Making: A Case Study of Army Materiel

DTIC Science & Technology

2014-12-24

scenarios. The USACEHR has been conducting research and devel- opment efforts on the incorporation of various ENMs into Army materiel, ranging from food ...materiel characteristics, and (3) apply the algorithm and associated risk ranking tool to prioritize additional assessments based on the human health risk...online correspondence to confirm, edit, and supplement the inventory with additional information (See Section 1 in Supplementary Information (SI) for

RS3PE syndrome: an overview.

PubMed

Olivieri, I; Salvarani, C; Cantini, F

2000-01-01

More than ten years ago McCarty et al. described the RS3PE syndrome based on their study of 23 patients. Numerous additional cases have since been reported. In addition to the isolated or "pure" type which probably forms part of the clinical spectrum of polymyalgia rheumatica, inflammatory swelling with pitting edema of the dorsum of the hands and/or feet can be observed in different inflammatory rheumatic diseases as well as in haematological and solid malignancies.

5 CFR 890.1025 - Cases where additional fact-finding is not required.

Code of Federal Regulations, 2013 CFR

2013-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional fact..., civil monetary penalties, or similar legal or administrative adjudications by Federal, State, or local...

5 CFR 890.1025 - Cases where additional fact-finding is not required.

Code of Federal Regulations, 2014 CFR

2014-01-01

... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1025 Cases where additional fact..., civil monetary penalties, or similar legal or administrative adjudications by Federal, State, or local...

5 CFR 890.1027 - Cases where an additional fact-finding proceeding is required.

Code of Federal Regulations, 2013 CFR

2013-01-01

... proceeding is required. 890.1027 Section 890.1027 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Administrative Sanctions Imposed Against Health Care Providers Permissive Debarments § 890.1027 Cases where an additional...

Analysis of Oxygen Saturations Recorded During Dental Intravenous Sedations: A Retrospective Quality Assurance of 3500 Cases

PubMed Central

Viljoen, Andre; Byth, Karen; Coombs, Malcolm; Mahoney, Greg; Stewart, Douglas

2011-01-01

The death of a patient under sedation in New South Wales, Australia, in 2002 has again raised the question of the safety of dental sedation. This study sought answers to 2 questions: Can safe oxygen saturation levels (≥94%) be consistently maintained by a single operator/sedationist? Does the additional use of propofol, in subanesthetic doses, increase the risk of exposure to hypoxemia? Three thousand five hundred cases generated between 1996 and 2006 were randomly examined and divided into 2 subcohorts: 1750 patients were sedated with midazolam and fentanyl, and 1750 patients received propofol, in subanesthetic increments, in addition to midazolam and fentanyl. Initial sedation was established using midazolam and fentanyl in both subcohorts. The second subcohort received propofol during times of noxious stimulation. Patient exposure to 2 or more oxygen desaturations below 94% was uncommon. The variables that were significantly associated with low saturations were age, gender, and weight. Neither the dose of midazolam nor the additional use of propofol was a significant risk factor. ASA classification (I or II) was not a determinant of risk. The data, within the limitations of the study, showed that a single operator/sedationist, supported by a well-trained team of nurses, can consistently maintain safe oxygen saturation levels. The additional use of propofol did not increase exposure to hypoxemia. PMID:21882986

Evaluation of ALK Rearrangement in Chinese Non-Small Cell Lung Cancer Using FISH, Immunohistochemistry, and Real-Time Quantitative RT- PCR on Paraffin-Embedded Tissues

PubMed Central

Zhang, Yun-Gang; Jin, Mu-Lan; Li, Li; Zhao, Hong-Ying; Zeng, Xuan; Jiang, Lei; Wei, Ping; Diao, Xiao-Li; Li, Xue; Cao, Qing; Tian, Xin-Xia

2013-01-01

Patients with ALK gene rearrangements often manifest dramatic responses to crizotinib, an ALK inhibitor. Accurate identification of patients with ALK-positive non-small cell lung cancer (NSCLC) is essential for the clinical application of ALK-targeted therapy. However, assessing EML4-ALK rearrangement in NSCLC remains challenging in routine pathology practice. The aim of this study was to compare the diagnostic accuracy of FISH, immunohistochemistry (IHC), and real-time quantitative RT-PCR (QPCR) methodologies for detection of EML4-ALK rearrangement in NSCLC and to appraise immunohistochemistry as a pre-screening tool. In this study, a total of 473 paraffin-embedded NSCLC samples from surgical resections and biopsies were analyzed by IHC with ALK antibody. ALK rearrangement was further confirmed by FISH and QPCR. ALK protein expression was detected in twenty patients (20/473, 4.2%). Of the 20 ALK-positive cases by IHC, 15 cases were further confirmed as ALK rearrangement by FISH, and 5 cases were not interpretable. Also, we evaluated 13 out of the 20 IHC-positive tissues by QPCR in additional to FISH, and found that 9 cases were positive and 2 cases were equivocal, whereas 2 cases were negative although they were positive by both IHC and FISH. The ALK status was concordant in 5 out of 8 cases that were interpretable by three methods. Additionally, none of the 110 IHC-negative cases with adenocarcinoma histology showed ALK rearrangements by FISH. Histologically, almost all the ALK-rearranged cases were adenocarcinoma, except that one case was sarcomatoid carcinoma. A solid signet-ring cell pattern or mucinous cribriform pattern was presented at least focally in all ALK-positive tumors. In conclusion, our findings suggested that ALK rearrangement was associated with ALK protein expression. The conventional IHC assay is a valuable tool for the pre-screening of patients with ALK rearrangement in clinical practice and a combination of FISH and QPCR is required for further confirmation. PMID:23741400