Idiopathic Pulmonary Fibrosis and Myasthenia Gravis: An Unusual Association

PubMed Central

Chogtu, Bharti; Malik, Daliparty Vasudev

2016-01-01

Idiopathic Pulmonary Fibrosis (IPF) is a chronic fibrosing lung condition with high morbidity and mortality, accounting for about 25% of the cases of interstitial lung diseases. It usually has a progressive course resulting in death due to respiratory failure. Myasthenia Gravis (MG) is an autoimmune neuromuscular disease, caused by antibody mediated activity against acetylcholine receptor at the neuromuscular junction. It is characterized by fluctuating muscle weakness and fatigue. Extensive literature search did not reveal any case report of an association between these two conditions. Here we present a case of a patient with IPF who also developed MG. The diagnosis of IPF was based on High Resolution Computed Tomography (HRCT) of the lung and that of MG was based on clinical criteria and electrophysiological testing. The case was successfully managed. PMID:27190866

A defect-driven diagnostic method for machine tool spindles

PubMed Central

Vogl, Gregory W.; Donmez, M. Alkan

2016-01-01

Simple vibration-based metrics are, in many cases, insufficient to diagnose machine tool spindle condition. These metrics couple defect-based motion with spindle dynamics; diagnostics should be defect-driven. A new method and spindle condition estimation device (SCED) were developed to acquire data and to separate system dynamics from defect geometry. Based on this method, a spindle condition metric relying only on defect geometry is proposed. Application of the SCED on various milling and turning spindles shows that the new approach is robust for diagnosing the machine tool spindle condition. PMID:28065985

Reaction time for trimolecular reactions in compartment-based reaction-diffusion models

NASA Astrophysics Data System (ADS)

Li, Fei; Chen, Minghan; Erban, Radek; Cao, Yang

2018-05-01

Trimolecular reaction models are investigated in the compartment-based (lattice-based) framework for stochastic reaction-diffusion modeling. The formulae for the first collision time and the mean reaction time are derived for the case where three molecules are present in the solution under periodic boundary conditions. For the case of reflecting boundary conditions, similar formulae are obtained using a computer-assisted approach. The accuracy of these formulae is further verified through comparison with numerical results. The presented derivation is based on the first passage time analysis of Montroll [J. Math. Phys. 10, 753 (1969)]. Montroll's results for two-dimensional lattice-based random walks are adapted and applied to compartment-based models of trimolecular reactions, which are studied in one-dimensional or pseudo one-dimensional domains.

5 CFR 315.603 - Appointment based on former incumbency of a position brought into the competitive service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or Career-Conditional Appointment Under Special Authorities § 315.603 Appointment based on former... type of case from this requirement. (b) Review of disapproved recommendations. Agencies shall establish...

Low noise WDR ROIC for InGaAs SWIR image sensor

NASA Astrophysics Data System (ADS)

Ni, Yang

2017-11-01

Hybridized image sensors are actually the only solution for image sensing beyond the spectral response of silicon devices. By hybridization, we can combine the best sensing material and photo-detector design with high performance CMOS readout circuitry. In the infrared band, we are facing typically 2 configurations: high background situation and low background situation. The performance of high background sensors are conditioned mainly by the integration capacity in each pixel which is the case for mid-wave and long-wave infrared detectors. For low background situation, the detector's performance is mainly limited by the pixel's noise performance which is conditioned by dark signal and readout noise. In the case of reflection based imaging condition, the pixel's dynamic range is also an important parameter. This is the case for SWIR band imaging. We are particularly interested by InGaAs based SWIR image sensors.

Simulations of the vortex in the Dellenback abrupt expansion, resembling a hydro turbine draft tube operating at part-load

NASA Astrophysics Data System (ADS)

Nilsson, H.

2012-11-01

This work presents an OpenFOAM case-study, based on the experimental studies of the swirling flow in the abrupt expansion by Dellenback et al.[1]. The case yields similar flow conditions as those of a helical vortex rope in a hydro turbine draft tube working at part-load. The case-study is set up similar to the ERCOFTAC Conical Diffuser and Centrifugal Pump OpenFOAM case-studies [2,3], making all the files available and the results fully reproducable using OpenSource software. The mesh generation is done using m4 scripting and the OpenFOAM built-in blockMesh mesh generator. The swirling inlet boundary condition is specified as an axi-symmetric profile. The outlet boundary condition uses the zeroGradient condition for all variables except for the pressure, which uses the fixed mean value boundary condition. The wall static pressure is probed at a number of locations during the simulations, and post-processing of the time-averaged solution is done using the OpenFOAM sample utility. Gnuplot scripts are provided for plotting the results. The computational results are compared to one of the operating conditions studied by Dellenback, and measurements for all the experimentally studied operating conditions are available in the case-study. Results from five cases are here presented, based on the kEpsilon model, the kOmegaSST model, and a filtered version of the same kOmegaSST model, named kOmegaSSTF [4,5]. Two different inlet boundary conditions are evaluated. It is shown that kEpsilon and kOmegaSST give steady solutions, while kOmegaSSTF gives a highly unsteady solution. The time-averaged solution of the kOmegaSSTF model is much more accurate than the other models. The kEpsilon and kOmegaSST models are thus unable to accurately model the effect of the large-scale unsteadiness, while kOmegaSSTF resolves those scales and models only the smaller scales. The use of two different boundary conditions shows that the boundary conditions are more important than the choice between kEpsilon and kOmegaSST, for the results just after the abrupt expansion.

Undertaking an Ecological Approach to Advance Game-Based Learning: A Case Study

ERIC Educational Resources Information Center

Shah, Mamta; Foster, Aroutis

2014-01-01

Systematic incorporation of digital games in schools is largely unexplored. This case study explored the ecological conditions necessary for implementing a game-based learning course by examining the interaction between three domains (the innovator, the innovation, and the context). From January-April 2012, one in-service teacher learned and…

Asthma exacerbation and proximity of residence to major roads: a population-based matched case-control study among the pediatric Medicaid population in Detroit, Michigan

PubMed Central

2011-01-01

Background The relationship between asthma and traffic-related pollutants has received considerable attention. The use of individual-level exposure measures, such as residence location or proximity to emission sources, may avoid ecological biases. Method This study focused on the pediatric Medicaid population in Detroit, MI, a high-risk population for asthma-related events. A population-based matched case-control analysis was used to investigate associations between acute asthma outcomes and proximity of residence to major roads, including freeways. Asthma cases were identified as all children who made at least one asthma claim, including inpatient and emergency department visits, during the three-year study period, 2004-06. Individually matched controls were randomly selected from the rest of the Medicaid population on the basis of non-respiratory related illness. We used conditional logistic regression with distance as both categorical and continuous variables, and examined non-linear relationships with distance using polynomial splines. The conditional logistic regression models were then extended by considering multiple asthma states (based on the frequency of acute asthma outcomes) using polychotomous conditional logistic regression. Results Asthma events were associated with proximity to primary roads with an odds ratio of 0.97 (95% CI: 0.94, 0.99) for a 1 km increase in distance using conditional logistic regression, implying that asthma events are less likely as the distance between the residence and a primary road increases. Similar relationships and effect sizes were found using polychotomous conditional logistic regression. Another plausible exposure metric, a reduced form response surface model that represents atmospheric dispersion of pollutants from roads, was not associated under that exposure model. Conclusions There is moderately strong evidence of elevated risk of asthma close to major roads based on the results obtained in this population-based matched case-control study. PMID:21513554

Dynamic Mesh Adaptation for Front Evolution Using Discontinuous Galerkin Based Weighted Condition Number Mesh Relaxation

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

Greene, Patrick T.; Schofield, Samuel P.; Nourgaliev, Robert

2016-06-21

A new mesh smoothing method designed to cluster mesh cells near a dynamically evolving interface is presented. The method is based on weighted condition number mesh relaxation with the weight function being computed from a level set representation of the interface. The weight function is expressed as a Taylor series based discontinuous Galerkin projection, which makes the computation of the derivatives of the weight function needed during the condition number optimization process a trivial matter. For cases when a level set is not available, a fast method for generating a low-order level set from discrete cell-centered elds, such as amore » volume fraction or index function, is provided. Results show that the low-order level set works equally well for the weight function as the actual level set. Meshes generated for a number of interface geometries are presented, including cases with multiple level sets. Dynamic cases for moving interfaces are presented to demonstrate the method's potential usefulness to arbitrary Lagrangian Eulerian (ALE) methods.« less

Precessing rotating flows with additional shear: stability analysis.

PubMed

Salhi, A; Cambon, C

2009-03-01

We consider unbounded precessing rotating flows in which vertical or horizontal shear is induced by the interaction between the solid-body rotation (with angular velocity Omega(0)) and the additional "precessing" Coriolis force (with angular velocity -epsilonOmega(0)), normal to it. A "weak" shear flow, with rate 2epsilon of the same order of the Poincaré "small" ratio epsilon , is needed for balancing the gyroscopic torque, so that the whole flow satisfies Euler's equations in the precessing frame (the so-called admissibility conditions). The base flow case with vertical shear (its cross-gradient direction is aligned with the main angular velocity) corresponds to Mahalov's [Phys. Fluids A 5, 891 (1993)] precessing infinite cylinder base flow (ignoring boundary conditions), while the base flow case with horizontal shear (its cross-gradient direction is normal to both main and precessing angular velocities) corresponds to the unbounded precessing rotating shear flow considered by Kerswell [Geophys. Astrophys. Fluid Dyn. 72, 107 (1993)]. We show that both these base flows satisfy the admissibility conditions and can support disturbances in terms of advected Fourier modes. Because the admissibility conditions cannot select one case with respect to the other, a more physical derivation is sought: Both flows are deduced from Poincaré's [Bull. Astron. 27, 321 (1910)] basic state of a precessing spheroidal container, in the limit of small epsilon . A Rapid distortion theory (RDT) type of stability analysis is then performed for the previously mentioned disturbances, for both base flows. The stability analysis of the Kerswell base flow, using Floquet's theory, is recovered, and its counterpart for the Mahalov base flow is presented. Typical growth rates are found to be the same for both flows at very small epsilon , but significant differences are obtained regarding growth rates and widths of instability bands, if larger epsilon values, up to 0.2, are considered. Finally, both flow cases are briefly discussed in view of a subsequent nonlinear study using pseudospectral direct numerical simulations, which is a natural continuation of RDT.

Extracting information from the text of electronic medical records to improve case detection: a systematic review

PubMed Central

Carroll, John A; Smith, Helen E; Scott, Donia; Cassell, Jackie A

2016-01-01

Background Electronic medical records (EMRs) are revolutionizing health-related research. One key issue for study quality is the accurate identification of patients with the condition of interest. Information in EMRs can be entered as structured codes or unstructured free text. The majority of research studies have used only coded parts of EMRs for case-detection, which may bias findings, miss cases, and reduce study quality. This review examines whether incorporating information from text into case-detection algorithms can improve research quality. Methods A systematic search returned 9659 papers, 67 of which reported on the extraction of information from free text of EMRs with the stated purpose of detecting cases of a named clinical condition. Methods for extracting information from text and the technical accuracy of case-detection algorithms were reviewed. Results Studies mainly used US hospital-based EMRs, and extracted information from text for 41 conditions using keyword searches, rule-based algorithms, and machine learning methods. There was no clear difference in case-detection algorithm accuracy between rule-based and machine learning methods of extraction. Inclusion of information from text resulted in a significant improvement in algorithm sensitivity and area under the receiver operating characteristic in comparison to codes alone (median sensitivity 78% (codes + text) vs 62% (codes), P = .03; median area under the receiver operating characteristic 95% (codes + text) vs 88% (codes), P = .025). Conclusions Text in EMRs is accessible, especially with open source information extraction algorithms, and significantly improves case detection when combined with codes. More harmonization of reporting within EMR studies is needed, particularly standardized reporting of algorithm accuracy metrics like positive predictive value (precision) and sensitivity (recall). PMID:26911811

Modelling for reactor-style aerobic composting based on coupling theory of mass-heat-momentum transport and Contois equation.

PubMed

He, Xueqin; Han, Lujia; Ge, Jinyi; Huang, Guangqun

2018-04-01

This study establishes an optimal mathematical modelling to rationally describe the dynamic changes and spatial distribution of temperature and oxygen concentration in the aerobic composting process using coupling mass-heat-momentum transfer based on the microbial mechanism. Two different conditional composting experiments, namely continuous aeration and intermittent aeration, were performed to verify the proposed model. The results show that the model accurately predicted the dynamic changes in temperature (case I: R 2  = 0.93, RMSE = 1.95 K; case II: R 2  = 0.86, RMSE = 4.69 K) and oxygen concentration (case I: R 2  = 0.90, RMSE = 1.26%; case II: R 2  = 0.75, RMSE = 2.93%) in the central point of compost substrates. It also systematically simulated fluctuations in oxygen concentration caused by boundary conditions and the spatial distribution of the actual temperature and oxygen concentration. The proposed model exhibits good applicability in simulating the actual working conditions of aerobic composting process. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Application of Simulation Method in Isothermal Elastic Natural Gas Pipeline

NASA Astrophysics Data System (ADS)

Xing, Chunlei; Guan, Shiming; Zhao, Yue; Cao, Jinggang; Chu, Yanji

2018-02-01

This Elastic pipeline mathematic model is of crucial importance in natural gas pipeline simulation because of its compliance with the practical industrial cases. The numerical model of elastic pipeline will bring non-linear complexity to the discretized equations. Hence the Newton-Raphson method cannot achieve fast convergence in this kind of problems. Therefore A new Newton Based method with Powell-Wolfe Condition to simulate the Isothermal elastic pipeline flow is presented. The results obtained by the new method aregiven based on the defined boundary conditions. It is shown that the method converges in all cases and reduces significant computational cost.

Iowa Case Management for Rural Drug Abuse

ERIC Educational Resources Information Center

Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

2009-01-01

Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

Treating Selective Mutism Using Modular CBT for Child Anxiety: A Case Study

ERIC Educational Resources Information Center

Reuther, Erin T.; Davis, Thompson E., III; Moree, Brittany N.; Matson, Johnny L.

2011-01-01

Selective mutism is a rare, debilitating condition usually seen in children. Unfortunately, there is little research examining effective treatments for this disorder, and designing an evidence-based treatment plan can be difficult. This case study presents the evidence-based treatment of an 8-year-old Caucasian boy with selective mutism using an…

Magazine Influence on Cartridge Case Ejection Patterns with Glock Pistols.

PubMed

Kerkhoff, Wim; Alberink, Ivo; Mattijssen, Erwin J A T

2018-01-01

In this study, the cartridge case ejection patterns of six different Glock model pistols (one specimen per model) were compared under three conditions: firing with a loaded magazine, an empty magazine, and without magazine. The distances, covered by the ejected cartridge cases given these three conditions, were compared for each of the six models. A significant difference was found between the groups of data for each of the tested specimens. This indicates that it is important that, to reconstruct a shooting scene incident based on the ejection patterns of a pistol, test shots are fired with the same pistol type and under the correct magazine condition. © 2017 American Academy of Forensic Sciences.

Hypnosis and the treatment of posttraumatic conditions: an evidence-based approach.

PubMed

Lynn, Steven Jay; Cardeña, Etzel

2007-04-01

This article reviews the evidence for the use of hypnosis in the treatment of posttraumatic conditions including posttraumatic stress disorder and acute stress disorder. The review focuses on empirically supported principles and practices and suggests that hypnosis can be a useful adjunctive procedure in the treatment of posttraumatic conditions. Cognitive-behavioral and exposure-based interventions, which have the greatest empirical support, are highlighted, and an illustrative case study is presented.

Iowa Case Management for Rural Drug Abuse

PubMed Central

Hall, James A.; Sarrazin, Mary S. Vaughan; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

2011-01-01

Objective The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. Results Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. Conclusion Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time. PMID:22065018

Robustness of delayed multistable systems with application to droop-controlled inverter-based microgrids

NASA Astrophysics Data System (ADS)

Efimov, Denis; Schiffer, Johannes; Ortega, Romeo

2016-05-01

Motivated by the problem of phase-locking in droop-controlled inverter-based microgrids with delays, the recently developed theory of input-to-state stability (ISS) for multistable systems is extended to the case of multistable systems with delayed dynamics. Sufficient conditions for ISS of delayed systems are presented using Lyapunov-Razumikhin functions. It is shown that ISS multistable systems are robust with respect to delays in a feedback. The derived theory is applied to two examples. First, the ISS property is established for the model of a nonlinear pendulum and delay-dependent robustness conditions are derived. Second, it is shown that, under certain assumptions, the problem of phase-locking analysis in droop-controlled inverter-based microgrids with delays can be reduced to the stability investigation of the nonlinear pendulum. For this case, corresponding delay-dependent conditions for asymptotic phase-locking are given.

A Study on Management of Contract Conditions of Yen Loan Projects in Philippine and Vietnam

NASA Astrophysics Data System (ADS)

Matsuba, Yasutaka; Ozawa, Kazumasa; Yasutani, Satoru

FIDIC conditions of contract are used in many cases as general conditions for public works funded by Japanese yen loan, but there are cases where the particular conditions are written as to add some special clauses or change some clauses of FIDIC general conditions based on their own current contract conditions and customs, which will lead to restriction of rights and duties of the Engineer and Contractor. This paper focuses on yen loan projects in Philippine and Vietnam, and describes the actual contract management of FIDIC conditions of contract from the viewpoints such as: a) relationship between Client, Contractor and the Engineer b) claim for rights and contract managements. Based on interviews to parties concerned and literature reviews of public works concerned, contractor's rights are granted relatively wider in yen loan projects compared with locally-funded projects. However, it is also observed that the Engineer's rights are restricted by particular conditions, which is written in line with their own public procurement policies of both countries. Some discussions are added how these local procurement policies affect the implementation of FIDIC conditions of contract, and clarified what are the differences of contract management between both countries.

Medical Conditions in the First Years of Life Associated with Future Diagnosis of ASD in Children.

PubMed

Alexeeff, Stacey E; Yau, Vincent; Qian, Yinge; Davignon, Meghan; Lynch, Frances; Crawford, Phillip; Davis, Robert; Croen, Lisa A

2017-07-01

This study examines medical conditions diagnosed prior to the diagnosis of autism spectrum disorder (ASD). Using a matched case control design with 3911 ASD cases and 38,609 controls, we found that 38 out of 79 medical conditions were associated with increased ASD risk. Developmental delay, mental health, and neurology conditions had the strongest associations (ORs 2.0-23.3). Moderately strong associations were observed for nutrition, genetic, ear nose and throat, and sleep conditions (ORs 2.1-3.2). Using machine learning methods, we clustered children based on their medical conditions prior to ASD diagnosis and demonstrated ASD risk stratification. Our findings provide new evidence indicating that children with ASD have a disproportionate burden of certain medical conditions preceding ASD diagnosis.

Comparison of three problem-based learning conditions (real patients, digital and paper) with lecture-based learning in a dermatology course: a prospective randomized study from China.

PubMed

Li, Jie; Li, Qing Ling; Li, Ji; Chen, Ming Liang; Xie, Hong Fu; Li, Ya Ping; Chen, Xiang

2013-01-01

The precise effect and the quality of different cases used in dermatology problem-based learning (PBL) curricula are yet unclear. To prospectively compare the impact of real patients, digital, paper PBL (PPBL) and traditional lecture-based learning (LBL) on academic results and student perceptions. A total of 120 students were randomly allocated into either real-patients PBL (RPBL) group studied via real-patient cases, digital PBL (DPBL) group studied via digital-form cases, PPBL group studied via paper-form cases, or conventional group who received didactic lectures. Academic results were assessed through review of written examination, objective structured clinical examination and student performance scores. A five-point Likert scale questionnaire was used to evaluate student perceptions. Compared to those receiving lectures only, all PBL participants had better results for written examination, clinical examination and overall performance. Students in RPBL group exhibited better overall performance than those in the other two PBL groups. Real-patient cases were more effective in helping develop students' self-directed learning skills, improving their confidence in future patient encounters and encouraging them to learn more about the discussed condition, compared to digital and paper cases. Both real patient and digital triggers are helpful in improving students' clinical problem-handling skills. However, real patients provide greater benefits to students.

Adhesive joint evaluation by ultrasonic interface and lamb waves

NASA Technical Reports Server (NTRS)

Rokhlin, S. I.

1986-01-01

Some results on the application of interface and Lamb waves for the study of curing of thin adhesive layers were summarized. In the case of thick substrates (thickness much more than the wave length) the interface waves can be used. In this case the experimental data can be inverted and the shear modulus of the adhesive film may be explicitly found based on the measured interface wave velocity. It is shown that interface waves can be used for the study of curing of structural adhesives as a function of different temperatures and other experimental conditions. The kinetics of curing was studied. In the case of thin substrates the wave phenomena are much more complicated. It is shown that for successful measurements proper selection of experimental conditions is very important. This can be done based on theoretical estimations. For correctly selected experimental conditions the Lamb waves may be a sensitive probe of adhesive bond quality and may be used or cure monitoring.

What Is Case Management? A Scoping and Mapping Review

PubMed Central

Millington, Michael; Salvador-Carulla, Luis

2016-01-01

The description of case management in research and clinical practice is highly variable which impedes quality analysis, policy and planning. Case management makes a unique contribution towards the integration of health care, social services and other sector services and supports for people with complex health conditions. There are multiple components and variations of case management depending on the context and client population. This paper aims to scope and map case management in the literature to identify how case management is described in the literature for key complex health conditions (e.g., brain injury, diabetes, mental health, spinal cord injury). Following literature searches in multiple databases, grey literature and exclusion by health condition, community-based and adequate description, there were 661 potential papers for data extraction. Data from 79 papers (1988–2013) were analysed to the point of saturation (no new information) and mapped to the model, components and activities. The results included 22 definitions, five models, with 69 activities or tasks of case managers mapped to 17 key components (interventions). The results confirm the significant terminological variance in case management which produces role confusion, ambiguity and hinders comparability across different health conditions and contexts. There is an urgent need for an internationally agreed taxonomy for the coordination, navigation and management of care. PMID:28413368

Association between bullous pemphigoid and neurologic diseases: a case-control study.

PubMed

Casas-de-la-Asunción, E; Ruano-Ruiz, J; Rodríguez-Martín, A M; Vélez García-Nieto, A; Moreno-Giménez, J C

2014-11-01

In the past 10 years, bullous pemphigoid has been associated with other comorbidities and neurologic and psychiatric conditions in particular. Case series, small case-control studies, and large population-based studies in different Asian populations, mainland Europe, and the United Kingdom have confirmed this association. However, no data are available for the Spanish population. This was an observational, retrospective, case-control study with 1:2 matching. Fifty-four patients with bullous pemphigoid were selected. We compared the percentage of patients in each group with concurrent neurologic conditions, ischemic heart disease, diabetes, chronic obstructive pulmonary disease, and solid tumors using univariate logistic regression. An association model was constructed with conditional multiple logistic regression. The case group had a significantly higher percentage of patients with cerebrovascular accident and/or transient ischemic attack (odds ratio [OR], 3.06; 95% CI, 1.19-7.87], dementia (OR, 5.52; 95% CI, 2.19-13.93), and Parkinson disease (OR, 5; 95% CI, 1.57-15.94). A significantly higher percentage of cases had neurologic conditions (OR, 6.34; 95% CI, 2.89-13.91). Dementia and Parkinson disease were independently associated with bullous pemphigoid in the multivariate analysis. Patients with bullous pemphigoid have a higher frequency of neurologic conditions. Copyright © 2013 Elsevier España, S.L.U. and AEDV. All rights reserved.

Ambient condition bias stress stability of vanadium (IV) oxide phthalocyanine based p-channel organic field-effect transistors

NASA Astrophysics Data System (ADS)

Obaidulla, Sk Md; Singh, Subhash; Mohapatra, Y. N.; Giri, P. K.

2018-01-01

High bias-stress stability and low threshold voltage (V th) shift under ambient conditions are highly desirable for practical applications of organic field-effect transistors (OFETs). We demonstrate here a 20-fold enhancement in the bias-stress stability for hexamethyledisilazane (HMDS) treated vanadium (IV) oxide phthalocyanine (VOPc) based OFETs as compared to the bare VOPc case under ambient conditions. VOPc based OFETs were fabricated on bare (non treated) SiO2 and a HMDS monolayer passivated SiO2 layer, with an operating voltage of 40 V. The devices with top contact gold (Au) electrodes exhibit excellent p-channel behavior with a moderate hole mobility for the HMDS-treated device. It is demonstrated that the time dependent ON-current decay and V th shift can be effectively controlled by using self-assembled monolayers of HMDS on the VOPc layer. For the HMDS-treated case, the bias stress stability study shows the stretched exponential decay of drain current by only ~15% during the long-term operation with constant bias voltage under ambient conditions, while it shows a large decay of  >70% for the nontreated devices operated for 1000 s. The corresponding characteric decay time constant (τ) is 104 s for the HMDS treated case, while that of the the non-treated SiO2 case is only ~480 s under ambient conditions. The inferior performance of the device with bare SiO2 is traced to the charge trapping at the voids in the inter-grain region of the films, while it is almost negligible for the HMDS-treated case, as confirmed from the AFM and XRD analyses. It is believed that HMDS treatment provides an excellent interface with a low density of traps and passivates the dangling bonds, which improve the charge transport characteristics. Also, the surface morphology of the VOPc film clearly influences the device performance. Thus, the HMDS treatment provides a very attractive approach for attaining long-term air stability and a low V th shift for the VOPc based OFET devices.

The Air Force Global Reach Laydown (GR1): An Allowance Standard Review Using the Estimating Supplies Program to Develop a Requirements-Based Materiel Solution

DTIC Science & Technology

2008-07-02

Cystitis, Prostatitis, Orchitis, Including Testicular Torsion, All Cases 280 Balanoposthitis All Cases 282 Infectious Mononucleosis All Cases 283...Hepatitis Infectious Viral All Cases 285 Cholecystitis Acute w/ Stones/cholecystitis All Cases 286 Pancreatitis Acute All Cases 287 Cirrhosis All...PEST AND VECTOR IDENTIFICATION Z580 MONITOR HEAT STRESS CONDITIONS Z600 SCREEN TREATMENT LOGS FOR INFECTIOUS DISEASE CASES Z601 COMPILE/REPORT

Comparing Single Case Design Overlap-Based Effect Size Metrics from Studies Examining Speech Generating Device Interventions

ERIC Educational Resources Information Center

Chen, Mo; Hyppa-Martin, Jolene K.; Reichle, Joe E.; Symons, Frank J.

2016-01-01

Meaningfully synthesizing single case experimental data from intervention studies comprised of individuals with low incidence conditions and generating effect size estimates remains challenging. Seven effect size metrics were compared for single case design (SCD) data focused on teaching speech generating device use to individuals with…

"I Am a Scientist": How Setting Conditions That Enhance Focused Concentration Positively Relate to Student Motivation and Achievement Outcomes in Inquiry-Based Science

ERIC Educational Resources Information Center

Ellwood, Robin B.

2013-01-01

This research investigated how student social interactions within two approaches to an inquiry-based science curriculum could be related to student motivation and achievement outcomes. This qualitative case study consisted of two cases, Off-Campus and On-Campus, and used ethnographic techniques of participant observation. Research participants…

Dynamic mesh adaptation for front evolution using discontinuous Galerkin based weighted condition number relaxation

DOE PAGES

Greene, Patrick T.; Schofield, Samuel P.; Nourgaliev, Robert

2017-01-27

A new mesh smoothing method designed to cluster cells near a dynamically evolving interface is presented. The method is based on weighted condition number mesh relaxation with the weight function computed from a level set representation of the interface. The weight function is expressed as a Taylor series based discontinuous Galerkin projection, which makes the computation of the derivatives of the weight function needed during the condition number optimization process a trivial matter. For cases when a level set is not available, a fast method for generating a low-order level set from discrete cell-centered fields, such as a volume fractionmore » or index function, is provided. Results show that the low-order level set works equally well as the actual level set for mesh smoothing. Meshes generated for a number of interface geometries are presented, including cases with multiple level sets. Lastly, dynamic cases with moving interfaces show the new method is capable of maintaining a desired resolution near the interface with an acceptable number of relaxation iterations per time step, which demonstrates the method's potential to be used as a mesh relaxer for arbitrary Lagrangian Eulerian (ALE) methods.« less

Radiation closure under broken cloud conditions at the BSRN site Payerne: A case study

NASA Astrophysics Data System (ADS)

Aebi, Christine; Gröbner, Julian; Kämpfer, Niklaus; Vuilleumier, Laurent

2017-04-01

Clouds have a substantial influence on the surface radiation budget and on the climate system. There are several studies showing the opposing effect of clouds on shortwave and longwave radiation and thus on the global energy budget. Wacker et al., 2013 show an agreement between radiation flux measurements and radiative transfer models (RTM) under clear sky conditions which is within the measurement uncertainty. Our current study combines radiation fluxes from surface-based observations with RTM under cloudy conditions. It is a case study with data from the BSRN (Baseline Surface Radiation Network) site Payerne (46.49˚ N, 6.56˚ E, 490 m asl). Observation data are retrieved from pyranometers and pyrgeometers and additional atmospheric parameters from radiosondes and a ceilometer. The cloud information is taken from visible all-sky cameras. In a first step observations and RTM are compared for cases with stratiform overcast cloud conditions. In a next step radiation fluxes are compared under broken cloud conditions. These analyses are performed for different cloud types. Wacker, S., J. Gröbner, and L. Vuilleumier (2014) A method to calculate cloud-free long-wave irradiance at the surface based on radiative transfer modeling and temperature lapse rate estimates, Theor. Appl. Climatol., 115, 551-561.

Simulation-based investigation of the generality of Lyzenga's multispectral bathymetry formula in Case-1 coral reef water

NASA Astrophysics Data System (ADS)

Manessa, Masita Dwi Mandini; Kanno, Ariyo; Sagawa, Tatsuyuki; Sekine, Masahiko; Nurdin, Nurjannah

2018-01-01

Lyzenga's multispectral bathymetry formula has attracted considerable interest due to its simplicity. However, there has been little discussion of the effect that variation in optical conditions and bottom types-which commonly appears in coral reef environments-has on this formula's results. The present paper evaluates Lyzenga's multispectral bathymetry formula for a variety of optical conditions and bottom types. A noiseless dataset of above-water remote sensing reflectance from WorldView-2 images over Case-1 shallow coral reef water is simulated using a radiative transfer model. The simulation-based assessment shows that Lyzenga's formula performs robustly, with adequate generality and good accuracy, under a range of conditions. As expected, the influence of bottom type on depth estimation accuracy is far greater than the influence of other optical parameters, i.e., chlorophyll-a concentration and solar zenith angle. Further, based on the simulation dataset, Lyzenga's formula estimates depth when the bottom type is unknown almost as accurately as when the bottom type is known. This study provides a better understanding of Lyzenga's multispectral bathymetry formula under various optical conditions and bottom types.

Automated unit-level testing with heuristic rules

NASA Technical Reports Server (NTRS)

Carlisle, W. Homer; Chang, Kai-Hsiung; Cross, James H.; Keleher, William; Shackelford, Keith

1990-01-01

Software testing plays a significant role in the development of complex software systems. Current testing methods generally require significant effort to generate meaningful test cases. The QUEST/Ada system is a prototype system designed using CLIPS to experiment with expert system based test case generation. The prototype is designed to test for condition coverage, and attempts to generate test cases to cover all feasible branches contained in an Ada program. This paper reports on heuristics sued by the system. These heuristics vary according to the amount of knowledge obtained by preprocessing and execution of the boolean conditions in the program.

New Insights into the Compulsion to Use Tobacco from an Adolescent Case-Series

ERIC Educational Resources Information Center

DiFranza, Joseph R.; Ursprung, W. W. Sanouri; Carson, Alisha

2010-01-01

Nicotine addiction is the most common preventable cause of premature death presenting during adolescence. No prior study has described the onset of this condition based on case histories. We used trained personnel to conduct individual semi-structured interviews to obtain case histories from 50 adolescent and young adult current and former…

Scleroderma prevalence: demographic variations in a population-based sample.

PubMed

Bernatsky, S; Joseph, L; Pineau, C A; Belisle, P; Hudson, M; Clarke, A E

2009-03-15

To estimate the prevalence of systemic sclerosis (SSc) using population-based administrative data, and to assess the sensitivity of case ascertainment approaches. We ascertained SSc cases from Quebec physician billing and hospitalization databases (covering approximately 7.5 million individuals). Three case definition algorithms were compared, and statistical methods accounting for imperfect case ascertainment were used to estimate SSc prevalence and case ascertainment sensitivity. A hierarchical Bayesian latent class regression model that accounted for possible between-test dependence conditional on disease status estimated the effect of patient characteristics on SSc prevalence and the sensitivity of the 3 ascertainment algorithms. Accounting for error inherent in both the billing and the hospitalization data, we estimated SSc prevalence in 2003 at 74.4 cases per 100,000 women (95% credible interval [95% CrI] 69.3-79.7) and 13.3 cases per 100,000 men (95% CrI 11.1-16.1). Prevalence was higher for older individuals, particularly in urban women (161.2 cases per 100,000, 95% CrI 148.6-175.0). Prevalence was lowest in young men (in rural areas, as low as 2.8 cases per 100,000, 95% CrI 1.4-4.8). In general, no single algorithm was very sensitive, with point estimates for sensitivity ranging from 20-73%. We found marked differences in SSc prevalence according to age, sex, and region. In general, no single case ascertainment approach was very sensitive for SSc. Therefore, using data from multiple sources, with adjustment for the imperfect nature of each, is an important strategy in population-based studies of SSc and similar conditions.

Junction-to-Case Thermal Resistance of a Silicon Carbide Bipolar Junction Transistor Measured

NASA Technical Reports Server (NTRS)

Niedra, Janis M.

2006-01-01

Junction temperature of a prototype SiC-based bipolar junction transistor (BJT) was estimated by using the base-emitter voltage (V(sub BE)) characteristic for thermometry. The V(sub BE) was measured as a function of the base current (I(sub B)) at selected temperatures (T), all at a fixed collector current (I(sub C)) and under very low duty cycle pulse conditions. Under such conditions, the average temperature of the chip was taken to be the same as that of the temperature-controlled case. At increased duty cycle such as to substantially heat the chip, but same I(sub C) pulse height, the chip temperature was identified by matching the V(sub BE) to the thermometry curves. From the measured average power, the chip-to-case thermal resistance could be estimated, giving a reasonable value. A tentative explanation for an observed bunching with increasing temperature of the calibration curves may relate to an increasing dopant atom ionization. A first-cut analysis, however, does not support this.

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

What is the business case for improving care for patients with complex conditions?

PubMed

Luck, Jeff; Parkerton, Patricia; Hagigi, Fred

2007-12-01

Patients with complex conditions account for a disproportionate share of health care spending. Although evidence indicates that care for these patients could be provided more efficiently, the financial impact of mechanisms to improve the care they receive is unclear. Numerous mechanisms-emphasizing patient self-management, care coordination, and evidence-based guidelines-aim to improve the quality of care and outcomes for patients with complex conditions. Assessing the overall "business case" for these mechanisms requires carefully estimating all relevant costs and financial benefits, then comparing them in present value terms. Mechanisms that are not cost-saving may still be implemented if they are cost-effective. We reviewed articles in peer-reviewed journals, as well as reports available on publicly accessible websites, which contained data about the business case for mechanisms to improve care for patients with complex conditions. Published studies do not provide clear evidence that current mechanisms are cost saving. This literature also has several major methodological shortcomings with respect to providing an understanding of the business case for these mechanisms. Further research using standardized methodologies is needed to understand the business case for mechanisms to improve care for patients with complex conditions. Implications for VA business case analyses include the necessity of establishing appropriate time horizons, scope of services, and target populations, as well as considering the impact of existing VA systems.

Conditioning 3D object-based models to dense well data

NASA Astrophysics Data System (ADS)

Wang, Yimin C.; Pyrcz, Michael J.; Catuneanu, Octavian; Boisvert, Jeff B.

2018-06-01

Object-based stochastic simulation models are used to generate categorical variable models with a realistic representation of complicated reservoir heterogeneity. A limitation of object-based modeling is the difficulty of conditioning to dense data. One method to achieve data conditioning is to apply optimization techniques. Optimization algorithms can utilize an objective function measuring the conditioning level of each object while also considering the geological realism of the object. Here, an objective function is optimized with implicit filtering which considers constraints on object parameters. Thousands of objects conditioned to data are generated and stored in a database. A set of objects are selected with linear integer programming to generate the final realization and honor all well data, proportions and other desirable geological features. Although any parameterizable object can be considered, objects from fluvial reservoirs are used to illustrate the ability to simultaneously condition multiple types of geologic features. Channels, levees, crevasse splays and oxbow lakes are parameterized based on location, path, orientation and profile shapes. Functions mimicking natural river sinuosity are used for the centerline model. Channel stacking pattern constraints are also included to enhance the geological realism of object interactions. Spatial layout correlations between different types of objects are modeled. Three case studies demonstrate the flexibility of the proposed optimization-simulation method. These examples include multiple channels with high sinuosity, as well as fragmented channels affected by limited preservation. In all cases the proposed method reproduces input parameters for the object geometries and matches the dense well constraints. The proposed methodology expands the applicability of object-based simulation to complex and heterogeneous geological environments with dense sampling.

Fetal small bowel volvulus without malrotation: the whirlpool & coffee bean signs.

PubMed

Jakhere, S G; Saifi, S A; Ranwaka, A A

2014-01-01

Intestinal volvulus is a common condition seen in infancy and adulthood, but small bowel volvulus is a rare condition affecting the fetus in utero. Very few cases have been reported describing the ultrasound findings of the same. We present a case report of a case of intestinal volvulus which was diagnosed prenatally based on the ultrasound features of whirlpool sign and coffee bean sign. An emergency caesarian section was performed, small bowel volvulus was confirmed on post-natal ultrasound, and the neonate was subsequently operated. Although these signs have been separately described previously in the literature, in our case both these signs were seen in the same patient. Our case is a rare presentation with the occurrence of volvulus without malrotation, the contrary being more common.

Analysis of case-only studies accounting for genotyping error.

PubMed

Cheng, K F

2007-03-01

The case-only design provides one approach to assess possible interactions between genetic and environmental factors. It has been shown that if these factors are conditionally independent, then a case-only analysis is not only valid but also very efficient. However, a drawback of the case-only approach is that its conclusions may be biased by genotyping errors. In this paper, our main aim is to propose a method for analysis of case-only studies when these errors occur. We show that the bias can be adjusted through the use of internal validation data, which are obtained by genotyping some sampled individuals twice. Our analysis is based on a simple and yet highly efficient conditional likelihood approach. Simulation studies considered in this paper confirm that the new method has acceptable performance under genotyping errors.

Conditions for a steady ice sheet ice shelf junction

NASA Astrophysics Data System (ADS)

Nowicki, S. M. J.; Wingham, D. J.

2008-01-01

This paper investigates the conditions under which a marine ice sheet may adopt a steady profile. The ice is treated as a linear viscous fluid caused to flow from a rigid base to and over water, treated as a denser but inviscid fluid. The solutions in the region around the point of flotation, or 'transition' zone, are calculated numerically. In-flow and out-flow conditions appropriate to ice sheet and ice shelf flow are applied at the ends of the transition zone and the rigid base is specified; the flow and steady free surfaces are determined as part of the solutions. The basal stress upstream, and the basal deflection downstream, of the flotation point are examined to determine which of these steady solutions satisfy 'contact' conditions that would prevent (i) the steady downstream basal deflection contacting the downstream base, and (ii) the upstream ice commencing to float in the event it was melted at the base. In the case that the upstream bed is allowed to slide, we find only one mass flux that satisfies the contact conditions. When no sliding is allowed at the bed, however, we find a range of mass fluxes satisfy the contact conditions. The effect of 'backpressure' on the solutions is investigated, and is found to have no affect on the qualitative behaviour of the junctions. To the extent that the numerical, linearly viscous treatment may be applied to the case of ice flowing out over the ocean, we conclude that when sliding is present, Weertman's 'instability' hypothesis holds.

On square-integrability of solutions of the stationary Schrödinger equation for the quantum harmonic oscillator in two dimensional constant curvature spaces

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

Noguera, Norman, E-mail: norman.noguera@ucr.ac.cr; Rózga, Krzysztof, E-mail: krzysztof.rozga@upr.edu

In this work, one provides a justification of the condition that is usually imposed on the parameters of the hypergeometric equation, related to the solutions of the stationary Schrödinger equation for the harmonic oscillator in two-dimensional constant curvature spaces, in order to determine the solutions which are square-integrable. One proves that in case of negative curvature, it is a necessary condition of square integrability and in case of positive curvature, a necessary condition of regularity. The proof is based on the analytic continuation formulas for the hypergeometric function. It is observed also that the same is true in case ofmore » a slightly more general potential than the one for harmonic oscillator.« less

Continued Evaluation of Gear Condition Indicator Performance on Rotorcraft Fleet

NASA Technical Reports Server (NTRS)

Delgado, Irebert R.; Dempsey, Paula J.; Antolick, Lance J.; Wade, Daniel R.

2013-01-01

This paper details analyses of condition indicator performance for the helicopter nose gearbox within the U.S. Army's Condition-Based Maintenance Program. Ten nose gearbox data sets underwent two specific analyses. A mean condition indicator level analysis was performed where condition indicator performance was based on a 'batting average' measured before and after part replacement. Two specific condition indicators, Diagnostic Algorithm 1 and Sideband Index, were found to perform well for the data sets studied. A condition indicator versus gear wear analysis was also performed, where gear wear photographs and descriptions from Army tear-down analyses were categorized based on ANSI/AGMA 1010-E95 standards. Seven nose gearbox data sets were analyzed and correlated with condition indicators Diagnostic Algorithm 1 and Sideband Index. Both were found to be most responsive to gear wear cases of micropitting and spalling. Input pinion nose gear box condition indicators were found to be more responsive to part replacement during overhaul than their corresponding output gear nose gear box condition indicators.

The use of random forests in modelling short-term air pollution effects based on traffic and meteorological conditions: A case study in Wrocław.

PubMed

Kamińska, Joanna A

2018-07-01

Random forests, an advanced data mining method, are used here to model the regression relationships between concentrations of the pollutants NO 2 , NO x and PM 2.5 , and nine variables describing meteorological conditions, temporal conditions and traffic flow. The study was based on hourly values of wind speed, wind direction, temperature, air pressure and relative humidity, temporal variables, and finally traffic flow, in the two years 2015 and 2016. An air quality measurement station was selected on a main road, located a short distance (40 m) from a large intersection equipped with a traffic flow measurement system. Nine different time subsets were defined, based among other things on the climatic conditions in Wrocław. An analysis was made of the fit of models created for those subsets, and of the importance of the predictors. Both the fit and the importance of particular predictors were found to be dependent on season. The best fit was obtained for models created for the six-month warm season (April-September) and for the summer season (June-August). The most important explanatory variable in the models of concentrations of nitrogen oxides was traffic flow, while in the case of PM 2.5 the most important were meteorological conditions, in particular temperature, wind speed and wind direction. Temporal variables (except for month in the case of PM 2.5 ) were found to have no significant effect on the concentrations of the studied pollutants. Copyright © 2018 Elsevier Ltd. All rights reserved.

Public Health Practice of Population-Based Birth Defects Surveillance Programs in the United States.

PubMed

Mai, Cara T; Kirby, Russell S; Correa, Adolfo; Rosenberg, Deborah; Petros, Michael; Fagen, Michael C

2016-01-01

Birth defects remain a leading cause of infant mortality in the United States and contribute substantially to health care costs and lifelong disabilities. State population-based surveillance systems have been established to monitor birth defects, yet no recent systematic examination of their efforts in the United States has been conducted. To understand the current population-based birth defects surveillance practices in the United States. The National Birth Defects Prevention Network conducted a survey of US population-based birth defects activities that included questions about operational status, case ascertainment methodology, program infrastructure, data collection and utilization, as well as priorities and challenges for surveillance programs. Birth defects contacts in the United States, including District of Columbia and Puerto Rico, received the survey via e-mail; follow-up reminders via e-mails and telephone were used to ensure a 100% response rate. Forty-three states perform population-based surveillance for birth defects, covering approximately 80% of the live births in the United States. Seventeen primarily use an active case-finding approach and 26 use a passive case-finding approach. These programs all monitor major structural malformations; however, passive case-finding programs more often monitor a broader list of conditions, including developmental conditions and newborn screening conditions. Active case-finding programs more often use clinical reviewers, cover broader pregnancy outcomes, and collect more extensive information, such as family history. More than half of the programs (24 of 43) reported an ability to conduct follow-up studies of children with birth defects. The breadth and depth of information collected at a population level by birth defects surveillance programs in the United States serve as an important data source to guide public health action. Collaborative efforts at the state and national levels can help harmonize data collection and increase utility of birth defects programs.

The Treatment of Anorexia Nervosa in a General Hospital: A Case Vignette of a Multi-Disciplinary General Hospital-Based Approach.

ERIC Educational Resources Information Center

Kronenberg, J.; And Others

1994-01-01

Describes anorexia nervosa as condition variable in etiology and resistant to treatment, which may lead to mortality in 5% of treated cases. Notes that efforts have been made for treating disorder in nonstigmatizing medical units outside psychiatric hospitals. Describes, through presentation of short case vignette, advantages of treating…

Confidence Interval Coverage for Cohen's Effect Size Statistic

ERIC Educational Resources Information Center

Algina, James; Keselman, H. J.; Penfield, Randall D.

2006-01-01

Kelley compared three methods for setting a confidence interval (CI) around Cohen's standardized mean difference statistic: the noncentral-"t"-based, percentile (PERC) bootstrap, and biased-corrected and accelerated (BCA) bootstrap methods under three conditions of nonnormality, eight cases of sample size, and six cases of population…

Taming the Technology.

ERIC Educational Resources Information Center

Clinton, Janeen S.

This document reports on efforts to find technology-based solutions for the diverse challenges faced by students with disabling conditions. Twenty-three case studies describe actual scenarios experienced in the school district of Palm Beach County, Florida. For each case study, a situation is described, a challenge is identified, solutions are…

Prior medical conditions and medication use and risk of non-Hodgkin lymphoma in Connecticut United States women.

PubMed

Zhang, Yawei; Holford, Theodore R; Leaderer, Brian; Zahm, Shelia Hoar; Boyle, Peter; Morton, Lindsay McOmber; Zhang, Bing; Zou, Kaiyong; Flynn, Stuart; Tallini, Giovanni; Owens, Patricia H; Zheng, Tongzhang

2004-05-01

To further investigate the role of prior medical conditions and medication use in the etiology of non-Hodgkin lymphoma (NHL), we analyzed the data from a population-based case-control study of NHL in Connecticut women. A total of 601 histologically confirmed incident cases of NHL and 717 population-based controls were included in this study. In-person interviews were administered using standardized, structured questionnaires to collect information on medical conditions and medication use. An increased risk was found among women who had a history of autoimmune disorders (such as rheumatoid arthritis, lupus erythematosus, Sjogren's syndrome, and multiple sclerosis), anemia, eczema, or psoriasis. An increased risk was also observed among women who had used steroidal anti-inflammatory drugs and tranquilizers. A reduced risk was found for women who had scarlet fever or who had used estrogen replacement therapy, aspirin, medications for non-insulin dependent diabetes, HMG-CoA reductase inhibitors, or beta-adrenergic blocking agents. Risk associated with past medical history appeared to vary based on NHL subtypes, but the results were based on small number of exposed subjects. A relationship between certain prior medical conditions and medication use and risk of NHL was observed in this study. Further studies are warranted to confirm our findings.

Topology optimization for three-dimensional electromagnetic waves using an edge element-based finite-element method.

PubMed

Deng, Yongbo; Korvink, Jan G

2016-05-01

This paper develops a topology optimization procedure for three-dimensional electromagnetic waves with an edge element-based finite-element method. In contrast to the two-dimensional case, three-dimensional electromagnetic waves must include an additional divergence-free condition for the field variables. The edge element-based finite-element method is used to both discretize the wave equations and enforce the divergence-free condition. For wave propagation described in terms of the magnetic field in the widely used class of non-magnetic materials, the divergence-free condition is imposed on the magnetic field. This naturally leads to a nodal topology optimization method. When wave propagation is described using the electric field, the divergence-free condition must be imposed on the electric displacement. In this case, the material in the design domain is assumed to be piecewise homogeneous to impose the divergence-free condition on the electric field. This results in an element-wise topology optimization algorithm. The topology optimization problems are regularized using a Helmholtz filter and a threshold projection method and are analysed using a continuous adjoint method. In order to ensure the applicability of the filter in the element-wise topology optimization version, a regularization method is presented to project the nodal into an element-wise physical density variable.

Topology optimization for three-dimensional electromagnetic waves using an edge element-based finite-element method

PubMed Central

Korvink, Jan G.

2016-01-01

This paper develops a topology optimization procedure for three-dimensional electromagnetic waves with an edge element-based finite-element method. In contrast to the two-dimensional case, three-dimensional electromagnetic waves must include an additional divergence-free condition for the field variables. The edge element-based finite-element method is used to both discretize the wave equations and enforce the divergence-free condition. For wave propagation described in terms of the magnetic field in the widely used class of non-magnetic materials, the divergence-free condition is imposed on the magnetic field. This naturally leads to a nodal topology optimization method. When wave propagation is described using the electric field, the divergence-free condition must be imposed on the electric displacement. In this case, the material in the design domain is assumed to be piecewise homogeneous to impose the divergence-free condition on the electric field. This results in an element-wise topology optimization algorithm. The topology optimization problems are regularized using a Helmholtz filter and a threshold projection method and are analysed using a continuous adjoint method. In order to ensure the applicability of the filter in the element-wise topology optimization version, a regularization method is presented to project the nodal into an element-wise physical density variable. PMID:27279766

Wind tunnel simulation of a wind turbine wake in neutral, stable and unstable wind flow

NASA Astrophysics Data System (ADS)

Hancock, P. E.; Zhang, S.; Pascheke, F.; Hayden, P.

2014-12-01

Measurements of mean velocity, Reynolds stresses, temperature and heat flux have been made in the wake of a model wind turbine in the EnFlo meteorology wind tunnel, for three atmospheric boundary layer states: the base-line neutral case, stable and unstable. The full-to-model scale is approximately 300:1. Primary instrumentation is two-component LDA combine with cold-wire thermometry to measure heat flux. In terms of surface conditions, the stratified cases are weak, but there is a strong 'imposed' condition in the stable case. The measurements were made between 0.5D and 10D, where D is the turbine disk diameter. In the stable case the velocity deficit decreases more slowly; more quickly in the unstable case. Heights at which quantities are maximum or minimum are greater in the unstable case and smaller in the stable case. In the stable case the wake height is suppressed but the width is increased, while in the unstable case the height is increased and the width (at hub height) reaches a maximum and then decreases. The turbulence in the wake behaves in a complex way. Further work needs to be done, to cover stronger levels of surface condition, requiring more extensive measurements to properly capture the wake development.

Progress toward an advanced condition monitoring system for reusable rocket engines

NASA Technical Reports Server (NTRS)

Maram, J.; Barkhoudarian, S.

1987-01-01

A new generation of advanced sensor technologies will allow the direct measurement of critical/degradable rocket engine components' health and the detection of degraded conditions before component deterioration affects engine performance, leading to substantial improvements in reusable engines' operation and maintenance. When combined with a computer-based engine condition-monitoring system, these sensors can furnish a continuously updated data base for the prediction of engine availability and advanced warning of emergent maintenance requirements. Attention is given to the case of a practical turbopump and combustion device diagnostic/prognostic health-monitoring system.

A Rare Case of Michelin Tire Baby Syndrome in a Newborn.

PubMed

Ramphul, Kamleshun; Mejias, Stephanie G; Ramphul-Sicharam, Yogeshwaree

2018-02-24

Kunze-Riehm syndrome also known as Michelin tire baby syndrome (MTBS) is a rare genetic condition with a characteristic generalized folding of excess skin. The diagnosis is usually made based on clinical symptoms. There are approximately only 30 cases reported in the literature and some cases were associated with non-cutaneous anomalies as well. Herein, we report a case of MTBS in a five-day-old male of Iraqi origin.

Assessing the role of case mix in cesarean delivery rates.

PubMed

Lieberman, E; Lang, J M; Heffner, L J; Cohen, A

1998-07-01

Implicit in comparisons of unadjusted cesarean rates for hospitals and providers is the assumption that differences result from management practices rather than differences in case mix. This study proposes a method for comparison of cesarean rates that takes the effect of case mix into account. All women delivered of infants at our institution from December 1, 1994, through July 31, 1995, were classified according to whether they received care from community-based practitioners (N=3913) or from the hospital-based practice that serves a higher-risk population (N=1556). Women were categorized according to both obstetric history (nulliparas, multiparas without a previous cesarean, multiparas with a previous cesarean) and the presence of obstetric conditions influencing the risk of cesarean delivery (multiple birth, breech presentation or transverse lie, preterm, no trial of labor for a medical indication). We determined the percent of women in each parity-obstetric condition subgroup and calculated a standardized cesarean rate for the hospital-based practice using the case mix of the community-based practitioners as the standard. The crude cesarean rate was higher for the hospital-based practice (24.4%) than for the community-based practitioners (21.5%), a rate difference of 2.9% (95% confidence interval=0.4%, 5.4%; P=.02). However, the proportion of women falling into categories conferring a high risk of cesarean delivery (multiple pregnancy, breech presentation or transverse lie, preterm, no trial of labor permitted) was twice as high for the hospital-based practice (24.4% hospital, 12.1% community). The standardization indicates that if the hospital-based practitioners had the same case mix as community-based practitioners, their overall cesarean rate would be 20.1%, similar to the 21.5% rate of community providers (rate difference=-1.4%, 95% confidence interval =-3.1%, 0.3%; P=.11). Standardization for case mix provides a mechanism for distinguishing differences in cesarean rates resulting from case mix from those relating to differences in practice. The methodology is not complex and could be applied to facilitate fairer comparisons of rates among providers and across institutions.

Discussion of Electrode Conditioning Mechanism Based on Pre-breakdown Current under Non-uniform Electric Field in Vacuum

NASA Astrophysics Data System (ADS)

Yasuoka, Takanori; Kato, Tomohiro; Kato, Katsumi; Okubo, Hitoshi

Electrode conditioning is very important technique for improvement of the insulation performance of vacuum circuit breakers (VCBs). This paper discusses the spark conditioning mechanism under non-uniform electric field focused on the pre-breakdown current. We quantitatively evaluated the spark conditioning effect by analyzing the pre-breakdown current based on Fowler-Nordheim equation. As a result, field enhancement factor β decreased with the increasing in breakdown voltage in the beginning of conditioning process, and finally β was saturated with the saturation of breakdown voltage. In addition, in case of non-uniform field, we found that β on high voltage rod electrode after conditioning varied according to the electric field strength on the rod electrode.

A retrospective likelihood approach for efficient integration of multiple omics factors in case-control association studies.

PubMed

Balliu, Brunilda; Tsonaka, Roula; Boehringer, Stefan; Houwing-Duistermaat, Jeanine

2015-03-01

Integrative omics, the joint analysis of outcome and multiple types of omics data, such as genomics, epigenomics, and transcriptomics data, constitute a promising approach for powerful and biologically relevant association studies. These studies often employ a case-control design, and often include nonomics covariates, such as age and gender, that may modify the underlying omics risk factors. An open question is how to best integrate multiple omics and nonomics information to maximize statistical power in case-control studies that ascertain individuals based on the phenotype. Recent work on integrative omics have used prospective approaches, modeling case-control status conditional on omics, and nonomics risk factors. Compared to univariate approaches, jointly analyzing multiple risk factors with a prospective approach increases power in nonascertained cohorts. However, these prospective approaches often lose power in case-control studies. In this article, we propose a novel statistical method for integrating multiple omics and nonomics factors in case-control association studies. Our method is based on a retrospective likelihood function that models the joint distribution of omics and nonomics factors conditional on case-control status. The new method provides accurate control of Type I error rate and has increased efficiency over prospective approaches in both simulated and real data. © 2015 Wiley Periodicals, Inc.

The case of value-based healthcare for people living with complex long-term conditions.

PubMed

Elf, Marie; Flink, Maria; Nilsson, Marie; Tistad, Malin; von Koch, Lena; Ytterberg, Charlotte

2017-01-11

There is a trend towards value-based health service, striving to cut costs while generating value for the patient. The overall objective comprises higher-quality health services and improved patient safety and cost efficiency. The approach could align with patient-centred care, as it entails a focus on the patient's experience of her or his entire cycle of care, including the use of well-defined outcome measurements. Challenges arise when the approach is applied to health services for people living with long-term complex conditions that require support from various healthcare services. The aim of this work is to critically discuss the value-based approach and its implications for patients with long-term complex conditions. Two cases from clinical practice and research form the foundation for our reasoning, illustrating several challenges regarding value-based health services for people living with long-term complex conditions. Achieving value-based health services that provide the health outcomes that matter to patients and providing greater patient-centredness will place increased demands on the healthcare system. Patients and their informal caregivers must be included in the development and establishment of outcome measures. The outcome measures must be standardized to allow evaluation of specific conditions at an aggregated level, but they must also be sensitive enough to capture each patient's individual needs and goals. Healthcare systems that strive to establish value-based services must collaborate beyond the organizational boundaries to create clear patient trajectories in order to avoid fragmentation. The shift towards value-based health services has the potential to align healthcare-service delivery with patient-centred care if serious efforts to take the patient's perspective into account are made. This is especially challenging in fragmented healthcare systems and for patients with long-term- and multi-setting-care needs.

Analysis of Coaxial Injectors Using CFD++

DTIC Science & Technology

2011-09-12

turpentine droplets d = 1-90 um Uc = 2.4 m/s Low turbulence intensity of 1.4% Model Validation Case 9/12/2011 28Distribution A: Approved for Public...Approved for Public Release (Pending) Case Conditions: •Two species (Air, Turpentine ) •Base Equation Type: Compressible Real Gas Navier-Stokes/Euler

Sustaining Latina Student Organizations: An Exploratory Instrumental Case Study

ERIC Educational Resources Information Center

Castellanos, Michelle

2016-01-01

Utilizing the exploratory case study methodology, the author examines the conditions that support and limit a Latina-based student organization at a predominately White institution of higher education. Seven organizational structures were found to influence the organization's ability to advance its aims, from interviews, documents, observations,…

Base stock system for patient vs impatient customers with varying demand distribution

NASA Astrophysics Data System (ADS)

Fathima, Dowlath; Uduman, P. Sheik

2013-09-01

An optimal Base-Stock inventory policy for Patient and Impatient Customers using finite-horizon models is examined. The Base stock system for Patient and Impatient customers is a different type of inventory policy. In case of the model I, Base stock for Patient customer case is evaluated using the Truncated Exponential Distribution. The model II involves the study of Base-stock inventory policies for Impatient customer. A study on these systems reveals that the Customers wait until the arrival of the next order or the customers leaves the system which leads to lost sale. In both the models demand during the period [0, t] is taken to be a random variable. In this paper, Truncated Exponential Distribution satisfies the Base stock policy for the patient customer as a continuous model. So far the Base stock for Impatient Customers leaded to a discrete case but, in this paper we have modeled this condition into a continuous case. We justify this approach mathematically and also numerically.

Progressing From Initially Ambiguous Functional Analyses: Three Case Examples

PubMed Central

Tiger, Jeffrey H.; Fisher, Wayne W.; Toussaint, Karen A.; Kodak, Tiffany

2009-01-01

Most often functional analyses are initiated using a standard set of test conditions, similar to those described by Iwata, Dorsey, Slifer, Bauman, and Richman (1982/1994). These test conditions involve the careful manipulation of motivating operations, discriminative stimuli, and reinforcement contingencies to determine the events related to the occurrence and maintenance of problem behavior. Some individuals display problem behavior that is occasioned and reinforced by idiosyncratic or otherwise unique combinations of environmental antecedents and consequences of behavior, which are unlikely to be detected using these standard assessment conditions. For these individuals, modifications to the standard test conditions or the inclusion of novel test conditions may result in clearer assessment outcomes. The current study provides three case examples of individuals whose functional analyses were initially undifferentiated; however, modifications to the standard conditions resulted in the identification of behavioral functions and the implementation of effective function-based treatments. PMID:19233611

Effects of Combining Case-Based Instruction and Mindfulness Activities on the Acquisition, Application, and Transfer of Complex Knowledge: An Experimental Comparison of Two Multiple-Case Treatments on Videodisc.

ERIC Educational Resources Information Center

Cunningham, Thomas H.; Thorkildsen, Ron J.

Two multiple-case instructional treatments were compared to determine their relative effectiveness for helping program participants acquire, apply, and transfer complex knowledge about Assistive Technology (AT) available to help people with impaired vision. Thirty-eight college students were randomly assigned to two conditions. Both treatments…

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.

College-Based Case Studies in Using PowerPoint Effectively

ERIC Educational Resources Information Center

Inoue-Smith, Yukiko

2016-01-01

This study reexamined PowerPoint's potential to enhance traditional pedagogical practices in higher education. The study addressed (1) the conditions under which PowerPoint meets students' needs in typical lecture-based classrooms, (2) whether professors consider PowerPoint-based lectures more effective than lectures supported by material on…

Network-based regularization for matched case-control analysis of high-dimensional DNA methylation data.

PubMed

Sun, Hokeun; Wang, Shuang

2013-05-30

The matched case-control designs are commonly used to control for potential confounding factors in genetic epidemiology studies especially epigenetic studies with DNA methylation. Compared with unmatched case-control studies with high-dimensional genomic or epigenetic data, there have been few variable selection methods for matched sets. In an earlier paper, we proposed the penalized logistic regression model for the analysis of unmatched DNA methylation data using a network-based penalty. However, for popularly applied matched designs in epigenetic studies that compare DNA methylation between tumor and adjacent non-tumor tissues or between pre-treatment and post-treatment conditions, applying ordinary logistic regression ignoring matching is known to bring serious bias in estimation. In this paper, we developed a penalized conditional logistic model using the network-based penalty that encourages a grouping effect of (1) linked Cytosine-phosphate-Guanine (CpG) sites within a gene or (2) linked genes within a genetic pathway for analysis of matched DNA methylation data. In our simulation studies, we demonstrated the superiority of using conditional logistic model over unconditional logistic model in high-dimensional variable selection problems for matched case-control data. We further investigated the benefits of utilizing biological group or graph information for matched case-control data. We applied the proposed method to a genome-wide DNA methylation study on hepatocellular carcinoma (HCC) where we investigated the DNA methylation levels of tumor and adjacent non-tumor tissues from HCC patients by using the Illumina Infinium HumanMethylation27 Beadchip. Several new CpG sites and genes known to be related to HCC were identified but were missed by the standard method in the original paper. Copyright © 2012 John Wiley & Sons, Ltd.

Quantifying the impact of chronic conditions on a diagnosis of major depressive disorder in adults: a cohort study using linked electronic medical records.

PubMed

Ryu, Euijung; Chamberlain, Alanna M; Pendegraft, Richard S; Petterson, Tanya M; Bobo, William V; Pathak, Jyotishman

2016-04-26

Major depressive disorder (MDD) is often comorbid with other chronic mental and physical health conditions. Although the literature widely acknowledges the association of many chronic conditions with the risk of MDD, the relative importance of these conditions on MDD risk in the presence of other conditions is not well investigated. In this study, we aimed to quantify the relative contribution of selected chronic conditions to identify the conditions most influential to MDD risk in adults and identify differences by age. This study used electronic health record (EHR) data on patients empanelled with primary care at Mayo Clinic in June 2013. A validated EHR-based algorithm was applied to identify newly diagnosed MDD patients between 2000 and 2013. Non-MDD controls were matched 1:1 to MDD cases on birth year (±2 years), sex, and outpatient clinic visits in the same year of MDD case diagnosis. Twenty-four chronic conditions defined by Chronic Conditions Data Warehouse were ascertained in both cases and controls using diagnosis codes within 5 years of index dates (diagnosis dates for cases, and the first clinic visit dates for matched controls). For each age group (45 years or younger, between 46 and 60, and over 60 years), conditional logistic regression models were used to test the association between each condition and subsequent MDD risk, adjusting for educational attainment and obesity. The relative influence of these conditions on the risk of MDD was quantified using gradient boosting machine models. A total of 11,375 incident MDD cases were identified between 2000 and 2013. Most chronic conditions (except for eye conditions) were associated with risk of MDD, with different association patterns observed depending on age. Among 24 chronic conditions, the greatest relative contribution was observed for diabetes mellitus for subjects aged ≤ 60 years and rheumatoid arthritis/osteoarthritis for those over 60 years. Our results suggest that specific chronic conditions such as diabetes mellitus and rheumatoid arthritis/osteoarthritis may have greater influence than others on the risk of MDD.

Deterministic convergence of chaos injection-based gradient method for training feedforward neural networks.

PubMed

Zhang, Huisheng; Zhang, Ying; Xu, Dongpo; Liu, Xiaodong

2015-06-01

It has been shown that, by adding a chaotic sequence to the weight update during the training of neural networks, the chaos injection-based gradient method (CIBGM) is superior to the standard backpropagation algorithm. This paper presents the theoretical convergence analysis of CIBGM for training feedforward neural networks. We consider both the case of batch learning as well as the case of online learning. Under mild conditions, we prove the weak convergence, i.e., the training error tends to a constant and the gradient of the error function tends to zero. Moreover, the strong convergence of CIBGM is also obtained with the help of an extra condition. The theoretical results are substantiated by a simulation example.

On the Effective Construction of Compactly Supported Wavelets Satisfying Homogenous Boundary Conditions on the Interval

NASA Technical Reports Server (NTRS)

Chiavassa, G.; Liandrat, J.

1996-01-01

We construct compactly supported wavelet bases satisfying homogeneous boundary conditions on the interval (0,1). The maximum features of multiresolution analysis on the line are retained, including polynomial approximation and tree algorithms. The case of H(sub 0)(sup 1)(0, 1)is detailed, and numerical values, required for the implementation, are provided for the Neumann and Dirichlet boundary conditions.

Occupational exposures and non-Hodgkin's lymphoma: Canadian case-control study.

PubMed

Karunanayake, Chandima P; McDuffie, Helen H; Dosman, James A; Spinelli, John J; Pahwa, Punam

2008-08-07

The objective was to study the association between Non-Hodgkin's Lymphoma (NHL) and occupational exposures related to long held occupations among males in six provinces of Canada. A population based case-control study was conducted from 1991 to 1994. Males with newly diagnosed NHL (ICD-10) were stratified by province of residence and age group. A total of 513 incident cases and 1506 population based controls were included in the analysis. Conditional logistic regression was conducted to fit statistical models. Based on conditional logistic regression modeling, the following factors independently increased the risk of NHL: farmer and machinist as long held occupations; constant exposure to diesel exhaust fumes; constant exposure to ionizing radiation (radium); and personal history of another cancer. Men who had worked for 20 years or more as farmer and machinist were the most likely to develop NHL. An increased risk of developing NHL is associated with the following: long held occupations of faer and machinist; exposure to diesel fumes; and exposure to ionizing radiation (radium). The risk of NHL increased with the duration of employment as a farmer or machinist.

A case report highlighting the growing trend of Internet-based self-diagnosis of "Morgellon's disease".

PubMed

Mortillaro, Gino; Rodgman, Christopher; Kinzie, Erik; Ryals, Sarah

2013-01-01

"Morgellon's Disease" is a term used to describe a bizarre condition characterized by the belief that strange sensations in the skin are due to filaments called "Morgellon's Bodies."' The focus of this case report is to inform readers of the growing incidence of this psychosomatic condition. Unfortunately, self-diagnosis has become increasingly common because of the widespread coverage on the Internet. While the validity of the diagnosis is in question, the impact on patient's lives is real, often debilitating, and bears more examination.

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

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

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.

Severe paediatric conditions linked with EV-A71 and EV-D68, France, May to October 2016

PubMed Central

Antona, Denise; Kossorotoff, Manoëlle; Schuffenecker, Isabelle; Mirand, Audrey; Leruez-Ville, Marianne; Bassi, Clément; Aubart, Mélodie; Moulin, Florence; Lévy-Bruhl, Daniel; Henquell, Cécile; Lina, Bruno; Desguerre, Isabelle

2016-01-01

We report 59 cases of severe paediatric conditions linked with enterovirus (EV)-A71 and EV-D68 in France between May and October 2016. Fifty-two children had severe neurological symptoms. EV sequence-based typing for 42 cases revealed EV-A71 in 21 (18 subgenotype C1, detected for the first time in France) and EV-D68 in eight. Clinicians should be encouraged to obtain stool and respiratory specimens from patients presenting with severe neurological disorders for EV detection and characterisation. PMID:27918268

Bayesian analysis of time-series data under case-crossover designs: posterior equivalence and inference.

PubMed

Li, Shi; Mukherjee, Bhramar; Batterman, Stuart; Ghosh, Malay

2013-12-01

Case-crossover designs are widely used to study short-term exposure effects on the risk of acute adverse health events. While the frequentist literature on this topic is vast, there is no Bayesian work in this general area. The contribution of this paper is twofold. First, the paper establishes Bayesian equivalence results that require characterization of the set of priors under which the posterior distributions of the risk ratio parameters based on a case-crossover and time-series analysis are identical. Second, the paper studies inferential issues under case-crossover designs in a Bayesian framework. Traditionally, a conditional logistic regression is used for inference on risk-ratio parameters in case-crossover studies. We consider instead a more general full likelihood-based approach which makes less restrictive assumptions on the risk functions. Formulation of a full likelihood leads to growth in the number of parameters proportional to the sample size. We propose a semi-parametric Bayesian approach using a Dirichlet process prior to handle the random nuisance parameters that appear in a full likelihood formulation. We carry out a simulation study to compare the Bayesian methods based on full and conditional likelihood with the standard frequentist approaches for case-crossover and time-series analysis. The proposed methods are illustrated through the Detroit Asthma Morbidity, Air Quality and Traffic study, which examines the association between acute asthma risk and ambient air pollutant concentrations. © 2013, The International Biometric Society.

Clinico-epidemiological study of tinea incognito with microbiological correlation.

PubMed

Dutta, Bornali; Rasul, Elmy Samsul; Boro, Bobita

2017-01-01

Tinea incognito is a dermatophytic infection with a clinical presentation that is modified due to previous treatment with topical or systemic steroids, as well as topical immunomodulators. It tends to mimic other dermatological conditions. To evaluate the various clinical manifestations, sites, predisposing factors and causative agents of tinea incognito. A prospective observational study was done on one hundred clinically suspected cases of tinea incognito, with a history of topical or systemic steroid use for a period of at least six weeks. They were subject to direct microscopy and fungal culture, and re-evaluated at the end of the third and sixth week. Eczema-like conditions were the most common clinical manifestation, followed by inflammatory, autoimmune and infective conditions. The face was the most commonly affected site. Direct microscopy was positive in 85% of cases, and fungal culture was positive in 63% of cases. Trichophyton rubrum was the most common species isolated. Pharmacists were responsible for 78% of tinea incognito cases, and betamethasone dipropionate was the most common drug used. As this was a hospital outpatient-based study, cases with severe systemic problems could have attended other departments. Cases involving the hair and nails were negligible. Tinea incognito is a commonly encountered, yet poorly reported entity in the study population. An increased level of awareness and vigilance on the sale of steroid containing compounds will help control this dermatological condition.

Hamate-pisiform coalition: morphology, clinical significance, and a simplified classification scheme for carpal coalition.

PubMed

Burnett, Scott E

2011-03-01

Hamate-pisiform coalition is characterized by the abnormal union of the pisiform bone and hamulus of the hamate. Because most reported cases are isolated, and literature on the subject is sparse, relatively little is known about this condition and its clinical significance. The purpose of this report is to discuss the occurrence, morphology, and frequency of hamate-pisiform coalition identified in a skeletal sample of native South Africans, and to conduct a metaanalysis of all known cases in order to clarify the sex distribution, laterality, form, and clinical significance of this condition. Five new cases (three male, two female) of hamate-pisiform coalition were identified in 527 native South Africans. Results indicate that hamate-pisiform coalition is infrequent (0.76%) but may be more likely encountered in individuals of African ancestry. Morphologically, non-osseous examples ranged in appearance from minor expressions involving pitting of an expanded hamulus base, to a variably pitted articulation between an elongated pisiform and hamulus. Osseous union between the two bones tends to extend beyond the hamulus base to adjacent areas of the hamate. Cases involving osseous union appear predisposed to fracture while ulnar neuropathy is significantly more frequent in individuals exhibiting non-osseous coalition. As both non-osseous and osseous cases can have clinical significance, awareness of the variable manifestations of this condition is necessary for hand specialists. A simplified classification system is suggested to more consistently characterize carpal coalitions. Copyright © 2010 Wiley-Liss, Inc.

Solitary intracranial plasmacytoma located in the spheno-clival region mimicking chordoma: a case report.

PubMed

Liu, Z Y; Qi, X Q; Wu, X J; Luo, C; Lu, Y C

2010-01-01

Solitary intracranial plasmacytoma (SIP) is very rare. This case report presents serial findings of SIP located in the spheno-clival region in a 54-year old female who presented with an inferior hemianopia in the right eye and an enlarged physiological blind spot in both eyes. Based on the initial diagnosis of a spheno-clival region chordoma, the tumour was partially resected by the nasal-sphenoidal sinus approach. Subsequently, the correct diagnosis of SIP was made based on the pathology and immunohistochemical staining of the tumour. The patient was treated using a whole skull-base radiation therapy protocol with 45 Gy and she was in good physical condition during the subsequent 22 months. The findings of a series of similar case reports documenting SIP in 20 cases published from 1976 to 2008 are also reviewed. Based on these case reports, the key features of SIP, including their clinical manifestations, clinical imaging characteristics, treatment and prognosis, are described.

Case-Deletion Diagnostics for Nonlinear Structural Equation Models

ERIC Educational Resources Information Center

Lee, Sik-Yum; Lu, Bin

2003-01-01

In this article, a case-deletion procedure is proposed to detect influential observations in a nonlinear structural equation model. The key idea is to develop the diagnostic measures based on the conditional expectation of the complete-data log-likelihood function in the EM algorithm. An one-step pseudo approximation is proposed to reduce the…

Cronkhite-Canada Syndrome (CCS)-A Rare Case Report.

PubMed

Chakrabarti, Subrata

2015-03-01

Cronkhite-Canada syndrome (CCS) is an extremely rare non-inherited condition characterized by gastrointestinal hamartomatous polyposis, alopecia, onychodystrophy, hyperpigmentation, weight loss and diarrhoea. The aetiology is probably autoimmune and diagnosis is based on history, physical examination, endoscopic findings of gastrointestinal polyposis, and histology. The disease is very rare; approximately 450 cases of CCS have been reported worldwide. The author reports a case of CCS in an elderly Indian male.

Association between prenatal care utilization and risk of preterm birth among Chinese women.

PubMed

Zhang, Bin; Yang, Rong; Liang, Sheng-Wen; Wang, Jing; Chang, Jen Jen; Hu, Ke; Dong, Guang-Hui; Hu, Rong-Hua; Flick, Louise H; Zhang, Yi-Ming; Zhang, Dan; Li, Qing-Jie; Zheng, Tong-Zhang; Xu, Shun-Qing; Yang, Shao-Ping; Qian, Zheng-Min

2017-08-01

It is recognized that prenatal care plays an important role in reducing adverse birth. Chinese pregnant women with medical condition were required to seek additional health care based on the recommended at least 5 times health care visits. This study was to estimate the association between prenatal care utilization (PCU) and preterm birth (PTB), and to investigate if medical conditions during pregnancy modified the association. This population-based case control study sampled women with PTB as cases; one control for each case was randomly selected from women with term births. The Electronic Perinatal Health Care Information System (EPHCIS) and a questionnaire were used for data collection. The PCU was measured by a renewed Prenatal Care Utilization (APNCU) index. Logistic regression models were used to estimate odds ratios (OR) and the 95% confidence interval (95% CI). Totally, 2393 women with PTBs and 4263 women with term births were collected. In this study, 695 (10.5%) women experienced inadequate prenatal care, and 5131 (77.1%) received adequate plus prenatal care. Inadequate PCU was associated with PTB (adjusted OR: 1.41, 95% CI: 1.32-1.84); the similar positive association was found between adequate plus PCU and PTB. Among women with medical conditions, these associations still existed; but among women without medical conditions, the association between inadequate PCU and PTB disappeared. Our data suggests that women receiving inappropriate PCU are at an increased risk of having PTB, but it does depend on whether the woman has a medical condition during pregnancy.

Modeling Soil Sodicity Problems under Dryland and Irrigated Conditions: Case Studies in Argentina and Colombia

NASA Astrophysics Data System (ADS)

Pla-Sentís, Ildefonso

2014-05-01

Salt-affected soils, both saline and sodic, my develop both under dryland and irrigated conditions, affecting negatively the physical and chemical soil properties, the crop production and the animal and human health.Among the development processes of salt-affected soils, the processes of sodification have been generally received less attention and is less understood than the development of saline soils. Although in both of them, hydrological processes are involved in their development, in the case of sodic soils we have to consider some additional chemical and physicochemical reactions, making more difficult their modeling and prediction. In this contribution we present two case studies: one related to the development of sodic soils in the lowlands of the Argentina Pampas, under dryland conditions and sub-humid temperate climate, with pastures for cattle production; the other deals with the development of sodic soils in the Colombia Cauca Valley, under irrigated conditions and tropical sub-humid climate, in lands used for sugarcane cropping dedicated to sugar and ethanol production. In both cases the development of sodicity in the surface soil is mainly related to the effects of the composition and level of groundwater, affected in the case of Argentina Pampas by the off-site changes in dryland use and management in the upper zones and by the drainage conditions in the lowlands, and in the case of the Cauca Valley, by the on-site irrigation and drainage management in lands with sugarcane. There is shown how the model SALSODIMAR, developed by the main author, based on the balance of water and soluble componentes of both the irrigation water and groundwater under different water and land management conditions, may be adapted for the diagnosis and prediction of both problems, and for the selection of alternatives for their management and amelioration.

A concordance index for matched case-control studies with applications in cancer risk.

PubMed

Brentnall, Adam R; Cuzick, Jack; Field, John; Duffy, Stephen W

2015-02-10

In unmatched case-control studies, the area under the receiver operating characteristic (ROC) curve (AUC) may be used to measure how well a variable discriminates between cases and controls. The AUC is sometimes used in matched case-control studies by ignoring matching, but it lacks interpretation because it is not based on an estimate of the ROC for the population of interest. We introduce an alternative measure of discrimination that is the concordance of risk factors conditional on the matching factors. Parametric and non-parametric estimators are given for different matching scenarios, and applied to real data from breast and lung cancer case-control studies. Diagnostic plots to verify the constancy of discrimination over matching factors are demonstrated. The proposed simple measure is easy to use, interpret, more efficient than unmatched AUC statistics and may be applied to compare the conditional discrimination performance of risk factors. Copyright © 2014 John Wiley & Sons, Ltd.

No static black hole hairs in gravitational theories with broken Lorentz invariance

NASA Astrophysics Data System (ADS)

Lin, Kai; Mukohyama, Shinji; Wang, Anzhong; Zhu, Tao

2017-06-01

In this paper, we revisit the issue of static hairs of black holes in gravitational theories with broken Lorentz invariance in the case that the speed cϕ of the khronon field becomes infinitely large, cϕ=∞ , for which the sound horizon of the khronon field coincides with the universal horizon, and the boundary conditions at the sound horizon reduce to those given normally at the universal horizons. As a result, fewer boundary conditions are present in this extreme case in comparison with the case cϕ=finite . Consequently, it is expected that static hairs might exist. However, we show analytically that, even in this case, static hairs still cannot exist, based on a decoupling limit analysis. We also consider the cases in which cϕ is finite but with cϕ≫1 , and we obtain the same conclusion.

Establishing Empirical Bases for Sustainability Objectives

Treesearch

Lawrence Martin

2006-01-01

The argument is made that sustainability should be construed as measurable environmental conditions, and that sustainable development strategies should be considered in terms of how well they contribute to the sustainable condition target. A case study of the Chesapeake Bay is presented to illustrate how use of Material Flow Analysis (MFA) as a basic component in the...

Exploring Conditions for Transformative Learning in Work-Integrated Education

ERIC Educational Resources Information Center

McRae, Norah

2015-01-01

A qualitative study was undertaken that explored the conditions for transformative learning in cooperative education as a form of work-integrated learning (WIL), towards the development of a theoretical model. Four case studies were analyzed based on interviews with WIL students, supervisors and their co-op coordinator. The findings revealed that…

A Peer Assessment System to Improve Student Team Experiences

ERIC Educational Resources Information Center

Anson, Robert; Goodman, James A.

2014-01-01

Groups are frequently used in courses, but there is substantial evidence that insufficient attention is paid to creating conditions for successful teamwork. One key condition is high-quality, individual, and team-level feedback. An online peer assessment system and team improvement process was developed for this test case based on three design…

Validating the WHO Maternal Near Miss Tool in a high-income country.

PubMed

Witteveen, Tom; de Koning, Ilona; Bezstarosti, Hans; van den Akker, Thomas; van Roosmalen, Jos; Bloemenkamp, Kitty W

2016-01-01

This study was performed to assess the applicability of the WHO Maternal Near Miss Tool (MNM Tool) and the organ dysfunction criteria in a high-income country. The MNM tool was applied to 2552 women who died of pregnancy-related causes or sustained severe acute maternal morbidity between August 2004 and August 2006 in one of the 98 hospitals with a maternity unit in the Netherlands. Fourteen (0.6%) cases had insufficient data for application. Each case was assessed according to the three main "MNM categories" specified in the MNM tool and their subcategory criteria: five disease-, four intervention- and seven organ dysfunction-based criteria. Potentially life-threatening conditions (disease-based inclusions) and life-threatening cases (organ dysfunction-based inclusions) were differentiated according to WHO methodology. Outcomes were incidence of all (sub)categories and case-fatality rates. Of the 2538 cases, 2308 (90.9%) women fulfilled disease-based, 2116 (83.4%) intervention-based and 1024 (40.3%) organ dysfunction-based criteria. Maternal death occurred in 48 women, of whom 23 (47.9%) fulfilled disease-based, 33 (68.8%) intervention-based and 31 (64.6%) organ dysfunction-based criteria. Case-fatality rates were 23/2308 (1.0%) for cases fulfilling the disease-based criteria, 33/2116 (1.6%) for intervention-based criteria and 31/1024 (3.0%) for women fulfilling the organ dysfunction-based criteria. In the Netherlands, where advanced laboratory and clinical monitoring are available, organ dysfunction-based criteria of the MNM tool failed to identify nearly two-thirds of sustained severe acute maternal morbidity cases and more than one-third of maternal deaths. Disease-based criteria remain important, and using only organ dysfunction-based criteria would lead to underestimating severe acute maternal morbidity. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

Weld pool oscillation during pulsed GTA welding

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

Aendenroomer, A.J.R.; Ouden, G. den

1996-12-31

This paper deals with weld pool oscillation during pulsed GTA welding and with the possibility to use this oscillation for in-process control of weld penetration. Welding experiments were carried out under different welding conditions. During welding the weld pool was triggered into oscillation by the normal welding pulses or by extra current pulses. The oscillation frequency was measured both during the pulse time and during the base time by analyzing the arc voltage variation using a Fast Fourier Transformation program. Optimal results are obtained when full penetration occurs during the pulse time and partial penetration during the base time. Undermore » these conditions elliptical overlapping spot welds are formed. In the case of full penetration the weld pool oscillates in a low frequency mode (membrane oscillation), whereas in the case of partial penetration the weld pool oscillates in a high frequency mode (surface oscillation). Deviation from the optimal welding conditions occurs when high frequency oscillation is observed during both pulse time and base time (underpenetration) or when low frequency oscillation is observed during both pulse time and base time (overpenetration). In line with these results a penetration sensing system with feedback control was designed, based on the criterion that optimal weld penetration is achieved when two peaks are observed in the frequency distribution. The feasibility of this sensing system for orbital tube welding was confirmed by the results of experiments carried out under various welding conditions.« less

LMI-based stability analysis of fuzzy-model-based control systems using approximated polynomial membership functions.

PubMed

Narimani, Mohammand; Lam, H K; Dilmaghani, R; Wolfe, Charles

2011-06-01

Relaxed linear-matrix-inequality-based stability conditions for fuzzy-model-based control systems with imperfect premise matching are proposed. First, the derivative of the Lyapunov function, containing the product terms of the fuzzy model and fuzzy controller membership functions, is derived. Then, in the partitioned operating domain of the membership functions, the relations between the state variables and the mentioned product terms are represented by approximated polynomials in each subregion. Next, the stability conditions containing the information of all subsystems and the approximated polynomials are derived. In addition, the concept of the S-procedure is utilized to release the conservativeness caused by considering the whole operating region for approximated polynomials. It is shown that the well-known stability conditions can be special cases of the proposed stability conditions. Simulation examples are given to illustrate the validity of the proposed approach.

Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow-up of people with complex chronic diseases.

PubMed

Morales-Asencio, Jose M; Kaknani-Uttumchandani, Shakira; Cuevas-Fernández-Gallego, Magdalena; Palacios-Gómez, Leopoldo; Gutiérrez-Sequera, José L; Silvano-Arranz, Agustina; Batres-Sicilia, Juan Pedro; Delgado-Romero, Ascensión; Cejudo-Lopez, Ángela; Trabado-Herrera, Manuel; García-Lara, Esteban L; Martin-Santos, Francisco J; Morilla-Herrera, Juan C

2015-10-01

Complex chronic diseases are a challenge for the current configuration of health services. Case management is a service frequently provided for people with chronic conditions, and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry-based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow-up, interventions developed by case managers and services used. The study was divided into three phases, covering the detection of information needs, the design and its implementation in the health care system, using literature review and expert consensus methods to select variables that would be included in the registry. A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. A web-based registry with modular and layered architecture was designed. The framework follows a pattern based on the model-view-controller approach. In its first 6 months after the implementation, 102 case managers have introduced an average number of 6.49 patients each one. The registry permits a complete and in-depth analysis of the characteristics of the patients who receive case management, the interventions delivered and some major outcomes as mortality, readmissions or adverse events. © 2015 John Wiley & Sons, Ltd.

A new polytopic approach for the unknown input functional observer design

NASA Astrophysics Data System (ADS)

Bezzaoucha, Souad; Voos, Holger; Darouach, Mohamed

2018-03-01

In this paper, a constructive procedure to design Functional Unknown Input Observers for nonlinear continuous time systems is proposed under the Polytopic Takagi-Sugeno framework. An equivalent representation for the nonlinear model is achieved using the sector nonlinearity transformation. Applying the Lyapunov theory and the ? attenuation, linear matrix inequalities conditions are deduced which are solved for feasibility to obtain the observer design matrices. To cope with the effect of unknown inputs, classical approach of decoupling the unknown input for the linear case is used. Both algebraic and solver-based solutions are proposed (relaxed conditions). Necessary and sufficient conditions for the existence of the functional polytopic observer are given. For both approaches, the general and particular cases (measurable premise variables, full state estimation with full and reduced order cases) are considered and it is shown that the proposed conditions correspond to the one presented for standard linear case. To illustrate the proposed theoretical results, detailed numerical simulations are presented for a Quadrotor Aerial Robots Landing and a Waste Water Treatment Plant. Both systems are highly nonlinear and represented in a T-S polytopic form with unmeasurable premise variables and unknown inputs.

Structured review: evaluating the effectiveness of nurse case managers in improving health outcomes in three major chronic diseases.

PubMed

Sutherland, Debbie; Hayter, Mark

2009-11-01

This paper presents the findings of a review and appraisal of the evidence for the effectiveness of nurse case management in improving health outcomes for patients living either with Diabetes, Chronic Obstructive Pulmonary Disease or Coronary Heart Disease. Long term chronic health conditions provide some of the greatest challenges to western health care systems. In the UK, three of the most significant chronic conditions are Diabetes, Chronic Obstructive Pulmonary Disease and Coronary Heart Disease. Patients with these long term conditions are high users of health services who often receive unplanned, poorly co-ordinated, ad-hoc care in response to an exacerbation or crisis. To counter this, the nurse case manager is identified as a central aspect of improving care for these patients. However, the evidence for the effectiveness of nurse case management in improving health outcomes for the chronically ill is scarce. A structured review of the literature. The review was undertaken focussing on studies that evaluated nurse case management with one or all of the three major long term chronic conditions. A total of 108 papers were initially reviewed and filtered to leave 75 citations that were appraised. About 18 papers were finally included in the review and subject to thematic analysis based on the health outcomes evaluated in the studies. Significantly positive results were reported for nurse case management impact on five health outcomes; 'objective clinical measurements', 'quality of life and functionality', 'patient satisfaction', 'adherence to treatment' and 'self care and service use'. The evidence generated in this review suggests that nurse case managers have the potential to achieve improved health outcomes for patients with long term conditions. Further research is required to support role development and create a more targeted approach to the intervention.

Outcomes of a Behavioral Intervention to Reduce HIV Risk among Drug-involved Female Sex Workers

PubMed Central

Surratt, Hilary L.; O’Grady, Catherine; Kurtz, Steven P.; Levi-Minzi, Maria A.; Chen, Minxing

2014-01-01

Although street-based female sex workers (FSWs) are highly vulnerable to HIV, they often lack access to needed health services and medical care. This paper reports the results of a recently completed randomized intervention trial for FSWs in Miami, Florida, which tested the relative efficacy of two case management interventions that aimed to link underserved FSWs with health services and to reduce risk behaviors for HIV. Participants were recruited using targeted sampling strategies and were randomly assigned to: a Strengths-Based/Professional Only (PO) or a Strengths-Based/Professional-Peer condition (PP). Follow-up data were collected 3 and 6 months post-baseline. Outcome analyses indicated that both intervention groups displayed significant reductions in HIV risk behaviors and significant increases in services utilization; the Professional-Peer condition provided no added benefit. HIV seropositive FSWs responded particularly well to the interventions, suggesting the utility of brief strengths-based case management interventions for this population in future initiatives. PMID:24558098

Using Family-Based Exposure With Response Prevention to Treat Obsessive-Compulsive Disorder in Young Children: A Case Study.

PubMed

Herren, Jenny; Freeman, Jennifer; Garcia, Abbe

2016-11-01

Cognitive-behavioral therapy (CBT) using exposure with response prevention (ERP) is the treatment of choice for obsessive-compulsive disorder (OCD); however, developmental modifications should be considered when treating young children. This article presents a case study illustrating family-based CBT using ERP with a 7-year-old boy. The delivery of ERP for this case was guided by 3 main principles: (a) family involvement with a focus on reducing family accommodation, (b) understanding the functional relation between the client's obsessions and compulsions, and (c) creating conditions to facilitate habituation during exposure. Outcomes for this case indicate significant improvement in functioning and OCD symptoms. Results highlight the importance of family involvement and the applicability of using a function-based habituation framework when delivering ERP to this unique population. © 2016 Wiley Periodicals, Inc.

The method of A-harmonic approximation and optimal interior partial regularity for nonlinear elliptic systems under the controllable growth condition

NASA Astrophysics Data System (ADS)

Chen, Shuhong; Tan, Zhong

2007-11-01

In this paper, we consider the nonlinear elliptic systems under controllable growth condition. We use a new method introduced by Duzaar and Grotowski, for proving partial regularity for weak solutions, based on a generalization of the technique of harmonic approximation. We extend previous partial regularity results under the natural growth condition to the case of the controllable growth condition, and directly establishing the optimal Hölder exponent for the derivative of a weak solution.

Selective mutism and anxiety: a review of the current conceptualization of the disorder.

PubMed

Sharp, William G; Sherman, Colleen; Gross, Alan M

2007-01-01

Selective mutism (SM) is a rare and interesting condition that has been associated with a wide variety of childhood psychiatric conditions. Historically viewed as more of an oddity than a distinct diagnostic entity, early conceptualizations of the condition were based largely on case studies that tended to link SM with oppositional behavior. More recently, controlled studies have enhanced our understanding of SM. This review summarizes the current conceptualization of SM, highlighting evidence supporting the notion that SM is an anxiety-related condition.

Preventing readmissions through comprehensive discharge planning.

PubMed

Hunter, Tabitha; Nelson, James Rex; Birmingham, Jackie

2013-01-01

Case managers, including nurses and social workers, provide essential services to hospitalized patients, including mandated discharge planning that has been shown to impact patient safety and patient outcomes. The heightened attention to readmission is evident in both reimbursement and accreditation initiatives. The Centers for Medicare & Medicaid Services, Office of Clinical Standards & Quality/Survey & Certification Group, is revising worksheets to be used by surveyors to review how hospitals are complying with the Medicare Conditions of Participation with a focus on discharge planning as it relates to patient safety. This is an opportunity for case managers to apply the principles of case management to the targeted problem of readmissions. Now case managers must identify the reasons for readmission on a patient-by-patient basis, collect data, analyze processes, and then change practice in the hospital and work more closely with community-based providers. The purpose of this article is to recommend improvement in a consistent case management practice that will positively influence patient readmissions. Hospital-based case managers who are responsible for discharge planning functions. Hospital administrators will also find this information valuable as a tool to assess strategies to control preventable readmissions and to comply with the Medicare Conditions of Participation for discharge planning. Hospital-based case managers, responsible for discharge planning, have a unique opportunity to interact face-to-face with patients who are readmitted to determine factors that lead to the readmission. Case managers need to change their practice to include assessing patients on the basis of their prior level of care. Pharmacists need to play a bigger role in discharge planning, especially for patients who have experienced a potentially avoidable readmission. Working closely with community-based providers is essential to target reasons for readmission. The Medicare Conditions of Participation for Discharge Planning can be used not only to show compliance but as tools to evaluate current practice and identify areas of improvement. Preventable readmissions or rehospitalizations directly affect patient safety, patient outcome, hospital reimbursement, and hospital accreditation. Preventable readmissions can be controlled by comprehensive discharge planning. Case managers are directly involved in discharge planning and thus have direct accountability regarding readmissions; therefore, they must refine the admission assessment screening to include specific information based on a patient's preadmission level of care. Collaboration with community-based providers is essential to managing readmissions or rehospitalizations. Hospitals will find it beneficial to track readmissions by using specific data points unique to readmissions such as source of admission and previous length of stay. Self-assessment of compliance will help identify opportunities for quality improvement in the case management department. PLEASE NOTE: Rules and regulations are constantly changing. It is critical to monitor changes in standards. Information contained in this article is current at the time of submission, and readers are encouraged to review the content of this article with administration before implementing changes.

The Microbiology of Subsurface, Salt-Based Nuclear Waste Repositories: Using Microbial Ecology, Bioenergetics, and Projected Conditions to Help Predict Microbial Effects on Repository Performance

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

Swanson, Juliet S.; Cherkouk, Andrea; Arnold, Thuro

This report summarizes the potential role of microorganisms in salt-based nuclear waste repositories using available information on the microbial ecology of hypersaline environments, the bioenergetics of survival under high ionic strength conditions, and “repository microbiology” related studies. In areas where microbial activity is in question, there may be a need to shift the research focus toward feasibility studies rather than studies that generate actual input for performance assessments. In areas where activity is not necessary to affect performance (e.g., biocolloid transport), repository-relevant data should be generated. Both approaches will lend a realistic perspective to a safety case/performance scenario that willmore » most likely underscore the conservative value of that case.« less

Remote sensing for site characterization

USGS Publications Warehouse

Kuehn, Friedrich; King, Trude V.; Hoerig, Bernhard; Peters, Douglas C.; Kuehn, Friedrich; King, Trude V.; Hoerig, Bernhard; Peters, Douglas C.

2000-01-01

This volume, Remote Sensing for Site Characterization, describes the feasibility of aircraft- and satellite-based methods of revealing environmental-geological problems. A balanced ratio between explanations of the methodological/technical side and presentations of case studies is maintained. The comparison of case studies from North America and Germany show how the respective territorial conditions lead to distinct methodological approaches.

50 CFR 18.118 - What are the mitigation, monitoring, and reporting requirements?

Code of Federal Regulations, 2010 CFR

2010-10-01

... availability of these marine mammals for subsistence uses. Dynamic management approaches, such as temporal or... emergency, should any vessel approach within a 805-m (0.5-mi) radius of walruses or polar bears observed on... issued by the Service on a case-by-case basis, based upon a review of seasonal ice conditions and...

50 CFR 18.118 - What are the mitigation, monitoring, and reporting requirements?

Code of Federal Regulations, 2011 CFR

2011-10-01

... availability of these marine mammals for subsistence uses. Dynamic management approaches, such as temporal or... emergency, should any vessel approach within a 805-m (0.5-mi) radius of walruses or polar bears observed on... issued by the Service on a case-by-case basis, based upon a review of seasonal ice conditions and...

50 CFR 18.118 - What are the mitigation, monitoring, and reporting requirements?

Code of Federal Regulations, 2012 CFR

2012-10-01

... availability of these marine mammals for subsistence uses. Dynamic management approaches, such as temporal or... emergency, should any vessel approach within a 805-m (0.5-mi) radius of walruses or polar bears observed on... issued by the Service on a case-by-case basis, based upon a review of seasonal ice conditions and...

Rough case-based reasoning system for continues casting

NASA Astrophysics Data System (ADS)

Su, Wenbin; Lei, Zhufeng

2018-04-01

The continuous casting occupies a pivotal position in the iron and steel industry. The rough set theory and the CBR (case based reasoning, CBR) were combined in the research and implementation for the quality assurance of continuous casting billet to improve the efficiency and accuracy in determining the processing parameters. According to the continuous casting case, the object-oriented method was applied to express the continuous casting cases. The weights of the attributes were calculated by the algorithm which was based on the rough set theory and the retrieval mechanism for the continuous casting cases was designed. Some cases were adopted to test the retrieval mechanism, by analyzing the results, the law of the influence of the retrieval attributes on determining the processing parameters was revealed. A comprehensive evaluation model was established by using the attribute recognition theory. According to the features of the defects, different methods were adopted to describe the quality condition of the continuous casting billet. By using the system, the knowledge was not only inherited but also applied to adjust the processing parameters through the case based reasoning method as to assure the quality of the continuous casting and improve the intelligent level of the continuous casting.

Pressure wave propagation studies for oscillating cascades

NASA Technical Reports Server (NTRS)

Huff, Dennis L.

1992-01-01

The unsteady flow field around an oscillating cascade of flat plates is studied using a time marching Euler code. Exact solutions based on linear theory serve as model problems to study pressure wave propagation in the numerical solution. The importance of using proper unsteady boundary conditions, grid resolution, and time step is demonstrated. Results show that an approximate non-reflecting boundary condition based on linear theory does a good job of minimizing reflections from the inflow and outflow boundaries and allows the placement of the boundaries to be closer than cases using reflective boundary conditions. Stretching the boundary to dampen the unsteady waves is another way to minimize reflections. Grid clustering near the plates does a better job of capturing the unsteady flow field than cases using uniform grids as long as the CFL number is less than one for a sufficient portion of the grid. Results for various stagger angles and oscillation frequencies show good agreement with linear theory as long as the grid is properly resolved.

Process-based reference conditions: An alternative approach for managed river systems

NASA Astrophysics Data System (ADS)

Grams, P.; Melis, T.; Wright, S.; Schmidt, J.; Topping, D.

2008-12-01

Physical reference conditions, whether based on historic information or the condition of nearby less impaired systems, provide necessary information that contributes to an assessment of stream condition and the nature of channel transformation. In many cases, however, the utility of this traditional 'reference' approach may end at the assessment stage and not be applicable to establishing and implementing restoration goals. Ongoing impacts such as continued existence of an upstream dam or the persistence of invasive vegetation may render restoration based on a physical reference infeasible. In these circumstances, an alternative approach is to identify and describe reference processes in place of physical reference conditions. This is the case for the Colorado River where large dams, a commitment to hydropower production, and legal mandates for regional distribution and off- channel consumption of water greatly reduce the relevance of historical conditions in setting goals for rehabilitation. In this setting, two strategies are available for setting reference conditions. One is maintenance of post-dam sediment mass balance, which attempts to ensure that the channel does not continue to degrade or aggrade and that riverine habitats do not continue to diverge from their historical condition. Post- dam sediment mass balance can be quantified at a reconnaissance or project scale. The second strategy is to define key processes that maintain the native ecosystem. These processes may, or may not, be consistent with maintenance of sediment mass balance, but they may be key to rejuvenation of spawning and rearing habitats, maintenance of historical ranges of temperature and turbidity, maintenance of a sustainable food base for the native aquatic community, or maintaining other riverine resources. Both strategies require careful monitoring of processes (e.g. sediment flux), which may add considerably to the cost and complexity of a monitoring program. An additional challenge in adopting the second strategy is that it is difficult to define when a process is adequately restored, since many ecosystem processes collectively limit recovery of populations of native communities.

Transforming School Conditions: Building Bridges to the Education System that Students and Teachers Deserve

ERIC Educational Resources Information Center

Daughtrey, Alesha

2010-01-01

In this report the TeacherSolutions Teacher Working Conditions team--a group of 14 accomplished teachers who work in mostly high-needs schools and districts, both urban and rural, draw on current research and Center for Teaching Quality case studies to identify essential, research-based principles that must undergird sustainable and effective…

TEACHING PHYSICS: Biking around a hollow sphere

NASA Astrophysics Data System (ADS)

Mak, Se-yuen; Yip, Din-yan

1999-11-01

The conditions required for a cyclist riding a motorbike in a horizontal circle on or above the equator of a hollow sphere are derived using concepts of equilibrium and the condition for uniform circular motion. The result is compared with an empirical analysis based on a video show. Some special cases of interest derived from the general solution are elaborated.

DETECTING CHANGES IN RIPARIAN HABITAT CONDITIONS BASED ON PATTERNS OF GREENNESS CHANGE: A CASE STUDY FROM THE UPPER SAN PEDRO RIVER BASIN, USA

EPA Science Inventory

Healthy riparian ecosystems in arid and semi-arid regions exhibit shifting patterns of vegetation in response to periodic flooding. Their conditions also depend upon the amount of grazing and other human uses. Taking advantage of these system properties, we developed and tested a...

Disease management: a leap of faith to lower-cost, higher-quality health care.

PubMed

Short, Ashley; Mays, Glen; Mittler, Jessica

2003-10-01

With managed care's promise to reduce costs and improve quality waning, employers and health plans are exploring more targeted ways to control rapidly rising health costs. Disease management programs, which focus on patients with chronic conditions such as asthma and diabetes, are growing in popularity, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. In addition to condition-based disease management programs, some health plans and employers are using intensive case management services to coordinate care for high-risk patients with potentially costly and complex medical conditions. Despite high expectations, evidence of both disease management and case management programs' success in controlling costs and improving quality remains limited.

Severe paediatric conditions linked with EV-A71 and EV-D68, France, May to October 2016.

PubMed

Antona, Denise; Kossorotoff, Manoëlle; Schuffenecker, Isabelle; Mirand, Audrey; Leruez-Ville, Marianne; Bassi, Clément; Aubart, Mélodie; Moulin, Florence; Lévy-Bruhl, Daniel; Henquell, Cécile; Lina, Bruno; Desguerre, Isabelle

2016-11-17

We report 59 cases of severe paediatric conditions linked with enterovirus (EV)-A71 and EV-D68 in France between May and October 2016. Fifty-two children had severe neurological symptoms. EV sequence-based typing for 42 cases revealed EV-A71 in 21 (18 subgenotype C1, detected for the first time in France) and EV-D68 in eight. Clinicians should be encouraged to obtain stool and respiratory specimens from patients presenting with severe neurological disorders for EV detection and characterisation. This article is copyright of The Authors, 2016.

Discussions On Worst-Case Test Condition For Single Event Burnout

NASA Astrophysics Data System (ADS)

Liu, Sandra; Zafrani, Max; Sherman, Phillip

2011-10-01

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

Generalized Sheet Transition Condition FDTD Simulation of Metasurface

NASA Astrophysics Data System (ADS)

Vahabzadeh, Yousef; Chamanara, Nima; Caloz, Christophe

2018-01-01

We propose an FDTD scheme based on Generalized Sheet Transition Conditions (GSTCs) for the simulation of polychromatic, nonlinear and space-time varying metasurfaces. This scheme consists in placing the metasurface at virtual nodal plane introduced between regular nodes of the staggered Yee grid and inserting fields determined by GSTCs in this plane in the standard FDTD algorithm. The resulting update equations are an elegant generalization of the standard FDTD equations. Indeed, in the limiting case of a null surface susceptibility ($\\chi_\\text{surf}=0$), they reduce to the latter, while in the next limiting case of a time-invariant metasurface $[\\chi_\\text{surf}\

Development of a traffic noise prediction model for an urban environment.

PubMed

Sharma, Asheesh; Bodhe, G L; Schimak, G

2014-01-01

The objective of this study is to develop a traffic noise model under diverse traffic conditions in metropolitan cities. The model has been developed to calculate equivalent traffic noise based on four input variables i.e. equivalent traffic flow (Q e ), equivalent vehicle speed (S e ) and distance (d) and honking (h). The traffic data is collected and statistically analyzed in three different cases for 15-min during morning and evening rush hours. Case I represents congested traffic where equivalent vehicle speed is <30 km/h while case II represents free-flowing traffic where equivalent vehicle speed is >30 km/h and case III represents calm traffic where no honking is recorded. The noise model showed better results than earlier developed noise model for Indian traffic conditions. A comparative assessment between present and earlier developed noise model has also been presented in the study. The model is validated with measured noise levels and the correlation coefficients between measured and predicted noise levels were found to be 0.75, 0.83 and 0.86 for case I, II and III respectively. The noise model performs reasonably well under different traffic conditions and could be implemented for traffic noise prediction at other region as well.

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.

Autoimmunity and susceptibility to Hodgkin lymphoma: a population-based case-control study in Scandinavia.

PubMed

Landgren, Ola; Engels, Eric A; Pfeiffer, Ruth M; Gridley, Gloria; Mellemkjaer, Lene; Olsen, Jørgen H; Kerstann, Kimberly F; Wheeler, William; Hemminki, Kari; Linet, Martha S; Goldin, Lynn R

2006-09-20

Personal history of autoimmune diseases is consistently associated with increased risk of non-Hodgkin lymphoma. In contrast, there are limited data on risk of Hodgkin lymphoma following autoimmune diseases and almost no data addressing whether there is a familial association between the conditions. Using population-based linked registry data from Sweden and Denmark, 32 separate autoimmune and related conditions were identified from hospital diagnoses in 7476 case subjects with Hodgkin lymphoma, 18,573 matched control subjects, and more than 86,000 first-degree relatives of case and control subjects. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) as measures of relative risks for each condition using logistic regression and also applied multivariable hierarchical regression models. All P values are two-sided. We found statistically significantly increased risks of Hodgkin lymphoma associated with personal histories of several autoimmune conditions, including rheumatoid arthritis (OR = 2.7, 95% CI = 1.9 to 4.0), systemic lupus erythematosus (OR = 5.8, 95% CI = 2.2 to 15.1), sarcoidosis (OR = 14.1, 95% CI = 5.4 to 36.8), and immune thrombocytopenic purpura (OR = infinity, P = .002). A statistically significant increase in risk of Hodgkin lymphoma was associated with family histories of sarcoidosis (OR = 1.8, 95% CI = 1.01 to 3.1) and ulcerative colitis (OR = 1.6, 95% CI = 1.02 to 2.6). Personal or family history of certain autoimmune conditions was strongly associated with increased risk of Hodgkin lymphoma. The association between both personal and family histories of sarcoidosis and a statistically significantly increased risk of Hodgkin lymphoma suggests shared susceptibility for these conditions.

Clinical features of shiitake dermatitis: a systematic review.

PubMed

Nguyen, Austin H; Gonzaga, Maria I; Lim, Victoria M; Adler, Michael J; Mitkov, Mario V; Cappel, Mark A

2017-06-01

Shiitake dermatitis is a rare cutaneous reaction to lentinan, a polysaccharide component in the cell walls of shiitake mushrooms (Lentinula edodes). Herein, we systematically review the case report and case series English-language literature on shiitake dermatitis, which refers to a total of 50 patients (38 males, 12 females; mean age: 44.58 years). The majority of cases occurred after the consumption of raw mushrooms, whereas 22% of cases were caused by the eating of lightly or undercooked mushrooms. The most common clinical presentations, localized symptoms, and systemic findings include linear flagellated dermatitis (98%), pruritus (78%), and fever, diarrhea, and mucosal ulcers, respectively. The diagnosis of this entity continues to be based on clinical findings as laboratory abnormalities, and the findings of skin biopsies and patch/prick tests are nonspecific and inconsistent. The condition is self-limiting, resolving in approximately 12.5 d without treatment. Based on the included case reports, it appears that medical treatment may slightly shorten the course of disease (to 9-11 d, varying by therapy) but should be considered on an individual patient basis. However, the treatment of symptoms, reassurance, and the avoidance of re-exposure are sufficient treatment recommendations for this condition. © 2017 The International Society of Dermatology.

Deep Borehole Disposal Safety Analysis.

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

Freeze, Geoffrey A.; Stein, Emily; Price, Laura L.

This report presents a preliminary safety analysis for the deep borehole disposal (DBD) concept, using a safety case framework. A safety case is an integrated collection of qualitative and quantitative arguments, evidence, and analyses that substantiate the safety, and the level of confidence in the safety, of a geologic repository. This safety case framework for DBD follows the outline of the elements of a safety case, and identifies the types of information that will be required to satisfy these elements. At this very preliminary phase of development, the DBD safety case focuses on the generic feasibility of the DBD concept.more » It is based on potential system designs, waste forms, engineering, and geologic conditions; however, no specific site or regulatory framework exists. It will progress to a site-specific safety case as the DBD concept advances into a site-specific phase, progressing through consent-based site selection and site investigation and characterization.« less

The Integrated Medical Model - Optimizing In-flight Space Medical Systems to Reduce Crew Health Risk and Mission Impacts

NASA Technical Reports Server (NTRS)

Kerstman, Eric; Walton, Marlei; Minard, Charles; Saile, Lynn; Myers, Jerry; Butler, Doug; Lyengar, Sriram; Fitts, Mary; Johnson-Throop, Kathy

2009-01-01

The Integrated Medical Model (IMM) is a decision support tool used by medical system planners and designers as they prepare for exploration planning activities of the Constellation program (CxP). IMM provides an evidence-based approach to help optimize the allocation of in-flight medical resources for a specified level of risk within spacecraft operational constraints. Eighty medical conditions and associated resources are represented in IMM. Nine conditions are due to Space Adaptation Syndrome. The IMM helps answer fundamental medical mission planning questions such as What medical conditions can be expected? What type and quantity of medical resources are most likely to be used?", and "What is the probability of crew death or evacuation due to medical events?" For a specified mission and crew profile, the IMM effectively characterizes the sequence of events that could potentially occur should a medical condition happen. The mathematical relationships among mission and crew attributes, medical conditions and incidence data, in-flight medical resources, potential clinical and crew health end states are established to generate end state probabilities. A Monte Carlo computational method is used to determine the probable outcomes and requires up to 25,000 mission trials to reach convergence. For each mission trial, the pharmaceuticals and supplies required to diagnose and treat prevalent medical conditions are tracked and decremented. The uncertainty of patient response to treatment is bounded via a best-case, worst-case, untreated case algorithm. A Crew Health Index (CHI) metric, developed to account for functional impairment due to a medical condition, provides a quantified measure of risk and enables risk comparisons across mission scenarios. The use of historical in-flight medical data, terrestrial surrogate data as appropriate, and space medicine subject matter expertise has enabled the development of a probabilistic, stochastic decision support tool capable of optimizing in-flight medical systems based on crew and mission parameters. This presentation will illustrate how to apply quantitative risk assessment methods to optimize the mass and volume of space-based medical systems for a space flight mission given the level of crew health and mission risk.

Human campylobacteriosis related to the consumption of raw milk sold by vending machines in Italy: Quantitative risk assessment based on official controls over four years.

PubMed

Giacometti, Federica; Bonilauri, Paolo; Amatiste, Simonetta; Arrigoni, Norma; Bianchi, Manila; Losio, Marina Nadia; Bilei, Stefano; Cascone, Giuseppe; Comin, Damiano; Daminelli, Paolo; Decastelli, Lucia; Merialdi, Giuseppe; Mioni, Renzo; Peli, Angelo; Petruzzelli, Annalisa; Tonucci, Franco; Piva, Silvia; Serraino, Andrea

2015-09-01

A quantitative risk assessment (RA) model was developed to describe the risk of campylobacteriosis linked to consumption of raw milk sold in vending machines in Italy. Exposure assessment was based on the official microbiological records of raw milk samples from vending machines monitored by the regional Veterinary Authorities from 2008 to 2011, microbial growth during storage, destruction experiments, consumption frequency of raw milk, serving size, consumption preference and age of consumers. The differential risk considered milk handled under regulation conditions (4°C throughout all phases) and the worst time-temperature field handling conditions detected. Two separate RA models were developed, one for the consumption of boiled milk and the other for the consumption of raw milk, and two different dose-response (D-R) relationships were considered. The RA model predicted no human campylobacteriosis cases per year either in the best (4°C) storage conditions or in the case of thermal abuse in case of boiling raw milk, whereas in case of raw milk consumption the annual estimated campylobacteriosis cases depend on the dose-response relationships used in the model (D-R I or D-R II), the milk time-temperature storage conditions, consumer behaviour and age of consumers, namely young (with two cut-off values of ≤5 or ≤6 years old for the sensitive population) versus adult consumers. The annual estimated cases for young consumers using D-R II for the sensitive population (≤5 years old) ranged between 1013.7/100,000 population and 8110.3/100,000 population and for adult consumers using D-R I between 79.4/100,000 population and 333.1/100,000 population. Quantification of the risks associated with raw milk consumption is necessary from a public health perspective and the proposed RA model represents a useful and flexible tool to perform future RAs based on local consumer habits to support decision-making on safety policies. Further educational programmes for raw milk consumers or potential raw milk consumers are required to encourage consumers to boil milk to reduce the associated risk of illness. Copyright © 2015 Elsevier B.V. All rights reserved.

Separation of Powers.

ERIC Educational Resources Information Center

Fisher, Margaret

1987-01-01

Describes a lesson which has students examine the limits of judicial power when executive branch decisions violate constitutional guarantees. The lesson is based on a hypothetical case involving living conditions in a run-down jail. (JDH)

Multi-year ground-based observations of aerosol-cloud interactions in the Mid-Atlantic of the United States

NASA Astrophysics Data System (ADS)

Li, Siwei; Joseph, Everette; Min, Qilong; Yin, Bangsheng

2017-02-01

The U.S. Mid-Atlantic region experiences a wide variability of aerosol loading and frequent episodes of elevated anthropogenic aerosol loading associated with urban pollution conditions during summer months. In this study, multi-year ground-based observations (2006 to 2010) of aerosol and cloud properties from passive, active and in situ measurements at an atmospheric measurement field station in the Baltimore-Washington corridor operated by Howard University were analyzed to examine aerosol indirect effect on single-layer warm clouds including cloud optical depth (COD), liquid water path (LWP), cloud droplet effective radius (Re) and cloud droplet number concentration (Nd) in this region. A greater occurrence of polluted episodes and cloud cases with smaller Re (<7 μm) were found during the polluted year summers (2006, 2007 and 2008) than the clean year summers (2009 and 2010). The measurements of aerosol particulate matter with aerodynamic diameter≤2.5 μm (PM2.5) were used to represent the aerosol loading under cloudy conditions. Significant negative relationships between cloud droplet Re and PM2.5 were observed. Cloud cases were separated into clean and polluted groups based on the value of PM2.5. The cloud droplet Re was found proportional to LWP under clean conditions but weakly dependent on LWP under polluted conditions. The Nd was proportional to LWP under polluted condition but weakly dependent on LWP under clean conditions. Moreover, the effects of increasing fine aerosol particles on modifying cloud microphysical properties were found more significant under large LWP than small LWP in this region.

Preliminary calculations related to the accident at Three Mile Island

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

Kirchner, W.L.; Stevenson, M.G.

This report discusses preliminary studies of the Three Mile Island Unit 2 (TMI-2) accident based on available methods and data. The work reported includes: (1) a TRAC base case calculation out to 3 hours into the accident sequence; (2) TRAC parametric calculations, these are the same as the base case except for a single hypothetical change in the system conditions, such as assuming the high pressure injection (HPI) system operated as designed rather than as in the accident; (3) fuel rod cladding failure, cladding oxidation due to zirconium metal-steam reactions, hydrogen release due to cladding oxidation, cladding ballooning, cladding embrittlement,more » and subsequent cladding breakup estimates based on TRAC calculated cladding temperatures and system pressures. Some conclusions of this work are: the TRAC base case accident calculation agrees very well with known system conditions to nearly 3 hours into the accident; the parametric calculations indicate that, loss-of-core cooling was most influenced by the throttling of High-Pressure Injection (HPI) flows, given the accident initiating events and the pressurizer electromagnetic-operated valve (EMOV) failing to close as designed; failure of nearly all the rods and gaseous fission product gas release from the failed rods is predicted to have occurred at about 2 hours and 30 minutes; cladding oxidation (zirconium-steam reaction) up to 3 hours resulted in the production of approximately 40 kilograms of hydrogen.« less

Case Reports, Case Series - From Clinical Practice to Evidence-Based Medicine in Graduate Medical Education.

PubMed

Sayre, Jerry W; Toklu, Hale Z; Ye, Fan; Mazza, Joseph; Yale, Steven

2017-08-07

Case reports and case series or case study research are descriptive studies that are prepared for illustrating novel, unusual, or atypical features identified in patients in medical practice, and they potentially generate new research questions. They are empirical inquiries or investigations of a patient or a group of patients in a natural, real-world clinical setting. Case study research is a method that focuses on the contextual analysis of a number of events or conditions and their relationships. There is disagreement among physicians on the value of case studies in the medical literature, particularly for educators focused on teaching evidence-based medicine (EBM) for student learners in graduate medical education. Despite their limitations, case study research is a beneficial tool and learning experience in graduate medical education and among novice researchers. The preparation and presentation of case studies can help students and graduate medical education programs evaluate and apply the six American College of Graduate Medical Education (ACGME) competencies in the areas of medical knowledge, patient care, practice-based learning, professionalism, systems-based practice, and communication. A goal in graduate medical education should be to assist residents to expand their critical thinking, problem-solving, and decision-making skills. These attributes are required in the teaching and practice of EBM. In this aspect, case studies provide a platform for developing clinical skills and problem-based learning methods. Hence, graduate medical education programs should encourage, assist, and support residents in the publication of clinical case studies; and clinical teachers should encourage graduate students to publish case reports during their graduate medical education.

Radar and optical mapping of surge persistence and marsh dieback along the New Jersey Mid-Atlantic coast after Hurricane Sandy

USGS Publications Warehouse

Rangoonwala, Amina; Enwright, Nicholas M.; Ramsey, Elijah W.; Spruce, Joseph P.

2016-01-01

This study combined a radar-based time series of Hurricane Sandy surge and estimated persistence with optical sensor-based marsh condition change to assess potential causal linkages of surge persistence and marsh condition change along the New Jersey Atlantic Ocean coast. Results based on processed TerraSAR-X and COSMO-SkyMed synthetic aperture radar (SAR) images indicated that surge flooding persisted for 12 h past landfall in marshes from Great Bay to Great Egg Harbor Bay and up to 59 h after landfall in many back-barrier lagoon marshes. Marsh condition change (i.e. loss of green marsh vegetation) was assessed from optical satellite images (Satellite Pour l’Observation de la Terre and Moderate Resolution Imaging Spectroradiometer) collected before and after Hurricane Sandy. High change in condition often showed spatial correspondence, with high surge persistence in marsh surrounding the lagoon portion of Great Bay, while in contrast, low change and high persistence spatial correspondence dominated the interior marshes of the Great Bay and Great Egg Harbor Bay estuaries. Salinity measurements suggest that these areas were influenced by freshwater discharges after landfall possibly mitigating damage. Back-barrier marshes outside these regions exhibited mixed correspondences. In some cases, topographic features supporting longer surge persistence suggested that non-correspondence between radar and optical data-based results may be due to differential resilience; however, in many cases, reference information was lacking to determine a reason for non-correspondence.

Prevalence and associations of symptoms of upper extremities, repetitive strain injuries (RSI) and 'RSI-like condition'. A cross sectional study of bank workers in Northeast Brazil.

PubMed

Lacerda, Eliana M; Nácul, Luis C; Augusto, Lia G da S; Olinto, Maria Teresa A; Rocha, Dyhanne C; Wanderley, Danielle C

2005-10-11

The repetitive strain injury syndrome (RSI) is a worldwide occupational health problem affecting all types of economic activities. We investigated the prevalence and some risk factors for RSI and related conditions, namely 'symptoms of upper limbs' and 'RSI-like condition'. We conducted a cross-sectional study with 395 bank workers in Recife, Northeast Brazil. Symptoms of upper limbs and 'RSI-like condition' were assessed by a simple questionnaire, which was used to screen probable cases of RSI. The diagnosis of RSI was confirmed by clinical examination. The associations of potential risk factors and the outcomes were assessed by multiple logistic regression analysis. We found prevalence rates of 56% for symptoms of the upper limbs and 30% for 'RSI-like condition'. The estimated prevalence of clinically confirmed cases of RSI was 22%. Female sex and occupation (as cashier or clerk) increased the risk of all conditions, but the associations were stronger for cases of RSI than for less specific diagnoses of 'RSI-like condition' and symptoms of upper limbs. Age was inversely related to the risk of symptoms of upper limbs but not to 'RSI-like' or RSI. The variation in the magnitude of risk according to the outcome assessed suggests that previous studies using different definitions may not be immediately comparable. We propose the use of a simple instrument to screen cases of RSI in population based studies, which still needs to be validated in other populations. The high prevalence of RSI and related conditions in this population suggests the need for urgent interventions to tackle the problem, which could be directed to individuals at higher risk and to changes in the work organization and environment of the general population.

Atopic conditions and brain tumor risk in children and adolescents--an international case-control study (CEFALO).

PubMed

Shu, X; Prochazka, M; Lannering, B; Schüz, J; Röösli, M; Tynes, T; Kuehni, C E; Andersen, T V; Infanger, D; Schmidt, L S; Poulsen, A H; Klaeboe, L; Eggen, T; Feychting, M

2014-04-01

A number of epidemiological studies indicate an inverse association between atopy and brain tumors in adults, particularly gliomas. We investigated the association between atopic disorders and intracranial brain tumors in children and adolescents, using international collaborative CEFALO data. CEFALO is a population-based case-control study conducted in Denmark, Norway, Sweden, and Switzerland, including all children and adolescents in the age range 7-19 years diagnosed with a primary brain tumor between 2004 and 2008. Two controls per case were randomly selected from population registers matched on age, sex, and geographic region. Information about atopic conditions and potential confounders was collected through personal interviews. In total, 352 cases (83%) and 646 controls (71%) participated in the study. For all brain tumors combined, there was no association between ever having had an atopic disorder and brain tumor risk [odds ratio 1.03; 95% confidence interval (CI) 0.70-1.34]. The OR was 0.76 (95% CI 0.53-1.11) for a current atopic condition (in the year before diagnosis) and 1.22 (95% CI 0.86-1.74) for an atopic condition in the past. Similar results were observed for glioma. There was no association between atopic conditions and risk of all brain tumors combined or of glioma in particular. Stratification on current or past atopic conditions suggested the possibility of reverse causality, but may also the result of random variation because of small numbers in subgroups. In addition, an ongoing tumor treatment may affect the manifestation of atopic conditions, which could possibly affect recall when reporting about a history of atopic diseases. Only a few studies on atopic conditions and pediatric brain tumors are currently available, and the evidence is conflicting.

Environmental Comfort in School Buildings: A Case Study of Awareness and Participation of Users

ERIC Educational Resources Information Center

Bernardi, Nubia; Kowaltowski, Doris C. C. K.

2006-01-01

This article describes the results of a study on user behavior in relation to environmental comfort conditions. A case study was conducted in school buildings in the region of the city of Campinas, So Paulo, Brazil. The methodology adopted was based on field observations of technical aspects of the school environment and of types of user behavior…

Analytical solutions to optimal underactuated spacecraft formation reconfiguration

NASA Astrophysics Data System (ADS)

Huang, Xu; Yan, Ye; Zhou, Yang

2015-11-01

Underactuated systems can generally be defined as systems with fewer number of control inputs than that of the degrees of freedom to be controlled. In this paper, analytical solutions to optimal underactuated spacecraft formation reconfiguration without either the radial or the in-track control are derived. By using a linear dynamical model of underactuated spacecraft formation in circular orbits, controllability analysis is conducted for either underactuated case. Indirect optimization methods based on the minimum principle are then introduced to generate analytical solutions to optimal open-loop underactuated reconfiguration problems. Both fixed and free final conditions constraints are considered for either underactuated case and comparisons between these two final conditions indicate that the optimal control strategies with free final conditions require less control efforts than those with the fixed ones. Meanwhile, closed-loop adaptive sliding mode controllers for both underactuated cases are designed to guarantee optimal trajectory tracking in the presence of unmatched external perturbations, linearization errors, and system uncertainties. The adaptation laws are designed via a Lyapunov-based method to ensure the overall stability of the closed-loop system. The explicit expressions of the terminal convergent regions of each system states have also been obtained. Numerical simulations demonstrate the validity and feasibility of the proposed open-loop and closed-loop control schemes for optimal underactuated spacecraft formation reconfiguration in circular orbits.

Evaluation of an online, case-based interactive approach to teaching pathophysiology.

PubMed

Van Dijken, Pieter Canham; Thévoz, Sara; Jucker-Kupper, Patrick; Feihl, François; Bonvin, Raphaël; Waeber, Bernard

2008-06-01

The aim of this study was to evaluate a new pedagogical approach in teaching fluid, electrolyte and acid-base pathophysiology in undergraduate students. This approach comprises traditional lectures, the study of clinical cases on the web and a final interactive discussion of these cases in the classroom. When on the web, the students are asked to select laboratory tests that seem most appropriate to understand the pathophysiological condition underlying the clinical case. The percentage of students having chosen a given test is made available to the teacher who uses it in an interactive session to stimulate discussion with the whole class of students. The same teacher used the same case studies during 2 consecutive years during the third year of the curriculum. The majority of students answered the questions on the web as requested and evaluated positively their experience with this form of teaching and learning. Complementing traditional lectures with online case-based studies and interactive group discussions represents, therefore, a simple means to promote the learning and the understanding of complex pathophysiological mechanisms. This simple problem-based approach to teaching and learning may be implemented to cover all fields of medicine.

"It's Not Like a Normal 9 to 5!": The Learning Journeys of Media Production Apprentices in Distributed Working Conditions

ERIC Educational Resources Information Center

Lahiff, Ann; Guile, David

2016-01-01

An apprenticeship in media production in England is at the centre of this case study exploration. The context is exemplified by the organisation of the process of production around project teams and the development of project-based working cultures. Given these developments, the working conditions and learning opportunities presented to…

Diagnosis-related group (DRG)-based case-mix funding system, a promising alternative for fee for service payment in China.

PubMed

Zhao, Cuirong; Wang, Chao; Shen, Chengwu; Wang, Qian

2018-05-13

Fee for services (FFS) is the prevailing method of payment in most Chinese public hospitals. Under this retrospective payment system, medical care providers are paid based on medical services and tend to over-treat to maximize their income, thereby contributing to rising medical costs and uncontrollable health expenditures to a large extent. Payment reform needs to be promptly implemented to move to a prospective payment plan. The diagnosis-related group (DRG)-based case-mix payment system, with its superior efficiency and containment of costs, has garnered increased attention and it represents a promising alternative. This article briefly describes the DRG-based case-mix payment system, it comparatively analyzes differences between FFS and case-mix funding systems, and it describes the implementation of DRGs in China. China's social and economic conditions differ across regions, so establishment of a national payment standard will take time and involve difficulties. No single method of provider payment is perfect. Measures to monitor and minimize the negative ethical implications and unintended effects of a DRG-based case-mix payment system are essential to ensuring the lasting social benefits of payment reform in Chinese public hospitals.

Promoting Conditional Use of Communication Skills for Learners With Complex Communication Needs: A Tutorial.

PubMed

Simacek, Jessica; Reichle, Joe; Byiers, Breanne J; Parker-McGowan, Quannah; Dimian, Adele F; Elmquist, Marianne

2018-05-03

Conditional use of communication skills refers to the ability of a learner to appropriately generalize and discriminate when, where, and how to communicate based on constant variation and shifts in environmental cues. We describe discrimination and generalization challenges encountered by learners with complex communication needs and ways in which these challenges are fostered through traditional communication intervention programming. We address arrangements in instruction that maximize the probability of learners acquiring the conditional use of new vocabulary and the modest instructional technology implemented when planning for generalization. We propose establishing well-discriminated and generalized use of new vocabulary items through the application of a general case instruction framework to communication intervention programming. We provide intervention methodology, including intervention steps for general case instruction, a plethora of functional examples, and graphic displays to assess and intervene to promote conditional use of communication skills for learners with complex communication needs.

Simpson-Golabi-Behmel syndrome in a female: A case report and an unsolved issue.

PubMed

Vaisfeld, Alessandro; Pomponi, Maria Grazia; Pietrobono, Roberta; Tabolacci, Elisabetta; Neri, Giovanni

2017-01-01

Simpson-Golabi-Behmel syndrome is an X-linked recessive overgrowth condition caused by alterations in GPC3 gene, encoding for the cell surface receptor glypican 3, whose clinical manifestations in affected males are well known. Conversely, there is little information regarding affected females, with very few reported cases, and a clinical definition of this phenotype is still lacking. In the present report we describe an additional case, the first to receive a primary molecular diagnosis based on strong clinical suspicion. Possible explanations for full clinical expression of X-linked recessive conditions in females include several mechanisms, such as skewed X inactivation or homozygosity/compound heterozygosity of the causal mutation. Both of these were excluded in our case. Given that the possibility of full expression of SGBS in females is now firmly established, we recommend that GPC3 analysis be performed in all suggestive female cases. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

How well can wave runup be predicted? comment on Laudier et al. (2011) and Stockdon et al. (2006)

USGS Publications Warehouse

Plant, Nathaniel G.; Stockdon, Hilary F.

2015-01-01

Laudier et al. (2011) suggested that there may be a systematic bias error in runup predictions using a model developed by Stockdon et al. (2006). Laudier et al. tested cases that sampled beach and wave conditions that differed from those used to develop the Stockdon et al. model. Based on our re-analysis, we found that in two of the three Laudier et al. cases observed overtopping was actually consistent with the Stockdon et al. predictions. In these cases, the revised predictions indicated substantial overtopping with, in one case, a freeboard deficit of 1 m. In the third case, the revised prediction had a low likelihood of overtopping, which reflected a large uncertainty due to wave conditions that included a broad and bi-modal frequency distribution. The discrepancy between Laudier et al. results and our re-analysis appear to be due, in part, to simplifications made by Laudier et al. when they implemented a reduced version of the Stockdon et al. model.

Study on the complexity pricing game and coordination of the duopoly air conditioner market with disturbance demand

NASA Astrophysics Data System (ADS)

Ma, Junhai; Xie, Lei

2016-03-01

The paper focuses on the dynamic pricing game of the duopoly air conditioner market with disturbance in demand and analyzes the influence of disturbance on the dynamic game system. Considering the demand for products, such as air conditioner, varies with different seasons, we assume three cases based on the condition of disturbance, including growth market (Case 1), declining market (Case 2) and completely random market (Case 3). By analyzing these three cases and making comparison among them, the paper shows that the growth market is more sensitive to the changing parameters such as the adjustment variable and the competitive factor than the declining market. It is more difficult to keep the system stable in a growth market. Although the demand is completely random, the dynamic system can reach a stable state, on condition that the adjustment variable is small enough. The results also indicate that the bullwhip effect between the order quantity and the actual demand is weakened gradually along with the price adjustment.

Simulation of tracer dispersion from elevated and surface releases in complex terrain

NASA Astrophysics Data System (ADS)

Hernández, J. F.; Cremades, L.; Baldasano, J. M.

A new version of an advanced mesoscale dispersion modeling system for simulating passive air pollutant dispersion in the real atmospheric planetary boundary layer (PBL), is presented. The system comprises a diagnostic mass-consistent meteorological model and a Lagrangian particle dispersion model (LADISMO). The former version of LADISMO, developed according to Zannetti (Air pollution modelling, 1990), was based on the Monte Carlo technique and included calculation of higher-order moments of vertical random forcing for convective conditions. Its ability to simulate complex flow dispersion has been stated in a previous paper (Hernández et al. 1995, Atmospheric Environment, 29A, 1331-1341). The new version follows Thomson's scheme (1984, Q. Jl Roy. Met. Soc.110, 1107-1120). It is also based on Langevin equation and follows the ideas given by Brusasca et al. (1992, Atmospheric Environment26A, 707-723) and Anfossi et al. (1992, Nuovo Cemento 15c, 139-158). The model is used to simulate the dispersion and predict the ground level concentration (g.l.c.) of a tracer (SF 6) released from both an elevated source ( case a) and a ground level source ( case b) in a highly complex mountainous terrain during neutral and synoptically dominated conditions ( case a) and light and apparently stable conditions ( case b). The last case is considered as being a specially difficult task to simulate. In fact, few works have reported situations with valley drainage flows in complex terrains and real stable atmospheric conditions with weak winds. The model assumes that nearly calm situations associated to strong stability and air stagnation, make the lowest layers of PBL poorly diffusive (Brusasca et al., 1992, Atmospheric Environment26A, 707-723). Model results are verified against experimental data from Guardo-90 tracer experiments, an intensive field campaign conducted in the Carrion river valley (Northern Spain) to study atmospheric diffusion within a steep walled valley in mountainous terrain (Ibarra, 1992, Energia, No. 1, 74-85).

Prediction-based control for LTI systems with uncertain time-varying delays and partial state knowledge

NASA Astrophysics Data System (ADS)

Léchappé, V.; Moulay, E.; Plestan, F.

2018-06-01

The stability of a prediction-based controller for linear time-invariant (LTI) systems is studied in the presence of time-varying input and output delays. The uncertain delay case is treated as well as the partial state knowledge case. The reduction method is used in order to prove the convergence of the closed-loop system including the state observer, the predictor and the plant. Explicit conditions that guarantee the closed-loop stability are given, thanks to a Lyapunov-Razumikhin analysis. Simulations illustrate the theoretical results.

Distributed Leader-Following Finite-Time Consensus Control for Linear Multiagent Systems under Switching Topology

PubMed Central

Xu, Xiaole; Chen, Shengyong

2014-01-01

This paper investigates the finite-time consensus problem of leader-following multiagent systems. The dynamical models for all following agents and the leader are assumed the same general form of linear system, and the interconnection topology among the agents is assumed to be switching and undirected. We mostly consider the continuous-time case. By assuming that the states of neighbouring agents are known to each agent, a sufficient condition is established for finite-time consensus via a neighbor-based state feedback protocol. While the states of neighbouring agents cannot be available and only the outputs of neighbouring agents can be accessed, the distributed observer-based consensus protocol is proposed for each following agent. A sufficient condition is provided in terms of linear matrix inequalities to design the observer-based consensus protocol, which makes the multiagent systems achieve finite-time consensus under switching topologies. Then, we discuss the counterparts for discrete-time case. Finally, we provide an illustrative example to show the effectiveness of the design approach. PMID:24883367

Developing integrated clinical reasoning competencies in dental students using scaffolded case-based learning - empirical evidence.

PubMed

Postma, T C; White, J G

2016-08-01

This study provides empirical evidence of the development of integrated clinical reasoning in the discipline-based School of Dentistry, University of Pretoria, South Africa. Students were exposed to case-based learning in comprehensive patient care (CPC) in the preclinical year of study, scaffolded by means of the four-component instructional design model for complex learning. Progress test scores of third- to fifth-year dental students, who received case-based teaching and learning in the third year (2009-2011), were compared to the scores of preceding fourth- and fifth-year cohorts. These fourth- and fifth-year cohorts received content-based teaching concurrently with their clinical training in CPC. The progress test consisted of a complex case study and 32 MCQs on tracer conditions. Students had to gather the necessary information and had to make diagnostic and treatment-planning decisions. Preclinical students who participated in the case-based teaching and learning achieved similar scores compared to final-year students who received lecture-based teaching and learning. Final-year students who participated in the case-based learning made three more correct clinical decisions per student, compared to those who received content-based teaching. Students struggled more with treatment-planning than with diagnostic decisions. The scaffolded case-based learning appears to contribute to accurate clinical decisions when compared to lecture-based teaching. It is suggested that the development of integrated reasoning competencies starts as early as possible in a dental curriculum, perhaps even in the preclinical year of study. Treatment-planning should receive particular attention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Management of Psoriasis with a XemaTop Topical Compounded Formula: A Case Report.

PubMed

Jones, Nat; Carvalho, Maria; Branvold-Herr, Andrea

2017-01-01

Skin conditions such as psoriasis and eczema negatively impact the patient's quality of life; the primary goal of topical treatments is to minimize the disease-specific symptoms. This case report discusses the management of two refractory psoriasis skin lesions in an adult male using a topical compounded formula. The psoriasis symptoms were assessed quantitatively using two validated research instruments, the Psoriasis Symptom Inventory, and an adapted Numeric Rating Scale. A qualitative assessment was also performed by evaluating the digital photographs taken by the patient during the course of treatment. The compounded formula containing zinc pyrithione, clobetasol propionate, and cyanocobalamin in the Professional Compounding Centers of America's proprietary base PCCA XemaTop, applied topically for three weeks, significantly reduced the patient's self-reported psoriasis symptoms and improved his overall condition by 81.2%. This successful case report is important evidence for healthcare professionals when considering new, innovative topical compounded formulas for managing skin conditions such as psoriasis and eczema. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

Risk factors for disability discharge in enlisted active duty Army soldiers.

PubMed

Piccirillo, Amanda L; Packnett, Elizabeth R; Cowan, David N; Boivin, Michael R

2016-04-01

The rate of permanent disability retirement in U.S. Army soldiers and the prevalence of combat-related disabilities have significantly increased over time. Prior research on risk factors associated with disability retirement included soldiers retired prior to conflicts in Iraq and Afghanistan. To identify risk factors for disability discharge among soldiers enlisted in the U.S. Army during military operations in Iraq and Afghanistan. In this case-control study, cases included active duty soldiers evaluated for disability discharge. Controls, randomly selected from soldiers with no history of disability evaluation, were matched to cases based on enlistment year and sex. Conditional logistic regression models calculated odds of disability discharge. Attributable fractions estimated burden of disability for specific pre-existing condition categories. Poisson regression models compared risk of disability discharge related to common disability types by deployment and combat status. Characteristics at military enlistment with increased odds of disability discharge included a pre-existing condition, increased age or body mass index, white race, and being divorced. Musculoskeletal conditions and overweight contributed the largest proportion of disabilities. Deployment was protective against disability discharge or receiving a musculoskeletal-related disability, but significantly increased the risk of disability related to a psychiatric or neurological condition. Soldiers with a pre-existing condition at enlistment, particularly a musculoskeletal condition, had increased odds of disability discharge. Risk of disability was dependent on condition category when stratified by deployment and combat status. Additional research examining conditions during pre-disability hospitalizations could provide insight on specific conditions that commonly lead to disability discharge. Copyright © 2016 Elsevier Inc. All rights reserved.

Analysis of critical operating conditions for LV distribution networks with microgrids

NASA Astrophysics Data System (ADS)

Zehir, M. A.; Batman, A.; Sonmez, M. A.; Font, A.; Tsiamitros, D.; Stimoniaris, D.; Kollatou, T.; Bagriyanik, M.; Ozdemir, A.; Dialynas, E.

2016-11-01

Increase in the penetration of Distributed Generation (DG) in distribution networks, raises the risk of voltage limit violations while contributing to line losses. Especially in low voltage (LV) distribution networks (secondary distribution networks), impacts of active power flows on the bus voltages and on the network losses are more dominant. As network operators must meet regulatory limitations, they have to take into account the most critical operating conditions in their systems. In this study, it is aimed to present the impact of the worst operation cases of LV distribution networks comprising microgrids. Simulation studies are performed on a field data-based virtual test-bed. The simulations are repeated for several cases consisting different microgrid points of connection with different network loading and microgrid supply/demand conditions.

A huge cemento-ossifying fibroma of paranasal sinus: a case report.

PubMed

Erdim, Ibrahim; Yazici, Zahide Mine; Yilmazer, Rasim; Sever, Nurten; Kayhan, Fatma Tulin

2012-01-01

Cemento-ossifying fibroma is a well-bordered, slow-growing, benign fibro-osseous disease. Although its localization is generally in the mandible, it can be seen in any area of the craniofacial region. Radiology and histopathology help to diagnose the condition. Treatment is based on close observation and/or surgical excision. In this case, we report the case of a 62-year-old male patient who had a large radiological appearance, cemento-ossifying fibroma in the paranasal sinuses.

The Effect of Nurse Practitioner Co-Management on the Care of Geriatric Conditions

PubMed Central

Reuben, David B.; Ganz, David A.; Roth, Carol P.; McCreath, Heather E.; Ramirez, Karina D.; Wenger, Neil S.

2013-01-01

Background/Objectives The quality of care for geriatric conditions remains poor. The Assessing Care of Vulnerable Elders (ACOVE)-2 model (case finding, delegation of data collection, structured visit notes, physician and patient education, and linkage to community resources) improves the quality of care for geriatric conditions when implemented by primary care physicians (PCPs) or by nurse practitioners (NPs) co-managing care with an academic geriatrician. However, it is unclear whether community-based PCP-NP co-management can achieve similar results. Design Case study. Setting Two community-based primary care practices. Participants Patients > 75 years who screened positive for at least one condition: falls, urinary incontinence (UI), dementia, and depression. Intervention The ACOVE-2 model augmented by NP co-management of conditions. Measurements Quality of care by medical record review using ACOVE-3 quality indicators (QIs). Patients receiving co-management were compared with those who received PCP care alone in the same practices. Results Of 1084 screened patients, 658 (61%) screened positive for > 1 condition; 485 of these patients were randomly selected for chart review and triggered a mean of 7 QIs. A NP saw approximately half (49%) for co-management. Overall, patients received 57% of recommended care. Quality scores for all conditions (falls: 80% versus 34%; UI: 66% versus 19%; dementia: 59% versus 38%) except depression (63% versus 60%) were higher for patients seen by a NP. In analyses adjusted for gender, age of patient, number of conditions, site, and a NP estimate of medical management style, NP co-management remained significantly associated with receiving recommended care (p<0.001), as did the NP estimate of medical management style (p=0.02). Conclusion Compared to usual care using the ACOVE-2 model, NP co-management is associated with better quality of care for geriatric conditions in community-based primary care. PMID:23772723

Functional Assessment Leading to a Behavior Plan for Transition Times at School.

ERIC Educational Resources Information Center

Dooley, Pamela; Wilczenski, Felicia L.; Torem, Christopher

This paper outlines a case study based upon the functional assessment of a pre-school child's aggressive and disruptive behaviors, revealing difficulties with transitions from one activity to another at school. Antecedent conditions and functional communication were addressed in the behavior plan using a schedule board based on the Picture…

Complexity-Based Learning and Teaching: A Case Study in Higher Education

ERIC Educational Resources Information Center

Fabricatore, Carlo; López, María Ximena

2014-01-01

This paper presents a learning and teaching strategy based on complexity science and explores its impacts on a higher education game design course. The strategy aimed at generating conditions fostering individual and collective learning in educational complex adaptive systems, and led the design of the course through an iterative and adaptive…

Low Speed and High Speed Correlation of SMART Active Flap Rotor Loads

NASA Technical Reports Server (NTRS)

Kottapalli, Sesi B. R.

2010-01-01

Measured, open loop and closed loop data from the SMART rotor test in the NASA Ames 40- by 80- Foot Wind Tunnel are compared with CAMRAD II calculations. One open loop high-speed case and four closed loop cases are considered. The closed loop cases include three high-speed cases and one low-speed case. Two of these high-speed cases include a 2 deg flap deflection at 5P case and a test maximum-airspeed case. This study follows a recent, open loop correlation effort that used a simple correction factor for the airfoil pitching moment Mach number. Compared to the earlier effort, the current open loop study considers more fundamental corrections based on advancing blade aerodynamic conditions. The airfoil tables themselves have been studied. Selected modifications to the HH-06 section flap airfoil pitching moment table are implemented. For the closed loop condition, the effect of the flap actuator is modeled by increased flap hinge stiffness. Overall, the open loop correlation is reasonable, thus confirming the basic correctness of the current semi-empirical modifications; the closed loop correlation is also reasonable considering that the current flap model is a first generation model. Detailed correlation results are given in the paper.

Condition Based vs. Time Based Maintenance: Case Study on Hypergolic Pumps

NASA Technical Reports Server (NTRS)

Gibson, Lewis J.

2007-01-01

Two Pad 39B Ox pumps were monitored with the Baker Instruments Explorer Motor tester. Using the torque spectrum it was determined that Ox pump #2 had a significant peak at a frequency, which indicated lubricant fluid whirl. Similar testing on Ox pump #1 didn't indicate this peak, an indication that this pump was in good mechanical condition. Subsequent disassembly of both motors validated these findings. Ox pump #2 rear bearing showed significant wear, the front bearing showed little wear. Ox pump #1 was still within manufacturers tolerances.

Value-based purchasing and hospital acquired conditions: are we seeing improvement?

PubMed

Spaulding, Aaron; Zhao, Mei; Haley, D Rob

2014-12-01

To determine if the Value-Based Purchasing Performance Scoring system correlates with hospital acquired condition quality indicators. This study utilizes the following secondary data sources: the American Hospital Association (AHA) annual survey and the Centers for Medicare and Medicaid (CMS) Value-Based Purchasing and Hospital Acquired Conditions databases. Zero-inflated negative binomial regression was used to examine the effect of CMS total performance score on counts of hospital acquired conditions. Hospital structure variables including size, ownership, teaching status, payer mix, case mix, and location were utilized as control variables. The secondary data sources were merged into a single database using Stata 10. Total performance scores, which are used to determine if hospitals should receive incentive money, do not correlate well with quality outcome in the form of hospital acquired conditions. Value-based purchasing does not appear to correlate with improved quality and patient safety as indicated by Hospital Acquired Condition (HAC) scores. This leads us to believe that either the total performance score does not measure what it should, or the quality outcome measurements do not reflect the quality of the total performance scores measure. Copyright © 2014 Elsevier Ireland Ltd. 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.

Idiopathic masseter muscle hypertrophy.

PubMed

Kebede, Biruktawit; Megersa, Shimalis

2011-11-01

Benign Masseteric Hypertrophy is a relatively uncommon condition that can occur unilaterally or bilaterally. Pain may be a symptom, but most frequently a clinician is consulted for cosmetic reasons. In some cases prominent Exostoses at the angle of the mandible are noted. Although it is tempting to point to Malocclusion, Bruxism, clenching, or Temporomandibular joint disorders, the etiology in the majority of cases is unclear. Diagnosis is based on awareness of the condition, clinical and radiographic findings, and exclusion of more serious Pathology such as Benign and Malignant Parotid Disease, Rhabdomyoma, and Lymphangioma. Treatment usually involves resection of a portion of the Masseter muscle with or without the underlying bone.

Motivation Conditions in a Foreign Language Reading Comprehension Course Offering Both a Web-Based Modality and a Face-to-Face Modality (Las condiciones de motivación en un curso de comprensión de lectura en lengua extranjera (LE) ofrecido tanto en la modalidad presencial como en la modalidad a distancia en la web)

ERIC Educational Resources Information Center

Lopera Medina, Sergio

2014-01-01

Motivation plays an important in role in education. Based on the ten macro-strategies proposed by Dörnyei and Csizér (1998), this article analyzes the motivation conditions in a foreign language reading comprehension course using both a web-based modality and a face-to-face modality. A case study was implemented as the primary research method, and…

Assessing the detail needed to capture rainfall-runoff dynamics with physics-based hydrologic response simulation

USGS Publications Warehouse

Mirus, B.B.; Ebel, B.A.; Heppner, C.S.; Loague, K.

2011-01-01

Concept development simulation with distributed, physics-based models provides a quantitative approach for investigating runoff generation processes across environmental conditions. Disparities within data sets employed to design and parameterize boundary value problems used in heuristic simulation inevitably introduce various levels of bias. The objective was to evaluate the impact of boundary value problem complexity on process representation for different runoff generation mechanisms. The comprehensive physics-based hydrologic response model InHM has been employed to generate base case simulations for four well-characterized catchments. The C3 and CB catchments are located within steep, forested environments dominated by subsurface stormflow; the TW and R5 catchments are located in gently sloping rangeland environments dominated by Dunne and Horton overland flows. Observational details are well captured within all four of the base case simulations, but the characterization of soil depth, permeability, rainfall intensity, and evapotranspiration differs for each. These differences are investigated through the conversion of each base case into a reduced case scenario, all sharing the same level of complexity. Evaluation of how individual boundary value problem characteristics impact simulated runoff generation processes is facilitated by quantitative analysis of integrated and distributed responses at high spatial and temporal resolution. Generally, the base case reduction causes moderate changes in discharge and runoff patterns, with the dominant process remaining unchanged. Moderate differences between the base and reduced cases highlight the importance of detailed field observations for parameterizing and evaluating physics-based models. Overall, similarities between the base and reduced cases indicate that the simpler boundary value problems may be useful for concept development simulation to investigate fundamental controls on the spectrum of runoff generation mechanisms. Copyright 2011 by the American Geophysical Union.

Identifying Complex Cultural Interactions in the Instructional Design Process: A Case Study of a Cross-Border, Cross-Sector Training for Innovation Program

ERIC Educational Resources Information Center

Russell, L. Roxanne; Kinuthia, Wanjira L.; Lokey-Vega, Anissa; Tsang-Kosma, Winnie; Madathany, Reeny

2013-01-01

The purpose of this research is to identify complex cultural dynamics in the instructional design process of a cross-sector, cross-border training environment by applying Young's (2009) Culture-Based Model (CBM) as a theoretical framework and taxonomy for description of the instructional design process under the conditions of one case. This…

Conditions for the Success of Online Mentoring a Case Study

ERIC Educational Resources Information Center

Nchindila, Bernard

2007-01-01

This paper reports on the findings about a mentoring project that failed. It is based on a case study in which the writer participated as a mentor of the staff members of the South African Department of Labour. In 2002, the South African Department of Labour (DoL) published a tender ref: Services/ta/cst/p1/wp3 for Communications Skills Training…

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

Podoskin, A. A., E-mail: podoskin@mail.ioffe.ru; Shashkin, I. S.; Slipchenko, S. O.

A model describing the operation of a completely optical cell, based on the competition of lasing of Fabry-Perot cavity modes and the high-Q closed mode in high-power semiconductor lasers is proposed. Based on rate equations, the conditions of lasing switching between Fabry-Perot modes for ground and excited lasing levels and the closed mode are considered in the case of increasing internal optical loss under conditions of high current pump levels. The optical-cell operation conditions in the mode of a high-power laser radiation switch (reversible mode-structure switching) and in the mode of a memory cell with bistable irreversible lasing switching betweenmore » mode structures with various Q-factors are considered.« less

On the thermal stability of coronal loop plasma

NASA Technical Reports Server (NTRS)

Antiochos, S. K.; Emslie, A. G.; Shoub, E. C.; An, C. H.

1982-01-01

The stability to thermal perturbation of static models of coronal loops is considered including the effects of cool, radiatively stable material at the loop base. The linear stability turns out to be sensitive only to the boundary conditions assumed on the velocity at the loop base. The question of the appropriate boundary conditions is discussed, and it is concluded that the free surface condition (the pressure perturbation vanishes), rather than the rigid wall (the velocity vanishes), is relevant to the solar case. The static models are found to be thermally unstable, with a growth time of the order of the coronal cooking time. The physical implications of these results for the solar corona and transition region are examined.

Reflective practice: a framework for case manager development.

PubMed

Brubakken, Karen; Grant, Sara; Johnson, Mary K; Kollauf, Cynthia

2011-01-01

The role of a nurse case manager (NCM) incorporates practice that is built upon knowledge gained in other roles as well as components unique to case management. The concept of reflective practice was used in creating a framework to recognize the developmental stages that occur within community based case management practice. The formation of this framework and its uses are described in this article. The practice setting is a community based case management department in a large midwestern metropolitan health care system with Magnet recognition. Advanced practice nurses provide care for clients with chronic health conditions. Twenty-four narratives were used to identify behaviors of community based case managers and to distinguish stages of practice. The behaviors of advanced practice found within the narratives were labeled and analyzed for similarities. Related behaviors were grouped and descriptor statements were written. These statements grouped into 3 domains of practice: relationship/partnership, coordination/collaboration, and clinical knowledge/decision making. The statements in each domain showed practice variations from competent to expert, and 3 stages were determined. Reliability and validity of the framework involved analysis of additional narratives. The reflective practice process, used for monthly case review presentations, provides opportunity for professional development and group learning focused on improving case manager practice. The framework is also being used in orientation as new case managers acclimate to the role. Reflective writing has unveiled the richness and depth of nurse case manager practice. The depth of knowledge and skills involved in community-based case management is captured within this reflective practice framework. This framework provides a format for describing community based case manager practice development over the course of time and has been used as a tool for orientation and peer review.

On the existence and stability conditions for mixed-hybrid finite element solutions based on Reissner's variational principle

NASA Technical Reports Server (NTRS)

Karlovitz, L. A.; Atluri, S. N.; Xue, W.-M.

1985-01-01

The extensions of Reissner's two-field (stress and displacement) principle to the cases wherein the displacement field is discontinuous and/or the stress field results in unreciprocated tractions, at a finite number of surfaces ('interelement boundaries') in a domain (as, for instance, when the domain is discretized into finite elements), is considered. The conditions for the existence, uniqueness, and stability of mixed-hybrid finite element solutions based on such discontinuous fields, are summarized. The reduction of these global conditions to local ('element') level, and the attendant conditions on the ranks of element matrices, are discussed. Two examples of stable, invariant, least-order elements - a four-node square planar element and an eight-node cubic element - are discussed in detail.

Parental decision-making on utilisation of out-of-home respite in children's palliative care: findings of qualitative case study research - a proposed new model.

PubMed

Ling, J; Payne, S; Connaire, K; McCarron, M

2016-01-01

Respite in children's palliative care aims to provide a break for family's from the routine of caring. Parental decision-making regarding the utilisation of out-of-home respite is dependent on many interlinking factors including the child's age, diagnosis, geographical location and the family's capacity to meet their child's care needs. A proposed model for out-of-home respite has been developed based on the findings of qualitative case study research. Utilising multiple, longitudinal, qualitative case study design, the respite needs and experiences of parents caring for a child with a life-limiting condition were explored. Multiple, in-depth interviews were undertaken with the parents identified by a hospital-based children's palliative care team. Data were analysed using thematic analysis. Each individual case consists of a whole study. Cross-case comparison was also conducted. Nine families were recruited and followed for two years. A total of 19 in-depth interviews were conducted with mothers and fathers (one or both) caring for a child with a life-limiting condition in Ireland. Each family reported vastly different needs and experiences of respite from their own unique perspective. Cross-case comparison showed that for all parents utilising respite care, regardless of their child's age and condition, home was the location of choice. Many interlinking factors influencing these decisions included: past experience of in-patient care, and trust and confidence in care providers. Issues were raised regarding the impact of care provision in the home on family life, siblings and the concept of home. Respite is an essential element of children's palliative care. Utilisation of out-of-home respite is heavily dependent on a number of interlinked and intertwined factors. The proposed model of care offers an opportunity to identify how these decisions are made and may ultimately assist in identifying the elements of responsive and family-focused respite that are important to families of children with life-limiting conditions. © 2015 John Wiley & Sons Ltd.

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

PubMed

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

2011-09-01

Conducting environmental risk assessment of engineered nanomaterials has been an extremely challenging endeavor thus far. Moreover, recent findings from the nano-risk scientific community indicate that it is unlikely that many of these challenges will be easily resolved in the near future, especially given the vast variety and complexity of nanomaterials and their applications. As an approach to help optimize environmental risk assessments of nanomaterials, we apply the Worst-Case Definition (WCD) model to identify best estimates for worst-case conditions of environmental risks of two case studies which use engineered nanoparticles, namely nZVI in soil and groundwater remediation and C(60) in an engine oil lubricant. Results generated from this analysis may ultimately help prioritize research areas for environmental risk assessments of nZVI and C(60) in these applications as well as demonstrate the use of worst-case conditions to optimize future research efforts for other nanomaterials. Through the application of the WCD model, we find that the most probable worst-case conditions for both case studies include i) active uptake mechanisms, ii) accumulation in organisms, iii) ecotoxicological response mechanisms such as reactive oxygen species (ROS) production and cell membrane damage or disruption, iv) surface properties of nZVI and C(60), and v) acute exposure tolerance of organisms. Additional estimates of worst-case conditions for C(60) also include the physical location of C(60) in the environment from surface run-off, cellular exposure routes for heterotrophic organisms, and the presence of light to amplify adverse effects. Based on results of this analysis, we recommend the prioritization of research for the selected applications within the following areas: organism active uptake ability of nZVI and C(60) and ecotoxicological response end-points and response mechanisms including ROS production and cell membrane damage, full nanomaterial characterization taking into account detailed information on nanomaterial surface properties, and investigations of dose-response relationships for a variety of organisms. Copyright © 2011 Elsevier B.V. All rights reserved.

Progressing from initially ambiguous functional analyses: three case examples.

PubMed

Tiger, Jeffrey H; Fisher, Wayne W; Toussaint, Karen A; Kodak, Tiffany

2009-01-01

Most often functional analyses are initiated using a standard set of test conditions, similar to those described by Iwata, Dorsey, Slifer, Bauman, and Richman [Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197-209 (Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3-20, 1982)]. These test conditions involve the careful manipulation of motivating operations, discriminative stimuli, and reinforcement contingencies to determine the events related to the occurrence and maintenance of problem behavior. Some individuals display problem behavior that is occasioned and reinforced by idiosyncratic or otherwise unique combinations of environmental antecedents and consequences of behavior, which are unlikely to be detected using these standard assessment conditions. For these individuals, modifications to the standard test conditions or the inclusion of novel test conditions may result in clearer assessment outcomes. The current study provides three case examples of individuals whose functional analyses were initially undifferentiated; however, modifications to the standard conditions resulted in the identification of behavioral functions and the implementation of effective function-based treatments.

Socioeconomic Status and Childhood Leukemia Incidence in Switzerland

PubMed Central

Adam, Martin; Kuehni, Claudia E.; Spoerri, Adrian; Schmidlin, Kurt; Gumy-Pause, Fabienne; Brazzola, Pierluigi; Probst-Hensch, Nicole; Zwahlen, Marcel

2015-01-01

Socioeconomic status (SES) discrepancies exist for child and adult cancer morbidity and are a major public health concern. In this Swiss population-based matched case–control study on the etiology of childhood leukemia, we selected the cases from the Swiss Childhood Cancer Registry diagnosed since 1991 and the controls randomly from census. We assigned eight controls per case from the 1990 and 2000 census and matched them by the year of birth and gender. SES information for both cases and controls was obtained from census records by probabilistic record linkage. We investigated the association of SES with childhood leukemia in Switzerland, and explored whether it varied with different definitions of socioeconomic status (parental education, living condition, area-based SES), time period, and age. In conditional logistic regression analyses of 565 leukemia cases and 4433 controls, we found no consistent evidence for an association between SES and childhood leukemia. The odds ratio comparing the highest with the lowest SES category ranged from 0.95 (95% CI: 0.71–1.26; Ptrend = 0.73) for paternal education to 1.37 (1.00–1.89; Ptrend = 0.064) for maternal education. No effect modification was found for time period and age at diagnosis. Based on this population-based study, which avoided participation and reporting bias, we assume the potential association of socioeconomic status and childhood leukemia if existing to be small. This study did not find evidence that socioeconomic status, of Switzerland or comparable countries, is a relevant risk factor or strong confounder in etiological investigations on childhood leukemia. PMID:26175964

Availability Simulation of AGT Systems

DOT National Transportation Integrated Search

1975-02-01

The report discusses the analytical and simulation procedures that were used to evaluate the effects of failure in a complex dual mode transportation system based on a worst case study-state condition. The computed results are an availability figure ...

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

Koenig, Robert

We propose a generalization of the quantum entropy power inequality involving conditional entropies. For the special case of Gaussian states, we give a proof based on perturbation theory for symplectic spectra. We discuss some implications for entanglement-assisted classical communication over additive bosonic noise channels.

Hygrothermal analysis of surface layers of historical masonry

NASA Astrophysics Data System (ADS)

Kočí, Václav; Maděra, Jiří; Keppert, Martin; Černý, Robert

2017-11-01

The paper deals with the hygrothermal analysis of surface layers of historical masonry. Solid brick provided with a traditional and two modified lime-based plasters is studied. The heat and moisture transport in the envelope is induced by an exposure of the wall from the exterior side to dynamic climatic conditions of Olomouc, Czech Republic. The transport processes are described using diffusion type of mathematical model based on experimentally determined material properties. The computational results indicate that hygric transport and accumulation properties of exterior plasters affect the hygrothermal performance of the underlying solid brick in a very significant way, being able to regulate the amount of transported moisture. The modified lime plasters are not found generally superior to the traditional lime plasters in that respect. Therefore, their suitability for historical masonry should be assessed case by case, with a particular attention to the climatic conditions and to the properties of the load bearing structure.

Implant-based oral rehabilitation of a variant model of type I dentinal dysplasia: A rare case report

PubMed Central

Nettem, Sowmya; Nettemu, Sunil Kumar; Basha, K.; Venkatachalapathi, S

2014-01-01

Dentin dysplasia is an exceptionally rare, autosomal-dominant, hereditary condition, primarily characterized by defective dentin formation affecting both the deciduous and permanent dentitions. The etiology remains imprecise to date, in spite of the numerous hypotheses put forward and the constant updates on this condition. This case report of type I dentin dysplasia exhibits radiographic findings that are unique and diverse from the classical findings of various subtypes of this disease reported to date. This article also depicts the implant-based oral rehabilitation of the young patient diagnosed with this variant model of dentin dysplasia type I. Early diagnosis and implementation of this preventive and curative therapy is vital for avoiding premature exfoliation of deciduous and permanent dentition and the associated residual ridge resorption, thereby overcoming functional and esthetic deficits and ensuring protection of the remaining dentition from further harm. PMID:25225567

A case of female epispadias.

PubMed

Tantibhedhyangkul, Julierut; Copland, Susannah D; Haqq, Andrea M; Price, Thomas M

2008-11-01

To present a case of unrecognized female epispadias. Case report. University-based reproductive endocrinology and fertility clinic. A 16-year-old girl with epispadias, history of mild urinary incontinence, auditory neuropathy, and functional hyperandrogenism. None. Peripheral blood array-based comparative genomic hybridization. The patient was referred for evaluation of excessive weight gain, secondary amenorrhea, and abnormal external genitalia. Examination under anesthesia revealed bilateral labia minora hypertrophy, bifid clitoris, and a patulous urethra, consistent with female epispadias. Hormonal evaluation showed functional hyperandrogenism, and peripheral blood array-based comparative genomic hybridization showed no chromosomal deletions or duplications. Female epispadias is a rare abnormality, not commonly recognized by most practitioners. The diagnosis is supported by a history of urinary incontinence and physical findings of bifid clitoris and patulous urethra. The condition can have serious physical and psychological consequences leading to a gross disruption of social function.

A case study of the microphysical and dynamical processes of fog and in-flight icing environments at Cold Lake Alberta, Canada

NASA Astrophysics Data System (ADS)

Wu, Di; Boudala, Faisal; Gultepe, Ismail; Isaac, George A.

2017-04-01

Pilot reports (PIREPs) of in-flight icing have been frequently been issued at Cold Lake airport (CYOD), Alberta, typically during descent on approach or climb after takeoff in the fall and winter seasons. Climatological data also indicate that this location is affected by various fog conditions. In order to better understand these conditions, Environment and Climate Change Canada (ECCC), in cooperation with the Department of National Defense (DND), installed a number of specialized instruments at Cold Lake. The ground based instruments include a Vaisala PWD22 present weather sensor, a multi-channel microwave profiling radiometer (MWRP) and a Jenoptik CHM15k ceilometer. A case study is presented of an icing event and foggy conditions that occurred very close to ground level and temperature changed from -1 C up to 2 C on 24 October, 2016. The microphysical and thermo-dynamical conditions within the boundary layer and aloft that led to these conditions were examined by integrating the ground based measurements with the Geostationary Operational Environmental Satellite (GOES) and the Canadian 2.5 km resolution NWP (HRDPS - High Resolution Deterministic Prediction System) model data. Preliminary results indicate that the ground based in-situ measurements were in agreement with the aviation weather observations (METAR). Both the HRDPS model and MWRP detected supercooled liquid water well during the icing event and its thermodynamic structure that remains to be investigated further. Furthermore, the icing potential and low clouds formation using the GOES Imager data will be compared with HRDPS simulations and verified by PIREPs.

[Medical expert assessment, objectivity and justice in disability pension cases. ].

PubMed

Solli, Hans Magnus

2003-08-14

The formal principle of justice is often interpreted as the requirement of objectivity when a person's situation is to be evaluated in the light of social justice. The aim of this article is to analyse whether or not the formal principle of justice is fulfilled by the ontological and the epistemological concept of objectivity when disability claims are evaluated medically in relation to the Norwegian legislation on disability benefits. material is legal and medical texts about medical disability evaluation. The method is text analysis. The main result is that the concept of ontological objectivity functions as the criterion of objectivity when the causal relations between sickness, impairment and disability are explained. This criterion is, however, problematic because it is based on the assumption that there is a linear causal model of these relations, which precludes the explanation of many cases of disability. The ontological concept of objectivity is not a necessary condition for impartiality and formal justice in relation to the causal relation between sickness and disability. In some situations this concept is a sufficient condition. The epistemological concept of objectivity is a sufficient condition, but it is not a necessary condition. Some cases must be reviewed on a discretionary basis.

The control effect in a detached laminar boundary layer of an array of normal synthetic jets

NASA Astrophysics Data System (ADS)

Valenzuela Calva, Fernando; Avila Rodriguez, Ruben

2016-11-01

In this work, 3D numerical simulations of an array of three normal circular synthetic jets embedded in an attached laminar boundary layer that separates under the influence of an inclined flap are performed for flow separation control. At the beginning of the present study, three cases are used to validate the numerical simulation with data obtained from experiments. The experimental data is chosen based on the cases which presented higher repeatability and reliability. Simulations showed reasonable agreement when compared with experiments. The simulations are undertaken at three synthetic jet operating conditions, i.e. Case A: L = 2, VR = 0.32; Case B: L = 4, VR = 0.64 and Case C: L = 6, VR = 0.96. The vortical structures produced for each synthetic jet operating condition are hairpin vortices for Case A and tilted vortices for Case B and C, respectively. By examining the spatial wall shear stress variations, the effect on the boundary layer prior to separation of the middle synthetic jet is evaluated. For effective flow control, produced at a relatively low the finding from this study suggests that hairpin vortical structures are more desirable structures. Universidad Nacional Autonoma de Mexico.

A new form of social withdrawal in Japan: a review of hikikomori.

PubMed

Teo, Alan R

2010-03-01

The purpose of this article is to provide a clinical review of a unique, emerging form of severe social withdrawal that has been described in Japan. This paper begins with a case vignette, then reviews the case definition, epidemiology, psychopathology, differential diagnosis, and treatment and management of the condition. Called hikikomori, it is well known to both the psychiatric community and general public in Japan but it has never been reviewed in the English medical literature. Patients are mostly adolescent and young adult men who become recluses in their parents' homes for months or years. They withdraw from contact with family, rarely have friends, and do not attend school or hold a job. Never described before the late 1970s, hikikomori has become a silent epidemic with tens, perhaps hundreds, of thousands of cases now estimated in Japan. The differential diagnosis includes anxiety and personality disorders, but current nosology in the Diagnostic and Statistic Manual of Mental Disorders may not adequately capture the concept of hikikomori. Treatment strategies are varied and lack a solid evidence base, but often include milieu, family, and exposure therapy. Much further research, including population-based and prospective studies, needs to be conducted to characterize and provide an evidence base for treatment of this condition.

A personalized health-monitoring system for elderly by combining rules and case-based reasoning.

PubMed

Ahmed, Mobyen Uddin

2015-01-01

Health-monitoring system for elderly in home environment is a promising solution to provide efficient medical services that increasingly interest by the researchers within this area. It is often more challenging when the system is self-served and functioning as personalized provision. This paper proposed a personalized self-served health-monitoring system for elderly in home environment by combining general rules with a case-based reasoning approach. Here, the system generates feedback, recommendation and alarm in a personalized manner based on elderly's medical information and health parameters such as blood pressure, blood glucose, weight, activity, pulse, etc. A set of general rules has used to classify individual health parameters. The case-based reasoning approach is used to combine all different health parameters, which generates an overall classification of health condition. According to the evaluation result considering 323 cases and k=2 i.e., top 2 most similar retrieved cases, the sensitivity, specificity and overall accuracy are achieved as 90%, 97% and 96% respectively. The preliminary result of the system is acceptable since the feedback; recommendation and alarm messages are personalized and differ from the general messages. Thus, this approach could be possibly adapted for other situations in personalized elderly monitoring.

[Microbial air purity in hospitals. Operating theatres with air conditioning system].

PubMed

Krogulski, Adam; Szczotko, Maciej

2010-01-01

The aim of this study was to show the influence of air conditioning control for microbial contamination of air inside the operating theatres equipped with correctly working air-conditioning system. This work was based on the results of bacteria and fungi concentration in hospital air obtained since 2001. Assays of microbial air purity conducted on atmospheric air in parallel with indoor air demonstrated that air filters applied in air-conditioning systems worked correctly in every case. To show the problem of fluctuation of bacteria concentration more precisely, every sequences of single results from successive measure series were examined independently.

Quantitative assessment of building fire risk to life safety.

PubMed

Guanquan, Chu; Jinhua, Sun

2008-06-01

This article presents a quantitative risk assessment framework for evaluating fire risk to life safety. Fire risk is divided into two parts: probability and corresponding consequence of every fire scenario. The time-dependent event tree technique is used to analyze probable fire scenarios based on the effect of fire protection systems on fire spread and smoke movement. To obtain the variation of occurrence probability with time, Markov chain is combined with a time-dependent event tree for stochastic analysis on the occurrence probability of fire scenarios. To obtain consequences of every fire scenario, some uncertainties are considered in the risk analysis process. When calculating the onset time to untenable conditions, a range of fires are designed based on different fire growth rates, after which uncertainty of onset time to untenable conditions can be characterized by probability distribution. When calculating occupant evacuation time, occupant premovement time is considered as a probability distribution. Consequences of a fire scenario can be evaluated according to probability distribution of evacuation time and onset time of untenable conditions. Then, fire risk to life safety can be evaluated based on occurrence probability and consequences of every fire scenario. To express the risk assessment method in detail, a commercial building is presented as a case study. A discussion compares the assessment result of the case study with fire statistics.

Modular expert system for the diagnosis of operating conditions of industrial anaerobic digestion plants.

PubMed

Lardon, L; Puñal, A; Martinez, J A; Steyer, J P

2005-01-01

Anaerobic digestion (AD) plants are highly efficient wastewater treatment processes with possible energetic valorisation. Despite these advantages, many industries are still reluctant to use them because of their instability in the face of changes in operating conditions. To the face this drawback and to enhance the industrial use of anaerobic digestion, one solution is to develop and to implement knowledge base (KB) systems that are able to detect and to assess in real-time the quality of operating conditions of the processes. Case-based techniques and heuristic approaches have been already tested and validated on AD processes but two major properties were lacking: modularity of the system (the knowledge base system should be easily tuned on a new process and should still work if one or more sensors are added or removed) and uncertainty management (the assessment of the KB system should remain relevant even in the case of too poor or conflicting information sources). This paper addresses these two points and presents a modular KB system where an uncertain reasoning formalism is used to combine partial and complementary fuzzy diagnosis modules. Demonstration of the interest of the approach is provided from real-life experiments performed on an industrial 2,000 m3 CSTR anaerobic digester.

Implementation and Testing of Advanced Surface Boundary Conditions Over Complex Terrain in A Semi-idealized Model

NASA Astrophysics Data System (ADS)

Li, Y.; Epifanio, C.

2017-12-01

In numerical prediction models, the interaction between the Earth's surface and the atmosphere is typically accounted for in terms of surface layer parameterizations, whose main job is to specify turbulent fluxes of heat, moisture and momentum across the lower boundary of the model domain. In the case of a domain with complex geometry, implementing the flux conditions (particularly the tensor stress condition) at the boundary can be somewhat subtle, and there has been a notable history of confusion in the CFD community over how to formulate and impose such conditions generally. In the atmospheric case, modelers have largely been able to avoid these complications, at least until recently, by assuming that the terrain resolved at typical model resolutions is fairly gentle, in the sense of having relatively shallow slopes. This in turn allows the flux conditions to be imposed as if the lower boundary were essentially flat. Unfortunately, while this flat-boundary assumption is acceptable for coarse resolutions, as grids become more refined and the geometry of the resolved terrain becomes more complex, the appproach is less justified. With this in mind, the goal of our present study is to explore the implementation and usage of the full, unapproximated version of the turbulent flux/stress conditions in atmospheric models, thus taking full account of the complex geometry of the resolved terrain. We propose to implement the conditions using a semi-idealized model developed by Epifanio (2007), in which the discretized boundary conditions are reduced to a large, sparse-matrix problem. The emphasis will be on fluxes of momentum, as the tensor nature of this flux makes the associated stress condition more difficult to impose, although the flux conditions for heat and moisture will be considered as well. With the resulotion of 90 meters, some of the results show that the typical differences between flat-boundary cases and full/stress cases are on the order of 10%, with extreme cases reaching as high as 30% based on typical disturbance wind speeds. And this difference dropping by a factor of six between grid spacings of 90 meters and 240 meters. It would thus appear that the need to apply the full stress condition is limited to relatively high-resolution modeling, with grid spacings on the order of 250 meters or less.

Application and comparison of the SCS-CN-based rainfall-runoff model in meso-scale watershed and field scale

NASA Astrophysics Data System (ADS)

Luo, L.; Wang, Z.

2010-12-01

Soil Conservation Service Curve Number (SCS-CN) based hydrologic model, has widely been used for agricultural watersheds in recent years. However, there will be relative error when applying it due to differentiation of geographical and climatological conditions. This paper introduces a more adaptable and propagable model based on the modified SCS-CN method, which specializes into two different scale cases of research regions. Combining the typical conditions of the Zhanghe irrigation district in southern part of China, such as hydrometeorologic conditions and surface conditions, SCS-CN based models were established. The Xinbu-Qiao River basin (area =1207 km2) and the Tuanlin runoff test area (area =2.87 km2)were taken as the study areas of basin scale and field scale in Zhanghe irrigation district. Applications were extended from ordinary meso-scale watershed to field scale in Zhanghe paddy field-dominated irrigated . Based on actual measurement data of land use, soil classification, hydrology and meteorology, quantitative evaluation and modifications for two coefficients, i.e. preceding loss and runoff curve, were proposed with corresponding models, table of CN values for different landuse and AMC(antecedent moisture condition) grading standard fitting for research cases were proposed. The simulation precision was increased by putting forward a 12h unit hydrograph of the field area, and 12h unit hydrograph were simplified. Comparison between different scales show that it’s more effectively to use SCS-CN model on field scale after parameters calibrated in basin scale These results can help discovering the rainfall-runoff rule in the district. Differences of established SCS-CN model's parameters between the two study regions are also considered. Varied forms of landuse and impacts of human activities were the important factors which can impact the rainfall-runoff relations in Zhanghe irrigation district.

Accounting for dynamics of mean precipitation in drought projections: A case study of Brazil for the 2050 and 2070 periods.

PubMed

Mpelasoka, Freddie; Awange, Joseph L; Goncalves, Rodrigo Mikosz

2018-05-01

Changes in drought around the globe are among the most daunting potential effects of climate change. However, changes in droughts are often not well distinguished from changes in aridity levels. As drought constitutes conditions of aridity, the projected declines in mean precipitation tend to override changes in drought. This results in projections of more dire changes in drought than ever. The overestimate of changes can be attributed to the use of 'static' normal precipitation in the derivation of drought events. The failure in distinguishing drought from aridity is a conceptual problem of concern, particularly to drought policymakers. Given that the key objective of drought policies is to determine drought conditions, which are rare and so protracted that they are beyond the scope of normal risk management, for interventions. The main objective of this Case Study of Brazil is to demonstrate the differences between projections of changes in drought based on 'static' and '30-year dynamic' precipitation normal conditions. First we demonstrate that the 'static' based projections suggest 4-fold changes in the probability of drought-year occurrences against changes by the dynamic normal precipitation. The 'static-normal mean precipitation' based projections tend to be monotonically increasing in magnitude, and were arguably considered unrealistic. Based on the '30-year dynamic' normal precipitation conditions, the 13-member GCM ensemble median projection estimates of changes for 2050 under rcp4.5 1 and rcp8.5 2 suggest: (i) Significant differences between changes associated with rcp4.5 and rcp8.5, and are more noticeable for droughts at long than short timescales in the 2070; (ii) Overall, the results demonstrate more realistic projections of changes in drought characteristics over Brazil than previous projections based on 'static' normal precipitation conditions. However, the uncertainty of response of droughts to climate change in CMIP5 simulations is still large, regardless of GCMs selection and translation processes undertaken. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical reasoning and population health: decision making for an emerging paradigm of health care.

PubMed

Edwards, Ian; Richardson, Barbara

2008-01-01

Chronic conditions now provide the major disease and disability burden facing humanity. This development has necessitated a reorientation in the practice skills of health care professions away from hospital-based inpatient and outpatient care toward community-based management of patients with chronic conditions. Part of this reorientation toward community-based management of chronic conditions involves practitioners' understanding and adoption of a concept of population health management based on appropriate theoretical models of health care. Drawing on recent studies of expertise in physiotherapy, this article proposes a clinical reasoning and decision-making framework to meet these challenges. The challenge of population and community-based management of chronic conditions also provides an opportunity for physiotherapists to further clarify a professional epistemology of practice that embraces the kinds of knowledge and clinical reasoning processes used in physiotherapy practice. Three case studies related to the management of chronic musculoskeletal pain in different populations are used to exemplify the range of epistemological perspectives that underpin community-based practice. They illustrate the link between conceptualizations of practice problems and knowledge sources that are used as a basis for clinical reasoning and decision making as practitioners are increasingly required to move between the clinic and the community.

Shortage and surplus of water in the socio-hydrological context

NASA Astrophysics Data System (ADS)

Schumann, A.; Nijssen, d.

2014-09-01

Balancing the temporal variability of hydrological conditions in the long- and short-term is often essential for steady socio-economic conditions. However, this equilibrium is very fragile in many cases. Hydrological changes or socio-economic changes may destroy it in a short time. If we extend the bearing capacity of socio-hydrological systems we increase, in many cases, the harmful consequences of failures. Here, two case studies are discussed to illustrate these problems. The limited success at adapting water resources to increasing human requirements without consideration of the natural capacities will be discussed with the example of water use for irrigation in northeastern China. The demand for a new planning approach, which is based on a combination of monitoring, model-based impact assessments and spatial distributed planning, is demonstrated. The problems of water surplus, which becomes evident during floods, are discussed in a second case study. It is shown that flood protection depends strongly on expectations of flood characteristics. The gap between the social requirement for complete flood prevention and the remaining risk of flood damage becomes obvious. An increase of risk-awareness would be more sustainable than promises of flood protection, which are the basis for technical measures to affect floods and (or) to prevent flood damages.

Empirical test of the performance of an acoustic-phonetic approach to forensic voice comparison under conditions similar to those of a real case.

PubMed

Enzinger, Ewald; Morrison, Geoffrey Stewart

2017-08-01

In a 2012 case in New South Wales, Australia, the identity of a speaker on several audio recordings was in question. Forensic voice comparison testimony was presented based on an auditory-acoustic-phonetic-spectrographic analysis. No empirical demonstration of the validity and reliability of the analytical methodology was presented. Unlike the admissibility standards in some other jurisdictions (e.g., US Federal Rule of Evidence 702 and the Daubert criteria, or England & Wales Criminal Practice Directions 19A), Australia's Unified Evidence Acts do not require demonstration of the validity and reliability of analytical methods and their implementation before testimony based upon them is presented in court. The present paper reports on empirical tests of the performance of an acoustic-phonetic-statistical forensic voice comparison system which exploited the same features as were the focus of the auditory-acoustic-phonetic-spectrographic analysis in the case, i.e., second-formant (F2) trajectories in /o/ tokens and mean fundamental frequency (f0). The tests were conducted under conditions similar to those in the case. The performance of the acoustic-phonetic-statistical system was very poor compared to that of an automatic system. Copyright © 2017 Elsevier B.V. All rights reserved.

Quantification of chaotic strength and mixing in a micro fluidic system

NASA Astrophysics Data System (ADS)

Kim, Ho Jun; Beskok, Ali

2007-11-01

Comparative studies of five different techniques commonly employed to identify the chaotic strength and mixing efficiency in micro fluidic systems are presented to demonstrate the competitive advantages and shortcomings of each method. The 'chaotic electroosmotic stirrer' of Qian and Bau (2002 Anal. Chem. 74 3616-25) is utilized as the benchmark case due to its well-defined flow kinematics. Lagrangian particle tracking methods are utilized to study particle dispersion in the conceptual device using spectral element and fourth-order Runge-Kutta discretizations in space and time, respectively. Stirring efficiency is predicted using the stirring index based on the box counting method, and Poincaré sections are utilized to identify the chaotic and regular regions under various actuation conditions. Finite time Lyapunov exponents are calculated to quantify the chaotic strength, while the probability density function of the stretching field is utilized as an alternative method to demonstrate the statistical analysis of chaotic and partially chaotic cases. Mixing index inverse, based on the standard deviation of scalar species distribution, is utilized as a metric to quantify the mixing efficiency. Series of numerical simulations are performed by varying the Peclet number (Pe) at fixed kinematic conditions. The mixing time (tm) is characterized as a function of the Pe number, and tm ~ ln(Pe) scaling is demonstrated for fully chaotic cases, while tm ~ Peα scaling with α ≈ 0.33 and α = 0.5 are observed for partially chaotic and regular cases, respectively. Employing the aforementioned techniques, optimum kinematic conditions and the actuation frequency of the stirrer that result in the highest mixing/stirring efficiency are identified.

Before you install exterior wood-based siding

Treesearch

Mark T. Knaebe

1995-01-01

Moisture accumulation and extreme fluctuations in moisture levels can adversely affect the service life of components, such as wood siding and windows. Adverse moisture conditions can induce checking, warping, paint failure, and in severe cases, rotting of the wood.

Speechlessness in Gilles de la Tourette Syndrome: Cannabis-Based Medicines Improve Severe Vocal Blocking Tics in Two Patients

PubMed Central

Jakubovski, Ewgeni; Müller-Vahl, Kirsten

2017-01-01

We report the cases of two young German male patients with treatment-resistant Tourette syndrome (TS), who suffer from incapacitating stuttering-like speech disfluencies caused by vocal blocking tics and palilalia. Case 1: a 19-year old patient received medical cannabis at a dose of 1 × 0.1 g cannabis daily. Case 2: a 16-year old patient initially received dronabinol at a maximum dose of 22.4–33.6 mg daily. Both treatments provided significant symptom improvement of vocal blocking tics as well as of comorbid conditions and were well tolerated. Thus, cannabis-based medicine appears to be effective in treatment-resistant TS patients with vocal blocking tics. PMID:28796166

Speechlessness in Gilles de la Tourette Syndrome: Cannabis-Based Medicines Improve Severe Vocal Blocking Tics in Two Patients.

PubMed

Jakubovski, Ewgeni; Müller-Vahl, Kirsten

2017-08-10

We report the cases of two young German male patients with treatment-resistant Tourette syndrome (TS), who suffer from incapacitating stuttering-like speech disfluencies caused by vocal blocking tics and palilalia. Case 1: a 19-year old patient received medical cannabis at a dose of 1 × 0.1 g cannabis daily. Case 2: a 16-year old patient initially received dronabinol at a maximum dose of 22.4-33.6 mg daily. Both treatments provided significant symptom improvement of vocal blocking tics as well as of comorbid conditions and were well tolerated. Thus, cannabis-based medicine appears to be effective in treatment-resistant TS patients with vocal blocking tics.

Linear control of oscillator and amplifier flows*

NASA Astrophysics Data System (ADS)

Schmid, Peter J.; Sipp, Denis

2016-08-01

Linear control applied to fluid systems near an equilibrium point has important applications for many flows of industrial or fundamental interest. In this article we give an exposition of tools and approaches for the design of control strategies for globally stable or unstable flows. For unstable oscillator flows a feedback configuration and a model-based approach is proposed, while for stable noise-amplifier flows a feedforward setup and an approach based on system identification is advocated. Model reduction and robustness issues are addressed for the oscillator case; statistical learning techniques are emphasized for the amplifier case. Effective suppression of global and convective instabilities could be demonstrated for either case, even though the system-identification approach results in a superior robustness to off-design conditions.

Metrological analysis of a virtual flowmeter-based transducer for cryogenic helium

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

Arpaia, P., E-mail: pasquale.arpaia@unina.it; Technology Department, European Organization for Nuclear Research; Girone, M., E-mail: mario.girone@cern.ch

2015-12-15

The metrological performance of a virtual flowmeter-based transducer for monitoring helium under cryogenic conditions is assessed. At this aim, an uncertainty model of the transducer, mainly based on a valve model, exploiting finite-element approach, and a virtual flowmeter model, based on the Sereg-Schlumberger method, are presented. The models are validated experimentally on a case study for helium monitoring in cryogenic systems at the European Organization for Nuclear Research (CERN). The impact of uncertainty sources on the transducer metrological performance is assessed by a sensitivity analysis, based on statistical experiment design and analysis of variance. In this way, the uncertainty sourcesmore » most influencing metrological performance of the transducer are singled out over the input range as a whole, at varying operating and setting conditions. This analysis turns out to be important for CERN cryogenics operation because the metrological design of the transducer is validated, and its components and working conditions with critical specifications for future improvements are identified.« less

Assessing the Sensitivity of Treatment Effect Estimates to Differential Follow-Up Rates: Implications for Translational Research

PubMed Central

McCaffrey, Daniel; Ramchand, Rajeev; Hunter, Sarah B.; Suttorp, Marika

2012-01-01

We develop a new tool for assessing the sensitivity of findings on treatment effectiveness to differential follow-up rates in the two treatment conditions being compared. The method censors the group with the higher response rate to create a synthetic respondent group that is then compared with the observed cases in the other condition to estimate a treatment effect. Censoring is done under various assumptions about the strength of the relationship between follow-up and outcomes to determine how informative differential dropout can alter inferences relative to estimates from models that assume the data are missing at random. The method provides an intuitive measure for understanding the strength of the association between outcomes and dropout that would be required to alter inferences about treatment effects. Our approach is motivated by translational research in which treatments found to be effective under experimental conditions are tested in standard treatment conditions. In such applications, follow-up rates in the experimental setting are likely to be substantially higher than in the standard setting, especially when observational data are used in the evaluation. We test the method on a case study evaluation of the effectiveness of an evidence-supported adolescent substance abuse treatment program (Motivational Enhancement Therapy/Cognitive Behavioral Therapy-5 [MET/CBT-5]) delivered by community-based treatment providers relative to its performance in a controlled research trial. In this case study, follow-up rates in the community based settings were extremely low (54%) compared to the experimental setting (95%) giving raise to concerns about non-ignorable drop-out. PMID:22956890

A case-control study of the association between ulcerative colitis and hyperthyroidism in an Asian population.

PubMed

Tsai, Ming-Chieh; Lin, Herng-Ching; Lee, Cha-Ze

2017-06-01

Ulcerative colitis (UC) is a chronic relapsing inflammatory disease with significant clinical diversity. However, the aetiology, pathogenesis and optimal treatment of UC remain unclear. The purpose of this case-control study was to investigate the association between previously diagnosed hyperthyroidism and UC using a large population-based data set in Taiwan. The data for this population-based case-control study were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. We included 2709 patients with UC as cases and 8127 sex- and age-matched patients without UC as controls. A conditional logistic regression analysis was conducted to compute the odds ratio (OR) and corresponding 95% confidence interval (CI) for the association between UC and prior hyperthyroidism. We found that, in total, 327 of the 10 836 sampled patients (3.02%) had previously been diagnosed with hyperthyroidism. There was a higher proportion of prior hyperthyroidism among cases than controls (4.10% vs 2.66%, P<.001). A conditional logistic regression showed that the OR of prior hyperthyroidism was 1.57 (95% CI=1.24-1.98) compared to controls. Similarly, after adjusting for monthly income, geographic location and urbanization level, cases were still more likely to have previously been diagnosed with hyperthyroidism than controls (OR=1.61, 95% CI=1.27-2.05). Furthermore, we analysed the ORs of prior hyperthyroidism between cases and controls according to age group. We found that of the youngest group of sampled patients (18-39 years), cases had the greatest adjusted OR for having previously been diagnosed with hyperthyroidism than controls (OR=1.98, 95% CI=1.04-3.79). This study demonstrated an association between UC and hyperthyroidism. © 2017 John Wiley & Sons Ltd.

Detecting changes in riparian habitat conditions based on patterns of greenness change: a case study from the upper San Pedro River Basin, USA

Treesearch

K. Bruce Jones; Curtis E. Edmonds; E. Terrance Slonecker; James D. Wickham; Anne C. Neale; Timothy G. Wade; Kurt H. Riitters; William G. Kepner

2008-01-01

Healthy riparian ecosystems in arid and semi-arid regions exhibit shifting patterns of vegetation in response to periodic flooding. Their conditions also depend upon the amount of grazing and other human uses. Taking advantage of these system properties, we developed and tested an approach that utilizes historical Landsat data to track changes in the patterns...

Algebraic Riccati equations in zero-sum differential games

NASA Technical Reports Server (NTRS)

Johnson, T. L.; Chao, A.

1974-01-01

The procedure for finding the closed-loop Nash equilibrium solution of two-player zero-sum linear time-invariant differential games with quadratic performance criteria and classical information pattern may be reduced in most cases to the solution of an algebraic Riccati equation. Based on the results obtained by Willems, necessary and sufficient conditions for existence of solutions to these equations are derived, and explicit conditions for a scalar example are given.

Microscopic Perspective on Photovoltaic Reciprocity in Ultrathin Solar Cells

NASA Astrophysics Data System (ADS)

Aeberhard, Urs; Rau, Uwe

2017-06-01

The photovoltaic reciprocity theory relates the electroluminescence spectrum of a solar cell under applied bias to the external photovoltaic quantum efficiency of the device as measured at short circuit conditions. Its derivation is based on detailed balance relations between local absorption and emission rates in optically isotropic media with nondegenerate quasiequilibrium carrier distributions. In many cases, the dependence of density and spatial variation of electronic and optical device states on the point of operation is modest and the reciprocity relation holds. In nanostructure-based photovoltaic devices exploiting confined modes, however, the underlying assumptions are no longer justifiable. In the case of ultrathin absorber solar cells, the modification of the electronic structure with applied bias is significant due to the large variation of the built-in field. Straightforward use of the external quantum efficiency as measured at short circuit conditions in the photovoltaic reciprocity theory thus fails to reproduce the electroluminescence spectrum at large forward bias voltage. This failure is demonstrated here by numerical simulation of both spectral quantities at normal incidence and emission for an ultrathin GaAs p -i -n solar cell using an advanced quantum kinetic formalism based on nonequilibrium Green's functions of coupled photons and charge carriers. While coinciding with the semiclassical relations under the conditions of their validity, the theory provides a consistent microscopic relationship between absorption, emission, and charge carrier transport in photovoltaic devices at arbitrary operating conditions and for any shape of optical and electronic density of states.

Microscopic Perspective on Photovoltaic Reciprocity in Ultrathin Solar Cells.

PubMed

Aeberhard, Urs; Rau, Uwe

2017-06-16

The photovoltaic reciprocity theory relates the electroluminescence spectrum of a solar cell under applied bias to the external photovoltaic quantum efficiency of the device as measured at short circuit conditions. Its derivation is based on detailed balance relations between local absorption and emission rates in optically isotropic media with nondegenerate quasiequilibrium carrier distributions. In many cases, the dependence of density and spatial variation of electronic and optical device states on the point of operation is modest and the reciprocity relation holds. In nanostructure-based photovoltaic devices exploiting confined modes, however, the underlying assumptions are no longer justifiable. In the case of ultrathin absorber solar cells, the modification of the electronic structure with applied bias is significant due to the large variation of the built-in field. Straightforward use of the external quantum efficiency as measured at short circuit conditions in the photovoltaic reciprocity theory thus fails to reproduce the electroluminescence spectrum at large forward bias voltage. This failure is demonstrated here by numerical simulation of both spectral quantities at normal incidence and emission for an ultrathin GaAs p-i-n solar cell using an advanced quantum kinetic formalism based on nonequilibrium Green's functions of coupled photons and charge carriers. While coinciding with the semiclassical relations under the conditions of their validity, the theory provides a consistent microscopic relationship between absorption, emission, and charge carrier transport in photovoltaic devices at arbitrary operating conditions and for any shape of optical and electronic density of states.

Medical expertise, existential suffering and ending life.

PubMed

Varelius, Jukka

2014-02-01

In this article, I assess the position that voluntary euthanasia (VE) and physician-assisted suicide (PAS) ought not to be accepted in the cases of persons who suffer existentially but who have no medical condition, because existential questions do not fall within the domain of physicians' professional expertise. I maintain that VE and PAS based on suffering arising from medical conditions involves existential issues relevantly similar to those confronted in connection with existential suffering. On that basis I conclude that if VE and PAS based on suffering arising from medical conditions is taken to fall within the domain of medical expertise, it is not consistent to use the view that physicians' professional expertise does not extend to existential questions as a reason for denying requests for VE and PAS from persons who suffer existentially but have no medical condition.

Melanin-based color of plumage: role of condition and of feathers' microstructure

USGS Publications Warehouse

D'Alba, Liliana; Van Hemert, Caroline R.; Spencer, Karen A.; Heidinger, Britt J.; Gill, Lisa; Evans, Neil P.; Monaghan, Pat; Handel, Colleen M.; Shawkey, Matthew D.

2014-01-01

Whether melanin-based colors honestly signal a bird's condition during the growth of feathers is controversial, and it is unclear if or how the physiological processes underlying melanogenesis or color-imparting structural feather microstructure may be adversely affected by condition. Here we report results from two experiments designed to measure the effect of condition on expression of eumelanic and pheomelanic coloration in black-capped chickadees (Poecile atricapillus) and zebra finches (Taeniopygia guttata), respectively. In chickadees, we compared feathers of birds affected and unaffected by avian keratin disorder, while in zebra finches we compared feathers of controls with feathers of those subjected to an unpredictable food supply during development. In both cases we found that control birds had brighter feathers (higher total reflectance) and more barbules, but similar densities of melanosomes. In addition, the microstructure of the feathers explained variation in color more strongly than did melanosome density. Together, these results suggest that melanin-based coloration may in part be condition-dependent, but that this may be driven by changes in keratin and feather development, rather than melanogenesis itself. Researchers should be cautious when assigning variation in melanin-based color to melanin alone and microstructure of the feather should be taken into account.

On physical optics for calculating scattering from coated bodies

NASA Technical Reports Server (NTRS)

Baldauf, J.; Lee, S. W.; Ling, H.; Chou, R.

1989-01-01

The familiar physical optics (PO) approximation is no longer valid when the perfectly conducting scatterer is coated with dielectric material. This paper reviews several possible PO formulations. By comparing the PO formulation with the moment method solution based on the impedance boundary condition for the case of the coated cone-sphere, a PO formulation using both electric and magnetic currents consistently gives the best numerical results. Comparisons of the exact moment method with the PO formulations using the impedance boundary condition and the PO formulation using the Fresnel reflection coefficient for the case of scattering from the cone-ellipsoid demonstrate that the Fresnel reflection coefficient gives the best numerical results in general.

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

Pirozhkov, A. S.; Mori, M.; Yogo, A.

High-power laser contrast is challenging to measure, especially in the real target irradiation conditions. We present a convenient and relatively simple contrast diagnostic technique based on the measurement of target specular reflectivity at full laser power. The reflectivity remains high even at intensities above 10{sup 19} W/cm{sup 2} in the case of a high-contrast prepulse-free laser. On the contrary, the specular reflectivity drops in the case of lower contrast, due to the beam break-up and increased absorption caused by the preformed plasma. The technique was demonstrated using three different laser systems with several contrast conditions: Astra (CLF, RAL), TiS lasermore » at APRI, GIST, and J-KAREN (APRC, JAEA).« less

[Electrocardiographic diagnosis: when QRS is wide.

PubMed

Conti, Matilde; Bregani, Enrico Rino

2018-04-01

Differential diagnosis of one or more wide QRS complexes on an electrocardiogram under emergency conditions takes into account three main sets of clinical conditions: ventricular pre-excitation, aberrant conduction and ventricular beats and it is based on the morphological analysis of the ECG and patient's anamnestic data. Several criteria can facilitate the differential diagnosis and if properly used and integrated with clinic data they can achieve good diagnostic accuracy in most cases. In this review several criteria based on evidence and literature are presented, paying attention in recognizing some morphologic pathways that can be used in emergency room and allow a correct ECG assessment.

Effect of the collector tube profile on Pitot pump performances

NASA Astrophysics Data System (ADS)

Komaki, K.; Kanemoto, T.; Sagara, K.; Umekage, T.

2013-12-01

The pitot pump is composed of the rotating casing with the impeller channel and the pitot tube type collector as the discharge line. The radial impeller feeds water to the rotating casing. The water rotating together with the casing is caught by the stationary pitot tube type collector, and then discharges to the outside. This type pump, as the extra high head pump, is provided mainly for boiler feed systems, and has been designed by trial and error. To optimize the pump profiles, it is desirable to investigate not only performances but also internal flow conditions. This paper discusses experimentally and numerically the relation between the pump performances and the flow conditions in the rotating casing. The moderately larger dimensions of the collector make the pump head and the discharge high with the higher hydraulic efficiency. The flow in the casing is almost the forced vortex type whose velocity is in proportion to the radius but the core velocity is affected with the drag force of the stationary collector. Based upon the above results, the profile of the pitot tube type collector was optimized with the numerical simulation.

MANAGEMENT OF ACUTE SPORTS INJURIES AND MEDICAL CONDITIONS BY PHYSICAL THERAPISTS: ASSESSMENT VIA CASE SCENARIOS

PubMed Central

Karges, Joy Renae; Salsbery, Mitchell A.; Smith, Danna; Stanley, Erica J.

2011-01-01

Purpose/Background: Some physical therapists (PTs) provide services at sporting events, but there are limited studies investigating whether PTs are properly prepared to provide such services. The purpose of this study was to assess acute sports injury and medical condition management decision-making skills of PTs. Methods: A Web-based survey presented 17 case scenarios related to acute medical conditions and sport injuries. PTs from the Sports Physical Therapy Section of The American Physical Therapy Association were e-mailed a cover letter/Web link to the survey and invited to participate over a 30-day period. Data were analyzed using SPSS 18.0. Results: A total of 411 of 5158 PTs who were members of the Sports Physical Therapy Association in 2009 and had valid e-mail addresses completed the survey, of which 389 (7.5%) were appropriate for analysis. Over 75.0% of respondents felt “prepared” or “somewhat prepared” to provide immediate care for 13 out of 16 medical conditions, with seizures, spinal cord injuries, and internal organ injuries having the lowest percentages. Over 75.0% of the respondents made “appropriate” or “overly cautious” decisions for 11 of the 17 acute injury or medical condition cases. Conclusions: Results of the current study indicate that PTs felt more “prepared” and tended to make “appropriate” return to play decisions on the acute sports injury and medical condition case studies more often than coaches who participated in a similar study, regardless of level of importance of the game or whether the athlete was a starter vs. non-starter. However, for PTs who plan on assisting at sporting events, additional preparation/education may be recommended, such as what is taught in an emergency responder course. PMID:21904695

Semi-supervised vibration-based classification and condition monitoring of compressors

NASA Astrophysics Data System (ADS)

Potočnik, Primož; Govekar, Edvard

2017-09-01

Semi-supervised vibration-based classification and condition monitoring of the reciprocating compressors installed in refrigeration appliances is proposed in this paper. The method addresses the problem of industrial condition monitoring where prior class definitions are often not available or difficult to obtain from local experts. The proposed method combines feature extraction, principal component analysis, and statistical analysis for the extraction of initial class representatives, and compares the capability of various classification methods, including discriminant analysis (DA), neural networks (NN), support vector machines (SVM), and extreme learning machines (ELM). The use of the method is demonstrated on a case study which was based on industrially acquired vibration measurements of reciprocating compressors during the production of refrigeration appliances. The paper presents a comparative qualitative analysis of the applied classifiers, confirming the good performance of several nonlinear classifiers. If the model parameters are properly selected, then very good classification performance can be obtained from NN trained by Bayesian regularization, SVM and ELM classifiers. The method can be effectively applied for the industrial condition monitoring of compressors.

The evolution of dispersal conditioned on migration status

PubMed Central

Asaduzzaman, Sarder Mohammed; Wild, Geoff

2012-01-01

We consider a model for the evolution of dispersal of offspring. Dispersal is treated as a parental trait that is expressed conditional upon a parent’s own “migration status,” that is, whether a parent, itself, is native or nonnative to the area in which it breeds. We compare the evolution of this kind of conditional dispersal to the evolution of unconditional dispersal, in order to determine the extent to which the former changes predictions about population-wide levels of dispersal. We use numerical simulations of an inclusive-fitness model, and individual-based simulations to predict population-average dispersal rates for the case in which dispersal based on migration status occurs. When our model predictions are compared to predictions that neglect conditional dispersal, observed differences between rates are only slight, and never exceed 0.06. While the effect of dispersal conditioned upon migration status could be detected in a carefully designed experiment, we argue that less-than-ideal experimental conditions, and factors such as dispersal conditioned on sex are likely to play a larger role that the type of conditional dispersal studied here. PMID:22837829

Prevalence and associations of symptoms of upper extremities, repetitive strain injuries (RSI) and 'RSI-like condition'. A cross sectional study of bank workers in Northeast Brazil

PubMed Central

Lacerda, Eliana M; Nácul, Luis C; da S Augusto, Lia G; Olinto, Maria Teresa A; Rocha, Dyhanne C; Wanderley, Danielle C

2005-01-01

Background The repetitive strain injury syndrome (RSI) is a worldwide occupational health problem affecting all types of economic activities. We investigated the prevalence and some risk factors for RSI and related conditions, namely 'symptoms of upper limbs' and 'RSI-like condition'. Methods We conducted a cross-sectional study with 395 bank workers in Recife, Northeast Brazil. Symptoms of upper limbs and 'RSI-like condition' were assessed by a simple questionnaire, which was used to screen probable cases of RSI. The diagnosis of RSI was confirmed by clinical examination. The associations of potential risk factors and the outcomes were assessed by multiple logistic regression analysis. Results We found prevalence rates of 56% for symptoms of the upper limbs and 30% for 'RSI-like condition'. The estimated prevalence of clinically confirmed cases of RSI was 22%. Female sex and occupation (as cashier or clerk) increased the risk of all conditions, but the associations were stronger for cases of RSI than for less specific diagnoses of 'RSI-like condition' and symptoms of upper limbs. Age was inversely related to the risk of symptoms of upper limbs but not to 'RSI-like' or RSI. Conclusion The variation in the magnitude of risk according to the outcome assessed suggests that previous studies using different definitions may not be immediately comparable. We propose the use of a simple instrument to screen cases of RSI in population based studies, which still needs to be validated in other populations. The high prevalence of RSI and related conditions in this population suggests the need for urgent interventions to tackle the problem, which could be directed to individuals at higher risk and to changes in the work organization and environment of the general population. PMID:16219095

Abnormal brain MRI signals in the splenium of the corpus callosum, basal ganglia and internal capsule in a suspected case with tuberculous meningitis.

PubMed

Hirotani, Makoto; Yabe, Ichiro; Hamada, Shinsuke; Tsuji, Sachiko; Kikuchi, Seiji; Sasaki, Hidenao

2007-01-01

A 34-year-old man visited the hospital with chief complaints of headache, fever, and disturbance of consciousness. In view of his clinical condition, the course of the disease, and results of examination, he was diagnosed with viral meningitis and treated accordingly. However, his clinical condition worsened, and MRI revealed abnormal signals in the splenium of the corpus callosum, in the basal ganglia and in the internal capsule, as well as the presence of severe inflammation in the base of the brain. Since he had a high ADA level in the cerebrospinal fluid and was consequently suspected to have tuberculous meningitis, he was placed on antitubercular agents. Then, his clinical condition began to improve. Additional steroid pulse therapy further improved his condition, and abnormal signals in the splenium of the corpus callosum and the basal ganglia resolved. This valuable case suggests that an immune mechanism contributed to the occurrence of central nervous system symptoms associated with tuberculous meningitis.

Case-Based Learning in Athletic Training

ERIC Educational Resources Information Center

Berry, David C.

2013-01-01

The National Athletic Trainers' Association (NATA) Executive Committee for Education has emphasized the need for proper recognition and management of orthopaedic and general medical conditions through their support of numerous learning objectives and the clinical integrated proficiencies. These learning objectives and integrated clinical…

Case history : use of Tenax and Tensar geogrids for base course stabilization : technical assistance report.

DOT National Transportation Integrated Search

1999-01-01

Geogrids can be used successfully for subgrade stabilization under permanent pavements. To be successful, proper designs incorporating existing soil conditions and anticipated loading need to be performed. subgrade soil strength should be determined ...

Conjugate gradient heat bath for ill-conditioned actions.

PubMed

Ceriotti, Michele; Bussi, Giovanni; Parrinello, Michele

2007-08-01

We present a method for performing sampling from a Boltzmann distribution of an ill-conditioned quadratic action. This method is based on heat-bath thermalization along a set of conjugate directions, generated via a conjugate-gradient procedure. The resulting scheme outperforms local updates for matrices with very high condition number, since it avoids the slowing down of modes with lower eigenvalue, and has some advantages over the global heat-bath approach, compared to which it is more stable and allows for more freedom in devising case-specific optimizations.

FAST TRACK COMMUNICATION: Singularity theorems based on trapped submanifolds of arbitrary co-dimension

NASA Astrophysics Data System (ADS)

Galloway, Gregory J.; Senovilla, José M. M.

2010-08-01

Standard singularity theorems are proven in Lorentzian manifolds of arbitrary dimension n if they contain closed trapped submanifolds of arbitrary co-dimension. By using the mean curvature vector to characterize trapped submanifolds, a unification of the several possibilities for the boundary conditions in the traditional theorems and their generalization to an arbitrary co-dimension is achieved. The classical convergence conditions must be replaced by a condition on sectional curvatures, or tidal forces, which reduces to the former in the cases of the co-dimension 1, 2 or n.

Testing for thrombophilia: an evidence‐based approach

PubMed Central

Merriman, L; Greaves, M

2006-01-01

Thrombophilia is a disorder of haemostasis in which there is a tendency for the occurrence of thrombosis. This tendency can be inherited or acquired. This review outlines common acquired and inherited thrombophilic conditions and discusses indications for testing. It is concluded that testing for acquired thrombophilic conditions should be considered in all cases of venous thrombosis, whereas testing for inherited thrombophilic conditions is unlikely to be helpful. If testing for inherited thrombophilia is to be carried out, the benefits, pitfalls and unwanted consequences of such testing should be taken into account. PMID:17099087

Entropic characterization of separability in Gaussian states

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

Sudha; Devi, A. R. Usha; Inspire Institute Inc., McLean, Virginia 22101

2010-02-15

We explore separability of bipartite divisions of mixed Gaussian states based on the positivity of the Abe-Rajagopal (AR) q-conditional entropy. The AR q-conditional entropic characterization provide more stringent restrictions on separability (in the limit q{yields}{infinity}) than that obtained from the corresponding von Neumann conditional entropy (q=1 case)--similar to the situation in finite dimensional states. Effectiveness of this approach, in relation to the results obtained by partial transpose criterion, is explicitly analyzed in three illustrative examples of two-mode Gaussian states of physical significance.

Testing by artificial intelligence: computational alternatives to the determination of mutagenicity.

PubMed

Klopman, G; Rosenkranz, H S

1992-08-01

In order to develop methods for evaluating the predictive performance of computer-driven structure-activity methods (SAR) as well as to determine the limits of predictivity, we investigated the behavior of two Salmonella mutagenicity data bases: (a) a subset from the Genetox Program and (b) one from the U.S. National Toxicology Program (NTP). For molecules common to the two data bases, the experimental concordance was 76% when "marginals" were included and 81% when they were excluded. Three SAR methods were evaluated: CASE, MULTICASE and CASE/Graph Indices (CASE/GI). The programs "learned" the Genetox data base and used it to predict NTP molecules that were not present in the Genetox compilation. The concordances were 72, 80 and 47% respectively. Obviously, the MULTICASE version is superior and approaches the 85% interlaboratory variability observed for the Salmonella mutagenicity assays when the latter was carried out under carefully controlled conditions.

Localized intraoperative virtual endoscopy (LIVE) for surgical guidance in 16 skull base patients.

PubMed

Haerle, Stephan K; Daly, Michael J; Chan, Harley; Vescan, Allan; Witterick, Ian; Gentili, Fred; Zadeh, Gelareh; Kucharczyk, Walter; Irish, Jonathan C

2015-01-01

Previous preclinical studies of localized intraoperative virtual endoscopy-image-guided surgery (LIVE-IGS) for skull base surgery suggest a potential clinical benefit. The first aim was to evaluate the registration accuracy of virtual endoscopy based on high-resolution magnetic resonance imaging under clinical conditions. The second aim was to implement and assess real-time proximity alerts for critical structures during skull base drilling. Patients consecutively referred for sinus and skull base surgery were enrolled in this prospective case series. Five patients were used to check registration accuracy and feasibility with the subsequent 11 patients being treated under LIVE-IGS conditions with presentation to the operating surgeon (phase 2). Sixteen skull base patients were endoscopically operated on by using image-based navigation while LIVE-IGS was tested in a clinical setting. Workload was quantitatively assessed using the validated National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire. Real-time localization of the surgical drill was accurate to ~1 to 2 mm in all cases. The use of 3-mm proximity alert zones around the carotid arteries and optic nerve found regular clinical use, as the median minimum distance between the tracked drill and these structures was 1 mm (0.2-3.1 mm) and 0.6 mm (0.2-2.5 mm), respectively. No statistical differences were found in the NASA-TLX indicators for this experienced surgical cohort. Real-time proximity alerts with virtual endoscopic guidance was sufficiently accurate under clinical conditions. Further clinical evaluation is required to evaluate the potential surgical benefits, particularly for less experienced surgeons or for teaching purposes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

On the use and misuse of scalar scores of confounders in design and analysis of observational studies.

PubMed

Pfeiffer, R M; Riedl, R

2015-08-15

We assess the asymptotic bias of estimates of exposure effects conditional on covariates when summary scores of confounders, instead of the confounders themselves, are used to analyze observational data. First, we study regression models for cohort data that are adjusted for summary scores. Second, we derive the asymptotic bias for case-control studies when cases and controls are matched on a summary score, and then analyzed either using conditional logistic regression or by unconditional logistic regression adjusted for the summary score. Two scores, the propensity score (PS) and the disease risk score (DRS) are studied in detail. For cohort analysis, when regression models are adjusted for the PS, the estimated conditional treatment effect is unbiased only for linear models, or at the null for non-linear models. Adjustment of cohort data for DRS yields unbiased estimates only for linear regression; all other estimates of exposure effects are biased. Matching cases and controls on DRS and analyzing them using conditional logistic regression yields unbiased estimates of exposure effect, whereas adjusting for the DRS in unconditional logistic regression yields biased estimates, even under the null hypothesis of no association. Matching cases and controls on the PS yield unbiased estimates only under the null for both conditional and unconditional logistic regression, adjusted for the PS. We study the bias for various confounding scenarios and compare our asymptotic results with those from simulations with limited sample sizes. To create realistic correlations among multiple confounders, we also based simulations on a real dataset. Copyright © 2015 John Wiley & Sons, Ltd.

Adjoint optimization of natural convection problems: differentially heated cavity

NASA Astrophysics Data System (ADS)

Saglietti, Clio; Schlatter, Philipp; Monokrousos, Antonios; Henningson, Dan S.

2017-12-01

Optimization of natural convection-driven flows may provide significant improvements to the performance of cooling devices, but a theoretical investigation of such flows has been rarely done. The present paper illustrates an efficient gradient-based optimization method for analyzing such systems. We consider numerically the natural convection-driven flow in a differentially heated cavity with three Prandtl numbers (Pr=0.15{-}7) at super-critical conditions. All results and implementations were done with the spectral element code Nek5000. The flow is analyzed using linear direct and adjoint computations about a nonlinear base flow, extracting in particular optimal initial conditions using power iteration and the solution of the full adjoint direct eigenproblem. The cost function for both temperature and velocity is based on the kinetic energy and the concept of entransy, which yields a quadratic functional. Results are presented as a function of Prandtl number, time horizons and weights between kinetic energy and entransy. In particular, it is shown that the maximum transient growth is achieved at time horizons on the order of 5 time units for all cases, whereas for larger time horizons the adjoint mode is recovered as optimal initial condition. For smaller time horizons, the influence of the weights leads either to a concentric temperature distribution or to an initial condition pattern that opposes the mean shear and grows according to the Orr mechanism. For specific cases, it could also been shown that the computation of optimal initial conditions leads to a degenerate problem, with a potential loss of symmetry. In these situations, it turns out that any initial condition lying in a specific span of the eigenfunctions will yield exactly the same transient amplification. As a consequence, the power iteration converges very slowly and fails to extract all possible optimal initial conditions. According to the authors' knowledge, this behavior is illustrated here for the first time.

Fostering Teacher Learning Communities: A Case Study of a School-Based Leadership Team's Action Research

ERIC Educational Resources Information Center

Fischer, Kenneth Brian

2013-01-01

The purpose of this study is to examine how a school-based leadership team identifies and alters school conditions to foster the development of TLCs. Many educators, school leaders, and politicians have embraced teacher learning communities (TLCs) as a vehicle for school reform. Despite the considerable documentation of the capability for TLCs to…

Risk of tinnitus in patients with sleep apnea: A nationwide, population-based, case-control study.

PubMed

Koo, Malcolm; Hwang, Juen-Haur

2017-09-01

To investigate the risk of tinnitus in patients with sleep disturbance or sleep apnea. Case control study. We identified 21,798 middle-aged and elderly patients with otolaryngologist-diagnosed tinnitus between January 1, 2000, and December 31, 2012, from the Longitudinal Health Insurance Database 2000 of the Taiwan National Health Insurance Research Database. A total of 108,990 controls were also identified from the same database based on frequency-matching on 10-year age interval, sex, and year of index date of the cases. Diagnoses of sleep disturbance (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] codes 780.50, 780.52, 307.4) and sleep apnea (ICD-9-CM codes 780.51, 780.53, 780.57) in the cases and controls prior to the index date were assessed. The risks of tinnitus in patients with sleep disturbance and sleep apnea were separately evaluated with multivariate logistic regression analyses. The mean age of the total 130,788 patients was 59.8 years, and 47% of them were males. The risk of tinnitus was higher in patients with sleep disturbance compared to those without the condition (adjusted odds ratio [OR] = 1.13, 95% confidence interval [CI] [95% CI] = 1.11-1.17), and the risk of tinnitus was higher in patients with sleep apnea compared to those without the condition (adjusted OR = 1.36, 95% CI = 1.16-1.60). In this population-based, case-control study, the risk of tinnitus was found to be significantly higher among middle-aged and elderly Taiwanese patients with sleep disturbances, especially with sleep apnea. 3b. Laryngoscope, 127:2171-2175, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Collaborative partnership in age-friendly cities: two case studies from Quebec, Canada.

PubMed

Garon, Suzanne; Paris, Mario; Beaulieu, Marie; Veil, Anne; Laliberté, Andréanne

2014-01-01

This article aims to explain the collaborative partnership conditions and factors that foster implementation effectiveness within the age-friendly cities (AFC) in Quebec (AFC-QC), Canada. Based on a community-building approach that emphasizes collaborative partnership, the AFC-QC implementation process is divided into three steps: (1) social diagnostic of older adults' needs; (2) an action plan based on a logic model; and (3) implementation through collaborations. AFC-QC promotes direct involvement of older adults and seniors' associations at each of the three steps of the implementation process, as well as other stakeholders in the community. Based on two contrasting case studies, this article illustrates the importance of collaborative partnership for the success of AFC implementation. Results show that stakeholders, agencies, and organizations are exposed to a new form of governance where coordination and collaborative partnership among members of the steering committee are essential. Furthermore, despite the importance of the senior associations' participation in the process, they encountered significant limits in the capacity of implementing age-friendly environments solely by themselves. In conclusion, we identify the main collaborative partnership conditions and factors in AFC-QC.

Fetal and maternal outcomes in pregnancies complicated with fetal macrosomia.

PubMed

Alsammani, Mohamed Alkahatim; Ahmed, Salah Roshdy

2012-06-01

Fetal macrosomia remains a considerable challenge in current obstetrics due to the fetal and maternal complications associated with this condition. This study was designed to determine the prevalence of fetal macrosomia and associated fetal and maternal morbidity and mortality in the Al Qassim Region of Saudi Arabia. This register-based study was conducted from January 1, 2011 through December 30, 2011 at the Maternity and Child Hospital, Qassim, Saudi Arabia. Macrosomia was defined as birth weight of 4 kg or greater. Malformed babies and those born dead were excluded. The total number of babies delivered was 9241; of these, 418 were macrosomic. Thus, the prevalence of fetal macrosomia was 4.5%. The most common maternal complications were postpartum hemorrhage (5 cases, 1.2%), perineal tear (7 cases, 1.7%), cervical lacerations (3 cases, 0.7%), and shoulder dystocia (40 cases, 9.6%) that resulted in 4 cases of Erb's palsy (0.96%), and 6 cases of bone fractures (1.4%). The rate of cesarean section among women delivering macrosomic babies was 47.6% (199), while 52.4% (219) delivered vaginally. Despite extensive efforts to reduce fetal and maternal complications associated with macrosomia, considerable fetal and maternal morbidity remain associated with this condition.

Attributes of Successful Actions to Restore Lakes and ...

EPA Pesticide Factsheets

As more success is achieved in restoring lakes and estuaries from the impacts of nutrient pollution, there is increased opportunity to evaluate the scientific, social, and policy factors associated with achieving restoration goals. We examined case studies where deliberate actions to reduce nutrient pollution and restore ecosystems resulted in ecological recovery. Prospective cases were identified from scientific literature and technical documents for lakes and estuaries with: (1) scientific evidence of nutrient pollution; (2) restoration actions taken to mitigate nutrient pollution; and (3) documented ecologicalimprovement. Using these criteria, we identified 9 estuaries and 7 lakes spanning countries, climatic regions, physical types, depths, and watershed areas. Among 16 case studies ultimately included, 8 achieved improvements short of stated restoration goals. Five more were successful initially, but condition subsequently declined. Three of the case studies achieved their goals fully and are currently managing to maintain the restored condition. We examined each case to identify both common attributesof nutrient management, grouped into ‘themes’, and variations on those attributes, which were coded into categorical variables based on thorough review of documents associated with each case. The themes and variables were organized into a broad conceptual model illustrating how they relate to each other and to nutrient management outcomes. We then explored

Acceptance of routine or case-based inquiry for intimate partner violence: a mixed method study.

PubMed

Stöckl, Heidi; Hertlein, Linda; Himsl, Isabelle; Ditsch, Nina; Blume, Carolin; Hasbargen, Uwe; Friese, Klaus; Stöckl, Doris

2013-03-26

The prevalence and detrimental health effects of intimate partner violence have resulted in international discussions and recommendations that health care professionals should screen women for intimate partner violence during general and antenatal health care visits. Due to the lack of discussion on routine or case-based inquiry for intimate partner violence during antenatal care in Germany, this study seeks to explore its acceptability among pregnant German women. A mixed methods approach was used, utilizing a self-administered survey on the acceptability of routine or case-based inquiry for intimate partner violence in a university hospital's maternity ward in Munich and in-depth interviews with seven women who experienced violence during pregnancy. Of the 401 women who participated in the survey, 92 percent were in favor of routine or case-based inquiry for intimate partner violence during antenatal care. Acceptance of routine or case-based inquiry for intimate partner violence during antenatal care was significantly associated with women's experiences of child sexual abuse, being young, less educated, single or divorced and smoking during pregnancy. Open-ended survey questions and in-depth interviews stressed adequate training for screening, sufficient time and provision of referral information as important conditions for routine or case-based inquiry for intimate partner violence. Women in this study showed an overwhelming support for routine or case-based screening for intimate partner violence in antenatal care in Germany. Until adequate training is in place to allow providers to inquire for intimate partner violence in a professional manner, this study recommends that health care providers are made aware of the prevalence and health consequences of violence during pregnancy.

Acceptance of routine or case-based inquiry for intimate partner violence: a mixed method study

PubMed Central

2013-01-01

Background The prevalence and detrimental health effects of intimate partner violence have resulted in international discussions and recommendations that health care professionals should screen women for intimate partner violence during general and antenatal health care visits. Due to the lack of discussion on routine or case-based inquiry for intimate partner violence during antenatal care in Germany, this study seeks to explore its acceptability among pregnant German women. Methods A mixed methods approach was used, utilizing a self-administered survey on the acceptability of routine or case-based inquiry for intimate partner violence in a university hospital’s maternity ward in Munich and in-depth interviews with seven women who experienced violence during pregnancy. Results Of the 401 women who participated in the survey, 92 percent were in favor of routine or case-based inquiry for intimate partner violence during antenatal care. Acceptance of routine or case-based inquiry for intimate partner violence during antenatal care was significantly associated with women’s experiences of child sexual abuse, being young, less educated, single or divorced and smoking during pregnancy. Open-ended survey questions and in-depth interviews stressed adequate training for screening, sufficient time and provision of referral information as important conditions for routine or case-based inquiry for intimate partner violence. Conclusions Women in this study showed an overwhelming support for routine or case-based screening for intimate partner violence in antenatal care in Germany. Until adequate training is in place to allow providers to inquire for intimate partner violence in a professional manner, this study recommends that health care providers are made aware of the prevalence and health consequences of violence during pregnancy. PMID:23531127

Impact of traffic oscillations on freeway crash occurrences.

PubMed

Zheng, Zuduo; Ahn, Soyoung; Monsere, Christopher M

2010-03-01

Traffic oscillations are typical features of congested traffic flow that are characterized by recurring decelerations followed by accelerations (stop-and-go driving). The negative environmental impacts of these oscillations are widely accepted, but their impact on traffic safety has been debated. This paper describes the impact of freeway traffic oscillations on traffic safety. This study employs a matched case-control design using high-resolution traffic and crash data from a freeway segment. Traffic conditions prior to each crash were taken as cases, while traffic conditions during the same periods on days without crashes were taken as controls. These were also matched by presence of congestion, geometry and weather. A total of 82 cases and about 80,000 candidate controls were extracted from more than three years of data from 2004 to 2007. Conditional logistic regression models were developed based on the case-control samples. To verify consistency in the results, 20 different sets of controls were randomly extracted from the candidate pool for varying control-case ratios. The results reveal that the standard deviation of speed (thus, oscillations) is a significant variable, with an average odds ratio of about 1.08. This implies that the likelihood of a (rear-end) crash increases by about 8% with an additional unit increase in the standard deviation of speed. The average traffic states prior to crashes were less significant than the speed variations in congestion. Published by Elsevier Ltd.

Heparin-induced thrombocytopenia and heart operation: management with tedelparin.

PubMed

Altés, A; Martino, R; Gari, M; Cámara, M L; Garín, R; Casas, J I; Fontcuberta, J

1995-02-01

Anticoagulation for cardiopulmonary bypass in the infrequent clinical setting of thrombocytopenia associated with the use of unfractionated heparin is a very serious problem. We describe a case in which a low-molecular-weight heparin (tedelparin) was selected for this purpose based on a platelet aggregation test, permitting adequate anticoagulation during cardiopulmonary bypass for valve replacement. This case report might help establish an adequate anticoagulation protocol when faced with a patient suffering from this condition.

Plasma cell gingivitis - A rare case related to Colocasia (arbi) leaves.

PubMed

Bali, Deepika; Gill, Sanjeet; Bali, Amit

2012-09-01

Plasma cell gingivitis is an uncommon inflammatory condition of uncertain etiology often flavoured chewing gum, spices, foods, candies, or dentifrices. The diagnosis of plasma cell gingivitis is based on comprehensive history taking, clinical examination, and appropriate diagnostic tests. Here we are presenting a rare case of plasma cell gingivitis caused by consumption of colocasia (arbi) leaves. Colocasia is a kind of vegetable, very commonly consumed in the regions of North India.

Investigating potential transferability of place-based research in land system science

NASA Astrophysics Data System (ADS)

Václavík, Tomáš; Langerwisch, Fanny; Cotter, Marc; Fick, Johanna; Häuser, Inga; Hotes, Stefan; Kamp, Johannes; Settele, Josef; Spangenberg, Joachim H.; Seppelt, Ralf

2016-09-01

Much of our knowledge about land use and ecosystem services in interrelated social-ecological systems is derived from place-based research. While local and regional case studies provide valuable insights, it is often unclear how relevant this research is beyond the study areas. Drawing generalized conclusions about practical solutions to land management from local observations and formulating hypotheses applicable to other places in the world requires that we identify patterns of land systems that are similar to those represented by the case study. Here, we utilize the previously developed concept of land system archetypes to investigate potential transferability of research from twelve regional projects implemented in a large joint research framework that focus on issues of sustainable land management across four continents. For each project, we characterize its project archetype, i.e. the unique land system based on a synthesis of more than 30 datasets of land-use intensity, environmental conditions and socioeconomic indicators. We estimate the transferability potential of project research by calculating the statistical similarity of locations across the world to the project archetype, assuming higher transferability potentials in locations with similar land system characteristics. Results show that areas with high transferability potentials are typically clustered around project sites but for some case studies can be found in regions that are geographically distant, especially when values of considered variables are close to the global mean or where the project archetype is driven by large-scale environmental or socioeconomic conditions. Using specific examples from the local case studies, we highlight the merit of our approach and discuss the differences between local realities and information captured in global datasets. The proposed method provides a blueprint for large research programs to assess potential transferability of place-based studies to other geographical areas and to indicate possible gaps in research efforts.

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.

Demographic and spatio-temporal distribution of cutaneous leishmaniasis in the Souf oasis (Eastern South of Algeria): Results of 13 years.

PubMed

Khezzani, Bachir; Bouchemal, Salah

2017-02-01

Cutaneous leishmaniasis is one of many dangerous parasitic diseases. It remains a serious public health problem not only in Souf oasis, but also in Algeria and all developing countries. The results of our thirteen-year study shows a recording of 4813 confirmed cases of cutaneous leishmaniasis and the details shows that this disease affects all municipalities and all age groups, from infants to elderly, but the most affected ones are teenagers aging (10-19) years with 1512 cases (31.41%) and infants less than 9 years old with 1237 cases (25.70%). In addition, males are more prone to this disease than females (65% and 35% respectively). Among the 18 municipalities in the Souf, the most affected were El-Oued with 1171 cases (24.33%) followed by Guemar with 997 cases (20.71%). Furthermore, more than 40.03% of all cases (1927 cases), were record just in one year in 2010. A parallel, this study shows that the original factors of the studied area, such as climatological, agricultural and environmental factors, was the reason do not apparition this epidemic for a long time, but the changes in these conditions, resulting from various human activities create new environmental conditions, which help with the emergence and spread of leishmaniasis disease. The effective fight against this disease should be based on the elimination of the vectors and reservoirs populations, by the overall improvement of sanitary conditions and hygiene, extensive research in epidemiology of leishmaniasis could also reduce the incidence of cutaneous leishmaniasis. Copyright © 2016 Elsevier B.V. All rights reserved.

Potentially preventable dental care in operating rooms for children enrolled in Medicaid.

PubMed

Bruen, Brian K; Steinmetz, Erika; Bysshe, Tyler; Glassman, Paul; Ku, Leighton

2016-09-01

In this study, the authors examined the prevalence and cost of care for children enrolled in Medicaid for potentially preventable dental conditions who receive surgical care in hospital operating rooms (ORs) or ambulatory surgery centers (ASCs). The authors analyzed Medicaid data from 8 states to find cases in which children aged 1 to 20 years received surgical care in ORs or ASCs in 2010 and 2011 for potentially preventable diagnoses, as defined with diagnostic codes. For 6 states with complete data, there were 26,373 cases in 2011 in which children received OR or ASC surgical care for potentially preventable conditions. These cases represent approximately 0.5% of all children enrolled in Medicaid in these states and approximately 1% of children enrolled in Medicaid who received any dental care. There were $68 million in total Medicaid payments for these cases, with an average of $2,581 per case. Diagnostic codes indicated that 98% of cases were related to treatment of dental caries. More than two-thirds of the cases (71%) were children aged 1 to 5 years. Extrapolation to the United States suggests that approximately $450 million in additional expenditures occurred in 2011 because of OR or ASC surgical care for potentially preventable pediatric dental conditions, primarily related to early childhood caries. Strategies to improve prevention of early childhood caries, including community- and family-based education, and to increase access to timely and early dental care for low-income children could reduce the burdens and costs of these dental problems. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Socioeconomic conditions among long-term gynaecological cancer survivors--a population-based case-control study.

PubMed

Platou, Toril Forbord; Skjeldestad, Finn Egil; Rannestad, Toril

2010-03-01

The population of gynaecological cancer survivors is growing, yet little is known about the effects of cancer and treatment on socioeconomic conditions well beyond the completion of therapy. The aim of this study was to investigate the socioeconomic conditions in long-term survivors of gynaecological cancer compared with a representative group of women from the general population. The study comprises women aged 32-75 residing in central part of Norway and who were treated as primary cases of gynaecological cancer at the University Hospital in Trondheim, Norway (n=160), and a control group from the general population (n=493). All analyses were done by chi(2) test and logistic regression. Gynaecological cancer survivors scored lower on a Socioeconomic Condition Index than the control group. They had on the average a complete remission period of 12 years. Compared with the control group, they were more often disabled (p<0.01) and had lower annual household income (p<0.01). No difference was detected between the groups in ability to pay bills. More cases than controls had experienced problems assigning personal insurance (p<0.03). Long-term gynaecological cancer survivors lived under poorer socioeconomic conditions, were more often disabled and had lower annual household income than the women in the control group, whereas no difference in ability to pay bills were found between the groups. In spite of poorer socioeconomic conditions, the gynaecological cancer survivors seem to adapt well to their financial situation.

Comparing Single Case Design Overlap-Based Effect Size Metrics From Studies Examining Speech Generating Device Interventions

PubMed Central

Chen, Mo; Hyppa-Martin, Jolene K.; Reichle, Joe E.; Symons, Frank J.

2017-01-01

Meaningfully synthesizing single case experimental data from intervention studies comprised of individuals with low incidence conditions and generating effect size estimates remains challenging. Seven effect size metrics were compared for single case design (SCD) data focused on teaching speech generating device use to individuals with intellectual and developmental disabilities (IDD) with moderate to profound levels of impairment. The effect size metrics included percent of data points exceeding the median (PEM), percent of nonoverlapping data (PND), improvement rate difference (IRD), percent of all nonoverlapping data (PAND), Phi, nonoverlap of all pairs (NAP), and Taunovlap. Results showed that among the seven effect size metrics, PAND, Phi, IRD, and PND were more effective in quantifying intervention effects for the data sample (N = 285 phase or condition contrasts). Results are discussed with respect to issues concerning extracting and calculating effect sizes, visual analysis, and SCD intervention research in IDD. PMID:27119210

Clinical decision-making by midwives: managing case complexity.

PubMed

Cioffi, J; Markham, R

1997-02-01

In making clinical judgements, it is argued that midwives use 'shortcuts' or heuristics based on estimated probabilities to simplify the decision-making task. Midwives (n = 30) were given simulated patient assessment situations of high and low complexity and were required to think aloud. Analysis of verbal protocols showed that subjective probability judgements (heuristics) were used more frequently in the high than low complexity case and predominated in the last quarter of the assessment period for the high complexity case. 'Representativeness' was identified more frequently in the high than in the low case, but was the dominant heuristic in both. Reports completed after each simulation suggest that heuristics based on memory for particular conditions affect decisions. It is concluded that midwives use heuristics, derived mainly from their clinical experiences, in an attempt to save cognitive effort and to facilitate reasonably accurate decisions in the decision-making process.

Strategy community development based on local resources

NASA Astrophysics Data System (ADS)

Meirinawati; Prabawati, I.; Pradana, G. W.

2018-01-01

The problem of progressing regions is not far from economic problems and is often caused by the inability of the regions in response to changes in economic conditions that occur, so the need for community development programs implemented to solve various problems. Improved community effort required with the real conditions and needs of each region. Community development based on local resources process is very important, because it is an increase in human resource capability in the optimal utilization of local resource potential. In this case a strategy is needed in community development based on local resources. The community development strategy are as follows:(1) “Eight Line Equalization Plus” which explains the urgency of rural industrialization, (2) the construction of the village will be more successful when combining strategies are tailored to regional conditions, (3) the escort are positioning themselves as the Planner, supervisor, information giver, motivator, facilitator, connecting at once evaluators.

Global Artificial Boundary Conditions for Computation of External Flow Problems with Propulsive Jets

NASA Technical Reports Server (NTRS)

Tsynkov, Semyon; Abarbanel, Saul; Nordstrom, Jan; Ryabenkii, Viktor; Vatsa, Veer

1998-01-01

We propose new global artificial boundary conditions (ABC's) for computation of flows with propulsive jets. The algorithm is based on application of the difference potentials method (DPM). Previously, similar boundary conditions have been implemented for calculation of external compressible viscous flows around finite bodies. The proposed modification substantially extends the applicability range of the DPM-based algorithm. In the paper, we present the general formulation of the problem, describe our numerical methodology, and discuss the corresponding computational results. The particular configuration that we analyze is a slender three-dimensional body with boat-tail geometry and supersonic jet exhaust in a subsonic external flow under zero angle of attack. Similarly to the results obtained earlier for the flows around airfoils and wings, current results for the jet flow case corroborate the superiority of the DPM-based ABC's over standard local methodologies from the standpoints of accuracy, overall numerical performance, and robustness.

Electronic-projecting Moire method applying CBR-technology

NASA Astrophysics Data System (ADS)

Kuzyakov, O. N.; Lapteva, U. V.; Andreeva, M. A.

2018-01-01

Electronic-projecting method based on Moire effect for examining surface topology is suggested. Conditions of forming Moire fringes and their parameters’ dependence on reference parameters of object and virtual grids are analyzed. Control system structure and decision-making subsystem are elaborated. Subsystem execution includes CBR-technology, based on applying case base. The approach related to analysing and forming decision for each separate local area with consequent formation of common topology map is applied.

Dynamic properties of hot-wire anemometric measurement circuits in the aspect of measurements in mine conditions / Właściwości dynamiczne termoanemometrycznych układów pomiarowych w aspekcie pomiarów w warunkach kopalnianych

NASA Astrophysics Data System (ADS)

Jamróz, Paweł; Ligęza, Paweł; Socha, Katarzyna

2012-12-01

The use of measurement apparatus under conditions which differ significantly from those under which the apparatus was adjusted carries the risk of altering the previously determined measurement characteristics. This is of special concern in the case of apparatus which is sensitive to external measurement conditions. Advanced measurement systems are equipped with algorithms which allow the negative effect of unstable environmental conditions on their static characteristics to be compensated for. Meanwhile, the problem of altered dynamic properties of such systems is often neglected. This paper presents a model study in which the effect of variable operational conditions on dynamic response of hot-wire anemometric measurement system in the case of simulated mine flows was investigated. A mathematical model of measurement system able to compensate the negative effect of changes in flow velocity and configuration of measurement apparatus itself on its dynamic properties was developed and investigated. Based on conducted experiments, we have developed an automatic regulation algorithm enabling the transmission band of measurement apparatus to be optimized for measurement conditions prevailing in mine environment.

Prescription-event monitoring: developments in signal detection.

PubMed

Ferreira, Germano

2007-01-01

Prescription-event monitoring (PEM) is a non-interventional intensive method for post-marketing drug safety monitoring of newly licensed medicines. PEM studies are cohort studies where exposure is obtained from a centralised service and outcomes from simple questionnaires completed by general practitioners. Follow-up forms are sent for selected events. Because PEM captures all events and not only the suspected adverse drug reactions, PEM cohorts potentially differ in respect to the distribution of number of events per person depending on the nature of the drug under study. This variance can be related either with the condition for which the drug is prescribed (e.g. a condition causing high morbidity will have, in average, a higher number of events per person compared with a condition with lower morbidity) or with the drug effect itself. This paper describes an exploratory investigation of the distortion caused by product-related variations of the number of events to the interpretation of the proportional reporting ratio (PRR) values ("the higher the PRR, the greater the strength of the signal") computed using drug-cohort data. We studied this effect by assessing the agreement between the PRR based on events (event of interest vs all other events) and PRR based on cases (cases with the event of interest vs cases with any other events). PRR were calculated for all combinations reported to ten selected drugs against a comparator of 81 other drugs. Three of the ten drugs had a cohort with an apparent higher proportion of patients with lower number of events. The PRRs based on events were systematically higher than the PRR based on cases for the combinations reported to these three drugs. Additionally, when applying the threshold criteria for signal screening (n > or =3, PRR > or =1.5 and Chi-squared > or =4), the binary agreement was generally high but apparently lower for these three drugs. In conclusion, the distribution of events per patient in drug cohorts shall be examined when comparing the 'strength of the signals' across drugs using PRR values. Further research will be required to address the sensitivity and specificity of the two ways of calculating PRR using data derived from drug cohorts.

An assessment of envelope-based demodulation in case of proximity of carrier and modulation frequencies

NASA Astrophysics Data System (ADS)

Shahriar, Md Rifat; Borghesani, Pietro; Randall, R. B.; Tan, Andy C. C.

2017-11-01

Demodulation is a necessary step in the field of diagnostics to reveal faults whose signatures appear as an amplitude and/or frequency modulation. The Hilbert transform has conventionally been used for the calculation of the analytic signal required in the demodulation process. However, the carrier and modulation frequencies must meet the conditions set by the Bedrosian identity for the Hilbert transform to be applicable for demodulation. This condition, basically requiring the carrier frequency to be sufficiently higher than the frequency of the modulation harmonics, is usually satisfied in many traditional diagnostic applications (e.g. vibration analysis of gear and bearing faults) due to the order-of-magnitude ratio between the carrier and modulation frequency. However, the diversification of the diagnostic approaches and applications shows cases (e.g. electrical signature analysis-based diagnostics) where the carrier frequency is in close proximity to the modulation frequency, thus challenging the applicability of the Bedrosian theorem. This work presents an analytic study to quantify the error introduced by the Hilbert transform-based demodulation when the Bedrosian identity is not satisfied and proposes a mitigation strategy to combat the error. An experimental study is also carried out to verify the analytical results. The outcome of the error analysis sets a confidence limit on the estimated modulation (both shape and magnitude) achieved through the Hilbert transform-based demodulation in case of violated Bedrosian theorem. However, the proposed mitigation strategy is found effective in combating the demodulation error aroused in this scenario, thus extending applicability of the Hilbert transform-based demodulation.

14 CFR 67.209 - Neurologic.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Neurologic. 67.209 Section 67.209... STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.209 Neurologic. Neurologic... neurologic condition that the Federal Air Surgeon, based on the case history and appropriate, qualified...

14 CFR 67.209 - Neurologic.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Neurologic. 67.209 Section 67.209... STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.209 Neurologic. Neurologic... neurologic condition that the Federal Air Surgeon, based on the case history and appropriate, qualified...

A case of coffee-ground emesis in an elderly patient

PubMed Central

De Palma, Giovanni D; Persico, Marcello; Forestieri, Pietro

2014-01-01

Key Clinical Message Black esophagus is an exceeding rare disorder with a multifactorial etiology. Clinical presentation is generally related to upper gastrointestinal bleeding. Diagnosis is based on endoscopic images. Overall mortality is largely related to the underlying medical condition. PMID:25356232

Optimization of the cultivation conditions for mushroom production with European wild strains of Agaricus subrufescens and Brazilian cultivars.

PubMed

Llarena-Hernández, Carlos R; Largeteau, Michèle L; Ferrer, Nathalie; Regnault-Roger, Catherine; Savoie, Jean-Michel

2014-01-15

The almond mushroom Agaricus subrufescens (formerly Agaricus blazei or Agaricus brasiliensis) is cultivated at commercial level in Brazil and some Asian countries on local substrates and casing mixtures. Despite its tropical origin, A. subrufescens might be a seasonal option for mushroom growers in western countries, where some wild strains have been isolated. For this purpose, cultivation conditions were developed starting from the substrate and casing mixture commonly used for commercial production of the button mushroom Agaricus bisporus in France. The commercial compost, based on wheat straw and horse manure, used for A. bisporus and the casing mixture (peat and limestone) supplemented with fine sand proved efficient to grow A. subrufescens. Increasing the depth of the casing layer improved significantly the yield and time to fruiting. Daily variations in temperature did not markedly modify the yield. Significantly higher mushroom biomass was obtained with three wild European strains compared with three Brazilian cultivars. The very productive wild strain CA438-A gave mushrooms of size and dry matter content comparable to those of a cultivar. Commercial production of A. subrufescens can be developed in western countries on the wheat straw-based substrate commonly used for A. bisporus in these regions, by a simple modification of the casing mixture and maintaining the incubation temperature throughout the crop, which is expected to save energy during summer. Good yields were obtained cultivating European strains under optimised parameters. © 2013 Society of Chemical Industry.

A population-based study on the association between chronic periodontitis and sialolithiasis.

PubMed

Hung, Shih-Han; Huang, Hung-Meng; Lee, Hsin-Chien; Ching Lin, Herng; Kao, Li-Ting; Wu, Chuan-Song

2016-04-01

Whereas the impression that poor oral hygiene is linked to the development of sialolithiasis may be widely accepted, very few studies provide evidence to support this. This study therefore aimed to evaluate the association between chronic periodontitis (CP) and the subsequent development of salivary gland stone based on a nationwide coverage database. A case-control study. A total of 987 subjects with sialolithiasis were included as cases. In a ratio of five controls per case, 4,935 controls matched in terms of sex and age group were selected. Conditional logistic regression analysis was performed to determine the possible association of sialolithiasis with previously diagnosed CP. The prevalence of prior CP between cases and controls demonstrated that 1,831 (30.9%) out of the 5,922 sampled subjects had prior CP. By Chi-square test, there was a significant difference in the prevalence of prior CP between the cases and controls (36.8% vs. 29.7%, P < 0.001). By conditional logistic regression analysis, the odds ratio (OR) of prior CP for cases was 1.37 (95% confidence interval [CI], 1.19-1.56) compared to the controls after adjusting for geographic location and tobacco use. Further analyzing the relationship between sialolithiasis and prior CP according to sex, sialolithiasis was associated with prior CP regardless of sex. The adjusted OR of prior CP for the cases was 1.34 (95% CI, 1.10-1.64) and 1.41 (95% CI, 1.15-1.73) for males and females, respectively, when compared to controls. This study demonstrates an association between CP and sialolithiasis. 3b. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

"Dis-able bodied" or "dis-able minded": stakeholders' return-to-work experiences compared between physical and mental health conditions.

PubMed

Vossen, Emmie; Van Gestel, Nicolette; Van der Heijden, Beatrice I J M; Rouwette, Etiënne A J A

2017-05-01

This study aimed to explore if and why the return-to-work (RTW) experiences of various workplace stakeholders in the Netherlands and Denmark differ between physical and mental health conditions, and to understand the consequences of potentially different experiences for the RTW process in both health conditions. We studied 21 cases of long-term sickness absence, and held a total of 61 semi-structured interviews with the various actors involved in these cases. Physical cases were seen as "easy" and mental cases as "difficult" to manage, based on the visibility and predictability of health complaints. On this ground, assessing work ability and following required RTW actions were perceived as more urgent in mental than in physical cases. Despite these perceptions, in practice, the assessment of work ability seemed to impair the RTW process in mental cases (but not in physical ones), and the (non-)uptake of RTW actions appeared to have similar results in both mental and physical cases. With these outcomes, the effectiveness of a differential approach is questioned, and the relevance of a bidirectional dialog on work ability and a phased RTW plan is highlighted, regardless of the absence cause. Our study also demonstrates how policymakers need to strike a balance between obligatory and permissive legislation to better involve workplaces in RTW issues. Implications for rehabilitation Both physically and mentally sick-listed employees could benefit from a bidirectional dialog on work ability as well as from a phased RTW plan. A greater role for employers in the RTW process should be accompanied with a support for sick-listed employees, in both physical and mental sickness absence cases. Dutch and Danish RTW legislation could be improved by carefully balancing obligatory and permissive rules and regulations to involve workplaces in RTW matters.

Concept design and coupled dynamic response analysis on 6-MW spar-type floating offshore wind turbine

NASA Astrophysics Data System (ADS)

Meng, Long; Zhou, Tao; He, Yan-ping; Zhao, Yong-sheng; Liu, Ya-dong

2017-10-01

Tower, Spar platform and mooring system are designed in the project based on a given 6-MW wind turbine. Under wind-induced only, wave-induced only and combined wind and wave induced loads, dynamic response is analyzed for a 6-MW Spar-type floating offshore wind turbine (FOWT) under operating conditions and parked conditions respectively. Comparison with a platform-fixed system (land-based system) of a 6-MW wind turbine is carried out as well. Results demonstrate that the maximal out-of-plane deflection of the blade of a Spar-type system is 3.1% larger than that of a land-based system; the maximum response value of the nacelle acceleration is 215% larger for all the designed load cases being considered; the ultimate tower base fore-aft bending moment of the Spar-type system is 92% larger than that of the land-based system in all of the Design Load Cases (DLCs) being considered; the fluctuations of the mooring tension is mainly wave-induced, and the safety factor of the mooring tension is adequate for the 6-MW FOWT. The results can provide relevant modifications to the initial design for the Spar-type system, the detailed design and model basin test of the 6-MW Spar-type system.

Temporal uncertainty analysis of human errors based on interrelationships among multiple factors: a case of Minuteman III missile accident.

PubMed

Rong, Hao; Tian, Jin; Zhao, Tingdi

2016-01-01

In traditional approaches of human reliability assessment (HRA), the definition of the error producing conditions (EPCs) and the supporting guidance are such that some of the conditions (especially organizational or managerial conditions) can hardly be included, and thus the analysis is burdened with incomprehensiveness without reflecting the temporal trend of human reliability. A method based on system dynamics (SD), which highlights interrelationships among technical and organizational aspects that may contribute to human errors, is presented to facilitate quantitatively estimating the human error probability (HEP) and its related variables changing over time in a long period. Taking the Minuteman III missile accident in 2008 as a case, the proposed HRA method is applied to assess HEP during missile operations over 50 years by analyzing the interactions among the variables involved in human-related risks; also the critical factors are determined in terms of impact that the variables have on risks in different time periods. It is indicated that both technical and organizational aspects should be focused on to minimize human errors in a long run. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Thirteen -weeks ovarian pregnancy following in vitro fertilization for primary infertility treatment: A case report.

PubMed

Ashrafganjoei, Tahereh; Nemati Honar, Behzad; Defaee, Sara

2014-11-01

Ovarian pregnancy constitutes 0.15-3% of all ectopic pregnancies. The incidence of ectopic pregnancy is on the rise owing to evolution in assisted reproductive techniques (ART). The incidence reported following In vitro fertilization (IVF) or embryo transfer (ET) is 0.27% per clinical pregnancy. We present a case of a 13-weeks ovarian pregnancy following IVF-ET and through a review of the literature, the specific symptomatology, diagnostic criteria, and treatment of this particular pathology will be described. Ovarian pregnancy is a rare condition and its diagnosis is difficult and relies on criteria based on intraoperative and histopathological findings. The management is, in spite of medical improvement, based on surgery. But the trend has shifted towards conservative surgeries in majority of cases.

Variability in CT lung-nodule quantification: Effects of dose reduction and reconstruction methods on density and texture based features.

PubMed

Lo, P; Young, S; Kim, H J; Brown, M S; McNitt-Gray, M F

2016-08-01

To investigate the effects of dose level and reconstruction method on density and texture based features computed from CT lung nodules. This study had two major components. In the first component, a uniform water phantom was scanned at three dose levels and images were reconstructed using four conventional filtered backprojection (FBP) and four iterative reconstruction (IR) methods for a total of 24 different combinations of acquisition and reconstruction conditions. In the second component, raw projection (sinogram) data were obtained for 33 lung nodules from patients scanned as a part of their clinical practice, where low dose acquisitions were simulated by adding noise to sinograms acquired at clinical dose levels (a total of four dose levels) and reconstructed using one FBP kernel and two IR kernels for a total of 12 conditions. For the water phantom, spherical regions of interest (ROIs) were created at multiple locations within the water phantom on one reference image obtained at a reference condition. For the lung nodule cases, the ROI of each nodule was contoured semiautomatically (with manual editing) from images obtained at a reference condition. All ROIs were applied to their corresponding images reconstructed at different conditions. For 17 of the nodule cases, repeat contours were performed to assess repeatability. Histogram (eight features) and gray level co-occurrence matrix (GLCM) based texture features (34 features) were computed for all ROIs. For the lung nodule cases, the reference condition was selected to be 100% of clinical dose with FBP reconstruction using the B45f kernel; feature values calculated from other conditions were compared to this reference condition. A measure was introduced, which the authors refer to as Q, to assess the stability of features across different conditions, which is defined as the ratio of reproducibility (across conditions) to repeatability (across repeat contours) of each feature. The water phantom results demonstrated substantial variability among feature values calculated across conditions, with the exception of histogram mean. Features calculated from lung nodules demonstrated similar results with histogram mean as the most robust feature (Q ≤ 1), having a mean and standard deviation Q of 0.37 and 0.22, respectively. Surprisingly, histogram standard deviation and variance features were also quite robust. Some GLCM features were also quite robust across conditions, namely, diff. variance, sum variance, sum average, variance, and mean. Except for histogram mean, all features have a Q of larger than one in at least one of the 3% dose level conditions. As expected, the histogram mean is the most robust feature in their study. The effects of acquisition and reconstruction conditions on GLCM features vary widely, though trending toward features involving summation of product between intensities and probabilities being more robust, barring a few exceptions. Overall, care should be taken into account for variation in density and texture features if a variety of dose and reconstruction conditions are used for the quantification of lung nodules in CT, otherwise changes in quantification results may be more reflective of changes due to acquisition and reconstruction conditions than in the nodule itself.

Computer aided fixture design - A case based approach

NASA Astrophysics Data System (ADS)

Tanji, Shekhar; Raiker, Saiesh; Mathew, Arun Tom

2017-11-01

Automated fixture design plays important role in process planning and integration of CAD and CAM. An automated fixture setup design system is developed where when fixturing surfaces and points are described allowing modular fixture components to get automatically select for generating fixture units and placed into position with satisfying assembled conditions. In past, various knowledge based system have been developed to implement CAFD in practice. In this paper, to obtain an acceptable automated machining fixture design, a case-based reasoning method with developed retrieval system is proposed. Visual Basic (VB) programming language is used in integrating with SolidWorks API (Application programming interface) module for better retrieval procedure reducing computational time. These properties are incorporated in numerical simulation to determine the best fit for practical use.

Use of chaos theory and complex systems modeling to study alcohol effects on fetal condition.

PubMed

Mehl, L E; Manchanda, S

1993-10-01

A systems dynamics computer model to predict birth complications for individual pregnant woman was developed from prospectively conducted data on a database of 125 pregnant women. The model is based upon nonlinear mathematics derived from the study of chaos and complex systems. The model was then tested prospectively on 27 additional pregnant women, making predictions on their level of obstetrical risk. The model was refined until it correctly predicted the outcomes of all 125 cases in the development database. Prediction was made with an accuracy of 25/27 cases for the prospective test cases. Predictions were made for fetal condition at birth, presence or absence of operative delivery, and presence or absence of uterine dysfunction. Then the model was used to explore alcohol use during pregnancy. A reasonable spread of alcohol use existed among subjects, allowing consideration of alcohol effects. Alcohol was found to have differential effects on fetal condition at birth depending upon the presence or absence of high levels of psychosocial stress and the use of other substances. In all cases, the effect of alcohol was only evident after the 10 drinks per week level was reached. For the high-stress/one other substance group, there could be an 18-fold effect on fetal condition at birth. For the low-stress/one other substance group, the effect was only 3-fold, and for the alcohol alone group, the effect was negligible.

Deep ECGNet: An Optimal Deep Learning Framework for Monitoring Mental Stress Using Ultra Short-Term ECG Signals.

PubMed

Hwang, Bosun; You, Jiwoo; Vaessen, Thomas; Myin-Germeys, Inez; Park, Cheolsoo; Zhang, Byoung-Tak

2018-02-08

Stress recognition using electrocardiogram (ECG) signals requires the intractable long-term heart rate variability (HRV) parameter extraction process. This study proposes a novel deep learning framework to recognize the stressful states, the Deep ECGNet, using ultra short-term raw ECG signals without any feature engineering methods. The Deep ECGNet was developed through various experiments and analysis of ECG waveforms. We proposed the optimal recurrent and convolutional neural networks architecture, and also the optimal convolution filter length (related to the P, Q, R, S, and T wave durations of ECG) and pooling length (related to the heart beat period) based on the optimization experiments and analysis on the waveform characteristics of ECG signals. The experiments were also conducted with conventional methods using HRV parameters and frequency features as a benchmark test. The data used in this study were obtained from Kwangwoon University in Korea (13 subjects, Case 1) and KU Leuven University in Belgium (9 subjects, Case 2). Experiments were designed according to various experimental protocols to elicit stressful conditions. The proposed framework to recognize stress conditions, the Deep ECGNet, outperformed the conventional approaches with the highest accuracy of 87.39% for Case 1 and 73.96% for Case 2, respectively, that is, 16.22% and 10.98% improvements compared with those of the conventional HRV method. We proposed an optimal deep learning architecture and its parameters for stress recognition, and the theoretical consideration on how to design the deep learning structure based on the periodic patterns of the raw ECG data. Experimental results in this study have proved that the proposed deep learning model, the Deep ECGNet, is an optimal structure to recognize the stress conditions using ultra short-term ECG data.

Designing field-controllable graphene-dot-graphene single molecule switches: A quantum-theoretical proof-of-concept under realistic operating conditions

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

Pejov, Ljupčo, E-mail: ljupcop@pmf.ukim.mk; Petreska, Irina; Kocarev, Ljupčo

2015-12-28

A theoretical proof of the concept that a particularly designed graphene-based moletronics device, constituted by two semi-infinite graphene subunits, acting as source and drain electrodes, and a central benzenoid ring rotator (a “quantum dot”), could act as a field-controllable molecular switch is outlined and analyzed with the density functional theory approach. Besides the ideal (0 K) case, we also consider the operation of such a device under realistic operating (i.e., finite-temperature) conditions. An in-depth insight into the physics behind device controllability by an external field was gained by thorough analyses of the torsional potential of the dot under various conditionsmore » (absence or presence of an external gating field with varying strength), computing the torsional correlation time and transition probabilities within the Bloembergen-Purcell-Pound formalism. Both classical and quantum mechanical tunneling contributions to the intramolecular rotation were considered in the model. The main idea that we put forward in the present study is that intramolecular rotors can be controlled by the gating field even in cases when these groups do not possess a permanent dipole moment (as in cases considered previously by us [I. Petreska et al., J. Chem. Phys. 134, 014708-1–014708-12 (2011)] and also by other groups [P. E. Kornilovitch et al., Phys. Rev. B 66, 245413-1–245413-7 (2002)]). Consequently, one can control the molecular switching properties by an external electrostatic field utilizing even nonpolar intramolecular rotors (i.e., in a more general case than those considered so far). Molecular admittance of the currently considered graphene-based molecular switch under various conditions is analyzed employing non-equilibrium Green’s function formalism, as well as by analysis of frontier molecular orbitals’ behavior.« less

Assessing rear-end collision risk of cars and heavy vehicles on freeways using a surrogate safety measure.

PubMed

Zhao, Peibo; Lee, Chris

2018-04-01

This study analyzes rear-end collision risk of cars and heavy vehicles on freeways using a surrogate safety measure. The crash potential index (CPI) was modified to reflect driver's reaction time and estimated by types of lead and following vehicles (car or heavy vehicle). CPIs were estimated using the individual vehicle trajectory data from a segment of the US-101 freeway in Los Angeles, U.S.A. It was found that the CPI was generally higher for the following heavy vehicle than the following car due to heavy vehicle's lower braking capability. This study also validates the CPI using the simulated traffic data which replicate the observed traffic conditions a few minutes before the crash time upstream and downstream of the crash locations. The observed data were obtained from crash records and loop detectors on a section of the Gardiner Expressway in Toronto, Canada. The result shows that the values of CPI were consistently higher during the traffic conditions immediately before the crash time (crash case) than the normal traffic conditions (non-crash case). This demonstrates that the CPI can be used to capture rear-end collision risk during car-following maneuver on freeways. The result also shows that rear-end collision risk is lower for heavy vehicles than cars in the crash case due to their shorter reaction time and lower speed when spacing is shorter. Thus, it is important to reflect the differences in driver behavior and vehicle performance characteristics between cars and heavy vehicles in estimating surrogate safety measures. Lastly, it was found that the CPI-based crash prediction model can correctly identify the crash and non-crash cases at higher accuracy than the other crash prediction models based on detectors. Copyright © 2018 Elsevier Ltd. All rights reserved.

Risk of multiple myeloma following medication use and medical conditions: a case-control study in Connecticut women.

PubMed

Landgren, Ola; Zhang, Yawei; Zahm, Sheila Hoar; Inskip, Peter; Zheng, Tongzhang; Baris, Dalsu

2006-12-01

Certain commonly used drugs and medical conditions characterized by chronic immune dysfunction and/or antigen stimulation have been suggested to affect important pathways in multiple myeloma tumor cell growth and survival. We conducted a population-based case-control study to investigate the role of medical history in the etiology of multiple myeloma among Connecticut women. A total of 179 incident multiple myeloma cases (21-84 years, diagnosed 1996-2002) and 691 population-based controls was included in this study. Information on medical conditions, medications, and medical radiation was obtained by in-person interviews. We calculated odds ratios (OR) as measures of relative risks using logistic regression models. A reduced multiple myeloma risk was found among women who had used antilipid statin therapy [OR, 0.4; 95% confidence interval (95% CI), 0.2-0.8] or estrogen replacement therapy (OR, 0.6; 95% CI, 0.4-0.99) or who had a medical history of allergy (OR, 0.4; 95% CI, 0.3-0.7), scarlet fever (OR, 0.5; 95% CI, 0.2-0.9), or bursitis (OR, 0.4; 95% CI, 0.2-0.7). An increased risk of multiple myeloma was found among women who used prednisone (OR, 5.1; 95% CI, 1.8-14.4), insulin (OR, 3.1; 95% CI, 1.1-9.0), or gout medication (OR, 6.7; 95% CI, 1.2-38.0). If our results are confirmed, mechanistic studies examining how prior use of insulin, prednisone, and, perhaps, gout medication might promote increased occurrence of multiple myeloma and how antilipid statins, estrogen replacement therapy, and certain medical conditions might protect against multiple myeloma may provide insights to the as yet unknown etiology of multiple myeloma.

Effects of a risk-based online mammography intervention on accuracy of perceived risk and mammography intentions.

PubMed

Seitz, Holli H; Gibson, Laura; Skubisz, Christine; Forquer, Heather; Mello, Susan; Schapira, Marilyn M; Armstrong, Katrina; Cappella, Joseph N

2016-10-01

This experiment tested the effects of an individualized risk-based online mammography decision intervention. The intervention employs exemplification theory and the Elaboration Likelihood Model of persuasion to improve the match between breast cancer risk and mammography intentions. 2918 women ages 35-49 were stratified into two levels of 10-year breast cancer risk (<1.5%; ≥1.5%) then randomly assigned to one of eight conditions: two comparison conditions and six risk-based intervention conditions that varied according to a 2 (amount of content: brief vs. extended) x 3 (format: expository vs. untailored exemplar [example case] vs. tailored exemplar) design. Outcomes included mammography intentions and accuracy of perceived breast cancer risk. Risk-based intervention conditions improved the match between objective risk estimates and perceived risk, especially for high-numeracy women with a 10-year breast cancer risk ≤1.5%. For women with a risk≤1.5%, exemplars improved accuracy of perceived risk and all risk-based interventions increased intentions to wait until age 50 to screen. A risk-based mammography intervention improved accuracy of perceived risk and the match between objective risk estimates and mammography intentions. Interventions could be applied in online or clinical settings to help women understand risk and make mammography decisions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effects of a Risk-based Online Mammography Intervention on Accuracy of Perceived Risk and Mammography Intentions

PubMed Central

Seitz, Holli H.; Gibson, Laura; Skubisz, Christine; Forquer, Heather; Mello, Susan; Schapira, Marilyn M.; Armstrong, Katrina; Cappella, Joseph N.

2016-01-01

Objective This experiment tested the effects of an individualized risk-based online mammography decision intervention. The intervention employs exemplification theory and the Elaboration Likelihood Model of persuasion to improve the match between breast cancer risk and mammography intentions. Methods 2,918 women ages 35-49 were stratified into two levels of 10-year breast cancer risk (< 1.5%; ≥ 1.5%) then randomly assigned to one of eight conditions: two comparison conditions and six risk-based intervention conditions that varied according to a 2 (amount of content: brief vs. extended) × 3 (format: expository vs. untailored exemplar [example case] vs. tailored exemplar) design. Outcomes included mammography intentions and accuracy of perceived breast cancer risk. Results Risk-based intervention conditions improved the match between objective risk estimates and perceived risk, especially for high-numeracy women with a 10-year breast cancer risk <1.5%. For women with a risk < 1.5%, exemplars improved accuracy of perceived risk and all risk-based interventions increased intentions to wait until age 50 to screen. Conclusion A risk-based mammography intervention improved accuracy of perceived risk and the match between objective risk estimates and mammography intentions. Practice Implications Interventions could be applied in online or clinical settings to help women understand risk and make mammography decisions. PMID:27178707

Reply to comment by X. X. Zhang et al. on "Three-dimensional quantification of soil hydraulic properties using X-ray computed tomography and image-based modeling"

NASA Astrophysics Data System (ADS)

Tracy, Saoirse R.; Daly, Keith R.; Sturrock, Craig J.; Crout, Neil M. J.; Mooney, Sacha J.; Roose, Tiina

2016-07-01

In response to the comment raised by Zhang et al. (2016, doi: 10.1002/2015WR018432) we explore the differences in average velocity computed using slip and no-slip boundary conditions at the air water interface. We consider a porous medium in which the air phase acts to impede the movement of water rather than to lubricate it, a case closer to the observed distribution of water in our CT images. We find that, whilst the slip boundary condition may be a more accurate approximation, in cases where the air phase is seen to impede water movement the differences between the two approaches are negligible.

Potential for early warning of maalria in India using NOAA-AVHRR based vegetation health indices

NASA Astrophysics Data System (ADS)

Dhiman, R. C.; Kogan, Felix; Singh, Neeru; Singh, R. P.; Dash, A. P.

Malaria is still a major public health problem in India with about 1 82 million cases annually and 1000 deaths As per World Health Organization WHO estimates about 1 3 million Disability Adjusted Life Years DALYs are lost annually due to malaria in India Central peninsular region of India is prone to malaria outbreaks Meteorological parameters changes in ecological conditions development of resistance in mosquito vectors development of resistance in Plasmodium falciparum parasite and lack of surveillance are the likely reasons of outbreaks Based on satellite data and climatic factors efforts have been made to develop Early Warning System EWS in Africa but there is no headway in this regard in India In order to find out the potential of NOAA satellite AVHRR derived Vegetation Condition Index VCI Temperature Condition Index TCI and a cumulative indicator Vegetation Health Index VHI were attempted to find out their potential for development of EWS Studies were initiated by analysing epidemiological data of malaria vis-a-vis VCI TCI and VHI from Bikaner and Jaisalmer districts of Rajasthan and Tumkur and Raichur districts of Karnataka Correlation coefficients between VCI and monthly malaria cases for epidemic years were computed Positive correlation 0 67 has been found with one-month lag between VCI and malaria incidence in respect of Tumkur while a negative correlation with TCI -0 45 is observed In Bikaner VCI is found to be negatively related -0 71 with malaria cases in epidemic year of 1994 Weekly

Fatigue Properties of Butt Welded Aluminum Alloy and Carbon Steel Joints by Friction Stirring

NASA Astrophysics Data System (ADS)

Okane, M.; Shitaka, T.; Ishida, M.; Chaki, T.; Yasui, T.; Fukumoto, M.

2017-05-01

The butt dissimilar joints of Al-Mg-Si alloy JIS A6063 and carbon steel JIS S45C by means of friction stir welding were prepared for investigating fatigue properties of the joints. The joining tool used has cemented carbide thread probe and a shoulder made of alloy tool steel. All the fatigue tests were carried out under a load-controlled condition with a load ratio R=0.1 in air at room temperature. From the experimental results, it was found that hardness near the interface in A6063 was lower than that of base material. Three types of fatigue fracture occurred even in case of same welding condition. The first one was fracture at boundary between the lower hardness region and base material in A6063, the second type was initiated in the stir zone by FSW process and the last one was fracture at interface. Fatigue strength in case of the second one was lower than others. Furthermore, to investigate the effect of heat treatment on fatigue properties of the dissimilar joints, fatigue tests were also carried out with using the specimens which were heat treated under the same condition to aging process in T6 treatment. Fatigue fracture was initiated at interface between A6063 and S45C in case of the heat treated specimen, but fatigue strength was improved approximately 25% as compared with that of the non-heat treated specimen.

How to Mutually Advance General Education and Major-Based Education: A Grounded Theory Study on the Course Level

ERIC Educational Resources Information Center

Fang, Hualiang

2018-01-01

The author employs grounded theory to investigate the teaching process of an interdisciplinary general education course at A University as a case. The author finds that under the condition of rather concrete relations between the subject of a major-based course and that of an elected general education course, if the major course is taught with a…

Conditional uncertainty principle

NASA Astrophysics Data System (ADS)

Gour, Gilad; Grudka, Andrzej; Horodecki, Michał; Kłobus, Waldemar; Łodyga, Justyna; Narasimhachar, Varun

2018-04-01

We develop a general operational framework that formalizes the concept of conditional uncertainty in a measure-independent fashion. Our formalism is built upon a mathematical relation which we call conditional majorization. We define conditional majorization and, for the case of classical memory, we provide its thorough characterization in terms of monotones, i.e., functions that preserve the partial order under conditional majorization. We demonstrate the application of this framework by deriving two types of memory-assisted uncertainty relations, (1) a monotone-based conditional uncertainty relation and (2) a universal measure-independent conditional uncertainty relation, both of which set a lower bound on the minimal uncertainty that Bob has about Alice's pair of incompatible measurements, conditioned on arbitrary measurement that Bob makes on his own system. We next compare the obtained relations with their existing entropic counterparts and find that they are at least independent.

Plasma cell gingivitis - A rare case related to Colocasia (arbi) leaves

PubMed Central

Bali, Deepika; Gill, Sanjeet; Bali, Amit

2012-01-01

Plasma cell gingivitis is an uncommon inflammatory condition of uncertain etiology often flavoured chewing gum, spices, foods, candies, or dentifrices. The diagnosis of plasma cell gingivitis is based on comprehensive history taking, clinical examination, and appropriate diagnostic tests. Here we are presenting a rare case of plasma cell gingivitis caused by consumption of colocasia (arbi) leaves. Colocasia is a kind of vegetable, very commonly consumed in the regions of North India. PMID:23230358

A Case of Polyarteritis Nodosa with Bilateral Ureteral Obstruction

PubMed Central

Yoo, Bin; Kim, Hong Kyu; Choi, Seung Won; Moon, Hee Bom

1996-01-01

We report a case of bilateral ureteral obstruction most likely caused by polyarteritis nodosa. The diagnosis was based upon muscle biopsy which showed typical necrotizing vasculitis in medium size artery in conjunction with microaneurysms in renal angiography. Ureteral obstruction is a rare manifestation of polyarteritis nodosa. This condition is thought to result from vasculitis of periureteral vessels. The patient was managed with prednisolone alone, which resulted in complete resolution of ureteral obstruction on both sides. PMID:8854655

The diffusion of medical technology, local conditions, and technology re-invention: a comparative case study on coronary stenting.

PubMed

Hashimoto, Hideki; Noguchi, Haruko; Heidenreich, Paul; Saynina, Olga; Moreland, Abigail; Miyazaki, Shunichi; Ikeda, Shunya; Kaneko, Yoshihiro; Ikegami, Naoki

2006-12-01

Innovation of medical technology is a major driving force behind the increase in medical expenditures in developed countries. Previous studies identified that the diffusion of medical technology varied across countries according to the characteristics of regulatory policy and payment systems. Based on Roger's diffusion of innovation theory, this study purported to see how local practice norms, the evolving nature of diffusing technology, and local clinical needs in addition to differences in politico-economic systems would affect the process of innovation diffusion. Taking a case of coronary stenting, an innovative therapeutic technology in early 1990s, we provided a case study of hospital-based data between two teaching high-tech hospitals in Japan and the US for discussion. Stenting began to be widely used in both countries when complementary new technology modified its clinical efficacy, but the diffusion process still differed between the two hospitals due to (1) distinctive payment systems for hospitals and physicians, (2) practice norms in favor of percutaneous intervention rather than bypass surgery that was shaped by payment incentives and cultural attitudes, and (3) local patient's clinical characteristics that the technology had to be tailored for. The case study described the diffusion of stent technology as a dynamic process between patients, physicians, hospitals, health care systems, and technology under global and local conditions.

Identification of the first New Zealand case of equine multinodular pulmonary fibrosis.

PubMed

Dunowska, M; Hardcastle, M R; Tonkin, F B

2014-07-01

A 10-year-old polo mare presented with a history of weight loss, poor condition and inappetance. The mare was tachycardic, tachypnoeic and febrile. Harsh lung sounds were auscultated over all lung fields. The mare initially responded to treatment with antibiotics, anti-inflammatory drugs and bronchodilators. Throughout the course of treatment, there was a variable lymphocytosis, monocytosis and fluctuation in concentrations of fibrinogen. The mare also developed a mild anaemia, most likely due to chronic disease. Despite treatment, the mare's condition deteriorated over the following 2 months, and she was subject to euthanasia. On post mortem examination, white to pale tan, large coalescing fibrous nodules up to 5 cm in diameter were found distributed throughout the lungs. Histopathology revealed a multifocally severe interstitial pneumonia with superimposed bronchiolar or alveolar inflammation, fibrosis, Type II pneumocyte hyperplasia and histiocytic intranuclear inclusion bodies, consistent with the findings previously reported for cases of equine multinodular pulmonary fibrosis (EMPF). Equine multinodular pulmonary fibrosis based on characteristic gross and histopathological findings. The diagnosis was strengthened by detection of DNA for equine herpesvirus 5 in the lung tissue. This report describes the first recognised case of EMPF in New Zealand. The affected horse did not respond to treatment and was subject to euthanasia. The prognosis for horses with EMPF, based on a limited number of cases worldwide, is currently considered poor.

14 CFR 67.109 - Neurologic.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Neurologic. 67.109 Section 67.109... STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.109 Neurologic. Neurologic standards... neurologic condition that the Federal Air Surgeon, based on the case history and appropriate, qualified...

14 CFR 67.309 - Neurologic.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Neurologic. 67.309 Section 67.309... STANDARDS AND CERTIFICATION Third-Class Airman Medical Certificate § 67.309 Neurologic. Neurologic standards... neurologic condition that the Federal Air Surgeon, based on the case history and appropriate, qualified...

14 CFR 67.109 - Neurologic.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Neurologic. 67.109 Section 67.109... STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.109 Neurologic. Neurologic standards... neurologic condition that the Federal Air Surgeon, based on the case history and appropriate, qualified...

14 CFR 67.309 - Neurologic.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Neurologic. 67.309 Section 67.309... STANDARDS AND CERTIFICATION Third-Class Airman Medical Certificate § 67.309 Neurologic. Neurologic standards... neurologic condition that the Federal Air Surgeon, based on the case history and appropriate, qualified...

Analysis of Levene's Test under Design Imbalance.

ERIC Educational Resources Information Center

Keyes, Tim K.; Levy, Martin S.

1997-01-01

H. Levene (1960) proposed a heuristic test for heteroscedasticity in the case of a balanced two-way layout, based on analysis of variance of absolute residuals. Conditions under which design imbalance affects the test's characteristics are identified, and a simple correction involving leverage is proposed. (SLD)

14 CFR 67.313 - General medical condition.

Code of Federal Regulations, 2014 CFR

2014-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.213 - General medical condition.

Code of Federal Regulations, 2012 CFR

2012-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.313 - General medical condition.

Code of Federal Regulations, 2012 CFR

2012-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.313 - General medical condition.

Code of Federal Regulations, 2011 CFR

2011-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.113 - General medical condition.

Code of Federal Regulations, 2012 CFR

2012-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.113 - General medical condition.

Code of Federal Regulations, 2014 CFR

2014-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.113 - General medical condition.

Code of Federal Regulations, 2011 CFR

2011-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.213 - General medical condition.

Code of Federal Regulations, 2014 CFR

2014-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.113 - General medical condition.

Code of Federal Regulations, 2013 CFR

2013-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.313 - General medical condition.

Code of Federal Regulations, 2013 CFR

2013-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.213 - General medical condition.

Code of Federal Regulations, 2013 CFR

2013-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

14 CFR 67.213 - General medical condition.

Code of Federal Regulations, 2011 CFR

2011-01-01

... established medical history or clinical diagnosis of diabetes mellitus that requires insulin or any other hypoglycemic drug for control. (b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment...

[Giant idiopathic hydronephrosis: toward a two-step therapeutic approach].

PubMed

Boudhaye, Taher Ismail; Sidimalek, Mohamed; Jdoud, Cheikhani

2017-01-01

Giant hydronephrosis is rare. It is usually caused by ureteropelvic junction syndrome. We here report the unusual case of a patient hospitalized with giant hydronephrosis associated with impaired general condition. Diagnosis was based on CT scan. The patient underwent deferred nephrectomy after percutaneous drainage.

Self-Directed Teacher Learning in Collaborative Contexts

ERIC Educational Resources Information Center

Slavit, David; Roth McDuffie, Amy

2013-01-01

Two related case studies of secondary mathematics teachers examine the roles and conditions helpful in initiating, directing, and/or supporting teachers' own professional development. Using multiple data sources from school-based and professional settings, we applied analytic induction to identify patterns of similarities and differences in…

An evidence-based approach to case management model selection for an acute care facility: is there really a preferred model?

PubMed

Terra, Sandra M

2007-01-01

This research seeks to determine whether there is adequate evidence-based justification for selection of one acute care case management model over another. Acute Inpatient Hospital. This article presents a systematic review of published case management literature, resulting in classification specific to terms of level of evidence. This review examines the best available evidence in an effort to select an acute care case management model. Although no single case management model can be identified as preferred, it is clear that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and to form a foundation for the efficacy of hospital case management practice. Although no single case management model can be identified as preferred, this systematic review demonstrates that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and forming a foundation for the efficacy of hospital case management practice. Distinctive aspects of case management frameworks can be used to guide the development of an acute care case management model. The study illustrates: * The effectiveness of case management when there is direct patient contact by the case manager regardless of disease condition: not only does the quality of care increase but also length of stay (LOS) decreases, care is defragmented, and both patient and physician satisfaction can increase. * The preferred case management models result in measurable outcomes that can directly relate to, and demonstrate alignment with, organizational strategy. * Acute care management programs reduce cost and LOS, and improve outcomes. * An integrated case management program that includes social workers, as well as nursing, is the most effective acute care management model. * The successful case management model will recognize physicians, as well as patients, as valued customers with whom partnership can positively affect financial outcomes in terms of reduction in LOS, improvement in quality, and delivery of care.

Approaches to ascertaining comorbidity information: validation of routine hospital episode data with clinician-based case note review.

PubMed

Soo, Martin; Robertson, Lynn M; Ali, Tariq; Clark, Laura E; Fluck, Nicholas; Johnston, Marjorie; Marks, Angharad; Prescott, Gordon J; Smith, William Cairns S; Black, Corri

2014-04-21

In clinical practice, research, and increasingly health surveillance, planning and costing, there is a need for high quality information to determine comorbidity information about patients. Electronic, routinely collected healthcare data is capturing increasing amounts of clinical information as part of routine care. The aim of this study was to assess the validity of routine hospital administrative data to determine comorbidity, as compared with clinician-based case note review, in a large cohort of patients with chronic kidney disease. A validation study using record linkage. Routine hospital administrative data were compared with clinician-based case note review comorbidity data in a cohort of 3219 patients with chronic kidney disease. To assess agreement, we calculated prevalence, kappa statistic, sensitivity, specificity, positive predictive value and negative predictive value. Subgroup analyses were also performed. Median age at index date was 76.3 years, 44% were male, 67% had stage 3 chronic kidney disease and 31% had at least three comorbidities. For most comorbidities, we found a higher prevalence recorded from case notes compared with administrative data. The best agreement was found for cerebrovascular disease (κ = 0.80) ischaemic heart disease (κ = 0.63) and diabetes (κ = 0.65). Hypertension, peripheral vascular disease and dementia showed only fair agreement (κ = 0.28, 0.39, 0.38 respectively) and smoking status was found to be poorly recorded in administrative data. The patterns of prevalence across subgroups were as expected and for most comorbidities, agreement between case note and administrative data was similar. Agreement was less, however, in older ages and for those with three or more comorbidities for some conditions. This study demonstrates that hospital administrative comorbidity data compared moderately well with case note review data for cerebrovascular disease, ischaemic heart disease and diabetes, however there was significant under-recording of some other comorbid conditions, and particularly common risk factors.

Celiac Disease and Concomitant Conditions: A Case-based Review.

PubMed

Lodhi, Muhammad Uzair; Stammann, Tracy; Kuzel, Aaron R; Syed, Intekhab Askari; Ishtiaq, Rizwan; Rahim, Mustafa

2018-02-02

Celiac disease is a chronic autoimmune disease with genetic predisposition, triggered by the ingestion of gluten. It has a wide range of clinical manifestations ranging from asymptomatic forms to classic presentation of malabsorption with diarrhea and abdominal cramps. Celiac disease can also present with several other concomitant disorders (at the time of diagnosis or during the course of celiac disease) such as: type 1 diabetes, inflammatory bowel disease, rheumatoid arthritis, thyroid disorders, nutritional deficiencies, and gram-negative sepsis. We present a 57-year-old female with past medical history of rheumatoid arthritis, who presented to the emergency department with a complaint of chronic diarrhea, complicated by gram-negative sepsis. The family history of the patient was significant for celiac disease, type 1 diabetes, and rheumatoid arthritis. The patient was closely monitored and treated appropriately. In this case-based review, we explore different associated conditions of celiac disease in the literature, as well as the patient's risk of developing malignancy.

Sound at the zoo: Using animal monitoring, sound measurement, and noise reduction in zoo animal management.

PubMed

Orban, David A; Soltis, Joseph; Perkins, Lori; Mellen, Jill D

2017-05-01

A clear need for evidence-based animal management in zoos and aquariums has been expressed by industry leaders. Here, we show how individual animal welfare monitoring can be combined with measurement of environmental conditions to inform science-based animal management decisions. Over the last several years, Disney's Animal Kingdom® has been undergoing significant construction and exhibit renovation, warranting institution-wide animal welfare monitoring. Animal care and science staff developed a model that tracked animal keepers' daily assessments of an animal's physical health, behavior, and responses to husbandry activity; these data were matched to different external stimuli and environmental conditions, including sound levels. A case study of a female giant anteater and her environment is presented to illustrate how this process worked. Associated with this case, several sound-reducing barriers were tested for efficacy in mitigating sound. Integrating daily animal welfare assessment with environmental monitoring can lead to a better understanding of animals and their sensory environment and positively impact animal welfare. © 2017 Wiley Periodicals, Inc.

HYPNOSIS IN THE TREATMENT OF MORGELLONS DISEASE: A Case Study1

PubMed Central

Gartner, Ashley M.; Dolan, Sara L.; Stanford, Matthew S.; Elkins, Gary R.

2014-01-01

Morgellons Disease is a condition involving painful skin lesions, fibrous growths protruding from the skin, and subcutaneous stinging and burning sensations, along with symptoms of anxiety, depression, fatigue, and memory and attention deficits. The etiological and physiological bases of these symptoms are unclear, making the diagnosis controversial and challenging to treat. There are currently no established treatments for Morgellons Disease. The following case example depicts treatment of a woman with Morgellons Disease using hypnotherapy. Data from this case example suggest that hypnotherapy is a promising intervention for the physical and psychological symptoms associated with Morgellons Disease. PMID:21390982

Hypnosis in the treatment of Morgellons disease: a case study.

PubMed

Gartner, Ashley M; Dolan, Sara L; Stanford, Matthew S; Elkins, Gary R

2011-04-01

Morgellons Disease is a condition involving painful skin lesions, fibrous growths protruding from the skin, and subcutaneous stinging and burning sensations, along with symptoms of anxiety, depression, fatigue, and memory and attention deficits. The etiological and physiological bases of these symptoms are unclear, making the diagnosis controversial and challenging to treat. There are currently no established treatments for Morgellons Disease. The following case example depicts treatment of a woman with Morgellons Disease using hypnotherapy. Data from this case example suggest that hypnotherapy is a promising intervention for the physical and psychological symptoms associated with Morgellons Disease.

How many referrals to a pediatric orthopaedic hospital specialty clinic are primary care problems?

PubMed

Hsu, Eric Y; Schwend, Richard M; Julia, Leamon

2012-01-01

Many primary care physicians believe that there are too few pediatric orthopaedic specialists available to meet their patients' needs. However, a recent survey by the Practice Management Committee of the Pediatric Orthopaedic Society of North America found that new referrals were often for cases that could have been managed by primary care practitioners. We wished to determine how many new referral cases seen by pediatric orthopaedic surgeons are in fact conditions that can be readily managed by a primary care physician should he/she chose to do so. We prospectively studied all new referrals to our hospital-based orthopaedic clinic during August 2010. Each new referral was evaluated for whether it met the American Board of Pediatrics criteria for being a condition that could be managed by a primary care pediatrician. Each referral was also evaluated for whether it met the American Academy of Pediatrics Surgery Advisory Panel guidelines recommending referral to an orthopaedic specialist, regardless of whether it is for general orthopaedics or pediatric orthopaedics. On the basis of these criteria, we classified conditions as either a condition manageable by primary care physicians or a condition that should be referred to an orthopaedic surgeon or a pediatric orthopaedic surgeon. We used these guidelines not to identify diagnosis that primary care physicians should treat but, rather, to compare the guideline-delineated referrals with the actual referrals our specialty pediatric orthopaedic clinic received over a period of 1 month. A total of 529 new patient referrals were seen during August 2010. A total of 246 (47%) were considered primary care conditions and 283 (53%) orthopaedic specialty conditions. The most common primary care condition was a nondisplaced phalanx fracture (25/246, 10.1%) and the most common specialty condition was a displaced single-bone upper extremity fracture needing reduction (36/283, 13%). Only 77 (14.6%) of the total cases met the strict American Academy of Pediatrics Surgery Advisory Panel guidelines recommending referral to pediatric orthopaedics, with scoliosis being the most frequent condition. For 38 (7.2%) cases, surgical treatment was required or recommended. Patient age, referral source, or type of insurance did not influence whether the condition was a primary care or a specialty care case. A total of 134 (25%) cases were referred without having an initial diagnosis made by the referring clinician. These patients were more likely to have been referred from a primary care practitioner than from a tertiary care practitioner whether the diagnosis eventually made was considered to be a primary care condition (P=0.03; relative risk, 1.9; 95% confidence interval, 96-3.86). Almost half of all new referrals to a tertiary pediatric orthopaedic clinic were for conditions considered to be manageable by primary care physicians should they chose to do so. This has implications for pediatric orthopaedic workforce availability, reimbursement under the Affordable Care Act, and pediatric musculoskeletal training needs for providers of primary care.

The brain injury case management taxonomy (BICM-T); a classification of community-based case management interventions for a common language.

PubMed

Lukersmith, Sue; Fernandez, Ana; Millington, Michael; Salvador-Carulla, Luis

2016-04-01

Case management is a complex intervention. Complexity arises from the interaction of different components: the model (theoretical basis), implementation context (service), population and health condition, focus for the intervention (client and/or their family), case manager's actions (interventions) and the target of case management (integrated care and support, client's community participation). There is a lack of understanding and a common language. To our knowledge there is no classification (taxonomy) for community-based case management. To develop a community-based case management in brain injury taxonomy (BICM-T), as a common language and understanding of case management for use in quality analysis, policy, planning and practice. The mixed qualitative methods used multiple sources of knowledge including scoping, framing and a nominal group technique to iteratively develop the Beta version (draft) of the taxonomy. A two part developmental evaluation involving case studies and mapping to international frameworks assessed the applicability and acceptability (feasibility) before finalization of the BICM-T. The BICM-T includes a definition of community-based case management, taxonomy trees, tables and a glossary. The interventions domain tree has 9 main actions (parent category): engagement, holistic assessment, planning, education, training and skills development, emotional and motivational support, advising, coordination, monitoring; 17 linked actions (children category); 8 related actions; 63 relevant terms defined in the glossary. The BICM-T provides a knowledge map with the definitions and relationships between the core actions (interventions domain). Use of the taxonomy as a common language will benefit practice, quality analysis, evaluation, policy, planning and resource allocation. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Hyperacute Simultaneous Cardiocerebral Infarction: Rescuing the Brain or the Heart First?

PubMed

Kijpaisalratana, Naruchorn; Chutinet, Aurauma; Suwanwela, Nijasri C

2017-01-01

Concurrent acute ischemic stroke and acute myocardial infarction is an uncommon medical emergency condition. The challenge for the physicians regarding the management of this situation is paramount since early management of one condition will inevitably delay the other. We present two illustrative cases of "hyperacute simultaneous cardiocerebral infarction" who presented with simultaneous cardiocerebral infarction and arrived at the hospital within the thrombolytic therapeutic window for acute ischemic stroke of 4.5 h. We propose an algorithm for managing the patient with hyperacute simultaneous cardiocerebral infarction based on hemodynamic status and suggest close cardiac monitoring based on the site of cerebral infarction.

Susceptibility to Mortality in Weather Extremes: Effect Modification by Personal and Small Area Characteristics In a Multi-City Case-Only Analysis

PubMed Central

Zanobetti, Antonella; O’Neill, Marie S.; Gronlund, Carina J.; Schwartz, Joel D

2015-01-01

Background Extremes of temperature have been associated with short-term increases in daily mortality. We identified subpopulations with increased susceptibility to dying during temperature extremes, based on personal demographics, small-area characteristics and preexisting medical conditions. Methods We examined Medicare participants in 135 U.S. cities and identified preexisting conditions based on hospitalization records prior to their deaths, from 1985–2006. Personal characteristics were obtained from the Medicare records, and area characteristics were assigned based on zip-code of residence. We conducted a case-only analysis of over 11 million deaths, and evaluated modification of the risk of dying associated with extremely hot days and extremely cold days, continuous temperatures, and water-vapor pressure. Modifiers included preexisting conditions, personal characteristics, zip-code-level population characteristics, and land-cover characteristics. For each effect modifier, a city-specific logistic regression model was fitted and then an overall national estimate was calculated using meta-analysis. Results People with certain preexisting conditions were more susceptible to extreme heat, with an additional 6% (95% confidence interval= 4% – 8%) increase in the risk of dying on an extremely hot day in subjects with previous admission for atrial fibrillation, an additional 8% (4%–12%) in subjects with Alzheimer disease, and an additional 6% (3%–9%) in subjects with dementia. Zip-code level and personal characteristics were also associated with increased susceptibility to temperature. Conclusions We identified several subgroups of the population who are particularly susceptible to temperature extremes, including persons with atrial fibrillation. PMID:24045717

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.

Student-generated case reports.

PubMed

Good, Christopher J

2009-01-01

When students create teaching materials, learning can be enhanced. Therefore, a project was designed based on the traditional clinical case report and the chiropractic technique and principles curriculum at the University of Bridgeport College of Chiropractic. The objectives were to increase mastery in a clinical topic, increase awareness of different patient presentations and management options, and enhance information technology skills. Following lectures about the components of a case report and neurological reflexes related to visceral comorbidities and subluxation and joint dysfunction, students created a case report based on a template provided by the instructor. A survey gathered student perspectives on the exercise. More than 70% of the surveyed students felt the project was at least moderately helpful in improving understanding of a case report, the condition investigated, their clinical reasoning, and the ability to integrate information. Most felt that they improved their understanding of neurological reflexes, use of the literature, and the practice of evidence-based care. The majority believed that they identified weakness in knowledge, improved self-learning skills, and increased confidence in managing patients. Most enjoyed it at least somewhat and 70% agreed that the project should be continued. Many believed that they were better prepared for national boards and had improved their writing skills.

Developing a Time Series Predictive Model for Dengue in Zhongshan, China Based on Weather and Guangzhou Dengue Surveillance Data.

PubMed

Zhang, Yingtao; Wang, Tao; Liu, Kangkang; Xia, Yao; Lu, Yi; Jing, Qinlong; Yang, Zhicong; Hu, Wenbiao; Lu, Jiahai

2016-02-01

Dengue is a re-emerging infectious disease of humans, rapidly growing from endemic areas to dengue-free regions due to favorable conditions. In recent decades, Guangzhou has again suffered from several big outbreaks of dengue; as have its neighboring cities. This study aims to examine the impact of dengue epidemics in Guangzhou, China, and to develop a predictive model for Zhongshan based on local weather conditions and Guangzhou dengue surveillance information. We obtained weekly dengue case data from 1st January, 2005 to 31st December, 2014 for Guangzhou and Zhongshan city from the Chinese National Disease Surveillance Reporting System. Meteorological data was collected from the Zhongshan Weather Bureau and demographic data was collected from the Zhongshan Statistical Bureau. A negative binomial regression model with a log link function was used to analyze the relationship between weekly dengue cases in Guangzhou and Zhongshan, controlling for meteorological factors. Cross-correlation functions were applied to identify the time lags of the effect of each weather factor on weekly dengue cases. Models were validated using receiver operating characteristic (ROC) curves and k-fold cross-validation. Our results showed that weekly dengue cases in Zhongshan were significantly associated with dengue cases in Guangzhou after the treatment of a 5 weeks prior moving average (Relative Risk (RR) = 2.016, 95% Confidence Interval (CI): 1.845-2.203), controlling for weather factors including minimum temperature, relative humidity, and rainfall. ROC curve analysis indicated our forecasting model performed well at different prediction thresholds, with 0.969 area under the receiver operating characteristic curve (AUC) for a threshold of 3 cases per week, 0.957 AUC for a threshold of 2 cases per week, and 0.938 AUC for a threshold of 1 case per week. Models established during k-fold cross-validation also had considerable AUC (average 0.938-0.967). The sensitivity and specificity obtained from k-fold cross-validation was 78.83% and 92.48% respectively, with a forecasting threshold of 3 cases per week; 91.17% and 91.39%, with a threshold of 2 cases; and 85.16% and 87.25% with a threshold of 1 case. The out-of-sample prediction for the epidemics in 2014 also showed satisfactory performance. Our study findings suggest that the occurrence of dengue outbreaks in Guangzhou could impact dengue outbreaks in Zhongshan under suitable weather conditions. Future studies should focus on developing integrated early warning systems for dengue transmission including local weather and human movement.

Non-invasive, home-based electroencephalography hypoglycaemia warning system for personal monitoring using skin surface electrodes: a single-case feasibility study.

PubMed

Clewett, Christopher J; Langley, Phillip; Bateson, Anthony D; Asghar, Aziz; Wilkinson, Antony J

2016-03-01

Hypoglycaemia unawareness is a common condition associated with increased risk of severe hypoglycaemia. The purpose of the authors' study was to develop a simple to use, home-based and non-invasive hypoglycaemia warning system based on electroencephalography (EEG), and to demonstrate its use in a single-case feasibility study. A participant with type 1 diabetes forms a single-person case study where blood sugar levels and EEG were recorded. EEG was recorded using skin surface electrodes placed behind the ear located within the T3 region by the participant in the home. EEG was analysed retrospectively to develop an algorithm which would trigger a warning if EEG changes associated with hypoglycaemia onset were detected. All hypoglycaemia events were detected by the EEG hypoglycaemia warning algorithm. Warnings were triggered with blood glucose concentration levels at or below 4.2 mmol/l in this participant and no warnings were issued when in euglycaemia. The feasibility of a non-invasive EEG-based hypoglycaemia warning system for personal monitoring in the home has been demonstrated in a single case study. The results suggest that further studies are warranted to evaluate the system prospectively in a larger group of participants.

Development of pig welfare assessment protocol integrating animal-, environment-, and management-based measures.

PubMed

Renggaman, Anriansyah; Choi, Hong L; Sudiarto, Sartika Ia; Alasaarela, Laura; Nam, Ok S

2015-01-01

Due to increased interest in animal welfare, there is now a need for a comprehensive assessment protocol to be used in intensive pig farming systems. There are two current welfare assessment protocols for pigs: Welfare Quality® Assessment Protocols (applicable in the Europe Union), that mostly focuses on animal-based measures, and the Swine Welfare Assurance Program (applicable in the United States), that mostly focuses on management- and environment-based measures. In certain cases, however, animal-based measures might not be adequate for properly assessing pig welfare status. Similarly, welfare assessment that relies only on environment- and management-based measures might not represent the actual welfare status of pigs. Therefore, the objective of this paper was to develop a new welfare protocol by integrating animal-, environment-, and management-based measures. The background for selection of certain welfare criteria and modification of the scoring systems from existing welfare assessment protocols are described. The developed pig welfare assessment protocol consists of 17 criteria that are related to four main principles of welfare (good feeding, good housing, good health, and appropriate behavior). Good feeding, good housing, and good health were assessed using a 3-point scale: 0 (good welfare), 1 (moderate welfare), and 2 (poor welfare). In certain cases, only a 2-point scale was used: 0 (certain condition is present) or 2 (certain condition is absent). Appropriate behavior was assessed by scan sampling of positive and negative social behaviors based on qualitative behavior assessment and human-animal relationship tests. Modification of the body condition score into a 3-point scale revealed pigs with a moderate body condition (score 1). Moreover, additional criteria such as feed quality confirmed that farms had moderate (score 1) or poor feed quality (score 2), especially those farms located in a high relative humidity region. The developed protocol can be utilized to assess welfare status in an intensive pig farming system. Although further improvements are still needed, this study is a first step in developing a pig welfare assessment protocol that combines animal-, environment-, and management-based measures.

Gelatinous Marrow Transformation: A Series of 11 Cases from a Tertiary Care Centre in South India

PubMed Central

Das, Sreeya; Mishra, Pritinanda; Kar, Rakhee; Basu, Debdatta

2014-01-01

Gelatinous marrow transformation (GMT) or serous atrophy of bone marrow (BM) is a rare disease characterised by focal marrow hypoplasia, fat atrophy, and accumulation of extracellular mucopolysaccharides abundant in hyaluronic acid. This study reviews 11 cases of GMT from South India. Clinical and haematological parameters, BM aspirate, and biopsies of all patients diagnosed with GMT over a period of 7 years were studied. GMT was diagnosed in BM biopsy based on characteristic morphological appearance and was confirmed by alcian blue positive staining pattern at pH levels of 2.5 and 0.5. Eleven patients were diagnosed with GMT. All were males within the age range of 15 to 50 years. The underlying clinical diagnosis was human immunodeficiency virus positivity in 5 cases, 2 with coexistent disseminated tuberculosis, 1 with cryptococcal meningitis, and 1 with oral candidiasis; disseminated tuberculosis in 1 case; pyrexia of unknown origin in 2 cases; Hodgkin’s lymphoma in 1 case; acute lymphoblastic lymphoma with maintenance chemotherapy in 1 case; and alcoholic pancreatitis in 1 case. BM aspirates showed gelatinous metachromatic seromucinous material in 3 cases. BM biopsies were hypocellular in 7 and normocellular in 4 cases and showed focal GMT in 5 and diffuse GMT in 6 cases. Reactive changes were seen in 4 cases and haemophagocytosis in addition to GMT in 1 case. GMT is a relatively uncommon condition and an indicator of severe illness. It should be differentiated from myelonecrosis, amyloidosis, and marrow oedema. A high index of suspicion is required to diagnose this condition. PMID:25035676

Gelatinous marrow transformation: a series of 11 cases from a tertiary care centre in South India.

PubMed

Das, Sreeya; Mishra, Pritinanda; Kar, Rakhee; Basu, Debdatta

2014-06-01

Gelatinous marrow transformation (GMT) or serous atrophy of bone marrow (BM) is a rare disease characterised by focal marrow hypoplasia, fat atrophy, and accumulation of extracellular mucopolysaccharides abundant in hyaluronic acid. This study reviews 11 cases of GMT from South India. Clinical and haematological parameters, BM aspirate, and biopsies of all patients diagnosed with GMT over a period of 7 years were studied. GMT was diagnosed in BM biopsy based on characteristic morphological appearance and was confirmed by alcian blue positive staining pattern at pH levels of 2.5 and 0.5. Eleven patients were diagnosed with GMT. All were males within the age range of 15 to 50 years. The underlying clinical diagnosis was human immunodeficiency virus positivity in 5 cases, 2 with coexistent disseminated tuberculosis, 1 with cryptococcal meningitis, and 1 with oral candidiasis; disseminated tuberculosis in 1 case; pyrexia of unknown origin in 2 cases; Hodgkin's lymphoma in 1 case; acute lymphoblastic lymphoma with maintenance chemotherapy in 1 case; and alcoholic pancreatitis in 1 case. BM aspirates showed gelatinous metachromatic seromucinous material in 3 cases. BM biopsies were hypocellular in 7 and normocellular in 4 cases and showed focal GMT in 5 and diffuse GMT in 6 cases. Reactive changes were seen in 4 cases and haemophagocytosis in addition to GMT in 1 case. GMT is a relatively uncommon condition and an indicator of severe illness. It should be differentiated from myelonecrosis, amyloidosis, and marrow oedema. A high index of suspicion is required to diagnose this condition.

Extended Performance Assessment in Accelerated Corrosion and Adhesion of CARC Prepared Aluminum Alloy 5059-H131 for Three Different Pretreatment Methods

DTIC Science & Technology

2008-03-01

conversion coating, only works well as part of a complete coating system as was the case in this study. Trivalent chromium pretreatments such as TCP must...conditions. The pretreatment conditions were abrasive blasted, a nonchromate pretreatment (NCP)1, and a commercial trivalent chromate pretreatment...ease of manufacturing via welds , excellent performance against fragmentation based threats, and excellent corrosion resistance. As threat levels have

Short-term effects of floods on Japanese encephalitis in Nanchong, China, 2007-2012: A time-stratified case-crossover study.

PubMed

Zhang, Feifei; Liu, Zhidong; Zhang, Caixia; Jiang, Baofa

2016-09-01

This time-stratified case-crossover study aimed to quantify the impact of floods on daily Japanese encephalitis (JE) cases from 2007 to 2012 in Nanchong city of Sichuan Province, China. Using conditional logistic regression analysis, we calculated the odds ratios (ORs) and 95% confidence intervals (CIs) at different lagged days, adjusting for daily average temperature (AT) and daily average relative humidity (ARH). A total of 370 JE cases were notified during the study period, with the median patient age being 4.2years. The seasonal pattern of JE cases clustered in July and August during the study period. Floods were significantly associated with an increased number of JE cases from lag 23 to lag 24, with the strongest lag effect at lag 23 (OR=2.00, 95% CI: 1.14-3.52). Similarly, AT and ARH were positively associated with daily JE cases from lag 0 to lag 8 and from lag 0 to lag 9, respectively. Floods, with AT and ARH, can be used to forecast JE outbreaks in the study area. Based on the results of this study, recommendations include undertaking control measures before the number of cases increases, especially for regions with similar geographic, climatic, and socio-economic conditions as those in the study area. Copyright © 2016 Elsevier B.V. All rights reserved.

Nonlinear analysis of r.c. framed buildings retrofitted with elastomeric and friction bearings under near-fault earthquakes

NASA Astrophysics Data System (ADS)

Mazza, Mirko

2015-12-01

Reinforced concrete (r.c.) framed buildings designed in compliance with inadequate seismic classifications and code provisions present in many cases a high vulnerability and need to be retrofitted. To this end, the insertion of a base isolation system allows a considerable reduction of the seismic loads transmitted to the superstructure. However, strong near-fault ground motions, which are characterised by long-duration horizontal pulses, may amplify the inelastic response of the superstructure and induce a failure of the isolation system. The above considerations point out the importance of checking the effectiveness of different isolation systems for retrofitting a r.c. framed structure. For this purpose, a numerical investigation is carried out with reference to a six-storey r.c. framed building, which, primarily designed (as to be a fixed-base one) in compliance with the previous Italian code (DM96) for a medium-risk seismic zone, has to be retrofitted by insertion of an isolation system at the base for attaining performance levels imposed by the current Italian code (NTC08) in a high-risk seismic zone. Besides the (fixed-base) original structure, three cases of base isolation are studied: elastomeric bearings acting alone (e.g. HDLRBs); in-parallel combination of elastomeric and friction bearings (e.g. high-damping-laminated-rubber bearings, HDLRBs and steel-PTFE sliding bearings, SBs); friction bearings acting alone (e.g. friction pendulum bearings, FPBs). The nonlinear analysis of the fixed-base and base-isolated structures subjected to horizontal components of near-fault ground motions is performed for checking plastic conditions at the potential critical (end) sections of the girders and columns as well as critical conditions of the isolation systems. Unexpected high values of ductility demand are highlighted at the lower floors of all base-isolated structures, while re-centring problems of the base isolation systems under near-fault earthquakes are expected in case of friction bearings acting alone (i.e. FPBs) or that in combination (i.e. SBs) with HDLRBs.

A trajectory generation framework for modeling spacecraft entry in MDAO

NASA Astrophysics Data System (ADS)

D`Souza, Sarah N.; Sarigul-Klijn, Nesrin

2016-04-01

In this paper a novel trajectory generation framework was developed that optimizes trajectory event conditions for use in a Generalized Entry Guidance algorithm. The framework was developed to be adaptable via the use of high fidelity equations of motion and drag based analytical bank profiles. Within this framework, a novel technique was implemented that resolved the sensitivity of the bank profile to atmospheric non-linearities. The framework's adaptability was established by running two different entry bank conditions. Each case yielded a reference trajectory and set of transition event conditions that are flight feasible and implementable in a Generalized Entry Guidance algorithm.

A Discrete Analysis of Non-reflecting Boundary Conditions for Discontinuous Galerkin Method

NASA Technical Reports Server (NTRS)

Hu, Fang Q.; Atkins, Harold L.

2003-01-01

We present a discrete analysis of non-reflecting boundary conditions for the discontinuous Galerkin method. The boundary conditions considered in this paper include the recently proposed Perfectly Matched Layer absorbing boundary condition for the linearized Euler equation and two non-reflecting boundary conditions based on the characteristic decomposition of the flux on the boundary. The analyses for the three boundary conditions are carried out in a unifled way. In each case, eigensolutions of the discrete system are obtained and applied to compute the numerical reflection coefficients of a specified out-going wave. The dependencies of the reflections at the boundary on the out-going wave angle and frequency as well as the mesh sizes arc? studied. Comparisons with direct numerical simulation results are also presented.

Homeopathic Treatment of Vitiligo: A Report of Fourteen Cases.

PubMed

Mahesh, Seema; Mallappa, Mahesh; Tsintzas, Dionysios; Vithoulkas, George

2017-12-02

BACKGROUND Vitiligo, also known as leukoderma, is an autoimmune skin condition that results in the loss of melanin pigment. Vitiligo is not a rare condition but is difficult to treat and is associated with psychological distress. CASE REPORT A series of 14 cases of vitiligo are presented that were treated with individualized homeopathic remedies that were based on plant, animal, or mineral compounds. There were 13 women and one man in the case series, with a mean age 29.8 years, and a mean follow-up from treatment of 58 months. The mean time between the onset of the appearance of vitiligo and the first consultation at our clinic was 96 months. Homeopathic treatment for patients is holistic and was performed on an individualized basis as described in this case series. Photographic images of the skin are presented before and after treatment. CONCLUSIONS In 14 patients with vitiligo treated with individualized homeopathy, the best results were achieved in the patients who were treated in the early stages of the disease. We believe that homeopathy may be effective in the early stages of vitiligo, but large controlled clinical studies are needed in this area.

From museum cases to the classroom: Emerging opportunities for specimen-based education

USDA-ARS?s Scientific Manuscript database

Natural history collections are one of the most powerful resources available for documenting the effects of changing environmental conditions on global biodiversity. Worldwide, more than 1.5 billion specimens are contained in natural history museums. These materials, collected over vast temporal and...

Treosulfan-based conditioning regimens for allogeneic HSCT in children with acute lymphoblastic leukaemia.

PubMed

Boztug, Heidrun; Zecca, Marco; Sykora, Karl-Walter; Veys, Paul; Lankester, Arjan; Slatter, Mary; Skinner, Roderick; Wachowiak, Jacek; Pötschger, Ulrike; Glogova, Evgenia; Peters, Christina

2015-02-01

Standard myeloablative conditioning regimens for children with acute lymphoblastic leukaemia are based on total body irradiation (TBI). However, TBI causes profound short-term and long-term side effects, provoking the necessity for alternative regimens. Treosulfan combines a potent immunosuppressive and antileukaemic effect with myeloablative activity and low toxicity profile. We retrospectively studied toxicity and outcome of 71 paediatric patients with acute lymphoblastic leukaemia (ALL) undergoing haematopoietic stem cell transplantation (HSCT) following treosulfan-based conditioning aiming to identify risk factors for treatment failure and dose-depending outcome differences. Early regimen-related toxicity was low. No case of veno-occlusive disease was reported. There was no association of toxicity with age or number of HSCT. Event-free survival (EFS) of infants was significantly better compared to older children. Overall survival (OS) at 3 years was 51 % and not significantly influenced by number of HSCT (first HSCT 54 %, ≥second HSCT 44 %, p = 0.71). In multivariate analysis, OS and EFS were significantly worse for patients transplanted without complete remission (p = 0.04 and 0.004). Treatment-related mortality was low at 14 %. We conclude that treosulfan-based conditioning is a safe and efficacious approach for paediatric ALL.

Outbreak of Chikungunya in the French Caribbean Islands of Martinique and Guadeloupe: Findings from a Hospital-Based Surveillance System (2013-2015).

PubMed

Dorléans, Frédérique; Hoen, Bruno; Najioullah, Fatiha; Herrmann-Storck, Cécile; Schepers, Kinda Maria; Abel, Sylvie; Lamaury, Isabelle; Fagour, Laurence; Césaire, Raymond; Guyomard, Stéphanie; Troudard, Ruth; Adélaïde, Yvette; Romagne, Marie-José; Davidas, Magguy; Rochais, Séverine; Boa, Sylvie; de Saint-Alary, Frédérique; Preira, Annabel; Saint-Martin, Patrick; Vaidie, Amandine; Melin, Mathilde; Daudens-Vaysse, Elise; Rosine, Jacques; Blateau, Alain; Carvalho, Luisiane; Septfons, Alexandra; Paty, Marie-Claire; Leduc, Ghislain; Cassadou, Sylvie; Ledrans, Martine; Cabié, André

2018-04-23

Chikungunya virus (CHIKV) emerged in the Caribbean island of Saint-Martin in December 2013. We implemented a hospital-based surveillance system to detect and describe CHIKV cases including severe forms of the infection and deaths in the islands of Martinique and Guadeloupe. A case was defined as a patient with a CHIKV laboratory confirmation cared for in a public hospital for chikungunya for at least 24 hours, and a severe CHIKV case was defined as a CHIKV case presenting one or more organ failures. Sociodemographic, clinical, and laboratory data were collected and cases classified into severe or nonsevere based on medical records. From December 2013 to January 2015, a total of 1,836 hospitalized cases were identified. Rate of hospital admissions for CHIKV infection was 60 per 10,000 suspected clinical CHIKV cases and severity accounted for 12 per 10,000. A total of 74 deaths related to CHIKV infection occurred. Infants and elderly people were more frequently hospitalized compared with others and severity was more frequently reported in elderly subjects and subjects with underlying health condition. Fifteen neonatal infections consecutive to mother-to-child transmission were diagnosed, seven of which were severe. The most vulnerable groups of the population, such as the elderly, infants, individuals with comorbidities, and pregnant women, should remain the main targets of public health priorities.

Urban women's use of rural-based health care services: the case of Igbo women in Aba City, Nigeria.

PubMed

Izugbara, C Otutubikey; Afangideh, A Isong

2005-03-01

This study addresses the quest for rural-based health care services among women in urban Nigeria relying on a large qualitative database obtained from 63 Igbo women living in Aba, Nigeria. Results indicate that urban Igbo women of different socioeconomic and demographic characteristics utilize the services of different rural-based health care providers-indigenous healers, traditional birth attendants (TBAs), faith/spiritual, western-trained doctors and nurses as well as chemist shopkeepers-for conditions ranging from infertility, through child birthing and abortions, to swollen body, epilepsy, bone setting, and stubborn skin diseases. Major attractions to rural-based therapists were the failure of urban-based health services to provide cure, perceived mystical nature of conditions, need to conceal information on therapeutic progress and/or the nature of specific disease conditions, belief in rural-based therapists' ability to cure condition, and affordability of the services of rural-based health care providers. Findings underscore the critical implications of service characteristics, cultural beliefs, and the symbolic content of place(s) for care seekers' patterns of resort. We suggest that need exists for policies and programs aimed at making health care services in urban Nigeria more responsive to care seekers' socioeconomic and cultural sensitivities, integrating informal health care providers into Nigeria's health care system, and strengthening public health education in Nigeria.

Incidence of listeriosis and related mortality among groups at risk of acquiring listeriosis.

PubMed

Goulet, Véronique; Hebert, Marjolaine; Hedberg, Craig; Laurent, Edith; Vaillant, Véronique; De Valk, Henriette; Desenclos, Jean-Claude

2012-03-01

Listeriosis is a foodborne disease of significant public health concern that primarily affects persons with recognized underlying conditions or diseases that impair cell-mediated immunity. The degree of risk posed by the different underlying conditions is crucial to prioritize prevention programs that target the highest risk populations. We reviewed cases of listeriosis reported in France from 2001 to 2008. Numbers of cases and deaths were tabulated by age and underlying condition. Measures of the impact of specific underlying conditions on the occurrence of listeriosis were calculated. For estimating the total number of persons living with specific diseases, we applied prevalence estimates of these diseases to the French population. Underlying conditions were ranked by the degree to which they increased the risk of listeriosis. From 2001 to 2008, 1959 cases of listeriosis were reported in France (mean annual incidence 0.39 per 100,000 residents). Compared with persons <65 years with no underlying conditions, those with chronic lymphocytic leukemia had a >1000-fold increased risk of acquiring listeriosis, and those with liver cancer; myeoloproliferative disorder; multiple myeloma; acute leukemia; giant cell arteritis; dialysis; esophageal, stomach, pancreas, lung, and brain cancer; cirrhosis; organ transplantation; and pregnancy had a 100-1000-fold increased risk of listeriosis. To be effective and acceptable to physicians and patients, listeriosis prevention strategies should be targeted based on evidence of increased risk. Stringent dietary guidance, to avoid specific foods with a high risk for Listeria contamination, should be targeted to pregnant women and to others at highest risk of listeriosis.

Conditioning of high voltage radio frequency cavities by using fuzzy logic in connection with rule based programming

NASA Astrophysics Data System (ADS)

Perreard, S.; Wildner, E.

1994-12-01

Many processes are controlled by experts using some kind of mental model to decide on actions and make conclusions. This model, based on heuristic knowledge, can often be represented by rules and does not have to be particularly accurate. Such is the case for the problem of conditioning high voltage RF cavities; the expert has to decide, by observing some criteria, whether to increase or to decrease the voltage and by how much. A program has been implemented which can be applied to a class of similar problems. The kernel of the program is a small rule base, which is independent of the kind of cavity. To model a specific cavity, we use fuzzy logic which is implemented as a separate routine called by the rule base, to translate from numeric to symbolic information.

Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia.

PubMed

Roth, Daniel E; Gaffey, Michelle F; Smith-Romero, Evelyn; Fitzpatrick, Tiffany; Morris, Shaun K

2015-12-01

To explore the variability in childhood acute respiratory infection case definitions for research in low-income settings where there is limited access to laboratory or radiologic investigations. We conducted a systematic review of community-based, longitudinal studies in South Asia published from January 1990 to August 2013, in which childhood acute respiratory infection outcomes were reported. Case definitions were classified by their label (e.g. pneumonia, acute lower respiratory infection) and clinical content 'signatures' (array of clinical features that would be always present, conditionally present or always absent among cases). Case definition heterogeneity was primarily assessed by the number of unique case definitions overall and by label. We also compared case definition-specific acute respiratory infection incidence rates for studies reporting incidence rates for multiple case definitions. In 56 eligible studies, we found 124 acute respiratory infection case definitions. Of 90 case definitions for which clinical content was explicitly defined, 66 (73%) were unique. There was a high degree of content heterogeneity among case definitions with the same label, and some content signatures were assigned multiple labels. Within studies for which incidence rates were reported for multiple case definitions, variation in content was always associated with a change in incidence rate, even when the content differed by a single clinical feature. There has been a wide variability in case definition label and content combinations to define acute upper and lower respiratory infections in children in community-based studies in South Asia over the past two decades. These inconsistencies have important implications for the synthesis and translation of knowledge regarding the prevention and treatment of childhood acute respiratory infection. © 2015 John Wiley & Sons Ltd.

Homeopathic Treatment of Vitiligo: A Report of Fourteen Cases

PubMed Central

Mahesh, Seema; Mallappa, Mahesh; Tsintzas, Dionysios; Vithoulkas, George

2017-01-01

Case series Patient: — Final Diagnosis: — Symptoms: Skin lesions Medication: — Clinical Procedure: — Specialty: Dermatology Objective: Unusual or unexpected effect of treatment Background: Vitiligo, also known as leukoderma, is an autoimmune skin condition that results in the loss of melanin pigment. Vitiligo is not a rare condition but is difficult to treat and is associated with psychological distress. Case Reports: A series of 14 cases of vitiligo are presented that were treated with individualized homeopathic remedies that were based on plant, animal, or mineral compounds. There were 13 women and one man in the case series, with a mean age 29.8 years, and a mean follow-up from treatment of 58 months. The mean time between the onset of the appearance of vitiligo and the first consultation at our clinic was 96 months. Homeopathic treatment for patients is holistic and was performed on an individualized basis as described in this case series. Photographic images of the skin are presented before and after treatment. Conclusions: In 14 patients with vitiligo treated with individualized homeopathy, the best results were achieved in the patients who were treated in the early stages of the disease. We believe that homeopathy may be effective in the early stages of vitiligo, but large controlled clinical studies are needed in this area. PMID:29196612

Association of Asthma with Rheumatoid Arthritis: A Population-Based Case-Control Study.

PubMed

Sheen, Youn Ho; Rolfes, Mary C; Wi, Chung-Il; Crowson, Cindy S; Pendegraft, Richard S; King, Katherine S; Ryu, Euijung; Juhn, Young J

T H 1 and T H 2 cells have counterregulatory relationships. However, the relationship between asthma, a T H 2-predominant condition, and risk of systemic inflammatory diseases such as rheumatoid arthritis (RA), a T H 1 condition, is poorly understood. We aimed to determine whether asthma was associated with increased risks of incident RA among adults. We conducted a retrospective population-based case-control study that examined existing incident RA cases and controls matched by age, sex, and registration year from the general population in Olmsted County, Minnesota, between January 2002 and December 2007. We performed comprehensive medical record reviews to ascertain asthma status using predetermined asthma criteria. The frequency of a history of asthma before the index date was compared between cases and controls. Logistic regression models were used to adjust for confounding factors. We enrolled 221 RA cases and 218 controls. Of the 221 RA cases, 156 (70.6%) were females, 207 (93.7%) were white, the median age at the index date was 52.5 years, and 53 (24.0%) had a history of asthma. Controls had similar characteristics except that 35 of 218 controls (16.1%) had a history of asthma. After adjustment for sex, age, smoking, body mass index, socioeconomic status, and comorbidity, asthma was significantly associated with increased risks of RA (adjusted odds ratio, 1.74; 95% CI, 1.05-2.90; P = .03). Despite the counterregulatory relationship between T H 1 and T H 2 cells, patients with asthma had a significantly higher risk of developing RA than healthy individuals. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

A Python object-oriented framework for the CMS alignment and calibration data

NASA Astrophysics Data System (ADS)

Dawes, Joshua H.; CMS Collaboration

2017-10-01

The Alignment, Calibrations and Databases group at the CMS Experiment delivers Alignment and Calibration Conditions Data to a large set of workflows which process recorded event data and produce simulated events. The current infrastructure for releasing and consuming Conditions Data was designed in the two years of the first LHC long shutdown to respond to use cases from the preceding data-taking period. During the second run of the LHC, new use cases were defined. For the consumption of Conditions Metadata, no common interface existed for the detector experts to use in Python-based custom scripts, resulting in many different querying and transaction management patterns. A new framework has been built to address such use cases: a simple object-oriented tool that detector experts can use to read and write Conditions Metadata when using Oracle and SQLite databases, that provides a homogeneous method of querying across all services. The tool provides mechanisms for segmenting large sets of conditions while releasing them to the production database, allows for uniform error reporting to the client-side from the server-side and optimizes the data transfer to the server. The architecture of the new service has been developed exploiting many of the features made available by the metadata consumption framework to implement the required improvements. This paper presents the details of the design and implementation of the new metadata consumption and data upload framework, as well as analyses of the new upload service’s performance as the server-side state varies.

Possible Further Evidence of Low Genetic Diversity in the El Sidrón (Asturias, Spain) Neandertal Group: Congenital Clefts of the Atlas

PubMed Central

Ríos, Luis; Rosas, Antonio; Estalrrich, Almudena; García-Tabernero, Antonio; Bastir, Markus; Huguet, Rosa; Pastor, Francisco; Sanchís-Gimeno, Juan Alberto; de la Rasilla, Marco

2015-01-01

We present here the first cases in Neandertals of congenital clefts of the arch of the atlas. Two atlases from El Sidrón, northern Spain, present respectively a defect of the posterior (frequency in extant modern human populations ranging from 0.73% to 3.84%), and anterior (frequency in extant modern human populations ranging from 0.087% to 0.1%) arch, a condition in most cases not associated with any clinical manifestation. The fact that two out of three observable atlases present a low frequency congenital condition, together with previously reported evidence of retained deciduous mandibular canine in two out of ten dentitions from El Sidrón, supports the previous observation based on genetic evidence that these Neandertals constituted a group with close genetic relations. Some have proposed for humans and other species that the presence of skeletal congenital conditions, although without clinical significance, could be used as a signal of endogamy or inbreeding. In the present case this interpretation would fit the general scenario of high incidence of rare conditions among Pleistocene humans and the specific scenariothat emerges from Neandertal paleogenetics, which points to long-term small and decreasing population size with reduced and isolated groups. Adverse environmental factors affecting early pregnancies would constitute an alternative, non-exclusive, explanation for a high incidence of congenital conditions. Further support or rejection of these interpretations will come from new genetic and skeletal evidence from Neandertal remains. PMID:26418427

Possible Further Evidence of Low Genetic Diversity in the El Sidrón (Asturias, Spain) Neandertal Group: Congenital Clefts of the Atlas.

PubMed

Ríos, Luis; Rosas, Antonio; Estalrrich, Almudena; García-Tabernero, Antonio; Bastir, Markus; Huguet, Rosa; Pastor, Francisco; Sanchís-Gimeno, Juan Alberto; de la Rasilla, Marco

2015-01-01

We present here the first cases in Neandertals of congenital clefts of the arch of the atlas. Two atlases from El Sidrón, northern Spain, present respectively a defect of the posterior (frequency in extant modern human populations ranging from 0.73% to 3.84%), and anterior (frequency in extant modern human populations ranging from 0.087% to 0.1%) arch, a condition in most cases not associated with any clinical manifestation. The fact that two out of three observable atlases present a low frequency congenital condition, together with previously reported evidence of retained deciduous mandibular canine in two out of ten dentitions from El Sidrón, supports the previous observation based on genetic evidence that these Neandertals constituted a group with close genetic relations. Some have proposed for humans and other species that the presence of skeletal congenital conditions, although without clinical significance, could be used as a signal of endogamy or inbreeding. In the present case this interpretation would fit the general scenario of high incidence of rare conditions among Pleistocene humans and the specific scenariothat emerges from Neandertal paleogenetics, which points to long-term small and decreasing population size with reduced and isolated groups. Adverse environmental factors affecting early pregnancies would constitute an alternative, non-exclusive, explanation for a high incidence of congenital conditions. Further support or rejection of these interpretations will come from new genetic and skeletal evidence from Neandertal remains.

Deterministic physical systems under uncertain initial conditions: the case of maximum entropy applied to projectile motion

NASA Astrophysics Data System (ADS)

Montecinos, Alejandra; Davis, Sergio; Peralta, Joaquín

2018-07-01

The kinematics and dynamics of deterministic physical systems have been a foundation of our understanding of the world since Galileo and Newton. For real systems, however, uncertainty is largely present via external forces such as friction or lack of precise knowledge about the initial conditions of the system. In this work we focus on the latter case and describe the use of inference methodologies in solving the statistical properties of classical systems subject to uncertain initial conditions. In particular we describe the application of the formalism of maximum entropy (MaxEnt) inference to the problem of projectile motion, given information about the average horizontal range over many realizations. By using MaxEnt we can invert the problem and use the provided information on the average range to reduce the original uncertainty in the initial conditions. Also, additional insight into the initial condition's probabilities, and the projectile path distribution itself, can be achieved based on the value of the average horizontal range. The wide applicability of this procedure, as well as its ease of use, reveals a useful tool with which to revisit a large number of physics problems, from classrooms to frontier research.

An analytical study of the dual mass mechanical system stability

NASA Astrophysics Data System (ADS)

Nikolov, Svetoslav; Sinapov, Petko; Kralov, Ivan; Ignatov, Ignat

2011-12-01

In this paper an autonomous, nonlinear model of five ordinary differential equations modeling the motion of a dual mass mechanical system with universal joint is studied. The model is investigated qualitatively. On the base of the stability analysis performed, we obtain that the system is: i) in an equilibrium state, or ii) in a structurally unstable behavior when equilibrium states disappear. In case (i) the system is in a normal technical condition and in case (ii) hard break-downs take place.

Filter membrane-based automated therapeutic plasma exchange: a report of two cases from Nigeria.

PubMed

Arogundade, Fatiu A; Sanusi, Abubakr A; Akinbodewa, Akinwunmi A; Hassan, Muzamil O; Omotosho, Bolanle O; Balogun, Rasheed A; Akinsola, Adewale

2013-02-01

These case reports demonstrated the diagnostic dilemma encountered in patients with systemic lupus erythematosus and thrombotic thrombocytopenic purpura particularly in settings with limited diagnostic facilities and laboratory support. The similarities in the diagnostic criteria for both conditions make clear distinction as well as management decisions difficult. We present the difficulties encountered with both the diagnosis and the management of these two patients that were managed in our facility. Copyright © 2013 Wiley Periodicals, Inc.

[Skin eruption and itching after travel to Asia--a case report].

PubMed

Ólafsson, Guðmundur Dagur; Sigurðsson, Emil L; Sigurðardóttir, Bryndís

2015-09-01

One of the more common reasons patients seek medical advice after traveling in tropical countries are skin eruptions. Here we describe two cases of individuals who, after traveling to south east Asia, developed a skin eruption later diagnosed as cutaneous larva migrans. This particular skin condition is common among travelers to countries where the hookworm responsible is endemic. The diagnosis is based on travel history and clinical examination. The patients were treated with albendazole with good results and complete resolution of the symptoms.

Factors associated with suicide: Case-control study in South Tyrol.

PubMed

Giupponi, Giancarlo; Innamorati, Marco; Baldessarini, Ross J; De Leo, Diego; de Giovannelli, Francesca; Pycha, Roger; Conca, Andreas; Girardi, Paolo; Pompili, Maurizio

2018-01-01

As suicide is related to many factors in addition to psychiatric illness, broad and comprehensive risk-assessment for risk of suicide is required. This study aimed to differentiate nondiagnostic risk factors among suicides versus comparable psychiatric patients without suicidal behavior. We carried out a pilot, case-control comparison of 131 cases of suicide in South Tyrol matched for age and sex with 131 psychiatric controls, using psychological autopsy methods to evaluate differences in clinically assessed demographic, social, and clinical factors, using bivariate conditional Odds Risk comparisons followed by conditional regression modeling controlled for ethnicity. Based on multivariable conditional regression modeling, suicides were significantly more likely to have experienced risk factors, ranking as: [a] family history of suicide or attempt≥[b] recent interpersonal stressors≥[c] childhood traumatic events≥[d] lack of recent clinician contacts≥[e] previous suicide attempt≥[f] non-Italian ethnicity, but did not differ in education, marital status, living situation, or employment, nor by psychiatric or substance-abuse diagnoses. Both recent and early factors were associated with suicide, including lack of recent clinical care, non-Italian cultural subgroup-membership, familial suicidal behavior, and recent interpersonal distress. Copyright © 2017 Elsevier Inc. All rights reserved.

Theoretical study of air forces on an oscillating or steady thin wing in a supersonic main stream

NASA Technical Reports Server (NTRS)

Garrick, I E; Rubinow, S I

1947-01-01

A theoretical study, based on the linearized equations of motion for small disturbance, is made of the air forces on wings of general plan forms moving forward at a constant supersonic speed. The boundary problem is set up for both the harmonically oscillating and the steady conditions. Two types of boundary conditions are distinguished, which are designated "purely supersonic" and "mixed supersonic." the method is illustrated by applications to a number of examples for both the steady and the oscillating conditions. The purely supersonic case involves independence of action of the upper and lower surfaces of the airfoil and present analysis is mainly concerned with this case. A discussion is first given of the fundamental or elementary solution corresponding to a moving source. The solutions for the velocity potential are then synthesized by means of integration of the fundamental solution for the moving source. The method is illustrated by applications to a number of examples for both the steady and the oscillating cases and for various plan forms, including swept wings and rectangular and triangular plan forms. The special results of a number of authors are shown to be included in the analysis.

Program VSAERO theory document: A computer program for calculating nonlinear aerodynamic characteristics of arbitrary configurations

NASA Technical Reports Server (NTRS)

Maskew, Brian

1987-01-01

The VSAERO low order panel method formulation is described for the calculation of subsonic aerodynamic characteristics of general configurations. The method is based on piecewise constant doublet and source singularities. Two forms of the internal Dirichlet boundary condition are discussed and the source distribution is determined by the external Neumann boundary condition. A number of basic test cases are examined. Calculations are compared with higher order solutions for a number of cases. It is demonstrated that for comparable density of control points where the boundary conditions are satisfied, the low order method gives comparable accuracy to the higher order solutions. It is also shown that problems associated with some earlier low order panel methods, e.g., leakage in internal flows and junctions and also poor trailing edge solutions, do not appear for the present method. Further, the application of the Kutta conditions is extremely simple; no extra equation or trailing edge velocity point is required. The method has very low computing costs and this has made it practical for application to nonlinear problems requiring iterative solutions for wake shape and surface boundary layer effects.

Numerical simulation of seasonality in the distribution and fate of pyrene in multimedia aquatic environments with Markov chains.

PubMed

Sun, Caiyun; Xu, Liang; Sun, Dazhi; Chen, Libo; Zou, Jiying; Zhang, Zhenxing

2017-08-29

This case study investigated the distribution and fate of organic pollutants in aquatic environments based on laboratory experiments and modeling. Pyrene (Pyr) is a hydrocarbon pollutant with adverse effects on aquatic ecosystems and human health, and was thus selected for this case study. The movement of Pyr was primarily influenced by its sorption from water onto sediment, and its desorption from sediment into water. Its elimination was mainly via biodegradation by microorganisms in sediment and by volatilization from water into air. The transport and elimination rates for Pyr were considerably influenced by temperature and moisture. Results of modeling with Markov chains revealed that the elimination of Pyr from water/sediment systems was the most rapid under wet conditions. Under average conditions, a Pyr concentration of 100 μg/L of in water in such a system declined to a negligible level over 250 h. Under wet conditions, this decrease occurred over 120 h. Finally, under dry conditions, it took 550 h to achieve the same degree of elimination.

A concurrent multiscale micromorphic molecular dynamics

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

Li, Shaofan, E-mail: shaofan@berkeley.edu; Tong, Qi

2015-04-21

In this work, we have derived a multiscale micromorphic molecular dynamics (MMMD) from first principle to extend the (Andersen)-Parrinello-Rahman molecular dynamics to mesoscale and continuum scale. The multiscale micromorphic molecular dynamics is a con-current three-scale dynamics that couples a fine scale molecular dynamics, a mesoscale micromorphic dynamics, and a macroscale nonlocal particle dynamics together. By choosing proper statistical closure conditions, we have shown that the original Andersen-Parrinello-Rahman molecular dynamics is the homogeneous and equilibrium case of the proposed multiscale micromorphic molecular dynamics. In specific, we have shown that the Andersen-Parrinello-Rahman molecular dynamics can be rigorously formulated and justified from firstmore » principle, and its general inhomogeneous case, i.e., the three scale con-current multiscale micromorphic molecular dynamics can take into account of macroscale continuum mechanics boundary condition without the limitation of atomistic boundary condition or periodic boundary conditions. The discovered multiscale scale structure and the corresponding multiscale dynamics reveal a seamless transition from atomistic scale to continuum scale and the intrinsic coupling mechanism among them based on first principle formulation.« less

Applying the Kanban Method in Problem-Based Project Work: A Case Study in A Manufacturing Engineering Bachelor's Programme at Aalborg University Copenhagen

ERIC Educational Resources Information Center

Balve, Patrick; Krüger, Volker; Tolstrup Sørensen, Lene

2017-01-01

Problem-based learning (PBL) has proven to be highly effective for educating students in an active and self-motivated manner in various disciplines. Student projects carried out following PBL principles are very dynamic and carry a high level of uncertainty, both conditions under which agile project management approaches are assumed to be highly…

Topological strings on singular elliptic Calabi-Yau 3-folds and minimal 6d SCFTs

NASA Astrophysics Data System (ADS)

Del Zotto, Michele; Gu, Jie; Huang, Min-xin; Kashani-Poor, Amir-Kian; Klemm, Albrecht; Lockhart, Guglielmo

2018-03-01

We apply the modular approach to computing the topological string partition function on non-compact elliptically fibered Calabi-Yau 3-folds with higher Kodaira singularities in the fiber. The approach consists in making an ansatz for the partition function at given base degree, exact in all fiber classes to arbitrary order and to all genus, in terms of a rational function of weak Jacobi forms. Our results yield, at given base degree, the elliptic genus of the corresponding non-critical 6d string, and thus the associated BPS invariants of the 6d theory. The required elliptic indices are determined from the chiral anomaly 4-form of the 2d worldsheet theories, or the 8-form of the corresponding 6d theories, and completely fix the holomorphic anomaly equation constraining the partition function. We introduce subrings of the known rings of Weyl invariant Jacobi forms which are adapted to the additional symmetries of the partition function, making its computation feasible to low base wrapping number. In contradistinction to the case of simpler singularities, generic vanishing conditions on BPS numbers are no longer sufficient to fix the modular ansatz at arbitrary base wrapping degree. We show that to low degree, imposing exact vanishing conditions does suffice, and conjecture this to be the case generally.

RWPV bioreactor mass transport: earth-based and in microgravity

NASA Technical Reports Server (NTRS)

Begley, Cynthia M.; Kleis, Stanley J.

2002-01-01

Mass transport and mixing of perfused scalar quantities in the NASA Rotating Wall Perfused Vessel bioreactor are studied using numerical models of the flow field and scalar concentration field. Operating conditions typical of both microgravity and ground-based cell cultures are studied to determine the expected vessel performance for both flight and ground-based control experiments. Results are presented for the transport of oxygen with cell densities and consumption rates typical of colon cancer cells cultured in the RWPV. The transport and mixing characteristics are first investigated with a step change in the perfusion inlet concentration by computing the time histories of the time to exceed 10% inlet concentration. The effects of a uniform cell utilization rate are then investigated with time histories of the outlet concentration, volume average concentration, and volume fraction starved. It is found that the operating conditions used in microgravity produce results that are quite different then those for ground-based conditions. Mixing times for microgravity conditions are significantly shorter than those for ground-based operation. Increasing the differential rotation rates (microgravity) increases the mixing and transport, while increasing the mean rotation rate (ground-based) suppresses both. Increasing perfusion rates enhances mass transport for both microgravity and ground-based cases, however, for the present range of operating conditions, above 5-10 cc/min there are diminishing returns as much of the inlet fluid is transported directly to the perfusion exit. The results show that exit concentration is not a good indicator of the concentration distributions in the vessel. In microgravity conditions, the NASA RWPV bioreactor with the viscous pump has been shown to provide an environment that is well mixed. Even when operated near the theoretical minimum perfusion rates, only a small fraction of the volume provides less than the required oxygen levels. 2002 Wiley Periodicals, Inc.

RWPV bioreactor mass transport: earth-based and in microgravity.

PubMed

Begley, Cynthia M; Kleis, Stanley J

2002-11-20

Mass transport and mixing of perfused scalar quantities in the NASA Rotating Wall Perfused Vessel bioreactor are studied using numerical models of the flow field and scalar concentration field. Operating conditions typical of both microgravity and ground-based cell cultures are studied to determine the expected vessel performance for both flight and ground-based control experiments. Results are presented for the transport of oxygen with cell densities and consumption rates typical of colon cancer cells cultured in the RWPV. The transport and mixing characteristics are first investigated with a step change in the perfusion inlet concentration by computing the time histories of the time to exceed 10% inlet concentration. The effects of a uniform cell utilization rate are then investigated with time histories of the outlet concentration, volume average concentration, and volume fraction starved. It is found that the operating conditions used in microgravity produce results that are quite different then those for ground-based conditions. Mixing times for microgravity conditions are significantly shorter than those for ground-based operation. Increasing the differential rotation rates (microgravity) increases the mixing and transport, while increasing the mean rotation rate (ground-based) suppresses both. Increasing perfusion rates enhances mass transport for both microgravity and ground-based cases, however, for the present range of operating conditions, above 5-10 cc/min there are diminishing returns as much of the inlet fluid is transported directly to the perfusion exit. The results show that exit concentration is not a good indicator of the concentration distributions in the vessel. In microgravity conditions, the NASA RWPV bioreactor with the viscous pump has been shown to provide an environment that is well mixed. Even when operated near the theoretical minimum perfusion rates, only a small fraction of the volume provides less than the required oxygen levels. 2002 Wiley Periodicals, Inc.

A Gaussian random field model for similarity-based smoothing in Bayesian disease mapping.

PubMed

Baptista, Helena; Mendes, Jorge M; MacNab, Ying C; Xavier, Miguel; Caldas-de-Almeida, José

2016-08-01

Conditionally specified Gaussian Markov random field (GMRF) models with adjacency-based neighbourhood weight matrix, commonly known as neighbourhood-based GMRF models, have been the mainstream approach to spatial smoothing in Bayesian disease mapping. In the present paper, we propose a conditionally specified Gaussian random field (GRF) model with a similarity-based non-spatial weight matrix to facilitate non-spatial smoothing in Bayesian disease mapping. The model, named similarity-based GRF, is motivated for modelling disease mapping data in situations where the underlying small area relative risks and the associated determinant factors do not vary systematically in space, and the similarity is defined by "similarity" with respect to the associated disease determinant factors. The neighbourhood-based GMRF and the similarity-based GRF are compared and accessed via a simulation study and by two case studies, using new data on alcohol abuse in Portugal collected by the World Mental Health Survey Initiative and the well-known lip cancer data in Scotland. In the presence of disease data with no evidence of positive spatial correlation, the simulation study showed a consistent gain in efficiency from the similarity-based GRF, compared with the adjacency-based GMRF with the determinant risk factors as covariate. This new approach broadens the scope of the existing conditional autocorrelation models. © The Author(s) 2016.

Towards a Computational Framework for Modeling the Impact of Aortic Coarctations Upon Left Ventricular Load

PubMed Central

Karabelas, Elias; Gsell, Matthias A. F.; Augustin, Christoph M.; Marx, Laura; Neic, Aurel; Prassl, Anton J.; Goubergrits, Leonid; Kuehne, Titus; Plank, Gernot

2018-01-01

Computational fluid dynamics (CFD) models of blood flow in the left ventricle (LV) and aorta are important tools for analyzing the mechanistic links between myocardial deformation and flow patterns. Typically, the use of image-based kinematic CFD models prevails in applications such as predicting the acute response to interventions which alter LV afterload conditions. However, such models are limited in their ability to analyze any impacts upon LV load or key biomarkers known to be implicated in driving remodeling processes as LV function is not accounted for in a mechanistic sense. This study addresses these limitations by reporting on progress made toward a novel electro-mechano-fluidic (EMF) model that represents the entire physics of LV electromechanics (EM) based on first principles. A biophysically detailed finite element (FE) model of LV EM was coupled with a FE-based CFD solver for moving domains using an arbitrary Eulerian-Lagrangian (ALE) formulation. Two clinical cases of patients suffering from aortic coarctations (CoA) were built and parameterized based on clinical data under pre-treatment conditions. For one patient case simulations under post-treatment conditions after geometric repair of CoA by a virtual stenting procedure were compared against pre-treatment results. Numerical stability of the approach was demonstrated by analyzing mesh quality and solver performance under the significantly large deformations of the LV blood pool. Further, computational tractability and compatibility with clinical time scales were investigated by performing strong scaling benchmarks up to 1536 compute cores. The overall cost of the entire workflow for building, fitting and executing EMF simulations was comparable to those reported for image-based kinematic models, suggesting that EMF models show potential of evolving into a viable clinical research tool. PMID:29892227

Laboratory Study on Macro-Features of Wave Breaking Over Bars and Artificial Reefs

DTIC Science & Technology

1990-07-01

Prototype and Model Conditions of Case CE400 ( Pilot Test ) . 72 7 List of Design Parameters for Base Tests ... ........... . 72 8 List of Design Parameters...bar configurations, and the procedure was repeated. Pilot test 112. A pilot test was performed as a trial of the methodology and vali- dation of the...criterion on bar depth given by Larson and Kraus (1989) prior to actual testing . In this pilot test , the wave conditions and equilibrium bar formed in a

The periodontal abscess: a review.

PubMed

Herrera, D; Roldán, S; Sanz, M

2000-06-01

The periodontal abscess is a frequent periodontal condition in which periodontal tissues may be rapidly destroyed. Its importance is based on the possible need of urgent care, the affectation of tooth prognosis, and the possibility of infection spreading. There is scant information in the scientific literature regarding this condition and most of it has been published as case reports and text books, where conclusions are not evidence-based, but rather empirical observations made by recognised clinicians. The aim of this review was to critically analyse all available information on this subject in the dental and medical literature, including information on its prevalence, proposed etiologies and pathogenesis, diagnosis, microbiology and treatment alternatives. The periodontal abscess is the 3rd most frequent dental emergency, and it is specially prevalent among untreated periodontal patients and periodontal patients during maintenance. Different etiologies have been proposed, and 2 main groups can be distinguished, depending on its relation with periodontal pockets. In the case of a periodontitis-related abscess, the condition may appear as an exacerbation of a non-treated periodontitis or during the course of periodontal therapy. In non-periodontitis related abscesses, impaction of foreign objects, and radicular abnormalities are the 2 main causes. The abscess microflora seems to be similar to that of adult periodontitis, and it is dominated by gram-negative anaerobic rods, including well-known periodontal pathogens. Complications and consequences include tooth loss and the spread of the infection to other body sites. Diagnosis and treatment is mainly based on empiricism, since evidence-based data are not available. The role of systemic antibiotics, in the treatment of periodontal abscesses, is especially controversial.

Launch Condition Deviations of Reusable Launch Vehicle Simulations in Exo-Atmospheric Zoom Climbs

NASA Technical Reports Server (NTRS)

Urschel, Peter H.; Cox, Timothy H.

2003-01-01

The Defense Advanced Research Projects Agency has proposed a two-stage system to deliver a small payload to orbit. The proposal calls for an airplane to perform an exo-atmospheric zoom climb maneuver, from which a second-stage rocket is launched carrying the payload into orbit. The NASA Dryden Flight Research Center has conducted an in-house generic simulation study to determine how accurately a human-piloted airplane can deliver a second-stage rocket to a desired exo-atmospheric launch condition. A high-performance, fighter-type, fixed-base, real-time, pilot-in-the-loop airplane simulation has been modified to perform exo-atmospheric zoom climb maneuvers. Four research pilots tracked a reference trajectory in the presence of winds, initial offsets, and degraded engine thrust to a second-stage launch condition. These launch conditions have been compared to the reference launch condition to characterize the expected deviation. At each launch condition, a speed change was applied to the second-stage rocket to insert the payload onto a transfer orbit to the desired operational orbit. The most sensitive of the test cases was the degraded thrust case, yielding second-stage launch energies that were too low to achieve the radius of the desired operational orbit. The handling qualities of the airplane, as a first-stage vehicle, have also been investigated.

Professions and Working Conditions Associated With Community-Acquired Pneumonia.

PubMed

Almirall, Jordi; Serra-Prat, Mateu; Bolíbar, Ignasi; Palomera, Elisabet; Roig, Jordi; Boixeda, Ramon; Bartolomé, Maria; de la Torre, Mari; Parra, Olga; Torres, Antoni

2015-12-01

Community-acquired pneumonia (CAP) is not considered a professional disease, and the effect of different occupations and working conditions on susceptibility to CAP is unknown. The aim of this study is to determine whether different jobs and certain working conditions are risk factors for CAP. Over a 1-year period, all radiologically confirmed cases of CAP (n=1,336) and age- and sex-matched controls (n=1,326) were enrolled in a population-based case-control study. A questionnaire on CAP risk factors, including work-related questions, was administered to all participants during an in-person interview. The bivariate analysis showed that office work is a protective factor against CAP, while building work, contact with dust and sudden changes of temperature in the workplace were risk factors for CAP. The occupational factor disappeared when the multivariate analysis was adjusted for working conditions. Contact with dust (previous month) and sudden changes of temperature (previous 3 months) were risk factors for CAP, irrespective of the number of years spent working in these conditions, suggesting reversibility. Some recent working conditions such as exposure to dust and sudden changes of temperature in the workplace are risk factors for CAP. Both factors are reversible and preventable. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Testing the Feasibility of a Passive and Active Case Ascertainment System for Multiple Rare Conditions Simultaneously: The Experience in Three US States

PubMed Central

McDermott, Suzanne; Ruttenber, Margaret; Mann, Joshua; Smith, Michael G; Royer, Julie; Valdez, Rodolfo

2016-01-01

Background Owing to their low prevalence, single rare conditions are difficult to monitor through current state passive and active case ascertainment systems. However, such monitoring is important because, as a group, rare conditions have great impact on the health of affected individuals and the well-being of their caregivers. A viable approach could be to conduct passive and active case ascertainment of several rare conditions simultaneously. This is a report about the feasibility of such an approach. Objective To test the feasibility of a case ascertainment system with passive and active components aimed at monitoring 3 rare conditions simultaneously in 3 states of the United States (Colorado, Kansas, and South Carolina). The 3 conditions are spina bifida, muscular dystrophy, and fragile X syndrome. Methods Teams from each state evaluated the possibility of using current or modified versions of their local passive and active case ascertainment systems and datasets to monitor the 3 conditions. Together, these teams established the case definitions and selected the variables and the abstraction tools for the active case ascertainment approach. After testing the ability of their local passive and active case ascertainment system to capture all 3 conditions, the next steps were to report the number of cases detected actively and passively for each condition, to list the local barriers against the combined passive and active case ascertainment system, and to describe the experiences in trying to overcome these barriers. Results During the test period, the team from South Carolina was able to collect data on all 3 conditions simultaneously for all ages. The Colorado team was also able to collect data on all 3 conditions but, because of age restrictions in its passive and active case ascertainment system, it was able to report few cases of fragile X syndrome. The team from Kansas was able to collect data only on spina bifida. For all states, the implementation of an active component of the ascertainment system was problematic. The passive component appears viable with minor modifications. Conclusions Despite evident barriers, the joint passive and active case ascertainment of rare disorders using modified existing surveillance systems and datasets seems feasible, especially for systems that rely on passive case ascertainment. PMID:27574026

Test Standards for Contingency Base Waste-to-Energy Technologies

DTIC Science & Technology

2015-08-01

test runs are preferred to allow a more comprehensive statistical evaluation of the results. In 8 • Minimize the complexity , difficulty, and...with water or, in the case of cyanide - or sulfide-bearing wastes, when exposed to mild acidic or basic conditions; 4) explode when subjected to a

Projected climate change impacts on skiing and snowmobiling: A case study of the United States

EPA Science Inventory

A physically-based water and energy balance model is used to simulate natural snow accumulation at 247 winter recreation locations across the continental United States. We combine this model with projections of snowmaking conditions to determine downhill skiing, cross-country ski...

Principals and Teachers Leading Together.

ERIC Educational Resources Information Center

Ryan, Sherrill A.

This report has two main purposes: to examine the perceived impact of teacher leadership, and to explore the conditions in schools that support or constrain teacher leadership. It discusses peer-nominated, nonadministrative leaders; leadership practices; and sources of power. The report is based on a multisite case study of three schools, serving…

Stochastic simulation by image quilting of process-based geological models

NASA Astrophysics Data System (ADS)

Hoffimann, Júlio; Scheidt, Céline; Barfod, Adrian; Caers, Jef

2017-09-01

Process-based modeling offers a way to represent realistic geological heterogeneity in subsurface models. The main limitation lies in conditioning such models to data. Multiple-point geostatistics can use these process-based models as training images and address the data conditioning problem. In this work, we further develop image quilting as a method for 3D stochastic simulation capable of mimicking the realism of process-based geological models with minimal modeling effort (i.e. parameter tuning) and at the same time condition them to a variety of data. In particular, we develop a new probabilistic data aggregation method for image quilting that bypasses traditional ad-hoc weighting of auxiliary variables. In addition, we propose a novel criterion for template design in image quilting that generalizes the entropy plot for continuous training images. The criterion is based on the new concept of voxel reuse-a stochastic and quilting-aware function of the training image. We compare our proposed method with other established simulation methods on a set of process-based training images of varying complexity, including a real-case example of stochastic simulation of the buried-valley groundwater system in Denmark.

First-principles calculation of defect free energies: General aspects illustrated in the case of bcc Fe

NASA Astrophysics Data System (ADS)

Murali, D.; Posselt, M.; Schiwarth, M.

2015-08-01

Modeling of nanostructure evolution in solids requires comprehensive data on the properties of defects such as the vacancy and foreign atoms. Since most processes occur at elevated temperatures, not only the energetics of defects in the ground state, but also their temperature-dependent free energies must be known. The first-principles calculation of contributions of phonon and electron excitations to free formation, binding, and migration energies of defects is illustrated in the case of bcc Fe. First of all, the ground-state properties of the vacancy, the foreign atoms Cu, Y, Ti, Cr, Mn, Ni, V, Mo, Si, Al, Co, O, and the O-vacancy pair are determined under constant volume (CV) as well as zero-pressure (ZP) conditions, and relations between the results of both kinds of calculations are discussed. Second, the phonon contribution to defect free energies is calculated within the harmonic approximation using the equilibrium atomic positions determined in the ground state under CV and ZP conditions. In most cases, the ZP-based free formation energy decreases monotonously with temperature, whereas for CV-based data both an increase and a decrease were found. The application of a quasiharmonic correction to the ZP-based data does not modify this picture significantly. However, the corrected data are valid under zero-pressure conditions at higher temperatures than in the framework of the purely harmonic approach. The difference between CV- and ZP-based data is mainly due to the volume change of the supercell since the relative arrangement of atoms in the environment of the defects is nearly identical in the two cases. A simple transformation similar to the quasiharmonic approach is found between the CV- and ZP-based frequencies. Therefore, it is not necessary to calculate these quantities and the corresponding defect free energies separately. In contrast to ground-state energetics, the CV- and ZP-based defect free energies do not become equal with increasing supercell size. Third, it was found that the contribution of electron excitations to the defect free energy can lead to an additional deviation of the total free energy from the ground-state value or can compensate the deviation caused by the phonon contribution. Finally, self-diffusion via the vacancy mechanism is investigated. The ratio of the respective CV- and ZP-based results for the vacancy diffusivity is nearly equal to the reciprocal of that for the equilibrium concentration. This behavior leads to almost identical CV- and ZP-based values for the self-diffusion coefficient. Obviously, this agreement is accidental. The consideration of the temperature dependence of the magnetization yields self-diffusion data in very good agreement with experiments.

When the beachhopper looks at the moon: The moon compass hypothesis

NASA Technical Reports Server (NTRS)

Enright, J. T.

1972-01-01

The function of moon position for shoreline orientation by talitrids is investigated. Three major results were found: (1) Observed cases of compensation for changes in the direction of the moon are based on physiological rhythm with a period of about 25 hours which can persist for at least several days under constant conditions. (2) The zeitgeber for physiological rhythm may be either moonlight or some other factor associated with the tides. (3) If talitrids are long removed from environmental entrainment, either artifically or naturally, the internal rhythm no longer exerts an appreciable influence on the angle of lunar orientation; in such cases the system deteriorates into constant angle orientation, with an angle which is determined by the beach orgin, but may be modified by lighting conditions.

A survey of quantum Lyapunov control methods.

PubMed

Cong, Shuang; Meng, Fangfang

2013-01-01

The condition of a quantum Lyapunov-based control which can be well used in a closed quantum system is that the method can make the system convergent but not just stable. In the convergence study of the quantum Lyapunov control, two situations are classified: nondegenerate cases and degenerate cases. For these two situations, respectively, in this paper the target state is divided into four categories: the eigenstate, the mixed state which commutes with the internal Hamiltonian, the superposition state, and the mixed state which does not commute with the internal Hamiltonian. For these four categories, the quantum Lyapunov control methods for the closed quantum systems are summarized and analyzed. Particularly, the convergence of the control system to the different target states is reviewed, and how to make the convergence conditions be satisfied is summarized and analyzed.

The Complete Remission of Acquired Immunodeficiency Syndrome-associated Isolated Central Nervous System Lymphomatoid Granulomatosis: A Case Report and Review of the Literature.

PubMed

Kano, Yasuhiro; Kodaira, Minori; Ushiki, Atsuhito; Kosaka, Makoto; Yamada, Mitsunori; Shingu, Kunihiko; Nishihara, Hiroshi; Hanaoka, Masayuki; Sekijima, Yoshiki

2017-09-15

A 49-year-old man presented with gradually progressive aphasia one month after being diagnosed with acquired immunodeficiency syndrome (AIDS). Brain magnetic resonance imaging showed multiple brain lesions with punctate and linear enhancement. A polymerase chain reaction detected Epstein-Barr virus (EBV) in the patient's cerebrospinal fluid. A diagnosis of isolated central nervous system lymphomatoid granulomatosis (CNS-LYG) was made based on the brain biopsy findings. The complete remission of CNS-LYG was achieved by anti-retroviral therapy (ART) alone. In the present case, the development of AIDS-associated CNS-LYG was considered to have been initiated by the reactivation of EBV in the CNS under immunosuppressive conditions. The patient's condition improved with the reconstitution of the patient's immune system.

Epidemiology of Heart Failure

PubMed Central

Roger, Véronique L.

2013-01-01

Heart failure (HF) has been singled out as an epidemic and is a staggering clinical and public health problem, associated with significant mortality, morbidity, and healthcare expenditures, particularly among those aged 65 and older. The case mix of HF is changing over time with a growing proportion of cases presenting with preserved ejection fraction for which there is no specific treatment. Despite progress in reducing HF-related mortality, hospitalizations for HF remain very frequent and rates of readmissions continuing to rise. To prevent hospitalizations, a comprehensive characterization of predictors of readmission in patients with HF is imperative and must integrate the impact of multimorbidity related to coexisting conditions. New models of patient-centered care that draw upon community-based resources to support HF patients with complex coexisting conditions are needed to decrease hospitalizations. PMID:23989710

Identifying High-Risk Patients without Labeled Training Data: Anomaly Detection Methodologies to Predict Adverse Outcomes

PubMed Central

Syed, Zeeshan; Saeed, Mohammed; Rubinfeld, Ilan

2010-01-01

For many clinical conditions, only a small number of patients experience adverse outcomes. Developing risk stratification algorithms for these conditions typically requires collecting large volumes of data to capture enough positive and negative for training. This process is slow, expensive, and may not be appropriate for new phenomena. In this paper, we explore different anomaly detection approaches to identify high-risk patients as cases that lie in sparse regions of the feature space. We study three broad categories of anomaly detection methods: classification-based, nearest neighbor-based, and clustering-based techniques. When evaluated on data from the National Surgical Quality Improvement Program (NSQIP), these methods were able to successfully identify patients at an elevated risk of mortality and rare morbidities following inpatient surgical procedures. PMID:21347083

The Development of an Interactive Computer-Based Training Program for Timely and Humane On-Farm Pig Euthanasia.

PubMed

Mullins, Caitlyn R; Pairis-Garcia, Monique D; Campler, Magnus R; Anthony, Raymond; Johnson, Anna K; Coleman, Grahame J; Rault, Jean-Loup

2018-02-05

With extensive knowledge and training in the prevention, management, and treatment of disease conditions in animals, veterinarians play a critical role in ensuring good welfare on swine farms by training caretakers on the importance of timely euthanasia. To assist veterinarians and other industry professionals in training new and seasoned caretakers, an interactive computer-based training program was created. It consists of three modules, each containing five case studies, which cover three distinct production stages (breeding stock, piglets, and wean to grower-finisher pigs). Case study development was derived from five specific euthanasia criteria defined in the 2015 Common Swine Industry Audit, a nationally recognized auditing program used in the US. Case studies provide information regarding treatment history, clinical signs, and condition severity of the pig and prompt learners to make management decisions regarding pig treatment and care. Once a decision is made, feedback is provided so learners understand the appropriateness of their decision compared to current industry guidelines. In addition to training farm personnel, this program may also be a valuable resource if incorporated into veterinary, graduate, and continuing education curricula. This innovative tool represents the first interactive euthanasia-specific training program in the US swine industry and offers the potential to improve timely and humane on-farm pig euthanasia.

Association of bladder pain syndrome/interstitial cystitis with urinary calculus: a nationwide population-based study.

PubMed

Keller, Joseph; Chen, Yi-Kuang; Lin, Herng-Ching

2013-04-01

Although one prior study reported an association between bladder pain syndrome/interstitial cystitis (BPS/IC) and urinary calculi (UC), no population-based study to date has been conducted to explore this relationship. Therefore, using a population-based data set in Taiwan, this study set out to investigate the association between BPS/IC and a prior diagnosis of UC. This study included 9,269 cases who had received their first-time diagnosis of BPS/IC between 2006 and 2007 and 46,345 randomly selected controls. We used conditional logistic regression analysis to compute the odds ratio (OR) and its corresponding 95 % confidence interval (CI) for having been previously diagnosed with UC between cases and controls. There was a significant difference in the prevalence of prior UC between cases and controls (8.1 vs 4.3 %, p < 0.001). Conditional logistic regression analysis revealed that cases were more likely to have been previously diagnosed with UC than controls (OR = 1.70; 95 % CI = 1.56-1.84) after adjusting for chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraine, sicca syndrome, allergy, endometriosis, and asthma. BPS/IC was found to be significantly associated with prior UC regardless of stone location; the adjusted ORs of kidney calculus, ureter calculus, bladder calculus, and unspecified calculus when compared to controls were 1.58 (95 % CI = 1.38-1.81), 1.73 (95 % CI = 1.45-2.05), 3.80 (95 % CI = 2.18-6.62), and 1.83 (95 % CI = 1.59-2.11), respectively. This work generates the hypothesis that UC may be associated with BPS/IC.

Diagnostic accuracy of administrative data algorithms in the diagnosis of osteoarthritis: a systematic review.

PubMed

Shrestha, Swastina; Dave, Amish J; Losina, Elena; Katz, Jeffrey N

2016-07-07

Administrative health care data are frequently used to study disease burden and treatment outcomes in many conditions including osteoarthritis (OA). OA is a chronic condition with significant disease burden affecting over 27 million adults in the US. There are few studies examining the performance of administrative data algorithms to diagnose OA. The purpose of this study is to perform a systematic review of administrative data algorithms for OA diagnosis; and, to evaluate the diagnostic characteristics of algorithms based on restrictiveness and reference standards. Two reviewers independently screened English-language articles published in Medline, Embase, PubMed, and Cochrane databases that used administrative data to identify OA cases. Each algorithm was classified as restrictive or less restrictive based on number and type of administrative codes required to satisfy the case definition. We recorded sensitivity and specificity of algorithms and calculated positive likelihood ratio (LR+) and positive predictive value (PPV) based on assumed OA prevalence of 0.1, 0.25, and 0.50. The search identified 7 studies that used 13 algorithms. Of these 13 algorithms, 5 were classified as restrictive and 8 as less restrictive. Restrictive algorithms had lower median sensitivity and higher median specificity compared to less restrictive algorithms when reference standards were self-report and American college of Rheumatology (ACR) criteria. The algorithms compared to reference standard of physician diagnosis had higher sensitivity and specificity than those compared to self-reported diagnosis or ACR criteria. Restrictive algorithms are more specific for OA diagnosis and can be used to identify cases when false positives have higher costs e.g. interventional studies. Less restrictive algorithms are more sensitive and suited for studies that attempt to identify all cases e.g. screening programs.

Trauma and conditional risk of posttraumatic stress disorder in two American Indian reservation communities.

PubMed

Beals, Janette; Belcourt-Dittloff, Annjeanette; Garroutte, Eva M; Croy, Calvin; Jervis, Lori L; Whitesell, Nancy Rumbaugh; Mitchell, Christina M; Manson, Spero M

2013-06-01

To determine conditional risk of posttraumatic stress disorder (PTSD) in two culturally distinct American Indian reservation communities. Data derived from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project, a cross-sectional population-based survey that was completed between 1997 and 2000. This study focused on 1,967 participants meeting the DSM-IV criteria for trauma exposure. Traumas were grouped into interpersonal, non-interpersonal, witnessed, and "trauma to close others" categories. Analyses examined distribution of worst traumas, conditional rates of PTSD following exposure, and distributions of PTSD cases deriving from these events. Bivariate and multivariate logistic regressions estimated associations of lifetime PTSD with trauma type. Overall, 15.9 % of those exposed to DSM-IV trauma qualified for lifetime PTSD, a rate comparable to similar US studies. Women were more likely to develop PTSD than were men. The majority (60 %) of cases of PTSD among women derived from interpersonal trauma exposure (in particular, sexual and physical abuse); among men, cases were more evenly distributed across trauma categories. Previous research has demonstrated higher rates of both trauma exposure and PTSD in American Indian samples compared to other Americans. This study shows that conditional rates of PTSD are similar to those reported elsewhere, suggesting that the elevated prevalence of this disorder in American Indian populations is largely due to higher rates of trauma exposure.

'Everyone assumes a man to be quite strong': Men, masculinity and rheumatoid arthritis: A case-study approach.

PubMed

Flurey, Caroline; White, Alan; Rodham, Karen; Kirwan, John; Noddings, Robert; Hewlett, Sarah

2018-01-01

Current literature has overlooked the impact of chronic illness on masculine identity. We therefore aimed to investigate the impact of rheumatoid arthritis (a long term condition, affecting more women than men) on masculine identity. Six focus groups with 22 men with rheumatoid arthritis (RA) (data reported elsewhere) followed by five one-to-one interviews with men (English, mean age: 59 years) sampled to reflect a heterogeneous experience of life with RA based on knowledge gained from the focus groups. Transcripts were analysed using thematic analysis and are presented as individual case studies. Whilst the case studies provide five distinct experiences, common themes can be drawn across them, such as the importance of paid work. The men needed to renegotiate their masculine identity to deal with their RA. Two dealt with this by pushing through pain to retain masculine activities, two replaced masculine roles they could no longer do with other roles, and one rejected masculinity completely. Men with long term conditions may need to re-write their masculinity scripts to enable them to accept and adapt to their condition. However, some men struggle with this, which should be taken into consideration when designing self-management services for men with long term conditions. © 2017 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

Case studies, cross-site comparisons, and the challenge of generalization: comparing agent-based models of land-use change in frontier regions

PubMed Central

Parker, Dawn C.; Entwisle, Barbara; Rindfuss, Ronald R.; Vanwey, Leah K.; Manson, Steven M.; Moran, Emilio; An, Li; Deadman, Peter; Evans, Tom P.; Linderman, Marc; Rizi, S. Mohammad Mussavi; Malanson, George

2009-01-01

Cross-site comparisons of case studies have been identified as an important priority by the land-use science community. From an empirical perspective, such comparisons potentially allow generalizations that may contribute to production of global-scale land-use and land-cover change projections. From a theoretical perspective, such comparisons can inform development of a theory of land-use science by identifying potential hypotheses and supporting or refuting evidence. This paper undertakes a structured comparison of four case studies of land-use change in frontier regions that follow an agent-based modeling approach. Our hypothesis is that each case study represents a particular manifestation of a common process. Given differences in initial conditions among sites and the time at which the process is observed, actual mechanisms and outcomes are anticipated to differ substantially between sites. Our goal is to reveal both commonalities and differences among research sites, model implementations, and ultimately, conclusions derived from the modeling process. PMID:19960107

Case studies, cross-site comparisons, and the challenge of generalization: comparing agent-based models of land-use change in frontier regions.

PubMed

Parker, Dawn C; Entwisle, Barbara; Rindfuss, Ronald R; Vanwey, Leah K; Manson, Steven M; Moran, Emilio; An, Li; Deadman, Peter; Evans, Tom P; Linderman, Marc; Rizi, S Mohammad Mussavi; Malanson, George

2008-01-01

Cross-site comparisons of case studies have been identified as an important priority by the land-use science community. From an empirical perspective, such comparisons potentially allow generalizations that may contribute to production of global-scale land-use and land-cover change projections. From a theoretical perspective, such comparisons can inform development of a theory of land-use science by identifying potential hypotheses and supporting or refuting evidence. This paper undertakes a structured comparison of four case studies of land-use change in frontier regions that follow an agent-based modeling approach. Our hypothesis is that each case study represents a particular manifestation of a common process. Given differences in initial conditions among sites and the time at which the process is observed, actual mechanisms and outcomes are anticipated to differ substantially between sites. Our goal is to reveal both commonalities and differences among research sites, model implementations, and ultimately, conclusions derived from the modeling process.

"I am a scientist": How setting conditions that enhance focused concentration positively relate to student motivation and achievement outcomes in inquiry-based science

NASA Astrophysics Data System (ADS)

Ellwood, Robin B.

This research investigated how student social interactions within two approaches to an inquiry-based science curriculum could be related to student motivation and achievement outcomes. This qualitative case study consisted of two cases, Off-Campus and On-Campus, and used ethnographic techniques of participant observation. Research participants included eight eighth grade girls, aged thirteen to fourteen years old. Data sources included formal and informal participant interviews, participant journal reflections, curriculum artifacts including quizzes, worksheets, and student-generated research posters, digital video and audio recordings, photographs, and researcher field notes. Data were transcribed verbatim and coded, then collapsed into emergent themes using NVIVO 9. The results of this research illustrate how setting conditions that promote focused concentration and communicative interactions can be positively related to student motivation and achievement outcomes in inquiry-based science. Participants in the Off-Campus case experienced more frequent states of focused concentration and out performed their peers in the On-Campus case on forty-six percent of classroom assignments. Off-Campus participants also designed and implemented a more cognitively complex research project, provided more in-depth analyses of their research results, and expanded their perceptions of what it means to act like a scientist to a greater extent than participants in the On-Campus case. These results can be understood in relation to Flow Theory. Student interactions that promoted the criteria necessary for initiating flow, which included having clearly defined goals, receiving immediate feedback, and maintaining a balance between challenges and skills, fostered enhanced student motivation and achievement outcomes. This research also illustrates the positive gains in motivation and achievement outcomes that emerge from student experiences with extended time in isolated areas referred to as "hot spots." Implications for science teaching and future research include shifting the current focus in inquiry-based science from a continuum that progresses from teacher-directed to open inquiry experiences to a continuum that also deliberately includes and promotes the necessary criteria for establishing flow. Attending to Flow Theory and incorporating student experiences with flow into inquiry-based science lessons will enhance student motivation and achievement outcomes in science and bolster the success of inquiry-based science.

Pneumafil casing blower through moving reference frame (MRF) - A CFD simulation

NASA Astrophysics Data System (ADS)

Manivel, R.; Vijayanandh, R.; Babin, T.; Sriram, G.

2018-05-01

In this analysis work, the ring frame of Pneumafil casing blower of the textile mills with a power rating of 5 kW have been simulated using Computational Fluid Dynamics (CFD) code. The CFD analysis of the blower is carried out in Ansys Workbench 16.2 with Fluent using MRF solver settings. The simulation settings and boundary conditions are based on literature study and field data acquired. The main objective of this work is to reduce the energy consumption of the blower. The flow analysis indicated that the power consumption is influenced by the deflector plate orientation and deflector plate strip situated at the outlet casing of the blower. The energy losses occurred in the blower is due to the recirculation zones formed around the deflector plate strip. The deflector plate orientation is changed and optimized to reduce the energy consumption. The proposed optimized model is based on the simulation results which had relatively lesser power consumption than the existing and other cases. The energy losses in the Pneumafil casing blower are reduced through CFD analysis.

Simulation of hydrogen adsorption systems adopting the flow through cooling concept

DOE PAGES

Corgnale, Claudio; Hardy, Bruce; Chahine, Richard; ...

2014-10-13

Hydrogen storage systems based on adsorbent materials have the potential of achieving the U.S. Department of Energy (DOE) targets, especially in terms of gravimetric capacity. This paper deals with analysis of adsorption storage systems adopting the flow through cooling concept. By this approach the feeding hydrogen provides the needed cold to maintain the tank at low temperatures. Two adsorption systems have been examined and modeled adopting the Dubinin-Astakhov model, to see their performance under selected operating conditions. A first case has been analyzed, modeling a storage tank filled with carbon based material (namely MaxSorb®) and comparing the numerical outcomes withmore » the available experimental results for a 2.5 L tank. Under selected operating conditions (minimum inlet hydrogen temperature of approximately 100 K and maximum pressure on the order of 8.5 MPa) and adopting the flow through cooling concept the material shows a gravimetric capacity of about 5.7 %. A second case has been modeled, examining the same tank filled with metal organic framework material (MOF5®) under approximately the same conditions. The model shows that the latter material can achieve a (material) gravimetric capacity on the order of 11%, making the system potentially able to achieve the DOE 2017 target.« less

Conditional Outlier Detection for Clinical Alerting

PubMed Central

Hauskrecht, Milos; Valko, Michal; Batal, Iyad; Clermont, Gilles; Visweswaran, Shyam; Cooper, Gregory F.

2010-01-01

We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management actions using past patient cases stored in an electronic health record (EHR) system. Our hypothesis is that patient-management actions that are unusual with respect to past patients may be due to a potential error and that it is worthwhile to raise an alert if such a condition is encountered. We evaluate this hypothesis using data obtained from the electronic health records of 4,486 post-cardiac surgical patients. We base the evaluation on the opinions of a panel of experts. The results support that anomaly-based alerting can have reasonably low false alert rates and that stronger anomalies are correlated with higher alert rates. PMID:21346986

Conditional outlier detection for clinical alerting.

PubMed

Hauskrecht, Milos; Valko, Michal; Batal, Iyad; Clermont, Gilles; Visweswaran, Shyam; Cooper, Gregory F

2010-11-13

We develop and evaluate a data-driven approach for detecting unusual (anomalous) patient-management actions using past patient cases stored in an electronic health record (EHR) system. Our hypothesis is that patient-management actions that are unusual with respect to past patients may be due to a potential error and that it is worthwhile to raise an alert if such a condition is encountered. We evaluate this hypothesis using data obtained from the electronic health records of 4,486 post-cardiac surgical patients. We base the evaluation on the opinions of a panel of experts. The results support that anomaly-based alerting can have reasonably low false alert rates and that stronger anomalies are correlated with higher alert rates.

Wake Numerical Simulation Based on the Park-Gauss Model and Considering Atmospheric Stability

NASA Astrophysics Data System (ADS)

Yang, Xiangsheng; Zhao, Ning; Tian, Linlin; Zhu, Jun

2016-06-01

In this paper, a new Park-Gauss model based on the assumption of the Park model and the Eddy-viscosity model is investigated to conduct the wake numerical simulation for solving a single wind turbine problem. The initial wake radius has been modified to improve the model’s numerical accuracy. Then the impact of the atmospheric stability based on the Park-Gauss model has been studied in the wake region. By the comparisons and the analyses of the test results, it turns out that the new Park-Gauss model could achieve better effects of the wind velocity simulation in the wake region. The wind velocity in the wake region recovers quickly under the unstable atmospheric condition provided the wind velocity is closest to the test result, and recovers slowly under stable atmospheric condition in case of the wind velocity is lower than the test result. Meanwhile, the wind velocity recovery falls in between the unstable and stable neutral atmospheric conditions.

Neuroradiology Using Secure Mobile Device Review.

PubMed

Randhawa, Privia A; Morrish, William; Lysack, John T; Hu, William; Goyal, Mayank; Hill, Michael D

2016-04-05

Image review on computer-based workstations has made film-based review outdated. Despite advances in technology, the lack of portability of digital workstations creates an inherent disadvantage. As such, we sought to determine if the quality of image review on a handheld device is adequate for routine clinical use. Six CT/CTA cases and six MR/MRA cases were independently reviewed by three neuroradiologists in varying environments: high and low ambient light using a handheld device and on a traditional imaging workstation in ideal conditions. On first review (using a handheld device in high ambient light), a preliminary diagnosis for each case was made. Upon changes in review conditions, neuroradiologists were asked if any additional features were seen that changed their initial diagnoses. Reviewers were also asked to comment on overall clinical quality and if the handheld display was of acceptable quality for image review. After the initial CT review in high ambient light, additional findings were reported in 2 of 18 instances on subsequent reviews. Similarly, additional findings were identified in 4 of 18 instances after the initial MR review in high ambient lighting. Only one of these six additional findings contributed to the diagnosis made on the initial preliminary review. Use of a handheld device for image review is of adequate diagnostic quality based on image contrast, sharpness of structures, visible artefacts and overall display quality. Although reviewers were comfortable with using this technology, a handheld device with a larger screen may be diagnostically superior.

Analytical estimation of laser phase noise induced BER floor in coherent receiver with digital signal processing.

PubMed

Vanin, Evgeny; Jacobsen, Gunnar

2010-03-01

The Bit-Error-Ratio (BER) floor caused by the laser phase noise in the optical fiber communication system with differential quadrature phase shift keying (DQPSK) and coherent detection followed by digital signal processing (DSP) is analytically evaluated. An in-phase and quadrature (I&Q) receiver with a carrier phase recovery using DSP is considered. The carrier phase recovery is based on a phase estimation of a finite sum (block) of the signal samples raised to the power of four and the phase unwrapping at transitions between blocks. It is demonstrated that errors generated at block transitions cause the dominating contribution to the system BER floor when the impact of the additive noise is negligibly small in comparison with the effect of the laser phase noise. Even the BER floor in the case when the phase unwrapping is omitted is analytically derived and applied to emphasize the crucial importance of this signal processing operation. The analytical results are verified by full Monte Carlo simulations. The BER for another type of DQPSK receiver operation, which is based on differential phase detection, is also obtained in the analytical form using the principle of conditional probability. The principle of conditional probability is justified in the case of differential phase detection due to statistical independency of the laser phase noise induced signal phase error and the additive noise contributions. Based on the achieved analytical results the laser linewidth tolerance is calculated for different system cases.

Uncertainty quantification for accident management using ACE surrogates

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

Varuttamaseni, A.; Lee, J. C.; Youngblood, R. W.

The alternating conditional expectation (ACE) regression method is used to generate RELAP5 surrogates which are then used to determine the distribution of the peak clad temperature (PCT) during the loss of feedwater accident coupled with a subsequent initiation of the feed and bleed (F and B) operation in the Zion-1 nuclear power plant. The construction of the surrogates assumes conditional independence relations among key reactor parameters. The choice of parameters to model is based on the macroscopic balance statements governing the behavior of the reactor. The peak clad temperature is calculated based on the independent variables that are known tomore » be important in determining the success of the F and B operation. The relationship between these independent variables and the plant parameters such as coolant pressure and temperature is represented by surrogates that are constructed based on 45 RELAP5 cases. The time-dependent PCT for different values of F and B parameters is calculated by sampling the independent variables from their probability distributions and propagating the information through two layers of surrogates. The results of our analysis show that the ACE surrogates are able to satisfactorily reproduce the behavior of the plant parameters even though a quasi-static assumption is primarily used in their construction. The PCT is found to be lower in cases where the F and B operation is initiated, compared to the case without F and B, regardless of the F and B parameters used. (authors)« less

A binocular approach to treating amblyopia: antisuppression therapy.

PubMed

Hess, Robert F; Mansouri, Behzad; Thompson, Benjamin

2010-09-01

We developed a binocular treatment for amblyopia based on antisuppression therapy. A novel procedure is outlined for measuring the extent to which the fixing eye suppresses the fellow amblyopic eye. We hypothesize that suppression renders a structurally binocular system, functionally monocular. We demonstrate using three strabismic amblyopes that information can be combined normally between their eyes under viewing conditions where suppression is reduced. Also, we show that prolonged periods of viewing (under the artificial conditions of stimuli of different contrast in each eye) during which information from the two eyes is combined leads to a strengthening of binocular vision in such cases and eventual combination of binocular information under natural viewing conditions (stimuli of the same contrast in each eye). Concomitant improvement in monocular acuity of the amblyopic eye occurs with this reduction in suppression and strengthening of binocular fusion. Furthermore, in each of the three cases, stereoscopic function is established. This provides the basis for a new treatment of amblyopia, one that is purely binocular and aimed at reducing suppression as a first step.

Hazard mitigation with cloud model based rainfall and convective data

NASA Astrophysics Data System (ADS)

Gernowo, R.; Adi, K.; Yulianto, T.; Seniyatis, S.; Yatunnisa, A. A.

2018-05-01

Heavy rain in Semarang 15 January 2013 causes flood. It is related to dynamic of weather’s parameter, especially with convection process, clouds and rainfall data. In this case, weather condition analysis uses Weather Research and Forecasting (WRF) model used to analyze. Some weather’s parameters show significant result. Their fluctuations prove there is a strong convection that produces convective cloud (Cumulonimbus). Nesting and 2 domains on WRF model show good output to represent weather’s condition commonly. The results of this study different between output cloud cover rate of observation result and output of model around 6-12 hours is because spinning-up of processing. Satellite Images of MTSAT (Multifunctional Transport Satellite) are used as a verification data to prove the result of WRF. White color of satellite image is Coldest Dark Grey (CDG) that indicates there is cloud’s top. This image consolidates that the output of WRF is good enough to analyze Semarang’s condition when the case happened.

Novel associations in disorders of sex development: findings from the I-DSD Registry.

PubMed

Cox, Kathryn; Bryce, Jillian; Jiang, Jipu; Rodie, Martina; Sinnott, Richard; Alkhawari, Mona; Arlt, Wiebke; Audi, Laura; Balsamo, Antonio; Bertelloni, Silvano; Cools, Martine; Darendeliler, Feyza; Drop, Stenvert; Ellaithi, Mona; Guran, Tulay; Hiort, Olaf; Holterhus, Paul-Martin; Hughes, Ieuan; Krone, Nils; Lisa, Lidka; Morel, Yves; Soder, Olle; Wieacker, Peter; Ahmed, S Faisal

2014-02-01

The focus of care in disorders of sex development (DSD) is often directed to issues related to sex and gender development. In addition, the molecular etiology remains unclear in the majority of cases. To report the range of associated conditions identified in the international DSD (I-DSD) Registry. Anonymized data were extracted from the I-DSD Registry for diagnosis, karyotype, sex of rearing, genetic investigations, and associated anomalies. If necessary, clarification was sought from the reporting clinician. Of 649 accessible cases, associated conditions occurred in 168 (26%); 103 (61%) cases had one condition, 31 (18%) had two conditions, 20 (12%) had three conditions, and 14 (8%) had four or more conditions. Karyotypes with most frequently reported associations included 45,X with 6 of 8 affected cases (75%), 45,X/46,XY with 19 of 42 cases (45%), 46,XY with 112 of 460 cases (24%), and 46,XX with 27 of 121 cases (22%). In the 112 cases of 46,XY DSD, the commonest conditions included small for gestational age in 26 (23%), cardiac anomalies in 22 (20%), and central nervous system disorders in 22 (20%), whereas in the 27 cases of 46,XX DSD, skeletal and renal anomalies were commonest at 12 (44%) and 8 (30%), respectively. Of 170 cases of suspected androgen insensitivity syndrome, 19 (11%) had reported anomalies and 9 of these had confirmed androgen receptor mutations. Over a quarter of the cases in the I-DSD Registry have an additional condition. These associations can direct investigators toward novel genetic etiology and also highlight the need for more holistic care of the affected person.

Healthcare cost savings estimator tool for chronic disease self-management program: a new tool for program administrators and decision makers.

PubMed

Ahn, SangNam; Smith, Matthew Lee; Altpeter, Mary; Post, Lindsey; Ory, Marcia G

2015-01-01

Chronic disease self-management education (CDSME) programs have been delivered to more than 100,000 older Americans with chronic conditions. As one of the Stanford suite of evidence-based CDSME programs, the chronic disease self-management program (CDSMP) has been disseminated in diverse populations and settings. The objective of this paper is to introduce a practical, universally applicable tool to assist program administrators and decision makers plan implementation efforts and make the case for continued program delivery. This tool was developed utilizing data from a recent National Study of CDSMP to estimate national savings associated with program participation. Potential annual healthcare savings per CDSMP participant were calculated based on averted emergency room visits and hospitalizations. While national data can be utilized to estimate cost savings, the tool has built-in features allowing users to tailor calculations based on their site-specific data. Building upon the National Study of CDSMP's documented potential savings of $3.3 billion in healthcare costs by reaching 5% of adults with one or more chronic conditions, two heuristic case examples were also explored based on different population projections. The case examples show how a small county and large metropolitan city were not only able to estimate healthcare savings ($38,803 for the small county; $732,290 for the large metropolitan city) for their existing participant populations but also to project significant healthcare savings if they plan to reach higher proportions of middle-aged and older adults. Having a tool to demonstrate the monetary value of CDSMP can contribute to the ongoing dissemination and sustainability of such community-based interventions. Next steps will be creating a user-friendly, internet-based version of Healthcare Cost Savings Estimator Tool: CDSMP, followed by broadening the tool to consider cost savings for other evidence-based programs.

Temperature issues with white laser diodes, calculation and approach for new packages

NASA Astrophysics Data System (ADS)

Lachmayer, Roland; Kloppenburg, Gerolf; Stephan, Serge

2015-01-01

Bright white light sources are of significant importance for automotive front lighting systems. Today's upper class systems mainly use HID or LED light sources. As a further step laser diode based systems offer a high luminance, efficiency and allow the realization of new dynamic and adaptive light functions and styling concepts. The use of white laser diode systems in automotive applications is still limited to laboratories and prototypes even though announcements of laser based front lighting systems have been made. But the environment conditions for vehicles and other industry sectors differ from laboratory conditions. Therefor a model of the system's thermal behavior is set up. The power loss of a laser diode is transported as thermal flux from the junction layer to the diode's case and on to the environment. Therefor its optical power is limited by the maximum junction temperature (for blue diodes typically 125 - 150 °C), the environment temperature and the diode's packaging with its thermal resistances. In a car's headlamp the environment temperature can reach up to 80 °C. While the difference between allowed case temperature and environment temperature is getting small or negative the relevant heat flux also becomes small or negative. In early stages of LED development similar challenges had to be solved. Adapting LED packages to the conditions in a vehicle environment lead to today's efficient and bright headlights. In this paper the need to transfer these results to laser diodes is shown by calculating the diodes lifetimes based on the presented model.

[Concealed penis and its surgical correction: a report of 63 cases].

PubMed

Cheng, Fan; Zhang, Xiaobin; Liu, Xiuheng; Zhou, Jiangqiao; Xia, Yue; Ge, Minghuan

2004-02-01

To evaluate the basic principles of surgical correction of concealed penis. From Jan. 1999 to Dec. 2002, 63 cases of concealed penis, aged from 1 year and 6 months to 19 years with a mean age of 7 years and 2 months, were corrected with two different approaches: 37 cases of group A with obesity were corrected by anchoring micrus tissue onto the pubis at the base of the penis, and 26 cases of group B by fixing the subcutateous tissues at both sides of the penile shaft to the deep tunica albuginea at the penile root. Then prepuce plasty was carried out. Six-month postoperative follow-up found adequate exposure of the penis in all of group A, prepuce oedema in 7 cases, abdomen fat liquidization in 3 cases, unsatisfactory recovery of incision hollow in 3 cases and patchy numbness of the glans in 1 case. The 25 cases of group B had satisfactory exposure of the penis, with no obvious prepuce oedema, 1 case with retraction of the penis 7 days after operation. Various surgical procedures could be adopted for concealed penis, and the key to the satisfactory appearance is the restoration of penile tunicae and the fixation at the base of the penis. Further study is needed to determine the natural history of these disorders as well as which conditions and what age will benefit most from surgical intervention.

[Self-determination of elderly persons with care needs: three case reports on individual and environmental resources of elderly persons].

PubMed

Kammerer, K; Falk, K; Heusinger, J; Kümpers, S

2012-10-01

The project Neighbourhood examined the opportunities for self-determination of older people with care needs and their social, spatial, and individual requirements. This article is based on three case reports on women from lower social milieus living on their own. The case reports show on which individual resources women relay in their everyday life and which environmental conditions help to enable or limit self-determination. The synopsis of the three cases reveals opportunities to support social participation and self-determination of persons with care needs on a local level. The concluding recommendations focus on requirements for networking and fundamentals for an easy access to counseling, supply and participatory structures.

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

Salko, Robert K; Sung, Yixing; Kucukboyaci, Vefa

The Virtual Environment for Reactor Applications core simulator (VERA-CS) being developed by the Consortium for the Advanced Simulation of Light Water Reactors (CASL) includes coupled neutronics, thermal-hydraulics, and fuel temperature components with an isotopic depletion capability. The neutronics capability employed is based on MPACT, a three-dimensional (3-D) whole core transport code. The thermal-hydraulics and fuel temperature models are provided by the COBRA-TF (CTF) subchannel code. As part of the CASL development program, the VERA-CS (MPACT/CTF) code system was applied to model and simulate reactor core response with respect to departure from nucleate boiling ratio (DNBR) at the limiting time stepmore » of a postulated pressurized water reactor (PWR) main steamline break (MSLB) event initiated at the hot zero power (HZP), either with offsite power available and the reactor coolant pumps in operation (high-flow case) or without offsite power where the reactor core is cooled through natural circulation (low-flow case). The VERA-CS simulation was based on core boundary conditions from the RETRAN-02 system transient calculations and STAR-CCM+ computational fluid dynamics (CFD) core inlet distribution calculations. The evaluation indicated that the VERA-CS code system is capable of modeling and simulating quasi-steady state reactor core response under the steamline break (SLB) accident condition, the results are insensitive to uncertainties in the inlet flow distributions from the CFD simulations, and the high-flow case is more DNB limiting than the low-flow case.« less

Use of Systematic Methods to Improve Disease Identification in Administrative Data: The Case of Severe Sepsis.

PubMed

Shahraz, Saeid; Lagu, Tara; Ritter, Grant A; Liu, Xiadong; Tompkins, Christopher

2017-03-01

Selection of International Classification of Diseases (ICD)-based coded information for complex conditions such as severe sepsis is a subjective process and the results are sensitive to the codes selected. We use an innovative data exploration method to guide ICD-based case selection for severe sepsis. Using the Nationwide Inpatient Sample, we applied Latent Class Analysis (LCA) to determine if medical coders follow any uniform and sensible coding for observations with severe sepsis. We examined whether ICD-9 codes specific to sepsis (038.xx for septicemia, a subset of 995.9 codes representing Systemic Inflammatory Response syndrome, and 785.52 for septic shock) could all be members of the same latent class. Hospitalizations coded with sepsis-specific codes could be assigned to a latent class of their own. This class constituted 22.8% of all potential sepsis observations. The probability of an observation with any sepsis-specific codes being assigned to the residual class was near 0. The chance of an observation in the residual class having a sepsis-specific code as the principal diagnosis was close to 0. Validity of sepsis class assignment is supported by empirical results, which indicated that in-hospital deaths in the sepsis-specific class were around 4 times as likely as that in the residual class. The conventional methods of defining severe sepsis cases in observational data substantially misclassify sepsis cases. We suggest a methodology that helps reliable selection of ICD codes for conditions that require complex coding.

Mental dysfunction and resource use in nursing homes.

PubMed

Fries, B E; Mehr, D R; Schneider, D; Foley, W J; Burke, R

1993-10-01

The role of dementia and other mental disorders in nursing home case-mix classification systems has been an area of controversy. The role of mental dysfunctions was considered in developing a new case-mix measurement system for facility payment in a national demonstration to understand staff time use in nursing homes. Nursing staff (nurses and aides) time and resident assessment data were collected for 6,663 nursing home residents in 6 states. Measures of signs and symptoms of cognitive impairment (dementia), depression, and delirium were created based on items from the new National Minimum Data Set. These measures then were used to determine whether mental dysfunctions were predictive of resource use (nursing staff times and costs) when controlling for other case-mix variables. Cognitive impairment was associated with slightly higher staff time only in less physically-impaired residents without serious medical conditions and not receiving heavy rehabilitation. Similarly, depression and delirium were associated with higher resource use only in selected types of residents. Based on these findings, the new Resource Utilization Groups Version III (RUG-III) contain a major category of residents who are cognitively impaired but not severely dependent in Activities of Daily Living. Depression is used to differentiate subgroups of residents with major medical conditions such as hemiplegia and aphasia. Delirium, when used together with other resident characteristics, was not found useful in explaining resource use. Case-mix groups defined by mental dysfunctions can foster improved care, but careful consideration must be given to appropriate incentives and documentation requirements for providers.

The CSAICLAWPS project: a multi-scalar, multi-data source approach to providing climate services for both modelling of climate change impacts on crop yields and development of community-level adaptive capacity for sustainable food security

NASA Astrophysics Data System (ADS)

Forsythe, N. D.; Fowler, H. J.

2017-12-01

The "Climate-smart agriculture implementation through community-focused pursuit of land and water productivity in South Asia" (CSAICLAWPS) project is a research initiative funded by the (UK) Royal Society through its Challenge Grants programme which is part of the broader UK Global Challenges Research Fund (GCRF). CSAICLAWPS has three objectives: a) development of "added-value" - bias assessed, statistically down-scaled - climate projections for selected case study sites across South Asia; b) investigation of crop failure modes under both present (observed) and future (projected) conditions; and c) facilitation of developing local adaptive capacity and resilience through stakeholder engagement. At AGU we will be presenting both next steps and progress to date toward these three objectives: [A] We have carried out bias assessments of a substantial multi-model RCM ensemble (MME) from the CORDEX South Asia (CORDEXdomain for case studies in three countries - Pakistan, India and Sri Lanka - and (stochastically) produced synthetic time-series for these sites from local observations using a Python-based implementation of the principles underlying the Climate Research Unit Weather Generator (CRU-WG) in order to enable probabilistic simulation of current crop yields. [B] We have characterised present response of local crop yields to climate variability in key case study sites using AquaCrop simulations parameterised based on input (agronomic practices, soil conditions, etc) from smallholder farmers. [C] We have implemented community-based hydro-climatological monitoring in several case study "revenue villages" (panchayats) in the Nainital District of Uttarakhand. The purpose of this is not only to increase availability of meteorological data, but also has the aspiration of, over time, leading to enhanced quantitative awareness of present climate variability and potential future conditions (as projected by RCMs). Next steps in our work will include: 1) future crop yield simulations driven by "perturbation" of synthetic time-series using "change factors from the CORDEX-SA MME; 2) stakeholder dialogues critically evaluating potential strategies at the grassroots (implementation) level to mitigate impacts of climate variability and change on crop yields.

Simulation of Earth textures by conditional image quilting

NASA Astrophysics Data System (ADS)

Mahmud, K.; Mariethoz, G.; Caers, J.; Tahmasebi, P.; Baker, A.

2014-04-01

Training image-based approaches for stochastic simulations have recently gained attention in surface and subsurface hydrology. This family of methods allows the creation of multiple realizations of a study domain, with a spatial continuity based on a training image (TI) that contains the variability, connectivity, and structural properties deemed realistic. A major drawback of these methods is their computational and/or memory cost, making certain applications challenging. It was found that similar methods, also based on training images or exemplars, have been proposed in computer graphics. One such method, image quilting (IQ), is introduced in this paper and adapted for hydrogeological applications. The main difficulty is that Image Quilting was originally not designed to produce conditional simulations and was restricted to 2-D images. In this paper, the original method developed in computer graphics has been modified to accommodate conditioning data and 3-D problems. This new conditional image quilting method (CIQ) is patch based, does not require constructing a pattern databases, and can be used with both categorical and continuous training images. The main concept is to optimally cut the patches such that they overlap with minimum discontinuity. The optimal cut is determined using a dynamic programming algorithm. Conditioning is accomplished by prior selection of patches that are compatible with the conditioning data. The performance of CIQ is tested for a variety of hydrogeological test cases. The results, when compared with previous multiple-point statistics (MPS) methods, indicate an improvement in CPU time by a factor of at least 50.

Gauge fields at finite temperatures—"Thermo field dynamics" and the KMS condition and their extension to gauge theories

NASA Astrophysics Data System (ADS)

Ojima, Izumi

1981-11-01

"Thermo field dynamics," allowing the Feynman diagram method to be applied to real-time causal Green's functions at finite temperatures ( not temperature Green's functions with imaginary times) expressed in the form of "vacuum" expectation values, is reconsidered in light of its connection with the algebraic formulation of statical machanics based upon the KMS condition. On the basis of so-obtained general basic formulae, the formalism is extended to the case of gauge theories, where the subsidiary condition specifying physical states, the notion of observables, and the structure of the physical subspace at finite temperatures are clarified.

Using ancestry matching to combine family-based and unrelated samples for genome-wide association studies‡

PubMed Central

Crossett, Andrew; Kent, Brian P.; Klei, Lambertus; Ringquist, Steven; Trucco, Massimo; Roeder, Kathryn; Devlin, Bernie

2015-01-01

We propose a method to analyze family-based samples together with unrelated cases and controls. The method builds on the idea of matched case–control analysis using conditional logistic regression (CLR). For each trio within the family, a case (the proband) and matched pseudo-controls are constructed, based upon the transmitted and untransmitted alleles. Unrelated controls, matched by genetic ancestry, supplement the sample of pseudo-controls; likewise unrelated cases are also paired with genetically matched controls. Within each matched stratum, the case genotype is contrasted with control pseudo-control genotypes via CLR, using a method we call matched-CLR (mCLR). Eigenanalysis of numerous SNP genotypes provides a tool for mapping genetic ancestry. The result of such an analysis can be thought of as a multidimensional map, or eigenmap, in which the relative genetic similarities and differences amongst individuals is encoded in the map. Once constructed, new individuals can be projected onto the ancestry map based on their genotypes. Successful differentiation of individuals of distinct ancestry depends on having a diverse, yet representative sample from which to construct the ancestry map. Once samples are well-matched, mCLR yields comparable power to competing methods while ensuring excellent control over Type I error. PMID:20862653

Conditional power and predictive power based on right censored data with supplementary auxiliary information.

PubMed

Sun, Libo; Wan, Ying

2018-04-22

Conditional power and predictive power provide estimates of the probability of success at the end of the trial based on the information from the interim analysis. The observed value of the time to event endpoint at the interim analysis could be biased for the true treatment effect due to early censoring, leading to a biased estimate of conditional power and predictive power. In such cases, the estimates and inference for this right censored primary endpoint are enhanced by incorporating a fully observed auxiliary variable. We assume a bivariate normal distribution of the transformed primary variable and a correlated auxiliary variable. Simulation studies are conducted that not only shows enhanced conditional power and predictive power but also can provide the framework for a more efficient futility interim analysis in terms of an improved accuracy in estimator, a smaller inflation in type II error and an optimal timing for such analysis. We also illustrated the new approach by a real clinical trial example. Copyright © 2018 John Wiley & Sons, Ltd.

A stochastic approach for automatic generation of urban drainage systems.

PubMed

Möderl, M; Butler, D; Rauch, W

2009-01-01

Typically, performance evaluation of new developed methodologies is based on one or more case studies. The investigation of multiple real world case studies is tedious and time consuming. Moreover extrapolating conclusions from individual investigations to a general basis is arguable and sometimes even wrong. In this article a stochastic approach is presented to evaluate new developed methodologies on a broader basis. For the approach the Matlab-tool "Case Study Generator" is developed which generates a variety of different virtual urban drainage systems automatically using boundary conditions e.g. length of urban drainage system, slope of catchment surface, etc. as input. The layout of the sewer system is based on an adapted Galton-Watson branching process. The sub catchments are allocated considering a digital terrain model. Sewer system components are designed according to standard values. In total, 10,000 different virtual case studies of urban drainage system are generated and simulated. Consequently, simulation results are evaluated using a performance indicator for surface flooding. Comparison between results of the virtual and two real world case studies indicates the promise of the method. The novelty of the approach is that it is possible to get more general conclusions in contrast to traditional evaluations with few case studies.

Hyperthyroidism and erectile dysfunction: a population-based case-control study.

PubMed

Keller, J; Chen, Y-K; Lin, H-C

2012-01-01

Dysthyroidism has been highlighted as a common endocrine disorder associated with erectile dysfunction (ED); however, to date, no large-scale population-based study has investigated the association between hyperthyroidism and ED. This case-control study aimed to explore the association between ED and hyperthyroidism using a population-based data set. In total, 6310 adult patients who received new diagnoses of ED were recruited as cases together with 18 930 matched enrollees with no history of ED who served as controls. Conditional logistic regressions were conducted to explore the association between ED and having been previously diagnosed with hyperthyroidism. In total, 569 (2.3%) of the 25 240 sampled subjects had been diagnosed with hyperthyroidism before the index date; hyperthyroidism was found in 207 (3.3%) cases and 362 (1.90%) controls. After adjusting for potential confounding factors, the odds ratio (OR) of prior hyperthyroidism among cases was 1.64 (95% confidence interval=1.37-1.96, P<0.001) than that of controls. No association was detected between prior hyperthyroidism and ED for the 18-30, 30-39 and >70 age groups. Subjects aged between 60 and 69 years had the highest ORs for prior hyperthyroidism among cases when compared to controls (OR=1.84; 95% confidence interval=1.20-2.84; P<0.001). Our study further confirms the existence of an association between ED and prior hyperthyroidism.

Infectious, autoimmune, and allergic diseases and risk of Hodgkin lymphoma in children and adolescents: A Children’s Oncology Group (COG) study

PubMed Central

Linabery, Amy M.; Erhardt, Erik B.; Fonstad, Rachel K.; Ambinder, Richard F.; Bunin, Greta R.; Ross, Julie A.; Spector, Logan G.; Grufferman, Seymour

2014-01-01

An infectious origin for pediatric Hodgkin lymphoma (HL) has long been suspected and Epstein-Barr virus (EBV) has been implicated in a subset of cases. Increased HL incidence in children with congenital and acquired immunodeficiencies, consistent associations between autoimmune diseases and adult HL, and genome-wide association and other genetic studies together suggest immune dysregulation is involved in lymphomagenesis. Here, healthy control children identified by random digit dialing were matched on sex, race/ethnicity, and age to HL cases diagnosed in 1989-2003 at 0-14 years at Children’s Oncology Group institutions. Parents of 517 cases and 784 controls completed telephone interviews, including items regarding medical histories. Tumor EBV status was determined for 355 cases. Using conditional logistic regression, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) for risk of HL. Cases were more likely to have had an infection >1 year prior to HL diagnosis (OR=1.69, 95% CI:0.98-2.91); case siblings were also more likely to have had a prior infection (OR=2.04, 95% CI:1.01-4.14). Parental history of autoimmunity associated with increased EBV+ HL risk (OR=2.97, 95% CI:1.34-6.58), while having a parent (OR=1.47, 95% CI:1.01-2.14) or sibling (OR=1.62, 95% CI:1.11-2.36) with an allergy was associated with EBV− HL. These results may indicate true increased risk for infections and increased risk with family history of autoimmune and allergic conditions that varies by tumor EBV status, or they may be attributable to inaccurate recall. In addition to employing biomarkers to confirm the role of immune-modulating conditions in pediatric HL, future studies should focus on family-based designs. PMID:24523151

Development of robust building energy demand-side control strategy under uncertainty

NASA Astrophysics Data System (ADS)

Kim, Sean Hay

The potential of carbon emission regulations applied to an individual building will encourage building owners to purchase utility-provided green power or to employ onsite renewable energy generation. As both cases are based on intermittent renewable energy sources, demand side control is a fundamental precondition for maximizing the effectiveness of using renewable energy sources. Such control leads to a reduction in peak demand and/or in energy demand variability, therefore, such reduction in the demand profile eventually enhances the efficiency of an erratic supply of renewable energy. The combined operation of active thermal energy storage and passive building thermal mass has shown substantial improvement in demand-side control performance when compared to current state-of-the-art demand-side control measures. Specifically, "model-based" optimal control for this operation has the potential to significantly increase performance and bring economic advantages. However, due to the uncertainty in certain operating conditions in the field its control effectiveness could be diminished and/or seriously damaged, which results in poor performance. This dissertation pursues improvements of current demand-side controls under uncertainty by proposing a robust supervisory demand-side control strategy that is designed to be immune from uncertainty and perform consistently under uncertain conditions. Uniqueness and superiority of the proposed robust demand-side controls are found as below: a. It is developed based on fundamental studies about uncertainty and a systematic approach to uncertainty analysis. b. It reduces variability of performance under varied conditions, and thus avoids the worst case scenario. c. It is reactive in cases of critical "discrepancies" observed caused by the unpredictable uncertainty that typically scenario uncertainty imposes, and thus it increases control efficiency. This is obtainable by means of i) multi-source composition of weather forecasts including both historical archive and online sources and ii) adaptive Multiple model-based controls (MMC) to mitigate detrimental impacts of varying scenario uncertainties. The proposed robust demand-side control strategy verifies its outstanding demand-side control performance in varied and non-indigenous conditions compared to the existing control strategies including deterministic optimal controls. This result reemphasizes importance of the demand-side control for a building in the global carbon economy. It also demonstrates a capability of risk management of the proposed robust demand-side controls in highly uncertain situations, which eventually attains the maximum benefit in both theoretical and practical perspectives.

Driver Injury Risk Variability in Finite Element Reconstructions of Crash Injury Research and Engineering Network (CIREN) Frontal Motor Vehicle Crashes.

PubMed

Gaewsky, James P; Weaver, Ashley A; Koya, Bharath; Stitzel, Joel D

2015-01-01

A 3-phase real-world motor vehicle crash (MVC) reconstruction method was developed to analyze injury variability as a function of precrash occupant position for 2 full-frontal Crash Injury Research and Engineering Network (CIREN) cases. Phase I: A finite element (FE) simplified vehicle model (SVM) was developed and tuned to mimic the frontal crash characteristics of the CIREN case vehicle (Camry or Cobalt) using frontal New Car Assessment Program (NCAP) crash test data. Phase II: The Toyota HUman Model for Safety (THUMS) v4.01 was positioned in 120 precrash configurations per case within the SVM. Five occupant positioning variables were varied using a Latin hypercube design of experiments: seat track position, seat back angle, D-ring height, steering column angle, and steering column telescoping position. An additional baseline simulation was performed that aimed to match the precrash occupant position documented in CIREN for each case. Phase III: FE simulations were then performed using kinematic boundary conditions from each vehicle's event data recorder (EDR). HIC15, combined thoracic index (CTI), femur forces, and strain-based injury metrics in the lung and lumbar vertebrae were evaluated to predict injury. Tuning the SVM to specific vehicle models resulted in close matches between simulated and test injury metric data, allowing the tuned SVM to be used in each case reconstruction with EDR-derived boundary conditions. Simulations with the most rearward seats and reclined seat backs had the greatest HIC15, head injury risk, CTI, and chest injury risk. Calculated injury risks for the head, chest, and femur closely correlated to the CIREN occupant injury patterns. CTI in the Camry case yielded a 54% probability of Abbreviated Injury Scale (AIS) 2+ chest injury in the baseline case simulation and ranged from 34 to 88% (mean = 61%) risk in the least and most dangerous occupant positions. The greater than 50% probability was consistent with the case occupant's AIS 2 hemomediastinum. Stress-based metrics were used to predict injury to the lower leg of the Camry case occupant. The regional-level injury metrics evaluated for the Cobalt case occupant indicated a low risk of injury; however, strain-based injury metrics better predicted pulmonary contusion. Approximately 49% of the Cobalt occupant's left lung was contused, though the baseline simulation predicted 40.5% of the lung to be injured. A method to compute injury metrics and risks as functions of precrash occupant position was developed and applied to 2 CIREN MVC FE reconstructions. The reconstruction process allows for quantification of the sensitivity and uncertainty of the injury risk predictions based on occupant position to further understand important factors that lead to more severe MVC injuries.

Factors influencing post abortion outcomes among high-risk patients in Zimbabwe.

PubMed

Mudokwenuy-Rawdon, C; Ehlers, V J; Bezuidenhout, M C

2005-11-01

Post abortion complications remain one of the major causes of mortality among women of child bearing age in Zimbabwe. Based on this problem, factors associated with mortalities due to abortion were investigated with the aim of improving post abortion outcomes for Zimbabwe's women, and possibly also for women of other African countries. Cases and controls were selected from 4895 post abortion records to conduct a retrospective case-control study. Significant risk factors identified for reducing mortalities due to post abortion complications included the administration of oxytocic drugs and evacuation of the uterus whilst anaemia and sepsis apparently reduced these women's chances of survival. Women who died (cases) from post abortion complications apparently received better reported quantitative care than controls. Recommendations based on this research report include improved education of health care workers and enhanced in-service training, regular audits of patients' records and changed policies for managing these conditions more effectively in Zimbabwe.

Coupled incompressible Smoothed Particle Hydrodynamics model for continuum-based modelling sediment transport

NASA Astrophysics Data System (ADS)

Pahar, Gourabananda; Dhar, Anirban

2017-04-01

A coupled solenoidal Incompressible Smoothed Particle Hydrodynamics (ISPH) model is presented for simulation of sediment displacement in erodible bed. The coupled framework consists of two separate incompressible modules: (a) granular module, (b) fluid module. The granular module considers a friction based rheology model to calculate deviatoric stress components from pressure. The module is validated for Bagnold flow profile and two standardized test cases of sediment avalanching. The fluid module resolves fluid flow inside and outside porous domain. An interaction force pair containing fluid pressure, viscous term and drag force acts as a bridge between two different flow modules. The coupled model is validated against three dambreak flow cases with different initial conditions of movable bed. The simulated results are in good agreement with experimental data. A demonstrative case considering effect of granular column failure under full/partial submergence highlights the capability of the coupled model for application in generalized scenario.

Enhanced Primary Care Treatment of Behavioral Disorders With ECHO Case-Based Learning.

PubMed

Komaromy, Miriam; Bartlett, Judy; Manis, Kathryn; Arora, Sanjeev

2017-09-01

The Extension for Community Healthcare Outcomes (ECHO) model offers a way for primary care providers to develop expertise in addressing behavioral health issues of primary care patients. It provides an alternative to traditional continuing medical education (CME) for ongoing training and support for health care providers. ECHO uses videoconferencing to connect multiple primary care teams simultaneously with academic specialists and builds capacity via mentorship and case-based learning. ECHO aims to expand access to care by developing capacity to treat common, complex conditions in underserved areas. Participants in an integrated addictions and psychiatry teleECHO program reported that when they presented a patient case, the feedback they received was highly valuable and led them to change their care plans more than 75% of the time. ECHO is an effective model for teaching primary care teams about behavioral health and may be more effective than traditional CME approaches.

Statistical Analysis of Q-matrix Based Diagnostic Classification Models

PubMed Central

Chen, Yunxiao; Liu, Jingchen; Xu, Gongjun; Ying, Zhiliang

2014-01-01

Diagnostic classification models have recently gained prominence in educational assessment, psychiatric evaluation, and many other disciplines. Central to the model specification is the so-called Q-matrix that provides a qualitative specification of the item-attribute relationship. In this paper, we develop theories on the identifiability for the Q-matrix under the DINA and the DINO models. We further propose an estimation procedure for the Q-matrix through the regularized maximum likelihood. The applicability of this procedure is not limited to the DINA or the DINO model and it can be applied to essentially all Q-matrix based diagnostic classification models. Simulation studies are conducted to illustrate its performance. Furthermore, two case studies are presented. The first case is a data set on fraction subtraction (educational application) and the second case is a subsample of the National Epidemiological Survey on Alcohol and Related Conditions concerning the social anxiety disorder (psychiatric application). PMID:26294801

Evaluation of the response of tritium-in-air instrumentation to HT in dry and humid conditions and to HTO vapor

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

Phillips, H.; Dean, J.; Privas, E.

2015-03-15

Nuclear plant operators (power generation, decommissioning and reprocessing operations) are required to monitor releases of tritium species for regulatory compliance and radiation protection purposes. Tritium monitoring is performed using tritium-in-air gas monitoring instrumentation based either on flow-through ion chambers or proportional counting systems. Tritium-in-air monitors are typically calibrated in dry conditions but in service may operate at elevated levels of relative humidity. The NPL (National Physical Laboratory) radioactive gas-in-air calibration system has been used to study the effect of humidity on the response to tritium of two tritium-in-air ion chamber based monitors and one proportional counting system which uses amore » P10/air gas mixture. The response of these instruments to HTO vapour has also been evaluated. In each case, instrument responses were obtained for HT in dry conditions (relative humidity (RH) about 2%), HT in 45% RH, and finally HTO at 45% RH. Instrumentation response to HT in humid conditions has been found to slightly exceed that in dry conditions. (authors)« less

Etiology and clinical presentation of birth defects: population based study

PubMed Central

Carey, John C; Byrne, Janice L B; Krikov, Sergey; Botto, Lorenzo D

2017-01-01

Objective To assess causation and clinical presentation of major birth defects. Design Population based case cohort. Setting Cases of birth defects in children born 2005-09 to resident women, ascertained through Utah’s population based surveillance system. All records underwent clinical re-review. Participants 5504 cases among 270 878 births (prevalence 2.03%), excluding mild isolated conditions (such as muscular ventricular septal defects, distal hypospadias). Main outcome measures The primary outcomes were the proportion of birth defects with a known etiology (chromosomal, genetic, human teratogen, twinning) or unknown etiology, by morphology (isolated, multiple, minors only), and by pathogenesis (sequence, developmental field defect, or known pattern of birth defects). Results Definite cause was assigned in 20.2% (n=1114) of cases: chromosomal or genetic conditions accounted for 94.4% (n=1052), teratogens for 4.1% (n=46, mostly poorly controlled pregestational diabetes), and twinning for 1.4% (n=16, conjoined or acardiac). The 79.8% (n=4390) remaining were classified as unknown etiology; of these 88.2% (n=3874) were isolated birth defects. Family history (similarly affected first degree relative) was documented in 4.8% (n=266). In this cohort, 92.1% (5067/5504) were live born infants (isolated and non-isolated birth defects): 75.3% (4147/5504) were classified as having an isolated birth defect (unknown or known etiology). Conclusions These findings underscore the gaps in our knowledge regarding the causes of birth defects. For the causes that are known, such as smoking or diabetes, assigning causation in individual cases remains challenging. Nevertheless, the ongoing impact of these exposures on fetal development highlights the urgency and benefits of population based preventive interventions. For the causes that are still unknown, better strategies are needed. These can include greater integration of the key elements of etiology, morphology, and pathogenesis into epidemiologic studies; greater collaboration between researchers (such as developmental biologists), clinicians (such as medical geneticists), and epidemiologists; and better ways to objectively measure fetal exposures (beyond maternal self reports) and closer (prenatally) to the critical period of organogenesis. PMID:28559234

Polyspectral signal analysis techniques for condition based maintenance of helicopter drive-train system

NASA Astrophysics Data System (ADS)

Hassan Mohammed, Mohammed Ahmed

For an efficient maintenance of a diverse fleet of air- and rotorcraft, effective condition based maintenance (CBM) must be established based on rotating components monitored vibration signals. In this dissertation, we present theory and applications of polyspectral signal processing techniques for condition monitoring of critical components in the AH-64D helicopter tail rotor drive train system. Currently available vibration-monitoring tools are mostly built around auto- and cross-power spectral analysis which have limited performance in detecting frequency correlations higher than second order. Studying higher order correlations and their Fourier transforms, higher order spectra, provides more information about the vibration signals which helps in building more accurate diagnostic models of the mechanical system. Based on higher order spectral analysis, different signal processing techniques are developed to assess health conditions of different critical rotating-components in the AH-64D helicopter drive-train. Based on cross-bispectrum, quadratic nonlinear transfer function is presented to model second order nonlinearity in a drive-shaft running between the two hanger bearings. Then, quadratic-nonlinearity coupling coefficient between frequency harmonics of the rotating shaft is used as condition metric to study different seeded shaft faults compared to baseline case, namely: shaft misalignment, shaft imbalance, and combination of shaft misalignment and imbalance. The proposed quadratic-nonlinearity metric shows better capabilities in distinguishing the four studied shaft settings than the conventional linear coupling based on cross-power spectrum. We also develop a new concept of Quadratic-Nonlinearity Power-Index spectrum, QNLPI(f), that can be used in signal detection and classification, based on bicoherence spectrum. The proposed QNLPI(f) is derived as a projection of the three-dimensional bicoherence spectrum into two-dimensional spectrum that quantitatively describes how much of the mean square power at certain frequency f is generated due to nonlinear quadratic interaction between different frequency components. The proposed index, QNLPI(f), can be used to simplify the study of bispectrum and bicoherence signal spectra. It also inherits useful characteristics from the bicoherence such as high immunity to additive Gaussian noise, high capability of nonlinear-systems identifications, and amplification invariance. The quadratic-nonlinear power spectral density PQNL(f) and percentage of quadratic nonlinear power PQNLP are also introduced based on the QNLPI(f). Concept of the proposed indices and their computational considerations are discussed first using computer generated data, and then applied to real-world vibration data to assess health conditions of different rotating components in the drive train including drive-shaft, gearbox, and hanger bearing faults. The QNLPI(f) spectrum enables us to gain more details about nonlinear harmonic generation patterns that can be used to distinguish between different cases of mechanical faults, which in turn helps to gaining more diagnostic/prognostic capabilities.

[The autoimmune rheumatic disease and laryngeal pathology].

PubMed

Osipenko, E V; Kotel'nikova, N M

Vocal disorders make up one of the autoimmune pathological conditions characterized by multiple organ system dysfunction. Laryngeal pathology in this condition has an autoimmune nature; it is highly diverse and poorly explored. The objective of the present work based on the analysis of the relevant literature publications was to study clinical manifestations of the autoimmune rheumatic disease affecting the larynx. 'Bamboo nodes' on the vocal folds is a rare manifestation of laryngeal autoimmune diseases. We found out references to 49 cases of this condition in the available literature. All the patients were women presenting with autoimmune diseases. The present review highlights the problems pertaining to etiology of 'bamboo nodes' on the vocal folds and the method for the treatment of this condition.

Risk factors and therapy for goat mastitis in a hospital-based case-control study in Bangladesh.

PubMed

Koop, Gerrit; Islam, Md Nurul; Rahman, Md Mizanur; Khatun, Momena; Ferdous, Jinnat; Sayeed, Md Abu; Islam, Shariful; Ahaduzzaman, Md; Akter, Sazeda; Mannan, Abdul; Hassan, Mohammad Mahmudul; Dissanayake, Ravi; Hoque, Md Ahasanul

2016-02-01

Bangladesh has a large population of goats, which contribute to the income, nutrition and welfare of the households of many families. Mastitis in goats has a low incidence, but is often very severe, making veterinary care necessary. The aim of this study was to identify seasonality and risk factors for goat mastitis in a hospital-based matched case-control study in a teaching veterinary hospital in Chittagong, Bangladesh and to describe the range of antimicrobial treatments applied in this situation. Cases of mastitis and controls were drawn from the hospital patient recording system, along with their risk factor status. Multiple imputation was applied to deal with the missing values in the data analysis. Mastitis occurred somewhat more in the rainy season, and comprised about 3% of all goats admitted to the hospital during January 2011-June 2014. Free-ranging farming system, poor body condition score and non-native goat breeds were significantly associated with case status. Treatment of clinical mastitis was variable and unsystematic, but the use of gentamicin was commonly recorded. The need for more prudent and evidence-based antimicrobial therapies is discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

[Adaptability of Brazilian strains of Agaricus subrufescens Peck to fruiting on various casing materials in commercial crops].

PubMed

Pardo-Giménez, Arturo; Pardo González, José Emilio; de Figueirêdo, Vinícius Reis; Zied, Diego Cunha

2014-01-01

Agaricus subrufescens Peck is a mushroom whose cultivation has aroused great interest worldwide in recent years, and is becoming increasingly popular. A rapid expansion of culture throughout the world is foreseen because of its medicinal and culinary properties. This work assesses the effect of 5 different casing layers on the production of 3 strains of Agaricus subrufescens. A growth cycle of Agaricus subrufescens under controlled conditions has been carried out. The main production parameters were evaluated. The best results were provided by the ABL 99/30 strain. Peat-based casings have a better yield than those based on mineral soil. The highest yield (6.75kg/m(2), biological efficiency 27.57kg/dt) was provided by the combination ABL 99/30-Euroveen. Our results suggest that the combination of the strain ABL 99/30 using a peat-based casing layer (Euroveen) offers a high potential for use on a commercial scale by the edible mushroom production sector. The availability of alternatives to the usually cultivated species can make better use of resources, and increase the profitability of this activity. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

Geographic expression of AIDS epidemic in Campinas, Southeastern Brazil, between 1980 and 2005.

PubMed

Stephan, Celso; Henn, Carlos Alberto; Donalisio, Maria Rita

2010-10-01

To analyze the spatial distribution of reported AIDS cases in adults and its association with living conditions in the city of Campinas, Southeastern Brazil. Data on AIDS cases in men (n=2,945) and women (n=1,230) aged more than 13 years and living in Campinas, recorded in the SINAN (Brazilian Information System for Notifiable Diseases), were used to map the spatial distribution of this disease and the male:female ratio. Maps were constructed for the following periods: from 1980 to 1995, from 1996 to 2000, and from 2001 to 2005. The variables included in the analysis were address, sex and age. A weighted composite index was used to study living and health conditions in the area. Patients' home addresses were geocoded on a cartographic base, after correction and standardization according to a reference database of streets. A generalized additive model was adjusted to analyze the spatial distribution of the ratio of male:female cases in space, in the three study periods. The ratio of male:female cases was higher in areas with better living conditions (central) and around the prison (northwestern), where families of prisoners and former prisoners live temporarily, while this ratio was lower in the city suburbs (southwestern). The trends towards the AIDS epidemic affecting more women and poorer individuals were confirmed by the decrease in the ratio of male:female cases in the period, particularly in vulnerable and impoverished populations. Geographic information systems and spatial data analysis can be useful for AIDS control and surveillance actions.

Finite-Rate Ablation Boundary Conditions for Carbon-Phenolic Heat-Shield

NASA Technical Reports Server (NTRS)

Chen, Y.-K.; Milos, Frank S.

2003-01-01

A formulation of finite-rate ablation surface boundary conditions, including oxidation, nitridation, and sublimation of carbonaceous material with pyrolysis gas injection, has been developed based on surface species mass conservation. These surface boundary conditions are discretized and integrated with a Navier-Stokes solver. This numerical procedure can predict aerothermal heating, chemical species concentration, and carbonaceous material ablation rate over the heatshield surface of re-entry space vehicles. In this study, the gas-gas and gas-surface interactions are established for air flow over a carbon-phenolic heatshield. Two finite-rate gas-surface interaction models are considered in the present study. The first model is based on the work of Park, and the second model includes the kinetics suggested by Zhluktov and Abe. Nineteen gas phase chemical reactions and four gas-surface interactions are considered in the present model. There is a total of fourteen gas phase chemical species, including five species for air and nine species for ablation products. Three test cases are studied in this paper. The first case is a graphite test model in the arc-jet stream; the second is a light weight Phenolic Impregnated Carbon Ablator at the Stardust re-entry peak heating conditions, and the third is a fully dense carbon-phenolic heatshield at the peak heating point of a proposed Mars Sample Return Earth Entry Vehicle. Predictions based on both finite-rate gas- surface interaction models are compared with those obtained using B' tables, which were created based on the chemical equilibrium assumption. Stagnation point convective heat fluxes predicted using Park's finite-rate model are far below those obtained from chemical equilibrium B' tables and Zhluktov's model. Recession predictions from Zhluktov's model are generally lower than those obtained from Park's model and chemical equilibrium B' tables. The effect of species mass diffusion on predicted ablation rate is also examined.

Estimating the ratio of pond size to irrigated soybeans land in Mississippi: A case study

USDA-ARS?s Scientific Manuscript database

Although more on-farm storage ponds have been constructed in recent years to mitigate groundwater resources depletion in Mississippi, little effort has been devoted to estimating the ratio of pond size to irrigated crop land based on pond matric and its hydrological conditions. Knowledge of this ra...

33 CFR 241.4 - General policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... amount of credits will be limited by the lower share. (f) The test is based on the following principles... in only a limited number of cases of severe economic hardship. (2) The test should depend not only on the economic circumstances within a project area, but also on the conditions of the state(s) in which...

Evolving Definitions of Autism and Impact on Eligibility for Developmental Disability Services: California Case Example

ERIC Educational Resources Information Center

Williams, Marian E.; Wheeler, Barbara Y.; Linder, Lisa; Jacobs, Robert A.

2017-01-01

When establishing eligibility for developmental disability (DD) services, definitions of specific diagnostic conditions, such as autism, impact policy. Under the Medicaid home and community-based waiver program, states have discretion in determining specific program or service eligibility criteria, the nature of supports to be provided, and the…

The Chicanos of El Paso: A Case of Changing Colonization.

ERIC Educational Resources Information Center

Martinez, Oscar J.

Using historical statistics and key indicators, data were synthesized to identify longitudinal trends and patterns in the social, economic, and political status of El Paso's Chicanos. Data related to group achievement were analyzed. A framework adapted to local conditions based on the internal colonialism model was used for the periodization of El…

Discussing Difference: Color-Blind Collectivism and Dynamic Dissonance in Two-Way Immersion Contexts

ERIC Educational Resources Information Center

Stolte, Laurel

2017-01-01

This comparative case study (based on observational, interview, and picture-sort data) examines how teachers and students talk about cultural, linguistic, racial, and socioeconomic difference in two elementary Spanish-English two-way immersion programs. In addition, I analyze how those discourses are associated with both contextual conditions and…

Ageing of Insensitive DNAN Based Melt-Cast Explosives

DTIC Science & Technology

2014-08-01

diurnal cycle (representative of the MEAO climate). Analysis of the ingredient composition, sensitiveness, mechanical and thermal properties was...first test condition was chosen to provide a worst-case scenario. Analysis of the ingredient composition, theoretical maximum density, sensitiveness...5 4.1.1 ARX-4027 Ingredient Analysis .............................................................. 5 4.1.2 ARX-4028 Ingredient Analysis

Desired future condition: Fish habitat in southwestern riparian-stream habitats

Treesearch

John N. Rinne

1996-01-01

Riparian ecosystems in the southwestern United States provide valuable habitats for many living organisms including native fishes. An analysis of habitat components important to native fishes was made based on the literature, case histories, and unpublished and observational data. Results suggest a natural, surface water hydrograph and lack of introduced species of...

Tribal, Proletarian and Entrepreneurial Career Stories: Junior Academics as a Case in Point

ERIC Educational Resources Information Center

Ylijoki, Oili-Helena; Henriksson, Lea

2017-01-01

This paper explores the career-building of junior academics in the current higher education environment, which is characterised by short-term employment conditions. The paper is based on focus group discussions with Finnish early career academics working in the social sciences. Drawing upon a narrative approach, five career stories are…

Enhancing Teachers' Curriculum Ownership via Teacher Engagement in State-Based Curriculum-Making: The Estonian Case

ERIC Educational Resources Information Center

Mikser, Rain; Kärner, Anita; Krull, Edgar

2016-01-01

Teachers' curriculum ownership is increasingly gaining attention in many countries. It is particularly important that under the conditions of centralized curriculum-making, teachers as final implementers of curricular ideas identify themselves with these ideas. This study investigates Estonian upper secondary school teachers' views on the impact…

Mentoring and Community: Inquiry as Stance and Science as Inquiry

ERIC Educational Resources Information Center

Melville, Wayne; Bartley, Anthony

2010-01-01

In this article, we investigate how mentoring relationships founded on inquiry as stance can work to emphasize the conditions that promote the development of teachers of science as inquiry. Drawing on data collected through semi-structured interviews, we have developed two narrative case studies based on the two mentoring relationships that exist…

Consensus for second-order multi-agent systems with position sampled data

NASA Astrophysics Data System (ADS)

Wang, Rusheng; Gao, Lixin; Chen, Wenhai; Dai, Dameng

2016-10-01

In this paper, the consensus problem with position sampled data for second-order multi-agent systems is investigated. The interaction topology among the agents is depicted by a directed graph. The full-order and reduced-order observers with position sampled data are proposed, by which two kinds of sampled data-based consensus protocols are constructed. With the provided sampled protocols, the consensus convergence analysis of a continuous-time multi-agent system is equivalently transformed into that of a discrete-time system. Then, by using matrix theory and a sampled control analysis method, some sufficient and necessary consensus conditions based on the coupling parameters, spectrum of the Laplacian matrix and sampling period are obtained. While the sampling period tends to zero, our established necessary and sufficient conditions are degenerated to the continuous-time protocol case, which are consistent with the existing result for the continuous-time case. Finally, the effectiveness of our established results is illustrated by a simple simulation example. Project supported by the Natural Science Foundation of Zhejiang Province, China (Grant No. LY13F030005) and the National Natural Science Foundation of China (Grant No. 61501331).

Small strain multiphase-field model accounting for configurational forces and mechanical jump conditions

NASA Astrophysics Data System (ADS)

Schneider, Daniel; Schoof, Ephraim; Tschukin, Oleg; Reiter, Andreas; Herrmann, Christoph; Schwab, Felix; Selzer, Michael; Nestler, Britta

2018-03-01

Computational models based on the phase-field method have become an essential tool in material science and physics in order to investigate materials with complex microstructures. The models typically operate on a mesoscopic length scale resolving structural changes of the material and provide valuable information about the evolution of microstructures and mechanical property relations. For many interesting and important phenomena, such as martensitic phase transformation, mechanical driving forces play an important role in the evolution of microstructures. In order to investigate such physical processes, an accurate calculation of the stresses and the strain energy in the transition region is indispensable. We recall a multiphase-field elasticity model based on the force balance and the Hadamard jump condition at the interface. We show the quantitative characteristics of the model by comparing the stresses, strains and configurational forces with theoretical predictions in two-phase cases and with results from sharp interface calculations in a multiphase case. As an application, we choose the martensitic phase transformation process in multigrain systems and demonstrate the influence of the local homogenization scheme within the transition regions on the resulting microstructures.

Fault Diagnosis for Rolling Bearings under Variable Conditions Based on Visual Cognition

PubMed Central

Cheng, Yujie; Zhou, Bo; Lu, Chen; Yang, Chao

2017-01-01

Fault diagnosis for rolling bearings has attracted increasing attention in recent years. However, few studies have focused on fault diagnosis for rolling bearings under variable conditions. This paper introduces a fault diagnosis method for rolling bearings under variable conditions based on visual cognition. The proposed method includes the following steps. First, the vibration signal data are transformed into a recurrence plot (RP), which is a two-dimensional image. Then, inspired by the visual invariance characteristic of the human visual system (HVS), we utilize speed up robust feature to extract fault features from the two-dimensional RP and generate a 64-dimensional feature vector, which is invariant to image translation, rotation, scaling variation, etc. Third, based on the manifold perception characteristic of HVS, isometric mapping, a manifold learning method that can reflect the intrinsic manifold embedded in the high-dimensional space, is employed to obtain a low-dimensional feature vector. Finally, a classical classification method, support vector machine, is utilized to realize fault diagnosis. Verification data were collected from Case Western Reserve University Bearing Data Center, and the experimental result indicates that the proposed fault diagnosis method based on visual cognition is highly effective for rolling bearings under variable conditions, thus providing a promising approach from the cognitive computing field. PMID:28772943

Conditioning of FRF measurements for use with frequency based substructuring

NASA Astrophysics Data System (ADS)

Nicgorski, Dana; Avitabile, Peter

2010-02-01

Frequency based substructuring approaches have been used for the generation of system models from component data. While numerical models show successful results, there have been many difficulties with actual measurements in many instances. Previous work has identified some of these typical problems using simulated data to incorporate specific measurement difficulties commonly observed along with approaches to overcome some of these difficulties. This paper presents the results using actual measured data for a laboratory structure subjected to both analytical and experimental studies. Various commonly used approaches are shown to illustrate some of the difficulties with measured data. A new approach to better condition the measured functions and purge commonly found data measurement contaminants is utilized to provide dramatically improved results. Several cases are explored to show the difficulties commonly observed as well as the improved conditioning of the measured data to obtain acceptable results.

Under-coding of secondary conditions in coded hospital health data: Impact of co-existing conditions, death status and number of codes in a record.

PubMed

Peng, Mingkai; Southern, Danielle A; Williamson, Tyler; Quan, Hude

2017-12-01

This study examined the coding validity of hypertension, diabetes, obesity and depression related to the presence of their co-existing conditions, death status and the number of diagnosis codes in hospital discharge abstract database. We randomly selected 4007 discharge abstract database records from four teaching hospitals in Alberta, Canada and reviewed their charts to extract 31 conditions listed in Charlson and Elixhauser comorbidity indices. Conditions associated with the four study conditions were identified through multivariable logistic regression. Coding validity (i.e. sensitivity, positive predictive value) of the four conditions was related to the presence of their associated conditions. Sensitivity increased with increasing number of diagnosis code. Impact of death on coding validity is minimal. Coding validity of conditions is closely related to its clinical importance and complexity of patients' case mix. We recommend mandatory coding of certain secondary diagnosis to meet the need of health research based on administrative health data.

Haemorrhoids are associated with erectile dysfunction: a population-based study.

PubMed

Keller, J J; Lin, H-C

2012-12-01

Haemorrhoids are associated with regional vascular abnormalities and rectal pain, which are hypothesized to increase the risk of erectile dysfunction (ED); however, few studies have investigated the association between ED and haemorrhoids. This case-control study aimed to estimate the association between haemorrhoids and ED by using a population-based data in Taiwan. We identified 6,310 patients with ED as cases and randomly selected 31,550 controls. Conditional logistic regression was performed to compute the odds ratio (OR) for having been previously diagnosed with haemorrhoids between cases and controls. The results show that haemorrhoids were found to be present among 1,572 (24.9%) cases and 4,491 (14.20%) controls. The OR for prior haemorrhoids among cases was 1.90 (95% CI = 1.78-2.03) when compared with controls after adjusting for monthly income, geographical location, hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity and alcohol abuse/alcohol dependence syndrome. Younger cases demonstrated a higher risk for prior haemorrhoids when compared with controls. In particular, the adjusted OR among cases <30 years old was 3.71 (95% CI = 2.74-5.02) when compared with controls. We concluded that there was an association between ED and a prior diagnosis of haemorrhoids. © 2012 The Authors. International Journal of Andrology © 2012 European Academy of Andrology.

Habitat and sex differences in physiological condition of breeding Southwestern Willow Flycatchers (Empidonax traillii extimus)

USGS Publications Warehouse

Owen, J.C.; Sogge, M.K.; Kern, M.D.

2005-01-01

The Southwestern Willow Flycatcher (Empidonax traillii extimus; here- after “flycatcher”) is a federally listed endangered species that breeds in densely vegetated riparian habitats dominated by native and exotic plants, including introduced monotypic saltcedar (Tamarix ramosissima). Some workers have theorized that saltcedar is unsuitable habitat for the flycatcher, primarily because it generally supports a smaller and less diverse invertebrate community (the flycatcher's food base) than native habitats (e.g. Salix spp.). However, differences in insect communities between native and saltcedar habitats are not proof that saltcedar habitats are inferior. The only way to evaluate whether the habitats differ in dietary or energetic quality is to document actual food limitation or its manifestations. Measurements of an individual's body condition and metabolic state can serve as indicators of environmental stressors, such as food limitation and environmental extremes. We captured 130 flycatchers breeding in native and saltcedar habitats in Arizona and New Mexico and measured 12 variables of physiological condition. These variables included body mass, fat level, body condition index, hematocrit, plasma triglycerides, plasma free fatty acids and glycerol, plasma glucose and beta-hydroxybutyrate, plasma uric acid, total leukocyte count, and heterophil-to-lymphocyte ratio. We found substantial sex-based differences in the condition of male and female flycatchers. Ten of the 12 measures of physiological condition differed significantly between the sexes. In all cases where male and female condition differed (except mass), the differences suggest that males were in poorer condition than females. We found few habitat-based differences in flycatcher condition. Only 3 of the 12 physiological condition indices differed significantly between habitats. Our data show that, at least in some parts of the flycatcher's range, there is no evidence that flycatchers breeding in saltcedar habitats exhibit poorer nutritional condition or are suffering negative physiological affects.

Dental, dermatological and radiographic findings in a case of Gorlin-Goltz Syndrome: report and review.

PubMed

Nilesh, Kumar; Tewary, Shivsagar; Zope, Sameer; Patel, Jinesh; Vande, Aaditee

2017-01-01

Gorlin-Goltz syndrome (GGS) is a rare autosomal dominant disorder. The disease shows multiple organ involvement with variable clinical presentation. Thus a multidisciplinary approach is required for its prompt clinical diagnosis and management of this condition. This paper highlights a case of GGS presenting in a young male patient with cranial, facial, dermatological, dental and skeletal involvement. The diagnosis of the syndrome was based on its clinical presentation, radiological features and histopathological findings. A review of the diagnostic criteria is also presented.

Dental, dermatological and radiographic findings in a case of Gorlin-Goltz Syndrome: report and review

PubMed Central

Nilesh, Kumar; Tewary, Shivsagar; Zope, Sameer; Patel, Jinesh; Vande, Aaditee

2017-01-01

Gorlin-Goltz syndrome (GGS) is a rare autosomal dominant disorder. The disease shows multiple organ involvement with variable clinical presentation. Thus a multidisciplinary approach is required for its prompt clinical diagnosis and management of this condition. This paper highlights a case of GGS presenting in a young male patient with cranial, facial, dermatological, dental and skeletal involvement. The diagnosis of the syndrome was based on its clinical presentation, radiological features and histopathological findings. A review of the diagnostic criteria is also presented. PMID:28819517

Revisiting tests for neglected nonlinearity using artificial neural networks.

PubMed

Cho, Jin Seo; Ishida, Isao; White, Halbert

2011-05-01

Tests for regression neglected nonlinearity based on artificial neural networks (ANNs) have so far been studied by separately analyzing the two ways in which the null of regression linearity can hold. This implies that the asymptotic behavior of general ANN-based tests for neglected nonlinearity is still an open question. Here we analyze a convenient ANN-based quasi-likelihood ratio statistic for testing neglected nonlinearity, paying careful attention to both components of the null. We derive the asymptotic null distribution under each component separately and analyze their interaction. Somewhat remarkably, it turns out that the previously known asymptotic null distribution for the type 1 case still applies, but under somewhat stronger conditions than previously recognized. We present Monte Carlo experiments corroborating our theoretical results and showing that standard methods can yield misleading inference when our new, stronger regularity conditions are violated.

Association between prostate cancer and urinary calculi: a population-based study.

PubMed

Chung, Shiu-Dong; Liu, Shih-Ping; Lin, Herng-Ching

2013-01-01

Understanding the reasons underlying the emerging trend and the changing demographics of Asian prostate cancer (PC) has become an important field of study. This study set out to explore the possibility that urinary calculi (UC) and PC may share an association by conducting a case-control study on a population-based database in Taiwan. The cases of this study included 2,900 subjects ≥ 40 years-old who had received their first-time diagnosis of PC and 14,500 randomly selected controls without PC. Conditional logistic regressions were employed to explore the association between PC and having been previously diagnosed with UC. We found that prior UC was found among 608 (21.0%) cases and 2,037 (14.1%) controls (p<0.001). Conditional logistic regression analysis revealed that compared to controls, the odds ratio (OR) of prior UC for cases was 1.63 (95% CI = 1.47-1.80). Furthermore, we found that cases were more likely to have been previously diagnosed with kidney calculus (OR = 1.71; 95% CI = 1.42-2.05), bladder calculus (OR = 2.06; 95% CI = 1.32-3.23), unspecified calculus (OR = 1.66; 95% CI = 1.37-2.00), and ≥2 locations of UC (OR = 1.73; 1.47-2.02) than controls. However, there was no significant relationship between PC and prior ureter calculus. We also found that of the patients with UC, there was no significant difference between PC and treatment method. This investigation detected an association between PC and prior UC. These results highlight a potential target population for PC screening.

[A case-control study on the risk factors of work-related acute pesticide poisoning among farmers from Jiangsu province].

PubMed

Tu, Zhi-bin; Cui, Meng-jing; Yao, Hong-yan; Hu, Guo-qing; Xiang, Hui-yun; Stallones, Lorann; Zhang, Xu-jun

2012-04-01

To explore the risk factors on cases regarding work-related acute pesticide poisoning among farmers of Jiangsu province. A population-based, 1:2 matched case-control study was carried out, with 121 patients as case-group paired by 242 persons with same gender, district and age less then difference of 3 years, as controls. Cases were the ones who had suffered from work-related acute pesticide poisoning. A unified questionnaire was used. Data base was established by EpiData 3.1, and SPSS 16.0 was used for both data single factor and multi-conditional logistics regression analysis. Results from the single factor logistic regression analysis showed that the related risk factors were: lack of safety guidance, lack of readable labels before praying pesticides, no regression during application, using hand to wipe sweat, using leaking knapsack, body contaminated during application and continuing to work when feeling ill after the contact of pesticides. Results from multi-conditional logistic regression analysis indicated that the lack of safety guidance (OR=2.25, 95%CI: 1.35-3.74), no readable labels before praying pesticides (OR=1.95, 95%CI: 1.19-3.18), wiping the sweat by hand during application (OR=1.97, 95%CI: 1.20-3.24) and using leaking knapsack during application (OR=1.82, 95%CI:1.10-3.01) were risk factors for the occurrence of work-related acute pesticide poisoning. The lack of safety guidance, no readable labels before praying pesticides, wiping the sweat by hand or using leaking knapsack during application were correlated to the occurrence of work-related acute pesticide poisoning.

Neovascular age-related macular degeneration is not associated with coronary heart disease in a Chinese Population: a population-based study.

PubMed

Hu, Chao-Chien; Lin, Herng-Ching; Sheu, Jau-Jiuan; Kao, Li-Ting

2017-11-01

This case-control study aimed to explore the association between prior coronary heart disease (CHD) and neovascular age-related macular degeneration (AMD) using a population-based data set in Taiwan. We analysed data sourced from the Taiwan Longitudinal Health Insurance Database 2005. The study consisted of 1970 patients with neovascular AMD as cases and 5910 age- and sex-matched controls. We performed a conditional logistic regression to examine the odds ratio (OR) and its corresponding 95% confidence interval (CI) for previously diagnosed CHD between cases and controls. Of the 7880 sampled patients, 24.5% had a prior history of CHD; CHD was found in 25.7% of cases and in 22.7% of controls (p = 0.008). The conditional logistic regression analysis indicated that the OR for prior CHD for cases was 1.17 [95% confidence interval (CI): 1.04-1.32] compared to the controls. However, after adjusting for patient's monthly income, geographic location, urbanization level, age, hyperlipidaemia, diabetes and hypertension, we failed to observe an association between prior CHD and AMD (OR = 1.03, 95% CI = 0.91-1.17). Additionally, the medical comorbidities of hyperlipidaemia (adjusted OR = 1.29, 95% CI = 1.15-1.45), hypertension (adjusted OR = 1.20, 95% CI = 1.05-1.37) and diabetes (adjusted OR = 1.47, 95% CI = 1.32-1.65) were significantly associated with AMD. This study presented no significant difference in the odds of prior CHD between patients with AMD and those without AMD after adjusting for comorbidities and sociodemographic characteristics in a Chinese population. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Synchronization of DNA array replication kinetics

NASA Astrophysics Data System (ADS)

Manturov, Alexey O.; Grigoryev, Anton V.

2016-04-01

In the present work we discuss the features of the DNA replication kinetics at the case of multiplicity of simultaneously elongated DNA fragments. The interaction between replicated DNA fragments is carried out by free protons that appears at the every nucleotide attachment at the free end of elongated DNA fragment. So there is feedback between free protons concentration and DNA-polymerase activity that appears as elongation rate dependence. We develop the numerical model based on a cellular automaton, which can simulate the elongation stage (growth of DNA strands) for DNA elongation process with conditions pointed above and we study the possibility of the DNA polymerases movement synchronization. The results obtained numerically can be useful for DNA polymerase movement detection and visualization of the elongation process in the case of massive DNA replication, eg, under PCR condition or for DNA "sequencing by synthesis" sequencing devices evaluation.

The Complete Remission of Acquired Immunodeficiency Syndrome-associated Isolated Central Nervous System Lymphomatoid Granulomatosis: A Case Report and Review of the Literature

PubMed Central

Kano, Yasuhiro; Kodaira, Minori; Ushiki, Atsuhito; Kosaka, Makoto; Yamada, Mitsunori; Shingu, Kunihiko; Nishihara, Hiroshi; Hanaoka, Masayuki; Sekijima, Yoshiki

2017-01-01

A 49-year-old man presented with gradually progressive aphasia one month after being diagnosed with acquired immunodeficiency syndrome (AIDS). Brain magnetic resonance imaging showed multiple brain lesions with punctate and linear enhancement. A polymerase chain reaction detected Epstein-Barr virus (EBV) in the patient's cerebrospinal fluid. A diagnosis of isolated central nervous system lymphomatoid granulomatosis (CNS-LYG) was made based on the brain biopsy findings. The complete remission of CNS-LYG was achieved by anti-retroviral therapy (ART) alone. In the present case, the development of AIDS-associated CNS-LYG was considered to have been initiated by the reactivation of EBV in the CNS under immunosuppressive conditions. The patient's condition improved with the reconstitution of the patient's immune system. PMID:28824078

A Survey of Quantum Lyapunov Control Methods

PubMed Central

2013-01-01

The condition of a quantum Lyapunov-based control which can be well used in a closed quantum system is that the method can make the system convergent but not just stable. In the convergence study of the quantum Lyapunov control, two situations are classified: nondegenerate cases and degenerate cases. For these two situations, respectively, in this paper the target state is divided into four categories: the eigenstate, the mixed state which commutes with the internal Hamiltonian, the superposition state, and the mixed state which does not commute with the internal Hamiltonian. For these four categories, the quantum Lyapunov control methods for the closed quantum systems are summarized and analyzed. Particularly, the convergence of the control system to the different target states is reviewed, and how to make the convergence conditions be satisfied is summarized and analyzed. PMID:23766732

Introduction Analysis of Refrigerating and Air-Conditioning Technologies in Micro Grid Type Food Industrial Park

NASA Astrophysics Data System (ADS)

Shimazaki, Yoichi

The aim of this study was to evaluate the refrigerating and air-conditioning technologies in cases of introducing both cogeneration system and energy network in food industrial park. The energy data of 14 factories were classified into steam, hot water, heating, cooling, refrigerating, freezing and electric power by interviews. The author developed a micro grid model based on linear programming so as to minimize the total system costs. The industrial park was divided into the 2,500 square meter mesh in order to take steam transport into consideration. Four cases were investigated. It was found that the electric power driven freezer was introduced compared with the ammonia absorption freezer. The ammonia absorption freezer was introduced in the factory that there is a little steam demand and large freezing demand at the same time.

Compact and low power operation optical switch using silicon-germanium/silicon hetero-structure waveguide.

PubMed

Sekiguchi, Shigeaki; Kurahashi, Teruo; Zhu, Lei; Kawaguchi, Kenichi; Morito, Ken

2012-04-09

We proposed a silicon-based optical switch with a carrier-plasma-induced phase shifter which employs a silicon-germanium (SiGe) / silicon (Si) hetero-structure in the waveguide core. A type-I hetero-interface formed by SiGe and Si is expected to confine carriers effectively in the SiGe waveguide core. The fabricated Mach-Zehnder optical switch shows a low switching power of only 1.53 mW with a compact phase shifter length of 250 μm. The switching time of the optical switch is less than 4.6 ns for the case of a square waveform driving condition, and 1 ns for the case of a pre-emphasis electric driving condition. These results show that our proposed SiGe/Si waveguide structure holds promise for active devices with compact size and low operation power.

Dancing to death: A case of heat stroke.

PubMed

Nadesan, K; Kumari, Chandra; Afiq, Mohd

2017-08-01

Heat stroke is a medical emergency which may lead to mortality unless diagnosed early and treated effectively. Heat stroke may manifest rapidly, hence making it difficult to differentiate it from other clinical causes in a collapsed victim. 1 We are presenting a case report of twelve patients who were admitted to our emergency department from a music festival held on 13-15th of March 2014. They developed complications arising from a combination of severe adverse weather condition, prolonged outdoor physical exertion due to long hours of dancing and drug-use, resulting in heat stroke. Three of them died while the remaining patients survived. Their condition was initially misdiagnosed as a classical illicit drug overdose. This was based on the history of drug ingestion by some of the patients who attended the music festival on that day. The information in this case report aims, to create awareness amongst members of the medical team on duty in outdoor events, pre hospital responders and ED physicians when treating and managing similar cases in the future. In addition it is intended to warn the organizers of such events to take adequate precautions to avoid such tragedies in the future. Copyright © 2017. Published by Elsevier Ltd.

Building International Sustainable Partnerships in Occupational Therapy: A Case Study.

PubMed

Tupe, Debra Ann; Kern, Stephen B; Salvant, Sabrina; Talero, Pamela

2015-09-01

Occupational therapy practitioners frequently identify opportunities for international practice. The World Health Organization and the World Federation of Occupational Therapists have encouraged occupational therapists to address transnational issues, social inclusion, and equal access to opportunities grounded in meaningful occupation (WFOT, 2012). This case study describes a partnership between two U.S. schools of occupational therapy and a Cuban community based pediatric clinic. It examines the dynamics that have sustained the partnership despite political, economic, and logistical barriers. The literature is scrutinized to show how this case study fits into other accounts of collaborative international partnerships. Particularly, it investigates structural and institutional conditions that shape international sustainable partnerships. In doing so, we answer the following questions: (1) Under which circumstances do international partnerships emerge and flourish? (2) What structural and institutional conditions shape international sustainable partnerships? And (3) How do partners perceive and experience the bilateral international partnership? It also discusses and illustrates the foundations and development of international partnerships that succeed. Through the use of a case study we illustrate the development of this partnership. Finally, we consider the next steps of this particular sustainable and collaborative international partnership. © 2015 John Wiley & Sons, Ltd.

Innovations in human genetics education. Incorporation of genetics into a problem-based medical school curriculum.

PubMed Central

Swinford, A E; McKeag, D B

1990-01-01

There has been recent interest in the development of problem-based human genetics curricula in U.S. medical schools. The College of Human Medicine at Michigan State University has had a problem-based curriculum since 1974. The vertical integration of genetics within the problem-based curriculum, called "Track II," has recently been revised. On first inspection, the curriculum appeared to lack a significant genetics component; however, on further analysis it was found that many genetics concepts were covered in the biochemistry, microbiology, pathology, and clinical science components. Both basic science concepts and clinical applications of genetics are covered in the curriculum by providing appropriate references for basic concepts and including inherited conditions within the differential diagnosis in the cases studied. Evaluations consist of a multiple-choice content exam and a modified essay exam based on a clinical case, allowing evaluation of both basic concepts and problem-solving ability. This curriculum prepares students to use genetics in a clinical context in their future careers. PMID:2220816

Flowfield analysis of helicopter rotor in hover and forward flight based on CFD

NASA Astrophysics Data System (ADS)

Zhao, Qinghe; Li, Xiaodong

2018-05-01

The helicopter rotor field is simulated in hover and forward flight based on Computational Fluid Dynamics(CFD). In hover case only one rotor is simulated with the periodic boundary condition in the rotational coordinate system and the grid is fixed. In the non-lift forward flight case, the total rotor is simulated in inertia coordinate system and the whole grid moves rigidly. The dual-time implicit scheme is applied to simulate the unsteady flowfield on the movement grids. The k – ω turbulence model is employed in order to capture the effects of turbulence. To verify the solver, the flowfield around the Caradonna-Tung rotor is computed. The comparison shows a good agreement between the numerical results and the experimental data.

Cost effectiveness of home and community-based care

PubMed Central

Vertrees, James C.; Manton, Kenneth G.; Adler, Gerald S.

1989-01-01

Medicaid section 2176 waivers allow States to provide home and community-based care to Medicaid eligibles who, but for these services, would enter Medicaid-funded nursing homes. One of the conditions required by Congress for granting these waivers is that this substitution results in no additional Medicaid spending (budget neutrality). The results of case studies of two of these waiver programs, one in California and one in Georgia, are presented in this article. The case studies contain a description of the operation of these programs in some detail. Next, the data and techniques needed to assess the ability of these programs to achieve budget neutrality are presented, and the performance of these programs along this dimension is evaluated. PMID:10313280

[Alkalosis].

PubMed

Kościelska, Malgorzata; Mieczkowski, Mariusz

2013-01-01

An elevation of arterial blood pH called alkalosis remains an underestimated condition in hospitalized patients. Serious alkalosis can be associated with high risk of death. The disorder can be caused by increased concentration of bicarbonate (metabolic alkalosis) or decreased concentration of carbon dioxide (respiratory alkalosis). In most cases of metabolic alkalosis it is generated by vomiting or diuretic use, whereas respiratory alkalosis is provoked by hyperventilation associated with respiratory or neurological disorder. Maintenance of metabolic alkalosis is possible only in patients with impaired renal base excretion which is most often produced by hypochloremia. In both respiratory and metabolic alkaloses treatment depends on the underlying factor. In hyperventilation syndrome is based on behavioral therapy. In most cases of metabolic alkalosis the administration of sodium and potassium chloride forms a substantial part of therapy.

Statistical analysis of multivariate atmospheric variables. [cloud cover

NASA Technical Reports Server (NTRS)

Tubbs, J. D.

1979-01-01

Topics covered include: (1) estimation in discrete multivariate distributions; (2) a procedure to predict cloud cover frequencies in the bivariate case; (3) a program to compute conditional bivariate normal parameters; (4) the transformation of nonnormal multivariate to near-normal; (5) test of fit for the extreme value distribution based upon the generalized minimum chi-square; (6) test of fit for continuous distributions based upon the generalized minimum chi-square; (7) effect of correlated observations on confidence sets based upon chi-square statistics; and (8) generation of random variates from specified distributions.

Static and dynamic behaviour of nonlocal elastic bar using integral strain-based and peridynamic models

NASA Astrophysics Data System (ADS)

Challamel, Noël

2018-04-01

The static and dynamic behaviour of a nonlocal bar of finite length is studied in this paper. The nonlocal integral models considered in this paper are strain-based and relative displacement-based nonlocal models; the latter one is also labelled as a peridynamic model. For infinite media, and for sufficiently smooth displacement fields, both integral nonlocal models can be equivalent, assuming some kernel correspondence rules. For infinite media (or finite media with extended reflection rules), it is also shown that Eringen's differential model can be reformulated into a consistent strain-based integral nonlocal model with exponential kernel, or into a relative displacement-based integral nonlocal model with a modified exponential kernel. A finite bar in uniform tension is considered as a paradigmatic static case. The strain-based nonlocal behaviour of this bar in tension is analyzed for different kernels available in the literature. It is shown that the kernel has to fulfil some normalization and end compatibility conditions in order to preserve the uniform strain field associated with this homogeneous stress state. Such a kernel can be built by combining a local and a nonlocal strain measure with compatible boundary conditions, or by extending the domain outside its finite size while preserving some kinematic compatibility conditions. The same results are shown for the nonlocal peridynamic bar where a homogeneous strain field is also analytically obtained in the elastic bar for consistent compatible kinematic boundary conditions at the vicinity of the end conditions. The results are extended to the vibration of a fixed-fixed finite bar where the natural frequencies are calculated for both the strain-based and the peridynamic models.

Solar Array Power Conditioning for a Spinning Satellite

NASA Astrophysics Data System (ADS)

De Luca, Antonio; Chirulli, Giovanni

2008-09-01

The conditioning of the output power from a solar array can mainly be achieved by the adoption of DET or MPPT based architecture. There are several factors that can orientate the choice of the system designer towards one solution or the other; some of them maybe inherent to the mission derived requirements (Illumination levels, EMC cleanliness, etc.), others come directly from a careful assessment of performances and losses of both power conditioner and solar array.Definition of the criteria on which basis the final choice is justified is important as they have to guarantee a clear determination of the available versus the required power in all those mission conditions identifiable as design drivers for the overall satellite system both in terms of mass and costs.Such criteria cannot just be simple theoretical enunciations of principles; nor the meticulous definition of them on a case by case basis for different types of missions as neither option gives a guarantee of being conclusive.The aim of this paper is then to suggest assessment steps and guidelines that can be considered generically valid for any mission case, starting from the exposition of the trade off activity performed in order to choose the power conditioning solution for a spinning satellite having unregulated power bus architecture. Calculations and numerical simulations have been made in order to establish the needed solar array surface in case of adoption of a DET or MPPT solution, taking into account temperature and illumination levels on the solar cells, as well as power losses and inefficiencies from the solar generator to the main power bus, in different mission phases. Particular attention has been taken in order to correctly evaluate the thermal effects on the rest of the spacecraft as function of the adopted power system regulation.

A Novel Method for Modeling Neumann and Robin Boundary Conditions in Smoothed Particle Hydrodynamics

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

Ryan, Emily M.; Tartakovsky, Alexandre M.; Amon, Cristina

2010-08-26

In this paper we present an improved method for handling Neumann or Robin boundary conditions in smoothed particle hydrodynamics. The Neumann and Robin boundary conditions are common to many physical problems (such as heat/mass transfer), and can prove challenging to model in volumetric modeling techniques such as smoothed particle hydrodynamics (SPH). A new SPH method for diffusion type equations subject to Neumann or Robin boundary conditions is proposed. The new method is based on the continuum surface force model [1] and allows an efficient implementation of the Neumann and Robin boundary conditions in the SPH method for geometrically complex boundaries.more » The paper discusses the details of the method and the criteria needed to apply the model. The model is used to simulate diffusion and surface reactions and its accuracy is demonstrated through test cases for boundary conditions describing different surface reactions.« less

Sterilization by Cooling in Isochoric Conditions: The Case of Escherichia coli

PubMed Central

Salinas-Almaguer, Samuel; Angulo-Sherman, Abril; Sierra-Valdez, Francisco Javier; Mercado-Uribe, Hilda

2015-01-01

High hydrostatic pressure (HHP) affects the structure, metabolism and survival of micro-organisms including bacteria. For this reason HHP is a promising treatment in the food industry. The aim of this work is to evaluate the effect of high pressure, under isochoric cooling conditions, on Escherichia coli, where such high pressure develops due to the fact water cannot expand. We combine survival curves obtained by spectrophotometry and images of atomic force microscopy in this study. Our results show that cooling at -20 and -30°C leads to a partial destruction of a Escherichia coli population. However, cooling at -15°C causes a total extermination of bacteria. This intriguing result is explained by the phase diagram of water. In the first case, the simultaneous formation of ice III and ice Ih crystals provides a safe environment for bacteria. In the second case (-15°C) Escherichia coli remains in a metastable and amorphous free-of-crystals liquid subjected to high pressure. Our work is the first experimental study carried out to inactivate Escherichia coli under isochoric cooling conditions. Unlike HHP, which is based on the application of an external load to augment the pressure, this technique only requires cooling. The method could be used for annihilation of other Escherichia coli strains and perhaps other micro-organisms. PMID:26480032

Thinking like a scientist: innateness as a case study.

PubMed

Knobe, Joshua; Samuels, Richard

2013-01-01

The concept of innateness appears in systematic research within cognitive science, but it also appears in less systematic modes of thought that long predate the scientific study of the mind. The present studies therefore explore the relationship between the properly scientific uses of this concept and its role in ordinary folk understanding. Studies 1-4 examined the judgments of people with no specific training in cognitive science. Results showed (a) that judgments about whether a trait was innate were not affected by whether or not the trait was learned, but (b) such judgments were impacted by moral considerations. Study 5 looked at the judgments of both non-scientists and scientists, in conditions that encouraged either thinking about individual cases or thinking about certain general principles. In the case-based condition, both non-scientists and scientists showed an impact of moral considerations but little impact of learning. In the principled condition, both non-scientists and scientists showed an impact of learning but little impact of moral considerations. These results suggest that both non-scientists and scientists are drawn to a conception of innateness that differs from the one at work in contemporary scientific research but that they are also both capable of 'filtering out' their initial intuitions and using a more scientific approach. Copyright © 2012 Elsevier B.V. All rights reserved.

Stereoselective synthesis of unsaturated α-amino acids.

PubMed

Fanelli, Roberto; Jeanne-Julien, Louis; René, Adeline; Martinez, Jean; Cavelier, Florine

2015-06-01

Stereoselective synthesis of unsaturated α-amino acids was performed by asymmetric alkylation. Two methods were investigated and their enantiomeric excess measured and compared. The first route consisted of an enantioselective approach induced by the Corey-Lygo catalyst under chiral phase transfer conditions while the second one involved the hydroxypinanone chiral auxiliary, both implicating Schiff bases as substrate. In all cases, the use of a prochiral Schiff base gave higher enantiomeric excess and yield in the final desired amino acid.

A climate-based spatiotemporal prediction for dengue fever epidemics: a case study in southern Taiwan

NASA Astrophysics Data System (ADS)

Yu, H.-L.; Yang, S.-J.; Lin, Y.-C.

2012-04-01

Dengue Fever (DF) has been identified by the World Health organization (WHO) as one of the most serious vector-borne infectious diseases in tropical and sub-tropical areas. DF has been one of the most important epidemics in Taiwan which occur annually especially in southern Taiwan during summer and autumn. Most DF studies have focused mainly on temporal DF patterns and its close association with climatic covariates, whereas few studies have investigated the spatial DF patterns (spatial dependence and clustering) and composite space-time effects of the DF epidemics. The present study proposes a spatio-temporal DF prediction approach based on stochastic Bayesian Maximum Entropy (BME) analysis. Core and site-specific knowledge bases are considered, including climate and health datasets under conditions of uncertainty, space-time dependence functions, and a Poisson regression model of climatic variables contributing to DF occurrences in southern Taiwan during 2007, when the highest number of DF cases was recorded in the history of Taiwan epidemics (over 2000). The obtained results show that the DF outbreaks in the study area are highly influenced by climatic conditions. Furthermore, the analysis can provide the required "one-week-ahead" outbreak warnings based on spatio-temporal predictions of DF distributions. Therefore, the proposed analysis can provide the Taiwan Disease Control Agency with a valuable tool to timely identify, control, and even efficiently prevent DF spreading across space-time.

A Simplified Approach for the Rapid Generation of Transient Heat-Shield Environments

NASA Technical Reports Server (NTRS)

Wurster, Kathryn E.; Zoby, E. Vincent; Mills, Janelle C.; Kamhawi, Hilmi

2007-01-01

A simplified approach has been developed whereby transient entry heating environments are reliably predicted based upon a limited set of benchmark radiative and convective solutions. Heating, pressure and shear-stress levels, non-dimensionalized by an appropriate parameter at each benchmark condition are applied throughout the entry profile. This approach was shown to be valid based on the observation that the fully catalytic, laminar distributions examined were relatively insensitive to altitude as well as velocity throughout the regime of significant heating. In order to establish a best prediction by which to judge the results that can be obtained using a very limited benchmark set, predictions based on a series of benchmark cases along a trajectory are used. Solutions which rely only on the limited benchmark set, ideally in the neighborhood of peak heating, are compared against the resultant transient heating rates and total heat loads from the best prediction. Predictions based on using two or fewer benchmark cases at or near the trajectory peak heating condition, yielded results to within 5-10 percent of the best predictions. Thus, the method provides transient heating environments over the heat-shield face with sufficient resolution and accuracy for thermal protection system design and also offers a significant capability to perform rapid trade studies such as the effect of different trajectories, atmospheres, or trim angle of attack, on convective and radiative heating rates and loads, pressure, and shear-stress levels.

Drag Minimization for Wings and Bodies in Supersonic Flow

NASA Technical Reports Server (NTRS)

Heaslet, Max A; Fuller, Franklyn B

1958-01-01

The minimization of inviscid fluid drag is studied for aerodynamic shapes satisfying the conditions of linearized theory, and subject to imposed constraints on lift, pitching moment, base area, or volume. The problem is transformed to one of determining two-dimensional potential flows satisfying either Laplace's or Poisson's equations with boundary values fixed by the imposed conditions. A general method for determining integral relations between perturbation velocity components is developed. This analysis is not restricted in application to optimum cases; it may be used for any supersonic wing problem.

Effect of Boundary Conditions on the Axial Compression Buckling of Homogeneous Orthotropic Composite Cylinders in the Long Column Range

NASA Technical Reports Server (NTRS)

Mikulas, Martin M., Jr.; Nemeth, Michael P.; Oremont, Leonard; Jegley, Dawn C.

2011-01-01

Buckling loads for long isotropic and laminated cylinders are calculated based on Euler, Fluegge and Donnell's equations. Results from these methods are presented using simple parameters useful for fundamental design work. Buckling loads for two types of simply supported boundary conditions are calculated using finite element methods for comparison to select cases of the closed form solution. Results indicate that relying on Donnell theory can result in an over-prediction of buckling loads by as much as 40% in isotropic materials.

Verification of the naval oceanic vertical aerosol model during FIRE

NASA Technical Reports Server (NTRS)

Davidson, K. L.; Deleeuw, G.; Gathman, S. G.; Jensen, D. R.

1990-01-01

The value of Naval Oceanic Vertical Aerosol Model (NOVAM) is illustrated for estimating the non-uniform and non-logarithmic extinction profiles, based on a severe test involving conditions close to and beyond the limits of applicability of NOVAM. A more comprehensive evaluation of NOVAM from the FIRE data is presented, which includes a clear-air case. For further evaluation more data are required on the vertical structure of the extinction in the marine atmospheric boundary layer (MABL), preferably for different meteorological conditions and in different geographic areas (e.g., ASTEX).

Correlation functions for Hermitian many-body systems: Necessary conditions

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

Brown, E.B.

1994-02-01

Lee [Phys. Rev. B 47, 8293 (1993)] has shown that the odd-numbered derivatives of the Kubo autocorrelation function vanish at [ital t]=0. We show that this condition is based on a more general property of nondiagonal Kubo correlation functions. This general property provides that certain functional forms (e.g., simple exponential decay) are not admissible for any symmetric or antisymmetric Kubo correlation function in a Hermitian many-body system. Lee's result emerges as a special case of this result. Applications to translationally invariant systems and systems with rotational symmetries are also demonstrated.

Burden of serious fungal infections in Guatemala.

PubMed

Medina, N; Samayoa, B; Lau-Bonilla, D; Denning, D W; Herrera, R; Mercado, D; Guzmán, B; Pérez, J C; Arathoon, E

2017-06-01

Guatemala is a developing country in Central America with a high burden of HIV and endemic fungal infections; we attempted to estimate the burden of serious fungal infections for the country. A full literature search was done to identify epidemiology papers reporting fungal infections from Guatemala. We used specific populations at risk and fungal infection frequencies in the population to estimate national rates. The population of Guatemala in 2013 was 15.4 million; 40% were younger than 15 and 6.2% older than 60. There are an estimated 53,000 adults with HIV infection, in 2015, most presenting late. The estimated cases of opportunistic fungal infections were: 705 cases of disseminated histoplasmosis, 408 cases of cryptococcal meningitis, 816 cases of Pneumocystis pneumonia, 16,695 cases of oral candidiasis, and 4,505 cases of esophageal candidiasis. In the general population, an estimated 5,568 adult asthmatics have allergic bronchopulmonary aspergillosis (ABPA) based on a 2.42% prevalence of asthma and a 2.5% ABPA proportion. Amongst 2,452 pulmonary tuberculosis patients, we estimated a prevalence of 495 for chronic pulmonary aspergillosis in this group, and 1,484 for all conditions. An estimated 232,357 cases of recurrent vulvovaginal candidiasis is likely. Overall, 1.7% of the population are affected by these conditions. The true fungal infection burden in Guatemala is unknown. Tools and training for improved diagnosis are needed. Additional research on prevalence is needed to employ public health measures towards treatment and improving the reported data of fungal diseases.

Working conditions, socioeconomic factors and low birth weight: path analysis.

PubMed

Mahmoodi, Zohreh; Karimlou, Masoud; Sajjadi, Homeira; Dejman, Masoumeh; Vameghi, Meroe; Dolatian, Mahrokh

2013-09-01

In recent years, with socioeconomic changes in the society, the presence of women in the workplace is inevitable. The differences in working condition, especially for pregnant women, has adverse consequences like low birth weight. This study was conducted with the aim to model the relationship between working conditions, socioeconomic factors, and birth weight. This study was conducted in case-control design. The control group consisted of 500 women with normal weight babies, and the case group, 250 women with low weight babies from selected hospitals in Tehran. Data were collected using a researcher-made questionnaire to determine mothers' lifestyle during pregnancy with low birth weight with health-affecting social determinants approach. This questionnaire investigated women's occupational lifestyle in terms of working conditions, activities, and job satisfaction. Data were analyzed with SPSS-16 and Lisrel-8.8 software using statistical path analysis. The final path model fitted well (CFI =1, RMSEA=0.00) and showed that among direct paths, working condition (β=-0.032), among indirect paths, household income (β=-0.42), and in the overall effect, unemployed spouse (β=-0.1828) had the most effects on the low birth weight. Negative coefficients indicate decreasing effect on birth weight. Based on the path analysis model, working condition and socioeconomic status directly and indirectly influence birth weight. Thus, as well as attention to treatment and health care (biological aspect), special attention must also be paid to mothers' socioeconomic factors.

Risk of endometrial cancer in relation to medical conditions and medication use.

PubMed

Fortuny, Joan; Sima, Camelia; Bayuga, Sharon; Wilcox, Homer; Pulick, Katherine; Faulkner, Shameka; Zauber, Ann G; Olson, Sara H

2009-05-01

We studied the relation of medical conditions related to obesity and medications used for these conditions with endometrial cancer. We also investigated the association of other medical conditions and medications with risk. This U.S. population-based case-control study included 469 endometrial cancer cases and 467 controls. Information on putative risk factors for endometrial cancer was collected through personal interviews. We asked women about their medical history and medications used for six months or longer and the number of years each medication was taken. Risk was strongly associated with increasing obesity (P for trend < 0.001). Among the conditions related to obesity, and after adjustment for age, body mass index, and other risk factors and conditions, uterine fibroids were independently related to an increased cancer risk [adjusted odds ratio (OR), 1.8; 95% confidence interval (95% CI), 1.2-2.5]. Although hypertension was not significantly related to endometrial cancer after adjustment for age and body mass index, the use of thiazide diuretics was independently associated with increased risk (OR, 1.8; 95% CI, 1.1-3.0). Anemia was associated with decreased risk (OR, 0.6; 95% CI, 0.5-0.9). Use of nonsteroidal anti-inflammatory drugs was related to a decreased risk (OR, 0.7; 95% CI, 0.5-0.97). To our knowledge, the observation about thiazide diuretics is novel and requires confirmation in other studies and populations.

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.

Optimal solution and optimality condition of the Hunter-Saxton equation

NASA Astrophysics Data System (ADS)

Shen, Chunyu

2018-02-01

This paper is devoted to the optimal distributed control problem governed by the Hunter-Saxton equation with constraints on the control. We first investigate the existence and uniqueness of weak solution for the controlled system with appropriate initial value and boundary conditions. In contrast with our previous research, the proof of solution mapping is local Lipschitz continuous, which is one big improvement. Second, based on the well-posedness result, we find a unique optimal control and optimal solution for the controlled system with the quadratic cost functional. Moreover, we establish the sufficient and necessary optimality condition of an optimal control by means of the optimal control theory, not limited to the necessary condition, which is another major novelty of this paper. We also discuss the optimality conditions corresponding to two physical meaningful distributed observation cases.

Occurrence of cohesion of metals during combined plastic deformation

NASA Technical Reports Server (NTRS)

Aynbinder, S. G.; Klokova, E. F.

1980-01-01

Experiments were conducted to study the cohesion of metals with surface films of varying thickness and hardness. It was established that the deformation necessary for the occurrence of cohesion is determined by the correlation of mechanical properties of the films and the base metal. The greater the relative hardness of the film the lower the deformation necessary for the occurrence of cohesion. The films are as plastic as the base metal prevent cohesion, since in this case it is impossible for sections of metal to appear that are free of contaminants. The physical perculiarities of metals that determine their capability for coalescence under conditions of dry friction are the relative hardness and plasticity of the oxide films formed on their surface under atmospheric conditions.

A Novel Method for Pulsometry Based on Traditional Iranian Medicine

PubMed Central

Yousefipoor, Farzane; Nafisi, Vahidreza

2015-01-01

Arterial pulse measurement is one of the most important methods for evaluation of healthy conditions. In traditional Iranian medicine (TIM), physician may detect radial pulse by holding four fingers on the patient's wrist. By using this method, under standard condition, the detected pulses are subjective and erroneous, in case of weak and/or abnormal pulses, the ambiguity of diagnosis may rise. In this paper, we present an equipment which is designed and implemented for automation of traditional pulse detection method. By this novel system, the developed noninvasive diagnostic method and database based on the TIM are way forward to apply traditional medicine and diagnose patients with present technology. The accuracy for period measuring is 76% and systolic peak is 72%. PMID:26955566

Case Study for the ARRA-funded Ground Source Heat Pump (GSHP) Demonstration at Wilders Grove Solid Waste Service Center in Raleigh, NC

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

Liu, Xiaobing; Malhotra, Mini; Xiong, Zeyu

High initial costs and lack of public awareness of ground-source heat pump (GSHP) technology are the two major barriers preventing rapid deployment of this energy-saving technology in the United States. Under the American Recovery and Reinvestment Act (ARRA), 26 GSHP projects have been competitively selected and carried out to demonstrate the benefits of GSHP systems and innovative technologies for cost reduction and/or performance improvement. This paper highlights the findings of a case study of one of the ARRA-funded GSHP demonstration projects, a distributed GSHP system for providing all the space conditioning, outdoor air ventilation, and 100% domestic hot water tomore » the Wilders Grove Solid Waste Service Center of City of Raleigh, North Carolina. This case study is based on the analysis of measured performance data, construction costs, and simulations of the energy consumption of conventional central heating, ventilation, and air-conditioning (HVAC) systems providing the same level of space conditioning and outdoor air ventilation as the demonstrated GSHP system. The evaluated performance metrics include the energy efficiency of the heat pump equipment and the overall GSHP system, pumping performance, energy savings, carbon emission reductions, and cost-effectiveness of the GSHP system compared with conventional HVAC systems. This case study also identified opportunities for reducing uncertainties in the performance evaluation and improving the operational efficiency of the demonstrated GSHP system.« less

Clinical risk management approach for long-duration space missions.

PubMed

Gray, Gary W; Sargsyan, Ashot E; Davis, Jeffrey R

2010-12-01

In the process of crewmember evaluation and certification for long-duration orbital missions, the International Space Station (ISS) Multilateral Space Medicine Board (MSMB) encounters a surprisingly wide spectrum of clinical problems. Some of these conditions are identified within the ISS Medical Standards as requiring special consideration, or as falling outside the consensus Medical Standards promulgated for the ISS program. To assess the suitability for long-duration missions on ISS for individuals with medical problems that fall outside of standards or are otherwise of significant concern, the MSMB has developed a risk matrix approach to assess the risks to the individual, the mission, and the program. The goal of this risk assessment is to provide a more objective, evidence- and risk-based approach for aeromedical disposition. Using a 4 x 4 risk matrix, the probability of an event is plotted against the potential impact. Event probability is derived from a detailed review of clinical and aerospace literature, and based on the best available evidence. The event impact (consequences) is assessed and assigned within the matrix. The result has been a refinement of MSMB case assessment based on evidence-based data incorporated into a risk stratification process. This has encouraged an objective assessment of risk and, in some cases, has resulted in recertification of crewmembers with medical conditions which hitherto would likely have been disqualifying. This paper describes a risk matrix approach developed for MSMB disposition decisions. Such an approach promotes objective, evidence-based decision-making and is broadly applicable within the aerospace medicine community.

Global strength assessment in oblique waves of a large gas carrier ship, based on a non-linear iterative method

NASA Astrophysics Data System (ADS)

Domnisoru, L.; Modiga, A.; Gasparotti, C.

2016-08-01

At the ship's design, the first step of the hull structural assessment is based on the longitudinal strength analysis, with head wave equivalent loads by the ships' classification societies’ rules. This paper presents an enhancement of the longitudinal strength analysis, considering the general case of the oblique quasi-static equivalent waves, based on the own non-linear iterative procedure and in-house program. The numerical approach is developed for the mono-hull ships, without restrictions on 3D-hull offset lines non-linearities, and involves three interlinked iterative cycles on floating, pitch and roll trim equilibrium conditions. Besides the ship-wave equilibrium parameters, the ship's girder wave induced loads are obtained. As numerical study case we have considered a large LPG liquefied petroleum gas carrier. The numerical results of the large LPG are compared with the statistical design values from several ships' classification societies’ rules. This study makes possible to obtain the oblique wave conditions that are inducing the maximum loads into the large LPG ship's girder. The numerical results of this study are pointing out that the non-linear iterative approach is necessary for the computation of the extreme loads induced by the oblique waves, ensuring better accuracy of the large LPG ship's longitudinal strength assessment.

Cardiac sarcoidosis resembling panic disorder: a case report.

PubMed

Tokumitsu, Keita; Demachi, Jun; Yamanoi, Yukichi; Oyama, Shigeto; Takeuchi, Junko; Yachimori, Koji; Yasui-Furukori, Norio

2017-01-13

Sarcoidosis is a systemic disease of unknown etiology, in which granulomas develop in various organs, including the skin, lungs, eyes, or heart. It has been reported that patients with sarcoidosis are more likely to develop panic disorder than members of the general population. However, there are many unknown factors concerning the causal relationship between these conditions. We present the case of a 57-year-old woman who appeared to have panic disorder, as she experienced repeated panic attacks induced by transient complete atrioventricular block, associated with cardiac sarcoidosis. Psychotherapy and pharmacotherapy were not effective in the treatment of her panic attacks. However, when we implanted a permanent pacemaker and initiated steroid treatment for cardiac sarcoidosis, panic attacks were ameliorated. Based on these findings, we diagnosed the patient's symptoms as an anxiety disorder associated with cardiac sarcoidosis, rather than panic disorder. This report highlights the importance of considering cardiac sarcoidosis in the differential diagnosis of panic disorder. This cardiac disease should be considered especially in patients have a history of cardiac disease (e.g., arrhythmia) and atypical presentations of panic symptoms. Panic disorder is a psychiatric condition that is typically diagnosed after other medical conditions have been excluded. Because the diagnosis of sarcoidosis is difficult in some patients, caution is required. The palpitations and symptoms of heart failure associated with cardiac sarcoidosis can be misdiagnosed as psychiatric symptoms of panic disorder. The condition described in the current case study appears to constitute a physical disease, the diagnosis of which requires significant consideration and caution.

Long-term survival and conditional survival of cancer patients in Japan using population-based cancer registry data

PubMed Central

Ito, Yuri; Miyashiro, Isao; Ito, Hidemi; Hosono, Satoyo; Chihara, Dai; Nakata-Yamada, Kayo; Nakayama, Masashi; Matsuzaka, Masashi; Hattori, Masakazu; Sugiyama, Hiromi; Oze, Isao; Tanaka, Rina; Nomura, Etsuko; Nishino, Yoshikazu; Matsuda, Tomohiro; Ioka, Akiko; Tsukuma, Hideaki; Nakayama, Tomio

2014-01-01

Although we usually report 5-year cancer survival using population-based cancer registry data, nowadays many cancer patients survive longer and need to be followed-up for more than 5 years. Long-term cancer survival figures are scarce in Japan. Here we report 10-year cancer survival and conditional survival using an established statistical approach. We received data on 1 387 489 cancer cases from six prefectural population-based cancer registries in Japan, diagnosed between 1993 and 2009 and followed-up for at least 5 years. We estimated the 10-year relative survival of patients who were followed-up between 2002 and 2006 using period analysis. Using this 10-year survival, we also calculated the conditional 5-year survival for cancer survivors who lived for some years after diagnosis. We reported 10-year survival and conditional survival of 23 types of cancer for 15–99-year-old patients and four types of cancer for children (0–14 years old) and adolescent and young adults (15–29 years old) patients by sex. Variation in 10-year cancer survival by site was wide, from 5% for pancreatic cancer to 95% for female thyroid cancer. Approximately 70–80% of children and adolescent and young adult cancer patients survived for more than 10 years. Conditional 5-year survival for most cancer sites increased according to years, whereas those for liver cancer and multiple myeloma did not increase. We reported 10-year cancer survival and conditional survival using population-based cancer registries in Japan. It is important for patients and clinicians to report these relevant figures using population-based data. PMID:25183551

Environmental comfort as criteria for energy management: a case study

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

Rhee, E.K.

This study is a field experiment aimed at evaluating environmental comfort by investigating the impact of different environmental conditions on the perceptions, behaviors and performance of building occupants. The development of a prediction model for thermal comfort and the determination of actual energy savings achieved by altering environmental conditions are other major goals of this study. The research approach is a case study applying a pretest-posttest experimental design. An office building in Ann Arbor is selected for the study. It represents a typical office building in terms of design, occupancy, building systems and environmental conditions, suggesting that the study resultsmore » may be applicable to other office settings. It was found that building occupants were satisfied with the pretest environmental conditions which were within the range of current comfort standards, and with the posttest conditions which were lower than current standards. Changes in environmental conditions had little effect on the occupants' perceptions, behavior and performance, although the changes achieved considerable energy savings during the heating season. Among the other major findings, it was demonstrated that psychological factors were more decisive than objective environmental conditions in determining thermal comfort. The study concludes that an energy management program in an office building that is based on 69/sup 0/F indoor temperature, 30% relative humidity, 10-15 cfm/person ventilation rate, 50 fc lighting level, and 105 F domestic hot water can save energy while maintaining environmental comfort among occupants.« less

Image-Based 3d Reconstruction Data as AN Analysis and Documentation Tool for Architects: the Case of Plaka Bridge in Greece

NASA Astrophysics Data System (ADS)

Kouimtzoglou, T.; Stathopoulou, E. K.; Agrafiotis, P.; Georgopoulos, A.

2017-02-01

Μodern advances in the field of image-based 3D reconstruction of complex architectures are valuable tools that may offer the researchers great possibilities integrating the use of such procedures in their studies. In the same way that photogrammetry was a well-known useful tool among the cultural heritage community for years, the state of the art reconstruction techniques generate complete and easy to use 3D data, thus enabling engineers, architects and other cultural heritage experts to approach their case studies in an exhaustive and efficient way. The generated data can be a valuable and accurate basis upon which further plans and studies will be drafted. These and other aspects of the use of image-based 3D data for architectural studies are to be presented and analysed in this paper, based on the experience gained from a specific case study, the Plaka Bridge. This historic structure is of particular interest, as it was recently lost due to extreme weather conditions and serves as a strong proof that preventive actions are of utmost importance in order to preserve our common past.

NEV supply chain coordination and sustainability considering sales effort and risk aversion under the CVaR criterion

PubMed Central

Xu, Xingzhong

2018-01-01

In a two-echelon new energy vehicle (NEV) supply chain consisting of a risk-neutral manufacturer and a risk-averse retailer, the coordination and sustainability problem is investigated. The risk-averse retailer, who makes sales effort and undertakes the incurred effort cost, decides the order quantity and sales effort level under the Conditional Value-at-Risk (CVaR) criterion. We derive the optimal centralized decisions of a vertically integrated supply chain where the retailer is owned by the manufacturer. Taking such a centralized case as the benchmark, we prove that the subsidy-sharing-based wholesale price (SS-WP) contract fails to coordinate the NEV supply chain under the decentralized case where the retailer makes decisions independently. Then we design a subsidy-sharing-based sales rebate/penalty (SS-SRP) contract and derive the contract parameters to achieve coordination. We evaluate the coordination efficiency of this contract and find that a well-designed SS-SRP contract can promote the NEV sales and lead to a Pareto-improving win-win situation for both the NEV manufacturer and retailer compared to the non-coordination case. A series of numerical experiments are carried out to compare the effects of significant parameters under the SS-WP and SS-SRP contract and provide additional observations and implications, including an indication of the necessary conditions to sustainably maintain the NEV supply chain. PMID:29912926

Maintenance of polygenic sex determination in a fluctuating environment: an individual-based model.

PubMed

Bateman, A W; Anholt, B R

2017-05-01

R. A. Fisher predicted that individuals should invest equally in offspring of both sexes, and that the proportion of males and females produced (the primary sex ratio) should evolve towards 1:1 when unconstrained. For many species, sex determination is dependent on sex chromosomes, creating a strong tendency for balanced sex ratios, but in other cases, multiple autosomal genes interact to determine sex. In such cases, the maintenance of multiple sex-determining alleles at multiple loci and the consequent among-family variability in sex ratios presents a puzzle, as theory predicts that such systems should be unstable. Theory also predicts that environmental influences on sex can complicate outcomes of genetic sex determination, and that population structure may play a role. Tigriopus californicus, a copepod that lives in splash-pool metapopulations and exhibits polygenic and environment-dependent sex determination, presents a test case for relevant theory. We use this species as a model for parameterizing an individual-based simulation to investigate conditions that could maintain polygenic sex determination. We find that metapopulation structure can delay the degradation of polygenic sex determination and that periods of alternating frequency-dependent selection, imposed by seasonal fluctuations in environmental conditions, can maintain polygenic sex determination indefinitely. © 2017 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2017 European Society For Evolutionary Biology.

Real-time forecasting of an epidemic using a discrete time stochastic model: a case study of pandemic influenza (H1N1-2009).

PubMed

Nishiura, Hiroshi

2011-02-16

Real-time forecasting of epidemics, especially those based on a likelihood-based approach, is understudied. This study aimed to develop a simple method that can be used for the real-time epidemic forecasting. A discrete time stochastic model, accounting for demographic stochasticity and conditional measurement, was developed and applied as a case study to the weekly incidence of pandemic influenza (H1N1-2009) in Japan. By imposing a branching process approximation and by assuming the linear growth of cases within each reporting interval, the epidemic curve is predicted using only two parameters. The uncertainty bounds of the forecasts are computed using chains of conditional offspring distributions. The quality of the forecasts made before the epidemic peak appears largely to depend on obtaining valid parameter estimates. The forecasts of both weekly incidence and final epidemic size greatly improved at and after the epidemic peak with all the observed data points falling within the uncertainty bounds. Real-time forecasting using the discrete time stochastic model with its simple computation of the uncertainty bounds was successful. Because of the simplistic model structure, the proposed model has the potential to additionally account for various types of heterogeneity, time-dependent transmission dynamics and epidemiological details. The impact of such complexities on forecasting should be explored when the data become available as part of the disease surveillance.

Rhabdomyolysis After Performing Blood Flow Restriction Training: A Case Report.

PubMed

Tabata, Shogo; Suzuki, Yukio; Azuma, Koichiro; Matsumoto, Hideo

2016-07-01

Tabata, S, Suzuki, Y, Azuma, K, and Matsumoto, H. Rhabdomyolysis after performing blood flow restriction training: a case report. J Strength Cond Res 30(7): 2064-2068, 2016-Rhabdomyolysis is a serious and potentially life-threatening condition related to resistance training. Despite numerous reports of low-intensity blood flow restriction (BFR) training inducing muscle hypertrophy and increasing strength, few reports of rhabdomyolysis related to BFR training have been published. Here, we report a 30-year-old obese Japanese man admitted to our hospital the day after his first BFR training session with complaints of severe muscle pain in his upper and lower extremities, high fever, and pharyngeal pain. He was diagnosed with acute rhabdomyolysis based on a serum creatine phosphokinase level of 56,475 U·L and a urine myoglobin level of >3,000 ng·ml, and with acute tonsillitis based on a white blood cell count of 17,390 and C-reactive protein level of 10.43 mg·dl. A number of factors are suspected to be related to the onset and exacerbation of rhabdomyolysis, including excessive muscular training with BFR, bacterial infection, and medication. After 10 days of hospitalization with intravenous fluids and antibacterial drugs, he recovered without complications. This case indicates that BFR training should be conducted with careful consideration of the physical condition and strength of the individual to prevent serious complications, such as rhabdomyolysis.

Rupture Dynamics Simulation for Non-Planar fault by a Curved Grid Finite Difference Method

NASA Astrophysics Data System (ADS)

Zhang, Z.; Zhu, G.; Chen, X.

2011-12-01

We first implement the non-staggered finite difference method to solve the dynamic rupture problem, with split-node, for non-planar fault. Split-node method for dynamic simulation has been used widely, because of that it's more precise to represent the fault plane than other methods, for example, thick fault, stress glut and so on. The finite difference method is also a popular numeric method to solve kinematic and dynamic problem in seismology. However, previous works focus most of theirs eyes on the staggered-grid method, because of its simplicity and computational efficiency. However this method has its own disadvantage comparing to non-staggered finite difference method at some fact for example describing the boundary condition, especially the irregular boundary, or non-planar fault. Zhang and Chen (2006) proposed the MacCormack high order non-staggered finite difference method based on curved grids to precisely solve irregular boundary problem. Based upon on this non-staggered grid method, we make success of simulating the spontaneous rupture problem. The fault plane is a kind of boundary condition, which could be irregular of course. So it's convinced that we could simulate rupture process in the case of any kind of bending fault plane. We will prove this method is valid in the case of Cartesian coordinate first. In the case of bending fault, the curvilinear grids will be used.

Prediction of fracture healing under axial loading, shear loading and bending is possible using distortional and dilatational strains as determining mechanical stimuli.

PubMed

Steiner, Malte; Claes, Lutz; Ignatius, Anita; Niemeyer, Frank; Simon, Ulrich; Wehner, Tim

2013-09-06

Numerical models of secondary fracture healing are based on mechanoregulatory algorithms that use distortional strain alone or in combination with either dilatational strain or fluid velocity as determining stimuli for tissue differentiation and development. Comparison of these algorithms has previously suggested that healing processes under torsional rotational loading can only be properly simulated by considering fluid velocity and deviatoric strain as the regulatory stimuli. We hypothesize that sufficient calibration on uncertain input parameters will enhance our existing model, which uses distortional and dilatational strains as determining stimuli, to properly simulate fracture healing under various loading conditions including also torsional rotation. Therefore, we minimized the difference between numerically simulated and experimentally measured courses of interfragmentary movements of two axial compressive cases and two shear load cases (torsional and translational) by varying several input parameter values within their predefined bounds. The calibrated model was then qualitatively evaluated on the ability to predict physiological changes of spatial and temporal tissue distributions, based on respective in vivo data. Finally, we corroborated the model on five additional axial compressive and one asymmetrical bending load case. We conclude that our model, using distortional and dilatational strains as determining stimuli, is able to simulate fracture-healing processes not only under axial compression and torsional rotation but also under translational shear and asymmetrical bending loading conditions.

Beckwith-Wiedemann syndrome and Chiari I malformation--a case-based review of central nervous system involvement in hemihypertrophy syndromes.

PubMed

Udayakumaran, Suhas; Onyia, Chiazor U

2015-05-01

Beckwith-Wiedemann syndrome (BWS) is an unusual complex of abnormalities that includes mainly omphalocele, macroglossia, gigantism, visceromegaly, and neonatal hypoglycemia. Type I Chiari malformation, on the other hand, is defined as ectopia of the cerebellar tonsils below the plane of the foramen magnum. Only one case of association of BWS with Chiari I malformation has been previously reported in the literature. Several conditions involving congenital hemihypertrophy have been previously reported in association with Type I Chiari malformation. The pathophysiological mechanism for most of these associations is thought to be quite complex and still remains unclear. However, the presence of tonsillar herniation in BWS has been explained by Tubbs and Oakes in the only one existing case report of BWS with Type I Chiari malformation in the literature, to be due to associated hemihypertrophy of the skull base. We additionally suggest that cerebellar hypertrophy may also contribute to the tonsillar herniation and fourth ventricular outlet obstruction. We now report our recent experience on this association following a review of the literature on association of other hemihypertrophy syndromes with the central nervous system anomalies. We believe that a common pathogenesis of Type I Chiari malformation occurs in conditions of hemihypertrophy including BWS, probably secondary to dysmorphology involving the posterior cranial fossa, and is not just an associated finding.

Skull base osteomyelitis: current microbiology and management.

PubMed

Spielmann, P M; Yu, R; Neeff, M

2013-01-01

Skull base osteomyelitis typically presents in an immunocompromised patient with severe otalgia and otorrhoea. Pseudomonas aeruginosa is the commonest pathogenic micro-organism, and reports of resistance to fluoroquinolones are now emerging, complicating management. We reviewed our experience of this condition, and of the local pathogenic organisms. A retrospective review from 2004 to 2011 was performed. Patients were identified by their admission diagnostic code, and computerised records examined. Twenty patients were identified. A facial palsy was present in 12 patients (60 per cent). Blood cultures were uniformly negative, and culture of ear canal granulations was non-diagnostic in 71 per cent of cases. Pseudomonas aeruginosa was isolated in only 10 (50 per cent) cases; one strain was resistant to ciprofloxacin but all were sensitive to ceftazidime. Two cases of fungal skull base osteomyelitis were identified. The mortality rate was 15 per cent. The patients' treatment algorithm is presented. Our treatment algorithm reflects the need for multidisciplinary input, early microbial culture of specimens, appropriate imaging, and prolonged and systemic antimicrobial treatment. Resolution of infection must be confirmed by close follow up and imaging.

Occupational risk factors for brain cancer: a population-based case-control study in Iowa.

PubMed

Zheng, T; Cantor, K P; Zhang, Y; Keim, S; Lynch, C F

2001-04-01

A number of occupations and industries have been inconsistently associated with the risk of brain cancer. To further explore possible relationships, we conducted a population-based case-control study of brain glioma in the state of Iowa, involving 375 histologically confirmed incident cases and 2434 population-based controls. Among men, the industries and/or occupations that had a significantly increased risk for employment of more than 10 years included roofing, siding, and sheet metalworking; newspaper work; rubber and plastics products, particularly tires and inner tubes; miscellaneous manufacturing industries; wholesale trade of durable goods, grain, and field beans; cleaning and building service occupations; miscellaneous mechanics and repairers; and janitors and cleaners. Subjects who worked in plumbing, heating, and air conditioning; electrical services; gasoline service stations; and military occupations also experienced a significantly increased risk. Among women, significant excess risk was observed for occupations in agricultural services and farming, apparel and textile products, electrical and electronic equipment manufacturing, various retail sales, record-keeping, and restaurant service. Workers in industries with a potential for gasoline or motor exhaust exposures experienced a non-significant excess risk of brain glioma.

Mucormycosis outbreak associated with hospital linens.

PubMed

Duffy, Jonathan; Harris, Julie; Gade, Lalitha; Sehulster, Lynne; Newhouse, Emily; O'Connell, Heather; Noble-Wang, Judith; Rao, Carol; Balajee, S Arunmozhi; Chiller, Tom

2014-05-01

Mucormycosis is an invasive fungal infection with a high fatality rate. We investigated an outbreak of mucormycosis in a pediatric hospital to determine routes of pathogen transmission from the environment and prevent additional infections. A case was defined as a hospital-onset illness consistent with mucormycosis, confirmed by culture or histopathology. Case-patient medical records were reviewed for clinical course and exposure to items and locations within the hospital. Environmental samples were collected from air and surfaces. Fungal isolates collected from case-patients and the environmental samples were identified using DNA sequencing. Five case-patients had hospital-associated cutaneous mucormycosis over an 11-month period; all subsequently died. Three case-patients had conditions known to be associated with susceptibility to mucormycosis, while 2 had cardiac conditions with persistent acidosis. The cases occurred on several different wards throughout the hospital, and hospital linens were the only exposure identified as common to the case-patients. Rhizopus species were recovered from 26 (42%) of 62 environmental samples from clean linens and associated areas and from 1 (4%) of 25 samples from nonlinen-related items. Case-patients were infected with Rhizopus delemar, which was also isolated from cultures of clean linens and clean linen delivery bins from the off-site laundry facility. Hospital linens were identified as a vehicle that carried R. delemar into contact with susceptible patients. Fungal species identification using DNA-based methods is useful for corroborating epidemiologic links in hospital outbreak investigations. Hospital linens should be laundered, packaged, shipped and stored in a manner that minimizes exposure to environmental contaminants.

Building America Case Study: Evaluating Through-Wall Air Transfer Fans, Pittsburgh, Pennsylvania (Fact Sheet)

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

Not Available

2014-10-01

In this project, Building America team IBACOS performed field testing in a new construction unoccupied test house in Pittsburgh, Pennsylvania to evaluate heating, ventilating, and air conditioning (HVAC) distribution systems during heating, cooling, and midseason conditions. Four air-based HVAC distribution systems were assessed:-a typical airflow ducted system to the bedrooms, a low airflow ducted system to the bedrooms, a system with transfer fans to the bedrooms, and a system with no ductwork to the bedrooms. The relative ability of each system was considered with respect to relevant Air Conditioning Contractors of America and ASHRAE standards for house temperature uniformity andmore » stability, respectively.« less

Meaner king uses biased bases

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

Reimpell, Michael; Werner, Reinhard F.

2007-06-15

The mean king problem is a quantum mechanical retrodiction problem, in which Alice has to name the outcome of an ideal measurement made in one of several different orthonormal bases. Alice is allowed to prepare the state of the system and to do a final measurement, possibly including an entangled copy. However, Alice gains knowledge about which basis was measured only after she no longer has access to the quantum system or its copy. We give a necessary and sufficient condition on the bases, for Alice to have a strategy to solve this problem, without assuming that the bases aremore » mutually unbiased. The condition requires the existence of an overall joint probability distribution for random variables, whose marginal pair distributions are fixed as the transition probability matrices of the given bases. In particular, in the qubit case the problem is decided by Bell's original three variable inequality. In the standard setting of mutually unbiased bases, when they do exist, Alice can always succeed. However, for randomly chosen bases her success probability rapidly goes to zero with increasing dimension.« less

Meaner king uses biased bases

NASA Astrophysics Data System (ADS)

Reimpell, Michael; Werner, Reinhard F.

2007-06-01

The mean king problem is a quantum mechanical retrodiction problem, in which Alice has to name the outcome of an ideal measurement made in one of several different orthonormal bases. Alice is allowed to prepare the state of the system and to do a final measurement, possibly including an entangled copy. However, Alice gains knowledge about which basis was measured only after she no longer has access to the quantum system or its copy. We give a necessary and sufficient condition on the bases, for Alice to have a strategy to solve this problem, without assuming that the bases are mutually unbiased. The condition requires the existence of an overall joint probability distribution for random variables, whose marginal pair distributions are fixed as the transition probability matrices of the given bases. In particular, in the qubit case the problem is decided by Bell’s original three variable inequality. In the standard setting of mutually unbiased bases, when they do exist, Alice can always succeed. However, for randomly chosen bases her success probability rapidly goes to zero with increasing dimension.

Student-Initiated Use of Technology--Friend and Foe

ERIC Educational Resources Information Center

Wiklund, Matilda; Andersson, Annika

2018-01-01

A multitude of different technologies are used in school today. Some are provided by the school and others are brought by the individual teacher or student. In addition, different applications are available. In this study the focus is on student-initiated uses of technology and how it conditions learning. Based on a case study with surveys,…

Recovery from a Subarachnoid Hemorrhage: Days 1 through 22

ERIC Educational Resources Information Center

Brice, Alejandro E.; Brice, Roanne G.; Wallace, Sarah E.

2016-01-01

Subarachnoid hemorrhages (SAHs) are a serious medical emergency, as 30% to 50% of all SAHs can result in death. Personal accounts and case studies are an important aspect of evidence-based practice. This first article of two presents a review of AB's (patient) condition immediately following an SAH in the intensive care and immediately post…

THE SAN PEDRO RIVER: A CASE STUDY FOR EXAMINING PAST LANDSCAPE CHANGE AND FORECASTING HYDROLOGICAL AND BIOLOGICAL RESPONSE TO URBAN GROWTH AND LAND USE CHANGE

EPA Science Inventory

It is currently possible to measure landscape change over large areas and determine trends in

environmental condition using advanced space-based technologies accompanied by geospatial data.

During the past two decades, important advances in the integration of remote...

Uncertainty estimation of the self-thinning process by Maximum-Entropy Principle

Treesearch

Shoufan Fang; George Z. Gertner

2000-01-01

When available information is scarce, the Maximum-Entropy Principle can estimate the distributions of parameters. In our case study, we estimated the distributions of the parameters of the forest self-thinning process based on literature information, and we derived the conditional distribution functions and estimated the 95 percent confidence interval (CI) of the self-...

Exploring the Effect of Illumination on Automatic Expression Recognition using the ICT-3DRFE Database

DTIC Science & Technology

2011-11-04

environmen- tal lighting conditions that one can actually come across. L7 and L8 are also cases of low illumination intensity. To produce our experimental...Graphics (Proceedings of ACM SIGGRAPH), 26(3). [9] Riklin- Raviv T., Shashua A., (1999). The quotient image: class based recognition and synthesis under

Adaptive Training Considerations for Use in Simulation-Based Systems

DTIC Science & Technology

2010-09-01

their rulings were given and three cases were used for both the pretest and posttest . In the fully adaptive condition, the number of instances...Mercado Anthony J. Aakre KAEGAN Corporation NAVAL AIR WARFARE CENTER TRAINING SYSTEMS DIVISION 12350 Research Parkway Orlando, FL, 32826-3275...Engineering Director, Research & Technology Division Department Special Report 2010-001 2

Ring Expansion and Rearrangements of Rhodium(II) Azavinyl Carbenes

PubMed Central

Selander, Nicklas; Worrell, Brady T.

2013-01-01

An efficient, regioselective and convergent method for the ring expansion and rearrangement of 1-sulfonyl-1,2,3-triazoles under rhodium(II)-catalyzed conditions is described. These denitrogenative reactions form substituted enaminone and olefin-based products, which in the former case can be further functionalized to unique products rendering the sulfonyl triazole traceless. PMID:23161725

Aerothermal modeling program, phase 1

NASA Technical Reports Server (NTRS)

Srinivasan, R.; Reynolds, R.; Ball, I.; Berry, R.; Johnson, K.; Mongia, H.

1983-01-01

Aerothermal submodels used in analytical combustor models are analyzed. The models described include turbulence and scalar transport, gaseous full combustion, spray evaporation/combustion, soot formation and oxidation, and radiation. The computational scheme is discussed in relation to boundary conditions and convergence criteria. Also presented is the data base for benchmark quality test cases and an analysis of simple flows.