Sample records for case studies section

  1. Fostering Entrepreneurship through Business Incubation: The Role and Prospects of Postsecondary Vocational-Technical Education. Report 2: Case Studies.

    ERIC Educational Resources Information Center

    Hernandez-Gantes, Victor M.; And Others

    This report presents nine case studies featuring efforts to foster community development through business incubation and entrepreneurial programs at two-year colleges. A background section discusses case description, and organization and format of case studies. The second section describes the case study design. Each case study is introduced with…

  2. Emotion, Engagement, and Case Studies

    ERIC Educational Resources Information Center

    Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

    2014-01-01

    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

  3. The Library Web: Case Studies in Web Site Creation and Implementation.

    ERIC Educational Resources Information Center

    Still, Julie M., Ed.

    This book presents 19 case studies in library web site creation and implementation. The book begins with an introduction--"Introduction: Step into My Parlor" (Julie M. Still)--and is divided into three sections. The first section, Academic Library Web Sites, contains six case studies: "U-SEARCH: The University of Saskatchewan…

  4. Frozen Section Evaluation of Margin Status in Primary Squamous Cell Carcinomas of the Head and Neck: A Correlation Study of Frozen Section and Final Diagnoses.

    PubMed

    Layfield, Eleanor M; Schmidt, Robert L; Esebua, Magda; Layfield, Lester J

    2018-06-01

    Frozen section is routinely used for intraoperative margin evaluation in carcinomas of the head and neck. We studied a series of frozen sections performed for margin status of head and neck tumors to determine diagnostic accuracy. All frozen sections for margin control of squamous carcinomas of the head and neck were studied from a 66 month period. Frozen and permanent section diagnoses were classified as negative or malignant. Correlation of diagnoses was performed to determine accuracy. One thousand seven hundred and ninety-six pairs of frozen section and corresponding permanent section diagnoses were obtained. Discordances were found in 55 (3.1%) pairs. In 35 pairs (1.9%), frozen section was reported as benign, but permanent sections disclosed carcinoma. In 21 cases, the discrepancy was due to sampling and in the remaining cases it was an interpretive error. In 20 cases (1.1%), frozen section was malignant, but the permanent section was interpreted as negative. Frozen section is an accurate method for evaluation of operative margins for head and neck carcinomas with concordance between frozen and permanent results of 97%. Most errors are false negative results with the majority of these being due to sampling issues.

  5. Central nervous system lesions: correlation of intraoperative and final diagnoses, six year experience at a referral centre in a developing country, Pakistan.

    PubMed

    Ud Din, Nasir; Memon, Aisha; Idress, Romana; Ahmad, Zubair; Hasan, Sheema

    2011-01-01

    Intraoperative consultation of CNS lesions provides accurate diagnosis to neurosurgeons. Some lesions, however, may cause diagnostic difficulty. In this study accuracy of intraoperative consultations of CNS lesions and discrepancies in diagnosis and deferrals were analysed. All CNS cases from May 1, 2004 to September 20, 2010 in which intraoperative frozen section had been performed, and which were reported in the Section of Histopathology, Aga Khan University Hospital, Karachi Pakistan were retrieved. The diagnoses given on FS were compared with the final diagnosis given on permanent sections (and additional material if received), as indicated in the frozen section and final pathology report. During the study period, 171 CNS cases were received for intraoperative consultation. In all cases, cryostat sections (FS) plus cytology smears were prepared. The ages of the patients ranged from 03 to 77 years. 106 were males and 65 were females. Out of these 171 cases, 160 cases (94.1 %) were concordant, 10 cases (5.8 %) were discrepant, and one case was deferred until permanent sections. The diagnostic accuracy of frozen section was 88.9%. The sensitivity and specificity were 94.8% and 87.5% respectively. The positive predictive value was 98.6% and negative predictive value was 63.6%. All our cases in which intraoperative consultation was requested were sent for primary diagnosis. Adequacy per se was not a criterion for sending cases for intraoperative consultation. Our results show a reasonably high percentage of accuracy in the intraoperative diagnosis of CNS lesions. However, there are limitations and some lesions pose a diagnostic challenge. There is a need to improve our own diagnostic skills and establish better communication with neurosurgeons.

  6. Research and Teaching: Eight Is Not Enough--The Level of Questioning and Its Impact on Learning in Clicker Cases

    ERIC Educational Resources Information Center

    Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric; Herreid, Clyde Freeman

    2016-01-01

    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

  7. Urinary tract injuries during cesarean section in patients with morbid placental adherence: retrospective cohort study.

    PubMed

    Alanwar, Ahmed; Al-Sayed, Helmy M; Ibrahim, Ahmed M; Elkotb, Ahmed M; Abdelshafy, Ahmed; Abdelhadi, Rasha; Abbas, Ahmed M; Abdelmenam, Hend S; Fares, Tamer; Nossair, Wael; Abdallah, Ameer A; Sabaa, Haitham; Nawara, Maii

    2017-12-03

    The purpose of this study is to evaluate the cases of lower urinary tract injuries during cesarean section with or without hysterectomy in cases with morbid placental adherence. This record based retrospective study was conducted at Ain Shams University Maternity Hospital in Cairo, Egypt during the period between January 2014 and December 2016. It included all patients who had urinary tract injuries during cesarean section with or without hysterectomy in the cases with morbid placental adherence and they were collected from files of pregnant women who were admitted at hospital planned for termination of pregnancy. Patients were enrolled in four groups, Group 1: cases without urinary tract injuries. Group 2: cases with injuries to the bladder. Group 3: cases with injuries of the ureter. Group 4: cases with injuries to the bladder and ureter. This study gave us new information about the incidence of urinary tract injuries during cesarean section with morbid adherence placenta was 21.7% (Bladder 11.7%, Ureter 4.7%, and bladder with ureter 5.3%). There were various types of repair of urinary tract injury, as the following, bladder repair 10.8%, ureteric catheterization 0.9%, ureterovesical repair or reimplantation 1.5%, bladder repair and ureterovesical 1.2%, bladder repair and ureteric catheterization 2.3%, ureteric catheterization and ureterovesical 1.5 and 6.4% of cases needed urologic consultations. There is a real relation between urinary tract injury and obesity (55.3%). Bladder invasion was found in only 26.9% of all cases according to sonography findings. Most of the cases were delivered by cesarean section in 67.5%, and the remainders were delivered by cesarean hysterectomy 32.5%. About 96.5% of cases needed a blood transfusion. The morbid adherent placenta is still a challenge, which faces us as obstetricians, due to high morbidity and mortality. A multidisciplinary team is mandatory to avoid complications.

  8. Building a Greenway: Using EnviroAtlas in the Classroom. CASE STUDY

    EPA Science Inventory

    In this hypothetical case study, funding to complete a pilot section of a greenway has been granted to a city Parks and Recreation Department. The proposed pilot section is being presented to the city council for review and approval. The proposal was drafted by the Parks and Recr...

  9. Accuracy of frozen section in the diagnosis of ovarian tumours.

    PubMed

    Toneva, F; Wright, H; Razvi, K

    2012-07-01

    The purpose of our retrospective study was to assess the accuracy of intraoperative frozen section diagnosis compared to final paraffin diagnosis in ovarian tumours at a gynaecological oncology centre in the UK. We analysed 66 cases and observed that frozen section consultation agreed with final paraffin diagnosis in 59 cases, which provided an accuracy of 89.4%. The overall sensitivity and specificity for all tumours were 85.4% and 100%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 100% and 89.4%, respectively. Of the seven cases with discordant results, the majority were large, mucinous tumours, which is in line with previous studies. Our study demonstrated that despite its limitations, intraoperative frozen section has a high accuracy and sensitivity for assessing ovarian tumours; however, care needs to be taken with large, mucinous tumours.

  10. Scenario-Based Case Study Method and the Functionality of the Section Called "From Production to Consumption" from the Perspective of Primary School Students

    ERIC Educational Resources Information Center

    Taneri, Ahu

    2018-01-01

    In this research, the aim was showing the evaluation of students on scenario-based case study method and showing the functionality of the studied section called "from production to consumption". Qualitative research method and content analysis were used to reveal participants' experiences and reveal meaningful relations regarding…

  11. Advanced Containment System

    DOEpatents

    Kostelnik, Kevin M.; Kawamura, Hideki; Richardson, John G.; Noda, Masaru

    2005-02-08

    An advanced containment system for containing buried waste and associated leachate. The advanced containment system comprises a plurality of casing sections with each casing section interlocked to an adjacent casing section. Each casing section includes a complementary interlocking structure that interlocks with the complementary interlocking structure on an adjacent casing section. A barrier filler substantially fills the casing sections and may substantially fill the spaces of the complementary interlocking structure to form a substantially impermeable barrier. Some of the casing sections may include sensors so that the casing sections and the zone of interest may be remotely monitored after the casing sections are emplaced in the ground.

  12. Survival bias and drug interaction can attenuate cross-sectional case-control comparisons of genes with health outcomes. An example of the kinesin-like protein 6 (KIF6) Trp719Arg polymorphism and coronary heart disease.

    PubMed

    Williams, Paul; Pendyala, Lakshmana; Superko, Robert

    2011-03-24

    Case-control studies typically exclude fatal endpoints from the case set, which we hypothesize will substantially underestimate risk if survival is genotype-dependent. The loss of fatal cases is particularly nontrivial for studies of coronary heart disease (CHD) because of significantly reduced survival (34% one-year fatality following a coronary attack). A case in point is the KIF6 Trp719Arg polymorphism (rs20455). Whereas six prospective studies have shown that carriers of the KIF6 Trp719Arg risk allele have 20% to 50% greater CHD risk than non-carriers, several cross-sectional case-control studies failed to show that carrier status is related to CHD. Computer simulations were therefore employed to assess the impact of the loss of fatal events on gene associations in cross-sectional case-control studies, using KIF6 Trp719Arg as an example. Ten replicates of 1,000,000 observations each were generated reflecting Canadian demographics. Cardiovascular disease (CVD) risks were assigned by the Framingham equation and events distributed among KIF6 Trp719Arg genotypes according to published prospective studies. Logistic regression analysis was used to estimate odds ratios between KIF6 genotypes. Results were examined for 33%, 41.5%, and 50% fatality rates for incident CVD.In the absence of any difference in percent fatalities between genotypes, the odds ratios (carriers vs. noncarriers) were unaffected by survival bias, otherwise the odds ratios were increasingly attenuated as the disparity between fatality rates increased between genotypes. Additional simulations demonstrated that statin usage, shown in four clinical trials to substantially reduce the excess CHD risk in the KIF6 719Arg variant, should also attenuate the KIF6 719Arg odds ratio in case-control studies. These computer simulations show that exclusions of prior CHD fatalities attenuate odds ratios of case-control studies in proportion to the difference in the percent fatalities between genotypes. Disproportionate CHD survival for KIF6 Trip719Arg carriers is suggested by their 50% greater risk for recurrent myocardial infarction. This, and the attenuation of KIF6 719Arg carrier risk with statin use, may explain the genotype's weak association with CHD in cross-sectional case-control studies. The results may be relevant to the underestimation of risk in cross-sectional case-control studies of other genetic CHD-risk factors affecting survival.

  13. 22 CFR 96.47 - Preparation of home studies in incoming cases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Preparation of home studies in incoming cases... Cases) § 96.47 Preparation of home studies in incoming cases. (a) The agency or person ensures that a home study on the prospective adoptive parent(s) (which for purposes of this section includes the...

  14. 22 CFR 96.47 - Preparation of home studies in incoming cases.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Preparation of home studies in incoming cases... Cases) § 96.47 Preparation of home studies in incoming cases. (a) The agency or person ensures that a home study on the prospective adoptive parent(s) (which for purposes of this section includes the...

  15. 22 CFR 96.47 - Preparation of home studies in incoming cases.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Preparation of home studies in incoming cases... Cases) § 96.47 Preparation of home studies in incoming cases. (a) The agency or person ensures that a home study on the prospective adoptive parent(s) (which for purposes of this section includes the...

  16. 22 CFR 96.47 - Preparation of home studies in incoming cases.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Preparation of home studies in incoming cases... Cases) § 96.47 Preparation of home studies in incoming cases. (a) The agency or person ensures that a home study on the prospective adoptive parent(s) (which for purposes of this section includes the...

  17. 22 CFR 96.47 - Preparation of home studies in incoming cases.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Preparation of home studies in incoming cases... Cases) § 96.47 Preparation of home studies in incoming cases. (a) The agency or person ensures that a home study on the prospective adoptive parent(s) (which for purposes of this section includes the...

  18. Maternal and neonatal copeptin levels at cesarean section and vaginal delivery.

    PubMed

    Foda, Ashraf A; Abdel Aal, Ibrahim A

    2012-12-01

    The objective of the study was to measure the copeptin levels in maternal serum and umbilical cord serum at cesarean section and vaginal delivery in normotensive pregnancy and pre-eclamptic women. This was a prospective study at Mansoura University Hospital, Egypt. Ninety cases were included. They were divided into six groups: (1) normal pregnancy near term, as a control group, (2) primiparas who had vaginal delivery, (3) primiparas who had vaginal delivery and mild preeclampsia, (4) elective repeat cesarean section, (5) intrapartum cesarean section for indications other than fetal distress, and (6) intrapartum cesarean section for fetal distress. Serum copeptin concentrations were quantified with an enzyme-linked immunosorbent assay (ELISA). Mean, standard deviation, and paired t-test were used to test for significant change in quantitative data. The vaginal delivery groups had higher levels of maternal serum copeptin than the elective cesarean section group (P<0.01). Higher maternal serum copeptin levels were found in cases with pre-eclampsia as compared with the normotensive cases. The maternal copeptin levels during intrapartum cesarean section were higher than that during elective repeat cesarean section. There was a significant correlation between maternal copeptin levels and the duration of the first stage. In the presence of fetal distress, umbilical cord serum copeptin levels were significantly higher than other groups. Vaginal delivery can be very painful and stressful, and is accompanied by a marked increase of maternal serum copeptin. Increased maternal levels of serum copeptin were found in cases with pre-eclampsia as compared with the normotensive cases, and it may be helpful in assessing the disease. Intrauterine fetal distress is a strong stimulus to the release of copeptin into the fetal circulation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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

    PubMed Central

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

    2017-01-01

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

  20. Full hoop casing for midframe of industrial gas turbine engine

    DOEpatents

    Myers, Gerald A.; Charron, Richard C.

    2015-12-01

    A can annular industrial gas turbine engine, including: a single-piece rotor shaft spanning a compressor section (82), a combustion section (84), a turbine section (86); and a combustion section casing (10) having a section (28) configured as a full hoop. When the combustion section casing is detached from the engine and moved to a maintenance position to allow access to an interior of the engine, a positioning jig (98) is used to support the compressor section casing (83) and turbine section casing (87).

  1. Vertical vs. transverse sections of scalp biopsy specimens: a pilot study on the comparison of the diagnostic value of two techniques in alopecia.

    PubMed

    Özcan, D; Özen, Ö; Seçkin, D

    2011-12-01

    Using both vertical and transverse sections is preferred for histopathological diagnosis of alopecia. However, in cases in which only a single biopsy is taken, it is not clear which type of sectioning is better. To compare the diagnostic value of transverse and vertical sections. In total, 53 patients with alopecia were enrolled in the study. Two biopsies were taken from each patient, and cut into either transverse or vertical sections. The clinical and histopathological findings were evaluated together for the definitive diagnosis. After the study period, a pathologist randomly re-evaluated the sections. We compared the histopathological diagnoses with the definitive diagnoses, and determined the sensitivity and specificity of each method. A definitive diagnosis was made for 47 patients (88.7%). Of these, 30 (63.8%) had noncicatricial and 17 (36.2%) had cicatricial alopecia, and the diagnosis was made by transverse and vertical sections for 43 (91.5%) and 39 (88%), respectively (P > 0.05; sensitivity; 91.5% vs. 82%). All 30 patients with noncicatricial alopecia were diagnosed by transverse sections, and 25 (83.3%) of the 30 were diagnosed with vertical sections (P = 0.05; sensitivity 100% vs. 83.3%). Of the 17 patients with cicatricial alopecia, 13 (76.5%) and 14 (82.4%) patients were diagnosed by transverse and vertical sections, respectively (P > 0.05; sensitivity 76.5% vs. 82.4%). Five patients with lichen planopilaris were diagnosed by vertical sections, and one by transverse sections. There were several limitations to the study: (i) statistical subtype analysis could be performed only for alopecia areata; (ii) no conclusion could be drawn about the interobserver reliability of two sections; and (iii) having the pathologist-blinded study performed retrospectively might have caused a recall bias. If only a single biopsy specimen is available, it may be preferable to have transverse sections in cases of suspected noncicatricial alopecia, and vertical sections in cases of suspected lichen planopilaris. Either type of sectioning is suitable for cicatricial alopecia when lichen planopilaris is clinically unlikely. © The Author(s). CED © 2011 British Association of Dermatologists.

  2. A study of X-ray multiple diffraction by means of section topography.

    PubMed

    Kohn, V G; Smirnova, I A

    2015-09-01

    The results of theoretical and experimental study are presented for the question of how the X-ray multiple diffraction in a silicon single crystal influences the interference fringes of section topography for the 400 reflection in the Laue case. Two different cases of multiple diffraction are discovered for zero and very small values of the azimuthal angle for the sample in the form of a plate with the surface normal to the 001 direction. The cases are seen on the same topogram without rotation of the crystal. Accurate computer simulations of the section topogram for the case of X-ray multiple diffraction are performed for the first time. It is shown that the structure of interference fringes on the section topogram in the region of multiple diffraction becomes more complicated. It has a very sharp dependence on the azimuthal angle. The experiment is carried out using a laboratory source under conditions of low resolution over the azimuthal angle. Nevertheless, the characteristic inclination of the interference fringes on the tails of the multiple diffraction region is easily seen. This phenomenon corresponds completely to the computer simulations.

  3. Modalities of Generalization Through Single Case Studies.

    PubMed

    Zittoun, Tania

    2017-06-01

    The value of case studies for theory building is still doubted in psychology. The paper argues for the importance of case studies and the possibility of generalizing from these for a specific sociocultural understanding of human development. The paper first clarifies the notion of abduction within case studies, drawing on pragmatists James and Peirce and expanding it with the work of Lewin, and argues that it is the core mechanism that allows generalization from case studies. The second section presents the possibility of generalizing from individual single case studies, for which not only the subjective perspective, but also the dynamics by which the social and cultural environment guide and enable the person's development, have to be accounted for. The third section elaborates the question of institutional case studies, where the challenge is to account both for institutional dynamics, and for persons' trajectories within; this is exemplified with an ongoing study on the process of obtaining citizenship in Switzerland. The paper briefly concludes by highlighting two possible implications of the paper, one concerning the process of theoretical reasoning, the other, the fact that sociocultural psychology could itself be seen as an institution in-the-making.

  4. Leadership Analysis in K-12 Case Study: Superintendent's Hiring Dilemma

    ERIC Educational Resources Information Center

    Alsobaie, Mohammed Fahad

    2016-01-01

    This paper will seek to analyze of the case "Superintendent's Hiring Dilemma" by Hoy and Tarter (2004) using multiple leadership perspectives. The last section of this analysis of the case study will provide the most effective leadership recommendations for the key players.

  5. Investigation of DBMS for Use in a Research Environment. Rand Paper Series 7002.

    ERIC Educational Resources Information Center

    Rosenfeld, Pilar N.

    This investigation of the use of database management systems (DBMS) in a research environment used the Rand Corporation as a case study. After a general introduction in section 1, eight sections present the major components of the study. Section 2 contains an overview of DBMS terminology and concepts, followed in section 3 by a general dsecription…

  6. Preparation and Support for Part-Time Teachers in Higher Education: Case Studies of Departmental Practice.

    ERIC Educational Resources Information Center

    Forster, Fred, Comp.; Thompson, Sheila, Comp.

    This publication presents 14 departmental case studies of the preparation and support provided to part-time teachers in Scottish institutions of higher education. The case studies are grouped in four sections according to the category of part-time staff involved: practicing professionals (professional teaching assistants, lawyers, artists, and…

  7. Frozen section analysis and sentinel lymph node biopsy in well differentiated thyroid cancer

    PubMed Central

    2013-01-01

    Background The aim of this study is to prospectively review the role of sentinel lymph node (SLN) biopsy in the management of well differentiated thyroid carcinoma (WDTC), and to determine the efficacy of intraoperative frozen section analysis at detecting SLN metastasis and central compartment involvement. Methods The SLN biopsy protocol using 1% methylene blue was performed in 300 patients undergoing thyroidectomy for WDTC. A limited pretracheal central compartment neck dissection (CCND) was performed on all patients. Lymph nodes staining blue were considered as SLN’s. Both frozen and permanent section analyses were performed. Results SLN’s with metastasis were found in 14.3% (43/300) of cases. Of this, 11% (33/300) were positive on intraoperative frozen section analysis. Frozen section results failed in predicting central compartment involvement in 15 cases (5%) whereas central neck compartment involvement was missed in 5 cases (1.7%) when based on permanent section results. On frozen section analysis, the sensitivity, specificity, positive predictive value and negative predictive value (95% CI) of our SLN biopsy technique aiming to remove all disease from the central compartment was 68.8% (53.6-80.9), 100% (98.1-100), 100% (87.0-100) and 94.4% (90.7-96.7) respectively with P < 0.0001. On permanent section analysis, the values were 89.6% (76.6-96.1), 100% (98.1-100), 100% (89.8-100), and 98.1% (95.3-99.3) with P < 0.0001. Conclusion This data series demonstrates that patients with WDTC have positive SLN’s in 14.3% of cases. Moreover, when the SLN’s are negative for metastasis on frozen section, the central compartment was disease-free in 94.4% of cases. Finally, this study shows that 23.3% of positive SLN’s were false negatives on intraoperative frozen section. According to this data, SLN involvement is an accurate predictor of central compartment metastasis, however surgeons should use caution when relying on intraoperative frozen section to determine whether to perform a CCND. PMID:24025621

  8. Fibrinogen Demonstration in Oral Lichen Planus: An Immunofluorescence Study on Archival Tissues.

    PubMed

    Shirol, Pallavi D; Naik, Veena; Kale, Alka

    2015-10-01

    Lichen planus is a premalignant condition with minimal diagnostic aids. This study is an attempt to use paraffin embedded sections of lichen planus with immunofluorescein stain and to evaluate the immunofluorescent sections to establish pattern of fibrinogen deposition. Thirty-five paraffin embedded sections of old and new cases of oral lichen planus (study group) and five normal oral mucosa (control group) were chosen. Two sections of each (H & E) case were taken, one was stained with hematoxylin and eosin and another with fluorescein isothiocynate conjugate (FITC) polyclonal rabbit antibody against fibrinogen. Fluorescent findings were examined with a fluorescent microscope. A high statistical significant correlation was found in respect to fluorescence positivity, intensity of fluorescence and distribution of fluorescence each with p < 0.0001 and fluorescence at blood vessel walls (p = 0.0003). This study suggested that paraffin embedded sections can be successfully used in direct immunofluorescence staining in routine set up where only formalin fixed tissues are received. Paraffin embedded sections can be successfully used in direct immunofluorescence staining when only formalin fixed tissues are received.

  9. How Plain English Works for Business: Twelve Case Studies.

    ERIC Educational Resources Information Center

    Office of Consumer Affairs, Washington, DC.

    Detailing the false starts, uncertainty, and internal questioning that occur as companies organize and manage language simplification projects, the 12 case studies contained in the two sections of this book reveal how some business organizations have benefited by simplifying consumer documents. Descriptions of each case contain information on the…

  10. 44 CFR 66.3 - Establishment of community case file and flood elevation study docket.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... case file and flood elevation study docket. 66.3 Section 66.3 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program CONSULTATION WITH LOCAL OFFICIALS § 66.3 Establishment of community case...

  11. 44 CFR 66.3 - Establishment of community case file and flood elevation study docket.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... case file and flood elevation study docket. 66.3 Section 66.3 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program CONSULTATION WITH LOCAL OFFICIALS § 66.3 Establishment of community case...

  12. 44 CFR 66.3 - Establishment of community case file and flood elevation study docket.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... case file and flood elevation study docket. 66.3 Section 66.3 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program CONSULTATION WITH LOCAL OFFICIALS § 66.3 Establishment of community case...

  13. Predictors of obstetric intervention rates: case-mix, staffing levels and organisational factors of hospital of birth.

    PubMed

    Joyce, Rachel; Webb, R; Peacock, Janet

    2002-11-01

    We performed a cross-sectional study of all Thames maternity units, 1994-96, including 540,834 live and stillbirths. In contrast to recent media speculation, no association of caesarean section rates with midwifery staffing levels was found after adjustment for confounders. The only association with staffing was with levels of junior obstetric staffing, which could be a reflection of less experienced management of labour. Caesarean section rates were also associated positively with the levels of delivery beds, which could be a reflection of the closer monitoring of labour that may result from increased bed availability. Both caesarean section and instrumental vaginal delivery rates were associated with epidural rates, which was expected from the literature. Variations in epidural rates were mainly associated with variations in demographic case-mix, due possibly to patient demand. Demographic case-mix was also associated with instrumental vaginal deliveries but not the caesarean section rate.

  14. Persistent measles virus infection of the intestine: confirmation by immunogold electron microscopy.

    PubMed Central

    Lewin, J; Dhillon, A P; Sim, R; Mazure, G; Pounder, R E; Wakefield, A J

    1995-01-01

    This study sought to investigate persistent measles virus infection of the intestine: a novel protocol for immunogold electron microscopy was developed using a polyclonal anti-measles nucleoprotein antibody on reprocessed, formalin fixed paraffin wax embedded tissue sections. Antibody binding was detected using both immunoperoxidase and light microscopy on tissue sections, and 10 nm gold conjugated secondary antibody and electron microscopy on ultrathin sections. The techniques were validated using both measles infected vero cells and human tissues with established measles infection: these included brain affected by subacute sclerosing panencephalitis and acute measles appendicitis. The technique was applied subsequently to six untreated cases of granulomatous Crohn's disease, and two cases of ileocaecal tuberculosis, a granulomatous control. Mumps primary antibody--applied to both mumps infected vero cells, and measles infected vero cells and tissues studied by immunoperoxidase, and measles antibody on mumps infected cells studied by immunoperoxidase and immunogold--were used as specificity controls: the primary antibodies identified their respective target antigen and there was no antibody cross reactivity. Measles virus nucleocapsids labelled with gold conjugated antibody in both infected cells and tissues, including foci of granulomatous inflammation in five of six cases of Crohn's disease: in the fifth case, the granuloma could not be identified in ultrathin section. In one of the tuberculosis cases, a low level of signal was noted while the second case was negative. Labelling adopted a characteristic pattern in all infected tissues, strengthening the specificity of these findings. This study provides the first direct confirmation of persistent measles virus infection of the intestine. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:7737565

  15. Evaluating oversight of human drugs and medical devices: a case study of the FDA and implications for nanobiotechnology.

    PubMed

    Paradise, Jordan; Tisdale, Alison W; Hall, Ralph F; Kokkoli, Efrosini

    2009-01-01

    This article evaluates the oversight of drugs and medical devices by the U.S. Food and Drug Administration (FDA) using an integration of public policy, law, and bioethics approaches and employing multiple assessment criteria, including economic, social, safety, and technological. Criteria assessment and expert elicitation are combined with existing literature, case law, and regulations in an integrative historical case studies approach. We then use our findings as a tool to explore possibilities for effective oversight and regulatory mechanisms for nanobiotechnology. Section I describes oversight mechanisms for human drugs and medical devices and presents current nanotechnology products. Section II describes the results of expert elicitation research. Section III highlights key criteria and relates them to the literature and larger debate. We conclude with broad lessons for the oversight of nanobiotechnology informed by Sections I-III in order to provide useful analysis from multiple disciplines and perspectives to guide discussions regarding appropriate FDA oversight.

  16. Using Case Study Multi-Methods to Investigate Close(r) Collaboration: Course-Based Tutoring and the Directive/Nondirective Instructional Continuum

    ERIC Educational Resources Information Center

    Corbett, Steven J.

    2011-01-01

    This essay presents case studies of "course-based tutoring" (CBT) and one-to-one tutorials in two sections of developmental first-year composition (FYC) at a large West Coast research university. The author's study uses a combination of rhetorical and discourse analyses and ethnographic and case study multi-methods to investigate both…

  17. Cellient™ automated cell block versus traditional cell block preparation: a comparison of morphologic features and immunohistochemical staining.

    PubMed

    Wagner, David G; Russell, Donna K; Benson, Jenna M; Schneider, Ashley E; Hoda, Rana S; Bonfiglio, Thomas A

    2011-10-01

    Traditional cell block (TCB) sections serve as an important diagnostic adjunct to cytologic smears but are also used today as a reliable preparation for immunohistochemical (IHC) studies. There are many ways to prepare a cell block and the methods continue to be revised. In this study, we compare the TCB with the Cellient™ automated cell block system. Thirty-five cell blocks were obtained from 16 benign and 19 malignant nongynecologic cytology specimens at a large university teaching hospital and prepared according to TCB and Cellient protocols. Cell block sections from both methods were compared for possible differences in various morphologic features and immunohistochemical staining patterns. In the 16 benign cases, no significant morphologic differences were found between the TCB and Cellient cell block sections. For the 19 malignant cases, some noticeable differences in the nuclear chromatin and cellularity were identified, although statistical significance was not attained. Immunohistochemical or special stains were performed on 89% of the malignant cases (17/19). Inadequate cellularity precluded full evaluation in 23% of Cellient cell block IHC preparations (4/17). Of the malignant cases with adequate cellularity (13/17), the immunohistochemical staining patterns from the different methods were identical in 53% of cases. The traditional and Cellient cell block sections showed similar morphologic and immunohistochemical staining patterns. The only significant difference between the two methods concerned the lower overall cell block cellularity identified during immunohistochemical staining in the Cellient cell block sections. Copyright © 2010 Wiley-Liss, Inc.

  18. Ovarian Fibroma: A Clinico-pathological Study of 23 Cases with Review of Literature.

    PubMed

    Parwate, Nikhil Sadanand; Patel, Shilpa M; Arora, Ruchi; Gupta, Monisha

    2016-12-01

    The purpose of this study was to correlate the clinical findings, RMI-4 index and frozen section, in cases of ovarian fibroma with the final histopathology. This is a retrospective study of clinical and pathological features of 23 patients of ovarian fibroma. The patient's age ranged from 34 to 66 years (mean-49 years). The most common presenting symptom was abdominal pain. On clinical examination, the mean size of ovarian tumor was 9.5 cm, CA-125 levels were found to be raised in 14 patients, and it was associated with ascites in 10 patients. USG showed a well-circumscribed mass (with a mean size of 14 cm), on the left side in 14 cases and on the right side in 9 patients. RMI-4 was calculated in all the patients, and it revealed the possibility of a benign histology in 17 patients. All patients underwent exploratory laparotomy with the removal of ovarian tumor followed by frozen section examination. All but one (22/23) patient had positive correlation among frozen section and final histopathological findings. Ovarian fibroma generally tends to occur in post-menopausal women. All the patients in our study of ovarian fibroma were symptomatic, with the presence of palpable mass in majority of patients. RMI-4 Index correlated very well with benign nature of disease. Frozen section has an invaluable role at surgery; fertility-conserving surgery is the choice in young women. Clinical findings, RMI-4 Index and frozen section, play vital roles before and during surgery in cases of benign ovarian tumors.

  19. The Impact on Vocational Training of Studies. Analysing and Forecasting Trends in Occupations. Case Studies in Germany, the Netherlands and Denmark. CEDEFOP Document.

    ERIC Educational Resources Information Center

    European Centre for the Development of Vocational Training, Thessaloniki (Greece).

    This report describes a study to verify the impact on vocational training policies of research and development work carried out in the field of anticipation of educational and training needs, labor market forecasts, and skills analysis. Section I provides background. Section II presents the framework of the study. Section III includes the full…

  20. When Does FDAMA Section 114 Apply? Ten Case Studies.

    PubMed

    Neumann, Peter J; Saret, Cayla J

    2015-07-01

    Section 114 of the Food and Drug Administration Modernization Act of 1997 regulates the promotion of health economic information by pharmaceutical companies to US health plans. Greater clarity is important given demands by payers and other stakeholders for evidence of value. To develop hypothetical case studies of health economic promotions to examine legal and policy implications. We constructed for pedagogical purposes 10 categories of potential health economic promotions. We generated hypothetical case studies for each category, including questions about whether each might be allowable under Section 114. The case studies were developed around the following categories: 1) costing out on-label clinical end points; 2) promotion of a costing exercise to physicians working in an accountable care organization setting; 3) burden-of-illness claims; 4) economic analysis of a formulary restriction policy; 5) extrapolations to doses, populations, or settings not covered in trials; 6) adherence claims; 7) "utilization of care" as a secondary end point in randomized clinical trials; 8) costing out a competitor drug's adverse event; 9) economic analysis of comparative effectiveness claims using an indirect treatment comparison; and 10) extrapolating from surrogate to long-term outcomes in an economic model. Most cases seem to fall into a gray zone given haziness around what constitutes "competent and reliable evidence" and "directly relate[d]" to an approved indication. In practice, it is difficult to know what the section allows given the imprecision of the statute and lack of guidance about its scope. Ideally, future guidance will provide clarity and flexibility. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  1. Frequency of placenta previa in previously scarred and non scarred uterus.

    PubMed

    Majeed, Tayyaba; Waheed, Fatima; Mahmood, Zahid; Saba, Kanwal; Mahmood, Hamis; Bukhari, Mulazim Hussain

    2015-01-01

    To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus. A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections (37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus) in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008- December 2011. Most patients (47.36%) were between 26-30 years age group, presented with gestational age between 36-40 weeks (70.17%), were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% (37 cases), and frequency in previously scarred uterus was 67.54% (77 cases). Major degree Previa was found in 88 cases (77.19%). There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa (10.67%) from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections. A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus.

  2. Frequency of placenta previa in previously scarred and non scarred uterus

    PubMed Central

    Majeed, Tayyaba; Waheed, Fatima; Mahmood, Zahid; Saba, Kanwal; Mahmood, Hamis; Bukhari, Mulazim Hussain

    2015-01-01

    Objective: To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus. Methods: A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections (37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus) in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008– December 2011. Results: Most patients (47.36%) were between 26-30 years age group, presented with gestational age between 36-40 weeks (70.17%), were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% (37 cases), and frequency in previously scarred uterus was 67.54% (77 cases). Major degree Previa was found in 88 cases (77.19%). There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa (10.67%) from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections. Conclusion: A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus. PMID:26101491

  3. Childhood Adversities Increase the Risk of Psychosis: A Meta-analysis of Patient-Control, Prospective- and Cross-sectional Cohort Studies

    PubMed Central

    Varese, Filippo; Smeets, Feikje; Drukker, Marjan; Lieverse, Ritsaert; Lataster, Tineke; Viechtbauer, Wolfgang; Read, John; van Os, Jim; Bentall, Richard P.

    2012-01-01

    Evidence suggests that adverse experiences in childhood are associated with psychosis. To examine the association between childhood adversity and trauma (sexual abuse, physical abuse, emotional/psychological abuse, neglect, parental death, and bullying) and psychosis outcome, MEDLINE, EMBASE, PsychINFO, and Web of Science were searched from January 1980 through November 2011. We included prospective cohort studies, large-scale cross-sectional studies investigating the association between childhood adversity and psychotic symptoms or illness, case-control studies comparing the prevalence of adverse events between psychotic patients and controls using dichotomous or continuous measures, and case-control studies comparing the prevalence of psychotic symptoms between exposed and nonexposed subjects using dichotomous or continuous measures of adversity and psychosis. The analysis included 18 case-control studies (n = 2048 psychotic patients and 1856 nonpsychiatric controls), 10 prospective and quasi-prospective studies (n = 41 803) and 8 population-based cross-sectional studies (n = 35 546). There were significant associations between adversity and psychosis across all research designs, with an overall effect of OR = 2.78 (95% CI = 2.34–3.31). The integration of the case-control studies indicated that patients with psychosis were 2.72 times more likely to have been exposed to childhood adversity than controls (95% CI = 1.90–3.88). The association between childhood adversity and psychosis was also significant in population-based cross-sectional studies (OR = 2.99 [95% CI = 2.12–4.20]) as well as in prospective and quasi-prospective studies (OR = 2.75 [95% CI = 2.17–3.47]). The estimated population attributable risk was 33% (16%–47%). These findings indicate that childhood adversity is strongly associated with increased risk for psychosis. PMID:22461484

  4. Learning Statistics at the Farmers Market? A Comparison of Academic Service Learning and Case Studies in an Introductory Statistics Course

    ERIC Educational Resources Information Center

    Hiedemann, Bridget; Jones, Stacey M.

    2010-01-01

    We compare the effectiveness of academic service learning to that of case studies in an undergraduate introductory business statistics course. Students in six sections of the course were assigned either an academic service learning project (ASL) or business case studies (CS). We examine two learning outcomes: students' performance on the final…

  5. 29 CFR 102.94 - Expeditious processing of section 10(j) cases.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Expeditious processing of section 10(j) cases. 102.94..., SERIES 8 Procedure in Cases Under Section 10(j), (l), and (m) of the Act § 102.94 Expeditious processing of section 10(j) cases. (a) Whenever temporary relief or a restraining order pursuant to section 10(j...

  6. Crescent Evaluation : appendix B : state case study evaluation report

    DOT National Transportation Integrated Search

    1994-02-01

    The state case study evaluation approach uniquely captured an understanding of the potential of such a system by documenting the experiences, issues, and opportunities of selected key state government personnel from a cross-section of involved agenci...

  7. [Clinical evaluation of propess for induction of term pregnancy].

    PubMed

    Gai, Ming-ying; Zhang, Jian-ping; Li, Yang; Han, Hong-jing; Yang, Jian-qiu; Wang, Shan-mi; Su, Qi-feng; Wu, Lian-fang

    2003-04-01

    To explore the efficacy and safety of continuously released prostaglandin E(2) (PGE(2)) suppository-propess used for induction of term pregnancy. A multicenter, prospective, case control clinical study was carried out, propess was used in 100 cases as study group, the suppository without PGE(2) was used in 49 cases as control group. The cervical maturity (by Bishop scoring), the time to labor starting, membrane rupture and delivery, the application of oxytocin, ceserean section rate, fetal and neonatal condition were compared between 2 groups after inserting of the suppository. At the same time, side effects caused by propess were investigated. Bishop score was increased >or= 2 points in 93% cases, >or= 3 points in 87% cases in study group, whereas only 4% cases whose Bishop score increased >or= 2 points in control group. The time to labor starting, membrane rupture, and delivery was shortened obviously in study group than that in control group after inserting suppository. The application of oxytocin was much less in study group, cesarean section rate was reduced in study group (32% vs 61%). There was no significant difference between 2 groups in fetal and neonatal conditions. The overstimulation of uterine contraction and mild gastrointestinal tract reaction occurred in 3 cases and 2 cases respectively in study groups. Propess can be used for induction of term pregnancy effectively and safely.

  8. Injury pattern among non-fatal road traffic accident cases: a cross-sectional study in Central India.

    PubMed

    Ganveer, Gunjan B; Tiwari, Rajnarayan R

    2005-01-01

    What is the pattern of injuries among non-fatal cases of road traffic accidents? To study the pattern of injuries among non-fatal cases of road traffic accidents. Cross-sectional study. Nagpur, a city in central India. 423 non-fatal cases of road traffic accidents reporting for treatment to Indira Gandhi Medical College, Nagpur during 1999-2000. Demographic characteristics, accident characteristics. Percentages, proportions, Chi-square test. Out of total 423 subjects, 363 (85.8%) were male while only 60 (14.2%) were female subjects. Majority of the victims (75%) were in the age group 18- 37 years. Sideways collision was the most common type of accident seen in 269 (63.59%) cases. Two wheelers and LMV were the common vehicle being involved in accidents (69.97%) and these accidents were almost equally distributed in both half of the day. Fracture of the bones was the common injury afflicted to the victims followed by multiple injuries like blunt injury, abrasions and lacerations. Lower extremity was involved in 192 (45.39%) cases while multiple sites were affected in 114 (26.95%) cases. In the present study, the fractures were the commonest injury among the victims of non-fatal road traffic accidents.

  9. Numerical Investigation of Flapwise-Torsional Vibration Model of a Smart Section Blade with Microtab

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

    Li, Nailu; Balas, Mark J.; Yang, Hua

    2015-01-01

    This study presents a method to develop an aeroelastic model of a smart section blade equipped with microtab. The model is suitable for potential passive vibration control study of the blade section in classic flutter. Equations of the model are described by the nondimensional flapwise and torsional vibration modes coupled with the aerodynamic model based on the Theodorsen theory and aerodynamic effects of the microtab based on the wind tunnel experimental data. The aeroelastic model is validated using numerical data available in the literature and then utilized to analyze the microtab control capability on flutter instability case and divergence instabilitymore » case. The effectiveness of the microtab is investigated with the scenarios of different output controllers and actuation deployments for both instability cases. The numerical results show that the microtab can effectively suppress both vibration modes with the appropriate choice of the output feedback controller.« less

  10. Special Feature: Epistemological Paradigms in Evaluation: Implications for Practice. Section 1: "Paradigm Contrast" Case Studies.

    ERIC Educational Resources Information Center

    Rose, Tom; And Others

    1991-01-01

    This section presents two pragmatic studies focusing on a real-life situation and specific applications in managerial decision making. One study deals with improving occupational safety in a bedding manufacturing plant, whereas the other concentrates on managing a state mental health program. (SLD)

  11. Does temproray bilateral balloon occlusion of the common iliac arteries reduce the need for intra-operative blood transfusion in cases of placenta accretism?

    PubMed

    Al-Hadethi, Sinan; Fernando, Shane; Hughes, Simon; Thakorlal, Ajay; Seruga, Adam; Scurry, Bonnie

    2017-06-01

    Bilateral balloon occlusion has been employed as a prophylactic measure in cases of placenta accretism prior to caesarean section with the aim of reducing blood loss and its associated morbidity/mortality. There is however no clear consensus on its efficacy in the current literature. The objective of this study was to assess the efficacy of bilateral balloon occlusion of the common iliac arteries (CIA) in reducing intra-operative morbidity in cases of placenta accretism. The databases of the pathology department and radiology interventional suite were reviewed over a nine year period. Fifty-two cases of confirmed placental accretism who underwent caesarean section with or without hysterectomy were identified and divided into two groups. Twenty-five cases had temporary occlusion of the common iliac arteries (CIA) during delivery and these were considered the study group. The reminder 27 cases did not have temporary occlusion of the CIA and were considered the control group. The two groups were compared based on gravidity, age group, post-operative haemoglobin, drop in haemoglobin, estimated blood loss (EBL), transfusion requirement and the histopathological sub-types of placenta accretism. There was no statistically difference between the study and the control groups regarding EBL, post-operative haemoglobin drop, transfusion requirement or in the placenta accretism histopathological subtype. Two cases in the study group had acute thromboembolic complications. Both groups had a single patient requiring a massive intra-operative transfusion. Our study was not able to detect a significant difference in blood loss or blood product requirement between patients who underwent CIA balloon in the setting of caesarean section for placenta accreta. This remains a challenging scenario requiring a multidisciplinary approach. © 2016 The Royal Australian and New Zealand College of Radiologists.

  12. Access Management Awareness Program. Phase II Report

    DOT National Transportation Integrated Search

    1997-01-01

    This report presents the results of a number of detailed Iowa access management case studies. Case studies were selected to provide a cross-section of locations and community sizes in Iowa as well as a variety of project types. Projects were analyzed...

  13. Case-control studies in diabetes. Do they really use a case-control design?

    PubMed

    Ramos, Analía; Mendoza, Lilian Cristina; Rabasa, Fernanda; Bolíbar, Ignasi; Puig, Teresa; Corcoy, Rosa

    2017-07-01

    Studies defined as case-control do not always use this design. We aimed to estimate the frequency of mislabelled case-control studies in published articles in the area of diabetes and to identify the predictors of incorrect labelling. We searched Medline and Web of Science for articles with "diabetes" and "case control" in title and filtered for language (English/Romance) and period (January 2010-December 2014). Inclusion criteria were: (1) statement to use a case-control design in title, (2) to be a final full-length publication and (3) to have original data in the area of diabetes. Three independent reviewers went through titles, looked for full texts and reviewed them. Discrepancies were settled with a fourth reviewer. Expert epidemiologist advice was requested in case of doubt. case-control mislabelling; addressed predictors: publication year, journal impact factor and journal subject. proportion of mislabelled CC articles and assessment of predictors by multivariate logistic regression analysis. We retrieved 362 articles, 251 of them fulfilling inclusion criteria. The proportion of mislabelled CC studies was 43.8% (confidence interval 95% 37.7-50.0%). Most mislabelled studies had a cross-sectional design (82.7%). Predictors of mislabelling were publication year, journal impact factor and journal area. A relevant subset of studies defined as case-control in the area of diabetes correspond to mislabelled cross-sectional studies. Incorrect labelling misleads readers regarding the interpretation of results and the cause-effect hypothesis. Researchers, reviewers and editors should be aware of and commit to settle this issue.

  14. Pathologic diagnosis of central centrifugal cicatricial alopecia on horizontal sections.

    PubMed

    Miteva, Mariya; Tosti, Antonella

    2014-11-01

    The pathologic findings in Central Centrifugal Cicatricial Alopecia (CCCA) have not been studied systematically in horizontal sections. Our objective was to establish the pathologic features, and their frequency in horizontal sections of scalp biopsies obtained from patients with clinically and histologically proven CCCA. Serial horizontal sections of 51 cases were evaluated retrospectively. All biopsies were assessed at 4 levels and at least on 24 horizontal sections. The most common pathologic findings were follicular miniaturization (81% of the cases); premature desquamation of the inner root sheath (96%), focal preservation of the sebaceous glands (94%), which in most of these cases appeared as surrounding "in a hug" an intact vellus follicle; compound follicular structures with perifollicular fibrosis and/or inflammation (89%), lamellar hyperkeratosis/parakeratosis in the hair canal (79%), absent or mild inflammation (77%), and naked hair shafts (68%). Horizontal sections are useful in CCCA to identify early or focal disease and to provide the clinician with better information on the presence of follicular miniaturization, inflammation, and scarring, which can be used to tailor the treatment to the individual patient.

  15. A Comparison of Vertical and Transverse Sections in the Histological Diagnosis of Alopecia Areata Scalp Biopsy Specimens

    PubMed Central

    Singh, Kanika; Sharma, Sonal; Singh, Usha Rani; Bhattacharya, Sambit Nath

    2016-01-01

    Context: Both vertical and transverse sections are used for the diagnosis of alopecia areata. However when a single biopsy is submitted the pathologist has to decide which type is better. Aims: To compare the diagnostic histological features in vertical and transverse sections in alopecia areata scalp biopsy specimens. Settings and Design: Tertiary Care Hospital. Comparative Study. Materials and Methods: A total of 30 patients were enrolled in the study. Two four mm punch biopsy were taken. One was used to take vertical sections and the other for transverse section and histological features of alopecia areata noted in both. Statistical Analysis Used: Chi-square test, percentage. Results: Diagnosis of alopecia areata could be made in 30 (100%) cases in transverse sections and 28 cases (93.3%) in vertical sections. The number of hair follicles available for evaluation was more in the transverse section. Nanogen follicles and miniaturization of follicles were better visualized in the transverse sections. However the catagen and telogen follicles were noted in both vertical and transverse sections but the number and the ratio of anagen and telogen hair follicles could be better assessed in the transverse sections. Presence of peribulbar lymphocytic infiltrate, eosinophils and pigment casts were noted in both transverse and vertical sections. Conclusions: Transverse sections provide a better assessment of the histological features of alopecia areata than vertical sections and thus should be preferred. PMID:27625562

  16. A Comparison of Vertical and Transverse Sections in the Histological Diagnosis of Alopecia Areata Scalp Biopsy Specimens.

    PubMed

    Singh, Kanika; Sharma, Sonal; Singh, Usha Rani; Bhattacharya, Sambit Nath

    2016-01-01

    Both vertical and transverse sections are used for the diagnosis of alopecia areata. However when a single biopsy is submitted the pathologist has to decide which type is better. To compare the diagnostic histological features in vertical and transverse sections in alopecia areata scalp biopsy specimens. Tertiary Care Hospital. Comparative Study. A total of 30 patients were enrolled in the study. Two four mm punch biopsy were taken. One was used to take vertical sections and the other for transverse section and histological features of alopecia areata noted in both. Chi-square test, percentage. Diagnosis of alopecia areata could be made in 30 (100%) cases in transverse sections and 28 cases (93.3%) in vertical sections. The number of hair follicles available for evaluation was more in the transverse section. Nanogen follicles and miniaturization of follicles were better visualized in the transverse sections. However the catagen and telogen follicles were noted in both vertical and transverse sections but the number and the ratio of anagen and telogen hair follicles could be better assessed in the transverse sections. Presence of peribulbar lymphocytic infiltrate, eosinophils and pigment casts were noted in both transverse and vertical sections. Transverse sections provide a better assessment of the histological features of alopecia areata than vertical sections and thus should be preferred.

  17. Liberalisation, gender, and the land question in sub-Saharan Africa.

    PubMed

    Izumi, K

    1999-11-01

    This article focuses on land reform initiatives undertaken in sub-Saharan African countries since the late 1980s. Section 1 sheds light on the changes in land tenure during the economic liberalization of the region. Section 2 briefly examines the gender-blind "mainstream" theoretical debates on land, and gender-sensitive studies on land issues. Section 3 offers insights on land issues in Africa from a gender perspective. Sections 4 and 5 reviewed the cases of Tanzania and Zimbabwe who have undergone a radical transition in terms of institutional land reforms since the 1980s, and the impact of economic and political liberalization on women's access and rights to land. Drawing on the two case studies, this paper is a call for policy makers, researchers, and activists to refocus their attention to these neglected issues.

  18. Vaginal breech delivery: results of a prospective registration study

    PubMed Central

    2013-01-01

    Background Most countries recommend planned cesarean section in breech deliveries, which is considered safer than vaginal delivery. As one of few countries in the western world Norway has continued to practice planned vaginal delivery in selected women. The aim of this study is to evaluate prospectively registered neonatal and maternal outcomes in term singleton breech deliveries in a Norwegian hospital during a ten years period. We aim to compare maternal and neonatal outcomes in term breech pregnancies subjected either to planned vaginal or elective cesarean section. Methods A prospective registration study including 568 women with term breech deliveries (>37 weeks) consecutively registered at Sorlandet Hospital Kristiansand between 2001 and 2011. Fetal and maternal outcomes were compared according to delivery method; planned vaginal delivery versus planned cesarean section. Results Of 568 women, elective cesarean section was planned in 279 (49%) cases and vaginal delivery was planned in 289 (51%) cases. Acute cesarean section was performed in 104 of the planned vaginal deliveries (36.3%). There were no neonatal deaths. Two cases of serious neonatal morbidity were reported in the planned vaginal group. One infant had seizures, brachial plexus injury, and cephalhematoma. The other infant had 5-minutes Apgar < 4. Twenty-nine in the planned vaginal group (10.0%) and eight in the planned cesarean section group (2.9%) (p < 0.001) were transferred to the neonatal intensive care unit. However, only one infant was admitted for ≥4 days. According to follow-up data (median six years) none of these infants had long-term sequelae. Regarding maternal morbidity, blood loss was the only variable that was significantly higher in the planned cesarean section group versus in the vaginal delivery group (p < 0.001). Conclusions Strict guidelines were followed in all cases. There were no neonatal deaths. Two infants had serious neonatal morbidity in the planned vaginal group without long-term sequelae. PMID:23883361

  19. [Macrosomia, shoulder dystocia and elongation of the brachial plexus: what is the role of caesarean section?

    PubMed

    Kehila, Mehdi; Derouich, Sadok; Touhami, Omar; Belghith, Sirine; Abouda, Hassine Saber; Cheour, Mariem; Chanoufi, Mohamed Badis

    2016-01-01

    The delivery of a macrosomic infant is associated with a higher risk for maternofoetal complications. Shoulder dystocia is the most feared fetal complication, leading sometimes to a disproportionate use of caesarean section. This study aims to evaluate the interest of preventive caesarean section. We conducted a retrospective study of 400 macrosomic births between February 2010 and December 2012. We also identified cases of infants with shoulder dystocia occurred in 2012 as well as their respective birthweight. Macrosomic infants weighed between 4000g and 4500g in 86.25% of cases and between 4500 and 5000 in 12.25% of cases. Vaginal delivery was performed in 68% of cases. Out of 400 macrosomic births, 9 cases with shoulder dystocia were recorded (2.25%). All of these cases occurred during vaginal delivery. The risk for shoulder dystocia invaginal delivery has increased significantly with the increase in birth weight (p <10-4). The risk for elongation of the brachial plexus was 11 per thousand vaginal deliveries of macrosomic infants. This risk was not correlated with birthweight (p = 0.38). The risk for post-traumatic sequelae was 0.71%. Shoulder dystocia affectd macrosoic infants in 58% of cases. Shoulder dystocia is not a complication exclusively associated with macrosomia. Screening for risky deliveries and increasing training of obstetricians on maneuvers in shoulder dystocia seem to be the best way to avoid complications.

  20. Simulations & Case Studies. [SITE 2002 Section].

    ERIC Educational Resources Information Center

    Seymour, Cathy R., Ed.

    This document contains the following papers on simulations and case studies from the SITE (Society for Information Technology & Teacher Education) 2002 conference: "3-D Virtual Classroom Technology" (Kimberly Arseneau Miller, Angela Glod); "Simulated Lesson Design Studios" (Willis Copeland); "Lights, Camera, Integration: Presentation Programs and…

  1. Working Together with Children and Families: Case Studies in Early Intervention.

    ERIC Educational Resources Information Center

    McWilliam, P. J., Ed.; Bailey, Donald B., Jr., Ed.

    This book presents 21 case studies of young children with disabilities in a variety of family situations and settings, for early interventionists to study in planning and applying recommended practices. Section I, "Defining and Delivering Quality Services in Early Intervention," provides two introductory chapters: "The Search for Quality…

  2. Descriptive studies: what they can and cannot do.

    PubMed

    Grimes, David A; Schulz, Kenneth F

    2002-01-12

    Descriptive studies often represent the first scientific toe in the water in new areas of inquiry. A fundamental element of descriptive reporting is a clear, specific, and measurable definition of the disease or condition in question. Like newspapers, good descriptive reporting answers the five basic W questions: who, what, why, when, where. and a sixth: so what? Case reports, case-series reports, cross-sectional studies, and surveillance studies deal with individuals, whereas ecological correlational studies examine populations. The case report is the least-publishable unit in medical literature. Case-series reports aggregate individual cases in one publication. Clustering of unusual cases in a short period often heralds a new epidemic, as happened with AIDS. Cross-sectional (prevalence) studies describe the health of populations. Surveillance can be thought of as watchfulness over a community; feedback to those who need to know is an integral component of surveillance. Ecological correlational studies look for associations between exposures and outcomes in populations-eg, per capita cigarette sales and rates of coronary artery disease-rather than in individuals. Three important uses of descriptive studies include trend analysis, health-care planning, and hypothesis generation. A frequent error in reports of descriptive studies is overstepping the data: studies without a comparison group allow no inferences to be drawn about associations, causal or otherwise. Hypotheses about causation from descriptive studies are often tested in rigorous analytical studies.

  3. [Pregnancy and delivery in patients with a personal history of cesarean section in Dakar: epidemiological, clinical, therapeutic and prognostic aspects].

    PubMed

    Koulimaya-Gombet, Cyr Espérance; Diouf, Abdoul Aziz; Diallo, Moussa; Dia, Anna; Sène, Codou; Moreau, Jean Charles; Diouf, Alassane

    2017-01-01

    The aim of our study was to determine hospitalization rate for vaginal birth after cesarean section in Pikine, to evaluate the quality of the management of pregnant women with previous cesarean section and to determine prognostic factors of the outcome of a trial of scar. We conducted a retrospective study based on medical records and operational protocols of patients who underwent vaginal birth after cesarean section over the period 1 January 2010 - 31 December 2011. We analyzed socio-demographic data, pregnancy follow-up, therapeutic modalities and prognosis. Data were collected and analyzed using Microsoft Office Excel 2007 software and SPSS software 17.0. The frequency of vaginal births after cesarean section was 9.6%. The average age of our patients was 29.4 years. Primiparous women accounted for 54%. Short spacing interval between births was found in 52.6% of cases. Based on the number of cesarean sections, the breakdown was as follows: patients with a history of one previous cesarean section (79.8%), patients with a history of two previous caesarean sections (17.9%) and patients with a history of three previous caesarean sections (2.3%). The number of antenatal consultations performed was greater than or equal to 3 in 79.8% of cases. Patients undergoing evacuation accounted for 54.2% and they were already in labor at the time of admission in 81.7% of cases. Trial of scar was authorized in 177 patients (34.3%) and, at the end of this test, 147 patients (83%) had vaginal birth, of whom 21.7% by vacuum extraction. Cesarean section was performed in 71.4% of cases with 245 emergency cesarean sections and 93 scheduled cesarean sections. A history of vaginal birth was a determining factor in normal delivery (p = 0.0001). There was also a significant relationship between mode of admission and decision to perform a cesarean section (p = 0.0001). Maternal mortality was 0.4%. Perinatal mortality rate was 28.2‰ of live births. We are witnessing a dramatic increase of deliveries after cesarean section in our SONUC Health Centre. The quality of management should be enhanced through a better strategy in preparation for delivery. Trial of scar is a procedure to encourage in order to reduce the rate of iterative cesarean sections.

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

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

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

    1983-06-01

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

  5. POLLUTION PREVENTION CAST STUDIES COMPENDIUM - 2ND EDITION

    EPA Science Inventory

    This compendium summarizes a compilation of case studies in the area of pollution prevention. he compendium is divided into 3 sections, featuring 3 of the Pollution Prevention Branch's key programs. An overview of each program is provided at the beginning of each section of the c...

  6. Improvements in Cesarean Section Techniques: Arad's Obstetrics Department Experience on Adapting the Vejnovic Cesarean Section Technique

    PubMed Central

    FURAU, Cristian; FURAU, Gheorghe; DASCAU, Voicu; CIOBANU, Gheorghe; ONEL, Cristina; STANESCU, Casiana

    2013-01-01

    ABSTRACT Objectives: Cesarean section has become recently the first choice for delivery in many clinics in Romania and worldwide. The purpose of our study is to assess the benefits of introducing the adapted Vejnovic uterine suture technique into daily practice. Material and Methods: A total of 1703 out of the 1776 cesarean section performed in the period January, 2012 - March, 2013 in the Obstetric Department of the Emergency Clinical County Hospital of Arad were retrospectively analyzed based on the cesarean section registries, birth registries and patient's personal medical records. We compared results between the group of patients undergoing adapted Vejnovic cesarean section technique and the group of patients operated in a classic manner. Outcomes: The cesarean section rate in the studied period was 56.48%. Adapted Vejnovic cesarean section technique was performed in 548 cases (30.86% of the cases), furthermore in the last 3 months studied it reached 57.27%. Mean APGAR score was better in the adapted Vejnovic cesarean section group (8.43) compared with the reference group (8.34). No significant differences were seen between the two groups regarding maternal age, gestation, weeks of gestation, newborn weight, anesthesia and indications for cesarean section. Exteriorizing the uterus helped the incidental diagnosis of 35 uterine myoma, 22 adnexal masses and 13 uterine malformations. Conclusion: In a society with a constant growth of cesarean rate, the adapted Vejnovic cesarean section technique is becoming popular amongst clinicians for its advantages, but further studies need to be developed for its standardization. PMID:24371494

  7. Effects of a Case-Based Reasoning System on Student Performance in a Java Programming Course

    ERIC Educational Resources Information Center

    Schmidt, Cecil

    2007-01-01

    The purpose of this study was to determine if a case-based reasoning tool would improve a student's understanding of the complex concepts in a Java programming course. Subjects for the study were randomly assigned from two sections of an introductory Java programming course. Posttests were used to measure the effects of the case-based reasoning…

  8. The efficacy of pre-delivery prophylactic trans-catheter arterial balloon occlusion of bilateral internal iliac artery in patients with suspected placental adhesion.

    PubMed

    Cho, Yoon Jin; Oh, Yong Taek; Kim, Suk Young; Kim, Ju Young; Jung, Sun Young; Chon, Seung Joo; Kim, Jeong Ho; Byun, Sung Su

    2017-01-01

    Prophylactic trans-catheter arterial balloon occlusion (PTABO) before cesarean section of placenta previa totalis has been introduced to prevent massive hemorrhage. The purpose of this study is to evaluate the clinical usefulness of PTABO in cases of suspected placental adhesion and to examine antepartal risk factors and perinatal outcomes in women with placental adhesion. Between January 2012 and December 2015, 77 patients who had undergone ultrasonography for evaluation of placenta previa were enrolled in this study. Seventeen of these patients with suspected placental adhesion by ultrasonography and Pelvic MRI underwent PTABO before cesarean section and another 59 patients underwent cesarean section without PTABO. Antepartal risk factors and peripartum maternal and neonatal outcomes were compared between patients with PTABO and those without PTABO. More advanced maternal age, longer in gestational weeks at delivery, and more common previous cesarean section history were observed in the PTABO group. Placenta adhesion, abnormal Doppler findings, and frequency of transfusion were more common in the PTABO group. However there was no significant difference in estimated blood loss, hospital days, and neonatal outcome. It had occurred 3 cases of hysterectomy and 1 case of uterine artery embolization after cesarean section in the PTABO group. Close surveillance of antepartum risk factors for placental adhesion using ultrasonography and pelvic magnetic resonance imaging is important to prevention of massive hemorrhage during cesarean section. PTABO before cesarean section might result in reduced blood loss and requirement for transfusion during the operation.

  9. Association of circulating total bilirubin with the metabolic syndrome and type 2 diabetes: A systematic review and meta-analysis of observational evidence.

    PubMed

    Nano, J; Muka, T; Cepeda, M; Voortman, T; Dhana, K; Brahimaj, A; Dehghan, A; Franco, O H

    2016-12-01

    Emerging evidence suggests that bilirubin levels might be associated with the metabolic syndrome (MetS) and type 2 diabetes (T2D), although the nature of the association remains unclear. This systematic review and meta-analysis investigated the relationship between total plasma bilirubin and the risk of MetS and T2D. Relevant studies were identified using five databases (Embase, Medline [Ovid], Web of Science, PubMed, Cochrane Central and Google Scholar), with the last search done on 21 October 2015. Study references were checked and authors contacted to identify additional studies. Randomized controlled trials, and cohort, case-control and cross-sectional studies of adults examining the association between blood bilirubin levels and MetS and T2D were included, irrespective of language and date of publication. Abstract and full-text selection was done by two independent reviewers, with a third reviewer available in case of disagreement. Data were extracted by two independent reviewers using a predesigned data collection form. MetS and T2D. Summary estimates were obtained by random-effects meta-analysis. Of the 2313 searched references, 16 observational studies (11 cross-sectional, two prospective, one that was both cross-sectional and prospective, two retrospective and one national survey) met our inclusion criteria. Overall, data were available for 175,911 non-overlapping participants, including 7414 MetS cases and 9406 T2D cases. In the meta-analysis of seven cross-sectional studies, the pooled odds ratio (95% confidence interval) for MetS in a comparison of extreme tertiles of serum bilirubin levels was 0.70 (95% CI: 0.62, 0.78), whereas no significant association was found for the pooled estimated relative risk between two prospective studies (0.57, 95% CI: 0.11, 2.94). The corresponding estimate was 0.77 (95% CI: 0.67, 0.87) for T2D from four cross-sectional studies. The available evidence, mainly from cross-sectional studies, supports an inverse association of bilirubin levels with adverse metabolic outcomes. Large-scale prospective studies are now needed to establish whether bilirubin levels may be useful in the prevention of MetS and T2D. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. Resilience in Utility Technologies

    NASA Astrophysics Data System (ADS)

    Seaton, Roger

    The following sections are included: * Scope of paper * Preamble * Background to the case-study projects * Source projects * Resilience * Case study 1: Electricity generation * Context * Model * Case study 2: Water recycling * Context * Model * Case study 3: Ecotechnology and water treatment * Context * The problem of classification: Finding a classificatory solution * Application of the new taxonomy to water treatment * Concluding comments and questions * Conclusions * Questions and issues * Purposive or Purposeful? * Resilience: Flexibility and adaptivity? * Resilience: With respect of what? * Risk, uncertainty, surprise, emergence - What sort of shock, and who says so? * Co-evolutionary friction * References

  11. 29 CFR 102.97 - Expeditious processing of section 10(l) and (m) cases in successive stages.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Expeditious processing of section 10(l) and (m) cases in... RULES AND REGULATIONS, SERIES 8 Procedure in Cases Under Section 10(j), (l), and (m) of the Act § 102.97 Expeditious processing of section 10(l) and (m) cases in successive stages. (a) Any complaint issued pursuant...

  12. 29 CFR 102.97 - Expeditious processing of section 10(l) and (m) cases in successive stages.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 2 2011-07-01 2011-07-01 false Expeditious processing of section 10(l) and (m) cases in... RULES AND REGULATIONS, SERIES 8 Procedure in Cases Under Section 10(j), (l), and (m) of the Act § 102.97 Expeditious processing of section 10(l) and (m) cases in successive stages. (a) Any complaint issued pursuant...

  13. Partial Left Ventriculectomy: Have Well-Succeeded Cases and Innovations in the Procedure Been Observed in the Last 12 Years?

    PubMed Central

    Domingues, José Sérgio; Vale, Marcos de Paula; Barbosa, Marcos Pinotti

    2015-01-01

    OBJECTIVE In 1996, the Brazilian cardiovascular surgeon, Dr. Randas Batista, introduced a surgical technique called partial left ventriculectomy, where he admitted the possibility of reducing the diameter of the left ventricle through the sectioning of one section of its wall. After the publication of this study, thousands of case reports and procedure analysis have been published, and due to several disappointing results, many doctors and institutions failed to execute it. As the main objective of this study, stands out the search for success cases of ventriculectomy in the last 12 years and if during this period it was achieved some significant development in this procedure that allows obtaining lower mortality rate postoperatively. METHODS Systematic review of indexed scientific literature over the past 12 years and the term "Partial Left Ventriculectomy". RESULTS There has been a considerable number of reported successful cases and highly significant findings in regard to determining the most suitable region for the section, proper selection of the patients indicated to the procedure, including the influence of the coronary artery anatomy in the nomination procedure and the need for preservation of ventricular geometry to ensure better quality of ventricular contractions after the sectioning. CONCLUSION This surgical procedure has been successfully performed, mainly in Japan, improvements in its efficiency were found and the need for a mathematical modeling of the slice to be severed is a prominent factor in many studies. PMID:26735606

  14. Potential of geographical variation analysis for realigning providers to value-based care. ECHO case study on lower-value indications of C-section in five European countries.

    PubMed

    García-Armesto, Sandra; Angulo-Pueyo, Ester; Martínez-Lizaga, Natalia; Mateus, Céu; Joaquim, Inês; Bernal-Delgado, Enrique

    2015-02-01

    Although C-section is a highly effective procedure, literature abounds with evidence of overuse and particularly misuse, in lower-value indications such as low-risk deliveries. This study aims to quantify utilization of C-section in low-risk cases, mapping out areas showing excess-usage in each country and to estimate excess-expenditure as a proxy of the opportunity cost borne by healthcare systems. Observational, ecologic study on deliveries in 913 sub-national administrative areas of five European countries (Denmark, England, Portugal, Slovenia and Spain) from 2002 to 2009. The study includes a cross-section analysis with 2009 data and a time-trend analysis for the whole period. Main endpoints: age-standardized utilization rates of C-section in low-risk pregnancies and deliveries per 100 deliveries. Secondary endpoints: Estimated excess-cases per geographical unit of analysis in two scenarios of minimized utilization. C-section is widely used in all examined countries (ranging from 19% of Slovenian deliveries to 33% of deliveries in Portugal). With the exception of Portugal, there are no systematic variations in intensity of use across areas in the same country. Cross-country comparison of lower-value C-section leaves Denmark with 10% and Portugal with 2%, the highest and lowest. Such behaviour was stable over the period of analysis. Within each country, the scattered geographical patterns of use intensity speak for local drivers playing a major role within the national trend. The analysis conducted suggests plenty of room for enhancing value in obstetric care and equity in women's access to such within the countries studied. The analysis of geographical variations in lower-value care can constitute a powerful screening tool. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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

    PubMed

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

    2014-02-01

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

  16. 14 CFR 302.213 - Procedures in foreign air carrier permit cases.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... cases. 302.213 Section 302.213 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF... Applications § 302.213 Procedures in foreign air carrier permit cases. (a) Applicability. This section applies to cases involving foreign air carrier permits under section 41302 of the Statute, including...

  17. 14 CFR 302.213 - Procedures in foreign air carrier permit cases.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... cases. 302.213 Section 302.213 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF... Applications § 302.213 Procedures in foreign air carrier permit cases. (a) Applicability. This section applies to cases involving foreign air carrier permits under section 41302 of the Statute, including...

  18. Leadership Learning through Student-Centered and Inquiry-Focused Approaches to Teaching Adaptive Leadership

    ERIC Educational Resources Information Center

    Haber-Curran, Paige; Tillapaugh, Daniel

    2013-01-01

    This qualitative study examines student learning about leadership across three sections of a capstone course in an undergraduate leadership minor. Qualitative methods were informed by exploratory case study analysis and phenomenology. Student-centered and inquiry-focused pedagogical approaches, including case-in-point, action inquiry, and…

  19. Outcome of forceps delivery in a teaching hospital: A 2 year experience

    PubMed Central

    John, Lopamudra B.; Nischintha, S.; Ghose, Seetesh

    2014-01-01

    Introduction: The art of forceps delivery though existing for centuries has earned a disreputation due to the possibility of poor maternal and fetal outcome. However, its safe use can reduce the rising cesarean section rates in the present times. This study is to see the outcome of its use in a teaching hospital over a 2 year period. Materials and Methods: In this retrospective observational study, 120 cases of forceps delivery were studied for maternal outcome such as injuries, postpartum hemorrhage, and fetal outcome such as Apgar score at birth, neonatal intensive care unit admissions, injury, and mortality. Results: The most common indication was fetal distress (47.5%). A total of 15 cases (12.5%) of maternal injuries occurred, with 2 uterine ruptures one of which was in a previous lower segment caesarean section case, 4 complete perineal tears and 9 minor cervical and vaginal lacerations. A total of 12 babies (10%) had poor Apgar scores who recovered after resuscitation and one out of them died, which was a case of multiple instrumentation. Conclusion: Forceps is a reasonable option for the obstetrician to reduce the caesarean section rates; however, extreme caution, proper expertise and judicial use of this instrument are required to prevent undue risk to mother and fetus. PMID:24678216

  20. An Analysis of the Rural-Urban Balance for Education in Developing Countries: A Case Study of Liberia.

    ERIC Educational Resources Information Center

    Coleman, Albert B.; Clark, Elmer J.

    A study to determine whether educational discrepancies exist between urban and rural sections of Liberia used descriptive analysis to examine curriculum, instructional personnel and facilities, finances, and administrative organization. Sources of data included official documents from the Liberian Ministry of Education; the education section of…

  1. Compilation of Case Studies: Exemplary Placement and Follow-Up Studies.

    ERIC Educational Resources Information Center

    Dale, Jack

    Examples of placement and follow-up conceptual models developed for a program of vocational education (kindergarten through university) are presented. Section 1 contains a historical overview of placement and follow-up activities in Florida and describes a comprehensive model. Section 2, describing a model for utilizing community resources for the…

  2. 29 CFR 102.95 - Priority of cases pursuant to section 10(l) and (m) of the Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 2 2011-07-01 2011-07-01 false Priority of cases pursuant to section 10(l) and (m) of the... AND REGULATIONS, SERIES 8 Procedure in Cases Under Section 10(j), (l), and (m) of the Act § 102.95 Priority of cases pursuant to section 10(l) and (m) of the Act. (a) Whenever a charge is filed alleging the...

  3. 29 CFR 102.95 - Priority of cases pursuant to section 10(l) and (m) of the Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Priority of cases pursuant to section 10(l) and (m) of the... AND REGULATIONS, SERIES 8 Procedure in Cases Under Section 10(j), (l), and (m) of the Act § 102.95 Priority of cases pursuant to section 10(l) and (m) of the Act. (a) Whenever a charge is filed alleging the...

  4. Two-photon production of leptons at hadron colliders in semielastic and elastic cases

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

    Manko, A. Yu., E-mail: andrej.j.manko@gmail.com; Shulyakovsky, R. G., E-mail: shul@ifanbel.bas-net.by, E-mail: shulyakovsky@iaph.bas-net.by

    The mechanism of two-photon dilepton production is studied in the equivalent-photon (Weizsäcker–Williams) approximation. This approximation is shown to describe well experimental data from hadron accelerators. The respective total and differential cross sections were obtained for the LHC and for the Tevatron collider at various energies of colliding hadrons. The differential cross sections were studied versus the dilepton invariant mass, transverse momentum, and emission angle in the reference frame comoving with the center of mass of colliding hadrons. The cases of semielastic and inelastic collisions were examined.

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

    ERIC Educational Resources Information Center

    Stout, Diana

    2013-01-01

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

  6. Exploring Pre-Operational and Concrete Operational Children's Thinking on Nutrition: A Case Study

    ERIC Educational Resources Information Center

    Brouse, Corey H.; Chow, Tracy H. F.

    2009-01-01

    Objective: In this exploratory study, we observed the process in which children make food choices from a cognitive development perspective and the implications that these choices have on the areas of cognitive development and health and nutrition education. Design: This was a cross-sectional case study that involved an in-depth examination of the…

  7. Visual Literacy in Primary Science: Exploring Anatomy Cross-Section Production Skills

    ERIC Educational Resources Information Center

    García Fernández, Beatriz; Ruiz-Gallardo, José Reyes

    2017-01-01

    Are children competent producing anatomy cross-sections? To answer this question, we carried out a case study research aimed at testing graphic production skills in anatomy of nutrition. The graphics produced by 118 children in the final year of primary education were analysed. The children had to draw a diagram of a human cross section,…

  8. Turning Students into Employees: The School-to-Work Payoff.

    ERIC Educational Resources Information Center

    Center for Occupational Research and Development, Inc., Waco, TX.

    This booklet describes the success of tech prep under the federal school-to-work (STW) initiative and provides case studies showing how schools and businesses are using tech prep to create the world's best work force for the new millennium. The first section discusses the payoff from STW, and the second section describes tech prep. Section 3…

  9. Vocational Training and Education in Alberta. Coombe Lodge Case Study. Information Bank Number 2003.

    ERIC Educational Resources Information Center

    Marsh, D. T.

    This paper describes the provision of vocational education in the Province of Alberta, especially the education provided by Alberta Vocational Centres (AVCs). The paper is organized in two sections. The first, introductory section describes the Province of Alberta and its educational system. The second section focuses on Alberta Vocational Centres…

  10. The utility of caesarean myomectomy as a safe procedure: a retrospective analysis of 21 cases with review of literature.

    PubMed

    Kumar R, Ramesh; Patil, Manjula; Sa, Shruthi

    2014-09-01

    Myomectomy at the time of caesarean delivery has been discouraged because of the risk of intractable haemorrhage and increased postoperative morbidity. The aim of this study is to determine the safety and feasibility of caesarean myomectomy. A retrospective case control study done between June 2012 to May 2013 in a tertiary care teaching hospital in Karnataka, India which included 21 pregnant women with uterine fibroids who underwent myomectomy during caesarean section and were compared with 42 matched controls without uterine fibroids who had caesarean section alone during the same period. Primary outcome measures studied were incidence of haemorrhage and need for blood transfusion. Secondary outcome measures were duration of operation, length of hospital stay, postpartum fever and wound infection. Statistical analysis is done using IBMSPSS 20.0 software and students t-test. For calculation of incidence of haemorrhage Fisher's exact test is used. Mean age of the 21 cases was 31.81yrs and 47.62% were primigravida. Total 37 fibroids were removed. Subserosal were 30 cases(81.08%) while 1(2.07%) was submucous. 21(56.76%)fibroids were situated in fundal region and 3(8.11%) were in lower segment. Mean change in the haemoglobin from preoperative to postoperative period in the cases was 1.3gm/dl(±1.155mg/dl) and control was 1.05% (±.854mg/dl). Two of the cases(9.52%) required blood transfusion compared to none in control. None in either group required hysterectomy. Mean duration of surgery was 68.57min (±15.012min)and 51.55min (±9.595min) for controls which is statistically significant. This study shows that myomectomy during caesarean section is a safe procedure and is not associated with major intraoperative and postoperative complications.

  11. EMS Response to Mass Casualty Incidents: The Critical Importance of Automatic Statewide Mutual Aid and MCI Training

    DTIC Science & Technology

    2008-09-01

    difficulty in implementation for each case study. After an overview, each case study is given a score against each of the criteria of “meets” or “exceeds...While expectations may be different for different individuals, the narrative section provides supporting information for the assigned score , with...decrease in response time will improve patient outcome? The narrative discussing the score will give information from the case study on the specific

  12. Vaginal birth after one previous caesarean section in a tertiary institution in Nigeria.

    PubMed

    Aisien, A O; Oronsaye, A U

    2004-11-01

    Vaginal birth after one previous lower segment caesarean section represents one of the most significant and challenging issues in obstetric practice. A 5-year retrospective study was carried out at the University of Benin Teaching Hospital between January 1999 and December 2003, to determine the incidence, the maternal and fetal outcome following vaginal delivery after one previous caesarean section with a view to evaluating its safety and efficacy. There were 5234 deliveries, with 395 cases of one previous caesarean section, giving an incidence of 7.5%. The incidences of emergency caesarean section, elective caesarean section and spontaneous vaginal delivery following trial of vaginal delivery were 34.7%, 9.4% and 48.1%, respectively. During the study period there were 1317 cases of caesarean section, giving an incidence of 25.2% caesarean section rate. The incidence of one previous section among all caesarean section births was 30%. The major morbidity following vaginal delivery was uterine rupture with an incidence of 1.5% and hysterectomy of 0.8%. Three of the uterine ruptures occurred before admission because the patients laboured at home. One maternal death occurred as a result of uterine rupture and postpartum haemorrhage, giving a maternal mortality ratio of 19/100,000 and a case fatality rate of 0.3%. The corrected perinatal mortality rate was 15.2/1000, mainly from obstructed labour, abruptio placenta and fetal distress. Both maternal and fetal mortalities from vaginal birth after one previous section were significantly less than the respective overall maternal and fetal mortality from the institution. The 1-minute apgar score of babies delivered by elective section was significantly (P < 0.001) higher than the apgar score of babies delivered by emergency section and vaginally. There was only one patient with wound dehiscence at elective section without associated perinatal death. Vaginal delivery following caesarean section is relatively safe. However, women in developing countries will continue to require counselling to counter the myths of aversion to operative delivery even at the expense of losing their lives. Our hospitals should have adequate monitoring equipment for high-risk pregnancies so that patients and their babies can be assured of survival.

  13. Cross-Sectional Study to Assess Risk Factors for Leishmaniasis in an Endemic Region in Sri Lanka

    PubMed Central

    Ranasinghe, Shalindra; Wickremasinghe, Rajitha; Munasinghe, Asoka; Hulangamuwa, Sanjeeva; Sivanantharajah, Sundaramoorthy; Seneviratne, Kamal; Bandara, Samantha; Athauda, Indira; Navaratne, Chaturi; Silva, Ositha; Wackwella, Hasini; Matlashewski, Greg; Wickremasinghe, Renu

    2013-01-01

    Sri Lanka reports significantly more cutaneous leishmaniasis (CL) cases than visceral leishmaniasis (VL) cases, both of which are caused by Leishmania donovani MON-37. A cross-sectional study conducted in an area with a high prevalence of CL prevalent included 954 participants of an estimated population of 61,674 to estimate the number of CL cases, ascertain whether there is a pool of asymptomatic VL cases, and identify risk factors for transmission. A total of 31 cases of CL were identified, of whom 21 were previously diagnosed and 10 were new cases. Using rK39 rapid diagnostic test to detect antibodies against Leishmania spp., we found that only one person was seropositive but did not have clinical symptoms of CL or VL, which indicated low transmission of VL in this area. χ2 test, independent sample t-test, and multivariate analysis of sociodemographic and spatial distribution of environmental risk factors showed that living near paddy fields is associated with increased risk for transmission of CL (P ≤ 0.01). PMID:23918217

  14. Measures of reducing obstetric emergencies hysterectomy incidence.

    PubMed

    Ren, Guo-ping; Wang, Bao-lian; Wang, Yan-hong

    2016-03-01

    To study the obstetric emergency hysterectomy which can reduce the incidence of measures. In maternity of Xinxiang Central Hospital, the total number of deliveries cases has been up to 50,526 in 20 years, of which 48 cases were retrospectively analyzed for the clinical data of Emergency uterine surgery cases. Cases underwent obstetric emergency hysterectomy accounted for 0.095% of total deliveries (48/50 526), in which 11 cases of vaginal delivery, 37 cases of cesarean section. The indications for surgery: 27 cases were cased by placental factors accounted for 56.25%; 14 cases of uterine inertia, accounting for 29.17%; uterine rupture in 4 cases, accounting for 8.33%; 3 cases of coagulopathy, accounting for 6.25%. Where the maternal placental factors hysterectomy is the most common (69.70%, 23/33) and the predominant factor is early maternal uterine inertia (60.00%, 9/15). There are 74.09% (20/27) of patients with placental abnormalities history of previous cesarean section or uterine surgery. The major risk factors leading to obstetric emergency hysterectomy is placental factors. Preventing the occurrence of placental abnormalities planting actively can effectively reduce the rate of obstetric hysterectomy.

  15. Dark matter relics and the expansion rate in scalar-tensor theories

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

    Dutta, Bhaskar; Jimenez, Esteban; Zavala, Ivonne, E-mail: dutta@physics.tamu.edu, E-mail: este1985@physics.tamu.edu, E-mail: e.i.zavalacarrasco@swansea.ac.uk

    We study the impact of a modified expansion rate on the dark matter relic abundance in a class of scalar-tensor theories. The scalar-tensor theories we consider are motivated from string theory constructions, which have conformal as well as disformally coupled matter to the scalar. We investigate the effects of such a conformal coupling to the dark matter relic abundance for a wide range of initial conditions, masses and cross-sections. We find that exploiting all possible initial conditions, the annihilation cross-section required to satisfy the dark matter content can differ from the thermal average cross-section in the standard case. We alsomore » study the expansion rate in the disformal case and find that physically relevant solutions require a nontrivial relation between the conformal and disformal functions. We study the effects of the disformal coupling in an explicit example where the disformal function is quadratic.« less

  16. Cranial pole nephrectomy in the pig model: anatomic analysis of arterial injuries in tridimensional endocasts.

    PubMed

    Pereira-Sampaio, Marco A; Henry, Robert W; Favorito, Luciano A; Sampaio, Francisco J B

    2012-06-01

    To assess the intrarenal arteries injuries after cranial pole nephrectomy in a pig model to compare these findings with those in humans. Polyester resin was injected through the ureter and the renal artery to make three-dimensional casts of 61 pig kidneys. The cranial pole of the kidneys was sectioned at four different sites before the solidification of the resin, and the casts were examined for arterial damage. Section performed through the hilus (15 kidneys): The cranial division of the renal artery was sectioned in two (13.33%) cases, the ventral branch of the cranial division of the renal artery was sectioned in 13 (86.7%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 11 (73.34%) cases. Section at 0.5 cm cranial to the hilus (16 kidneys): The cranial division of the renal artery was sectioned in 1 (6.25%) case, the ventral branch of the cranial division of the renal artery was sectioned in 14 (87.5%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 13 (81.25%) cases. Section at 1.0 cm cranial to the hilus (15 kidneys): The ventral branch of the cranial division of the renal artery was sectioned in five (33.33%) cases, and the dorsal branch of the cranial division of the renal artery was injured in five (33.33%) cases. Section at 1.5 cm cranial to the hilus (15 kidneys): No lesions were found in the main arteries, only in the interlobular branches. As previously demonstrated in humans, sections at 1.0 cm or more cranially to the hilus in pigs also showed a significant decrease in damage to the major intrarenal arteries. Therefore, as regards arterial damage, the pig kidney is a useful model for partial nephrectomy in the cranial (upper) pole.

  17. On the Circulation Manifold for Two Adjacent Lifting Sections

    NASA Technical Reports Server (NTRS)

    Zannetti, Luca; Iollo, Angelo

    1998-01-01

    The circulation functional relative to two adjacent lifting sections is studied for two cases. In the first case we consider two adjacent circles. The circulation is computed as a function of the displacement of the secondary circle along the axis joining the two centers and of the angle of attack of the secondary circle, The gradient of such functional is computed by deriving a set of elliptic functions with respect both to their argument and to their Period. In the second case studied, we considered a wing-flap configuration. The circulation is computed by some implicit mappings, whose differentials with respect to the variation of the geometrical configuration in the physical space are found by divided differences. Configurations giving rise to local maxima and minima in the circulation manifold are presented.

  18. Television-Centered, Instructional Delivery Systems: Costs and Case Studies. A Review of Research.

    ERIC Educational Resources Information Center

    Maher, Thomas G.

    This paper reviews the post-1975 research on the capacities, logistics, and costs of the various delivery technologies used in educational television, and details case studies of television-centered operations, particularly in relationship to adult learners. The paper begins with a section on general definitions and the capacities of various…

  19. Adult Education in Development. Methods and Approaches from Changing Societies.

    ERIC Educational Resources Information Center

    McGivney, Veronica; Murray, Frances

    The case studies described in this book provide examples of initiatives illustrating the role of adult education in development and its contribution to the process of change in developing countries. The book is organized in five sections. Case studies in Part 1, "Health Education," illustrate the links between primary health care and…

  20. Development and validation of a protocol for optimizing the use of paraffin blocks in molecular epidemiological studies: The example from the HPV-AHEAD study.

    PubMed

    Mena, Marisa; Lloveras, Belen; Tous, Sara; Bogers, Johannes; Maffini, Fausto; Gangane, Nitin; Kumar, Rekha Vijay; Somanathan, Thara; Lucas, Eric; Anantharaman, Devasena; Gheit, Tarik; Castellsagué, Xavier; Pawlita, Michael; de Sanjosé, Silvia; Alemany, Laia; Tommasino, Massimo

    2017-01-01

    Worldwide use of formalin-fixed paraffin-embedded blocks (FFPE) is extensive in diagnosis and research. Yet, there is a lack of optimized/standardized protocols to process the blocks and verify the quality and presence of the targeted tissue. In the context of an international study on head and neck cancer (HNC)-HPV-AHEAD, a standardized protocol for optimizing the use of FFPEs in molecular epidemiology was developed and validated. First, a protocol for sectioning the FFPE was developed to prevent cross-contamination and distributed between participating centers. Before processing blocks, all sectioning centers underwent a quality control to guarantee a satisfactory training process. The first and last sections of the FFPEs were used for histopathological assessment. A consensus histopathology evaluation form was developed by an international panel of pathologists and evaluated for four indicators in a pilot analysis in order to validate it: 1) presence/type of tumor tissue, 2) identification of other tissue components that could affect the molecular diagnosis and 3) quality of the tissue. No HPV DNA was found in sections from empty FFPE generated in any histology laboratories of HPV-AHEAD consortium and all centers passed quality assurance for processing after quality control. The pilot analysis to validate the histopathology form included 355 HNC cases. The form was filled by six pathologists and each case was randomly assigned to two of them. Most samples (86%) were considered satisfactory. Presence of >50% of invasive carcinoma was observed in all sections of 66% of cases. Substantial necrosis (>50%) was present in <2% of samples. The concordance for the indicators targeted to validate the histopathology form was very high (kappa > 0.85) between first and last sections and fair to high between pathologists (kappa/pabak 0.21-0.72). The protocol allowed to correctly process without signs of contamination all FFPE of the study. The histopathology evaluation of the cases assured the presence of the targeted tissue, identified the presence of other tissues that could disturb the molecular diagnosis and allowed the assessment of tissue quality.

  1. Working towards Best Practice in Assessment. A Case Study Approach to Some Issues Concerning Competency-Based Assessment in the Vocational Education and Training Sector.

    ERIC Educational Resources Information Center

    Bloch, Barbara; Thomson, Peter

    Between July and November 1993, a cross-section of Australia's school- and workplace-based vocational education and training programs was studied to identify programs using innovative assessment strategies and materials. As innovative strategies/materials were identified, the study methodology was revised and a case study approach was adopted. The…

  2. An Approach to Developing Language Awareness in the Irish Language Classroom: A Case Study

    ERIC Educational Resources Information Center

    O Laoire, Muiris

    2007-01-01

    This case study deals with language awareness (LA) oriented instruction in the Irish language classroom, based on qualitative-type research conducted in a class of 21 English-medium secondary students studying Irish as a subject. Having outlined the general background to the teaching of Irish in secondary schools, the first section of the paper…

  3. Real Options in Defense R and D: A Decision Tree Analysis Approach for Options to Defer, Abandon, and Expand

    DTIC Science & Technology

    2016-12-01

    chosen rather than complex ones , and responds to the criticism of the DTA approach. Chapter IV provides three separate case studies in defense R&D...defense R&D projects. To this end, the first section describes the case study method and the advantages of using simple models over more complex ones ...the analysis lacked empirical data and relied on subjective data, the analysis successfully combined the DTA approach with the case study method and

  4. Frozen section evaluation via dynamic real-time non-robotic Telepathology system in a university Cancer center by resident / faculty cooperation team.

    PubMed

    Vosoughi, Aram; Smith, Paul Taylor; Zeitouni, Joseph A; Sodeman, Gregori M; Jorda, Merce; Gomez-Fernandez, Carmen; Garcia-Buitrago, Monica; Petito, Carol K; Chapman, Jennifer R; Campuzano-Zuluaga, German; Rosenberg, Andrew E; Kryvenko, Oleksandr N

    2018-04-30

    Frozen section telepathology interpretation experience has been largely limited to practices with locations significantly distant from one another with sporadic need for frozen section diagnosis. In 2010 we established a real-time non-robotic telepathology system in a very active cancer center for daily frozen section service. Herein, we evaluate its accuracy compared to direct microscopic interpretation performed in the main hospital by the same faculty and its cost-efficiency over a 1-year period. From 643 (1416 parts) cases requiring intraoperative consultation, 333 cases (690 parts) were examined by telepathology and 310 cases (726 parts) by direct microscopy. Corresponding discrepancy rates were 2.6% (18 cases: 6 (0.9%) sampling and 12 (1.7%) diagnostic errors) and 3.2% (23 cases: 8 (1.1%) sampling and 15 (2.1%) diagnostic errors), P=.63. The sensitivity and specificity of intraoperative frozen diagnosis were 0.92 and 0.99, respectively, in telepathology, and 0.90 and 0.99, respectively, in direct microscopy. There was no correlation of error incidence with post graduate year level of residents involved in the telepathology service. Cost analysis indicated that the time saved by telepathology was $19691 over one year of the study period while the capital cost for establishing the system was $8924. Thus, real-time non-robotic telepathology is a reliable and easy to use tool for frozen section evaluation in busy clinical settings, especially when frozen section service involves more than one hospital, and it is cost efficient when travel is a component of the service. Copyright © 2018. Published by Elsevier Inc.

  5. Not the usual suspects: addressing layers of vulnerability.

    PubMed

    Luna, Florencia; Vanderpoel, Sheryl

    2013-07-01

    This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of 'usual suspects', focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different approaches to 'vulnerability' are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. © 2013 John Wiley & Sons Ltd.

  6. Production cross sections for Lee-Wick massive electromagnetic bosons and for spin-zero and spin-one W bosons at high energies.

    NASA Technical Reports Server (NTRS)

    Linsker, R.

    1972-01-01

    Production cross sections for three types of hypothetical particles are calculated in the presented paper. Several (Z, Z') cases were studied corresponding to elastic scattering off protons and neutrons (either free or embedded within a Fermi sea), coherent scattering off a nucleus, and inelastic scattering off a proton (in which case Z' denotes a nucleon resonance or hadronic system in the continuum). Detailed structure-function data are used to improve the accuracy of the inelastic scattering calculation. Results of calculations are given for beam energies between 50 and 10,000 GeV, and masses between 5 and 40 GeV for the massive Lee-Wick spin-1 boson. Cross sections were computed for resonant and semiweak processes. The production cross section of spin-zero weak intermediate bosons was found to be at least one order of magnitude smaller than for spin-1 weak bosons in nearly all regions of interest. The production cross section of spin-zero weak intermediate bosons for inelastic scattering off protons compares with that for elastic scattering in the regions of interest. In the case of massive spin-1 bosons and spin-1 weak intermediates, the main contribution to total production cross section off protons is elastic.

  7. A nonlinear theory for spinning anisotropic beams using restrained warping functions

    NASA Technical Reports Server (NTRS)

    Ie, C. A.; Kosmatka, J. B.

    1993-01-01

    A geometrically nonlinear theory is developed for spinning anisotropic beams having arbitrary cross sections. An assumed displacement field is developed using the standard 3D kinematics relations to describe the global beam behavior supplemented with an additional field that represents the local deformation within the cross section and warping out of the cross section plane. It is assumed that the magnitude of this additional field is directly proportional to the local stress resultants. In order to take into account the effects of boundary conditions, a restraining function is introduced. This function plays the role of reducing the amount of free warping deformation throughout the field due to the restraint of the cross section(s) at the end(s) of the beam, e.g., in the case of a cantilever beam. Using a developed ordering scheme, the nonlinear strains are calculated to the third order. The FEM is developed using the weak form variational formulation. Preliminary interesting numerical results have been obtained that indicate the role of the restraining function in the case of a cantilever beam with circular cross section. These results are for the cases of a tip displacement (static) and free vibration studies for both isotropic and anisotropic materials with varied fiber orientations.

  8. Manual Of The Judge Advocate General (Jagman)

    DTIC Science & Technology

    2004-03-15

    1114, MCM, and section 0155. ( 2 ) Companion cases tried separately. In court- martial cases where the separate trial of a companion case is...under escort in cases of deliv- ery in accordance with section 0613) to a naval or Marine Corps activity as set forth in the agreement; ( 2 ) the...command not permit service, see section 0616e. ( 2 ) Out-of-state process. In those cases where the process is to be served by authority of a

  9. Squash preparation: A reliable diagnostic tool in the intraoperative diagnosis of central nervous system tumors

    PubMed Central

    Mitra, Sumit; Kumar, Mohan; Sharma, Vivek; Mukhopadhyay, Debasis

    2010-01-01

    Background: Intraoperative cytology is an important diagnostic modality improving on the accuracy of the frozen sections. It has shown to play an important role especially in the intraoperative diagnosis of central nervous system tumors. Aim: To study the diagnostic accuracy of squash preparation and frozen section (FS) in the intraoperative diagnosis of central nervous system (CNS) tumors. Materials and Methods: This prospective study of 114 patients with CNS tumors was conducted over a period of 18 months (September 2004 to February 2006). The cytological preparations were stained by the quick Papanicolaou method. The squash interpretation and FS diagnosis were later compared with the paraffin section diagnosis. Results: Of the 114 patients, cytological diagnosis was offered in 96 cases. Eighteen nonneoplastic or noncontributory cases were excluded. Using hematoxylin and eosin-stained histopathology sections as the gold standard, the diagnostic accuracy of cytology was 88.5% (85/96) and the accuracy on FS diagnosis was 90.6% (87/96). Among these cases, gliomas formed the largest category of tumors (55.2%). The cytological accuracy in this group was 84.9% (45/53) and the comparative FS figure was 86.8% (46/53). In cases where the smear and the FS diagnosis did not match, the latter opinion was offered. Conclusions: Squash preparation is a reliable, rapid and easy method and can be used as a complement to FS in the intraoperative diagnosis of CNS tumors. PMID:21187881

  10. Mast cells and angiogenesis in wound healing.

    PubMed

    Gaber, Mohamed A; Seliet, Iman A; Ehsan, Nermin A; Megahed, Mohamed A

    2014-02-01

    To investigate the role of mast cells and vascular endothelial growth factor (VEGF) as a mediator of angiogenesis to promote wound healing in surgical and pathological scars. The study was carried out on 40 patients who presented with active scar lesions. They were subdivided into 4 groups. They included granulation tissue (10 cases), surgical scar (10 cases), hypertrophic scar (10 cases), and keloid scar (10 cases). Also 10 healthy volunteers of the same age and sex were selected as a control group. Skin biopsies were taken from the patients and the control group. Skin biopsies from clinically assessed studied groups were processed for routine histology and embedded in paraffin. Four sections were prepared from each paraffin block. The first section was stained with hematoxylin and eosin for histological evaluation. The second and third sections were processed for immunostaining of mast cells that contain chymase (MCCs) and mast cells that contain tryptase (MCTs). The fourth section was processed for immunostaining of VEGF. MCCs exhibited mild expression in normal tissue, granulation tissue, and surgical, hypertrophic and keloid scars. MCTs exhibited mild expression in normal tissue, granulation tissue and keloid, whereas moderate expression was exhibited in hypertrophic and surgical scars. VEGF expression was absent in normal tissue, mild in keloid, surgical and hypertrophic scars, and moderate in keloids and granulation tissue. Mast cell expression variation among different scar types signals the pathological evolution of the lesion, and hence may guide the need for therapeutic intervention.

  11. Numerical Investigation of Flapwise-Torsional Vibration Model of a Smart Section Blade with Microtab

    DOE PAGES

    Li, Nailu; Balas, Mark J.; Yang, Hua; ...

    2015-01-01

    This paper presents a method to develop an aeroelastic model of a smart section blade equipped with microtab. The model is suitable for potential passive vibration control study of the blade section in classic flutter. Equations of the model are described by the nondimensional flapwise and torsional vibration modes coupled with the aerodynamic model based on the Theodorsen theory and aerodynamic effects of the microtab based on the wind tunnel experimental data. The aeroelastic model is validated using numerical data available in the literature and then utilized to analyze the microtab control capability on flutter instability case and divergence instabilitymore » case. The effectiveness of the microtab is investigated with the scenarios of different output controllers and actuation deployments for both instability cases. The numerical results show that the microtab can effectively suppress both vibration modes with the appropriate choice of the output feedback controller.« less

  12. Association of Placenta Previa with a History of Previous Cesarian Deliveries and Indications for a Possible Role of a Genetic Component

    PubMed Central

    M, Matalliotakis; A, Velegrakis; GN, Goulielmos; E, Niraki; AE, Patelarou; I, Matalliotakis

    2017-01-01

    Abstract A prior Cesaria section (C-section) is an important risk factor that leads to endometrial damage and abnormal implantation of the placenta. Our retrospective study aims to correlate the frequency of placenta previa to previous C-sections, to determine the effect of male gender in this condition and to evaluate further the maternal outcome. Seventy-six cases with placenta previa were selected out of 5200 live births. Diagnosis was confirmed by ultrasound and in the operating theater. In the 76 women examined, we found 50 cases with a history of a previous C-section (66.0%) and 49 male offspring (65.0%) (p <0.001), with a mean birth weight of 2635 ± 740 g. Of all these patients, six (8.0%) cases developed placenta percreta, seven (9.0%) were transferred to the intensive care unit (ICU), 14 (18.0%) women needed blood transfusion and eight (11.0%) underwent hysterectomy. The results of our series show a strong correlation of placenta previa to a history of previous C-sections and a predominance of male fetuses. Early recognition and proper monitoring could minimize the possibility of a poor outcome. PMID:29876227

  13. Association of Placenta Previa with a History of Previous Cesarian Deliveries and Indications for a Possible Role of a Genetic Component.

    PubMed

    M, Matalliotakis; A, Velegrakis; Gn, Goulielmos; E, Niraki; Ae, Patelarou; I, Matalliotakis

    2017-12-01

    A prior Cesaria section (C-section) is an important risk factor that leads to endometrial damage and abnormal implantation of the placenta. Our retrospective study aims to correlate the frequency of placenta previa to previous C-sections, to determine the effect of male gender in this condition and to evaluate further the maternal outcome. Seventy-six cases with placenta previa were selected out of 5200 live births. Diagnosis was confirmed by ultrasound and in the operating theater. In the 76 women examined, we found 50 cases with a history of a previous C-section (66.0%) and 49 male offspring (65.0%) ( p <0.001), with a mean birth weight of 2635 ± 740 g. Of all these patients, six (8.0%) cases developed placenta percreta, seven (9.0%) were transferred to the intensive care unit (ICU), 14 (18.0%) women needed blood transfusion and eight (11.0%) underwent hysterectomy. The results of our series show a strong correlation of placenta previa to a history of previous C-sections and a predominance of male fetuses. Early recognition and proper monitoring could minimize the possibility of a poor outcome.

  14. CD30 expression in follicular lymphoma.

    PubMed

    Gardner, L J; Polski, J M; Evans, H L; Perkins, S L; Dunphy, C H

    2001-08-01

    CD30(+) anaplastic large cell lymphomas were originally described as being of T-cell, null cell, and B-cell origin. CD30, however, is not a specific marker of anaplastic large cell lymphoma and has been found to be expressed in reactive as well as neoplastic populations as a probable activation marker. In addition, CD30(+) cells have also been described in both diffuse large B-cell and follicular lymphomas (FLs), resembling the pattern seen in reactive tonsils and lymph nodes. We report an index case of FL with CD30 expression, which on initial touch preparations and flow cytometric immunophenotyping revealed a prominent population of CD30(+) cells with marked cellular pleomorphism (anaplasia) in a background of typical FL. Immunohistochemistry of the paraffin section for CD30 in our index case confirmed unequivocal CD30(+) pleomorphic cells in the malignant nodules in occasional clusters. This case prompted a study of additional cases of FL for pattern of immunoreactivity with CD30 on paraffin sections. Twenty-two additional cases of FL (grades 1-3) were retrieved for CD30 immunoperoxidase staining as in the index case. This study demonstrated 32% of the additional cases of FL had definitive CD30(+), large, pleomorphic malignant cells by paraffin immunohistochemistry. In 2 cases (9%), the pattern of immunoreactivity with CD30 showed clustering and variable staining of large cells, as our index case. This study underscores the morphologic and immunophenotypic spectrum of FL that includes CD30 staining and cellular pleomorphism.

  15. Eight Case Studies of Communication Patterns in a Black, Urban Slum.

    ERIC Educational Resources Information Center

    Ryan, Michael

    The Kerner Commission was critical six years ago in its assessment of media coverage of black problems, and eight case studies conducted in Philadelphia indicate that news media may not yet be effectively meeting the needs of some blacks. In January 1974 interviews were held with eight residents in a section of north Philadelphia characterized in…

  16. Current Trends in Microform Use by Secondary Schools: Four Case Studies.

    ERIC Educational Resources Information Center

    Lee, Thomas Graham

    The case study section of this booklet discusses a number of current microform programs in secondary schools. The remainder of the booklet presents an overview of microform activity, including comments on the history of secondary school microform utilization and an up-to-date listing of microform selection aids. The amount of information available…

  17. Delphi in Criminal Justice Policy: A Case Study on Judgmental Forecasting

    ERIC Educational Resources Information Center

    Loyens, Kim; Maesschalck, Jeroen; Bouckaert, Geert

    2011-01-01

    This article provides an in-depth case study analysis of a pilot project organized by the section "Strategic Analysis" of the Belgian Federal Police. Using the Delphi method, which is a judgmental forecasting technique, a panel of experts was questioned about future developments of crime, based on their expertise in criminal or social…

  18. A Case Study of Enabling Factors in the Technology Integration Change Process

    ERIC Educational Resources Information Center

    Hsu, Pi-Sui; Sharma, Priya

    2008-01-01

    The purpose of this qualitative case study was to analyze enabling factors in the technology integration change process in a multi-section science methods course, SCIED 408 (pseudonym), from 1997 to 2003 at a large northeastern university in the United States. We used two major data collection methods, in-depth interviewing and document reviews.…

  19. Bitter Strawberries: The Construction of Differences in a Multicultural School: A Case Study

    ERIC Educational Resources Information Center

    González-Faraco, Juan Carlos; Jiménez-Vicioso, Juan Ramón; Pérez-Moreno, Heliodoro Manuel

    2013-01-01

    This paper presents the results of a case study looking at the views of teachers and other educational professionals pertaining to the academic progress and general integration of immigrant schoolchildren in multicultural schools in the province of Huelva (Andalusia, Spain). It is organised into three sections: first, the geographical and social…

  20. Ministries of Education in Small States: Case Studies of Organization and Management.

    ERIC Educational Resources Information Center

    Bray, Mark, Ed.

    Case studies on ministries of education were sought from states with populations under 1.5 million and displaying a wide range of economic, geographic, and cultural diversity. The introduction has six main sections: (1) information on definitions and the contents of the book; (2) an account of other Commonwealth Secretariat initiatives on…

  1. Fluorescence of fungi in superficial and deep fungal infections

    PubMed Central

    Elston, Dirk M

    2001-01-01

    Background Fluorescence of many fungi is noted when H&E stained sections are examined under a fluorescent microscope. In theory, this phenomenon could aid in the diagnosis of cutaneous and disseminated fungal infections without the delay associated with special stains. Seventy-six cases of superficial and deep fungal infections and 3 cases of protothecosis were studied to determine the clinical usefulness of this technique. Results In most cases, fluorescence was noted, but was not intense. Fluorescence of fungi did not correlate with the age of the specimen. In most cases, organisms in H&E stained sections were more easily identified with routine light microscopy than with fluorescent microscopy. Conclusion This report suggests that in H&E stained skin specimens, fluorescent microscopy is of little benefit in the identification of fungal organisms. PMID:11602016

  2. Trends in the Mental Health Act Review Tribunals: a Welsh experience 2004-2008.

    PubMed

    Aziz, V M

    2009-10-01

    This study aims at identifying any local trend in the appeal process and to determine if we are complying with the MHA 1983 and the Code of Practice by reviewing all the appeals to Mental Health Review Tribunals in a psychiatric hospital in South Wales for the period from 2004 to 2008. The total numbers of sections and appeals remain steady over the years. Men are slightly more detained than women mainly under Sections 2 and 3 of the MH Act 1983. The main diagnoses for detention were: bipolar affective disorder, schizophrenia and psychosis. 95% of cases had appeals and 5% referrals. A hearing was held in 52% of cases (n=60), the RMO discharged 38% of patients and the patient withdrew appeal in 10% of cases. 95% of cases were British White ethnicity. Single men tended to appeal more than women 68% vs. 32%. There was no observed trend in the result of the appeals and the proportions of appeal discharged by the hearing remained unchanged. The results of the appeals were not associated with gender, ethnicity, marital status, age or the type of section involved. The patients who were previously detained tend to appeal more, i.e. the more number of detentions, the more number of appeals. In only 12% of cases who had the hearings, the appeal was successful and the patients were discharged from their sections. The study shows steady volume of sections and appeals and the appeals are no more likely to result in discharge. The amendments of the Act 2007 also attract an increase in the appeal process especially in relation to the Community Treatment Orders and the Deprivation of Liberty. The use of both the Act and the Mental Capacity Act 2005 will increase workload for all involved practitioners. 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine.

  3. Families Today: A Research Sampler on Families and Children. Volume II. NIMH Science Monographs 1.

    ERIC Educational Resources Information Center

    Corfman, Eunice, Ed.

    The second of two volumes, this book contains 21 studies of children and families. Selections, grouped into three sections, are intended to provide a representative sample of current research, including case studies and less formal reports. The first section reports on families in distress. Articles focus on adults who were antisocial children,…

  4. Benefits of Early Intervention for Special Children.

    ERIC Educational Resources Information Center

    Bailey, Pamela W.; Trohanis, Pascal L.

    The document contains summaries of over 50 publicly available publications which support the case for early intervention for handicapped children and their families. Section 1 contains studies pertaining to the effectiveness of any intervention. This section also describes projects approved by the United States Department of Education's Joint…

  5. Environmental Education & Communication for a Sustainable World: Handbook for International Practitioners.

    ERIC Educational Resources Information Center

    Day, Brian A., Ed.; Monroe, Martha C., Ed.

    This document targets organizations and practitioners developing an environmental education or communication project. The manual presents case studies to share experiences, information, and models of working in education. There are 15 chapters in 4 sections. Section One entitled "Fundamental Concepts in Environmental Education and…

  6. Curriculum Leadership: Development and Implementation

    ERIC Educational Resources Information Center

    Glatthorn, Allan A.; Boschee, Floyd; Whitehead, Bruce M.

    2005-01-01

    This book is a resource written for educational leaders who want to successfully restructure and enhance curriculum in schools today. It provides innovative and successful curriculum ideas, including reflective case studies, "Keys to Leadership" sections, curriculum tips, and "Challenge" sections with key issues and questions in every chapter.…

  7. Funding Continuing Training in Small and Medium-Sized Enterprises: Discussion and Case Studies from across the EU. CEDEFOP Panorama Series.

    ERIC Educational Resources Information Center

    Pukkinen, Tommi; Romijn, Clemens; Elson-Rogers, Sarah

    There are three main parts to this report of a study that used case studies to showcase the different approaches used to encourage more continuing training within small and medium-sized enterprises (SMEs) across the European Union (EU). Section 1 discusses the importance of funding training in SMEs and highlights the various types of funding…

  8. [Krukenberg ovary tumor pathological clinical study of 56 cases in the Instituto Nacional de Enfermedades Neoplasicas (National Cancer Institute)].

    PubMed

    Sánchez Lihón, Juvenal

    2009-01-01

    We report 56 cases of ovary Krukenberg tumor at Instituto Nacional de Enfermedades NeoplAsicas en relation to microscopic diagnosis, primary origin and clinicopathologic correlation. The patients ranged from 18 to 84 years. The most frecuent primary tumor was stomach 33 (58.9%) cases. Abdominal swelling and pain usually accounted for the clinical presentation. Ascitis, abnormal vaginal bleeding. 21 patients had frozen section.11(52.3%) cases the primary carcinoma was found during an operation for the ovary tumor and the most frecuent was stomach 9/21. 35 cases the tumor was bilateral the largest dimension was 30 x 20 cm microscopic examination showed variety of patterns.the survival data, follow up and prognosis is bad. It is important the correct diagnosis of Krukenberg tumor. We recommended frozen section. The prognosis is very poor.

  9. Risk factors for asthma and allergy associated with urban migration: background and methodology of a cross-sectional study in Afro-Ecuadorian school children in Northeastern Ecuador (Esmeraldas-SCAALA Study).

    PubMed

    Cooper, Philip J; Chico, Martha E; Vaca, Maritza G; Rodriguez, Alejandro; Alcântara-Neves, Neuza M; Genser, Bernd; de Carvalho, Lain Pontes; Stein, Renato T; Cruz, Alvaro A; Rodrigues, Laura C; Barreto, Mauricio L

    2006-09-13

    Asthma and allergic diseases are becoming increasingly frequent in children in urban centres of Latin America although the prevalence of allergic disease is still low in rural areas. Understanding better why the prevalence of asthma is greater in urban migrant populations and the role of risk factors such as life style and environmental exposures, may be key to understand what is behind this trend. The Esmeraldas-SCAALA (Social Changes, Asthma and Allergy in Latin America) study consists of cross-sectional and nested case-control studies of school children in rural and urban areas of Esmeraldas Province in Ecuador. The cross-sectional study will investigate risk factors for atopy and allergic disease in rural and migrant urban Afro-Ecuadorian school children and the nested case-control study will examine environmental, biologic and social risk factors for asthma among asthma cases and non-asthmatic controls from the cross-sectional study. Data will be collected through standardised questionnaires, skin prick testing to relevant aeroallergen extracts, stool examinations for parasites, blood sampling (for measurement of IgE, interleukins and other immunological parameters), anthropometric measurements for assessment of nutritional status, exercise testing for assessment of exercise-induced bronchospasm and dust sampling for measurement of household endotoxin and allergen levels. The information will be used to identify the factors associated with an increased risk of asthma and allergies in migrant and urbanizing populations, to improve the understanding of the causes of the increase in asthma prevalence and to identify potentially modifiable factors to inform the design of prevention programmes to reduce the risk of allergy in urban populations in Latin America.

  10. Risk factors for asthma and allergy associated with urban migration: background and methodology of a cross-sectional study in Afro-Ecuadorian school children in Northeastern Ecuador (Esmeraldas-SCAALA Study)

    PubMed Central

    Cooper, Philip J; Chico, Martha E; Vaca, Maritza G; Rodriguez, Alejandro; Alcântara-Neves, Neuza M; Genser, Bernd; de Carvalho, Lain Pontes; Stein, Renato T; Cruz, Alvaro A; Rodrigues, Laura C; Barreto, Mauricio L

    2006-01-01

    Background Asthma and allergic diseases are becoming increasingly frequent in children in urban centres of Latin America although the prevalence of allergic disease is still low in rural areas. Understanding better why the prevalence of asthma is greater in urban migrant populations and the role of risk factors such as life style and environmental exposures, may be key to understand what is behind this trend. Methods/design The Esmeraldas-SCAALA (Social Changes, Asthma and Allergy in Latin America) study consists of cross-sectional and nested case-control studies of school children in rural and urban areas of Esmeraldas Province in Ecuador. The cross-sectional study will investigate risk factors for atopy and allergic disease in rural and migrant urban Afro-Ecuadorian school children and the nested case-control study will examine environmental, biologic and social risk factors for asthma among asthma cases and non-asthmatic controls from the cross-sectional study. Data will be collected through standardised questionnaires, skin prick testing to relevant aeroallergen extracts, stool examinations for parasites, blood sampling (for measurement of IgE, interleukins and other immunological parameters), anthropometric measurements for assessment of nutritional status, exercise testing for assessment of exercise-induced bronchospasm and dust sampling for measurement of household endotoxin and allergen levels. Discussion The information will be used to identify the factors associated with an increased risk of asthma and allergies in migrant and urbanizing populations, to improve the understanding of the causes of the increase in asthma prevalence and to identify potentially modifiable factors to inform the design of prevention programmes to reduce the risk of allergy in urban populations in Latin America. PMID:16970809

  11. [Syphilitic pleuritis. Description of a clinical case].

    PubMed

    Cattini, G C; Greco, N; Tosto, L; Falcieri, E; Biagini, G

    1983-02-25

    A rare case of luetic pleurisy diagnosed in a patient with tertiary syphilis, when the aetiological agent was discovered in the pleuritic exudate is described. The spirochaetes, first revealed by dark field microscopy, were studied further under the electron microscope, using negative colouring and fine sections.

  12. Exploring incomplete fusion fraction in 6,7Li induced nuclear reactions

    NASA Astrophysics Data System (ADS)

    Parkar, V. V.; Jha, V.; Kailas, S.

    2017-11-01

    We have included breakup effects explicitly to simultaneously calculate the measured cross-sections of the complete fusion, incomplete fusion, and total fusion for 6,7Li projectiles on various targets using the Continuum Discretized Coupled Channels method. The breakup absorption cross-sections obtained with different choices of short range imaginary potentials are utilized to evaluate the individual α-capture and d/t-capture cross-sections and compare with the measured data. It is interesting to note, while in case of 7Li projectile the cross-sections for triton-ICF/triton-capture is far more dominant than α-ICF/α-capture at all energies, similar behavior is not observed in case of 6Li projectile for the deuteron-ICF/deuteron-capture and α-ICF/α-capture. Both these observations are also corroborated by the experimental data for all the systems studied.

  13. Use of remote video microscopy (telepathology) as an adjunct to neurosurgical frozen section consultation.

    PubMed

    Becker, R L; Specht, C S; Jones, R; Rueda-Pedraza, M E; O'Leary, T J

    1993-08-01

    We investigated the use of remote video microscopy (telepathology) to assist in the diagnosis of 52 neurosurgical frozen section cases. The TelMed system (Discovery Medical Systems, Overland Park, KS), in which the referring pathologist selects appropriate fields for transmission to the consultant, was used for the study. There was a high degree of concordance between the diagnosis rendered on the basis of transmitted video images and that rendered on the basis of direct evaluation of frozen sections; however, in seven cases there was substantial disagreement. Remote evaluation was associated with a more rapid consultation from the standpoint of the consultant, who spent approximately 2 minutes less per case when using remote microscopy; this was achieved at the expense of considerably greater effort on the part of the referring pathologist, who spent approximately 16 minutes per case selecting an average of 4.5 images for transmission to the consultant. The use of remote video microscopy for pathology consultation is associated with a complex series of tradeoffs involving cost, information loss, and timeliness of consultation.

  14. Image selection in static telepathology through the Internet.

    PubMed

    Della Mea, V; Cataldi, P; Boi, S; Finato, N; Della Palma, P; Beltrami, C A

    1998-01-01

    A telepathology study was carried out to examine the differences occurring when the images were selected by an experienced pathologist, a junior pathologist and a first-year resident. One hundred and fifty-five consecutive frozen-section pathology cases were collected and sent for consultation to a remote experienced pathologist using multimedia email. Local diagnoses (as reported in the files of the Institute, not from the image selector) and remote diagnoses (based on the images) were compared with those performed on paraffin-embedded sections. Acquisition time and number of selected images were recorded for each case and used to compare the different behaviour of the three local pathologists. Of the 155 cases sent by telepathology, four were considered insufficient for a diagnosis by the remote pathologist and thus the diagnosis was postponed. In the remaining 151 cases, the overall diagnostic agreement between remote and definitive diagnosis was 96.7%. The results indicate that in the routine diagnostic work of a frozen-section service, an inexperienced pathologist can select images which are sufficiently informative for a remote diagnosis, in a sufficiently short time.

  15. Video Cases. [SITE 2002 Section].

    ERIC Educational Resources Information Center

    Talley, Sue, Ed.

    This document contains the following papers on video case studies from the SITE (Society for Information Technology & Teacher Education) 2002 conference: (1) "Developing Digital Video Resources To Improve Teaching with Technology: The PT3--'Best Practices' Project"; (2) "Portraits of Three Schools from the U.S.A. Exemplary Technology-Supported…

  16. Diagnostic accuracy of frozen-section analysis of cancer-containing bladder transurethral resection specimens for the presence of muscularis propria invasion.

    PubMed

    Goyal, Rajen; Zhu, Bing; Parimi, Vamsi; Lin, Xiaoqi; Rohan, Stephen M

    2014-07-01

    Frozen section (FS) consultation is generally an accurate diagnostic modality. At our institution, we are frequently asked to assess transurethral resection specimens (TURBT) at FS for muscularis propria (MP) invasion by carcinoma. This study documents our experience in evaluating cancer-containing TURBT specimens at FS for MP invasion. 32 TURBT sent for FS from 2008-2010 were identified. The FS and permanent section (PS) diagnoses were reviewed. Cases excluded from the calculation of test performance included: (1) cases without cancer on FS or PS slides, (2) FS diagnosis deferred, (3) cases without MP on FS and subsequent PS slides. Sensitivity (SEN), specificity (SPEC), positive predictive value (PPV), and negative predictive value (NPV) for identifying MP invasion at FS were calculated. In 6 cases, no cancer was present in FS or PS slides (18%). The FS diagnosis was deferred on 3 cases (9%). In one case (3%) MP was not present in the FS or the subsequent PS slides. Of the remaining 22 cases, 2 false positive and 6 false negative diagnoses of MP invasion were identified. The test performance for FS assessment of MP invasion in TURB were SEN=33%, SPEC=84%, PPV=60%, and NPV=64%. Identifying MP invasion on PS can be difficult, and our results suggest that this is more difficult at FS. Though this study is based on small numbers, our results point to the conclusion that examination of TURBT specimens for MP invasion is best done on PS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Weaknesses in the reporting of cross-sectional studies according to the STROBE statement: the case of metabolic syndrome in adults from Peru.

    PubMed

    Tapia, Jose Carlos; Ruiz, Eloy F; Ponce, Oscar J; Malaga, German; Miranda, Jaime

    2015-12-30

    The inadequate reporting of cross-sectional studies, as in the case of the prevalence of metabolic syndrome, could cause problems in the synthesis of new evidence and lead to errors in the formulation of public policies. To evaluate the reporting quality of the articles regarding metabolic syndrome prevalence in Peruvian adults using the STROBE recommendations. We conducted a thorough literature search with the terms "Metabolic Syndrome", "Sindrome Metabolico" and "Peru" in MEDLINE/PubMed, LILACS, SciELO, LIPECS and BVS-Peru until December 2014. We selected those who were population-based observational studies with randomized sampling that reported prevalence of metabolic syndrome in adults aged 18 or more of both sexes. Information was analysed through the STROBE score per item and recommendation. Seventeen articles were included in this study. All articles met the recommendations related to the report of the study's rationale, design, and provision of summary measures. The recommendations with the lowest scores were those related to the sensitivity analysis (8%, n= 1/17), participant flowchart (18%, n= 3/17), missing data analysis (24%, n= 4/17), and number of participants in each study phase (24%, n= 4/17). Cross-sectional studies regarding the prevalence of metabolic syndrome in peruvian adults have an inadequate reporting on the methods and results sections. We identified a clear need to improve the quality of such studies.

  18. Work Habits of Students in Traditional and Online Sections of an Introductory Physics Course: A Case Study

    ERIC Educational Resources Information Center

    Kortemeyer, Gerd

    2016-01-01

    The study compares the work habits of two student groups in an introductory physics course, one in traditional and one in online sections. Both groups shared the same online materials and online homework, as well as the same discussion boards and examinations, but one group in addition had traditional lectures. The groups were compared with…

  19. Higher Education and Employment: The Changing Relationship. The Case of the Humanities and Social Science. Country Study: Sweden.

    ERIC Educational Resources Information Center

    Andersson, Dan; And Others

    This report, one of a series of country studies on higher education and employment, particularly in the humanities and social sciences, looks at employment for social science and humanities graduates in Sweden. Following an introduction in section 1, section 2 offers a short description of the evolution of humanities and social sciences in Swedish…

  20. The Wall Interference of a Wind Tunnel of Elliptic Cross Section

    NASA Technical Reports Server (NTRS)

    Tani, Itiro; Sanuki, Matao

    1944-01-01

    The wall interference is obtained for a wind tunnel of elliptic section for the two cases of closed and open working sections. The approximate and exact methods used gave results in practically good agreement. Corresponding to the result given by Glauert for the case of the closed rectangular section, the interference is found to be a minimum for a ratio of minor to major axis of 1:square root of 6 This, however, is true only for the case where the span of the airfoil is small in comparison with the width of the tunnel. For a longer airfoil the favorable ellipse is flatter. In the case of the open working section the circular shape gives the minimum interference.

  1. Case Citations 1991. Eleventh Series.

    ERIC Educational Resources Information Center

    Sharp, Linda A., Ed.

    Case citations from five legal areas--college students, liability on campus, sport law, employment, and employment discrimination--are presented in this document. Each section offers brief summaries of cases and concludes with a table of cases. The first section on college students examines litigation involving student finances, disciplinary…

  2. Oxidative stress and frailty: A systematic review and synthesis of the best evidence.

    PubMed

    Soysal, Pinar; Isik, Ahmet Turan; Carvalho, Andre F; Fernandes, Brisa S; Solmi, Marco; Schofield, Patricia; Veronese, Nicola; Stubbs, Brendon

    2017-05-01

    Oxidative stress (OS) is associated with accelerated aging. Previous studies have suggested a possible relationship between OS and frailty but this association remains unclear. We conducted a systematic review to investigate potential interactions between OS and frailty. A systematic literature search of original reports providing data on 'OS and antioxidant' parameters and frailty was carried out across major electronic databases from inception until May 2016. Cross-sectional/case control and longitudinal studies reporting data on the association between frailty and anti-oxidants-OS biomarkers were considered for inclusion. Results were summarized with a synthesis based on the best evidence. From 1856 hits, 8 studies (cross-sectional/case control) were included (N=6349; mean age of 75±12years; 56.4% females). Overall, there were 588 (=9.3%) frail, 3036 pre-frail (=47.8%), 40 (=0.6%) pre-frail/robust, and 2685 (=42.3%) robust subjects. Six cross-sectional/case control studies demonstrated that frailty was associated with an increase in peripheral OS biomarkers, including lipoprotein phospholipase A2 (1 study), isoprostanes (2 studies), malonaldehyde (2 studies), 8-hydroxy-20-deoxyguanosine (2 studies), derivate of reactive oxygen metabolites (2 studies), oxidized glutathione/glutathione (1 study), 4-hydroxy-2,3-nonenal (1 study), and protein carbonylation levels (1 study). In addition, preliminary evidence points to lower anti-oxidant parameters (vitamin C, E, α-tocopherol, biological anti-oxidant potential, total thiol levels) in frailty. Frailty and pre-frailty appear to be associated with higher OS and possibly lower anti-oxidant parameters. However, due to the cross-sectional design, it is not possible to disentangle the directionality of the relationships observed. Thus, future high-quality and in particular longitudinal research is required to confirm or refute these relationships and to further elucidate pathophysiological mechanisms. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Mode of delivery following successful external cephalic version: comparison with spontaneous cephalic presentations at delivery.

    PubMed

    Kuppens, Simone M I; Hutton, Eileen K; Hasaart, Tom H M; Aichi, Nassira; Wijnen, Henrica A; Pop, Victor J M

    2013-10-01

    To compare the obstetric outcomes of pregnant women after successful external cephalic version (ECV) (cases) with a large group of pregnant women with a spontaneously occurring cephalic fetal position at delivery (controls). We conducted a retrospective matched cohort study in a teaching hospital in the Netherlands. Delivery outcomes of women with a successful ECV were compared with those of women with spontaneously occurring cephalic presentations, controlling for maternal age, parity, gestational age at delivery, and onset of labour (spontaneous or induced). Exclusion criteria were a history of Caesarean section, delivery at < 35 weeks, and elective Caesarean section. The primary outcome was the prevalence of Caesarean section and instrumental delivery in both groups; secondary outcomes were the characteristics of cases requiring intervention such as Caesarean section or instrumental delivery. Women who had a successful ECV had a significantly higher Caesarean section rate than the women in the control group (33/220 [15%] vs. 62/1030 [6.0 %]; P < 0.001). There was no difference in the incidence of instrumental delivery (20/220 [9.1%] vs. 103/1030 [10%]). Comparison of characteristics of women in the cases group showed that nulliparity, induction of labour, and occiput posterior presentation were associated with Caesarean section and instrumental deliveries. Compared with delivery of spontaneous cephalic presenta-tions, delivery of cephalic presenting babies following successful ECV is associated with an increased rate of Caesarean section, especially in nulliparous women and women whose labour is induced.

  4. 8 CFR 204.3 - Orphan cases under section 101(b)(1)(F) of the Act (non-Convention cases).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... advanced processing application (or the advanced processing application concurrently with the orphan... home study preparer and/or fingerprint check. Advanced processing application means Form I-600A (Application for Advanced Processing of Orphan Petition) completed in accordance with the form's instructions...

  5. 8 CFR 204.3 - Orphan cases under section 101(b)(1)(F) of the Act (non-Convention cases).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... advanced processing application (or the advanced processing application concurrently with the orphan... home study preparer and/or fingerprint check. Advanced processing application means Form I-600A (Application for Advanced Processing of Orphan Petition) completed in accordance with the form's instructions...

  6. 8 CFR 204.3 - Orphan cases under section 101(b)(1)(F) of the Act (non-Convention cases).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... advanced processing application (or the advanced processing application concurrently with the orphan... home study preparer and/or fingerprint check. Advanced processing application means Form I-600A (Application for Advanced Processing of Orphan Petition) completed in accordance with the form's instructions...

  7. 8 CFR 204.3 - Orphan cases under section 101(b)(1)(F) of the Act (non-Convention cases).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... advanced processing application (or the advanced processing application concurrently with the orphan... home study preparer and/or fingerprint check. Advanced processing application means Form I-600A (Application for Advanced Processing of Orphan Petition) completed in accordance with the form's instructions...

  8. 8 CFR 204.3 - Orphan cases under section 101(b)(1)(F) of the Act (non-Convention cases).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... advanced processing application (or the advanced processing application concurrently with the orphan... home study preparer and/or fingerprint check. Advanced processing application means Form I-600A (Application for Advanced Processing of Orphan Petition) completed in accordance with the form's instructions...

  9. Sexual Assault of Older Women by Strangers

    ERIC Educational Resources Information Center

    Lea, Susan J.; Hunt, Laura; Shaw, Steve

    2011-01-01

    This study examines victim, offender, and offence characteristics associated with sexual assaults by strangers of older women compared to those against younger women. Cases are obtained from the Serious Crime Analysis Section of the United Kingdom National Policing Improvement Agency (NPIA; formerly Centrex). All possible cases of rape, attempted…

  10. [Risk factors for bladder injuries during cesarean section].

    PubMed

    Alcocer Urueta, Jaime; Bonilla Mares, Marcela; Gorbea Chávez, Viridiana; Velázquez Valassi, Beatriz

    2009-01-01

    To identify risk factors for bladder injury during cesarean delivery, to let patients and doctors know them and their importance. We conducted a case-control study of women undergoing cesarean delivery at the Instituto Nacional de PerinatologíaIsidro Espinosa de los Reyes between January 2001 and December 2007. Cases were women with bladder injuries at the time of cesarean section. Two controls per case were selected randomly. Medical records were reviewed for clinical and demographic data to compare them. Twenty-one bladder injuries were identified among 24, 057 cesarean sections, (incidence 0.087%), only 19 were analized. Prior cesarean section was more prevalent among cases than controls (63% vs 42% p 0.134), with an OR of 2.35 (95% CI 0.759-7.319), when we take only patients with one cesarea in contrast with no cesarea the OR is 3.75 (95% CI 1.002- 14.07). Statistically significant differences (P values < .05) between cases and controls were found in gestacional age (38.16 vs 37.35 weeks), prior cesareans (42% vs 18%), adhesions (79% vs 5%), Odds ratio of 67.5 (95% CI 11.14- 408), VBAC (31.5 vs 3%), median skin incisión (16% vs 68%), Pfannenstiel (84% vs 32%), blood loss (744cc vs 509cc) and length of surgery 135 vs 58 minutes). No differences were found among age, BMI, prior surgery, labor, premature rupture of membranes, station, chorioamnioitis, induction, uterine incision, timing of delivery, uterine rupture. Prior cesarean section and adhesions are risk factors for bladder injury at the time of repeat cesarean delivery. Elective cesarean delivery is valid but it is duty of physicians to inform patients the risks of it.

  11. A case study on the successful management of Cotard's syndrome in pregnancy: Case Reports.

    PubMed

    Howe, G; Srinivasan, M

    1999-01-01

    Cotard's Syndrome is rare and no cases have been reported in pregnancy. We describe a case of a woman in the third trimester who attempted suicide by jumping out of a window, sustaining multiple fractures. Delivery of her baby by Caesarean section and orthopaedic intervention was necessary before electroconvulsive therapy (ECT) could be administered, resulting in a successful outcome for both mother and child. (Int J Psych Clin Pract 1999; 3: 293-295).

  12. Intraoperative consultation of central nervous system lesions. Frozen section, cytology or both?

    PubMed

    Sharifabadi, Ali Haidari; Haeri, Hayedeh; Zeinalizadeh, Mehdi; Zargari, Neda; Razavi, Amirnader Emami; Shahbazi, Nargess; Tahvildari, Malahat; Azmoudeh-Ardalan, Farid

    2016-03-01

    Frozen section is the traditional method of assessing central nervous system (CNS) lesions intraoperatively. Our aim is to determine the diagnostic accuracy of frozen section and/or cytological evaluation of CNS lesions in our center. A total of 157 patients with CNS lesions underwent open surgical biopsy or excision in our center during a period of 2 years (2012-2013). All specimens were studied cytologically; of these specimens, 146 cases were also examined by frozen section. Cytology and frozen section slides were studied separately by two general pathologists who were blind to final diagnoses. The final diagnoses were based on permanent sections and IHC studies. The accuracy rates of frozen section analysis and cytological evaluation were 87% and 86%, respectively. If the two methods were considered together, the accuracy rate improved to about 95%. Cytological evaluation is an acceptable alternative to frozen section analysis and also a great supplement to the diagnosis of CNS lesions. Copyright © 2015 Elsevier GmbH. All rights reserved.

  13. Anatomical variations of the arterial pattern in the right hemiliver.

    PubMed

    Mlakar, Bostjan; Gadzijev, Eldar M; Ravnik, Dean; Hribernik, Marija

    2002-12-01

    The arterial supply to the right hemiliver was studied in 80 liver casts. The arteries were divided into 10 groups according to their origin and branching pattern. The right hemiliver was supplied by one artery in 96% of cases and by two arteries in 4%. When there was only one artery it originated from the proper hepatic artery in 73/77 cases and from the superior mesenteric artery in 4/77 cases. The replacing right hepatic artery which originated from the superior mesenteric vessel supplied the whole right hemiliver in 5% of cases. The incomplete replacing right hepatic artery which supplied only a part of the right hemiliver was found in 4% of cases. The anterior section (segments 5 and 8) was supplied by one artery in 61%, by two arteries in 30% and by three arteries in 9% of cases. The posterior section (segments 6 and 7) was supplied by one artery in 66%, by two arteries in 31% and by three arteries in 3% of cases. Segments 5 and 7 were predominantly supplied by one artery, whereas segments 6 and 8 by two arteries.

  14. Successful use of balloon tamponade in the management of postpartum hemorrhage in a case of bicornuate uterus.

    PubMed

    Khan, Erum Saleem; Basharat, Ayesha

    2018-01-01

    Worldwide 50%-70% of all cases of maternal morbidity have been attributed to postpartum hemorrhage. This report discusses a case of bicornuate uterus in a term pregnancy. The delivery was by cesarean section, which was followed by massive postpartum hemorrhage, managed successfully with balloon tamponade. This is the second reported case of successful management of post partum hemorrhage in a bicornuate uterus with balloon tamponade. A 22-year-old primigravida at 39 weeks of gestational age presented with vaginal leaking of clear fluid. Cesarean section was done due to meconium stained liquor in early labor; with an incidental finding of bicornuate uterus followed by massive postpartum hemorrhage managed successfully with balloon tamponade. The use of uterine balloon tamponade as an effective method to control postpartum hemorrhage has been studied extensively, but use in cases of hemorrhage associated with uterine malformations has not been reported much in literature. Use of uterine balloon tamponade in case of uterine malformations has been highlighted in our case as an effective non-surgical method to control hemorrhage.

  15. Decision-case mix model for analyzing variation in cesarean rates.

    PubMed

    Eldenburg, L; Waller, W S

    2001-01-01

    This article contributes a decision-case mix model for analyzing variation in c-section rates. Like recent contributions to the literature, the model systematically takes into account the effect of case mix. Going beyond past research, the model highlights differences in physician decision making in response to obstetric factors. Distinguishing the effects of physician decision making and case mix is important in understanding why c-section rates vary and in developing programs to effect change in physician behavior. The model was applied to a sample of deliveries at a hospital where physicians exhibited considerable variation in their c-section rates. Comparing groups with a low versus high rate, the authors' general conclusion is that the difference in physician decision tendencies (to perform a c-section), in response to specific obstetric factors, is at least as important as case mix in explaining variation in c-section rates. The exact effects of decision making versus case mix depend on how the model application defines the obstetric condition of interest and on the weighting of deliveries by their estimated "risk of Cesarean." The general conclusion is supported by an additional analysis that uses the model's elements to predict individual physicians' annual c-section rates.

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

    PubMed

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

    2014-12-01

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

  17. The Social Computer

    NASA Astrophysics Data System (ADS)

    Serugendo, Giovanna Di Marzo; Risoldi, Matteo; Solemayni, Mohammad

    The following sections are included: * Introduction * Problem and Research Questions * State of the Art * TSC Structure and Computational Awareness * Methodology and Research Directions * Case Study: Democracy * Conclusions

  18. Findings from case studies of state and local immunization programs.

    PubMed

    Fairbrother, G; Kuttner, H; Miller, W; Hogan, R; McPhillips, H; Johnson, K A; Alexander, E R

    2000-10-01

    As part of its examination of federal support for immunization services during the past decade, the Institute of Medicine (IOM) Committee on Immunization Finance Policies and Practices (IFPP) commissioned eight case studies of the states of Alabama, Maine, Michigan, New Jersey, North Carolina, Texas, and Washington; and a two-county study of Los Angeles and San Diego in California. Specifically, the IOM Committee and these studies reviewed the use of Section 317 grants by the states. Section 317 is a discretionary grant program that supports vaccine purchase and other immunization-related program activities. These studies afforded the Committee an in-depth look at local policy choices, the performance of immunization programs, and federal and state spending for immunization during the past decade. The case-study reports were developed through interviews with state and local health department officials, including immunization program directors, Medicaid agency staff, budget analysts, and Centers for Disease Control and Prevention public health advisors to the jurisdiction. Other sources included state and federal administrative records and secondary sources on background factors and state-level trends. The case studies were supplemented by site visits to Detroit, Houston, Los Angeles, Newark, and San Diego. The nature of immunization "infrastructure" supported by the Section 317 program is shifting from primarily service delivery to a broader set of roles that puts the public effort at the head of a broad immunization partnership among public health, health financing, and other entities in both the public and private sectors. The rate and intensity of transition vary across the case-study areas. In the emerging pattern, service delivery increasingly takes place in the private sector and is related to managed care. "Infrastructure" is moving beyond supporting a core state staff and local health department service delivery to include such activities as immunization registries, quality improvement, and coordination with programs outside public health agencies. At the same time, the recent decline in federal Section 317 support is forcing difficult choices between old and new activities at the state and local levels. Immunization programs function as an organic component of the local health care financing and delivery systems of which they are a part. Immunization efforts are organized and conducted within distinctive state and local fiscal, economic, and health care contexts. Section 317 Financial Assistance grants, while playing a vital role in supporting immunization "infrastructure," have been too unstable and unpredictable to elicit the strategic planning, programming, and own-source spending that would be optimal for state and local programs. The predominant immunization function of state and local public health agencies is becoming assurance of age-appropriate immunization throughout the lifespan. To be successful in this emerging role, the health agencies must be supported with appropriate staffing, interagency collaboration, and clearly articulated authority.

  19. Preassembled Building Components. Proceedings of a Program Conducted as Part of the Conferences of the Building Research Institute Division of Engineering and Industrial Research (Fall 1960).

    ERIC Educational Resources Information Center

    National Academy of Sciences - National Research Council, Washington, DC.

    Four aspects of preassembled building components are discussed--(1) attitudes on preassembled components, (2) principles of preassembled components construction, (3) structural component case studies, and (4) mechanical component case studies. In section 1, various views on preassembled components are discussed including--(1) the architect's view,…

  20. 14 CFR 399.62 - Target dates in hearing cases.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

  1. 14 CFR 399.62 - Target dates in hearing cases.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

  2. 14 CFR 399.62 - Target dates in hearing cases.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

  3. 14 CFR 399.62 - Target dates in hearing cases.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

  4. 14 CFR 399.62 - Target dates in hearing cases.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Target dates in hearing cases. 399.62... Target dates in hearing cases. (a) Applicability. This section applies to initial and recommended.... (b) Issuance of target dates. In cases to which this section applies, the Board or the administrative...

  5. Evidence-Based Advances in Reptile Medicine.

    PubMed

    Mitchell, Mark A; Perry, Sean M

    2017-09-01

    Evidence-based medicine allows veterinarians to practice high-quality medicine, because the basis for all decision making is quantitative, objective, and reproducible. Case reports and case series are limited in their scope and application. Cross-sectional studies, likewise, cannot provide answers to specific variable testing with a temporal application. It is essential for the reptile specialty to expand into case-control studies, cohort studies, and experimental/intervention studies. Unfortunately, much of the reptile literature remains limited to descriptive studies. This article reviews current evidence-based topics in reptile medicine and shares how everyone practicing in the field can contribute to improving this specialty. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Probing the mechanism for Deep Submarine Groundwater Discharge using a Case Study in the Levant Basin (Achziv Canyon)

    NASA Astrophysics Data System (ADS)

    Paldor, A.; Aharonov, E.; Katz, O.

    2017-12-01

    Deep Submarine Groundwater Discharge (DSGD) is a ubiquitous and highly significant phenomenon, yet it remains poorly understood. Here we use numerical modeling (FEFLOW) to investigate a case study of DSGD offshore northern Israel, aiming to unravel the main features and mechanics of steady-state DSGD: the hydrology that enables its formation, the controls on rates and salinity of seepage, and the residence time of fluid underground. In addition, we investigate the geometry of the fresh-salt water interface within the seeping offshore aquifer. The first part of this work constructs a large scale (70 km) geologic cross-section of our case-study region. The mapping suggests outcropping of confined aquifer strata (Upper Cenomanian Judea Group) on the continental shelf break, 5-15 km offshore. The second part consists of hydrological simulations of DSGD from a confined aquifer similar to the case-study aquifer. The main findings are thus: steady-state DSGD from a confined aquifer occurs far offshore even under moderate heads. It is accompanied by a circulation cell that forms around an intrinsic freshwater-seawater interface. Circulation consists of seawater entering the confined aquifer at the exposed section offshore, mixing with terrestrial groundwater within the aquifer, and seeping saline water out the upper part of the exposed section. In addition, the simulated confined aquifer displays a very flat fresh-salt water interface extending far offshore, as observed in natural offshore aquifers. Preliminary results of a hydrographic survey in the area of study suggest a low-salinity anomaly close to the seafloor, implying seepage of brines in that area, as expected from the model. These new insights have potentially important implications for coastal hydrology, seawater chemistry, biogeochemistry, and submarine slope instability.

  7. Caesarean section and asthma in Malaysian children: a case-control study.

    PubMed

    Nathan, Anna Marie; de Bruyne, Jessie; Khalid, Farah; Arumugam, Kulantheran

    2012-09-01

    Birth cohort studies in some countries have shown a link between caesarean section and asthma. To determine if there is an association between asthma and delivery via caesarean section in Malaysian children. This is a case-control study involving 156 children aged 3-15 years old, in a tertiary hospital in Kuala Lumpur, Malaysia. Seventy-eight children with a confirmed diagnosis of asthma and seventy-eight age-matched controls (no history of asthma or wheezing) were enrolled. Demographic data including mode of delivery and family history of allergic disorders was obtained. Total serum immunoglobulin E (IgE) was measured and skin prick tests (SPT) to 6 common aeroallergens were performed. The median age of the patients was 8 years old. One hundred and three (66%) children were delivered via normal vaginal delivery, 8 (5.1%) via assisted vaginal delivery and 45 children (28.9%) via caesarean section. Delivery via caesarean section was not significantly associated with asthma (OR = 1.21 [95% CI 0.60-2.41], p = 0.596). Children delivered via caesarean section did not have higher IgE levels nor were they more sensitized to aeroallergens. Multiple logistic regression showed that asthma was significantly associated with a positive family history of atopy (OR = 13.8 [95% CI 5.96, 32.1], p < 0.001). Introduction of semi-solid food after 6 months old had a protective effect against asthma (OR = 0.97 [95% CI 0.94, 0.99], p = 0.034). Childhood asthma in Malaysian children was not associated with delivery by caesarean section.

  8. Red, orange and green Caesarean sections: a new communication tool for on-call obstetricians.

    PubMed

    Dupuis, Olivier; Sayegh, Isabelle; Decullier, Evelyne; Dupont, Corinne; Clément, Henri-Jacques; Berland, Michel; Rudigoz, René-Charles

    2008-10-01

    To evaluate the effect of a novel communication tool, related to the degree of urgency for Caesarean sections (CSs), on the decision-to-delivery interval for emergency CS. Red CS are very urgent cases corresponding to life-threatening maternal or foetal situations, orange CS are urgent cases and green CS are non-urgent intrapartum CS. We carried out this cohort study in a French maternity hospital. The study included all emergency Caesarean sections during two 6-month periods, before and after introduction of the code. We compared the decision-to-delivery interval of the two study periods. Our study included 174 emergency CS. The mean decision-to-delivery interval after introduction of the code was 31.7 min, significantly shorter (p=0.02) than the 39.6 min interval before introduction of the colour code. Except for the preparation time, each time interval decreased. This included transporting the patient into the operating theatre, and the incision-to-delivery time interval. This study suggests that the use of the three-colour code could significantly shorten the decision-to-delivery interval in emergency CS. Further prospective studies are needed to confirm this result.

  9. Do Acute Myocardial Infarction and Heart Failure Readmissions Flagged as Potentially Preventable by the 3M Potentially Preventable Readmissions Software Have More Process-of-Care Problems?

    PubMed

    Borzecki, Ann M; Chen, Qi; Mull, Hillary J; Shwartz, Michael; Bhatt, Deepak L; Hanchate, Amresh; Rosen, Amy K

    2016-09-01

    The 3M Potentially Preventable Readmissions (3M-PPR) software matches clinically related index admission and readmission diagnoses that may signify in-hospital or postdischarge quality problems. To assess whether the PPR algorithm identifies preventable readmissions, we compared processes of care between PPR software-flagged and nonflagged cases. Using 2006 to 2010 national VA administrative data, we identified acute myocardial infarction and heart failure discharges associated with 30-day all-cause readmissions, then flagged cases (PPR-Yes/PPR-No) using the 3M-PPR software. To assess care quality, we abstracted medical records of 100 readmissions per condition using tools containing explicit processes organized into admission work-up, in-hospital evaluation/treatment, discharge readiness, postdischarge period. We derived quality scores, scaled to a maximum of 25 per section (maximum total score=100) and compared cases on total and section-specific mean scores. For acute myocardial infarction, 77 of 100 cases were flagged as PPR-Yes. Section quality scores were highest for in-hospital evaluation/treatment (20.5±2.8) and lowest for postdischarge care (6.8±9.1). Total and section-related mean scores did not differ by PPR status; respective PPR-Yes versus PPR-No total scores were 61.6±11.1 and 60.4±9.4; P=0.98. For heart failure, 86 of 100 cases were flagged as PPR-Yes. Section scores were highest for discharge readiness (18.8±2.4) and lowest for postdischarge care (7.3±8.1). Like acute myocardial infarction, total and section-related mean scores did not differ by PPR status; PPR-Yes versus PPR-No total scores were 61.2±10.8 and 63.4±7.0, respectively; P=0.47. Among VA acute myocardial infarction and heart failure readmissions, the 3M-PPR software does not distinguish differences in case-level quality of care. Whether 3M-PPR software better identifies preventable readmissions by using other methods to capture poorly documented processes or performing different comparisons requires further study. © 2016 American Heart Association, Inc.

  10. Fixed Route Accessible Bus Service in Connecticut : A Case Study

    DOT National Transportation Integrated Search

    1981-07-01

    U.S. Department of Transportation regulations implementing Section 504 of the Rehabilitation Act of 1973, require transit agencies to provide wheelchair accessibility on fixed-route bus service. The study is part of the series which included studies ...

  11. [Value of computer tomography in the managment of brain injuries].

    PubMed

    Keita, A D; Toure, M; Sissako, A; Doumbia, S; Coulibaly, Y; Doumbia, D; Kane, M; Diallo, A K; Toure, A A; Traore, I

    2005-11-01

    The purpose of this prospective study conducted from January 2001 to December 2001 was to ascertain the value of computer tomography for evaluation of brain injuries. Computer tomography was performed using a Toshiba X VID system with contiguous 5 mm axial sections through the posterior fossa and 10 mm contiguous axial sections through the subtentorial region without contrast injection. A total of 107 patients with brain injuries were enrolled over the one-year study period. These patients accounted for 0.8% of all admissions to surgical emergency unit of Gabriel Toure Hospital in Bamako, Mali. The predominant age group for brain injuries was the 20- to 29-year-old group (35 cases). The male-to-female sex ratio was 5:1. Vehicular accident was the most frequent cause of brain injury (76 cases). Trauma was severe in 48 patients with a Glasgow score less than 8. Coma occurred immediately after injury in 90 cases. Ventricular hemorrhage led to coma in 100% of cases whereas brain hemorrhage and hematoma led to coma in 93.3% and 83.3% of cases respectively. Treatment was medical in 99 cases and neurosurgical in 8. The mortality rate was 34% and the morbidity rate (permanent sequels) was 36%. Computer tomography is a valuable tool for therapeutic decision-making in medico-surgical emergencies involving brain injuries.

  12. Dietary habits after myocardial infarction - results from a cross-sectional study.

    PubMed

    Wallström, P; Mattisson, I; Tydén, P; Berglund, G; Janzon, L

    2005-04-01

    Comparing habitual nutrient intakes in persons with a history of acute myocardial infarction (AMI), and age-matched controls. Design. Cross-sectional study. Subjects. Men and women (525 cases and 1890 matched controls), aged 47-73 years, of the population-based Malmö Diet and Cancer cohort. Nutrient intakes were assessed by a validated modified diet history method. Body fatness was assessed by bioimpedance analysis. Case ascertainment was provided by national and regional registries. Men and women were analysed separately. Median time since AMI was 5.5 years in men and 3.8 years in women. Cases reported lower energy intakes (EIs) than controls, despite having similar basal metabolic rates. After adjustment for total EI, both male and female cases had lower fat intake and higher intake of several micronutrients, such as ascorbic acid, folate, and vitamin E, than controls, the difference being largest in men. Most of the cases reporting dietary change quoted 'disease' as their main reason for change. They had lower EI and lower energy-adjusted intake of fat than other cases. Survivors of AMI reported dietary habits more in line with current recommendations, particularly those who afterwards reported having changed their dietary habits. The possible bias introduced by social desirability is discussed.

  13. Appraisal of cooperation with a palliative care case manager by general practitioners and community nurses: a cross-sectional questionnaire study.

    PubMed

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

    2016-01-01

    To investigate how general practitioners and community nurses value the support that they receive from a nurse case manager with expertise in palliative care, whether they think the case manager is helpful in realizing appropriate care and what characteristics of the patient and case management are associated with this view. For sustainable palliative care in an ageing society, basic palliative care is provided by generalists and specialist palliative care is reserved for complex situations. Acceptance of and cooperation with specialist palliative care providers by the general practitioner and community nurse is pivotal. Cross-sectional questionnaire study. Questionnaire data from 168 general practitioners and 125 community nurses were analysed using chi-square tests, univariate and multivariate logistic regression. Data were gathered between March 2011-December 2013. Of general practitioners, 46% rated the case manager as helpful in realizing care that is appropriate for the patient; for community nurses this was 49%. The case manager did not hinder the process of care and had added value for patients, according to the general practitioners and community nurses. The tasks of the case manager were associated with whether or not the case manager was helpful in realizing appropriate care, whereas patient characteristics and the number of contacts with the case manager were not. General practitioners and community nurses are moderately positive about the support from the case manager. To improve cooperation further, case managers should invest in contact with general practitioners and community nurses. © 2015 John Wiley & Sons Ltd.

  14. Decentralization in Education: Technical Demands as a Critical Ingredient.

    ERIC Educational Resources Information Center

    Hannaway, Jane

    The implications of decentralization reform on the amount of serious attention and effort that teachers give to teaching and learning activities are explored in this paper. The discussion is informed by the results of two case studies of school districts recognized as exemplary cases of decentralization. The first section describes limitations of…

  15. Exploring the Geography of America's Religious Denominations: A Presbyterian Example

    ERIC Educational Resources Information Center

    Heatwole, Charles A.

    1977-01-01

    The historically sectional nature of the Presbyterian Church is examined as a case study which illustrates how study of the geography of religious groups can be applied at various academic levels. (AV)

  16. Environmental impact case study : Martinsville bypass.

    DOT National Transportation Integrated Search

    1971-01-01

    At the request of the Environmental Quality Division, the Environmental and Economics Section of the Virginia Highway Research Council conducted an environmental impact study of the proposed Route 220 bypass around Martinsville. This evaluation of th...

  17. Amphetamine-type stimulants and HIV infection among men who have sex with men: implications on HIV research and prevention from a systematic review and meta-analysis

    PubMed Central

    Thu Vu, Nga Thi; Maher, Lisa; Zablotska, Iryna

    2015-01-01

    Introduction HIV infections and the use of amphetamine-type stimulants (ATS) among men who have sex with men (MSM) have been increasing internationally, but the role of ATS use as a co-factor for HIV infection remains unclear. We aimed to summarize the association between ATS use and HIV infection among MSM. Methods We conducted a systematic search of MEDLINE, EMBASE, GLOBAL HEALTH and PsycINFO for relevant English, peer-reviewed articles of quantitative studies published between 1980 and 25 April 2013. Pooled estimates of the association – prevalence rate ratios (PRR, cross-sectional studies), odds ratio (OR, case-control studies) and hazard ratio (HR, longitudinal studies), with 95% Confidence Intervals (CI) – were calculated using random-effects models stratified by study design and ATS group (meth/amphetamines vs. ecstasy). We assessed the existence of publication bias in funnel plots and checked for sources of heterogeneity using meta-regression and subgroup analysis. Results We identified 6710 article titles, screened 1716 abstracts and reviewed 267 full text articles. A total of 35 publications were eligible for data abstraction and meta-analysis, resulting in 56 records of ATS use. Most studies (31/35) were conducted in high-income countries. Published studies used different research designs, samples and measures of ATS use. The pooled association between meth/amphetamine use and HIV infection was statistically significant in all three designs (PRR=1.86; 95% CI: 1.57–2.17; OR=2.73; 95% CI: 2.16–3.46 and HR=3.43; 95% CI: 2.98–3.95, respectively, for cross-sectional, case-control and longitudinal studies). Ecstasy use was not associated with HIV infection in cross-sectional studies (PRR=1.15; 95% CI: 0.88–1.49; OR=3.04; 95% CI: 1.29–7.18 and HR=2.48; 95% CI: 1.42–4.35, respectively, for cross-sectional, case-control and longitudinal studies). Results in cross-sectional studies were highly heterogeneous due to issues with ATS measurement and different sampling frames. Conclusions While meth/amphetamine use was significantly associated with HIV infection among MSM in high-income countries in all study designs, evidence of the role of ecstasy in HIV infection was lacking in cross-sectional studies. Cross-sectional study design, measurement approaches and source populations may also be important modifiers of the strength and the direction of associations. Event-specific measure of individual drug is required to establish temporal relationship between ATS use and HIV infection. HIV prevention programmes targeting MSM should consider including interventions designed to address meth/amphetamine use. PMID:25609214

  18. A comparison of digitized frozen section and smear preparations for intraoperative neurotelepathology.

    PubMed

    Gould, Peter V; Saikali, Stephan

    2012-01-01

    Intraoperative consultations in neuropathology are often assessed by smear preparations rather than by frozen sections. Both techniques are standard practice for light microscopic examination on site, but there is little data comparing these techniques in a telepathology setting. Thirty cases of brain tumours submitted for intraoperative consultation at our institution between July and December 2010 were identified in which both frozen section and tissue smear preparations were available for digitization at 20× magnification. Slides were digitized using a Hamamatsu Nanozoomer 2.0 HT whole slide scanner, and resulting digital images were visualized at 1680 × 1050 pixel resolution with NDP. view software. The original intraoperative diagnosis was concordant with the sign out diagnosis in 29/30 cases; one tumeur was initially interpreted as a high grade glioma but proved to be a lymphoma at sign out. Digitized frozen section slides were sufficient for diagnosis at 10× magnification in 27/30 cases. Digitized tissue smears were sufficient for diagnosis at 10× magnification in 28/30 cases. In two cases tumour was present on the tissue smear but not the frozen section (one case of recurrent astrocytoma, one case of meningeal carcinomatosis). In one case of lymphoma, tumour was present on frozen section only. These discrepancies were attributed to tissue sampling rather than image quality. Examination of digitized slides at higher magnfication (20×) permitted confirmation of mitoses and Rosenthal fibers on tissue smear preparations, but did not change the primary diagnosis. Intra-slide variations in tissue thickness on smear preparations led to variable loss of focus in digitized images, but did not affect image quality in thinner areas of the smear or impede diagnosis. Digitized tissue smears are suitable for intraoperative neurotelepathology and provide comparable information to digitized frozen sections at medium power magnification.

  19. Assessing Self-Efficacy Beliefs and Academic Outcomes: The Case for Specificity and Correspondence.

    ERIC Educational Resources Information Center

    Pajares, Frank

    Guidelines regarding self-efficacy assessment are highlighted in the first section of this paper. In the second section, the issue of specificity versus generality of measurement is clarified. And last, preliminary results of a study of eighth graders (n=172) are presented which demonstrate that: (1) the optimal level of specificity of any…

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

    Coronado-Gonzalez, Jose Antonio; Razo, Luz Maria del; Garcia-Vargas, Gonzalo

    Inorganic arsenic exposure in drinking water has been recently related to diabetes mellitus. To evaluate this relationship the authors conducted in 2003, a case-control study in an arseniasis-endemic region from Coahuila, a northern state of Mexico with a high incidence of diabetes. The present analysis includes 200 cases and 200 controls. Cases were obtained from a previous cross-sectional study conducted in that region. Diagnosis of diabetes was established following the American Diabetes Association criteria, with two fasting glucose values {>=}126 mg/100 ml ({>=}7.0 mmol/l) or a history of diabetes treated with insulin or oral hypoglycemic agents. The next subject studied,more » subsequent to the identification of a case in the cross-sectional study was taken as control. Inorganic arsenic exposure was measured through total arsenic concentrations in urine, measured by hydride-generation atomic absorption spectrophotometry. Subjects with intermediate total arsenic concentration in urine (63.5-104 {mu}g/g creatinine) had two-fold higher risk of having diabetes (odds ratio=2.16; 95% confidence interval: 1.23, 3.79), but the risk was almost three times greater in subjects with higher concentrations of total arsenic in urine (odds ratio=2.84; 95% confidence interval: 1.64, 4.92). This data provides additional evidence that inorganic arsenic exposure may be diabetogenic.« less

  1. Influence of the 2009 financial crisis on detection of advanced pulmonary tuberculosis in Osaka city, Japan: a cross-sectional study.

    PubMed

    Danno, Katsura; Komukai, Jun; Yoshida, Hideki; Matsumoto, Kenji; Koda, Shinichi; Terakawa, Kazuhiko; Iso, Hiroyasu

    2013-01-01

    To investigate the association between the economic recession and the detection of advanced cases of pulmonary tuberculosis in Osaka city from 2007 to 2009. A repeated cross-sectional study. Osaka city has been the highest tuberculosis burden area in Japan. After the previous global financial crisis, the unemployment rate in Osaka prefecture has deteriorated from 5.3% in 2008 to 6.6% in 2009. During the study period, 3406 pulmonary tuberculosis cases were enrolled: 2530 males and 876 females; 1546 elderly cases (65 years and above) and 1860 young cases (under 65 years); 417 homeless cases and 2989 non-homeless cases. Patients' information included the sex, age, registry, health insurances, places of detection, sputum smear test results, patients' delay, doctors' delay and the grade of chest x-ray findings. They were statistically analysed between 2007 and 2008, two years before and just before the financial crisis, and between 2008 and 2009, just before and after the financial crisis. The total numbers of pulmonary tuberculosis cases were 1172 in 2007, 1083 in 2008 and 1151 in 2009. In health examinations for non-homeless people, higher number of cases in 2009 were sputum smear positive, had respiratory symptoms and showed advanced disease in chest x-rays than those in 2008, with a longer patients' delay. On the contrary, in health examination for homeless people, fewer cases of advanced pulmonary tuberculosis were found in 2009 than in 2008, with a shorter patients' delay. In clinical examinations, there was no trend towards a difference between non-homeless and homeless people. Although homeless people might be protected by public assistance, tuberculosis prevention and control need to be reinforced for the non-homeless population after the financial crisis.

  2. Image sampling in static telepathology for frozen section diagnosis.

    PubMed

    Della Mea, V; Cataldi, P; Boi, S; Finato, N; Dalla Palma, P; Beltrami, C A

    1999-10-01

    A frozen section diagnostic service is often not directly available in small rural or mountain hospitals. In these cases, it could be possible to provide frozen section diagnosis through telepathology systems. Telepathology is based on two main methods: static and dynamic. The former is less expensive, but involves the crucial problem of image sampling. To characterise the differences in image sampling for static telepathology when undertaken by pathologists with different experience. As a test field, a previously studied telepathology method based on multimedia email was adopted. Using this method, three pathologists with different levels of experience sampled images from 155 routine frozen sections and sent them to a distant pathology institute, where diagnoses were made on digital images. After the telepathology diagnoses, the glass slides of both the frozen sections and the definitive sections were sent to the remote pathologists for review. Four of 155 transmissions were considered inadequate by the remote pathologist. In the remaining 151 cases, the telepathology diagnosis agreed with the gold standard in 146 (96.7%). There was no significant divergence between the three pathologists in their sampling of the images. Each case comprised five images on average, acquired in four minutes. The overall time for transmission was about 19 minutes. The results suggest that in routine frozen section diagnosis an inexperienced pathologist can sample images sufficiently well to permit remote diagnosis. However, as expected, the internet is too unreliable for such a time dependent task. An improvement in the system would involve integrated real time features, so that there could be interaction between the two pathologists.

  3. Chronic inflammation in refractory hippocampal sclerosis-related temporal lobe epilepsy.

    PubMed

    Gales, Jordan M; Prayson, Richard A

    2017-10-01

    Emerging evidence suggests chronic inflammation may play a role in hippocampal sclerosis-associated temporal lobe epilepsy. We sought to systematically evaluate for its presence in a group of 315 patients who underwent surgery for medically-refractory epilepsy and who had hippocampal sclerosis. Upon histologic review of hematoxylin and eosin stained tissue sections, 95 (41%) cases demonstrated the presence of lymphocytes within the perivascular region and diffusely within the brain parenchyma. Those cases with chronic inflammation evident on hematoxylin and eosin staining were significantly more likely to experience a post-operative seizure recurrence than those without it (p=0.03). In 9 cases of hippocampi with chronic inflammation observed on hematoxylin and eosin stained sections, there was a mixture of both T (CD3+) and B (CD20+) lymphocytes located around blood vessels and interspersed within the brain parenchyma and a predominance of CD4 positive T cells versus CD8 positive cells. Ten hippocampi, apparently devoid of chronic inflammation upon inspection with hematoxylin and eosin stained sections, were stained with the lymphocyte common antigen CD45. In all 10 cases, scattered lymphoid cells were observed in the brain parenchyma, suggesting some level of chronic inflammation may be present in more cases than casual inspection might suggest. This study was the first to evaluate the incidence of chronic inflammation within a large temporal lobe epilepsy population. The study findings suggest chronic inflammation may be a more common component of hippocampal sclerosis -associated temporal lobe epilepsy than previously believed. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. [Caesarean section with vacuum extraction of the head].

    PubMed

    Dimitrov, A; Pavlova, E; Krŭsteva, K; Nikolov, A

    2008-01-01

    The aim of the study is to investigate the benefits and the limits in using the soft cup vacuum extractor on the fetal scalp during the caesarean section. The prospective study includes 19 cases of caesarean sections (group A), with vacuum assisted delivery using the soft cup vacuum extractor on the fetal scalp (diameter 6 cm) and 25 cases (group B) of caesarean sections with usual, manual extraction of the head assisted by fundal compression. All of the patients had undergone a planned caesarean section on term in absence of uterine activity and preserved amniotic membranes. Our results doesn't show differences in the Apgar score on the first and 5-th minute in the newborns of the two groups. The duration of the scalp traction was significantly shorter (30 +/- 4 sec) in comparison to the classical manual extraction (53 +/- 21 sec). The mean duration for applying the vacuum cup was 10 sec and 25 sec for tractions. The total blood loose and total duration of the caesarean sections were shorter than in the control group. The applied traction with the vacuum cup was sufficient for head extraction and there was no need for additional fundal compression. In conclusion we consider that the extraction of the fetal head in high position in caesarean section with vacuum extractor is an easy, non traumatic and rapid method which can put away the need of rough and prolonged fundal compression and its consequences.

  5. Caffeine intake from coffee or tea and cognitive disorders: a meta-analysis of observational studies.

    PubMed

    Kim, Young-Seok; Kwak, Sang Mi; Myung, Seung-Kwon

    2015-01-01

    Observational epidemiological studies such as cross-sectional, case-control, and cohort studies have reported inconsistent findings regarding the association between caffeine intake from coffee or tea and the risk of cognitive disorders such as dementia, Alzheimer's disease, cognitive impairment, and cognitive decline. We searched PubMed and EMBASE in September 2014. Three evaluators independently extracted and reviewed articles, based on predetermined selection criteria. Out of 293 articles identified through the search and bibliographies of relevant articles, 20 epidemiological studies from 19 articles, which involved 31,479 participants (8,398 in six cross-sectional studies, 4,601 in five case-control studies, and 19,918 in nine cohort studies), were included in the final analysis. The pooled odds ratio (OR) or relative risk (RR) of caffeine intake from coffee or tea for cognitive disorders (dementia, Alzheimer's disease, cognitive impairment, and cognitive decline) was 0.82 (95% confidence interval [CI], 0.67-1.01, I² = 63.2%) in a random-effects meta-analysis. In the subgroup meta-analysis by caffeine sources, the summary OR or RR of coffee intake was 0.83 (95% CI, 0.70-0.98; I² = 44.8%). However, in the subgroup meta-analysis by study design, the summary estimates (RR or OR) of coffee intake for cognitive disorders were 0.70 (95% CI, 0.50-0.98; I² = 42.0%) for cross-sectional studies, 0.82 (95% CI, 0.55-1.24; I² = 33.4%) for case-control studies, and 0.90 (95% CI, 0.59-1.36; I² = 60.0%) for cohort studies. This meta-analysis found that caffeine intake from coffee or tea was not associated with the risk of cognitive disorders.

  6. Urinary Estrogen Metabolites, Active and Sedentary Behaviors, and Breast Cancer Risk

    Cancer.gov

    A cross-sectional study of approximately 600 postmenopausal controls in the Breast Cancer Case-Control Study in Poland to assess urinary estrogen metabolites in relation to accelerometer-based measures of active and sedentary behaviors

  7. Late Maastrichtian foraminiferids and diatoms from the Polish Carpathians (Ropianka Formation, Skole Nappe): a case study from the Chmielnik-Grabówka composite section

    NASA Astrophysics Data System (ADS)

    Gasiński, M. Adam; Olshtynska, Alexandra; Uchman, Alfred

    2013-12-01

    Gasiński, M.A., Olshtynska, A. and Uchman, A. 2013. Late Maastrichtian foraminiferids and diatoms from the Polish Carpathians (Ropianka Formation, Skole Nappe): a case study from the Chmielnik-Grabowka composite section. Acta Geologica Polonica, 63(4), 515-525. Warszawa. Well-preserved foraminiferids have been found in the Chmielnik-Grabowka section (Skole Nappe, Polish Carpathians). The Abathomphalus mayaroensis (late Maastrichtian) and Racemiguembelina fructicosa (earlylate Maastrichtian) standard planktonic foraminiferal biozones have been recognized, based on the occurrence of their respective index species. Sediments of the R. fructicosa Zone contain diatoms, which are a rare component of Cretaceous flysch microfossil assemblages in the Carpathians. The diatom frustules and some foraminiferid tests are pyritized, probably after burial in the sediment, below the redox boundary or in the oxygen- deficient microenvironment inside the frustules or tests of microfossils; the presence of trace fossils and bioturbational structures in the same bed indicate an oxygenated sea floor.

  8. Investigation of certain wing shapes with sections varying progressively along the span

    NASA Technical Reports Server (NTRS)

    Arsandaux, L

    1931-01-01

    This investigation has a double object: 1) the calculation of the general characteristics of certain wings with progressively varying sections; 2) the determination of data furnishing, in certain cases, some information on the actual distribution of the external forces acting on a wing. We shall try to show certain advantages belonging to the few wing types of variable section which we shall study and that, even if the general aerodynamic coefficients of these wings are not often clearly superior to those of certain wings of uniform section, the wings of variable section nevertheless have certain advantages over those of uniform section in the distribution of the attainable stresses.

  9. Whipple Resection: Concordance Between Frozen Section And Permanent Section Diagnosis Of Surgical Margins.

    PubMed

    Bilal, Muhammad; Tariq, Hina; Mamoon, Nadira

    2018-01-01

    Margin assessment is done in Whipple procedures which are usually performed to resect tumours of head of pancreas and ampullary/periampullary region. Aims and objective of the study are to determine the concordance between frozen sections (FS) and permanent sections (PS) of surgical margins in Whipple resections. It is a retrospective study, from January 2008 to January 2015 (07 years). It includes the specimen with malignancy in final report and for which FS of pancreatic and/or CBD margin(s) were requested. Data was retrieved from Laboratory information system (LIS) database. Of the 41 bile duct margins in cases of ampullary tumours, 03 were positive on FS as well as PS, 35 were negative on FS as well as on PS. Results showed 100% sensitivity, 92.1% specificity, 50% PPV and 100% NPV. Results of 36 pancreatic margins in cases of ampullary showed 100% sensitivity, 97.1% specificity, 50% PPV and 100% NPV. In pancreatic carcinoma cases, none of CBD margins were reported as positive on FS, 02 margins reported as negative were found positive on PS, while 17 were negative on FS as well as PS. Results showed 100% specificity and 89.5% NPV. Of the 27 pancreatic margins tested in pancreatic tumours 100% sensitivity, 94.1% specificity, 88.9% PPV and 100% NPV was found. Factors such as absent prior tissue diagnosis and/or inflammatory processes make margin diagnosis difficult. However, a high concordance was observed between our FS and PS diagnosis.

  10. Capture-recapture analysis of East Coast fever in smallholder dairy herds in the Dar es Salaam region of Tanzania.

    PubMed

    Kivaria, F M; Noordhuizen, J P T M

    2010-05-01

    The prevalence of and case fatality rate due to East Coast fever (ECF) were estimated in 1402 dairy cattle in 87 small herds in the Dar es Salaam region of Tanzania, from January 2003 to January 2005 using a capture-recapture method. Information on clinical cases and deaths due to ECF were obtained from farm records and from a questionnaire-based cross-sectional survey conducted between July 2003 and March 2005 as part of longitudinal studies of bovine mastitis in these herds. The number of clinical cases identified was 567 (from farm records) and 496 (from the questionnaire), and the number of deaths recorded were 305 (from farm records) and 251 (from the questionnaire). In all, 450 clinical cases and 191 deaths due to ECF were identified from the two sources, giving an observed prevalence of 32% (CI(95%) 30-35%) and observed case fatality rate of 42% (CI(95%) 38-47%). Following application of the capture-recapture method, the estimated number of clinical cases and deaths was 625 (CI(95%) 617-633) and 401 (CI(95%) 384-418), respectively. The respective prevalence and case fatality rates were 45% (CI(95%) 41-48%) and 64% (CI(95%) 60-68%). The estimates obtained using the capture-recapture method are higher than those identified by traditional cross-sectional studies conducted in the same study area, and probably provide a more accurate epidemiological picture of ECF in this region of Tanzania. Copyright 2009 Elsevier Ltd. All rights reserved.

  11. Triangulating case-finding tools for patient safety surveillance: a cross-sectional case study of puncture/laceration.

    PubMed

    Taylor, Jennifer A; Gerwin, Daniel; Morlock, Laura; Miller, Marlene R

    2011-12-01

    To evaluate the need for triangulating case-finding tools in patient safety surveillance. This study applied four case-finding tools to error-associated patient safety events to identify and characterise the spectrum of events captured by these tools, using puncture or laceration as an example for in-depth analysis. Retrospective hospital discharge data were collected for calendar year 2005 (n=48,418) from a large, urban medical centre in the USA. The study design was cross-sectional and used data linkage to identify the cases captured by each of four case-finding tools. Three case-finding tools (International Classification of Diseases external (E) and nature (N) of injury codes, Patient Safety Indicators (PSI)) were applied to the administrative discharge data to identify potential patient safety events. The fourth tool was Patient Safety Net, a web-based voluntary patient safety event reporting system. The degree of mutual exclusion among detection methods was substantial. For example, when linking puncture or laceration on unique identifiers, out of 447 potential events, 118 were identical between PSI and E-codes, 152 were identical between N-codes and E-codes and 188 were identical between PSI and N-codes. Only 100 events that were identified by PSI, E-codes and N-codes were identical. Triangulation of multiple tools through data linkage captures potential patient safety events most comprehensively. Existing detection tools target patient safety domains differently, and consequently capture different occurrences, necessitating the integration of data from a combination of tools to fully estimate the total burden.

  12. Connecting Schools to Neighborhood Revitalization: The Case of the Maple Heights Neighborhood Association

    ERIC Educational Resources Information Center

    Pesch, Lawrence P.

    2014-01-01

    This case study focuses on the way a neighborhood association connects schools to broad change in an urban neighborhood of a large Midwestern city. The first section provides a review of the literature on community involvement in school and neighborhood reform. It reviews the historical origins of the current school-community relationship, the…

  13. Another look at roles and functions: has hospital case management lost its way?

    PubMed

    Reynolds, John J

    2013-01-01

    The purpose of this study was to identify the roles, functions, and types of activities that hospital case managers engage in on a day-to-day basis and that leverage the most amounts of time. Previous studies superimpose a priori categories on research tools. Hospital case management. This study analyzes 4,064 spontaneous, unstructured list serve postings from the American Case Management Association Learning Link list serve from August 15, 2011, to August 18, 2012. The study group was a cross section of 415 case management professionals. The data suggest that hospital case managers' time is inordinately leveraged by issues related to observation status/leveling of patients and the Centers for Medicare and Medicaid Services compliance. The data also suggest that hospital case management has taken a conceptual trajectory that has deviated significantly from what was initially conceived (quality, advocacy, and care coordination) and what is publicly purported. Case management education and practical orientation will need to be commensurate with this emerging emphasis. Case management leadership will need to be adept at mitigating the stresses of role confusion, role conflict, and role ambiguity.

  14. Method for isolating two aquifers in a single borehole

    DOEpatents

    Burklund, P.W.

    1984-01-20

    A method for isolating and individually instrumenting separate aquifers within a single borehole is disclosed. A borehole is first drilled from the ground surface, through an upper aquifer, and into a separating confining bed. A casing, having upper and lower sections separated by a coupling collar, is lowered into the borehole. The borehole is grouted in the vicinity of the lower section of the casing. A borehole is then drilled through the grout plug and into a lower aquifer. After the lower aquifer is instrumented, the borehole is grouted back into the lower portion of the casing. Then the upper section of the casing is unscrewed via the coupling collar and removed from the borehole. Finally, instrumentation is added to the upper aquifer and the borehole is appropriately grouted. The coupling collar is designed to have upper right-hand screw threads and lower left-hand screw thread, whereby the sections of the casing can be readily separated.

  15. Method for isolating two aquifers in a single borehole

    DOEpatents

    Burklund, Patrick W.

    1985-10-22

    A method for isolating and individually instrumenting separate aquifers within a single borehole. A borehole is first drilled from the ground surface, through an upper aquifer, and into a separating confining bed. A casing, having upper and lower sections separated by a coupling collar, is lowered into the borehole. The borehole is grouted in the vicinity of the lower section of the casing. A borehole is then drilled through the grout plug and into a lower aquifer. After the lower aquifer is instrumented, the borehole is grouted back into the lower portion of the casing. Then the upper section of the casing is unscrewed via the coupling collar and removed from the borehole. Finally, instrumentation is added to the upper aquifer and the borehole is appropriately grouted. The coupling collar is designed to have upper right-hand screw threads and lower left-hand screw thread, whereby the sections of the casing can be readily separated.

  16. Rainbows in rotationally inelastic scattering: a comparative study of different model potential surfaces and dynamical approximations

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

    Schinke, R.; Korsch, H.J.; Poppe, D.

    1982-12-15

    Rainbow structures in rotationally elastic and inelastic differential cross sections in atom--diatom collisions are investigated by comparison of three model potential energy surfaces labeled I, II, and III which are represented by V(R,..gamma..) = V/sub 0/(R)+V/sub 2/(R)P/sub 2/(cos ..gamma..). The cross sections are calculated within the quantal infinite-order-sudden (IOS) approximation. The anisotropic part V/sub 2/ is the same for all potentials and purely repulsive. The isotropic part V/sub 0/ for potential I is also repulsive and the differential cross sections show the well-studied rotational rainbow structures. Structural changes occur for collisions in potential II and III which have V/sub 0/more » terms being attractive at intermediate and large atom--molecule separations and having well depths of 10% and 25% of the collision energy, respectively. For example, the elastic cross section has no classical rainbow in the case of potential I but three in the case of potential III. The rainbow structures are analyzed within the classical and semiclassical versions of the IOS approximation and interpreted in terms of catastrophe theory. The quantitative comparison of the classical with the quantal IOS cross sections manifests possible quantum effects, i.e., tunneling into nonclassical regions and interference effects due to the superposition of several contributions (up to six in the present study). They can be very prominent and thus we conclude that much caution is needed if experimental data are compared with classical calculations. The accuracy of the IOS approximation is tested by comparison of classical IOS cross sections with cross sections obtained from exact classical trajectory calculations. The agreement is generally good with the exemption of the rainbow region and small angle, rotationally elastic scattering.« less

  17. Evaluation of synaptophysin as an immunohistochemical marker for equine grass sickness.

    PubMed

    Waggett, B E; McGorum, B C; Shaw, D J; Pirie, R S; MacIntyre, N; Wernery, U; Milne, E M

    2010-05-01

    It has been proposed that synaptophysin, an abundant integral membrane protein of synaptic vesicles, is an immunohistochemical marker for degenerating neurons in equine grass sickness (GS). In the present study, a statistically generated decision tree based on assessment of synaptophysin-immunolabelled ileal sections facilitated correct differentiation of all 20 cases of GS and 24 cases of non-GS disease (comprising eight horses with colic, six with neuroparalytic botulism and 10 controls). This technique also facilitated correct diagnosis of GS in all three cases that had been erroneously classified as having non-GS disease based on conventional interpretation of haematoxylin and eosin-stained cryostat sections of ileal surgical biopsies. Further prospective studies involving larger numbers of horses are required to fully validate this decision tree. In contrast to GS, botulism did not alter ileal neuron density or synaptophysin labelling, indicating that different mechanisms cause neuronal damage and/or dysfunction in GS and botulism. Copyright 2009 Elsevier Ltd. All rights reserved.

  18. Methodology Series Module 3: Cross-sectional Studies.

    PubMed

    Setia, Maninder Singh

    2016-01-01

    Cross-sectional study design is a type of observational study design. In a cross-sectional study, the investigator measures the outcome and the exposures in the study participants at the same time. Unlike in case-control studies (participants selected based on the outcome status) or cohort studies (participants selected based on the exposure status), the participants in a cross-sectional study are just selected based on the inclusion and exclusion criteria set for the study. Once the participants have been selected for the study, the investigator follows the study to assess the exposure and the outcomes. Cross-sectional designs are used for population-based surveys and to assess the prevalence of diseases in clinic-based samples. These studies can usually be conducted relatively faster and are inexpensive. They may be conducted either before planning a cohort study or a baseline in a cohort study. These types of designs will give us information about the prevalence of outcomes or exposures; this information will be useful for designing the cohort study. However, since this is a 1-time measurement of exposure and outcome, it is difficult to derive causal relationships from cross-sectional analysis. We can estimate the prevalence of disease in cross-sectional studies. Furthermore, we will also be able to estimate the odds ratios to study the association between exposure and the outcomes in this design.

  19. Microtunneling systems and methods of use

    DOEpatents

    Richardson, John G.; Kostelnik, Kevin M.; Nickelson, Reva A.; Sloan, Paul A.

    2006-07-04

    A tunneling system including a tunneling apparatus including a cutting structure for forming a borehole and at least one linkage section for transmitting a force generally toward the cutting structure is disclosed. A method of disposing a casing string within a subterranean formation by applying a force generally to the trailing end of the tunneling apparatus, generally toward the leading end thereof, but without transmitting the entire force through the entire casing string is also disclosed. At least one linkage section extending within but not in contact with at least one casing section of the casing string may transmit the force. Also, a force limiting member may limit a force applied to the casing string.

  20. Coal Mine Roadway Stability in Soft Rock: A Case Study

    NASA Astrophysics Data System (ADS)

    Shen, Baotang

    2014-11-01

    Roadway instability has always been a major concern in deep underground coal mines where the surrounding rock strata and coal seams are weak and the in situ stresses are high. Under the high overburden and tectonic stresses, roadways could collapse or experience excessive deformation, which not only endangers mining personnel but could also reduce the functionality of the roadway and halt production. This paper describes a case study on the stability of roadways in an underground coal mine in Shanxi Province, China. The mine was using a longwall method to extract coal at a depth of approximately 350 m. Both the coal seam and surrounding rock strata were extremely weak and vulnerable to weathering. Large roadway deformation and severe roadway instabilities had been experienced in the past, hence, an investigation of the roadway failure mechanism and new support designs were needed. This study started with an in situ stress measurement programme to determine the stress orientation and magnitude in the mine. It was found that the major horizontal stress was more than twice the vertical stress in the East-West direction, perpendicular to the gateroads of the longwall panel. The high horizontal stresses and low strength of coal and surrounding rock strata were the main causes of roadway instabilities. Detailed numerical modeling was conducted to evaluate the roadway stability and deformation under different roof support scenarios. Based on the modeling results, a new roadway support design was proposed, which included an optimal cable/bolt arrangement, full length grouting, and high pre-tensioning of bolts and cables. It was expected the new design could reduce the roadway deformation by 50 %. A field experiment using the new support design was carried out by the mine in a 100 m long roadway section. Detailed extensometry and stress monitorings were conducted in the experimental roadway section as well as sections using the old support design. The experimental section produced a much better roadway profile than the previous roadway sections. The monitoring data indicated that the roadway deformation in the experimental section was at least 40-50 % less than the previous sections. This case study demonstrated that through careful investigation and optimal support design, roadway stability in soft rock conditions can be significantly improved.

  1. The course of the buccal nerve: relationships with the temporalis muscle during the prenatal period

    PubMed Central

    MÉRIDA-VELASCO, J. R.; RODRÍGUEZ-VÁZQUEZ, J. F.; CUADRA, C.; MÉRIDA-VELASCO, J. A.; JIMÉNEZ-COLLADO, J.

    2001-01-01

    The aim of this study was to describe the course of the buccal nerve and its relationships with the temporalis muscle during the prenatal period. Serial sections of 90 human fetal specimens ranging from 9 to 17 wk development were studied by light microscopy. Each fetal specimen was studied on both right and left sides, making a total of 180 cases for study. A 3-D reconstruction of the region analysed in one of the specimens was made. In 89 cases the buccal nerve was located medial to the temporalis muscle; in 73 cases it penetrated the muscle; in 15 cases it lay in a canal formed by the muscle fibres and was covered by fascia, and finally, in 3 cases it was a branch of the inferior alveolar nerve. The study has revealed that in a large number of cases the buccal nerve maintains an intimate association with the temporalis muscle. PMID:11327204

  2. Universal Parameterization of Absorption Cross Sections

    NASA Technical Reports Server (NTRS)

    Tripathi, R. K.; Cucinotta, Francis A.; Wilson, John W.

    1999-01-01

    Our prior nuclear absorption cross sections model is extended for light systems (A less than or equal to 4) where either both projectile and target are light particles or one is a light particle and the other is a medium or heavy nucleus. The agreement with experiment is excellent for these cases as well. Present work in combination with our original model provides a comprehensive picture of absorption cross sections for light, medium, and heavy systems, a very valuable input for radiation protection studies.

  3. IFLA General Conference, 1991. Division of Education and Research: Section of Education and Training; Continuing Professional Education (RT); Section of Library Theory and Research; Library History (RT); Research in Reading (RT); Editors of Library Journals (RT). Booklet 7.

    ERIC Educational Resources Information Center

    International Federation of Library Associations and Institutions, The Hague (Netherlands).

    The 12 papers in this collection were presented at 6 sections of the Division of Education and Research: (1) "Emergence of the Asian Pacific Area and Its Impact on Education and Training of Librarians" (Maxine K. Rochester, Australia); (2) "The Cultural Aspects of Colonialism: Case Study of the Relevance of the Imported Curriculum…

  4. Case study of 4(f) litigation/rulings.

    DOT National Transportation Integrated Search

    2004-06-01

    This study addresses issues related to compliance with Section 4(f). By referring to the manual Cabinet employees will be to: 1) Conduct an assessment of proposed alternatives to evaluate prudence and feasibility of a proposed project alternative; 2)...

  5. Environmental impact case study : Project 0100-077-105, C-501 : Dublin, Virginia.

    DOT National Transportation Integrated Search

    1971-01-01

    At the request of the Environmental Quality Division of the Virginia Department of Highways, the Environmental and Economics Section of the Virginia Highway Research Council conducted a study to determine the probable socioeconomic and environmental ...

  6. 27 CFR 70.164 - Surrender of property subject to levy in the case of life insurance and endowment contracts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the case of life insurance and endowment contracts. (a) In general. This section provides special rules relating to the surrender of property subject to levy in the case of life insurance and endowment... subject to levy in the case of life insurance and endowment contracts. 70.164 Section 70.164 Alcohol...

  7. An Analysis of U.S. Foreign Direct Investment Policy and Economic Development. A.I.D. Discussion Paper No. 36.

    ERIC Educational Resources Information Center

    Bergsten, C. Fred; De Castro, Bruce

    The purpose of the paper is to analyze U.S. policies toward financial investment in developing nations. The paper is presented in two sections. In section I, the controversial effects of direct foreign investment on development are discussed. Case studies of investment policies toward India, the Philippines, Ghana, Guatemala, and Argentina are…

  8. Revealing organization of cellulose in wood cell walls by Raman imaging

    Treesearch

    Umesh P. Agarwal; Sally A. Ralph

    2007-01-01

    Anisotropy of cellulose organization in mature black spruce wood cell wall was investigated by Raman imaging using a 1 [mu]m lateral-resolution capable confocal Raman microscope. In these studies, wood cross sections (CS) and radial longitudinal sections (LS) that were partially delignified by acid chlorite treatment were used. In the case of CS where latewood cells...

  9. 49 CFR 511.26 - Settlement.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 6 2010-10-01 2010-10-01 false Settlement. 511.26 Section 511.26 Transportation...; Summary Judgment; Settlement § 511.26 Settlement. (a) Applicability. This section applies only to cases of..., 89 Stat. 911 (15 U.S.C. section 2007(3)). Settlement in other cases may be made only in accordance...

  10. Index of Federal Regulations and Court Cases on the Implementation of Section 504 of the Rehabilitation Act of 1973.

    ERIC Educational Resources Information Center

    California State and Consumer Services Agency, Sacramento. Office of Statewide Compliance Coordination.

    This index is divided into two sections: an Index on Federal Regulations and an Abstracts section of Court Cases and Administrative Decisions. Section 1 provides a topic index and comparison of contents and coverage of 16 federal departments with regulations established as of August 1981. Presented in tabular form, this index shows major topics…

  11. The Misconception of Case-Control Studies in the Plastic Surgery Literature: A Literature Audit.

    PubMed

    Hatchell, Alexandra C; Farrokhyar, Forough; Choi, Matthew

    2017-06-01

    Case-control study designs are commonly used. However, many published case-control studies are not true case-controls and are in fact mislabeled. The purpose of this study was to identify all case-control studies published in the top three plastic surgery journals over the past 10 years, assess which were truly case-control studies, clarify the actual design of the articles, and address common misconceptions. MEDLINE, Embase, and Web of Science databases were searched for case-control studies in the three highest-impact factor plastic surgery journals (2005 to 2015). Two independent reviewers screened the resulting titles, abstracts, and methods, if applicable, to identify articles labeled as case-control studies. These articles were appraised and classified as true case-control studies or non-case-control studies. The authors found 28 articles labeled as case-control studies. However, only six of these articles (21 percent) were truly case-control designs. Of the 22 incorrectly labeled studies, one (5 percent) was a randomized controlled trial, three (14 percent) were nonrandomized trials, two (9 percent) were prospective comparative cohort designs, 14 (64 percent) were retrospective comparative cohort designs, and two (9 percent) were cross-sectional designs. The mislabeling was worse in recent years, despite increases in evidence-based medicine awareness. The majority of published case-control studies are not in fact case-control studies. This misunderstanding is worsening with time. Most of these studies are actually comparative cohort designs. However, some studies are truly clinical trials and thus a higher level of evidence than originally proposed.

  12. High caseload of childhood tuberculosis in hospitals on Java Island, Indonesia: a cross sectional study.

    PubMed

    Lestari, Trisasi; Probandari, Ari; Hurtig, Anna-Karin; Utarini, Adi

    2011-10-11

    Childhood tuberculosis (TB) has been neglected in the fight against TB. Despite implementation of Directly Observed Treatment Shortcourse (DOTS) program in public and private hospitals in Indonesia since 2000, the burden of childhood TB in hospitals was largely unknown. The goals of this study were to document the caseload and types of childhood TB in the 0-4 and 5-14 year age groups diagnosed in DOTS hospitals on Java Island, Indonesia. Cross-sectional study of TB cases recorded in inpatient and outpatient registers of 32 hospitals. Cases were analyzed by hospital characteristics, age groups, and types of TB. The number of cases reported in the outpatient unit was compared with that recorded in the TB register. Of 5,877 TB cases in the inpatient unit and 15,694 in the outpatient unit, 11% (648) and 27% (4,173) respectively were children. Most of the childhood TB cases were under five years old (56% and 53% in the inpatient and outpatient clinics respectively). The proportion of smear positive TB was twice as high in the inpatient compared to the outpatient units (15.6% vs 8.1%). Extra-pulmonary TB accounted for 15% and 6% of TB cases in inpatient and outpatient clinics respectively. Among children recorded in hospitals only 1.6% were reported to the National TB Program. In response to the high caseload and gross under-reporting of childhood TB cases, the National TB Program should give higher priority for childhood TB case management in designated DOTS hospitals. In addition, an international guidance on childhood TB recording and reporting and improved diagnostics and standardized classification is required.

  13. Long-term complications of rattlesnake bites: a telephone survey from Central California.

    PubMed

    Spano, Susanne J; Vohra, Rais; Macias, Fernando

    2014-06-01

    The purpose of this institutional review board-approved, cross-sectional study was to identify residual symptoms and signs of envenomation reported by snakebite survivors via a telephone survey. Victims of rattlesnake bite who were treated at a single hospital center during a 10-year period were contacted through a telephone survey. Study subjects were included through a diagnosis-based retrospective chart review of snakebite victims, and excluded if they did not receive rattlesnake antivenom. Data collection was done using a standardized form that included sections about residual, recurrent, or new pain, weakness, paresthesias, or other limitations of the bitten limb. We identified 46 snakebite cases including 5 of 46 "dry" bites. The remaining cases (41 of 46) all received Crofab. Interviews were completed for 31% of these patients (13 of 41), and the remainder were lost to follow-up. Most bites occurred in men (12 cases, 92% males) and on the arms (9 cases, 69%). Six of the 13 respondents (46%) reported residual symptoms from the bite. Persistent symptoms described included localized pain at the bite site (3 cases), numbness or paresthesias (2 cases), abnormal skin peeling and discoloration at the bite site (2 cases), and persistent weakness of the bitten extremity (1 case). Among patients reporting persistent symptoms, the bite-to-survey interval ranged from 7 months to 12 years, with a median interval of 4 years. Our study population demonstrated a notable incidence (43%) of self-reported persistent symptoms related to their rattlesnake bites, although the overall level of disability from these injuries seems low. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  14. International Conference on the Physics of Electronic and Atomic Collisions (14th) Held in Palo Alto, California on 24-30 July 1985 (Electronic and Atomic Collisions. Invited Papers)

    DTIC Science & Technology

    1985-07-30

    OA 3’, one of the cases studied by Lohmann et al(2 ). The new feature in their measurement is that they normalize their cross section by an...dynamic behav- ior of neutral and ionic clusters[lO]. In the case of ionic clusters there have been already extensive studies on their stability and...The specific cases studied so far on an ab initio level (e + F2 [12], e + N2 [13], e + H2 [14]) indicate that nonlocal effects are generally important

  15. 25 CFR 41.10 - Technical assistance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... to, consulting services for the development of programs, plans, and feasibility studies and... section may be undertaken in the same manner as in the case of negative determinations of feasibility...

  16. Effort-reward imbalance and work ability: cross-sectional and longitudinal findings from the Second German Sociomedical Panel of Employees

    PubMed Central

    2012-01-01

    Background Although data from longitudinal studies are sparse, effort-reward imbalance (ERI) seems to affect work ability. However, the potential pathway from restricted work ability to ERI must also be considered. Therefore, the aim of our study was to analyse cross-sectional and longitudinal associations between ERI and work ability and vice versa. Methods Data come from the Second German Sociomedical Panel of Employees. Logistic regression models were estimated to determine cross-sectional and longitudinal associations. The sample used to predict new cases of poor or moderate work ability was restricted to cases with good or excellent work ability at baseline. The sample used to predict new cases of ERI was restricted to persons without ERI at baseline. Results The cross-sectional analysis included 1501 full-time employed persons. The longitudinal analyses considered 600 participants with good or excellent baseline work ability and 666 participants without baseline ERI, respectively. After adjustment for socio-demographic variables, health-related behaviour and factors of the work environment, ERI was cross-sectionally associated with poor or moderate work ability (OR = 1.980; 95% CI: 1.428 to 2.747). Longitudinally, persons with ERI had 2.1 times higher odds of poor or moderate work ability after one year (OR = 2.093; 95% CI: 1.047 to 4.183). Conversely, persons with poor or moderate work ability had 2.6 times higher odds of an ERI after one year (OR = 2.573; 95% CI: 1.314 to 5.041). Conclusions Interventions that enable workers to cope with ERI or address indicators of ERI directly could promote the maintenance of work ability. Integration management programmes for persons with poor work ability should also consider their psychosocial demands. PMID:23067110

  17. Peculiarities of section topograms for the multiple diffraction of X rays

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

    Kohn, V. G., E-mail: kohnvict@yandex.ru; Smirnova, I. A.

    The distortion of interference fringes on the section topograms of single crystal due to the multiple diffraction of X rays has been investigated. The cases of the 220 and 400 reflections in a silicon crystal in the form of a plate with a surface oriented normally to the [001] direction are considered both theoretically and experimentally. The same section topogram exhibits five cases of multiple diffraction at small azimuthal angles for the 400 reflection and MoK{sub α} radiation, while the topogram for the 220 reflection demonstrates two cases of multiple diffraction. All these cases correspond to different combinations of reciprocalmore » lattice vectors. Exact theoretical calculations of section topograms for the aforementioned cases of multiple diffraction have been performed for the first time. The section topograms exhibit two different distortion regions. The distortions in the central region of the structure are fairly complex and depend strongly on the azimuthal angle. In the tails of the multiple diffraction region, there is a shift of two-beam interference fringes, which can be observed even with a laboratory X-ray source.« less

  18. Intra-Operative Frozen Sections for Ovarian Tumors – A Tertiary Center Experience

    PubMed Central

    Arshad, Nur Zaiti Md; Ng, Beng Kwang; Paiman, Noor Asmaliza Md; Mahdy, Zaleha Abdullah; Noor, Rushdan Mohd

    2018-01-01

    Background: Accuracy of diagnosis with intra-operative frozen sections is extremely important in the evaluation of ovarian tumors so that appropriate surgical procedures can be selected. Study design: All patients who with intra-operative frozen sections for ovarian masses in a tertiary center over nine years from June 2008 until April 2017 were reviewed. Frozen section diagnosis and final histopathological reports were compared. Main outcome measures: Sensitivity, specificity, positive and negative predictive values of intra-operative frozen section as compared to final histopathological results for ovarian tumors. Results: A total of 92 cases were recruited for final evaluation. The frozen section diagnoses were comparable with the final histopathological reports in 83.7% of cases. The sensitivity, specificity, positive predictive value and negative predictive value for benign and malignant ovarian tumors were 95.6%, 85.1%, 86.0% and 95.2% and 69.2%, 100%, 100% and 89.2% respectively. For borderline ovarian tumors, the sensitivity and specificity were 76.2% and 88.7%, respectively; the positive predictive value was 66.7% and the negative predictive value was 92.7%. Conclusion: The accuracy of intra-operative frozen section diagnoses for ovarian tumors is high and this approach remains a reliable option in assessing ovarian masses intra-operatively. PMID:29373916

  19. Exposure of the sciatic nerve in the gluteal region without sectioning the gluteus maximus: Analysis of a series of 18 cases

    PubMed Central

    Socolovsky, Mariano; Masi, Gilda Di

    2012-01-01

    Background: Dissecting through the gluteus maximus muscle by splitting its fibers, instead of complete sectioning of the muscle, is faster, involves less damage to tissues, and diminishes recovery time. The objective of the current paper is to present a clinical series of sciatic nerve lesions where the nerve was sufficiently exposed via the transgluteal approach. Methods: We retrospectively selected 18 traumatic sciatic nerve lesions within the buttock, operated upon from January 2005 to December 2009, with a minimum follow-up of 2 years. In all patients, a transgluteal approach was employed to explore and reconstruct the nerve. Results: Ten males and eight females, with a mean age of 39.7 years, were studied. The etiology of the nerve lesion was previous hip surgery (n = 7), stab wound (n = 4), gunshot wound (n = 3), injection (n = 3), and hip dislocation (n = 1). In 15 (83.3%) cases, a motor deficit was present; in 12 (66.6%) cases neuropathic pain and in 12 (66.6%) cases sensory alterations were present. In all cases, the transgluteal approach was adequate to expose the injury and treat it by neurolysis alone (10 cases), neurolysis and neurorrhaphy (4 cases), and reconstruction with grafts (4 cases; three of these paired with neurolysis). The mean pre- and postoperative grades for the tibial nerve (LSUHSC scale) were 1.6 and 3.6, respectively; meanwhile, for the peroneal division, preoperative grade was 1.2 and postoperative grade was 2.4. Conclusions: The transgluteal approach adequately exposes sciatic nerve injuries of traumatic origin in the buttock and allows for adequate nerve reconstruction without sectioning the gluteus maximus muscle. PMID:22439106

  20. Assessment of horse owners' ability to recognise equine laminitis: A cross-sectional study of 93 veterinary diagnosed cases in Great Britain.

    PubMed

    Pollard, D; Wylie, C E; Verheyen, K L P; Newton, J R

    2017-11-01

    Use of owner-reported data could further epidemiological knowledge of equine laminitis. However, owner recognition of laminitis has not previously been assessed. The primary objective was to establish whether cases of owner-suspected laminitis would be confirmed as laminitis by the attending veterinary surgeon. Secondary objectives were to compare owner- and veterinary-reported information from veterinary-confirmed cases of equine laminitis. Cross-sectional study. Twenty-five British veterinary practices were invited to submit laminitis reporting forms (LRFs) for active laminitis cases attended between January 2014 and October 2015; detailing 27 clinical signs, 5 underlying conditions and 7 risk factors associated with laminitis. Owners were invited to independently complete a modified LRF if reason for the veterinary visit was suspicion of laminitis. Differences between paired veterinary and owner LRFs, and between cases where owners did and did not recognise laminitis, were assessed using McNemar's and Fisher's Exact tests, respectively. Veterinary LRFs were received for 93 veterinary-diagnosed laminitis cases. All 51 owner-suspected cases were confirmed by veterinary diagnosis, with the remaining 42 (45.2%) not recognised as laminitis by owners. Undefined lameness, foot abscesses, colic and stiffness were common reasons for owner-requested veterinary visits in owner-unrecognised cases. 'Divergent growth rings' (prevalence difference: +27.3%, P = 0.01) and 'breed type' (prevalence difference: +21.2%, P = 0.04) were more commonly reported by veterinary surgeons in owner-recognised compared to owner-unrecognised cases. 'Difficulty turning', 'shifting weight' and risk factor 'body condition' were more frequently reported by veterinary surgeons whilst 'increased hoof temperature' was reported more frequently by owners. The limited clinical data restricted statistical inferences regarding the secondary objectives. All owner-suspected laminitis cases were confirmed upon veterinary examination, showing validity for the inclusion of owner-reported cases in future epidemiological studies. However, failure of laminitis recognition by owners highlights further need for evidence-based education to ensure early disease detection. © 2017 EVJ Ltd.

  1. Bibliometric Analysis of Journal of Clinical and Diagnostic Research (Dentistry Section; 2007-2014)

    PubMed Central

    Basavaraj, P; Singla, Ashish; Singh, Khushboo; Kundu, Hansa; Vashishtha, Vaibhav; Pandita, Venisha; Malhi, Ravneet

    2015-01-01

    Background: The role of scientific journals in diffusion of data concerning researches in the field of Public Health Dentistry is of premier importance. Bibliometric analysis involves analysis of publications reflecting the type of research work. Aim: The present study was conducted with an aim to determine the number and trends of published articles in Journal of Clinical and Diagnostic Research (JCDR) from Feb. 2007 to Oct.2014. Settings and Design: A retrospective observational study was conducted for JCDR. Materials and Methods: All issues of JCDR were electronically searched for the parameters : study design, area of interest of research, state /college where research was conducted, authorship pattern, source of articles published each year, changing study trends, disease under study and publication bias. Statistical Analysis used: The data was organized and analyzed using software SPSS - version 21.0; descriptive statistics was used. Results: Bibliometric analysis was done for 601 articles of JCDR published from Feb. 2007 to Oct. 2014. The total number of articles published under Dentistry section have tremendously increased from mere 2 articles in 2007 to 328 articles in 2014.Majority of the study designs published in both the journal were case reports (42.6%) followed by cross sectional studies (24.8%). 96.3% of the articles were from India. Majority of the articles published were of multi authors (65.2%) and from Educational institutes (98.4%). The trends of the articles published indicated that the case reports/series formed the major bulk (others=59.1%) followed by research studies (21.3%). Conclusion: It was concluded that most articles published were case reports followed by researches indicating an inclination towards better quality methodology. The SJR and the citation count of the articles published also indicated the quality of the scientific articles published. PMID:26023643

  2. Bibliometric analysis of journal of clinical and diagnostic research (dentistry section; 2007-2014).

    PubMed

    Jain, Swati; Basavaraj, P; Singla, Ashish; Singh, Khushboo; Kundu, Hansa; Vashishtha, Vaibhav; Pandita, Venisha; Malhi, Ravneet

    2015-04-01

    The role of scientific journals in diffusion of data concerning researches in the field of Public Health Dentistry is of premier importance. Bibliometric analysis involves analysis of publications reflecting the type of research work. The present study was conducted with an aim to determine the number and trends of published articles in Journal of Clinical and Diagnostic Research (JCDR) from Feb. 2007 to Oct.2014. A retrospective observational study was conducted for JCDR. All issues of JCDR were electronically searched for the parameters : study design, area of interest of research, state /college where research was conducted, authorship pattern, source of articles published each year, changing study trends, disease under study and publication bias. The data was organized and analyzed using software SPSS - version 21.0; descriptive statistics was used. Bibliometric analysis was done for 601 articles of JCDR published from Feb. 2007 to Oct. 2014. The total number of articles published under Dentistry section have tremendously increased from mere 2 articles in 2007 to 328 articles in 2014.Majority of the study designs published in both the journal were case reports (42.6%) followed by cross sectional studies (24.8%). 96.3% of the articles were from India. Majority of the articles published were of multi authors (65.2%) and from Educational institutes (98.4%). The trends of the articles published indicated that the case reports/series formed the major bulk (others=59.1%) followed by research studies (21.3%). It was concluded that most articles published were case reports followed by researches indicating an inclination towards better quality methodology. The SJR and the citation count of the articles published also indicated the quality of the scientific articles published.

  3. [Factors associated with road accidents in the city of Lubumbashi].

    PubMed

    Kandolo, Simon Ilunga; Matungulu, Charles Matungulu; Mukanya, Pascal Kimba; Umba, Irène Kabange; Kabamba, Julie Ndayi; Numbi, Oscar Luboya; Ilunga, Benjamin Kabyla; Kaj, Françoise Malonga; Lubaba, Célestin Banza; Ngongo, Ghislain Mashini

    2014-01-01

    We conducted a retrospective non-comparative cross-sectional study in Lubumbashi on factors associated with road accidents. To contribute to the reduction of morbidity and mortality related to road accidents based on a better understanding of this phenomenon in the city of Lubumbashi, to assess the frequency and the growth of road accidents in the city of Lubumbashi and to determine the factors predisposing to these accidents. This non-controlled retrospective cross-sectional descriptive study covered the period from 1st January to 31st December 2008, and included all cases of vehicles registered by the police department after an accident. A total of 1,915 road traffic were reported, mostly caused by public transport vehicles (59%) driven by young adult males (89% of cases) with a mean age of 28 years. The main cause was speeding combined with other factors (34% of cases). The majority of these accidents occurred in the city of Lubumbashi (52.9% of cases) between 6:00 a.m. and 6:00 p.m. (74% of cases). Transit vehicles were exposed to a greater risk of road accidents (59%). There is an urgent need for accurate information on the rules of the road for drivers and road users to reduce the mortality and morbidity due to road accidents.

  4. Utility of intraoperative frozen sections in surgical decision making for acute invasive fungal rhinosinusitis.

    PubMed

    Papagiannopoulos, Peter; Lin, Diana Murro; Al-Khudari, Samer; Rajan, Kumar; Reddy, Swathi; Gattuso, Paulo; Tajudeen, Bobby; Batra, Pete S

    2017-05-01

    Acute invasive fungal rhinosinusitis (AIFRS) represents a fulminant, potentially fatal, disease process in immunocompromised patients. The diagnosis often rests on high index of clinical suspicion, with relative paucity of data on the diagnostic and therapeutic implications of intraoperative frozen sections. Retrospective review was performed for 18 cases undergoing endoscopic sinus surgery for AIFRS. Reliability of intraoperative frozen section diagnosis was evaluated for all patients using final pathology as the gold standard. A total of 66 frozen sections were performed. Diagnostic accuracy of frozen sections illustrated sensitivity of 72.7% (95% confidence interval [CI], 0.57 to 0.85), specificity of 100% (95% CI, 0.85 to 1.00), positive predictive value (PPV) of 100% (95% CI, 0.89 to 1.00), and negative predictive value (NPV) of 64.7% (95% CI, 0.46 to 0.80). There was no statistically significant difference in sensitivity of frozen sections in cases of Mucor and Aspergillus at 68.8%% and 76.2%, respectively (p = 0.61). This study represents the largest series assessing the diagnostic accuracy of frozen section analysis in AIFRS. Frozen section analysis is an effective tool for guiding intraoperative decision making in patients with AIFRS with a high PPV. A Low NPV underscores the importance of clinical suspicion and intraoperative decision making based on endoscopic findings when negative frozen section results are encountered. Further, frozen section analysis appears to be equally effective in detecting either Mucor or Aspergillus. © 2017 ARS-AAOA, LLC.

  5. Resonant parametric interference effect in spontaneous bremsstrahlung of an electron in the field of a nucleus and two pulsed laser waves

    NASA Astrophysics Data System (ADS)

    Lebed', A. A.; Padusenko, E. A.; Roshchupkin, S. P.; Dubov, V. V.

    2018-04-01

    Electron-nucleus bremsstrahlung in the field of two moderately strong pulsed laser waves in the case of incommensurate frequencies is theoretically studied under resonant conditions. The process is studied in detail in a special kinematic region, where stimulated processes with correlated emission and absorption of photons of the first and second waves become predominant (parametric interference effect). The availability of this region is caused by interference of the first and second laser waves. The correspondence between the emission angle and the final-electron energy is established in this interference kinematic. In this case, the cross-sectional properties are determined by the multiphoton quantum interference parameter, which is proportional to the product of intensities of the first and second waves. The resonant differential cross section of electron-nucleus spontaneous bremsstrahlung with simultaneous registration of both emission angles of the spontaneous photon and the scattered electron can exceed by four or five orders of magnitude the corresponding cross section in the absence of an external field. It was shown for nonrelativistic electrons that the resonant cross section of the studied process in the field of two pulsed laser waves within the interference region in two order of magnitude may exceed corresponding cross sections at other scattering kinematics. The obtained results may be experimentally verified, for example, by scientific facilities at sources of pulsed laser radiation (such as SLAC, FAIR, XFEL, ELI).

  6. A series of forensic toxicology and drug seizure cases involving illicit fentanyl alone and in combination with heroin, cocaine or heroin and cocaine.

    PubMed

    Marinetti, Laureen J; Ehlers, Brooke J

    2014-10-01

    The Montgomery County Coroner's Office Toxicology Section and the Miami Valley Regional Crime Lab (MVRCL) Drug Chemistry Section have been receiving case work in drug seizures, death cases and human performance cases involving products marketed as heroin or as illicit fentanyl. Upon analysis by the Drug Chemistry Section, these products were found to contain various drug(s) including illicit fentanyl only, illicit fentanyl and heroin, illicit fentanyl and cocaine and illicit fentanyl, heroin and cocaine. Both the Chemistry and Toxicology Sections began seeing these combinations starting in late October 2013. The percentage of the combinations encountered by the MVRCL as well as the physical appearance of the product, and the results of presumptive screening tests will be discussed. The demographics of the users and the results of toxicology and autopsy findings on the decedents will also be discussed. According to regional drug task force undercover agents, there is evidence that some of the products are being sold as illicit fentanyl and not just as a heroin product. Also, there is no evidence to support that the fentanyl source is being diverted from pharmaceutical grade fentanyl. The chemistry section currently has over 109 confirmed cases, and the toxicology section currently has 81 confirmed drug deaths, 8 driving under the influence of drugs and 1 suicidal hanging. Both sections are continuing to see these cases at the present time. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Absence of asymptomatic cases of malaria in a historically endemic indigenous locality of the Department of Caaguazú, Paraguay: moving toward elimination.

    PubMed

    Barrios, Eugenia Duarte de; Russomando, Graciela; Puerto, Florencia Del

    2016-01-01

    Paraguay was among the 16 countries that reported zero indigenous malaria cases in 2014. A cross-sectional observational descriptive study was performed in 100 adults from Santa Teresa, Paraguay. Parasite detection was carried out using seminested multiplex polymerase chain reaction (PCR) and microscopy. Among the participants, 44% were female and 56% were male, and 89% had a malaria history. No parasites were detected with either of the methods. There were no asymptomatic cases in Santa Teresa, and this finding is very promising. A longitudinal study should be performed to confirm that there are no asymptomatic cases in this locality.

  8. Profile of Kidney Histopathology in Cases of Burns - Particular Emphasis on Acridine Orange Fluorescence Study and to Explore its Forensic Utility

    PubMed Central

    Desai, Nandini J.; Gupta, B.D.; Patel, Pratik N.

    2016-01-01

    Introduction The major cause of death in the burn patients includes multiple organ failure and infection but, sometimes the exact cause of death in many fatally burned patients is difficult to detect. Many times in medico-legal post-mortem examinations in cases of burns, histopathological examination of organs is requested. Aim The aim was to study various histopathological changes in kidneys in the post-mortem cases of burns, by using routine Haematoxylin and Eosin stain (H&E stain), special Periodic and Schiff’s Stain (PAS) stain, to study the role of acridine orange fluorescence study, to explore the forensic utility of this microscopic study and to find out the relationship between duration of survival and histopathological changes observed. Materials and Methods An experimental longitudinal prospective study from October 2010 to September 2012. Total 32 cases of death due to burns were autopsied at mortuary, the Department of Forensic Medicine and Toxicology in our hospital. Bilateral kidneys were removed and preserved in 10% formalin solution. These were forwarded to Department of Pathology for histopathological examination. Routine microscopic examination by H&E stain as well as PAS stain and fluorescence study by acridine orange stain were done in all cases. Results It was observed that in 21 (65.63%) cases gross findings in kidneys were normal, in 06 (18.75%) were grossly pale and in 05 (15.62%) heavy & congested. Sections taken from kidneys and studied by H&E stain showed overlapping histopathological changes in all cases. In 26 (81.25%) cases, changes of Acute Tubular Necrosis (ATN) while in remaining 06 (18.75%), changes of cloudy swelling were observed. The sections stained by acridine orange and observed under fluorescent microscope were lightly positive in 15 (46.88%), brightly positive in 08 (25.00%) whereas, negative in 09 (28.12%). Conclusion Microscopy by various methods helps in getting specific lesions in kidney due to burns. However, it does not add any new tool to resolve any forensic issues of burns. Therefore, microscopy (including florescent), if done would be redundant. PMID:27190809

  9. Identifying Inconsistencies and Reporting Deficits in Therapeutic Massage and Bodywork (TMB) Case Reports Authored by TMB Practitioners: a TMB-Adapted CAse REport (CARE) Guidelines Audit Through 2014.

    PubMed

    Munk, Niki; Shue, Sarah; Freeland, Emilee; Ralston, Rick; Boulanger, Karen T

    2016-09-01

    Case reports are a fundamental tool through which therapeutic massage and bodywork (TMB) practitioners can inform research and impact their field by detailing the presentation, treatment, and follow-up of a single individual encountered in practice. Inconsistencies in case reporting limit their impact as fundamental sources of clinical evidence. Using the TMB-adapted CAse REport (CARE) guidelines, the current study sought to provide a rich description regarding the reporting quality of TMB practitioner authored TMB case reports in the literature. 1) Systematic identification of published, peer-reviewed TMB case reports authored by TMB practitioners following PRISMA recommendations; 2) audit development based on TMB-adapted CARE guidelines; 3) audit implementation; and 4) descriptive analysis of audit scores. Our search identified 977 articles and 35 met study inclusion criteria. On average, TMB case reports included approximately 58% of the total items identified as necessary by the TMB-adapted CARE guidelines. Introduction sections of case reports had the best item reporting (80% on average), while Case Presentation (54%) and Results (52%) sections scored moderately overall, with only 20% of necessary Practitioner Description items included on average. Audit scores revealed inconsistent abstract reporting and few audited case reports including client race (20%), perspective (26%), and occupation/activities (40%); practitioner practice setting (12%), training (12%), scope-of-practice (29%), and credentialing (20%); adverse events or lack thereof (17%); and some aspect of informed consent (34%). Treatment descriptor item reporting varied from high to low. Various implications of concern are discussed. The current audit and descriptive analysis highlight several reporting inconsistencies in TMB case reports prior to 2015. Reporting guidelines for case reports are important if standards for, and impact of, TMB case reports are desired. Adherence to reporting specifications outlined by the TMB-adapted CARE guidelines could improve the impact and usability of TMB case reports in research, education, and practice.

  10. Identifying Inconsistencies and Reporting Deficits in Therapeutic Massage and Bodywork (TMB) Case Reports Authored by TMB Practitioners: a TMB-Adapted CAse REport (CARE) Guidelines Audit Through 2014†

    PubMed Central

    Munk, Niki; Shue, Sarah; Freeland, Emilee; Ralston, Rick; Boulanger, Karen T.

    2016-01-01

    Introduction Case reports are a fundamental tool through which therapeutic massage and bodywork (TMB) practitioners can inform research and impact their field by detailing the presentation, treatment, and follow-up of a single individual encountered in practice. Inconsistencies in case reporting limit their impact as fundamental sources of clinical evidence. Using the TMB-adapted CAse REport (CARE) guidelines, the current study sought to provide a rich description regarding the reporting quality of TMB practitioner authored TMB case reports in the literature. Methods 1) Systematic identification of published, peer-reviewed TMB case reports authored by TMB practitioners following PRISMA recommendations; 2) audit development based on TMB-adapted CARE guidelines; 3) audit implementation; and 4) descriptive analysis of audit scores. Results Our search identified 977 articles and 35 met study inclusion criteria. On average, TMB case reports included approximately 58% of the total items identified as necessary by the TMB-adapted CARE guidelines. Introduction sections of case reports had the best item reporting (80% on average), while Case Presentation (54%) and Results (52%) sections scored moderately overall, with only 20% of necessary Practitioner Description items included on average. Audit scores revealed inconsistent abstract reporting and few audited case reports including client race (20%), perspective (26%), and occupation/activities (40%); practitioner practice setting (12%), training (12%), scope-of-practice (29%), and credentialing (20%); adverse events or lack thereof (17%); and some aspect of informed consent (34%). Treatment descriptor item reporting varied from high to low. Various implications of concern are discussed. Conclusion The current audit and descriptive analysis highlight several reporting inconsistencies in TMB case reports prior to 2015. Reporting guidelines for case reports are important if standards for, and impact of, TMB case reports are desired. Adherence to reporting specifications outlined by the TMB-adapted CARE guidelines could improve the impact and usability of TMB case reports in research, education, and practice. PMID:27648108

  11. A Rare Case of Transvesical Cesarean Section

    PubMed Central

    Juneja, Sunil Kumar; Tandon, Pooja; Kochhar, Bakul; Singh, Harman Deep; Sharma, Bhanupriya

    2017-01-01

    Cesarean section, also commonly known as C-section, is a surgical procedure in which incision is made through a mother's abdomen and uterus to deliver one or more babies. According to urgency, they are classified either as elective or emergency. According to technique, they have been classified as classical, lower uterine segment and cesarean hysterectomy. Intentional transvesical cesarean though not a routinely practiced technique is used for delivery in women born with imperforate anus, ectopic intravaginal urethra, vaginal and urethral strictures, and bladder adherent completely over the uterus. Since such cases are very rare, we are reporting one such case of transvesical cesarean section. PMID:28904925

  12. Frozen section analysis of margins for head and neck tumor resections: reduction of sampling errors with a third histologic level.

    PubMed

    Olson, Stephen M; Hussaini, Mohammad; Lewis, James S

    2011-05-01

    Frozen section analysis is an essential tool for assessing margins intra-operatively to assure complete resection. Many institutions evaluate surgical defect edge tissue provided by the surgeon after the main lesion has been removed. With the increasing use of transoral laser microsurgery, this method is becoming even more prevalent. We sought to evaluate error rates at our large academic institution and to see if sampling errors could be reduced by the simple method change of taking an additional third section on these specimens. All head and neck tumor resection cases from January 2005 through August 2008 with margins evaluated by frozen section were identified by database search. These cases were analyzed by cutting two levels during frozen section and a third permanent section later. All resection cases from August 2008 through July 2009 were identified as well. These were analyzed by cutting three levels during frozen section (the third a 'much deeper' level) and a fourth permanent section later. Error rates for both of these periods were determined. Errors were separated into sampling and interpretation types. There were 4976 total frozen section specimens from 848 patients. The overall error rate was 2.4% for all frozen sections where just two levels were evaluated and was 2.5% when three levels were evaluated (P=0.67). The sampling error rate was 1.6% for two-level sectioning and 1.2% for three-level sectioning (P=0.42). However, when considering only the frozen section cases where tumor was ultimately identified (either at the time of frozen section or on permanent sections) the sampling error rate for two-level sectioning was 15.3 versus 7.4% for three-level sectioning. This difference was statistically significant (P=0.006). Cutting a single additional 'deeper' level at the time of frozen section identifies more tumor-bearing specimens and may reduce the number of sampling errors.

  13. Post-stroke bacteriuria among stroke patients attending a physiotherapy clinic in Ghana: a cross-sectional study

    PubMed Central

    Donkor, Eric S; Akumwena, Amos; Amoo, Philip K; Owolabi, Mayowa O; Aspelund, Thor; Gudnason, Vilmundur

    2016-01-01

    Background Infections are known to be a major complication of stroke patients. In this study, we evaluated the risk of community-acquired bacteriuria among stroke patients, the associated factors, and the causative organisms. Methods This was a cross-sectional study involving 70 stroke patients and 83 age- and sex-matched, apparently healthy controls. Urine specimens were collected from all the study subjects and were analyzed by standard microbiological methods. Demographic and clinical information was also collected from the study subjects. For stroke patients, the information collected also included stroke parameters, such as stroke duration, frequency, and subtype. Results Bacteriuria was significantly higher among stroke patients (24.3%, n=17) than among the control group (7.2%, n=6), with a relative risk of 3.36 (confidence interval [CI], 1.40–8.01, P=0.006). Among the control group, all six bacteriuria cases were asymptomatic, whereas the 17 stroke bacteriuria cases comprised 15 cases of asymptomatic bacteriuria and two cases of symptomatic bacteriuria. Female sex (OR, 3.40; CI, 1.12–10.30; P=0.03) and presence of stroke (OR, 0.24; CI, 0.08–0.70; P=0.009) were significantly associated with bacteriuria. The etiology of bacteriuria was similar in both study groups, and coagulase-negative Staphylococcus spp. were the most predominant organisms isolated from both stroke patients (12.9%) and the control group (2.4%). Conclusion Stroke patients in the study region have a significantly higher risk of community-acquired bacteriuria, which in most cases is asymptomatic. Community-acquired bacteriuria in stroke patients appears to have little or no relationship with clinical parameters of stroke such as stroke subtype, duration and frequency. PMID:27051289

  14. Volume II: Ecosystem management: principles and applications.

    Treesearch

    M.E. Jensen; P.S. Bourgeron

    1994-01-01

    This document provides land managers with practical suggestions for implementing ecosystem management. It contains 28 papers organized into five sections: historical perspectives, ecological principles, sampling design, case studies, and implementation strategies.

  15. Proposed alternative revision strategy for broken S1 pedicle screw: radiological study, review of the literature, and case reports.

    PubMed

    Elgafy, Hossein; Miller, Jacob D; Benedict, Gregory M; Seal, Ryan J; Liu, Jiayong

    2013-07-01

    There have been many reports outlining differing methods for managing a broken S1 screw. To the authors' best knowledge, the technique used in the present study has not been described previously. It involves insertion of a second pedicle screw without removing the broken screw shaft. Radiological study, literature review, and two case reports of the surgical technique. To report a proposed new surgical technique for management of broken S1 pedicle screws. Computed tomography (CT) scans of 50 patients with a total of 100 S1 pedicles were analyzed. There were 25 male and 25 female patients with an average age of 51 years ranging from 36 to 68 years. The cephalad-caudal length, medial-lateral width, and cross-sectional area of the S1 pedicle were measured and compared with the diameter of a pedicle screw to illustrate the possibility of inserting a second screw in S1 pedicle without removal of the broken screw shaft. Two case reports of the proposed technique are presented. The left and right S1 pedicle cross-sectional area in female measured 456.00 ± 4.00 and 457.00 ± 3.00 mm(2), respectively. The left and right S1 pedicle cross-section area in male measured 638.00 ± 2.00 and 639.00 ± 1.00 mm(2), respectively. There were statistically significant differences when comparing male and female S1 pedicle length, width, and cross-sectional area (p<.05). At 2-year follow-up, the two case reports of the proposed technique showed resolution of low back pain and radicular pain. Plain radiograph and CT scan showed posterolateral fusion mass and hardware in good position with no evidence of screw loosening. The S1 pedicle dimensions measured on CT scan reviewed in the present study showed that it may be anatomically feasible to place a second screw through the S1 pedicle without the removal of the broken screw shaft. This treatment method will reduce the complications associated with other described revision strategies for broken S1 screws. Published by Elsevier Inc.

  16. Issues and Advances in the Systematic Review of Single-Case Research: A Commentary on the Exemplars

    ERIC Educational Resources Information Center

    Manolov, Rumen; Guilera, Georgina; Solanas, Antonio

    2017-01-01

    The current text comments on three systematic reviews published in the special section "Issues and Advances in the Systematic Review of Single-Case Research: An Update and Exemplars." The commentary is provided in relation to the need to combine the assessment of the methodological quality of the studies included in systematic reviews,…

  17. Higher Education Challenges in Developing Countries: The Case of Vietnam

    ERIC Educational Resources Information Center

    Oliver, Diane E.

    2004-01-01

    This review of literature was written in preparation for conducting a research study on the U.S. community college system as a potential model for developing countries, and using Vietnam as a specific case. It is divided into four sections: (a) a discussion of the purposes of higher education (HE), (b) an examination of problems faced by the HE…

  18. A histomorphological study of sarcoptic acariasis in the dog: 19 cases.

    PubMed

    Morris, D O; Dunstan, R W

    1996-01-01

    Nineteen cases of canine sarcoptic acariasis (Sarcoptes scabiei var. canis) were diagnosed histologically by identifying sarcoptic mites present in the stratum corneum. The inflammatory responses to these mites could be staged as early, fully developed, or late lesions. No histomorphological features were identified that could serve as reliable markers of infestation in the absence of a sectioned mite.

  19. No evidence for Helicobacter pylori in oral lichen planus.

    PubMed

    Hulimavu, Shwetha R; Mohanty, Leeky; Tondikulam, Narayan V; Shenoy, Sadhana; Jamadar, Saleha; Bhadranna, Abhishek

    2014-09-01

    Oral lichen planus is a T-cell-mediated mucosal disease of unknown etiology. Numerous predisposing factors have been put forward in the etiology of this disease. This includes stress, drugs, genetic susceptibility, certain viruses, and bacterial infections. Recently, there have been studies published on possible role of Helicobacter pylori infection in pathogenesis of mucocutaneous diseases including oral lichen planus (OLP). The aim of this study was to detect immunohistochemically the presence of Helicobacter pylori in oral lichen planus. Paraffin-embedded tissue blocks of 50 cases of OLP and 10 cases of normal buccal mucosal biopsies and 6 endoscopic biopsies of patients with peptic ulcer (control group) were sectioned and stained by hematoxylin and eosin. Serial sections of same were stained immunohistochemically using Anti-Helicobacter pylori antibody and observed under microscope for presence or absence of Helicobacter pylori. Except for the control group, none of the cases of OLP and normal buccal mucosal biopsies showed positivity for Helicobacter pylori. As we did not detect the presence of Helicobacter pylori in any of the OLP cases, we question the role of these organisms in the pathogenesis of OLP planus if any. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Contraction Bands Are Induced by Cardiac Massage Itself.

    PubMed

    Morita, Satomu; Furukawa, Satoshi; Nishi, Katsuji; Hitosugi, Masahito

    2016-09-01

    Pathological contraction bands (CB) are recognized as a type of necrosis pattern found in the myocardium. It is well known that CB are induced by cardiopulmonary resuscitation (CPR) with cardiac massage. However, it is not known whether the reperfusion or massage itself causes the formation of CB. We studied 10 cardiac tissues taken from forensic autopsy cases that had not received CPR. We excluded the cases where the cause of death was a cardiac event. After making sections for forensic research, we massaged the left ventricles for 10 minutes. We found CB in all cases with massage performed within 12 hours after death, which is the time frame for supravital reactions. We did not find CB in any cases where more than 24 hours had elapsed since the time of death. Contraction bands were not observed in any sections that were taken before massage. We suggested here that CB induced by CPR were caused by the cardiac massage itself, and that most CPR-induced CB are not contraction band necrosis but rather artifactual CB.

  1. An alternative simple method for preparing and preserving cross-section of leaves and roots in herbaceous plants: Case study in Orchidaceae

    NASA Astrophysics Data System (ADS)

    Metusala, D.

    2017-07-01

    This alternative method provides a simple and faster procedure for preparing cross-sections of leaves and roots in herbaceous plants, especially for living specimens of orchids (Orchidaceae). This method used a clamp-on hand sliding microtome to make cross-sections of leaves and roots, with sections preserved inside the microtubes containing preservation liquid. This preservation technique allowed the sections to be restained and to be used for further usage in future. This method was more practical than the paraffin embedding method because it does not need the additional steps of paraffin embedding and deparaffinization. It may also provide better cross-section results than free-hand sectioning method. The procedure is very feasible and is recommended for use in plant anatomy observation.

  2. Evaluating the Role of Immunological Cells (Tissue Eosinophils and Mast Cells) in Progression of Oral Squamous Cell Carcinoma.

    PubMed

    Saxena, S; Singh, A; Singh, P; Sundaragiri, K S; Sankhla, B; Bhargava, A

    2018-04-01

    Mast cells and eosinophils are increased in oral squamous cell carcinoma. The significance of such an association has been variably thought to be either a potential diagnostic tool for stromal invasion or as a prognostic indicator. The aim of the study was to study the mast cells and eosinophils between normal oral mucosa, leukoplakia and oral squamous cell carcinoma and to study the significance of mast cells in the progression of the lesion. A retrospective study was done on archival tissue received from January 2015 to December 2015, in the Department of Oral Pathology, RUHS College of Dental Sciences, Jaipur, Rajasthan, India. Seventy (70) cases were studied (30 cases each of leukoplakia and carcinoma and 10 cases of control group), sections were stained with toluidine blue solution to reveal mast cells. Eosinophils were studied in Haematoxylin & Eosin stained sections. Mast cell density significantly increased from: normal mucosa to oral leukoplakia to carcinoma, suggesting a role of the mast cells in the development of these lesions. The higher eosinophil counts in carcinoma group compared to dysplasia group proved that they might have a role in stromal invasion. The assessment of these could become, in the future, useful for therapeutic approaches in this subset of the patient.

  3. Immunohistochemical and Biochemical Expression Patterns of TTF-1, RAGE, GLUT-1 and SOX2 in HCV-Associated Hepatocellular Carcinomas

    PubMed Central

    Aboushousha, Tarek; Mamdouh, Samah; Hamdy, Hussam; Helal, Noha; Khorshed, Fatma; Safwat, Gehan; Seleem, Mohamed

    2018-01-01

    Objective: To investigate the expression of TTF-1, RAGE, GLUT1 and SOX2 in HCV-associated HCCs and in surrounding non-tumorous liver tissue. Material and Methods: Tissue material from partial hepatectomy cases for HCC along with corresponding serum samples and 30 control serum samples from healthy volunteers were studied. Biopsies were classified into: non-tumor hepatic tissue (36 sections); HCC (33 sections) and liver cell dysplasia (LCD) (15 sections). All cases were positive for HCV. Immunohistochemistry (IHC), gene extraction and quantitative real-time reverse-transcription assays (qRT-PCR) were applied. Results: By IHC, LCD and HCC showed significantly high percentages of positive cases with all markers. SOX2 showed significant increase with higher HCC grades, while RAGE demonstrated an inverse relation and GLUT-1 and TTF-1 lacked any correlation. In nontumorous-HCV tissue, we found significantly high TTF-1, low RAGE and negative SOX2 expression. RAGE, GLUT-1 and SOX2 show non-significant elevation positivity in high grade HCV compared to low grade lesions. TTF-1, RAGE and SOX2 exhibited low expression in cirrhosis compared to fibrosis. Biochemical studies on serum and tissue extracts revealed significant down-regulation of RAGE, GLUT-1 and SOX2 genes, as well as significant up-regulation of the TTF-1 gene in HCC cases compared to controls. All studied genes show significant correlation with HCC grade. In non-tumor tissue, only TTF-1 gene expression had a significant correlation with the fibrosis score. Conclusion: Higher expression of TTF-1, RAGE, GLUT-1 and SOX2 in HCC and dysplasia compared to non-tumor tissues indicates up-regulation of these markers as early events during the development of HCV-associated HCC. PMID:29373917

  4. Immunohistochemical and Biochemical Expression Patterns of TTF-1, RAGE, GLUT-1 and SOX2 in HCV-Associated Hepatocellular Carcinomas

    PubMed

    Aboushousha, Tarek; Mamdouh, Samah; Hamdy, Hussam; Helal, Noha; Khorshed, Fatma; Safwat, Gehan; Seleem, Mohamed

    2018-01-27

    Objective: To investigate the expression of TTF-1, RAGE, GLUT1 and SOX2 in HCV-associated HCCs and in surrounding non-tumorous liver tissue. Material and Methods: Tissue material from partial hepatectomy cases for HCC along with corresponding serum samples and 30 control serum samples from healthy volunteers were studied. Biopsies were classified into: non-tumor hepatic tissue (36 sections); HCC (33 sections) and liver cell dysplasia (LCD) (15 sections). All cases were positive for HCV. Immunohistochemistry (IHC), gene extraction and quantitative real-time reverse-transcription assays (qRT-PCR) were applied. Results: By IHC, LCD and HCC showed significantly high percentages of positive cases with all markers. SOX2 showed significant increase with higher HCC grades, while RAGE demonstrated an inverse relation and GLUT-1 and TTF-1 lacked any correlation. In nontumorous-HCV tissue, we found significantly high TTF-1, low RAGE and negative SOX2 expression. RAGE, GLUT-1 and SOX2 show non-significant elevation positivity in high grade HCV compared to low grade lesions. TTF-1, RAGE and SOX2 exhibited low expression in cirrhosis compared to fibrosis. Biochemical studies on serum and tissue extracts revealed significant down-regulation of RAGE, GLUT-1 and SOX2 genes, as well as significant up-regulation of the TTF-1 gene in HCC cases compared to controls. All studied genes show significant correlation with HCC grade. In non-tumor tissue, only TTF-1 gene expression had a significant correlation with the fibrosis score. Conclusion: Higher expression of TTF-1, RAGE, GLUT-1 and SOX2 in HCC and dysplasia compared to non-tumor tissues indicates up-regulation of these markers as early events during the development of HCV-associated HCC. Creative Commons Attribution License

  5. Characteristic study of flat spray nozzle by using particle image velocimetry (PIV) and ANSYS simulation method

    NASA Astrophysics Data System (ADS)

    Pairan, M. Rasidi; Asmuin, Norzelawati; Isa, Nurasikin Mat; Sies, Farid

    2017-04-01

    Water mist sprays are used in wide range of application. However it is depend to the spray characteristic to suit the particular application. This project studies the water droplet velocity and penetration angle generated by new development mist spray with a flat spray pattern. This research conducted into two part which are experimental and simulation section. The experimental was conducted by using particle image velocimetry (PIV) method, ANSYS software was used as tools for simulation section meanwhile image J software was used to measure the penetration angle. Three different of combination pressure of air and water were tested which are 1 bar (case A), 2 bar (case B) and 3 bar (case C). The flat spray generated by the new development nozzle was examined at 9cm vertical line from 8cm of the nozzle orifice. The result provided in the detailed analysis shows that the trend of graph velocity versus distance gives the good agreement within simulation and experiment for all the pressure combination. As the water and air pressure increased from 1 bar to 2 bar, the velocity and angle penetration also increased, however for case 3 which run under 3 bar condition, the water droplet velocity generated increased but the angle penetration is decreased. All the data then validated by calculate the error between experiment and simulation. By comparing the simulation data to the experiment data for all the cases, the standard deviation for this case A, case B and case C relatively small which are 5.444, 0.8242 and 6.4023.

  6. 26 CFR 301.9100-14T - Individual's election to terminate taxable year when case commences.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... when case commences. 301.9100-14T Section 301.9100-14T Internal Revenue INTERNAL REVENUE SERVICE... Rules Application of Internal Revenue Laws § 301.9100-14T Individual's election to terminate taxable year when case commences. (a) Scope. The regulations prescribed in this section provide rules for...

  7. Behaviour of wrapped cold-formed steel columns under different loading conditions

    NASA Astrophysics Data System (ADS)

    Baabu, B. Hari; Sreenath, S.

    2017-07-01

    The use of Cold Formed Steel (CFS) sections as structural members is widely accepted because of its light nature. However, the load carrying capacity of these sections will be less compared to hot rolled sections. This study is meant to analyze the possibility of strengthening cold formed members by wrapping it with Glass Fiber Reinforced Polymer (GFRP) laminates. Light gauge steel columns of cross sectional dimensions 100mm x 50mm x 3.15mm were taken for this study. The effective length of the section is about 750mm. A total of 8 specimens including the control specimen is tested under axial and eccentric loading. The columns were tested keeping both ends hinged. For both loading cases the buckling behaviour, ultimate load carrying capacity and load-deflection characteristics of the CFS columns were analyzed. The GFRP laminates were wrapped on columns in three different ways such that wrapping the outer surface of web and flange throughout the length of specimen, wrapping the outer surface of web alone throughout the length of specimen and wrapping the outer surface of web and flange for the upper half length of the specimen where the buckling is expected. For both loading cases, the results indicated that the column with wrapping at the outer surface of web and flange throughout the length of specimen provides better strength for it.

  8. Composite Structure Modeling and Analysis of Advanced Aircraft Fuselage Concepts

    NASA Technical Reports Server (NTRS)

    Mukhopadhyay, Vivek; Sorokach, Michael R.

    2015-01-01

    NASA Environmentally Responsible Aviation (ERA) project and the Boeing Company are collabrating to advance the unitized damage arresting composite airframe technology with application to the Hybrid-Wing-Body (HWB) aircraft. The testing of a HWB fuselage section with Pultruded Rod Stitched Efficient Unitized Structure (PRSEUS) construction is presently being conducted at NASA Langley. Based on lessons learned from previous HWB structural design studies, improved finite-element models (FEM) of the HWB multi-bay and bulkhead assembly are developed to evaluate the performance of the PRSEUS construction. In order to assess the comparative weight reduction benefits of the PRSEUS technology, conventional cylindrical skin-stringer-frame models of a cylindrical and a double-bubble section fuselage concepts are developed. Stress analysis with design cabin-pressure load and scenario based case studies are conducted for design improvement in each case. Alternate analysis with stitched composite hat-stringers and C-frames are also presented, in addition to the foam-core sandwich frame and pultruded rod-stringer construction. The FEM structural stress, strain and weights are computed and compared for relative weight/strength benefit assessment. The structural analysis and specific weight comparison of these stitched composite advanced aircraft fuselage concepts demonstrated that the pressurized HWB fuselage section assembly can be structurally as efficient as the conventional cylindrical fuselage section with composite stringer-frame and PRSEUS construction, and significantly better than the conventional aluminum construction and the double-bubble section concept.

  9. Advanced Containment System

    DOEpatents

    Kostelnik, Kevin M.; Kawamura, Hideki; Richardson, John G.; Noda, Masaru

    2004-10-12

    An advanced containment system for containing buried waste and associated leachate. A trench is dug on either side of the zone of interest containing the buried waste so as to accommodate a micro tunnel boring machine. A series of small diameter tunnels are serially excavated underneath the buried waste. The tunnels are excavated by the micro tunnel boring machine at a consistent depth and are substantially parallel to each other. As tunneling progresses, steel casing sections are connected end to end in the excavated portion of the tunnel so that a steel tube is formed. Each casing section has complementary interlocking structure running its length that interlocks with complementary interlocking structure on the adjacent casing section. Thus, once the first tube is emplaced, placement of subsequent tubes is facilitated by the complementary interlocking structure on the adjacent, previously placed, casing sections.

  10. Advanced Containment System

    DOEpatents

    Kostelnik, Kevin M.; Kawamura, Hideki; Richardson, John G.; Noda, Masaru

    2005-05-24

    An advanced containment system for containing buried waste and associated leachate. A trench is dug on either side of the zone of interest containing the buried waste so as to accommodate a micro tunnel boring machine. A series of small diameter tunnels are serially excavated underneath the buried waste. The tunnels are excavated by the micro tunnel boring machine at a consistent depth and are substantially parallel to each other. As tunneling progresses, steel casing sections are connected end to end in the excavated portion of the tunnel so that a steel tube is formed. Each casing section has complementary interlocking structure running its length that interlocks with complementary interlocking structure on the adjacent casing section. Thus, once the first tube is emplaced, placement of subsequent tubes is facilitated by the complementary interlocking structure on the adjacent, previously placed, casing sections.

  11. Program to Optimize Simulated Trajectories II (POST2) Surrogate Models for Mars Ascent Vehicle (MAV) Performance Assessment

    NASA Technical Reports Server (NTRS)

    Zwack, M. R.; Dees, P. D.; Thomas, H. D.; Polsgrove, T. P.; Holt, J. B.

    2017-01-01

    The primary purpose of the multiPOST tool is to enable the execution of much larger sets of vehicle cases to allow for broader trade space exploration. However, this exploration is not achieved solely with the increased case throughput. The multiPOST tool is applied to carry out a Design of Experiments (DOE), which is a set of cases that have been structured to capture a maximum amount of information about the design space with minimal computational effort. The results of the DOE are then used to fit a surrogate model, ultimately enabling parametric design space exploration. The approach used for the MAV study includes both DOE and surrogate modeling. First, the primary design considerations for the vehicle were used to develop the variables and ranges for the multiPOST DOE. The final set of DOE variables were carefully selected in order to capture the desired vehicle trades and take into account any special considerations for surrogate modeling. Next, the DOE sets were executed through multiPOST. Following successful completion of the DOE cases, a manual verification trial was performed. The trial involved randomly selecting cases from the DOE set and running them by hand. The results from the human analyst's run and multiPOST were then compared to ensure that the automated runs were being executed properly. Completion of the verification trials was then followed by surrogate model fitting. After fits to the multiPOST data were successfully created, the surrogate models were used as a stand-in for POST2 to carry out the desired MAV trades. Using the surrogate models in lieu of POST2 allowed for visualization of vehicle sensitivities to the input variables as well as rapid evaluation of vehicle performance. Although the models introduce some error into the output of the trade study, they were very effective at identifying areas of interest within the trade space for further refinement by human analysts. The next section will cover all of the ground rules and assumptions associated with DOE setup and multiPOST execution. Section 3.1 gives the final DOE variables and ranges, while section 3.2 addresses the POST2 specific assumptions. The results of the verification trials are given in section 4. Section 5 gives the surrogate model fitting results, including the goodness-of-fit metrics for each fit. Finally, the MAV specific results are discussed in section 6.

  12. Environmental impact case study : Route 220, Fincastle to Eagle Rock : Project 0220-002-106.

    DOT National Transportation Integrated Search

    1971-01-01

    At the request of the Environmental Quality Division, the Environmental and Economics Section of the Virginia Highway Research Council conducted a study to determine the probable socioeconomic and environmental impact of the proposed dual-laning of R...

  13. Diagnostic pitfalls of infarcted Warthin tumor in frozen section evaluation.

    PubMed

    Tan, Yaohong; Kryvenko, Oleksandr N; Kerr, Darcy A; Chapman, Jennifer R; Kovacs, Christina; Arnold, David J; Rosenberg, Andrew E; Gomez-Fernandez, Carmen R

    2016-12-01

    Warthin tumor (WT) is the second most common benign salivary gland neoplasm and has characteristic cytologic and histologic findings. Fine-needle aspiration is a common and useful preoperative diagnostic technique, which sometimes leads to ischemic injury resulting in the infarction of these lesions. Infarcted WT may demonstrate variable gross and histologic alterations that may render the diagnosis challenging, particularly during intraoperative frozen section evaluation. In this study, we collected 11 resection specimens from 9 patients with infarcted WT. Seven patients were men and 2 were women, ranging from 49 to 85 years (mean, 69). All the patients had fine-needle aspiration before the resection. Macroscopically, the tumors were tan-white and contained soft, yellow, exudative material. The histologic findings were variable and included necrosis, ghosts of papillae, squamous metaplasia, cholesterol clefts, foamy macrophages, multinucleated giant cell reaction, necrotizing granulomas, and fibrosis. Each case predominantly demonstrated 1 or 2 of these histomorphologic features. In the permanent sections, additional sampling revealed foci of residual viable WT in 8 cases. Three cases were completely infarcted; however, they all had ghost-like papillae in which the architecture of WT was evident. Infarcted WT may present a diagnostic challenge during intraoperative frozen section evaluation. Associated morphologic alterations may preclude a definitive diagnosis of WT and may mimic malignancy. Awareness of the gross and microscopic features associated with infarcted WT is important, particularly for accurate frozen section evaluation of these salivary gland tumors. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Factors associated with severe maternal morbidity in Kelantan, Malaysia: A comparative cross-sectional study.

    PubMed

    Norhayati, Mohd Noor; Nik Hazlina, Nik Hussain; Aniza, Abd Aziz; Sulaiman, Zaharah

    2016-07-26

    Knowledge on the factors associated with severe maternal morbidity enables a better understanding of the problem and serves as a foundation for the development of an effective preventive strategy. However, various definitions of severe maternal morbidity have been applied, leading to inconsistencies between studies. The objective of this study was to identify the sociodemographic characteristics, medical and gynaecological history, past and present obstetric performance and the provision of health care services as associated factors for severe maternal morbidity in Kelantan, Malaysia. A comparative cross-sectional study was conducted in two tertiary referral hospitals in 2014. Postpartum women with severe morbidity and without severe morbidity who fulfilled the inclusion and exclusion criteria were eligible as cases and controls, respectively. The study population included all postpartum women regardless of their age. Pregnancy at less than 22 weeks of gestation, more than 42 days after the termination of pregnancy and non-Malaysian citizens were excluded. Consecutive sampling was applied for the selection of cases and for each case identified, one unmatched control from the same hospital was selected using computer-based simple random sampling. Simple and multiple logistic regressions were performed using Stata Intercooled version 11.0. A total of 23,422 pregnant women were admitted to these hospitals in 2014 and 395 women with severe maternal morbidity were identified, of which 353 were eligible as cases. An age of 35 or more years old [Adj. OR (95 % CI): 2.6 (1.67, 4.07)], women with past pregnancy complications [Adj. OR (95 % CI): 1.7 (1.00, 2.79)], underwent caesarean section deliveries [Adj. OR (95 % CI): 6.8 (4.68, 10.01)], preterm delivery [Adj. OR (95 % CI): 3.4 (1.87, 6.32)] and referral to tertiary centres [Adj. OR (95 % CI): 2.7 (1.87, 3.97)] were significant associated factors for severe maternal morbidity. Our study suggests the enhanced screening and monitoring of women of advanced maternal age, women with past pregnancy complications, those who underwent caesarean section deliveries, those who delivered preterm and the mothers referred to tertiary centres as they are at increased risk of severe maternal morbidity. Identifying these factors may contribute to specific and targeted strategies aimed at tackling the issues related to maternal morbidity.

  15. 26 CFR 1.832-4 - Gross income.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...

  16. 26 CFR 1.832-4 - Gross income.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...

  17. 26 CFR 1.832-4 - Gross income.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...

  18. 26 CFR 1.832-4 - Gross income.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... TAXES (CONTINUED) Other Insurance Companies § 1.832-4 Gross income. (a)(1) Gross income as defined in... under section 61, except that in the case of a mutual fire insurance company described in section 831(a... gross income. Section 832(b)(1)(D) provides that in the case of a mutual fire or flood insurance company...

  19. Supervisor Behaviours that Facilitate Training Transfer

    ERIC Educational Resources Information Center

    Lancaster, Sue; Di Milia, Lee; Cameron, Roslyn

    2013-01-01

    Purpose: The purpose of this paper is to describe the supervisor behaviours that employees found to be helpful and unhelpful in facilitating training transfer. The study aims to provide rich qualitative data from the employee's perspective. Design/methodology/approach: This study utilises a cross-sectional design. A case study and a qualitative…

  20. Subgroup Benchmark Calculations for the Intra-Pellet Nonuniform Temperature Cases

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

    Kim, Kang Seog; Jung, Yeon Sang; Liu, Yuxuan

    A benchmark suite has been developed by Seoul National University (SNU) for intrapellet nonuniform temperature distribution cases based on the practical temperature profiles according to the thermal power levels. Though a new subgroup capability for nonuniform temperature distribution was implemented in MPACT, no validation calculation has been performed for the new capability. This study focuses on bench-marking the new capability through a code-to-code comparison. Two continuous-energy Monte Carlo codes, McCARD and CE-KENO, are engaged in obtaining reference solutions, and the MPACT results are compared to the SNU nTRACER using a similar cross section library and subgroup method to obtain self-shieldedmore » cross sections.« less

  1. Perinatal factors and the risk of bipolar disorder in Finland.

    PubMed

    Chudal, Roshan; Sourander, Andre; Polo-Kantola, Päivi; Hinkka-Yli-Salomäki, Susanna; Lehti, Venla; Sucksdorff, Dan; Gissler, Mika; Brown, Alan S

    2014-02-01

    Complications during the perinatal period have been associated with neurodevelopmental disorders like schizophrenia and autism. However, similar studies on bipolar disorder (BPD) have been limited and the findings are inconsistent. The aim of this study was to examine the association between perinatal risk factors and BPD. This nested case-control study, based on the Finnish Prenatal Study of Bipolar Disorders (FIPS-B), identified 724 cases and 1419 matched controls from population based registers. Conditional logistic regression was used to examine the associations between perinatal factors and BPD adjusting for potential confounding due to maternal age, psychiatric history and educational level, place of birth, number of previous births and maternal smoking during pregnancy. Children delivered by planned cesarean section had a 2.5-fold increased risk of BPD (95% CI: 1.32-4.78, P<0.01). No association was seen between other examined perinatal risk factors and BPD. The limitations of this study include: the restriction in the sample to treated cases of BPD in the population, and usage of hospital based clinical diagnosis for case ascertainment. In addition, in spite of the large sample size, there was low power to detect associations for certain exposures including the lowest birth weight category and pre-term birth. Birth by planned cesarean section was associated with risk of BPD, but most other perinatal risk factors examined in this study were not associated with BPD. Larger studies with greater statistical power to detect less common exposures and studies utilizing prospective biomarker-based exposures are necessary in the future. © 2013 Published by Elsevier B.V.

  2. Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series

    PubMed Central

    Patil, Shankargouda; Sarode, Gargi S.; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

    2017-01-01

    Background Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. Method A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of ‘Oral submucous fibrosis’, ‘prosthesis’, ‘dentures’ and/or ‘restricted mouth opening’. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. Results A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Conclusion Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results. PMID:28877246

  3. Prosthetic rehabilitation of oral submucous fibrosis patients: A systematic review of published case reports and case series.

    PubMed

    Patil, Shankargouda; Sarode, Sachin Chakradhar; Sarode, Gargi S; Bhandi, Shilpa; Awan, Kamran Habib; Ferrari, Marco

    2017-01-01

    Oral submucous fibrosis (OSF) is an insidious chronic condition characterized by restricted mouth opening. Prosthetic rehabilitation is challenging for OSF patients as obtaining a good impression requires adequate mouth opening. The aim of the present review is to systematically present the data from case reports published in the English-language literature. A comprehensive search of the literature databases (PubMed, Medline, SCOPUS, Web of Science and Google Scholar) along with the references of published articles on prosthetic rehabilitation in OSF patients published to date was conducted. Keywords included a combination of 'Oral submucous fibrosis', 'prosthesis', 'dentures' and/or 'restricted mouth opening'. Citations from selected references and bibliographic linkages taken from similar cases were included in this review. The inclusion criteria selected for case reports on prosthetic rehabilitation in OSF patients, and cases of restricted mouth opening due to causes other than OSF were excluded from the study. A total of 21 cases were identified and analysed from 17 papers published in the English-language literature. Of these, 9 cases employed the sectional denture technique, 4 cases emphasized the need-based treatment approach in which conventional methods were modified, and 4 cases used mouth exercising devices. Finally, 1 case each involved, flexible denture, oral screen prosthesis, oral stents, surgery in conjunction with dentures. Prosthetic rehabilitation in OSF patients is a multifaceted approach and should be patient specific, although sectional dentures have achieved the best results.

  4. Tribal 319: 2010 NPS Workshop

    EPA Pesticide Factsheets

    This tribal training was offered during the first day of the National Water Quality Monitoring Council conference held in Denver, Colorado. The session covered CWA Section 106 and 319 topics, and featured three tribal case studies.

  5. Wind Energy Applications for Municipal Water Services: Opportunities, Situation Analyses, and Case Studies; Preprint

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

    Flowers, L.; Miner-Nordstrom, L.

    2006-01-01

    As communities grow, greater demands are placed on water supplies, wastewater services, and the electricity needed to power the growing water services infrastructure. Water is also a critical resource for thermoelectric power plants. Future population growth in the United States is therefore expected to heighten competition for water resources. Many parts of the United States with increasing water stresses also have significant wind energy resources. Wind power is the fastest-growing electric generation source in the United States and is decreasing in cost to be competitive with thermoelectric generation. Wind energy can offer communities in water-stressed areas the option of economicallymore » meeting increasing energy needs without increasing demands on valuable water resources. Wind energy can also provide targeted energy production to serve critical local water-system needs. The research presented in this report describes a systematic assessment of the potential for wind power to support water utility operation, with the objective to identify promising technical applications and water utility case study opportunities. The first section describes the current situation that municipal providers face with respect to energy and water. The second section describes the progress that wind technologies have made in recent years to become a cost-effective electricity source. The third section describes the analysis employed to assess potential for wind power in support of water service providers, as well as two case studies. The report concludes with results and recommendations.« less

  6. Mandibular molar uprighting using mini-implants: different approaches for different clinical cases--two case reports.

    PubMed

    Derton, Nicola; Perini, Alessandro; Mutinelli, Sabrina; Gracco, Antonio

    2012-01-01

    To detail two different clinical protocols and case studies using mini-implant anchorage developed to respond to certain clinical conditions. Two clinical protocols are described to upright mesially tilted mandibular molars. In the first protocol, a single mini-implant is inserted distally to the molar to be uprighted, and an elastic traction chain is applied to the tooth. In the second clinical approach, two mini-implants are inserted mesially. A screw-suspended TMA sectional archwire is applied (Derton-Perini technique). Two cases, descriptive of the two different treatment protocols, are described. In the first case, the mandibular right second premolar was missing and the adjacent first molar needed to be uprighted. A single screw was inserted distally to the first molar, and an elastic chain was applied. In the second case, the mandibular left second molar was missing and the third molar needed to be uprighted. Two mini-implants were inserted mesially and a fully screw-supported sectional archwire was used to upright and bodily mesialize the third molar. Both uprighting approaches uprighted the molar axis without loss of anchorage. The two approaches to mandibular molar uprighting, developed as rational responses to different clinical cases, were both found to be effective.

  7. A subleading operator basis and matching for gg → H

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

    Moult, Ian; Stewart, Iain W.; Vita, Gherardo

    The Soft Collinear Effective Theory (SCET) is a powerful framework for studying factorization of amplitudes and cross sections in QCD. While factorization at leading power has been well studied, much less is known at subleading powers in the λ << 1 expansion. In SCET subleading soft and collinear corrections to a hard scattering process are described by power suppressed operators, which must be fixed case by case, and by well established power suppressed Lagrangians, which correct the leading power dynamics of soft and collinear radiation. Here we present a complete basis of power suppressed operators for gg → H, classifyingmore » all operators which contribute to the cross section at O(λ 2), and showing how helicity selection rules significantly simplify the construction of the operator basis. We perform matching calculations to determine the tree level Wilson coefficients of our operators. These results are useful for studies of power corrections in both resummed and fixed order perturbation theory, and for understanding the factorization properties of gauge theory amplitudes and cross sections at subleading power. As one example, our basis of operators can be used to analytically compute power corrections for N -jettiness subtractions for gg induced color singlet production at the LHC.« less

  8. A subleading operator basis and matching for gg → H

    DOE PAGES

    Moult, Ian; Stewart, Iain W.; Vita, Gherardo

    2017-07-01

    The Soft Collinear Effective Theory (SCET) is a powerful framework for studying factorization of amplitudes and cross sections in QCD. While factorization at leading power has been well studied, much less is known at subleading powers in the λ << 1 expansion. In SCET subleading soft and collinear corrections to a hard scattering process are described by power suppressed operators, which must be fixed case by case, and by well established power suppressed Lagrangians, which correct the leading power dynamics of soft and collinear radiation. Here we present a complete basis of power suppressed operators for gg → H, classifyingmore » all operators which contribute to the cross section at O(λ 2), and showing how helicity selection rules significantly simplify the construction of the operator basis. We perform matching calculations to determine the tree level Wilson coefficients of our operators. These results are useful for studies of power corrections in both resummed and fixed order perturbation theory, and for understanding the factorization properties of gauge theory amplitudes and cross sections at subleading power. As one example, our basis of operators can be used to analytically compute power corrections for N -jettiness subtractions for gg induced color singlet production at the LHC.« less

  9. Case report: Anesthesia management for emergency cesarean section in a patient with dwarfism.

    PubMed

    Li, Xiaoxi; Duan, Hongjun; Zuo, Mingzhang

    2015-04-28

    Dwarfism is characterized by short stature. Pregnancy in women with dwarfism is uncommon and cesarean section is generally indicated for delivery. Patients with dwarfism are high-risk population for both general and regional anesthesia, let alone in an emergency surgery. In this case report we present a 27-year-old Chinese puerpera with dwarfism who underwent emergency cesarean section under combined spinal and epidural anesthesia. It is an original case report, which provides instructive significance for anesthesia management especially combined spinal and epidural anesthesia in this rare condition. There was only one former article that reported a puerpera who underwent combined spinal and epidural anesthesia for a selective cesarean section.

  10. A petrographic thin sectioning technique for evaluating composite materials

    NASA Technical Reports Server (NTRS)

    Parker, D. S.; Yee, A. F.

    1989-01-01

    Petrographic thin sectioning by a low-speed diamond saw has been used in conjunction with transmission polarized light microscopy for the characterization of the microstructure and deformation mechanisms of a variety of polymer systems. It has proven possible by these means to study three types of thermoplastic matrices for composite applications: PEEK, BPA-based polycarbonate (PC), and a rubber-modified PC. The reinforcing fibers for these matrices were in all cases AS4 carbon fibers, unidirectionally arrayed. Superior analyzability of matrix morphology and subsurface fracture processes is achieved by thin sectioning.

  11. Extraneous tissue in surgical pathology: a College of American Pathologists Q-Probes study of 275 laboratories.

    PubMed

    Gephardt, G N; Zarbo, R J

    1996-11-01

    To develop a multi-institutional reference database of extraneous tissue (contaminants) in surgical pathology. In 1994, participants in the College of American Pathologists Q-Probes quality improvement program performed prospective and retrospective evaluations of extraneous tissue found in surgical pathology microscopic sections for a period of 4 weeks or until 1000 slides were reviewed in each participating laboratory. Two hundred seventy-five surgical pathology laboratories institutions, predominantly from North America. Extraneous tissue contamination rate for slides in prospective and retrospective reviews; staffing and practice procedures; location of extraneous tissue on slides; type of extraneous tissue (normal, abnormal, nonneoplastic, neoplasm, microorganisms, etc); class of extraneous tissue (slide or block contaminants); source of extraneous tissue (different or same case); origin of extraneous tissue (pathology laboratory, physician's office or operating room); and degree of diagnostic difficulty caused by extraneous tissue. Three hundred twenty-one thousand seven hundred fifty-seven slides were reviewed in the prospective study and 57083 slides in the retrospective study. There was an overall extraneous tissue rate of 0.6% of slides (2074/321757) in the prospective study and 2.9% of slides (1653/57083) in the retrospective study. Of those slides with extraneous tissue, the extraneous tissue was located near diagnostic tissue sections in 59.5% of the slides reviewed prospectively and in 25.3% of slides reviewed retrospectively; deeper sections were performed to evaluate extraneous tissue in 12.2% of prospective cases and in 3.1% of retrospective cases. Of the laboratories, 98% had written guidelines for changing solution in tissue processors, and 64.9% had guidelines for maintaining water baths free of extraneous tissue. A total of 98.9% used lens paper, filter bags, or sponges for processing fragmented and small specimens. Written protocols for documentation of extraneous tissue in surgical pathology reports were established in 6.1% of laboratories, for removal of extraneous tissue from blocks in 5.7%, and for removal of extraneous tissue from microscopic slides in 4.7%. In 24% of laboratories no comment or record was kept to document extraneous tissue. Extraneous tissue consisted of neoplasm in 12.7% of the prospectively reviewed slides and in 6.0% of the retrospectively reviewed slides. For the prospective study, 59.4% of extraneous tissue was classified as slide contaminants, and 28.4% was found to be contaminants within the paraffin block; for the retrospective study, 72.9% was classified as slide contaminants and 15.9% as block contaminants. For the prospective study, 63.2% of extraneous tissue was presumed to be from a different case, and in the retrospective study, 48.5% was presumed to be from a different case. Over 90% of extraneous tissue was thought to originate from the pathology laboratory. The degree of diagnostic difficulty caused by extraneous tissue was judged to be severe in 0.4% of slides in the prospective study and 0.1% of slides in the retrospective study. In the prospective study, it could not be determined whether the tissue in the diagnostic sections was extraneous in 0.6% of slides, and in the retrospective study, it could not be determined whether tissue in the diagnostic sections was extraneous in 0.1%. This study has documented the frequency, type, origin, source, and diagnostic difficulty of extraneous tissue and presents benchmarks of extraneous tissue experienced in the general practice of surgical pathology.

  12. Benefit of computer-aided detection analysis for the detection of subsolid and solid lung nodules on thin- and thick-section CT.

    PubMed

    Godoy, Myrna C B; Kim, Tae Jung; White, Charles S; Bogoni, Luca; de Groot, Patricia; Florin, Charles; Obuchowski, Nancy; Babb, James S; Salganicoff, Marcos; Naidich, David P; Anand, Vikram; Park, Sangmin; Vlahos, Ioannis; Ko, Jane P

    2013-01-01

    The objective of our study was to evaluate the impact of computer-aided detection (CAD) on the identification of subsolid and solid lung nodules on thin- and thick-section CT. For 46 chest CT examinations with ground-glass opacity (GGO) nodules, CAD marks computed using thin data were evaluated in two phases. First, four chest radiologists reviewed thin sections (reader(thin)) for nodules and subsequently CAD marks (reader(thin) + CAD(thin)). After 4 months, the same cases were reviewed on thick sections (reader(thick)) and subsequently with CAD marks (reader(thick) + CAD(thick)). Sensitivities were evaluated. Additionally, reader(thick) sensitivity with assessment of CAD marks on thin sections was estimated (reader(thick) + CAD(thin)). For 155 nodules (mean, 5.5 mm; range, 4.0-27.5 mm)-74 solid nodules, 22 part-solid (part-solid nodules), and 59 GGO nodules-CAD stand-alone sensitivity was 80%, 95%, and 71%, respectively, with three false-positives on average (0-12) per CT study. Reader(thin) + CAD(thin) sensitivities were higher than reader(thin) for solid nodules (82% vs 57%, p < 0.001), part-solid nodules (97% vs 81%, p = 0.0027), and GGO nodules (82% vs 69%, p < 0.001) for all readers (p < 0.001). Respective sensitivities for reader(thick), reader(thick) + CAD(thick), reader(thick) + CAD(thin) were 40%, 58% (p < 0.001), and 77% (p < 0.001) for solid nodules; 72%, 73% (p = 0.322), and 94% (p < 0.001) for part-solid nodules; and 53%, 58% (p = 0.008), and 79% (p < 0.001) for GGO nodules. For reader(thin), false-positives increased from 0.64 per case to 0.90 with CAD(thin) (p < 0.001) but not for reader(thick); false-positive rates were 1.17, 1.19, and 1.26 per case for reader(thick), reader(thick) + CAD(thick), and reader(thick) + CAD(thin), respectively. Detection of GGO nodules and solid nodules is significantly improved with CAD. When interpretation is performed on thick sections, the benefit is greater when CAD marks are reviewed on thin rather than thick sections.

  13. 26 CFR 1.611-5 - Depreciation of improvements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... Section 611 provides in the case of mines, oil and gas wells, other natural deposits, and timber that... governing the apportioning of depreciation allowances under sections 611 and 167 in the case of property held by one person for life with remainder to another or in the case of property held in trust or by an...

  14. 26 CFR 20.2014-4 - Application of credit in cases involving a death tax convention.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... death tax convention. 20.2014-4 Section 20.2014-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... 16, 1954 Credits Against Tax § 20.2014-4 Application of credit in cases involving a death tax... section 2014, whichever is the more beneficial to the estate. For cases where credit may be taken under...

  15. 45 CFR 302.52 - Distribution of support collected in Title IV-E foster care maintenance cases.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... under paragraphs (b) (1) and (2) of this section, but not the total unreimbursed foster care maintenance... foster care maintenance cases. 302.52 Section 302.52 Public Welfare Regulations Relating to Public... Distribution of support collected in Title IV-E foster care maintenance cases. Effective October 1, 1984, the...

  16. Comparison of CFD simulations to non-rotating MEXICO blades experiment in the LTT wind tunnel of TUDelft

    NASA Astrophysics Data System (ADS)

    Zhang, Ye; van Zuijlen, Alexander; van Bussel, Gerard

    2014-06-01

    In this paper, three dimensional flow over non-rotating MEXICO blades is simulated by CFD methods. The numerical results are compared with the latest MEXICO wind turbine blades measurements obtained in the low speed low turbulence (LTT) wind tunnel of Delft University of Technology. This study aims to validate CFD codes by using these experimental data measured in well controlled conditions. In order to avoid use of wind tunnel corrections, both the blades and the wind tunnel test section are modelled in the simulations. The ability of Menter's k - ω shear stress transport (SST) turbulence model is investigated at both attached flow and massively separated flow cases. Steady state Reynolds averaged Navier Stokes (RANS) equations are solved in these computations. The pressure distribution at three measured sections are compared under the conditions of different inflow velocities and a range of angles of attack. The comparison shows that at attached flow condition, good agreement can be obtained for all three airfoil sections. Even with massively separated flow, still fairly good pressure distribution comparison can be found for the DU and NACA airfoil sections, although the RISØ section shows poor comparison. At the near stall case, considerable deviations exists on the forward half part of the upper surface for all three sections.

  17. A Simulation to Study Speed Distributions in a Solar Plasma

    NASA Technical Reports Server (NTRS)

    Cheeseman, Peter; Alvarellos, Jose Luis

    1999-01-01

    We have carried out a numerical simulation of a plasma with characteristics similar to those found in the core of the Sun. Particular emphasis is placed on the Coulomb interaction between the ions and electrons, which could result in a relative velocity distribution different from the Maxwell-Boltzmann (MB) distribution generally assumed for a plasma. The fact that the distribution may not exactly follow the MB distribution could have very important consequences for a variety of problems in solar physics, especially the neutrino problem. Very briefly, the neutrino problem is that the observed neutrino detections from the Sun are smaller than what the standard solar theory predicts. In Section I we introduce the problem and in section II we discuss the approach to try to solve the problem: i.e., a molecular dynamics approach. In section III we provide details about the integration method, and any simplifications that can be applied to the problem. In section IV (the core of this report) we state our results. First for the specific case of 1000 particles and then for other cases with different number of particles. In section V we summarize our findings and state our conclusions. Sections VI VII and VIII provide the list of figures, reference material and acknowledgements respectively.

  18. Reversal of the decision for caesarean section in the second stage of labour on the basis of consultant vaginal assessment.

    PubMed

    Oláh, K S

    2005-02-01

    During a 5-year period there were 32 cases where the vaginal assessment performed by a specialist registrar in the second stage of labour was re-assessed within 15 minutes by a consultant obstetrician. The examination was prompted by a request for permission to perform a caesarean section in the second stage of labour. The results suggest a significant discrepancy between the consultants and the specialist registrar's findings, with 44% of the cases indicating a difference in the position of the head, and 81% a difference in the station of the head. No comment was made about caput or moulding in the majority of cases (94%). The study findings suggest that vaginal examination, like instrumental delivery, is a skill that is being eroded and will require formal instruction to address this problem.

  19. Growth and resilience of pioneering nonprofit human service organizations: a cross-case analysis of organizational histories.

    PubMed

    Kimberlin, Sara E; Schwartz, Sara L; Austin, Michael J

    2011-01-01

    Knowledge of organizational history is important for recognizing patterns in effective management and understanding how organizations respond to internal and external challenges. This cross-case analysis of 12 histories of pioneering nonprofit human service organizations contributes an important longitudinal perspective on organizational history, complementing the cross-sectional case studies that dominate the existing research on nonprofit organizations. The literature on organizational growth, including lifecycle models and growth management, is reviewed, along with the literature on organizational resilience. Based on analysis of the 12 organizational histories, a conceptual model is presented that synthesizes key factors in the areas of leadership, internal operations, and external relations that influence organizational growth and resilience to enable nonprofit organizations to survive and thrive over time. Both cross-sectional and longitudinal examples from the organizational histories illustrate the conceptual map. The paper concludes with a discussion of directions for future research on nonprofit organizational history.

  20. [The Role of Segmental Analysis of Clonazepam in Hair in Drug Facilitated Cases].

    PubMed

    Chen, H; Xiang, P; Shen, M

    2017-06-01

    To infer the frequency of dosage and medication history investigate of the victims in drug facilitated cases by the segmental analysis of clonazepam in hair. Freezing milling under liquid nitrogen environment combined with ultrasonic bath was used as sample pretreatment in this study, and liquid chromatography-tandem mass spectrometry was used for the segmental analysis of the hair samples collected from 6 victims in different cases. The concentrations of clonazepam and 7-aminoclonazepam were detected in each hair section. Clonazepam and its metabolite 7-aminoclonazepam were detected in parts of hair sections from the 6 victims. The occurrence time of drug peak concentration was consistent with the intake timing provided by victims. Segmental analysis of hair can provide the information of frequency of dosage and intake timing, which shows an unique evidential value in drug facilitated crimes. Copyright© by the Editorial Department of Journal of Forensic Medicine

  1. A case study of experimental passing zones on Route 8 in Patrick County.

    DOT National Transportation Integrated Search

    1982-01-01

    This study examined the operational characteristics of the four-mile section of Route 8 between Routes 57 and 58. It was noted that these characteristics were significantly improved after provision of the experimental passing zones. Average and 85th ...

  2. Common acute lymphoblastic leukaemia-lymphoma expressing cytokeratin: a case report.

    PubMed

    Menestrina, F; Lestani, M; Scarpa, A; Viale, G; Bonetti, F; Pizzolo, G; Chilosi, M

    1994-01-01

    This report presents a case of common acute lymphoblastic leukaemia-lymphoma expressing low molecular weight cytokeratin but no leukocyte common antigen (CD45) in a 57-year-old man. The unusual morphology and clinical course together with the aberrant immunohistochemical results suggested a diagnosis of undifferentiated carcinoma. A detailed immunohistochemistry study on frozen and paraffin sections and molecular analysis prevented a diagnostic mistake.

  3. PLA2G7 genotype, Lp-PLA2 activity and coronary heart disease risk in 10,494 cases and 15,624 controls of European ancestry

    PubMed Central

    Casas, Juan P.; Ninio, Ewa; Panayiotou, Andrie; Palmen, Jutta; Cooper, Jackie A; Ricketts, Sally L; Sofat, Reecha; Nicolaides, Andrew N; Corsetti, James P; Fowkes, F Gerry R; Tzoulaki, Ioanna; Kumari, Meena; Brunner, Eric J; Kivimaki, Mika; Marmot, Michael G; Hoffmann, Michael M; Winkler, Karl; März, Winfred; Ye, Shu; Stirnadel, Heide A; MBBChir, Kay-Tee Khaw; Humphries, Steve E; Sandhu, Manjinder S; Hingorani, Aroon D; Talmud, Philippa J

    2012-01-01

    Background Higher Lp-PLA2 activity is associated with increased risk of coronary heart disease (CHD), making Lp-PLA2 a potential therapeutic target. PLA2G7 variants associated with Lp-PLA2 activity could evaluate whether this relationship is causal. Methods and Results A meta-analysis including a total of 12 studies (5 prospective, 4 case-control, 1 case-only and 2 cross-sectional, n=26,118) was undertaken to examine the association of: (i) LpPLA2 activity vs. cardiovascular biomarkers and risk factors and CHD events (two prospective studies; n=4884); ii) PLA2G7 SNPs and Lp-PLA2 activity (3 prospective, 2 case-control, 2 cross-sectional studies; up to n=6094); and iii) PLA2G7 SNPs and angiographic coronary artery disease (2 case-control, 1 case-only study; n=4971 cases) and CHD events (5 prospective, 2 case-control studies; n=5523). Lp-PLA2 activity correlated with several CHD risk markers. Hazard ratio for CHD events top vs. bottom quartile of Lp-PLA2 activity was 1.61 (95%CI: 1.31, 1.99) and 1.17 (95%CI: 0.91, 1.51) after adjustment for baseline traits. Of seven SNPs, rs1051931 (A379V) showed the strongest association with Lp-PLA2 activity, VV subjects having 7.2% higher activity than AAs. Genotype was not associated with risk markers, angiographic coronary disease (OR 1.03 (95%CI 0.80, 1.32), or CHD events (OR 0.98 (95%CI 0.82, 1.17). Conclusions Unlike Lp-PLA2 activity, PLA2G7 variants associated with modest effects on Lp-PLA2 activity were not associated with cardiovascular risk markers, coronary atheroma or CHD. Larger association studies, identification of SNPs with larger effects, or randomised trials of specific Lp-PLA2 inhibitors are needed to confirm/refute a contributory role for Lp-PLA2 in CHD. PMID:20479152

  4. Reducing Uncertainties in Neutron-Induced Fission Cross Sections Using a Time Projection Chamber

    NASA Astrophysics Data System (ADS)

    Manning, Brett; Niffte Collaboration

    2015-10-01

    Neutron-induced fission cross sections for actinides have long been of great interest for nuclear energy and stockpile stewardship. Traditionally, measurements were performed using fission chambers which provided limited information about the detected fission events. For the case of 239Pu(n,f), sensitivity studies have shown a need for more precise measurements. Recently the Neutron Induced Fission Fragment Tracking Experiment (NIFFTE) has developed the fission Time Projection Chamber (fissionTPC) to measure fission cross sections to better than 1% uncertainty by providing 3D tracking of fission fragments. The fissionTPC collected data to calculate the 239Pu(n,f) cross section at the Weapons Neutron Research facility at the Los Alamos Neutron Science Center during the 2014 run cycle. Preliminary analysis has been focused on studying particle identification and target and beam non-uniformities to reduce the uncertainty on the cross section. Additionally, the collaboration is investigating other systematic errors that could not be well studied with a traditional fission chamber. LA-UR-15-24906.

  5. Influence of the 2009 financial crisis on detection of advanced pulmonary tuberculosis in Osaka city, Japan: a cross-sectional study

    PubMed Central

    Danno, Katsura; Komukai, Jun; Yoshida, Hideki; Matsumoto, Kenji; Koda, Shinichi; Terakawa, Kazuhiko; Iso, Hiroyasu

    2013-01-01

    Objective To investigate the association between the economic recession and the detection of advanced cases of pulmonary tuberculosis in Osaka city from 2007 to 2009. Design A repeated cross-sectional study. Setting Osaka city has been the highest tuberculosis burden area in Japan. After the previous global financial crisis, the unemployment rate in Osaka prefecture has deteriorated from 5.3% in 2008 to 6.6% in 2009. Participants During the study period, 3406 pulmonary tuberculosis cases were enrolled: 2530 males and 876 females; 1546 elderly cases (65 years and above) and 1860 young cases (under 65 years); 417 homeless cases and 2989 non-homeless cases. Outcome measures Patients’ information included the sex, age, registry, health insurances, places of detection, sputum smear test results, patients’ delay, doctors’ delay and the grade of chest x-ray findings. They were statistically analysed between 2007 and 2008, two years before and just before the financial crisis, and between 2008 and 2009, just before and after the financial crisis. Results The total numbers of pulmonary tuberculosis cases were 1172 in 2007, 1083 in 2008 and 1151 in 2009. In health examinations for non-homeless people, higher number of cases in 2009 were sputum smear positive, had respiratory symptoms and showed advanced disease in chest x-rays than those in 2008, with a longer patients’ delay. On the contrary, in health examination for homeless people, fewer cases of advanced pulmonary tuberculosis were found in 2009 than in 2008, with a shorter patients’ delay. In clinical examinations, there was no trend towards a difference between non-homeless and homeless people. Conclusions Although homeless people might be protected by public assistance, tuberculosis prevention and control need to be reinforced for the non-homeless population after the financial crisis. PMID:23558729

  6. 40 CFR 63.56 - Requirements for case-by-case determination of equivalent emission limitations after promulgation...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 63.56 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Technology Determinations for Major Sources in Accordance With Clean Air Act Sections, Sections 112(g) and...

  7. 75 FR 22548 - Requirements for Control Technology Determinations for Major Sources in Accordance With Clean Air...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-29

    ..., Sections 112(g) and 112(j) AGENCY: Environmental Protection Agency (EPA). ACTION: Extension of public... case-by-case emission limits for major sources of hazardous air pollutants under section 112(j) of the..., when EPA published a proposed rule (75 FR 15655) amending the Section 112(j) rule (40 CFR part 63...

  8. General Potential Theory of Arbitrary Wing Sections

    NASA Technical Reports Server (NTRS)

    Theodorsen, T.; Garrick, I. E.

    1979-01-01

    The problem of determining the two dimensional potential flow around wing sections of any shape is examined. The problem is condensed into the compact form of an integral equation capable of yielding numerical solutions by a direct process. An attempt is made to analyze and coordinate the results of earlier studies relating to properties of wing sections. The existing approximate theory of thin wing sections and the Joukowski theory with its numerous generalizations are reduced to special cases of the general theory of arbitrary sections, permitting a clearer perspective of the entire field. The method which permits the determination of the velocity at any point of an arbitrary section and the associated lift and moments is described. The method is also discussed in terms for developing new shapes of preassigned aerodynamical properties.

  9. Lack of association between human herpesvirus and vestibular schwannoma: analysis of 121 cases.

    PubMed

    Bhimrao, Sanjiv K; Maguire, John; Garnis, Cathie; Tang, Patrick; Lea, Jane; Akagami, Ryojo; Westerberg, Brian D

    2015-03-01

    To assess for the presence of human herpesvirus (HHV) using immunohistochemical and polymerase chain reaction (PCR) assay in surgically excised vestibular schwannoma (VS) samples. Cross-sectional study. A retrospective laboratory-based study of tumors from patients with vestibular schwannoma. Tissue microarrays (TMAs) representing sporadic and NF2-associated VS from 121 patients, as well as appropriate positive and negative controls, were studied. TMA sections were immunostained using antibodies directed against HHV-1, HHV-2, HHV-3, HHV-4, HHV-5, and HHV-8. PCR was used for the detection of all 8 known human herpesviruses. There was no detectable HHV (HHV-1, HHV-2, HHV-3, HHV-4, HHV-5, HHV-8) by immunohistochemistry in any of the 121 cases of sporadic and NF2 cases analyzed. These data were further validated by DNA sequence analyses using PCR in a subset of the VS samples, all of which were found to be negative for all HHV. The data offer no support for an association between HHV and the development of sporadic or NF2-associated VS in humans. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  10. The "Nursing Home Compare" measure of urinary/fecal incontinence: cross-sectional variation, stability over time, and the impact of case mix.

    PubMed

    Li, Yue; Schnelle, John; Spector, William D; Glance, Laurent G; Mukamel, Dana B

    2010-02-01

    To assess the impact of facility case mix on cross-sectional variations and short-term stability of the "Nursing Home Compare" incontinence quality measure (QM) and to determine whether multivariate risk adjustment can minimize such impacts. Retrospective analyses of the 2005 national minimum data set (MDS) that included approximately 600,000 long-term care residents in over 10,000 facilities in each quarterly sample. Mixed logistic regression was used to construct the risk-adjusted QM (nonshrinkage estimator). Facility-level ordinary least-squares models and adjusted R(2) were used to estimate the impact of case mix on cross-sectional and short-term longitudinal variations of currently published and risk-adjusted QMs. At least 50 percent of the cross-sectional variation and 25 percent of the short-term longitudinal variation of the published QM are explained by facility case mix. In contrast, the cross-sectional and short-term longitudinal variations of the risk-adjusted QM are much less susceptible to case-mix variations (adjusted R(2)<0.10), even for facilities with more extreme or more unstable outcome. Current "Nursing Home Compare" incontinence QM reflects considerable case-mix variations across facilities and over time, and therefore it may be biased. This issue can be largely addressed by multivariate risk adjustment using risk factors available in the MDS.

  11. Subsurface condition evaluation for asphalt pavement preservation treatments.

    DOT National Transportation Integrated Search

    2013-04-01

    This report presents a case study on the SR70 section with microsurface for understanding its performance; a development of a : methodology for evaluating the asphalt pavement subsurface condition for applying pavement preservation treatments; and...

  12. Optimization of FNAC findings as a preoperative diagnostic aid for odontogenic cysts.

    PubMed

    Jain, Garima; Shetty, Pushparaja

    2015-01-01

    Fine-needle aspiration cytology (FNAC) is not a definitive preoperative diagnostic procedure done for all cases of odontogenic cysts. This is because of the inconsistent results obtained with it. This study was done to optimize FNAC findings and help in preoperative characterization of odontogenic cysts. Cystic fluid was collected and centrifuged from 50 odontogenic cysts that were planned for excision. Three smears were prepared from the cell sediment obtained after centrifugation and stained. The stained sections were examined for presence and type of epithelial cells, to formulate a preopererative diagnosis. Epithelial cells were detected in 46% cases in smear 1, 48% cases in smear 2, and 52% cases in smear 3. When all three smears from one case were studied, 86% cases showed epithelial cells for evaluation. Cystic aspirate should be centrifuged and the entire cell sediment should be examined by making multiple smears for evaluation of cystic epithelial lining cells.

  13. Cost Convergence between Public and For-Profit Hospitals under Prospective Payment and High Competition in Taiwan

    PubMed Central

    Xirasagar, Sudha; Lin, Herng-Ching

    2004-01-01

    Objective To test the hypotheses that: (1) average adjusted costs per discharge are higher in high-competition relative to low-competition markets, and (2) increased competition is associated with cost convergence between public and for-profit (FP) hospitals for case payment diagnoses, but not for cost-plus reimbursed diagnoses. Data Sources Taiwan's National Health Insurance database; 325,851 inpatient claims for cesarean section, vaginal delivery, prostatectomy, and thyroidectomy (all case payment), and bronchial asthma and cholelithiasis (both cost-based payment). Study Design Retrospective population-based, cross-sectional study. Data Analysis Diagnosis-wise regression analyses were done to explore associations between cost per discharge and hospital ownership under high and low competition, adjusted for clinical severity and institutional characteristics. Principal Findings Adjusted costs per discharge are higher for all diagnoses in high-competition markets. For case payment diagnoses, the magnitudes of adjusted cost differences between public and FP hospitals are lower under high competition relative to low competition. This is not so for the cost-based diagnoses. Conclusions We find that the empirical evidence supports both our hypotheses. PMID:15544646

  14. Accelerated recovery of sensorimotor function in a dog submitted to quasi-total transection of the cervical spinal cord and treated with PEG.

    PubMed

    Kim, C-Yoon; Hwang, In-Kyu; Kim, Hana; Jang, Se-Woong; Kim, Hong Seog; Lee, Won-Young

    2016-01-01

    A case report on observing the recovery of sensory-motor function after cervical spinal cord transection. Laminectomy and transection of cervical spinal cord (C5) was performed on a male beagle weighing 3.5 kg. After applying polyethylene glycol (PEG) on the severed part, reconstruction of cervical spinal cord was confirmed by the restoration of sensorimotor function. Tetraplegia was observed immediately after operation, however, the dog showed stable respiration and survival without any complication. The dog showed fast recovery after 1 week, and recovered approximately 90% of normal sensorimotor function 3 weeks after the operation, although urinary disorder was still present. All recovery stages were recorded by video camera twice a week for behavioral analysis. While current belief holds that functional recovery is impossible after a section greater than 50% at C5-6 in the canine model, this case study shows the possibility of cervical spinal cord reconstruction after near-total transection. Furthermore, this case study also confirms that PEG can truly expedite the recovery of sensorimotor function after cervical spinal cord sections in dogs.

  15. Contact-angle hysteresis on periodic microtextured surfaces: Strongly corrugated liquid interfaces.

    PubMed

    Iliev, Stanimir; Pesheva, Nina

    2016-06-01

    We study numerically the shapes of a liquid meniscus in contact with ultrahydrophobic pillar surfaces in Cassie's wetting regime, when the surface is covered with identical and periodically distributed micropillars. Using the full capillary model we obtain the advancing and the receding equilibrium meniscus shapes when the cross-sections of the pillars are both of square and circular shapes, for a broad interval of pillar concentrations. The bending of the liquid interface in the area between the pillars is studied in the framework of the full capillary model and compared to the results of the heterogeneous approximation model. The contact angle hysteresis is obtained when the three-phase contact line is located on one row (block case) or several rows (kink case) of pillars. It is found that the contact angle hysteresis is proportional to the line fraction of the contact line on pillars tops in the block case and to the surface fraction for pillar concentrations 0.1-0.5 in the kink case. The contact angle hysteresis does not depend on the shape (circular or square) of the pillars cross-section. The expression for the proportionality of the receding contact angle to the line fraction [Raj et al., Langmuir 28, 15777 (2012)LANGD50743-746310.1021/la303070s] in the case of block depinning is theoretically substantiated through the capillary force, acting on the solid plate at the meniscus contact line.

  16. Simulation of 3-D Nonequilibrium Seeded Air Flow in the NASA-Ames MHD Channel

    NASA Technical Reports Server (NTRS)

    Gupta, Sumeet; Tannehill, John C.; Mehta, Unmeel B.

    2004-01-01

    The 3-D nonequilibrium seeded air flow in the NASA-Ames experimental MHD channel has been numerically simulated. The channel contains a nozzle section, a center section, and an accelerator section where magnetic and electric fields can be imposed on the flow. In recent tests, velocity increases of up to 40% have been achieved in the accelerator section. The flow in the channel is numerically computed us ing a 3-D parabolized Navier-Stokes (PNS) algorithm that has been developed to efficiently compute MHD flows in the low magnetic Reynolds number regime: The MHD effects are modeled by introducing source terms into the PNS equations which can then be solved in a very efficient manner. The algorithm has been extended in the present study to account for nonequilibrium seeded air flows. The electrical conductivity of the flow is determined using the program of Park. The new algorithm has been used to compute two test cases that match the experimental conditions. In both cases, magnetic and electric fields are applied to the seeded flow. The computed results are in good agreement with the experimental data.

  17. Association between periodontitis and ischemic stroke: a systematic review and meta-analysis.

    PubMed

    Leira, Yago; Seoane, Juan; Blanco, Miguel; Rodríguez-Yáñez, Manuel; Takkouche, Bahi; Blanco, Juan; Castillo, José

    2017-01-01

    Several observational studies have suggested an association between periodontitis and cerebral ischemia. This meta-analysis aimed to investigate whether this link exists, and if so, the degree to which it is significant. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline for systematic review was used. The search strategy included using electronic databases and hand searching works published up to March 2015. MEDLINE via PubMed, EMBASE, Proceedings Web of Science and Current Contents Connect were searched by two independent reviewers. Case-control, cross-sectional or cohort studies including patients with measures of periodontitis and ischemic stroke were eligible to be included in the analysis. Quality assessments of selected studies were performed. From a total of 414 titles and abstracts, 57 potentially relevant full text papers were identified. After inclusion criteria were applied, 8 studies were included in the present systematic review (5 case-control and 3 cohort studies). Although it was not the intention, cross-sectional studies were excluded due to eligibility criteria were not accomplished. Therefore, meta-analyses were conducted with data retrieved from the 8 studies included. These meta-analyses showed statistically significant association between periodontitis and ischemic stroke in both cohort pooled relative risks at 2.52 (1.77-3.58), and case-control studies pooled relative risks at 3.04 (1.10-8.43). In conclusion, the present meta-analysis demonstrated an association between periodontitis and ischemic stroke. However, well-designed prospective studies should be carried out to provide robust evidence of the link between both diseases. In regards to ischemic stroke subtypes, further case-control studies should be carried out to investigate whether there is any association between the different subtypes of cerebral infarcts and periodontitis.

  18. Combining ESPI with laser scanning for 3D characterization of racing tyres sections

    NASA Astrophysics Data System (ADS)

    Pagliarulo, Vito; Farroni, Flavio; Ferraro, Pietro; Lanzotti, Antonio; Martorelli, Massimo; Memmolo, Pasquale; Speranza, Domenico; Timpone, Francesco

    2018-05-01

    In this work is exploited the possibility to use two optical techniques and combining their measurements for the 3D characterization of different tyres with particular attention to the tyre's section. Electronic Speckle Pattern Interferometry (ESPI) and Laser Scanner (LS) based on principle of triangulation have been employed for investigating and studying the tyre's section and 3D shape respectively. As case studies two different racing tyres, Michelin S9H and Pirelli Diablo respectively, have been considered. The investigation has been focused at the aim to evaluate and measure the section's components in order to add to the 3D model obtained by Laser Scanning accurate information about the different layers along through the tyres sections. It is important to note that the assessment about the different layers along the section is a very difficult task to obtain by visual inspection or classical microscopy and even with the LS. Here we demonstrate that the different layers can be easily highlighted and identified by mean of the ESPI.

  19. 28 CFR 68.57 - Judicial review of the final agency order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Judicial review of the final agency order of an Administrative Law Judge in cases arising under section 274B. 68.57 Section 68.57 Judicial... BEFORE ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR...

  20. 28 CFR 68.57 - Judicial review of the final agency order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Judicial review of the final agency order of an Administrative Law Judge in cases arising under section 274B. 68.57 Section 68.57 Judicial... BEFORE ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR...

  1. 28 CFR 68.57 - Judicial review of the final agency order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Judicial review of the final agency order of an Administrative Law Judge in cases arising under section 274B. 68.57 Section 68.57 Judicial... BEFORE ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR...

  2. 28 CFR 68.57 - Judicial review of the final agency order of an Administrative Law Judge in cases arising under...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Judicial review of the final agency order of an Administrative Law Judge in cases arising under section 274B. 68.57 Section 68.57 Judicial... BEFORE ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR...

  3. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

    PubMed

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2014-12-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Gingival enlargement in a pregnant woman with acute monocytic leukaemia: a case report.

    PubMed

    Fu, Y-W; Xu, H-Z

    2017-09-01

    The objective of the present study was to report the case of a pregnant woman with severe gingival enlargement for 3 months with undiagnosed acute leukaemia. The pregnant woman presented with anaemia and generalized gingival enlargement. A provisional diagnosis of gingival enlargement in pregnancy was made. Twelve days after the initial treatment, the patient was referred and admitted to the haematology department of a local hospital with clinical signs of anaemia and thrombocytopenia. Blood count showed a white blood cell count of 9.68 × 10 9 /L, with a haemoglobin count of 64.0 g/L and a platelet count of 17 × 10 9 /L. Bone marrow aspiration showed 94.5% monoblasts, and the morphological diagnosis was acute monocytic leukaemia. One day after admission, the patient delivered a male infant by Caesarean section. Ten days after the Caesarean section, the patient was started on a course of chemotherapy. Pulmonary infection, hypokalaemia, and respiratory failure developed, and the patient died 23 days after the Caesarean section. The present case shows the importance of awareness of severe gingival enlargement as an initial oral sign of acute leukaemia. © 2017 Australian Dental Association.

  5. Service Learning: High School Social Studies Students "Building Bridges" to the Community

    ERIC Educational Resources Information Center

    Cranford, Sara L.

    2011-01-01

    This case study examined the relationships between the programmatic features of service learning and student willingness to participate in and development during a service learning opportunity in the secondary, Social Studies classroom. The sample included two sections of Advanced Placement Psychology which consisted of 58 junior and senior…

  6. Asthma and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Prospective Cohort Study

    ERIC Educational Resources Information Center

    Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

    2013-01-01

    Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…

  7. A clinico-epidemiological study of herpes zoster.

    PubMed

    Aggarwal, S K; Radhakrishnan, S

    2016-04-01

    Herpes zoster is a common viral infection of skin caused by reactivation of varicella zoster virus infection from the spinal ganglia. The clinico-epidemiological patterns of this disease in an Indian setting required to be studied. A cross sectional study was conducted on all consecutive cases of herpes zoster reporting to the Dermatology Outpatient Department at a Tertiary Care Hospital in Bangalore during a period of one year from 01 Jun 2013 to 31 May 2014. Detailed history, examination, HIV screening and Tzanck smear were carried out in all cases. 84 cases of herpes zoster were seen with a mean age of 30 years. Majority (39%) of cases were seen in the 21-30 year age group. Thoracic segments were involved in 65.4%, cervical in 11.9%, cranial in 11.5%, lumbar in 8.3% and sacral segments in 3.5%. 63% of cases had zoster associated pain. One case had motor involvement.3.57% of the patients were HIV positive. This study shows a lower age incidence of herpes zoster HIV positivity and zoster associated pain as compared to other studies. The pattern of segmental involvement in herpes zoster seen in this study was similar to other studies.

  8. [Prevalence of congenital heart diseases in Koranic schools (daara) in Dakar: a cross-sectional study based on clinical and echocardiographic screening in 2019 school children].

    PubMed

    Bodian, M; Ngaïdé, A A; Mbaye, A; Sarr, S A; Jobe, M; Ndiaye, M B; Kane, A D; Aw, F; Gaye, N D; Ba, F G; Bah, M B; Tabane, A; Dioum, M; Diagne, D; Diao, M; Diack, B; Sarr, M; Kane, A; Bâ, S A

    2015-02-01

    Congenital heart diseases are one of the major cardiovascular diseases in developing countries. Most prevalence studies were based on clinical examination of children with echocardiographic confirmation of suspected cases and underestimate its prevalence. The objective of this study was to investigate the prevalence of congenital heart disease in "daara" (Koranic schools) in the city of Dakar and its suburbs on the basis of clinical examination and Doppler echocardiography in school children. This cross-sectional survey was carried out from 9(th) August to 24(th) December 2011, and included a population of 2019 school children aged 5 to 18 years in 16 selected "daaras" under the Academic Inspectorate of Dakar and its suburbs. Anamnestic, clinical and echocardiographic data were recorded in a validated questionnaire. A p < 0.05 was considered to be statistically significant in bivariate analysis. 2 019 school children were included out of which 60.1% were male (sex-ratio: 0.66). The average age was 9.7 years (± 3.3 years). 18 cases of congenital heart diseases were detected being a prevalence of 8.9 per 1 000 (95 % CI: 1.8 to 7.9). This included 6 cases of inter-atrial septal aneurysm, 5 cases of peri-membranous ventricular septal defects, 4 cases of patent ductusarteriosus and 3 cases of tetralogy of Fallot. Factors correlated with the presence of congenital heart disease were ageless than 8 (p <0.001) and residence in the suburbs of Dakar (p <0.001). We also detected 10 cases of rheumatic valvular disease, a prevalence of 4.9 per 1 000 (95% CI: 2.4 to 9.1). Our study shows a high prevalence of congenital heart diseases, which is almost identical to the WHO estimates and that ultrasound screening is more sensitive than clinical screening. Reducing the prevalence of these diseases requires implementation of appropriate policies, focusing on awareness and early detection.

  9. What puts them at risk? A cross-sectional case-control survey of demographic profile and sexual behavior of patients with sexually transmitted infections at a tertiary care center in North India.

    PubMed

    Raj, Rama; Gupta, Vishal; Pathak, Mona; Sreenivas, Vishnubhatla; Sood, Seema; Singh, Sarman; Verma, Kaushal K; Khanna, Neena; Das, Bimal K; Gupta, Somesh

    2017-01-01

    Sexually transmitted infections (STIs) are a major public health problem in developing nations. Identification of risk factors can help in formulating effective strategies against them. The present study was conducted in a tertiary care hospital in North India over 1 year to identify the risk factors associated with STIs. A questionnaire-based cross-sectional case-control survey was conducted where participants answered questions on demographic details, sexual behavior, and awareness of STIs. Cases were patients with STIs whereas controls were randomly selected from healthy individuals accompanying patients with nonvenereal complaints attending our hospital. There were 106 cases and 64 controls. STI patients had sexual debut 2 years before controls. A higher proportion of STI cases had lower education, multiple sexual partners, lived separately from their partner, had nonregular partners, had protected sex in the last month, had sex under influence of alcohol/illicit drugs, sex in unstructured settings, and engaged in transactional sex, in comparison to controls ( P < 0.05). More cases were aware of the symptoms/preventive measures of STIs ( P < 0.001). On multivariate analysis, multiple sexual partners, sex under influence of alcohol/illicit drugs with nonregular partner, protected sex in the last month, and knowledge of preventive measures were found to be statistically associated with STIs ( P < 0.05). Our study identifies risk-behavior patterns in patients with STIs, which should be modified to reduce the burden of these diseases. Increasing the knowledge about STIs in these patients can translate into more common condom usage that lends support for strengthening sexual health programs at grass-root levels. The small size of the study population could have led to decreased power of the study to detect differences between cases and controls. The external validity of our results needs to be tested in different population groups involving larger sample sizes.

  10. 28 CFR 68.53 - Review of an interlocutory order of an Administrative Law Judge in cases arising under section...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... proceedings. Review of an Administrative Law Judge's interlocutory order will not stay the proceeding unless... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Review of an interlocutory order of an Administrative Law Judge in cases arising under section 274A or 274C. 68.53 Section 68.53 Judicial Administration...

  11. Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case-control study.

    PubMed

    Farquhar, Cynthia M; Li, Zhuoyang; Lensen, Sarah; McLintock, Claire; Pollock, Wendy; Peek, Michael J; Ellwood, David; Knight, Marian; Homer, Caroline Se; Vaughan, Geraldine; Wang, Alex; Sullivan, Elizabeth

    2017-10-05

    Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. Case-control study. Sites in Australia and New Zealand with at least 50 births per year. Cases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls. Data were collected using the Australasian Maternity Outcomes Surveillance System. Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). The incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs <30: 19.1, 95% CI 4.6 to 80.3) and current multiple birth (AOR: 6.1, 95% CI 1.1 to 34.1). In multiparous women, independent risk factors were prior CS (AOR ≥2 prior sections vs 0: 13.8, 95% CI 7.4 to 26.1) and current placenta praevia (AOR: 36.3, 95% CI 14.0 to 93.7). There were two maternal deaths (case fatality rate 0.7%).Women with placenta accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Exploring Pedagogical Content Knowledge of Biology Graduate Teaching Assistants through Their Participation in Lesson Study

    ERIC Educational Resources Information Center

    Lampley, Sandra A.; Gardner, Grant E.; Barlow, Angela T.

    2018-01-01

    Graduate teaching assistants (GTAs) are responsible for teaching the majority of biology undergraduate laboratory sections, although many feel underprepared to do so. This study explored the impact of biology GTA participation in a professional development model known as lesson study. Using a case study methodology with multiple qualitative data…

  13. [Adhesion prevention after Cesarean section by short-term biological barrier of modified chitosan].

    PubMed

    Shen, Wei; Shen, Guofang; Li, Lüwei

    2014-02-25

    To evaluate the efficacies of modified chitosan, an adhesive prevention substance, as a biological barrier for preventing adhesion after Cesarean section. A total of 250 cases undergoing primary Cesarean section from January 2011 to June 2012 at our hospital were recruited. They were randomly divided into experiment (n = 130) and control (n = 120) groups. The experiment group received modified chitosan during Cesarean section while no adhesive prevention substance was offered for the control group. Postoperative flatus time, postoperative infection and pelvic adhesion were used to evaluate the clinical efficacies. For the experiment group, the average postoperative flatus time was (25 ± 7) hours. Three cases had postoperative infections with a postoperative infection rate of 2.3%. There were 2 cases of pelvic adhesion (pelvic adhesion rate: 1.5%) during the postoperative follow-up period. For the control group, the average postoperative flatus time was (34 ± 11) hours. Five cases had postoperative infections with a postoperative infection rate of 4.2%. There were 5 cases of pelvic adhesion (pelvic adhesion rate: 4.2%) during the postoperative follow-up period. There were significant inter-group differences in postoperative flatus time, postoperative infection and pelvic adhesion (P < 0.05). Modified chitosan can prevent pelvic adhesion after Cesarean section.

  14. I-66--a case study

    DOT National Transportation Integrated Search

    1982-01-01

    The Arlington-Fairfax County section of 1-66 is similar to many : urban highway projects, yet in many ways this project represents a : milestone in urban transportation planning. 1-66, not unlike many : others, required non-technical political groups...

  15. Transportation Management For Corridors And Activity Centers: Opportunities And Experiences, Final Report

    DOT National Transportation Integrated Search

    1986-05-01

    THIS REPORT CONSISTS OF TWO SECTIONS, TRANSPORTATION MANAGEMENT FOR CORRIDORS AND TRANSPORTATION MANAGEMENT FOR ACTIVITY CENTERS, THAT DESCRIBE TRANSPORTATION MANAGEMENT EXPERIENCES IN THE UNITED STATES. : CASE STUDIES ARE THE FOCUS OF EACH SECTIO...

  16. Epidemiology of autistic disorder in Bahrain: prevalence and obstetric and familial characteristics.

    PubMed

    Al-Ansari, A M; Ahmed, M M

    2013-09-01

    European and North American studies show that the prevalence of autistic disorder is inccreasing. This study was performed to identify the prevalence of autistic disorder in Bahrain, and determine some of the demographic and family characteristics. Using a case-control design, 100 children who received a diagnosis of autistic disorder according to DSM-IV-TR during the period 2000-2010 were selected. An equal numberofcontrols who had received a diagnosis of nocturnal enuresis and no psychopathology were selected, matched for sex and age group. The prevalence of autistic disorder was estimated as 4.3 per 10,000 population, with a male:female sex ratio of 4:1. Significantly more cases than controls were delivered by caesarean section and had mothers who suffered prenatal complications. The prevalence estimate in Bahrain is comparable to previous reports using similar methods. Obstetric complications and caesarean section delivery may be associated with autistic disorder.

  17. Indication and method of frozen section in vaginal radical trachelectomy.

    PubMed

    Chênevert, Jacinthe; Têtu, Bernard; Plante, Marie; Roy, Michel; Renaud, Marie-Claude; Grégoire, Jean; Grondin, Katherine; Dubé, Valérie

    2009-09-01

    Vaginal radical trachelectomy (VRT) is a fertility-sparing surgical technique used as an alternative to radical hysterectomy in early stage cervical carcinoma. With the advent of VRT, preoperative evaluation of the surgical margin has become imperative, because if the tumor is found within 5 mm of the endocervical margin, additional surgical resection is required. In a study published earlier from our center, we came to the conclusion that a frozen section should be conducted only when a cancerous lesion is grossly visible, and that it could be omitted in normal-looking specimens or VRT with nonspecific lesions. Since then, 53 VRT have been performed in our center, and frozen sections were conducted according to these recommendations. Fifteen VRT were grossly normal, 24 had a nonspecific lesion and 14 showed a grossly visible lesion. Final margins were satisfactory on all 15 grossly normal specimens. Of the 24 VRT with nonspecific lesions, 2 cases for which no frozen section was performed had unsatisfactory final margins (<5 mm). Of the 14 VRT with grossly visible lesions, 3 cases were inadequately evaluated by frozen section due to sampling errors, which led to unsatisfactory final margin assessment. These results confirm that a frozen section can be omitted on normal looking VRT specimens, but contrary to results published earlier, we recommend that a frozen section be performed on all VRT with nonspecific lesions. As for VRT with a grossly visible lesion, frozen section evaluation is still warranted, and we recommend increasing the sampling to improve the adequacy of frozen sections.

  18. Diagnostic accuracy of touch imprint cytology for head and neck malignancies: a useful intra-operative tool in resource limited countries.

    PubMed

    Naveed, Hania; Abid, Mariam; Hashmi, Atif Ali; Edhi, Muhammad Muzammamil; Sheikh, Ahmareen Khalid; Mudassir, Ghazala; Khan, Amir

    2017-01-01

    Intraoperative consultation is an important tool for the evaluation of the upper aerodigestive tract (UAT) malignancies. Although frozen section analysis is a preferred method of intra-operative consultation, however in resource limited countries like Pakistan, this facility is not available in most institutes; therefore, we aimed to evaluate the diagnostic accuracy of touch imprint cytology for UAT malignancies using histopathology of the same tissue as gold standard. The study involved 70 cases of UAT lesions operated during the study period. Intraoperatively, after obtaining the fresh biopsy specimen and prior to placing them in fixative, each specimen was imprinted on 4-6 glass slides, fixed immediately in 95% alcohol and stained with Hematoxylin and Eosin stain. After completion of the cytological procedure, the surgical biopsy specimen was processed. The slides of both touch Imprint cytology and histopathology were examined by two consultant histopathologists. The result of touch imprint cytology showed that touch imprint cytology was diagnostic in 68 cases (97.1%), 55 (78.6%) being malignant, 2 cases (2.9%) were suspicious for malignancy, 11 cases (15.7%) were negative for malignancy while 2 cases (2.9%) were false negative. Amongst the 70 cases, 55 cases (78.6%) were malignant showing squamous cell carcinoma in 49 cases (70%), adenoid cystic carcinoma in 2 cases (2.9%), non-Hodgkin lymphoma 2 cases (2.9%), Mucoepidermoid carcinoma 1 case (1.4%), spindle cell sarcoma in 1 case (1.4%). Two cases (2.9%) were suspicious of malignancy showing atypical squamoid cells on touch imprint cytology, while 13 cases (18.6%) were negative for malignancy, which also included 2 false negative cases. The overall diagnostic accuracy of touch imprint cytology came out to be 96.7% with a sensitivity and specificity of 96 and 100%, respectively while PPV and NPV of touch imprint cytology was found to be 100 and 84%, respectively. Our experience in this study has demonstrated that touch imprint cytology provides reliable specific diagnoses and can be used as an adjunct to histopathology, particularly in developing countries, where the facility of frozen section is often not available, since a rapid preliminary diagnosis may help in the surgical management planning.

  19. Patients with Learning Disabilities Who Lack Capacity Detained under the Mental Health Act in the UK: A Case Study

    ERIC Educational Resources Information Center

    Sawhney, Indermeet; Zia, Asif; Gates, Bob

    2017-01-01

    In the UK, the Mental Health Tribunal is a long-established safeguard for patients detained under the Mental Health Act. This gives such patients an effective appeal mechanism to ensure legal protection of their liberty. This act contains sections that allow for civil detention in the case of mental disorder. The right to apply to the tribunal…

  20. Office of Workers’ Compensation Programs (OWCP). Data Codebook. Version 1.0

    DTIC Science & Technology

    1993-12-01

    Section 4. OWCP Data Codebook 4.1 Codebook Description ........................... 5 4.2 Codebook Column WHading Defnitions ............... 5 4.3 Data...OWCP (EARLY-REF) First character: variable. It was originally used T = Test group case between 1987 and 1990 in a C = Control group case study done...Nondestructive testing 4255 Fuel distribution system mechanic 3707 Metalizing 4301 Miscellaneous pliable materials work 3708 Metal process working 4351

  1. The Clinical Value of Prenatal 3D Ultrasonic Diagnosis on Fetus Hemivertebra Deformity- A Preliminary Study.

    PubMed

    Wen, Yanting; Xiang, Guishuang; Liang, Xiaoqiu; Tong, Xiaoqian

    2018-02-01

    The present study is planned to discuss the clinical value of prenatal 3D ultra-sonic diagnosis on fetus hemivertebra deformity through the retrospective analysis of clinical data of fetus hemivertebra deformity. Selected 9 fetus hemivertebra deformity cases, which have been admitted to our hospital during the period from January, 2010 to January, 2016 as study samples, and analyzed their 2D and 3D ultrasonic examination data. 4 cases of the fetus hemivertebra deformity occurred at lumbar vertebra, 3 cases at thoracic vertebra, and 2 cases at thoracolumbar vertebra. There were scoliosis and opened spine bifida (OSB). In 7 cases, there was absence of ribs in fetus. The 2D ultrasonic image showed that: The echo at the center of fetus vertebral arch lesion was blurred or lost. The coronal section showed the deformity of the spine. There was obvious loss of the ossification center. From the cross section, we could see that the vertebral body of the fetus was shrinking and the edges were relatively blurred. The 3D ultrasonic image showed that: the echo at the ossification center of the fetus vertebra was relatively blurred, or even lost. The image also indicated scoliosis deformity of the spine. The vertebral body lesion could be accurately located. 9 cases of fetus hemivertebra deformity have been detected through examination. Labor inductions have been carried out after getting the permission from the family members. The X-ray examination of the fetus after labor induction showed that the diagnosis was correct. Prenatal ultra-sonic examination holds strong potential for the diagnosis of fetus hemivertebra deformity quite early and deserves further clinical evaluation with large sample size.

  2. The Publication Rate of Abstracts Presented at the 2003 Urological Brazilian Meeting

    PubMed Central

    Oliveira, Leonardo Resende Sousa; Figueiredo, André Avarese; Choi, Mauro; Ferrarez, Carlos Eduardo Prata Fernandes; Bastos, Andre Netto; Netto, Jose Murillo Bastos

    2009-01-01

    OBJECTIVE: To determine the publication rate of orally-presented abstracts from the 2003 Urological Brazilian Meeting, as well as the factors determining this publication rate. MATERIALS AND METHODS: The publication rate of the 313 orally-presented abstracts at the 2003 Urological Brazilian Meeting was evaluated by scanning the Lilacs, Scielo and Medline databases. The time between presentation and publication, the state and country of the abstract, the research methodology (cross-sectional, case-control, retrospective case series, prospective case series or clinical trial), whether drugs were utilized and the topic of the study were all characterized. RESULTS: Thirty-nine percent of the abstracts were published after a median time of 14 months (range: 1 to 51 months). There were high publication rates for cross-sectional abstracts (75%), drug utilization studies (51.3%), clinical trials (50%) and prospective case series’ (48.1%). However, there was only a moderate statistical trend towards a higher publication rate in the prospective case series (p=0.07), while the retrospective case series’ showed statistically lower publication rates than the other groups (33.7%, p=0.04). Abstracts on laparoscopic surgery had the highest publication rate (61.9%, p=0.03) compared to others topics. In 57% of the unpublished abstracts, there was no interest in or attempt to publish, and rejection was responsible for the lack of publication of only 4% of the abstracts. CONCLUSION: The publication rate of the orally-presented abstracts from the 2003 Urological Brazilian Meeting was comparable to that of international congresses. The subsequent publication of presented abstracts and the selection of prospective studies with stronger evidence should be encouraged and may improve the scientific quality of the meeting. PMID:19488593

  3. Asymptotic quantum elastic generalized Lorenz Mie theory

    NASA Astrophysics Data System (ADS)

    Gouesbet, G.

    2006-10-01

    The (electromagnetic) generalized Lorenz-Mie theory describes the interaction between an electromagnetic arbitrary shaped beam and a homogeneous sphere. It is a generalization of the Lorenz-Mie theory which deals with the simpler case of a plane-wave illumination. In a recent paper, we established that, if we restrict ourselves to the study of cross-sections, both for elastic and inelastic scatterings, a macroscopic sphere in Lorenz-Mie theory is formally equivalent to a quantum-like radial potential. To generalize this result, a prerequisite is to possess an asymptotic quantum generalized Lorenz-Mie theory expressing cross-sections in the case of a quantum radial potential interacting with a sub-class of quantum arbitrary wave-packets. Such a theory, restricted however to elastic scattering, is presented in this paper.

  4. A Case Study of an Aeronautical Systems Division System Program Office.

    DTIC Science & Technology

    1982-09-01

    11111 -’.-- m 1 1.25 111111.4 1 1.6_ MICROCOPY RESOLUTION TEST CHART NATIONAL BUREAU OF STANDARDS-1963-A If. t 1’ I I( N 2> - .~.. * .~ .~-I ~ k~’ ~K ~r...office....assesses.................. 8 Section 11 The Standard Aircraft Sensor UnitProgram........ 32 Section III Terms and Defnition ...contracts with industry, (b) test programs with both industry and other DOD organizations, (c) aircraft production or modification programs with both

  5. 28 CFR 0.95 - General functions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... and personnel, pursuant to section 5003 of title 18 of the U.S. Code. (h) Conduct of studies and the preparation and submission of reports and recommendations to committing courts respecting disposition of cases... and prepare, or cause to be conducted and prepared, studies and submit reports to the court and the...

  6. Arizona Conserve Water Educators Guide

    ERIC Educational Resources Information Center

    Project WET Foundation, 2007

    2007-01-01

    This award-winning, 350-page, full-color book provides a thorough study of Arizona water resources from a water conservation perspective. Its background section contains maps, graphs, diagrams and photos that facilitate the teaching of 15 interactive, multi-disciplinary lessons to K-12 students. In addition, 10 Arizona case studies are highlighted…

  7. 75 FR 66822 - Study on Extraterritorial Private Rights of Action

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-29

    ... Extraterritorial Private Rights of Action AGENCY: Securities and Exchange Commission. ACTION: Request for Comments... and thereafter conduct a study to determine the extent to which private rights of action under the... United States to bring actions under Section 10(b) in cases involving transnational securities fraud...

  8. 26 CFR 1.613-4 - Gross income from the property in the case of minerals other than oil and gas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... definitions of the terms controlled and group, see paragraph (j) (1) and (2) of this section. (c) Cases where... income from the property, as used in section 613(c)(1), means, in the case of a mineral property other... relating to the minerals and deposits in question. The fact that the taxpayer applies slightly different...

  9. 26 CFR 1.613-4 - Gross income from the property in the case of minerals other than oil and gas.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... definitions of the terms controlled and group, see paragraph (j) (1) and (2) of this section. (c) Cases where... income from the property, as used in section 613(c)(1), means, in the case of a mineral property other... relating to the minerals and deposits in question. The fact that the taxpayer applies slightly different...

  10. Prolonged labour as indication for emergency caesarean section: a quality assurance analysis by criterion-based audit at two Tanzanian rural hospitals.

    PubMed

    Maaløe, N; Sorensen, B L; Onesmo, R; Secher, N J; Bygbjerg, I C

    2012-04-01

    To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour. A quality assurance analysis of a retrospective criterion-based audit supplemented by in-depth interviews with hospital staff. Two Tanzanian rural mission hospitals. Audit of 144 cases of women undergoing caesarean sections for prolonged labour; in addition, eight staff members were interviewed. Criteria of realistic best practice were established, and the case files were audited and compared with these. Hospital staff were interviewed about what they felt might be the causes for the audit findings. Prevalence of suboptimal management and themes emerging from an analysis of the transcripts. Suboptimal management was identified in most cases. Non-invasive interventions to potentially avoid operative delivery were inadequately used. When deciding on caesarean section, in 26% of the cases labour was not prolonged, and in 16% the membranes were still intact. Of the women with genuine prolonged labour, caesarean sections were performed with a fully dilated cervix in 36% of the cases. Vacuum extraction was not considered. Amongst the hospital staff interviewed, the awareness of evidence-based guidelines was poor. Word of mouth, personal experience, and fear, especially of HIV transmission, influenced management decisions. The lack of use and awareness of evidence-based guidelines led to misinterpretation of clinical signs, fear of simple interventions, and an excessive rate of emergency caesarean sections. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  11. Double balloon catheter for induction of labour in Chinese women with previous caesarean section: one-year experience and literature review.

    PubMed

    Cheuk, Queenie K Y; Lo, T K; Lee, C P; Yeung, Anita P C

    2015-06-01

    To evaluate the efficacy and safety of double balloon catheter for induction of labour in Chinese women with one previous caesarean section and unfavourable cervix at term. Retrospective cohort study. A regional hospital in Hong Kong. Women with previous caesarean delivery requiring induction of labour at term and with an unfavourable cervix from May 2013 to April 2014. Primary outcome was to assess rate of successful vaginal delivery (spontaneous or instrument-assisted) using double balloon catheter. Secondary outcomes were double balloon catheter induction-to-delivery and removal-to-delivery interval; cervical score improvement; oxytocin augmentation; maternal or fetal complications during cervical ripening, intrapartum and postpartum period; and risk factors associated with unsuccessful induction. All 24 Chinese women tolerated double balloon catheter well. After double balloon catheter expulsion or removal, the cervix successfully ripened in 18 (75%) cases. The improvement in Bishop score 3 (interquartile range, 2-4) was statistically significant (P<0.001). Overall, 18 (75%) cases were delivered vaginally. The median insertion-to-delivery and removal-to-delivery intervals were 19 (interquartile range, 13.4-23.0) hours and 6.9 (interquartile range, 4.1-10.8) hours, respectively. Compared with cases without, the interval to delivery was statistically significantly shorter in those with spontaneous balloon expulsion or spontaneous membrane rupture during ripening (7.8 vs 3.0 hours; P=0.025). There were no major maternal or neonatal complications. The only factor significantly associated with failed vaginal birth after caesarean was previous caesarean section for failure to progress (P<0.001). This is the first study using double balloon catheter for induction of labour in Asian Chinese women with previous caesarean section. Using double balloon catheter, we achieved a vaginal birth after caesarean rate of 75% without major complications.

  12. Stall Flutter Control of a Smart Blade Section Undergoing Asymmetric Limit Oscillations

    DOE PAGES

    Li, Nailu; Balas, Mark J.; Nikoueeyan, Pourya; ...

    2016-01-01

    Stall flutter is an aeroelastic phenomenon resulting in unwanted oscillatory loads on the blade, such as wind turbine blade, helicopter rotor blade, and other flexible wing blades. While the stall flutter and related aeroelastic control have been studied theoretically and experimentally, microtab control of asymmetric limit cycle oscillations (LCOs) in stall flutter cases has not been generally investigated. This paper presents an aeroservoelastic model to study the microtab control of the blade section undergoing moderate stall flutter and deep stall flutter separately. The effects of different dynamic stall conditions and the consequent asymmetric LCOs for both stall cases are simulatedmore » and analyzed. Then, for the design of the stall flutter controller, the potential sensor signal for the stall flutter, the microtab control capability of the stall flutter, and the control algorithm for the stall flutter are studied. Lastly, the improvement and the superiority of the proposed adaptive stall flutter controller are shown by comparison with a simple stall flutter controller.« less

  13. [Incidence and risk factors for acute gastroenteritis among pilgrims following the French way to Santiago de Compostela (Spain) in summer 2008].

    PubMed

    Duran, Jaume Giménez; Fernández, Miguel Angel Luque; Urrego, Johana Rodríguez; Gil, Cristina Linares; Vargas, Luis Alberto Bonilla; Savulescu, Camelia; Clerger, Guerrier; Martínez-Lamas, Lucia; Pousa, Anxela; Donado, Juan de Mata; Herrera, Dionisio; Martínez, María Victoria

    2010-01-01

    To determine the incidence of acute gastroenteritis in pilgrims on St. James' Way, as well as associated risk factors and microbiological characteristics. Two studies were designed simultaneously: a cross-sectional study through self-completed questionnaires among pilgrims reaching Santiago, and a case-control study of pilgrims traveling along the Way. Multivariate analysis was performed using logistic regression. In the cross-sectional study, the incidence rate was 23.5 episodes of acute gastroenteritis/10³ pilgrims-day (95% CI: 18.9-2.4/10³. In the case-control study, the major risk factors were age <20 years (OR=4.72; 95% CI: 2.16-10.28), traveling in groups (three or more) (OR=1.49; 95% CI: 0.98-2.28), and drinking unbottled water (OR=2.09; 95% CI: 0.91-4.82). The most frequent etiologic agent was norovirus (56%). Age less than 20 years, traveling in groups and drinking unbottled water were important risk factors for acute gastroenteritis. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. Alcohol Intake and Risk of Thyroid Cancer: A Meta-Analysis of Observational Studies.

    PubMed

    Hong, Seung-Hee; Myung, Seung-Kwon; Kim, Hyeon Suk

    2017-04-01

    The purpose of this study was to assess whether alcohol intake is associated with the risk of thyroid cancer by a meta-analysis of observational studies. We searched PubMed and EMBASE in June of 2015 to locate eligible studies. We included observational studies such as cross-sectional studies, case-control studies, and cohort studies reporting odd ratios (ORs) or relative risk (RRs) with 95% confidence intervals (CIs). We included 33 observational studies with two cross-sectional studies, 20 case-controls studies, and 11 cohort studies, which involved a total of 7,725 thyroid cancer patients and 3,113,679 participants without thyroid cancer in the final analysis. In the fixed-effect model meta-analysis of all 33 studies, we found that alcohol intake was consistently associated with a decreased risk of thyroid cancer (OR or RR, 0.74; 95% CI, 0.67 to 0.83; I 2 =38.6%). In the subgroup meta-analysis by type of study, alcohol intake also decreased the risk of thyroid cancer in both case-control studies (OR, 0.77; 95% CI, 0.65 to 0.92; I 2 =29.5%; n=20) and cohort studies (RR, 0.70; 95% CI, 0.60 to 0.82; I 2 =0%; n=11). Moreover, subgroup meta-analyses by type of thyroid cancer, gender, amount of alcohol consumed, and methodological quality of study showed that alcohol intake was significantly associated with a decreased risk of thyroid cancer. The current meta-analysis of observational studies found that, unlike most of other types of cancer, alcohol intake decreased the risk of thyroid cancer.

  15. Association between parental myopia and the risk of myopia in a child

    PubMed Central

    ZHANG, XIAOYU; QU, XINHUA; ZHOU, XINGTAO

    2015-01-01

    The association between parental myopia and a child's risk of developing the condition is not well understood. Therefore, the present study conducted a meta-analysis of the results of observational studies in order to investigate the association between myopia in parents and their child's risk of developing the condition. The current study systematically examined the databases MEDLINE, Embase and Ovid for relevant studies. Two reviewers independently evaluated the data and extracted the odds ratios (ORs) and 95% confidence intervals (CIs) from the suitable studies. Heterogeneity, publication bias and subgroup analyses were performed. The present meta-analysis included 31,677 participants from 16 studies with 8,393 cases of myopia (six prospective cohort, eight cross-sectional and two case-control studies). The OR of giving birth to a child with myopia, according to the prospective cohort, cross-sectional and case-control studies, was 1.53 (95% CI, 1.21–1.85), 1.96 (95% CI, 1.53–2.39), and 2.13 (95% CI, 1.79–2.46), respectively, when one parent had myopia, and 2.10 (95% CI, 1.42–2.77), 2.96 (95% CI, 2.21–3.71), and 2.13 (95% CI, 1.79–2.46), respectively, when two parents had myopia. The current study identified a significant positive association between parental myopia and a child's risk of developing myopia. Children of two parents with myopia had a higher risk of developing myopia compared to those with one myopic parent. PMID:26136998

  16. The National Biological Information Infrastructure: Coming of age

    USGS Publications Warehouse

    Cotter, G.; Frame, M.; Sepic, R.; Zolly, L.

    2000-01-01

    Coordinated by the US Geological Survey, the National Biological Information Infrastructure (NBII) is a Web-based system that provides increased access to data and information on the nation's biological resources. The NBII can be viewed from a variety of perspectives. This article - an individual case study and not a broad survey with extensive references to the literature - addresses the structure of the NBII related to thematic sections, infrastructure sections and place-based sections, and other topics such as the Integrated Taxonomic Information System (one of our more innovative tools) and the development of our controlled vocabulary.

  17. [New diagnostic procedures in assessing male fertility].

    PubMed

    Schütte, B

    1989-04-15

    In 160 patients with normal and pathological semen samples, we studied the penetration of human spermatozoa in standardized bovine cervical mucus (assay Penetrak). Our results indicate that Penetrak can detect those dysfunctions of sperm motility which cannot be diagnosed by conventional semen analysis - The toluidine blue-pyronine staining is an easy way to differentiate between spermatozoa within an hour. The reliability of this technique is comparable to that of conventional methods and therefore appropriate for routine diagnostics. - As case studies on 140 patients proved, the level of carnitine in the seminal plasm can be regarded as a parameter of epididymal function. In combination with the examination of FSH serum levels, this method may be helpful in the differential diagnosis of azoospermia due to obstruction, Sertoli-cell-only syndrome, or spermatogenic arrest. - In severe oligozoospermia, testicular biopsy using semithin sections may be of high diagnostic and prognostic value. In contrast to paraffin sections, this technique is particularly appropriate for the detection of cytological characteristics of germ cells. The type and number of pathological germ cells are decisive regarding the prognosis. Furthermore, a carcinoma in situ (CIS) can be definitely identified by means of semithin sections. - In a study on 2047 patients, we found seminoma cells in 15 cases (0.73%); 5 of these patients already had a solid seminoma in the testicular rete. Risk-patients are those showing oligozoospermia of less than 10 million spermatozoa per ml or azoospermia associated with unilaterally or bilaterally subnormal testicular volume. In these cases, the testicles are inconspicuous, both palpatorically and sonographifically.

  18. [The practice of special observation in adults in the German-speaking part of Switzerland - a descriptive cross-sectional study].

    PubMed

    Lienhardt, Andrea; Rabenschlag, Franziska; Panfil, Eva-Maria

    2018-06-08

    The practice of special observation in adults in the German-speaking part of Switzerland - a descriptive cross-sectional study Abstract. Psychiatric Special Observation (PSO) is an intervention often used by nurses to prevent service users of harming themselves or to protect others. The intervention ranges between control and therapy and is resource intensive. Despite the widespread use of PSO, there is still no data on the practice of the intervention in Switzerland. What is the current practice of PSO in adults in psychiatric hospitals in the German-speaking part of Switzerland? Descriptive cross-sectional study. Nurses from inpatient psychiatric services in the German-speaking part of Switzerland completed a questionnaire based on a concept analysis of PSO. 538 questionnaires were analysed. PSO was more often conducted intermittent than as constant observation. In more than one out of four cases, suicidality reasoned as a cause for prescription. Nurses generally used standardized instruments to assess the risk of harming oneself or others. The duration of PSO lasted eight hours or more in three out of four cases. In every fifth case, there was no validation of the need of the intervention taking place during one shift. Nurses have a neutral attitude towards the intervention and are experiencing no or weak negative feelings during performance of PSO. The results suggest that there is an inconsistent performance of PSO in Switzerland as well as in other countries. The validation of the need of the intervention is insufficient. To facilitate PSO as a justified performance, the preparation of an interprofessional guideline is recommended.

  19. JPRS Report, Supplement. East Europe: Recent Legislation

    DTIC Science & Technology

    1990-10-19

    cases mentioned in Section 68. ( 2 ) Increase in capitalization is possible by subscription of new stocks, converting of corporate assets in exceess...public in cases mentioned in Section 13, Paragraph 2 . 2 . The editor in chief is obliged to publish the position of the government agency...The purpose of this law is to regulate the status and legal relations of state enterprise (hereinafter Enterprise). Section 2 . The Enterprise, Its

  20. Occupational injury and illness recording and reporting requirements. Final rule.

    PubMed

    2001-10-12

    The Occupational Safety and Health Administration (OSHA) is delaying the effective date of three provisions of the Occupational Injury and Illness Recording and Reporting Requirements rule published January 19, 2001 (66 FR 5916-6135) and is establishing interim criteria for recording cases of work-related hearing loss. The provisions being delayed are sections 1904.10 (a) and (b), which specify recording criteria for cases involving occupational hearing loss, section 1904.12, which defines "musculoskeletal disorder (MSD)" and requires employers to check the MSD column on the OSHA Log if an employee experiences a work-related musculoskeletal disorder, and section 1904.29(b)(7)(vi), which states that MSDs are not considered privacy concern cases. The effective date of these provisions is delayed from January 1, 2002 until January 1, 2003. OSHA will continue to evaluate sections 1904.10 and 1904.12 over the next year. OSHA is also adding a new paragraph(c) to section 1904.10, establishing criteria for recording cases of work-related hearing loss during calendar year 2002. Section 1904.10(c) codifies the enforcement policy in effect since 1991, under which employers must record work related shifts in hearing of an average of 25 dB or more at 2000, 3000 and 4000 hertz in either ear.

  1. Procalcitonin levels in patients with positive blood culture, positive body fluid culture, sepsis, and severe sepsis: a cross-sectional study.

    PubMed

    Yu, Ying; Li, Xia-Xi; Jiang, Ling-Xiao; Du, Meng; Liu, Zhan-Guo; Cen, Zhong-Ran; Wang, Hua; Guo, Zhen-Hui; Chang, Ping

    2016-01-01

    Numerous investigations on procalcitonin (PCT) have been carried out, although few with large sample size. To deal with the complexity of sepsis, an understanding of PCT in heterogeneous clinical conditions is required. Hospitalized patients aged 10-79 years were included in this retrospective and cross-sectional study. PCT tests were assayed within 2 days of blood culture. A total of 2952 cases (from 2538 patients) were enrolled in this study, including 440 cases in the 'positive BC' group, 123 cases in the 'positive body fluid culture' group, and 2389 cases in the 'negative all culture' group. Median PCT values were 4.53 ng/ml, 2.95 ng/ml, and 0.49 ng/ml, respectively. Median PCT values in the gram-negative BC group and gram-positive BC group, respectively, were 6.99 ng/ml and 2.96 ng/ml. Median PCT values in the 'positive hydrothorax culture' group, 'positive ascites culture' group, 'positive bile culture' group, and 'positive cerebrospinal fluid culture' group, respectively, were 1.39 ng/ml, 8.32 ng/ml, 5.98 ng/ml, and 0.46 ng/ml. In all, 357 cases were classified into the 'sepsis' group, 150 of them were classified into the 'severe sepsis' group. Median PCT values were 5.63 ng/ml and 11.06 ng/ml, respectively. PCT could be used in clinical algorithms to diagnose positive infections and sepsis. Different PCT levels could be related to different kinds of microbemia, different infection sites, and differing severity of sepsis.

  2. Influence of perceived difficulty of cases on student osteopaths' diagnostic reasoning: a cross sectional study.

    PubMed

    Noyer, Aurelien L; Esteves, Jorge E; Thomson, Oliver P

    2017-01-01

    Diagnostic reasoning refers to the cognitive processes by which clinicians formulate diagnoses. Despite the implications for patient safety and professional identity, research on diagnostic reasoning in osteopathy remains largely theoretical. The aim of this study was to investigate the influence of perceived task difficulty on the diagnostic reasoning of students osteopaths. Using a single-blinded, cross sectional study design, sixteen final year pre-registration osteopathy students diagnosed two standardized cases under two context conditions (complex versus control). Context difficulty was manipulated via verbal manipulation and case order was randomized and counterbalanced across subjects to ensure that each case was diagnosed evenly under both conditions (i.e. half of the subjects performed either case A or B first). After diagnosis, participants were presented with items (literal, inferred and filler) designed to represent analytical and non-analytical reasoning. Response time and error rate for each item were measured. A repeated measures analysis of variance (concept type x context) was performed to identify differences across conditions and make inferences on diagnostic reasoning. Participants made significantly more errors when judging literal concepts and took significantly less time to recognize filler concepts in the complex context. No significant difference in ability to judge inferred concepts across contexts was found. Although speculative and preliminary, our findings suggest the perception of complexity led to an increased reliance on analytical reasoning at the detriment of non-analytical reasoning. To reduce the associated cognitive load, osteopathic educational institutions could consider developing the intuitive diagnostic capabilities of pre-registration students. Postgraduate mentorship opportunities could be considered to enhance the diagnostic reasoning of professional osteopaths, particularly recent graduates. Further research exploring the influence of expertise is required to enhance the validity of this study.

  3. Mandibular third molar angulation in extraction and non extraction orthodontic cases.

    PubMed

    Ahmed, Imtiaz; Gul-e-Erum; Kumar, Naresh

    2011-01-01

    The purpose of this study is to determine the angulation of mandibular third molar in orthodontic cases which are planned for extraction and non extraction. This is a cross-sectional descriptive study in which pre-treatment panoramic radiographs of 49 patients, age range 11-26 years were taken from the OPD of Department of Orthodontics, Dr. Ishrat- ul -Ebad Khan Institute of Oral and Health Sciences (DIKIOHS), Dow University of Health Sciences. The angles between the long axis of the second and third molars were measured. Descriptive statistics were applied. Mann-Whitney U-test was used for intergroup comparison extraction and non extraction cases. This study consists of 49 patients with mean age of 17.94 years. Over all result concluded that mandibular third molar angulations were from 8-94 degrees in extraction cases and 10-73 degrees in non extraction cases. However, the pre-treatment 3rd molar angulation differences in extraction and non extraction cases were statistically insignificant with p-value >0.05. This study evaluates third molar angulations in pre-treatment cases, the differences in angulation were like other morphological differences but changes in angulation after treatment may or may not be related to extractions.

  4. Synchronized navigation of current and prior studies using image registration improves radiologist's efficiency.

    PubMed

    Forsberg, Daniel; Gupta, Amit; Mills, Christopher; MacAdam, Brett; Rosipko, Beverly; Bangert, Barbara A; Coffey, Michael D; Kosmas, Christos; Sunshine, Jeffrey L

    2017-03-01

    The purpose of this study was to investigate how the use of multi-modal rigid image registration integrated within a standard picture archiving and communication system affects the efficiency of a radiologist while performing routine interpretations of cases including prior examinations. Six radiologists were recruited to read a set of cases (either 16 neuroradiology or 14 musculoskeletal cases) during two crossover reading sessions. Each radiologist read each case twice, one time with synchronized navigation, which enables spatial synchronization across examinations from different study dates, and one time without. Efficiency was evaluated based upon time to read a case and amount of scrolling while browsing a case using Wilcoxon signed rank test. Significant improvements in efficiency were found considering either all radiologists simultaneously, the two sections separately and the majority of individual radiologists for time to read and for amount of scrolling. The relative improvement for each individual radiologist ranged from 4 to 32% for time to read and from 14 to 38% for amount of scrolling. Image registration providing synchronized navigation across examinations from different study dates provides a tool that enables radiologists to work more efficiently while reading cases with one or more prior examinations.

  5. Trends in prevalence of patient case-mix adjusters used in the Medicare dialysis payment system.

    PubMed

    Hollenbeak, Christopher S; Rubin, Robert J; Tzivelekis, Spiros; Stephens, J Mark

    2015-06-01

    The Medicare End-Stage Renal Disease Prospective Payment System (PPS) used data from 2006-08 to set weights for each case-mix adjuster that is part of the bundled payment formula. The details of the population case-mix were not made public, and little is known about consistency of case-mix over time. This study estimated the prevalence of case-mix adjusters during 2006-2008 and analyzed changes in case-mix prevalence from 2000-2008. Cross-sectional cohort study using United States Renal Data System data for Medicare dialysis patients. Three 3-year cohorts (2000-02, 2003-05, 2006-08) were analyzed for changes over time in case-mix prevalence. Double-digit trends were observed in many case-mix categories between 2000-02 and 2006-08. Large declines were observed in prevalence of patients with low BMI, pericarditis, new to dialysis, and ages 18-44. Large increases were observed in chronic co-morbidities, pneumonia and age cohort 80+. Substantial changes in case-mix adjuster prevalence suggest the PPS payment formula should be regularly updated.

  6. EIA model documentation: World oil refining logistics demand model,``WORLD`` reference manual. Version 1.1

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

    Not Available

    1994-04-11

    This manual is intended primarily for use as a reference by analysts applying the WORLD model to regional studies. It also provides overview information on WORLD features of potential interest to managers and analysts. Broadly, the manual covers WORLD model features in progressively increasing detail. Section 2 provides an overview of the WORLD model, how it has evolved, what its design goals are, what it produces, and where it can be taken with further enhancements. Section 3 reviews model management covering data sources, managing over-optimization, calibration and seasonality, check-points for case construction and common errors. Section 4 describes in detailmore » the WORLD system, including: data and program systems in overview; details of mainframe and PC program control and files;model generation, size management, debugging and error analysis; use with different optimizers; and reporting and results analysis. Section 5 provides a detailed description of every WORLD model data table, covering model controls, case and technology data. Section 6 goes into the details of WORLD matrix structure. It provides an overview, describes how regional definitions are controlled and defines the naming conventions for-all model rows, columns, right-hand sides, and bounds. It also includes a discussion of the formulation of product blending and specifications in WORLD. Several Appendices supplement the main sections.« less

  7. Acridine orange--its use in the specific staining of DNA in mammalian tissue sections.

    PubMed

    Dutt, M K

    1981-01-01

    This paper reports on a new method for the use of acridine orange (AO) in an aqueous solution at pH 4.5 for staining DNA of rat tissue sections from which RNA has been extracted selectively with cold phosphoric acid. Not only this, AO can also be used as dye-SO2 reagent, prepared with NHCl and potassium metabisulphite, for staining DNA-aldehyde molecules of acid-hydrolysed tissue sections. AO samples, manufactured by the National Aniline Division as well as by G. T. Gurr have been used with equal success. Studies of stained sections under light microscope reveal the presence of specifically stained yellowish-orange nuclei. Those sections under fluorescent microscope with proper exciter and barrier filters reveal nuclei of maroon colour. The in situ absorption spectra of nuclei stained with AO-SO2 following acid-hydrolysis of tissue sections as well as those of nuclei stained with an aqueous solution of the dye following extraction of RNA have been presented herein. The mode of binding in the former case has been considered to be due to binding of the teritary amino group of the dye molecules with the DNA-aldehyde molecules and in the latter case to be due to electrostatic binding between the positively charged dye molecules with negatively charged phosphate groups of DNA. Implications of all these findings have been discussed.

  8. Morphological changes in carotid arteries in stroke cases.

    PubMed

    Thapa, Guna Bahadur; Sundas, Alin; Rauniyar, Raj Kumar

    2013-01-01

    Majority of stroke is due to ischemic infarction and occurs in carotid artery territory. The extra cranial parts of carotid arteries are the common sites for the atherosclerotic plaque formation. Ultrasonography is the first line of investigation for screening of the carotid artery diseases to localize and characterize the plaques. Objective was to study the morphological changes in extra cranial part of carotid arteries in cases of ischemic infarction using Ultrasonography. It was an institution based prospective study and convenience sampling method was used. Computed Tomography proven ischemic infarct, lacunar infarction and transient ischemic infarction cases were included in the study. Fifty four cases were included in the study. Mean of Intimo-medial Complex Thickness was 0.89 mm and 0.88 mm in right and left side respectively. Sixty five percent cases had plaque in extra cranial part of carotid artery. Ninety three percent of plaque was found in and adjacent to the carotid bulb region. Ipsilateral plaque was found in 76% and 65% cases on right and left side respectively. Fifty three percent of cases had soft plaque. Majority of cases had less than 50% narrowing of the lumen diameter in term of cross-sectional area due to plaque. Thirteen (24%) cases had plaque in internal carotid artery. Carotid ultrasound can be used for screening of the asymptomatic but high-risk cases and following up of the symptomatic cases to plan for necessary management as required.

  9. 75 FR 61530 - Issuance of Regulatory Guides

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ... Materials Code Case Acceptability, ASME Section III,'' and RG 1.147, Rev. 16, ``Inservice Inspection Code Case Acceptability, ASME Section XI, Division 1.'' FOR FURTHER INFORMATION CONTACT: Wallace E. Norris... specific problems or postulated accidents, and data the staff needs in its review of applications for...

  10. Red Cell Distribution Width and Serum BNP Level Correlation in Diabetic Patients with Cardiac Failure: A Cross - Sectional Study.

    PubMed

    A R, Subhashree

    2014-06-01

    Red cell distribution width (RDW) is a red cell measurement given by fully automated hematology analyzers. It is a measure of heterogeneity in the size of circulating erythrocytes. Studies have shown that it is a prognostic marker in non - anemic diabetic patients with symptomatic cardiovascular disease but its correlation with cardiac failure in diabetics has not been studied so far. Moreover, studies have also shown that a higher RDW may reflect an underlying inflammatory state. Since Diabetes is a pro inflammatory state there is a possibility that it might have an influence on the RDW values even when there is no cardiac failure, but research data on this aspect is lacking. B-type natriuretic peptide (BNP) is a proven marker for cardiac failure whose values are comparable with echo cardio graphic findings in assessing the left ventricular dysfunction. This study aimed to find out the correlation between RDW% and serum BNP levels in Diabetics with heart failure (cases) when compared to those without failure (controls). Further, we compared the RDW % values of the cases with controls. Settings and Design : The study was approved by institutional ethical and research committee. A cross-sectional study was conducted with patients attending the Diabetes clinic of a tertiary care hospital in Chennai, India, during the period of October to December 2013. Hundred known cases of type II Diabetes mellitus attending Diabetes centre of the Hospital, with clinical and Echo cardio graphic features of cardiac failure were included as cases. Hundred age and gender matched diabetics with negative history of cardiovascular disease and with normal Echo cardio graphic features were included as controls. Informed consent was obtained from all the cases and controls. Demographic data and clinical history were gathered from all the cases and controls by using a standardized self - administered questionnaire. Biochemical and hematological parameters which included Fasting and Postprandial blood sugar, Glycosylated hemoglobin, Complete Blood count including RDW and serum BNP were performed for all the cases and controls. RESULTS were tabulated and analysed using SPSS 20.0 version A statistically significant correlation (p<.001) was found between Red cell Distribution Width % and Serum B type Natriuretic Peptide values in the cases. Further, RDW% showed a statistically significant difference between cases and controls. RDW% can be used as a screening parameter to identify cardiac failure in Diabetic patients similar to non-diabetic cardiac failure. RDW% values are significantly higher in cases of Diabetes with failure in comparison to uncomplicated Diabetes.

  11. Prevalence of Pulmonary Tuberculosis among Prison Inmates in Ethiopia, a Cross-Sectional Study

    PubMed Central

    Ali, Solomon; Haileamlak, Abraham; Wieser, Andreas; Pritsch, Michael; Heinrich, Norbert; Loscher, Thomas; Hoelscher, Michael; Rachow, Andrea

    2015-01-01

    Setting Tuberculosis (TB) is one of the major health problems in prisons. Objective This study was done to assess the prevalence and determinants of active tuberculosis in Ethiopian prisons. Design A cross-sectional study was conducted from January 2013 to December 2013 in 13 zonal prisons. All incarcerated inmates underwent TB symptom screening according to WHO criteria. From identified TB-suspects two sputum samples were analyzed using smear microscopy and solid culture. A standardized questionnaire assessing TB risk factors was completed for each TB suspect. Results 765 (4.9%) TB suspects were identified among 15,495 inmates. 51 suspects were already on anti-TB treatment (6.67%) and 20 (2.8%) new culture-confirmed TB cases were identified in the study, resulting in an overall TB prevalence of 458.1/100,000 (95%CI: 350-560/100,000). Risk factors for active TB were alcohol consumption, contact with a TB case before incarceration and no window in prison cell. HIV prevalence was not different between TB suspects and active TB cases. Further, the TB burden in prisons increased with advancing distance from the capital Addis Ababa. Conclusions The overall TB prevalence in Ethiopian prisons was high and extremely variable among different prisons. TB risk factors related to conditions of prison facilities and the impact of implemented TB control measures need to be further studied in order to improve TB control among inmates. PMID:26641654

  12. Dynamic Analysis of UTAUT: The Case of Microsoft Project Management Software

    ERIC Educational Resources Information Center

    Abualbasal, Wejdan; Abu-Shanab, Emad; Al-Quraan, Heba

    2016-01-01

    The technology adoption domain is rich with studies that utilized a cross-sectional snapshot of subjects' perceptions regarding the adoption of new technology. This research tried to implement a longitudinal study that took three measures within 4 months to estimate the influence of time and experience on students' perceptions. The study adopted a…

  13. Further clarity on cooperation and morality.

    PubMed

    Oderberg, David S

    2017-04-01

    I explore the increasingly important issue of cooperation in immoral actions, particularly in connection with healthcare. Conscientious objection, especially as pertains to religious freedom in healthcare, has become a pressing issue in the light of the US Supreme Court judgement in Hobby Lobby Section 'Moral evaluation using the basic principles of cooperation' outlines a theory of cooperation inspired by Catholic moral theologians such as those cited by the court. The theory has independent plausibility and is at least worthy of serious consideration-in part because it is an instance of double-effect reasoning, which is also independently plausible despite its association with moral theology. Section 'Case study: Burwell v. Hobby Lobby ' examines Hobby Lobby in detail. Even if the judgement was correct in that case the reasoning was not, as it involved applying a 'mere sincerity' test to the cooperation question. The mere sincerity test leads to absurd consequences, whereas a reasonableness test applied using the theory of cooperation defended here would avoid absurdity. Section 'A question of remoteness: "accommodations" and opt-outs' explores the post- Hobby Lobby problem further, examining opt-outs and accommodations: the Little Sisters of the Poor case shows how opt-outs are misunderstood on a mere sincerity test, which the court rightly rejected. Section 'Application to the medical field: Doogan and Wood ' discusses the UK case of Doogan and Wood , concerning participation in abortion. Again, a judicially recognised ethic of cooperation, if it were part of the fabric of legal reasoning in such cases, would have enabled the conscientious objectors in this and similar situations to have their freedom of conscience and religion respected in a way that it currently is not. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Cerebral amyloid angiopathy initially occurs in the meningeal vessels.

    PubMed

    Takeda, Shigeki; Yamazaki, Kazunori; Miyakawa, Teruo; Onda, Kiyoshi

    2017-12-01

    To clarify the frequency of CAA in the brain parenchyma and subarachnoid space (SAS), we counted sections of blood vessels showing positive staining for Aβ in the SAS, cerebral cortex (CC) and cerebral white matter (WM) using paraffin-embedded sections of the frontal, temporal and occipital lobes. The specimens had been taken for routine neuropathological examination from the brains of 105 Japanese patients (aged 40-95 years) selected from among 200 consecutive patients autopsied between 1989 and 2015 at our hospital. We examined the anatomical ratios of blood-vessel sections in the SAS relative to the CC in three selected CAA cases, and those of Aβ-positive blood-vessel sections in CAA cases. CAA was found in 53 of the 105 cases (50.5%), and the youngest patient affected was a 51-year-old man. The incidence of CAA increased with age. The anatomical ratio of blood vessel sections in the SAS relative to the CC was 1/3.70-1/4.37 (mean: 1/3.94). The ordinary CAA group, in which CAA was seen in both the SAS and CC, included 41 cases (77.4%). In 37 of these cases, the SAS/CC ratio of Aβ-positive blood vessels was 1/0.05-1/0.66 (mean: 1/0.26), and in the other four cases the ratio was 1/1-1/1.5. In the ordinary CAA group, the SAS/CC ratio of Aβ-positive blood vessels was smaller than the anatomical ratio. The meningeal CAA group, in which CAA was found only in the SAS, included 12 cases (22.6%). These patients ranged in age from their fifties to their nineties. There was no case in which CAA was limited only to the CC. We concluded that CAA initially develops in the meningeal blood vessels, and not in the cortical blood vessels. CAA in the WM was seen in 10 cases, not only in nine cases that were severe, but also in a mild case. © 2017 Japanese Society of Neuropathology.

  15. Risk Factors of Congenital Heart Diseases: A Case-Control Study inNorthwest Iran.

    PubMed

    Naghavi-Behzad, Mohammad; Alizadeh, Mahasti; Azami, Saber; Foroughifar, Shirin; Ghasempour-Dabbaghi, Khazar; Karzad, Nazila; Ahadi, Hamid-Reza; Naghavi-Behzad, Ali

    2013-01-01

    Congenital heart diseases are of immense importance and also a high prevalence. Contributing factors to developing these defects have not been abundantly studied. Therefore, the current study was conducted aiming at determining the effective factors on Congenital Heart Disease (CHD) in newborn infants of Northwest Iran. A case-control study was carried out in North-West of Iran from 2002 to 2012 and a total of 473 infants entered the study. Required data were obtained through check lists completed by the information of hospital records and interview with mothers of 267 newborn infants with CHD together with medical records of mothers as the case group, and 206 medical records of healthy infants at the same period all together with those of their mothers as the control group. The obtained data were statistically analyzed using descriptive statistical methods, T-test, Spearman's correlation coefficient, and Multi-variable Logistic Regression Model (OR with 95% CI), using SPSS.19. In the present study, P value less than 0.05 was considered statistically significant. Based on the results of univariable analyses, the number of previous cesarean sections, past medical history of diseases, gestational age (GA), fetal weight at birth, diastolic blood pressure, fetal heart rate, pulse rate, fetal hemoglobin and hematocrit levels, and fetal head circumference at birth have significant relationship with incidence of congenital abnormalities (P<0.05). Family history, past cesarean sections history, past medical history and GA had significant relationship with CHD incidence. Based on the results of present study, in order to control and reduce the cases of CHD, it is crucial to make proper decisions and implement policies for reducing cesarean cases, lowering consanguineous marriages, providing proper pre-marriage counseling, prompt treatment of mothers' illnesses, improving pregnancy health care and mothers' health status for the purpose of better well-being of newborn infants.

  16. The costs of 'free': Experiences of facility-based childbirth after Benin's caesarean section exemption policy.

    PubMed

    Lange, Isabelle L; Kanhonou, Lydie; Goufodji, Sourou; Ronsmans, Carine; Filippi, Véronique

    2016-11-01

    As one of many similar policies in the region, in 2009 Benin launched a free c-section policy in publicly funded hospitals intended to decrease the barriers to facility delivery and the heavy financial burdens on women and their families. We conducted a qualitative study for eight months between 2012 and 2014 to understand women's experiences of care in maternity wards. We carried out semi-structured interviews with 30 women who had delivered via c-section at five hospitals. Two of these hospitals became case study sites where in-depth research was undertaken that consisted of participant observation in each maternity ward and 32 further interviews with women who had complicated, vaginal and c-section deliveries. Overall, women continue to pay for care, both in the form of under-the-table payments to health workers and prescribed payments for services not covered by the policy, though they consider the costs reasonable compared to what the charges were before. Lifting the fees has facilitated conditions for midwives to alert doctors that the procedure might be needed. Partly because c-sections are still feared by most women, in one hospital this led to some women perceiving them as a threat if their labour was progressing more slowly. Implementation of the policy differed greatly between the two case study hospitals. We conclude that some burdens on women's access to care have been addressed but deterrents remain to the improved perception of quality of care on the part of women. Findings detail how important context is to the implementation of the policy, and suggest that similar user-fee removal policies should be accompanied by other measures addressing staff management and quality of care. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders--A case-control ultrasound speckle tracking analysis.

    PubMed

    Landén Ludvigsson, Maria; Peterson, Gunnel; Jull, Gwendolen; Trygg, Johan; Peolsson, Anneli

    2016-02-01

    Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood. This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and following loaded arm abduction. A cross-sectional case-control study of 36 people (26 female and 10 male, mean age 38 (SD 11)) with chronic WAD and 36 controls, matched for age and gender. Real-time ultrasound recordings of upper trapezius were taken during both scapular elevation tasks. Post-process speckle tracking analysis was undertaken of three different sections of the upper trapezius muscle (superficial, middle, deep). The WAD group had lower deformation of the superficial section of the upper trapezius compared to the control group in both concentric and eccentric phases of scapular elevation (p < 0.05) especially before the loaded arm abduction. After arm abduction, the deformation of the trapezius was reduced in both groups but only significantly in the WAD-group (p = 0.03). Within-group analysis revealed that the control group least engaged the deep section of upper trapezius during the task (p < 0.01). This study, measuring mechanical deformation of the upper trapezius during a scapular elevation task indicates that persons with WAD may display different patterns in engagement of the muscle sections than those in the control group. Further research is needed to replicate and understand the reasons for and implications of this possible change in motor strategy within upper trapezius. Clinical Trials.gov, Number: NCT01547624. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. [Metastatic tumors in the ovary, difficulties of histologic diagnosis].

    PubMed

    Tamás, Judit; Vereczkey, Ildikó; Tóth, Erika

    2015-09-01

    The ovary is a common site of metastases. Secondary tumors account for 3-40% of all ovarian malignancies. Most ovarian metastases arise from the colon, although tumors of the breast, stomach and endometrium are also common places of origin. Clinical and histological features of metastatic tumors frequently mimic primary ovarian malignancies, causing serious diagnostic problems for the surgical pathologist. However, differentiation between primary ovarian cancer and ovarian metastasis is important in order to prevent inappropriate management and suboptimal treatment. The distinction between primary and secondary ovarian malignancies is especially difficult in cases when the metastasis is diagnosed before the primary tumor. Frozen section is widely used in the intra-operative assessment of patients with ovarian tumors but it can be very difficult to distinguish certain types of primary ovarian tumors and metastases from other sites. We examined 152 cases of secondary ovarian neoplasm diagnosed at the National Institute of Oncology, Hungary from 2000 to 2014. Colorectal cancer was the most common primary tumor (58 cases), followed by breast (33 cases), endometrium (30 cases) and stomach cancer (13 cases). The differential diagnosis proved the most difficult in cases when endometrioid and mucinous tumors were present in the ovaries. Metastases of colorectal and gastric adenocarcinomas may simulate benign or borderline cystadenomas too. In these cases the knowledge of the patient's history and immunohistochemical stains were helpful. In our study we discuss the diagnostic challenge of distinguishing these secondary ovarian tumors from primary ovarian neoplasms and the limits of the intraoperative frozen sections.

  19. 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.

  20. [Cutaneous tuberculosis in Bamako, Mali].

    PubMed

    Dicko, Adama; Faye, Ousmane; Fofana, Youssouf; Soumoutera, Moussa; Berthé, Siritio; Touré, Saidou; Traoré, Bekaye; Guindo, Binta; Tall, Koureissi; Keita, Alimata; Kéita, Lassine; Coulibaly, Karim; Keita, Somita

    2017-01-01

    Tuberculosis is the most common mycobacteriosis in sub-Saharan Africa. Cutaneous tuberculosis is rare and underdiagnosed due to its clinical polymorphism and to the smallness of technical equipment. This study aims to describe the epidemiological, clinical, histopathological aspects of cutaneous tuberculosis in Bamako (Mali). We conducted a cross-sectional descriptive study from January 1991 to December 2008. The study was performed in the Department of Dermatology at the National Center for Disease Control and in the Department of Pneumophtisiology at the Hospital of Point G. The patients with tuberculosis confirmed by histological and/or biological examination were included in the study. Out of 4269 patients? medical records, 61 cases of cutaneous tuberculosis were identified (1.43%). Men accounted for 59% of the cases (36 patients) and women 41% (25 cases); sex-ratio was 1.44. The age of the patients ranged from 3 months to 61 years, with an average age of 27.56 ± 36 years. The average length of follow-up was 10.9 ± 10 months. The identified clinical forms were scrofuloderma (41 cases), ulcerative form (13 cases), verrucous form (4 cases), and tuberculous Lupus (3 cases). Tuberculosis was associated with HIV in 7 cases, with leprosy in 3 cases. Cutaneous tuberculosis is underdiagnosed in Mali. Efforts are needed to improve the accessibility and the technical equipment available in the Departments, in order to conduct an extensive interdisciplinary study on this pathology.

  1. Economic Implications of Widespread Expansion of Frozen Section Margin Analysis to Guide Surgical Resection in Women With Breast Cancer Undergoing Breast-Conserving Surgery.

    PubMed

    Boughey, Judy C; Keeney, Gary L; Radensky, Paul; Song, Christine P; Habermann, Elizabeth B

    2016-04-01

    In the current health care environment, cost effectiveness is critically important in policy setting and care of patients. This study performed a health economic analysis to assess the implications to providers and payers of expanding the use of frozen section margin analysis to minimize reoperations for patients undergoing breast cancer lumpectomy. A health care economic impact model was built to assess annual costs associated with breast lumpectomy procedures with and without frozen section margin analysis to avoid reoperation. If frozen section margin analysis is used in 20% of breast lumpectomies and under a baseline assumption that 35% of initial lumpectomies without frozen section analysis result in reoperations, the potential annual cost savings are $18.2 million to payers and $0.4 million to providers. Under the same baseline assumption, if 100% of all health care facilities adopted the use of frozen section margin analysis for breast lumpectomy procedures, the potential annual cost savings are $90.9 million to payers and $1.8 million to providers. On the basis of 10,000 simulations, use of intraoperative frozen section margin analysis yields cost saving for payers and is cost neutral to slightly cost saving for providers. This economic analysis indicates that widespread use of frozen section margin evaluation intraoperatively to guide surgical resection in breast lumpectomy cases and minimize reoperations would be beneficial to cost savings not only for the patient but also for payers and, in most cases, for providers. Copyright © 2016 by American Society of Clinical Oncology.

  2. [Breech presentation and vaginal delivery: evolution of acceptability by obstetricians and patients].

    PubMed

    Lagrange, E; Ab der Halden, M; Ughetto, S; Boda, C; Accoceberry, M; Neyrat, C; Houlle, C; Vendittelli, F; Laurichesse-Delmas, H; Jacquetin, B; Lémery, D; Gallot, D

    2007-09-01

    To investigate the influence of obstetrician and patient respectively on mode of delivery in case of breech presentation at term. This retrospective study included all women with a singleton pregnancy in a breech presentation delivered at term in a tertiary care maternity unit from January 1998 to December 2004. Mode of delivery was suggested by a score based on maternal age, parity, obstetrical past history, radiopelvimetry and cephalopelvic confrontation. The obstetrician was free to follow or not the score indication and patient's informed consent was required concerning the mode of delivery. Our main outcome measurements were mode of delivery and neonatal parameters. Two hundred cases were identified. Elective cesarean section increased progressively (from 52% in 1998 to 80% in 2004 [P=0,002]). Neonatal status and proportion of score in favour of vaginal birth remained stable during the study period. The rise in cesarean section rate was mainly due to patient's request (P=0,001) whereas the trend of obstetrician in favour of cesarean did not reach significance (P=0,3). The rise of elective cesarean section for term breech delivery in a maternity unit using a predefinite score is mainly induced by patient's request. This evolution has no effect on neonatal status.

  3. The Effect of Air Preheat at Atmospheric Pressure on the Formation of NO(x) in the Quick-Mix Sections of an Axially Staged Combustor

    NASA Technical Reports Server (NTRS)

    Vardakas, M. A.; Leong, M. Y.; Brouwer, J.; Samuelsen, G. S.; Holdeman, J. D.

    1999-01-01

    The Rich-burn/Quick-mix/Lean-burn (RQL) combustor concept has been proposed to minimize the formation of nitrogen oxides (NO(x)) in gas turbine systems. The success of this combustor strategy is dependent upon the efficiency of the mixing section bridging the fuel-rich and fuel-lean stages. Note that although these results were obtained from an experiment designed to study an RQL mixer, the link between mixing and NOx signatures is considerably broader than this application, in that the need to understand this link exists in most advanced combustors. The experiment reported herein was designed to study the effects of inlet air temperature on NO(x) formation in a mixing section. The results indicate that NO(x) emission is increased for all preheated cases compared to non-preheated cases. When comparing the various mixing modules, the affect of jet penetration is important, as this determines where NO(x) concentrations peak, and affects overall NO(x) production. Although jet air comprises 70 percent of the total airflow, the impact that jet air preheat has on overall NO(x) emissions is small compared to preheating both main and jet air flow.

  4. Diagnosis of filamentous fungi on tissue sections by immunohistochemistry using anti-aspergillus antibody.

    PubMed

    Challa, Sundaram; Uppin, Shantveer G; Uppin, Megha S; Pamidimukkala, Umabala; Vemu, Lakshmi

    2015-06-01

    Identification based on histology alone has limitations as Aspergillus species share morphology with other filamentous fungi. Differentiation of Aspergillus species from hyalohyphomycetes and dematiaceous fungi is important as the antifungal susceptibility varies among different species and genera. Given these problems, ancillary techniques are needed to increase specificity. Our aim was to study the utility of immunohistochemistry (IHC) with anti-Aspergillus antibody in the identification of Aspergillus species and to differentiate them from other filamentous fungi. Fifty formalin fixed, paraffin embedded tissue sections including 47 from cases of culture proven filamentous fungi, 3 from colonies of cultures of hyalohyphomycetes, and 11 smears from cultures were subjected to IHC studies using polyclonal rabbit anti-Aspergillus antibody (Abcam, UK) after antigen retrieval. The IHC on tissue sections was positive in 88% cases involving culture proven Aspergillus species. There was no cross reactivity with Mucorales species, Candida species, dematiaceous fungi and hyalohyphomycetes. Hence immunohistochemistry can be used as an ancillary technique for the diagnosis of Aspergillus species. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. An observational prospective cohort study of incidence and characteristics of failed spinal anaesthesia for caesarean section.

    PubMed

    Sng, B L; Lim, Y; Sia, A T H

    2009-07-01

    A prospective cohort study was performed in 800 parturients undergoing elective caesarean section under spinal anaesthesia from May 2005 to April 2006 in a large maternity hospital in Singapore, in order to determine the incidence of and risk factors for total and partial failure of spinal anaesthesia. A routine single-shot spinal technique using intrathecal 0.5% heavy bupivacaine 2.0 mL (10 mg) and morphine 100 microg was administered with a 27-gauge Whitacre spinal needle via a 20-gauge introducer. Demographic, surgical and anaesthetic data were collected to determine risk factors for failure of spinal anaesthesia. Incidence of total failure requiring conversion to general anaesthesia was 0.5% (4 cases) in which three cases had inadequate block (loss of sensation to cold less than T6) and one case had no sensory block. Thirty-three parturients (4.1%) required intravenous fentanyl and seven (0.9%) required Entonox for intraoperative analgesic supplementation. Postpartum sterilization (P<0.001) was an independent risk factor for partial failure requiring intravenous fentanyl and Entonox. Spinal anaesthesia using bupivacaine 10 mg with morphine 100 microg produces reliable anaesthesia for elective caesarean section. Postpartum sterilization involves exteriorisation of the uterus with additional surgical manipulation and hence may necessitate analgesic supplementation. The initial use of a combined spinal-epidural technique or the addition of intrathecal fentanyl or clonidine or an increased dose of local anaesthetic may be considered to decrease the incidence of intraoperative pain.

  6. Rising threat of terrorist bomb blasts in Karachi--a 5-year study.

    PubMed

    Mirza, Farhat Hussain; Parhyar, Hamid Ali; Tirmizi, Syed Zubair Ahmed

    2013-08-01

    This study aims to determine the frequency of injuries and fatalities associated with terrorist bomb explosions in the city of Karachi from 1 January 2007 to 31 December 2011. Moreover, this study is aimed to determine age and sex vulnerability among the victims of blast explosion. A descriptive cross-sectional study was conducted. The study was carried out at mortuaries and medicolegal sections at Jinnah Postgraduate Medical Center, Civil Hospital and Abbasi-Shaheed Hospital Karachi, the three main hospitals, which cater to all these cases of Karachi. The study included all bomb blast victims examined and autopsied from January 2007 to December 2011 at Jinnah Postgraduate Medical Center, Civil Hospital and Abbassi Shaheed Hospital Karachi. Details of 1142 cases were collected for those medicolegal deaths and injured persons, identified to be the victims of bomb blasts from January 2007 to December 2011. Data were collected on a preformed proforma from the mortuaries and medicolegal sections of these three public sector hospitals. The variables investigated include age, gender, year-wise distribution of the injured and the dead along with the cause of death and body parts injured in survivors. Out of the total 11,109 autopsies during the study period, 249 (2.24%) were carried out on deaths due to bomb blasts. Similarly, 135,065 injury cases were reported during the study period out of which 893 (0.66%) cases were due to bomb blasts. An initial peak in the year 2007, followed by a decline in 2008 and since then a steady rise of bomb blast incidences with casualties and fatalities, has been observed. The highest numbers of injured victims were reported in the year 2010 and fatalities in 2007. Among 1142 cases, 95.18% were male and 4.82% female with a male to female ratio of 19.76:1. Persons of ages between 15 and 45 years were chiefly involved. Shock due to multiple injuries was the leading cause of death, followed by head injury with or without haemorrhage. The lower extremities sustained the highest number of injuries in survivors, followed by the upper extremities. Fatalities and casualties due to explosions are increasing each year. The pattern of injuries indicates open-air bombing in Karachi. Males of the age group 15-45 years are the main victims. The forensic speciality needs to understand their role of correct certification, helpful to law enforcement agencies. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  7. Ram-Jet off Design Performances

    NASA Astrophysics Data System (ADS)

    Andriani, Roberto; Ghezzi, Umberto

    2002-01-01

    In this work it is intended to study the off-design performances of a ram jet engine. To this purpouse it has been analyzed in a first time the behaviour of an ideal engine, that means to not consider the losses in the various components, or, under a thermodynamic point of view, to consider the fluid transformation through the air intake and exhaust nozzle, remembering that in a ram jet there are not rotating components as compressor and turbine, isentropic. Referring to the ram-jet scheme of fig.1. we can say, neglecting the fuel introduced, that the air mass flow rate throughout the engine is constant. If we consider the two control sections 4 and 8, respectively the throat section of the converging-diverging supersonic inlet and the throat section of the discharge nozzle, the condition of constant mass flow leads to the relation: m4 =f (M 4 ) m8 = m 4 = m8 We can imaging that the throat section # 4 is always choked for any value of the flight Mach number M0. This means that the throat section 4 is adjusted at any value of M0 so that the flow Mach number in 4 is equal to unity. In this it follows: R. Andriani, U. Ghezzi1 Since in an ideal case T t8 The relation [1] allows to determine the T8 temperature, that represent the maximum cycle temperature, for different operating conditions, as flight Mach number and altitude. We then have two cases: the first is A8 (nozzle throat section) fixed, and the second is A8 variable. In the first case the maximum temperature T8 is univocally determined by the operating condition. In the second case A8 can be varied so to maintain T8 at a chosen value. The graphic of fig.2 shows the first case. In particular it has been considered as design point an altitude of 15000 meters and a flight Mach number equal to 2. In this condition it has been evaluated the section A8 for unity mass flow rate. At the same altitude, varying the flight Mach number, with the section A4 always choked, the graphic shows the variation of the maximum cycle temperature according to the equation *. We notice as the temperature raises to unacceptable levels as we accelerate from the design point. For instance we can see as if we move to flight Mach number 2.2 the maximum temperature raises from 1800 Kelvin degrees (design point) to more than 2900 [K], a value practically unreachable. This shows as the ramjet with fixed discharge nozzle allows very little variation of the operating conditions around the design point. If we consider instead the possibility to vary the nozzle section A8 we can imagine to adjust it so to maintain constant the temperature T8, according to the relation *. The graphics of fig.3 show the area variation required to the section A8 to maintain constant the temperature T8 at the same altitude for different values of the flight Mach number. Considering a circular section, on the same R. Andriani, U. Ghezzi2 picture is reported the corresponding variation of the diameter. On the Y-axis it is reported the ratio between the entity (section and diameter) at the considered condition and at the design point. For the case of A8 section variable it has also been evaluated the behavior of the specific fuel consumption, the mass flow rate and the thrust. In fig.4 they are reported the behavior TSFC and Fuel/air ratio at different flight Mach numbers, and the ratio between them and the design value. In fig .5 it is reported the ratio between the thrust and mass flow rate at different flight conditions and their value at design point. R. Andriani, U. Ghezzi3

  8. Placenta previa with early opening of the uterine isthmus is associated with high risk of bleeding during pregnancy, and massive haemorrhage during caesarean delivery.

    PubMed

    Goto, M; Hasegawa, J; Arakaki, T; Takita, H; Oba, T; Nakamura, M; Sekizawa, A

    2016-06-01

    To demonstrate the relationship between the timing of opening of the uterine isthmus and bleeding during pregnancy and caesarean section in patients with placenta previa. A prospective observational study was conducted at a single perinatal centre. All patients with placenta previa, diagnosed between 20 and 22 weeks of gestation, who were followed up at the study hospital and underwent caesarean section were enrolled. The condition of the uterine isthmus was examined every 2 weeks. The timing (in gestational weeks) of complete opening of the uterine isthmus was determined. Patients were divided into two groups: patients in whom the uterine isthmus opened before 25 weeks of gestation (EO-previa), and patients in whom the uterine isthmus opened after 25 weeks of gestation (LO-previa). The frequency of bleeding during pregnancy and the amount of intra-operative bleeding were compared between the two groups. Forty-four cases of EO-previa and 55 cases of LO-previa were analysed. Complete placenta previa at delivery was observed more frequently in the EO-previa group than in the LO-previa group (88.6% vs 47.3%, p<0.001). An emergency caesarean section due to active bleeding was performed more frequently in the EO-previa group (48%) than in the LO-previa group (25%) (p=0.021). The frequency of massive haemorrage (>2500ml) during caesarean section was higher in the EO-previa group than in the LO-previa group (25% vs 9%, p=0.033). Placenta previa was associated with a high risk of bleeding leading to emergency caesarean section during pregnancy, and massive haemorrhage during caesarean section in patients in whom the uterine isthmus opened before 25 weeks of gestation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. [Two observations of evisceration after caesarean section performed according the so-called Stark procedure].

    PubMed

    Fournié, A; Madzou, S; Sentilhes, L; Descamps, P

    2008-12-01

    Two cases of evisceration after caesarean sections performed according the Misgav Ladach General Hospital procedure (Stark's procedure) are reported. In these cases, omentum was sutured between the edges of fascia recti, creating a weakness of the abdominal sheath. These cases claim about a strict procedure for fascia suture. Also, these cases question about the parietal peritoneal closure and the drawing of rectus muscles, which are vertical breaks; so, these sutures close transversal incision of the abdominal wall with cross sutures, which are very secure.

  10. Use of standardised patients to assess antibiotic dispensing for tuberculosis by pharmacies in urban India: a cross-sectional study.

    PubMed

    Satyanarayana, Srinath; Kwan, Ada; Daniels, Benjamin; Subbaraman, Ramnath; McDowell, Andrew; Bergkvist, Sofi; Das, Ranendra K; Das, Veena; Das, Jishnu; Pai, Madhukar

    2016-11-01

    India's total antibiotic use is the highest of any country. Patients often receive prescription-only drugs directly from pharmacies. Here we aimed to assess the medical advice and drug dispensing practices of pharmacies for standardised patients with presumed and confirmed tuberculosis in India. In this cross-sectional study in the three Indian cities Delhi, Mumbai, and Patna, we developed two standardised patient cases: first, a patient presenting with 2-3 weeks of pulmonary tuberculosis symptoms (Case 1); and second, a patient with microbiologically confirmed pulmonary tuberculosis (Case 2). Standardised patients were scheduled to present each case once to sampled pharmacies. We defined ideal management for both cases a priori as referral to a health-care provider without dispensing antibiotics or steroids or both. Between April 1, 2014, and Nov 29, 2015, we sampled 622 pharmacies in Delhi, Mumbai, and Patna. Standardised patients completed 1200 (96%) of 1244 interactions. We recorded ideal management (defined as referrals without the use of antibiotics or steroids) in 80 (13%) of 599 Case 1 interactions (95% CI 11-16) and 372 (62%) of 601 Case 2 interactions (95% CI 58-66). Antibiotic use was significantly lower in Case 2 interactions (98 [16%] of 601, 95% CI 13-19) than in Case 1 (221 [37%] of 599, 95% CI 33-41). First-line anti-tuberculosis drugs were not dispensed in any city. The differences in antibiotic or steroid use and number of medicines dispensed between Case 1 and Case 2 were almost entirely attributable to the difference in referral behaviour. Only some urban Indian pharmacies correctly managed patients with presumed tuberculosis, but most correctly managed a case of confirmed tuberculosis. No pharmacy dispensed anti-tuberculosis drugs for either case. Absence of a confirmed diagnosis is a key driver of antibiotic misuse and could inform antimicrobial stewardship interventions. Grand Challenges Canada, Bill & Melinda Gates Foundation, Knowledge for Change Program, and World Bank Development Research Group. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

  11. Methodological approach and tools for systems thinking in health systems research: technical assistants' support of health administration reform in the Democratic Republic of Congo as an application.

    PubMed

    Ribesse, Nathalie; Bossyns, Paul; Marchal, Bruno; Karemere, Hermes; Burman, Christopher J; Macq, Jean

    2017-03-01

    In the field of development cooperation, interest in systems thinking and complex systems theories as a methodological approach is increasingly recognised. And so it is in health systems research, which informs health development aid interventions. However, practical applications remain scarce to date. The objective of this article is to contribute to the body of knowledge by presenting the tools inspired by systems thinking and complexity theories and methodological lessons learned from their application. These tools were used in a case study. Detailed results of this study are in process for publication in additional articles. Applying a complexity 'lens', the subject of the case study is the role of long-term international technical assistance in supporting health administration reform at the provincial level in the Democratic Republic of Congo. The Methods section presents the guiding principles of systems thinking and complex systems, their relevance and implication for the subject under study, and the existing tools associated with those theories which inspired us in the design of the data collection and analysis process. The tools and their application processes are presented in the results section, and followed in the discussion section by the critical analysis of their innovative potential and emergent challenges. The overall methodology provides a coherent whole, each tool bringing a different and complementary perspective on the system.

  12. Compulsory removal to and detention in hospital in the case of notifiable disease: a survey of public health doctors.

    PubMed

    Kaur, B; Bingham, P

    1993-05-01

    Compulsory detention of an individual in hospital, because they have a notifiable disease, is controversial. Difficulties experienced by the authors in applying Sections 37 and 38 of the Public Health (Control of Disease) Act 1984 led them to conduct a postal survey of the experience of Consultants in Communicable Disease Control/Medical Officers of Environmental Health (CCDC/MOEH) currently in post in England. Out of 138 respondents (80% response rate), 48 respondents (34.8%) had dealt with 'non-compliant' individuals posing an infectious risk to the community. Of the 48, 13 respondents achieved compliance by threatening to use Section 37/38 and only 6 respondents resorted to using Section 37/38, equivalent to less than one use of the sections for every hundred years of CCDC/MOEH experience. In most cases the notifiable disease in question was tuberculosis. In contrast to our experience and previously reported cases, the survey suggests generally satisfactory experience of Section 37/38 amongst CCDC/MOEH currently in post. Recommended guidelines for the use of Section 37/38 are given.

  13. Individual Differences in the Lexical Development of French-English Bilingual Children

    ERIC Educational Resources Information Center

    David, Annabelle; Wei, Li

    2008-01-01

    The large and rapidly expanding body of literature on bilingual acquisition is mostly comprised of either single-case or cross-sectional studies. While these studies have made major contributions to our understanding of bilingual children's language development, they do not allow researchers to compare and contrast results with regard to…

  14. Adiposity and Quality of Life: A Case Study from an Urban Center in Nigeria

    ERIC Educational Resources Information Center

    Akinpelu, Aderonke O.; Akinola, Odunayo T.; Gbiri, Caleb A.

    2009-01-01

    Objective: To determine relationship between adiposity indices and quality of life (QOL) of residents of a housing estate in Lagos, Nigeria. Design: Cross-sectional survey employing multistep random sampling method. Setting: Urban residential estate. Participants: This study involved 900 randomly selected residents of Abesan Housing Estate, Lagos,…

  15. Teaching Large Sections of a Business Communication Course: A Multicase Study

    ERIC Educational Resources Information Center

    Wright, Carol

    2017-01-01

    The purpose of this research is to examine specific examples of how business communication courses are delivered in large, face-to-face university classes to discover implications of these large courses. This case study reviewed four classes from two different midsized universities whose classes range from 48 to 300 students. Findings suggest…

  16. Reciprocity in the electronic stopping of slow ions in matter

    NASA Astrophysics Data System (ADS)

    Sigmund, P.

    2008-04-01

    The principle of reciprocity, i.e., the invariance of the inelastic excitation in ion-atom collisions against interchange of projectile and target, has been applied to the electronic stopping cross section of low-velocity ions and tested empirically on ion-target combinations supported by a more or less adequate amount of experimental data. Reciprocity is well obeyed (within ~10%) for many systems studied, and deviations exceeding ~20% are exceptional. Systematic deviations such as gas-solid or metal-insulator differences have been looked for but not identified on the present basis. A direct consequence of reciprocity is the equivalence of Z1 with Z2 structure for random slowing down. This feature is reasonably well supported empirically for ion-target combinations involving carbon, nitrogen, aluminium and argon. Reciprocity may be utilized as a criterion to reject questionable experimental data. In cases where a certain stopping cross section has not been or cannot be measured, the stopping cross section for the inverted system may be available and serve as a first estimate. It is suggested to build in reciprocity as a fundamental requirement into empirical interpolation schemes directed at the stopping of low-velocity ions. Examination of the SRIM and MSTAR codes reveals cases where reciprocity is obeyed accurately, but deviations of up to a factor of two are common. In case of heavy ions such as gold, electronic stopping cross sections predicted by SRIM are asserted to be almost an order of magnitude too high.

  17. Students' perceptions of the flipped classroom model in an engineering course: a case study

    NASA Astrophysics Data System (ADS)

    Baytiyeh, Hoda; Naja, Mohamad K.

    2017-11-01

    The flipped classroom model is an innovative educational trend that has been widely adopted in the social sciences but not engineering education. In this model, an active instructional approach shifts the educational strategy from a teacher- to a student-centred approach. The purpose of this study is to compare the learning outcomes of engineering students attending a flipped-model section of the Dynamics of Structures course with students attending a traditional, lecture-based section of the same course taught by the same instructor. The results confirm previous research showing that test scores in the flipped course sections were slightly higher than traditional sections. Although the improvement in test scores was statistically insignificant, student statements indicated that the flipped model promoted a deeper, broader perspective on learning, facilitated problem-solving strategies and improved critical-thinking abilities, self-confidence and teamwork skills, which are needed for a successful engineering career.

  18. Work Habits of Students in Traditional and Online Sections of an Introductory Physics Course: A Case Study

    NASA Astrophysics Data System (ADS)

    Kortemeyer, Gerd

    2016-10-01

    The study compares the work habits of two student groups in an introductory physics course, one in traditional and one in online sections. Both groups shared the same online materials and online homework, as well as the same discussion boards and examinations, but one group in addition had traditional lectures. The groups were compared with respect to amount and frequency of access to different online course resources. It was found that with few exceptions, both groups exhibited very similar work habits. Students in the online sections more frequently accessed content pages and more frequently contributed to course discussions. It was also found that regular access of the materials throughout the week, rather than only on homework deadline nights, is a predictor of success on examinations, and that this indicator is more reliable for students in the online sections. Overall, though, the effect of traditional lectures is minimal.

  19. The impact of different strategies to handle missing data on both precision and bias in a drug safety study: a multidatabase multinational population-based cohort study

    PubMed Central

    Martín-Merino, Elisa; Calderón-Larrañaga, Amaia; Hawley, Samuel; Poblador-Plou, Beatriz; Llorente-García, Ana; Petersen, Irene; Prieto-Alhambra, Daniel

    2018-01-01

    Background Missing data are often an issue in electronic medical records (EMRs) research. However, there are many ways that people deal with missing data in drug safety studies. Aim To compare the risk estimates resulting from different strategies for the handling of missing data in the study of venous thromboembolism (VTE) risk associated with antiosteoporotic medications (AOM). Methods New users of AOM (alendronic acid, other bisphosphonates, strontium ranelate, selective estrogen receptor modulators, teriparatide, or denosumab) aged ≥50 years during 1998–2014 were identified in two Spanish (the Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria [BIFAP] and EpiChron cohort) and one UK (Clinical Practice Research Datalink [CPRD]) EMR. Hazard ratios (HRs) according to AOM (with alendronic acid as reference) were calculated adjusting for VTE risk factors, body mass index (that was missing in 61% of patients included in the three databases), and smoking (that was missing in 23% of patients) in the year of AOM therapy initiation. HRs and standard errors obtained using cross-sectional multiple imputation (MI) (reference method) were compared to complete case (CC) analysis – using only patients with complete data – and longitudinal MI – adding to the cross-sectional MI model the body mass index/smoking values as recorded in the year before and after therapy initiation. Results Overall, 422/95,057 (0.4%), 19/12,688 (0.1%), and 2,051/161,202 (1.3%) VTE cases/participants were seen in BIFAP, EpiChron, and CPRD, respectively. HRs moved from 100.00% underestimation to 40.31% overestimation in CC compared with cross-sectional MI, while longitudinal MI methods provided similar risk estimates compared with cross-sectional MI. Precision for HR improved in cross-sectional MI versus CC by up to 160.28%, while longitudinal MI improved precision (compared with cross-sectional) only minimally (up to 0.80%). Conclusion CC may substantially affect relative risk estimation in EMR-based drug safety studies, since missing data are not often completely at random. Little improvement was seen in these data in terms of power with the inclusion of longitudinal MI compared with cross-sectional MI. The strategy for handling missing data in drug safety studies can have a large impact on both risk estimates and precision.

  20. The impact of different strategies to handle missing data on both precision and bias in a drug safety study: a multidatabase multinational population-based cohort study.

    PubMed

    Martín-Merino, Elisa; Calderón-Larrañaga, Amaia; Hawley, Samuel; Poblador-Plou, Beatriz; Llorente-García, Ana; Petersen, Irene; Prieto-Alhambra, Daniel

    2018-01-01

    Missing data are often an issue in electronic medical records (EMRs) research. However, there are many ways that people deal with missing data in drug safety studies. To compare the risk estimates resulting from different strategies for the handling of missing data in the study of venous thromboembolism (VTE) risk associated with antiosteoporotic medications (AOM). New users of AOM (alendronic acid, other bisphosphonates, strontium ranelate, selective estrogen receptor modulators, teriparatide, or denosumab) aged ≥50 years during 1998-2014 were identified in two Spanish (the Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria [BIFAP] and EpiChron cohort) and one UK (Clinical Practice Research Datalink [CPRD]) EMR. Hazard ratios (HRs) according to AOM (with alendronic acid as reference) were calculated adjusting for VTE risk factors, body mass index (that was missing in 61% of patients included in the three databases), and smoking (that was missing in 23% of patients) in the year of AOM therapy initiation. HRs and standard errors obtained using cross-sectional multiple imputation (MI) (reference method) were compared to complete case (CC) analysis - using only patients with complete data - and longitudinal MI - adding to the cross-sectional MI model the body mass index/smoking values as recorded in the year before and after therapy initiation. Overall, 422/95,057 (0.4%), 19/12,688 (0.1%), and 2,051/161,202 (1.3%) VTE cases/participants were seen in BIFAP, EpiChron, and CPRD, respectively. HRs moved from 100.00% underestimation to 40.31% overestimation in CC compared with cross-sectional MI, while longitudinal MI methods provided similar risk estimates compared with cross-sectional MI. Precision for HR improved in cross-sectional MI versus CC by up to 160.28%, while longitudinal MI improved precision (compared with cross-sectional) only minimally (up to 0.80%). CC may substantially affect relative risk estimation in EMR-based drug safety studies, since missing data are not often completely at random. Little improvement was seen in these data in terms of power with the inclusion of longitudinal MI compared with cross-sectional MI. The strategy for handling missing data in drug safety studies can have a large impact on both risk estimates and precision.

  1. Cost convergence between public and for-profit hospitals under prospective payment and high competition in Taiwan.

    PubMed

    Xirasagar, Sudha; Lin, Herng-Ching

    2004-12-01

    To test the hypotheses that: (1) average adjusted costs per discharge are higher in high-competition relative to low-competition markets, and (2) increased competition is associated with cost convergence between public and for-profit (FP) hospitals for case payment diagnoses, but not for cost-plus reimbursed diagnoses. Taiwan's National Health Insurance database; 325,851 inpatient claims for cesarean section, vaginal delivery, prostatectomy, and thyroidectomy (all case payment), and bronchial asthma and cholelithiasis (both cost-based payment). Retrospective population-based, cross-sectional study. Diagnosis-wise regression analyses were done to explore associations between cost per discharge and hospital ownership under high and low competition, adjusted for clinical severity and institutional characteristics. Adjusted costs per discharge are higher for all diagnoses in high-competition markets. For case payment diagnoses, the magnitudes of adjusted cost differences between public and FP hospitals are lower under high competition relative to low competition. This is not so for the cost-based diagnoses. We find that the empirical evidence supports both our hypotheses.

  2. The Cellient System for Paraffin Histology Can Be Combined with HPV Testing and Morphotyping the Vaginal Microbiome Thanks to BoonFixing

    PubMed Central

    Boon, Mathilde E.

    2013-01-01

    The Cellient Automated Cell Block System (Hologic) can be used to process cervical scrapes to paraffin sections. For the first study on this subject, cervical scrapes were fixed in the formalin-free fixative BoonFix. This pilot study was limited to cases classified as atypical squamous lesion of unknown significance (ASCUS) and high-grade squamous lesion (HSIL) as diagnosed in the ThinPrep slide. The Cellient paraffin sections were classified into negative, atypical, CIN 1, CIN 2, and CIN 3. Multiple HPV genotypes were encountered in 79% of the scrapes. This study showed that the Cellient system for paraffin sections can be combined with HPV testing thanks to the formalin-free BoonFix. In two additional studies it was shown that such samples can also be used for morphotyping the vaginal microbiome and preparing cytologic ThinPrep slides. PMID:23577033

  3. The Cellient System for Paraffin Histology Can Be Combined with HPV Testing and Morphotyping the Vaginal Microbiome Thanks to BoonFixing.

    PubMed

    Boon, Mathilde E

    2013-01-01

    The Cellient Automated Cell Block System (Hologic) can be used to process cervical scrapes to paraffin sections. For the first study on this subject, cervical scrapes were fixed in the formalin-free fixative BoonFix. This pilot study was limited to cases classified as atypical squamous lesion of unknown significance (ASCUS) and high-grade squamous lesion (HSIL) as diagnosed in the ThinPrep slide. The Cellient paraffin sections were classified into negative, atypical, CIN 1, CIN 2, and CIN 3. Multiple HPV genotypes were encountered in 79% of the scrapes. This study showed that the Cellient system for paraffin sections can be combined with HPV testing thanks to the formalin-free BoonFix. In two additional studies it was shown that such samples can also be used for morphotyping the vaginal microbiome and preparing cytologic ThinPrep slides.

  4. Acute pulmonary emphysema in death by hanging: a morphometric digital study.

    PubMed

    Castiglioni, Claudia; Baumann, Pia; Fracasso, Tony

    2016-09-01

    Acute pulmonary emphysema (APE) has been described in cases of mechanical asphyxia such as ligature or manual strangulation but not in cases of hanging. In this study, we wanted to verify by morphometric digital analysis of lung tissue whether APE occurs in death by hanging.We investigated 16 cases of hanging (eight complete, eight incomplete), 10 cases of freshwater drowning (positive control group), and 10 cases of acute external bleeding (negative control group). Tissue sections were obtained from each pulmonary lobe. For each slide, five fields were randomly selected. The area of every alveolar space was measured by image analysis software. The mean alveolar area (MAA) was calculated for each group.In incomplete hanging, MAA was significantly higher than that observed in complete hanging and similar to the one observed in freshwater drowning.APE in cases of incomplete hanging can be considered as a sign of vitality. The high number of conditions that can cause alveolar distension (that were excluded in this study) limits the applicability of this vital sign in the routine forensic practice.

  5. Adolescent suicide prevention.

    PubMed

    Novick, Lloyd F; Cibula, Donald A; Sutphen, Sally M

    2003-05-01

    This case-prevention of adolescent suicide-is one of a series of teaching cases in the Case-Based Series in Population-Oriented Prevention (C-POP). It has been developed for use in medical school and residency prevention curricula. The complete set of cases is presented in this supplement to the American Journal of Preventive Medicine. This teaching case examines the issue of prevention of adolescent and young adult suicide both at an individual and at a population or community level, using data from the Onondaga County Health Department. In the first section of the case, students are asked to determine whether five deaths related to falling or jumping at a local shopping mall should be considered to be suicidal deaths. Students then develop skills in the reporting as well as in the epidemiology of adolescent suicidal deaths in Onondaga County. As the case progresses, students analyze the results of a local surveillance study of suicidal attempts and ideation. The case concludes with students evaluating a hypothetical screening study intended to reduce the risk of suicidal death and discussing a research design to examine the effectiveness of this prevention strategy.

  6. Prevalence of Propionibacterium acnes in Intervertebral Discs of Patients Undergoing Lumbar Microdiscectomy: A Prospective Cross-Sectional Study

    PubMed Central

    Capoor, Manu N.; Ruzicka, Filip; Machackova, Tana; Jancalek, Radim; Smrcka, Martin; Schmitz, Jonathan E.; Hermanova, Marketa; Sana, Jiri; Michu, Elleni; Baird, John C.; Ahmed, Fahad S.; Maca, Karel; Lipina, Radim; Alamin, Todd F.; Coscia, Michael F.; Stonemetz, Jerry L.; Witham, Timothy; Ehrlich, Garth D.; Gokaslan, Ziya L.; Mavrommatis, Konstantinos; Birkenmaier, Christof; Fischetti, Vincent A.; Slaby, Ondrej

    2016-01-01

    Background The relationship between intervertebral disc degeneration and chronic infection by Propionibacterium acnes is controversial with contradictory evidence available in the literature. Previous studies investigating these relationships were under-powered and fraught with methodical differences; moreover, they have not taken into consideration P. acnes’ ability to form biofilms or attempted to quantitate the bioburden with regard to determining bacterial counts/genome equivalents as criteria to differentiate true infection from contamination. The aim of this prospective cross-sectional study was to determine the prevalence of P. acnes in patients undergoing lumbar disc microdiscectomy. Methods and Findings The sample consisted of 290 adult patients undergoing lumbar microdiscectomy for symptomatic lumbar disc herniation. An intraoperative biopsy and pre-operative clinical data were taken in all cases. One biopsy fragment was homogenized and used for quantitative anaerobic culture and a second was frozen and used for real-time PCR-based quantification of P. acnes genomes. P. acnes was identified in 115 cases (40%), coagulase-negative staphylococci in 31 cases (11%) and alpha-hemolytic streptococci in 8 cases (3%). P. acnes counts ranged from 100 to 9000 CFU/ml with a median of 400 CFU/ml. The prevalence of intervertebral discs with abundant P. acnes (≥ 1x103 CFU/ml) was 11% (39 cases). There was significant correlation between the bacterial counts obtained by culture and the number of P. acnes genomes detected by real-time PCR (r = 0.4363, p<0.0001). Conclusions In a large series of patients, the prevalence of discs with abundant P. acnes was 11%. We believe, disc tissue homogenization releases P. acnes from the biofilm so that they can then potentially be cultured, reducing the rate of false-negative cultures. Further, quantification study revealing significant bioburden based on both culture and real-time PCR minimize the likelihood that observed findings are due to contamination and supports the hypothesis P. acnes acts as a pathogen in these cases of degenerative disc disease. PMID:27536784

  7. Prevalence of Propionibacterium acnes in Intervertebral Discs of Patients Undergoing Lumbar Microdiscectomy: A Prospective Cross-Sectional Study.

    PubMed

    Capoor, Manu N; Ruzicka, Filip; Machackova, Tana; Jancalek, Radim; Smrcka, Martin; Schmitz, Jonathan E; Hermanova, Marketa; Sana, Jiri; Michu, Elleni; Baird, John C; Ahmed, Fahad S; Maca, Karel; Lipina, Radim; Alamin, Todd F; Coscia, Michael F; Stonemetz, Jerry L; Witham, Timothy; Ehrlich, Garth D; Gokaslan, Ziya L; Mavrommatis, Konstantinos; Birkenmaier, Christof; Fischetti, Vincent A; Slaby, Ondrej

    2016-01-01

    The relationship between intervertebral disc degeneration and chronic infection by Propionibacterium acnes is controversial with contradictory evidence available in the literature. Previous studies investigating these relationships were under-powered and fraught with methodical differences; moreover, they have not taken into consideration P. acnes' ability to form biofilms or attempted to quantitate the bioburden with regard to determining bacterial counts/genome equivalents as criteria to differentiate true infection from contamination. The aim of this prospective cross-sectional study was to determine the prevalence of P. acnes in patients undergoing lumbar disc microdiscectomy. The sample consisted of 290 adult patients undergoing lumbar microdiscectomy for symptomatic lumbar disc herniation. An intraoperative biopsy and pre-operative clinical data were taken in all cases. One biopsy fragment was homogenized and used for quantitative anaerobic culture and a second was frozen and used for real-time PCR-based quantification of P. acnes genomes. P. acnes was identified in 115 cases (40%), coagulase-negative staphylococci in 31 cases (11%) and alpha-hemolytic streptococci in 8 cases (3%). P. acnes counts ranged from 100 to 9000 CFU/ml with a median of 400 CFU/ml. The prevalence of intervertebral discs with abundant P. acnes (≥ 1x103 CFU/ml) was 11% (39 cases). There was significant correlation between the bacterial counts obtained by culture and the number of P. acnes genomes detected by real-time PCR (r = 0.4363, p<0.0001). In a large series of patients, the prevalence of discs with abundant P. acnes was 11%. We believe, disc tissue homogenization releases P. acnes from the biofilm so that they can then potentially be cultured, reducing the rate of false-negative cultures. Further, quantification study revealing significant bioburden based on both culture and real-time PCR minimize the likelihood that observed findings are due to contamination and supports the hypothesis P. acnes acts as a pathogen in these cases of degenerative disc disease.

  8. Systematic effects on cross section data derived from reaction rates in reactor spectra and a re-analysis of 241Am reactor activation measurements

    NASA Astrophysics Data System (ADS)

    Žerovnik, Gašper; Schillebeeckx, Peter; Becker, Björn; Fiorito, Luca; Harada, Hideo; Kopecky, Stefan; Radulović, Vladimir; Sano, Tadafumi

    2018-01-01

    Methodologies to derive cross section data from spectrum integrated reaction rates were studied. The Westcott convention and some of its approximations were considered. Mostly measurements without and with transmission filter are combined to determine the reaction cross section at thermal energy together with the resonance integral. The accuracy of the results strongly depends on the assumptions that are made about the neutron energy distribution, which is mostly parameterised as a sum of a thermal and an epi-thermal component. Resonance integrals derived from such data can be strongly biased and should only be used in case no other data are available. The cross section at thermal energy can be biased for reaction cross sections which are dominated by low energy resonances. The amplitude of the effect is related to the lower energy limit that is used for the epi-thermal component of the neutron energy distribution. It is less affected by the assumptions on the shape of the energy distribution. When the energy dependence of the cross section is known and information about the neutron energy distribution is available, a method to correct for a bias on the cross section at thermal energy is proposed. Reactor activation measurements to determine the thermal 241Am(n, γ) cross section reported in the literature were reviewed. In case enough information was available, the results were corrected to account for possible biases and included in a least squares fit. These data combined with results of time-of-flight measurements give a capture cross section 720 (14) b for 241Am(n, γ) at thermal energy.

  9. 7 CFR 800.199 - Conflict-of-interest provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Conflict-of-interest provisions. 800.199 Section 800... Delegations, Designations, Approvals, Contracts, and Conflicts of Interest § 800.199 Conflict-of-interest...) Prohibited conflicts of interest. Unless waived on a case-by-case basis by the Administrator under section 11...

  10. Leprosy among schoolchildren in the Amazon region: A cross-sectional study of active search and possible source of infection by contact tracing

    PubMed Central

    Dias, Luiz Claudio; Galban, Enrique; Leturiondo, André; Palheta, Jamile; Santos, Monica; Moraes, Milton Ozório; Talhari, Carolina

    2018-01-01

    Background The high rate of leprosy cases among children under 15 years of age in Brazil indicates ongoing transmission within the community. The identification of the new leprosy cases among contacts can help identify the source of infection and interrupt the transmission chain. This study aims to determine the detection rate of previously undiagnosed cases of leprosy among schoolchildren who are under 15 years of age living in Manaus, Amazonas, Brazil, and their possible source of infection by contact tracing. Methodology/Principal findings This was a school-based, cross-sectional study in which the identification of active leprosy cases was conducted in 277 out of 622 randomly selected public schools in Manaus, Amazonas, Brazil. Suspected cases of leprosy were referred to the Alfredo da Matta Foundation, a reference center for leprosy in Manaus. A total of 34,547 schoolchildren were examined, and 40 new leprosy cases were diagnosed. Among new cases, 57.5% were males, and 80.0% demonstrated paucibacillary leprosy. A total of 196 of 206 registered contacts were screened, and 52.5% of the newly diagnosed children’s cases had at least one positive household contact. In these contacts, grandparents (52.4%) were the most common co-prevalent cases, while 14.3% were uncles, 9.5% were parents and 9.5% were granduncles. Seven contacts (5.0%), including four siblings of child patients were newly diagnosed. Our data indicate that the prevalence is 11.58 per 10,000, which is 17 times higher than the registered rate. Conclusions/Significance This study suggests that the detection rate of leprosy among schoolchildren may have remained unchanged over the past thirty years. It also indicates that that active case finding is necessary for reaching the World Health Organization’s goals of zero detection among children, especially in endemic areas where the prevalence of leprosy is obscure. Moreover, we assert that all children must have their household contacts examined in order to identify the possible source of infection and interrupt the disease’s transmission. Novel strategies to reinforce contact tracing associated with large-scale strategies of chemo- and immune-prophylaxis should be expanded to prevent the perpetuation of the disease cycle. PMID:29481570

  11. Brain MRI volumetry in a single patient with mild traumatic brain injury.

    PubMed

    Ross, David E; Castelvecchi, Cody; Ochs, Alfred L

    2013-01-01

    This letter to the editor describes the case of a 42 year old man with mild traumatic brain injury and multiple neuropsychiatric symptoms which persisted for a few years after the injury. Initial CT scans and MRI scans of the brain showed no signs of atrophy. Brain volume was measured using NeuroQuant®, an FDA-approved, commercially available software method. Volumetric cross-sectional (one point in time) analysis also showed no atrophy. However, volumetric longitudinal (two points in time) analysis showed progressive atrophy in several brain regions. This case illustrated in a single patient the principle discovered in multiple previous group studies, namely that the longitudinal design is more powerful than the cross-sectional design for finding atrophy in patients with traumatic brain injury.

  12. Operational effectiveness and quality assurance mechanisms with stochastic demand of blood supply: blood bank case study.

    PubMed

    Smith, Alan D

    2011-01-01

    A general overview of various blood products operational effectiveness and related strategies that can be utilised by service providers (in particular, healthcare providers) is presented in the present study. In terms of the massive volumes of blood products, the North American blood centres collect more than eight million units of whole blood, which represents appropriately 50% of the US and Quebec, Canada?s volunteer donor blood supply. A case study of the quality inspection and inventory control concerns of the Central Blood Bank, located in the metropolitan area of Pittsburgh, PA, is presented. Initially, brief introduction to its general operating environment is followed by sections describing its general situation, quality-service initiatives, and followed by a fairly detailed discussion of the practical applications of lessons learned from the case study.

  13. Viruses and interstitial cystitis: adenovirus genomes cannot be demonstrated in urinary bladder biopsies.

    PubMed

    Hukkanen, V; Haarala, M; Nurmi, M; Klemi, P; Kiilholma, P

    1996-01-01

    Microbes may be involved in the pathogenesis of interstitial cystitis (IC). Adenoviruses and BK virus (BKV) can infect epithelial cells in urinary bladder and they are causative agents for hemorrhagic cystitis. We therefore studied the presence of adenovirus and BKV genomes in urinary bladder tissue specimens of patients with IC using polymerase chain reaction (PCR) and in situ hybridization (ISH). Controls were specimens from cases with transitional cell carcinoma of the bladder. Nucleic acids were extracted from paraffin sections of the bladder tissue for PCR. Primers detecting all adenovirus types were used. In situ hybridization was carried out for the paraffin sections using digoxigenin-labeled DNA probes for adenovirus and BKV. The adenovirus DNA PCR was able to detect one to two infected cells/specimen. All the seven IC cases studied and six controls were negative for adenovirus DNA by PCR and ISH. The ISH test for BKV genomes was also considered negative in IC cases and controls. The specimens which were negative in PCR tests yielded a signal with beta-globin primers, thus being amplifiable. We conclude that adenovirus and BKV do not play a major pathogenetic role in interstitial cystitis.

  14. Delivery after external cephalic version, is there an increased rate of cesarian section?

    PubMed

    Lago Leal, Victor; Pradillo Aramendi, Tamara; Nicolas Montero, Estefania; Ocaña Martínez, Vanesa; Del Barrio Fernández, Pablo; Martínez-Cortés, Luis

    2016-04-01

    The aim of this study was to compare the obstetric outcomes after successful external cephalic version (cases) with a group of pregnant women with a spontaneous cephalic fetal position at delivery (controls). Retrospective review of the cohort of study was performed at the University Hospital of Getafe (Madrid, Spain) between January 2012 and January 2013. 1516 patients (48 cases; 1468 controls). We compared the type of delivery in pregnant women after ECV performed successfully (cases) with spontaneous cephalic presentations (controls). Pregnancies with vaginal delivery contraindicated, elective cesarean section (CS) justified by maternal disease, multiple pregnancies, or pregnancies below 37 weeks were excluded. Maternal age, BMI, parity, gestational age at delivery, and onset of labor (spontaneous or induced) were controlled. Prevalence of CS and operative delivery in both groups. Women who underwent a successful ECV had a significantly higher CS rate compared with the women of the control group (12/48 [25%] vs. 202/1468 [13.76%]; P=0.028). There was no difference in the rate of operative delivery (6/48 [12.5%] vs. 177/1468 [12.05%] P=0.92). Deliveries following a successful ECV are associated with an increased CS rate compared with deliveries of fetuses with spontaneous cephalic presentations.

  15. An Epidemiologic Study of Pediatric Poisoning; a Six-month Cross-sectional Study.

    PubMed

    Manouchehrifar, Mohammad; Derakhshandeh, Niloufar; Shojaee, Majid; Sabzghabaei, Anita; Farnaghi, Fariba

    2016-01-01

    Intentional and unintentional poisoning are among the most common reasons for referrals to emergency department (ED). Therefore, the present study was designed to evaluate epidemiologic features and effective risk factors of intentional and unintentional poisoning in children. This prospective cross-sectional study was carried out in ED of Loghman Hakim Hospital, greatest referral poison center of Iran, Tehran during March to August 2014. Demographic data, medical history, history of psychiatric disease in child, the cause of poisoning, parents' educational level, household monthly income, location of residence, history of addiction or divorce in family, and the poisoning intentionality were gathered. Data were analyzed using SPSS 18 and appropriate statistical tests based on the purpose of study. 414 participants with the mean age of 4.2 ± 3.43 years were included (57.5% male). Children in the 0-4 year(s) age range had the most frequency with 281 (67.9%) cases. 29 (7%) cases were intentional (62% female, 76% in the 10-14 years old group). Methadone with 123 (29.7%) cases was the most frequent toxic agent in general and in unintentional cases. 10-14 years of age (p = 0.001), and the history of psychiatric disease in children (p <0.001), had a direct correlation with probability of intentional poisoning. While, history of addiction in the family showed an indirect correlation with this probability (p = 0.045). Based on the results of this study, most cases of poisoning in the children were unintentional methadone intoxication in boys in the 0-4 age range with a history of a psychiatric disease, and those who had a history of addiction in the family. In addition, the most powerful risk factor for the children's intentional poisoning was their history of psychiatric disease. The history of addiction in the child's family had indirect correlation with intentional intoxications.

  16. Primary prevention of lead poisoning in children: a cross-sectional study to evaluate state specific lead-based paint risk reduction laws in preventing lead poisoning in children.

    PubMed

    Kennedy, Chinaro; Lordo, Robert; Sucosky, Marissa Scalia; Boehm, Rona; Brown, Mary Jean

    2014-11-07

    Children younger than 72 months are most at risk of environmental exposure to lead from ingestion through normal mouthing behavior. Young children are more vulnerable to lead poisoning than adults because lead is absorbed more readily in a child's gastrointestinal tract. Our focus in this study was to determine the extent to which state mandated lead laws have helped decrease the number of new cases of elevated blood-lead levels (EBLL) in homes where an index case had been identified. A cross-sectional study was conducted to compare 682 residential addresses, identified between 2000 and 2009, in two states with and one state without laws to prevent childhood lead poisoning among children younger than 72 months, to determine whether the laws were effective in preventing subsequent cases of lead poisoning detected in residential addresses after the identification of an index case. In this study, childhood lead poisoning was defined as the blood lead level (BLL) that would have triggered an environmental investigation in the residence. The two states with lead laws, Massachusetts (MA) and Ohio (OH), had trigger levels of ≥25 μg/dL and ≥15 μg/dL respectively. In Mississippi (MS), the state without legislation, the trigger level was ≥15 μg/dL. The two states with lead laws, MA and OH, were 79% less likely than the one without legislation, MS, to have residential addresses with subsequent lead poisoning cases among children younger than 72 months, adjusted OR = 0.21, 95% CI (0.08-0.54). For the three states studied, the evidence suggests that lead laws such as those studied herein effectively reduced primary exposure to lead among young children living in residential addresses that may have had lead contaminants.

  17. What can be done when the cored specimen in a Frey procedure for chronic pancreatitis is reported as adenocarcinoma?

    PubMed

    Mahesh, S; Lekha, V; Manipadam, John Mathew; Venugopal, A; Ramesh, H

    2016-11-01

    The aim of this study is to analyze the outcomes of patients with chronic pancreatitis who underwent the Frey procedure and who had a histologic evidence of adenocarcinoma in the cored out specimen.The type of analysis is retrospective. Out of 523 patients who underwent Frey procedure for chronic pancreatitis, seven (five males and two females; age range 42 to 54 years) had histologically proven adenocarcinoma. In the first four cases, intraoperative frozen section was not done. The diagnosis was made on routine histopathology and only one out of four could undergo attempted curative therapy. In the remaining three cases, intraoperative frozen section confirmation was available, and curative resection performed. Only four out of seven had a clear-cut mass lesion: (a) cancer can occur in chronic pancreatitis in the absence of a mass lesion and (b) intraoperative frozen section of the cored specimen is crucial to exercising curative therapeutic options and must be performed routinely. If frozen section is reported as adenocarcinoma, a head resection with repeat frozen of the margins of resection is appropriate. If the adenocarcinoma is reported on regular histopathology after several days, then a total pancreatectomy may be more appropriate.

  18. [Eccrine Porocarcinoma: clinical-pathological study of 19 cases in the Instituto Nacional de Enfermedades Neoplásicas, Lima - Peru].

    PubMed

    Casavilca, Sandro; Lama, Anny; Guerrero, Melvy; Essary, Lydia R; Mantilla, Raúl; Cano, Luis; Barrionuevo, Carlos

    2013-07-01

    In order to describe the clinical-pathological characteristics of the cases of Eccrine Porocarcinoma (EP) found in the Instituto Nacional de Enfermedades Neoplásicas (INEN), a cross-sectional study was carried out, including all EP cases recorded between 1998 and 2009. A revision of the clinical-pathological records indentified and a new reading of the pathology slides of the cases found were performed. 19 EP cases were found, the median age of which was 64 years (range: 37-98). EP was primarily found on male patients (57.9%) and was most commonly located on the foot (21.1%), followed by the head, thorax and thigh (15.8%, respectively). In one case, EP was located on the gluteal region, and showed an unusually invasive behavior and rectal involvement. We conclude that EP is a rather uncommon entity in Peru. Its most common location is on the foot and it affects mostly male patients for the most part.

  19. A preliminary study of EAT and BITE scores for one school year in Bermuda: increased early anorexic measures related to socio-economic factors.

    PubMed

    Marlowe, Karl

    2005-03-01

    Bermuda is a unique heterogeneous ethnic population in which it is possible to study the interaction of ethnicity, culture, gender and economic factors that influence abnormal eating attitudes. A cross-sectional survey of 836 adolescents, one total school year in Bermuda. The BITE and EAT self-report questionnaires were administered in a classroom setting. The analysis was for caseness and for total scores. Caseness represents possible developing anorexic or bulimic eating disorder pathology for this non-adult population. 7.3% fulfilled EAT caseness, 0.24% fulfilled BITE caseness. There was no gender or ethnic difference for caseness. Multivariate analysis for EAT caseness found Odds Ratios of 2.89 (95% CI 1.37, 6.11) for Manual maternal job status. Despite the limitation of a questionnaire analysis, lower socioeconomic status increases the risk of possible eating disorder pathology in this adolescent population. Developing anorexic eating attitudes were more prevalent compared to bulimic attitudes for schoolchildren in this unique cultural setting.

  20. Do pneumonia readmissions flagged as potentially preventable by the 3M PPR software have more process of care problems? A cross-sectional observational study.

    PubMed

    Borzecki, Ann M; Chen, Qi; Restuccia, Joseph; Mull, Hillary J; Shwartz, Michael; Gupta, Kalpana; Hanchate, Amresh; Strymish, Judith; Rosen, Amy

    2015-12-01

    In the USA, administrative data-based readmission rates such as the Centers for Medicare and Medicaid Services' all-cause readmission measures are used for public reporting and hospital payment penalties. To improve this measure and identify better quality improvement targets, 3M developed the Potentially Preventable Readmissions (PPRs) measure. It matches clinically related index admission and readmission diagnoses that may indicate readmissions resulting from admission- or post-discharge-related quality problems. To examine whether PPR software-flagged pneumonia readmissions are associated with poorer quality of care. Using a retrospective observational study design and Veterans Health Administration (VA) data, we identified pneumonia discharges associated with 30-day readmissions, and then flagged cases as PPR-yes or PPR-no using the PPR software. To assess quality of care, we abstracted electronic medical records of 100 random readmissions using a tool containing explicit care processes organised into admission work-up, in-hospital evaluation/treatment, discharge readiness and post-discharge period. We derived quality scores, scaled to a maximum of 25 per section (maximum total score=100) and compared cases by total and section-specific mean scores using t tests and effect size (ES) to characterise the clinical significance of findings. Our abstraction sample was selected from 11,278 pneumonia readmissions (readmission rate=16.5%) during 1 October 2005-30 September 2010; 77% were flagged as PPR-yes. Contrary to expectations, total and section mean quality scores were slightly higher, although non-significantly, among PPR-yes (N=77) versus PPR-no (N=23) cases (respective total scores, 71.2±8.7 vs 65.8±11.5, p=0.14); differences demonstrated ES >0.30 overall and for admission work-up and post-discharge period sections. Among VA pneumonia readmissions, PPR categorisation did not produce the expected quality of care findings. Either PPR-yes cases are not more preventable, or preventability assessment requires other data collection methods to capture poorly documented processes (eg, direct observation). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Comparison of the gas-liquid dual support fixation and Heitzman fixation techniques for preparing lung specimens

    PubMed Central

    Yu, Dongsheng; Qu, Weili; Xia, Haipeng; Li, Xiaofeng; Luan, Zhenfeng; Yan, Renjie; Lu, Xiaodong; Zhao, Peng

    2017-01-01

    The aim of the present study was to compare the gas-liquid dual support fixation and Heitzman fixation techniques for the preparation of lung specimens. A total of 40 fresh lung samples were surgically collected from 40 male patients with lung cancer by biopsy. Patients were recruited from the Affiliated Hospital of Qingdao University Medical College (Qingdao, China) between July 2007 and June 2014. Samples were prepared using either the gas-liquid dual support fixation method (group A; n=26) or the Heitzman fixation method (group B; n=14). High-resolution computed tomography (HRCT) scanning was performed prior to surgery and corresponding postoperative HRCT scanning was conducted for the lung specimens; the gross transverse specimen section, cord photography images and histological sections were evaluated. Morphological observations of lung specimens indicated that there were 22 cases in group A with grade I (84.6%) and 4 cases with grade II (15.4%), whereas, in group B, there were 5 cases with grade II (35.7%) and 9 cases with grade III (64.3%). Statistical analysis demonstrated that the grades of specimens between the two groups were significantly different (P<0.01). Results from imaging and histological studies found that the quality of lung specimens was superior in group A, compared with group B. In conclusion, the present study demonstrated that, compared with the Heitzman fixation method, gas-liquid dual support fixation may be a superior technique for the preparation of lung specimens. This finding may facilitate the improvement of lung HRCT and pathological studies. PMID:28673006

  2. Comparison of the gas-liquid dual support fixation and Heitzman fixation techniques for preparing lung specimens.

    PubMed

    Yu, Dongsheng; Qu, Weili; Xia, Haipeng; Li, Xiaofeng; Luan, Zhenfeng; Yan, Renjie; Lu, Xiaodong; Zhao, Peng

    2017-07-01

    The aim of the present study was to compare the gas-liquid dual support fixation and Heitzman fixation techniques for the preparation of lung specimens. A total of 40 fresh lung samples were surgically collected from 40 male patients with lung cancer by biopsy. Patients were recruited from the Affiliated Hospital of Qingdao University Medical College (Qingdao, China) between July 2007 and June 2014. Samples were prepared using either the gas-liquid dual support fixation method (group A; n=26) or the Heitzman fixation method (group B; n=14). High-resolution computed tomography (HRCT) scanning was performed prior to surgery and corresponding postoperative HRCT scanning was conducted for the lung specimens; the gross transverse specimen section, cord photography images and histological sections were evaluated. Morphological observations of lung specimens indicated that there were 22 cases in group A with grade I (84.6%) and 4 cases with grade II (15.4%), whereas, in group B, there were 5 cases with grade II (35.7%) and 9 cases with grade III (64.3%). Statistical analysis demonstrated that the grades of specimens between the two groups were significantly different (P<0.01). Results from imaging and histological studies found that the quality of lung specimens was superior in group A, compared with group B. In conclusion, the present study demonstrated that, compared with the Heitzman fixation method, gas-liquid dual support fixation may be a superior technique for the preparation of lung specimens. This finding may facilitate the improvement of lung HRCT and pathological studies.

  3. A cross sectional study of maternal 'near-miss' cases in major public hospitals in Egypt, Lebanon, Palestine and Syria.

    PubMed

    Bashour, Hyam; Saad-Haddad, Ghada; DeJong, Jocelyn; Ramadan, Mohammed Cherine; Hassan, Sahar; Breebaart, Miral; Wick, Laura; Hassanein, Nevine; Kharouf, Mayada

    2015-11-13

    The maternal near-miss approach has been increasingly used as a tool to evaluate and improve the quality of care in maternal health. We report findings from the formative stage of a World Health Organization (WHO) funded implementation research study that was undertaken to collect primary data at the facility level on the prevalence, characteristics, and management of maternal near-miss cases in four major public referral hospitals - one each in Egypt, Lebanon, Palestine and Syria. We conducted a cross sectional study of maternal near-miss cases in the four contexts beginning in 2011, where we collected data on severe maternal morbidity in the four study hospitals, using the WHO form (Individual Form HRP A65661). In each hospital, a research team including trained hospital healthcare providers carried out the data collection. A total of 9,063 live birth deliveries were reported during the data collection period across the four settings, with a total of 77 cases of severe maternal outcomes (71 maternal near-miss cases and 6 maternal deaths). Higher indices for the maternal mortality index were found in both Al Galaa hospital, in Egypt (8.6%) and Dar Al Tawleed hospital in Syria (14.3%), being large referral hospitals, compared to Ramallah hospital in Palestine and Rafik Hariri University hospital in Lebanon. Compared to the WHO's Multicountry Survey using the same data collection tool, our study's mortality indices are higher than the index of 5.6% among countries with a moderate maternal mortality ratio in the WHO Survey. Overall, haemorrhage-related complications were the most frequent conditions among maternal near-miss cases across the four study hospitals. In all hospitals, coagulation dysfunctions (76.1%) were the most prevalent dysfunction among maternal near-miss cases, followed by cardiovascular dysfunctions. The coverage of key evidence-based interventions among women experiencing a near-miss was either universal or very high in the study hospitals. Findings from this formative stage confirmed the need for quality improvement interventions. The high reported coverage of the main clinical interventions in the study hospitals would appear to be in contradiction with the above findings as the level of coverage of key evidence-based interventions was high.

  4. [Pathogen identification of 10 suspected cases of sparganosis mansoni].

    PubMed

    Zeng, Qing-Ren; He, Mei; Wang, Fang; Zhang, Zu-Ping; Su, Zhan-San; Zhou, Jun; Liu, Bao-An; Lan, Zhi-Hua; Hu, Mian-Juan; Cai, Li-Ting

    2012-06-30

    To diagnose 10 cases of clinically suspected cases of sparganosis mansoni by pathogen identification. In the period from August 2009 to August 2011, 10 biopsy specimens were obtained from 10 patients of four hospitals to identify the pathogen. Among the 10 cases, 4 cases showed abdominal subcutaneous mass, 3 showed eyelid swelling, 1 displayed brain lesions, 1 showed pulmonary mass, and 1 showed pleural effusion. There was one parasite each from three patients with eyelid swelling, and one patient with abdominal subcutaneous mass, which were observed by naked eye and microscope morphologically and histologically. Specimens from other six cases were examined by microscope after paraffin embedding, sectioning, and HE staining. For further identification, the parasite biopsy tissue specimens were detected by immunohistochemistry with Sparganum mansoni-immunized rabbit serum as the primary antibody. Three intact worms, from three patients with eyelid swelling, showed typical S. mansoni morphological characteristics. One residue parasite from the abdominal subcutaneous mass showed network structures and full of calcareous corpuscles in the body under microscope same as that of S. mansoni. The histological structure in three of the six sections showed typically the body wall with folds, which was dense, thick and deeply eosine stained, part of the tegument outside was covered by micro-hairs. In the worm body there was net-like loose structure and calcareous corpuscles without cavity. The structure of the other three worm sections was atypical. The six worm sections were positive by immunohistochemical detection. The 10 clinically suspected cases are diagnosed as sparganosis mansoni.

  5. Insight and Figurative Language in Psychotherapy: Two Fragments of a Case Study.

    ERIC Educational Resources Information Center

    Barlow, Jack M.; And Others

    This study discusses the role figurative language can play in promoting insight in a patient undergoing psychotherapy. The first part of the study reviews some of the research into the nature of creative insight; the next section discusses some of the research relating to the value of metaphor in the treatment of schizophrenic patients. The major…

  6. Case studies of the access and mobility impact of freeway removal.

    DOT National Transportation Integrated Search

    2013-01-01

    Throughout the United States, there is a growing movement to remove selected sections of : freeways from city centers. Largely seen as a way to restore life and vitality to these areas, this : strategy has the potential for numerous benefits includin...

  7. Application of IHSDM: KY 30 case study : final report.

    DOT National Transportation Integrated Search

    2017-09-01

    A section of KY 30 in Jackson and Owsley Counties is targeted for redesign to provide a safer and more efficient corridor that will support economic activity in eastern Kentucky. Data for the existing KY 30 alignment and eight alternative alignments ...

  8. Prenatal assessment of ventriculomegaly: an anatomical study.

    PubMed

    Glonek, Michał; Kedzia, Alicja; Derkowski, Wojciech

    2003-07-01

    The aim of the study was to analyze the development of the lateral ventricles during the 1st and 2nd trimester of fetal life using computerized image processing, and to compare the findings with the results obtained by ultrasound imaging and MRI. The material consisted of 32 fetuses from spontaneous abortions, 54-235 mm crown-rump length. After detached craniotomy, the brains were cut into axial sections; the sections were filmed with a video camera and then analyzed using specialized software In 12 analyzed brains, no significant pathological changes were observed in the cerebral hemispheres, whereas the remaining 20 (63%) demonstrated visible pathology. In 10 cases there were areas of leukomalacia, in 5 intra- and periventricular hemorrhages, and in 2 fetuses ventriculomegaly with lateral ventricular triangles over 10 mm wide (in cases of active hydrocephalus and colpocephaly). In 1 case of an 18-week-old fetus, lateral ventricular morphology typical of hydrocephalus (generalized distension) was observed with ventricular triangles 8.5 mm wide. The other 2 fetuses demonstrated developmental defects. The frontal horns were the most markedly enlarged in both cases of hydrocephalus (100%) and were semicircular, whereas after intra- and periventricular hemorrhages they were less enlarged and triangular, with the base of the triangle directed to the front and frequent significant asymmetry. The shape of the ventricular system, including that of the frontal horns, is important in the diagnostics of fetal CNS.

  9. Anaesthetic management of severe hypertrophic obstructive cardiomyopathy with bronchial asthma for emergency caesarean section.

    PubMed

    Rajesh, M C; Varma, Ravi; Lima, P; Ramdas, E K

    2012-10-01

    A 39-year-old primi and a known case of hypertrophic obstructive cardiomyopathy presented for emergency lower segment caesarean section. She was also an asthmatic with a recent exacerbation. She underwent uneventful lower segment caesarean section under general anaesthesia with lumbar epidural analgesia for postoperative pain relief. Anaesthetic agents and techniques were selected to suit the haemodynamic profile of severe hypertrophic obstructive cardiomyopathy in pregnancy. The case has been reported because of successful outcome in an emergency scenario with such high intraventricular gradients and omissions in the case so that it will be of benefit to readers who may happen to land up in similar situations.

  10. Alcohol Intake and Risk of Thyroid Cancer: A Meta-Analysis of Observational Studies

    PubMed Central

    Hong, Seung-Hee; Myung, Seung-Kwon; Kim, Hyeon Suk

    2017-01-01

    Purpose The purpose of this study was to assess whether alcohol intake is associated with the risk of thyroid cancer by a meta-analysis of observational studies. Materials and Methods We searched PubMed and EMBASE in June of 2015 to locate eligible studies. We included observational studies such as cross-sectional studies, case-control studies, and cohort studies reporting odd ratios (ORs) or relative risk (RRs) with 95% confidence intervals (CIs). Results We included 33 observational studies with two cross-sectional studies, 20 case-controls studies, and 11 cohort studies, which involved a total of 7,725 thyroid cancer patients and 3,113,679 participants without thyroid cancer in the final analysis. In the fixed-effect model meta-analysis of all 33 studies, we found that alcohol intake was consistently associated with a decreased risk of thyroid cancer (OR or RR, 0.74; 95% CI, 0.67 to 0.83; I2=38.6%). In the subgroup meta-analysis by type of study, alcohol intake also decreased the risk of thyroid cancer in both case-control studies (OR, 0.77; 95% CI, 0.65 to 0.92; I2=29.5%; n=20) and cohort studies (RR, 0.70; 95% CI, 0.60 to 0.82; I2=0%; n=11). Moreover, subgroup meta-analyses by type of thyroid cancer, gender, amount of alcohol consumed, and methodological quality of study showed that alcohol intake was significantly associated with a decreased risk of thyroid cancer. Conclusion The current meta-analysis of observational studies found that, unlike most of other types of cancer, alcohol intake decreased the risk of thyroid cancer. PMID:27456949

  11. Calculation of the extinction cross section and lifetime of a gold nanoparticle using FDTD simulations

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

    Radhakrishnan, Archana, E-mail: anju.archana@gmail.com; Murugesan, Dr V., E-mail: murugesh@serc.iisc.in

    The electromagnetic theory of light explains the behavior of light in most of the domains quite accurately. The problem arises when the exact solution of the Maxwell's equation is not present, in case of objects with arbitrary geometry. To find the extinction cross-section and lifetime of the gold nanoparticle, the software FDTD solutions 8.6 by Lumerical is employed. The extinction cross-sections and lifetimes of Gold nanospheres of different sizes and arrangements are studied using pulse lengths of the order of femtoseconds. The decay constant and other properties are compared. Further, the lifetimes are calculated using frequency and time domain calculations.

  12. Criticality Calculations with MCNP6 - Practical Lectures

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

    Brown, Forrest B.; Rising, Michael Evan; Alwin, Jennifer Louise

    2016-11-29

    These slides are used to teach MCNP (Monte Carlo N-Particle) usage to nuclear criticality safety analysts. The following are the lecture topics: course information, introduction, MCNP basics, criticality calculations, advanced geometry, tallies, adjoint-weighted tallies and sensitivities, physics and nuclear data, parameter studies, NCS validation I, NCS validation II, NCS validation III, case study 1 - solution tanks, case study 2 - fuel vault, case study 3 - B&W core, case study 4 - simple TRIGA, case study 5 - fissile mat. vault, criticality accident alarm systems. After completion of this course, you should be able to: Develop an input modelmore » for MCNP; Describe how cross section data impact Monte Carlo and deterministic codes; Describe the importance of validation of computer codes and how it is accomplished; Describe the methodology supporting Monte Carlo codes and deterministic codes; Describe pitfalls of Monte Carlo calculations; Discuss the strengths and weaknesses of Monte Carlo and Discrete Ordinants codes; The diffusion theory model is not strictly valid for treating fissile systems in which neutron absorption, voids, and/or material boundaries are present. In the context of these limitations, identify a fissile system for which a diffusion theory solution would be adequate.« less

  13. New electron-energy transfer rates for vibrational excitation of O2

    NASA Astrophysics Data System (ADS)

    Jones, D. B.; Campbell, L.; Bottema, M. J.; Brunger, M. J.

    2003-09-01

    We report on our computation of electron-energy transfer rates for vibrational excitation of O2. This work was necessitated by inadequacies in the electron-impact cross section databases employed in previous studies and, in one case, an inaccurate approximate formulation to the rate equation. Both these inadequacies led to incorrect energy transfer rates being published in the literature. We also demonstrate the importance of using cross sections that encompass an energy range that is extended enough to appropriately describe the environment under investigation.

  14. A coupled-cluster study of photodetachment cross sections of closed-shell anions

    NASA Astrophysics Data System (ADS)

    Cukras, Janusz; Decleva, Piero; Coriani, Sonia

    2014-11-01

    We investigate the performance of Stieltjes Imaging applied to Lanczos pseudo-spectra generated at the coupled cluster singles and doubles, coupled cluster singles and approximate iterative doubles and coupled cluster singles levels of theory in modeling the photodetachment cross sections of the closed shell anions H-, Li-, Na-, F-, Cl-, and OH-. The accurate description of double excitations is found to play a much more important role than in the case of photoionization of neutral species.

  15. A coupled-cluster study of photodetachment cross sections of closed-shell anions.

    PubMed

    Cukras, Janusz; Decleva, Piero; Coriani, Sonia

    2014-11-07

    We investigate the performance of Stieltjes Imaging applied to Lanczos pseudo-spectra generated at the coupled cluster singles and doubles, coupled cluster singles and approximate iterative doubles and coupled cluster singles levels of theory in modeling the photodetachment cross sections of the closed shell anions H(-), Li(-), Na(-), F(-), Cl(-), and OH(-). The accurate description of double excitations is found to play a much more important role than in the case of photoionization of neutral species.

  16. Implementation of ASME Code, Section XI, Code Case N-770, on Alternative Examination Requirements for Class 1 Butt Welds Fabricated with Alloy 82/182

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

    Sullivan, Edmund J.; Anderson, Michael T.

    In May 2010, the NRC issued a proposed notice of rulemaking that includes a provision to add a new section to its rules to require licensees to implement ASME Code Case N-770, ‘‘Alternative Examination Requirements and Acceptance Standards for Class 1 PWR Piping and Vessel Nozzle Butt Welds Fabricated with UNS N06082 or UNS W86182 Weld Filler Material With or Without the Application of Listed Mitigation Activities, Section XI, Division 1,’’ with 15 conditions. Code Case N-770 contains baseline and inservice inspection (ISI) requirements for unmitigated butt welds fabricated with Alloy 82/182 material and preservice and ISI requirements for mitigatedmore » butt welds. The NRC stated that application of ASME Code Case N-770 is necessary because the inspections currently required by the ASME Code, Section XI, were not written to address stress corrosion cracking Alloy 82/182 butt welds, and the safety consequences of inadequate inspections can be significant. The NRC expects to issue the final rule incorporating this code case into its regulations in the spring 2011 time frame. This paper discusses the new examination requirements, the conditions that NRC is imposing , and the major concerns with implementation of the new Code Case.« less

  17. [New international networks in radiology graduate and continuing education: www.eurorad.org--a EAR Project for online publication of radiological data].

    PubMed

    Vorwerk, D

    2002-02-01

    Eurorad (www.eurorad.org) is a joint project of EAR and has support of 27 national and 8 subspeciality radiology societies. Eurorad is the first noncommercial radiological publication that is exclusively based on the internet as a communication line with all steps of submission, reviewing and publication being performed online. Eurorad wants to build up a huge and exhaustive case file of diagnostic and interventional radiology. Like all scientific publications, Eurorad bases on an editor in chief and 13 section editors who are responsible for organizing each section of Eurorad. Each section has a number of peer reviewer with an overall total of more than 100. For submission and publication, all cases are structured in the same manner with case report, method and discussion. For the time being, Eurorad hosts 779 cases, of whom 346 are free available on the net. The actual rejection rate is 4.5%, other cases are under review.

  18. Benefits of using intrathecal buprenorphine.

    PubMed

    Rabiee, Seyed Mozaffar; Alijanpour, Ebrahim; Jabbari, Ali; Rostami, Sara

    2014-01-01

    General anesthesia draws attention to the most commonly used modalities for post cesarean delivery pain relief in systemic administration of opioids, while the administration of small dose of intrathecal opioid during spinal anesthesia can be a possible alternative. The aim of this study was to evaluate the effects of buprenorphine on cesarean section prescribed intrathecally. This double blind randomized clinical trial study was conducted in patients for cesarean section under spinal anesthesia. The patients were randomly divided into case and control groups. Case group (208 patients) received 65-70 mg of 5% lidocaine plus 0.2 ml of buprenorphine while the same amount of 5% lidocaine diluted with 0.2 ml of normal saline was given to 234 cases in the control group. Hemodynamic changes and neonatal APGAR scores (Appearance, Pulse, Grimace, Activity, Respiration) were recorded. Pain score was recorded according to the visual analog scale. This study was registered in the Iranian Registry of clinical Trials; IRCT2013022112552N1. The mean age of case and control groups was 24.4±5.38 and 26.84±5.42 years, respectively. Systolic blood pressure was not significantly different until the 45th minute but diastolic blood pressure showed a significant difference at the 15th and the 60th minutes (P<0.001). Heart rate changes were significantly different between cases and controls at the initial 5th, 15th and after 60th minutes (P<0.001). Pain-free period was significantly different between two groups (1.25 h versus 18.73 h) (P<0.001). The results show that prescription of intratechal buprenorphine prolongs the duration of analgesia without any significant considerable side effects.

  19. Association between grip strength and diabetes prevalence in black, South-Asian, and white European ethnic groups: a cross-sectional analysis of 418 656 participants in the UK Biobank study.

    PubMed

    Ntuk, U E; Celis-Morales, C A; Mackay, D F; Sattar, N; Pell, J P; Gill, J M R

    2017-08-01

    To quantify the extent to which ethnic differences in muscular strength might account for the substantially higher prevalence of diabetes in black and South-Asian compared with white European adults. This cross-sectional study used baseline data from the UK Biobank study on 418 656 white European, black and South-Asian participants, aged 40-69 years, who had complete data on diabetes status and hand-grip strength. Associations between hand-grip strength and diabetes were assessed using logistic regression and were adjusted for potential confounding factors. Lower grip strength was associated with higher prevalence of diabetes, independent of confounding factors, across all ethnicities in both men and women. Diabetes prevalence was approximately three- to fourfold higher in South-Asian and two- to threefold higher in black participants compared with white European participants across all levels of grip strength, but grip strength in South-Asian men and women was ~ 5-6 kg lower than in the other ethnic groups. Thus, the attributable risk for diabetes associated with low grip strength was substantially higher in South-Asian participants (3.9 and 4.2 cases per 100 men and women, respectively) than in white participants (2.0 and 0.6 cases per 100 men and women, respectively). Attributable risk associated with low grip strength was also high in black men (4.3 cases) but not in black women (0.4 cases). Low strength is associated with a disproportionately large number of diabetes cases in South-Asian men and women and in black men. Trials are needed to determine whether interventions to improve strength in these groups could help reduce ethnic inequalities in diabetes prevalence. © 2017 Diabetes UK.

  20. Tea consumption may decrease the risk of osteoporosis: an updated meta-analysis of observational studies.

    PubMed

    Guo, Ming; Qu, Hua; Xu, Lin; Shi, Da-Zhuo

    2017-06-01

    Several epidemiological investigations have evaluated the correlation between tea consumption and risk of osteoporosis, but the results are inconsistent. Therefore, we conducted an updated meta-analysis of observational studies to assess this association. We searched for all relevant studies including cohort, cross-sectional, and case-control studies published from database inception to July 15, 2016, using MEDLINE EMBASE, and Cochrane Library. Polled odds ratios (ORs) were calculated using the random-effect model. Fourteen articles (16 studies) that examined 138523 patients were included in this meta-analysis. Seven studies concerning bone mineral density (BMD) showed an increase in BMD with tea consumption, including 4 cross-sectional studies (OR, 0.04, 95% confidence interval [CI], 0.01-0.08) and 3 cohort studies (OR, 0.01; 95% CI, 0.01-0.01). The remaining 9 studies concerning fracture, including 6 case-control studies and 3 cohort studies, showed no association between tea consumption and osteoporotic fracture (OR, 0.86; 95% CI, 0.74-1.01). This updated meta-analysis demonstrates that tea consumption could increase BMD, but the association with osteoporotic fracture requires further investigation. Together, the results highlight the need for future, high-quality-designed clinical trials on tea consumption and osteoporosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. A stitch in time saves nine? A repeated cross-sectional case study on the implementation of the intersectoral community approach Youth At a Healthy Weight.

    PubMed

    van der Kleij, Rianne M J J; Crone, Mathilde R; Paulussen, Theo G W M; van de Gaar, Vivan M; Reis, Ria

    2015-10-08

    The implementation of programs complex in design, such as the intersectoral community approach Youth At a Healthy Weight (JOGG), often deviates from their application as intended. There is limited knowledge of their implementation processes, making it difficult to formulate sound implementation strategies. For two years, we performed a repeated cross-sectional case study on the implementation of a JOGG fruit and water campaign targeting children age 0-12. Semi-structured observations, interviews, field notes and professionals' logs entries were used to evaluate implementation process. Data was analyzed via a framework approach; within-case and cross-case displays were formulated and key determinants identified. Principles from Qualitative Comparative Analysis (QCA) were used to identify causal configurations of determinants per sector and implementation phase. Implementation completeness differed, but was highest in the educational and health care sector, and higher for key than additional activities. Determinants and causal configurations of determinants were mostly sector- and implementation phase specific. High campaign ownership and possibilities for campaign adaptation were most frequently mentioned as facilitators. A lack of reinforcement strategies, low priority for campaign use and incompatibility of own goals with campaign goals were most often indicated as barriers. We advise multiple 'stitches in time'; tailoring implementation strategies to specific implementation phases and sectors using both the results from this study and a mutual adaptation strategy in which professionals are involved in the development of implementation strategies. The results of this study show that the implementation process of IACOs is complex and sustainable implementation is difficult to achieve. Moreover, this study reveals that the implementation process is influenced by predominantly sector and implementation phase specific (causal configurations of) determinants.

  2. Genotoxic Evaluation of Mexican Welders Occupationally Exposed to Welding-Fumes Using the Micronucleus Test on Exfoliated Oral Mucosa Cells: A Cross-Sectional, Case-Control Study.

    PubMed

    Jara-Ettinger, Ana Cecilia; López-Tavera, Juan Carlos; Zavala-Cerna, María Guadalupe; Torres-Bugarín, Olivia

    2015-01-01

    An estimated 800,000 people worldwide are occupationally exposed to welding-fumes. Previous studies show that the exposure to such fumes is associated with damage to genetic material and increased cancer risk. In this study, we evaluate the genotoxic effect of welding-fumes using the Micronucleus Test on oral mucosa cells of Mexican welders. We conducted a cross-sectional, matched case-control study of n = 66 (33 exposed welders, and 33 healthy controls). Buccal mucosa smears were collected and stained with acridine orange, observed under 100x optical amplification with a fluorescence lamp, and a single-blinded observer counted the number of micronuclei and other nuclear abnormalities per 2,000 observed cells. We compared the frequencies of micronuclei and other nuclear abnormalities, and fitted generalised linear models to investigate the interactions between nuclear abnormalities and the exposure to welding-fumes, while controlling for smoking and age. Binucleated cells and condensed-chromatin cells showed statistically significant differences between cases and controls. The frequency of micronuclei and the rest of nuclear abnormalities (lobed-nuclei, pyknosis, karyolysis, and karyorrhexis) did not differ significantly between the groups. After adjusting for smoking, the regression results showed that the occurrence of binucleated cells could be predicted by the exposure to welding-fumes plus the presence of tobacco consumption; for the condensed-chromatin cells, our model showed that the exposure to welding-fumes is the only reliable predictor. Our findings suggest that Mexican welders who are occupationally exposed to welding-fumes have increased counts of binucleated and condensed-chromatin cells. Nevertheless, the frequencies of micronuclei and the rest of nuclear abnormalities did not differ between cases and controls. Further studies should shed more light on this subject.

  3. Rising dynamics of a bubble confined in vertical cells with rectangular cross-sections

    NASA Astrophysics Data System (ADS)

    Murano, Mayuko; Okumura, Ko

    2017-11-01

    Recently, the drag friction acting on a fluid drop in confined space has been actively studied. Here, we investigate the rising velocity of a bubble in a vertical cell with a rectangular cross-section, both theoretically and experimentally, in which understanding of the drag force acting on the rising bubble is crucial. Although the drag force in such confined space could involve several regimes, we study a special case in which the bubble is long and the aspect-ratio of the rectangular cross-section of the cell is high. As a result, we found new scaling law for the rising velocity and the drag force, and confirmed the laws experimentally. Crossover to the rising dynamics in a Hele-Shaw cell will be also discussed.

  4. Effectiveness of Vascular Markers (Immunohistochemical Stains) in Soft Tissue Sarcomas.

    PubMed

    Naeem, Namra; Mushtaq, Sajid; Akhter, Noreen; Hussain, Mudassar; Hassan, Usman

    2018-05-01

    To ascertain the effectiveness of IHC markers of vascular origin like CD31, CD34, FLI1 and ERG in vascular soft tissue sarcomas including angiosarcomas, Kaposi sarcomas, epithelioid hemangioendothelioma and a non-vascular soft tissue sarcoma (Epithelioid sarcoma). Descriptive study. Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from 2011 to 2017. Diagnosed cases of angiosarcomas (n=48), epithelioid hemangioendothelioma (n=9), Kaposi sarcoma (n=9) and epithelioid sarcoma (n=20) were selected. Immunohistochemical staining as performed on formalin fixed paraffin embedded sections. The sections were stained for the following markers: CD34 (VENTANA clone Q Bend 10), CD31 (Leica clone 1 A 10), FLI1 (CELL MARQUE clone MRQ-1) and ERG (CELL MARQUE clone EP111). A complete panel of CD34, CD31 and ERG was applied on 8/48 cases of angiosarcomas with triple positivity in 6 cases. Eight cases showed positivity for only CD31 and ERG and 2 cases showed positivity for only ERG. A complete panel of CD34, CD31 and ERG was applied on 3/9 cases of epithelioid hemangioendothelioma with positivity for all markers in 2 cases. Combined positivity for ERG and CD34 was seen in 2 cases and on 4 cases only CD31 immunohistochemical was solely applied with 100% positivity. FLI1 was not applied on any case. Among 9 cases of Kaposi sarcoma, ERG, CD34 and CD31 in combination were applied on only 1 case with triple positivity. Remaining cases show positivity for either CD34, CD31 or FLI1. Majority of cases of epithelioid sarcomas were diagnosed on the basis of cytokeratin and CD34 positivity with loss of INI1. The other vascular markers showed negativity in all cases. Among these four markers, ERG immunohistochemical stain is highly effective for endothelial differentiation due to its specific nuclear staining pattern in normal blood vessel endothelial cells (internal control) as well as neoplastic cells of vascular tumors and lack of background staining.

  5. 26 CFR 1.1443-1 - Foreign tax-exempt organizations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... unrelated business taxable income. In the case of a foreign organization that is described in section 501(c... under section 512 and section 513 in computing the organization's unrelated business taxable income are... includible under section 512 and section 513 in computing the organization's unrelated business taxable...

  6. 5 CFR 1201.201 - Statement of purpose.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... statutory provisions covering attorney fee awards. Because most MSPB cases are appeals under 5 U.S.C. 7701... only to certain whistleblower appeals. Sections 1201.202(a)(5) and (a)(6) apply only to corrective and disciplinary action cases brought by the Special Counsel. Section 1201.202(a)(7) applies only to appeals...

  7. 20 CFR 422.205 - Review by Appeals Council.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Council unless the case is considered as provided under paragraph (e) of this section. (c) The denial of a... constitute the decision of the Appeals Council unless the case is considered as provided under paragraph (e) of this section. (e) On call of the Chairman, the Appeals Council may meet en banc or a...

  8. 20 CFR 422.205 - Review by Appeals Council.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Council unless the case is considered as provided under paragraph (e) of this section. (c) The denial of a... constitute the decision of the Appeals Council unless the case is considered as provided under paragraph (e) of this section. (e) On call of the Chairman, the Appeals Council may meet en banc or a...

  9. 20 CFR 422.205 - Review by Appeals Council.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Council unless the case is considered as provided under paragraph (e) of this section. (c) The denial of a... constitute the decision of the Appeals Council unless the case is considered as provided under paragraph (e) of this section. (e) On call of the Chairman, the Appeals Council may meet en banc or a...

  10. 14 CFR 1212.501 - Record systems determined to be exempt.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... exempted. (i) The Inspector General Investigations Case Files system of records is exempt from all sections... there may exist noncriminal investigative files within this system of records, the Inspector General Investigations Case Files system of records is exempt from the following sections of the Privacy Act (5 U.S.C...

  11. 40 CFR 268.5 - Procedures for case-by-case extensions to an effective date.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... construct or otherwise provide alternative treatment, recovery (e.g., recycling), or disposal capacity that... under this section, during the period for which such extension is in effect: (1) The storage... in effect, the surface impoundment, if newly subject to RCRA section 3005(j)(1) due to the...

  12. 40 CFR 268.5 - Procedures for case-by-case extensions to an effective date.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... construct or otherwise provide alternative treatment, recovery (e.g., recycling), or disposal capacity that... under this section, during the period for which such extension is in effect: (1) The storage... in effect, the surface impoundment, if newly subject to RCRA section 3005(j)(1) due to the...

  13. 40 CFR 268.5 - Procedures for case-by-case extensions to an effective date.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... construct or otherwise provide alternative treatment, recovery (e.g., recycling), or disposal capacity that... under this section, during the period for which such extension is in effect: (1) The storage... in effect, the surface impoundment, if newly subject to RCRA section 3005(j)(1) due to the...

  14. 26 CFR 1.367(a)-8 - Gain recognition agreement requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .... Paragraph (k) of this section provides exceptions for certain events that would otherwise require gain to be... certain cases where it is not appropriate for the gain recognition agreement to continue. See paragraph (k... paragraph (k)(14) of this section. In the case of a gain recognition agreement entered into pursuant to...

  15. 26 CFR 1.367(a)-8 - Gain recognition agreement requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    .... Paragraph (k) of this section provides exceptions for certain events that would otherwise require gain to be... certain cases where it is not appropriate for the gain recognition agreement to continue. See paragraph (k... paragraph (k)(14) of this section. In the case of a gain recognition agreement entered into pursuant to...

  16. Modeling the transmission dynamics and control of rabies in China.

    PubMed

    Ruan, Shigui

    2017-04-01

    Human rabies was first recorded in ancient China in about 556 BC and is still one of the major public-health problems in China. From 1950 to 2015, 130,494 human rabies cases were reported in Mainland China with an average of 1977 cases per year. It is estimated that 95% of these human rabies cases are due to dog bites. The purpose of this article is to provide a review about the models, results, and simulations that we have obtained recently on studying the transmission of rabies in China. We first construct a basic susceptible, exposed, infectious, and recovered (SEIR) type model for the spread of rabies virus among dogs and from dogs to humans and use the model to simulate the human rabies data in China from 1996 to 2010. Then we modify the basic model by including both domestic and stray dogs and apply the model to simulate the human rabies data from Guangdong Province, China. To study the seasonality of rabies, in Section 4 we further propose a SEIR model with periodic transmission rates and employ the model to simulate the monthly data of human rabies cases reported by the Chinese Ministry of Health from January 2004 to December 2010. To understand the spatial spread of rabies, in Section 5 we add diffusion to the dog population in the basic SEIR model to obtain a reaction-diffusion equation model and determine the minimum wave speed connecting the disease-free equilibrium to the endemic equilibrium. Finally, in order to investigate how the movement of dogs affects the geographically inter-provincial spread of rabies in Mainland China, in Section 6 we propose a multi-patch model to describe the transmission dynamics of rabies between dogs and humans and use the two-patch submodel to investigate the rabies virus clades lineages and to simulate the human rabies data from Guizhou and Guangxi, Hebei and Fujian, and Sichuan and Shaanxi, respectively. Some discussions are provided in Section 7. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Malignant pleural mesothelioma in Italy

    PubMed Central

    Bianchi, Claudio; Bianchi, Tommaso

    2009-01-01

    This study reviews a series of 811 malignant pleural mesothelioma cases, diagnosed at hospitals in Trieste and Monfalcone districts of north eastern Italy, a narrow coastal strip with a population of about three lakh, in the period 1968-2008. The diagnosis was based on histological examination in 801 cases, and cytological findings in 10. Necropsy was performed in 610 cases. Occupational histories were obtained directly from the patients or their relatives through personal or telephone interviews. Routine lung sections were examined for asbestos bodies in 500 cases. In 143 cases asbestos bodies were isolated and counted by chemical digestion of the lung tissue using the Smith-Naylor method. The series included 717 men and 94 women aged between 32 and 93 years (mean 69.2 years). Detailed occupational data was obtained for 732 cases. The majority of patients had marine jobs - shipbuilding (449 cases), maritime trades (56 cases), and port activities (39 cases). The nature of work of other patients included a variety of occupations, with non-shipbuilding industries being the most common. Thirty-four women cleaned the work clothes of family members occupationally exposed and hence had a history of asbestos exposure at home. Most of the patients had their first exposure to asbestos before 1960. The latency period ranged between 13 and 73 years (mean 48.2). Latency period among insulators and dock workers were shorter than other categories. Asbestos bodies were detected on routine lung sections in 343 cases (68.6%). Lung asbestos body burdens after isolation ranged between two to 10 millions bodies per gram of dried tissue. Despite some limitations in the use of asbestos in this area since the 1970s, the incidence of tumor remained high during the last years. PMID:20386624

  18. Malignant pleural mesothelioma in Italy.

    PubMed

    Bianchi, Claudio; Bianchi, Tommaso

    2009-08-01

    This study reviews a series of 811 malignant pleural mesothelioma cases, diagnosed at hospitals in Trieste and Monfalcone districts of north eastern Italy, a narrow coastal strip with a population of about three lakh, in the period 1968-2008. The diagnosis was based on histological examination in 801 cases, and cytological findings in 10. Necropsy was performed in 610 cases. Occupational histories were obtained directly from the patients or their relatives through personal or telephone interviews. Routine lung sections were examined for asbestos bodies in 500 cases. In 143 cases asbestos bodies were isolated and counted by chemical digestion of the lung tissue using the Smith-Naylor method. The series included 717 men and 94 women aged between 32 and 93 years (mean 69.2 years). Detailed occupational data was obtained for 732 cases.The majority of patients had marine jobs - shipbuilding (449 cases), maritime trades (56 cases), and port activities (39 cases). The nature of work of other patients included a variety of occupations, with non-shipbuilding industries being the most common. Thirty-four women cleaned the work clothes of family members occupationally exposed and hence had a history of asbestos exposure at home. Most of the patients had their first exposure to asbestos before 1960. The latency period ranged between 13 and 73 years (mean 48.2). Latency period among insulators and dock workers were shorter than other categories. Asbestos bodies were detected on routine lung sections in 343 cases (68.6%). Lung asbestos body burdens after isolation ranged between two to 10 millions bodies per gram of dried tissue. Despite some limitations in the use of asbestos in this area since the 1970s, the incidence of tumor remained high during the last years.

  19. Detection of microinvasion in vulvar and cervical intraepithelial neoplasia using double immunostaining for cytokeratin and basement membrane components.

    PubMed

    Rush, Demaretta; Hyjek, Elizabeth; Baergen, Rebecca N; Ellenson, Lora H; Pirog, Edyta C

    2005-06-01

    Identification of early invasion in vulvar intraepithelial neoplasia 3 (VIN 3) and cervical intraepithelial neoplasia 3 (CIN 3) may be difficult with the use of routine hematoxylin-eosin staining. Presence of obscuring inflammation and tangential tissue sectioning are the most common diagnostic pitfalls. To examine the utility of double immunostaining for cytokeratin-collagen IV or cytokeratin-laminin in the detection of early invasion in VIN 3 and CIN 3. The study group consisted of 10 cases of "VIN 3, suspicious for invasion" and 10 cases of "CIN 3, suspicious for invasion." The negative control group consisted of VIN 3 (n = 15) and CIN 3 (n = 10). The positive control group consisted of cases of invasive vulvar carcinoma (n = 11) and invasive cervical carcinoma (n = 25). All cases were double immunostained for cytokeratin and collagen IV and, in a separate reaction, for cytokeratin and laminin. The continuity of the basement membrane and the presence of stromal invasion were assessed in the stained sections. The staining for collagen IV and laminin yielded identical results. A well-defined, continuous basement membrane was visualized in all cases of VIN 3 and CIN 3. A discontinuous or absent basement membrane was observed around the malignant cells on the invasive tumor front in all cases of vulvar and cervical carcinoma. In 2 of 10 cases of VIN 3, suspicious for invasion and in 4 of 10 cases of CIN 3, suspicious for invasion definitive foci of microinvasion were identified with the use of double immunostaining. A well-defined, continuous basement membrane was present in the remaining cases "suspicious for invasion." Double immunostaining for cytokeratin- collagen IV or cytokeratin-laminin is useful for evaluation of early invasion in equivocal cases of VIN 3 and CIN 3.

  20. Severe maternal morbidity due to respiratory disease and impact of 2009 H1N1 influenza A pandemic in Brazil: results from a national multicenter cross-sectional study.

    PubMed

    Pfitscher, L C; Cecatti, J G; Pacagnella, R C; Haddad, S M; Parpinelli, M A; Souza, J P; Quintana, S M; Surita, F G; Sousa, M H; Costa, M L

    2016-05-21

    The aim of this study was to assess the burden of respiratory disease, considering the influenza A pandemic season (H1N1pdm09), within the Brazilian Network for Surveillance of Severe Maternal Morbidity, and factors associated with worse maternal outcome. A multicenter cross-sectional study, involving 27 referral maternity hospitals in five Brazilian regions. Cases were identified in a prospective surveillance by using the WHO standardized criteria for potentially life-threatening conditions (PLTC) and maternal near miss (MNM). Women with severe complications from respiratory disease identified as suspected or confirmed cases of H1N1 influenza or respiratory failure were compared to those with other causes of severe morbidity. A review of suspected H1N1 influenza cases classified women as non-tested, tested positive and tested negative, comparing their outcomes. Factors associated with severe maternal outcome (SMO = MNM + MD) were assessed in both groups, in comparison to PLTC, using PR and 95 % CI adjusted for design effect of cluster sampling. Among 9555 cases of severe maternal morbidity, 485 (5 %) had respiratory disease. Respiratory disease occurred in one-quarter of MNM cases and two-thirds of MD. H1N1 virus was suspected in 206 cases with respiratory illness. Around 60 % of these women were tested, yielding 49 confirmed cases. Confirmed H1N1 influenza cases had worse adverse outcomes (MNM:MD ratio < 1 (0.9:1), compared to 12:1 in cases due to other causes), and a mortality index > 50 %, in comparison to 7.4 % in other causes of severe maternal morbidity. Delay in medical care was associated with SMO in all cases considered, with a two-fold increased risk among respiratory disease patients. Perinatal outcome was worse in cases complicated by respiratory disease, with increased prematurity, stillbirth, low birth weight and Apgar score < 7. Respiratory disease, especially considering the influenza season, is a very severe cause of maternal near miss and death. Increased awareness about this condition, preventive vaccination during pregnancy, early diagnosis and treatment are required to improve maternal health.

  1. Study on modification of the Misgav Ladach method for cesarean section.

    PubMed

    Li, M; Zou, L; Zhu, J

    2001-01-01

    172 cases of pregnant women scheduled for delivery by cesarean section were randomly assigned to 59 cases in modification group with modified Misgav Ladach technique, 57 cases in Misgav Ladach group with Misgav Ladach technique and 56 cases in Pfannenstiel group with Pfannenstiel technique from May to Dec. 1999. The modified points included: transversely incising the fascia 2 to 3 cm, then dividing it bluntly; without opening and dissociating the visceral peritoneum; two layers suturing of low transverse uterine incision; closing the skin by continuous suturing. Results showed the average delivery time in the modification group was (3.6 +/- 2.6) min and (5.7 +/- 2.9) min in the Misgav Ladach group (P < 0.05). Median operating time was (28.3 +/- 5.4) min in modification group compared with (27.5 +/- 6.5) min in the Misgav Ladach group (P > 0.05). Average blood loss was (128 +/- 35) ml in modification group compared with (212 +/- 147) ml in the Pfannenstiel group (P < 0.05). It was concluded that the modified Misgav Ladach technique not only preserved all advantages of Misgav Ladach method, but also had additional advantages, such as faster in delivering the fetus, less damage, easier mastering for obstetricians.

  2. Hydroxychloroquine-induced hyperpigmentation in systemic diseases: prevalence, clinical features and risk factors: a cross-sectional study of 41 cases.

    PubMed

    Bahloul, E; Jallouli, M; Garbaa, S; Marzouk, S; Masmoudi, A; Turki, H; Bahloul, Z

    2017-10-01

    Introduction Hydroxychloroquine is an antimalarial agent widely prescribed in internal medicine, rheumatology and dermatology. Its use can be complicated by various side effects including skin pigmentation. Objectives The aim of the study is to review epidemiological, clinical features and risk factors of hydroxychloroquine-induced pigmentation. Materials and methods We performed a cross-sectional study conducted over a period of 5 months. During this period, patients who had been treated with hydroxychloroquine for over 6 months, in the internal medicine department, underwent a complete dermatological examination. All patients completed a structured questionnaire to collect demographic data, dosage and treatment duration of hydroxychloroquine, other drug intake, hydroxychloroquine indication, and presence of pigmentary changes on the skin, nail, hair, and mucosa. Results A total of 41 patients (38 women and 3 men) were included in the study. The mean age was 39.2 ± 15.4 years. The hydroxychloroquine was indicated for systemic lupus erythematosus in 73.2%, dermatomyositis in 12.2%, rheumatoid arthritis in 9.8%, actinic lichen and sarcoidosis each in 2.4%. Cutaneous pigmented lesions were found in 21 cases (51%), mucous pigmentation in 5 cases (12%) and nail pigmentation in 1 case (2.5%). In 12 of 41 (29%) of the hydroxychloroquine users, we conclude a hydroxychloroquine-induced pigmentation. There were 11 women and one man with a mean age of 43 years and all of them were systemic lupus erythematosus patients. Pigmented lesions were located on the lower limbs in seven cases, the face in two cases, lips in two cases and the gum in two cases. Pigmentation appeared after a median duration of hydroxychloroquine treatment of 32 months with a median cumulative dose of 361 g. Overall, two patients reported that the appearance of pigmented lesions was preceded by the occurrence of ecchymotic areas following microtrauma. Significant association was found between hydroxychloroquine-induced pigmentation and treatment with oral anticoagulants and/or antiplatelet agents ( p = 0.03). Conclusion Our systematic examination of patients demonstrated that hydroxychloroquine-induced pigmentation is not rare. The imputability of hydroxychloroquine in the genesis of this discoloration is difficult to establish. Our study supports the hypothesis that ecchymosis, platelet antiaggregants and oral anticoagulants may be the main predisposing factors to hydroxychloroquine-induced pigmentation.

  3. Fusion cross sections measurements with MUSIC

    NASA Astrophysics Data System (ADS)

    Carnelli, P. F. F.; Fernández Niello, J. O.; Almaraz-Calderon, S.; Rehm, K. E.; Albers, M.; Digiovine, B.; Esbensen, H.; Henderson, D.; Jiang, C. L.; Nusair, O.; Palchan-Hazan, T.; Pardo, R. C.; Ugalde, C.; Paul, M.; Alcorta, M.; Bertone, P. F.; Lai, J.; Marley, S. T.

    2014-09-01

    The interaction between exotic nuclei plays an important role for understanding the reaction mechanism of the fusion processes as well as for the energy production in stars. With the advent of radioactive beams new frontiers for fusion reaction studies have become accessible. We have performed the first measurements of the total fusion cross sections in the systems 10 , 14 , 15C + 12C using a newly developed active target-detector system (MUSIC). Comparison of the obtained cross sections with theoretical predictions show a good agreement in the energy region accessible with existing radioactive beams. This type of comparison allows us to calibrate the calculations for cases that cannot be studied in the laboratory with the current experimental capabilities. The high efficiency of this active detector system will allow future measurements with even more neutron-rich isotopes. The interaction between exotic nuclei plays an important role for understanding the reaction mechanism of the fusion processes as well as for the energy production in stars. With the advent of radioactive beams new frontiers for fusion reaction studies have become accessible. We have performed the first measurements of the total fusion cross sections in the systems 10 , 14 , 15C + 12C using a newly developed active target-detector system (MUSIC). Comparison of the obtained cross sections with theoretical predictions show a good agreement in the energy region accessible with existing radioactive beams. This type of comparison allows us to calibrate the calculations for cases that cannot be studied in the laboratory with the current experimental capabilities. The high efficiency of this active detector system will allow future measurements with even more neutron-rich isotopes. This work is supported by the U.S. DOE Office of Nuclear Physics under Contract No. DE-AC02-06CH11357 and the Universidad Nacional de San Martin, Argentina, Grant SJ10/39.

  4. Two gimbal bearing case studies: Some lessons learned

    NASA Technical Reports Server (NTRS)

    Loewenthal, Stuart H.

    1988-01-01

    Two troublesome, torque related problems associated with gimbal actuators are discussed. Large, thin section angular contact bearings can have a surprisingly high torque sensitivity to radial thermal gradients. A predictive thermal-mechanical bearing analysis, as described, was helpful in establishing a safe temperature operating envelope. In the second example, end-of-travel torque limits of an oscillatory gimbal bearing appoached motor stall during limit cycling life tests. Bearing modifications required to restore acceptable torque performance are described. The lessons learned from these case studies should benefit designers of precision gimbals where singular bearing torque related problems are not uncommon.

  5. The Use of Computer Simulation Gaming in Teaching Broadcast Economics.

    ERIC Educational Resources Information Center

    Mancuso, Louis C.

    The purpose of this study was to develop a broadcast economic computer simulation and to ascertain how a lecture-computer simulation game compared as a teaching method with a more traditional lecture and case study instructional methods. In each of three sections of a broadcast economics course, a different teaching methodology was employed: (1)…

  6. A Psycholinguistic Description of the Development of Writing in Selected First Grade Students.

    ERIC Educational Resources Information Center

    Milz, Vera E.

    A study was conducted to examine writing development in first grade children. The writings from an entire classroom were collected. From these, six children's writings were chosen for cross-sectional analysis. Two children from this group were then selected for further in-depth case studies. Interviews, parent surveys, and observations were used…

  7. Moving a Mountain: Transforming the Role of Contingent Faculty in Composition Studies and Higher Education.

    ERIC Educational Resources Information Center

    Schell, Eileen E., Ed.; Stock, Patricia Lambert, Ed.

    This book addresses the counterproductive conditions in which part-time and non-tenure-track composition faculty must teach, using case studies, local narratives, and models for ethical employment practices. It presents and evaluates a range of proactive strategies for change, both for local conditions and broader considerations. Section 1,…

  8. A Transfer Subject: Tracing Boundary-Work and Micro-Transfer in First-Year Composition

    ERIC Educational Resources Information Center

    Medina, Dylan London

    2017-01-01

    This dissertation draws on data from a quarter-long case study implementing a number of social science and humanities research methods. This study was conducted at the University of Washington in two sections of First-Year Composition and investigates the boundary-marking interactions that occur in a writing class by tracing the experiences of…

  9. Incorporating Active Learning with Videos: A Case Study from Physics

    ERIC Educational Resources Information Center

    Lee, Kester J.; Sharma, Manjula D.

    2008-01-01

    Watching a video often results in passive learning and does not actively engage students. In this study, a class of 20 HSC Physics students were introduced to a teaching model that incorporated active learning principles with the watching of a video that explored the Meissner Effect and superconductors. Students would watch short sections of the…

  10. Interplay of School Welfare Provision and Teacher Performance: The Case of Ugandan Secondary Schools

    ERIC Educational Resources Information Center

    Naluwemba, Frances; Sekiwu, Denis; Okwenje, Vicent

    2016-01-01

    This is an account of a cross-sectional study of how school welfare provision influences teacher performance in six government aided secondary schools in Uganda. The study was largely a mixed method involving semi-structured questionnaires and interviews with a convenience sample of 221 participants in the categories of teachers, head teachers,…

  11. Case Studies of UMTA Private Sector Initiative Projects in Syracuse, Central New Jersey, and Atlanta

    DOT National Transportation Integrated Search

    1987-12-01

    This report documents the results of three grants awarded in 1983 by the Urban Mass Transportation Administration for Section 8 Private Sector Initiative projects. The grants were intended to encourage cooperative public and private planning for the ...

  12. 28 CFR 90.65 - Evaluation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Evaluation. 90.65 Section 90.65 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) VIOLENCE AGAINST WOMEN Arrest Policies in Domestic Violence Cases § 90.65 Evaluation. (a) The National Institute of Justice will conduct evaluations and studies of...

  13. Developing a regional approach to transportation demand management and nonmotorized transportation : best practice case studies

    DOT National Transportation Integrated Search

    1995-01-01

    This report is being forwarded to Congress pursuant to Section 6054 (c) of the Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA). The first Implementation Report, transmitted to Congress in June 1994, described the achievements of DOT ...

  14. Food Sensitivities: Education and Intervention Strategies for the Counselor.

    ERIC Educational Resources Information Center

    Lawson, David M.

    1987-01-01

    Discusses the etiology of food sensitivities and their relationship to the counseling profession and presents practical counseling strategies for intervention and remediation. Includes sections on the client predicament, stimulatory and withdrawal symptoms, identifying food addiction, psychosocial factors, a case study, and a conclusion.…

  15. 28 CFR 90.65 - Evaluation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Evaluation. 90.65 Section 90.65 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) VIOLENCE AGAINST WOMEN Arrest Policies in Domestic Violence Cases § 90.65 Evaluation. (a) The National Institute of Justice will conduct evaluations and studies of...

  16. Forensic case profiling aspects on multiple homicides from the Cologne-Bonn metropolitan area 1985-2000.

    PubMed

    Schmidt, Peter H; Padosch, Stephan A; Rothschild, Markus A; Madea, Burkhard

    2005-10-29

    The medicolegal and subsequent criminologic interpretation of forensic and pathological findings in cases of homicide makes up an important tool of case profiling. In a retrospective study of 26 cases of "multiple homicides" involving 31 perpetrators (30 males, 1 female, mean age 33.5 years) and 73 victims (33 males, 40 females, mean age 36 years, 68 fatalities, 5 survivors), autopsy reports and prosecution authorities' files were investigated with regard to individual characteristics of victims and offenders, circumstances as well as mode of commitment. The major aim of this study was to comprehensively elucidate and characterise relevant forensic and criminologic features, which may gain importance for forensic case profiling. Forty-six victims were found in the close social environment of the perpetrator and 45 homicides were committed either in the victim's, the perpetrator's or the shared domicile. The main motives included concealment of a crime (n=13), personal conflicts/domestic arguments (n=7) and greed (n=12). The relevant injuries with regard to the cause of death were attributable to sharp force (n=13), blunt force (n=7), gunshot wounds (n=24), ligature strangulation (n=3), smothering (n=5), fire/carbon monoxide (n=4) and combined impacts (n=11). In 15 cases, so called defence injuries were found. In 5 victims a post-mortem blood alcohol concentration >1.5 g/l was determined. In six perpetrators, a severe psychiatric impairment of juridical responsibility was ascertained (Section 20 German criminal code, n=2, psychosis; Section 21 German criminal code, n=4, acute alcohol intoxication). As far as conviction data were available, 27 crimes were juridically assessed as murder, 12 as manslaughter and one as bodily harm with fatal consequences.

  17. Validation of a TFE3 break-apart FISH assay for Xp11.2 translocation renal cell carcinomas.

    PubMed

    Mosquera, Juan-Miguel; Dal Cin, Paola; Mertz, Kirsten D; Perner, Sven; Davis, Ian J; Fisher, David E; Rubin, Mark A; Hirsch, Michelle S

    2011-09-01

    Renal cell carcinomas (RCCs) with an Xp11.2 translocation predominantly affect young patients, and can present at an advanced stage. However, more cases in older patients and incidentally detected cancers at earlier stages are also being identified. As the histology of Xp11.2 RCCs overlaps with clear cell and papillary RCCs, it is not infrequent that Xp11.2 RCCs are overlooked and misdiagnosed. The objective of this study was to validate the use of fluorescence in-situ hybridization (FISH) for identifying Xp11.2 RCCs. One hundred fifty-eight consecutive, unselected renal tumors were evaluated in tissue microarrays, including 109 clear cell RCCs, 20 papillary RCCs, 3 RCCs with mixed papillary and clear cell features, 1 Xp11.2 translocation RCC, 8 chromophobe RCCs, 10 oncocytomas, and 7 angiomyolipomas. FISH evaluation was performed blinded to karyotype data, available in about two-thirds of cases. Furthermore, conventional sections of 4 Xp11.2 RCCs, 4 RCCs with mixed papillary and clear cell features, and 4 cases of alveolar soft part sarcoma (the latter for control purposes) were also assessed by FISH. Break-apart signals were homogeneously identified throughout tumor cells in 2 cases from the tissue microarrays including 1 known Xp11.2 RCC and 1 misdiagnosed Xp11.2 RCC. All conventional sections from the Xp11.2 RCC and alveolar soft part sarcoma cases were positive for the TFE3 rearrangement by FISH. All remaining cases were negative. Our study shows the clinical application of FISH in formalin-fixed, paraffin-embedded tissue for detection of Xp11.2 translocation RCCs and other tumors with this genetic aberration.

  18. Case mix adjusted variation in cesarean section rate in Sweden.

    PubMed

    Mesterton, Johan; Ladfors, Lars; Ekenberg Abreu, Anna; Lindgren, Peter; Saltvedt, Sissel; Weichselbraun, Marianne; Amer-Wåhlin, Isis

    2017-05-01

    Cesarean section (CS) rate is a well-established indicator of performance in maternity care and is also related to resource use. Case mix adjustment of CS rates when performing comparisons between hospitals is important. The objective of this study was to estimate case mix adjusted variation in CS rate between hospitals in Sweden. In total, 139 756 deliveries in 2011 and 2012 were identified in administrative systems in seven regions covering 67% of all deliveries in Sweden. Data were linked to the Medical birth register and population data. Twenty-three different sociodemographic and clinical characteristics were used for adjustment. Analyses were performed for the entire study population as well as for two subgroups. Logistic regression was used to analyze differences between hospitals. The overall CS rate was 16.9% (hospital minimum-maximum 12.1-22.6%). Significant variations in CS rate between hospitals were observed after case mix adjustment: hospital odds ratios for CS varied from 0.62 (95% CI 0.53-0.73) to 1.45 (95% CI 1.37-1.52). In nulliparous, cephalic, full-term, singletons the overall CS rate was 14.3% (hospital minimum-maximum: 9.0-19.0%), whereas it was 4.7% for multiparous, cephalic, full-term, singletons with no previous CS (hospital minimum-maximum: 3.2-6.7%). In both subgroups significant variations were observed in case mix adjusted CS rates. Significant differences in CS rate between Swedish hospitals were found after adjusting for differences in case mix. This indicates a potential for fewer interventions and lower resource use in Swedish childbirth care. Best practice sharing and continuous monitoring are important tools for improving childbirth care. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  19. Acromegaly and aging: a comparative cross-sectional study.

    PubMed

    Hatipoglu, Esra; Yuruyen, Mehmet; Keskin, Ela; Yavuzer, Hakan; Niyazoglu, Mutlu; Doventas, Alper; Erdincler, Deniz Suna; Beger, Tanju; Kadioglu, Pinar; Gundogdu, Sadi

    2015-02-01

    Cognitive and functional geriatric assessment may change in acromegaly. Herein we aimed to determine at which points geriatric assessment of the cases with acromegaly differs from that of general elderly population. In this comparative cross-sectional study, a total of 30 cases with acromegaly (controlled n = 14, uncontrolled n = 16) and 30 gender and body-mass index-matched cases without acromegaly (control group, CG) above 60 years old were included. Cognitive functions were evaluated on the basis of the mini-mental state exam (MMSE). Affective status was determined using the geriatric depression scale. Activities of daily living (ADL) were ranked according to the Barthel index while instrumental activities of daily living (IADL) were graded on the basis of the Lawton scale. Nutritional status was evaluated using the mini-nutritional assessment (MNA). Body composition was measured through bioimpedance analysis. Functional mobility was determined using the Timed Up and Go test (TUG) and muscle strength with the handgrip strength test. Scores on the MMSE were significantly lower in the elderly cases with acromegaly than in the cases without acromegaly (p < 0.001). Dementia was more frequent in the acromegaly group than in the CG (p = 0.04). Total MNA scores were significantly lower in cases with acromegaly than in the CG (p = 0.006). More subjects in the acromegaly group (33%) were at greater risk of malnutrition than in the CG (3%) (p = 0.003). There was greater moderate functional impairment based on Barthel ADL in the acromegaly group than in the CG (p = 0.04). Acromegaly may impair cognitive functions, functional mobility and instrumental daily living activities in the geriatric population. With acromegaly, the risk of malnutrition may also increase. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Aggressive Rare T-cell Lymphomas with Manifestation in the Skin: A Monocentric Cross-sectional Case Study.

    PubMed

    Brüggen, Marie-Charlotte; Kerl, Katrin; Haralambieva, Eugenia; Schanz, Urs; Chang, Yun-Tsan; Ignatova, Desislava; Dummer, Reinhard; Cozzio, Antonio; Hoetzenecker, Wolfram; French, Lars E; Guenova, Emmanuella

    2018-04-24

    Rare T- or NK-cell lymphomas with cutaneous manifestation may display a highly aggressive clinical course and major diagnostic/therapeutic challenges. This report describes our experiences with different lymphomas of this rare category and the therapeutic options used. This retrospective, descriptive, monocentric, cross-sectional case study, identified 4 rare aggressive T-/NK-cell lymphomas with manifestation in the skin, which were diagnosed in a tertiary care centre over a period of 4 years. Two patients had an Epstein-Barr virus-associated extranodal NK/T-cell lymphoma and 2 patients had a primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma. Concomitant extracutaneous involvement was observed in 2 of all 4 patients. Two patients had fulminant disease progression and resistance to chemotherapy. Two patients underwent allogeneic haematopoietic stem cell transplantation, which resulted in one complete remission and one partial remission. This report emphasizes the importance of an early diagnostic work-up and a prompt aggressive therapeutic approach.

  1. Medical Students' Stress, Psychological Morbidity, and Coping Strategies: a Cross-Sectional Study from Pakistan.

    PubMed

    Imran, Nazish; Tariq, Khaula Fatima; Pervez, Muhammad Ijaz; Jawaid, Masood; Haider, Imran Ijaz

    2016-02-01

    The authors studied the prevalence of psychological morbidity, sources and severity of stresses, as well as coping strategies in Pakistani medical students. Medical students in Lahore, Pakistan, completed a cross-sectional, self-administered questionnaire in 2013 on the sources and severity of various stressors. The General Health Questionnaire-12 (GHQ-12) and Brief COPE assessed the psychological morbidity and coping strategies. Out of 1500 students, 527 responded to the survey. The prevalence of psychological morbidity was 23.3%; 52.3% respondents showed evidence of distress. By logistic regression analysis, GHQ-12 caseness was associated with being male and occurrence of health-related stressors. The most common stressors were related to academic concerns. Coping strategies showed variation by GHQ-caseness. The significant psychological morbidity and distress warrants establishing support systems to support students and bringing about evidence-based changes to teaching and evaluation systems. Adequate counseling facilities should be made available and students encouraged to seek help.

  2. Safety of long-term clozapine administration. Frequency of cardiomyopathy and hyponatraemia: two cross-sectional, naturalistic studies.

    PubMed

    Serrano, Ana; Rangel, Nairy; Carrizo, Edgardo; Uzcátegui, Euderruh; Sandia, Ignacio; Zabala, Angélica; Fernández, Erika; Tálamo, Eduardo; Servigna, Mercedes; Prieto, Dexi; Connell, Lisette; Baptista, Trino

    2014-02-01

    The antipsychotic drug (APD) clozapine (CLZ) is under-prescribed because of concerns about its safety. We evaluated in separate protocols the frequency of cardiomyopathy and hyponatraemia, which are adverse drug effects, where few comparative studies are available. Cross-sectional studies in subjects treated for at least 3 consecutive months with the same drug were conducted. Cardiomyopathy: Patients undergoing treatment either with CLZ (n = 125) or with other typical or atypical APDs (n = 59) were examined by a cardiologist who also recorded echocardiograms and electrocardiograms in order to diagnose cardiomyopathy. Hyponatraemia: Fasting sodium levels were assessed in patients receiving any of the following treatments: CLZ (n = 88), other atypical APDs (n = 61), typical APDs (n = 23), typical + atypical APDs (n = 11), and other drugs/drug-free (n = 36). Cardiomyopathy: No case of cardiomyopathy was detected. The frequency of abnormal ventricular ejection fraction (< 55%) was similar in both treatment groups (p = 1). Hyponatraemia: The frequency of hyponatraemia (percentage; 95% CI) was: CLZ (3.4%; -0.7, 7.1); other atypical APDs (4.9%; -0.5, 10.3); typical APDs (26.1%; 8.2, 44.0); typical + atypical APDs (9.1%; -7.8, 26.0); other drugs/drug-free (0%). None of the CLZ hyponatraemia subjects were on monotherapy. Our results are at odds with previous studies of CLZ-associated cardiomyopathy. However, they must be compared to further cross-sectional or prospective studies because most published data come from either case reports or pharmacovigilance systems. The frequency of hyponatraemia during CLZ administration was similar to that observed with other atypical APDs, and it was significantly lower than that recorded with typical agents. These results, along with numerous case reports on the effects of CLZ in patients with polydipsia and water intoxication, point to a safe or even positive profile of CLZ on electrolytic regulation.

  3. Nuclear Data Matters - The obvious case of a bad mixing ratio for 58Co

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

    Hoffman, R. D.; Nesaraja, Caroline D.; Mattoon, Caleb

    We present results of modeled cross sections for neutron- and proton-induced reactions leading to the final product nucleus 58Co. In each case the gamma-cascade branching ratios given in the ENSDF database circa 2014 predict modeled nuclear cross sections leading to the ground and first excited metastable state that are incompatible with measured cross sections found in the NNDC experimental cross section database EXFOR. We show that exploring the uncertainty in the mixing ratio used to calculate the gamma-cascade branching ratios for the 53.15 keV 2 nd excited state leads to changes in the predicted partial cross sections by amounts thatmore » give good agreement with measured data.« less

  4. 30 CFR 250.524 - When am I required to take action from my casing diagnostic test?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... casing diagnostic test; (c) Any well that has demonstrated tubing/casing, tubing/riser, casing/casing... casing diagnostic test? 250.524 Section 250.524 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT... Gas Well-Completion Operations Casing Pressure Management § 250.524 When am I required to take action...

  5. Casing for a gas turbine engine

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

    Wiebe, David J.; Little, David A.; Charron, Richard C.

    2016-07-12

    A casing for a can annular gas turbine engine, including: a compressed air section (40) spanning between a last row of compressor blades (26) and a first row of turbine blades (28), the compressed air section (40) having a plurality of openings (50) there through, wherein a single combustor/advanced duct assembly (64) extends through each opening (50); and one top hat (68) associated with each opening (50) configured to enclose the associated combustor/advanced duct assembly (64) and seal the opening (50). A volume enclosed by the compressed air section (40) is not greater than a volume of a frustum (54)more » defined at an upstream end (56) by an inner diameter of the casing at the last row of compressor blades (26) and at a downstream end (60) by an inner diameter of the casing at the first row of turbine blades (28).« less

  6. Evaluation of the acute flaccid paralysis (AFP) surveillance system, Gokwe North district, Zimbabwe, 2015: a descriptive cross sectional study.

    PubMed

    Makoni, Annamercy; Chemhuru, Milton; Gombe, Notion; Shambira, Gerald; Juru, Tsitsi; Bangure, Donewell; Tshimanga, Mufuta

    2017-01-01

    AFP surveillance was adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. Gokwe North district with an estimated 119 655 children <15 years detected 2 cases, 4 cases and 1 case of AFP in 2012, 2013 and 2014 respectively against a target of 5 cases per year. We therefore set out to evaluate the system and find out why it was failing to detect at least 5 cases per year. A descriptive cross sectional study was carried out. All three hospitals in the district were purposively selected. Twelve of the nineteen health facilities were randomly selected and forty nine health workers were purposively recruited. An interviewer administered questionnaire and key informant interview guide were used to collect data. Quantitative data was analysed using Epi info. Out of the 49 respondents, 17(34.7%) knew the target age group for AFP surveillance. Twelve (24.5%) knew the number of notification forms to be filled. Seven (14.3%) and ten (20.4%) respondents knew when to follow up an AFP case and when an AFP case should be followed up and completely notified and investigated respectively. Forty one (83.7%) respondents were not trained on AFP surveillance. Nineteen (39%) had AFP notification forms at the clinic and 33(67%) had displayed AFP case definitions. All the 22 health facilities in the district participate in AFP surveillance; however, all have hard to reach areas. Seventeen (34.7%) reportedly took public health actions based on AFP data. The system was found to be useful, simple, acceptable, timely, unstable, not representative and not sensitive. The system was threatened by lack of health worker knowledge and community active search. Advocacy, communication and social mobilization on AFP surveillance might improve the performance of the system in Gokwe North district.

  7. What Case Managers Should Know About Their Roles and Functions: A National Study From the Commission for Case Manager Certification: Part 1.

    PubMed

    Tahan, Hussein M; Watson, Annette C; Sminkey, Patrice V

    2015-01-01

    The purpose of this national role and function study was to identify the essential activities and necessary knowledge areas for effective case manager practice from the perspective of those currently functioning in various care settings and across diverse professional disciplines. The national study covered all case management practices and/or work settings across the full continuum of health care. This cross-sectional descriptive study used the practice analysis method and online survey research design. It employed a purposive sample of case managers, in which 52,370 individuals received an invitation to participate. Data collection completed over a 4-week period, resulting in 7,668 useable survey responses (nearly a 15% response rate). The study identified the common activities and knowledge areas necessary for competent and effective performance of case managers, as is highlighted in this article, which is the first of a 2-part series on the role and function study. The results informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination, as will be delineated in Part 2 of the article series, to ensure that it continues to be substantiated in current practice. Of special note are the emergence of specific activity and knowledge domains in the area of case management ethical, legal, and practice standards, and an increase in the number of employers requiring certified case managers to fill vacant positions and compensating them financially for such qualifications. This study helps keep the CCM credentialing examination evidence-based and maintain its validity for evaluating competency of case managers. Specifically, the study identified essential activities and knowledge domains that define competent case management practice. Findings can be used for developing programs and curricula for the training and development of case managers. The study instrument also can be used for further research of case management practice.

  8. Cesarean section without medical indication and risk of childhood asthma, and attenuation by breastfeeding.

    PubMed

    Chu, Shuyuan; Chen, Qian; Chen, Yan; Bao, Yixiao; Wu, Min; Zhang, Jun

    2017-01-01

    Previous studies suggest that caesarean section (CS) may increase the risk of asthma in children, but none of them could preclude potential confounding effects of underlying medical indications for CS. We aim to assess the association between CS itself (without medical indications) and risk of childhood asthma. We conducted a hospital-based case-control study on childhood asthma with 573 cases and 812 controls in Shanghai. Unconditional logistic regression models in SAS were employed to control for potential confounders. Our study found that CS without medical indication was significantly associated with elevated asthma risk (adjusted OR = 1.58 [95% CI 1.17-2.13]). However, this risk was attenuated in children fed by exclusive breastfeeding in the first six months after birth (adjusted OR = 1.39 [95% CI 0.92-2.10]). In contrast, the risk was more prominent in children with non-exclusive breastfeeding or bottle feeding (adjusted OR = 1.91 [95% CI 1.22-2.99]). CS without medical indication was associated with an increased risk of childhood asthma. Exclusive breastfeeding in infancy may attenuate this risk.

  9. Histologic features of alopecia areata other than peribulbar lymphocytic infiltrates.

    PubMed

    Peckham, Steven J; Sloan, Steven B; Elston, Dirk M

    2011-09-01

    Histologic features other than a lymphocytic infiltrate around follicular bulbs are now recognized as helpful clues to the diagnosis of alopecia areata, especially in long-standing lesions where the peribulbar lymphocytic infiltrate may be sparse or absent. We sought to determine the frequency of peribulbar lymphocytic infiltrates, eosinophils, lymphocytes, and melanin in fibrous tracts, pigment casts in follicles, the presence of catagen/telogen follicles, follicular miniaturization, and dystrophic ("nanogen") follicles in alopecia areata. Secondly, we sought to compare the diagnostic use of transversely sectioned versus horizontally sectioned specimens in those cases for which both were available (15 of 109 cases). The pathology archives of Geisinger Medical Center (Danville, PA), Wilford Hall US Air Force Medical Center (San Antonio, TX), and Brooke US Army Medical Center (San Antonio, TX) were searched for the term "alopecia areata" in the diagnostic field from the period of 1991 to 2006, which yielded 109 cases with sections suitable for review. Cases from the two military institutions from 1997 or earlier were excluded to avoid any overlap with data previously reported by our group. A peribulbar lymphocytic infiltrate was present in 92 specimens (84%), eosinophils in fibrous tracts in 48 (44%), lymphocytes in fibrous tracts in 102 (94%), melanin within fibrous tracts in 92 (84%), pigment casts within follicular canals in 46 (44%), catagen follicles in 101 (93%), and miniaturized follicles in 98 (90%). Dystrophic miniaturized follicles were rare (4 cases). In 14 of 15 cases with both vertical and transverse sections, either was diagnostic. One case showed diagnostic features only in vertical sections. Comparable vertical and transverse sections were only available for a limited number of the cases. We did not correlate duration of disease with individual findings. Our results were correlated with the clinical diagnosis but not with serologic tests for syphilis. Although most specimens showed evidence of a peribulbar lymphocytic infiltrate (84%), a higher percentage showed evidence of follicles in catagen/telogen phase (93%) and evidence of miniaturization of follicles (90%). This could lead to an incorrect diagnosis of trichotillomania or pattern alopecia. Pigment casts within the hair canal were also found in a significant number of follicles, especially in catagen follicles, creating further potential for misdiagnosis as trichotillomania. A significant percentage showed evidence of eosinophils (44%), melanin (84%), and lymphocytes (94%) in fibrous tracts. These features are particularly helpful when a peribulbar lymphocytic infiltrate is lacking. Vertical and transverse sections appear comparable. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  10. Epithelial dysplasia in oral lichen planus. A preliminary report of a Dutch-Hungarian study of 100 cases.

    PubMed

    De Jong, W F; Albrecht, M; Bánóczy, J; van der Waal, I

    1984-06-01

    In a combined study of the Free University, Amsterdam and the Semmelweis Medical University, Budapest, the presence of epithelial dysplasia was studied in 100 cases of oral lichen planus. The criteria of epithelial dysplasia which were used in this study correspond with those reported by the WHO Collaborating Centre for Oral Precancerous Lesions in 1978. In approximately 25% of all cases, moderate or at least mild dysplasia was observed. The number of dysplastic changes per section did not show any significant correlation with the clinical type, nor with age or sex. There were no marked differences between the Amsterdam and Budapest material. Long-term data on the follow-up were not available yet. No comment can therefore be given about the meaning of the finding of epithelial dysplasia in lichen planus being a sign of premalignancy or not.

  11. Prevalence and comorbidity of eating disorders among a community sample of adolescents: 2-year follow-up.

    PubMed

    Rojo-Moreno, Luis; Arribas, Pilar; Plumed, Javier; Gimeno, Natalia; García-Blanco, Ana; Vaz-Leal, Francisco; Luisa Vila, María; Livianos, Lorenzo

    2015-05-30

    The previous literature about comorbidity between eating disorders (ED) and other DSM-IV psychiatric disorders in adolescence has employed cross-sectional studies with clinical samples, where the comorbid disorders were diagnosed retrospectively. The present study aims to overcome these limitations by the analysis of comorbidity in a community population during 2-year follow-up. A semi-structured interview was applied to a teenager sample. Firstly, a cross-sectional and non-randomized study on psychiatric morbidity was conducted with 993 teenagers between the ages of 12 and 16 from five schools. Secondly, 326 students between 14 and 17 years old of one school were reassessed 2 years later in order to detect ED new cases and find associations with previous psychiatric disorders. The ED prevalence was 3.6%. Cross-sectional analysis revealed that 62.9% of individuals with an ED had comorbid disorders: anxiety disorders (51.4%), Attention Deficit Hyperactivity Disorder (31.4%), oppositional defiant disorder (11.4%), and obsessive compulsive disorder (8.6%). Prospective longitudinal analysis showed an ED incidence rate of 2.76% over the course of 2 years. 22.2% of new cases had received previous psychiatric diagnoses, of which all were anxiety disorders. Thus, ED exhibited a high comorbidity rate among adolescent populations and anxiety disorders were the most common comorbid diagnosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. ACHP | How to Contact the ACHP

    Science.gov Websites

    Section 106 cases. Use the OFAP Agency Organizational Chart to identify the appropriate OFAP contact for in key areas. Use the OFAP Section Policy Organizational Chart to identify the appropriate section

  13. Rapid-quench axially staged combustor

    DOEpatents

    Feitelberg, Alan S.; Schmidt, Mark Christopher; Goebel, Steven George

    1999-01-01

    A combustor cooperating with a compressor in driving a gas turbine includes a cylindrical outer combustor casing. A combustion liner, having an upstream rich section, a quench section and a downstream lean section, is disposed within the outer combustor casing defining a combustion chamber having at least a core quench region and an outer quench region. A first plurality of quench holes are disposed within the liner at the quench section having a first diameter to provide cooling jet penetration to the core region of the quench section of the combustion chamber. A second plurality of quench holes are disposed within the liner at the quench section having a second diameter to provide cooling jet penetration to the outer region of the quench section of the combustion chamber. In an alternative embodiment, the combustion chamber quench section further includes at least one middle region and at least a third plurality of quench holes disposed within the liner at the quench section having a third diameter to provide cooling jet penetration to at least one middle region of the quench section of the combustion chamber.

  14. Vernix caseosa peritonitis: report of two cases.

    PubMed

    Val-Bernal, José-Fernando; Mayorga, Marta; García-Arranz, Pilar; Salcedo, Waleska; León, Alicia; Fernández, Fidel A

    2015-01-01

    Vernix caseosa peritonitis is a rare complication caused by inflammatory response to amniotic fluid spilled into the maternal peritoneal cavity. Most cases occur after cesarean section. We discuss herein two patients, aged 33 and 29 years, who presented with vernix caseosa peritonitis seven to nine days after a cesarean delivery. Laparotomy was performed and it revealed neither uterine rupture nor other surgical emergencies, but cheesy exudates on the serosal surface of all viscera. Appendicectomy was performed. Histopathologic study revealed acute fibrinous serositis and a mixed cellular infiltrate, rich in neutrophils, around fetal desquamated anucleate squamous cells. Patients´ recovery was complete. Clinical diagnosis of vernix caseosa peritonitis should be suspected in patients presenting post-cesarean section with an acute abdomen. Distinctive histopathologic findings allow making the correct diagnosis. Vigilant monitoring after diagnosis is essential as delayed morbidities may appear.

  15. Effects of delivery on maternal & neonatal irisin levels in normal and preeclamptic pregnant women.

    PubMed

    Foda, Ashraf A; Foda, Engy A

    2017-10-01

    The aim of this work was to measure the irisin levels in maternal and umbilical cord serums at cesarean section and vaginal delivery. This is a case-control study conducted at the Obstetric Department of the Mansoura University Hospital, Mansoura University, Egypt. The 150 nulliparous cases were divided into three groups. Serum irisin concentrations were assayed by enzyme-linked immunosorbent assay (ELISA) method. Unpaired t-test and correlation were done by using the Statistical Package for Social Scientists (SPSS). The maternal irisin levels in cases with mild preeclampsia were found to be significantly lower than that of the normal cases. In cases with mild preeclampsia, the maternal irisin levels early in labor for vaginal deliveries were significantly higher than that during cesarean section. The maternal irisin levels after vaginal deliveries were significantly higher than the levels early in labor. The maternal serum irisin was a significantly correlated with the duration of the first stage. The umbilical cord serum irisin levels were significantly correlated with the neonatal weight and with the duration of the first stage of labor. Labor is a strong stimulus to the release of irisin into the maternal and fetal circulations. Neonatal serum irisin levels are positively correlated with the birth weight and with the duration of the first stage. The neonatal birth weight and the duration of the first stage of labor are positively correlated with the umbilical cord serum irisin levels. Copyright © 2017 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

  16. Examining Issues of E-Learning Practices in Chinese Higher Education: A Cross-Sectional Study of Mainland China, Taiwan and Hong Kong

    ERIC Educational Resources Information Center

    Szeto, Elson

    2013-01-01

    Empirical studies of e-learning practices in Chinese higher education are still controversial. Shared Chinese beliefs in education, moving towards mass higher education for global competitiveness and improving e-readiness levels press for ubiquitous use of e-learning in mainland China, Taiwan and Hong Kong. This is a small-scale case study using a…

  17. Correlates of the Intention to Remain Sexually Inactive among Male Adolescents in an Islamic Country: Case of the Republic of Iran

    ERIC Educational Resources Information Center

    Mohtasham, Ghaffari; Shamsaddin, Niknami; Bazargan, Mohsen; Anosheravan, Kazemnejad; Elaheh, Mirzaee; Fazlolah, Ghofranipour

    2009-01-01

    Background: There are very few studies that have examined sexual intentions and behaviors of adolescents in Islamic countries. This study employs the Health Belief Model to assess the correlates of the intention to remain sexually inactive among male adolescents in the Republic of Iran. Methods: This cross-sectional study was performed with a…

  18. The Effects of Problem-Based Learning with Flipped Classroom on Elementary Students' Computing Skills: A Case Study of the Production of Ebooks

    ERIC Educational Resources Information Center

    Tsai, Chia-Wen; Shen, Pei-Di; Lu, Yu-Jui

    2015-01-01

    This study investigated, via quasi-experiments, the effects of problem-based learning with flipped classroom (FPBL) on the development of students' learning performance. In this study, 144 elementary school students were selected from sixth-grade sections taking a course titled "Production of Ebook," and were assigned into the following…

  19. 26 CFR 31.6051-1 - Statements for employees.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the remuneration paid by such employer to such employee during the calendar year, the tax return copy... paragraph (b)(8) of § 31.3401(a)-1. (v) In the case of remuneration paid for service described in section... 3121(i)(2) and section 3122. (vi) In the case of remuneration in the form of tips received by an...

  20. Bias in Cross-Sectional Analyses of Longitudinal Mediation: Partial and Complete Mediation under an Autoregressive Model

    ERIC Educational Resources Information Center

    Maxwell, Scott E.; Cole, David A.; Mitchell, Melissa A.

    2011-01-01

    Maxwell and Cole (2007) showed that cross-sectional approaches to mediation typically generate substantially biased estimates of longitudinal parameters in the special case of complete mediation. However, their results did not apply to the more typical case of partial mediation. We extend their previous work by showing that substantial bias can…

  1. Remarks about the prognosis in case of antenatal diagnosis of gastroschisis.

    PubMed

    Poulain, P; Milon, J; Frémont, B; Proudhon, J F; Odent, S; Babut, J M; Le Marec, B; Grall, J Y; Giraud, J R

    1994-05-18

    We report our experience of 15 cases of gastroschisis which occurred between 1981 and 1993. All but one were diagnosed antenatally by ultrasound between 16 and 32 weeks of pregnancy. We made a termination of the pregnancy in 3 cases, for multiple malformations in 2 cases and one case of very early premature rupture of the membranes (PROM). When checked (11 cases), the karyotype was normal. We made a cesarean section in 11 cases: the indication was a complication for 6 (fetal distress, PROM, polyhydramnios, large dilatation of the gut). We noted growth retardation in 7 newborns and prematurity in 5/12 (mean gestational age of 36.8 weeks). The preoperative study of the gut noted 5 cases with intestinal damage and one case of complete necrosis of the gut. The global prognosis is not as good as usual, with a perinatal mortality of 41.6% (5/12). We discuss this latter point and examine the literature.

  2. Characteristics of phase-correcting fresnel zone plates and elliptical waveguides

    NASA Astrophysics Data System (ADS)

    Wiltse, James C.

    1994-02-01

    The primary area of activity has been concentrated on the investigations relating to Fresnel zone plate antennas. A secondary effort has dealt with the characteristics of propagation in waveguides of elliptical cross section. In both cases, applications at microwave and millimeter-wavelengths have been emphasized. Thorough literature searches were conducted, and the results are given in Appendices A and B. The zone plate work has dealt with both transmission and reflection types, and has included considering the off-axis-fed cases. In the latter case, the plate may consist of elliptical zones, rather than the usual circular configuration. In general, the characteristics studied include far-field patterns, focal region fields, off-axis performance, bandwidth, and aberrations. In the case of propagation in elliptical waveguides, the attenuation and modal properties were studied for enclosed metal waveguides, coaxial transmission lines, and various surface waveguides.

  3. Criteria-based audit of caesarean section in a referral hospital in rural Tanzania.

    PubMed

    Heemelaar, S; Nelissen, E; Mdoe, P; Kidanto, H; van Roosmalen, J; Stekelenburg, J

    2016-04-01

    WHO uses the Caesarean section (CS) rate to monitor implementation of emergency obstetric care (EmOC). Although CS rates are rising in sub-Saharan Africa, maternal outcome has not improved. We audited indications for CS and related complications among women with severe maternal morbidity and mortality in a referral hospital in rural Tanzania. Cross-sectional study was from November 2009 to November 2011. Women with severe maternal morbidity and mortality were identified and those with CS were included in this audit. Audit criteria were developed based on the literature review and (inter)national guidelines. Tanzanian and Dutch doctors reviewed hospital notes. The main outcome measured was prevalence of substandard quality of care leading to unnecessary CS and delay in performing interventions to prevent CS. A total of 216 maternal near misses and 32 pregnancy-related deaths were identified, of which 82 (33.1%) had a CS. Indication for CS was in accordance with audit criteria for 36 of 82 (44.0%) cases without delay. In 20 of 82 (24.4%) cases, the indication was correct; however, there was significant delay in providing standard obstetric care. In 16 of 82 (19.5%) cases, the indication for CS was not in accordance with audit criteria. During office hours, CS was more often correctly indicated than outside office hours (60.0% vs. 36.0%, P < 0.05). Caesarean section rate is not an useful indicator to monitor quality of EmOC as a high rate of unnecessary and potentially preventable CS was identified in this audit. © 2016 John Wiley & Sons Ltd.

  4. The value of ultrasounds exam correlated with frozen section diagnosis in the breast tumors.

    PubMed

    Venter, Alina; Roşca, Elena; Muţiu, Gabriela; Pirte, Adriana; Roşca, D M

    2010-01-01

    The paper represents a parallel study regarding the harmony between the ultrasounds and the frozen section diagnosis in the breast cancer. We examined at an ultrasounds machine a group of 146 women aged between 16-73-year-old, which came presenting palpable formations at the level of breasts, in the Pelican Medical Centre from Oradea. The suspect lesions were subject to excisional biopsy or surgical intervention. The elements followed at the ultrasounds exam were: echogenicity, echostructure, contour, presence and absence of posterior shadowing, microcalcifiation, orientation of lesion, compressibility, aspect of adjacent structures. Histopathological diagnosis of suspect lesions emphasized malignant lesions in a percentage of 64.86% of cases; the frozen section exam diagnosed invasive ductal carcinoma in 86% of the cases, invasive lobular carcinoma 8%, medullar carcinoma 2%, and benign lesions 4%. The clinical-anatomopathological collaboration is absolutely compulsory for a correct microscopic diagnosis. The ultrasounds modifications separated after the criteria taken into account allow the orientation of diagnosis to malignant-benign. At 14% of the women examined, additional lesions were identified in comparison to those palpated, the ultrasounds having a role in detecting the multifocality and muticentricity of lesions. At 29.05% from the identified lesions, malignant lesions were histopathologically identified. The frozen section diagnosis in the breast cancer allows a rapid diagnosis, correct in high percentage of cases, allowing taking an intra-surgery therapeutic attitude in only one surgical intervention, thus reducing the costs. The anatomopathologist's experience reduces the diagnosis risk in excess and÷or in minus.

  5. Brain drain or links to the world: views on emigrants from Singapore.

    PubMed

    Yap, M T

    1994-01-01

    "This article will present a general picture of emigration and emigrants from Singapore, with specific references to Australia where the data permit. The first section presents some flow data on the magnitudes of emigration from Singapore.... It is necessary to place this outflow against the background of the constraints imposed by the country's small size. This is discussed in the second section, together with the economic policies and strategies adopted to overcome these constraints. The third section documents the public debate on emigration and the responses to the 'problem.' This is followed in the last section by a prognosis for the future, particularly with regard to the implications for Australia. The article ends with a discussion of the relationship between emigration and nation building, using Singapore as a case study." excerpt

  6. The imperatives of narrative: health interest groups and morality in network news.

    PubMed

    Braun, Joshua A

    2007-08-01

    This article examines some of the story conventions of network television news to explain the ways in which healthcare interest groups develop and maintain their presence in this medium - a process that has significant implications for public understanding of healthcare issues, and therefore to bioethics. The article is divided into three sections. The first section focuses on three major normative conventions of television news: adherence to a simple narrative structure, the balance ethic, and avoidance of the "think-piece" and outlines the basic strategies available to interest groups for exploiting these normative conventions. Section two introduces three case studies of organizations and individuals who have run high-profile media campaigns. Section three explores the implications for bioethics of the observations made in this article.

  7. Accurate universal parameterization of absorption cross sections III--light systems

    NASA Technical Reports Server (NTRS)

    Tripathi, R. K.; Cucinotta, F. A.; Wilson, J. W.

    1999-01-01

    Our prior nuclear absorption cross sections model [R.K. Tripathi, F.A. Cucinotta, J.W. Wilson, Nucl. Instr. and Meth. B 117 (1996) 347; R.K. Tripathi, J.W. Wilson, F.A. Cucinotta, Nucl. Instr. and Meth. B 129 (1997) 11] is extended for light systems (A < or = 4) where either both projectile and target are light particles or one is light particle and the other is medium or heavy nucleus. The agreement with experiment is excellent for these cases as well. Present work in combination with our original model provides a comprehensive picture of absorption cross sections for light, medium and heavy systems. As a result the extended model can reliably be used in all studies where there is a need for absorption cross sections.

  8. Neonatal clavicle fracture in cesarean delivery: incidence and risk factors.

    PubMed

    Choi, Hyun Ah; Lee, Yeon Kyung; Ko, Sun Young; Shin, Son Moon

    2017-07-01

    Neonatal clavicle fracture in cesarean delivery is rare and has not been extensively studied. We performed a retrospective review of cesarean deliveries with neonatal clavicle fracture during a 12-year period. Maternal and neonatal factors as well as surgical factors related to cesarean delivery for the fracture were determined and compared to the control group to analyze their significance. Among a total 89 367 deliveries during the study period, 36 286 babies were born via cesarean section. Nineteen cases of clavicle fractures in cesarean section were identified (0.05% of total live births via cesarean section). In the analysis of maternal and neonatal risk factors, birthweight, birthweight ≥ 4000  g and maternal age were significantly associated with clavicle fracture in cesarean section. However, clavicle fractures were not correlated with the selected surgical factors such as indication for cesarean section, skin incision to delivery time and incision type of skin and uterus. Logistic regression analysis showed that birthweight was the major risk factor for clavicle fracture. Clavicle fractures complicated 0.05% of cesarean deliveries. The main risk factor related to a clavicle fracture in cesarean section was the birthweight of an infant. As reported in previous studies associated with vaginal delivery, clavicle fracture is considered to be an unavoidable event and may not be eliminated, even in cesarean delivery.

  9. Global dengue death before and after the new World Health Organization 2009 case classification: A systematic review and meta-regression analysis.

    PubMed

    Low, Gary Kim-Kuan; Ogston, Simon A; Yong, Mun-Hin; Gan, Seng-Chiew; Chee, Hui-Yee

    2018-06-01

    Since the introduction of 2009 WHO dengue case classification, no literature was found regarding its effect on dengue death. This study was to evaluate the effect of 2009 WHO dengue case classification towards dengue case fatality rate. Various databases were used to search relevant articles since 1995. Studies included were cohort and cross-sectional studies, all patients with dengue infection and must report the number of death or case fatality rate. The Joanna Briggs Institute appraisal checklist was used to evaluate the risk of bias of the full-texts. The studies were grouped according to the classification adopted: WHO 1997 and WHO 2009. Meta-regression was employed using a logistic transformation (log-odds) of the case fatality rate. The result of the meta-regression was the adjusted case fatality rate and odds ratio on the explanatory variables. A total of 77 studies were included in the meta-regression analysis. The case fatality rate for all studies combined was 1.14% with 95% confidence interval (CI) of 0.82-1.58%. The combined (unadjusted) case fatality rate for 69 studies which adopted WHO 1997 dengue case classification was 1.09% with 95% CI of 0.77-1.55%; and for eight studies with WHO 2009 was 1.62% with 95% CI of 0.64-4.02%. The unadjusted and adjusted odds ratio of case fatality using WHO 2009 dengue case classification was 1.49 (95% CI: 0.52, 4.24) and 0.83 (95% CI: 0.26, 2.63) respectively, compared to WHO 1997 dengue case classification. There was an apparent increase in trend of case fatality rate from the year 1992-2016. Neither was statistically significant. The WHO 2009 dengue case classification might have no effect towards the case fatality rate although the adjusted results indicated a lower case fatality rate. Future studies are required for an update in the meta-regression analysis to confirm the findings. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. The role of peripheral blood, bone marrow aspirate and especially bone marrow trephine biopsy in distinguishing atypical chronic myeloid leukemia from chronic granulocytic leukemia and chronic myelomonocytic leukemia.

    PubMed

    Xubo, Gong; Xingguo, Lu; Xianguo, Wu; Rongzhen, Xu; Xibin, Xiao; Lin, Wang; Lei, Zhu; Xiaohong, Zhang; Genbo, Xu; Xiaoying, Zhao

    2009-10-01

    To better realize the features of peripheral blood (PB), bone marrow (BM) aspirate and especially BM trephine biopsy in atypical chronic myeloid leukemia (aCML). We studied PB, BM smears in 35 cases of aCML and compared with 84 cases of chronic granulocytic leukemia chronic phase (CGL-CP), 39 cases of chronic myelomonocytic leukemia (CMML). In addition, we evaluated characteristics of BM trephine biopsies in 21 cases of aCML and compared with 68 cases of CGL-CP, 20 cases of CMML. All aCML patients presented with leukocytosis (median WBC 17.3 x 10(9)/L), 48% had moderate anemia, and 85% had thrombocytopenia. Values of monocytes, eosinophils, basophils, percentage of immature granulocytes and monocytes (0.63 +/- 0.41 x 10(9)/L, 0.18 +/- 0.16 x 10(9)/L, 0.09 +/-0.08 x 10(9)/L, 6.27 +/- 3.09%, and 2.46 +/- 1.75%, respectively) were useful in distinguishing aCML from CGL-CP and CMML groups. The BM smears showed that striking dysgranulopoieis (100%), dyserythropoiesis (48.6%), percentage of blasts, nucleated erythrocytes, monocytes, eosinophils, and basophils (2.45 +/- 2.06%, 7.76 +/- 2.89%, 1.30 +/- 1.21%, 1.47 +/- 1.60%, and 1.15 +/- 1.08%, respectively) were all important parameters for a diagnosis of aCML. On BM trephine sections, aCML was characterized as hypercellularity, a moderate degree of reticulin fibrosis (71.4%), lymphocytopenia (76.2%), plasmacytopenia (90.5%), abnormal localization of immature precursors (28.5%), and absence of eosinophilia, basophilia, monocytosis. Furthermore, BM imprints, immunohistochemical, and cytochemical staining findings provided important morphological reference to BM trephine sections and made the identification of nucleated cells more convenient. Besides the findings observed in PB and BM aspirate, features of BM trephine biopsy (including BM trephine section, BM imprint, immunohistochemical, and cytochemical staining) can also aid in the diagnosis of aCML.

  11. Proficiency Effect on L2 Pragmatic Competence

    ERIC Educational Resources Information Center

    Xiao, Feng

    2015-01-01

    This paper synthesizes cross-sectional studies of the effect of proficiency on second language (L2) pragmatics to answer the synthesis question: Does proficiency affect adult learners' pragmatic competence? Findings have revealed an overall positive proficiency effect on pragmatic competence, and in most cases higher proficiency learners have…

  12. Assessment under Resource Constraints

    ERIC Educational Resources Information Center

    Lovett, Steve; Curtis, Mary G.

    2015-01-01

    Assessment and the measurement of learning are receiving increasing emphasis in American higher education. This is a case study that demonstrates a simple, inexpensive method of measuring freshman to senior "gains" or learning using a cross-sectional methodology. Seniors and freshmen within a four-year business program were both given…

  13. 10 CFR 602.4 - Deviations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Deviations. 602.4 Section 602.4 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.4 Deviations. (a) Single-case deviations from this part may be authorized in writing by the...

  14. 10 CFR 602.4 - Deviations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Deviations. 602.4 Section 602.4 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.4 Deviations. (a) Single-case deviations from this part may be authorized in writing by the...

  15. 10 CFR 602.4 - Deviations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Deviations. 602.4 Section 602.4 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.4 Deviations. (a) Single-case deviations from this part may be authorized in writing by the...

  16. 10 CFR 602.4 - Deviations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Deviations. 602.4 Section 602.4 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.4 Deviations. (a) Single-case deviations from this part may be authorized in writing by the...

  17. A Professional Development School Partnership: Conflict and Collaboration.

    ERIC Educational Resources Information Center

    Campoy, Renee W.

    This book describes complex issues involved in an elementary Professional Development School (PDS) partnership. Section one presents contextual information on the nature of the PDS phenomenon. It includes three chapters: (1) "Introduction and PDS as a Reform Initiative"; (2) "Methodology of the Case Study"; and (3)…

  18. 29 CFR 1910.1027 - Cadmium.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... employee on the basis of one or more personal breathing zone air samples reflecting full shift exposure on... achieve compliance, including engineering plans and studies used to determine methods selected for... requirements of paragraph (l)(2)(ii) of this section within the past 12 months. In that case, such records...

  19. 29 CFR 1910.1027 - Cadmium.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... employee on the basis of one or more personal breathing zone air samples reflecting full shift exposure on... achieve compliance, including engineering plans and studies used to determine methods selected for... requirements of paragraph (l)(2)(ii) of this section within the past 12 months. In that case, such records...

  20. 29 CFR 1910.1027 - Cadmium.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... employee on the basis of one or more personal breathing zone air samples reflecting full shift exposure on... achieve compliance, including engineering plans and studies used to determine methods selected for... requirements of paragraph (l)(2)(ii) of this section within the past 12 months. In that case, such records...

Top