The Heart of School Improvement: A Multi-Site Case Study of Leadership for Teacher Learning in Vietnam

ERIC Educational Resources Information Center

Tran, Ngoc H.; Hallinger, Philip; Truong, Thang

2018-01-01

This study addressed the research question: How do Vietnamese principals lead the professional learning of teachers? The research was comprised of a multiple-site case study of leadership and teacher learning in four Vietnamese schools. Qualitative data analysis aimed at identifying modal practices adopted by these Vietnamese principals to lead…

The Peculiar Institution?: A Multisite Case Study of Athletic Department Cultures at Small Christian Institutions

ERIC Educational Resources Information Center

Ramseyer, Paul Robert

2017-01-01

This multisite case study explored the perceptions of athletic department members of the important factors of organizational cultures in athletic departments at small Christian institutions in the Midwestern United States. The study comprised of site visits to three small Christian institutions in the Midwestern United States. At each site, six…

A Qualitative Multi-Site Case Study: Examining Principals' Leadership Styles and School Performance

ERIC Educational Resources Information Center

Preyear, Loukisha

2015-01-01

The purpose of this qualitative multi-site case study was to explore the impact of principals' leadership styles on student academic achievement in a high-poverty low-performing school district in Louisiana. A total of 17 participants, principals and teachers, from this school district were used in this study. Data source triangulation of…

Review of ecological-based risk management approaches used at five Army Superfund sites.

PubMed

Poucher, Sherri L; Tracey, Gregory A; Johnson, Mark S; Haines, Laurie B

2012-04-01

Factors used in environmental remedial decision making concerning ecological risk are not well understood or necessarily consistent. Recent Records of Decision (RODs) for Army CERCLA sites were reviewed to select case studies where remedial management occurred in response to ecological risks. Thirty-four Army RODs were evaluated representing decisions promulgated between 1996 and 2004. Five were selected based on assessments that remedial actions were clearly linked to concern for ecological receptors. The Ecological Risk Assessment (ERA) approach and the subsequent risk management process were reviewed for each site. The case studies demonstrated that the ERA findings, as well as critical management decisions regarding interpretation of identified ecological risks, were determinants of remedial action objectives. Decisions regarding the selection of remedial alternatives were based on a set of criteria prescribed by Superfund requirements and guidance. Remedial alternative evaluations require protection of human health and the environment, but protective conditions were determined using different methods at each site. Examining the remedial management process for the 5 case study sites revealed that uncertainty in the risk assessment and decisions regarding appropriate spatial scales for both risk assessment and remediation were important factors influencing remedial action decisions. The case reviews also revealed that levels of documentation were variable from site to site. In the future, more detailed documentation of decision criteria and the development of criteria that consider the resilience of the site will result in more technically defensible ecological risk management. Copyright © 2011 SETAC.

Factors Influencing Teachers' Technology Self-Efficacy: A Case Study

ERIC Educational Resources Information Center

Farah, Amy Caroline

2012-01-01

Factors influencing teachers' levels of technology self-efficacy were examined through a qualitative multi-site, multi-subject case study research design. An initial survey was administered to all full-time, certified teachers at three school sites in order to gauge teachers' current level of technology self-efficacy. From that…

Case Study of the Triad Approach: Expedited Characterization of Petroleum Constituents and PCBs Using Test Kits and a Mobile Chromatography Laboratory at the Former Cos Cob Power Plant Site

EPA Pesticide Factsheets

The case study was developed as part of EPA's ongoing initiative to promote the use of an integrated Triad approach to limit decision uncertainty at hazardous waste sites through the use of sound science.

Transportation planning effectiveness: twenty case studies

DOT National Transportation Integrated Search

1977-12-31

This document consists of 20 site-specific case studies of urban area experience with the Technical Study Grant Program of the Urban Mass Transportation Administration (UMTA). The objective of the case studies is to determine how the Technical Study ...

Spatial and temporal seed dispersal of squarrose knapweed (Centaurea virgata Lam. ssp. squarrosa (Willd.) Gugler) in west central Utah, a case study

Treesearch

Scott L. Jensen; Stephen B. Monsen; Pat Fosse

2008-01-01

This case study documents temporal and spatial squarrose knapweed (Centaurea virgata Lam. spp. squarrosa (Willd.) Gugler) seed dispersal from study sites in central Utah. Felt seed traps were placed along transects extending from sites occupied by squarrose knapweed into adjacent plant communities. Seed dispersal from knapweed...

Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort

PubMed Central

Budhathoki, Sanjeev; Hidaka, Akihisa; Sawada, Norie; Tanaka-Mizuno, Sachiko; Kuchiba, Aya; Charvat, Hadrien; Goto, Atsushi; Kojima, Satoshi; Sudo, Natsuki; Shimazu, Taichi; Sasazuki, Shizuka; Inoue, Manami; Tsugane, Shoichiro; Iwasaki, Motoki

2018-01-01

Abstract Objective To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study. Design Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort. Setting Nine public health centre areas across Japan. Participants 3301 incident cases of cancer and 4044 randomly selected subcohort participants. Exposure Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference. Main outcome measure Incidence of overall or site specific cancer. Results Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios. Conclusions In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites. PMID:29514781

An evaluation of North Carolina Department of Transportation wetland mitigation sites : selected case studies, phase 2 report.

DOT National Transportation Integrated Search

2012-03-01

Phase 1 of this study evaluated 50 NCDOT wetland compensatory mitigation sites and 11 reference sites in 1999. The : Phase 2 component (this report) examines five of the compensatory mitigation sites to provide a more in-depth analysis. The : objecti...

Implant failure and history of failed endodontic treatment: A retrospective case-control study.

PubMed

Chatzopoulos, Georgios S; Wolff, Larry F

2017-11-01

Residual bacterial biofilm and/or bacteria in planktonic form may be survived in the bone following an extraction of an infected tooth that was endodontically treated unsuccessfully Failed endodontic treatment may be associated with failure of implants to osseointegrate in the same sites. Therefore, the aim of this retrospective case-control study is to examine the risk of implant failure in previous failed endodontic sites. This retrospective case-control study is based on 94 dental records of implants placed at the University of Minnesota School of Dentistry. Dental records of patients who received an implant in sites with previously failed endodontic therapy in the dental school were identified from the electronic database, while control subjects were obtained from the same pool of patients with the requirement to have received an implant in a site that was not endodontically treated. The mean age of the population was 62.89±14.17 years with 57.4% of the sample being females and 42.6% of them being males. In regards to the socio-economic status and dental insurance, 84.0% of this population was classified as low socio-economic status and 68.1% had dental insurance. Tobacco use was self-reported by 9.6% and hypercholesterolemia was the most prevalent systemic medical condition. Dental implant failure was identified in two of the included records (2.1%), both of which were placed in sites with a history of failed endodontic treatment. Within the limitations of this retrospective case-control study, further investigation with a larger population group into implant failure of sites that previously had unsuccessful endodontic treatment would be warranted. Implant failure may be associated with a history of failed endodontic treatment. Key words: Implantology, endodontics, osseointegration, treatment outcome, case-control study.

Innovations in Site Characterization: Streamlining Cleanup at Vapor Intrusion and Product Removal Sites Using the Triad Approach: Hartford Plume Site, Hartford, Illinois

EPA Pesticide Factsheets

The Hartford Plume Site case study provides a detailed example of the strategies and technologies used at the site that are available to environmental practitioners to use at large and small hydrocarbon sites.

Remote sensing for site characterization

USGS Publications Warehouse

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

2000-01-01

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

A needs analysis method for land-use planning of illegal dumping sites: a case study in Aomori-Iwate, Japan.

PubMed

Ishii, Kazuei; Furuichi, Toru; Nagao, Yukari

2013-02-01

Land use at contaminated sites, following remediation, is often needed for regional redevelopment. However, there exist few methods of developing economically and socially feasible land-use plans based on regional needs because of the wide variety of land-use requirements. This study proposes a new needs analysis method for the conceptual land-use planning of contaminated sites and illustrates this method with a case study of an illegal dumping site for hazardous waste. In this method, planning factors consisting of the land-use attributes and related facilities are extracted from the potential needs of the residents through a preliminary questionnaire. Using the extracted attributes of land use and the related facilities, land-use cases are designed for selection-based conjoint analysis. A second questionnaire for respondents to the first one who indicated an interest in participating in the second questionnaire is conducted for the conjoint analysis to determine the utility function and marginal cost of each attribute in order to prioritize the planning factors to develop a quantitative and economically and socially feasible land-use plan. Based on the results, site-specific land-use alternatives are developed and evaluated by the utility function obtained from the conjoint analysis. In this case study of an illegal dumping site for hazardous waste, the uses preferred as part of a conceptual land-use plan following remediation of the site were (1) agricultural land and a biogas plant designed to recover energy from biomass or (2) a park with a welfare facility and an athletic field. Our needs analysis method with conjoint analysis is applicable to the development of conceptual land-use planning for similar sites following remediation, particularly when added value is considered. Copyright © 2012 Elsevier Ltd. All rights reserved.

Assessing the performance of a plastic optical fibre turbidity sensor for measuring post-fire erosion from plot to catchment scale

NASA Astrophysics Data System (ADS)

Keizer, J. J.; Martins, M. A. S.; Prats, S. A.; Santos, L. F.; Vieira, D. C. S.; Nogueira, R.; Bilro, L.

2015-09-01

This study is the first comprehensive testing of a novel plastic optical fibre turbidity sensor with runoff samples collected in the field and, more specifically, with a total of 158 streamflow samples and 925 overland flow samples from a recently burnt forest area in north-central Portugal, collected mainly during the first year after the wildfire, as well as with 56 overland flow samples from a nearby long-unburnt study site. Sediment concentrations differed less between overland flow and streamflow samples than between study sites and, at one study site, between plots with and without effective erosion mitigation treatments. Maximum concentrations ranged from 0.91 to 8.19 g L-1 for the micro-plot overland flow samples from the six burnt sites, from 1.74 to 8.99 g L-1 for the slope-scale overland flow samples from these same sites, and amounted to 4.55 g L-1 for the streamflow samples. Power functions provided (reasonably) good fits to the - expected - relationships of increasing normalized light loss with increasing sediment concentrations for the different sample types from individual study sites. The corresponding adjusted R2 values ranged from 0.64 to 0.81 in the case of the micro-plot samples from the six burnt sites, from 0.72 to 0.89 in the case of the slope-scale samples from these same sites, and was 0.85 in the case of the streamflow samples. While the overall performance of the sensor was thus rather satisfactory, the results pointed to the need for scale of site-specific calibrations to maximize the reliability of the predictions of sediment concentration by the POF (plastic optical fibre) sensor. This especially applied to the cases in which sediment concentrations were comparatively low, for example following mulching with forest residues.

75 FR 11183 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-10

... technology. Written comments should be received within 60 days of this notice. Proposed Project Case Studies... case studies of six CPPW-funded states and 15 CPPW-funded communities. The case study sites will be... region, and targeted population. Case study information will be collected by conducting personal...

The Home Instruction Program for Preschool Youngsters (HIPPY).

ERIC Educational Resources Information Center

Baker, Amy J. L.; Piotrkowski, Chaya S.; Brooks-Gunn, Jeanne

1999-01-01

Describes the Home Instruction Program for Preschool Youngsters (HIPPY), a two-year home-based early-education intervention program designed to help parents with limited formal education prepare their children for school. Presents findings from a two-site HIPPY study, a one-site case study, and a three-site qualitative study. (SLD)

1+1 Gaudin Model

NASA Astrophysics Data System (ADS)

Zotov, Andrei V.

2011-07-01

We study 1+1 field-generalizations of the rational and elliptic Gaudin models. For sl(N) case we introduce equations of motion and L-A pair with spectral parameter on the Riemann sphere and elliptic curve. In sl(2) case we study the equations in detail and find the corresponding Hamiltonian densities. The n-site model describes n interacting Landau-Lifshitz models of magnets. The interaction depends on position of the sites (marked points on the curve). We also analyze the 2-site case in its own right and describe its relation to the principal chiral model. We emphasize that 1+1 version impose a restriction on a choice of flows on the level of the corresponding 0+1 classical mechanics.

Transitioning from Marketing-Oriented Design to User-Oriented Design: A Case Study

ERIC Educational Resources Information Center

Laster, Shari; Stitz, Tammy; Bove, Frank J.; Wise, Casey

2011-01-01

The transition to a new architecture and design for an academic library Web site does not always proceed smoothly. In this case study, a library at a large research university hired an outside Web development contractor to create a new architecture and design for the university's Web site using dotCMS, an open-source content management system. The…

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…

Risk assessment of groundwater environmental contamination: a case study of a karst site for the construction of a fossil power plant.

PubMed

Liu, Fuming; Yi, Shuping; Ma, Haiyi; Huang, Junyi; Tang, Yukun; Qin, Jianbo; Zhou, Wan-Huan

2017-12-20

This paper presents a demonstration of an integrated risk assessment and site investigation for groundwater contamination through a case study, in which the geologic and hydrogeological feature of the site and the blueprint of the fossil power plant (FPP) were closely analyzed. Predictions for groundwater contamination in case of accidents were performed by groundwater modeling system (GMS) and modular three-dimensional multispecies transport model (MT3DMS). Results indicate that the studied site area presents a semi-isolated hydrogeological unit with multiplicity in stratum lithology, the main aquifers at the site are consisted of the filled karst development layer with a thickness between 6.0 and 40.0 m. The poor permeability of the vadose zone at the FPP significantly restricted the infiltration of contaminants through the vadose zone to the subsurface. The limited influence of rarely isotropic porous karstified carbonate rocks on the groundwater flow system premised the simulate scenarios of plume migration. Analysis of the present groundwater chemistry manifested that that the groundwater at the site and the local area are of the HCO 3 -Ca, HCO 3 , and SO 4 -Ca types. A few of the water samples were contaminated by coliform bacteria and ammonia nitrogen as a result of the local cultivation. Prediction results indicate that the impact of normal construction and operation processes on the groundwater environment is negligible. However, groundwater may be partly contaminated within a certain period in the area of leakage from the diesel tanks, the industrial wastewater pool, and the cooling tower water tank in case of accidents. On a positive note, none of the plumes would reach the local sensitive areas for groundwater using. Finally, an anti-seepage scheme and a monitoring program are proposed to safeguard the groundwater protection. The integrated method of the site investigation and risk assessment used in this case study can facilitate the protection of groundwater for the construction of large-scale industrial project.

Crosswalk markings and the risk of pedestrian-motor vehicle collisions in older pedestrians.

PubMed

Koepsell, Thomas; McCloskey, Lon; Wolf, Marsha; Moudon, Anne Vernez; Buchner, David; Kraus, Jess; Patterson, Matthew

2002-11-06

Motor vehicles struck and killed 4739 pedestrians in the United States in the year 2000. Older pedestrians are at especially high risk. To determine whether crosswalk markings at urban intersections influence the risk of injury to older pedestrians. Case-control study in which the units of study were crossing locations. Six cities in Washington and California, with case accrual from February 1995 through January 1999. A total of 282 case sites were street-crossing locations at an intersection where a pedestrian aged 65 years or older had been struck by a motor vehicle while crossing the street; 564 control sites were other nearby crossings that were matched to case sites based on street classification. Trained observers recorded environmental characteristics, vehicular traffic flow and speed, and pedestrian use at each site on the same day of the week and time of day as when the case event had occurred. Risk of pedestrian-motor vehicle collision involving an older pedestrian. After adjusting for pedestrian flow, vehicle flow, crossing length, and signalization, risk of a pedestrian-motor vehicle collision was 2.1-fold greater (95% confidence interval, 1.1-4.0) at sites with a marked crosswalk. Almost all of the excess risk was due to 3.6-fold (95% confidence interval, 1.7-7.9) higher risk associated with marked crosswalks at sites with no traffic signal or stop sign. Crosswalk markings appear associated with increased risk of pedestrian-motor vehicle collision to older pedestrians at sites where no signal or stop sign is present to halt traffic.

Innovations in Site Characterization Case Study: Site Cleanup of the Wenatchee Tree Fruit Test Plot Site Using a Dynamic Work Plan

EPA Pesticide Factsheets

The Wenatchee Tree Fruit Research and Extension Center site contained soils contaminated with organochlorine pesticides, organophosphorus pesticides, and other pesticides due to agriculture-related research activities conducted from 1966 until...

Convection, diffusion and reaction in a surface-based biosensor: modeling of cooperativity and binding site competition on the surface and in the hydrogel.

PubMed

Lebedev, Konstantin; Mafé, Salvador; Stroeve, Pieter

2006-04-15

We study theoretically the transport and kinetic processes underlying the operation of a biosensor (particularly the surface plasmon sensor "Biacore") used to study the surface binding kinetics of biomolecules in solution to immobilized receptors. Unlike previous studies, we concentrate mainly on the modeling of system-specific phenomena rather than on the influence of mass transport limitations on the intrinsic kinetic rate constants determined from binding data. In the first problem, the case of two-site binding where each receptor unit on the surface can accommodate two analyte molecules on two different sites is considered. One analyte molecule always binds first to a specific site. Subsequently, the second analyte molecule can bind to the adjacent unoccupied site. In the second problem, two different analytes compete for one binding site on the same surface receptor. Finally, the third problem considers the case of positive cooperativity among bound molecules in the hydrogel using a simple mean-field approach. The transport in both the flow channel and the hydrogel phases of the biosensor is taken into account in this case (with few exceptions, most previous studies assume a simpler model in which the hydrogel is treated as a planar surface with the receptors). We consider simultaneously diffusion and convection through the flow channel together with diffusion and cooperativity binding on the surface and in the hydrogel. In each case, typical results for the concentration contours of the free and bound molecules in the flow channel and hydrogel regions are presented together with the time-dependent association/dissociation curves and reaction rates. For binding site competition, the analysis predicts overshoot phenomena.

Case Study: An Ethics Case Study of HIV Prevention Research on Facebook: The Just/Us Study

PubMed Central

Breslin, Lindsey T.; Wright, Erin E.; Black, Sandra R.; Levine, Deborah; Santelli, John S.

2011-01-01

Objective To consider issues related to research with youth on social networking sites online. Methods Description of the data collection process from 1,588 participants in a randomized controlled trial testing the efficacy of HIV prevention education delivered on Facebook. Using respondent-driven sampling, staff-recruited participants are encouraged to recruit up to three friends to enroll in the study. Results Researchers should (a) consider whether an online social networking site is an appropriate place to implement a research study; (b) offer opportunities to review informed consent documents at multiple times and in multiple locations throughout the study; and (c) collect data outside the social networking site and store it behind secure firewalls to ensure it will not be accessible to any person on the social networking site. Conclusions Online social networks are growing in popularity. Conducting research on social media sites requires deliberate attention to consent, confidentiality, and security. PMID:21292724

Tracking Mallards (Anas platyrhynchos) with GPS Satellite Transmitters Along Their Migration Route Through Northeast Asia.

PubMed

Shin, Jeong-Hwa; Lee, Ki-Sup; Kim, Seol-Hee; Hwang, Jong-Kyung; Woo, Chanjin; Kim, Jiyeon; Kim, Jung-Hyun; Suh, Jae-Hwa; Jeong, Jipseol; Wang, Seung-Jun; Chung, Hyen-Mi; Yu, Seung-do; Choi, Kyung-Hee; Mo, In-Pil

2016-05-01

In this study, Global Positioning System satellite transmitters were attached to three mallards (Anas platyrhynchos) wintering in South Korea to track their migration routes, stopover sites, breeding sites, and migration patterns. We successfully tracked only one mallard (no. 108917) from November 15, 2011, to November 29, 2013, and determined separate migration routes in two cases of spring migration and one case of fall migration. The mallard repeatedly migrated to the same final destination, even though the travel path varied. We identified six stopover sites: Hunhe River, Liaohe River, Yinma River, Yalu River, Songjeon Bay, and Dahuofang Reservoir in China and South Korea. The wintering sites of two migration cases were discovered to be identical (Gokgyo River in Asan, South Korea). The terminal sites, which were presumed to be breeding grounds, were the same in both cases (Hinggan League in Inner Mongolia Autonomous Region, China). On the basis of the migration routes identified in this study, we suggest that future efforts to control highly pathogenic avian influenza (HPAI) should not only include avian influenza surveillance but also implement flyway-based strategies, with regard to all countries affected by potential HPAI outbreaks.

Negotiating the COAPRT Learning Outcomes Transition Using Quality Management Tools: A Case Study of the COAPRT Beta Test Site

ERIC Educational Resources Information Center

Ellis, Gary D.

2014-01-01

This paper is a case study. It tells the story of the process that the Council on Accreditation for Parks, Recreation, Tourism and Related Professions beta test site created its learning outcomes assessment program. A planning process was used that has evolved from quality management philosophy and practice: DMADV. Use of DMADV required precise…

Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort.

PubMed

Budhathoki, Sanjeev; Hidaka, Akihisa; Yamaji, Taiki; Sawada, Norie; Tanaka-Mizuno, Sachiko; Kuchiba, Aya; Charvat, Hadrien; Goto, Atsushi; Kojima, Satoshi; Sudo, Natsuki; Shimazu, Taichi; Sasazuki, Shizuka; Inoue, Manami; Tsugane, Shoichiro; Iwasaki, Motoki

2018-03-07

To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study. Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort. Nine public health centre areas across Japan. 3301 incident cases of cancer and 4044 randomly selected subcohort participants. Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference. Incidence of overall or site specific cancer. Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios. In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites. 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.

Maternal residential proximity to waste sites and industrial facilities and conotruncal heart defects in offspring.

PubMed

Langlois, Peter H; Brender, Jean D; Suarez, Lucina; Zhan, F Benjamin; Mistry, Jatin H; Scheuerle, Angela; Moody, Karen

2009-07-01

Most studies of the relationship between maternal residential proximity to sources of environmental pollution and congenital cardiovascular malformations have combined heart defects into one group or broad subgroups. The current case-control study examined whether risk of conotruncal heart defects, including subsets of specific defects, was associated with maternal residential proximity to hazardous waste sites and industrial facilities with recorded air emissions. Texas Birth Defects Registry cases were linked to their birth or fetal death certificate. Controls without birth defects were randomly selected from birth certificates. Distances from maternal addresses at delivery to National Priority List (NPL) waste sites, state superfund waste sites, and Toxic Release Inventory (TRI) facilities were determined for 1244 cases (89.5% of those eligible) and 4368 controls (88.0%). Living within 1 mile of a hazardous waste site was not associated with risk of conotruncal heart defects [adjusted odds ratio (aOR) = 0.83, 95% confidence interval (CI) = 0.54, 1.27]. This was true whether looking at most types of defects or waste sites. Only truncus arteriosus showed statistically elevated ORs with any waste site (crude OR: 2.80, 95% CI 1.19, 6.54) and with NPL sites (crude OR: 4.63, 95% CI 1.18, 13.15; aOR 4.99, 95% CI 1.26, 14.51), but the latter was based on only four exposed cases. There was minimal association between conotruncal heart defects and proximity to TRI facilities (aOR = 1.10, 95% CI = 0.91, 1.33). Stratification by maternal age or race/ethnic group made little difference in effect estimates for waste sites or industrial facilities. In this study population, maternal residential proximity to waste sites or industries with reported air emissions was not associated with conotruncal heart defects or its subtypes in offspring, with the exception of truncus arteriosus.

Integrating care for high-risk patients in England using the virtual ward model: lessons in the process of care integration from three case sites

PubMed Central

Lewis, Geraint; Vaithianathan, Rhema; Wright, Lorraine; Brice, Mary R; Lovell, Paul; Rankin, Seth; Bardsley, Martin

2013-01-01

Background Patients at high risk of emergency hospitalisation are particularly likely to experience fragmentation in care. The virtual ward model attempts to integrate health and social care by offering multidisciplinary case management to people at high predicted risk of unplanned hospitalisation. Objective To describe the care practice in three virtual ward sites in England and to explore how well each site had achieved meaningful integration. Method Case studies conducted in Croydon, Devon and Wandsworth during 2011–2012, consisting of semi-structured interviews, workshops, and site visits. Results Different versions of the virtual wards intervention had been implemented in each site. In Croydon, multidisciplinary care had reverted back to one-to-one case management. Conclusions To integrate successfully, virtual ward projects should safeguard the multidisciplinary nature of the intervention, ensure the active involvement of General Practitioners, and establish feedback processes to monitor performance such as the number of professions represented at each team meeting. PMID:24250284

Procedural Guide for Designation Surveys of Ocean Dredged Material Disposal Sites.

DTIC Science & Technology

1981-01-01

sites in the ocean will be executed by EPA or CE and will be based on Environmental studies of each site, and on historical knowledge of the impact...3 The results of the-s’ studies will be used to prepare an E-A and in some cases an EIS. An important provision regarding the number of separate...assessment for all sites within a particular geographic area may be prepared based on complete disposal site designation or evaluation studies on a typical

Green and sustainable remediation (GSR) evaluation: framework, standards, and tool. A case study in Taiwan.

PubMed

Huang, Wen-Yen; Hung, Weiteng; Vu, Chi Thanh; Chen, Wei-Ting; Lai, Jhih-Wei; Lin, Chitsan

2016-11-01

Taiwan has a large number of poorly managed contaminated sites in need of remediation. This study proposes a framework, a set of standards, and a spreadsheet-based evaluation tool for implementing green and sustainable principles into remediation projects and evaluating the projects from this perspective. We performed a case study to understand how the framework would be applied. For the case study, we used a spreadsheet-based evaluation tool (SEFA) and performed field scale cultivation tests on a site contaminated with total petroleum hydrocarbons (TPHs). The site was divided into two lots: one treated by chemical oxidation and the other by bioremediation. We evaluated five core elements of green and sustainable remediation (GSR): energy, air, water resources, materials and wastes, and land and ecosystem. The proposed evaluation tool and field scale cultivation test were found to efficiently assess the effectiveness of the two remediation alternatives. The framework and related tools proposed herein can potentially be used to support decisions about the remediation of contaminated sites taking into account engineering management, cost effectiveness, and social reconciliation.

Does site of buccal mucosa graft for bulbar urethra stricture affect outcome? A comparative analysis of ventral, dorso-lateral and dorsal buccal mucosa graft augmentation urethroplasty

PubMed Central

Pathak, Hemant R.; Jain, Tarunkumar Prakash; Bhujbal, Sachin A.; Meshram, Kunal R.; Gadekar, Chetan; Parab, Sandesh

2017-01-01

Objective To compare long- term outcomes of buccal mucosa graft (BMG) augmentation urethroplasty for long segment bulbar urethral strictures done by placing the graft ventrally, dorso-laterally and dorsally. Material and methods We conducted a single institution retrospective study on 112 who underwent BMG augmentation urethroplasty for non-traumatic bulbar urethral strictures between January 2005 to December 2014. The cases were divided into three groups based on the site of placement of BMG graft i.e. (a) Ventral (n=44), (b) Dorso-lateral (n=48) and (c) Dorsal (n=20). Follow-up period was from one year to five years. Patients with failed outcomes underwent urethroscopy or retrograde urethrogram to note the site of recurrence of stricture. Results Out of 112 cases 91 (81%) were successful and 21 (19%) failed. The success rates for ventral, dorso-lateral and dorsal BMG augmentation procedures were 89%, 79% and 70%, respectively (p=0.18). Among 21 failed cases, 12 cases (57%) had stricture at proximal anastomotic site, 4 cases (19%) at graft and 5 cases (24%) at distal anastomotic site (p=0.01). Conclusion The overall success rate for BMG augmentation urethroplasty is equal for all techniques. Ventral onlay urethroplasty provides better exposure of proximal anastomotic site thus it is associated with minimum proximal anastomotic site recurrence rates. Patients with extensive spongiofibrosis and long segment strictures had higher rates of failure. PMID:28861310

Does site of buccal mucosa graft for bulbar urethra stricture affect outcome? A comparative analysis of ventral, dorso-lateral and dorsal buccal mucosa graft augmentation urethroplasty.

PubMed

Pathak, Hemant R; Jain, Tarunkumar Prakash; Bhujbal, Sachin A; Meshram, Kunal R; Gadekar, Chetan; Parab, Sandesh

2017-09-01

To compare long- term outcomes of buccal mucosa graft (BMG) augmentation urethroplasty for long segment bulbar urethral strictures done by placing the graft ventrally, dorso-laterally and dorsally. We conducted a single institution retrospective study on 112 who underwent BMG augmentation urethroplasty for non-traumatic bulbar urethral strictures between January 2005 to December 2014. The cases were divided into three groups based on the site of placement of BMG graft i.e. (a) Ventral (n=44), (b) Dorso-lateral (n=48) and (c) Dorsal (n=20). Follow-up period was from one year to five years. Patients with failed outcomes underwent urethroscopy or retrograde urethrogram to note the site of recurrence of stricture. Out of 112 cases 91 (81%) were successful and 21 (19%) failed. The success rates for ventral, dorso-lateral and dorsal BMG augmentation procedures were 89%, 79% and 70%, respectively (p=0.18). Among 21 failed cases, 12 cases (57%) had stricture at proximal anastomotic site, 4 cases (19%) at graft and 5 cases (24%) at distal anastomotic site (p=0.01). The overall success rate for BMG augmentation urethroplasty is equal for all techniques. Ventral onlay urethroplasty provides better exposure of proximal anastomotic site thus it is associated with minimum proximal anastomotic site recurrence rates. Patients with extensive spongiofibrosis and long segment strictures had higher rates of failure.

Clinical outcomes with the corticotomy-first technique associated with the Ilizarov method for the management of the septic long bones non-union.

PubMed

Hosny, Gamal Ahmed; Ahmed, Abdel-Salam Abdel-Aleem; Hussein, Mohamed Abd-Elaal

2018-04-07

Corticotomy is an integral part of the Ilizarov method on management of infected nonunited fractures that are challenging orthopaedic surgeons. However, the presence of active draining sinuses may contaminate the operative field with the potential of developing corticotomy site infection. The authors present a surgical technique aiming at minimizing or avoiding the risk of surgical site infection (SSI) in the corticotomy zone. A total of 144 cases of draining infected nonunions were treated by Ilizarov fixator using the corticotomy-first technique. The study included humeral (18 cases), femoral (52 cases), and tibial (74 cases) nonunions. The mean age was 44.48 years with 87 males and 57 females. The mean duration of nonunion was 28.69 months. After debridement, the combined shortening and nonunion gap averaged 5.98 (range 3-10) cm. Evaluation of bone and functional results was done according to Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria. The follow-up period averaged 51.05 (range 36-72) months. None of the cases developed corticotomy site or distraction gap infection. Union was successfully achieved in 141 cases (97.92%). Nonunion persisted in three cases (2.08%) in the distal tibia. Infection was eventually controlled in 138 cases (95.83%). Bone grafting was not needed in any case. The Ilizarov fixator with the corticotomy-first technique was effective in the management of draining infected non-united fractures of long bones while avoiding the SSI in the corticotomy site in all cases.

A Case Study on the Impact of Homogenous Small Class Instruction as an Academic Intervention for At-Risk Students

ERIC Educational Resources Information Center

Mays, Jessica E.

2015-01-01

This case study examined the impact of a site-specific intervention for at-risk students in a small rural elementary school in the foothills of North Carolina. The research site uses a small homogenous class setting as a basis for accelerating academic growth for students who are considered at-risk in literacy based on the state-required literacy…

Beyond Description: Converting Web Site Usage Statistics into Concrete Site Improvement Ideas

ERIC Educational Resources Information Center

Arendt, Julie; Wagner, Cassie

2010-01-01

Web site usage statistics are a widely used tool for Web site development, but libraries are still learning how to use them successfully. This case study summarizes how Morris Library at Southern Illinois University Carbondale implemented Google Analytics on its Web site and used the reports to inform a site redesign. As the main campus library at…

Alternative Endpoints and Approaches Selected for the Remediation of Contaminated Groundwater at Complex Sites

NASA Astrophysics Data System (ADS)

Deeb, R. A.; Hawley, E.

2011-12-01

This presentation will focus on findings, statistics, and case studies from a recently-completed report for the Department of Defense's Environmental Security Technology Certification Program (ESTCP) (Project ER-0832) on alternative endpoints and alternative remedial strategies for groundwater remediation under a variety of Federal and state cleanup programs, including technical impracticability (TI) and other Applicable or Relevant and Appropriate Requirement (ARAR) waivers, state and local designations such as groundwater management zones, Alternate Concentration Limits (ACLs), use of monitored natural attenuation (MNA) over long timeframes, and more. The primary objective of the project was to provide environmental managers and regulators with tools, metrics, and information needed to evaluate alternative endpoints for groundwater remediation at complex sites. A statistical analysis of Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) sites receiving TI waivers will be presented as well as case studies of other types of alternative endpoints and alternative remedial strategies to illustrate the variety of approaches used at complex sites and the technical analyses used to predict and document cost, timeframe, and potential remedial effectiveness. Case studies provide examples of the flexible, site-specific, application of alternative endpoints and alternative remedial strategies that have been used in the past to manage and remediate groundwater contamination at complex sites. For example, at least 13 states consider some designation for groundwater containment in their corrective action policies, such as groundwater management zones, containment zones, and groundwater classification exemption areas. These designations typically indicate that groundwater contamination is present above permissible levels. Soil and groundwater within these zones are managed to protect human health and the environment. Lesson learned for the analyses conducted and the case studies evaluated allow for a more careful consideration of alternative, beneficial, and cost-effective cleanup objectives and metrics that can be achieved over the short-term (while eventually meeting long-term cleanup objectives or demonstrating the applicability of alternative endpoints), thus improving the site cleanup process at complex sites where appropriate.

Unintentional Epinephrine Auto-injector Injuries: A National Poison Center Observational Study.

PubMed

Anshien, Marco; Rose, S Rutherfoord; Wills, Brandon K

2016-11-24

Epinephrine is the only first-line therapeutic agent used to treat life-threatening anaphylaxis. Epinephrine auto-injectors are commonly carried by patients at risk for anaphylaxis, and reported cases of unintentional auto-injector injury have increased over the last decade. Modifications of existing designs and release of a new style of auto-injector are intended to reduce epinephrine auto-injector misuse. The aim of the study was to characterize reported cases of unintentional epinephrine auto-injector exposures from 2013 to 2014 and compare demographics, auto-injector model, and anatomical site of such exposures. The American Association of Poison Control Center's National Poison Data System was searched from January 1, 2013, to December 31, 2014, for cases of unintentional epinephrine auto-injector exposures. Anatomical site data were obtained from all cases reported to the Virginia Poison Center and participating regional poison center for Auvi-Q cases. A total of 6806 cases of unintentional epinephrine auto-injector exposures were reported to US Poison Centers in 2013 and 2014. Of these cases, 3933 occurred with EpiPen, 2829 with EpiPen Jr, 44 with Auvi-Q, and no case reported of Adrenaclick. The most common site of unintentional injection for traditional epinephrine auto-injectors was the digit or thumb, with 58% of cases for EpiPen and 39% of cases with EpiPen Jr. With Auvi-Q, the most common site was the leg (78% of cases). The number of unintentional epinephrine auto-injector cases reported to American Poison Centers in 2013-2014 has increased compared with previous data. Most EpiPen exposures were in the digits, whereas Auvi-Q was most frequently in the leg. Because of the limitations of Poison Center data, more research is needed to identify incidence of unintentional exposures and the effectiveness of epinephrine auto-injector redesign.

A New Perspective on Sustainable Soil Remediation-Case Study Suggests Novel Fungal Genera Could Facilitate in situ Biodegradation of Hazardous Contaminants.

PubMed

Czaplicki, L M; Cooper, E; Ferguson, P L; Stapleton, H M; Vilgalys, R; Gunsch, C K

2016-01-01

Deciding upon a cost effective and sustainable method to address soil pollution is a challenge for many remedial project managers. High pressure to quickly achieve cleanup goals pushes for energy-intensive remedies that rapidly address the contaminants of concern with established technologies, often leaving little room for research and development especially for slower treatment technologies, such as bioremediation, for the more heavily polluted sites. In the present case study, new genomic approaches have been leveraged to assess fungal biostimulation potential in soils polluted with particularly persistent hydrophobic contaminants. This new approach provides insights into the genetic functions available at a given site in a way never before possible. In particular, this article presents a case study where next generation sequencing (NGS) has been used to categorize fungi in soils from the Atlantic Wood Industries Superfund site in Portsmouth, Virginia. Data suggest that original attempts to harness fungi for bioremediation may have focused on fungal genera poorly suited to survive under heavily polluted site conditions, and that more targeted approaches relying on native indigenous fungi which are better equipped to survive under site specific conditions may be more appropriate.

A New Perspective on Sustainable Soil Remediation—Case Study Suggests Novel Fungal Genera Could Facilitate in situ Biodegradation of Hazardous Contaminants

PubMed Central

Czaplicki, L.M.; Cooper, E.; Ferguson, P.L.; Stapleton, H.M.; Vilgalys, R.; Gunsch, C.K.

2016-01-01

Deciding upon a cost effective and sustainable method to address soil pollution is a challenge for many remedial project managers. High pressure to quickly achieve cleanup goals pushes for energy-intensive remedies that rapidly address the contaminants of concern with established technologies, often leaving little room for research and development especially for slower treatment technologies, such as bioremediation, for the more heavily polluted sites. In the present case study, new genomic approaches have been leveraged to assess fungal biostimulation potential in soils polluted with particularly persistent hydrophobic contaminants. This new approach provides insights into the genetic functions available at a given site in a way never before possible. In particular, this article presents a case study where next generation sequencing (NGS) has been used to categorize fungi in soils from the Atlantic Wood Industries Superfund site in Portsmouth, Virginia. Data suggest that original attempts to harness fungi for bioremediation may have focused on fungal genera poorly suited to survive under heavily polluted site conditions, and that more targeted approaches relying on native indigenous fungi which are better equipped to survive under site specific conditions may be more appropriate. PMID:27917031

Using unassisted ecosystem development to restore marginal land case study of post mining areas

NASA Astrophysics Data System (ADS)

Frouz, Jan

2017-04-01

When we evaluate efficiency of individual restoration measures we typically compare individual restoration treatments or compare them with initial state or similar ecosystem in surrounding landscape. We argue that sensible way to show added value of restoration measure is to compare them with unassisted ecosystem development. Case study of ecosystem development in Sokolov post mining district (Czech Republic) show that spontaneous succession of ecosystem can be, in many parameters, comparable with various reclamation approaches. In suitable substrates the succession is driven mainly by site topography. In sites which were leveled grassy vegetation develops. In sites where original wave like topography was preserved the ecosystem develops towards forest. In forest sites the development on most of the investigated ecosystem parameters (cower, biomass soil developments, water holding capacity, carbon storage) in succession sites is little bit slower compare to reclaimed plantation during first 15-20 years. However in older sites differences disappear and succession sites show similarity with restored sites. Despite similarity in these ecosystem functions possibilities of spontaneous sites for commercial use has to be explored.

SUMMARY OF TECHNIQUES AND UNIQUE USES FOR DIRECT PUSH METHODS IN SITE CHARACTERIZATION ON CONTAMINATED FIELD SITES

EPA Science Inventory

Site characterization of subsurface contaminant transport is often hampered by a lack of knowledge of site heterogeneity and temporal variations in hydrogeochemistry. Two case studies are reviewed to illustrate the utility of macro-scale mapping information along with spatially-...

Discovering How Students Search a Library Web Site: A Usability Case Study.

ERIC Educational Resources Information Center

Augustine, Susan; Greene, Courtney

2002-01-01

Discusses results of a usability study at the University of Illinois Chicago that investigated whether Internet search engines have influenced the way students search library Web sites. Results show students use the Web site's internal search engine rather than navigating through the pages; have difficulty interpreting library terminology; and…

Ultrasound-Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study.

PubMed

Zipfel, Jonathan; Kastler, Adrian; Tatu, Laurent; Behr, Julien; Kechidi, Rachid; Kastler, Bruno

2016-01-01

Two studies recently reported that computed tomography (CT) guided infiltration of the greater occipital nerve at its intermediate site allows a high efficacy rate with long-lasting pain relief following procedure in occipital neuralgia and in various craniofacial pain syndromes. The purpose of our study was to evaluate the technical feasibility and safety of ultrasound-guided intermediate site greater occipital nerve infiltration. Retrospective study. This study was conducted at the imaging department of a 1,409 bed university hospital. Local institutional review board approval was obtained and written consent was waived. In this retrospective study, 12 patients suffering from refractory occipital neuralgia or craniofacial pain syndromes were included between April and October 2014. They underwent a total of 21 ultrasound-guided infiltrations. Infiltration of the greater occipital nerve was performed at the intermediate site of the greater occipital nerve, at its first bend between obliqus capitis inferior and semispinalis capitis muscles with local anestetics and cortivazol. Technical success was defined as satisfactory diffusion of added iodinated contrast media in the fatty space between these muscles depicted on control CT scan. We also reported first data of immediate block test efficacy and initial clinical efficacy at 7 days, one month, and 3 months, defined by a decrease of at least 50% of visual analog scale (VAS) scores. Technical success rate was 95.24%. Patients suffered from right unilateral occipital neuralgia in 3 cases, left unilateral occipital neuralgia in 2 cases, bilateral occipital neuralgia in 2 cases, migraine in one case, cervicogenic headache in one case, tension-type headache in 2 cases, and cluster headache in one case. Block test efficacy was found in 93.3% (14/15) cases. Clinical efficacy was found in 80% of cases at 7 days, in 66.7% of cases at one month and in 60% of cases at 3 months. No major complications were noted. Some of the limitations of our study include that it represents a single institution. The low number of infiltrations included in this study, for this guidance procedure, is another bias. This ultrasound-guided infiltration technique appears to be feasible, safe, non-ionizing, and fast when targeting the greater occipital nerve in its intermediate portion. This imaging guidance modality should be used in routine clinical practice. Greater occipital nerve, infiltration, ultrasound guidance, corticosteroids, occipital neuralgia, craniofacial pain syndrome.

Collaborating for care: initial experience of embedded case managers across five medical homes.

PubMed

Treadwell, Janet; Giardino, Angelo

2014-01-01

The purpose of this intervention was to answer the following question: Does an embedded nurse case manager from a health plan performing embedded care coordination and supporting a quality improvement project impact medical home service use, role satisfaction, and per member per month expense? The setting for this study was primary care medical home practices with a minimum of 1,000 lives, contracted with a health plan delivering Medicaid and Children's Health Insurance coverage. Five medical home practice sites were selected for the intervention. The study began with case manager training and project permission in 5 medical homes, followed by implementation of care coordination with health plan clients. The nurse case manager performed care coordination functions for clients and initiated a Lean Six Sigma quality improvement project at the medical home site. The analysis strategy was to compare each medical home with itself before and after the intervention, as well as to obtain satisfaction information from medical home staff and care coordinators. Reductions in expense, as demonstrated by decreased per member per month claim cost, admissions per thousand, and reduced variation in days per thousand, were documented. Quality projects attained significant improvements in 4 out of 5 sites, and practice staff as well as case managers described satisfaction with the embedded nurse case manager role. These findings support medical homes as being an effective delivery model of the Affordable Care Act. Case managers who practice in primary care sites can make a significant difference in patient outcomes and practice efficiencies. Embedded case managers have the ability to impact the population being served through modeling and supporting interprofessional relationships and case management expertise. Use of motivational interviewing, assessment skills, advocacy, and joint care planning engage patients in their own care, whereas quality initiatives bring efficiencies and effectiveness to overall operations. There is need for research to be conducted across a larger number of practice sites and diverse populations to substantiate the effect of embedded case management in medical home.

How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

ERIC Educational Resources Information Center

Fallek, Max

This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

Well Casing Baseline Analysis for the Big Hill Strategic Petroleum Reserve Site

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

Moriarty, Dylan Michael; Roberts, Barry L.

This report analyzes data from multi-arm caliper (MAC) surveys taken at the Big Hill SPR site to determine the most likely casing weights within each well. Radial arm data from MAC surveys were used to calculate the approximate wall thickness of each well. Results from this study indicate that (1) most wells at the site have thinner wall thicknesses than expected, (2) most wells experienced an acute increase in diameter near the salt/caprock interface, and (3) there were isolated instances of well sections being the wrong casing weight. All three findings could have a negative impact on well integrity.

Outbreak of legionnaires' disease from a cooling water system in a power station.

PubMed

Morton, S; Bartlett, C L; Bibby, L F; Hutchinson, D N; Dyer, J V; Dennis, P J

1986-09-01

In September and October 1981 six cases of pneumonia occurred among men working in a power station under construction. Three were identified as cases of legionella pneumonia and two others had serology suggestive of legionella infection. In a sample of 92 men from the site 10 had low levels of antibodies to legionella; a similar sample of men working on an adjacent site showed none with positive serology. In a case control study it was found that cases of pneumonia were more likely than controls to have worked on a part of the site where four small capacity cooling towers were located. Legionella pneumophila serogroup 1 was isolated from the water systems of these four towers but was not found in samples from any other cooling towers or hot or cold water outlets on the site. It would appear that there was airborne spread of the organism from these cooling water systems which had not received conventional treatment to inhibit corrosion and organic growth. This is the first outbreak of legionnaires' disease to be recorded in an industrial setting in the United Kingdom. No cases of legionella infection have occurred on the site since the introduction of control measures.

A Mixed Methods Sampling Methodology for a Multisite Case Study

ERIC Educational Resources Information Center

Sharp, Julia L.; Mobley, Catherine; Hammond, Cathy; Withington, Cairen; Drew, Sam; Stringfield, Sam; Stipanovic, Natalie

2012-01-01

The flexibility of mixed methods research strategies makes such approaches especially suitable for multisite case studies. Yet the utilization of mixed methods to select sites for these studies is rarely reported. The authors describe their pragmatic mixed methods approach to select a sample for their multisite mixed methods case study of a…

Monitored Natural Attenuation Case Study Evaluations

EPA Science Inventory

Monitored natural attenuation (MNA) has been selected as a component of groundwater remedies at several sites with metals and/or radionuclide contamination. An overview of the site characterization effort and remedy performance will be provided for several sites where MNA was se...

Three-Dimensional Implant Positioning with a Piezosurgery Implant Site Preparation Technique and an Intraoral Surgical Navigation System: Case Report.

PubMed

Pellegrino, Gerardo; Taraschi, Valerio; Vercellotti, Tomaso; Ben-Nissan, Besim; Marchetti, Claudio

This case report describes new implant site preparation techniques joining the benefits of using an intraoral navigation system to optimize three-dimensional implant site positioning in combination with an ultrasonic osteotomy. A report of five patients is presented, and the implant positions as planned in the navigation software with the postoperative scan image were compared. The preliminary results are useful, although further clinical studies with larger populations are needed to confirm these findings.

Direction, site and the muzzle target distance of bullet in the head and neck at close range as an indication of suicide or homicide.

PubMed

Suwanjutha, T

1988-05-01

Direction, site and muzzle target distance can indicate suicide or homicide. This conclusion can be drawn from autopsies of 57 cases of suicide and 68 cases of homicide by handgun fired at close range to the head and neck together with going to the crimescene in some cases. This study was carried out in Bangkok during the period from January 1983 to January 1986. In order to determine whether it was suicide or homicide, the path of the bullet, the site, the muzzle target distance must be considered. The angle of the bullet would be either elevated (from below upward), horizontal or an angle of depression (from above downward). For suicide, the direction of the bullet should be at an angle of elevation in the majority of cases. The position of the handgun in relation to the head in suicide was most often in tight contact and near contact. For homicide, the direction of the bullet should be horizontal in most cases. The bullet was at close range in the majority of the cases. There are 8 common sites for suicide and homicide and 10 different sites in the case of homicide which are at neck, left cheek, left aural region, lip, left occipital area orbit, chin, left eyebrow, submental and nose.

Influence of ballistic and autopsy parameters on the manner of death in case of long firearms fatalities.

PubMed

de la Grandmaison, Geoffroy Lorin; Fermanian, Christophe; Aegerter, Philippe; Durigon, Michel

2008-05-20

A retrospective study was carried out on 132 fatalities due to gunshot wounds secondary to long firearms. One group of suicide (n=72) and one group of homicide (n=60) were statistically compared regarding age and sex of the victim, number of shots, range of fire, direction of the projectile(s), anatomical distribution of entrance sites, weapon and ammunition types and the nature of eventual associated traumatic lesions. The frequency of suicide was higher when the victim's age increased. Females constituted about 43% of the homicide victims and about 8% of the suicide victims. 51.5% of the homicide victims and about 10% of the suicide victims had sustained more than one gunshot wound. Close range was respectively found in 53.5% of the homicide cases and in all suicide cases. Most of the suicide cases (85% of the cases) showed typical entrance sites. Entrance sites in the limbs and lateral or posterior wall of the chest were only encountered in homicide cases. Associated traumatic lesions were found in about 23% of the homicide cases and in 18% of the suicide cases. In case of suicidal gunshots to the left chest, both upwards and downwards directions, and also both right-to-left and left-to-right directions can occur. From 22 suicide cases showing entrance wound in the mouth, a downwards direction was found in only one. This study underlines the importance but also the limits of the autopsy findings (including direction of the projectile(s) related to the entrance site) for giving an indication of the manner of death (homicide vs. suicide).

Intraoperative visible bubbling of air may be the first sign of venous air embolism during posterior surgery for scoliosis.

PubMed

Wills, John; Schwend, Richard M; Paterson, Andrew; Albin, Maurice S

2005-10-15

Case report of two children sustaining venous air embolism (VAE) during posterior surgery for scoliosis. To report 2 cases where visible bubbling at the operative site was the first clinical indication of VAE-induced cardiovascular collapse and to raise the level of consciousness that VAE in the prone position can occur, often with serious consequences. Twenty-two cases of VAE during surgery for scoliosis in the prone position have been reported. Ten were fatal and ten were in children. Visible bubbling at the operative site was noted in two published cases. Retrospective study of 2 cases of VAE at one institution. Clinical, anesthetic, and radiographic features are presented. Details of previously published cases are reviewed and discussed. Both patients were girls with adolescent scoliosis who underwent prone positioned posterior spinal fusion with instrumentation. Visible bubbling of air at the thoracic aspect of the surgical site was noted near the completion of instrumentation and was the first indication of VAE. In both cases, this was clinically recognized and promptly treated. One patient survived normally and the other died. Visible air bubbling at the operative site may herald the onset of massive VAE during multilevel posterior spinal fusion and instrumentation. A prospective multicenter study using precordial Doppler, central venous catheter, and end-tidal CO2 is recommended to determine the true incidence of VAE in spinal deformity surgery and to evaluate monitoring and treatment methods.

Case Study: del Amo Bioventing

EPA Science Inventory

The attached presentation discusses the fundamentals of bioventing in the vadose zone. The basics of bioventing are presented. The experience to date with the del Amo Superfund Site is presented as a case study.

Is Privacy at Risk when Commercial Websites Target Primary School Children? A Case Study in Korea

ERIC Educational Resources Information Center

Kim, Sora; Yi, Soon-Hyung

2010-01-01

This study discusses privacy risk factors when commercial web sites target primary school children in Korea. Specifically, the authors examined types of personal information required for membership subscriptions and whether privacy policies at commercial sites for children abide by privacy guidelines. A total of 159 commercial sites targeting…

Study of New Youth Initiatives in Apprenticeship. Interim Report. Volume 2: Site Visit Reports.

ERIC Educational Resources Information Center

CSR, Inc., Washington, DC.

This second volume of the interim report provides detailed case study reports on each of the eight Youth Apprenticeship Projects. (Volume 1, an overview of data from the site visits, is available separately as CE 032 791.) Discussion areas covered in each site visit report are local context/operational environment, administrative information,…

Ecological, political and social challenges of prescribed fire restoration in east Texas pineywoods ecosystems: a case study

Treesearch

Sandra Rideout; Brian P. Oswald; Michael H. Legg

2003-01-01

The effectiveness of prescribed fire restoration of forested sites in three state parks in east Texas, USA was studied. Two sites consisted of mixed shortleaf (Pinus echinata Mill.) or loblolly pine (Pinus taeda L.) and broadleaf overstoreys. The third site was a longleaf pine (Pinus palustris Mill.)/little...

Geographic Risk for Lyme Disease and Human Granulocytic Ehrlichiosis in Southern New York State†

PubMed Central

Daniels, Thomas J.; Boccia, Theresa M.; Varde, Shobha; Marcus, Jonathan; Le, Jianhua; Bucher, Doris J.; Falco, Richard C.; Schwartz, Ira

1998-01-01

Ixodes scapularis, the tick vector of Lyme disease and human granulocytic ehrlichiosis (HGE), is prevalent in much of southern New York state. The distribution of this species has increased, as have reported cases of both Lyme disease and HGE. The unreliability of case reports, however, demonstrates the need for tick and pathogen surveillance in order to accurately define areas of high risk. In this study, a total of 89,550 m2 at 34 study sites was drag sampled in 1995 and a total of 51,540 m2 at 40 sites was sampled in 1996 to determine tick and pathogen distribution in southern New York state. I. scapularis was collected from 90% of the sites sampled, and regionally, a 2.5-fold increase in nymphal abundance occurred from 1995 to 1996. I. scapularis individuals from all sites were infected with Borrelia burgdorferi in 1995, while an examination of ticks for both B. burgdorferi and the agent of HGE in 1996 confirmed that these organisms were present in all counties; the average coinfection rate was 1.9%. No correlation was found between estimated risk and reported cases of Lyme disease. The geographic disparity of risk observed among sites in this study underscores the need for vector and pathogen surveillance on a regional level. An entomologic risk index can help identify sites for targeted tick control efforts. PMID:9835546

A comparison of single- and multi-site calibration and validation: a case study of SWAT in the Miyun Reservoir watershed, China

NASA Astrophysics Data System (ADS)

Bai, Jianwen; Shen, Zhenyao; Yan, Tiezhu

2017-09-01

An essential task in evaluating global water resource and pollution problems is to obtain the optimum set of parameters in hydrological models through calibration and validation. For a large-scale watershed, single-site calibration and validation may ignore spatial heterogeneity and may not meet the needs of the entire watershed. The goal of this study is to apply a multi-site calibration and validation of the Soil andWater Assessment Tool (SWAT), using the observed flow data at three monitoring sites within the Baihe watershed of the Miyun Reservoir watershed, China. Our results indicate that the multi-site calibration parameter values are more reasonable than those obtained from single-site calibrations. These results are mainly due to significant differences in the topographic factors over the large-scale area, human activities and climate variability. The multi-site method involves the division of the large watershed into smaller watersheds, and applying the calibrated parameters of the multi-site calibration to the entire watershed. It was anticipated that this case study could provide experience of multi-site calibration in a large-scale basin, and provide a good foundation for the simulation of other pollutants in followup work in the Miyun Reservoir watershed and other similar large areas.

Evaluating Contaminant Flux from the Vadose Zone to the Groundwater in the Hanford Central Plateau. SX Tank Farms Case Study

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

Truex, Michael J.; Oostrom, Martinus; Last, George V.

At the DOE Hanford Site, contaminants were discharged to the subsurface through engineered waste sites in the Hanford Central Plateau. Additional waste was released through waste storage tank leaks. Much of the contaminant inventory is still present within the unsaturated vadose zone sediments. The nature and extent of future groundwater contaminant plumes and the growth or decline of current groundwater plumes beneath the Hanford Central Plateau are a function of the contaminant flux from the vadose zone to the groundwater. In general, contaminant transport is slow through the vadose zone and it is difficult to directly measure contaminant flux inmore » the vadose zone. Predictive analysis, supported by site characterization and monitoring data, was applied using a structured, systems-based approach to estimate the future contaminant flux to groundwater in support of remediation decisions for the vadose zone and groundwater (Truex and Carroll 2013). The SX Tank Farm was used as a case study because of the existing contaminant inventory in the vadose zone, observations of elevated moisture content in portions of the vadose zone, presence of a limited-extent groundwater plume, and the relatively large amount and wide variety of data available for the site. Although the SX Tank Farm case study is most representative of conditions at tank farm sites, the study has elements that are also relevant to other types of disposal sites in the Hanford Central Plateau.« less

The interplay of contextual elements in implementation: an ethnographic case study.

PubMed

McCullough, Megan B; Chou, Ann F; Solomon, Jeffrey L; Petrakis, Beth Ann; Kim, Bo; Park, Angela M; Benedict, Ashley J; Hamilton, Alison B; Rose, Adam J

2015-02-14

Contextual elements have significant impact on uptake of health care innovations. While existing conceptual frameworks in implementation science suggest contextual elements interact with each other, little research has described how this might look in practice. To bridge this gap, this study identifies the interconnected patterns among contextual elements that influence uptake of an anticoagulation clinic improvement initiative. We completed 51 semi-structured interviews and ethnographic observations across five case study sites involved in an evidence-based practice (EBP) quality improvement initiative. We analyzed data in NVivo 10 using an a priori approach based on the Promoting Action on Research Implementation in Health Services (PARIHS) model and an emergent thematic analysis. Key contextual elements, such as leadership, teamwork, and communication, interacted with each other in contributing to site-level uptake of the EBP, often yielding results that could not be predicted by looking at just one of these elements alone. Sites with context conducive to change in these areas predictably had high uptake, while sites with uniformly weak contextual elements had low uptake. Most sites presented a mixed picture, with contextual elements being strongly supportive of change in some areas and weak or moderate in others. In some cases, we found that sites with strong context in at least one area only needed to have adequate context in other areas to yield high uptake. At other sites, weak context in just one area had the potential to contribute to low uptake, despite countervailing strengths. Even a site with positive views of EBPs could not succeed when context was weak. Interrelationships among different contextual elements can act as barriers to uptake at some sites and as facilitators at others. Accounting for interconnections among elements enables PARIHS to more fully describe the determinants of successful implementation as they operate in real-world settings.

HYDROGEOLOGIC CASE STUDIES

EPA Science Inventory

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

Abstracts of Remediation Case Studies, Volume 9

EPA Pesticide Factsheets

This report, published by the Federal Remediation Technologies Roundtable (FRTR), is a collection of recently published abstracts summarizing 13 cost and performance case studies on the use of remediation technologies at contaminated sites.

Evaluating the Effectiveness of Natura 2000 Network for Wolf Conservation: A Case-Study in Greece

NASA Astrophysics Data System (ADS)

Votsi, Nefta-Eleftheria P.; Zomeni, Maria S.; Pantis, J. D.

2016-02-01

The wolf ( Canis lupus) is used as a case study to rate Natura 2000 sites in Greece based on preferred wolf habitat characteristics and test whether the network is suitable for their conservation. Road density, agricultural area, site area, connectivity, food availability (i.e., presence of natural prey), and elevation in 237 sites are combined in a logistic regression model. The occurrence of the wolf's natural prey was the most prevalent factor determining wolf presence, followed by agricultural cover. Considering the current status of these features at N2K site level, most sites currently hosting wolves (85.7 %) have good or excellent prospects for the long-term presence of the wolf. On the contrary, 11 sites which now have wolves are predicted to be ineffective in keeping them in the future due to the absence of wild ungulates and their high agricultural coverage. Four sites with no wolf presence currently have excellent prospects to host wolves in the future. Roadless sites are a priority for protection and retaining their current condition is strongly suggested. The proposed approach aims to detect gaps in protection for the wolf and identify priority sites in need of mitigation actions. It can also assist the assessment of conservation policies in Greece and elsewhere toward accomplishing set goals in protected areas. By focusing on wolf protection, we hope to increase agencies' attention to deal with conservation effectiveness, especially in cases like Greece, where a number of sites are insufficiently known and protected and management measures are not properly implemented.

Systems-Oriented Workplace Learning Experiences for Early Learners: Three Models.

PubMed

O'Brien, Bridget C; Bachhuber, Melissa R; Teherani, Arianne; Iker, Theresa M; Batt, Joanne; O'Sullivan, Patricia S

2017-05-01

Early workplace learning experiences may be effective for learning systems-based practice. This study explores systems-oriented workplace learning experiences (SOWLEs) for early learners to suggest a framework for their development. The authors used a two-phase qualitative case study design. In Phase 1 (spring 2014), they prepared case write-ups based on transcribed interviews from 10 SOWLE leaders at the authors' institution and, through comparative analysis of cases, identified three SOWLE models. In Phase 2 (summer 2014), studying seven 8-week SOWLE pilots, the authors used interview and observational data collected from the seven participating medical students, two pharmacy students, and site leaders to construct case write-ups of each pilot and to verify and elaborate the models. In Model 1, students performed specific patient care activities that addressed a system gap. Some site leaders helped students connect the activities to larger systems problems and potential improvements. In Model 2, students participated in predetermined systems improvement (SI) projects, gaining experience in the improvement process. Site leaders had experience in SI and often had significant roles in the projects. In Model 3, students worked with key stakeholders to develop a project and conduct a small test of change. They experienced most elements of an improvement cycle. Site leaders often had experience with SI and knew how to guide and support students' learning. Each model could offer systems-oriented learning opportunities provided that key elements are in place including site leaders facile in SI concepts and able to guide students in SOWLE activities.

Effects of the number of people on efficient capture and sample collection: a lion case study.

PubMed

Ferreira, Sam M; Maruping, Nkabeng T; Schoultz, Darius; Smit, Travis R

2013-05-24

Certain carnivore research projects and approaches depend on successful capture of individuals of interest. The number of people present at a capture site may determine success of a capture. In this study 36 lion capture cases in the Kruger National Park were used to evaluate whether the number of people present at a capture site influenced lion response rates and whether the number of people at a sampling site influenced the time it took to process the collected samples. The analyses suggest that when nine or fewer people were present, lions appeared faster at a call-up locality compared with when there were more than nine people. The number of people, however, did not influence the time it took to process the lions. It is proposed that efficient lion capturing should spatially separate capture and processing sites and minimise the number of people at a capture site.

Case study: development of and stakeholder responses to a nursing home consumer information system.

PubMed

O'Meara, Janis; Kitchener, Martin; Collier, Eric; Lyons, Margaret; de Billwiller-Kiss, Ana; Simon, Lisa Payne; Harrington, Charlene

2005-01-01

California Nursing Home Search (www.calnhs.org), launched in October 2002, provides information about nursing home quality to a broad range of stakeholders. This case study discusses the process of developing a consumer-oriented nursing home Web site and presents an analysis of postlaunch responses from a number of sources (i.e., media, outreach, Web site use, correspondence, meetings, interviews) to determine the impact of the site and how it can be improved and used as an example. Consumers found the Web site valuable, but some needed clarification on navigation. Providers had complaints about the use of quality ratings and concerns about public availability of the data. Most discharge planners and care managers do not use Internet resources to find facilities. Feedback, modifications, updates, and outreach are needed on a continuous basis to ensure the site is a helpful tool for all stakeholders.

Rural Midwestern Public College Safe Ride Program Case Study

ERIC Educational Resources Information Center

Mohfeld, Kathy I.

2017-01-01

The central phenomenon researched in this case study was higher education administrators' decisions to institutionalize a safe ride program at a small, rural college. The purpose of this single/within-site case study was to describe the changes that happened at a rural public institution of higher education and the surrounding community in the…

Overview of EPA's Approach to Developing Prospective Case Studies Technical Workshop: Case Studies to Assess Potential Impacts of Hydraulic Fracturing on Drinking Water Resources

EPA Science Inventory

One component of the United States Environmental Protection Agency's (EPA) study of the potential impacts of hydraulic fracturing on drinking water resources is prospective case studies, which are being conducted to more fully understand and assess if and how site specific hydrau...

Enhanced Web-Based Otitis Study Case vs Simple Paper-Case: Impact on Medical Student Objective Structured Clinical Exam (OSCE) Performance.

PubMed

Malloy, Michael H

2002-12-01

Distance education methods have taken on greater importance as medical student education has moved off campus into the community. What the best methods are for conveying information to students at distant sites has not been determined. To determine if students at distant community sites who received an otitis media study case by e-mail that was enhanced with a referral to a web-based otitis study case, performed better on otitis OSCE stations than students who received the same case not enhanced with visuals or referrals to a web-based otitis case. Students were randomized by community site to receive either the enhanced (E) or simple otitis study case (S). Students were e-mailed an otitis media study case during the 5th week of the rotation. Those randomized to the E-case received a case that started with a case scenario followed by a "Task" that instructed them to go to this web address: http://www.aap.org/otitismedia/www/vc/ear/index.cfm (American Academy of Pediatrics Otitis Web Site). They were then to select "Case 1" which was a continuation of the case scenario present on their e-mail. A list of learning objectives was also printed on the e-mail. Students receiving the S-case viewed the same case scenario and objectives, but were not instructed to go to the web-page. All students rotated through two OSCE otitis stations. In the first station they interviewed a simulated patient(OSCE-SP) and counseled her on the management of her 12 month old with otitis. Within that station they viewed a video of a pneumoscopic exam of two ears, one ear with otitis and the other ear normal. At the 2 nd otitis station the student presented the case to a faculty and was asked a series of questions about otitis media(OSCE-PR). Scores on the two stations were compared by group. There were 198 students who took the OSCE. 178 (90%) responded to a survey that indicated they had opened and read the e-mailed case. There were 87 students in the E-group and 91 in the S-group. The mean ±s.d. OSCE-SP station score for the E-group was 72.6 ±12.0 vs 75.4 ±9.8 for the S-group, p=0.09. For the otitis presentation station the scores for the E-group and S-group were respectively, 82.9 ±9.6 and 83.7 ±9.4, p=0.55. These data suggest that enhanced visual distance education cases may offer no distinct advantage over simple paper-type case study guides.

Influenza-associated severe acute respiratory infections in 2 sentinel sites in Lebanon-September 2015 to August 2016.

PubMed

Saleh, Majd; Bazzi, Lara; Ismail, Ebstissam; Mroueh, Lina; Jammal, Nisrine; Elkholy, Amgad; Mrad, Pamela; Samadi, Ahmad Al; Hijazi, Ahmad; Abiad, Firass; Nsouli, Ghazi; Rady, Alissar; Khan, Wasiq; Malik, Mamunur; Zalloua, Pierre; Ammar, Walid; Ghosn, Nada

2018-05-01

Given the sparse information on the burden of influenza in Lebanon, the Ministry of Public Health established a sentinel surveillance for severe acute respiratory infections (SARI) to identify the attribution of influenza to reported cases. We aim to highlight the proportion of influenza-associated SARI from September 1st, 2015 to August 31st, 2016 in 2 Lebanese hospitals. The study was conducted in 2 sentinel sites located in Beirut suburbs and southern province of Lebanon. WHO's 2011 standardized SARI case definition was used. Data from September 1, 2015 to August 31, 2016 were reviewed, and all-cause hospital admission numbers were obtained. Nasopharyngeal swabs were collected and tested by RT-PCR. Descriptive and bivariate analyses were conducted using STATA 13. The 2 sentinel sites reported 746 SARI cases during the studied time frame: 467 from the southern province site and 279 from the Beirut suburbs site. SARI reports peaked between January and March 2016. All, except 4, cases were sampled, and a co-dominance of influenza B (43%) and influenza A (H1N1) (41%) was evident. A high proportion of cases was reported in children <2 years 274 (37%). The proportional contribution of influenza-associated SARI to all-cause hospital admissions was high in children <2 years in the south (4.5% [95% CI: 3.1-6.5]) and in children <5 years in Beirut (0.7% [95% CI: 0.6-0.8]). This is the first study to highlight the proportion of influenza-associated SARI in 2 hospitals in Lebanon. The findings will be beneficial for supporting respiratory prevention and immunization program policies. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Standardization of Clinical Assessment and Sample Collection Across All PERCH Study Sites

PubMed Central

Prosperi, Christine; Baggett, Henry C.; Brooks, W. Abdullah; Deloria Knoll, Maria; Hammitt, Laura L.; Howie, Stephen R. C.; Kotloff, Karen L.; Levine, Orin S.; Madhi, Shabir A.; Murdoch, David R.; O’Brien, Katherine L.; Thea, Donald M.; Awori, Juliet O.; Bunthi, Charatdao; DeLuca, Andrea N.; Driscoll, Amanda J.; Ebruke, Bernard E.; Goswami, Doli; Hidgon, Melissa M.; Karron, Ruth A.; Kazungu, Sidi; Kourouma, Nana; Mackenzie, Grant; Moore, David P.; Mudau, Azwifari; Mwale, Magdalene; Nahar, Kamrun; Park, Daniel E.; Piralam, Barameht; Seidenberg, Phil; Sylla, Mamadou; Feikin, Daniel R.; Scott, J. Anthony G.; O’Brien, Katherine L.; Levine, Orin S.; Knoll, Maria Deloria; Feikin, Daniel R.; DeLuca, Andrea N.; Driscoll, Amanda J.; Fancourt, Nicholas; Fu, Wei; Hammitt, Laura L.; Higdon, Melissa M.; Kagucia, E. Wangeci; Karron, Ruth A.; Li, Mengying; Park, Daniel E.; Prosperi, Christine; Wu, Zhenke; Zeger, Scott L.; Watson, Nora L.; Crawley, Jane; Murdoch, David R.; Brooks, W. Abdullah; Endtz, Hubert P.; Zaman, Khalequ; Goswami, Doli; Hossain, Lokman; Jahan, Yasmin; Ashraf, Hasan; Howie, Stephen R. C.; Ebruke, Bernard E.; Antonio, Martin; McLellan, Jessica; Machuka, Eunice; Shamsul, Arifin; Zaman, Syed M.A.; Mackenzie, Grant; Scott, J. Anthony G.; Awori, Juliet O.; Morpeth, Susan C.; Kamau, Alice; Kazungu, Sidi; Kotloff, Karen L.; Tapia, Milagritos D.; Sow, Samba O.; Sylla, Mamadou; Tamboura, Boubou; Onwuchekwa, Uma; Kourouma, Nana; Toure, Aliou; Madhi, Shabir A.; Moore, David P.; Adrian, Peter V.; Baillie, Vicky L.; Kuwanda, Locadiah; Mudau, Azwifarwi; Groome, Michelle J.; Baggett, Henry C.; Thamthitiwat, Somsak; Maloney, Susan A.; Bunthi, Charatdao; Rhodes, Julia; Sawatwong, Pongpun; Akarasewi, Pasakorn; Thea, Donald M.; Mwananyanda, Lawrence; Chipeta, James; Seidenberg, Phil; Mwansa, James; wa Somwe, Somwe; Kwenda, Geoffrey

2017-01-01

Abstract Background. Variable adherence to standardized case definitions, clinical procedures, specimen collection techniques, and laboratory methods has complicated the interpretation of previous multicenter pneumonia etiology studies. To circumvent these problems, a program of clinical standardization was embedded in the Pneumonia Etiology Research for Child Health (PERCH) study. Methods. Between March 2011 and August 2013, standardized training on the PERCH case definition, clinical procedures, and collection of laboratory specimens was delivered to 331 clinical staff at 9 study sites in 7 countries (The Gambia, Kenya, Mali, South Africa, Zambia, Thailand, and Bangladesh), through 32 on-site courses and a training website. Staff competency was assessed throughout 24 months of enrollment with multiple-choice question (MCQ) examinations, a video quiz, and checklist evaluations of practical skills. Results. MCQ evaluation was confined to 158 clinical staff members who enrolled PERCH cases and controls, with scores obtained for >86% of eligible staff at each time-point. Median scores after baseline training were ≥80%, and improved by 10 percentage points with refresher training, with no significant intersite differences. Percentage agreement with the clinical trainer on the presence or absence of clinical signs on video clips was high (≥89%), with interobserver concordance being substantial to high (AC1 statistic, 0.62–0.82) for 5 of 6 signs assessed. Staff attained median scores of >90% in checklist evaluations of practical skills. Conclusions. Satisfactory clinical standardization was achieved within and across all PERCH sites, providing reassurance that any etiological or clinical differences observed across the study sites are true differences, and not attributable to differences in application of the clinical case definition, interpretation of clinical signs, or in techniques used for clinical measurements or specimen collection. PMID:28575355

Cemeteries Are Effective Sites For Monitoring La Crosse Virus (LACv) and these Environments May Play a Role in LACv Infection

PubMed Central

Trout Fryxell, Rebecca T.; Freyman, Kimberly; Ulloa, Armando; Hendricks, Brian; Paulsen, Dave; Odoi, Agricola; Moncayo, Abelardo

2015-01-01

La Crosse encephalitis (LAC) is the leading arboviral disease among children, and was previously limited to the upper Midwest. In 2012 nine pediatric cases of LAC occurred in eastern Tennessee, including one fatal case. In an attempt to identify sites near an active LACv infection and describe the abundance and distribution of potential LACv vectors near a fatal LAC case in the Appalachian region, we initiated an end of season study using a combination of questing and oviposition mosquito traps placed at forty-nine sites consisting of cemeteries and houses within 16 radial kilometers of two pediatric infections. LACv was isolated from three Aedes triseriatus pools collected from cemeteries and spatial clustering analysis identified clusters of Ae. triseriatus and Ae. albopictus populations that overlapped in the same area as the 2012 LACv cases. Results indicate cemeteries are effective sites for monitoring LACv. The role of cemeteries and specific environmental features will be the focus of future investigations. PMID:25860584

HYDROGEOLOGIC CASE STUDIES (DENVER PRESENTATION)

EPA Science Inventory

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

Hydrogeologic Case Studies (Seattle, WA)

EPA Science Inventory

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

HYDROGEOLOGIC CASE STUDIES (CHICAGO, IL)

EPA Science Inventory

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

MULTIPLE CONTAMINANTS CASE STUDIES

EPA Science Inventory

The presentation provides information taken from the arsenic demonstration program projects that have treatment systems removing multiply contaminants from drinking water. The case studies sited in the presentation consist of projects that have arsenic along with either nitrate, ...

Sodium intake, salt taste and gastric cancer risk according to Helicobacter pylori infection, smoking, histological type and tumor site in China.

PubMed

Zhong, Chen; Li, Kai-Nan; Bi, Jing-Wang; Wang, Bao-Cheng

2012-01-01

The risk factors mostly strongly associated with gastric cancer are gastric bacteria Helicobacter pylori and diet. Using a case-control study among residents in Jinan, we examined the association between the salt taste and gastric cancer according to H. pylori infection, smoking and histological type as well as tumor site. This population-based case-control study included 207 cases and 410 controls. Data on potential risk factors of gastric cancer were obtained by interview of cases and controls with a questionnaire, salt taste preference was measured for all subjects, and IgG antibodies to H. pylori were applied to assess infection. Risk measures were determined using unconditional logistic regression. The proportions of salt taste at intervals of 1.8-7.2 g/L and ≥ 7.2 g/L were significantly higher in cases than controls, with ORs of 1.56 (1.23-3.64) and 2.03 (2.12- 4.11), respectively, subjects with high salt intake having an elevated risk for gastric cancer when infected with H. pylori. Significant modification by smoking and tumor site was observed across the different measures of salt intake, the highest salt taste showed higher cancer risk in ever smokers or with non-cardia cancers. Our study supports the view that high intake of sodium is an important dietary risk factor for gastric cancer, with a synergistic effect found between salt and H.pylori and smoking, dependent on the tumor site.

Efficacy of dexpanthenol in skin protection against irritation: a double-blind, placebo-controlled study.

PubMed

Biro, Kathrin; Thaçi, Diamant; Ochsendorf, Falk R; Kaufmann, Roland; Boehncke, Wolf-Henning

2003-08-01

Dexpanthenol is popular in treating various dermatoses and in skin care, but few controlled clinical trials have been performed. We investigated the efficacy of dexpanthenol in skin protection against irritation in a randomized, prospective, double-blind, placebo-controlled study. 25 healthy volunteers (age 18-45 years) were treated for the inner aspect of both forearms with either Bepanthol Handbalsam containing 5% dexpanthenol or placebo x2 daily for 26 days. From day 15-22, sodium lauryl sulfate (SLS) 2% was applied to these areas x2 daily. Documentation comprised sebumetry, corneometry, pH value and clinical appearance (photographs). 21 volunteers completed the study, 3 were excluded because of non-compliance and 1 experienced a non-study-related, severe, adverse event. Only corneometry yielded a statistically significant difference, with decreased values following SLS challenge at the placebo sites (P < 0.05). Intraindividual comparisons showed superior results at the dexpanthenol-treated sites in 11 cases and in only 1 case at the placebo site. 6 volunteers experienced an irritant contact dermatitis, with more severe symptoms at the placebo site in 5 cases. In conclusion, dexpanthenol exhibits protective effects against skin irritation. The initiation of a study to evaluate the efficacy of dexpanthenol in preventing irritant occupational contact dermatitis under real workplace conditions is validated.

Closure of the Radial Forearm Free Flap Donor Site Using the Combined Local Triangular Full-Thickness Skin Graft.

PubMed

Moreno-Sánchez, Manuel; González-García, Raúl; Ruiz-Laza, Luis; Manzano Solo de Zaldívar, Damián; Moreno-García, Carlos; Monje, Florencio

2016-01-01

Traditional donor-site closure has been associated with serious esthetic and functional morbidity. The purpose of this study was to assess morbidity in esthetics and function and measure the postoperative complications of the radial forearm free flap (RFFF) donor site after using combined local triangular full-thickness skin grafting. This prospective study of patients who underwent reconstruction of head and neck defects using an RFFF was conducted from July 2008 through December 2014. The donor site was repaired with a combined local triangular full-thickness skin graft. Quality of the scar, color match, tendon exposure, presence of necrosis, dehiscence of the suture, and presence of dysesthesia were recorded and analyzed using SPSS 21.0 software. One hundred consecutive patients (71 male and 29 female) underwent RFFF harvesting. RFFF donor-site defects ranged from 15 to 70 cm2; partial skin graft loss occurred in 7% of patients. Five patients (5%) had small dehiscences of the forearm skin graft, and 2 cases (2%) presented tendon exposure. In all cases, these sites healed secondarily by conservative management, with no final impairment of function. Esthetic results were considered excellent in 87%, good in 11%, and suboptimal in 2% of the cases. The combined local triangular full-thickness skin graft is a reliable method for closing RFFF donor-site defects because it obviates a second surgical site, it provides excellent color match and pliability, and it can be used for covering large defects of the donor site. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Surgical Scar Site Recurrence in Patients With Cervical Cancer on 18F-FDG PET-CT: A Case-Control Study.

PubMed

Dhull, Varun S; Khangembam, Bangkim C; Sharma, Punit; Rana, Neelima; Verma, Satyavrat; Sharma, Dayanand; Shamim, Shamim A; Kumar, Sunesh; Kumar, Rakesh

2016-02-01

The purpose of this study was to assess the role of fluorine 18 ((18)F)-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) in evaluating various parameters in patients with surgical scar site recurrence in cervical carcinoma. Data of all patients with cervical cancer (n = 329) who underwent PET-CT at our institute between 2005 and 2013 was reviewed. Of these 329 patients, 132 patients who were surgically treated and underwent restaging/follow-up PET-CT were included in the present study for final analysis. Tumor recurrence at the abdominal surgical scar site was looked for. Abnormal uptakes suggestive of active disease at other sites were also noted. Maximum standardized uptake value was measured for all the lesions. Patients with scar site recurrence were taken as cases (n = 6), whereas the remaining patients served as controls (n = 126). Comparison with conventional imaging modalities was made wherever available. Histopathological examination was always sought for. The incidence of scar site recurrence after surgery was found to be 4.5% (6/117). A total of 56 of 132 patients had recurrent disease, including 6 patients with scar site recurrence. All of the patients with scar site recurrence also had recurrent disease at other sites (local, nodal, or distant). Conventional imaging modalities were available in 4 of these 6 patients and detected scar site recurrence in 3 of those 4 patients. In patients with scar site recurrence, the mean ± SD time to scar site recurrence was 14.0 ± 10.9 months (median, 10 months; range, 7-36 months). Significant difference was seen between cases and control for International Federation of Genecology and Oncology stage (P = 0.001) and nodal recurrence (P = 0.007). Additionally, age, nodal recurrence, distant recurrence, and scar site recurrence were significantly associated with death. Scar site recurrence carries a poor prognosis, and the incidence is much higher than previously known when PET-CT is used as a modality for its detection.

How Institutional and University Counselor Policies Effectively Respond to Victims of Cyber Violent Acts: A Multisite Case Study

ERIC Educational Resources Information Center

Richards, Gretchen M.

2012-01-01

This multisite case study examined how institutional and university counselor policies effectively respond to cyber violent acts. Stake's (2006) multisite case study methodology was used to identify seven themes from current literature. Two sites with four participants were selected. The participants included two counseling directors and the…

HYDROGEOLOGIC CASE STUDIE(PRESENTATION FOR MNA WORKSHOP)

EPA Science Inventory

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

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

PubMed

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

2012-02-01

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

Reclamation of sanitary landfills: A case study in Shelby County, Tennessee

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

Riddick, P.M.; Kirsch, S.; Kung, Hsiang-Te

1992-07-01

Approximately 30,000 sanitary landfills were in operation in the United States in 1976; today, there are <7,000. The remaining 23,000 closed sites can be reclaimed to actually enhance the surrounding community; cost is the only limiting factor. Abandoned sanitary landfill sites do have problems, namely leachates, methane build-up, and subsidence. However, with modern techniques and planning, these problems can be overcome. Across the nation, old landfills have been converted into golf courses, parks, ski resorts, libraries, and even methane power plants. In some cases, a community's property value has actually increased after reclamation of the local landfill. Shelby County, inmore » southwestern Tennessee, currently has four closed sanitary landfills. Only one site has been fully utilized as a recreational facility. At this site, four soccer fields are home to over 150 league soccer teams. Two sites are home to airplane radio-control clubs, although most land at these sites is currently unused. The fourth site is completely unused and up for sale. All of these closed sanitary landfills have potential use as recreation areas, but, as is often the case, lack of money and initiative is preventing development. 7 refs.« less

Commuter choice program case study development and analysis

DOT National Transportation Integrated Search

2004-08-01

This paper presents the results of a study in which the case study method was used to sort out the internal and external conditions that might affect the success of a work site trip reduction program. Investigators attempted to disprove a null hypoth...

Novel Method to Detect and Characterize 18F-FDG Infiltration at the Injection Site: A Single-Institution Experience.

PubMed

Muzaffar, Razi; Frye, Sarah A; McMunn, Anna; Ryan, Kelley; Lattanze, Ron; Osman, Medhat M

2017-12-01

A novel quality control and quality assurance device provides time-activity curves that can identify and characterize PET/CT radiotracer infiltration at the injection site during the uptake phase. The purpose of this study was to compare rates of infiltration detected by the device with rates detected by physicians. We also assessed the value of using the device to improve injection results in our center. Methods: 109 subjects consented to the study. All had passive device sensors applied to their skin near the injection site and mirrored on the contralateral arm during the entire uptake period. Nuclear medicine physicians reviewed standard images for the presence of dose infiltration. Sensor-generated time-activity curves were independently examined and then compared with the physician reports. Injection data captured by the software were analyzed, and the results were provided to the technologists. Improvement measures were implemented, and rates were remeasured. Results: Physician review of the initial 40 head-to-toe field-of-view images identified 15 cases (38%) of dose infiltration (9 minor, 5 moderate, and 1 significant). Sensor time-activity curves on these 40 cases independently identified 22 cases (55%) of dose infiltration (16 minor, 5 moderate, and 1 significant). After the time-activity curve results and the contributing factor analysis were shared with technologists, injection techniques were modified and an additional 69 cases were studied. Of these, physician review identified 17 cases (25%) of infiltration (13 minor, 3 moderate, and 1 significant), a 34% decline. Sensor time-activity curves identified 4 cases (6%) of infiltration (2 minor and 2 moderate), an 89% decline. Conclusion: The device provides valuable quality control information for each subject. Time-activity curves can further characterize visible infiltration. Even when the injection site was out of the field of view, the time-activity curves could still detect and characterize infiltration. Our initial experience showed that the quality assurance information obtained from the device helped reduce the rate and severity of infiltration. The device revealed site-specific contributing factors that helped nuclear medicine physicians and technologists customize their quality improvement efforts to these site-specific issues. Reducing infiltration can improve image quality and SUV quantification, as well as the ability to minimize variability in a site's PET/CT results. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

Skate Bathyraja spp. egg predation in the eastern Bering Sea.

PubMed

Hoff, G R

2009-01-01

Predation on skate eggs by snails was examined for three skate species at seven nursery sites in three regions (north, middle and south) of the eastern Bering Sea. Mean predation levels were 6.46% for the Alaska skate Bathyraja parmifera, 2.65% for the Aleutian skate Bathyraja aleutica and 22.25% for the Bering skate Bathyraja interrupta. Predation levels were significantly higher at the middle and north sites than the south sites for all species combined. Predation levels decreased with increasing egg-case densities at all nursery sites, and the highest predation levels occurred where egg-case densities were very low. Predated egg-case density increased with increasing snail densities across all nursery sites examined. The Oregon triton Fusitriton oregonensis was the most abundant snail species at all nursery sites and displayed ability to drill holes in the egg case of B. parmifera. Holes left by predatory snails in egg cases of B. parmifera were significantly larger, and of different shape at the middle site compared to the south site. Holes in B. parmifera were also significantly larger than those in egg cases of B. interrupta across all sites examined. Egg cases of B. aleutica possess surface spines that cover the egg case and may inhibit predation by snails at a greater rate than that of the B. parmifera and B. interrupta, which have a smoother egg-case surface.

Implementation of case studies in undergraduate didactic nursing courses: a qualitative study.

PubMed

Dutra, Danette K

2013-07-04

The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students' levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

Implementation of case studies in undergraduate didactic nursing courses: a qualitative study

PubMed Central

2013-01-01

Background The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students’ levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Methods Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. Results The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Conclusion Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience. PMID:23826925

Experiences of practice facilitators working on the Improved Delivery of Cardiovascular Care project: Retrospective case study.

PubMed

Liddy, Clare; Rowan, Margo; Valiquette-Tessier, Sophie-Claire; Drosinis, Paul; Crowe, Lois; Hogg, William

2018-01-01

To examine the barriers to and facilitators of practice facilitation experienced by participants in the Improving Delivery of Cardiovascular Care (IDOCC) project. Case studies of practice facilitators' narrative reports. Eastern Ontario. Primary care practices that participated in the IDOCC project. Cases were identified by calculating sum scores in order to determine practices' performance relative to their peers. Two case exemplars were selected that scored within ± 1 SD of the total mean score, and a qualitative analysis of practice facilitators' narrative reports was conducted using a 5-factor implementation framework to identify barriers and facilitators. Narratives were divided into 3 phases: planning, implementation, and sustainability. Barriers and facilitators fluctuated over the intervention's 3 phases. Site A reported more barriers (n = 47) than facilitators (n = 38), while site B reported a roughly equal number of barriers (n = 144) and facilitators (n = 136). In both sites, the most common barriers involved organizational and provider factors and the most common facilitators were associated with innovation and structural factors. Both practices encountered various barriers and facilitators throughout the IDOCC's 3 phases. The case studies reveal the complex interactions of these factors over time, and provide insight into the implementation of practice facilitation programs. Copyright© the College of Family Physicians of Canada.

Risk-Based Decision Making Case Study: Application at a Superfund Cleanup.

ERIC Educational Resources Information Center

Blacker, Stanley; Goodman, Daniel

1994-01-01

Describes a case study comparing an integrated approach to Superfund cleanup with traditional approaches at a particular Superfund site. Emphasizes ways to save time and money while still achieving the desired risk reduction level. (LZ)

OPTIMIZED REAL-TIME CONTROL OF COMBINED SEWERAGE SYSTEMS: TWO CASE STUDIES

EPA Science Inventory

The paper presents results of two case studies of Real-Time Control (RTC) alternatives evaluations that were conducted on portions of sewerage systems near Paris, France and in Quebec City, Canada, respectively. The studies were performed at real-scale demonstration sites. RTC ...

Case Studies of Schools Receiving School Improvement Grants: Findings after the First Year of Implementation. NCEE 2014-4015

ERIC Educational Resources Information Center

Le Floch, Kerstin Carlson; Birman, Beatrice; O'Day, Jennifer; Hurlburt, Steven; Mercado-Garcia, Diana; Goff, Rose; Manship, Karen; Brown, Seth; Therriault, Susan Bowles; Rosenberg, Linda; Angus, Megan Hague; Hulsey, Lara

2014-01-01

The Study of School Turnaround examines the improvement process in a purposive sample of 35 case study schools receiving federal School Improvement Grants (SIG) over a three-year period (2010-11 to 2012-13 school years). Using site visit, teacher survey, and fiscal data, the case studies describe the school contexts, the principals' leadership…

A Process Evaluation of Project Developmental Continuity. Interim Report II, Part A: Program Case Studies. Volume 2.

ERIC Educational Resources Information Center

Spencer, Lynn, Ed.

These 7 case studies are part of a series of documents on the evaluation of Project Developmental Continuity (PDC), a Head Start demonstration program aimed at providing educational and developmental continuity between children's Head Start and primary school experiences. Each case study reviews the planning year at a PDC demonstration site in one…

A Process Evaluation of Project Developmental Continuity. Interim Report II, Part A: Program Case Studies. Volume I.

ERIC Educational Resources Information Center

Spencer, Lynn, Ed.

These 8 case studies are part of a series of documents on the evaluation of Project Developmental Continuity (PDC), a Head Start demonstration program aimed at providing educational and developmental continuity between children's Head Start and primary school experiences. Each case study reviews the planning year at a PDC demonstration site in one…

Turning a hazardous waste lagoon into reclaimed land for wildlife management: A case study

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

Leong, A.K.

Brownfields are turning back to green. This paper presents a case study of a former dump site for hazardous waste that has been remediated and will be developed into an enhanced wildlife management habitat. This successful remediation case combined various investigations, remedial designs, risk assessments, ecological studies, and engineering practices. 3 refs., 1 fig., 1 tab.

Exploring Library 2.0 on the Social Web

ERIC Educational Resources Information Center

Brantley, John S.

2010-01-01

Library 2.0 literature has described many of the possibilities Web 2.0 technologies offer to libraries. Case studies have assessed local use, but no studies have measured the Library 2.0 phenomenon by searching public social networking sites. This study used library-specific terms to search public social networking sites, blog search engines, and…

CHARACTERIZING SITE HYDROLOGY (REGION 5)

EPA Science Inventory

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

75 FR 74024 - Notice of Submission for OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-30

... purpose of the Study of School Turnaround is to document over time the intervention models, approaches... with school principals, district administrators and state officials; site visits to case study schools... study team will conduct in-depth case studies over three years, and two sets of 10 ``special topics...

Exit-site infections by non-diphtheria corynebacteria in CAPD.

PubMed

Schiffl, Helmut; Mücke, Claudia; Lang, Susanne M

2004-01-01

Non-diphtheria corynebacteria species cause disease in risk populations such as immunocompromised patients and patients with indwelling medical devices. Despite reports of exit-site infection and peritonitis caused by non-diphtheria corynebacteria, these organisms are frequently dismissed as contaminants. During a 10-year observation period, we prospectively identified 8 cases of exit-site/tunnel infections caused by 2 different species of corynebacteria (Corynebacterium striatum in 5 and C. jeikeium in 3 cases). Four patients experienced a second episode of exit-site infection 3 months (2 cases), 25 months, and 40 months, respectively, after termination of an oral cephalosporin therapy of 4 to 6 weeks' duration. Non-diphtheria corynebacteria accounted for 9% of all exit-site infections during the study period. All catheter-related infections healed; no catheter had to be removed. The diagnosis of catheter-related non-diphtheria corynebacteria infection may be suspected when Gram stain shows gram-positive rods and with colony morphology and commercial biochemical identification systems. Susceptibility of non-diphtheria corynebacteria to antibiotics may vary, especially in C. jeikeium. Virtually all Corynebacterium species are sensitive to vancomycin. Empirical antibiotic therapy with vancomycin should be initiated while antibiotic susceptibility testing is being carried out. Oral cephalosporin may be an alternative treatment regimen for exit-site infections if sensitive. This study highlights the importance of non-diphtheria corynebacteria as emerging nosocomial pathogens in the population of end-stage renal disease patients on on continuous ambulatory peritoneal dialysis.

Cases of maternal cannibalism in wild bonobos (Pan paniscus) from two different field sites, Wamba and Kokolopori, Democratic Republic of the Congo.

PubMed

Tokuyama, Nahoko; Moore, Deborah Lynn; Graham, Kirsty Emma; Lokasola, Albert; Furuichi, Takeshi

2017-01-01

Maternal cannibalism, whereby a mother consumes her own offspring, occurs in various animal taxa and is commonly explained by nutritional stress or environmental pressures. It is rare in nonhuman primates and is considered an aberrant behavior only observed under high-stress conditions. It was therefore surprising when, in the first reported case of cannibalism in wild bonobos, a mother consumed part of the dead infant at LuiKotale. Here we report two more cases of maternal cannibalism by wild bonobos at two different study sites, Wamba and Kokolopori. The dead infants' mothers participated in the cannibalism in both cases. At Kokolopori, although the mother did consume part of the carcass, it was held and shared by another dominant female. At Wamba, the mother was a dominant female within the community and was the primary consumer of the carcass. In both cases, cannibalism resembled other meat-eating events, with the dominant female controlling meat consumption. Infanticide was not observed in either case, but its occurrence could not be ruled out. Although rare, the occurrence of maternal cannibalism at three different study sites suggests that this may represent part of the behavioral repertoire of bonobos, rather than an aberrant behavior.

Library Facility Siting and Location Handbook. The Greenwood Library Management Collection.

ERIC Educational Resources Information Center

Koontz, Christine M.

This handbook is a guide to the complex process of library facility siting and location. It includes relevant research and professionals' siting experiences, as well as actual case studies of closures, openings, mergers, and relocations of library facilities. While the bulk of the volume provides practical information, the work also presents an…

Face, content, and construct validity of four, inanimate training exercises using the da Vinci ® Si surgical system configured with Single-Site ™ instrumentation.

PubMed

Jarc, Anthony M; Curet, Myriam

2015-08-01

Validated training exercises are essential tools for surgeons as they develop technical skills to use robot-assisted minimally invasive surgical systems. The purpose of this study was to show face, content, and construct validity of four, inanimate training exercises using the da Vinci (®) Si surgical system configured with Single-Site (™) instrumentation. New (N = 21) and experienced (N = 6) surgeons participated in the study. New surgeons (11 Gynecology [GYN] and 10 General Surgery [GEN]) had not completed any da Vinci Single-Site cases but may have completed multiport cases using the da Vinci system. They participated in this study prior to attending a certification course focused on da Vinci Single-Site instrumentation. Experienced surgeons (5 GYN and 1 GEN) had completed at least 25 da Vinci Single-Site cases. The surgeons completed four inanimate training exercises and then rated them with a questionnaire. Raw metrics and overall normalized scores were computed using both video recordings and kinematic data collected from the surgical system. The experienced surgeons significantly outperformed new surgeons for many raw metrics and the overall normalized scores derived from video review (p < 0.05). Only one exercise did not achieve a significant difference between new and experienced surgeons (p = 0.08) when calculating an overall normalized score using both video and advanced metrics derived from kinematic data. Both new and experienced surgeons rated the training exercises as appearing, to train and measure technical skills used during da Vinci Single-Site surgery and actually testing the technical skills used during da Vinci Single-Site surgery. In summary, the four training exercises showed face, content, and construct validity. Improved overall scores could be developed using additional metrics not included in this study. The results suggest that the training exercises could be used in an overall training curriculum aimed at developing proficiency in technical skills for surgeons new to da Vinci Single-Site instrumentation.

Preventing Delays in First-Case Starts on the Neurosurgery Service: A Resident-Led Initiative at an Academic Institution.

PubMed

Han, Seunggu J; Rolston, John D; Zygourakis, Corinna C; Sun, Matthew Z; McDermott, Michael W; Lau, Catherine Y; Aghi, Manish K

2016-01-01

On-time starts for the first case of the day are critical to maintaining efficiency in operating rooms (ORs). We studied whether a resident-led initiative to ensure on-time site marking and documentation of surgical consent could lead to improved first-case start time. In a resident-led initiative at a large 600-bed academic hospital with 25 ORs, we aimed to complete site marking and surgical consents half an hour before the scheduled start time for all first-case neurosurgical patients. We monitored the occurrence of delayed first starts and the length of delay during our initiative, and compared these cases to neurosurgical cases 3 months before the implementation of the initiative and to first-start nonneurosurgical cases. In the year of the initiative, both site marking and surgical consents were completed 30 minutes before the case start in 97% of neurosurgical cases. The average delay across all first-case starts was reduced to 7.17 minutes (N = 1271), compared with 9.67 minutes before the intervention (N = 345). During the study period, non-neurosurgical cases were delayed on average 10.3 minutes (N = 3592). There was a significant difference in latencies between the study period and the period before the initiative (p < 0.001), and also between neurosurgical cases and nonneurosurgical cases (p < 0.001). There was no reduction in delay times seen on the non-neurosurgical services in the study period when compared to the case 3 months before. Considering its effect across 1271 cases, this initiative over 1 year resulted in a total reduction of 52 hours and 57 minutes in delays. Through a resident-led quality improvement program, neurosurgical trainees successfully reduced delays in first-case starts on a surgical service. Engaging physician trainees in quality improvement and enhancing OR efficiency can be successfully achieved and can have a significant clinical and financial effect. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Suitability of Exoseal Vascular Closure Device for Antegrade Femoral Artery Puncture Site Closure

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

Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Liebl, Andrea; Poullos, Nektarios

Purpose. To assess the efficacy and safety of the Exoseal vascular closure device for antegrade puncture of the femoral artery. Methods. In a prospective study from February 2011 to January 2012, a total of 93 consecutive patients received a total of 100 interventional procedures via an antegrade puncture of the femoral artery. An Exoseal vascular closure device (6F) was used for closure in all cases. Puncture technique, duration of manual compression, and use of compression bandages were documented. All patients were monitored by vascular ultrasound and color-coded duplex sonography of their respective femoral artery puncture site within 12 to 36more » h after angiography to check for vascular complications. Results. In 100 antegrade interventional procedures, the Exoseal vascular closure device was applied successfully for closure of the femoral artery puncture site in 96 cases (96 of 100, 96.0 %). The vascular closure device could not be deployed in one case as a result of kinking of the vascular sheath introducer and in three cases because the bioabsorbable plug was not properly delivered to the extravascular space adjacent to the arterial puncture site, but instead fully removed with the delivery system (4.0 %). Twelve to 36 h after the procedure, vascular ultrasound revealed no complications at the femoral artery puncture site in 93 cases (93.0 %). Minor vascular complications were found in seven cases (7.0 %), with four cases (4.0 %) of pseudoaneurysm and three cases (3.0 %) of significant late bleeding, none of which required surgery. Conclusion. The Exoseal vascular closure device was safely used for antegrade puncture of the femoral artery, with a high rate of procedural success (96.0 %), a low rate of minor vascular complications (7.0 %), and no major adverse events.« less

Groundwater data for selected wells within the Eastern San Joaquin Groundwater Subbasin, California, 2003-8

USGS Publications Warehouse

Clark, Dennis A.; Izbicki, John A.; Metzger, Loren F.; Everett, Rhett; Smith, Gregory A.; O'Leary, David R.; Teague, Nicholas F.; Burgess, Matthew K.

2012-01-01

Data were collected by the U.S. Geological Survey from 2003 through 2008 in the Eastern San Joaquin Groundwater Subbasin, 80 miles east of San Francisco, California, as part of a study of the increasing chloride concentrations in groundwater processes. Data collected include geologic, geophysical, chemical, and hydrologic data collected during and after the installation of five multiple-well monitoring sites, from three existing multiple-well sites, and from 79 selected public-supply, irrigation, and domestic wells. Each multiple-well monitoring site installed as part of this study contained three to five 2-inch diameter polyvinyl chloride (PVC)-cased wells ranging in depth from 68 to 880 feet below land surface. Continuous water-level data were collected from the 19 wells installed at these 5 sites and from 10 existing monitoring wells at 3 additional multiple-well sites in the study area. Thirty-one electromagnetic logs were collected seasonally from the deepest PVC-cased monitoring well at seven multiple-well sites. About 200 water samples were collected from 79 wells in the study area. Coupled well-bore flow data and depth-dependent water-quality data were collected from 12 production wells under pumped conditions, and well-bore flow data were collected from 10 additional wells under unpumped conditions.

The unaccountability case of plastic pellet pollution.

PubMed

Karlsson, Therese M; Arneborg, Lars; Broström, Göran; Almroth, Bethanie Carney; Gipperth, Lena; Hassellöv, Martin

2018-04-01

Plastic preproduction pellets are found in environmental samples all over the world and their presence is often linked to spills during production and transportation. To better understand how these pellets end up in the environment we assessed the release of plastic pellets from a polyethylene production site in a case study area on the Swedish west coast. The case study encompasses; field measurements to evaluate the level of pollution and pathways, models and drifters to investigate the potential spread and a revision of the legal framework and the company permits. This case study show that millions of pellets are released from the production site annually but also that there are national and international legal frameworks that if implemented could help prevent these spills. Bearing in mind the negative effects observed by plastic pollution there is an urgent need to increase the responsibility and accountability of these spills. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Case Studies of Urban Schools: Portrayals of Schools in Change.

ERIC Educational Resources Information Center

Wermuth, Thomas R.; Maddy-Bernstein, Carolyn; Grayson, Thomas E.

A purposeful sample of four comprehensive urban high schools involved in educational restructuring initiatives was analyzed to determine how each site has implemented educational restructuring efforts and how vocational education fits into those restructuring efforts. The four sites studied were as follows: Bryan High School in Omaha, Nebraska;…

CHARACTERIZING SITE HYDROLOGY (WORKSHOP MSA PRESENTATION)

EPA Science Inventory

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

Characterizing Site Hydrology (Region 10, Seattle, WA)

EPA Science Inventory

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

CHARACTERIZING SITE HYDROLOGY (REGION 8 WORKSHOP)

EPA Science Inventory

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

LFA-1 expression in a series of colorectal adenocarcinomas.

PubMed

Papas, Maria G; Karatzas, Pantelis S; Papanikolaou, Ioannis S; Karamitopoulou, Evanthia; Delicha, Eumorphia M; Adler, Andreas; Triantafyllou, Konstantinos; Thomopoulou, Georgia-Heleni; Patsouris, Efstratios; Lazaris, Andreas C

2012-09-01

LFA-1 is an adhesion molecule which belongs to the β2-integrin family. Overexpression of LFA-1 in hepatic natural killer cells has been associated with increased apoptosis of neoplastic cells in colorectal cancer (CRC); moreover, studies in CRC have linked LFA-1 overexpression in neoplastic cells with vascular intrusion through adhesion to endothelial cells, thus implying a possible role in creation of metastases. We studied the expression of LFA-1 in a series of 82 patients with CRC. A standard three-step immunohistochemical analysis was performed on formalin-fixed, paraffin-embedded tissue sections. An IgG2a anti-CD11a monoclonal antibody was used. Cases were characterized according to clinicopathological variables including sex, age, tumor localization, size, grade, Dukes stage, wall invasion, and presence of metastatic lymph nodes (mLNs) or distal metastases. LFA-1 was expressed at the primary tumor site in 51 cases and 6/33 cases with metastatic lymphnodes. In Dukes D cases (n = 4), only one case was LFA-1(+). LFA-1 expression at the primary tumor site was associated with the absence of metastatic disease and with Dukes B stage. However, in those cases with LFA-1 expression in cancer cells in mLNs, this was associated with its expression at the primary tumor site. The positive association of LFA-1 expression in mLNs when the primary tumor site is also LFA-1(+) could imply an adaptation advantage of this specific cellular clone to its micro-environment, predisposing it to creation of mLNs, pointing to a role for LFA-1 in creation of mLNs in CRC.

Kidney Dysfunction in Adult Offspring Exposed In Utero to Type 1 Diabetes Is Associated with Alterations in Genome-Wide DNA Methylation

PubMed Central

Gautier, Jean-François; Porcher, Raphaël; Abi Khalil, Charbel; Bellili-Munoz, Naima; Fetita, Lila Sabrina; Travert, Florence; Choukem, Simeon-Pierre; Riveline, Jean-Pierre; Hadjadj, Samy; Larger, Etienne; Boudou, Philippe; Blondeau, Bertrand; Roussel, Ronan; Ferré, Pascal; Ravussin, Eric; Rouzet, François; Marre, Michel

2015-01-01

Background Fetal exposure to hyperglycemia impacts negatively kidney development and function. Objective Our objective was to determine whether fetal exposure to moderate hyperglycemia is associated with epigenetic alterations in DNA methylation in peripheral blood cells and whether those alterations are related to impaired kidney function in adult offspring. Design Twenty nine adult, non-diabetic offspring of mothers with type 1 diabetes (T1D) (case group) were matched with 28 offspring of T1D fathers (control group) for the study of their leukocyte genome-wide DNA methylation profile (27,578 CpG sites, Human Methylation 27 BeadChip, Illumina Infinium). In a subset of 19 cases and 18 controls, we assessed renal vascular development by measuring Glomerular Filtration Rate (GFR) and Effective Renal Plasma Flow (ERPF) at baseline and during vasodilatation produced by amino acid infusion. Results Globally, DNA was under-methylated in cases vs. controls. Among the 87 CpG sites differently methylated, 74 sites were less methylated and 13 sites more methylated in cases vs. controls. None of these CpG sites were located on a gene known to be directly involved in kidney development and/or function. However, the gene encoding DNA methyltransferase 1 (DNMT1)—a key enzyme involved in gene expression during early development–was under-methylated in cases. The average methylation of the 74 under-methylated sites differently correlated with GFR in cases and controls. Conclusion Alterations in methylation profile imprinted by the hyperglycemic milieu of T1D mothers during fetal development may impact kidney function in adult offspring. The involved pathways seem to be a nonspecific imprinting process rather than specific to kidney development or function. PMID:26258530

Kidney Dysfunction in Adult Offspring Exposed In Utero to Type 1 Diabetes Is Associated with Alterations in Genome-Wide DNA Methylation.

PubMed

Gautier, Jean-François; Porcher, Raphaël; Abi Khalil, Charbel; Bellili-Munoz, Naima; Fetita, Lila Sabrina; Travert, Florence; Choukem, Simeon-Pierre; Riveline, Jean-Pierre; Hadjadj, Samy; Larger, Etienne; Boudou, Philippe; Blondeau, Bertrand; Roussel, Ronan; Ferré, Pascal; Ravussin, Eric; Rouzet, François; Marre, Michel

2015-01-01

Fetal exposure to hyperglycemia impacts negatively kidney development and function. Our objective was to determine whether fetal exposure to moderate hyperglycemia is associated with epigenetic alterations in DNA methylation in peripheral blood cells and whether those alterations are related to impaired kidney function in adult offspring. Twenty nine adult, non-diabetic offspring of mothers with type 1 diabetes (T1D) (case group) were matched with 28 offspring of T1D fathers (control group) for the study of their leukocyte genome-wide DNA methylation profile (27,578 CpG sites, Human Methylation 27 BeadChip, Illumina Infinium). In a subset of 19 cases and 18 controls, we assessed renal vascular development by measuring Glomerular Filtration Rate (GFR) and Effective Renal Plasma Flow (ERPF) at baseline and during vasodilatation produced by amino acid infusion. Globally, DNA was under-methylated in cases vs. controls. Among the 87 CpG sites differently methylated, 74 sites were less methylated and 13 sites more methylated in cases vs. controls. None of these CpG sites were located on a gene known to be directly involved in kidney development and/or function. However, the gene encoding DNA methyltransferase 1 (DNMT1)--a key enzyme involved in gene expression during early development--was under-methylated in cases. The average methylation of the 74 under-methylated sites differently correlated with GFR in cases and controls. Alterations in methylation profile imprinted by the hyperglycemic milieu of T1D mothers during fetal development may impact kidney function in adult offspring. The involved pathways seem to be a nonspecific imprinting process rather than specific to kidney development or function.

Application of remote sensing for prediction and detection of thermal pollution, phase 2

NASA Technical Reports Server (NTRS)

Veziroglu, T. N.; Lee, S. S.

1975-01-01

The development of a predictive mathematical model for thermal pollution in connection with remote sensing measurements was continued. A rigid-lid model has been developed and its application to far-field study has been completed. The velocity and temperature fields have been computed for different atmospheric conditions and for different boundary currents produced by tidal effects. In connection with the theoretical work, six experimental studies of the two sites in question (Biscayne Bay site and Hutchinson Island site) have been carried out. The temperature fields obtained during the tests at the Biscayne Bay site have been compared with the predictions of the rigid-lid model and these results are encouraging. The rigid-lid model is also being applied to near-field study. Preliminary results for a simple case have been obtained and execution of more realistic cases has been initiated. The development of a free-surface model also been initiated. The governing equations have been formulated and the computer programs have been written.

Design Of Bioremediation Systems For Groundwater (Aerobic and Anaerobic Plus Representative Case Studies)

EPA Science Inventory

The attached presentation discusses the fundamentals of bioremediation in the subsurface. The basics of aerobic, cometabolic, and anaerobic bioremediation are presented. Case studies from the Delaware Sand & Gravel Superfund Site, Dover Cometabolic Research Project and the SABR...

Optimized Real-Time Control of Combined Sewerage Systems: Two Case Studies (Proceedings Paper)

EPA Science Inventory

The paper presents results of two case studies of Real-Time Control (RTC) alternatives evaluations that were conducted on portions of sewerage systems near Paris, France and in Quebec City, Canada, respectively. The studies were performed at real-scale demonstration sites. RTC al...

Nature's Classroom: An Ethnographic Case Study of Environmental Education

ERIC Educational Resources Information Center

Owens, Dorothea Jody

2012-01-01

This ethnographic case study examines the dynamic relationship between culture and environmental education within the context of a specific Florida-based public education program. The School District of Hillsborough County (SDHC) offers the program through a three-day field trip to the study site, Nature's Classroom, and accompanying classroom…

Engineering geologic and geotechnical analysis of paleoseismic shaking using liquefaction effects: Field examples

USGS Publications Warehouse

Green, R.A.; Obermeier, S.F.; Olson, S.M.

2005-01-01

The greatest impediments to the widespread acceptance of back-calculated ground motion characteristics from paleoliquefaction studies typically stem from three uncertainties: (1) the significance of changes in the geotechnical properties of post-liquefied sediments (e.g., "aging" and density changes), (2) the selection of appropriate geotechnical soil indices from individual paleoliquefaction sites, and (3) the methodology for integration of back-calculated results of strength of shaking from individual paleoliquefaction sites into a regional assessment of paleoseismic strength of shaking. Presented herein are two case studies that illustrate the methods outlined by Olson et al. [Engineering Geology, this issue] for addressing these uncertainties. The first case study is for a site near Memphis, Tennessee, wherein cone penetration test data from side-by-side locations, one of liquefaction and the other of no liquefaction, are used to readily discern that the influence of post-liquefaction "aging" and density changes on the measured in situ soil indices is minimal. In the second case study, 12 sites that are at scattered locations in the Wabash Valley and that exhibit paleoliquefaction features are analyzed. The features are first provisionally attributed to the Vincennes Earthquake, which occurred around 6100 years BP, and are used to illustrate our proposed approach for selecting representative soil indices of the liquefied sediments. These indices are used in back-calculating the strength of shaking at the individual sites, the results from which are then incorporated into a regional assessment of the moment magnitude, M, of the Vincennes Earthquake. The regional assessment validated the provisional assumption that the paleoliquefaction features at the scattered sites were induced by the Vincennes Earthquake, in the main, which was determined to have M ??? 7.5. The uncertainties and assumptions used in the assessment are discussed in detail. ?? 2004 Elsevier B.V. All rights reserved.

Life-threatening methemoglobinemia after unintentional ingestion of antifreeze admixtures containing sodium nitrite in the construction sites.

PubMed

Sohn, C H; Seo, D W; Ryoo, S M; Lee, J H; Kim, W Y; Lim, K S; Oh, B J

2014-01-01

Construction workers are exposed to a wide variety of health hazards such as poisoning at the construction sites. Various forms of poisoning incidents in construction workers have been reported. However, studies on methemoglobinemia caused by unintentional ingestion of antifreeze admixtures containing sodium nitrite at the construction sites have not been reported yet. The aim of this study was to evaluate life-threatening methemoglobinemia after unintentional ingestion of antifreeze admixtures containing sodium nitrite at the construction sites and describe similar incidents involving ingestion of antifreeze admixtures in Korea. Retrospective observational case series study on patients with methemoglobinemia after unintentional ingestion of antifreeze admixtures containing sodium nitrite admitted to the emergency department (ED) from January 1, 2010 to December 31, 2012 and cases reported to the Korea Occupational Safety and Health Agency (KOSHA) was performed. Results. Six victims were admitted to our ED. They had methemoglobin levels ranging from 32.4% to 71.5% and all of them recovered after receiving one (2 mg/kg) or two doses infusion of methylene blue. From the data of the KOSHA, six incidents that caused 27 victims were identified. Of 27 victims, five were included in the ED cases. For all incidents, antifreeze admixtures were not contained in their original containers and all new containers did not have a new label. All workers mistook antifreeze admixtures for water. Among the 28 victims included in this study, four died. Unintentional ingestion of antifreeze admixtures containing sodium nitrite at the construction sites can cause life-threatening methemoglobinemia. There is a need to store and label potentially hazardous materials properly to avoid unintentional ingestion at the construction sites.

Essential Resources for Implementation and Sustainability of Evidence-Based Health Promotion Programs: A Mixed Methods Multi-Site Case Study.

PubMed

Dattalo, M; Wise, M; Ford Ii, J H; Abramson, B; Mahoney, J

2017-04-01

As of October 2016, use of federal Older Americans Act funds for health promotion and disease prevention will be restricted to the Administration on Aging's criteria for high-level evidence-based health promotion programs. Dissemination of these programs to rural communities remains limited. Therefore a strong need exists to identify strategies that facilitate program implementation and sustainability. The objective of this study was to compare organizational readiness and implementation strategies used by rural communities that achieved varying levels of success in sustaining evidence-based health promotion programs for older adults. We utilized a qualitative multi-site case study design to analyze the longitudinal experiences of eight rural sites working to implement evidence-based health promotion program over 3 years (8/2012-7/2015). Multiple sources of data (interviews, documents, reports, surveys) from each site informed the analysis. We used conventional content analysis to conduct a cross-case comparison to identify common features of rural counties that successfully implemented and sustained their target evidence-based health promotion program. Readiness to implement evidence-based programs as low at baseline as all site leaders described needing to secure additional resources for program implementation. Sites that successfully utilized six essential resources implemented and sustained greater numbers of workshops: (1) External Partnerships, (2) Agency Leadership Commitment, (3) Ongoing Source of Workshop Leaders, (4) Health Promotion Coordination Tasks Assigned to Specific Staff, (5) Organizational Stability, and (6) Change Team Engagement. The six essential resources described in this study can help rural communities assess their readiness to implement health promotion programs and work secure the resources necessary for successful implementation.

Mesothelioma incidence and asbestos exposure in Italian national priority contaminated sites.

PubMed

Binazzi, Alessandra; Marinaccio, Alessandro; Corfiati, Marisa; Bruno, Caterina; Fazzo, Lucia; Pasetto, Roberto; Pirastu, Roberta; Biggeri, Annibale; Catelan, Dolores; Comba, Pietro; Zona, Amerigo

2017-11-01

Objectives This study aimed to (i) describe mesothelioma incidence in the Italian national priority contaminated sites (NPCS) on the basis of data available from the Italian National Mesothelioma Registry (ReNaM) and (ii) profile NPCS using Bayesian rank analysis. Methods Incident cases of mesothelioma and standardized incidence ratios (SIR) were estimated for both genders in each of the 39 selected NPCS in the period 2000-2011. Age-standardized rates of Italian geographical macro areas were used to estimate expected cases. Rankings of areas were produced by a hierarchical Bayesian model. Asbestos exposure modalities were discussed for each site. Results In the study period, 2683 incident cases of mesothelioma (1998 men, 685 women) were recorded. An excess of mesothelioma incidence was confirmed in sites with a known past history of direct use of asbestos (among men) such as Balangero (SIR 197.1, 95% CI 82.0-473.6), Casale Monferrato (SIR 910.7, 95% CI 816.5-1012.8), and Broni (SIR 1288.5, 95% CI 981.9-1691.0), in sites with shipyards and harbors (eg, Trieste, La Spezia, Venice, and Leghorn), and in settings without documented direct use of asbestos. The analysis ranked the sites of Broni and Casale Monferrato (both genders) and Biancavilla (only for women) the highest. Conclusions The present study confirms that asbestos pollution is a risk for people living in polluted areas, due to not only occupational exposure in industrial settings with direct use of asbestos but also the presence of asbestos in the environment. Epidemiological surveillance of asbestos-related diseases is a fundamental tool for monitoring the health profile in NPCS.

An eCommerce Development Case: Your Company's eCommerce Web Site

ERIC Educational Resources Information Center

Ballenger, Robert M.

2007-01-01

This case provides a real-world semester long project-oriented case study for students enrolled in an electronic commerce course that has a significant development component. The case provides the technical framework in the form of functional requirements for students to design and build a fully functional transaction processing e-commerce Web…

Diet, Helicobacter pylori, and p53 mutations in gastric cancer: a molecular epidemiology study in Italy.

PubMed

Palli, D; Caporaso, N E; Shiao, Y H; Saieva, C; Amorosi, A; Masala, G; Rice, J M; Fraumeni, J F

1997-12-01

A series of 105 gastric cancer (GC) cases with paraffin-embedded specimens interviewed in a previous population-based case-control study conducted in a high-risk area around Florence, Italy, was examined for the presence of p53 mutations. Overall, 33 of 105 cases had a mutation (p53+) identified by single-strand conformational polymorphism and confirmed by sequencing (Y-H. Shiao et al., submitted for publication). p53+ cases had a more traditional dietary pattern (i.e., corn meal mush, meat soup, and other homemade dishes) and reported less frequent consumption of raw vegetables (particularly lettuce and raw carrots). A positive association with a high nitrite intake and a negative association with raw vegetables and diffuse type histology persisted in a multivariate analysis. In addition, p53+ cases tended to be located in the upper portion of the stomach and to be associated with advanced age and blood group A. No relation was found between the presence of p53 mutations and histologically defined Helicobacter pylori infection, smoking history, family history of gastric cancer, education, and social class. Of the 33 p53+ cases, 19 had G:C-->A:T transitions at CpG sites. These tumors tended to occur in females and in association with H. pylori infection but not other risk factors. The remaining 14 cases with a p53 mutation had mainly transversions but also two deletions and two transitions at non-CpG sites. These tumors showed a strong positive association with a traditional dietary pattern and with the estimated intake of selected nutrients (nitrite, protein, and fat, particularly from animal sources). The findings of this case-case analysis suggest that p53 mutations at non-CpG sites are related to exposure to alkylating compounds from diet, whereas p53 mutations at CpG sites might be related to H. pylori infection.

Strongly Correlated Electron Systems: An Operatorial Perspective

NASA Astrophysics Data System (ADS)

Di Ciolo, Andrea; Avella, Adolfo

2018-05-01

We discuss the operatorial approach to the study of strongly correlated electron systems and show how the exact solution of target models on small clusters chosen ad-hoc (minimal models) can suggest very efficient bulk approximations. We use the Hubbard model as case study (target model) and we analyze and discuss the crucial role of spin fluctuations in its 2-site realization (minimal model). Accordingly, we devise a novel three-pole approximation for the 2D case, including in the basic field an operator describing the dressing of the electronic one by the nearest-neighbor spin-fluctuations. Such a solution is in very good agreement with the exact one in the minimal model (2-site case) and performs very well once compared to advanced (semi-)numerical methods in the 2D case, being by far less computational-resource demanding.

User-Centered Design and Usability Testing of a Web Site: An Illustrative Case Study.

ERIC Educational Resources Information Center

Corry, Michael D.; Frick, Theodore W.; Hansen, Lisa

1997-01-01

Presents an overview of user-centered design and usability testing. Describes a Web site evaluation project at a university, the iterative process of rapid prototyping and usability testing, and how the findings helped to improve the design. Discusses recommendations for university Web site design and reflects on problems faced in usability…

Facilitating Participation: From the EML Web Site to the Learning Network for Learning Design

ERIC Educational Resources Information Center

Hummel, Hans G. K.; Tattersall, Colin; Burgos, Daniel; Brouns, Francis; Kurvers, Hub; Koper, Rob

2005-01-01

This article investigates conditions for increasing active participation in on-line communities. As a case study, we use three generations of facilities designed to promote learning in the area of Educational Modelling Languages. Following a description of early experience with a conventional web site and with a community site offering facilities…

Transition to a Unified System: Using Perl To Drive Library Databases and Enhance Web Site Functionality.

ERIC Educational Resources Information Center

Fagan, Judy Condit

2001-01-01

Discusses the need for libraries to routinely redesign their Web sites, and presents a case study that describes how a Perl-driven database at Southern Illinois University's library improved Web site organization and patron access, simplified revisions, and allowed staff unfamiliar with HTML to update content. (Contains 56 references.) (Author/LRW)

The Community Science Workshop Network Story: Case Studies of the CSW Sites

ERIC Educational Resources Information Center

St. John, Mark

2014-01-01

The Community Science Workshops (CSWs)--with funding from the S.D. Bechtel, Jr. Foundation, and the Gordon and Betty Moore Foundation--created a network among the CSW sites in California. The goals of the CSW Network project have been to improve programs, build capacity throughout the Network, and establish new sites. Inverness Research has been…

Integrating basic research and long-term management: a case study using avian research at the Savannah River Site

Treesearch

John B. Dunning; John C. Kilgo

2000-01-01

In this introduction to Avian Research at the Savannah River Site: A Model for Integrating Basic Research and Long-term Management, editors Dunning and Kilgo discuss the interrelationship between research and management at the Savannah River Site. They emphasize the increasing need for collaboration between scientists and land managers....

Web Analytics: A Picture of the Academic Library Web Site User

ERIC Educational Resources Information Center

Black, Elizabeth L.

2009-01-01

This article describes the usefulness of Web analytics for understanding the users of an academic library Web site. Using a case study, the analysis describes how Web analytics can answer questions about Web site user behavior, including when visitors come, the duration of the visit, how they get there, the technology they use, and the most…

Pain Sensitivity Risk Factors for Chronic TMD: Descriptive Data and Empirically Identified Domains from the OPPERA Case Control Study

PubMed Central

Greenspan, Joel D.; Slade, Gary D.; Bair, Eric; Dubner, Ronald; Fillingim, Roger B.; Ohrbach, Richard; Knott, Charlie; Mulkey, Flora; Rothwell, Rebecca; Maixner, William

2011-01-01

Many studies report that people with temporomandibular disorders (TMD) are more sensitive to experimental pain stimuli than TMD-free controls. Such differences in sensitivity are observed in remote body sites as well as in the orofacial region, suggesting a generalized upregulation of nociceptive processing in TMD cases. This large case-control study of 185 adults with TMD and 1,633 TMD-free controls measured sensitivity to painful pressure, mechanical cutaneous, and heat stimuli, using multiple testing protocols. Based on an unprecedented 36 experimental pain measures, 28 showed statistically significantly greater pain sensitivity in TMD cases than controls. The largest effects were seen for pressure pain thresholds at multiple body sites and cutaneous mechanical pain threshold. The other mechanical cutaneous pain measures and many of the heat pain measures showed significant differences, but with lesser effect sizes. Principal component analysis (PCA) of the pain measures derived from 1,633 controls identified five components labeled: (1) heat pain ratings, (2) heat pain aftersensations and tolerance, (3) mechanical cutaneous pain sensitivity, (4) pressure pain thresholds, and (5) heat pain temporal summation. These results demonstrate that, compared to TMD-free controls, chronic TMD cases are more sensitive to many experimental noxious stimuli at extra-cranial body sites, and provides for the first time the ability to directly compare the case-control effect sizes of a wide range of pain sensitivity measures. PMID:22074753

An Epidemiological Study on Pattern and Incidence of Mandibular Fractures

PubMed Central

Natu, Subodh S.; Pradhan, Harsha; Gupta, Hemant; Alam, Sarwar; Gupta, Sumit; Pradhan, R.; Mohammad, Shadab; Kohli, Munish; Sinha, Vijai P.; Shankar, Ravi; Agarwal, Anshita

2012-01-01

Mandible is the second most common facial fracture. There has been a significant increase in the number of cases in recent years with the advent of fast moving automobiles. Mandibular fractures constitute a substantial proportion of maxillofacial trauma cases in Lucknow. This study was undertaken to study mandibular fractures clinicoradiologically with an aim to calculate incidence and study pattern and the commonest site of fractures in population in and around Lucknow. Patient presenting with history of trauma at various centers of maxillofacial surgery in and around Lucknow were included in this study. Detailed case history was recorded followed by thorough clinical examination, and radiological interpretation was done for establishing the diagnosis and the data obtained was analyzed statistically. Out of 66 patients with mandibular fractures, highest percentage was found in 21–30 years of age with male predominance. Road traffic accidents were the most common cause of fracture with parasymphysis being commonest site. Commonest combination was parasymphysis with subcondyle. There was no gender bias in etiology with number of fracture sites. The incidence and causes of mandibular fracture reflect trauma patterns within the community and can provide a guide to the design of programs geared toward prevention and treatment. PMID:23227327

A case of laryngeal cancer induced by exposure to asbestos in a construction site supervisor.

PubMed

Roh, Sooyong; Park, Soyong; Tae, Gyeong; Song, Jaechul

2016-01-01

Construction site supervisors are exposed to many chemicals, dusts, and metals including asbestos. Asbestos is a hazardous chemical that is carcinogenic. Laryngeal cancer is not a rare disease in Korea. The most common causes of this disease are tobacco and alcohol, and representative occupational cause is asbestos. However, up to now, no case of laryngeal cancer induced by asbestos has been reported in Korea. In this study, we report such a case in a construction site supervisor. A 60-year-old man who had been experiencing hoarseness for 2 months was diagnosed with laryngeal cancer. The pathologic diagnosis was squamous cell carcinoma in situ, based on examination of a biopsy specimen obtained by resection of the lesion. The patient had been exposed to asbestos for 38 years at construction sites where he worked until diagnosed with laryngeal cancer. He had been exposed to asbestos when demolishing buildings and inspecting materials. The patient in this case worked with construction materials including asbestos and supervised construction for 38 years, and was thus exposed to asbestos at construction sites. Much of the asbestos was highly concentrated especially during demolition processes. We therefore consider the laryngeal cancer of this patient to be a work-related disease.

The European I-MOVE Multicentre 2013-2014 Case-Control Study. Homogeneous moderate influenza vaccine effectiveness against A(H1N1)pdm09 and heterogenous results by country against A(H3N2).

PubMed

Valenciano, Marta; Kissling, Esther; Reuss, Annicka; Jiménez-Jorge, Silvia; Horváth, Judit K; Donnell, Joan M O; Pitigoi, Daniela; Machado, Ausenda; Pozo, Francisco

2015-06-04

In the first five I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe) influenza seasons vaccine effectiveness (VE) results were relatively homogenous among participating study sites. In 2013-2014, we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in six European Union (EU) countries to measure 2013-2014 influenza VE against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. Influenza A(H3N2) and A(H1N1)pdm09 viruses co-circulated during the season. Practitioners systematically selected ILI patients to swab within eight days of symptom onset. We compared cases (ILI positive to influenza A(H3N2) or A(H1N1)pdm09) to influenza negative patients. We calculated VE for the two influenza A subtypes and adjusted for potential confounders. We calculated heterogeneity between sites using the I(2) index and Cochrane's Q test. If the I(2) was <50%, we estimated pooled VE as (1 minus the OR)×100 using a one-stage model with study site as a fixed effect. If the I(2) was >49% we used a two-stage random effects model. We included in the A(H1N1)pdm09 analysis 531 cases and 1712 controls and in the A(H3N2) analysis 623 cases and 1920 controls. For A(H1N1)pdm09, the Q test (p=0.695) and the I(2) index (0%) suggested no heterogeneity of adjusted VE between study sites. Using a one-stage model, the overall pooled adjusted VE against influenza A(H1N1)pdm2009 was 47.5% (95% CI: 16.4-67.0). For A(H3N2), the I(2) was 51.5% (p=0.067). Using a two-stage model for the pooled analysis, the adjusted VE against A(H3N2) was 29.7 (95% CI: -34.4-63.2). The results suggest a moderate 2013-2014 influenza VE against A(H1N1)pdm09 and a low VE against A(H3N2). The A(H3N2) estimates were heterogeneous among study sites. Larger sample sizes by study site are needed to prevent statistical heterogeneity, decrease variability and allow for two-stage pooled VE for all subgroup analyses. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Age Estimation Based on Appearance of Gray Hair in Different Body Sites of Sri Lankan Autopsy Cases.

PubMed

Senanayake, Harshana Mahendra Kumara; Wickramasinghe, Nuwan Darshana

2017-07-01

Owing to the scanty evidence on usefulness of information of appearance of gray hair for age estimation, this study was conducted to estimate age based on the appearance of gray hair on different body sites in a sample of autopsy cases in Sri Lanka. A descriptive cross-sectional study was conducted in Teaching Hospital-Kurunegala during 2011 to 2013. Based on the pattern of the presence of gray hair in different body sites, six stages of gray hair were computed. The analysis 1155 autopsy cases revealed strong, positive correlations between age and appearance of gray hair in head, mustache, beard, and pubic area among males and strong, positive correlations between age and the appearance of gray hair in head and pubic area among females (p < 0.01). Our findings demonstrate the value of information of appearance of gray hair for age estimation in the field of forensic science. © 2016 American Academy of Forensic Sciences.

Professional Development Sites: Revitalizing Preservice Education in Middle Schools.

ERIC Educational Resources Information Center

Bell, Nancy M.

This case study reports on the experiences of teachers and student teachers during the process of developing and implementing professional development sites (PDSs) at one urban and two rural middle schools. The study examines the phases of development that teachers go through in the process of developing PDSs and how teachers' level of development…

Impact assessment of on-site sanitation system on groundwater quality in alluvial settings: A case study from Lucknow city in North India.

PubMed

Jangam, Chandrakant; Ramya Sanam, S; Chaturvedi, M K; Padmakar, C; Pujari, Paras R; Labhasetwar, Pawan K

2015-10-01

The present case study has been undertaken to investigate the impact of on-site sanitation on groundwater quality in alluvial settings in Lucknow City in India. The groundwater samples have been collected in the areas of Lucknow City where the on-site sanitation systems have been implemented. The groundwater samples have been analyzed for the major physicochemical parameters and fecal coliform. The results of analysis reveal that none of the groundwater samples exceeded the Bureau of Indian Standards (BIS) limits for all the parameters. Fecal coliform was not found in majority of the samples including those samples which were very close to the septic tank. The study area has a thick alluvium cover as a top layer which acts as a natural barrier for groundwater contamination from the on-site sanitation system. The t test has been performed to assess the seasonal effect on groundwater quality. The statistical t test implies that there is a significant effect of season on groundwater quality in the study area.

Development of a site fidelity index based on population capture-recapture data

PubMed Central

Ferrari, Mariano A.; Crespo, Enrique A.; Coscarella, Mariano A.

2018-01-01

Background Site fidelity is considered as an animal’s tendency to return to a previously occupied place; this is a component of animal behaviour that allows us to understand movement patterns and aspects related to the animal’s life history. Although there are many site fidelity metrics, the lack of standardisation presents a considerable challenge in terms of comparability among studies. Methods This investigation focused on the theoretical development of a standardised composite site fidelity index and its statistical distribution in order to obtain reliable population-level site fidelity comparisons. The arithmetic and harmonic means were used as mathematical structures in order to create different indexes by combining the most commonly used indicators for site fidelity such as Occurrence, Permanence and Periodicity. The index performance was then evaluated in simulated populations and one real population of Commerson’s dolphins (Cephalorhynchus commersonii (Lacépède 1804)). In the first case, the indexes were evaluated based on how they were affected by different probability values such as the occurrence of the individual within the study area (φ) and capture probability (p). As a precision measure for the comparison of the indexes, the Wald confidence interval (CI) and the mean square error were applied. Given that there was no previous data concerning the distribution parameters of this population, bootstrap CIs were applied for the study case. Results Eight alternative indexes were developed. The indexes with an arithmetic mean structure, in general, had a consistently inferior performance than those with a harmonic mean structure. The index IH4, in particular, achieved the best results in all of the scenarios and in the study case. Additionally, this index presented a normal distribution. As such, it was proposed as a standardised measure for site fidelity (Standardised Site Fidelity Index—SSFI). Discussion The SSFI is the first standardised metric that quantifies site fidelity at a populational level. It is an estimator that varies between zero and one and works in situations where detection is not perfect and effort can be constant or not. Moreover, it has an associated CI that allows users to make comparisons. PMID:29761064

Development of a site fidelity index based on population capture-recapture data.

PubMed

Tschopp, Ayelen; Ferrari, Mariano A; Crespo, Enrique A; Coscarella, Mariano A

2018-01-01

Site fidelity is considered as an animal's tendency to return to a previously occupied place; this is a component of animal behaviour that allows us to understand movement patterns and aspects related to the animal's life history. Although there are many site fidelity metrics, the lack of standardisation presents a considerable challenge in terms of comparability among studies. This investigation focused on the theoretical development of a standardised composite site fidelity index and its statistical distribution in order to obtain reliable population-level site fidelity comparisons. The arithmetic and harmonic means were used as mathematical structures in order to create different indexes by combining the most commonly used indicators for site fidelity such as Occurrence, Permanence and Periodicity. The index performance was then evaluated in simulated populations and one real population of Commerson's dolphins ( Cephalorhynchus commersonii (Lacépède 1804)). In the first case, the indexes were evaluated based on how they were affected by different probability values such as the occurrence of the individual within the study area (φ) and capture probability ( p ). As a precision measure for the comparison of the indexes, the Wald confidence interval (CI) and the mean square error were applied. Given that there was no previous data concerning the distribution parameters of this population, bootstrap CIs were applied for the study case. Eight alternative indexes were developed. The indexes with an arithmetic mean structure, in general, had a consistently inferior performance than those with a harmonic mean structure. The index IH4, in particular, achieved the best results in all of the scenarios and in the study case. Additionally, this index presented a normal distribution. As such, it was proposed as a standardised measure for site fidelity (Standardised Site Fidelity Index-SSFI). The SSFI is the first standardised metric that quantifies site fidelity at a populational level. It is an estimator that varies between zero and one and works in situations where detection is not perfect and effort can be constant or not. Moreover, it has an associated CI that allows users to make comparisons.

Risk of surgical site infection in paediatric herniotomies without any prophylactic antibiotics: A preliminary experience.

PubMed

Vaze, Dhananjay; Samujh, Ram; Narasimha Rao, Katragadda Lakshmi

2014-01-01

Different studies underline the use of pre-operative antibiotic prophylaxis in clean surgeries like herniotomy and inguinal orchiopexy. But, the meta-analyses do not recommend nor discard the use of prophylactic pre-operative antibiotics. The scarcity of controlled clinical trials in paediatric population further vitiates the matter. This study assessed the difference in the rate of early post-operative wound infection cases in children who received single dose of pre-operative antibiotics and children who did not receive antibiotics after inguinal herniotomy and orchiopexy. This randomised prospective study was conducted in Paediatric Surgery department of PGIMER Chandigarh. Out of 251 patients, 112 patients were randomised to the case group and 139 were ascribed to the control group. The patients in control group were given a standard regimen of single dose of intravenous antibiotic at the time of induction followed by 3-4 days of oral antibiotic. Case group patients underwent the surgical procedure in similar manner with no antibiotic either at the time of induction or post-operatively. The incidence of surgical site infection in case group was 3.73 % and that in control group was 2.22%. The observed difference in the incidence of surgical site infection was statistically insignificant (P value = 0.7027). The overall infection rate in case and control group was 2.89%. Our preliminary experience suggests that there is no statistically significant difference in the proportion of early post-operative wound infection between the patients who received single dose of pre-operative antibiotics and the patients who received no antibiotics after inguinal herniotomy and orchiopexy. The risk of surgical site infection in paediatric heriotomies does not increase even if the child's weight is less than his/her expected weight for age.

Friends or foes? Monetized Life Cycle Assessment and Cost-Benefit Analysis of the site remediation of a former gas plant.

PubMed

Huysegoms, Lies; Rousseau, Sandra; Cappuyns, Valérie

2018-04-01

Site contamination is a global concern because of the potential risks for human health and ecosystem quality. Every contaminated site has its own specific characteristics and the increased availability and efficiency of remediation techniques makes the choice of remediation alternative increasingly complicated. In this paper an attributional Life Cycle Assessment (LCA) of the secondary environmental impacts of a site remediation is performed and its results are monetized using two different monetization techniques, namely Stepwise 2006 and Ecovalue 08. Secondly, we perform a social Cost-Benefit Analysis (CBA) on the same case study using the same data sources. The case study used in this paper entails the soil and groundwater remediation of a tar, poly-aromatic hydrocarbons (PAH) and cyanide contamination of a school ground by a former gas plant. The remediation alternative chosen in this case study is excavation with off-site thermal treatment of the contaminated soil. The outcome of the social CBA, stating that the remediation project is socially beneficial in the long term, is critically compared to the outcome of the different LCA monetization methods. This comparison indicates that monetized LCA is a good complement to social CBA when it comes to the assessment of secondary environmental impacts. Combining the two methods provides decision makers with a more extensive and detailed assessment of the soil remediation project. Copyright © 2017 Elsevier B.V. All rights reserved.

A Methodology to Evaluate Ecological Resources and Risk Using Two Case Studies at the Department of Energy's Hanford Site

NASA Astrophysics Data System (ADS)

Burger, Joanna; Gochfeld, Michael; Bunn, Amoret; Downs, Janelle; Jeitner, Christian; Pittfield, Taryn; Salisbury, Jennifer; Kosson, David

2017-03-01

An assessment of the potential risks to ecological resources from remediation activities or other perturbations should involve a quantitative evaluation of resources on the remediation site and in the surrounding environment. We developed a risk methodology to rapidly evaluate potential impact on ecological resources for the U.S. Department of Energy's Hanford Site in southcentral Washington State. We describe the application of the risk evaluation for two case studies to illustrate its applicability. The ecological assessment involves examining previous sources of information for the site, defining different resource levels from 0 to 5. We also developed a risk rating scale from non-discernable to very high. Field assessment is the critical step to determine resource levels or to determine if current conditions are the same as previously evaluated. We provide a rapid assessment method for current ecological conditions that can be compared to previous site-specific data, or that can be used to assess resource value on other sites where ecological information is not generally available. The method is applicable to other Department of Energy's sites, where its development may involve a range of state regulators, resource trustees, Tribes and other stakeholders. Achieving consistency across Department of Energy's sites for valuation of ecological resources on remediation sites will assure Congress and the public that funds and personnel are being deployed appropriately.

A Methodology to Evaluate Ecological Resources and Risk Using Two Case Studies at the Department of Energy's Hanford Site.

PubMed

Burger, Joanna; Gochfeld, Michael; Bunn, Amoret; Downs, Janelle; Jeitner, Christian; Pittfield, Taryn; Salisbury, Jennifer; Kosson, David

2017-03-01

An assessment of the potential risks to ecological resources from remediation activities or other perturbations should involve a quantitative evaluation of resources on the remediation site and in the surrounding environment. We developed a risk methodology to rapidly evaluate potential impact on ecological resources for the U.S. Department of Energy's Hanford Site in southcentral Washington State. We describe the application of the risk evaluation for two case studies to illustrate its applicability. The ecological assessment involves examining previous sources of information for the site, defining different resource levels from 0 to 5. We also developed a risk rating scale from non-discernable to very high. Field assessment is the critical step to determine resource levels or to determine if current conditions are the same as previously evaluated. We provide a rapid assessment method for current ecological conditions that can be compared to previous site-specific data, or that can be used to assess resource value on other sites where ecological information is not generally available. The method is applicable to other Department of Energy's sites, where its development may involve a range of state regulators, resource trustees, Tribes and other stakeholders. Achieving consistency across Department of Energy's sites for valuation of ecological resources on remediation sites will assure Congress and the public that funds and personnel are being deployed appropriately.

An automated database case definition for serious bleeding related to oral anticoagulant use.

PubMed

Cunningham, Andrew; Stein, C Michael; Chung, Cecilia P; Daugherty, James R; Smalley, Walter E; Ray, Wayne A

2011-06-01

Bleeding complications are a serious adverse effect of medications that prevent abnormal blood clotting. To facilitate epidemiologic investigations of bleeding complications, we developed and validated an automated database case definition for bleeding-related hospitalizations. The case definition utilized information from an in-progress retrospective cohort study of warfarin-related bleeding in Tennessee Medicaid enrollees 30 years of age or older. It identified inpatient stays during the study period of January 1990 to December 2005 with diagnoses and/or procedures that indicated a current episode of bleeding. The definition was validated by medical record review for a sample of 236 hospitalizations. We reviewed 186 hospitalizations that had medical records with sufficient information for adjudication. Of these, 165 (89%, 95%CI: 83-92%) were clinically confirmed bleeding-related hospitalizations. An additional 19 hospitalizations (10%, 7-15%) were adjudicated as possibly bleeding-related. Of the 165 clinically confirmed bleeding-related hospitalizations, the automated database and clinical definitions had concordant anatomical sites (gastrointestinal, cerebral, genitourinary, other) for 163 (99%, 96-100%). For those hospitalizations with sufficient information to distinguish between upper/lower gastrointestinal bleeding, the concordance was 89% (76-96%) for upper gastrointestinal sites and 91% (77-97%) for lower gastrointestinal sites. A case definition for bleeding-related hospitalizations suitable for automated databases had a positive predictive value of between 89% and 99% and could distinguish specific bleeding sites. Copyright © 2011 John Wiley & Sons, Ltd.

Safety and Feasibility of Transradial Access for Visceral Interventions in Patients with Thrombocytopenia.

PubMed

Titano, J J; Biederman, D M; Marinelli, B S; Patel, R S; Kim, E; Tabori, N E; Nowakowski, F S; Lookstein, R A; Fischman, A M

2016-05-01

Transradial access (TRA) has shown lower morbidity and decreased bleeding complications compared to transfemoral access. This study evaluates the safety and feasibility of TRA in thrombocytopenic patients undergoing visceral interventions. Patients who underwent visceral interventions via the radial artery with platelet count less than or equal to 50,000/µL were included in the study. Outcome variables included technical success, access site, bleeding, transfusion, and neurological complications. From July 1, 2012, to May 31, 2015, a total of 1353 peripheral interventions via TRA were performed, of which 85 procedures were performed in 64 patients (mean age 62.2 years) with a platelet count <50,000/µL (median 39,000/µL). Interventions included chemoembolization (n = 46), selective internal radiation therapy (n = 30), and visceral embolization (n = 9). Technical success was 97.6% with two cases of severe vessel spasm requiring ipsilateral femoral crossover. There was no major access site, bleeding, or neurological adverse events at 30 days. Minor access site hematomas occurred in five cases (5.9%) and were treated conservatively in all cases. Pre-procedural platelet transfusions were administered in 23 (27.1%) cases. There was no statistically significant difference in access site or bleeding complications between the transfused and nontransfused groups. Transradial visceral interventions in patients with thrombocytopenia are both feasible and safe, possibly without the need for platelet transfusions.

Energy conserving site design case study: Shenandoah, Georgia. Final report

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

Not Available

The case study examines the means by which energy conservation can be achieved at an aggregate community level by using proper planning and analytical techniques for a new town, Shenandoah, Georgia, located twenty-five miles southwest of Atlanta's Hartsfield International Airport. A potentially implementable energy conservation community plan is achieved by a study team examining the land use options, siting characteristics of each building type, alternate infrastructure plans, possible decentralized energy options, and central utility schemes to determine how community energy conservation can be achieved by use of pre-construction planning. The concept for the development of mixed land uses as amore » passively sited, energy conserving community is based on a plan (Level 1 Plan) that uses the natural site characteristics, maximizes on passive energy siting requirement, and allows flexibility for the changing needs of the developers. The Level 2 Plan is identical with Level 1 plan plus a series of decentraized systems that have been added to the residential units: the single-family detached, the apartments, and the townhouses. Level 3 Plan is similar to the Level 1 Plan except that higher density dwellings have been moved to areas adjacent to central site. The total energy savings for each plan relative to the conventional plan are indicated. (MCW)« less

Socioeconomic environment and cancer incidence: a French population-based study in Normandy

PubMed Central

2014-01-01

Background The struggle against social inequalities is a priority for many international organizations. The objective of the study was to quantify the cancer burden related to social deprivation by identifying the cancer sites linked to socioeconomic status and measuring the proportion of cases associated with social deprivation. Methods The study population comprised 68 967 cases of cancer diagnosed between 1997 and 2009 in Normandy and collected by the local registries. The social environment was assessed at an aggregated level using the European Deprivation Index (EDI). The association between incidence and socioeconomic status was assessed by a Bayesian Poisson model and the excess of cases was calculated with the Population Attributable Fraction (PAF). Results For lung, lips-mouth-pharynx and unknown primary sites, a higher incidence in deprived was observed for both sexes. The same trend was observed in males for bladder, liver, esophagus, larynx, central nervous system and gall-bladder and in females for cervix uteri. The largest part of the incidence associated with deprivation was found for cancer of gall-bladder (30.1%), lips-mouth-pharynx (26.0%), larynx (23.2%) and esophagus (19.6%) in males and for unknown primary sites (18.0%) and lips-mouth-pharynx (12.7%) in females. For prostate cancer and melanoma in males, the sites where incidence increased with affluence, the part associated with affluence was respectively 9.6% and 14.0%. Conclusions Beyond identifying cancer sites the most associated with social deprivation, this kind of study points to health care policies that could be undertaken to reduce social inequalities. PMID:24524213

Guidelines for Evaluating the Thermal Environment of Enclosed Spaces

DTIC Science & Technology

2009-09-01

space. Three studies of concrete tanks and metal containers, the High Mobility Multipurpose Wheeled Vehicle; and the Bradley Fighting Vehicle, are...24 13 The initial CST-WMD training site was a concrete casting site. The teams practiced entry and evacuation...Environmental Medicine (USARIEM) studies. Examples are presented from three case studies: one that involved monitoring large concrete septic tanks

78 FR 77433 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... in all cases every possible measure will be taken to select a pathway of approach to study sites that... in the study plots or while biologists walk from one location to another. No motorized equipment is... found at any one of PISCO's study sites is variable, and often no California sea lions are observed...

Management Perception of Introducing Social Networking Sites as a Knowledge Management Tool in Higher Education: A Case Study

ERIC Educational Resources Information Center

Garcia, Elaine; Annansingh, Fenio; Elbeltagi, Ibrahim

2011-01-01

Purpose: The purpose of this paper is to present a study of the understanding and usage of social networking sites (SNS) as a knowledge management (KM) tool in knowledge-intensive enterprises. Design/methodology/approach: In terms of research approach, the study has taken an interpretitivist framework, using a higher education (HE) institution as…

The influence of specific neighboring bases on substitution bias in noncoding regions of the plant chloroplast genome.

PubMed

Morton, B R; Oberholzer, V M; Clegg, M T

1997-09-01

Substitutions occurring in noncoding sequences of the plant chloroplast genome violate the independence of sites that is assumed by substitution models in molecular evolution. The probability that a substitution at a site is a transversion, as opposed to a transition, increases significantly with increasing A + T content of the two adjacent nucleotides. In the present study, this dependency of substitutions on local context is examined further in a number of noncoding regions from the chloroplast genome of members of the grass family (Poaceae). Two features were examined; the influence of specific neighboring bases, as opposed to the general A + T content, on transversion proportion and an influence on substitutions by nucleotides other than the two immediately adjacent to the site of substitution. In both cases, a significant effect was found. In the case of specific nucleotides, transversion proportion is significantly higher at sites with a pyrimidine immediately 5' on either strand. Substitutions at sites of the type YNR, where N is the site of substitution, have the highest rate of transversion. This specific effect is secondary to the A + T content effect such that, in terms of proportion of substitutions that are transversions, the nucleotides are ranked T > A > C > G as to their effect when they are immediately 5' to the site of substitution. In the case of nucleotides other than the immediate neighbors, a significant influence on substitution dynamics is observed in the case where the two neighboring bases are both A and/or T. Thus, substitutions are primarily, but not exclusively, influenced by the composition of the two nucleotides that are immediately adjacent. These results indicate that the pattern of molecular evolution of the plant chloroplast genome is extremely complex as a result of a variety of inter-site dependencies.

Errors in Representing Regional Acid Deposition with Spatially Sparse Monitoring: Case Studies of the Eastern US Using Model Predictions

EPA Science Inventory

The current study uses case studies of model-estimated regional precipitation and wet ion deposition to estimate errors in corresponding regional values derived from the means of site-specific values within regions of interest located in the eastern US. The mean of model-estimate...

Third Culture Kids and College Support: A Case Study

ERIC Educational Resources Information Center

Holdren, Sarah Jennifer

2013-01-01

This single site case study applies the "Transition Cycle" framework (Pollock & Van Reken, 2009) to an institutionally-based, student-run support program for Third Culture Kids. The purpose of this study was to examine how Lewis and Clark College responded to the presence of Third Culture Kid, or Global Nomad, students on campus by…

Successful Leadership in Three High-Poverty Urban Elementary Schools

ERIC Educational Resources Information Center

Jacobson, Stephen L.; Brooks, Sharon; Giles, Corrie; Johnson, Lauri; Ylimaki, Rose

2007-01-01

This study examined the beliefs and practices of three principals during whose tenure their high-poverty urban elementary schools experienced improved student achievement. A two-stage, multiple case-study methodology was employed. First, New York State Education Department (NYSED) school report card data were analyzed to identify case-study sites.…

Penetration, Completeness, and Representativeness of The Society of Thoracic Surgeons Adult Cardiac Surgery Database.

PubMed

Jacobs, Jeffrey P; Shahian, David M; He, Xia; O'Brien, Sean M; Badhwar, Vinay; Cleveland, Joseph C; Furnary, Anthony P; Magee, Mitchell J; Kurlansky, Paul A; Rankin, J Scott; Welke, Karl F; Filardo, Giovanni; Dokholyan, Rachel S; Peterson, Eric D; Brennan, J Matthew; Han, Jane M; McDonald, Donna; Schmitz, DeLaine; Edwards, Fred H; Prager, Richard L; Grover, Frederick L

2016-01-01

The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) has been successfully linked to the Centers for Medicare and Medicaid (CMS) Medicare database, thereby facilitating comparative effectiveness research and providing information about long-term follow-up and cost. The present study uses this link to determine contemporary completeness, penetration, and representativeness of the STS ACSD. Using variables common to both STS and CMS databases, STS operations were linked to CMS data for all CMS coronary artery bypass graft (CABG) surgery hospitalizations discharged between 2000 and 2012, inclusive. For each CMS CABG hospitalization, it was determined whether a matching STS record existed. Center-level penetration (number of CMS sites with at least one matched STS participant divided by the total number of CMS CABG sites) increased from 45% in 2000 to 90% in 2012. In 2012, 973 of 1,081 CMS CABG sites (90%) were linked to an STS site. Patient-level penetration (number of CMS CABG hospitalizations done at STS sites divided by the total number of CMS CABG hospitalizations) increased from 51% in 2000 to 94% in 2012. In 2012, 71,634 of 76,072 CMS CABG hospitalizations (94%) occurred at an STS site. Completeness of case inclusion at STS sites (number of CMS CABG cases at STS sites linked to STS records divided by the total number of CMS CABG cases at STS sites) increased from 88% in 2000 to 98% in 2012. In 2012, 69,213 of 70,932 CMS CABG hospitalizations at STS sites (98%) were linked to an STS record. Linkage of STS and CMS databases demonstrates high and increasing penetration and completeness of the STS database. Linking STS and CMS data facilitates studying long-term outcomes and costs of cardiothoracic surgery. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Informatics tools to improve clinical research study implementation.

PubMed

Brandt, Cynthia A; Argraves, Stephanie; Money, Roy; Ananth, Gowri; Trocky, Nina M; Nadkarni, Prakash M

2006-04-01

There are numerous potential sources of problems when performing complex clinical research trials. These issues are compounded when studies are multi-site and multiple personnel from different sites are responsible for varying actions from case report form design to primary data collection and data entry. We describe an approach that emphasizes the use of a variety of informatics tools that can facilitate study coordination, training, data checks and early identification and correction of faulty procedures and data problems. The paper focuses on informatics tools that can help in case report form design, procedures and training and data management. Informatics tools can be used to facilitate study coordination and implementation of clinical research trials.

Wind to Hydrogen in California: Case Study

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

Antonia, O.; Saur, G.

2012-08-01

This analysis presents a case study in California for a large scale, standalone wind electrolysis site. This is a techno-economic analysis of the 40,000 kg/day renewable production of hydrogen and subsequent delivery by truck to a fueling station in the Los Angeles area. This quantity of hydrogen represents about 1% vehicle market penetration for a city such as Los Angeles (assuming 0.62 kg/day/vehicle and 0.69 vehicles/person) [8]. A wind site near the Mojave Desert was selected for proximity to the LA area where hydrogen refueling stations are already built.

Prospective Comparison of Collagen Plug (Angio-Seal™) and Suture-Mediated (the Closer S™) Closure Devices at Femoral Access Sites

PubMed Central

Park, Yulri; Choo, Sung Wook; Lee, Sung Hoon; Shin, Sung Wook; Do, Young Soo; Byun, Hong Sik; Park, Kwang Bo; Jeon, Pyoung

2005-01-01

Objective Rapid and effective hemostasis at femoral puncture sites minimizes both the hospital stay and patient discomfort. Therefore, a variety of arterial closure devices have been developed to facilitate the closure of femoral arteriotomy. The objective of this prospective study was to compare the efficacy of two different closure devices; a collagen plug device (Angio-Seal) and a suture-mediated closure device (the Closer S). Materials and Methods From March 28, 2003 to August 31, 2004, we conducted a prospective study in which 1,676 cases of 1,180 patients were treated with two different types of closure device. Angio-Seal was used in 961 cases and the Closer S in 715 cases. The efficacy of the closure devices was assessed, as well as complications occurring at the puncture sites. Results Successful immediate hemostasis was achieved in 95.2% of the cases treated with Angio-Seal, and in 89.5% of the cases treated with the Closer S (p < 0.05). The rates of minor and major complications occurring between the two groups were not significantly different. In the Closer S group, we observed four major complications (0.6%), that consisted of one massive retroperitoneal hemorrhage (surgically explored) and three pseudoaneurysms. In the Angio-Seal group, we observed three major complications (0.3%) that consisted of one femoral artery occlusion, one case of infection treated with intravenous antibiotics and one pseudoaneurysm. Conclusion The use of Angio-Seal was found to be more effective than that of the Closer S with regard to the immediate hemostasis of the femoral puncture sites. However, we detected no significant differences in the rate at which complications occurred. PMID:16374083

Traditions in Spider Monkeys Are Biased towards the Social Domain

PubMed Central

Santorelli, Claire J.; Schaffner, Colleen M.; Campbell, Christina J.; Notman, Hugh; Pavelka, Mary S.; Weghorst, Jennifer A.; Aureli, Filippo

2011-01-01

Cross-site comparison studies of behavioral variation can provide evidence for traditions in wild species once ecological and genetic factors are excluded as causes for cross-site differences. These studies ensure behavior variants are considered within the context of a species' ecology and evolutionary adaptations. We examined wide-scale geographic variation in the behavior of spider monkeys (Ateles geoffroyi) across five long-term field sites in Central America using a well established ethnographic cross-site survey method. Spider monkeys possess a relatively rare social system with a high degree of fission-fusion dynamics, also typical of chimpanzees (Pan troglodytes) and humans (Homo sapiens). From the initial 62 behaviors surveyed 65% failed to meet the necessary criteria for traditions. The remaining 22 behaviors showed cross-site variation in occurrence ranging from absent through to customary, representing to our knowledge, the first documented cases of traditions in this taxon and only the second case of multiple traditions in a New World monkey species. Of the 22 behavioral variants recorded across all sites, on average 57% occurred in the social domain, 19% in food-related domains and 24% in other domains. This social bias contrasts with the food-related bias reported in great ape cross-site comparison studies and has implications for the evolution of human culture. No pattern of geographical radiation was found in relation to distance across sites. Our findings promote A. geoffroyi as a model species to investigate traditions with field and captive based experiments and emphasize the importance of the social domain for the study of animal traditions. PMID:21373196

Dispersal of emerald ash borer at outlier sites: three case studies

Treesearch

Deborah G. McCullough; Nathan W. Siegert; Therese M. Poland; David L. Cappaert; Ivich Fraser; David Williams

2005-01-01

We worked with cooperators from several state and federal agencies in 2003 and 2004 to assess dispersal of emerald ash borer (EAB), Agrilus planipennis Fairmaire, from known source points in three outlier sites. In February 2003, we felled and sampled more than 200 ash trees at an outlier site near Tipton, Michigan, where one generation of adult...

Brief Report: Autism of the Asperger Type Associated with an Autosomal Fragile Site.

ERIC Educational Resources Information Center

Saliba, Joseph R.; Griffiths, Mike

1990-01-01

This case study describes a 12-year-old boy with autism in association with the folate-sensitive fragile site fra(2)(q13). Cytogenetic results of blood analysis are described, and two possibilities are discussed: the fragile site may be a coincidental finding unrelated to the autism, or may represent an area of potential gene damage. (JDD)

Reconstructing the temporal and spatial dynamics of emerald ash borer in black ash: a case study of an outlier site in Roscommon County, Michigan

Treesearch

Nathan W. Siegert; Deborah G. McCullough; Andrew M. Liebhold; Frank W. Telewski

2005-01-01

The temporal and spatial dynamics of emerald ash borer (EAB), Agrilus planipennis Fairmaire (Coleoptera: Buprestidae), in an outlier site in Roscommon County, Michigan, were reconstructed using dendrochronological analyses. The site was characterized by pockets of black ash, Fraxinus nigra Marsh., located in swampy areas surrounded...

Ultrasonic implant site preparation using piezosurgery: a multicenter case series study analyzing 3,579 implants with a 1- to 3-year follow-up.

PubMed

Vercellotti, Tomaso; Stacchi, Claudio; Russo, Crescenzo; Rebaudi, Alberto; Vincenzi, Giampaolo; Pratella, Umberto; Baldi, Domenico; Mozzati, Marco; Monagheddu, Chiara; Sentineri, Rosario; Cuneo, Tommaso; Di Alberti, Luca; Carossa, Stefano; Schierano, Gianmario

2014-01-01

This multicenter case series introduces an innovative ultrasonic implant site preparation (UISP) technique as an alternative to the use of traditional rotary instruments. A total of 3,579 implants were inserted in 1,885 subjects, and the sites were prepared using a specific ultrasonic device with a 1- to 3-year follow-up. No surgical complications related to the UISP protocol were reported for any of the implant sites. Seventy-eight implants (59 maxillary, 19 mandibular) failed within 5 months of insertion, for an overall osseointegration percentage of 97.82% (97.14% maxilla, 98.75% mandible). Three maxillary implants failed after 3 years of loading, with an overall implant survival rate of 97.74% (96.99% maxilla, 98.75% mandible).

Innovations in Site Characterization Case Study: Hanscom Air Force Base, Operable Unit 1

EPA Pesticide Factsheets

This document is a condensation of the information provided in the much more detailed Hanscom AFB Report entitled A Dynamic Site Investigation: Adaptive Sampling and Analysis Program for Operable Unit 1 at Hanscom Air Force Base, Bedford, Massachusetts.

Environmental Chemistry Principles in Site Remediation (CEECHE 2018 Krakow Poland)

EPA Science Inventory

In CEECHE meeting, we will present scientific, engineering information and case studies on sustainable and innovative remediation technologies used in contaminated sites in Europe and the United States. One of the most important tasks to be performed to remediate contaminated si...

CASE STUDY OF AN INTEGRATED PASSIVE BIOLOGICAL ARD TREATMENT SYSTEM

EPA Science Inventory

Many active mine sites, mines in the closure stage and some abandoned mines are and have utilized cyanidation to remove and recover precious metals. Discharges from these sites normally contain significant amounts of metal cyanide complexes and concentrations of thiocyanate, solu...

Labouring Together: collaborative alliances in maternity care in Victoria, Australia—protocol of a mixed-methods study

PubMed Central

Nagle, Cate; Kent, Bridie; Hutchinson, Alison M

2017-01-01

Introduction For over a decade, enquiries into adverse perinatal outcomes have led to reports that poor collaboration has been detrimental to the safety and experience of maternity care. Despite efforts to improve collaboration, investigations into maternity care at Morecambe Bay (UK) and Djerriwarrh Health Services (Australia) have revealed that poor collaboration and decision-making remain a threat to perinatal safety. The Labouring Together study will investigate how elements hypothesised to influence the effectiveness of collaboration are reflected in perceptions and experiences of clinicians and childbearing women in Victoria, Australia. The study will explore conditions that assist clinicians and women to work collaboratively to support positive maternity outcomes. Results of the study will provide a platform for consumers, clinician groups, organisations and policymakers to work together to improve the quality, safety and experience of maternity care. Methods and analysis 4 case study sites have been selected to represent a range of models of maternity care in metropolitan and regional Victoria, Australia. A mixed-methods approach including cross-sectional surveys and interviews will be used in each case study site, involving both clinicians and consumers. Quantitative data analysis will include descriptive statistics, 2-way multivariate analysis of variance for the dependent and independent variables, and χ2 analysis to identify the degree of congruence between consumer preferences and experiences. Interview data will be analysed for emerging themes and concepts. Data will then be analysed for convergent lines of enquiry supported by triangulation of data to draw conclusions. Ethics and dissemination Organisational ethics approval has been received from the case study sites and Deakin University Human Research Ethics Committee (2014–238). Dissemination of the results of the Labouring Together study will be via peer-reviewed publications and conference presentations, and in written reports for each case study site to support organisational change. PMID:28270390

Labouring Together: collaborative alliances in maternity care in Victoria, Australia-protocol of a mixed-methods study.

PubMed

Watkins, Vanessa; Nagle, Cate; Kent, Bridie; Hutchinson, Alison M

2017-03-07

For over a decade, enquiries into adverse perinatal outcomes have led to reports that poor collaboration has been detrimental to the safety and experience of maternity care. Despite efforts to improve collaboration, investigations into maternity care at Morecambe Bay (UK) and Djerriwarrh Health Services (Australia) have revealed that poor collaboration and decision-making remain a threat to perinatal safety. The Labouring Together study will investigate how elements hypothesised to influence the effectiveness of collaboration are reflected in perceptions and experiences of clinicians and childbearing women in Victoria, Australia. The study will explore conditions that assist clinicians and women to work collaboratively to support positive maternity outcomes. Results of the study will provide a platform for consumers, clinician groups, organisations and policymakers to work together to improve the quality, safety and experience of maternity care. 4 case study sites have been selected to represent a range of models of maternity care in metropolitan and regional Victoria, Australia. A mixed-methods approach including cross-sectional surveys and interviews will be used in each case study site, involving both clinicians and consumers. Quantitative data analysis will include descriptive statistics, 2-way multivariate analysis of variance for the dependent and independent variables, and χ 2 analysis to identify the degree of congruence between consumer preferences and experiences. Interview data will be analysed for emerging themes and concepts. Data will then be analysed for convergent lines of enquiry supported by triangulation of data to draw conclusions. Organisational ethics approval has been received from the case study sites and Deakin University Human Research Ethics Committee (2014-238). Dissemination of the results of the Labouring Together study will be via peer-reviewed publications and conference presentations, and in written reports for each case study site to support organisational change. 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/.

Declining Student Enrollment: A Case Study Exploring How Three Suburban School Districts Crafted Coherence

ERIC Educational Resources Information Center

Dimmitt, Eric J.

2012-01-01

This qualitative multi-site case study's purpose was to prove that the crafting coherence process was evident when three suburban Midwestern school districts implemented schools' goals while experiencing reductions in instructional programming, staffing, and facilities resources along with school closings due to significant declining student…

International Schools as Sites of Social Change

ERIC Educational Resources Information Center

Dunne, Sandra; Edwards, Julie

2010-01-01

This article examines the potential of international schools to act as agents of social transformation in developing countries. The method comprises a case study at two international schools in the Philippines. The case study explored ways in which schools foster host-national students' sense of social responsibility, particularly through…

NITRATE CONTAMINATION OF GROUND WATER FROM LAND APPLICATION OF SWINE WASTE: CASE STUDY AND GENERAL CONSIDERATIONS

EPA Science Inventory

Guidelines for land application of CAFO waste may not be sufficient to prevent ground water contamination by nitrate. A case study is presented illustrating the problem for one field site disposing of swine waste. Data are discussed in context with documented land application ...

Collaborative Design of World Wide Web Pages: A Case Study.

ERIC Educational Resources Information Center

Andrew, Paige G; Musser, Linda R.

1997-01-01

This case study of the collaborative design of an earth science World Wide Web page at Pennsylvania State University highlights the role of librarians. Discusses the original Web site and links, planning, the intended audience, and redesign and recommended changes; and considers the potential contributions of librarians. (LRW)

Site-Based Leadership: Extrapolating from Small Business to Charter Schools

ERIC Educational Resources Information Center

Arbisi Little, Joan

2012-01-01

Using a participant-observer perspective, this comparative case study sought to identify similarities between business and education to contribute to charter school training, leadership development, and school reform. This inquiry is a qualitative comparative case study using a participant observer perspective presented in a scholarly personal…

Air Quality Analysis of a Multilevel Complex Interchange : Case Study Using the Improved TSC/EPA Model

DOT National Transportation Integrated Search

1976-12-01

This report describes a case study of an air quality analysis prepared by the U.S. Department of Transportation (DOT), Transportation Systems Center (TSC). The site analyzed was the proposed I-83/I-95 interchange in Baltimore, Maryland. This intercha...

Web Site Usability: A Case Study of Student Perceptions of Educational Web Sites

ERIC Educational Resources Information Center

Ballard, Joyce Kimberly

2010-01-01

The purpose of this research study was to understand the construct of usability from the perspective of 74 students enrolled in six online courses offered by one online and distance learning program at a large, public university in the Midwest. Six courses, designed and developed by two different groups, professional and nonprofessional…

Extending Library Services to Remote Sites: Regis University as Case Study.

ERIC Educational Resources Information Center

Potter, Susan; Boyd, Sandra Hughes

This report considers the ways that the Regis University (Colorado) library has addressed needs created by new adult education programs offered at 10 campus locations in the region, 15 prison sites, a number of corporations, and through independent study. Creation of a new position for a full-time librarian for extended library services and…

Comparison of perioperative outcomes between endoscope-assisted technique and handheld acoustic Doppler for perforator identification in fasciocutaneous flaps.

PubMed

Huang, Jen-Wu; Huang, Chih-Sheng; Shih, Yu-Chung; Perng, Cherng-Kang; Lin, Yi-Ying; Wu, Szu-Hsien

2018-06-01

The endoscopic technique has been utilized to harvest muscle flaps and detect perforators of fasciocutaneous flaps. This study aimed to compare the perioperative outcomes between the endoscope-assisted technique and handheld acoustic Doppler for perforator identification in fasciocutaneous flaps.This retrospective case-control study included patients who underwent fasciocutaneous flap reconstruction for traumatic soft tissue defects. In the case group, perforator identification was assisted by the endoscope-assisted technique. In the control group, age- and sex-matched patients received handheld acoustic Doppler to detect perforators. Perioperative outcomes, flap characteristics, and postoperative complications were compared.There were 12 patients in the case group and 12 in the control group. Compared with the control group, the case group had a significantly shorter length of donor-site wounds (9 cm vs 12 cm, P = .023) and a significantly smaller proportion of patients receiving skin grafting at the donor sites (0% vs 41.7%, P = .037). The case group had a longer operative time, but the difference was not statistically significant (180 minutes vs 150 minutes, P = .367). The amount of blood loss, the time length of postoperative drainage, and complications did not significantly differ between the 2 groups.The endoscope-assisted technique for perforator identification of fasciocutaneous flaps provided less donor-site morbidity and a significantly shorter length of donor-site wounds than the conventional handheld acoustic Doppler, which suggests that this technique could be a valuable alternative when a precise design is indicated.

Impact of case-relevant and case-irrelevant communication within the surgical team on surgical-site infection.

PubMed

Tschan, F; Seelandt, J C; Keller, S; Semmer, N K; Kurmann, A; Candinas, D; Beldi, G

2015-12-01

Surgical-site infections (SSIs) are the most common complications after surgery. An influence from talking and distractions during surgery on patient outcomes has been suggested, but there is limited evidence. The aim of this prospective observational study was to assess the relationship between intraoperative communication within the surgical team and SSI, and between intraoperative distractions and SSI. This prospective observational study included patients undergoing elective, open abdominal procedures. For each procedure, intraoperative case-relevant and case-irrelevant communication, and intraoperative distractions were observed continuously on site. The influence of communication and distractions on SSI after surgery was assessed using logistic regressions, adjusting for risk factors. A total of 167 observed procedures were analysed; their mean(s.d.) duration was 4·6(2·1) h. A total of 24 SSIs (14·4 per cent) were diagnosed. Case-relevant communication during the procedure was independently associated with a reduced incidence of organ/space SSI (propensity score-adjusted odds ratio 0·86, 95 per cent c.i. 0·77 to 0·97; P = 0·014). Case-irrelevant communication during the closing phase of the procedure was independently associated with increased incidence of incisional SSI (propensity score-adjusted odds ratio 1·29, 1·08 to 1·55; P = 0·006). Distractions had no association with SSI. More case-relevant communication was associated with fewer organ/space SSIs, and more case-irrelevant communication during wound closure was associated with incisional SSI. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

[Clinical significance of four quadrant localization in the diagnosis and treatment of metastatic carcinoma of the neck with unknown primary].

PubMed

Gao, Y Y; Chen, X H

2017-06-05

Objective: The aim of this study is to investigate the clinical significance of four quadrant localization in the diagnosis and treatment of unknown primary cervical metastases. Method: The clinical data with unknown primary cervical metastases, were analyzed retrospectively. All the patients have not been found the original site in the initial treatment. There are four quadrants in the neck, the neck line as the longitudinal axis, and edge of cricoid cartilage as the horizontal axis. When cervical metastasis occurred in the left and right upper quadrant, the primary tumor site and radiotherapy from the skull base to the root of the neck; when appear in left and right lower quadrant, the primary investigation site and radiotherapy from neck to thoracic mediastinum, left lower abdomen also includes following primary search. At the same time, bilateral cervical metastasis cancers, focusing on the central line near the primary focus. Specific treatment strategies include ipsilateral total neck dissection and radical radiotherapy of the above radiotherapy site. Result: Left upper neck in 4 cases, right upper neck in 5 cases, left lower neck in 7 cases, lower right neck in 8 cases and mixed area in 6 cases. Only 10 of 30 patients (33.3%) with primary sites were found in the follow up period. In accordance with the four quadrant localization, the median time was 6 months. Conclusion: Four quadrant localization to locate the primary site is accurate, and individualized comprehensive treatment is the key to improve the curative effect. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

The value of core lab stress echocardiography interpretations: observations from the ISCHEMIA Trial.

PubMed

Kataoka, Akihisa; Scherrer-Crosbie, Marielle; Senior, Roxy; Gosselin, Gilbert; Phaneuf, Denis; Guzman, Gabriela; Perna, Gian; Lara, Alfonso; Kedev, Sasko; Mortara, Andrea; El-Hajjar, Mohammad; Shaw, Leslee J; Reynolds, Harmony R; Picard, Michael H

2015-12-18

Stress echocardiography (SE) is dependent on subjective interpretations. As a prelude to the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) Trial, potential sites were required to submit two SE, one with moderate or severe left ventricular (LV) myocardial ischemia and one with mild ischemia. We evaluated the concordance of site and core lab interpretations. Eighty-one SE were submitted from 41 international sites. Ischemia was classified by the number of new or worsening segmental LV wall motion abnormalities (WMA): none, mild (1 or 2) or moderate or severe (3 or more) by the sites and the core lab. Core lab classified 6 SE as no ischemia, 35 mild and 40 moderate or greater. There was agreement between the site and core in 66 of 81 total cases (81%, weighted kappa coefficient [K] =0.635). Agreement was similar for SE type - 24 of 30 exercise (80%, K = 0.571) vs. 41 of 49 pharmacologic (84%, K = 0.685). The agreement between poor or fair image quality (27 of 36 cases, 75%, K = 0.492) was not as good as for the good or excellent image quality cases (39 of 45 cases, 87%, K = 0.755). Differences in concordance were noted for degree of ischemia with the majority of discordant interpretations (87%) occurring in patients with no or mild LV myocardial ischemia. While site SE interpretations are largely concordant with core lab interpretations, this appears dependent on image quality and the extent of WMA. Thus core lab interpretations remain important in clinical trials where consistency of interpretation across a range of cases is critical. ClinicalTrials.gov NCT01471522.

Beyond surgical care improvement program compliance: antibiotic prophylaxis implementation gaps.

PubMed

Hawkins, Russell B; Levy, Shauna M; Senter, Casey E; Zhao, Jane Y; Doody, Kaitlin; Kao, Lillian S; Lally, Kevin P; Tsao, KuoJen

2013-10-01

Despite increased compliance with Surgical Care Improvement Project infection measures, surgical-site infections are not decreasing. The aim of this study was to test the hypothesis that documented compliance with antibiotic prophylaxis guidelines on a pediatric surgery service does not reflect implementation fidelity or adherence to guidelines as intended. A 7-week observational study of elective pediatric surgical cases was conducted. Adherence was evaluated for appropriate administration, type, timing, weight-based dosing, and redosing of antibiotics. Prophylactic antibiotics were administered appropriately in 141 of 143 cases (99%). Of 100 cases (70%) in which antibiotic prophylaxis was indicated, compliance was documented in 100% cases in the electronic medical record, but only 48% of cases adhered to all 5 guidelines. Lack of adherence was due primarily to dosing or timing errors. Lack of implementation fidelity in antibiotic prophylaxis guidelines may partly explain the lack of expected reduction in surgical-site infections. Future studies of Surgical Care Improvement Project effectiveness should measure adherence and implementation fidelity rather than just documented compliance. Copyright © 2013 Elsevier Inc. All rights reserved.

Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

PubMed

Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

2015-06-01

Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture.

Deep Borehole Disposal Safety Analysis.

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

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

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

Modeling Complex Equilibria in ITC Experiments: Thermodynamic Parameters Estimation for a Three Binding Site Model

PubMed Central

Le, Vu H.; Buscaglia, Robert; Chaires, Jonathan B.; Lewis, Edwin A.

2013-01-01

Isothermal Titration Calorimetry, ITC, is a powerful technique that can be used to estimate a complete set of thermodynamic parameters (e.g. Keq (or ΔG), ΔH, ΔS, and n) for a ligand binding interaction described by a thermodynamic model. Thermodynamic models are constructed by combination of equilibrium constant, mass balance, and charge balance equations for the system under study. Commercial ITC instruments are supplied with software that includes a number of simple interaction models, for example one binding site, two binding sites, sequential sites, and n-independent binding sites. More complex models for example, three or more binding sites, one site with multiple binding mechanisms, linked equilibria, or equilibria involving macromolecular conformational selection through ligand binding need to be developed on a case by case basis by the ITC user. In this paper we provide an algorithm (and a link to our MATLAB program) for the non-linear regression analysis of a multiple binding site model with up to four overlapping binding equilibria. Error analysis demonstrates that fitting ITC data for multiple parameters (e.g. up to nine parameters in the three binding site model) yields thermodynamic parameters with acceptable accuracy. PMID:23262283

[Data analysis on hepatitis B through pilot surveillance reporting system in Henan province, 2012-2016].

PubMed

Guo, Y H; Lyu, Y Y; Yang, J H; Xu, J; Li, J; Ye, Y; Zhang, Y Y

2018-04-10

Objective: To standardize the reporting system on hepatitis B in order to improve the quality of monitoring program in Henan province. Methods: A total of 6 sites of Hepatitis B pilot surveillance were selected in Xinzheng of Zhengzhou city, Linzhou of Anyang city, Shanyang district of Jiaozuo city, Shaoling district of Luohe city, Yongcheng of Shangqiu city, Pingqiao district of Xinyang city in Henan province. Subjects under study were those reported hepatitis B cases, from 2012 to 2016. Cases diagnosed in 2011 were chosen as controls. Data on classification of hepatitis B, time that HBsAg became positive and ALT value of the cases were analyzed annually. 5 ml venous blood was collected and anti-HBc IgM confirmed test was made for those suspected acute cases on hepatitis B. Based on the 2016 data from the monitoring system, the incidence of acute hepatitis B in Henan province was estimated. Results: The number of reported hepatitis B cases had declined in 6 sites of Hepatitis B pilot surveillance substantially. A total of 17 436 hepatitis B reported in 2011 but only 2 632 cases were reported in 2016, with a reduction of 84.90%(14 804/17 436) in these six monitoring sites. The number of unclassified hepatitis B cases also dropped sharply. In 2011, 36.87% of the cases were unclassified, but the figure reduced to 0.08% in 2016, from the six sites. The rate on ALT detection also gradually improved. The rate of misdiagnosis on HBV carrier from hepatitis B almost disappeared. From 2013 to 2016, 777 blood samples were collected from six pilot sites. 29.34% (228/777) of the blood samples were tested positive for anti-HBc IgM after confirmed by the hepatitis laboratory of the China Center for Disease Control and Prevention. Conclusions: Since the development of the pilot surveillance program, the quality of reporting system on hepatitis B had been improved, as well as the accuracy of diagnosis. Rate on the accuracy of reporting on hepatitis B and the methods of testing should be improved at the monitoring sites.

Exit-Site Infection of Peritoneal Catheter is Reduced by the Use of Polyhexanide. Results of a Prospective Randomized Trial

PubMed Central

Núñez-Moral, M.; Sánchez-Álvarez, E.; González-Díaz, I.; Peláez-Requejo, B.; Fernández-Viña, A.; Quintana-Fernández, A.; Rodríguez-Suárez, C.

2014-01-01

♦ Background: One of the most common and severe complications affecting peritoneal dialysis (PD) patients is exit-site infection of the peritoneal catheter; it is therefore of vital importance to prevent it. This complication has a negative impact on the success of the technique. In spite of this, there are no clear guidelines concerning how to take care of the exit site. The objective of this study was to assess the efficacy of polyhexanide in preventing exit-site infection over a 12-month period. ♦ Methods: We designed a single-center, prospective, open-labeled, randomized controlled clinical trial with parallel groups. Requirements for participation in the study included implantation of the peritoneal catheter at least six weeks before entering the study and no infectious complications requiring either hospital admission or antibiotic treatment for at least three months before entering into the study. Patients were randomized to be daily cured as follows: Group A: traditional care with saline serum and povidone-iodine; and Group B: polyhexanide solution. Exit sites were evaluated at baseline and every four to six weeks or if any event occurred, according to the Twardowski criteria. ♦ Results: Of the 60 included patients, 46 completed the 12-month follow-up period. Six underwent transplantation, five died and three were transferred to hemodialysis (HD). The treatment was well tolerated, with no side effects nor abandonments due to such effects. Throughout the study period, six patients (20%) undergoing traditional care and only two (6,7%) receiving polyhexanide developed an exit-site infection (p = 0.032). There were a total number of 12 infections; nine occurred in patients following the traditional approach and only three in patients treated with polyhexanide (p = 0.037). The germs responsible for the infections were: S. aureus (six cases), Corynebacterium jeikeium (two cases) and P. aeruginosa (one case) in the saline serum and povidone-iodine group and P. aeruginosa (three cases) in the polyhexanide group. The mean rate of exit-site infection was 1 episode/36.6 patient-months for the traditional care group and 1 episode/102.7 patient-months for the polyhexanide group (p = 0.017). Patients following the traditional treatment required fewer days to get infected than those using polyhexanide (p = 0.033; log rank: 4.2). ♦ Conclusions: These results show that using polyhexanide is efficient for the prevention of exit-site infections. Patients treated with this product suffer from fewer infections and need more time to become infected. Polyhexanide application is painless, no allergies have been described and it is well tolerated by patients. We therefore propose that it may be used routinely from now on for the care of healthy exit site. PMID:24497599

Environmental Exposures and Breast Cancer on Long Island

Cancer.gov

A nested, case-control study to determine if residence in close proximity to hazardous waste sites, toxic release inventory sites, prior land use (for example, farm land), and exposure to various chemicals in drinking water may be associated with breast cancer on Long Island.

CASE STUDY: SITE CONCEPTUAL MODEL FOR ENHANCED MNA OF ARSENIC

EPA Science Inventory

Field investigations have been conducted to understand the fate of arsenic in contaminated ground water during discharge into the Halls Brook Holding Area (HBHA) Pond at the Industri-Plex Superfund Site in Massachusetts. The ground water plume contains elevated levels of arsenic...

Staples.com: Focus on Usability.

ERIC Educational Resources Information Center

McCann, Tom; Hynes, Colin

2002-01-01

Describes the Staples.com electronic commerce Web site; discusses its steady growth rate; and details two case studies in which data from a variety of sources were used to identify and resolve site usability issues and which are supported by compelling ROI (return on investment) figures. (Author/LRW)

Mixed mechanisms of multi-site phosphorylation

PubMed Central

Suwanmajo, Thapanar; Krishnan, J.

2015-01-01

Multi-site phosphorylation is ubiquitous in cell biology and has been widely studied experimentally and theoretically. The underlying chemical modification mechanisms are typically assumed to be distributive or processive. In this paper, we study the behaviour of mixed mechanisms that can arise either because phosphorylation and dephosphorylation involve different mechanisms or because phosphorylation and/or dephosphorylation can occur through a combination of mechanisms. We examine a hierarchy of models to assess chemical information processing through different mixed mechanisms, using simulations, bifurcation analysis and analytical work. We demonstrate how mixed mechanisms can show important and unintuitive differences from pure distributive and processive mechanisms, in some cases resulting in monostable behaviour with simple dose–response behaviour, while in other cases generating new behaviour-like oscillations. Our results also suggest patterns of information processing that are relevant as the number of modification sites increases. Overall, our work creates a framework to examine information processing arising from complexities of multi-site modification mechanisms and their impact on signal transduction. PMID:25972433

A fuelwood plantation site selection procedure using geographic information system technology: A case study in support of the NASA Global Habitability Program

NASA Technical Reports Server (NTRS)

Roller, N. E. G.; Colwell, J. E.; Sellman, A. N.

1985-01-01

A study undertaken in support of NASA's Global Habitability Program is described. A demonstration of geographic information system (GIS) technology for site evaluation and selection is given. The objective was to locate potential fuelwood plantations within a 50 km radius of Nairobi, Kenya. A model was developed to evaluate site potential based on capability and suitability criteria and implemented using the Environmental Research Institute of Michigan's geographic information system.

Description of piezometers installed in the middle Rio Grande basin area, 1997-99, central New Mexico

USGS Publications Warehouse

Bartolino, J.R.; Rankin, D.R.

2000-01-01

Since 1993, the Santa Fe Group aquifer system in the Middle Rio Grande Basin, and particularly in the Albuquerque area, has been the focus of studies to further define the extent of the most productive parts of the aquifer and to gain a better understanding of how ground- water levels are changing over time. The U.S. Geological Survey, in cooperation with the New Mexico Office of the State Engineer, installed nine piezometers during 1998-99 at five sites in and near the margin of the Middle Rio Grande Basin in central New Mexico. In addition, the New Mexico Office of the State Engineer installed another nine piezometers at three sites during 1997. These piezometers allow for collection of ground-water-level data in areas for which little information is available. Most of the piezometers were constructed of 2.5-inch-diameter flush-joint polyvinyl chloride (PVC) schedule 80 casing with 10-foot stainless steel screens; the shallow piezometer at the Tome site has a 40-foot screen, and the single piezometers at the Dome Road and Phoenix Road sites have steel casing with welded joints and a 10- and a 20-foot screen, respectively. Steel casing with a locking lid covers the uppermost 2 feet of the piezometer casing. Drillers' logs and petrophysical logs were collected from the deepest borehole at each site.

Key Elements in Successful Training A Comparative Study of Two Workplaces. Project Report, 2000-2001.

ERIC Educational Resources Information Center

Adult Literacy and Numeracy Australian Research Consortium, Alice Springs. Northern Territory Centre.

This publication presents case studies of two sites--one with and one without a history of involvement in Workplace English Language and Literacy (WELL)-funded training programs. Case study 1, "Partnership, Flexibility, and Experience: Key Elements in Successful Training" (Jenny McGuirk), investigates a food processing company in New South Wales…

Transformation of Palm Beach Community College to Palm Beach State College: A Case Study

ERIC Educational Resources Information Center

Basiratmand, Mehran

2013-01-01

The purpose of this single-site case study was to examine the organization and leadership change process of Palm Beach State College, a publicly funded institution in Florida, as it embarked on offering bachelor's degree programs. The study examined the organizational change process and the extent to which Palm Beach State College's organization…

Involving Employers in Training: Case Studies. Research and Evaluation Report Series 97-J.

ERIC Educational Resources Information Center

Isbell, Kellie; Trutko, John W.; Barnow, Burt S.; Nightengale, Demetra; Pindus, Nancy

This document contains in-depth descriptions and assessments of 17 exemplary employer-based training (EBT) programs that were studied as part of an examination of EBT programs. The case studies are based on site visits to each firm, during which interviews were conducted with company management, supervisors of workers in training, individuals…

Integrating Factors of Grit in School Culture: Case Studies of Two Freshman Academies

ERIC Educational Resources Information Center

Coates, Margaret Marie

2017-01-01

The purpose of this qualitative case study is to explore the cultural manifestation of grit in two freshman academy environments and describe factors of grit that support student success. This study used purposeful sampling to select sites and participants. Data were collected through: administration of Douglas' (1982) grid and group 24-question…

Evaluation of the implantation site morphology in spontaneous abortion.

PubMed

Manolea, Maria Magdalena; Dijmărescu, Anda Lorena; Popescu, Florina Carmen; Novac, Marius Bogdan; DiŢescu, Damian

2015-01-01

The aim of this study was the characterization of the implantation site through histological and immunohistochemical exams and the evaluation of the changes that appear in the pregnancies ended by spontaneous abortion compared to normal pregnancies ended by requested abortion. One hundred eight patients were divided in two groups: the study group that included 58 patients with spontaneous abortion and the control group that included 50 patients with requested abortion. There has been made uterine curettage in all the cases after a complete preoperative evaluation and the obtained product was sent for histopathological evaluation and immunohistochemical study using a VEGF antibody. Studying the histological sections, we noticed the vasculogenesis stages chronology and then according to the histological aspects of normal pregnancy we noticed the histological changes that occurred at the site of implantation in the cases with pathological pregnancies ended by miscarriage. Our results from this study seem to indicate a correlation between decidual vascular changes and the appearance of miscarriage. In pregnancies ended by miscarriage, we found delays in the trophoblast development according to the gestational age at which the event abortifacient happened. The study emphases the temporal differentiation of utero-placental angiogenesis comparing to villous vasculogenesis and angiogenesis in the first trimester miscarriage and normal pregnancy. At the control group, VEGF expression was positive in 88% of cases, while in the study group, pregnancies ended by spontaneous abortion, positive expression of VEGF was present in only 31% of cases. Our data suggest vascular disorders and are in concordance with other histological and ultrasound studies postulating the idea of a link between miscarriage and placental vascular bed pattern changes.

Social Networking Sites' Influence on Travelers' Authentic Experience a Case Study of Couch Surfing

ERIC Educational Resources Information Center

Liu, Xiao

2013-01-01

This study explored travelers' experiences in the era of network hospitality 2.0 using CouchSurfing.org as a case study. The following research questions guided this study: 1) what experience does CouchSurfing create for travelers before, during and after their travel? 2) how does couch surfers' experience relate to authenticity in context of…

Single-Parents' Persistence in Pursuit of Higher Education: A Case Study

ERIC Educational Resources Information Center

Poindexter, Beryle Jean

2017-01-01

The purpose of this qualitative case study is an exploratory study to examine what contributes to the failure of the persistence of non-residential single-parents pursuing a college degree. The participants of this study included ten non-residential single-parent students between the ages of 21 and 50. The site of the interviews was in the…

Stakeholder involvement for management of the coastal zone.

PubMed

Oen, Amy Mp; Bouma, Geiske M; Botelho, Maria; Pereira, Patrícia; Haeger-Eugensson, Marie; Conides, Alexis; Przedrzymirska, Joanna; Isaksson, Ingela; Wolf, Christina; Breedveld, Gijs D; Slob, Adriaan

2016-10-01

The European Union (EU) has taken the lead to promote the management of coastal systems. Management strategies are implemented by the Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD), as well as the recent Maritime Spatial Planning (MSP) Directive. Most EU directives have a strong focus on public participation; however, a recent review found that the actual involvement of stakeholders was variable. The "Architecture and roadmap to manage multiple pressures on lagoons" (ARCH) research project has developed and implemented participative methodologies at different case study sites throughout Europe. These cases represent a broad range of coastal systems, and they highlight different legislative frameworks that are relevant for coastal zone management. Stakeholder participation processes were subsequently evaluated at 3 case study sites in order to assess the actual implementation of participation in the context of their respective legislative frameworks: 1) Byfjorden in Bergen, Norway, in the context of the WFD; 2) Amvrakikos Gulf, Greece, in the context of the MSFD; and 3) Nordre Älv Estuary, Sweden, in the context of the MSP Directive. An overall assessment of the evaluation criteria indicates that the ARCH workshop series methodology of focusing first on the current status of the lagoon or estuary, then on future challenges, and finally on identifying management solutions provided a platform that was conducive for stakeholder participation. Results suggest that key criteria for a good participatory process were present and above average at the 3 case study sites. The results also indicate that the active engagement that was initiated at the 3 case study sites has led to capacity building among the participants, which is an important intermediary outcome of public participation. A strong connection between participatory processes and policy can ensure the legacy of the intermediary outcomes, which is an important and necessary start toward more permanent resource management outcomes such as ecological and economic improvement. Integr Environ Assess Manag 2016;12:701-710. © 2016 SETAC. © 2016 SETAC.

Plantar pressures are elevated in people with longstanding diabetes-related foot ulcers during follow-up

PubMed Central

Fernando, Malindu E.; Crowther, Robert G.; Lazzarini, Peter A.; Yogakanthi, Saiumaeswar; Sangla, Kunwarjit S.; Buttner, Petra; Jones, Rhondda; Golledge, Jonathan

2017-01-01

Objective High plantar pressures are implicated in the development of diabetes-related foot ulcers. Whether plantar pressures remain high in patients with chronic diabetes-related foot ulcers over time is uncertain. The primary aim of this study was to compare plantar pressures at baseline and three and six months later in participants with chronic diabetes-related foot ulcers (cases) to participants without foot ulcers (controls). Methods Standardised protocols were used to measure mean peak plantar pressure and pressure-time integral at 10 plantar foot sites (the hallux, toes, metatarsals 1 to 5, mid-foot, medial heel and lateral heel) during barefoot walking. Measurements were performed at three study visits: baseline, three and six months. Linear mixed effects random-intercept models were utilised to assess whether plantar pressures differed between cases and controls after adjusting for age, sex, body mass index, neuropathy status and follow-up time. Standardised mean differences (Cohen’s d) were used to measure effect size. Results Twenty-one cases and 69 controls started the study and 16 cases and 63 controls completed the study. Cases had a higher mean peak plantar pressure at several foot sites including the toes (p = 0.005, Cohen’s d = 0.36) and mid-foot (p = 0.01, d = 0.36) and a higher pressure-time integral at the hallux (p<0.001, d = 0.42), metatarsal 1 (p = 0.02, d = 0.33) and mid-foot (p = 0.04, d = 0.64) compared to controls throughout follow-up. A reduction in pressure-time integral at multiple plantar sites over time was detected in all participants (p<0.05, respectively). Conclusions Plantar pressures assessed during gait are higher in diabetes patients with chronic foot ulcers than controls at several plantar sites throughout prolonged follow-up. Long term offloading is needed in diabetes patients with diabetes-related foot ulcers to facilitate ulcer healing. PMID:28859075

Rotational Flap to Enhance Buccal Gingival Thickness and Implant Emergence Profile in the Esthetic Zone: Two Cases Reports

PubMed Central

AL-Juboori, Mohammed Jasim

2017-01-01

Objective: Many techniques have been developed to enhance the gingival thickness, gingival level and emergence profile around the implant in the esthetic zone. Introduction: In this study, a buccal rotational flap was used to improve the implant site in the esthetic zone and increase gingival tissue thickness. Methods: Two cases involved the use of a rotational flap during second-stage implant surgery, one case involved the use of a temporary crown with a healing abutment, and another case involved the use of a healing abutment. Result: The cases were followed up until the final crown was placed. The implant site was improved in 2 cases; the gingival thickness increased, the gingival level was enhanced and the emergence profile was developed. Conclusion: Many factors affect the results of a rotational flap; some factors are surgical, while others are prosthetic, biological and anatomical. PMID:28839477

A GIS-BASED MULTI-CRITERIA EVALUATION SYSTEM FOR SELECTION OF LANDFILL SITES: a case study from Abu Dhabi, United Arab Emirates

NASA Astrophysics Data System (ADS)

Issa, S. M.; Shehhi, B. Al

2012-07-01

Landfill sites receive 92% of total annual solid waste produced by municipalities in the emirate of Abu Dhabi. In this study, candidate sites for an appropriate landfill location for the Abu Dhabi municipal area are determined by integrating geographic information systems (GIS) and multi-criteria evaluation (MCE) analysis. To identify appropriate landfill sites, eight input map layers including proximity to urban areas, proximity to wells and water table depth, geology and topography, proximity to touristic and archeological sites, distance from roads network, distance from drainage networks, and land slope are used in constraint mapping. A final map was generated which identified potential areas showing suitability for the location of the landfill site. Results revealed that 30% of the study area was identified as highly suitable, 25% as suitable, and 45% as unsuitable. The selection of the final landfill site, however, requires further field research.

Clinical peri-implant sounding accuracy in the presence of chronic inflammation of peri-implant tissues. Clinical observation study.

PubMed

Romeo, E; Lops, D; Storelli, S; Ghisolfi, M

2009-03-01

The aim of this study was to assess if the probing pocket depth is a reliable clinical parameter in the evaluation of the depth of the peri-implant sulci. In case of chronic inflamed peri-implant tissues, this evaluation is useful for understanding the level of bone resorption. The study enrolled 22 patients. All of them were diagnosed for a peri-implantitis and were scheduled for a resective surgery with implantoplasty. During the surgery, a full thickness flap was raised and resective surgery was performed as well as an implantoplasty procedure. Peri-implant probing values before the surgery (PAL) were recorded, as were values of bone resorption after flap elevation (DIB), at all four sites around each implant (88 sites). The mean value of PAL calculated for all 88 sites was 5.67 mm (+/-1.46); the correspondent value of DIB was 6.37 mm (+/-1.81). In 52 sites out of 88 (59.1%) the values of PAL and DIB were exactly the same (maximum difference 0.5 mm). In only 10 cases (11.3%) the difference between PAL and DIB was >2 mm. The mean values for PAL and DIB were not statistically different. Authors have concluded that in case of chronic inflammation of peri-implant tissues, the probe reaches the bone pick, allowing the clinician to have reliable information on the actual bone resorption.

Superfund Record of Decision (EPA Region 3): Voortman Farm Site, Lehigh County, Pennsylvania (first remedial action) June 1988. Final report

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

Not Available

1988-06-30

The 43-acre Voortman Farm site is located in Upper Salucon Township, Lehigh County, Pennsylvania. The site consists of a sinkhole that contained empty battery casings disposed of in late 1979 and early 1980. Citizen complaints in 1980 prompted the prohibition of dumping and subsequent site investigation. In September 1986, the battery casings in the sinkhole caught on fire. Since the battery casings were burning underground, attempts to extinguish the fire remained unsuccessful. There does not appear to be any leaching from any residual metals, contaminated soils or battery casings present. The selected remedial action for the site is included.

Facebook as a Learning Tool? A Case Study on the Appropriation of Social Network Sites from Mobile Phones in Developing Countries

ERIC Educational Resources Information Center

Pimmer, Christoph; Linxen, Sebastian; Grohbiel, Urs

2012-01-01

This exploratory research investigates how students and professionals use social network sites (SNSs) in the setting of developing and emerging countries. Data collection included focus groups consisting of medical students and faculty as well as the analysis of a Facebook site centred on medical and clinical topics. The findings show how users,…

Institutionalizing evidence-based practice: an organizational case study using a model of strategic change

PubMed Central

2009-01-01

Background There is a general expectation within healthcare that organizations should use evidence-based practice (EBP) as an approach to improving the quality of care. However, challenges exist regarding how to make EBP a reality, particularly at an organizational level and as a routine, sustained aspect of professional practice. Methods A mixed method explanatory case study was conducted to study context; i.e., in terms of the presence or absence of multiple, inter-related contextual elements and associated strategic approaches required for integrated, routine use of EBP ('institutionalization'). The Pettigrew et al. Content, Context, and Process model was used as the theoretical framework. Two sites in the US were purposively sampled to provide contrasting cases: i.e., a 'role model' site, widely recognized as demonstrating capacity to successfully implement and sustain EBP to a greater degree than others; and a 'beginner' site, self-perceived as early in the journey towards institutionalization. Results The two sites were clearly different in terms of their organizational context, level of EBP activity, and degree of institutionalization. For example, the role model site had a pervasive, integrated presence of EBP versus a sporadic, isolated presence in the beginner site. Within the inner context of the role model site, there was also a combination of the Pettigrew and colleagues' receptive elements that, together, appeared to enhance its ability to effectively implement EBP-related change at multiple levels. In contrast, the beginner site, which had been involved for a few years in EBP-related efforts, had primarily non-receptive conditions in several contextual elements and a fairly low overall level of EBP receptivity. The beginner site thus appeared, at the time of data collection, to lack an integrated context to either support or facilitate the institutionalization of EBP. Conclusion Our findings provide evidence of some of the key contextual elements that may require attention if institutionalization of EBP is to be realized. They also suggest the need for an integrated set of receptive contextual elements to achieve EBP institutionalization; and they further support the importance of specific interactions among these elements, including ways in which leadership affects other contextual elements positively or negatively. PMID:19948064

Off-Site Distance Education Faculty: A Checklist of Considerations

ERIC Educational Resources Information Center

Stewart, Barbara L.; Goodson, Carole; Miertschin, Susan

2012-01-01

Case studies informed the development of a checklist for use in determining whether to engage in online educational practices whereby the family and consumer sciences (FCS) instructor teaches from a location distant from campus.Objective and subjective case details were recorded and analyzed for commonality and variance. From cross-case analysis,…

Guided bone regeneration using nonexpanded polytetrafluoroethylene membranes in preparation for dental implant placements--a report of 420 cases.

PubMed

Barboza, Eliane Porto; Stutz, Bianca; Ferreira, Vinícius Farias; Carvalho, Waldimir

2010-02-01

The biologic principle of guided bone regeneration has been successfully used to prevent bone loss in extraction sites. This study comprises 420 cases of alveolar ridge maintenance in preparation for dental implant placements. Nonexpanded polytetrafluoroethylene membranes were positioned over all extraction sites and left intentionally exposed. Lyophilized mineralized bone allografts were used to prevent membrane collapse when buccal bone walls were lost. Membranes were removed at week 4. At the time of implant placements, all sites presented soft tissue compatibility with keratinized gingiva. The mucogingival junction position seemed to be preserved. Exposed nonexpanded polytetrafluoroethylene membranes associated, or not, with bone graft provide tissue formation suitable for implant placement.

Evaluation of Fuzzy-Logic Framework for Spatial Statistics Preserving Methods for Estimation of Missing Precipitation Data

NASA Astrophysics Data System (ADS)

El Sharif, H.; Teegavarapu, R. S.

2012-12-01

Spatial interpolation methods used for estimation of missing precipitation data at a site seldom check for their ability to preserve site and regional statistics. Such statistics are primarily defined by spatial correlations and other site-to-site statistics in a region. Preservation of site and regional statistics represents a means of assessing the validity of missing precipitation estimates at a site. This study evaluates the efficacy of a fuzzy-logic methodology for infilling missing historical daily precipitation data in preserving site and regional statistics. Rain gauge sites in the state of Kentucky, USA, are used as a case study for evaluation of this newly proposed method in comparison to traditional data infilling techniques. Several error and performance measures will be used to evaluate the methods and trade-offs in accuracy of estimation and preservation of site and regional statistics.

Third-molar extraction with ultrasound bone surgery: a case-control study.

PubMed

Mozzati, Marco; Gallesio, Giorgia; Russo, Andrea; Staiti, Giorgio; Mortellaro, Carmen

2014-05-01

The aim of this case-control study was to evaluate the postoperative period and healing between 2 surgical methods (traditional and ultrasound bone surgery) that are used for mandibular third-molar extraction. Fifteen patients with impaction of both of the lower third molars and indications for their extractions were used in this study. Bilateral-mandibular third-molar extractions were performed at the same surgical time: traditional surgery with burrs was used on 1 side (control site), and ultrasound surgery was used on the other side (test [T] site). After surgery, the patients were examined at 7 and 14 days and at 1 and 3 months to evaluate tissue healing. The following was assessed at every follow-up: pain, trismus, swelling, and alveolar bone level. The study included 15 patients, and 30 mandibular third-molar extractions were performed. We found only 1 postoperative complication: 1 patient had alveolitis in the control site. Complete recoveries without any complications were reported in all of the patients at the T sites. Complete recoveries without any complication were reported in all patients at the T sites. The only disadvantage of the piezoelectric technique was the length of operation time, which was increased by approximately 8 minutes; however, this effect was offset by reducing the morbidity. Our preliminary study showed that Piezosurgery is an excellent tool for reducing the risk of complications and improving the postoperative period.

A Methodology to Evaluate Ecological Resources and Risk Using Two Case Studies at the Department of Energy’s Hanford Site

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

Burger, Joanna; Gochfeld, Michael; Bunn, Amoret

An assessment of the potential risks to ecological resources from remediation activities or other perturbations should involve a quantitative evaluation of resources on the remediation site and in the surrounding environment. We developed a risk methodology to rapidly evaluate potential impact on ecological resources for the U.S. Department of Energy’s Hanford Site in southcentral Washington State. We describe the application of the risk evaluation for two case studies to illustrate its applicability. The ecological assessment involves examining previous sources of information for the site, defining different resource levels from 0 to 5. We also developed a risk rating scale frommore » nondiscernable to very high. Field assessment is the critical step to determine resource levels or to determine if current conditions are the same as previously evaluated. We provide a rapid assessment method for current ecological conditions that can be compared to previous site-specific data, or that can be used to assess resource value on other sites where ecological information is not generally available. The method is applicable to other Department of Energy’s sites, where its development may involve a range of state regulators, resource trustees, Tribes and other stakeholders. Achieving consistency across Department of Energy’s sites for valuation of ecological resources on remediation sites will assure Congress and the public that funds and personnel are being deployed appropriately.« less

Toward a Conceptual Framework for Blending Social and Biophysical Attributes in Conservation Planning: A Case-Study of Privately-Conserved Lands

NASA Astrophysics Data System (ADS)

Pasquini, Lorena; Twyman, Chasca; Wainwright, John

2010-11-01

There has been increasing recognition within systematic conservation planning of the need to include social data alongside biophysical assessments. However, in the approaches to identify potential conservation sites, there remains much room for improvement in the treatment of social data. In particular, few rigorous methods to account for the diversity of less-easily quantifiable social attributes that influence the implementation success of conservation sites (such as willingness to conserve) have been developed. We use a case-study analysis of private conservation areas within the Little Karoo, South Africa, as a practical example of the importance of incorporating social data into the process of selecting potential conservation sites to improve their implementation likelihood. We draw on extensive data on the social attributes of our case study obtained from a combination of survey questionnaires and semi-structured interviews. We discuss the need to determine the social attributes that are important for achieving the chosen implementation strategy by offering four tested examples of important social attributes in the Little Karoo: the willingness of landowners to take part in a stewardship arrangement, their willingness to conserve, their capacity to conserve, and the social capital among private conservation area owners. We then discuss the process of using an implementation likelihood ratio (derived from a combined measure of the social attributes) to assist the choice of potential conservation sites. We conclude by summarizing our discussion into a simple conceptual framework for identifying biophysically-valuable sites which possess a high likelihood that the desired implementation strategy will be realized on them.

Revascularization of the anterior cerebral artery by Y-shaped superficial temporal artery interposition graft for the treatment of a de novo aneurysm arising at the site of A3-A3 bypass: technical case report.

PubMed

Endo, Hidenori; Sugiyama, Shin-Ichiro; Endo, Toshiki; Fujimura, Miki; Shimizu, Hiroaki; Tominaga, Teiji

2017-12-22

The most frequently used option to reconstruct the anterior cerebral artery (ACA) is an ACA-ACA side-to-side anastomosis. The long-term outcome and complications of this technique are unclear. The authors report a case of a de novo aneurysm arising at the site of A 3 -A 3 anastomosis. A 53-year-old woman underwent A 3 -A 3 side-to-side anastomosis for the treatment of a ruptured right A 2 dissecting aneurysm. At 44 months after surgery, a de novo aneurysm developed at the site of anastomosis. The aneurysm developed in the front wall of the anastomosis site, and projected to the anterosuperior direction. A computational fluid dynamics (CFD) study showed the localized region with high wall shear stress coincident with the pulsation in the front wall of the anastomosis site, where the aneurysm developed. A Y-shaped superficial temporal artery (STA) interposition graft was used successfully to reconstruct both ACAs, and then the aneurysm was trapped. To the authors' knowledge, this is the first case of a de novo aneurysm that developed at the site of an ACA-ACA side-to-side anastomosis. A CFD study showed that hemodynamic stress might be an underlying cause of the aneurysm formation. A Y-shaped STA interposition graft is a useful option to treat this aneurysm. Long-term follow-up is necessary to detect this rare complication after ACA-ACA anastomosis.

Suicidal single gunshot injury to the head: differences in site of entrance wound and direction of the bullet path between right- and left-handed--an autopsy study.

PubMed

Nikolić, Slobodan; Zivković, Vladimir; Babić, Dragan; Juković, Fehim

2012-03-01

The aim of this study was to determine the differences in the anatomical site of a gunshot entrance wound and the direction of the bullet path between right- and left-handed subjects who committed a suicide by a single gunshot injury to the head. The retrospective autopsy study was performed for a 10-year period, and it included selected cases of single suicidal gunshot head injury, committed by handguns. We considered only contact or near-contact wounds. The sample included 479 deceased, with average age 47.1 ± 19.1 years (range, 12-89 years): 432 males and 47 females, with 317 right-handed, 25 left-handed, and 137 subjects with unknown dominant hand. In our observed sample, most cases involved the right temple as the site of entrance gunshot wound (about 67%), followed by the mouth (16%), forehead (7%), left temple (6%), submental (2%), and parietal region (1%). The left temple, right temple, and forehead were the sites of the gunshot entrance wounds, which were the best predictors of the handedness of the deceased (Spearman ρ = 0.149, P = 0.006). Our study showed that the direction of the bullet intracranial path in cases of suicide was even a more potent predictor of the handedness of the deceased (Spearman ρ = 0.263, P = 0.000; Wald = 149.503, P = 0.000).

Massive cortico-subcortical ischemic stroke with a consecutive hemorrhagic event: a case report.

PubMed

Pirici, D; Ion, Daniela Adriana; Mogoantă, L; Mărgăritescu, Otilia; Pirici, Ionica; Foarfă, Camelia; Tudorică, Valerica; Panduru, N M; Coconu, Marieta; Checheriţă, I A

2011-01-01

We report a case of a 78-year-old woman with a large cerebral infarction probably due to athermanous embolism following atrial fibrillation. The patient, known with atrial fibrillation, high blood pressure and heart failure, complained of headache and motor impairment on the left side of the body. CT imaging revealed a subacute ischemic lesion in the right fronto-occipital lobes, and an old ischemic lesion in the right fronto-parietal lobes. Anticoagulant treatment was conducted with careful monitoring of the coagulability status. After almost three weeks, suddenly the patient became comatose and died shortly after. Macroscopic and microscopic examination confirmed the cortico-subcortical ischemic lesions, but also identified a fresh hemorrhagic site in pons, distant from the initial lesion sites. An immunohistochemical study identified blood vessels in the ischemic sites completely isolated from any glial support. This is a rare case of a large cerebral infarction with a pontine hemorrhagic event.

The transportation and environmental impacts of infill versus greenfield development: a comparative case study analysis.

DOT National Transportation Integrated Search

1999-10-01

This paper tries to answer the question of which site provides more efficient or better transportation services to a new residential or commercial development - an urban infill site or a suburban edge/greenfield? In order to answer this question, the...

Cost Effectiveness of On-site versus Off-site Depression Collaborative Care in Rural Federally Qualified Health Centers

PubMed Central

Pyne, Jeffrey M.; Fortney, John C.; Mouden, Sip; Lu, Liya; Hudson, Teresa J; Mittal, Dinesh

2018-01-01

Objective Collaborative care for depression is effective and cost-effective in primary care settings. However, there is minimal evidence to inform the choice of on-site versus off-site models. This study examined the cost-effectiveness of on-site practice-based collaborative care (PBCC) versus off-site telemedicine-based collaborative care (TBCC) for depression in Federally Qualified Health Centers (FQHCs). Methods Multi-site randomized pragmatic comparative cost-effectiveness trial. 19,285 patients were screened for depression, 14.8% (n=2,863) screened positive (PHQ9 ≥10) and 364 were enrolled. Telephone interview data were collected at baseline, 6-, 12-, and 18-months. Base case analysis used Arkansas FQHC healthcare costs and secondary analysis used national cost estimates. Effectiveness measures were depression-free days and quality-adjusted life years (QALYs) derived from depression-free days, Medical Outcomes Study SF-12, and Quality of Well Being scale (QWB). Nonparametric bootstrap with replacement methods were used to generate an empirical joint distribution of incremental costs and QALYs and acceptability curves. Results Mean base case FQHC incremental cost-effectiveness ratio (ICER) using depression-free days was $10.78/depression-free day. Mean base case ICERs using QALYs ranged from $14,754/QALY (depression-free day QALY) to $37,261/QALY (QWB QALY). Mean secondary national ICER using depression-free days was $8.43/depression-free day and using QALYs ranged from $11,532/QALY (depression-free day QALY) to $29,234/QALY (QWB QALY). Conclusions These results support the cost-effectiveness of the TBCC intervention in medically underserved primary care settings. Results can inform the decision about whether to insource (make) or outsource (buy) depression care management in the FQHC setting within the current context of Patient-Centered Medical Home, value-based purchasing, and potential bundled payments for depression care. The www.clinicaltrials.gov # for this study is NCT00439452. PMID:25686811

Safety and Feasibility of Transradial Access for Visceral Interventions in Patients with Thrombocytopenia

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

Titano, J. J., E-mail: joseph.titano@mountsinai.org; Biederman, D. M., E-mail: derek.biederman@mountsinai.org; Marinelli, B. S., E-mail: brett.marinelli@exchange.mssm.edu

PurposeTransradial access (TRA) has shown lower morbidity and decreased bleeding complications compared to transfemoral access. This study evaluates the safety and feasibility of TRA in thrombocytopenic patients undergoing visceral interventions.Methods and MaterialsPatients who underwent visceral interventions via the radial artery with platelet count less than or equal to 50,000/µL were included in the study. Outcome variables included technical success, access site, bleeding, transfusion, and neurological complications.ResultsFrom July 1, 2012, to May 31, 2015, a total of 1353 peripheral interventions via TRA were performed, of which 85 procedures were performed in 64 patients (mean age 62.2 years) with a platelet count <50,000/µLmore » (median 39,000/µL). Interventions included chemoembolization (n = 46), selective internal radiation therapy (n = 30), and visceral embolization (n = 9). Technical success was 97.6 % with two cases of severe vessel spasm requiring ipsilateral femoral crossover. There was no major access site, bleeding, or neurological adverse events at 30 days. Minor access site hematomas occurred in five cases (5.9 %) and were treated conservatively in all cases. Pre-procedural platelet transfusions were administered in 23 (27.1 %) cases. There was no statistically significant difference in access site or bleeding complications between the transfused and nontransfused groups.ConclusionsTransradial visceral interventions in patients with thrombocytopenia are both feasible and safe, possibly without the need for platelet transfusions.« less

Diagnosis of abnormal patterns in multivariate microclimate monitoring: a case study of an open-air archaeological site in Pompeii (Italy).

PubMed

Merello, Paloma; García-Diego, Fernando-Juan; Zarzo, Manuel

2014-08-01

Chemometrics has been applied successfully since the 1990s for the multivariate statistical control of industrial processes. A new area of interest for these tools is the microclimatic monitoring of cultural heritage. Sensors record climatic parameters over time and statistical data analysis is performed to obtain valuable information for preventive conservation. A case study of an open-air archaeological site is presented here. A set of 26 temperature and relative humidity data-loggers was installed in four rooms of Ariadne's house (Pompeii). If climatic values are recorded versus time at different positions, the resulting data structure is equivalent to records of physical parameters registered at several points of a continuous chemical process. However, there is an important difference in this case: continuous processes are controlled to reach a steady state, whilst open-air sites undergo tremendous fluctuations. Although data from continuous processes are usually column-centred prior to applying principal components analysis, it turned out that another pre-treatment (row-centred data) was more convenient for the interpretation of components and to identify abnormal patterns. The detection of typical trajectories was more straightforward by dividing the whole monitored period into several sub-periods, because the marked climatic fluctuations throughout the year affect the correlation structures. The proposed statistical methodology is of interest for the microclimatic monitoring of cultural heritage, particularly in the case of open-air or semi-confined archaeological sites. Copyright © 2014 Elsevier B.V. All rights reserved.

Conservative management of mesh-site infection in hernia repair surgery: a case series.

PubMed

Meagher, H; Clarke Moloney, M; Grace, P A

2015-04-01

The aim of this study is to assess the outcome of conservative management of infected mesh grafts following abdominal wall hernia repair. This study retrospectively examined the charts of patients who developed mesh-site infection following surgery for abdominal hernia repair to determine how effective conservative management in the form of antibiotics and wound management was on the resolution of infection and wound healing. Over a period of 30 months, 13 patients developed infected mesh grafts post-hernia repair surgery. Twelve patients were successfully treated conservatively with local wound care and antibiotics if clinically indicated. One patient returned to theatre to have the infected mesh removed. Of the patients that healed eleven were treated with negative pressure wound therapy (VAC(®)). This series of case studies indicate that conservative management of abdominal wall-infected hernia mesh cases is likely to be successful.

Effective environmental factors on geographical distribution of traffic accidents on pedestrians, downtown of Tehran City.

PubMed

Moradi, Ali; Rahmani, Khaled; Kavousi, Amir; Eshghabadi, Farshid; Nematollahi, Shahrzad; Zainni, Slahedyn; Soori, Hamid

2018-02-20

The aim of this study was to geographically analyse the traffic casualties in pedestrians in downtown of Tehran City. Study population consisted of pedestrians who had traffic injury accidents from April 2014 to March 2015 in Tehran City. Data were extracted from the offices of traffic police and municipality. For analysis of environmental factors and site of accidents, Ordinary Least Square (OLS) regression models and Geographically Weighted Regression (GWR) were used. All pedestrian accidents including 514 accidents were assessed in this study in which the site of accidents included arterial streets in 370 (71.9%) cases, collector streets in 133 cases (25.2%) and highways in 11 cases (2.1%). Geographical units of traffic accidents in pedestrians had statistically significant relationship with the number of bus stations, number of crossroads and recreational areas. Neighbourhoods close to markets are considered as the most dangerous places for injury in traffic accidents.

Case Studies of Selected Cooperative Adult Education Programs.

ERIC Educational Resources Information Center

Moore, Allen B., Ed.; And Others

Third in a series of five, the document presents case study reports of site visits to cooperative adult education programs. The five locations visited included programs between: (1) Wharton County Junior College and Johnson Testers, Inc. (Texas); (2) Louisiana State Department of Education and B. F. Trappey and Sons (Louisiana); (3) Grand Rapids…

Assessment of Sediment Measurements in Lake Michigan as a Case Study: Implications for Monitoring and Modeling

EPA Science Inventory

Lake Michigan, the sixth largest freshwater lake in the world by surface area, was utilized as a water body for assessment within a case study. Field data collected at 116 sediment sampling sites throughout the lake in an intensive monitoring effort were utilized for assessment ...

Primary Datasets for Case Studies of River-Water Quality

ERIC Educational Resources Information Center

Goulder, Raymond

2008-01-01

Level 6 (final-year BSc) students undertook case studies on between-site and temporal variation in river-water quality. They used professionally-collected datasets supplied by the Environment Agency. The exercise gave students the experience of working with large, real-world datasets and led to their understanding how the quality of river water is…

French-Algonquian Interaction in Canada: A Michif Case Study

ERIC Educational Resources Information Center

Rosen, Nicole

2008-01-01

This paper discusses the language contact situation between Algonquian languages and French in Canada. Michif, a French-Plains Cree mixed language, is used as a case study for linguistic results of language contact. The paper describes the phonological, morphological, and syntactic conflict sites between the grammars of Plains Cree and French, as…

Classifying Language-Minority Students: A Closer Look at Individual Student Data

ERIC Educational Resources Information Center

Okhremtchouk, Irina S.

2014-01-01

This article presents an exploratory case study of site-level classification practices for language-minority students. The study examines individual classification data of 439 language-minority student cases from one California urban school district and two of its schools. The review process involved a thorough examination of data integrity,…

Traditional-Aged College Juniors' Career Planning Self-Efficacy: A Case Study

ERIC Educational Resources Information Center

Sherman, Dawn C.

2012-01-01

The purpose of this single-site case study was to explore and describe traditional-age college juniors' reports of self-efficacy (Bandura, 1997) regarding Career Planning (Barker & Kellen, 1998). More specifically, the career planning confidence levels of college juniors enrolled in a required career development course at a private business…

Discovering How Students Search a University Web Site: A Comparative Usability Case Study for PC and Mobile Devices

ERIC Educational Resources Information Center

Sengel, Erhan

2014-01-01

This study aims to investigate the usability level of web site of a university by observing 10 participants who are required to complete 11 tasks, which have been defined by the researchers before to gather data about effectiveness, efficiency and satisfaction. System Usability Scale was used to collect data about satisfaction. The research…

Environmental Justice and the Spatial Distribution of Outdoor Recreation sites: an Applications of Geographic Information Systems

Treesearch

Michael A. Tarrant; H. Ken Cordell

1999-01-01

This study examines the spatial distribution of outdoor recreation sites and their proximity to census block groups (CBGs), in order to determine potential socio-economic inequities. It is framed within the context of environmental justice. Information from the Southern Appalachian Assessment database was applied to a case study of the Chattahoochee National Forest in...

Using a Social Networking Site for Experiential Learning: Appropriating, Lurking, Modeling and Community Building

ERIC Educational Resources Information Center

Arnold, Nike; Paulus, Trena

2010-01-01

With social networking sites playing an increasingly important role in today's society, educators are exploring how they can be used as a teaching and learning tool. This article reports the findings of a qualitative case study about the integration of "Ning" into a blended course. The study draws on the perspectives of the students, the…

Feasibility and reliability of remote assessment of PALS psychomotor skills via interactive videoconferencing.

PubMed

Weeks, Douglas L; Molsberry, Dianne M

2009-03-01

This study determined inter-rater agreement between skill assessments provided by on-site PALS evaluators with ratings from evaluators at a remote site viewing the same skill performance over a videoconferencing network. Judgments about feasibility of remote evaluation were also obtained from the evaluators and PALS course participants. Two remote and two on-site instructors independently rated performance of 27 course participants who performed cardiac and shock/respiratory emergency core cases. Inter-rater reliability was assessed with the intraclass correlation coefficient (ICC). Feasibility was assessed with surveys of evaluators and course participants. Core cases were under the direction of the remote evaluators. The ICC for overall agreement on pass/fail decisions was 0.997 for the cardiac cases and 0.998 for the shock/respiratory cases. Perfect agreement was reached on 52 of 54 pass/fail decisions. Across all evaluators, all core cases, and all participants, 2584 ratings of individual skill criteria were provided, of which 21 (0.8%) were ratings in which a single evaluator disagreed with the other three evaluators. No trends emerged for location of the disagreeing evaluator. Survey responses indicated that remote evaluation was acceptable and feasible to course participants and to the evaluators. Videoconferencing technology was shown to provide adequate spatial and temporal resolution for PALS evaluators at-a-distance from course participants to agree with ratings of on-site evaluators.

An ArcGIS decision support tool for artificial reefs site selection (ArcGIS ARSS)

NASA Astrophysics Data System (ADS)

Stylianou, Stavros; Zodiatis, George

2017-04-01

Although the use and benefits of artificial reefs, both socio-economic and environmental, have been recognized with research and national development programmes worldwide their development is rarely subjected to a rigorous site selection process and the majority of the projects use the traditional (non-GIS) approach, based on trial and error mode. Recent studies have shown that the use of Geographic Information Systems, unlike to traditional methods, for the identification of suitable areas for artificial reefs siting seems to offer a number of distinct advantages minimizing possible errors, time and cost. A decision support tool (DSS) has been developed based on the existing knowledge, the multi-criteria decision analysis techniques and the GIS approach used in previous studies in order to help the stakeholders to identify the optimal locations for artificial reefs deployment on the basis of the physical, biological, oceanographic and socio-economic features of the sites. The tool provides to the users the ability to produce a final report with the results and suitability maps. The ArcGIS ARSS support tool runs within the existing ArcMap 10.2.x environment and for the development the VB .NET high level programming language has been used along with ArcObjects 10.2.x. Two local-scale case studies were conducted in order to test the application of the tool focusing on artificial reef siting. The results obtained from the case studies have shown that the tool can be successfully integrated within the site selection process in order to select objectively the optimal site for artificial reefs deployment.

SU-E-T-760: Tolerance Design for Site-Specific Range in Proton Patient QA Process Using the Six Sigma Model

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

Lah, J; Shin, D; Kim, G

Purpose: To show how tolerance design and tolerancing approaches can be used to predict and improve the site-specific range in patient QA process in implementing the Six Sigma. Methods: In this study, patient QA plans were selected according to 6 site-treatment groups: head &neck (94 cases), spine (76 cases), lung (89 cases), liver (53 cases), pancreas (55 cases), and prostate (121 cases), treated between 2007 and 2013. We evaluated a model of the Six Sigma that determines allowable deviations in design parameters and process variables in patient-specific QA, where possible, tolerance may be loosened, then customized if it necessary tomore » meet the functional requirements. A Six Sigma problem-solving methodology is known as DMAIC phases, which are used stand for: Define a problem or improvement opportunity, Measure process performance, Analyze the process to determine the root causes of poor performance, Improve the process by fixing root causes, Control the improved process to hold the gains. Results: The process capability for patient-specific range QA is 0.65 with only ±1 mm of tolerance criteria. Our results suggested the tolerance level of ±2–3 mm for prostate and liver cases and ±5 mm for lung cases. We found that customized tolerance between calculated and measured range reduce that patient QA plan failure and almost all sites had failure rates less than 1%. The average QA time also improved from 2 hr to less than 1 hr for all including planning and converting process, depth-dose measurement and evaluation. Conclusion: The objective of tolerance design is to achieve optimization beyond that obtained through QA process improvement and statistical analysis function detailing to implement a Six Sigma capable design.« less

Single-Site Laparoscopic Surgery for Inflammatory Bowel Disease

PubMed Central

Bedros, Nicole; Hakiman, Hekmat; Araghizadeh, Farshid Y.

2014-01-01

Background and Objectives: Single-site laparoscopic colorectal surgery has been firmly established; however, few reports addressing this technique in the inflammatory bowel disease population exist. Methods: We conducted a case-matched retrospective review of 20 patients who underwent single-site laparoscopic procedures for inflammatory bowel disease compared with 20 matched patients undergoing multiport laparoscopic procedures. Data regarding these patients were tabulated in the following categories: demographic characteristics, operative parameters, and perioperative outcomes. Results: A wide range of cases were completed: 9 ileocolic resections, 7 cases of proctocolectomy with end ileostomy or ileal pouch anal anastomosis, 2 cases of proctectomy with ileal pouch anal anastomosis, and 2 total abdominal colectomies with end ileostomy were all matched to equivalent multiport laparoscopic cases. No single-incision cases were converted to multiport laparoscopy, and 2 single-incision cases (10%) were converted to an open approach. For single-incision cases, the mean length of stay was 7.7 days, the mean time to oral intake was 3.3 days, and the mean period of intravenous analgesic use was 5.0 days. There were no statistically significant differences between single-site and multiport cases. Conclusions: Single-site laparoscopic surgery is technically feasible in inflammatory bowel disease. The length of stay and period of intravenous analgesic use (in days) appear to be higher than those in comparable series examining outcomes of single-site laparoscopic colorectal surgery, and the outcomes are comparable with those of multiport laparoscopy. This may be because of the nature of inflammatory bowel disease, limiting the benefits of a single-site approach in this population. PMID:24960490

Regulatory Oversight of the Legacy Gunner Uranium Mine and Mill Site in Northern Saskatchewan, Canada - 13434

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

Stenson, Ron; Howard, Don

2013-07-01

As Canada's nuclear regulator, the Canadian Nuclear Safety Commission (CNSC) is responsible for licensing all aspects of uranium mining, including remediation activities at legacy sites. Since these sites already existed when the current legislation came into force in 2000, and the previous legislation did not apply, they present a special case. The Nuclear Safety and Control Act (NSCA), was written with cradle-to- grave oversight in mind. Applying the NSCA at the end of a 'facilities' life-cycle poses some challenges to both the regulator and the proponent. When the proponent is the public sector, even more challenges can present themselves. Althoughmore » the licensing process for legacy sites is no different than for any other CNSC license, assuring regulatory compliance can be more complicated. To demonstrate how the CNSC has approached the oversight of legacy sites the history of the Commission's involvement with the Gunnar uranium mine and mill site provides a good case study. The lessons learned from the CNSC's experience regulating the Gunnar site will benefit those in the future who will need to regulate legacy sites under existing or new legislation. (authors)« less

Decreased bed rest post-percutaneous coronary intervention with a 7-French arterial sheath and its effects on vascular complications.

PubMed

Wentworth, Laura J; Bechtum, Elizabeth L; Hoffman, Jessica G; Kramer, Robert R; Bartel, David C; Slusser, Joshua P; Tilbury, Ralph Thomas

2018-01-01

To compare the incidence of femoral access puncture site complications in the control group, who underwent 6 hr of bed rest, with patients in the case group, who underwent 4 hr of bed rest. The ideal bed rest length after percutaneous coronary intervention with a 7-French arterial sheath has been investigated by nursing practice. However, in this larger-sheath-size group, best practices have not been determined, and bed rest time continues to vary markedly among institutions. Retrospective study. Data were retrieved from the National Cardiovascular Data Registry and electronic health records in this retrospective study. Sample size was 401 patients: 152 case patients with 4-hr bed rest and 249 controls with 6-hr bed rest. Case group data were obtained from 20 May 2013-31 December 2014; and control group data, 15 June 2011-20 May 2013. National Cardiovascular Data Registry event rates were generally low in both groups: Only three patients in each group had a bleeding event within 72 hr (2% vs. 1%) and no patient and only two controls had arteriovenous fistula (0% vs. 1%). Complications documented in the electronic health records with institutional femoral access puncture site complication definitions identified bleeding at the access site in eight case patients (5%) and nine controls (4%). Haematoma at the access site occurred in 21 case patients (14%) and 25 controls (10%). The practice change of decreasing bed rest from 6-4 hr for patients with 7-French arterial sheaths post-percutaneous coronary intervention was associated with no significant change in femoral access puncture site complications in either National Cardiovascular Data Registry data or institutional electronic health records data. This introduces expanded evidence of safety in decreasing bed rest length in larger (7-French) arterial sheaths post-percutaneous coronary intervention. © 2017 John Wiley & Sons Ltd.

Science plus management equals successful remediation -- A case study

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

Buehlman, M.D.; Rogers, D.T.; Payne, F.C.

In the past, owners of contaminated sites attempted to remediate as quickly as possible, usually by excavating contaminated soil or pumping and treating contaminated groundwater. Often, they started remediation before identifying all potential types and sources of contaminants, and before conducting a thorough hydrogeologic study. Such premature action usually resulted in the selected remedy not working, the contamination spreading, or unnecessary remedial activities. Today, successful site remediation is recognized as a complex and time-consuming undertaking--requiring a combination of careful scientific study, effective negotiation with the regulatory agencies and skillful management of multidisciplinary efforts. A case study involving a Brownfields sitemore » in southeastern Michigan clearly illustrates the elements of successful remediation. The site`s soil was contaminated with polychlorinated biphenyls (PCBs) and its groundwater with a variety of chlorinated solvents. The original estimate for remediation had exceeded $30 million. Several phases of investigation were conducted to evaluate the nature and sources of contaminants, the site`s hydrogeology, potential risks to human health and the environment, and feasible remedial technologies. Multiple cleanup criteria were established for different affected areas based on the results of the investigations, changes that were taking place with the state cleanup regulations and standards and subsequent negotiations with state and federal regulators. Innovative remedial technologies were selected. The result was a remediation that met or exceeded all soil and groundwater cleanup objectives, was performed on schedule, and was highly cost-effective. The final cost was limited to $3 million--one-tenth of the original estimate.« less

Propeller Flaps and Its Outcomes - A Prospective Study of 15 Cases Over Two-years.

PubMed

K T, Ramesha; J, Vijay; M, Shankarappa

2014-01-01

Cover flaps are needed in management of any bodily defect involving bone, tendon, nerve & vessels. The major objective of a plastic surgeon, facing a complex soft-tissue defect, is to replace "like with like" tissues at minimal donor site "cost" and with maximal accuracy & efficacy. To study the "Propeller Flaps" utility in reconstructive surgeries, evaluate its planning and complications involving donor site morbidity. The prospective study was conducted on 15 cases (11 males/4 females) of propeller flaps during the period of two years (2010-12) in Department of Plastic Surgery and Burns, Bangalore Medical College and Research Institute (BMCRI), Karnataka, India. The propeller flaps were performed in cases with defects due to any cause. Cases with Peripheral Vascular Disease (PVD). Flaps were performed and details recorded. Overall results revealed problem resolution in 87% cases (13 cases). Comprehensive description of each flap type and its related cases are given in the table. It has been categorically found that there were 2 flap partial losses. Partial necrosis has been reported in heavy-smoker patients. This current study clearly justifies that careful application, optimal designing & judicious scientific application of local perforator flaps for lower-limb wounds including rest of the body is successful in many aspects providing high-quality reconstruction ensuring minimal morbidity. It is cost-effective as well as time-saving.

Concealed Accessory Pathways with a Single Ventricular and Two Discrete Atrial Insertion Sites.

PubMed

Kipp, Ryan T; Abu Sham'a, Raed; Hiroyuki, Ito; Han, Frederick T; Refaat, Marwan; Hsu, Jonathan C; Field, Michael E; Kopp, Douglas E; Marcus, Gregory M; Scheinman, Melvin M; Hoffmayer, Kurt S

2017-03-01

Atrioventricular reciprocating tachycardia (AVRT) utilizing a concealed accessory pathway is common. It is well appreciated that some patients may have multiple accessory pathways with separate atrial and ventricular insertion sites. We present three cases of AVRT utilizing concealed pathways with evidence that each utilizing a single ventricular insertion and two discrete atrial insertion sites. In case one, two discrete atrial insertion sites were mapped in two separate procedures, and only during the second ablation was the Kent potential identified. Ablation of the Kent potential at this site remote from the two atrial insertion sites resulted in the termination of the retrograde conduction in both pathways. Case two presented with supraventricular tachycardia (SVT) with alternating eccentric atrial activation patterns without alteration in the tachycardia cycle length. The two distinct atrial insertion sites during orthodromic AVRT and ventricular pacing were targeted and each of the two atrial insertion sites were successfully mapped and ablated. In case three, retrograde decremental conduction utilizing both atrial insertion sites was identified prior to ablation. After mapping and ablation of the first discrete atrial insertion site, tachycardia persisted utilizing the second atrial insertion site. Only after ablation of the second atrial insertion site was SVT noninducible, and VA conduction was no longer present. Concealed retrograde accessory pathways with discrete atrial insertion sites may have a common ventricular insertion site. Identification and ablation of the ventricular insertion site or the separate discrete atrial insertion sites result in successful treatment. © 2017 Wiley Periodicals, Inc.

Analysis of Suicide Notes: An experience in Eskişehir City.

PubMed

Karbeyaz, Kenan; Akkaya, Harun; Balci, Yasemin; Urazel, Beyza

2014-09-01

It is estimated that a million people around the world die by suicide each year. It has been reported that a note was left in 5%-43% of the suicides. In this study, it we aimed to evaluate and discuss suicide notes in our city which is situated in Western Anatolia and where several universities are located. All forensic deaths in Eskişehir in 10-year period between 2001 and 2011 were evaluated. Forensic investigation files were assessed. After investigation, Out of 399 cases, 168 (42.1%) cases, who were determined to have left a suicide letter, telephone message (sms) or message via social network sites, were included in the scope of the study. It was found that 95 (56.5%) of all cases had left a suicide letter, 69 (41.1%) cases had sent a telephone message to a person or more than one person, 4 (2.4%) cases had written notes about suicide and death in social networking sites. A suicide note is an important finding in suicide cases to clarify the case. However, the note should be confirmed by investigation to be accepted as evidence.

Evaluation of stormwater harvesting sites using multi criteria decision methodology

NASA Astrophysics Data System (ADS)

Inamdar, P. M.; Sharma, A. K.; Cook, Stephen; Perera, B. J. C.

2018-07-01

Selection of suitable urban stormwater harvesting sites and associated project planning are often complex due to spatial, temporal, economic, environmental and social factors, and related various other variables. This paper is aimed at developing a comprehensive methodology framework for evaluating of stormwater harvesting sites in urban areas using Multi Criteria Decision Analysis (MCDA). At the first phase, framework selects potential stormwater harvesting (SWH) sites using spatial characteristics in a GIS environment. In second phase, MCDA methodology is used for evaluating and ranking of SWH sites in multi-objective and multi-stakeholder environment. The paper briefly describes first phase of framework and focuses chiefly on the second phase of framework. The application of the methodology is also demonstrated over a case study comprising of the local government area, City of Melbourne (CoM), Australia for the benefit of wider water professionals engaged in this area. Nine performance measures (PMs) were identified to characterise the objectives and system performance related to the eight alternative SWH sites for the demonstration of the application of developed methodology. To reflect the stakeholder interests in the current study, four stakeholder participant groups were identified, namely, water authorities (WA), academics (AC), consultants (CS), and councils (CL). The decision analysis methodology broadly consisted of deriving PROMETHEE II rankings of eight alternative SWH sites in the CoM case study, under two distinct group decision making scenarios. The major innovation of this work is the development and application of comprehensive methodology framework that assists in the selection of potential sites for SWH, and facilitates the ranking in multi-objective and multi-stakeholder environment. It is expected that the proposed methodology will assist the water professionals and managers with better knowledge that will reduce the subjectivity in the selection and evaluation of SWH sites.

Science plus management equals successful remediation: A case study

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

Buehlman, M.D.; Rogers, D.T.; Payne, F.C.

A case study involving a Brownfields site in southeastern Michigan clearly illustrates the elements of successful remediation. The site`s soil was contaminated with polychlorinated biphenyls (PCBs) and its groundwater with a variety of chlorinated solvents. The original estimate for remediation has exceeded $30 million. Several phases of investigation were conducted to evaluate the nature and sources of contaminants, the site`s hydrogeology, potential risks to human health and the environment, and feasible remedial technologies. Multiple cleanup criteria were established for different affected areas based on the results of the investigations, changes that were taking place with the state cleanup regulations andmore » standards and subsequent negotiations with state and federal regulators. Innovative remedial technologies were selected. The result was a remediation that met or exceeded all soil and groundwater cleanup objectives, was performed on schedule, and was highly cost-effective. The final cost was limited to $3 million--one-tenth of the original estimate. The success of this project involved meticulous scientific study and comprehensive understanding of applicable regulatory requirements and available remediation technologies. It also required effective project management to coordinate the multidisciplinary efforts involved and to maintain the constant vertical and horizontal communications necessary to ensure sound decisions at every step in the process.« less

Perspectives on ... Multiculturalism and Library Exhibits: Sites of Contested Representation

ERIC Educational Resources Information Center

Reece, Gwendolyn J.

2005-01-01

This article analyzes a multicultural library exhibit presenting the Palestinian/Israeli conflict as a site of contested representation. Qualitative methodology is used to interrogate the exhibit and its audience reception. Drawing on insights from critical pedagogy, implications for libraries arising from this case study are given and suggestions…

Use of GIS-based Site-specific Nitrogen Management for Improving Energy Efficiency

USDA-ARS?s Scientific Manuscript database

To our knowledge, geographical information system (GIS)-based site-specific nitrogen management (SSNM) techniques have not been used to assess agricultural energy costs and efficiency. This chapter uses SSNM case studies for corn (Zea mays L.) grown in Missouri and cotton (Gossypium hirsutum L.) gro...

Describing an Environment for a Self-Sustaining Technology Transfer Service in a Small Research Budget University: A Case Study

ERIC Educational Resources Information Center

Nieb, Sharon Lynn

2014-01-01

This single-site qualitative study sought to identify the characteristics that contribute to the self sustainability of technology transfer services at universities with small research budgets through a case study analysis of a small research budget university that has been operating a financially self-sustainable technology transfer service for…

How Customer Facing Professionals Adapt to Changing Customer Needs in a Digital Environment: A Single Case Study

ERIC Educational Resources Information Center

Hendriks, Stefan

2017-01-01

This qualitative single case study explored how customer facing professionals (CFPs) adapt to changing customer needs in a digital environment. This study focuses on: (1) Changing customer needs; (2) Competencies needed in a digital environment; (3) How they learn; and (4) What factors help or hinder their success. The site is a global Human…

Case Studies of Successful Schoolwide Enrichment Model-Reading (SEM-R) Classroom Implementations. Research Monograph Series. RM10204

ERIC Educational Resources Information Center

Reis, Sally M.; Little, Catherine A.; Fogarty, Elizabeth; Housand, Angela M.; Housand, Brian C.; Sweeny, Sheelah M.; Eckert, Rebecca D.; Muller, Lisa M.

2010-01-01

The purpose of this qualitative study was to examine the scaling up of the Schoolwide Enrichment Model in Reading (SEM-R) in 11 elementary and middle schools in geographically diverse sites across the country. Qualitative comparative analysis was used in this study, with multiple data sources compiled into 11 in-depth school case studies…

Exploring Enrollment Management for an Independent, Faith-Based, Secondary School: A Case Study

ERIC Educational Resources Information Center

McMaster, Jason Andrew

2017-01-01

This single site case study looked specifically at the foundation and the structure of an independent school in California with respect to how it managed its enrollment and retention rates. For context, the institution being studied utilized a high-tuition strategy combined with a strong financial aid program. In 2012, the school peaked in its…

The Relationship between Pedagogical Beliefs and Teacher Efficacy: A Case Study of Chinese Foreign Language Teachers in Texas

ERIC Educational Resources Information Center

Liu, I-Chun

2012-01-01

This study investigated an emerging language learning culture by examining the relationship between teachers' pedagogical beliefs and perceived efficacy in two cities in southern Texas. Drawing on Bandura's (1994) theory of self-efficacy and Ashton and Webb's (1986) notions about teacher efficacy, a multi-sited case study was conducted to explore…

A Multiple Case Study: The Effect of Professional Development on Teachers' Perceived Ability to Foster Resilience

ERIC Educational Resources Information Center

Klinger, Mary A.

2012-01-01

The purpose of this mixed methods study was to determine the effect of professional development on teachers' perceptions of their ability to foster resilience. Secondary questions investigated the effects of school level and socioeconomic status. An exploratory multi-site case study was designed to compare the perceptions of educators from…

Preliminary geologic framework developed for a proposed environmental monitoring study of a deep, unconventional Marcellus Shale drill site, Washington County, Pennsylvania

USGS Publications Warehouse

Stamm, Robert G.

2018-06-08

BackgroundIn the fall of 2011, the U.S. Geological Survey (USGS) was afforded an opportunity to participate in an environmental monitoring study of the potential impacts of a deep, unconventional Marcellus Shale hydraulic fracturing site. The drill site of the prospective case study is the “Range Resources MCC Partners L.P. Units 1-5H” location (also referred to as the “RR–MCC” drill site), located in Washington County, southwestern Pennsylvania. Specifically, the USGS was approached to provide a geologic framework that would (1) provide geologic parameters for the proposed area of a localized groundwater circulation model, and (2) provide potential information for the siting of both shallow and deep groundwater monitoring wells located near the drill pad and the deviated drill legs.The lead organization of the prospective case study of the RR–MCC drill site was the Groundwater and Ecosystems Restoration Division (GWERD) of the U.S. Environmental Protection Agency. Aside from the USGS, additional partners/participants were to include the Department of Energy, the Pennsylvania Geological Survey, the Pennsylvania Department of Environmental Protection, and the developer Range Resources LLC. During the initial cooperative phase, GWERD, with input from the participating agencies, drafted a Quality Assurance Project Plan (QAPP) that proposed much of the objectives, tasks, sampling and analytical procedures, and documentation of results.Later in 2012, the proposed cooperative agreement between the aforementioned partners and the associated land owners for a monitoring program at the drill site was not executed. Therefore, the prospective case study of the RR–MCC site was terminated and no installation of groundwater monitoring wells nor the collection of nearby soil, stream sediment, and surface-water samples were made.Prior to the completion of the QAPP and termination of the perspective case study the geologic framework was rapidly conducted and nearly completed. This was done for three principal reasons. First, there was an immediate need to know the distribution of the relatively undisturbed surface to near-surface bedrock geology and unconsolidated materials for the collection of baseline surface data prior to drill site development (drill pad access road, drill pad leveling) and later during monitoring associated with well drilling, well development, and well production. Second, it was necessary to know the bedrock geology to support the siting of: (1) multiple shallow groundwater monitoring wells (possibly as many as four) surrounding and located immediately adjacent to the drill pad, and (2) deep groundwater monitoring wells (possibly two) located at distance from the drill pad with one possibly being sited along one of the deviated production drill legs. Lastly, the framework geology would provide the lateral extent, thickness, lithology, and expected discontinuities of geologic units (to be parsed or grouped as hydrostratigraphic units) and regional structure trends as inputs into the groundwater model.This report provides the methodology of geologic data accumulation and aggregation, and its integration into a geographic information system (GIS) based program. The GIS program will allow multiple data to be exported in various formats (shapefiles [.shp], database files [.dbf], and Keyhole Markup Language files [.KML]) for use in surface and subsurface geologic site characterization, for sampling strategies, and for inputs for groundwater modeling.

Public School Teacher Use of Instructional Technology from an Organizational Culture Perspective: An Explanatory Case Study of Two Middle Schools

ERIC Educational Resources Information Center

Spitzer, Bruce Alan; Stansbury, Susan

2004-01-01

The purpose of this qualitative case study is to study the organizational culture and context of two school sites in which instructional technology (IT) use by teachers is evident; to study what and who influences individual teacher preferences toward IT use; and to describe the relationship of Mary Douglas' (1982, 1989, 1992) grid and group…

Characterization of CD22 Expression in Acute Lymphoblastic Leukemia

PubMed Central

Shah, Nirali N.; Stetler-Stevenson, Maryalice; Yuan, Constance M.; Richards, Kelly; Delbrook, Cindy; Kreitman, Robert J.; Pastan, Ira; Wayne, Alan S.

2015-01-01

Background CD22 is a B-lineage differentiation antigen that has emerged as a leading therapeutic target in acute lymphoblastic leukemia (ALL). Procedure Properties of CD22 expression relevant to therapeutic targeting were characterized in primary samples obtained from children and young adults with relapsed and chemotherapy refractory B-precursor (pre-B) ALL. Results CD22 expression was demonstrated in all subjects (n=163) with detection on at least 90% of blasts in 155 cases. Median antigen site density of surface CD22 was 3,470 sites/cell (range 349 – 19,653, n=160). Blasts from patients with known 11q23 (MLL) rearrangement had lower site density (median 1,590 sites/cell, range 349-3,624, n=20 versus 3,853 sites/cell, range 451-19,653, n=140; p=<0.0001) and 6 of 21 cases had sub-populations of blasts lacking CD22 expression (22% – 82% CD22+). CD22 expression was maintained in serial studies of 73 subjects, including those treated with anti-CD22 targeted therapy. The levels of soluble CD22 in blood and marrow by ELISA were low and not expected to influence the pharmacokinetics of anti-CD22 directed agents. Conclusions These characteristics make CD22 an excellent potential therapeutic target in patients with relapsed and chemotherapy-refractory ALL, although cases with MLL rearrangement require close study to exclude the presence of a CD22-negative blast population. PMID:25728039

Schoolgirls in Cyberspace: A Cross-Case Analysis of the Literacy Practices of Three Fifth-Grade Girls in a Social Network Site

ERIC Educational Resources Information Center

Lindstrom, Denise Lorraine

2012-01-01

This dissertation is an exploratory study of the literacy practices of three fifth-grade girls as they used a social network site (SNS) for school related purposes. SNSs are widely used by adolescents, and because communication in these sites is accomplished mainly through writing, it is important to improve our understanding of what this kind of…

Legionnaires' Disease in Hotels and Passenger Ships: A Systematic Review of Evidence, Sources, and Contributing Factors.

PubMed

Mouchtouri, Varvara A; Rudge, James W

2015-01-01

Travel-associated Legionnaires' disease (LD) is a serious problem, and hundreds of cases are reported every year among travelers who stayed at hotels, despite the efforts of international and governmental authorities and hotel operators to prevent additional cases. A systematic review of travel-associated LD events (cases, clusters, outbreaks) and of environmental studies of Legionella contamination in accommodation sites was conducted. Two databases were searched (PubMed and EMBASE). Data were extracted from 50 peer-reviewed articles that provided microbiological and epidemiological evidence for linking the accommodation sites with LD. The strength of evidence was classified as strong, possible, and probable. Three of the 21 hotel-associated events identified and four of nine ship-associated events occurred repeatedly on the same site. Of 197 hotel-associated cases, 158 (80.2%) were linked to hotel cooling towers and/or potable water systems. Ship-associated cases were most commonly linked to hot tubs (59/83, 71.1%). Common contributing factors included inadequate disinfection, maintenance, and monitoring; water stagnation; poor temperature control; and poor ventilation. Across all 30 events, Legionella concentrations in suspected water sources were >10,000 cfu/L, <10,000 cfu/L, and unknown in 11, 3, and 13 events, respectively. In five events, Legionella was not detected only after repeated disinfections. In environmental studies, Legionella was detected in 81.1% of ferries (23/28) and 48.9% of hotels (587/1,200), while all 12 cruise ships examined were negative. This review highlights the need for LD awareness strategies targeting operators of accommodation sites. Increased standardization of LD investigation and reporting, and more rigorous follow-up of LD events, would help generate stronger, more comparable evidence on LD sources, contributing factors, and control measure effectiveness. © 2015 International Society of Travel Medicine.

Real-time porphyrin detection in plaque and caries: a case study

NASA Astrophysics Data System (ADS)

Timoshchuk, Mari-Alina I.; Ridge, Jeremy S.; Rugg, Amanda L.; Nelson, Leonard Y.; Kim, Amy S.; Seibel, Eric J.

2015-02-01

An ultrathin scanning fiber endoscope, originally developed for cancer diagnosis, was used in a case study to locate plaque and caries. The imaging system incorporated software mitigation of background auto-fluorescence (AF). In conventional fluorescence imaging, varying AF across a tooth surface can mask low-level porphyrin signals. Laser-induced auto-fluorescence signals of dental tissue excited using a 405-nm laser typically produce fluorescence over a wavelength range extending from 440-nm to 750-nm. Anaerobic bacterial metabolism produces various porphyrin species (eg. protoporphyrin IX) that are located in carious enamel, dentin, gingivitis sites, and plaque. In our case study, these porphyrin deposits remained as long as one day after prophylaxis. Imaging the tooth surface using 405-nm excitation and subtracting the natural AF enhances the image contrast of low-level porphyrin deposits, which would otherwise be masked by the high background AF. In a case study, healthy tissues as well as sites of early and advanced caries formations were scanned for visual and quantitative signs of red fluorescence associated with porphyrin species using a background mitigation algorithm. Initial findings show increasing amplitudes of red fluorescence as caries severity increases from early to late stages. Sites of plaque accumulation also displayed red fluorescence similar to that found in carious dental tissue. The use of real-time background mitigation of natural dental AF can enhance the detection of low porphyrin concentrations that are indicators of early stage caries formation.

Greater Polar Moment of Inertia at the Tibia in Athletes Who Develop Stress Fractures

PubMed Central

Weidauer, Lee A.; Binkley, Teresa; Vukovich, Matt; Specker, Bonny

2014-01-01

Background: Several previous investigations have determined potential risk factors for stress fractures in athletes and military personnel. Purpose: To determine factors associated with the development of stress fractures in female athletes. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 88 female athletes (cross-country, n = 29; soccer, n = 15; swimming, n = 9; track and field, n = 14; volleyball, n = 12; and basketball, n = 9) aged 18 to 24 years were recruited to participate in a longitudinal bone study and had their left distal tibia at the 4%, 20%, and 66% sites scanned by peripheral quantitative computed tomography (pQCT). Patients included 23 athletes who developed stress fractures during the following year (cases). Whole body, hip, and spine scans were obtained using dual-energy x-ray absorptiometry (DXA). Analysis of covariance was used to determine differences in bone parameters between cases and controls after adjusting for height, lower leg length, lean mass, fat mass, and sport. Results: No differences were observed between cases and controls in any of the DXA measurements. Cases had significantly greater unadjusted trabecular bone mineral content (BMC), greater polar moment of inertia (PMI) at the 20% site, and greater cortical BMC at the 66% site; however, after adjusting for covariates, the differences became nonsignificant. When analyses were repeated using all individuals who had ever had a stress fracture as cases (n = 31) and after controlling for covariates, periosteal circumference was greater in the cases than the controls (71.1 ± 0.7 vs 69.4 ± 0.5 mm, respectively; P = .04). Conclusion: A history of stress fractures is associated with larger bones. These findings are important because larger bones were previously reported to be protective against fractures and stress fractures, but study findings indicate that may not always be true. One explanation could be that individuals who sustain stress fractures have greater loading that results in greater periosteal circumference but also results in the development of stress fractures. PMID:26535343

Update of the Case Definitions for Population-Based Surveillance of Periodontitis

PubMed Central

Eke, Paul I.; Page, Roy C.; Wei, Liang; Thornton-Evans, Gina; Genco, Robert J.

2018-01-01

Background This report adds a new definition for mild periodontitis that allows for better descriptions of the overall prevalence of periodontitis in populations. In 2007, the Centers for Disease Control and Prevention in partnership with the American Academy of Periodontology developed and reported standard case definitions for surveillance of moderate and severe periodontitis based on measurements of probing depth (PD) and clinical attachment loss (AL) at interproximal sites. However, combined cases of moderate and severe periodontitis are insufficient to determine the total prevalence of periodontitis in populations. Methods The authors proposed a definition for mild periodontitis as ≥2 interproximal sites with AL ≥3 mm and ≥2 interproximal sites with PD ≥4 mm (not on the same tooth) or one site with PD ≥5 mm. The effect of the proposed definition on the total burden of periodontitis was assessed in a convenience sample of 456 adults ≥35 years old and compared with other previously reported definitions for similar categories of periodontitis. Results Addition of mild periodontitis increases the total prevalence of periodontitis by ≈31% in this sample when compared with the prevalence of severe and moderate disease. Conclusion Total periodontitis using the case definitions in this study should be based on the sum of mild, moderate, and severe periodontitis. PMID:22420873

Myxoid liposarcoma of the foot: a study of 8 cases.

PubMed

Bekers, Elise M; Song, Wangzhao; Suurmeijer, Albert J H; Bonenkamp, Johannes J; van der Geest, Ingrid C; Braam, Petra M; Ploegmakers, Marieke J M; Desar, Ingrid M E; Tops, Bastiaan B J; van Gorp, Joost M; Creytens, David H; Mentzel, Thomas; Flucke, Uta

2016-12-01

Myxoid liposarcoma is the only translocation-associated liposarcoma subtype. It classically originates in the deep soft tissues of the thigh. At distal sites of the extremities, this tumor is exceedingly rare. We present a series of 8 cases occurring in the foot/ankle. Two female and 6 male patients, aged between 32 and 77 years (mean, 54.3 years), were identified. Tumor size ranged from 1.1 to 10 cm (mean, 6.8 cm). Two lesions eroded bone. All tumors were treated by excision and 7 by (neo)adjuvant radiotherapy. R0 status was reached in 2 cases with 1 case followed by metastasis in the groin. All other cases were documented with R1 (n=2) or R2 (n=4) resection status. In 1 patient, the follow-up status was unknown. All other patients were alive 15-135 (mean, 55.8) months after initial diagnosis. We conclude that myxoid liposarcoma at acral sites are exceedingly rare, and in this series, prognosis was good irrespective of resection status. Clinicians and pathologists have to be aware because this sarcoma type shows a peculiar clinical behavior with high radio- and chemosensitivity and metastatic spread to extrapulmonary sites. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of sexual history-based screening of anatomic sites for chlamydia trachomatis and neisseria gonorrhoeae infection in men having sex with men in routine practice.

PubMed

Peters, Remco P H; Verweij, Stephan P; Nijsten, Noëmi; Ouburg, Sander; Mutsaers, Johan; Jansen, Casper L; van Leeuwen, A Petra; Morré, Servaas A

2011-07-26

Sexually transmitted infection (STI) screening programmes are implemented in many countries to decrease burden of STI and to improve sexual health. Screening for Chlamydia trachomatis and Neisseria gonorrhoeae has a prominent role in these protocols. Most of the screening programmes concerning men having sex with men (MSM) are based on opportunistic urethral testing. In The Netherlands, a history-based approach is used. The aim of this study is to evaluate the protocol of screening anatomic sites for C. trachomatis and N. gonorrhoeae infection based on sexual history in MSM in routine practice in The Netherlands. All MSM visiting the clinic for STI in The Hague are routinely asked about their sexual practice during consulting. As per protocol, tests for urogenital, oropharyngeal and anorectal infection are obtained based on reported site(s) of sexual contact. All consultations are entered into a database as part of the national STI monitoring system. Data of an 18 months period were retrieved from this database and analysed. A total of 1455 consultations in MSM were registered during the study period. The prevalence of C. trachomatis and N. gonorrhoeae per anatomic site was: urethral infection 4.0% respectively and 2.8%, oropharynx 1.5% and 4.2%, and anorectum 8.2% and 6.0%. The majority of chlamydia cases (72%) involved a single anatomic site, which was especially manifest for anorectal infections (79%), while 42% of gonorrhoea cases were single site. Twenty-six percent of MSM with anorectal chlamydia and 17% with anorectal gonorrhoea reported symptoms of proctitis; none of the oropharyngeal infections were symptomatic. Most cases of anorectal infection (83%) and oropharyngeal infection (100%) would have remained undiagnosed with a symptom-based protocol. The current strategy of sexual-history based screening of multiple anatomic sites for chlamydia and gonorrhoea in MSM is a useful and valid guideline which is to be preferred over a symptom-based screening protocol.

Utilising a collective case study system theory mixed methods approach: a rural health example

PubMed Central

2014-01-01

Background Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. Method A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. Results 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. Conclusions The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research. PMID:25066241

[Correlation between polymorphisms in the coagulation factor VII gene hypervariable region 4 site and the risk of coronary heart disease in population with different ethnic backgrounds: a Meta-analysis].

PubMed

Wang, Li-li; Ma, Bin; Qian, Dun; Pang, Jun; Yao, Ya-li

2013-12-01

To assess the correlation between polymorphisms in the coagulation factor VII (F VII)gene hypervariable region 4 (HVR4)site and risk related to coronary heart disease (CHD)in different ethnic populations, especially the Asian populations. Publications up to April 2013, from CBM, CNKI, Wanfang Database,VIP, PubMed, Cochrane Library and Embase were searched to collect data from case-control studies related to F VII gene HVR4 site and CHD in populations from different ethnicities. Quality of studies was evaluated, available data extracted and both RevMan 5.1 and Stata 11.0 softwares were used for Meta-analysis. Fifteen case-control studies were included, involving 3167 cases with CHD group and 3168 cases in the control group. on this Meta-analysis showed that:a)polymorphism of the F VII gene HVR4 site H7/H6+H5 and CHD, b)H7H7/H6H6 + H7H6 and CHD were both slightly correlated between people with different ethnic backgrounds. However, the H6 allele versus H7+H5 allele and CHD showed different results-a high correlation seen in different ethnic groups. H5 allele versus H6+H7 allele and CHD did not appear significant difference(OR = 1.20, 95%CI:0.76-1.90, P = 0.43). Both F VII gene HVR4 polymorphisms H7 allele and the H7H7 genotype might have served as protective factors for CHD in different ethnic groups, H6 allele might serve as a risk factor for CHD, but H5 allele was likely not to be associated with CHD in different ethnic groups.

Low-frequency coherent motions within the spruce canopy on the upwind vs. downwind side of a forested ridge

NASA Astrophysics Data System (ADS)

Potužníková, K.; Sedlák, P.; Šauli, P.

2009-09-01

Airflow and turbulence within and above the forest canopy determine the forest - atmosphere exchange of atmospheric constituents and pollutants. Our investigation is related to the existence of large-scale intermittent coherent structures, which have been detected in turbulence time series measured at the Experimental Ecological Study Site Bílý Kříž (800-900 m a.s.l.) in the Czech Republic. The site is situated on a steep (13°) SSW-faced slope near the top of a mountain ridge forested by a young Norway spruce plantation. Flow directions across the ridge (along the slope) strongly prevail at the site. Results based on a recent study reveal significant differences between the cases when the site is on the upwind vs. downwind side of the ridge. Typical downwind cases are characterized by a low wind speed above the canopy and by relatively higher friction velocity than in the upwind cases. This is explained by the flow retardation by the upslope-directed hydrodynamic pressure gradient and by the large wind shear in the upper part of the wake behind the ridge top. This contribution concentrates on the vertical coherency of the turbulent flow within the forest canopy. Analysed variables include the high-frequency wind velocity components and sonic temperature measured during periods of neutral thermal stratification at two different levels. Wavelet analysis was used for detection of characteristic temporal scale of coherent structures, their persistence and effectivity parameter. Special attention is paid to the differences between the upwind and downwind cases. Acknowledgements: The study is supported by the grant IAA300420803 and IAA300420704 from Grant Agency of Academy of Sciences of the Czech Republic.

Utilising a collective case study system theory mixed methods approach: a rural health example.

PubMed

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2014-07-28

Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research.

Does consumption of leafy vegetables grown in peri-urban agriculture pose a risk to human health?

PubMed

Nabulo, G; Black, C R; Craigon, J; Young, S D

2012-03-01

Concentrations of potentially toxic elements were measured in soils and five contrasting tropical leafy vegetables grown in a replicated field trial at five contaminated urban agriculture sites in Kampala City, Uganda. Soil contamination at each site could be tentatively ascribed to known waste disposal practices. There was considerable variation in metal uptake between vegetable types. Washing leafy vegetables reduced chromium and lead concentrations but exogenous contamination of leaves also depended on vegetable type, with Gynandropsis gynandra L. showing a marked tendency to accumulate Pb and Cr. For the worst case scenario of children consuming unwashed vegetables, some metal 'hazard quotient' (HQ) limits (1.0) were violated at four of the five sites studied. For the 25 'site-vegetable' combinations assessed, the HQ for Pb exceeded 1.0 in 36% of cases. A vegetable-specific site screening tool based on soil extraction with 0.01 M CaCl(2) and extrapolation to provide HQ values was assessed. Copyright © 2011 Elsevier Ltd. All rights reserved.

A retrospective tiered environmental assessment of the Mount Storm Wind Energy Facility, West Virginia,USA

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

Efroymson, Rebecca Ann; Day, Robin; Strickland, M. Dale

Bird and bat fatalities from wind energy projects are an environmental and public concern, with post-construction fatalities sometimes differing from predictions. Siting facilities in this context can be a challenge. In March 2012 the U.S. Fish and Wildlife Service (USFWS) released Land-based Wind Energy Guidelines to assess collision fatalities and other potential impacts to species of concern and their habitats to aid in siting and management. The Guidelines recommend a tiered approach for assessing risk to wildlife, including a preliminary site evaluation that may evaluate alternative sites, a site characterization, field studies to document wildlife and habitat and to predictmore » project impacts, post construction studies to estimate impacts, and other post construction studies. We applied the tiered assessment framework to a case study site, the Mount Storm Wind Energy Facility in Grant County, West Virginia, USA, to demonstrate the use of the USFWS assessment approach, to indicate how the use of a tiered assessment framework might have altered outputs of wildlife assessments previously undertaken for the case study site, and to assess benefits of a tiered ecological assessment framework for siting wind energy facilities. The conclusions of this tiered assessment for birds are similar to those of previous environmental assessments for Mount Storm. This assessment found risk to individual migratory tree-roosting bats that was not emphasized in previous preconstruction assessments. Differences compared to previous environmental assessments are more related to knowledge accrued in the past 10 years rather than to the tiered structure of the Guidelines. Benefits of the tiered assessment framework include good communication among stakeholders, clear decision points, a standard assessment trajectory, narrowing the list of species of concern, improving study protocols, promoting consideration of population-level effects, promoting adaptive management through post-construction assessment and mitigation, and sharing information that can be used in other assessments.« less

Community-based screening for obstetric fistula in Nigeria: a novel approach

PubMed Central

2014-01-01

Background Obstetric fistula continues to have devastating effects on the physical, social, and economic lives of thousands of women in many low-resource settings. Governments require credible estimates of the backlog of existing cases requiring care to effectively plan for the treatment of fistula cases. Our study aims to quantify the backlog of obstetric fistula cases within two states via community-based screenings and to assess the questions in the Demographic Health Survey (DHS) fistula module. Methods The screening sites, all lower level health facilities, were selected based on their geographic coverage, prior relationships with the communities and availability of fistula surgery facilities in the state. This cross-sectional study included women who presented for fistula screenings at study facilities based on their perceived fistula-like symptoms. Research assistants administered the pre-screening questionnaire. Nurse-midwives then conducted a medical exam. Univariate and bivariate analyses are presented. Results A total of 268 women attended the screenings. Based on the pre-screening interview, the backlog of fistula cases reported was 75 (28% of women screened). The backlog identified after the medical exam was 26 fistula cases (29.5% of women screened) in Kebbi State sites and 12 cases in Cross River State sites (6.7%). Verification assessment showed that the DHS questionnaire had 92% sensitivity, 83% specificity with 47% positive predictive value and 98% negative predictive value for identifying women afflicted by fistula among women who came for the screenings. Conclusions This methodology, involving effective, locally appropriate messaging and community outreach followed up with medical examination by nurse-midwives at lower level facilities, is challenging, but represents a promising approach to identify the backlog of women needing surgery and to link them with surgical facilities. PMID:24456506

Physical activity and cancer risk: dose-response and cancer, all sites and site-specific.

PubMed

Thune, I; Furberg, A S

2001-06-01

The association between physical activity and overall and site-specific cancer risk is elaborated in relation to whether any observed dose-response association between physical activity and cancer can be interpreted in terms of how much physical activity (type, intensity, duration, frequency) is needed to influence site- and gender-specific cancer risk. Observational studies were reviewed that have examined the independent effect of the volume of occupational physical activity (OPA) and/or leisure time physical activity (LPA) on overall and site-specific cancer risk. The evidence of cohort and case-control studies suggests that both leisure time and occupational physical activity protect against overall cancer risk, with a graded dose-response association suggested in both sexes. Confounding effects such as diet, body weight, and parity are often included as a covariate in the analyses, with little influence on the observed associations. A crude graded inverse dose-response association was observed between physical activity and colon cancer in 48 studies including 40,674 colon/colorectal cancer cases for both sexes. A dose-response effect of physical activity on colon cancer risk was especially observed, when participation in activities of at least moderate activity (>4.5 MET) and demonstrated by activities expressed as MET-hours per week. An observed inverse association with a dose-response relationship between physical activity and breast cancer was also identified in the majority of the 41 studies including 108,031 breast cancer cases. The dose-response relationship was in particular observed in case-control studies and supported by observations in cohort studies when participation in activities of at least moderate activity (>4.5 MET) and demonstrated by activities expressed by MET-hours per week. This association between physical activity and breast cancer risk is possibly dependent on age at exposure, age at diagnosis, menopausal status and other effect modifiers, e.g., body mass index. Furthermore, data concerning carcinoma of other cancers (prostate, lung, endometrium, ovary, and testicular cancers) are required. A protective effect of physical activity on site-specific cancer risk with a dose-response association between physical activity and colon and pre- and postmenopausal breast cancer supported by identified biological mechanisms has been observed. The optimal permutation of type, intensity, duration, and frequency of physical activity across the lifespan is unclear, but it is gender, age, and site specific and supports moderate activity (>4.5 MET) more than light activities (<4.5 MET). The complicated nature of the physical activity variable, combined with lack of knowledge regarding possible biological mechanisms operating between physical activity and cancer, warrants further studies including controlled clinical randomized trials.

Online Social Networking Goes to College: Two Case Studies of Higher Education Institutions That Implemented College-Created Social Networking Sites for Recruiting Undergraduate Students

ERIC Educational Resources Information Center

Ferguson, Christopher Paul

2010-01-01

With increased competition among higher education institutions for best- fit students, the profession of college admissions is compelled to implement innovative recruiting strategies (e.g. online social networking sites), that may impact college access and persistence in the United States. This qualitative study examined the reasons why two…

Breast and splenic metastases of squamous cell carcinoma from the uterine cervix: a case report.

PubMed

Aitelhaj, Meryem; Khoyaali, Siham L; Boukir, Anouar; Elkabous, Mustapha; Abahssain, Halima; Mrabti, Hind; El Khannoussi, Basma; Errihani, Hassan

2014-11-04

Metastases to the breast from extramammary malignancies are infrequent, the most common primary sites are malignant melanoma, leukemia, lymphoma, and cancer of the lung, stomach, prostate and ovary. The cervical origin is exceptional. Splenic metastasis from squamous cell carcinoma of the cervix is also rare. To the best of our knowledge, only three cases of isolated splenic metastasis have been reported in the literature. We describe the case of a 55-year-old North African woman who presented with a nodule in her left breast eight months after treatment for stage IIB squamous cell uterine cervical carcinoma. The excisional biopsy with histological study demonstrated a poorly differentiated squamous cell carcinoma. A computed tomography scan revealed a splenic secondary location. We report here a case of two unusual metastatic sites of uterine cervical carcinoma, the breast and spleen. It is the first case of this association without widespread disease.

On-road bicycle facilities and bicycle crashes in Iowa, 2007-2010.

PubMed

Hamann, Cara; Peek-Asa, Corinne

2013-07-01

An average of 611 deaths and over 47,000 bicyclists are injured in traffic-related crashes in the United States each year. Efforts to increase bicycle safety are needed to reduce and prevent injuries and fatalities, especially as trends indicate that ridership is increasing rapidly. The objective of this study was to evaluate the effect of bicycle-specific roadway facilities (e.g., signage and bicycle lanes) in reducing bicycle crashes. We conducted a case site-control site study of 147 bicycle crash-sites identified from the Iowa Department of Transportation crash database from 2007 to 2010 and 147 matched non-crash sites. Control sites were randomly selected from intersections matched to case sites on neighborhood (census block group) and road classification (arterial, feeder, collector, etc.). We examined crash risk by any on-road bicycle facility present and by facility type (pavement markings--bicycle lanes and shared lane arrows, bicycle-specific signage, and the combination of markings and signage), controlling for bicycle volume, motor vehicle volume, street width, sidewalks, and traffic controls. A total of 11.6% of case sites and 15.0% of controls had an on-road bicycle facility. Case intersections had higher bicycle volume (3.52 vs. 3.34 per 30 min) and motor vehicle volume (248.77 vs. 205.76 per 30 min) than controls. Our results are suggestive that the presence of an on-road bicycle facility decreases crash risk by as much as 60% with a bicycle lane or shared lane arrow (OR=0.40, 95% CI=0.09-1.82) and 38% with bicycle-specific signage (OR=0.62, 95% CI=0.15-2.58). Investments in bicycle-specific pavement markings and signage have been shown to be beneficial to traffic flow, and our results suggest that they may also reduce the number of bicycle-motor vehicle crashes and subsequent injuries and fatalities. As a relatively low-cost traffic feature, community considerations for further implementation of these facilities are justified. Copyright © 2012 Elsevier Ltd. All rights reserved.

Use of Facebook: A Case Study of Singapore Students' Experience

ERIC Educational Resources Information Center

Hew, Khe Foon; Cheung, Wing Sum

2012-01-01

Facebook has become one of the most popular social network sites among many students. However, current research on Facebook use has focused mainly on Anglo-American students. Relatively little is known about Facebook use in Singapore. Data were collected from 83 students (ages ranged from 15 to 23). This study uses a naturalistic case study…

Engaged Teaching and Learning with Adult Karen Refugees in a Service-Learning Site

ERIC Educational Resources Information Center

Smolen, Lynn Atkinson; Zhang, Wei; Detwiler, Stephen

2013-01-01

This article describes a case study of a service-learning project connected to a TESOL (teaching English to speakers of other languages) teacher preparation program. The case study explored the teacher candidates' experiences teaching English to Karen refugees from Myanmar (Burma) in a midwestern city in the United States. The teacher candidates'…

Success Despite Socioeconomics: A Case Study of a High-Achieving, High-Poverty School

ERIC Educational Resources Information Center

Tilley, Thomas Brent; Smith, Samuel J.; Claxton, Russell L.

2012-01-01

This case study of a high-achieving, high-poverty school describes the school's leadership, culture, and programs that contributed to its success. Data were collected from two surveys (the School Culture Survey and the Vanderbilt Assessment of Leadership in Education), observations at the school site, and interviews with school personnel. The…

Parental Involvement in Active Transport to School Initiatives: A Multi-Site Case Study

ERIC Educational Resources Information Center

Eyler, Amy; Baldwin, Julie; Carnoske, Cheryl; Nickelson, Jan; Troped, Philip; Steinman, Lesley; Pluto, Delores; Litt, Jill; Evenson, Kelly; Terpstra, Jennifer; Brownson, Ross; Schmid, Thomas

2008-01-01

Background: Increasing physical activity in youth is a recommended approach to curbing the childhood obesity epidemic. One way to help increase children's daily activity is to promote active transportation to and from school (ATS). Purpose: The purpose of this case study was to explore parental perception of, and participation in, ATS initiatives.…

A Case Study of Legitimate Literacies: Teens' "Small World" and the School Library

ERIC Educational Resources Information Center

Comstock, Sharon L.

2012-01-01

This dissertation is a dual-site ethnographic case study of the lived information literacy experiences of students in their junior year of high school relative to their school library and librarians. What began as an investigation of an apparent gap in understanding between the views of teens and school librarians regarding "information…

A Case Study of Israeli Higher-Education Institutes Sharing Scholarly Information with the Community via Social Networks

ERIC Educational Resources Information Center

Forkosh-Baruch, Alona; Hershkovitz, Arnon

2012-01-01

The purpose of this study is to empirically examine cases in which Social Networking Sites (SNS) are being utilized for scholarly purposes by higher-education institutes in Israel. The research addresses questions regarding content patterns, activity patterns, and interactivity within Facebook and Twitter accounts of these institutes. Research…

Standards of Competence: A Multi-Site Case Study of School Reform. Project: Effects of Testing Reforms and Standards.

ERIC Educational Resources Information Center

Ellwein, Mary Catherine; Glass, Gene V.

A qualitative case study involving five educational institutions assessed the use of competency testing as a prerequisite for high school graduation, criterion for admission into college, criterion for teacher certification, and statewide assessment tool. Focus was on persons and processes involved in setting educational standards associated with…

The School Principal as Change Agent: An Explanatory Case Study.

ERIC Educational Resources Information Center

McLaughlin, Lisa; Hyle, Adrienne E.

This single-site case study was designed to investigate ways in which a principal considers the individual needs of faculty members when promoting a particular change, as perceived by faculty and staff. Four research questions were addressed: (1) How does a principal create a context for change? (2) Is school culture acknowledged as an integral…

The costs of housing developments on sites with elevated landslide risk in the UK

NASA Astrophysics Data System (ADS)

Barclay, K.; Heath, A.

2015-09-01

New housing targets are being set for local planning authorities resulting in more areas being zoned for development. There is currently no requirement for a landslide assessment prior to this zoning, and sites at elevated risk of landslides are being put forward for development without consideration of the additional costs and other impacts of building on these higher risk sites. This study aimed to reveal the increased financial, economic, social and environmental costs associated with these decisions. Case studies were focused on the city of Bath, an area of increasing population and “one of the most intensely landslipped areas in Britain’’. The case studies found the financial costs associated with building in a landslide risk area to be significantly higher than the equivalent construction in areas of greater geological stability. Furthermore, it was found that uncertainty in cost when developing in unstable areas exacerbates this problem as the final cost cannot be accurately predicted before construction.

Surgical infection in a videolaparoscopic cholecystectomy when using peracetic acid for the sterilization of instruments.

PubMed

de Melo, Edluza Maria Viana Bezerra; Leão, Cristiano de Souza; Andreto, Luciana Marques; de Mello, Maria Júlia Gonçalves

2013-01-01

To determine the frequency of surgical site infection in patients undergoing laparoscopic cholecystectomy with instruments sterilized by peracetic acid. We conducted a retrospective, cohort, descriptive, cross-sectional study. Peracetic acid has been used for sterilization following the protocol recommended by the manufacturer. We observed the criteria and indicators of process and structure for preventing surgical site infection pre and intraoperatively. For epidemiological surveillance, outpatient visits were scheduled for the 15th and between the 30th and 45th days after discharge. Among the 247 patients, there were two cases of surgical site infection (0.8%). One patient was readmitted to systemic antibiotic therapy and percutaneous puncture; in the other the infection was superficial and followed at the clinic. Ethical issues prevent the conduction of a prospective study because of peracetic acid have been banned for the sterilization of instruments that penetrate organs and cavities. Nevertheless, these results encourage prospective case-control studies comparing its use (historical control) with ethylene oxide sterilization.

Single-incision laparoscopic surgery through an ostomy site: a natural approach by an unnatural orifice.

PubMed

Lopez, Nicole E; Peterson, Carrie Y; Ramamoorthy, Sonia L; McLemore, Elisabeth C; Sedrak, Michael F; Lowy, Andrew M; Horgan, Santiago; Talamini, Mark A; Sicklick, Jason K

2015-02-01

Single-incision laparoscopic surgery (SILS) is gaining popularity for a wide variety of surgical operations and capitalizes on the benefits of traditional laparoscopic surgery without incurring multiple incision sites. Traditionally, SILS is performed by a midline periumbilical approach. However, such a minimally invasive approach may be utilized in patients who already have an abdominal incision. Our series retrospectively reviews 7 cases in which we utilized the fascial defect at the time of after ostomy reversal as our SILS incision site. In turn, we performed a variety of concurrent intra-abdominal procedures with excellent technical success and outcomes. Our study is the largest single-institution case series of this novel approach and suggests that utilizing an existing ostomy-site abdominal incision is a safe and effective location for SILS port placement and should be considered in patients undergoing concurrent procedures.

Cysticercosis: The day to day public health problem and the various sites affected by it - A one year study.

PubMed

Srikanth, S; Anandam, G

2013-07-01

The present study is done to highlight the various regions in the body affected by cysticercosis and to educate the people about the personal hygiene and prevention of the parasite. This is a study done on patients who were referred for swelling in the body, which were diagnosed as cysticercosis in one of their differential diagnosis clinically. During the 1 year study (from October 2011 to September 2012) we diagnosed seven cases of cysticercosis involving the various sites in the body. Our cases highlight the rare presentation of cysticercus infestation as cause of treatablelymphadenopathy. Cysticercosis should be included in the differential diagnosis of cervical swellings especially in endemic regions. Timely diagnosis and intervention help in preventing fatal complications.

Development of a Comprehensive Database System for Safety Analyst

PubMed Central

Paz, Alexander; Veeramisti, Naveen; Khanal, Indira; Baker, Justin

2015-01-01

This study addressed barriers associated with the use of Safety Analyst, a state-of-the-art tool that has been developed to assist during the entire Traffic Safety Management process but that is not widely used due to a number of challenges as described in this paper. As part of this study, a comprehensive database system and tools to provide data to multiple traffic safety applications, with a focus on Safety Analyst, were developed. A number of data management tools were developed to extract, collect, transform, integrate, and load the data. The system includes consistency-checking capabilities to ensure the adequate insertion and update of data into the database. This system focused on data from roadways, ramps, intersections, and traffic characteristics for Safety Analyst. To test the proposed system and tools, data from Clark County, which is the largest county in Nevada and includes the cities of Las Vegas, Henderson, Boulder City, and North Las Vegas, was used. The database and Safety Analyst together help identify the sites with the potential for safety improvements. Specifically, this study examined the results from two case studies. The first case study, which identified sites having a potential for safety improvements with respect to fatal and all injury crashes, included all roadway elements and used default and calibrated Safety Performance Functions (SPFs). The second case study identified sites having a potential for safety improvements with respect to fatal and all injury crashes, specifically regarding intersections; it used default and calibrated SPFs as well. Conclusions were developed for the calibration of safety performance functions and the classification of site subtypes. Guidelines were provided about the selection of a particular network screening type or performance measure for network screening. PMID:26167531

Recurrent Penile Fracture-Case Report and Alternative Surgical Approach.

PubMed

Nascimento, Bruno; Guglielmetti, Giuliano B; Miranda, Eduardo P; Ivanovic, Renato F; Batagello, Carlos A; Nahas, William C; Srougi, Miguel; Cury, José

2018-05-03

Penile refracture is an exceedingly rare event, with very few published studies. To the best of our knowledge, this is the first documented case in the literature of penile fracture with 3 same-site recurrences. To describe the case of a 25-year-old Caucasian man with recurrent penile fracture ultimately treated with resuture and patch reinforcement. Patient history (clinical and surgical) and literature review. After the 3rd same-site recurrence, patch reinforcement over the sutured area was performed. The patient had an uneventful recovery and no recurrences to date. There is no evidence indicating the superiority of non-absorbable sutures. Bovine pericardium reinforcement over the sutured area was used to minimize the chance of another recurrence. More studies are necessary to investigate its safety and efficacy in this scenario. Nascimento B, Guglielmetti GB, Miranda EP, et al. Recurrent Penile Fracture-Case Report and Alternative Surgical Approach. Sex Med 2018;X:XX-XX. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Isolated port-site metastasis after surgical staging for low-risk endometrioid endometrial cancer: A case report.

PubMed

Mautone, Daniele; Dall'asta, Andrea; Monica, Michela; Galli, Letizia; Capozzi, Vito Andrea; Marchesi, Federico; Giordano, Giovanna; Berretta, Roberto

2016-07-01

Port-site metastases (PSMs) are well-known potential complications of laparoscopic surgery for gynaecologic malignancies. The present case study reports PSM following laparoscopic surgery for Stage IA Grade 1 endometrioid endometrial cancer (EEC). The recurrence developed within 7 months following primary surgery and required surgical excision followed by adjuvant chemo-radio therapy. After 9 months, the patient remains disease-free. PSMs are rare complications following laparoscopic surgery. Amongst the 23 cases of endometrial cancer PSMs reported so far, only 4 followed EEC Stage IA Grade 1-2. The present study reports a rare case of PSM after Stage IA Grade 1 EEC. The clinical and prognostic relevance of PSMs has not been identified so far; and it is not known whether PSMs represent a local recurrence or a systemic recurrence. Surgeons should be aware that even low-risk EEC may be followed by PSMs and should take steps to prevent these rare recurrences.

Postmortem dynamic cerebral angiography for detecting aneurysm and bleeding sites in cases of subarachnoid hemorrhage.

PubMed

Inokuchi, Go; Yajima, Daisuke; Hayakawa, Mutsumi; Motomura, Ayumi; Chiba, Fumiko; Torimitsu, Suguru; Makino, Yohsuke; Iwase, Hirotaro

2014-12-01

One of the advantages of postmortem imaging is its ability to obtain diagnostic findings in a non-destructive manner when autopsy is either difficult or may destroy forensic evidence. In recent years, efforts have been made to incorporate computed tomography (CT) based postmortem angiography into forensic pathology; however, it is not currently clear how well the modality can determine sites of bleeding in cases of subarachnoid hemorrhage. Therefore, in this study, we investigated the utility of postmortem cerebral angiography using multi-detector row CT (MDCT) by injecting a contrast medium through a catheter inserted into the internal carotid and vertebral arteries of 10 subarachnoid hemorrhage cases. While postmortem MDCT angiography (PMCTA) was capable of detecting aneurysms in a non-destructive manner, it was sometimes difficult to identify the aneurysm and bleeding sites because of a large amount of contrast medium leaking into the extravascular space. To overcome this problem, we developed the novel contrast imaging method "dynamic cerebral angiography," which involves scanning the same area multiple times while injecting contrast medium to enable real-time observation of the contrasted vasculature. Using multiphase contrast images acquired by this method, we successfully captured the moment when contrast medium leaked from the hemorrhage site. This method will be useful for identifying exact bleeding sites on PMCTA.

On-site customization of silicone stents: towards optimal palliation of complex airway conditions.

PubMed

Breen, David P; Dutau, Hervé

2009-01-01

Stents may be indicated as treatment of benign and malignant conditions of the central airways. Occasionally, aberrant and/or distorted airways secondary to therapy or surgery may preclude the use of commercially manufactured stents. The customization of stents is well described for nonpulmonary diseases, but to date there are only limited data in the literature on prosthesis customization for airway disease. To review all the different techniques and indications of on-site silicone stent customizations and their related complications. A retrospective study was undertaken to identify all patients who underwent treatment with a silicone stent which was customized on site by the physician. The study included subjects treated during an 8-year period. Forty-nine on-site customizations were performed in 43 patients (34 males, mean age 63 +/- 5.2 years). Stent customization was performed in 5.4% of the cases. Stent customization was performed for malignant and benign disease in 35 (81.3%) and 8 (18.7%) cases, respectively. In all cases, the stent deployed successfully and performed well while in situ. Stent manipulation did not increase complications. Customization of airway stents by the physician can lead to successful stenting of difficult airway lesions with a good short-term safety profile. Standard commercially available stents may have resulted in suboptimal management of complex airway pathologies. A prospective study is warranted to further investigate the safety profile and complications associated with stent customization. Copyright 2009 S. Karger AG, Basel.

Development of policies for Natura 2000 sites: a multi-criteria approach to support decision makers.

PubMed

Cortina, Carla; Boggia, Antonio

2014-08-01

The aim of this study is to present a methodology to support decision makers in the choice of Natura 2000 sites needing an appropriate management plan to ensure a sustainable socio-economic development. In order to promote sustainable development in the Natura 2000 sites compatible with nature preservation, conservation measures or management plans are necessary. The main issue is to decide when only conservation measures can be applied and when the sites need an appropriate management plan. We present a case study for the Italian Region of Umbria. The methodology is based on a multi-criteria approach to identify the biodiversity index (BI), and on the development of a human activities index (HAI). By crossing the two indexes for each site on a Cartesian plane, four groups of sites were identified. Each group corresponds to a specific need for an appropriate management plan. Sites in the first group with a high level both of biodiversity and human activities have the most urgent need of an appropriate management plan to ensure sustainable development. The proposed methodology and analysis is replicable in other regions or countries by using the data available for each site in the Natura 2000 standard data form. A multi-criteria analysis is especially suitable for supporting decision makers when they deal with a multidimensional decision process. We found the multi-criteria approach particularly sound in this case, due to the concept of biodiversity itself, which is complex and multidimensional, and to the high number of alternatives (Natura 2000 sites) to be assessed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Costs of cloud computing for a biometry department. A case study.

PubMed

Knaus, J; Hieke, S; Binder, H; Schwarzer, G

2013-01-01

"Cloud" computing providers, such as the Amazon Web Services (AWS), offer stable and scalable computational resources based on hardware virtualization, with short, usually hourly, billing periods. The idea of pay-as-you-use seems appealing for biometry research units which have only limited access to university or corporate data center resources or grids. This case study compares the costs of an existing heterogeneous on-site hardware pool in a Medical Biometry and Statistics department to a comparable AWS offer. The "total cost of ownership", including all direct costs, is determined for the on-site hardware, and hourly prices are derived, based on actual system utilization during the year 2011. Indirect costs, which are difficult to quantify are not included in this comparison, but nevertheless some rough guidance from our experience is given. To indicate the scale of costs for a methodological research project, a simulation study of a permutation-based statistical approach is performed using AWS and on-site hardware. In the presented case, with a system utilization of 25-30 percent and 3-5-year amortization, on-site hardware can result in smaller costs, compared to hourly rental in the cloud dependent on the instance chosen. Renting cloud instances with sufficient main memory is a deciding factor in this comparison. Costs for on-site hardware may vary, depending on the specific infrastructure at a research unit, but have only moderate impact on the overall comparison and subsequent decision for obtaining affordable scientific computing resources. Overall utilization has a much stronger impact as it determines the actual computing hours needed per year. Taking this into ac count, cloud computing might still be a viable option for projects with limited maturity, or as a supplement for short peaks in demand.

A Case Study of a Male School Principal's Leadership Practices: An Exploration of Emotion & the Ethic of Care

ERIC Educational Resources Information Center

Myers, Edward L.

2013-01-01

This qualitative single-site case study examined the philosophy, decisions, and behaviors of a particular male school principal who subscribed to a form of care-based leadership practice. A Pennsylvania high school principal with a distinct leadership philosophy centered on the ethic of care was chosen to participate in this study. The purpose of…

Social Media Policy on Campus: A Case Study of the Development and Implementation of a Social Media Policy for University Administrators, Faculty, and Staff

ERIC Educational Resources Information Center

Garber, Michelle Brooks

2011-01-01

This single-site qualitative study sought to address the challenges associated with the growing use of social media by university administrators, faculty, and staff (Wandel, 2007) through a case study analysis of a university with a social media policy for university employees. The study describes the development and implementation of a university…

A multisite validation of whole slide imaging for primary diagnosis using standardized data collection and analysis.

PubMed

Wack, Katy; Drogowski, Laura; Treloar, Murray; Evans, Andrew; Ho, Jonhan; Parwani, Anil; Montalto, Michael C

2016-01-01

Text-based reporting and manual arbitration for whole slide imaging (WSI) validation studies are labor intensive and do not allow for consistent, scalable, and repeatable data collection or analysis. The objective of this study was to establish a method of data capture and analysis using standardized codified checklists and predetermined synoptic discordance tables and to use these methods in a pilot multisite validation study. Fifteen case report form checklists were generated from the College of American Pathology cancer protocols. Prior to data collection, all hypothetical pairwise comparisons were generated, and a level of harm was determined for each possible discordance. Four sites with four pathologists each generated 264 independent reads of 33 cases. Preestablished discordance tables were applied to determine site by site and pooled accuracy, intrareader/intramodality, and interreader intramodality error rates. Over 10,000 hypothetical pairwise comparisons were evaluated and assigned harm in discordance tables. The average difference in error rates between WSI and glass, as compared to ground truth, was 0.75% with a lower bound of 3.23% (95% confidence interval). Major discordances occurred on challenging cases, regardless of modality. The average inter-reader agreement across sites for glass was 76.5% (weighted kappa of 0.68) and for digital it was 79.1% (weighted kappa of 0.72). These results demonstrate the feasibility and utility of employing standardized synoptic checklists and predetermined discordance tables to gather consistent, comprehensive diagnostic data for WSI validation studies. This method of data capture and analysis can be applied in large-scale multisite WSI validations.

Sustainable Community Case Study: An Assessment of EPA’s Sustainable Development Plan for Stella, Missouri

EPA Science Inventory

In 2006, citizens of Stella, Missouri asked the EPA for technical assistance in demolition and site remediation of an abandoned hospital; and how to redevelop the site to help the community be more sustainable. EPA Region 7 teamed with EPA Office of Research and Development (ORD...

Designing Hypercontextualized Games: A Case Study with LieksaMyst

ERIC Educational Resources Information Center

Sedano, Carolina Islas; Sutinen, Erkki; Vinni, Mikko; Laine, Teemu H.

2012-01-01

Digital technology empowers one to access vast amounts of on-line data. From a learning perspective, however, it is difficult to access meaningful on-site information within a given context. The Hypercontextualized Game (HCG) design model interweaves on-site resources, translated as content, and the digital game. As a local game design process,…

Learning through Social Networking Sites--The Critical Role of the Teacher

ERIC Educational Resources Information Center

Callaghan, Noelene; Bower, Matt

2012-01-01

This comparative case study examined factors affecting behaviour and learning in social networking sites (SNS). The behaviour and learning of two classes completing identical SNS based modules of work was observed and compared. All student contributions to the SNS were analysed, with the cognitive process dimension of the Revised Bloom's Taxonomy…

Incorporating Social Networking Sites into Traditional Pedagogy: A Case of Facebook

ERIC Educational Resources Information Center

Naghdipour, Bakhtiar; Eldridge, Nilgün Hancioglu

2016-01-01

The use of online social networking sites for educational purposes or expanding curricular opportunities has recently sparked debates in scholarly forums. This potential, however, has yet to attract sufficient attention in second language classes, and particularly in English as a Foreign Language (EFL) contexts. The current study explores the…

Toward Integrated Family Services in Rural Settings: A Summary of Research and Practice. Program Report.

ERIC Educational Resources Information Center

Stoops, Jack W.; Hull, Janis L.

This report synthesizes research findings with observations of three Pacific Northwest sites attempting service integration in rural settings. At case-study sites in Washington and Oregon, rural schools, communities, and service providers collaborate to deliver services to students and community members suffering from high unemployment, alcohol…

Designing Multi-Channel Web Frameworks for Cultural Tourism Applications: The MUSE Case Study.

ERIC Educational Resources Information Center

Garzotto, Franca; Salmon, Tullio; Pigozzi, Massimiliano

A framework for the design of multi-channel (MC) applications in the cultural tourism domain is presented. Several heterogeneous interface devices are supported including location-sensitive mobile units, on-site stationary devices, and personalized CDs that extend the on-site experience beyond the visit time thanks to personal memories gathered…

Incidence and risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture: A systematic review and meta-analysis.

PubMed

Shao, Jiashen; Chang, Hengrui; Zhu, Yanbin; Chen, Wei; Zheng, Zhanle; Zhang, Huixin; Zhang, Yingze

2017-05-01

This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture. Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture. Stata 11.0 software was used for this meta-analysis. Eight studies involving 2214 cases of tibial plateau fracture treated by open reduction and internal fixation and 219 cases of surgical site infection were included in this meta-analysis. The following parameters were identified as significant risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture (p < 0.05): open fracture (OR 3.78; 95% CI 2.71-5.27), compartment syndrome (OR 3.53; 95% CI 2.13-5.86), operative time (OR 2.15; 95% CI 1.53-3.02), tobacco use (OR 2.13; 95% CI 1.13-3.99), and external fixation (OR 2.07; 95% CI 1.05-4.09). Other factors, including male sex, were not identified as risk factors for surgical site infection. Patients with the abovementioned medical conditions are at risk of surgical site infection after open reduction and internal fixation of tibial plateau fracture. Surgeons should be cognizant of these risks and give relevant preoperative advice. Copyright © 2017. Published by Elsevier Ltd.

Remediation System Evaluation, Northwest Pipe and Casing Site

EPA Pesticide Factsheets

The Northwest Pipe and Casing Site is located in Clackamas, Oregon, approximately 20 miles southeastof Portland. The site consists of approximately 53 acres, and has historically been divided into two parcels(Parcel A to the north and Parcel B to the..

Landfill Site Selection by AHP Based Multi-criteria Decision Making Tool: A Case Study in Kolkata, India

NASA Astrophysics Data System (ADS)

Majumdar, Ankush; Hazra, Tumpa; Dutta, Amit

2017-09-01

This work presents a Multi-criteria Decision Making (MCDM) tool to select a landfill site from three candidate sites proposed for Kolkata Municipal Corporation (KMC) area that complies with accessibility, receptor, environment, public acceptability, geological and economic criteria. Analytical Hierarchy Process has been used to solve the MCDM problem. Suitability of the three sites (viz. Natagachi, Gangajoara and Kharamba) as landfills as proposed by KMC has been checked by Landfill Site Sensitivity Index (LSSI) as well as Economic Viability Index (EVI). Land area availability for disposing huge quantity of Municipal Solid Waste for the design period has been checked. Analysis of the studied sites show that they are moderately suitable for landfill facility construction as both LSSI and EVI scores lay between 300 and 750. The proposed approach represents an effective MCDM tool for siting sanitary landfill in growing metropolitan cities of developing countries like India.

Gingival involvement in oral paracoccidioidomycosis.

PubMed

Silva, Cléverson O; Almeida, Aroldo Dos Santos; Pereira, Alessandro Antônio Costa; Sallum, Antônio Wilson; Hanemann, João Adolfo Costa; Tatakis, Dimitris N

2007-07-01

Paracoccidioidomycosis, a deep mycosis endemic in parts of Latin America, often presents with oral lesions involving the gingiva. Nevertheless, the periodontal literature is devoid of references to oral paracoccidioidomycosis. The purpose of this study was to characterize the gingival involvement in oral paracoccidioidomycosis and to contrast clinical and histopathologic diagnosis of the disease. Differential diagnosis and management of oral paracoccidioidomycosis were reviewed. From January 1995 to October 2006, the files of the Oral Pathology Laboratory, School of Dentistry, Alfenas Federal University, were reviewed to identify cases referred because of a clinical diagnosis of oral paracoccidioidomycosis. Data collected included patient demographics (age, gender, race, and occupation), clinical information (oral lesion location), and histopathologic diagnosis. Forty-six cases were identified, and 34 were histopathologically confirmed as paracoccidioidomycosis. Of the remaining 12 cases, one-half were diagnosed as either carcinoma or dysplastic leukoplakia. Of the 34 confirmed paracoccidioidomycosis cases, 45% presented with multiple site involvement, whereas the gingiva/alveolar process was the most prevalent site overall (52%). The gingiva/alveolar process was the most prevalent site in both multiple and single site cases. The majority of patients were men (88%), white (75%), and in their fourth decade of life (47%). Statistical analysis revealed that patients with gingival/alveolar process involvement were demographically indistinguishable from those without. Oral paracoccidioidomycosis has a strong predilection for the gingiva, whereas patients with gingival lesions do not differ from patients lacking such involvement. Early diagnosis of gingival/oral lesions may prevent life-threatening complications of this mycosis.

Clinico-epidemiological study of tinea incognito with microbiological correlation.

PubMed

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

2017-01-01

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

Example evaluation of a permit application for a proposed hazardous-waste landfill in eastern Adams County, Colorado

USGS Publications Warehouse

Banta, E.R.

1986-01-01

A project was undertaken by the U.S. Geological Survey in cooperation with the U. S. Environmental Protection Agency to demonstrate methods by which RCRA (Resources Conservation and Recovery Act of 1976) Part B permit applications might be evaluated. The purpose of the project was to prepare a report that would supplement a series of case studies to be made available to permit writers in the U.S. Environmental Protection Agency. Four sites in the United States were chosen for their potential applicability to geologically similar sites. The Adams County, Colorado, site was chosen to be representative of sites in the Upper Cretaceous Pierre Shale. The intent of this report is to provide an example of how available earth-science information might be used in evaluating an application and not to evaluate the acceptability of the site. Because this study is an evaluation of a permit application, the data used are limited to the data supplied in the application and in published reports. Of the five criteria required by the U.S. Environmental Protection Agency to be addressed in the permit application considered in the case study, the application was evaluated to be inadequate in addressing three criteria: (1) Site characterization, (2) ability to monitor the location, and (3) flow paths and 100-foot time of travel. Details of the inadequacies and a description of the information needed to eliminate the inadequacies are included in the report. (USGS)

Landfill site selection using combination of GIS and fuzzy AHP, a case study: Iranshahr, Iran.

PubMed

Torabi-Kaveh, M; Babazadeh, R; Mohammadi, S D; Zaresefat, M

2016-03-09

One of the most important recent challenges in solid waste management throughout the world is site selection of sanitary landfill. Commonly, because of simultaneous effects of social, environmental, and technical parameters on suitability of a landfill site, landfill site selection is a complex process and depends on several criteria and regulations. This study develops a multi-criteria decision analysis (MCDA) process, which combines geographic information system (GIS) analysis with a fuzzy analytical hierarchy process (FAHP), to determine suitable sites for landfill construction in Iranshahr County, Iran. The GIS was used to calculate and classify selected criteria and FAHP was used to assess the criteria weights based on their effectiveness on selection of potential landfill sites. Finally, a suitability map was prepared by overlay analyses and suitable areas were identified. Four suitability classes within the study area were separated, including high, medium, low, and very low suitability areas, which represented 18%, 15%, 55%, and 12% of the study area, respectively. © The Author(s) 2016.

Breast and splenic metastases of squamous cell carcinoma from the uterine cervix: a case report

PubMed Central

2014-01-01

Introduction Metastases to the breast from extramammary malignancies are infrequent, the most common primary sites are malignant melanoma, leukemia, lymphoma, and cancer of the lung, stomach, prostate and ovary. The cervical origin is exceptional. Splenic metastasis from squamous cell carcinoma of the cervix is also rare. To the best of our knowledge, only three cases of isolated splenic metastasis have been reported in the literature. Case presentation We describe the case of a 55-year-old North African woman who presented with a nodule in her left breast eight months after treatment for stage IIB squamous cell uterine cervical carcinoma. The excisional biopsy with histological study demonstrated a poorly differentiated squamous cell carcinoma. A computed tomography scan revealed a splenic secondary location. Conclusions We report here a case of two unusual metastatic sites of uterine cervical carcinoma, the breast and spleen. It is the first case of this association without widespread disease. PMID:25366471

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

Adamczyk, S; Goer, D; Ash, R

Purpose: We analyzed data collected from worldwide centers active in electron IORT with a focus on the technical variables of the treatment. Particular attention was given to the dominant tumor sites. Methods: 54 Mobetron users from 14 countries in clinical operation prior to December 31, 2014, were invited to participate in this study. 29 centers contributed to this survey in sufficient detail to be included in this report. 6,035 patients were treated since 1997. Parameters were analyzed separately for each treatment site. However, special attention was given to the breast cancer, which turned out to be dominant tumor site. Results:more » The average number of patients treated per year in each center was 41 and exceeded 100 patients/year in 3 centers. For data received, 70% of patients worldwide were treated for breast cancer (93% in Europe, 14% in the U.S. and 21% in Asia). In 31% of cases electron IORT was the only breast irradiation. In breast patients, 9 MeV was used in 50% cases; 4MeV, 6MeV and 12MeV in 2%, 25% and 23% of cases respectively. 85% of patients were treated with field sizes between 4 and 6 cm and 35% of them were treated with 1/2 cm sized applicators. Beveled applicators (0°, 15° and 30° tips) were used in 51%, 33% and 16% of cases respectively. In 55% cases bolus was required with 5mm bolus used twice as often as 10mm. Chest-wall protectors were used in 53% of treatment procedures. For Non-breast data, main sites were: colorectal tumors (31%), pancreatic cancers (20%), extremity sarcomas (13%) and retroperitoneal sarcomas (5%). Conclusion: A large variety of tumors have been treated with IORT, with breast, colorectal, pancreas and sarcomas being the most frequently treated sites. This survey shows the most common applicators and energies used to treat each tumor site.« less

Land subsidence caused by dissolution of salt near four oil and gas wells in central Kansas

USGS Publications Warehouse

Fader, Stuart Wesley

1975-01-01

Collapse of the overlying strata into voids caused by dissolution of salt is the apparent cause of progressive land subsidence at the sites of several oil wells that were drilled through the salt beds of the Wellington Formation in Kansas. The purpose of this investigation was to determine if data from four sites, shown in figure 1, substantiate the hypothesis that corroded, broken, or improperly sealed casing permitted relatively fresh water from the shallow aquifers to circulate within the salt zone and that the resulting brine solution leaked downward into permeable zones that would accept the fluid under hydrostatic pressure.Strata similar to those penetrated by wells at the four sites (shown in tables 1 and 2) underlie much of central Kansas. Many thousands of oil and gas wells have been drilled through the salt beds, but land subsidence has been reported at few of the sites. Reported sites are near highways, and two well-documented instances of subsidence involve the stability of highway right-of-way. Because many wells have been drilled in remote areas, similar occurrences may remain unreported. The scope of this investigation is limited to the compilation, analysis and interpretation of the available data from four sites shown in figure 1, and the mention of a fifth site.The photograph (fig. 2) shows a deteriorated casing pulled from a well located between Sites 3 and 4 in western Rice County. The casing consists of inner and outer pipes with the annular space between filled with cement. The almost complete failure of the outer pipe is evident. The casing is believed to be from the well in the concrete pit that is in the lower right of the photograph. The pond in the background is a sink that has developed near the well; detailed historical data, however, were unavailable for further study of this site.The investigation was requested by the Energy Research and Develop-ment Administration (formerly U.S. Atomic Energy Commission) as part of a study of bedded salt in Kansas as a repository for radioactive wastes. Data for the report were collected from the files of several Kansas State agencies; the Highway Commission, Department of Health and Environment, Geological Survey, and the Corporation Commission. The author particularly wishes to thank V. A. Burgat and W. K. Taylor of the Highway Commission;B. F. Latta, D. L. Butcher, and M. W. Glotzback of the Department of Health and Environment; and F. W. Wilson of the Geological Survey for information based on personal observations and for resolving apparent contradictions in the available data.The geologic formations that underlie the four sites selected for this study are described in table 1 and information about the oil and gas wells at the sites is given in table 2.

Retrospective Case Study in the Raton Basin, Colorado

EPA Pesticide Factsheets

Study site locations in Las Animas and Huerfano Counties were selected in response to ongoing complaints about changes in appearance, odor, and taste associated with drinking water in domestic wells. \

[Obstetrical vesico-vaginal fistula in Guinea: Data analysis of three sites of treatment at Engender Health ONG].

PubMed

Diallo, A B; Sy, T; Bah, M D; Diallo, T M O; Barry, M S; Bah, I; Barry, T H; Blanchot, J; Rochat, C-H; Diallo, M B

2016-03-01

To analyze the management of obstetric vesico-vaginal fistula in the three sites of Engender Health in Guinea. It was a retrospective study of descriptive type having helped collect 450 cases of vesico-vaginal fistulas in three support sites engender health between January 2008 and December 2011. The variables studied were epidemiological, clinical and therapeutic reasons and treatment outcomes were evaluated after a decline of at least six months. The mean age of onset of the fistula was 25years, ranging from 12 to 55years and 58.8% (n=265) of patients were aged between 18 and 30years. The mean duration of fistula was 11years, ranging from 1 to 38years. Eighty-two percent (n=416) of patients were housewives and 66.4% (n=299) off school. The complex fistula with 66% (n=297) was the most frequent. The treatment consisted of a fistulorraphie after splitting vesico-vaginal in 93.3% (n=420) of cases. Therapeutic results considered after a mean of 8months have resulted in a cure in 79.3% (n=357) of cases, improvement in 4.2% (n=19) of cases and failure in 16 4% (n=74) of cases. Vesico-vaginal fistula is a major cause of maternal morbidity in Guinea. The establishment of a real health policy based on sound medical and social structures contributes to its eradication. 5. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

An Analysis of Online Students' Behaviors on Course Sites and the Effect on Learning Performance: A Case Study of Four LIS Online Classes

ERIC Educational Resources Information Center

Zhang, Xiangmin

2016-01-01

This research investigated the relationship between online students' behaviors in a learning management system and their learning performance, as measured by their final grades. Four online information technology classes in a major U.S. library and information science program were studied. The course sites' log data, as well as the students' final…

Basal Cell Carcinoma in Cases with or without Xeroderma Pigmentosum.

PubMed

Ghartimagar, Dilasma; Ghosh, Arnab; Shrestha, Sushil Ram; Shrestha, Sachet; Thapa, Sushma; Narasimhan, Raghavan; Talwar, O P

2017-01-01

Basal cell carcinoma is the most common form of cancer in humans and comprises the vast majority of skin cancers. It predominantly affects fair-skinned individuals, and its incidence is rapidly increasing. The objective of the study is to identify the epidemiology, its topography and different histological subtypes of basal cell carcinoma in patients with or without Xeroderma Pigmentosum. A cross-sectional descriptive study was conducted at Manipal Teaching Hospital, Pokhara from Jan 2009 to Dec 2016. Ethical approval was taken from MEMG/IRC/GA. The study included patients with a confirmed diagnosis of basal cell carcinoma irrespective of their age and sex. This study showed 77 individuals with 91 biopsies of BCC including 5 cases of Xeroderma Pigmentosum. The predominant histological subtype was nodular with 41 (53.94%) cases, followed by the 14 (18.42%) cases of pigmented and 10 (13.15%) cases baso-squamous subtype. The most frequent sites of involvement were the head and neck, with predominance in the nasal and orbital region. The mean age was 57.68 years but the basal cell carcinoma in cases of Xeroderma Pigmentosum was seen more in younger age groups. There were 43 (55.84 %) male patients and 34 (44.16 %) female patients with a male to female ratio of 1.26:1. Nodular and pigmented varieties were the most frequent subtypes with nose being the commonest site of involvement. Basal cell carcinomas in cases of Xeroderma Pigmentosum were noted in younger age group with multiple lesions.

Residential proximity to industrial sites in the area of Taranto (Southern Italy). A case-control cancer incidence study.

PubMed

Marinaccio, Alessandro; Belli, Stefano; Binazzi, Alessandra; Scarselli, Alberto; Massari, Stefania; Bruni, Antonella; Conversano, Michele; Crosignani, Paolo; Minerba, Aldo; Zona, Amerigo; Comba, Pietro

2011-01-01

The association between cancer incidence and the residence near polluting facilities in an industrial area nearby Taranto has been investigated. Age, sex and occupational exposure were controlled as confounding variables in a case-control study (658 cases, 2092 controls). High risks were evidenced close to the steel mill (OR: 3.54), coke plant (OR: 4.80), mineral deposit (OR: 3.33) and shipbuilding (OR: 4.29) for pleural neoplasm, and to the steel mill (OR: 1.65) and shipbuilding (OR: 1.79) for lung cancer. After adjustment for occupational exposure, increasing trends of risk were observed both for lung and bladder cancers. Cancer risks were evidenced near industrial sites and the introduction of "occupational exposure" as a confounder modified significantly the risks with respect to distance from the source of pollution, particularly for pleural, lung and bladder cancers.

Distribution of sediment measurements in Lake Michigan as a case study: Implications for estimating sediment and water interactions in eutrophication and bioaccumulation models

EPA Science Inventory

Lake Michigan, the sixth largest freshwater lake in the world by surface area, was utilized as a water body for assessment within a case study. Field data collected at 116 sampling sites throughout the lake in an intensive monitoring effort were utilized for evaluation of the di...

An Examination of Physical Education Data Sources and Collection Procedures during a Federally Funded Grant

ERIC Educational Resources Information Center

Dauenhauer, Brian D.; Keating, Xiaofen D.; Lambdin, Dolly

2018-01-01

Purpose: This study aimed to conduct an in-depth investigation into physical education data sources and collection procedures in a district that was awarded a Physical Education Program (PEP) grant. Method: A qualitative, multi-site case study was conducted in which a single school district was the overarching case and eight schools served as…

Case Study of a Discontinued Start-Up Engineering Program: Critical Challenges and Lessons Learned

ERIC Educational Resources Information Center

Friess, Wilhelm A.

2017-01-01

The explanatory case study presented here analyzes the factors that have contributed to the failure of a start-up engineering program launched at an off-campus site, and aimed at imparting the first two years of the BSc Mechanical, Electrical, Computer and Civil Engineering utilizing an integrated curriculum. Findings indicate the root cause for…

BladeRunners and Picasso Cafe: A Case Study Evaluation of Two Work-Based Training Programs for Disadvantaged Youth.

ERIC Educational Resources Information Center

Currie, Sheila; Foley, Kelly; Schwartz, Saul; Taylor-Lewis, Musu

In 1998, Canada's Social Research and Demonstration Corporation (SRDC) conducted case studies of two work-based training and skill development programs for street youth in Vancouver, British Columbia. The BladeRunners program places youth on construction sites while encouraging them to work toward an apprenticeship in the building trades. The…

Freedom to Hate: Weighing First Amendment Rights against School Violence--A Case Study

ERIC Educational Resources Information Center

Kaplan, H. Roy

2007-01-01

River Run High School, located in rural west central Florida, was the site for a case study of student conflict precipitated by the wearing and display of Confederate flags on campus. Following a series of tense student encounters over Confederate and other racist symbols, a conflict resolution team was invited to intervene. Team members created a…

Created in Context: A Comparative Case Study of the Use of Music in Two Reggio Emilia-Inspired Schools

ERIC Educational Resources Information Center

Bond, Vanessa L.

2015-01-01

The purpose of this comparative case study was to investigate the use of music in two Reggio-inspired preschools in the United States. I used purposeful sampling to select two sites that represented contrasting sociocultural contexts: one urban school serving a Latino population from low socioeconomic backgrounds and one suburban early childhood…

The California Conservation Corps: A Case Study. Working Paper #5. The State Youth Initiatives Project.

ERIC Educational Resources Information Center

Bailin, Michael A.

Through site visits, a case study was made of the California Conservation Corps (CCC) in order to provide a description of its history, objectives, program features, participants, funding patterns, future plans, and key issues scheduled to be addressed by the program. Descended from similar earlier programs, the CCC was established in 1976. After…

Organisational readiness and Lean Thinking implementation: findings from three emergency department case studies in New Zealand.

PubMed

Rees, Gareth H

2014-01-01

This paper describes and contrasts the implementation of Lean Thinking – a quality methodology that emphasises waste reduction and performing at higher levels of productivity with the same or less resources – into New Zealand's healthcare system. As the field is relatively new, three literature-based exemplar cases were developed to provide an analysis framework to analyse the three New Zealand research sites, which had activities, teamwork, leadership and sustainability as its core themes. Each research site's case was developed from primary data gathered through interviews, augmented by secondary data from project reports, District Health Board websites and media stories. The results highlight the benefits of a supportive quality-focussed organisational culture, executive management involvement and cross-functional teams as enablers. Further, work intensification and workplace resistance were also evident in varying levels within the sites. The study, while reiterating the problems of introducing quality methods from other domains into healthcare, presents the New Zealand context and reinforces that organisational preparedness as a significant factor which contributes to implementation success. This study goes beyond investigations of the use of Lean tools, changing improvement metrics and descriptive statistics to identify the contexts and variables which surround quality and process improvement implementations. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Characterization of CD22 expression in acute lymphoblastic leukemia.

PubMed

Shah, Nirali N; Stevenson, Maryalice Stetler; Yuan, Constance M; Richards, Kelly; Delbrook, Cindy; Kreitman, Robert J; Pastan, Ira; Wayne, Alan S

2015-06-01

CD22 is a B-lineage differentiation antigen that has emerged as a leading therapeutic target in acute lymphoblastic leukemia (ALL). Properties of CD22 expression relevant to therapeutic targeting were characterized in primary samples obtained from children and young adults with relapsed and chemotherapy refractory B-precursor (pre-B) ALL. CD22 expression was demonstrated in all subjects (n = 163) with detection on at least 90% of blasts in 155 cases. Median antigen site density of surface CD22 was 3,470 sites/cell (range 349-19,653, n = 160). Blasts from patients with known 11q23 (MLL) rearrangement had lower site density (median 1,590 sites/cell, range 349-3,624, n = 20 versus 3,853 sites/cell, range 451-19,653, n = 140; P = <0.0001) and 6 of 21 cases had sub-populations of blasts lacking CD22 expression (22%-82% CD22 +). CD22 expression was maintained in serial studies of 73 subjects, including those treated with anti-CD22 targeted therapy. The levels of soluble CD22 in blood and marrow by ELISA were low and not expected to influence the pharmacokinetics of anti-CD22 directed agents. These characteristics make CD22 an excellent potential therapeutic target in patients with relapsed and chemotherapy-refractory ALL, although cases with MLL rearrangement require close study to exclude the presence of a CD22-negative blast population. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Report on the Results of Site Testing to Determine National Register Eligibility for Sites 39GR32, 39GR53, 39LM33 and 39LM39, in the Lake Francis Case Area, South Dakota. Volume 2. Appendices

DTIC Science & Technology

1987-06-01

WESTERN STUDIES AUGUSTANA COLLEGE, SIOUX FALLS, SOUTH DAKOTA 57105 ARCHEOLOGICAL CONTRACT SERIES NUMBER 29 VOLUME 2 APPENDICES 1. Location of Sites...Specialist Report - Report on the Soils at Sites 39GR53 and 39LM33, by Dr. Frederick Westin APPENDIX I Location of Sites on UGSG 7.5’ Quadrangle Maps...QUADANGL LOCTIO / (r\\\\ 2~0 SCALE 12000 0~ 1 0IL QUDANL OATO 1PPROXLOMETERA 51ONOU INTRVA 10LNAIN FEET DAU 1S MEILEALEE Location of site 39LM39. J~27 . ~ FIt

Etonogestrel implant migration to the vasculature, chest wall, and distant body sites: cases from a pharmacovigilance database.

PubMed

Kang, Sarah; Niak, Ali; Gada, Neha; Brinker, Allen; Jones, S Christopher

2017-12-01

To describe clinical outcomes of etonogestrel implant patients with migration to the vasculature, chest wall and other distant body sites spontaneously reported to the US Food and Drug Administration Adverse Event Reporting System (FAERS) database. We performed a standardized Medical Dictionary for Regulatory Activities (MedDRA) query in the FAERS database (through November 15, 2015), with reports coded with one or more MedDRA preferred terms that indicate complications with device placement or migration of the device from the original site of insertion to the vasculature, chest wall and other distant body sites. We excluded any cases previously described in the medical literature. We identified 38 cases of pronounced etonogestrel implant migration. Migration locations included the lung/pulmonary artery (n=9), chest wall (n=1), vasculature at locations other than the lung/pulmonary artery (n=14) and extravascular migrations (n=14) to other body sites (e.g., the axilla and clavicle/neck line/shoulder). The majority of cases were asymptomatic and detected when the patient desired implant removal; however, seven cases reported symptoms such as pain, discomfort and dyspnea in association with implant migration. Three cases also describe pulmonary fibrosis and skin reactions as a result of implant migration to the vasculature, chest wall and other distant body sites. Sixteen cases reported surgical removal in an operating room setting. Our FAERS case series demonstrates etonogestrel implant migration to the vasculature, chest wall and other body sites distant from the site of original insertion. As noted by the sponsor in current prescribing information, a key determinant in the risk for etonogestrel contraceptive implant migration appears to be improper insertion technique. Although migration of etonogestrel implants to the vasculature is rare, awareness of migration and education on proper insertion technique may reduce the risk. Published by Elsevier Inc.

Axillary lymph node uptake of technetium-99m-MDP

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

Ongseng, F.; Goldfarb, C.R.; Finestone, H.

We sought to determine the frequency and significance of axillary lymph node visualization on bone scans performed with diphosphonates. Consecutive {sup 99m}Tc-methylene diphosphonate ({sup 99m}Tc-MDP) bone scans (2435) were inspected for axillary soft-tissue uptake. In positive cases, the results of physical examination, correlative imaging studies and serial bone scans were recorded, as was the site of venipuncture. Forty-eight studies (2%) showed axillary uptake ipsilateral to the injection site. Extravasation of tracer, documented by focal activity near the injection site, was present in every case. There was no association with axillary adenopathy, mass, induration of radiographically visible calcification. On some images,more » foci adjacent to the axilla were superimposed on the rib, scapula, or humerus. The bone-to-background ratio was frequently reduced; repeat imaging after 1-2 hr usually improved osseous detail. Ipsilateral axillary lymph node visualization due to extravasation of {sup 99m}Tc-MDP is frequently associated with additional foci superimposed on osseous structures simulating pathology. Delayed skeletal uptake is common in such cases and necessitates a greater time interval between injection and imaging. 7 refs., 3 figs.« less

Greater Polar Moment of Inertia at the Tibia in Athletes Who Develop Stress Fractures.

PubMed

Weidauer, Lee A; Binkley, Teresa; Vukovich, Matt; Specker, Bonny

2014-07-01

Several previous investigations have determined potential risk factors for stress fractures in athletes and military personnel. To determine factors associated with the development of stress fractures in female athletes. Case-control study; Level of evidence, 3. A total of 88 female athletes (cross-country, n = 29; soccer, n = 15; swimming, n = 9; track and field, n = 14; volleyball, n = 12; and basketball, n = 9) aged 18 to 24 years were recruited to participate in a longitudinal bone study and had their left distal tibia at the 4%, 20%, and 66% sites scanned by peripheral quantitative computed tomography (pQCT). Patients included 23 athletes who developed stress fractures during the following year (cases). Whole body, hip, and spine scans were obtained using dual-energy x-ray absorptiometry (DXA). Analysis of covariance was used to determine differences in bone parameters between cases and controls after adjusting for height, lower leg length, lean mass, fat mass, and sport. No differences were observed between cases and controls in any of the DXA measurements. Cases had significantly greater unadjusted trabecular bone mineral content (BMC), greater polar moment of inertia (PMI) at the 20% site, and greater cortical BMC at the 66% site; however, after adjusting for covariates, the differences became nonsignificant. When analyses were repeated using all individuals who had ever had a stress fracture as cases (n = 31) and after controlling for covariates, periosteal circumference was greater in the cases than the controls (71.1 ± 0.7 vs 69.4 ± 0.5 mm, respectively; P = .04). A history of stress fractures is associated with larger bones. These findings are important because larger bones were previously reported to be protective against fractures and stress fractures, but study findings indicate that may not always be true. One explanation could be that individuals who sustain stress fractures have greater loading that results in greater periosteal circumference but also results in the development of stress fractures.

Testing CMAQ chemistry sensitivities in base case and emissions control runs at SEARCH and SOS99 surface sites in the southeastern US

NASA Astrophysics Data System (ADS)

Arnold, J. R.; Dennis, Robin L.

CMAQ was run to simulate urban and regional tropospheric conditions in the southeastern US over 14 days in July 1999 at 32, 8 and 2 km grid spacings. Runs were made with either of two older mechanisms, Carbon Bond IV (CB4) and the Regional Acid Deposition Model, version 2 (RADM2), and with the more recent and complete California Statewide Air Pollution Research Center, version 1999 mechanism (SAPRC99) in a sensitivity matrix with a full emissions base case and separate 50% control scenarios for emissions of nitrogen oxides (NO X) and volatile organic compounds (VOC). Results from the base case were compared to observations at the Southeastern Aerosol Research and Characterization Study (SEARCH) site at Jefferson Street in Atlanta, GA (JST) and the Southern Oxidant Study (SOS) Cornelia Fort Airpark (CFA) site downwind of Nashville, TN. In the base case, SAPRC99 predicted more ozone (O 3) than CB4 or RADM2 almost every hour and especially for afternoon maxima at both JST and CFA. Performance of the 8 km models at JST was better than that of the 32 km ones for all chemistries, reducing the 1 h peak bias by as much as 30 percentage points; at CFA only the RADM2 8 km model improved. The 2 km solutions did not show improved performance over the 8 km ones at either site, with normalized 1 h bias in the peak O 3 ranging from 21% at CFA to 43% at JST. In the emissions control cases, SAPRC99 was generally more responsive than CB4 and RADM2 to NO X and VOC controls, excepting hours at JST with predicted increased O 3 from NO X control. Differential sensitivity to chemical mechanism varied by more than ±10% for NO X control at JST and CFA, and in a similar range for VOC control at JST. VOC control at the more strongly NO X- limited urban CFA site produced a differential sensitivity response of <5%. However, even when differential sensitivities in control cases were small, neither their sign nor their magnitude could be reliably determined from model performance in the full emissions case, meaning that the degree of O 3 response to a change in chemical mechanism can differ substantially with the level of precursor emissions. Hence we conclude that properly understanding the effects of changes in a model's chemical mechanism always requires emissions control cases as part of model sensitivity analysis.

A case study of risk assessment in contaminated site remediation in China

NASA Astrophysics Data System (ADS)

Ye, S.; Guo, J.; Wu, J.; Wang, J.; Chien, C.; Stahl, R.; Mack, E.; Grosso, N.

2013-12-01

A field site in Nanjing, China was selected for a case study of risk assessment in contaminated site remediation. This site is about 100m long and 100m wide. A chemical plant (1999-2010) at the site manufactured optical brightener PF, 2-Amino-4-methylphenol and 2-Nitro-4-methylphenol, totally three products. Soil and groundwater samples were collected and analyzed for PPL 126 (126 pollutants in the 'Priority Pollutants List' issued by US EPA). Values of the Dutch Standards were used as the screening criteria for soil and ground water. Low levels of ethylbenezene, chlorobenzene, 1,3-dichlorobenzene and 1,4- dichlorobenzene were detected in one soil sample. Concentrations above Dutch Target Value (DTV) of benzene, toluene, ethylbenzene, chlorobenzene, 1,2-dichlorobenzene, 1,3-dichlorobenzene, 1,4-dichlorobenzene, and/or 1,2,4-trichlorobenzene, phenol, and/or 2,4-dichlorophenol were exhibited in two groundwater samples. The ground water was especially highly impacted by bichlorobenzenes and trichlorobenzenes. The maximum concentration of impacts was 7.3 mg/L of 1,2,4-trichlorobenzene in groundwater which was 730 times higher than Dutch Intervention Values (DIV). Risk of soil and groundwater at this site was assessed according to the guidelines issued by Chinese MEP and US EPA, respectively. Finally, remedy techniques were selected according to the result of risk assessment and the characteristics of hydrogeology conditions and contaminants.

Dynamical Friedel oscillations of a Fermi sea

NASA Astrophysics Data System (ADS)

Zhang, J. M.; Liu, Y.

2018-02-01

We study the scenario of quenching an interaction-free Fermi sea on a one-dimensional lattice ring by suddenly changing the potential of a site. From the point-of-view of the conventional Friedel oscillation, which is a static or equilibrium problem, it is of interest what temporal and spatial oscillations the local sudden quench will induce. Numerically, the primary observation is that for a generic site, the local particle density switches between two plateaus periodically in time. Making use of the proximity of the realistic model to an exactly solvable model and employing the Abel regularization to assign a definite value to a divergent series, we obtain an analytical formula for the heights of the plateaus, which turns out to be very accurate for sites not too close to the quench site. The unexpect relevance and the incredible accuracy of the Abel regularization are yet to be understood. Eventually, when the contribution of the defect mode is also taken into account, the plateaus for those sites close to or on the quench site can also be accurately predicted. We have also studied the infinite lattice case. In this case, ensuing the quench, the out-going wave fronts leave behind a stable density oscillation pattern. Because of some interesting single-particle property, this dynamically generated Friedel oscillation differs from its conventional static counterpart only by the defect mode.

RecutClub.com: An Open Source, Whole Slide Image-based Pathology Education System

PubMed Central

Christensen, Paul A.; Lee, Nathan E.; Thrall, Michael J.; Powell, Suzanne Z.; Chevez-Barrios, Patricia; Long, S. Wesley

2017-01-01

Background: Our institution's pathology unknown conferences provide educational cases for our residents. However, the cases have not been previously available digitally, have not been collated for postconference review, and were not accessible to a wider audience. Our objective was to create an inexpensive whole slide image (WSI) education suite to address these limitations and improve the education of pathology trainees. Materials and Methods: We surveyed residents regarding their preference between four unique WSI systems. We then scanned weekly unknown conference cases and study set cases and uploaded them to our custom built WSI viewer located at RecutClub.com. We measured site utilization and conference participation. Results: Residents preferred our OpenLayers WSI implementation to Ventana Virtuoso, Google Maps API, and OpenSlide. Over 16 months, we uploaded 1366 cases from 77 conferences and ten study sets, occupying 793.5 GB of cloud storage. Based on resident evaluations, the interface was easy to use and demonstrated minimal latency. Residents are able to review cases from home and from their mobile devices. Worldwide, 955 unique IP addresses from 52 countries have viewed cases in our site. Conclusions: We implemented a low-cost, publicly available repository of WSI slides for resident education. Our trainees are very satisfied with the freedom to preview either the glass slides or WSI and review the WSI postconference. Both local users and worldwide users actively and repeatedly view cases in our study set. PMID:28382224

Spinal epidural hematomas: personal experience and literature review of more than 1000 cases.

PubMed

Domenicucci, Maurizio; Mancarella, Cristina; Santoro, Giorgio; Dugoni, Demo Eugenio; Ramieri, Alessandro; Arezzo, Maria Felice; Missori, Paolo

2017-08-01

OBJECTIVE The goal of this study was to identify factors that contribute to the formation of acute spinal epidural hematoma (SEH) by correlating etiology, age, site, clinical status, and treatment with immediate results and long-term outcomes. METHODS The authors reviewed their series of 15 patients who had been treated for SEH between 1996 and 2012. In addition, the authors reviewed the relevant international literature from 1869 (when SEH was first described) to 2012, collecting a total of 1010 cases. Statistical analysis was performed in 959 (95%) cases that were considered valid for assessing the incidence of age, sex, site, and clinical status at admission, correlating each of these parameters with the treatment results. Statistical analysis was also performed in 720 (71.3%) cases to study the incidence of etiological factors that favor SEH formation: coagulopathy, trauma, spinal puncture, pregnancy, and multifactorial disorders. The clinical status at admission and long-term outcome were studied for each group. Clinical status was assessed using the Neuro-Grade (NG) scale. RESULTS The mean patient age was 47.97 years (range 0-91 years), and a significant proportion of patients were male (60%, p < 0.001). A bimodal distribution has been reported for age at onset with peaks in the 2nd and 6th decades of life. The cause of the SEH was not reported in 42% of cases. The etiology concerned mainly iatrogenic factors (18%), such as coagulopathy or spinal puncture, rather than noniatrogenic factors (29%), such as genetic or metabolic coagulopathy, trauma, and pregnancy. The etiology was multifactorial in 11.1% of cases. The most common sites for SEH were C-6 (n = 293, 31%) and T-12 (n = 208, 22%), with maximum extension of 6 vertebral bodies in 720 cases (75%). At admission, 806 (84%) cases had moderate neurological impairment (NG 2 or 3), and only lumbar hematoma was associated with a good initial clinical neurological status (NG 0 or 1). Surgery was performed in 767 (80%) cases. Mortality was greater in patients older than 40 years of age (9%; p < 0.01). Sex did not influence any of these data (p > 0.05). CONCLUSIONS Factors that contribute to the formation of acute SEH are iatrogenic, not iatrogenic, or multifactorial. The treatment of choice is surgery, and the results of treatment are influenced by the patient's clinical and neurological status at admission, age, and the craniocaudal site.

Methods for using clinical laboratory test results as baseline confounders in multi-site observational database studies when missing data are expected.

PubMed

Raebel, Marsha A; Shetterly, Susan; Lu, Christine Y; Flory, James; Gagne, Joshua J; Harrell, Frank E; Haynes, Kevin; Herrinton, Lisa J; Patorno, Elisabetta; Popovic, Jennifer; Selvan, Mano; Shoaibi, Azadeh; Wang, Xingmei; Roy, Jason

2016-07-01

Our purpose was to quantify missing baseline laboratory results, assess predictors of missingness, and examine performance of missing data methods. Using the Mini-Sentinel Distributed Database from three sites, we selected three exposure-outcome scenarios with laboratory results as baseline confounders. We compared hazard ratios (HRs) or risk differences (RDs) and 95% confidence intervals (CIs) from models that omitted laboratory results, included only available results (complete cases), and included results after applying missing data methods (multiple imputation [MI] regression, MI predictive mean matching [PMM] indicator). Scenario 1 considered glucose among second-generation antipsychotic users and diabetes. Across sites, glucose was available for 27.7-58.9%. Results differed between complete case and missing data models (e.g., olanzapine: HR 0.92 [CI 0.73, 1.12] vs 1.02 [0.90, 1.16]). Across-site models employing different MI approaches provided similar HR and CI; site-specific models provided differing estimates. Scenario 2 evaluated creatinine among individuals starting high versus low dose lisinopril and hyperkalemia. Creatinine availability: 44.5-79.0%. Results differed between complete case and missing data models (e.g., HR 0.84 [CI 0.77, 0.92] vs. 0.88 [0.83, 0.94]). HR and CI were identical across MI methods. Scenario 3 examined international normalized ratio (INR) among warfarin users starting interacting versus noninteracting antimicrobials and bleeding. INR availability: 20.0-92.9%. Results differed between ignoring INR versus including INR using missing data methods (e.g., RD 0.05 [CI -0.03, 0.13] vs 0.09 [0.00, 0.18]). Indicator and PMM methods gave similar estimates. Multi-site studies must consider site variability in missing data. Different missing data methods performed similarly. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Two-tier Haddon matrix approach to fault analysis of accidents and cybernetic search for relationship to effect operational control: a case study at a large construction site.

PubMed

Mazumdar, Atmadeep; Sen, Krishna Nirmalya; Lahiri, Balendra Nath

2007-01-01

The Haddon matrix is a potential tool for recognizing hazards in any operating engineering system. This paper presents a case study of operational hazards at a large construction site. The fish bone structure helps to visualize and relate the chain of events, which led to the failure of the system. The two-tier Haddon matrix approach helps to analyze the problem and subsequently prescribes preventive steps. The cybernetic approach has been undertaken to establish the relationship among event variables and to identify the ones with most potential. Those event variables in this case study, based on the cybernetic concepts like control responsiveness and controllability salience, are (a) uncontrolled swing of sheet contributing to energy, (b) slippage of sheet from anchor, (c) restricted longitudinal and transverse swing or rotation about the suspension, (d) guilt or uncertainty of the crane driver, (e) safe working practices and environment.

A critical review of hydrological data collection for assessing preservation risk for urban waterlogged archaeology: A case study from the City of York, UK.

PubMed

Holden, Joseph; Howard, Andy J; West, L Jared; Maxfield, Eleanor; Panter, Ian; Oxley, John

2009-08-01

Environmental change caused by urban development, possibly augmented by climate change, may result in accelerated decay of in situ archaeological resources. Damage may be related to changes in hydrological processes. Such archaeological resources have to be considered in environmental planning. In this paper we highlight the need for improved hydrological data from urban archaeological sites using the case study of the City of York, UK, arguably one of the most well studied and well preserved urban archaeological environments globally. We suggest that the quality of hydrological data collected during routine surveys and experimental work must be improved and standardised in order for us to produce reliable archaeological risk models for urban sites.

Genome-Wide Assessment of Differential DNA Methylation Associated with Autoantibody Production in Systemic Lupus Erythematosus.

PubMed

Chung, Sharon A; Nititham, Joanne; Elboudwarej, Emon; Quach, Hong L; Taylor, Kimberly E; Barcellos, Lisa F; Criswell, Lindsey A

2015-01-01

Systemic lupus erythematosus (SLE) is characterized by the development of autoantibodies associated with specific clinical manifestations. Previous studies have shown an association between differential DNA methylation and SLE susceptibility, but have not investigated SLE-related autoantibodies. Our goal was to determine whether DNA methylation is associated with production of clinically relevant SLE-related autoantibodies, with an emphasis on the anti-dsDNA autoantibody. In this study, we characterized the methylation status of 467,314 CpG sites in 326 women with SLE. Using a discovery and replication study design, we identified and replicated significant associations between anti-dsDNA autoantibody production and the methylation status of 16 CpG sites (pdiscovery<1.07E-07 and preplication<0.0029) in 11 genes. Associations were further investigated using multivariable regression to adjust for estimated leukocyte cell proportions and population substructure. The adjusted mean DNA methylation difference between anti-dsDNA positive and negative cases ranged from 1.2% to 19%, and the adjusted odds ratio for anti-dsDNA autoantibody production comparing the lowest and highest methylation tertiles ranged from 6.8 to 18.2. Differential methylation for these CpG sites was also associated with anti-SSA, anti-Sm, and anti-RNP autoantibody production. Overall, associated CpG sites were hypomethylated in autoantibody positive compared to autoantibody negative cases. Differential methylation of CpG sites within the major histocompatibility region was not strongly associated with autoantibody production. Genes with differentially methylated CpG sites represent multiple biologic pathways, and have not been associated with autoantibody production in genetic association studies. In conclusion, hypomethylation of CpG sites within genes from different pathways is associated with anti-dsDNA, anti-SSA, anti-Sm, and anti-RNP production in SLE, and these associations are not explained by genetic variation. Thus, studies of epigenetic mechanisms such as DNA methylation represent a complementary method to genetic association studies to identify biologic pathways that may contribute to the clinical heterogeneity of autoimmune diseases.

Local full-thickness skin graft of the donor arm--a novel technique for the reduction of donor site morbidity in radial forearm free flap.

PubMed

Riecke, B; Assaf, A T; Heiland, M; Al-Dam, A; Gröbe, A; Blessmann, M; Wikner, J

2015-08-01

A novel technique to reduce donor site morbidity after radial forearm free flap (RFFF) harvest, using a local full-thickness skin graft (FTSG), is described. Thirty consecutive patients undergoing RFFF for head and neck reconstruction were enrolled in a prospective study. Donor site defect closure was performed with spindle-shaped FTSGs excised from the wavelike skin incision made for the vascular pedicle. Both the removal site of the FTSG on the volar forearm and the covered RFFF donor site healed uneventfully in 29 cases, with no impairment of function related to the skin graft. No skin graft failure and no exposure, tenting, or adherence of the flexor tendons occurred. All patients expressed satisfaction with postoperative pain, the functional outcome, and cosmetic appearance. Primary donor site defect closure could be achieved in all cases with the use of a local FTSG. This graft can be gained at the access incision for the vascular pedicle, avoids expansion of the incision for a local flap technique, and does not prolong wound healing, and thus reduces both donor site and graft site morbidity of the RFFF. This technique leads to an inconspicuous aesthetic result with no apparent relevant functional deficits and avoids the need for a second donor site. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

The role of economics in the QUERI program: QUERI Series

PubMed Central

Smith, Mark W; Barnett, Paul G

2008-01-01

Background The United States (U.S.) Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) has implemented economic analyses in single-site and multi-site clinical trials. To date, no one has reviewed whether the QUERI Centers are taking an optimal approach to doing so. Consistent with the continuous learning culture of the QUERI Program, this paper provides such a reflection. Methods We present a case study of QUERI as an example of how economic considerations can and should be integrated into implementation research within both single and multi-site studies. We review theoretical and applied cost research in implementation studies outside and within VA. We also present a critique of the use of economic research within the QUERI program. Results Economic evaluation is a key element of implementation research. QUERI has contributed many developments in the field of implementation but has only recently begun multi-site implementation trials across multiple regions within the national VA healthcare system. These trials are unusual in their emphasis on developing detailed costs of implementation, as well as in the use of business case analyses (budget impact analyses). Conclusion Economics appears to play an important role in QUERI implementation studies, only after implementation has reached the stage of multi-site trials. Economic analysis could better inform the choice of which clinical best practices to implement and the choice of implementation interventions to employ. QUERI economics also would benefit from research on costing methods and development of widely accepted international standards for implementation economics. PMID:18430199

The role of economics in the QUERI program: QUERI Series.

PubMed

Smith, Mark W; Barnett, Paul G

2008-04-22

The United States (U.S.) Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) has implemented economic analyses in single-site and multi-site clinical trials. To date, no one has reviewed whether the QUERI Centers are taking an optimal approach to doing so. Consistent with the continuous learning culture of the QUERI Program, this paper provides such a reflection. We present a case study of QUERI as an example of how economic considerations can and should be integrated into implementation research within both single and multi-site studies. We review theoretical and applied cost research in implementation studies outside and within VA. We also present a critique of the use of economic research within the QUERI program. Economic evaluation is a key element of implementation research. QUERI has contributed many developments in the field of implementation but has only recently begun multi-site implementation trials across multiple regions within the national VA healthcare system. These trials are unusual in their emphasis on developing detailed costs of implementation, as well as in the use of business case analyses (budget impact analyses). Economics appears to play an important role in QUERI implementation studies, only after implementation has reached the stage of multi-site trials. Economic analysis could better inform the choice of which clinical best practices to implement and the choice of implementation interventions to employ. QUERI economics also would benefit from research on costing methods and development of widely accepted international standards for implementation economics.

A la Recherche du Temps Perdu: Case-Study Evidence from Off-Site and Pupil Referral Units.

ERIC Educational Resources Information Center

Garner, Philip

1996-01-01

Argues that current provisions for students excluded for behavior problems (Pupil Referral Units) differ little from those found before 10 years of educational reform (the former "off-site units"). Presents evidence gathered from excluded children and their teachers in four aspects of provisions: (1) resourcing and accommodation; (2)…

Language Views on Social Networking Sites for Language Learning: The Case of Busuu

ERIC Educational Resources Information Center

Álvarez Valencia, José Aldemar

2016-01-01

Social networking has compelled the area of computer-assisted language learning (CALL) to expand its research palette and account for new virtual ecologies that afford language learning and socialization. This study focuses on Busuu, a social networking site for language learning (SNSLL), and analyzes the views of language that are enacted through…

Sharing Lived Experience with Incarceration to Encourage Visitor Empathy: A Case Study through Conversation

ERIC Educational Resources Information Center

Robinson, Marvin; Zalut, Lauren

2018-01-01

In an effort to humanize the issues surrounding mass incarceration, and to foster empathy in historic site visitors, Eastern State Penitentiary Historic Site launched a pilot tour program that hired formerly incarcerated people to give tours of the building. These 15-minute tours allowed visitors to hear personal stories of incarceration alongside…

Lexicogrammar in the International Construction Industry: A Corpus-Based Case Study of Japanese-Hong-Kongese On-Site Interactions in English

ERIC Educational Resources Information Center

Handford, Michael; Matous, Petr

2011-01-01

The purpose of this research is to identify and interpret statistically significant lexicogrammatical items that are used in on-site spoken communication in the international construction industry, initially through comparisons with reference corpora of everyday spoken and business language. Several data sources, including audio and video…

Relational Databases: A Transparent Framework for Encouraging Biology Students to Think Informatically

ERIC Educational Resources Information Center

Rice, Michael; Gladstone, William; Weir, Michael

2004-01-01

We discuss how relational databases constitute an ideal framework for representing and analyzing large-scale genomic data sets in biology. As a case study, we describe a Drosophila splice-site database that we recently developed at Wesleyan University for use in research and teaching. The database stores data about splice sites computed by a…

Erosion at decommissioned road-stream crossings: case studies from three northern California watersheds

Treesearch

Sam A. Flanagan; David Fuller; Leonard Job; Sam Morrison

2012-01-01

Post-treatment erosion was observed for 41 decommissioned road stream crossings in three northern California watersheds. Sites were purposefully selected in order to characterize the nature and range of post-treatment erosional responses. Sites with the highest visible erosion were selected in order to better understand the dominant process and incorporate any...

Silviculture and multi-resource management case studies for southwestern pinyon-juniper woodlands

Treesearch

Gerald J. Gottfried

2008-01-01

Southwestern pinyon-juniper and juniper woodlands cover large areas of the Western United States. The woodlands are heterogeneous, consisting of numerous combinations of tree, shrub, and herbaceous species and stand densities that are representative of the wide range of sites and habitat types they occupy. Silvicultural methods can be employed on better sites to meet...

A Case Study of District Decentralization and Site-Based Budgeting: Cordell Place School District.

ERIC Educational Resources Information Center

Fermanich, Mark; Odden, Allan; Archibald, Sarah

A previously high-ranking suburban school district with declining student achievement changed to site-based budgeting. The account of the change may also be a cautionary tale about change taken too rapidly. Although a poor economy, the annexation of two Department of Defense schools, and organizational stagnation helped to create lower student…

CAN A MODEL TRANSFERABILITY FRAMEWORK IMPROVE ECOSYSTEM SERVICE ESTIMATES? A CASE STUDY OF SOIL FOREST CARBON SEQUESTRATION IN TILLAMOOK BAY, OR, USA

EPA Science Inventory

Budget constraints and policies that limit primary data collection have fueled a practice of transferring estimates (or models to generate estimates) of ecological endpoints from sites where primary data exists to sites where little to no primary data were collected. Whereas bene...

Ethnicity vs. National Culture in One Nationalized Educational Site: The Case of the Annual School Trip

ERIC Educational Resources Information Center

Markovich, Dalya Yafa

2016-01-01

This study examines the interface between ethnicity and nationality in a nationalized educational site--the annual school trip--that took place in a Jewish high school in Israel that serves underprivileged ethnic groups. Based on ethnographic field work, I analyze how the Ashkenazi (central-eastern European origin) hegemonic national culture that…

Online Social Networks as Formal Learning Environments: Learner Experiences and Activities

ERIC Educational Resources Information Center

Veletsianos, George; Navarrete, Cesar C.

2012-01-01

While the potential of social networking sites to contribute to educational endeavors is highlighted by researchers and practitioners alike, empirical evidence on the use of such sites for formal online learning is scant. To fill this gap in the literature, we present a case study of learners' perspectives and experiences in an online course…

77 FR 47617 - Notice of Submission for OMB Review; Office of Planning, Evaluation and Policy Development...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

... information technology. Please note that written comments received in response to this notice will be... conducting qualitative case studies of up to 15 sites with a focus on preventing students from dropping out... qualitative data across multiple respondents to generate portraits of programs and strategies that the sites...

Multiple Site Action Research Case Studies: Practical and Theoretical Benefits and Challenges

ERIC Educational Resources Information Center

Pereira, Mary Delfin; Vallance, Roger

2006-01-01

A curriculum initiative project was implemented in four schools in Singapore over a span of five to six weeks during 2004. The project employed a number of different schools: girls only, boys only and co-educational schools; different levels of performance in a graded situation; multiple teachers and classes within each site; and control and…

Geoelectrical mapping of the Soil and Groundwater Contaminated Site: Case Study from Taiwan

NASA Astrophysics Data System (ADS)

Liu, H. C.; Lin, C. P.; Wang, T. P.

2016-12-01

In recent years, geophysical technology has been widely used in soil and groundwater investigation and remediation of contaminated sites assessments in Taiwan, such technology can securely work in either small or large sampler areas, and collect data from the traditional one-dimensional data to two-dimensional and three-dimensional data. In other words, geophysical technology helps provide more information to assist the data interpretation, and improves the overall effectiveness of soil and groundwater contamination surveys. Electrical Resistivity Tomography (ERT) is one of useful geophysical technology to the soil and groundwater contaminated sites. By estimating the groundwater flow direction and distribution of contaminations, we could establish monitoring or sampling wells in potential pollution areas. ERT survey could delineate the contaminated areas with high concentrations in relatively simple sites. Even in the seriously DNAPL leakage cases, it is possible to directly detect the DNAPL pool. In this study, we presented the investigation outcomes of electrical resistivity tomography (ERT) and ground-penetrating radar (GPR) at the DNAPLs-impacted site. Evaluation of ERT/GPR technique deployment in detecting buried DNAPLs and assessment of remediation efforts are also discussed. Results indicated zones with anomalously high resistivity to be associated with contaminated DNAPLs presence. Resistivity maps clearly outlined the subsurface distribution and the possible migration path of DNAPLs.

Multifocal pigmented villonodular synovitis in a child. A case report.

PubMed

Kay, R M; Eckardt, J J; Mirra, J M

1996-01-01

Pigmented villonodular synovitis is a well-described disease that almost universally involves a single site. This is a report of an unusual case of multiple site involvement of pigmented villonodular synovitis in a child. In addition to multiple site involvement, the case is unusual for several reasons: asymmetric involvement, involvement of both upper and lower extremities, involvement of the pes anserine tendons, and the patient is an otherwise healthy child.

Pre-operative skin preparation practices: results of the 2007 French national assessment.

PubMed

Borgey, F; Thibon, P; Ertzscheid, M-A; Bernet, C; Gautier, C; Mourens, C; Bettinger, A; Aggoune, M; Galy, E; Lejeune, B; Kadi, Z

2012-05-01

Pre-operative skin preparation, aimed at reducing the endogenous microbial flora, is one of the main preventive measures employed to decrease the likelihood of surgical site infection. National recommendations on pre-operative management of infection risks were issued in France in 2004. To assess compliance with the French national guidelines for pre-operative skin preparation in 2007. A prospective audit was undertaken in French hospitals through interviews with patients and staff, and observation of professional practice. Compliance with five major criteria selected from the guidelines was studied: patient information, pre-operative showering, pre-operative hair removal, surgical site disinfection and documentation of these procedures. Data for 41,188 patients from all specialties at 609 facilities were analysed. Patients were issued with information about pre-operative showering in 88.2% of cases [95% confidence interval (CI) 87.9-88.5]. The recommended procedure for pre-operative showering, including hairwashing, with an antiseptic skin wash solution was followed by 70.3% of patients (95% CI 69.9-70.8); this percentage was higher when patients had received appropriate information (P < 0.001). Compliance with hair removal procedures was observed in 91.5% of cases (95% CI 91.2-91.8), and compliance with surgical site disinfection recommendations was observed in 25,529 cases (62.0%, 95% CI 61.5-62.5). The following documentary evidence was found: information given to patient, 35.6% of cases; pre-operative surgical hygiene, 82.3% of cases; and pre-operative site disinfection, 71.7% of cases. The essential content of the French guidelines seems to be understood, but reminders need to be issued. Some recommendations may need to be adapted for certain specialties. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

The Prevalence of Inflammatory and Developmental Odontogenic Cysts in a Libyan Population

PubMed Central

El Gehani, R; Krishnan, B; Orafi, H

2008-01-01

Objective The aim of this study was to determine the prevalence of odontogenic jaw cysts in a Libyan population and to compare the data with previously published reports from other countries. Materials and methods We retrieved and analyzed 2190 case notes and biopsy records of the Department of Oral and Maxillofacial Surgery and the Department of Oral Pathology and Microbiology, Al Arab Medical Sciences University, Benghazi, Libya, dating from January 1990 to December 2005. There were 326 cases (14.8%) of diagnosed odontogenic cysts among the 2190 biopsies performed during this period. The cases were analyzed for age and sex distribution, site of presentation, association with impacted teeth, and the method of treatment. Results The male to female ratio of patients was 1.3:1 Radicular cysts accounted for 222 cases (68.1%), followed by dentigerous cysts (n=49, 15%) and odontogenic keratocysts (n=43, 14.1%). Mean ages of the patients were, respectively, 31.7, 22.7 and 36.1 years. The maxilla was more commonly involved than the mandible (1.3:1). The anterior maxilla was the commonest site (n=132, 37.4%) followed by the posterior mandible (n=96, 29.4%). Fifty three cases were associated with impacted teeth, and the highest frequency was for dentigerous cysts (n=37). Enucleation and curettage was performed on 300 patients, marsupialization on 14, and marginal/segmental resection on 12. Conclusion To our knowledge, this is the first such study on a Libyan population. Our results are comparable to studies from other countries. Knowledge of the relative frequencies and sites of presentation of odontogenic cysts in different ethno-geographic backgrounds is essential for the early diagnosis and management of these benign yet potentially destructive lesions. PMID:21499462

Analysis of closed medical litigation in urology

PubMed Central

Shin, Su Hwan; Kim, So Yoon; Jang, Seung Gyeong

2017-01-01

Purpose The objective of this study was to provide a descriptive understanding of the characteristics of malpractice litigation related to urology by examining court cases. Materials and Methods A total of 6,074 court cases related to medical malpractice litigation filed between 2005 and 2010 were received from the Lower Courts, the Appellate Courts, and the Supreme Court of Korea. Of the received cases, 34 urology-related civil proceedings were analyzed. The following information was compiled and investigated from the cases: background, age and sex of patient, categorization of the defendant, opinion of the court, amount claimed and awarded in damages, type of medical treatment involved, and negative effects resulting from the medical accident. Results The average amount in damages paid out to plaintiffs in this research was 27,186,504±32,371,008 Korean won (KRW) (range, 1,000,000–100,000,000 KRW). A total of 9 of the 34 analyzed cases (26.5%) ruled in favor of the plaintiff, with all 9 cases involving a surgery. An analysis of the surgery sites further revealed that the penis was the most frequently litigated over site of surgery, making up 14 of the 35 sites (40.0%). Conclusions Information regarding urology malpractice lawsuits should be made available to help prevent further disputes and litigation. Continuous efforts must be expended in the prevention of accidents and disputes, alongside research into urology-related cases beyond 2010. Extensive cause analysis and recurrence prevention methods must also be researched to enhance overall patient safety. PMID:28868502

The Supraclavicular Artery Perforator Flap: A Comparative Study of Imaging Techniques Used in Preoperative Mapping.

PubMed

Sheriff, Hemin Oathman; Mahmood, Kawa Abdullah; Hamawandi, Nzar; Mirza, Aram Jamal; Hawas, Jawad; Moreno, Esther Granell; Clavero, Juan Antonio; Hankins, Christopher; Masia, Jaume

2018-05-18

 The supraclavicular artery flap is an excellent flap for head and neck reconstruction. The aim of this study is to assess imaging techniques to define the precise vascular boundaries of this flap.  Six imaging techniques were used for supraclavicular artery mapping in 65 cases; handheld Doppler, triplex ultrasound, computed tomography angiography, magnetic resonance angiography, digital subtraction angiography, and indocyanine green angiography. We checked the site of the perforators, the course of a supraclavicular artery, and anatomical mapping of the supraclavicular artery.  Handheld Doppler identified perforators' sites in 80% of the cases but showed no results for the course of the vessel. Triplex ultrasound identified the site of perforators in 52.9%, and partial mapping of the course of a supraclavicular artery in 64.7% of the cases. Computerized tomography angiography showed the site of perforators in 60%, and the course of supraclavicular artery completely in 45%, and partially in an additional 30%of the cases examined. Magnetic resonance angiography showed negative results for all parameters. Digital subtraction angiography showed the partial course of a supraclavicular artery in 62.5%, but showed no perforators. Indocyanine green angiography showed the site of perforators in 60% and a partial course of supraclavicular artery distal to perforators in 60%.Anatomical mapping of the vessel was possible with computerized tomography angiogram completely in 45%, and partially in 30%, and was also possible with indocyanine green angiography partially in 60%.  Computerized tomography angiography showed best results in the mapping of the supraclavicular artery, but with an inability to define the perforator perfusion territories, and also with risks of irradiation, while indocyanine green angiography is a good alternative as it could precisely map the superficial course of the artery and angiosomes, with no radiation exposure. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Registrar Staging Assistant (SEER*RSA) - SEER

Cancer.gov

Use this site for cases diagnosed 2018 and forward to code Extent of Disease 2018, Summary Stage 2018, Site-Specific Data Items, and Grade. Use it for 2016 and 2017 cases to determine UICC TNM 7th edition stage, Collaborative Stage v.02.05.50, and Site-Specific predictive and prognostic factors.

An analysis of the costs of implementing the National Newborn Hearing Screening Programme in England.

PubMed

Uus, K; Bamford, J; Taylor, R

2006-01-01

The primary aim of this analysis was to prospectively assess the full economic costs associated with implementing Newborn Hearing Screening Programme (NHSP) based on a two-stage screen, transient evoked otoacoustic emissions followed, if there is no clear response, by automated auditory brainstem response. Economic data were also collected from the Infant Distraction Test Screening (IDTS) service performed by health visitors at around eight months of age, which was being phased out. A comparison of costs and outcomes associated with NHSP and IDTS was conducted. 20 NHSP sites were invited to provide detailed cost data on NHSP implementation and 14 of these sites were selected to provide costs on the IDTS service that was being supplanted. There was marked variability in the costs. Given the higher yield of NHSP sites, the average cost per case detected across NHSP sites (31,410 pounds/case) was approximately half that of IDTS sites (69,919 pounds/case). Including family costs, the average total cost per case of NHSP (34,826 pounds/case) was almost a quarter of IDTS (117,942 pounds/case). Family costs and cost per case associated with NHSP are considerably less than that with IDTS. These findings support the policy of implementation of NHSP and the phasing out of the IDTS.

Geographic information system for fusion and analysis of high-resolution remote sensing and ground data

NASA Technical Reports Server (NTRS)

Freeman, Anthony; Way, Jo Bea; Dubois, Pascale; Leberl, Franz

1993-01-01

We seek to combine high-resolution remotely sensed data with models and ground truth measurements, in the context of a Geographical Information System (GIS), integrated with specialized image processing software. We will use this integrated system to analyze the data from two Case Studies, one at a boreal forest site, the other a tropical forest site. We will assess the information content of the different components of the data, determine the optimum data combinations to study biogeophysical changes in the forest, assess the best way to visualize the results, and validate the models for the forest response to different radar wavelengths/polarizations. During the 1990's, unprecedented amounts of high-resolution images from space of the Earth's surface will become available to the applications scientist from the LANDSAT/TM series, European and Japanese ERS-1 satellites, RADARSAT and SIR-C missions. When the Earth Observation Systems (EOS) program is operational, the amount of data available for a particular site can only increase. The interdisciplinary scientist, seeking to use data from various sensors to study his site of interest, may be faced with massive difficulties in manipulating such large data sets, assessing their information content, determining the optimum combinations of data to study a particular parameter, visualizing his results and validating his model of the surface. The techniques to deal with these problems are also needed to support the analysis of data from NASA's current program of Multi-sensor Airborne Campaigns, which will also generate large volumes of data. In the Case Studies outlined in this proposal, we will have somewhat unique data sets. For the Bonanza Creek Experimental Forest (Case 1) calibrated DC-8 SAR (Synthetic Aperture Radar) data and extensive ground truth measurement are already at our disposal. The data set shows documented evidence to temporal change. The Belize Forest Experiment (Case 2) will produce calibrated DC-8 SAR and AVIRIS data, together with extensive measurements on the tropical rain forest itself. The extreme range of these sites, one an Arctic forest, the other a tropical rain forest, has been deliberately chosen to find common problems which can lead to generalized observations and unique problems with data which raise issues for the EOS System.

Geographic information system for fusion and analysis of high-resolution remote sensing and ground truth data

NASA Technical Reports Server (NTRS)

Freeman, Anthony; Way, Jo Bea; Dubois, Pascale; Leberl, Franz

1992-01-01

We seek to combine high-resolution remotely sensed data with models and ground truth measurements, in the context of a Geographical Information System, integrated with specialized image processing software. We will use this integrated system to analyze the data from two Case Studies, one at a bore Al forest site, the other a tropical forest site. We will assess the information content of the different components of the data, determine the optimum data combinations to study biogeophysical changes in the forest, assess the best way to visualize the results, and validate the models for the forest response to different radar wavelengths/polarizations. During the 1990's, unprecedented amounts of high-resolution images from space of the Earth's surface will become available to the applications scientist from the LANDSAT/TM series, European and Japanese ERS-1 satellites, RADARSAT and SIR-C missions. When the Earth Observation Systems (EOS) program is operational, the amount of data available for a particular site can only increase. The interdisciplinary scientist, seeking to use data from various sensors to study his site of interest, may be faced with massive difficulties in manipulating such large data sets, assessing their information content, determining the optimum combinations of data to study a particular parameter, visualizing his results and validating his model of the surface. The techniques to deal with these problems are also needed to support the analysis of data from NASA's current program of Multi-sensor Airborne Campaigns, which will also generate large volumes of data. In the Case Studies outlined in this proposal, we will have somewhat unique data sets. For the Bonanza Creek Experimental Forest (Case I) calibrated DC-8 SAR data and extensive ground truth measurement are already at our disposal. The data set shows documented evidence to temporal change. The Belize Forest Experiment (Case II) will produce calibrated DC-8 SAR and AVIRIS data, together with extensive measurements on the tropical rain forest itself. The extreme range of these sites, one an Arctic forest, the other a tropical rain forest, has been deliberately chosen to find common problems which can lead to generalized observations and unique problems with data which raise issues for the EOS System.

Merging Contexts and Shifting Practice within Professional Development Schools: Teachers as Teacher Educators and the Nature of Resistance--A Critical Multi-Case Study

ERIC Educational Resources Information Center

Wallace, Mary Ann

2012-01-01

This qualitative critical multi-case study examines the nature of resistance as it emerges within the work of two urban secondary teachers acting as teacher educators, each teaching a secondary teacher preparation course within their own respective school context. Both research sites are discursively and functionally similar in terms of their…

Defense Infrastructure: The Enhanced Use Lease Program Requires Management Attention

DTIC Science & Technology

2011-06-01

included in our EUL case studies, the escrow agreements executed by the Army in connection with the EUL at Yuma Proving Ground , Arizona, and the EUL at...research park. 6 Army Redstone Arsenal, Alabama 2009 50 468 acres Site for office and research center development. 7 Army Yuma Proving Ground ...9The three Army EUL case studies were located at Aberdeen Proving Ground , Maryland; Fort

A Case Study of Mentoring Relationships between Faculty Ambassadors and First Generation Hispanic Students in a First-Year Initiative Program

ERIC Educational Resources Information Center

Swafford, Clark Elliott

2017-01-01

This qualitative case study sought understanding of unique mentoring relationships of six faculty ambassadors and nine Hispanic first-generation students (HFGS) as part of a first-year initiative program. The single site was a career college in Texas, Taylor College. There were three research questions to guide inquiry comprised of six faculty…

"Beyond the Four Walls of My Building": A Case Study of #Edchat as a Community of Practice

ERIC Educational Resources Information Center

Britt, Virginia G.; Paulus, Trena

2016-01-01

Although Twitter and other social media sites have grown in popularity with educators, we still do not know what is happening within this online space or how it supports teachers. The purpose of this case study of #Edchat, a group of educators who meet weekly on Twitter, was to investigate informal professional development through the lens of…

Health Risks to Ecological Workers on Contaminated Sites - the Department of Energy as a Case Study

PubMed Central

Burger, Joanna; Gochfeld, Michael

2016-01-01

Background At most contaminated sites the risk to workers focuses on those ‘hazardous waste workers’ directly exposed to chemicals or radionuclides, and to the elaborate approaches implemented to protecting their health and safety. Ecological workers generally are not considered. Objectives To explore the risks to the health and safety of ecological workers on sites with potential chemical and radiological exposures before, during or after remediation of contamination. To use the U.S. Department of Energy as a case study, and to develop concepts that apply generally to sites contaminated with hazardous or nuclear wastes, Methods Develop categories of ecological workers, describe their usual jobs, and provide information on the kinds of risks they face. Ecological activities include continued surveillance and monitoring work on any sites with residual contamination, subject to institutional controls and engineered barriers following closure as well as the restoration. Results The categories of ecological workers and their tasks include 1) Ecological characterization, mapping and monitoring, 2) biodiversity studies, 2) Contaminant fate and transport, 3) On-going industrial activities 4) Remediation activities (environmental management), 5) Environmental restoration, 6) Post-cleanup surveillance and monitoring, and 7) Post-closure future site activities. There are a set of functional activities that can occur with different frequencies and intensities, including visual inspection, collecting biological samples, collecting media physical samples, collecting biological debris, restoration planting, and maintaining ecosystems. Conclusions Ecological workers face different exposures and risks than other environmental cleanup workers. Many of their tasks mimic shift work with long hours leading to fatigue, and they are exposed to biological as well as chemical/radiological hazards. DOE and other entities need to examine the risks to ecological workers on site with an eye to risk reduction. PMID:27668128

Zampanolide Binding to Tubulin Indicates Cross-Talk of Taxane Site with Colchicine and Nucleotide Sites.

PubMed

Field, Jessica J; Pera, Benet; Gallego, Juan Estévez; Calvo, Enrique; Rodríguez-Salarichs, Javier; Sáez-Calvo, Gonzalo; Zuwerra, Didier; Jordi, Michel; Andreu, José M; Prota, Andrea E; Ménchon, Grégory; Miller, John H; Altmann, Karl-Heinz; Díaz, J Fernando

2018-03-23

The marine natural product zampanolide and analogues thereof constitute a new chemotype of taxoid site microtubule-stabilizing agents with a covalent mechanism of action. Zampanolide-ligated tubulin has the switch-activation loop (M-loop) in the assembly prone form and, thus, represents an assembly activated state of the protein. In this study, we have characterized the biochemical properties of the covalently modified, activated tubulin dimer, and we have determined the effect of zampanolide on tubulin association and the binding of tubulin ligands at other binding sites. Tubulin activation by zampanolide does not affect its longitudinal oligomerization but does alter its lateral association properties. The covalent binding of zampanolide to β-tubulin affects both the colchicine site, causing a change of the quantum yield of the bound ligand, and the exchangeable nucleotide binding site, reducing the affinity for the nucleotide. While these global effects do not change the binding affinity of 2-methoxy-5-(2,3,4-trimethoxyphenyl)-2,4,6-cycloheptatrien-1-one (MTC) (a reversible binder of the colchicine site), the binding affinity of a fluorescent analogue of GTP (Mant-GTP) at the nucleotide E-site is reduced from 12 ± 2 × 10 5 M -1 in the case of unmodified tubulin to 1.4 ± 0.3 × 10 5 M -1 in the case of the zampanolide tubulin adduct, indicating signal transmission between the taxane site and the colchicine and nucleotide sites of β-tubulin.

Three-dimensional geological modelling of anthropogenic deposits at small urban sites: a case study from Sheepcote Valley, Brighton, UK.

PubMed

Tame, C; Cundy, A B; Royse, K R; Smith, M; Moles, N R

2013-11-15

Improvements in computing speed and capacity and the increasing collection and digitisation of geological data now allow geoscientists to produce meaningful 3D spatial models of the shallow subsurface in many large urban areas, to predict ground conditions and reduce risk and uncertainty in urban planning. It is not yet clear how useful this 3D modelling approach is at smaller urban scales, where poorly characterised anthropogenic deposits (artificial/made ground and fill) form the dominant subsurface material and where the availability of borehole and other geological data is less comprehensive. This is important as it is these smaller urban sites, with complex site history, which frequently form the focus of urban regeneration and redevelopment schemes. This paper examines the extent to which the 3D modelling approach previously utilised at large urban scales can be extended to smaller less well-characterised urban sites, using a historic landfill site in Sheepcote Valley, Brighton, UK as a case study. Two 3D models were generated and compared using GSI3D™ software, one using borehole data only, one combining borehole data with local geological maps and results from a desk study (involving collation of available site data, including ground contour plans). These models clearly delimit the overall subsurface geology at the site, and allow visualisation and modelling of the anthropogenic deposits present. Shallow geophysical data collected from the site partially validate the 3D modelled data, and can improve GSI3D™ outputs where boundaries of anthropogenic deposits may not be clearly defined by surface, contour or borehole data. Attribution of geotechnical and geochemical properties to the 3D model is problematic without intrusive investigations and sampling. However, combining available borehole data, shallow geophysical methods and site histories may allow attribution of generic fill properties, and consequent reduction of urban development risk and uncertainty. Copyright © 2013 Elsevier Ltd. All rights reserved.

Using MCDA and GIS for hazardous waste landfill siting considering land scarcity for waste disposal

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

Feo, Giovanni De, E-mail: g.defeo@unisa.it; Gisi, Sabino De

Highlights: • Wasting land for the siting of hazardous waste landfills must be avoided. • The siting procedure is based on a land use map of potentially suitable areas. • All the waste facilities of the management system are simultaneously considered. • A case study is developed considering two multi-criteria techniques. • An innovative criteria weighting tool (PSW) is used in combination with the AHP. - Abstract: The main aim of this study was to develop a procedure that minimizes the wasting of space for the siting of hazardous waste landfills as part of a solid waste management system. Wemore » wanted to tackle the shortage of land for waste disposal that is a serious and growing problem in most large urban regions. The procedure combines a multi-criteria decision analysis (MCDA) approach with a geographical information system (GIS). The GIS was utilised to obtain an initial screening in order to eliminate unsuitable areas, whereas the MCDA was developed to select the most suitable sites. The novelty of the proposed siting procedure is the introduction of a new screening phase before the macro-siting step aimed at producing a “land use map of potentially suitable areas” for the siting of solid waste facilities which simultaneously takes into consideration all plant types. The issue of obtaining sites evaluations of a specific facility was coupled with the issue of not wasting land appropriate to facilitate other types of waste management options. In the developed case study, the use of an innovative criteria weighting tool (the “Priority Scale”) in combination with the Analytic Hierarchy Process was useful to easier define the priorities of the evaluation criteria in comparison with other classic methods such as the Paired Comparison Technique in combination with the Simple Additive Weighting method.« less

Handling the difficult Brownfields issues: A case study of privately funded remediation to residential standards update 1997

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

McLeod, D.P.; Ridley, A.P.

Most Brownfields projects are based on either direct or indirect government funding. This paper describes a more unusual scenario: the remediation of a contaminated industrial site for re-use as residential property. Using the ASTM RBCA risk assessment methodology and an innovative fixed fee arrangement between Woodward-Clyde Consultants and the site owner, they developed and successfully implemented a plan to clean up the site to residential standards over a twelve (12) month time period.

Serramonte Transit Center Study

DOT National Transportation Integrated Search

1983-06-01

The purposes of the study are to determine, from this particular case -- the : Serramonte Center Plan -- guidelines for achieving the successful design and : operation of a bus station and bus access arrangement on a shopping center site, : including...

Urban Environment Development based on Universal Design Principles

NASA Astrophysics Data System (ADS)

Harsritanto, Bangun Ir

2018-02-01

Universal Design is a design which facilitated full range of human diversity. By applying Universal design principles, urban environment can be more functional and more user-friendly for everyone. This study examined five urban streets of South Korea as a country experienced on developing various urban street designs based on universal design. This study aimed to examine and compare the South Korea cases using seven principles of universal design. The research methods of this study are literature study, case study, and site observation. The results of this study are: South Korea cases are good practices, urgency of implementing the direction into local regulations; and change of urban development paradigm.

A rare case of acute presentation of trocar site hernia from robot-assisted laparoscopic partial nephrectomy.

PubMed

Ng, Zi Qin; Pemberton, Richard; Tan, Patrick

2018-02-15

Trocar site hernia is not a common acute complication encountered after robot-assisted surgery, especially in the urological cohort of patients. A few case reports of small bowel obstruction secondary to incarceration by trocar site hernia have been described in gynaecological surgery and prostatectomies. As the clinical presentation is non-specific, late diagnosis has significant implication on morbidity and mortality. Here, we present a rare case of a patient with recent robot-assisted laparoscopic partial nephrectomy for a renal cell carcinoma presented with features of impending bowel obstruction secondary to incarcerated small bowel in the trocar site. We also reviewed the literature focusing on clinical features of trocar site hernia and preventive measures.

Actinic keratosis-related signs predictive of squamous cell carcinoma in renal transplant recipients: a nested case-control study.

PubMed

Jiyad, Z; O'Rourke, P; Soyer, H P; Green, A C

2017-04-01

Squamous cell carcinoma (SCC) and intraepidermal carcinoma (IEC) commonly arise in actinically damaged skin. To identify clinical features of actinic change that correlate with an increased risk of SCC or IEC in the short-to-medium term as guidance for prioritizing field treatment. In a nested case-control study, cases were renal transplant recipients who developed an incident SCC or IEC within 18 months following baseline examination and photography. Controls without SCC or IEC were matched to cases on age, sex and duration of immunosuppression. Predefined skin sites on the head, neck and upper limbs were examined using baseline photographs to assess objectively the following features of actinic damage: presence of actinic keratosis (AK) patch (defined as AK > 1 cm 2 ), number of AK patches, number of AKs and area affected by AK. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using McNemar's test to identify differences in SCC/IEC risk combined and SCC risk alone between case and control skin sites. Thirty-nine cases were matched to 39 controls. Significant associations with the presence of an AK patch, number of AK patches, number of AKs and area affected by AKs were identified. The presence of an AK patch conferred an 18-fold increased risk of SCC (OR 18·00, 95% CI 2·84-750) and more than a sixfold increased risk of SCC/IEC combined (OR 6·60, 95% CI 2·56-21·66). AK patches are predictive of SCC/IEC development within 18 months. This can be used to guide site selection for field treatment in patients with widespread actinic damage. © 2016 British Association of Dermatologists.

Skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus (MRSA): an affliction of the underclass.

PubMed

Vayalumkal, Joseph V; Suh, Kathryn N; Toye, Baldwin; Ramotar, Karamchand; Saginur, Raphael; Roth, Virginia R

2012-11-01

The objective of this study was to determine whether skin and soft tissue infections (SSTIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) in patients presenting to The Ottawa Hospital emergency departments (TOHEDs) differed from SSTIs caused by methicillin-susceptible Staphylococcus aureus (MSSA) with regard to risk factors, management, and outcomes. All patients seen at TOHEDs in 2006 and 2007 with SSTIs who yielded MRSA or MSSA in cultures from the site of infection were eligible for inclusion. We excluded patients with decubitus ulcers and infections related to diabetes or peripheral vascular disease. We used an unmatched case-control design. Cases were defined as patients with MRSA isolated from the infection site, and controls were defined as patients with MSSA isolated from the infection site. Data were collected retrospectively from health records and laboratory and hospital information systems. A total of 153 patients were included in the study (81 cases and 72 controls). The mean age of cases was 37 years, compared to 47 years for the controls (p < 0.001). Cases were more likely to have transient residence (31% v. 3% [OR 15.6, 95% CI 3.9-61.8, p < 0.001]), present with abscesses (64% v. 15% [OR 9.9, 95% CI 4.3-23.7, p < .001]), have a documented history of hepatitis C infection (28% v. 3% [OR 13.9, 95% CI 3.9-55.0, p < 0.001]), and have a history of substance abuse (53% v. 10% [OR 10.5, 95% CI 4.4-25.1, p < 0.001]). Cases most commonly used crack cocaine and injection drugs. SSTIs caused by MRSA at TOHEDs mainly occur in a population that is young and transient with comorbidities such as hepatitis C and substance abuse.

The prevalence of squamous cell carcinoma in different sites of oral cavity at our Rural Health Care Centre in Loni, Maharashtra – a retrospective 10-year study

PubMed Central

Dadhich, Anuj; Saluja, Harish; Bawane, Shilpa; Sachdeva, Shivani

2017-01-01

Aim of the study Oral cancer ranks in the top three of all cancers in India and is quickly becoming a global health priority. More than 90% of oral and oropharyngeal cancers are squamous cell carcinoma. The purpose of this study was to document its incidence depending upon the involvement of different sites of oral cavity, and its variation with age and gender. Material and methods Histopathologically proven oral squamous cell carcinoma cases were collected from the department of oral and maxillofacial surgery RDC, PIMS. The cases were systematically grouped under three headings: anatomical sub-site of oral cavity, age group, and gender, which were analysed to calculate the prevalence of oral cancer. The study was undertaken after obtaining approval from the institutional Ethical Committee board. Results Among the different sites of oral cavity, the highest incidence (31.47%) of oral squamous cell carcinoma was seen for buccal mucosa in our study. The most affected age group (39.50%) were patients above 50 years old, predominantly involving males. Conclusions The population in this study were mostly from remote areas, among which a high rate of occurrence of oral cancer was encountered because the people were of low socio-economic class, had a casual attitude towards their health, high rate of tobacco consumption, and limited health care facilities. This study provides valuable data of the prevalence of oral cancer among the rural population. PMID:28947890

Future enhanced clinical role of pharmacists in Emergency Departments in England: multi-site observational evaluation.

PubMed

Hughes, Elizabeth; Terry, David; Huynh, Chi; Petridis, Konstantinos; Aiello, Matthew; Mazard, Louis; Ubhi, Hirminder; Terry, Alex; Wilson, Keith; Sinclair, Anthony

2017-08-01

Background There are concerns about maintaining appropriate clinical staffing levels in Emergency Departments. Pharmacists may be one possible solution. Objective To determine if Emergency Department attendees could be clinically managed by pharmacists with or without advanced clinical practice training. Setting Prospective 49 site cross-sectional observational study of patients attending Emergency Departments in England. Method Pharmacist data collectors identified patient attendance at their Emergency Department, recorded anonymized details of 400 cases and categorized each into one of four possible options: cases which could be managed by a community pharmacist; could be managed by a hospital pharmacist independent prescriber; could be managed by a hospital pharmacist independent prescriber with additional clinical training; or medical team only (unsuitable for pharmacists to manage). Impact indices sensitive to both workload and proportion of pharmacist manageable cases were calculated for each clinical group. Main outcome measure Proportion of cases which could be managed by a pharmacist. Results 18,613 cases were observed from 49 sites. 726 (3.9%) of cases were judged suitable for clinical management by community pharmacists, 719 (3.9%) by pharmacist prescribers, 5202 (27.9%) by pharmacist prescribers with further training, and 11,966 (64.3%) for medical team only. Impact Indices of the most frequent clinical groupings were general medicine (13.18) and orthopaedics (9.69). Conclusion The proportion of Emergency Department cases that could potentially be managed by a pharmacist was 36%. Greatest potential for pharmacist management was in general medicine and orthopaedics (usually minor trauma). Findings support the case for extending the clinical role of pharmacists.

Oral Thrombus: Report of 122 cases with clinically descriptive data.

PubMed

Tobouti, P-L; Pigatti, F-M; Martins-Mussi, M-C; Machado de Sousa, S-C-O

2017-05-01

The aim of the present study was to assess the frequency and characterize clinic-pathologic aspects of thrombus occurring as a single lesion or in association with other oral pathologies. 122 cases of thrombus from the oral cavity were retrieved. Information regarding site of the lesion, age, sex and clinical diagnosis or hypothesis and associated lesions were collected from the patients' records. The lesions occurred in a wide age range but the 5th decade was the most prevalent and female patients were more affected. The most frequent site for the lesion was the lip, followed by tongue, buccal mucosa, alveolar ridge, gingiva, floor of the mouth and vestibule. Thirty-five cases were associated with other vascular anomalies or actinic cheilitis. Microscopically, typical thrombus morphology was present. Organized thrombus presented neovascularization and fibroblasts, associated with hemorrhagic areas. Only 4 cases of oral thrombus have been described in the oral cavity. Given the limited number of cases reported, the importance of a thrombus in the oral cavity is not well established. This study contributes to establishing the profile of patients presenting oral thrombus, a lesion not rare but not well documented.

[Analysis of sequelae of the latissimus dorsi flap removal. Report of 44 cases reviewed and tested].

PubMed

Legré, R; Boghossian, V; Servant, J M; Magalon, G; Bureau, H

1990-01-01

Since Tanzini, the latissimus dorsi muscle flap has been widely used in plastic surgery. Based on the experience of two plastic surgery units, we decided to try to define the sequelae of this operation. In order to simplify our analysis we only considered free flaps. Out study is based on 42 patients (26 pure muscular flaps and 16 musculo-cutaneous flaps). The sequelae were analysed in terms of aesthetic and functional criteria. The aesthetic sequelae appeared to be minima in the case of pure muscular flaps, but more severe in the case of musculo-cutaneous flaps. Functional sequelae in the shoulder were observed on muscle testing in 30% of cases, although there were no repercussions on sport or work activities. Analysis of spinal posture demonstrated a modification in the frontal plane in 40% of cases although this could not be clearly attributed to the donor site. On the basis of this study, we can conclude that the latissimus dorsi flap retains an important place in the therapeutic arsenal of plastic surgery due to its reliability and its minor cicatricial and functional sequelae at the donor site.

Critical assessment of the anterolateral thigh flap donor site.

PubMed

Townley, W A; Royston, E C; Karmiris, N; Crick, A; Dunn, R L R

2011-12-01

The free anterolateral thigh flap (ALT) is now used as a 'workhorse flap'. The donor site morbidity is thought to be minimal, although most evidence derives from questionnaire-based studies rather than rigorous objective clinical assessment. In particular, robust quantitative data on thigh sensibility and quadriceps function is lacking. The aim of this study was to provide a comprehensive clinical assessment of donor site morbidity. We performed a prospective study of consecutive free ALT perforator flaps performed at Salisbury Foundation Trust between March 2008 and April 2010. The donor site was assessed at six months including a questionnaire (symptoms, function), scar analysis (Vancouver Scar Scale, VSS), and evaluation of quadriceps power and lateral thigh sensibility (compared with the contralateral unoperated thigh). One hundred ALT flaps were performed on 97 patients (mean age 46.8 years). The donor site was closed directly in 88 cases and using a split skin graft in 12 cases. At follow-up (n=68), tingling was the most common reported symptom (59%), whereas pain, itching and muscle herniation were reported infrequently. Donor site scars were mostly flat, pale and soft but widened. Pathological scarring was rare. Sensibility was reduced in donor thighs (p<0.001) and correlated with flap width but peak quadriceps contraction was similar between donor and unoperated thighs. There was a high throughput and diverse application of ALT flap reconstructions during the study period. Reduced sensibility was common around the scar but rarely troublesome. Quadriceps function was not affected even when dissection of intramuscular perforators was required. The ALT is a versatile flap that can deliver a large skin paddle with minimal impact on thigh function. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Improving the knowledge of labour and delivery nurses in India: a randomized controlled trial of mentoring and case sheets in primary care centres.

PubMed

Bradley, Janet; Jayanna, Krishnamurthy; Shaw, Souradet; Cunningham, Troy; Fischer, Elizabeth; Mony, Prem; Ramesh, B M; Moses, Stephen; Avery, Lisa; Crockett, Maryanne; Blanchard, James F

2017-01-07

Birthing in health facilities in India has increased over the last few years, yet maternal and neonatal mortality rates remain high. Clinical mentoring with case sheets or checklists for nurses is viewed as essential for on-going knowledge transfer, particularly where basic training is inadequate. This paper summarizes a study of the effect of such a programme on staff knowledge and skills in a randomized trial of 295 nurses working in 108 Primary Health Centres (PHCs) in Karnataka, India. Stratifying by district, half of the PHCs were randomly assigned to be intervention sites and provided with regular mentoring visits where case sheet/checklists were a central job and teaching aid, and half to be control sites, where no support was provided except provision of case sheets. Nurses' knowledge and skills around normal labour, labour complications and neonate issues were tested before the intervention began and again one year later. Univariate and multivariate analyses were conducted to examine the effect of mentoring and case sheets. Overall, on none of the 3 measures, did case sheet use without mentoring add anything to the basic nursing training when controlling for other factors. Only individuals who used both case-sheets and received mentoring scored significantly higher on the normal labour and neonate indices, scoring almost twice as high as those who only used case-sheets. This group was also associated with significantly higher scores on the complications of labour index, with their scores 2.3 times higher on average than the case sheet only control group. Individuals from facilities with 21 or more deliveries in a month tended to fare worse on all 3 indices. There were no differences in outcomes according to district or years of experience. This study demonstrates that provision of case sheets or checklists alone is insufficient to improve knowledge and practices. However, on-site mentoring in combination with case sheets can have a demonstrable effect on improving nurse knowledge and skills around essential obstetric and neonatal care in remote rural areas of India. We recommend scaling up of this mentoring model in order to improve staff knowledge and skills and reduce maternal and neonatal mortality in India. This study is registered at clinicaltrials.gov, Identifier No. NCT02004912 , November 27, 2013.

Analytical Modeling of Groundwater Seepages to St. Lucie Estuary

NASA Astrophysics Data System (ADS)

Lee, J.; Yeh, G.; Hu, G.

2008-12-01

In this paper, six analytical models describing hydraulic interaction of stream-aquifer systems were applied to St Lucie Estuary (SLE) River Estuaries. These are analytical solutions for: (1) flow from a finite aquifer to a canal, (2) flow from an infinite aquifer to a canal, (3) the linearized Laplace system in a seepage surface, (4) wave propagation in the aquifer, (5) potential flow through stratified unconfined aquifers, and (6) flow through stratified confined aquifers. Input data for analytical solutions were obtained from monitoring wells and river stages at seepage-meter sites. Four transects in the study area are available: Club Med, Harbour Ridge, Lutz/MacMillan, and Pendarvis Cove located in the St. Lucie River. The analytical models were first calibrated with seepage meter measurements and then used to estimate of groundwater discharges into St. Lucie River. From this process, analytical relationships between the seepage rate and river stages and/or groundwater tables were established to predict the seasonal and monthly variation in groundwater seepage into SLE. It was found the seepage rate estimations by analytical models agreed well with measured data for some cases but only fair for some other cases. This is not unexpected because analytical solutions have some inherently simplified assumptions, which may be more valid for some cases than the others. From analytical calculations, it is possible to predict approximate seepage rates in the study domain when the assumptions underlying these analytical models are valid. The finite and infinite aquifer models and the linearized Laplace method are good for sites Pendarvis Cove and Lutz/MacMillian, but fair for the other two sites. The wave propagation model gave very good agreement in phase but only fairly agreement in magnitude for all four sites. The stratified unconfined and confined aquifer models gave similarly good agreements with measurements at three sites but poorly at the Club Med site. None of the analytical models presented here can fit the data at this site. To give better estimates at all sites numerical modeling that couple river hydraulics and groundwater flow involving less simplifications of and assumptions for the system may have to be adapted.

Behavior-based safety on construction sites: a case study.

PubMed

Choudhry, Rafiq M

2014-09-01

This work presents the results of a case study and describes an important area within the field of construction safety management, namely behavior-based safety (BBS). This paper adopts and develops a management approach for safety improvements in construction site environments. A rigorous behavioral safety system and its intervention program was implemented and deployed on target construction sites. After taking a few weeks of safety behavior measurements, the project management team implemented the designed intervention and measurements were taken. Goal-setting sessions were arranged on-site with workers' participation to set realistic and attainable targets of performance. Safety performance measurements continued and the levels of performance and the targets were presented on feedback charts. Supervisors were asked to give workers recognition and praise when they acted safely or improved critical behaviors. Observers were requested to have discussions with workers, visit the site, distribute training materials to workers, and provide feedback to crews and display charts. They were required to talk to operatives in the presence of line managers. It was necessary to develop awareness and understanding of what was being measured. In the process, operatives learned how to act safely when conducting site tasks using the designed checklists. Current weekly scores were discussed in the weekly safety meetings and other operational site meetings with emphasis on how to achieve set targets. The reliability of the safety performance measures taken by the company's observers was monitored. A clear increase in safety performance level was achieved across all categories: personal protective equipment; housekeeping; access to heights; plant and equipment, and scaffolding. The research reveals that scores of safety performance at one project improved from 86% (at the end of 3rd week) to 92.9% during the 9th week. The results of intervention demonstrated large decreases in unsafe behaviors and significant increases in safe behaviors. The results of this case study showed that an approach based on goal setting, feedback, and an effective measure of safety behavior if properly applied by committed management, can improve safety performance significantly in construction site environments. The results proved that the BBS management technique can be applied to any country's culture, showing that it would be a good approach for improving the safety of front-line workers and that it has industry wide application for ongoing construction projects. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prospective analysis of the quality of Spanish health information web sites after 3 years.

PubMed

Conesa-Fuentes, Maria C; Hernandez-Morante, Juan J

2016-12-01

Although the Internet has become an essential source of health information, our study conducted 3 years ago provided evidence of the low quality of Spanish health web sites. The objective of the present study was to evaluate the quality of Spanish health information web sites now, and to compare these results with those obtained 3 years ago. For the original study, the most visited health information web sites were selected through the PageRank® (Google®) system. The present study evaluated the quality of the same web sites from February to May 2013, using the method developed by Bermúdez-Tamayo et al. and HONCode® criteria. The mean quality of the selected web sites was low and has deteriorated since the previous evaluation, especially in regional health services and institutions' web sites. The quality of private web sites remained broadly similar. Compliance with privacy and update criteria also improved in the intervening period. The results indicate that, even in the case of health web sites, design or appearance is more relevant to developers than quality of information. It is recommended that responsible institutions should increase their efforts to eliminate low-quality health information that may further contribute to health problems.

Using a telehealth service delivery approach to working with an undergraduate student with a traumatic brain injury: A case study.

PubMed

Quaco, Carrie

2017-09-14

Project Career is a five year NIDILRR-funded interprofessional demonstration project aimed to improve the academic and career success of undergraduate students who have a traumatic brain injury (TBI). The information for this case study was collected and synthesized by an occupational therapy graduate student intern for one of the Project Career sites in collaboration with the Technology and Employment Coordinator for the site, the co-PI for Project Career, and the student participant. A case study is presented to provide an understanding of one of the Project Career participant's experience using a telehealth service delivery approach to working with Project Career for academic and career support. The participant's case notes, direct communication with the intern, and outcome assessments were used to perform a qualitative analysis. The participant reported that he believed Project Career was an effective support service for him. However, the participant's initial and 6-month outcome assessment scores are inconclusive regarding improvements in his academic abilities and satisfaction with academic and career attainment. Further research on the effectiveness of using a telehealth service delivery approach to working with undergraduate students with a TBI is needed.

SU-E-J-92: On-Line Cone Beam CT Based Planning for Emergency and Palliative Radiation Therapy

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

Held, M; Morin, O; Pouliot, J

2014-06-01

Purpose: To evaluate and develop the feasibility of on-line cone beam CT based planning for emergency and palliative radiotherapy treatments. Methods: Subsequent to phantom studies, a case library of 28 clinical megavoltage cone beam CT (MVCBCT) was built to assess dose-planning accuracies on MVCBCT for all anatomical sites. A simple emergency treatment plan was created on the MVCBCT and copied to its reference CT. The agreement between the dose distributions of each image pair was evaluated by the mean dose difference of the dose volume and the gamma index of the central 2D axial plane. An array of popular urgentmore » and palliative cases was also evaluated for imaging component clearance and field-of-view. Results: The treatment cases were categorized into four groups (head and neck, thorax/spine, pelvis and extremities). Dose distributions for head and neck treatments were predicted accurately in all cases with a gamma index of >95% for 2% and 2 mm criteria. Thoracic spine treatments had a gamma index as low as 60% indicating a need for better uniformity correction and tissue density calibration. Small anatomy changes between CT and MVCBCT could contribute to local errors. Pelvis and sacral spine treatment cases had a gamma index between 90% and 98% for 3%/3 mm criteria. The limited FOV became an issue for large pelvis patients. Imaging clearance was difficult for cases where the tumor was positioned far off midline. Conclusion: The MVCBCT based dose planning and delivery approach is feasible in many treatment cases. Dose distributions for head and neck patients are unrestrictedly predictable. Some FOV restrictions apply to other treatment sites. Lung tissue is most challenging for accurate dose calculations given the current imaging filters and corrections. Additional clinical cases for extremities need to be included in the study to assess the full range of site-specific planning accuracies. This work is supported by Siemens.« less

Old Dogs, New Tricks: Training Mature-Aged Manufacturing Workers

ERIC Educational Resources Information Center

Smith, Erica; Smith, Andrew; Smith, Chris Selby

2010-01-01

Purpose: This paper aims to examine the employment and training of mature-aged workers, so that suggestions for improving training for mature-aged workers may be offered. Design/methodology/approach: Six expert interviews were carried out by telephone, and three case studies involving company site visits were completed. Each company case study…

Online Religious Advertising: The Case of Australian Christian Youth Festivals

ERIC Educational Resources Information Center

Teusner, Paul Emerson

2014-01-01

This chapter explores the changing nature of Christian denominational discourse in an Australian context as informed by Internet technologies. It will take as its case study three Internet sites developed and published for the promotion of three separate Christian youth festivals held in Australia between July 2008 and January 2009, undertaking a…

Robotic single-access splenectomy using the Da Vinci Single-Site® platform: a case report.

PubMed

Corcione, Francesco; Bracale, Umberto; Pirozzi, Felice; Cuccurullo, Diego; Angelini, Pier Luigi

2014-03-01

Single-access laparoscopic splenectomy can offer patients some advantages. It has many difficulties, such as instrument clashing, lack of triangulation, odd angles and lack of space. The Da Vinci Single-Site® robotic surgery platform could decrease these difficulties. We present a case of single-access robotic splenectomy using this device. A 37 year-old female with idiopathic thrombocytopenic purpura was operated on with a single-site approach, using the Da Vinci Single-Site robotic surgery device. The procedure was successfully completed in 140 min. No intraoperative and postoperative complications occurred. The patient was discharged from hospital on day 3. Single-access robotic splenectomy seems to be feasible and safe using the new robotic single-access platform, which seems to overcome certain limits of previous robotic or conventional single-access laparoscopy. We think that additional studies should also be performed to explore the real cost-effectiveness of the platform. Copyright © 2013 John Wiley & Sons, Ltd.

Acute myeloid leukemia with monosomy 7, ectopic virus integration site-1 overexpression and central diabetes insipidus: A case report.

PubMed

Ma, Hongbing; Yang, Jing; Xiang, Bing; Jia, Yongqian

2015-06-01

Central diabetes insipidus (DI) is a rare complication in patients with acute myeloid leukemia (AML), typically occurring in patients with abnormalities of chromosomes 3 or 7. The association between AML with monosomy 7 and DI has been described in a number of studies; however, DI has been rarely reported in cases of ectopic virus integration site-1 ( EVI1 )-positive AML with monosomy 7. The current study reports a case of AML with monosomy 7 and EVI1 overexpression, with central DI as the initial symptom. The patient was an 18-year-old female who presented with polyuria and polydipsia. Bone marrow aspiration revealed 83.5% myeloperoxidase-positive blasts without trilineage myelodysplasia. The karyotype was 45,XX,-7, and the patient presented monosomy 7 and EVI1 overexpression (- 7/EVI1 + ) without 3q aberration. Treatment with induction therapy was unsuccessful. To the best of our knowledge, this is the second case of DI-AML with - 7/EVI1 + and without a 3q aberration. The possible mechanisms associated with EVI1 , monosomy 7 and DI were investigated.

Ab initio full-potential fully relativistic study of atomic carbon, nitrogen, and oxygen chemisorption on the (111) surface of δ-Pu

NASA Astrophysics Data System (ADS)

Atta-Fynn, Raymond; Ray, Asok K.

2007-05-01

First-principles total-energy calculations within the framework of generalized gradient approximation to density-functional theory have been performed for atomic carbon, nitrogen, and oxygen chemisorption on the (111) surface of δ-Pu . The full-potential all-electron linearized augmented plane wave plus local orbitals method with the Perdew-Burke-Ernzerhof exchange-correlation functional has been employed. Chemisorption energies have been optimized with respect to the distance of the adatom from the Pu surface for four adsorption sites, namely, the top, bridge, hollow fcc, and hollow hcp sites, with the adlayer structure corresponding to a coverage of 0.50 of a monolayer in all cases. Computations were carried out at two theoretical levels, one without spin-orbit coupling (NSOC) and one with spin-orbit coupling (SOC). For NSOC calculations, the hollow fcc adsorption site was found to be the most stable site for C and N with chemisorption energies of 6.272 and 6.504eV , respectively, while the hollow hcp adsorption site was found to be the most stable site for O with chemisorption energy of 8.025eV . For SOC calculations, the hollow fcc adsorption site was found to be the most stable site in all cases with chemisorption energies for C, N, and O being 6.539, 6.714, and 8.2eV , respectively. The respective distances of the C, N, and O adatoms from the surface were found to be 1.16, 1.08, and 1.25Å . Our calculations indicate that SOC has negligible effect on the chemisorption geometries, but energies with SOC are more stable than the cases with NSOC within a range of 0.05-0.27eV . The work function and net magnetic moments, respectively, increased and decreased in all cases upon chemisorption compared with the bare δ-Pu (111) surface. The partial charges inside the muffin tins, difference charge-density distributions, and the local density of states have been used to analyze the Pu-adatom bond interactions.

An investigation of solar erythemal ultraviolet radiation at two sites in tourist attraction areas of Thailand

NASA Astrophysics Data System (ADS)

Buntoung, Sumaman; Pattarapanitchai, Somjet; Wattan, Rungrat; Masiri, Itsara; Promsen, Worrapass; Tohsing, Korntip; Janjai, Serm

2013-05-01

Islands on the southern coasts of Thailand are famous attractions for local and foreign tourists. Tourists usually expose their skins to solar radiation for tanning. Thus information on solar ultraviolet radiation (UV) is of importance for tourists to protect themselves from adverse effects of UV. In this work, solar erythemal ultraviolet radiation (EUV) at two touristic sites namely Samui island (9.451°N, 100.033°E) and Phuket island (8.104°N, 98.304°E) was investigated. In investigating EUV, broadband UV radiometers (Kipp & Zonen, model UVS-B-C) were installed at existing meteorological stations in Samui and Phuket islands. A one-year period of EUV data from these two sites was analyzed. The level of UV index at these sites was studied. The values of UV index higher than 12 at noon time of clear days are usually found in the summer at both sites. Seasonal variation of EUV at both sites was investigated. It was found that the tropical monsoons have strong influence on this variation. Finally, global broadband radiation measured at the sites was also used to establish a correlation between EUV and global broadband radiation. Higher correlation was found for the case of clear sky, as compared to the case of cloudy sky. The correlation obtained from this analysis can be used to estimate EUV from global broadband radiation at these two sites.

Suprafascial versus traditional harvesting technique for free antero lateral thigh flap: A case-control study to assess the best functional and aesthetic result in extremity reconstruction.

PubMed

Maruccia, Michele; Fallico, Nefer; Cigna, Emanuele; Ciudad, Pedro; Nicoli, Fabio; Trignano, Emilio; Nacchiero, Eleonora; Giudice, Giuseppe; Ribuffo, Diego; Chen, Hung-Chi

2017-11-01

Clinical applications of ALT flap have currently extended to extremity (hand and foot) as well as oral cavity reconstruction. In these anatomical areas, the traditional harvesting technique presents a few disadvantages such as bulkiness of the recipient site and potential donor site morbidity including damage to the deep fascia and skin graft adhesions. The purpose of the present study was to compare the functional and aesthetic outcomes of upper and lower extremity reconstruction with either suprafascial or subfascial harvested anterolateral (ALT) flaps. Sixty patients who underwent hand or foot reconstruction with an ALT flap between January 2013 and January 2015 were included in the study (34 flaps elevated on a subfascial plane and 26 on a suprafascial plane). Group 1 (subfascial harvested ALT flap) was composed of 23 male and 11 female patients with an average age of 53.4 years (range, 36-72 years). Group 2 (suprafascial harvested ALT flap) was composed of 18 male and 8 female patients with an average age of 48.7 years (range, 32-69 years). Surgical indication was tumor resection for 20 patients in group 1 and 16 patients in group 2, chronic ulcer for 8 patients in group 1 and 6 patients in group 2, and trauma for 6 patients in group 1 and 4 patients in group 2. Complications were documented. Aesthetic outcomes were considered in terms of bulkiness of the recipient site, subsequent request for a debulking procedure, and donor site morbidity. Donor site scars were evaluated for cosmesis using a modified Hollander Wound Evaluation Scale (HWES). Skin grafts outcomes were assessed according to the modified Vancouver Scar Scale (VSS). Functional outcome at the recipient site was measured using the Enneking functional outcome score (ESS). Total range of motion (ROM) was recorded. All flaps were successfully elevated with at least one viable perforator with both approaches. The survival rates of suprafascial and subfascial harvested ALT flaps were 96.2 and 97% respectively (P = .85). The mean flap size was 110.4 ± 27.8 cm 2 in group 1 and 159.7 ± 44.4 cm 2 in group 2. The average flap thickness was 26.2± 5.2 mm in group 1 and 13.9 mm ± 4.1 in group 2. Complications included total flap loss (1 case in group 1 and 1 case in group 2), partial flap loss (2 cases in group 1 and 1 case in group 2), skin graft failure (3 cases in group 1), and muscle herniation at the donor site (1 case in group 1; P < .17). Secondary debulking procedures were needed for 20 flaps in the subfascial group and for one flap in the suprafascial group (P-value <.01). Donor site closure with skin grafts was necessary in 42 cases: 32 in group 1 and 10 in group 2. The suprafascial harvested ALT flap group reported a significant difference in terms of donor site morbidity. The HWES score of donor site scars was significantly lower in group 1 (mean 1.2 ± 0.54) than in group 2 (mean 2.4 ± 0.58), P < .01. Similarly, the VSS score for skin graft outcomes was lower in patients of group 1 (mean 4.5 ± 0.93) than in patients of group 2 (mean 6.7 ± 0.96), P < .01. There was also a significant lower score of postoperative ESS in patients of group 1 (mean 21.2 ± 3.4) when compared with patients of group 2 (mean 23.6 ± 2.7), P < .01. Total ROM improved on average 60° after surgery (P-value <.01). The suprafascial plane for elevating ALT flaps presented several advantages over the traditional subfascial approach in terms of functional and aesthetic outcomes, providing a thin flap allowing increased versatility to achieve better contour of flap, and minimizing the need for secondary debulking. © 2017 Wiley Periodicals, Inc.

Effective Strategies for School-Based Early Childhood Centers. The Northwest Regional Educational Laboratory Program Report.

ERIC Educational Resources Information Center

Jewett, Janet

Effective strategies for developing early childhood centers in public schools are discussed in this paper, which draws from a research-based literature search and intensive case studies of six Northwest sites. The sites represent a range of rural, suburban, and urban programs; large and small schools; and a variety of program features. The sites…

"That Dog Won't Hunt!": Exemplary School Change Efforts within the Kentucky Reform.

ERIC Educational Resources Information Center

Wolf, Shelby A.; Borko, Hilda; Elliott, Rebekah L.; McIver, Monette C.

2000-01-01

Presents case studies of four exemplary schools as they worked to meet the demands of the Kentucky Education Reform Act (KERA) and the assessment system, the Kentucky Instructional Results Information System. Finds that the ways schools met the challenges were unique to each site, but outlines aspect common to teachers in all four sites. (SLD)

Does a University Teacher Need to Change e-Learning Beliefs and Practices When Using a Social Networking Site? A Longitudinal Case Study

ERIC Educational Resources Information Center

Scott, Karen M.

2013-01-01

While much of the e-learning development at universities in the past 15 years has been on institutionally supported Learning Management Systems (LMSs), alternative educational technologies are being taken up following the rapid growth in emerging technologies, including social networking sites (SNSs). While teachers may choose educational…

The effects of site factors on the rate of hemlock decline: a case study in New Jersey

Treesearch

Denise Royle; Richard Lathrop

2000-01-01

The rate of decline of hemlock (Tsuga canadensis) trees infested with hemlock woolly adelgid (Adelges tsugae) appears to be highly variable and site dependent. Rates of hemlock forest decline have not been quantified at the landscape scale and reasons for observed variations in the rate of decline remain unknown. Others have...

Investigating habitat value to inform contaminant remediation options: case study

Treesearch

Rebecca A. Efroymson; Mark J. Peterson; Neil R. Giffen; Michael G. Ryon; John G. Smith; William W. Hargrove; W. Kelly Roy; Christopher J. Welsh; Daniel L. Druckenbrod; Harry D. Quarles

2008-01-01

Habitat valuation methods were implemented to support remedial decisions for aquatic and terrestrial contaminated sites at the East Tennessee Technology Park (ETTP) on the US Department of Energy (DOE) Oak Ridge Reservation in Oak Ridge, TN, USA. The habitat valuation was undertaken for six contaminated sites: Contractor’s Spoil Area, K-901-N Disposal Area, K-770...

Health effects of a thorium waste disposal site.

PubMed Central

Najem, G R; Voyce, L K

1990-01-01

A case-control study of 112 households residing in the vicinity of a thorium waste disposal site found a higher prevalence of birth defects (RR 2.1) and liver diseases (RR 2.3) among exposed than the unexposed group. The numbers were quite small and the confidence intervals wide, however, so that no definite conclusions can be drawn from these data. PMID:2316775

Study methods, recruitment, socio-demographic findings and demographic representativeness in the OPPERA study

PubMed Central

Slade, Gary D.; Bair, Eric; By, Kunthel; Mulkey, Flora; Baraian, Cristina; Rothwell, Rebecca; Reynolds, Maria; Miller, Vanessa; Gonzalez, Yoly; Gordon, Sharon; Ribeiro-Dasilva, Margarete; Lim, Pei Feng; Greenspan, Joel D; Dubner, Ron; Fillingim, Roger B; Diatchenko, Luda; Maixner, William; Dampier, Dawn; Knott, Charles; Ohrbach, Richard

2011-01-01

This paper describes methods used in the project “Orofacial Pain Prospective Evaluation and Risk Assessment” (OPPERA) and evaluates socio-demographic characteristics associated with temporomandibular disorders (TMD) in the OPPERA case-control study. Representativeness was investigated by comparing socio-demographic profiles of OPPERA participants with population census profiles of counties near study sites and by comparing age- and gender-associations with TMD in OPPERA and the 2007-09 US National Health Interview Survey. Volunteers aged 18-44 years were recruited at four US study sites: 3,263 people without TMD were enrolled into the prospective cohort study; 1,633 of them were selected as controls for the baseline case-control study. Cases were 185 volunteers with examiner-classified TMD. Distributions of some demographic characteristics among OPPERA participants differed from census profiles, although there was less difference in socio-economic profiles. Odds of TMD was associated with greater age in this 18-44 year range; females had three times the odds of TMD as males; and relative to non-Hispanic-Whites, other racial groups had one-fifth the odds of TMD. Age- and gender-associations with chronic TMD were strikingly similar to associations observed in the US population. Assessments of representativeness in this demographically diverse group of community volunteers suggest that OPPERA case-control findings have good internal validity. PMID:22074749

Chemical Warfare Materiel in Sediment at a Deep-Water Discarded Military Munitions Site

NASA Astrophysics Data System (ADS)

Briggs, C. W.; Bissonnette, M. C.; Edwards, M.; Shjegstad, S. M.

2016-12-01

Understanding the release and transformation of chemical agent (CA) at underwater discarded military munitions (DMM) sites is essential to determine the potential risk to human health and impact on the ocean environment; yet few studies have been conducted at sites in excess of 250 m, the depth at which most U.S. CA munitions were disposed. Maritime construction workers installing cables or pipelines at a CA DMM site, as well as fishermen and scientific researchers deploying bottom-contact gear, represent possible exposure pathways to human receptors. The Hawai`i Undersea Military Munitions Assessment (HUMMA) sought to characterize a historic munitions sea-disposal site at depths between 400-650 m. During the 2014 HUMMA Sampling Survey, the Jason 2 remotely operated vehicle was used to collect sediments within two meters of suspected World War II chemical munitions, confirmed to be 100-lb M47 series bombs containing sulfur mustard. When environmental media was brought to the surface, samples were screened for distilled sulfur mustard (HD) and related agent breakdown products (ABP) (collectively referred to as chemical warfare materiel [CWM]). Detectable concentrations of HD and/or its ABP 1,4-dithiane were found in sediments collected at all CA DMM sites; HD was also detected at two control sites. The location and extent of munitions casing deterioration strongly influenced the distribution and level of CWM in sediment. The interior of the casing contained levels of CWM orders of magnitudes higher than that observed in the surrounding sediment at one meter distance, indicating the majority of the CWM is hydrolyzed as it is released from the munitions casing and a fraction of the fill materiel persists in the environment for decades following disposal. Although the potential for future site users to become exposed to CWA in recovered sediments and debris exists, the level of risk is significantly mitigated by the depth and location of the sea-disposal site.

Annualized earthquake loss estimates for California and their sensitivity to site amplification

USGS Publications Warehouse

Chen, Rui; Jaiswal, Kishor; Bausch, D; Seligson, H; Wills, C.J.

2016-01-01

Input datasets for annualized earthquake loss (AEL) estimation for California were updated recently by the scientific community, and include the National Seismic Hazard Model (NSHM), site‐response model, and estimates of shear‐wave velocity. Additionally, the Federal Emergency Management Agency’s loss estimation tool, Hazus, was updated to include the most recent census and economic exposure data. These enhancements necessitated a revisit to our previous AEL estimates and a study of the sensitivity of AEL estimates subjected to alternate inputs for site amplification. The NSHM ground motions for a uniform site condition are modified to account for the effect of local near‐surface geology. The site conditions are approximated in three ways: (1) by VS30 (time‐averaged shear‐wave velocity in the upper 30 m) value obtained from a geology‐ and topography‐based map consisting of 15 VS30 groups, (2) by site classes categorized according to National Earthquake Hazards Reduction Program (NEHRP) site classification, and (3) by a uniform NEHRP site class D. In case 1, ground motions are amplified using the Seyhan and Stewart (2014) semiempirical nonlinear amplification model. In cases 2 and 3, ground motions are amplified using the 2014 version of the NEHRP site amplification factors, which are also based on the Seyhan and Stewart model but are approximated to facilitate their use for building code applications. Estimated AELs are presented at multiple resolutions, starting with the state level assessment and followed by detailed assessments for counties, metropolitan statistical areas (MSAs), and cities. AEL estimate at the state level is ∼$3.7  billion, 70% of which is contributed from Los Angeles–Long Beach–Santa Ana, San Francisco–Oakland–Fremont, and Riverside–San Bernardino–Ontario MSAs. The statewide AEL estimate is insensitive to alternate assumptions of site amplification. However, we note significant differences in AEL estimates among the three sensitivity cases for smaller geographic units.

Role of strategic human resource management in crisis management in Australian greenfield hospital sites: a crisis management theory perspective.

PubMed

Kendrick, Madeleine Iris; Bartram, Timothy; Cavanagh, Jillian; Burgess, John

2017-11-20

Objective This study examined strategic human resource management (SHRM) activities in two case hospitals relative to their approach to greenfield site success. Methods A comparative case study analysis approach was used, with documents sourced from public, open-access sites. The theoretical framework of crisis management theory's (CMT) proactive management and open communication channels was used to examine the documents, which were annual reports addressing both hospitals' first year of performance, union publications and transcripts of relevant parliamentary inquiries. Results The hospital that effectively used CMT in its first 12 months was demonstratively more 'successful' than the hospital that reported to not have effectively used CMT. 'Success' in this project was articulated as the hospital's ability to consolidate operations, without ongoing negative media attention, after 12 months. Conclusion This study provided an identification of how the use of CMT in a hospital's greenfield stage can increase the hospital's chances of 'success'. What is known about the topic? Journal and media articles illustrated a gap in greenfield human resource management (HRM) regarding successful consolidation, especially the healthcare context. Although manufacturing firms are addressed in academic literature in a greenfield context, there is a lack of knowledge concerning successful greenfield HRM in a healthcare context. What does this paper add? This study is among the first to identify the role of CMT in successful greenfield site establishment by identifying its presence in management activities. What are the implications for practitioners? The findings of this study suggest a potential link between the implementation of CMT and greenfield site success. This could allow future greenfield healthcare sites to operate with less cost and risk. The lack of stakeholder participation in the present study limits the applicability of its findings. However, archival document analysis provides a strong foundation for future studies.

Evaluation of specific neural marker GAP-43 and TH combined with Masson-trichrome staining for forensic autopsy cases with old myocardial infarction.

PubMed

Yu, Tian-Shui; Wang, Xu; Zhang, Hai-Dong; Bai, Ru-Feng; Zhao, Rui; Guan, Da-Wei

2018-01-01

It has been a puzzling forensic task to determine the cause of death as a result of old myocardial infarction (OMI) in the absence of recognizable acute myocardial infarction. Recent studies indicated that the heterogeneous cardiac nerve sprouting and sympathetic hyperinnervation at border zones of the infarcted site played important roles in sudden cardiac death (SCD). So, the present study explored the value of growth associated protein-43 (GAP-43) and tyrosine hydroxylase (TH) as objective and specific neural biomarkers combined with Masson-trichrome staining for forensic autopsy cases. Myocardium of left ventricle of 58 medicolegal autopsy cases, 12 OMI cases, 12 acute/OMI cases, and 34 control cases, were immunostained with anti-GAP-43 and anti-TH antibodies. Immunoreactivity of GAP-43 and TH identified nerve fibers and vascular wall in OMI cases and acute/OMI cases. Specifically, TH-positive nerve fibers were abundant at border zones of the infarcted site. There were a few GAP-43 and TH expressions in the control cases. With Masson-trichrome staining, collagen fibers were blue and cardiac muscle fibers were pink in marked contrast with the surrounding tissue, which improved the location of nerve fibers. Thus, these findings suggest that immunohistochemical detection of GAP-43 and TH combined with Masson-trichrome staining can provide the evidence for the medicolegal expertise of SCD due to OMI, and further demonstrate a close relationship between sympathetic hyperinnervation and SCD.

Cigarette Smoking and Risk of Lung Metastasis from Esophageal Cancer

PubMed Central

Abrams, Julian A.; Lee, Paul C.; Port, Jeffrey L.; Altorki, Nasser K.; Neugut, Alfred I.

2008-01-01

Background While extensive research has explored the impact of environmental factors on the etiology of specific cancers, the influence of exposures such as smoking on risk of site-specific metastasis is unknown. We investigated the association of cigarette smoking with lung metastasis in esophageal cancer. Methods We performed a case-control study of esophageal cancer patients from two centers, comparing cases with lung metastases to controls without lung metastases. Information was gathered from medical records on smoking history, imaging results, site(s) of metastasis, and other patient and tumor characteristics. We used logistic regression to assess association. Results We identified 354 esophageal cancer cases; smoking status was known in 289 (82%). Among patients with lung metastases, 73.6% (39/53) were ever smokers, versus 47.8% (144/301) of patients without lung metastases (p=0.001) (summary OR 2.52, 95%CI 1.17-5.45; stratified by histology). Smoking was associated with a nonsignificant increased adjusted odds of lung metastasis (OR 1.89, 95%CI 0.80-4.46). Upper esophageal subsite (OR 4.71, 95%CI 1.20-18.5) but not histology (squamous OR 0.65,95%CI 0.27-1.60) was associated with lung metastasis. Compared to the combined never/unknown smoking status group, smoking was associated with a significantly increased odds of lung metastasis (OR 2.35, 95%CI 1.11-4.97). There was no association between liver metastasis and smoking (OR 0.88, 95%CI 0.42-1.83) Conclusions Smoking is associated with increased odds of lung metastasis from esophageal cancer, and this relationship appears to be site-specific. Future studies are needed to determine whether smoking affects the tumor cell or the site of metastasis, and whether this changes the survival outcome. PMID:18843013

Cigarette smoking and risk of lung metastasis from esophageal cancer.

PubMed

Abrams, Julian A; Lee, Paul C; Port, Jeffrey L; Altorki, Nasser K; Neugut, Alfred I

2008-10-01

Whereas extensive research has explored the effect of environmental factors on the etiology of specific cancers, the influence of exposures such as smoking on risk of site-specific metastasis is unknown. We investigated the association of cigarette smoking with lung metastasis in esophageal cancer. We conducted a case-control study of esophageal cancer patients from two centers, comparing cases with lung metastases to controls without lung metastases. Information was gathered from medical records on smoking history, imaging results, site(s) of metastasis, and other patient and tumor characteristics. We used logistic regression to assess association. We identified 354 esophageal cancer cases; smoking status was known in 289 (82%). Among patients with lung metastases, 73.6% (39 of 53) were ever smokers, versus 47.8% (144 of 301) of patients without lung metastases [P=0.001; summary odds ratio (OR), 2.52; 95% confidence interval (95% CI), 1.17-5.45; stratified by histology]. Smoking was associated with a nonsignificant increased adjusted odds of lung metastasis (OR, 1.89; 95% CI, 0.80-4.46). Upper esophageal subsite (OR, 4.71; 95% CI, 1.20-18.5), but not histology (squamous OR 0.65,95% CI 0.27-1.60), was associated with lung metastasis. Compared with the combined never/unknown smoking status group, smoking was associated with a significantly increased odds of lung metastasis (OR, 2.35; 95% CI, 1.11-4.97). There was no association between liver metastasis and smoking (OR, 0.88; 95% CI, 0.42-1.83). Smoking is associated with increased odds of lung metastasis from esophageal cancer, and this relationship seems to be site specific. Future studies are needed to determine whether smoking affects the tumor cell or the site of metastasis, and whether this changes the survival outcome.

Clinical characterization of unusual cystic echinococcosis in southern part of Turkey.

PubMed

Akcam, Atlgan Tolga; Ulku, Abdullah; Koltas, Ismail Soner; Izol, Volkan; Bicer, Omer Sunkar; Kilicbagir, Emine; Sakman, Gurhan; Poyrazoglu, Hakan; Erman, Tahsin; Aridogan, Ibrahim Atilla; Parsak, Cem Kaan; Inal, Mehmet; Iskit, Serdar

2014-01-01

The incidence of primary extrahepatic cystic echinococcosis (CE) is rare. Generally, radiological and serological findings can help establish the diagnosis of hepatic and pulmonary CE, but a CE in an unusual location with atypical radiological findings may complicate the differential diagnosis. The objective of this study is to present the characteristics of cases with extrahepatic CE in respect of sites of involvement, clinical presentations, radiological findings, serological diagnostic evaluations, and outcomes of infected patients. A retrospective analysis of surgically treated CE was conducted between January 1993 and January 2014 in the General Surgery, Pediatric Surgery, Urology, Cardiovascular Surgery, Neurosurgery, and Orthopedics departments of University of Cukurova, Faculty of Medicine, Balcal Hospital. Among the 661 patients managed for CE, 134 had unusual sites of involvement. Radiological and serological examinations were used to differentiate CE from alveolar echinococcosis. Of 134 cases with unusual sites of involvement, 32 cases had liver CE (23.9%), 7 cases had lung CE (5.2%), and 2 cases had concomitant liver and lung CE (1.5%). In 93 (69.4%) cases, unusual organ involvement was isolated without any liver or lung involvement. The mean age was 45 years. Abdominal pain was the main symptom and was found in 104 patients. Thirty-one (23.1%) of 134 extrahepatic CE cases were evaluated as negative with indirect hemagglutination (IHA). However, positive results were obtained in 54 cases evaluated with Echinococcus granulosus IgG Western blot (WB), including 10 IHA-negative cases. CE with unusual localizations may cause serious problems of diagnostic confusion. The combination of clinical history, radiological findings, and serological test results (especially the WB) are valuable in diagnosing extrahepatic CE.

Active transportation measurement : Minneapolis case study.

DOT National Transportation Integrated Search

2013-06-01

This research examines longitudinal bicycle count data to better understand the impact of new bicycle facilities on use. The study site is Minneapolis which has invested close to $25 million over 8 years to improve active transportation facilities as...

Retrospective Case Study in Killdeer, North Dakota

EPA Pesticide Factsheets

This study site was chosen at the request of the state to specifically examine any water resource impacts from a well blowout in September 2010 that resulted in an uncontrolled release of hydraulic fracturing fluids and formation fluids.

Prospective Cohort Study with Active Surveillance for Fever in Four Dengue Endemic Countries in Latin America

PubMed Central

Dayan, Gustavo; Arredondo, Jose L.; Carrasquilla, Gabriel; Deseda, Carmen C.; Dietze, Reynaldo; Luz, Kleber; Costa, Maria Selma N.; Cunha, Rivaldo V.; Rey, Luis C.; Morales, Javier; Reynales, Humberto; Miranda, Maria; Zambrano, Betzana; Rivas, Enrique; Garbes, Pedro; Noriega, Fernando

2015-01-01

To prepare for a Phase III dengue vaccine efficacy trial, 20 investigational sites were selected for this observational study to identify dengue infections in a closed cohort (N = 3,000 children 9–16 years of age). Of 255 acute febrile episodes experienced by 235 children, 50 (21.3%) were considered serologically probable dengue, and 18 (7.7%) were considered virologically confirmed (i.e., dengue NS1 antigen positive) dengue cases. Considering the disease-free and at-risk period from study start to onset of symptoms, the overall incidence density of acute febrile episodes was 17.7 per 100 person-years of follow-up, ranging from 15.3 in Colombia to 22.0 in Puerto Rico. This study showed that all sites were capable of capturing and following up acute febrile episodes within a specific timeframe among the established cohort and to detect dengue cases. PMID:26013373

Association between an outbreak strain causing mycoplasma bovis mastitis and its asymptomatic carriage in the herd: a case study from Idaho, USA.

PubMed

Punyapornwithaya, V; Fox, L K; Hancock, D D; Gay, J M; Alldredge, J R

2010-01-01

The objective of this study was to determine the association between mycoplasma mastitis and colonization of mycoplasma organisms at body sites of asymptomatic carriers. The investigation was done in a dairy herd with a first outbreak of mycoplasma mastitis. Milk and swab solution specimens from accessible mucosal surfaces of body sites from cows and replacements were sampled at quarterly intervals (Herd Samplings 1-4). Samples were cultured and Mycoplasma spp. were isolated, speciated and fingerprinted. During Herd Sampling 1 two cows with mycoplasma bovis mastitis were identified and all swabbing solutions of body site samples from 18 of 84 cows and 36 of 77 replacements were positive to Mycoplasma bovis and fingerprinted as the same strain. A case of clinical M. bovis mastitis developed during Herd Sampling 3. During Herd Samplings 2-4, 4 lactating cows and 12 replacements were positive to M. bovis at various body sites with 4 different strains. Three isolates of Mycoplasma californicum were found from swabbing solutions of three cows during Herd Samplings 3 and 4. Only one strain of M. bovis caused mastitis although four strains were isolated from body sites of animals. Isolation of M. bovis from a body site never preceded mastitis. No lactating cow developed mastitis during Herd Sampling 4 although some animals were colonized with the organism. It appears that during the initial outbreak of M. bovis mastitis colonization of body sites by the outbreak strain may be common. However, the prevalence of colonization subsides and colonization does not appear to precede mastitis.

Single-site multiport combined splenectomy and cholecystectomy with conventional laparoscopic instruments: Case series and review of literature

PubMed Central

Ozemir, Ibrahim Ali; Bayraktar, Baris; Bayraktar, Onur; Tosun, Salih; Bilgic, Cagri; Demiral, Gokhan; Ozturk, Erman; Yigitbasi, Rafet; Alimoglu, Orhan

2015-01-01

Introduction Conventional laparoscopic procedures have been used for splenic diseases and concomitant gallbladder stones, frequently in patients with hereditary spherocytosis since 1990’s. The aim of this study is to evaluate the feasibility of single-site surgery with conventional instruments in combined procedures. Presentation of case series Six consecutive patients who scheduled for combined cholecystectomy and splenectomy because of hereditary spherocytosis or autoimmune hemolytic anemia were included this study. Both procedures were performed via trans-umbilical single-site multiport approach using conventional instruments. All procedures completed successfully without conversion to open surgery or conventional laparoscopic surgery. An additional trocar was required for only one patient. The mean operation time was 190 min (150–275 min). The mean blood loss was 185 ml (70–300 ml). Median postoperative hospital stay was two days. No perioperative mortality or major complications occurred in our series. Recurrent anemia, hernia formation or wound infection was not observed during the follow-up period. Discussion Nowadays, publications are arising about laparoscopic or single site surgery for combined diseases. Surgery for combined diseases has some difficulties owing to the placement of organs and position of the patient during laparoscopic surgery. Single site laparoscopic surgery has been proposed to have better cosmetic outcome, less postoperative pain, greater patient satisfaction and faster recovery compared to standard laparoscopy. Conclusion We consider that single-site multiport laparoscopic approach for combined splenectomy and cholecystectomy is a safe and feasible technique, after gaining enough experience on single site surgery. PMID:26708949

GIS and the Analytic Hierarchy Process for Regional Landfill Site Selection in Transitional Countries: A Case Study From Serbia

NASA Astrophysics Data System (ADS)

Zelenović Vasiljević, Tamara; Srdjević, Zorica; Bajčetić, Ratko; Vojinović Miloradov, Mirjana

2012-02-01

The Serbian National Waste Management Strategy for the Period 2010-2019, harmonized with the European Union Directives, mandates new and very strict requirements for landfill sites. To enable analysis of a number of required qualitative and quantitative factors for landfill site selection, the traditional method of site selection must be replaced with a new approach. The combination of GIS and the Analytic Hierarchy Process (AHP) was selected to solve this complex problem. The Srem region in northern Serbia, being one of the most environmentally sensitive areas, was chosen as a case study. Seventeen factors selected as criteria/sub-criteria were recognized as most important, divided into geo-natural, environmental, social and techno-economic factors, and were evaluated by experts from different fields using an AHP extension in Arc GIS. Weighted spatial layers were combined into a landfill suitability map which was then overlapped with four restriction maps, resulting in a final suitability map. According to the results, 82.65% of the territory of Srem is unsuitable for regional landfill siting. The most suitable areas cover 9.14%, suitable areas 5.24%, while areas with low and very low suitability cover 2.21 and 0.76% of the territory, respectively. Based on these findings, five sites close to two large urban agglomerations were suggested as possible locations for a regional landfill site in Srem. However, the final decision will require further field investigation, a public acceptance survey, and consideration of ownership status and price of the land.

The importance of the verbal shift handover report: a multi-site case study.

PubMed

Randell, Rebecca; Wilson, Stephanie; Woodward, Peter

2011-11-01

Shift handover is seen as a key tool in ensuring continuity of care yet a number of studies have highlighted the role of shift handovers in adverse events. This, combined with the increased frequency of shift handovers, has led to interest in providing technological support for handover to enhance safety. The aim of this paper is to describe current practices for the conduct of shift handovers and to use this as a basis for considering the role that technology could play in supporting handover. A multi-site case study of handover was conducted. Data included observations of 15 medical shift handovers and 33 nursing shift handovers across three case sites. The findings highlight the way in which the verbal shift handover report is practically focused, displaying the healthcare professional's ability to know what information is required and where further explanation is needed. As well as supporting teaching and team cohesion, shift handover can provide an opportunity to reflect on the previous shift and for discussion with patients and their families. The benefits provided by a face to face handover suggest that technology should focus on supporting rather than replacing the verbal shift handover report, providing a flexible solution that allows handover participants to gather more information as it is required. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Dietary Inflammatory Index and Risk of Colorectal Cancer: A Case-Control Study in Korea.

PubMed

Cho, Young Ae; Lee, Jeonghee; Oh, Jae Hwan; Shin, Aesun; Kim, Jeongseon

2016-07-30

The role of diet-associated inflammation in colorectal cancer is of interest. Accordingly, we aimed to examine whether the dietary inflammatory index (DII) was associated with the risk of colorectal cancer in a case-control study conducted in Korea. The DII was based on dietary intake, which was determined by a 106-item semi-quantitative food frequency questionnaire completed by 923 colorectal cancer cases and 1846 controls. Logistic regression was used to estimate odd ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were conducted by the anatomical site of the cancer, sex, and other risk factors. Higher DII scores were associated with an increased incidence of colorectal cancer (OR (95% CI) = 2.16 (1.71, 2.73) for highest vs. lowest tertile). The magnitude differed by anatomical site and sex. This association was slightly weaker in subjects with proximal colon cancer (1.68 (1.08, 2.61)) and was stronger in women (2.50 (1.64, 3.82)). Additionally, stronger associations were observed in subjects who were older than 50 years (p for interaction = 0.004) and engaged in physical activity (p for interaction < 0.001). Results from this study suggest that diet-associated inflammation may increase the risk of colorectal cancer, and this effect may differ by certain factors, such as anatomical site, age, sex, and lifestyle.

Development of a Method for Selecting Optimum Sites for the Automatic Mountain Meteorology Observation Station (AMOS) to Improve Predictability of Forest Fires in Inaccessible Area

NASA Astrophysics Data System (ADS)

Yoon, S.; Won, M.; Jang, K.; Lim, J.

2016-12-01

As there has been a recent increase in the case of forest fires in North Korea descending southward through the De-Militarized Zone (DMZ), ensuring proper response to such events has been a challenge. Therefore, in order to respond and manage these forest fires appropriately, an improvement in the forest fire predictability through integration of mountain weather information observed at the most optimal site is necessary. This study is a proactive case in which a spatial analysis and an on-site assessment method were developed for selecting an optimum site for a mountain weather observation in national forest. For spatial analysis, the class 1 and 2 forest fire danger areas for the past 10 years, accessibility maximum 100m, Automatic Weather Station (AWS) redundancy within 2.5km, and mountain terrains higher than 200m were analyzed. A final overlay analysis was performed to select the candidates for the field assessment. The sites selected through spatial analysis were quantitatively evaluated based on the optimal meteorological environment, forest and hiking trail accessibility, AWS redundancy, and supply of wireless communication and solar powered electricity. The sites with total score of 70 and higher were accepted as adequate. At the final selected sites, an AMOS was established, and integration of mountain and Korea Meteorological Administration (KMA) weather data improved the forest fire predictability in South Korea by 10%. Given these study results, we expect that establishing an automatic mountain meteorology observation station at the optimal sites in inaccessible area and integrating mountain weather data will improve the predictability of forest fires.

Health Care Delivery Practices in Huntington's Disease Specialty Clinics: An International Survey.

PubMed

Frich, Jan C; Rae, Daniela; Roxburgh, Richard; Miedzybrodzka, Zofia H; Edmondson, Mary; Pope, Erika Bjorklund; Goodman, LaVonne; Haddad, Monica S; Giuliano, Joe; Nelson, Eugene C; Guttman, Mark; Nance, Martha

2016-06-27

Little is known about the organization of clinical services for Huntington's disease (HD). To describe how health care services are organized and delivered in HD-clinics taking part in or eligible for the Enroll-HD study. In 2014, a 69-item survey was administered to sites taking part in or eligible for the Enroll-HD study. Of 231 sites surveyed, 121 (52.2%) sites in Europe, North America, Latin America, and Oceania responded. Most sites in the sample serve large populations, with 61.1% serving more than 1.5 million people, and a further 33% serving >500,000. Almost all (86.0%) centers see patients from outside their region. The majority of centers (59.7%) follow 50-199 patients, 21.9% care for more than 200. Most centers provide care in all stages of HD, and nearly all review pre-symptomatic cases. Multidisciplinary case reviews are offered in 54.5% of sites, with outreach clinics offered by 48.1%. Videoconferencing and telemedicine are used by 23.6%. Separate consultations for caregivers are offered in more than half of the centers. Most centers (70.4%) report following published guidelines or local care pathways for HD. Most centers serve a large population and use a multidisciplinary approach. The survey gives insight into factors underpinning HD service delivery globally. There is a need for more in-depth studies of clinical practice to understand how services are organized and how such features may be associated with quality of care.

Breast screening: What can the interval cancer review teach us? Are we perhaps being a bit too hard on ourselves?

PubMed

Lekanidi, Katerina; Dilks, Phil; Suaris, Tamara; Kennett, Steffan; Purushothaman, Hema

2017-09-01

The aim of this study was to determine the features that make interval cancers apparent on the preceding screening mammogram and determine whether changes in the ways of performing the interval cancer review will affect the true interval cancer rate. This study was approved by the clinical governance committee. Mammograms of women diagnosed with an interval cancer were included in the study if they had been allocated to either the "suspicious signs" group or "subtle signs" group, during the historic interval cancer review. Three radiologists, individually and blinded to the site of interval cancer, reviewed the mammograms and documented the presence, site, characteristics and classification of any abnormality. Findings were compared with the appearances of the abnormality at the site of subsequent cancer development by a different breast radiologist. The chi-squared test was used in the analysis of the results, seeking associations between recall concordance and cancer mammographic or histological characteristics. 111/590 interval cancers fulfilled the study inclusion criteria. In 17% of the cases none of the readers identified the relevant abnormality on the screening mammogram. 1/3 readers identified the relevant lesion in 22% of the cases, 2/3 readers in 28% of cases and all 3 readers in 33% of cases. The commonest unanimously recalled abnormality was microcalcification and the most challenging mammographic abnormality to detect was asymmetric density. We did not find any statistically significant association between recall concordance and time to interval cancer, position of lesion in the breast, breast density or cancer grade. Even the simple step of performing an independent blinded review of interval cancers reduces the rate of interval cancers classified as missed by up to 39%. Copyright © 2017 Elsevier B.V. All rights reserved.

Validity Evidence and Scoring Guidelines for Standardized Patient Encounters and Patient Notes From a Multisite Study of Clinical Performance Examinations in Seven Medical Schools.

PubMed

Park, Yoon Soo; Hyderi, Abbas; Heine, Nancy; May, Win; Nevins, Andrew; Lee, Ming; Bordage, Georges; Yudkowsky, Rachel

2017-11-01

To examine validity evidence of local graduation competency examination scores from seven medical schools using shared cases and to provide rater training protocols and guidelines for scoring patient notes (PNs). Between May and August 2016, clinical cases were developed, shared, and administered across seven medical schools (990 students participated). Raters were calibrated using training protocols, and guidelines were developed collaboratively across sites to standardize scoring. Data included scores from standardized patient encounters for history taking, physical examination, and PNs. Descriptive statistics were used to examine scores from the different assessment components. Generalizability studies (G-studies) using variance components were conducted to estimate reliability for composite scores. Validity evidence was collected for response process (rater perception), internal structure (variance components, reliability), relations to other variables (interassessment correlations), and consequences (composite score). Student performance varied by case and task. In the PNs, justification of differential diagnosis was the most discriminating task. G-studies showed that schools accounted for less than 1% of total variance; however, for the PNs, there were differences in scores for varying cases and tasks across schools, indicating a school effect. Composite score reliability was maximized when the PN was weighted between 30% and 40%. Raters preferred using case-specific scoring guidelines with clear point-scoring systems. This multisite study presents validity evidence for PN scores based on scoring rubric and case-specific scoring guidelines that offer rigor and feedback for learners. Variability in PN scores across participating sites may signal different approaches to teaching clinical reasoning among medical schools.

Assessment of the living and workplace health and safety conditions of site-resident construction workers in Tehran, Iran.

PubMed

Mohseni, Peyman Hossein; Farshad, Ali Asghar; Mirkazemi, Roksana; Orak, Rouhangiz Jamshidi

2015-01-01

The purpose of this study was to assess living and workplace safety conditions of construction workers in Tehran, Iran. This cross-sectional study was conducted among 410 construction sites in a municipal area of Tehran whose municipal building permits were issued in 2011. Data on ventilation, workplace safety and hygiene were collected by direct observation and interviews with site foremen. Noise levels were estimated from 10 sound-level-meter stations in the municipality area. Lack of ventilation in the workers' rooms was abundant. Bathrooms were unhygienic and minimum requirements such as lighting and ventilation did not exist in 80% of the cases. In nearly 50% of large construction sites, sewage and garbage disposal were inappropriate. Elevator safety was poor at all sites and no measures for fall prevention were present in over 88% of active construction sites. This study showed that the mean 24-h equivalent continuous sound level Leq was over 70 dB in 80% of the sites during weekdays. The results of this study revealed poor health and safety living and working conditions of construction workers in Tehran.

Case study to examine the effects of a growing-season burn and annosum root disease on mortality in a longleaf pine stand

Treesearch

Michelle M. Cram; Dan Shea; Ken Forbus

2010-01-01

A case study of a growing-season burn in a longleaf pine (Pinus palustris) stand affected by annosum root disease was conducted at Savannah River Site, SC. The project utilized a longleaf pine stand from a 1995 evaluation of a stump applicator system. The Tim-bor® (disodium octaborate tetrahydrate) and no stump treatment blocks (NST) were...

Literacy and Numeracy on the Motorway: A Case Study of the Effects of the Inclusion of Literacy and Numeracy Competencies within the Civil Construction Industry Training Package.

ERIC Educational Resources Information Center

Kelly, Ann; Searle, Jean

The effects of the inclusion of literacy and numeracy competencies within Australia's civil construction industry training package were examined in a case study in Queensland. Data were collected through the following activities: interviews with trainers, workplace teachers, and workers; observations of training at an on-site training session on…

Superficial basal cell carcinoma: A comparison of superficial only subtype with superficial combined with other subtypes by age, sex and anatomic site in 3150 cases.

PubMed

Pyne, John H; Myint, Esther; Barr, Elizabeth M; Clark, Simon P; David, Michael; Na, Renua; Hou, Ruihang

2017-08-01

Basal cell carcinoma (BCC) may present as superficial subtype alone (sBCC) or superficial combined with other subtypes. The objective of this study was to compare sBCC without or with other BCC subtypes by age, sex and anatomic site. We retrospectively collected superficial BCC with the above characteristics from an Australian center during 2009 to 2014. We recorded 1528 sBCC and 1622 superficial BCC combined with other BCC subtype cases. Males numbered 2007 and females 1140. On males, head sites (forehead, cheek, nose and ear combined) compared to limb plus trunk sites displayed a higher incidence of superficial BCC combined with either nodular and or aggressive BCC subtypes (OR 13.15 CI 95% 8.9-19.5 P < .0001). On females a similar comparison also found a higher incidence of superficial BCC combined with solid subtype BCC on head sites compared to trunk and limb sites (OR 9.66 CI 95% 5.8-16.1 P < .0001). Superficial BCC alone is more likely on younger females on trunk and limb sites. Small partial biopsies reported as sBCC may miss other BCC subtypes present with higher risk on facial sites for males and females. Males had smaller proportions of superficial only subtype BCC on facial and ear sites compared to females. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Application of Electrical Resistivity Imaging for Engineering Site Investigation. A Case Study on Prospective Hospital Site, Varamin, Iran

NASA Astrophysics Data System (ADS)

Amini, Amin; Ramazi, Hamidreza

2016-12-01

The article addresses the application of electrical resistivity imaging for engineering site investigation in Pishva Hospital, Varamin, Iran. Some aqueduct shafts exist in the study area backfilled by loose materials. The goals of this study are to detect probable aqueduct tunnels and their depth, investigate filling quality in the shafts as well as connection(s) between them. Therefore, three profiles were surveyed by dipoledipole electrode array. Also, to investigate the potentially anomalous areas more accurately, five additional resistivity profiles were measured by a Combined Resistivity Sounding-Profiling array (CRSP). According to the results of 2-D inversion modelling, a main aqueduct tunnel was detected beneath the central part of the site. Finally, the resistivity pattern of the detected aqueduct system passing the investigated area was provided using the obtained results.

Frequency and prevention of laparoscopic port site infection.

PubMed

Taj, Muhammad Naeem; Iqbal, Yasmeen; Akbar, Zakia

2012-01-01

The present study was conducted to evaluate the usefulness and safety of the nonpowder surgical glove for extraction of the gallbladder in laparoscopic cholecystectomy. The study was carried out in Capital Hospital Islamabad and in a private hospital. The duration of study was from March 2009 to March 2012. This was an observational study carried out in 492 patients who underwent laparoscopic cholecystectomy using the surgical glove for extraction of the gallbladder and compared with the conventional method of gall bladder removal in two hospitals were analyzed. The operative findings, port site infection and co morbid conditions were evaluated. Postoperative wound infection was found in 27 (5.48%) of 492 cases. Umbilical port infection was found in 26 (5.28%) of cases in which gall bladder was removed without endogloves and only one case (0.2%) had infection when gall bladder was removed with the endogloves. Wound infection was more in acute cholecystitis (25.9%) and empyema of Gall Bladder (44.4%). Among the co morbid conditions, diabetes mellitus has got higher frequency of wound infection (44%). The use of the surgical glove for extraction of the gallbladder is safe, cheap, simple and potentially reduces significant morbidity. Its routine use at laparoscopic cholecystectomy is mandatory in all cases.

Do nursing homes for older people have the support they need to provide end-of-life care? A mixed methods enquiry in England

PubMed Central

Seymour, Jane E; Kumar, Arun; Froggatt, Katherine

2011-01-01

Nursing homes are a common site of death, but older residents receive variable quality of end-of-life care. We used a mixed methods design to identify external influences on the quality of end-of-life care in nursing homes. Two qualitative case studies were conducted and a postal survey of 180 nursing homes surrounding the case study sites. In the case studies, qualitative interviews were held with seven members of nursing home staff and 10 external staff. Problems in accessing support for end-of-life care reported in the survey included variable support by general practitioners (GPs), reluctance among GPs to prescribe appropriate medication, lack of support from other agencies, lack of out of hours support, cost of syringe drivers and lack of access to training. Most care homes were implementing a care pathway. Those that were not rated their end-of-life care as in need of improvement or as average. The case studies suggest that critical factors in improving end-of-life care in nursing homes include developing clinical leadership, developing relationships with GPs, the support of ‘key’ external advocates and leverage of additional resources by adoption of care pathway tools. PMID:21282349

A land classification protocol for pollinator ecology research: An urbanization case study.

PubMed

Samuelson, Ash E; Leadbeater, Ellouise

2018-06-01

Land-use change is one of the most important drivers of widespread declines in pollinator populations. Comprehensive quantitative methods for land classification are critical to understanding these effects, but co-option of existing human-focussed land classifications is often inappropriate for pollinator research. Here, we present a flexible GIS-based land classification protocol for pollinator research using a bottom-up approach driven by reference to pollinator ecology, with urbanization as a case study. Our multistep method involves manually generating land cover maps at multiple biologically relevant radii surrounding study sites using GIS, with a focus on identifying land cover types that have a specific relevance to pollinators. This is followed by a three-step refinement process using statistical tools: (i) definition of land-use categories, (ii) principal components analysis on the categories, and (iii) cluster analysis to generate a categorical land-use variable for use in subsequent analysis. Model selection is then used to determine the appropriate spatial scale for analysis. We demonstrate an application of our protocol using a case study of 38 sites across a gradient of urbanization in South-East England. In our case study, the land classification generated a categorical land-use variable at each of four radii based on the clustering of sites with different degrees of urbanization, open land, and flower-rich habitat. Studies of land-use effects on pollinators have historically employed a wide array of land classification techniques from descriptive and qualitative to complex and quantitative. We suggest that land-use studies in pollinator ecology should broadly adopt GIS-based multistep land classification techniques to enable robust analysis and aid comparative research. Our protocol offers a customizable approach that combines specific relevance to pollinator research with the potential for application to a wide range of ecological questions, including agroecological studies of pest control.

Identification and Characterization of Sites Where Persistent Atrial Fibrillation Is Terminated by Localized Ablation.

PubMed

Zaman, Junaid A B; Sauer, William H; Alhusseini, Mahmood I; Baykaner, Tina; Borne, Ryan T; Kowalewski, Christopher A B; Busch, Sonia; Zei, Paul C; Park, Shirley; Viswanathan, Mohan N; Wang, Paul J; Brachmann, Johannes; Krummen, David E; Miller, John M; Rappel, Wouter Jan; Narayan, Sanjiv M; Peters, Nicholas S

2018-01-01

The mechanisms by which persistent atrial fibrillation (AF) terminates via localized ablation are not well understood. To address the hypothesis that sites where localized ablation terminates persistent AF have characteristics identifiable with activation mapping during AF, we systematically examined activation patterns acquired only in cases of unequivocal termination by ablation. We recruited 57 patients with persistent AF undergoing ablation, in whom localized ablation terminated AF to sinus rhythm or organized tachycardia. For each site, we performed an offline analysis of unprocessed unipolar electrograms collected during AF from multipolar basket catheters using the maximum -dV/dt assignment to construct isochronal activation maps for multiple cycles. Additional computational modeling and phase analysis were used to study mechanisms of map variability. At all sites of AF termination, localized repetitive activation patterns were observed. Partial rotational circuits were observed in 26 of 57 (46%) cases, focal patterns in 19 of 57 (33%), and complete rotational activity in 12 of 57 (21%) cases. In computer simulations, incomplete segments of partial rotations coincided with areas of slow conduction characterized by complex, multicomponent electrograms, and variations in assigning activation times at such sites substantially altered mapped mechanisms. Local activation mapping at sites of termination of persistent AF showed repetitive patterns of rotational or focal activity. In computer simulations, complete rotational activation sequence was observed but was sensitive to assignment of activation timing particularly in segments of slow conduction. The observed phenomena of repetitive localized activation and the mechanism by which local ablation terminates putative AF drivers require further investigation. © 2018 American Heart Association, Inc.

SOLIDIFICATION/STABILIZATION CASE STUDIES AT USEPA SUPERFUND SITES

EPA Science Inventory

Oral presentation dicumenting several completed Superfund remediations using solidification/stabilization, both in situ and ex-situ, to treat soils containing metals and organics.
65 slide presentation.

SU-E-T-148: Benchmarks and Pre-Treatment Reviews: A Study of Quality Assurance Effectiveness

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

Lowenstein, J; Nguyen, H; Roll, J

Purpose: To determine the impact benchmarks and pre-treatment reviews have on improving the quality of submitted clinical trial data. Methods: Benchmarks are used to evaluate a site’s ability to develop a treatment that meets a specific protocol’s treatment guidelines prior to placing their first patient on the protocol. A pre-treatment review is an actual patient placed on the protocol in which the dosimetry and contour volumes are evaluated to be per protocol guidelines prior to allowing the beginning of the treatment. A key component of these QA mechanisms is that sites are provided timely feedback to educate them on howmore » to plan per the protocol and prevent protocol deviations on patients accrued to a protocol. For both benchmarks and pre-treatment reviews a dose volume analysis (DVA) was performed using MIM softwareTM. For pre-treatment reviews a volume contour evaluation was also performed. Results: IROC Houston performed a QA effectiveness analysis of a protocol which required both benchmarks and pre-treatment reviews. In 70 percent of the patient cases submitted, the benchmark played an effective role in assuring that the pre-treatment review of the cases met protocol requirements. The 35 percent of sites failing the benchmark subsequently modified there planning technique to pass the benchmark before being allowed to submit a patient for pre-treatment review. However, in 30 percent of the submitted cases the pre-treatment review failed where the majority (71 percent) failed the DVA. 20 percent of sites submitting patients failed to correct their dose volume discrepancies indicated by the benchmark case. Conclusion: Benchmark cases and pre-treatment reviews can be an effective QA tool to educate sites on protocol guidelines and to minimize deviations. Without the benchmark cases it is possible that 65 percent of the cases undergoing a pre-treatment review would have failed to meet the protocols requirements.Support: U24-CA-180803.« less

An ergonomic study on the navigation structure and information units of websites with multimedia content. A case study of the Xbox 360 promotional website.

PubMed

Ariel, Eduardo; de Moraes, Anamaria

2012-01-01

This paper presents an ergonomic study on the navigation structures and information units of entertainment sites with multimedia content. This research is a case study on the XBOX 360 promotional website. It analyzes the presentation of the content on a grid that simulates the spatial displacement of the screen's elements and evaluates the interaction that the page allows for, from the users' point of view.

Effectiveness of Telementoring in Surgery Compared With On-site Mentoring: A Systematic Review.

PubMed

Bilgic, Elif; Turkdogan, Sena; Watanabe, Yusuke; Madani, Amin; Landry, Tara; Lavigne, Daniel; Feldman, Liane S; Vassiliou, Melina C

2017-08-01

Mentorship is important but may not be feasible for distance learning. To bridge this gap, telementoring has emerged. The purpose of this systematic review was to evaluate the effectiveness of telementoring compared with on-site mentoring. A search was done up to March 2015. Studies were included if they used telementoring between surgeons during a clinical encounter and if they compared on-site mentoring and telementoring. A total of 11 studies were included. All reported no difference in complication rates, and 9 (82%) reported similar operative times; 4 (36%) reported technical issues, which was 3% of the total number of cases in the 11 studies. No study reported on higher levels of evidence for effectiveness of telementoring as an educational intervention. Studies reported that telementoring is associated with similar complication rates and operative times compared with on-site mentoring. However, the level of evidence to support the effectiveness of telementoring as a training tool is limited. There is a need for studies that provide evidence for the equivalence of the effectiveness of telementoring as an educational intervention in comparison with on-site mentoring.

The Ecology of Sustainable Implementation: Reflection on a 10-Year Case History Illustration.

PubMed

Rimehaug, Tormod

2014-01-01

The primary aim of this paper is to illustrate the strategic and ecological nature of implementation. The ultimate aim of implementation is not dissemination but sustainability beyond the implementation effort. A case study is utilized to illustrate these broad and long-term perspectives of sustainable implementation based on qualitative analyses of a 10-year implementation effort. The purveyors aimed to develop selective community prevention services for children in families burdened by parental psychiatric or addictive problems. Services were gradually disseminated to 23 sites serving 40 municipalities by 2013. Up to 2013, only one site terminated services after initial implementation. Although many sites suspended services for shorter periods, services are still offered at 22 sites. This case analysis is based on project reports, user evaluations, practitioner interviews, and service statistics. The paper focuses on the analyses and strategies utilized to cope with quality decay and setbacks as well as progress and success in disseminating and sustaining the services and their quality. Low-cost multilevel strategies to implement services at the community level were organized by a prevention unit in child psychiatry, supervised by a university department (purveyors). The purveyors were also involved in national and international collaboration and development. Multilevel strategies included manualized intervention, in-practice training methods, organizational responsibility, media strategies, service evaluation, staff motivation maintenance, quality assurance, and proposals for new law regulations. These case history aspects will be discussed in relation to the implementation literature, focusing on possible applicability across settings.

Mapping of Arithmetic Processing by Navigated Repetitive Transcranial Magnetic Stimulation in Patients with Parietal Brain Tumors and Correlation with Postoperative Outcome.

PubMed

Ille, Sebastian; Drummer, Katharina; Giglhuber, Katrin; Conway, Neal; Maurer, Stefanie; Meyer, Bernhard; Krieg, Sandro M

2018-06-01

Preserving functionality is important during neurosurgical resection of brain tumors. Specialized centers also map further brain functions apart from motor and language functions, such as arithmetic processing (AP). The mapping of AP by navigated repetitive transcranial magnetic stimulation (nrTMS) in healthy volunteers has been reported. The present study aimed to correlate the results of mapping AP with functional patient outcomes. We included 26 patients with parietal brain tumors. Because of preoperative impairment of AP, mapping was not possible in 8 patients (31%). We stimulated 52 cortical sites by nrTMS while patients performed a calculation task. Preoperatively and postoperatively, patients underwent a standardized number-processing and calculation test (NPCT). Tumor resection was blinded to nrTMS results, and the change in NPCT performance was correlated to resected AP-positive spots as identified by nrTMS. The resection of AP-positive sites correlated with a worsening of the postoperative NPCT result in 12 cases. In 3 cases, no AP-positive sites were resected and the postoperative NPCT result was similar to or better than preoperatively. Also, in 3 cases, the postoperative NPCT result was better than preoperatively, although AP-positive sites were resected. Despite presenting only a few cases, nrTMS might be a useful tool for preoperative mapping of AP. However, the reliability of the present results has to be evaluated in a larger series and by intraoperative mapping data. Copyright © 2018 Elsevier Inc. All rights reserved.

Localized cortical chronic traumatic encephalopathy pathology after single, severe axonal injury in human brain.

PubMed

Shively, Sharon B; Edgerton, Sarah L; Iacono, Diego; Purohit, Dushyant P; Qu, Bao-Xi; Haroutunian, Vahram; Davis, Kenneth L; Diaz-Arrastia, Ramon; Perl, Daniel P

2017-03-01

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with repetitive mild impact traumatic brain injury from contact sports. Recently, a consensus panel defined the pathognomonic lesion for CTE as accumulations of abnormally hyperphosphorylated tau (p-tau) in neurons (neurofibrillary tangles), astrocytes and cell processes distributed around small blood vessels at sulcal depths in irregular patterns within the cortex. The pathophysiological mechanism for this lesion is unknown. Moreover, a subset of CTE cases harbors cortical β-amyloid plaques. In this study, we analyzed postmortem brain tissues from five institutionalized patients with schizophrenia and history of surgical leucotomy with subsequent survival of at least another 40 years. Because leucotomy involves severing axons bilaterally in prefrontal cortex, this surgical procedure represents a human model of single traumatic brain injury with severe axonal damage and no external impact. We examined cortical tissues at the leucotomy site and at both prefrontal cortex rostral and frontal cortex caudal to the leucotomy site. For comparison, we analyzed brain tissues at equivalent neuroanatomical sites from non-leucotomized patients with schizophrenia, matched in age and gender. All five leucotomy cases revealed severe white matter damage with dense astrogliosis at the axotomy site and also neurofibrillary tangles and p-tau immunoreactive neurites in the overlying gray matter. Four cases displayed p-tau immunoreactivity in neurons, astrocytes and cell processes encompassing blood vessels at cortical sulcal depths in irregular patterns, similar to CTE. The three cases with apolipoprotein E ε4 haplotype showed scattered β-amyloid plaques in the overlying gray matter, but not the two cases with apolipoprotein E ε3/3 genotype. Brain tissue samples from prefrontal cortex rostral and frontal cortex caudal to the leucotomy site, and all cortical samples from the non-leucotomized patients, showed minimal p-tau and β-amyloid pathology. These findings suggest that chronic axonal damage contributes to the unique pathology of CTE over time.

Reduction in dengue cases observed during mass control of Aedes (Stegomyia) in street catch basins in an endemic urban area in Colombia

PubMed Central

Ocampo, Clara B.; Mina, Neila Julieth; Carabalí, Mabel; Alexander, Neal; Osorio, Lyda

2015-01-01

Dengue incidence continues to increase globally and, in the absence of an efficacious vaccine, prevention strategies are limited to vector control. It has been suggested that targeting the most productive breeding sites instead of all water-holding containers could be a cost-effective vector control strategy. We sought to identify and continuously control the most productive Aedes (Stegomyia) breeding site in an endemic urban area in Colombia and followed the subsequent incidence of dengue. In the urban area of Guadalajara de Buga, southwestern Colombia, potential breeding sites inside and outside houses were first characterized, and local personnel trained to assess their productivity based on the pupae/person index. Simultaneously, training and monitoring were implemented to improve the dengue case surveillance system. Entomological data and insecticide resistance studies were used to define the targeted intervention. Then, a quasi-experimental design was used to assess the efficacy of the intervention in terms of the positivity index of the targeted and non- targeted breeding sites, and the impact on dengue cases. Street catch basins (storm drains) were the potential breeding site most frequently found containing Aedes immature stages in the baseline (58.3% of 108). Due to the high resistance to temephos (0% mortality after 24 h), the intervention consisted of monthly application of pyriproxyfen in all the street catch basins (n = 4800). A significant decrease in catch basins positivity for Aedes larvae was observed after each monthly treatment (p < 0.001). Over the intervention period, a reduction in the dengue incidence in Buga was observed (rate ratio 0.19, 95% CI 0.12–0.30, p < 0.0001) after adjusting for autocorrelation and controlling with a neighboring town, Palmira, This study highlights the importance of street catch basins as Aedes breeding sites and suggests that their targeted control could help to decrease dengue transmission in such areas. PMID:24388794

Epidemiologic investigation of a cancer cluster in professional football players

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

Kraut, A.; Chan, E.; Landrigan, P.J.

In 1976, the New York Giants profession football team relocated to the newly constructed Meadowlands Sports Complex (MSC) in East Rutherford, NJ. Between 1980 and 1987 four team members developed cancer: one case each of non-hodgkin's lymphoma, glioblastoma, angiosarcoma, and Hodgkin's disease. Because the surrounding area contains three superfund sites, concern was widespread that the cancers were related to environmental contamination. To assess for a possible environmental etiology, the authors conducted clinical, environmental, and epidemiologic studies at the MSC. Measurements of volatile organic compounds were all below occupational exposure limits and were similar to ambient levels in nearby Lyndhurst, NJ.more » Outdoor AM radio broadcast field strengths were in the uppermost 0.1% of field strengths measured in urban areas of the US. Proportionate mortality ratio and proportional cancer incidence ratio studies of the MSC workforce found no excesses of cancer deaths or of incident cancer cases either for all sites combined or for any specific site. No significant differences in cancer incidence or mortality were found between indoor and nonindoor workers. Based on examination of all available data, the four cancer cases were judged most likely to have been clustered by chance and not to have been caused by environmental conditions at the MSC.« less

Using Dust Assessment Technology to Leverage Mine Site Manager-Worker Communication and Health Behavior: A Longitudinal Case Study

PubMed Central

Haas, Emily J.; Cecala, Andrew B.; Hoebbel, Cassandra L.

2016-01-01

Research continues to investigate barriers to managing occupational health and safety behaviors among the workforce. Recent literature argues that (1) there is a lack of consistent, multilevel communication and application of health and safety practices, and (2) social scientific methods are absent when determining how to manage injury prevention in the workplace. In response, the current study developed and tested a multilevel intervention case study at two industrial mineral mines to help managers and workers communicate about and reduce respirable silica dust exposures at their mine sites. A dust assessment technology, the Helmet-CAM, was used to identify and encourage communication about potential problem areas and tasks on site that contributed to elevated exposures. The intervention involved pre- and post-assessment field visits, four weeks apart that included multiple forms of data collection from workers and managers. Results revealed that mine management can utilize dust assessment technology as a risk communication tool to prompt and communicate about healthier behaviors with their workforce. Additionally, when workers were debriefed with the Helmet-CAM data through the device software, the dust exposure data can help improve the knowledge and awareness of workers, empowering them to change subtle behaviors that could reduce future elevated exposures to respirable silica dust. This case study demonstrates that incorporating social scientific methods into the application of health and safety management strategies, such as behavioral modification and technology integration, can leverage managers’ communication practices with workers, subsequently improving health and safety behaviors. PMID:26807445

Biofuel on contaminated land

NASA Astrophysics Data System (ADS)

Suer, Pascal; Andersson-Sköld, Yvonne; Blom, Sonja; Bardos, Paul; Polland, Marcel; Track, Thomas

2010-05-01

Desktop studies of two Swedish contaminated sites has indicated that growing biofuel crops on these sites may be more environmentally beneficial than alternative risk management approaches such as excavation / removal or containment The demand for biofuel increases pressure on the cultivatable soil of the world. While contaminated land is not very suitable for food production, cultivation of low and medium contaminated soil may remove some pressure from agricultural soils. For larger sites, biofuel cultivation may be economically viable without a remediation bonus. Suitable sites have topographic conditions that allow agricultural machinery, are not in urgent need of remediation, and contamination levels are not plant toxic. Life cycle assessment (LCA) was done for two cases. The (desk top) case studies were - Case K, a 5000 m2 site where salix (willow) was cultivated with hand-held machinery and the biofuel harvest was left on site, and - Case F, a 12 ha site were on site ensuring was being considered, and were salix might have rented an economic profit if the remediation had not been urgent due to exploitation pressure. Some selected results for biofuel K; biofuel F; excavation K; and on site ensuring F respectively: Energy: 0,05; 1,4; 3,5; 19 TJ Waste: 1; 9; 1200; 340 ton Land use off-site: 190; 3 500; 200 000; 1 400 000 m² a Global warming: 3; 86; 230; 1 200 ton CO2 eq Acidification: 25; 1 000; 2 600; 14 000 kg SO2 eq Photochemical smog: 10; 180; 410; 2 300 kg ethene eq Human health: 2; 51; 150; 620 index The environmental impact of the traditional remediation methods of excavation and on-site ensuring was mainly due to the transport of contaminated soil and replacement soil, and landfilling of the contaminated soil. Biofuel cultivation avoids these impacts, while fertiliser production and agricultural machinery would have a lower environmental impact than moving large volumes of soil around. Journeys of a controller to check on the groundwater quality also contributed to the biofuel impacts. The net CO2 equivalent emission on a 100 year basis per MJ energy in the Salix Vinimalis was between -0.02 and -0.1 kgCO2e/MJ. The fate of the stubble and roots of the salix was crucial for the carbon footprint. While stubble and roots remain in the soil (as increased soil organic matter), the carbon dioxide they took up while growing is not contributing to global warming. This pool was much larger than the CO2 emissions from soil transport and other processes. Biodiversity was difficult to include, and the results are uncertain. But the results indicated that biodiversity impact of biofuel cultivation may be large compared to "easier" categories like global warming and human health, and the net impact of biofuel cultivation may well be benifical to the environment instead of damaging.

Oral cancer: A multicenter study

PubMed Central

Rojanawatsirivej, Somsri; Thosaporn, Watcharaporn; Kintarak, Sompid; Subarnbhesaj, Ajiravudh; Darling, Mark; Kryshtalskyj, Eugene; Chiang, Chun-Pin; Shin, Hong-In; Choi, So-Young; Lee, Sang-shin; Shakib, Pouyan-Amini

2018-01-01

Background To determine the prevalence and clinicopathologic features of the oral cancer patients. Material and Methods Biopsy records of the participating institutions were reviewed for oral cancer cases diagnosed from 2005 to 2014. Demographic data and site of the lesions were collected. Sites of the lesion were subdivided into lip, tongue, floor of the mouth, gingiva, alveolar mucosa, palate, buccal/labial mucosa, maxilla and mandible. Oral cancer was subdivided into 7 categories: epithelial tumors, salivary gland tumors, hematologic tumors, bone tumors, mesenchymal tumors, odontogenic tumors, and others. Data were analyzed by descriptive statistics using SPSS software version 17.0. Results Of the 474,851 accessioned cases, 6,151 cases (1.30%) were diagnosed in the category of oral cancer. The mean age of the patients was 58.37±15.77 years. A total of 4,238 cases (68.90%) were diagnosed in males, whereas 1911 cases (31.07%) were diagnosed in females. The male-to-female ratio was 2.22:1. The sites of predilection for oral cancer were tongue, labial/buccal mucosa, gingiva, palate, and alveolar mucosa, respectively. The three most common oral cancer in the descending order of frequency were squamous cell carcinoma, non-Hodgkin lymphoma and mucoepidermoid carcinoma. Conclusions Although the prevalence of oral cancer is not high compared to other entities, oral cancer pose significant mortality and morbidity in the patients, especially when discovered late in the course of the disease. This study highlights some anatomical locations where oral cancers are frequently encountered. As a result, clinicians should pay attention to not only teeth, but oral mucosa especially in the high prevalence area as well since early detection of precancerous lesions or cancers in the early stage increase the chance of patient being cured and greatly reduce the mortality and morbidity. This study also shows some differences between pediatric and elderly oral cancer patients as well as between Asian and non-Asian oral cancer patients. Key words:Oral cancer, prevalence, clinic-pathologic features, retrospective study. PMID:29274153

Are integrated HIV services less stigmatizing than stand-alone models of care? A comparative case study from Swaziland

PubMed Central

Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Simelane, Dudu; Mayhew, Susannah H

2013-01-01

Introduction Integrating HIV with primary health services has the potential to reduce HIV-related stigma through delivering care in settings disassociated with HIV. This study investigated the relationship between integrated care and felt stigma. The study design was a comparative case study of four models of HIV care in Swaziland, ranging from fully integrated to fully stand-alone HIV care. Methods An exit survey (N=602) measured differences in felt stigma across model of care; the primary outcome “perception of HIV status exposure through clinic attendance” was analyzed using multivariable logistic regression. In-depth interviews (N=22) explored whether and how measured differences in stigma experiences were related to service integration. Results There were significant differences in perceived status exposure across models of care. After adjustment for potential confounding between sites, those at a partially integrated site and a partially stand-alone site had greater odds of perceived status exposure than those at the fully stand-alone site (aOR 3.33, 95% CI 1.98–5.60; and aOR 11.84, 95% CI 6.89–20.36, respectively). There was no difference between the fully stand-alone and the fully integrated clinic. Qualitative data suggested that many clients at HIV-only sites felt greater confidentiality knowing that those around them were positive, and support was gained from other HIV care clients. Confidentiality was maintained in various ways, even in stand-alone sites, through separate waiting areas for HIV testing and HIV treatment, and careful clinic and room labelling. Conclusions The relationship between model of care and stigma was complex, and the hypothesis that stigma is higher at stand-alone sites did not hold true in this high prevalence setting. Policy-makers should ensure that service integration does not increase stigma, in particular within partially integrated models of care. PMID:23336726

Modelling study of soil C, N and pH response to air pollution and climate change using European LTER site observations.

PubMed

Holmberg, Maria; Aherne, Julian; Austnes, Kari; Beloica, Jelena; De Marco, Alessandra; Dirnböck, Thomas; Fornasier, Maria Francesca; Goergen, Klaus; Futter, Martyn; Lindroos, Antti-Jussi; Krám, Pavel; Neirynck, Johan; Nieminen, Tiina Maileena; Pecka, Tomasz; Posch, Maximilian; Pröll, Gisela; Rowe, Ed C; Scheuschner, Thomas; Schlutow, Angela; Valinia, Salar; Forsius, Martin

2018-05-31

Current climate warming is expected to continue in coming decades, whereas high N deposition may stabilize, in contrast to the clear decrease in S deposition. These pressures have distinctive regional patterns and their resulting impact on soil conditions is modified by local site characteristics. We have applied the VSD+ soil dynamic model to study impacts of deposition and climate change on soil properties, using MetHyd and GrowUp as pre-processors to provide input to VSD+. The single-layer soil model VSD+ accounts for processes of organic C and N turnover, as well as charge and mass balances of elements, cation exchange and base cation weathering. We calibrated VSD+ at 26 ecosystem study sites throughout Europe using observed conditions, and simulated key soil properties: soil solution pH (pH), soil base saturation (BS) and soil organic carbon and nitrogen ratio (C:N) under projected deposition of N and S, and climate warming until 2100. The sites are forested, located in the Mediterranean, forested alpine, Atlantic, continental and boreal regions. They represent the long-term ecological research (LTER) Europe network, including sites of the ICP Forests and ICP Integrated Monitoring (IM) programmes under the UNECE Convention on Long-range Transboundary Air Pollution (LRTAP), providing high quality long-term data on ecosystem response. Simulated future soil conditions improved under projected decrease in deposition and current climate conditions: higher pH, BS and C:N at 21, 16 and 12 of the sites, respectively. When climate change was included in the scenario analysis, the variability of the results increased. Climate warming resulted in higher simulated pH in most cases, and higher BS and C:N in roughly half of the cases. Especially the increase in C:N was more marked with climate warming. The study illustrates the value of LTER sites for applying models to predict soil responses to multiple environmental changes. Copyright © 2017 Elsevier B.V. All rights reserved.

Disinfectant Residual – Representative Monitoring & Maintaining Residuals

EPA Science Inventory

In this presentation we will: review history of distribution system chlorine monitoring siting, review State regulations and guidance, and present a case study demonstrating a chlorine monitoring locations evaluation

Disinfectant Residual – Representative Monitoring & Maintaining Residuals

EPA Science Inventory

In this presentation we will: review history of distribution system chlorine monitoring siting, review State regulations and guidance, and present a case study demonstrating a chlorine monitoring locations evaluation.

Is It Safe to Re-Harvest the Anterior Iliac Crest to Manage Le Fort I Interpositional Defects in Young Adults With a Repaired Cleft?

PubMed

Posnick, Jeffrey C; Gray, James A

2015-12-01

Re-harvesting the anterior iliac crest to obtain autogenous bone grafts is a controversial practice. The purpose of this study was to assess the feasibility and associated disability of re-harvesting the anterior iliac crest. To address the research purpose, the authors executed a retrospective case series study. The sample consisted of young adult patients with cleft (<26 yr old) with prior harvesting of the anterior iliac crest during mixed dentition for management of an alveolar cleft(s) and then re-harvesting of the same donor site for management of interpositional defects after Le Fort I advancement. Wound-healing parameters were reviewed at the donor and recipient sites. A survey questionnaire was provided after completion of treatment to document patient perception of early and any long-term donor-site disability. Descriptive statistics were computed for the variables. The sample was composed of 27 patients with a mean age at re-harvesting of 17 years (range, 14 to 25 yr). Patients underwent on average 7.4-mm horizontal advancement, 2.4-mm lengthening, and 2.6-mm transverse expansion of the maxilla. Adequate bone graft was re-harvested to accomplish objectives in all cases. There were no perioperative complications at the donor or recipient sites. Twenty-six of the 27 patients (97%) had fewer donor-site recovery difficulties at the time of re-harvesting compared with the first time graft was taken. There were no cases of lateral femoral cutaneous nerve injury and no long-term discomfort with walking, running, or other activities. The study confirms the safety and efficacy of re-harvesting corticocancellous bone from the anterior iliac crest for management of interpositional defects associated with Le Fort I advancement in young adults with a repaired cleft. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Environmental and economic evaluation of pre-disaster plans for disaster waste management: Case study of Minami-Ise, Japan.

PubMed

Tabata, Tomohiro; Wakabayashi, Yohei; Tsai, Peii; Saeki, Takashi

2017-03-01

Although it is important that disaster waste be demolished and removed as soon as possible after a natural disaster, it is also important that its treatment is environmentally friendly and economic. Local municipalities do not conduct environmental and economic feasibility studies of pre-disaster waste management; nevertheless, pre-disaster waste management is extremely important to promote treatment of waste after natural disasters. One of the reasons that they cannot conduct such evaluations is that the methods and inventory data required for the environmental and economic evaluation does not exist. In this study, we created the inventory data needed for evaluation and constructed evaluation methods using life cycle assessment (LCA) and life cycle cost (LCC) methodologies for future natural disasters. We selected the Japanese town of Minami-Ise for the related case study. Firstly, we estimated that the potential disaster waste generation derived from dwellings would be approximately 554,000t. Based on this result, the land area required for all the temporary storage sites for storing the disaster waste was approximately 55ha. Although the public domain and private land area in this case study is sufficient, several sites would be necessary to transport waste to other sites with enough space because local space is scarce. Next, we created inventory data of each process such as waste transportation, operation of the temporary storage sites, and waste treatment. We evaluated the environmental burden and cost for scenarios in which the disaster waste derived from specified kinds of home appliances (refrigerators, washing machines, air-conditioners and TV sets) was transported, stored and recycled. In the scenario, CO 2 , SO x , NO X and PM emissions and total cost were 142t, 7kg, 257kg, 38kg and 1772 thousand USD, respectively. We also focused on SO x emission as a regional pollution source because transportation and operation of the temporary storage sites generates air pollution. If the treatment of all waste were finished in 3years, the environmental standard would be satisfied by setting work duration to 4.8h/d. Copyright © 2016 Elsevier Ltd. All rights reserved.

A density functional study of atomic hydrogen and oxygen chemisorption on the relaxed (0001) surface of double hexagonal close packed americium

NASA Astrophysics Data System (ADS)

Dholabhai, P. P.; Atta-Fynn, R.; Ray, A. K.

2008-02-01

Ab initio total energy calculations within the framework of density functional theory have been performed for atomic hydrogen and oxygen chemisorption on the (0001) surface of double hexagonal packed americium using a full-potential all-electron linearized augmented plane wave plus local orbitals method. Chemisorption energies were optimized with respect to the distance of the adatom from the relaxed surface for three adsorption sites, namely top, bridge, and hollow hcp sites, the adlayer structure corresponding to coverage of a 0.25 monolayer in all cases. Chemisorption energies were computed at the scalar-relativistic level (no spin-orbit coupling NSOC) and at the fully relativistic level (with spin-orbit coupling SOC). The two-fold bridge adsorption site was found to be the most stable site for O at both the NSOC and SOC theoretical levels with chemisorption energies of 8.204 eV and 8.368 eV respectively, while the three-fold hollow hcp adsorption site was found to be the most stable site for H with chemisorption energies of 3.136 eV at the NSOC level and 3.217 eV at the SOC level. The respective distances of the H and O adatoms from the surface were found to be 1.196 Åand 1.164 Å. Overall our calculations indicate that chemisorption energies in cases with SOC are slightly more stable than the cases with NSOC in the 0.049 0.238 eV range. The work functions and net magnetic moments respectively increased and decreased in all cases compared with the corresponding quantities of bare dhcp Am (0001) surface. The partial charges inside the muffin-tins, difference charge density distributions, and the local density of states have been used to analyze the Am-adatom bond interactions in detail. The implications of chemisorption on Am 5f electron localization-delocalization are also discussed.

External validation of the Society of Thoracic Surgeons General Thoracic Surgery Database.

PubMed

Magee, Mitchell J; Wright, Cameron D; McDonald, Donna; Fernandez, Felix G; Kozower, Benjamin D

2013-11-01

The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) reports outstanding results for lung and esophageal cancer resection. However, a major weakness of the GTSD has been the lack of validation of this voluntary registry. The purpose of this study was to perform an external, independent audit to assess the accuracy of the data collection process and the quality of the database. An independent firm was contracted to audit 5% of sites randomly selected from the GTDB in 2011. Audits were performed remotely to maximize the number of audits performed and reduce cost. Auditors compared lobectomy cases submitted to the GTSD with the hospital operative logs to evaluate completeness of the data. In addition, 20 lobectomy records from each site were audited in detail. Agreement rates were calculated for 32 individual data elements, 7 data categories pertaining to patient status or care delivery, and an overall agreement rate for each site. Six process variables were also evaluated to assess best practice for data collection and submission. Ten sites were audited from the 222 participants. Comparison of the 559 submitted lobectomy cases with operative logs from each site identified 28 omissions, a 94.6% agreement rate (discrepancies/site range, 2 to 27). Importantly, cases not submitted had no mortality or major morbidity, indicating a lack of purposeful omission. The aggregate agreement rates for all categories were greater than 90%. The overall data accuracy was 94.9%. External audits of the GTSD validate the accuracy and completeness of the data. Careful examination of unreported cases demonstrated no purposeful omission or gaming. Although these preliminary results are quite good, it is imperative that the audit process is refined and continues to expand along with the GTSD to insure reliability of the database. The audit results are currently being incorporated into educational and quality improvement processes to add further value. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Understanding Teachers' Perspectives of Factors That Influence Parental Involvement Practices in Special Education in Barbados

ERIC Educational Resources Information Center

Blackman, Stacey; Mahon, Erin

2016-01-01

Parental involvement has been defined in various ways by researchers and is reported to have many advantages for children's education. The research utilises a case study strategy to investigate teachers' perspectives of parental involvement at four case sites in Barbados. In-depth interviews were done with teachers and analysis utilised content…

Feline-transmitted sporotrichosis: A case study from California.

PubMed

Rees, Rachel K; Swartzberg, John E

2011-06-15

We report a case of cat-associated sporotrichosis in an adult female in California. A retrospectively diagnosed cutaneous sporotrichosis infection in the patient's cat and the unusual site of the primary lesion in the patient contributed to delayed diagnosis and treatment. Here, we also review the English literature regarding the epidemiology of Sporothrix schenkii as a cat-associated zoonosis.

Guideline-conforming timing of invasive management in troponin-positive or high-risk ACS without persistent ST-segment elevation in German chest pain units. Urban university maximum care vs. rural regional primary care.

PubMed

Breuckmann, F; Remberg, F; Böse, D; Lichtenberg, M; Kümpers, P; Pavenstädt, H; Waltenberger, J; Fischer, D

2016-03-01

This study aimed to analyze guideline adherence in the timing of invasive management for myocardial infarction without persistent ST-segment elevation (NSTEMI) in two exemplary German centers, comparing an urban university maximum care facility and a rural regional primary care facility. All patients diagnosed as having NSTEMI during 2013 were retrospectively enrolled in two centers: (1) site I, a maximum care center in an urban university setting, and (b) site II, a primary care center in a rural regional care setting. Data acquisition included time intervals from admission to invasive management, risk criteria, rate of intervention, and medical therapy. The median time from admission to coronary angiography was 12.0 h (site I) or 17.5 h (site II; p = 0.17). Guideline-adherent timing was achieved in 88.1 % (site I) or 82.9 % (site II; p = 0.18) of cases. Intervention rates were high in both sites (site I-75.5 % vs. site II-75.3 %; p = 0.85). Adherence to recommendations of medical therapy was high and comparable between the two sites. In NSTEMI or high-risk acute coronary syndromes without persistent ST-segment elevation, guideline-adherent timing of invasive management was achieved in about 85 % of cases, and was comparable between urban maximum and rural primary care settings. Validation by the German Chest Pain Unit Registry including outcome analysis is required.

Superfund Site Information

EPA Pesticide Factsheets

This asset includes a number of individual data sets related to site-specific information for Superfund, which is governed under the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) of 1980, which was amended by the Superfund Amendments and Reauthorization Act (SARA) in 1986. The Superfund Enterprise Management System (SEMS) contains basic site description, location, schedule of activities, enforcement and settlement data, contaminants and selected remedy and much more, as well as the records that clearly document site decisions. This asset also includes sampling data and lab results (CLPSS, EDDs), redevelopment and technical assistance case studies, site reuse and land revitalization information, EPAOSC.net information, Superfund Technical Assistance Grants information, site management information records (RODs, Remediation plans, cleanup directives), contract management information, and more.Superfund site management information can also be found in agency wide systems such as EAS and COMPASS.

Remote Sensing of Water Quality in Multipurpose Reservoirs: Case Study Applications in Indonesia, Mexico, and Uruguay

NASA Astrophysics Data System (ADS)

Miralles-Wilhelm, F.; Serrat-Capdevila, A.; Rodriguez, D.

2017-12-01

This research is focused on development of remote sensing methods to assess surface water pollution issues, particularly in multipurpose reservoirs. Three case study applications are presented to comparatively analyze remote sensing techniquesforo detection of nutrient related pollution, i.e., Nitrogen, Phosphorus, Chlorophyll, as this is a major water quality issue that has been identified in terms of pollution of major water sources around the country. This assessment will contribute to a better understanding of options for nutrient remote sensing capabilities and needs and assist water agencies in identifying the appropriate remote sensing tools and devise an application strategy to provide information needed to support decision-making regarding the targeting and monitoring of nutrient pollution prevention and mitigation measures. A detailed review of the water quality data available from ground based measurements was conducted in order to determine their suitability for a case study application of remote sensing. In the first case study, the Valle de Bravo reservoir in Mexico City reservoir offers a larger database of water quality which may be used to better calibrate and validate the algorithms required to obtain water quality data from remote sensing raw data. In the second case study application, the relatively data scarce Lake Toba in Indonesia can be useful to illustrate the value added of remote sensing data in locations where water quality data is deficient or inexistent. The third case study in the Paso Severino reservoir in Uruguay offers a combination of data scarcity and persistent development of harmful algae blooms. Landsat-TM data was obteined for the 3 study sites and algorithms for three key water quality parameters that are related to nutrient pollution: Chlorophyll-a, Total Nitrogen, and Total Phosphorus were calibrated and validated at the study sites. The three case study applications were developed into capacity building/training workshops for water resources students, applied scientists, practitioners, reservoir and water quality managers, and other interested stakeholders.

Assessment of leachates from uncontrolled landfill: Tangier case study

NASA Astrophysics Data System (ADS)

Elmaghnougi, I.; Afilal Tribak, A.; Maatouk, M.

2018-05-01

Landfill site of Tangier City is non-engineered low lying open dump. It has neither bottom liner nor leachate collection and treatment system. Therefore, all the leachate generated finds its paths into the surrounding environment Leachate samples of landfill site were collected and analyzed to estimate its pollution potential. The analyzed samples contained a high concentration of organic and inorganic compounds, beyond the permissible limits.

Social Media and Implication for Education: Case Study in Faculty of Technology and Science Universitas Buddhi Dharma, Tangerang, Indonesia

ERIC Educational Resources Information Center

Mardiana, Harisa

2016-01-01

Nowadays, people have demonstrated the same amount of internet usage, and surprisingly, students have demonstrated more and have consumed a lot of time of using social media site. Not only the college students but also the educators, and they believe about social media sites because in general social media and the internet were very helpful; they…

Reasonable Choices: Understanding Why Under-Educated Individuals Choose Not To Participate in Adult Education. Summary Report for the Department for Adult Education & Literacy.

ERIC Educational Resources Information Center

Jensen, Jane; Haleman, Diana; Goldstein, Beth; Anderman, Eric

The reasons why undereducated individuals choose not to participate in adult education were examined in a comparative, qualitative case study that was conducted in eight nonmetropolitan sites (including the pilot site) in diverse economic regions across Kentucky. Data were collected from the following sources: in-depth interviews with 84 adults…

Remediation to Reduce Ecological Risk from Trace Element Contamination: A Decision Case Study

ERIC Educational Resources Information Center

Pierzynski, Gary M.; Vaillant, Grace C.

2006-01-01

The cumulative result of almost 100 years of mining, milling, and smelting has left areas of Jasper County, Missouri, contaminated with high levels of the trace metals Pb, Cd, and Zn. The site was listed on the National Priorities List in 1990 and is now known as the Jasper County or Oronogo-Duenweg Mining Belt Superfund Site. The U.S.…

Comparison of the Content of Web Sites of Higher Education Institutions Providing for Sports Management Education: The Case of Turkish and English Universities

ERIC Educational Resources Information Center

Katirci, Hakan

2016-01-01

Considering various themes, this study aims to examine the content of web sites of universities that provide sports management education in higher education level in Turkey and in England. Within this framework, the websites of the higher education institutions that provide sports management education are analyzed by using the content analysis…

A method for locating potential tree-planting sites in urban areas: a case study of Los Angeles, USA

Treesearch

Chunxia Wua; Qingfu Xiaoa; Gregory E. McPherson

2008-01-01

A GIS-based method for locating potential tree-planting sites based on land cover data is introduced. Criteria were developed to identify locations that are spatially available for potential tree planting based on land cover, sufficient distance from impervious surfaces, a minimum amount of pervious surface, and no crown overlap with other trees. In an ArcGIS...

The Nature Conservancy's Gulf Wings Project – A Case Study in Conservation Planning for Migratory Birds

Treesearch

Charles Duncan; Becky Abel; Danny Kwan; David Mehlman

2005-01-01

The Nature Conservancy has adopted a framework for mission success called Conservation by Design. We plan at the ecoregional level to define conservation targets and the portfolio of sites needed to protect them. We consider threats and strategies for abating them at these key sites, and we define measures of success to hold ourselves accountable. Migratory birds...

False Killer Whales (Pseudorca crassidens) Around the Main Hawaiian Islands: Long-term Site Fidelity, Inter-island Movements, and Association Patterns

DTIC Science & Technology

2008-07-01

van Beneden (1889, cited in Tomilin 1967) reported a group following a vessel from Brazil to the English Channel. However, there is no published...of site fidelity: A case study involving nearctic-neotropical migrant songbirds wintering in a Costa Rican mangrove . Biological Conservation 77:143–150. Received: 6 July 2007 Accepted: 12 February 2008

Identifying the Infection Control Areas Requiring Modifications in Thoracic Surgery Units: Results of a Two-Year Surveillance of Surgical Site Infections in Hospitals in Southern Poland.

PubMed

Dubiel, Grzegorz; Rogoziński, Paweł; Żaloudik, Elżbieta; Bruliński, Krzysztof; Różańska, Anna; Wójkowska-Mach, Jadwiga

2017-10-01

Surgical site infection (SSI) is considered to be a priority in infection control. The objective of this study is the analysis of results of active targeted surveillance conducted over a two-year period in the Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra, in southern Poland. The retrospective analysis was carried out on the basis of results of active monitoring of SSI in the 45-bed Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra between April 1, 2014 and April 30, 2016. Surgical site infections were identified based on the definitions of the European Centre for Disease Prevention and Control (ECDC) taking into account the time of symptom onset, specifically, whether the symptoms occurred within 30 d after the surgical procedure. Detection of SSI relied on daily inspection of incisions by a trained nurse, analysis of medical and nursing entries in the computer system, and analysis of all results of microbiologic tests taken in the unit and in the operating room. In the study period, data were collected regarding 1,387 treatment procedures meeting the registration criteria. Forty cases of SSI were detected yielding an incidence rate of 3%. Most cases (55%) were found in the course of hospitalization and 45% were detected after the patient's discharge. The SSIs were classified as follows: superficial, 37.5%; deep infections, 7.5%; and organ/space infection, 55%. Among patients who were diagnosed with SSI, most were male (77.5%). For patients with an American Society of Anesthesiologists (ASA) score I-II the incidence rate was 2%; ASA score III or more, 3.7%. The incidence rate varied from 0.3% in clean surgical site to 6.5% in clean-contaminated site. The study validated the usefulness of targeted surveillance in monitoring SSIs in patients hospitalized in thoracic surgery departments. Surgical site infection surveillance identified areas of care requiring modifications, namely, organization of post-discharge and microbiologic diagnostics of infection cases.

Malignant head and neck tumours in Radiology Department JPMC Karachi -- a tertiary care experience.

PubMed

Kadri, Shazia; Uddin, Sami; Ahmed, Naveed; Mahmood, Tariq

2015-08-01

To study age, gender and sites of malignant head and neck tumours on contrast-enhanced computed tomography and to elucidate its role. The retrospective study was conducted at the Jinnah Postgraduate Medical Centre, Karachi, and comprised data of patients with histologically proven malignant head and neck tumours reporting from February 2013 to February 2014. Contrast enhanced computed tomography with puffed cheek technique was done in cases of oral cancer, while routine contrast computed tomography was done in cases of other head and neck tumours. SPSS 19 was used for statistical analysis. A total of 100 biopsy-proven cases of malignant tumours comprised the study sample. The male: female ratio was 1.5:1 with an overall mean age of 46.4±16-76 years. . The most common histopathologically proven tumour was squamous cell carcinoma affecting oral mucosa 43(43%), followed by larynx 27(27%) and pharynx 10(10%) . Oral squamous cell carcinoma was the commonest tumour. Compute tomography scan with puffed cheek technique played a beneficial role in locating the site of primary tumour.

Low-Dose Radiation Therapy (2 Gy × 2) in the Treatment of Orbital Lymphoma

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

Fasola, Carolina E.; Jones, Jennifer C.; Huang, Derek D.

2013-08-01

Purpose: Low-dose radiation has become increasingly used in the management of indolent non-Hodgkin lymphoma (NHL), but has not been studied specifically for cases of ocular adnexal involvement. The objective of this study is to investigate the effectiveness of low-dose radiation in the treatment of NHL of the ocular adnexa. Methods and Materials: We reviewed the records of 20 NHL patients with 27 sites of ocular adnexal involvement treated with low-dose radiation consisting of 2 successive fractions of 2 Gy at our institution between 2005 and 2011. The primary endpoint of this study is freedom from local relapse (FFLR). Results: Atmore » a median follow-up time of 26 months (range 7-92), the overall response rate for the 27 treated sites was 96%, with a complete response (CR) rate of 85% (n=23) and a partial response rate of 11% (n=3). Among all treated sites with CR, the 2-year FFLR was 100%, with no in-treatment field relapses. The 2-year freedom from regional relapse rate was 96% with 1 case of relapse within the ipsilateral orbit (outside of the treatment field). This patient underwent additional treatment with low-dose radiation of 4 Gy to the area of relapse achieving a CR and no evidence of disease at an additional 42 months of follow-up. Orbital radiation was well tolerated with only mild acute side effects (dry eye, conjunctivitis, transient periorbital edema) in 30% of treated sites without any reports of long-term toxicity. Conclusions: Low-dose radiation with 2 Gy × 2 is effective and well tolerated in the treatment of indolent NHL of the ocular adnexa with high response rates and durable local control with the option of reirradiation in the case of locoregional relapse.« less

Rocky Mountain spotted fever in Arizona: documentation of heavy environmental infestations of Rhipicephalus sanguineus at an endemic site.

PubMed

Nicholson, William L; Paddock, Christopher D; Demma, Linda; Traeger, Marc; Johnson, Brian; Dickson, Jeffrey; McQuiston, Jennifer; Swerdlow, David

2006-10-01

A recent epidemiologic investigation identified 16 cases and 2 deaths from Rocky Mountain spotted fever (RMSF) in two eastern Arizona communities. Prevalence studies were conducted by collecting free-living ticks (Acari: Ixodidae) from the home sites of RMSF patients and from other home sites within the community. Dry ice traps and flagging confirmed heavy infestations at many of the home sites. Only Rhipicephalus sanguineus ticks were identified and all developmental stages were detected. It is evident that under certain circumstances, this species does transmit Rickettsia rickettsii to humans and deserves reconsideration as a vector in other geographic areas.

The challenge posed to children's health by mixtures of toxic waste: the Tar Creek superfund site as a case-study.

PubMed

Hu, Howard; Shine, James; Wright, Robert O

2007-02-01

In the United States, many of the millions of tons of hazardous wastes that have been produced since World War II have accumulated in sites throughout the nation. Citizen concern about the extent of this problem led Congress to establish the Superfund Program in 1980 to locate, investigate, and clean up the worst sites nationwide. Most such waste exists as a complex mixture of many substances. This article discusses the issue of toxic mixtures and children's health by focusing on the specific example of mining waste at the Tar Creek Superfund Site in Northeast Oklahoma.

Optimization Under Uncertainty of Site-Specific Turbine Configurations

NASA Astrophysics Data System (ADS)

Quick, J.; Dykes, K.; Graf, P.; Zahle, F.

2016-09-01

Uncertainty affects many aspects of wind energy plant performance and cost. In this study, we explore opportunities for site-specific turbine configuration optimization that accounts for uncertainty in the wind resource. As a demonstration, a simple empirical model for wind plant cost of energy is used in an optimization under uncertainty to examine how different risk appetites affect the optimal selection of a turbine configuration for sites of different wind resource profiles. If there is unusually high uncertainty in the site wind resource, the optimal turbine configuration diverges from the deterministic case and a generally more conservative design is obtained with increasing risk aversion on the part of the designer.

Site selection and traverse planning to support a lunar polar rover mission: A case study at Haworth Crater

NASA Astrophysics Data System (ADS)

Heldmann, Jennifer L.; Colaprete, Anthony; Elphic, Richard C.; Bussey, Ben; McGovern, Andrew; Beyer, Ross; Lees, David; Deans, Matt

2016-10-01

Studies of lunar polar volatile deposits are of interest for scientific purposes to understand the nature and evolution of the volatiles, and also for exploration reasons as a possible in situ resource to enable long term human exploration and settlement of the Moon. Both theoretical and observational studies have suggested that significant quantities of volatiles exist in the polar regions, although the lateral and horizontal distribution remains unknown at the km scale and finer resolution. A lunar polar rover mission is required to further characterize the distribution, quantity, and character of lunar polar volatile deposits at these higher spatial resolutions. Here we present a case study for NASA's Resource Prospector (RP) mission concept for a lunar polar rover and utilize this mission architecture and associated constraints to evaluate whether a suitable landing site exists to support an RP flight mission. We evaluate the landing site criteria to characterize the Haworth Crater region in terms of expected hydrogen abundance, surface topography, and prevalence of shadowed regions, as well as solar illumination and direct to Earth communications as a function of time to develop a notional rover traverse plan that addresses both science and engineering requirements. We also present lessons-learned regarding lunar traverse path planning focusing on the critical nature of landing site selection, the influence of illumination patterns on traverse planning, the effects of performing shadowed rover operations, the influence of communications coverage on traverse plan development, and strategic planning to maximize rover lifetime and science at end of mission. Here we present a detailed traverse path scenario for a lunar polar volatiles rover mission and find that the particular site north of Haworth Crater studied here is suitable for further characterization of polar volatile deposits.

Transmission of Mycobacterium tuberculosis through casual contact with an infectious case.

PubMed

Golub, J E; Cronin, W A; Obasanjo, O O; Coggin, W; Moore, K; Pope, D S; Thompson, D; Sterling, T R; Harrington, S; Bishai, W R; Chaisson, R E

2001-10-08

An ongoing restriction fragment length polymorphism study of Mycobacterium tuberculosis isolates from tuberculosis cases showed an identical 12-band IS6110 pattern unique to 3 unrelated patients (Patients A-C) diagnosed as having tuberculosis within a 9-month period. In an attempt to identify epidemiologic links between the 3 patients, we performed site visits to the retail business work site of patient A and conducted detailed interviews with all 3 patients and their contacts. Patient B had visited patient A's work site 3 times during patient A's infectious period, spending no more than 15 minutes each time. Patient C visited patient A's work site on 6 to 10 occasions during this period for no more than 45 minutes at any one time. There were no other epidemiologic links between these 3 cases other than the contact at the store. Contact investigation identified 4 tuberculin skin test conversions among 8 (50%) of patient A's coworkers, 6 positive tests among 15 household contacts (40%), and 8 positive tests among 16 identified customers who were casual contacts (50%). Patient B and patient C were most likely infected by patient A during one of their brief visits to patient A's work site. These data demonstrate that some tuberculosis is spread through casual contact not normally pursued in traditional contact investigations and that, in certain situations, M tuberculosis can be transmitted despite minimal duration of exposure. In addition, this outbreak emphasizes the importance of DNA fingerprinting data for identifying unusual transmission in unexpected settings.

The distribution of lectin receptor sites in human breast lesions.

PubMed

Skutelsky, E; Hoenig, S; Griffel, B; Alroy, J

1988-08-01

Conflicting data regarding the status of A, B, H and T antigens in epithelium of normal, mastopathies, fibroadenomas and carcinomas of the breast stimulated us to re-examine the carbohydrate residues in these condition. Currently, we extended the number of carbohydrate residues studied by using ten different biotinylated lectins as probes and avidin-biotin-peroxidase complex (ABC) as a visualant. In addition, the pattern of lectin staining of cancerous cells in primary and metastatic sites was compared. In primary and metastatic breast carcinomas, lectin receptor sites were stained more intensely with Concanavalia ensiformi agglutinin (*Con A), Ricinus communis agglutinin-I (RCA-I) and wheat germ agglutinin (WGA), than in normal breast, in mastopathies or in fibroadenomas. Cryptic receptor sites for peanut agglutinin (PNA) were stained in all cases of breast carcinomas, while free PNA sites stained only in a few cases of well-differentiated carcinomas. Receptors sites for Ulex europaeus agglutinin-I (UEA-I) stained non-malignant epithelium of patients with blood group H but did not stain malignant cells. The results show significant differences in lectin-binding patterns and staining intensities between normal and non-malignant, and malignant epithelial breast cells. Furthermore, these results indicate that in malignant cells, there is an increased content of sialic acid-rich carbohydrates but not of asialylated glycoconjugates.

Incidence of medically attended influenza infection and cases averted by vaccination, 2011/12 and 2012/13 influenza seasons

PubMed Central

Jackson, Michael L.; Jackson, Lisa A.; Kieke, Burney; McClure, David; Gaglani, Manjusha; Murthy, Kempapura; Malosh, Ryan; Monto, Arnold; Zimmerman, Richard K.; Foppa, Ivo M.; Flannery, Brendan; Thompson, Mark G.

2018-01-01

Background We estimated the burden of outpatient influenza and cases prevented by vaccination during the 2011/12 and 2012/13 influenza seasons using data from the United States Influenza Vaccine Effectiveness (US Flu VE) Network. Methods We defined source populations of persons who could seek care for acute respiratory illness (ARI) at each of the five US Flu VE Network sites. We identified all members of the source population who were tested for influenza during US Flu VE influenza surveillance. Each influenza-positive subject received a sampling weight based on the proportion of source population members who were tested for influenza, stratified by site, age, and other factors. We used the sampling weights to estimate the cumulative incidence of medically attended influenza in the source populations. We estimated cases averted by vaccination using estimates of cumulative incidence, vaccine coverage, and vaccine effectiveness. Results Cumulative incidence of medically attended influenza ranged from 0.8% to 2.8% across sites during 2011/12 and from 2.6% to 6.5% during the 2012/13 season. Stratified by age, incidence ranged from 1.2% among adults 50 years of age and older in 2011/12 to 10.9% among children 6 months to 8 years of age in 2012/13. Cases averted by vaccination ranged from 4 to 41 per 1,000 vaccinees, depending on the study site and year. Conclusions The incidence of medically attended influenza varies greatly by year and even by geographic region within the same year. The number of cases averted by vaccination varies greatly based on overall incidence and on vaccine coverage. PMID:26271827

Safety and Outcomes of Transradial Access in Patients with International Normalized Ratio 1.5 or above.

PubMed

Titano, Joseph J; Biederman, Derek M; Zech, John; Korff, Ricki; Ranade, Mona; Patel, Rahul; Kim, Edward; Nowakowski, Francis; Lookstein, Robert; Fischman, Aaron M

2018-03-01

To examine the safety and outcomes for patients undergoing transradial noncoronary interventions with international normalized ratio (INR) ≥1.5. A retrospective review of 2,271 transradial access (TRA) cases performed from July 2012 to July 2016 was conducted. Criteria for inclusion were moderate bleeding risk cases with preprocedure INR ≥1.5. Within the study period, there were 176 moderate bleeding risk procedures (transarterial chemoembolization: 70/176 [39.8%]; Barbeau B: 121/176 [68.8%]; 5-F sheath: 157/176 [89.2%]) performed on 122 patients (age 61.6 ± 12.1 years, 68.9% male, body mass index 28.0 kg/m 2 ) with INR ≥1.5. Technical success was achieved in 98.9% of cases. Grade 1/2 hematomas developed in 10 cases (5.7%). Age ≥65 years (P = .042) and female sex (P = .046) were predictive of access site bleeding complications. Fresh frozen plasma (FFP) transfusion was administered in 11.4% of cases (n = 20). Baseline INR and creatinine were significantly different between transfused and nontransfused cases (P values .006 and .028, respectively). Minor access site bleeding occurred in 3/20 cases (15%) receiving prior FFP transfusion and 7/156 nontransfused cases (4.5%), with no significant difference between these 2 groups (P = .072). TRA in patients with elevated INR appears to be safe in our experience. Age ≥65 years and female sex were associated with increased incidence of access site bleeding. Although INR correction was not standardized in this cohort, preprocedure FFP transfusion did not decrease bleeding complications. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Fatal occupational injuries in the South Delhi construction industry: a retrospective study.

PubMed

Rautji, R; Lalwani, S; Dogra, T D

2005-04-01

One hundred and forty-five unselected autopsy cases of construction site accidents received from South Delhi were studied during the period from 1996--2002. Data for the study was gathered from autopsy reports and hospital records. The cases represented approximately 1.61% of all autopsy cases received from South Delhi at the All India Institute of Medical Sciences, New Delhi (India). Data was analysed with regard to the age and sex of the victim, the part of the body involved, the manner of accident, the cause of death and the pattern of injuries in different body regions. Death occurred at the scene of the fatal event in thirty-four cases; forty-three cases were dead on arrival at the hospital; sixty-eight cases died after being admitted to the hospital. Ethanol was detected in the blood of 16% of the cases.

Analysis of Malpractice Claims Associated with Surgical Site Infection in the Field of Plastic Surgery.

PubMed

Park, Bo Young; Kwon, Jung Woo; Kang, So Ra; Hong, Seung Eun

2016-12-01

Postoperative infections are rare after plastic surgery; however, when present, they can affect the aesthetic outcome. Currently, many malpractice lawsuits are associated with surgical site infection. The present study aimed to analyze malpractice claims associated with surgical site infection in the field of plastic surgery through a review of Korean precedents. We analyzed the type of procedure, associated complications, and legal judgment in these cases. Most claimants were women, and claims were most often related to breast surgery. The common complications related to surgical site infection were deformity, scar, and asymmetry. Among the 40 cases, 34 were won by the plaintiff, and the mean claim settlement was 2,832,654 KRW (USD 2,636.6). The reasons for these judgements were as follows: 1) immediate bacterial culture tests were not performed and appropriate antibiotics were not used; 2) patients were not transferred to a high-level hospital or the infection control department was not consulted; 3) surgical site infection control measures were not appropriate; and 4) surgical procedures were performed without preoperative explanation about surgical site infection. The number of claims owing to surgical site infection after surgery is increasing. Infection handling was one of the key factors that influenced the judgement, and preoperative explanation about the possibility of infection is important. The findings will help surgeons achieve high patient satisfaction and reduce liability concerns.