Modeling stimulus variation in three common implicit attitude tasks.

PubMed

Wolsiefer, Katie; Westfall, Jacob; Judd, Charles M

2017-08-01

We explored the consequences of ignoring the sampling variation due to stimuli in the domain of implicit attitudes. A large literature in psycholinguistics has examined the statistical treatment of random stimulus materials, but the recommendations from this literature have not been applied to the social psychological literature on implicit attitudes. This is partly because of inherent complications in applying crossed random-effect models to some of the most common implicit attitude tasks, and partly because no work to date has demonstrated that random stimulus variation is in fact consequential in implicit attitude measurement. We addressed this problem by laying out statistically appropriate and practically feasible crossed random-effect models for three of the most commonly used implicit attitude measures-the Implicit Association Test, affect misattribution procedure, and evaluative priming task-and then applying these models to large datasets (average N = 3,206) that assess participants' implicit attitudes toward race, politics, and self-esteem. We showed that the test statistics from the traditional analyses are substantially (about 60 %) inflated relative to the more-appropriate analyses that incorporate stimulus variation. Because all three tasks used the same stimulus words and faces, we could also meaningfully compare the relative contributions of stimulus variation across the tasks. In an appendix, we give syntax in R, SAS, and SPSS for fitting the recommended crossed random-effects models to data from all three tasks, as well as instructions on how to structure the data file.

[Diagnostic criteria and risk assessment of complications after gastric cancer surgery in western countries].

PubMed

Wu, Zhouqiao; Wang, Qi; Shi, Jinyao; Cherry, Koh; Desiderio, Jacopo; Li, Ziyu; Ji, Jiafu

2017-02-25

Postoperative complications are important outcome measurements for surgical quality and safety control. However, the complication registration has always been problematic due to the lack of definition consensus and the other practical difficulties. This narrative review summarizes the data registry system for single institutional registry, national data registry, international multi-center trial registries in the western world, aiming to share the experience of complication classification and data registration. We interviewed Dr. Koh from Royal Prince Alfred Hospital in Australia for single institutional experience, Dr. van der Wielen and Dr. Desideriofor, from two international multi-center trial(STOMACH) and registry (IMIGASTRIC) respectively, and Prof. Dr. Wijnhoven from the Dutch Upper GI Audit(DUCA). The major questions include which complications are obligated to report in the respective registry, what are the definitions of those complications, who perform the registration, and how are the complications evaluated or classified. Four telephone conferences were initiated to discuss the above-mentioned topics. The DUCA and IMGASTRIC provided the definition of the major complications. The consent definition provided by DUCA was based on the LOW classification which came out after a four-year discussion and consensus meeting among international experts in the according field. However, none of the four registries asked for an obligatory standardization of the diagnostic criteria among the participating centers or surgeons. Instead, all the registries required a detailed recording of the diagnostic strategy and classification of the complications with the Clavien-Dindo scoring system. Most data were registered by surgeons or data managers during or immediately after the hospitalization. The investigators or an independent third party conducted the auditing of the data quality. Standardization of complication diagnosis among different centers is a difficult task, consuming much effort and time. On top of that, standardization of the complication registration is of critical and practical importance. We encourage all centers to register complications with the diagnostic criteria and following intervention. Based on this, the Clavien-Dindo classification can be properly justified, which has been widely accepted by most centers and should be routinely used as the standard evaluation system for postoperative complications in gastric tumor surgery.

Complications in hair restoration.

PubMed

Lam, Samuel M

2013-11-01

Hair restoration requires a high level of specialized skill on the part of both the surgeon and the assistant team. Recipient-site problems can manifest from either surgeon or assistant error. The surgeon can create an unnatural hairline due to lack of knowledge of natural hair-loss patterns or badly executed recipient sites. He must also be cognizant of how hairs naturally are angled on the scalp to re-create a pattern that appears natural when making recipient sites. Assistants can also greatly contribute to the success or failure of surgery in their task of graft dissection and graft placement. Copyright © 2013 Elsevier Inc. All rights reserved.

Global maternal health and newborn health: Looking backwards to learn from history.

PubMed

Bergström, Staffan

2016-10-01

The late appearance of the 'M' on the international health agenda - in its own right and not just as a carrier of the intrauterine passenger - is thought-provoking. The 'M' was absent for decades in textbooks of 'tropical medicine' until the rhetoric question was formulated: 'Where is the "M" in MCH?' The selective antenatal 'high-risk approach' gained momentum but had to give way to the fact that all pregnant women are at risk due to unforeseeable complications. In order to provide trained staff to master such complications in impoverished rural areas (with no doctors), some countries have embarked on training of non-physician clinicians/associate clinicians for major surgery with excellent results in 'task-shifting' practice. The alleged but non-existent 'human right' to survive birth demonstrates that there have been no concrete accountability and no 'legal teeth' to make a failing accountability legally actionable to guarantee such a right. Copyright © 2016. Published by Elsevier Ltd.

A novel ultrasonic NDE for shrink fit welded structures using interface waves.

PubMed

Lee, Jaesun; Park, Junpil; Cho, Younho

2016-05-01

Reactor vessel inspection is a critical part of safety maintenance in a nuclear power plant. The inspection of shrink fit welded structures in a reactor nozzle can be a challenging task due to the complicated geometry. Nozzle inspection using pseudo interface waves allows us to inspect the nozzle from outside of the nuclear reactor. In this study, layered concentric pipes were manufactured with perfect shrink fit conditions using stainless steel 316. The displacement distributions were calculated with boundary conditions for a shrink fit welded structure. A multi-transducer guided wave phased array system was employed to monitor the welding quality of the nozzle end at a distance from a fixed position. The complicated geometry of a shrink fit welded structure can be overcome by using the pseudo interface waves in identifying the location and size of defects. The experimental results demonstrate the feasibility of detecting weld delamination and defects. Copyright © 2016 Elsevier B.V. All rights reserved.

Burn Resuscitation

DTIC Science & Technology

2009-01-01

The modified Brooke formula may not be effective in preventing all complications of fluid loading in all patients. The important concept is that if...addition to complicated mathematical computations [39]. They used their knowledge of expected fluid loss rates to devise a formula, based on trials of...burn resuscitations in order to prevent such a complication . This has proven to be a difficult task. The use of colloid has been examined in

Parameter Estimation of a Spiking Silicon Neuron

PubMed Central

Russell, Alexander; Mazurek, Kevin; Mihalaş, Stefan; Niebur, Ernst; Etienne-Cummings, Ralph

2012-01-01

Spiking neuron models are used in a multitude of tasks ranging from understanding neural behavior at its most basic level to neuroprosthetics. Parameter estimation of a single neuron model, such that the model’s output matches that of a biological neuron is an extremely important task. Hand tuning of parameters to obtain such behaviors is a difficult and time consuming process. This is further complicated when the neuron is instantiated in silicon (an attractive medium in which to implement these models) as fabrication imperfections make the task of parameter configuration more complex. In this paper we show two methods to automate the configuration of a silicon (hardware) neuron’s parameters. First, we show how a Maximum Likelihood method can be applied to a leaky integrate and fire silicon neuron with spike induced currents to fit the neuron’s output to desired spike times. We then show how a distance based method which approximates the negative log likelihood of the lognormal distribution can also be used to tune the neuron’s parameters. We conclude that the distance based method is better suited for parameter configuration of silicon neurons due to its superior optimization speed. PMID:23852978

Experimental evaluation of the concept of supevisory manipulation

NASA Technical Reports Server (NTRS)

Brooks, T. L.; Sheridan, T. B.

1982-01-01

A computer-controlled teleoperator system which is based on task-referenced sensor-aided control has been developed to study supervisory manipulation. This system, called SUPERMAN, is capable of performing complicated tasks in real-time by utilizing the operator for high-level functions related to the unpredictable portions of a task, while the subordinate machine performs the more well-defined subtasks under human supervison. To determine whether supervisory control schemes such as these offer any advantage over manual control under real-time conditions, a number of experiments involving both simple and complicated tasks were performed. Six representative tasks were chosen for the study: (1) obtaining a tool from a rack, (2) returning the tool to the rack, (3) removing a nut, (4) placing samples in a storage bin, (5) opening and closing a valve, and (6) digging with a shovel. The experiments were performed under simulated conditions using four forms of manual control (i.e., switch rate, joystick rate, master-slave position control, and master-slave with force feedback), as well as supervisory control. Through these experiments the effectiveness and quality of control were evaluated on the basis of the time required to complete each portion of the task and the type and number of errors which occurred.

On the Variation of Hardness Due to Uniaxial and Equi-Biaxial Residual Surface Stresses at Elastic-Plastic Indentation

NASA Astrophysics Data System (ADS)

Larsson, Per-Lennart

2018-05-01

It is established long since that the material hardness is independent of residual stresses at predominantly plastic deformation close to the contact region at indentation. Recently though, it has been shown that when elastic and plastic deformations are of equal magnitude this invariance is lost. For materials such as ceramics and polymers, this will complicate residual stress determination but can also, if properly understood, provide additional important information for performing such a task. Indeed, when the residual stresses are equi-biaxial, the situation is quite well understood, but additional efforts have to be made to understand the mechanical behavior in other loading states. Presently therefore, the variation of hardness, due to residual stresses, is examined at a uniaxial stress state. Correlation with global indentation quantities is analyzed, discussed and compared to corresponding equi-biaxial results. Cone indentation of elastic-perfectly plastic materials is considered.

Standardized mappings--a framework to combine different semantic mappers into a standardized web-API.

PubMed

Neuhaus, Philipp; Doods, Justin; Dugas, Martin

2015-01-01

Automatic coding of medical terms is an important, but highly complicated and laborious task. To compare and evaluate different strategies a framework with a standardized web-interface was created. Two UMLS mapping strategies are compared to demonstrate the interface. The framework is a Java Spring application running on a Tomcat application server. It accepts different parameters and returns results in JSON format. To demonstrate the framework, a list of medical data items was mapped by two different methods: similarity search in a large table of terminology codes versus search in a manually curated repository. These mappings were reviewed by a specialist. The evaluation shows that the framework is flexible (due to standardized interfaces like HTTP and JSON), performant and reliable. Accuracy of automatically assigned codes is limited (up to 40%). Combining different semantic mappers into a standardized Web-API is feasible. This framework can be easily enhanced due to its modular design.

Paper-based ion concentration polarization device for selective preconcentration of muc1 and lamp-2 genes

NASA Astrophysics Data System (ADS)

Son, Seok Young; Lee, Hyomin; Kim, Sung Jae

2017-12-01

Recently, novel biomolecules separation and detection methods based on ion concentration polarization (ICP) phenomena have been extensively researched due to its high amplification ratio and high-speed accumulation. Despite of these bright advances, the fabrication of conventional ICP devices still have complicated and times-consuming tasks. As an alternative platform, a paper have been recently used for the identical ICP operations. In this work, we demonstrated the selective preconcentration of a muc1 gene fragment as human breast cancer marker and a lamp-2 gene fragment as the cause of Danon disease in paper-based ICP devices. As a result, these two DNA fragments were successfully concentrated up to 60 fold at different location in a single paper-channel. The device would be a promising platform for point-of-care device due to an economic fabrication, the easy extraction of concentrated sample and an easy disposability.

Support Vector Feature Selection for Early Detection of Anastomosis Leakage From Bag-of-Words in Electronic Health Records.

PubMed

Soguero-Ruiz, Cristina; Hindberg, Kristian; Rojo-Alvarez, Jose Luis; Skrovseth, Stein Olav; Godtliebsen, Fred; Mortensen, Kim; Revhaug, Arthur; Lindsetmo, Rolv-Ole; Augestad, Knut Magne; Jenssen, Robert

2016-09-01

The free text in electronic health records (EHRs) conveys a huge amount of clinical information about health state and patient history. Despite a rapidly growing literature on the use of machine learning techniques for extracting this information, little effort has been invested toward feature selection and the features' corresponding medical interpretation. In this study, we focus on the task of early detection of anastomosis leakage (AL), a severe complication after elective surgery for colorectal cancer (CRC) surgery, using free text extracted from EHRs. We use a bag-of-words model to investigate the potential for feature selection strategies. The purpose is earlier detection of AL and prediction of AL with data generated in the EHR before the actual complication occur. Due to the high dimensionality of the data, we derive feature selection strategies using the robust support vector machine linear maximum margin classifier, by investigating: 1) a simple statistical criterion (leave-one-out-based test); 2) an intensive-computation statistical criterion (Bootstrap resampling); and 3) an advanced statistical criterion (kernel entropy). Results reveal a discriminatory power for early detection of complications after CRC (sensitivity 100%; specificity 72%). These results can be used to develop prediction models, based on EHR data, that can support surgeons and patients in the preoperative decision making phase.

EARLY COMPLICATIONS IN THE ORTHOPEDIC TREATMENT OF BONE METASTASES

PubMed Central

Teixeira, Luiz Eduardo Moreira; Miranda, Ricardo Horta; Ghedini, Daniel Ferreira; Aguilar, Rafael Bazílio; Novais, Eduardo Nilo Vasconcelos; de Abreu e Silva, Guilherme Moreira; Araújo, Ivana Duval; de Andrade, Marco Antônio Percope

2015-01-01

Objective: To assess the early complications in the orthopedic treatment of metastatic bone lesions and the factors associated with these complications. Method: There were assessed, retrospectively, 64 patients that underwent surgical treatment for bone metastases, analyzing the complications that occurred in the pre-operative and early post- operative period and associating them with the tumor origin, type of procedure done, the need of blood reposition before the surgery, the need of new surgical procedures and the mortality due to the complications. Results: Early complications in the treatment were observed in 17 (26.6%) patients, of which six (35.2%) ended up dying due to these complications. Regarding the type, 15 (23.8%) cases were due to surgical complications, four (6.3%) clinical and three (4.7%) patients showed clinical and surgical complications. There was no significant difference in the frequency of complications or mortality when assessed the type of reconstruction or affected region. The tumors with a renal origin needed more blood reposition and showed a bigger frequency of complications. Conclusion: The complications occurred in 26.6%. The complications are not related to the kind of treatment performed or to the region affected. The renal origin tumors showed a higher risk of hemorrhage. PMID:27077063

EARLY COMPLICATIONS IN THE ORTHOPEDIC TREATMENT OF BONE METASTASES.

PubMed

Teixeira, Luiz Eduardo Moreira; Miranda, Ricardo Horta; Ghedini, Daniel Ferreira; Aguilar, Rafael Bazílio; Novais, Eduardo Nilo Vasconcelos; de Abreu E Silva, Guilherme Moreira; Araújo, Ivana Duval; de Andrade, Marco Antônio Percope

2009-01-01

To assess the early complications in the orthopedic treatment of metastatic bone lesions and the factors associated with these complications. There were assessed, retrospectively, 64 patients that underwent surgical treatment for bone metastases, analyzing the complications that occurred in the pre-operative and early post- operative period and associating them with the tumor origin, type of procedure done, the need of blood reposition before the surgery, the need of new surgical procedures and the mortality due to the complications. Early complications in the treatment were observed in 17 (26.6%) patients, of which six (35.2%) ended up dying due to these complications. Regarding the type, 15 (23.8%) cases were due to surgical complications, four (6.3%) clinical and three (4.7%) patients showed clinical and surgical complications. There was no significant difference in the frequency of complications or mortality when assessed the type of reconstruction or affected region. The tumors with a renal origin needed more blood reposition and showed a bigger frequency of complications. The complications occurred in 26.6%. The complications are not related to the kind of treatment performed or to the region affected. The renal origin tumors showed a higher risk of hemorrhage.

Endoscopic management of pancreatic fluid collections-revisited

PubMed Central

Nabi, Zaheer; Basha, Jahangeer; Reddy, D Nageshwar

2017-01-01

The development of pancreatic fluid collections (PFC) is one of the most common complications of acute severe pancreatitis. Most of the acute pancreatic fluid collections resolve and do not require endoscopic drainage. However, a substantial proportion of acute necrotic collections get walled off and may require drainage. Endoscopic drainage of PFC is now the preferred mode of drainage due to reduced morbidity and mortality as compared to surgical or percutaneous drainage. With the introduction of new metal stents, the efficiency of endoscopic drainage has improved and the task of direct endoscopic necrosectomy has become easier. The requirement of re-intervention is less with new metal stents as compared to plastic stents. However, endoscopic drainage is not free of adverse events. Severe complications including bleeding, perforation, sepsis and embolism have been described with endoscopic approach to PFC. Therefore, the endoscopic management of PFC is a multidisciplinary affair and involves interventional radiologists as well as GI surgeons to deal with unplanned adverse events and failures. In this review we discuss the recent advances and controversies in the endoscopic management of PFC. PMID:28487603

[Congenital heart disease in adulthood].

PubMed

Baumgartner, Helmut; Däbritz, Sabine

2008-03-15

While a few decades ago only a minority of patients, particularly of those with complex congenital heart disease, could reach adulthood, progress of pediatric cardiology and cardiac surgery allows now the survival of the majority. Thus, adult cardiology is faced with a new challenging patient population. Since only a few congenital heart defects can be cured, regular follow-up during adult life is of major importance. Residual as well as consequently developed lesions must be recognized. Optimal timing of surgery or catheter intervention is necessary to provide the best long-term outcome. Despite optimal treatment part of the patients will develop long-term complications such as arrhythmias, pulmonary hypertension and, eventually, heart failure. Acute complications such as arrhythmias, aortic dissection or rupture, endocarditis, cerebral events due to embolism, bleeding or abscesses, and pulmonary embolism or bleeding must be recognized early and treated appropriately. Management of noncardiac surgery, pregnancy and delivery can be challenging. Another task is counseling regarding exercise and sports, choice of profession, driving and insurance issues. Finally, psychosocial issues must be taken into account for appropriate care of this special patient group.

Development of a Subjective Evaluation Tool for Assessing Marksmanship Training Effectiveness

DTIC Science & Technology

2013-01-28

used to break down the marksmanship domain, as presented in the USMC Rifle Marksmanship Manual, into sub-tasks that were converted into training-task... Mangos for his expertise in survey development and, along with Dr. Joseph Chandler, for guidance on the analysis of a complicated data set; Mr. Clarke...alternative to lengthy and resource-demanding training effectiveness evaluations. A task analytic approach was used to break down the marksmanship domain, as

Using Curriculum-Based Measurement to Drive IEPs and Instruction in Written Expression

ERIC Educational Resources Information Center

Hessler, Terri; Konrad, Moira

2008-01-01

Setting meaningful individualized education program (IEP) goals and objectives is one of the challenges that special education teachers face. In written expression, this task is even more difficult. Not only is assessing writing a subjective and difficult endeavor, but writing itself is a complicated task. Because many students with disabilities…

Immune Thrombocytopenia in Pregnancy

PubMed Central

Stavrou, Evi; McCrae, Keith R.

2009-01-01

SYNOPSIS Management of ITP in pregnancy can be a complex and challenging task, and may be complicated by fetal/neonatal thrombocytopenia. Though fetal intracranial hemorrhage is a rare complication of ITP in pregnancy, invasive studies designed to determine the fetal platelet count before delivery are associated with greater risk than that of fetal intracranial hemorrhage, and therefore are discouraged. Moreover, the risk of neonatal bleeding complications does not correlate with the mode of delivery, and thus cesarean section should be reserved for obstetric indications only. PMID:19932435

Research of GIS-services applicability for solution of spatial analysis tasks.

NASA Astrophysics Data System (ADS)

Terekhin, D. A.; Botygin, I. A.; Sherstneva, A. I.; Sherstnev, V. S.

2017-01-01

Experiments for working out the areas of applying various gis-services in the tasks of spatial analysis are discussed in this paper. Google Maps, Yandex Maps, Microsoft SQL Server are used as services of spatial analysis. All services have shown a comparable speed of analyzing the spatial data when carrying out elemental spatial requests (building up the buffer zone of a point object) as well as the preferences of Microsoft SQL Server in operating with more complicated spatial requests. When building up elemental spatial requests, internet-services show higher efficiency due to cliental data handling with JavaScript-subprograms. A weak point of public internet-services is an impossibility to handle data on a server side and a barren variety of spatial analysis functions. Microsoft SQL Server offers a large variety of functions needed for spatial analysis on the server side. The authors conclude that when solving practical problems, the capabilities of internet-services used in building up routes and completing other functions with spatial analysis with Microsoft SQL Server should be involved.

Water resources vulnerability assessment in the Adriatic Sea region: the case of Corfu Island.

PubMed

Kanakoudis, Vasilis; Tsitsifli, Stavroula; Papadopoulou, Anastasia; Cencur Curk, Barbara; Karleusa, Barbara

2017-09-01

Cross-border water resources management and protection is a complicated task to achieve, lacking a common methodological framework. Especially in the Adriatic region, water used for drinking water supply purposes pass from many different countries, turning its management into a hard task to achieve. During the DRINKADRIA project, a common methodological framework has been developed, for efficient and effective cross-border water supply and resources management, taking into consideration different resources types (surface and groundwater) emphasizing in drinking water supply intake. The common methodology for water resources management is based on four pillars: climate characteristics and climate change, water resources availability, quality, and security. The present paper assesses both present and future vulnerability of water resources in the Adriatic region, with special focus on Corfu Island, Greece. The results showed that climate change is expected to impact negatively on water resources availability while at the same time, water demand is expected to increase. Water quality problems will be intensified especially due to land use changes and salt water intrusion. The analysis identified areas where water resources are more vulnerable, allowing decision makers develop management strategies.

Can Games Help Creative Writing Students to Collaborate on Story-Writing Tasks?

ERIC Educational Resources Information Center

Jackson, David

2017-01-01

Story writing is a complex semantic and creative task, and the difficulty of managing it is made greater by attempting to write in collaboration with others. This complication can deter students from experimenting with collaboration before mastering their own practice in relative privacy. Such reticence is in spite of the fact that there are many…

Postsecondary Settings and Transition Services for Students with Intellectual Disabilities: Models and Research

ERIC Educational Resources Information Center

Neubert, Debra A.; Moon, M. Sherril

2006-01-01

Postsecondary high school students for college and employment that leads to adult self-sufficiency is a daunting task for educators (Lerner & Brand, 2006; Spence, 2007). This task becomes more complicated as technology changes rapidly, as policy makers mandate standards that all students must meet, and as schools evolve to serve more students with…

Prevention of lyme disease: promising research or sisyphean task?

PubMed

Krupka, Michal; Zachova, Katerina; Weigl, Evzen; Raska, Milan

2011-08-01

Borrelia burgdorferi sensu lato (Spirochaetes) is a group of at least 12 closely related species, some of which are responsible for chronic zoonotic infection that may cause Lyme disease. The only experimentally confirmed vector transmitting Borrelia to mammals is the Ixodes ticks. Borrelia is a highly adapted pathogen that can survive in the host organism in spite of the intense immune responses. Some patients have chronic long-lasting complications despite antibiotic therapy, probably due to adverse effects of the immune responses. A preventive vaccine against this bacterium has not been available due to the relatively broad spectrum and antigenic variability of Borrelia-surface lipoproteins and the different epitope recognition by experimental animals and humans. Although a human vaccine was marketed in the USA, it has been already pulled off the market. In addition, this vaccine was effective only in the USA, where the only pathogenic species is B. burgdorferi sensu stricto. Recent data indicate that a broadly effective vaccine will to be composed of a mixture of several antigens or multiple epitopes.

Adverse medical complications: an under-reported contributory cause of death in New York City.

PubMed

Gill, J R; Ely, S F; Toriello, A; Hirsch, C S

2014-04-01

The current death certification system in the USA fails to accurately track deaths due to adverse medical events. The aim of this study was to demonstrate the under-reporting of deaths due to adverse medical events due to limitations in the current death certification/reporting system, and the benefits of using the term 'therapeutic complication' as the manner of death. Retrospective review and comparison of death certificates and vital statistical coding. The manner of death is certified as a therapeutic complication when death is caused by predictable complications of appropriate therapy, and would not have occurred but for the medical intervention. Based on medical examiner records, complications that caused or contributed to deaths over a five-year period were examined retrospectively. These fatalities were compared with deaths coded as medical and surgical complications by the New York City Bureau of Vital Statistics. The Medical Examiner's Office certified 2471 deaths as therapeutic complications and 312 deaths as accidents occurring in healthcare facilities. In contrast, the New York City Bureau of Vital Statistics reported 188 deaths due to complications of medical and surgical care. Use of the term 'therapeutic complication' as the manner of death identified nearly 14 times more deaths than were reported by the New York City Bureau of Vital Statistics. If these therapeutic complications and medical accidents were considered as a 'disease', they would rank as the 10th leading cause of death in New York City, surpassing homicides and suicides in some years. Nationwide policy shifts that use the term 'therapeutic complication' would improve the capture and reporting of these deaths, thus allowing better identification of fatal adverse medical events in order to focus on and assess preventative strategies. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Microbial co-culturing systems: butanol production from organic wastes through consolidated bioprocessing.

PubMed

Jiang, Yujia; Zhang, Ting; Lu, Jiasheng; Dürre, Peter; Zhang, Wenming; Dong, Weiliang; Zhou, Jie; Jiang, Min; Xin, Fengxue

2018-05-07

Biobutanol can be indigenously synthesized by solventogenic Clostridium species; however, these microorganisms possess inferior capability of utilizing abundant and renewable organic wastes, such as starch, lignocellulose, and even syngas. The common strategy to achieve direct butanol production from these organic wastes is through genetic modification of wild-type strains. However, due to the complex of butanol synthetic and hydrolytic enzymes expression systems, the recombinants show unsatisfactory results. Recently, setting up microbial co-culturing systems became more attractive, as they could not only perform more complicated tasks, but also endure changeable environments. Hence, this mini-review comprehensively summarized the state-of-the-art biobutanol production from different substrates by using microbial co-culturing systems. Furthermore, strategies regarding establishment principles of microbial co-culturing systems were also analyzed and compared.

ESPR uroradiology task force and ESUR Paediatric Work Group--Imaging recommendations in paediatric uroradiology, part VI: childhood renal biopsy and imaging of neonatal and infant genital tract. Minutes from the task force session at the annual ESPR Meeting 2012 in Athens on childhood renal biopsy and imaging neonatal genitalia.

PubMed

Riccabona, Michael; Lobo, Maria Luisa; Willi, Ulrich; Avni, Fred; Damasio, Beatrice; Ording-Mueller, Lil-Sofie; Blickman, Johan; Darge, Kassa; Papadopoulou, Frederika; Vivier, Pierre-Hugues

2014-04-01

The European Society of Paediatric Radiology Uroradiology Task Force and the ESUR Paediatric Work Group jointly publish guidelines for paediatric urogenital imaging. Two yet unaddressed topics involving patient safety and imaging load are addressed in this paper: renal biopsy in childhood and imaging of the neonatal genital tract, particularly in girls. Based on our thorough review of literature and variable practice in multiple centers, procedural recommendations are proposed on how to perform renal biopsy in children and how to approach the genital tract in (female) neonates. These are statements by consensus due to lack of sufficient evidence-based data. The procedural recommendation on renal biopsy in childhood aims at improving patient safety and reducing the number of unsuccessful passes and/or biopsy-related complications. The recommendation for an imaging algorithm in the assessment of the neonatal genital tract focuses on the potential of ultrasonography to reduce the need for more invasive or radiating imaging, however, with additional fluoroscopy or MRI to be used in selected cases. Adherence to these recommendations will allow comparable data and evidence to be generated for future adaptation of imaging strategies in paediatric uroradiology.

Convolutional neural networks and face recognition task

NASA Astrophysics Data System (ADS)

Sochenkova, A.; Sochenkov, I.; Makovetskii, A.; Vokhmintsev, A.; Melnikov, A.

2017-09-01

Computer vision tasks are remaining very important for the last couple of years. One of the most complicated problems in computer vision is face recognition that could be used in security systems to provide safety and to identify person among the others. There is a variety of different approaches to solve this task, but there is still no universal solution that would give adequate results in some cases. Current paper presents following approach. Firstly, we extract an area containing face, then we use Canny edge detector. On the next stage we use convolutional neural networks (CNN) to finally solve face recognition and person identification task.

Development of a QFD-based expert system for CNC turning centre selection

NASA Astrophysics Data System (ADS)

Prasad, Kanika; Chakraborty, Shankar

2015-12-01

Computer numerical control (CNC) machine tools are automated devices capable of generating complicated and intricate product shapes in shorter time. Selection of the best CNC machine tool is a critical, complex and time-consuming task due to availability of a wide range of alternatives and conflicting nature of several evaluation criteria. Although, the past researchers had attempted to select the appropriate machining centres using different knowledge-based systems, mathematical models and multi-criteria decision-making methods, none of those approaches has given due importance to the voice of customers. The aforesaid limitation can be overcome using quality function deployment (QFD) technique, which is a systematic approach for integrating customers' needs and designing the product to meet those needs first time and every time. In this paper, the adopted QFD-based methodology helps in selecting CNC turning centres for a manufacturing organization, providing due importance to the voice of customers to meet their requirements. An expert system based on QFD technique is developed in Visual BASIC 6.0 to automate the CNC turning centre selection procedure for different production plans. Three illustrative examples are demonstrated to explain the real-time applicability of the developed expert system.

3D Guided Wave Motion Analysis on Laminated Composites

NASA Technical Reports Server (NTRS)

Tian, Zhenhua; Leckey, Cara; Yu, Lingyu

2013-01-01

Ultrasonic guided waves have proved useful for structural health monitoring (SHM) and nondestructive evaluation (NDE) due to their ability to propagate long distances with less energy loss compared to bulk waves and due to their sensitivity to small defects in the structure. Analysis of actively transmitted ultrasonic signals has long been used to detect and assess damage. However, there remain many challenging tasks for guided wave based SHM due to the complexity involved with propagating guided waves, especially in the case of composite materials. The multimodal nature of the ultrasonic guided waves complicates the related damage analysis. This paper presents results from parallel 3D elastodynamic finite integration technique (EFIT) simulations used to acquire 3D wave motion in the subject laminated carbon fiber reinforced polymer composites. The acquired 3D wave motion is then analyzed by frequency-wavenumber analysis to study the wave propagation and interaction in the composite laminate. The frequency-wavenumber analysis enables the study of individual modes and visualization of mode conversion. Delamination damage has been incorporated into the EFIT model to generate "damaged" data. The potential for damage detection in laminated composites is discussed in the end.

Studying the HIT-Complexity Interchange.

PubMed

Kuziemsky, Craig E; Borycki, Elizabeth M; Kushniruk, Andre W

2016-01-01

The design and implementation of health information technology (HIT) is challenging, particularly when it is being introduced into complex settings. While complex adaptive system (CASs) can be a valuable means of understanding relationships between users, HIT and tasks, much of the existing work using CASs is descriptive in nature. This paper addresses that issue by integrating a model for analyzing task complexity with approaches for HIT evaluation and systems analysis. The resulting framework classifies HIT-user tasks and issues as simple, complicated or complex, and provides insight on how to study them.

Screening for Preeclampsia: US Preventive Services Task Force Recommendation Statement.

PubMed

Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2017-04-25

Preeclampsia affects approximately 4% of pregnancies in the United States. It is the second leading cause of maternal mortality worldwide and may lead to serious maternal complications, including stroke, eclampsia, and organ failure. Adverse perinatal outcomes for the fetus and newborn include intrauterine growth restriction, low birth weight, and stillbirth. Many of the complications associated with preeclampsia lead to early induction of labor or cesarean delivery and subsequent preterm birth. Preeclampsia is more prevalent among African American women than among white women. Differences in prevalence may be, in part, due to African American women being disproportionally affected by risk factors for preeclampsia. African American women also have case fatality rates related to preeclampsia 3 times higher than rates among white women. Inequalities in access to adequate prenatal care may contribute to poor outcomes associated with preeclampsia in African American women. To update the 1996 US Preventive Services Task Force (USPSTF) recommendation on screening for preeclampsia. The USPSTF reviewed the evidence on the accuracy of screening and diagnostic tests for preeclampsia, the potential benefits and harms of screening for preeclampsia, the effectiveness of risk prediction tools, and the benefits and harms of treatment of screen-detected preeclampsia. Given the evidence that treatment can reduce maternal and perinatal morbidity and mortality, and the well-established accuracy of blood pressure measurements, the USPSTF found adequate evidence that screening for preeclampsia results in a substantial benefit for the mother and infant. In addition, there is adequate evidence to bound the harms of screening for and treatment of preeclampsia as no greater than small. Therefore, the USPSTF concludes with moderate certainty that there is a substantial net benefit of screening for preeclampsia in pregnant women. The USPSTF recommends screening for preeclampsia in pregnant women with blood pressure measurements throughout pregnancy. (B recommendation).

Three-dimensional modelling and geothermal process simulation

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

Burns, K.L.

1990-01-01

The subsurface geological model or 3-D GIS is constructed from three kinds of objects, which are a lithotope (in boundary representation), a number of fault systems, and volumetric textures (vector fields). The chief task of the model is to yield an estimate of the conductance tensors (fluid permeability and thermal conductivity) throughout an array of voxels. This is input as material properties to a FEHM numerical physical process model. The main task of the FEHM process model is to distinguish regions of convective from regions of conductive heat flow, and to estimate the fluid phase, pressure and flow paths. Themore » temperature, geochemical, and seismic data provide the physical constraints on the process. The conductance tensors in the Franciscan Complex are to be derived by the addition of two components. The isotropic component is a stochastic spatial variable due to disruption of lithologies in melange. The deviatoric component is deterministic, due to smoothness and continuity in the textural vector fields. This decomposition probably also applies to the engineering hydrogeological properties of shallow terrestrial fluvial systems. However there are differences in quantity. The isotropic component is much more variable in the Franciscan, to the point where volumetric averages are misleading, and it may be necessary to select that component from several, discrete possible states. The deviatoric component is interpolated using a textural vector field. The Franciscan field is much more complicated, and contains internal singularities. 27 refs., 10 figs.« less

Complications of hysteroscopic surgery: "Beyond the learning curve".

PubMed

Shveiky, David; Rojansky, Nathan; Revel, Ariel; Benshushan, Abraham; Laufer, Neri; Shushan, Asher

2007-01-01

To investigate the actual complication rate of hysteroscopic surgery performed by experienced endoscopic surgeons in a single medical center. A prospective descriptive study (Canadian Task Force classification III). An endoscopic gynecology unit at a tertiary care university hospital. Women from 21 to 82 (median 45.0) years, undergoing operative hysteroscopy for uterine disease. Operative hysteroscopy with glycine or saline solution used as an irrigation medium. Data of short-term complications were prospectively collected during surgery and at the 2-week follow-up visit. Six hundred procedures were investigated. The total complication rate was 3%, with 1% of uterine perforations. Two-thirds of the complications were related to cervical dilation or uterine entry, and infertility was found to be a risk factor. Hysteroscopic surgery, performed by a well-trained hysteroscopic surgeon, is a safe procedure with an overall complication rate of 3%. Most complications are related to cervical dilation or uterine entry techniques. Efforts therefore should be focused on identifying the patients at risk and finding novel techniques for cervical priming.

The Influence of Daily Stressors, Severity of Behavior Problems, Uncertainty, and Coping Strategies on Family Adaptation in Families of Adolescents with Autism Spectrum Disorders

ERIC Educational Resources Information Center

O'Brien, Sandra L.

2013-01-01

The prevalence of autism spectrum disorder (ASD) is rising exponentially. U.S. public health authorities report a 78% increase in ASD prevalence rate during the period (2002-2008), effecting 1 child in 50. Families of adolescents with ASD face the complex task of managing their children's transition into adulthood. Complicating this task is…

Leadership for the 1970s. Organizational Leadership Tasks for Army Leadership Training

DTIC Science & Technology

1977-05-01

environment, training and development efforts in the leadership / management field become extremely complicated. It is a most difficult--perhaps fruitless...principles theory of learning for the soft skills area, we are not faced with the necessity to list ever task implicit in the leadership / management domain...a monumental undertaking by any standards. This monograph represents an attempt to clarify leadership / management activities within reasonable limits

Child care and parenting issues for the young stroke survivor.

PubMed

Culler, Kathleen Hilko; Jasch, Christine; Scanlan, Susan

1994-03-01

Parenting is a complex and challenging task for any parent and it becomes even more complicated for an individual who experiences a disability. Literature addressing the parenting role for individuals who have experienced a stroke is limited. This article provides information on evaluation tools available for assessing an individual's ability to perform child care tasks and intervention strategies such as adaptive techniques and equipment for maximizing ability and promoting safe performance of child care tasks by the individual who has experienced a stroke. Product and literature resources that can be used by either the health professional or the parent with a stroke to facilitate parenting and child care task performance are included.

Patient prognosis based on feature extraction, selection and classification of EEG periodic activity.

PubMed

Sánchez-González, Alain; García-Zapirain, Begoña; Maestro Saiz, Iratxe; Yurrebaso Santamaría, Izaskun

2015-01-01

Periodic activity in electroencephalography (PA-EEG) is shown as comprising a series of repetitive wave patterns that may appear in different cerebral regions and are due to many different pathologies. The diagnosis based on PA-EEG is an arduous task for experts in Clinical Neurophysiology, being mainly based on other clinical features of patients. Considering this difficulty in the diagnosis it is also very complicated to establish the prognosis of patients who present PA-EEG. The goal of this paper is to propose a method capable of determining patient prognosis based on characteristics of the PA-EEG activity. The approach, based on a parallel classification architecture and a majority vote system has proven successful by obtaining a success rate of 81.94% in the classification of patient prognosis of our database.

[Forensic aspects of gunshot suicides in Germany].

PubMed

Kunz, Sebastian Niko; Meyer, Harald J; Kraus, Sybille

2013-12-01

Suicidal gunshot wounds are a common appearance in forensic casework. The main task of the coroner lies in the detection of typical pathomorphological correlates, thus differentiating between homicide, suicide and accident. Apart from characteristic bloodstain patterns on the gun and shooting hand, the localisation of the entrance wound and the position of the weapon, additional details such as family background or medical history are important aspects of forensic investigation. An uncommon choice of weaponry and its unusual morphological manifestation often complicate the examination and reconstruction of such cases. Furthermore, due to social stigmatisation, the possibility of secondary changes by relatives at the crime scene should be considered. In addition to autopsy findings, a careful crime scene investigation and bloodstain pattern analysis, a ballistic reconstruction can be an essential tool to gain knowledge of the shooting distance and position of the gun.

[Pathophysiology of myopia: nature versus nurture].

PubMed

Cassagne, M; Malecaze, F; Soler, V

2014-05-01

Myopia is the most frequent refractive disorder in the world. It has become a real Public Health problem, due to its frequency and to high myopia-related blinding complications. Myopic progression depends on genetic and environmental factors. Genetic studies have identified more than forty candidate genes that take part in pathophysiological pathways, from retinal phototransduction to axial lengthening via scleral remodelling. Environmental factors also influence scleral remodelling by way of visual perception. In the case of predominant attention to near tasks, a physiological feedback loop leads to axial growth. This phenomenon, called active emmetropization, is particularly obvious in animal models and in some human populations. To date, research has failed to identify a molecule common to all the implicated metabolic pathways which could be a target for an effective preventive treatment against myopic progression. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Stable Isotope Quantitative N-Glycan Analysis by Liquid Separation Techniques and Mass Spectrometry.

PubMed

Mittermayr, Stefan; Albrecht, Simone; Váradi, Csaba; Millán-Martín, Silvia; Bones, Jonathan

2017-01-01

Liquid phase separation analysis and subsequent quantitation remains a challenging task for protein-derived oligosaccharides due to their inherent structural complexity and diversity. Incomplete resolution or co-detection of multiple glycan species complicates peak area-based quantitation and associated statistical analysis when optical detection methods are used. The approach outlined herein describes the utilization of stable isotope variants of commonly used fluorescent tags that allow for mass-based glycan identification and relative quantitation following separation by liquid chromatography (LC) or capillary electrophoresis (CE). Comparability assessment of glycoprotein-derived oligosaccharides is performed by derivatization with commercially available isotope variants of 2-aminobenzoic acid or aniline and analysis by LC- and CE-mass spectrometry. Quantitative information is attained from the extracted ion chromatogram/electropherogram ratios generated from the light and heavy isotope clusters.

Rate of complications due to neuromuscular scoliosis spine surgery in a 30-years consecutive series.

PubMed

Turturro, Francesco; Montanaro, Antonello; Calderaro, Cosma; Labianca, Luca; Di Sanzo, Vincenzo; Ferretti, Andrea

2017-10-01

The aim of this study was to evaluate the rate of intraoperative and postoperative complications in a large series of patients affected by neuromuscular scoliosis. It was a monocentric retrospective study. In this study have been considered complications those events that significantly affected the course of treatment, such as getting the hospital stay longer, or requiring a subsequent surgical procedure, or corrupting the final result of the treatment. Of the 358 patients affected by neuromuscular scoliosis treated from January 1985 to December 2010, 185 that met the inclusion criteria were included in the study. There were recorded 66 complications in 55/185 patients. Of that 66 complications, 54 complications occurred in 46/120 patients with Luque's instrumentation, while only 12 complications occurred in 9/65 patients with hybrid instrumentation and this difference was statistically significant (p < 0.05); 11/126 patients with pelvic fixation and 5/59 without pelvic fixation, as well as 45/156 patients treated by posterior approach alone and 10/29 patient that underwent combined anterior-posterior approach suffered complications but both this did not result in a statistical significant difference (p > 0.05). The surgical treatment in neuromuscular scoliosis is burdened by a large number of complications. An accurate knowledge of possible complications is mandatory to prepare strategies due to prevent adverse events. A difference in definitions could completely change results in good or bad as well as in our same series the adverse events amounted at almost 30% of cases, but complications that due to complete failure would amount at 9.19% of patients.

Extravehicular Activity Asteroid Exploration and Sample Collection Capability

NASA Technical Reports Server (NTRS)

Scoville, Zebulon; Sipila, Stephanie; Bowie, Jonathan

2014-01-01

NASA's Asteroid Redirect Crewed Mission (ARCM) is challenged with primary mission objectives of demonstrating deep space Extravehicular Activity (EVA) and tools, and obtaining asteroid samples to return to Earth for further study. Although the Modified Advanced Crew Escape Suit (MACES) is used for the EVAs, it has limited mobility which increases fatigue and decreases the crews' capability to perform EVA tasks. Furthermore, previous Shuttle and International Space Station (ISS) spacewalks have benefited from EVA interfaces which have been designed and manufactured on Earth. Rigid structurally mounted handrails, and tools with customized interfaces and restraints optimize EVA performance. For ARCM, some vehicle interfaces and tools can leverage heritage designs and experience. However, when the crew ventures onto an asteroid capture bag to explore the asteroid and collect rock samples, EVA complexity increases due to the uncertainty of the asteroid properties. The variability of rock size, shape and composition, as well as bunching of the fabric bag will complicate EVA translation, tool restraint and body stabilization. The unknown asteroid hardness and brittleness will complicate tool use. The rock surface will introduce added safety concerns for cut gloves and debris control. Feasible solutions to meet ARCM EVA objectives were identified using experience gained during Apollo, Shuttle, and ISS EVAs, terrestrial mountaineering practices, NASA Extreme Environment Mission Operations (NEEMO) 16 mission, and during Neutral Buoyancy Laboratory testing in the MACES suit. The proposed concept utilizes expandable booms and integrated features of the asteroid capture bag to position and restrain the crew at the asteroid worksite. These methods enable the capability to perform both finesse, and high load tasks necessary to collect samples for scientific characterization of the asteroid. This paper will explore the design trade space and options that were examined for EVA, the overall concept for the EVAs including translation paths and body restraint methods, potential tools used to extract the samples, design implications for the Asteroid Redirect Vehicle (ARV) for EVA, the results of early development testing of potential EVA tasks, and extensibility of the EVA architecture to NASA's exploration missions.

Coastal livelihood transitions under globalization with implications for trans-ecosystem interactions.

PubMed

Kramer, Daniel B; Stevens, Kara; Williams, Nicholas E; Sistla, Seeta A; Roddy, Adam B; Urquhart, Gerald R

2017-01-01

Anthropogenic threats to natural systems can be exacerbated due to connectivity between marine, freshwater, and terrestrial ecosystems, complicating the already daunting task of governance across the land-sea interface. Globalization, including new access to markets, can change social-ecological, land-sea linkages via livelihood responses and adaptations by local people. As a first step in understanding these trans-ecosystem effects, we examined exit and entry decisions of artisanal fishers and smallholder farmers on the rapidly globalizing Caribbean coast of Nicaragua. We found that exit and entry decisions demonstrated clear temporal and spatial patterns and that these decisions differed by livelihood. In addition to household characteristics, livelihood exit and entry decisions were strongly affected by new access to regional and global markets. The natural resource implications of these livelihood decisions are potentially profound as they provide novel linkages and spatially-explicit feedbacks between terrestrial and marine ecosystems. Our findings support the need for more scientific inquiry in understanding trans-ecosystem tradeoffs due to linked-livelihood transitions as well as the need for a trans-ecosystem approach to natural resource management and development policy in rapidly changing coastal regions.

Automation based on knowledge modeling theory and its applications in engine diagnostic systems using Space Shuttle Main Engine vibrational data. M.S. Thesis

NASA Technical Reports Server (NTRS)

Kim, Jonnathan H.

1995-01-01

Humans can perform many complicated tasks without explicit rules. This inherent and advantageous capability becomes a hurdle when a task is to be automated. Modern computers and numerical calculations require explicit rules and discrete numerical values. In order to bridge the gap between human knowledge and automating tools, a knowledge model is proposed. Knowledge modeling techniques are discussed and utilized to automate a labor and time intensive task of detecting anomalous bearing wear patterns in the Space Shuttle Main Engine (SSME) High Pressure Oxygen Turbopump (HPOTP).

Pre-processing Tasks in Indonesian Twitter Messages

NASA Astrophysics Data System (ADS)

Hidayatullah, A. F.; Ma'arif, M. R.

2017-01-01

Twitter text messages are very noisy. Moreover, tweet data are unstructured and complicated enough. The focus of this work is to investigate pre-processing technique for Twitter messages in Bahasa Indonesia. The main goal of this experiment is to clean the tweet data for further analysis. Thus, the objectives of this pre-processing task is simply removing all meaningless character and left valuable words. In this research, we divide our proposed pre-processing experiments into two parts. The first part is common pre-processing task. The second part is a specific pre-processing task for tweet data. From the experimental result we can conclude that by employing a specific pre-processing task related to tweet data characteristic we obtained more valuable result. The result obtained is better in terms of less meaningful word occurrence which is not significant in number comparing to the result obtained by just running common pre-processing tasks.

Gender differences in memory for objects and their locations: a study on automatic versus controlled encoding and retrieval contexts.

PubMed

De Goede, Maartje; Postma, Albert

2008-04-01

Object-location memory is the only spatial task where female subjects have been shown to outperform males. This result is not consistent across all studies, and may be due to the combination of the multi-component structure of object location memory with the conditions under which different studies were done. Possible gender differences in object location memory and its component object identity memory were assessed in the present study. In order to disentangle these two components, an object location memory task (in which objects had to be relocated in daily environments), and a separate object identity recognition task were carried out. This study also focused on the conditions under which object locations were encoded and retrieved. Only half of the participants were aware of the fact that object locations had to be retrieved later on. Moreover, by applying the 'process dissociation procedure' to the object location memory assessments and the 'remember-know' paradigm to the object identity measure, the amount of explicit (conscious) and implicit (unconscious) retrieval was estimated for each component. In general, females performed better than males on the object location memory task. However, when controlled for object identity memory, females no longer outperformed males, whereas they did not obtain a higher general object identity memory score, nor did they have more explicit or implicit recollection of the object identities. These complicated effects might stem from a difference between males and females, in the way locations or associations between objects and locations are retrieved. In general, participants had more explicit (conscious) recollection than implicit (unconscious) recollection. No effect of encoding context was found, nor any interaction effect of gender, encoding and retrieval context.

Providing surgical care in Somalia: A model of task shifting.

PubMed

Chu, Kathryn M; Ford, Nathan P; Trelles, Miguel

2011-07-15

Somalia is one of the most political unstable countries in the world. Ongoing insecurity has forced an inconsistent medical response by the international community, with little data collection. This paper describes the "remote" model of surgical care by Medecins Sans Frontieres, in Guri-El, Somalia. The challenges of providing the necessary prerequisites for safe surgery are discussed as well as the successes and limitations of task shifting in this resource-limited context. In January 2006, MSF opened a project in Guri-El located between Mogadishu and Galcayo. The objectives were to reduce mortality due to complications of pregnancy and childbirth and from violent and non-violent trauma. At the start of the program, expatriate surgeons and anesthesiologists established safe surgical practices and performed surgical procedures. After January 2008, expatriates were evacuated due to insecurity and surgical care has been provided by local Somalian doctors and nurses with periodic supervisory visits from expatriate staff. Between October 2006 and December 2009, 2086 operations were performed on 1602 patients. The majority (1049, 65%) were male and the median age was 22 (interquartile range, 17-30). 1460 (70%) of interventions were emergent. Trauma accounted for 76% (1585) of all surgical pathology; gunshot wounds accounted for 89% (584) of violent injuries. Operative mortality (0.5% of all surgical interventions) was not higher when Somalian staff provided care compared to when expatriate surgeons and anesthesiologists. The delivery of surgical care in any conflict-settings is difficult, but in situations where international support is limited, the challenges are more extreme. In this model, task shifting, or the provision of services by less trained cadres, was utilized and peri-operative mortality remained low demonstrating that safe surgical practices can be accomplished even without the presence of fully trained surgeon and anesthesiologists. If security improves in Somalia, on-site training by expatriate surgeons and anesthesiologists will be re-established. Until then, the best way MSF has found to support surgical care in Somalia is continue to support in a "remote" manner.

Strongyloidiasis Current Status with Emphasis in Diagnosis and Drug Research

PubMed Central

Minori, Karen

2017-01-01

Strongyloidiasis is a parasitic neglected disease caused by the nematode Strongyloides stercoralis affecting 30 to 100 million people worldwide. Complications, strongly associated with alcoholism, organ transplants, and HTLV-1 virus, often arise due to late diagnosis, frequently leading to patient death. Lack of preemptive diagnosis is not the only difficulty when dealing with this parasite, since there are no gold standard diagnostic techniques, and the ones used have problems associated with sensitivity, resulting in false negatives. Treatment is also an issue as ivermectin and benzimidazoles administration leads to inconsistent cure rates and several side effects. Researching new anti-Strongyloides drugs is a difficult task since S. stercoralis does not develop until the adult stages in Mus musculus (with the exception of SCID mice), the main experimental host model. Fortunately, alternative parasite models can be used, namely, Strongyloides ratti and S. venezuelensis. However, even with these models, there are other complications in finding new drugs, which are associated with specific in vitro assay protocol steps, such as larvae decontamination. In this review, we highlight the challenges associated with new drug search, the compounds tested, and a list of published in vitro assay methodologies. We also point out advances being made in strongyloidiasis diagnosis so far. PMID:28210503

Hypoglycaemia and cognitive function.

PubMed

Warren, Roderick E; Frier, Brian M

2005-09-01

Acute hypoglycaemia impairs cerebral function, and available data indicate that cognitive performance becomes impaired at a blood glucose level of 2.6-3.0 mmol/l in healthy subjects. Methodological problems limit comparisons between studies, but in general complex tasks are more sensitive to hypoglycaemia than simple tasks, and some cognitive abilities are completely abolished. The onset of hypoglycaemic cognitive dysfunction is immediate, but recovery may be considerably delayed. There is persuasive evidence of adaptation to hypoglycaemia, partly due to increased brain glucose uptake capacity, although other mechanisms may exist. Patients who are exposed to chronic or recurrent hypoglycaemia become remarkably tolerant to the state, but this is insufficient to prevent severe hypoglycaemia with neuroglycopenic decompensation, probably because symptomatic and counterregulatory responses adapt even more. During experimental hypoglycaemia, administration of non-glucose cerebral fuels preserves cognitive function. However, little progress has been made as yet towards protecting cognitive function during hypoglycaemia in clinical practice. The chronic effects of recurrent hypoglycaemia remain contentious. There are numerous case reports of hypoglycaemic brain damage and of cognitive deterioration attributed to repeated severe hypoglycaemia. The major prospective studies, including the Diabetes Control and Complications Trial, did not report cognitive declines in intensively treated patients, but had unrepresentative study populations and may have been too short to detect such effects. Structural and functional brain changes are not only associated with recurrent severe hypoglycaemia, but also with hyperglycaemia and early disease onset and may in part be due to hyperglycaemic microvascular disease. Children may be more prone to acute metabolic insults, and there is evidence of developmental disadvantage associated with hypoglycaemic episodes.

Management of tetanus complication

NASA Astrophysics Data System (ADS)

Somia, I. K. A.

2018-03-01

The mortality rate of tetanus is still high; it is because of various complications due to muscle spasms, autonomic dysfunction, as well as due to prolonged critical care. Management of tetanus with its complications is in intensive care facilities. Management goals include stopping toxin production, neutralization of unbound toxin, management of the airway, muscle spasm control, treatment of autonomic dysfunction and general supportive management. Currently, diazepam is still an effective medication to control of muscle spasm and rigidity. Therapy for autonomic dysfunction that supported by evidence is MgSO4. Also, general supportive management for long-term care remains necessary to prevent other complications such as thromboembolism, infection, malnutrition, and others.

Left-handers look before they leap: handedness influences reactivity to novel Tower of Hanoi tasks

PubMed Central

Wright, Lynn; Hardie, Scott M.

2015-01-01

A sample of 203 task naïve left- and right-handed participants were asked to complete a combination of the 3- and 4-disk Towers of Hanoi (ToH), manipulating novelty and complexity. Self-reported state anxiety and latency to respond (initiation time) were recorded before each ToH. Novelty had a major effect on initiation time, particularly for left-handers. Left-handers had a longer latency to start and this was significantly longer on the first trial. Irrespective of hand-preference, initiation time reduced on the second trial, however, this was greatest for left-handers. Condition of task did not systematically influence initiation time for right handers, but did for left-handers. State anxiety was influenced by task novelty and complexity in a more complicated way. During the first trial, there was a significant handedness × number of disks interaction with left-handers having significantly higher state anxiety levels before the 3-disk ToH. This suggests that the initial reaction to this task for left-handers was not simply due to perceived difficulty. On their second trial, participants completing a novel ToH had higher state anxiety scores than those completing a repeated version. Overall, left-handers had a larger reduction in their state anxiety across trials. Relating to this, the expected strong positive correlation between state and trait anxiety was absent for left-handed females in their first tower presentation, but appeared on their second. This was driven by low trait anxiety individuals showing a higher state anxiety response in the first (novel) trial, supporting the idea that left-handed females respond to novelty in a way that is not directly a consequence of their trait anxiety. A possible explanation may be stereotype threat influencing the behavior of left-handed females. PMID:25691878

Nutritional and metabolic complications of bariatric surgery.

PubMed

Malinowski, Scott S

2006-04-01

Bariatric surgery is an effective treatment for patients with clinically severe obesity. In addition to significant weight loss, it is also associated with improvements in comorbidities. Unfortunately, bariatric surgery also has the potential to cause a variety of nutritional and metabolic complications. These complications are mostly due to the extensive surgically induced anatomical changes incurred by the patient's gastrointestinal tract, particularly with roux-en-Y gastric bypass and biliopancreatic diversion. Complications associated with vertical banded gastroplasty are mostly due to decreased intake amounts of specific nutrients. Macronutrient deficiencies can include severe protein-calorie malnutrition and fat malabsorption. The most common micronutrient deficiencies are of vitamin B12, iron, calcium, and vitamin D. Other micronutrient deficiencies that can lead to serious complications include thiamine, folate, and the fat-soluble vitamins. Counseling, monitoring, and nutrient and mineral supplementation are essential for the treatment and prevention of nutritional and metabolic complications after bariatric surgery.

Patient Safety in Interventional Radiology: A CIRSE IR Checklist

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

Lee, M. J., E-mail: mlee@rcsi.ie; Fanelli, F.; Haage, P.

2012-04-15

Interventional radiology (IR) is an invasive speciality with the potential for complications as with other invasive specialities. The World Health Organization (WHO) produced a surgical safety checklist to decrease the morbidity and mortality associated with surgery. The Cardiovascular and Interventional Society of Europe (CIRSE) set up a task force to produce a checklist for IR. Use of the checklist will, we hope, reduce the incidence of complications after IR procedures. It has been modified from the WHO surgical safety checklist and the RAD PASS from Holland.

Rehabilitation in severe memory deficit: A case study

PubMed Central

Sousa, Nariana Mattos Figueiredo

2017-01-01

The term amnesia refers to a pathological state of mind in which memory and learning are affected to a greater extent than other cognitive functions in a patient without altered level of consciousness. The aim of the current study was to describe a case of severe amnesia in a patient during neurological rehabilitation and to report the importance of preserved cognitive functions to compensate for the mnemonic deficit. VJA presented a clinical condition suggestive of encephalopathy due to caloric-protein malnutrition following several abdominal surgical procedures for complicated choledocholithiasis. A descriptive analysis of the results was carried out to outline the goals attained and the factors limiting implementation of memory aids. After the intervention program, consisting of individual and group activities, VJA showed improvement in level of recall with repetition of tasks, but still required constant external monitoring. Longitudinal follow-up is necessary to obtain more consistent results. PMID:29213515

Mixture model-based clustering and logistic regression for automatic detection of microaneurysms in retinal images

NASA Astrophysics Data System (ADS)

Sánchez, Clara I.; Hornero, Roberto; Mayo, Agustín; García, María

2009-02-01

Diabetic Retinopathy is one of the leading causes of blindness and vision defects in developed countries. An early detection and diagnosis is crucial to avoid visual complication. Microaneurysms are the first ocular signs of the presence of this ocular disease. Their detection is of paramount importance for the development of a computer-aided diagnosis technique which permits a prompt diagnosis of the disease. However, the detection of microaneurysms in retinal images is a difficult task due to the wide variability that these images usually present in screening programs. We propose a statistical approach based on mixture model-based clustering and logistic regression which is robust to the changes in the appearance of retinal fundus images. The method is evaluated on the public database proposed by the Retinal Online Challenge in order to obtain an objective performance measure and to allow a comparative study with other proposed algorithms.

Methods for Dissecting Motivation and Related Psychological Processes in Rodents.

PubMed

Ward, Ryan D

2016-01-01

Motivational impairments are increasingly recognized as being critical to functional deficits and decreased quality of life in patients diagnosed with psychiatric disease. Accordingly, much preclinical research has focused on identifying psychological and neurobiological processes which underlie motivation . Inferring motivation from changes in overt behavioural responding in animal models, however, is complicated, and care must be taken to ensure that the observed change is accurately characterized as a change in motivation , and not due to some other, task-related process. This chapter discusses current methods for assessing motivation and related psychological processes in rodents. Using an example from work characterizing the motivational impairments in an animal model of the negative symptoms of schizophrenia, we highlight the importance of careful and rigorous experimental dissection of motivation and the related psychological processes when characterizing motivational deficits in rodent models . We suggest that such work is critical to the successful translation of preclinical findings to therapeutic benefits for patients.

Rehabilitation in severe memory deficit: A case study.

PubMed

Sousa, Nariana Mattos Figueiredo

2017-01-01

The term amnesia refers to a pathological state of mind in which memory and learning are affected to a greater extent than other cognitive functions in a patient without altered level of consciousness. The aim of the current study was to describe a case of severe amnesia in a patient during neurological rehabilitation and to report the importance of preserved cognitive functions to compensate for the mnemonic deficit. VJA presented a clinical condition suggestive of encephalopathy due to caloric-protein malnutrition following several abdominal surgical procedures for complicated choledocholithiasis. A descriptive analysis of the results was carried out to outline the goals attained and the factors limiting implementation of memory aids. After the intervention program, consisting of individual and group activities, VJA showed improvement in level of recall with repetition of tasks, but still required constant external monitoring. Longitudinal follow-up is necessary to obtain more consistent results.

Harmony search optimization in dimensional accuracy of die sinking EDM process using SS316L stainless steel

NASA Astrophysics Data System (ADS)

Deris, A. M.; Zain, A. M.; Sallehuddin, R.; Sharif, S.

2017-09-01

Electric discharge machine (EDM) is one of the widely used nonconventional machining processes for hard and difficult to machine materials. Due to the large number of machining parameters in EDM and its complicated structural, the selection of the optimal solution of machining parameters for obtaining minimum machining performance is remain as a challenging task to the researchers. This paper proposed experimental investigation and optimization of machining parameters for EDM process on stainless steel 316L work piece using Harmony Search (HS) algorithm. The mathematical model was developed based on regression approach with four input parameters which are pulse on time, peak current, servo voltage and servo speed to the output response which is dimensional accuracy (DA). The optimal result of HS approach was compared with regression analysis and it was found HS gave better result y giving the most minimum DA value compared with regression approach.

A Framework for the Development of Context-Adaptable User Interfaces for Ubiquitous Computing Systems.

PubMed

Varela, Gervasio; Paz-Lopez, Alejandro; Becerra, Jose A; Duro, Richard

2016-07-07

This paper addresses the problem of developing user interfaces for Ubiquitous Computing (UC) and Ambient Intelligence (AmI) systems. These kind of systems are expected to provide a natural user experience, considering interaction modalities adapted to the user abilities and preferences and using whatever interaction devices are present in the environment. These interaction devices are not necessarily known at design time. The task is quite complicated due to the variety of devices and technologies, and the diversity of scenarios, and it usually burdens the developer with the need to create many different UIs in order to consider the foreseeable user-environment combinations. Here, we propose an UI abstraction framework for UC and AmI systems that effectively improves the portability of those systems between different environments and for different users. It allows developers to design and implement a single UI capable of being deployed with different devices and modalities regardless the physical location.

CFD Simulation of the Space Shuttle Launch Vehicle with Booster Separation Motor and Reaction Control System Plumes

NASA Technical Reports Server (NTRS)

Gea, L. M.; Vicker, D.

2006-01-01

The primary objective of this paper is to demonstrate the capability of computational fluid dynamics (CFD) to simulate a very complicated flow field encountered during the space shuttle ascent. The flow field features nozzle plumes from booster separation motor (BSM) and reaction control system (RCS) jets with a supersonic incoming cross flow at speed of Mach 4. The overset Navier-Stokes code OVERFLOW, was used to simulate the flow field surrounding the entire space shuttle launch vehicle (SSLV) with high geometric fidelity. The variable gamma option was chosen due to the high temperature nature of nozzle flows and different plume species. CFD predicted Mach contours are in good agreement with the schlieren photos from wind tunnel test. Flow fields are discussed in detail and the results are used to support the debris analysis for the space shuttle Return To Flight (RTF) task.

CFD Simulation of the Space Shuttle Launch Vehicle with Booster Separation Motor and Reaction Control Plumes

NASA Technical Reports Server (NTRS)

Gea, L. M.; Vicker, D.

2006-01-01

The primary objective of this paper is to demonstrate the capability of computational fluid dynamics (CFD) to simulate a very complicated flow field encountered during the space shuttle ascent. The flow field features nozzle plumes from booster separation motor (BSM) and reaction control system (RCS) jets with a supersonic incoming cross flow at speed of Mach 4. The overset Navier-Stokes code OVERFLOW, was used to simulate the flow field surrounding the entire space shuttle launch vehicle (SSLV) with high geometric fidelity. The variable gamma option was chosen due to the high temperature nature of nozzle flows and different plume species. CFD predicted Mach contours are in good agreement with the schlieren photos from wind tunnel test. Flow fields are discussed in detail and the results are used to support the debris analysis for the space shuttle Return To Flight (RTF) task.

Dead time corrections using the backward extrapolation method

NASA Astrophysics Data System (ADS)

Gilad, E.; Dubi, C.; Geslot, B.; Blaise, P.; Kolin, A.

2017-05-01

Dead time losses in neutron detection, caused by both the detector and the electronics dead time, is a highly nonlinear effect, known to create high biasing in physical experiments as the power grows over a certain threshold, up to total saturation of the detector system. Analytic modeling of the dead time losses is a highly complicated task due to the different nature of the dead time in the different components of the monitoring system (e.g., paralyzing vs. non paralyzing), and the stochastic nature of the fission chains. In the present study, a new technique is introduced for dead time corrections on the sampled Count Per Second (CPS), based on backward extrapolation of the losses, created by increasingly growing artificially imposed dead time on the data, back to zero. The method has been implemented on actual neutron noise measurements carried out in the MINERVE zero power reactor, demonstrating high accuracy (of 1-2%) in restoring the corrected count rate.

An efficient approach for inverse kinematics and redundancy resolution scheme of hyper-redundant manipulators

NASA Astrophysics Data System (ADS)

Chembuly, V. V. M. J. Satish; Voruganti, Hari Kumar

2018-04-01

Hyper redundant manipulators have a large number of degrees of freedom (DOF) than the required to perform a given task. Additional DOF of manipulators provide the flexibility to work in highly cluttered environment and in constrained workspaces. Inverse kinematics (IK) of hyper-redundant manipulators is complicated due to large number of DOF and these manipulators have multiple IK solutions. The redundancy gives a choice of selecting best solution out of multiple solutions based on certain criteria such as obstacle avoidance, singularity avoidance, joint limit avoidance and joint torque minimization. This paper focuses on IK solution and redundancy resolution of hyper-redundant manipulator using classical optimization approach. Joint positions are computed by optimizing various criteria for a serial hyper redundant manipulators while traversing different paths in the workspace. Several cases are addressed using this scheme to obtain the inverse kinematic solution while optimizing the criteria like obstacle avoidance, joint limit avoidance.

Nanoscale surface characterization using laser interference microscopy

NASA Astrophysics Data System (ADS)

Ignatyev, Pavel S.; Skrynnik, Andrey A.; Melnik, Yury A.

2018-03-01

Nanoscale surface characterization is one of the most significant parts of modern materials development and application. The modern microscopes are expensive and complicated tools, and its use for industrial tasks is limited due to laborious sample preparation, measurement procedures, and low operation speed. The laser modulation interference microscopy method (MIM) for real-time quantitative and qualitative analysis of glass, metals, ceramics, and various coatings has a spatial resolution of 0.1 nm for vertical and up to 100 nm for lateral. It is proposed as an alternative to traditional scanning electron microscopy (SEM) and atomic force microscopy (AFM) methods. It is demonstrated that in the cases of roughness metrology for super smooth (Ra >1 nm) surfaces the application of a laser interference microscopy techniques is more optimal than conventional SEM and AFM. The comparison of semiconductor test structure for lateral dimensions measurements obtained with SEM and AFM and white light interferometer also demonstrates the advantages of MIM technique.

[Neurologic complications of subarachnoid hemorrhage due to intracranial aneurysm rupture].

PubMed

Rama-Maceiras, P; Fàbregas Julià, N; Ingelmo Ingelmo, I; Hernández-Palazón, J

2010-12-01

The high rates of morbidity and mortality after subarachnoid hemorrhage due to spontaneous rupture of an intracranial aneurysm are mainly the result of neurologic complications. Sixty years after cerebral vasospasm was first described, this problem remains unsolved in spite of its highly adverse effect on prognosis after aneurysmatic rupture. Treatment is somewhat empirical, given that uncertainties remain in our understanding of the pathophysiology of this vascular complication, which involves structural and biochemical changes in the endothelium and smooth muscle of vessels. Vasospasm that is refractory to treatment leads to cerebral infarction. Prophylaxis, early diagnosis, and adequate treatment of neurologic complications are key elements in the management of vasospasm if neurologic damage, lengthy hospital stays, and increased use of health care resources are to be avoided. New approaches to early treatment of cerebral lesions and cortical ischemia in cases of subarachnoid hemorrhage due to aneurysm rupture should lead to more effective, specific management.

Severe anemia following uvulectomy in Kenya.

PubMed

Lowe, Karla R

2004-09-01

Uvulectomy is a common practice in eastern Africa for treatment of a variety of throat conditions. Traditional healers perform the procedure. I present a case report to illustrate a complication of uvulectomy. This is a report of a child who presented with severe anemia secondary to uvulectomy performed for treatment of chronic cough. This case report is intended to illustrate a procedure not commonly performed by western otolaryngologists and to describe the management of a severe complication. Western physicians are increasingly being tasked in medical situations in which they encounter traditional medical practices outside of their scope of training. The intent of this report is to familiarize western physicians with one such procedure and its potential complications.

The deployment of attention in short-term memory tasks: trade-offs between immediate and delayed deployment.

PubMed

Bunting, Michael F; Cowan, Nelson; Colflesh, Greg H

2008-06-01

Memory at times depends on attention, as when attention is used to encode incoming, serial verbal information. When encoding and rehearsal are difficult or when attention is divided during list presentation, more attention is needed in the time following the presentation and just preceding the response. Across 12 experimental conditions observed in several experiments, we demonstrated this by introducing a nonverbal task with three levels of effort (no task, a natural nonverbal task, or an unnatural version of the task) during a brief retention interval in a short-term digit recall task. Interference from the task during the retention interval was greater when resources were drawn away from the encoding of the stimuli by other factors, including unpredictability of the end point of the list, rapid presentation, and a secondary task during list presentation. When those conditions complicate encoding of the list, we argue, attention is needed after the list so that the contents of passive memory (i.e., postcategorical phonological storage and/or precategorical sensory memory) may be retrieved and become the focus of attention for recall.

[DEONTOLOGICAL QUESTIONS IN PROPHYLACTIC OF ENDOSCOPIC COMPLICATIONS: THE SIGNIFICANCE OF RATIONAL AND PSYCHOLOGICAL FACTORS (analytical overview)].

PubMed

Vernik, N V; Ivantsova, M A; Yashin, D I

2015-01-01

To evaluate the ways of reduction complications during endoscopic procedures based on principals of professional ethics and improving the quality of working area. Data of fundamental literature, evidence based medicine, science publications and internet portals. Deontology is the fundamental principle of medical practice and one of the main factors of professional effectiveness. Complications in endoscopy are often the investigations of deviation from the deontological principals. The whole number of psychological factors influences on professional activity of endoscopists, where the emotional "burn-out" syndrome (EBS) occupies one of the main places. Prophylactic and timely relief of EBS serves improvement of the practical work quality. Creation of favorable working area is the strategically important task in prophylactics of endoscopy complications. The questions of practical realization of deontological principles in endoscopy are the subject of further discussion.

Impact of Diabetic Complications on Balance and Falls: Contribution of the Vestibular System

PubMed Central

Lin, James; Staecker, Hinrich; Whitney, Susan L.; Kluding, Patricia M.

2016-01-01

Diabetes causes many complications, including retinopathy and peripheral neuropathy, which are well understood as contributing to gait instability and falls. A less understood complication of diabetes is the effect on the vestibular system. The vestibular system contributes significantly to balance in static and dynamic conditions by providing spatially orienting information. It is noteworthy that diabetes has been reported to affect vestibular function in both animal and clinical studies. Pathophysiological changes in peripheral and central vestibular structures due to diabetes have been noted. Vestibular dysfunction is associated with impaired balance and a higher risk of falls. As the prevalence of diabetes increases, so does the potential for falls due to diabetic complications. The purpose of this perspective article is to present evidence on the pathophysiology of diabetes-related complications and their influence on balance and falls, with specific attention to emerging evidence of vestibular dysfunction due to diabetes. Understanding this relationship may be useful for screening (by physical therapists) for possible vestibular dysfunction in people with diabetes and for further developing and testing the efficacy of interventions to reduce falls in this population. PMID:26251477

Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline.

PubMed

Gordon, Catherine M; Ackerman, Kathryn E; Berga, Sarah L; Kaplan, Jay R; Mastorakos, George; Misra, Madhusmita; Murad, M Hassan; Santoro, Nanette F; Warren, Michelle P

2017-05-01

The American Society for Reproductive Medicine, the European Society of Endocrinology, and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society. To formulate clinical practice guidelines for the diagnosis and treatment of functional hypothalamic amenorrhea (FHA). The participants include an Endocrine Society-appointed task force of eight experts, a methodologist, and a medical writer. This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The task force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies. One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society committees and members and cosponsoring organizations reviewed and commented on preliminary drafts of this guideline. FHA is a form of chronic anovulation, not due to identifiable organic causes, but often associated with stress, weight loss, excessive exercise, or a combination thereof. Investigations should include assessment of systemic and endocrinologic etiologies, as FHA is a diagnosis of exclusion. A multidisciplinary treatment approach is necessary, including medical, dietary, and mental health support. Medical complications include, among others, bone loss and infertility, and appropriate therapies are under debate and investigation. Copyright © 2017 Endocrine Society

Sports Participation, Functional Outcome, and Complications After Ankle Arthrodesis: Midterm Follow-up.

PubMed

Kerkhoff, Yvonne R A; Keijsers, Noël L W; Louwerens, Jan Willem K

2017-10-01

Ankle arthrodesis provides satisfactory functional outcome based on basic daily activities, but information regarding more demanding tasks is limited. Also, studies reporting longer term survival and complication rates are sparse and concern small study populations. This study reports functional outcome with more focus on demanding tasks and sports and reports the mid- to long-term union and complication rates in a large study population. Between 2005 and 2010, an ankle arthrodesis was performed on 185 ankles. Clinical results were retrospectively assessed with the Foot Function Index (FFI), visual analog scale (VAS) for pain, and the Foot and Ankle Ability Measure (FAAM). Information regarding sports pre- and postoperatively was obtained through a questionnaire. In addition, postoperative complications, reoperations, and failures (defined as nonunion of the ankle arthrodesis) were determined. Mean follow-up time was 8 years. FFI scores significantly improved, the FAAM ADL score was 70%, and the mean VAS for pain at the ankle/hindfoot at follow-up was 20. Sports participation slightly diminished from 79.5% prior to the onset of disabling complaints to 68.9% postoperatively. Of the patients, 73.1% were able to hike with a median hiking time of 40 minutes (range, 2-600 minutes). Kneeling could be performed on average 10 minutes (range, 2-60 minutes) in 39.8% and jumping down from steps by 23.5% of the patients. A small selection of patients was able to sprint (14%), and 16.8% of the patients were able to run a median distance of 60 meters (range, 3-1000 meters). Failure occurred in 9.2% and other postoperative complications were present in 21.6%, requiring reoperation in 8.6% of the cases. Ankle arthrodesis led to satisfactory functional outcome and pain reduction. Most patients remained active in sports, but a transition to less demanding sporting activities was seen. The complication and failure rates were similar with previous literature, and the incidence of nonrevision secondary surgery was relatively low. Level III, retrospective comparative study.

Bicycle safety education for children from a developmental and learning perspective.

DOT National Transportation Integrated Search

2014-01-01

When children ride bicycles in and near traffic, they engage in a complicated task of combining motor skills and cognitive skills. In addition to developing bicycle-handling skills, bicycle safety education programs teach children how to ride safely ...

Parallel processing considerations for image recognition tasks

NASA Astrophysics Data System (ADS)

Simske, Steven J.

2011-01-01

Many image recognition tasks are well-suited to parallel processing. The most obvious example is that many imaging tasks require the analysis of multiple images. From this standpoint, then, parallel processing need be no more complicated than assigning individual images to individual processors. However, there are three less trivial categories of parallel processing that will be considered in this paper: parallel processing (1) by task; (2) by image region; and (3) by meta-algorithm. Parallel processing by task allows the assignment of multiple workflows-as diverse as optical character recognition [OCR], document classification and barcode reading-to parallel pipelines. This can substantially decrease time to completion for the document tasks. For this approach, each parallel pipeline is generally performing a different task. Parallel processing by image region allows a larger imaging task to be sub-divided into a set of parallel pipelines, each performing the same task but on a different data set. This type of image analysis is readily addressed by a map-reduce approach. Examples include document skew detection and multiple face detection and tracking. Finally, parallel processing by meta-algorithm allows different algorithms to be deployed on the same image simultaneously. This approach may result in improved accuracy.

Laparoscopy vs robotics in surgical management of endometrial cancer: comparison of intraoperative and postoperative complications.

PubMed

Seror, Julien; Bats, Anne-Sophie; Huchon, Cyrille; Bensaïd, Chérazade; Douay-Hauser, Nathalie; Lécuru, Fabrice

2014-01-01

To compare the rates of intraoperative and postoperative complications of robotic surgery and laparoscopy in the surgical treatment of endometrial cancer. Unicentric retrospective study (Canadian Task Force classification II-2). Tertiary teaching hospital. The study was performed from January 2002 to December 2011 and included patients with endometrial cancer who underwent laparoscopic or robotically assisted laparoscopic surgical treatment. Data collected included preoperative data, tumor characteristics, intraoperative data (route of surgery, surgical procedures, and complications), and postoperative data (early and late complications according to the Clavien-Dindo classification, and length of hospital stay). Morbidity was compared between the 2 groups. The study included 146 patients, of whom 106 underwent laparoscopy and 40 underwent robotically assisted surgery. The 2 groups were comparable in terms of demographic and preoperative data. Intraoperative complications occurred in 9.4% of patients who underwent laparoscopy and in none who underwent robotically assisted surgery (p = .06). There was no difference between the 2 groups in terms of postoperative events. Robotically assisted surgery is not associated with a significant difference in intraoperative and postoperative complications, even when there were no intraoperative complications of robotically assisted surgery. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

An Assessment of Instant Messaging Interruptions on Knowledge Workers' Task Performance in E-Learning-Based Training

ERIC Educational Resources Information Center

Mansi, Gary R.

2011-01-01

The modern workplace environment is filled with interruptions due to the necessity of coworkers to communicate with each other. Studies have revealed that interruptions can disrupt the ability of a knowledge worker to concentrate on a task, which can impact task performance (TP). Communication interruptions are due, in part, to the unavoidable…

Treatment of displaced talar neck fractures using delayed procedures of plate fixation through dual approaches.

PubMed

Xue, Youdi; Zhang, Hui; Pei, Fuxing; Tu, Chongqi; Song, Yueming; Fang, Yue; Liu, Lei

2014-01-01

Treatment of talar neck fractures is challenging. Various surgical approaches and fixation methods have been documented. Clinical outcomes are often dissatisfying due to inadequate reduction and fixation with high rates of complications. Obtaining satisfactory clinical outcomes with minimum complications remains a hard task for orthopaedic surgeons. In the period from May 2007 to September 2010, a total of 31 cases with closed displaced talar neck fractures were treated surgically in our department. Injuries were classified according to the Hawkins classification modified by Canale and Kelly. Under general anaesthesia with sufficient muscle relaxation, urgent closed reduction was initiated once the patients were admitted; if the procedure failed, open reduction and provisional stabilisation with Kirschner wires through an anteromedial approach with tibiometatarsal external fixation were performed. When the soft tissue had recovered, definitive fixation was performed with plate and screws through dual approaches. The final follow-up examination included radiological analysis, clinical evaluation and functional outcomes which were carried out according to the Ankle-Hindfoot Scale of the American Orthopaedic Foot and Ankle Society (AOFAS), patient satisfaction and SF-36. Twenty-eight patients were followed up for an average of 25 months (range 18-50 months) after the injury. Only two patients had soft tissue complications, and recovery was satisfactory with conservative treatment. All of the fractures healed anatomically without malunion and nonunion, and the average union time was 14 weeks (range 12-24 weeks). Post-traumatic arthritis developed in ten cases, while six patients suffered from avascular necrosis of the talus. Secondary procedures included three cases of subtalar arthrodesis, one case of ankle arthrodesis and one case of total ankle replacement. The mean AOFAS hindfoot score was 78 (range 65-91). According to the SF-36, the average score of the physical component summary was 68 (range 59-81), and the average score of the mental component summary was 74 (range 63-85). Talar neck fractures are associated with a high incidence of long-term disability and complications. Urgent reduction of the fracture-dislocation and delayed plate fixation through a dual approach when the soft tissue has recovered may minimise the complications and provide good clinical outcomes.

An unusual complication of combined gonioscopy-assisted transluminal trabeculotomy and phacoemulsification: vision loss due to intracapsular hematoma.

PubMed

Yalinbas, Duygu; Aktas, Zeynep; Hepsen, İbrahim; Dilekmen, Nilay

2017-09-23

To report two cases with an acute vision loss due to intracapsular hemorrhage (hematoma) after an uncomplicated gonioscopy-assisted transluminal trabeculotomy (GATT) combined with phacoemulsification surgery. Case report. Seventy-six-year-old male and 75-year-old female patients with cataract and pseudoexfoliative glaucoma (XFG) uncontrolled with maximum medical therapy both underwent GATT combined with phacoemulsification. Shortly after the surgery, intracapsular hematoma behind the intraocular lens (IOL) were noted in both patients. Hematoma cleared in both of them via IOL extraction-anterior vitrectomy and YAG-laser capsulotomy, respectively. Hematoma cleared in both patients without any surgical complications. Vision loss due to unclearing intracapsular hematoma might be an early complication of combined GATT and phacoemulsification surgery.

Auditory short-term memory activation during score reading.

PubMed

Simoens, Veerle L; Tervaniemi, Mari

2013-01-01

Performing music on the basis of reading a score requires reading ahead of what is being played in order to anticipate the necessary actions to produce the notes. Score reading thus not only involves the decoding of a visual score and the comparison to the auditory feedback, but also short-term storage of the musical information due to the delay of the auditory feedback during reading ahead. This study investigates the mechanisms of encoding of musical information in short-term memory during such a complicated procedure. There were three parts in this study. First, professional musicians participated in an electroencephalographic (EEG) experiment to study the slow wave potentials during a time interval of short-term memory storage in a situation that requires cross-modal translation and short-term storage of visual material to be compared with delayed auditory material, as it is the case in music score reading. This delayed visual-to-auditory matching task was compared with delayed visual-visual and auditory-auditory matching tasks in terms of EEG topography and voltage amplitudes. Second, an additional behavioural experiment was performed to determine which type of distractor would be the most interfering with the score reading-like task. Third, the self-reported strategies of the participants were also analyzed. All three parts of this study point towards the same conclusion according to which during music score reading, the musician most likely first translates the visual score into an auditory cue, probably starting around 700 or 1300 ms, ready for storage and delayed comparison with the auditory feedback.

Neuropsychological assessment of language functions during functional magnetic resonance imaging: development of new tasks. Preliminary report.

PubMed

Fersten, Ewa; Jakuciński, Maciej; Kuliński, Radosław; Koziara, Henryk; Mroziak, Barbara; Nauman, Paweł

2011-01-01

Due to the complex and extended cerebral organization of language functions, the brain regions crucial for speech and language, i.e. eloquent areas, have to be affected by neurooncological surgery. One of the techniques that may be helpful in pre-operative planning of the extent of tumour removal and estimating possible complications seems to be functional magnetic resonance imaging (fMRI). The aim of the study was to develop valid procedures for neuropsychological assessment of various language functions visualisable by fMRI in healthy individuals. In this fMRI study, 10 healthy (with no CNS pathology), right-handed volunteers aged 25-35 were examined using four tasks designed to measure different language functions, and one for short-term memory assessment. A 1.5-T MRI scanner performing ultrafast functional (EPI) sequences with 4-mm slice thickness and 1-mm interslice gap was used to detect the BOLD response to stimuli present-ed in a block design (30-second alternating blocks of activity and rest). The analyses used the SPM software running in a MATLAB environment, and the obtained data were interpreted by means of colour-coded maps superimposed on structural brain scans. For each of the tasks developed for particular language functions, a different area of increased neuronal activity was found. The differential localization of function-related neuronal activity seems interesting and the research worth continuing, since verbal communication failure may result from impairment of any of various language functions, and studies reported in the literature seem to focus on verbal expression only.

Auditory Short-Term Memory Activation during Score Reading

PubMed Central

Simoens, Veerle L.; Tervaniemi, Mari

2013-01-01

Performing music on the basis of reading a score requires reading ahead of what is being played in order to anticipate the necessary actions to produce the notes. Score reading thus not only involves the decoding of a visual score and the comparison to the auditory feedback, but also short-term storage of the musical information due to the delay of the auditory feedback during reading ahead. This study investigates the mechanisms of encoding of musical information in short-term memory during such a complicated procedure. There were three parts in this study. First, professional musicians participated in an electroencephalographic (EEG) experiment to study the slow wave potentials during a time interval of short-term memory storage in a situation that requires cross-modal translation and short-term storage of visual material to be compared with delayed auditory material, as it is the case in music score reading. This delayed visual-to-auditory matching task was compared with delayed visual-visual and auditory-auditory matching tasks in terms of EEG topography and voltage amplitudes. Second, an additional behavioural experiment was performed to determine which type of distractor would be the most interfering with the score reading-like task. Third, the self-reported strategies of the participants were also analyzed. All three parts of this study point towards the same conclusion according to which during music score reading, the musician most likely first translates the visual score into an auditory cue, probably starting around 700 or 1300 ms, ready for storage and delayed comparison with the auditory feedback. PMID:23326487

Posterior Circulation Stroke After Bronchial Artery Embolization. A Rare but Serious Complication

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

Laborda, Alicia; Tejero, Carlos; Fredes, Arturo, E-mail: fredesarturo@gmail.com

Bronchial artery embolization (BAE) is the treatment of choice for massive hemoptysis with rare complications that generally are mild and transient. There are few references in the medical literature with acute cerebral embolization as a complication of BAE. We report a case of intracranial posterior territory infarctions as a complication BAE in a patient with hemoptysis due to bronchiectasis.

Antibiotics for pre-term pre-labour rupture of membranes: prevention of neonatal deaths due to complications of pre-term birth and infection.

PubMed

Cousens, Simon; Blencowe, Hannah; Gravett, Michael; Lawn, Joy E

2010-04-01

In high-income countries, it is standard practice to give antibiotics to women with pre-term, pre-labour rupture of membranes (pPROM) to delay birth and reduce the risk of infection. In low and middle-income settings, where some 2 million neonatal deaths occur annually due to complications of pre-term birth or infection, many women do not receive antibiotic therapy for pPROM. To review the evidence for and estimate the effect on neonatal mortality due to pre-term birth complications or infection, of administration of antibiotics to women with pPROM, in low and middle-income countries. We performed a systematic review to update a Cochrane review. Standardized abstraction forms were used. The quality of the evidence provided by individual studies and overall was assessed using an adapted GRADE approach. Eighteen RCTs met our inclusion criteria. Most were from high-income countries and provide strong evidence that antibiotics for pPROM reduce the risk of respiratory distress syndrome [risk ratio (RR) = 0.88; confidence interval (CI) 0.80, 0.97], and early onset postnatal infection (RR = 0.61; CI 0.48, 0.77). The data are consistent with a reduction in neonatal mortality (RR = 0.90; CI 0.72, 1.12). Antibiotics for pPROM reduce complications due to pre-term delivery and post-natal infection in high-income settings. There is moderate quality evidence that, in low-income settings, where access to other interventions (antenatal steroids, surfactant therapy, ventilation, antibiotic therapy) may be low, antibiotics for pPROM could prevent 4% of neonatal deaths due to complications of prematurity and 8% of those due to infection.

A Bayesian Approach for Summarizing and Modeling Time-Series Exposure Data with Left Censoring.

PubMed

Houseman, E Andres; Virji, M Abbas

2017-08-01

Direct reading instruments are valuable tools for measuring exposure as they provide real-time measurements for rapid decision making. However, their use is limited to general survey applications in part due to issues related to their performance. Moreover, statistical analysis of real-time data is complicated by autocorrelation among successive measurements, non-stationary time series, and the presence of left-censoring due to limit-of-detection (LOD). A Bayesian framework is proposed that accounts for non-stationary autocorrelation and LOD issues in exposure time-series data in order to model workplace factors that affect exposure and estimate summary statistics for tasks or other covariates of interest. A spline-based approach is used to model non-stationary autocorrelation with relatively few assumptions about autocorrelation structure. Left-censoring is addressed by integrating over the left tail of the distribution. The model is fit using Markov-Chain Monte Carlo within a Bayesian paradigm. The method can flexibly account for hierarchical relationships, random effects and fixed effects of covariates. The method is implemented using the rjags package in R, and is illustrated by applying it to real-time exposure data. Estimates for task means and covariates from the Bayesian model are compared to those from conventional frequentist models including linear regression, mixed-effects, and time-series models with different autocorrelation structures. Simulations studies are also conducted to evaluate method performance. Simulation studies with percent of measurements below the LOD ranging from 0 to 50% showed lowest root mean squared errors for task means and the least biased standard deviations from the Bayesian model compared to the frequentist models across all levels of LOD. In the application, task means from the Bayesian model were similar to means from the frequentist models, while the standard deviations were different. Parameter estimates for covariates were significant in some frequentist models, but in the Bayesian model their credible intervals contained zero; such discrepancies were observed in multiple datasets. Variance components from the Bayesian model reflected substantial autocorrelation, consistent with the frequentist models, except for the auto-regressive moving average model. Plots of means from the Bayesian model showed good fit to the observed data. The proposed Bayesian model provides an approach for modeling non-stationary autocorrelation in a hierarchical modeling framework to estimate task means, standard deviations, quantiles, and parameter estimates for covariates that are less biased and have better performance characteristics than some of the contemporary methods. Published by Oxford University Press on behalf of the British Occupational Hygiene Society 2017.

Comparison of Complications Rates in Endoscopic Surgery Performed by a Clinical Assistant vs. An Experienced Endoscopic Surgeon

PubMed Central

Singhi, Aditi

2009-01-01

Study Objectives: (a) To find out the actual incidence of complications during endoscopic surgeries. (b) Comparison of complication rate between an experienced laparoscopic surgeon (> 10 years of experience in endoscopic surgery) and a clinical assistant (> 3 years of experience in endoscopic surgery). (c) How to manage complications in endoscopic surgery. (d) Concrete suggestions to reduce the complication rate. Design: Retrospective study (Canadian Task Force classification ii-2). Setting: Tertiary gynecologic endoscopic unit. Patients: A total of 3204 cases of gynecologic endoscopic surgery out of which 2001 were laparoscopic and 1203 were hysteroscopic surgeries. Interventions: Laparoscopic and hysteroscopic gynecologic surgeries in indicated cases. Measurements and Main Results: The study was carried out between April 2003 and October 2007 at a referral center for endoscopic surgery. A total of 3204 cases of gynecologic endoscopic surgery were studied. There were five significant complications in laparoscopic surgeries and four significant complications in hysteroscopic surgeries seen in four years and six months. All the complications could be managed with no mortality. Conversion to laparotomy was needed in eight cases of laparoscopic surgeries and none in hysteroscopic surgeries. Conclusion: The risk of complication reduces with the experience in endoscopic surgery. However, the proper grooming of a novice in experienced hands, for a sufficient period of time, can minimize the complication rate in the initial learning phase. The complication may be utilized as a stepping-stone to overcome any given situation without panic, but with adequate safety. PMID:22442510

Coastal livelihood transitions under globalization with implications for trans-ecosystem interactions

PubMed Central

Stevens, Kara; Williams, Nicholas E.; Sistla, Seeta A.; Roddy, Adam B.; Urquhart, Gerald R.

2017-01-01

Anthropogenic threats to natural systems can be exacerbated due to connectivity between marine, freshwater, and terrestrial ecosystems, complicating the already daunting task of governance across the land-sea interface. Globalization, including new access to markets, can change social-ecological, land-sea linkages via livelihood responses and adaptations by local people. As a first step in understanding these trans-ecosystem effects, we examined exit and entry decisions of artisanal fishers and smallholder farmers on the rapidly globalizing Caribbean coast of Nicaragua. We found that exit and entry decisions demonstrated clear temporal and spatial patterns and that these decisions differed by livelihood. In addition to household characteristics, livelihood exit and entry decisions were strongly affected by new access to regional and global markets. The natural resource implications of these livelihood decisions are potentially profound as they provide novel linkages and spatially-explicit feedbacks between terrestrial and marine ecosystems. Our findings support the need for more scientific inquiry in understanding trans-ecosystem tradeoffs due to linked-livelihood transitions as well as the need for a trans-ecosystem approach to natural resource management and development policy in rapidly changing coastal regions. PMID:29077748

Implant-Retained Obturator for an Edentulous Patient with a Hemimaxillectomy Defect Complicated with Microstomia

PubMed Central

2016-01-01

Patient. A 68-year-old man was operated on for squamous cell carcinoma (T3N3M0) of the maxilla creating the hemimaxillary surgical defect on right side. The remaining arch was completely edentulous. There was remarkable limitation in the oral opening with reduced perimeter of the oral cavity due to radiation and surgical scar contracture. This article describes prosthetic rehabilitation by modifying the design of the obturator and achieving the retention with dental implant. Discussion. Severe limitation in the oral opening may occur in clinical situations following the postsurgical management of oral and maxillofacial defects. The prosthetic rehabilitation of the surgical defect in such patients becomes a challenging task due to limited access to the oral cavity. This challenge becomes even more difficult if the patient is edentulous and there are no teeth to gain the retention, stability, and support. Conclusion. In severe microstomia prosthesis insertion and removal can be achieved with modification of the maximum width of the prosthesis. Dental implant retention is useful treatment option in edentulous patients with maxillary surgical defect provided that sufficient bone volume and accessibility are there for implant placement. PMID:27843652

Diagnosis and Management of Gaucher Disease in India - Consensus Guidelines of the Gaucher Disease Task Force of the Society for Indian Academy of Medical Genetics and the Indian Academy of Pediatrics.

PubMed

Puri, Ratna Dua; Kapoor, Seema; Kishnani, Priya S; Dalal, Ashwin; Gupta, Neerja; Muranjan, Mamta; Phadke, Shubha R; Sachdeva, Anupam; Verma, Ishwar C; Mistry, Pramod K

2018-02-15

Gaucher disease (GD) is amongst the most frequently occurring lysosomal storage disorder in all ethnicities. The clinical manifestations and natural history of GD is highly heterogeneous with extreme geographic and ethnic variations. The literature on GD has paucity of information and optimal management guidelines for Indian patients. Gaucher Disease Task Force was formed under the auspices of the Society for Indian Academy of Medical Genetics. Invited experts from various specialties formulated guidelines for the management of patients with GD. A writing committee was formed and the draft guidelines were circulated by email to all members for comments and inputs. The guidelines were finalized in December 2016 at the annual meeting of the Indian Academy of Medical Genetics. These guidelines are intended to serve as a standard framework for treating physicians and the health care systems for optimal management of Gaucher disease in India and to define unique needs of this patient population. Manifestations of GD are protean and a high index of suspicion is essential for timely diagnosis. Patients frequently experience diagnostic delays during which severe irreversible complications occur. Leucocyte acid b-glucosidase activity is mandatory for establishing the diagnosis of Gaucher disease; molecular testing can help identify patients at risk of neuronopathic disease. Enzyme replacement therapy for type 1 and type 3 Gaucher disease is the standard of care. Best outcomes are achieved by early initiation of therapy before onset of irreversible complications. However, in setting of progressive neurological symptoms such as seizures and or/ neuroregression, ERT is not recommended, as it cannot cross the blood brain barrier. The recommendations herein are for diagnosis, for initiation of therapy, therapeutic goals, monitoring and follow up of patients. We highlight that prevention of recurrence of the disease through genetic counseling and prenatal diagnosis is essential in India, due to uniformly severe phenotypes encountered in our population.

Dynamics modelling and Hybrid Suppression Control of space robots performing cooperative object manipulation

NASA Astrophysics Data System (ADS)

Zarafshan, P.; Moosavian, S. Ali A.

2013-10-01

Dynamics modelling and control of multi-body space robotic systems composed of rigid and flexible elements is elaborated here. Control of such systems is highly complicated due to severe under-actuated condition caused by flexible elements, and an inherent uneven nonlinear dynamics. Therefore, developing a compact dynamics model with the requirement of limited computations is extremely useful for controller design, also to develop simulation studies in support of design improvement, and finally for practical implementations. In this paper, the Rigid-Flexible Interactive dynamics Modelling (RFIM) approach is introduced as a combination of Lagrange and Newton-Euler methods, in which the motion equations of rigid and flexible members are separately developed in an explicit closed form. These equations are then assembled and solved simultaneously at each time step by considering the mutual interaction and constraint forces. The proposed approach yields a compact model rather than common accumulation approach that leads to a massive set of equations in which the dynamics of flexible elements is united with the dynamics equations of rigid members. To reveal such merits of this new approach, a Hybrid Suppression Control (HSC) for a cooperative object manipulation task will be proposed, and applied to usual space systems. A Wheeled Mobile Robotic (WMR) system with flexible appendages as a typical space rover is considered which contains a rigid main body equipped with two manipulating arms and two flexible solar panels, and next a Space Free Flying Robotic system (SFFR) with flexible members is studied. Modelling verification of these complicated systems is vigorously performed using ANSYS and ADAMS programs, while the limited computations of RFIM approach provides an efficient tool for the proposed controller design. Furthermore, it will be shown that the vibrations of the flexible solar panels results in disturbing forces on the base which may produce undesirable errors and perturb the object manipulation task. So, it is shown that these effects can be significantly eliminated by the proposed Hybrid Suppression Control algorithm.

Monte Carlo reference data sets for imaging research: Executive summary of the report of AAPM Research Committee Task Group 195.

PubMed

Sechopoulos, Ioannis; Ali, Elsayed S M; Badal, Andreu; Badano, Aldo; Boone, John M; Kyprianou, Iacovos S; Mainegra-Hing, Ernesto; McMillan, Kyle L; McNitt-Gray, Michael F; Rogers, D W O; Samei, Ehsan; Turner, Adam C

2015-10-01

The use of Monte Carlo simulations in diagnostic medical imaging research is widespread due to its flexibility and ability to estimate quantities that are challenging to measure empirically. However, any new Monte Carlo simulation code needs to be validated before it can be used reliably. The type and degree of validation required depends on the goals of the research project, but, typically, such validation involves either comparison of simulation results to physical measurements or to previously published results obtained with established Monte Carlo codes. The former is complicated due to nuances of experimental conditions and uncertainty, while the latter is challenging due to typical graphical presentation and lack of simulation details in previous publications. In addition, entering the field of Monte Carlo simulations in general involves a steep learning curve. It is not a simple task to learn how to program and interpret a Monte Carlo simulation, even when using one of the publicly available code packages. This Task Group report provides a common reference for benchmarking Monte Carlo simulations across a range of Monte Carlo codes and simulation scenarios. In the report, all simulation conditions are provided for six different Monte Carlo simulation cases that involve common x-ray based imaging research areas. The results obtained for the six cases using four publicly available Monte Carlo software packages are included in tabular form. In addition to a full description of all simulation conditions and results, a discussion and comparison of results among the Monte Carlo packages and the lessons learned during the compilation of these results are included. This abridged version of the report includes only an introductory description of the six cases and a brief example of the results of one of the cases. This work provides an investigator the necessary information to benchmark his/her Monte Carlo simulation software against the reference cases included here before performing his/her own novel research. In addition, an investigator entering the field of Monte Carlo simulations can use these descriptions and results as a self-teaching tool to ensure that he/she is able to perform a specific simulation correctly. Finally, educators can assign these cases as learning projects as part of course objectives or training programs.

Body piercing with fatal consequences.

PubMed

Ranga, N; Jeffery, A J

2011-01-25

Body modifications such as piercings, tattoos and surgery have increased in popularity in recent times and have become more socially acceptable. The common complications of piercing different parts of the human anatomy are well-documented, including sepsis, allergic reactions and, more rarely, endocarditis and ischaemia. Deaths related to piercing complications are primarily septic in origin. In this case, a man in his 50s died due to complications of his multiple umbilical piercings. The cause of death was unusually linked to body modification; the umbilical piercings had ultimately led to a mesenteric infarction. Cases such as these are forensically important due to potential manslaughter charges that could be brought against a piercing establishment. More importantly, this case highlights another extreme complication of body modification. Fashion statements are always changing and impact upon many lives. It is important to highlight to people the potentially life-threatening complications of common piercing practices.

Double whammy- acute splenic sequestration crisis in patient with aplastic crisis due to acute parvovirus infection.

PubMed

Minhas, Parminder S; K Virdi, Jaspreet; Patel, Rajeshkumar

2017-07-01

Splenic dysfunction is a major feature of sickle cell disease (SCD) and can manifest as acute splenic sequestration crisis (ASSC), which is the earliest life-threatening complication seen in patients with SCD. Aplastic crisis is another potentially deadly complication of sickle cell disease that develops when erythrocyte production temporarily drops. Infection with parvovirus B-19 frequently causes aplastic crises. These two complications are known to be mutually exclusive due to their classic presentation signs and symptoms but there have been few cases where a patient can have concomitant presentation of both phenomena, which can result in a fatal outcome. These few cases force us to rethink the etiology and subsequent management guidelines of these complications. We present to you a case of an unfortunate 23-year-old female who had both complications occurring at the same time, resulting in death.

Mothers have heavy burden in West Africa.

PubMed

1998-01-01

This article summarizes findings from a study of women's health during pregnancy, delivery, and the postpartum periods in West African countries. The sample included about 20,300 reproductive-age women. One in three women reported a health problem of some kind during the course of pregnancy. One in 16 reported a very severe problem. 1 in 340 died as a result of the pregnancy. 33% of severe complications were due to obstructed labor. 21% were due to hemorrhage before or during delivery. Eclampsia and hypertensive complications were the cause of 10% of severe complications. Only 1.5% of complications were due to infections, but these infections were the cause of most maternal mortality. One woman in five reported a current unwanted pregnancy. 80% of pregnant women delivered in a health facility. 83% were full-term pregnancies. 22% of births weighed under 2500 g (low birth weight). Most women had at least two prenatal visits by the 8th month of pregnancy, but consultations were not successful in identifying complications. Researchers recommend improved training of health providers, strengthened care during the 3rd trimester, and training of motivated persons to assist at the birth.

Relations between fine motor skill and parental report of attention in young children with neurofibromatosis type 1.

PubMed

Casnar, Christy L; Janke, Kelly M; van der Fluit, Faye; Brei, Natalie G; Klein-Tasman, Bonita P

2014-01-01

Neurofibromatosis type 1 (NF1) is one of the most common genetic disorders presenting in approximately 1 in 3,500 live births. NF1 is a highly variable condition with a large number of complications. A common complication is neuropsychological problems, including developmental delays and learning difficulties that affect as many as 60% of patients. Research has suggested that school-aged children with NF1 often have poorer fine motor skills and are at greater risk for attention difficulties than the general population. Thirty-eight children with NF1 and 23 unaffected children between the ages of 4 and 6 years, who are enrolled in a study of early development in NF1, were included in the present study. Varying levels of fine motor functioning were examined (simple to complex fine motor tasks). For children with NF1, significant difficulties were demonstrated on lab-based mid-level and complex fine motor tasks, even after controlling for nonverbal reasoning abilities, but not on simple fine motor tasks. Parental report also indicated difficulties in everyday adaptive fine motor functioning. No significant correlations were found between complex fine motor ability and attention difficulties. This study provides much needed descriptive data on the early emergence of fine motor difficulties and attention difficulties in young children with NF1.

Challenges Facing Group Work Online

ERIC Educational Resources Information Center

Chang, Bo; Kang, Haijun

2016-01-01

Online group work can be complicated because of its asynchronous characteristics and lack of physical presence, and its requirements for skills in handling technology, human relationships, and content-related tasks. This study focuses on the administrative, logistical and relationship-related challenges in online group work. Challenges in areas…

Neurological Complications Comparing Endoscopically vs. Open Harvest of the Radial Artery

ClinicalTrials.gov

2016-07-05

Complications Due to Coronary Artery Bypass Graft; Coronary Artery Disease; Myocardial Ischemia; Coronary Disease; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

RF model of the distribution system as a communication channel, phase 2. Volume 2: Task reports

NASA Technical Reports Server (NTRS)

Rustay, R. C.; Gajjar, J. T.; Rankin, R. W.; Wentz, R. C.; Wooding, R.

1982-01-01

Based on the established feasibility of predicting, via a model, the propagation of Power Line Frequency on radial type distribution feeders, verification studies comparing model predictions against measurements were undertaken using more complicated feeder circuits and situations. Detailed accounts of the major tasks are presented. These include: (1) verification of model; (2) extension, implementation, and verification of perturbation theory; (3) parameter sensitivity; (4) transformer modeling; and (5) compensation of power distribution systems for enhancement of power line carrier communication reliability.

Trends in complicated newborn hospital stays & costs, 2002-2009: implications for the future.

PubMed

Trudnak Fowler, Tara; Fairbrother, Gerry; Owens, Pamela; Garro, Nicole; Pellegrini, Cynthia; Simpson, Lisa

2014-01-01

With the steady growth in Medicaid enrollment since the recent recession, concerns have been raised about care for newborns with complications. This paper uses all-payer administrative data from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS), to examine trends from 2002 through 2009 in complicated newborn hospital stays, and explores the relationship between expected sources of payment and reasons for hospitalizations. Trends in complicated newborn stays, expected sources of payment, costs, and length of stay were examined. A logistic regression was conducted to explore likely payer source for the most prevalent diagnoses in 2009. Complicated births and hospital discharges within 30 days of birth remained relatively constant between 2002 and 2009, but average costs per discharge increased substantially (p<.001 for trend). Most strikingly, over time, the proportion of complicated births billed to Medicaid increased, while the proportion paid by private payers decreased. Among complicated births, the most prevalent diagnoses were preterm birth/low birth weight (23%), respiratory distress (18%), and jaundice (10%). The top two diagnoses (41% of newborns) accounted for 61% of the aggregate cost. For infants with complications, those with Medicaid were more likely to be complicated due to preterm birth/low birth weight and respiratory distress, while those with private insurance were more likely to be complicated due to jaundice. State Medicaid programs are paying for an increasing proportion of births and costly complicated births. Policies to prevent common birth complications have the potential to reduce costs for public programs and improve birth outcomes.

New insights into HIV-1-primary skin disorders

PubMed Central

2011-01-01

Since the first reports of AIDS, skin involvement has become a burdensome stigma for seropositive patients and a challenging task for dermatologist and infectious disease specialists due to the severe and recalcitrant nature of the conditions. Dermatologic manifestations in AIDS patients act as markers of disease progression, a fact that enhances the importance of understanding their pathogenesis. Broadly, cutaneous disorders associated with HIV type-1 infection can be classified as primary and secondary. While the pathogenesis of secondary complications, such as opportunistic infections and skin tumours, is directly correlated with a decline in the CD4+ T cell count, the origin of the certain manifestations primarily associated with the retroviral infection itself still remains under investigation. The focus of this review is to highlight the immunological phenomena that occur in the skin of HIV-1-seropositive patients, which ultimately lead to skin disorders, such as seborrhoeic dermatitis, atopic dermatitis, psoriasis and eosinophilic folliculitis. Furthermore, we compile the latest data on how shifts in the cytokines milieu, impairments of the innate immune compartment, reactions to xenobiotics and autoimmunity are causative agents in HIV-1-driven skin diseases. Additionally, we provide a thorough analysis of the small animal models currently used to study HIV-1-associated skin complications, centering on transgenic rodent models, which unfortunately, have not been able to fully unveil the role of HIV-1 genes in the pathogenesis of their primarily associated dermatological manifestations. PMID:21261982

Extravehicular Activity Asteroid Exploration and Sample Collection Capability

NASA Technical Reports Server (NTRS)

Sipila, Stephanie A.; Scoville, Zebulon C.; Bowie, Jonathan T.; Buffington, Jesse A.

2014-01-01

One of the challenging primary objectives associated with NASA's Asteroid Redirect Crewed Mission (ARCM) is to demonstrate deep space Extravehicular Activity (EVA) and tools and to obtain asteroid samples to return to Earth for further study. Prior Shuttle and International Space Station (ISS) spacewalks have benefited from engineered EVA interfaces which have been designed and manufactured on Earth. Rigid structurally mounted handrails, and tools with customized interfaces and restraints optimize EVA performance. For ARCM, EVA complexity increases due to the uncertainty of the asteroid properties. The variability of rock size, shape and composition, as well as behavior of the asteroid capture mechanism will complicate EVA translation, tool restraint, and body stabilization. The unknown asteroid hardness and brittleness will complicate tool use. The rock surface will introduce added safety concerns for cut gloves and debris control. Feasible solutions to meet ARCM EVA objectives were identified using experience gained during Apollo, Shuttle, and ISS EVAs, terrestrial mountaineering practices, NASA Extreme Environment Mission Operations (NEEMO) 16 mission, and during Neutral Buoyancy Laboratory testing in the Modified Advanced Crew Escape Suit (MACES) suit. This paper will summarize the overall operational concepts for conducting EVAs for the ARCM mission including translation paths and body restraint methods, potential tools used to extract the samples, design implications for the Asteroid Redirect Vehicle (ARV) for EVA, and the results of early development testing of potential EVA tasks.

The persistence of attachment: complicated grief, threat, and reaction times to the deceased's name.

PubMed

Mancini, Anthony D; Bonanno, George A

2012-08-01

Complicated grief is increasingly recognized as a debilitating disorder with significant mental and health consequences. The underlying mechanisms of complicated grief remain unclear, however. In the present study, we investigated a specific mechanism of complicated grief (CG) derived from attachment theory: the accessibility of the deceased's mental representation under threat. In a matched comparison of complicated (n=26) and asymptomatic grievers (n=30), we used an emotional Stroop task following subliminal threat or neutral primes to examine the accessibility of mental representations of the deceased, current attachment figures, and close others. Complicated grievers did not evidence differential accessibility to the deceased's mental representation across priming conditions, whereas asymptomatic grievers showed reduced accessibility (deactivation) of the deceased's mental representation specifically in the threat prime condition. These effects were independent of depressive symptoms. Across grievers, attachment anxiety and avoidance uniquely predicted accessibility of the deceased's name in the threat condition. The limitations of this study are its small sample size and reliance on analog attachment threats. These data support that accessibility of the deceased's mental representation in threatening contexts is an important component of complicated and asymptomatic grieving and that attachment insecurity contributes to a maladaptive reliance on the deceased as an attachment figure. Copyright © 2012 Elsevier B.V. All rights reserved.

Capturing the Peer Context: The Paradox of Progress

ERIC Educational Resources Information Center

Laursen, Brett

2010-01-01

Adolescents lead enormously complicated social lives. Many youth find it difficult to keep track of their own relationships with friends and romantic interests. For the investigator, the task is exponentially more complex because overlapping and interlocking relationships and networks must be disentangled, dissected, and diagrammed. This special…

Using the Battlefield Telemedicine System (BTS) to train deployed medical personnel in complicated medical tasks - a proof of concept.

PubMed

Irizarry, Daniel; Wadman, Michael C; Bernhagen, Mary A; Miljkovic, Nikola; Boedeker, Ben H

2012-01-01

This work describes the use of Adobe Connect software along with algorithm software to provide the necessary audio visual communication platform for telementoring a complex medical procedure to novice providers located at a distant site.

A Tale of Three Teachers

ERIC Educational Resources Information Center

Chapman, Sue; Leonard, Allison; Burciaga, Sandra; Jernigan, Theresa

2013-01-01

The improvement of mathematics teaching and learning is a complicated undertaking. It relies on teacher understanding of math curriculum in addition to awareness of how children acquire mathematics concepts. It also depends on teachers' abilities to translate these understandings into learning tasks and instructional routines, as well as the…

Toward Political Ecologies of Environmental Education

ERIC Educational Resources Information Center

Henderson, Joseph A.; Zarger, Rebecca K.

2017-01-01

Drawing a causal line between educational practice and ecological impact is a difficult intellectual task given the complexity of variables at work between educational event and ecological effect. This is further complicated by the anthropological fact that diverse peoples interact with nature in myriad ways. Our environmental interactions are…

A study to mitigate rural high-speed horizontal curve crashes in Kansas.

DOT National Transportation Integrated Search

2015-05-01

Driving on horizontal curves is a more complicated task than on straight sections of a roadway, and poses more : workload on drivers as well. While a small portion of roadways are made up of horizontal curve sections, : approximately a quarter of all...

[Chronic complications of diabetes mellitus. Recommendations from the American Diabetes Association 2011. Prevention and management].

PubMed

Isla Pera, Pilar

2012-09-01

Diabetes mellitus (DM) is one of the diseases with greater impact public health, not only because of its high prevalence, but, above all, by the consequences of the chronic complications arising from this disease. Hyperglycemia generates damage both in the field of microcirculation and the great vessels causing injury, macroangiopathies and microangiopathies. Macroangiopathies complications are generated from alterations or injury in the great vessels of the arterial to the most important, being from the clinical point of view, ischemic heart disease, disease stroke and peripheral arterial disease. Microangiopathies complications are due to alterations or injury of small vessels being the most important, from a clinical point of view, nephropathy, retinopathy and diabetic neuropathy. Macroangiopathies complications are generated from alterations or injury in the great vessels of the arterial to the most important, being from the clinical point of view, ischemic heart disease, disease stroke and peripheral arterial disease. Microangiopathies complications are due to alterations or injury of small vessels being the most important, from a clinical point of view, nephropathy, retinopathy and diabetic neuropathy.

Development of L2 Interactional Resources for Online Collaborative Task Accomplishment

ERIC Educational Resources Information Center

Balaman, Ufuk; Sert, Olcay

2017-01-01

Technology-mediated task environments have long been considered integral parts of L2 learning and teaching processes. However, the interactional resources that the learners deploy to complete tasks in these environments have remained largely unexplored due to an overall focus on task design and outcomes rather than task engagement processes. With…

Human task animation from performance models and natural language input

NASA Technical Reports Server (NTRS)

Esakov, Jeffrey; Badler, Norman I.; Jung, Moon

1989-01-01

Graphical manipulation of human figures is essential for certain types of human factors analyses such as reach, clearance, fit, and view. In many situations, however, the animation of simulated people performing various tasks may be based on more complicated functions involving multiple simultaneous reaches, critical timing, resource availability, and human performance capabilities. One rather effective means for creating such a simulation is through a natural language description of the tasks to be carried out. Given an anthropometrically-sized figure and a geometric workplace environment, various simple actions such as reach, turn, and view can be effectively controlled from language commands or standard NASA checklist procedures. The commands may also be generated by external simulation tools. Task timing is determined from actual performance models, if available, such as strength models or Fitts' Law. The resulting action specification are animated on a Silicon Graphics Iris workstation in real-time.

Providing surgical care in Somalia: A model of task shifting

PubMed Central

2011-01-01

Background Somalia is one of the most political unstable countries in the world. Ongoing insecurity has forced an inconsistent medical response by the international community, with little data collection. This paper describes the "remote" model of surgical care by Medecins Sans Frontieres, in Guri-El, Somalia. The challenges of providing the necessary prerequisites for safe surgery are discussed as well as the successes and limitations of task shifting in this resource-limited context. Methods In January 2006, MSF opened a project in Guri-El located between Mogadishu and Galcayo. The objectives were to reduce mortality due to complications of pregnancy and childbirth and from violent and non-violent trauma. At the start of the program, expatriate surgeons and anesthesiologists established safe surgical practices and performed surgical procedures. After January 2008, expatriates were evacuated due to insecurity and surgical care has been provided by local Somalian doctors and nurses with periodic supervisory visits from expatriate staff. Results Between October 2006 and December 2009, 2086 operations were performed on 1602 patients. The majority (1049, 65%) were male and the median age was 22 (interquartile range, 17-30). 1460 (70%) of interventions were emergent. Trauma accounted for 76% (1585) of all surgical pathology; gunshot wounds accounted for 89% (584) of violent injuries. Operative mortality (0.5% of all surgical interventions) was not higher when Somalian staff provided care compared to when expatriate surgeons and anesthesiologists. Conclusions The delivery of surgical care in any conflict-settings is difficult, but in situations where international support is limited, the challenges are more extreme. In this model, task shifting, or the provision of services by less trained cadres, was utilized and peri-operative mortality remained low demonstrating that safe surgical practices can be accomplished even without the presence of fully trained surgeon and anesthesiologists. If security improves in Somalia, on-site training by expatriate surgeons and anesthesiologists will be re-established. Until then, the best way MSF has found to support surgical care in Somalia is continue to support in a "remote" manner. PMID:21762491

Infective Endocarditis Complicated by Intraventricular Abscesses, Pericarditis, and Mycotic Aneurysm Due to an Emerging Strain of Serotype VI Streptococcus agalactiae.

PubMed

Hirai, Nobuyasu; Kasahara, Kei; Uno, Kenji; Ogawa, Yoshihiko; Ogawa, Taku; Yonekawa, Shinsuke; Nakano, Ryuichi; Yano, Hisakazu; Sakagami, Azusa; Uemura, Takayuki; Okura, Hiroyuki; Saito, Yoshihiko; Yoshikawa, Masahide; Mikasa, Keiichi

2017-11-22

An increasing number of invasive infections due to Streptococcus agalactiae in non-pregnant adults have been reported. We report a case of infective endocarditis complicated by intraventricular abscesses, pericarditis, and mycotic aneurysm due to S. agalactiae belonging to ST681 with a capsular serotype VI in a woman with diabetes. The patient also had a myocardial infarction and was treated with percutaneous coronary intervention, pericardiocentesis, and 6 weeks of antibiotic treatment. Invasive infections due to serotype VI S. agalactiae are common in Asian countries such as Taiwan and Japan, so continuous monitoring of invasive S. agalactiae strains is warranted.

Optical mapping of the brain activity in children with Down's syndrome

NASA Astrophysics Data System (ADS)

Yuan, Zhen; Lu, Fengmei

2018-02-01

Down's syndrome (DS) has been shown to be associated with many neurological complications, including cognitive deficits, seizures, early-onset dementia that resembles Alzheimer's disease, and neurological complications of systemic disorders. DS patients show to have poor performance in executive functions (EF) and fine motor skills. In this study, we examined the brain hemodynamic responses and brain activation patterns of DS children during the completion of EF tasks. Revealing its neural mechanism of DS is not only able to contribute to the early intervention of this children with DS, but also increase understanding of developmental cascades in childhood.

Nonsurgical management of complicated splenic rupture in infectious mononucleosis.

PubMed

Jenni, Fabienne; Lienhardt, Barbara; Fahrni, Gabriela; Yuen, Bernd

2013-07-01

We report on a 35-year-old man who presented to the emergency department with acute abdominal pain, postural hypotension, and tachycardia after having been diagnosed with Epstein-Barr virus infection 1 week before. Abdominal ultrasound and computed tomography revealed splenic rupture, and the patient underwent successful proximal angiographic embolization of the splenic artery. The course was complicated by painful splenic necrosis and respiratory insufficiency due to bilateral pleural effusions. Six weeks later, he additionally developed severe sepsis with Propionibacterium granulosum due to an intrasplenic infected hematoma, which required drainage. All complications were treated without surgical splenectomy, and the patient finally made a full recovery.

Healthcare and the Roles of the Medical Profession in the Big Data Era*1

PubMed Central

YAMAMOTO, Yuji

2016-01-01

The accumulation of large amounts of healthcare information is in progress, and society is about to enter the Health Big Data era by linking such data. Medical professionals’ daily tasks in clinical practice have become more complicated due to information overload, accelerated technological development, and the expansion of conceptual frameworks for medical care. Further, their responsibilities are more challenging and their workload is consistently increasing. As medical professionals enter the Health Big Data era, we need to reevaluate the fundamental significance and role of medicine and investigate ways to utilize this available information and technology. For example, a data analysis on diabetes patients has already shed light on the status of accessibility to physicians and the treatment response rate. In time, large amounts of health data will help find solutions including new effective treatment that could not be discovered by conventional means. Despite the vastness of accumulated data and analyses, their interpretation is necessarily conducted by attending physicians who communicate these findings to patients face to face; this task cannot be replaced by technology. As medical professionals, we must take the initiative to evaluate the framework of medicine in the Health Big Data era, study the ideal approach for clinical practitioners within this framework, and spread awareness to the public about our framework and approach while implementing them. PMID:28299246

Purtscher's retinopathy and renal cortical necrosis: two rare vaso-occlusive complications in a patient with acute pancreatitis: a case report.

PubMed

Haque, Wasim Md Mohosin Ul; Ananna, Mehruba Alam; Haque, Hasna Fahmima; Rahim, Muhammad Abdur; Samad, Tabassum; Iqbal, Sarwar

2016-11-15

Purtscher's retinopathy and renal cortical necrosis are two rare vaso-occlusive complications of acute pancreatitis. Purtscher's retinopathy causes sudden impairment of vision, which was first reported in a patient with head trauma. Subsequently, it was also reported as a complication of acute pancreatitis and few other clinical conditions. Acute pancreatitis also rarely causes renal cortical necrosis leading to acute kidney injury. However, the simultaneous presence of both complications is rarely reported. A 20-year-old Bengali man presented to our hospital with a history of acute upper abdominal pain, vomiting, anuria, and disorientation. He was ultimately found to have bilateral complete blindness due to Purtscher's retinopathy and acute kidney injury due to renal cortical necrosis, as sequelae of acute pancreatitis. He became dialysis-dependent, his vision did not recover, and he died 16 months after diagnosis. This case highlights Purtscher's retinopathy and renal cortical necrosis might be considered as a recognized pair complication of acute pancreatitis.

San Joaquin River Up-Stream DO TMDL Project Task 4: MonitoringStudy Interim Task Report #3

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

Stringfellow, William; Borglin, Sharon; Dahlgren, Randy

2007-03-30

The purpose of the Dissolved Oxygen Total Maximum Daily LoadProject (DO TMDLProject) is to provide a comprehensive understanding ofthe sources and fate of oxygen consuming materials in the San JoaquinRiver (SJR) watershed between Channel Point and Lander Avenue (upstreamSJR). When completed, this study will provide the stakeholders anunderstanding of the baseline conditions of the basin, provide input foran allocation decision, and provide the stakeholders with a tool formeasuring the impact of any waterquality management program that may beimplemented as part of the DO TMDL process. Previous studies haveidentified algal biomass as the most significant oxygen-demandingsubstance in the DO TMDL Projectmore » study-area between of Channel Point andLander Ave onthe SJR. Other oxygen-demanding substances found in theupstream SJR include ammonia and organic carbon from sources other thanalgae. The DO TMDL Project study-area contains municipalities, dairies,wetlands, cattle ranching, irrigated agriculture, and industries thatcould potentially contribute biochemical oxygen demand (BOD) to the SJR.This study is designed to discriminate between algal BOD and othersources of BOD throughout the entire upstream SJR watershed. Algalbiomass is not a conserved substance, but grows and decays in the SJR;hence, characterization of oxygen-demanding substances in the SJR isinherently complicated and requires an integrated effort of extensivemonitoring, scientific study, and modeling. In order to achieve projectobjectives, project activities were divided into a number of Tasks withspecific goals and objectives. In this report, we present the results ofmonitoring and research conducted under Task 4 of the DO TMDL Project.The major objective of Task 4 is to collect sufficient hydrologic (flow)and water quality (WQ) data to characterize the loading of algae, otheroxygen-demanding materials, and nutrients fromindividual tributaries andsub-watersheds of the upstream SJR between Mossdale and Lander Avenue.This data is specifically being collected to provide data for the Task 6Modeling effort. Task 4 provides input and calibration data for flow andWQ modeling associated with the low DO problems in the SJR watershed,including modeling on the linkage among nutrients, algae, and low DO.Task 4 is providing a higher volume of high quality and coherent data tothe modeling team than was available in the past for the upstream SJR.The monitoring and research activities under Task 4 are integrated withthe Modeling effort (Task 6) and are not designed to be a stand aloneprogram. Although, the majority of analysis of the Task 4 data isoccurring as part of the Task 6 Modeling program, analysis of Task 4 dataindependently of the modeling effort is also an important component ofthe DO TMDL Project effort. In this report, we present the results ofmonitoring and research conducted under Task 4. The major purposes ofthis report are to 1) document activities undertaken as part of theDOTMDL Project; 2) organize electronic data for delivery to Stateagencies, stakeholders and principal investigators (cooperators) on theDO TMDL Project; 3) provide a summary analysis of the data for referenceand to assist stakeholders in planning watershed activities inresponse tothe DO TMDL requirements; and 5) provide a preliminary scientificinterpretation independently of the Task 6 Modeling effort. Due to theextensive scope of theTask 4 portion of the DO TMDL Project, the Task 4March 2007 Interim Report is divided into a numbers of chapters andassociated appendixes designed to be able to stand1-3 independently ofeach other. The purpose of this chapter is to provide an overview of Task4 data collection and to explain the structure of the overallreport.« less

What is forest restoration?

Treesearch

John A. Stanturf

2005-01-01

The need to repair habitat and restore forest structure and funciton is recognized throughout the temperate and boreal zones as a component of sustainable forest management (Krishnaswamy and Hanson 1999; Dobson et al. 1997). Forest restoration is a complex task, complicated by diverse ecological and social conditions, that challenges our understanding of forest...

Visualizing Three-Dimensional Hybrid Atomic Orbitals Using Winplot: An Application for Student Self Instruction

ERIC Educational Resources Information Center

Saputra, Andrian; Canaval, Lorentz R.; Sunyono; Fadiawati, Noor; Diawati, Chansyanah; Setyorini, M.; Kadaritna, Nina; Kadaryanto, Budi

2015-01-01

Quick and real-time plotting equations using the Winplot software can be employed to create accurate hybrid atomic orbitals without complicated scripting. Performing this task on their own, students can more easily understand and remember hybrid atomic orbitals, in terms of shape and orientation.

A Diffusion Model Account of Normal and Impaired Readers

ERIC Educational Resources Information Center

Ratcliff, Roger; Perea, Manuel; Colangelo, Annette; Buchanan, Lori

2004-01-01

Acquired aphasics and dyslexics with even very profound word reading impairments have been shown to perform relatively well on the lexical decision task (e.g., Buchanan, Hildebrandt, & MacKinnon, 1999), but direct contrasts with unimpaired participant's data is often complicated by extremely long reaction times for patient data. The dissociation…

75 FR 24365 - National Physical Fitness and Sports Month, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... complications from conditions like heart disease, diabetes, and obesity, which are among our most costly and... generation, and America's epidemic of childhood obesity requires our immediate attention. The Department of... the White House Task Force on Childhood Obesity are partnering with First Lady Michelle Obama's ``Let...

The Empirical Nature and Statistical Treatment of Missing Data

ERIC Educational Resources Information Center

Tannenbaum, Christyn E.

2009-01-01

Introduction. Missing data is a common problem in research and can produce severely misleading analyses, including biased estimates of statistical parameters, and erroneous conclusions. In its 1999 report, the APA Task Force on Statistical Inference encouraged authors to report complications such as missing data and discouraged the use of…

Flipping Introduction to MIS for a Connected World

ERIC Educational Resources Information Center

Law, Wai K.

2014-01-01

It has been increasingly challenging to provide an introductory coverage of the rapidly expanding fields in Information Systems (IS). The task has been further complicated by the popularity of web resources and cloud services. A new generation of technically savvy learners, while recognizing the significance of information systems, expects…

Anesthetic management of a case of armored brain.

PubMed

Gupta, Surender Kumar; Pandia, Mihir Prakash

2015-01-01

Armored brain is condition, which occurs due to calcification in a chronic subdural hematoma (SDH). Here, we are reporting a case of armored brain due to chronic SDH as a complication of vetriculoperitoneal shunt (VP shunt). Patient had undergone major surgery for removal of calcified hematoma. VP shunt is a simple surgery, but can lead to catastrophic complications like this. In this report, we had described this condition and its aspects.

Effect of Traumatic Brain Injury Among U.S. Servicemembers with Amputation

DTIC Science & Technology

2013-01-01

than servicemembers without TBI (Table 6). For individ- ual complications, servicemembers with TBI had three times the odds of developing cellulitis ...number of other injuries; and (4) more postinjury complications, especially cellulitis , infection due to a device, or DVT and/or PE. Frequency of... Cellulitis Infection/Inflammation Due to Device Nonhealing Wound Pneumonia DVT and/or PE Bacterial Infection Anemia Phantom Limb Syndrome Amputation Residual

Spontaneous asymptomatic gallbladder perforation

PubMed Central

Seçil, Mustafa

2014-01-01

Gallstone disease is common. However, a proportion of patients are asymptomatic and remain undiagnosed until the occurrence of complications. Common complications include acute cholecystitis, biliary obstruction, acute pancreatitis and cholangitis. Severe complications include gallbladder perforation, Mirizzi syndrome and fistula formation are usually associated with significant morbidity and mortality. We report a case of asymptomatic spotaneous gallbladder perforation due to acute cholecystitis. PMID:24914424

Varicella complicated by scarlet fever.

PubMed

Yavuz, Taner; Parlak, Ali Haydar; Kocabay, Kenan

2003-10-01

We report a 3-year-old boy with varicella complicated by cellulitis and scarlet fever. He developed a typical rash of scarlet fever following the onset of varicella. Streptococcus pyogenes was isolated from the ulcers due to varicella. The present case suggests that scarlet fever may rarely develop following varicella and should be considered in children with complicated varicella.

Making progress with the automation of systematic reviews: principles of the International Collaboration for the Automation of Systematic Reviews (ICASR).

PubMed

Beller, Elaine; Clark, Justin; Tsafnat, Guy; Adams, Clive; Diehl, Heinz; Lund, Hans; Ouzzani, Mourad; Thayer, Kristina; Thomas, James; Turner, Tari; Xia, Jun; Robinson, Karen; Glasziou, Paul

2018-05-19

Systematic reviews (SR) are vital to health care, but have become complicated and time-consuming, due to the rapid expansion of evidence to be synthesised. Fortunately, many tasks of systematic reviews have the potential to be automated or may be assisted by automation. Recent advances in natural language processing, text mining and machine learning have produced new algorithms that can accurately mimic human endeavour in systematic review activity, faster and more cheaply. Automation tools need to be able to work together, to exchange data and results. Therefore, we initiated the International Collaboration for the Automation of Systematic Reviews (ICASR), to successfully put all the parts of automation of systematic review production together. The first meeting was held in Vienna in October 2015. We established a set of principles to enable tools to be developed and integrated into toolkits.This paper sets out the principles devised at that meeting, which cover the need for improvement in efficiency of SR tasks, automation across the spectrum of SR tasks, continuous improvement, adherence to high quality standards, flexibility of use and combining components, the need for a collaboration and varied skills, the desire for open source, shared code and evaluation, and a requirement for replicability through rigorous and open evaluation.Automation has a great potential to improve the speed of systematic reviews. Considerable work is already being done on many of the steps involved in a review. The 'Vienna Principles' set out in this paper aim to guide a more coordinated effort which will allow the integration of work by separate teams and build on the experience, code and evaluations done by the many teams working across the globe.

Method of synthesis of abstract images with high self-similarity

NASA Astrophysics Data System (ADS)

Matveev, Nikolay V.; Shcheglov, Sergey A.; Romanova, Galina E.; Koneva, Ð.¢atiana A.

2017-06-01

Abstract images with high self-similarity could be used for drug-free stress therapy. This based on the fact that a complex visual environment has a high affective appraisal. To create such an image we can use the setup based on the three laser sources of small power and different colors (Red, Green, Blue), the image is the pattern resulting from the reflecting and refracting by the complicated form object placed into the laser ray paths. The images were obtained experimentally which showed the good therapy effect. However, to find and to choose the object which gives needed image structure is very difficult and requires many trials. The goal of the work is to develop a method and a procedure of finding the object form which if placed into the ray paths can provide the necessary structure of the image In fact the task means obtaining the necessary irradiance distribution on the given surface. Traditionally such problems are solved using the non-imaging optics methods. In the given case this task is very complicated because of the complicated structure of the illuminance distribution and its high non-linearity. Alternative way is to use the projected image of a mask with a given structure. We consider both ways and discuss how they can help to speed up the synthesis procedure for the given abstract image of the high self-similarity for the setups of drug-free therapy.

Mecp2 truncation in male mice promotes affiliative social behavior

PubMed Central

Pearson, B.L.; Defensor, E.B.; Pobbe, R.L.H.; Yamamoto, L.H.L.; Bolivar, V.J.; Blanchard, D.C.; Blanchard, R.J.

2018-01-01

Mouse models of Rett syndrome, with targeted mutations in the Mecp2 gene, show a high degree of phenotypic consistency with the clinical syndrome. In addition to severe and age-specific regression in motor and cognitive abilities, a variety of studies have demonstrated that Mecp2 mutant mice display impaired social behavior. Conversely, other studies indicate complex enhancements of social behavior in Mecp2 mutant mice. Since social behavior is a complicated accumulation of constructs, we performed a series of classic and refined social behavior tasks and revealed a relatively consistent pattern of enhanced pro-social behavior in hypomorphic Mecp2308/Y mutant mice. Analyses of repetitive motor acts, and cognitive stereotypy did not reveal any profound differences due to genotype. Taken together, these results suggest that the mutations associated with Rett syndrome are not necessarily associated with autism-relevant social impairment in mice. However, this gene may be a valuable candidate for revealing basic mechanisms of affiliative behavior. PMID:21909962

Subrandom methods for multidimensional nonuniform sampling.

PubMed

Worley, Bradley

2016-08-01

Methods of nonuniform sampling that utilize pseudorandom number sequences to select points from a weighted Nyquist grid are commonplace in biomolecular NMR studies, due to the beneficial incoherence introduced by pseudorandom sampling. However, these methods require the specification of a non-arbitrary seed number in order to initialize a pseudorandom number generator. Because the performance of pseudorandom sampling schedules can substantially vary based on seed number, this can complicate the task of routine data collection. Approaches such as jittered sampling and stochastic gap sampling are effective at reducing random seed dependence of nonuniform sampling schedules, but still require the specification of a seed number. This work formalizes the use of subrandom number sequences in nonuniform sampling as a means of seed-independent sampling, and compares the performance of three subrandom methods to their pseudorandom counterparts using commonly applied schedule performance metrics. Reconstruction results using experimental datasets are also provided to validate claims made using these performance metrics. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality of Diagnosis and Treatment Plans After Using the 'Diagnostic Guideline for Anxiety and Challenging Behaviours' in People with Intellectual Disabilities: A Comparative Multiple Case Study Design.

PubMed

Pruijssers, Addy; van Meijel, Berno; Maaskant, Marian; Keeman, Noortje; van Achterberg, Theo

2016-07-01

People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. Working with the 'Diagnostic Guideline for Anxiety and CB' leads to improved diagnoses and treatment plans compared with care as usual. © 2015 John Wiley & Sons Ltd.

A Framework for the Development of Context-Adaptable User Interfaces for Ubiquitous Computing Systems

PubMed Central

Varela, Gervasio; Paz-Lopez, Alejandro; Becerra, Jose A.; Duro, Richard

2016-01-01

This paper addresses the problem of developing user interfaces for Ubiquitous Computing (UC) and Ambient Intelligence (AmI) systems. These kind of systems are expected to provide a natural user experience, considering interaction modalities adapted to the user abilities and preferences and using whatever interaction devices are present in the environment. These interaction devices are not necessarily known at design time. The task is quite complicated due to the variety of devices and technologies, and the diversity of scenarios, and it usually burdens the developer with the need to create many different UIs in order to consider the foreseeable user-environment combinations. Here, we propose an UI abstraction framework for UC and AmI systems that effectively improves the portability of those systems between different environments and for different users. It allows developers to design and implement a single UI capable of being deployed with different devices and modalities regardless the physical location. PMID:27399711

Bayesian analysis of longitudinal dyadic data with informative missing data using a dyadic shared-parameter model.

PubMed

Ahn, Jaeil; Morita, Satoshi; Wang, Wenyi; Yuan, Ying

2017-01-01

Analyzing longitudinal dyadic data is a challenging task due to the complicated correlations from repeated measurements and within-dyad interdependence, as well as potentially informative (or non-ignorable) missing data. We propose a dyadic shared-parameter model to analyze longitudinal dyadic data with ordinal outcomes and informative intermittent missing data and dropouts. We model the longitudinal measurement process using a proportional odds model, which accommodates the within-dyad interdependence using the concept of the actor-partner interdependence effects, as well as dyad-specific random effects. We model informative dropouts and intermittent missing data using a transition model, which shares the same set of random effects as the longitudinal measurement model. We evaluate the performance of the proposed method through extensive simulation studies. As our approach relies on some untestable assumptions on the missing data mechanism, we perform sensitivity analyses to evaluate how the analysis results change when the missing data mechanism is misspecified. We demonstrate our method using a longitudinal dyadic study of metastatic breast cancer.

Automated processing for proton spectroscopic imaging using water reference deconvolution.

PubMed

Maudsley, A A; Wu, Z; Meyerhoff, D J; Weiner, M W

1994-06-01

Automated formation of MR spectroscopic images (MRSI) is necessary before routine application of these methods is possible for in vivo studies; however, this task is complicated by the presence of spatially dependent instrumental distortions and the complex nature of the MR spectrum. A data processing method is presented for completely automated formation of in vivo proton spectroscopic images, and applied for analysis of human brain metabolites. This procedure uses the water reference deconvolution method (G. A. Morris, J. Magn. Reson. 80, 547(1988)) to correct for line shape distortions caused by instrumental and sample characteristics, followed by parametric spectral analysis. Results for automated image formation were found to compare favorably with operator dependent spectral integration methods. While the water reference deconvolution processing was found to provide good correction of spatially dependent resonance frequency shifts, it was found to be susceptible to errors for correction of line shape distortions. These occur due to differences between the water reference and the metabolite distributions.

A combined method for correlative 3D imaging of biological samples from macro to nano scale

NASA Astrophysics Data System (ADS)

Kellner, Manuela; Heidrich, Marko; Lorbeer, Raoul-Amadeus; Antonopoulos, Georgios C.; Knudsen, Lars; Wrede, Christoph; Izykowski, Nicole; Grothausmann, Roman; Jonigk, Danny; Ochs, Matthias; Ripken, Tammo; Kühnel, Mark P.; Meyer, Heiko

2016-10-01

Correlative analysis requires examination of a specimen from macro to nano scale as well as applicability of analytical methods ranging from morphological to molecular. Accomplishing this with one and the same sample is laborious at best, due to deformation and biodegradation during measurements or intermediary preparation steps. Furthermore, data alignment using differing imaging techniques turns out to be a complex task, which considerably complicates the interconnection of results. We present correlative imaging of the accessory rat lung lobe by combining a modified Scanning Laser Optical Tomography (SLOT) setup with a specially developed sample preparation method (CRISTAL). CRISTAL is a resin-based embedding method that optically clears the specimen while allowing sectioning and preventing degradation. We applied and correlated SLOT with Multi Photon Microscopy, histological and immunofluorescence analysis as well as Transmission Electron Microscopy, all in the same sample. Thus, combining CRISTAL with SLOT enables the correlative utilization of a vast variety of imaging techniques.

A visual tracking method based on improved online multiple instance learning

NASA Astrophysics Data System (ADS)

He, Xianhui; Wei, Yuxing

2016-09-01

Visual tracking is an active research topic in the field of computer vision and has been well studied in the last decades. The method based on multiple instance learning (MIL) was recently introduced into the tracking task, which can solve the problem that template drift well. However, MIL method has relatively poor performance in running efficiency and accuracy, due to its strong classifiers updating strategy is complicated, and the speed of the classifiers update is not always same with the change of the targets' appearance. In this paper, we present a novel online effective MIL (EMIL) tracker. A new update strategy for strong classifier was proposed to improve the running efficiency of MIL method. In addition, to improve the t racking accuracy and stability of the MIL method, a new dynamic mechanism for learning rate renewal of the classifier and variable search window were proposed. Experimental results show that our method performs good performance under the complex scenes, with strong stability and high efficiency.

Double-Pedicled Free Deep Inferior Epigastric Perforator Flap for the Coverage of Thigh Soft-Tissue Defect.

PubMed

Bota, Olimpiu; Spindler, Nick; Sauber, Jeannine; Aydogan, Emrah; Langer, Stefan

2017-08-01

Soft-tissue defects caused by radiation injury are a challenging task for the reconstructive surgeon, due to the extent of the soft-tissue damage and the associated injuries of the local blood vessels and bone tissue. We present the application of the versatile deep inferior epigastric perforator (DIEP) flap for the coverage of an extended lateral thigh soft-tissue defect after the surgical resection of an undifferentiated pleomorphic high-grade sarcoma, neoadjuvant chemotherapy, and adjuvant chemo- and radiotherapy. A double-pedicled free DIEP flap (756 cm 2 ) was harvested and anastomosed to the transverse branch of the lateral femoral circumflex artery and a lateral branch of the popliteal artery (P1). The flap survived completely without serious complications, and the patient was able to walk with crutches 3 months postoperatively. This is the first case report of a free bipedicled DIEP flap for the coverage of a thigh defect in a male patient.

Double-Pedicled Free Deep Inferior Epigastric Perforator Flap for the Coverage of Thigh Soft-Tissue Defect

PubMed Central

Spindler, Nick; Sauber, Jeannine; Aydogan, Emrah; Langer, Stefan

2017-01-01

Summary: Soft-tissue defects caused by radiation injury are a challenging task for the reconstructive surgeon, due to the extent of the soft-tissue damage and the associated injuries of the local blood vessels and bone tissue. We present the application of the versatile deep inferior epigastric perforator (DIEP) flap for the coverage of an extended lateral thigh soft-tissue defect after the surgical resection of an undifferentiated pleomorphic high-grade sarcoma, neoadjuvant chemotherapy, and adjuvant chemo- and radiotherapy. A double-pedicled free DIEP flap (756 cm2) was harvested and anastomosed to the transverse branch of the lateral femoral circumflex artery and a lateral branch of the popliteal artery (P1). The flap survived completely without serious complications, and the patient was able to walk with crutches 3 months postoperatively. This is the first case report of a free bipedicled DIEP flap for the coverage of a thigh defect in a male patient. PMID:28894652

A Study of Plazomicin Compared With Colistin in Patients With Infection Due to Carbapenem-Resistant Enterobacteriaceae (CRE)

ClinicalTrials.gov

2016-10-03

Bloodstream Infections (BSI) Due to CRE; Hospital-Acquired Bacterial Pneumonia (HABP) Due to CRE; Ventilator-Associated Bacterial Pneumonia (VABP) Due to CRE; Complicated Urinary Tract Infection (cUTI) Due to CRE; Acute Pyelonephritis (AP) Due to CRE

The management of vertebral artery injury in anterior cervical spine operation: a systematic review of published cases.

PubMed

Park, Hyung-Ki; Jho, Hae-Dong

2012-12-01

Anterior cervical spine operations (ACSO) are generally considered to be safe and effective, but the vertebral artery (VA) is at risk during the procedure. Because the consequences of VA injury can be catastrophic, properly managing a VA injury is very important. However, due to the rarity of these injuries, there is no agreed upon treatment strategy. Studies were identified for inclusion in the review via sensitive searches of electronic databases through 31 December 2011. All cases included in the review were qualitatively analyzed to explore the relationship between type of VA injury management and neurological complications. Seventeen articles describing 39 cases of VA injury during ACSO were included in this study. Seven patients (17.9 %) had neurological complications followed by VA insufficiency. Two patients (5.1 %) had root damage due to ligation. One case (2.6 %) resulted in intraoperative death due to fatal bleeding. Delayed vascular complications were identified in nine (45.0 %) of the 20 patients that underwent only tamponade or hemostatic agent during the operation. Four patients underwent intraoperative endovascular treatment, and three of these patients had a cerebral infarction. All three patients who underwent clipping also had neurological complications. The five patients treated by direct repair did not have any complications. Our review suggests the management of VA injury should be considered in order listed: (1) performing tamponade with a hemostatic agent, (2) direct repair, (3) postoperative endovascular procedures to prevent delayed complications. If tamponade fails to achieve proper hemostasis, additional procedures as endovascular embolization, clipping and ligation should be considered but carry the risk of neurological complications. Because of the limitations of this review, further studies are recommended with larger sample sizes.

Outcomes of Retreatment after Aborted Laser In Situ Keratomileusis due to Flap Complications.

PubMed

Al-Mezaine, Hani S; Al-Amro, Saleh A; Al-Fadda, Abdulaziz; Al-Obeidan, Saleh

2011-07-01

To determine the refractive outcomes and complications of retreatment after aborted primary laser in situ keratomileusis (LASIK) due to flap complications. This retrospective study evaluated 50 retreated eyes that had flap complications during primary LASIK at the Eye Consultants Center in Riyadh, Saudi Arabia. Data were analyzed for patients with at least 3 months follow-up post retreatment. Thirty-three eyes of 31 consecutive patients with 3 months follow-up or later post retreatment were included. The primary LASIK was aborted due to incomplete flaps in 22 eyes (66.7%), buttonhole flaps in 7 eyes (21.2%), free partial flaps in 3 eyes (9.1%), and a free complete flap in 1 eye (3.0%). Twenty-two eyes (66.7%) were retreated with LASIK, and 11 eyes (33.3%) were retreated with surface ablation. The mean spherical equivalent (SE) was -0.23 ± 0.72 D, the mean astigmatism was -0.65 ± 0.89 D, and the mean loss of the best corrected visual acuity (BCVA) was 0.78 lines at the final postoperative visit. At the last postoperative visit, 20/30 or better BCVA was achieved in 90.1% of eyes that underwent retreatment with LASIK and in 91% of eyes that were retreated with surface ablation. There was no statistical difference in postoperative SE between eyes retreated with LASIK and eyes retreated with surface ablation (P = 0.610). There was no statistical difference in postoperative BCVA between eyes retreated with LASIK and those retreated with surface ablation (P = 0.756). There were no intraoperative complications and no eyes required a second retreatment. Creation of a flap after a previous intraoperative flap complication was not associated with any complications. The refractive outcomes of retreatment with LASIK or surface ablation were comparable and reasonably favorable.

Global complication rates of type 2 diabetes in Indigenous peoples: A comprehensive review.

PubMed

Naqshbandi, Mariam; Harris, Stewart B; Esler, James G; Antwi-Nsiah, Fred

2008-10-01

The world's Indigenous peoples are experiencing an unprecedented epidemic of type 2 diabetes [T2DM] but little has been published describing the complications burden. The objective of this paper was to conduct a systematic review of T2DM complications in Indigenous populations worldwide. A literature review was conducted using PubMed and EMBASE to examine available complications data. Country, Indigenous population, authors, publication year, total sample size, Indigenous sample size, age, methodology, and prevalence of nephropathy, end-stage renal disease, retinopathy, neuropathy, lower extremity amputations, cardiovascular disease, hospitalizations and mortality due to diabetes were recorded. One-hundred and eleven studies were selected. Results revealed a disproportionate burden of disease complications among all Indigenous peoples regardless of their geographic location. Complication rates were seen to vary widely across Indigenous groups. Gaps were found in the published literature on complications among Indigenous populations, especially those living in underdeveloped countries. These gaps may be in part due to the challenges caused by varying operational practices, research methodologies, and definitions of the term Indigenous, making documentation of rates among these peoples problematic. Comprehensive surveillance applying standardized definitions and methodologies is needed to design targeted prevention and disease management strategies for Indigenous peoples with T2DM.

The impact of parental divorce for adolescents: a consideration of intervention beyond the crisis.

PubMed

Steinman, S; Petersen, V

2001-10-01

The effects of divorce on children and adolescents remain a major public health issue. Over the last three decades, there has been ongoing debate among researchers and mental health and legal professionals who counsel divorcing families as to whether the effects are acute but time-limited or more enduring. This chapter looks at the tasks of normal adolescent psychosocial development and how divorce complicates those tasks. It suggests ways that pediatricians and other health professionals can intervene effectively with divorcing families within the context of their role. Divorce-specific resources and services are explained.

Anesthetic management of a case of armored brain

PubMed Central

Gupta, Surender Kumar; Pandia, Mihir Prakash

2015-01-01

Armored brain is condition, which occurs due to calcification in a chronic subdural hematoma (SDH). Here, we are reporting a case of armored brain due to chronic SDH as a complication of vetriculoperitoneal shunt (VP shunt). Patient had undergone major surgery for removal of calcified hematoma. VP shunt is a simple surgery, but can lead to catastrophic complications like this. In this report, we had described this condition and its aspects. PMID:25558206

Assessing performance in complex team environments.

PubMed

Whitmore, Jeffrey N

2005-07-01

This paper provides a brief introduction to team performance assessment. It highlights some critical aspects leading to the successful measurement of team performance in realistic console operations; discusses the idea of process and outcome measures; presents two types of team data collection systems; and provides an example of team performance assessment. Team performance assessment is a complicated endeavor relative to assessing individual performance. Assessing team performance necessitates a clear understanding of each operator's task, both at the individual and team level, and requires planning for efficient data capture and analysis. Though team performance assessment requires considerable effort, the results can be very worthwhile. Most tasks performed in Command and Control environments are team tasks, and understanding this type of performance is becoming increasingly important to the evaluation of mission success and for overall system optimization.

Gamification of Clinical Routine: The Dr. Fill Approach.

PubMed

Bukowski, Mark; Kühn, Martin; Zhao, Xiaoqing; Bettermann, Ralf; Jonas, Stephan

2016-01-01

Gamification is used in clinical context in the health care education. Furthermore, it has shown great promises to improve the performance of the health care staff in their daily routine. In this work we focus on the medication sorting task, which is performed manually in hospitals. This task is very error prone and needs to be performed daily. Nevertheless, errors in the medication are crucial and lead to serious complications. In this work we present a real world gamification approach of the medication sorting task in a patient's daily pill organizer. The player of the game needs to sort the correct medication into the correct dispenser slots and is rewarded or punished in real time. At the end of the game, a score is given and the user can register in a leaderboard.

Vascular Ehlers-Danlos Syndrome With a Novel Missense COL3A1 Mutation Present With Pulmonary Complications and Iliac Arterial Dissection.

PubMed

Gu, Guangchao; Yang, Hang; Cui, Lijia; Fu, Yuanyuan; Li, Fangda; Zhou, Zhou; Zheng, Yuehong

2018-02-01

Vascular Ehlers-Danlos syndrome (vEDS) is a life-threatening connective tissue disorder due to its high tendency of arterial and organ rupture. Pulmonary complications in vEDS are rare. We present a young male patient with vEDS who developed severe pulmonary complications and severe rupture of the iliac artery at different stages of his life. Vascular Ehlers-Danlos syndrome was diagnosed based on clinical manifestations and confirmed by the identification of COL3A1 gene mutation. Due to high bleeding tendency and weak cardiopulmonary capacity, conservative treatment was taken for him. To our knowledge, this is the first report of vEDS case in which the patient developed both pulmonary complications and dissection of large arteries. Our report emphasizes the importance of considering vEDS when an adolescent develops unexplained pulmonary cysts with fragility of lung tissues. Genetic counseling and close monitoring should be performed for earlier diagnosis and prevention of severe complications of large arteries. The typical presentations of vEDS were also discussed by means of a review of case reports on vEDS with pulmonary complications.

[Severe generalized dystonia due to postradiotherapy cerebral calcifications].

PubMed

Chanson, J-B; Anheim, M; Lagha-Boukbiza, O; Fleury, M; Sellal, F; Tranchant, C

2008-05-01

Cerebral calcifications are a cause of secondary dystonia and may be an uncommon complication of radiotherapy. We report a very severe case of generalized dystonia due to postradiotherapy basal ganglia calcifications. An 8-year-old girl received 53 grays radiotherapy after surgery for craniopharyngioma. One year later she developed generalized dystonia. Computed tomography showed bilateral basal ganglia calcifications, especially of the lenticular nuclei. Pharmacological treatment with tetrabenazine, clonazepam and trihexiphenydile allowed a very limited improvement of dystonia; the course was complicated by dystonic storms and decompensations resulting from the iatrogenous panhypopituitarism. This case illustrates a severe complication of cranial irradiation which should be considered in the indications of this treatment, especially for children.

Technical complications of implant-causes and management: A comprehensive review

PubMed Central

Gupta, Swati; Gupta, Hemant; Tandan, Amrit

2015-01-01

Given the increasing popularity of dental implants, the number of failures due to late implant fracture is also expected to increase. Hence, the scope for prevention and management needs to be emphasized. The objective of this review article is to analyze the various causes of failure of dental implants due to implant fixture/abutment screw fractures and also to enumerate the management and the preventive options for these failures, thereby aiming to help the clinicians to properly plan the implant-supported prosthesis treatment by considering the important biomechanical aspects of this type of rehabilitation. The present review emphasizes the causes and management of technical complications and not the incidence of such complications. PMID:26668445

Training for Fluency and Generalization of Math Facts Using Technology

ERIC Educational Resources Information Center

Musti-Rao, Shobana; Lynch, Tom Liam; Plati, Erin

2015-01-01

As American students struggle with basic mathematical skills, the importance of math fact fluency has gained the attention of educators and researchers. Generalization of math fact fluency is also important for the transfer of skills to other settings and formats, assisting students in the completion of more varied and complicated math tasks. This…

Effectiveness of Partner Social Support Predicts Enduring Psychological Distress after Hematopoietic Stem Cell Transplantation

ERIC Educational Resources Information Center

Rini, Christine; Redd, William H.; Austin, Jane; Mosher, Catherine E.; Meschian, Yeraz Markarian; Isola, Luis; Scigliano, Eileen; Moskowitz, Craig H.; Papadopoulos, Esperanza; Labay, Larissa E.; Rowley, Scott; Burkhalter, Jack E.; Schetter, Christine Dunkel; DuHamel, Katherine N.

2011-01-01

Objective: Hematopoietic stem cell transplant (HSCT) survivors who are 1 to 3 years posttransplant are challenged by the need to resume valued social roles and activities--a task that may be complicated by enduring transplant-related psychological distress common in this patient population. The present study investigated whether transplant…

Trauma and Early Adolescent Development: Case Examples from a Trauma-Informed Public Health Middle School Program

ERIC Educational Resources Information Center

Frydman, Jason Scott; Mayor, Christine

2017-01-01

Middle-school-age children are faced with a variety of developmental tasks, including the beginning phases of individuation from the family, building peer groups, social and emotional transitions, and cognitive shifts associated with the maturation process. This article summarizes how traumatic events impair and complicate these developmental…

Back to Work: A Guide for Expectant and New Working Parents.

ERIC Educational Resources Information Center

O'Brien, Mary Parys

This guide for expectant and new working parents addresses practical and emotional issues that complicate the task of balancing work and family. Chapter 1, which addresses maternity and paternity leave, and the Pregnancy Disability Act, provides information regarding preparation for maternity leave after childbirth. Included are a worksheet to aid…

Tracking Hazard Analysis Data in a Jungle of Changing Design

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

Sullivan, Robin S.; Young, Jonathan

2006-05-16

Tracking hazard analysis data during the 'life cycle' of a project can be an extremely complicated task. However, a few simple rules, used consistently, can give you the edge that will save countless headaches and provide the information that will help integrate the hazard analysis and design activities even if performed in parallel.

62P-165

NASA Image and Video Library

1962-10-18

The Atlas-Agena B space Vehicle waits on the launch pad to launch the National Aeronautics and Space Administration’s Ranger V Spacecraft on a 66 – 62 hour journey to the moon. Ranger V is a 735-pound gold and chrome Plated payload designed to perform a series of complicated tasks, including taking television pictures of the lunar surface.

Succeeding in the City: Challenges and Best Practices on Urban Commuter Campuses

ERIC Educational Resources Information Center

Clark, Marcia Roe

2006-01-01

The work of helping students succeed on urban commuter campuses may be some of the most complicated in higher education. Even in understanding their tasks, educators at city-based institutions must typically draw on research and practice from an amalgam of other types of institutions, including community colleges, metropolitan universities, urban…

The Magnitude Response Learning Tool for DSP Education: A Case Study

ERIC Educational Resources Information Center

Kulmer, Florian; Wurzer, Christian Gun; Geiger, Bernhard C.

2016-01-01

Many concepts in digital signal processing are intuitive, despite being mathematically challenging. The lecturer not only has to teach the complicated math but should also help students develop intuition about the concept. To aid the lecturer in this task, the Magnitude Response Learning Tool has been introduced, a computer-based learning game…

Choosing Selves: The Salience of Parental Identity in the School Choice Process

ERIC Educational Resources Information Center

Cucchiara, Maia Bloomfield; Horvat, Erin McNamara

2014-01-01

With the proliferation of choice policies in education, parents are increasingly positioned as "consumers" tasked with choosing the "best" school for their children. Yet a large body of research has shown that the process of selecting a school is far more complicated than policy-makers and researchers often predict. This…

Using a Group Approach to Motivate Adults to Learn Braille

ERIC Educational Resources Information Center

Farrow, Kendra R.

2015-01-01

Teaching braille is one of the most time-consuming tasks for a vision rehabilitation therapist. Complicating this process, adults who might be considered to be good candidates for learning braille are often resistant to the idea (Ponchillia & Ponchillia, 1996). In an attempt to address these challenges, a combination of correspondence braille…

Cable Television: Technical Considerations in Franchising Major Market Systems.

ERIC Educational Resources Information Center

Pilnick, Carl

The 1972 Federal Communications Commission's (FCC) regulations on cable television were intended to assist the penetration of cable television into the large metropolitan regions of the United States. In these major market areas, the task for developing an appropriate franchise is complicated by the changing functional nature of the cable systems…

A Low-Cost EEG System-Based Hybrid Brain-Computer Interface for Humanoid Robot Navigation and Recognition

PubMed Central

Choi, Bongjae; Jo, Sungho

2013-01-01

This paper describes a hybrid brain-computer interface (BCI) technique that combines the P300 potential, the steady state visually evoked potential (SSVEP), and event related de-synchronization (ERD) to solve a complicated multi-task problem consisting of humanoid robot navigation and control along with object recognition using a low-cost BCI system. Our approach enables subjects to control the navigation and exploration of a humanoid robot and recognize a desired object among candidates. This study aims to demonstrate the possibility of a hybrid BCI based on a low-cost system for a realistic and complex task. It also shows that the use of a simple image processing technique, combined with BCI, can further aid in making these complex tasks simpler. An experimental scenario is proposed in which a subject remotely controls a humanoid robot in a properly sized maze. The subject sees what the surrogate robot sees through visual feedback and can navigate the surrogate robot. While navigating, the robot encounters objects located in the maze. It then recognizes if the encountered object is of interest to the subject. The subject communicates with the robot through SSVEP and ERD-based BCIs to navigate and explore with the robot, and P300-based BCI to allow the surrogate robot recognize their favorites. Using several evaluation metrics, the performances of five subjects navigating the robot were quite comparable to manual keyboard control. During object recognition mode, favorite objects were successfully selected from two to four choices. Subjects conducted humanoid navigation and recognition tasks as if they embodied the robot. Analysis of the data supports the potential usefulness of the proposed hybrid BCI system for extended applications. This work presents an important implication for the future work that a hybridization of simple BCI protocols provide extended controllability to carry out complicated tasks even with a low-cost system. PMID:24023953

A low-cost EEG system-based hybrid brain-computer interface for humanoid robot navigation and recognition.

PubMed

Choi, Bongjae; Jo, Sungho

2013-01-01

This paper describes a hybrid brain-computer interface (BCI) technique that combines the P300 potential, the steady state visually evoked potential (SSVEP), and event related de-synchronization (ERD) to solve a complicated multi-task problem consisting of humanoid robot navigation and control along with object recognition using a low-cost BCI system. Our approach enables subjects to control the navigation and exploration of a humanoid robot and recognize a desired object among candidates. This study aims to demonstrate the possibility of a hybrid BCI based on a low-cost system for a realistic and complex task. It also shows that the use of a simple image processing technique, combined with BCI, can further aid in making these complex tasks simpler. An experimental scenario is proposed in which a subject remotely controls a humanoid robot in a properly sized maze. The subject sees what the surrogate robot sees through visual feedback and can navigate the surrogate robot. While navigating, the robot encounters objects located in the maze. It then recognizes if the encountered object is of interest to the subject. The subject communicates with the robot through SSVEP and ERD-based BCIs to navigate and explore with the robot, and P300-based BCI to allow the surrogate robot recognize their favorites. Using several evaluation metrics, the performances of five subjects navigating the robot were quite comparable to manual keyboard control. During object recognition mode, favorite objects were successfully selected from two to four choices. Subjects conducted humanoid navigation and recognition tasks as if they embodied the robot. Analysis of the data supports the potential usefulness of the proposed hybrid BCI system for extended applications. This work presents an important implication for the future work that a hybridization of simple BCI protocols provide extended controllability to carry out complicated tasks even with a low-cost system.

Surgical Complications in En Bloc Renal Transplantation.

PubMed

Moreno de la Higuera Díaz, M A; Calvo Romero, N; Pérez-Flores, I; Calvo Arévalo, M; Rodríguez Cubillo, B; Shabaka, A; López de la Manzanara, V; Gómez Vegas, Á; Blázquez Izquierdo, J; Sánchez-Fructuoso, A I

2016-11-01

En bloc pediatric transplantation (EBPT) began with the aim of increasing the donor pool due to the existing high demand for donors. At its inception, it was considered a type of suboptimal transplantation due to its association with a high incidence of vascular, urologic, and immunologic complications. The main objective of this study was to update information on EBPT with the largest case series that exists on a worldwide scale. In a retrospective study, the results obtained from brain-dead donors (BDDs; n = 770) were compared to those of EBPT (n = 100) from January 1990 to December 2012. The median of follow-up was 12.8 years (interquartile range 8.1 to 17.2). The variables collected for analysis were demographic factors (age and sex of recipients, age and weight of donors), renal function, graft survival, recipient survival, surgical complications (thrombosis, lymphocele, urologic complications, and renal artery stenosis and need for revascularization with angioplasty and/or stents). Subsequently in a second analysis, we studied the association between graft survival, thrombosis, angioplasty, stents, and appearance of lymphoceles with the different factors that were considered to be related in accordance with published literature and our own experience. Graft loss due to surgical complications was more frequent in EBPT than in BDD (15% vs 2.2 % in BDD; P < .001), and interstitial fibrosis and tubular atrophy were more frequent in BDD (13% vs 2%; P < .001). EBPT offers a good survival rate after overcoming the possible surgical complications that may arise. Copyright © 2016 Elsevier Inc. All rights reserved.

User-friendly program for multitask analysis

NASA Astrophysics Data System (ADS)

Caporali, Sergio A.; Akladios, Magdy; Becker, Paul E.

2000-10-01

Research on lifting activities has led to the design of several useful tools for evaluating tasks that involve lifting and material handling. The National Institute for Occupational Safety and Health (NIOSH) has developed a single task lifting equation. This formula has been frequently used as a guide in the field of ergonomics and material handling. While being much more complicated, the multi-task formula will provide a more realistic analysis for the evaluation of lifting and material handling jobs. A user friendly tool has been developed to assist professionals in the field of ergonomics in analyzing multitask types of material handling jobs. The program allows for up to 10 different tasks to be evaluated. The program requires a basic understanding of the NIOSH lifting guidelines and the six multipliers that are involved in the analysis of each single task. These multipliers are: Horizontal Distance Multiplier (HM), Vertical Distance Multiplier (VM), Vertical Displacement Multiplier (DM), Frequency of lifting Multiplier (FM), Coupling Multiplier (CM), and the Asymmetry Multiplier (AM). Once a given job is analyzed, a researched list of recommendations is provided to the user in an attempt to reduce the potential risk factors that are associated with each task.

[Psychological perspectives of abortion care -- when, what and how can psychotherapeutic assistance help during pregnancy termination].

PubMed

Sz Makó, Hajnalka

2014-01-01

Research data on the psychological consequences of induced abortion show that almost 20 per cent of women are affected by related, long term psychological complications such as anxiety disorders, depression and PTSD. The aim of this review is to summarise support possibilities which are significant to prevent recurrent abortions and psychiatric problems following surgical interventions. Besides acute crisis management, the primary tasks of psychological interventions must also include screening women at high risk of later psychological problems and recurring abortions, supporting bereavement work when experience of loss emerges; as well as professional psychotherapeutic assistance in cases of complicated grief.

Case report: perinephric-splenic fistula--a complication of percutaneous perinephric abscess drainage.

PubMed

Stewart, I E; Borland, C

1994-09-01

A case of acute perinephric abscess due to chronic parenchymal disease and calculi is presented. During percutaneous drainage a reno-splenic vein communication developed acutely. The aetiology and treatment complications of perinephric abscesses are reviewed.

Study of Hydatidosis-Attributed Mortality in Endemic Area

PubMed Central

Belhassen-García, Moncef; Romero-Alegria, Angela; Velasco-Tirado, Virginia; Alonso-Sardón, Montserrat; Lopez-Bernus, Amparo; Alvela-Suarez, Lucia; del Villar, Luis Perez; Carpio-Perez, Adela; Galindo-Perez, Inmaculada; Cordero-Sanchez, Miguel; Pardo-Lledias, Javier

2014-01-01

Background Cystic hydatid disease is still an important health problem in European Mediterranean areas. In spite of being traditionally considered as a “benign” pathology, cystic echinococcosis is an important cause of morbidity in these areas. Nevertheless, there are few analyses of mortality attributed to human hydatidosis. Objective To describe the epidemiology, the mortality rate and the causes of mortality due to E. granulosus infection in an endemic area. Methodology A retrospective study followed up over a period of 14 years (1998–2011). Principal Findings Of the 567 patients diagnosed with hydatid disease over the period 1998–2011, eleven deaths directly related to hydatid disease complications were recorded. Ten patients (90.9%) died due to infectious complications and the remaining one (9.1%) died due to mechanical complications after a massive hemoptysis. We registered a case fatality rate of 1.94% and a mortality rate of 3.1 per 100.000 inhabitants. Conclusions Hydatidosis is still a frequent parasitic disease that causes a considerable mortality. The main causes of mortality in patients with hydatidosis are complications related to the rupture of CE cysts with supurative collangitis. Therefore, an expectant management can be dangerous and it must be only employed in well-selected patients. PMID:24632824

Human-Robot Cooperation with Commands Embedded in Actions

NASA Astrophysics Data System (ADS)

Kobayashi, Kazuki; Yamada, Seiji

In this paper, we first propose a novel interaction model, CEA (Commands Embedded in Actions). It can explain the way how some existing systems reduce the work-load of their user. We next extend the CEA and build ECEA (Extended CEA) model. The ECEA enables robots to achieve more complicated tasks. On this extension, we employ ACS (Action Coding System) which can describe segmented human acts and clarifies the relationship between user's actions and robot's actions in a task. The ACS utilizes the CEA's strong point which enables a user to send a command to a robot by his/her natural action for the task. The instance of the ECEA led by using the ACS is a temporal extension which has the user keep a final state of a previous his/her action. We apply the temporal extension of the ECEA for a sweeping task. The high-level task, a cooperative task between the user and the robot can be realized. The robot with simple reactive behavior can sweep the region of under an object when the user picks up the object. In addition, we measure user's cognitive loads on the ECEA and a traditional method, DCM (Direct Commanding Method) in the sweeping task, and compare between them. The results show that the ECEA has a lower cognitive load than the DCM significantly.

Visual Prognosis and Ocular Complications in Herpetic versus HLA-B27- or Ankylosing Spondylitis-associated Anterior Uveitis.

PubMed

Hoeksema, Lisette; Los, Leonoor I

2016-06-01

To investigate the visual prognosis and ocular complications in patients with herpetic versus HLA-B27 associated anterior uveitis (AU). This was a retrospective, observational study conducted at the ophthalmology department of the University Medical Center of Groningen. Sixty-two herpetic and 113 HLA-B27-associated AU patients were included. The main outcome measures were visual acuity and ocular complications. Visual acuity over time was significantly lower in herpetic as compared to HLA-B27 AU, mainly due to corneal scarring. The incidence rate of any ocular complication was higher in herpetic AU compared to HLA-B27-associated AU (0.140/EY versus 0.076/EY, p = <0.001), which was mainly due to glaucoma (0.033/EY versus 0.004/EY, p < 0.001) and cataract (0.059/EY versus 0.023/EY, p < 0.001). The most prominent finding was a worse visual prognosis in herpetic AU, which is probably related to higher prevalence of corneal scarring and glaucoma. In addition, herpetic AU patients have more ocular complications overall.

Acute demyelinating encephalomyelitis due to neural antirabies vaccine.

PubMed

Shah, Ira

2008-01-01

Rabies is highly endemic in India and seen with dog bites from rabid dogs. In India, nervous tissue vaccine is commonly used as it is inexpensive and freely available despite frequent neurological complications. Neurological complications seen with traditional vaccine are morbid and the medical community should switch over to the cell culture rabies vaccine in spite of the expense to prevent these complications with rabies vaccine.

Temporal trends of in-hospital complications associated with catheter ablation of atrial fibrillation in the United States: An update from Nationwide Inpatient Sample database (2011-2014).

PubMed

Tripathi, Byomesh; Arora, Shilpkumar; Kumar, Varun; Abdelrahman, Mohamed; Lahewala, Sopan; Dave, Mihir; Shah, Mahek; Tan, Bryan; Savani, Sejal; Badheka, Apurva; Gopalan, Radha; Shantha, Ghanshyam Palamaner Subash; Viles-Gonzalez, Juan; Deshmukh, Abhishek

2018-05-01

Catheter ablation is widely accepted intervention for atrial fibrillation (AF) refractory to antiarrhythmic drugs, but limited data are available regarding contemporary trends in major complications and in-hospital mortality due to the procedure. This study was aimed at exploring the temporal trends of in-hospital mortality, major complications, and impact of hospital volume on frequency of AF ablation-related outcomes. The Nationwide Inpatient Sample database was utilized to identify the AF patients treated with catheter ablation. In-hospital death and common complications including vascular access complications, cardiac perforation and/or tamponade, pneumothorax, stroke, and transient ischemic attack, were identified using International Classification of Disease (ICD-9-CM) codes. In-hospital mortality rate of 0.15% and overall complication rate of 5.46% were noted among AF ablation recipients (n = 50,969). Significant increase in complications during study period (relative increase 56.37%, P-trend < 0.001) was observed. Cardiac (2.65%), vascular (1.33%), and neurological (1.05%) complications were most common. On multivariate analysis (odds ratio [OR]; 95% confidence interval [95% CI]; P value), significant predictors of complications were female sex (OR = 1.40; CI = 1.17-1.68; P value < 0.001), high burden of comorbidity as indicated by Charlson Comorbidity Index ≥2 (OR = 2.84; CI = 2.29-3.52; P value < 0.001), and low hospital volume (< 50 procedures). Our study noted a decline in AF ablation-related hospitalizations and complications associated with the procedure. These findings largely reflect shifting trends of outpatient performance of the procedure and increasing safety profile due to improved institutional expertise and catheter techniques. © 2018 Wiley Periodicals, Inc.

Complications leading to surgical revision in implantable cardioverter defibrillator patients: comparison of patients with single-chamber, dual-chamber, and biventricular devices.

PubMed

Duray, Gabor Z; Schmitt, Joern; Cicek-Hartvig, Sule; Hohnloser, Stefan H; Israel, Carsten W

2009-03-01

Implantable cardioverter defibrillator (ICD) technology has become more complex, particularly with respect to biventricular resynchronization devices. The incidence of hardware-related complications in single (SC)-, dual (DC)-, and triple (BiV)-chamber devices requiring surgical revision has not been investigated systematically. We analysed data from consecutive ICD recipients implanted between January 2000 and December 2007 with respect to the need of surgical re-intervention for device- or lead-related complications. Generator exchanges due to normal battery depletion were not considered. From 816 patients (81% male, 69% ischaemic cardiomyopathy, 48% secondary prevention ICDs) followed for 31 +/- 24 months (2118 cumulative patient-years), 98 patients underwent 110 revisions (5.2% per patient-year). Complications included lead-related revision procedures in 81 cases and generator-related problems in 29 cases. The annual incidence of surgical revision due to complications was 11.8% in BiV compared with 4.9% in SC and 4.1% in DC patients (P = 0.002). This higher revision rate was mainly caused by lead-related complications. Implantation of a BiV system was an independent risk factor of the need for surgical revision (relative risk 2.37, 95% confidence interval 1.38-4.04). Even with long-lasting operator experience, complications requiring surgical revision remain a clinically important problem of ICD therapy. The incidence of complications is significantly higher in BiV resynchronization devices than in SC and DC systems.

Clinical utility of insulin and insulin analogs

PubMed Central

Sanlioglu, Ahter D.; Altunbas, Hasan Ali; Balci, Mustafa Kemal; Griffith, Thomas S.; Sanlioglu, Salih

2013-01-01

Diabetes is a pandemic disease characterized by autoimmune, genetic and metabolic abnormalities. While insulin deficiency manifested as hyperglycemia is a common sequel of both Type-1 and Type-2 diabetes (T1DM and T2DM), it does not result from a single genetic defect—rather insulin deficiency results from the functional loss of pancreatic β cells due to multifactorial mechanisms. Since pancreatic β cells of patients with T1DM are destroyed by autoimmune reaction, these patients require daily insulin injections. Insulin resistance followed by β cell dysfunction and β cell loss is the characteristics of T2DM. Therefore, most patients with T2DM will require insulin treatment due to eventual loss of insulin secretion. Despite the evidence of early insulin treatment lowering macrovascular (coronary artery disease, peripheral arterial disease and stroke) and microvascular (diabetic nephropathy, neuropathy and retinopathy) complications of T2DM, controversy exists among physicians on how to initiate and intensify insulin therapy. The slow acting nature of regular human insulin makes its use ineffective in counteracting postprandial hyperglycemia. Instead, recombinant insulin analogs have been generated with a variable degree of specificity and action. Due to the metabolic variability among individuals, optimum blood glucose management is a formidable task to accomplish despite the presence of novel insulin analogs. In this article, we present a recent update on insulin analog structure and function with an overview of the evidence on the various insulin regimens clinically used to treat diabetes. PMID:23584214

Metastatic Complications from Staphylococcus intermedius, a Zoonotic Pathogen

PubMed Central

Sree, Aruna; Tirrell, Sandra; Torres, Brenda; Rothman, Alan L.

2012-01-01

Metastatic infection is an infrequent complication of non-Staphylococcus aureus staphylococcal infection. Here we report a case of bloodstream infection due to Staphylococcus intermedius. To our knowledge, ours is the only known case of metastatic infection with S. intermedius. PMID:22170938

Reward-based spatial crowdsourcing with differential privacy preservation

NASA Astrophysics Data System (ADS)

Xiong, Ping; Zhang, Lefeng; Zhu, Tianqing

2017-11-01

In recent years, the popularity of mobile devices has transformed spatial crowdsourcing (SC) into a novel mode for performing complicated projects. Workers can perform tasks at specified locations in return for rewards offered by employers. Existing methods ensure the efficiency of their systems by submitting the workers' exact locations to a centralised server for task assignment, which can lead to privacy violations. Thus, implementing crowsourcing applications while preserving the privacy of workers' location is a key issue that needs to be tackled. We propose a reward-based SC method that achieves acceptable utility as measured by task assignment success rates, while efficiently preserving privacy. A differential privacy model ensures rigorous privacy guarantee, and Laplace noise is introduced to protect workers' exact locations. We then present a reward allocation mechanism that adjusts each piece of the reward for a task using the distribution of the workers' locations. Through experimental results, we demonstrate that this optimised-reward method is efficient for SC applications.

Facial and Periorbital Cellulitis due to Skin Peeling with Jet Stream by an Unauthorized Person.

PubMed

Kaptanoglu, Asli Feride; Mullaaziz, Didem; Suer, Kaya

2014-01-01

Technologies and devices for cosmetic procedures are developing with each passing day. However, increased and unauthorized use of such emerging technologies may also lead to increases in unexpected results and complications as well. Here, we report a case of facial cellulitis after a "beauty parlor" session of skin cleaning with jet stream peeling device in 19-year old female patient for the first time. Complications due to improper and unauthorized use of jet stream peeling devices may also cause doubts about the safety and impair the reputation of the technology as well. In order to avoid irreversible complications, local authorities should follow the technology and update the regulations where the dermatologists should take an active role.

[Case report of live threatening complications due to self insertion of foreign body into the vagina for masturbation purpose].

PubMed

Kuzaka, Bolesław; Kobryń, Andrzej; Niemierko, Maciej; Czaplicki, Maciej

2009-01-01

Authors have reported a case report of life threatening complications due to insertion of foreign bodies into the vagina, because of masturbation purpose. In this case subsequently came to perforation of the urinary bladder by the huge calculus that developed over the foreign body, and next to the peritoneum with development peritonitis and acute renal insufficiency with the need of dialysotherapy. After a number of surgical operations, the patient with a definitive percutaneous nephrostomy was discharged.

Three eyelid localized cutaneous anthrax cases.

PubMed

Esmer, Oktay; Karadag, Remzi; Bilgili, Serap Gunes; Gultepe, Bilge; Bayramlar, Huseyin; Karadag, Ayse Serap

2014-12-01

Anthrax is primarily seen in the developing countries, but it can be a worldwide medical concern due to bioterrorism threats. Palpebral anthrax is a rare form of cutaneous anthrax. Untreated cutaneous anthrax can be lethal. Patients with palpebral anthrax can develop complications including cicatrisation and ectropion. Thus, anthrax should be considered in differential diagnosis for patients presenting with preseptal cellulitis in high-risk regions. Herein, we report three anthrax cases (with different age) involving eyelids that were cured without any complications due to early diagnosis and treatment.

Renoduodenal Fistula After Transcatheter Embolization of Renal Angiomyolipoma

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

Sheth, Rahul A.; Feldman, Adam S.; Walker, T. Gregory, E-mail: tgwalker@partners.org

Transcatheter embolization of renal angiomyolipomas is a routinely performed, nephron-sparing procedure with a favorable safety profile. Complications from this procedure are typically minor in severity, with postembolization syndrome the most common minor complication. Abscess formation is a recognized but uncommon major complication of this procedure and is presumably due to superinfection of the infarcted tissue after arterial embolization. In this case report, we describe the formation of a renoduodenal fistula after embolization of an angiomyolipoma, complicated by intracranial abscess formation and requiring multiple percutaneous drainage procedures and eventual partial nephrectomy.

Arterio-biliary fistula as rare complication of chemoradiation therapy for intrahepatic cholangiocarcinoma

PubMed Central

Hayano, Koichi; Miura, Fumihiko; Amano, Hodaka; Toyota, Naoyuki; Wada, Keita; Kato, Kenichiro; Takada, Tadahiro; Asano, Takehide

2010-01-01

Significant hemobilia due to arterio-biliary fistula is a very rare complication of chemoradiation therapy (CRT) for unresectable intrahepatic cholangiocarcinoma (ICC). Here we report a case of arterio-biliary fistula after CRT for unresectable ICC demonstrated by angiographic examinations. This fistula was successfully treated by endovascular embolization. Hemobilia is a rare complication, but arterio-biliary fistula should be considered after CRT of ICC. PMID:21160700

Beyond the Definitions of the Phenotypic Complications of Sickle Cell Disease: An Update on Management

PubMed Central

Ballas, Samir K.; Kesen, Muge R.; Goldberg, Morton F.; Lutty, Gerard A.; Dampier, Carlton; Osunkwo, Ifeyinwa; Wang, Winfred C.; Hoppe, Carolyn; Hagar, Ward; Darbari, Deepika S.; Malik, Punam

2012-01-01

The sickle hemoglobin is an abnormal hemoglobin due to point mutation (GAG → GTG) in exon 1 of the β globin gene resulting in the substitution of glutamic acid by valine at position 6 of the β globin polypeptide chain. Although the molecular lesion is a single-point mutation, the sickle gene is pleiotropic in nature causing multiple phenotypic expressions that constitute the various complications of sickle cell disease in general and sickle cell anemia in particular. The disease itself is chronic in nature but many of its complications are acute such as the recurrent acute painful crises (its hallmark), acute chest syndrome, and priapism. These complications vary considerably among patients, in the same patient with time, among countries and with age and sex. To date, there is no well-established consensus among providers on the management of the complications of sickle cell disease due in part to lack of evidence and in part to differences in the experience of providers. It is the aim of this paper to review available current approaches to manage the major complications of sickle cell disease. We hope that this will establish another preliminary forum among providers that may eventually lead the way to better outcomes. PMID:22924029

Self-expandable Metallic Stents Contribute to Reducing Perioperative Complications in Colorectal Cancer Patients with Acute Obstruction.

PubMed

Furuke, Hirotaka; Komatsu, Shuhei; Ikeda, Jun; Tanaka, Sachie; Kumano, Tatsuya; Imura, Ken-Ichiro; Shimomura, Katsumi; Taniguchi, Fumihiro; Ueshima, Yasuo; Takashina, Ken-Ichiro; Lee, Chol Joo; Deguchi, Eiichi; Ikeda, Eito; Otsuji, Eigo; Shioaki, Yasuhiro

2018-03-01

The self-expandable metallic stent (SEMS) is an excellent non-invasive tool for emergent bowel obstruction. This study was designed to evaluate the clinical usefulness of the SEMS for avoiding perioperative complications. We analyzed a total of 47 consecutive patients who had a bowel obstruction due to colorectal cancer at initial diagnosis between 2012 and 2017 from hospital records. Perioperative complications occurred in 30% (14/47) of patients. Univariate and multivariate logistic regression analyses identified an age of more than 75 years [p=0.037, OR=6.84 (95% CI=1.11-41.6)] and the absence of an SEMS treatment [p=0.028, OR=18.5 (95% CI=1.36-250.0)] as independent risk factors for perioperative complications. Pneumonia (12.7% (6/47)) was the most common complication. There were no pneumonia patients (0% (0/15)) who were treated with the SEMS. In contrast to patients with the non-SEMS treatment, 18.7% (6/32) of all patients and 35.7% (5/14) of elderly patients had pneumonia. The SEMS is a safe and effective treatment for avoiding perioperative complications, particularly pneumonia, and may be a crucial strategy in elderly patients with acute obstruction due to colorectal cancer. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Beyond the definitions of the phenotypic complications of sickle cell disease: an update on management.

PubMed

Ballas, Samir K; Kesen, Muge R; Goldberg, Morton F; Lutty, Gerard A; Dampier, Carlton; Osunkwo, Ifeyinwa; Wang, Winfred C; Hoppe, Carolyn; Hagar, Ward; Darbari, Deepika S; Malik, Punam

2012-01-01

The sickle hemoglobin is an abnormal hemoglobin due to point mutation (GAG → GTG) in exon 1 of the β globin gene resulting in the substitution of glutamic acid by valine at position 6 of the β globin polypeptide chain. Although the molecular lesion is a single-point mutation, the sickle gene is pleiotropic in nature causing multiple phenotypic expressions that constitute the various complications of sickle cell disease in general and sickle cell anemia in particular. The disease itself is chronic in nature but many of its complications are acute such as the recurrent acute painful crises (its hallmark), acute chest syndrome, and priapism. These complications vary considerably among patients, in the same patient with time, among countries and with age and sex. To date, there is no well-established consensus among providers on the management of the complications of sickle cell disease due in part to lack of evidence and in part to differences in the experience of providers. It is the aim of this paper to review available current approaches to manage the major complications of sickle cell disease. We hope that this will establish another preliminary forum among providers that may eventually lead the way to better outcomes.

Health services fail women who suffer unsafe abortion.

PubMed

1994-02-01

Physicians, medical schools, and health systems are failing, respectively, to provide the treatment, training, and facilities necessary for proper care of women suffering from the complications of unsafe abortions. Family planning services, also, are failing to reach the women at risk. Thousands of women are dying because of this. In some countries, unsafe abortions may account for as many as half of maternal deaths; however, due to social attitudes, information is hard to obtain. The report of the World Health Organization Technical Working Group on the Prevention and Management of Unsafe Abortion has been released. This report states that treatment of these complications should be extended throughout the health care system; more training and facilities, especially at the primary care level, are necessary; physicians should give higher priority to complications due to unsafe abortions; "punitive attitudes" or health care workers should not effect treatment; more research on the management of complications of unsafe abortions and on the use of contraception after abortion is necessary; family planning advice and assistance should be offered after treatment for complications; and family planning services should be designed with women's preferences in mind. The report also lists tests, treatments, and services necessary at primary care and first referral levels for women with complications from unsafe abortions.

Supporting Individuals with Autism Spectrum Disorder in Understanding and Coping with Complex Social Emotional Issues

ERIC Educational Resources Information Center

Ahlers, Kaitlyn P.; Gabrielsen, Terisa P.; Lewis, Danielle; Brady, Anna M.; Litchford, April

2017-01-01

Core deficits in autism spectrum disorder (ASD) center around social communication and behavior. For those with ASD, these deficits complicate the task of learning how to cope with and manage complex social emotional issues. Although individuals with ASD may receive sufficient academic and basic behavioral support in school settings, supports for…

Control of Randomly Sampled Robotic Systems

DTIC Science & Technology

1989-05-01

task is so cumbersome and complicated that we would not be able to do without lots of mistakes. To avoid this formidable business , a Lisp program is...Artificial Inteligence Laboratory, 1972. PumA26O.c Ned Mar 8 17:51:04 1989 1 #include <rnath.h> #define real float #define mm 6 #define G 9.83. #define M6

Conceptions of Connectivity: How Swiss Teachers, Trainers and Apprentices Perceive Vocational Learning and Teaching across Different Learning Sites

ERIC Educational Resources Information Center

Sappa, Viviana; Aprea, Carmela

2014-01-01

The integration of learning across different learning sites is an important and challenging task for each vocational education and training system. Although various integrative teaching and learning models have been developed and many reforms have been undertaken, their implementation is complicated by several factors. In particular, individual…

The Literacy of America's College Students

ERIC Educational Resources Information Center

Baer, Justin D.; Cook, Andrea L.; Baldi, Stephane

2006-01-01

Rapid changes in technology make it necessary for adults of all ages to use written information in new and more complex ways. For example, learning how to operate computers, filling out complicated tax forms, and comparing price labels when shopping for groceries are just a few of the many tasks that are important parts of peoples lives. Every…

Teaching Movable "Du": Guidelines for Developing Enrhythmic Reading Skills

ERIC Educational Resources Information Center

Dalby, Bruce

2015-01-01

Reading music notation with fluency is a complex skill requiring well-founded instruction by the music teacher and diligent practice on the part of the learner. The task is complicated by the fact that there are multiple ways to notate a given rhythm. Beginning music students typically have their first encounter with enrhythmic notation when they…

The Americans with Disabilities Act: A Decision Tree for Social Services Administrators

ERIC Educational Resources Information Center

O'Brien, Gerald V.; Ellegood, Christina

2005-01-01

The 1990 Americans with Disabilities Act has had a profound influence on social workers and social services administrators in virtually all work settings. Because of the multiple elements of the act, however, assessing the validity of claims can be a somewhat arduous and complicated task. This article provides a "decision tree" for…

[Mucosal tolerance and low level laser therapy: Is the delegation to radiation technicians possible?].

PubMed

Duchosal, S

2015-10-01

Mucositis remains a frequent complication of radiotherapy. Low level laser applications are used to accelerate the healing process. This technique is used routinely in our centre. It is performed by delegation by radiotherapists. The conditions of this delegation of tasks are addressed here. Copyright © 2015. Published by Elsevier SAS.

Restoration for the future: endpoints, targets, and indicators of progress and success

Treesearch

Daniel C. Dey; Callie Jo. Schweitzer

2014-01-01

Setting endpoints and targets in forest restoration is a complicated task that is best accomplished in cooperative partnerships that account for the ecology of the system, production of desired ecosystem goods and services, economics and well-being of society, and future environments. Clearly described and quantitative endpoints and intermediary targets are needed to...

Exploring Formative Assessment in Primary School Classrooms: Developing a Framework of Actions and Strategies

ERIC Educational Resources Information Center

Antoniou, Panayiotis; James, Mary

2014-01-01

The importance of formative assessment in facilitating student learning has been well established in the literature. However, defining and implementing formative assessment in classroom settings is a rather complicated task. The aim of this study is to explore formative assessment, as implemented in primary classrooms in Cyprus, and develop a…

Comparison of Normalized Gain and Cohen's "d" for Analyzing Gains on Concept Inventories

ERIC Educational Resources Information Center

Nissen, Jayson M.; Talbot, Robert M.; Thompson, Amreen Nasim; Van Dusen, Ben

2018-01-01

Measuring student learning is a complicated but necessary task for understanding the effectiveness of instruction and issues of equity in college science, technology, engineering, and mathematics (STEM) courses. Our investigation focused on the implications on claims about student learning that result from choosing between one of two commonly used…

Complicated Lower Extremity Wound Caused by Immune Thrombocytopenic Purpura Leading to Hypercoagulable State: A Team Approach for Limb Salvage

PubMed Central

Simman, Richard; Haluschak, John; Jackson, Sarah

2010-01-01

This article describes a complicated lower extremity wound due to hypercoagulable state caused by immune thrombocytopenic purpura. A team approach was important to limb salvage. A literature review is included. PMID:24527141

Betwixt and between: workplace perspectives on work reintegration in the eldercare sector in Denmark.

PubMed

Ladekjær Larsen, Eva; Labriola, Merete; Vinther Nielsen, Claus; Schultz Petersen, Kirsten

2015-01-01

Contemporary return-to-work (RTW) policies in Denmark and other welfare nations recommend employees on long-term sick leave, due to physical or mental health problems, to RTW gradually. Factors that influence the process of work reintegration (WR) is well documented, however, co-workers experiences of this process are a rather new research topic. Moreover, in the context of the present research, no studies have so far explored the workplace as an arena for social interaction. The aim of this study was to explore co-workers' experiences of the reintegration process and how these experiences are related to social positions at the workplace. Ethnographic fieldwork was conducted at two nursing homes that were in a process WR after long-term sick leave. The data consist of field notes, policy documents, individual interviews, and focus group interviews. Data were organized by use of NVivo. A theoretical framework was adopted which enabled us to approach and interpret the reintegration process as one that changed the social position of the returning employee. The dataset demonstrates how the returnee is in a state of being betwixt and between the social positions of a co-worker and a non-co-worker. This is illustrated in three cases which show that this state prevents the returnee from taking on the role as a co-worker, excludes the returnee from the workplace, and creates uncertainty for all workplace actors. The study highlighted that WR creates a social position for the returnee that complicates the working routine and causes uncertainty in social interactions. Implications for Rehabilitation Work reintegration (WR) after long-term sick leave is commonly characterized by reduced working hours and modified working tasks. The WR process influences the whole work place including co-workers' everyday working life and complicates work situations where work tasks and roles are negotiated between the returning worker and co-workers. Future WR policies and guidelines could benefit from integrating co-workers' perspective to ensure that the returning worker is not socially excluded as well as ensuring that co-workers are not overburdened in the process.

Hysterectomy for complications after uterine artery embolization for leiomyoma: results of a Canadian multicenter clinical trial.

PubMed

Pron, Gaylene; Mocarski, Eva; Cohen, Marsha; Colgan, Terence; Bennett, John; Common, Andrew; Vilos, George; Kung, Rose

2003-02-01

To determine the complication-related hysterectomy rate after uterine artery embolization (UAE) for symptomatic uterine leiomyomas. Prospective, multicenter, nonrandomized, single-arm clinical trial (Canadian Task Force classification II-2). Eight Ontario University-affiliated teaching and community hospitals. Five hundred fifty-five women. Polyvinyl alcohol particles were delivered through a catheter into uterine arteries under fluoroscopic guidance. Prospective follow-up investigations consisted of telephone interviews, ultrasound examinations, and reviews of pathology and surgery reports. Median follow-up was 8.1 months, and all but five patients had complete 3-month follow-up. At 3 months, eight women (1.5%, 95% CI 0.6-2.8) underwent complication-related hysterectomy. Half of the surgeries were performed at institutions other than where UAE had been performed. Indications for hysterectomies were infections (2), postembolization pain (4), vaginal bleeding (1), and prolapsed leiomyoma (1). The 3-month complication rate resulting in hysterectomy after UAE in a large cohort of women was low. Hysterectomy after UAE is an important measure of safety and a key outcome measure of this new therapy.

Shared processing in multiple object tracking and visual working memory in the absence of response order and task order confounds

PubMed Central

Howe, Piers D. L.

2017-01-01

To understand how the visual system represents multiple moving objects and how those representations contribute to tracking, it is essential that we understand how the processes of attention and working memory interact. In the work described here we present an investigation of that interaction via a series of tracking and working memory dual-task experiments. Previously, it has been argued that tracking is resistant to disruption by a concurrent working memory task and that any apparent disruption is in fact due to observers making a response to the working memory task, rather than due to competition for shared resources. Contrary to this, in our experiments we find that when task order and response order confounds are avoided, all participants show a similar decrease in both tracking and working memory performance. However, if task and response order confounds are not adequately controlled for we find substantial individual differences, which could explain the previous conflicting reports on this topic. Our results provide clear evidence that tracking and working memory tasks share processing resources. PMID:28410383

Shared processing in multiple object tracking and visual working memory in the absence of response order and task order confounds.

PubMed

Lapierre, Mark D; Cropper, Simon J; Howe, Piers D L

2017-01-01

To understand how the visual system represents multiple moving objects and how those representations contribute to tracking, it is essential that we understand how the processes of attention and working memory interact. In the work described here we present an investigation of that interaction via a series of tracking and working memory dual-task experiments. Previously, it has been argued that tracking is resistant to disruption by a concurrent working memory task and that any apparent disruption is in fact due to observers making a response to the working memory task, rather than due to competition for shared resources. Contrary to this, in our experiments we find that when task order and response order confounds are avoided, all participants show a similar decrease in both tracking and working memory performance. However, if task and response order confounds are not adequately controlled for we find substantial individual differences, which could explain the previous conflicting reports on this topic. Our results provide clear evidence that tracking and working memory tasks share processing resources.

Mimicry of Appendicitis Symptomatology in Congenital Anomalies and Diseases of the Genitourinary System and Pregnancy

PubMed Central

Dalpiaz, Amanda; Gandhi, Jason; Smith, Noel L.; Dagur, Gautam; Schwamb, Richard; Weissbart, Steven J.; Khan, Sardar Ali

2017-01-01

Introduction Appendicitis is a prevailing cause of acute abdomen, but is often difficult to diagnose due to its wide range of symptoms, anatomical variations, and developmental abnormalities. Urological disorders of the genitourinary tract may be closely related to appendicitis due to the close proximity of the appendix to the genitourinary tract. This review provides a summary of the urological complications and simulations of appendicitis. Both typical and urological symptoms of appendicitis are discussed, as well as recommended diagnostic and treatment methods. Methods Medline searches were conducted via PubMed in order to incorporate data from the recent and early literature. Results Urological manifestations of appendicitis affect the adrenal glands, kidney, retroperitoneum, ureter, bladder, prostate, scrotum, and penis. Appendicitis in pregnancy is difficult to diagnose due to variations in appendiceal position and trimester-specific symptoms. Ultrasound, CT, and MRI are used in diagnosis of appendicitis and its complications. Treatment of appendicitis may be done via open appendectomy or laparoscopic appendectomy. In some cases, other surgeries are required to treat urological complications, though surgery may be avoided completely in other cases. Conclusion Clinical presentation and complications of appendicitis vary among patients, especially when the genitourinary tract is involved. Appendicitis may mimic urological disorders and vice versa. Awareness of differential diagnosis and proper diagnostic techniques is important in preventing delayed diagnosis and possible complications. MRI is recommended for diagnosis of pregnant patients. Ultrasound is preferred in patients exhibiting typical symptoms. PMID:28413377

SPIKY: a graphical user interface for monitoring spike train synchrony

PubMed Central

Mulansky, Mario; Bozanic, Nebojsa

2015-01-01

Techniques for recording large-scale neuronal spiking activity are developing very fast. This leads to an increasing demand for algorithms capable of analyzing large amounts of experimental spike train data. One of the most crucial and demanding tasks is the identification of similarity patterns with a very high temporal resolution and across different spatial scales. To address this task, in recent years three time-resolved measures of spike train synchrony have been proposed, the ISI-distance, the SPIKE-distance, and event synchronization. The Matlab source codes for calculating and visualizing these measures have been made publicly available. However, due to the many different possible representations of the results the use of these codes is rather complicated and their application requires some basic knowledge of Matlab. Thus it became desirable to provide a more user-friendly and interactive interface. Here we address this need and present SPIKY, a graphical user interface that facilitates the application of time-resolved measures of spike train synchrony to both simulated and real data. SPIKY includes implementations of the ISI-distance, the SPIKE-distance, and the SPIKE-synchronization (an improved and simplified extension of event synchronization) that have been optimized with respect to computation speed and memory demand. It also comprises a spike train generator and an event detector that makes it capable of analyzing continuous data. Finally, the SPIKY package includes additional complementary programs aimed at the analysis of large numbers of datasets and the estimation of significance levels. PMID:25744888

SPIKY: a graphical user interface for monitoring spike train synchrony.

PubMed

Kreuz, Thomas; Mulansky, Mario; Bozanic, Nebojsa

2015-05-01

Techniques for recording large-scale neuronal spiking activity are developing very fast. This leads to an increasing demand for algorithms capable of analyzing large amounts of experimental spike train data. One of the most crucial and demanding tasks is the identification of similarity patterns with a very high temporal resolution and across different spatial scales. To address this task, in recent years three time-resolved measures of spike train synchrony have been proposed, the ISI-distance, the SPIKE-distance, and event synchronization. The Matlab source codes for calculating and visualizing these measures have been made publicly available. However, due to the many different possible representations of the results the use of these codes is rather complicated and their application requires some basic knowledge of Matlab. Thus it became desirable to provide a more user-friendly and interactive interface. Here we address this need and present SPIKY, a graphical user interface that facilitates the application of time-resolved measures of spike train synchrony to both simulated and real data. SPIKY includes implementations of the ISI-distance, the SPIKE-distance, and the SPIKE-synchronization (an improved and simplified extension of event synchronization) that have been optimized with respect to computation speed and memory demand. It also comprises a spike train generator and an event detector that makes it capable of analyzing continuous data. Finally, the SPIKY package includes additional complementary programs aimed at the analysis of large numbers of datasets and the estimation of significance levels. Copyright © 2015 the American Physiological Society.

Diabetes complications in youth: qualitative analysis of parents' perspectives of family learning and knowledge.

PubMed

Buckloh, Lisa M; Lochrie, Amanda S; Antal, Holly; Milkes, Amy; Canas, J Atilio; Hutchinson, Sally; Wysocki, Tim

2008-08-01

Youth with type 1 diabetes face long-term risks of health complications of the disease. Little is known about patients' and parents' knowledge, acquisition of information, and family communication regarding these complications. This paper reports qualitative analyses of parental focus-group discussions of this topic. A total of 47 participants (30 mothers, 14 fathers, and 3 others) representing 33 children between the ages of 8 and 18 years with type 1 diabetes participated in 1 of 13 focus groups. Open-ended questions focused on the type and amount of information about long-term complications presented to parents by health care professionals at different time points, as well as the way that information was presented. Questions also elicited details about parent-child communication and exposure to misconceptions about diabetes complications. Qualitative analysis of the transcribed focus groups revealed that participants experienced significant anxiety about diabetes complications, with a shift from concern about daily management tasks to concern about long-term complications over time. Participants desired a flexible, collaborative educational approach, especially regarding the timing and type of information, relative to the child's age and duration of diabetes. Many parents wanted more sensitive communication and emotional support from health care providers. Motivating children appeared to be a particular challenge; family burnout with regard to diabetes care over time was reported. Knowledge was gained in many ways, yet misinformation was uncommon. Obtaining information about long-term complications is an important process that changes over the course of the disease and with the child's developmental level. More research is needed, especially regarding youth knowledge, learning, and beliefs about diabetes complications.

Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia.

PubMed

Mills, Kelly A; Markun, Leslie C; San Luciano, Marta; Rizk, Rami; Allen, I Elaine; Racine, Caroline A; Starr, Philip A; Alberts, Jay L; Ostrem, Jill L

2015-04-01

Subthalamic nucleus (STN) deep brain stimulation (DBS) can improve motor complications of Parkinson's disease (PD) but may worsen specific cognitive functions. The effect of STN DBS on cognitive function in dystonia patients is less clear. Previous reports indicate that bilateral STN stimulation in patients with PD amplifies the decrement in cognitive-motor dual-task performance seen when moving from a single-task to dual-task paradigm. We aimed to determine if the effect of bilateral STN DBS on dual-task performance in isolated patients with dystonia, who have less cognitive impairment and no dementia, is similar to that seen in PD. Eight isolated predominantly cervical patients with dystonia treated with bilateral STN DBS, with average dystonia duration of 10.5 years and Montreal Cognitive Assessment score of 26.5, completed working memory (n-back) and motor (forced-maintenance) tests under single-task and dual-task conditions while on and off DBS. A multivariate, repeated-measures analysis of variance showed no effect of stimulation status (On vs Off) on working memory (F=0.75, p=0.39) or motor function (F=0.22, p=0.69) when performed under single-task conditions, though as working memory task difficulty increased, stimulation disrupted the accuracy of force-tracking. There was a very small worsening in working memory performance (F=9.14, p=0.019) when moving from single-task to dual-tasks when using the 'dual-task loss' analysis. This study suggests the effect of STN DBS on working memory and attention may be much less consequential in patients with dystonia than has been reported in PD. 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.

Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia

PubMed Central

Mills, Kelly A; Markun, Leslie C; Luciano, Marta San; Rizk, Rami; Allen, I Elaine; Racine, Caroline A; Starr, Philip A; Alberts, Jay L; Ostrem, Jill L

2015-01-01

Objective Subthalamic nucleus (STN) deep brain stimulation (DBS) can improve motor complications of Parkinson's disease (PD) but may worsen specific cognitive functions. The effect of STN DBS on cognitive function in dystonia patients is less clear. Previous reports indicate that bilateral STN stimulation in patients with PD amplifies the decrement in cognitive-motor dual-task performance seen when moving from a single-task to dual-task paradigm. We aimed to determine if the effect of bilateral STN DBS on dual-task performance in isolated patients with dystonia, who have less cognitive impairment and no dementia, is similar to that seen in PD. Methods Eight isolated predominantly cervical patients with dystonia treated with bilateral STN DBS, with average dystonia duration of 10.5 years and Montreal Cognitive Assessment score of 26.5, completed working memory (n-back) and motor (forced-maintenance) tests under single-task and dual-task conditions while on and off DBS. Results A multivariate, repeated-measures analysis of variance showed no effect of stimulation status (On vs Off) on working memory (F=0.75, p=0.39) or motor function (F=0.22, p=0.69) when performed under single-task conditions, though as working memory task difficulty increased, stimulation disrupted the accuracy of force-tracking. There was a very small worsening in working memory performance (F=9.14, p=0.019) when moving from single-task to dual-tasks when using the ‘dual-task loss’ analysis. Conclusions This study suggests the effect of STN DBS on working memory and attention may be much less consequential in patients with dystonia than has been reported in PD. PMID:25012202

Improving performance with clinical decision support.

PubMed

Brailer, D J; Goldfarb, S; Horgan, M; Katz, F; Paulus, R A; Zakrewski, K

1996-07-01

CADU/CIS (Clinical and Administrative Decision-support Utility and Clinical Information System) is a clinical decision-support workstation that allows large volumes of clinical information systems data to be analyzed in a timely and user-friendly fashion. CARE PROCESS MEASUREMENT: For any given disease, subgroups of patients are identified, and automated, customized "clinical pathways" are generated. For each subgroup, the best practice norms for use of test and therapies are identified. Practice style variations are then compared to outcomes to focus inquiry on decisions that significantly affect outcomes. INTESTINAL OBSTRUCTION: Graduate Health Systems, a multisite integrated provider in the Philadelphia area, has used CADU/CIS to improve quality problems, reduce treatment-intensity variations, and improve clinical participation in care process evaluation and decision making. A task force selected intestinal obstruction without hernia as its first study because of the related high-volume and high-morbidity complications. Use of a ten-step method for clinical performance improvement showed that the intravenous administration of unnecessary fluids to 104 patients with intestinal obstruction induced congestive heart failure (CHF) in 5 patients. Task force members and other practicing physicians are now developing guidelines and other interventions aimed at fluid use. Indeed, the task force used CADU/CIS to identify an additional 250 patients in one year whose conditions were complicated by CHF. A clinical decision support tool can be instrumental in detecting problems with important clinical and economic implications, identifying their important underlying causes, tracking the associated tests and therapies, and monitoring interventions.

[Diagnosis and treatment of the complications of otitis media in adults. Case series and literature review].

PubMed

Govea-Camacho, Luis Humberto; Pérez-Ramírez, Ramón; Cornejo-Suárez, Arnulfo; Fierro-Rizo, Roberto; Jiménez-Sala, Claudia Janet; Rosales-Orozco, Carlos Silvino

2016-01-01

The complications of otitis media (intra-cranial and extra-cranial) used to have a high morbidity and mortality in the pre-antibiotic era, but these are now relatively rare, mainly due to the use of antibiotics and the use of ventilation tubes, reducing the incidence of such complications significantly. Currently, an early suspicion of these complications is a major challenge for diagnosis and management. The cases of 5 patients (all male) are presented, who were diagnosed with complicated otitis media, 80% (4) with a mean age of 34.6 years (17-52). There was major comorbidity in 60% (3), with one patient with diabetes mellitus type 2, and two with chronic renal failure. There were 3 (60%) intra-cranial complications: one patient with thrombosis of the sigmoid sinus and a cerebellar abscess; another with a retroauricular and brain abscess, and a third with meningitis. Of the 2 (40%) extra-cranial complications: one patient had a Bezold abscess, and the other with a soft tissue abscess and petrositis. All patients were managed with surgery and antibiotic therapy, with 100% survival (5), and with no neurological sequelae. The clinical course of otitis media is usually short, limiting the infection process in the majority of patients due to the immune response and sensitivity of the microbe to the antibiotic used. However, a small number of patients (1-5%) may develop complications. Otitis media is a common disease in our country, complications are rare, but should be suspected when the picture is of torpid evolution with clinical worsening and manifestation of neurological signs. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Outcomes of Retreatment after Aborted Laser In Situ Keratomileusis due to Flap Complications

PubMed Central

Al-Mezaine, Hani S.; Al-Amro, Saleh A.; Al-Fadda, Abdulaziz; Al-Obeidan, Saleh

2011-01-01

Purpose: To determine the refractive outcomes and complications of retreatment after aborted primary laser in situ keratomileusis (LASIK) due to flap complications. Materials and Methods: This retrospective study evaluated 50 retreated eyes that had flap complications during primary LASIK at the Eye Consultants Center in Riyadh, Saudi Arabia. Data were analyzed for patients with at least 3 months follow-up post retreatment. Results: Thirty-three eyes of 31 consecutive patients with 3 months follow-up or later post retreatment were included. The primary LASIK was aborted due to incomplete flaps in 22 eyes (66.7%), buttonhole flaps in 7 eyes (21.2%), free partial flaps in 3 eyes (9.1%), and a free complete flap in 1 eye (3.0%). Twenty-two eyes (66.7%) were retreated with LASIK, and 11 eyes (33.3%) were retreated with surface ablation. The mean spherical equivalent (SE) was –0.23 ± 0.72 D, the mean astigmatism was –0.65 ± 0.89 D, and the mean loss of the best corrected visual acuity (BCVA) was 0.78 lines at the final postoperative visit. At the last postoperative visit, 20/30 or better BCVA was achieved in 90.1% of eyes that underwent retreatment with LASIK and in 91% of eyes that were retreated with surface ablation. There was no statistical difference in postoperative SE between eyes retreated with LASIK and eyes retreated with surface ablation (P = 0.610). There was no statistical difference in postoperative BCVA between eyes retreated with LASIK and those retreated with surface ablation (P = 0.756). There were no intraoperative complications and no eyes required a second retreatment. Conclusion: Creation of a flap after a previous intraoperative flap complication was not associated with any complications. The refractive outcomes of retreatment with LASIK or surface ablation were comparable and reasonably favorable. PMID:21887080

Changes in the chemical composition of mineralised teeth in children after antineoplastic treatment.

PubMed

Krasuska-Sławińska, Ewa; Dembowska-Bagińska, Bożenna; Brożyna, Agnieszka; Olczak-Kowalczyk, Dorota; Czarnowska, Elżbieta; Sowińska, Agnieszka

2018-01-01

Chemotherapy, neoplasms, and their complications linked to malabsorption, malnutrition, and metabolic disorders may lead to improper tooth development and frequent severe caries in patients during/after antineoplastic treatment and to a more frequent improper tooth development in patients undergoing chemotherapy during odontogenesis. However, the causes of these abnormalities remain unknown; there are no studies on the impact of antineoplastic treatment and its complications on the chemical composition of mineralised teeth. To compare the chemical composition of mineralised teeth extracted due to complicated caries in children after chemotherapy, and of teeth extracted due to orthodontic treatment in generally healthy children. The treatment group included five teeth extracted due to complicated caries in children after antineoplastic treatment. The control group included five teeth extracted due to orthodontic treatment in generally healthy children. The chemical composition of enamel, dentine, cementum, interior of the canal, and enamel abnormalities in teeth extracted from patients after chemotherapy and in generally healthy patients were assessed with energy-dispersive X-ray spectroscopy. Results were analysed statistically. The magnesium (Mg) and zinc (Zn) mass contents in the enamel of patients after chemotherapy increased and so did the calcium (Ca) to phosphorus (P) ratio when compared to controls. Areas with abnormal enamel in patients after chemotherapy had lower concentrations of Ca and P, and higher concentrations of trace elements (Mg, Cl, and Na). The levels of the assessed elements in dentine, cementum, and inside the canal were similar in both groups of teeth.

[Surgical assessment of complications after thyroid gland operations].

PubMed

Dralle, H

2015-01-01

The extent, magnitude and technical equipment used for thyroid surgery has changed considerably in Germany during the last decade. The number of thyroidectomies due to benign goiter have decreased while the extent of thyroidectomy, nowadays preferentially total thyroidectomy, has increased. Due to an increased awareness of surgical complications the number of malpractice claims is increasing. In contrast to surgical databases the frequency of complications in malpractice claims reflects the individual impact of complications on the quality of life. In contrast to surgical databases unilateral and bilateral vocal fold palsy are therefore at the forefront of malpractice claims. As guidelines are often not applicable for the individual surgical expert review, the question arises which are the relevant criteria for the professional expert witness assessing the severity of the individual complication. While in surgical databases major complications after thyroidectomy, such as vocal fold palsy, hypoparathyroidism, hemorrhage and infections are equally frequent (1-3 %), in malpractice claims vocal fold palsy is significantly more frequent (50 %) compared to hypoparathyroidism (15 %), hemorrhage and infections (about 5 % each). To avoid bilateral nerve palsy intraoperative nerve monitoring has become of utmost importance for surgical strategy and malpractice suits alike. For surgical expert review documentation of individual risk-oriented indications, the surgical approach and postoperative management are highly important. Guidelines only define the treatment corridors of good clinical practice. Surgical expert reviews in malpractice suits concerning quality of care and causality between surgical management, complications and sequelae of complications are therefore highly dependent on the grounds and documentation of risk-oriented indications for thyroidectomy, intraoperative and postoperative surgical management.

Spatial effects, sampling errors, and task specialization in the honey bee.

PubMed

Johnson, B R

2010-05-01

Task allocation patterns should depend on the spatial distribution of work within the nest, variation in task demand, and the movement patterns of workers, however, relatively little research has focused on these topics. This study uses a spatially explicit agent based model to determine whether such factors alone can generate biases in task performance at the individual level in the honey bees, Apis mellifera. Specialization (bias in task performance) is shown to result from strong sampling error due to localized task demand, relatively slow moving workers relative to nest size, and strong spatial variation in task demand. To date, specialization has been primarily interpreted with the response threshold concept, which is focused on intrinsic (typically genotypic) differences between workers. Response threshold variation and sampling error due to spatial effects are not mutually exclusive, however, and this study suggests that both contribute to patterns of task bias at the individual level. While spatial effects are strong enough to explain some documented cases of specialization; they are relatively short term and not explanatory for long term cases of specialization. In general, this study suggests that the spatial layout of tasks and fluctuations in their demand must be explicitly controlled for in studies focused on identifying genotypic specialists.

[Pecularities of organisation and health care delivery to military servicemen under conditions of mid- and high mountains].

PubMed

Khalimov, Yu Sh; Vetryakov, O V; Makiev, R G; Kuzmich, V G

2016-01-01

The authors present an analysis of adverse climatic factors mid- and high mountains, which have a significant negative impact on fighting facility and capacity for work in military servicemen that may cause an acute mountain sickness and severe complications (high altitude pulmonary edema and high-altitude cerebral edema). Complicated mechanisms of organism disorder are shown. Sophisticated medical and tactical factors of mountain theatre of war, defining the nature of actions of troops, require special approaches to organisation of medical support. One of the major tasks of the medical service and the commanders is the timely prevention of health disorders troops in mountainous terrain.

[Circumscribed and diffuse peritonitis: severe complications in bariatric and metabolic surgery; specifics related to their diagnosis and therapy].

PubMed

Špička, P; Vaverka, P; Gryga, A; Malý, T

Cases of localized and diffuse peritonitis are severe surgical conditions. Despite expanding possibilities for the diagnosis and therapy, patients with peritonitis, its diffuse form in particular, still suffer from high morbidity and mortality. The management of this condition, both in the healthy and especially seriously ill population, is not satisfactory. Recently, we have witnessed an increase in bariatric and metabolic surgery in response to an ever rising number of extremely obese patients worldwide. Bariatric patients belong to a group of seriously ill patients with a significant risk of post-operative complications due to an infection. Although their treatment is identical to that of the normal population, a great emphasis is put on early recognition of complications, and the decision on any potential surgical revision should be actively approached, often necessitating the absence of frequently lengthy paraclinical assessments. We conducted a retrospective analysis of 346 obese bariatric patients undergoing surgical treatment for morbid obesity between August 2011 and August 2015. A total of 6 patients experienced severe complications including two cases of diffuse peritonitis, two cases of localized peritonitis and two cases of intraperitoneal bleeding. One patient died after her discharge from hospital due to toxic shock caused by stomach perforation. We describe two case reports in greater detail to highlight the importance of early detection of complications and a timely surgical intervention. In principle, bariatric patients are a severely ill population where standard diagnostic procedures for post-operative complications often fail. Clinical findings and the surgeons experience are commonly the only diagnostic signs that trigger a surgical revision. In contrast, surgical treatment of post-operative complications in obese patients with peritonitis is virtually identical to that in patients with normal or slightly increased BMI. It involves thorough toilette of the abdominal cavity, lavage and drainage. Due to high morbidity and large peritoneal surface, obese patients may deteriorate rapidly. Timely surgical intervention is thus the only proper therapeutic approach, even without any, often lengthy paraclinical assessments. peritonitis - bariatric surgery - complications in bariatric surgery.

Complications of adenotonsillectomy: a case report of meningitis due to dual infection with nontypeable Haemophilus influenzae and Streptococcus pneumoniae, and a prospective study of the rate of postoperative bacteremia.

PubMed

Tanaka, Junko; Kurosaki, Tomomichi; Shimada, Akiko; Kameyama, Yumi; Mitsuda, Toshihiro; Ishiwada, Naruhiko; Kohno, Yoichi

2013-08-01

Bacterial meningitis is a rare complication of adenotonsillectomy. We present a case of meningitis due to nontypeable Haemophilus influenzae and Streptococcus pneumoniae after adenotonsillectomy. Pulsed-field gel electrophoresis patterns indicated that the oral cavity was the source of H. influenzae and S. pneumoniae isolated from the cerebrospinal fluid. BLOOD CULTURE STUDY: As bacteremia is thought to be one of the etiologies of meningitis, we prospectively investigated the rate of bacteremia as a complication of adenotonsillectomy. Of the 46 patients included in the study, mean age of five years old, 11 (24%) had positive blood cultures during the operation. H. influenzae was the commonest organism grown (seven cultures), three of seven produced beta-lactamase, followed by S. pneumoniae (one culture), H. parainfluenzae (one culture), Peptostreptococcus micros (one culture), and Veillonella spp. (one culture). The bacteria were composed of tonsil or adenoid surface cultures in eight of 11 patients (73%). We present a rare case of meningitis complicating a adenotonsillectomy procedure, in a three years old boy. Meningitis is a rare complication of adenotonsillectomy, but bacteremia which may lead to meningitis occurs frequently, as the results.

[Surgical treatment for liver haematoma following endoscopic retrograde cholangiopancreatography; An unusual case].

PubMed

González-López, Rogelio; García-Cano, Eugenio; Espinosa-González, Omar; Cruz-Salgado, Ángel; Montiel-Jarquin, Álvaro-José; Hernández-Zamora, Valeria

2015-01-01

Even in expert hands, there can be serious complications when performing an endoscopic retrograde cholangiopancreatography. The most frequent complications are pancreatitis, cholangitis, bleeding, perforation, and acute cholecystitis. The hepatic subcapsular haematoma is a rare complication, with few cases described worldwide. A case is presented of an extremely rare complication of endoscopic retrograde cholangiopancreatography, which required surgical treatment for its resolution without success. This is second case of mortality reported in the literature. Female patient of 30 years old, with indication for endoscopic retrograde cholangiopancreatography due to benign strictures. A hydro-pneumatic dilation and stent placement of 2 gauge 10 fr was performed. She presented abdominal pain after the procedure and significant decline in haemoglobin with no evidence of haemodynamic instability so an abdominal tomography scan was performed, showing no evidence of liver injury. The patient was haemodynamic unstable within 72 h. A laparotomy was required for damage control, with fatal outcome in the intensive care unit due to multiple organ failure. Subcapsular hepatic haematoma after endoscopic retrograde cholangiopancreatography is a rare complication, with few cases reported in the literature. Treatment described in the literature is conservative, resulting in a satisfactory resolution. Copyright © 2015. Published by Masson Doyma México S.A.

Urinary obstruction is an important complicating factor in patients with septic shock due to urinary infection.

PubMed

Reyner, Karina; Heffner, Alan C; Karvetski, Colleen H

2016-04-01

Urinary tract infection (UTI) is a common cause of severe sepsis, and anatomic urologic obstruction is a recognized factor for complicated disease. We aimed to identify the incidence of urinary obstruction complicating acute septic shock and determine the characteristics and outcomes of this group. Patients prospectively enrolled in a sepsis treatment pathway registry between October 2013 and July 2014 were reviewed for the diagnosis of UTI. Standardized medical record review was performed to confirm sepsis due to UTI and determine clinical variables including the presence of anatomic urinary obstruction. Patients with septic shock due to UTI with obstruction were compared with those without obstruction. The primary outcomes were incidence of urinary obstruction and hospital mortality. Among 1084 registry enrollees, 209 (19.2%) met inclusion criteria for the study. Acute anatomic obstruction was identified in 22 (10.5%) patients. Hospital mortality in patients with obstruction was 27.3% compared with 11.2% in patients without obstruction (absolute difference of 16.1%; P = .03; 95% confidence interval [CI], 1.2%-30.9%). Hospital length of stay among survivors was 12.8 days compared with 8.3 days (absolute difference of 4.5 days; P = .04; 95% CI, 0.2-8.8 days). History of urinary stone disease was independently associated with obstruction (odds ratio, 5.6; 95% CI, 2.2-14.3). Approximately 1 in 10 patients presenting with septic shock due to a urinary source is complicated by anatomic urinary obstruction. These patients have significantly higher mortality compared with patients without obstruction. Early imaging of patients with septic shock due to suspected urinary source should be considered to identify obstruction requiring emergency intervention. Copyright © 2015 Elsevier Inc. All rights reserved.

Problems and research issues associated with the hybrid control of force and displacement

NASA Technical Reports Server (NTRS)

Paul, R. P.

1987-01-01

The hybrid control of force and position is basic to the science of robotics but is only poorly understood. Before much progress can be made in robotics, this problem needs to be solved in a robust manner. However, the use of hybrid control implies the existence of a model of the environment, not an exact model (as the function of hybrid control is to accommodate these errors), but a model appropriate for planning and reasoning. The monitored forces in position control are interpreted in terms of a model of the task as are the monitored displacements in force control. The reaction forces of the task of writing are far different from those of hammering. The programming of actions in such a modeled world becomes more complicated and systems of task level programming need to be developed. Sensor based robotics, of which force sensing is the most basic, implies an entirely new level of technology. Indeed, robot force sensors, no matter how compliant they may be, must be protected from accidental collisions. This implies other sensors to monitor task execution and again the use of a world model. This new level of technology is the task level, in which task actions are specified, not the actions of individual sensors and manipulators.

Real-Time Performance Feedback for the Manual Control of Spacecraft

NASA Astrophysics Data System (ADS)

Karasinski, John Austin

Real-time performance metrics were developed to quantify workload, situational awareness, and manual task performance for use as visual feedback to pilots of aerospace vehicles. Results from prior lunar lander experiments with variable levels of automation were replicated and extended to provide insights for the development of real-time metrics. Increased levels of automation resulted in increased flight performance, lower workload, and increased situational awareness. Automated Speech Recognition (ASR) was employed to detect verbal callouts as a limited measure of subjects' situational awareness. A one-dimensional manual tracking task and simple instructor-model visual feedback scheme was developed. This feedback was indicated to the operator by changing the color of a guidance element on the primary flight display, similar to how a flight instructor points out elements of a display to a student pilot. Experiments showed that for this low-complexity task, visual feedback did not change subject performance, but did increase the subjects' measured workload. Insights gained from these experiments were applied to a Simplified Aid for EVA Rescue (SAFER) inspection task. The effects of variations of an instructor-model performance-feedback strategy on human performance in a novel SAFER inspection task were investigated. Real-time feedback was found to have a statistically significant effect of improving subject performance and decreasing workload in this complicated four degree of freedom manual control task with two secondary tasks.

Correcting Memory Improves Accuracy of Predicted Task Duration

ERIC Educational Resources Information Center

Roy, Michael M.; Mitten, Scott T.; Christenfeld, Nicholas J. S.

2008-01-01

People are often inaccurate in predicting task duration. The memory bias explanation holds that this error is due to people having incorrect memories of how long previous tasks have taken, and these biased memories cause biased predictions. Therefore, the authors examined the effect on increasing predictive accuracy of correcting memory through…

[Complicated chickenpox in a national pediatric Peruvian hospital, 2001-2011].

PubMed

Miranda-Choque, Edwin; Candela-Herrera, Jorge; Díaz-Pera, Javier; Farfán-Ramos, Sonia; Muñoz-Junes, Edith María; Escalante-Santivañez, Imelda Rita

2013-03-01

The objective of the study was to describe the clinical and epidemiological characteristics of complicated chickenpox cases seen at the National Institute of Children's Health (INSN, Spanish acronym) of Peru from 2001 to 2011. A case series was collected, including a total of 1,073 children with complicated chickenpox. The median age was 2.5 years (IQR 1.1-4.8 years), of which 578 (54%) were male. The most frequent complications were secondary skin and soft tissue infections with 768 cases (72%). 13 deaths (1.4%) were recorded. In conclusion, the hospitalizations due to complicated chickenpox in the INSN included mostly children under five, with a short stay and a low proportion of deaths most complications being related to secondary skin and soft tissue infections.

Rhombencephalitis associated with Dengue fever.

PubMed

Verma, Rajesh; Bharti, Kavita; Mehta, Mannan; Bansod, Amrit

2016-05-01

Dengue infection is gradually disseminating throughout the world in alarming proportions. It is a arbovirus infection,transmitted by aedes mosquitoes. It is a multi-systemic disorder associated with varied neurological complications. There is increased trend of development of neurological complications in dengue fever. The neurological complications arising due to dengue infection can be categorized into central and neuromuscular complications. The central nervous system disorders reported with dengue fever are encephalopathy,encephalitis and myelitis.Here we report a case of rhombencephalitis associated with dengue fever. The literature does not mention rhombencephalitis occurring with dengue illness. Copyright © 2016 Elsevier B.V. All rights reserved.

Interdisciplinary cognitive task analysis: a strategy to develop a comprehensive endoscopic retrograde cholangiopancreatography protocol for use in fellowship training.

PubMed

Canopy, Erin; Evans, Matt; Boehler, Margaret; Roberts, Nicole; Sanfey, Hilary; Mellinger, John

2015-10-01

Endoscopic retrograde cholangiopancreatography is a challenging procedure performed by surgeons and gastroenterologists. We employed cognitive task analysis to identify steps and decision points for this procedure. Standardized interviews were conducted with expert gastroenterologists (7) and surgeons (4) from 4 institutions. A procedural step and cognitive decision point protocol was created from audio-taped transcriptions and was refined by 5 additional surgeons. Conceptual elements, sequential actions, and decision points were iterated for 5 tasks: patient preparation, duodenal intubation, selective cannulation, imaging interpretation with related therapeutic intervention, and complication management. A total of 180 steps were identified. Gastroenterologists identified 34 steps not identified by surgeons, and surgeons identified 20 steps not identified by gastroenterologists. The findings suggest that for complex procedures performed by diverse practitioners, more experts may help delineate distinctive emphases differentiated by training background and type of practice. Copyright © 2015 Elsevier Inc. All rights reserved.

Development of a structural optimization capability for the aeroelastic tailoring of composite rotor blades with straight and swept tips

NASA Technical Reports Server (NTRS)

Friedmann, P. P.; Venkatesan, C.; Yuan, K.

1992-01-01

This paper describes the development of a new structural optimization capability aimed at the aeroelastic tailoring of composite rotor blades with straight and swept tips. The primary objective is to reduce vibration levels in forward flight without diminishing the aeroelastic stability margins of the blade. In the course of this research activity a number of complicated tasks have been addressed: (1) development of a new, aeroelastic stability and response analysis; (2) formulation of a new comprehensive sensitive analysis, which facilitates the generation of the appropriate approximations for the objective and the constraints; (3) physical understanding of the new model and, in particular, determination of its potential for aeroelastic tailoring, and (4) combination of the newly developed analysis capability, the sensitivity derivatives and the optimizer into a comprehensive optimization capability. The first three tasks have been completed and the fourth task is in progress.

Problem-based learning in optical engineering studies

NASA Astrophysics Data System (ADS)

Voznesenskaya, Anna

2016-09-01

Nowadays, the Problem-Based Learning (PBL) is one of the most prospective educational technologies. PBL is based on evaluation of learning outcomes of a student, both professional and personal, instead of traditional evaluation of theoretical knowledge and selective practical skills. Such an approach requires changes in the curricula development. There should be introduced projects (cases) imitating real tasks from the professional life. These cases should include a problem summary with necessary theoretic description, charts, graphs, information sources etc, task to implement and evaluation indicators and criteria. Often these cases are evaluated with the assessment-center method. To motivate students for the given task they could be divided into groups and have a contest. Whilst it looks easy to implement in social, economic or teaching fields PBL is pretty complicated in engineering studies. Examples of cases in the first-cycle optical engineering studies are shown in this paper. Procedures of the PBL implementation and evaluation are described.

The effect of intensive speech rate and intonation therapy on intelligibility in Parkinson's disease.

PubMed

Martens, Heidi; Van Nuffelen, Gwen; Dekens, Tomas; Hernández-Díaz Huici, Maria; Kairuz Hernández-Díaz, Hector Arturo; De Letter, Miet; De Bodt, Marc

2015-01-01

Most studies on treatment of prosody in individuals with dysarthria due to Parkinson's disease are based on intensive treatment of loudness. The present study investigates the effect of intensive treatment of speech rate and intonation on the intelligibility of individuals with dysarthria due to Parkinson's disease. A one group pretest-posttest design was used to compare intelligibility, speech rate, and intonation before and after treatment. Participants included eleven Dutch-speaking individuals with predominantly moderate dysarthria due to Parkinson's disease, who received five one-hour treatment sessions per week during three weeks. Treatment focused on lowering speech rate and magnifying the phrase final intonation contrast between statements and questions. Intelligibility was perceptually assessed using a standardized sentence intelligibility test. Speech rate was automatically assessed during the sentence intelligibility test as well as during a passage reading task and a storytelling task. Intonation was perceptually assessed using a sentence reading task and a sentence repetition task, and also acoustically analyzed in terms of maximum fundamental frequency. After treatment, there was a significant improvement of sentence intelligibility (effect size .83), a significant increase of pause frequency during the passage reading task, a significant improvement of correct listener identification of statements and questions, and a significant increase of the maximum fundamental frequency in the final syllable of questions during both intonation tasks. The findings suggest that participants were more intelligible and more able to manipulate pause frequency and statement-question intonation after treatment. However, the relationship between the change in intelligibility on the one hand and the changes in speech rate and intonation on the other hand is not yet fully understood. Results are nuanced in the light of the operated research design. The reader will be able to: (1) describe the effect of intensive speech rate and intonation treatment on intelligibility of speakers with dysarthria due to PD, (2) describe the effect of intensive speech rate treatment on rate manipulation by speakers with dysarthria due to PD, and (3) describe the effect of intensive intonation treatment on manipulation of the phrase final intonation contrast between statements and questions by speakers with dysarthria due to PD. Copyright © 2015 Elsevier Inc. All rights reserved.

Restoration for the future: Setting endpoints and targets and selecting indicators of progress and success

Treesearch

Daniel C. Dey; Callie Jo Schweitzer; John M. Kabrick

2014-01-01

Setting endpoints and targets in forest restoration is a complicated task that is best accomplished in cooperative partnerships that account for the ecology of the system, production of desired ecosystem goods and services, economics and well-being of society, and future environments. Clearly written and quantitative endpoints and intermediary targets need to be...

Student Produced Television Programs: The Relationship of Play Theory, Flow Experiences, and Experiential Learning.

ERIC Educational Resources Information Center

Koehn, Stephen C.; Lowry, David N.

Television production is a complicated task. It requires advanced technical skills and abilities, as well as tremendous creative input. It requires an outlying of time by an individual to learn the skills and implement the creative ideas he or she might have for a television show. A study examined the perceptions of 30 students who were highly…

Age/Order of Acquisition Effects and the Cumulative Learning of Foreign Words: A Word Training Study

ERIC Educational Resources Information Center

Izura, Cristina; Perez, Miguel A.; Agallou, Elizabeth; Wright, Victoria C.; Marin, Javier; Stadthagen-Gonzalez, Hans; Ellis, Andrew W.

2011-01-01

Early acquired words are processed faster than later acquired words in lexical and semantic tasks. Demonstrating such age of acquisition (AoA) effects beyond reasonable doubt, and then investigating those effects empirically, is complicated by the natural correlation between AoA and other word properties such as frequency and imageability. In an…

Complicity as Infiltration: The (Im)possibilities of Research with/in NSF Engineering Grants in the Age of Neoliberal Scientism

ERIC Educational Resources Information Center

Daza, Stephanie Lynn

2012-01-01

In this article, I use a Spivakian decolonizing perspective to take simplification to task in two ways--the simplification of methodology with/in grants and the simplification of critique that skirts the impossibility of noncomplicitous research and researchers. I posit that "neoliberal scientism"'s grants culture is colonizing research--narrowly…

Circuit modification and research of operation modes of high-frequency pulsed resonant converter of the X-ray tube power supply

NASA Astrophysics Data System (ADS)

Klonov, V. V.; Larionov, I. A.; Bessonov, V. B.

2018-02-01

Despite obvious drawbacks of the resonant converter, such as complicated calculation, increased size and weight of the device, deviations of the circuit parameters from product to product, the resonant converter shows significant advantages in comparison with other. The task was to design the generator, which is built on a resonant topology.

Searching for French Civilization: Reflections On Situating Information Literacy Skills in an Undergraduate Curriculum

ERIC Educational Resources Information Center

O'Reilly, Carmel

2014-01-01

This chapter questions and reflects on the changing role of the foreign language and civilization lecturer as educator, when information literacy skills are situated in an undergraduate curriculum. As such, it does not set itself the task of providing solutions. Instead, it considers all the complications which occur en route to a greater use of…

Challenges and Strategies in Social Work and Social Welfare PhD Education: Helping Candidates Jump through the Dissertation Hoops

ERIC Educational Resources Information Center

Berger, Roni

2015-01-01

A major task of social work doctoral programs is preparing the next generation of researchers and educators in the profession. To develop competence in generating new knowledge relevant to social work practice and disseminating it to future practitioners, doctoral candidates need to master a broad and complicated set of theoretical, empirical, and…

Forest carbon estimation using the Forest Vegetation Simulator: Seven things you need to know

Treesearch

Coeli M. Hoover; Stephanie A. Rebain

2011-01-01

Interest in options for forest-related greenhouse gas mitigation is growing, and so is the need to assess the carbon implications of forest management actions. Generating estimates of key carbon pools can be time consuming and cumbersome, and exploring the carbon consequences of management alternatives is often a complicated task. In response to this, carbon reporting...

Considerations of Additional Stressors and Developmental Issues for Gay, Lesbian, Bisexual, and Transgender College Students

ERIC Educational Resources Information Center

Zubernis, Lynn; Snyder, Matthew

2007-01-01

At some point every college freshman asks "Am I okay?" or "Am I normal?" Helping students answer this question is a familiar part of college counseling. However, this task becomes more complicated when students who are gay, lesbian, bisexual, transgender (GLBT), or questioning their sexuality seek counseling. The universal issues which all college…

[Visual perception of Kanji characters and complicated figures. II. Visual P300 event-related potentials in patients with mental retardation].

PubMed

Sata, Yoshimi; Inagaki, Masumi; Shirane, Seiko; Kaga, Makiko

2002-11-01

In order to objectively evaluate visual perception of patients with mental retardation (MR), the P300 event-related potentials (ERPs) for visual oddball tasks were recorded in 26 patients and 13 age-matched healthy volunteers. The latency and amplitude of visual P300 in response to the Japanese ideogram stimuli (a pair of familiar Kanji characters or unfamiliar Kanji characters) and a pair of meaningless complicated figures were measured. In almost all MR patients visual P300 was observed, however, the peak latency was significantly prolonged compared to control subjects. There was no significant difference of P300 latency among the three tasks. The distribution pattern of P300 in MR patients was different from that in the controls and the amplitudes in the frontal region was larger in MR patients. The latency decreased with age even in both groups. The developmental change of P300 latency corresponded to developmental age rather than the chronological age. These findings suggest that MR patients have impairment in processing of visual perception. Assessment of P300 latencies to the visual stimuli may be useful as an objective indicator of mental deficit.

Intraoperative complications in pediatric neurosurgery: review of 1807 cases.

PubMed

van Lindert, Erik J; Arts, Sebastian; Blok, Laura M; Hendriks, Mark P; Tielens, Luc; van Bilsen, Martine; Delye, Hans

2016-09-01

OBJECTIVE Minimal literature exists on the intraoperative complication rate of pediatric neurosurgical procedures with respect to both surgical and anesthesiological complications. The aim of this study, therefore, was to establish intraoperative complication rates to provide patients and parents with information on which to base their informed consent and to establish a baseline for further targeted improvement of pediatric neurosurgical care. METHODS A clinical complication registration database comprising a consecutive cohort of all pediatric neurosurgical procedures carried out in a general neurosurgical department from January 1, 2004, until July 1, 2012, was analyzed. During the study period, 1807 procedures were performed on patients below the age of 17 years. RESULTS Sixty-four intraoperative complications occurred in 62 patients (3.5% of procedures). Intraoperative mortality was 0.17% (n = 3). Seventy-eight percent of the complications (n = 50) were related to the neurosurgical procedures, whereas 22% (n = 14) were due to anesthesiology. The highest intraoperative complication rates were for cerebrovascular surgery (7.7%) and tumor surgery (7.4%). The most frequently occurring complications were cerebrovascular complications (33%). CONCLUSIONS Intraoperative complications are not exceptional during pediatric neurosurgical procedures. Awareness of these complications is the first step in preventing them.

Intratemporal complications of otitis media.

PubMed

Maranhão, André Souza de Albuquerque; Andrade, José Santos Cruz de; Godofredo, Valéria Romero; Matos, Rafaella Caruso; Penido, Norma de Oliveira

2013-01-01

Otitis media (OM) is considered a potentially severe disease due to the risk of complications. To establish the annual incidence of intratemporal complications (ITC) resulting from OM and to prospectively assess patients for epidemiological and clinical factors. This prospective cohort study included patients admitted during one year at a university hospital diagnosed with intratemporal complications of OM. Patients were analyzed for age, gender, type of intratemporal complication, treatment, and clinical outcome. The overall incidence of complications and the specific incidence rates of each type of complication were determined. 1,816 patients were diagnosed with OM; 592 (33%) had chronic OM; 1224 (67%) had acute OM. Fifteen patients were diagnosed with OM ITC, adding up to an annual incidence of 0.8%. Nineteen diagnoses of ITC were made in 15 patients. Seven (36.8%) patients were diagnosed with labyrinthine fistula, five (26.3%) with mastoiditis, four (21.1%) with peripheral facial palsy, and three (15.8%) with labyrinthitis. The incidence of intratemporal complications remains significant when compared to the rates seen in developed countries. Chronic cholesteatomatous otitis media is the most frequent etiology of intratemporal complications. Labyrinthine fistula is the most common intratemporal complication.

Surgical treatment of neurologic complications of bacterial meningitis in children in Kosovo.

PubMed

Namani, Sadie A; Koci, Remzie A; Kuchar, Ernest; Dedushi, Kreshnike H

2012-04-01

Neurologic complications of bacterial meningitis can occur any time during the course of the disease and some of them need neurosurgical aproach. to determine the incidence of neurologic complications of bacterial meningitis in children requring neurosurgical treatment. a total of 277 children were followed and treated for bacterial meningitis at the Clinic of Infectious Diseases in Prishtina. The authors have analyzed cases who developed acute neurologic complications and treatment procedures. of the 277 children treated for bacterial meningitis, due to the suspicion for neurologic complications, 109 children underwent a head computerized tomography scan. About 47 cases (43%) had evident structural abnormalities while only 15/277 cases (5%) required neurosurgical treatment; 9/38 cases with subdural collections, 5 cases with hydrocephalus and 1 case of spinal abscess. Neurosurgical intervention were not common in pediatric bacterial meningitis cases (5%) but were highly significant in cases complicated with acute neurologic complications (32%).

Influenza-related postinfectious encephalomyelitis complicated by a perforated peptic ulcer.

PubMed

Hsueh, Chang-Wei; Yu, Hui-Ming; Chen, Huan-Sheng; Wu, Chin-Pyng

2013-08-01

Influenza virus infection is extremely common and raises global concern due to the increasing prevalence of pandemic H1N1 infection. Influenza may occasionally be associated with neurologic complications and, also, rarely with gastrointestinal complications. Here, we report a rare case complicated with appendicitis, duodenum perforation, and transient delirious behavior after influenza A viral infection in a pediatric patient aged 14 years. The transient delirious behavior could be attributed to postinfectious encephalopathy. The perforated peptic ulcer could have resulted from influenza infection, could have been an adverse event related to oseltamivir administration, or could have been a complication of preceding gastroenteritis. Our case highlights the importance of pediatric healthcare workers to be aware of possible complications arising from both influenza infection and oseltamivir therapy, even though some of these complications may be relatively rare. Copyright © 2013. Published by Elsevier B.V.

Tactile discrimination activates the visual cortex of the recently blind naive to Braille: a functional magnetic resonance imaging study in humans.

PubMed

Sadato, Norihiro; Okada, Tomohisa; Kubota, Kiyokazu; Yonekura, Yoshiharu

2004-04-08

The occipital cortex of blind subjects is known to be activated during tactile discrimination tasks such as Braille reading. To investigate whether this is due to long-term learning of Braille or to sensory deafferentation, we used fMRI to study tactile discrimination tasks in subjects who had recently lost their sight and never learned Braille. The occipital cortex of the blind subjects without Braille training was activated during the tactile discrimination task, whereas that of control sighted subjects was not. This finding suggests that the activation of the visual cortex of the blind during performance of a tactile discrimination task may be due to sensory deafferentation, wherein a competitive imbalance favors the tactile over the visual modality.

Incisionless otoplasty: a reliable and replicable technique for the correction of prominauris.

PubMed

Mehta, Shaun; Gantous, Andres

2014-01-01

This study evaluates the postoperative outcomes achieved with incisionless otoplasty for the correction of prominauris. To determine whether incisionless otoplasty is a reliable and replicable technique in correcting prominauris. This study consisted of a retrospective electronic medical record review for 72 patients undergoing incisionless otoplasty for the correction of prominauris by a single surgeon from November 2006 to April 2013. Follow-up ranged from 1 to 87 months. The patients were operated on at both St Joseph's Health Centre (a community hospital) and The Cumberland Clinic (private practice) in Toronto, Ontario, Canada. All patients undergoing an incisionless otoplasty for the correction of prominauris were eligible. Participants' ages ranged from 3 to 55 years, with the majority being adults. Seventy patients were followed up for outcomes. Incisionless otoplasty. Number and type of sutures used, perioperative complications, and postoperative follow-up including complications and revisions. Complications included infection, hematoma, bleeding, perichondritis, suture granuloma, suture exposure, and suture failure. A mean (SD) 2.5 (0.8) sutures were used in the left ear, 2.48 (0.75) in the right ear, and 4.69 (1.75) in total. The number of sutures used in the left vs right ear was not significantly different (P = .60). All patients had horizontal mattress sutures placed for correction of prominauris. There were no serious perioperative complications such as infection, bleeding, hematoma, perichondritis, or cartilage necrosis. Follow-up data were extracted and analyzed in 70 patients, with a mean follow-up time of 31 months. Complications were seen in 10 patients (14%): 4 were due to suture failure, 3 were due to suture exposure, 2 were due to granuloma formation, and 1 was due to a Polysporin (bacitracin zinc/polymyxin B sulfate) reaction. Nine patients (13%) needed a revision to achieve a desirable result. The technique of incisionless otoplasty used in this study was well tolerated and effective in both pediatric and adult patients, producing favorable outcomes with minimal complications. This procedure is less invasive than its open counterpart and seems at least equally effective in longevity.

A framework of space weather satellite data pipeline

NASA Astrophysics Data System (ADS)

Ma, Fuli; Zou, Ziming

Various applications indicate a need of permanent space weather information. The diversity of available instruments enables a big variety of products. As an indispensable part of space weather satellite operation system, space weather data processing system is more complicated than before. The information handled by the data processing system has been used in more and more fields such as space weather monitoring and space weather prediction models. In the past few years, many satellites have been launched by China. The data volume downlinked by these satellites has achieved the so-called big data level and it will continue to grow fast in the next few years due to the implementation of many new space weather programs. Because of the huge amount of data, the current infrastructure is no longer incapable of processing data timely, so we proposed a new space weather data processing system (SWDPS) based on the architecture of cloud computing. Similar to Hadoop, SWDPS decomposes the tasks into smaller tasks which will be executed by many different work nodes. Control Center in SWDPS, just like NameNode and JobTracker within Hadoop which is the bond between the data and the cluster, will establish work plan for the cluster once a client submits data. Control Center will allocate node for the tasks and the monitor the status of all tasks. As the same of TaskTrakcer, Compute Nodes in SWDPS are the salves of Control Center which are responsible for calling the plugins(e.g., dividing and sorting plugins) to execute the concrete jobs. They will also manage all the tasks’ status and report them to Control Center. Once a task fails, a Compute Node will notify Control Center. Control Center decides what to do then; it may resubmit the job elsewhere, it may mark that specific record as something to avoid, and it may even blacklist the Compute Node as unreliable. In addition to these modules, SWDPS has a different module named Data Service which is used to provide file operations such as adding, deleting, modifying and querying for the clients. Beyond that Data Service can also split and combine files based on the timestamp of each record. SWDPS has been used for quite some time and it has been successfully dealt with many satellites, such as FY1C, FY1D, FY2A, FY2B, etc. The good performance in actual operation shows that SWDPS is stable and reliable.

The Outcomes of Nonelongating Intramedullary Fixation of the Lower Extremity for Pediatric Osteogenesis Imperfecta Patients: A Meta-analysis.

PubMed

Scollan, Joseph P; Jauregui, Julio J; Jacobsen, Christina M; Abzug, Joshua M

Osteogenesis imperfecta is usually due to autosomal dominant mutations in type I collagen, leading to an increase in fractures and bone deformities, especially in the long bones of the lower extremities. The use of nonelongating intramedullary rods is an established surgical intervention to address such deformities. The rate of surgical complications has been reported to be as high as 187%, with revision rates as high as 90%, although exact global rates are unknown. As such, we sought to determine the published rates of (1) bone-related complications (including both fracture and deformity), (2) rod migration, and (3) complications that require reoperation. Following the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines, 1295 studies were evaluated. After cross-referencing, and applying specific inclusion and exclusion criteria, a total of 7 studies were included in the final cohort. Data were extracted from the studies and analyzed. Random effect models determined the complication rates of intramedullary nonelongating rod procedures. A total of 359 primary nonelongating intramedullary rod procedures of tibiae and femurs, in patients with a mean age of 6 years (5.2 to 7.3 y), at a mean follow-up of 63 months (24 to 118 mo), were evaluated. 60% of the surgical procedures were on femurs, and 40% were on tibiae. The reoperation rate was 39.4%. The most common complication was rod migration, with a rate of 25.7%. The rate of bone-related complications was 19.5% including fractures (15.0%) and worsening bone deformity (4.3%). This is the first meta-analysis to identify the rates of complication and reoperation in lower limb intramedullary fixation for pediatric osteogenesis imperfecta patients. This study has shown that rod migration is the most common complication, followed by bone-related complications including fractures and deformity. Reoperations occur after nearly 40% of all procedures due to rod migration or bone-related complications. Level IV-retrospective meta-analysis.

Cost of the treatment of complications of unsafe abortion in public hospitals.

PubMed

Naghma-e-Rehan

2011-02-01

To study the cost of induced abortions (unsafe abortion) and treatment of the complications of such abortions. Descriptive study was conducted between July, 2008 and December, 2008 in four tertiary care hospitals of Lahore: Sir Ganga Ram Hospital, Lady Wellingdon Hospital, General Hospital and Family Health Hospital of Family Planning Association of Pakistan. One hundred women admitted with complications of induced abortion were interviewed by lady doctors, who were trained to conduct the interviews. The data was collected through a structured pre-designed and pre-tested questionnaire approved by International Planned Parenthood Federation. Based on the information provided by the woman and/or her husband and hospital sources, the average cost of abortion was Rs.1686/-. The cost varied from Rs. 500/- to 7,000/-depending on the city, type of provider and facilities available at the clinic. The average cost of treating the complications was Rs. 4,197/- ranging from Rs. 1600/- to Rs 45,000/-. At the present exchange rate (September, 2009), the cost will be US$ 20/- to 560/-. Wide variation between two extremes was due to the type and extent of complications. Treatment for abortion-related complications consumes a large portion of hospital budgets for obstetrics and gynaecology and results in considerable mortality and morbidity. Due to restrictive laws and high cost of safe abortions, most women faced with an unwanted pregnancy resort to unsafe abortions.

Severe bleeding complications other than intracranial hemorrhage in neonatal alloimmune thrombocytopenia: a case series and review of the literature.

PubMed

Winkelhorst, Dian; Kamphuis, Marije M; de Kloet, Liselotte C; Zwaginga, Jaap Jan; Oepkes, Dick; Lopriore, Enrico

2016-05-01

The most feared bleeding complication in fetal and neonatal alloimmune thrombocytopenia (FNAIT) is an intracranial hemorrhage (ICH). However, FNAIT may also lead to other severe bleeding problems. The aim was to analyze this spectrum and evaluate the occurrence of severe hemorrhages other than ICH in fetuses or neonates with FNAIT. A retrospective chart analysis of cases of FNAIT presenting with severe bleeding complications other than ICH at our institution from 1990 to 2015 was conducted. Additionally, a review of the literature was performed to identify case reports and case series on FNAIT presenting with extracranial hemorrhage. Of 25 fetuses or neonates with severe bleeding due to FNAIT, three had isolated severe internal organ hemorrhage other than ICH, two pulmonary hemorrhages and one gastrointestinal hemorrhage. Two of these three neonates died due to this bleeding. Eighteen cases of extracranial bleeding complications as a first presentation of FNAIT were found in the literature, including ocular, gastrointestinal, spinal cord, pulmonary, renal, subgaleal, and genitourinary hemorrhages. Bleeding complications other than ICH may be more extensive, and the presentation of FNAIT may have a greater spectrum than previously described. A high index of suspicion on the possible diagnosis of FNAIT with any bleeding complication in a fetus or neonate may enable adequate diagnostics, adequate treatment, and appropriate follow-up in future pregnancies, as is especially relevant for FNAIT. © 2016 AABB.

[A comparative study of complications after vagotomy-pyloroplasty using Sugiura-Futagawa procedure and surgery of acid peptic disease].

PubMed

Orozco, H; Mercado, M A; Morales-Linares, J C; Gómez-Méndez, T J

1996-01-01

The frequency of complications of vagotomy and pyloroplasty for treating peptic disease is considerable. The modification of the Sugiura-Futagawa procedure includes bilateral truncal vagotomy and pyloroplasty as part of the devascularization, with a low frequency of related complications. To study the effects after VP in the outcome of both groups of patients. The results of a retrospective, comparative, not randomized, controlled trial of 153 medical records of patients who underwent our modification of the Sugiura-Futagawa operation (SFO) due to Hemorrhagic Portal Hypertension (HPH), and 100 patients with bilateral truncal vagotomy and pyloroplasty (VP) due to Acid-Peptic Disease (APD) are presented. In both groups VP was done. The first group as part of SFO, and the second to treat their disease. We found 47 complications; 40 (40%) were observed in patients who underwent VP for APD and 7 (4%) in SFO: Post-vagotomy Diarrhea (PVD): 11% after APD and 2% after SFO. Dumping Syndrome (DS): 22% and 1%, and Alkaline Reflux Gastritis (ARG): 7% and 0.5% respectively. The calculated risk of developing complications related to vagotomy and pyloroplasty in peptic ulcer disease was 14 times higher. The incidence of these post VP complications at the SFO group was low (4%), in relation to 40% for the APD; the outcomes were statistically significative (p < 0.05).

Pregnancy and Delivery in Patients with Mastocytosis Treated at the Polish Center of the European Competence Network on Mastocytosis (ECNM)

PubMed Central

Pabin, Izabela; Adamski, Przemyslaw; Leszczynska, Katarzyna; Preis, Krzysztof; Olszewska, Hanna; Wydra, Dariusz G.; Hansdorfer-Korzon, Rita

2016-01-01

Objective To present current guidelines regarding treatment of mastocytosis in pregnancy on the example of observed patients. Design Case control national study. Setting Polish Center of the European Competence Network on Mastocytosis (ECNM). Population or Sample 23 singleton spontaneous pregnancies in 17 women diagnosed with mastocytosis in years 1999–2014, before becoming pregnant. Methods Prospective analysis outcomes of pregnancies and deliveries. Main Outcome Measures Survey developed in cooperation with the Spanish Instituto de Estudios de Mastocitosis de Castilla-La Mancha (CLMast), Hospital Virgen del Valle, Toledo, Red Espańola de Mastocitosis (REMA), Spain. Results All 23 pregnancies resulted from natural conception. Obstetrical complications recorded in the first trimester included spontaneous miscarriage (5 pregnancies). Four patients delivered preterm, including one delivery due to preeclampsia at 26 weeks which resulted with neonate death due to extreme prematurity. Five women delivered via cesarean: four due to obstetrical indications and one due to mastocytosis, during which no anesthesia related complications were recorded. Of patients delivering vaginally, two received extradural anesthesia, three required oxytocin infusion due to uterine hypotonia. No labor complications were recorded. In one woman with pregnancy-induced hypertension, early puerperium was complicated by the presence of persistent arterial hypertension. One neonate was born with the signs of cutaneous mastocytosis. Another neonate was diagnosed with Patau syndrome. Four women were treated for mastocytosis prior to conception and continued therapy after becoming pregnant. One patient was put on medications in the first trimester due to worsening of her symptoms. Pregnancy exerted only a slight effect on the intensity and frequency of mastocytosis-related symptoms observed. Worsening of the disease-related symptoms was documented in only four patients (23%). None of the patients showed the signs of anaphylaxis, either before becoming pregnant, or during pregnancy and puerperium. Conclusions There is no contraindication to pregnancy when mastocystosis-related pathologies are under appropriate medical control. PMID:26796887

Pregnancy and Delivery in Patients with Mastocytosis Treated at the Polish Center of the European Competence Network on Mastocytosis (ECNM).

PubMed

Ciach, Katarzyna; Niedoszytko, Marek; Abacjew-Chmylko, Anna; Pabin, Izabela; Adamski, Przemyslaw; Leszczynska, Katarzyna; Preis, Krzysztof; Olszewska, Hanna; Wydra, Dariusz G; Hansdorfer-Korzon, Rita

2016-01-01

To present current guidelines regarding treatment of mastocytosis in pregnancy on the example of observed patients. Case control national study. Polish Center of the European Competence Network on Mastocytosis (ECNM). 23 singleton spontaneous pregnancies in 17 women diagnosed with mastocytosis in years 1999-2014, before becoming pregnant. Prospective analysis outcomes of pregnancies and deliveries. Survey developed in cooperation with the Spanish Instituto de Estudios de Mastocitosis de Castilla-La Mancha (CLMast), Hospital Virgen del Valle, Toledo, Red Espańola de Mastocitosis (REMA), Spain. All 23 pregnancies resulted from natural conception. Obstetrical complications recorded in the first trimester included spontaneous miscarriage (5 pregnancies). Four patients delivered preterm, including one delivery due to preeclampsia at 26 weeks which resulted with neonate death due to extreme prematurity. Five women delivered via cesarean: four due to obstetrical indications and one due to mastocytosis, during which no anesthesia related complications were recorded. Of patients delivering vaginally, two received extradural anesthesia, three required oxytocin infusion due to uterine hypotonia. No labor complications were recorded. In one woman with pregnancy-induced hypertension, early puerperium was complicated by the presence of persistent arterial hypertension. One neonate was born with the signs of cutaneous mastocytosis. Another neonate was diagnosed with Patau syndrome. Four women were treated for mastocytosis prior to conception and continued therapy after becoming pregnant. One patient was put on medications in the first trimester due to worsening of her symptoms. Pregnancy exerted only a slight effect on the intensity and frequency of mastocytosis-related symptoms observed. Worsening of the disease-related symptoms was documented in only four patients (23%). None of the patients showed the signs of anaphylaxis, either before becoming pregnant, or during pregnancy and puerperium. There is no contraindication to pregnancy when mastocystosis-related pathologies are under appropriate medical control.

Individual differences in social information gathering revealed through Bayesian hierarchical models

PubMed Central

Pearson, John M.; Watson, Karli K.; Klein, Jeffrey T.; Ebitz, R. Becket; Platt, Michael L.

2013-01-01

As studies of the neural circuits underlying choice expand to include more complicated behaviors, analysis of behaviors elicited in laboratory paradigms has grown increasingly difficult. Social behaviors present a particular challenge, since inter- and intra-individual variation are expected to play key roles. However, due to limitations on data collection, studies must often choose between pooling data across all subjects or using individual subjects' data in isolation. Hierarchical models mediate between these two extremes by modeling individual subjects as drawn from a population distribution, allowing the population at large to serve as prior information about individuals' behavior. Here, we apply this method to data collected across multiple experimental sessions from a set of rhesus macaques performing a social information valuation task. We show that, while the values of social images vary markedly between individuals and between experimental sessions for the same individual, individuals also differentially value particular categories of social images. Furthermore, we demonstrate covariance between values for image categories within individuals and find evidence suggesting that magnitudes of stimulus values tend to diminish over time. PMID:24062635

Correlation Filters for Detection of Cellular Nuclei in Histopathology Images.

PubMed

Ahmad, Asif; Asif, Amina; Rajpoot, Nasir; Arif, Muhammad; Minhas, Fayyaz Ul Amir Afsar

2017-11-21

Nuclei detection in histology images is an essential part of computer aided diagnosis of cancers and tumors. It is a challenging task due to diverse and complicated structures of cells. In this work, we present an automated technique for detection of cellular nuclei in hematoxylin and eosin stained histopathology images. Our proposed approach is based on kernelized correlation filters. Correlation filters have been widely used in object detection and tracking applications but their strength has not been explored in the medical imaging domain up till now. Our experimental results show that the proposed scheme gives state of the art accuracy and can learn complex nuclear morphologies. Like deep learning approaches, the proposed filters do not require engineering of image features as they can operate directly on histopathology images without significant preprocessing. However, unlike deep learning methods, the large-margin correlation filters developed in this work are interpretable, computationally efficient and do not require specialized or expensive computing hardware. A cloud based webserver of the proposed method and its python implementation can be accessed at the following URL: http://faculty.pieas.edu.pk/fayyaz/software.html#corehist .

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

Neugent, Kathryn F.; Massey, Philip; Skiff, Brian

Due to their transitionary nature, yellow supergiants (YSGs) provide a critical challenge for evolutionary modeling. Previous studies within M31 and the Small Magellanic Cloud show that the Geneva evolutionary models do a poor job at predicting the lifetimes of these short-lived stars. Here, we extend this study to the Large Magellanic Cloud (LMC) while also investigating the galaxy's red supergiant (RSG) content. This task is complicated by contamination by Galactic foreground stars that color and magnitude criteria alone cannot weed out. Therefore, we use proper-motions and the LMC's large systemic radial velocity ({approx}278 km s{sup -1}) to separate out thesemore » foreground dwarfs. After observing nearly 2000 stars, we identified 317 probable YSGs, 6 possible YSGs, and 505 probable RSGs. Foreground contamination of our YSG sample was {approx}80%, while that of the RSG sample was only 3%. By placing the YSGs on the Hertzsprung-Russell diagram and comparing them against the evolutionary tracks, we find that new Geneva evolutionary models do an exemplary job at predicting both the locations and the lifetimes of these transitory objects.« less

A BPMN solution for chaining OGC services to quality assure location-based crowdsourced data

NASA Astrophysics Data System (ADS)

Meek, Sam; Jackson, Mike; Leibovici, Didier G.

2016-02-01

The Open Geospatial Consortium (OGC) Web Processing Service (WPS) standard enables access to a centralized repository of processes and services from compliant clients. A crucial part of the standard includes the provision to chain disparate processes and services to form a reusable workflow. To date this has been realized by methods such as embedding XML requests, using Business Process Execution Language (BPEL) engines and other external orchestration engines. Although these allow the user to define tasks and data artifacts as web services, they are often considered inflexible and complicated, often due to vendor specific solutions and inaccessible documentation. This paper introduces a new method of flexible service chaining using the standard Business Process Markup Notation (BPMN). A prototype system has been developed upon an existing open source BPMN suite to illustrate the advantages of the approach. The motivation for the software design is qualification of crowdsourced data for use in policy-making. The software is tested as part of a project that seeks to qualify, assure, and add value to crowdsourced data in a biological monitoring use case.

Huntington Disease - principles and practice of nutritional management.

PubMed

Zukiewicz-Sobczak, Wioletta; Król, Renata; Wróblewska, Paula; Piątek, Jacek; Gibas-Dorna, Magdalena

2014-01-01

Huntington disease (HD) is a degenerative brain disease clinically manifested by the characteristic triad: physical symptoms including involuntary movements and poor coordination, cognitive changes with less ability to organize routine tasks, and some emotional and behavioral disturbances. For patients with HD, feeding is one of the problems they have to face. People with HD often have lower than average body weight and struggle with malnutrition. As a part of therapy, good nutrition is an intervention maintaining health and functional ability for maximally prolonged time. In the early stages of HD, small amounts of blenderized foods given orally are recommended. In more advanced stages, enteral nutrition is essential using gastric, or jejunal tubes for short term. Most severe cases require gastrostomy or gastrojejunostomy. Although enteral feeding is well tolerated by most of the patients, a number of complications may occur, including damage to the nose, pharynx, or esophagus, aspiration pneumonia, sinusitis, metabolic imbalances due to improper nutrient and fluid supply, adverse effects affecting gastrointestinal system, and refeeding syndrome. Copyright © 2014 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

The Overall Survival, Complication-Free Survival, and Related Complications of Combined Tooth-Implant Fixed Partial Dentures: A Literature Review

PubMed Central

Borg, Peter; Puryer, James; McNally, Lisa; O’Sullivan, Dominic

2016-01-01

This paper reviews the literature regarding possible complications, complication-free survival, and overall survival of fixed dental prostheses that use both implants and natural teeth as abutments. The paper also provides clinical guidelines for treatment based on this literature review. An electronic search utilizing the MEDLINE, BIOSIS Citation Index, and Web of Science™ Core Collection databases was undertaken, and a review of the 25 selected texts studying 22 different patient cohorts was carried out. From a total of 1610 implants reviewed, 40 were lost (33 due to loss of integration and 7 due to fracture), whereas, out of a total of 1301 teeth, 38 were lost, of which 16 were due to fracture. Seventy-three cases of tooth intrusion were detected. From a total of 676 frameworks reviewed (metal n = 645, Zirconia n = 31), 7 fractured, while veneer material fracture occurred in 70 out of 672 bridges. Overall, 502 out of 531 tooth-implant fixed prostheses (TIPFs) remained functional, and 336 out of 439 prostheses showed no technical or biological complications and remained functional. Rigid TIFPs permanently cemented to teeth with sufficient coronal structure and with limited use of prosthetic attachments offer a good long-term treatment option to patients with good oral hygiene following sound implant placement. This mode of treatment should be used when free-standing implant-supported options may not be possible. Larger randomized control studies and other clinical studies comparing tooth-to-implant-connected treatment with other forms of treatment are needed to better understand the place of TIFP treatment in oral rehabilitation. PMID:29563458

Assessing the Impact of Diabetes Mellitus on Donor Corneal Endothelial Cell Density.

PubMed

Liaboe, Chase A; Aldrich, Benjamin T; Carter, Pamela C; Skeie, Jessica M; Burckart, Kimberlee A; Schmidt, Gregory A; Reed, Cynthia R; Zimmerman, M Bridget; Greiner, Mark A

2017-05-01

To quantify changes in endothelial cell density (ECD) of donor corneal tissue in relation to the presence or absence of a medical history of diabetes mellitus diagnosis, treatment, and complications. A retrospective review was performed for all corneas collected at Iowa Lions Eye Bank between January 2012 and December 2015. For purposes of analysis, donor corneas were divided into 4 groups: nondiabetic, non-insulin-dependent diabetic, insulin-dependent diabetic without medical complications due to diabetes, and insulin-dependent diabetic with medical complications due to diabetes. ECD values (obtained through specular microscopy) and transplant suitability for endothelial transplantation (determined by the standard protocol of the eye bank) were compared among groups using linear mixed model analysis. In total, 4185 corneas from 2112 donors were included for analysis. Insulin-dependent diabetic samples with medical complications due to diabetes (N = 231 from 119 donors) showed lower ECD values compared with nondiabetic samples (-102 cells/mm, P = 0.049) and non-insulin-dependent diabetic samples (-117 cells/mm, P = 0.031). ECD values did not differ significantly among the remaining groups. The likelihood of suitability for endothelial transplantation did not differ among all 4 groups. Corneas from donors with insulin-dependent diabetes mellitus and medical complications resulting from the disease have lower mean ECD values compared with other donors. However, our analysis suggests that these corneas are equally likely to be included in the donor pool for corneal transplantation. Additional studies are needed to determine the mechanism(s) contributing to cell loss in donors with advanced diabetes and to assess associated endothelial cell functional impairment.

The Effects of Partner-Check Self-Recording of On-Task Behavior on Academic Productivity in Children with Behavior Problems

ERIC Educational Resources Information Center

Ohakamnu, George N.

2010-01-01

Due to an increase in behavior problems among school children, especially at-risk children who have problems staying on-task, there is a need for a teaching strategy that will enable children to be focused and on task in the classroom. This quantitative study investigated whether partner-check self-recording of on-task behavior will increase the…

Predicting Handwriting Difficulties Through Spelling Processes.

PubMed

Rodríguez, Cristina; Villarroel, Rebeca

This study examined whether spelling tasks contribute to the prediction of the handwriting status of children with poor and good handwriting skills in a cross-sectional study with 276 Spanish children from Grades 1 and 3. The main hypothesis was that the spelling tasks would predict the handwriting status of the children, although this influence would decrease with age due to a gradual automatization of handwriting skills. The results confirmed this hypothesis. Another interesting result was that the pattern of pseudoword and irregular word spellings as predictors of handwriting status changed from Grade 1 to Grade 3. In Grade 1, the pseudoword spelling task made a significant contribution, whereas the irregular word spelling task did not. The opposite pattern was found in Grade 3. These results may be a consequence of progressive acquisition of orthographic representations. The orthographic role of the task of writing the alphabet in order from memory in the prediction model was also analyzed. The writing of the alphabet in order from memory task made a significant contribution to the prediction of handwriting status of the children beyond the orthographic influence of spelling tasks. The additional effect of this task on the prediction of handwriting status is presumably due to the fact that this measure is based on fluency.

Evaluation of a mobile augmented reality application for image guidance of neurosurgical interventions.

PubMed

Kramers, Matthew; Armstrong, Ryan; Bakhshmand, Saeed M; Fenster, Aaron; de Ribaupierre, Sandrine; Eagleson, Roy

2014-01-01

Image guidance can provide surgeons with valuable contextual information during a medical intervention. Often, image guidance systems require considerable infrastructure, setup-time, and operator experience to be utilized. Certain procedures performed at bedside are susceptible to navigational errors that can lead to complications. We present an application for mobile devices that can provide image guidance using augmented reality to assist in performing neurosurgical tasks. A methodology is outlined that evaluates this mode of visualization from the standpoint of perceptual localization, depth estimation, and pointing performance, in scenarios derived from a neurosurgical targeting task. By measuring user variability and speed we can report objective metrics of performance for our augmented reality guidance system.

Influence of HIV virus in the hospital stay and the occurrence of postoperative complications classified according to the Clavien-Dindo classification and in comparison with the Charlson Comorbidity Index in patients subjected to urologic and general surgery operations. Our preliminary results.

PubMed

Dimitroulis, Dimitrios; Karaolanis, Georgios; Katafigiotis, Ioannis; Anastasiou, Ioannis; Palla, Viktoria-Varvara; Kontos, Athanasios; Duvdevani, Mordechai; Kontzoglou, Konstantinos

2017-06-30

From the first time that human immunodeficiency virus (HIV) was discovered, till today both the quality of life and survival expectancy of HIV-infected patients have markedly improved. As the life expectancy of these patients increases due to the use of highly active anti-retroviral therapy (HAART) also increases the number of HIV-positive patient to be subjected to an operation. Different studies have examined the occurrence of complications in this particular group of patients and their possible susceptibility to infections or other complications that could lead to increased hospital stay, morbidity and mortality with controversial results. We retrospectively analyzed the data of 25 HIV-patients that were subjected to general surgery and urologic operations and we also examined in comparison with the Charlson score and their comorbidities the occurrence of complications and subsequently the possibility of an increase hospital stay due to their HIV infection. Alongside we classified their complications according to the Clavien-Dindo and compared these complications in relation to their Charlson score and CD4 count. 10/25 (40%) of the population had prolonged hospital stay and from this population 6 (6/25) (24%) patients had less than 200 CD4 constituting the AIDS subpopulation. The decline of the CD4 count showed a tendency for the occurrence of a complication and comorbidities to HIV-positive patients seem to affect more the AIDS subpopulation. Although this is a small retrospective study, we tried to classify our complications according to the Clavien- Dindo classification and combine the classification to the age adjusted Charlson score index of comorbidities.

BC4GO: a full-text corpus for the BioCreative IV GO Task

USDA-ARS?s Scientific Manuscript database

Gene function curation via Gene Ontology (GO) annotation is a common task among Model Organism Database (MOD) groups. Due to its manual nature, this task is time-consuming and labor-intensive, and thus considered one of the bottlenecks in literature curation. There have been many previous attempts a...

Bilingual Advantage in Attentional Control: Evidence from the Forced-Attention Dichotic Listening Paradigm

ERIC Educational Resources Information Center

Soveri, Anna; Laine, Matti; Hamalainen, Heikki; Hugdahl, Kenneth

2011-01-01

It has been claimed that due to their experience in controlling two languages, bilinguals exceed monolinguals in certain executive functions, especially inhibition of task-irrelevant stimuli. Here we investigated the effects of bilingualism on an executive phonological task, namely the forced-attention dichotic listening task with syllabic…

Bridge-in-a-Backpack(TM). Task 7 : investigation of damage and repairs for concrete filled FRP tubular arches.

DOT National Transportation Integrated Search

2015-04-01

This report includes fulfillment of Task 7 of a multi-task contract to further enhance concrete filled FRP tubes, or : the Bridge in a Backpack. : Damage due to impact of the FRP shell of the concrete filled FRP tubular arch bridges has been and stil...

Household Task Participation of Children with and without Attentional Problems

ERIC Educational Resources Information Center

Dunn, Louise; Coster, Wendy J.; Orsmond, Gael I.; Cohn, Ellen S.

2009-01-01

Children with attention deficit/hyperactivity disorder (ADHD) often demonstrate problems in their participation in family occupations, such as household tasks, due to their needs for assistance and their behavior. Because participation in household tasks is part of family life and may be one way that families prepare children for adult roles, it…

Neuropsychiatric features associated with nutritional and metabolic status in a gastric bypass patient.

PubMed

Waserman, Jessica E; Hategan, Ana; Bourgeois, James A

2015-01-01

Bariatric patients may present for psychiatric evaluation due to exacerbation of preexisting psychiatric disorders, new onset psychiatric disorders and/or neuropsychiatric complications associated with abnormal nutritional and metabolic states following the surgical procedure. These neuropsychiatric complications can be insidious, and clinical manifestations may vary, possibly due to the individual central nervous system (CNS) vulnerability to nutritional decline. Lack of awareness of these complications and their symptoms can result in delays in diagnosis and treatment. Identifying and correcting underlying pathophysiologic processes that lead to such neuropsychiatric syndromes can be challenging. We report a case of a patient who developed a protracted course of mood and cognitive disorder after gastric bypass surgery, which illustrates some of the complexities encountered in diagnosing and managing these patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Fecal Microbiota Transplantation for Refractory Clostridium difficile Colitis in Solid Organ Transplant Recipients

PubMed Central

Friedman-Moraco, R. J.; Mehta, A. K.; Lyon, G. M.; Kraft, C. S.

2015-01-01

Fecal microbiota transplantation (FMT) has been shown to be safe and efficacious in individuals with refractory Clostridium difficile . It has not been widely studied in individuals with immunosuppression due to concerns about infectious complications. We describe two solid organ transplant recipients, one lung and one renal, in this case report that both had resolution of their diarrhea caused by C. difficile after FMT. Both recipients required two FMTs to achieve resolution of their symptoms and neither had infectious complications. Immunosuppressed individuals are at high risk for acquisition of C. difficile and close monitoring for infectious complications after FMT is necessary, but should not preclude its use in patients with refractory disease due to C. difficile . Sequential FMT may be used to achieve cure in these patients with damaged microbiota from antibiotic use and immunosuppression. PMID:24433460

How to reduce avoidable admissions due to acute diabetes complications?: interrelation between primary and specialized attention in a diabetes unit.

PubMed

García-Talavera Espín, N V; López-Ruiz, A; Nuñez Sánchez, Ma Á; Meoro Avilés, A; Sánchez Cañizares, C; Romero López-Reinoso, H; López Olivar, Ma D; Lapaz Jorge, Ma Á; Guirao Sastre, J Ma; San Eustaquio Tudanca, F; Soriano Palao, J

2012-01-01

Type 2 Diabetes Mellitus is a serious health problem. In the year 2030 it will affect 366 million people around the world. Evaluate the effectiveness of a mixed intervention and reducing the amount and seriousness of acute complications in diabetics from our Health Area. Protocols of action as well as information documents were produced. Diabetes Unit coordinated educational activities in the different support levels of the Area VII of Murcia. Information talks were provided for the people in charge of the Diabetes Unit in every Care Center and Service of the Health Area. Personalized training was provided for patients treated in the different Care levels. The study comprised three stages. Information leaflets were spread and talks offered to the patient regarding in house handling of hypo and hyper glycemia. A reduction of 39% of the emergencies due to acute non complicated diabetes was achieved, as well as a reduction of 47.6% of hospital admissions. There was a reduction of 67.8% of the amount of total hospital stays for the group of patients under 35 years who were admitted into the hospital due to type 1 or 2 diabetes mellitus that didn't show any complications (GRD295). There was a reduction of more than thirty percent in the emergencies due to acute decompensations in the disease and a significant reduction in the avoidable hospital stays in the young adult, thus improving the patients' life quality and reducing the social cost of the diabetic patient.

An observational study of complications in chickenpox with special reference to unusual complications in an apex infectious disease hospital, Kolkata, India.

PubMed

Kole, A K; Roy, R; Kole, D C

2013-01-01

Chickenpox can cause serious complications and even death in persons without any risk factors. To observe the different complications with special reference to unusual complications of chickenpox and their outcomes. The present study was a prospective observational study where 300 patients suffering from chickenpox were evaluated with special reference to unusual complications and outcomes. The usual complications of chickenpox commonly observed were acute hepatitis in 30 (10%) and cerebellar ataxia in 22 patients (7.3%), whereas common unusual complications were acute pancreatitis in 45 (15%), hemorrhagic rash in 10 (3.3%), Guillain-Barrι syndrome in 4 (1.3%), disseminated intravascular coagulation in 4 (1.3%), necrotizing fasciitis in 4 (1.3%), and acute renal failure in 3 patients (1%). It had been observed that most of these unusual complications occurred in patients without any risk factor. A total of 18 patients (6%) died in this study and of them 12 patients (4%) died due to unusual complications. Compulsory childhood varicella vaccination including vaccination of risk groups and susceptible individuals are all essential to reduce the incidence of chickenpox, associated complications, and subsequent death.

Operating Room of the Future: Advanced Technologies in Safe and Efficient Operating Rooms

DTIC Science & Technology

2008-10-01

fit” or compatibility with different tasks. Ideally, the optimal match between tasks and well-designed display alternatives will be self -apparent...hierarchical display environment. The FARO robot arm is used as an accurate and reliable tracker to control a virtual camera. The virtual camera pose is...in learning outcomes due to self -feedback, improvements in learning outcomes due to instructor feedback and synchronous versus asynchronous

Complications of Elastic Stable Intramedullary Nailing for treating paediatric long bone fractures

PubMed Central

Nisar, Aamer; Bhosale, Abhijit; Madan, Sanjeev S.; Flowers, Mark J.; Fernandes, James A.; Jones, Stanley

2013-01-01

This study reports the complications observed in children with long bone fractures treated using Elastic Stable Intramedullary Nailing (ESIN). One hundred and sixty-four (n = 164) fractures in 160 patients under the age of 16 years formed the basis of our review. This included 108 boys and 52 girls with the median age of 11 years and median follow up of 7.5 months. The analysis included fractures of the radius/ulna, humerus, femur and tibia. All pathological fractures were excluded. In this series 54 patients (34%) had complications however majority of these were minor complications with irritation due to prominent nail ends being the commonest complication. No long-term sequelae were encountered in our patients. PMID:24403743

Intubations and airway management: An overview of Hassles through third millennium.

PubMed

Alanazi, Abdullah

2015-01-01

The placement of a tube into a patient's trachea "the intubation" as we call is not as simple as it looks. It is a very tricky and tedious maneuver that entails skills to assess and perform. Nevertheless, often this is left to the chores of inefficient hands due to a paucity of the availability of experts. They seldom are able to complete the task and often wind up calling the attention of the unit. The present review is an attempt to describe the need to undertake intubation, the procedures and techniques, the complications, including morbidity and mortality and airway management. This overview includes explicit descriptions of the difficult airway which represents multifaceted interface amid patient factors, clinical setting, and skills of the practitioner. To accomplish the target, peer-reviewed English language articles published during third millennium up to 2013 were selected from Pub Med, Pub Med Central, Science Direct, Up-to-date, Med Line, comprehensive databases, Cochrane library, and the Internet (Google, Yahoo). The review constituted a systematic search of literature on the requirements that necessitate the practice of intubation, different techniques that facilitate easy conduct of procedure, the complications, including, morbidity and mortality, and the airway management. Recording every single detail has been beyond the scope of this review, however; some aspects have been wrapped up in nutshell. Some areas of the review are too basic which the medics are well aware of and knowledgeable. Nevertheless, these are difficult to be dispensed with in consideration of their source to the awareness of a common man and a great majority of the patients.

QRTEngine: An easy solution for running online reaction time experiments using Qualtrics.

PubMed

Barnhoorn, Jonathan S; Haasnoot, Erwin; Bocanegra, Bruno R; van Steenbergen, Henk

2015-12-01

Performing online behavioral research is gaining increased popularity among researchers in psychological and cognitive science. However, the currently available methods for conducting online reaction time experiments are often complicated and typically require advanced technical skills. In this article, we introduce the Qualtrics Reaction Time Engine (QRTEngine), an open-source JavaScript engine that can be embedded in the online survey development environment Qualtrics. The QRTEngine can be used to easily develop browser-based online reaction time experiments with accurate timing within current browser capabilities, and it requires only minimal programming skills. After introducing the QRTEngine, we briefly discuss how to create and distribute a Stroop task. Next, we describe a study in which we investigated the timing accuracy of the engine under different processor loads using external chronometry. Finally, we show that the QRTEngine can be used to reproduce classic behavioral effects in three reaction time paradigms: a Stroop task, an attentional blink task, and a masked-priming task. These findings demonstrate that QRTEngine can be used as a tool for conducting online behavioral research even when this requires accurate stimulus presentation times.

General proactive interference and the N450 response.

PubMed

Tays, William J; Dywan, Jane; Segalowitz, Sidney J

2009-10-25

Strategic repetition of verbal stimuli can effectively produce proactive interference (PI) effects in the Sternberg working memory task. Unique fronto-cortical activation to PI-eliciting letter probes has been interpreted as reflecting brain responses to PI. However, the use of only a small set of stimuli (e.g., letters and digits) requires constant repetition of stimuli in both PI and baseline trials, potentially creating a general PI effect in all conditions. We used event-related potentials to examine general PI effects by contrasting the interference-related frontal N450 response in two Sternberg tasks using a small versus large set size. We found that the N450 response differed significantly from baseline during the small set-size task only for response-conflict PI trials but not when PI was created solely from stimulus repetition. During the large set-size task N450 responses in both the familiarity-based and response-conflict PI conditions differed from baseline but not from each other. We conclude that the general stimulus repetition inherent in small set-size conditions can mask effects of familiarity-based PI and complicate the interpretation of any associated neural response.

Cold-Blooded Attention: Finger Temperature Predicts Attentional Performance.

PubMed

Vergara, Rodrigo C; Moënne-Loccoz, Cristóbal; Maldonado, Pedro E

2017-01-01

Thermal stress has been shown to increase the chances of unsafe behavior during industrial and driving performances due to reductions in mental and attentional resources. Nonetheless, establishing appropriate safety standards regarding environmental temperature has been a major problem, as modulations are also be affected by the task type, complexity, workload, duration, and previous experience with the task. To bypass this attentional and thermoregulatory problem, we focused on the body rather than environmental temperature. Specifically, we measured tympanic, forehead, finger and environmental temperatures accompanied by a battery of attentional tasks. We considered a 10 min baseline period wherein subjects were instructed to sit and relax, followed by three attentional tasks: a continuous performance task (CPT), a flanker task (FT) and a counting task (CT). Using multiple linear regression models, we evaluated which variable(s) were the best predictors of performance. The results showed a decrement in finger temperature due to instruction and task engagement that was absent when the subject was instructed to relax. No changes were observed in tympanic or forehead temperatures, while the environmental temperature remained almost constant for each subject. Specifically, the magnitude of the change in finger temperature was the best predictor of performance in all three attentional tasks. The results presented here suggest that finger temperature can be used as a predictor of alertness, as it predicted performance in attentional tasks better than environmental temperature. These findings strongly support that peripheral temperature can be used as a tool to prevent unsafe behaviors and accidents.

Transcatheter Arterial Embolization of Intramuscular Active Hemorrhage with N-Butyl Cyanoacrylate

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

Yoo, Dong Hyun; Jae, Hwan Jun, E-mail: jhj@radiol.snu.ac.kr; Kim, Hyo-Cheol

Purpose: This study was designed to evaluate the clinical efficacy and safety of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for intramuscular active hemorrhage of varied etiologies and anatomic sites. Methods: Eighteen patients who demonstrated hematoma with pseudoaneurysm and/or active extravasation of contrast media underwent TAE with NBCA. Etiologies of hematoma included trauma, postoperative complication, and coagulopathy (due to underlying disease or anticoagulation therapy). Sites of embolization included chest wall, abdomen wall, retroperitoneum, and extremity. TAE was performed by using 1:3 to 1:5 mixtures of NBCA and iodized oil, either solely (n = 15) or in combination with microcoilmore » (n = 3). The technical and clinical success rate, procedure-related complications, and clinical outcomes were evaluated. Results: The technical and clinical success rates were 100% and 83% (15/18), respectively. Two patients expired while admitted due to other comorbidities. One patient expired due to recurrent bleeding at another site. There were no serious complications relating to the embolization procedure. Conclusions: TAE with NBCA is effective and safe treatment modality for intramuscular active hemorrhage.« less

Vascular ring complicates accidental button battery ingestion.

PubMed

Mercer, Ronald W; Schwartz, Matthew C; Stephany, Joshua; Donnelly, Lane F; Franciosi, James P; Epelman, Monica

2015-01-01

Button battery ingestion can lead to dangerous complications, including vasculoesophageal fistula formation. The presence of a vascular ring may complicate battery ingestion if the battery lodges at the level of the ring and its important vascular structures. We report a 4-year-old boy with trisomy 21 who was diagnosed with a vascular ring at the time of button battery ingestion and died 9 days after presentation due to massive upper gastrointestinal bleeding from esophageal erosion and vasculoesophageal fistula formation. Copyright © 2015 Elsevier Inc. All rights reserved.

Unusual Severe Complication Following Transarterial Chemoembolization for Metastatic Malignant Melanoma: Giant Intrahepatic Cyst and Fatal Hepatic Failure

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

Ataergin, Selmin, E-mail: sataergin@superonline.co; Tasar, Mustafa; Solchaga, Luis

2009-03-15

We describe a 45-year-old male patient with malignant melanoma who underwent hepatic arterial chemoembolization due to liver metastases. Four months after the procedure, the patient developed a giant cystic cavity in the liver. Cytologic examination of the cystic fluid retention revealed necrotic tumor material. The fluid was drained by percutaneous catheter, but the patient developed hepatic failure. This case represents another rare complication of transarterial chemoembolization and shows that transarterial chemoembolization may have rare fatal complications.

Frozen Elephant Trunk and Antegrade Visceral Debranching in the Surgical Treatment of Type B Aortic Dissection: An Alternative Method

PubMed Central

Tuncer, Altug; Akbulut, Mustafa; Adademir, Taylan; Tas, Serpil; Ak, Adnan; Arslan, Özgür; Erden, Benay; Şişmanoğlu, Mesut

2016-01-01

Intervention is inevitable in complicated Type B aortic dissections. Classical surgical procedures and endovascular interventions are far from ideal treatments due to their high risk of periprocedural complications and mortality. There is often a need for alternative method in cases of difficult anatomy. We present the combined use of frozen elephant trunk and antegrade visceral debranching methods in the treatment of a 54-year-old male patient with complicated Type B aortic dissection. PMID:28516092

Assessing the Safety of Expanded Polytetrafluoroethylene Synthetic Grafts in Living Donor Liver Transplantation: Graft Migration Into Hollow Viscous Organs - Diagnosis and Treatment Options.

PubMed

Hsu, Shih-Chao; Thorat, Ashok; Yang, Horng-Ren; Poon, Kin-Shing; Li, Ping-Chun; Yeh, Chun-Chieh; Chen, Te-Hung; Jeng, Long-Bin

2017-07-06

BACKGROUND Our recent studies have highlighted the importance and safety of backtable venoplasty for middle hepatic vein (MHV) and inferior right hepatic veins (IRHV) reconstruction using expanded polytetrafluoroethylene (ePTFE) vascular grafts. In this study, we aim to analyze the complications associated with ePTFE graft use and discuss the management of the rare, but, potentially life threatening complications directly related to ePTFE conduits. MATERIAL AND METHODS From January 2012 to October 2015 a total of 397 patients underwent living donor liver transplantation (LDLT). The ePTFE vascular grafts were used during the backtable venoplasty for outflow reconstruction in 262 of the liver allografts. Recipients who developed ePTFE-related complications were analyzed. RESULTS ePTFE-related complications developed in 1.52% (4/262) of the patients. One patient (0.38%) developed complete thrombosis with sepsis at 24 months post-transplantation and died due to multiorgan failure. Three patients (1.1%) developed graft migration into the second portion of the duodenum, without overt peritonitis. Surgical exploration and ePTFE graft removal was done in all the patients. One patient died due to overwhelming sepsis. CONCLUSIONS ePTFE graft migration into the duodenum causing perforation is a new set of complications that has been recently described in LDLT and can be treated effectively by surgical removal of the infected vascular graft and duodenal perforation closure. Despite of such complications, in our experience, ePTFE use in LDLT continues to have wide safety margin, with a complication rate of only 1.52%.

Cardiac Complications, Earlier Treatment, and Initial Disease Severity in Kawasaki Disease.

PubMed

Abrams, Joseph Y; Belay, Ermias D; Uehara, Ritei; Maddox, Ryan A; Schonberger, Lawrence B; Nakamura, Yosikazu

2017-09-01

To assess if observed higher observed risks of cardiac complications for patients with Kawasaki disease (KD) treated earlier may reflect bias due to confounding from initial disease severity, as opposed to any negative effect of earlier treatment. We used data from Japanese nationwide KD surveys from 1997 to 2004. Receipt of additional intravenous immunoglobulin (IVIG) (data available all years) or any additional treatment (available for 2003-2004) were assessed as proxies for initial disease severity. We determined associations between earlier or later IVIG treatment (defined as receipt of IVIG on days 1-4 vs days 5-10 of illness) and cardiac complications by stratifying by receipt of additional treatment or by using logistic modeling to control for the effect of receiving additional treatment. A total of 48 310 patients with KD were included in the analysis. In unadjusted analysis, earlier IVIG treatment was associated with a higher risk for 4 categories of cardiac complications, including all major cardiac complications (risk ratio, 1.10; 95% CI, 1.06-1.15). Stratifying by receipt of additional treatment removed this association, and earlier IVIG treatment became protective against all major cardiac complications when controlling for any additional treatment in logistic regressions (OR, 0.90; 95% CI, 0.80-1.00). Observed higher risks of cardiac complications among patients with KD receiving IVIG treatment on days 1-4 of the illness are most likely due to underlying higher initial disease severity, and patients with KD should continue to be treated with IVIG as early as possible. Published by Elsevier Inc.

Comparison of inhibition in two timed reaction tasks: the color and emotion Stroop tasks.

PubMed

Cothran, D Lisa; Larsen, Randy

2008-07-01

The authors examined the cross-task consistency of the ability to inhibit the processing of irrelevant information. They compared interference scores on 2 widely used inhibition tasks and found that color word Stroop interference scores correlated with emotion word Stroop interference scores. An examination of physiological reactivity showed that, in general, the color Stroop was more arousing than was the emotion Stroop, most likely due to increased response conflict.

Airway Complications of Total Artificial Heart.

PubMed

Pathak, Vikas; Donovan, Colin; Malhotra, Rajiv

2017-02-01

The total artificial heart is the mechanical device which is used as a bridge to the heart transplant in patients with biventricular failure. Due to the mechanical nature of the device, patients receiving total artificial heart (TAH) require to be on anticoagulation therapy. Hemorrhage and coagulopathy are few of the known complications of TAH.

Unusual complication of toxic megacolon in typhoid colitis.

PubMed

Arun Babu, Thirunavukkarasu; Ananthakrishnan, Shanthi; Jayakumar, P; Kullu, Poonam

2014-05-01

Colitis is a rare manifestation of enteric fever in children. Toxic megacolon complicating typhoid colitis is even rarer and requires early recognition and aggressive management due to the high mortality associated with this condition. The authors report a rare case of Toxic megacolon secondary to typhoid colitis in a seven-year-old girl.

[Acute dacryocystitis complicating primary mononucleosis infection].

PubMed

Delbet, C; PhamDang, N; Mondie, J-M; Barthelemy, I

2010-01-01

Infectious mononucleosis may lead to numerous complications. Tonsillar hyperplasia with risk of airway obstruction is well known. Dacryocystitis is a rare but potentially severe complication. A 6-year-old child with primary mononucleosis infectious diagnosed 8 days before, developed acute dacryocystitis, with rapid evolution to orbital cellulitis, despite adequate antibiotherapy. Emergency surgical drainage was required. Dacryocystitis is a rare and little documented complication of EBV infection. Its acute evolution to orbital cellulitis is possible and potentially severe. Its physiopathology is specific. Patients are initially free of chronic stenosis and epiphora, which express acute obstruction of the lachrymal sac due to general lymphoid hyperplasia. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Models of Lung Transplant Research: a consensus statement from the National Heart, Lung, and Blood Institute workshop.

PubMed

Lama, Vibha N; Belperio, John A; Christie, Jason D; El-Chemaly, Souheil; Fishbein, Michael C; Gelman, Andrew E; Hancock, Wayne W; Keshavjee, Shaf; Kreisel, Daniel; Laubach, Victor E; Looney, Mark R; McDyer, John F; Mohanakumar, Thalachallour; Shilling, Rebecca A; Panoskaltsis-Mortari, Angela; Wilkes, David S; Eu, Jerry P; Nicolls, Mark R

2017-05-04

Lung transplantation, a cure for a number of end-stage lung diseases, continues to have the worst long-term outcomes when compared with other solid organ transplants. Preclinical modeling of the most common and serious lung transplantation complications are essential to better understand and mitigate the pathophysiological processes that lead to these complications. Various animal and in vitro models of lung transplant complications now exist and each of these models has unique strengths. However, significant issues, such as the required technical expertise as well as the robustness and clinical usefulness of these models, remain to be overcome or clarified. The National Heart, Lung, and Blood Institute (NHLBI) convened a workshop in March 2016 to review the state of preclinical science addressing the three most important complications of lung transplantation: primary graft dysfunction (PGD), acute rejection (AR), and chronic lung allograft dysfunction (CLAD). In addition, the participants of the workshop were tasked to make consensus recommendations on the best use of these complimentary models to close our knowledge gaps in PGD, AR, and CLAD. Their reviews and recommendations are summarized in this report. Furthermore, the participants outlined opportunities to collaborate and directions to accelerate research using these preclinical models.

Status of etoricoxib in the treatment of rheumatic diseases. Expert panel opinion

PubMed Central

Majdan, Maria; Mastalerz-Migas, Agnieszka; Niewada, Maciej; Skrzydło-Radomańska, Barbara; Mamcarz, Artur

2017-01-01

Pain is one of the most disabling symptoms of rheumatoid diseases. Patients with pain secondary to osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis (AS) or gout require effective analgesic treatment, and the physician’s task is to select a drug that is best suited for an individual patient. The choice of pharmacotherapy should be based both on drug potency and clinical efficacy, and its safety profile, particularly in the elderly population, as the number of comorbidities (and hence the risk of treatment complications and drug interactions) rises with age. In cases involving a high risk of gastrointestinal complications or concerns about hepatotoxicity, with a low cardiovascular risk, the first-line nonsteroidal anti-inflammatory drugs to consider should be coxibs including etoricoxib. PMID:29491537

Website Redesign: A Case Study.

PubMed

Wu, Jin; Brown, Janis F

2016-01-01

A library website redesign is a complicated and at times arduous task, requiring many different steps including determining user needs, analyzing past user behavior, examining other websites, defining design preferences, testing, marketing, and launching the site. Many different types of expertise are required over the entire process. Lessons learned from the Norris Medical Library's experience with the redesign effort may be useful to others undertaking a similar project.

Indicators of Youth Social Capital: The Case for Not Using Adult Indicators in the Measurement of Youth Social Capital

ERIC Educational Resources Information Center

Billett, Paulina

2012-01-01

Social capital is a difficult concept to define, and the task of defining the social capital of youth is even more complicated. The concept has not only been poorly researched but is also imperfectly understood. This article examines the problems faced in the use of adult indicators in youth social capital research and explores current…

Deliberative Democracy: A Contested Interactive Space. A Response to "Deliberative Democracy in English Language Education: Cultural and Linguistic Inclusion in the School Community"

ERIC Educational Resources Information Center

De La Vega, Esperanza

2016-01-01

This is a response to Liggett's (2014) call to implement "deliberate democracy" in English language education classrooms. While the concept of participating in deliberate democracy is a solid ideal and worthy of pursuit, I present questions and scenarios that illustrate the complicated nature of the tasks. By sharing my…

Laparoscopic correction of right transverse colostomy prolapse.

PubMed

Gundogdu, Gokhan; Topuz, Ufuk; Umutoglu, Tarik

2013-08-01

Colostomy prolapse is a frequently seen complication of transverse colostomy. In one child with recurrent stoma prolapse, we performed a loop-to-loop fixation and peritoneal tethering laparoscopically. No prolapse had recurred at follow-up. Laparoscopic repair of transverse colostomy prolapse seems to be a less invasive method than other techniques. © 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

Hybrid Techniques for Quantum Circuit Simulation

DTIC Science & Technology

2014-02-01

Detailed theorems and proofs describing these results are included in our published manuscript [10]. Embedding of stabilizer geometry in the Hilbert ...space. We also describe how the discrete embedding of stabilizer geometry in Hilbert space complicates several natural geometric tasks. As described...the Hilbert space in which they are embedded, and that they are arranged in a fairly uniform pattern. These factors suggest that, if one seeks a

Task switching and response correspondence in the psychological refractory period paradigm

NASA Technical Reports Server (NTRS)

Lien, Mei-Ching; Schweickert, Richard; Proctor, Robert W.

2003-01-01

Three experiments examined the effects of task switching and response correspondence in a psychological refractory period paradigm. A letter task (vowel-consonant) and a digit task (odd-even) were combined to form 4 possible dual-task pairs in each trial: letter-letter, letter-digit, digit-digit, and digit-letter. Foreknowledge of task transition (repeat or switch) and task identity (letter or digit) was varied across experiments: no foreknowledge in Experiment 1, partial foreknowledge (task transition only) in Experiment 2, and full foreknowledge in Experiment 3. For all experiments, the switch cost for Task 2 was additive with stimulus onset asynchrony, and the response-correspondence effect for Task 2 was numerically smaller in the switch condition than in the repeat condition. These outcomes suggest that reconfiguration for Task 2 takes place after the central processing of Task 1 and that the crosstalk correspondence effect is due to response activation by way of stimulus-response associations.

Severe Hypothyroidism due to the Loss of Therapeutic Efficacy of l-Thyroxine in a Patient with Esophageal Complication Associated with Systemic Sclerosis.

PubMed

Lobasso, Antonio; Nappi, Liliana; Barbieri, Letizia; Peirce, Carmela; Ippolito, Serena; Arpaia, Debora; Rossi, Francesca Wanda; de Paulis, Amato; Biondi, Bernadette

2017-01-01

Thyroid function abnormalities and thyroid autoantibodies have been frequently described in patients with systemic autoimmune diseases as systemic sclerosis (SSc). Serum TSH levels are higher in SSc patients with more severe skin diseases and a worse modified Rodnan skin score. Asymptomatic esophageal involvement due to SSc has never been described as a cause of severe hypothyroidism due to l-thyroxine (l-T4) malabsorption in patients with Hashimoto's thyroiditis (HT) and SSc. Here, we report a case of a 56-year-old female affected by both SSc and HT who developed severe hypothyroidism due to the loss of therapeutic efficacy of l-T4. Therapeutic failure resulted from the altered l-T4 absorption because of SSc esophageal complications. Clinical findings improved after the administration of oral liquid l-T4. Thyroid function completely normalized with a full clinical recovery, the disappearance of the pericardial effusion and the improvement of the pulmonary pressure. A recognition of a poor absorption is crucial in patients with hypothyroidism and SSc to reduce the risk of the subsequent adverse events. This case suggests the importance of clinical and laboratory surveillance in patients with SSc and HT because the systemic complications of these dysfunctions may worsen the prognosis of hypothyroid SSc/HT patients.

Heritability of Cognitive Abilities as Measured by Mental Chronometric Tasks: A Meta-Analysis

ERIC Educational Resources Information Center

Beaujean, A.A.

2005-01-01

The purpose of this study is to meta-analyze the published studies that measure the performance differences in mental chronometric tasks using a behavioral genetic research design. Because chronometric tasks are so simple, individual differences in the time it takes to complete them are largely due to underlying biological and physiological…

Aortic Pseudoaneurysm Secondary to Mediastinitis due to Esophageal Perforation

PubMed Central

Zuluaga, Claudia Patricia; Aluja Jaramillo, Felipe; Velásquez Castaño, Sergio Andrés; Rivera Bernal, Aura Lucía; Granada, Julio Cesar; Carrillo Bayona, Jorge Alberto

2016-01-01

Esophageal perforation is a condition associated with high morbidity and mortality rates; it requires early diagnosis and treatment. The most common complication of esophageal rupture is mediastinitis. There are several case reports in the literature of mediastinitis secondary to esophageal perforation and development of aortic pseudoaneurysm as a complication. We report the case of a patient with an 8-day history of esophageal perforation due to foreign body (fishbone) with mediastinitis and aortic pseudoaneurysm. The diagnosis was made using Computed Tomography (CT) with intravenous and oral water-soluble contrast material. An esophagogastroduodenoscopy did not detect the perforation. PMID:26977330

Modified incision for maxillectomy: our experience.

PubMed

Bhavana, Kranti; Tyagi, Isha; Ramani, Mukesh Kumar

2012-06-01

Radical maxillectomy has usually been done by the classical Weber Ferguson incision since age old times and still is being used widely due to its advantage of excellent exposure and minimal scarring as the incision follows the natural skin crease. In our modification of radical maxillectomy incision we avoid a scar on the midface by performing a midface degloving and combining it with a subconjunctival eye incision thus avoiding any cosmetic deformity and associated eye complication. It also avoids the late complication of cutaneous fistula following radiotherapy to these areas and due to early healing of the wound, early radiotherapy can be started.

Life-threatening hemothorax due to azygos vein rupture after chest compression during cardiopulmonary resuscitation.

PubMed

Yang, Euiseok; Jeong, WonJoon; Lee, JunWan; Kim, SeungWhan

2014-11-01

Hemothorax is not an uncommon cardiopulmonary resuscitation(CPR)–related complication. But hemothorax related to azygos vein injury (AVI) is a rare condition following blunt chest trauma, with no report of CPR-related AVI in the literature. We present a case of azygosve in rupture in a middle-aged woman after repeated chest compression during 1 hour of CPR. She eventually presented with massive hemothorax due to azygos vein rupture diagnosed by computed tomography (CT). When faced with a patient with massive hemothorax after chest compression, azygos vein rupture should be considered as a complication.

[Case report: Aneurysmatic subarachnoid hemorrhage -- complicated course due to coincidental manifestation of an inverted Tako-Tsubo-cardiomyopathy].

PubMed

Zech, Nina; Kieninger, Martin; Seemann, Milena; Künzig, Holger; Bele, Sylvia; Dietl, Alexander

2014-07-01

We report the case of a patient who suffered a serious subarachnoid hemorrhage with a cardialaffection and development of an inverted Tako-Tsubo-cardiomyopathy. To avoid apparent cerebral ischemia due to severe cerebral vasospasm after exhaustion of conservative therapeutic options a temporarily endovascular therapy with continuous intra-arterial application of Nimodipine was necessary. In the overall protracted and complicated course the special challenge were the therapeutic efforts to avoid apparent cerebral ischemia in context to the significant cardial affection. © Georg Thieme Verlag Stuttgart · New York.

Measuring the burden of preventable diabetic hospitalisations in the Mexican Institute of Social Security (IMSS).

PubMed

Lugo-Palacios, David G; Cairns, John; Masetto, Cynthia

2016-08-02

The prevalence of diabetes among adults in Mexico has increased markedly from 6.7 % in 1994 to 14.7 % in 2015. Although the main diabetic complications can be prevented or delayed with timely and effective primary care, a high percentage of diabetic patients have developed them imposing an important preventable burden on Mexican society and on the health system. This paper estimates the financial and health burden caused by potentially preventable hospitalisations due to diabetic complications in hospitals operated by the largest social security institution in Latin America, the Mexican Institute of Social Security (IMSS), in the period 2007-2014. Hospitalisations in IMSS hospitals whose main cause was a diabetic complication were identified. The financial burden was estimated using IMSS diagnostic-related groups. To estimate the health burden, DALYs were computed under the assumption that patients would not have experienced complications if they had received timely and effective primary care. A total of 322,977 hospitalisations due to five diabetic complications were identified during the period studied, of which hospitalisations due to kidney failure and diabetic foot represent 78 %. The financial burden increased by 8.4 % in real terms between 2007 and 2014. However, when measured as cost per IMSS affiliate, it decreased by 11.3 %. The health burden had an overall decrease of 13.6 % and the associated DALYs in 2014 reached 103,688. Resources used for the hospital treatment of diabetic complications are then not available for other health care interventions. In order to prevent these hospitalisations more resources might need to be invested in primary care; the first step could be to consider the financial burden of these hospitalisations as a potential target for switching resources from hospital care to primary care services. However, more evidence of the effectiveness of different primary care interventions is needed to know how much of the burden could be prevented by better primary care.

Executor Framework for DIRAC

NASA Astrophysics Data System (ADS)

Casajus Ramo, A.; Graciani Diaz, R.

2012-12-01

DIRAC framework for distributed computing has been designed as a group of collaborating components, agents and servers, with persistent database back-end. Components communicate with each other using DISET, an in-house protocol that provides Remote Procedure Call (RPC) and file transfer capabilities. This approach has provided DIRAC with a modular and stable design by enforcing stable interfaces across releases. But it made complicated to scale further with commodity hardware. To further scale DIRAC, components needed to send more queries between them. Using RPC to do so requires a lot of processing power just to handle the secure handshake required to establish the connection. DISET now provides a way to keep stable connections and send and receive queries between components. Only one handshake is required to send and receive any number of queries. Using this new communication mechanism DIRAC now provides a new type of component called Executor. Executors process any task (such as resolving the input data of a job) sent to them by a task dispatcher. This task dispatcher takes care of persisting the state of the tasks to the storage backend and distributing them among all the Executors based on the requirements of each task. In case of a high load, several Executors can be started to process the extra load and stop them once the tasks have been processed. This new approach of handling tasks in DIRAC makes Executors easy to replace and replicate, thus enabling DIRAC to further scale beyond the current approach based on polling agents.

Inhibitory Processes in Young Children and Individual Variation in Short-Term Memory

PubMed Central

Espy, Kimberly Andrews; Bull, Rebecca

2009-01-01

A precise definition of executive control remains elusive, related in part to the variations among executive tasks in the nature of the task demands, which complicate the identification of test-specific versus construct-specific performance. In this study, tasks were chosen that varied in the nature of the stimulus (verbal, nonverbal), response (naming, somatic motor), conflict type (proactive interference, distraction), and inhibitory process (attention control, response suppression) required. Then performance differences were examined in 184 young children (age range = 3 years 6 months to 6 years 1 month), comparing those with high (5 or more digits) and low (3 or fewer digits) spans to determine the dependence on short-term memory. Results indicated that there was communality in inhibitory task demands across instruments, although the specific pattern of task intercorrelations varied in children with high and low spans. Furthermore, only performance on attention control tasks—that is, that require cognitive engagement/disengagement among an internally represented rule or response set that was previously active versus those currently active—differed between children of high and low spans. In contrast, there were differences neither between children with high and low spans on response suppression tasks nor on tasks when considered by type of stimulus, response, or conflict. Individual differences in well-regulated thought may rest in variations in the ability to maintain information in an active, quickly retrievable state that subserve controlling attention in a goal-relevant fashion. PMID:16144432

Between-Trial Forgetting Due to Interference and Time in Motor Adaptation.

PubMed

Kim, Sungshin; Oh, Youngmin; Schweighofer, Nicolas

2015-01-01

Learning a motor task with temporally spaced presentations or with other tasks intermixed between presentations reduces performance during training, but can enhance retention post training. These two effects are known as the spacing and contextual interference effect, respectively. Here, we aimed at testing a unifying hypothesis of the spacing and contextual interference effects in visuomotor adaptation, according to which forgetting between trials due to either spaced presentations or interference by another task will promote between-trial forgetting, which will depress performance during acquisition, but will promote retention. We first performed an experiment with three visuomotor adaptation conditions: a short inter-trial-interval (ITI) condition (SHORT-ITI); a long ITI condition (LONG-ITI); and an alternating condition with two alternated opposite tasks (ALT), with the same single-task ITI as in LONG-ITI. In the SHORT-ITI condition, there was fastest increase in performance during training and largest immediate forgetting in the retention tests. In contrast, in the ALT condition, there was slowest increase in performance during training and little immediate forgetting in the retention tests. Compared to these two conditions, in the LONG-ITI, we found intermediate increase in performance during training and intermediate immediate forgetting. To account for these results, we fitted to the data six possible adaptation models with one or two time scales, and with interference in the fast, or in the slow, or in both time scales. Model comparison confirmed that two time scales and some degree of interferences in either time scale are needed to account for our experimental results. In summary, our results suggest that retention following adaptation is modulated by the degree of between-trial forgetting, which is due to time-based decay in single adaptation task and interferences in multiple adaptation tasks.

Regular long-term red blood cell transfusions for managing chronic chest complications in sickle cell disease

PubMed Central

Estcourt, Lise J; Fortin, Patricia M; Hopewell, Sally; Trivella, Marialena; Hambleton, Ian R; Cho, Gavin

2016-01-01

Background Sickle cell disease is a genetic haemoglobin disorder, which can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Sickle cell disease is one of the most common severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. The two most common chronic chest complications due to sickle cell disease are pulmonary hypertension and chronic sickle lung disease. These complications can lead to morbidity (such as reduced exercise tolerance) and increased mortality. This is an update of a Cochrane review first published in 2011 and updated in 2014. Objectives We wanted to determine whether trials involving people with sickle cell disease that compare regular long-term blood transfusion regimens with standard care, hydroxycarbamide (hydroxyurea) any other drug treatment show differences in the following: mortality associated with chronic chest complications; severity of established chronic chest complications; development and progression of chronic chest complications; serious adverse events. Search methods We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group’s Haemoglobinopathies Trials Register. Date of the last search: 25 April 2016. We also searched for randomised controlled trials in the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 1, 26 January 2016), MEDLINE (from 1946), Embase (from 1974), CINAHL (from 1937), the Transfusion Evidence Library (from 1950), and ongoing trial databases to 26 January 2016. Selection criteria We included randomised controlled trials of people of any age with one of four common sickle cell disease genotypes, i.e. Hb SS, Sß0, SC, or Sß+ that compared regular red blood cell transfusion regimens (either simple or exchange transfusions) to hydroxycarbamide, any other drug treatment, or to standard care that were aimed at reducing the development or progression of chronic chest complications (chronic sickle lung and pulmonary hypertension). Data collection and analysis We used the standard methodological procedures expected by Cochrane. Main results No studies matching the selection criteria were found. Authors’ conclusions There is a need for randomised controlled trials looking at the role of long-term transfusion therapy in pulmonary hypertension and chronic sickle lung disease. Due to the chronic nature of the conditions, such trials should aim to use a combination of objective and subjective measures to assess participants repeatedly before and after the intervention. PMID:27198469

The current total economic burden of diabetes mellitus in the Netherlands.

PubMed

Peters, M L; Huisman, E L; Schoonen, M; Wolffenbuttel, B H R

2017-09-01

Insight into the total economic burden of diabetes mellitus (DM) is essential for decision makers and payers. Currently available estimates for the Netherlands only include part of the total burden or are no longer up-to-date. Therefore, this study aimed to determine the current total economic burden of DM and its complications in the Netherlands, by including all the relevant cost components. The study combined a systematic literature review to identify all relevant published information and a targeted review to identify relevant information in the grey literature. The identified evidence was then combined to estimate the current total economic burden. In 2016, there were an estimated 1.1 million DM patients in the Netherlands, of whom approximately 10% had type 1 and 90% had type 2 DM. The estimated current total economic burden of DM was € 6.8 billion in 2016. Healthcare costs (excluding costs of complications) were € 1.6 billion, direct costs of complications were € 1.3 billion and indirect costs due to productivity losses, welfare payments and complications were € 4.0 billion. DM and its complications pose a substantial economic burden to the Netherlands, which is expected to rise due to changing demographics and lifestyle. Indirect costs, such as welfare payments, accounted for a large portion of the current total economic burden of DM, while these cost components are often not included in cost estimations. Publicly available data for key cost drivers such as complications were scarce.

Current Care and Investigational Therapies in Achondroplasia.

PubMed

Unger, Sheila; Bonafé, Luisa; Gouze, Elvire

2017-04-01

The goal of this review is to evaluate the management options for achondroplasia, the most common non-lethal skeletal dysplasia. This disease is characterized by short stature and a variety of complications, some of which can be quite severe. Despite several attempts to standardize care, there is still no widely accepted consensus. This is in part due to absence of concrete data on the incidence of sudden unexplained death in infants with achondroplasia and the best investigation for ascertaining which individuals could benefit from foramen magnum decompression surgery. In this review, we identify the different options of care and management for the various orthopedic, neurologic, and respiratory complications. In parallel, several innovative or drug repositioning therapies are being investigated that would restore bone growth but may also prevent complications. Achondroplasia is the most common non-lethal skeletal dysplasia. It is characterized by short stature and a variety of complications, some of which can be quite severe. Despite several attempts to standardize care, there is still no widely accepted consensus. This is in part due to absence of concrete data on the incidence of sudden unexplained death in infants with achondroplasia and the best investigation for ascertaining which individuals could benefit from foramen magnum decompression surgery. In this review, we identify the different options of care and management for the various orthopedic, neurologic, and respiratory complications. In parallel, several innovative or drug repositioning therapies are being investigated that would restore bone growth but may also prevent complications.

Echocardiography in patients with complications related to pacemakers and cardiac defibrillators.

PubMed

Almomani, Ahmed; Siddiqui, Khadija; Ahmad, Masood

2014-03-01

The evolving indications and uses for implantable cardiac devices have led to a significant increase in the number of implanted devices each year. Implantation of endocardial leads for permanent pacemakers and cardiac defibrillators can cause many delayed complications. Complications may be mechanical and related to the interaction of the device leads with the valves and endomyocardium, e.g., perforation, infection, and thrombosis, or due to the electrical pacing of the myocardium and conduction abnormalities, e.g., left ventricular dyssynchrony. Tricuspid regurgitation, another delayed complication in these patients, may be secondary to both mechanical and pacing effects of the device leads. Echocardiography plays an important role in the diagnosis of these device-related complications. Both two-dimensional transthoracic echocardiography and transesophageal echocardiography provide useful diagnostic information. Real time three-dimensional echocardiography is a novel technique that can further enhance the detection of lead-related complications. © 2013, Wiley Periodicals, Inc.

Factors influencing post abortion outcomes among high-risk patients in Zimbabwe.

PubMed

Mudokwenuy-Rawdon, C; Ehlers, V J; Bezuidenhout, M C

2005-11-01

Post abortion complications remain one of the major causes of mortality among women of child bearing age in Zimbabwe. Based on this problem, factors associated with mortalities due to abortion were investigated with the aim of improving post abortion outcomes for Zimbabwe's women, and possibly also for women of other African countries. Cases and controls were selected from 4895 post abortion records to conduct a retrospective case-control study. Significant risk factors identified for reducing mortalities due to post abortion complications included the administration of oxytocic drugs and evacuation of the uterus whilst anaemia and sepsis apparently reduced these women's chances of survival. Women who died (cases) from post abortion complications apparently received better reported quantitative care than controls. Recommendations based on this research report include improved education of health care workers and enhanced in-service training, regular audits of patients' records and changed policies for managing these conditions more effectively in Zimbabwe.

Severe Tricuspid Regurgitation Diagnosed 13 Years after a Car Accident: A Case Report

PubMed Central

Acar, Burak; Suleymanoglu, Muhammed; Burak, Cengiz; Demirkan, Burcu Mecit; Guray, Yesim; Tufekcioglu, Omac; Aydogdu, Sinan

2015-01-01

Abstract Blunt chest traumas mostly occur due to car accidents and can cause many cardiac complications such as septal rupture, free-wall rupture, coronary artery dissection or thrombosis, heart failure, arrhythmias, and chordae and papillary muscle rupture. One of the most serious complication is tricuspid regurgitation (TR), which can be simply diagnosed by physical examination and confirmed by echocardiography. We describe a 48-year-old female patient, diagnosed with severe TR 13 years after a blunt chest trauma due to a car accident. TR was diagnosed with transthoracic echocardiography and three dimensional transthoracic echocardiography had defined the exact pathology of the tricuspid valve. The patient underwent successful surgery with bioprosthetic valve implantation and was discharged at 6th postoperative day without any complication. The patient had no problem according to the follow-up one month and six months after operation. PMID:26157464

Numerical analysis of turbulent coaxial flow with internal heat generation

NASA Technical Reports Server (NTRS)

Lin, A.; Weinstein, H.

1981-01-01

A computational method with which to obtain a physical understanding of the turbulent field of two coaxial jets entering an axisymmetric chamber is developed. Even the laminar field of this flow is quite complicated. This is due to the many different domains which exist in the field especially in the entrance region. Physically, three regions may be identified: the wall region, the initial region near the axis of symmetry and the mixing region. Advancing downstream, these regions change relative size with the ratio of the two jets' mass fluxes as the main parameter. The turbulent field of these flows is much more complicated due to the difference in the effective transport coefficients and turbulence level from region to region. However, being aware beforehand of the complications and the different regions of this field, the appropriate turbulence model and numerical scheme can be adjusted to treat the problem.

Rapid Resolution of Grief with IV Infusion of Ketamine: A Unique Phenomenological Experience

PubMed Central

Gowda, Mahesh Ramanna; Srinivasa, Preethi; Kumbar, Prabha S.; Ramalingaiah, Vinay Hosagavi; Muthyalappa, Chandrashekar; Durgoji, Sumit

2016-01-01

Ketamine, a primarily FDA-approved anaesthetic agent is also used as recreational drug. Based on preclinical findings and later the clinical observations it is noted to have rapid antidepressant effect due to its mechanisms related to NMDA antagonism. In spite of established evidence of ketamine being effective in depression with significant role in treatment resistant cases as well, there was absolute dearth of literature regarding its utility in grief-related disorders. In this context we present a case of 28-year-old graduate male who presented to us in complicated grief following death of his wife due to obstetric complications. With the patient and immediate family members consenting for use of ketamine as off-label use, patient had single IV infusion of ketamine following which he had unique phenomenological experience ultimately resolving his grief in few minutes. Through this case we highlight the enormous therapeutic promise of ketamine in complicated grief. PMID:27011405

Performance changes in lung nodule detection following perceptual feedback of eye movements

NASA Astrophysics Data System (ADS)

Donovan, T.; Manning, D. J.; Crawford, T.

2008-03-01

In a previously reported study we demonstrated that expert performance can decline following perceptual feedback of eye movements in the relatively simple radiological task of wrist fracture detection. This study was carried out to determine if the same effect could be observed using a more complicated radiological task of identifying lung nodules on chest radiographs. Four groups (n=10 in each group) of observers with different levels of expertise were tested. The groups were naÃve observers, level 1 radiography students, level 2 radiography students and experts. Feedback was presented to the observers in the form of their scan paths and fixations. Half the observers had feedback and half had no perceptual feedback. JAFROC analysis was used to measure observer performance. A repeated measures ANOVA was carried out. There was no significant effect between the pre and post "no feedback" condition. There was a significant difference between the pre and post "feedback" condition with a significant improvement following feedback (F(1,16)=6.6,p = 0.021). Overall the mean percentage improvement was small of 3.3%, with most of the improvement due to the level 1 group where the percentage increase in the figure of merit (FOM) was 8.4% and this was significant (p<0.05). Eye tracking metrics indicate that the expert and naÃve observers were less affected by feedback or a second look whereas there were mixed results between the level 1 and level 2 students possibly reflecting the different search strategies used. Perceptual feedback may be beneficial for those early in their training.

Stereotactic ventrooralis thalamotomy for task-specific focal hand dystonia (writer's cramp).

PubMed

Taira, Takaomi; Hori, Tomokatsu

2003-01-01

Writer's cramp is a type of focal dystonia due to dysfunction of the pallido-thalamo-cortical circuit. The symptom is refractory to most conservative treatment, though botulinum toxin injection is generally used for symptomatic relief. As a surgical treatment of dystonia, we performed stereotactic nucleus ventrooralis (Vo) thalamotomy for dystonic cramp of the hand. Twelve patients (5 men, 3 women; age 26-40 years, mean 32.1 years) with medically intractable task-specific focal dystonia of the hand underwent Vo thalamotomy. The stereotactic target was chosen at the junction of the anterior and posterior Vo nuclei. The mean duration of the symptom ranged from 3 to 6 years (mean 4.5 years.) All patients had complained of difficulty in writing. Seven patients were professionals, such as a comic artist, guitarist and barber, and, because of the dystonic symptoms occurring during their work, they had stopped pursuing their profession. All patients showed immediate postoperative disappearance of dystonic symptoms, and the effect was sustained during the follow-up period (3-33 months, mean 13.1 months), except in one case. Two patients showed partial recurrence of the symptom and underwent second thalamotomy 5 months after the initial surgery with satisfactory results. The score on the writer's cramp rating scale decreased significantly (p < 0.001) after Vo thalamotomy. There were no permanent operative complications. There was no mortality or permanent morbidity. Although a longer follow-up is needed, stereotactic Vo thalamotomy is a useful and safe therapeutic option for writer's cramp. Copyright 2003 S. Karger AG, Basel

Skin tumor area extraction using an improved dynamic programming approach.

PubMed

Abbas, Qaisar; Celebi, M E; Fondón García, Irene

2012-05-01

Border (B) description of melanoma and other pigmented skin lesions is one of the most important tasks for the clinical diagnosis of dermoscopy images using the ABCD rule. For an accurate description of the border, there must be an effective skin tumor area extraction (STAE) method. However, this task is complicated due to uneven illumination, artifacts present in the lesions and smooth areas or fuzzy borders of the desired regions. In this paper, a novel STAE algorithm based on improved dynamic programming (IDP) is presented. The STAE technique consists of the following four steps: color space transform, pre-processing, rough tumor area detection and refinement of the segmented area. The procedure is performed in the CIE L(*) a(*) b(*) color space, which is approximately uniform and is therefore related to dermatologist's perception. After pre-processing the skin lesions to reduce artifacts, the DP algorithm is improved by introducing a local cost function, which is based on color and texture weights. The STAE method is tested on a total of 100 dermoscopic images. In order to compare the performance of STAE with other state-of-the-art algorithms, various statistical measures based on dermatologist-drawn borders are utilized as a ground truth. The proposed method outperforms the others with a sensitivity of 96.64%, a specificity of 98.14% and an error probability of 5.23%. The results demonstrate that this STAE method by IDP is an effective solution when compared with other state-of-the-art segmentation techniques. The proposed method can accurately extract tumor borders in dermoscopy images. © 2011 John Wiley & Sons A/S.

Effect of fibrin sealant in positioning and stabilizing microvascular pedicle: A comparative study.

PubMed

Kim, Jeong Tae; Kim, Youn Hwan; Kim, Sang Wha

2017-07-01

Fibrin sealants have had applications in hemostasis, cohesion, and promotion of healing in plastic surgery. In this article, we review cases where fibrin sealant was used to stabilize microvascular pedicles and compared with previous free flaps performed without fibrin sealant. Between 2008 and 2010, 62 consecutive patients underwent free tissue transfer for reconstruction; this involved 33 latissimus dorsi perforator flaps, 14 thoracodorsal artery perforator flaps, 9 latissimus dorsi myocutaneous flaps, 3 lateral thoracic artery perforator flaps, and 3 transverse rectus abdominis myocutaneous flaps, used in head and neck reconstruction, lower limb reconstructions, breast reconstructions, and facial palsy reconstruction. Following microvascular anastomosis, the microvascular pedicles were placed in the optimal position, and fibrin sealant was used to fix and stabilize them. The complications, such as venous thrombosis, arterial thrombosis, hematoma, and vascular pedicle kinking, were compared with that of 672 previous free flaps without fibrin sealant for stabilizing microvascular pedicles. Among the 62 free tissue transfers using fibrin sealant, there was only one complication involving flap failure (1.6%), in this case due to venous thrombosis. Analysis of 672 free flaps performed without application of fibrin sealant revealed 24 complications (3.6%), due to 3 venous thrombosis, 1 arterial thrombosis, 4 vascular pedicel compression due to hematoma, and 16 pedicle kinking. However, the comparison of complications between the free flap using fibrin sealant and the free flap without fibrin sealant were not statistically significant (P = 0.65). Fibrin sealant can be used to prevent vascular kinking and to position anastomosed vessels after successful micro-anastomosis and allow the reconstructive surgeon to overcome challenging situations of vascular pedicle related complications © 2016 Wiley Periodicals, Inc. Microsurgery 37:406-409, 2017. © 2016 Wiley Periodicals, Inc.

[Analysis of disability due to ocular complications of diabetes in Tashkent over a ten-year period].

PubMed

Dzhamalova, Sh A; Iskandarova, Sh T; Nabiev, A M

2016-01-01

to study peculiarities of primary and recurrent disability due to ocular complications of diabetes in Tashkent over the years 2003-2012 and to assess the impact of risk factors on the effectiveness of laser photocoagulation of the retina. A total of 347 disability examination reports of diabetic patients with ocular complications were copied and 48 case histories of patients with type II diabetes who underwent laser photocoagulation of the retina - retrospectively analyzed. Stabilization of visual function was used as the effectiveness criterion. The rate of new cases of disability over the studied decade averaged 0.55 per 100,000 population per year, while that of recurrent disability was 1.8 times higher - 0.97. The overall rate of disability was not high - 1.53; at that, severe disability (i.e. grade I and II) prevailed. Both recurrent and primary disability groups were made up by middle-aged patients and those in their retirement age; however, in the recurrent disability group the number of young disabled people was 4.5 times higher than in the primary disability group. Studies of the effectiveness of laser photocoagulation of the retina in relation to the compensation of diabetes and blood pressure level showed that unstable general condition was associated with not only significant deterioration of visual function, but also complications, including severe. The rate of disability due to ocular complications of diabetes is generally not high, however, grades I and II disabilities that require greater social support has been found to prevail in both groups. Most of disabled people are middle-aged (working-age population), which also causes economic damage. In cases of decompensated diabetes and unstable blood pressure, the effectiveness of laser photocoagulation of the retina is reduced.

Complications of serogroup B meningococcal disease in survivors: a review.

PubMed

Dastouri, Fereshteh; Hosseini, Ahmad Mirmohammad; Haworth, Elizabeth; Khandaker, Gulam; Rashid, Harunor; Booy, Robert

2014-01-01

This systematic review evaluates the prevalence of long-term complications of serogroup B meningococcal disease (MD) in light of the recent licensure of a vaccine against meningococcal B disease. Twelve appropriate studies were identified by searching available databases from 1946 to July 2014. The average prevalence of hearing impairment was 4.2% among serogroup B MD survivors; 2.3% suffered amputation and 2.3% developed seizures. When compared with complications due to non-meningococcal B bacterial meningitis, physical impairment and seizures were more common in survivors of meningococcal B disease but hearing impairment had similar prevalence. Few studies quantified less frequent complications such as visual impairment and cognitive dysfunction. Better comprehensive reporting of the complications and costs of serogroup B MD in survivors and their families is needed to inform vaccination policy.

Musculoskeletal and neurological complications following coronary artery bypass graft surgery: A comparison between saphenous vein and internal mammary artery grafting.

PubMed

El-Ansary, Doa; Adams, Roger; Ghandi, Ajay

2000-01-01

The internal (thoracic) mammary artery (IMA) is currently the vessel of choice for coronary artery bypass grafting (CABG), due to its long term patency. The purpose of this study was to compare the incidence and nature of musculoskeletal and neurological complications following saphenous vein grafting (SVG) and internal mammary artery grafting (IMAG). Ninety-seven patients were screened by a physiotherapist for musculoskeletal and neurological complications three to six weeks following cardiac surgery. The incidence of new musculoskeletal and neurological complications was significantly higher in patients following IMAG (78.5 per cent) than SVG (45 per cent) (p < 0.001, chi2(1) = 17.04). A significant association between musculoskeletal complications affecting the anterior chest and harvesting of the IMA was also demonstrated.

The Relationship between Maternal Employment Status and Pregnancy Outcomes.

PubMed

Khojasteh, Farnoush; Arbabisarjou, Azizollah; Boryri, Tahere; Safarzadeh, Amneh; Pourkahkhaei, Mohammad

2016-09-01

Women comprise a large percentage of the workforce in industrial countries. In Europe and many other places in the world, women of reproductive age comprise a significant proportion of the workforce at the workplaces, and the rules and regulations require employers to evaluate and minimize health risks to pregnant women. In U.K, 70%, and in the United States 59% of women are employed. In Iran, 13% of women are employed, which comes down to less than 5% at Sistan& Baluchestan Province. Various studies have reported contradictory results about the effects of maternal employment tasks such as standing, repetitive bending, climbing stairs, and lifting heavy objects during pregnancy on fetal growth, preterm birth and other obstetric complications. Given the growing number of working women, and potential complications for mothers, the present study has conducted to investigate the relationship between maternal employment status and pregnancy outcomes in Zahedan city, Iran. This cross-sectional study was based on survey conducted on 227 women (121 housewives, and 106 employed women) attending health centers in 2014. Using purposive convenient sampling method, eligible pregnant mothers (with no chronic diseases, singleton pregnancy, gravida 1-3, and no addiction) were selected as study subjects. Data were collected and recorded through a researcher-made questionnaire and also from mothers' medical records, including personal details, prenatal and labor complications, and infant's details. Collected data were fed into the SPSS version 21(IBM Corp, USA). Frequency of placental abruption was greater among housewives (P=0.02), and a significant relationship was found between employment status and lifting heavy objects, which was more frequent among housewives (P=0.01). Lifting heavy objects during pregnancy was only significantly related to reduced amniotic fluid (P=0.001) and low birth weight (P=0.01). Frequency of preterm labor was higher among housewives compared to employed women, but not significantly. Type of delivery was significantly related to employment, and employed mothers had more cesarean deliveries (P=0.0001). The results suggest more frequent lifting of heavy objects by housewives than by employed mothers, leading to increased complications such as reduced amniotic fluid, placental abruption, and low birth weight. Perhaps due to higher education levels, frequency of cesarean section and preterm labor was higher among employed mothers. However, employment alone does not predict pregnancy outcomes.

Complications of infective endocarditis.

PubMed

Mocchegiani, R; Nataloni, M

2009-12-01

Infective endocarditis (IE) is a lethal disease if not promptly treated with antibiotics, either in association with surgery or not. The incidence of disease has not decreased over the last decades due to the change of risk conditions. Complications of IE may involve cardiac structures when the infection spreads within the heart, or extra cardiac ones when the cause is usually from embolic origin; they may also be due to medical treatment or to the septic condition itself. A variety of complications may occur in most of patients. The literature reports one complication of IE in 57%, two in 26% and three or more in about 14% of patients examined. The frequency of specific complications depends on variables as the infecting pathogen, duration of disease before therapy and type of treatment. However it is often difficult to assess the true incidence of complications because the published reviews in literature are frequently based on retrospective chart reviews and different diagnostic criteria are used. The decision over either indication or timing of surgery should be individualized and based on a multidisciplinary approach involving at least cardiologists and cardiac surgeons. Congestive heart failure (CHF) is the most important complication of IE, which has the greatest impact on prognosis. Periannular abscesses are a relatively common complication of IE (42% to 85% of cases during surgery or at autopsy respectively), associated with a higher morbidity and mortality. Systemic embolization occurs in 22% to 50% of cases; emboli may involve major arteries, mostly affecting the central nervous system, but also other organs. Splenic abscess is a rare complication of IE, due to direct seeding of spleen by an embolus or bacterial seeding of a bland infarction. Neurological complications develop in 20% to 40% of patients with IE and represent a dangerous subset of complications. Mycotic aneurysms are rare, resulting from diffusion of infection to the vessel wall. Actually the clinical profile, the best treatment (medical or surgical approach) and outcome of complicated IE are not well defined. Changing trends in aetiology of IE with emerging infections from Staphylococci, bacteria of the HACEK group and Fungi have resulted in an increased frequency of culture negative IE. Sepsis or persistent fever despite appropriate antimicrobial therapy, recurrent emboli, heart failure or new pathologic murmurs suggest haemodynamic impairment and/or infection extending beyond the valve leaflet or prosthetic valvular annulus. The course of the disease will consequently get worse with an increasing need of surgery. Patients who develop abscesses are more likely to undergo surgery than those who do not (84-91% vs 36%), and also their in-hospital mortality rate is higher (19% vs 11%). A prompt detection of complications often allows an earlier surgical treatment which represents the best way to improve the outcome. The introduction of molecular methods techniques has increased the ability to identify the causal agents of IE, mostly in cases of culture negative endocarditis. Echocardiography, mainly from transesophageal (TEE) approach, has significantly improved the evaluation of IE allowing to detect the specific signs of the disease as vegetations, abscesses, valve insufficiency, prosthetic valve dehiscence, fistulas. In our 3rd referral Hospital (Lancisi Heart Hospital, Ancona, Italy) we performed a follow-up (mean 8.26 years) of 15 patients with periannular complications associated with IE. The long term follow-up showed low mortality rate, high incidence of reintervention, improved New York Heart Association (NYHA) class in survivors and no changes of the lesions at the echocardiographic examination, suggesting that periannular complications have not significantly influenced the overall survival in our patients at the follow-up.

The stability of working memory: do previous tasks influence complex span?

PubMed

Healey, M Karl; Hasher, Lynn; Danilova, Elena

2011-11-01

Schmeichel (2007) reported that performing an initial task before completing a working memory span task can lower span scores and suggested that the effect was due to depleted cognitive resources. We showed that the detrimental effect of prior tasks depends on a match between the stimuli used in the span task and the preceding task. A task requiring participants to ignore words reduced performance on a subsequent word-based verbal span task but not on an arrow-based spatial span task. Ignoring arrows had the opposite pattern of effects: reducing performance on the spatial span task but not on the word-based span task. Finally, we showed that antisaccade, a nonverbal task that taxes domain-general processes implicated in working memory, did not influence subsequent performance of either a verbal or a spatial span task. Together these results suggest that while span is sensitive to prior tasks, that sensitivity does not stem from depleted resources. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

Visual short-term memory load strengthens selective attention.

PubMed

Roper, Zachary J J; Vecera, Shaun P

2014-04-01

Perceptual load theory accounts for many attentional phenomena; however, its mechanism remains elusive because it invokes underspecified attentional resources. Recent dual-task evidence has revealed that a concurrent visual short-term memory (VSTM) load slows visual search and reduces contrast sensitivity, but it is unknown whether a VSTM load also constricts attention in a canonical perceptual load task. If attentional selection draws upon VSTM resources, then distraction effects-which measure attentional "spill-over"-will be reduced as competition for resources increases. Observers performed a low perceptual load flanker task during the delay period of a VSTM change detection task. We observed a reduction of the flanker effect in the perceptual load task as a function of increasing concurrent VSTM load. These findings were not due to perceptual-level interactions between the physical displays of the two tasks. Our findings suggest that perceptual representations of distractor stimuli compete with the maintenance of visual representations held in memory. We conclude that access to VSTM determines the degree of attentional selectivity; when VSTM is not completely taxed, it is more likely for task-irrelevant items to be consolidated and, consequently, affect responses. The "resources" hypothesized by load theory are at least partly mnemonic in nature, due to the strong correspondence they share with VSTM capacity.

Choosing Your Poison: Optimizing Simulator Visual System Selection as a Function of Operational Tasks

NASA Technical Reports Server (NTRS)

Sweet, Barbara T.; Kaiser, Mary K.

2013-01-01

Although current technology simulator visual systems can achieve extremely realistic levels they do not completely replicate the experience of a pilot sitting in the cockpit, looking at the outside world. Some differences in experience are due to visual artifacts, or perceptual features that would not be present in a naturally viewed scene. Others are due to features that are missing from the simulated scene. In this paper, these differences will be defined and discussed. The significance of these differences will be examined as a function of several particular operational tasks. A framework to facilitate the choice of visual system characteristics based on operational task requirements will be proposed.

A Developmental Learning Approach of Mobile Manipulator via Playing

PubMed Central

Wu, Ruiqi; Zhou, Changle; Chao, Fei; Zhu, Zuyuan; Lin, Chih-Min; Yang, Longzhi

2017-01-01

Inspired by infant development theories, a robotic developmental model combined with game elements is proposed in this paper. This model does not require the definition of specific developmental goals for the robot, but the developmental goals are implied in the goals of a series of game tasks. The games are characterized into a sequence of game modes based on the complexity of the game tasks from simple to complex, and the task complexity is determined by the applications of developmental constraints. Given a current mode, the robot switches to play in a more complicated game mode when it cannot find any new salient stimuli in the current mode. By doing so, the robot gradually achieves it developmental goals by playing different modes of games. In the experiment, the game was instantiated into a mobile robot with the playing task of picking up toys, and the game is designed with a simple game mode and a complex game mode. A developmental algorithm, “Lift-Constraint, Act and Saturate,” is employed to drive the mobile robot move from the simple mode to the complex one. The experimental results show that the mobile manipulator is able to successfully learn the mobile grasping ability after playing simple and complex games, which is promising in developing robotic abilities to solve complex tasks using games. PMID:29046632

75 FR 32362 - Fresh Garlic From the People's Republic of China: Extension of Time Limit for the Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... that tolled the deadlines for all Import Administration cases by seven calendar days due to the Federal...-day period to 300 days if it determines that the case is extraordinarily complicated. See 19 CFR 351... shipper reviews involve extraordinarily complicated methodological issues, including the examination of...

Checklists in Neurosurgery to Decrease Preventable Medical Errors: A Review

PubMed Central

Enchev, Yavor

2015-01-01

Neurosurgery represents a zero tolerance environment for medical errors, especially preventable ones like all types of wrong site surgery, complications due to the incorrect positioning of patients for neurosurgical interventions and complications due to failure of the devices required for the specific procedure. Following the excellent and encouraging results of the safety checklists in intensive care medicine and in other surgical areas, the checklist was naturally introduced in neurosurgery. To date, the reported world experience with neurosurgical checklists is limited to 15 series with fewer than 20,000 cases in various neurosurgical areas. The purpose of this review was to study the reported neurosurgical checklists according to the following parameters: year of publication; country of origin; area of neurosurgery; type of neurosurgical procedure-elective or emergency; person in charge of the checklist completion; participants involved in completion; whether they prevented incorrect site surgery; whether they prevented complications due to incorrect positioning of the patients for neurosurgical interventions; whether they prevented complications due to failure of the devices required for the specific procedure; their specific aims; educational preparation and training; the time needed for checklist completion; study duration and phases; number of cases included; barriers to implementation; efforts to implementation; team appreciation; and safety outcomes. Based on this analysis, it could be concluded that neurosurgical checklists represent an efficient, reliable, cost-effective and time-saving tool for increasing patient safety and elevating the neurosurgeons’ self-confidence. Every neurosurgical department must develop its own neurosurgical checklist or adopt and modify an existing one according to its specific features and needs in an attempt to establish or develop its safety culture. The world, continental, regional and national neurosurgical societies could promote safety checklists and their benefits. PMID:26740891

Diabetes insipidus in pregnancy: how to advice the patient?

PubMed

Refardt, Julie; Christ-Crain, Mirjam

2018-02-19

Diabetes insipidus, characterized by polyuria and polydipsia, is a rare disease during pregnancy. Nevertheless, its recognition is important to avoid complications due to dehydration and hypernatremia. Its manifestation during pregnancy ranges from exacerbation of pre-existing central or nephrogenic diabetes insipidus to transient pregnancy-induced diabetes insipidus due to the increased metabolism of the antidiuretic hormone vasopressin by the placental vasopressinase. Diagnosis can be challenging, as urinary frequency is common during pregnancy and primary polydipsia also needs to be excluded. Also the standard water deprivation test is not recommended during pregnancy due to the increased risk of complications. Treatment depends upon the final diagnosis, with desmopressin (DDAVP) being the medication of choice in AVP-deficient diabetes insipidus, whereas nephrogenic diabetes insipidus requires treatment of the underlying disease and supportive measures.

Prior history of FDI muscle contraction: different effect on MEP amplitude and muscle activity.

PubMed

Talis, V L; Kazennikov, O V; Castellote, J M; Grishin, A A; Ioffe, M E

2014-03-01

Motor evoked potentials (MEPs) in the right first dorsal interosseous (FDI) muscle elicited by transcranial magnetic stimulation of left motor cortex were assessed in ten healthy subjects during maintenance of a fixed FDI contraction level. Subjects maintained an integrated EMG (IEMG) level with visual feedback and reproduced this level by memory afterwards in the following tasks: stationary FDI muscle contraction at the level of 40 ± 5 % of its maximum voluntary contraction (MVC; 40 % task), at the level of 20 ± 5 % MVC (20 % task), and also when 20 % MVC was preceded by either no contraction (0-20 task), by stronger muscle contraction (40-20 task) or by no contraction with a previous strong contraction (40-0-20 task). The results show that the IEMG level was within the prescribed limits when 20 and 40 % stationary tasks were executed with and without visual feedback. In 0-20, 40-20, and 40-0-20 tasks, 20 % IEMG level was precisely controlled in the presence of visual feedback, but without visual feedback the IEMG and force during 20 % IEMG maintenance were significantly higher in the 40-0-20 task than those in 0-20 and 40-20 tasks. That is, without visual feedback, there were significant variations in muscle activity due to different prehistory of contraction. In stationary tasks, MEP amplitudes in 40 % task were higher than in 20 % task. MEPs did not differ significantly during maintenance of the 20 % level in tasks with different prehistory of muscle contraction with and without visual feedback. Thus, in spite of variations in muscle background activity due to different prehistory of contraction MEPs did not vary significantly. This dissociation suggests that the voluntary maintenance of IEMG level is determined not only by cortical mechanisms, as reflected by corticospinal excitability, but also by lower levels of CNS, where afferent signals and influences from other brain structures and spinal cord are convergent.

Regularization iteration imaging algorithm for electrical capacitance tomography

NASA Astrophysics Data System (ADS)

Tong, Guowei; Liu, Shi; Chen, Hongyan; Wang, Xueyao

2018-03-01

The image reconstruction method plays a crucial role in real-world applications of the electrical capacitance tomography technique. In this study, a new cost function that simultaneously considers the sparsity and low-rank properties of the imaging targets is proposed to improve the quality of the reconstruction images, in which the image reconstruction task is converted into an optimization problem. Within the framework of the split Bregman algorithm, an iterative scheme that splits a complicated optimization problem into several simpler sub-tasks is developed to solve the proposed cost function efficiently, in which the fast-iterative shrinkage thresholding algorithm is introduced to accelerate the convergence. Numerical experiment results verify the effectiveness of the proposed algorithm in improving the reconstruction precision and robustness.

A Reasoning Hardware Platform for Real-Time Common-Sense Inference

PubMed Central

Barba, Jesús; Santofimia, Maria J.; Dondo, Julio; Rincón, Fernando; Sánchez, Francisco; López, Juan Carlos

2012-01-01

Enabling Ambient Intelligence systems to understand the activities that are taking place in a supervised context is a rather complicated task. Moreover, this task cannot be successfully addressed while overlooking the mechanisms (common-sense knowledge and reasoning) that entitle us, as humans beings, to successfully undertake it. This work is based on the premise that Ambient Intelligence systems will be able to understand and react to context events if common-sense capabilities are embodied in them. However, there are some difficulties that need to be resolved before common-sense capabilities can be fully deployed to Ambient Intelligence. This work presents a hardware accelerated implementation of a common-sense knowledge-base system intended to improve response time and efficiency. PMID:23012540

Six degree of freedom sensor

DOEpatents

Vann, Charles S.

1999-01-01

This small, non-contact optical sensor increases the capability and flexibility of computer controlled machines by detecting its relative position to a workpiece in all six degrees of freedom (DOF). At a fraction of the cost, it is over 200 times faster and up to 25 times more accurate than competing 3-DOF sensors. Applications range from flexible manufacturing to a 6-DOF mouse for computers. Until now, highly agile and accurate machines have been limited by their inability to adjust to changes in their tasks. By enabling them to sense all six degrees of position, these machines can now adapt to new and complicated tasks without human intervention or delay--simplifying production, reducing costs, and enhancing the value and capability of flexible manufacturing.

Six degree of freedom sensor

DOEpatents

Vann, C.S.

1999-03-16

This small, non-contact optical sensor increases the capability and flexibility of computer controlled machines by detecting its relative position to a workpiece in all six degrees of freedom (DOF). At a fraction of the cost, it is over 200 times faster and up to 25 times more accurate than competing 3-DOF sensors. Applications range from flexible manufacturing to a 6-DOF mouse for computers. Until now, highly agile and accurate machines have been limited by their inability to adjust to changes in their tasks. By enabling them to sense all six degrees of position, these machines can now adapt to new and complicated tasks without human intervention or delay--simplifying production, reducing costs, and enhancing the value and capability of flexible manufacturing. 3 figs.

Update on the Global Campaign Against Terrorist Financing: Second Report of an Independent Task Force on Terrorist Financing

DTIC Science & Technology

2004-06-15

therefore should be the subject of additional due diligence . Independent Task Force on Terrorist Financing 47 • Cooperate fully with any multilateral...unusually talented group who brought enthusiasm, diligence , and strong analytical skills to this project. We are especially appreciative of the hard...State Department’s latest Patterns of Global Terrorism report, continue to give praise where praise is due but too often go to lengths to avoid

Transsphenoidal surgery and diabetes mellitus: An analysis of inpatient data and complications.

PubMed

Pines, Morgan J; Raikundalia, Milap D; Svider, Peter F; Baredes, Soly; Liu, James K; Eloy, Jean Anderson

2015-10-01

Transsphenoidal surgery (TSS) has emerged as the standard approach for pituitary resection due to its minimally invasive nature. There has been little analysis examining the impact of diabetes mellitus (DM) on patients undergoing TSS. In this study, we characterize DM's association with postoperative TSS complications. In addition to analysis of associated charges and patient demographics, we performed comparison of complication rates between DM and non-DM patients who have undergone TSS in recent years. The Nationwide Inpatient Sample, a database encompassing nearly 8 million inpatient hospitalizations, was evaluated for patients undergoing TSS from 2002 to 2010. Of 12,938 TSS patients, 2,173 (16.8%) had a DM diagnosis. The non-DM cohort was younger (50.1 y ± 16.6SD vs. 56.8 y ± 14.1; P < 0.001) and had shorter hospitalizations and lesser charges. DM patients had a greater incidence of pulmonary, cardiac, urinary/renal, and fluid/electrolyte complications, and had a lesser incidence of diabetes insipidus (P < 0.05). Upon controlling for age, the greater incidence of pulmonary and fluid/electrolyte complications was present only among patients < 60 years of age. Higher occurrence of cerebrospinal fluid rhinorrhea was noted among black diabetics when compared to non-DM blacks. DM is associated with greater length of stay and hospital charges among TSS patients. DM patients undergoing TSS have a significantly greater incidence of pulmonary and fluid/electrolyte complications among patients under the age of 60, and greater risk for urinary/renal complications across all ages. Despite a theoretical concern due to an impaired wound-healing in DM patients, association with cerebrospinal fluid rhinorrhea was only noted among black diabetics. 2C. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Imaging in lung transplants: Checklist for the radiologist.

PubMed

Madan, Rachna; Chansakul, Thanissara; Goldberg, Hilary J

2014-10-01

Post lung transplant complications can have overlapping clinical and imaging features, and hence, the time point at which they occur is a key distinguisher. Complications of lung transplantation may occur along a continuum in the immediate or longer postoperative period, including surgical and mechanical problems due to size mismatch and vascular as well as airway anastomotic complication, injuries from ischemia and reperfusion, acute and chronic rejection, pulmonary infections, and post-transplantation lymphoproliferative disorder. Life expectancy after lung transplantation has been limited primarily by chronic rejection and infection. Multiple detector computed tomography (MDCT) is critical for evaluation and early diagnosis of complications to enable selection of effective therapy and decrease morbidity and mortality among lung transplant recipients.

Complications of Blepharoplasty: Prevention and Management

PubMed Central

Oestreicher, James; Mehta, Sonul

2012-01-01

Blepharoplasty is an operation to modify the contour and configuration of the eyelids in order to restore a more youthful appearance. The surgery involves removing redundant skin, fat, and muscle. In addition, supporting structures such as canthal tendons are tightened. Other conditions such as ptosis, brow ptosis, entropion, ectropion, or eyelid retraction may also need to be corrected at the time a blepharoplasty is performed to ensure the best functional and aesthetic result. Due to the complexity and intricate nature of eyelid anatomy, complications do exist. In addition to a thorough pre operative assessment and meticulous surgical planning, understanding the etiology of complications is key to prevention. Finally, management of complications is just as important as surgical technique. PMID:22655191

Urgent liver transplantation for acute liver failure due to parvovirus B19 infection complicated by primary Epstein-Barr virus and cytomegalovirus infections and aplastic anaemia.

PubMed

So, K; Macquillan, G; Garas, G; Delriviere, L; Mitchell, A; Speers, D; Mews, C; Augustson, B; de Boer, W B; Baker, D; Jeffrey, G P

2007-03-01

An 11-year-old boy presented with hepatic failure secondary to parvovirus B19 infection, requiring urgent liver transplantation. His recovery was complicated by primary Epstein-Barr virus and cytomegalovirus infections. He subsequently developed aplastic anaemia that has been refractory to antithymocyte globulin and cyclosporine therapy and may now require bone marrow transplantation. We present this case to emphasize parvovirus as a rare cause of hepatic failure and of aplastic anaemia as a complication of the virus.

[Complex case with respiratory, endocrine and digestive manifestations--late complications after a colic replacement of the esophagus for lye ingestion].

PubMed

Bolca, Ciprian; Tănăsescu, Mihaela; Dănăilă, Olga; Paleru, Cristian; Cordoş, Ioan

2014-01-01

Long term complications after colic replacement of the esophagus are well known and their managment is known as being difficult, due to multiple associated comorbidities; we present the case of a 26-year-old patient with multiple late complications after a coloesophagoplaty for lye ingestion during childhood. The patient finally died despite all the eforts of treatement during a prolonged hospitalisation. We will try to analyse the key moments on patient's evolution and discuss other possible options in this case.

Recommendations for Secure Initialization Routines in Operating Systems

DTIC Science & Technology

2004-12-01

monolithic design is used. This term is often used to distinguish the operating system from supporting software, e.g. “The Linux kernel does not specify...give the operating system structure and organization. Yet the overall monolithic design of the kernel still falls under Tannenbaum and Woodhull’s “Big...modules that handle initialization tasks. Any further subdivision would complicate interdependencies that are a result of having a monolithic kernel

Crossing the Finish Line: Helping Adults with Significant College Credit Get Back on Track to a College Degree. Complete to Compete Briefing Paper

ERIC Educational Resources Information Center

Michelau, Demaree K.

2011-01-01

Nearly all states are grappling with the question of how to boost college attainment to meet workforce needs with the resources available. For many states, that task is complicated by the fact that the young adult population is projected neither to grow nor decline over the next several years. There is a significant opportunity, however, for…

Practical Considerations in Pediatric Surgery

PubMed Central

Louis, Matthew R.; Meaike, Jesse D.; Chamata, Edward; Hollier, Larry H.

2016-01-01

The care of pediatric patients requires special considerations that are often not addressed in the literature. Relatively straightforward tasks such as clinical evaluation, antibiotic use, splinting, wound closure, and care of simple burns become complicated in the pediatric population for several reasons. The authors seek to demystify some of these topics using the senior author's years of clinical experience treating pediatric patients by giving practical advice and general considerations when treating children. PMID:27895539

Development of a Leader Training Model and System

DTIC Science & Technology

1980-01-01

recognition--are (a) the free - play , two-sided engagement which incorporates the crucial elements of complexity and uncertainty, (b) objective and real-time...changing conditions, many created by opposition action. In such a dynamic free - play environ- ment, further complicated by the confounding conditions...the ISD model with its emphasis on task analysis was considered less than adequate for the combat arms. The free - play character of the combat setting

Altered neural circuits accompany lower performance during narrative comprehension in children with reading difficulties: an fMRI study.

PubMed

Horowitz-Kraus, Tzipi; Buck, Catherine; Dorrmann, Dana

2016-10-01

Narrative comprehension is a linguistic ability that is foundational for future reading ability. The aim of the current study was to examine the neural circuitry of children with reading difficulties (RD) compared to typical readers during a narrative-comprehension task. We hypothesized that due to deficient executive functions, which support narrative comprehension abilities, children with RD would display altered activation and functional connectivity, as well as lower performance on a narrative-comprehension task. Children with RD and typical readers were scanned during a narrative-comprehension task and administered reading behavioral tests. Children with RD scored significantly lower on the narrative-comprehension task than did typical readers. Composite activation maps showed more diffused activation during narrative comprehension in the RD group. Maps comparing the two reading groups showed more activation in the frontal lobes (regions responsible for executive functions), and functional connectivity showed higher global efficiency in children with RD than in typical readers. Global efficiency was negatively correlated with phonological awareness and reading and executive function scores in the entire study group. Children with RD may suffer from narrative-comprehension difficulties due to diffused activation of language areas, as was observed during a narrative-comprehension task. Greater effort in this task may be reflected by the engagement of brain regions related to executive functions and higher functional connectivity or attributed to difficulties in phonological processing and reading and executive functions. Therefore, the accommodation given to children with RD of reading aloud may need to be revised due to the observed difficulty in this domain.

Effects of Task-oriented Approach on Affected Arm Function in Children with Spastic Hemiplegia Due to Cerebral Palsy.

PubMed

Song, Chiang-Soon

2014-06-01

[Purpose] The purpose of the present study was to examine the effects of task-oriented approach on motor function of the affected arm in children with spastic hemiplegia due to cerebral palsy. [Subjects] Twelve children were recruited by convenience sampling from 2 local rehabilitation centers. The present study utilized a one-group pretest-posttest design. All of children received task-oriented training for 6 weeks (40 min/day, 5 days/week) and also underwent regular occupational therapy. Three clinical tests, Box and Block Test (BBT), Manual Ability Measure (MAM-16), and Wee Functional Independence Measure (WeeFIM) were performed 1 day before and after training to evaluate the effects of the training. [Results] Compared with the pretest scores, there was a significant increase in the BBT, MAM-16, and WeeFIM scores of the children after the 6-week practice period. [Conclusion] The results of this study suggest that a task-oriented approach to treatment of the affected arm improves functional activities, such as manual dexterity and fine motor performance, as well as basic daily activities of patients with spastic hemiplegia due to cerebral palsy.

Research on Intelligent Interface in Double-front Work Machines

NASA Astrophysics Data System (ADS)

Kamezaki, Mitsuhiro; Iwata, Hiroyasu; Sugano, Shigeki

This paper proposes a work state identification method with full independent of work environmental conditions and operator skill levels for construction machinery. Advanced operated-work machines, which have been designed for complicated tasks, require intelligent systems that can provide the quantitative work analysis needed to determine effective work procedures and that can provide operational and cognitive support for operators. Construction work environments are extremely complicated, however, and this makes state identification, which is a key technology for an intelligent system, difficult. We therefore defined primitive static states (PSS) that are determined using on-off information for the lever inputs and manipulator loads for each part of the grapple and front and that are completely independent of the various environmental conditions and variation in operator skill level that can cause an incorrect work state identification. To confirm the usefulness of PSS, we performed experiments with a demolition task by using our virtual reality simulator. We confirmed that PSS could robustly and accurately identify the work states and that untrained skills could be easily inferred from the results of PSS-based work analysis. We also confirmed in skill-training experiments that advice information based on PSS-based skill analysis greatly improved operator's work performance. We thus confirmed that PSS can adequately identify work states and are useful for work analysis and skill improvement.

Emotional recognition from dynamic facial, vocal and musical expressions following traumatic brain injury.

PubMed

Drapeau, Joanie; Gosselin, Nathalie; Peretz, Isabelle; McKerral, Michelle

2017-01-01

To assess emotion recognition from dynamic facial, vocal and musical expressions in sub-groups of adults with traumatic brain injuries (TBI) of different severities and identify possible common underlying mechanisms across domains. Forty-one adults participated in this study: 10 with moderate-severe TBI, nine with complicated mild TBI, 11 with uncomplicated mild TBI and 11 healthy controls, who were administered experimental (emotional recognition, valence-arousal) and control tasks (emotional and structural discrimination) for each domain. Recognition of fearful faces was significantly impaired in moderate-severe and in complicated mild TBI sub-groups, as compared to those with uncomplicated mild TBI and controls. Effect sizes were medium-large. Participants with lower GCS scores performed more poorly when recognizing fearful dynamic facial expressions. Emotion recognition from auditory domains was preserved following TBI, irrespective of severity. All groups performed equally on control tasks, indicating no perceptual disorders. Although emotional recognition from vocal and musical expressions was preserved, no correlation was found across auditory domains. This preliminary study may contribute to improving comprehension of emotional recognition following TBI. Future studies of larger samples could usefully include measures of functional impacts of recognition deficits for fearful facial expressions. These could help refine interventions for emotional recognition following a brain injury.

Ongoing Walking Recovery 2 Years After Locomotor Training in a Child With Severe Incomplete Spinal Cord Injury

PubMed Central

Fox, Emily J.; Tester, Nicole J.; Phadke, Chetan P.; Nair, Preeti M.; Senesac, Claudia R.; Howland, Dena R.

2010-01-01

Background and Purpose The authors previously reported on walking recovery in a nonambulatory child with chronic, severe, incomplete cervical spinal cord injury (SCI) after 76 sessions of locomotor training (LT). Although clinical measures did not predict his recovery, reciprocal patterned leg movements developed, affording recovery of independent walking with a reverse rolling walker. The long-term functional limitations and secondary complications often associated with pediatric-onset SCI necessitate continued follow-up of children with SCI. Therefore, the purpose of this case report is to describe this child's walking function and musculoskeletal growth and development during the 2 years since his participation in an LT program and subsequent walking recovery. Case Description Following LT, the child attended elementary school as a full-time ambulator. He was evaluated 1 month (baseline), 1 year, and 2 years after LT. Examination of walking function included measures of walking independence, gait speed and spatiotemporal parameters, gait kinematics, and daily step activity. Growth and development were assessed by tracking his height, weight, incidence of musculoskeletal complications, and gross motor task performance. Outcomes Over the 2 years, the child continued to ambulate independently with a reverse rolling walker, increasing his fastest gait speed. Spatiotemporal and kinematic features of his walking improved, and daily step activity increased. Height and weight remained on their preinjury trajectory and within age-appropriate norms. The child experienced only minor musculoskeletal complications. Additionally, he gained the ability to use reciprocal patterned leg movements during locomotor tasks such as assisted stair climbing and independent tricycle pedaling. Conclusions Two years after recovery of walking, this child with incomplete SCI had maintained and improved his walking function and experienced age-appropriate growth and development. PMID:20299409

Ongoing walking recovery 2 years after locomotor training in a child with severe incomplete spinal cord injury.

PubMed

Fox, Emily J; Tester, Nicole J; Phadke, Chetan P; Nair, Preeti M; Senesac, Claudia R; Howland, Dena R; Behrman, Andrea L

2010-05-01

The authors previously reported on walking recovery in a nonambulatory child with chronic, severe, incomplete cervical spinal cord injury (SCI) after 76 sessions of locomotor training (LT). Although clinical measures did not predict his recovery, reciprocal patterned leg movements developed, affording recovery of independent walking with a reverse rolling walker. The long-term functional limitations and secondary complications often associated with pediatric-onset SCI necessitate continued follow-up of children with SCI. Therefore, the purpose of this case report is to describe this child's walking function and musculoskeletal growth and development during the 2 years since his participation in an LT program and subsequent walking recovery. Following LT, the child attended elementary school as a full-time ambulator. He was evaluated 1 month (baseline), 1 year, and 2 years after LT. Examination of walking function included measures of walking independence, gait speed and spatiotemporal parameters, gait kinematics, and daily step activity. Growth and development were assessed by tracking his height, weight, incidence of musculoskeletal complications, and gross motor task performance. Over the 2 years, the child continued to ambulate independently with a reverse rolling walker, increasing his fastest gait speed. Spatiotemporal and kinematic features of his walking improved, and daily step activity increased. Height and weight remained on their preinjury trajectory and within age-appropriate norms. The child experienced only minor musculoskeletal complications. Additionally, he gained the ability to use reciprocal patterned leg movements during locomotor tasks such as assisted stair climbing and independent tricycle pedaling. Two years after recovery of walking, this child with incomplete SCI had maintained and improved his walking function and experienced age-appropriate growth and development.

Male Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: A Report From the Children's Oncology Group

PubMed Central

Kenney, Lisa B.; Cohen, Laurie E.; Shnorhavorian, Margarett; Metzger, Monika L.; Lockart, Barbara; Hijiya, Nobuko; Duffey-Lind, Eileen; Constine, Louis; Green, Daniel; Meacham, Lillian

2012-01-01

The majority of children, adolescents, and young adults diagnosed with cancer will become long-term survivors. Although cancer therapy is associated with many adverse effects, one of the primary concerns of young male cancer survivors is reproductive health. Future fertility is often the focus of concern; however, it must be recognized that all aspects of male health, including pubertal development, testosterone production, and sexual function, can be impaired by cancer therapy. Although pretreatment strategies to preserve reproductive health have been beneficial to some male patients, many survivors remain at risk for long-term reproductive complications. Understanding risk factors and monitoring the reproductive health of young male survivors are important aspects of follow-up care. The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) were created by the COG to provide recommendations for follow-up care of survivors at risk for long-term complications. The male health task force of the COG-LTFU Guidelines, composed of pediatric oncologists, endocrinologists, nurse practitioners, a urologist, and a radiation oncologist, is responsible for updating the COG-LTFU Guidelines every 2 years based on literature review and expert consensus. This review summarizes current task force recommendations for the assessment and management of male reproductive complications after treatment for childhood, adolescent, and young adult cancers. Issues related to male health that are being investigated, but currently not included in the COG-LTFU Guidelines, are also discussed. Ongoing investigation will inform future COG-LTFU Guideline recommendations for follow-up care to improve health and quality of life for male survivors. PMID:22649147

The Use of Cognitive Cues for Anticipatory Strategies in a Dynamic Postural Control Task - Validation of a Novel Approach to Dual-Task Testing.

PubMed

Laessoe, Uffe; Grarup, Bo; Bangshaab, Jette

2016-01-01

Dual-task testing is relevant in the assessment of postural control. A combination of a primary (motor) and a secondary (distracting cognitive) tasks is most often used. It remains a challenge however, to standardize and monitor the cognitive task. In this study a new dual-task testing approach with a facilitating, rather than distracting, cognitive component was evaluated. Thirty-one community-dwelling elderly and fifteen young people were tested with respect to their ability to use anticipatory postural control strategies. The motor task consisted of twenty-five repetitive tasks in which the participants needed to exceed their limit of stability in order to touch one out of eight lights. The participants performed three tests. In two of the tests the color cues of the lights allowed the participants to utilize cognitive strategies to plan their next movement and improve their performance time. The young performed the baseline motor task test in an average of 29 seconds, while the average time for the elderly was 44 seconds. When comparing the performance time with a leading cue to the time with no cue, the young group improved their performance time significantly better than the elderly did: young: 17% (5), elderly: 5% (8); p<0.001. Similar differences were seen with a more complicated leading cue: young: 12% (5), elderly: 4% (9); p<0.01. The reliability of the test showed moderate to substantial agreement (ICC = 0.74), with a small learning effect between two sessions. The dual-task test was sensitive enough to discriminate between elderly and young people. It revealed that the elderly did not utilize cognitive cues for their anticipatory postural control strategies as well as the young were able to. The test procedure was feasible and comprehensible for the participants, and it may be relevant to standardize a similar test for an alternative dual-task approach in the clinical setting.

MO-F-CAMPUS-T-05: SQL Database Queries to Determine Treatment Planning Resource Usage

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

Fox, C; Gladstone, D

2015-06-15

Purpose: A radiation oncology clinic’s treatment capacity is traditionally thought to be limited by the number of machines in the clinic. As the number of fractions per course decrease and the number of adaptive plans increase, the question of how many treatment plans a clinic can plan becomes increasingly important. This work seeks to lay the ground work for assessing treatment planning resource usage. Methods: Care path templates were created using the Aria 11 care path interface. Care path tasks included key steps in the treatment planning process from the completion of CT simulation through the first radiation treatment. SQLmore » Server Management Studio was used to run SQL queries to extract task completion time stamps along with care path template information and diagnosis codes from the Aria database. 6 months of planning cycles were evaluated. Elapsed time was evaluated in terms of work hours within Monday – Friday, 7am to 5pm. Results: For the 195 validated treatment planning cycles, the average time for planning and MD review was 22.8 hours. Of those cases 33 were categorized as urgent. The average planning time for urgent plans was 5 hours. A strong correlation between diagnosis code and range of elapsed planning time was as well as between elapsed time and select diagnosis codes was observed. It was also observed that tasks were more likely to be completed on the date due than the time that they were due. Follow-up confirmed that most users did not look at the due time. Conclusion: Evaluation of elapsed planning time and other tasks suggest that care paths should be adjusted to allow for different contouring and planning times for certain diagnosis codes and urgent cases. Additional clinic training around task due times vs dates or a structuring of care paths around due dates is also needed.« less

Linked shoulder replacement: current design problems and a new design proposal.

PubMed

Mohammed, Ali Abdullah; Frostick, Simon Peter

2016-04-01

Totally constrained shoulder replacement with linked components is one of the surgical options in post-tumor resection shoulder reconstruction or in complex shoulder revision operations. In this paper, we intend to shed light on such an implant design, which provides a linked constrained connection between the humeral head and the glenoid, and to show some immediate postoperative complications, implant progression to decrease the chances of implant mechanical postinsertion failure, and a new design proposal. In our center, we use the linked prosthesis in complex revision situations; however, there have been some complications, which could be attributed mainly to the engineering and the implant design, and hence potentially avoidable by making a different design to cover for those mechanical issues. Two such complications are described in this paper. Early revisions after linked shoulder replacement implantation were needed in two occasions due to implant disconnection: one of them was due to dislodgement from the native glenoid, and the second one was due to the disengagement of the ringlet which secures the linkage mechanism between the humeral head and the implanted glenoid shell. There is a need for a more stable design construct to avoid the reported complications that needed early revision surgeries. The new design proposed is an attempt to help providing a better and more stable implant to decrease the chances of revision in those complex situations where the patient already had many major operations, and working to increase the durability of the implant is crucial.

The Time Course of the Influence of Valence and Arousal on the Implicit Processing of Affective Pictures

PubMed Central

Feng, Chunliang; Wang, Lili; Liu, Chao; Zhu, Xiangru; Dai, Ruina; Mai, Xiaoqin; Luo, Yue-Jia

2012-01-01

In the current study, we investigated the time course of the implicit processing of affective pictures with an orthogonal design of valence (negative vs. positive) by arousal (low vs. high). Previous studies with explicit tasks suggested that valence mainly modulates early event-related potential (ERP) components, whereas arousal mainly modulates late components. However, in this study with an implicit task, we observed significant interactions between valence and arousal at both early and late stages over both parietal and frontal sites, which were reflected by three different ERP components: P2a (100–200 ms), N2 (200–300 ms), and P3 (300–400 ms). Furthermore, there was also a significant main effect of arousal on P2b (200–300 ms) over parieto-occipital sites. Our results suggest that valence and arousal effects on implicit affective processing are more complicated than previous ERP studies with explicit tasks have revealed. PMID:22295062

Exploring the repetition bias in voluntary task switching.

PubMed

Mittelstädt, Victor; Dignath, David; Schmidt-Ott, Magdalena; Kiesel, Andrea

2018-01-01

In the voluntary task-switching paradigm, participants are required to randomly select tasks. We reasoned that the consistent finding of a repetition bias (i.e., participants repeat tasks more often than expected by chance) reflects reasonable adaptive task selection behavior to balance the goal of random task selection with the goals to minimize the time and effort for task performance. We conducted two experiments in which participants were provided with variable amount of preview for the non-chosen task stimuli (i.e., potential switch stimuli). We assumed that switch stimuli would initiate some pre-processing resulting in improved performance in switch trials. Results showed that reduced switch costs due to extra-preview in advance of each trial were accompanied by more task switches. This finding is in line with the characteristics of rational adaptive behavior. However, participants were not biased to switch tasks more often than chance despite large switch benefits. We suggest that participants might avoid effortful additional control processes that modulate the effects of preview on task performance and task choice.

Female urethral diverticulum containing a giant calculus: a CARE-compliant case report.

PubMed

Dong, ZhiLong; Wang, Hanzhang; Zuo, LinJun; Hou, MingLi

2015-05-01

Urethral diverticula with calculi have a low incidence as reported in the literature. Diverticulum of female urethra is rare, often discovered due to associated complications. We report a case of diverticulum of the female urethra containing giant calculi in a 62-year-old multiparous woman. She consulted with our office due to dysuria and a hard, painful periurethral mass in the anterior vagina wall. The diverticulum was approached surgically by a vaginal route, and local extraction of the calculi and subsequent diverticulectomy successfully treated the condition.Diagnosis of a complicated diverticulum can be easily achieved if one possesses a high degree of clinical symptoms.

The Role of Task-Related Learned Representations in Explaining Asymmetries in Task Switching

PubMed Central

Barutchu, Ayla; Becker, Stefanie I.; Carter, Olivia; Hester, Robert; Levy, Neil L.

2013-01-01

Task switch costs often show an asymmetry, with switch costs being larger when switching from a difficult task to an easier task. This asymmetry has been explained by difficult tasks being represented more strongly and consequently requiring more inhibition prior to switching to the easier task. The present study shows that switch cost asymmetries observed in arithmetic tasks (addition vs. subtraction) do not depend on task difficulty: Switch costs of similar magnitudes were obtained when participants were presented with unsolvable pseudo-equations that did not differ in task difficulty. Further experiments showed that neither task switch costs nor switch cost asymmetries were due to perceptual factors (e.g., perceptual priming effects). These findings suggest that asymmetrical switch costs can be brought about by the association of some tasks with greater difficulty than others. Moreover, the finding that asymmetrical switch costs were observed (1) in the absence of a task switch proper and (2) without differences in task difficulty, suggests that present theories of task switch costs and switch cost asymmetries are in important ways incomplete and need to be modified. PMID:23613919

Neurologic Complications of Psychomotor Stimulant Abuse.

PubMed

Sanchez-Ramos, Juan

2015-01-01

Psychomotor stimulants are drugs that act on the central nervous system (CNS) to increase alertness, elevate mood, and produce a sense of well-being. These drugs also decrease appetite and the need for sleep. Stimulants can enhance stamina and improve performance in tasks that have been impaired by fatigue or boredom. Approved therapeutic applications of stimulants include attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. These agents also possess potent reinforcing properties that can result in excessive self-administration and abuse. Chronic use is associated with adverse effects including psychosis, seizures, and cerebrovascular accidents, though these complications usually occur in individuals with preexisting risk factors. This chapter reviews the adverse neurologic consequences of chronic psychomotor stimulant use and abuse, with a focus on two prototypical stimulants methamphetamine and cocaine. © 2015 Elsevier Inc. All rights reserved.

IT Solution concept development for tracking and analyzing the labor effectiveness of employees

NASA Astrophysics Data System (ADS)

Ilin, Igor; Shirokova, Svetlana; Lepekhin, Aleksandr

2018-03-01

Labor efficiency and productivity of employees is an important aspect for the environment within any type of organization. This is particularly crucial factor for the companies, if which operations are associated with physical labor, such as construction companies. Productivity and efficiency are both very complicated concepts and a huge variety of methods and approaches to its analysis can be implemented within the organization. Despite that, it is important to choose the methods, which not only analyze the key performance indicators of employee, but take into account personal indicators, which might affect performance even more than professional skills. For this complicated analysis task it is important to build IT solution for tracking and analyzing of the labor effectiveness. The concept for designing this IT solution is proposed in the current research.

Robotic general surgery experience: a gradual progress from simple to more complex procedures.

PubMed

Al-Naami, M; Anjum, M N; Aldohayan, A; Al-Khayal, K; Alkharji, H

2013-12-01

Robotic surgery was introduced at our institution in 2003, and we used a progressive approach advancing from simple to more complex procedures. A retrospective chart review. Cases included totalled 129. Set-up and operative times have improved over time and with experience. Conversion rates to standard laparoscopic or open techniques were 4.7% and 1.6%, respectively. Intraoperative complications (6.2%), blood loss and hospital stay were directly proportional to complexity. There were no mortalities and the postoperative complication rate (13.2%) was within accepted norms. Our findings suggest that robot technology is presently most useful in cases tailored toward its advantages, i.e. those confined to a single space, those that require performance of complex tasks, and re-do procedures. Copyright © 2013 John Wiley & Sons, Ltd.

Neurological complication after low-voltage electric injury: a case report.

PubMed

Kim, Ha Min; Ko, Yeong-A; Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young

2014-04-01

Electrical shock can result in neurological complications, involving both peripheral and central nervous systems, which may present immediately or later on. However, delayed neurological complications caused by low-voltage electric shock are rarely reported. Here, a case of a man suffering from weakness and aphasia due to the delayed-onset of the peripheral nerve injury and ischemic stroke following an electrical shock is presented. Possible mechanisms underlying the neurological complications include thermal injury to perineural tissue, overactivity of the sympathetic nervous system, vascular injury, and histological or electrophysiological changes. Moreover, vasospasms caused by low-voltage alternating current may predispose individuals to ischemic stroke. Therefore, clinicians should consider the possibility of neurological complications, even if the onset of the symptoms is delayed, and should perform diagnostic tests, such as electrophysiology or imaging, when patients present with weakness following an electric injury.

Prognosis of cocaine body-packers.

PubMed

de Prost, Nicolas; Lefebvre, Aurélie; Questel, Frank; Roche, Nicolas; Pourriat, Jean-Louis; Huchon, Gérard; Rabbat, Antoine

2005-07-01

To study the prognosis and complications of cocaine body-packing (concealment of cocaine in the body for transportation between countries). We retrospectively reviewed the files of all cocaine body-packers hospitalized during a 4-year period in a medico-judiciary emergency unit. Subjects included in the survey were identified from the hospital databases using ICD-10 codes. The Medico-Judiciary Emergency Unit of Hôtel-Dieu university hospital in Paris is a unique medical and surgical emergency unit receiving all patients in legal custody arrested at the two Paris international airports and suspected of body-packing. All the cases of cocaine body-packers (n=581) hospitalized between January 1999 and December 2002 were studied. They had been arrested at Paris airports while arriving from drug-producing countries. The mean number of carried packets was 70.0+/-20.4 (range 18-150). The mean duration of hospitalization was 5.0+/-1.6 days (range 1-18). No complication occurred in 573 body-packers cases. Eight subjects developed a complication requiring admission to an intensive care unit: six acute cocaine intoxications due to packet rupture and two intestinal occlusions. No one died. Surgical treatment was necessary in six cases. Good prognosis observed in these body-packers cases is due to the careful monitoring of asymptomatic patients, allowing early detection and treatment of complications. Surgical removal of the packets when complication occurs is warranted.

Incidence and Causes of Intentional Fetal or Neonatal Demise in Twin-Twin Transfusion Syndrome

PubMed Central

Spruijt, Marjolijn S.; Tameeris, Ellen; Zhao, De-Peng; Middeldorp, Johanna M.; Haak, Monique C.; Oepkes, Dick; Lopriore, Enrico

2018-01-01

Introduction The aim of this study is to evaluate the incidence and causes of intentional fetal and neonatal demise in twin-twin transfusion syndrome (TTTS). Material and Methods All TTTS pregnancies managed at our centre between 2000 and 2014 were included. We evaluated incidence and causes of intentional fetal/neonatal demise, defined as termination of pregnancy, selective fetal reduction, or withdrawal of neonatal intensive care. Results Intentional fetal/neonatal demise occurred in 9.8% (110/1,122) of fetuses and was due to termination of pregnancy (2.2%), selective fetal reduction (4.2%), or withdrawal of neonatal intensive care (3.4%). Reasons for termination of pregnancy included complications of laser treatment (72.0%), severe fetal anomaly (20.0%), and unwanted pregnancy (8.0%). Reasons for selective fetal reduction were technical difficulties to perform laser surgery (51.1%), fetal complications (38.3%), and parental preference for fetal reduction rather than laser treatment (10.6%). Reasons for withdrawal of neonatal intensive care treatment were severe cerebral injury (47.4%), severe pulmonary complications (15.8%), birth asphyxia (5.3%), multiple complications of TTTS and/or prematurity combined (21.1%), or other (10.5%). Conclusions Intentional fetal or neonatal demise in TTTS occurs frequently and is often due to complications after laser surgery and/or severe (cerebral) injury in affected fetuses or neonates. PMID:28285310

Vascular complications following intra-aortic balloon pump implantation: an updated review

PubMed Central

de Jong, Monique M; Lorusso, Roberto; Al Awami, Fatima; Matteuci, Francesco; Parise, Orlando; Lozekoot, Pieter; Bonacchi, Massimo; Maessen, Jos G; Johnson, Daniel M; Gelsomino, Sandro

2017-01-01

Background: The use of the intra-aortic balloon pump (IABP) as a support device remains controversial due to the fact that a number of studies have shown no benefit in end mortality whilst using this device. One of the reasons for this could be the increase in vascular complications when using the pump. Therefore, the aim of the present review was to assess the current literature available with regards to IABP vascular complications during the clinical situation. Methods: A literature search was performed, searching for IABP complications in adult human studies between 1990 and 2016. Results: A total of 20 reports were identified as fitting the criteria of this study. The majority of vascular complications were limb ischemia, bleeding or mesenteric ischemia. The overall incidence of vascular complications ranged from 0.94% to 31.1%. Diabetes, peripheral vascular disease and hypertension, as well as smoking were all identified as risk factors for complications following IABP. Furthermore, studies supported the use of sheathless balloon insertion to reduce the risk of complications. Conclusion: Major vascular complications, including limb and mesenteric ischemia as well as bleeding and hemorrhage, have been associated with IABP. However, the incidence of these complications was generally low. Further studies are still required to truly understand the risk/benefit associated with the use of IABP. PMID:28816093

[The complications of skin expansion in paediatrics: Diagnostic, taking over and prevention].

PubMed

Pascal, S; Philandrianos, C; Bertrand, B; Bardot, J; Degardin, N; Casanova, D

2016-10-01

Skin expansion is a difficult and long process in which can occur more or less serious complications. Overall complications rates describe in the literature vary between 13 and 37%. We can categorize them in major complications, which can lead to a failure maybe even an aggravation of the anterior status, and in minor complications that do not compromise the expansion process but can alter it. The main major complications are infection, skin suffering and necrosis which can lead to prosthesis exposition, leaks and technical problems with equipment dysfunctions that may cause difficulties or a failure of the inflations. The main minor complications are hematomas, seromas, valve or tube exposition, pains with paraesthesias caused by neighbouring organs compression, pathologic and unsightly scares and can lead to an important psychological impact. These complications can be due to a precarious skin's state, a material dysfunction or unpredictable technical problems but also by an inappropriate preoperative indication or planning. The emerging of a complication, however, is not synonymous to a failure of the procedure; a satisfactory reconstruction may still be obtained in 75% of all cases. The purpose of this article is to help to identify the situations at risk of complications in order to prevent, detect and treat them early. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Modeling Operator Performance in Low Task Load Supervisory Domains

DTIC Science & Technology

2011-06-01

PDF Probability Distribution Function SAFE System for Aircrew Fatigue Evaluation SAFTE Sleep , Activity, Fatigue, and Task Effectiveness SCT...attentional capacity due to high mental workload. In low task load settings, fatigue is mainly caused by lack of sleep and boredom experienced by...performance decrements. Also, psychological fatigue is strongly correlated with lack of sleep . Not surprisingly, operators of the morning shift reported the

Bottom-Up Mechanisms Are Involved in the Relation between Accuracy in Timing Tasks and Intelligence--Further Evidence Using Manipulations of State Motivation

ERIC Educational Resources Information Center

Ullen, Fredrik; Soderlund, Therese; Kaaria, Lenita; Madison, Guy

2012-01-01

Intelligence correlates with accuracy in various timing tasks. Such correlations could be due to both bottom-up mechanisms, e.g. neural properties that influence both temporal accuracy and cognitive processing, and differences in top-down control. We have investigated the timing-intelligence relation using a simple temporal motor task, isochronous…

Impaired reasoning and problem-solving in individuals with language impairment due to aphasia or language delay

PubMed Central

Baldo, Juliana V.; Paulraj, Selvi R.; Curran, Brian C.; Dronkers, Nina F.

2015-01-01

The precise nature of the relationship between language and thought is an intriguing and challenging area of inquiry for scientists across many disciplines. In the realm of neuropsychology, research has investigated the inter-dependence of language and thought by testing individuals with compromised language abilities and observing whether performance in other cognitive domains is diminished. One group of such individuals is patients with aphasia who have an impairment in speech and language arising from a brain injury, such as a stroke. Our previous research has shown that the degree of language impairment in these individuals is strongly associated with the degree of impairment on complex reasoning tasks, such as the Wisconsin Card Sorting Task (WCST) and Raven’s Matrices. In the current study, we present new data from a large group of individuals with aphasia that show a dissociation in performance between putatively non-verbal tasks on the Wechsler Adult Intelligence Scale (WAIS) that require differing degrees of reasoning (Picture Completion vs. Picture Arrangement tasks). We also present an update and replication of our previous findings with the WCST showing that individuals with the most profound core language deficits (i.e., impaired comprehension and disordered language output) are particularly impaired on problem-solving tasks. In the second part of the paper, we present findings from a neurologically intact individual known as “Chelsea” who was not exposed to language due to an unaddressed hearing loss that was present since birth. At the age of 32, she was fitted with hearing aids and exposed to spoken and signed language for the first time, but she was only able to acquire a limited language capacity. Chelsea was tested on a series of standardized neuropsychological measures, including reasoning and problem-solving tasks. She was able to perform well on a number of visuospatial tasks but was disproportionately impaired on tasks that required reasoning, such as Raven’s Matrices and the WAIS Picture Arrangement task. Together, these findings suggest that language supports complex reasoning, possibly due to the facilitative role of verbal working memory and inner speech in higher mental processes. PMID:26578991

Laparoscopic treatment of abdominal complications following ventriculoperitoneal shunt

PubMed Central

Grigorean, VT; Onose, G; Popescu, M; Strambu, V; Sandu, AM

2009-01-01

The aim of this study is the evaluation of laparoscopic treatment in abdominal complications following ventriculoperitoneal (VP) shunt. Methods: We report a retrospective study including 17 patients with abdominal complications secondary to VP shunt for hydrocephalus, laparoscopically treated in our department, between 2000 and 2007. Results: Patients' age ranged from 1 to 72 years old (mean age 25.8 years old). Male: female ratio was 1.4. Abdominal complications encountered were: shunt disconnection with intraperitoneal distal catheter migration 47.05% (8/17), infections 23.52% (4/17) such as abscesses and peritonitis, pseudocysts 11.76% (2/17), CSF ascites 5.88% (1/17), inguinal hernia 5.88% (1/17), and shunt malfunction due to excessive length of intraperitoneal tube 5.88% (1/17). Free–disease interval varies from 1 day to 21 years, depending on the type of complication, short in peritoneal irritation syndrome and abscesses (days) and long in ascites, pseudocysts(months– years). Laparoscopic treatment was: extraction of the foreign body in shunt disconnection with intraperitoneal distal catheter migration, evacuation, debridement, lavage and drainage for pseudocysts, abscess and peritonitis, shortening of the tube in shunt malfunction due to excessive length of intraperitoneal tube a nd hernioraphy. One diagnostic laparoscopy was performed in a peritoneal irritation syndrome, which found only CSF ascites. There were no conversions to open surgery. The overall mortality was of 5.88% and postoperative morbidity was of 11.76%. In 7 patients operated for abscesses, peritonitis, pseudocysts, and CSF ascites the shunting system was converted in to a ventriculocardiac shunt. Conclusions: Abdominal complication following VP shunt can be successfully performed laparoscopically. Abdominal surgery required, in selected cases, the repositioning of the distal catheter, frequently as a ventriculocardiac shunt. There are abdominal complications with no indication of surgery, like peritoneal irritation syndrome and CSF ascites. Free– disease interval varies from days (peritoneal irritation syndrome, abscesses) to month–years (pseudocyst, ascites), according to type of complication. PMID:20108757

Management of abortion complications at a rural hospital in Uganda: a quality assessment by a partially completed criterion-based audit.

PubMed

Mellerup, Natja; Sørensen, Bjarke L; Kuriigamba, Gideon K; Rudnicki, Martin

2015-09-20

Complications of unsafe abortion are a major contributor to maternal deaths in developing countries. This study aimed to evaluate the clinical assessment for life-threatening complications and the following management in women admitted with complications from abortions at a rural hospital in Uganda. A partially completed criterion-based audit was conducted comparing actual to optimal care. The audit criteria cover initial clinical assessment of vital signs and management of common severe complications such as sepsis and haemorrhage. Sepsis shall be managed by immediate evacuation of the uterus and antibiotics in relation to and after surgical management. Shock by aggressive rehydration followed by evacuation. In total 238 women admitted between January 2007 and April 2012 were included. Complications were categorized as incomplete, threatened, inevitable, missed or septic abortion and by trimester. Actual management was compared to the audit criteria and presented by descriptive statistics. Fifty six per cent of the women were in second trimester. Abortion complications were distributed as follows: 53 % incomplete abortions, 28 % threatened abortions, 12 % inevitable abortions, 4 % missed abortions and 3 % septic abortions. Only one of 238 cases met all criteria of optimal clinical assessment and management. Thus, vital signs were measured in 3 %, antibiotic criteria was met in 59 % of the cases, intravenous fluid resuscitation was administered to 35 % of women with hypotension and pain was managed in 87 % of the cases. Sharp curettage was used in 69 % of those surgically evacuated and manual vacuum aspiration in 14 %. In total 3 % of the abortions were categorized as unsafe. Two of eight women with septic abortion had evacuation performed during admission-day, one woman died due to septic abortion and one from severe haemorrhage. Guidelines were not followed and suboptimal assessment or management was observed in all but one case. This was especially due to missing documentation of vital signs necessary to diagnose life-threatening complications, poor fluid resuscitation at signs of shock, and delayed evacuation of septic abortion.

Aortic homograft endocarditis caused by Cardiobacterium hominis and complicated by agranulocytosis due to ceftriaxone

PubMed Central

Braun, Dominique; Horovitz, Arthur; Bertea, Mihai; Jenni, Rolf; Günthard, Huldrych F

2010-01-01

The present report describes a very rare case of an aortic homograft valve endocarditis caused by Cardiobacterium hominis. The case was complicated by an agranulocytosis after 3 weeks of antibiotic treatment induced by ceftriaxone. Alternative oral treatment with ciprofloxacin and rifampicin was successful, no surgical intervention was needed and homograft function could be preserved. PMID:22797477

Sudden asphyxial death complicating infectious mononucleosis.

PubMed

Boglioli, L R; Taff, M L

1998-06-01

Infectious mononucleosis (IM) is a disease traditionally defined by a triad of clinical, laboratory, and serologic factors. It is typically a benign, self-limited disease of children and young adults. Upper airway obstruction is a rare but potentially fatal complication of IM resulting from massive tonsillar enlargement, pharyngeal edema, or both. We report a case of sudden death due to airway obstruction in IM.

[Preventing complications due to dilatation by intracervical application of a prostaglandin-gel (author's transl)].

PubMed

Kühnie, H; Grande, P; Kuhn, W

1977-08-01

Mechanical injuries by dilatating the cervix uteri for artificial abortion may lead to intra- and postoperative complications; of these cervical insufficiency during subsequent pregnancy is of main importance. In order to prevent this complication 160 patients in the 8th to 18th week of pregnancy, who were going to have a legal abortion, were treated with a gel consisting of 3--5 mg Prostaglandin F2alpha which was applicated in the cervix uteri. In more than 90% of these cases a mechanical dilatation was not necessary afterwards. Generally the cervix uteri was softened and dilatated to Hegar 12. 32% of the patients had a spontaneous abortion. Therefore only a curettage without a dilatation had to be performed. Complications due to the application of the gel did not occur. The combined application of the gel with the extraamnial instillation of Prostaglandin for artificial abortion during the second trimenon reduced by half the period of indwelling of the intrauterine foley-catheter and therewith the risk of infection as well as the period of labour pains. Further possible ways of applicating the Prostaglandin gel in gynecology and obstetrics concern missed abortion, intrauterine death, and cervical dystocia during delivery.

[A case of pulmonary embolism and a case of ileus as complications after laparoscopic radical prostatectomy].

PubMed

Fujita, Akiko; Yamazaki, Yasuo; Yamashita, Tomomitsu; Ibuki, Takae; Hosokawa, Toyoshi; Tanaka, Yoshifumi

2003-01-01

In recent years, the use of laparoscopic techniques for surgical operations has been increasing, because this procedure is less invasive and is excellent in regard to patient's quality of life. Normally, complications are rare in laparoscopic surgery. However, we experienced a case of pulmonary embolism and one case of ileus as complications after laparoscopic radical prostatectomy. Especially, in this type of operation, the danger of complications is increased due to the severe head down and lithotomy position, which is employed to ensure a good view during operation. In this particular case, the long duration of operation may have been another related risk factor. There were no risk factors for pulmonary embolism such as those encountered when a patient is aged, obese, or bed ridden for a long time. However, an intermittent air massage must be applied to the lower legs to prevent thrombus due to poor blood circulation of the lower extremities below the knee during the surgery. It is also necessary to change the posture of the patient frequently after the operation. In addition, the administration of low molecular weight heparin may also be effective.

High complication rate in reconstruction of Paprosky type IIIa acetabular defects using an oblong implant with modular side plates and a hook.

PubMed

Babis, G C; Sakellariou, V I; Chatziantoniou, A N; Soucacos, P N; Megas, P

2011-12-01

We report the results of 62 hips in 62 patients (17 males, 45 females) with mean age of 62.4 years (37 to 81), who underwent revision of the acetabular component of a total hip replacement due to aseptic loosening between May 2003 and November 2007. All hips had a Paprosky type IIIa acetabular defect. Acetabular revision was undertaken using a Procotyl E cementless oblong implant with modular side plates and a hook combined with impaction allografting. At a mean follow-up of 60.5 months (36 to 94) with no patients lost to follow-up and one died due to unrelated illness, the complication rate was 38.7%. Complications included aseptic loosening (19 hips), deep infection (3 hips), broken hook and side plate (one hip) and a femoral nerve palsy (one hip). Further revision of the acetabular component was required in 18 hips (29.0%) and a further four hips (6.4%) are currently loose and awaiting revision. We observed unacceptably high rates of complication and failure in our group of patients and cannot recommend this implant or technique.

Gastric Ulcer Hemorrhage - a Potential Life-Threatening Complication of Intragastric Balloon Treatment of Obesity.

PubMed

Mojkowska, Aleksandra; Gazdzinski, Stefan; Fraczek, Mariusz; Wyleżoł, Mariusz

2017-01-01

Some morbidly obese patients do not qualify for bariatric surgery due to general health contraindications. Intragastric balloon treatment might be a therapeutic option in the above-mentioned cases. It can prime super-obese patients with end-stage disease for bariatric surgery. As a neoadjuvant therapy before surgery, it leads to a downstage of the disease by preliminary weight reduction, to an improvement in general health and, in summary, to a reduction of the perioperative risk. It is generally considered to be a safe method. However, due to the wide range of possible complications and unusual symptoms after intragastric balloon treatment, an interdisciplinary, instead of only a surgical or endoscopic, treatment and follow-up might be recommended in these patients. We here describe a potential life-threatening complication in the form of gastric bleeding as a consequence of intragastric balloon treatment and simultaneous aspirin taking and Helicobacter pylori infection. There have been reports of some complications of intragastric balloon treatment. However, to the best of our knowledge there were no reports concerning life-threatening hemorrhage from gastric ulcer. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Periorbital and Mediastinal Emphysema after Upper Gastrointestinal Endoscopy: Case Report of a Rare Complication.

PubMed

Lekha, Thankappan; Venkatakrishnan, Leelakrishnan; Divya, Karuppannasamy; Lavanya, Perumal

2017-01-01

To report a rare case of periorbital emphysema concurrent with cervicofacial and mediastinal emphysema in an elderly woman who underwent upper gastrointestinal endoscopy for chronic liver disease. An elderly woman with decompensated chronic liver disease presented with features of periorbital, facial, and mediastinal emphysema, characterized with crepitant swelling over the right periorbital area, face, neck, and mediastinum after undergoing upper gastrointestinal endoscopy. There was no history of trauma or Valsalva maneuver. Ocular findings were stable with no evidence of orbital compartmental syndrome. Urgent computed tomography scans of the orbit and chest were performed, and emergency systemic treatment with nasogastric decompression and antibiotics was initiated. However, she suddenly collapsed and succumbed despite all resuscitative efforts. Our case demonstrates that periorbital emphysema can occur following procedures such as upper gastrointestinal endoscopy, in the eyes without history of local trauma. This complication should be suspected especially if there is associated cervicofacial and mediastinal emphysema. Subcutaneous emphysema is usually self-resolving; however, extension of air into deeper planes can cause dangerous complications such as blindness due to orbital emphysema or mortality due to mediastinal emphysema. Hence, prompt diagnosis and urgent intervention are crucial to avoid vision and life threatening complications.

"iSS-Hyb-mRMR": Identification of splicing sites using hybrid space of pseudo trinucleotide and pseudo tetranucleotide composition.

PubMed

Iqbal, Muhammad; Hayat, Maqsood

2016-05-01

Gene splicing is a vital source of protein diversity. Perfectly eradication of introns and joining exons is the prominent task in eukaryotic gene expression, as exons are usually interrupted by introns. Identification of splicing sites through experimental techniques is complicated and time-consuming task. With the avalanche of genome sequences generated in the post genomic age, it remains a complicated and challenging task to develop an automatic, robust and reliable computational method for fast and effective identification of splicing sites. In this study, a hybrid model "iSS-Hyb-mRMR" is proposed for quickly and accurately identification of splicing sites. Two sample representation methods namely; pseudo trinucleotide composition (PseTNC) and pseudo tetranucleotide composition (PseTetraNC) were used to extract numerical descriptors from DNA sequences. Hybrid model was developed by concatenating PseTNC and PseTetraNC. In order to select high discriminative features, minimum redundancy maximum relevance algorithm was applied on the hybrid feature space. The performance of these feature representation methods was tested using various classification algorithms including K-nearest neighbor, probabilistic neural network, general regression neural network, and fitting network. Jackknife test was used for evaluation of its performance on two benchmark datasets S1 and S2, respectively. The predictor, proposed in the current study achieved an accuracy of 93.26%, sensitivity of 88.77%, and specificity of 97.78% for S1, and the accuracy of 94.12%, sensitivity of 87.14%, and specificity of 98.64% for S2, respectively. It is observed, that the performance of proposed model is higher than the existing methods in the literature so for; and will be fruitful in the mechanism of RNA splicing, and other research academia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Quercetin prevents chronic unpredictable stress induced behavioral dysfunction in mice by alleviating hippocampal oxidative and inflammatory stress.

PubMed

Mehta, Vineet; Parashar, Arun; Udayabanu, Malairaman

2017-03-15

It is now evident that chronic stress is associated with anxiety, depression and cognitive dysfunction and very few studies have focused on identifying possible methods to prevent these stress-induced disorders. Previously, we identified abundance of quercetin in Urtica dioica extract, which efficiently attenuated stress related complications. Therefore, current study was designed to investigate the effect of quercetin on chronic unpredicted stress (CUS) induced behavioral dysfunction, oxidative stress and neuroinflammation in the mouse hippocampus. Animals were subjected to unpredicted stress for 21days, during which 30mg/kg quercetin was orally administered to them. Effect of CUS and quercetin treatment on animal behavior was assessed between day 22-26. Afterward, the hippocampus was processed to evaluate neuronal damage, oxidative and inflammatory stress. Results revealed that stressed animals were highly anxious (Elevated Plus Maze and Open Field), showed depressive-like behavior (sucrose preference task), performed poorly in short-term and long-term associative memory task (passive avoidance step-through task) and displayed reduced locomotion (open field). Quercetin alleviated behavioral dysfunction in chronically stressed animals. Compared to CUS, quercetin treatment significantly reduced anxiety, attenuated depression, improved cognitive dysfunction and normalized locomotor activity. Further, CUS elevated the levels of oxidative stress markers (TBARS, nitric oxide), lowered antioxidants (total thiol, catalase), enhanced expression of pro-inflammatory cytokines (IL-6, TNF-α, IL-1β and COX-2) in the hippocampus and damaged hippocampal neurons. Quercetin treatment significantly lowered oxidative and inflammatory stress and prevented neural damage. In conclusion, quercetin can efficiently prevent stress induced neurological complications by rescuing brain from oxidative and inflammatory stress. Copyright © 2017 Elsevier Inc. All rights reserved.

The use of a displacement device negatively affects the performance of dogs (Canis familiaris) in visible object displacement tasks

PubMed Central

Müller, Corsin A.; Riemer, Stefanie; Range, Friederike; Huber, Ludwig

2014-01-01

Visible and invisible displacement tasks have been used widely for comparative studies of animals’ understanding of object permanence, with evidence accumulating that some species can solve invisible displacement tasks and thus reach Piagetian stage 6 of object permanence. In contrast, dogs appear to rely on associative cues, such as the location of the displacement device, during invisible displacement tasks. It remains unclear, however, whether dogs, and other species that failed in invisible displacement tasks, do so due to their inability to form a mental representation of the target object, or simply due to the involvement of a more salient but potentially misleading associative cue, the displacement device. Here we show that the use of a displacement device impairs the performance of dogs also in visible displacement tasks: their search accuracy was significantly lower when a visible displacement was performed with a displacement device, and only two of initially 42 dogs passed the sham-baiting control conditions. The negative influence of the displacement device in visible displacement tasks may be explained by strong associative cues overriding explicit information about the target object’s location, reminiscent of an overshadowing effect, and/or object individuation errors as the target object is placed within the displacement device and moves along a spatiotemporally identical trajectory. Our data suggest that a comprehensive appraisal of a species’ performance in object permanence tasks should include visible displacement tasks with the same displacement device used in invisible displacements, which typically has not been done in the past. PMID:24611641

Shoulder Arthroplasty for Humeral Head Avascular Necrosis Is Associated With Increased Postoperative Complications.

PubMed

Burrus, M Tyrrell; Cancienne, Jourdan M; Boatright, Jeffrey D; Yang, Scott; Brockmeier, Stephen F; Werner, Brian C

2018-02-01

Humeral head avascular necrosis (AVN) of differing etiologies may lead to shoulder arthroplasty due to subchondral bone collapse and deformity of the articular surface. There have been no large studies evaluating the complications for these patients after they undergo total shoulder arthroplasty (TSA). The first objective of this study is to evaluate the complication rate after TSA in patients with humeral head AVN. The secondary objective is to compare the complication rates among the different etiologies of the AVN. Patients who underwent TSA were identified in the PearlDiver database using ICD-9 codes. Patients who underwent shoulder arthroplasty for humeral head AVN were identified using ICD-9 codes and were subclassified according to AVN etiology (posttraumatic, alcohol use, chronic steroid use, and idiopathic). Complications evaluated included postoperative infection within 6 months, dislocation within 1 year, revision shoulder arthroplasty up to 8 years postoperatively, shoulder stiffness within 1 year, and periprosthetic fracture within 1 year and systemic complications within 3 months. Postoperative complication rates were compared to controls. The study cohorts included 4129 TSA patients with AVN with 141,778 control TSA patients. Patients with posttraumatic AVN were significantly more likely to have a postoperative infection (OR 2.47, P  < 0.001), dislocation (OR 1.45, P  = 0.029), revision surgery (OR 1.53, P  = 0.001), stiffness (OR 1.24, P  = 0.042), and systemic complication (OR 1.49, P  < 0.001). Steroid-associated AVN was associated with a significantly increased risk for a postoperative infection (OR 1.72, P  = 0.004), revision surgery (OR 1.33, P  = 0.040), fracture (OR 2.76, P  = 0.002), and systemic complication (OR 1.59, P  < 0.001). Idiopathic and alcohol-associated AVN were not significantly associated with any of the postoperative evaluated complications. TSA in patients with humeral head AVN is associated with significantly increased rates of numerous postoperative complications compared to patients without a diagnosis of AVN, including infection, dislocation, revision arthroplasty, stiffness, periprosthetic fracture, and medical complications. Specifically, AVN due to steroid use or from a posttraumatic cause appears to be associated with the statistically highest rates of postoperative TSA complications. Given these findings, orthopedic surgeons should be increasingly aware of this association, which should influence the shared decision-making process of undergoing TSA in patients with humeral head AVN.

Observing of tree trunks and other cylindrical objects using GPR

NASA Astrophysics Data System (ADS)

Jezova, Jana; Lambot, Sebastien

2016-04-01

Trees are a part of our everyday life, hence it is important to prevent their collapse to protect people and urban infrastructures. It is also important to characterize tree wood properties for usages in construction. In order to investigate internal parts of tree trunks non-invasively, ground-penetrating radar (GPR), or in this case, ultra-wideband microwave radar as a general tool, appears to be a very promising technology. Nevertheless, tree trunk tomography using microwave radar is a complicated task due to the circular shape of the trunk and the very complex (heterogeneous and anisotropic) internal structures of the trunk. Microwave sensing of tree trunks is also complicated due to the electromagnetic properties of living wood, which strongly depend on water content, density and temperature of wood. The objective of this study is to describe tree trunk radar cross sections including specific features originating from the particular circumferential data acquisition geometry. In that respect, three experiments were performed: (1) numerical simulations using a finite-difference time-domain software, namely, gprMax 2D, (2) measurements on a simplified laboratory trunk model including plastic and cardboard pipes, sand and air, and (3) measurements over a real tree trunk. The analysis was further deepened by considering: (1) common zero-offset reflection imaging, (2) imaging with a planar perfect electrical conductor (PEC) at the opposite side of the trunk, and (3) imaging with a PEC arc at the opposite side of the trunk. Furthermore, the shape of the reflection curve of a cylindrical target was analytically derived based on the straight-ray propagation approximation. Subsequently, the total internal reflection (TIR) phenomenon occurring in cylindrical objects was observed and analytically described. Both the straight-ray reflection curve and TIR were well observed on the simulated and laboratory radar data. A comparison between all experiments and radar configurations is presented. Future research will focus on the design of an adapted radar antenna for that application to optimize living tree trunk tomography. This research is funded by the Fonds de la Recherche Scientifique (FNRS, Belgium) and benefits from networking activities carried out within the EU COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar".

Nutritional Care of Gastric Cancer Patients with Clinical Outcomes and Complications: A Review.

PubMed

Choi, Wook Jin; Kim, Jeongseon

2016-04-01

The incidence and mortality of gastric cancer have been steadily decreased over the past few decades. However, gastric cancer is still one of the leading causes of cancer deaths across many regions of the world, particularly in Asian countries. In previous studies, nutrition has been considered one of significant risk factors in gastric cancer patients. Especially, malnourished patients are at greater risk of adverse clinical outcomes (e.g., longer hospital stay) and higher incidence of complications (e.g., wound/infectious complications) compared to well-nourished patients. Malnutrition is commonly found in advanced gastric cancer patients due to poor absorption of essential nutrients after surgery. Therefore, nutritional support protocols, such as early oral and enternal feeding, have been proposed in many studies, to improve unfavorable clinical outcomes and to reduce complications due to delayed application of oral nutritional support or parental feeding. Also, the supplied with enternal immune-enriched diet had more benefits in improving clinical outcomes and fewer complications compared to a group supplied with control formula. Using nutritional screening tools, such as nutritional risk index (NRI) and nutritional risk screening (NRS 2002), malnourished patients showed higher incidence of complications and lower survival rates than non-malnourished patients. However, a long-term nutritional intervention, such as nutritional counseling, was not effective in the patients. Therefore, early assessment of nutritional status in patients using a proper nutritional screening tool is suggested to prevent malnutrition and adverse health outcomes. Further studies with numerous ethnic groups may provide stronger scientific evidences in association between nutritional care and recovery from surgery in patients with gastric cancer.

Ocular complications and loss of vision due to herpes zoster ophthalmicus in patients with HIV infection and a comparison with HIV-negative patients.

PubMed

Nithyanandam, S; Joseph, M; Stephen, J

2013-02-01

The aim of the work is to describe the occurrence of ocular complications and loss of vision due to herpes zoster ophthalmicus (HZO) in HIV-positive patients who received early antiviral therapy for HZO.This is a post hoc analysis of prospectively collected data.Twenty-four HIV-positive patients with HZO were included in this report; male to female ratio was 3.8:1; mean age was 33.5 (±14.9) years. The visual outcome was good, with 14/24 patients having 6/6 vision; severe vision loss (≤6/60) occurred in only 2/24. There was no statistical difference in the visual outcome between the HIV-positive and -negative patients (P = 0.69), although severe vision loss was more likely in HIV-infected patients. The ocular complications of HZO in HIV-infected patients were: reduced corneal sensation (17/24), corneal epithelial lesions (14/24), uveitis (12/24), elevated intraocular pressure (10/24) and extra-ocular muscle palsy (3/24). The severity of rash was similar in the two groups but multidermatomal rash occurred only in HIV-infected patients (4/24). There was no difference in the occurrence of ocular complications of HZO between HIV-positive and HIV-negative patients. HZO associated ocular complications and visual loss is low in HIV-infected patients if treated with HZO antiviral therapy and was comparable with HIV-negative patients. Early institution of HZO antiviral therapy is recommended to reduce ocular complication and vision loss.

What drives the 'August effect'? A observational study of the effect of junior doctor changeover on out of hours work.

PubMed

Blakey, John D; Fearn, Andrew; Shaw, Dominick E

2013-01-01

To investigate whether measurements of junior doctor on-call workload and performance can clarify the mechanisms underlying the increase in morbidity and mortality seen after junior doctor changeover: the 'August effect'. Quantitative retrospective observational study of routinely collected data on junior doctor workload. Two large teaching hospitals in England. Task level data from a wireless out of hours system (n = 29,885 requests) used by medical staff, nurses, and allied health professionals. Number and type of tasks requested by nurses, time to completion of tasks by junior doctors. There was no overall change in the number of tasks requested by nurses out of hours around the August changeover (median requests per hour 15 before and 14 after, p = 0.46). However, the number of tasks classified as urgent was greater (p = 0.016) equating to five more urgent tasks per day. After changeover, doctors took less time to complete tasks overall due to a reduction in time taken for routine tasks (median 74 vs. 66 min; p = 3.9 × 10(-9)). This study suggests that the 'August effect' is not due to new junior doctors completing tasks more slowly or having a greater workload. Further studies are required to investigate the causes of the increased number of urgent tasks seen, but likely factors are errors, omissions, and poor prioritization. Thus, improved training and quality control has the potential to address this increased duration of unresolved patient risk. The study also highlights the potential of newer technologies to facilitate quantitative study of clinical activity.

Human Research Program Space Human Factors Engineering (SHFE) Standing Review Panel (SRP)

NASA Technical Reports Server (NTRS)

Wichansky, Anna; Badler, Norman; Butler, Keith; Cummings, Mary; DeLucia, Patricia; Endsley, Mica; Scholtz, Jean

2009-01-01

The Space Human Factors Engineering (SHFE) Standing Review Panel (SRP) evaluated 22 gaps and 39 tasks in the three risk areas assigned to the SHFE Project. The area where tasks were best designed to close the gaps and the fewest gaps were left out was the Risk of Reduced Safety and Efficiency dire to Inadequate Design of Vehicle, Environment, Tools or Equipment. The areas where there were more issues with gaps and tasks, including poor or inadequate fit of tasks to gaps and missing gaps, were Risk of Errors due to Poor Task Design and Risk of Error due to Inadequate Information. One risk, the Risk of Errors due to Inappropriate Levels of Trust in Automation, should be added. If astronauts trust automation too much in areas where it should not be trusted, but rather tempered with human judgment and decision making, they will incur errors. Conversely, if they do not trust automation when it should be trusted, as in cases where it can sense aspects of the environment such as radiation levels or distances in space, they will also incur errors. This will be a larger risk when astronauts are less able to rely on human mission control experts and are out of touch, far away, and on their own. The SRP also identified 11 new gaps and five new tasks. Although the SRP had an extremely large quantity of reading material prior to and during the meeting, we still did not feel we had an overview of the activities and tasks the astronauts would be performing in exploration missions. Without a detailed task analysis and taxonomy of activities the humans would be engaged in, we felt it was impossible to know whether the gaps and tasks were really sufficient to insure human safety, performance, and comfort in the exploration missions. The SRP had difficulty evaluating many of the gaps and tasks that were not as quantitative as those related to concrete physical danger such as excessive noise and vibration. Often the research tasks for cognitive risks that accompany poor task or information design addressed only part, but not all, of the gaps they were programmed to fill. In fact the tasks outlined will not close the gap but only scratch the surface in many cases. In other cases, the gap was written too broadly, and really should be restated in a more constrained way that can be addressed by a well-organized and complementary set of tasks. In many cases, the research results should be turned into guidelines for design. However, it was not clear whether the researchers or another group would construct and deliver these guidelines.

Complication Risk Factors in Anterior Choroidal Artery Aneurysm Treatment.

PubMed

André, Arthur; Boch, Anne-Laure; Di Maria, Federico; Nouet, Aurélien; Sourour, Nader; Clémenceau, Stéphane; Gabrieli, Joseph; Degos, Vincent; Zeghal, Chiheb; Chiras, Jacques; Cornu, Philippe; Clarençon, Frédéric

2017-03-20

The anterior choroidal artery (AChoA) is a rare location for intracranial aneurysms. The treatment of these aneurysms may be challenging due to the risk of occlusion of such a small and eloquent artery as the AChoA. We aimed to evaluate the risk factors for complications in AChoA aneurysm treatment. We retrospectively analyzed 47 consecutive AChoA aneurysms in 40 patients treated in our institution from 1999 and 2014 by endovascular means (87%) or surgical clipping (13%). Minor (transient or minor neurological deficits) and major complications (severe permanent neurological deficits or death) were systematically recorded. The influence of patient age, sex, aneurysm size, neck size, shape, dome-to-neck ratio and treatment technique on the occurrence of procedure-related complications was evaluated. Of the patients 11 experienced procedure-related complications (5 major, 6 minor). Aneurysms with multilobed shape were significantly associated with a higher procedure-related complication rate. There was a tendency for higher major procedure-related complication rate in small volume aneurysms. We did not find any association between the other factors analyzed and occurrence of procedure-related complications. Treatment of AChoA aneurysms has an acceptable complication risk. We did not find any significant differences between surgical and endovascular treatment in terms of procedure-related complication rates. Multilobed aneurysms were significantly associated with a higher procedure-related complication rate.

Models of Lung Transplant Research: a consensus statement from the National Heart, Lung, and Blood Institute workshop

PubMed Central

Lama, Vibha N.; Belperio, John A.; Christie, Jason D.; El-Chemaly, Souheil; Fishbein, Michael C.; Gelman, Andrew E.; Hancock, Wayne W.; Keshavjee, Shaf; Kreisel, Daniel; Looney, Mark R.; McDyer, John F.; Shilling, Rebecca A.; Panoskaltsis-Mortari, Angela; Wilkes, David S.; Eu, Jerry P.; Nicolls, Mark R.

2017-01-01

Lung transplantation, a cure for a number of end-stage lung diseases, continues to have the worst long-term outcomes when compared with other solid organ transplants. Preclinical modeling of the most common and serious lung transplantation complications are essential to better understand and mitigate the pathophysiological processes that lead to these complications. Various animal and in vitro models of lung transplant complications now exist and each of these models has unique strengths. However, significant issues, such as the required technical expertise as well as the robustness and clinical usefulness of these models, remain to be overcome or clarified. The National Heart, Lung, and Blood Institute (NHLBI) convened a workshop in March 2016 to review the state of preclinical science addressing the three most important complications of lung transplantation: primary graft dysfunction (PGD), acute rejection (AR), and chronic lung allograft dysfunction (CLAD). In addition, the participants of the workshop were tasked to make consensus recommendations on the best use of these complimentary models to close our knowledge gaps in PGD, AR, and CLAD. Their reviews and recommendations are summarized in this report. Furthermore, the participants outlined opportunities to collaborate and directions to accelerate research using these preclinical models. PMID:28469087

Inguinal hernia repair: toward Asian guidelines.

PubMed

Lomanto, Davide; Cheah, Wei-Keat; Faylona, Jose Macario; Huang, Ching Shui; Lohsiriwat, Darin; Maleachi, Andy; Yang, George Pei Cheung; Li, Michael Ka-Wai; Tumtavitikul, Sathien; Sharma, Anil; Hartung, Rolf Ulrich; Choi, Young Bai; Sutedja, Barlian

2015-02-01

Groin hernias are very common, and surgical treatment is usually recommended. In fact, hernia repair is the most common surgical procedure performed worldwide. In countries such as the USA, China, and India, there may easily be over 1 million repairs every year. The need for this surgery has become an important socioeconomic problem and may affect health-care providers, especially in aging societies. Surgical repair using mesh is recommended and widely employed in Western countries, but in many developing countries, tissue-to-tissue repair is still the preferred surgical procedure due to economic constraints. For these reason, the development and implementation of guidelines, consensus, or recommendations may aim to clarify issues related to best practices in inguinal hernia repair in Asia. A group of Asian experts in hernia repair gathered together to debate inguinal hernia treatments in Asia in an attempt to reach some consensus or develop recommendations on best practices in the region. The need for recommendations or guidelines was unanimously confirmed to help overcome the discrepancy in clinical practice between countries; the experts decided to focus mainly on the technical aspects of open repair, which is the most common surgery for hernia in our region. After the identification of 12 main topics for discussion (indication, age, and sex; symptomatic and asymptomatic hernia: type of hernia; type of treatment; hospital admission; preoperative care; anesthesia; surgical technique; perioperative care; postoperative care; early complications; and long-term complications), a search of the literature was carried out according to the five levels of the Oxford Classification of Evidence and the four grades of recommendation. © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

Intubations and airway management: An overview of Hassles through third millennium

PubMed Central

Alanazi, Abdullah

2015-01-01

Background: The placement of a tube into a patient's trachea “the intubation” as we call is not as simple as it looks. It is a very tricky and tedious maneuver that entails skills to assess and perform. Nevertheless, often this is left to the chores of inefficient hands due to a paucity of the availability of experts. They seldom are able to complete the task and often wind up calling the attention of the unit. The present review is an attempt to describe the need to undertake intubation, the procedures and techniques, the complications, including morbidity and mortality and airway management. This overview includes explicit descriptions of the difficult airway which represents multifaceted interface amid patient factors, clinical setting, and skills of the practitioner. Materials and Methods: To accomplish the target, peer-reviewed English language articles published during third millennium up to 2013 were selected from Pub Med, Pub Med Central, Science Direct, Up-to-date, Med Line, comprehensive databases, Cochrane library, and the Internet (Google, Yahoo). Review of Literature: The review constituted a systematic search of literature on the requirements that necessitate the practice of intubation, different techniques that facilitate easy conduct of procedure, the complications, including, morbidity and mortality, and the airway management. Conclusion: Recording every single detail has been beyond the scope of this review, however; some aspects have been wrapped up in nutshell. Some areas of the review are too basic which the medics are well aware of and knowledgeable. Nevertheless, these are difficult to be dispensed with in consideration of their source to the awareness of a common man and a great majority of the patients. PMID:25949040

Topical liposomal Rose Bengal for photodynamic white hair removal: randomized, controlled, double-blind study.

PubMed

Samy, Nevien; Fadel, Maha

2014-04-01

Blond and white hair removal by laser is a complicated task with weak satisfactory results due to the deficiency in laser-absorbing chromophore. To investigate if repetitive sessions of photodynamic therapy (PDT) using external application of liposomal Rose bengal (RB) photosensitizer followed by intense pulsed light (IPL) exposure enables removal of gray and white hair. Rose bengal loaded in liposomes (LRB) was constructed, prepared in hydrogel, and was studied for some pharmaceutical properties. Penetration and selective hair follicle damage in mice skin were studied. Topical gel containing LRB was used for treating fifteen adult females who were complaining of facial white terminal hair. Unwanted facial hair was treated for three sessions at intervals of 4-6 weeks using intense pulsed light (IPL). At each session, the treatment area was pre-treated with topical LRB gel, while a control group of another 15 patients applied placebo gel before IPL treatment. Evaluations included hair regrowth, which was measured 4 weeks after each treatment session and at 6 months follow-up by counting the number of terminal hair compared with baseline pretreatment values. Treatment outcomes and complications if any were also reported. Average hair regrowth in the LRB group was 56% after 3 treatment cycles. After six-months follow up, average terminal hair count compared with baseline pretreatment showed 40% reduction and no recorded side effects. A significant difference (P<0.05) was seen compared with the control group; the clinical results were promising. Photodynamic hair removal using rose bengal-encapsulated liposomal gel in combination with IPL treatment showed significant efficacy in the treatment of white hair compared with a control group.

Cancer Diagnosis Epigenomics Scientific Workflow Scheduling in the Cloud Computing Environment Using an Improved PSO Algorithm

PubMed

N, Sadhasivam; R, Balamurugan; M, Pandi

2018-01-27

Objective: Epigenetic modifications involving DNA methylation and histone statud are responsible for the stable maintenance of cellular phenotypes. Abnormalities may be causally involved in cancer development and therefore could have diagnostic potential. The field of epigenomics refers to all epigenetic modifications implicated in control of gene expression, with a focus on better understanding of human biology in both normal and pathological states. Epigenomics scientific workflow is essentially a data processing pipeline to automate the execution of various genome sequencing operations or tasks. Cloud platform is a popular computing platform for deploying large scale epigenomics scientific workflow. Its dynamic environment provides various resources to scientific users on a pay-per-use billing model. Scheduling epigenomics scientific workflow tasks is a complicated problem in cloud platform. We here focused on application of an improved particle swam optimization (IPSO) algorithm for this purpose. Methods: The IPSO algorithm was applied to find suitable resources and allocate epigenomics tasks so that the total cost was minimized for detection of epigenetic abnormalities of potential application for cancer diagnosis. Result: The results showed that IPSO based task to resource mapping reduced total cost by 6.83 percent as compared to the traditional PSO algorithm. Conclusion: The results for various cancer diagnosis tasks showed that IPSO based task to resource mapping can achieve better costs when compared to PSO based mapping for epigenomics scientific application workflow. Creative Commons Attribution License

Task shifting for the delivery of pediatric antiretroviral treatment: a systematic review.

PubMed

Penazzato, Martina; Davies, Mary-Ann; Apollo, Tsitsi; Negussie, Eyerusalem; Ford, Nathan

2014-04-01

Pediatric antiretroviral treatment coverage in resource-limited settings continues to lag behind adults. Task shifting is an effective approach broadly used for adults, which some countries have also adopted for children, but implementation is limited by lack of confidence and skills among nonspecialist staff. A systematic review was conducted by combining key terms for task shifting, antiretroviral therapy (ART), and children. Five databases and two conferences were searched from inception till August 01, 2013. Eight observational studies provided outcome data for 11,828 children who received ART from nonphysician providers across 10 countries in sub-Saharan Africa. The cumulative pooled proportion of deaths was 3.2% [95% confidence interval (CI): 2.0 to 4.5] at 6 months, 4.6% (95% CI: 2.1 to 7.1) at 12 months, 6.2% (95% CI: 3.7 to 8.8) at 24 months, and 5.9% (95% CI: 3.5 to 8.3) at 36 months. Mortality and loss to follow-up in task-shifting programs were comparable to those reported by programs providing doctor- or specialist-led care. Our review suggests that task shifting of ART care can result in outcomes comparable to routine physician care, and this approach should be considered as part of a strategy to scale-up pediatric treatment. Specialist care will remain important for management of sick patients and complicated cases. Further qualitative research is needed to inform optimal implementation of task shifting for pediatric patients.

Using a contextualized sensemaking model for interaction design: A case study of tumor contouring.

PubMed

Aselmaa, Anet; van Herk, Marcel; Laprie, Anne; Nestle, Ursula; Götz, Irina; Wiedenmann, Nicole; Schimek-Jasch, Tanja; Picaud, Francois; Syrykh, Charlotte; Cagetti, Leonel V; Jolnerovski, Maria; Song, Yu; Goossens, Richard H M

2017-01-01

Sensemaking theories help designers understand the cognitive processes of a user when he/she performs a complicated task. This paper introduces a two-step approach of incorporating sensemaking support within the design of health information systems by: (1) modeling the sensemaking process of physicians while performing a task, and (2) identifying software interaction design requirements that support sensemaking based on this model. The two-step approach is presented based on a case study of the tumor contouring clinical task for radiotherapy planning. In the first step of the approach, a contextualized sensemaking model was developed to describe the sensemaking process based on the goal, the workflow and the context of the task. In the second step, based on a research software prototype, an experiment was conducted where three contouring tasks were performed by eight physicians respectively. Four types of navigation interactions and five types of interaction sequence patterns were identified by analyzing the gathered interaction log data from those twenty-four cases. Further in-depth study on each of the navigation interactions and interaction sequence patterns in relation to the contextualized sensemaking model revealed five main areas for design improvements to increase sensemaking support. Outcomes of the case study indicate that the proposed two-step approach was beneficial for gaining a deeper understanding of the sensemaking process during the task, as well as for identifying design requirements for better sensemaking support. Copyright © 2016. Published by Elsevier Inc.

[COMPLICATED URINARY TRACT INFECTIONS IN THE ELDERLY].

PubMed

Ćosić, I; Ćosić, V

2016-12-01

Urinary tract infections (UTI) are the most common bacterial infections involving lower (cystitis, prostatitis) or upper (pyelonephritis, renal abscess, perinephric abscess) urinary tract. Differentiation of complicated and uncomplicated UTI is usually based on the presence of structural or functional urinary tract abnormalities, which can increase the risk of treatment failure and development of serious complications. Factors that increase the risk are foreign bodies, stones, obstruction, neurogenic bladder, kidney transplantation, immunosuppression, and pregnancy. Complicated UTI includes a spectrum of conditions that increase the risk of treatment failure, as well as of serious complications such as bacteremia and sepsis, perinephric abscess, renal impairment and emphysematous pyelonephritis. To avoid the potentially devastating outcomes, appropriate diagnostic procedures, antibiotic and surgical treatment, and appropriate follow-up are required. The incidence of complicated UTI will grow in the future due to general aging of the population, increasing incidence of diabetes, and ever growing number of immunocompromised and immunosuppressed patients. It is of key importance to recognize complicated UTI on time, and treat it wisely and aggressively to reduce duration of the disease and the risk of antibiotic resistance.

Enhanced/Operator Machine Interface Phase I

DTIC Science & Technology

1997-12-22

investigation proposes an adaptive OMI technique using a cognitive task analysis (CTA) approach derived from research by several experts in the Cognitive...Science field. The research reveals that adaptive interfaces have not been widely implemented due to the difficulty of the cognitive task analysis . Moreover

[Influenza infection in intensive cardiac care unit patients].

PubMed

Ciuraszkiewicz, Katrzyna; Sielski, Janusz; Janion-Sadowska, Agnieszka; Stern, Agnieszka; Zychowicz, Joanna; Kaziród-Wolski, Karol; Paluchowski, Marian

2014-03-01

Infection with influenza type A virus may cause serious cardiovascular complications, such as myocarditis, heart failure, acute myocardial infarction. Also infection with influenza type AH1N1 may contribute to aggravation of cardiac disorders, i.e. acute coronary syndrome, heart failure, cardiogenic shock, severe ventricular arrythmias. One of the most fatal complication of influenza is pneumonia leading to acute respiratory insufficiency requiring artifitial ventilation. Symptoms of respiratory tract infections durnig influenza epidemy should always be treated with a high index of suspicion. Early diagnosis and adequate antiviral treatment may prevent those complications. A series of four cases of patients hospitalised in intensive cardiac care unit due to suspected cardiac dyspnea and finally diagnosed as a cardiac disease complicated by influenza pneumonia is presented.

[Plasmapheresis--possible complications and their prevention].

PubMed

Seczyńska, Bozena; Sega, Aurelia; Nowak, Ilona; Fajfer, Izabela; Królikowski, Wiesław; Szczeklik, Wojciech

2011-01-01

Plasmapheresis it is a therapeutic method based on extracorporeal plasma exchange. First attempts at treatment with plasmapheresis date back to the beginning of the 20th century. However, it was first brought to clinical practice only in the 1950s as a way of treating Waldenstrom macroglobulinemia and in last decades a dynamic improvement in this method has been observed. At the moment plasmapheresis is used in the treatment of over 150 diseases. Like every invasive method, it may cause complications, which are due to anticoagulation, the use of replacement fluids, the technical part of the procedure, and the presence of intravenous catheters. The knowledge of potential complications and the way of preventing them by the medical staff help to avoid complications and to decrease their harmful effects.

Quantifying the effect of complications on patient flow, costs and surgical throughputs.

PubMed

Almashrafi, Ahmed; Vanderbloemen, Laura

2016-10-21

Postoperative adverse events are known to increase length of stay and cost. However, research on how adverse events affect patient flow and operational performance has been relatively limited to date. Moreover, there is paucity of studies on the use of simulation in understanding the effect of complications on care processes and resources. In hospitals with scarcity of resources, postoperative complications can exert a substantial influence on hospital throughputs. This paper describes an evaluation method for assessing the effect of complications on patient flow within a cardiac surgical department. The method is illustrated by a case study where actual patient-level data are incorporated into a discrete event simulation (DES) model. The DES model uses patient data obtained from a large hospital in Oman to quantify the effect of complications on patient flow, costs and surgical throughputs. We evaluated the incremental increase in resources due to treatment of complications using Poisson regression. Several types of complications were examined such as cardiac complications, pulmonary complications, infection complications and neurological complications. 48 % of the patients in our dataset experienced one or more complications. The most common types of complications were ventricular arrhythmia (16 %) followed by new atrial arrhythmia (15.5 %) and prolonged ventilation longer than 24 h (12.5 %). The total number of additional days associated with infections was the highest, while cardiac complications have resulted in the lowest number of incremental days of hospital stay. Complications had a significant effect on perioperative operational performance such as surgery cancellations and waiting time. The effect was profound when complications occurred in the Cardiac Intensive Care (CICU) where a limited capacity was observed. The study provides evidence supporting the need to incorporate adverse events data in resource planning to improve hospital performance.

Database Design for Personnel Management in Republic of Korea Army.

DTIC Science & Technology

1984-06-01

model for performing personnel management in ROK Army. After being designed, the computer programs should be fully tested. The author’s recommendations...S. CONTRACT OR GRANT NUMERae)" Kwang Soo Baek II 9. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT. TASKAREA 6 WORK UN IT...of these requirements complicate the already difficult task of providing safe and effcient access to computerized data. The designer should select an

[Where internists work?].

PubMed

Ramiro-H, Manuel; Casares-Queralt, Salvador; Arévalo-Vargas, Angel; Juárez, Irina Elizabeth; Pons-Álvarez, Octavio Noel; Castañeda-Del Toro, Alejandro

2016-01-01

For health institutions, knowing the fate of human resources within their classrooms is an extremely complicated task. Within the Instituto Mexicano del Seguro Social, where most specialists are trained in our country, with a clear orientation towards the pursuit of excellence and satisfaction of their needs human resources for health in Mexico is provided, hence the need to identify the professional profile and career destination of its graduates, which will be useful in the training of human resources for health.

Proactive restoration: planning, implementation, and early results of silvicultural strategies for increasing resilience against gypsy moth infestation in upland oak forests on the Daniel Boone National Forest, Kentucky

Treesearch

Callie Schweitzer; Stacy L. Clark; Kurt W. Gottschalk; Jeff Stringer; Robbie Sitzlar

2014-01-01

Determining targets in forest restoration is a complicated task that can be facilitated by cooperative partnerships. Too often restoration plans are implemented after adverse events that cause widespread tree mortality, such as drought or insect outbreaks, have occurred. Reactive management precludes the use of preemptive management techniques that can result in more...

A Retrospective Analysis of Complication Rates in Mohs Micrographic Surgery Patients With Clinically Large Tumors and Tumors With Aggressive Subclinical Extension.

PubMed

Cowan, Natasha; Goldenberg, Alina; Basu, Pallavi; Eilers, Robert; Hau, Jennifer; I Brian Jiang, Shang

2018-05-01

Clinically large cutaneous tumors and those with aggressive subclinical extension (ASE) often require wider margins and increased operative time during Mohs micrographic surgery (MMS). Our goal is to improve dermatologic surgeons' counseling information on complication risks for aggressive tumors. To examine the incidence of postoperative complications in MMS patients, with a focus on differences between aggressive and non-aggressive tumors. We performed a retrospective cross-sectional chart review of 4151 MMS cases at the University of California, San Diego. A postoperative complication was defined as an adverse event directly related to MMS reported within 6 weeks of the procedure. Clinically, large tumors had 50 times the odds of postoperative complication as compared to all other tumors (P less than 0.001). ASE was not found to be significantly associated with higher rates of postoperative complications when controlled for other factors. Clinically, large tumors may be at higher risk for complications following MMS due to their increased size and need for repair with methods other than linear closures. Tumors with ASE were not found to be at higher risk for postoperative complications. J Drugs Dermatol. 2018;17(5):511-515.

The effects of task difficulty and resource requirements on attention strategies

NASA Technical Reports Server (NTRS)

King, Teresa

1991-01-01

The patterns of attention strategies for task difficulty/resource tasks for which experimental results are presented and analyzed support the hypothesis that subjects may adopt an alternating (rather than concurrent one) when compelled to do so by either the size or the complexity of a visual display. According to the multiple resource model, if subjects had been performing the two tasks concurrently, the cost of this strategy would have been shown by a decrement in the spatial format, rather than the verbal format, due to competition for the same resource. Subjects may apply different strategies as a function of task difficulty and/or resource demand.

Long-term mortality of patients with septic ocular or central nervous system complications from pyogenic liver abscess: a population-based study.

PubMed

Lin, Yi-Tsung; Liu, Chia-Jen; Chen, Tzeng-Ji; Fung, Chang-Phone

2012-01-01

Taiwan is endemic for pyogenic liver abscess (PLA). Septic ocular or central nervous system (CNS) complications derived from PLA can result in catastrophic disability. We investigated the epidemiology and long-term prognosis of PLA patients with septic ocular or CNS complications over an 8-year period. We extracted 21,307 patients with newly diagnosed PLA from a nationwide health registry in Taiwan between 2000 and 2007. The frequency of and risk factors for PLA with septic ocular or CNS complications were determined. The 2-year survival of these patients was compared between those with and without septic ocular or CNS complications. Septic ocular or CNS complications accounted for 2.1% of all PLA patients. Age and the Charlson comorbidity index were significantly lower in PLA patients with ocular or CNS complications than those without. Diabetes and age <65 years were independent predictors of septic ocular or CNS complications. The 2-year mortality of patients with septic ocular or CNS complications was similar to those without complications (24.8% vs. 27.5%, p = 0.502). However, among patients <65 years old and a Charlson index ≤ 1, the 2-year mortality was significantly higher in those with than without complications (18.6% vs. 11.8%, p = 0.001). Physicians should recognize that catastrophic disability due to ocular or neurological complications from PLA could lead to a poor long-term prognosis, and should follow-up these patients more closely.

Innovations in vital signs measurement for the detection of hypertension and shock in pregnancy.

PubMed

Vousden, Nicola; Nathan, Hannah L; Shennan, Andrew H

2018-06-22

Approximately 820 women die in pregnancy and childbirth every day worldwide, with 99% of these occurring in low-resource settings. The most common causes of maternal mortality are haemorrhage, sepsis and hypertensive disorders. There are established, effective solutions to these complications, however challenges remain in identifying who is at greatest risk and ensuring that interventions are delivered early when they have the greatest potential to benefit. Measuring vital signs is the first step in identifying women at risk. Overstretched or poorly trained staff and inadequate access to accurate, reliable equipment to measure vital signs can potentially result in delayed treatment initiation. Early warning systems may help alert users to identify patients at risk, especially where novel technologies can improve usability by automating calculations and alerting users to abnormalities. This may be of greatest benefit in under-resourced settings where task-sharing is common and early identification of complications can allow for prioritisation of life-saving interventions. This paper highlights the challenges of accurate vital sign measurement in pregnancy and identifies innovations which may improve detection of pregnancy complications.

[Pro: Epidural Analgesia Remains the Gold Standard for Abdominal and Thoracic Surgery].

PubMed

Listing, Hannah; Pöpping, Daniel

2018-04-01

Pain relief with epidural analgesia is superior compared to systemic opioid analgesia after major abdominal and thoracic surgery. It remains a safe procedure, as long as it is embedded in a concept covering the whole perioperative period. This includes the knowledge of the anesthesiologist how to operate the process of catheter insertion as well as to treat complications like the hypotension, associated with the application of epidural local anesthetics. A close postoperative monitoring by an acute pain service team is a responsible task and should be available 24/7. Despite the low incidence of complications, their consequences could be disastrous for patients. To avoid persisting neurological damage, standardized diagnostic procedures must be established and surgical intervention should be available within six hours if necessary. Non-analgetic benefits of epidural analgesia include reduced pulmonary complications like pneumonia and lower incidences for cardiac arrhythmia. Furthermore, perioperative mortality could be decreased by epidural analgesia. These effects should be considered as "add-on". The excellent pain relief is more than enough to recommend this method. Georg Thieme Verlag KG Stuttgart · New York.

[Minimally invasive surgery for treating of complicated fronto-ethmoidal sinusitis].

PubMed

Pomar Blanco, P; Martín Villares, C; San Román Carbajo, J; Fernández Pello, M; Tapia Risueño, M

2005-01-01

Functional endoscopic sinus surgery (FESS) is nowadays the "gold standard" for frontal sinus pathologies, but management of acute situations and the aproach and/or the extent of the surgery perfomed in the frontal recess remains controversial nowadays. We report our experience in 4 patients with orbital celulitis due to frontal sinusitis who underwent combined external surgery (mini-trephination) and endoscopic sinus surgery. All patients managed sinus patency without any complications. We found this combined sinusotomy as an easy, effective and reproductible technique in order to resolve the difficult surgical management of complicated frontal sinusitis.

Spontaneous Splenic Rupture in Vascular Ehlers-Danlos Syndrome.

PubMed

Batagini, Nayara Cioffi; Gornik, Heather; Kirksey, Lee

2015-01-01

Vascular Ehlers-Danlos Syndrome (VEDS) is a rare autosomal dominant collagen vascular disorder. Different from other Ehler-Danlos Syndrome subtypes, VEDS has poor prognosis due to severe fragility of connective tissues and association with life-threatening vascular and gastrointestinal complications. Spontaneous splenic rupture is a rare but hazardous complication related to this syndrome. To date, only 2 cases have been reported in the literature. Here we present another case of this uncommon complication, occurring in a 54-year-old woman in clinical follow-up for VEDS who presented with sudden onset of abdominal pain and hypotension. © The Author(s) 2015.

Hemorrhagic iliopsoas bursitis complicating well-functioning ceramic-on-ceramic total hip arthroplasty.

PubMed

Park, Kyung Soon; Diwanji, Sanket R; Kim, Hyung Keun; Song, Eun Kyoo; Yoon, Taek Rim

2009-08-01

Iliopsoas bursitis has been increasingly recognized as a complication of total hip arthroplasty and is usually associated with polyethylene wear. Here, the authors report a case of hemorrhagic iliopsoas bursitis complicating an otherwise well-functioning ceramic-on-ceramic arthroplasty performed by minimal invasive modified 2-incision technique. The bursitis in turn resulted in femoral nerve palsy and femoral vein compression. In this report, there was no evidence to support that the bursitis was due to an inflammatory response to ceramic wear particles or any other wear particles originating from the total hip arthroplasty.

[Pneumorachis and pneumopericardium after ecstasy use: an uncommon complication].

PubMed

Kubbenga, Iris E; Postma, Nynke; Ramakers, Bart P

2015-01-01

Over the past few years there has been an increase in the use of ecstasy among the Dutch population. A number of complications are associated with this drug, hyperthermia being the most well-known. A less commonly-occurring complication is pneumomediastinum. A 20-year-old man presented at the emergency department with extensive subcutaneous emphysema, pneumomediastinum, pneumopericardium and pneumorachis (air within the spinal canal), which had developed after visiting a festival. After excluding the most likely causes, it was concluded that it was due to a combination of ecstasy use and intensive activity (dancing). He was managed conservatively and after two days of observation in the ICU the patient fully recovered. This case illustrates a rare complication that seems - indirectly - related to using ecstasy. In most cases conservative treatment is adequate but the presence of pneumopericardium means that given the risk of cardiovascular complications, cardiopulmonary monitoring is essential to trace them.

Imaging acute complications in cancer patients: what should be evaluated in the emergency setting?

PubMed Central

2014-01-01

Increased incidence world-wide of cancer and increased survival has also resulted in physicians seeing more complications in patients with cancer. In many cases, complications are the first manifestations of the disease. They may be insidious and develop over a period of months, or acute and manifest within minutes to days. Imaging examinations play an essential role in evaluating cancer and its complications. Plain radiography and ultrasonography (US) are generally performed initially in an urgent situation due to their wide availability, low cost, and minimal or no radiation exposure. However, depending on a patient’s symptoms, evaluation with cross-sectional imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI) is often necessary. In this review article, we discuss some of the most important acute noninfectious oncological complications for which imaging methods play an essential role in diagnosis. PMID:25609051

[Peripheral Regional Anesthesia Without Any Complications - a Dream Comes True?!

PubMed

Wiesmann, Thomas; Döffert, Jens; Steinfeldt, Thorsten

2018-04-01

Peripheral regional anesthesia procedures, such as femoral nerve block, are relatively safe procedures in clinical anesthesia. Nevertheless, it may lead to typical, usually transient and rarely even persistent complications. This article aims to highlight key aspects of complications in peripheral regional anesthesia and, in particular, strategies to reduce risk. Moreover, beside general complications, which might potentially occur in any peripheral nerve blockade ("bleeding/infection/nerve damage"), accidental co-blockades of other nerval structures are discussed using the example of the brachial plexus. In addition to the presentation of the possible complications, this article discusses improvements in the techniques during the last two decades. Due to the use of ultrasound, some side effects nowadays are supposed to occur less likely. An outlook into the future will inform the reader about improved or more selective blockages. Georg Thieme Verlag KG Stuttgart · New York.

Cerebral venous thrombosis and secondary polycythemia in a case of nephrotic syndrome.

PubMed

Nagaraju, Shankar Prasad; Bairy, Manohar; Attur, Ravindra Prabhu; Sambhaji, Charudutt Jayant

2016-03-01

Cerebral venous thrombosis (CVT) and polycythemia are considered as rare and life threatening complications of nephrotic syndrome. We report an unusual combination of both these complications in a case of nephrotic syndrome due to minimal change disease that was treated successfully. There was prompt and complete remission of nephrotic syndrome with steroid therapy, concurrent with complete resolution of polycythemia and CVT.

Scoping a perforated bleeding peptic ulcer: learning points.

PubMed

Wani, Abdul Majid; Hussain, Waleed Mohd; AlMiamini, Wail; Khoujah, Amer M; Diari, Mohd S; Akhtar, Mubeena; Alharbi, Zeyad S

2011-03-24

Peptic ulcer perforation and haemorrhage is not unusual as a complication of peptic ulcer disease. In the older patientspresentation can be dramatic and atypical. The authors are presenting a case of duodenal ulcer perforation and haemorrhage which was misdiagnosed as a gastric malignancy and thus failure to have Helicobacter pylori eradication, recurrence with complication and hesitancy in surgical intervention due to initial label of malignancy.

Risk of complications in coeliac patients depends on age at diagnosis and type of clinical presentation.

PubMed

Biagi, Federico; Schiepatti, Annalisa; Maiorano, Gregorio; Fraternale, Giacomo; Agazzi, Simona; Zingone, Fabiana; Ciacci, Carolina; Volta, Umberto; Caio, Giacomo; Tortora, Raffaella; Klersy, Catherine; Corazza, Gino R

2018-06-01

Coeliac disease is characterised by an increased mortality mostly due to its complications. To study the risk of developing complications according to clinical presentation and age at diagnosis, a combined retrospective-prospective longitudinal study was performed in three Italian centres. Incidence of complications and mortality rates were calculated using type and age at diagnosis of coeliac disease, sex, and centre of diagnosis as predictors. Patients referred after being found to suffer from coeliac disease elsewhere were excluded. Between 01/1999 and 06/2015, 2225 adult coeliac patients were directly diagnosed in our centres. 17 of them developed a complication and 29 died. In patients older than 60 years at diagnosis of coeliac disease, the risk of complication is 18 times higher than in patients diagnosed at 18-40 years and 9 times higher than in patients diagnosed at 40-60 years. Classical presentation increases the risk of complications by 7 times compared to non-classical presentation; in asymptomatic patients the risk of complication is virtually absent. The risk of developing complications in coeliac patients is linked to age at diagnosis of coeliac disease and type of clinical presentation. Follow-up methods of coeliac patients should be tailored according to these parameters. Copyright © 2017. Published by Elsevier Ltd.

Complications associated with prone positioning in elective spinal surgery.

PubMed

DePasse, J Mason; Palumbo, Mark A; Haque, Maahir; Eberson, Craig P; Daniels, Alan H

2015-04-18

Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity. Although many of these complications remain uncommon, the range of possible morbidities is wide and includes multiple organ systems. Perioperative visual loss (POVL) is a well described, but uncommon complication that may occur due to ischemia to the optic nerve, retina, or cerebral cortex. Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery. Peripheral nerve injuries, such as those caused by prolonged traction to the brachial plexus, are more commonly encountered postoperative events. Myocutaneous complications including pressure ulcers and compartment syndrome may also occur after prone positioning, albeit rarely. Other uncommon positioning complications such as tongue swelling resulting in airway compromise, femoral artery ischemia, and avascular necrosis of the femoral head have also been reported. Many of these are well-understood and largely avoidable through thoughtful attention to detail. Other complications, such as POVL, remain incompletely understood and thus more difficult to predict or prevent. Here, the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity.

Complications associated with prone positioning in elective spinal surgery

PubMed Central

DePasse, J Mason; Palumbo, Mark A; Haque, Maahir; Eberson, Craig P; Daniels, Alan H

2015-01-01

Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity. Although many of these complications remain uncommon, the range of possible morbidities is wide and includes multiple organ systems. Perioperative visual loss (POVL) is a well described, but uncommon complication that may occur due to ischemia to the optic nerve, retina, or cerebral cortex. Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery. Peripheral nerve injuries, such as those caused by prolonged traction to the brachial plexus, are more commonly encountered postoperative events. Myocutaneous complications including pressure ulcers and compartment syndrome may also occur after prone positioning, albeit rarely. Other uncommon positioning complications such as tongue swelling resulting in airway compromise, femoral artery ischemia, and avascular necrosis of the femoral head have also been reported. Many of these are well-understood and largely avoidable through thoughtful attention to detail. Other complications, such as POVL, remain incompletely understood and thus more difficult to predict or prevent. Here, the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity. PMID:25893178

Tele-mentored damage-control and emergency trauma surgery: A feasibility study using live-tissue models.

PubMed

Dawe, Philip; Kirkpatrick, Andrew; Talbot, Max; Beckett, Andrew; Garraway, Naisan; Wong, Heather; Hameed, Syed Morad

2018-05-01

Damage-control and emergency surgical procedures in trauma have the potential to save lives. They may occasionally not be performed due to clinician inexperience or lack of comfort and knowledge. Canadian Armed Forces (CAF) non-surgeon Medical Officers (MOs) participated in a live tissue training exercise. They received tele-mentoring assistance using a secure video-conferencing application on a smartphone/tablet platform. Feasibility of tele-mentored surgery was studied by measuring their effectiveness at completing a set series of tasks in this pilot study. Additionally, their comfort and willingness to perform studied procedures was gauged using pre- and post-study surveys. With no pre-procedural teaching, participants were able to complete surgical airway, chest tube insertion and resuscitative thoracotomy with 100% effectiveness with no noted complications. Comfort level and willingness to perform these procedures were improved with tele-mentoring. Participants felt that tele-mentored surgery would benefit their performance of resuscitative thoracotomy most. The use of tele-mentored surgery to assist non-surgeon clinicians in the performance of damage-control and emergency surgical procedures is feasible. More study is required to validate its effectiveness. Copyright © 2018 Elsevier Inc. All rights reserved.

Numerical study of metal foam heat sinks under uniform impinging flow

NASA Astrophysics Data System (ADS)

Andreozzi, A.; Bianco, N.; Iasiello, M.; Naso, V.

2017-01-01

The ever-increasing demand for performance improvement and miniaturization of electronics has led to a significant generation of waste heat that must be dissipated to ensure a reliable device operation. The miniaturization of the components complicates this task. In fact, reducing the heat transfer area, at the same required heat rate, it is necessary to increase the heat flux, so that the materials operate in a temperature range suitable to its proper functioning. Traditional heat sinks are no longer capable of dissipating the generated heat and innovative approaches are needed to address the emerging thermal management challenges. Recently, heat transfer in open-cell metal foams under an impinging jet has received attention due to the considerable heat transfer potential of combining two cooling technologies: impinging jet and porous medium. This paper presents a numerical study on Finned Metal Foam (FMF) and Metal Foam (MF) heat sinks under impinging air jet cooling. The analysis is carried out by means of the commercial software COMSOL Multiphysics®. The purpose is to analyze the thermal performance of the metal foam heat sink, finned or not, varying its geometric parameters. Results are presented in terms of predicted dissipated heat rate, convective heat transfer coefficient and pressure losses.

A study on special test stand of automatic and manual descent control in presence of simulated g-load effect

NASA Astrophysics Data System (ADS)

Glazkov, Yury; Artjuchin, Yury; Astakhov, Alexander; Vas'kov, Alexander; Malyshev, Veniamin; Mitroshin, Edward; Glinsky, Valery; Moiseenko, Vasily; Makovlev, Vyacheslav

The development of aircraft-type reusable space vehicles (RSV) involves the problem of complete compatibility of automatic, director and manual control. Task decision is complicated, in particular, due to considerable quantitative and qualitative changes of vehicle dynamic characteristics, little stability margins (and even of unstability) of the RSV, and stringent requirements to control accuracy at some flight phases. Besides, during control a pilot is affected by g-loads which hamper motor activity and deteriorate its accuracy, alter the functional status of the visual analyser, and influence higher nervous activity. A study of g-load effects on the control efficiency, especially in manual and director modes, is of primary importance. The main tools for study of a rational selection of manual and director vehicle control systems and as an aid in formulating recommendations for optimum crew-automatic control system interactions are special complex and functional flight simulator test stands. The proposed simulator stand includes a powerful digital computer complex combined with the control system of the centrifuge. The interior of a pilot's vehicle cabin is imitated. A situation image system, pyscho-physical monitoring system, physician, centrifuge operator, and instructor stations are linked with the test stand.

Computerized Hammer Sounding Interpretation for Concrete Assessment with Online Machine Learning.

PubMed

Ye, Jiaxing; Kobayashi, Takumi; Iwata, Masaya; Tsuda, Hiroshi; Murakawa, Masahiro

2018-03-09

Developing efficient Artificial Intelligence (AI)-enabled systems to substitute the human role in non-destructive testing is an emerging topic of considerable interest. In this study, we propose a novel hammering response analysis system using online machine learning, which aims at achieving near-human performance in assessment of concrete structures. Current computerized hammer sounding systems commonly employ lab-scale data to validate the models. In practice, however, the response signal patterns can be far more complicated due to varying geometric shapes and materials of structures. To deal with a large variety of unseen data, we propose a sequential treatment for response characterization. More specifically, the proposed system can adaptively update itself to approach human performance in hammering sounding data interpretation. To this end, a two-stage framework has been introduced, including feature extraction and the model updating scheme. Various state-of-the-art online learning algorithms have been reviewed and evaluated for the task. To conduct experimental validation, we collected 10,940 response instances from multiple inspection sites; each sample was annotated by human experts with healthy/defective condition labels. The results demonstrated that the proposed scheme achieved favorable assessment accuracy with high efficiency and low computation load.

A tool for measuring the bending length in thin wires

NASA Astrophysics Data System (ADS)

Lorenzini, M.; Cagnoli, G.; Cesarini, E.; Losurdo, G.; Martelli, F.; Piergiovanni, F.; Vetrano, F.; Viceré, A.

2013-03-01

Great effort is currently being put into the development and construction of the second generation, advanced gravitational wave detectors, Advanced Virgo and Advanced LIGO. The development of new low thermal noise suspensions of mirrors, based on the experience gained in the previous experiments, is part of this task. Quasi-monolithic suspensions with fused silica wires avoid the problem of rubbing friction introduced by steel cradle arrangements by directly welding the wires to silica blocks bonded to the mirror. Moreover, the mechanical loss level introduced by silica (ϕfs ˜ 10-7 in thin fused silica wires) is by far less than the one associated with steel. The low frequency dynamical behaviour of the suspension can be computed and optimized, provided that the wire bending shape under pendulum motion is known. Due to the production process, fused silica wires are thicker near the two ends (necks), so that analytical bending computations are very complicated. We developed a tool to directly measure the low frequency bending parameters of fused silica wires, and we tested it on the wires produced for the Virgo+ monolithic suspensions. The working principle and a set of test measurements are presented and explained.

A tool for measuring the bending length in thin wires.

PubMed

Lorenzini, M; Cagnoli, G; Cesarini, E; Losurdo, G; Martelli, F; Piergiovanni, F; Vetrano, F; Viceré, A

2013-03-01

Great effort is currently being put into the development and construction of the second generation, advanced gravitational wave detectors, Advanced Virgo and Advanced LIGO. The development of new low thermal noise suspensions of mirrors, based on the experience gained in the previous experiments, is part of this task. Quasi-monolithic suspensions with fused silica wires avoid the problem of rubbing friction introduced by steel cradle arrangements by directly welding the wires to silica blocks bonded to the mirror. Moreover, the mechanical loss level introduced by silica (φfs ∼ 10(-7) in thin fused silica wires) is by far less than the one associated with steel. The low frequency dynamical behaviour of the suspension can be computed and optimized, provided that the wire bending shape under pendulum motion is known. Due to the production process, fused silica wires are thicker near the two ends (necks), so that analytical bending computations are very complicated. We developed a tool to directly measure the low frequency bending parameters of fused silica wires, and we tested it on the wires produced for the Virgo+ monolithic suspensions. The working principle and a set of test measurements are presented and explained.

On the Use of Low-Cost Radar Networks for Collision Warning Systems Aboard Dumpers

PubMed Central

González-Partida, José-Tomás; León-Infante, Francisco; Blázquez-García, Rodrigo; Burgos-García, Mateo

2014-01-01

The use of dumpers is one of the main causes of accidents in construction sites, many of them with fatal consequences. These kinds of work machines have many blind angles that complicate the driving task due to their large size and volume. To guarantee safety conditions is necessary to use automatic aid systems that can detect and locate the different objects and people in a work area. One promising solution is a radar network based on low-cost radar transceivers aboard the dumper. The complete system is specified to operate with a very low false alarm rate to avoid unnecessary stops of the dumper that reduce its productivity. The main sources of false alarm are the heavy ground clutter, and the interferences between the radars of the network. This article analyses the clutter for LFM signaling and proposes the use of Offset Linear Frequency Modulated Continuous Wave (OLFM-CW) as radar signal. This kind of waveform can be optimized to reject clutter and self-interferences. Jointly, a data fusion chain could be used to reduce the false alarm rate of the complete radar network. A real experiment is shown to demonstrate the feasibility of the proposed system. PMID:24577521

Comparison of normalized gain and Cohen's d for analyzing gains on concept inventories

NASA Astrophysics Data System (ADS)

Nissen, Jayson M.; Talbot, Robert M.; Nasim Thompson, Amreen; Van Dusen, Ben

2018-06-01

Measuring student learning is a complicated but necessary task for understanding the effectiveness of instruction and issues of equity in college science, technology, engineering, and mathematics (STEM) courses. Our investigation focused on the implications on claims about student learning that result from choosing between one of two commonly used metrics for analyzing shifts in concept inventories. The metrics are normalized gain (g ), which is the most common method used in physics education research and other discipline based education research fields, and Cohen's d , which is broadly used in education research and many other fields. Data for the analyses came from the Learning About STEM Student Outcomes (LASSO) database and included test scores from 4551 students on physics, chemistry, biology, and math concept inventories from 89 courses at 17 institutions from across the United States. We compared the two metrics across all the concept inventories. The results showed that the two metrics lead to different inferences about student learning and equity due to the finding that g is biased in favor of high pretest populations. We discuss recommendations for the analysis and reporting of findings on student learning data.

Optimized bit extraction using distortion modeling in the scalable extension of H.264/AVC.

PubMed

Maani, Ehsan; Katsaggelos, Aggelos K

2009-09-01

The newly adopted scalable extension of H.264/AVC video coding standard (SVC) demonstrates significant improvements in coding efficiency in addition to an increased degree of supported scalability relative to the scalable profiles of prior video coding standards. Due to the complicated hierarchical prediction structure of the SVC and the concept of key pictures, content-aware rate adaptation of SVC bit streams to intermediate bit rates is a nontrivial task. The concept of quality layers has been introduced in the design of the SVC to allow for fast content-aware prioritized rate adaptation. However, existing quality layer assignment methods are suboptimal and do not consider all network abstraction layer (NAL) units from different layers for the optimization. In this paper, we first propose a technique to accurately and efficiently estimate the quality degradation resulting from discarding an arbitrary number of NAL units from multiple layers of a bitstream by properly taking drift into account. Then, we utilize this distortion estimation technique to assign quality layers to NAL units for a more efficient extraction. Experimental results show that a significant gain can be achieved by the proposed scheme.

Architectures for Rainfall Property Estimation From Polarimetric Radar

NASA Astrophysics Data System (ADS)

Collis, S. M.; Giangrande, S. E.; Helmus, J.; Troemel, S.

2014-12-01

Radars that transmit and receive signals in polarizations aligned both horizontal and vertical to the horizon collect a number of measurements. The relation both between these measurements and between measurements and desired microphysical quantities (such as rainfall rate) is complicated due to a number of scattering mechanisms. The result is that there ends up being an intractable number of often incompatible techniques for extracting geophysical insight. This presentation will discuss methods developed by the Atmospheric Measurement Climate (ARM) Research Facility to streamline the creation of application chains for retrieving rainfall properties for the purposes of fine scale model evaluation. By using a Common Data Model (CDM) approach and working in the popular open source Python scientific environment analysis techniques such as Linear Programming (LP) can be bought to bear on the task of retrieving insight from radar signals. This presentation will outline how we have used these techniques to detangle polarimetric phase signals, estimate a three-dimensional precipitation field and then objectively compare to cloud resolving model derived rainfall fields from the NASA/DoE Mid-Latitude Continental Convective Clouds Experiment (MC3E). All techniques show will be available, open source, in the Python-ARM Radar Toolkit (Py-ART).

Electromagnetic optimisation of a 2.45 GHz microwave plasma source operated at atmospheric pressure and designed for hydrogen production

NASA Astrophysics Data System (ADS)

Miotk, R.; Jasiński, M.; Mizeraczyk, J.

2018-03-01

This paper presents the partial electromagnetic optimisation of a 2.45 GHz cylindrical-type microwave plasma source (MPS) operated at atmospheric pressure. The presented device is designed for hydrogen production from liquid fuels, e.g. hydrocarbons and alcohols. Due to industrial requirements regarding low costs for hydrogen produced in this way, previous testing indicated that improvements were required to the electromagnetic performance of the MPS. The MPS has a duct discontinuity region, which is a result of the cylindrical structure located within the device. The microwave plasma is generated in this discontinuity region. Rigorous analysis of the region requires solving a set of Maxwell equations, which is burdensome for complicated structures. Furthermore, the presence of the microwave plasma increases the complexity of this task. To avoid calculating the complex Maxwell equations, we suggest the use of the equivalent circuit method. This work is based upon the idea of using a Weissfloch circuit to characterize the area of the duct discontinuity and the plasma. The resulting MPS equivalent circuit allowed the calculation of a capacitive metallic diaphragm, through which an improvement in the electromagnetic performance of the plasma source was obtained.

Robust Optical Recognition of Cursive Pashto Script Using Scale, Rotation and Location Invariant Approach

PubMed Central

Ahmad, Riaz; Naz, Saeeda; Afzal, Muhammad Zeshan; Amin, Sayed Hassan; Breuel, Thomas

2015-01-01

The presence of a large number of unique shapes called ligatures in cursive languages, along with variations due to scaling, orientation and location provides one of the most challenging pattern recognition problems. Recognition of the large number of ligatures is often a complicated task in oriental languages such as Pashto, Urdu, Persian and Arabic. Research on cursive script recognition often ignores the fact that scaling, orientation, location and font variations are common in printed cursive text. Therefore, these variations are not included in image databases and in experimental evaluations. This research uncovers challenges faced by Arabic cursive script recognition in a holistic framework by considering Pashto as a test case, because Pashto language has larger alphabet set than Arabic, Persian and Urdu. A database containing 8000 images of 1000 unique ligatures having scaling, orientation and location variations is introduced. In this article, a feature space based on scale invariant feature transform (SIFT) along with a segmentation framework has been proposed for overcoming the above mentioned challenges. The experimental results show a significantly improved performance of proposed scheme over traditional feature extraction techniques such as principal component analysis (PCA). PMID:26368566

Evaluation of Anomaly Detection Method Based on Pattern Recognition

NASA Astrophysics Data System (ADS)

Fontugne, Romain; Himura, Yosuke; Fukuda, Kensuke

The number of threats on the Internet is rapidly increasing, and anomaly detection has become of increasing importance. High-speed backbone traffic is particularly degraded, but their analysis is a complicated task due to the amount of data, the lack of payload data, the asymmetric routing and the use of sampling techniques. Most anomaly detection schemes focus on the statistical properties of network traffic and highlight anomalous traffic through their singularities. In this paper, we concentrate on unusual traffic distributions, which are easily identifiable in temporal-spatial space (e.g., time/address or port). We present an anomaly detection method that uses a pattern recognition technique to identify anomalies in pictures representing traffic. The main advantage of this method is its ability to detect attacks involving mice flows. We evaluate the parameter set and the effectiveness of this approach by analyzing six years of Internet traffic collected from a trans-Pacific link. We show several examples of detected anomalies and compare our results with those of two other methods. The comparison indicates that the only anomalies detected by the pattern-recognition-based method are mainly malicious traffic with a few packets.

Bayesian inference on EMRI signals using low frequency approximations

NASA Astrophysics Data System (ADS)

Ali, Asad; Christensen, Nelson; Meyer, Renate; Röver, Christian

2012-07-01

Extreme mass ratio inspirals (EMRIs) are thought to be one of the most exciting gravitational wave sources to be detected with LISA. Due to their complicated nature and weak amplitudes the detection and parameter estimation of such sources is a challenging task. In this paper we present a statistical methodology based on Bayesian inference in which the estimation of parameters is carried out by advanced Markov chain Monte Carlo (MCMC) algorithms such as parallel tempering MCMC. We analysed high and medium mass EMRI systems that fall well inside the low frequency range of LISA. In the context of the Mock LISA Data Challenges, our investigation and results are also the first instance in which a fully Markovian algorithm is applied for EMRI searches. Results show that our algorithm worked well in recovering EMRI signals from different (simulated) LISA data sets having single and multiple EMRI sources and holds great promise for posterior computation under more realistic conditions. The search and estimation methods presented in this paper are general in their nature, and can be applied in any other scenario such as AdLIGO, AdVIRGO and Einstein Telescope with their respective response functions.

On the use of low-cost radar networks for collision warning systems aboard dumpers.

PubMed

González-Partida, José-Tomás; León-Infante, Francisco; Blázquez-García, Rodrigo; Burgos-García, Mateo

2014-02-26

The use of dumpers is one of the main causes of accidents in construction sites, many of them with fatal consequences. These kinds of work machines have many blind angles that complicate the driving task due to their large size and volume. To guarantee safety conditions is necessary to use automatic aid systems that can detect and locate the different objects and people in a work area. One promising solution is a radar network based on low-cost radar transceivers aboard the dumper. The complete system is specified to operate with a very low false alarm rate to avoid unnecessary stops of the dumper that reduce its productivity. The main sources of false alarm are the heavy ground clutter, and the interferences between the radars of the network. This article analyses the clutter for LFM signaling and proposes the use of Offset Linear Frequency Modulated Continuous Wave (OLFM-CW) as radar signal. This kind of waveform can be optimized to reject clutter and self-interferences. Jointly, a data fusion chain could be used to reduce the false alarm rate of the complete radar network. A real experiment is shown to demonstrate the feasibility of the proposed system.

What works with worked examples: Extending self-explanation and analogical comparison to synthesis problems

NASA Astrophysics Data System (ADS)

Badeau, Ryan; White, Daniel R.; Ibrahim, Bashirah; Ding, Lin; Heckler, Andrew F.

2017-12-01

The ability to solve physics problems that require multiple concepts from across the physics curriculum—"synthesis" problems—is often a goal of physics instruction. Three experiments were designed to evaluate the effectiveness of two instructional methods employing worked examples on student performance with synthesis problems; these instructional techniques, analogical comparison and self-explanation, have previously been studied primarily in the context of single-concept problems. Across three experiments with students from introductory calculus-based physics courses, both self-explanation and certain kinds of analogical comparison of worked examples significantly improved student performance on a target synthesis problem, with distinct improvements in recognition of the relevant concepts. More specifically, analogical comparison significantly improved student performance when the comparisons were invoked between worked synthesis examples. In contrast, similar comparisons between corresponding pairs of worked single-concept examples did not significantly improve performance. On a more complicated synthesis problem, self-explanation was significantly more effective than analogical comparison, potentially due to differences in how successfully students encoded the full structure of the worked examples. Finally, we find that the two techniques can be combined for additional benefit, with the trade-off of slightly more time on task.

Complications and total care of a child with acute leukemia.

PubMed

Vietti, T J; Ragab, A H

1975-03-01

The complications which occur in a child with acute leukemia depend on the stage of the disease and the therapeutic regiman. Most children will present with some manifestation of marrow failure. An occasional child will have marked leukocytosis and disturbance of organ function due to massive leukemic infiltrates. Metabolic disturbances such as hyperuricemia and hyperphosphatemia-hypocalcemia may develop, expecially after therapy is initiated. The myelosuppression and immunosuppression due to drug toxicity may result in opportunistic infections. Other toxicities which can occur with a chemotherapeutic regimen are numerois and varied, and the physician must be cognizant of them in order to minimize damage. Therapy to the central nervous system, either for subclinical or clinical disease, has been associated with a variety of symptoms ranging from meningismus to paraplegia and death. To prevent the development of these complications, and to manage them effectively if they occur, the physician must be knowlegeable about their etiology, clinical and laboratory manifestations, and treatment.

Bridging knee arthrodesis for limb salvage using an intramedullary cemented nail: a retrospective outcome analysis of a case series.

PubMed

Neuerburg, Carl; Bieger, Ralf; Jung, Sebastian; Kappe, Thomas; Reichel, Heiko; Decking, Ralf

2012-08-01

Failed total knee replacement with compromised bone and soft-tissues can be challenging. In these situations, arthrodesis remains a treatment option of a limb-saving procedure. We investigated the outcome of treatment with an intramedullary cemented knee arthrodesis nail implanted in 22 consecutive patients with forlorn situations after failed total knee replacement. There were three major complications due to re-infection and two minor complications due to wound-healing disturbances that healed with the implant retained after an average follow-up of 3.4 years. Clinical examination, Short Form-36 and Oxford knee scores revealed low pain levels, safe implant anchorage, and improved stability of the knee, whilst autonomous mobility utilizing walking aids was still possible. Bridging knee arthrodesis with an intramedullary nail is a valuable salvage procedure with acceptable clinical results. As recurring infection remains the most challenging complication, regular clinical and radiological follow-up examinations are necessary following implant-related knee arthrodesis to allow timely intervention in case of loosening.

[Duration of treatment and oral administrad on of antibiotics in community acquired pneumonia].

PubMed

Bernal-Vargas, Mónica A; Cortés, Jorge A

2016-04-01

Community acquired pneumonia (CAP) is an important cause of morbidity and mortality around the world, with high treatment costs due to hospitalization and complications (adverse events due to medications, antibiotic resistance, healthcare associated infections, etc.). It has been proposed administration of short courses and early switch of intravenous administration to oral therapy to avoid costs and complications. There are recommendations about these topics in national and intemational guidelines, based on clinical trials which do not demónstrate diffe-rences in mortality and complications when there is an early change from intravenous administration to the oral route. There are no statistically significant differences in safety and resolution of the disease when short and long treatment schemes were compared. In this review we present the most important guidelines and clinical studies, taking into account the pharmacological differences between different medications. It is considered that early switch from intravenous to oral administration route and use of short cycles in CAP is safe and brings benefits to patients and institutions.

Rapid Transfer of Abstract Rules to Novel Contexts in Human Lateral Prefrontal Cortex

PubMed Central

Cole, Michael W.; Etzel, Joset A.; Zacks, Jeffrey M.; Schneider, Walter; Braver, Todd S.

2011-01-01

Flexible, adaptive behavior is thought to rely on abstract rule representations within lateral prefrontal cortex (LPFC), yet it remains unclear how these representations provide such flexibility. We recently demonstrated that humans can learn complex novel tasks in seconds. Here we hypothesized that this impressive mental flexibility may be possible due to rapid transfer of practiced rule representations within LPFC to novel task contexts. We tested this hypothesis using functional MRI and multivariate pattern analysis, classifying LPFC activity patterns across 64 tasks. Classifiers trained to identify abstract rules based on practiced task activity patterns successfully generalized to novel tasks. This suggests humans can transfer practiced rule representations within LPFC to rapidly learn new tasks, facilitating cognitive performance in novel circumstances. PMID:22125519

Variations in definition and method of retrieval of complications influence outcomes statistics after pancreatoduodenectomy: comparison of NSQIP with non-NSQIP methods.

PubMed

Sanford, Dominic E; Woolsey, Cheryl A; Hall, Bruce L; Linehan, David C; Hawkins, William G; Fields, Ryan C; Strasberg, Steven M

2014-09-01

NSQIP and the Accordion Severity Grading System have recently been used to develop quantitative methods for measuring the burden of postoperative complications. However, other audit methods such as chart reviews and prospective institutional databases are commonly used to gather postoperative complications. The purpose of this study was to evaluate discordance between different audit methods in pancreatoduodenectomy--a common major surgical procedure. The chief aim was to determine how these different methods could affect quantitative evaluations of postoperative complications. Three common audit methods were compared with NSQIP in 84 patients who underwent pancreatoduodenectomy. The methods were use of a prospective database, a chart review based on discharge summaries only, and a detailed retrospective chart review. The methods were evaluated for discordance with NSQIP and among themselves. Severity grading was performed using the Modified Accordion System. Fifty-three complications were listed by NSQIP and 31 complications were identified that were not listed by NSQIP. There was poor agreement for NSQIP-type complications between NSQIP and the other audit methods for mild and moderate complications (kappa 0.381 to 0.744), but excellent agreement for severe complications (kappa 0.953 to 1.00). Discordance was usually due to variations in definition of the complications in non-NSQIP methods. There was good agreement among non-NSQIP methods for non-NSQIP complications for moderate and severe complications, but not for mild complications. There are important differences in perceived surgical outcomes based on the method of complication retrieval. The non-NSQIP methods used in this study could not be substituted for NSQIP in a quantitative analysis unless that analysis was limited to severe complications. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Research on a dynamic workflow access control model

NASA Astrophysics Data System (ADS)

Liu, Yiliang; Deng, Jinxia

2007-12-01

In recent years, the access control technology has been researched widely in workflow system, two typical technologies of that are RBAC (Role-Based Access Control) and TBAC (Task-Based Access Control) model, which has been successfully used in the role authorizing and assigning in a certain extent. However, during the process of complicating a system's structure, these two types of technology can not be used in minimizing privileges and separating duties, and they are inapplicable when users have a request of frequently changing on the workflow's process. In order to avoid having these weakness during the applying, a variable flow dynamic role_task_view (briefly as DRTVBAC) of fine-grained access control model is constructed on the basis existed model. During the process of this model applying, an algorithm is constructed to solve users' requirements of application and security needs on fine-grained principle of privileges minimum and principle of dynamic separation of duties. The DRTVBAC model is implemented in the actual system, the figure shows that the task associated with the dynamic management of role and the role assignment is more flexible on authority and recovery, it can be met the principle of least privilege on the role implement of a specific task permission activated; separated the authority from the process of the duties completing in the workflow; prevented sensitive information discovering from concise and dynamic view interface; satisfied with the requirement of the variable task-flow frequently.

Lung Infections in Systemic Rheumatic Disease: Focus on Opportunistic Infections.

PubMed

Di Franco, Manuela; Lucchino, Bruno; Spaziante, Martina; Iannuccelli, Cristina; Valesini, Guido; Iaiani, Giancarlo

2017-01-29

Systemic rheumatic diseases have significant morbidity and mortality, due in large part to concurrent infections. The lung has been reported among the most frequent sites of infection in patients with rheumatic disease, who are susceptible to developing pneumonia sustained both by common pathogens and by opportunistic microorganisms. Patients with rheumatic disease show a peculiar vulnerability to infectious complications. This is due in part to intrinsic disease-related immune dysregulation and in part to the immunosuppressive treatments. Several therapeutic agents have been associated to a wide spectrum of infections, complicating the management of rheumatic diseases. This review discusses the most frequent pulmonary infections encountered in rheumatic diseases, focusing on opportunistic agents, consequent diagnostic challenges and appropriate therapeutic strategies.

Meta-analysis of age and skill effects on recalling chess positions and selecting the best move.

PubMed

Moxley, Jerad H; Charness, Neil

2013-10-01

A meta-analysis was conducted of studies that measured the effects of both age and skill in chess on the tasks of selecting the best move for chess positions (the best move task) as well as recalling chess game positions (the recall task). Despite a small sample of studies, we demonstrated that there are age and skill effects on both tasks: age being negatively associated with performance on both tasks and skill being positively associated with performance on both tasks. On the best move task, we found that skill was the dominant effect, while on the recall task, skill and age were approximately equally strong effects. We also found that skill was best measured by the best move task. In the case of the best move task, this result is consistent with the argument that it accurately replicates expert performance (Ericsson & Smith, 1991). Results for the recall task argue that this task captures effects related to skill, but also effects likely due to a general aging process. Implications for our understanding of aging in skilled domains are also discussed.

Modeling Stream Temperatures with the Inclusion of Irradiance Change due to Forest Biomass Shifts.

EPA Science Inventory

Changes in stream temperature are directly and indirectly due to solar energy loading levels. Solar radiation is a significant environmental driver that impacts the quality and resilience of terrestrial and aquatic habitats, yet its spatiotemporal variations are complicated to mo...

A case of bowel perforation due to traumatic hernia at a pelvic fracture site: a case report and review of the literature.

PubMed

Tanaka, Ryota; Nagahara, Hisashi; Maeda, Kiyoshi; Ohtani, Hiroshi; Shibutani, Masatsune; Tamura, Tatsuro; Ikeya, Tetsuro; Sugano, Kenji; Iseki, Yasuhito; Sakurai, Katsunobu; Yamazoe, Sadaaki; Kimura, Kenjiro; Toyokawa, Takahiro; Amano, Ryosuke; Kubo, Naoshi; Tanaka, Hiroaki; Muguruma, Kazuya; Hirakawa, Kosei; Ohira, Masaichi

2017-07-12

Common complications of pelvic fractures include visceral injury, large-volume hemorrhage, genitourinary injury, rectal injury, and pulmonary embolism. On the other hand, traumatic hernia is a rare complication, especially in association with pelvic fractures. We report a case of bowel perforation due to traumatic hernia at a pelvic fracture site. A 65-year-old female was presented at our hospital for further examination and treatment of ileus. She was diagnosed with bowel perforation due to traumatic hernia at a pelvic fracture site, and an emergency operation was thus immediately performed. We performed segmental jejunum resection and constructed jejunostomy, and the iliac bone fracture was fixed with four pins. In the postoperative course, she received antibiotics and vasopressors for septic shock. However, there was no need for either a ventilator, dialysis or admission to the ICU. At seven days after the operation, a residual abscess was detected in the pouch of Douglas. We performed percutaneous drainage (Clavien-Dindo IIIa) and jejunostomy closedown 35 days after the first operation. The postoperative course was without complication, but she received rehabilitation until she was able to walk unaided. She was discharged 64 days after the first operation. The occurrence of traumatic hernia is rare, especially in association with pelvic fractures. Although its rarity, traumatic hernia follows a severe course. Thus, proper diagnosis and effective treatment are necessary. Surgeons treating patients with pelvic injuries should consider the possibility of any complications and perform a work-up examination in order to achieve an accurate diagnosis at an earlier time point.

Increased N250 amplitudes for other-race faces reflect more effortful processing at the individual level.

PubMed

Herzmann, Grit

2016-07-01

The N250 and N250r (r for repetition, signaling a difference measure of priming) has been proposed to reflect the activation of perceptual memory representations for individual faces. Increased N250r and N250 amplitudes have been associated with higher levels of familiarity and expertise, respectively. In contrast to these observations, the N250 amplitude has been found to be larger for other-race than own-race faces in recognition memory tasks. This study investigated if these findings were due to increased identity-specific processing demands for other-race relative to own-race faces and whether or not similar results would be obtained for the N250 in a repetition priming paradigm. Only Caucasian participants were available for testing and completed two tasks with Caucasian, African-American, and Chinese faces. In a repetition priming task, participants decided whether or not sequentially presented faces were of the same identity (individuation task) or same race (categorization task). Increased N250 amplitudes were found for African-American and Chinese faces relative to Caucasian faces, replicating previous results in recognition memory tasks. Contrary to the expectation that increased N250 amplitudes for other-race face would be confined to the individuation task, both tasks showed similar results. This could be due to the fact that face identity information needed to be maintained across the sequential presentation of prime and target in both tasks. Increased N250 amplitudes for other-race faces are taken to represent increased neural demands on the identity-specific processing of other-race faces, which are typically processed less holistically and less on the level of the individual. Copyright © 2016 Elsevier B.V. All rights reserved.

Discrepancy of performance among working memory-related tasks in autism spectrum disorders was caused by task characteristics, apart from working memory, which could interfere with task execution.

PubMed

Nakahachi, Takayuki; Iwase, Masao; Takahashi, Hidetoshi; Honaga, Eiko; Sekiyama, Ryuji; Ukai, Satoshi; Ishii, Ryouhei; Ishigami, Wataru; Kajimoto, Osami; Yamashita, Ko; Hashimoto, Ryota; Tanii, Hisashi; Shimizu, Akira; Takeda, Masatoshi

2006-06-01

Working memory performance has been inconsistently reported in autism spectrum disorders (ASD). Several studies in ASD have found normal performance in digit span and poor performance in digit symbol task although these are closely related with working memory. It is assumed that poor performance in digit symbol could be explained by confirmatory behavior, which is induced due to the vague memory representation of number-symbol association. Therefore it was hypothesized that the performance of working memory task, in which vagueness did not cause confirmatory behavior, would be normal in ASD. For this purpose, the Advanced Trail Making Test (ATMT) was used. The performance of digit span, digit symbol and ATMT was compared between ASD and normal control. The digit span, digit symbol and ATMT was given to 16 ASD subjects and 28 IQ-, age- and sex-matched control subjects. The scores of these tasks were compared. A significantly lower score for ASD was found only in digit symbol compared with control subjects. There were no significant difference in digit span and working memory estimated by ATMT. Discrepancy of scores among working memory-related tasks was demonstrated in ASD. Poor digit symbol performance, normal digit span and normal working memory in ATMT implied that ASD subjects would be intact in working memory itself, and that superficial working memory dysfunction might be observed due to confirmatory behavior in digit symbol. Therefore, to evaluate working memory in ASD, tasks that could stimulate psychopathology specific to ASD should be avoided.

Interaction Effects of Acute Kidney Injury, Acute Respiratory Failure, and Sepsis on 30-Day Postoperative Mortality in Patients Undergoing High-Risk Intraabdominal General Surgical Procedures.

PubMed

Kim, Minjae; Brady, Joanne E; Li, Guohua

2015-12-01

Acute kidney injury (AKI), acute respiratory failure, and sepsis are distinct but related pathophysiologic processes. We hypothesized that these 3 processes may interact to synergistically increase the risk of short-term perioperative mortality in patients undergoing high-risk intraabdominal general surgery procedures. We performed a retrospective, observational cohort study of data (2005-2011) from the American College of Surgeons-National Surgical Quality Improvement Program, a high-quality surgical outcomes data set. High-risk procedures were those with a risk of AKI, acute respiratory failure, or sepsis greater than the average risk in all intraabdominal general surgery procedures. The effects of AKI, acute respiratory failure, and sepsis on 30-day mortality were assessed using a Cox proportional hazards model. Additive interactions were assessed with the relative excess risk due to interaction. Of 217,994 patients, AKI, acute respiratory failure, and sepsis developed in 1.3%, 3.7%, and 6.8%, respectively. The 30-day mortality risk with sepsis, acute respiratory failure, and AKI were 11.4%, 24.1%, and 25.1%, respectively, compared with 0.85% without these complications. The adjusted hazard ratios and 95% confidence intervals for a single complication (versus no complication) on mortality were 7.24 (6.46-8.11), 10.8 (8.56-13.6), and 14.2 (12.8-15.7) for sepsis, AKI, and acute respiratory failure, respectively. For 2 complications, the adjusted hazard ratios were 30.8 (28.0-33.9), 42.6 (34.3-52.9), and 65.2 (53.9-78.8) for acute respiratory failure/sepsis, AKI/sepsis, and acute respiratory failure/AKI, respectively. Finally, the adjusted hazard ratio for all 3 complications was 105 (92.8-118). Positive additive interactions, indicating synergism, were found for each combination of 2 complications. The relative excess risk due to interaction for all 3 complications was not statistically significant. In high-risk general surgery patients, the development of AKI, acute respiratory failure, or sepsis is independently associated with an increase in 30-day mortality. In addition, the development of 2 complications shows significant positive additive interactions to further increase the risk of mortality. Our findings suggest that interactions between these 3 perioperative complications increase the risk of mortality more than would be expected by the independent effects of each complication alone.

Improving Visual Threat Detection: Research to Validate the Threat Detection Skills Trainer

DTIC Science & Technology

2013-08-01

potential threats present in this scene and explain the meaning and implications of these threats. You have two minutes to write a response...could be due to the nature of the tasks or to fatigue. Requiring Soldiers to write answers on multiple trials, and across similar tasks, might have...tasks will likely be significantly different from those experienced in the trainer. This would remove the writing requirement over multiple trials

Venous Access Ports: Indications, Implantation Technique, Follow-Up, and Complications

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

Walser, Eric M., E-mail: walser.eric@mayo.edu

The subcutaneous venous access device (SVAD or 'port') is a critical component in the care of patients with chronic disease. The modern SVAD provides reliable access for blood withdrawal and medication administration with minimal disruption to a patient's lifestyle. Because of improved materials and catheter technology, today's ports are lighter and stronger and capable of high-pressure injections of contrast for cross-sectional imaging. The majority of SVAD placement occurs in interventional radiology departments due to their ability to provide this service at lower costs, lower, complication rates, and greater volumes. Port-insertion techniques vary depending on the operator, but all consist ofmore » catheter placement in the central venous circulation followed by subcutaneous pocket creation and port attachment to the catheter with fixation and closure of the pocket. Venous access challenges occasionally occur in patients with central vein occlusions, necessitating catheterization of collateral veins or port placement in alternate locations. Complications of SVADs include those associated with the procedure as well as short- (<30 days) and long-term problems. Procedural and early complications are quite rare due to the near-universal use of real-time ultrasound guidance for vein puncture, but they can include hematoma, catheter malposition, arrhythmias, and pneumothorax. Late problems include both thrombotic complications (native venous or port-catheter thrombosis) and infections (tunnel or pocket infections or catheter-associated bloodstream infections). Most guidelines suggest that 0.3 infections/1000 catheter days is an appropriate upper threshold for the insertion of SVADs.« less

ISHM-oriented adaptive fault diagnostics for avionics based on a distributed intelligent agent system

NASA Astrophysics Data System (ADS)

Xu, Jiuping; Zhong, Zhengqiang; Xu, Lei

2015-10-01

In this paper, an integrated system health management-oriented adaptive fault diagnostics and model for avionics is proposed. With avionics becoming increasingly complicated, precise and comprehensive avionics fault diagnostics has become an extremely complicated task. For the proposed fault diagnostic system, specific approaches, such as the artificial immune system, the intelligent agents system and the Dempster-Shafer evidence theory, are used to conduct deep fault avionics diagnostics. Through this proposed fault diagnostic system, efficient and accurate diagnostics can be achieved. A numerical example is conducted to apply the proposed hybrid diagnostics to a set of radar transmitters on an avionics system and to illustrate that the proposed system and model have the ability to achieve efficient and accurate fault diagnostics. By analyzing the diagnostic system's feasibility and pragmatics, the advantages of this system are demonstrated.

Fibrin glue in ophthalmology

PubMed Central

Panda, Anita; Kumar, Sandeep; Kumar, Abhiyan; Bansal, Raseena; Bhartiya, Shibal

2009-01-01

Suturing is a time consuming task in ophthalmology and suture induced irritation and redness are frequent problems. Postoperative wound infection and corneal graft rejection are examples of possible suture related complications. To prevent these complications, ophthalmic surgeons are switching to sutureless surgery. A number of recent developments have established tissue adhesives like cyanoacrylate glue and fibrin glue as attractive alternatives to sutures. A possible and promising new application for tissue adhesives is to provide a platform for tissue engineering. Currently, tissue glue is being used for conjunctival closure following pterygium and strabismus surgery, forniceal reconstruction surgery, amniotic membrane transplantation, lamellar corneal grafting, closure of corneal perforations and descematoceles, management of conjunctival wound leaks after trabeculectomy, lid surgery, adnexal surgery and as a hemostat to minimise bleeding. The purpose of this review is to discuss the currently available information on fibrin glue. PMID:19700876

Common component classification: what can we learn from machine learning?

PubMed

Anderson, Ariana; Labus, Jennifer S; Vianna, Eduardo P; Mayer, Emeran A; Cohen, Mark S

2011-05-15

Machine learning methods have been applied to classifying fMRI scans by studying locations in the brain that exhibit temporal intensity variation between groups, frequently reporting classification accuracy of 90% or better. Although empirical results are quite favorable, one might doubt the ability of classification methods to withstand changes in task ordering and the reproducibility of activation patterns over runs, and question how much of the classification machines' power is due to artifactual noise versus genuine neurological signal. To examine the true strength and power of machine learning classifiers we create and then deconstruct a classifier to examine its sensitivity to physiological noise, task reordering, and across-scan classification ability. The models are trained and tested both within and across runs to assess stability and reproducibility across conditions. We demonstrate the use of independent components analysis for both feature extraction and artifact removal and show that removal of such artifacts can reduce predictive accuracy even when data has been cleaned in the preprocessing stages. We demonstrate how mistakes in the feature selection process can cause the cross-validation error seen in publication to be a biased estimate of the testing error seen in practice and measure this bias by purposefully making flawed models. We discuss other ways to introduce bias and the statistical assumptions lying behind the data and model themselves. Finally we discuss the complications in drawing inference from the smaller sample sizes typically seen in fMRI studies, the effects of small or unbalanced samples on the Type 1 and Type 2 error rates, and how publication bias can give a false confidence of the power of such methods. Collectively this work identifies challenges specific to fMRI classification and methods affecting the stability of models. Copyright © 2010 Elsevier Inc. All rights reserved.

Fatigue in U.S. Astronauts Onboard the International Space Station: Environmental Factors, Operational Impacts, and Implementation of Countermeasures

NASA Technical Reports Server (NTRS)

Scheuring, R. A.; Moomaw, R. C.; Johnston, S. L.

2014-01-01

Since 2000, US astronauts have been supporting missions up to a six month duration on the International Space Station (ISS). Crewmembers have experienced fatigue for reasons similar to military deployments. Astronauts experience psychological stressors such as heavy workloads, extended duty periods, circadian misalignment, inadequate/ineffective sleep, and loss of the environmental cues of a gravity environment. Complicating the psychological stressors are environmental factors; distracting background noise, unexpected and variable mission schedules, unfavorable thermal control, elevated CO2 levels, and an unusual sleep environment with schedules that impinge on pre-sleep periods. Physiological contributors to poor sleep and fatigue include a cephalad fluid shift and back pain. Restful sleep is further challenged due to a lack of gravity-related proprioceptive cues and need for restraints. The term "space fog" has been used by astronauts to describe a phenomenon of forgetfulness, slowed reaction time and transient confusion while trying to complete tasks. There is a distinct temporal correlation with arrival on the Space Station and the onset of slowed cognitive skills and a spontaneous resolution that may take up to 6 weeks. The Genesis of this phenomenon may be chronic fatigue secondary to transitioning from a planar environment to a 360deg microgravity perspective. Recently, countermeasures to improve sleep duration and quality in astronauts on the ISS have been instituted with moderate degrees of success as measured by self-reaction time (psychomotor vigilance task testing), actigraphy, and subjective reports. Judicious use of stimulants and hypnotics, light therapy, controlled sleep periods and sleep shifting and reducing ambient CO2 levels are a few of the most promising countermeasures being used in space to improve sleep and reduce fatigue.

Sex differences in neural efficiency: Are they due to the stereotype threat effect?☆

PubMed Central

Dunst, Beate; Benedek, Mathias; Bergner, Sabine; Athenstaedt, Ursula; Neubauer, Aljoscha C.

2013-01-01

The neural efficiency hypothesis postulates a more efficient use of brain resources in more intelligent people as compared to less intelligent ones. However, this relationship was found to be moderated by sex and task content. While the phenomenon of neural efficiency was previously supported for men when performing visuo-spatial tasks it occurred for women only when performing verbal tasks. One possible explanation for this finding could be provided by the well-studied phenomenon called stereotype threat. Stereotype threat arises when a negative stereotype of one’s own group is made salient and can result in behavior that confirms the stereotype. Overall, 32 boys and 31 girls of varying intellectual ability were tested with a mental rotation task, either under a stereotype exposure or a no-stereotype exposure condition while measuring their EEG. The behavioral results show that an activated negative stereotype not necessarily hampers the performance of girls. Physiologically, a confirmation of the neural efficiency phenomenon was only obtained for boys working under a no-stereotype exposure condition. This result pattern replicates previous findings without threat and thus suggests that sex differences in neural efficiency during visuo-spatial tasks may not be due to the stereotype threat effect. PMID:24092950

Dislocation and spontaneous reduction of the femoral implant against the femoral neck in an infected metal on metal hip resurfacing with complex collection.

PubMed

Tins, Bernhard

2011-07-01

Metal on metal resurfacing hip implants are known to have complications unique to this type of implant. The case presented adds a further previously not described complication, the dislocation and spontaneous reduction of the pin of the femoral component against the femoral neck. The radiographic and CT findings are demonstrated. The dislocation was aided by bone loss due to an infection with a large periarticular collection. Periarticular collections in hip resurfacings are often due to a hypersensitivity type reaction to metal debris. However in the case presented it was due to infection. MRI was not able to discern the infection from a sterile collection. CT demonstrated bone loss and periosteal reaction suggestive of infection. In addition calcification of the pseudocapsule was seen, this is not a recognized feature of sterile collections. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Estimation of the economic and health impact of complications of type 2 diabetes mellitus in the autonomous community of Madrid (Spain).

PubMed

Arrieta, Francisco; Rubio-Terrés, Carlos; Rubio-Rodríguez, Darío; Magaña, Ana; Piñera, Marbella; Iglesias, Pedro; Nogales, Pedro; Calañas, Alfonso; Novella, Blanca; Botella-Carretero, José Ignacio; Debán, Carlos; Zamarrón, Isabel; Mora, Gustavo; Balsa, José Antonio; Vázquez, Clotilde

2014-04-01

To estimate the economic and health impact of chronic complications (macrovascular and microvascular) of type 2 diabetes mellitus (T2DM) in the autonomous community of Madrid (Spain) (ACM). The number of expected complications was obtained from a descriptive, cross-sectional study on a cohort of 3,268 patients with T2DM from the ACM. Cost of complications (€, 2012) was assessed both at hospitals and in primary care. The number of medical visits in primary care and drug treatment for complications were collected by a panel of 21 physicians experienced in treatment of T2DM. Population and epidemiological data and healthcare costs were obtained from Spanish sources. Univariate sensitivity analyses were performed. It is estimated that there are 390,944 patients with T2DM in the ACM, and that they experience 172,406 and 212,283 macrovascular and microvascular complications respectively during their lifetimes. Mean cost of T2DM complications per patient is estimated at € 4,121.54 (66% due to macrovascular complications). The economic impact of T2DM complications in the ACM would be € 1,611 million (1,065 and 545 millions from macrovascular and microvascular complications respectively). The economic impact would range from € 1,249 and 2.509 million euro depending on T2DM prevalence. Complications of T2DM have a great health and economic impact in ACM. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

Using task analysis to generate evidence for strengthening midwifery education, practice, and regulation in Ethiopia

PubMed Central

Yigzaw, Tegbar; Carr, Catherine; Stekelenburg, Jelle; van Roosmalen, Jos; Gibson, Hannah; Gelagay, Mintwab; Admassu, Azeb

2016-01-01

Purpose Realizing aspirations for meeting the global reproductive, maternal, newborn, and child health goals depends not only on increasing the numbers but also on improving the capability of midwifery workforce. We conducted a task analysis study to identify the needs for strengthening the midwifery workforce in Ethiopia. Methods We conducted a cross-sectional study of recently qualified midwives in Ethiopia. Purposively selected participants from representative geographic and practice settings completed a self-administered questionnaire, making judgments about the frequency of performance, criticality, competence, and location of training for a list of validated midwifery tasks. Using Statistical Package for the Social Sciences, Version 20, we computed the percentages and averages to describe participant and practice characteristics. We identified priority preservice education gaps by considering the tasks least frequently learned in preservice, most frequently mentioned for not being trained, and had the highest not capable response. Identification of top priorities for in-service training considered tasks with highest “not capable” and “never” done responses. We determined the licensing exam blueprint by weighing the composite mean scores for frequency and criticality variables and expert rating across practice categories. Results One hundred and thirty-eight midwives participated in the study. The majority of respondents recognized the importance of midwifery tasks (89%), felt they were capable (91.8%), reported doing them frequently (63.9%), and learned them during preservice education (56.3%). We identified competence gaps in tasks related to obstetric complications, gynecology, public health, professional duties, and prevention of mother to child transmission of HIV. Moreover, our study helped to determine composition of the licensing exam for university graduates. Conclusion The task analysis indicates that midwives provide critical reproductive, maternal, newborn, and child health care services and supports continuing investment in this cadre. However, there were substantial competence gaps that limit their ability to accelerate progress toward health development goals. Moreover, basing the licensure exam on task analysis helped to ground it in national practice priorities. PMID:27313478

Using task analysis to generate evidence for strengthening midwifery education, practice, and regulation in Ethiopia.

PubMed

Yigzaw, Tegbar; Carr, Catherine; Stekelenburg, Jelle; van Roosmalen, Jos; Gibson, Hannah; Gelagay, Mintwab; Admassu, Azeb

2016-01-01

Realizing aspirations for meeting the global reproductive, maternal, newborn, and child health goals depends not only on increasing the numbers but also on improving the capability of midwifery workforce. We conducted a task analysis study to identify the needs for strengthening the midwifery workforce in Ethiopia. We conducted a cross-sectional study of recently qualified midwives in Ethiopia. Purposively selected participants from representative geographic and practice settings completed a self-administered questionnaire, making judgments about the frequency of performance, criticality, competence, and location of training for a list of validated midwifery tasks. Using Statistical Package for the Social Sciences, Version 20, we computed the percentages and averages to describe participant and practice characteristics. We identified priority preservice education gaps by considering the tasks least frequently learned in preservice, most frequently mentioned for not being trained, and had the highest not capable response. Identification of top priorities for in-service training considered tasks with highest "not capable" and "never" done responses. We determined the licensing exam blueprint by weighing the composite mean scores for frequency and criticality variables and expert rating across practice categories. One hundred and thirty-eight midwives participated in the study. The majority of respondents recognized the importance of midwifery tasks (89%), felt they were capable (91.8%), reported doing them frequently (63.9%), and learned them during preservice education (56.3%). We identified competence gaps in tasks related to obstetric complications, gynecology, public health, professional duties, and prevention of mother to child transmission of HIV. Moreover, our study helped to determine composition of the licensing exam for university graduates. The task analysis indicates that midwives provide critical reproductive, maternal, newborn, and child health care services and supports continuing investment in this cadre. However, there were substantial competence gaps that limit their ability to accelerate progress toward health development goals. Moreover, basing the licensure exam on task analysis helped to ground it in national practice priorities.

To Assess the Effect of Maternal BMI on Obstetrical Outcome

NASA Astrophysics Data System (ADS)

Lakhanpal, Shuchi; Aggarwal, Asha; Kaur, Gurcharan

2012-06-01

AIMS: To assess the effect of maternal BMI on complications in pregnancy, mode of delivery, complications of labour and delivery.METHODS:A crossectional study was carried out in the Obst and Gynae department, Kasturba Hospital, Delhi. The study enrolled 100 pregnant women. They were divided into 2 groups based on their BMI, more than or equal to 30.0 kg/m2 were categorized as obese and less than 30 kg/m2 as non obese respectively. Maternal complications in both types of patients were studied.RESULTS:CONCLUSION: As the obstetrical outcome is significantly altered due to obesity, we can improve maternal outcome by overcoming obesity. As obesity is a modifiable risk factor, preconception counseling creating awareness regarding health risk associated with obesity should be encouraged and obstetrical complications reduced.

[Improvement of work of chiefs of therapeutic and diagnostic hospital departments--chief medical specialists of military districts (fleet)].

PubMed

Tregubov, V N; Kostiuchenko, A I; Stetsenko, B G

2009-03-01

In now-day conditions, on the background of enlargement and complication of tasks', solved by military health service, it's supervised the increase of significance of qualitative and effective administration by collectives of military-medical organizations. An important role belongs to activity of chiefs of treatment-diagnostic units (centers) of military hospitals. These chiefs in the same time are staff or inorganic medical specialists of military regions (NAVYs).

Endogenous synchronous fluorescence spectroscopy (SFS) of basal cell carcinoma-initial study

NASA Astrophysics Data System (ADS)

Borisova, E.; Zhelyazkova, Al.; Keremedchiev, M.; Penkov, N.; Semyachkina-Glushkovskaya, O.; Avramov, L.

2016-01-01

The human skin is a complex, multilayered and inhomogeneous organ with spatially varying optical properties. Analysis of cutaneous fluorescence spectra could be a very complicated task; therefore researchers apply complex mathematical tools for data evaluation, or try to find some specific approaches, that would simplify the spectral analysis. Synchronous fluorescence spectroscopy (SFS) allows improving the spectral resolution, which could be useful for the biological tissue fluorescence characterization and could increase the tumour detection diagnostic accuracy.

Maternal Warm Responsiveness and Negativity Following Traumatic Brain Injury in Young Children

PubMed Central

Fairbanks, Joy M.; Brown, Tanya M.; Cassedy, Amy; Taylor, H. Gerry; Yeates, Keith O.; Wade, Shari L.

2014-01-01

Purpose/Objective To understand how traumatic brain injury (TBI) affects maternal warm responsiveness and negativity over the first 12 months following injury. Method/Design We used a concurrent cohort research design to examine dyadic interactions in young children with a TBI (n = 78) and a comparison group of young children with orthopedic injuries (OI; n = 112) and their families during the initial weeks following injury (i.e., baseline) and at two follow-up periods (approximately 6 and 12 months later). Trained raters coded videotaped interactions during a free play and structured teaching task for maternal warm responsiveness and negativity. Results Mothers in the complicated mild/moderate TBI group, but not those in the severe TBI group, exhibited significantly lower levels of maternal warm responsiveness than mothers in the OI group. However, these differences were observed only at baseline during free play and only at baseline and 6 months postinjury during the structured teaching task, suggesting diminishing adverse effects of complicated mild/moderate TBI on parenting over time postinjury. Analysis failed to reveal group differences in maternal negativity at any of the assessments. Across groups, lower socioeconomic status (SES) was associated with lower levels of warm responsiveness and higher levels of negativity. Conclusions/Implications These findings, though preliminary, indicate possible alterations in mother–child interactions in the months following a TBI. PMID:23978080

[Progressive renal insufficiency in a 55-year-old man with psoriasis].

PubMed

Herfurth, K; Busch, M; Gröne, H J; Wolf, G

2018-06-05

Treatment with tumor necrosis factor alpha (TNF-α) inhibitors is a well-established therapeutic strategy for various autoimmune diseases. However, little is known about renal complications and possible causality of renal injury due to this treatment. The following case of a patient with psoriasis demonstrates the difficulties in classifying renal complications of anti-TNF-α therapy versus kidney involvement caused by the underlying disease.

Determining Types of Health Effects To Persian Gulf Veterans Due To Exposure To Occupational Hazards

DTIC Science & Technology

1995-12-01

complications . No other systemic effects were observed in animal tests [59:271. No studies have been found pertaining to immunological, developmental...lethargy, coma, and semicoma, and complications of the central nervous system [59:281. Other effects noted were convulsions, unconsciousness...more often in women than in men [11:20491. Many investigators feel that CFS is closely related to Epstein-Barr syndrome, mononucleosis , postviral

[Cervical disc hernia decompensation complicated by postoperative transitory tetraparesia about long-term haemodialysis patient].

PubMed

Caltot, E; Hélaine, L; Cadic, A; Muller, C; Arvieux, C-C

2011-01-01

We report a case of a 51-year-old man who underwent a third kidney transplantation that was complicated by tetraparesia due to a C5-C6 cervical disc hernia decompensation in the immediate postoperative period. Preoperative consultation for long-term haemodialysis patients could be perfected by further neurological investigation and additional imagery. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Lessons Learned from Crowdsourcing Complex Engineering Tasks.

PubMed

Staffelbach, Matthew; Sempolinski, Peter; Kijewski-Correa, Tracy; Thain, Douglas; Wei, Daniel; Kareem, Ahsan; Madey, Gregory

2015-01-01

Crowdsourcing is the practice of obtaining needed ideas, services, or content by requesting contributions from a large group of people. Amazon Mechanical Turk is a web marketplace for crowdsourcing microtasks, such as answering surveys and image tagging. We explored the limits of crowdsourcing by using Mechanical Turk for a more complicated task: analysis and creation of wind simulations. Our investigation examined the feasibility of using crowdsourcing for complex, highly technical tasks. This was done to determine if the benefits of crowdsourcing could be harnessed to accurately and effectively contribute to solving complex real world engineering problems. Of course, untrained crowds cannot be used as a mere substitute for trained expertise. Rather, we sought to understand how crowd workers can be used as a large pool of labor for a preliminary analysis of complex data. We compared the skill of the anonymous crowd workers from Amazon Mechanical Turk with that of civil engineering graduate students, making a first pass at analyzing wind simulation data. For the first phase, we posted analysis questions to Amazon crowd workers and to two groups of civil engineering graduate students. A second phase of our experiment instructed crowd workers and students to create simulations on our Virtual Wind Tunnel website to solve a more complex task. With a sufficiently comprehensive tutorial and compensation similar to typical crowd-sourcing wages, we were able to enlist crowd workers to effectively complete longer, more complex tasks with competence comparable to that of graduate students with more comprehensive, expert-level knowledge. Furthermore, more complex tasks require increased communication with the workers. As tasks become more complex, the employment relationship begins to become more akin to outsourcing than crowdsourcing. Through this investigation, we were able to stretch and explore the limits of crowdsourcing as a tool for solving complex problems.

The Effects of Aging and IQ on Item and Associative Memory

PubMed Central

Ratcliff, Roger; Thapar, Anjali; McKoon, Gail

2011-01-01

The effects of aging and IQ on performance were examined in four memory tasks: item recognition, associative recognition, cued recall, and free recall. For item and associative recognition, accuracy and the response time distributions for correct and error responses were explained by Ratcliff’s (1978) diffusion model, at the level of individual participants. The values of the components of processing identified by the model for the recognition tasks, as well as accuracy for cued and free recall, were compared across levels of IQ ranging from 85 to 140 and age (college-age, 60-74 year olds, and 75-90 year olds). IQ had large effects on the quality of the evidence from memory on which decisions were based in the recognition tasks and accuracy in the recall tasks, except for the oldest participants for whom some of the measures were near floor values. Drift rates in the recognition tasks, accuracy in the recall tasks, and IQ all correlated strongly with each other. However, there was a small decline in drift rates for item recognition and a large decline for associative recognition and accuracy in cued recall (about 70 percent). In contrast, there were large age effects on boundary separation and nondecision time (which correlated across tasks), but little effect of IQ. The implications of these results for single- and dual- process models of item recognition are discussed and it is concluded that models that deal with both RTs and accuracy are subject to many more constraints than models that deal with only one of these measures. Overall, the results of the study show a complicated but interpretable pattern of interactions that present important targets for response time and memory models. PMID:21707207

Classifying Hydroceles of the Pelvis and Groin: An Overview of Etiology, Secondary Complications, Evaluation, and Management

PubMed Central

Dagur, Gautam; Gandhi, Jason; Suh, Yiji; Weissbart, Steven; Sheynkin, Yefim R.; Smith, Noel L.; Joshi, Gargi; Khan, Sardar Ali

2017-01-01

Introduction A hydrocele is defined as the pathological buildup of serous fluid in the pelvis and groin due to various etiologies such as diseases or trauma. It has distinct clinical manifestations, particularly discomfort and psychosocial distress. Understanding the anatomy, embryology, and physiology associated with hydrocele formation is crucial to understand its onset and progression. Materials and Methods A MEDLINE® search was conducted using keywords for the relevant classification of hydrocele and its etiology, complications, sexual barriers, evaluation, and management. Results Appropriately classifying the hydrocele as primary, secondary communicating, secondary noncommunicating, microbe-induced, inflammatory, iatrogenic, trauma-induced, tumor-induced, canal of Nuck, congenital, and giant is important for identifying the underlying etiology. Often this process is overlooked when the classification or etiology is too rare. A focused evaluation is important for this, so that timely management can be provided. We comprehensively review the classifications, etiology, and secondary complications of hydrocele. Pitfalls of current diagnostic techniques are explored along with recommended methods for accurate diagnosis and current treatment options. Conclusion Due to the range of classifications and etiologies of hydrocele in the pelvis and groin, a deliberate differential diagnosis is essential to avoiding imminent life-threatening complications as well as providing the appropriate treatment. PMID:28559772

A serious but rare complication of laparoscopic adjustable gastric banding: bowel obstruction due to caecal volvulus.

PubMed

Agahi, Afshin; Harle, Robin

2009-08-01

Laparoscopic adjustable gastric banding (LAGB) is a widely performed surgical procedure for the treatment of morbid obesity. LAGB complications have declined since its development in the early 1990s. However, LAGB complications are still occurring and can sometimes be serious and life threatening. These complications are related either to the band or to the access port, such as band slippage or tubing disconnection, retrospectively. We report a rare case of bowel obstruction due to caecal volvulus caused by connecting tube used in LAP-BAND system in a bariatric operation, which obstructed a caecal loop, in a female who had undergone LAGB 2 years previously. Diagnosis of bowel obstruction was established with plain abdominal radiograph appearances. Follow-up abdominal computed tomography findings confirmed the diagnosis of caecal obstruction and revealed the underlying cause for this obstruction. Surgery was performed, and intraoperative examination demonstrated that connecting tube of the LAP-BAND system was a main causative factor. We can hypothesize that bowel obstruction secondary to LAGB operation may become frequently diagnosed as more LAGB operations performed worldwide. The emergence of many problems, such as this, can be minimized with enhancement in the development of better surgical materials, proper operative technique, and close postoperative management and follow-up.

Thrombophilia and Pregnancy Complications

PubMed Central

Simcox, Louise E.; Ormesher, Laura; Tower, Clare; Greer, Ian A.

2015-01-01

There is a paucity of strong evidence associated with adverse pregnancy outcomes and thrombophilia in pregnancy. These problems include both early (recurrent miscarriage) and late placental vascular-mediated problems (fetal loss, pre-eclampsia, placental abruption and intra-uterine growth restriction). Due to poor quality case-control and cohort study designs, there is often an increase in the relative risk of these complications associated with thrombophilia, particularly recurrent early pregnancy loss, late fetal loss and pre-eclampsia, but the absolute risk remains very small. It appears that low-molecular weight heparin has other benefits on the placental vascular system besides its anticoagulant properties. Its use is in the context of antiphospholipid syndrome and recurrent pregnancy loss and also in women with implantation failure to improve live birth rates. There is currently no role for low-molecular weight heparin to prevent late placental-mediated complications in patients with inherited thrombophilia and this may be due to small patient numbers in the studies involved in summarising the evidence. There is potential for low-molecular weight heparin to improve pregnancy outcomes in women with prior severe vascular complications of pregnancy such as early-onset intra-uterine growth restriction and pre-eclampsia but further high quality randomised controlled trials are required to answer this question. PMID:26633369

Demographic and etiologic characteristics of children with traumatic serious hyphema.

PubMed

Türkcü, Fatih Mehmet; Yüksel, Harun; Sahin, Alparslan; Cingü, Kürşat; Arı, Seyhmus; Cınar, Yasin; Sahin, Muhammed; Yıldırım, Adnan; Caça, Ihsan

2013-07-01

We aimed to evaluate the etiologic factors, complications, follow-up, and treatment outcomes in serious hyphema following blunt ocular trauma in childhood. The medical records of 136 patients diagnosed as grade 3 or 4 hyphema due to blunt ocular trauma between January 2006 and December 2011 were evaluated. Visual acuity (VA), complications, and medical and surgical treatments were analyzed. Factors affecting visual prognosis were compared in grade 3 and 4 hyphema cases. The mean age of patients was 9.7±4 years. Etiologic factors for trauma were stone in 53 (39%), bead bullet in 25 (18.4%) and others in 58 (42.6%) patients. The most common complication of grade 3 and 4 hyphema was traumatic mydriasis (19.1%), followed by cataract (9.6%) and glaucoma (5.1%). Medical treatment was successful in 114 (83.8%) patients, and 22 (16.2%) patients underwent surgery. Mean initial and final VA of grade 4 patients were found to be significantly lower than those of grade 3 patients. In grade 3 and 4 hyphema due to blunt trauma, visual prognosis worsened in the presence of additional ocular pathologies. Considering the bad visual prognosis of severe hyphema patients, prompt treatment and close follow-up may prevent complications resulting in poor VA.

Primary anastomosis or ostomy in necrotizing enterocolitis?

PubMed

Haricharan, Ramanathapura N; Gallimore, Jade Palazzola; Nasr, Ahmed

2017-11-01

In neonates requiring operation for necrotizing enterocolitis (NEC), the complications due to enterostomy (ES) and the need for another operation to restore continuity have prompted several surgeons to employ primary anastomosis (PA) after resection as the operative strategy of choice. Our objective was to compare primary anastomosis to stoma formation in this population using systematic review and meta-analysis. Publications describing both interventions were identified by searching multiple databases. Appropriate studies that reported outcomes after PA and ES for NEC were included for analysis that was performed using the MedCalc3000 software. Results are reported as odds ratios (OR, 95% CI). No randomized trials were identified. Twelve studies were included for the final analysis. Neonates who underwent PA were associated with significantly less risk of mortality when compared to those who underwent ES (OR 0.34, 95% CI 0.17-0.68, p 0.002), possibly due to differences in severity of NEC. Although the types of complications in these groups were different, there was no significant difference in risk of complication (OR 0.86, 0.55-1.33, p 0.50). In neonates undergoing an operation for severe NEC, there is no significant difference in the risk of complications between primary anastomosis and enterostomy. A definitive suggestion cannot be made regarding the choice of one operative strategy over another.

Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) with multiple vascular complications misdiagnosed as Dubowitz syndrome.

PubMed

Dieks, Jana-Katharina; Baumer, Alessandra; Wilichowski, Ekkehard; Rauch, Anita; Sigler, Matthias

2014-09-01

To date, the genetic basis of Dubowitz syndrome (short stature, microcephaly, facial abnormalities, eczema) is unknown and vascular complications are not known to be associated with this syndrome. In microcephalic osteodysplastic primordial dwarfism type II (MOPD II; disproportionate short statue, microcephaly, facial abnormalities), however, cerebral aneurysms and other vascular abnormalities are frequent complications. MOPD II is a genetic disorder caused by mutations in the pericentrin (PCNT) gene (21q22). We report on a patient who came to our attention as a 22-year-old with subarachnoid bleeding due to a ruptured cranial aneurysm. Until then, the patient was thought and published to have Dubowitz syndrome; previously, he was treated with coronary bypass surgery for extensive coronary angiopathy. Consecutive genetic testing revealed MOPD II. After clinical stabilization, the patient was discharged to a specialized rehabilitation center where he died due to re-rupture of a cranial aneurysm. In patients with short stature-especially when clinical features are accompanied by vascular complications-MOPD II should be considered as a differential diagnosis leading to consecutive genetic testing. After detection of mutations in the PCNT gene, a full vascular status including cerebral imaging and cardiac evaluation needs to be determined in order to analyze vascular abnormalities and initiate prophylactic treatment.

Integrating Markets to Bridge Supply and Demand for Knowledge Intensive Tasks

NASA Astrophysics Data System (ADS)

Overbeek, Sietse; Janssen, Marijn; van Bommel, Patrick

The advent of the knowledge-based economy has underlined the importance of intellectual capital that is possessed by knowledge intensive organizations. Three general observations of knowledge intensive work produced by actors working in such organizations served as the basis for the initiation of this research. First, knowledge intensive tasks become increasingly complex. Second, actors that perform such tasks experience an increase in cognitive load. Third, the desired quality of task performance and the produced task results are at stake due to the aforementioned two developments. In this research we investigate how supply and demand of intangible assets such as knowledge, cognitive characteristics, and quality factors can be matched based on market mechanisms.

The effect of methylphenidate on postural stability under single and dual task conditions in children with attention deficit hyperactivity disorder - a double blind randomized control trial.

PubMed

Jacobi-Polishook, Talia; Shorer, Zamir; Melzer, Itshak

2009-05-15

To investigate the effects of Methylphenidate (MPH) on postural stability in attention deficit hyperactivity disorder (ADHD) children in single and dual task conditions. A randomized controlled double-blind study analyzing postural stability in 24 ADHD children before and after MPH vs. placebo treatments, in three task conditions: (1) Single task, standing still; (2) dual task, standing still performing a memory-attention demanding task; (3) standing still listening to music. MPH resulted in a significant improvement in postural stability during the dual task condition and while listening to music, with no equivalent improvement in placebo controls. MPH improves postural stability in ADHD, especially when an additional task is performed. This is probably due to enhanced attention abilities, thus contributing to improved balance control during performance of tasks that require attention. MPH remains to be studied as a potential drug treatment to improve balance control and physical functioning in other clinical populations.

A transportation-scheduling system for managing silvicultural projects

Treesearch

Jorge F. Valenzuela; H. Hakan Balci; Timothy McDonald

2005-01-01

A silvicultural project encompasses tasks such as sitelevel planning, regeneration, harvestin, and stand-tending treatments. an essential problem in managing silvicultural projects is to efficiently schedule the operations while considering project task due dates and costs of moving scarce resources to specific job locations. Transportation costs represent a...

EEG Correlates of Fluctuation in Cognitive Performance in an Air Traffic Control Task

DTIC Science & Technology

2014-11-01

using non-parametric statistical analysis to identify neurophysiological patterns due to the time-on-task effect. Significant changes in EEG power...EEG, Cognitive Performance, Power Spectral Analysis , Non-Parametric Analysis Document is available to the public through the Internet...3 Performance Data Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 EEG

Electrophysiological Correlates of Semantic Processing in Williams Syndrome

ERIC Educational Resources Information Center

Pinheiro, Ana P.; Galdo-Alvarez, Santaigo; Sampaio, Adriana; Niznikiewicz, Margaret; Goncalves, Oscar F.

2010-01-01

Williams syndrome (WS), a genetic neurodevelopmental disorder due to microdeletion in chromosome 7, has been described as a syndrome with an intriguing socio-cognitive phenotype. Cognitively, the relative preservation of language and face processing abilities coexists with severe deficits in visual-spatial tasks, as well as in tasks involving…

Secondary visual workload capability with primary visual and kinesthetic-tactual displays

NASA Technical Reports Server (NTRS)

Gilson, R. D.; Burke, M. W.; Jagacinski, R. J.

1978-01-01

Subjects performed a cross-adaptive tracking task with a visual secondary display and either a visual or a quickened kinesthetic-tactual (K-T) primary display. The quickened K-T display resulted in superior secondary task performance. Comparisons of secondary workload capability with integrated and separated visual displays indicated that the superiority of the quickened K-T display was not simply due to the elimination of visual scanning. When subjects did not have to perform a secondary task, there was no significant difference between visual and quickened K-T displays in performing a critical tracking task.

Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia

PubMed Central

Vasiliadis, Elias S; Grivas, Theodoros B; Psarakis, Spyridon A; Papavasileiou, Evangelos; Kaspiris, Angelos; Triantafyllopoulos, Georgios

2009-01-01

Background Treatment of distal tibial intra-articular fractures is challenging due to the difficulties in achieving anatomical reduction of the articular surface and the instability which may occur due to ligamentous and soft tissue injury. The purpose of this study is to present an algorithm in the application of external fixation in the management of intra-articular fractures of the distal tibia either from axial compression or from torsional forces. Materials and methods Thirty two patients with intra-articular fractures of the distal tibia have been studied. Based on the mechanism of injury they were divided into two groups. Group I includes 17 fractures due to axial compression and group II 15 fractures due to torsional force. An Ilizarov external fixation was used in 15 patients (11 of group I and 4 of group II). In 17 cases (6 of group I and 11 of group II) a unilateral hinged external fixator was used. In 7 out of 17 fractures of group I an additional fixation of the fibula was performed. Results All fractures were healed. The mean time of removal of the external fixator was 11 weeks for group I and 10 weeks for group II. In group I, 5 patients had radiological osteoarthritic lesions (grade III and IV) but only 2 were symptomatic. Delayed union occurred in 3 patients of group I with fixed fibula. Other complications included one patient of group II with subluxation of the ankle joint after removal of the hinged external fixator, in 2 patients reduction found to be insufficient during the postoperative follow up and were revised and 6 patients had a residual pain. The range of ankle joint motion was larger in group II. Conclusion Intra-articular fractures of the distal tibia due to axial compression are usually complicated with cartilaginous problems and are requiring anatomical reduction of the articular surface. Fractures due to torsional forces are complicated with ankle instability and reduction should be augmented with ligament repair, in order to restore normal movement of talus against the mortise. Both Ilizarov and hinged external fixators are unable to restore ligamentous stability. External fixation is recommended only for fractures of the ankle joint caused by axial compression because it is biomechanically superior and has a lower complication rate. PMID:19754962

Biological and technical complications and failures with fixed partial dentures (FPD) on implants and teeth after four to five years of function.

PubMed

Brägger, U; Aeschlimann, S; Bürgin, W; Hämmerle, C H; Lang, N P

2001-02-01

The aim of this study was to compare the frequency of biological and technical complications with fixed partial dentures (FPDs) on implants, teeth and as mixed tooth-implant supported FPDs over 4 to 5 years of function. All implants belonged to the ITI Dental Implant System. Group I-I (implant FPD) included 33 patients with 40 FPDs, group T-T (tooth FPDs) 40 patients with 58 FPDs, group I-T (mixed tooth-implant FPDs) 15 with 18 FPD. Of the bridge abutments 144 were teeth and 105 were implants. The median number of units replaced by the FPDs was 3 (range 2-14). The mean age of the patients was 55.7 years (range 23-83). Complete failures resulted in the loss of one FPD in each group. Two implants were lost due to fracture secondarily to development of a bone defect. One tooth had a vertical fracture and 1 tooth was lost due to periodontitis. Biological complications (peri-implantitis, PPD > or = 5 mm and BOP+) occurred at 9.6% (10) of the implants. This number was, however, reduced to 5% if the threshold for definition of peri-implantitis was set at PPD > or = 6 mm and BOP+. Biological complications occurred in 11.8% (17) of the abutment teeth (NS compared to implants); 2.8% (4) had secondary caries, 4.9% (7) endodontic problems and 4.1% (6) had periodontitis (PPD > or = 5 mm, BOP+). Ten out of 32 patients with a general health problem indicated a biological complication, whereas 9 out of 53 patients with no general health problem had a biological complication (chi 2: NS). Statistically significantly more technical complications were found in FPDs on implants (chi 2, P < or = 0.05). The technical complications were associated with bruxism. Out of 10 bruxers 6 had a technical complication whereas 13 out of 75 non-bruxers had such a complication (chi 2 < or = 0.01). Extensions were associated with more technical complications (13 out of 35 with extensions versus 9 out of 81 without). In conclusion, favourable clinical conditions were found at tooth and implant abutments after 4-5 years of function. Loss of FPD over 4-5 years occurred at a similar rate with mixed, implant or tooth supported reconstructions. Significantly more porcelain fractures were found in FPDs on implants. Impaired general health status was not significantly associated with more biological failures but bruxism as well as extensions were associated with more technical failures.

Elephantiasis nostras verrucosa: a rare complication of lower limb lymphoedema.

PubMed

Kar Keong, Neoh; Siing Ngi, Angelina Tang; Muniandy, Pubalan; Voon Fei, Wong

2017-08-28

We reported a case of a 49-year-old man who had chronic lymphoedema of bilateral lower limbs for 30 years, but he did not seek treatment. His disease was complicated with irreversible changes of elephantiasis nostras verrucosa and had recurrent admissions due to infection. He was not keen for surgical intervention. This case report illustrated a rare and non-reversible complication of a common skin disease, lymphoedema and also the importance of identifying and treating it early. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Neonatal alloimmune thrombocytopenia with HLA alloimmunization: case report with immunohematologic and placental findings.

PubMed

De Tar, Michael W; Klohe, Ellen; Grosset, Alan; Rau, Thomas

2002-01-01

Severe neonatal thrombocytopenia is associated with a significant risk of neonatal bleeding complications. It may result from increased consumption, increased destruction, deficient production, or abnormal sequestration within the spleen. When immune mediated, most cases of clinically significant neonatal thrombocytopenia are due to maternal alloimmunization to paternally derived platelet antigens present on fetal platelets. We present the clinical, placental, and immunohematologic findings of a case of severe neonatal alloimmune thrombocytopenia (NAITP) complicated by additional HLA group alloimmunization. The placenta showed chronic villitis of unknown etiology (VUE) and diffuse microthrombi within the villous capillaries, indicating that abnormal thrombogenesis can be a complication of severe NAITP.