Petri nets as a modeling tool for discrete concurrent tasks of the human operator. [describing sequential and parallel demands on human operators

NASA Technical Reports Server (NTRS)

Schumacher, W.; Geiser, G.

1978-01-01

The basic concepts of Petri nets are reviewed as well as their application as the fundamental model of technical systems with concurrent discrete events such as hardware systems and software models of computers. The use of Petri nets is proposed for modeling the human operator dealing with concurrent discrete tasks. Their properties useful in modeling the human operator are discussed and practical examples are given. By means of and experimental investigation of binary concurrent tasks which are presented in a serial manner, the representation of human behavior by Petri nets is demonstrated.

75 FR 5042 - Initiation of Five-year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-01

... DEPARTMENT OF COMMERCE International Trade Administration Initiation of Five-year (``Sunset... of Commerce (``the Department'') is automatically initiating a five-year review (``Sunset Review...'') is publishing concurrently with this notice its notice of Institution of Five-year Review which...

Concurrent malaria and typhoid fever in the tropics: the diagnostic challenges and public health implications.

PubMed

Uneke, C J

2008-06-01

Malaria and typhoid fever still remain diseases of major public health importance in the tropics. Individuals in areas endemic for both the diseases are at substantial risk of contracting both these diseases, either concurrently or an acute infection superimposed on a chronic one. The objective of this report was to systematically review scientific data from studies conducted in the tropics on concurrent malaria and typhoid fever within the last two decades (1987-2007), to highlight the diagnostic challenges and the public health implications. Using the MedLine Entrez-PubMed search, relevant publications were identified for the review via the key words Malaria and Typhoid fever, which yielded 287 entries as of January 2008. Most of the studies reviewed expressed concern that poor diagnosis continues to hinder effective control of concurrent malaria and typhoid fever in the tropics due to: non-specific clinical presentation of the diseases; high prevalence of asymptomatic infections; lack of resources and insufficient access to trained health care providers and facilities; and widespread practice of self-treatment for clinically suspected malaria or typhoid fever. There were considerably higher rates of concurrent malaria and typhoid fever by Widal test compared to the bacteriological culture technique. Although culture technique remains the gold standard in typhoid fever diagnosis, Widal test is still of significant diagnostic value provided judicious interpretation of the test is made against a background of pertinent information. Malaria could be controlled through interventions to minimize human-vector contact, while improved personal hygiene, targeted vaccination campaigns and intensive community health education could help to control typhoid fever in the tropics.

Concurrent chemo-radiotherapy with S-1 as an alternative therapy for elderly Chinese patients with non-metastatic esophageal squamous cancer: evidence based on a systematic review and meta-analysis.

PubMed

Song, Guo-Min; Tian, Xu; Liu, Xiao-Ling; Chen, Hui; Zhou, Jian-Guo; Bian, Wei; Chen, Wei-Qing

2017-06-06

This systematic review and meta-analysis aims to systematically assess the effects of concurrent chemo-radiotherapy (CRT) compared with radiotherapy (RT) alone for elderly Chinese patients with non-metastatic esophageal squamous cancer. We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), China Biomedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) databases. We retrieved randomized controlled trials on concurrent CRT with Gimeraciland Oteracil Porassium (S-1) compared with RT alone for aged Chinese patients with non-metastatic esophageal squamous cancer performed until August 2016. Eight eligible studies involving 536 patients were subjected to meta-analysis. As a response rate measure, a relative risk (RR) of 1.37 [95% confidence intervals (CIs): 1.24, 1.53; P = 0.00], which reached statistical significance, was estimated when concurrent CRT with S-1 was performed compared with RT alone. Sensitivity analysis on response rate confirmed the robustness of the pooled result. The RR values of 1.44 (95% CIs: 1.22, 1.70; P = 0.00) and 1.77 (95% CIs: 1.26, 2.48; P = 0.00) estimated for 1- and 2-year survival rate indices, respectively, were also statistically significant. The incidence of adverse events was similar in both groups. This review concluded that concurrent CRT with S-1 can improve the efficacy and prolong the survival period of elderly Chinese patients with non-metastatic esophageal squamous cancer and does not significantly increase the acute adverse effects of RT alone.

Dynamic MRI to quantify musculoskeletal motion: A systematic review of concurrent validity and reliability, and perspectives for evaluation of musculoskeletal disorders.

PubMed

Borotikar, Bhushan; Lempereur, Mathieu; Lelievre, Mathieu; Burdin, Valérie; Ben Salem, Douraied; Brochard, Sylvain

2017-01-01

To report evidence for the concurrent validity and reliability of dynamic MRI techniques to evaluate in vivo joint and muscle mechanics, and to propose recommendations for their use in the assessment of normal and impaired musculoskeletal function. The search was conducted on articles published in Web of science, PubMed, Scopus, Academic search Premier, and Cochrane Library between 1990 and August 2017. Studies that reported the concurrent validity and/or reliability of dynamic MRI techniques for in vivo evaluation of joint or muscle mechanics were included after assessment by two independent reviewers. Selected articles were assessed using an adapted quality assessment tool and a data extraction process. Results for concurrent validity and reliability were categorized as poor, moderate, or excellent. Twenty articles fulfilled the inclusion criteria with a mean quality assessment score of 66% (±10.4%). Concurrent validity and/or reliability of eight dynamic MRI techniques were reported, with the knee being the most evaluated joint (seven studies). Moderate to excellent concurrent validity and reliability were reported for seven out of eight dynamic MRI techniques. Cine phase contrast and real-time MRI appeared to be the most valid and reliable techniques to evaluate joint motion, and spin tag for muscle motion. Dynamic MRI techniques are promising for the in vivo evaluation of musculoskeletal mechanics; however results should be evaluated with caution since validity and reliability have not been determined for all joints and muscles, nor for many pathological conditions.

Gray Bananas and a Red Letter A - From Synesthetic Sensation to Memory Colors.

PubMed

Weiss, Franziska; Greenlee, Mark W; Volberg, Gregor

2018-01-01

Grapheme-color synesthesia is a condition in which objectively achromatic graphemes induce concurrent color experiences. While it was long thought that the colors emerge during perception, there is growing support for the view that colors are integral to synesthetes' cognitive representations of graphemes. In this work, we review evidence for two opposing theories positing either a perceptual or cognitive origin of concurrent colors: the cross-activation theory and the conceptual-mediation model. The review covers results on inducer and concurrent color processing as well as findings concerning the brain structure and grapheme-color mappings in synesthetes and trained mappings in nonsynesthetes. The results support different aspects of both theories. Finally, we discuss how research on memory colors could provide a new perspective in the debate about the level of processing at which the synesthetic colors occur.

Ethnic Studies, Policies, and Programs: A Response to Assembly Concurrent Resolution 71.

ERIC Educational Resources Information Center

Petersen, Allan; Cepeda, Rita

Assembly Concurrent Resolution 71 (ACR 71) requests California's three public segments of higher education to review those policies and programs that are aimed at ensuring that all graduates "possess an understanding and awareness of non-white ethnic groups" and to consider adopting necessary policies to ensure that goal. This report…

Systematic review of the concurrent and predictive validity of MRI biomarkers in OA

PubMed Central

Hunter, D.J.; Zhang, W.; Conaghan, Philip G.; Hirko, K.; Menashe, L.; Li, L.; Reichmann, W.M.; Losina, E.

2012-01-01

SUMMARY Objective To summarize literature on the concurrent and predictive validity of MRI-based measures of osteoarthritis (OA) structural change. Methods An online literature search was conducted of the OVID, EMBASE, CINAHL, PsychInfo and Cochrane databases of articles published up to the time of the search, April 2009. 1338 abstracts obtained with this search were preliminarily screened for relevance by two reviewers. Of these, 243 were selected for data extraction for this analysis on validity as well as separate reviews on discriminate validity and diagnostic performance. Of these 142 manuscripts included data pertinent to concurrent validity and 61 manuscripts for the predictive validity review. For this analysis we extracted data on criterion (concurrent and predictive) validity from both longitudinal and cross-sectional studies for all synovial joint tissues as it relates to MRI measurement in OA. Results Concurrent validity of MRI in OA has been examined compared to symptoms, radiography, histology/pathology, arthroscopy, CT, and alignment. The relation of bone marrow lesions, synovitis and effusion to pain was moderate to strong. There was a weak or no relation of cartilage morphology or meniscal tears to pain. The relation of cartilage morphology to radiographic OA and radiographic joint space was inconsistent. There was a higher frequency of meniscal tears, synovitis and other features in persons with radiographic OA. The relation of cartilage to other constructs including histology and arthroscopy was stronger. Predictive validity of MRI in OA has been examined for ability to predict total knee replacement (TKR), change in symptoms, radiographic progression as well as MRI progression. Quantitative cartilage volume change and presence of cartilage defects or bone marrow lesions are potential predictors of TKR. Conclusion MRI has inherent strengths and unique advantages in its ability to visualize multiple individual tissue pathologies relating to pain and also predict clinical outcome. The complex disease of OA which involves an array of tissue abnormalities is best imaged using this imaging tool. PMID:21396463

Concurrent apatinib and local radiation therapy for advanced gastric cancer: A case report and review of the literature.

PubMed

Zhang, Ming; Deng, Weiye; Cao, Xiaoci; Shi, Xiaoming; Zhao, Huanfen; Duan, Zheping; Lv, Bonan; Liu, Bin

2017-03-01

Apatinib is a novel anti-angiogenic agent targeting vascular endothelial growth factor receptor-2, which is effective in patients with chemotherapy-refractory gastric cancer. There are no reports of concurrent apatinib with local radiation therapy in elderly patients with advanced gastric cancer. PATIENT CONCERNS AND DIAGNOSES:: we present the first published report of a 70-year-old male patient with advanced gastric cancer who received concurrent apatinib and local radiation therapy after failure of oxaliplatin and S-1 chemotherapy. The patient received concurrent apatinib and local radiation therapy and was followed up 7 months after therapy without disease progress, 14 months later indicated extensive metastasis and this patient died of pulmonary infection. Elderly patients with advanced gastric cancer may benefit from concurrent apatinib with local radiation therapy when chemotherapy is not tolerated or successful. Further studies are needed to investigate the clinical outcomes and toxicities associated with concurrent apatinib and radiation therapy in gastric cancer.

49 CFR 520.29 - Internal review of final environmental impact statements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... FEIS to TES for concurrence. Unless other notification is provided within 2 weeks after receipt in TES, the statement will be considered concurred in by TES. (b) After concurrence by TES, the FEIS will be... approval of the Secretary or Deputy Secretary pursuant to a request by them or by TES, TGC, or the NHTSA...

49 CFR 520.29 - Internal review of final environmental impact statements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... FEIS to TES for concurrence. Unless other notification is provided within 2 weeks after receipt in TES, the statement will be considered concurred in by TES. (b) After concurrence by TES, the FEIS will be... approval of the Secretary or Deputy Secretary pursuant to a request by them or by TES, TGC, or the NHTSA...

49 CFR 520.29 - Internal review of final environmental impact statements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... FEIS to TES for concurrence. Unless other notification is provided within 2 weeks after receipt in TES, the statement will be considered concurred in by TES. (b) After concurrence by TES, the FEIS will be... approval of the Secretary or Deputy Secretary pursuant to a request by them or by TES, TGC, or the NHTSA...

49 CFR 520.29 - Internal review of final environmental impact statements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... FEIS to TES for concurrence. Unless other notification is provided within 2 weeks after receipt in TES, the statement will be considered concurred in by TES. (b) After concurrence by TES, the FEIS will be... approval of the Secretary or Deputy Secretary pursuant to a request by them or by TES, TGC, or the NHTSA...

Gray Bananas and a Red Letter A — From Synesthetic Sensation to Memory Colors

PubMed Central

Weiss, Franziska; Volberg, Gregor

2018-01-01

Grapheme–color synesthesia is a condition in which objectively achromatic graphemes induce concurrent color experiences. While it was long thought that the colors emerge during perception, there is growing support for the view that colors are integral to synesthetes’ cognitive representations of graphemes. In this work, we review evidence for two opposing theories positing either a perceptual or cognitive origin of concurrent colors: the cross-activation theory and the conceptual-mediation model. The review covers results on inducer and concurrent color processing as well as findings concerning the brain structure and grapheme–color mappings in synesthetes and trained mappings in nonsynesthetes. The results support different aspects of both theories. Finally, we discuss how research on memory colors could provide a new perspective in the debate about the level of processing at which the synesthetic colors occur. PMID:29899968

Dynamic MRI to quantify musculoskeletal motion: A systematic review of concurrent validity and reliability, and perspectives for evaluation of musculoskeletal disorders

PubMed Central

Lempereur, Mathieu; Lelievre, Mathieu; Burdin, Valérie; Ben Salem, Douraied; Brochard, Sylvain

2017-01-01

Purpose To report evidence for the concurrent validity and reliability of dynamic MRI techniques to evaluate in vivo joint and muscle mechanics, and to propose recommendations for their use in the assessment of normal and impaired musculoskeletal function. Materials and methods The search was conducted on articles published in Web of science, PubMed, Scopus, Academic search Premier, and Cochrane Library between 1990 and August 2017. Studies that reported the concurrent validity and/or reliability of dynamic MRI techniques for in vivo evaluation of joint or muscle mechanics were included after assessment by two independent reviewers. Selected articles were assessed using an adapted quality assessment tool and a data extraction process. Results for concurrent validity and reliability were categorized as poor, moderate, or excellent. Results Twenty articles fulfilled the inclusion criteria with a mean quality assessment score of 66% (±10.4%). Concurrent validity and/or reliability of eight dynamic MRI techniques were reported, with the knee being the most evaluated joint (seven studies). Moderate to excellent concurrent validity and reliability were reported for seven out of eight dynamic MRI techniques. Cine phase contrast and real-time MRI appeared to be the most valid and reliable techniques to evaluate joint motion, and spin tag for muscle motion. Conclusion Dynamic MRI techniques are promising for the in vivo evaluation of musculoskeletal mechanics; however results should be evaluated with caution since validity and reliability have not been determined for all joints and muscles, nor for many pathological conditions. PMID:29232401

Concurrent partnerships and HIV: an inconvenient truth

PubMed Central

2011-01-01

The strength of the evidence linking concurrency to HIV epidemic severity in southern and eastern Africa led the Joint United Nations Programme on HIV/AIDS and the Southern African Development Community in 2006 to conclude that high rates of concurrent sexual partnerships, combined with low rates of male circumcision and infrequent condom use, are major drivers of the AIDS epidemic in southern Africa. In a recent article in the Journal of the International AIDS Society, Larry Sawers and Eileen Stillwaggon attempt to challenge the evidence for the importance of concurrency and call for an end to research on the topic. However, their "systematic review of the evidence" is not an accurate summary of the research on concurrent partnerships and HIV, and it contains factual errors concerning the measurement and mathematical modelling of concurrency. Practical prevention-oriented research on concurrency is only just beginning. Most interventions to raise awareness about the risks of concurrency are less than two years old; few evaluations and no randomized-controlled trials of these programmes have been conducted. Determining whether these interventions can help people better assess their own risks and take steps to reduce them remains an important task for research. This kind of research is indeed the only way to obtain conclusive evidence on the role of concurrency, the programmes needed for effective prevention, the willingness of people to change behaviour, and the obstacles to change. PMID:21406080

Effectiveness of concurrent procedures during high tibial osteotomy for medial compartment osteoarthritis: a systematic review and meta-analysis.

PubMed

Lee, O-Sung; Ahn, Soyeon; Ahn, Jin Hwan; Teo, Seow Hui; Lee, Yong Seuk

2018-02-01

The purpose of this systematic review and meta-analysis was to evaluate the efficacy of concurrent cartilage procedures during high tibial osteotomy (HTO) for medial compartment osteoarthritis (OA) by comparing the outcomes of studies that directly compared the use of HTO plus concurrent cartilage procedures versus HTO alone. Results that are possible to be compared in more than two articles were presented as forest plots. A 95% confidence interval was calculated for each effect size, and we calculated the I 2 statistic, which presents the percentage of total variation attributable to the heterogeneity among studies. The random effects model was used to calculate the effect size. Seven articles were included to the final analysis. Case groups were composed of HTO without concurrent procedures and control groups were composed of HTO with concurrent procedures such as marrow stimulation procedure, mesenchymal stem cell transplantation, and injection. The case group showed a higher hospital for special surgery score and mean difference was 4.10 [I 2 80.8%, 95% confidence interval (CI) - 9.02 to 4.82]. Mean difference of the mechanical femorotibial angle in five studies was 0.08° (I 2 0%, 95% CI - 0.26 to 0.43). However, improved arthroscopic, histologic, and MRI results were reported in the control group. Our analysis support that concurrent procedures during HTO for medial compartment OA have little beneficial effect regarding clinical and radiological outcomes. However, they might have some beneficial effects in terms of arthroscopic, histologic, and MRI findings even though the quality of healed cartilage is not good as that of original cartilage. Therefore, until now, concurrent procedures for medial compartment OA have been considered optional. Nevertheless, no conclusions can be drawn for younger patients with focal cartilage defects and concomitant varus deformity. This question needs to be addressed separately.

Methods for design and evaluation of integrated hardware-software systems for concurrent computation

NASA Technical Reports Server (NTRS)

Pratt, T. W.

1985-01-01

Research activities and publications are briefly summarized. The major tasks reviewed are: (1) VAX implementation of the PISCES parallel programming environment; (2) Apollo workstation network implementation of the PISCES environment; (3) FLEX implementation of the PISCES environment; (4) sparse matrix iterative solver in PSICES Fortran; (5) image processing application of PISCES; and (6) a formal model of concurrent computation being developed.

10 CFR 1022.11 - Floodplain or wetland determination.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Floodplain or wetland determination. 1022.11 Section 1022.11 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.11 Floodplain or wetland determination. (a) Concurrent with its review...

10 CFR 1022.11 - Floodplain or wetland determination.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Floodplain or wetland determination. 1022.11 Section 1022.11 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.11 Floodplain or wetland determination. (a) Concurrent with its review...

10 CFR 1022.11 - Floodplain or wetland determination.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Floodplain or wetland determination. 1022.11 Section 1022.11 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.11 Floodplain or wetland determination. (a) Concurrent with its review...

10 CFR 1022.11 - Floodplain or wetland determination.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Floodplain or wetland determination. 1022.11 Section 1022.11 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) COMPLIANCE WITH FLOODPLAIN AND WETLAND ENVIRONMENTAL REVIEW REQUIREMENTS Procedures for Floodplain and Wetland Reviews § 1022.11 Floodplain or wetland determination. (a) Concurrent with its review...

Olfactory-Induced Synesthesias: A Review and Model

ERIC Educational Resources Information Center

Stevenson, Richard J.; Tomiczek, Caroline

2007-01-01

Recent reviews of synesthesia concentrate upon rare neurodevelopmental examples and exclude common olfactory-induced experiences with which they may profitably be compared. Like the neurodevelopmental synesthesias, odor-induced experiences involve different sensory modalities; are reliable, asymmetric (concurrents cannot induce), and automatic;…

An Inadvertent Concurrent Replication: Same Roadmap, Different Journey

ERIC Educational Resources Information Center

Lemons, Christopher J.; King, Seth A.; Davidson, Kimberly A.; Berryessa, Teresa L.; Gajjar, Shimul A.; Sacks, Lia H.

2016-01-01

Replication is a critical aspect of scientific inquiry that presents a variety of challenges to researchers, even under the best of conditions. We conducted a review of replication rates in special education journals similar to the review conducted by Makel et al. in this issue. Unknowingly conducting independent reviews allowed for an unexpected…

Implementation of the Southwestern Oncology Group Committee on Women’s Health Research Agenda: A Special Sabbatical for the Chairperson.

DTIC Science & Technology

1996-07-01

phase II study 1987-1989 Principal Investigator, Loyola/Hines pilot study of cisplatin preceded by concurrent cytarabine and oral hydroxyurea in...Investigator, Loyola/Hines pilot study of cisplatin preceded by concurrent 31 5 intravenous hydroxyurea and cytarabine . 1989-1992 Primary Study Coordinator...Conference: Modulation of cisplatin resistance by cytarabine and hydroxyurea. Illinois Cancer Council Annual Symposium: Review of Breast Cancer Growth

Concurrent orthopedic and neurosurgical procedures in pediatric patients with spinal deformity.

PubMed

Mooney, James F; Glazier, Stephen S; Barfield, William R

2012-11-01

The management of pediatric patients with complex spinal deformity often requires both an orthopedic and a neurosurgical intervention. The reasons for multiple subspecialty involvement include, but are not limited to, the presence of a tethered cord requiring release or a syrinx requiring decompression. It has been common practice to perform these procedures in a staged manner, although there is little evidence in the literature to support separate interventions. We reviewed a series of consecutive patients who underwent spinal deformity correction and a neurosurgical intervention concurrently in an attempt to assess the safety, efficacy, and possible complications associated with such an approach. Eleven patients were reviewed who underwent concurrent orthopedic and neurosurgical procedures. Data were collected for patient demographics, preoperative diagnosis, procedures performed, intraoperative and perioperative complications, as well as any unexpected return to the operating room for any reason. Operative notes and anesthesia records were reviewed to determine estimated blood loss, surgical time, and the use of intraoperative neurological monitoring. Patient diagnoses included myelodysplasia (N=6), congenital scoliosis and/or kyphosis (N=4), and scoliosis associated with Noonan syndrome (N=1). Age at the time of surgery averaged 9 years 2 months (range=14 months to 17 years 2 months). Estimated blood loss averaged 605 ml (range=50-3000 ml). The operative time averaged 313 min (range=157-477 min). There were no intraoperative complications, including incidental dural tears or deterioration in preoperative neurological status. One patient developed a sore associated with postoperative cast immobilization that led to a deep wound infection. It appears that concurrent orthopedic and neurosurgical procedures in pediatric patients with significant spinal deformities can be performed safely and with minimal intraoperative and postoperative complications when utilizing modern surgical and neuromonitoring techniques. Level of evidence=Level IV. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Radical-intent hypofractionated radiotherapy for locally advanced non-small-cell lung cancer: a systematic review of the literature.

PubMed

Kaster, Tyler S; Yaremko, Brian; Palma, David A; Rodrigues, George B

2015-03-01

To identify survival and toxicity characteristics associated with radical-intent hypofractionated radiotherapy for the treatment of stage III non-small-cell lung cancer (NSCLC). Relevant studies were identified from a systematic PubMed search of articles published between January 1990 and January 2014. All studies were peer reviewed and included both retrospective and prospective studies of NSCLC patients being treated with radical hypofractionated radiotherapy. Data on overall survival (OS) and toxicity were extracted from each of the studies where available. Of 685 studies initially identified by the search, a total of 33 studies were found to be relevant and were included in this systematic review. The number of fractions ranged from 15 to 35, the dose per fraction ranged from 2.3 to 3.5 Gy, and the delivered dose ranged from 45.0 to 85.5 Gy. Fifteen of the studies included concurrent chemotherapy, while 18 did not. OS was found to be associated with tumor biological effective dose, with the Pearson correlation coefficient ranging from 0.34 to 0.48. For both concurrent and nonconcurrent chemoradiotherapy acute pulmonary, late esophageal and late pulmonary incidences of toxicity ranged from 1.2% to 12.2%, but had 95% confidence intervals that included zero. The greatest incidence of toxicity was acute esophageal toxicity at 14.9% (95% confidence interval, 0.7%, 29.1%). There is a moderate linear relationship between biological effective dose and OS, and greater acute esophageal toxicity with concurrent chemotherapy. Improving outcomes in stage III NSCLC may involve some form of hypofractionation in the context of systemic concurrent therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

28 CFR 91.67 - State Environmental Policy Acts.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Environmental Impact Review Procedures for VOI/TIS Grant Program Other State and Federal Law Requirements § 91... that any state, local, or tribal environmental impact review requirements similar to the Federal NEPA procedures will be met concurrently, to the extent possible, through requesting the appropriate non-federal...

28 CFR 91.67 - State Environmental Policy Acts.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Environmental Impact Review Procedures for VOI/TIS Grant Program Other State and Federal Law Requirements § 91... that any state, local, or tribal environmental impact review requirements similar to the Federal NEPA procedures will be met concurrently, to the extent possible, through requesting the appropriate non-federal...

28 CFR 91.67 - State Environmental Policy Acts.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Environmental Impact Review Procedures for VOI/TIS Grant Program Other State and Federal Law Requirements § 91... that any state, local, or tribal environmental impact review requirements similar to the Federal NEPA procedures will be met concurrently, to the extent possible, through requesting the appropriate non-federal...

28 CFR 91.67 - State Environmental Policy Acts.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Environmental Impact Review Procedures for VOI/TIS Grant Program Other State and Federal Law Requirements § 91... that any state, local, or tribal environmental impact review requirements similar to the Federal NEPA procedures will be met concurrently, to the extent possible, through requesting the appropriate non-federal...

Primary tracheoesophageal puncture and cricopharyngeal myotomy in stapler-assisted total laryngectomy.

PubMed

Beswick, D M; Damrose, E J

2016-07-01

To evaluate the utility of the hybrid tracheoesophageal puncture procedure in stapler-assisted laryngectomy. Patients who underwent total laryngectomy at a single institution from 2009 to 2015 were reviewed. The interventions assessed were surgical creation of a tracheoesophageal puncture and placement of a voice prosthesis. The outcomes measured included voicing ability and valve failure. Thirty-nine patients underwent total laryngectomy or pharyngolaryngectomy. Of these, nine underwent stapler-assisted laryngectomy; seven of the nine patients underwent concurrent stapler-assisted laryngectomy, cricopharyngeal myotomy and a hybrid tracheoesophageal puncture procedure. These seven patients were the focus of this review. Successful voicing and oral alimentation was achieved in all patients. Mean time to phonation was 30 days (range, 7-77 days) and mean time to first valve change was 90 days (range, 35-117 days). Primary tracheoesophageal puncture with concurrent voice prosthesis placement and cricopharyngeal myotomy is easily performed with stapler-assisted laryngectomy. The hybrid tracheoesophageal puncture procedure is a simple method that enables a single operator to achieve primary tracheoesophageal puncture and valve placement; in addition, it facilitates concurrent cricopharyngeal myotomy.

Local Working Agreements and the Tennessee SOPs

EPA Pesticide Factsheets

TN Interagency workgroup convened to improve communication and Coordination, identify permit requirements, implement concurrent reviews, reduce permit revisions; and develop coordinated JD/Pre-App process

14 CFR 1260.17 - Evaluation and selection of unsolicited proposals.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... NASA recommends contact with NASA technical personnel before submission of an unsolicited proposal to...) prepared by the cognizant technical office. The JAUP shall be submitted for the approval of the grant officer after review and concurrence at a level above the technical officer. However, review and...

Entanglement in the Anisotropic Kondo Necklace Model

NASA Astrophysics Data System (ADS)

Mendoza-Arenas, J. J.; Franco, R.; Silva-Valencia, J.

We study the entanglement in the one-dimensional Kondo necklace model with exact diagonalization, calculating the concurrence as a function of the Kondo coupling J and an anisotropy η in the interaction between conduction spins, and we review some results previously obtained in the limiting cases η = 0 and 1. We observe that as J increases, localized and conduction spins get more entangled, while neighboring conduction spins diminish their concurrence; localized spins require a minimum concurrence between conduction spins to be entangled. The anisotropy η diminishes the entanglement for neighboring spins when it increases, driving the system to the Ising limit η = 1 where conduction spins are not entangled. We observe that the concurrence does not give information about the quantum phase transition in the anisotropic Kondo necklace model (between a Kondo singlet and an antiferromagnetic state), but calculating the von Neumann block entropy with the density matrix renormalization group in a chain of 100 sites for the Ising limit indicates that this quantity is useful for locating the quantum critical point.

Cumulative cisplatin dose in concurrent chemoradiotherapy for head and neck cancer: A systematic review.

PubMed

Strojan, Primož; Vermorken, Jan B; Beitler, Jonathan J; Saba, Nabil F; Haigentz, Missak; Bossi, Paolo; Worden, Francis P; Langendijk, Johannes A; Eisbruch, Avraham; Mendenhall, William M; Lee, Anne W M; Harrison, Louis B; Bradford, Carol R; Smee, Robert; Silver, Carl E; Rinaldo, Alessandra; Ferlito, Alfio

2016-04-01

The optimal cumulative dose and timing of cisplatin administration in various concurrent chemoradiotherapy protocols for nonmetastatic head and neck squamous cell carcinoma (HNSCC) has not been determined. The absolute survival benefit at 5 years of concurrent chemoradiotherapy protocols versus radiotherapy alone observed in prospective randomized trials reporting on the use of cisplatin monochemotherapy for nonnasopharyngeal HNSCC was extracted. In the case of nonrandomized studies, the outcome results at 2 years were compared between groups of patients receiving different cumulative cisplatin doses. Eleven randomized trials and 7 nonrandomized studies were identified. In 6 definitive radiotherapy phase III trials, a statistically significant association (p = .027) between cumulative cisplatin dose, independent of the schedule, and overall survival benefit was observed for higher doses. Results support the conclusion that the cumulative dose of cisplatin in concurrent chemoradiation protocols for HNSCC has a significant positive correlation with survival. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2151-E2158, 2016. © 2015 Wiley Periodicals, Inc.

14 CFR 1216.320 - Environmental review and consultation requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., assessments, and any impact statement preparation concurrently with environmental reviews required by the laws... properties which may be eligible for the National Register within the area of the potential impact of a NASA proposed action. Evaluation of the impact of the NASA action on such properties shall be discussed in draft...

14 CFR 1216.320 - Environmental review and consultation requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., assessments, and any impact statement preparation concurrently with environmental reviews required by the laws... properties which may be eligible for the National Register within the area of the potential impact of a NASA proposed action. Evaluation of the impact of the NASA action on such properties shall be discussed in draft...

14 CFR 1216.320 - Environmental review and consultation requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., assessments, and any impact statement preparation concurrently with environmental reviews required by the laws... properties which may be eligible for the National Register within the area of the potential impact of a NASA proposed action. Evaluation of the impact of the NASA action on such properties shall be discussed in draft...

75 FR 22047 - Intent To Initiate Consultation and Coordinate the National Oceanic and Atmospheric...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

... purposes and policies of the NMSA (73 FR 53161). The management plan review process occurs concurrently... management plan was written as part of the sanctuary designation process and published in the Final... Environmental Impact Statement under the authority of NEPA (73 FR 53161). The management plan review process is...

42 CFR 422.622 - Requesting immediate QIO review of the decision to discharge from the inpatient hospital.

Code of Federal Regulations, 2010 CFR

2010-10-01

... discharge from the inpatient hospital. 422.622 Section 422.622 Public Health CENTERS FOR MEDICARE & MEDICAID... to discharge from the inpatient hospital. (a) Enrollee's right to an immediate QIO review. An... directly or through its utilization committee), with physician concurrence determines that inpatient care...

Is Peer Victimization Associated with Academic Achievement? A Meta-Analytic Review

ERIC Educational Resources Information Center

Nakamoto, Jonathan; Schwartz, David

2010-01-01

This paper presents a meta-analytic review of 33 studies, with a total of 29,552 participants, that examined the concurrent association between peer victimization and academic achievement. The results revealed a small but significant negative correlation between peer victimization and academic achievement under both the random-effects model (r =…

The validity of upper-limb neurodynamic tests for detecting peripheral neuropathic pain.

PubMed

Nee, Robert J; Jull, Gwendolen A; Vicenzino, Bill; Coppieters, Michel W

2012-05-01

The validity of upper-limb neurodynamic tests (ULNTs) for detecting peripheral neuropathic pain (PNP) was assessed by reviewing the evidence on plausibility, the definition of a positive test, reliability, and concurrent validity. Evidence was identified by a structured search for peer-reviewed articles published in English before May 2011. The quality of concurrent validity studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool, where appropriate. Biomechanical and experimental pain data support the plausibility of ULNTs. Evidence suggests that a positive ULNT should at least partially reproduce the patient's symptoms and that structural differentiation should change these symptoms. Data indicate that this definition of a positive ULNT is reliable when used clinically. Limited evidence suggests that the median nerve test, but not the radial nerve test, helps determine whether a patient has cervical radiculopathy. The median nerve test does not help diagnose carpal tunnel syndrome. These findings should be interpreted cautiously, because diagnostic accuracy might have been distorted by the investigators' definitions of a positive ULNT. Furthermore, patients with PNP who presented with increased nerve mechanosensitivity rather than conduction loss might have been incorrectly classified by electrophysiological reference standards as not having PNP. The only evidence for concurrent validity of the ulnar nerve test was a case study on cubital tunnel syndrome. We recommend that researchers develop more comprehensive reference standards for PNP to accurately assess the concurrent validity of ULNTs and continue investigating the predictive validity of ULNTs for prognosis or treatment response.

Concurrent aerobic plus resistance exercise versus aerobic exercise alone to improve health outcomes in paediatric obesity: a systematic review and meta-analysis.

PubMed

García-Hermoso, Antonio; Ramírez-Vélez, Robinson; Ramírez-Campillo, Rodrigo; Peterson, Mark D; Martínez-Vizcaíno, Vicente

2018-02-01

To determine if the combination of aerobic and resistance exercise is superior to aerobic exercise alone for the health of obese children and adolescents. Systematic review with meta-analysis. Computerised search of 3 databases (MEDLINE, EMBASE, and Cochrane Controlled Trials Registry). Studies that compared the effect of supervised concurrent exercise versus aerobic exercise interventions, with anthropometric and metabolic outcomes in paediatric obesity (6-18 years old). The mean differences (MD) of the parameters from preintervention to postintervention between groups were pooled using a random-effects model. 12 trials with 555 youths were included in the meta-analysis. Compared with aerobic exercise alone, concurrent exercise resulted in greater reductions in body mass (MD=-2.28 kg), fat mass (MD=-3.49%; and MD=-4.34 kg) and low-density lipoprotein cholesterol (MD=-10.20 mg/dL); as well as greater increases in lean body mass (MD=2.20 kg) and adiponectin level (MD=2.59 μg/mL). Differences were larger for longer term programmes (>24 weeks). Concurrent aerobic plus resistance exercise improves body composition, metabolic profiles, and inflammatory state in the obese paediatric population. CRD42016039807. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Acute-onset chronic inflammatory demyelinating polyneuropathy with focal segmental glomerulosclerosis.

PubMed

Quek, Amy May Lin; Soon, Derek; Chan, Yee Cheun; Thamboo, Thomas Paulraj; Yuki, Nobuhiro

2014-06-15

Inflammatory neuropathies have been reported to occur in association with nephrotic syndrome. Their underlying immuno-pathogenic mechanisms remain unknown. A 50-year-old woman concurrently presented with acute-onset chronic inflammatory demyelinating polyneuropathy and nephrotic syndrome secondary to focal segmental glomerulosclerosis. Both neuropathy and proteinuria improved after plasma exchange and steroids. Literature review of cases of concurrent inflammatory neuropathies and nephrotic syndrome revealed similar neuro-renal presentations. This neuro-renal condition may be mediated by autoantibodies targeting myelin and podocytes. Copyright © 2014 Elsevier B.V. All rights reserved.

[THE CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF MALARIA CONCURRENT WITH OTHER INFECTIONS AND INVASIONS].

PubMed

Kondrashin, A V; Tokmalaev, A K; Morozov, E N; Morozova, L F

2016-01-01

The present review considers malaria infection concurrent with different species of helminths, bacterial and viral infections, as well as mixed malaria pathogens in the subtropical and tropical countries of the world, causing the clinical picture and epidemiological situation to be different. Malaria co-infections with different pathogenic micro-organisms, such as HIV, tuberculosis, viral hepatitides, and others, affect almost one third of the planet's population. It is known that people who are at risk for malaria may be also at risk for other parasitic and infectious diseases, most commonly helminthisms.

The Viability of a Software Tool to Assist Students in the Review of Literature

ERIC Educational Resources Information Center

Anderson, Timothy R.

2013-01-01

Most doctoral students are novice researchers and may not possess the skills to effectively conduct a comprehensive review of the literature and frame a problem designed to conduct original research. Students need proper training and tools necessary to critically evaluate, synthesize and organize literature. The purpose of this concurrent mixed…

Concurrent chart review provides more accurate documentation and increased calculated case mix index, severity of illness, and risk of mortality.

PubMed

Frazee, Richard C; Matejicka, Anthony V; Abernathy, Stephen W; Davis, Matthew; Isbell, Travis S; Regner, Justin L; Smith, Randall W; Jupiter, Daniel C; Papaconstantinou, Harry T

2015-04-01

Case mix index (CMI) is calculated to determine the relative value assigned to a Diagnosis-Related Group. Accurate documentation of patient complications and comorbidities and major complications and comorbidities changes CMI and can affect hospital reimbursement and future pay for performance metrics. Starting in 2010, a physician panel concurrently reviewed the documentation of the trauma/acute care surgeons. Clarifications of the Centers for Medicare and Medicaid Services term-specific documentation were made by the panel, and the surgeon could incorporate or decline the clinical queries. A retrospective review of trauma/acute care inpatients was performed. The mean severity of illness, risk of mortality, and CMI from 2009 were compared with the 3 subsequent years. Mean length of stay and mean Injury Severity Score by year were listed as measures of patient acuity. Statistical analysis was performed using ANOVA and t-test, with p < 0.05 for significance. Each year demonstrated an increase in severity of illness, risk of mortality, and CMI compared with baseline values (p < 0.05). Length of stay was not significantly different, reflecting similar patient populations throughout the study. Injury Severity Score decreased in 2011 and 2012 compared with 2009, reflecting a lower level of injury in the trauma population. A concurrent documentation review significantly increases severity of illness, risk of mortality, and CMI scores in a trauma/acute care service compared with pre-program levels. These changes reflect more accurate key word documentation rather than a change in patient acuity. The increased scores might impact hospital reimbursement and more accurately stratify outcomes measures for care providers. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Polymeric micelles for multi-drug delivery in cancer.

PubMed

Cho, Hyunah; Lai, Tsz Chung; Tomoda, Keishiro; Kwon, Glen S

2015-02-01

Drug combinations are common in cancer treatment and are rapidly evolving, moving beyond chemotherapy combinations to combinations of signal transduction inhibitors. For the delivery of drug combinations, i.e., multi-drug delivery, major considerations are synergy, dose regimen (concurrent versus sequential), pharmacokinetics, toxicity, and safety. In this contribution, we review recent research on polymeric micelles for multi-drug delivery in cancer. In concurrent drug delivery, polymeric micelles deliver multi-poorly water-soluble anticancer agents, satisfying strict requirements in solubility, stability, and safety. In sequential drug delivery, polymeric micelles participate in pretreatment strategies that "prime" solid tumors and enhance the penetration of secondarily administered anticancer agent or nanocarrier. The improved delivery of multiple poorly water-soluble anticancer agents by polymeric micelles via concurrent or sequential regimens offers novel and interesting strategies for drug combinations in cancer treatment.

Changes in average length of stay and average charges generated following institution of PSRO review.

PubMed Central

Westphal, M; Frazier, E; Miller, M C

1979-01-01

A five-year review of accounting data at a university hospital shows that immediately following institution of concurrent PSRO admission and length of stay review of Medicare-Medicaid patients, there was a significant decrease in length of stay and a fall in average charges generated per patient against the inflationary trend. Similar changes did not occur for the non-Medicare-Medicaid patients who were not reviewed. The observed changes occurred even though the review procedure rarely resulted in the denial of services to patients, suggesting an indirect effect of review. PMID:393658

Design, Development and Utilization Perspectives on Database Management Systems

ERIC Educational Resources Information Center

Shneiderman, Ben

1977-01-01

This paper reviews the historical development of integrated data base management systems and examines competing approaches. Topics include management and utilization, implementation and design, query languages, security, integrity, privacy and concurrency. (Author/KP)

Documenting improved mobility techniques on SIS and TRIP facilities

DOT National Transportation Integrated Search

2007-11-01

The 2005 growth management legislation charged the Florida Department of Transportation (FDOT) with reviewing and providing concurrence on a variety of development types regarding their impacts on the state transportation system. Of particular concer...

Legislative Review. A Look at Higher Education in Week 12: March 23-27, 2009

ERIC Educational Resources Information Center

North Dakota University System, 2009

2009-01-01

This issue of "Legislative Review" takes a look at the news in higher education from March 23 to 27, 2009. It is reported that during this week: (1) work continues on SB 2003, the North Dakota University System (NDUS) budget bill, in the House Appropriations, Education and Environment Division; (2) HCR 3016, a concurrent resolution…

40 CFR 63.93 - Approval of State requirements that substitute for a section 112 rule.

Code of Federal Regulations, 2010 CFR

2010-07-01

... submitted concurrently to the State. (2) If, after review of public comments and any State responses to... include either: State rules, title V permits, title V general permits, Federal new source review permits... applicable to the source even if it takes steps that would otherwise release it from an obligation to have a...

A critical review of complementary and alternative medicine use among people with arthritis: a focus upon prevalence, cost, user profiles, motivation, decision-making, perceived benefits and communication.

PubMed

Yang, Lu; Sibbritt, David; Adams, Jon

2017-03-01

A critical review of complementary and alternative medicine (CAM) use among people with arthritis was conducted focusing upon prevalence and profile of CAM users as well as their motivation, decision-making, perceived benefits and communication with healthcare providers. A comprehensive search of peer-reviewed literature published from 2008 to 2015 was undertaken via CINAHL, Medline and AMED databases. The initial search identified 4331 articles, of which 49 articles met selection criteria. The review shows a high prevalence of CAM use (often multiple types and concurrent to conventional medical care) among those with arthritis which is not restricted to any particular geographic or social-economic status. A large proportion of arthritis sufferers using CAM consider these medicines to be somewhat or very effective but almost half do not inform their healthcare provider about their CAM use. It is suggested that rheumatologists and others providing health care for patients with arthritis should be cognizant of the high prevalence of CAM use and the challenges associated with possible concurrent use of CAM and conventional medicine among their patients.

A Characterization of Student Reflections in an Introductory Pharmacy Practice Experience Discussion Course.

PubMed

Dinkins, Melissa M; Haltom, Wesley R

2018-04-01

Objective. To characterize weekly student reflections in an introductory pharmacy practice experience (IPPE) discussion course meeting concurrently with IPPE rotations in institutional pharmacy. Methods. A qualitative analysis was conducted to identify themes within weekly reflective statements submitted by second year pharmacy students (P2) enrolled in an IPPE rotation and concurrent discussion course. Weekly reflections from the 2015-2016 offering of the course were reviewed by investigators to identify common themes via an iterative process. Subsequently, investigators coded each submission into one of the identified categories. Initial agreement between investigators was assessed using the Cohen kappa coefficient. Discrepancies between coding were resolved through discussion to reach consensus. Results. A total of 402 reflection assignments were reviewed from 85 P2 students enrolled in the IPPE course. Ten themes were identified, with the most common themes being interprofessional teamwork, pharmacist and technician roles and responsibilities, and policies and procedures. Substantial initial agreement between investigators was found, with the most discrepancies arising within the themes of medication distribution and pharmacy administration/organizational structure. Conclusion. Student reflections on IPPEs centered on 10 key topics, primarily related to distributive, legal, and regulatory functions of institutional pharmacy practice. Structuring an IPPE rotation longitudinally in an academic term, with a concurrent discussion course, builds a framework for regular student reflection.

Fatal hemorrhagic cystitis induced by pelvic irradiation and cyclophosphamide therapy. Case reports and review

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

Price, W.E.; Keldahl, L.R.

The potent cytotoxic drug cyclophosphamide has been used extensively for neoplastic and non-neoplastic diseases. Patients taking this drug may have received or may be receiving pelvic irradiation concurrently. This report describes two patients who developed fatal hemorrhagic cystitis induced by pelvic irradiation and cyclophosphamide therapy. Etiology, incidence, pathologic descriptions, and diagnostic and therapeutic aspects of this entity are described. The incidence and risk of serious, life-threatening bladder hemorrhage from cyclophosphamide therapy is increased by prior or concurrent pelvic irradiation. Alternative cytotoxic, non-urotoxic chemotherapy should be used in these high-risk patients.

Next-generation concurrent engineering: developing models to complement point designs

NASA Technical Reports Server (NTRS)

Morse, Elizabeth; Leavens, Tracy; Cohanim, Babak; Harmon, Corey; Mahr, Eric; Lewis, Brian

2006-01-01

Concurrent Engineering Design (CED) teams have made routine the rapid development of point designs for space missions. The Jet Propulsion Laboratory's Team X is now evolving into a 'next-generation CED; in addition to a point design, the Team develops a model of the local trade space. The process is a balance between the power of a model developing tools and the creativity of humal experts, enabling the development of a variety of trade models for any space mission. This paper reviews the modeling method and its practical implementation in the ED environment. Example results illustrate the benefit of this approach.

48 CFR 1427.201-2 - Contract clauses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract clauses. 1427.201-2 Section 1427.201-2 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR GENERAL... the CCO with legal review and concurrence. ...

Traffic incident management quick clearance laws : a national review of best practices.

DOT National Transportation Integrated Search

2008-12-01

Constituting Quick Clearance Laws, three types of general legislation Move Over, Driver Removal, and Authority Removal laws - support concurrent Quick Clearance operations intended to enhance motorist and responder safety, as well as reduce...

Diagnostic accuracy of histopathologic and cytopathologic examination of Aspergillus species.

PubMed

Shah, Akeesha A; Hazen, Kevin C

2013-01-01

To assess the diagnostic accuracy of histopatho-logic and cytopathologic examination (HCE) of Aspergillus species (spp), we performed an 11-year retrospective review to correlate surgical/cytology cases with a diagnosis of Aspergillus spp with their concurrent fungal culture results. Diagnostic accuracy was defined as the percentage of cases with culture-proven Aspergillus spp divided by the number of cases diagnosed as Aspergillus spp on HCE that had growth on fungal culture. Ninety surgical/cytology cases with concurrent fungal culture were reviewed, 58 of which grew a fungal organism. Of these 58 cases, 45 grew an Aspergillus spp, whereas 13 grew an organism other than Aspergillus spp, including both common (Scedosporium, Fusarium, and Paecilomyces spp) and uncommon mimickers (Trichosporon loubieri), resulting in a diagnostic accuracy of 78%. The low diagnostic accuracy indicates that several fungal organisms can morphologically mimic Aspergillus spp and can only be distinguished by fungal culture and DNA sequencing.

The impact of indicated prevention and early intervention on co-morbid eating disorder and depressive symptoms: a systematic review.

PubMed

Rodgers, Rachel F; Paxton, Susan J

2014-01-01

Depressive and eating disorder symptoms are highly comorbid. To date, however, little is known regarding the efficacy of existing programs in decreasing concurrent eating disorder and depressive symptoms. We conducted a systematic review of selective and indicated controlled prevention and early intervention programs that assessed both eating disorder and depressive symptoms. We identified a total of 26 studies. The large majority of identified interventions (92%) were successful in decreasing eating disorder symptoms. However fewer than half (42%) were successful in decreasing both eating disorder and depressive symptoms. Intervention and participant characteristics did not predict success in decreasing depressive symptoms. Indicated prevention and early intervention programs targeting eating disorder symptoms are limited in their success in decreasing concurrent depressive symptoms. Further efforts to develop more efficient interventions that are successful in decreasing both eating disorder and depressive symptoms are warranted.

Concurrent Use of Cannabis and Alcohol: Neuropsychiatric Effect Consequences.

PubMed

Romaguera, Anna; Torrens, Marta; Papaseit, Esther; Arellano, Ana Lucia; Farré, Magi

2017-01-01

Concurrent use of cannabis and alcohol is frequent. According different studies, the prevalence is among 20-34% depending on different samples studied. In contrast with the wide evidence available about neuropsychiatric effects associated to the use of cannabis or alcohol separately, there are few studies of the neuropsychiatric effects of their combination. Our aim was to review the literature regarding this topic. We performed a search in MEDLINE and from 114 potentially eligible studies, 27 were selected. Most of them studied the relation between cannabis and alcohol, and with them combined to other substances of abuse, but only a few considered their concurrent effect among mental disorders (ADHD, bipolar disorder) and neuropsychological performance. More research in the neuropsychiatric effects of the concomitant use of cannabis and alcohol is needed. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Detection of malignancy in body fluids: a comparison of the hematology and cytology laboratories.

PubMed

Jerz, Jaclyn L; Donohue, Rachel E; Mody, Rayomond R; Schwartz, Mary R; Mody, Dina R; Zieske, Arthur W

2014-05-01

Body fluids submitted to the hematology laboratory for cell counts may also be examined for the presence of malignancy. Previous studies evaluating the hematology laboratory's performance at detecting malignancy in body fluids have reached conflicting conclusions. To investigate the hematology laboratory's ability to detect malignancy in body fluids by comparison with cytology. Retrospective analysis of 414 body fluid samples during an 18-month period, with introduction of new quality assurance measures after the first 210 cases. If no concurrent cytology was ordered, results were compared with recent previous and/or subsequent cytologic, histologic, or flow cytometric diagnoses. Of the initial 210 cases, the hematology laboratory detected 3 of 13 malignancies diagnosed by concurrent cytology (23% sensitivity), with no false-positives (100% specificity). Malignancy was not identified on retrospective review of the hematology slides in the 10 discrepant cases. After the initial study, educational sessions on morphology for the medical technologists and a more thorough hematology-cytology correlation policy were implemented. The subsequent 204 hematology laboratory cases had increased sensitivity for the detection of malignancy (60%; 6 of 10). Definitive features of malignancy were seen in only one discrepant hematology laboratory slide on retrospective review. This case had not been flagged for hematopathologist review. None of the discrepancies before or after implementation of the additional quality assurance measures impacted patient care. Body fluid processing by the hematology laboratory is not optimized for the detection of malignancy. Concurrent cytologic examination is critical for the detection of malignancy, and needs to be considered as cost-saving measures are increasingly implemented.

Inter-examiner classification reliability of Mechanical Diagnosis and Therapy for extremity problems - Systematic review.

PubMed

Takasaki, Hiroshi; Okuyama, Kousuke; Rosedale, Richard

2017-02-01

Mechanical Diagnosis and Therapy (MDT) is used in the treatment of extremity problems. Classifying clinical problems is one method of providing effective treatment to a target population. Classification reliability is a key factor to determine the precise clinical problem and to direct an appropriate intervention. To explore inter-examiner reliability of the MDT classification for extremity problems in three reliability designs: 1) vignette reliability using surveys with patient vignettes, 2) concurrent reliability, where multiple assessors decide a classification by observing someone's assessment, 3) successive reliability, where multiple assessors independently assess the same patient at different times. Systematic review with data synthesis in a quantitative format. Agreement of MDT subgroups was examined using the Kappa value, with the operational definition of acceptable reliability set at ≥ 0.6. The level of evidence was determined considering the methodological quality of the studies. Six studies were included and all studies met the criteria for high quality. Kappa values for the vignette reliability design (five studies) were ≥ 0.7. There was data from two cohorts in one study for the concurrent reliability design and the Kappa values ranged from 0.45 to 1.0. Kappa values for the successive reliability design (data from three cohorts in one study) were < 0.6. The current review found strong evidence of acceptable inter-examiner reliability of MDT classification for extremity problems in the vignette reliability design, limited evidence of acceptable reliability in the concurrent reliability design and unacceptable reliability in the successive reliability design. Copyright © 2017 Elsevier Ltd. All rights reserved.

Radiation therapy in the management of head-and-neck cancer of unknown primary origin: how does the addition of concurrent chemotherapy affect the therapeutic ratio?

PubMed

Chen, Allen M; Farwell, D Gregory; Lau, Derick H; Li, Bao-Qing; Luu, Quang; Donald, Paul J

2011-10-01

To determine how the addition of cisplatin-based concurrent chemotherapy to radiation therapy influences outcomes among a cohort of patients treated for head-and-neck cancer of unknown primary origin. The medical records of 60 consecutive patients treated by radiation therapy for squamous cell carcinoma of the head and neck presenting as cervical lymph node metastasis of occult primary origin were reviewed. Thirty-two patients (53%) were treated by concurrent chemoradiation, and 28 patients (47%) were treated by radiation therapy alone. Forty-five patients (75%) received radiation therapy after surgical resection, and 15 patients (25%) received primary radiation therapy. Thirty-five patients (58%) were treated by intensity-modulated radiotherapy. The 2-year estimates of overall survival, local-regional control, and progression-free survival were 89%, 89%, and 79%, respectively, among patients treated by chemoradiation, compared to 90%, 92%, and 83%, respectively, among patients treated by radiation therapy alone (p > 0.05, for all). Exploratory analysis failed to identify any subset of patients who benefited from the addition of concurrent chemotherapy to radiation therapy. The use of concurrent chemotherapy was associated with a significantly increased incidence of Grade 3+ acute and late toxicity (p < 0.001, for both). Concurrent chemoradiation is associated with significant toxicity without a clear advantage to overall survival, local-regional control, and progression-free survival in the treatment of head-and-neck cancer of unknown primary origin. Although selection bias cannot be ignored, prospective data are needed to further address this question. Copyright © 2011 Elsevier Inc. All rights reserved.

Model-Based Engineering Design for Trade Space Exploration throughout the Design Cycle

NASA Technical Reports Server (NTRS)

Lamassoure, Elisabeth S.; Wall, Stephen D.; Easter, Robert W.

2004-01-01

This paper presents ongoing work to standardize model-based system engineering as a complement to point design development in the conceptual design phase of deep space missions. It summarizes two first steps towards practical application of this capability within the framework of concurrent engineering design teams and their customers. The first step is standard generation of system sensitivities models as the output of concurrent engineering design sessions, representing the local trade space around a point design. A review of the chosen model development process, and the results of three case study examples, demonstrate that a simple update to the concurrent engineering design process can easily capture sensitivities to key requirements. It can serve as a valuable tool to analyze design drivers and uncover breakpoints in the design. The second step is development of rough-order- of-magnitude, broad-range-of-validity design models for rapid exploration of the trade space, before selection of a point design. At least one case study demonstrated the feasibility to generate such models in a concurrent engineering session. The experiment indicated that such a capability could yield valid system-level conclusions for a trade space composed of understood elements. Ongoing efforts are assessing the practicality of developing end-to-end system-level design models for use before even convening the first concurrent engineering session, starting with modeling an end-to-end Mars architecture.

15 CFR 930.41 - State agency response.

Code of Federal Regulations, 2010 CFR

2010-01-01

... MANAGEMENT FEDERAL CONSISTENCY WITH APPROVED COASTAL MANAGEMENT PROGRAMS Consistency for Federal Agency... concurrence with or objection to the Federal agency's consistency determination at the earliest practicable time, after providing for public participation in the State agency's review of the consistency...

48 CFR 303.104-7 - Violations or possible violations of the Procurement Integrity Act.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... That individual shall— (i) Refer the matter immediately to the Associate DAS for Acquisition for review... or concurrence of the Associate DAS for Acquisition before proceeding with an action. (b) The HCA...

Multicenter evaluation of signalment and comorbid conditions associated with aortic thrombotic disease in dogs.

PubMed

Winter, Randolph L; Budke, Christine M

2017-08-15

OBJECTIVE To assess signalment and concurrent disease processes in dogs with aortic thrombotic disease (ATD). DESIGN Retrospective case-control study. ANIMALS Dogs examined at North American veterinary teaching hospitals from 1985 through 2011 with medical records submitted to the Veterinary Medical Database. PROCEDURES Medical records were reviewed to identify dogs with a diagnosis of ATD (case dogs). Five control dogs without a diagnosis of ATD were then identified for every case dog. Data were collected regarding dog age, sex, breed, body weight, and concurrent disease processes. RESULTS ATD was diagnosed in 291 of the 984,973 (0.03%) dogs included in the database. The odds of a dog having ATD did not differ significantly by sex, age, or body weight. Compared with mixed-breed dogs, Shetland Sheepdogs had a significantly higher odds of ATD (OR, 2.59). Protein-losing nephropathy (64/291 [22%]) was the most commonly recorded concurrent disease in dogs with ATD. CONCLUSIONS AND CLINICAL RELEVANCE Dogs with ATD did not differ significantly from dogs without ATD in most signalment variables. Contrary to previous reports, cardiac disease was not a common concurrent diagnosis in dogs with ATD.

Concurrent Engineering for Composites

DTIC Science & Technology

1991-10-01

1990), 44. Cooper, R.G. and Kleinschmidt, E.J., Journal of Product Innovation Management . 3[2], (1986), 71.. Drucker, P.F., Harvard Business Review...Journal of Product Innovation Management 6(1], (1989), 43. Hollins, B. and Pugh, S., Successful Product Design, Buttcrworths, London, 1990. Johnson

Impact of Combined Abiotic and Biotic Stresses on Plant Growth and Avenues for Crop Improvement by Exploiting Physio-morphological Traits

PubMed Central

Pandey, Prachi; Irulappan, Vadivelmurugan; Bagavathiannan, Muthukumar V.; Senthil-Kumar, Muthappa

2017-01-01

Global warming leads to the concurrence of a number of abiotic and biotic stresses, thus affecting agricultural productivity. Occurrence of abiotic stresses can alter plant–pest interactions by enhancing host plant susceptibility to pathogenic organisms, insects, and by reducing competitive ability with weeds. On the contrary, some pests may alter plant response to abiotic stress factors. Therefore, systematic studies are pivotal to understand the effect of concurrent abiotic and biotic stress conditions on crop productivity. However, to date, a collective database on the occurrence of various stress combinations in agriculturally prominent areas is not available. This review attempts to assemble published information on this topic, with a particular focus on the impact of combined drought and pathogen stresses on crop productivity. In doing so, this review highlights some agriculturally important morpho-physiological traits that can be utilized to identify genotypes with combined stress tolerance. In addition, this review outlines potential role of recent genomic tools in deciphering combined stress tolerance in plants. This review will, therefore, be helpful for agronomists and field pathologists in assessing the impact of the interactions between drought and plant-pathogens on crop performance. Further, the review will be helpful for physiologists and molecular biologists to design agronomically relevant strategies for the development of broad spectrum stress tolerant crops. PMID:28458674

Performing concurrent operations in academic vascular neurosurgery does not affect patient outcomes.

PubMed

Zygourakis, Corinna C; Lee, Janelle; Barba, Julio; Lobo, Errol; Lawton, Michael T

2017-11-01

OBJECTIVE Concurrent surgeries, also known as "running two rooms" or simultaneous/overlapping operations, have recently come under intense scrutiny. The goal of this study was to evaluate the operative time and outcomes of concurrent versus nonconcurrent vascular neurosurgical procedures. METHODS The authors retrospectively reviewed 1219 procedures performed by 1 vascular neurosurgeon from 2012 to 2015 at the University of California, San Francisco. Data were collected on patient age, sex, severity of illness, risk of mortality, American Society of Anesthesiologists (ASA) status, procedure type, admission type, insurance, transfer source, procedure time, presence of resident or fellow in operating room (OR), number of co-surgeons, estimated blood loss (EBL), concurrent vs nonconcurrent case, severe sepsis, acute respiratory failure, postoperative stroke causing neurological deficit, unplanned return to OR, 30-day mortality, and 30-day unplanned readmission. For aneurysm clipping cases, data were also obtained on intraoperative aneurysm rupture and postoperative residual aneurysm. Chi-square and t-tests were performed to compare concurrent versus nonconcurrent cases, and then mixed-effects models were created to adjust for different procedure types, patient demographics, and clinical indicators between the 2 groups. RESULTS There was a significant difference in procedure type for concurrent (n = 828) versus nonconcurrent (n = 391) cases. Concurrent cases were more likely to be routine/elective admissions (53% vs 35%, p < 0.001) and physician referrals (59% vs 38%, p < 0.001). This difference in patient/case type was also reflected in the lower severity of illness, risk of death, and ASA class in the concurrent versus nonconcurrent cases (p < 0.01). Concurrent cases had significantly longer procedural times (243 vs 213 minutes) and more unplanned 30-day readmissions (5.7% vs 3.1%), but shorter mean length of hospital stay (11.2 vs 13.7 days), higher rates of discharge to home (66% vs 51%), lower 30-day mortality rates (3.1% vs 6.1%), lower rates of acute respiratory failure (4.3% vs 8.2%), and decreased 30-day unplanned returns to the OR (3.3% vs 6.9%; all p < 0.05). Rates of severe sepsis, postoperative stroke, intraoperative aneurysm rupture, and postoperative aneurysm residual were equivalent between the concurrent and nonconcurrent groups (all p values nonsignificant). Mixed-effects models showed that after controlling for procedure type, patient demographics, and clinical indicators, there was no significant difference in acute respiratory failure, severe sepsis, 30-day readmission, postoperative stroke, EBL, length of stay, discharge status, or intraoperative aneurysm rupture between concurrent and nonconcurrent cases. Unplanned return to the OR and 30-day mortality were significantly lower in concurrent cases (odds ratio 0.55, 95% confidence interval 0.31-0.98, p = 0.0431, and odds ratio 0.81, p < 0.001, respectively), but concurrent cases had significantly longer procedure durations (odds ratio 21.73; p < 0.001). CONCLUSIONS Overall, there was a significant difference in the types of concurrent versus nonconcurrent cases, with more routine/elective cases for less sick patients scheduled in an overlapping fashion. After adjusting for patient demographics, procedure type, and clinical indicators, concurrent cases had longer procedure times, but equivalent patient outcomes, as compared with nonconcurrent vascular neurosurgical procedures.

Psychosis and concurrent impulse control disorder in Parkinson's disease: A review based on a case report.

PubMed

Guedes, Bruno Fukelmann; Gonçalves, Marcia Rubia; Cury, Rubens Gisbert

2016-01-01

Psychosis, impulse control disorders (e.g., pathological gambling and hypersexuality) and repetitive behaviors such as punding are known psychiatric complications of Parkinson's disease (PD). Impulsive, compulsive and repetitive behaviors are strongly associated with dopamine-replacement therapy. We present the case of a 58-year-old man with PD and a myriad of psychiatric symptoms. Concurrent psychosis, punding and pathological gambling developed more than six years after the introduction of pramipexole and ceased shortly after the addition of quetiapine and discontinuation of pramipexole. This report emphasizes the importance of monitoring for a wide array of psychiatric symptoms in patients on dopamine replacement therapy.

Effect of helminth-induced immunity on infections with microbial pathogens

PubMed Central

2016-01-01

Helminth infections are ubiquitous worldwide and can trigger potent immune responses that differ from and potentially antagonize host protective responses to microbial pathogens. In this Review we focus on the three main killers in infectious disease—AIDS, tuberculosis and malaria—and critically assesses whether helminths adversely influence host control of these diseases. We also discuss emerging concepts for how M2 macrophages and helminth-modulated dendritic cells can potentially influence the protective immune response to concurrent infections. Finally, we present evidence advocating for more efforts to determine how and to what extent helminths interfere with the successful control of specific concurrent coinfections. PMID:24145791

78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

.... Requests that come from other sources are referred to the PCOs for their review and concurrence. In.... Annually, lists of designated HPSAs are made available to all PCOs, state medical and dental societies, and...

Coping with Multiple Innovations in Schools: An Exploratory Study.

ERIC Educational Resources Information Center

Wallace, Mike

1991-01-01

Reviews small-scale, exploratory research into British schools' management of concurrent educational reform innovations generated by government, local education authorities, and the schools themselves. Describes changing innovations patterns, key factors influencing their adoption and implementation, the central management strategies employed, and…

48 CFR 244.304 - Surveillance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Surveillance. 244.304 Section 244.304 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT... Reviews 244.304 Surveillance. (b) The ACO, or the purchasing system analyst (PSA) with the concurrence of...

77 FR 49002 - Towing Safety Advisory Committee; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-15

... concurrent meetings of the four subcommittees, ``Recommendations for the Prevention of Towing Vessel Crewmember Falls Overboard'', ``Review and recommendations for the revision of NVIC 1-95, Voluntary Training Standards for Entry-Level Personnel on Towing Industry Vessels'', ``Recommendations for the Enhancement of...

Radiation Therapy in the Management of Head-and-Neck Cancer of Unknown Primary Origin: How Does the Addition of Concurrent Chemotherapy Affect the Therapeutic Ratio?

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

Chen, Allen M., E-mail: allen.chen@ucdmc.ucdavis.edu; Farwell, D. Gregory; Lau, Derick H.

2011-10-01

Purpose: To determine how the addition of cisplatin-based concurrent chemotherapy to radiation therapy influences outcomes among a cohort of patients treated for head-and-neck cancer of unknown primary origin. Methods and Materials: The medical records of 60 consecutive patients treated by radiation therapy for squamous cell carcinoma of the head and neck presenting as cervical lymph node metastasis of occult primary origin were reviewed. Thirty-two patients (53%) were treated by concurrent chemoradiation, and 28 patients (47%) were treated by radiation therapy alone. Forty-five patients (75%) received radiation therapy after surgical resection, and 15 patients (25%) received primary radiation therapy. Thirty-five patientsmore » (58%) were treated by intensity-modulated radiotherapy. Results: The 2-year estimates of overall survival, local-regional control, and progression-free survival were 89%, 89%, and 79%, respectively, among patients treated by chemoradiation, compared to 90%, 92%, and 83%, respectively, among patients treated by radiation therapy alone (p > 0.05, for all). Exploratory analysis failed to identify any subset of patients who benefited from the addition of concurrent chemotherapy to radiation therapy. The use of concurrent chemotherapy was associated with a significantly increased incidence of Grade 3+ acute and late toxicity (p < 0.001, for both). Conclusions: Concurrent chemoradiation is associated with significant toxicity without a clear advantage to overall survival, local-regional control, and progression-free survival in the treatment of head-and-neck cancer of unknown primary origin. Although selection bias cannot be ignored, prospective data are needed to further address this question.« less

Stereotactic Radiosurgery: Treatment of Brain Metastasis Without Interruption of Systemic Therapy

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

Shen, Colette J.; Kummerlowe, Megan N.; Redmond, Kristin J.

Purpose: To evaluate the prevalence, outcomes, and toxicities of concurrent delivery of systemic therapy with stereotactic radiosurgery (SRS) for treatment of brain metastases. Methods and Materials: We conducted a retrospective review of 193 patients treated at our institution with SRS without prior whole-brain radiation therapy (WBRT) for brain metastases between 2009 and 2014. Outcome metrics included administration of concurrent systemic therapy, myelosuppression, neurotoxicity, and survival. Results: One hundred ninety-three patients with a median age of 61 years underwent a total of 291 SRS treatments. Thirty-seven percent of SRS treatments were delivered concurrently with systemic therapy, of which 46% were with conventional myelosuppressivemore » chemotherapy, and 54% with targeted and immune therapy agents. Myelosuppression was minimal after treatment with both systemic therapy and SRS, with 14% grade 3-4 toxicity for lymphopenia and 4-9% for leukopenia, neutropenia, anemia, and thrombocytopenia. Neurotoxicity was also minimal after combined therapy, with no grade 4 and <5% grade 3 toxicity, 34% dexamethasone requirement, and 4% radiation necrosis, all similar to treatments with SRS alone. Median overall survival was similar after SRS alone (14.4 months) versus SRS with systemic therapy (12.9 months). In patients with a new diagnosis of primary cancer with brain metastasis, early treatment with concurrent systemic therapy and SRS correlated with improved survival versus SRS alone (41.6 vs 21.5 months, P<.05). Conclusions: Systemic therapy can be safely given concurrently with SRS for brain metastases: our results suggest minimal myelosuppression and neurotoxicity. Concurrent therapy is an attractive option for patients who have both intracranial and extracranial metastatic disease and may be particularly beneficial in patients with a new diagnosis of primary cancer with brain metastasis.« less

Concurrent endocrine neoplasias in dogs and cats: a retrospective study (2004-2014).

PubMed

Beatrice, Laura; Boretti, Felicitas Schär; Sieber-Ruckstuhl, Nadja S; Mueller, Claudia; Kümmerle-Fraune, Claudia; Hilbe, Monika; Grest, Paula; Reusch, Claudia E

2018-03-17

Multiple endocrine neoplasia (MEN) is a well-known syndrome in human medicine, whereas only a few cases of concurrent endocrine neoplasias have been reported in dogs and cats. The aim of this study was to evaluate the prevalence of concurrent endocrine neoplasias in dogs and cats at our clinic, identify possible breed and sex predispositions and investigate similarities with MEN syndromes in humans. Postmortem reports of 951 dogs and 1155 cats that died or were euthanased at the Clinic for Small Animal Internal Medicine, University of Zurich, between 2004 and 2014 were reviewed, and animals with at least two concurrent endocrine neoplasias and/or hyperplasias were included. Twenty dogs and 15 cats met the inclusion criteria. In dogs, the adrenal glands were most commonly affected. Multiple tumours affecting the adrenal glands and the association of these tumours with pituitary adenomas were the most common tumour combinations. Only one dog had a combination resembling human MEN type 1 syndrome (pituitary adenoma and insulinoma). In cats, the thyroid glands were most commonly affected and there were no similarities to human MEN syndromes. The prevalence of concurrent endocrine neoplasia was 2.1 per cent in dogs and 1.3 per cent in cats and MEN-like syndromes are very rare in these species. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Concurrency of Guillain-Barre syndrome and acute transverse myelitis: a case report and review of literature.

PubMed

Tolunay, Orkun; Çelik, Tamer; Çelik, Ümit; Kömür, Mustafa; Tanyeli, Zeynep; Sönmezler, Abdurrahman

2016-11-01

Guillain-Barré syndrome and acute transverse myelitis manifest as demyelinating diseases of the peripheral and central nervous system. Concurrency of these two disorders is rarely documented in literature. A 4-year-old girl presenting with cough, fever, and an impaired walking ability was admitted to hospital. She had no previous complaints in her medical history. A physical examination revealed lack of muscle strength of the lower extremities and deep tendon reflexes. MRI could not be carried out due to technical problems; therefore, both Guillain-Barré syndrome and acute transverse myelitis were considered for the diagnosis. Intravenous immunoglobulin treatment was started as first line therapy. Because this treatment did not relieve the patient's symptoms, spinal MRI was carried out on the fourth day of admission and demyelinating areas were identified. Based on the new findings, the patient was diagnosed with acute transverse myelitis, and high dose intravenous methylprednisolone therapy was started. Electromyography findings were consistent with acute polyneuropathy affecting both motor and sensory fibers. Therefore, the patient was diagnosed with concurrency of Guillain-Barré syndrome and acute transverse myelitis. Interestingly, while concurrency of these 2 disorders is rare, this association has been demonstrated in various recent publications. Progress in diagnostic tests (magnetic resonance imaging and electrophysiological examination studies) has enabled clinicians to establish the right diagnosis. The possibility of concurrent Guillain-Barré syndrome and acute transverse myelitis should be considered if recovery takes longer than anticipated.

Concurrent cervical and craniofacial pain. A review of empiric and basic science evidence.

PubMed

Browne, P A; Clark, G T; Kuboki, T; Adachi, N Y

1998-12-01

Because many patients present themselves for treatment with both craniofacial and craniocervical pain, 2 questions arise: (1) What are the sensory and motor consequences of dysfunction in either of these areas on the other? (2) Do craniofacial and craniocervical pain have a similar cause? These questions formed the impetus for this review article. The phenomenon of concurrent pain in craniofacial and cervical structures is considered, and clinical reports and opinions are presented regarding theories of cervical-to-craniofacial and craniofacial-to-cervical pain referral. Because pain referral between these 2 areas requires anatomic and functional connectivity between trigeminally and cervically innervated structures, basic neurophysiologic and neuroanatomic literature is reviewed. The published data clearly demonstrate neurophysiologic and structural convergence of cervical sensory and muscle afferent inputs onto trigeminal subnucleus caudalis nociceptive and non-nociceptive neurons. Moreover, changes in metabolic activity and blood flow in the brainstem and cervical dorsal horn of the spinal cord in both monkeys and cats have been demonstrated after electric stimulation of the V1-innervated superior sagittal sinus. In conclusion, the animal experimental data support the findings of human empiric and experimental studies, which suggest that strong connectivity exists between trigeminal and cervical motor and sensory responses.

Combat Fluid Resuscitation Interoperable Capability (Capacite Interoperable de Liquides de Reanimation en Situation de Combat)

DTIC Science & Technology

2010-10-01

biological samples from 120 patients (generating > 1 million data points) for the determination of biomarkers. An independent Data Safety and...total of 2,184 patients (853 Shock patients and 1,331 TBI patients). Concurrently, DRDC analyzed over 500 biological samples obtained from 120...Center for Biologics Evaluation and Research and Office of Blood Research and Review. The FDA also reviewed the plan for community notification and

Effects of feline hyperthyroidism on kidney function: a review.

PubMed

Vaske, Heather H; Schermerhorn, Thomas; Grauer, Gregory F

2016-02-01

Chronic kidney disease and hyperthyroidism are two commonly diagnosed conditions in the geriatric feline population, and are often seen concurrently. Management of both diseases is recommended; however, the physiologic implications of both diseases must be understood to ensure the most favorable outcome for each patient. This report reviews the complex interplay between hyperthyroidism and kidney function, as well as the effects of hyperthyroid therapy on kidney function. © ISFM and AAFP 2015.

Review of the Badger report FE-2416-24, conceptual design of a coal to methanol commercial plant, February 1978

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

Salmon, R.; Hartman, H.F.; Niemann, B.

1979-10-01

This report gives the results of a review by Oak Ridge National Laboratory of the conceptual design study of a 415,000-bbl/day coal-to-methanol facility published in February 1978 by Badger Plants, Incorporated. A critical assessment is made of the technology and economics of the proposed plant and of the Badger-recommended program for concurrent development and construction.

Pernicious Anemia with Autoimmune Hemolytic Anemia: A Case Report and Literature Review

PubMed Central

Manchandani, Raj Pal; Oneal, Patricia

2016-01-01

Pernicious anemia is a common cause of vitamin B12 deficiency. Here, we discuss a case of a young woman who presented with severe anemia along with a history of iron deficiency anemia. After a review of her clinical presentation and laboratory data, we identified an autoimmune hemolytic anemia and a concomitant pernicious anemia. The concurrence of both these hematological diagnoses in a patient is rare. PMID:27559485

Developing a "toolkit" to measure implementation of concurrent palliative care in rural community cancer centers.

PubMed

Zubkoff, Lisa; Dionne-Odom, J Nicholas; Pisu, Maria; Babu, Dilip; Akyar, Imatullah; Smith, Tasha; Mancarella, Gisella A; Gansauer, Lucy; Sullivan, Margaret Murray; Swetz, Keith M; Azuero, Andres; Bakitas, Marie A

2018-02-01

Despite national guidelines recommending early concurrent palliative care for individuals newly diagnosed with metastatic cancer, few community cancer centers, especially those in underserved rural areas do so. We are implementing an early concurrent palliative care model, ENABLE (Educate, Nurture, Advise, Before Life Ends) in four, rural-serving community cancer centers. Our objective was to develop a "toolkit" to assist community cancer centers that wish to integrate early palliative care for patients with newly diagnosed advanced cancer and their family caregivers. Guided by the RE-AIM (Reach, Effectiveness-Adoption, Implementation, Maintenance) framework, we undertook an instrument-development process based on the literature, expert and site stakeholder review and feedback, and pilot testing during site visits. We developed four instruments to measure ENABLE implementation: (1) the ENABLE RE-AIM Self-Assessment Tool to assess reach, adoption, implementation, and maintenance; (2) the ENABLE General Organizational Index to assess institutional implementation; (3) an Implementation Costs Tool; and (4) an Oncology Clinicians' Perceptions of Early Concurrent Oncology Palliative Care survey. We developed four measures to determine early palliative care implementation. These measures have been pilot-tested, and will be integrated into a comprehensive "toolkit" to assist community cancer centers to measure implementation outcomes. We describe the lessons learned and recommend strategies for promoting long-term program sustainability.

A Review of Existing Relational Aggression Programs: Strengths, Limitations, and Future Directions

ERIC Educational Resources Information Center

Leff, Stephen S.; Waasdorp, Tracy Evian; Crick, Nicki R.

2010-01-01

Research suggests that involvement in relational aggression is associated with serious adjustment problems, including concurrent and future social maladjustment (e.g., problematic friendships; rejection), internalizing problems (e.g., depressive symptoms), and school avoidance. Despite the burgeoning literature focusing on the harmful and damaging…

45 CFR 150.313 - Market conduct examinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Non-Federal Governmental Plans-Civil Money Penalties § 150.313 Market conduct examinations. (a..., or the operation of a non-Federal governmental plan, involving the review of one or more (or a... consist of one of the following: (i) Concurrence with the issuer's or non-Federal governmental plan's...

45 CFR 150.313 - Market conduct examinations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Non-Federal Governmental Plans-Civil Money Penalties § 150.313 Market conduct examinations. (a..., or the operation of a non-Federal governmental plan, involving the review of one or more (or a... consist of one of the following: (i) Concurrence with the issuer's or non-Federal governmental plan's...

Effects of Tasks on BOLD Signal Responses to Sentence Contrasts: Review and Commentary

PubMed Central

Caplan, David; Gow, David

2010-01-01

Functional neuroimaging studies of syntactic processing have been interpreted as identifying the neural locations of parsing and interpretive operations. However, current behavioral studies of sentence processing indicate that many operations occur simultaneously with parsing and interpretation. In this review, we point to issues that arise in discriminating the effects of these concurrent processes from those of the parser/interpreter in neural measures and to approaches that may help resolve them. PMID:20932562

Concurrent Training for Sports Performance: The Two Sides of the Medal.

PubMed

Berryman, Nicolas; Mujika, Inigo; Bosquet, Laurent

2018-05-29

The classical work by Robert C. Hickson showed in 1980 that the addition of a resistance training protocol to a predominantly aerobic program could lead to impaired leg strength adaptations in comparison to a resistance-only training regimen. This interference phenomenon was later highlighted in many reports, including a meta-analysis. However, it seems that the interference effect has not been consistently reported, probably because of the complex interactions between training variables and methodological issues. On the other side of the medal, Dr Hickson and colleagues subsequently (1986) reported that a strength training mesocycle could be beneficial for endurance performance in running and cycling. In recent meta-analyses and review articles, it was demonstrated that such a training strategy could improve middle- and long-distance performance in many disciplines (running, cycling, cross-country skiing and swimming). Interestingly, it appears that improvements in the energy cost of locomotion could be associated with these performance enhancements. Despite these benefits, it was also reported that strength training could represent a detrimental stimulus for endurance performance if an inappropriate training plan has been prepared. Taken together, these observations suggest that coaches and athletes should be careful when concurrent training seems imperative in order to meet the complex physiological requirements of their sport. Therefore, this brief review will present a practical appraisal of concurrent training for sports performance. In addition, recommendations will be provided so that practitioners could adapt their interventions based on the training objectives.

Relative Carnitine Deficiency in Autism

ERIC Educational Resources Information Center

Filipek, Pauline A.; Juranek, Jenifer; Nguyen, Minh T.; Cummings, Christa; Gargus, J. Jay

2004-01-01

A random retrospective chart review was conducted to document serum carnitine levels on 100 children with autism. Concurrently drawn serum pyruvate, lactate, ammonia, and alanine levels were also available in many of these children. Values of free and total carnitine ([rho] less than 0.001), and pyruvate ([rho]=0.006) were significantly reduced…

Interventions to Prevent and Reduce Cyber Abuse of Youth: A Systematic Review

ERIC Educational Resources Information Center

Mishna, Faye; Cook, Charlene; Saini, Michael; Wu, Meng-Jia; MacFadden, Robert

2011-01-01

Objectives: The Internet has created a new communication tool, particularly for young people whose use of electronic communication is exploding worldwide. While there are many benefits that result from electronic-based communication, the Internet is concurrently a potential site for abuse and victimization. Methods: This paper systematically…

Errors of Logic and Scholarship Concerning Dissociative Identity Disorder

ERIC Educational Resources Information Center

Ross, Colin A.

2009-01-01

The author reviewed a two-part critique of dissociative identity disorder published in the "Canadian Journal of Psychiatry". The two papers contain errors of logic and scholarship. Contrary to the conclusions in the critique, dissociative identity disorder has established diagnostic reliability and concurrent validity, the trauma histories of…

48 CFR 801.602-70 - General review requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... prior to processing requests for acquisitions of IT and telecommunications software, equipment, and/or... concurrence from Acquisition Resources Service staff before issuing a change order where: (1) The change order (unilateral agreement) has an anticipated value of $100,000 or more; or (2) The change order is for a time...

24 CFR 242.45 - Early commencement of work.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Early commencement of work. 242.45... MORTGAGE INSURANCE FOR HOSPITALS Construction § 242.45 Early commencement of work. (a) Site preparation... work can commence only after the review of the work and concurrence by HUD, including the environmental...

76 FR 23818 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... Project Evaluating Act Against AIDS Social Marketing Campaign Phases Targeting Consumers--New--National... concurrently. Each phase of the campaign will use mass media and direct-to-consumer channels to deliver HIV... effectiveness of these social marketing messages aimed at increasing HIV awareness and delivering HIV prevention...

Review of Electrocution Deaths in Iraq: Part 1 - Electrocution of Staff Sergeant Ryan D. Maseth, U.S. Army

DTIC Science & Technology

2009-07-24

concurrently. Photographs of LSF-1 from before and after June 2006 are consistent with the believed installation date. A forensic engineering...other services such as refuse collection and disposal, entomology , etc. Starting in November 2003, Washington Group International/Black and Veatch

24 CFR 3282.404 - Manufacturers' determinations and related concurrences.

Code of Federal Regulations, 2014 CFR

2014-04-01

... REGULATIONS Consumer Complaint Handling and Remedial Actions § 3282.404 Manufacturers' determinations and... manufacturer must review the information, the known facts, and the circumstances relating to the complaint or..., complaints that can be traced to the same faulty design or faulty construction, problems known to exist in...

Predictive and concurrent validity of the Braden scale in long-term care: a meta-analysis.

PubMed

Wilchesky, Machelle; Lungu, Ovidiu

2015-01-01

Pressure ulcer prevention is an important long-term care (LTC) quality indicator. While the Braden Scale is a recommended risk assessment tool, there is a paucity of information specifically pertaining to its validity within the LTC setting. We, therefore, undertook a systematic review and meta-analysis comparing Braden Scale predictive and concurrent validity within this context. We searched the Medline, EMBASE, PsychINFO and PubMed databases from 1985-2014 for studies containing the requisite information to analyze tool validity. Our initial search yielded 3,773 articles. Eleven datasets emanating from nine published studies describing 40,361 residents met all meta-analysis inclusion criteria and were analyzed using random effects models. Pooled sensitivity, specificity, positive predictive value (PPV), and negative predictive values were 86%, 38%, 28%, and 93%, respectively. Specificity was poorer in concurrent samples as compared with predictive samples (38% vs. 72%), while PPV was low in both sample types (25 and 37%). Though random effects model results showed that the Scale had good overall predictive ability [RR, 4.33; 95% CI, 3.28-5.72], none of the concurrent samples were found to have "optimal" sensitivity and specificity. In conclusion, the appropriateness of the Braden Scale in LTC is questionable given its low specificity and PPV, in particular in concurrent validity studies. Future studies should further explore the extent to which the apparent low validity of the Scale in LTC is due to the choice of cutoff point and/or preventive strategies implemented by LTC staff as a matter of course. © 2015 by the Wound Healing Society.

Comparison of Revision Rates of Anterior- and Posterior-Approach Ptosis Surgery: A Retrospective Review of 1519 Cases.

PubMed

Chou, Eva; Liu, Jun; Seaworth, Cathleen; Furst, Meredith; Amato, Malena M; Blaydon, Sean M; Durairaj, Vikram D; Nakra, Tanuj; Shore, John W

To compare revision rates for ptosis surgery between posterior-approach and anterior-approach ptosis repair techniques. This is the retrospective, consecutive cohort study. All patients undergoing ptosis surgery at a high-volume oculofacial plastic surgery practice over a 4-year period. A retrospective chart review was conducted of all patients undergoing posterior-approach and anterior-approach ptosis surgery for all etiologies of ptosis between 2011 and 2014. Etiology of ptosis, concurrent oculofacial surgeries, revision, and complications were analyzed. The main outcome measure is the ptosis revision rate. A total of 1519 patients were included in this study. The mean age was 63 ± 15.4 years. A total of 1056 (70%) of patients were female, 1451 (95%) had involutional ptosis, and 1129 (74.3%) had concurrent upper blepharoplasty. Five hundred thirteen (33.8%) underwent posterior-approach ptosis repair, and 1006 (66.2%) underwent anterior-approach ptosis repair. The degree of ptosis was greater in the anterior-approach ptosis repair group. The overall revision rate for all patients was 8.7%. Of the posterior group, 6.8% required ptosis revision; of the anterior group, 9.5% required revision surgery. The main reason for ptosis revision surgery was undercorrection of one or both eyelids. Concurrent brow lifting was associated with a decreased, but not statistically significant, rate of revision surgery. Patients who underwent unilateral ptosis surgery had a 5.1% rate of Hering's phenomenon requiring ptosis repair in the contralateral eyelid. Multivariable logistic regression for predictive factors show that, when adjusted for gender and concurrent blepharoplasty, the revision rate in anterior-approach ptosis surgery is higher than posterior-approach ptosis surgery (odds ratio = 2.08; p = 0.002). The overall revision rate in patients undergoing ptosis repair via posterior-approach or anterior-approach techniques is 8.7%. There is a statistically higher rate of revision with anterior-approach ptosis repair.

Outcomes with Concurrent Use of Clopidogrel and Proton-Pump Inhibitors: A Cohort Study

PubMed Central

Ray, Wayne A.; Murray, Katherine T.; Griffin, Marie R.; Chung, Cecilia P.; Smalley, Walter E.; Hall, Kathi; Daugherty, James R.; Kaltenbach, Lisa A.; Stein, C. Michael

2011-01-01

Background Proton-pump inhibitors (PPIs) and clopidogrel are frequently co-prescribed though the benefits and harms of their concurrent use are unclear. Objective To examine the association between concurrent PPI and clopidogrel use and the risks for gastroduodenal bleeding hospitalizations and serious cardiovascular disease. Design Retrospective cohort study that used automated data to identify patients who received clopidogrel between 1999 through 2005 following hospitalization for coronary heart disease. Setting Tennessee Medicaid Program Patients 20,596 patients (including 7593 concurrent users of clopidogrel and PPIs) hospitalized for myocardial infarction, coronary artery revascularization, or unstable angina pectoris. Measurements Baseline and followup drug use assessed from automated records of dispensed prescriptions. Primary outcomes were hospitalizations for gastroduodenal bleeding and serious cardiovascular disease (fatal or nonfatal myocardial infarction/sudden cardiac death, stroke, or other cardiovascular death). Results Pantoprazole and omeprazole accounted for 62% and 9% of the concurrent PPI use. Adjusted gastroduodenal bleeding hospitalization incidence in concurrent PPI users was 50% lower than that in nonusers (HR, 0.50 [95% CI, 0.39 to 0.65]). For patients at highest risk of bleeding, PPI use was associated with an absolute reduction of 28 (12 to 37) gastroduodenal bleeding hospitalizations per 1000 person years. The hazard ratio associated with concurrent PPI use for risk of serious cardiovascular disease was 0.99 (CI, 0.82 to 1.19) and was 1.01 (CI, 0.77 to 1.30) among patients who had percutaneous coronary interventions with stenting. Limitations There was possible unmeasured confounding and misclassification of exposure (no information on adherence or over-the-counter use of drugs) and endpoints (not confirmed by medical record review). Because many patients entered the cohort from hospitals with relatively few cohort members, the analysis relied on the assumption that after adjusting for observed covariates, PPI users from one such hospital could be compared with nonusers from a different hospital. Conclusion Among patients with serious coronary heart disease treated with clopidogrel, concurrent PPI use was associated with reduced incidence of gastroduodenal bleeding hospitalizations. The corresponding point estimate for serious cardiovascular disease was not increased; however, the 95% confidence interval included a clinically important increased risk. Funding Agency for Healthcare Quality and Research, National Heart Lung and Blood Institute. PMID:20231564

Position Regarding Concurrent Review Under PSD and the Offset Policy

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Modelling the impact of correlations between condom use and sexual contact pattern on the dynamics of sexually transmitted infections.

PubMed

Yamamoto, Nao; Ejima, Keisuke; Nishiura, Hiroshi

2018-05-31

It is believed that sexually active people, i.e. people having multiple or concurrent sexual partners, are at a high risk of sexually transmitted infections (STI), but they are likely to be more aware of the risk and may exhibit greater fraction of the use of condom. The purpose of the present study is to examine the correlation between condom use and sexual contact pattern and clarify its impact on the transmission dynamics of STIs using a mathematical model. The definition of sexual contact pattern can be broad, but we focus on two specific aspects: (i) type of partnership (i.e. steady or casual partnership) and (ii) existence of concurrency (i.e. with single or multiple partners). Systematic review and meta-analysis of published studies are performed, analysing literature that epidemiologically examined the relationship between condom use and sexual contact pattern. Subsequently, we employ an epidemiological model and compute the reproduction number that accounts for with and without concurrency so that the corresponding coverage of condom use and its correlation with existence of concurrency can be explicitly investigated using the mathematical model. Combining the model with parameters estimated from the meta-analysis along with other assumed parameters, the impact of varying the proportion of population with multiple partners on the reproduction number is examined. Based on systematic review, we show that a greater number of people used condoms during sexual contact with casual partners than with steady partners. Furthermore, people with multiple partners use condoms more frequently than people with a single partner alone. Our mathematical model revealed a positive relationship between the effective reproduction number and the proportion of people with multiple partners. Nevertheless, the association was reversed to be negative by employing a slightly greater value of the relative risk of condom use for people with multiple partners than that empirically estimated. Depending on the correlation between condom use and the existence of concurrency, association between the proportion of people with multiple partners and the reproduction number can be reversed, suggesting the sexually active population is not necessary a primary target population to encourage condom use (i.e., sexually less active individuals could equivalently be a target in some cases).

The next chapter in patient blood management: real-time clinical decision support.

PubMed

Goodnough, Lawrence Tim; Shah, Neil

2014-12-01

Blood transfusion was identified by the American Medical Association as one of the top five most frequently overused therapies. Utilization review has been required by accreditation agencies, but retrospective review has been ineffective due to labor-intense resources applied to only a sampling of transfusion events. Electronic medical records have allowed clinical decision support (CDS) to occur via a best practices alert at the critical decision point concurrently with physician order entry. We review emerging strategies for improving blood utilization. Implementation of CDS at our institution decreased the percentage of transfusions in patients with a hemoglobin level of more than 8 g/dL from 60% to less than 30%. Annual RBC transfusions were reduced by 24%, despite concurrent increases in patient discharge volumes and case mix complexity. This resulted in acquisition costs savings (direct blood product purchase costs) of $6.4 million over 4 years. We have been able to significantly reduce inappropriate blood transfusions and related costs through an educational initiative coupled with real-time CDS. In deriving increased value out of health care, CDS can be applied to a number of overuse measures in laboratory testing, radiology, and therapy such as antibiotics, as outlined by the American Board of Internal Medicine's Choosing Wisely campaign. Copyright© by the American Society for Clinical Pathology.

Genetic analysis of ossification of the posterior longitudinal ligament.

PubMed

Matsunaga, S; Yamaguchi, M; Hayashi, K; Sakou, T

1999-05-15

The human leukocyte antigen (HLA) haplotypes in families of patients with known ossification of the posterior longitudinal ligament (OPLL) were reviewed. To clarify how genetic factors relate to the development of OPLL. The association between genetic factors and the development of OPLL is still unknown. The association between HLA haplotypes and OPLL was studied in families of 24 patients with OPLL. The prevalence of OPLL was higher in the siblings showing a higher share of identical HLA haplotypes: 10 (53%) of 19 with concurrence of two strands, and 5 (24%) of 21 with concurrence of one strand. Of 21 subjects who had no HLA haplotype identical with that in OPLL patients, only one showed evidence of OPLL. Genetic factors predispose toward the development of OPLL.

Protocol for the CONVERT trial-Concurrent ONce-daily VErsus twice-daily RadioTherapy: an international 2-arm randomised controlled trial of concurrent chemoradiotherapy comparing twice-daily and once-daily radiotherapy schedules in patients with limited stage small cell lung cancer (LS-SCLC) and good performance status.

PubMed

Faivre-Finn, Corinne; Falk, Sally; Ashcroft, Linda; Bewley, Michelle; Lorigan, Paul; Wilson, Elena; Groom, Nicki; Snee, Michael; Fournel, Pierre; Cardenal, Felipe; Bezjak, Andrea; Blackhall, Fiona

2016-01-20

Concurrent ONce-daily VErsus twice-daily RadioTherapy (CONVERT) is the only multicentre, international, randomised, phase III trial open in Europe and Canada looking at optimisation of chemoradiotherapy (RT) in limited stage small cell lung cancer (LS-SCLC). Following on from the Turrisi trial of once-daily versus twice-daily (BD) concurrent chemoradiotherapy, there is a real need for a new phase III trial using modern conformal RT techniques and investigating higher once-daily radiation dose. This trial has the potential to define a new standard chemo-RT regimen for patients with LS-SCLC and good performance status. 447 patients with histologically or cytologically proven diagnosis of SCLC were recruited from 74 centres in eight countries between 2008 and 2013. Patients were randomised to receive either concurrent twice-daily RT(45 Gy in 30 twice-daily fractions over 3 weeks) or concurrent once-daily RT(66 Gy in 33 once-daily fractions over 6.5 weeks) both starting on day 22 of cycle 1. Patients are followed up until death. The primary end point of the study is overall survival and secondary end points include local progression-free survival, metastasis-free survival, acute and late toxicity based on the Common Terminology Criteria for Adverse Events V.3.0, chemotherapy and RTdose intensity. The trial received ethical approval from NRES Committee North West-Greater Manchester Central (07/H1008/229). There is a trial steering committee, including independent members and an independent data monitoring committee. Results will be published in a peer-reviewed journal and presented at international conferences. ISRCTN91927162; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Acquisition of choice in concurrent chains: Assessing the cumulative decision model.

PubMed

Grace, Randolph C

2016-05-01

Concurrent chains is widely used to study pigeons' choice between terminal links that can vary in delay, magnitude, or probability of reinforcement. We review research on the acquisition of choice in this procedure. Acquisition has been studied with a variety of research designs, and some studies have incorporated no-food trials to allow for timing and choice to be observed concurrently. Results show that: Choice can be acquired rapidly within sessions when terminal links change unpredictably; under steady-state conditions, acquisition depends on both initial- and terminal-link schedules; and initial-link responding is mediated by learning about the terminal-link stimulus-reinforcer relations. The cumulative decision model (CDM) proposed by Christensen and Grace (2010) and Grace and McLean (2006, 2015) provides a good description of within-session acquisition, and correctly predicts the effects of initial and terminal-link schedules in steady-state designs (Grace, 2002a). Questions for future research include how abrupt shifts in preference within individual sessions and temporal control of terminal-link responding can be modeled. Copyright © 2016 Elsevier B.V. All rights reserved.

Knowledge and Intellectual Capital. Symposium 13. [Concurrent Symposium Session at AHRD Annual Conference, 2000.

ERIC Educational Resources Information Center

2000

Three presentations are provided from Symposium 13, Knowledge and Intellectual Capital, of the Academy of Human Resource Development (HRD) 2000 Conference proceedings. "Human Capital Measurement" (Joanne Provo) begins with a literature review that provides a context for understanding how investments in human capital add value to the…

A Systematic Review of Student Self-Report Instruments That Assess Student-Teacher Relationships

ERIC Educational Resources Information Center

Phillipo, Kate; Conner, Jerusha Osber; Davidson, Shannon; Pope, Denise

2017-01-01

Background: A large body of survey-based research asserts that the quality and strength of student-teacher relationships (STRs) predict a host of academic and nonacademic outcomes; however, advances in survey design research have led some to question existing survey instruments' psychometric soundness. Concurrently, qualitative research on STRs…

Management and conservation of migratory landbirds overwintering in the neotropics

Treesearch

Daniel R. Petit; James F. Lynch; Richard L. Hutto; John G. Blake; Robert B. Waide

1993-01-01

Loss of tropical broadleaved forests and concurrent population declines of long-distance migratory birds in temperate breeding areas have been closely linked in both scientific and popular literature; however, little evidence of a causal association currently exists. We review the current land use situation in the neotropics, the projected outcome of deforestation...

Conservation of Louisiana's coastal wetland forests

Treesearch

Jim L. Chambers; Richard F. Keim; William H. Conner; John W. Jr. Day; Stephen P. Faulkner; Emile S. Gardiner; Melinda s. Hughes; Sammy L. King; Kenneth W. McLeod; Craig A. Miller; J. Andrew Nyman; Gary P. Shaffer

2006-01-01

Large-scale efforts to protect and restore coastal wetlands and the concurrent renewal of forest harvesting in cypress-tupelo swamps have brought new attention to Louisiana's coastal wetland forests in recent years. Our understanding of these coastal wetland forests has been limited by inadequate data and the lack of a comprehensive review of existing information...

78 FR 41369 - Certain Small Diameter Carbon and Alloy Seamless Standard, Line and Pressure Pipe From Romania...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-10

... Carbon and Alloy Seamless Standard, Line and Pressure Pipe From Romania: Preliminary Results of..., line and pressure pipe (small diameter seamless pipe) from Romania. The period of review (POR) is... and Alloy Seamless Standard, Line and Pressure Pipe from Romania,'' dated concurrently with this...

Tracking in 4 dimensions

DOE PAGES

Cartiglia, N.; Arcidiacono, R.; Baldassarri, B.; ...

2016-06-03

In this contribution we will review the progresses toward the construction of a tracking system able to measure the passage of charged particles with a combined precision of ~10 ps and ~10 μm, either using a single type of sensor, able to concurrently measure position and time, or a combination of position and time sensors.

Literature Review on Concurrent Dual Career Development in the URL (unrestricted Line)

DTIC Science & Technology

1989-06-01

Career Development Systems, (3) Multiple Career Paths in Organizations, (4) Skills Required for Management, (5) Predicting Career Success , (6) Skill...10 Sum m ary .............................................................. 11 Predicting Career Success ................................................. 11...Career Paths in Organizations, (4) Skills Required for Management, (5) Predicting Career Success , (6) Skill Requirements of Jobs, (7) Formal Training, (8

Effects of Stimulus Duration and Choice Delay on Visual Categorization in Pigeons

ERIC Educational Resources Information Center

Lazareva, Olga F.; Wasserman, Edward A.

2009-01-01

We [Lazareva, O. F., Freiburger, K. L., & Wasserman, E. A. (2004). "Pigeons concurrently categorize photographs at both basic and superordinate levels." "Psychonomic Bulletin and Review," 11, 1111-1117] previously trained four pigeons to classify color photographs into their basic-level categories (cars, chairs, flowers, or people) or into their…

Affirmative Action's Fate: Are 20 More Years Enough?

ERIC Educational Resources Information Center

Moses, Michele S.; Yun, John T.; Marin, Patricia

2009-01-01

In this article we examine the current status of affirmative action in postsecondary admissions through a concurrent review of recent court rulings, state legislation, and higher education enrollment data. Analyzing each of these factors in the context of the others is important because the court decisions and state-level legislation interact to…

40 CFR 8.6 - Preliminary environmental review.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the obligations of Article 8 and Annex I of the Protocol. The EPA will provide its comments to the... of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation. If EPA does not provide such notice within...

40 CFR 8.6 - Preliminary environmental review.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the obligations of Article 8 and Annex I of the Protocol. The EPA will provide its comments to the... of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation. If EPA does not provide such notice within...

40 CFR 8.6 - Preliminary environmental review.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the obligations of Article 8 and Annex I of the Protocol. The EPA will provide its comments to the... of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation. If EPA does not provide such notice within...

40 CFR 8.6 - Preliminary environmental review.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the obligations of Article 8 and Annex I of the Protocol. The EPA will provide its comments to the... of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation. If EPA does not provide such notice within...

40 CFR 8.6 - Preliminary environmental review.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the obligations of Article 8 and Annex I of the Protocol. The EPA will provide its comments to the... of Article 8 and Annex I of the Protocol and the provisions of this part. This finding will be made with the concurrence of the National Science Foundation. If EPA does not provide such notice within...

77 FR 39680 - Folding Metal Tables and Chairs From the People's Republic of China: Final Results of Antidumping...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

... Development Limited Quanzhou City (``Feili''), a mandatory respondent in the administrative review, Cosco Home... Feili Furniture Development Limited Quanzhou City (``Feili''), dated concurrently with this notice, at Attachment 5. We applied a market-economy purchase price to Feili's factors of production of rivets and...

75 FR 38076 - Carbazole Violet Pigment 23 from India: Final Results of Antidumping Duty Administrative Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-01

... brief. We did not receive a request for a hearing. \\1\\ Nation Ford Chemical Company and Sun Chemical... Acting Deputy Assistant Secretary Paul Piquado dated concurrently with this notice, which is hereby..., 2010. Paul Piquado, Acting Deputy Assistant Secretary for Import Administration. Appendix 1...

Using Reinforcement Learning to Examine Dynamic Attention Allocation during Reading

ERIC Educational Resources Information Center

Liu, Yanping; Reichle, Erik D.; Gao, Ding-Guo

2013-01-01

A fundamental question in reading research concerns whether attention is allocated strictly serially, supporting lexical processing of one word at a time, or in parallel, supporting concurrent lexical processing of two or more words (Reichle, Liversedge, Pollatsek, & Rayner, 2009). The origins of this debate are reviewed. We then report three…

Clinical and pathological features of kidney transplant patients with concurrent polyomavirus nephropathy and rejection-associated endarteritis

PubMed Central

McGregor, Stephanie M; Chon, W James; Kim, Lisa; Chang, Anthony; Meehan, Shane M

2015-01-01

AIM: To describe the clinicopathologic features of concurrent polyomavirus nephropathy (PVN) and endarteritis due to rejection in renal allografts. METHODS: We searched our electronic records database for cases with transplant kidney biopsies demonstrating features of both PVN and acute rejection (AR). PVN was defined by the presence of typical viral cytopathic effect on routine sections and positive polyomavirus SV40 large-T antigen immunohistochemistry. AR was identified by endarteritis (v1 by Banff criteria). All cases were subjected to chart review in order to determine clinical presentation, treatment course and outcomes. Outcomes were recorded with a length of follow-up of at least one year or time to nephrectomy. RESULTS: Of 94 renal allograft recipients who developed PVN over an 11-year period at our institution, we identified 7 (7.4%) with viral cytopathic changes, SV40 large T antigen staining, and endarteritis in the same biopsy specimen, indicative of concurrent PVN and AR. Four arose after reduction of immunosuppression (IS) (for treatment of PVN in 3 and tuberculosis in 1), and 3 patients had no decrease of IS before developing simultaneous concurrent disease. Treatment consisted of reduced oral IS and leflunomide for PVN, and anti-rejection therapy. Three of 4 patients who developed endarteritis in the setting of reduced IS lost their grafts to rejection. All 3 patients with simultaneous PVN and endarteritis cleared viremia and were stable at 1 year of follow up. Patients with endarteritis and PVN arising in a background of reduced IS had more severe rejection and poorer outcome. CONCLUSION: Concurrent PVN and endarteritis may be more frequent than is currently appreciated and may occur with or without prior reduction of IS. PMID:26722657

Measuring disability: a systematic review of the validity and reliability of the Global Activity Limitations Indicator (GALI).

PubMed

Van Oyen, Herman; Bogaert, Petronille; Yokota, Renata T C; Berger, Nicolas

2018-01-01

GALI or Global Activity Limitation Indicator is a global survey instrument measuring participation restriction. GALI is the measure underlying the European indicator Healthy Life Years (HLY). Gali has a substantial policy use within the EU and its Member States. The objective of current paper is to bring together what is known from published manuscripts on the validity and the reliability of GALI. Following the PRISMA guidelines, two search strategies (PUBMED, Google Scholar) were combined to identify manuscripts published in English with publication date 2000 or beyond. Articles were classified as reliability studies, concurrent or predictive validity studies, in national or international populations. Four cross-sectional studies (of which 2 international) studied how GALI relates to other health measures (concurrent validity). A dose-response effect by GALI severity level on the association with the other health status measures was observed in the national studies. The 2 international studies (SHARE, EHIS) concluded that the odds of reporting participation restriction was higher in subjects with self-reported or observed functional limitations. In SHARE, the size of the Odds Ratio's (ORs) in the different countries was homogeneous, while in EHIS the size of the ORs varied more strongly. For the predictive validity, subjects were followed over time (4 studies of which one international). GALI proved, both in national and international data, to be a consistent predictor of future health outcomes both in terms of mortality and health care expenditure. As predictors of mortality, the two distinct health concepts, self-rated health and GALI, acted independently and complementary of each other. The one reliability study identified reported a sufficient reliability of GALI. GALI as inclusive one question instrument fits all conceptual characteristics specified for a global measure on participation restriction. In none of the studies, included in the review, there was evidence of a failing validity. The review shows that GALI has a good and sufficient concurrent and predictive validity, and reliability.

Impact of tumour bed boost integration on acute and late toxicity in patients with breast cancer: A systematic review.

PubMed

Hamilton, Daniel George; Bale, Rebecca; Jones, Claire; Fitzgerald, Emma; Khor, Richard; Knight, Kellie; Wasiak, Jason

2016-06-01

The purpose of this systematic review was to summarise the evidence from studies investigating the integration of tumour bed boosts into whole breast irradiation for patients with Stage 0-III breast cancer, with a focus on its impact on acute and late toxicities. A comprehensive systematic electronic search through the Ovid MEDLINE, EMBASE and PubMed databases from January 2000 to January 2015 was conducted. Studies were considered eligible if they investigated the efficacy of hypo- or normofractionated whole breast irradiation with the inclusion of a daily concurrent boost. The primary outcomes of interest were the degree of observed acute and late toxicity following radiotherapy treatment. Methodological quality assessment was performed on all included studies using either the Newcastle-Ottawa Scale or a previously published investigator-derived quality instrument. The search identified 35 articles, of which 17 satisfied our eligibility criteria. Thirteen and eleven studies reported on acute and late toxicities respectively. Grade 3 acute skin toxicity ranged from 1 to 7% whilst moderate to severe fibrosis and telangiectasia were both limited to 9%. Reported toxicity profiles were comparable to historical data at similar time-points. Studies investigating the delivery of concurrent boosts with whole breast radiotherapy courses report safe short to medium-term toxicity profiles and cosmesis rates. Whilst the quality of evidence and length of follow-up supporting these findings is low, sufficient evidence has been generated to consider concurrent boost techniques as an alternative to conventional sequential techniques. Copyright © 2016 Elsevier Ltd. All rights reserved.

Retrospective review of congenital heart disease in 976 dogs.

PubMed

Oliveira, P; Domenech, O; Silva, J; Vannini, S; Bussadori, R; Bussadori, C

2011-01-01

Knowledge of epidemiology is important for recognition of cardiovascular malformations. Review the incidence of congenital heart defects in dogs in Italy and assess breed and sex predispositions. Nine hundred and seventy-six dogs diagnosed with congenital heart disease (CHD) of 4,480 dogs presented to Clinica Veterinaria Gran Sasso for cardiovascular examination from 1997 to 2010. A retrospective analysis of medical records regarding signalment, history, clinical examination, radiography, electrocardiography, echocardiography, angiography, and postmortem examination was performed. Breed and sex predisposition were assessed with the odds ratio test. CHD was observed in 21.7% of cases. A total of 1,132 defects were observed with single defects in 832 cases (85%), 2 concurrent defects in 132 cases (14%), and 3 concurrent defects in 12 cases (1%). The most common defects were pulmonic stenosis (PS; 32.1%), subaortic stenosis (SAS; 21.3%), and patent ductus arteriosus (20.9%), followed by ventricular septal defect (VSD; 7.5%), valvular aortic stenosis (AS; 5.7%), and tricuspid dysplasia (3.1%). SAS, PS, and VSD frequently were associated with other defects. Several breed and sex predispositions were identified. The results of this study are in accordance with previous studies, with slight differences. The breed and sex predilections identified may be of value for the diagnosis and screening of CHD in dogs. Additionally, the relatively high percentage of concurrent heart defects emphasizes the importance of accurate and complete examinations for identification. Because these data are from a cardiology referral center, a bias may exist. Copyright © 2011 by the American College of Veterinary Internal Medicine.

Correlations Between Extreme Atmospheric Hazards and Global Teleconnections: Implications for Multihazard Resilience

NASA Astrophysics Data System (ADS)

Steptoe, H.; Jones, S. E. O.; Fox, H.

2018-03-01

Occurrences of concurrent extreme atmospheric hazards represent a significant area of uncertainty for organizations involved in disaster mitigation and risk management. Understanding risks posed by natural disasters and their relationship with global climate drivers is crucial in preparing for extreme events. In this review we quantify the strength of the physical mechanisms linking hazards and atmosphere-ocean processes. We demonstrate how research from the science community may be used to support disaster risk reduction and global sustainable development efforts. We examine peer-reviewed literature connecting 16 regions affected by extreme atmospheric hazards and eight key global drivers of weather and climate. We summarize current understanding of multihazard disaster risk in each of these regions and identify aspects of the global climate system that require further investigation to strengthen our resilience in these areas. We show that some drivers can increase the risk of concurrent hazards across different regions. Organizations that support disaster risk reduction, or underwrite exposure, in multiple regions may have a heightened risk of facing multihazard losses. We find that 15 regional hazards share connections via the El Niño-Southern Oscillation, with the Indian Ocean Dipole, North Atlantic Oscillation, and the Southern Annular Mode being secondary sources of significant regional interconnectivity. From a hazard perspective, rainfall over China shares the most connections with global drivers and has links to both Northern and Southern Hemisphere modes of variability. We use these connections to assess the global likelihood of concurrent hazard occurrence in support of multihazard resilience and disaster risk reduction goals.

Hearing outcome after concurrent endolymphatic shunt and vestibular nerve section.

PubMed

Moody-Antonio, Stephanie; House, John W

2003-05-01

To determine if endolymphatic shunt surgery concurrent with vestibular nerve section improves hearing outcome compared with vestibular nerve section alone. Retrospective observational study with cross-sectional survey. Tertiary otologic private practice. Thirty-five patients who underwent vestibular nerve section and endolymphatic shunt surgery and 17 patients who had vestibular nerve section alone between 1985 and 2000. Chart review and correspondence for audiogram results and survey. Hearing at last follow-up. Hearing Handicap Inventory, Dizziness Handicap Inventory, Tinnitus Handicap Inventory, and SF-36. Eight patients in the vestibular nerve section and 15 in the vestibular nerve section and endolymphatic shunt surgery group had an audiogram at more than 16 months after surgery available for review. In the vestibular nerve section group, three patients had same hearing whereas five were worse. In the vestibular nerve section and endolymphatic shunt surgery group, 2 patients showed improvement, 2 were the same, and 11 were worse. There was no significant difference in the change from preoperative pure tone average or Word Discrimination Score to postoperative levels between the surgical groups. Eighteen patients had serviceable hearing preoperatively. Five of 8 in the vestibular nerve section and 4 of 10 in the vestibular nerve section and endolymphatic shunt surgery groups maintained serviceable hearing postoperatively. Of the 52 patients, 33 responded to the survey (63%). There were no significant differences between the groups for Dizziness Handicap Inventory, Hearing Handicap Inventory, Tinnitus Handicap Inventory, or SF-36, suggesting that patient-oriented outcomes are the same in both groups. Concurrent endolymphatic shunt surgery and vestibular nerve section does not improve hearing or tinnitus outcome over vestibular nerve section alone.

Self-rating inventory for posttraumatic stress disorder: review of the psychometric properties of a new brief Dutch screening instrument.

PubMed

Hovens, J E; Bramsen, I; van der Ploeg, H M

2002-06-01

The Self-rating Inventory for Posttraumatic Stress Disorder of 22 items was developed for use with populations without identified traumatic experiences. The inventory has been used extensively in survey research in The Netherlands. This paper examines the psychometric properties. In four different groups (trauma and psychiatric patients, elderly Dutch subjects, former peacekeepers, and medical students) internal consistency, test-retest reliability, concurrent and discriminant validity, and sensitivity and specificity are analyzed. The inventory showed good internal consistency, test-retest reliability, concurrent and discriminant validity, and high sensitivity and specificity. It appears to be valuable for survey research on posttraumatic stress in nonselected populations. As a screening device, high sensitivity for PTSD symptoms is evident even when the traumatic event has not been defined.

Whatever happened to "What might have been"? Regrets, happiness, and maturity.

PubMed

King, Laura A; Hicks, Joshua A

2007-10-01

Although lost opportunities and mistaken expectations are unpleasant to think and talk about, these experiences may have a role to play in personality development. Drawing on research using narratives of lost possible selves, the authors review the relations of regrettable experiences to 2 important and independent aspects of maturity, happiness and complexity. Thinking about a lost possible self is related to concurrent regrets, distress, and lowered well-being; however, elaborating on a lost possible self is related, concurrently, to complexity and predicts complexity, prospectively, over time. In this article, the authors describe the role that regrettable experiences have in promoting both happiness and complexity. Finally, expanding on previous work, the authors examine potential affordances of happy maturity and suggest psychological capacities that may promote happy maturity. Copyright 2007 APA, all rights reserved.

Using reinforcement learning to examine dynamic attention allocation during reading.

PubMed

Liu, Yanping; Reichle, Erik D; Gao, Ding-Guo

2013-01-01

A fundamental question in reading research concerns whether attention is allocated strictly serially, supporting lexical processing of one word at a time, or in parallel, supporting concurrent lexical processing of two or more words (Reichle, Liversedge, Pollatsek, & Rayner, 2009). The origins of this debate are reviewed. We then report three simulations to address this question using artificial reading agents (Liu & Reichle, 2010; Reichle & Laurent, 2006) that learn to dynamically allocate attention to 1-4 words to "read" as efficiently as possible. These simulation results indicate that the agents strongly preferred serial word processing, although they occasionally attended to more than one word concurrently. The reason for this preference is discussed, along with implications for the debate about how humans allocate attention during reading. Copyright © 2013 Cognitive Science Society, Inc.

48 CFR 306.304 - Approval of the justification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... where the individual designated as the CA does not meet the requirements of FAR 6.304 (a)(3)(ii). This... acquisitions in the dollar amount cited in FAR 6.304(a)(2) through (a)(4), the CCO, if applicable, and the HCA shall indicate their review of, and concurrence with, the justification by signing the JOFOC. (a) The...

48 CFR 306.304 - Approval of the justification.

Code of Federal Regulations, 2014 CFR

2014-10-01

... where the individual designated as the CA does not meet the requirements of FAR 6.304 (a)(3)(ii). This... acquisitions in the dollar amount cited in FAR 6.304(a)(2) through (a)(4), the CCO, if applicable, and the HCA shall indicate their review of, and concurrence with, the justification by signing the JOFOC. (a) The...

48 CFR 306.304 - Approval of the justification.

Code of Federal Regulations, 2012 CFR

2012-10-01

... where the individual designated as the CA does not meet the requirements of FAR 6.304 (a)(3)(ii). This... acquisitions in the dollar amount cited in FAR 6.304(a)(2) through (a)(4), the CCO, if applicable, and the HCA shall indicate their review of, and concurrence with, the justification by signing the JOFOC. (a) The...

48 CFR 306.304 - Approval of the justification.

Code of Federal Regulations, 2013 CFR

2013-10-01

... where the individual designated as the CA does not meet the requirements of FAR 6.304 (a)(3)(ii). This... acquisitions in the dollar amount cited in FAR 6.304(a)(2) through (a)(4), the CCO, if applicable, and the HCA shall indicate their review of, and concurrence with, the justification by signing the JOFOC. (a) The...

Perspectives on Age and Continuing Professional Development for Nurses: A Literature Review

ERIC Educational Resources Information Center

Pool, Inge A.; Poell, Rob F.; ten Cate, Th. J.

2013-01-01

The need for nurses to participate in continuing professional development (CPD) is growing to keep abreast of rapid changes in nursing care. Concurrently, the nursing workforce is growing older. Ageing leads to changes in biological, psychological, and social functioning. Little is known about the effects of age-related changes on nurses'…

48 CFR 215.407-5-70 - Disclosure, maintenance, and review requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... concurrence or at the request of the ACO, determines it to be in the best interest of the Government (e.g... contractors meeting the criteria in paragraph (b)(2)(i) of this section; (ii) Consider whether to apply the... contractors subject to paragraph (b)(2) of this section, shall— (i) Determine the acceptability of the...

76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-03

.... The majority of the requests come from the Primary Care Offices (PCOs) in the State Health Departments... are referred to the PCOs for their review and concurrence. In addition, applicants are expected to..., lists of designated HPSAs are provided to all PCOs, state medical and dental societies and others, with...

Review of "Spend Smart: Fix Our Broken School Funding System"

ERIC Educational Resources Information Center

Baker, Bruce

2011-01-01

ConnCAN's Spend Smart: "Fix Our Broken School Funding System" was released concurrently with a bill introduced in the Connecticut legislature, based on the principles outlined in the report. However, the report is of negligible value to the policy debate over Connecticut school finance because it provides little or no support for any of…

Aviation Pilot Training I & II. Flight Syllabus. Field Review Copy.

ERIC Educational Resources Information Center

Upchurch, Richard

This guide for aviation pilot training I and II begins with a course description, resource information, and a course outline. The syllabus is designed to be used concurrently with the ground school program. A minimum of 29 flights are scheduled with a minimum of 40 hours total flight time. Tasks/competencies are categorized into five concept/duty…

78 FR 14069 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Shrimp Fishery Off the Southern...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-04

...-BC58 Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Shrimp Fishery Off the Southern... Fishery Management Plan for the Shrimp Fishery of the South Atlantic Region (FMP) for review, approval... Atlantic states may request a concurrent closure of the penaeid shrimp (brown, pink, and white shrimp...

Regular Classroom Teachers' Attitudes toward Mainstreaming the Emotionally Disturbed: Can They Be Changed?

ERIC Educational Resources Information Center

Beare, Paul L.

This study reviews the effects of training and service in a student advocacy program for Emotionally Disturbed (ED) children on attitudes of 16 secondary teachers toward ED children in the regular class. The intervention program involved 6 days of inservice training on working with ED students, delivered concurrent with the teachers' serving in an…

76 FR 65172 - Fresh Garlic From the People's Republic of China: Partial Preliminary Results, Rescission of, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-20

...'s Republic of China: Partial Preliminary Results, Rescission of, and Intent To Rescind, in Part, the... from the People's Republic of China (PRC) covering the period of review (POR) of November 1, 2009... Republic of China, dated concurrently with this notice. The Department invites interested parties to...

Effect of Using Separate Laboratory and Lecture Courses for Introductory Crop Science on Student Performance.

ERIC Educational Resources Information Center

Wiebold, W. J.; Slaughter, Leon

1986-01-01

Reviews a study that examined the effects of laboratories on the grade performance of undergraduates in an introductory crop science course. Results indicated that students enrolled in lecture and laboratory concurrently did not receive higher lecture grades than students enrolled solely in lecture, but did have higher laboratory grades. (ML)

76 FR 69159 - Airworthiness Directives; The Boeing Company Airplanes Model 737-600, -700, -700C, -800, -900...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... evacuating the aircraft. Relevant Service Information We reviewed Goodrich Service Bulletin 5A3307-25-389... certain part numbers, Goodrich Service Bulletin 5A3307-25-389, dated November 8, 2010, specifies... Bulletin 5A3307-25-389, dated November 8, 2010, also specifies concurrent accomplishment of Goodrich...

Comment on "Information Processing in the Cerebral Hemispheres: Selective Activation and Capacity Limitations" by Hellige, Cox, and Litvac.

ERIC Educational Resources Information Center

Cohen, Gillian

1979-01-01

Kinsbourne's attentional model of hemisphere differences is reviewed, and some difficulties inherent in this model are described. Although others have succeeded in identifying some factors that govern effects of selective activation, effects of general activation are uncertain, so the overall outcome of concurrent memory loading is still difficult…

Permanent antibiotic impregnated intramedullary nail in diabetic limb salvage: a case report and literature review

PubMed Central

Woods, Jason B.; Lowery, Nicholas J.; Burns, Patrick R.

2012-01-01

Managing complications after attempted hind foot and ankle arthrodesis with intramedullary nail fixation is a challenge. This situation becomes more problematic in the patient with diabetes mellitus and multiple comorbidities. Infection and subsequent osteomyelitis can be a devastating, limb threatening complication associated with these procedures. The surgeon must manage both the infectious process and the skeletal instability concurrently. This article provides a literature review and detailed management strategies for a modified technique of employing antibiotic impregnated polymethylmethacrylate-coated intramedullary nailing. PMID:22396833

Contact drying: a review of experimental and mechanistic modeling approaches.

PubMed

Sahni, Ekneet Kaur; Chaudhuri, Bodhisattwa

2012-09-15

Drying is one of the most complex unit operations with simultaneous heat and mass transfer. The contact drying process is also not well understood as several physical phenomena occur concurrently. This paper reviews current experimental and modeling approaches employed towards a better understanding of the contact drying operation. Additionally, an overview of some fundamental aspects relating to contact drying is provided. A brief discussion of some model extensions such as incorporation of noncontact forces, interstitial fluids and attrition rate is also presented. Copyright © 2012 Elsevier B.V. All rights reserved.

Concurrent exercise training: do opposites distract?

PubMed Central

Coffey, Vernon G.

2016-01-01

Abstract Specificity is a core principle of exercise training to promote the desired adaptations for maximising athletic performance. The principle of specificity of adaptation is underpinned by the volume, intensity, frequency and mode of contractile activity and is most evident when contrasting the divergent phenotypes that result after undertaking either prolonged endurance or resistance training. The molecular profiles that generate the adaptive response to different exercise modes have undergone intense scientific scrutiny. Given divergent exercise induces similar signalling and gene expression profiles in skeletal muscle of untrained or recreationally active individuals, what is currently unclear is how the specificity of the molecular response is modified by prior training history. The time course of adaptation and when ‘phenotype specificity’ occurs has important implications for exercise prescription. This context is essential when attempting to concomitantly develop resistance to fatigue (through endurance‐based exercise) and increased muscle mass (through resistance‐based exercise), typically termed ‘concurrent training’. Chronic training studies provide robust evidence that endurance exercise can attenuate muscle hypertrophy and strength but the mechanistic underpinning of this ‘interference’ effect with concurrent training is unknown. Moreover, despite the potential for several key regulators of muscle metabolism to explain an incompatibility in adaptation between endurance and resistance exercise, it now seems likely that multiple integrated, rather than isolated, effectors or processes generate the interference effect. Here we review studies of the molecular responses in skeletal muscle and evidence for the interference effect with concurrent training within the context of the specificity of training adaptation. PMID:27506998

Hepatic lipidosis: Clinical review drawn from collective effort.

PubMed

Webb, Craig B

2018-03-01

Practical relevance: Hepatic lipidosis (HL) is the most common form of liver dysfunction in cats. If recognized early and treated appropriately, the prognosis is good; if not, the prognosis is grave. Clinical challenges: Distinguishing HL as idiopathic or secondary is critical since the presence of a concurrent disease affects the therapeutic plan and the prognosis. Despite the unique and severe nature of a cat's response to anorexia and the complexity of the metabolic changes underlying this condition, the clinical acumen and technical ability to effectively diagnose and treat HL are readily available to all small animal practitioners. Patient group: Although many species develop a 'fatty liver', the cat is one of relatively few species that suffer from HL. The classic presentation is that of an overweight cat that stops eating for days to weeks, losing weight in the process. Equipment: Abdominal ultrasound is frequently employed in the diagnostic work-up of an anorectic cat; ultrasonographic findings often support a presumptive diagnosis, provide samples for cytology and, perhaps most importantly, help identify concurrent conditions that must be addressed for therapeutic success. All of the equipment necessary for essential nutritional intervention in an anorectic cat is readily available and easily affordable. Evidence base: The material for this review draws heavily on a relatively large number of original studies, excellent reviews by recognized experts, and informative communication with experienced clinicians, hence the term 'collective effort'.

Revisiting the J shaped curve, exploring the association between cardiovascular risk factors and concurrent depressive symptoms in patients with cardiometabolic disease: Findings from a large cross-sectional study.

PubMed

Jani, Bhautesh Dinesh; Cavanagh, Jonathan; Barry, Sarah J E; Der, Geoff; Sattar, Naveed; Mair, Frances S

2014-10-28

Depression is common in patients with cardiometabolic diseases but little is known about the relationship, if any, between cardiovascular risk factor values and depressive symptoms in patients with these conditions. The objective of this paper is to study the association between cardiovascular risk factors and concurrent depressive symptoms in patients with three common cardiometabolic conditions: coronary heart disease (CHD), stroke and diabetes. We retrospectively reviewed primary care data for N = 35537 with 1 of the above 3 conditions who underwent depression screening using the depressive subscale of hospital anxiety and depression score (HADS-D). We reviewed 4 cardiometabolic risk factors (Systolic Blood Pressure [SBP], Diastolic Blood Pressure [DBP], BMI and total cholesterol) recorded concurrently in all patients and HbA1c in patients with diabetes (n = 18453). We analysed the association between individual risk factor value and a positive HADS-D screening result (>7) using logistic regression. SBP and BMI were noted to have a non-linear "J-shaped" relationship with the probability of having a positive HADS-D and observed nadirs (levels with the lowest probability) of 148 mm Hg and 30.70 kg/m2, respectively. Total cholesterol and DBP found to have a weaker curvilinear association with concurrent depression symptoms and nadirs of 3.60 mmol/l and 74 mmHg. Among patients with Diabetes, HbA1c was also found to have a "J-shaped" relationship with probability of having a positive HADS-D with an observed nadir of 7.06% DCCT. The above relationships remain significant after adjusting for age, sex, socio-economic status and number of co-morbid conditions. In patients with cardiometabolic disease, cardiovascular risk factor values at both extremes were associated with higher positive depression screening after adjusting for confounders. These findings have potentially important implications for clinical practice in relation to both risk stratification for depression and approaches to secondary prevention in individuals with cardiometabolic disease and merit further investigation to determine the nature and direction of the observed association.Please see related article: http://www.biomedcentral.com/1741-7015/12/199.

Emotion socialization and child conduct problems: A comprehensive review and meta-analysis.

PubMed

Johnson, Ameika M; Hawes, David J; Eisenberg, Nancy; Kohlhoff, Jane; Dudeney, Joanne

2017-06-01

Decades of research have emphasized the role that coercive and ineffective discipline plays in shaping child and adolescent conduct problems, yet an emerging body of evidence has suggested that parents' emotion socialization behaviors (ESBs) (e.g., reactions to emotions, discussion of emotions, and emotion coaching) may also be implicated. This meta-analysis examined concurrent and longitudinal associations between parental ESBs and conduct problems, and tested for moderators of these associations. A systematic search identified 49 studies for which data on concurrent associations between ESBs and conduct problems were available (n=6270), and 14 studies reporting on prospective associations (n=1899). Parental ESBs were found to be significantly associated with concurrent (r=-0.08) and prospective (r =-0.11) conduct problems, in the order of small effect sizes. Key findings of moderator analyses were that ESBs were more strongly associated with conduct problems at younger ages and when ESBs were focused on the socialization of negative rather than positive emotions. Findings support the integration of ESBs into family-based models of antisocial behavior, and have the potential to inform the design of parent training interventions for the prevention and treatment of child conduct problems. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Neurologist and emergency neuroendovascular revascularization -training programs for endovascular procedures-].

PubMed

Imai, Keisuke; Hamanaka, Masashi; Yamada, Takehiro; Yamazaki, Hidekazu; Yamamoto, Atsushi; Tsuto, Kazuma; Takegami, Tetsuro; Umezawa, Kunihiko; Ikeda, Eito; Mizuno, Toshiki

2014-01-01

Emergency neuroendovascular revascularization is a reperfusion therapy for acute stroke. The operator for this therapy has to obtain a license as a specialist in endovascular procedures. For neurologists wishing to acquire this license, there are two kinds of training programs: full-time training and concurrent training. Full-time training was chosen by the first author of this review, while concurrent training will be performed by staff in the author's department. The advantage of full-time training is the acquisition of a lot of experience of various diseases that are treated with endovascular procedures and managed in the periprocedural period. However, full-time training has the disadvantages of a requirement to discontinue medical care of neurological diseases except for stroke and employment at a remote institution. The advantages and disadvantages of concurrent training are the reverse of those of full-time training. Neither training system can succeed without cooperation from Departments of Neurology in neighboring universities and the institutional Department of Neurosurgery. It is particularly important for each neurologist to establish a goal of becoming an operator for recanalization therapy alone or for all fields of endovascular procedures because training will differ for attainment of each operator's goal.

Artificial concurrent catalytic processes involving enzymes.

PubMed

Köhler, Valentin; Turner, Nicholas J

2015-01-11

The concurrent operation of multiple catalysts can lead to enhanced reaction features including (i) simultaneous linear multi-step transformations in a single reaction flask (ii) the control of intermediate equilibria (iii) stereoconvergent transformations (iv) rapid processing of labile reaction products. Enzymes occupy a prominent position for the development of such processes, due to their high potential compatibility with other biocatalysts. Genes for different enzymes can be co-expressed to reconstruct natural or construct artificial pathways and applied in the form of engineered whole cell biocatalysts to carry out complex transformations or, alternatively, the enzymes can be combined in vitro after isolation. Moreover, enzyme variants provide a wider substrate scope for a given reaction and often display altered selectivities and specificities. Man-made transition metal catalysts and engineered or artificial metalloenzymes also widen the range of reactivities and catalysed reactions that are potentially employable. Cascades for simultaneous cofactor or co-substrate regeneration or co-product removal are now firmly established. Many applications of more ambitious concurrent cascade catalysis are only just beginning to appear in the literature. The current review presents some of the most recent examples, with an emphasis on the combination of transition metal with enzymatic catalysis and aims to encourage researchers to contribute to this emerging field.

Traumatic Fractures of the Cervical Spine: Analysis of Changes in Incidence, Cause, Concurrent Injuries, and Complications Among 488,262 Patients from 2005 to 2013.

PubMed

Passias, Peter G; Poorman, Gregory W; Segreto, Frank A; Jalai, Cyrus M; Horn, Samantha R; Bortz, Cole A; Vasquez-Montes, Dennis; Diebo, Bassel G; Vira, Shaleen; Bono, Olivia J; De La Garza-Ramos, Rafael; Moon, John Y; Wang, Charles; Hirsch, Brandon P; Zhou, Peter L; Gerling, Michael; Koller, Heiko; Lafage, Virginie

2018-02-01

The causes and epidemiology of traumatic cervical spine fracture have not been described with sufficient power or recency. Our goal is to describe demographics, incidence, cause, spinal cord injuries (SCIs), concurrent injuries, treatments, and complications of traumatic cervical spine fractures. A retrospective review was carried out of the Nationwide Inpatient Sample. International Classification of Disease, Ninth Revision E-codes identified trauma cases from 2005 to 2013. Patients with cervical fracture were isolated. Demographics, incidence, cause, fracture levels, concurrent injuries, surgical procedures, and complications were analyzed. t tests elucidated significance for continuous variables and χ 2 for categorical variables. Level of significance was P < 0.05. A total of 488,262 patients were isolated (age, 55.96 years; male, 60.0%; white, 77.5%). Incidence (2005, 4.1% vs. 2013, 5.4%), Charlson Comorbidity Index (2005, 0.6150 vs. 2013, 1.1178), and total charges (2005, $71,228.60 vs. 2013, $108,119.29) have increased since 2005, whereas length of stay decreased (2005, 9.22 vs. 2013, 7.86) (all P < 0.05). The most common causes were motor vehicle accident (29.3%), falls (23.7%), and pedestrian accidents (15.7%). The most frequent fracture types were closed at C2 (32.0%) and C7 (20.9%). Concurrent injury rates have significantly increased since 2005 (2005, 62.3% vs. 2013, 67.6%). Common concurrent injuries included fractures to the rib/sternum/larynx/trachea (19.6%). Overall fusion rates have increased since 2005 (2005, 15.7% vs. 2013, 18.0%), whereas decompressions and halo insertion rates have decreased (all P < 0.05). SCIs have significantly decreased since 2005, except for upper cervical central cord syndrome. Complication rates have significantly increased since 2005 (2005, 31.6% vs. 2013, 36.2%). Common complications included anemia (7.7%), mortality (6.6%), and acute respiratory distress syndrome (6.6%). Incidence, complications, concurrent injuries, and fusions have increased since 2005. Length of stay, SCIs, decompressions, and halo insertions have decreased. Indicated trends should guide future research in management guidelines. Copyright © 2017 Elsevier Inc. All rights reserved.

78 FR 14824 - Agency Information Collection Activities: Submitted for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-07

... Alaska. Value is the average of the daily mean ANS spot prices published in any ONRR-approved publication during the trading month most concurrent with the production month. (1) To calculate the daily mean spot... ANS spot price is an unreasonable value. (1) . . . you may apply to the ONRR Director to establish a...

Where to cut, where to run : prospects for U.S. South softwood timber supplies and prices

Treesearch

Henry Spelter

1999-01-01

A review of market history shows that southern pine sawtimber stumpage prices have increased by over 150 percent in this decade (Timber Mart South). Concurrently, some (i.e. Cubbage and Abt (1996) Nilsson et al (1999)) have questioned the adequacy of southern timber supplies to meet projected demands, which are projected to increase by...

76 FR 31958 - Information Collection Being Submitted for Review and Approval to the Office of Management and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-02

... enhance the quality, utility, and clarity of the information collected; (d) ways to minimize the burden of... frequencies. Section 90.545(c)(1) requires that public safety applicants select one of three ways to meet TV... engineering study to justify other separations; or (3) obtain concurrence from the applicable TV/DTV station(s...

Management of Concurrent Pregnancy and Acute Lymphoblastic Malignancy in Teenaged Patients: Two Illustrative Cases and Review of the Literature

PubMed Central

Johnson, Liza-Marie; Church, Christopher L.; Gomez-Garcia, Wendy C.; Popescu, Marcela I.; Margolin, Judith F.; Ribeiro, Raul C.

2014-01-01

The usual age range of acute lymphoblastic malignancies (acute lymphoblastic leukemia and advanced-stage lymphoblastic lymphoma) includes teenagers and young adults (<22 years of age) and coincides with the age of fertility. Concurrence of acute lymphoblastic malignancy with pregnancy is therefore most likely to happen during the younger childbearing ages. However, the therapeutic challenges posed by the dual diagnosis of lymphoblastic malignancy and pregnancy have not specifically been studied in the context of age, and management guidelines for pregnant young patients are lacking. Inconsistency in defining the legal decision-making rights of pregnant teenaged patients adds a further level of complexity in this age group. Management of this challenging combination in the young patient therefore entails unique ethical considerations. Here we present two illustrative cases of teenage pregnancy complicated by acute lymphoblastic malignancy, review the available literature, and offer suggestions for the therapeutic management of such cases in adolescent and young adult patients. Importantly, practical management recommendations are provided in the context of clinical ethics principles that are universally applicable, including in developing countries, where the highest incidence of adolescent pregnancies has been documented. PMID:25538861

Visualizing the Comorbidity Burden in Children with Autism Spectrum Disorder Receiving Dental Treatment Under General Anesthesia.

PubMed

Mathu-Muju, Kavita R; Li, Hsin-Fang; Nam, Lisa H; Bush, Heather M

2016-01-01

The purposes of this study were to: (1) describe the comorbidity burden in children with autism spectrum disorder (ASD) receiving dental treatment under general anesthesia (GA); and (2) characterize the complexity of these concurrent comorbidities. A retrospective chart review was completed of 303 children with ASD who received dental treatment under GA. All comorbidities, in addition to the primary diagnosis of ASD, were categorized using the International Classification of Diseases-10 codes. The interconnectedness of the comorbidities was graphically displayed using a network plot. Network indices (degree centrality, betweenness centrality, closeness centrality) were used to characterize the comorbidities that exhibited the highest connectedness to ASD. The network plot of medical diagnoses for children with ASD was highly complex, with multiple connected comorbidities. Developmental delay, speech delay, intellectual disability, and seizure disorders exhibited the highest connectedness to ASD. Children with autism spectrum disorder may have a significant comorbidity burden of closely related neurodevelopmental disorders. The medical history review should assess the severity of these concurrent disorders to evaluate a patient's potential ability to cooperate for dental treatment and to determine appropriate behavior guidance techniques to facilitate the delivery of dental care.

Management of elderly patients with glioblastoma-multiforme-a systematic review.

PubMed

Almadani, Asmaa; Sanjay, Dixit; Chris, Rowland-Hill; Shailendra, Achawal; Chitoor, Rajaraman; Gerry, O'Reilly; Robin, Highley; Masood, Hussain; Louise, Baker; Lynne, Gill; Holly, Morris; Mohan, Hingorani

2018-03-09

The management of elderly patients with glioblastoma-multiforme (GBM) remains poorly defined with many experts in the past advocating best supportive care, in view of limited evidence on efficacy of more aggressive treatment protocols. There is randomised evidence (NORDIC and NA-O8 studies) to support the use of surgery followed by adjuvant monotherapy with either radiotherapy (RT) using hypofractionated regimes (e.g. 36 Gy in 6 fractions OR 40 Gy in 15 fractions) or chemotherapy with temozolomide (TMZ) in patients expressing methylation of promoter for O 6 -methylguanine-DNA methyltransferase enzyme. However, the role of combined-modality therapy involving the use of combined RT and TMZ protocols has remained controversial with data from the EORTC (European Organisation for Research and Treatment of Cancer)-NCIC (National Cancer Institute of Canada) studies indicating that patients more than 65 years of age may not benefit significantly from combining standard RT fractionation using 60 Gy in 30 fractions with concurrent and adjuvant TMZ. More recently, randomised data has emerged on combining hypofractionated RT with concurrent and adjuvant TMZ. We provide a comprehensive review of literature with the aim of defining an evidence-based algorithm for management of elderly glioblastoma-multiforme population.

The Diagnostic Dilemma of Pathological Appearance and Performance Enhancing Drug Use

PubMed Central

Hildebrandt, Tom; Lai, Justine K.; Langenbucher, James W.; Schneider, Melanie; Yehuda, Rachel; Pfaff, Donald W.

2010-01-01

Appearance and performance enhancing drug (APED) use includes the use of a range of pharmacologically distinct substances and concurrent investment in outward appearance or achievement, dietary control, and frequent exercise. A number of existing reviews and conceptual papers have defined pathological forms of APED use within the APED class of anabolic-androgenic steroids (AASs) and using the framework of AAS dependence. We review published data on APED use including human studies of AAS users and identified three defining phenomenological features associated with increased health risk and pathology. These features included (1) polypharmacy or the concurrent use of several pharmacologically distinct substances used to change outward appearance or increase likelihood of personal achievement; (2) significant body image disturbance; (3) rigid practices and preoccupations with diet and exercise. Investigations into the latent structure of APED use suggest these features cluster together in a homogenous group of APED users who have the highest health risk and most psychopathology. These features are discussed in the context of AAS dependence and problems with defining classic tolerance-withdrawal symptoms among APED users. Suggestions for a resolution and outline for future research needed to determine the best system for identifying and diagnosing pathological APED use are discussed. PMID:21115306

Avoiding Severe Toxicity From Combined BRAF Inhibitor and Radiation Treatment: Consensus Guidelines from the Eastern Cooperative Oncology Group (ECOG)

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

Anker, Christopher J., E-mail: chris.anker@UVMHealth.org; Grossmann, Kenneth F.; Atkins, Michael B.

2016-06-01

BRAF kinase gene V600 point mutations drive approximately 40% to 50% of all melanomas, and BRAF inhibitors (BRAFi) have been found to significantly improve survival outcomes. Although radiation therapy (RT) provides effective symptom palliation, there is a lack of toxicity and efficacy data when RT is combined with BRAFi, including vemurafenib and dabrafenib. This literature review provides a detailed analysis of potential increased dermatologic, pulmonary, neurologic, hepatic, esophageal, and bowel toxicity from the combination of BRAFi and RT for melanoma patients described in 27 publications. Despite 7 publications noting potential intracranial neurotoxicity, the rates of radionecrosis and hemorrhage from wholemore » brain RT (WBRT), stereotactic radiosurgery (SRS), or both do not appear increased with concurrent or sequential administration of BRAFis. Almost all grade 3 dermatitis reactions occurred when RT and BRAFi were administered concurrently. Painful, disfiguring nondermatitis cutaneous reactions have been described from concurrent or sequential RT and BRAFi administration, which improved with topical steroids and time. Visceral toxicity has been reported with RT and BRAFi, with deaths possibly related to bowel perforation and liver hemorrhage. Increased severity of radiation pneumonitis with BRAFi is rare, but more concerning was a potentially related fatal pulmonary hemorrhage. Conversely, encouraging reports have described patients with leptomeningeal spread and unresectable lymphadenopathy rendered disease free from combined RT and BRAFi. Based on our review, the authors recommend holding RT ≥3 days before and after fractionated RT and ≥1 day before and after SRS. No fatal reactions have been described with a dose <4 Gy per fraction, and time off systemic treatment should be minimized. Future prospective data will serve to refine these recommendations.« less

Avoiding Severe Toxicity From Combined BRAF Inhibitor and Radiation Treatment: Consensus Guidelines from the Eastern Cooperative Oncology Group (ECOG)

PubMed Central

Anker, Christopher J.; Grossmann, Kenneth F.; Atkins, Michael B.; Suneja, Gita; Tarhini, Ahmad A.; Kirkwood, John M.

2016-01-01

BRAF kinase gene V600 point mutations drive approximately 40% to 50% of all melanomas, and BRAF inhibitors (BRAFi) have been found to significantly improve survival outcomes. Although radiation therapy (RT) provides effective symptom palliation, there is a lack of toxicity and efficacy data when RT is combined with BRAFi, including vemurafenib and dabrafenib. This literature review provides a detailed analysis of potential increased dermatologic, pulmonary, neurologic, hepatic, esophageal, and bowel toxicity from the combination of BRAFi and RT for melanoma patients described in 27 publications. Despite 7 publications noting potential intracranial neurotoxicity, the rates of radionecrosis and hemorrhage from whole brain RT (WBRT), stereotactic radiosurgery (SRS), or both do not appear increased with concurrent or sequential administration of BRAFis. Almost all grade 3 dermatitis reactions occurred when RT and BRAFi were administered concurrently. Painful, disfiguring nondermatitis cutaneous reactions have been described from concurrent or sequential RT and BRAFi administration, which improved with topical steroids and time. Visceral toxicity has been reported with RT and BRAFi, with deaths possibly related to bowel perforation and liver hemorrhage. Increased severity of radiation pneumonitis with BRAFi is rare, but more concerning was a potentially related fatal pulmonary hemorrhage. Conversely, encouraging reports have described patients with leptomeningeal spread and unresectable lymphadenopathy rendered disease free from combined RT and BRAFi. Based on our review, the authors recommend holding BRAFi and/or MEK inhibitors ≥3 days before and after fractionated RT and ≥1 day before and after SRS. No fatal reactions have been described with a dose <4 Gy per fraction, and time off systemic treatment should be minimized. Future prospective data will serve to refine these recommendations. PMID:27131079

Attention Demands of Spoken Word Planning: A Review

PubMed Central

Roelofs, Ardi; Piai, Vitória

2011-01-01

Attention and language are among the most intensively researched abilities in the cognitive neurosciences, but the relation between these abilities has largely been neglected. There is increasing evidence, however, that linguistic processes, such as those underlying the planning of words, cannot proceed without paying some form of attention. Here, we review evidence that word planning requires some but not full attention. The evidence comes from chronometric studies of word planning in picture naming and word reading under divided attention conditions. It is generally assumed that the central attention demands of a process are indexed by the extent that the process delays the performance of a concurrent unrelated task. The studies measured the speed and accuracy of linguistic and non-linguistic responding as well as eye gaze durations reflecting the allocation of attention. First, empirical evidence indicates that in several task situations, processes up to and including phonological encoding in word planning delay, or are delayed by, the performance of concurrent unrelated non-linguistic tasks. These findings suggest that word planning requires central attention. Second, empirical evidence indicates that conflicts in word planning may be resolved while concurrently performing an unrelated non-linguistic task, making a task decision, or making a go/no-go decision. These findings suggest that word planning does not require full central attention. We outline a computationally implemented theory of attention and word planning, and describe at various points the outcomes of computer simulations that demonstrate the utility of the theory in accounting for the key findings. Finally, we indicate how attention deficits may contribute to impaired language performance, such as in individuals with specific language impairment. PMID:22069393

Challenges in treating patients with inflammatory bowel disease and concurrent viral hepatitis infection.

PubMed

Degasperi, Elisabetta; Caprioli, Flavio; El Sherif, Omar; Back, David; Colombo, Massimo; Aghemo, Alessio

2016-12-01

Inflammatory bowel diseases (IBD) require long-term administration of immunomodulatory treatments to maintain disease remission. Due to the high worldwide prevalence of hepatitis B (HBV) or C (HCV) virus infections, presence of concurrent hepatitis can be a relevant clinical issue to manage when treating IBD. Areas covered: The paper summarizes epidemiological data about IBD and HBV/HCV infection and reviews current knowledge about the natural history of HBV and HCV in the IBD setting, concentrating on risk of hepatitis reactivation during immunosuppressive treatment. Most updated recommendations for management of HBV and HCV infections in IBD patients are discussed. Expert commentary: The development of new drugs for IBD with different molecular targets and the availability of potent and efficacious antiviral drugs for HBV and HCV will simplify management of hepatitis infection in IBD patients in the near future.

Preclinical Determinants of Drug Choice under Concurrent Schedules of Drug Self-Administration

PubMed Central

Banks, Matthew L.; Negus, S. Stevens

2012-01-01

Drug self-administration procedures have played a critical role in the experimental analysis of psychoactive compounds, such as cocaine, for over 50 years. While there are numerous permutations of this procedure, this paper will specifically focus on choice procedures using concurrent schedules of intravenous drug self-administration. The aims of this paper are to first highlight the evolution of drug choice procedures and then review the subsequent preclinical body of literature utilizing these choice procedures to understand the environmental, pharmacological, and biological determinants of the reinforcing stimulus effects of drugs. A main rationale for this paper is our proposition that choice schedules are underutilized in investigating the reinforcing effects of drugs in assays of drug self-administration. Moreover, we will conclude with potential future directions and unexplored scientific space for the use of drug choice procedures. PMID:23243420

Polypharmacy in multimorbid older adults: protocol for a systematic review.

PubMed

Sirois, Caroline; Laroche, Marie-Laure; Guénette, Line; Kröger, Edeltraut; Cooper, Dan; Émond, Valérie

2017-05-19

Polypharmacy, the concurrent use of multiple medications, consistently evokes a negative connotation, notably because it is associated with a plethora of adverse events. Nonetheless, the number of individuals exposed to polypharmacy is increasing steeply, especially for older people with multiple diseases. There is a need to carefully study the phenomenon at the population scale to full assess the associated health outcomes. Yet, this reveals a complex task because there exists no consensus indicator of polypharmacy. In fact, the definitions of polypharmacy are heterogeneous and its predisposing factors and associated outcomes are not well defined. The goal of this systematic review is to summarize the literature on polypharmacy in multimorbid individuals aged 65 years and over, targeting three objectives: (1) to identify the definitions of polypharmacy that are used in the context of multimorbidity among older individuals (≥65 years); (2) to ascertain predisposing and concurrent factors associated with polypharmacy; and (3) to describe positive and negative outcomes of polypharmacy among older individuals, including hospitalizations, mortality and costs. We will include publications from 2004 to 2016 that target four concepts: polypharmacy, older individuals, multimorbidity and positive/negative outcomes. The search will be performed using EBM Reviews, Embase, Global Health, MEDLINE, AgeLine, CINAHL, Health Policy Reference Center, Public Affairs Index, SocINDEX and Google Scholar. Two independent reviewers will screen the articles, extract the information and evaluate the methodological quality of included studies. The results will be presented in tables and narrative summaries will be performed. We will perform meta-analyses (objective 3) if the heterogeneity is not important. This review will help describe the various ways of conceptualizing polypharmacy and how it is associated with health outcomes. We have selected outcomes most relevant for public surveillance performed with administrative databases. Other positive and negative outcomes have been associated with polypharmacy but may not be included in the review. PROSPERO CRD42014014989.

Long life assurance study for manned spacecraft long life hardware. Volume 1: Summary of long life assurance guidelines

NASA Technical Reports Server (NTRS)

1972-01-01

A long life assurance program for the development of design, process, test, and application guidelines for achieving reliable spacecraft hardware was conducted. The study approach consisted of a review of technical data performed concurrently with a survey of the aerospace industry. The data reviewed included design and operating characteristics, failure histories and solutions, and similar documents. The topics covered by the guidelines are reported. It is concluded that long life hardware is achieved through meticulous attention to many details and no simple set of rules can suffice.

Working on the Boundaries: Philosophies and Practices of the Design Process

NASA Technical Reports Server (NTRS)

Ryan, R.; Blair, J.; Townsend, J.; Verderaime, V.

1996-01-01

While systems engineering process is a program formal management technique and contractually binding, the design process is the informal practice of achieving the design project requirements throughout all design phases of the systems engineering process. The design process and organization are systems and component dependent. Informal reviews include technical information meetings and concurrent engineering sessions, and formal technical discipline reviews are conducted through the systems engineering process. This paper discusses and references major philosophical principles in the design process, identifies its role in interacting systems and disciplines analyses and integrations, and illustrates the process application in experienced aerostructural designs.

Acute Leukemia and Concurrent Mediastinal Germ Cell Tumor: Case Report and Literature Review.

PubMed

Maese, Luke; Li, K David; Xu, Xinjie; Afify, Zeinab; Paxton, Christian N; Putnam, Angelica

2017-04-01

There is a known association of primary nonseminomatous mediastinal germ cell tumors (NSMGCT) and hematologic malignancy in younger males not linked to treatment. When combined these two rare entities convey a very poor prognosis. Here we report a 16-year-old male with an anterior mediastinal mass diagnosed as a malignant germ cell tumor based on elevation of serologic markers. He was found to have acute leukemia with megakaryocytic differentiation several days later. We focus our report on the pathologic findings, including a review of the literature, and a novel molecular analysis of the germ cell tumor.

Adenoid cystic carcinoma of the urethra/Cowper's gland with concurrent high-grade prostatic adenocarcinoma: a detailed clinicopathologic case report and review of the literature.

PubMed

Zhang, Miao; Pettaway, Curtis; Vikram, Raghu; Tamboli, Pheroze

2016-12-01

Primary adenoid cystic carcinoma of the urethra is uncommon with only 9 cases reported in the medical literature; all tumors arose from Cowper's glands. Herein, we report the histological features and immunohistochemical characteristics of 1 patient with primary adenoid cystic carcinoma involving the entire posterior urethra, prostate gland, corpus spongiosum, corpora cavernosa, urogenital diaphragm, perianal soft tissue, and muscularis propria layer of rectum. We also review other published cases to evaluate the prognosis and treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

A systematic review of the literature exploring the interplay between prostate cancer and type two diabetes mellitus

PubMed Central

Crawley, Danielle; Chamberlain, Florence; Garmo, Hans; Rudman, Sarah; Zethelius, Björn; Holmberg, Lars; Adolfsson, Jan; Stattin, Par; Carroll, Paul; Van Hemelrijck, Mieke

2018-01-01

Prostate cancer (PCa) and type two diabetes mellitus (T2DM) are both increasing prevalent conditions and often occur concurrently. However, the relationship between the two is more complex than just two prevalent conditions co-existing. This review systematically explores the literature around the interplay between the two conditions. It covers the impact of pre-existing T2DM on PCa incidence, grade and stage, as well as exploring the impact of T2DM on PCa outcomes and mortality and the interaction between T2DM and PCa treatments. PMID:29456619

Challenges in the concurrent management of malaria and HIV in pregnancy in sub-Saharan Africa.

PubMed

Brentlinger, Paula E; Behrens, Christopher B; Micek, Mark A

2006-02-01

Approximately one million pregnancies are complicated by both malaria and HIV infection in sub-Saharan Africa annually. Both infections have been associated with maternal and infant morbidity and mortality. Intermittent preventive treatment, usually with sulfadoxine-pyrimethamine, has been shown to prevent pregnancy-related malaria and its complications. Several different regimens of antiretroviral therapy are now available to prevent mother-to-child transmission of HIV and/or progression of maternal HIV infection during pregnancy. However, no published studies have yet shown whether standard intermittent preventive treatment and antiretroviral regimens are medically and operationally compatible in pregnancy. We reviewed existing policies regarding prevention and treatment of HIV and malaria in pregnancy, as well as published literature on adverse effects of antiretrovirals and antimalarials commonly used in pregnancy in developing countries, and found that concurrent prescription of sulfadoxine-pyrimethamine, co-trimoxazole (trimethoprim-sulfamethoxazole), and antiretroviral agents including nevirapine and zidovudine per existing protocols for prevention of malaria and vertical HIV transmission may result in adverse drug interactions or overlapping, diagnostically challenging drug toxicities. Insecticide-treated bednets should be provided for HIV-infected pregnant women at risk for malaria. Sulfadoxine-pyrimethamine should be prescribed cautiously in women concurrently receiving daily nevirapine and/or zidovudine, and should be avoided in women on daily co-trimoxazole. Further research is urgently needed to define safe and effective protocols for concurrent management of HIV and malaria in pregnancy, and to define appropriate interventions for different populations subject to differing levels of malaria transmission and antimalarial drug resistance.

Concurrent exercise training: do opposites distract?

PubMed

Coffey, Vernon G; Hawley, John A

2017-05-01

Specificity is a core principle of exercise training to promote the desired adaptations for maximising athletic performance. The principle of specificity of adaptation is underpinned by the volume, intensity, frequency and mode of contractile activity and is most evident when contrasting the divergent phenotypes that result after undertaking either prolonged endurance or resistance training. The molecular profiles that generate the adaptive response to different exercise modes have undergone intense scientific scrutiny. Given divergent exercise induces similar signalling and gene expression profiles in skeletal muscle of untrained or recreationally active individuals, what is currently unclear is how the specificity of the molecular response is modified by prior training history. The time course of adaptation and when 'phenotype specificity' occurs has important implications for exercise prescription. This context is essential when attempting to concomitantly develop resistance to fatigue (through endurance-based exercise) and increased muscle mass (through resistance-based exercise), typically termed 'concurrent training'. Chronic training studies provide robust evidence that endurance exercise can attenuate muscle hypertrophy and strength but the mechanistic underpinning of this 'interference' effect with concurrent training is unknown. Moreover, despite the potential for several key regulators of muscle metabolism to explain an incompatibility in adaptation between endurance and resistance exercise, it now seems likely that multiple integrated, rather than isolated, effectors or processes generate the interference effect. Here we review studies of the molecular responses in skeletal muscle and evidence for the interference effect with concurrent training within the context of the specificity of training adaptation. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

78 FR 43148 - Takes of Marine Mammals Incidental to Specified Activities; Taking Marine Mammals Incidental to a...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-19

.... Section 101(a)(5)(D) establishes a 45-day time limit for NMFS review of an application followed by a 30... concurrently and only one impact hammer rig was operated at a time. Due to delays in beginning construction..., Coleman, 2011, Caltrans, 2012). The variability in attenuation levels is due to variation in design, as...

Implementing Set Based Design into Department of Defense Acquisition

DTIC Science & Technology

2016-12-01

challenges for the DOD. This report identifies the original SBD principles and characteristics based on Toyota Motor Corporation’s Set Based Concurrent...Engineering Model. Additionally, the team reviewed DOD case studies that implemented SBD. The SBD principles , along with the common themes from the...perennial challenges for the DOD. This report identifies the original SBD principles and characteristics based on Toyota Motor Corporation’s Set

Low-grade and character-marked hardwoods: A research review and synthesis of solid wood manufacturing and marketing

Treesearch

David Nicholls; Matt Bumgardner

2015-01-01

There is a substantial body of research from the past half-century addressing hardwood utilization and markets in North America. This synthesis is the first to our knowledge to consider two major (and related) aspects of this research concurrently: low-grade hardwood utilization and marketing of character-marked wood features. We first consider low-grade hardwood...

CHARACTERISTICS OF MULTIPLE AND CONCURRENT PARTNERSHIPS AMONG WOMEN AT HIGH RISK FOR HIV INFECTION

PubMed Central

Adimora, Adaora A.; Hughes, James P.; Wang, Jing; Haley, Danielle F.; Golin, Carol E.; Magnus, Manya; Rompalo, Anne; Justman, Jessica; del Rio, Carlos; El-Sadr, Wafaa; Mannheimer, Sharon; Soto-Torres, Lydia; Hodder, Sally L.

2014-01-01

Objectives We examined parameters of sexual partnerships, including respondents’ participation in concurrency, belief that their partner had concurrent partnerships (partners’ concurrency), and partnership intervals, among the 2,099 women in HIV Prevention Trials Network 064, a study of women at high risk for HIV infection, in ten US communities. Methods We analyzed baseline survey responses about partnership dates to determine prevalence of participants’ and partners’ concurrency, intervals between partnerships, knowledge of whether recent partner(s) had undergone HIV testing, and intercourse frequency during the preceding 6 months. Results Prevalence of participants’ and partners’ concurrency was 40% and 36% respectively; 24% of respondents had both concurrent partnerships and non-monogamous partners. Among women with >1 partner and no concurrent partnerships themselves, the median gap between partners was one month. Multiple episodes of unprotected vaginal intercourse with >2 of their most recent partners was reported by 60% of women who had both concurrent partnerships and non-monogamous partners, 50% with only concurrent partners and no partners’ concurrency, and 33% with only partners’ concurrency versus 14% of women with neither type of concurrency (p<.0001). Women who had any involvement with concurrency were also more likely than women with no concurrency involvement to report lack of awareness of whether recent partners had undergone HIV testing (participants’ concurrency 41%, partners’ concurrency 40%, both participants’ and partners’ concurrency 48%, neither 17%; p<.0001). Conclusions These network patterns and short gaps between partnerships may create substantial opportunities for HIV transmission in this sample of women at high risk for HIV infection. PMID:24056163

A systematic review and meta-analysis examining the effect of eating rate on energy intake and hunger.

PubMed

Robinson, Eric; Almiron-Roig, Eva; Rutters, Femke; de Graaf, Cees; Forde, Ciarán G; Tudur Smith, Catrin; Nolan, Sarah J; Jebb, Susan A

2014-07-01

Reductions in eating rate are recommended to prevent and treat obesity; yet, the relation between eating rate and energy intake has not been systematically reviewed, with studies producing mixed results. Our main objective was to examine how experimentally manipulated differences in eating rate influence concurrent energy intake and subjective hunger ratings. We systematically reviewed studies that experimentally manipulated eating rate and measured concurrent food intake, self-reported hunger, or both. We combined effect estimates from studies by using inverse variance meta-analysis, calculating the standardized mean difference (SMD) in food intake between fast and slow eating rate conditions. Twenty-two studies were eligible for inclusion. Evidence indicated that a slower eating rate was associated with lower energy intake in comparison to a faster eating rate (random-effects SMD: 0.45; 95% CI: 0.25, 0.65; P < 0.0001). Subgroup analysis indicated that the effect was consistent regardless of the type of manipulation used to alter eating rate, although there was a large amount of heterogeneity between studies. There was no significant relation between eating rate and hunger at the end of the meal or up to 3.5 h later. Evidence to date supports the notion that eating rate affects energy intake. Research is needed to identify effective interventions to reduce eating rate that can be adopted in everyday life to help limit excess consumption. © 2014 American Society for Nutrition.

Measures of Wellness in Young Adult College Students: An Integrative Review.

PubMed

Nair, Julie McCulloh

2018-04-01

Wellness behaviors typically form during the college years, making wellness evaluation crucial during this time frame. Instruments often assess health rather than wellness. Thus, the purpose of this integrative review is to identify and evaluate instruments measuring wellness among young adult college students. Google Scholar, CINAHL, PubMed, MEDLINE, PsycINFO, ERIC, and other databases were searched yielding 350 studies initially. Seven studies met inclusion criteria and were retained for this review. Reliability and validity is reported in each study with ongoing analysis. Homogeneous samples were reported in each study, and administering concurrent instruments created feasibility issues. A summary of instruments measuring wellness in young adult college students is provided. However, few wellness instruments exist in this population. Thus, further development is needed.

Design of psychosocial factors questionnaires: a systematic measurement approach

PubMed Central

Vargas, Angélica; Felknor, Sarah A

2012-01-01

Background Evaluation of psychosocial factors requires instruments that measure dynamic complexities. This study explains the design of a set of questionnaires to evaluate work and non-work psychosocial risk factors for stress-related illnesses. Methods The measurement model was based on a review of literature. Content validity was performed by experts and cognitive interviews. Pilot testing was carried out with a convenience sample of 132 workers. Cronbach’s alpha evaluated internal consistency and concurrent validity was estimated by Spearman correlation coefficients. Results Three questionnaires were constructed to evaluate exposure to work and non-work risk factors. Content validity improved the questionnaires coherence with the measurement model. Internal consistency was adequate (α=0.85–0.95). Concurrent validity resulted in moderate correlations of psychosocial factors with stress symptoms. Conclusions Questionnaires´ content reflected a wide spectrum of psychosocial factors sources. Cognitive interviews improved understanding of questions and dimensions. The structure of the measurement model was confirmed. PMID:22628068

Conservative management of neonatal cerebral sinovenous thrombosis with coexisting thrombophilia.

PubMed

Khatri, Vidushi; Chan, Anthony K C; Stein, Nina; Paes, Bosco; Bhatt, Mihir

2018-06-01

: Neonatal cerebral sinovenous thrombosis (CSVT) comprises approximately 50% of all pediatric-related CSVT. Although guidelines support anticoagulation in pediatric CSVT, the role of anticoagulation in neonatal CSVT remains controversial. This case report details the course of a neonate diagnosed with extensive CSVT and concurrent bilateral thalamic and intraventricular hemorrhage. Due to existing hemorrhage at the time of diagnosis, anticoagulation therapy was not administered. Despite coexisting protein C and antithrombin deficiency, CSVT resolved spontaneously, and neurodevelopmental follow-up after 13 years suggests a good prognosis. Although our case had a positive outcome, the association between the use of anticoagulation with concurrent hemorrhage and long-term outcome in neonatal CSVT has not been investigated in prospective studies to firmly guide optimum treatment. Current literature and guidelines for the treatment of neonatal CSVT are reviewed in this article. Until robust studies are available, expert opinion recommends anticoagulation in a stable neonate with CSVT.

Risperidone induced angioedema with concurrent EPS symptoms: a case report and review of literature

PubMed Central

Samra, Gursharan Singh; Kant, Saumitra; Chow, Robert

2018-01-01

ABSTRACT Angioedema has recently been reported as a side effect associated with the antipsychotic risperidone. We report a case of dystonia with concurrent angioedema due to risperidone. A 40-year-old male with a history of schizophrenia was started on 3 mg of risperidone BID and developed perioral and periorbital edema along with increased muscle rigidity and hand tremor within 24 h of initial administration. His symptoms abated after cessation of risperidone and intravenous administration of corticosteroids and antihistamine. This case study adds to the current literature, which has already established angioedema as a dose-dependent side effect of risperidone. Moreover, this case study aims to increase awareness about the potential for the simultaneous occurrence of angioedema and extrapyramidal symptoms, and promotes vigilance among prescribers so that the life-threatening consequences of such effects can be avoided. PMID:29686794

Histoplasma Urinary Antigen Testing Obviates the Need for Coincident Serum Antigen Testing.

PubMed

Libert, Diane; Procop, Gary W; Ansari, Mohammad Q

2018-03-07

Serum and urine antigen (SAg, UAg) detection are common tests for Histoplasma capsulatum. UAg detection is more widely used and reportedly has a higher sensitivity. We investigated whether SAg detection contributes meaningfully to the initial evaluation of patients with suspected histoplasmosis. We reviewed 20,285 UAg and 1,426 SAg tests ordered from 1997 to 2016 and analyzed paired UAg and SAg tests completed on the same patient within 1 week. We determined the positivity rate for each test. Of 601 paired specimens, 542 were concurrent negatives and 48 were concurrent positives (98% agreement). Medical records were available for eight of 11 pairs with discrepant results. UAg was falsely positive in six instances, truly positive once, and falsely negative once. These findings support using a single antigen detection test, rather than both UAg and SAg, as an initial screen for suspected histoplasmosis. This aligns with the current practice of most physicians.

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

PubMed

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

2015-02-01

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

Multiple endocrine diseases in cats: 15 cases (1997-2008).

PubMed

Blois, Shauna L; Dickie, Erica L; Kruth, Stephen A; Allen, Dana G

2010-08-01

The objective of this retrospective study was to characterize a population of cats from a tertiary care center diagnosed with multiple endocrine disorders, including the specific disorders and time intervals between diagnosis of each disorder. Medical records of 15 cats diagnosed with more than one endocrine disorder were reviewed. The majority of cats were domestic shorthairs, and the mean age at the time of diagnosis of the first disorder was 10.3 years. The most common combination of disorders was diabetes mellitus and hyperthyroidism. Two cats had concurrent diabetes mellitus and hyperadrenocorticism, one cat had concurrent central diabetes insipidus and diabetes mellitus. A mean of 25.7 months elapsed between diagnoses of the first and second endocrine disorder, but this was variable. This study suggests the occurrence of multiple endocrine disorders is uncommon in cats. Copyright 2010 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.

Reliability and validity of the Wii Balance Board for assessment of standing balance: A systematic review.

PubMed

Clark, Ross A; Mentiplay, Benjamin F; Pua, Yong-Hao; Bower, Kelly J

2018-03-01

The use of force platform technologies to assess standing balance is common across a range of clinical areas. Numerous researchers have evaluated the low-cost Wii Balance Board (WBB) for its utility in assessing balance, with variable findings. This review aimed to systematically evaluate the reliability and concurrent validity of the WBB for assessment of static standing balance. Articles were retrieved from six databases (Medline, SCOPUS, EMBASE, CINAHL, Web of Science, Inspec) from 2007 to 2017. After independent screening by two reviewers, 25 articles were included. Two reviewers performed the data extraction and quality assessment. Test-retest reliability was investigated in 12 studies, with intraclass correlation coefficients or Pearson's correlation values showing a range from poor to excellent reliability (range: 0.27 to 0.99). Concurrent validity (i.e. comparison with another force platform) was examined in 21 studies, and was generally found to be excellent in studies examining the association between the same outcome measures collected on both devices. For studies reporting predominantly poor to moderate validity, potentially influential factors included the choice of 1) criterion reference (e.g. not a common force platform), 2) test duration (e.g. <30 s for double leg), 3) outcome measure (e.g. comparing a centre of pressure variable from the WBB with a summary score from the force platform), 4) data acquisition platform (studies using Apple iOS reported predominantly moderate validity), and 5) low sample size. In conclusion, evidence suggests that the WBB can be used as a reliable and valid tool for assessing standing balance. Protocol registration number: PROSPERO 2017: CRD42017058122. Copyright © 2018 Elsevier B.V. All rights reserved.

Adverse effects of ketoconazole in dogs--a retrospective study.

PubMed

Mayer, Ursula K; Glos, Katharina; Schmid, Matthias; Power, Helen T; Bettenay, Sonya V; Mueller, Ralf S

2008-08-01

Although ketoconazole has been used extensively in dogs for the treatment of various fungal infections, information about adverse effects is mainly anecdotal. Common adverse effects in humans include dose-dependant anorexia, nausea and vomiting, allergic rashes and pruritus. Drug-induced hepatitis is very rare, but potentially fatal. The aim of this study was to evaluate the type and frequency of adverse effects associated with ketoconazole therapy in dogs treated for skin diseases and any possible influence of dosage, duration of therapy, signalment or concurrent medication. The medical records of 632 dogs treated with ketoconazole (2.6-33.4 mg/kg) were reviewed. Adverse effects occurred in 14.6% (92 dogs) and included vomiting (7.1%), anorexia (4.9%), lethargy (1.9%), diarrhea (1.1%), pruritus (0.6%), erythema (0.3%) and other adverse effects (2.5%). Of the dogs with other adverse effects, four of 16 (25%) were ataxic and three of these received concurrent ivermectin. Adverse effects were significantly more often recorded in dogs concurrently treated with ciclosporin (P = 0.034) or ivermectin (P = 0.007). Increased liver enzyme levels were reported rarely, and icterus was not seen in any of the dogs. However, monitoring liver enzymes during therapy is recommended, although this might not necessarily prevent severe idiosyncratic hepatotoxicity.

Metformin association with lower prostate cancer recurrence in type 2 diabetes: a systematic review and meta-analysis.

PubMed

Hwang, In Cheol; Park, Sang Min; Shin, Doosup; Ahn, Hong Yup; Rieken, Malte; Shariat, Shahrokh F

2015-01-01

Accumulating evidence suggests that metformin possesses anticarcinogenic properties, and its use is associated with favorable outcomes in several cancers. However, it remains unclear whether metformin influences prognosis in prostate cancer (PCa) with concurrent type 2 diabetes (T2D). We searched PubMed, EMBASE, and the Cochrane Library from database inception to April 16, 2014 without language restrictions to identify studies investigating the effect of metformin treatment on outcomes of PCa with concurrent T2D. We conducted a meta-analysis to quantify the risk of recurrence, progression, cancer-specific mortality, and all-cause mortality. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were calculated. Publication bias was assessed by Begg's rank correlation test. A total of eight studies fulfilled the eligibility criteria. We found that diabetic PCa patients who did not use metformin were at increased risk of cancer recurrence (RR, 1.20; 95%CI, 1.00-1.44), compared with those who used metformin. A similar trend was observed for other outcomes, but their relationships did not reach statistical significance. Funnel plot asymmetry was not observed among studies reporting recurrence (p=0.086). Our results suggest that metformin may improve outcomes in PCa patients with concurrent T2D. Well-designed large studies and collaborative basic research are warranted.

Concurrent administration of anticancer chemotherapy drug and herbal medicine on the perspective of pharmacokinetics.

PubMed

Cheng, Yung-Yi; Hsieh, Chen-Hsi; Tsai, Tung-Hu

2018-04-01

With an increasing number of cancer patients seeking an improved quality of life, complementary and alternative therapies are becoming more common ways to achieve such improvements. The potential risks of concurrent administration are serious and must be addressed. However, comprehensive evidence for the risks and benefits of combining anticancer drugs with traditional herbs is rare. Pharmacokinetic investigations are an efficient way to understand the influence of concomitant remedies. Therefore, this study aimed to collect the results of pharmacokinetic studies relating to the concurrent use of cancer chemotherapy and complementary and alternative therapies. According to the National Health Insurance (NHI) database in Taiwan and several publications, the three most commonly prescribed formulations for cancer patients are Xiang-Sha-Liu-Jun-Zi-Tang, Jia-Wei-Xiao-Yao-San and Bu-Zhong-Yi-Qi-Tang. The three most commonly prescribed single herbs for cancer patients are Hedyotis diffusa, Scutellaria barbata, and Astragalus membranaceus. Few studies have discussed herb-drug interactions involving these herbs from a pharmacokinetics perspective. Here, we reviewed Jia-Wei-Xiao-Yao-San, Long-Dan-Xie-Gan-Tang, Curcuma longa and milk thistle to provide information based on pharmacokinetic evidence for healthcare professionals to use in educating patients about the risks of the concomitant use of various remedies. Copyright © 2018. Published by Elsevier B.V.

A measurement-based study of concurrency in a multiprocessor

NASA Technical Reports Server (NTRS)

Mcguire, Patrick John

1987-01-01

A systematic measurement-based methodology for characterizing the amount of concurrency present in a workload, and the effect of concurrency on system performance indices such as cache miss rate and bus activity are developed. Hardware and software instrumentation of an Alliant FX/8 was used to obtain data from a real workload environment. Results show that 35% of the workload is concurrent, with the concurrent periods typically using all available processors. Measurements of periods of change in concurrency show uneven usage of processors during these times. Other system measures, including cache miss rate and processor bus activity, are analyzed with respect to the concurrency measures. Probability of a cache miss is seen to increase with concurrency. The change in cache miss rate is much more sensitive to the fraction of concurrent code in the worklaod than the number of processors active during concurrency. Regression models are developed to quantify the relationships between cache miss rate, bus activity, and the concurrency measures. The model for cache miss rate predicts an increase in the median miss rate value as much as 300% for a 100% increase in concurrency in the workload.

ACT-R/E: An Embodied Cognitive Architecture for Human-Robot Interaction

DTIC Science & Technology

2013-01-01

Threaded Cognition: An Integrated Theory of Concurrent Multitasking . Psychological Review, 115(1), 101–130, http://dx.doi.org/10.1037/0033-295X...Trafton, Naval Research Laboratory, Washington, DC, USA Email : greg.trafton@nrl.navy.mil Laura Hiatt, Naval Research Laboratory, Washington, DC, USA Email ...laura.hiatt@nrl.navy.mil Anthony Harrison, Naval Research Laboratory, Washington, DC, USA Email : anthony.harrison@nrl.navy.mil Frank Tamborello, Naval

A concurrent resolution expressing the sense of Congress that the United States should neither become a signatory to the Rome Statute of the International Criminal Court nor attend the Review Conference of the Rome Statute in Kampala, Uganda in May 2010.

THOMAS, 111th Congress

Sen. Vitter, David [R-LA

2010-04-21

Senate - 04/21/2010 Referred to the Committee on Foreign Relations. (text of measure as introduced: CR S2528) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Tmproving the Consult Management Process at David Grant Medical Center

DTIC Science & Technology

1998-08-01

and the regional referral facility for the DoD Health Services Region 10 in Northern California. It offers most major medical, surgical , and dental...services (Payne, 1987). The primary components of UM include pre -certification, concurrent and retrospective review, case management, and discharge...6-13. O’Brien, K., McComb, J., Fox, N., Beam, D., & Wright, J. (1996). Do dentists refer orthodontic patients inappropriately. British Dental

A patient self-assessment tool for cardiac rehabilitation.

PubMed

Phelan, C; Finnell, M D; Mottla, K A

1989-01-01

A patient self-assessment tool was designed, tested, and implemented to promote cardiac-specific data collection, based on Gordon's Functional Health Patterns, to maximize patient/family involvement in determining a plan of care, and to streamline primary nurses' documentation requirements. Retrospective and concurrent chart reviews provided data for quality assurance monitoring. The results of the monitoring demonstrated that the self-assessment tool markedly improved the patient-specific data base.

Department of the Navy Acquisition and Capabilities Guidebook

DTIC Science & Technology

2012-05-01

Cost Estimates/Service Cost Position..................................... 5-1 5.1.2 Cost Analysis Requirements Description ( CARD ) 5-2 5.1.3...Description ( CARD ). 7. Satisfactory review of program health. 8. Concurrence with draft TDS, TES, and SEP. 9. Approval of full funding...Description ( CARD ) SECNAV M-5000.2 May 2012 5-3 Enclosure (1) A sound cost estimate is based on a well-defined program. The CARD is used

Human factor design of habitable space facilities

NASA Technical Reports Server (NTRS)

Clearwater, Yvonne A.

1987-01-01

Current fundamental and applied habitability research conducted as part of the U.S. space program is reviewed with emphasis on methods, findings, and applications of the results to the planning and design of the International Space Station. The discussion covers the following six concurrent directions of habitability research: operational simulation, functional interior decor research, space crew privacy requirements, interior layout and configuration analysis, human spatial habitability model, and analogous environments research.

[Acute heart failure: precipitating factors and prevention].

PubMed

Aramburu Bodas, Oscar; Conde Martel, Alicia; Salamanca Bautista, Prado

2014-03-01

Acute heart failure episodes, whether onset or decompensation of a chronic form, are most often precipitated by a concurrent process or disease, described as precipitating factors of heart failure. In this article, we review these precipitating factors, their proportions and clinical relevance in general and in subgroups of patients, their relationship with prognosis, and their possible prevention. Copyright © 2014 Elsevier España, S.L. All rights reserved.

Control architecture for an adaptive electronically steerable flash lidar and associated instruments

NASA Astrophysics Data System (ADS)

Ruppert, Lyle; Craner, Jeremy; Harris, Timothy

2014-09-01

An Electronically Steerable Flash Lidar (ESFL), developed by Ball Aerospace & Technologies Corporation, allows realtime adaptive control of configuration and data-collection strategy based on recent or concurrent observations and changing situations. This paper reviews, at a high level, some of the algorithms and control architecture built into ESFL. Using ESFL as an example, it also discusses the merits and utility such adaptable instruments in Earth-system studies.

Aligning Infrastructure Decisions with Strategic Vision

DTIC Science & Technology

2012-03-22

last ten years and produced several documents such as: Global Defense Posture Review ( GDPR ), Overseas Basing Commission Report, Base Realignment and...significant force structure changes in the form of GDPR , Army Modular Force, and the ARFORGEN process. These concurrent demands forced a holistic...returning to domestic bases as part of the GDPR and the reduction of leased space in the DoD portfolio.26 BRAC 2005 demonstrated failures in cost

Drug interactions between buprenorphine, methadone and hepatitis C therapeutics.

PubMed

Ogbuagu, Onyema; Friedland, Gerald; Bruce, R Douglas

2016-07-01

People who inject drugs (PWID) and other individuals with opioid use disorders have a dramatically higher prevalence of hepatitis C virus (HCV) infection than the general population. The availability of novel direct acting antivirals (DAAs) for the treatment of HCV infection with very high efficacy, improved tolerability and shortened treatment durations have led to global efforts to ramp up treatment for all HCV-infected individuals to prevent or delay complications of the disease. Individuals with opioid use disorders, including those on medication-assisted therapy such as methadone or buprenorphine, are a key demographic group that can benefit from HCV treatment given their high HCV prevalence; however, pharmacokinetic and pharmacodynamic drug interactions could blunt their utility. We performed a comprehensive literature review of published and unpublished data from PubMed database, relevant conference abstracts/proceedings and FDA approved drug package inserts, to review the pharmacokinetic (PK) profile and drug interactions between currently approved HCV DAAs and methadone and buprenorphine. The paper highlights specific drug combinations which result in altered opioid drug levels including telaprevir/methadone, daclatasvir/buprenorphine, and Abbvie 3D combination regimen (paritaprevir, ritonavir, ombitasvir and dasabuvir)/buprenorphine. However, concurrent pharmacodynamics assessments did not reveal significant signs and symptoms of opioid withdrawal or toxicity that would preclude concurrent administration.

Concurrent chemoradiotherapy with elective lymph node irradiation for esophageal cancer: a systemic review and pooled analysis of the literature.

PubMed

Du, Dexi; Song, Tao; Liang, Xiaodong; Fang, Min; Wu, Shixiu

2017-02-01

Concurrent chemoradiotherapy (CCRT) has been accepted as the standard non-surgical treatment for esophageal cancer. However, no consistent conclusions have been reached whether elective lymph node irradiation (ENI) should be delivered. Therefore, we performed a systematic review and pooled analysis to evaluate the value of CCRT with ENI. A literature search based on PubMed, Embase and Google Scholar was carried out and all of the studies were evaluated carefully regarding with survival outcomes, response rates, patterns of failure rates and acute/late toxicities. Twenty-two studies were identified based on the criteria: median overall survival time was 21.0 months; pooled response rates were 56.8% (CR) and 85.8% (CR+PR), respectively; residual disease rate, local-regional recurrence rate, distant failure rate and both (local-regional recurrence plus distant failure) rate was 28%, 21%, 11%, and 7%, respectively; hematologic toxicities were the most sever acute toxicities and esophagus-related toxicity was the most common radiation-related toxicity both in acute (15.7%) and late (6.2%) phase. In conclusion, ENI is feasible with acceptable toxicities in esophageal carcinoma and the efficacy should be verified in randomized trials. © 2016 International Society for Diseases of the Esophagus.

Risk of upper gastrointestinal bleeding with selective serotonin reuptake inhibitors with or without concurrent nonsteroidal anti-inflammatory use: a systematic review and meta-analysis.

PubMed

Anglin, Rebecca; Yuan, Yuhong; Moayyedi, Paul; Tse, Frances; Armstrong, David; Leontiadis, Grigorios I

2014-06-01

There is emerging concern that selective serotonin reuptake inhibitors (SSRIs) may be associated with an increased risk of upper gastrointestinal (GI) bleeding, and that this risk may be further increased by concurrent use of nonsteroidal anti-inflammatory (NSAID) medications. Previous reviews of a relatively small number of studies have reported a substantial risk of upper GI bleeding with SSRIs; however, more recent studies have produced variable results. The objective of this study was to obtain a more precise estimate of the risk of upper GI bleeding with SSRIs, with or without concurrent NSAID use. MEDLINE, EMBASE, PsycINFO, the Cochrane central register of controlled trials (through April 2013), and US and European conference proceedings were searched. Controlled trials, cohort, case-control, and cross-sectional studies that reported the incidence of upper GI bleeding in adults on SSRIs with or without concurrent NSAID use, compared with placebo or no treatment were included. Data were extracted independently by two authors. Dichotomous data were pooled to obtain odds ratio (OR) of the risk of upper GI bleeding with SSRIs +/- NSAID, with a 95% confidence interval (CI). The main outcome and measure of the study was the risk of upper GI bleeding with SSRIs compared with placebo or no treatment. Fifteen case-control studies (including 393,268 participants) and four cohort studies were included in the analysis. There was an increased risk of upper GI bleeding with SSRI medications in the case-control studies (OR=1.66, 95% CI=1.44,1.92) and cohort studies (OR=1.68, 95% CI=1.13,2.50). The number needed to harm for upper GI bleeding with SSRI treatment in a low-risk population was 3,177, and in a high-risk population it was 881. The risk of upper GI bleeding was further increased with the use of both SSRI and NSAID medications (OR=4.25, 95% CI=2.82,6.42). SSRI medications are associated with a modest increase in the risk of upper GI bleeding, which is lower than has previously been estimated. This risk is significantly elevated when SSRI medications are used in combination with NSAIDs, and physicians prescribing these medications together should exercise caution and discuss this risk with patients.

Timely deposition of macromolecular structures is necessary for peer review

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

Joosten, Robbie P.; Soueidan, Hayssam; Wessels, Lodewyk F. A.

2013-12-01

Deposition of crystallographic structures should be concurrent with or prior to manuscript submission for peer review, enabling validation and increasing reliability of the PDB. Most of the macromolecular structures in the Protein Data Bank (PDB), which are used daily by thousands of educators and scientists alike, are determined by X-ray crystallography. It was examined whether the crystallographic models and data were deposited to the PDB at the same time as the publications that describe them were submitted for peer review. This condition is necessary to ensure pre-publication validation and the quality of the PDB public archive. It was found thatmore » a significant proportion of PDB entries were submitted to the PDB after peer review of the corresponding publication started, and many were only submitted after peer review had ended. It is argued that clear description of journal policies and effective policing is important for pre-publication validation, which is key in ensuring the quality of the PDB and of peer-reviewed literature.« less

How to develop a proactive formulary system.

PubMed

Crane, V S; Gonzalez, E R; Hull, B L

1994-10-01

To develop a quality formulary system, a proactive approach is necessary. This approach incorporates a prospective product and concurrent product analyses. A prospective product analysis, in turn, involves a review of current formulary agents, those likely to enter the marketplace shortly, and the formation of an expert review panel. This panel's tasks are to examine therapeutic, economic, and humanistic aspects of therapy and to set initial parameters for appropriate and cost-effective use of accepted products. Keys to a successful formulary system are to continuously monitor drug use and compliance with criteria and to work collaboratively with all institutional professionals in the development, implementation, and monitoring of the system.

Review of magnetostrictive vibration energy harvesters

NASA Astrophysics Data System (ADS)

Deng, Zhangxian; Dapino, Marcelo J.

2017-10-01

The field of energy harvesting has grown concurrently with the rapid development of portable and wireless electronics in which reliable and long-lasting power sources are required. Electrochemical batteries have a limited lifespan and require periodic recharging. In contrast, vibration energy harvesters can supply uninterrupted power by scavenging useful electrical energy from ambient structural vibrations. This article reviews the current state of vibration energy harvesters based on magnetostrictive materials, especially Terfenol-D and Galfenol. Existing magnetostrictive harvester designs are compared in terms of various performance metrics. Advanced techniques that can reduce device size and improve performance are presented. Models for magnetostrictive devices are summarized to guide future harvester designs.

Panitumumab Use in Metastatic Colorectal Cancer and Patterns of KRAS Testing: Results from a Europe-Wide Physician Survey and Medical Records Review.

PubMed

Trojan, Jörg; Mineur, Laurent; Tomášek, Jiří; Rouleau, Etienne; Fabian, Pavel; de Maglio, Giovanna; García-Alfonso, Pilar; Aprile, Giuseppe; Taylor, Aliki; Kafatos, George; Downey, Gerald; Terwey, Jan-Henrik; van Krieken, J Han

2015-01-01

From 2008-2013, the European indication for panitumumab required that patients' tumor KRAS exon 2 mutation status was known prior to starting treatment. To evaluate physician awareness of panitumumab prescribing information and how physicians prescribe panitumumab in patients with metastatic colorectal cancer (mCRC), two European multi-country, cross-sectional, observational studies were initiated in 2012: a physician survey and a medical records review. The first two out of three planned rounds for each study are reported. The primary objective in the physician survey was to estimate the prevalence of KRAS testing, and in the medical records review, it was to evaluate the effect of test results on patterns of panitumumab use. The medical records review study also included a pathologists' survey. In the physician survey, nearly all oncologists (299/301) were aware of the correct panitumumab indication and the need to test patients' tumor KRAS status before treatment with panitumumab. Nearly all oncologists (283/301) had in the past 6 months of clinical practice administered panitumumab correctly to mCRC patients with wild-type KRAS status. In the medical records review, 97.5% of participating oncologists (77/79) conducted a KRAS test for all of their patients prior to prescribing panitumumab. Four patients (1.3%) did not have tumor KRAS mutation status tested prior to starting panitumumab treatment. Approximately one-quarter of patients (85/306) were treated with panitumumab and concurrent oxaliplatin-containing chemotherapy; of these, 83/85 had confirmed wild-type KRAS status prior to starting panitumumab treatment. All 56 referred laboratories that participated used a Conformité Européenne-marked or otherwise validated KRAS detection method, and nearly all (55/56) participated in a quality assurance scheme. There was a high level of knowledge amongst oncologists around panitumumab prescribing information and the need to test and confirm patients' tumors as being wild-type KRAS prior to treatment with panitumumab, with or without concurrent oxaliplatin-containing therapy.

Trends of Concurrent Ankle Arthroscopy at the Time of Operative Treatment of Ankle Fracture: A National Database Review.

PubMed

Ackermann, Jakob; Fraser, Ethan J; Murawski, Christopher D; Desai, Payal; Vig, Khushdeep; Kennedy, John G

2016-04-01

The purpose of this study was to report trends associated with concurrent ankle arthroscopy at the time of operative treatment of ankle fracture. The current procedural terminology (CPT) billing codes were used to search the PearlDiver Patient Record Database and identify all patients who were treated for acute ankle fracture in the United States. The Medicare Standard Analytic Files were searchable between 2005 and 2011 and the United Healthcare Orthopedic Dataset from 2007 to 2011. Annual trends were expressed only between 2007 and 2011, as it was the common time period among both databases. Demographic factors were identified for all procedures as well as the cost aspect using the Medicare data set. In total, 32 307 patients underwent open reduction internal fixation (ORIF) of an ankle fracture, of whom 313 (1.0%) had an ankle arthroscopy performed simultaneously. Of those 313 cases, 70 (22.4%) patients received microfracture treatment. Between 2005 and 2011, 85 203 patients were treated for an ankle fracture whether via ORIF or closed treatment. Of these, a total of 566 patients underwent arthroscopic treatment within 7 years. The prevalence of arthroscopy after ankle fracture decreased significantly by 45% from 2007 to 2011 (P< .0001). When ORIF and microfracture were performed concurrently, the total average charge for both procedures drops to $4253.00 and average reimbursement to $818.00 compared with approximately $4964.00 and $1069.00, respectively, when they were performed subsequently. Despite good evidence in favor of arthroscopy at the time of ankle fracture treatment, it appears that only a small proportion of surgeons in the United States perform these procedures concurrently. Therapeutic, Level IV: Retrospective. © 2015 The Author(s).

A novel multiplex real-time PCR assay for the concurrent detection of hepatitis A, B and C viruses in patients with acute hepatitis.

PubMed

Park, Yongjung; Kim, Beom Seok; Choi, Kyu Hun; Shin, Dong Ho; Lee, Mi Jung; Cho, Yonggeun; Kim, Hyon-Suk

2012-01-01

A novel multiplex real-time PCR assay for concurrent detection of hepatitis viruses was evaluated for its clinical performance in screening patients with acute hepatitis. A total of 648 serum samples were collected from patients with acute symptoms of hepatitis. Concurrent detection of nucleic acids of HAV, HBV and HCV was performed using the Magicplex™ HepaTrio Real-time Detection test. Serum nucleic acid levels of HBV and HCV were also quantified by the Cobas® AmpliPrep/Cobas® TaqMan® (CAP/CTM) HBV and HCV tests. Patients' medical records were also reviewed. Concordance rates between the results from the HepaTrio and the CAP/CTM tests for the detection of HBV and HCV were 94.9% (k = 0.88) and 99.2% (k = 0.98), respectively. The cycle threshold values with the HepaTrio test were also correlated well with the levels of HBV DNA (r = -0.9230) and HCV RNA (r = -0.8458). The sensitivity and specificity of the HepaTrio test were 93.8% and 98.2%, respectively, for detecting HBV infection, and 99.1% and 100.0%, respectively, for HCV infection. For the HepaTrio test, 21 (3.2%) cases were positive for both HBV and HCV. Among the positive cases, 6 (0.9%) were true coinfections. This test also detected 18 (2.8%) HAV positives. The HepaTrio test demonstrated good clinical performance and produced results that agreed well with those of the CAP/CTM assays, especially for the detection of HCV. This assay was also able to detect HAV RNA from anti-HAV IgM-positive individuals. Therefore, this new multiplex PCR assay could be useful for the concurrent detection of the three hepatitis viruses.

High-dose versus standard-dose radiotherapy with concurrent chemotherapy in stages II-III esophageal cancer.

PubMed

Suh, Yang-Gun; Lee, Ik Jae; Koom, Wong Sub; Cha, Jihye; Lee, Jong Young; Kim, Soo Kon; Lee, Chang Geol

2014-06-01

In this study, we investigated the effects of radiotherapy ≥60 Gy in the setting of concurrent chemo-radiotherapy for treating patients with Stages II-III esophageal cancer. A total of 126 patients treated with 5-fluorouracilbased concurrent chemo-radiotherapy between January 1998 and February 2008 were retrospectively reviewed. Among these patients, 49 received a total radiation dose of <60 Gy (standard-dose group), while 77 received a total radiation dose of ≥60 Gy (high-dose group). The median doses in the standard- and high-dose groups were 54 Gy (range, 45-59.4 Gy) and 63 Gy (range, 60-81 Gy), respectively. The high-dose group showed significantly improved locoregional control (2-year locoregional control rate, 69 versus 32%, P < 0.01) and progression-free survival (2-year progression-free survival, 47 versus 20%, P = 0.01) than the standard-dose group. Median overall survival in the high- and the standard-dose groups was 28 and 18 months, respectively (P = 0.26). In multivariate analysis, 60 Gy or higher radiotherapy was a significant prognostic factor for improved locoregional control, progression-free survival and overall survival. No significant differences were found in frequencies of late radiation pneumonitis, post-treatment esophageal stricture or treatment-related mortality between the two groups. High-dose radiotherapy of 60 Gy or higher with concurrent chemotherapy improved locoregional control and progression-free survival without a significant increase of in treatment-related toxicity in patients with Stages II-III esophageal cancer. Our study could provide the basis for future randomized clinical trials. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Concurrent epidemics of skin and soft tissue infection and bloodstream infection due to community-associated methicillin-resistant Staphylococcus aureus.

PubMed

Tattevin, Pierre; Schwartz, Brian S; Graber, Christopher J; Volinski, Joann; Bhukhen, Akta; Bhukhen, Arti; Mai, Thuy T; Vo, Nhung H; Dang, Denise N; Phan, Tiffany HaiVan; Basuino, Li; Perdreau-Remington, Françoise; Chambers, Henry F; Diep, Binh An

2012-09-01

Since its emergence in 2000, epidemic spread of the methicillin-resistant Staphylococcus aureus (MRSA) clone USA300 has led to a high burden of skin and soft tissue infections (SSTIs) in the United States, yet its impact on MRSA bloodstream infections (BSIs) is poorly characterized. To assess clonality of the MRSA isolates causing SSTI and BSI during the epidemic period, a stratified, random sample of 1350 unique infection isolates (from a total of 7252) recovered at the Community Health Network of San Francisco from 2000 to 2008 were selected for genotyping. Risk factors and outcomes for 549 BSI cases caused by the USA300 epidemic clone and non-USA300 MRSA clones were assessed by retrospective review of patient medical records. From 2000 to 2008, secular trends of USA300 SSTI and USA300 BSI were strongly correlated (Pearson r = 0.953). USA300 accounted for 55% (304/549) of BSIs as it was the predominant MRSA clone that caused community-associated (115/160), healthcare-associated community-onset (125/207), and hospital-onset (64/182) BSIs. Length of hospitalization after BSI diagnosis and mortality rates for USA300 and non-USA300 were similar. Two independent risk factors for USA300 BSI were identified: concurrent SSTI (adjusted relative risk, 1.4 [95% confidence interval {CI}, 1.2-1.6]) and anti-MRSA antimicrobial use in the preceding 30 days (0.7 [95% CI, .6-.8]). Isolates from concurrent SSTI were indistinguishable genotypically from the USA300 isolates that caused BSI. USA300 SSTIs serve as a source for BSI. Strategies to control the USA300 SSTI epidemic may lessen the severity of the concurrent USA300 BSI epidemic.

Characterizing Distributed Concurrent Engineering Teams: A Descriptive Framework for Aerospace Concurrent Engineering Design Teams

NASA Technical Reports Server (NTRS)

Chattopadhyay, Debarati; Hihn, Jairus; Warfield, Keith

2011-01-01

As aerospace missions grow larger and more technically complex in the face of ever tighter budgets, it will become increasingly important to use concurrent engineering methods in the development of early conceptual designs because of their ability to facilitate rapid assessments and trades in a cost-efficient manner. To successfully accomplish these complex missions with limited funding, it is also essential to effectively leverage the strengths of individuals and teams across government, industry, academia, and international agencies by increased cooperation between organizations. As a result, the existing concurrent engineering teams will need to increasingly engage in distributed collaborative concurrent design. This paper is an extension of a recent white paper written by the Concurrent Engineering Working Group, which details the unique challenges of distributed collaborative concurrent engineering. This paper includes a short history of aerospace concurrent engineering, and defines the terms 'concurrent', 'collaborative' and 'distributed' in the context of aerospace concurrent engineering. In addition, a model for the levels of complexity of concurrent engineering teams is presented to provide a way to conceptualize information and data flow within these types of teams.

The PSRO hospital review system.

PubMed

Goran, M J; Roberts, J S; Kellogg, M A; Fielding, J; Jessee, W

1975-04-01

The 1972 Social Security amendments contained the landmark Professional Standards Review Organization (PSRO) provisions as well as several sections upgrading existing utilization review (UR) requirements under Medicare and Medicaid. With issuance of the PSRO Program Manual and the recent publication of the new UR regulations, HEW for the first time has brought Medicare and Medicaid hospital review requirements into conformity and made them compatible with and supportive of the PSRO program. This article defines the PSRO hospital review system, describes how the three major components-concurrent review, medical care evaluation studies, and profile analysis-interrelate and provides examples of each of these components. Under utilization review requirements or PSRO, hospitals will be required to implement an integrated system of review designed to assure appropriate utilization practices and improve the quality of care. These aims are to be accomplished through the application of concepts of peer review, the use of norms, criteria, and standards, the identification of deficiencies in the quality, administration, or appropriateness of health care services, and their correction through linkage with programs of continuing medical education. Although PSROs are initially responsible for review in hospitals, they will likely provide the locus for a community-wide system of peer review for all services provided under National Health Insurance.

HER2-positive male breast cancer with thyroid cancer: an institutional report and review of literature.

PubMed

Bardhan, Pooja; Bui, Marilyn M; Minton, Susan; Loftus, Loretta; Carter, W Bradford; Laronga, Christine; Ismail-Khan, Roohi

2012-01-01

We report a rare finding of two male breast cancer patients with HER2-positive breast cancer who also developed thyroid cancer. We reviewed 45 male breast cancer patients treated in our institution from 2003 to 2008. Only five male breast cancer patients were HER2-positive. In reviewing the published data, we found no cases of thyroid cancer and concurrent breast cancer in men. However, breast cancer and thyroid cancer have shown close association in women. This finding therefore provokes speculation as to whether we should investigate whether women with HER2-positive breast cancer are at a higher risk for thyroid cancer. Although this observation seems to be clinically prevalent, publications are sparse in clinical research areas linking thyroid cancer to breast cancer.

Exercise as Treatment for Anxiety: Systematic Review and Analysis

PubMed Central

Stonerock, Gregory L.; Hoffman, Benson M.; Smith, Patrick J.; Blumenthal, James A.

2015-01-01

Background Exercise has been shown to reduce symptoms of anxiety, but few studies have studied exercise in individuals pre-selected because of their high anxiety. Purpose To review and critically evaluate studies of exercise training in adults with either high levels of anxiety or an anxiety disorder. Methods We conducted a systematic review of randomized clinical trials (RCTs) in which anxious adults were randomized to an exercise or non-exercise control condition. Data were extracted concerning anxiety outcomes and study design. Existing meta-analyses were also reviewed. Results Evidence from 12 RCTs suggested benefits of exercise, for select groups, similar to established treatments and greater than placebo. However, most studies had significant methodological limitations, including small sample sizes, concurrent therapies, and inadequate assessment of adherence and fitness levels. Conclusions Exercise may be a useful treatment for anxiety, but lack of data from rigorous, methodologically sound RCTs precludes any definitive conclusions about its effectiveness. PMID:25697132

Exercise as Treatment for Anxiety: Systematic Review and Analysis.

PubMed

Stonerock, Gregory L; Hoffman, Benson M; Smith, Patrick J; Blumenthal, James A

2015-08-01

Exercise has been shown to reduce symptoms of anxiety, but few studies have studied exercise in individuals preselected because of their high anxiety. The objective of this study is to review and critically evaluate studies of exercise training in adults with either high levels of anxiety or an anxiety disorder. We conducted a systematic review of randomized clinical trials (RCTs) in which anxious adults were randomized to an exercise or nonexercise control condition. Data were extracted concerning anxiety outcomes and study design. Existing meta-analyses were also reviewed. Evidence from 12 RCTs suggested benefits of exercise, for select groups, similar to established treatments and greater than placebo. However, most studies had significant methodological limitations, including small sample sizes, concurrent therapies, and inadequate assessment of adherence and fitness levels. Exercise may be a useful treatment for anxiety, but lack of data from rigorous, methodologically sound RCTs precludes any definitive conclusions about its effectiveness.

Measuring spirituality and religiosity in clinical research: a systematic review of instruments available in the Portuguese language.

PubMed

Lucchetti, Giancarlo; Lucchetti, Alessandra Lamas Granero; Vallada, Homero

2013-01-01

Despite numerous spirituality and/or religiosity (S/R) measurement tools for use in research worldwide, there is little information on S/R instruments in the Portuguese language. The aim of the present study was to map out the S/R scales available for research in the Portuguese language. Systematic review of studies found in databases. A systematic review was conducted in three phases. Phases 1 and 2: articles in Portuguese, Spanish and English, published up to November 2011, dealing with the Portuguese translation and/or validation of S/R measurement tools for clinical research, were selected from six databases. Phase 3: the instruments were grouped according to authorship, cross-cultural adaptation, internal consistency, concurrent and discriminative validity and test-retest procedures. Twenty instruments were found. Forty-five percent of these evaluated religiosity, 40% spirituality, 10% religious/spiritual coping and 5% S/R. Among these, 90% had been produced in (n = 3) or translated to (n = 15) Brazilian Portuguese and two (10%) solely to European Portuguese. Nevertheless, the majority of the instruments had not undergone in-depth psychometric analysis. Only 40% of the instruments presented concurrent validity, 45% discriminative validity and 15% a test-retest procedure. The characteristics of each instrument were analyzed separately, yielding advantages, disadvantages and psychometric properties. Currently, 20 instruments for measuring S/R are available in the Portuguese language. Most have been translated (n = 15) or developed (n = 3) in Brazil and present good internal consistency. Nevertheless, few instruments have been assessed regarding all their psychometric qualities.

Smokeless Tobacco Use in the United States Military: A Systematic Review

PubMed Central

Hunt, Yvonne M.; Augustson, Erik

2012-01-01

Introduction: Smokeless tobacco (ST) use represents an important target for intervention in the U.S. military population because it impairs “military readiness” and harms the health of the military. This paper aims to provide a systematic review of ST studies conducted in the U.S. military population in order to assess the content of existing ST research in this population, provide estimates of prevalence and clinically relevant use patterns, and discuss how these findings might be used to guide future ST research among this population. Methods: We reviewed articles published through December 2010 using PubMed and PsycINFO databases, Google Scholar, and any relevant articles’ reference lists. Inclusion criteria included focus on a U.S. military sample, English language, measured tobacco use, and ST prevalence was reported or could be calculated. To the extent possible, each article was coded for demographics, socioeconomic status, prevalence, amount, frequency, and length of use, and quit intentions/attempts. Results: Thirty-nine articles met criteria for inclusion. Less than half focused primarily on ST use among military personnel. The remaining studies measured ST use in the context of other behaviors. Findings related to clinically relevant behaviors included a need for more cohort and intervention studies, a better understanding of ST use in combination with cigarettes (i.e., concurrent use), and identifying risk factors for ST initiation and use. Discussion: ST use is prevalent among military personnel, as is concurrent use of cigarettes and ST. We provide a number of recommendations to guide future research in this important, yet understudied, area. PMID:22123789

Antibiotic-Induced Rash in Patients With Infectious Mononucleosis.

PubMed

Thompson, Dennis F; Ramos, Carroll L

2017-02-01

To provide an extensive review of case reports, epidemiological data, and the underlying mechanism of antibiotic-induced skin rash in patients with concurrent infectious mononucleosis (IM). A MEDLINE literature search inclusive of the dates 1946 to June 2016 was performed using the search terms anti-bacterial agents and infectious mononucleosis. EMBASE (1980 to June 2016) was searched using the terms mononucleosis and antibiotic agent and drug eruption. References of all relevant articles were reviewed for additional citations and information. We selected English-language, primary literature, review articles, and mechanistic articles that addressed antibiotic-induced skin rash in patients with concurrent IM. We assessed all case reports available for causality utilizing a modified Naranjo nomogram specifically designed for this subject. We assembled the available epidemiological data into tables to identify trends in incidence rates over the years. We identified 17 case reports of antibiotic-associated rash in patients with IM. The median Naranjo score was 6 (range = 1 to 8). The top 3 reported drugs were ampicillin, azithromycin, and amoxicillin. Incidence of this adverse effect was higher in the 1960s (55.6%, 45%, and 33%) than in 2013 (33% and 15%). The mechanism most commonly proposed is a transient virus-mediated immune alteration that sets the stage for loss of antigenic tolerance and the development of a reversible, delayed-type hypersensitivity reaction to the antibiotic. A reassessment of the long-held belief of the high incidence (80%-100%) of antibiotic-induced skin rash in patients with IM seems prudent. Additional studies will be necessary to clarify this issue.

Occupational and environmental risk factors of adult primary brain cancers: a systematic review.

PubMed

Gomes, J; Al Zayadi, A; Guzman, A

2011-04-01

The incidence of brain neoplasm has been progressively increasing in recent years in the industrialized countries. One of the reasons for this increased incidence could be better access to health care and improved diagnosis in the industrialized countries. It also appears that Caucasians have a higher incidence than blacks or Hispanics or Asians. A number of risk factors have been identified and described including the genetic, ethnic and age-based factors. Certain occupational and environmental factors are also believed to influence the risk of primary adult brain tumors. Potential occupational and environmental factors include exposure to diagnostic and therapeutic radiations, electromagnetic radiation from cellular phones and other wireless devices, infectious agents, air pollution and residence near landfills and high-voltage power lines and jobs as firefighters, farmers, physician, chemists and jobs in industries such as petrochemical, power generation, synthetic rubber manufacturing, agricultural chemicals manufacturing. The purpose of this systematic review is to examine occupational and environmental risk factors of brain neoplasm. A range of occupational and environmental exposures are evaluated for significance of their relationship with adult primary brain tumors. On the basis of this review we suggest a concurrent evaluation of multiple risk factors both within and beyond occupational and environmental domains. The concurrent approach needs to consider better exposure assessment techniques, lifetime occupational exposures, genotypic and phenotypic characteristics and lifestyle and dietary habits. This approach needs to be interdisciplinary with contributions from neurologists, oncologists, epidemiologists and molecular biologists. Conclusive evidence that has eluded multitude of studies with single focus and single exposure needs to multifaceted and multidisciplinary.

Reactive airway and anaesthesia: challenge to the anaesthetist and the way forward.

PubMed

Lawal, I; Bakari, A G

2009-09-01

Patients with concurrent medical conditions such as Reactive airway disease presenting for anaesthesia, and surgery have potentially increased risk of perioperative morbidity and mortality if not well managed. To highlight the need for adequate perioperative care and review the evidence for selection of techniques in the anesthesia for such cases" An illustrative case is presented. The main goal of the anaesthetist is to administer safe and sufficient anaestheia without precipitating bronchospasm.

School Law in Review, 1999. Papers presented at the National School Boards Association Council of School Attorneys' Annual School Law Seminar (San Francisco, California, April 8-10, 1999).

ERIC Educational Resources Information Center

National School Boards Association, Alexandria, VA. Council of School Attorneys.

The Annual School Law Seminar, held in conjunction with the conference of the National School Boards Asociation (NSBA), is the NSBA Council of School Attorney's forum for presenting the most recent developments in the practice of school law. The two general sessions and two concurrent sessions included the following papers: "Presenting Threats of…

Acute kidney injury associated with concomitant vancomycin and piperacillin/tazobactam administration: a systematic review and meta-analysis.

PubMed

Chen, Xiao-Yu; Xu, Ri-Xiang; Zhou, Xin; Liu, Yang; Hu, Cheng-Yang; Xie, Xue-Feng

2018-05-11

As a tricyclic glycopeptide antibiotic used to treat acute infections, Vancomycin (VAN) is often administered with piperacillin/tazobactam (PT) to treat various infections in clinical practice. However, whether the combination of these two drugs, compared to VAN alone, can cause an increased risk of acute kidney injury (AKI) remains controversial. This study aims to identify the correlation between the development of AKI and the combined use of VAN and PT. We conducted a meta-analysis of eight observational cohort studies (a total of 10727 participants received VAN and PT versus VAN and other β-lactams). PubMed, Chinese Biological Medicine Database (CBM), China National Knowledge Infrastructure (CNKI) Database, Wan Fang Digital Periodicals Database (WFDP), and China Science Citation Database (CSCD) were searched through April 2017 using "vancomycin" and "piperacillin" and "tazobactam" as well as "acute kidney injury" or "acute renal failure" or "AKI" or "ARF" or "nephrotoxicity." Two reviewers extracted the data and assessed the risk of bias. A correlation was found between the development of AKI and concurrent use of VAN and PT compared with concomitant VAN and β-lactams (OR 1.57; 95% CI, 1.13-2.01; I 2  = 76.4%, p < 0.001). Similar findings were obtained in an analysis of studies comparing concurrent VAN and PT use with concurrent VAN and β-lactam (cefepime) use (OR 1.50; 95% CI, 1.07-1.93; I 2  = 80.5%, p < 0.001). Exclusion of fair-quality and low-quality articles did not change the results (OR 1.49; 95% CI, 1.06-1.92; I 2  = 84.1%, p < 0.001). Regarding β-lactam therapy in clinical practice, an elevated risk of AKI due to the combined use of VAN and PT should be considered.

Phase 2 Study of Concurrent Cetuximab Plus Definitive Thoracic Radiation Therapy Followed by Consolidation Docetaxel Plus Cetuximab in Poor Prognosis or Elderly Patients With Locally Advanced Non-Small Cell Lung Cancer

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

Dilling, Thomas J.; Extermann, Martine; Kim, Jongphil

Background: Recursive partitioning analysis has shown that Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) ≥2, male sex, and age ≥70 years are prognostic of poor outcome in locally advanced non-small cell lung cancer (LA-NSCLC) patients. Concurrent chemoradiation therapy (CRT) improves survival, but toxicity is a concern in this frail patient cohort. We therefore opened this trial of concurrent definitive thoracic radiation therapy (XRT) and cetuximab, followed by consolidation docetaxel plus cetuximab. Methods and Materials: Eligible patients had pathologically proven, unresectable LA-NSCLC (stage IIA-“dry” IIIB). They had ECOG PS 2 or weight loss ≥5% in 3 months or were aged ≥70 years. Themore » primary objective was progression-free survival (PFS). Secondary objectives included overall survival (OS) and overall response rate (ORR). Results: From May 2008 to November 2010, a total of 32 patients were evaluated in our single-institution, institutional review board–approved prospective clinical trial. Three patients were screen failures and 2 more withdrew consent before treatment, leaving 27 evaluable patients. One was removed because of poor therapy compliance, and 2 were taken off trial because of grade 3 cetuximab-related toxicities but were followed up under intent-to-treat analysis. The median follow-up and OS were 10.5 months. The median PFS was 7.5 months. The ORR was 59.3%. Eight early/sudden deaths were reported. Upon review, 6 patients developed severe pulmonary complications. Conclusions: Patients enrolled in this trial had improved OS compared with poor-PS historical controls (10.5 vs 6.4 months) and comparable OS to good-PS historical controls (10.5 vs 11.9 months) treated with XRT alone. However, pulmonary toxicity is a concern. Consolidative cetuximab/docetaxel, in conjunction with high-dose radiation therapy, is a putative cause.« less

Production and manipulation of bovine embryos: techniques and terminology.

PubMed

Machaty, Z; Peippo, J; Peter, A

2012-09-15

There are numerous publications regarding bovine embryos, ranging from descriptions of their appearance and development to emerging techniques in the field of assisted reproductive technology. Concurrently, several specialized terms have been developed to describe the bovine embryo. The purpose of the current review is two-fold; it is primarily to describe techniques involved in the in vivo and in vitro production of bovine embryos and their manipulation, and secondarily to summarize specialized terms used in these processes. The intention is not to review these techniques in detail, but instead to provide salient points and current knowledge regarding these techniques, with a focus on terminology. The first review dealt with classical and contemporary terminology used to describe morphologic aspects of ovarian dynamics in cattle. Subsequently, the terms and current understanding of processes involved in preattachment bovine embryos were described in the second review. As the third article in a series, this mini-review is focused on defining the production, manipulation, and transfer of bovine preattachment embryos. Copyright © 2012 Elsevier Inc. All rights reserved.

Chemoradiation for ductal pancreatic carcinoma: principles of combining chemotherapy with radiation, definition of target volume and radiation dose.

PubMed

Wilkowski, Ralf; Thoma, Martin; Weingandt, Helmut; Dühmke, Eckhart; Heinemann, Volker

2005-05-10

Review of the role of chemoradiotherapy in the treatment of locally advanced pancreatic cancer with a specific focus on the technical feasibility and the integration of chemoradiotherapy into multimodal treatment concepts. Combined chemoradiotherapy of pancreatic cancer is a safe treatment with an acceptable profile of side effects when applied with modern planning and radiation techniques as well as considering tissue tolerance. Conventionally fractionated radiation regimens with total doses of 45-50 Gy and small-volume boost radiation with 5.4 Gy have found the greatest acceptance. Locoregional lymphatic drainage should be included in the planning of target volumes because the risk of tumor involvement and local or loco-regional recurrence is high. Up to now, 5-fluorouracil has been considered the "standard" agent for concurrent chemoradiotherapy. The role of gemcitabine given concurrently with radiation has not yet been defined, since high local efficacy may also be accompanied by enhanced toxicities. In addition, no dose or administration form has been determined to be "standard" up to now. The focus of presently ongoing research is to define an effective and feasible regimen of concurrent chemoradiotherapy. While preliminary results indicate promising results using gemcitabine-based chemoradiotherapy, reliable data derived from mature phase III trials are greatly needed. Intensity-modulated radiotherapy has been developed to improve target-specific radiation and to reduce organ toxicity. Its clinical relevance still needs to be defined.

Nomograms Predicting Progression-Free Survival, Overall Survival, and Pelvic Recurrence in Locally Advanced Cervical Cancer Developed From an Analysis of Identifiable Prognostic Factors in Patients From NRG Oncology/Gynecologic Oncology Group Randomized Trials of Chemoradiotherapy

PubMed Central

Rose, Peter G.; Java, James; Whitney, Charles W.; Stehman, Frederick B.; Lanciano, Rachelle; Thomas, Gillian M.; DiSilvestro, Paul A.

2015-01-01

Purpose To evaluate the prognostic factors in locally advanced cervical cancer limited to the pelvis and develop nomograms for 2-year progression-free survival (PFS), 5-year overall survival (OS), and pelvic recurrence. Patients and Methods We retrospectively reviewed 2,042 patients with locally advanced cervical carcinoma enrolled onto Gynecologic Oncology Group clinical trials of concurrent cisplatin-based chemotherapy and radiotherapy. Nomograms for 2-year PFS, five-year OS, and pelvic recurrence were created as visualizations of Cox proportional hazards regression models. The models were validated by bootstrap-corrected, relatively unbiased estimates of discrimination and calibration. Results Multivariable analysis identified prognostic factors including histology, race/ethnicity, performance status, tumor size, International Federation of Gynecology and Obstetrics stage, tumor grade, pelvic node status, and treatment with concurrent cisplatin-based chemotherapy. PFS, OS, and pelvic recurrence nomograms had bootstrap-corrected concordance indices of 0.62, 0.64, and 0.73, respectively, and were well calibrated. Conclusion Prognostic factors were used to develop nomograms for 2-year PFS, 5-year OS, and pelvic recurrence for locally advanced cervical cancer clinically limited to the pelvis treated with concurrent cisplatin-based chemotherapy and radiotherapy. These nomograms can be used to better estimate individual and collective outcomes. PMID:25732170

Concurrent clinical intraocular findings in horses with depigmented punctate chorioretinal foci.

PubMed

Mathes, Rachel L; Burdette, Erin L; Moore, Phillip A; Myrna, Kathern E

2012-03-01

To report concurrent clinical intraocular findings in horses with depigmented punctate chorioretinal foci and to document any correlation with equine recurrent uveitis (ERU). Records of 131 horses (241 eyes) examined at the University of Georgia Veterinary Teaching hospital from 2001 to 2010 were reviewed with either clinically normal fundi or depigmented punctate chorioretinal foci in the absence of other fundic pathology. Data collected included patient signalment, concurrent clinical ocular findings and follow-up information. Sex, presence of no other intraocular findings, presence of ERU, presence of cataracts, and presence of vitreal disease were compared between normal and foci groups using chi-squared analysis. Age and length of follow-up time were compared using a student's t-test. Ninety-one horses (167 eyes) with chorioretinal foci and forty horses (74 eyes) with clinically normal ocular fundi were examined. Fifty-eight (64%) horses with chorioretinal foci and 20 (50%) horses with clinically normal fundi had a normal intraocular examination. There was no significant difference in any of the criteria examined between groups. Horses with depigmented punctate chorioretinal foci, in the absence of other fundic pathology, are not more likely to have intraocular disease or ERU than horses with clinically normal ocular fundi. These findings suggest that depigmented punctate fundic foci in horses are not indicative of or associated with ERU. © 2011 American College of Veterinary Ophthalmologists.

Absolute Reliability and Concurrent Validity of Hand Held Dynamometry and Isokinetic Dynamometry in the Hip, Knee and Ankle Joint: Systematic Review and Meta-analysis

PubMed Central

Chamorro, Claudio; Armijo-Olivo, Susan; De la Fuente, Carlos; Fuentes, Javiera; Javier Chirosa, Luis

2017-01-01

Abstract The purpose of the study is to establish absolute reliability and concurrent validity between hand-held dynamometers (HHDs) and isokinetic dynamometers (IDs) in lower extremity peak torque assessment. Medline, Embase, CINAHL databases were searched for studies related to psychometric properties in muscle dynamometry. Studies considering standard error of measurement SEM (%) or limit of agreement LOA (%) expressed as percentage of the mean, were considered to establish absolute reliability while studies using intra-class correlation coefficient (ICC) were considered to establish concurrent validity between dynamometers. In total, 17 studies were included in the meta-analysis. The COSMIN checklist classified them between fair and poor. Using HHDs, knee extension LOA (%) was 33.59%, 95% confidence interval (CI) 23.91 to 43.26 and ankle plantar flexion LOA (%) was 48.87%, CI 35.19 to 62.56. Using IDs, hip adduction and extension; knee flexion and extension; and ankle dorsiflexion showed LOA (%) under 15%. Lower hip, knee, and ankle LOA (%) were obtained using an ID compared to HHD. ICC between devices ranged between 0.62, CI (0.37 to 0.87) for ankle dorsiflexion to 0.94, IC (0.91to 0.98) for hip adduction. Very high correlation were found for hip adductors and hip flexors and moderate correlations for knee flexors/extensors and ankle plantar/dorsiflexors. PMID:29071305

Multivariate analysis of survival, local control, and time to distant metastases in patients with unresectable non-small-cell lung carcinoma treated with 3-dimensional conformal radiation therapy with or without concurrent chemotherapy.

PubMed

Wolski, Michal J; Bhatnagar, Ajay; Flickinger, John C; Belani, Chandra P; Ramalingam, Suresh; Greenberger, Joel S

2005-09-01

Three-dimensional (3D) conformal radiation therapy (CRT) and chemotherapy have recently improved lung cancer management. We reviewed outcomes in 68 patients with unresectable stage I-III non-small-cell lung cancer. Treatment consisted of 3D CRT alone or with concurrent chemotherapy (CCR). Concurrent chemotherapy improved survival, to a median of 17 months +/- 4.9 months, compared with 8 months+/- 4.1 months for the radiation therapy (RT) alone group (P=0.0347). The 2- and 5-year survival rates were 40.3%+/-7.7% and 14.1%+/-6.4%, respectively, with CCR, compared with 19.6%+/- 9.6% and 0, respectively, for RT alone. In a subgroup analysis for age > 65, patients who received CCR (n=20) had significantly improved survival and local control (P=0.005 and P=0.0286, respectively). Acute esophageal toxicity Radiation Therapy Oncology Group grade >or= 3 was significantly higher in the CCR group and correlated with the RT dose (19% in CCR vs. 0 in RT, P=0.0234; P=0.050). The overall incidences of esophageal and pulmonary toxicity grade >or= 3 were 20.6% and 5.9%, respectively. Our study confirms that CCR is associated with improved survival over RT alone, with a tolerable increase in acute toxicity.

Concomitant Anterior and Posterior Urethral Valves: A Comprehensive Review of Literature.

PubMed

Keihani, Sorena; Kajbafzadeh, Abdol-Mohammad

2015-07-01

Posterior urethral valves (PUVs) are the most common cause of infravesical obstruction in children, whereas anterior urethral valves and/or diverticula (AUV/D) are less commonly encountered. Concomitant AUV/D and PUV is believed to be very rare and may be missed on the initial evaluation. In this review, we provide brief information on embryology of AUV/D and PUV to explain the concurrent presence of these anomalies. We also summarize the information on published cases of concomitant AUV/D and PUV in the English literature with a special focus on diagnosis and the importance of both voiding cystourethrography and careful urethrocystoscopy. Copyright © 2015 Elsevier Inc. All rights reserved.

Role of Wnt signaling during inflammation and sepsis: A review of the literature.

PubMed

Houschyar, Khosrow Siamak; Chelliah, Malcolm P; Rein, Susanne; Maan, Zeshaan N; Weissenberg, Kristian; Duscher, Dominik; Branski, Ludwik K; Siemers, Frank

2018-05-01

Despite the development of modern intensive care and new antimicrobial agents, the mortality of patients with severe sepsis and septic shock remains high. Systemic inflammation is a consequence of activation of the innate immune system. It is characterized by the intravascular release of proinflammatory cytokines and other vasoactive mediators, with concurrent activation of innate immune cells. The Wnt signaling pathway plays a critical role in the development of multicellular organisms. Abnormal Wnt signaling has been associated with many human diseases, ranging from inflammation and degenerative diseases to cancer. This article reviews the accumulating evidence that the Wnt signaling pathway plays a distinct role in inflammation and sepsis.

The wound healing, chronic fibrosis, and cancer progression triad

PubMed Central

Rybinski, Brad; Franco-Barraza, Janusz

2014-01-01

For decades tumors have been recognized as “wounds that do not heal.” Besides the commonalities that tumors and wounded tissues share, the process of wound healing also portrays similar characteristics with chronic fibrosis. In this review, we suggest a tight interrelationship, which is governed as a concurrence of cellular and microenvironmental reactivity among wound healing, chronic fibrosis, and cancer development/progression (i.e., the WHFC triad). It is clear that the same cell types, as well as soluble and matrix elements that drive wound healing (including regeneration) via distinct signaling pathways, also fuel chronic fibrosis and tumor progression. Hence, here we review the relationship between fibrosis and cancer through the lens of wound healing. PMID:24520152

High prevalence of atypical hyperplasia in the endometrium of patients with epithelial ovarian cancer.

PubMed

Mingels, Marjanka J J M; Masadah, Rina; Geels, Yvette P; Otte-Höller, Irene; de Kievit, Ineke M; van der Laak, Jeroen A W M; van Ham, Maaike A P C; Bulten, Johan; Massuger, Leon F A G

2014-08-01

The aim of the present study is to determine the prevalence of endometrial premalignancies in women diagnosed with epithelial ovarian cancer (EOC). Endometrial and ovarian specimens of 186 patients with EOC were retrospectively selected using the nationwide pathology network and registry, and sections were comprehensively reviewed: 136 (73%) serous, 19 (10%) endometrioid, 15 (8%) mucinous, seven (4%) clear cell, and nine (5%) undifferentiated. Immunohistochemical phenotypes were compared for patients with serous EOC with concurrent endometrial pathology. In 31%, endometrial (pre)malignancy was found: carcinoma in 3%, endometrial intraepithelial carcinoma (EIC) in 4%, and atypical hyperplasia in 24%. Atypical hyperplasia was found in 47% of endometrioid EOCs but in 7% to 33% of other subtypes. Body mass index was higher concurrent to atypical hyperplasia (P=.001). Serous EOC and EIC immunophenotypes were comparable, whereas atypical hyperplasia was expressed differently. Apart from synchronous endometrial carcinoma, endometrial premalignancies should be taken into account when determining optimal treatment for women diagnosed with EOC. Copyright© by the American Society for Clinical Pathology.

PRETREATMENT NUTRITIONAL STATUS AND LOCOREGIONAL FAILURE IN PATIENTS WITH HEAD AND NECK CANCER UNDERGOING DEFINITIVE CONCURRENT CHEMORADIATION THERAPY

PubMed Central

Platek, Mary E.; Reid, Mary E.; Wilding, Gregory E.; Jaggernauth, Wainwright; Rigual, Nestor R.; Hicks, Wesley L.; Popat, Saurin R.; Warren, Graham W.; Sullivan, Maureen; Thorstad, Wade L.; Khan, Mohamed K.; Loree, Thom R.; Singh, Anurag K.

2015-01-01

Background This study was carried out to determine if markers of nutritional status predict for locoregional failure following intensity-modulated radiation therapy (IMRT) with concurrent chemoradiotherapy (CCRT) for squamous cell carcinoma of the head and neck (SCCHN). Methods We performed a retrospective chart review of 78 patients with SCCHN who received definitive CCRT. We compared patient factors, tumor characteristics, and nutritional status indicators between patients with and without locoregional failure. Results Fifteen of 78 patients (19%) experienced locoregional failure. Median follow-up for live patients was 38 months. On univariate analysis, pretreatment percentage of ideal body weight (%IBW) (p < .01), pretreatment hemoglobin (p = .04), and treatment duration (p < .01) were significant predictors of failure. On multivariate analysis, pretreatment %IBW (p = .04) and treatment time (p < .01) remained statistically significant. Conclusions Although treatment time is an accepted risk factor for failure, differences in outcome for patients with head and neck cancer undergoing definitive CCRT based on pre-treatment %IBW should be examined further. PMID:21990220

Concurrent Group Treatment for Hepatitis C: Implementation and Outcomes in a Methadone Maintenance Treatment Program

PubMed Central

Stein, Melissa R.; Soloway, Irene J.; Jefferson, Karen S.; Roose, Robert J.; Arnsten, Julia H.; Litwin, Alain H.

2012-01-01

Chronic hepatitis C virus (HCV) infection is highly prevalent among current and former drug users. However, the minority of patients enrolled in drug treatment programs have initiated HCV treatment. New models are needed to overcome barriers to care. In this retrospective study, we describe the implementation and outcomes of 42 patients treated in a Concurrent Group Treatment (CGT) program. Patients participated in weekly provider-led group treatment sessions which included review of side effects; discussion of adherence and side effect management; administration of interferon injections; brief physical exam; and ended with brief meditation. Of the first 27 patients who initiated CGT, 42% achieved a sustained viral response. Additionally, 87% (13/15) of genotype-1 infected patients treated with direct acting antiviral agent achieved an undetectable viral load at 24 weeks. The CGT model may be effective in overcoming barriers to treatment and improving adherence and outcomes among patients enrolled in drug treatment programs. PMID:23036920

Polyuria with the Concurrent manifestation of Central Diabetes Insipidus (CDI) & Type 2 Diabetes Mellitus (DM)

PubMed Central

Shin, Hyun-Jong; Kim, Jae-Ha; Han, Sang-Woong; Kim, Ho-Jung

2012-01-01

We report a rare case of the concurrent manifestation of central diabetes insipidus (CDI) and type 2 diabetes mellitus (DM). A 56 year-old man was diagnosed as a type 2 DM on the basis of hyperglycemia with polyuria and polydipsia at a local clinic two months ago and started an oral hypoglycemic medication, but resulted in no symptomatic improvement at all. Upon admission to the university hospital, the patient's initial fasting blood sugar level was 140 mg/dL, and he showed polydipsic and polyuric conditions more than 8 L urine/day. Despite the hyperglycemia controlled with metformin and diet, his symptoms persisted. Further investigations including water deprivation test confirmed the coexisting CDI of unknown origin, and the patient's symptoms including an intense thirst were markedly improved by desmopressin nasal spray (10 µg/day). The possibility of a common origin of CDI and type 2 DM is raised in a review of the few relevant adult cases in the literature. PMID:23508726

Polyuria with the Concurrent manifestation of Central Diabetes Insipidus (CDI) & Type 2 Diabetes Mellitus (DM).

PubMed

Shin, Hyun-Jong; Kim, Jae-Ha; Yi, Joo-Hark; Han, Sang-Woong; Kim, Ho-Jung

2012-12-01

We report a rare case of the concurrent manifestation of central diabetes insipidus (CDI) and type 2 diabetes mellitus (DM). A 56 year-old man was diagnosed as a type 2 DM on the basis of hyperglycemia with polyuria and polydipsia at a local clinic two months ago and started an oral hypoglycemic medication, but resulted in no symptomatic improvement at all. Upon admission to the university hospital, the patient's initial fasting blood sugar level was 140 mg/dL, and he showed polydipsic and polyuric conditions more than 8 L urine/day. Despite the hyperglycemia controlled with metformin and diet, his symptoms persisted. Further investigations including water deprivation test confirmed the coexisting CDI of unknown origin, and the patient's symptoms including an intense thirst were markedly improved by desmopressin nasal spray (10 µg/day). The possibility of a common origin of CDI and type 2 DM is raised in a review of the few relevant adult cases in the literature.

New technologies for space avionics

NASA Technical Reports Server (NTRS)

Aibel, David W.; Dingus, Peter; Lanciault, Mark; Hurdlebrink, Debra; Gurevich, Inna; Wenglar, Lydia

1994-01-01

This report reviews a 1994 effort that continued 1993 investigations into issues associated with the definition of requirements, with the practice concurrent engineering and rapid prototyping in the context of the development of a prototyping of a next-generation reaction jet driver controller. This report discusses lessons learned, the testing of the current prototype, the details of the current design, and the nature and performance of a mathematical model of the life cycle of a pilot operated valve solenoid.

Lymphoepithelioma-Like Carcinoma of the Skin Treated with Wide Local Excision and Chemoradiation Therapy: A Case Report and Review of the Literature

DTIC Science & Technology

2012-01-01

oral cavity mucositis . He received concurrent cisplatin (20 milligram per meter squared) weekly for five weeks. He was also referred to an outside...carcinoma, melanoma , lymphoma, and cutaneous lymphadenoma. It can generally be differentiated from undifferentiated nasopharyngeal carcinoma by the...overlying epidermis. Melanoma is positive for S100 and lymphoma cells will be positive for lymphoid markers. Cutaneous lymphadenoma is benign and does not

Why have southern pine beetle outbreaks declined in the southeastern U.S. with the expansion of intensive pine silviculture? A brief review of hypotheses

Treesearch

Christopher Asaro; John T. Nowak; Anthony Elledge

2017-01-01

The southern pine beetle has shown a dramatic decline in outbreak activity over much of the southeastern States since the turn of the 21st century compared to previous decades. Concurrently, from the 1950s through the present day, a twenty-fold increase in pine plantation area has occurred across the region while trends in genetic tree improvement and pine...

New Technologies for Space Avionics, 1993

NASA Technical Reports Server (NTRS)

Aibel, David W.; Harris, David R.; Bartlett, Dave; Black, Steve; Campagna, Dave; Fernald, Nancy; Garbos, Ray

1993-01-01

The report reviews a 1993 effort that investigated issues associated with the development of requirements, with the practice of concurrent engineering and with rapid prototyping, in the development of a next-generation Reaction Jet Drive Controller. This report details lessons learned, the current status of the prototype, and suggestions for future work. The report concludes with a discussion of the vision of future avionics architectures based on the principles associated with open architectures and integrated vehicle health management.

Radiation Therapy Intensification for Solid Tumors: A Systematic Review of Randomized Trials

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

Yamoah, Kosj; Showalter, Timothy N.; Ohri, Nitin, E-mail: ohri.nitin@gmail.com

Purpose: To systematically review the outcomes of randomized trials testing radiation therapy (RT) intensification, including both dose escalation and/or the use of altered fractionation, as a strategy to improve disease control for a number of malignancies. Methods and Materials: We performed a literature search to identify randomized trials testing RT intensification for cancers of the central nervous system, head and neck, breast, lung, esophagus, rectum, and prostate. Findings were described qualitatively. Where adequate data were available, pooled estimates for the effect of RT intensification on local control (LC) or overall survival (OS) were obtained using the inverse variance method. Results: Inmore » primary central nervous system tumors, esophageal cancer, and rectal cancer, randomized trials have not demonstrated that RT intensification improves clinical outcomes. In breast cancer and prostate cancer, dose escalation has been shown to improve LC or biochemical disease control but not OS. Radiation therapy intensification may improve LC and OS in head and neck and lung cancers, but these benefits have generally been limited to studies that did not incorporate concurrent chemotherapy. Conclusions: In randomized trials, the benefits of RT intensification have largely been restricted to trials in which concurrent chemotherapy was not used. Novel strategies to optimize the incorporation of RT in the multimodality treatment of solid tumors should be explored.« less

[Clinical relevance of drug interactions between nonsteroidal antiinflammatory drugs (NSAIDs) and antihypertensives].

PubMed

Villa, Juan; Cano, Alejandra; Franco, David; Monsalve, Mauricio; Hincapié, Jaime; Amariles, Pedro

2014-11-01

To establish the clinical relevance of drug interactions between nonsteroidal antiinflammatory drugs (NSAIDs) and antihypertensives, based on the interaction severity and probability of occurrence. Systematic review. A PubMed/Medline search was made using the MeSH terms: NSAIDs, Antihypertensive drugs, and Drug interactions. Articles between 2002 and 2012, human studies, in Spanish and English and full text access were included. Found articles were included and some of the references used in this works. Studies with in vitro methods, effects on ocular hypertension and those who do not consider the interaction NSAIDs, antihypertensives were excluded. For the selection of the papers included three independent reviewers were involved. We used a tool for data extraction and for assess of the interaction clinical relevance. Nineteen of 50 papers found were included. There were identified 21 interactions with pharmacodynamic mechanism, classified by their clinical relevance in level-2 high risk (76.2%) and level-3 medium risk (23.8%). In addition, evidence of 16 combinations of no interaction were found. Some NSAIDs may attenuate the effectiveness of antihypertensive drugs when used concurrently, especially with angiotensin converting enzyme inhibitors, diuretics, beta blockers and angiotensin receptorsii blockers. There was no evidence of effect modification of calcium channel antagonists, especially dihydropyridine, by concurrent use of NSAIDs. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Analysing concurrent transcranial magnetic stimulation and electroencephalographic data: A review and introduction to the open-source TESA software.

PubMed

Rogasch, Nigel C; Sullivan, Caley; Thomson, Richard H; Rose, Nathan S; Bailey, Neil W; Fitzgerald, Paul B; Farzan, Faranak; Hernandez-Pavon, Julio C

2017-02-15

The concurrent use of transcranial magnetic stimulation with electroencephalography (TMS-EEG) is growing in popularity as a method for assessing various cortical properties such as excitability, oscillations and connectivity. However, this combination of methods is technically challenging, resulting in artifacts both during recording and following typical EEG analysis methods, which can distort the underlying neural signal. In this article, we review the causes of artifacts in EEG recordings resulting from TMS, as well as artifacts introduced during analysis (e.g. as the result of filtering over high-frequency, large amplitude artifacts). We then discuss methods for removing artifacts, and ways of designing pipelines to minimise analysis-related artifacts. Finally, we introduce the TMS-EEG signal analyser (TESA), an open-source extension for EEGLAB, which includes functions that are specific for TMS-EEG analysis, such as removing and interpolating the TMS pulse artifact, removing and minimising TMS-evoked muscle activity, and analysing TMS-evoked potentials. The aims of TESA are to provide users with easy access to current TMS-EEG analysis methods and to encourage direct comparisons of these methods and pipelines. It is hoped that providing open-source functions will aid in both improving and standardising analysis across the field of TMS-EEG research. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Sex-Specific Effects of Combined Exposure to Chemical and Non-chemical Stressors on Neuroendocrine Development: a Review of Recent Findings and Putative Mechanisms.

PubMed

Cowell, Whitney J; Wright, Rosalind J

2017-12-01

Environmental toxicants and psychosocial stressors share many biological substrates and influence overlapping physiological pathways. Increasing evidence indicates stress-induced changes to the maternal milieu may prime rapidly developing physiological systems for disruption by concurrent or subsequent exposure to environmental chemicals. In this review, we highlight putative mechanisms underlying sex-specific susceptibility of the developing neuroendocrine system to the joint effects of stress or stress correlates and environmental toxicants (bisphenol A, alcohol, phthalates, lead, chlorpyrifos, and traffic-related air pollution). We provide evidence indicating that concurrent or tandem exposure to chemical and non-chemical stressors during windows of rapid development is associated with sex-specific synergistic, potentiated and reversed effects on several neuroendocrine endpoints related to hypothalamic-pituitary-adrenal axis function, sex steroid levels, neurotransmitter circuits, and innate immune function. We additionally identify gaps, such as the role that the endocrine-active placenta plays, in our understanding of these complex interactions. Finally, we discuss future research needs, including the investigation of non-hormonal biomarkers of stress. We demonstrate multiple physiologic systems are impacted by joint exposure to chemical and non-chemical stressors differentially among males and females. Collectively, the results highlight the importance of evaluating sex-specific endpoints when investigating the neuroendocrine system and underscore the need to examine exposure to chemical toxicants within the context of the social environment.

[Neonatal hyperthyroidism: a case report and literature review].

PubMed

Li, Ning; Li, Xiao-Hua; Yao, Ying-Min

2013-10-01

We report a case of neonatal thyrotoxicosis with concurrent respiratory failure in an infant born to a mother with Graves' disease and review the published literature describing neonatal hyperthyroidism. The male infant who was born by spontaneous delivery at 35 weeks of gestational age presented with fever, tachycardia and tachypnea at rest on day 11 after birth, and developed severe apnea on day 14. Thyroid function studies revealed hyperthyroidism in the infant, and his mother was confirmed to have Grave's disease during pregnancy. Literature review showed that among the 33 infants with similar conditions, tachycardia, tachypnea and poor weight gain were the most distinct clinical features of congenital hyperthyroidism. Accurate diagnosis of Graves' disease in the mother during pregnancy and awareness of the clinical presentations of neonatal hyperthyroidism are key to reducing missed diagnosis or misdiagnosis of neonatal hyperthyroidism.

Automated Concurrent Blackboard System Generation in C++

NASA Technical Reports Server (NTRS)

Kaplan, J. A.; McManus, J. W.; Bynum, W. L.

1999-01-01

In his 1992 Ph.D. thesis, "Design and Analysis Techniques for Concurrent Blackboard Systems", John McManus defined several performance metrics for concurrent blackboard systems and developed a suite of tools for creating and analyzing such systems. These tools allow a user to analyze a concurrent blackboard system design and predict the performance of the system before any code is written. The design can be modified until simulated performance is satisfactory. Then, the code generator can be invoked to generate automatically all of the code required for the concurrent blackboard system except for the code implementing the functionality of each knowledge source. We have completed the port of the source code generator and a simulator for a concurrent blackboard system. The source code generator generates the necessary C++ source code to implement the concurrent blackboard system using Parallel Virtual Machine (PVM) running on a heterogeneous network of UNIX(trademark) workstations. The concurrent blackboard simulator uses the blackboard specification file to predict the performance of the concurrent blackboard design. The only part of the source code for the concurrent blackboard system that the user must supply is the code implementing the functionality of the knowledge sources.

Predictors of radiation-induced esophageal toxicity in patients with non-small-cell lung cancer treated with three-dimensional conformal radiotherapy.

PubMed

Singh, Anurag K; Lockett, Mary Ann; Bradley, Jeffrey D

2003-02-01

To evaluate the incidence and clinical/dosimetric predictors of acute and late Radiation Therapy Oncology Group Grade 3-5 esophageal toxicity in patients with non-small-cell lung cancer (NSCLC) treated with definitive three-dimensional conformal radiotherapy (3D-CRT). We retrospectively reviewed the charts of 207 consecutive patients with NSCLC who were treated with high-dose, definitive 3D-CRT between March 1991 and December 1998. This population consisted of 107 men and 100 women. The median age was 67 years (range 31-90). The following patient and treatment parameters were studied: age, gender, race, performance status, sequential chemotherapy, concurrent chemotherapy, presence of subcarinal nodes, pretreatment weight loss, mean dose to the entire esophagus, maximal point dose to the esophagus, and percentage of volume of esophagus receiving >55 Gy. All doses are reported without heterogeneity corrections. The median prescription dose to the isocenter in this population was 70 Gy (range 60-74) delivered in 2-Gy daily fractions. All patients were treated once daily. Acute and late esophageal toxicities were graded by Radiation Therapy Oncology Group criteria. Patient and clinical/dosimetric factors were coded and correlated with acute and late Grade 3-5 esophageal toxicity using univariate and multivariate regression analyses. Of 207 patients, 16 (8%) developed acute (10 patients) or late (13 patients) Grade 3-5 esophageal toxicity. Seven patients had both acute and late Grade 3-5 esophageal toxicity. One patient died (Grade 5 esophageal toxicity) of late esophageal perforation. Concurrent chemotherapy, maximal point dose to the esophagus >58 Gy, and a mean dose to the entire esophagus >34 Gy were significantly associated with a risk of Grade 3-5 esophageal toxicity on univariate analysis. Concurrent chemotherapy and maximal point dose to the esophagus >58 Gy retained significance on multivariate analysis. Of 207 patients, 53 (26%) received concurrent chemotherapy. Fourteen (88%) of the 16 patients who developed Grade 3-5 esophageal toxicity had received concurrent chemotherapy (p = 0.0001, Pearson's chi-square test). No case of Grade 3-5 esophageal toxicity occurred in patients who received a maximal point dose to the esophagus of <58 Gy (p = 0.0001, Fisher's exact test, two-tail). Only 2 patients developed Grade 3-5 esophageal toxicity in the absence of concurrent chemotherapy; both received a maximal esophageal point dose >69 Gy. All assessable patients who developed Grade 3-5 esophageal toxicity had a mean dose to the entire esophagus >34 Gy (p = 0.0351, Pearson's chi-square test). However, the mean dose was not predictive on multivariate analysis. Concurrent chemotherapy and the maximal esophageal point dose were significantly associated with a risk of Grade 3-5 esophageal toxicity in patients with NSCLC treated with high-dose 3D-CRT. In patients who received concurrent chemotherapy, the threshold maximal esophageal point dose for Grade 3-5 esophageal toxicity was 58 Gy. An insufficient number of patients developed Grade 3-5 esophageal toxicity in the absence of chemotherapy to allow a valid statistical analysis of the relationship between the maximal esophageal point dose and esophagitis.

The Effectiveness of Concurrent Design on the Cost and Schedule Performance of Defense Weapons System Acquisitions

NASA Astrophysics Data System (ADS)

Robertson, Randolph B.

This study investigates the impact of concurrent design on the cost growth and schedule growth of US Department of Defense Major Defense Acquisition Systems (MDAPs). It is motivated by the question of whether employment of concurrent design in the development of a major weapon system will produce better results in terms of cost and schedule than traditional serial development methods. Selected Acquisition Reports were used to determine the cost and schedule growth of MDAPs as well as the degree of concurrency employed. Two simple linear regression analyses were used to determine the degree to which cost growth and schedule growth vary with concurrency. The results were somewhat surprising in that for major weapon systems the utilization of concurrency as it was implemented in the programs under study was shown to have no effect on cost performance, and that performance to development schedule, one of the purported benefits of concurrency, was actually shown to deteriorate with increases in concurrency. These results, while not an indictment of the concept of concurrency, indicate that better practices and methods are needed in the implementation of concurrency in major weapon systems. The findings are instructive to stakeholders in the weapons acquisition process in their consideration of whether and how to employ concurrent design strategies in their planning of new weapons acquisition programs.

Evaluation of concurrent priority queue algorithms. Technical report

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

Huang, Q.

1991-02-01

The priority queue is a fundamental data structure that is used in a large variety of parallel algorithms, such as multiprocessor scheduling and parallel best-first search of state-space graphs. This thesis addresses the design and experimental evaluation of two novel concurrent priority queues: a parallel Fibonacci heap and a concurrent priority pool, and compares them with the concurrent binary heap. The parallel Fibonacci heap is based on the sequential Fibonacci heap, which is theoretically the most efficient data structure for sequential priority queues. This scheme not only preserves the efficient operation time bounds of its sequential counterpart, but also hasmore » very low contention by distributing locks over the entire data structure. The experimental results show its linearly scalable throughput and speedup up to as many processors as tested (currently 18). A concurrent access scheme for a doubly linked list is described as part of the implementation of the parallel Fibonacci heap. The concurrent priority pool is based on the concurrent B-tree and the concurrent pool. The concurrent priority pool has the highest throughput among the priority queues studied. Like the parallel Fibonacci heap, the concurrent priority pool scales linearly up to as many processors as tested. The priority queues are evaluated in terms of throughput and speedup. Some applications of concurrent priority queues such as the vertex cover problem and the single source shortest path problem are tested.« less

Association of perceived partner non-monogamy with prevalent and incident sexual concurrency

PubMed Central

Sanchez, Diana M; Schoenbach, Victor J; Harvey, S Marie; Warren, Jocelyn T; Adimora, Adaora A; Poole, Charles; Leone, Peter A; Agnew, Christopher R

2016-01-01

Objectives Concurrency is suggested as an important factor in sexually transmitted infection transmission and acquisition, though little is known regarding factors that may predict concurrency initiation. We examined the association between perception of a partner’s non-monogamy (PPNM) and simultaneous or subsequent concurrency among at-risk heterosexual young adults in the Los Angeles area. Methods We used Poisson regression models to estimate the relationship between PPNM and incident concurrency among 536 participants participating in a cohort study, interviewed at 4-month periods during 1 year. Concurrency was defined as an overlap in reported sexual partnership dates; PPNM was defined as believing a partner was also having sex with someone else. Results Participants (51% female; 30% non-Hispanic white, 28% non-Hispanic black, 27% Hispanic/Latino) had a mean age of 23 years and lifetime median of nine sex partners. At each interview (baseline, 4-month, 8-month and 12-month), 4-month concurrency prevalence was, respectively, 38.8%, 27.4%, 23.1% and 24.5%. Four-month concurrency incidence at 4, 8 and 12 months was 8.5%, 10.6% and 17.8%, respectively. Participants with recent PPNM were more likely to initiate concurrency (crude 4-month RR=4.6; 95% CI 3.0, 7.0; adjusted 4-month RR=4.0, 95% CI 2.6 to 6.1). Conclusions Recent PPNM was associated with incident concurrency. Among young adults, onset of concurrency may be stimulated, relatively quickly, by the PPNM. Programmes which promote relationship communication skills and explicit monogamy expectations may help reduce concurrency. PMID:26574570

But Everyone is Doing It (Sort of)! Perceived Sexual Risks in the Social Environment and the Impact on Homeless Youth Engagement in Concurrent Sexual Relationships.

PubMed

Hsu, Hsun-Ta; Fulginiti, Anthony; Rice, Eric; Rhoades, Harmony; Winetrobe, Hailey; Danforth, Laura

2018-05-03

Although homeless youth are likely to engage in concurrent sexual relationships and doing so can accelerate HIV transmission, the issue of sexual concurrency (i.e., having sexual partnerships that overlap in time) has received scarce attention in this vulnerable population. The literature that exists tends to focus on individuals' characteristics that may be associated with concurrency and overlooks the influence of their social environment. Informed by the risk amplification and abatement model (RAAM), this study explored the association between pro-social and problematic social network connections, and sexual concurrency among homeless youth using drop-in center services (N = 841). Nearly 37% of youth engaged in concurrency. Partially consistent with the RAAM, regression analyses showed that affiliation with more problematic ties (i.e., having more network members who practice concurrency and unprotected sex) was associated with greater sexual concurrency. Programs addressing HIV risk among homeless youth in drop-in centers should consider the role youths' network composition may play in concurrency.

Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review.

PubMed

Fitzpatrick-Lewis, Donna; Ganann, Rebecca; Krishnaratne, Shari; Ciliska, Donna; Kouyoumdjian, Fiona; Hwang, Stephen W

2011-08-10

Research on interventions to positively impact health and housing status of people who are homeless has received substantially increased attention over the past 5 years. This rapid review examines recent evidence regarding interventions that have been shown to improve the health of homeless people, with particular focus on the effect of these interventions on housing status. A total of 1,546 articles were identified by a structured search of five electronic databases, a hand search of grey literature and relevant journals, and contact with experts. Two reviewers independently screened the first 10% of titles and abstracts for relevance. Inter-rater reliability was high and as a result only one reviewer screened the remaining titles and abstracts. Articles were included if they were published between January 2004 and December 2009 and examined the effectiveness of an intervention to improve the health or healthcare utilization of people who were homeless, marginally housed, or at risk of homelessness. Two reviewers independently scored all relevant articles for quality. Eighty-four relevant studies were identified; none were of strong quality while ten were rated of moderate quality. For homeless people with mental illness, provision of housing upon hospital discharge was effective in improving sustained housing. For homeless people with substance abuse issues or concurrent disorders, provision of housing was associated with decreased substance use, relapses from periods of substance abstinence, and health services utilization, and increased housing tenure. Abstinent dependent housing was more effective in supporting housing status, substance abstinence, and improved psychiatric outcomes than non-abstinence dependent housing or no housing. Provision of housing also improved health outcomes among homeless populations with HIV. Health promotion programs can decrease risk behaviours among homeless populations. These studies provide important new evidence regarding interventions to improve health, housing status, and access to healthcare for homeless populations. The additional studies included in this current review provide further support for earlier evidence which found that coordinated treatment programs for homeless persons with concurrent mental illness and substance misuse issues usually result in better health and access to healthcare than usual care. This review also provides a synthesis of existing evidence regarding interventions that specifically support homeless populations with HIV.

Effectiveness of interventions to improve the health and housing status of homeless people: a rapid systematic review

PubMed Central

2011-01-01

Background Research on interventions to positively impact health and housing status of people who are homeless has received substantially increased attention over the past 5 years. This rapid review examines recent evidence regarding interventions that have been shown to improve the health of homeless people, with particular focus on the effect of these interventions on housing status. Methods A total of 1,546 articles were identified by a structured search of five electronic databases, a hand search of grey literature and relevant journals, and contact with experts. Two reviewers independently screened the first 10% of titles and abstracts for relevance. Inter-rater reliability was high and as a result only one reviewer screened the remaining titles and abstracts. Articles were included if they were published between January 2004 and December 2009 and examined the effectiveness of an intervention to improve the health or healthcare utilization of people who were homeless, marginally housed, or at risk of homelessness. Two reviewers independently scored all relevant articles for quality. Results Eighty-four relevant studies were identified; none were of strong quality while ten were rated of moderate quality. For homeless people with mental illness, provision of housing upon hospital discharge was effective in improving sustained housing. For homeless people with substance abuse issues or concurrent disorders, provision of housing was associated with decreased substance use, relapses from periods of substance abstinence, and health services utilization, and increased housing tenure. Abstinent dependent housing was more effective in supporting housing status, substance abstinence, and improved psychiatric outcomes than non-abstinence dependent housing or no housing. Provision of housing also improved health outcomes among homeless populations with HIV. Health promotion programs can decrease risk behaviours among homeless populations. Conclusions These studies provide important new evidence regarding interventions to improve health, housing status, and access to healthcare for homeless populations. The additional studies included in this current review provide further support for earlier evidence which found that coordinated treatment programs for homeless persons with concurrent mental illness and substance misuse issues usually result in better health and access to healthcare than usual care. This review also provides a synthesis of existing evidence regarding interventions that specifically support homeless populations with HIV. PMID:21831318

NASA Institute for Advanced Concepts

NASA Technical Reports Server (NTRS)

Cassanova, Robert A.

1999-01-01

The purpose of NASA Institute for Advanced Concepts (NIAC) is to provide an independent, open forum for the external analysis and definition of space and aeronautics advanced concepts to complement the advanced concepts activities conducted within the NASA Enterprises. The NIAC will issue Calls for Proposals during each year of operation and will select revolutionary advanced concepts for grant or contract awards through a peer review process. Final selection of awards will be with the concurrence of NASA's Chief Technologist. The operation of the NIAC is reviewed biannually by the NIAC Science, Exploration and Technology Council (NSETC) whose members are drawn from the senior levels of industry and universities. The process of defining the technical scope of the initial Call for Proposals was begun with the NIAC "Grand Challenges" workshop conducted on May 21-22, 1998 in Columbia, Maryland. These "Grand Challenges" resulting from this workshop became the essence of the technical scope for the first Phase I Call for Proposals which was released on June 19, 1998 with a due date of July 31, 1998. The first Phase I Call for Proposals attracted 119 proposals. After a thorough peer review, prioritization by NIAC and technical concurrence by NASA, sixteen subgrants were awarded. The second Phase I Call for Proposals was released on November 23, 1998 with a due date of January 31, 1999. Sixty-three (63) proposals were received in response to this Call. On December 2-3, 1998, the NSETC met to review the progress and future plans of the NIAC. The next NSETC meeting is scheduled for August 5-6, 1999. The first Phase II Call for Proposals was released to the current Phase I grantees on February 3,1999 with a due date of May 31, 1999. Plans for the second year of the contract include a continuation of the sequence of Phase I and Phase II Calls for Proposals and hosting the first NIAC Annual Meeting and USRA/NIAC Technical Symposium in NASA HQ.

47 CFR 61.132 - Method of filing concurrences.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 3 2012-10-01 2012-10-01 false Method of filing concurrences. 61.132 Section 61.132 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) TARIFFS Concurrences § 61.132 Method of filing concurrences. A carrier proposing to concur in...

Concurrent sexual partnerships among married Zimbabweans – implications for HIV prevention

PubMed Central

Mugweni, Esther; Pearson, Stephen; Omar, Mayeh

2015-01-01

Background Concurrent sexual partnerships play a key role in sustaining the HIV epidemic in Zimbabwe. Married couples are at an increased risk of contracting HIV from sexual networks produced by concurrent sexual partnerships. Addressing these partnerships is an international HIV prevention priority. Methods Our qualitative study presents the socioeconomic factors that contribute to the occurrence of concurrent sexual partnerships among married people in Zimbabwe. We conducted 36 in-depth interviews and four focus group discussions with married men and women in Zimbabwe in 2008 to understand the organizations of concurrent sexual partnerships. Data were analyzed using framework analysis. Results Our study indicates that relationship dissatisfaction played a key role in the engagement of concurrent sexual partnerships. Depending on the source of the dissatisfaction, there were four possible types of concurrent sexual relationships that were formed: sex worker, casual partner, regular girlfriend or informal polygyny which was referred to as “small house”. These relationships had different levels of intimacy, which had a bearing on practicing safer sex. Participants described three characteristics of hegemonic masculinity that contributed to the sources of dissatisfaction leading to concurrent sexual activity. Similarly, various aspects of emphasized femininity were described as creating opportunities for the occurrence of concurrent sexual relationships. Economic status was also listed as a factor that contributed to the occurrence of concurrent sexual partnerships. Conclusion Marital dissatisfaction was indicated as a contributing factor to the occurrence of concurrent sexual relationships. There were several reports of satisfying marital relationships in which affairs did not occur. Lessons from these marriages can be made part of future HIV prevention interventions targeted at preventing concurrent sexual partnerships by married couples. PMID:26491372

Association of perceived partner non-monogamy with prevalent and incident sexual concurrency.

PubMed

Sanchez, Diana M; Schoenbach, Victor J; Harvey, S Marie; Warren, Jocelyn T; Adimora, Adaora A; Poole, Charles; Leone, Peter A; Agnew, Christopher R

2016-06-01

Concurrency is suggested as an important factor in sexually transmitted infection transmission and acquisition, though little is known regarding factors that may predict concurrency initiation. We examined the association between perception of a partner's non-monogamy (PPNM) and simultaneous or subsequent concurrency among at-risk heterosexual young adults in the Los Angeles area. We used Poisson regression models to estimate the relationship between PPNM and incident concurrency among 536 participants participating in a cohort study, interviewed at 4-month periods during 1 year. Concurrency was defined as an overlap in reported sexual partnership dates; PPNM was defined as believing a partner was also having sex with someone else. Participants (51% female; 30% non-Hispanic white, 28% non-Hispanic black, 27% Hispanic/Latino) had a mean age of 23 years and lifetime median of nine sex partners. At each interview (baseline, 4-month, 8-month and 12-month), 4-month concurrency prevalence was, respectively, 38.8%, 27.4%, 23.1% and 24.5%. Four-month concurrency incidence at 4, 8 and 12 months was 8.5%, 10.6% and 17.8%, respectively. Participants with recent PPNM were more likely to initiate concurrency (crude 4-month RR=4.6; 95% CI 3.0, 7.0; adjusted 4-month RR=4.0, 95% CI 2.6 to 6.1). Recent PPNM was associated with incident concurrency. Among young adults, onset of concurrency may be stimulated, relatively quickly, by the PPNM. Programmes which promote relationship communication skills and explicit monogamy expectations may help reduce concurrency. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Histiocytoid Sweet Syndrome Diagnosed with Concurrent Myelodysplastic Syndrome with t(1;3) on Bone Marrow Examination

DTIC Science & Technology

2017-10-08

your materials. If you have any questions or concerns. please contact the 5g CRD/Publications and Presentations Section at 292-7141 for assistance. 8...and approval. 10. If your manuscript is accepted for scientific publication, please contact the 59 CRD/Publications and Presentations Section at 292...reduce turn-around time. If you have any questions regarding legal reviews, please contact the legal office at (210) 671-5795/3365, OSN 473. NOTE

Balancing Materiel Readiness Risks and Concurrency in Weapon System Acquisition: A Handbook for Program Managers

DTIC Science & Technology

1984-07-15

ftViCCii UWNC COMMAND MIX CM AFT DCP OUTUNC moo ffEOUCST FOR PROGRAM DECISION DRAFT DCP AFSC REVIEW RECOWMEM CATIONS OHI*OC Arse wioc...CS.P3 F16. El*. P» MCA Exhibit 4-6b. EMBEDDED COMPUTER HARDWARE vs. SOFTWARE Exhibit 4-6c. DoD EMBEDDED COMPUTER MARKET 31.J1...the mix of stores carried by that vehicle 6. Anticipated combat tactics employed by the carrying or launching vehicle and its maneuvering

Dual pathology in a patient with right lower quadrant pain.

PubMed

Deutsch, Gary B; Sathyanarayana, Sandeep Anantha; Nicastro, Jeffrey; Molmenti, Ernesto; Coppa, Gene; Rubach, Eugene; Friedman, Barak

2012-09-01

Meckel diverticula are remnants of the omphalomesenteric duct. They have 2% incidence in the general population, are usually asymptomatic, and tend to be diagnosed incidentally. The generally held principle had been that asymptomatic cases do not require resection, as exemplified by a 2008 systematic review of over 200 studies. However, a recent series reported an increased risk of malignancies, and recommended mandatory resection. We present a case of Meckel diverticulitis with concurrent infiltrative appendiceal carcinoid in a patient with right lower quadrant pain.

Dual Pathology in a Patient with Right Lower Quadrant Pain

PubMed Central

Deutsch, Gary B.; Sathyanarayana, Sandeep Anantha; Nicastro, Jeffrey; Molmenti, Ernesto; Coppa, Gene; Rubach, Eugene; Friedman, Barak

2012-01-01

Meckel diverticula are remnants of the omphalomesenteric duct. They have 2% incidence in the general population, are usually asymptomatic, and tend to be diagnosed incidentally. The generally held principle had been that asymptomatic cases do not require resection, as exemplified by a 2008 systematic review of over 200 studies. However, a recent series reported an increased risk of malignancies, and recommended mandatory resection. We present a case of Meckel diverticulitis with concurrent infiltrative appendiceal carcinoid in a patient with right lower quadrant pain. PMID:23997560

Terahertz source requirements for molecular spectroscopy

NASA Astrophysics Data System (ADS)

De Lucia, Frank C.; Goyette, Thomas M.

1994-06-01

Molecular spectroscopy was the earliest application in the terahertz spectral region and remains one of the most important. With the development of modern technology, spectroscopy has expanded beyond the laboratory and is the basis for a number of important remote sensing systems, especially in atmospheric science and studies of the interstellar medium. Concurrently, these spectroscopic applications have been one of the prime motivators for the development of terahertz technology. This paper will review these issues in the context of the requirements placed on future technology developments by spectroscopic applications.

Terahertz source requirements for molecular spectroscopy

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

De Lucia, F.C.; Goyette, T.M.

1994-12-31

Molecular spectroscopy was the earliest application in the terahertz spectral region and remains one of the most important. With the development of modern technology, spectroscopy has expanded beyond the laboratory and is the basis for a number of important remote sensing systems, especially in atmospheric science and studies of the interstellar medium. Concurrently, these spectroscopic applications have been one of the prime motivators for the development of terahertz technology. This paper will review these issues in the context of the requirements placed on future technology developments by spectroscopic applications.

Report of the third session of the West African Monsoon Experiment (WAMEX) scientific regional committee

NASA Astrophysics Data System (ADS)

After completion of the field phase of WAMEX, operations were assessed, further planning of data management activities was reviewed, and plans for the research and evaluation phase were coordinated. The WAMEX project was conducted concurrently with the first GARP Global Experiment. Impending data collection and processing activities are stressed in plans to promote the timely and complete analysis of the present situation. The advantages to be gained through international cooperation among scientists are emphasized.

Congenital malalignment of the great toenails: case report and literature review.

PubMed

Cohen, P R

1991-03-01

A 10-year-old black boy had congenital malalignment of the great toenails (CMGTN). It is important to recognize this condition since several nail disorders can occur concurrently with and/or clinically mimic it. Treatment is dependent on the severity of the condition, and includes conservative management and subsequent examination to detect CMGTN-associated complications for patients with mild lateral deviation of the nail plate, or surgical realignment for individuals with either marked nail plate deviation or condition-related disabling sequelae.

Hyperthyroidism and Jaundice

PubMed Central

Bal, CS; Chawla, Madhavi

2010-01-01

Development of hyperbilirubinemia, concurrent or subsequent to hyperthyroidism, can be due to thyrotoxicosis per se, or due to drug treatment of hyperthyroidism. Other rare conditions: autoimmune thyroid disease, or causes unrelated to hyperthyroidism like viral hepatitis, alcohol abuse, sepsis, cholangitis, or as a side effect of certain medications. In this article, we review these causes of co-existent hyperthyroidism and jaundice. We also highlight the changes to be expected while interpreting thyroid function tests vis-a-vis liver function tests in this subgroup of patients. PMID:21713219

Inferences from the dynamical history of Mercury's rotation

NASA Technical Reports Server (NTRS)

Peale, S. J.

1976-01-01

The history of Mercury's spin angular momentum is reviewed. It is shown that the current nonsynchronous but resonant spin and the nearly zero obliquity place almost no restrictions on the primordial spin state. The only exception comes about from a liquid core-solid mantle interaction which excludes a slow primordial spin concurrent with a large obliquity. The current occupancy of a final evolutionary spin state leads to the description of a scheme by which we can determine the extent of a currently liquid Mercurian core.

Handheld computing in pathology

PubMed Central

Park, Seung; Parwani, Anil; Satyanarayanan, Mahadev; Pantanowitz, Liron

2012-01-01

Handheld computing has had many applications in medicine, but relatively few in pathology. Most reported uses of handhelds in pathology have been limited to experimental endeavors in telemedicine or education. With recent advances in handheld hardware and software, along with concurrent advances in whole-slide imaging (WSI), new opportunities and challenges have presented themselves. This review addresses the current state of handheld hardware and software, provides a history of handheld devices in medicine focusing on pathology, and presents future use cases for such handhelds in pathology. PMID:22616027

Outcomes of Concurrent Operations: Results From the American College of Surgeons' National Surgical Quality Improvement Program.

PubMed

Liu, Jason B; Berian, Julia R; Ban, Kristen A; Liu, Yaoming; Cohen, Mark E; Angelos, Peter; Matthews, Jeffrey B; Hoyt, David B; Hall, Bruce L; Ko, Clifford Y

2017-09-01

To determine whether concurrently performed operations are associated with an increased risk for adverse events. Concurrent operations occur when a surgeon is simultaneously responsible for critical portions of 2 or more operations. How this practice affects patient outcomes is unknown. Using American College of Surgeons' National Surgical Quality Improvement Program data from 2014 to 2015, operations were considered concurrent if they overlapped by ≥60 minutes or in their entirety. Propensity-score-matched cohorts were constructed to compare death or serious morbidity (DSM), unplanned reoperation, and unplanned readmission in concurrent versus non-concurrent operations. Multilevel hierarchical regression was used to account for the clustered nature of the data while controlling for procedure and case mix. There were 1430 (32.3%) surgeons from 390 (77.7%) hospitals who performed 12,010 (2.3%) concurrent operations. Plastic surgery (n = 393 [13.7%]), otolaryngology (n = 470 [11.2%]), and neurosurgery (n = 2067 [8.4%]) were specialties with the highest proportion of concurrent operations. Spine procedures were the most frequent concurrent procedures overall (n = 2059/12,010 [17.1%]). Unadjusted rates of DSM (9.0% vs 7.1%; P < 0.001), reoperation (3.6% vs 2.7%; P < 0.001), and readmission (6.9% vs 5.1%; P < 0.001) were greater in the concurrent operation cohort versus the non-concurrent. After propensity score matching and risk-adjustment, there was no significant association of concurrence with DSM (odds ratio [OR] 1.08; 95% confidence interval [CI] 0.96-1.21), reoperation (OR 1.16; 95% CI 0.96-1.40), or readmission (OR 1.14; 95% CI 0.99-1.29). In these analyses, concurrent operations were not detected to increase the risk for adverse outcomes. These results do not lessen the need for further studies, continuous self-regulation and proactive disclosure to patients.

Concurrent Sexual Partnerships among Youth in Urban Kenya: Prevalence and Partnership Effects

PubMed Central

XU, Hongwei; LUKE, Nancy; ZULU, Eliya

2010-01-01

Research on concurrent sexual partnerships in sub-Saharan Africa is hindered by lack of accurate partnership data. Life history calendars could be beneficial for gathering such information. Using retrospective calendar data from a population-based sample of youth ages 18-24 in Kenya (N=608), we estimated the prevalence and correlates of concurrency. In the sixth month before the survey, 3.5 per cent of females and 4.0 per cent of males experienced concurrency. Males had more concurrencies and of shorter duration than females. Using survival analysis, we found that the characteristics of initial partnerships affect entry into a second (concurrent) relationship. Among females, marriage decreases and geographic separation from a partner increases the risk of concurrency, and relationship duration increases the risk for males. For both sexes, casual relationships and the perception of partner infidelity increase the risk, suggesting that concurrency expands one's egocentric sexual network and bridges additional networks involving partners' other partners. PMID:20865631

Lower bounds of concurrence for N-qubit systems and the detection of k-nonseparability of multipartite quantum systems

NASA Astrophysics Data System (ADS)

Qi, Xianfei; Gao, Ting; Yan, Fengli

2017-01-01

Concurrence, as one of the entanglement measures, is a useful tool to characterize quantum entanglement in various quantum systems. However, the computation of the concurrence involves difficult optimizations and only for the case of two qubits, an exact formula was found. We investigate the concurrence of four-qubit quantum states and derive analytical lower bound of concurrence using the multiqubit monogamy inequality. It is shown that this lower bound is able to improve the existing bounds. This approach can be generalized to arbitrary qubit systems. We present an exact formula of concurrence for some mixed quantum states. For even-qubit states, we derive an improved lower bound of concurrence using a monogamy equality for qubit systems. At the same time, we show that a multipartite state is k-nonseparable if the multipartite concurrence is larger than a constant related to the value of k, the qudit number and the dimension of the subsystems. Our results can be applied to detect the multipartite k-nonseparable states.

Concurrent sexual partnerships and associated factors: a cross-sectional population-based survey in a rural community in Africa with a generalised HIV epidemic.

PubMed

Maher, Dermot; Waswa, Laban; Karabarinde, Alex; Baisley, Kathy

2011-08-17

Although concurrent sexual partnerships may play an important role in HIV transmission in Africa, the lack of an agreed definition of concurrency and of standard methodological approaches has hindered studies. In a long-standing general population cohort in rural Uganda we assessed the prevalence of concurrency and investigated its association with sociodemographic and behavioural factors and with HIV prevalence, using the new recommended standard definition and methodological approaches. As part of the 2010 annual cohort HIV serosurvey among adults, we used a structured questionnaire to collect information on sociodemographic and behavioural factors and to measure standard indicators of concurrency using the recommended method of obtaining sexual-partner histories. We used logistic regression to build a multivariable model of factors independently associated with concurrency. Among those eligible, 3,291 (66%) males and 4,052 (72%) females participated in the survey. Among currently married participants, 11% of men and 25% of women reported being in a polygynous union. Among those with a sexual partner in the past year, the proportion reporting at least one concurrent partnership was 17% in males and 0.5% in females. Polygyny accounted for a third of concurrency in men and was not associated with increased HIV risk. Among men there was no evidence of an association between concurrency and HIV prevalence (but too few women reported concurrency to assess this after adjusting for confounding). Regarding sociodemographic factors associated with concurrency, females were significantly more likely to be younger, unmarried, and of lower socioeconomic status than males. Behavioural factors associated with concurrency were young age at first sex, increasing lifetime partners, and a casual partner in the past year (among men and women) and problem drinking (only men). Our findings based on the new standard definition and methodological approaches provide a baseline for measuring changes in concurrency and HIV incidence in future surveys, and a benchmark for other studies. As campaigns are now widely conducted against concurrency, such surveys and studies are important in evaluating their effectiveness in decreasing HIV transmission.

Concurrent bariatric operations and association with perioperative outcomes: registry based cohort study.

PubMed

Liu, Jason B; Ban, Kristen A; Berian, Julia R; Hutter, Matthew M; Huffman, Kristopher M; Liu, Yaoming; Hoyt, David B; Hall, Bruce L; Ko, Clifford Y

2017-09-26

Objective  To determine whether perioperative outcomes differ between patients undergoing concurrent compared with non-concurrent bariatric operations in the USA. Design  Retrospective, propensity score matched cohort study. Setting  Hospitals in the US accredited by the American College of Surgeons' metabolic and bariatric surgery accreditation and quality improvement program. Participants  513 167 patients undergoing bariatric operations between 1 January 2014 and 31 December 2016. Main outcome measures  The primary outcome measure was a composite of 30 day death, morbidity, readmission, reoperation, anastomotic or staple line leak, and bleeding events. Operative duration and lengths of stay were also assessed. Operations were defined as concurrent if they overlapped by 60 or more minutes or in their entirety. Results  In this study of 513 167 operations, 739 (29.5%) surgeons at 483 (57.8%) hospitals performed 6087 (1.2%) concurrent operations. The most frequently performed concurrent bariatric operations were sleeve gastrectomy (n=3250, 53.4%) and Roux-en-Y gastric bypass (n=1601, 26.3%). Concurrent operations were more often performed at large academic medical centers with higher operative volumes and numbers of trainees and by higher volume surgeons. Compared with non-concurrent operations, concurrent operations lasted a median of 34 minutes longer (P<0.001) and resulted in 0.3 days longer average length of stay (P<0.001). Perioperative adverse events were not observed to more likely occur in concurrent compared with non-concurrent operations (7.5% v 7.4%; relative risk 1.02, 95% confidence interval 0.90 to 1.15; P=0.84). Conclusions  Concurrent bariatric operations occurred infrequently, but when they did, there was no observable increased risk for adverse perioperative outcomes compared with non-concurrent operations. These results, however, do not argue against improved and more meaningful disclosure of concurrent surgery practices. 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.

Reducing Concurrent Sexual Partnerships Among Blacks in the Rural Southeastern United States: Development of Narrative Messages for a Radio Campaign.

PubMed

Cates, Joan R; Francis, Diane B; Ramirez, Catalina; Brown, Jane D; Schoenbach, Victor J; Fortune, Thierry; Powell Hammond, Wizdom; Adimora, Adaora A

2015-01-01

In the United States, heterosexual transmission of HIV infection is dramatically higher among Blacks than among Whites. Overlapping (concurrent) sexual partnerships promote HIV transmission. The authors describe their process for developing a radio campaign (Escape the Web) to raise awareness among 18-34-year-old Black adults of the effect of concurrency on HIV transmission in the rural South. Radio is a powerful channel for the delivery of narrative-style health messages. Through six focus groups (n = 51) and 42 intercept interviews, the authors explored attitudes toward concurrency and solicited feedback on sample messages. Men were advised to (a) end concurrent partnerships and not to begin new ones; (b) use condoms consistently with all partners; and (c) tell others about the risks of concurrency and benefits of ending concurrent partnerships. The narrative portrayed risky behaviors that trigger initiation of casual partnerships. Women were advised to (a) end partnerships in which they are not their partner's only partner; (b) use condoms consistently with all partners; and (c) tell others about the risks of concurrency and benefits of ending concurrent partnerships. Messages for all advised better modeling for children.

Reducing Concurrent Sexual Partnerships Among Blacks in the Rural Southeastern United States: Development of Narrative Messages for a Radio Campaign

PubMed Central

CATES, JOAN R.; FRANCIS, DIANE B.; RAMIREZ, CATALINA; BROWN, JANE D.; SCHOENBACH, VICTOR J.; FORTUNE, THIERRY; HAMMOND, WIZDOM POWELL; ADIMORA, ADAORA A.

2015-01-01

In the United States, heterosexual transmission of HIV infection is dramatically higher among Blacks than among Whites. Overlapping (concurrent) sexual partnerships promote HIV transmission. The authors describe their process for developing a radio campaign (Escape the Web) to raise awareness among 18–34-year-old Black adults of the effect of concurrency on HIV transmission in the rural South. Radio is a powerful channel for the delivery of narrative-style health messages. Through six focus groups (n = 51) and 42 intercept interviews, the authors explored attitudes toward concurrency and solicited feedback on sample messages. Men were advised to (a) end concurrent partnerships and not to begin new ones; (b) use condoms consistently with all partners; and (c) tell others about the risks of concurrency and benefits of ending concurrent partnerships. The narrative portrayed risky behaviors that trigger initiation of casual partnerships. Women were advised to (a) end partnerships in which they are not their partner’s only partner; (b) use condoms consistently with all partners; and (c) tell others about the risks of concurrency and benefits of ending concurrent partnerships. Messages for all advised better modeling for children. PMID:26134387

Panitumumab Use in Metastatic Colorectal Cancer and Patterns of KRAS Testing: Results from a Europe-Wide Physician Survey and Medical Records Review

PubMed Central

Trojan, Jörg; Mineur, Laurent; Tomášek, Jiří; Rouleau, Etienne; Fabian, Pavel; de Maglio, Giovanna; García-Alfonso, Pilar; Aprile, Giuseppe; Taylor, Aliki; Kafatos, George; Downey, Gerald; Terwey, Jan-Henrik; van Krieken, J. Han

2015-01-01

Background From 2008–2013, the European indication for panitumumab required that patients’ tumor KRAS exon 2 mutation status was known prior to starting treatment. To evaluate physician awareness of panitumumab prescribing information and how physicians prescribe panitumumab in patients with metastatic colorectal cancer (mCRC), two European multi-country, cross-sectional, observational studies were initiated in 2012: a physician survey and a medical records review. The first two out of three planned rounds for each study are reported. Methods The primary objective in the physician survey was to estimate the prevalence of KRAS testing, and in the medical records review, it was to evaluate the effect of test results on patterns of panitumumab use. The medical records review study also included a pathologists’ survey. Results In the physician survey, nearly all oncologists (299/301) were aware of the correct panitumumab indication and the need to test patients’ tumor KRAS status before treatment with panitumumab. Nearly all oncologists (283/301) had in the past 6 months of clinical practice administered panitumumab correctly to mCRC patients with wild-type KRAS status. In the medical records review, 97.5% of participating oncologists (77/79) conducted a KRAS test for all of their patients prior to prescribing panitumumab. Four patients (1.3%) did not have tumor KRAS mutation status tested prior to starting panitumumab treatment. Approximately one-quarter of patients (85/306) were treated with panitumumab and concurrent oxaliplatin-containing chemotherapy; of these, 83/85 had confirmed wild-type KRAS status prior to starting panitumumab treatment. All 56 referred laboratories that participated used a Conformité Européenne-marked or otherwise validated KRAS detection method, and nearly all (55/56) participated in a quality assurance scheme. Conclusions There was a high level of knowledge amongst oncologists around panitumumab prescribing information and the need to test and confirm patients’ tumors as being wild-type KRAS prior to treatment with panitumumab, with or without concurrent oxaliplatin-containing therapy. PMID:26491871

Do adolescent delinquency and problem drinking share psychosocial risk factors? A literature review.

PubMed

Curcio, Angela L; Mak, Anita S; George, Amanda M

2013-04-01

Despite the prevalence and damaging effects of adolescent problem drinking, relative to delinquency, far less research has focused on drinking using an integrated theoretical approach. The aim of the current research was to review existing literature on psychosocial risk factors for delinquency and problem drinking, and explore whether integrating elements of social learning theory with an established psychosocial control theory of delinquency could explain adolescent problem drinking. We reviewed 71 studies published post-1990 with particular focus on articles that empirically researched risk factors for adolescent problem drinking and delinquency in separate and concurrent studies and meta-analytic reviews. We found shared risk factors for adolescent delinquency and problem drinking that are encompassed by an extension of psychosocial control theory. The potential of an extended psychosocial control theory providing a parsimonious theoretical approach to explaining delinquency, problem drinking and other adolescent problem behaviours, along with suggestions for future investigations, is discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Bovine placenta: a review on morphology, components, and defects from terminology and clinical perspectives.

PubMed

Peter, Augustine T

2013-10-15

The bovine placenta has been the subject of many studies. Concurrently, several specialized terms have been developed to describe its development, morphology, components, function, and pathology. Many of these terms are simple, some are difficult to understand and use, and others are antiquated and may not be scientifically accurate. Defining and adopting terminology for the bovine placenta that is clear, precise and understandable, and available in a single source is expected to facilitate exchange of clinical and research information. This review presents a brief overview of the current knowledge regarding the bovine placenta and attempts to define terms. In this process, conventional terminology is presented, and contemporary and novel terms are proposed from a biological perspective. For example, use of terms such as syndesmochorial, retained placenta, and large offspring syndrome should be revisited. Furthermore, the clinical relevance of the structure and function of the bovine placenta is reviewed. Finally, terms discussed in this review are summarized (in table format). Copyright © 2013 Elsevier Inc. All rights reserved.

Chemoradiation in nasopharyngeal carcinoma: a 6-year experience in Tehran cancer institute.

PubMed

Kalaghchi, Bita; Kazemian, Ali; Hashem, Farnaz Amouzegar; Aghili, Mehdi; Farhan, Farshid; Haddad, Peiman

2011-01-01

To determine the addition of value of neoadjuvant, concurrent and adjuvant chemotherapy to radiation in the treatment of nasopharyngeal carcinoma with regard to the overall survival (OS) and disease free survival (DFS) within a six year period in Tehran cancer institute. Files of all patients with nasopharyngeal carcinoma treated by radiotherapy with or without concurrent chemotherapy in a curative setting in Tehran cancer institute during the period of 1999-2005 were retrospectively reviewed.. A total of 103 patients with nasopharyngeal carcinoma had been treated during the study period with radiotherapy or chemoradiotherapy in our institute. There were 29 (28.2%) females and 74 (71.8%) males. The median age at the time of radiotherapy was 47 years old (range 9-75 years). The patients were followed 2 to 76 months with a median follow-up of 14 months. Time of first recurrence after treatment was 3-44 months with a median of 10 months.. Survival in 2 groups of patients treated with radiotherapy alone or chemoradiation did not have a significant difference (P>0.1). Two-year survival in patients treated with or without adjuvant chemotherapy and had local recurrence after treatment did not have significant difference (P>0.1). Two-year survival in patients with or without local recurrence after treatment did not have significant difference (P>0.1). A beneficial affect or a survival benefit of adjuvant/neoadjuvant chemotherapy and concurrent chemoradiation was not observed in Iranian patients.

14 CFR 221.142 - Method of withdrawing portion of authority conferred by concurrence.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Giving and Revoking... carrier desires to issue a concurrence conferring less authority than a previous concurrence given to the... Revocation of Concurrence in a form acceptable to the Office of International Aviation. Such revocation...

14 CFR 221.142 - Method of withdrawing portion of authority conferred by concurrence.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Giving and Revoking... carrier desires to issue a concurrence conferring less authority than a previous concurrence given to the... Revocation of Concurrence in a form acceptable to the Office of International Aviation. Such revocation...

14 CFR 221.142 - Method of withdrawing portion of authority conferred by concurrence.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Giving and Revoking... carrier desires to issue a concurrence conferring less authority than a previous concurrence given to the... Revocation of Concurrence in a form acceptable to the Office of International Aviation. Such revocation...

14 CFR 221.142 - Method of withdrawing portion of authority conferred by concurrence.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Giving and Revoking... carrier desires to issue a concurrence conferring less authority than a previous concurrence given to the... Revocation of Concurrence in a form acceptable to the Office of International Aviation. Such revocation...

14 CFR 221.142 - Method of withdrawing portion of authority conferred by concurrence.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Giving and Revoking... carrier desires to issue a concurrence conferring less authority than a previous concurrence given to the... Revocation of Concurrence in a form acceptable to the Office of International Aviation. Such revocation...

From conventionally fractionated radiation therapy to hyperfractionated radiation therapy alone and with concurrent chemotherapy in patients with early-stage nonsmall cell lung cancer.

PubMed

Jeremić, Branislav; Milicić, Biljana

2008-02-15

The authors' single-institution experience in patients with early-stage (I and II) nonsmall cell lung cancer (NSCLC) who were treated between 1980 and 1998 with either conventionally fractionated (CF) radiation therapy (RT), or hyperfractionated (HFX) RT, or HFX RT with concurrent paclitaxel/carboplatin (HFX RT-Pac/C) was reviewed. Seventy-eight patients received 60 grays (Gy) in 30 daily fractions (CF), 116 patients received 69.6 Gy (1.2 Gy twice daily), and 56 patients received 67.6 Gy (1.3 Gy twice daily) with concurrent, low-dose, daily C (25 mg/m2) and Pac (10 mg/m2). Biologically equivalent doses for the 3 groups were 72 Gy, 78 Gy, and 76 Gy, respectively, for acute effects (alpha/beta = 10 Gy) and 120 Gy, 111 Gy, and 111 Gy, respectively, for late effects (alpha/beta = 2 Gy). For all 250 patients, the overall median survival was 27 months, the cause-specific survival was 27 months, the local progression-free survival was 32 months, and distant metastasis-free survival was not achieved; and the respective 5-year survival rates were 27%, 32%, 45%, and 68%. CF achieved significantly inferior survival than either HFX RT alone or HFX RT-Pac/C (P = .0332 and P = .0013, respectively), and no difference was observed between the 2 HFX RT regimens (P = .1934). Only acute hematologic high-grade toxicity (grade >or=3) was more frequent with HFX RT-Pac/C than with either RT alone, whereas other toxicities were similar between the 3 treatment groups. HFX RT with or without concurrent chemotherapy may be better than CF in patients with early-stage NSCLC. The role of chemotherapy deserves further investigation, because the group that received chemotherapy in the current study had a higher incidence of acute high-grade hematologic toxicity. Cancer 2008. (c) 2008 American Cancer Society.

Is the progression free survival advantage of concurrent gemcitabine plus cisplatin and radiation followed by adjuvant gemcitabine and cisplatin in patients with advanced cervical cancer worth the additional cost? A cost-effectiveness analysis.

PubMed

Smith, B; Cohn, D E; Clements, A; Tierney, B J; Straughn, J M

2013-09-01

The objective of this study is to determine whether concurrent and adjuvant chemoradiation with gemcitabine/cisplatin is cost-effective in patients with stage IIB to IVA cervical cancer. A cost-effectiveness model compared two arms of the trial performed by Duenas-Gonzalez et al. [1]: concurrent and adjuvant chemoradiation with gemcitabine/cisplatin (RT/GC+GC) versus concurrent radiation with cisplatin (RT/C). Major adverse events (AEs) and progression free survival (PFS) rates of each arm were incorporated in the model. AEs were defined as any hospitalization including grade 4 anemia, grade 4 neutropenia, and death. Medicare data and literature review were used to estimate costs. Incremental cost-effectiveness ratios (ICERs) per progression-free life-year saved (PF-LYS) were calculated. Sensitivity analyses were performed for pertinent uncertainties. For 10,000 women with locally advanced cervical cancer, the cost of therapy and AEs was $173.9 million (M) for RT/C versus $259.8M for RT/GC+GC. There were 879 additional 3-year progression-free survivors in the RT/GC+GC arm. The ICER for RT/GC+GC was $97,799 per PF-LYS. When the rate of hospitalization was equalized to 4.3%, the ICER for RT/GC+GC exceeded $80,000. The resultant ICER when increasing PFS in the RT/GC+GC arm by 5% was $62,605 per PF-LYS. When the cost of chemotherapy was decreased by 50%, the ICER was below $50,000 at $41,774 per PF-LYS. Radiation and gemcitabine/cisplatin for patients with stage IIB to IVA cervical cancer are not cost-effective. The increased financial burden of radiation with gemcitabine/cisplatin and associated toxicities appears to outweigh the benefit of increased 3-year PFS and is primarily dependent on chemotherapy drug costs. Copyright © 2013 Elsevier Inc. All rights reserved.

Hypoxia and acidification in ocean ecosystems: coupled dynamics and effects on marine life.

PubMed

Gobler, Christopher J; Baumann, Hannes

2016-05-01

There is increasing recognition that low dissolved oxygen (DO) and low pH conditions co-occur in many coastal and open ocean environments. Within temperate ecosystems, these conditions not only develop seasonally as temperatures rise and metabolic rates accelerate, but can also display strong diurnal variability, especially in shallow systems where photosynthetic rates ameliorate hypoxia and acidification by day. Despite the widespread, global co-occurrence of low pH and low DO and the likelihood that these conditions may negatively impact marine life, very few studies have actually assessed the extent to which the combination of both stressors elicits additive, synergistic or antagonistic effects in marine organisms. We review the evidence from published factorial experiments that used static and/or fluctuating pH and DO levels to examine different traits (e.g. survival, growth, metabolism), life stages and species across a broad taxonomic spectrum. Additive negative effects of combined low pH and low DO appear to be most common; however, synergistic negative effects have also been observed. Neither the occurrence nor the strength of these synergistic impacts is currently predictable, and therefore, the true threat of concurrent acidification and hypoxia to marine food webs and fisheries is still not fully understood. Addressing this knowledge gap will require an expansion of multi-stressor approaches in experimental and field studies, and the development of a predictive framework. In consideration of marine policy, we note that DO criteria in coastal waters have been developed without consideration of concurrent pH levels. Given the persistence of concurrent low pH-low DO conditions in estuaries and the increased mortality experienced by fish and bivalves under concurrent acidification and hypoxia compared with hypoxia alone, we conclude that such DO criteria may leave coastal fisheries more vulnerable to population reductions than previously anticipated. © 2016 The Author(s).

Hypoxia and acidification in ocean ecosystems: coupled dynamics and effects on marine life

PubMed Central

Baumann, Hannes

2016-01-01

There is increasing recognition that low dissolved oxygen (DO) and low pH conditions co-occur in many coastal and open ocean environments. Within temperate ecosystems, these conditions not only develop seasonally as temperatures rise and metabolic rates accelerate, but can also display strong diurnal variability, especially in shallow systems where photosynthetic rates ameliorate hypoxia and acidification by day. Despite the widespread, global co-occurrence of low pH and low DO and the likelihood that these conditions may negatively impact marine life, very few studies have actually assessed the extent to which the combination of both stressors elicits additive, synergistic or antagonistic effects in marine organisms. We review the evidence from published factorial experiments that used static and/or fluctuating pH and DO levels to examine different traits (e.g. survival, growth, metabolism), life stages and species across a broad taxonomic spectrum. Additive negative effects of combined low pH and low DO appear to be most common; however, synergistic negative effects have also been observed. Neither the occurrence nor the strength of these synergistic impacts is currently predictable, and therefore, the true threat of concurrent acidification and hypoxia to marine food webs and fisheries is still not fully understood. Addressing this knowledge gap will require an expansion of multi-stressor approaches in experimental and field studies, and the development of a predictive framework. In consideration of marine policy, we note that DO criteria in coastal waters have been developed without consideration of concurrent pH levels. Given the persistence of concurrent low pH–low DO conditions in estuaries and the increased mortality experienced by fish and bivalves under concurrent acidification and hypoxia compared with hypoxia alone, we conclude that such DO criteria may leave coastal fisheries more vulnerable to population reductions than previously anticipated. PMID:27146441

High Cryptococcal Antigen Titers in Blood Are Predictive of Subclinical Cryptococcal Meningitis Among Human Immunodeficiency Virus-Infected Patients.

PubMed

Wake, Rachel M; Britz, Erika; Sriruttan, Charlotte; Rukasha, Ivy; Omar, Tanvier; Spencer, David C; Nel, Jeremy S; Mashamaite, Sello; Adelekan, Adeboye; Chiller, Tom M; Jarvis, Joseph N; Harrison, Thomas S; Govender, Nelesh P

2018-02-10

High mortality rates among asymptomatic cryptococcal antigen (CrAg)-positive patients identified through CrAg screening, despite preemptive fluconazole treatment, may be due to undiagnosed cryptococcal meningitis. Symptoms were reviewed in CrAg-positive patients identified by screening 19233 individuals with human immunodeficiency virus infection and CD4 cell counts <100/µL at 17 clinics and 3 hospitals in Johannesburg from September 2012 until September 2015, and at 2 hospitals until June 2016. Cerebrospinal fluid samples from 90 of 254 asymptomatic patients (35%) and 78 of 173 (45%) with headache only were analyzed for cryptococcal meningitis, considered present if Cryptococcus was identified by means of India ink microscopy, culture, or CrAg test. CrAg titers were determined with stored blood samples from 62 of these patients. The associations between blood CrAg titer, concurrent cryptococcal meningitis, and mortality rate were assessed. Cryptococcal meningitis was confirmed in 34% (95% confidence interval, 25%-43%; 31 of 90) of asymptomatic CrAg-positive patients and 90% (81%-96%; 70 of 78) with headache only. Blood CrAg titer was significantly associated with concurrent cryptococcal meningitis in asymptomatic patients (P < .001) and patients with headache only (P = .003). The optimal titer for predicting cryptococcal meningitis was >160 (sensitivity, 88.2%; specificity, 82.1%); the odds ratio for concurrent cryptococcal meningitis was 34.5 (95% confidence interval, 8.3-143.1; P < .001). About a third of asymptomatic CrAg-positive patients have concurrent cryptococcal meningitis. More effective clinical assessment strategies and antifungal regimens are required for CrAg-positive patients, including investigation for cryptococcal meningitis irrespective of symptoms. Where it is not possible to perform lumbar punctures in all CrAg-positive patients, blood CrAg titers should be used to target those most at risk of cryptococcal meningitis. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Predictive factors for survival and correlation to toxicity in advanced Stage III non-small cell lung cancer patients with concurrent chemoradiation.

PubMed

Kim, Yong-Hyub; Ahn, Sung-Ja; Kim, Young-Chul; Kim, Kyu-Sik; Oh, In-Jae; Ban, Hee-Jung; Chung, Woong-Ki; Nam, Taek-Keun; Yoon, Mee Sun; Jeong, Jae-Uk; Song, Ju-Young

2016-02-01

Concurrent chemoradiotherapy is the standard treatment for locally advanced Stage III non-small cell lung cancer in patients with a good performance status and minimal weight loss. This study aimed to define subgroups with different survival outcomes and identify correlations with the radiation-related toxicities. We retrospectively reviewed 381 locally advanced Stage III non-small cell lung cancer patients with a good performance status or weight loss of <10% who received concurrent chemoradiotherapy between 2004 and 2011. Three-dimensional conformal radiotherapy was administered once daily, combined with weekly chemotherapy. The Kaplan-Meier method was used for survival comparison and Cox regression for multivariate analysis. Multivariate analysis was performed using all variables with P values <0.1 from the univariate analysis. Median survival of all patients was 24 months. Age > 75 years, the diffusion lung capacity for carbon monoxide ≤80%, gross tumor volume ≥100 cm(3) and subcarinal nodal involvement were the statistically significant predictive factors for poor overall survival both in univariate and multivariate analyses. Patients were classified into four groups according to these four predictive factors. The median survival times were 36, 29, 18 and 14 months in Groups I, II, III and IV, respectively (P < 0.001). Rates of esophageal or lung toxicity ≥Grade 3 were 5.9, 14.1, 12.5 and 22.2%, respectively. The radiotherapy interruption rate differed significantly between the prognostic subgroups; 8.8, 15.4, 22.7 and 30.6%, respectively (P = 0.017). Severe toxicity and interruption of radiotherapy were more frequent in patients with multiple adverse predictive factors. To maintain the survival benefit in patients with concurrent chemoradiotherapy, strategies to reduce treatment-related toxicities need to be deeply considered. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Postmortem diagnostic investigation of disease in free-ranging marine turtle populations: A review of common pathologic findings and protocols

USGS Publications Warehouse

Flint, Mark; Patterson-Kane, Janet C.; Limpus, C.J.; Work, Thierry M.; Blair, David; Mills, Paul C.

2009-01-01

Over the past few decades, there have been increasing numbers of reports of diseases in marine turtles. Furthermore, in recent years, there have been documented instances of apparently new diseases emerging in these species of which the etiology and/or pathogenesis remain unknown. These instances i) raise concern for the survival of marine turtles, and ii) question the health and stability of the benthic marine environments in which turtles live. Knowledge of common disease processes and pathologic changes in lesions, along with a standardized approach to postmortem and sample collection are required to document and understand the host-agent-environment interactions in marine turtle health. This review combines, for the first time, a standardized approach to the postmortem of marine turtles for veterinary clinicians, with a concurrent descriptive review of the gross and microscopic pathologic changes in lesions commonly seen.

Stress and tension-type headache mechanisms.

PubMed

Cathcart, Stuart; Winefield, Anthony H; Lushington, Kurt; Rolan, Paul

2010-10-01

Stress is widely demonstrated as a contributing factor in tension-type headache (TTH). The mechanisms underlying this remain unclear at present. Recent research indicates the importance of central pain processes in tension-type headache (TTH) pathophysiology. Concurrently, research with animals and healthy humans has begun to elucidate the relationship between stress and pain processing in the central nervous system, including central pain processes putatively dysfunctional in TTH. Combined, these two fields of research present new insights and hypotheses into possible mechanisms by which stress may contribute to TTH. To date, however, there has been no comprehensive review of this literature. The present paper provides such a review, which may be valuable in facilitating a broader understanding of the central mechanisms by which stress may contribute to TTH.

Cancer Management in Kabuki Syndrome: The First Case of Wilms Tumor and a Literature Review.

PubMed

Teranishi, Hideto; Koga, Yuhki; Nakashima, Kentaro; Morihana, Eiji; Ishii, Kanako; Sakai, Yasunari; Taguchi, Tomoaki; Oda, Yoshinao; Miyake, Noriko; Matsumoto, Naomichi; Ohga, Shouichi

2018-02-27

A 3-year-old Japanese girl treated for hypoplastic left heart syndrome and Dandy-Walker syndrome was diagnosed with Kabuki syndrome (KS) with a mutation of KMT2D; c.13285C>T:p.Q4429*. Concurrently, macrohematuria portended the diagnosis of Wilms tumor. Postoperative chemotherapy has achieved complete remission despite a prolonged and reduced regimen due to liver dysfunction and convulsions. Cancer predisposition has been suggested for KS due to oncogenic mutations in KMT2D or KDM6A. The first case of nephroblastoma exemplified the treatability of malignancies in KS patients, as shown in the 9 cases reviewed. Active screening and intervention are recommended for the cure of malignancy in KS children.

Drug-nutrient interactions: a review.

PubMed

Maka, D A; Murphy, L K

2000-11-01

Concurrent administration of medications and nutrients can lead to interactions that change the absorption or metabolism of the medication or nutrient. Some of these interactions have little or no impact on the patient while others may be fatal. The objective of this article is to review the mechanisms of various drug-nutrient interactions. Topics to be discussed include specific populations at risk of interactions, nutrients that have a positive and negative effect on drug absorption, nutrients that result in alterations of drug metabolism, and a variety of pharmacologic interactions of medications with nutrients. It is vital that healthcare providers are familiar with drug-nutrient interactions and continue to educate themselves and their patients to optimize the effectiveness and minimize the toxicities of medications.

Measuring safety climate in health care.

PubMed

Flin, R; Burns, C; Mearns, K; Yule, S; Robertson, E M

2006-04-01

To review quantitative studies of safety climate in health care to examine the psychometric properties of the questionnaires designed to measure this construct. A systematic literature review was undertaken to study sample and questionnaire design characteristics (source, no of items, scale type), construct validity (content validity, factor structure and internal reliability, concurrent validity), within group agreement, and level of analysis. Twelve studies were examined. There was a lack of explicit theoretical underpinning for most questionnaires and some instruments did not report standard psychometric criteria. Where this information was available, several questionnaires appeared to have limitations. More consideration should be given to psychometric factors in the design of healthcare safety climate instruments, especially as these are beginning to be used in large scale surveys across healthcare organisations.

Reduction of Left Visual Field Lexical Decision Accuracy as a Result of Concurrent Nonverbal Auditory Stimulation

ERIC Educational Resources Information Center

Van Strien, Jan W.

2004-01-01

To investigate whether concurrent nonverbal sound sequences would affect visual-hemifield lexical processing, lexical-decision performance of 24 strongly right-handed students (12 men, 12 women) was measured in three conditions: baseline, concurrent neutral sound sequence, and concurrent emotional sound sequence. With the neutral sequence,…

29 CFR 502.17 - Concurrent actions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Concurrent actions. 502.17 Section 502.17 Labor Regulations... AND NATIONALITY ACT (SUSPENDED 6-29-2009) Enforcement of Work Contracts § 502.17 Concurrent actions. The taking of any one of the actions referred to above shall not be a bar to the concurrent taking of...

29 CFR 501.17 - Concurrent actions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Concurrent actions. 501.17 Section 501.17 Labor Regulations... AND NATIONALITY ACT Enforcement § 501.17 Concurrent actions. OFLC has primary responsibility to make.... The taking of any one of the actions referred to above shall not be a bar to the concurrent taking of...

29 CFR 500.141 - Concurrent actions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Concurrent actions. 500.141 Section 500.141 Labor... SEASONAL AGRICULTURAL WORKER PROTECTION Enforcement § 500.141 Concurrent actions. The taking of any one of the actions referred to in § 500.140 shall not be a bar to the concurrent taking of any other action...

Implicit attitudes to sexual partner concurrency vary by sexual orientation but not by gender-A cross sectional study of Belgian students.

PubMed

Kenyon, Chris R; Wolfs, Kenny; Osbak, Kara; van Lankveld, Jacques; Van Hal, Guido

2018-01-01

High rates of sexual partner concurrency have been shown to facilitate the spread of various sexually transmitted infections. Assessments of explicit attitudes to concurrency have however found little difference between populations. Implicit attitudes to concurrency may vary between populations and play a role in generating differences in the prevalence of concurrency. We developed a concurrency implicit associations test (C-IAT) to assess if implicit attitudes towards concurrency may vary between individuals and populations and what the correlates of these variations are. A sample of 869 Belgian students (mean age 23, SD 5.1) completed an online version of the C-IAT together with a questionnaire concerning sexual behavior and explicit attitudes to concurrency. The study participants C-IATs demonstrated a strong preference for monogamy (-0.78, SD = 0.41). 93.2% of participants had a pro-monogamy C-IAT. There was no difference in this implicit preference for monogamy between heterosexual men and women. Men who have sex with men and women who have sex with women were more likely to exhibit implicit but not explicit preferences for concurrency compared to heterosexual men and women. Correlates of the C-IAT varied between men and women.

Urban African-American Men Speak Out on Sexual Partner Concurrency

PubMed Central

Carey, Michael P.; Senn, Theresa E.; Seward, Derek X.; Vanable, Peter A.

2008-01-01

Sexual partner concurrency, which fuels the spread of HIV, has been hypothesized as a cause of higher rates of HIV among low-income, urban African-Americans. Despite this hypothesis, little is known about the phenomenology of partner concurrency. To address this gap in the literature, we recruited 20 urban African-American men from a public STD clinic to elicit their ideas about partner concurrency. Five themes emerged during focus group discussions. First, there was a general consensus that it is normative to have more than one sexual partner. Second, men agreed it is acceptable for men to have concurrent partners, but disagreed about whether it was acceptable for women. Third, although men provided many reasons for concurrent partnerships, the most common reasons were that (a) multiple partners fulfill different needs, and (b) it is in a man’s nature to have multiple partners. Fourth, men described some (but not all) of the negative consequences of having concurrent partners. Finally, men articulated spoken and unspoken rules that govern concurrent partnerships. These findings increase knowledge about urban, African-American men’s attitudes toward concurrent partnerships, and can help to improve the efficacy of sexual risk-reduction interventions for this group of underserved men and their partners. PMID:18483847

Concurrent sexual partnerships among female sex workers and their non-commercial male partners in Tijuana and Ciudad Juarez, Mexico.

PubMed

Robertson, Angela Marie; Syvertsen, Jennifer L; Rangel, M Gudelia; Staines, Hugo S; Morris, Martina; Patterson, Thomas L; Ulibarri, Monica D; Strathdee, Steffanie A

2013-06-01

To investigate the prevalence and correlates of concurrent (overlapping) sexual partnerships among female sex workers (FSWs) and their non-commercial male partners in two Mexico-US border cities. A cross-sectional survey of FSWs and their non-commercial male partners was conducted in Tijuana and Ciudad Juárez, Mexico (2010-2011). Eligible FSWs and verified non-commercial partners were aged ≥18 years; FSWs had ever used hard drugs (lifetime) and recently exchanged sex for money, drugs or other goods (past month). Participants underwent baseline questionnaires obtaining dates of sex and condom use with ≤5 other recurring partners, including FSWs' regular clients. These dates were compared with dates of sex with enrolled study partners to determine overlap (ie, 'recurring' concurrency). Bivariate probit regression identified recurring concurrency correlates. Among 428 individuals (214 couples), past-year recurring concurrency prevalence was 16% and was higher among women than their non-commercial male partners (26% vs 6%). In 10 couples (5%), both partners reported recurring concurrency. The majority of couples (64%) always had unprotected sex, and most of the individuals (70%) with recurring concurrency 'sometimes' or 'never' used condoms with their concurrent partners. Recurring concurrency was positively associated with FSWs' income, men's caballerismo (a form of traditional masculinity) and men's belief that their FSW partners had sexually transmitted infections (STIs). Recurring concurrency, representing sustained periods of overlapping partnerships in which unprotected sex was common, should be addressed by couple-based STI prevention interventions.

Radioisotope Power Systems Reference Book for Mission Designers and Planners

NASA Technical Reports Server (NTRS)

Lee, Young; Bairstow, Brian

2015-01-01

The RPS Program's Program Planning and Assessment (PPA) Office commissioned the Mission Analysis team to develop the Radioisotope Power Systems (RPS) Reference Book for Mission Planners and Designers to define a baseline of RPS technology capabilities with specific emphasis on performance parameters and technology readiness. The main objective of this book is to provide RPS technology information that could be utilized by future mission concept studies and concurrent engineering practices. A progress summary from the major branches of RPS technology research provides mission analysis teams with a vital tool for assessing the RPS trade space, and provides concurrent engineering centers with a consistent set of guidelines for RPS performance characteristics. This book will be iterated when substantial new information becomes available to ensure continued relevance, serving as one of the cornerstone products of the RPS PPA Office. This book updates the original 2011 internal document, using data from the relevant publicly released RPS technology references and consultations with RPS technologists. Each performance parameter and RPS product subsection has been reviewed and cleared by at least one subject matter representative. A virtual workshop was held to reach consensus on the scope and contents of the book, and the definitions and assumptions that should be used. The subject matter experts then reviewed and updated the appropriate sections of the book. The RPS Mission Analysis Team then performed further updates and crosschecked the book for consistency. Finally, a second virtual workshop was held to ensure all subject matter experts and stakeholders concurred on the contents.

Infrapatellar bursitis in children with juvenile idiopathic arthritis: a case series.

PubMed

Alqanatish, Jubran T; Petty, Ross E; Houghton, Kristin M; Guzman, Jaime; Tucker, Lori B; Cabral, David A; Cairns, Robyn A

2011-02-01

Children with juvenile idiopathic arthritis (JIA) may infrequently present with localized anterior knee pain or swelling, in addition to generalize knee pain induced by JIA. We report five cases of deep infrapatellar bursitis in children with JIA. The clinical features, radiological findings, management, and outcome of five children with JIA and deep infrapatellar bursitis are reviewed. Three boys and two girls with a mean age of 9.8 years (range 6-14 years) were reviewed. Four children had persistent oligoarticular JIA, and one child had extended oligoarticular JIA. The presentation of deep infrapatellar bursitis was variable. In only one patient was the bursal swelling painful. Knee magnetic resonance imaging (MRI) was performed in four patients and demonstrated coexistent knee joint synovitis in three. Treatment included targeted corticosteroid injections into the deep infrapatellar bursa in two cases with complete resolution. One case was treated with corticosteroid injection by an outside health care provider with poor clinical response. Two cases are being treated with non-steroidal anti-inflammatory drugs and methotrexate. Deep infrapatellar bursitis can occur as an isolated finding or concurrently with knee joint synovitis in patients with JIA. Awareness of this entity is important because direct injection of the bursa may be needed for treatment, as the bursa does not communicate with the knee joint. Furthermore, when bursitis is suspected in JIA, MRI can be helpful to confirm the diagnosis, detect concurrent knee joint synovitis, and exclude other pathologies.

Management of normal tissue toxicity associated with chemoradiation (primary skin, esophagus, and lung).

PubMed

Yazbeck, Victor Y; Villaruz, Liza; Haley, Marsha; Socinski, Mark A

2013-01-01

Nearly one quarter of patients with lung cancer present with locally advanced disease where concurrent chemoradiotherapy is the current standard of care for patients with good performance status. Cisplatin-based concurrent chemoradiotherapy consistently showed an improvement in survival compared with sequential chemoradiotherapy, at the expense of an increase in the toxicity profile. Over the past decades, several encouraging biomarkers such as transforming growth factor-beta and radioprotective agents such as amifostine were studied but without reaching approval for patient care. We reviewed the prevalence and risk factors for different adverse effects associated with the combined chemoradiotherapy modality, especially dermatitis, mucositis, esophagitis, and pneumonitis. These adverse effects can further be divided into acute, subacute, and chronic. Dermatitis is usually rare and responds well to topical steroids and usual skin care. Acute esophagitis occurs in 30% of patients and is treated with proton pump inhibitors, promotility agents, local anesthetic, and dietary changes. Radiation pneumonitis is a subacute complication seen in 15% of patients and is usually managed with steroids. Chronic adverse effects such as radiation fibrosis and esophageal stricture occur approximately 6 months after completion of radiation therapy and are usually permanent. In this review, complications of chemoradiotherapy for patients with locally advanced lung cancer are delineated, and approaches to their management are described. Given that treatment interruption is associated with a worse outcome, patients are aggressively treated with a curative intent. Therefore, planning for treatment adverse effects improves patient tolerance, compliance, and outcome.

NASA's Planetary Science Summer School: Training Future Mission Leaders in a Concurrent Engineering Environment

NASA Astrophysics Data System (ADS)

Mitchell, K. L.; Lowes, L. L.; Budney, C. J.; Sohus, A.

2014-12-01

NASA's Planetary Science Summer School (PSSS) is an intensive program for postdocs and advanced graduate students in science and engineering fields with a keen interest in planetary exploration. The goal is to train the next generation of planetary science mission leaders in a hands-on environment involving a wide range of engineers and scientists. It was established in 1989, and has undergone several incarnations. Initially a series of seminars, it became a more formal mission design experience in 1999. Admission is competitive, with participants given financial support. The competitively selected trainees develop an early mission concept study in teams of 15-17, responsive to a typical NASA Science Mission Directorate Announcement of Opportunity. They select the mission concept from options presented by the course sponsors, based on high-priority missions as defined by the Decadal Survey, prepare a presentation for a proposal authorization review, present it to a senior review board and receive critical feedback. Each participant assumes multiple roles, on science, instrument and project teams. They develop an understanding of top-level science requirements and instrument priorities in advance through a series of reading assignments and webinars help trainees. Then, during the five day session at Jet Propulsion Laboratory, they work closely with concurrent engineers including JPL's Advanced Projects Design Team ("Team X"), a cross-functional multidisciplinary team of engineers that utilizes concurrent engineering methodologies to complete rapid design, analysis and evaluation of mission concept designs. All are mentored and assisted directly by Team X members and course tutors in their assigned project roles. There is a strong emphasis on making difficult trades, simulating a real mission design process as accurately as possible. The process is intense and at times dramatic, with fast-paced design sessions and late evening study sessions. A survey of PSSS alumni administered in 2013 provides information on the program's impact on trainees' career choices and leadership roles as they pursue their employment in planetary science and related fields. Results will be presented during the session, along with highlights of topics and missions covered since the program's inception.

Concurrence of three Jaynes-Cummings systems

NASA Astrophysics Data System (ADS)

Qiang, Wen-Chao; Sun, Guo-Hua; Dong, Qian; Camacho-Nieto, Oscar; Dong, Shi-Hai

2018-04-01

We apply genuine multipartite concurrence to investigate entanglement properties of three Jaynes-Cummings systems. Three atoms are initially put in GHZ-like state and locally interact with three independent cavities, respectively. We present analytical concurrence expressions for various subsystems including three-atom, three-cavity and some atom-cavity mixed systems. We also examine the global system and illustrate the evolution of its concurrence. Except for the sudden death of entanglement, we find for some initial entanglement parameter θ , the concurrence of the global system may maintain unchanged in some time intervals.

Three endocrine neoplasms: an unusual combination of pheochromocytoma, pituitary adenoma, and papillary thyroid carcinoma.

PubMed

Sisson, James C; Giordano, Thomas J; Avram, Anca M

2012-04-01

Three endocrine neoplasms-bilateral pheochromocytomas, somatotrophic pituitary adenoma inducing acromegaly, and papillary carcinoma of the thyroid-occurred concurrently in a patient. A genetic mutation was hypothesized. Possible previously described genetic mutations were explored. Clinical assessments, laboratory data, images of tumors, histopathology, and immunohistochemistry of excised tissues documented the three neoplasms. Clinical assessment of the patient, family history, and a review of the literature sought a familial basis for the disorders. The methods confirmed the presence of three endocrine neoplasms. Each neoplasm was surgically excised and histologically verified. Surgical and (131)I treatments reduced the papillary carcinoma, but eventually this tumor progressed to a lethal degree. History, including that of nine siblings, uncovered no familial neoplasms. No similar case was found in the literature, but possible associations with germline mutations were considered. The concurrent development of pheochromocytomas, pituitary somatotrophic adenoma, and papillary thyroid carcinoma appears to be unique. Nevertheless, such tumors, particularly bilateral pheochromocytomas, strongly suggest a de novo germline mutation in a gene not previously associated with multiple endocrine neoplasia syndromes.

Cardiovascular Consequences of Metabolic Syndrome

PubMed Central

Tune, Johnathan D.; Goodwill, Adam G.; Sassoon, Daniel J.; Mather, Kieren J.

2017-01-01

The metabolic syndrome (MetS) is defined as the concurrence of obesity-associated cardiovascular risk factors including abdominal obesity, impaired glucose tolerance, hypertriglyceridemia, decreased HDL cholesterol, and/or hypertension. Earlier conceptualizations of the MetS focused on insulin resistance as a core feature, and it is clearly coincident with the above list of features. Each component of the MetS is an independent risk factor for cardiovascular disease and the combination of these risk factors elevates rates and severity of cardiovascular disease, related to a spectrum of cardiovascular conditions including microvascular dysfunction, coronary atherosclerosis and calcification, cardiac dysfunction, myocardial infarction, and heart failure. While advances in understanding the etiology and consequences of this complex disorder have been made, the underlying pathophysiologic mechanisms remain incompletely understood, and it is unclear how these concurrent risk factors conspire to produce the variety of obesity-associated adverse cardiovascular diseases. In this review we highlight current knowledge regarding the pathophysiologic consequences of obesity and the MetS on cardiovascular function and disease, including considerations of potential physiologic and molecular mechanisms that may contribute to these adverse outcomes. PMID:28130064

Advanced abdominal pregnancy: an increasingly challenging clinical concern for obstetricians

PubMed Central

Huang, Ke; Song, Lei; Wang, Longxia; Gao, Zhiying; Meng, Yuanguang; Lu, Yanping

2014-01-01

Advanced abdominal pregnancy is rare. The low incidence, high misdiagnosis rate, and lack of specific clinical signs and symptoms explain the fact that there are no standard diagnostic and treatment options available for advanced abdominal pregnancy. We managed a case of abdominal pregnancy in a woman who was pregnant for the first time. This case was further complicated by a concurrent singleton intrauterine pregnancy; the twin pregnancy was not detected until 20 weeks of pregnancy. The case was confirmed at 26 weeks gestational age using MRI to be an abdominal combined with intrauterine pregnancy. The pregnancy was terminated by cesarean section at 33 + 5 weeks gestation. We collected the relevant data of the case while reviewing the advanced abdominal pregnancy-related English literature in the Pubmed, Proquest, and OVID databases. We compared and analyzed the pregnancy history, gestational age when the diagnosis was confirmed, the placental colonization position, the course of treatment and surgical processes, related concurrency rate, post-operative drug treatment programs, and follow-up results with the expectation to provide guidance for other physicians who might encounter similar cases. PMID:25337188

Update on Integrated Optical Design Analyzer

NASA Technical Reports Server (NTRS)

Moore, James D., Jr.; Troy, Ed

2003-01-01

Updated information on the Integrated Optical Design Analyzer (IODA) computer program has become available. IODA was described in Software for Multidisciplinary Concurrent Optical Design (MFS-31452), NASA Tech Briefs, Vol. 25, No. 10 (October 2001), page 8a. To recapitulate: IODA facilitates multidisciplinary concurrent engineering of highly precise optical instruments. The architecture of IODA was developed by reviewing design processes and software in an effort to automate design procedures. IODA significantly reduces design iteration cycle time and eliminates many potential sources of error. IODA integrates the modeling efforts of a team of experts in different disciplines (e.g., optics, structural analysis, and heat transfer) working at different locations and provides seamless fusion of data among thermal, structural, and optical models used to design an instrument. IODA is compatible with data files generated by the NASTRAN structural-analysis program and the Code V (Registered Trademark) optical-analysis program, and can be used to couple analyses performed by these two programs. IODA supports multiple-load-case analysis for quickly accomplishing trade studies. IODA can also model the transient response of an instrument under the influence of dynamic loads and disturbances.

Preference, resistance to change, and the cumulative decision model.

PubMed

Grace, Randolph C

2018-01-01

According to behavioral momentum theory (Nevin & Grace, 2000a), preference in concurrent chains and resistance to change in multiple schedules are independent measures of a common construct representing reinforcement history. Here I review the original studies on preference and resistance to change in which reinforcement variables were manipulated parametrically, conducted by Nevin, Grace and colleagues between 1997 and 2002, as well as more recent research. The cumulative decision model proposed by Grace and colleagues for concurrent chains is shown to provide a good account of both preference and resistance to change, and is able to predict the increased sensitivity to reinforcer rate and magnitude observed with constant-duration components. Residuals from fits of the cumulative decision model to preference and resistance to change data were positively correlated, supporting the prediction of behavioral momentum theory. Although some questions remain, the learning process assumed by the cumulative decision model, in which outcomes are compared against a criterion that represents the average outcome value in the current context, may provide a plausible model for the acquisition of differential resistance to change. © 2018 Society for the Experimental Analysis of Behavior.

Binding in visual working memory: the role of the episodic buffer.

PubMed

Baddeley, Alan D; Allen, Richard J; Hitch, Graham J

2011-05-01

The episodic buffer component of working memory is assumed to play a central role in the binding of features into objects, a process that was initially assumed to depend upon executive resources. Here, we review a program of work in which we specifically tested this assumption by studying the effects of a range of attentionally demanding concurrent tasks on the capacity to encode and retain both individual features and bound objects. We found no differential effect of concurrent load, even when the process of binding was made more demanding by separating the shape and color features spatially, temporally or across visual and auditory modalities. Bound features were however more readily disrupted by subsequent stimuli, a process we studied using a suffix paradigm. This suggested a need to assume a feature-based attentional filter followed by an object based storage process. Our results are interpreted within a modified version of the multicomponent working memory model. We also discuss work examining the role of the hippocampus in visual feature binding. Copyright © 2011 Elsevier Ltd. All rights reserved.

Acute kidney injury as the presenting manifestation of sarcoidosis: A case series and review of literature.

PubMed

Rajkumar, Theepika; Lea-Henry, Tom; Chacko, Bobby

2018-06-01

Acute kidney injury is rarely the presenting feature of sarcoidosis. We present a case series of patients whose diagnosis of sarcoidosis was only brought to light by the development of renal impairment. Concurrent hypercalcaemia was noted, prompting further investigation. The patients discussed experienced a significant and rapid improvement in both renal function and hypercalcaemia in response to therapy with prednisolone. This is out of keeping with previous reports of sarcoidosis-induced renal impairment. Our case series highlights the importance of testing for hypercalcaemia in the context of acute kidney injury. Sarcoidosis is primarily a disease of the lungs and reticuloendothelial system; however, the prevalence of renal involvement with sarcoidosis may be under-recognized. The renal manifestations of sarcoidosis are discussed in the context of the current literature. Furthermore, from our experience, we postulate that in the context of sarcoidosis-induced renal injury, concurrent hypercalcaemia may present prior to the development of chronic renal injury and therefore these patients may be more likely to recover renal function. © 2017 Asian Pacific Society of Nephrology.

Concurrent sexual partnerships among female sex workers and their non-commercial male partners in Tijuana and Ciudad Juárez, Mexico

PubMed Central

Robertson, Angela M.; Syvertsen, Jennifer L.; Rangel, M. Gudelia; Staines, Hugo S.; Morris, Martina; Patterson, Thomas L.; Ulibarri, Monica D.; Strathdee, Steffanie A.

2013-01-01

Objectives To investigate the prevalence and correlates of concurrent (overlapping) sexual partnerships among female sex workers (FSWs) and their non-commercial male partners in two Mexico-U.S. border cities. Methods A cross-sectional survey of FSWs and their non-commercial male partners was conducted in Tijuana and Ciudad Juárez, Mexico (2010–2011). Eligible FSWs and verified non-commercial partners were aged ≥18 years; FSWs had ever used hard drugs (lifetime) and recently exchanged sex for money, drugs, or other goods (past month). Participants underwent baseline questionnaires obtaining dates of sex and condom use with ≤5 other recurring partners, including FSWs’ regular clients. These dates were compared to dates of sex with enrolled study partners to determine overlap (i.e., “recurring” concurrency). Bivariate probit regression identified recurring concurrency correlates. Results Among 428 individuals (214 couples), past-year recurring concurrency prevalence was 16% and was higher among women than their non-commercial male partners (26% vs. 6%). In 10 couples (5%), both partners reported recurring concurrency. The majority of couples (64%) always had unprotected sex, and most of the individuals (70%) with recurring concurrency “sometimes” or “never” used condoms with their concurrent partners. Recurring concurrency was positively associated with FSWs’ income, men’s caballerismo (a form of traditional masculinity), and men’s belief that their FSW-partners had STIs. Conclusions Recurring concurrency, representing sustained periods of overlapping partnerships in which unprotected sex was common, should be addressed by couple-based STI prevention interventions. PMID:23172036

Energy drinks and alcohol-related risk among young adults.

PubMed

Caviness, Celeste M; Anderson, Bradley J; Stein, Michael D

2017-01-01

Energy drink consumption, with or without concurrent alcohol use, is common among young adults. This study sought to clarify risk for negative alcohol outcomes related to the timing of energy drink use. The authors interviewed a community sample of 481 young adults, aged 18-25, who drank alcohol in the last month. Past-30-day energy drink use was operationalized as no-use, use without concurrent alcohol, and concurrent use of energy drinks with alcohol ("within a couple of hours"). Negative alcohol outcomes included past-30-day binge drinking, past-30-day alcohol use disorder, and drinking-related consequences. Just over half (50.5%) reported no use of energy drinks,18.3% reported using energy drinks without concurrent alcohol use, and 31.2% reported concurrent use of energy drinks and alcohol. Relative to those who reported concurrent use of energy drinks with alcohol, and controlling for background characteristics and frequency of alcohol consumption, those who didn't use energy drinks and those who used without concurrent alcohol use had significantly lower binge drinking, negative consequences, and rates of alcohol use disorder (P < .05 for all outcomes). There were no significant differences between the no-use and energy drink without concurrent alcohol groups on any alcohol-related measure (P > .10 for all outcomes). Concurrent energy drink and alcohol use is associated with increased risk for negative alcohol consequences in young adults. Clinicians providing care to young adults could consider asking patients about concurrent energy drink and alcohol use as a way to begin a conversation about risky alcohol consumption while addressing 2 substances commonly used by this population.

Effect of concurrent walking and interlocutor distance on conversational speech intensity and rate in Parkinson's disease.

PubMed

McCaig, Cassandra M; Adams, Scott G; Dykstra, Allyson D; Jog, Mandar

2016-01-01

Previous studies have demonstrated a negative effect of concurrent walking and talking on gait in Parkinson's disease (PD) but there is limited information about the effect of concurrent walking on speech production. The present study examined the effect of sitting, standing, and three concurrent walking tasks (slow, normal, fast) on conversational speech intensity and speech rate in fifteen individuals with hypophonia related to idiopathic Parkinson's disease (PD) and fourteen age-equivalent controls. Interlocuter (talker-to-talker) distance effects and walking speed were also examined. Concurrent walking was found to produce a significant increase in speech intensity, relative to standing and sitting, in both the control and PD groups. Faster walking produced significantly greater speech intensity than slower walking. Concurrent walking had no effect on speech rate. Concurrent walking and talking produced significant reductions in walking speed in both the control and PD groups. In general, the results of the present study indicate that concurrent walking tasks and the speed of concurrent walking can have a significant positive effect on conversational speech intensity. These positive, "energizing" effects need to be given consideration in future attempts to develop a comprehensive model of speech intensity regulation and they may have important implications for the development of new evaluation and treatment procedures for individuals with hypophonia related to PD. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

7 CFR 1610.6 - Concurrent Bank and RUS cost-of-money loans.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 11 2012-01-01 2012-01-01 false Concurrent Bank and RUS cost-of-money loans. 1610.6..., DEPARTMENT OF AGRICULTURE LOAN POLICIES § 1610.6 Concurrent Bank and RUS cost-of-money loans. (a) The Bank makes loans, under section 408 of the Act, concurrently with RUS cost-of-money loans made under section...

7 CFR 1610.6 - Concurrent Bank and RUS cost-of-money loans.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 11 2013-01-01 2013-01-01 false Concurrent Bank and RUS cost-of-money loans. 1610.6..., DEPARTMENT OF AGRICULTURE LOAN POLICIES § 1610.6 Concurrent Bank and RUS cost-of-money loans. (a) The Bank makes loans, under section 408 of the Act, concurrently with RUS cost-of-money loans made under section...

7 CFR 1610.6 - Concurrent Bank and RUS cost-of-money loans.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Concurrent Bank and RUS cost-of-money loans. 1610.6..., DEPARTMENT OF AGRICULTURE LOAN POLICIES § 1610.6 Concurrent Bank and RUS cost-of-money loans. (a) The Bank makes loans, under section 408 of the Act, concurrently with RUS cost-of-money loans made under section...

25 CFR 161.800 - How does the Navajo Nation provide concurrence to BIA?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false How does the Navajo Nation provide concurrence to BIA... Nation provide concurrence to BIA? (a) Actions taken by BIA under this part require concurrence of the Navajo Nation under section 640d-9(e)(1)(A) of the Settlement Act. (b) For any action requiring the...

Young Men's Social Network Characteristics and Associations with Sexual Partnership Concurrency in Tanzania.

PubMed

Yamanis, Thespina J; Fisher, Jacob C; Moody, James W; Kajula, Lusajo J

2016-06-01

Social network influence on young people's sexual behavior is understudied in sub-Saharan Africa. Previous research identified networks of mostly young men in Dar es Salaam who socialize in "camps". This study describes network characteristics within camps and their relationship to young men's concurrent sexual partnerships. We conducted surveys with a nearly complete census of ten camp networks (490 men and 160 women). Surveys included name generators to identify camp-based networks. Fifty seven percent of sexually active men (n = 471) reported past year concurrency, measured using the UNAIDS method. In a multivariable model, men's individual concurrency was associated with being a member of a closer knit camp in which concurrency was the normative behavior. Younger men who had older members in their networks were more likely to engage in concurrency. Respondent concurrency was also associated with inequitable personal gender norms. Our findings suggest strategies for leveraging social networks for HIV prevention among young men.

Skeletal Muscle Hypertrophy with Concurrent Exercise Training: Contrary Evidence for an Interference Effect.

PubMed

Murach, Kevin A; Bagley, James R

2016-08-01

Over the last 30+ years, it has become axiomatic that performing aerobic exercise within the same training program as resistance exercise (termed concurrent exercise training) interferes with the hypertrophic adaptations associated with resistance exercise training. However, a close examination of the literature reveals that the interference effect of concurrent exercise training on muscle growth in humans is not as compelling as previously thought. Moreover, recent studies show that, under certain conditions, concurrent exercise may augment resistance exercise-induced hypertrophy in healthy human skeletal muscle. The purpose of this article is to outline the contrary evidence for an acute and chronic interference effect of concurrent exercise on skeletal muscle growth in humans and provide practical literature-based recommendations for maximizing hypertrophy when training concurrently.

Influences on Sexual Partnering Among African American Adolescents With Concurrent Sexual Relationships

PubMed Central

Reed, Sarah J.; Bangi, Audrey; Sheon, Nicolas; Harper, Gary W.; Catania, Joseph A.; Richards, Kimberly A. M.; Dolcini, M. Margaret; Boyer, Cherrie B.

2012-01-01

Adolescents often engage in concurrent sexual partnerships as part of a developmental process of gaining experience with sexuality. The authors qualitatively examined patterns of concurrency and variation in normative and motivational influences on this pattern of sexual partnering among African American adolescents (31 males; 20 females), ages 15 to 17 years. Using content analysis, gender and contextual differences in social norms and motivations for concurrency were explored. Findings describe the normative influences on adolescent males and females with regard to sexual concurrency and the transfer of these norms from one generation to the next. PMID:22505843

Conceptualizing and measuring personality vulnerability to depression: comment on Coyne and Whiffen (1995).

PubMed

Zuroff, David C; Mongrain, Myriam; Santor, Darcy A

2004-05-01

J. C. Coyne and V. E. Whiffen (1995) reviewed research on personality vulnerability to depression, focusing on S. J. Blatt's (1974, 1990) concepts of dependency and self-criticism and A. T. Beck's (1983) concepts of sociotropy and autonomy. The authors discuss 6 issues raised in that review: (a) the typological or dimensional nature of vulnerability, (b) the theoretical implications of "mixed" vulnerability, (c) the relations of vulnerability to Neuroticism. (d) the potential confounding of vulnerability with concurrent depression, (e) the potential confounding of vulnerability with social context, and (f) the differentiation of dependency from relatedness. The authors conclude that Blatt's and Beck's concepts are continuous, nearly orthogonal dimensions that can be identified and measured independently from Neuroticism, depression, and social context. ((c) 2004 APA, all rights reserved)

Poster presentations: valuing all forms of evidence.

PubMed

Halligan, Phil

2008-01-01

This paper aims to assist readers who are considering submitting a poster presentation to a conference to appreciate their true worth and demonstrate the important contribution they can make to nursing scholarship and secondly, to provide new insights to conference reviewers who have the task of selecting appropriate contributions for conferences. The author will argue that the use of poster presentations is an ideal opportunity to disseminate research findings and clinical innovations. It offers a new, interesting, and thought-provoking perspective on poster presentations, which includes appraisal of extant literature and reflections about the significance of poster presentations to nursing scholarship. It highlights the benefits of submitting a poster presentation and concludes with some key points for conference reviewers to consider when deciding to select the suitability of abstracts for poster presentations or concurrent sessions.

Athena Mission Status

NASA Astrophysics Data System (ADS)

Lumb, D.

2016-07-01

Athena has been selected by ESA for its second large mission opportunity of the Cosmic Visions programme, to address the theme of the Hot and Energetic Universe. Following the submission of a proposal from the community, the technical and programmatic aspects of the mission design were reviewed in ESA's Concurrent Design Facility. The proposed concept was deemed to betechnically feasible, but with potential constraints from cost and schedule. Two parallel industry study contracts have been conducted to explore these conclusions more thoroughly, with the key aim of providing consolidated inputs to a Mission Consolidation Review that was conducted in April-May 2016. This MCR has recommended a baseline design, which allows the agency to solicit proposals for a community provided payload. Key design aspects arising from the studies are described, and the new reference design is summarised.

Software Construction and Analysis Tools for Future Space Missions

NASA Technical Reports Server (NTRS)

Lowry, Michael R.; Clancy, Daniel (Technical Monitor)

2002-01-01

NASA and its international partners will increasingly depend on software-based systems to implement advanced functions for future space missions, such as Martian rovers that autonomously navigate long distances exploring geographic features formed by surface water early in the planet's history. The software-based functions for these missions will need to be robust and highly reliable, raising significant challenges in the context of recent Mars mission failures attributed to software faults. After reviewing these challenges, this paper describes tools that have been developed at NASA Ames that could contribute to meeting these challenges; 1) Program synthesis tools based on automated inference that generate documentation for manual review and annotations for automated certification. 2) Model-checking tools for concurrent object-oriented software that achieve memorability through synergy with program abstraction and static analysis tools.

Psychosomatic approaches to obstetrics, gynaecology and andrology--a review.

PubMed

Lal, Mira

2009-01-01

This review aims to clarify the scope and clinical importance of psychosomatic approaches to obstetrics, gynaecology and andrology. This gradually expanding sub-specialty covers a wide domain of complex disease conditions that can be managed more effectively if the various biological, psychological and social aspects are recognised at the start and concurrent treatment initiated. The current need to practise biopsychosocial management of disease conditions is highlighted along with a description of what this would involve. The nine-field psychosomatic approach, which can be applied to everyday clinical encounters, has been illustrated. Clinical applications of the psychosomatic approach are discussed for various conditions including chronic pelvic pain, eating disorders, tokophobia, post-traumatic stress disorder, depression, menstrual disorders, infertility, bereavement and testicular cancer. Cultural considerations and the need for further research are also briefly discussed.

Request for Concurrence as to Applicability of PSD and NSPS Regulations to Marblehead Lime Company Proposed Lime Plant

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Medicinal cannabis: rational guidelines for dosing.

PubMed

Carter, Gregory T; Weydt, Patrick; Kyashna-Tocha, Muraco; Abrams, Donald I

2004-05-01

The medicinal value of cannabis (marijuana) is well documented in the medical literature. Cannabinoids, the active ingredients in cannabis, have many distinct pharmacological properties. These include analgesic, anti-emetic, anti-oxidative, neuroprotective and anti-inflammatory activity, as well as modulation of glial cells and tumor growth regulation. Concurrent with all these advances in the understanding of the physiological and pharmacological mechanisms of cannabis, there is a strong need for developing rational guidelines for dosing. This paper will review the known chemistry and pharmacology of cannabis and, on that basis, discuss rational guidelines for dosing.

The prevention of gastropathy and upper abdominal symptoms caused by nonsteroidal anti-inflammatory drugs.

PubMed

Vakil, Nimish

2006-01-01

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is increasing, primarily due to arthritis in the aging population. This article reviews current data on the risk of gastrointestinal complications related to NSAIDs and strategies to manage risk in patients taking these agents. Risks of NSAID use include gastrointestinal ulceration, hemorrhage, or perforation; renal dysfunction; death; and dyspepsia. Alternate therapies include use of non-NSAID analgesics; low-dose NSAIDs; and concurrent administration of cytoprotective agents with NSAIDs, acid inhibitors, proton pump inhibitors, and COX-2 agents.

The Kidney in Aging: Physiological Changes and Pathological Implications.

PubMed

Sobamowo, H; Prabhakar, S S

2017-01-01

Aging is associated with progressive decline in renal function along with concurrent morphological changes that ultimately lead to glomerulosclerosis. The mechanisms leading to such changes in the kidney with age as well as the basis of controversies that surround the physiological basis vs pathological nature of aging kidney are the focus of this in-depth review. In addition, the renal functional defects of acid-base homeostasis and electrolyte disturbances in elderly and the physiological basis of such disorders are also discussed. © 2017 Elsevier Inc. All rights reserved.

Endoscopic Rectus Abdominis and Prepubic Aponeurosis Repairs for Treatment of Athletic Pubalgia.

PubMed

Matsuda, Dean K; Matsuda, Nicole A; Head, Rachel; Tivorsak, Tanya

2017-02-01

Review of the English orthopaedic literature reveals no prior report of endoscopic repair of rectus abdominis tears and/or prepubic aponeurosis detachment. This technical report describes endoscopic reattachment of an avulsed prepubic aponeurosis and endoscopic repair of a vertical rectus abdominis tear immediately after endoscopic pubic symphysectomy for coexistent recalcitrant osteitis pubis as a single-stage outpatient surgery. Endoscopic rectus abdominis repair and prepubic aponeurosis repair are feasible surgeries that complement endoscopic pubic symphysectomy for patients with concurrent osteitis pubis and expand the less invasive options for patients with athletic pubalgia.

Telemedicine and neurosciences.

PubMed

Ganapathy, K

2005-11-01

It is well known that in most countries there is a perennial shortage of specialists in neurosciences. The available neurologists and neurosurgeons are clustered in the metropolitan, urban areas. Those living in suburban and rural areas may have limited or no access to neurological care. Concurrently, there has been an unprecedented growth in information and communication technology (ICT). In this article, the author will demonstrate how the practice of neurosciences will change, with increasing use of telemedicine and ICT. In addition to presenting the author's personal experience, the literature on telemedicine in neurosciences is reviewed.

One Not to Miss: Ovarian Vein Thrombosis Causing Pulmonary Embolism with Literature Review

PubMed Central

Verde, Franco; Johnson, Pamela T.

2012-01-01

Ovarian vein thrombosis (OVT) is an uncommon entity typically seen in the post-partum, patients with pelvic surgery, infection, or inflammation, and hypercoagulabilty. Concurrent pulmonary embolism (PE) may occur in these patients; however, is an uncommon complication. Treatment commonly involves anti-coagulation and antibiotics in the setting of pelvic inflammatory disease. Presented is a case report of ovarian vein thrombosis leading to pulmonary embolism in the setting of malignancy, underscoring the importance of inspecting the gonadal vein during interpretation, particularly in the emergency setting. PMID:23378885

Abdominal rectus muscle pyomyositis: Report of a case and review of the literature

PubMed Central

Fountoukis, Tilemachos; Tsatsanidis, Nikolaos; Tilkeridou, Maria; Konstantinou, Ioannis; Fytas, Pantelis; Skandalos, Ioannis

2018-01-01

Pyomyositis is an uncommon primary bacterial infection of skeletal muscles, usually caused by Staphylococcus aureus. Predisposing factors for pyomyositis include immunodeficiency, trauma, injection drug use, concurrent infection and malnutrition. The diagnosis, staging of the disease and differential diagnosis are established by ultrasound, CT and MRI. Treatment involves surgical drainage and antibiotic therapy. We report a case of abdominal rectus muscle pyomyositis, which constitutes, as far as we know, the second reported in bibliography, while Prevotella disiens is firstly reported as causative agent. PMID:29721242

Errors of logic and scholarship concerning dissociative identity disorder.

PubMed

Ross, Colin A

2009-01-01

The author reviewed a two-part critique of dissociative identity disorder published in the Canadian Journal of Psychiatry. The two papers contain errors of logic and scholarship. Contrary to the conclusions in the critique, dissociative identity disorder has established diagnostic reliability and concurrent validity, the trauma histories of affected individuals can be corroborated, and the existing prospective treatment outcome literature demonstrates improvement in individuals receiving psychotherapy for the disorder. The available evidence supports the inclusion of dissociative identity disorder in future editions of the Diagnostic and Statistical Manual of Mental Disorders.

Concurrent versus sequential sorafenib therapy in combination with radiation for hepatocellular carcinoma.

PubMed

Wild, Aaron T; Gandhi, Nishant; Chettiar, Sivarajan T; Aziz, Khaled; Gajula, Rajendra P; Williams, Russell D; Kumar, Rachit; Taparra, Kekoa; Zeng, Jing; Cades, Jessica A; Velarde, Esteban; Menon, Siddharth; Geschwind, Jean F; Cosgrove, David; Pawlik, Timothy M; Maitra, Anirban; Wong, John; Hales, Russell K; Torbenson, Michael S; Herman, Joseph M; Tran, Phuoc T

2013-01-01

Sorafenib (SOR) is the only systemic agent known to improve survival for hepatocellular carcinoma (HCC). However, SOR prolongs survival by less than 3 months and does not alter symptomatic progression. To improve outcomes, several phase I-II trials are currently examining SOR with radiation (RT) for HCC utilizing heterogeneous concurrent and sequential treatment regimens. Our study provides preclinical data characterizing the effects of concurrent versus sequential RT-SOR on HCC cells both in vitro and in vivo. Concurrent and sequential RT-SOR regimens were tested for efficacy among 4 HCC cell lines in vitro by assessment of clonogenic survival, apoptosis, cell cycle distribution, and γ-H2AX foci formation. Results were confirmed in vivo by evaluating tumor growth delay and performing immunofluorescence staining in a hind-flank xenograft model. In vitro, concurrent RT-SOR produced radioprotection in 3 of 4 cell lines, whereas sequential RT-SOR produced decreased colony formation among all 4. Sequential RT-SOR increased apoptosis compared to RT alone, while concurrent RT-SOR did not. Sorafenib induced reassortment into less radiosensitive phases of the cell cycle through G1-S delay and cell cycle slowing. More double-strand breaks (DSBs) persisted 24 h post-irradiation for RT alone versus concurrent RT-SOR. In vivo, sequential RT-SOR produced the greatest tumor growth delay, while concurrent RT-SOR was similar to RT alone. More persistent DSBs were observed in xenografts treated with sequential RT-SOR or RT alone versus concurrent RT-SOR. Sequential RT-SOR additionally produced a greater reduction in xenograft tumor vascularity and mitotic index than either concurrent RT-SOR or RT alone. In conclusion, sequential RT-SOR demonstrates greater efficacy against HCC than concurrent RT-SOR both in vitro and in vivo. These results may have implications for clinical decision-making and prospective trial design.

Concurrent versus Sequential Sorafenib Therapy in Combination with Radiation for Hepatocellular Carcinoma

PubMed Central

Chettiar, Sivarajan T.; Aziz, Khaled; Gajula, Rajendra P.; Williams, Russell D.; Kumar, Rachit; Taparra, Kekoa; Zeng, Jing; Cades, Jessica A.; Velarde, Esteban; Menon, Siddharth; Geschwind, Jean F.; Cosgrove, David; Pawlik, Timothy M.; Maitra, Anirban; Wong, John; Hales, Russell K.; Torbenson, Michael S.; Herman, Joseph M.; Tran, Phuoc T.

2013-01-01

Sorafenib (SOR) is the only systemic agent known to improve survival for hepatocellular carcinoma (HCC). However, SOR prolongs survival by less than 3 months and does not alter symptomatic progression. To improve outcomes, several phase I-II trials are currently examining SOR with radiation (RT) for HCC utilizing heterogeneous concurrent and sequential treatment regimens. Our study provides preclinical data characterizing the effects of concurrent versus sequential RT-SOR on HCC cells both in vitro and in vivo. Concurrent and sequential RT-SOR regimens were tested for efficacy among 4 HCC cell lines in vitro by assessment of clonogenic survival, apoptosis, cell cycle distribution, and γ-H2AX foci formation. Results were confirmed in vivo by evaluating tumor growth delay and performing immunofluorescence staining in a hind-flank xenograft model. In vitro, concurrent RT-SOR produced radioprotection in 3 of 4 cell lines, whereas sequential RT-SOR produced decreased colony formation among all 4. Sequential RT-SOR increased apoptosis compared to RT alone, while concurrent RT-SOR did not. Sorafenib induced reassortment into less radiosensitive phases of the cell cycle through G1-S delay and cell cycle slowing. More double-strand breaks (DSBs) persisted 24 h post-irradiation for RT alone versus concurrent RT-SOR. In vivo, sequential RT-SOR produced the greatest tumor growth delay, while concurrent RT-SOR was similar to RT alone. More persistent DSBs were observed in xenografts treated with sequential RT-SOR or RT alone versus concurrent RT-SOR. Sequential RT-SOR additionally produced a greater reduction in xenograft tumor vascularity and mitotic index than either concurrent RT-SOR or RT alone. In conclusion, sequential RT-SOR demonstrates greater efficacy against HCC than concurrent RT-SOR both in vitro and in vivo. These results may have implications for clinical decision-making and prospective trial design. PMID:23762417

Translating and testing the ENABLE: CHF-PC concurrent palliative care model for older adults with heart failure and their family caregivers.

PubMed

Dionne-Odom, J Nicholas; Kono, Alan; Frost, Jennifer; Jackson, Lisa; Ellis, Daphne; Ahmed, Ali; Azuero, Andres; Bakitas, Marie

2014-09-01

Heart failure (HF) and palliative care (PC) organizations recommend early PC to improve the quality of life of patients living with HF. We conducted a two-phase formative evaluation study to translate a cancer-focused concurrent PC intervention into one that would be appropriate for rural-dwelling adults with New York Heart Association Class III-IV HF and their primary caregivers. Phase I: We tailored the intervention for an HF population via literature review, expert consultation, and clinician (N=15) small group interviews. Phase II: We enrolled 11 patient/caregiver dyads to assess intervention feasibility and satisfaction. We assessed participants' experiences and satisfaction after session/week three and session/week six via digitally recorded interviews. Clinician and participant interviews were transcribed and content analyzed. Outcome measures were evaluated for completion rates and effect sizes. Phase I: Clinicians described barriers to initiating PC in HF, triggers for initiating PC, and suggestions for intervention improvement. Phase II: Participants were able to complete the majority of study sessions, measures, and interviews. Satisfaction interviews revealed the content to be relevant and comprehensive in addressing HF patient and caregiver primary concerns; however, participants unanimously suggested making the intervention available earlier in the illness trajectory. Efficacy measures demonstrated small to medium effect sizes. We tailored and demonstrated feasibility of providing an early, concurrent palliative care intervention to patients with advanced HF and their caregivers. Based on this experience we are now conducting an efficacy trial in a racially diverse sample.

Articular cartilage scores in cranial cruciate ligament-deficient dogs with or without bucket handle tears of the medial meniscus.

PubMed

Kaufman, Kathryn; Beale, Brian S; Thames, Howard D; Saunders, W Brian

2017-01-01

To compare articular cartilage scores in cranial cruciate ligament (CCL)-deficient dogs with or without concurrent bucket handle tears (BHT) of the medial meniscus. Retrospective case series. Client-owned dogs treated with arthroscopy and tibial plateau leveling osteotomy or extracapsular repair for complete CCL rupture (290 stifles from 264 dogs). Medical records and arthroscopic images were reviewed. Medial femoral condyle (MFC) and medial tibial plateau (MTP) cartilage was scored using the modified Outerbridge scale. Periarticular osteophytosis (PAO) and injury to the medial meniscus were recorded. Data were analyzed using Student's t-tests, Wilcoxon rank-sum test, and Fisher's exact test for changes in the stifle based on meniscal condition, body weight, and duration of lameness. PAO, MFC, and MTP articular cartilage scores were not significantly different in dogs with or without BHT. There were no significant differences in MFC or MTP scores when dogs were evaluated based on bodyweight and the presence or absence of a BHT. However, PAO formation was significantly increased in dogs weighing >13.6 kg and concurrent meniscal injury vs. dogs weighing <13.6 kg and concurrent meniscal injury (P < .001). Significantly more stifles with chronic lameness (40 of 89; 44.9%) had the highest PAO score of 2 reported compared to only 42 of 182 stifles (23.1%) with acute lameness (P < .001). The presence of a BHT of the medial meniscus was not associated with more severe arthroscopic articular cartilage lesions in the medial joint compartment at the time of surgery. © 2016 The American College of Veterinary Surgeons.

Thoracoscopy with Concurrent Esophagoscopy for Persistent Right Aortic Arch in 9 Dogs.

PubMed

Townsend, Sarah; Oblak, Michelle L; Singh, Ameet; Steffey, Michele A; Runge, Jeffrey J

2016-11-01

To report the diagnosis, treatment, and short-term outcome in dogs with suspected persistent right aortic arch (PRAA) undergoing thoracoscopy with concurrent esophagoscopy. Multi-institutional retrospective case series. Dogs with suspected PRAA (n=9). Medical records were reviewed from 2012 to 2016. Dogs undergoing thoracoscopy for PRAA at 3 referral hospitals were included. Signalment, clinical signs, diagnostic imaging, anesthesia protocol (including the use of one-lung ventilation), surgical approach, complications, and short-term outcome were recorded. Dogs underwent a left-sided intercostal thoracoscopic approach with concurrent intraoperative esophagoscopy. The ligamentum arteriosum (LA) and constricting fibers were divided using a vessel-sealing device using a 3 or 4 port thoracoscopy technique. Visualization and dissection of the LA was aided by transesophageal illumination by esophagoscopy. Thoracoscopy confirmed PRAA in 9 dogs, with an aberrant left subclavian artery (LS) identified in 5 dogs. Major complications occurred in 2 dogs: postoperative hemorrhage from the LS and esophageal perforation, which resulted in euthanasia. Median follow-up was 250 days (range, 56-1,595). Regurgitation resolved in 4 of 8 surviving dogs. One dog had recurrence of regurgitation 1,450 days postoperatively, esophageal compression by the LS was identified, and regurgitation resolved following LS transection. Esophagoscopy aided identification and dissection of the LA in all cases. Due to the potential for the LS to cause clinical esophageal constriction postoperatively, a recommendation for LS transection may be warranted. Vascular clips can also be considered as an alternative for vessel ligation to avoid complications associated with vessel-sealing device use. © Copyright 2016 by The American College of Veterinary Surgeons.

Meperidine utilization and compliance with Agency for Health Care Policy and Research guidelines in a tertiary care hospital.

PubMed

Pellegrini, J E; Paice, J; Faut-Callahan, M

1999-11-01

The Agency for Health Care Policy and Research (AHCPR) established guidelines for the use of meperidine (demerol), a common inpatient analgesic. These guidelines define standards of care for acute and chronic cancer pain management and address many of the problems with meperidine and its metabolite, normeperidine. The purpose of this study was to determine whether meperidine was prescribed in compliance with AHCPR guidelines, whether patients exhibited any adverse reactions to meperidine, and to determine the analgesic efficacy of meperidine. Three hundred inpatient charts were reviewed and identified meperidine as the primary analgesic in 157 nonobstetric inpatients. Age, sex, weight, dosing interval, route of administration, duration of meperidine use, serum chemistry values, primary diagnosis, associated medical conditions, and medications concurrently being taken with meperidine were the parameters analyzed. An interview was conducted to ascertain medical and drug history, chronicity of pain syndromes, analgesic drug history, and analgesic efficacy. A visual analog scale for pain (range = 0 to 10) and an analgesic satisfaction survey (range = 1 to 5) were used. Of 157 patients, 124 (79.8%) were in conflict with AHCPR guidelines. The most frequent conflict was found to be suboptimal dosing regimen and treatment of chronic pain. Often concurrent analgesics were given with the meperidine to achieve adequate analgesia. Higher analgesic satisfaction scores were noted when meperidine was given with concurrent analgesics. Meperidine also was administered to patients in renal failure or with medications contraindicated with meperidine use. No significant adverse effects were noted with meperidine use in this sample population other than an increased incidence of confusion in the elderly population.

Punctate retinal hemorrhage and its relation to ocular and systemic disease in dogs: 83 cases.

PubMed

Violette, Nathaniel P; Ledbetter, Eric C

2018-05-01

To describe clinical aspects of dogs with punctate retinal hemorrhage (PRH). 83 dogs (119 eyes) with PRH. Medical records of dogs evaluated by the Cornell University ophthalmology service with a clinical diagnosis of PRH between 2006 and 2015 were reviewed. For this study, PRH was defined as retinal hemorrhages ≤ 1 optic disk diameter in size and dogs with other posterior segment ocular diseases were excluded. Signalment and clinical features of the dogs were recorded, including concurrent ocular and systemic diseases. Punctate retinal hemorrhage was identified in 119 eyes of 83 dogs. The mean (±standard deviation) age of dogs was 10.0 (±3.8) years. Mixed-breed dogs, Golden Retrievers, Jack Russell Terriers, and English Springer Spaniels were statistically overrepresented relative to the ophthalmology service canine referral population during the same period. Hemorrhages were found in all retinal locations and varied in number. Concurrent ocular disease was present in 78 eyes (66%) including keratoconjunctivitis sicca, uveitis, and cataracts. Fifty dogs (60%) suffered from concurrent systemic disease and diabetes mellitus, multiple myeloma, and systemic hypertension were statistically overrepresented in the PRH population. Less frequently, other serious systemic diseases were present in dogs with PRH including immune-mediated thrombocytopenia, leptospirosis, metastatic neoplasia, and thromboembolic disease. The risk of PRH in dogs may be increased by certain ocular and systemic diseases. As the presence of PRH can be associated with underlying systemic disease in dogs, it may prompt further clinical investigation and diagnostics. © 2017 American College of Veterinary Ophthalmologists.

Missed opportunities for concurrent HIV-STD testing in an academic emergency department.

PubMed

Klein, Pamela W; Martin, Ian B K; Quinlivan, Evelyn B; Gay, Cynthia L; Leone, Peter A

2014-01-01

We evaluated emergency department (ED) provider adherence to guidelines for concurrent HIV-sexually transmitted disease (STD) testing within an expanded HIV testing program and assessed demographic and clinical factors associated with concurrent HIV-STD testing. We examined concurrent HIV-STD testing in a suburban academic ED with a targeted, expanded HIV testing program. Patients aged 18-64 years who were tested for syphilis, gonorrhea, or chlamydia in 2009 were evaluated for concurrent HIV testing. We analyzed demographic and clinical factors associated with concurrent HIV-STD testing using multivariate logistic regression with a robust variance estimator or, where applicable, exact logistic regression. Only 28.3% of patients tested for syphilis, 3.8% tested for gonorrhea, and 3.8% tested for chlamydia were concurrently tested for HIV during an ED visit. Concurrent HIV-syphilis testing was more likely among younger patients aged 25-34 years (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [CI] 0.78, 2.10) and patients with STD-related chief complaints at triage (AOR=11.47, 95% CI 5.49, 25.06). Concurrent HIV-gonorrhea/chlamydia testing was more likely among men (gonorrhea: AOR=3.98, 95% CI 2.25, 7.02; chlamydia: AOR=3.25, 95% CI 1.80, 5.86) and less likely among patients with STD-related chief complaints at triage (gonorrhea: AOR=0.31, 95% CI 0.13, 0.82; chlamydia: AOR=0.21, 95% CI 0.09, 0.50). Concurrent HIV-STD testing in an academic ED remains low. Systematic interventions that remove the decision-making burden of ordering an HIV test from providers may increase HIV testing in this high-risk population of suspected STD patients.

Children concurrently wasted and stunted: A meta‐analysis of prevalence data of children 6–59 months from 84 countries

PubMed Central

Khara, Tanya; Mwangome, Martha; Ngari, Moses

2017-01-01

Abstract Children can be stunted and wasted at the same time. Having both deficits greatly elevates risk of mortality. The analysis aimed to estimate the prevalence and burden of children aged 6–59 months concurrently wasted and stunted. Data from demographic and health survey and Multi‐indicator Cluster Surveys datasets from 84 countries were analysed. Overall prevalence for being wasted, stunted, and concurrently wasted and stunted among children 6 to 59 months was calculated. A pooled prevalence of concurrence was estimated and reported by gender, age, United Nations regions, and contextual categories. Burden was calculated using population figures from the global joint estimates database. The pooled prevalence of concurrence in the 84 countries was 3.0%, 95% CI [2.97, 3.06], ranging from 0% to 8.0%. Nine countries reported a concurrence prevalence greater than 5%. The estimated burden was 5,963,940 children. Prevalence of concurrence was highest in the 12‐ to 24‐month age group 4.2%, 95% CI [4.1, 4.3], and was significantly higher among boys 3.54%, 95% CI [3.47, 3.61], compared to girls; 2.46%, 95% CI [2.41, 2.52]. Fragile and conflict‐affected states reported significantly higher concurrence 3.6%, 95% CI [3.5, 3.6], than those defined as stable 2.24%, 95% CI [2.18, 2.30]. This analysis represents the first multiple country estimation of the prevalence and burden of children concurrently wasted and stunted. Given the high risk of mortality associated with concurrence, the findings indicate a need to report on this condition as well as investigate whether these children are being reached through existing programmes. PMID:28944990

Gender asymmetry in concurrent partnerships and HIV prevalence.

PubMed

Leung, Ka Yin; Powers, Kimberly A; Kretzschmar, Mirjam

2017-06-01

The structure of the sexual network of a population plays an essential role in the transmission of HIV. Concurrent partnerships, i.e. partnerships that overlap in time, are important in determining this network structure. Men and women may differ in their concurrent behavior, e.g. in the case of polygyny where women are monogamous while men may have concurrent partnerships. Polygyny has been shown empirically to be negatively associated with HIV prevalence, but the epidemiological impacts of other forms of gender-asymmetric concurrency have not been formally explored. Here we investigate how gender asymmetry in concurrency, including polygyny, can affect the disease dynamics. We use a model for a dynamic network where individuals may have concurrent partners. The maximum possible number of simultaneous partnerships can differ for men and women, e.g. in the case of polygyny. We control for mean partnership duration, mean lifetime number of partners, mean degree, and sexually active lifespan. We assess the effects of gender asymmetry in concurrency on two epidemic phase quantities (R 0 and the contribution of the acute HIV stage to R 0 ) and on the endemic HIV prevalence. We find that gender asymmetry in concurrent partnerships is associated with lower levels of all three epidemiological quantities, especially in the polygynous case. This effect on disease transmission can be attributed to changes in network structure, where increasing asymmetry leads to decreasing network connectivity. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Flame Spread and Extinction Over a Thick Solid Fuel in Low-Velocity Opposed and Concurrent Flows

NASA Astrophysics Data System (ADS)

Zhu, Feng; Lu, Zhanbin; Wang, Shuangfeng

2016-05-01

Flame spread and extinction phenomena over a thick PMMA in purely opposed and concurrent flows are investigated by conducting systematical experiments in a narrow channel apparatus. The present tests focus on low-velocity flow regime and hence complement experimental data previously reported for high and moderate velocity regimes. In the flow velocity range tested, the opposed flame is found to spread much faster than the concurrent flame at a given flow velocity. The measured spread rates for opposed and concurrent flames can be correlated by corresponding theoretical models of flame spread, indicating that existing models capture the main mechanisms controlling the flame spread. In low-velocity gas flows, however, the experimental results are observed to deviate from theoretical predictions. This may be attributed to the neglect of radiative heat loss in the theoretical models, whereas radiation becomes important for low-intensity flame spread. Flammability limits using oxygen concentration and flow velocity as coordinates are presented for both opposed and concurrent flame spread configurations. It is found that concurrent spread has a wider flammable range than opposed case. Beyond the flammability boundary of opposed spread, there is an additional flammable area for concurrent spread, where the spreading flame is sustainable in concurrent mode only. The lowest oxygen concentration allowing concurrent flame spread in forced flow is estimated to be approximately 14 % O2, substantially below that for opposed spread (18.5 % O2).

Planning sentences while doing other things at the same time: effects of concurrent verbal and visuospatial working memory load.

PubMed

Klaus, Jana; Mädebach, Andreas; Oppermann, Frank; Jescheniak, Jörg D

2017-04-01

This study investigated to what extent advance planning during sentence production is affected by a concurrent cognitive load. In two picture-word interference experiments in which participants produced subject-verb-object sentences while ignoring auditory distractor words, we assessed advance planning at a phonological (lexeme) and at an abstract-lexical (lemma) level under visuospatial or verbal working memory (WM) load. At the phonological level, subject and object nouns were found to be activated before speech onset with concurrent visuospatial WM load, but only subject nouns were found to be activated with concurrent verbal WM load, indicating a reduced planning scope as a function of type of WM load (Experiment 1). By contrast, at the abstract-lexical level, subject and object nouns were found to be activated regardless of type of concurrent load (Experiment 2). In both experiments, sentence planning had a more detrimental effect on concurrent verbal WM task performance than on concurrent visuospatial WM task performance. Overall, our results suggest that advance planning at the phonological level is more affected by a concurrently performed verbal WM task than advance planning at the abstract-lexical level. Also, they indicate an overlap of resources allocated to phonological planning in speech production and verbal WM.

Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review

PubMed Central

Hanskamp-Sebregts, Mirelle; Zegers, Marieke; Vincent, Charles; van Gurp, Petra J; de Vet, Henrica C W; Wollersheim, Hub

2016-01-01

Objectives Record review is the most used method to quantify patient safety. We systematically reviewed the reliability and validity of adverse event detection with record review. Design A systematic review of the literature. Methods We searched PubMed, EMBASE, CINAHL, PsycINFO and the Cochrane Library and from their inception through February 2015. We included all studies that aimed to describe the reliability and/or validity of record review. Two reviewers conducted data extraction. We pooled κ values (κ) and analysed the differences in subgroups according to number of reviewers, reviewer experience and training level, adjusted for the prevalence of adverse events. Results In 25 studies, the psychometric data of the Global Trigger Tool (GTT) and the Harvard Medical Practice Study (HMPS) were reported and 24 studies were included for statistical pooling. The inter-rater reliability of the GTT and HMPS showed a pooled κ of 0.65 and 0.55, respectively. The inter-rater agreement was statistically significantly higher when the group of reviewers within a study consisted of a maximum five reviewers. We found no studies reporting on the validity of the GTT and HMPS. Conclusions The reliability of record review is moderate to substantial and improved when a small group of reviewers carried out record review. The validity of the record review method has never been evaluated, while clinical data registries, autopsy or direct observations of patient care are potential reference methods that can be used to test concurrent validity. PMID:27550650

C formal verification with unix communication and concurrency

NASA Technical Reports Server (NTRS)

Hoover, Doug N.

1990-01-01

The results of a NASA SBIR project are presented in which CSP-Ariel, a verification system for C programs which use Unix system calls for concurrent programming, interprocess communication, and file input and output, was developed. This project builds on ORA's Ariel C verification system by using the system of Hoare's book, Communicating Sequential Processes, to model concurrency and communication. The system runs in ORA's Clio theorem proving environment. The use of CSP to model Unix concurrency and sketch the CSP semantics of a simple concurrent program is outlined. Plans for further development of CSP-Ariel are discussed. This paper is presented in viewgraph form.

The Challenges of Career and Technical Education Concurrent Enrollment: An Administrative Perspective

ERIC Educational Resources Information Center

Haag, Patricia W.

2015-01-01

Career and technical education concurrent enrollment may pose unique challenges in programming and enrollment for program administrators, and this chapter describes the experiences and challenges of a CTE concurrent enrollment administrator.

Document Concurrence System

NASA Technical Reports Server (NTRS)

Muhsin, Mansour; Walters, Ian

2004-01-01

The Document Concurrence System is a combination of software modules for routing users expressions of concurrence with documents. This system enables determination of the current status of concurrences and eliminates the need for the prior practice of manually delivering paper documents to all persons whose approvals were required. This system runs on a server, and participants gain access via personal computers equipped with Web-browser and electronic-mail software. A user can begin a concurrence routing process by logging onto an administration module, naming the approvers and stating the sequence for routing among them, and attaching documents. The server then sends a message to the first person on the list. Upon concurrence by the first person, the system sends a message to the second person, and so forth. A person on the list indicates approval, places the documents on hold, or indicates disapproval, via a Web-based module. When the last person on the list has concurred, a message is sent to the initiator, who can then finalize the process through the administration module. A background process running on the server identifies concurrence processes that are overdue and sends reminders to the appropriate persons.

Concurrent cetuximab versus platinum-based chemoradiation for the definitive treatment of locoregionally advanced head and neck cancer.

PubMed

Tang, Chad; Chan, Cato; Jiang, Wen; Murphy, James D; von Eyben, Rie; Colevas, A Dimitrios; Pinto, Harlan; Lee-Enriquez, Nancy; Kong, Christina; Le, Quynh-Thu

2015-03-01

The purpose of this study was to present our experience utilizing cetuximab and platinum-based concurrent chemoradiotherapy for the definitive treatment of head and neck squamous cell carcinoma (HNSCC). Patients (n = 177) who received definitive concurrent chemoradiotherapy for HNSCC were stratified into 3 groups: receiving cetuximab monotherapy (n = 24), cetuximab and chemotherapy combination (n = 33), or platinum-based chemotherapy without cetuximab (n = 120). Primary endpoints were freedom from relapse, event-free survival, and overall survival (OS). Patients receiving cetuximab monotherapy were older with lower Karnofsky performance status (KPS) and higher Charlson comorbidity scores compared with those treated with combination cetuximab and chemotherapy or platinum-based concurrent chemoradiotherapy. Patients treated with platinum-based concurrent chemoradiotherapy exhibited significantly better freedom from relapse, event-free survival, and OS compared with those receiving cetuximab monotherapy or cetuximab and chemotherapy combination therapies (all p < .05). Differences between patients receiving cetuximab monotherapy and platinum-based concurrent chemoradiotherapy held on multivariate Cox regression. This study suggests that platinum-based concurrent chemoradiotherapy is superior to cetuximab-based monotherapy for the definitive treatment of HNSCC. © 2014 Wiley Periodicals, Inc.

Potential human exposures to neonicotinoid insecticides: A review.

PubMed

Zhang, Q; Li, Z; Chang, C H; Lou, J L; Zhao, M R; Lu, C

2018-05-01

Due to their systemic character and high efficacy to insect controls, neonicotinoid insecticides (neonics) have been widely used in global agriculture since its introduction in early 1990. Recent studies have indicated that neonics may be ubiquitous, have longer biological half-lives in the environment once applied, and therefore implicitly suggested the increasing probability for human exposure to neonics. Despite of neonics' persistent characters and widespread uses, scientific literature in regard of pathways in which human exposure could occur is relatively meager. In this review, we summarized results from peer-reviewed articles published prior to 2017 that address potential human exposures through ingestion and inhalation, as well as results from human biomonitoring studies. In addition, we proposed the use of relative potency factor approach in order to facilitate the assessment of concurrent exposure to a mixture of neonics with similar chemical structures and toxicological endpoints. We believe that the scientific information that we presented in this review will aid to future assessment of total neonic exposure and subsequently human health risk characterization. Copyright © 2018 Elsevier Ltd. All rights reserved.

Comorbid forms of psychopathology: key patterns and future research directions.

PubMed

Cerdá, Magdalena; Sagdeo, Aditi; Galea, Sandro

2008-01-01

The purpose of this review is to systematically appraise the peer-reviewed literature about clustered forms of psychopathology and to present a framework that can be useful for studying comorbid psychiatric disorders. The review focuses on four of the most prevalent types of mental health problems: anxiety, depression, conduct disorder, and substance abuse. The authors summarize existing empirical research on the distribution of concurrent and sequential comorbidity in children and adolescents and in adults, and they review existing knowledge about exogenous risk factors that influence comorbidity. The authors include articles that used a longitudinal study design and used psychiatric definitions of the disorders. A total of 58 articles met the inclusion criteria and were assessed. Current evidence demonstrates a reciprocal, sequential relation between most comorbid pairs, although the mechanisms that mediate such links remain to be explained. Methodological concerns include the inconsistency of measurement of the disorders across studies, small sample sizes, and restricted follow-up times. Given the significant mental health burden placed by comorbid disorders, and their high prevalence across populations, research on the key risk factors for clustering of psychopathology is needed.

Image-Processing Software For A Hypercube Computer

NASA Technical Reports Server (NTRS)

Lee, Meemong; Mazer, Alan S.; Groom, Steven L.; Williams, Winifred I.

1992-01-01

Concurrent Image Processing Executive (CIPE) is software system intended to develop and use image-processing application programs on concurrent computing environment. Designed to shield programmer from complexities of concurrent-system architecture, it provides interactive image-processing environment for end user. CIPE utilizes architectural characteristics of particular concurrent system to maximize efficiency while preserving architectural independence from user and programmer. CIPE runs on Mark-IIIfp 8-node hypercube computer and associated SUN-4 host computer.

Monogamy relations of concurrence for any dimensional quantum systems

NASA Astrophysics Data System (ADS)

Zhu, Xue-Na; Li-Jost, Xianqing; Fei, Shao-Ming

2017-11-01

We study monogamy relations for arbitrary dimensional multipartite systems. Monogamy relations based on concurrence and concurrence of assistance for any dimensional m_1⊗ m_2⊗ \\cdots ⊗ mN quantum states are derived, which give rise to the restrictions on the entanglement distributions among the subsystems. Besides, we give the lower bound of concurrence for four-partite mixed states. The approach can be readily generalized to arbitrary multipartite systems.

Substantial increase in concurrent droughts and heatwaves in the United States

PubMed Central

Mazdiyasni, Omid; AghaKouchak, Amir

2015-01-01

A combination of climate events (e.g., low precipitation and high temperatures) may cause a significant impact on the ecosystem and society, although individual events involved may not be severe extremes themselves. Analyzing historical changes in concurrent climate extremes is critical to preparing for and mitigating the negative effects of climatic change and variability. This study focuses on the changes in concurrences of heatwaves and meteorological droughts from 1960 to 2010. Despite an apparent hiatus in rising temperature and no significant trend in droughts, we show a substantial increase in concurrent droughts and heatwaves across most parts of the United States, and a statistically significant shift in the distribution of concurrent extremes. Although commonly used trend analysis methods do not show any trend in concurrent droughts and heatwaves, a unique statistical approach discussed in this study exhibits a statistically significant change in the distribution of the data. PMID:26324927

Substantial increase in concurrent droughts and heatwaves in the United States.

PubMed

Mazdiyasni, Omid; AghaKouchak, Amir

2015-09-15

A combination of climate events (e.g., low precipitation and high temperatures) may cause a significant impact on the ecosystem and society, although individual events involved may not be severe extremes themselves. Analyzing historical changes in concurrent climate extremes is critical to preparing for and mitigating the negative effects of climatic change and variability. This study focuses on the changes in concurrences of heatwaves and meteorological droughts from 1960 to 2010. Despite an apparent hiatus in rising temperature and no significant trend in droughts, we show a substantial increase in concurrent droughts and heatwaves across most parts of the United States, and a statistically significant shift in the distribution of concurrent extremes. Although commonly used trend analysis methods do not show any trend in concurrent droughts and heatwaves, a unique statistical approach discussed in this study exhibits a statistically significant change in the distribution of the data.

Aerospace Concurrent Engineering Design Teams: Current State, Next Steps and a Vision for the Future

NASA Technical Reports Server (NTRS)

Hihn, Jairus; Chattopadhyay, Debarati; Karpati, Gabriel; McGuire, Melissa; Borden, Chester; Panek, John; Warfield, Keith

2011-01-01

Over the past sixteen years, government aerospace agencies and aerospace industry have developed and evolved operational concurrent design teams to create novel spaceflight mission concepts and designs. These capabilities and teams, however, have evolved largely independently. In today's environment of increasingly complex missions with limited budgets it is becoming readily apparent that both implementing organizations and today's concurrent engineering teams will need to interact more often than they have in the past. This will require significant changes in the current state of practice. This paper documents the findings from a concurrent engineering workshop held in August 2010 to identify the key near term improvement areas for concurrent engineering capabilities and challenges to the long-term advancement of concurrent engineering practice. The paper concludes with a discussion of a proposed vision for the evolution of these teams over the next decade.

Measuring coherence with entanglement concurrence

NASA Astrophysics Data System (ADS)

Qi, Xianfei; Gao, Ting; Yan, Fengli

2017-07-01

Quantum coherence is a fundamental manifestation of the quantum superposition principle. Recently, Baumgratz et al (2014 Phys. Rev. Lett. 113 140401) presented a rigorous framework to quantify coherence from the view of theory of physical resource. Here we propose a new valid quantum coherence measure which is a convex roof measure, for a quantum system of arbitrary dimension, essentially using the generalized Gell-Mann matrices. Rigorous proof shows that the proposed coherence measure, coherence concurrence, fulfills all the requirements dictated by the resource theory of quantum coherence measures. Moreover, strong links between the resource frameworks of coherence concurrence and entanglement concurrence is derived, which shows that any degree of coherence with respect to some reference basis can be converted to entanglement via incoherent operations. Our work provides a clear quantitative and operational connection between coherence and entanglement based on two kinds of concurrence. This new coherence measure, coherence concurrence, may also be beneficial to the study of quantum coherence.

Developing Concurrency Messages for the Black Community in Seattle, Washington

PubMed Central

Chapman, Caitlin Hughes; Clad, Rachel; Murray, Kate; Foster, Jennifer; Morris, Martina; Parks, Malcolm R.; Kurth, Ann Elizabeth

2013-01-01

In the United States, Blacks are disproportionately impacted by HIV/AIDS. Sexual networks and concurrent relationships have emerged as important contributors to the heterosexual transmission of HIV. To date, Africa is the only continent where an understanding of the impact of sexual concurrency has been conveyed in HIV prevention messaging. This project was developed by researchers and members of the Seattle, WA African American and African-Born communities, using the principles of community-based participatory research (CBPR). Interest in developing concurrency messaging came from the community and resulted in the successful submission of a community-academic partnership proposal to develop and disseminate HIV prevention messaging around concurrency. We describe: (a) the development of concurrency messaging through the integration of collected formative data and findings from the scientific literature; (b) the process of disseminating the message in the local Black community; and (c) important factors to consider in the development of similar campaigns. PMID:23206202

Rotational injury of cervical facets: CT analysis of fracture patterns with implications for management and neurologic outcome.

PubMed

Shanmuganathan, K; Mirvis, S E; Levine, A M

1994-11-01

Imaging studies of patients with rotational facet injuries of the cervical spine were retrospectively reviewed to determine the prevalence and pattern of associated fractures, to correlate injury pattern with recommended surgical stabilization, and to assess neurologic outcome. Radiographs and CT scans obtained for 40 consecutive patients with rotational facet injuries of the cervical spine during a 70-month period were retrospectively reviewed to determine injury level, presence, and orientation of facet fractures, and concurrent nonfacet injuries. Imaging findings were reviewed to assess the likelihood of instability and to determine the most appropriate stabilization requirement. Medical records were reviewed to ascertain mechanism of injury, initial neurologic deficit, and surgical findings. Among the 40 patients with cervical rotational facet injuries, 11 (27%) had pure unilateral facet dislocation or subluxation without associated fractures, and 29 (73%) had concurrent facet fractures involving the inferior facet of the rotated vertebra (n = 13), the superior facet of the subjacent vertebra (n = 9), or both (n = 7). Injury of the rotated vertebra was unilateral in 22 patients but bilateral in 18 patients. Facet fractures frequently extended into the ipsilateral lamina or articular pillar or both. An avulsion fracture from the posteroinferior aspect of the rotated vertebral body, indicating disk disruption, occurred in 10 patients (25%), and seven patients (17%) had complete isolation of an articular pillar. Facet fractures were confirmed for 27 patients who underwent surgical stabilization. Neurologic deficits developed in 29 (73%) of the 40 patients and included radiculopathy in 11 patients and cord syndromes in 18 patients. Pure dislocation without a facet fracture was more likely to lead to a cord syndrome (p = .006). Cervical rotational facet injuries are often accompanied by facet fractures and bilateral damage of the rotated vertebra. These injuries contribute to rotational instability and require specific internal fixation based on a precise delineation of all injuries. Facet dislocations without fractures have a significantly higher association with cord syndromes than do rotational facet injuries with fractures. CT, particularly with parasagittal reformations, is valuable in identifying all injuries of the rotated and subjacent vertebrae.

Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures.

PubMed

Loh, Sook Y; Mcleod, Robert W J; Elhassan, Hassan A

2017-07-01

The aim of this review was to compare systematically the subjective measure of trismus between different interventions to treat head and neck cancer, particularly those of the oropharynx. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines, Six databases were searched for the text using various terms which include "oropharyngeal/head and neck cancer", "trismus/mouth opening" and the various treatment modalities. Included in the review were clinical studies (> or =10 patients). Three observers independently assessed the papers identified. Among the six studies reviewed, five showed a significantly worst outcome with regard to the quality-of-life questionnaire scores for a radiotherapy or surgery and radiotherapy (RT) ± chemotherapy or chemoradiotherapy when compared to surgery alone. Only one study showed no significant difference between surgery alone and other treatment modalities. Subjective quality-of-life measures are a concurrent part of modern surgical practice. Although subjective measures were utilised to measure post operative trismus successfully, there was no consensus as to which treatment modality had overall better outcomes, with conflicting studies in keeping with the current debate in this field. Larger and higher quality studies are needed to compare all three treatment modalities.

Disgust, Fear, and the Anxiety Disorders: A Critical Review

PubMed Central

Cisler, Josh M.; Olatunji, Bunmi O.; Lohr, Jeffrey M.

2010-01-01

Anxiety disorders have traditionally been conceptualized as reflecting the emotions of fear and anxiety. A developing program of research demonstrates a relation between disgust and three specific anxiety disorders: blood-injection-injury (BII) phobia, spider phobia, and contamination-related obsessive-compulsive disorder (OCD). This review serves three purposes. First, the authors review the response patterns predicted to be observed if the emotional response in these disorders involved disgust versus fear. The review suggests specific response patterns that characterize disgust and fear in the domains of heart rate, facial expression, neural activity, and cognitive processes. Second, the authors review extant research employing measures of these domains in spider phobia, BII phobia, and contamination-related OCD. The evidence suggests that both fear and disgust characterize each of these disorders, but the magnitude at which the emotions characterize the disorders may depend on the response domain measured. For example, disgust may be more involved in spider phobia in appraisals and facial expression, but less involved in neural correlates or heart rate domains. Third, the authors suggest guidelines for future research, including concurrent use of specific measures as well as examining whether the different emotions in different response domains respond to similar interventions (e.g., exposure). PMID:18977061

Concurrency-Induced Transitions in Epidemic Dynamics on Temporal Networks.

PubMed

Onaga, Tomokatsu; Gleeson, James P; Masuda, Naoki

2017-09-08

Social contact networks underlying epidemic processes in humans and animals are highly dynamic. The spreading of infections on such temporal networks can differ dramatically from spreading on static networks. We theoretically investigate the effects of concurrency, the number of neighbors that a node has at a given time point, on the epidemic threshold in the stochastic susceptible-infected-susceptible dynamics on temporal network models. We show that network dynamics can suppress epidemics (i.e., yield a higher epidemic threshold) when the node's concurrency is low, but can also enhance epidemics when the concurrency is high. We analytically determine different phases of this concurrency-induced transition, and confirm our results with numerical simulations.

Concurrency-Induced Transitions in Epidemic Dynamics on Temporal Networks

NASA Astrophysics Data System (ADS)

Onaga, Tomokatsu; Gleeson, James P.; Masuda, Naoki

2017-09-01

Social contact networks underlying epidemic processes in humans and animals are highly dynamic. The spreading of infections on such temporal networks can differ dramatically from spreading on static networks. We theoretically investigate the effects of concurrency, the number of neighbors that a node has at a given time point, on the epidemic threshold in the stochastic susceptible-infected-susceptible dynamics on temporal network models. We show that network dynamics can suppress epidemics (i.e., yield a higher epidemic threshold) when the node's concurrency is low, but can also enhance epidemics when the concurrency is high. We analytically determine different phases of this concurrency-induced transition, and confirm our results with numerical simulations.

The Concert system - Compiler and runtime technology for efficient concurrent object-oriented programming

NASA Technical Reports Server (NTRS)

Chien, Andrew A.; Karamcheti, Vijay; Plevyak, John; Sahrawat, Deepak

1993-01-01

Concurrent object-oriented languages, particularly fine-grained approaches, reduce the difficulty of large scale concurrent programming by providing modularity through encapsulation while exposing large degrees of concurrency. Despite these programmability advantages, such languages have historically suffered from poor efficiency. This paper describes the Concert project whose goal is to develop portable, efficient implementations of fine-grained concurrent object-oriented languages. Our approach incorporates aggressive program analysis and program transformation with careful information management at every stage from the compiler to the runtime system. The paper discusses the basic elements of the Concert approach along with a description of the potential payoffs. Initial performance results and specific plans for system development are also detailed.

Dose density in adjuvant chemotherapy for breast cancer.

PubMed

Citron, Marc L

2004-01-01

Dose-dense chemotherapy increases the dose intensity of the regimen by delivering standard-dose chemotherapy with shorter intervals between the cycles. This article discusses the rationale for dose-dense therapy and reviews the results with dose-dense adjuvant regimens in recent clinical trials in breast cancer. The papers for this review covered evidence of a dose-response relation in cancer chemotherapy; the rationale for dose-intense (and specifically dose-dense) therapy; and clinical experience with dose-dense regimens in adjuvant chemotherapy for breast cancer, with particular attention to outcomes and toxicity. Evidence supports maintaining the dose intensity of adjuvant chemotherapy within the conventional dose range. Disease-free and overall survival with combination cyclophosphamide, methotrexate, and fluorouracil are significantly improved when patients receive within 85% of the planned dose. Moderate and high dose cyclophosphamide, doxorubicin, and fluorouracil within the standard range results in greater disease-free and overall survival than the low dose regimen. The sequential addition of paclitaxel after concurrent doxorubicin and cyclophosphamide also significantly improves survival. Disease-free and overall survival with dose-dense sequential or concurrent doxorubicin, cyclophosphamide, and paclitaxel with filgrastim (rhG-CSF; NEUPOGEN) support are significantly greater than with conventional schedules (q21d). The delivered dose intensity of adjuvant chemotherapy within the standard dose range is an important predictor of the clinical outcome. Prospective trials of high-dose chemotherapy have shown no improvement over standard regimens, and toxicity was greater. Dose-dense adjuvant chemotherapy improves the clinical outcomes with doxorubicin-containing regimens. Filgrastim support enables the delivery of dose-dense chemotherapy and reduces the risk of neutropenia and its complications.

Bacterial coinfections in dengue virus disease: what we know and what is still obscure about an emerging concern.

PubMed

Trunfio, Mattia; Savoldi, Alessia; Viganò, Ottavia; d'Arminio Monforte, Antonella

2017-02-01

Dengue virus is the most frequent arthropod-borne viral infection worldwide. Simultaneously to the growth of its incidence, cases of bacterial coinfection in dengue have been increasingly reported. The clinical course of dual infections may worsen for reciprocal interactions and delays in the diagnosis, so that clinicians should be aware of this eventuality. Therefore, we reviewed literature to provide an overview of the epidemiological, clinical, and physiopathological issues related to bacterial coinfections and bacteremia in dengue. Clinical studies and case reports regarding bacteremia and bacterial coinfections in dengue and the interactions between the pathogens published on PubMed were reviewed. We found 26 case reports, only 3 studies on concurrent bacteremia and 12 studies reporting data on bacterial coinfections in dengue. According to the three available studies, the 0.18-7 % of dengue infections are accompanied by concurrent bacteremia, while the 14.3-44.4 % of dengue-related deaths seem associated to bacterial coinfections. Comorbidities, advanced age, and more severe dengue manifestations could be risk factors for dual infections. A longer duration of fever and alterations in laboratory parameters such as procalcitonin, hyponatremia, leukocyte count, and renal function tests can raise the suspicion. Despite the real burden and consequences of this emerging concern is still not computable accurately due to the lack of a significant number of studies on large cohorts, clinicians need a greater awareness about it to early recognize warning signs, to properly use available diagnostic tools and to readily start antibiotic treatment able to prevent worsening in mortality and morbidity.

A review of hydrological and chemical stressors in the Adige catchment and its ecological status.

PubMed

Chiogna, Gabriele; Majone, Bruno; Cano Paoli, Karina; Diamantini, Elena; Stella, Elisa; Mallucci, Stefano; Lencioni, Valeria; Zandonai, Fabiana; Bellin, Alberto

2016-01-01

Quantifying the effects of multiple stressors on Alpine freshwater ecosystems is challenging, due to the lack of tailored field campaigns for the contemporaneous measurement of hydrological, chemical and ecological parameters. Conducting exhaustive field campaigns is costly and hence most of the activities so far have been performed addressing specific environmental issues. An accurate analysis of existing information is therefore useful and necessary, to identify stressors that may act in synergy and to design new field campaigns. We present an extended review of available studies and datasets concerning the hydrological, chemical and ecological status of the Adige, which is the second longest river and the third largest river basin in Italy. The most relevant stressors are discussed in the light of the information extracted from a large number of studies. The detailed analysis of these studies identified that hydrological alterations caused by hydropower production are the main source of stress for the freshwater ecosystems in the Adige catchment. However, concurrent effects with other stressors, such as the release of pollutants from waste water treatment plants or from agricultural and industrial activities, have not been explored at depth, so far. A wealth of available studies address a single stressor separately without exploring their concurrent effect. It is concluded that a combination of extended experimental field campaigns, focusing on the coupled effects of multiple stressors, and modeling activities is highly needed in order to quantify the impact of the multifaceted human pressures on freshwater ecosystems in the Adige river. Copyright © 2015. Published by Elsevier B.V.

Social welfare matters: a realist review of when, how, and why unemployment insurance impacts poverty and health.

PubMed

O'Campo, Patricia; Molnar, Agnes; Ng, Edwin; Renahy, Emilie; Mitchell, Christiane; Shankardass, Ketan; St John, Alexander; Bambra, Clare; Muntaner, Carles

2015-05-01

The recent global recession and concurrent rise in job loss makes unemployment insurance (UI) increasingly important to smooth patterns of consumption and keep households from experiencing extreme material poverty. In this paper, we undertake a realist review to produce a critical understanding of how and why UI policies impact on poverty and health in different welfare state contexts between 2000 and 2013. We relied on literature and expert interviews to generate an initial theory and set of propositions about how UI might alleviate poverty and mental distress. We then systematically located and synthesized peer-review studies to glean supportive or contradictory evidence for our initial propositions. Poverty and psychological distress, among unemployed and even the employed, are impacted by generosity of UI in terms of eligibility, duration and wage replacement levels. Though unemployment benefits are not intended to compensate fully for a loss of earnings, generous UI programs can moderate harmful consequences of unemployment. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Review of photorejuvenation: devices, cosmeceuticals, or both?

PubMed

Rokhsar, Cameron K; Lee, Sandra; Fitzpatrick, Richard E

2005-09-01

Both the public and the medical profession have placed a lot of attention on reversal of signs of aging and photodamage, resulting in numerous cosmeceutical products and nonablative laser techniques designed to achieve these results. The purpose of this report is to briefly review both the cosmeceutical products and nonablative laser techniques that appear to be most promising based on published studies. After this review, recommendations for potential enhancement of benefits by combining cosmeceuticals and laser treatments will be explored. Pulsed dye lasers targeting microvessels, intense pulsed light targeting both melanin and microvessels, and midinfrared lasers targeting dermal water and collagen all appear to have some ability to improve skin texture, color, and wrinkling. Retinoids, vitamin C, alpha-hydroxy acids, and topical growth factors may also stimulate repair mechanisms that result in similar improvements in photodamaged skin. Although supported only by theoretic considerations and anecdotal reports, it seems logical that the concurrent use of appropriate cosmeceuticals with nonablative laser photorejuvenation should result in enhanced benefits.

Combining qualitative and quantitative research within mixed method research designs: a methodological review.

PubMed

Östlund, Ulrika; Kidd, Lisa; Wengström, Yvonne; Rowa-Dewar, Neneh

2011-03-01

It has been argued that mixed methods research can be useful in nursing and health science because of the complexity of the phenomena studied. However, the integration of qualitative and quantitative approaches continues to be one of much debate and there is a need for a rigorous framework for designing and interpreting mixed methods research. This paper explores the analytical approaches (i.e. parallel, concurrent or sequential) used in mixed methods studies within healthcare and exemplifies the use of triangulation as a methodological metaphor for drawing inferences from qualitative and quantitative findings originating from such analyses. This review of the literature used systematic principles in searching CINAHL, Medline and PsycINFO for healthcare research studies which employed a mixed methods approach and were published in the English language between January 1999 and September 2009. In total, 168 studies were included in the results. Most studies originated in the United States of America (USA), the United Kingdom (UK) and Canada. The analytic approach most widely used was parallel data analysis. A number of studies used sequential data analysis; far fewer studies employed concurrent data analysis. Very few of these studies clearly articulated the purpose for using a mixed methods design. The use of the methodological metaphor of triangulation on convergent, complementary, and divergent results from mixed methods studies is exemplified and an example of developing theory from such data is provided. A trend for conducting parallel data analysis on quantitative and qualitative data in mixed methods healthcare research has been identified in the studies included in this review. Using triangulation as a methodological metaphor can facilitate the integration of qualitative and quantitative findings, help researchers to clarify their theoretical propositions and the basis of their results. This can offer a better understanding of the links between theory and empirical findings, challenge theoretical assumptions and develop new theory. Copyright © 2010 Elsevier Ltd. All rights reserved.

Concurrent deep-superficial dyspareunia: prevalence, associations, and outcomes in a multidisciplinary vulvodynia program.

PubMed

Yong, Paul J; Sadownik, Leslie; Brotto, Lori A

2015-01-01

Little is known about women with concurrent diagnoses of deep dyspareunia and superficial dyspareunia. The aim of this study was to determine the prevalence, associations, and outcome of women with concurrent deep-superficial dyspareunia. This is a prospective study of a multidisciplinary vulvodynia program (n = 150; mean age 28.7 ± 6.4 years). Women with superficial dyspareunia due to provoked vestibulodynia were divided into two groups: those also having deep dyspareunia (i.e., concurrent deep-superficial dyspareunia) and those with only superficial dyspareunia due to provoked vestibulodynia. Demographics, dyspareunia-related factors, other pain conditions, and psychological variables at pretreatment were tested for an association with concurrent deep-superficial dyspareunia. Outcome in both groups was assessed to 6 months posttreatment. Level of dyspareunia pain (0-10) and Female Sexual Distress Scale were the main outcome measures. The prevalence of concurrent deep-superficial dyspareunia was 44% (66/150) among women with superficial dyspareunia due to provoked vestibulodynia. At pretreatment, on multiple logistic regression, concurrent deep-superficial dyspareunia was independently associated with a higher level of dyspareunia pain (odds ratio [OR] = 1.19 [1.01-1.39], P = 0.030), diagnosis of endometriosis (OR = 4.30 [1.16-15.90], P = 0.022), history of bladder problems (OR = 3.84 [1.37-10.76], P = 0.008), and more depression symptoms (OR = 1.07 [1.02-1.12], P = 0.007), with no difference in the Female Sexual Distress Scale. At 6 months posttreatment, women with concurrent deep-superficial dyspareunia improved in the level of dyspareunia pain and in the Female Sexual Distress Scale to the same degree as women with only superficial dyspareunia due to provoked vestibulodynia. Concurrent deep-superficial dyspareunia is reported by almost half of women in a multidisciplinary vulvodynia program. In women with provoked vestibulodynia, concurrent deep-superficial dyspareunia may be related to endometriosis or interstitial cystitis, and is associated with depression and more severe dyspareunia symptoms. Standardized multidisciplinary care is effective for women with concurrent dyspareunia. © 2014 International Society for Sexual Medicine.

Multiple and concurrent sexual partnerships among men who have sex with men in Viet Nam: results from a National Internet-based Cross-sectional Survey.

PubMed

García, M C; Duong, Q L; Meyer, S B; Ward, P R

2016-03-01

Men who have sex with men (MSM) are one of the largest HIV risk groups in Viet Nam and have been understudied. Sexual concurrency and multiple sex partnerships may contribute to high HIV incidence among MSM in Viet Nam. Limited information is available on concurrency and multiple sexual partnerships among MSM in Viet Nam or on the extent to which this population engages in concurrent and multiple unprotected anal intercourse. Data are from a self-administered Internet-based survey of Vietnamese MSM aged 18 years or older, having sex with male partner(s) in the last 12 months and recruited from social networking MSM-specific websites in Viet Nam. Multiple partnerships and concurrency were measured using the UNAIDS-recommended sexual partner matrix, a key component in the questionnaire. Concurrent and multiple sexual partnerships were analyzed at the individual level. Logistic regression analyses were conducted to assess the demographic characteristics and behaviors associated with multiple sexual partnerships. A total of 1695 MSM reported on multiple sexual partnerships; 69.5% indicated multiple sexual partnerships in the last 6 months. A total of 257 MSM reported on concurrent sexual partnerships, with 51.0% reporting penetrative sex with concurrent partners in the last 6 months. Respondents were more likely to engage in multiple sexual partnerships if they were no longer a student, consumed alcohol before and/or during sex, used the Internet to meet casual sex partners and had never participated in a behavioral HIV intervention. Multiple sexual partnerships in the previous 6 months were common among MSM surveyed, as was sexual concurrency. High levels of multiple and concurrent sexual partnerships may be catalyzing the transmission of HIV among MSM in Viet Nam. Given the high prevalence of this high-risk sexual behavior, our findings underscore the urgent need for targeted prevention efforts, focusing on the reduction of multiple and concurrent sexual partners among this key population. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Factors Associated With the Benefits of Concurrent Administration of Intratympanic Steroid Injection With Oral Steroids in Patients With Acute Acoustic Trauma.

PubMed

Chang, Young-Soo; Bang, Kanghyun; Choi, Nayeon; Kim, Jong Sei; Lee, Gang-Gyu

2018-06-01

To analyze the factors associated with the benefits of concurrent administration of intratympanic steroid injection (ITSI) and oral steroids in patients with acute acoustic trauma (AAT) incurred during military training. Retrospective analysis. Nineteen patients eligible under the criteria established concerning treatment for AAT were retrospectively reviewed in this study. ITSI treatments were administered simultaneously alongside oral prednisolone. Patients were categorized into two groups depending on the time elapsed between exposure to the noise and treatment initiation: 1) "Early Treatment initiation," defined as the treatment being initiated between 3 and 7 days; and 2) "Delayed treatment initiation," defined as the treatment being initiated in >7 days. Pure-tone air conduction threshold audiometry, to record the pure-tone average (PTA) at 2, 4, and 8 kHz, was conducted upon each patient's initial visit, and 1 month after starting treatment. The degree of hearing gain (hearing gain [dB] = [initial PTA] - [final PTA]) was calculated and used as the metric for determining the treatment's outcome. The initial PTA and treatment onset were adopted as possible associated factors. The mean ages of each group were 22.00 ± 2.12 years and 22.83 ± 2.64 years, respectively (p = 0.28). The initial PTAs were 46.41 ± 12.73 dB and 47.22 ± 14.74 dB, respectively (p = 1.00).In the multivariable linear regression analysis, the initial PTA and the treatment initiation showed a significant association (R = 0.37). The unstandardized regression coefficient of the initial PTA was 0.37 (p = 0.04). Patients with early treatment initiation showed significant improvement in the degree of hearing gain compared with delayed treatment initiation (unstandardized regression coefficient = 12.63, p = 0.01). We demonstrated the importance of early treatment onset for maximizing the benefits of concurrent administration of ITSI with oral steroids in patients with AAT suffered during military training. Further evaluation is needed to confirm the factors associated with the efficacy of concurrent ITSI with oral steroids.

Concurrent sexual partnerships among men who have sex with men in Shenzhen, China.

PubMed

Ha, Toan H; Liu, Hongjie; Liu, Hui; Cai, Yumao; Feng, Tiejian

2010-08-01

The HIV epidemic spreads among men who have sex with men (MSM) in China. The objective of this study was to examine and compare HIV/AIDS knowledge and sexual risk for HIV between MSM who engaged in concurrent sexual partnerships and MSM who did not. A cross-sectional study using respondent driven sampling was conducted among 351 MSM in Shenzhen, China. About half (49%) of respondents reported having concurrent sexual partnerships during the past 6 months. Among MSM with concurrent sexual partnerships, 62% had only male partners and 38% had both male and female partners. The proportion of inconsistent condom use was 42% among MSM with concurrent partners and 30% among MSM without. These 2 groups reported a similar level of self-perceived risk for HIV. Compared to MSM without concurrent sexual partners, those with such partners were more likely to work in entertainment venues and had a lower level of HIV/AIDS knowledge. The large number of MSM engaging in concurrent sexual partnerships and the high prevalence of bisexuality could accelerate the spread of HIV to the general population unless effective HIV interventions for MSM are implemented in China.

Product design for energy reduction in concurrent engineering: An Inverted Pyramid Approach

NASA Astrophysics Data System (ADS)

Alkadi, Nasr M.

Energy factors in product design in concurrent engineering (CE) are becoming an emerging dimension for several reasons; (a) the rising interest in "green design and manufacturing", (b) the national energy security concerns and the dramatic increase in energy prices, (c) the global competition in the marketplace and global climate change commitments including carbon tax and emission trading systems, and (d) the widespread recognition of the need for sustainable development. This research presents a methodology for the intervention of energy factors in concurrent engineering product development process to significantly reduce the manufacturing energy requirement. The work presented here is the first attempt at integrating the design for energy in concurrent engineering framework. It adds an important tool to the DFX toolbox for evaluation of the impact of design decisions on the product manufacturing energy requirement early during the design phase. The research hypothesis states that "Product Manufacturing Energy Requirement is a Function of Design Parameters". The hypothesis was tested by conducting experimental work in machining and heat treating that took place at the manufacturing lab of the Industrial and Management Systems Engineering Department (IMSE) at West Virginia University (WVU) and at a major U.S steel manufacturing plant, respectively. The objective of the machining experiment was to study the effect of changing specific product design parameters (Material type and diameter) and process design parameters (metal removal rate) on a gear head lathe input power requirement through performing defined sets of machining experiments. The objective of the heat treating experiment was to study the effect of varying product charging temperature on the fuel consumption of a walking beams reheat furnace. The experimental work in both directions have revealed important insights into energy utilization in machining and heat-treating processes and its variance based on product, process, and system design parameters. In depth evaluation to how the design and manufacturing normally happen in concurrent engineering provided a framework to develop energy system levels in machining within the concurrent engineering environment using the method of "Inverted Pyramid Approach", (IPA). The IPA features varying levels of output energy based information depending on the input design parameters that is available during each stage (level) of the product design. The experimental work, the in-depth evaluation of design and manufacturing in CE, and the developed energy system levels in machining provided a solid base for the development of the model for the design for energy reduction in CE. The model was used to analyze an example part where 12 evolving designs were thoroughly reviewed to investigate the sensitivity of energy to design parameters in machining. The model allowed product design teams to address manufacturing energy concerns early during the design stage. As a result, ranges for energy sensitive design parameters impacting product manufacturing energy consumption were found in earlier levels. As designer proceeds to deeper levels in the model, this range tightens and results in significant energy reductions.

Advanced Practitioners Are Peers in Trauma Performance Improvement Peer Review.

PubMed

Collins, Tara Ann; Sicoutris, Corinna P; McNicholas, Amanda; Krumrie, Nicole; Eddinger, Abby; Fernandez, Forrest B; Schwab, C William; Reilly, Patrick M; Kim, Patrick K

2016-01-01

Advanced practitioners (APs) have been successfully integrated into the clinical care of injured patients. Given the expanding role of APs in trauma care, we hypothesized that APs can perform Performance Improvement and Patient Safety (PIPS) peer review at a level comparable with trauma surgeons. For Phase 1, cases previously reviewed by a trauma surgeon were randomly selected by the PIPS coordinator and peer reviewed by an AP. The trauma surgeons' and APs' reviews were compared. For Phase 2, cases requiring concurrent review were peer reviewed by both an AP and an MD, who were blinded to each other's review. Both the APs' and trauma surgeons' reviews of the same medical record were presented at a bimonthly performance improvement (PI) meeting. In Phase 1, 46 PI cases were reviewed including 22 deaths. Trauma surgeons and APs had high concordance (96.0%) regarding appropriateness or inappropriateness of care (κ = 0.774). Among disagreements, APs were 3 times more likely than trauma surgeons to determine care to be inappropriate. Trauma surgeons and APs had similarly high concordance (95.5%) regarding preventability of mortality (κ = 0.861). In Phase 2, 38 PI cases were reviewed, including 31 deaths. Trauma surgeons and APs had high concordance (89.0%) regarding appropriateness or inappropriateness of care (κ = 0.585). Among disagreements, trauma surgeons and APs had similarly high concordance (86.2%) regarding preventability of mortality (κ = 0.266). We found that APs had high concordance with trauma surgeons regarding medical record reviews and are thus able to effectively review medical records for the purposes of PIPS.

18 CFR 341.7 - Concurrences.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Concurrences. 341.7 Section 341.7 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT... at carriers' offices and produced upon request. Cancellations or changes to concurrences affecting...

18 CFR 341.7 - Concurrences.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Concurrences. 341.7 Section 341.7 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT... at carriers' offices and produced upon request. Cancellations or changes to concurrences affecting...

18 CFR 341.7 - Concurrences.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Concurrences. 341.7 Section 341.7 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT... at carriers' offices and produced upon request. Cancellations or changes to concurrences affecting...

18 CFR 341.7 - Concurrences.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Concurrences. 341.7 Section 341.7 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT... at carriers' offices and produced upon request. Cancellations or changes to concurrences affecting...

Concurrent Software Engineering Project

ERIC Educational Resources Information Center

Stankovic, Nenad; Tillo, Tammam

2009-01-01

Concurrent engineering or overlapping activities is a business strategy for schedule compression on large development projects. Design parameters and tasks from every aspect of a product's development process and their interdependencies are overlapped and worked on in parallel. Concurrent engineering suffers from negative effects such as excessive…

40 CFR 798.5460 - Rodent heritable translocation assays.

Code of Federal Regulations, 2010 CFR

2010-07-01

... treatment and control groups. (4) Control groups—(i) Concurrent controls. No concurrent positive or negative... control groups. Historical or concurrent controls shall be specified, as well as the randomization... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5460 Rodent...

40 CFR 798.5460 - Rodent heritable translocation assays.

Code of Federal Regulations, 2013 CFR

2013-07-01

... treatment and control groups. (4) Control groups—(i) Concurrent controls. No concurrent positive or negative... control groups. Historical or concurrent controls shall be specified, as well as the randomization... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5460 Rodent...

40 CFR 798.5460 - Rodent heritable translocation assays.

Code of Federal Regulations, 2012 CFR

2012-07-01

... treatment and control groups. (4) Control groups—(i) Concurrent controls. No concurrent positive or negative... control groups. Historical or concurrent controls shall be specified, as well as the randomization... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5460 Rodent...

40 CFR 798.5460 - Rodent heritable translocation assays.

Code of Federal Regulations, 2011 CFR

2011-07-01

... treatment and control groups. (4) Control groups—(i) Concurrent controls. No concurrent positive or negative... control groups. Historical or concurrent controls shall be specified, as well as the randomization... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5460 Rodent...

40 CFR 798.5460 - Rodent heritable translocation assays.

Code of Federal Regulations, 2014 CFR

2014-07-01

... treatment and control groups. (4) Control groups—(i) Concurrent controls. No concurrent positive or negative... control groups. Historical or concurrent controls shall be specified, as well as the randomization... SUBSTANCES CONTROL ACT (CONTINUED) HEALTH EFFECTS TESTING GUIDELINES Genetic Toxicity § 798.5460 Rodent...

36 CFR 292.69 - Concurrent reclamation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Concurrent reclamation. 292.69 Section 292.69 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Other Provisions § 292.69 Concurrent...

Generalized monogamy relations of concurrence for N -qubit systems

NASA Astrophysics Data System (ADS)

Zhu, Xue-Na; Fei, Shao-Ming

2015-12-01

We present a different kind of monogamous relations based on concurrence and concurrence of assistance. For N -qubit systems A B C1...CN -2 , the monogamy relations satisfied by the concurrence of N -qubit pure states under the partition A B and C1...CN -2 , as well as under the partition A B C1 and C2...CN -2 , are established, which gives rise to a kind of restrictions on the entanglement distribution and trade off among the subsystems.

Acute kidney injury in acute liver failure: a review.

PubMed

Moore, Joanna K; Love, Eleanor; Craig, Darren G; Hayes, Peter C; Simpson, Kenneth J

2013-11-01

Acute liver failure is a rare and often devastating condition consequent on massive liver cell necrosis that frequently affects young, previously healthy individuals resulting in altered cognitive function, coagulopathy and peripheral vasodilation. These patients frequently develop concurrent acute kidney injury (AKI). This abrupt and sustained decline in renal function, through a number of pathogenic mechanisms such as renal hypoperfusion, direct drug-induced nephrotoxicity or sepsis/systemic inflammatory response contributes to increased morbidity and is strongly associated with a worse prognosis. Improved understanding of the pathophysiology AKI in the context of acute liver failure may be beneficial in a number of areas; the development of new and sensitive biomarkers of renal dysfunction, refining prognosis and organ allocation, and ultimately leading to the development of novel treatment strategies, these issues are discussed in more detail in this expert review.

Troubling Gender or Engendering Trouble? The Problem With Gender Dysphoria in Psychoanalysis.

PubMed

Barkai, Ayelet R

2017-02-01

This paper reviews existing case reports in the psychoanalytic literature of children diagnosed with gender identity disorder (GID), now called gender dysphoria. It concentrates on a review of problems and psychoanalytic dilemmas inherent in the use of the term GID and elucidates the concurrent quandaries this term both signifies and is symptomatic of. The focus is on reports of child psychoanalyses published during or after 1991, when the American Psychoanalytic Association formally adopted a nondiscrimination policy against homosexuality. These cases reflect common problematic themes in these treatments, for example, the lack of neutrality in specifying the treatment goal of same-gender identification. This paper explores the effects of these problems on the treatments, raises questions regarding the emphasis on gender in the treatments, and discusses an alternative psychoanalytic approach to children with gender variation.

Therapeutic and biological importance of getting nucleotides out of cells: a case for the ABC transporters, MRP4 and 5.

PubMed

Adachi, Masashi; Reid, Glen; Schuetz, John D

2002-11-18

The energy dependent transport of drugs contributes to cellular resistance and is undoubtedly a prime suspect in chemotherapeutic failure of a variety of disease processes. Early studies focused on a single gene, the multidrug resistance gene, MDR1, as a main contributor to chemotherapeutic failure. However, the multifaceted nature of cellular resistance lead to the discovery of the MRP gene. This pivotal finding and the concurrent rapid development of gene databases lead to the expansion of the MRP gene family. The purpose of this review is to discuss two of the recently described MRP family members that were orphans until their role in drug resistance was discovered. This review will provide an overview of the current state of our understanding of MRP4 and 5.

Sleep patterns and the risk for unipolar depression: a review

PubMed Central

Wiebe, Sabrina T; Cassoff, Jamie; Gruber, Reut

2012-01-01

Psychological disorders, particularly mood disorders, such as unipolar depression, are often accompanied by comorbid sleep disturbances, such as insomnia, restless sleep, and restricted sleep duration. The nature of the relationship between unipolar depression and these sleep disturbances remains unclear, as sleep disturbance may be a risk factor for development, an initial manifestation of the disorder, or a comorbid condition affected by similar mechanisms. Various studies have examined the impact of sleep deprivation on the presence of (or exacerbation of) depressive symptoms, and have examined longitudinal and concurrent associations between different sleep disturbances and unipolar depression. This review examines the evidence for sleep disturbances as a risk factor for the development and presence of depression, as well as examining common underlying mechanisms. Clinical implications pertaining to the comorbid nature of various sleep patterns and depression are considered. PMID:23620679

Comparison of sensitivity and reading time for the use of computer aided detection (CAD) of pulmonary nodules at MDCT as concurrent or second reader

NASA Astrophysics Data System (ADS)

Beyer, F.; Zierott, L.; Fallenberg, E. M.; Juergens, K.; Stoeckel, J.; Heindel, W.; Wormanns, D.

2006-03-01

Purpose: To compare sensitivity and reading time when using CAD as second reader resp. concurrent reader. Materials and Methods: Fifty chest MDCT scans due to clinical indication were analysed independently by four radiologists two times: First with CAD as concurrent reader (display of CAD results simultaneously to the primary reading by the radiologist); then after a median of 14 weeks with CAD as second reader (CAD results were shown after completion of a reading session without CAD). A prototype version of Siemens LungCAD (Siemens,Malvern,USA) was used. Sensitivities and reading times for detecting nodules >=4mm of concurrent reading, reading without CAD and second reading were recorded. In a consensus conference false positive findings were eliminated. Student's T-Test was used to compare sensitivities and reading times. Results: 108 true positive nodules were found. Mean sensitivity was .68 for reading without CAD, .68 for concurrent reading and .75 for second reading. Differences of sensitivities were significant between concurrent and second reading (p<.001) resp. reading without CAD and second reading (p=.001). Mean reading time for concurrent reading was significant shorter (274s) compared to reading without CAD (294s;p=.04) and second reading (337sp<.001). New work to be presented: To our knowledge this is the first study that compares sensitivities and reading times between use of CAD as concurrent resp. second reader. Conclusion: CAD can either be used to speed up reading of chest CT cases for pulmonary nodules without loss of sensitivity as concurrent reader -OR (and not AND) to increase sensitivity and reading time as second reader.

High Prevalence of Concurrent Male-Male Partnerships in the Context of Low Human Immunodeficiency Virus Testing Among Men Who Have Sex With Men in Bamako, Mali.

PubMed

Hakim, Avi; Patnaik, Padmaja; Telly, Nouhoum; Ballo, Tako; Traore, Bouyagui; Doumbia, Seydou; Lahuerta, Maria

2017-09-01

Concurrent male-male sexual partnerships have been understudied in sub-Saharan Africa and are especially important because human immunodeficiency virus (HIV) prevalence and acquisition probability are higher among men who have sex with men (MSM) than among heterosexual men and women. We conducted a respondent-driven sampling survey of 552 men who have sex with men in Bamako, Mali from October 2014 to February 2015. Eligibility criteria included 18 years or older, history of oral or anal sex with another man in the last 6 months, residence in or around Bamako in the last 6 months, ability to communicate in French. HIV prevalence was 13.7%, with 86.7% of MSM with HIV unaware of their infection. Concurrent male-male sexual partnerships were common, with 60.6% of MSM having a concurrent male sexual partnerships or believing their sex partner did in the last 6 months, and 27.3% having a concurrent male sexual partnerships and believing their sex partner did in the last 6 months. Over half (52.5%) of MSM had sex with women, and 30.8% had concurrent male partnerships and sex with a woman in the last 6 months. Concurrency was more likely among MSM with limited education, telling only MSM of same-sex behaviors, high social cohesion, and not knowing anyone with HIV. The high proportion of HIV-infected MSM in Bamako who are unaware of their HIV infection and the high prevalence of concurrent partnerships could further the spread of HIV in Bamako. Increasing testing through peer educators conducting mobile testing could improve awareness of HIV status and limit the spread of HIV in concurrent partnerships.

High-throughput state-machine replication using software transactional memory.

PubMed

Zhao, Wenbing; Yang, William; Zhang, Honglei; Yang, Jack; Luo, Xiong; Zhu, Yueqin; Yang, Mary; Luo, Chaomin

2016-11-01

State-machine replication is a common way of constructing general purpose fault tolerance systems. To ensure replica consistency, requests must be executed sequentially according to some total order at all non-faulty replicas. Unfortunately, this could severely limit the system throughput. This issue has been partially addressed by identifying non-conflicting requests based on application semantics and executing these requests concurrently. However, identifying and tracking non-conflicting requests require intimate knowledge of application design and implementation, and a custom fault tolerance solution developed for one application cannot be easily adopted by other applications. Software transactional memory offers a new way of constructing concurrent programs. In this article, we present the mechanisms needed to retrofit existing concurrency control algorithms designed for software transactional memory for state-machine replication. The main benefit for using software transactional memory in state-machine replication is that general purpose concurrency control mechanisms can be designed without deep knowledge of application semantics. As such, new fault tolerance systems based on state-machine replications with excellent throughput can be easily designed and maintained. In this article, we introduce three different concurrency control mechanisms for state-machine replication using software transactional memory, namely, ordered strong strict two-phase locking, conventional timestamp-based multiversion concurrency control, and speculative timestamp-based multiversion concurrency control. Our experiments show that speculative timestamp-based multiversion concurrency control mechanism has the best performance in all types of workload, the conventional timestamp-based multiversion concurrency control offers the worst performance due to high abort rate in the presence of even moderate contention between transactions. The ordered strong strict two-phase locking mechanism offers the simplest solution with excellent performance in low contention workload, and fairly good performance in high contention workload.

High-throughput state-machine replication using software transactional memory

PubMed Central

Yang, William; Zhang, Honglei; Yang, Jack; Luo, Xiong; Zhu, Yueqin; Yang, Mary; Luo, Chaomin

2017-01-01

State-machine replication is a common way of constructing general purpose fault tolerance systems. To ensure replica consistency, requests must be executed sequentially according to some total order at all non-faulty replicas. Unfortunately, this could severely limit the system throughput. This issue has been partially addressed by identifying non-conflicting requests based on application semantics and executing these requests concurrently. However, identifying and tracking non-conflicting requests require intimate knowledge of application design and implementation, and a custom fault tolerance solution developed for one application cannot be easily adopted by other applications. Software transactional memory offers a new way of constructing concurrent programs. In this article, we present the mechanisms needed to retrofit existing concurrency control algorithms designed for software transactional memory for state-machine replication. The main benefit for using software transactional memory in state-machine replication is that general purpose concurrency control mechanisms can be designed without deep knowledge of application semantics. As such, new fault tolerance systems based on state-machine replications with excellent throughput can be easily designed and maintained. In this article, we introduce three different concurrency control mechanisms for state-machine replication using software transactional memory, namely, ordered strong strict two-phase locking, conventional timestamp-based multiversion concurrency control, and speculative timestamp-based multiversion concurrency control. Our experiments show that speculative timestamp-based multiversion concurrency control mechanism has the best performance in all types of workload, the conventional timestamp-based multiversion concurrency control offers the worst performance due to high abort rate in the presence of even moderate contention between transactions. The ordered strong strict two-phase locking mechanism offers the simplest solution with excellent performance in low contention workload, and fairly good performance in high contention workload. PMID:29075049

Prediction of concurrent endometrial carcinoma in women with endometrial hyperplasia.

PubMed

Matsuo, Koji; Ramzan, Amin A; Gualtieri, Marc R; Mhawech-Fauceglia, Paulette; Machida, Hiroko; Moeini, Aida; Dancz, Christina E; Ueda, Yutaka; Roman, Lynda D

2015-11-01

Although a fraction of endometrial hyperplasia cases have concurrent endometrial carcinoma, patient characteristics associated with concurrent malignancy are not well described. The aim of our study was to identify predictive clinico-pathologic factors for concurrent endometrial carcinoma among patients with endometrial hyperplasia. A case-control study was conducted to compare endometrial hyperplasia in both preoperative endometrial biopsy and hysterectomy specimens (n=168) and endometrial carcinoma in hysterectomy specimen but endometrial hyperplasia in preoperative endometrial biopsy (n=43). Clinico-pathologic factors were examined to identify independent risk factors of concurrent endometrial carcinoma in a multivariate logistic regression model. The most common histologic subtype in preoperative endometrial biopsy was complex hyperplasia with atypia [CAH] (n=129) followed by complex hyperplasia without atypia (n=58) and simple hyperplasia with or without atypia (n=24). The majority of endometrial carcinomas were grade 1 (86.0%) and stage I (83.7%). In multivariate analysis, age 40-59 (odds ratio [OR] 3.07, p=0.021), age≥60 (OR 6.65, p=0.005), BMI≥35kg/m(2) (OR 2.32, p=0.029), diabetes mellitus (OR 2.51, p=0.019), and CAH (OR 9.01, p=0.042) were independent predictors of concurrent endometrial carcinoma. The risk of concurrent endometrial carcinoma rose dramatically with increasing number of risk factors identified in multivariate model (none 0%, 1 risk factor 7.0%, 2 risk factors 17.6%, 3 risk factors 35.8%, and 4 risk factors 45.5%, p<0.001). Hormonal treatment was associated with decreased risk of concurrent endometrial cancer in those with ≥3 risk factors. Older age, obesity, diabetes mellitus, and CAH are predictive of concurrent endometrial carcinoma in endometrial hyperplasia patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Concurrency and HIV transmission network characteristics among MSM with recent HIV infection.

PubMed

Pines, Heather A; Wertheim, Joel O; Liu, Lin; Garfein, Richard S; Little, Susan J; Karris, Maile Y

2016-11-28

Sexual partner concurrency is common among MSM and may increase the probability of HIV transmission during recent (acute or early) infection. We examined the relationship between concurrency and HIV transmission network characteristics (proxies for HIV transmission) among MSM with recent HIV infection. Observational study integrating behavioral, clinical, and molecular epidemiology. We inferred a partial HIV transmission network using 986 HIV-1 pol sequences obtained from HIV-infected individuals in San Diego, California (1996-2015). We further analyzed data from 285 recently HIV-infected MSM in the network who provided information on up to three sexual partners in the past 3 months, including the timing of intercourse with each partner. Concurrency was defined as sexual partners overlapping in time. Logistic and negative binomial regressions were used to investigate the link between concurrency and HIV transmission network characteristics (i.e. clustering and degree or number of connections to others in the network) among these MSM. Of recently HIV-infected MSM (n = 285), 54% reported concurrent partnerships and 54% were connected by at least one putative transmission link to others (i.e. clustered) in the network (median degree = 1.0; interquartile range: 0.0-3.0). Concurrency was positively associated with HIV transmission network clustering (adjusted odds ratio = 1.83, 95% confidence interval: 1.08, 3.10) and degree (adjusted incidence rate ratio = 1.48, 95% confidence interval: 1.02, 2.15). Our findings provide empirical evidence consistent with the hypothesis that concurrency facilitates HIV transmission during recent infection. Interventions to mitigate the impact of concurrency on HIV transmission may help curb the HIV epidemic among MSM.

Barista: A Framework for Concurrent Speech Processing by USC-SAIL

PubMed Central

Can, Doğan; Gibson, James; Vaz, Colin; Georgiou, Panayiotis G.; Narayanan, Shrikanth S.

2016-01-01

We present Barista, an open-source framework for concurrent speech processing based on the Kaldi speech recognition toolkit and the libcppa actor library. With Barista, we aim to provide an easy-to-use, extensible framework for constructing highly customizable concurrent (and/or distributed) networks for a variety of speech processing tasks. Each Barista network specifies a flow of data between simple actors, concurrent entities communicating by message passing, modeled after Kaldi tools. Leveraging the fast and reliable concurrency and distribution mechanisms provided by libcppa, Barista lets demanding speech processing tasks, such as real-time speech recognizers and complex training workflows, to be scheduled and executed on parallel (and/or distributed) hardware. Barista is released under the Apache License v2.0. PMID:27610047

Barista: A Framework for Concurrent Speech Processing by USC-SAIL.

PubMed

Can, Doğan; Gibson, James; Vaz, Colin; Georgiou, Panayiotis G; Narayanan, Shrikanth S

2014-05-01

We present Barista, an open-source framework for concurrent speech processing based on the Kaldi speech recognition toolkit and the libcppa actor library. With Barista, we aim to provide an easy-to-use, extensible framework for constructing highly customizable concurrent (and/or distributed) networks for a variety of speech processing tasks. Each Barista network specifies a flow of data between simple actors, concurrent entities communicating by message passing, modeled after Kaldi tools. Leveraging the fast and reliable concurrency and distribution mechanisms provided by libcppa, Barista lets demanding speech processing tasks, such as real-time speech recognizers and complex training workflows, to be scheduled and executed on parallel (and/or distributed) hardware. Barista is released under the Apache License v2.0.

Writing abilities and the role of working memory in children with symptoms of attention deficit and hyperactivity disorder.

PubMed

Capodieci, Agnese; Serafini, Alice; Dessuki, Alice; Cornoldi, Cesare

2018-02-20

The writing abilities of children with ADHD symptoms were examined in a simple dictation task, and then in two conditions with concurrent verbal or visuospatial working memory (WM) loads. The children with ADHD symptoms generally made more spelling mistakes than controls, and the concurrent loads impaired their performance, but with partly different effects. The concurrent verbal WM task prompted an increase in the phonological errors, while the concurrent visuospatial WM task prompted more non-phonological errors, matching the Italian phonology, but not the Italian orthography. In the ADHD group, the children proving better able to cope with a concurrent verbal WM load had a better spelling performance too. The ADHD and control groups had a similar handwriting speed, but the former group's writing quality was poorer. Our results suggest that WM supports writing skills, and that children with ADHD symptoms have general writing difficulties, but strength in coping with concurrent verbal information may support their spelling performance.

Comparing Estimates of Multiple and Concurrent Partnerships Across Population Based Surveys: Implications for Combination HIV Prevention

PubMed Central

Morris, Martina; Leslie-Cook, Ayn; Akom, Eniko; Stephen, Aloo; Sherard, Donna

2014-01-01

We compare estimates of multiple and concurrent sexual partnerships from Demographic and Health Surveys (DHS) with comparable Population Services International (PSI) surveys in four African countries (Kenya, Lesotho, Uganda, Zambia). DHS data produce significantly lower estimates of all indicators for both sexes in all countries. PSI estimates of multiple partnerships are 1.7 times higher [1.4 for men (M), 3.0 for women (W)], cumulative prevalence of concurrency is 2.4 times higher (2.2 M, 2.7 W), the point prevalence of concurrency is 3.5 times higher (3.5 M, 3.3 W), and the fraction of multi-partnered persons who report concurrency last year is 1.4 times higher (1.6 M, 0.9 W). These findings provide strong empirical evidence that DHS surveys systematically underestimate levels of multiple and concurrent partnerships. The underestimates will contaminate both empirical analyses of the link between sexual behavior and HIV infection, and theoretical models for combination prevention that use these data for inputs. PMID:24077973

Comparing Estimates of Multiple and Concurrent Partnerships Across Population Based Surveys: Implications for Combination HIV Prevention.

PubMed

Morris, Martina; Vu, Lung; Leslie-Cook, Ayn; Akom, Eniko; Stephen, Aloo; Sherard, Donna

2014-04-01

We compare estimates of multiple and concurrent sexual partnerships from Demographic and Health Surveys (DHS) with comparable Population Services International (PSI) surveys in four African countries (Kenya, Lesotho, Uganda, Zambia). DHS data produce significantly lower estimates of all indicators for both sexes in all countries. PSI estimates of multiple partnerships are 1.7 times higher [1.4 for men (M), 3.0 for women (W)], cumulative prevalence of concurrency is 2.4 times higher (2.2 M, 2.7 W), the point prevalence of concurrency is 3.5 times higher (3.5 M, 3.3 W), and the fraction of multi-partnered persons who report concurrency last year is 1.4 times higher (1.6 M, 0.9 W). These findings provide strong empirical evidence that DHS surveys systematically underestimate levels of multiple and concurrent partnerships. The underestimates will contaminate both empirical analyses of the link between sexual behavior and HIV infection, and theoretical models for combination prevention that use these data for inputs.

Concurrent apatinib and local radiation therapy for advanced gastric cancer

PubMed Central

Zhang, Ming; Deng, Weiye; Cao, Xiaoci; Shi, Xiaoming; Zhao, Huanfen; Duan, Zheping; Lv, Bonan; Liu, Bin

2017-01-01

Abstract Rationale: Apatinib is a novel anti-angiogenic agent targeting vascular endothelial growth factor receptor-2, which is effective in patients with chemotherapy-refractory gastric cancer. There are no reports of concurrent apatinib with local radiation therapy in elderly patients with advanced gastric cancer. Patient concerns and Diagnoses: we present the first published report of a 70-year-old male patient with advanced gastric cancer who received concurrent apatinib and local radiation therapy after failure of oxaliplatin and S-1 chemotherapy. Interventions and Outcomes: The patient received concurrent apatinib and local radiation therapy and was followed up 7 months after therapy without disease progress, 14 months later indicated extensive metastasis and this patient died of pulmonary infection. Lessons: Elderly patients with advanced gastric cancer may benefit from concurrent apatinib with local radiation therapy when chemotherapy is not tolerated or successful. Further studies are needed to investigate the clinical outcomes and toxicities associated with concurrent apatinib and radiation therapy in gastric cancer. PMID:28248891

The effect of concurrent hand movement on estimated time to contact in a prediction motion task.

PubMed

Zheng, Ran; Maraj, Brian K V

2018-04-27

In many activities, we need to predict the arrival of an occluded object. This action is called prediction motion or motion extrapolation. Previous researchers have found that both eye tracking and the internal clocking model are involved in the prediction motion task. Additionally, it is reported that concurrent hand movement facilitates the eye tracking of an externally generated target in a tracking task, even if the target is occluded. The present study examined the effect of concurrent hand movement on the estimated time to contact in a prediction motion task. We found different (accurate/inaccurate) concurrent hand movements had the opposite effect on the eye tracking accuracy and estimated TTC in the prediction motion task. That is, the accurate concurrent hand tracking enhanced eye tracking accuracy and had the trend to increase the precision of estimated TTC, but the inaccurate concurrent hand tracking decreased eye tracking accuracy and disrupted estimated TTC. However, eye tracking accuracy does not determine the precision of estimated TTC.

Clinical value of concurrent radiochemotherapy in cervical cancer and comparison of ultrasonography findings before and after radiochemotherapy.

PubMed

Yan, W M; Li, X Z; Yu, Z L; Zhang, J; Sun, X G

2015-04-17

Herein, we investigated the clinical value of concurrent radiochemotherapy for patients with advanced cervical cancer and its effects on adverse clinical symptoms. Forty patients with cervical cancer were recruited from January 2011 to January 2014 for this study. Participants were randomly allocated into a test or control group, with 20 patients in each group. Patients in the test group were treated with concurrent radiochemotherapy, whereas patients in the control group received only traditional radiotherapy. At the end of the observation period, clinical efficacy in the two groups was compared. Patients were followed up for 2 years, and the rates of recurrence, survival, and complications were compared; ultrasonographic findings before and after radiotherapy were also correlated. Patients in the test group who received concurrent radiochemotherapy showed significantly higher clinical efficacy than the control group at the end of treatment cycles. After 2 years of follow-up, the rates of recurrence, mortality, and complications were all significantly lower in the test group than in the control group (P < 0.05). Comparison of ultrasonographic findings before and after radiochemotherapy showed that the size of the tumor was significantly smaller in patients after concurrent radiochemotherapy. Compared with traditional radiotherapy, concurrent radiochemotherapy significantly improved clinical outcomes in patients with advanced cervical cancer. Concurrent radiochemotherapy also enhanced the rate of survival and decreased the rate of relapse, with enhanced clinical safety and no significant side effects. Thus, concurrent radiochemotherapy can be more broadly applied in the treatment of advanced cervical cancer.

Surgical treatment outcomes of patients with bilateral warthin tumors in the parotid gland.

PubMed

Lee, Dong Hoon; Yoon, Tae Mi; Lee, Joon Kyoo; Lim, Sang Chul

2014-01-01

We describe the treatment outcomes of patients with bilateral Warthin tumors in the parotid gland according to surgical methods. The medical records of ten patients with bilateral Warthin tumors in the parotid gland who underwent surgery between 2004 and 2011 were retrospectively reviewed. Ten patients were included in the study and 13 parotidectomies were performed. Patients with bilateral Warthin tumors in the parotid gland were divided into three groups according to the surgical methods used to treat these individuals. In group 1, the patients were closely observed without undergoing contralateral parotidectomy after unilateral parotidectomy. In group 2, the patients underwent concurrent bilateral parotidectomies. In group 3, the patient underwent contralateral parotidectomy 2 months after unilateral parotidectomy was performed. The overall rate of transient facial nerve dysfunction was 31%. Our findings suggest that concurrent superficial parotidectomy may be an appropriate method for treating bilateral Warthin tumors in the parotid gland, at least for desired patients. The symptoms of this type of tumor and physical examination findings are frequently non-specific and present in the unilateral parotid gland. Therefore, a high degree of discernment is needed and imaging techniques are essential for the determining the correct pre-operative diagnosis.

Creatine and Caffeine: Considerations for Concurrent Supplementation.

PubMed

Trexler, Eric T; Smith-Ryan, Abbie E

2015-12-01

Nutritional supplementation is a common practice among athletes, with creatine and caffeine among the most commonly used ergogenic aids. Hundreds of studies have investigated the ergogenic potential of creatine supplementation, with consistent improvements in strength and power reported for exercise bouts of short duration (≤ 30 s) and high intensity. Caffeine has been shown to improve endurance exercise performance, but results are mixed in the context of strength and sprint performance. Further, there is conflicting evidence from studies comparing the ergogenic effects of coffee and caffeine anhydrous supplementation. Previous research has identified independent mechanisms by which creatine and caffeine may improve strength and sprint performance, leading to the formulation of multi-ingredient supplements containing both ingredients. Although scarce, research has suggested that caffeine ingestion may blunt the ergogenic effect of creatine. While a pharmacokinetic interaction is unlikely, authors have suggested that this effect may be explained by opposing effects on muscle relaxation time or gastrointestinal side effects from simultaneous consumption. The current review aims to evaluate the ergogenic potential of creatine and caffeine in the context of high-intensity exercise. Research directly comparing coffee and caffeine anhydrous is discussed, along with previous studies evaluating the concurrent supplementation of creatine and caffeine.

Food and aeroallergens in eosinophilic esophagitis: role of the allergist in patient management.

PubMed

Aceves, Seema S

2014-07-01

Eosinophilic esophagitis is a clinicopathologic disease of increasing worldwide prevalence that is triggered by food antigens. The concurrent management of all of the atopic diseases affecting a single individual is likely to be important for successful long-term eosinophilic esophagitis management. This review covers the role of the allergist in eosinophilic esophagitis with a focus on the literature from the past 2  years. Studies in the past 2  years document that testing for immediate and delayed allergic hypersensitivity to foods can be of utility in building elimination diets in children, but that this may not be the case in adults. In addition, it has been shown that a number of cells and interleukins involved in Th2 inflammation such as invariant natural killer T cells, basophils, and interleukin-9 are important in eosinophilic esophagitis pathogenesis. Finally, the role of foods in generating esophageal remodeling has been shown using murine models. Recent studies support the role of the allergist in eosinophilic esophagitis management, especially for food allergen testing, interpretation, and the management of food allergies concurrent atopic diatheses. In addition, allergists have made significant research contributions in our understanding of eosinophilic esophagitis.

Conducting qualitative research within Clinical Trials Units: avoiding potential pitfalls.

PubMed

Cooper, Cindy; O'Cathain, Alicia; Hind, Danny; Adamson, Joy; Lawton, Julia; Baird, Wendy

2014-07-01

The value of using qualitative research within or alongside randomised controlled trials (RCTs) is becoming more widely accepted. Qualitative research may be conducted concurrently with pilot or full RCTs to understand the feasibility and acceptability of the interventions being tested, or to improve trial conduct. Clinical Trials Units (CTUs) in the United Kingdom (UK) manage large numbers of RCTs and, increasingly, manage the qualitative research or collaborate with qualitative researchers external to the CTU. CTUs are beginning to explicitly manage the process, for example, through the use of standard operating procedures for designing and implementing qualitative research with trials. We reviewed the experiences of two UK Clinical Research Collaboration (UKCRC) registered CTUs of conducting qualitative research concurrently with RCTs. Drawing on experiences gained from 15 studies, we identify the potential for the qualitative research to undermine the successful completion or scientific integrity of RCTs. We show that potential problems can arise from feedback of interim or final qualitative findings to members of the trial team or beyond, in particular reporting qualitative findings whilst the trial is on-going. The problems include: We make recommendations for improving the management of qualitative research within CTUs. Copyright © 2014. Published by Elsevier Inc.

Improving our understanding of multi-tasking in healthcare: Drawing together the cognitive psychology and healthcare literature.

PubMed

Douglas, Heather E; Raban, Magdalena Z; Walter, Scott R; Westbrook, Johanna I

2017-03-01

Multi-tasking is an important skill for clinical work which has received limited research attention. Its impacts on clinical work are poorly understood. In contrast, there is substantial multi-tasking research in cognitive psychology, driver distraction, and human-computer interaction. This review synthesises evidence of the extent and impacts of multi-tasking on efficiency and task performance from health and non-healthcare literature, to compare and contrast approaches, identify implications for clinical work, and to develop an evidence-informed framework for guiding the measurement of multi-tasking in future healthcare studies. The results showed healthcare studies using direct observation have focused on descriptive studies to quantify concurrent multi-tasking and its frequency in different contexts, with limited study of impact. In comparison, non-healthcare studies have applied predominantly experimental and simulation designs, focusing on interleaved and concurrent multi-tasking, and testing theories of the mechanisms by which multi-tasking impacts task efficiency and performance. We propose a framework to guide the measurement of multi-tasking in clinical settings that draws together lessons from these siloed research efforts. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Arytenoid lateralization for management of combined laryngeal paralysis and laryngeal collapse in small dogs.

PubMed

Nelissen, Pieter; White, Richard A S

2012-02-01

To identify combined laryngeal paralysis and collapse in small dogs and describe postoperative outcome after arytenoid lateralization. Case series. Small nonbrachycephalic breed dogs with laryngeal paralysis and collapse (n = 6). Medical records of small breed dogs with airway problems and undergoing laryngeal surgery (January-December 2008) were reviewed. Dogs with combined laryngeal paralysis and laryngeal collapse (LPLC) had arytenoid lateralization. The immediate, 4 week and 6 month postoperative outcomes were described. Direct visual laryngeal exam under a light plane of anesthesia revealed bilateral failure of arytenoid and vocal fold movement and concurrent bilateral medial folding with contact of the cuneiform processes in all dogs. None of the dogs had intra- or immediate postoperative complications after arytenoid lateralization. Two dogs required a 2nd contralateral procedure. Follow-up after 6 months revealed marked improvement in clinical signs related to upper airway obstruction, but all dogs continued to have mild respiratory noise. Concurrent laryngeal paralysis and collapse should be considered as part of the differential diagnosis for small, nonbrachycephalic dogs with upper airway disease. Arytenoid lateralization resulted in improvement of clinical signs related to obstructive airway disease. © Copyright 2011 by The American College of Veterinary Surgeons.

Development and validation of a novel patient-reported treatment satisfaction measure for hyperfunctional facial lines: facial line satisfaction questionnaire.

PubMed

Pompilus, Farrah; Burgess, Somali; Hudgens, Stacie; Banderas, Benjamin; Daniels, Selena

2015-12-01

Facial lines or wrinkles are among the most visible signs of aging, and minimally invasive cosmetic procedures are becoming increasingly popular. The aim of this study was to develop and validate the Facial Line Satisfaction Questionnaire (FLSQ) for use in adults with upper facial lines (UFL). A literature review, concept elicitation interviews (n = 33), and cognitive debriefing interviews (n = 23) of adults with UFL were conducted to develop the FLSQ. The FLSQ comprises Baseline and Follow-up versions and was field-tested with 150 subjects in a US observational study designed to assess its psychometric performance. Analyses included acceptability (item and scale distribution [i.e. missingness, floor, and ceiling effects]), reliability, and validity (including concurrent validity). In total, 69 concepts were elicited during patient interviews. Following cognitive debriefing interviews, the FLSQ-Baseline version included 11 items and the Follow-up version included 13 items. Response rates for the FLSQ were 100% and 73% at baseline and follow-up, respectively; no items had excessive missing data. Questionnaire scale scores were normally distributed. Most domain scores demonstrated good internal consistency reliability (Cronbach's α ≥ 0.70). Most items within their respective domains exhibited good convergent (item-scale correlations > 0.40) and discriminant (items had higher correlation with their hypothesized scales than other scales) validity. Concurrent validity correlation coefficients of the FLSQ domain scores with the associated concurrent measures were acceptable (range: r = 0.40-0.70). Six FLSQ items demonstrated reliability and validity as stand-alone items outside their domains. The FLSQ is a valid questionnaire for assessing treatment expectations, satisfaction, impact, and preference in adults with UFL. © 2015 The Authors. Journal of Cosmetic Dermatology Published by Wiley Periodicals, Inc.

Nursing home outbreak of invasive group a streptococcal infections caused by 2 distinct strains.

PubMed

Thigpen, Michael C; Thomas, D Michael; Gloss, David; Park, Sarah Y; Khan, Amy J; Fogelman, Vicky L; Beall, Bernard; Van Beneden, Chris A; Todd, Randall L; Greene, Carolyn M

2007-01-01

To identify factors contributing to a cluster of deaths from invasive group A streptococcus (GAS) infection in a nursing home facility and to prevent additional cases. Outbreak investigation. A 146-bed nursing home facility in northern Nevada. We defined a case as the isolation of GAS from a normally sterile site in a resident of nursing home A. To identify case patients, we reviewed resident records from nursing home A, the local hospital, and the hospital laboratory. We obtained oropharyngeal and skin lesion swabs from staff and residents to assess GAS colonization and performed emm typing on available isolates. To identify potential risk factors for transmission, we performed a cohort study and investigated concurrent illness among residents and surveyed staff regarding infection control practices. Six residents met the case patient definition; 3 (50%) of them died. Among invasive GAS isolates available for analysis, 2 distinct strains were identified: emm11 (3 isolates) and emm89 (2 isolates). The rate of GAS carriage was 6% among residents and 4% among staff; carriage isolates were emm89 (8 isolates), emm11 (2 isolates), and emm1 (1 isolate). Concurrently, 35 (24%) of the residents developed a respiratory illness of unknown etiology; 41% of these persons died. Twenty-one (30%) of the surveyed employees did not always wash their hands before patient contacts, and 27 (38%) did not always wash their hands between patient contacts. Concurrent respiratory illness likely contributed to an outbreak of invasive GAS infection from 2 strains in a highly susceptible population. This outbreak highlights the importance of appropriate infection control measures, including respiratory hygiene practices, in nursing home facilities.

ROS1 fusions rarely overlap with other oncogenic drivers in non-small cell lung cancer

PubMed Central

Lin, Jessica J.; Ritterhouse, Lauren L.; Ali, Siraj M.; Bailey, Mark; Schrock, Alexa B.; Gainor, Justin F.; Ferris, Lorin A.; Mino-Kenudson, Mari; Miller, Vincent A.; Iafrate, Anthony J.; Lennerz, Jochen K.; Shaw, Alice T.

2017-01-01

Introduction Chromosomal rearrangements involving the ROS proto-oncogene 1 receptor tyrosine kinase gene (ROS1) define a distinct molecular subset of non-small cell lung cancer (NSCLC) with sensitivity to ROS1 inhibitors. Recent reports have suggested a significant overlap between ROS1 fusions and other oncogenic driver alterations, including mutations in epidermal growth factor receptor (EGFR) and KRAS proto-oncogene (KRAS). Methods We identified patients at our institution with ROS1-rearranged NSCLC who had undergone testing for genetic alterations in additional oncogenes, including EGFR, KRAS, and anaplastic lymphoma kinase (ALK). Clinicopathologic features and genetic testing results were reviewed. We also examined a separate database of ROS1-rearranged NSCLCs identified through a commercial FoundationOne assay. Results Among 62 patients with ROS1-rearranged NSCLC evaluated at our institution, none harbored concurrent ALK fusions (0%) or EGFR activating mutations (0%). KRAS mutations were detected in two cases (3.2%), one of which harbored a concurrent non-canonical KRAS I24N mutation of unknown biological significance. In a separate ROS1 FISH-positive case, targeted sequencing failed to confirm a ROS1 fusion, but instead identified a KRAS G13D mutation. No concurrent mutations in BRAF, ERBB2, PIK3CA, AKT1, or MAP2K1 were detected. Analysis of an independent dataset of 166 ROS1-rearranged NSCLCs identified by FoundationOne demonstrated rare cases with co-occurring driver mutations in EGFR (1/166) and KRAS (3/166), and no cases with co-occurring ROS1 and ALK rearrangements. Conclusions ROS1 rearrangements rarely overlap with alterations in EGFR, KRAS, ALK, or other targetable oncogenes in NSCLC. PMID:28088512

Valproic Acid Use During Radiation Therapy for Glioblastoma Associated With Improved Survival

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

Barker, Christopher A., E-mail: barkerc@mskcc.org; Bishop, Andrew J.; Chang, Maria

2013-07-01

Purpose: Valproic acid (VA) is an antiepileptic drug (AED) and histone deacetylase (HDAC) inhibitor taken by patients with glioblastoma (GB) to manage seizures, and it can modulate the biologic effects of radiation therapy (RT). We investigated whether VA use during RT for GB was associated with overall survival (OS). Methods and Materials: Medical records of 544 adults with GB were retrospectively reviewed. Analyses were performed to determine the association of Radiation Therapy Oncology Group recursive partitioning analysis (RTOG RPA) class, seizure history, and concurrent temozolomide (TMZ) and AED use during RT with OS. Results: Seizures before the end of RTmore » were noted in 217 (40%) patients, and 403 (74%) were taking an AED during RT; 29 (7%) were taking VA. Median OS in patients taking VA was 16.9 months (vs 13.6 months taking another AED, P=.16). Among patients taking an AED during RT, OS was associated with VA (P=.047; hazard ratio [HR], 0.67; 95% confidence interval [CI], 0.27-1.07), and RTOG RPA class (P<.0001; HR, 1.49; 95% CI, 1.37-1.61). Of the 5 most common AEDs, only VA was associated with OS. Median OS of patients receiving VA and TMZ during RT was 23.9 months (vs 15.2 months for patients taking another AED, P=.26). When the analysis was restricted to patients who received concurrent TMZ, VA use was marginally associated with OS (P=.057; HR, 0.54; 95% CI, −0.09 to 1.17), independently of RTOG RPA class and seizure history. Conclusions: VA use during RT for GB was associated with improved OS, independently of RTOG RPA, seizure history, and concurrent TMZ use. Further studies of treatment that combines HDAC inhibitors and RT are warranted.« less

Nelarabine neurotoxicity with concurrent intrathecal chemotherapy: Case report and review of literature.

PubMed

Ngo, Dat; Patel, Samit; Kim, Eun Jeong; Brar, Rondeep; Koontz, Michael Z

2015-08-01

Severe nelarabine neurotoxicity in a patient who received concurrent intrathecal (IT) chemotherapy is reported. A 37-year-old Caucasian woman with a history of T-cell lymphoblastic lymphoma was admitted for relapsed disease. She was originally treated with induction chemotherapy followed by an autologous transplant. She developed relapsed disease 10 months later with leukemic involvement. She was re-induced with nelarabine 1500 mg/m(2) on days 1, 3, and 5 with 1 dose of IT cytarabine 100 mg on day 2 as central nervous system (CNS) prophylaxis. At the time of treatment, she was on continuous renal replacement therapy due to sequelae of tumor lysis syndrome (TLS). She tolerated therapy well, entered a complete remission, and recovered her renal function. She received a second cycle of nelarabine without additional IT prophylaxis one month later. A week after this second cycle, she noted numbness in her lower extremities. Predominantly sensory, though also motor and autonomic, peripheral neuropathy started in her feet, ascended proximally to the mid-thoracic region, and eventually included her distal upper extremities. A magnetic resonance imaging (MRI) of her spine demonstrated changes from C2 to C6 consistent with subacute combined degeneration. Nelarabine was felt to be the cause of her symptoms. Her neuropathy stabilized and showed slight improvement and ultimately received an unrelated, reduced-intensity allogeneic transplant while in complete remission, but relapsed disease 10 weeks later. She is currently being treated with best supportive care. To our knowledge, this is the first published case report of severe neurotoxicity caused by nelarabine in a patient who received concurrent IT chemotherapy. © The Author(s) 2014.

Concurrent Chemoradiotherapy With Helical Tomotherapy for Oropharyngeal Cancer: A Preliminary Result

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

Shueng, Pei-Wei; Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan; General Education Center, Oriental Technology Institute, Taipei, Taiwan

Purpose: To review the experience with and evaluate the treatment plan for helical tomotherapy for the treatment of oropharyngeal cancer. Methods and Materials: Between November 1, 2006 and January 31, 2009, 10 histologically confirmed oropharyngeal cancer patients were enrolled. All patients received definitive concurrent chemoradiation with helical tomotherapy. The prescription dose to the gross tumor planning target volume, the high-risk subclinical area, and the low-risk subclinical area was 70Gy, 63Gy, and 56Gy, respectively. During radiotherapy, all patients were treated with cisplatin, 30mg/m{sup 2}, plus 5-fluorouracil (425mg/m{sup 2})/leucovorin (30mg/m{sup 2}) intravenously weekly. Toxicity of treatment was scored according to the Commonmore » Terminology Criteria for Adverse Events, version 3.0. Several parameters, including maximal or median dose to critical organs, uniformity index, and conformal index, were evaluated from dose-volume histograms. Results: The mean survival was 18 months (range, 7-22 months). The actuarial overall survival, disease-free survival, locoregional control, and distant metastasis-free rates at 18 months were 67%, 70%, 80%, and 100%, respectively. The average for uniformity index and conformal index was 1.05 and 1.26, respectively. The mean of median dose for right side and left side parotid glands was 23.5 and 23.9Gy, respectively. No Grade 3 toxicity for dermatitis and body weight loss and only one instance of Grade 3 mucositis were noted. Conclusion: Helical tomotherapy achieved encouraging clinical outcomes in patients with oropharyngeal carcinoma. Treatment toxicity was acceptable, even in the setting of concurrent chemotherapy. Long-term follow-up is needed to confirm these preliminary findings.« less

Profile of cognitive impairment and underlying pathology in multiple system atrophy.

PubMed

Koga, Shunsuke; Parks, Adam; Uitti, Ryan J; van Gerpen, Jay A; Cheshire, William P; Wszolek, Zbigniew K; Dickson, Dennis W

2017-03-01

The objectives of this study were to elucidate any potential association between α-synuclein pathology and cognitive impairment and to determine the profile of cognitive impairment in multiple system atrophy (MSA) patients. To do this, we analyzed the clinical and pathologic features in autopsy-confirmed MSA patients. We retrospectively reviewed medical records, including neuropsychological test data, in 102 patients with autopsy-confirmed MSA in the Mayo Clinic brain bank. The burden of glial cytoplasmic inclusions and neuronal cytoplasmic inclusions were semiquantitatively scored in the limbic regions and middle frontal gyrus. We also assessed concurrent pathologies potentially causing dementia including Alzheimer's disease, hippocampal sclerosis, and cerebrovascular pathology. Of 102 patients, 33 (32%) were documented to have cognitive impairment. Those that received objective testing, deficits primarily in processing speed and attention/executive functions were identified, which suggests a frontal-subcortical pattern of dysfunction. Of these 33 patients with cognitive impairment, 8 patients had concurrent pathologies of dementia. MSA patients with cognitive impairment had a greater burden of neuronal cytoplasmic inclusions in the dentate gyrus than patients without cognitive impairment, both including and excluding patients with concurrent pathologies of dementia. The cognitive deficits observed in this study were more evident on neuropsychological assessment than with cognitive screens. Based on these findings, we recommend that clinicians consider more in-depth neuropsychological assessments if patients with MSA present with cognitive complaints. Although we did not identify the correlation between cognitive deficits and responsible neuroanatomical regions, a greater burden of neuronal cytoplasmic inclusions in the limbic regions was associated with cognitive impairment in MSA. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

Peroxisome Proliferator-Activated Receptor Gamma (PPARγ) as a Target for Concurrent Management of Diabetes and Obesity-Related Cancer.

PubMed

Wang, Qingqing; Imam, Mustapha Umar; Yida, Zhang; Wang, Fudi

2017-01-01

Peroxisome proliferator-activated receptor gamma (PPARγ) is a member of the nuclear receptor superfamily of ligand-inducible transcription factors that regulate adipogenesis, lipid metabolism, cell proliferation, inflammation and insulin sensitization. Abnormalities in PPARγ signaling have been associated with obesity, diabetes and cancer. The use of agonists to manage these diseases has been limited by their side effects. Accordingly, dual or pan agonists targeting the PPARα or PPARα and PPARδ, respectively, in addition to the PPARγ have been developed to overcome these side effects. This review details the shared PPARγ-dependent mechanisms between obesity-related cancers and diabetes and their potential therapeutic values. We performed a systematic literature search through pubmed, Scopus and google scholar for articles on PPARγ-dependent signaling in diabetes or cancer. There is growing co-occurrence of obesity-related cancers and diabetes, necessitating the use of effective therapies with the least amount of side effects for concurrent management of these diseases, by targeting potentially shared PPARγ-dependent mechanisms including abnormalities of the wnt/β-catenin, lysosomal acid lipase, inflammatory and cell cycle pathways, and the plasminogen activator system. Taking advantage of the multiple docking sites of the PPARγ and the pleiotropic nature of its signaling, structure-activity relationship and molecular docking studies have provided insights into designer PPARγ agonists or dual PPARα/γ agonists that modulate PPARγ signaling and negate side effects of full PPARγ agonists. Effective therapies, possibly devoid of side effects, for concurrent management of obesity-related cancers and diabetes can be developed through diligent structure-activity and molecular docking studies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Concurrent infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus bacteremia.

PubMed

Wang, Li Jun; Du, Xiao Qin; Nyirimigabo, Eric; Shou, Song Tao

2014-04-01

It is rare to see a concurrent infection with infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus in Tianjin, China. Until now, there is still no any single recorded case of concurrent infectious mononucleosis and community-associated methicillin-resistant Staphylococcus aureus bacteremia.

78 FR 72859 - Concurrence With OIE Risk Designations for Bovine Spongiform Encephalopathy

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-04

... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2013-0064] Concurrence With OIE Risk Designations for Bovine Spongiform Encephalopathy AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Notice. SUMMARY: We are advising the public of our preliminary concurrence...

A Concurrent Support Course for Intermediate Algebra

ERIC Educational Resources Information Center

Cooper, Cameron I.

2011-01-01

This article summarizes the creation and implementation of a concurrent support class for TRS 92--Intermediate Algebra, a developmental mathematics course at Fort Lewis College in Durango, Colorado. The concurrent course outlined in this article demonstrates a statistically significant increase in student success rates since its inception.…

Impact of elevated cardiac biomarkers on mortality after vascular surgery procedures.

PubMed

Buckley, Ryan; Stevens, Scott L

2014-12-01

Concurrent cardiac disease is an important cause of morbidity and mortality in vascular surgical patients. Increasingly, cardiac biomarkers are used to identify cardiac injury in these high-risk patients. This review provides data demonstrating that perioperative troponin elevation correlates with poor short- and long-term outcomes for vascular surgical patients. In addition, the data demonstrate that patients with high circulating troponin levels fair worse than those with lower levels. Early identification of patients with cardiac injury using biomarkers allows timely diagnosis, risk stratification, and aggressive medical therapy for vascular surgical patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Nanomedicine in chemoradiation

PubMed Central

Miller, Seth M; Wang, Andrew Z

2013-01-01

Chemoradiotherapy, the concurrent administration of chemotherapy and radiotherapy, is a treatment paradigm in oncology. It is part of the standard of care and curative treatment of many cancers. Given its importance, one of the primary goals of cancer research has been to identify agents and/or strategies that can improve the therapeutic index of chemoradiation. Recent advances in nanomedicine have provided a unique and unprecedented opportunity for improving chemoradiotherapy. Nanoparticles possess properties that are ideally suited for delivering chemotherapy in the chemoradiation setting. The goal of this review is to examine the role of incorporating nanomedicine into chemoradiation and the potential impact of nanomedicine to chemoradiotherapy. PMID:23343162

Treatment of hypertension and other cardiovascular risk factors in patients with metabolic syndrome.

PubMed

Suzuki, Takeki; Homma, Shunichi

2007-11-01

Metabolic syndrome (MetS), a concurrence of hypertension, abdominal obesity, impaired fasting glucose, and dyslipidemia, has been shown to be a risk factor for cardiovascular disease. Insulin resistance has been thought to be one of the pathophysiologies of the syndrome. Reduction of the underlying causes of MetS, such as obesity, physical inactivity, and atherogenic diet, is first-line therapy. Treatment of hypertension and other cardiometabolic risk factors of MetS is also required. This article reviews the treatment of the metabolic syndrome with a focus on the importance of lifestyle changes and treatment of hypertension.

Mixed-Methods Research in the Discipline of Nursing.

PubMed

Beck, Cheryl Tatano; Harrison, Lisa

2016-01-01

In this review article, we examined the prevalence and characteristics of 294 mixed-methods studies in the discipline of nursing. Creswell and Plano Clark's typology was most frequently used along with concurrent timing. Bivariate statistics was most often the highest level of statistics reported in the results. As for qualitative data analysis, content analysis was most frequently used. The majority of nurse researchers did not specifically address the purpose, paradigm, typology, priority, timing, interaction, or integration of their mixed-methods studies. Strategies are suggested for improving the design, conduct, and reporting of mixed-methods studies in the discipline of nursing.

Steroid-responsive polyradiculopathy in association with focal segmental glomerulosclerosis

PubMed Central

Chapman, Andrew R.; Gamble, Paul; Pollock, Anne Marie; Joss, Nicola

2013-01-01

An 80-year-old woman presented with simultaneous increasing muscle weakness and nephrotic syndrome. A renal biopsy confirmed focal segmental glomerulosclerosis (FSGS). Her neurological diagnosis best fitted with a Guillain–Barre-like syndrome. There have been several cases of FSGS in combination with both conventional and atypical Guillain–Barre syndrome (GBS). Our patient was treated with high-dose steroids and resolution of both nephrotic syndrome and neurological symptoms occurred over 6 months. This article reviews all previously published presentations of this nature and discusses putative mechanisms for the development of concurrent FSGS and GBS. PMID:26069832

External beam radiation therapy for clinically localized prostate cancer: when and how we optimize with concurrent hormonal deprivation.

PubMed

Koontz, Bridget F; Lee, W Robert

2011-10-01

Androgen deprivation plays a major role in the treatment of prostate cancer.Preclinical studies have shown that androgen deprivation provides both an independent cytotoxic effect and radiosensitization on prostate tumors. For men with non-metastatic prostate cancer, the addition of androgen deprivation to radiotherapy has been shown to improve survival for intermediate and high risk disease compared to radiation alone.This review discusses the clinical trial data regarding combination of androgen deprivation and radiation and provides recommendations for its use in men undergoing radiotherapy for localized prostate cancer.

Light ion beam fusion research at Sandia National Laboratories

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

Yonas, G.

1983-01-01

Data has been collected on PBFA I using three related diode types: (1) the Ampfion diode, (2) the applied field diode, and (3) the pinch reflex diode. Concurrent with these PBFA I experiments, complementary experiments were carried out on Proto I at Sandia, as well as the Lion accelerator at Cornell University, and the Gamble II accelerator at the Naval Research Laboratory. In addition to these experiments, improved electromagnetic particle-in-cell codes and analytical treatments were brought to bear on improving our understanding of diode phenomena. A brief review of some of the results is given.

Decision Support Systems for Research and Management in Advanced Life Support

NASA Technical Reports Server (NTRS)

Rodriquez, Luis F.

2004-01-01

Decision support systems have been implemented in many applications including strategic planning for battlefield scenarios, corporate decision making for business planning, production planning and control systems, and recommendation generators like those on Amazon.com(Registered TradeMark). Such tools are reviewed for developing a similar tool for NASA's ALS Program. DSS are considered concurrently with the development of the OPIS system, a database designed for chronicling of research and development in ALS. By utilizing the OPIS database, it is anticipated that decision support can be provided to increase the quality of decisions by ALS managers and researchers.

Identification of mast cells in buffy coat preparations from dogs with inflammatory skin diseases.

PubMed

Cayatte, S M; McManus, P M; Miller, W H; Scott, D W

1995-02-01

In 100 dogs with 4 inflammatory dermatologic diseases, buffy coat preparations from EDTA-treated blood samples were examined cytologically. Fifty-four dogs had atopy, 26 had flea-bite hypersensitivity, 17 had sarcoptic mange, and 3 had food allergy. Twenty-eight dogs had 2 or more concurrent skin diseases; most of these had secondary pyoderma. Dogs did not have mast cell tumors. Thirteen samples contained 1 or more mast cells/4 slides reviewed. This study revealed that dogs with inflammatory skin diseases can have a few to many mast cells evident on cytologic examination of buffy coat preparations.

Multifunctional agents for concurrent imaging and therapy in cardiovascular disease

PubMed Central

McCarthy, Jason R.

2010-01-01

The development of agents for the simultaneous detection and treatment of disease has recently gained significant attention. These multifunctional theranostic agents posses a number of advantages over their monofunctional counterparts, as they potentially allow for the concomitant determination of agent localization, release, and efficacy. Whereas the development of these agents for use in cancers has received the majority of the attention, their use in cardiovascular disease is steadily increasing. As such, this review summarized some of the most poignant recent advances in the development of theranostic agents for the treatment of this class of diseases. PMID:20654664

Ultrasensitive biomolecular assays with amplifying nanowire FET biosensors

NASA Astrophysics Data System (ADS)

Chui, Chi On; Shin, Kyeong-Sik; Mao, Yufei

2013-09-01

In this paper, we review our recent development and validation of the ultrasensitive electronic biomolecular assays enabled by our novel amplifying nanowire field-effect transistor (nwFET) biosensors. Our semiconductor nwFET biosensor platform technology performs extreme proximity signal amplification in the electrical domain that requires neither labeling nor enzymes nor optics. We have designed and fabricated the biomolecular assay prototypes and developed the corresponding analytical procedures. We have also confirmed their analytical performance in quantitating key protein biomarker in human serum, demonstrating an ultralow limit of detection and concurrently high output current level for the first time.

Enhanced identification of eligibility for depression research using an electronic medical record search engine.

PubMed

Seyfried, Lisa; Hanauer, David A; Nease, Donald; Albeiruti, Rashad; Kavanagh, Janet; Kales, Helen C

2009-12-01

Electronic medical records (EMRs) have become part of daily practice for many physicians. Attempts have been made to apply electronic search engine technology to speed EMR review. This was a prospective, observational study to compare the speed and clinical accuracy of a medical record search engine vs. manual review of the EMR. Three raters reviewed 49 cases in the EMR to screen for eligibility in a depression study using the electronic medical record search engine (EMERSE). One week later raters received a scrambled set of the same patients including 9 distractor cases, and used manual EMR review to determine eligibility. For both methods, accuracy was assessed for the original 49 cases by comparison with a gold standard rater. Use of EMERSE resulted in considerable time savings; chart reviews using EMERSE were significantly faster than traditional manual review (p=0.03). The percent agreement of raters with the gold standard (e.g. concurrent validity) using either EMERSE or manual review was not significantly different. Using a search engine optimized for finding clinical information in the free-text sections of the EMR can provide significant time savings while preserving clinical accuracy. The major power of this search engine is not from a more advanced and sophisticated search algorithm, but rather from a user interface designed explicitly to help users search the entire medical record in a way that protects health information.

Searching ClinicalTrials.gov did not change the conclusions of a systematic review.

PubMed

Wilson, Lisa M; Sharma, Ritu; Dy, Sydney M; Waldfogel, Julie M; Robinson, Karen A

2017-10-01

We assessed the effect of searching ClinicalTrials.gov on the conclusions of a systematic review. We conducted this case study concurrently with a systematic review. We searched ClinicalTrials.gov on March 9, 2016, to identify trial records eligible for inclusion in the review. Two independent reviewers screened ClinicalTrials.gov records. We compared conclusions and strength of evidence grade with and without ClinicalTrials.gov records for 31 comparisons and 2 outcomes. We identified 106 trials (53 in the peer-reviewed literature only, 23 in ClinicalTrials.gov only, and 30 in both sources). For one comparison, the addition of results identified through ClinicalTrials.gov reduced the pooled effect size. We found evidence of selective outcome reporting for two comparisons and suspected publication bias for another two comparisons. For all other comparisons, searching ClinicalTrials.gov did not change conclusions or the strength of evidence grading for the two outcomes. Our search of ClinicalTrials.gov bolstered suspicions of reporting biases but did not change either the conclusions or the strength of evidence grading. Further research is needed to determine the effect of searching ClinicalTrials.gov on the conclusions of systematic reviews in different topic areas and as the new rules for registration of trial results take effect. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of Pharmacist Impact on Culture Review Process for Patients Discharged From the Emergency Department.

PubMed

Santiago, Ruben D; Bazan, Jose A; Brown, Nicole V; Adkins, Eric J; Shirk, Mary Beth

2016-10-01

Background: Accurate and timely review of microbiological test results is a core component of antimicrobial stewardship. There is documented success of these programs in the inpatient setting; however, emergency department (ED) patients are typically not included in these initiatives. Objectives: To assess the impact of an emergency medicine pharmacist (EMP)-facilitated review process of positive microbiological test results from patients discharged from the ED as measured by time to positive result review and number of indicated interventions completed. Methods: This was a retrospective study that compared EMP-facilitated to ED charge nurse (CN)-facilitated physician review of randomly selected positive microbiological test results. Groups were compared concurrently within the time frame of July 1, 2012 through December 31, 2012. Results: One hundred seventy-eight positive microbiological test results were included (EMP, n = 91; CN, n = 87). The median (IQR) time to initial review was 3 (1.0-6.3) hours for the EMP and 2 (0.3-5.5) hours for the CN group ( p = .35). Four percent (1/25) of indicated interventions were not completed in the EMP group versus 47% (14/30) in the CN group ( p = .0004). Conclusion: An EMP was significantly less likely to miss an intervention when indicated with no difference in time to review of positive microbiological results. These findings support the role of the EMP in antimicrobial stewardship in the ED.

Enhanced Identification of Eligibility for Depression Research Using an Electronic Medical Record Search Engine

PubMed Central

Seyfried, Lisa; Hanauer, David; Nease, Donald; Albeiruti, Rashad; Kavanagh, Janet; Kales, Helen C.

2009-01-01

Purpose Electronic medical records (EMR) have become part of daily practice for many physicians. Attempts have been made to apply electronic search engine technology to speed EMR review. This was a prospective, observational study to compare the speed and accuracy of electronic search engine vs. manual review of the EMR. Methods Three raters reviewed 49 cases in the EMR to screen for eligibility in a depression study using the electronic search engine (EMERSE). One week later raters received a scrambled set of the same patients including 9 distractor cases, and used manual EMR review to determine eligibility. For both methods, accuracy was assessed for the original 49 cases by comparison with a gold standard rater. Results Use of EMERSE resulted in considerable time savings; chart reviews using EMERSE were significantly faster than traditional manual review (p=0.03). The percent agreement of raters with the gold standard (e.g. concurrent validity) using either EMERSE or manual review was not significantly different. Conclusions Using a search engine optimized for finding clinical information in the free-text sections of the EMR can provide significant time savings while preserving reliability. The major power of this search engine is not from a more advanced and sophisticated search algorithm, but rather from a user interface designed explicitly to help users search the entire medical record in a way that protects health information. PMID:19560962

Parallel Algorithm Solves Coupled Differential Equations

NASA Technical Reports Server (NTRS)

Hayashi, A.

1987-01-01

Numerical methods adapted to concurrent processing. Algorithm solves set of coupled partial differential equations by numerical integration. Adapted to run on hypercube computer, algorithm separates problem into smaller problems solved concurrently. Increase in computing speed with concurrent processing over that achievable with conventional sequential processing appreciable, especially for large problems.

37 CFR 1.989 - Merger of concurrent reexamination proceedings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Merger of concurrent... November 29, 1999 Concurrent Proceedings Involving Same Patent in Inter Partes Reexamination § 1.989 Merger... suspend one of the two proceedings. Where merger is ordered, the merged examination will normally result...

A Model-Driven Approach to Teaching Concurrency

ERIC Educational Resources Information Center

Carro, Manuel; Herranz, Angel; Marino, Julio

2013-01-01

We present an undergraduate course on concurrent programming where formal models are used in different stages of the learning process. The main practical difference with other approaches lies in the fact that the ability to develop correct concurrent software relies on a systematic transformation of formal models of inter-process interaction (so…

Interference in Joint Picture Naming

ERIC Educational Resources Information Center

Gambi, Chiara; Van de Cavey, Joris; Pickering, Martin J.

2015-01-01

In 4 experiments we showed that picture naming latencies are affected by beliefs about the task concurrently performed by another speaker. Participants took longer to name pictures when they believed that their partner concurrently named pictures than when they believed their partner was silent (Experiments 1 and 4) or concurrently categorized the…

The Concurrent Validity of Four Tests of Metalinguistic Awareness.

ERIC Educational Resources Information Center

Day, Kaaren C.; Day, H. D.

1991-01-01

Examines the concurrent validity of four metalinguistic awareness tests (Written Language Awareness Test, Test of Early Reading Ability, Linguistic Awareness in Reading Readiness Test, and the Concepts about Print Test). Finds rather low concurrent validity coefficients which suggests that further work is needed to clarify the operations required…

23 CFR 751.23 - Concurrent junkyard control and right-of-way projects.

Code of Federal Regulations, 2010 CFR

2010-04-01

...-way projects. The State is encouraged to coordinate junkyard control and highway right-of-way projects. Expenses incurred in furtherance of concurrent projects shall be prorated between projects. ... 23 Highways 1 2010-04-01 2010-04-01 false Concurrent junkyard control and right-of-way projects...

Separate versus Concurrent Calibration Methods in Vertical Scaling.

ERIC Educational Resources Information Center

Karkee, Thakur; Lewis, Daniel M.; Hoskens, Machteld; Yao, Lihua; Haug, Carolyn

Two methods to establish a common scale across grades within a content area using a common item design (separate and concurrent) have previously been studied under simulated conditions. Separate estimation is accomplished through separate calibration and grade-by-grade chained linking. Concurrent calibration established the vertical scale in a…

Finite elements and the method of conjugate gradients on a concurrent processor

NASA Technical Reports Server (NTRS)

Lyzenga, G. A.; Raefsky, A.; Hager, G. H.

1985-01-01

An algorithm for the iterative solution of finite element problems on a concurrent processor is presented. The method of conjugate gradients is used to solve the system of matrix equations, which is distributed among the processors of a MIMD computer according to an element-based spatial decomposition. This algorithm is implemented in a two-dimensional elastostatics program on the Caltech Hypercube concurrent processor. The results of tests on up to 32 processors show nearly linear concurrent speedup, with efficiencies over 90 percent for sufficiently large problems.

A Concurrent Distributed System for Aircraft Tactical Decision Generation

NASA Technical Reports Server (NTRS)

McManus, John W.

1990-01-01

A research program investigating the use of artificial intelligence (AI) techniques to aid in the development of a Tactical Decision Generator (TDG) for Within Visual Range (WVR) air combat engagements is discussed. The application of AI programming and problem solving methods in the development and implementation of a concurrent version of the Computerized Logic For Air-to-Air Warfare Simulations (CLAWS) program, a second generation TDG, is presented. Concurrent computing environments and programming approaches are discussed and the design and performance of a prototype concurrent TDG system are presented.

Finite elements and the method of conjugate gradients on a concurrent processor

NASA Technical Reports Server (NTRS)

Lyzenga, G. A.; Raefsky, A.; Hager, B. H.

1984-01-01

An algorithm for the iterative solution of finite element problems on a concurrent processor is presented. The method of conjugate gradients is used to solve the system of matrix equations, which is distributed among the processors of a MIMD computer according to an element-based spatial decomposition. This algorithm is implemented in a two-dimensional elastostatics program on the Caltech Hypercube concurrent processor. The results of tests on up to 32 processors show nearly linear concurrent speedup, with efficiencies over 90% for sufficiently large problems.

Concurrent alcohol and tobacco use among a middle-aged and elderly population in Mumbai.

PubMed

Gupta, Prakash C; Maulik, Pallab K; Pednekar, Mangesh S; Saxena, Shekhar

2005-01-01

The concurrent use of alcohol and tobacco and its deleterious effects have been reported in the western literature. However, studies on the relationship between concurrent alcohol and tobacco use in India are limited. This study outlines the association between concurrent alcohol and tobacco use among a middle-aged and elderly population in a western Indian cohort after controlling for various sociodemographic factors. A total of 35 102 men, 45 years of age and above were interviewed for concurrent alcohol and tobacco use. The sample was part of an earlier cohort drawn from the general population. The data were analysed after controlling for age, education, religion and mother-tongue. Among alcohol users, 51.1% smoked tobacco and 35.6% used smokeless tobacco. The relative risk of alcohol use was highest among those smoking cigarettes or beedis and among those using mishri with betel quid and tobacco. The risk of alcohol use increased with the frequency of tobacco use. The risk also increased with higher amounts of alcohol consumption, but peaked at around 100-150 ml of absolute alcohol use. The study highlights the association between concurrent alcohol and tobacco use among the Indian population. This has important public health implications since concurrent use of these is synergistic for increased risk of oropharyngeal cancers.

Increased risk of concurrent hepatitis C among Male patients with schizophrenia.

PubMed

Chiu, Yu-Lung; Lin, Herng-Ching; Kao, Nai-Wen; Kao, Senyong; Lee, Hsin-Chien

2017-12-01

Prior studies attempted to explore the association between schizophrenia and hepatitis C virus (HCV). However, their conclusions were inconsistent. This study aimed to examine the association of schizophrenia with HCV using a population-based dataset in Taiwan. There were 6097 patients with schizophrenia and 6097 sex- and age-matched comparison patients without schizophrenia included in this study. We defined the dependent variable of interest as whether or not a patient had received a diagnosis of HCV. We found that of the sampled patients, 2.1% of patients with schizophrenia and 1.4% of comparison patients had concurrent HCV. We further found that schizophrenia was not significantly associated with concurrent HCV after adjusting for sex, age, urbanization level, geographic region, monthly income, and drug abuse. However, of the sampled male patients, the adjusted odds of concurrent hepatitis C for patients with schizophrenia were 1.72-times higher than the odds of concurrent HCV among comparison patients. We failed to observe this association among female sampled patients. We concluded that schizophrenia was not significantly associated with concurrent HCV. However, of the sampled male patients, the risk of concurrent HCV among patients with schizophrenia was higher than comparison patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Concurrent Disorders and Health Care Utilization Among Homeless and Vulnerably Housed Persons in Canada.

PubMed

Zhang, Linda; Norena, Monica; Gadermann, Anne; Hubley, Anita; Russell, Lara; Aubry, Tim; To, Matthew J; Farrell, Susan; Hwang, Stephen; Palepu, Anita

2018-01-01

Individuals who are homeless or vulnerably housed have a higher prevalence of concurrent disorders, defined as having a mental health diagnosis and problematic substance use, compared to the general housed population. The study objective was to investigate the effect of having concurrent disorders on health care utilization among homeless or vulnerably housed individuals, using longitudinal data from the Health and Housing in Transition Study. In 2009, 1190 homeless or vulnerably housed adults were recruited in Ottawa, Toronto, and Vancouver, Canada. Participants completed baseline interviews and four annual follow-up interviews, providing data on sociodemographics, housing history, mental health diagnoses, problematic drug use with the Drug Abuse Screening Test (DAST-10), problematic alcohol use with the Alcohol Use Disorders Identification Test (AUDIT), chronic health conditions, and utilization of the following health care services: emergency department (ED), hospitalization, and primary care. Concurrent disorders were defined as the participant having ever received a mental health diagnosis at baseline and having problematic substance use (i.e., DAST-10 ≥ 6 and/or AUDIT ≥ 20) at any time during the study period. Three generalized mixed effects logistic regression models were used to examine the independent association of having concurrent disorders and reporting ED use, hospitalization, or primary care visits in the past 12 months. Among our sample of adults who were homeless or vulnerably housed, 22.6% (n = 261) reported having concurrent disorders at baseline. Individuals with concurrent disorders had significantly higher odds of ED use (adjusted odds ratio [AOR] = 1.71; 95% confidence interval [CI], 1.4-2.11), hospitalization (AOR = 1.45; 95% CI, 1.16-1.81), and primary care visits (AOR = 1.34; 95% CI, 1.05-1.71) in the past 12 months over the four-year follow-up period, after adjusting for potential confounders. Concurrent disorders were associated with higher rates of health care utilization when compared to those without concurrent disorders among homeless and vulnerably housed individuals. Comprehensive programs that integrate mental health and addiction services with primary care as well as community-based outreach may better address the unmet health care needs of individuals living with concurrent disorders who are vulnerable to poor health outcomes.

Patterns of and Motivations for Concurrent Use of Video Games and Substances

PubMed Central

Ream, Geoffrey L.; Elliott, Luther C.; Dunlap, Eloise

2011-01-01

“Behavioral addictions” share biological mechanisms with substance dependence, and “drug interactions” have been observed between certain substances and self-reinforcing behaviors. This study examines correlates of patterns of and motivations for playing video games while using or feeling the effects of a substance (concurrent use). Data were drawn from a nationally-representative survey of adult Americans who “regularly” or “occasionally” played video games and had played for at least one hour in the past seven days (n = 3,380). Only recent concurrent users’ data were included in analyses (n = 1,196). Independent variables included demographics, substance use frequency and problems, game genre of concurrent use (identified by looking titles up in an industry database), and general game playing variables including problem video game play (PVP), consumer involvement, enjoyment, duration, and frequency of play. Exploratory factor analysis identified the following dimensions underlying patterns of and motivations for concurrent use: pass time or regulate negative emotion, enhance an already enjoyable or positive experience, and use of video games and substances to remediate each other’s undesirable effects. Multivariate regression analyses indicated PVP and hours/day of video game play were associated with most patterns/motivations, as were caffeine, tobacco, alcohol, marijuana, and painkiller use problems. This suggests that concurrent use with some regular situational pattern or effect-seeking motivation is part of the addictive process underlying both PVP and substance dependence. Various demographic, game playing, game genre of concurrent use, and substance use variables were associated with specific motivations/patterns, indicating that all are important in understanding concurrent use. PMID:22073024

A study of pedestrian compliance with traffic signals for exclusive and concurrent phasing.

PubMed

Ivan, John N; McKernan, Kevin; Zhang, Yaohua; Ravishanker, Nalini; Mamun, Sha A

2017-01-01

This paper describes a comparison of pedestrian compliance at traffic signals with two types of pedestrian phasing: concurrent, where both pedestrians and vehicular traffic are directed to move in the same directions at the same time, and exclusive, where pedestrians are directed to move during their own dedicated phase while all vehicular traffic is stopped. Exclusive phasing is usually perceived to be safer, especially by senior and disabled advocacy groups, although these safety benefits depend upon pedestrians waiting for the walk signal. This paper investigates whether or not there are differences between pedestrian compliance at signals with exclusive pedestrian phasing and those with concurrent phasing and whether these differences continue to exist when compliance at exclusive phasing signals is evaluated as if they had concurrent phasing. Pedestrian behavior was observed at 42 signalized intersections in central Connecticut with both concurrent and exclusive pedestrian phasing. Binary regression models were estimated to predict pedestrian compliance as a function of the pedestrian phasing type and other intersection characteristics, such as vehicular and pedestrian volume, crossing distance and speed limit. We found that pedestrian compliance is significantly higher at intersections with concurrent pedestrian phasing than at those with exclusive pedestrian phasing, but this difference is not significant when compliance at exclusive phase intersections is evaluated as if it had concurrent phasing. This suggests that pedestrians treat exclusive phase intersections as though they have concurrent phasing, rendering the safety benefits of exclusive pedestrian phasing elusive. No differences were observed for senior or non-senior pedestrians. Published by Elsevier Ltd.

Socioeconomic Inequality in Concurrent Tobacco and Alcohol Consumption

PubMed Central

Intarut, Nirun; Pukdeesamai, Piyalak

2017-01-01

Background: Whilst several studies have examined inequity of tobacco use and inequity of alcohol drinking individually, comparatively little is known about concurrent tobacco and alcohol consumption. The present study therefore investigated inequity of concurrent tobacco and alcohol consumption in Thailand. Methods: The 2015 Health and Welfare Survey was obtained from Thailand’s National Statistical Office and used as a source of national representative data. Concurrent tobacco and alcohol consumption was defined as current and concurrent use of both tobacco and alcohol. The wealth assets index was used as an indicator of socioeconomic inequity. Socioeconomic status included 5 groups ranging from poorest (Q1) to richest (Q5). A total of 55,920 households and 113,705 participants aged 15 years or over were included and analyzed. A weighted multiple logistic regression was performed. Results: The prevalence of concurrent tobacco and alcohol consumption, tobacco consumption only, and alcohol consumption only were 15.2% (95% CI: 14.9, 15.4), 4.7% (95% CI: 4.5, 4.8), and 18.9% (95% CI: 18.7, 19.1), respectively. Weighted multiple logistic regression showed that concurrent tobacco and alcohol consumption was high in the poorest socioeconomic group (P for trend <0.001), and tobacco consumption only was also high in the poorest group (P for trend <0.001). A high prevalence of alcohol consumption was observed in the richest group (P for trend <0.001). Conclusions: These findings suggest that tobacco and alcohol consumption prevention programs would be more effective if they considered socioeconomic inequities in concurrent tobacco and alcohol consumption rather than focusing on single drug use. PMID:28749620

Patterns of and motivations for concurrent use of video games and substances.

PubMed

Ream, Geoffrey L; Elliott, Luther C; Dunlap, Eloise

2011-10-01

"Behavioral addictions" share biological mechanisms with substance dependence, and "drug interactions" have been observed between certain substances and self-reinforcing behaviors. This study examines correlates of patterns of and motivations for playing video games while using or feeling the effects of a substance (concurrent use). Data were drawn from a nationally-representative survey of adult Americans who "regularly" or "occasionally" played video games and had played for at least one hour in the past seven days (n = 3,380). Only recent concurrent users' data were included in analyses (n = 1,196). Independent variables included demographics, substance use frequency and problems, game genre of concurrent use (identified by looking titles up in an industry database), and general game playing variables including problem video game play (PVP), consumer involvement, enjoyment, duration, and frequency of play. Exploratory factor analysis identified the following dimensions underlying patterns of and motivations for concurrent use: pass time or regulate negative emotion, enhance an already enjoyable or positive experience, and use of video games and substances to remediate each other's undesirable effects. Multivariate regression analyses indicated PVP and hours/day of video game play were associated with most patterns/motivations, as were caffeine, tobacco, alcohol, marijuana, and painkiller use problems. This suggests that concurrent use with some regular situational pattern or effect-seeking motivation is part of the addictive process underlying both PVP and substance dependence. Various demographic, game playing, game genre of concurrent use, and substance use variables were associated with specific motivations/patterns, indicating that all are important in understanding concurrent use.

Impact of high-intensity concurrent training on cardiovascular risk factors in persons with multiple sclerosis - pilot study.

PubMed

Keytsman, Charly; Hansen, Dominique; Wens, Inez; O Eijnde, Bert

2017-10-27

High-intensity concurrent training positively affects cardiovascular risk factors. Because this was never investigated in multiple sclerosis, the present pilot study explored the impact of this training on cardiovascular risk factors in this population. Before and after 12 weeks of high-intense concurrent training (interval and strength training, 5 sessions per 2 weeks, n = 16) body composition, resting blood pressure and heart rate, 2-h oral glucose tolerance (insulin sensitivity, glycosylated hemoglobin, blood glucose and insulin concentrations), blood lipids (high- and low-density lipoprotein, total cholesterol, triglyceride levels) and C-reactive protein were analyzed. Twelve weeks of high-intense concurrent training significantly improved resting heart rate (-6%), 2-h blood glucose concentrations (-13%) and insulin sensitivity (-24%). Blood pressure, body composition, blood lipids and C-reactive protein did not seem to be affected. Under the conditions of this pilot study, 12 weeks of concurrent high-intense interval and strength training improved resting heart rate, 2-h glucose and insulin sensitivity in multiple sclerosis but did not affect blood C-reactive protein levels, blood pressure, body composition and blood lipid profiles. Further, larger and controlled research investigating the effects of high-intense concurrent training on cardiovascular risk factors in multiple sclerosis is warranted. Implications for rehabilitation High-intensity concurrent training improves cardiovascular fitness. This pilot study explores the impact of this training on cardiovascular risk factors in multiple sclerosis. Despite the lack of a control group, high-intense concurrent training does not seem to improve cardiovascular risk factors in multiple sclerosis.

Compatibility of ASO3-adjuvanted H1N1pdm09 and seasonal trivalent influenza vaccines in adults: results of a randomized, controlled trial.

PubMed

Scheifele, David W; Ward, Brian J; Dionne, Marc; Vanderkooi, Otto G; Loeb, Mark; Coleman, Brenda L; Li, Yan

2012-07-06

When Canada chose a novel adjuvanted vaccine to combat the 2009 influenza pandemic, seasonal trivalent inactivated vaccine (TIV) was also available but compatibility of the two had not been assessed. To compare responses after concurrent or sequential administration of these vaccines, adults 20-59 years old were randomly assigned (1:1) to receive ASO3-adjuvanted H1N1pdm09 vaccine (Arepanrix, GSK, Quebec City, Quebec), with TIV (Vaxigrip, Sanofi Pasteur, Toronto) given concurrently or 21 days later. Blood was obtained at baseline and 21 days after each vaccination to measure hemagglutination inhibition (HAI) titers. Adverse effects were assessed using symptom diaries and personal interviews. 282 participants completed the study (concurrent vaccines 145, sequential vaccines 137). HAI titers to H1N1pdm09 were ≥ 40 at baseline in 15-18% of participants and following vaccination in 91-92%. Initially seropositive subjects (titer ≥ 10) had lower H1N1pdm09 geometric mean HAI titers (GMT) after concurrent than separate vaccinations (320.0 vs 476.5, p=0.039) but both exceeded GM responses of initially naïve participants, which were unaffected by concurrent TIV. Responses to TIV were not lower after concurrent than separate vaccination. Adverse event rates were not increased by concurrent vaccinations above those with H1N1pdm09 vaccine alone. This adjuvanted H1N1pdm09 vaccine was immunogenic and compatible with concurrently administered TIV. Copyright © 2012 Elsevier Ltd. All rights reserved.

23 CFR 751.23 - Concurrent junkyard control and right-of-way projects.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Concurrent junkyard control and right-of-way projects. 751.23 Section 751.23 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RIGHT-OF-WAY AND ENVIRONMENT JUNKYARD CONTROL AND ACQUISITION § 751.23 Concurrent junkyard control and right-of...

23 CFR 751.23 - Concurrent junkyard control and right-of-way projects.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Concurrent junkyard control and right-of-way projects. 751.23 Section 751.23 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RIGHT-OF-WAY AND ENVIRONMENT JUNKYARD CONTROL AND ACQUISITION § 751.23 Concurrent junkyard control and right-of...

23 CFR 751.23 - Concurrent junkyard control and right-of-way projects.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 23 Highways 1 2012-04-01 2012-04-01 false Concurrent junkyard control and right-of-way projects. 751.23 Section 751.23 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RIGHT-OF-WAY AND ENVIRONMENT JUNKYARD CONTROL AND ACQUISITION § 751.23 Concurrent junkyard control and right-of...

23 CFR 751.23 - Concurrent junkyard control and right-of-way projects.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Concurrent junkyard control and right-of-way projects. 751.23 Section 751.23 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RIGHT-OF-WAY AND ENVIRONMENT JUNKYARD CONTROL AND ACQUISITION § 751.23 Concurrent junkyard control and right-of...

To a Higher Degree: Addressing Disparities in College Access with Concurrent Enrollment

ERIC Educational Resources Information Center

Ulate, David Delgado

2011-01-01

Concurrent enrollment--defined as high school students enrolling in college coursework--is increasingly being used as strategy to improve the college readiness levels of underrepresented students and to reduce disparities in college-going rates. States have developed policy and analyzed data to evaluate the practice of concurrent enrollment. This…

Concurrence control for transactions with priorities

NASA Technical Reports Server (NTRS)

Marzullo, Keith

1989-01-01

Priority inversion occurs when a process is delayed by the actions of another process with less priority. With atomic transactions, the concurrency control mechanism can cause delays, and without taking priorities into account can be a source of priority inversion. Three traditional concurrency control algorithms are extended so that they are free from unbounded priority inversion.

76 FR 76037 - Office of the Attorney General; Assumption of Concurrent Federal Criminal Jurisdiction in Certain...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... Office of the Attorney General; Assumption of Concurrent Federal Criminal Jurisdiction in Certain Areas of Indian Country AGENCY: Office of the Attorney General, Department of Justice. ACTION: Final rule... concurrent criminal jurisdiction within the tribe's Indian country, and for the Attorney General to decide...

39 CFR 273.7 - Concurrence of Attorney General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Concurrence of Attorney General. 273.7 Section 273... PROGRAM FRAUD CIVIL REMEDIES ACT § 273.7 Concurrence of Attorney General. (a) The Attorney General is... the Attorney General or his designee approves such action in a written statement which specifies: (1...