Safety and Social Networking: How Can We Maximize the Learning Power of Participatory Web Sites while Ensuring Students Are Protected and Behave Responsibly?

ERIC Educational Resources Information Center

Couros, Alec

2008-01-01

The various scandals around social networking abuses have garnered lots of press in the past couple of years. Predators, bullying, slander, and harassment of all kinds on sites such as MySpace and Facebook are increasingly the subjects of horror stories and play into a renewed wave of fear about the dangers online. However, once the fear of safety…

Suing the doctor: lawsuits by injured workers against the occupational physician.

PubMed

Postol, L P

1989-11-01

Occupational physicians are beginning to learn that they, like other physicians, can be targets for lawsuits. This article attempts to outline the relationship between the workers' compensation system and occupational physicians' personal liability. Consideration is given to potential liability due to malpractice, negligent interference with a workers' contractual relationship with his or her employer, libel and slander, and unauthorized release of information. The requirements of the Occupational Health and Safety Administration for medical examinations and recordkeeping are also highlighted. Finally, the need to clarify the relationship between the doctor, patient/worker, and employer is analyzed. Once the occupational physician recognizes the areas for liability, he or she can take practical steps to minimize his or her exposure.

Exchanging honest employment references: tiptoeing between defamation and negligent hiring.

PubMed

McConnell, Charles R

2007-01-01

In present day reference checking, many of the same organizations that seek as much information as possible about people they wish to hire resist giving out more than a bare minimum of information to other organizations. The strongest force driving this minimal reference information release is fear of legal action taken because of something said about an individual ("defamation," supposedly). Many employers seem so frightened of being sued for libel or slander that they share nothing of substance, usually not realizing that in supposedly protecting themselves against defamation charges, they are increasing the risk of negligent hiring charges. However, truthful reference information can be provided with minimal risk if it is provided in good faith, given only to those who have a legitimate need to know, is strictly job related, and is not communicated maliciously. References must always be provided objectively with information verifiable in personnel files.

Enhancing masculinity by slandering homosexuals: the role of homophobic epithets in heterosexual gender identity.

PubMed

Carnaghi, Andrea; Maass, Anne; Fasoli, Fabio

2011-12-01

The current studies investigate the effects of homophobic labels on the self-perception of heterosexual males, hypothesizing that when exposed to homophobic epithets, they are motivated to underline their masculinity and claim a distinctly heterosexual identity by taking distance from homosexuals and, to a lesser degree, from women. Heterosexual male participants were subliminally (Study 1) and supraliminally (Study 2) primed either by a homophobic epithet or by a category label, and completed the Traditional Beliefs About Gender and Gender Identity scale. Participants stressed their heterosexual identity, but not their gender distinctiveness, when exposed to homophobic epithets, compared to category labels. Study 2 demonstrated that the relation between the homophobic label and the participants' heterosexual identity was mediated by how negatively they reacted to the antigay label. Heterosexual identity was enhanced in reaction to homophobic labels but not to an equally derogatory label referring to regional identity. Results are discussed within an intergroup framework.

Employment references: walking scared between the minefield of defamation and the specter of negligent hiring.

PubMed

McConnell, C R

2000-12-01

In present day reference checking, many of the same organizations that seek as much information as possible about people they wish to hire resist giving out more than a bare minimum of information to other organizations. The strongest force driving this minimal reference information release is fear of legal action taken because of something said about an individual (defamation, supposedly). Many employers appear so frightened of being sued for libel or slander that they share nothing of substance, usually not realizing that in trying to protect themselves against defamation charges they are increasing their legal risk associated with negligent hiring charges. However, truthful reference information can be provided with minimal risk if it is provided in good faith, given only to someone who has a legitimate need to know, is related strictly to job in character, and is not communicated maliciously. Also, reference always must be answered completely objectively with information verifiable in the individual's personnel file.

Sorcery and publicity: the Cadière-Girard scandal of 1730-1731.

PubMed

Kuznicki, Jason T

2007-01-01

The Cadière-Girard trial of 1730-1731 is an early example of a sensational, nationally publicized French trial in which the major parties were private individuals. Cadière, a female penitent, accused Girard, her Jesuit confessor, of bewitching and raping her; Girard claimed that Cadière was guilty of slander. It was to be the last witchcraft trial in the francophone world. Another notable feature of the trial was its publicity, in which the contesting parties almost immediately became stand-ins for the Society of Jesus and for its Jansenist adversaries. This paper argues that certain anti-Jesuits, particularly Cadière's defence team and in the Parlement of Aix-en-Provence, acted to prolong the trial with the aim of creating as much bad publicity as possible for the Society of Jesus; it also shows how Jansenist publicists took advantage of the lengthy process, creating literature that "burned Girard in spirit," and with him, the Jesuits as a whole.

Winged Auxiliaries: Women Pilots in the UK and US during World War Two

NASA Astrophysics Data System (ADS)

Schrader, Helena P.

2006-05-01

During World War II women in the US and the UK were given the then unprecedented opportunity to fly military aircraft. Yet while the women flying in the UK soon gained the privileges and status enjoyed by their male colleagues, the American women pilots were expressly denied the same status, rank, pay, and benefits as USAAF pilots. In fact, after an ugly slander campaign against the women pilots' organisation, the US programme was discontinued and the women were sent home before their job was done. The American women pilots were not less dedicated or inherently less capable than the women flying in Britain. Rather, key environmental and organisational differences and above all a failure of leadership accounts for their fate. This paper summarises the differences and their impact. The complete findings of the comparative research on the experiences of women pilots in the US and the UK during WWII will be published by Pen & Sword Books Inc early in 2006 under the title Sisters in Arms.

26 CFR 521.117 - Claims in cases of double taxation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 19 2010-04-01 2010-04-01 false Claims in cases of double taxation. 521.117...) REGULATIONS UNDER TAX CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents of Denmark and of Danish Corporations § 521.117 Claims in cases of double taxation. Under Article XX...

26 CFR 521.117 - Claims in cases of double taxation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 19 2011-04-01 2010-04-01 true Claims in cases of double taxation. 521.117...) REGULATIONS UNDER TAX CONVENTIONS DENMARK General Income Tax Taxation of Nonresident Aliens Who Are Residents of Denmark and of Danish Corporations § 521.117 Claims in cases of double taxation. Under Article XX...

Double lung point in an 18-month-old child: a case report and literature review

PubMed Central

2015-01-01

Objective Double lung point is a rare sign of pneumothorax in clinical practice. In this report I presented an 18-month-old child who presented with bilateral pneumothorax. Data synthesis and case presentation Ultrasonography examination revealed conventional lung point sign on the right and double lung point on the left side. Thoracentesis was attempted and closed thoracic drainage was performed on the right side, but no gas was drawn on the left side. Clinical implication of double lung point sign found in chest ultrasonography is that the size of pneumothorax is limited and conservative treatment is enough. Conclusions To the best of our knowledge, this is the first case of double lung point identified with ultrasonography in child. The strength of the case is that the double lung point sign is supported by computed tomography (CT). Furthermore, we propose that the presence of double lung point indicates limited pneumothorax and conservative management may well be attempted. PMID:25922750

Impact of inhomogeneity on SH-type wave propagation in an initially stressed composite structure

NASA Astrophysics Data System (ADS)

Saha, S.; Chattopadhyay, A.; Singh, A. K.

2018-02-01

The present analysis has been made on the influence of distinct form of inhomogeneity in a composite structure comprised of double superficial layers lying over a half-space, on the phase velocity of SH-type wave propagating through it. Propagation of SH-type wave in the said structure has been examined in four distinct cases of inhomogeneity viz. when inhomogeneity in double superficial layer is due to exponential variation in density only (Case I); when inhomogeneity in double superficial layers is due to exponential variation in rigidity only (Case II); when inhomogeneity in double superficial layer is due to exponential variation in rigidity, density and initial stress (Case III) and when inhomogeneity in double superficial layer is due to linear variation in rigidity, density and initial stress (Case IV). Closed-form expression of dispersion relation has been accomplished for all four aforementioned cases through extensive application of Debye asymptotic analysis. Deduced dispersion relations for all the cases are found in well-agreement to the classical Love-wave equation. Numerical computation has been carried out to graphically demonstrate the effect of inhomogeneity parameters, initial stress parameters as well as width ratio associated with double superficial layers in the composite structure for each of the four aforesaid cases on dispersion curve. Meticulous examination of distinct cases of inhomogeneity and initial stress in context of considered problem has been carried out with detailed analysis in a comparative approach.

Etiological aspects of double monsters.

PubMed

Jaschevatzky, O E; Goldman, B; Kampf, D; Wexler, H; Grünstein, S

1980-06-01

Four cases of double monsters are reported, including a rare case of craniofacial duplication (diprosopus). Based on the findings observed, etiological factors of these malformations are discussed. We suggest that exogenous (environmental) factors such as habits, way of life or religious practices of certain populations can influence the development of double monsters.

Laparoscopic cholecystectomy in double gallbladder with dual pathology.

PubMed

Ghosh, Sumanta Kumar

2014-04-01

Double gallbladder is a rare embryological anomaly of clinical significance. Despite availability of modern imaging, only 50% of recently reported cases had preoperative diagnosis, which is desirable in every case to avoid serious operative complications. Double pathology in double gallbladder is extremely rare with only 3 reporting's available till date to the best of author's knowledge. With a preoperative diagnosis of double gallbladder, laparoscopic cholecystectomy can be safely and successfully performed with meticulous dissection, aided by operative cholangiogram. However in all such attempts a lower threshold should be kept for conversion to open surgery. Awareness about this anomaly amongst radiologists and surgeons is of crucial importance. Double gallbladder does not present with any specific symptom, neither it increases disease possibility in either lobe. Prophylactic cholecystectomy has no role in asymptomatic cases diagnosed accidentally. Author reports a case of a symptomatic young male with double gallbladder who presented with short history of dyspepsia, abdominal pain and fever. Definite preoperative diagnosis was reached with ultrasound scan and magnetic resonance cholangio pancreatography and subsequently dealt with laparoscopically. Calculous cholecystitis affected one lobe and acalculous empyema the other. While the 1st lobe drained though a cystic duct into common bile duct (CBD), the 2nd was without any communication with either CBD or its counterpart, thus remained as a blind vesicle.

Biomechanical Comparison of Single- Versus Double-Row Capsulolabral Repair for Shoulder Instability: A Review.

PubMed

Yousif, Matthew John; Bicos, James

2017-12-01

The glenohumeral joint is the most commonly dislocated joint in the body. Failure rates of capsulolabral repair have been reported to be approximately 8%. Recent focus has been on restoration of the capsulolabral complex by a double-row capsulolabral repair technique in an effort to decrease redislocation rates after arthroscopic capsulolabral repair. To present a review of the biomechanical literature comparing single- versus double-row capsulolabral repairs and discuss the previous case series of double-row fixation. Narrative review. A simple review of the literature was performed by PubMed search. Only biomechanical studies comparing single- versus double-row capsulolabral repair were included for review. Only those case series and descriptive techniques with clinical results for double-row repair were included in the discussion. Biomechanical comparisons evaluating the native footprint of the labrum demonstrated significantly superior restoration of the footprint through double-row capsulolabral repair compared with single-row repair. Biomechanical comparisons of contact pressure at the repair interface, fracture displacement in bony Bankart lesion, load to failure, and decreased external rotation (suggestive of increased load to failure) were also significantly in favor of double- versus single-row repair. Recent descriptive techniques and case series of double-row fixation have demonstrated good clinical outcomes; however, no comparative clinical studies between single- and double-row repair have assessed functional outcomes. The superiority of double-row capsulolabral repair versus single-row repair remains uncertain because comparative studies assessing clinical outcomes have yet to be performed.

Double pituitary adenomas: six surgical cases.

PubMed

Sano, T; Horiguchi, H; Xu, B; Li, C; Hino, A; Sakaki, M; Kannuki, S; Yamada, S

1999-05-01

While double pituitary adenomas have been found in approximately 1% of autopsy pituitaries, those in surgically resected material have been only rarely reported. We report herein 6 cases of double pituitary adenomas, which consisted of two histologically and/or immunohistochemically different areas among approximately 450 surgical specimens. Five out of 6 patients were men and the age was ranged between 18 and 61 years old. All these 6 patients presented acromegaly or acrogigantism and hyperprolactinemia was noted in 3 patients. In 2 patients (cases 1 and 2) the two adenomas belonged to different adenoma groups (GH-PRL-TSH group and FSH/LH group), while in the remaining 4 patients (cases 3-6) the two adenomas belonged to the same group (GH-PRL-TSH group). Thus, in all patients at least one of the two adenomas was GH-producing adenoma. Reasons for a high incidence of GH-producing adenomas in surgically resected double pituitary adenomas may include the presence of a variety of histologic subtypes among GH-producing adenomas and the advantage of cytokeratin immunostaining to distinguish these subtypes. In regard to pathogenesis of double pituitary adenomas, adenomas in cases 1 and 2 may be of multicentric occurrence, while those in cases 3-6 may occur through different clonal proliferation within originally one adenoma, resulting in diverse phenotypic expressions. Since there were patients with familial MEN 1 (case 2) and familial pituitary adenoma unrelated MEN 1 (case 3), genetic background should be also considered. Double pituitary adenomas in surgically resected material may not be so infrequent. Further molecular analysis will provide new insights into understanding the pathogenesis of pituitary adenomas and their mechanisms of multidirectional phenotypic diffrentiation.

Posterior double PCL sign: a case report of unusual MRI finding of bucket-handle tear of medial meniscus.

PubMed

Yoo, Jae Ho; Hahn, Sung Ho; Yi, Seung Rim; Kim, Seong Wan

2007-11-01

Among the MRI signs of bucket-handle tears of medial meniscus, double posterior cruciate ligament (PCL) sign denotes a low signal band anterior and parallel to the PCL, which looks like another PCL in MR images. If the bucket-handle fragment subsequently tears at the anterior horn, the torn meniscal substance can be displaced to the posterosuperior region of the PCL, and looks like another PCL behind the original PCL. We propose the lesion be called the "posterior double PCL sign" in contrast to the ordinary double PCL sign. We present a case showing the posterior double PCL sign.

The comparation of effects and security of double-J stent retention and ureteroscopy lithotripsy in the treatment of symptomatic ureteral calculi during pregnancy.

PubMed

Tan, Shu-Tao; Chen, Xiaonan; Sun, Ming; Wu, Bin

2018-06-01

To describe the efficacy of double-J stent retention and ureteroscopy lithotripsy, we performed a study to evaluate the management of symptomatic ureteral calculi during pregnancy. From January 2005 and June 2015, 53 pregnant women with symptomatic ureteral calculi were admitted and treated in our hospital. According to the treatment techniques, there were divided into two groups: double-J stent retention group (30 cases) and ureteroscopy lithotripsy group (23 cases). We collected the characteristics and treatment outcome of the patients. Double-J stent retention was performed on 30 patients. And the stents were successfully inserted in 25 patients (83.3%). 4 cases got complication in double-J group (16%). The mean operating time, medical cost and hospitalization time of double-J group were 20.6 min, 1632 yuan and 1.3 days. Ureteroscopy lithotripsy was performed on 23 patients. 20 patients were operated successfully (87.0%). 2 cases got complication in ureteroscopy group (10.0%). The mean operating time, medical cost and hospitalization time of ureteroscopy group were 41.5 min, 2792 yuan and 6.0 days. In summary, both double-J stent retention and ureteroscopy lithotripsy are effective and safe in the managation of ureteral calculi during pregnancy. Copyright © 2018 Elsevier B.V. All rights reserved.

Clinicopathological and genomic analysis of double-hit follicular lymphoma: comparison with high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements.

PubMed

Miyaoka, Masashi; Kikuti, Yara Y; Carreras, Joaquim; Ikoma, Haruka; Hiraiwa, Shinichiro; Ichiki, Akifumi; Kojima, Minoru; Ando, Kiyoshi; Yokose, Tomoyuki; Sakai, Rika; Hoshikawa, Masahiro; Tomita, Naoto; Miura, Ikuo; Takata, Katsuyoshi; Yoshino, Tadashi; Takizawa, Jun; Bea, Silvia; Campo, Elias; Nakamura, Naoya

2018-02-01

Most high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements are aggressive B-cell lymphomas. Occasional double-hit follicular lymphomas have been described but the clinicopathological features of these tumors are not well known. To clarify the characteristics of double-hit follicular lymphomas, we analyzed 10 cases of double-hit follicular lymphomas and 15 cases of high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements for clinicopathological and genome-wide copy-number alterations and copy-neutral loss-of-heterozygosity profiles. For double-hit follicular lymphomas, the median age was 67.5 years (range: 48-82 years). The female/male ratio was 2.3. Eight patients presented with advanced clinical stage. The median follow-up time was 20 months (range: 1-132 months). At the end of the follow-up, 8 patients were alive, 2 patients were dead including 1 patient with diffuse large B-cell lymphoma transformation. Rearrangements of MYC/BCL2, MYC/BCL6, and MYC/BCL2/BCL6 were seen in 8, 1, and 1 cases, respectively. The partner of MYC was IGH in 6 cases. There were no cases of histological grade 1, 4 cases of grade 2, 5 cases of grade 3a, and 1 case of grade 3b. Two cases of grade 3a exhibited immunoblast-like morphology. Immunohistochemistry demonstrated 9 cases with ≥50% MYC-positive cells. There was significant difference in MYC intensity (P=0.00004) and MIB-1 positivity (P=0.001) between double-hit follicular lymphomas and high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements. The genome profile of double-hit follicular lymphomas was comparable with conventional follicular lymphomas (GSE67385, n=198) with characteristic gains of 2p25.3-p11.1, 7p22.3-q36.3, 12q11-q24.33, and loss of 18q21.32-q23 (P<0.05). In comparison with high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements, double-hit follicular lymphomas had fewer copy-number alterations and minimal common region of gain at 2p16.1 (70%), locus also significant against conventional follicular lymphomas (P=0.0001). In summary, double-hit follicular lymphomas tended to be high-grade histology, high MYC protein expression, high MYC/IGH fusion, and minimal common region of gain at 2p16.1. Double-hit follicular lymphomas seemed to be a different disease from high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 rearrangements and have an indolent clinical behavior similar to follicular lymphomas without MYC rearrangement.

ERP evidence for different strategies in the processing of case markers in native speakers and non-native learners

PubMed Central

Mueller, Jutta L; Hirotani, Masako; Friederici, Angela D

2007-01-01

Background The present experiments were designed to test how the linguistic feature of case is processed in Japanese by native and non-native listeners. We used a miniature version of Japanese as a model to compare sentence comprehension mechanisms in native speakers and non-native learners who had received training until they had mastered the system. In the first experiment we auditorily presented native Japanese speakers with sentences containing incorrect double nominatives and incorrect double accusatives, and with correct sentences. In the second experiment we tested trained non-natives with the same material. Based on previous research in German we expected an N400-P600 biphasic ERP response with specific modulations depending on the violated case and whether the listeners were native or non-native. Results For native Japanese participants the general ERP response to the case violations was an N400-P600 pattern. Double accusatives led to an additional enhancement of the P600 amplitude. For the learners a native-like P600 was present for double accusatives and for double nominatives. The additional negativity, however, was present in learners only for double nominative violations, and it was characterized by a different topographical distribution. Conclusion The results indicate that native listeners use case markers for thematic as well as syntactic structure building during incremental sentence interpretation. The modulation of the P600 component for double accusatives possibly reflects case specific syntactic restrictions in Japanese. For adult language learners later processes, as reflected in the P600, seem to be more native-like compared to earlier processes. The anterior distribution of the negativity and its selective emergence for canonical sentences were taken to suggest that the non-native learners resorted to a rather formal processing strategy whereby they relied to a large degree on the phonologically salient nominative case marker. PMID:17331265

Biomechanical Comparison of Single- Versus Double-Row Capsulolabral Repair for Shoulder Instability: A Review

PubMed Central

Yousif, Matthew John; Bicos, James

2017-01-01

Background: The glenohumeral joint is the most commonly dislocated joint in the body. Failure rates of capsulolabral repair have been reported to be approximately 8%. Recent focus has been on restoration of the capsulolabral complex by a double-row capsulolabral repair technique in an effort to decrease redislocation rates after arthroscopic capsulolabral repair. Purpose: To present a review of the biomechanical literature comparing single- versus double-row capsulolabral repairs and discuss the previous case series of double-row fixation. Study Design: Narrative review. Methods: A simple review of the literature was performed by PubMed search. Only biomechanical studies comparing single- versus double-row capsulolabral repair were included for review. Only those case series and descriptive techniques with clinical results for double-row repair were included in the discussion. Results: Biomechanical comparisons evaluating the native footprint of the labrum demonstrated significantly superior restoration of the footprint through double-row capsulolabral repair compared with single-row repair. Biomechanical comparisons of contact pressure at the repair interface, fracture displacement in bony Bankart lesion, load to failure, and decreased external rotation (suggestive of increased load to failure) were also significantly in favor of double- versus single-row repair. Recent descriptive techniques and case series of double-row fixation have demonstrated good clinical outcomes; however, no comparative clinical studies between single- and double-row repair have assessed functional outcomes. Conclusion: The superiority of double-row capsulolabral repair versus single-row repair remains uncertain because comparative studies assessing clinical outcomes have yet to be performed. PMID:29230427

[Efficacy of double balloon enteroscopy for patients with intestinal lymphangiectasia, case report of primary intestinal lymphangiectasia].

PubMed

Yakami, Yoshikazu; Watanabe, Kenji; Kameda, Natsuhiko; Machida, Hirohisa; Okazaki, Hirotoshi; Yamagami, Hirokazu; Shiba, Masatsugu; Fujiwara, Yasuhiro; Oshitani, Nobuhide; Arakawa, Tetsuo

2008-11-01

A 31-year-old man has visited our hospital, complaining diarrhea and leg edema. Blood test showed hypoalbuminea, but we couldn't find the reason by several examinations. Therefore, we performed double balloon enteroscopy, and intestinal lymphangiectasia was diagnosed histologically by biopsy. It's useful and effective to perform double balloon enteroscopy and histological examination for the unknown origin case of protein loosing enteropathy.

Isolated double adrenocorticotropic hormone-secreting pituitary adenomas: A case report and review of the literature

PubMed Central

PU, JIUJUN; WANG, ZHIMING; ZHOU, HUI; ZHONG, AILING; JIN, KAI; RUAN, LUNLIANG; YANG, GANG

2016-01-01

Only a few cases of double or multiple pituitary adenomas have previously been reported in the literature; however, isolated double adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas are even more rare. The present study reports a rare case of a 50-year-old female patient who presented with typical clinical features of Cushing's disease and was diagnosed with isolated double ACTH-secreting pituitary adenomas. Endocrinological examination revealed an ACTH-producing pituitary adenoma, and preoperative magnetic resonance imaging (MRI) demonstrated a microadenoma with a lower intensity on the right side of the pituitary gland. The patient underwent endoscopic endonasal transsphenoidal surgery, which revealed another pituitary tumor in the left side of the pituitary gland. The two, clearly separated, pituitary adenomas identified in the same gland were completely resected. Immunohistochemistry and pathology revealed that the clearly separated double pituitary adenomas were positive for ACTH, thyroid-stimulating, growth and prolactin hormones. Postoperatively, the levels of ACTH and cortisol hormone decreased rapidly. The case reported in the present study is considerably rare, due to the presence of a second pituitary adenoma in the same gland, which was not detected by preoperative MRI scan, but was noticed during surgery. Intraoperative evaluation may be important in the identification of double or multiple pituitary adenomas. PMID:27347184

Detection of microinvasion in vulvar and cervical intraepithelial neoplasia using double immunostaining for cytokeratin and basement membrane components.

PubMed

Rush, Demaretta; Hyjek, Elizabeth; Baergen, Rebecca N; Ellenson, Lora H; Pirog, Edyta C

2005-06-01

Identification of early invasion in vulvar intraepithelial neoplasia 3 (VIN 3) and cervical intraepithelial neoplasia 3 (CIN 3) may be difficult with the use of routine hematoxylin-eosin staining. Presence of obscuring inflammation and tangential tissue sectioning are the most common diagnostic pitfalls. To examine the utility of double immunostaining for cytokeratin-collagen IV or cytokeratin-laminin in the detection of early invasion in VIN 3 and CIN 3. The study group consisted of 10 cases of "VIN 3, suspicious for invasion" and 10 cases of "CIN 3, suspicious for invasion." The negative control group consisted of VIN 3 (n = 15) and CIN 3 (n = 10). The positive control group consisted of cases of invasive vulvar carcinoma (n = 11) and invasive cervical carcinoma (n = 25). All cases were double immunostained for cytokeratin and collagen IV and, in a separate reaction, for cytokeratin and laminin. The continuity of the basement membrane and the presence of stromal invasion were assessed in the stained sections. The staining for collagen IV and laminin yielded identical results. A well-defined, continuous basement membrane was visualized in all cases of VIN 3 and CIN 3. A discontinuous or absent basement membrane was observed around the malignant cells on the invasive tumor front in all cases of vulvar and cervical carcinoma. In 2 of 10 cases of VIN 3, suspicious for invasion and in 4 of 10 cases of CIN 3, suspicious for invasion definitive foci of microinvasion were identified with the use of double immunostaining. A well-defined, continuous basement membrane was present in the remaining cases "suspicious for invasion." Double immunostaining for cytokeratin- collagen IV or cytokeratin-laminin is useful for evaluation of early invasion in equivocal cases of VIN 3 and CIN 3.

Numerical Investigation of Double-Cone Flows with High Enthalpy Effects

NASA Astrophysics Data System (ADS)

Nompelis, I.; Candler, G. V.

2009-01-01

A numerical study of shock/shock and shock/boundary layer interactions generated by a double-cone model that is placed in a hypersonic free-stream is presented. Computational results are compared with the experimental measurements made at the CUBRC LENS facility for nitrogen flows at high enthalpy conditions. The CFD predictions agree well with surface pressure and heat-flux measurements for all but one of the double-cone cases that have been studied by the authors. Unsteadiness is observed in computations of one of the LENS cases, however for this case the experimental measurements show that the flowfield is steady. To understand this discrepancy, several double-cone experiments performed in two different facilities with both air and nitrogen as the working gas are examined in the present study. Computational results agree well with measurements made in both the AEDC tunnel 9 and the CUBRC LENS facility for double-cone flows at low free-stream Reynolds numbers where the flow is steady. It is shown that at higher free- stream pressures the double-cone simulations develop instabilities that result in an unsteady separation.

Oesophageal foreign body and a double aortic arch: rare dual pathology.

PubMed

O'Connor, T E; Cooney, T

2009-12-01

We report the rare case of an oesophageal foreign body which lodged above the site of oesophageal compression by a double aortic arch. Case report and a review of the literature surrounding the classification, embryology, diagnosis and management of vascular rings and slings. An eight-month-old male infant presented with symptoms of tracheal compression following ingestion of an oesophageal foreign body. Following removal of the oesophageal foreign body, the infant's symptoms improved initially. However, subsequent recurrence of respiratory symptoms lead to a repeat bronchoscopy and the diagnosis of a coexisting double aortic arch, causing tracheal and oesophageal compression. To our knowledge, this is only the second reported case of a double aortic arch being diagnosed in a patient following removal of an oesophageal foreign body.

Double Gallbladder Originating from Left Hepatic Duct: A Case Report and Review of Literature

PubMed Central

Gorecki, Piotr J.; Andrei, Valeriu E; Musacchio, Tito

1998-01-01

Background: Double gallbladder is a rare anomaly of the biliary tract. Double gallbladder arising from the left hepatic duct was previously reported only once in the literature. Case Report: A case of symptomatic cholelithiasis in a double gallbladder, diagnosed on preoperative ultrasound, computed tomography (CT) and endoscopic retrograde cholangiopancreatogram (ERCP) is reported. At laparoscopic cholangiography via the accessory gallbladder no accessory cystic duct was visualized. After conversion to open cholecystectomy, the duplicated gallbladder was found to arise directly from the left hepatic duct; it was resected and the duct repaired. Conclusions: We emphasize that a careful intraoperative cholangiographic evaluation of the accessory gallbladder is mandatory in order to prevent inadvertent injury to bile ducts, since a large variety of ductal abnormality may exist. PMID:10036124

Detection of colorectal carcinoma on double contrast barium enema when double reporting is routinely performed: an audit of current practice.

PubMed

Leslie, A; Virjee, J P

2002-03-01

To determine the sensitivity of double contrast barium enema (DCBE) in the detection of colorectal carcinoma (CRC) when double reporting is routinely performed. Over a 1-year period all patients with a diagnosis of CRC within a large teaching hospital were identified. Using computer records, any patient with CRC who had had a DCBE within 5 years of diagnosis was identified. During this time period all DCBE were double reported by the radiographer or radiology trainee who performed the enema and by a consultant radiologist specializing in gastrointestinal radiology. Over the 1-year period 169 patients were identified with a diagnosis of CRC. Seventy patients had had a DCBE within the preceding 5 years. Sixty-four patients had had CRC diagnosed on the DCBE. One patient had a sessile polyp diagnosed, which was removed at colonoscopy and found to be an invasive adenocarcinoma. In five cases (7%) the CRC was not diagnosed on DCBE. In three cases the lesions could be seen retrospectively, in one case the lesion could not be seen and in one case the examination had been incomplete. In our series the miss-rate for CRC was 7%. Previous studies have shown miss-rates of 15-24%. These studies have not routinely employed double reporting. Our results suggest that double reporting of DCBE significantly reduces the miss-rate and that this reduction is due to fewer perceptive errors. Copyright 2002 The Royal College of Radiologists.

Advanced Amine Solvent Formulations and Process Integration for Near-Term CO2 Capture Success

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

Fisher, Kevin S.; Searcy, Katherine; Rochelle, Gary T.

2007-06-28

This Phase I SBIR project investigated the economic and technical feasibility of advanced amine scrubbing systems for post-combustion CO2 capture at coal-fired power plants. Numerous combinations of advanced solvent formulations and process configurations were screened for energy requirements, and three cases were selected for detailed analysis: a monoethanolamine (MEA) base case and two “advanced” cases: an MEA/Piperazine (PZ) case, and a methyldiethanolamine (MDEA) / PZ case. The MEA/PZ and MDEA/PZ cases employed an advanced “double matrix” stripper configuration. The basis for calculations was a model plant with a gross capacity of 500 MWe. Results indicated that CO2 capture increased themore » base cost of electricity from 5 cents/kWh to 10.7 c/kWh for the MEA base case, 10.1 c/kWh for the MEA / PZ double matrix, and 9.7 c/kWh for the MDEA / PZ double matrix. The corresponding cost per metric tonne CO2 avoided was 67.20 $/tonne CO2, 60.19 $/tonne CO2, and 55.05 $/tonne CO2, respectively. Derated capacities, including base plant auxiliary load of 29 MWe, were 339 MWe for the base case, 356 MWe for the MEA/PZ double matrix, and 378 MWe for the MDEA / PZ double matrix. When compared to the base case, systems employing advanced solvent formulations and process configurations were estimated to reduce reboiler steam requirements by 20 to 44%, to reduce derating due to CO2 capture by 13 to 30%, and to reduce the cost of CO2 avoided by 10 to 18%. These results demonstrate the potential for significant improvements in the overall economics of CO2 capture via advanced solvent formulations and process configurations.« less

MYC/BCL2/BCL6 triple hit lymphoma: a study of 40 patients with a comparison to MYC/BCL2 and MYC/BCL6 double hit lymphomas.

PubMed

Huang, Wenting; Medeiros, L Jeffrey; Lin, Pei; Wang, Wei; Tang, Guilin; Khoury, Joseph; Konoplev, Sergej; Yin, C Cameron; Xu, Jie; Oki, Yasuhiro; Li, Shaoying

2018-05-21

High-grade B-cell lymphomas with MYC, BCL2, and BCL6 rearrangements (triple hit lymphoma) are uncommon. We studied the clinicopathologic features of 40 patients with triple hit lymphoma and compared them to 157 patients with MYC/BCL2 double hit lymphoma and 13 patients with MYC/BCL6 double hit lymphoma. The triple hit lymphoma group included 25 men and 15 women with a median age of 61 years (range, 34-85). Nine patients had a history of B-cell lymphoma. Histologically, 23 (58%) cases were diffuse large B-cell lymphoma and 17 cases had features of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Most cases of triple hit lymphoma were positive for CD10 (100%), BCL2 (95%), BCL6 (82%), MYC (74%), and 71% with MYC and BCL2 coexpression. P53 was overexpressed in 29% of triple hit lymphoma cases. The clinicopathological features of triple hit lymphoma patients were similar to patients with MYC/BCL2 and MYC/BCL6 double hit lymphoma, except that triple hit lymphoma cases were more often CD10 positive compared with MYC/BCL6 double hit lymphoma (p < 0.05). Induction chemotherapy used was similar for patients with triple hit lymphoma and double hit lymphoma and overall survival in triple hit lymphoma patients was 17.6 months, similar to the overall survival of patients with double hit lymphoma (p = 0.67). Patients with triple hit lymphoma showing P53 overexpression had significantly worse overall survival compared with those without P53 overexpression (p = 0.04). On the other hand, double expressor status and prior history of B-cell lymphoma did not correlate with overall survival. In conclusion, most patients with triple hit lymphoma have an aggressive clinical course and poor prognosis and these tumors have a germinal center B-cell immunophenotype, similar to patients with double hit lymphomas. P53 expression is a poor prognostic factor in patients with triple hit lymphoma.

A case of complete double aortic arch visualized by transthoracic echocardiography.

PubMed

Saito, Naka; Kato, Shingo; Saito, Noritaka; Nakachi, Tatsuya; Fukui, Kazuki; Iwasawa, Tae; Kosuge, Masami; Kimura, Kazuo

2017-08-01

A case of double aortic arch that was well visualized using transthoracic echocardiography is reported. A 38-year-old man underwent transthoracic echocardiography for the evaluation of dyspnea. A suprasternal view of transthoracic echocardiography showed the ascending aorta bifurcate to left and right aortic arches, with blood flow from the ascending aorta to bilateral aortic arches. The diagnosis of right side-dominant double aortic arch was made, and the patient's symptom was conceivably related to compression of the trachea due to a vascular ring. This report indicates the potential usefulness of transthoracic echocardiography for noninvasive detection of double aortic arch in adults. © 2017, Wiley Periodicals, Inc.

Rare transformation to double hit lymphoma in Waldenstrom's macroglobulinemia.

PubMed

Okolo, Onyemaechi N; Johnson, Ariel C; Yun, Seongseok; Arnold, Stacy J; Anwer, Faiz

2017-08-01

Waldenström macroglobulinemia (WM) is a lymphoproliferative lymphoma that is characterized by monoclonal immunoglobulin M (IgM) protein and bone marrow infiltration. Its incidence is rare and rarer still is its ability to transform to a B-cell lymphoma, particularly the aggressive diffuse large B-cell lymphoma, which bodes a poor prognosis. When transformation includes mutations of MYC, BCL-2 and/or BCL-6, it is known as a 'double hit' or 'triple hit' lymphoma respectively. This paper presents a rare case of WM with mutations positive for MYC and BCL2, making it a case of double hit B-cell lymphoplasmacytic lymphoma with plasmatic differentiation without morphological transformation to aggressive histology like DLBCL. The paper also broadens to include discussions on current topics in the classification, diagnosis, possible causes of transformation, and treatment of WM, including transformation to double hit lymphoma. The significance of this case lies in that the presence of double hit lymphoma-like genetic mutations in WM have not been previously described in the literature and potentially such changes are harbinger of extra-nodal presentation, aggressive growth, and possibly poor prognosis, if data from other double-hit lymphoma are extrapolated.

Placental Histomorphology in a Case of Double Trisomy 48,XXX,+18

PubMed Central

2018-01-01

Background Approximately 50% of early spontaneous abortions are found to have chromosomal abnormalities. In these cases, certain histopathologic abnormalities are suggestive of, although not diagnostic for, the presence of chromosomal abnormalities. However, placental histomorphology in cases of complex chromosomal abnormalities, including double trisomies, is virtually unknown. Case Report We present the case of a 27-year-old G3P22002 female presenting at 19 weeks and 1 day of gestation by last menstrual period for scheduled prenatal visit. Ultrasound revealed a single fetus without heart tones and adequate amniotic fluid. Limited fetal measurements were consistent with estimated gestational age of 17 weeks. Labor was induced with misoprostol due to fetal demise. Autopsy revealed an immature female fetus with grade 1-2 maceration. The ears were low-set and posteriorly rotated. The fingers were short bilaterally, and the right foot showed absence of the second and third digits. Evaluation of the organs showed predominantly marked autolysis consistent with retained stillbirth. Placental examination revealed multiple findings, including focal pseudovillous papilliform trophoblastic proliferation of the undersurface of the chorionic plate and clustering of perpendicularly oriented sclerotic chorionic villi in the chorion laeve, which have not been previously reported in cases of chromosomal abnormalities. Karyotype of placental tissue revealed a 48,XXX,+18 karyotype and the same double trisomy of fetal thymic tissue by FISH. Conclusion In addition to convoluted outlines of chorionic villi, villous trophoblastic pseudoinclusions, and clusters of villous cytotrophoblasts, the previously unreported focal pseudovillous papilliform trophoblastic proliferation of the undersurface of the chorionic plate and clustering of perpendicularly oriented sclerotic chorionic villi in the chorion laeve were observed in this double trisomy case. More cases have to be examined to show if the histology is specific for this double trisomy. PMID:29707399

Esthetic management of a primary double tooth using a silicone putty guide: a case report.

PubMed

Agarwal, Ravi; Chaudhry, Kalpna; Yeluri, Ramakrishna; Munshi, Autar Krishen

2013-03-01

The term double tooth is often used to describe fusion and gemination. The development of isolated large or joined teeth is not rare, but the literature is confusing when the appropriate terminology is presented. The objective of this paper is to present a case of a primary double tooth in a 5-year-old girl with a history of trauma. The tooth was endodontically treated and esthetic management was carried out using a silicone putty guide.

A fully redundant double difference algorithm for obtaining minimum variance estimates from GPS observations

NASA Technical Reports Server (NTRS)

Melbourne, William G.

1986-01-01

In double differencing a regression system obtained from concurrent Global Positioning System (GPS) observation sequences, one either undersamples the system to avoid introducing colored measurement statistics, or one fully samples the system incurring the resulting non-diagonal covariance matrix for the differenced measurement errors. A suboptimal estimation result will be obtained in the undersampling case and will also be obtained in the fully sampled case unless the color noise statistics are taken into account. The latter approach requires a least squares weighting matrix derived from inversion of a non-diagonal covariance matrix for the differenced measurement errors instead of inversion of the customary diagonal one associated with white noise processes. Presented is the so-called fully redundant double differencing algorithm for generating a weighted double differenced regression system that yields equivalent estimation results, but features for certain cases a diagonal weighting matrix even though the differenced measurement error statistics are highly colored.

Multicenter comparison of double-balloon enteroscopy and spiral enteroscopy.

PubMed

Rahmi, Gabriel; Samaha, Elia; Vahedi, Kouroche; Ponchon, Thierry; Fumex, Fabien; Filoche, Bernard; Gay, Gerard; Delvaux, Michel; Lorenceau-Savale, Camille; Malamut, Georgia; Canard, Jean-Marc; Chatellier, Gilles; Cellier, Christophe

2013-06-01

Spiral enteroscopy is a novel technique for small bowel exploration. The aim of this study is to compare double-balloon and spiral enteroscopy in patients with suspected small bowel lesions. Patients with suspected small bowel lesion diagnosed by capsule endoscopy were prospectively included between September 2009 and December 2010 in five tertiary-care academic medical centers. After capsule endoscopy, 191 double-balloon enteroscopy and 50 spiral enteroscopies were performed. Indications were obscure gastrointestinal bleeding in 194 (80%) of cases. Lesions detected by capsule endoscopy were mainly angioectasia. Double-balloon and spiral enteroscopy resulted in finding one or more lesions in 70% and 75% of cases, respectively. The mean diagnosis procedure time and the average small bowel explored length during double-balloon and spiral enteroscopy were, respectively, 60 min (45-80) and 55 min (45-80) (P=0.74), and 200 cm (150-300) and 220 cm (200-300) (P=0.13). Treatment during double-balloon and spiral enteroscopy was possible in 66% and 70% of cases, respectively. There was no significant major procedure-related complication. Spiral enteroscopy appears as safe as double-balloon enteroscopy for small bowel exploration with a similar diagnostic and therapeutic yield. Comparison between the two procedures in terms of duration and length of small bowel explored is slightly in favor of spiral enteroscopy but not significantly. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Double aortic arch presenting with a foreign object in the oesophagus: a case report and imaging diagnosis.

PubMed

Yang, Xiuzhen; Ye, Jingjing; Gao, Zhan

2017-10-01

In this article, we report a rare case of double aortic arch. The case presented initially with a foreign object in the oesophagus. The patient was a 2-year-old boy, who was referred with primary symptoms of tussis (15 days) and emesis (2 days). He had a history of ingesting a coin. Routine chest X-ray indicated a rounded, metal foreign object in the upper oesophagus. A half-Yuan coin was removed by gastroduodenoscopy. Echocardiographic imaging suggested that the patient had double aortic arch, which was subsequently diagnosed by CT angiography with three-dimensional reconstruction. The right subclavian artery arose from the right loop of the double aortic arch. The left subclavian artery as well as left and right common carotid arteries had distinct origins from the left aortic arch. Imaging also indicated atresia of the distal left arch. The patient underwent corrective surgery and made a full recovery. Despite the rarity, double aortic arch should be considered when patients present with a foreign object in the oesophagus. Echocardiography and CT angiography can inform the diagnosis.

Placental Histomorphology in a Case of Double Trisomy 48,XXX,+18.

PubMed

Shah, Sujal I; Dyer, Lisa; Stanek, Jerzy

2018-01-01

Approximately 50% of early spontaneous abortions are found to have chromosomal abnormalities. In these cases, certain histopathologic abnormalities are suggestive of, although not diagnostic for, the presence of chromosomal abnormalities. However, placental histomorphology in cases of complex chromosomal abnormalities, including double trisomies, is virtually unknown. We present the case of a 27-year-old G3P22002 female presenting at 19 weeks and 1 day of gestation by last menstrual period for scheduled prenatal visit. Ultrasound revealed a single fetus without heart tones and adequate amniotic fluid. Limited fetal measurements were consistent with estimated gestational age of 17 weeks. Labor was induced with misoprostol due to fetal demise. Autopsy revealed an immature female fetus with grade 1-2 maceration. The ears were low-set and posteriorly rotated. The fingers were short bilaterally, and the right foot showed absence of the second and third digits. Evaluation of the organs showed predominantly marked autolysis consistent with retained stillbirth. Placental examination revealed multiple findings, including focal pseudovillous papilliform trophoblastic proliferation of the undersurface of the chorionic plate and clustering of perpendicularly oriented sclerotic chorionic villi in the chorion laeve, which have not been previously reported in cases of chromosomal abnormalities. Karyotype of placental tissue revealed a 48,XXX,+18 karyotype and the same double trisomy of fetal thymic tissue by FISH. In addition to convoluted outlines of chorionic villi, villous trophoblastic pseudoinclusions, and clusters of villous cytotrophoblasts, the previously unreported focal pseudovillous papilliform trophoblastic proliferation of the undersurface of the chorionic plate and clustering of perpendicularly oriented sclerotic chorionic villi in the chorion laeve were observed in this double trisomy case. More cases have to be examined to show if the histology is specific for this double trisomy.

Building America Case Study: Monitoring of Double Stud Wall Moisture Conditions in the Northeast, Devens, Massachusetts (Fact Sheet)

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

Not Available

2015-03-01

Double-stud walls insulated with cellulose or low-density spray foam can have R-values of 40 or higher. However, double stud walls have a higher risk of interior-sourced condensation moisture damage, when compared with high-R approaches using exterior insulating sheathing. Moisture conditions in double stud walls were monitored in Zone 5A (Massachusetts); three double stud assemblies were compared.

Deformed quantum double realization of the toric code and beyond

NASA Astrophysics Data System (ADS)

Padmanabhan, Pramod; Ibieta-Jimenez, Juan Pablo; Bernabe Ferreira, Miguel Jorge; Teotonio-Sobrinho, Paulo

2016-09-01

Quantum double models, such as the toric code, can be constructed from transfer matrices of lattice gauge theories with discrete gauge groups and parametrized by the center of the gauge group algebra and its dual. For general choices of these parameters the transfer matrix contains operators acting on links which can also be thought of as perturbations to the quantum double model driving it out of its topological phase and destroying the exact solvability of the quantum double model. We modify these transfer matrices with perturbations and extract exactly solvable models which remain in a quantum phase, thus nullifying the effect of the perturbation. The algebra of the modified vertex and plaquette operators now obey a deformed version of the quantum double algebra. The Abelian cases are shown to be in the quantum double phase whereas the non-Abelian phases are shown to be in a modified phase of the corresponding quantum double phase. These are illustrated with the groups Zn and S3. The quantum phases are determined by studying the excitations of these systems namely their fusion rules and the statistics. We then go further to construct a transfer matrix which contains the other Z2 phase namely the double semion phase. More generally for other discrete groups these transfer matrices contain the twisted quantum double models. These transfer matrices can be thought of as being obtained by introducing extra parameters into the transfer matrix of lattice gauge theories. These parameters are central elements belonging to the tensor products of the algebra and its dual and are associated to vertices and volumes of the three dimensional lattice. As in the case of the lattice gauge theories we construct the operators creating the excitations in this case and study their braiding and fusion properties.

Occurrence and Nature of Double Alleles in Variable-Number Tandem-Repeat Patterns of More than 8,000 Mycobacterium tuberculosis Complex Isolates in The Netherlands

PubMed Central

Kamst, Miranda; van Hunen, Rianne; de Zwaan, Carolina Catherina; Mulder, Arnout; Supply, Philip; Anthony, Richard; van der Hoek, Wim; van Soolingen, Dick

2017-01-01

ABSTRACT Since 2004, variable-number tandem-repeat (VNTR) typing of Mycobacterium tuberculosis complex isolates has been applied on a structural basis in The Netherlands to study the epidemiology of tuberculosis (TB). Although this technique is faster and technically less demanding than the previously used restriction fragment length polymorphism (RFLP) typing, reproducibility remains a concern. In the period from 2004 to 2015, 8,532 isolates were subjected to VNTR typing in The Netherlands, with 186 (2.2%) of these exhibiting double alleles at one locus. Double alleles were most common in loci 4052 and 2163b. The variables significantly associated with double alleles were urban living (odds ratio [OR], 1.503; 95% confidence interval [CI], 1.084 to 2.084; P = 0.014) and pulmonary TB (OR, 1.703; 95% CI, 1.216 to 2.386; P = 0.002). Single-colony cultures of double-allele strains were produced and revealed single-allele profiles; a maximum of five single nucleotide polymorphisms (SNPs) was observed between the single- and double-allele isolates from the same patient when whole-genome sequencing (WGS) was applied. This indicates the presence of two bacterial populations with slightly different VNTR profiles in the parental population, related to genetic drift. This observation is confirmed by the fact that secondary cases from TB source cases with double-allele isolates sometimes display only one of the two alleles present in the source case. Double alleles occur at a frequency of 2.2% in VNTR patterns in The Netherlands. They are caused by biological variation rather than by technical aberrations and can be transmitted either as single- or double-allele variants. PMID:29142049

46 CFR 153.250 - Double-bottom and deep tanks as cargo tanks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 5 2011-10-01 2011-10-01 false Double-bottom and deep tanks as cargo tanks. 153.250... Equipment Cargo Tanks § 153.250 Double-bottom and deep tanks as cargo tanks. Except in those cases in which Commandant (CG-522) specifically approves another arrangement, such as a double-bottom or deep tank as a...

46 CFR 153.250 - Double-bottom and deep tanks as cargo tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 5 2013-10-01 2013-10-01 false Double-bottom and deep tanks as cargo tanks. 153.250... Equipment Cargo Tanks § 153.250 Double-bottom and deep tanks as cargo tanks. Except in those cases in which Commandant (CG-ENG) specifically approves another arrangement, such as a double-bottom or deep tank as a...

46 CFR 153.250 - Double-bottom and deep tanks as cargo tanks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Double-bottom and deep tanks as cargo tanks. 153.250... Equipment Cargo Tanks § 153.250 Double-bottom and deep tanks as cargo tanks. Except in those cases in which Commandant (CG-522) specifically approves another arrangement, such as a double-bottom or deep tank as a...

46 CFR 153.250 - Double-bottom and deep tanks as cargo tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 5 2014-10-01 2014-10-01 false Double-bottom and deep tanks as cargo tanks. 153.250... Equipment Cargo Tanks § 153.250 Double-bottom and deep tanks as cargo tanks. Except in those cases in which Commandant (CG-ENG) specifically approves another arrangement, such as a double-bottom or deep tank as a...

46 CFR 153.250 - Double-bottom and deep tanks as cargo tanks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 5 2012-10-01 2012-10-01 false Double-bottom and deep tanks as cargo tanks. 153.250... Equipment Cargo Tanks § 153.250 Double-bottom and deep tanks as cargo tanks. Except in those cases in which Commandant (CG-ENG) specifically approves another arrangement, such as a double-bottom or deep tank as a...

Endodontic treatment and esthetic management of a primary double tooth with direct composite using silicone buildup guide.

PubMed

Kulkarni, Vinaya Kumar; Ragavendra, T Raju; Deshmukh, Jeevanand; Vanka, Amit; Duddu, Mahesh Kumar; Patil, Anand Kumar G

2012-04-01

Gemination and fusion are morphological dental anomalies, characterized by the formation of a clinically wide tooth. Gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite. The terms double teeth, double formation, conjoined teeth, geminifusion, vicinifusion and dental twinning are often used to describe fusion and gemination. Double teeth are associated with clinical problems such as poor esthetics, spacing problems and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This report presents a case of primary double tooth in a 6-year-old boy involving maxillary left central incisor. The anomalous tooth was carious and pulpally involved. This was treated conservatively by endodontic treatment and esthetic rehabilitation was done with direct composite restoration using a silicone buildup guide. The treated tooth was followed up until exfoliation.

Endodontic treatment and esthetic management of a primary double tooth with direct composite using silicone buildup guide

PubMed Central

Kulkarni, Vinaya Kumar; Ragavendra, T. Raju; Deshmukh, Jeevanand; Vanka, Amit; Duddu, Mahesh Kumar; Patil, Anand Kumar G.

2012-01-01

Gemination and fusion are morphological dental anomalies, characterized by the formation of a clinically wide tooth. Gemination occurs when one tooth bud tries to divide, while fusion occurs if two buds unite. The terms double teeth, double formation, conjoined teeth, geminifusion, vicinifusion and dental twinning are often used to describe fusion and gemination. Double teeth are associated with clinical problems such as poor esthetics, spacing problems and caries susceptibility. Management of such cases requires a comprehensive knowledge of the clinical entity as well as the problems associated with it. This report presents a case of primary double tooth in a 6-year-old boy involving maxillary left central incisor. The anomalous tooth was carious and pulpally involved. This was treated conservatively by endodontic treatment and esthetic rehabilitation was done with direct composite restoration using a silicone buildup guide. The treated tooth was followed up until exfoliation. PMID:22629077

On the motion of one-dimensional double pendulum

NASA Astrophysics Data System (ADS)

Burian, S. N.; Kalnitsky, V. S.

2018-05-01

A two-dimensional dynamic Lagrangian system of a double mathematical pendulum with one special constraint is considered. Configuration spaces for a given constraints (ellipses) are studied. The diagrams of paths and reactions in the course of motion along them are shown. The calculations of the transversal intersection case and in the case of tangency are given.

Reflection and Double Loop Learning: The Case of HS2

ERIC Educational Resources Information Center

Synnott, Michael

2013-01-01

This paper focuses on the potential role of reflection and double loop learning in policy analysis and shared community learning. The discussion is illustrated by the case of HS2, a proposed high-speed railway project in England. It is noted that the foundation of social learning models is a rejection of traditional reliance on technologies or…

Clinical Results of Flexor Tendon Repair in Zone II Using a six Strand Double Loop Technique.

PubMed

Savvidou, Christiana; Tsai, Tsu-Min

2015-06-01

The purpose of this study is to report the clinical results after repair of flexor tendon zone II injuries utilizing a 6-strand double-loop technique and early post-operative active rehabilitation. We retrospectively reviewed 22 patients involving 51 cases with zone II flexor tendon repair using a six strand double loop technique from September 1996 to December 2012. Most common mechanism of injuries was sharp lacerations (86.5 %). Tendon injuries occurred equally in manual and non-manual workers and were work-related in 33 % of the cases. The Strickland score for active range of motion (ROM) postoperatively was excellent and good in the majority of the cases (81 %). The rupture rate was 1.9 %. The six strand double loop technique for Zone II flexor tendon repair leads to good and excellent motion in the majority of patients and low re- rupture rate. It is clinically effective and allows for early postoperative active rehabilitation.

Jailed double-microcatheter technique following horizontal stenting for coil embolization of intracranial wide-necked bifurcation aneurysms: A technical report of two cases.

PubMed

Kitahara, Takahiro; Hatano, Taketo; Hayase, Makoto; Hattori, Etsuko; Miyakoshi, Akinori; Nakamura, Takehiko

2017-04-01

The horizontal stenting technique facilitates endovascular treatment of wide-necked bifurcation intracranial aneurysms. Previous literature shows, however, that subsequent coil embolization at initial treatment results in incomplete obliteration in many cases. The authors present two consecutive cases of wide-necked large bifurcation aneurysms to describe an additional coil embolization technique following horizontal stenting. The patients were a 53-year-old female with an unruptured internal carotid artery terminus aneurysm and a 57-year-old female with a recurrent basilar artery tip aneurysm. Both patients underwent endovascular treatment with horizontal stenting followed by coil embolization with jailed double-microcatheters. Immediate complete obliteration was achieved with no complications, and no recanalization was observed at the one-year follow-up in both cases. Coil embolization with jailed double-microcatheter technique following horizontal stenting is a safe and effective strategy for wide-necked bifurcation aneurysms.

Frequent PIK3CA Mutations in Colorectal and Endometrial Cancer with Double Somatic Mismatch Repair Mutations

PubMed Central

Cohen, Stacey A.; Turner, Emily H.; Beightol, Mallory B.; Jacobson, Angela; Gooley, Ted A.; Salipante, Stephen J.; Haraldsdottir, Sigurdis; Smith, Christina; Scroggins, Sheena; Tait, Jonathan F.; Grady, William M.; Lin, Edward H.; Cohn, David E.; Goodfellow, Paul J.; Arnold, Mark W.; de la Chapelle, Albert; Pearlman, Rachel; Hampel, Heather; Pritchard, Colin C.

2016-01-01

Background & Aims Double somatic mutations in mismatch repair (MMR) genes have recently been described in colorectal and endometrial cancers with microsatellite instability (MSI) not attributable to MLH1 hypermethylation or germline mutation. We sought to define the molecular phenotype of this newly recognized tumor subtype. Methods From two prospective Lynch syndrome screening studies, we identified patients with colorectal and endometrial tumors harboring ≥2 somatic MMR mutations, but normal germline MMR testing (“double somatic”). We determined the frequencies of tumor PIK3CA, BRAF, KRAS, NRAS, and PTEN mutations by targeted next-generation sequencing and used logistic-regression models to compare them to: Lynch syndrome, MLH1 hypermethylated, and microsatellite stable (MSS) tumors. We validated our findings using independent datasets from The Cancer Genome Atlas (TCGA). Results Among colorectal cancer cases, we found that 14/21 (67%) of double somatic cases had PIK3CA mutations vs. 4/18 (22%) Lynch syndrome, 2/10 (20%) MLH1 hypermethylated, and 12/78 (15%) MSS tumors; p<0.0001. PIK3CA mutations were detected in 100% of 13 double somatic endometrial cancers (p=0.04). BRAF mutations were absent in double somatic and Lynch syndrome colorectal tumors. We found highly similar results in a validation cohort from TCGA (113 colorectal, 178 endometrial cancer), with 100% of double somatic cases harboring a PIK3CA mutation (p<0.0001). Conclusions PIK3CA mutations are present in double somatic mutated colorectal and endometrial cancers at substantially higher frequencies than other MSI subgroups. PIK3CA mutation status may better define an emerging molecular entity in colorectal and endometrial cancers, with the potential to inform screening and therapeutic decision making. PMID:27302833

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

PubMed

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

2015-06-01

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

Systematization, description, and territory of the caudal cerebral artery in surface of the brain of the ostrich (Struthio camelus).

PubMed

Nazer, Manoel; Campos, Rui

2014-08-01

Brain specimens from 30 ostriches were injected with red-dyed latex via the internal carotid arteries, and the caudal cerebral arteries and their branches were systematically described. On the right side, the caudal cerebral artery was double-, triple-, quadruple-, and single-branched in 73.5%, 23.3%, 3.3%, and 3.3% of cases, respectively; on the left side, it was double-, triple-, quadruple-, and single-branched in 76.7%, 20%, 3.3%, and 3.3% of cases, respectively. The dorsal tectal mesencephalic artery appeared as a single vessel in 96.7% of cases, emerging as a collateral branch of the caudal cerebral artery. The dorsal mesencephalic tectal artery originated from the right dorsal cerebellar artery in 40% of cases and from the left side in 63.3% of cases. On the right side, there were four and three medial occipital hemispheric branches in 46.7% and 20% of cases, respectively; on the left side, there were four and three branches in 30% and 26.7% of cases. On the right side, the pineal artery was double-, single-, triple-, and quadruple-branched in 50%, 23.3%, 20%, and 6.7% of cases, respectively; on the left side, this artery was double-, single-, triple-, and quadruple-branched in 50%, 23.3%, 16.7%, and 10% of cases, respectively. The diencephalic artery was on the right side in 43.3% of cases and on the left side in 56.7% of cases. The interhemispheric artery was on the right side in 56.7% of cases and on the left side in 43.3% of cases; four, three, two, five, and one dorsal hemispheric trunks branched off of the interhemispheric artery in 40%, 40%, 10%, 6.7%, and 26.7% of cases, respectively. The caudal cerebral artery was classified as Type I in 56.7% of cases (subtype IA in 33.3% of cases and IB in 23.3% of cases), Type II in 40% of cases (subtype IIA in 20% of cases and IIB in 20% of cases), and Type III in 3.3% of cases. Copyright © 2014 Wiley Periodicals, Inc.

Frequency of glove perforation and the protective effect of double gloves in gynecological surgery.

PubMed

Murta, Eddie F C; Silva, Cléber S; Júnior, Odilon R A

2003-06-01

The purposes of this prospective study were to verify the frequency of glove perforation during gynecological operations and to evaluate the efficacy of double gloving in preventing damage to the inner glove. From May 2000 to May 2001, three house staff and 12 residents were asked to place their used gloves in bags labeled with the following information: procedure performed, presence of a recognized glove perforation, and role in operating team (surgeon, first or second assistant, and instrumentalist). All glove sets were tested using the method of water pression. Damaged gloves were excluded from that analysis. In all, 35 and 51 operations were utilized with single and double gloves, respectively. There were 240 single gloves and 792 double gloves tested. Perforation occurred in 10.4% of the single gloves and 9.8% of the outer double gloves. There were no cases of perforation in the inner double gloves. In cases of operating time that lasted more than 2 h, 56% of the surgeries that used single gloves had perforation vs 58.5% of the double gloves. The first assistant had the major risk for glove perforation with the use of single or double gloves. The indicator finger of the non-dominant hand was the major risk for perforation. In conclusion, we recommend double gloving in all gynecological surgery to reduce the risk of contracting blood-borne diseases.

Quantum scattering in one-dimensional systems satisfying the minimal length uncertainty relation

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

Bernardo, Reginald Christian S., E-mail: rcbernardo@nip.upd.edu.ph; Esguerra, Jose Perico H., E-mail: jesguerra@nip.upd.edu.ph

In quantum gravity theories, when the scattering energy is comparable to the Planck energy the Heisenberg uncertainty principle breaks down and is replaced by the minimal length uncertainty relation. In this paper, the consequences of the minimal length uncertainty relation on one-dimensional quantum scattering are studied using an approach involving a recently proposed second-order differential equation. An exact analytical expression for the tunneling probability through a locally-periodic rectangular potential barrier system is obtained. Results show that the existence of a non-zero minimal length uncertainty tends to shift the resonant tunneling energies to the positive direction. Scattering through a locally-periodic potentialmore » composed of double-rectangular potential barriers shows that the first band of resonant tunneling energies widens for minimal length cases when the double-rectangular potential barrier is symmetric but narrows down when the double-rectangular potential barrier is asymmetric. A numerical solution which exploits the use of Wronskians is used to calculate the transmission probabilities through the Pöschl–Teller well, Gaussian barrier, and double-Gaussian barrier. Results show that the probability of passage through the Pöschl–Teller well and Gaussian barrier is smaller in the minimal length cases compared to the non-minimal length case. For the double-Gaussian barrier, the probability of passage for energies that are more positive than the resonant tunneling energy is larger in the minimal length cases compared to the non-minimal length case. The approach is exact and applicable to many types of scattering potential.« less

Coexistence of true talon cusp and double dens invaginatus in a single tooth: a rare case report and review of the literature.

PubMed

Nu Nu Lwin, Hnin; Phyo Kyaw, Pyae; Wai Yan Myint Thu, Sai

2017-12-01

Co-occurrence of a talon cusp and double dens invaginatus is an extremely rare developmental dental anomaly. This case report represents a talon cusp with two dens invaginatus on a maxillary right lateral incisor. Early identification is needed for prevention of potential problems on the affected or opposing tooth.

Tunnelling in asymmetric double-well potentials: varying initial states

NASA Astrophysics Data System (ADS)

Cordes, J. G.; Das, A. K.

2001-02-01

Tunnelling in a double-well potential has features which are not derivable through a mere extension of the concepts used in the context of a single potential barrier with no confining walls on either side. Furthermore, an asymmetric double-well potential, relevant in many contemporary areas of physics and chemistry, possesses certain distinctive aspects in contrast to the relatively simple case of a symmetric double-well potential. In this paper a self-contained numerical and analytical study of these features is reported, and a theoretical model is presented with special attention being given to a unified treatment of both the symmetric and asymmetric cases. The popularly used pair-state model is critically examined, and the important role of the initial state (which is rarely discussed in the literature) is highlighted with specific examples.

Double-hit follicular lymphoma with MYC and BCL2 translocations: a study of 7 cases with a review of literature.

PubMed

Miao, Yuan; Hu, Shimin; Lu, Xinyan; Li, Shaoying; Wang, Wei; Medeiros, L Jeffrey; Lin, Pei

2016-12-01

Follicular lymphoma with MYC and BCL2 translocations, so-called double-hit follicular lymphoma (DH-FL), is rare. Here, we report the clinicopathological features of 7 cases of DH-FL. All neoplasms had a follicular pattern (1 partially diffuse). Five cases were predominantly low grade, 4 of which had focal (≤20%) grade 3A areas, and 2 cases were of grade 3. All cases were positive for pan-B-cell antigens, CD10, and BCL6; 6 cases were positive for BCL2. Ki-67 was less than or equal to 50% in 6 cases and 90% in 1 grade 3 case. Three patients presented with stage IV disease and 3 had a Follicular Lymphoma International Prognostic Index score of greater than 2. Six patients received immunochemotherapy, and 1 is still under induction therapy with rituximab, ibrutinib, and lenalidomide. Four achieved complete remission and two had a partial response with persistent or refractory disease. The median follow-up time was 25 months (range, 8.5-53.7 months). Two patients treated with standard regimen for follicular lymphoma had relapsed or refractory disease, and 1 died from complications of allogeneic stem cell transplant administered for relapse. In contrast, all 4 patients treated with more intensive regimen for double-hit lymphoma achieved complete remission. In summary, despite predominantly low-grade histology, cases of DH-FL in this study were aggressive and responded better to more intensive than standard treatment regimens, suggesting DH-FL is part of the spectrum of double-hit high-grade lymphoma. Copyright © 2016 Elsevier Inc. All rights reserved.

Thermal anomalies and magmatism due to lithospheric doubling and shifting

NASA Astrophysics Data System (ADS)

Vlaar, N. J.

1983-11-01

We present some thermal and magmatic consequences of the processes of lithospheric doubling and lithospheric shifting. Lithospheric doubling concerns the obduction of a cold continental or old oceanic lithospheric plate over a young and hot oceanic lithosphere/upper mantle system, including an oceanic ridge. Lithospheric shifting concerns the translation and rotation of a lithospheric plate relative to the upper mantle. In both cases the resulting thermal state of the upper mantle below the obducting or shifting lithosphere may be perturbed relative to a "normal" continental or oceanic geothermal situation. The perturbed geothermal state gives rise to a density inversion at depth and thus induces a vertical gravitational instability which favours magmatism. We speculate about the magmatic consequences of this situation and infer that in the case of lithospheric doubling our model may account for the petrology and geochemistry of the resulting magma. The original layering and composition of the overridden young oceanic lithosphere may strongly influence magmatic processes. We dwell shortly on the genesis of kimberlites within the framework of our lithospheric doubling model and on magmatism in general. Lithospheric recycling is inherent to the mechanism of lithospheric doubling.

Double-chambered left ventricle in a cat.

PubMed

Smith, Paul J; Tarazi, Marwan N; Ho, Siew Yen

2014-06-01

Double-chambered left ventricle is a rare congenital disorder in which the left ventricular cavity is subdivided into two cavities by an anomalous septum or muscle band. We describe a case of double-chambered left ventricle, most likely caused by the presence of excessive left ventricular bands, in an asymptomatic cat. Copyright © 2014 Elsevier B.V. All rights reserved.

Tibial plateau fracture after primary anatomic double-bundle anterior cruciate ligament reconstruction: a case report.

PubMed

Gobbi, Alberto; Mahajan, Vivek; Karnatzikos, Georgios

2011-05-01

Tibial plateau fracture after primary anatomic double-bundle anterior cruciate ligament (ACL) reconstruction is rare. To our knowledge, this is the first case report of a tibial plateau fracture after primary anatomic double-bundle ACL reconstruction. In our patient the tibial plateau fracture occurred after a torsional injury to the involved extremity. The fracture occurred 4.5 years after the ACL reconstruction. The fracture was intra-articular Schatzker type IV and had a significant displacement. The patient was treated operatively by open reduction-internal fixation. He recovered well. Copyright © 2011 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

The Association of Congenital Urethral Duplication and Double Megalourethra

PubMed Central

Uçar, Murat; Karagözlü Akgül, Ahsen; Kılıç, Nizamettin; Balkan, Emin

2017-01-01

Background: Urethral duplication and megalourethra are rare urethral anomalies. However, the concomitance of urethral duplication and double megalourethra has not been reported previously. Case Report: A newborn was presented with penile swelling during voiding. Physical examination revealed a retractable foreskin and two external meatus of a double urethra. Retrograde urethrography demonstrated two complete megalourethras. Urethro-urethrostomy and urethroplasty were performed when the patient was 10 months old. The patient was followed up for one year without any urinary problems and has good cosmetics and urinary continence. Conclusion: The concomitance of these two rare anomalies and more importantly its surgical treatment makes this case report unique and valuable. PMID:29215339

Total Maxillary Reconstruction Using a Double-Barreled and Double Skin Paddle Fibular Flap after Total Maxillectomy

PubMed Central

Sanchez, Gerardo; Lopez, Jaime; Perez, Adrian; Naal, Norberto

2013-01-01

Chondroblastomas are rare entities accounting for approximately 1% of all primary bone tumors. We describe a case of a 7-year-old girl with a giant chondroblastoma of the maxilla, treated with bilateral class III maxillectomy and reconstruction with a double-barreled and double skin paddle fibular free flap. We show evidence of an excellent aesthetic outcome at 6 months' follow up with no evidence of tumor recurrence. PMID:24286054

Who is entitled to double effect?

PubMed

Boyle, J

1991-10-01

The doctrine of double effect continues to be an important tool in bioethical casuistry. Its role within the Catholic moral tradition continues, and there is considerable interest in it by contemporary moral philosophers. But problems of justification and correct application remain. I argue that if the traditional Catholic conviction that there are exceptionless norms prohibiting inflicting some kinds of harms on people is correct, then double effect is justified and necessary. The objection that double effect is superfluous is a rejection of that normative conviction, not a refutation of double effect itself. This justification suggests the correct way of applying double effect to controversial cases. But versions of double effect which dispense with the absolutism of the Catholic tradition lack justification and fall to the objection that double effect is an unnecessary complication.

Comparative study of single lateral locked plating versus double plating in type C bicondylar tibial plateau fractures.

PubMed

Neogi, Devdatta Suhas; Trikha, Vivek; Mishra, Kaushal Kant; Bandekar, Shivanand M; Yadav, Chandra Shekhar

2015-01-01

Bicondylar tibial plateau fractures are complex injuries and treatment is challenging. Ideal method is still controversial with risk of unsatisfactory results if not treated properly. Many different techniques of internal and external fixation are used. This study compares the clinical results in single locked plating versus dual plating (DP) using two incision approaches. Our hypothesis was that DP leads to less collapse and change in alignment at final followup compared with single plating. 61 cases of Type C tibial plateau fractures operated between January 2007 and June 2011 were included in this prospective study. All cases were operated either by single lateral locked plate by anterolateral approach or double plating through double incision. All cases were followed for a minimum of 24 months radiologically and clinically. The statistical analysis was performed using software SPSS 10.0 to analyze the data. Twenty nine patients in a single lateral locked plate and 32 patients in a double plating group were followed for minimum 2 years. All fractures healed, however there was a significant incidence of malalignment in the single lateral plating group. Though there was a significant increase in soft tissue issues with the double plating group; however, there was only 3.12% incidence of deep infection. There was no significant difference in Hospital for special surgery score at 2 years followup. Double plating through two incisions resulted in a better limb alignment and joint reduction with an acceptable soft tissue complication rate.

Are physicians' strikes ever morally justifiable? A call for a return to tradition.

PubMed

Mawere, Munyaradzi

2010-08-21

Though physicians strike provides an opportunity to generate more knowledge about the process in which legitimacy of an organization can be restored, it meets with a great deal of resistance not only by the public but from within the medical profession. This paper critically examines the legitimacy of strike by medical doctors heretofore referred to as physicians. Though critically reflecting on strikes of physicians in general, the paper makes more emphasis on Africa where physician strikes are rampant. More importantly, the paper argues that strike implies a failure for everyone in the organization (including the strikers themselves), not only the responsible government or authority. This is because when a strike occurs, an organization/fraternity is subjected to questions, scrutiny and slander. It becomes difficult to decouple what is said, decided and done. Traditionally, all medical fraternities the world-over are committed to acting comfortably to external demands-guaranteeing the patients' lives and public health. By paying attention to external reactions, the medical fraternity adapts and learns what ought and should be done so that it is never again caught in the same messy. At the same time, the fraternity prepares itself for the future strikes. When the fraternity and those outside consider it is doing up to the external expectations, its lost legitimacy is restored. When legitimacy is restored, external pressure like once disturbed water returns to normal.

Florence Nightingale and the Salisbury incident.

PubMed

Palmer, I S

1976-01-01

Florence Nightingale's astute handling of mismanagement in Free Gifts Stores during the Crimean War underscored her administrative ability. Miss Nightingale went to Scutari ostensibly to nurse the British soldiers, and while there encountered innumerable instances of administrative and managerial ineffectiveness and difficulties. Among these were the problems in the accountability and deployment of supplies as well as the assignment and supervision of female personnel-an untried situation. The article identifies the misdirected organizational management which occasioned the introduction of women into British war nursing and the voluntary participation of the British citizenry in providing supplies and comfort for the Army. Through analysis of Miss Nightingale's and others' private correspondence, the problems of personnel management and supply distribution are brought into sharp focus. The interplay of policies and principles to which Miss Nightingale subscribed, the human frailty of one of her women, Miss Nightingale's illness, and the confusion and stress which characterized the Crimean War are discussed. The compassion, understanding, and rectitude as well as the human values to which Miss Nightingale subscribed in protecting a woman guilty of a breach of trust and felony and the troublesome slanderous attack to which Miss Nightingale was subjected at the instigation of her foes on the home front provide a background for the presentation of the Salisbury affair as an interesting aspect of historical research into the life of the Victorian heroine.

Retreatment of recanalized aneurysms after Y-stent-assisted coil embolization with double enterprise stents: case report and systematic review of the literature.

PubMed

Kono, Kenichi; Shintani, Aki; Terada, Tomoaki

2014-01-01

It is necessary to consider possibility of recanalization and retreatment after coil embolization for cerebral aneurysms. There is concern that retreatment for recanalized aneurysms after Y-stent-assisted coil embolization may be difficult because of double stents, especially in Y-stents with double closed-cell stents owing to narrowed structures. However, no detailed reports of retreatment after Y-stent have been reported. Between July 2010 and June 2013, we treated four aneurysms with Y-stent-assisted coil embolization using Enterprise closed-cell stents. Recanalization occurred in one case (25%), and retreatment was performed. We easily navigated a microcatheter into the target portions of the aneurysm through the Y-stent and occluded the aneurysm with coils. Additionally, by systematically searching in PubMed, we found 105 cases of Y-stent-assisted coil embolization using Enterprise stents or Neuroform stents with more than 6 months of follow-up. Among them, retreatment was performed in 10 cases (9.5%). There were no significant differences in retreatment rates among different stent combinations (P=0.91; Fisher's exact test). In conclusion, navigation of a microcatheter into the aneurysm through the Y-stent with double Enterprise stents was feasible, and retreatment rates after Y-stent-assisted coiling may not depend on stent combinations.

Double-Shift Schooling and EFA Goals: Assessing Economic, Educational and Social Impacts

ERIC Educational Resources Information Center

Orkodashvili, Mariam

2009-01-01

The aim of the paper is to discuss the system of double-shift schooling and assess it from economic, social and educational angles referring to different cases from Sub-Saharan African countries. The paper makes an attempt to prove that despite certain challenges that it faces, the system of double-shift schooling is the best solution for poor…

Lung Ultrasonography to Diagnose Transient Tachypnea of the Newborn.

PubMed

Liu, Jing; Chen, Xin-Xin; Li, Xiang-Wen; Chen, Shui-Wen; Wang, Yan; Fu, Wei

2016-05-01

This study explored the sensitivity and specificity of ultrasound for diagnosing transient tachypnea of the newborn (TTN). Ultrasound was performed by one export. Patients were placed in a supine, lateral recumbent, or prone position. The probe was placed perpendicular or parallel to the ribs, and each region of the lung was scanned. The scan results were compared with conventional chest radiographic results. A total of 1,358 infants were included in this study. We identified 412 cases without pulmonary diseases, 228 TTN cases, 358 respiratory distress syndrome (RDS) cases, 85 meconium aspiration syndrome (MAS) cases, 215 infectious pneumonia cases, and 60 other cases. The primary ultrasonic characteristic of TTN was pulmonary edema. "White lung" or a "compact B-line" were only observed in severe cases, whereas TTN primarily presented as pulmonary interstitial syndrome or "double lung point." Furthermore, double lung point could appear during the recovery period of severe TTN or RDS, MAS, and pneumonia. Lung consolidation with air bronchograms was not observed in TTN patients. The results showed that white lung or a compact B-line exhibited a sensitivity of 33.8% and a specificity of 91.3% in diagnosing TTN, whereas double lung point exhibited a sensitivity of 45.6% and a specificity of 94.8% in diagnosing severe TTN. Pulmonary edema, alveolar-interstitial syndrome, double lung point, white lung, and compact B-line are the primary ultrasound characteristics of TTN. Ultrasonic diagnosis of TTN based on these findings is accurate and reliable. TTN can be ruled out in the presence of lung consolidation with air bronchograms. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Bilateral complete ureteral duplication with calculi obstructing both limbs of left double ureter.

PubMed

Aiken, William D; Johnson, Peter B; Mayhew, Richard G

2015-01-01

A woman with bilateral complete ureteral duplication with stones simultaneously obstructing both limbs of the left double ureter is presented. A search of the English medical literature suggests that this is the first reported case. Based on the initial difficulty accessing the stones via ureteroscopy we make recommendations regarding how this rare problem should be approached if encountered. A 37-year old woman with left-sided flank pain was discovered on CT scan to have bilateral complete ureteral duplication and three stones obstructing both limbs of the left double ureter. Ureteroscopy was initially unsuccessful due to the very small calibre and unyielding nature of the ureters and both ureteral limbs were stented. Repeat ureteroscopy was easily achieved after pre-stenting and the impacted stones were completely cleared with intracorporeal laser lithotripsy. The smaller calibre of both double ureters and their presence in a common adventitial sheath distally, made initial attempts at ureteroscopy difficult. Stenting both limbs increased ureteral compliance, passively dilated both ureters and allowed for improved manoeuvrability and retrograde passage of the ureteroscope. Based on the experience with this first reported case it is recommended that pre-stenting should be routinely performed prior to any attempt at ureteroscopy in cases of stones complicating completely duplicated ureters. We report the first recorded case of bilateral complete ureteral duplication with stones simultaneously obstructing both limbs of the double ureter and recommend that routine pre-stenting be done prior to ureteroscopy to allow easy uncomplicated retrograde passage of the ureteroscope. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Computing Determinants by Double-Crossing

ERIC Educational Resources Information Center

Leggett, Deanna; Perry, John; Torrence, Eve

2011-01-01

Dodgson's method of computing determinants is attractive, but fails if an interior entry of an intermediate matrix is zero. This paper reviews Dodgson's method and introduces a generalization, the double-crossing method, that provides a workaround for many interesting cases.

Delusion of inanimate doubles: description of a case of focal retrograde amnesia.

PubMed

Abbate, Carlo; Trimarchi, Pietro Davide; Salvi, Gian Pietro; Quarenghi, Anna Maria; Vergani, Carlo; Luzzatti, Claudio

2012-01-01

This paper reports the case of a patient, M.P., who developed delusion of inanimate doubles, without Capgras syndrome, after traumatic brain injury. His delusional symptoms were studied longitudinally and the cognitive impairments associated with delusion were investigated. Data suggest that M.P. did 'perceive' the actual differences between doubles and originals rather than 'confabulate' them. The cognitive profile, characterized by retrograde episodic amnesia, but neither object processing impairment nor confabulations, supports this hypothesis. The study examines the nature of object misidentification based on Ellis' and Staton's account and proposes a new account based on concurrent unbiased retrieval of semantic memory traces and biased recollection of episodic memory traces.

Double separate versus contiguous pituitary adenomas: MRI features and endocrinological follow up.

PubMed

Roberts, Sammie; Borges, Manuel Thomas; Lillehei, Kevin O; Kleinschmidt-DeMasters, B K

2016-10-01

Double pituitary adenomas are defined as two adenomas within a gland. These have distinct light microscopic and immunohistochemical features and may be clearly-separate or contiguous. Most reports have focused on the various hormonal combinations in double tumors rather than on any potential increased risk for residual mass or endocrinopathy. Departmental files were searched to identify all double adenomas from 1/1/2000 to 3/1/2016, with review of magnetic resonance imaging (MRI) to determine if the dual nature of the lesions could be discerned retrospectively after histologic diagnosis of double adenoma. All cases were immunostained for standard anterior pituitary hormones. Eight cases were identified: 2 follicle-stimulating hormone (FSH)/alpha subunit (ASU) + prolactinoma (PRL); 1 PRL + corticotroph (ACTH); 1 hormone-negative + PRL; 1 ACTH + ASU/growth hormone (GH)/PRL; 1 GH/PR + PRL; 1 FSH/ASU, + ACTH; 1 GH + luteinizing hormone (LH). One patient had clearly-separate lesions identified preoperatively and required two surgical procedures for gross total resection. A second patient had 2 lesions recognized at surgery and afterwards on retrospective neuroimaging. The remaining 6 patients had double adenomas discovered at the time of histologic examination that were not resolvable at surgery or on retrospective neuroimaging. Four patients, 2 with clearly-separate and 2 with contiguous double adenomas, had persistent MRI abnormalities, and one had continued endocrine abnormalities. Double contiguous pituitary adenomas are difficult to anticipate preoperatively or to resolve intraoperatively. Although double contiguous adenomas are much more common than double separate lesions, both have a risk for subtotal resection and, thus, residual mass and/or endocrinopathy may ensue.

Double standards and the international trade of pesticides: the Brazilian case.

PubMed

Porto, Marcelo Firpo; Milanez, Bruno; Soares, Wagner Lopes; Meyer, Armando

2010-01-01

Despite bans on certain pesticides and their replacement by others considered less hazardous, the widespread use of these substances in agriculture continues to threaten the environment and the health of millions of people. This article discusses the current double standard in the international trade of pesticides and focuses on Brazil, one of the main users of pesticides in the world, analyzing the trends in foreign trade (imports and exports) of selected pesticides as a function of changes in legislation in the United States, the European Union, and Brazil from 1989 to 2006. We applied time line analysis to eight organochlorines already banned in Brazil and conducted a case-by-case qualitative and quantitative analysis of nine other pesticides. The results indicate the existence of double standards, as demonstrated by the continued exports to Brazil of some pesticides banned in the United States and Europe.

A Review of Double Common Bile Duct and Its Sequelae.

PubMed

Kolli, Sindhura; Etienne, Denzil; Reddy, Madhavi; Shahzad, Ghulamullah

2018-02-01

A double or accessory common bile duct (ACBD) is a rare congenital anomaly. We report the case of a 60-year-old American Asian male, who was found to have a double or duplicated common bile duct after being admitted for evaluation of a pancreatic mass. A duplicated bile duct has the same mucosa histologically as a single bile duct. However, the opening of a duplicated bile duct lacks a sphincter allowing retrograde flow of gut contents which results in a higher probability of intraductal calculus formation. On rare occasions, it can predispose to liver abscesses, pancreatitis, pancreatic cancer, gallbladder cancer, gastric cancer, and ampullary cancer depending on the location of the opening of the ACBD. We present an integrative review of the limited cases of ACBD with correlation to the current case and discussion regarding the aspects of diagnosis and management.

Minimally-aggressive gestational trophoblastic neoplasms.

PubMed

Cole, Laurence A

2012-04-01

We have previously defined a new syndrome "Minimally-aggressive gestational trophoblastic neoplasms" in which choriocarcinoma or persistent hydatidiform mole has a minimal growth rate and becomes chemorefractory. Previously we described a new treatment protocol, waiting for hCG rise to >3000 mIU/ml and disease becomes more advanced, then using combination chemotherapy. Initially we found this treatment successful in 8 of 8 cases, here we find this protocol appropriate in a further 16 cases. Initially we used hyperglycosylated hCG, a limited availability test, to identify this syndrome. Here we propose also using hCG doubling rate to detect this syndrome. Minimally aggressive gestational trophoblastic disease can be detected by chemotherapy resistance or low hyperglycosylated hCG, <40% of total hCG. It can also be identified by hCG doubling rate, with doubling time greater than 2 weeks. Nineteen new cases were identified as having minimally aggressive gestational trophoblastic disease by hyperglycosylated hCG and by hCG doubling test. All were recommended to hold off further chemotherapy until hCG >3000mIU/ml. One case died prior to the start of the study, one case withdrew because of a lung nodule and one withdrew refusing the suggested combination chemotherapy. The remaining 16 women were all successfully treated. A total of 8 plus 16 or 24 of 24 women were successfully treated using the proposed protocol, holding back on chemotherapy until hCG >3000mIU/ml. Copyright © 2011 Elsevier Inc. All rights reserved.

Open abdominal surgical training differences experienced by integrated vascular and general surgery residents.

PubMed

Tanious, Adam; Wooster, Mathew; Jung, Andrew; Nelson, Peter R; Armstrong, Paul A; Shames, Murray L

2017-10-01

As the integrated vascular residency program reaches almost a decade of maturity, a common area of concern among trainees is the adequacy of open abdominal surgical training. It is our belief that although their overall exposure to open abdominal procedures has decreased, integrated vascular residents have an adequate and focused exposure to open aortic surgery during training. National operative case log data supplied by the Accreditation Council for Graduate Medical Education were compiled for both graduating integrated vascular surgery residents (IVSRs) and graduating categorical general surgery residents (GSRs) for the years 2012 to 2014. Mean total and open abdominal case numbers were compared between the IVSRs and GSRs, with more in-depth exploration into open abdominal procedures by organ system. Overall, the mean total 5-year case volume of IVSRs was 1168 compared with 980 for GSRs during the same time frame (P < .0001). IVSRs reported nearly double the number of surgeon-chief cases compared with GSRs (452 vs 239; P < .0001). GSRs reported more than double the number of open abdominal procedures compared with IVSRs (205 vs 83; P < .0001). Sixty-five percent of the open abdominal experience for IVSRs was focused on procedures involving the aorta and its branches, with an average of 54 open aortic cases recorded throughout their training. The largest single contributor to open surgical experience for a GSR was alimentary tract surgery, representing 57% of all open abdominal cases. GSRs completed an average of 116 open alimentary tract surgeries during their training. Open abdominal surgery represented an average of 7.1% of the total vascular case volume for the vascular residents, whereas open abdominal surgery represented 21% of a GSR's total surgical experience. IVSRs reported almost double the number of total cases during their training, with double chief-level cases. Sixty-five percent of open abdominal surgeries performed by IVSRs involved the aorta or its renovisceral branches. Whereas open abdominal surgery represented 7.1% of an IVSR's surgical training, GSRs had a far broader scope of open abdominal procedures, completing nearly double those of IVSRs. The differences in open abdominal procedures pertain to the differing diseases treated by GSRs and IVSRs. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Comparative study of single lateral locked plating versus double plating in type C bicondylar tibial plateau fractures

PubMed Central

Neogi, Devdatta Suhas; Trikha, Vivek; Mishra, Kaushal Kant; Bandekar, Shivanand M.; Yadav, Chandra Shekhar

2015-01-01

Background: Bicondylar tibial plateau fractures are complex injuries and treatment is challenging. Ideal method is still controversial with risk of unsatisfactory results if not treated properly. Many different techniques of internal and external fixation are used. This study compares the clinical results in single locked plating versus dual plating (DP) using two incision approaches. Our hypothesis was that DP leads to less collapse and change in alignment at final followup compared with single plating. Materials and Methods: 61 cases of Type C tibial plateau fractures operated between January 2007 and June 2011 were included in this prospective study. All cases were operated either by single lateral locked plate by anterolateral approach or double plating through double incision. All cases were followed for a minimum of 24 months radiologically and clinically. The statistical analysis was performed using software SPSS 10.0 to analyze the data. Results: Twenty nine patients in a single lateral locked plate and 32 patients in a double plating group were followed for minimum 2 years. All fractures healed, however there was a significant incidence of malalignment in the single lateral plating group. Though there was a significant increase in soft tissue issues with the double plating group; however, there was only 3.12% incidence of deep infection. There was no significant difference in Hospital for special surgery score at 2 years followup. Conclusion: Double plating through two incisions resulted in a better limb alignment and joint reduction with an acceptable soft tissue complication rate. PMID:26015609

Estimation of Moisture Content of Forest Canopy and Floor from SAR Data Part II: Trunk-Ground Double-Bounce Case

NASA Technical Reports Server (NTRS)

Moghaddam, M.; Saatchi, S.

1996-01-01

Several scattering mechanisms contribute to the total radar backscatter cross section measured by the synthetic aperture radar. These are volume scattering, trunk-ground double-bounce scattering, branch-ground double-bounce scattering, and surface scattering. All of these mechanisms are directly related to the dielectric constant of forest components responsible for that mechanism and their moisture.

Physical mechanisms of active control of sound transmission through rib stiffened double-panel structure

NASA Astrophysics Data System (ADS)

Ma, Xiyue; Chen, Kean; Ding, Shaohu; Yu, Haoxin

2016-06-01

This paper presents an analytical investigation on physical mechanisms of actively controlling sound transmission through a rib stiffened double-panel structure using point source in the cavity. The combined modal expansion and vibro-acoustic coupling methods are applied to establish the theoretical model of such active structure. Under the condition of minimizing radiated power of the radiating ribbed plate, the physical mechanisms are interpreted in detail from the point of view of modal couplings similar as that used in existed literatures. Results obtained demonstrate that the rule of sound energy transmission and the physical mechanisms for the rib stiffened double-panel structure are all changed, and affected by the coupling effects of the rib when compared with the analytical results obtained for unribbed double-panel case. By taking the coupling effects of the rib into considerations, the cavity modal suppression and rearrangement mechanisms obtained in existed investigations are modified and supplemented for the ribbed plate case, which gives a clear interpretation for the physical nature involved in the active rib stiffened double-panel structure.

High penetrance of pheochromocytoma associated with the novel C634Y/Y791F double germline mutation in the RET protooncogene.

PubMed

Toledo, Rodrigo A; Wagner, Simona M; Coutinho, Flavia L; Lourenço, Delmar M; Azevedo, Juliana A; Longuini, Viviane C; Reis, Mariana T A; Siqueira, Sheila A C; Lucon, Antonio M; Tavares, Marcos R; Fragoso, Maria C B V; Pereira, Adelaide A; Dahia, Patricia L M; Mulligan, Lois M; Toledo, Sergio P A

2010-03-01

Previous studies have shown that double RET mutations may be associated with unusual multiple endocrine neoplasia type 2 (MEN 2) phenotypes. Our objective was to report the clinical features of patients harboring a previously unreported double mutation of the RET gene and to characterize this mutation in vitro. Sixteen patients from four unrelated families and harboring the C634Y/Y791F double RET germline mutation were included in the study. Large pheochromocytomas measuring 6.0-14 cm and weighing up to 640 g were identified in the four index cases. Three of the four tumors were bilateral. High penetrance of pheochromocytoma was also seen in the C634Y/Y791F-mutation-positive relatives (seven of nine, 77.7%). Of these, two cases had bilateral tumors, one presented with multifocal tumors, two cases had large tumors (>5 cm), and one case, which was diagnosed with a large (5.5 x 4.5 x 4.0 cm) pheochromocytoma, reported early onset of symptoms of the disease (14 yr old). The overall penetrance of pheochromocytoma was 84.6% (11 of 13). Development of medullary thyroid carcinoma in our patients seemed similar to that observed in patients with codon 634 mutations. Haplotype analysis demonstrated that the mutation did not arise from a common ancestor. In vitro studies showed the double C634Y/Y791F RET receptor was significantly more phosphorylated than either activated wild-type receptor or single C634Y and Y791F RET mutants. Our data suggest that the natural history of the novel C634Y/Y791F double mutation carries a codon 634-like pattern of medullary thyroid carcinoma development, is associated with increased susceptibility to unusually large bilateral pheochromocytomas, and is likely more biologically active than each individual mutation.

Double transverse myocutaneous gracilis free flaps for unilateral breast reconstruction.

PubMed

Werdin, Frank; Haug, Daniel M; Amr, Amro; Schoeller, Thomas

2016-10-01

In cases were the deep inferior epigastric perforator flap (DIEP flap) is not available and unilateral transverse myocutaneous gracilis flap (TMG flap) is not sufficient for breast reconstruction, we perform double TMG flaps as a reconstructive method. In this report, we present our results of the use of double TMG free-flap-transfer for unilateral breast reconstruction. Between August 2004 and June 2012 we performed 58 TMG flaps in 29 patients for unilateral breast reconstruction. Patient data were analyzed and operative outcome (operation time, complication rate and aesthetic results) were investigated. Aesthetic outcome was evaluated retrospectively via photo documentation by an independent plastic surgeon. The results were classified in;unsatisfactory, satisfactory, good and very good. The average operating time was 6 hours 55 minutes (295 - 650 minutes). Of 58 TMG flaps, 57 (98.3%) were successful. Thrombosis occurred in seven (12%) cases (1 arterial, 6 venous). Flap salvage was successful in six cases and flap failure occurred in one (1.7%) case. The results of 25 patients were graded as good and very good. Three patients showed satisfying and one patient unsatisfying results. Double TMG flaps in unilateral breast reconstruction could lead to good operative results. This method further expands the range of options with autologous tissue in reconstructive breast surgery. © 2015 Wiley Periodicals, Inc. Microsurgery 36:539-545, 2016. © 2015 Wiley Periodicals, Inc.

Brilliant Blue G double staining enhances successful internal limiting membrane peeling with minimal adverse effect by low cellular permeability into live cells.

PubMed

Hisatomi, Toshio; Notomi, Shoji; Tachibana, Takashi; Oishi, Seiichiro; Asato, Ryo; Yamashita, Takehiro; Murakami, Yusuke; Ikeda, Yasuhiro; Enaida, Hiroshi; Sakamoto, Taiji; Ishibashi, Tatsuro

2015-02-01

Brilliant Blue G is used as a surgical adjuvant for retinal surgery. Although BBG double or multiple staining was reported, the effectiveness and safety of repeated staining is still elusive. To further examine the effectiveness and safety, we examined BBG in clinical cases in vivo, primary cell culture in vitro, and surgically resected specimen ex vivo. A retrospective interventional case series with in vitro and ex vivo studies were performed. Vitrectomy was performed in 28 cases of epiretinal membrane with BBG single to multiple staining. The surgically resected membranes were stained by BBG with or without cellular fixation. Primary cell cultures were examined with BBG and live/death cell markers, such as Calcein AM and TUNEL. Single staining provided satisfactory staining in seven cases. Double or multiple staining substantially visualized internal limiting membrane (21 cases), especially the edges of remaining internal limiting membrane (11 cases). Adverse retinal staining was not noted and the final visual acuity showed no difference with multiple staining. The live cells barely stained with BBG, while some dead cells were stained. Brilliant Blue G multiple staining substantially enhanced the visualization of internal limiting membrane. The absence of abnormal staining supports the safety of repeated BBG staining.

Landslide: Systematic Dynamic Race Detection in Kernel Space

DTIC Science & Technology

2012-05-01

schedule_in_flight← true; CAUSE_TIMER_INTERRUPT(); end if end function Thread Scheduling Finally, the Landslide scheduler is responsible for managing ...child process vanish() simultaneously. • double_wait: Tests interactions of multiple waiters on a single child. • double_thread_fork: Tests for...conditions using Landslide. We describe them here. • Too many waiters allowed. Using the double_wait test case, Group 1 found a bug in which more threads

Clinical Significance of "Double-hit" and "Double-protein" expression in Primary Gastric B-cell Lymphomas.

PubMed

He, Miaoxia; Chen, Keting; Li, Suhong; Zhang, Shimin; Zheng, Jianming; Hu, Xiaoxia; Gao, Lei; Chen, Jie; Song, Xianmin; Zhang, Weiping; Wang, Jianmin; Yang, Jianmin

2016-01-01

Primary gastric B-cell lymphoma is the second most common malignancy of the stomach. There are many controversial issues about its diagnosis, treatment and clinical management. "Double-hit" and "double-protein" involving gene rearrangement and protein expression of c-Myc and bcl2/bcl6 are the most used terms to describe DLBCL poor prognostic factors in recent years. However, very little is known about the role of these prognostic factors in primary gastric B-cell lymphomas. This study aims to obtain a molecular pathology prognostic model of gastric B-cell lymphoma for clinical stratified management by evaluating how the "double-hit" and "double-protein" in tumor cells as well as microenvironmental reaction of tumor stromal tissue affect clinical outcome in primary gastric B-cell lymphomas. Data and tissues of 188 cases diagnosed with gastric B-cell lymphomas were used in this study. Tumor tissue microarray (TMA) of formalin fixed and paraffin embedded (FFPE) tissues was constructed for fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) analysis with a serial of biomarkers containing MYC, BCL2, BCL6, CD31, SPARC, CD10, MUM1 and Ki-67. Modeled period analysis was used to estimate 3-year and 5-year overall survival (OS) and disease-free survival (DFS) distributions. There was no definite "double-hit" case though the gene rearrangement of c-Myc (5.9%), bcl2 (0.1%) and bcl6 (7.4%) was found in gastric B-cell lymphomas. The gene amplification or copy gains of c-Myc (10.1%), bcl-2 (17.0%) and bcl-6 (0.9%) were present in these lymphomas. There were 12 cases of the lymphomas with the "double-protein" expression of MYC and BCL2/BCL6. All patients with "double-protein" gastric B-cell lymphomas had poor outcome compared with those without. More importantly, "MYC-BCL2-BCL6" negative group of gastric B-cell lymphoma patients had favorable clinical outcome regardless clinical stage, pathological types and therapeutic modalities. And the similar better prognosis was found in the cases with low microvessel density (MVD) in tumor tissue and high expression of SPARC (SPARC≥5%) in stromal cells. "Double-hit" lymphoma was rare among primary gastric lymphoma, while patients with multiple gene amplification and/or copy gains of c-Myc, bcl2 and bcl6, and "double-protein" gastric B-cell lymphomas had a poor clinical outcome. In addition, patients with MYC, BCL2 and BCL6 expression negative or low MVD in tumor tissue with high expression of SPARC in stromal cells could have better prognosis than other gastric B-cell lymphomas regardless of their clinical stage and pathological types. These results would be of very importance for clinical stratified management and precision medicine of gastric B-cell lymphomas.

Benefits of the quality assured double and arbitration reading of mammograms in the early diagnosis of breast cancer in symptomatic women.

PubMed

Waldmann, Annika; Kapsimalakou, Smaragda; Katalinic, Alexander; Grande-Nagel, Isabell; Stoeckelhuber, Beate M; Fischer, Dorothea; Barkhausen, Joerg; Vogt, Florian M

2012-05-01

To address the benefits of double and arbitration reading regarding tumour detection rates, percentage of in situ tumours, and number (of patients) needed to send for expert reading (number needed to treat; NNT) for one additional tumour finding. QuaMaDi is a quality assured breast cancer diagnosis programme; with two-view mammography (craniocaudal, mediolateral oblique) and, in case of breast density ACR 3 or 4, routine ultrasound imaging; and with independent double reading of all images. A consecutive sample of symptomatic women, i.e. women at risk for breast cancer, women aged 70 and above, and/or women with preceding BI-RADS III findings, was analysed. 28,558 mammograms were performed (mean age of women: 57.3 [standard deviation: 12.3] years). Discordant findings were present in 3,837 double readings and were sent for arbitration reading. After histopathological assessment, 52 carcinomas were found (thereof 32% in situ). These carcinomas accounted for 1.8 tumours per 1,000 examinations in the total cohort and increased the tumour detection rate up to 16.4/1,000. The NNT in discordant cases was 74. Double and arbitration reading appears to be a useful tool to ensure the quality of early detection of breast lesions in symptomatic women during indication-based, standardised mammography. • Quality assured breast cancer diagnosis is feasible outside organised screening structures. • Double and arbitration reading is beneficial for populations ineligible for screening. • Double and arbitration reading increases the tumour detection rate. • Double and arbitration reading increases the percentage of in situ cancers.

Log file-based patient dose calculations of double-arc VMAT for head-and-neck radiotherapy.

PubMed

Katsuta, Yoshiyuki; Kadoya, Noriyuki; Fujita, Yukio; Shimizu, Eiji; Majima, Kazuhiro; Matsushita, Haruo; Takeda, Ken; Jingu, Keiichi

2018-04-01

The log file-based method cannot display dosimetric changes due to linac component miscalibration because of the insensitivity of log files to linac component miscalibration. The purpose of this study was to supply dosimetric changes in log file-based patient dose calculations for double-arc volumetric-modulated arc therapy (VMAT) in head-and-neck cases. Fifteen head-and-neck cases participated in this study. For each case, treatment planning system (TPS) doses were produced by double-arc and single-arc VMAT. Miscalibration-simulated log files were generated by inducing a leaf miscalibration of ±0.5 mm into the log files that were acquired during VMAT irradiation. Subsequently, patient doses were estimated using the miscalibration-simulated log files. For double-arc VMAT, regarding planning target volume (PTV), the change from TPS dose to miscalibration-simulated log file dose in D mean was 0.9 Gy and that for tumor control probability was 1.4%. As for organ-at-risks (OARs), the change in D mean was <0.7 Gy and normal tissue complication probability was <1.8%. A comparison between double-arc and single-arc VMAT for PTV showed statistically significant differences in the changes evaluated by D mean and radiobiological metrics (P < 0.01), even though the magnitude of these differences was small. Similarly, for OARs, the magnitude of these changes was found to be small. Using the log file-based method for PTV and OARs, the log file-based method estimate of patient dose using the double-arc VMAT has accuracy comparable to that obtained using the single-arc VMAT. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Can a limited double reading/second opinion of initially recalled breast ultrasound screening examinations improve radiologists' performances?

NASA Astrophysics Data System (ADS)

Gur, David; Harnist, Kimberly; Gizienski, Terri-Ann; Zuley, Margarita; Hakim, Christiane; Lu, Amy; Sumkin, Jules; Abrams, Gordon; Ganott, Marie A.; Kelly, Amy E.; Tyma, Cathy S.; Chang, Thomas; BÓ§hm-Vélez, Marcella; Sobolewski, Robin

2018-03-01

Interpretations of breast ultrasound screening examinations result in high recall rates and large inter-radiologist variability, frequently leading to "conservative" recommendations. Double reading of all breast ultrasound screening examinations is cost prohibitive, but double reading of only "initially recalled" cases may prove efficacious. We assessed changes in recommendations, if any, by providing a consensus second opinion in a limited subset of examinations initially recommended for recall. We performed a retrospective reader study with 197 ultrasound examinations (97 not recalled and 100 recalled clinically). First, we generated a consensus "second opinion" consisting of the majority vote of three independent readings of each case by experienced ultrasound interpreters. During the reader study that followed, if the reader recommended a "recall" and the "consensus second opinion" did not, a message to that effect was displayed and the reader was asked to re-review the exam and re-assess if, knowing the second opinion, a re-rating of the case was warranted. We compared performance levels pre- and post- the second opinion. The second opinion resulted in "no recall" recommendations of 141 cases in the entire set, including four cancer cases missed by all three readers. On average, radiologists received "warning" messages in 30 cases (range 15-50), or in 15% of cases. Rating changes (downgrades to no recall) occurred in 36 of these cases. These changes resulted in a possible recall rate reduction of 28% in prompted cases or 14% overall recall reduction, while increasing the false negative rate by only one case missed by 2 readers ( 1%).

Double trisomy 48,XXX,+18 with multiple dysmorphic features.

PubMed

Jiang, Zi-Yan; Wu, Xiao-Hui; Zou, Chao-Chun

2015-02-01

Chromosomal abnormality is a common cause of congenital anomalies, psychiatric disorders, and mental retardation. However, the double trisomy 48,XXX,+18 is a rare chromosome abnormality. Case report and literature review. A 7-hour-old girl presented to our unit because of poor response after birth. She presented with multiple dysmorphic features, including small for gestational age infant, flat nasal bridge, widely-spaced eyes, the left thumb deformities, flat facial profile, raised sternum, ventricular septal defect, the third lateral brain ventricle enlargement, and small liver. This case expands the spectrum of malformations reported in association with the double trisomy 48,XXX,+18. The literature on 16 fetuses or infants with the 48,XXX,+18 were also reviewed. These data suggested that in patients with clinical features similar to trisomy 18, especially with anomalies of the ears and/or reproductive malformations, double trisomy (48,XXX,+18) should be considered and karyotyping should be performed although it is a rare disease.

Long-term remission of a Her2/neu positive primary breast cancer under double monoclonal antibody therapy with trastuzumab and bevacizumab

PubMed Central

Königsberg, Robert; Maierhofer, Julia; Steininger, Tanja; Kienzer, Gabriele; Dittrich, Christian

2014-01-01

Background The attempt to act on several signalling pathways involved in tumour development simultaneously appears to be more attractive than attacking a single target structure alone. Vascular endothelial growth factor (VEGF) over-expression is frequently observed in human epidermal growth factor receptor 2 (Her2/neu) positive patients with breast cancer and over-expression of the proto-oncogene Her2/neu is associated with an up-regulation of VEGF. Case report The case of a Her2/neu positive patient with breast cancer who refused cytotoxic chemotherapy with its potential side effects as well as mastectomy is presented. Our patient has been receiving the combined double administration of bevacizumab and trastuzumab for more than 4 years. Conclusions This case report shows that (a) the combined double administration of bevacizumab and trastuzumab was be clinically effective. (b) The combination of bevacizumab and trastuzumab is safe and non-toxic. (c) Bevacizumab and trastuzumab can be used as a long-term application. PMID:24991208

Double Current Sheet Instabilities and the Transition to Turbulence.

NASA Astrophysics Data System (ADS)

Pucci, F.; Velli, M.; Biferale, L.; Sahoo, G.

2016-12-01

The double tearing instability has often been studied as a proxy for the m=1 kink mode in cylindrical plasma. In this paper we describe the results of 3D simulations of an initially periodic double current sheet described by Harris equilibria with a guide field in two cases: 1) zero net helicity and an average magnetic field and 2) a well defined helicity (force free but non constant alpha). We study and contrast the de-stabilization and transition to turbulence for these two cases: we describe spectra, cascades, and possible application to heliospheric phenomena, in particular CME evolution and relaxation. The research leading to these results has received fund- ing from the European Union's Seventh Framework Pro- gramme (FP7/2007-2013) under grant agreement No. 339032

Biological characterization of adult MYC-translocation-positive mature B-cell lymphomas other than molecular Burkitt lymphoma.

PubMed

Aukema, Sietse M; Kreuz, Markus; Kohler, Christian W; Rosolowski, Maciej; Hasenclever, Dirk; Hummel, Michael; Küppers, Ralf; Lenze, Dido; Ott, German; Pott, Christiane; Richter, Julia; Rosenwald, Andreas; Szczepanowski, Monika; Schwaenen, Carsten; Stein, Harald; Trautmann, Heiko; Wessendorf, Swen; Trümper, Lorenz; Loeffler, Markus; Spang, Rainer; Kluin, Philip M; Klapper, Wolfram; Siebert, Reiner

2014-04-01

Chromosomal translocations affecting the MYC oncogene are the biological hallmark of Burkitt lymphomas but also occur in a subset of other mature B-cell lymphomas. If accompanied by a chromosomal break targeting the BCL2 and/or BCL6 oncogene these MYC translocation-positive (MYC(+)) lymphomas are called double-hit lymphomas, otherwise the term single-hit lymphomas is applied. In order to characterize the biological features of these MYC(+) lymphomas other than Burkitt lymphoma we explored, after exclusion of molecular Burkitt lymphoma as defined by gene expression profiling, the molecular, pathological and clinical aspects of 80 MYC-translocation-positive lymphomas (31 single-hit, 46 double-hit and 3 MYC(+)-lymphomas with unknown BCL6 status). Comparison of single-hit and double-hit lymphomas revealed no difference in MYC partner (IG/non-IG), genomic complexity, MYC expression or gene expression profile. Double-hit lymphomas more frequently showed a germinal center B-cell-like gene expression profile and had higher IGH and MYC mutation frequencies. Gene expression profiling revealed 130 differentially expressed genes between BCL6(+)/MYC(+) and BCL2(+)/MYC(+) double-hit lymphomas. BCL2(+)/MYC(+) double-hit lymphomas more frequently showed a germinal center B-like gene expression profile. Analysis of all lymphomas according to MYC partner (IG/non-IG) revealed no substantial differences. In this series of lymphomas, in which immunochemotherapy was administered in only a minority of cases, single-hit and double-hit lymphomas had a similar poor outcome in contrast to the outcome of molecular Burkitt lymphoma and lymphomas without the MYC break. Our data suggest that, after excluding molecular Burkitt lymphoma and pediatric cases, MYC(+) lymphomas are biologically quite homogeneous with single-hit and double-hit lymphomas as well as IG-MYC and non-IG-MYC(+) lymphomas sharing various molecular characteristics.

[A case of double monster--duplicitas anterior with diprosopia].

PubMed

Meyer, R

1983-01-01

Report on a delivery of a double monster, duplicitas anterior with diprosopia. The course of delivery is compared with literature. The exclusion of malformations in early pregnancy is possible and necessary. Perinatal mortality can be reduced by abortion in time. The psychic burden of women concerned needs a special regard.

Double layers without current

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

Perkins, F.W.; Sun, Y.C.

1980-11-01

The steady-state solution of the nonlinear Vlasov-Poisson equations is reduced to a nonlinear eigenvalue problem for the case of double-layer (potential drop) boundary conditions. Solutions with no relative electron-ion drifts are found. The kinetic stability is discussed. Suggestions for creating these states in experiments and computer simulations are offered.

Physical Properties of the Double Kerr Solution

NASA Astrophysics Data System (ADS)

Herdeiro, Carlos A. R.; Rebelo, Carmen

We consider two special cases, dubbed counter-rotating and co-rotating of the double-Kerr solution, in four spacetime dimensions. We discuss how various physical properties of the black holes vary as the distance between them varies, namely: the horizon angular velocity and extremality condition, the horizon and ergo-surface geometry.

Seeing Double: How One Period Visualises Another

ERIC Educational Resources Information Center

Card, Jane

2004-01-01

When pupils study interpretations or representations of the past which are neither from their own period nor from the period being interpreted/represented, they are having to employ sophisticated knowledge and skill. Jane Card describes this as "double vision": the pupils must think about "the period depicted" (in this case the…

Clearance of yellow tattoo ink with a novel 532-nm picosecond laser.

PubMed

Alabdulrazzaq, Hamad; Brauer, Jeremy A; Bae, Yoon-Soo; Geronemus, Roy G

2015-04-01

Although technology and tattoo removal methods continue to evolve, yellow pigment clearance continues to be challenging and usually unsuccessful. We describe a case series of six tattoos containing yellow ink, successfully treated with a frequency-doubled Nd:YAG 532-nm picosecond laser. Case series with six subjects participating for the treatment of multicolored tattoos that contain yellow pigment. Treatments performed with a frequency-doubled Nd:YAG 532-nm picosecond laser at 6-8 week intervals. One subject achieved complete clearance of the treated site after one session, and five subjects required 2-4 treatments to achieve over 75% clearance. Minimal downtime was experienced, and no scarring or textural skin changes were observed in any of the treated sites. This is the first case series that demonstrates effective and consistent reduction of yellow tattoo ink using a frequency doubled Nd:YAG 532-nm laser with a picosecond pulse duration. Treatments were well tolerated and subjects had positive outcomes. This is a small observational case series from an ongoing clinical trial, and studies with a larger sample size and comparative group are needed in the future. © 2015 Wiley Periodicals, Inc.

Thermal properties of spin-S Kitaev-Heisenberg model on a honeycomb lattice

NASA Astrophysics Data System (ADS)

Suzuki, Takafumi; Yamaji, Youhei

2018-05-01

Temperature (T) dependence of heat capacity C (T) in the S = 1 / 2 Kitaev honeycomb model shows a double-peak structure resulting from fractionalization of spins into two kinds of Majorana fermions. Recently it has been discussed that the double-peak structure in C (T) is also observed in magnetic ordered phases of the S = 1 / 2 Kitaev-Heisenberg (KH) model on a honeycomb lattice when the system is located in the vicinity of the Kitaev's spin liquid phase. In addition to the S = 1 / 2 spin case, similar double-peak structure has been confirmed in the KH honeycomb model for classical Heisenberg spins, where spin S is regarded as S → ∞ . We investigate spin-S dependence of C (T) for the KH honeycomb models by using thermal pure quantum state. We also perform classical Monte Carlo calculations to obtain C (T) for the classical KH model. From obtained results, we find that the origin of the high-temperature peak is different between the quantum spin case with small Ss and the classical Heisenberg spin case. Furthermore, the high-temperature peak in the quantum spin case, which is one of the clues for fractionalization of spins, disappears for S > 1 .

Generating functions for weighted Hurwitz numbers

NASA Astrophysics Data System (ADS)

Guay-Paquet, Mathieu; Harnad, J.

2017-08-01

Double Hurwitz numbers enumerating weighted n-sheeted branched coverings of the Riemann sphere or, equivalently, weighted paths in the Cayley graph of Sn generated by transpositions are determined by an associated weight generating function. A uniquely determined 1-parameter family of 2D Toda τ -functions of hypergeometric type is shown to consist of generating functions for such weighted Hurwitz numbers. Four classical cases are detailed, in which the weighting is uniform: Okounkov's double Hurwitz numbers for which the ramification is simple at all but two specified branch points; the case of Belyi curves, with three branch points, two with specified profiles; the general case, with a specified number of branch points, two with fixed profiles, the rest constrained only by the genus; and the signed enumeration case, with sign determined by the parity of the number of branch points. Using the exponentiated quantum dilogarithm function as a weight generator, three new types of weighted enumerations are introduced. These determine quantum Hurwitz numbers depending on a deformation parameter q. By suitable interpretation of q, the statistical mechanics of quantum weighted branched covers may be related to that of Bosonic gases. The standard double Hurwitz numbers are recovered in the classical limit.

Control of Leakage Flow by Triple Squealer Configuration in Axial Flow Turbine

NASA Astrophysics Data System (ADS)

El-Ghandour, Mohamed; Ibrahim, Mohammed K.; Mori, Koichi; Nakamura, Yoshiaki

A new turbine blade tip shape called triple squealer is proposed. This shape is based on the conventional double squealer, and the cavity on the tip surface is divided into two parts by using a third squealer along the blade camber line. The effect of the ratio of groove depth to span (GDS ratio) was investigated. The flat-tip case (baseline case) and double-squealer case were calculated for comparison. In-house, unstructured, 3D, Navier-Stokes, finite volume, multiblock code with DES (Detached Eddy Simulation) as turbulence model was used to calculate the flow field around the tip. The computational results show that the reduction in the mass flow rate of the leakage flow for the triple squealer is 15.69% compared to the flat-tip case.

Double bubble with the big-bubble technique during deep anterior lamellar keratoplasty.

PubMed

Wise, Stephanie; Dubord, Paul; Yeung, Sonia N

2017-04-28

To report a case of intraoperative double bubble that formed during big-bubble DALK surgery in a patient with corneal scarring secondary to herpetic stromal keratitis. Case report. A 22 year old woman presented with a large corneal scar, likely secondary to previous herpetic stromal keratitis. She underwent big-bubble DALK surgery for visual rehabilitation. Intraoperatively, a mixed bubble with persistent type 2 bubble postoperatively was noted. The second bubble resorbed with clearance of the graft and good visual outcome after 6 weeks. This case report describes the unusual development of a mixed bubble during big-bubble DALK surgery. This graft cleared with resolution of the second bubble postoperatively without further surgical intervention.

Role of Echocardiograghy in Treating a Case of Double Chamber Right Ventricle with Delayed Presentation.

PubMed

Barik, Ramachandra

2017-01-01

The clinical diagnosis of double chamber right ventricle (DCRV) is not straightforward. Clinical history, clinical examination, 12-lead electrocardiogram, chest X-ray, and Echocardiography (echo) contribute to morphological diagnosis. Cardiac catheterization is essential for hemodynamic evaluation. A thorough presurgical workup helps the cardiac surgeon to choose the appropriate surgical approach and timing of surgery in an individual case. We present a case of a DCRV who presented to us in the fifth decade of life. Echo confirmed the morphological diagnosis and cardiac catheterization complemented the exact pull back gradient across the obstruction in the right ventricle. This patient was suggested muscle bundle resection and ventricular septal defect closure using right atrial approach.

The nature of double concomitant myxopapillary ependymoma: report of a case.

PubMed

Salomão, J Francisco; de Andrade, Cecília Vianna; Bellas, Antonio Rosa; Cervante, Tatiana Protzenko

2014-03-01

Myxopapillary ependymomas are almost exclusively seen at the conus medullaris/filum terminale/cauda equina region, usually as solitary space-occupying lesions. The authors report the case of a 14-year-old boy with double concomitant myxopapillary ependymoma, proximal and caudal on the filum terminale in which a totally gross removal was achieved in two stages. This presentation is rare and, so far, we have known just three similar cases that were previously reported in children. The true nature of these lesions is controversial, and while some argue that they are related to metastatic seeding, others consider them independent lesions developing synchronously. A review on dissemination of spinal myxopapillary ependymomas was done.

Efficacy of superficial temporal artery-middle cerebral artery double anastomoses in a patient with rapidly progressive moyamoya disease: case report.

PubMed

Yokosawa, Michiko; Hayashi, Toshiaki; Shirane, Reizo; Tominaga, Teiji

2014-01-01

Moyamoya disease can be associated with a rapidly progressive course in young patients. This report describes a patient with moyamoya disease who experienced rapid disease progression, resulting in cerebral infarction and a wide area of diminished cerebral perfusion. Double superficial temporal artery (STA)-middle cerebral artery (MCA) anastomoses were utilized to immediately increase cerebral perfusion in the affected area. This case involved a 5-year-old girl who had been diagnosed with moyamoya disease and had undergone STA-MCA anastomosis with indirect bypass in the right hemisphere at the age of 3. At the time of presentation, magnetic resonance (MR) imaging showed cerebral infarction at the left frontal lobe, and MR angiography showed rapidly progressive narrowing of the left MCA that had not been present 3 months prior. N-isopropyl-p-[I123] iodoamphetamine single-photon emission computed tomography (IMP-SPECT) showed markedly decreased uptake in the left hemisphere. She underwent emergent STA-MCA double anastomoses with indirect bypass on the left side. IMP-SPECT showed marked increase in uptake in the left hemisphere. The anterior cerebral artery (ACA) territory adjacent to the cerebral infarction also showed increased uptake on the SPECT. Postoperatively, there were no clinical or radiographic indications of ischemic or hemorrhagic complications. Double anastomoses are effective in quickly and significantly increasing blood flow. The postoperative course in this case was uneventful. Double anastomoses are a surgical option for patients with moyamoya disease who show rapid disease progression, even in those in the acute phase of cerebral infarction.

Efficacy of Superficial Temporal Artery-Middle Cerebral Artery Double Anastomoses in a Patient with Rapidly Progressive Moyamoya Disease: Case Report

PubMed Central

YOKOSAWA, Michiko; HAYASHI, Toshiaki; SHIRANE, Reizo; TOMINAGA, Teiji

2014-01-01

Moyamoya disease can be associated with a rapidly progressive course in young patients. This report describes a patient with moyamoya disease who experienced rapid disease progression, resulting in cerebral infarction and a wide area of diminished cerebral perfusion. Double superficial temporal artery (STA)-middle cerebral artery (MCA) anastomoses were utilized to immediately increase cerebral perfusion in the affected area. This case involved a 5-year-old girl who had been diagnosed with moyamoya disease and had undergone STA-MCA anastomosis with indirect bypass in the right hemisphere at the age of 3. At the time of presentation, magnetic resonance (MR) imaging showed cerebral infarction at the left frontal lobe, and MR angiography showed rapidly progressive narrowing of the left MCA that had not been present 3 months prior. N-isopropyl-p-[I123] iodoamphetamine single-photon emission computed tomography (IMP-SPECT) showed markedly decreased uptake in the left hemisphere. She underwent emergent STA-MCA double anastomoses with indirect bypass on the left side. IMP-SPECT showed marked increase in uptake in the left hemisphere. The anterior cerebral artery (ACA) territory adjacent to the cerebral infarction also showed increased uptake on the SPECT. Postoperatively, there were no clinical or radiographic indications of ischemic or hemorrhagic complications. Double anastomoses are effective in quickly and significantly increasing blood flow. The postoperative course in this case was uneventful. Double anastomoses are a surgical option for patients with moyamoya disease who show rapid disease progression, even in those in the acute phase of cerebral infarction. PMID:24584280

Exploring avenues for best use of cytotechnologists in non-gynaecological cytology: Double screening or independent sign-out.

PubMed

Fischer, G; Haddad, M; Cormier, K

2018-02-01

Cytotechnologist (CT) screening workload has been decreasing due to the falling number of Papanicolaou tests. This continuing trend has prompted exploration of ways to best employ the CT skillset. One potential way of more effective use is by having two CTs double screen non-gynaecological (NGC) cases to assess whether this improves screening quality and concordance with pathologists. Another is evaluating the CT's performance on low-complexity negative NGC cases for a potential independent CT sign-out without pathologist review. In total, 1119 NGC cases were reviewed; 577 screened by two CTs and 542 screened by one CT. All cases were signed out by a pathologist and all CT interpretations were compared to the pathologist final diagnoses. The disagreements were classified based on degree of discrepancy. The extra workload by adding the second screener was assessed. The agreement rate between the CT's screening interpretation and pathologist's interpretation did not improve by adding a second CT compared to a single screener (91.5% vs 92.9%, respectively). CT to pathologist concordance was very high on low complexity NGC cases (voided urine, fluid, sputum) whether screened and interpreted as negative by one CT (97.3%) or two CTs (99.3%). Double screening of NGC cases by two cytotechnologists prior to pathologist sign-out does not improve screening quality and is not cost-effective. The high concordance between the CTs and pathologists in this limited group of low complexity negative cases suggests that such cases could be signed out independently by cytotechnologists. © 2017 John Wiley & Sons Ltd.

Double-Row Capsulolabral Repair Increases Load to Failure and Decreases Excessive Motion.

PubMed

McDonald, Lucas S; Thompson, Matthew; Altchek, David W; McGarry, Michelle H; Lee, Thay Q; Rocchi, Vanna J; Dines, Joshua S

2016-11-01

Using a cadaver shoulder instability model and load-testing device, we compared biomechanical characteristics of double-row and single-row capsulolabral repairs. We hypothesized a greater reduction in glenohumeral motion and translation and a higher load to failure in a mattress double-row capsulolabral repair than in a single-row repair. In 6 matched pairs of cadaveric shoulders, a capsulolabral injury was created. One shoulder was repaired with a single-row technique, and the other with a double-row mattress technique. Rotational range of motion, anterior-inferior translation, and humeral head kinematics were measured. Load-to-failure testing measured stiffness, yield load, deformation at yield load, energy absorbed at yield load, load to failure, deformation at ultimate load, and energy absorbed at ultimate load. Double-row repair significantly decreased external rotation and total range of motion compared with single-row repair. Both repairs decreased anterior-inferior translation compared with the capsulolabral-injured condition, however, no differences existed between repair types. Yield load in the single-row group was 171.3 ± 110.1 N, and in the double-row group it was 216.1 ± 83.1 N (P = .02). Ultimate load to failure in the single-row group was 224.5 ± 121.0 N, and in the double-row group it was 373.9 ± 172.0 N (P = .05). Energy absorbed at ultimate load in the single-row group was 1,745.4 ± 1,462.9 N-mm, and in the double-row group it was 4,649.8 ± 1,930.8 N-mm (P = .02). In cases of capsulolabral disruption, double-row repair techniques may result in decreased shoulder rotational range of motion and improved load-to-failure characteristics. In cases of capsulolabral disruption, repair techniques with double-row mattress repair may provide more secure fixation. Double-row capsulolabral repair decreases shoulder motion and increases load to failure, yield load, and energy absorbed at yield load more than single-row repair. Published by Elsevier Inc.

[Psychopathologic language. 1. The double-meaning dialogue].

PubMed

Fernandez-Zoila, A

1982-01-01

The psychopathological language is analysed in three forms about the intra-personnal and the inter-personnal relations: 1) The double without dialogue; 2) The ego in the soliloque; 3) The sex of the words. In this first part a clinical case is proposed by "The double" than by F. Dostoïevski. The most obscure part of the personality, the non-self, is the origine of a delusion. The development of delusion is favorised by a non-control of the dialogical structure of the language under social pressures.

The double power law in human collaboration behavior: The case of Wikipedia

NASA Astrophysics Data System (ADS)

Kwon, Okyu; Son, Woo-Sik; Jung, Woo-Sung

2016-11-01

We study human behavior in terms of the inter-event time distribution of revision behavior on Wikipedia, an online collaborative encyclopedia. We observe a double power law distribution for the inter-editing behavior at the population level and a single power law distribution at the individual level. Although interactions between users are indirect or moderate on Wikipedia, we determine that the synchronized editing behavior among users plays a key role in determining the slope of the tail of the double power law distribution.

A coupled-cluster study of photodetachment cross sections of closed-shell anions

NASA Astrophysics Data System (ADS)

Cukras, Janusz; Decleva, Piero; Coriani, Sonia

2014-11-01

We investigate the performance of Stieltjes Imaging applied to Lanczos pseudo-spectra generated at the coupled cluster singles and doubles, coupled cluster singles and approximate iterative doubles and coupled cluster singles levels of theory in modeling the photodetachment cross sections of the closed shell anions H-, Li-, Na-, F-, Cl-, and OH-. The accurate description of double excitations is found to play a much more important role than in the case of photoionization of neutral species.

A coupled-cluster study of photodetachment cross sections of closed-shell anions.

PubMed

Cukras, Janusz; Decleva, Piero; Coriani, Sonia

2014-11-07

We investigate the performance of Stieltjes Imaging applied to Lanczos pseudo-spectra generated at the coupled cluster singles and doubles, coupled cluster singles and approximate iterative doubles and coupled cluster singles levels of theory in modeling the photodetachment cross sections of the closed shell anions H(-), Li(-), Na(-), F(-), Cl(-), and OH(-). The accurate description of double excitations is found to play a much more important role than in the case of photoionization of neutral species.

[Effectiveness comparison of suspension fixation plus hinged external fixator and double plate internal fixation in treatment of type C humeral intercondylar fractures].

PubMed

Zhang, Jian; Lin, Xu; Zhong, Zeli; Wu, Chao; Tan, Lun

2017-07-01

To compare the effectiveness of suspension fixation plus hinged external fixator with double plate internal fixation in the treatment of type C humeral intercondylar fractures. Between January 2014 and April 2016, 30 patients with type C (Association for the Study of Internal Fixation, AO/ASIF) humeral intercondylar fractures were treated. Kirschner wire suspension fixation plus hinged external fixator was used in 14 cases (group A), and double plate internal fixation in 16 cases (group B). There was no significant difference in gender, age, injury cause, disease duration, injury side, and type of fracture between 2 groups ( P >0.05). There was no significant difference in operation time and hospitalization stay between 2 groups ( P >0.05). But the intraoperative blood loss in group A was significantly less than that in group B ( P <0.05); the visual analogue scale (VAS) score at 1 day and 3 days after operation in group A were significantly less than those in group B ( P <0.05). Primary healing of incision was obtained in all patients of 2 groups, and no surgery-related complications occurred. The patients were followed up 6-24 months (mean, 12.3 months) in group A and 6-24 months (mean, 12.8 months) in group B. The self-evaluation satisfaction rate was 85.7% (12/14) in group A and was 81.2% (13/16) in group B at 3 months after operation, showing no significant difference ( χ 2 =0.055, P =0.990). Based on the improved Gassebaum elbow performance score at 6 months after operation, excellent and good rate of the elbow function was 78.6% (excellent in 5 cases, good in 6 cases, fair in 2 cases, and poor in 1 case) in group A and was 81.2% (excellent in 6 cases, good in 7 cases, fair in 2 cases, and poor in 1 case) in group B, showing no significant difference between 2 groups ( χ 2 =0.056, P =0.990). Heterotopic ossification occurred at 3 months after operation in 1 case of each group respectively. The X-ray films showed bony union in all cases; no loosening or breakage of screw was observed. The bone union time showed no significant difference between 2 groups ( t =-0.028, P =0.978). The time of internal fixation removal, the intraoperative blood loss, and VAS score at 1 day and 3 days after operation in group A were significant better than those in group B ( P <0.05). The suspension fixation plus hinged external fixator and double plate internal fixation for the treatment of type C humeral intercondylar fractures have ideal outcome in elbow function. But the suspension fixation plus hinged external fixator is better than double plate internal fixation in intraoperative blood loss, postoperative VAS score, and time of internal fixation removal.

Factorization of differential expansion for non-rectangular representations

NASA Astrophysics Data System (ADS)

Morozov, A.

2018-04-01

Factorization of the differential expansion (DE) coefficients for colored HOMFLY-PT polynomials of antiparallel double braids, originally discovered for rectangular representations R, in the case of rectangular representations R, is extended to the first non-rectangular representations R = [2, 1] and R = [3, 1]. This increases chances that such factorization will take place for generic R, thus fixing the shape of the DE. We illustrate the power of the method by conjecturing the DE-induced expression for double-braid polynomials for all R = [r, 1]. In variance with the rectangular case, the knowledge for double braids is not fully sufficient to deduce the exclusive Racah matrix S¯ — the entries in the sectors with nontrivial multiplicities sum up and remain unseparated. Still, a considerable piece of the matrix is extracted directly and its other elements can be found by solving the unitarity constraints.

A controlled ac Stark echo for quantum memories.

PubMed

Ham, Byoung S

2017-08-09

A quantum memory protocol of controlled ac Stark echoes (CASE) based on a double rephasing photon echo scheme via controlled Rabi flopping is proposed. The double rephasing scheme of photon echoes inherently satisfies the no-population inversion requirement for quantum memories, but the resultant absorptive echo remains a fundamental problem. Herein, it is reported that the first echo in the double rephasing scheme can be dynamically controlled so that it does not affect the second echo, which is accomplished by using unbalanced ac Stark shifts. Then, the second echo is coherently controlled to be emissive via controlled coherence conversion. Finally a near perfect ultralong CASE is presented using a backward echo scheme. Compared with other methods such as dc Stark echoes, the present protocol is all-optical with advantages of wavelength-selective dynamic control of quantum processing for erasing, buffering, and channel multiplexing.

Noble metal nanostructures for double plasmon resonance with tunable properties

NASA Astrophysics Data System (ADS)

Petr, M.; Kylián, O.; Kuzminova, A.; Kratochvíl, J.; Khalakhan, I.; Hanuš, J.; Biederman, H.

2017-02-01

We report and compare two vacuum-based strategies to produce Ag/Au materials characterized by double plasmon resonance peaks: magnetron sputtering and method based on the use of gas aggregation sources (GAS) of nanoparticles. It was observed that the double plasmon resonance peaks may be achieved by both of these methods and that the intensities of individual localized surface plasmon resonance peaks may be tuned by deposition conditions. However, in the case of sputter deposition it was necessary to introduce a separation dielectric interlayer in between individual Ag and Au nanoparticle films which was not the case of films prepared by GAS systems. The differences in the optical properties of sputter deposited bimetallic Ag/Au films and coatings consisted of individual Ag and Au nanoparticles produced by GAS is ascribed to the divers mechanisms of nanoparticles formation.

A novel mechanism for creating double pulsars

NASA Technical Reports Server (NTRS)

Sigurdsson, Steinn; Hernquist, Lars

1992-01-01

Simulations of encounters between pairs of hard binaries, each containing a neutron star and a main-sequence star, reveal a new formation mechanism for double pulsars in dense cores of globular clusters. In many cases, the two normal stars are disrupted to form a common envelope around the pair of neutron stars, both of which will be spun up to become millisecond pulsars. We predict that a new class of pulsars, double millisecond pulsars, will be discovered in the cores of dense globular clusters. The genesis proceeds through a short-lived double-core common envelope phase, with the envelope ejected in a fast wind. It is possible that the progenitor may also undergo a double X-ray binary phase. Any circular, short-period double pulsar found in the galaxy would necessarily come from disrupted disk clusters, unlike Hulse-Taylor class pulsars or low-mass X-ray binaries which may be ejected from clusters or formed in the galaxy.

HEATS OF FORMATION OF GIBBSITE AND LIGHT ELEMENT DOUBLE OXIDES,

DTIC Science & Technology

The heat of formation of gibbsite , from alpha-alumina and water, has been redetermined by solution calorimetry in hydrofluoric acid at 75C. A value...calorimetry in hydrofluoric acid at 75C. In the case of the double oxides that contained alumina, gibbsite was used as a reference compound. (Author)

Case Studies of Effects of Artificial Food Colors on Hyperactivity.

ERIC Educational Resources Information Center

Spring, Carl; And Others

1981-01-01

A double blind, double crossover study with six hyperactive boys (8 to 13 years old) tested B. Feingold's hypothesis that synthetic food colors cause hyperactivity in some children. All Ss were on the Feingold diet, eliminating artificial colors and flavors. The authors conclude that evidence for Feingold's hypothesis is weak. (Author)

Evaluating Computational Models in Cognitive Neuropsychology: The Case from the Consonant/Vowel Distinction

ERIC Educational Resources Information Center

Knobel, Mark; Caramazza, Alfonso

2007-01-01

Caramazza et al. [Caramazza, A., Chialant, D., Capasso, R., & Miceli, G. (2000). Separable processing of consonants and vowels. "Nature," 403(6768), 428-430.] report two patients who exhibit a double dissociation between consonants and vowels in speech production. The patterning of this double dissociation cannot be explained by appealing to…

Use of Double-Loop Learning to Combat Advanced Persistent Threat: Multiple Case Studies

ERIC Educational Resources Information Center

Lamb, Christopher J.

2013-01-01

The Advanced Persistent Threat (APT) presents an ever present and more growing threat to organizations across the globe. Traditional Information Technology (IT) incident response falls short in effectively addressing this threat. This researcher investigated the use of single-loop and double-loop learning in two organizations with internal…

Abnormal connection of the inferior vena cava to the left atrium with double outlet right ventricle and heterotaxia: a case report.

PubMed

Günal, N; Bilgiç, A; Lenk, M K; Yurdakul, Y; Sarigül, A; Ispir, S

1996-03-01

A 4-year-old boy with abnormal connection of the inferior vena cava to the left atrium and double outlet right ventricle and right atrial isomerism is presented. The anomalies were detected by echocardiography and angiography, and later verified through surgical intervention.

Investigation of airflow effects on the dielectric barrier discharge with single/double discharge channel arrangement

NASA Astrophysics Data System (ADS)

Fan, Zhihui; Yan, Huijie; Liu, Yidi; Guo, Hongfei; Wang, Yuying; Ren, Chunsheng

2018-05-01

Atmospheric-pressure dielectric barrier discharge (DBD) with airflow participation has been widely used in recent years. In this paper, effects of airflow on DBD characteristics are experimentally investigated by single/double pin-to-plate DBD arrangements with an AC exciting source. The discharge electrical characteristics and the movements of discharge channels in airflow are investigated with a single pin electrode arrangement. The current intensities increase in positive cycles and decrease in negative cycles with the increase in airflow velocity. The transition from a filamentary discharge to a diffuse discharge is observed under certain airflow conditions, and the discharge channels move with the airflow with a movement velocity less than the corresponding airflow velocity. In the cases of double pin electrode arrangements, the repulsion between double pin discharge channels is apparent at a 10 mm distance but is not obvious at a 20 mm distance. When the airflow is introduced into the discharge gap, not as in the case of single pin electrode arrangement, the movements of discharge channels in airflow are affected by adjacent discharge channels. The corresponding reasons are analyzed in the paper.

[Tentorial Dural Arteriovenous Fistula Successfully Treated with Transvenous Embolization Using a Double Catheterization Technique through Venous Drainage:A Case Report].

PubMed

Yamakawa, Akira; Fujita, Atsushi; Tanaka, Hirotomo; Ikeda, Mitsuru; Morikawa, Masashi; Kohmura, Eiji

2017-07-01

Tentorial dural arteriovenous fistulas(dAVFs)are a rare clinical entity accounting for less than 10% of all intracranial dAVFs. Because these lesions are characterized by high hemorrhagic risk, aggressive treatment should be considered. Although the number of reported cases treated with endovascular transarterial embolization(TAE)using glue has been increasing, little is known about the transvenous approach. Here, we report the case of a patient with a tentorial dAVF who was successfully treated with transvenous embolization(TVE)through venous drainage using a double catheterization technique. A 68-year-old male patient who had a history of left putaminal hemorrhage treated with a craniotomy was diagnosed with a tentorial dAVF on a magnetic resonance angiogram. Because the patient refused another craniotomy for surgical interruption of the dAVF, an endovascular approach was considered. We first attempted to perform TAE with glue, but catheterization into the tortuous meningohypophyseal trunk failed. We then performed a TVE of the venous drainage near the shunt with detachable coils and achieved complete obliteration of the fistula. During coil embolization of the venous drainage, insertion of small coils near the shunt was supported by another anchor coil that was delivered using a double catheterization technique. The method of TVE through venous drainage using a double catheterization technique, which involved placing coils in the fragile drainage vein, was safe and effective in a case of tentorial dAVF. This technique should be considered as another option for the management of complex tentorial dAVFs.

Statistical Analysis of the Polarimetric Cloud Analysis and Seeding Test (POLCAST) Field Projects

NASA Astrophysics Data System (ADS)

Ekness, Jamie Lynn

The North Dakota farming industry brings in more than $4.1 billion annually in cash receipts. Unfortunately, agriculture sales vary significantly from year to year, which is due in large part to weather events such as hail storms and droughts. One method to mitigate drought is to use hygroscopic seeding to increase the precipitation efficiency of clouds. The North Dakota Atmospheric Research Board (NDARB) sponsored the Polarimetric Cloud Analysis and Seeding Test (POLCAST) research project to determine the effectiveness of hygroscopic seeding in North Dakota. The POLCAST field projects obtained airborne and radar observations, while conducting randomized cloud seeding. The Thunderstorm Identification Tracking and Nowcasting (TITAN) program is used to analyze radar data (33 usable cases) in determining differences in the duration of the storm, rain rate and total rain amount between seeded and non-seeded clouds. The single ratio of seeded to non-seeded cases is 1.56 (0.28 mm/0.18 mm) or 56% increase for the average hourly rainfall during the first 60 minutes after target selection. A seeding effect is indicated with the lifetime of the storms increasing by 41 % between seeded and non-seeded clouds for the first 60 minutes past seeding decision. A double ratio statistic, a comparison of radar derived rain amount of the last 40 minutes of a case (seed/non-seed), compared to the first 20 minutes (seed/non-seed), is used to account for the natural variability of the cloud system and gives a double ratio of 1.85. The Mann-Whitney test on the double ratio of seeded to non-seeded cases (33 cases) gives a significance (p-value) of 0.063. Bootstrapping analysis of the POLCAST set indicates that 50 cases would provide statistically significant results based on the Mann-Whitney test of the double ratio. All the statistical analysis conducted on the POLCAST data set show that hygroscopic seeding in North Dakota does increase precipitation. While an additional POLCAST field project would be necessary to obtain standardly accepted statistically significant results (p < 0.5) for the double ratio of precipitation amount, the obtained p-value of 0.063 is close and considering the positive result from other hygroscopic seeding experiments, the North Dakota Cloud Modification Project should consider implementation of hygroscopic seeding.

Prospective study of glove perforation in obstetrical and gynecological operations: are we safe enough?

PubMed

Malhotra, Monika; Sharma, Jai Bhagwan; Wadhwa, Leena; Arora, Raksha

2004-08-01

To assess the glove perforation rate, efficacy of double gloving, effect of duration of surgery, expertise of surgeon and operative urgency on the glove perforation rate in obstetrical and gynecologic operations. From February to September 2002, double glove protocol was made necessary for all major obstetrical and gynecologic procedures. The operating surgeon, first and second assistant were included in the study. Gloves damage was noted (overt by inspection, occult by hydroinsufflation technique). Of the 156 procedures included in study, 32 procedures were performed (all emergency operations) single-gloved because surgeons found double gloving clumsy (56%), made it difficult to tie knots due to lack of dexterity (24%), or were too tight (20%). One thousand one hundred and twenty single gloves were examined after each procedure by hydroinsufflation. The overall perforation rate was 13.6% (single versus double outer gloves, 13.8% versus l3.2%, P > 0.05). Matching perforations were found in six cases (4.6%). Thus, the protection offered by double gloves was 95.4% even if the outer gloves were perforated. Four inner gloves had preexisting perforations. Sixty unused gloves checked similarly revealed a perforation rate of 1.6%. Emergency cases had higher perforation rate compared to elective surgeries (16.6% versus 10.8%, P < 0.00 1). Surgeries lasting for more than 40 min had a higher perforation rate compared to those finished in less than or equal to 40 min (18.6% versus 7.6%, P < 0.001). The middle finger of the left hand was the most commonly involved. The surgeon, first assistant and second assistant were involved in 73.6, 23.3 and 3.2% cases, respectively. Double gloving offers considerable protection against exposure to contaminants in the blood and body fluids of the patient and should be made routine, especially in developing countries where HIV, hepatitis B and C are widely prevalent. Double gloving should be made mandatory in emergency procedures, which have a higher perforation rate due to operative urgency, and gloves should be changed in operations lasting for more than 40 min to ensure integrity of barrier.

The LPM effect in sequential bremsstrahlung 2: factorization

DOE PAGES

Arnold, Peter; Chang, Han-Chih; Iqbal, Shahin

2016-09-13

The splitting processes of bremsstrahlung and pair production in a medium are coherent over large distances in the very high energy limit, which leads to a suppression known as the Landau-Pomeranchuk-Migdal (LPM) effect. In this paper, we continue analysis of the case when the coherence lengths of two consecutive splitting processes overlap (which is important for understanding corrections to standard treatments of the LPM effect in QCD), avoiding soft-gluon approximations. In particular, this paper analyzes the subtle problem of how to precisely separate overlapping double splitting (e.g. overlapping double bremsstrahlung) from the case of consecutive, independent bremsstrahlung (which is themore » case that would be implemented in a Monte Carlo simulation based solely on single splitting rates). As an example of the method, we consider the rate of real double gluon bremsstrahlung from an initial gluon with various simplifying assumptions (thick media; q approximation; large N c; and neglect for the moment of processes involving 4-gluon ver-tices) and explicitly compute the correction Δ dΓ/dx dy due to overlapping formation times.« less

True double bifurcation lesions: new application of the self-expandable Axxess stent and review of literature with dedicated bifurcation devices.

PubMed

Borgia, Francesco; Niglio, Tullio; De Luca, Nicola; Di Serafino, Luigi; Esposito, Giovanni; Trimarco, Bruno; Cirillo, Plinio

2018-04-21

Complex coronary artery bifurcation lesions occurred in hard clinical scenarios, such as acute coronary syndromes, may represent a challenge for interventional cardiologists, with not-defined general consensus on treatment. Even if provisional stenting is the most common option used to restore rapidly the coronary branches flow, improvements in industrial technologies and design of new dedicated bifurcation devices might open new modalities of treatment in these complex cases. The Axxess stent (Biosensors Europe SA, Morges, Switzerland) is a self-expanding biolimus-eluting conical V-shape stent, specifically designed to treat "easily" coronary artery bifurcation lesions, with reported favorable long-term clinical results in stable patients compared to a provisional technique. We report for the first time the feasibility to use this device in a case of "true double coronary bifurcation lesion" occurred in the context of acute coronary syndrome. Moreover, we reviewed studies with bifurcation dedicated devices and available cases of "true double bifurcation lesions", underlying advantages/disadvantages of using one device over the others during acute coronary syndrome. Copyright © 2018 Elsevier Inc. All rights reserved.

Compound double ileoileal and ileocecocolic intussusception caused by lipoma of the ileum in an adult patient: A case report

PubMed Central

2011-01-01

Introduction The initial diagnosis of intussusception in adults very often can be missed and cause delayed treatment and possible serious complications. We report the case of an adult patient with complicated double ileoileal and ileocecocolic intussusception. Case presentation A 46-year-old Caucasian man was transferred from the gastroenterology service to the abdominal surgery service with severe abdominal pain, nausea, and vomiting. An abdominal ultrasound, barium enema, and abdominal computed tomography scan revealed an intraluminal obstruction of his ascending colon. Plain abdominal X-rays showed diffuse air-fluid levels in his small intestine. A double ileoileal and ileocecocolic intussusception was found during an emergent laparotomy. A right hemicolectomy, including resection of a long segment of his ileum, was performed. The postoperative period was complicated by acute renal failure, shock liver, and pulmonary thromboembolism. Our patient was discharged from the hospital after 30 days. An anatomical pathology examination revealed a lipoma of his ileum. Conclusions Intussusception in adults requires early surgical resection regardless of the nature of the initial cause. Delayed treatment can cause very serious complications. PMID:21910876

[Urologic surgical procedures in patients with uterus neoplasm and colon-rectal cancer].

PubMed

Marino, G; Laudi, M; Capussotti, L; Zola, P

2008-01-01

INTRODUCTION. During the last 30 years, the multidisciplinary treatments of colon and uterus neoplasm have yielded an increase in total survival rates, fostering therefore the increase of cases with regional relapse involving the urinary tract. In these cases the iterative surgery can be performed, if no disease secondary to pelvic pain, haemostatic or debulking procedure is present, and must be considered and discussed with the patient, according to his/her general status. MATERIALS AND METHODS. From 1997 to August 2007 we performed altogether 43 pelvic iterative surgeries, with simultaneous urologic surgical procedure because of pelvic tumor relapse in patients with uterus neoplasm and colon and rectal cancer. In 4 cases of anal cancer, the urological procedure were: one radical prostatectomy with continent vesicostomy in the first case, while in the other 3 cases radical pelvectomy with double-barrelled uretero-cutaneostomy. In 23 cases of colon cancer, the urologic procedures were: 9 cases of radical cystectomy with double-barrelled uretero-cutaneostomy, 4 cases of radical cystectomy with uretero-ileo-cutaneostomy according to Bricker- Wallace II procedure, and 9 cases of partial cystectomy with pelvic ureterectomy and ureterocystoneostomy according to Lich-Gregoire technique (7 cases) and Lembo-Boari (2 cases) procedure. In 16 cases of uterus cancer, the urological procedure were: 7 cases of partial cystectomy with pelvic ureterectomy and uretero-cystoneostomy according to Lich-Gregoire procedure; in 3 cases, a radical cystectomy with urinary continent cutaneous diversion according to the Ileal T-pouch procedure; 2 cases of total pelvectomy and double uretero-cutaneostomy, and 4 cases of bilateral uretero-cutaneostomy. RESULTS. No patients died in the perioperative time; early systemic complications were: 2 esophageal candidiasis, 1 case of venous thrombosis. CONCLUSIONS. The iterative pelvic surgery in the case of oncological relapse involving the urinary tract aims to achieve the best quality of life with the utmost oncological radicality. The equation: eradication of pelvic neoplasm and urinary tract reconstruction, with acceptable quality of life, will be the future target; nevertheless, it is not possible to establish guidelines beforehand, and the therapy must be adapted to each single case.

Endoscopic placement of double-J ureteric stents in children as a treatment for primary hydronephrosis.

PubMed

Pogorelić, Zenon; Brković, Tomislava; Budimir, Dražen; Todorić, Jakov; Košuljandić, Đurđica; Jerončić, Ana; Biočić, Mihovil; Saraga, Marijan

2017-06-01

The aim of this study was to determine the efficacy and potential complications of double-J ureteric stents in the treatment of primary hydronephrosis in pediatric patients. A retrospective case-records review of 133 patients (45 girls and 88 boys) treated because of primary hydronephrosis with double-J ureteric stents, in Department of Pediatric Surgery, Split University Hospital, between December 1997 and December 2014, was performed. Success of treatment, results of follow up investigations and complications were recorded. Patients were followed up clinically and radiologically for a minimum of 2 years following stent insertion. In all, 133 endoscopic double-J ureteric stents insertions were performed. Of the total number of patients, left-sided hydronephrosis was found in 82 patients, right-sided in 38, and bilateral in 13 patients. The median age of children was 2 years (range 0-17 years). Mean hospital stay was 2 days (range 1-10 days). In primary hydronephrosis, double-J ureteric stenting alone was effective with resolution of hydronephrosis in 73% of cases (97/133 insertions). Regarding the age of the patients the highest success of 83.5% was achieved in age group 0-4 years. Success in groups 5-9 years; 10-14 years and 15-17 years were 47%; 33.5% and 0%, respectively. Several complications have been recorded: symptomatic infections, migration in the renal pelvis and bladder, progression of hydronephrosis, spontaneously prolapse of prosthesis, bleeding and perforation of the renal pelvis. A significant, decreasing trend in success rates by age of participants was observed (p < 0.001). Ureteric stenting is minimally invasive procedure that provides an alternative to open surgery in patients with primary hydronephrosis. Endoscopic placement of ureteric double-J stents should be considered as a first-line treatment in the management of primary hydronephrosis especially in children till 4 years of age, with success rate of 83.5% and without the need for conventional surgery. In a case of failure we are time-consuming to definitive surgery.

Role of Echocardiograghy in Treating a Case of Double Chamber Right Ventricle with Delayed Presentation

PubMed Central

Barik, Ramachandra

2017-01-01

The clinical diagnosis of double chamber right ventricle (DCRV) is not straightforward. Clinical history, clinical examination, 12-lead electrocardiogram, chest X-ray, and Echocardiography (echo) contribute to morphological diagnosis. Cardiac catheterization is essential for hemodynamic evaluation. A thorough presurgical workup helps the cardiac surgeon to choose the appropriate surgical approach and timing of surgery in an individual case. We present a case of a DCRV who presented to us in the fifth decade of life. Echo confirmed the morphological diagnosis and cardiac catheterization complemented the exact pull back gradient across the obstruction in the right ventricle. This patient was suggested muscle bundle resection and ventricular septal defect closure using right atrial approach. PMID:28465983

An overlap case of Parry-Romberg syndrome and en coup de sabre with striking ocular involvement and anti-double-stranded DNA positivity.

PubMed

Ataş, Hatice; Gönül, Müzeyyen; Gökçe, Aysun; Acar, Mutlu; Gürdal, Canan

2018-02-01

Parry-Romberg syndrome (PRS) may overlap localized scleroderma (morphea) lesions with linear depression (en coup de sabre [ECDS]). Overlap case with PRS and ECDS was presented. Enophthalmos, uveitis, ocular torticollis, keratic linear precipitates, and anti-double-stranded DNA positivity were identified. Subendothelial keratic precipitates detected by an in vivo laser scanning confocal microscopy were the first profiled in the literature. Patients must be evaluated and followed up carefully by their clinics to prevent misdiagnosis and unnecessary procedures such as surgery of ocular torticollis as muscular torticollis.

[Double localization of pancreatic insulinoma. Diagnostic and therapeutic difficulties].

PubMed

Ungureanu, C D; David, L; Braşoveanu, V; Herlea, V; Coculescu, M; Popescu, I

2005-01-01

Insulinomas are the most common cause of hypoglycemia resulting from endogenous hyperinsulinism. Because most of insulinomas are less than 2 cm in size and rarely they not may be visible by CT scan or transabdominal ultrasonography. Intraoperative ultrasonography may be a solution. Although as surgical method is preferred enucleation because operative time is shorter and easier and the low frequency postoperative complications, pancreaticoduodenectomy Whipple is indicated in selected cases. We report a case of double insulinoma located in the head of the pancreas in which the diagnosis and surgical treatment presented difficulties which determined a particular clinical evolution.

Young's double-slit interference with two-color biphotons.

PubMed

Zhang, De-Jian; Wu, Shuang; Li, Hong-Guo; Wang, Hai-Bo; Xiong, Jun; Wang, Kaige

2017-12-12

In classical optics, Young's double-slit experiment with colored coherent light gives rise to individual interference fringes for each light frequency, referring to single-photon interference. However, two-photon double-slit interference has been widely studied only for wavelength-degenerate biphoton, known as subwavelength quantum lithography. In this work, we report double-slit interference experiments with two-color biphoton. Different from the degenerate case, the experimental results depend on the measurement methods. From a two-axis coincidence measurement pattern we can extract complete interference information about two colors. The conceptual model provides an intuitional picture of the in-phase and out-of-phase photon correlations and a complete quantum understanding about the which-path information of two colored photons.

A mechanical comparison of linear and double-looped hung supplemental heavy chain resistance to the back squat: a case study.

PubMed

Neelly, Kurt R; Terry, Joseph G; Morris, Martin J

2010-01-01

A relatively new and scarcely researched technique to increase strength is the use of supplemental heavy chain resistance (SHCR) in conjunction with plate weights to provide variable resistance to free weight exercises. The purpose of this case study was to determine the actual resistance being provided by a double-looped versus a linear hung SHCR to the back squat exercise. The linear technique simply hangs the chain directly from the bar, whereas the double-looped technique uses a smaller chain to adjust the height of the looped chain. In both techniques, as the squat descends, chain weight is unloaded onto the floor, and as the squat ascends, chain weight is progressively loaded back as resistance. One experienced and trained male weight lifter (age = 33 yr; height = 1.83 m; weight = 111.4 kg) served as the subject. Plate weight was set at 84.1 kg, approximately 50% of the subject's 1 repetition maximum. The SHCR was affixed to load cells, sampling at a frequency of 500 Hz, which were affixed to the Olympic bar. Data were collected as the subject completed the back squat under the following conditions: double-looped 1 chain (9.6 kg), double-looped 2 chains (19.2 kg), linear 1 chain, and linear 2 chains. The double-looped SHCR resulted in a 78-89% unloading of the chain weight at the bottom of the squat, whereas the linear hanging SHCR resulted in only a 36-42% unloading. The double-looped technique provided nearly 2 times the variable resistance at the top of the squat compared with the linear hanging technique, showing that attention must be given to the technique used to hang SHCR.

The full metallic double-pigtail ureteral stent: Review of the clinical outcome and current status

PubMed Central

Kallidonis, Panagiotis S.; Georgiopoulos, Ioannis S.; Kyriazis, Iason D.; Kontogiannis, Stavros; Al-Aown, Abdulrahman M.; Liatsikos, Evangelos N.

2015-01-01

The full metallic double-J ureteral stent (MS) was introduced as a method for providing long-term drainage in malignant ureteral obstruction. Experimental evaluation of the MS revealed that its mechanical features allow efficient drainage in difficult cases, which could not be managed by the insertion of a standard polymeric double-J stent. Clinical experience with the MS showed controversial results. Careful patient selection results in efficient long-term management of malignant ureteral obstruction. The use of the MS should also be considered in selected benign cases. Major complications are uncommon and the minor complications should not hinder its use. Experience in pediatric patients is limited and warrants additional study. The cost-effectiveness of the MS seems to be appropriate for long-term treatment. Further investigation with comparative clinical trials would document the outcome more extensively and establish the indications as well as the selection criteria for the MS. PMID:25624569

Double-barrelled wet colostomy formation after pelvic exenteration for locally advanced or recurrent rectal cancer.

PubMed

Bloemendaal, A L A; Kraus, R; Buchs, N C; Hamdy, F C; Hompes, R; Cogswell, L; Guy, R J

2016-11-01

In advanced pelvic cancer it may be necessary to perform a total pelvic exenteration. In such cases urinary tract reconstruction is usually achieved with the creation of an ileal conduit with a urinary stoma on the right side of the patient's abdomen and an end colostomy separately on the left. The potential morbidity from a second stoma may be avoided by the use of a double-barrelled wet colostomy (DBWC), as a single stoma. Another advantage is the possibility of using a vertical rectus abdominis muscle flap for perineal reconstruction. All patients undergoing formation of a DBWC were included. A DBWC was formed in 10 patients. One patient underwent formation of a double-barrelled wet ileostomy. In this technical note we present our early experience in 11 cases and a video of DBWC formation in a male patient. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

Three-dimensional supersonic flow around double compression ramp with finite span

NASA Astrophysics Data System (ADS)

Lee, H. S.; Lee, J. H.; Park, G.; Park, S. H.; Byun, Y. H.

2017-01-01

Three-dimensional flows of Mach number 3 around a double-compression ramp with finite span have been investigated numerically. Shadowgraph visualisation images obtained in a supersonic wind tunnel are used for comparison. A three-dimensional Reynolds-averaged Navier-Stokes solver was used to obtain steady numerical solutions. Two-dimensional numerical results are also compared. Four different cases were studied: two different second ramp angles of 30° and 45° in configurations with and without sidewalls, respectively. Results showed that there is a leakage of mass and momentum fluxes heading outwards in the spanwise direction for three-dimensional cases without sidewalls. The leakage changed the flow characteristics of the shock-induced boundary layer and resulted in the discrepancy between the experimental data and two-dimensional numerical results. It is found that suppressing the flow leakage by attaching the sidewalls enhances the two-dimensionality of the experimental data for the double-compression ramp flow.

Fixation of comminuted midshaft clavicle fractures with bone fragments separated by soft tissue using a novel double ligature technique: A case report.

PubMed

Ju, Wei-Na; Wang, Cheng-Xue; Wang, Tie-Jun; Qi, Bao-Chang

2017-11-01

Clavicle fractures are common, and mostly occur in the midshaft. Methods for operative treatment of midshaft clavicle fractures are evolving, as they improve clinical outcomes compared with traditional conservative management. However, fixation of comminuted midshaft clavicle fractures with bone fragments separated by soft tissue remains a challenge. Here, we present a case of comminuted midshaft clavicle fracture with a bone fragment separated from the main fracture by soft tissue. Left comminuted midshaft clavicle fracture. We treated this patient with a novel double ligature technique using absorbable suturing. In the past 7 years, we have treated >50 patients with this technique. We have achieved good clinical outcomes with no complications. We recommend widespread use of our novel double ligature technique for treating comminuted midshaft clavicle fractures with bone fragments separated by soft tissue.

Biological approach to treatment of intra-articular proximal tibial fractures with double osteosynthesis.

PubMed

Singh, Saurabh; Patel, Pankaj R; Joshi, Anil Kumar; Naik, Rajnikant N; Nagaraj, Chethan; Kumar, Sudeep

2009-02-01

The treatment of intra-articular proximal tibial fractures is associated with complications, and much conflicting literature exists concerning the treatment of choice. In our study, an attempt has been made to develop an ideal and adequate treatment protocol for these intra-articular fractures. The principle of double osteosynthesis, i.e., lateral minimally invasive plate osteosynthesis (MIPO), was combined with a medial external fixator to treat 22 intra-articular proximal tibial fractures with soft tissue injury with a mean follow-up of 25 months. Superficial pin track infection was observed in one case, and no soft tissue breakdown was noted. Loss of articular reconstruction was reported in one case. Bridging callus was seen at 12 weeks (8 weeks-7 months). The principle of substitution or double osteosynthesis, i.e., lateral MIPO, was combined with a medial external fixator and proved to be a fairly good method of fixation in terms of results and complications.

[Subcortical laminar heterotopia 'double cortex syndrome'].

PubMed

Teplyshova, A M; Gaskin, V V; Kustov, G V; Gudkova, A A; Luzin, R V; Trifonov, I S; Lebedeva, A V

2017-01-01

This article presents a clinical case of a 29-year-old patient with 'Double cortex syndrome' with epilepsy, intellectual and mental disorders. Subcortical band heterotopia is a rare disorder of neuronal migration. Such patients typically present with epilepsy and variable degrees of mental retardation and behavioral and intellectual disturbances. The main diagnostic method is magnetic resonance imaging (MRI).

A Placebo Double-Blind Pilot Study of Dextromethorphan for Problematic Behaviors in Children with Autism

ERIC Educational Resources Information Center

Woodard, Cooper; Groden, June; Goodwin, Matthew; Bodfish, James

2007-01-01

We used a mixed group/single-case, double-blind, placebo-controlled, ABAB design to examine the safety and efficacy of the glutamate antagonist dextromethorphan for the treatment of problematic behaviors and core symptoms in eight children diagnosed with autism. All participants had increased levels of irritability at baseline as measured by the…

Double suturless hepaticojejunostomy.

PubMed

Brătucu, E; Straja, D; Cirimbei, C; Alecu, M; Nechita, D

2011-01-01

In iatrogenic lesions of the main bile duct, especially when the injury is above the level of the hepatic bifurcation, the surgeon ought to use two short and thin biliary stumps. It is necessary to perform separate anastomoses, using a "Y loop" and creating a double hepaticojejunostomy. Technical difficulties increase when the biliary ducts are thinner, tighter and separated from one another for a distance more than 2 cm. In such case we have attempted to develop a double sutureless hepaticojejunostomy by simply keeping the bilioenteric partners in apposition with continuous traction exerted via the biliary stents.

A medulloblastoma showing an unusually long doubling time: reflection of its singular nature.

PubMed

Doron, Omer; Zauberman, Jacob; Feldman, Ze'ev

2016-06-01

In this paper, we present a case of a 4-year-old male diagnosed with a desmoplastic, SHH-type medulloblastoma. Retrospectively, we discovered that the patient underwent an MRI scan at 21 months for reasons unrelated, revealing a T1-enhanced lesion at the vermis, later recognized as the source of the tumor. This unique case provides us with a glimpse into the natural history of this tumor. Our ability to measure tumor volume at two defined time points, 31 months apart, enabled us to deduce the tumor's doubling time. This is defined as the time of one cell cycle divided by the amount of cycling cells, multiplied by cell loss factor. Potential doubling time (Tpot) and actual doubling time (Td), calculated using the Gompertzian model, are the most clinically relevant with regard to a tumor's response to radiotherapy. Here, we show an actual doubling-time (Td) of 78 days, and an extrapolated tumor diameter at the time of birth of 0.25 mm. These results both support the medulloblastoma's embryonic origin, and indicating a threefold longer actual doubling time when compared to previous studies. Taking into account the reported range of medulloblastoma potential doubling time, we deduced a cell loss factor of between 48.9 and 95.5 %. These percentages fall in line with other malignant tumors. Although limited due to the obvious reliance on only two points in time and using the Gompertzian model to complete the remainder, to the best of our knowledge, this is the longest follow-up period reported for medulloblastoma. We have described how a unique turn of events enabled us to get a glimpse into the in situ development of a medulloblastoma over a 31-month period. Regarded sometimes as an idiosyncratic tumor comprised of an array of molecular changes, the complexity of medulloblastoma is displayed here, by revealing for the first time an actual doubling time three- to fourfold the previously known length.

MYC immunohistochemical and cytogenetic analysis are required for identification of clinically relevant aggressive B cell lymphoma subtypes.

PubMed

Raess, Philipp W; Moore, Stephen R; Cascio, Michael J; Dunlap, Jennifer; Fan, Guang; Gatter, Ken; Olson, Susan B; Braziel, Rita M

2018-06-01

Accurate subclassification of aggressive B cell lymphomas (ABCLs) requires integration of morphologic, immunohistochemical (IHC), and cytogenetic information. Optimal strategies have not been well defined for diagnosis of high grade B cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements (HGBLwR) and double expressor lymphomas with MYC and BCL2 protein overexpression. One hundred and eighty seven ABCLs were investigated with complete IHC and FISH analysis. Morphologic and IHC analysis was insufficient to identify clinically relevant HGBLwR. Approximately, 75% of cases classified as HGBLwR showed conventional DLBCL morphologic features. Fourteen percent of MYC-rearranged cases were negative by IHC. Conversely, 60% of cases positive for MYC by IHC did not demonstrate a MYC rearrangement. Analysis by FISH without MYC and BCL2 IHC would miss 41 cases of double expressor lymphoma. Complete IHC and FISH analysis is recommended in the evaluation of all ABCLs.

Influence of the charge double layer on solid oxide fuel cell stack behavior

NASA Astrophysics Data System (ADS)

Whiston, Michael M.; Bilec, Melissa M.; Schaefer, Laura A.

2015-10-01

While the charge double layer effect has traditionally been characterized as a millisecond phenomenon, longer timescales may be possible under certain operating conditions. This study simulates the dynamic response of a previously developed solid oxide fuel cell (SOFC) stack model that incorporates the charge double layer via an equivalent circuit. The model is simulated under step load changes. Baseline conditions are first defined, followed by consideration of minor and major deviations from the baseline case. This study also investigates the behavior of the SOFC stack with a relatively large double layer capacitance value, as well as operation of the SOFC stack under proportional-integral (PI) control. Results indicate that the presence of the charge double layer influences the SOFC stack's settling time significantly under the following conditions: (i) activation and concentration polarizations are significantly increased, or (ii) a large value of the double layer capacitance is assumed. Under normal (baseline) operation, on the other hand, the charge double layer effect diminishes within milliseconds, as expected. It seems reasonable, then, to neglect the charge double layer under normal operation. However, careful consideration should be given to potential variations in operation or material properties that may give rise to longer electrochemical settling times.

Step-doubling at Vicinal Ni(111) Surfaces Investigated with a Curved Crystal

DOE PAGES

Ilyn, Max; Magana, Ana; Walter, Andrew Leigh; ...

2017-01-25

Here, vicinal surfaces may undergo structural transformations as a function of temperature or in the presence of adsorbates. Step-doubling, in which monatomic steps pair up forming double-atom high staircases, is the simplest example. Here we investigate the case of Ni(111) using a curved crystal surface, which allows us to explore the occurrence of step-doubling as a function of temperature and vicinal plane (miscut α and step type). We find a striking A-type ({100}-like microfacets) versus B-type ({111}-like) asymmetry towards step-doubling. The terrace-width distribution analysis performed from Scanning Tunneling Microscopy data points to elastic step interactions overcoming entropic effects at verymore » small miscut α in A-type vicinals, as compared to B-type steps. For A-type vicinals, we elaborate the temperature/miscut phase diagram, on which we establish a critical miscut α c = 9.3° for step-doubling to take place.« less

Statistical and hydrodynamic properties of double-ring polymers with a fixed linking number between twin rings.

PubMed

Uehara, Erica; Deguchi, Tetsuo

2014-01-28

For a double-ring polymer in solution we evaluate the mean-square radius of gyration and the diffusion coefficient through simulation of off-lattice self-avoiding double polygons consisting of cylindrical segments with radius rex of unit length. Here, a self-avoiding double polygon consists of twin self-avoiding polygons which are connected by a cylindrical segment. We show numerically that several statistical and dynamical properties of double-ring polymers in solution depend on the linking number of the constituent twin ring polymers. The ratio of the mean-square radius of gyration of self-avoiding double polygons with zero linking number to that of no topological constraint is larger than 1, in particular, when the radius of cylindrical segments rex is small. However, the ratio is almost constant with respect to the number of vertices, N, and does not depend on N. The large-N behavior of topological swelling is thus quite different from the case of knotted random polygons.

Step-doubling at Vicinal Ni(111) Surfaces Investigated with a Curved Crystal

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

Ilyn, Max; Magana, Ana; Walter, Andrew Leigh

Here, vicinal surfaces may undergo structural transformations as a function of temperature or in the presence of adsorbates. Step-doubling, in which monatomic steps pair up forming double-atom high staircases, is the simplest example. Here we investigate the case of Ni(111) using a curved crystal surface, which allows us to explore the occurrence of step-doubling as a function of temperature and vicinal plane (miscut α and step type). We find a striking A-type ({100}-like microfacets) versus B-type ({111}-like) asymmetry towards step-doubling. The terrace-width distribution analysis performed from Scanning Tunneling Microscopy data points to elastic step interactions overcoming entropic effects at verymore » small miscut α in A-type vicinals, as compared to B-type steps. For A-type vicinals, we elaborate the temperature/miscut phase diagram, on which we establish a critical miscut α c = 9.3° for step-doubling to take place.« less

[POSTERIOR LUMBAR INTERBODY FUSION FOR DOUBLE-SEGMENTAL BILATERAL ISTHMIC LUMBAR SPONDYLOLISTHESIS].

PubMed

Xing, Wenhua; Huo Hongjun; Yang, Xuejun; Xiao, Yulong; Zhao, Yan; Fu, Yu; Zhu, Yong; Li, Feng; Xin, Daqi

2015-12-01

To explore the effectiveness of posterior lumbar interbody fusion in the treatment of double-segmental bilateral isthmic lumbar spondylolisthesis. Between February 2008 and December 2013, 17 patients with double-segmental bilateral isthmic lumbar spondylolisthesis were treated with posterior lumbar interbody fusion. There were 12 males and 5 females, with an age ranged 48-69 years (mean, 55.4 years). The disease duration ranged from 11 months to 17 years (median, 22 months). According to the Meyerding classification, 30 vertebrea were rated as degree I, 3 as degree II, and 1 as degree III. L₄,₅ was involved in 14 cases and L₃,₄ in 3 cases. The preoperative visual analogue scale (VAS) score was 8.6 ± 3.2. Cerebrospinal fluid leakage occurred in 2 cases because of intraoperative dural tear; primary healing of incision was obtained, with no operation related complication in the other patients. The patients were followed up 1-6 years (mean, 3.4 years). At last follow-up, VAS score was decreased significantly to 1.1 ± 0.4, showing significant difference when compared with preoperative score (t=7.652, P=0.008). X-ray films showed that slippage vertebral body obtained different degree of reduction, with a complete reduction rate of 85% (29/34) at 1 week after operation. All patients achieved bony union at 6-12 months (mean, 7.4 months). According to the Lenke classification, 13 cases were rated as grade A and 4 cases as grade B. No internal fixation loosening and fracture were observed during the follow-up. Intervertebral disc height was maintained, no loss of spondylolisthesis reduction was found. It can obtain satisfactory clinical result to use spinal canal decompression by posterior approach, and screw fixation for posterior fusion in treatment of double-segmental bilateral isthmic lumbar spondylolisthesis. The key points to successful operation include accurate insertion of screw, effective decompression, distraction before reduction, rational use of pulling screws, and interbody fusion.

Double-black-hole solutions of the Einstein-Maxwell-dilaton theory in five dimensions

NASA Astrophysics Data System (ADS)

Stelea, Cristian

2018-01-01

We describe a solution-generating technique that maps a static charged solution of the Einstein-Maxwell theory in four (or five) dimensions to a five-dimensional solution of the Einstein-Maxwell-Dilaton theory. As examples of this technique first we show how to construct the dilatonic version of the Reissner-Nordström solution in five dimensions and then we consider the more general case of the double black hole solutions and describe some of their properties. We found that in the general case the value of the conical singularities in between the black holes is affected by the dilaton's coupling constant to the gauge field and only in the particular case when all charges are proportional to the masses this dependence cancels out.

Triple Hit Lymphoma: Rare Cases With Less Dire Than Usual Prognosis.

PubMed

Kallen, Michael E; Alexanian, Serge; Said, Jonathan; Quintero-Rivera, Fabiola

2016-12-01

Triple hit lymphomas are a subset of so-called double hit non-Hodgkin lymphomas exhibiting simultaneous gene translocations/disruption of MYC, BCL2, and BCL6; however, their overlapping morphologic features and complex genetic rearrangements can render classification and prognostication vexing. Clinically triple hit lymphomas are thought to demonstrate aggressive behavior, similar to or worse than that of double hit lymphomas. Only rare reports of long term survivors exist and raise the possibility that unidentified morphologic, immunologic, or cytogenetic differences may impart a less adverse prognosis than current literature and opinion may suggest. Here we report 3 such cases with less aggressive behavior. Cases such as these may prove useful in comparing outcomes, and underlying mechanisms of tumor progression, in aggressive non-Hodgkin lymphomas. © The Author(s) 2016.

[Survival of patients with primary central nervous system diffuse large B-cell lymphoma: impact of gene aberrations and protein overexpression of bcl-2 and C-MYC, and selection of chemotherapy regimens].

PubMed

Yin, W J; Zhu, X; Yang, H Y; Sun, W Y; Wu, M J

2018-01-08

Objective: To investigate the impact of clinicopathological features, gene rearrangements and protein expression of bcl-6, bcl-2, C-MYC and chemotherapy regime on the prognosis of patients with primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL). Methods: Thirty-three cases of PCNS-DLBCL diagnosed from January 2006 to December 2016 at Zhejiang Cancer Hospital were collected. The expression of CD10, bcl-6, bcl-2, MUM1 and MYC were detected by immunohistochemical staining (IHC). The presence of EB virus was detected by in situ hybridization(EBER). Copy number variation (ICN) and translocation status of bcl-6, bcl-2 and C-MYC genes were detected by fluorescence in situ hybridization (FISH). The relationship between the above indexes and the prognosis was analyzed by univariate, bivariate survival analysis and multiple Cox hazard regression analysis. Results: The study included 33 patients of PCNS-DLBCL, without evidence of primary or secondary immunodeficient disease. Male to female ratio was 1.36∶1.00, and the average age was 56 years. Twenty cases had single lesion while 13 had multiple lesions. Deep brain involvement was seen in 12 cases. All patients underwent partial or total tumor resection. Five patients received whole brain post-surgery radiotherapy, nine patients received high-dose methotrexate (HD-MTX) based chemotherapy, and 12 patients received whole-brain radiotherapy combined with HD-MTX based chemotherapy. Severn patients received no further treatment and rituximab was used in 8 patients. According to the Hans model, 27 cases were classified as non-GCB subtypes (81.8%). Bcl-2 was positive in 25 cases (75.8%, 25/33) and highly expressed in 8 (24.2%). MYC was positive in 12 cases (36.4%) and double expression of bcl-2 and MYC was seen in 6 cases. EBER positive rate was 10.0%(3/30), all of which had multiple lesions. Two bcl-6 gene translocations and 3 amplifications were found in 28 patients. Two translocations, 3 ICN or with both bcl-2 gene translocation and ICN were found in 30 patients. Four ICNs of C-MYC gene were found in 28 patients. Elevated protein in cerebrospinal fluid (CSF) was found in 13 patients. LDH increased in 10 cases. Follow-up period was 2-90 months with the average survival time of (23.0±3.7) months and two-year survival rate of 39.0%. Univariate survival analysis showed that overexpression of bcl-2 protein (≥70%) and MYC protein (≥40%), bcl-2 gene abnormality (including copy number increase and translocation), C-MYC gene copy number increased were adverse factors for survival. C-MYC/ bcl-2 gene double hit was seen in 2 cases. Bivariate survival analysis found that of bcl-2/MYC protein double expression and bcl-2 and C-MYC genes double aberration were significantly associated with adverse outcomes. Cox multivariate risk regression analysis found that gender, cerebrospinal fluid protein increasing, and ICN of C-MYC gene were independent poor prognostic factors. DH-MTX based comprehensive chemotherapy was associated with better prognosis. Conclusions: Double hit at genomic level (copy number variations and gene rearrangements) and double protein expression of bcl-2 and C-MYC in PCNS-DLBCL are significantly associated with an adverse outcome. DH-MTX based comprehensive treatment may prolong the patient survival.

Marriage and Family Therapists Working with Couples Who Have Children with Autism

ERIC Educational Resources Information Center

Ramisch, Julie

2012-01-01

Current research about families and couples who have children with autism is discussed using the Double ABCX model as a guide. A case study is presented along with recommendations for therapists who work with couples who have children with autism. Marriage and family therapists are encouraged to use the Double ABCX model as both an assessment tool…

Double PCL sign does not always indicate a bucket-handle tear of medial meniscus.

PubMed

Liu, Chen; Zheng, Hua Yong; Huang, Yan; Li, Hai Peng; Wu, Han; Sun, Tian Sheng; Yao, Jian Hua

2016-09-01

The discoid medial meniscus is an extremely rare anomaly. Bilateral discoid medial menisci are much more rare but intermittently reported. We report the first case of bilateral discoid medial menisci with positive double PCL sign, which typically indicates a bucket-handle tear of medial meniscus. A literature review was also conducted on bilateral discoid medial menisci.

Past Organizational Change and Managerial Evaluations of Crisis: A Case of Double-Loop Learning Effects in Non-Profit Organizations

ERIC Educational Resources Information Center

Mano, Rita S.

2010-01-01

Purpose: This paper examines the critical effect of learning from past changes on employees' evaluations regarding the extent that a crisis can be controlled and prevented. It is suggested that previous changes incorporate elements of a double-loop learning process that shape managerial perceptions of crisis controllability and crisis prevention.…

The Doubles: A Case Study on Developing a Technology-Based Substance Abuse Education Curriculum

ERIC Educational Resources Information Center

Epstein, Joel; Collins, Karen Kadela; Pancella, Thom

2004-01-01

The Doubles, funded by the National Institute on Drug Abuse, is a seven-episode series of media tools designed to teach third and fourth grade students about the science of drug addiction. The program's curriculum is delivered via a set of videos, interactive CD-ROMs, workbooks, or an Internet site. This article examines the process used to…

Steady state conductance in a double quantum dot array: the nonequilibrium equation-of-motion Green function approach.

PubMed

Levy, Tal J; Rabani, Eran

2013-04-28

We study steady state transport through a double quantum dot array using the equation-of-motion approach to the nonequilibrium Green functions formalism. This popular technique relies on uncontrolled approximations to obtain a closure for a hierarchy of equations; however, its accuracy is questioned. We focus on 4 different closures, 2 of which were previously proposed in the context of the single quantum dot system (Anderson impurity model) and were extended to the double quantum dot array, and develop 2 new closures. Results for the differential conductance are compared to those attained by a master equation approach known to be accurate for weak system-leads couplings and high temperatures. While all 4 closures provide an accurate description of the Coulomb blockade and other transport properties in the single quantum dot case, they differ in the case of the double quantum dot array, where only one of the developed closures provides satisfactory results. This is rationalized by comparing the poles of the Green functions to the exact many-particle energy differences for the isolate system. Our analysis provides means to extend the equation-of-motion technique to more elaborate models of large bridge systems with strong electronic interactions.

Tendoscopic Double-Row Suture Bridge Peroneal Retinaculum Repair for Recurrent Dislocation of Peroneal Tendons in the Ankle.

PubMed

Nishimura, Akinobu; Nakazora, Shigeto; Ito, Naoya; Fukuda, Aki; Kato, Ko; Sudo, Akihiro

2016-06-01

Traumatic dislocation of peroneal tendons in the ankle is an uncommon lesion that mainly affects young adults. Unfortunately, most cases lead to recurrent dislocation of the peroneal tendons of the ankle (RPTD). Therefore, most cases need operative treatment. One of the most common operative procedures is superior peroneal retinaculum (SPR) repair. Recently, surgery for RPTD has been achieved with less invasive arthroscopic procedures. In this article, tendoscopic surgery for RPTD using a double-row suture bridge technique is introduced. This technique consists of debridement of the lateral aspect of the fibula under an intrasheath pseudo-cavity, suture anchor insertion into the fibular ridge, and reattachment of the SPR to the fibula using a knotless anchor screwed into the lateral aspect of the fibula. This technique mimics the double-row suture bridge technique for rotator cuff tear repair. The double-row suture bridge technique requires more surgical steps than the single-row technique, but it provides a wider bone-SPR contact surface and tighter fixation than the single-row technique. This procedure is an attractive option because it is less invasive and has achieved results similar to open procedures.

Generalized zeta function representation of groups and 2-dimensional topological Yang-Mills theory: The example of GL(2, #Mathematical Double-Struck Capital F#{sub q}) and PGL(2, #Mathematical Double-Struck Capital F#{sub q})

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

Roche, Ph., E-mail: philippe.roche@univ-montp2.fr

We recall the relation between zeta function representation of groups and two-dimensional topological Yang-Mills theory through Mednikh formula. We prove various generalisations of Mednikh formulas and define generalization of zeta function representations of groups. We compute some of these functions in the case of the finite group GL(2, #Mathematical Double-Struck Capital F#{sub q}) and PGL(2, #Mathematical Double-Struck Capital F#{sub q}). We recall the table characters of these groups for any q, compute the Frobenius-Schur indicator of their irreducible representations, and give the explicit structure of their fusion rings.

Double-loop frequency selective surfaces for multi frequency division multiplexing in a dual reflector antenna

NASA Technical Reports Server (NTRS)

Wu, Te-Kao (Inventor)

1994-01-01

A multireflector antenna utilizes a frequency-selective surface (FSS) in a subreflector to allow signals in two different RF bands to be selectively reflected back into a main reflector and to allow signals in other RF bands to be transmitted through it to the main reflector for primary focus transmission. A first approach requires only one FSS at the subreflector which may be an array of double-square-loop conductive elements. A second approach uses two FSS's at the subreflector which may be an array of either double-square-loop (DSL) or double-ring (DR). In the case of DR elements, they may be advantageously arranged in a triangular array instead of the rectangular array for the DSL elements.

Double Aortic Arch With Previously Undescribed Head and Neck Vessel Branching.

PubMed

Hashemi, Sassan; Parks, W James; Sallee, Denver; Slesnick, Timothy

2017-04-01

Vascular ring in the form of a double aortic arch is a rare anomaly that can cause airway compression. It occasionally occurs with unusual head and neck vessel branching. A 5-year-old boy with chronic respiratory symptoms was referred because of a tracheal indentation on his chest x-ray. Magnetic resonance imaging showed a double aortic arch with arch origins of a common carotid, vertebral, and subclavian on the right and internal and external carotids, vertebral, and subclavian arteries on the left. Our case represents, to our knowledge, the first report of a double aortic arch with 7 separate vessels arising from the transverse arches. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

[Sorting role of p16(INK4a)/Ki-67 double immunostaining in the cervical cytology specimens of ASCUS and LSIL cases].

PubMed

Yu, J; Zhu, H T; Zhao, J J; Su, J Z; Xia, Y D

2017-05-08

Objective: To investigate the sorting effect of p16(INK4a)/Ki-67 double immunostaining method in patients with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) cytology results. Methods: Four-hundred and twenty cases collected during April 2014 to February 2015 of cervical cytology of ASCUS ( n =318) and LSIL ( n =102) were selected, and residual liquid-based cytology specimens were used for p16(INK4a)/Ki-67 double immunostaining. The sensitivity and specificity of the detection of cervical precancerous lesions and cervical cancer were calculated, and the results were compared with high risk HPV. Taking histological follow-up as the gold standard, the test was considered positive when at least one cell exhibited p16(INK4a)/Ki-67 co-staining, without requirement of adjunct morphologic interpretation of positive cells. Results: Further screening CIN2+ in cytology ASCUS and LSIL group , the sensitivity of p16(INK4a)/Ki-67 double immunostaining was slightly lower than high risk HPV (84.2% vs . 94.7%), while the specificity was higher (84.0% vs . 53.9%). For ASCUS patients, the sensitivity of p16(INK4a)/Ki-67 double immunostaining and high risk HPV was 82.6% and 91.3%, and the specificity was 88.8% and 63.7%, respectively. For LSIL patients, the sensitivity of p16(INK4a)/Ki-67 double immunostaining and high risk HPV was 86.7% and 100.0%, and the specificity was 67.8% and 20.7%, respectively. For patients younger and older than 30 years, specificity of p16(INK4a)/Ki-67 double immunostaining was both higher than that of high risk HPV (80.8% vs . 42.3%; 84.6% vs . 56.9%). Conclusions: p16(INK4a)/Ki-67 double immunostaining can effectively identify the high risk population in ASCUS or LSIL, with higher specificity than high risk HPV test. p16(INK4a)/Ki-67 double immunostaining may benefit patients younger than 30 years of age as a preliminary or potential cytology-combining screening tool.

Two cases of the double inferior venae cavae.

PubMed

Yano, R; Hayakawa, D; Emura, S; Chen, H; Ozawa, Y; Taguchi, H; Shoumura, S

2000-10-01

Two cases of the double inferior venae cavae (IVC) were found during the student dissection practice in 1997 in Gifu University School of Medicine. On the first case (70-year-old male), the calibers of the right and left IVC were 15 mm and 13 mm, respectively. An anastomosis (4-mm caliber) ran obliquely from the left internal iliac vein to the right IVC. On the second case (86-year-old male), the calibers of the right and left IVC were 15 mm and 10 mm, respectively. We found no anastomosis between the right and left IVC. Each IVC was observed behind the ureter. Both cases belong to Type BC of the classification of McClure and Butler (1925), that is based on the combinations of the right and left IVC, and on their location to the ureters. Both cases also belong to Type II-b-2 of the classification of Takemoto et al. (1978), that is based on the calibers of the right and left IVC and on the running course of the interiliac vein. These are the first and second cases among 808 cadavers in Gifu University School of Medicine and the 93rd and 94th cases in Japan since 1901.

Congenital anomalies of the left brachiocephalic vein detected in adults on computed tomography.

PubMed

Yamamuro, Hiroshi; Ichikawa, Tamaki; Hashimoto, Jun; Ono, Shun; Nagata, Yoshimi; Kawada, Shuichi; Kobayashi, Makiko; Koizumi, Jun; Shibata, Takeo; Imai, Yutaka

2017-10-01

Anomalous left brachiocephalic vein (BCV) is a rare and less known systemic venous anomaly. We evaluated congenital anomalies of the left BCV in adults detected during computed tomography (CT) examinations. This retrospective study included 81,425 patients without congenital heart disease who underwent chest CT. We reviewed the recorded reports and CT images for congenital anomalies of the left BCV including aberrant and supernumerary BCVs. The associated congenital aortic anomalies were assessed. Among 73,407 cases at a university hospital, 22 (16 males, 6 females; mean age, 59 years) with aberrant left BCVs were found using keyword research on recorded reports (0.03%). Among 8018 cases at the branch hospital, 5 (4 males, 1 female; mean age, 67 years) with aberrant left BCVs were found using CT image review (0.062%). There were no significant differences in incidences of aberrant left BCV between the two groups. Two cases had double left BCVs. Eleven cases showed high aortic arches. Two cases had the right aortic arch, one case had an incomplete double aortic arch, and one case was associated with coarctation. Aberrant left BCV on CT examination in adults was extremely rare. Some cases were associated with aortic arch anomalies.

Dissecting slander and crying for justice: Carlos Chagas and the Nobel Prize of 1921.

PubMed

Bestetti, Reinaldo B; Cardinalli-Neto, Augusto

2013-10-03

Chagas disease was discovered by Carlos Chagas in 1909. Chagas worked at Oswaldo Cruz Institute, where the bases of experimental medicine were settled in Brazil, and that had no connection with the Faculty of Medicine of Rio de Janeiro. Chagas had several enemies at Oswaldo Cruz Institute mainly because of his election to Head of Service in 1910, and for the position of Oswaldo Cruz Directorship in 1917. Furthermore, Chagas gained enemies at Faculty of Medicine of Rio de Janeiro, which did not like to see the economical political autonomy of Oswaldo Cruz Institute. This allowed the Institute not only to perform top experimental research, but also to take the leadership of research in the country. Chagas was nominated to the Nobel Prize of 1921 in December, 1920. None was awarded the Nobel Prize in that year. He seems to have been evaluated by the Noble Committee of Karolinska Institute from March to May of 1921. At that time, his enemies were denying his discovery of Trypanosoma cruzi, a key point in Chagas' nomination by Karolinska Institute, and giving no epidemiological importance for the disease. By the same way, the obligation of small pox vaccination was tarnishing his public image. Having taken into account the epidemiologic importance of Chagas disease, the strong historical mistake in the process of Chagas evaluation, and the inequity behind all these facts, we insist on a posthumous Nobel Prize for the man who made the most complete medical-scientist discovery of all time. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Towards a double field theory on para-Hermitian manifolds

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

Vaisman, Izu

In a previous paper, we have shown that the geometry of double field theory has a natural interpretation on flat para-Kähler manifolds. In this paper, we show that the same geometric constructions can be made on any para-Hermitian manifold. The field is interpreted as a compatible (pseudo-)Riemannian metric. The tangent bundle of the manifold has a natural, metric-compatible bracket that extends the C-bracket of double field theory. In the para-Kähler case, this bracket is equal to the sum of the Courant brackets of the two Lagrangian foliations of the manifold. Then, we define a canonical connection and an action ofmore » the field that correspond to similar objects of double field theory. Another section is devoted to the Marsden-Weinstein reduction in double field theory on para-Hermitian manifolds. Finally, we give examples of fields on some well-known para-Hermitian manifolds.« less

Film cooling: case of double rows of staggered jets.

PubMed

Dorignac, E; Vullierme, J J; Noirault, P; Foucault, E; Bousgarbiès, J L

2001-05-01

An experimental investigation of film cooling of a wall in a case of double rows of staggered hot jets (65 degrees C) in an ambient air flow. The wall is heated at a temperature value between the one of the jets and the one of the main flow. Experiments have been carried out for different injection rates, the main flow velocity is maintained at 32 m/s. Association of the measures of temperature profiles by cold wire and the measures of wall temperature by infrared thermography allows us to describe the behaviour of the flows and to propose the best injection which assures a good cooling of the plate.

Advertising Phuket's nightlife on the Internet: a case study of double binds and hegemonic masculinity in sex tourism.

PubMed

Hobbs, Jeffrey Dale; Pattalung, Piengpen Na; Chandler, Robert C

2011-01-01

One significant human rights violation in Southeast Asia is the exploitation of women through sex tourism. Such sexual exploitation occurs in Thailand because institutions are complacent and society accepts the practice. This case study, guided by the concepts of double binds and hegemonic masculinity, sought to understand if Thai culture is symbolically constructed in ways to portray Thailand as a desirable "sex tourist" destination. Websites portray Phuket as a patriarchal world where men can live their fantasies of being perfect hegemonic males because Thai bar girls are young nymphomaniacs that have no need to be talked to or understood.

An axisymmetric non-hydrostatic model for double-diffusive water systems

NASA Astrophysics Data System (ADS)

Hilgersom, Koen; Zijlema, Marcel; van de Giesen, Nick

2018-02-01

The three-dimensional (3-D) modelling of water systems involving double-diffusive processes is challenging due to the large computation times required to solve the flow and transport of constituents. In 3-D systems that approach axisymmetry around a central location, computation times can be reduced by applying a 2-D axisymmetric model set-up. This article applies the Reynolds-averaged Navier-Stokes equations described in cylindrical coordinates and integrates them to guarantee mass and momentum conservation. The discretized equations are presented in a way that a Cartesian finite-volume model can be easily extended to the developed framework, which is demonstrated by the implementation into a non-hydrostatic free-surface flow model. This model employs temperature- and salinity-dependent densities, molecular diffusivities, and kinematic viscosity. One quantitative case study, based on an analytical solution derived for the radial expansion of a dense water layer, and two qualitative case studies demonstrate a good behaviour of the model for seepage inflows with contrasting salinities and temperatures. Four case studies with respect to double-diffusive processes in a stratified water body demonstrate that turbulent flows are not yet correctly modelled near the interfaces and that an advanced turbulence model is required.

Gradient forces on double-negative particles in optical tweezers using Bessel beams in the ray optics regime.

PubMed

Ambrosio, Leonardo A; Hernández-Figueroa, Hugo E

2010-11-08

Gradient forces on double negative (DNG) spherical dielectric particles are theoretically evaluated for v-th Bessel beams supposing geometrical optics approximations based on momentum transfer. For the first time in the literature, comparisons between these forces for double positive (DPS) and DNG particles are reported. We conclude that, contrary to the conventional case of positive refractive index, the gradient forces acting on a DNG particle may not reverse sign when the relative refractive index n goes from |n|>1 to |n|<1, thus revealing new and interesting trapping properties.

Double-hit or dual expression of MYC and BCL2 in primary cutaneous large B-cell lymphomas.

PubMed

Menguy, Sarah; Frison, Eric; Prochazkova-Carlotti, Martina; Dalle, Stephane; Dereure, Olivier; Boulinguez, Serge; Dalac, Sophie; Machet, Laurent; Ram-Wolff, Caroline; Verneuil, Laurence; Gros, Audrey; Vergier, Béatrice; Beylot-Barry, Marie; Merlio, Jean-Philippe; Pham-Ledard, Anne

2018-03-26

In nodal diffuse large B-cell lymphoma, the search for double-hit with MYC and BCL2 and/or BCL6 rearrangements or for dual expression of BCL2 and MYC defines subgroups of patients with altered prognosis that has not been evaluated in primary cutaneous large B-cell lymphoma. Our objectives were to assess the double-hit and dual expressor status in a cohort of 44 patients with primary cutaneous large B-cell lymphoma according to the histological subtype and to evaluate their prognosis relevance. The 44 cases defined by the presence of more than 80% of large B-cells in the dermis corresponded to 21 primary cutaneous follicle centre lymphoma with large cell morphology and 23 primary cutaneous diffuse large B-cell lymphoma, leg type. Thirty-one cases (70%) expressed BCL2 and 29 (66%) expressed MYC. Dual expressor profile was observed in 25 cases (57%) of either subtypes (n = 6 or n = 19, respectively). Only one primary cutaneous follicle centre lymphoma, large-cell case had a double-hit status (2%). Specific survival was significantly worse in primary cutaneous diffuse large B-cell lymphoma, leg type than in primary cutaneous follicle centre lymphoma, large cell (p = 0.021) and for the dual expressor primary cutaneous large B-cell lymphoma group (p = 0.030). Both overall survival and specific survival were worse for patients belonging to the dual expressor primary cutaneous diffuse large B-cell lymphoma, leg type subgroup (p = 0.001 and p = 0.046, respectively). Expression of either MYC and/or BCL2 negatively impacted overall survival (p = 0.017 and p = 0.018 respectively). As the differential diagnosis between primary cutaneous follicle centre lymphoma, large cell and primary cutaneous diffuse large B-cell lymphoma, leg type has a major impact on prognosis, dual-expression of BCL2 and MYC may represent a new diagnostic criterion for primary cutaneous diffuse large B-cell lymphoma, leg type subtype and further identifies patients with impaired survival. Finally, the double-hit assessment does not appear clinically relevant in primary cutaneous large B-cell lymphoma.

Accuracy of Corneal Power Measurements for Intraocular Lens Power Calculation after Myopic Laser In situ Keratomileusis.

PubMed

Helaly, Hany A; El-Hifnawy, Mohammad A M; Shaheen, Mohamed Shafik; Abou El-Kheir, Amr F

2016-01-01

To evaluate the accuracy of corneal power measurements for intraocular lens (IOL) power calculation after myopic laser in situ keratomileusis (LASIK). The study evaluated 45 eyes with a history of myopic LASIK. Corneal power was measured using manual keratometry, automated keratometry, optical biometry, and Scheimflug tomography. Different hypothetical IOL power calculation formulas were performed for each case. The steepest mean K value was measured with manual keratometry (37.48 ± 2.86 D) followed by automated keratometry (37.31 ± 2.83 D) then optical biometry (37.06 ± 2.98 D) followed by Scheimflug tomography (36.55 ± 3.08). None of the K values generated by Scheimflug tomography were steeper than the measurements from the other 3 instruments. Using equivalent K reading (EKR) 4 mm with the Double-K SRK/T formula, the refractive outcome generated 97.8% of cases within ± 2 D, 80.0% of cases within ± 1 D, and 42.2% of cases within ± 0.5 D. The best combination of formulas was "Shammas-PL + Double-K SRK/T formula using EKR 4 mm." Scheimflug tomography imaging using the Holladay EKR 4 mm improved the accuracy of IOL power calculation in post-LASIK eyes. The best option is a combination of formulas. We recommended the use the combined "Shammas-PL ± Double-K SRK/T formula using EKR 4 mm"h for optical outcomes.

Relationship among mismatch repair deficiency, CDX2 loss, p53 and E-cadherin in colon carcinoma and suitability of using a double panel of mismatch repair proteins by immunohistochemistry.

PubMed

Sayar, Ilyas; Akbas, Emin Murat; Isik, Arda; Gokce, Aysun; Peker, Kemal; Demirtas, Levent; Gürbüzel, Mehmet

2015-09-01

Biomarkers such as mismatch repair proteins, CDX2, p53, and E-cadherin are blamed for colon cancers, but the relationships of these biomarkers with each other and with pathological risk factors in colon carcinoma are still not clear. The aim of this study was to evaluate the association of these biomarkers with each other by using immunohistochemical staining and to compare their expression with pathological risk factors for colonic adenocarcinoma. We also aimed to study the usability of a double panel of mismatch repair proteins. One hundred and eleven cases with colonic adenocarcinoma were examined. There was a statistically significant relationship between tumor histological differentiation and perineural invasion, vascular invasion, mismatch repair deficiency, p53, CDX2, and E-cadherin (p < 0.05). PMS2 and MSH6 loss covered 100% of cases with mismatch repair deficiency. Mismatch repair deficiency was correlated with CDX2 loss and E-cadherin expression (p < 0.05). It was also observed that cases with PMS2 loss covered all the cases with CDX2 loss. In conclusion, this double panel may be used instead of a quadruple panel for detecting mismatch repair deficiency. Association of CDX2 and PMS2 in the present study is necessary to conduct further genetic and pathological studies focusing on these two markers together.

A retrospective comparative study of arthroscopic fixation in acute Rockwood type IV acromioclavicular joint dislocation: single versus double paired Endobutton technique.

PubMed

Xu, Jian; Liu, Haifeng; Lu, Wei; Li, Dingfu; Zhu, Weimin; Ouyang, Kan; Wu, Bing; Peng, Liangquan; Wang, Daping

2018-05-24

Rockwood type IV acromioclavicular joint (ACJ) dislocation is a trauma usually needs surgical treatment. Paired EndoButton technique (PET) is used in treating such condition. However, the effect of using different types of PET (single versus double PET) for fixation remains controversial. This study aims to evaluate and compare the efficacy of single and double PET and to provide a suitable option for the surgeons. We retrospectively reviewed the charts of patients with acute Rockwood type IV ACJ dislocation who had undergone arthroscopic fixation using single or double PET fixation between March 2009 and March 2015. Seventy-eight consecutive patients identified from chart review were picked and were divided into the single and double PET group with 39 cases in each group. The indexes of visual analog scale score (VAS) for pain, the radiographs of the affected shoulder at different time points of the follow-up, the time of return to activities and sports, the constant functional score, and the Karlsson acromioclavicular joint (ACJ) score, were assessed in a minimum of 2 years postoperation. The average coracoclavicular (CC) and acromioclavicular (AC) distances of the affected joints in the double PET group were significantly smaller than those of the single PET group 2 years postoperation (P < 0.05). The average AC and CC distances in the healthy shoulder joints were significantly smaller than those of the affected joints in the single PET group (P < 0.05); however, these values were not significantly different from those of the affected joints in the double PET group (P > 0.05). The mean VAS pain score was not significantly different, while significant difference was found for the number and times of cases return to activities and sports, constant functional score, and Karlsson ACJ score (P < 0.05) between the two groups. Therefore, the double PET group has better outcome than the single PET group. Complications including redislocation, button slippage, erosion, or AC joint instability occurred in the single PET group, while the complication in the double PET group was rare. Compared with the single PET, the double PET group achieved better outcome with less complications in arthroscopically treating acute Rockwood type IV ACJ dislocation.

Delusion of fetal duplication in a Capgras patient.

PubMed

Silva, J A; Leong, G B; Longhitano, M; Botello, T E

1991-02-01

A case of Capgras syndrome in a pregnant patient is described. In addition to perceiving living family members as impostors, she believed that there was a double or twin of her fetus. She conceptualized her "twins" differently than the way she viewed doubles of family members. Her fetus may represent the youngest "person" to have been duplicated. The relationship of Capgras syndrome to misidentification phenomena is discussed.

[Simultaneous double prosthesis implant more artificial urinary sphincter via transscrotal: surgical technique].

PubMed

Martínez-Salamanca, Juan Ignacio; Moncada, Ignacio; del Portillo, Luis; Sola, Ignacio; Martínez-Ballesteros, Claudio; Carballido, Joaquín

2011-04-01

Moderate-severe urinary incontinence and refractory-to-treatment erectile dysfunction after radical prostatectomy are two entities causing an important loss of quality of life to patients. The double implant of penile prosthesis and artificial urinary sphincter is a safe and effective option in these cases. This article describes preoperative considerations and the most important technical steps to do it satisfactorily.

Quantum Transport

DTIC Science & Technology

1993-05-14

Lent 6 I We have studied transmission in quantum waveguides in the presence of resonant cavities. This work was inspired by our previous modeling of the...conductance of resonantly- coupled quantum wire systems. We expected to find qualitatively the same phenomena as in the much studied case of double...transmission peaks does not give the location of the quasi-bound3 states, like for double-barrier resonant tunneling. In current work, we study

A Case Study of Teacher Responses to a Doubling Error and Difficulty in Learning Equivalent Fractions

ERIC Educational Resources Information Center

Ding, Meixia; Li, Xiaobao; Capraro, Mary Margaret; Kulm, Gerald

2012-01-01

This study qualitatively explored teachers' responses to doubling errors (e.g., 3/4 x 2 = 6/8) that typically reflect students' difficulties in understanding the "rule" for finding equivalent fractions (e.g., 3/4 x 2/2 = 6/8). Although all teachers claimed to teach for understanding in interviews, their responses varied in terms of effectiveness…

Double-ended ceramic helical-rotor expander

DOEpatents

Mohr, Peter B.; Myers, Wendell B.

1995-01-01

A ceramic helical rotor expander using a double-ended or tandem herringbone type rotor arrangement with bearing and seal assemblies remote from the hot gas inlets and especially capable of operating at an inlet temperature of above 1100.degree. C. The rotors are solid or hollow and bonded to hollow metal shafts, and mounted in a composite or simple prismatic casing. The rotors, casing and shafts are constructed from low expansivity materials. In the preferred embodiment the rotors are constructed of silicon nitride and the shafts constructed of an molybdenum alloy, with the metal shafts being supported in bearings and secured to synchronizing gears. The rotors and casing may be provided with coolant channels therein, and are constructed to eliminate the problem of end leakages at inlet temperature and pressure, and the need for high temperature bearings and seals.

Double-ended ceramic helical-rotor expander

DOEpatents

Mohr, P.B.; Myers, W.B.

1995-02-28

A ceramic helical rotor expander is disclosed using a double-ended or tandem herringbone type rotor arrangement with bearing and seal assemblies remote from the hot gas inlets and especially capable of operating at an inlet temperature of above 1,100 C. The rotors are solid or hollow and bonded to hollow metal shafts, and mounted in a composite or simple prismatic casing. The rotors, casing and shafts are constructed from low expansivity materials. In the preferred embodiment the rotors are constructed of silicon nitride and the shafts constructed of an molybdenum alloy, with the metal shafts being supported in bearings and secured to synchronizing gears. The rotors and casing may be provided with coolant channels therein, and are constructed to eliminate the problem of end leakages at inlet temperature and pressure, and the need for high temperature bearings and seals. 3 figs.

Prenatal diagnosis and genetic analysis of double trisomy 48,XXX,+18.

PubMed

Chen, C P; Chern, S R; Yeh, L F; Chen, W L; Chen, L F; Wang, W

2000-09-01

Prenatal diagnosis of simultaneous occurrence of double trisomy involving chromosomes 18 and X is extremely rare. We report on the prenatal diagnosis, genetic analysis and clinical manifestations of a fetus with both trisomy 18 and trisomy X. A 26-year-old, para 1 woman was referred for genetic counselling at 36 weeks' gestation with the sonographic findings of intrauterine growth retardation (IUGR), polyhydramnios, ventricular septal defect, and an enlarged cisterna magna. Both cordocentesis and amniocentesis revealed a consistent karyotype of 48,XXX,+18. Quantitative fluorescent polymerase chain reaction using polymorphic small tandem repeat markers specific for chromosomes 18 and X rapidly determined that both aneuploidies arose as a result of non-disjunction in maternal meiosis II. Our case shows that two non-disjunction events can occur not only in the same parent, but also in the same cell division. Our case also shows that double trisomy, 48,XXX,+18, can demonstrate an enlarged cisterna magna, IUGR and polyhydramnios in prenatal ultrasound. Copyright 2000 John Wiley & Sons, Ltd.

On the validity of microscopic calculations of double-quantum-dot spin qubits based on Fock-Darwin states

NASA Astrophysics Data System (ADS)

Chan, GuoXuan; Wang, Xin

2018-04-01

We consider two typical approximations that are used in the microscopic calculations of double-quantum dot spin qubits, namely, the Heitler-London (HL) and the Hund-Mulliken (HM) approximations, which use linear combinations of Fock-Darwin states to approximate the two-electron states under the double-well confinement potential. We compared these results to a case in which the solution to a one-dimensional Schr¨odinger equation was exactly known and found that typical microscopic calculations based on Fock-Darwin states substantially underestimate the value of the exchange interaction, which is the key parameter that controls the quantum dot spin qubits. This underestimation originates from the lack of tunneling of Fock-Darwin states, which is accurate only in the case with a single potential well. Our results suggest that the accuracies of the current two-dimensional molecular- orbit-theoretical calculations based on Fock-Darwin states should be revisited since underestimation could only deteriorate in dimensions that are higher than one.

A Lyme Disease Case Study and Individualized Healthcare Plan

ERIC Educational Resources Information Center

Cavendish, Roberta

2003-01-01

The Atlantic and Pacific coasts are the boundaries of Lyme disease with the Northeastern and Midwestern regions of the United States continuing to report the majority of cases. New reported cases of Lyme disease doubled from 1991 to 2001 according to statistics published by the Centers for Disease Control and Prevention (CDC, 2002). Within that…

The Double Feature of Musical "Folkbildning": Three Swedish Examples

ERIC Educational Resources Information Center

Brandstrom, Sture; Soderman, Johan; Thorgersen, Ketil

2012-01-01

The purpose of this article is to analyse three case study examples of musical "folkbildning" in Sweden. The first case study is from the establishment of the state-funded Framnas Folk High Music School in the middle of the last century. The second case study, Hagstrom's music education, is from the same time but describes a music school…

Digital Technology: A Double-Edged Sword for a School Principal in Rural Pennsylvania

ERIC Educational Resources Information Center

Kotok, Stephen; Kryst, Erica L.

2017-01-01

This case study was inspired by visits to several different rural high schools in Pennsylvania. The case illuminates the challenges faced by rural principals and superintendents who want to integrate digital technology into their curriculum, but who lack certain financial and human capital resources. Although this case occurred in a remote, rural…

The prognosis of MYC translocation positive diffuse large B-cell lymphoma depends on the second hit.

PubMed

Clipson, Alexandra; Barrans, Sharon; Zeng, Naiyan; Crouch, Simon; Grigoropoulos, Nicholas F; Liu, Hongxiang; Kocialkowski, Sylvia; Wang, Ming; Huang, Yuanxue; Worrillow, Lisa; Goodlad, John; Buxton, Jenny; Neat, Michael; Fields, Paul; Wilkins, Bridget; Grant, John W; Wright, Penny; Ei-Daly, Hesham; Follows, George A; Roman, Eve; Watkins, A James; Johnson, Peter W M; Jack, Andrew; Du, Ming-Qing

2015-07-01

A proportion of MYC translocation positive diffuse large B-cell lymphomas (DLBCL) harbour a BCL2 and/or BCL6 translocation, known as double-hit DLBCL, and are clinically aggressive. It is unknown whether there are other genetic abnormalities that cooperate with MYC translocation and form double-hit DLBCL, and whether there is a difference in clinical outcome between the double-hit DLBCL and those with an isolated MYC translocation. We investigated TP53 gene mutations along with BCL2 and BCL6 translocations in a total of 234 cases of DLBCL, including 81 with MYC translocation. TP53 mutations were investigated by PCR and sequencing, while BCL2 and BCL6 translocation was studied by interphase fluorescence in situ hybridization. The majority of MYC translocation positive DLBCLs (60/81 = 74%) had at least one additional genetic hit. In MYC translocation positive DLBCL treated by R-CHOP ( n  = 67), TP53 mutation and BCL2, but not BCL6 translocation had an adverse effect on patient overall survival. In comparison with DLBCL with an isolated MYC translocation, cases with MYC/TP53 double-hits had the worst overall survival, followed by those with MYC/BCL2 double-hits. In MYC translocation negative DLBCL treated by R-CHOP ( n  = 101), TP53 mutation, BCL2 and BCL6 translocation had no impact on patient survival. The prognosis of MYC translocation positive DLBCL critically depends on the second hit, with TP53 mutations and BCL2 translocation contributing to an adverse prognosis. It is pivotal to investigate both TP53 mutations and BCL2 translocations in MYC translocation positive DLBCL, and to distinguish double-hit DLBCLs from those with an isolated MYC translocation.

Synoptic Formation of Double Tropopauses

NASA Astrophysics Data System (ADS)

Liu, Chengji; Barnes, Elizabeth

2018-01-01

Double tropopauses are ubiquitous in the midlatitude winter hemisphere and represent the vertical stacking of two stable tropopause layers separated by a less stable layer. By analyzing COSMIC GPS data, reanalysis, and eddy life cycle simulations, we demonstrate that they often occur during Rossby wave breaking and act to increase the stratosphere-to-troposphere exchange of mass. We further investigate the adiabatic formation of double tropopauses and propose two mechanisms by which they can occur. The first mechanism operates at the tropopause break in the subtropics where the higher tropical tropopause sits on one side of the break and the lower extratropical tropopause sits on the other. The double tropopauses are then formed by differential meridional advection of the higher and lower tropopauses on the two sides of the tropopause break. We show that anticyclonic wave breaking can form double tropopauses mainly by providing stronger poleward advection of the higher tropopause in its poleward lobe. Cyclonic wave breaking mainly forms double tropopauses by providing stronger equatorward advection of the lower tropopause in its equatorward lobe. We demonstrate in the COSMIC GPS data and reanalysis that about half of the double tropopauses in the Northern Hemisphere winter can be directly attributed to such differential advection. For the second mechanism, adiabatic destabilization of the air above the tropopause contributes to the formation of a double tropopause. In this case, a tropopause inversion layer is necessary for this destabilization to result in a double tropopause.

Technology Solutions Case Study: Monitoring of Double Stud Wall Moisture Conditions in the Northeast, Devens, Massachusetts

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

None

2015-03-01

Double stud walls have a higher risk of interior-sourced condensation moisture damage when compared with high-R approaches using exterior insulating sheathing. In this project, Building Science Corporation monitored moisture conditions in double-stud walls from 2011 through 2014 at a new production house located in Devens, Massachusetts. The builder, Transformations, Inc., has been using double-stud walls insulated with 12 in. of open cell polyurethane spray foam (ocSPF); however, the company has been considering a change to netted and blown cellulose insulation for cost reasons. Cellulose is a common choice for double-stud walls because of its lower cost (in most markets). However,more » cellulose is an air-permeable insulation, unlike spray foams, which increases interior moisture risks. The team compared three double-stud assemblies: 12 in. of ocSPF, 12 in. of cellulose, and 5-½ in. of ocSPF at the exterior of a double-stud wall (to approximate conventional 2 × 6 wall construction and insulation levels, acting as a control wall). These assemblies were repeated on the north and south orientations, for a total of six assemblies.« less

Reinforcement mechanism of multi-anchor wall with double wall facing

NASA Astrophysics Data System (ADS)

Suzuki, Kouta; Kobayashi, Makoto; Miura, Kinya; Konami, Takeharu; Hayashi, Taketo

2017-10-01

The reinforced soil wall has high seismic performance as generally known. However, the seismic behavior has not been clarified accurately yet, especially on multi-anchor wall with double wall facing. Indefinite behavior of reinforced soil wall during earthquake make us complicated in case with adopting to the abutment, because of arrangement of anchor plate as reinforcement often different according to the width of roads. In this study, a series of centrifuge model tests were carried out to investigate the reinforcement mechanism of multi anchor wall with double wall facing from the perspective of the vertical earth pressure. Several types of reinforce arrangement and rigid wall were applied in order to verify the arch function in the reinforced regions. The test results show unique behavior of vertical earth pressure, which was affected by arch action. All the vertical earth pressure placed behind facing panel, are larger than that of middle part between facing panel despite of friction between backfill and facing panel. Similar results were obtained in case using rigid wall. On the other hands, the vertical earth pressure, which were measured at the 3cm high from bottom of model container, shows larger than that of bottom. This results show the existence of arch action between double walls. In addition, it implies that the wall facing of such soil structure confined the backfill as pseudo wall, which is very reason that the multi anchor wall with double wall facing has high seismic performance.

Double layers and double wells in arbitrary degenerate plasmas

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

Akbari-Moghanjoughi, M.

Using the generalized hydrodynamic model, the possibility of variety of large amplitude nonlinear excitations is examined in electron-ion plasma with arbitrary electron degeneracy considering also the ion temperature effect. A new energy-density relation is proposed for plasmas with arbitrary electron degeneracy which reduces to the classical Boltzmann and quantum Thomas-Fermi counterparts in the extreme limits. The pseudopotential method is employed to find the criteria for existence of nonlinear structures such as solitons, periodic nonlinear structures, and double-layers for different cases of adiabatic and isothermal ion fluids for a whole range of normalized electron chemical potential, η{sub 0}, ranging from dilutemore » classical to completely degenerate electron fluids. It is observed that there is a Mach-speed gap in which no large amplitude localized or periodic nonlinear excitations can propagate in the plasma under consideration. It is further revealed that the plasma under investigation supports propagation of double-wells and double-layers the chemical potential and Mach number ranges of which are studied in terms of other plasma parameters. The Mach number criteria for nonlinear waves are shown to significantly differ for cases of classical with η{sub 0} < 0 and quantum with η{sub 0} > 0 regimes. It is also shown that the localized structure propagation criteria possess significant dissimilarities for plasmas with adiabatic and isothermal ions. Current research may be generalized to study the nonlinear structures in plasma containing positrons, multiple ions with different charge states, and charged dust grains.« less

Synchronous double primary cancers of the extrahepatic bile duct: A case report and literature review.

PubMed

Nishi, Takeshi; Sato, Yoshitoshi; Hanaoka, Takuya; Takahashi, Takuya; Miura, Hiroshi; Takubo, Kenji

2018-01-01

Double cancers of the biliary tract system are rare. Most of these cancers are synchronous double cancers of the gall bladder and bile duct, associated with pancreaticobiliary maljunction (PBM). Synchronous double cancers of the extrahepatic bile duct without PBM are especially rare, and only 4 cases have been reported. A 78-year-old woman was admitted to our hospital for examination of hyperbilirubinemia and liver dysfunction. Contrast-enhanced abdominal computed tomography, Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography revealed 2 stenotic regions in the common bile duct: at its junction with the cystic duct and in the distal bile duct. No findings suggested PBM, such as a markedly long common channel. The diagnosis based on endoscopic brush cytology from both stricture portions was adenocarcinoma. The patient had a pylorus-preserving pancreaticoduodenectomy with regional lymph node resection. Macroscopically, there were 2 stenotic regions at the cystic duct junction and in the distal bile duct. Microscopically, the tumor at the junction of the cystic duct was a well-to-moderately differentiated adenocarcinoma. On the other hand, the tumor of the distal bile duct was a poorly differentiated adenocarcinoma. There was no evidence of communication between these 2 cancers. Double cancers of the extrahepatic bile duct without PBM are very rare. Therefore, an accurate diagnosis prior to surgery is necessary. Furthermore, this rare condition seems to be associated with a poor prognosis. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cutaneous double-hit B-cell lymphoma: an aggressive form of B-cell lymphoma with a propensity for cutaneous dissemination.

PubMed

Magro, Cynthia M; Wang, Xuan; Subramaniyam, Shivakumar; Darras, Natasha; Mathew, Susan

2014-04-01

Diffuse large cell B-cell lymphoma of the skin is most commonly represented by diffuse large cell variants of primary cutaneous follicle center cell lymphoma and the leg-type lymphoma. In a minority of cases, the infiltrates are an expression of stage 4 disease of established extracutaneous B-cell lymphoma. We describe 3 patients with an aggressive form of B-cell lymphoma secondarily involving the skin. Two of the patients were in the ninth decade of life, whereas 1 patient was 34 years of age. In the elderly patients, there was an antecedent and/or concurrent history of follicular lymphoma, whereas in the younger patient, the tumor was a de novo presentation of this aggressive form of lymphoma. The elderly patients succumbed to their disease within less than a year from the time of diagnosis, whereas 1 patient is alive but with persistent and progressive disease despite chemotherapeutic intervention. The infiltrates in all 3 cases were diffuse and composed of large malignant hematopoietic cells that exhibited a round nucleus with a finely dispersed chromatin. Phenotypically, the tumor cells were Bcl-2 and CD10 positive, whereas Bcl-6 and Mum-1 showed variable positivity. One case showed combined Mum-1 positivity along with an acute lymphoblastic lymphoma phenotype, including the absence of CD20 expression. In each case, there was a c-MYC and BCL2/IGH rearrangement diagnostic of double-hit lymphoma. In one case, there was an additional BCL6 rearrangement, defining what is in essence triple-hit lymphoma. In conclusion, double-hit lymphoma is an aggressive form of B-cell neoplasia resistant to standard chemotherapy regimens, which in many but not all cases represents tumor progression in the setting of a lower grade B-cell malignancy.

A multidisciplinary audit of clinical coding accuracy in otolaryngology: financial, managerial and clinical governance considerations under payment-by-results.

PubMed

Nouraei, S A R; O'Hanlon, S; Butler, C R; Hadovsky, A; Donald, E; Benjamin, E; Sandhu, G S

2009-02-01

To audit the accuracy of otolaryngology clinical coding and identify ways of improving it. Prospective multidisciplinary audit, using the 'national standard clinical coding audit' methodology supplemented by 'double-reading and arbitration'. Teaching-hospital otolaryngology and clinical coding departments. Otolaryngology inpatient and day-surgery cases. Concordance between initial coding performed by a coder (first cycle) and final coding by a clinician-coder multidisciplinary team (MDT; second cycle) for primary and secondary diagnoses and procedures, and Health Resource Groupings (HRG) assignment. 1250 randomly-selected cases were studied. Coding errors occurred in 24.1% of cases (301/1250). The clinician-coder MDT reassigned 48 primary diagnoses and 186 primary procedures and identified a further 209 initially-missed secondary diagnoses and procedures. In 203 cases, patient's initial HRG changed. Incorrect coding caused an average revenue loss of 174.90 pounds per patient (14.7%) of which 60% of the total income variance was due to miscoding of a eight highly-complex head and neck cancer cases. The 'HRG drift' created the appearance of disproportionate resource utilisation when treating 'simple' cases. At our institution the total cost of maintaining a clinician-coder MDT was 4.8 times lower than the income regained through the double-reading process. This large audit of otolaryngology practice identifies a large degree of error in coding on discharge. This leads to significant loss of departmental revenue, and given that the same data is used for benchmarking and for making decisions about resource allocation, it distorts the picture of clinical practice. These can be rectified through implementing a cost-effective clinician-coder double-reading multidisciplinary team as part of a data-assurance clinical governance framework which we recommend should be established in hospitals.

First performance evaluation of software for automatic segmentation, labeling and reformation of anatomical aligned axial images of the thoracolumbar spine at CT.

PubMed

Scholtz, Jan-Erik; Wichmann, Julian L; Kaup, Moritz; Fischer, Sebastian; Kerl, J Matthias; Lehnert, Thomas; Vogl, Thomas J; Bauer, Ralf W

2015-03-01

To evaluate software for automatic segmentation, labeling and reformation of anatomical aligned axial images of the thoracolumbar spine on CT in terms of accuracy, potential for time savings and workflow improvement. 77 patients (28 women, 49 men, mean age 65.3±14.4 years) with known or suspected spinal disorders (degenerative spine disease n=32; disc herniation n=36; traumatic vertebral fractures n=9) underwent 64-slice MDCT with thin-slab reconstruction. Time for automatic labeling of the thoracolumbar spine and reconstruction of double-angulated axial images of the pathological vertebrae was compared with manually performed reconstruction of anatomical aligned axial images. Reformatted images of both reconstruction methods were assessed by two observers regarding accuracy of symmetric depiction of anatomical structures. In 33 cases double-angulated axial images were created in 1 vertebra, in 28 cases in 2 vertebrae and in 16 cases in 3 vertebrae. Correct automatic labeling was achieved in 72 of 77 patients (93.5%). Errors could be manually corrected in 4 cases. Automatic labeling required 1min in average. In cases where anatomical aligned axial images of 1 vertebra were created, reconstructions made by hand were significantly faster (p<0.05). Automatic reconstruction was time-saving in cases of 2 and more vertebrae (p<0.05). Both reconstruction methods revealed good image quality with excellent inter-observer agreement. The evaluated software for automatic labeling and anatomically aligned, double-angulated axial image reconstruction of the thoracolumbar spine on CT is time-saving when reconstructions of 2 and more vertebrae are performed. Checking results of automatic labeling is necessary to prevent errors in labeling. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Modeling Slab-Slab Interactions: Dynamics of Outward Dipping Double-Sided Subduction Systems

NASA Astrophysics Data System (ADS)

Király, Ágnes; Holt, Adam F.; Funiciello, Francesca; Faccenna, Claudio; Capitanio, Fabio A.

2018-03-01

Slab-slab interaction is a characteristic feature of tectonically complex areas. Outward dipping double-sided subduction is one of these complex cases, which has several examples on Earth, most notably the Molucca Sea and Adriatic Sea. This study focuses on developing a framework for linking plate kinematics and slab interactions in an outward dipping subduction geometry. We used analog and numerical models to better understand the underlying subduction dynamics. Compared to a single subduction model, double-sided subduction exhibits more time-dependent and vigorous toroidal flow cells that are elongated (i.e., not circular). Because both the Molucca and Adriatic Sea exhibit an asymmetric subduction configuration, we also examine the role that asymmetry plays in the dynamics of outward dipping double-sided subduction. We introduce asymmetry in two ways; with variable initial depths for the two slabs ("geometric" asymmetry), and with variable buoyancy within the subducting plate ("mechanical" asymmetry). Relative to the symmetric case, we probe how asymmetry affects the overall slab kinematics, whether asymmetric behavior intensifies or equilibrates as subduction proceeds. While initial geometric asymmetry disappears once the slabs are anchored to the 660 km discontinuity, the mechanical asymmetry can cause more permanent differences between the two subduction zones. In the most extreme case, the partly continental slab stops subducting due to the unequal slab pull force. The results show that the slab-slab interaction is most effective when the two trenches are closer than 10-8 cm in the laboratory, which is 600-480 km when scaled to the Earth.

Tidal double detonation: a new mechanism for the thermonuclear explosion of a white dwarf induced by a tidal disruption event

NASA Astrophysics Data System (ADS)

Tanikawa, Ataru

2018-03-01

We suggest tidal double detonation as a new mechanism for the thermonuclear explosion of a white dwarf (WD) induced by a tidal disruption event (TDE). Tidal detonation is also a WD explosion induced by a TDE. In this case, helium (He) and carbon-oxygen (CO) detonation waves incinerate He WDs and CO WDs, respectively. On the other hand, for tidal double detonation, He detonation is first excited in the He shell of a CO WD, which then drives CO detonation in the CO core. We name this mechanism after the double detonation scenario in the context of type Ia supernovae. In this paper, by performing numerical simulations for CO WDs of mass 0.60 M⊙ with and without a He shell, we show that tidal double detonation occurs in the shallower encounter of a CO WD with an intermediate-mass black hole (IMBH) compared to simple tidal detonation. We expect tidal double detonation will increase the possibility of the occurrence of WD TDEs, which can help us to understand IMBHs.

The Electrical Double Layer and Its Structure

NASA Astrophysics Data System (ADS)

Stojek, Zbigniew

At any electrode immersed in an electrolyte solution, a specific interfacial region is formed. This region is called the double layer. The electrical properties of such a layer are important, since they significantly affect the electrochemical measurements. In an electrical circuit used to measure the current that flows at a particular working electrode, the double layer can be viewed as a capacitor. Figure I.1.1 depicts this situation where the electrochemical cell is represented by an electrical circuit and capacitor C d corresponds to the differential capacity of the double layer. To obtain a desired potential at the working electrodes, the double-layer capacitor must be first appropriately charged, which means that a capacitive current, not related to the reduction or oxidation of the substrates, flows in the electrical circuit. While this capacitive current carries some information concerning the double layer and its structure, and in some cases can be used for analytical purposes, in general, it interferes with electrochemical investigations. A variety of methods are used in electrochemistry to depress, isolate, or filter the capacitive current.

Urine Fibrosis Markers and Risk of Allograft Failure in Kidney Transplant Recipients: A Case-Cohort Ancillary Study of the FAVORIT Trial.

PubMed

Ix, Joachim H; Katz, Ronit; Bansal, Nisha; Foster, Meredith; Weiner, Daniel E; Tracy, Russell; Jotwani, Vasantha; Hughes-Austin, Jan; McKay, Dianne; Gabbai, Francis; Hsu, Chi-Yuan; Bostom, Andrew; Levey, Andrew S; Shlipak, Michael G

2017-03-01

Kidney tubulointerstitial fibrosis marks risk for allograft failure in kidney transplant recipients, but is poorly captured by estimated glomerular filtration rate (eGFR) or urine albumin-creatinine ratio (ACR). Whether urinary markers of tubulointerstitial fibrosis can noninvasively identify risk for allograft failure above and beyond eGFR and ACR is unknown. Case-cohort study. The FAVORIT (Folic Acid for Vascular Outcome Reduction in Transplantation) Trial was a randomized double-blind trial testing vitamin therapy to lower homocysteine levels in stable kidney transplant recipients. We selected a subset of participants at random (n=491) and all individuals with allograft failure during follow-up (cases; n=257). Using spot urine specimens from the baseline visit, we measured 4 urinary proteins known to correlate with tubulointerstitial fibrosis on biopsy (urine α 1 -microglobulin [A1M], monocyte chemoattractant protein 1 [MCP-1], and procollagen type III and type I amino-terminal amino pro-peptide). Death-censored allograft failure. In models adjusted for demographics, chronic kidney disease risk factors, eGFR, and ACR, higher concentrations of urine A1M (HR per doubling, 1.73; 95% CI, 1.43-2.08) and MCP-1 (HR per doubling, 1.60; 95% CI, 1.32-1.93) were strongly associated with allograft failure. When additionally adjusted for concentrations of other urine fibrosis and several urine injury markers, urine A1M (HR per doubling, 1.76; 95% CI, 1.27-2.44]) and MCP-1 levels (HR per doubling, 1.49; 95% CI, 1.17-1.89) remained associated with allograft failure. Urine procollagen type III and type I levels were not associated with allograft failure. We lack kidney biopsy data, BK titers, and HLA antibody status. Urine measurement of tubulointerstitial fibrosis may provide a noninvasive method to identify kidney transplant recipients at higher risk for future allograft failure, above and beyond eGFR and urine ACR. Published by Elsevier Inc.

Glomerular basement membrane injuries in IgA nephropathy evaluated by double immunostaining for α5(IV) and α2(IV) chains of type IV collagen and low-vacuum scanning electron microscopy.

PubMed

Masuda, Yukinari; Yamanaka, Nobuaki; Ishikawa, Arimi; Kataoka, Mitue; Arai, Takashi; Wakamatsu, Kyoko; Kuwahara, Naomi; Nagahama, Kiyotaka; Ichikawa, Kaori; Shimizu, Akira

2015-06-01

The glomerulus contains well-developed capillaries, which are at risk of injury due to high hydrostatic pressure, hyperfiltration, hypertension and inflammation. However, the pathological alterations of the injured glomerular basement membrane (GBM), the main component of the glomerular filtration barrier, are still uncertain in cases of glomerulonephritis. We examined the alterations of the GBM in 50 renal biopsy cases with IgA nephropathy (31.8 ± 17.6 years old) using double immunostaining for the α2(IV) and α5(IV) chains of type IV collagen, and examining the ultrastructural alterations by transmission electron microscopy (TEM) and low-vacuum scanning electron microscopy (LV-SEM). The GBM of IgA nephropathy cases showed various morphological and qualitative alterations. In the TEM findings, thinning, gaps, rupture, thickening with a lamellar and reticular structure and double contours were detected in the GBM. Double immunostaining for α5(IV) and α2(IV) showed thickening of the GBM with reduced α5(IV) and increased α2(IV), or mosaic images of α5(IV) and α2(IV), and holes, fractures, spiny projections and rupture of α5(IV) in the GBM. In addition, LV-SEM showed an etched image and multiple holes in a widening and wavy GBM. These findings might be associated with the development of a brittle GBM in IgA nephropathy. Glomerular basement membrane alterations were frequently noted in IgA nephropathy, and were easily evaluated by double immunostaining for α2(IV) and α5(IV) of type IV collagen and LV-SEM. The application of these analyses to human renal biopsy specimens may enhance our understanding of the alterations of the GBM that occur in human glomerular diseases.

Taxi Regulatory Revision in Oakland and Berkeley, California : Two Case Studies

DOT National Transportation Integrated Search

1983-06-01

A case study was performed of regulatory changes pertaining to taxicabs in Oakland and neighboring Berkeley, CA. In Oakland rates were approximately doubled and limits on the number of taxi permits removed. Companies were allowed to levy a per-trip s...

[Type IIb primary hyperlipoproteinemia. An homogenous series of 412 cases].

PubMed

Rouffy, J; Loeper, J; Dreux, C; Lemogne, M; Loeper, J; Pestel, M; Dakkak, R

1976-03-20

On the basis of a homogeneous series of 412 cases of type IIb primary hyperlipoproteinaemia, the authors compare their experience with findings in the literature. The prevalence of this type of hyperlipoproteinaemia in the general population has been underestimated at 3%. Biological diagnosis remains simple (identification of a double and distinct excess in beta and pre beta lipoproteins). Extravascular lipid deposits (gerontoxon, xanthelasma, tendon xanthomata) are not type specific. Hyperlipidaemic syndrome is rare. Above all, the importance of type IIb in atheromatous disease in the young subject now seems obvious. The mode of hereditary transmission of the familial anomaly is not certain but would appear to be often associated with a double heterozygote condition.

CT arthrographic patterns in recurrent glenohumeral instability.

PubMed

Singson, R D; Feldman, F; Bigliani, L

1987-10-01

CT double-contrast arthrograms were performed on 54 shoulders in 53 patients with recurrent dislocation or subluxation to detect responsible underlying bony or soft-tissue abnormalities. Lesions of the anterior labrum in 52 (96%) of 54 cases and of the capsuloligamentous complex in 42 (78%) of 54 cases were the two most common abnormalities. There was no difference in the degree or number of labral lesions between subluxations and dislocations. However, more severe capsular lesions, subscapularis tendon tears, and widened subscapularis bursae were consistently found among patients with dislocations. Subsequent clinical, arthroscopic, and surgical findings showed that the use of CT double-contrast arthrograms resulted in improved definition of the multiple lesions associated with glenohumeral dysfunction.

Idiopathic small bowel diaphragm disease identified by laparoscopic-assisted double-balloon enteroscopy in a child: an integrated successful definitive therapeutic method.

PubMed

Soccorso, Giampiero; Sarkhy, Ahmed; Lindley, Richard M; Marven, Sean S; Thomson, Mike

2012-08-01

In adults, small bowel diaphragm disease is a rare complication of small bowel enteropathy secondary to the use of nonsteroidal antiinflammatory drugs. The main clinical manifestations are gastrointestinal bleeding and subacute obstruction, and management can be challenging. We present a case of a 5-year-old girl with small bowel diaphragm disease. To our knowledge, this is the first idiopathic case (no history of nonsteroidal antiinflammatory drug use) in the pediatric age group. This report describes an integrated successful definitive therapeutic method of double-balloon enteroscopy and minimal invasive bowel surgery for small bowel pathology. Copyright © 2012 Elsevier Inc. All rights reserved.

Treatment of plastic deformation of the forearm in young adults with double-level osteotomies: case reports.

PubMed

Moon, Edward S; Howlett, John; Wiater, Brett P; Trumble, Thomas E

2011-04-01

Plastic deformation of the forearm is a rare injury in young adults that occurs when a slow bending or rotational force is applied to the arm, most commonly in the setting of an industrial workplace accident. There are currently no guidelines for treatment of the residual forearm deformity that often results in limitations of forearm supination and pronation. We present 2 cases demonstrating that deformity correction with single cortex, double-level osteotomies combined with rigid plate fixation and early range of motion exercise that results in good functional outcomes. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Death by Edible Mushroom: First Report of Volvariella volvacea as an Etiologic Agent of Invasive Disease in a Patient following Double Umbilical Cord Blood Transplantation▿

PubMed Central

Salit, R. B.; Shea, Y. R.; Gea-Banacloche, J.; Fahle, G. A.; Abu-Asab, M.; Sugui, J. A.; Carpenter, A. E.; Quezado, M. M.; Bishop, M. R.; Kwon-Chung, K. J.

2010-01-01

We describe a case of invasive fungal infection caused by Volvariella volvacea following double umbilical cord blood transplantation (UCBT). Although infections caused by several mushroom species have been documented, we believe this to be the first published report of invasive infection with Volvariella volvacea, an edible mushroom belonging to Agaricales. PMID:20826647

Holt-oram syndrome associated with double outlet right ventricle: A rare association

PubMed Central

Singh, Bhupinder; Kariyappa, Mallesh; Vijayalakshmi, Ishwarappa Balekundri; Nanjappa, Manjunath C

2013-01-01

Holt-Oram syndrome is a rare inherited disorder that causes abnormalities of the hands, arms, and the heart. Most commonly, there are defects in the carpal bones of the wrist and in the bones of the thumb along with cardiac defects such as atrial or ventricular septal defects. We report a case of Holt-Oram syndrome with a rare association of double outlet right ventricle. PMID:23626447

Assessing double counting of carbon emissions between forest land cover change and forest wildfires: a case study in the United States, 1992-2006

Treesearch

Daolan Zheng; Linda S. Heath; Mark J. Ducey; Brad Quayle

2013-01-01

The relative contributions of double counting of carbon emissions between forest-to-nonforest cover change (FNCC) and forest wildfires are an unknown in estimating net forest carbon exchanges at large scales. This study employed land-cover change maps and forest fire data in the four representative states (Arkansas, California, Minnesota, and Washington) of the US for...

Spinning particles, axion radiation, and the classical double copy

NASA Astrophysics Data System (ADS)

Goldberger, Walter D.; Li, Jingping; Prabhu, Siddharth G.

2018-05-01

We extend the perturbative double copy between radiating classical sources in gauge theory and gravity to the case of spinning particles. We construct, to linear order in spins, perturbative radiating solutions to the classical Yang-Mills equations sourced by a set of interacting color charges with chromomagnetic dipole spin couplings. Using a color-to-kinematics replacement rule proposed earlier by one of the authors, these solutions map onto radiation in a theory of interacting particles coupled to massless fields that include the graviton, a scalar (dilaton) ϕ and the Kalb-Ramond axion field Bμ ν. Consistency of the double copy imposes constraints on the parameters of the theory on both the gauge and gravity sides of the correspondence. In particular, the color charges carry a chromomagnetic interaction which, in d =4 , corresponds to a gyromagnetic ratio equal to Dirac's value g =2 . The color-to-kinematics map implies that on the gravity side, the bulk theory of the fields (ϕ ,gμ ν,Bμ ν) has interactions which match those of d -dimensional "string gravity," as is the case both in the BCJ double copy of pure gauge theory scattering amplitudes and the KLT relations between the tree-level S -matrix elements of open and closed string theory.

Double-button Fixation System for Management of Acute Acromioclavicular Joint Dislocation

PubMed Central

Torkaman, Ali; Bagherifard, Abolfazl; Mokhatri, Tahmineh; Haghighi, Mohammad Hossein Shabanpour; Monshizadeh, Siamak; Taraz, Hamid; Hasanvand, Amin

2016-01-01

Background: Surgical treatments for acromioclavicular (AC) joint dislocation present with some complications. The present study was designed to evaluate the double-button fixation system in the management of acute acromioclavicular joint dislocation. Methods: This cross sectional study, done between February 2011 to June 2014, consisted of 28 patients who underwent surgical management by the double-button fixation system for acute AC joint dislocation. Age, sex, injury mechanism, dominant hand, side with injury, length of follow up, time before surgery, shoulder and hand (DASH), constant and visual analogue scale (VAS) scores, and all complications of the cases during the follow up were recorded. Results: The mean age of patients was 33.23±6.7 years. Twenty four patients (85.71%) were male and four (14.28%) were female. The significant differences were observed between pre-operation VAS, constant shoulder scores and post-operation measurements. There were not any significant differences between right and left coracoclavicular, but two cases of heterotrophic ossifications were recorded. The mean follow-up time was 16.17±4.38 months. Conclusion: According to the results, the double-button fixation system for management of acute acromioclavicular joint dislocation has suitable results and minimal damage to the soft tissues surrounding the coracoclavicular ligaments. PMID:26894217

Birth outcomes of cases with conotruncal defects of heart - a population-based case-control study.

PubMed

Vereczkey, Attila; Kósa, Zsolt; Csáky-Szunyogh, Melinda; Gerencsér, Balázs; Czeizel, Andrew E

2015-03-01

The aim of this study was to evaluate the birth outcomes of cases with four types of conotruncal defects (CTDs), i.e. common truncus, transposition of great arteries, tetralogy of Fallot and double-outlet right ventricle. Birth outcomes of 597 live-born cases with CTD and 38,151 population controls without any defects were compared in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities completed by socio-demographic variables of their mothers. There was a male excess in cases with CTD (56.8%) with the same mean gestational age (39.4 versus 39.4 weeks) and preterm birth rate (8.2 versus 9.2%), but their mean birth weight was smaller (3077 versus 3276 g) with a high rate of low birthweight (14.6 versus 5.7%) compared to the birth outcomes of population controls. These data indicate intrauterine growth restriction of fetuses affected with transposition of great arteries, tetralogy of Fallot and double-outlet right ventricle particularly in females, while there were a shorter mean gestational age and smaller mean birth weigh in cases with common truncus. In general CTD, except common truncus, had no effect for gestational age but associated with a high risk for intrauterine fetal growth restriction particularly in female cases.

‘Double cortex’ sign on FDG-PET/CT in diffuse band heterotopia

PubMed Central

Tripathi, Madhavi; Tripathi, Manjari; Kumar, Ganesh; Malhotra, Arun; Bal, Chandra Sekhar

2013-01-01

F-18 Fluorodeoxyglucose (FDG) Positron emission tomography/Computed Tomography (PET/CT) has come to play an increasingly important role for the pre-surgical evaluation of drug resistant epilepsy and complements Magnetic Resonance Imaging (MRI) in the evaluation of grey matter heterotopias. This case illustrates the characteristic pattern of metabolic abnormality in diffuse band heterotopia (DBH) which is otherwise called double cortex syndrome. The presence of metabolic activity in the heterotopic inner cortical band and in the overlying true cortex gives rise to the ‘double cortex’ sign on FDG-PET, concurrent CT provides a good anato-metabolic coregistration. PMID:24379541

An unusual mechanism of ocular trauma in badminton players: two incidental cases.

PubMed

Khandelwal, Rekha; Majumdar, Mohana Raja; Gupta, Archana

2012-08-08

Badminton is a famous sport usually played without any protective eyewear. Ocular injury from one's own partner in a doubles game, with the shuttlecock, is rare. Two untrained badminton players presented with severe ocular trauma during a smash shot from the partner in a 'doubles' game. Both the players developed blind eye (vision <3/60) in spite of immediate treatment. This article describes an unusual mode of severe blunt trauma with a shuttlecock while playing a 'doubles' game, leading to coup-countercoup injury. In addition, the article highlights the need for awareness of the fatal ocular complications and life-long visual disability, especially in untrained badminton enthusiasts.

[When is the prescription of prismatic eyeglasses reasonable?].

PubMed

Kommerell, G

2014-03-01

Prismatic glasses are used to deflect rays of light. In ophthalmology, prisms are mainly used to correct double vision caused by strabismus which is acquired after early childhood. In congenital or infantile strabismus, the image of the deviated eye is usually suppressed so that double vision does not occur and prismatic glasses are not indicated. Latent strabismus is very common and only rarely leads to double vision or asthenopic symptoms so that correction with prismatic glasses is only indicated in exceptional cases. The "Measuring and Correcting Methodology after H.-J. Haase" is based on flawed assumptions, and therefore can not be recommended for the prescription of prisms.

Proposal for a new classification of variations in the iliac venous system based on internal iliac veins: a case series and a review of double and left inferior vena cava.

PubMed

Hayashi, Shogo; Naito, Munekazu; Hirai, Shuichi; Terayama, Hayato; Miyaki, Takayoshi; Itoh, Masahiro; Fukuzawa, Yoshitaka; Nakano, Takashi

2013-09-01

There are many reports on variations in the inferior vena cava (IVC), particularly double IVC (DIVC) and left IVC (LIVC). However, no systematic report has recorded iliac vein (IV) flow patterns in the DIVC and LIVC. In this study, we examined IV flow patterns in both DIVC and LIVC observed during gross anatomy courses conducted for medical students and in previously reported cases. During the gross anatomy courses, three cases of DIVC and one case of LIVC were found in 618 cadavers. The IV flow pattern from these four cases and all other previously reported cases can be classified into one of the following three types according to the vein into which the internal iliac vein drained: the ipsilateral external IV; confluence of the ipsilateral external IV and IVC; and the communicating vein, which connects the IVC and the contralateral IVC or its iliac branch. This classification, which is based on the internal IV course, is considered to be useful because IV variations have the potential to cause clinical problems during related retroperitoneal surgery, venous interventional radiology, and diagnostic procedures for pelvic cancer.

Inverse problem of the vibrational band gap of periodically supported beam

NASA Astrophysics Data System (ADS)

Shi, Xiaona; Shu, Haisheng; Dong, Fuzhen; Zhao, Lei

2017-04-01

The researches of periodic structures have a long history with the main contents confined in the field of forward problem. In this paper, the inverse problem is considered and an overall frame is proposed which includes two main stages, i.e., the band gap criterion and its optimization. As a preliminary investigation, the inverse problem of the flexural vibrational band gap of a periodically supported beam is analyzed. According to existing knowledge of its forward problem, the band gap criterion is given in implicit form. Then, two cases with three independent parameters, namely the double supported case and the triple one, are studied in detail and the explicit expressions of the feasible domain are constructed by numerical fitting. Finally, the parameter optimization of the double supported case with three variables is conducted using genetic algorithm aiming for the best mean attenuation within specified frequency band.

Effective theory of monolayer TMDC double quantum dots

NASA Astrophysics Data System (ADS)

David, Alessandro; Burkard, Guido; Kormányos, Andor

2018-07-01

Monolayer transition metal dichalcogenides (TMDCs) are promising candidates for quantum technologies, such as spin qubits in quantum dots, because they are truly two-dimensional semiconductors with a direct band gap. In this work, we analyse theoretically the behaviour of a double quantum dot (DQD) system created in the conduction band of these materials, with two electrons in the (1,1) charge configuration. Motivated by recent experimental progress, we consider several scenarios, including different spin–orbit splittings in the two dots and including the case when the valley degeneracy is lifted due to an insulating ferromagnetic substrate. Finally, we discuss in which cases it is possible to reduce the low energy subspace to the lowest Kramers pairs. We find that in this case the low energy model is formally identical to the Heisenberg exchange Hamiltonian, indicating that such Kramers pairs may serve as qubit implementations.

Numerically simulated two-dimensional auroral double layers

NASA Technical Reports Server (NTRS)

Borovsky, J. E.; Joyce, G.

1983-01-01

A magnetized 2 1/2-dimensional particle-in-cell system which is periodic in one direction and bounded by reservoirs of Maxwellian plasma in the other is used to numerically simulate electrostatic plasma double layers. For the cases of both oblique and two-dimensional double layers, the present results indicate periodic instability, Debye length rather than gyroradii scaling, and low frequency electrostatic turbulence together with electron beam-excited electrostatatic electron-cyclotron waves. Estimates are given for the thickness of auroral doule layers, as well as the separations within multiple auroral arcs. Attention is given to the temporal modulation of accelerated beams, and the possibilities for ion precipitation and ion conic production by the double layer are hypothesized. Simulations which include the atmospheric backscattering of electrons imply the action of an ionospheric sheath which accelerates ionospheric ions upward.

The treatment of idiopathic scoliosis in adolescents: rotation or in situ bending?

PubMed

Gennari, J M; Tallet, J M; Hornung, H; Bergoin, M

1997-12-01

Rotation alone is not fully efficient in order to correct all types of scoliotic curvatures. We report a series of 30 cases instrumented with the EUROS spine system and analyse reductions obtained with in situ rotation or bending alone or with combined maneuvres. The average age of surgery is 17 years for this series composed of 24 female and 6 male patients. The average follow-up is 2.3 years. The curve patterns are displayed with 6 major thoracic, 5 genuine double major, 4 double major thoracic predominant, 6 double major lumbar predominant and 9 double thoracic curves. Combination of both reduction techniques is advisable and is to be made according to the type of curvature and its reducibility in situ bending is made easier with this system without lockers and by reduced diameter of the rod.

Curie temperature behavior in half-metallic ferromagnetic double perovskites within the electronic correlation picture

NASA Astrophysics Data System (ADS)

Estrada, F.; Guzmán, E. J.; Navarro, O.; Avignon, M.

2018-05-01

The half-metallic ferromagnetic compound Sr2FeMoO6 is considered a fundamental material to understand the role of electronic parameters controlling the half-metallic ground state and high Curie temperature in double perovskite. We present an electronic approach using the Green's function technique and the renormalization perturbation expansion method to study the thermodynamical properties of double perovskites. The model is based on a correlated electron picture with localized Fe spins and conduction electrons interacting with the local spins via a double-exchange-type mechanism. Electron correlations within the conduction band are also included in order to study the Curie temperature TC. Our results show an increases of TC by increasing the carrier density in La-doped Sr2FeMoO6 compounds in contrast to the case of uncorrelated itinerant electrons.

Four-dimensional ultrasonography of the fetal heart using color Doppler spatiotemporal image correlation.

PubMed

Gonçalves, Luís F; Romero, Roberto; Espinoza, Jimmy; Lee, Wesley; Treadwell, Marjorie; Chintala, Kavitha; Brandl, Helmut; Chaiworapongsa, Tinnakorn

2004-04-01

To describe clinical and research applications of 4-dimensional imaging of the fetal heart using color Doppler spatiotemporal image correlation. Forty-four volume data sets were acquired by color Doppler spatiotemporal image correlation. Seven subjects were examined: 4 fetuses without abnormalities, 1 fetus with ventriculomegaly and a hypoplastic cerebellum but normal cardiac anatomy, and 2 fetuses with cardiac anomalies detected by fetal echocardiography (1 case of a ventricular septal defect associated with trisomy 21 and 1 case of a double-inlet right ventricle with a 46,XX karyotype). The median gestational age at the time of examination was 21 3/7 weeks (range, 19 5/7-34 0/7 weeks). Volume data sets were reviewed offline by multiplanar display and volume-rendering methods. Representative images and online video clips illustrating the diagnostic potential of this technology are presented. Color Doppler spatiotemporal image correlation allowed multiplanar visualization of ventricular septal defects, multiplanar display and volume rendering of tricuspid regurgitation, volume rendering of the outflow tracts by color and power Doppler ultrasonography (both in a normal case and in a case of a double-inlet right ventricle with a double-outlet right ventricle), and visualization of venous streams at the level of the foramen ovale. Color Doppler spatiotemporal image correlation has the potential to simplify visualization of the outflow tracts and improve the evaluation of the location and extent of ventricular septal defects. Other applications include 3-dimensional evaluation of regurgitation jets and venous streams at the level of the foramen ovale.

Preliminary study of percutaneous nephrolithotomy on an ambulatory basis.

PubMed

El-Tabey, Magdy Ahmed; Abd-Allah, Osama Abdel-Wahab; Ahmed, Ahmed Sebaey; El-Barky, Ehab Mohammed; Noureldin, Yasser Abdel-Sattar

2013-02-01

Preliminary study to assess the feasibility and safety of percutaneous nephrolithotomy (PCNL) as an ambulatory procedure. Between February 2011 and September 2012, 84 patients with renal calculi fulfilling the inclusion criteria were admitted to the Urology Department of Benha University Hospitals for PCNL. All patients were subjected to a full medical history, clinical, laboratory and radiological examinations. Tubeless PCNLs were done in the supine position, and an antegrade double-J stent was inserted. Operative time and intraoperative complications were recorded. Postoperatively, the hematocrit value, postoperative pain and analgesics, need of blood transfusion, stone-free rate, and length of hospital stay were recorded. Stable patients that could be safely discharged within 24 hours after surgery were considered ambulatory. All cases of tubeless PCNL were successfully done and no cases converted to open surgery. The overall stone-free rate was 91.7%, the mean postoperative pain score measured by the visual analog scale was 4.4 ± 1.2, the mean overall hematocrit deficit was 4.8 ± 2.2% and the mean hospital stay was 33.4 ± 17.5 hours. Ambulatory PCNL was accomplished in 60 out of 84 patients (71.4%) and double-J stents were removed 7-10 days postoperatively. In the non-ambulatory cases, double-J stents were removed after auxillary procedures were done according to each case. PCNL can be safely done on an ambulatory basis under strict criteria, but further studies are needed to confirm and expand these findings.

Heat transfer and thermal management of electric vehicle batteries with phase change materials

NASA Astrophysics Data System (ADS)

Ramandi, M. Y.; Dincer, I.; Naterer, G. F.

2011-07-01

This paper examines a passive thermal management system for electric vehicle batteries, consisting of encapsulated phase change material (PCM) which melts during a process to absorb the heat generated by a battery. A new configuration for the thermal management system, using double series PCM shells, is analyzed with finite volume simulations. A combination of computational fluid dynamics (CFD) and second law analysis is used to evaluate and compare the new system against the single PCM shells. Using a finite volume method, heat transfer in the battery pack is examined and the results are used to analyse the exergy losses. The simulations provide design guidelines for the thermal management system to minimize the size and cost of the system. The thermal conductivity and melting temperature are studied as two important parameters in the configuration of the shells. Heat transfer from the surroundings to the PCM shell in a non-insulated case is found to be infeasible. For a single PCM system, the exergy efficiency is below 50%. For the second case for other combinations, the exergy efficiencies ranged from 30-40%. The second shell content did not have significant influence on the exergy efficiencies. The double PCM shell system showed higher exergy efficiencies than the single PCM shell system (except a case for type PCM-1). With respect to the reference environment, it is found that in all cases the exergy efficiencies decreased, when the dead-state temperatures rises, and the destroyed exergy content increases gradually. For the double shell systems for all dead-state temperatures, the efficiencies were very similar. Except for a dead-state temperature of 302 K, with the other temperatures, the exergy efficiencies for different combinations are well over 50%. The range of exergy efficiencies vary widely between 15 and 85% for a single shell system, and between 30-80% for double shell systems.

Outcomes of the modified Brostrom procedure using suture anchors for chronic lateral ankle instability--a prospective, randomized comparison between single and double suture anchors.

PubMed

Cho, Byung-Ki; Kim, Yong-Min; Kim, Dong-Soo; Choi, Eui-Sung; Shon, Hyun-Chul; Park, Kyoung-Jin

2013-01-01

The present prospective, randomized study was conducted to compare the clinical outcomes of the modified Brostrom procedure using single and double suture anchors for chronic lateral ankle instability. A total of 50 patients were followed up for more than 2 years after undergoing the modified Brostrom procedure. Of the 50 procedures, 25 each were performed using single and double suture anchors by 1 surgeon. The Karlsson scale had improved significantly to 89.8 points and 90.6 points in the single and double anchor groups, respectively. Using the Sefton grading system, 23 cases (92%) in the single anchor group and 22 (88%) in the double anchor group achieved satisfactory results. The talar tilt angle and anterior talar translation on stress radiographs using the Telos device had improved significantly to an average of 5.7° and 4.6 mm in the single anchor group and 4.5° and 4.3 mm in the double anchor group, respectively. The double anchor technique was superior with respect to the postoperative talar tilt. The single and double suture anchor techniques produced similar clinical and functional outcomes, with the exception of talar tilt as a reference of mechanical stability. The modified Brostrom procedure using both single and double suture anchors appears to be an effective treatment method for chronic lateral ankle instability. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

A prospective comparison of performance during back-to-back, anterograde manual spiral enteroscopy and double-balloon enteroscopy.

PubMed

Despott, Edward J; Murino, Alberto; Bourikas, Leonidas; Nakamura, Masanao; Ramachandra, Vino; Fraser, Chris

2015-05-01

Spiral enteroscopy is a recently introduced technology alternative to balloon-assisted enteroscopy for examination of the small bowel. To compare small bowel insertion depths and procedure duration by spiral enteroscopy and double-balloon enteroscopy performed in the same cohort of patients, in immediate succession, using the same method of insertion depth estimation. A prospective, back-to-back comparative study was performed in 15 patients. Spiral enteroscopy procedures were performed first and a tattoo was placed to mark the most distal point. Double-balloon enteroscopy passed the tattoo placed at spiral enteroscopy in 14/15 cases (93%). Median insertion depths for double-balloon enteroscopy and spiral enteroscopy were 265cm and 175cm, respectively (P=0.004). Median time to achieve maximal depth of insertion was significantly shorter for spiral enteroscopy compared with double-balloon enteroscopy (24min vs. 45min, respectively; P=0.0005). However, in 14 patients no differences were found in median time to reach the same insertion depth (P=0.28). Double-balloon enteroscopy achieved significantly greater small bowel insertion depth than spiral enteroscopy. Although overall double-balloon enteroscopy procedure duration was longer, the time taken to reach the same small bowel insertion depth by both spiral enteroscopy and double-balloon enteroscopy was similar. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

What Are Student Inservice Teachers Talking about in Their Online Communities of Practice? Investigating Student Inservice Teachers' Experiences in a Double-Layered CoP

ERIC Educational Resources Information Center

Lee, Kyungmee; Brett, Clare

2013-01-01

This qualitative case study is the first phase of a large-scale design-based research project to implement a theoretically derived double-layered CoP model within real-world teacher development practices. The main goal of this first iteration is to evaluate the courses and test and refine the CoP model for future implementations. This paper…

New design space regainers: 'lingual arch crossbow' and 'double banded space regainer'.

PubMed

Chalakkal, P; Chalakka, P; Thomas, A M; Akkara, F; Pavaskar, R

2012-01-01

This article highlights the use of two new design space regainers--the "lingual arch crossbow" and the "double-banded space regainer." The former may be used for distalizing a mesially migrated mandibular first premolar, if it erupts prior to the canine. The latter may be used in conventional cases of interdental space loss. They both contain assemblies that function through the action of NiTi open coil springs.

Paths to Victory: Detailed Insurgency Case Studies

DTIC Science & Technology

2013-01-01

insurgency with informers , spies, and double agents. Eager to snuff out insurgent cross-border sanctuaries, Spinola exe- cuted Operation Mal Verde, a ...fruit when Magaia was shot dead by a fellow FRELIMO fighter suspected of being a double agent working for the COIN force, a move that exploited the...established a network of informants in the local community and, to some degree, within the Clandestine Front as well. It also relied heavily on

Closed form solution for a double quantum well using Gröbner basis

NASA Astrophysics Data System (ADS)

Acus, A.; Dargys, A.

2011-07-01

Analytical expressions for the spectrum, eigenfunctions and dipole matrix elements of a square double quantum well (DQW) are presented for a general case when the potential in different regions of the DQW has different heights and the effective masses are different. This was achieved by using a Gröbner basis algorithm that allowed us to disentangle the resulting coupled polynomials without explicitly solving the transcendental eigenvalue equation.

Lidar observation of transition of cirrus clouds over a tropical station Gadanki (13.45° N, 79.18° E): case studies

NASA Astrophysics Data System (ADS)

Srinivasan, M. A.; Rao, C. Dhananjaya; Krishnaiah, M.

2016-05-01

The present study describes Mie lidar observations of the cirrus cloud passage showing transition between double thin layers into single thick and single thick layer into double thin layers of cirrus over Gadanki region. During Case1: 17 January 2007, Case4: 12 June 2007, Case5: 14 July 2007 and Case6: 24 July 2007 the transition is found to from two thin cirrus layers into single geometrically thick layer. Case2: 14 May 2007 and Case3: 15 May 2007, the transition is found to from single geometrically thick layer into two thin cirrus layers. Linear Depolarization Ratio (LDR) and Back Scatter Ration (BSR) are found to show similar variation with strong peaks during transition; both LDR and Cloud Optical Depth (COD) is found to show similar variation except during transition with strong peaks in COD which is not clearly found from LDR for the all cases. There is a significant weakening of zonal and meridional winds during Case1 which might be due to the transition from multiple to single thick cirrus indicating potential capability of thick cirrus in modulating the wind fields. There exists strong upward wind dominance contributed to significant ascent in cloud-base altitude thereby causing transition of multiple thin layers into single thick cirrus.

Non-mean-field theory of anomalously large double layer capacitance

NASA Astrophysics Data System (ADS)

Loth, M. S.; Skinner, Brian; Shklovskii, B. I.

2010-07-01

Mean-field theories claim that the capacitance of the double layer formed at a metal/ionic conductor interface cannot be larger than that of the Helmholtz capacitor, whose width is equal to the radius of an ion. However, in some experiments the apparent width of the double layer capacitor is substantially smaller. We propose an alternate non-mean-field theory of the ionic double layer to explain such large capacitance values. Our theory allows for the binding of discrete ions to their image charges in the metal, which results in the formation of interface dipoles. We focus primarily on the case where only small cations are mobile and other ions form an oppositely charged background. In this case, at small temperature and zero applied voltage dipoles form a correlated liquid on both contacts. We show that at small voltages the capacitance of the double layer is determined by the transfer of dipoles from one electrode to the other and is therefore limited only by the weak dipole-dipole repulsion between bound ions so that the capacitance is very large. At large voltages the depletion of bound ions from one of the capacitor electrodes triggers a collapse of the capacitance to the much smaller mean-field value, as seen in experimental data. We test our analytical predictions with a Monte Carlo simulation and find good agreement. We further argue that our “one-component plasma” model should work well for strongly asymmetric ion liquids. We believe that this work also suggests an improved theory of pseudocapacitance.

How I treat double-hit lymphoma.

PubMed

Friedberg, Jonathan W

2017-08-03

The 2016 revision of the World Health Organization (WHO) classification for lymphoma has included a new category of lymphoma, separate from diffuse large B-cell lymphoma, termed high-grade B-cell lymphoma with translocations involving myc and bcl-2 or bcl-6 . These lymphomas, which occur in <10% of cases of diffuse large B-cell lymphoma, have been referred to as double-hit lymphomas (or triple-hit lymphomas if all 3 rearrangements are present). It is important to differentiate these lymphomas from the larger group of double-expressor lymphomas, which have increased expression of MYC and BCL-2 and/or BCL-6 by immunohistochemistry, by using variable cutoff percentages to define positivity. Patients with double-hit lymphomas have a poor prognosis when treated with standard chemoimmunotherapy and have increased risk of central nervous system involvement and progression. Double-hit lymphomas may arise as a consequence of the transformation of the underlying indolent lymphoma. There are no published prospective trials in double-hit lymphoma, however retrospective studies strongly suggest that aggressive induction regimens may confer a superior outcome. In this article, I review my approach to the evaluation and treatment of double-hit lymphoma, with an eye toward future clinical trials incorporating rational targeted agents into the therapeutic armamentarium. © 2017 by The American Society of Hematology.

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

Descartes, M.; Longshore, J.W.; Crawford, E.

We report an infant with double trisomy 48,XXX,+18, who also displayed features of Roberts syndrome. All previously published cases with similar double trisomy have presented with features of trisomy 18 syndrome. The chromosome analysis done at birth revealed the double trisomy; parental chromosomes were normal. The proband presented with microbrachycephaly, unilateral cleft lip and palate, choanal atresia, midfacial capillary hemanioma, thin nares, shallow orbits, malformed ears, sparse hair, hypomelia of the upper limbs, rocker-bottom feet, auricular septal defect and agenesis of the corpus callosum. Characteristic features of Roberts syndrome included hypomelia, midfacial defects, and severe growth deficiency. Among the manymore » different features reported in the literature for patients with trisomy 18 syndrome, the most consistent were growth deficiency, clenched fingers and congenital heart defects (e.g. VSD, ASD, PDA). Although some of our patient`s features such as cleft lip and cleft palate, low-set malformed ears, ASD, defects of the corpus callosum, choanal atresia, radial aplasia could also be seen in trisomy 18 syndrome (in 10-50% of the cases), her phenotype was more typical of Roberts syndrome because of symmetrical hypomelia and midfacial defects. Our patient`s chromosomes did not show premature separation of centromeric heterochromatin, a feature reported to occur in approximately one-half of individuals with Roberts syndrome. Sporadic aneuploidy involving different chromosomes has been found in lymphocyte cultures from some Roberts syndrome patients and is considered by some authors as a mitotic mutant. This aneuploidy is most likely to be chromosome gain. The simultaneous occurrence of trisomy X and 18 is extremely rare with only 11 cases having been reported in the literature. Our patient is unique since she has the double trisomy in addition to the characteristic features of Roberts syndrome.« less

The impact of postoperative expansion initiation timing on breast expander capsular characteristics: a prospective combined clinical and scanning electron microscopy study.

PubMed

Paek, Laurence S; Giot, Jean-Philippe; Tétreault-Paquin, Jean-Olivier; St-Jacques, Samuel; Nelea, Monica; Danino, M Alain

2015-04-01

In the first stage of expander-to-implant breast reconstruction, postoperative expansion is classically initiated at 10 to 14 days (conventional approach). The authors hypothesized that it may be beneficial to wait 6 weeks postoperatively before initiating serial expansion (delayed approach). Clinical and ultrastructural periprosthetic capsule analysis is first required before determining whether a delayed approach ultimately improves capsular tissue adherence and expansion process predictability. Patients undergoing two-stage implant-based breast reconstruction were enrolled prospectively in this study. During expander-to-implant exchange, the clinical presence of "Velcro" effect, biofilm, and double capsule was noted. Periprosthetic capsule samples were also sent for scanning electron microscopic observation of three parameters: surface relief, cellularity, and biofilm. Samples were divided into four groups for data analysis (group 1, conventional/Biocell; group 2, delayed/Biocell; group 3, conventional/Siltex; and group 4, delayed/Siltex). Fifty-six breast reconstructions were included. Each group comprised between 13 and 15 breasts. In group 1, no cases exhibited the Velcro effect and there was a 53.8 percent incidence of both biofilm and double capsule. In group 2, all cases demonstrated the Velcro effect and there were no incidences of biofilm or double capsule. Group 3 and group 4 cases did not exhibit a Velcro effect or double-capsule formation; however, biofilm was present in up to 20.0 percent. All group 2 samples revealed more pronounced three-dimensional relief on scanning electron microscopy. Variations in expansion protocols can lead to observable modifications in periprosthetic capsular architecture. There may be real benefits to delaying expander inflation until 6 weeks postoperatively with Biocell expanders.

Gender and ergonomics: a case study on the 'non-formal' work of women nurses.

PubMed

Salerno, Silvana; Livigni, Lucilla; Magrini, Andrea; Talamanca, Irene Figà

2012-01-01

Women's work activities are often characterised by 'non-formal actions' (such as giving support). Gender differences in ergonomics may be due to this peculiarity. We applied the method of organisational congruencies (MOC) to ascertain the 'non-formal' work portion of nurses employed in three hospital units (haematology, emergency room and general medicine) during the three work shifts in a major University Hospital in Rome, Italy. We recorded a total of 802 technical actions performed by nine nurses in 72 h of work. Twenty-six percent of the actions in direct patient's care were communicative actions (mainly giving psychological support) while providing physical care. These 'double actions' are often not considered to be a formal part of the job by hospital management. In our case study, the 'non-formal' work of nurses (psychological support) is mainly represented by double actions while taking physical care of the patients. The dual task paradigm in gender oriented research is discussed in terms of its implications in prevention in occupational health. The main purpose of the study was to assess all the formal and non-formal activities of women in the nursing work setting. Offering psychological support to patients is often not considered to be a formal part of the job. Our case study found that nurses receive no explicit guidelines on this activity and no time is assigned to perform it. In measuring the burden of providing psychological support to patients, we found that this is often done while nurses are performing tasks of physical care for the patients (double actions). The article discusses the significance of non-formal psychological work load of women nurses through double actions from the ergonomic point view.

[Research on the application of "H shaped" single-tube double-lumen drainage tube in the treatment of chronic subdural hematoma].

PubMed

Sun, T; Jiang, Z Q; Zhang, S J; Lou, F Y; Zhang, T; Han, Y; Zheng, X L

2016-04-05

To explore the effect of chronic subdural hematoma external drainage surgery using self-made "H shaped" flush type single-tube double-lumen drainage tube. There were 56 cases chosen from the First Affiliated Hospital of Bengbu Medical College between Jan 2013 and Aug 2015. These patients with unilateral chronic subdural hematoma requiring surgery to place drilling external drainage catheter were randomly divided into group A (21 cases, using self-made single-tube double lumen "H shaped" drainage tube) and group B (35 cases, traditional silicone drainage tube), then the residual liquid volume after drainage on the first day, the days that the tube stay in body and the residual fluid volume after removing the tube were compared between the two groups. The residual liquid volume after drainage on the first day in group A was (23±15)ml, in group B was (31±15)ml. The days that the tube stay in body in group A was (2.7±1.0)d, in group B was (3.3±1.1)d, the two groups had statistical differences (P<0.05). The residual fluid volume after removing the tube in group A was (13±7) ml, in group B was (16±8)ml, but the data in these two groups had no significantly statistical differences (P>0.05). The effect of self-made "H shaped" flush type single-tube double-lumen drainage tube in the drainage of chronic subdural hematoma drainage is good, with short tube stay in the body; therefore, it is a safe and effective way to treat chronic subdural hematoma, and is worthy of clinical application.

Double trisomy (XXX+21 karyotype) in a six-year-old girl with down phenotype.

PubMed

Vergara-Mendez, Laura Daniela; Talero-Gutiérrez, Claudia; Velez-Van-Meerbeke, Alberto

2018-03-01

We describe a case of a six-year-old girl who presents multiple dysmorphic features characteristic of Down's syndrome. She has a significant general developmental delay, with a score that correspond to 32 months of developmental age. This delay is especially in language, with a very scant vocabulary. She communicates with some hand sign words or pointing, although her auditory responses in hearing test were normal. Two previous karyotype studies showed 47, XXX, +21 anomalies. This double trisomy is a rare condition described in isolated cases in the literature and none of these refers to the developmental aspects of these children (Balwan et al. 2008; Li et al. 2004; Park et al. 1995; Day et al. 1963).

Blaming the Victim and Exonerating the Perpetrator in Cases of Rape and Robbery: Is There a Double Standard?

ERIC Educational Resources Information Center

Bieneck, Steffen; Krahe, Barbara

2011-01-01

Research in legal decision making has demonstrated the tendency to blame the victim and exonerate the perpetrator of sexual assault. This study examined the hypothesis of a special leniency bias in rape cases by comparing them to cases of robbery. N = 288 participants received descriptions of rape and robbery of a female victim by a male…

Constraining the double gluon distribution by the single gluon distribution

DOE PAGES

Golec-Biernat, Krzysztof; Lewandowska, Emilia; Serino, Mirko; ...

2015-10-03

We show how to consistently construct initial conditions for the QCD evolution equations for double parton distribution functions in the pure gluon case. We use to momentum sum rule for this purpose and a specific form of the known single gluon distribution function in the MSTW parameterization. The resulting double gluon distribution satisfies exactly the momentum sum rule and is parameter free. Furthermore, we study numerically its evolution with a hard scale and show the approximate factorization into product of two single gluon distributions at small values of x, whereas at large values of x the factorization is always violatedmore » in agreement with the sum rule.« less

Effect of multiple plasmon excitation on single, double and multiple ionizations of C60 in collisions with fast highly charged Si ions

NASA Astrophysics Data System (ADS)

Kelkar, A. H.; Kadhane, U.; Misra, D.; Kumar, A.; Tribedi, L. C.

2007-06-01

We have investigated the single and multiple ionizations of the C60 molecule in collisions with fast Siq+ projectiles for various projectile charge states (q) between q = 6 and 14. The q-dependence of the ionization cross sections and their ratios is compared with the giant dipole plasmon resonance (GDPR) model. The excellent qualitative agreement with the model in case of single and double ionizations and also a reasonable agreement with the triple (and to some extent with quadruple) ionization (without evaporation) yields signify dominant contributions of the single-, double- and triple-plasmon excitations on the single- and multiple-ionization process.

Delamination-restacking behaviour of surfactant intercalated layered hydroxy double salts, M 3Zn 2(OH) 8(surf) 2ṡ2H 2O [M = Ni, Co and surf = dodecyl sulphate (DS), dodecyl benzene sulphonate (DBS)

NASA Astrophysics Data System (ADS)

Rajamathi, Jacqueline T.; Ravishankar, N.; Rajamathi, Michael

2005-02-01

Surfactant anion intercalated nickel-zinc and cobalt-zinc layered hydroxy double salts were prepared through a modified acetate hydrolysis route. These organo-inorganic hybrids delaminate readily in alcohols such as 1-butanol to give stable translucent colloids. The extent of delamination and the stability of the colloids obtained are comparable to what has been observed in the case of layered double hydroxides (LDHs). The original layered solid could be obtained either by evaporation of the colloid or precipitation by the addition of a polar solvent such as acetone.

The double universal joint wrist on a manipulator: Solution of inverse position kinematics and singularity analysis

NASA Technical Reports Server (NTRS)

Williams, Robert L., III

1992-01-01

This paper presents three methods to solve the inverse position kinematics position problem of the double universal joint attached to a manipulator: (1) an analytical solution for two specific cases; (2) an approximate closed form solution based on ignoring the wrist offset; and (3) an iterative method which repeats closed form position and orientation calculations until the solution is achieved. Several manipulators are used to demonstrate the solution methods: cartesian, cylindrical, spherical, and an anthropomorphic articulated arm, based on the Flight Telerobotic Servicer (FTS) arm. A singularity analysis is presented for the double universal joint wrist attached to the above manipulator arms. While the double universal joint wrist standing alone is singularity-free in orientation, the singularity analysis indicates the presence of coupled position/orientation singularities of the spherical and articulated manipulators with the wrist. The cartesian and cylindrical manipulators with the double universal joint wrist were found to be singularity-free. The methods of this paper can be implemented in a real-time controller for manipulators with the double universal joint wrist. Such mechanically dextrous systems could be used in telerobotic and industrial applications, but further work is required to avoid the singularities.

[Effectiveness of Vitex agnus-castus preparations].

PubMed

Gorkow, C; Wuttke, W; März, R W

2002-01-01

The prolactin-inhibiting effect of ACF-preparations, which is due to dopaminergic activities, has been shown in humans too and gives a pharmacological rationale for the clinical effects observed in the different indications (2, 11, 25, 26, 35, 41). Confirmation of efficacy in the treatment of mastalgia has been best endorsed by two recently published double-blind studies conducted according to the principles of GCP (14, 41). One double-blind study, several open and postmarketing surveillance studies have shown that the premenstrual syndrome, or individual symptoms, can be influenced positively (3, 6, 7, 9, 19, 21, 37). Design shortcomings in a second double-blind study should be eliminated in future studies in this indication to improve the body of evidence (18). Hither to there has been one controlled double-blind study of cycle disorders in the case of corpus luteum insufficiency with significant results and a number of non-controlled open studies (1, 4, 15, 16, 20, 24, 26, 27, 32, 35, 36). The high success rates in the open studies indicate therapeutic effects, and it should be possible to reproduce these results under double-blind conditions. The success rates on fertility disorders should be confirmed in controlled double-blind studies (10, 33, 34).

[Complexities of the stress experienced by employees of the Fukushima nuclear plants].

PubMed

Sano, Shin-Ya; Tanigawa, Takeshi; Shigemura, Jun; Satoh, Yutaka; Yoshino, Aihide; Fujii, Chiyo; Tatsuzawa, Yasutaka; Kuwahara, Tatsuro; Tachibana, Shoichi; Nomura, Soichiro

2012-01-01

Fukushima Daiichi Nuclear Power Plants suffered serious damage by the Great East Japan Earthquake and Tsunami. The employees of the plant worked very hard to stabilize the nuclear reactor and to prevent any secondary accidents. They were in one of the most severe situations in this disaster, but they were the people who hesitated most to request help for themselves. We started visiting the Fukushima Daini Plant office that was used as the frontline base for Daiichi Plant workers since July, 2011. These visits were held once or twice a month and we offered mental health support to the employees. We have completed interview with the total number of 339 plant workers by April, 2012. We offered several ways of mental support including clinical treatment, continuous counseling, or one time advice, depending on mental condition of each interviewee. Complexity of huge disaster and individuality of suffering from it were discussed in this article. Like local residents, many plant workers also experienced death/missing of family, loss of housing, refuge life, and dispersion of family. Furthermore, they have been suffering from various kinds of criticism and slander against Tokyo Electric Power Company. Many workers, even though they were not in management positions, seemed to have guilty conscience and sense of responsibility that forced them to stay in the risky working site. We could find some struggling coexistence of sense of guilt (as a causer of disaster) and sense of victim in their mind. It was suggested that continuous effort to listen and pay attention to their talk is important in order to support their mission to stabilize the power plant and to prevent them from over-stress and burnout.

Vitamin D and ferritin correlation with chronic neck pain using standard statistics and a novel artificial neural network prediction model.

PubMed

Eloqayli, Haytham; Al-Yousef, Ali; Jaradat, Raid

2018-02-15

Despite the high prevalence of chronic neck pain, there is limited consensus about the primary etiology, risk factors, diagnostic criteria and therapeutic outcome. Here, we aimed to determine if Ferritin and Vitamin D are modifiable risk factors with chronic neck pain using slandered statistics and artificial intelligence neural network (ANN). Fifty-four patients with chronic neck pain treated between February 2016 and August 2016 in King Abdullah University Hospital and 54 patients age matched controls undergoing outpatient or minor procedures were enrolled. Patients and control demographic parameters, height, weight and single measurement of serum vitamin D, Vitamin B12, ferritin, calcium, phosphorus, zinc were obtained. An ANN prediction model was developed. The statistical analysis reveals that patients with chronic neck pain have significantly lower serum Vitamin D and Ferritin (p-value <.05). 90% of patients with chronic neck pain were females. Multilayer Feed Forward Neural Network with Back Propagation(MFFNN) prediction model were developed and designed based on vitamin D and ferritin as input variables and CNP as output. The ANN model output results show that, 92 out of 108 samples were correctly classified with 85% classification accuracy. Although Iron and vitamin D deficiency cannot be isolated as the sole risk factors of chronic neck pain, they should be considered as two modifiable risk. The high prevalence of chronic neck pain, hypovitaminosis D and low ferritin amongst women is of concern. Bioinformatics predictions with artificial neural network can be of future benefit in classification and prediction models for chronic neck pain. We hope this initial work will encourage a future larger cohort study addressing vitamin D and iron correction as modifiable factors and the application of artificial intelligence models in clinical practice.

Numerical analysis of lasing characteristics in highly bend-compensated large-mode-area ytterbium-doped double-clad leakage channel fibers.

PubMed

Thavasi Raja, G; Halder, Raktim; Varshney, S K

2015-12-10

The bend-induced mode-area reduction and thermal effects are vital factors that affect the power scaling of fiber lasers. Recently, bend-compensated large-mode-area double-clad modified hybrid leakage channel fiber (M-HLCF) has been reported with a mode area greater than 1000  μm, while sustaining the single-mode behavior at 1064 nm for high-temperature environments. In this work, the lasing characteristics of a newly designed ytterbium-doped double-clad M-HLCF (YDMHLCF) have been numerically investigated for strongly pumped conditions. The doped region size is optimally found through simulations, equivalent to the size of core diameter ∼38  μm in order to achieve maximum conversion efficiency for the bent and straight cases. Numerical simulations further confirm that a 2 m long YDMHLCF exhibits slope efficiency of 78% and conversion efficiency of 79% for the straight case and also almost the same for the practical bending radius of 7.5 cm when pumped with a 975 nm laser source.

Partial double-layered patella in a nondysplasic adolescent.

PubMed

García-Mata, Serafín; Hidalgo-Ovejero, Angel

2016-11-01

Double-layered patella (DLP) is a rare patella-formation abnormality reported in association with multiple epiphyseal dysplasia. DLP is one of the five types of bipartite patella, caused by a coronal septum that divides the patella into anterior and posterior segments. Although the double layer of bone has been reported as complete, it may also manifest as partial, as in our case. A 13-year-old male patient attended A&E after accidentally falling and sustaining a direct injury to his left knee, with pain in the anterior surface of the right patella. He was diagnosed with an incomplete vertical fracture of the left patella. An axial view radiography indicated an external partial DLP. No bone dysplasia was found. Computed tomographic scan and MRI showed partial DLP and bone marrow oedema because of the injury in the femoral condyle, but no fracture. The reason for highlighting this type of patella abnormality is to present the case of a patient without bone dysplasia, either partial or incomplete, that has not been reported previously. We also wish to emphasize the importance of not confusing it with a fracture in standard radiographies.

Anterior lumbar instrumentation improves correction of severe lumbar Lenke C curves in double major idiopathic scoliosis

PubMed Central

Yeon, Howard B.; Weinberg, Jacob; Arlet, Vincent; Ouelett, Jean A.

2007-01-01

Fifteen skeletally immature patients with double major adolescent idiopathic scoliosis with large lumbar curves and notable L4 and L5 coronal plane obliquity were retrospectively studied. Seven patients who underwent anterior release and fusion of the lumbar curve with segmental anterior instrumentation and subsequent posterior instrumentation ending at L3 were compared with eight patients treated with anterior release and fusion without anterior instrumentation followed by posterior instrumentation to L3 or L4. At 4.5 years follow-up (range 2.5–7 years), curve correction, coronal balance and fusion rate were not statistically different between the two groups; however, the group with anterior instrumentation had improved coronal plane, near normalangulation in the distal unfused segment compared with the group without anterior instrumentation. In cases involving severe lumbar curvatures in the context of double major scoliosis, when as a first stage anterior release is chosen, the addition of instrumentation appears to restore normal coronal alignment of the distal unfused lumbar segment, and may in certain cases save a level compared with traditional fusions to L4. PMID:17464517

Double peak searches for scalar and pseudoscalar resonances at the LHC

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

Carena, Marcela; Huang, Peisi; Ismail, Ahmed

2016-12-01

Many new physics models contain a neutral scalar resonance that can be predominantly produced via gluon fusion through loops. In such a case, there could be important effects of additional particles, that in turn may hadronize before decaying and form bound states. This interesting possibility may lead to novel signatures with double peaks that can be searched for at the LHC. We study the phenomenology of double peak searches in diboson final states from loop-induced production and decay of a new neutral spin-0 resonance at the LHC. The loop-induced couplings should be mediated by particles carrying color and electroweak chargemore » that after forming bound states will induce a second peak in the diboson invariant mass spectrum near twice their mass. A second peak could be present via loop-induced couplings into gg (dijet),gamma gamma and Z gamma final states as well as in the WW and ZZ channels for the case of a pseudoscalar resonance or for scalars with suppressed tree-level coupling to gauge bosons« less

Double peak searches for scalar and pseudoscalar resonances at the LHC

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

Carena, Marcela; Huang, Peisi; Ismail, Ahmed

2016-12-01

Many new physics models contain a neutral scalar resonance that can be predominantly produced via gluon fusion through loops. In such a case, there could be important effects of additional particles, that in turn may hadronize before decaying and form bound states. This interesting possibility may lead to novel signatures with double peaks that can be searched for at the LHC. We study the phenomenology of double peak searches in diboson final states from loop induced production and decay of a new neutral spin-0 resonance at the LHC. The loop-induced couplings should be mediated by particles carrying color and electroweak charge that after forming bound states will induce a second peak in the diboson invariant mass spectrum near twice their mass. As a result, a second peak could be present via loop-induced couplings intomore » $gg$ (dijet), $$\\gamma\\gamma$$ and $$Z\\gamma$$ final states as well as in the $WW$ and $ZZ$ channels for the case of a pseudo-scalar resonance or for scalars with suppressed tree-level coupling to gauge bosons.« less

Scleral and intraocular amoebic dissemination in Acanthamoeba keratitis.

PubMed

Arnalich-Montiel, Francisco; Jaumandreu, Laia; Leal, Marina; Valladares, Basilio; Lorenzo-Morales, Jacob

2013-12-01

To review an Acanthamoeba keratitis case series for the documented extracorneal spread of the amoeba. A retrospective review of an observational case series from a single institution. Three patients with 4 instances of microbiologically confirmed extracorneal amoebic spread were identified. Patient 1 had nodular scleritis after undergoing penetrating keratoplasty and was treated successfully with double freeze-thaw cryotherapy; patient 2 had intraocular dissemination of the amoeba detected in a retrocorneal membrane; and patient 3 had, after undergoing tectonic keratoplasty, intraocular dissemination of the amoeba that was treated successfully with intraocular and systemic voriconazole and, afterwards, a nodular scleritis treated with double freeze-thaw cryotherapy and a large-diameter corneal graft to treat corneal recurrence. Acanthamoeba can migrate to the sclera or to the intraocular tissues in some instances, such as in long-standing disease or in penetrating keratoplasty. A prompt biopsy for microbiological analysis and early treatment are required, if this is suspected. Voriconazole can be effective for intraocular invasion when used orally and intraocularly. Scleral involvement might require a surgical approach with double freeze-thaw cryotherapy to treat the localized disease.

Neuroethics: A New Way of Doing Ethics

PubMed Central

Levy, Neil

2011-01-01

The aim of this article is to argue, by example, for neuroethics as a new way of doing ethics. Rather than simply giving us a new subject matter—the ethical issues arising from neuroscience—to attend to, neuroethics offers us the opportunity to refine the tools we use. Ethicists often need to appeal to the intuitions provoked by consideration of cases to evaluate the permissibility of types of actions; data from the sciences of the mind give us reason to believe that some of these intuitions are less reliable than others. I focus on the doctrine of double effect to illustrate my case, arguing that experimental results suggest that appeal to it might be question-begging. The doctrine of double effect is supposed to show that there is a moral difference between effects that are brought about intentionally and those that are merely foreseen; I argue that the data suggest that we regard some effects as merely foreseen only because we regard bringing them about as permissible. Appeal to the doctrine of double effect therefore cannot establish that there are such moral differences. PMID:22318976

Spectral features of the tunneling-induced transparency and the Autler-Townes doublet and triplet in a triple quantum dot.

PubMed

Luo, Xiao-Qing; Li, Zeng-Zhao; Jing, Jun; Xiong, Wei; Li, Tie-Fu; Yu, Ting

2018-02-15

We theoretically investigate the spectral features of tunneling-induced transparency (TIT) and Autler-Townes (AT) doublet and triplet in a triple-quantum-dot system. By analyzing the eigenenergy spectrum of the system Hamiltonian, we can discriminate TIT and double TIT from AT doublet and triplet, respectively. For the resonant case, the presence of the TIT does not exhibit distinguishable anticrossing in the eigenenergy spectrum in the weak-tunneling regime, while the occurrence of double anticrossings in the strong-tunneling regime shows that the TIT evolves to the AT doublet. For the off-resonance case, the appearance of a new detuning-dependent dip in the absorption spectrum leads to double TIT behavior in the weak-tunneling regime due to no distinguished anticrossing occurring in the eigenenergy spectrum. However, in the strong-tunneling regime, a new detuning-dependent dip in the absorption spectrum results in AT triplet owing to the presence of triple anticrossings in the eigenenergy spectrum. Our results can be applied to quantum measurement and quantum-optics devices in solid systems.

Haag duality for Kitaev’s quantum double model for abelian groups

NASA Astrophysics Data System (ADS)

Fiedler, Leander; Naaijkens, Pieter

2015-11-01

We prove Haag duality for cone-like regions in the ground state representation corresponding to the translational invariant ground state of Kitaev’s quantum double model for finite abelian groups. This property says that if an observable commutes with all observables localized outside the cone region, it actually is an element of the von Neumann algebra generated by the local observables inside the cone. This strengthens locality, which says that observables localized in disjoint regions commute. As an application, we consider the superselection structure of the quantum double model for abelian groups on an infinite lattice in the spirit of the Doplicher-Haag-Roberts program in algebraic quantum field theory. We find that, as is the case for the toric code model on an infinite lattice, the superselection structure is given by the category of irreducible representations of the quantum double.

Simultaneous double-rod rotation technique in posterior instrumentation surgery for correction of adolescent idiopathic scoliosis.

PubMed

Ito, Manabu; Abumi, Kuniyoshi; Kotani, Yoshihisa; Takahata, Masahiko; Sudo, Hideki; Hojo, Yoshihiro; Minami, Akio

2010-03-01

The authors present a new posterior correction technique consisting of simultaneous double-rod rotation using 2 contoured rods and polyaxial pedicle screws with or without Nesplon tapes. The purpose of this study is to introduce the basic principles and surgical procedures of this new posterior surgery for correction of adolescent idiopathic scoliosis. Through gradual rotation of the concave-side rod by 2 rod holders, the convex-side rod simultaneously rotates with the the concave-side rod. This procedure does not involve any force pushing down the spinal column around the apex. Since this procedure consists of upward pushing and lateral translation of the spinal column with simultaneous double-rod rotation maneuvers, it is simple and can obtain thoracic kyphosis as well as favorable scoliosis correction. This technique is applicable not only to a thoracic single curve but also to double major curves in cases of adolescent idiopathic scoliosis.

Digital double random amplitude image encryption method based on the symmetry property of the parametric discrete Fourier transform

NASA Astrophysics Data System (ADS)

Bekkouche, Toufik; Bouguezel, Saad

2018-03-01

We propose a real-to-real image encryption method. It is a double random amplitude encryption method based on the parametric discrete Fourier transform coupled with chaotic maps to perform the scrambling. The main idea behind this method is the introduction of a complex-to-real conversion by exploiting the inherent symmetry property of the transform in the case of real-valued sequences. This conversion allows the encrypted image to be real-valued instead of being a complex-valued image as in all existing double random phase encryption methods. The advantage is to store or transmit only one image instead of two images (real and imaginary parts). Computer simulation results and comparisons with the existing double random amplitude encryption methods are provided for peak signal-to-noise ratio, correlation coefficient, histogram analysis, and key sensitivity.

Fused primary first mandibular macromolar with a unique relation to its permanent successors: A rare tooth anomaly.

PubMed

Dhindsa, Abhishek; Garg, Shalini; Damle, S G; Opal, Shireen; Singh, Tavleen

2013-04-01

Dental anomalies of number and forms may occur in the primary and permanent dentition. Various terms have been used to describe dental twinning anomalies: Germination, fusion, concrescence, double teeth, conjoined teeth, twinned teeth, geminifusion, and vicinifusion. Fused tooth is a developmental anomaly that is seen more frequently in the primary than the permanent dentition. Double tooth involving deciduous anterior teeth is found mostly in the mandible. Very few cases of nonsyndromic double primary molar have been reported in the literature. The succeeding permanent tooth is often found missing congenitally in the same region. This article reports a very rare unilateral occurrence of an anomalous, primary mandibular first macromolar formed by fusion with a dysmorphic premolar like supernumerary tooth in deciduous dentition period. Instead of agenesis of succedaneous tooth, the double tooth has been succeeded by normally developing mandibular first premolar in the same region.

Double Internal Limiting Membrane Insertion for Macular Hole-Associated Retinal Detachment

PubMed Central

Chen, San-Ni

2017-01-01

Purpose To describe a modified technique of internal limiting membrane (ILM) insertion for macular hole- (MH-) associated retinal detachment (RD) in highly myopic eyes. Methods Nine eyes underwent pars plana vitrectomy, cortical vitreous removal, and fovea-sparing ILM peeling. Double ILM insertion into the hole was performed with inverted perifoveal ILM and a free ILM flap followed by air-fluid exchange. Results Two of the 9 eyes had perifoveal ILM partially torn after cortical vitreous or epiretinal removal. All eyes had the ILM plug stabilized within the MH after double ILM insertion. Postoperatively, MH was sealed with the retina reattached in all the eyes. Conclusion Double ILM insertion may further secure the ILM flap in place in the eyes with MH-associated RD, especially in cases in which insufficient perifoveal ILM was left. This trial is registered with the clinical registration number Clinicaltrials.gov NCT03174639. PMID:28845304

AMSARA: Accession Medical Standards Analysis and Research Activity. Report of 2007 Attrition and Morbidity Data for 2006 Accessions

DTIC Science & Technology

2008-08-04

31 43.7 Available data for curve types (i.e. scoliosis, kyphosis, lordosis ) and subtypes of scoliosis (i.e. thoracic, lumbar, thoracolumbar, double...1% were lordosis . Among scoliosis subtypes, double major curves were the most prevalent (19% of all cases), followed by thoracic, thoracolumbar, and...lumbar. 8 FIGURE 1.2 SPINAL CURVATURE TYPES AND SCOLIOSIS SUBTYPES FORSPINAL CURVATURE EPTS DISCHARGES (2006) N = 71 Lordosis 1% Kyphosis_ 11

Clinical evaluation of double-pigtail stent in patients with upper urinary tract diseases: report of 2685 cases.

PubMed

Hao, Ping; Li, Weibing; Song, Caiping; Yan, Junan; Song, Bo; Li, Longkun

2008-01-01

To review the indications, procedures, complications, and related treatments of double pigtail stent (DPS) placement as an adjunct for some types of endoscopic and open urologic surgery. From July 1998 to December 2006, 2413 patients aged 8 to 81 years underwent stent placement (2685 total placements). The indications consisted of ureteroscopic lithotripsy (1984 cases), percutaneous nephrolithotomy (329 cases), ureteral incision to remove calculi (71 cases), extracorporeal shockwave lithotripsy for upper urinary tract calculi (145 cases), ureteropelvic junction obstruction (31 cases), ureterocystoneostomy (29 cases), benign ureteral stenosis (52 cases), extrinsic ureteral stenosis (16 cases), and iatrogenic ureteral trauma (28 cases). DPSs were inserted into the ureter by cystoscopy (115 stents), ureteroscopy (2052 stents), percutaneous nephrostomy (393 stents), or open surgery (125 stents), and were kept inside the body for 28 +/- 1.7 days (range 1-193 days). The mean follow-up period was 31 +/- 1.9 days (range 1-123 days). Three hundred sixty-five patients (19.6%) experienced one or more problems during the stenting procedure. The main complications were gross hematuria (385 cases), pain (101 cases), bladder irritation (105 cases), high fever (6 cases), encrustation (53 cases), stent migration (42 cases), and stenosis or restenosis (51 cases). Most of the complications were mild and tolerable, and all were immediately treated appropriately. However, 60 stents had to be removed: 29 for gross hematuria, 18 for pain, 7 for bladder irritation, and 6 for high fever. DPS is a safe and useful adjunct for both endoscopic and open procedures to treat upper urinary tract diseases. Most of the complications of DPS placement can be well managed.

Reply to Boyle's "Who is entitled to double effect?

PubMed

Quinn, Warren

1991-10-01

I have only minor quibbles with Boyle's presentation of my version of the Doctrine of Double Effect (DDE) (Boyle, 1991). On my view, the extra morally problematic element in cases of direct intention is the subordination of a victim to purposes that he or she either rightfully rejects or (and this is something that I should now wish to add in light of Boyle's criticisms) cannot rightfully accept. In cases of indirect intention the victim is incidentally affected by an agent's strategy, but in cases of direct intention the victim is made part of the strategy. Boyle suggests at one point that this amounts to using the person.... But I do not think the "using" metaphor is always apt in these cases, although it is perhaps helpful in pointing to the objectionable element in direct intention, which in its perfectly general form can be put only more abstractly.... My only other concern with Boyle's exposition of my view involves his use of the expression "intentionally harming"....The discussion there tends to suggest, in contrast to what Boyle has said earlier, that I represent DDE as discriminating between cases of incidental and intentional harming. But this is precisely what I tried to avoid....

Influence of Double-J Catheters on Urinary Infections After Kidney Transplantation.

PubMed

Jonas, M; Jóźwik, A; Kawecki, D; Durlik, M; Pączek, L; Młynarczyk, G; Chmura, A

2016-06-01

One of the most important problem in kidney transplantation is risk of the urinary anastomosis stricture. In uncertain cases the use of a double-J (or JJ) catheter is a standard solution. In case of urinary leak or fistula after the reanastomosis operation, transuretheral JJ implantation is used. A number of patients after JJ use present urinary infection. Between 2012 and 2014, 283 kidney transplantations were performed in our center. In 77 cases (27.2%), a JJ was used at the time of operation, in 10 other cases (3.5%) during postoperative period. Urinary infection was observed in 95 patients (33.6%), with Proteus, Klebsiella, Enterobacter, Escherichia, Enterococcus, Pseudomonas, Morganella, and Staphylococcus cultures. In the group of patients without JJ catheters, infections were found in 27.6% of cases and in group with JJ, in 47.1% (46.8% in intraoperative use of catheters and 50% in postoperative curse). The analysis shows that use of JJ catheters gives urinary infections almost twice more frequent (47.1% vs 27.6%; P = .001) with no difference if the implantation took place during or after the operation. Copyright © 2016. Published by Elsevier Inc.

Disciplinary and Academic Decisions Pertaining to Students: A Review of the 1997 Judicial Decisions.

ERIC Educational Resources Information Center

Stoner, Edward N.; Schupansky, Susan P.

1998-01-01

Reviews key cases concerning disciplinary and academic decisions in higher education handed down by courts in 1997. Cases touched on procedural due process (for medical residents, academic versus disciplinary decisions, other notable issues), double jeopardy, breach of contract, student discipline records under the Family Education Rights and…

Do-It-Yourself Cases for Accountants.

ERIC Educational Resources Information Center

Vik, Gretchen N.; Doran, Martha; Venable, Carol

1999-01-01

Presents a do-it-yourself case that has the double advantage of giving students practice in formulating questions for a specific company (not just a list from a book or assignment) and of giving them valuable field experience without involving faculty in lining up local companies and screening projects. Describes an example payroll project in an…

Towards Defining Adequate Lithium Trials for Individuals with Mental Retardation and Mental Illness.

ERIC Educational Resources Information Center

Pary, Robert J.

1991-01-01

Use of lithium with mentally retarded individuals with psychiatric conditions and/or behavior disturbances is discussed. The paper describes components of an adequate clinical trial and reviews case studies and double-blind cases. The paper concludes that aggression is the best indicator for lithium use, and reviews treatment parameters and…

Endodontic treatment of developmental anomalies in posterior teeth: treatment of geminated/fused teeth--report of two cases.

PubMed

Tsesis, I; Steinbock, N; Rosenberg, E; Kaufman, A Y

2003-05-01

Gemination or fusion is a rare occurrence in the mandibular posterior teeth. Endodontic treatment of these teeth needs special care and attention to the bizarre anatomy. The aim of this article is to describe the problems encountered and the strategy in treating such cases. Two cases of complex endodontic treatment of fused/geminated teeth are presented. The first is an 11-year-old girl with an anomalous 'double' first mandibular molar and premolar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin; the second is a 16-year-old boy with 'double' second and supernumerary mandibular molars, who was diagnosed with irreversible pulpitis. Both cases were treated successfully in multiple appointments. The common features and treatment modalities are discussed. Failure to diagnose fused/geminated teeth leads to misdiagnosis and a treatment plan that could cause permanent damage and tooth loss. Generally, there is communication between root canal systems of fused/geminated teeth which should be treated as one entity. Use of magnification is an important aid during treatment.

True duplication of the vas deferens: a case report and review of literature.

PubMed

Liang, Mike K; Subramanian, Anuradha; Weedin, John; Griffith, Donald P; Awad, Samir S

2012-04-01

Duplication of the vas deferens is the identification of a second vas deferens within the spermatic cord; it is a rarely reported congenital anomaly. Duplicate vas deferens should not be confused with double vas deferens that describes ipsilateral renal agenesis with a blind ureter ending in the ejaculatory system. We present a case of duplicated vas deferens, and a PubMed Medline (National Library of Medicine) search was performed using the terms "[duplicated OR double]" and "vas deferens". Nineteen papers for a total of twenty-two cases (including ours) were identified. Duplication of vas deferens is a rare finding; it is likely under-reported and underrecognized. Failure to recognize this variation can result in injury to the vas deferens or an ineffective vasectomy. Following identification of a suspected duplicated vas deferens, the structure should be tracked from the internal ring down to the epididymis and intra-operative Doppler should be performed. Post-operatively, renal and bladder imaging can be considered though there have been no reported cases of non-testicular genito-urinary anomalies associated with duplicated vas deferens.

SU-E-J-53: Dosimetric Evaluation at Volumetric Modulated Arc Therapy for Treatment of Prostate Cancer Using Single Or Double Arcs

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

Silva, D; Salmon, H; Pavan, G

2014-06-01

Purpose: Evaluate and compare retrospective prostate treatment plan using Volumetric Modulated Arc Therapy (RapidArc™ - Varian) technique with single or double arcs at COI Group. Methods: Ten patients with present prostate and seminal vesicle neoplasia were replanned as a target treatment volume and a prescribed dose of 78 Gy. A baseline planning, using single arc, was developed for each case reaching for the best result on PTV, in order to minimize the dose on organs at risk (OAR). Maintaining the same optimization objectives used on baseline plan, two copies for optimizing single and double arcs, have been developed. The plansmore » were performed with 10 MV photon beam energy on Eclipse software, version 11.0, making use of Trilogy linear accelerator with Millenium HD120 multileaf collimator. Comparisons on PTV have been performed, such as: maximum, minimum and mean dose, gradient dose, as well as the quantity of monitor units, treatment time and homogeneity and conformity index. OARs constrains dose have been evaluated, comparing both optimizations. Results: Regarding PTV coverage, the difference of the minimum, maximum and mean dose were 1.28%, 0.7% and 0.2% respectively higher for single arc. When analyzed the index of homogeneity found a difference of 0.99% higher when compared with double arcs. However homogeneity index was 0.97% lower on average by using single arc. The doses on the OARs, in both cases, were in compliance to the recommended limits RTOG 0415. With the use of single arc, the quantity of monitor units was 10,1% lower, as well as the Beam-On time, 41,78%, when comparing double arcs, respectively. Conclusion: Concerning the optimization of patients with present prostate and seminal vesicle neoplasia, the use of single arc reaches similar objectives, when compared to double arcs, in order to decrease the treatment time and the quantity of monitor units.« less

Chronic subdural hematomas treated by burr hole trepanation and a subperiostal drainage system.

PubMed

Zumofen, Daniel; Regli, Luca; Levivier, Marc; Krayenbühl, Niklaus

2009-06-01

Most symptomatic chronic subdural hematomas are treated by subdural drainage. However, a subperiostal (i.e., extracranial) passive closed-drainage system in combination with double burr hole trepanation is used at our institution. Therefore, we wanted to analyze our results and compare them with the alternate treatment strategies reported in the current literature. In a retrospective single-center study, we analyzed the data of all patients undergoing double burr hole trepanation with a subperiostal passive closed-drainage system. Data analysis included general patient data, complications, postoperative seizure rate, and outcome. One hundred forty-seven patients underwent surgery for 183 symptomatic chronic subdural hematomas. The perioperative mortality rate was 3.4%. Hematoma persistence or recurrence occurred in 13.1% of the cases. The postoperative seizure rate was 6.6%, and the infection rate was 1.6%, including 3 cases of superficial wound infection and 1 case with deep infection. The reintervention rate was 9.3%, including trepanation in 8.2% of the patients and craniotomy in 1.1%. The overall complication rate was 10.9%. Double burr hole trepanation combined with a subperiostal passive closed-drainage system is a technically easy, highly effective, safe, and cost-efficient treatment strategy for symptomatic chronic subdural hematomas. The absence of a drain in direct contact with the hematoma capsule may moderate the risk of postoperative seizure and limit the secondary spread of infection to intracranial compartments.

Formulation of state projected centroid molecular dynamics: Microcanonical ensemble and connection to the Wigner distribution.

PubMed

Orr, Lindsay; Hernández de la Peña, Lisandro; Roy, Pierre-Nicholas

2017-06-07

A derivation of quantum statistical mechanics based on the concept of a Feynman path centroid is presented for the case of generalized density operators using the projected density operator formalism of Blinov and Roy [J. Chem. Phys. 115, 7822-7831 (2001)]. The resulting centroid densities, centroid symbols, and centroid correlation functions are formulated and analyzed in the context of the canonical equilibrium picture of Jang and Voth [J. Chem. Phys. 111, 2357-2370 (1999)]. The case where the density operator projects onto a particular energy eigenstate of the system is discussed, and it is shown that one can extract microcanonical dynamical information from double Kubo transformed correlation functions. It is also shown that the proposed projection operator approach can be used to formally connect the centroid and Wigner phase-space distributions in the zero reciprocal temperature β limit. A Centroid Molecular Dynamics (CMD) approximation to the state-projected exact quantum dynamics is proposed and proven to be exact in the harmonic limit. The state projected CMD method is also tested numerically for a quartic oscillator and a double-well potential and found to be more accurate than canonical CMD. In the case of a ground state projection, this method can resolve tunnelling splittings of the double well problem in the higher barrier regime where canonical CMD fails. Finally, the state-projected CMD framework is cast in a path integral form.

A generic double-curvature piezoelectric shell energy harvester: Linear/nonlinear theory and applications

NASA Astrophysics Data System (ADS)

Zhang, X. F.; Hu, S. D.; Tzou, H. S.

2014-12-01

Converting vibration energy to useful electric energy has attracted much attention in recent years. Based on the electromechanical coupling of piezoelectricity, distributed piezoelectric zero-curvature type (e.g., beams and plates) energy harvesters have been proposed and evaluated. The objective of this study is to develop a generic linear and nonlinear piezoelectric shell energy harvesting theory based on a double-curvature shell. The generic piezoelectric shell energy harvester consists of an elastic double-curvature shell and piezoelectric patches laminated on its surface(s). With a current model in the closed-circuit condition, output voltages and energies across a resistive load are evaluated when the shell is subjected to harmonic excitations. Steady-state voltage and power outputs across the resistive load are calculated at resonance for each shell mode. The piezoelectric shell energy harvesting mechanism can be simplified to shell (e.g., cylindrical, conical, spherical, paraboloidal, etc.) and non-shell (beam, plate, ring, arch, etc.) distributed harvesters using two Lamé parameters and two curvature radii of the selected harvester geometry. To demonstrate the utility and simplification procedures, the generic linear/nonlinear shell energy harvester mechanism is simplified to three specific structures, i.e., a cantilever beam case, a circular ring case and a conical shell case. Results show the versatility of the generic linear/nonlinear shell energy harvesting mechanism and the validity of the simplification procedures.

Formulation of state projected centroid molecular dynamics: Microcanonical ensemble and connection to the Wigner distribution

NASA Astrophysics Data System (ADS)

Orr, Lindsay; Hernández de la Peña, Lisandro; Roy, Pierre-Nicholas

2017-06-01

A derivation of quantum statistical mechanics based on the concept of a Feynman path centroid is presented for the case of generalized density operators using the projected density operator formalism of Blinov and Roy [J. Chem. Phys. 115, 7822-7831 (2001)]. The resulting centroid densities, centroid symbols, and centroid correlation functions are formulated and analyzed in the context of the canonical equilibrium picture of Jang and Voth [J. Chem. Phys. 111, 2357-2370 (1999)]. The case where the density operator projects onto a particular energy eigenstate of the system is discussed, and it is shown that one can extract microcanonical dynamical information from double Kubo transformed correlation functions. It is also shown that the proposed projection operator approach can be used to formally connect the centroid and Wigner phase-space distributions in the zero reciprocal temperature β limit. A Centroid Molecular Dynamics (CMD) approximation to the state-projected exact quantum dynamics is proposed and proven to be exact in the harmonic limit. The state projected CMD method is also tested numerically for a quartic oscillator and a double-well potential and found to be more accurate than canonical CMD. In the case of a ground state projection, this method can resolve tunnelling splittings of the double well problem in the higher barrier regime where canonical CMD fails. Finally, the state-projected CMD framework is cast in a path integral form.

Double hump sign in indentation gonioscopy is correlated with presence of plateau iris configuration regardless of patent iridotomy.

PubMed

Kiuchi, Yoshiaki; Kanamoto, Takashi; Nakamura, Takao

2009-02-01

A plateau iris is one of the clinical forms of angle closure glaucoma. In patients with a patent iridotomy, the double hump sign detected during indentation gonioscopy has been reported to indicate the existence of a plateau iris configuration. The purpose of this study was to determine whether the double hump sign is correlated with the presence of the plateau iris syndrome regardless of the patency of the iridotomy. Five women and 3 men without a patent iridotomy presented with narrow angles on gonioscopy and a double hump sign on indentation gonioscopy. Ultrasound biomicroscopy (UBM) imaging was performed to determine the etiology of the narrow angle and double hump sign, and to determine the appropriate treatment to prevent the progression of visual field damage. Ten patients with narrow angles and without a double hump sign were also examined by UBM to serve as a control group. All 8 patients who showed double hump sign had a short iris root, which was inserted anterior to the ciliary face, a typical anatomic appearance of a plateau iris. On the other hand, only 1 eye of 10 eyes in control group appeared to have a plateau iris. A double hump sign observed on indentation gonioscopy is strongly correlated with the presence of a plateau iris, and therefore a useful indicator of a plateau iris configuration regardless of the patency of a laser iridotomy. Thus, a plateau iris configuration can be detected without using a UBM in many cases.

Tsukamurella tyrosinosolvens - An unusual case report of bacteremic pneumonia after lung transplantation

PubMed Central

2009-01-01

Background Lung transplant recipients have an increased risk for actinomycetales infection secondary to immunosuppressive regimen. Case presentation A case of pulmonary infection with bacteremia due to Tsukamurella tyrosinosolvens in a 54-year old man who underwent a double lung transplantation four years previously is presented. Conclusion The identification by conventional biochemical assays was unsuccessful and hsp gene sequencing was used to identify Tsukamurella tyrosinosolvens. PMID:19909497

Consequences count: against absolutism at the end of life.

PubMed

Snelling, Paul C

2004-05-01

There has been a considerable amount of debate in the nursing literature about euthanasia, and especially the distinctions between acts and omissions, and killing and letting die. These distinctions are required by opponents of euthanasia to justify allowing some cases of passive euthanasia while forbidding all cases of active euthanasia. This paper adds to the debate by arguing that the position that absolutely forbids euthanasia is theoretically inconsistent. The paper first considers the place of moral theory in analysing moral problems, within the framework of the principles of biomedical ethics. It is argued that despite a moral pluralism that operates in many areas, the legal status of euthanasia is based upon an absolute deontological position against deliberate killing, which cannot be overridden by appeals to favourable consequences. In order that certain forms of passive euthanasia can be allowed, this position allows distinctions within three pairs of concepts--acts and omissions, killing and letting die, and ordinary and extraordinary means. A further method of justifying certain actions near the end of life is the doctrine of double effect. These paired concepts and the doctrine of double effect are analysed with special reference to their consequences. The application of the doctrine of double effect and the three distinctions relies on consideration of their consequences, allowing in practice what in theory is denied. This is important because it weakens the absolute case against euthanasia, which disallows any direct consequentialist appeal. If consequences count in the application of the doctrine and the distinctions, then they should also count directly prior to their application. This strengthens the argument for active euthanasia in certain cases.

Neutrinoless double beta decay in type I+II seesaw models

NASA Astrophysics Data System (ADS)

Borah, Debasish; Dasgupta, Arnab

2015-11-01

We study neutrinoless double beta decay in left-right symmetric extension of the standard model with type I and type II seesaw origin of neutrino masses. Due to the enhanced gauge symmetry as well as extended scalar sector, there are several new physics sources of neutrinoless double beta decay in this model. Ignoring the left-right gauge boson mixing and heavy-light neutrino mixing, we first compute the contributions to neutrinoless double beta decay for type I and type II dominant seesaw separately and compare with the standard light neutrino contributions. We then repeat the exercise by considering the presence of both type I and type II seesaw, having non-negligible contributions to light neutrino masses and show the difference in results from individual seesaw cases. Assuming the new gauge bosons and scalars to be around a TeV, we constrain different parameters of the model including both heavy and light neutrino masses from the requirement of keeping the new physics contribution to neutrinoless double beta decay amplitude below the upper limit set by the GERDA experiment and also satisfying bounds from lepton flavor violation, cosmology and colliders.

Double-regge exchange limit for the γp→ K⁺K⁻p reaction

DOE PAGES

Shi, M.; Danilkin, I. V.; Fernández-Ramírez, C.; ...

2015-02-01

We apply the generalized Veneziano model (B₅ model) in the double-Regge exchange limit to the γp→K⁺K⁻p reaction. Four different cases defined by the possible combinations of the signature factors of leading Regge exchanges ((K *,a₂/f₂), (K *,ρ/ω), (K *₂,a₂/f₂), and (K *₂,ρ/ω)) have been simulated through the Monte Carlo method. Suitable event candidates for the double-Regge exchange high-energy limit were selected employing Van Hove plots as a better alternative to kinematical cuts in the K⁺K⁻p Dalitz plot. In this way we predict and analyze the double-Regge contribution to the K⁺K⁻p Dalitz plot, which constitutes one of the major backgrounds inmore » the search for strangeonia, hybrids and exotics using γp→K⁺K⁻p reaction. We expect that data currently under analysis, and that to come in the future, will allow verification of the double-Regge behavior and a better assessment of this component of the amplitude.« less

A general mixture equation of state for double bonding carboxylic acids with ≥2 association sites

NASA Astrophysics Data System (ADS)

Marshall, Bennett D.

2018-05-01

In this paper, we obtain the first general multi-component solution to Wertheim's thermodynamic perturbation theory for the case that molecules can participate in cyclic double bonds. In contrast to previous authors, we do not restrict double bonding molecules to a 2-site association scheme. Each molecule in a multi-component mixture can have an arbitrary number of donor and acceptor association sites. The one restriction on the theory is that molecules can have at most one pair of double bonding sites. We also incorporate the effect of hydrogen bond cooperativity in cyclic double bonds. We then apply this new association theory to 2-site and 3-site models for carboxylic acids within the polar perturbed chain statistical associating fluid theory equation of state. We demonstrate the accuracy of the approach by comparison to both pure and multi-component phase equilibria data. It is demonstrated that the 3-site association model gives substantially a different hydrogen bonding structure than a 2-site approach. We also demonstrate that inclusion of hydrogen bond cooperativity has a substantial effect on a liquid phase hydrogen bonding structure.

ILT for double exposure lithography with conventional and novel materials

NASA Astrophysics Data System (ADS)

Poonawala, Amyn; Borodovsky, Yan; Milanfar, Peyman

2007-03-01

Multiple paths exists to provide lithography solutions pursuant to Moore's Law for next 3-5 generations of technology, yet each of those paths inevitably leads to solutions eventually requiring patterning at k I < 0.30 and below. In this article, we explore double exposure single development lithography for k I >= 0.25 (using conventional resist) and k1 < 0.25 (using new out-of-sight out-of-mind materials). For the case of k I >= 0.25, we propose a novel double exposure inverse lithography technique (ILT) to split the pattern. Our algorithm is based on our earlier proposed single exposure ILT framework, and works by decomposing the aerial image (instead of the target pattern) into two parts. It also resolves the phase conflicts automatically as part of the decomposition, and the combined aerial image obtained using the estimated masks has a superior contrast. For the case of k I < 0.25, we focus on analyzing the use of various dual patterning techniques enabled by the use of hypothetic materials with properties that allow for the violation of the linear superposition of intensities from the two exposures. We investigate the possible use of two materials: contrast enhancement layer (CEL) and two-photon absorption resists. We propose a mathematical model for CEL, define its characteristic properties, and derive fundamental bounds on the improvement in image log-slope. Simulation results demonstrate that double exposure single development lithography using CEL enables printing 80nm gratings using dry lithography. We also combine ILT, CEL, and DEL to synthesize 2-D patterns with k I = 0.185. Finally, we discuss the viability of two-photon absorption resists for double exposure lithography.

Two-dimensional quasi-double-layers in two-electron-temperature, current-free plasmas

NASA Astrophysics Data System (ADS)

Merino, Mario; Ahedo, Eduardo

2013-02-01

The expansion of a plasma with two disparate electron populations into vacuum and channeled by a divergent magnetic nozzle is analyzed with an axisymmetric model. The purpose is to study the formation and two-dimensional shape of a current-free double-layer in the case when the electric potential steepening can still be treated within the quasineutral approximation. The properties of this quasi-double-layer are investigated in terms of the relative fraction of the high-energy electron population, its radial distribution when injected into the nozzle, and the geometry and intensity of the applied magnetic field. The two-dimensional double layer presents a curved shape, which is dependent on the natural curvature of the equipotential lines in a magnetically expanded plasma and the particular radial distribution of high-energy electrons at injection. The double layer curvature increases the higher the nozzle divergence is, the lower the magnetic strength is, and the more peripherally hot electrons are injected. A central application of the study is the operation of a helicon plasma thruster in space. To this respect, it is shown that the curvature of the double layer does not increment the thrust, it does not modify appreciably the downstream divergence of the plasma beam, but it increases the magnetic-to-pressure thrust ratio. The present study does not attempt to cover current-free double layers involving plasmas with multiple populations of positive ions.

Evaluation Report of the Double Wall Air Inflated MUST Shelter Made from Three Dimensional Fabric

DTIC Science & Technology

1975-10-22

II Natick laboratory Test Results on Spray Coated 3-D Woven Fabric iWST Shelter Casing Material ......... 29 11 3-D Casing Fabric D1mensions, as Woven...of yarns shoi . be achieved before spraying. 3.1.3 The casing surface should be inspected afhir each of the first several spray coats for pinholes in...Coated Fabric Casing Material After two days of drying time, a three-foot-wide portion was cut off from one end of a sprayed casing . Part of this coated

A Family of Finite-Dimensional Representations of Generalized Double Affine Hecke Algebras of Higher Rank

NASA Astrophysics Data System (ADS)

Fu, Yuchen; Shelley-Abrahamson, Seth

2016-06-01

We give explicit constructions of some finite-dimensional representations of generalized double affine Hecke algebras (GDAHA) of higher rank using R-matrices for U_q(sl_N). Our construction is motivated by an analogous construction of Silvia Montarani in the rational case. Using the Drinfeld-Kohno theorem for Knizhnik-Zamolodchikov differential equations, we prove that the explicit representations we produce correspond to Montarani's representations under a monodromy functor introduced by Etingof, Gan, and Oblomkov.

Double Star Measurements at the Southern Sky with a 50 cm Reflector in 2016

NASA Astrophysics Data System (ADS)

Anton, Rainer

2017-10-01

A 50 cm Ritchey-Chrétien reflector was used for recordings of double stars with a CCD webcam, and measurements of 95 pairs were mostly obtained from “lucky images”, and in some cases by speckle interferometry. The image scale was calibrated with reference systems from the recently published Gaia catalogue of precise position data. For several pairs, deviations from currently assumed orbits were found. Some images of noteworthy systems are also pre-sented.

Growth analysis of pulmonary metastases from salivary gland tumors.

PubMed

Twardzik, F G; Sklaroff, D M

1976-03-01

Three cases of primary salivary gland tumors with lung metastasis are presented with extremely long survival (six, ten, and twelve years). The tumor doubling time was calculated and the growth rate of the pulmonary metastasis was found to be slow and erratic. A simplified table was devised, which permits rapid calculation of the tumor doubling time without the use of graphs. The presence of lung metastasis from some primary malignant salivary tumor is not necessarily an ominous sign: a long survival without symtoms is possible.

Turner syndrome and 45,X/47,XXX mosaicism.

PubMed

Akbas, E; Mutluhan, H; Savasoglu, K; Soylemez, F; Ozturk, I; Yazici, G

2009-01-01

The occurrence of double aneuploidy is a relatively rare phenomenon. We report on a 17-year-old woman with short stature, minimal pubic and axillar hair and short hands. In cultured lymphocyte a double aneuploidy mosaicism was detected, consisting of a cell line with trisomy for X chromosome and a cell line with monosomy for the X-chromosome and no cell line with a normal karyotype. To our knowledge, this is the first case of mosaic 45,X/47,XXX in Turkey.

Electron transport in electrically biased inverse parabolic double-barrier structure

NASA Astrophysics Data System (ADS)

M, Bati; S, Sakiroglu; I, Sokmen

2016-05-01

A theoretical study of resonant tunneling is carried out for an inverse parabolic double-barrier structure subjected to an external electric field. Tunneling transmission coefficient and density of states are analyzed by using the non-equilibrium Green’s function approach based on the finite difference method. It is found that the resonant peak of the transmission coefficient, being unity for a symmetrical case, reduces under the applied electric field and depends strongly on the variation of the structure parameters.

Cu sbnd Al sbnd Fe layered double hydroxides with CO32- and anionic surfactants with different alkyl chains in the interlayer

NASA Astrophysics Data System (ADS)

Trujillano, Raquel; Holgado, María Jesús; González, José Luis; Rives, Vicente

2005-08-01

Layered double hydroxides (LDHs), with the hydrotalcite-like structure containing Cu(II), Al(III) and Fe(III) in the layers, and different alkyl sulfonates in the interlayer, have been prepared and characterized by powder X-ray diffraction, FT-IR spectroscopy, differential thermal analysis and thermogravimetric analysis. Pure crystalline phases have been obtained in all cases. Upon heating, combustion of the organic chain takes place at lower temperature than the corresponding sodium salts.

Double autologous lymph node transplantation (ALNT) at the level of the knee and inguinal region for advanced lymphoedema of the lower limb (elephantiasis).

PubMed

Gómez Martín, C; Murillo, C; Maldonado, A A; Cristóbal, L; Fernández-Cañamaque, J L

2014-02-01

Primary lower-limb lymphoedema is a chronic, progressive and debilitating condition with a difficult management, especially in advanced cases (elephantiasis). Recently, autologous lymph node transplantation (ALNT) appears to be a promising treatment for extremity lymphoedema. A case of a double ALNT for an advanced primary lower-limb lymphoedema is here reported: a contralateral inguinal lymph node flap was transferred to the knee and, in a second surgery, a thoracic lymph node flap was transplanted to the inguinal region. Clinical outcomes at 5 months postoperatively are very satisfactory with reduction in limb circumferences and improvement in skin quality and social impairment. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

[Double mutant alleles in the EXT1 gene not previously reported in a teenager with hereditary multiple exostoses].

PubMed

Cammarata-Scalisi, Francisco; Cozar, Mónica; Grinberg, Daniel; Balcells, Susana; Asteggiano, Carla G; Martínez-Domenech, Gustavo; Bracho, Ana; Sánchez, Yanira; Stock, Frances; Delgado-Luengo, Wilmer; Zara-Chirinos, Carmen; Chacín, José Antonio

2015-04-01

Hereditary forms of multiple exostoses, now called EXT1/EXT2-CDG within Congenital Disorders of Glycosylation, are the most common benign bone tumors in humans and clinical description consists of the formation of several cartilage-capped bone tumors, usually benign and localized in the juxta-epiphyseal region of long bones, although wide body dissemination in severe cases is not uncommon. Onset of the disease is variable ranging from 2-3 years up to 13-15 years with an estimated incidence ranging from 1/18,000 to 1/50,000 cases in European countries. We present a double mutant alleles in the EXT1 gene not previously reported in a teenager and her family with hereditary multiple exostoses.

Structure of conducting channel of lightning

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

Alanakyan, Yu. R.

2013-08-15

The spatial distribution of the plasma density in a lightning channel is studied theoretically. It is shown that the electric-field double layer is formed at the channel boundary. In this case, the electron temperature changes abruptly and ions are accelerated by the electric field of the double layer. The ion momentum flux density is close to the surrounding gas pressure. Cleaning of the channel from heavy particles occurs in particle-exchange processes between the plasma channel and the surrounding air. Hydrogen ions are accumulated inside the expanding channel from the surrounding air, which is enriched by hydrogen-contained molecules. In this case,more » the plasma channel is unstable and splits to a chain of equidistant bunches of plasma. The hydrogen-enrich bunches burn diffusely after recombination exhibiting the bead lightning behavior.« less

Pseudoaneurysm of the articular branch of the descending genicular artery following double-bundle anterior cruciate ligament reconstruction.

PubMed

Tsubosaka, Masanori; Matsushita, Takehiko; Kuroda, Ryosuke; Matsumoto, Tomoyuki; Kurosaka, Masahiro

2017-09-01

This report describes a case of a pseudoaneurysm of the articular branch of the descending genicular artery following double-bundle anterior cruciate ligament (ACL) reconstruction. An 18-year-old male received double-bundle ACL reconstruction. During ACL reconstruction, a far anteromedial portal was created for femoral tunnel drilling. The patient presented with pulsatile swelling on the medial side of the knee on the second post-operative day. The pseudoaneurysm was diagnosed using contrast computed tomography and Doppler ultrasonography and was subsequently treated by embolization with a microcatheter. Although a vascular injury is a very rare complication of knee arthroscopy, it should be considered a possibility in patients who undergo such procedures. V.

A patient with PMP22-related hereditary neuropathy and DBH-gene-related dysautonomia.

PubMed

Bartoletti-Stella, Anna; Chiaro, Giacomo; Calandra-Buonaura, Giovanna; Contin, Manuela; Scaglione, Cesa; Barletta, Giorgio; Cecere, Annagrazia; Garagnani, Paolo; Tieri, Paolo; Ferrarini, Alberto; Piras, Silvia; Franceschi, Claudio; Delledonne, Massimo; Cortelli, Pietro; Capellari, Sabina

2015-10-01

Recurrent focal neuropathy with liability to pressure palsies is a relatively frequent autosomal-dominant demyelinating neuropathy linked to peripheral myelin protein 22 (PMP22) gene deletions. The combination of PMP22 gene mutations with other genetic variants is known to cause a more severe phenotype than expected. We present the case of a patient with severe orthostatic hypotension since 12 years of age, who inherited a PMP22 gene deletion from his father. Genetic double trouble was suspected because of selective sympathetic autonomic disturbances. Through exome-sequencing analysis, we identified two novel mutations in the dopamine beta hydroxylase gene. Moreover, with interactome analysis, we excluded a further influence on the origin of the disease by variants in other genes. This case increases the number of unique patients presenting with dopamine-β-hydroxylase deficiency and of cases with genetically proven double trouble. Finding the right, complete diagnosis is crucial to obtain adequate medical care and appropriate genetic counseling.

Fermionic Approach to Weighted Hurwitz Numbers and Topological Recursion

NASA Astrophysics Data System (ADS)

Alexandrov, A.; Chapuy, G.; Eynard, B.; Harnad, J.

2017-12-01

A fermionic representation is given for all the quantities entering in the generating function approach to weighted Hurwitz numbers and topological recursion. This includes: KP and 2D Toda {τ} -functions of hypergeometric type, which serve as generating functions for weighted single and double Hurwitz numbers; the Baker function, which is expanded in an adapted basis obtained by applying the same dressing transformation to all vacuum basis elements; the multipair correlators and the multicurrent correlators. Multiplicative recursion relations and a linear differential system are deduced for the adapted bases and their duals, and a Christoffel-Darboux type formula is derived for the pair correlator. The quantum and classical spectral curves linking this theory with the topological recursion program are derived, as well as the generalized cut-and-join equations. The results are detailed for four special cases: the simple single and double Hurwitz numbers, the weakly monotone case, corresponding to signed enumeration of coverings, the strongly monotone case, corresponding to Belyi curves and the simplest version of quantum weighted Hurwitz numbers.

Fermionic Approach to Weighted Hurwitz Numbers and Topological Recursion

NASA Astrophysics Data System (ADS)

Alexandrov, A.; Chapuy, G.; Eynard, B.; Harnad, J.

2018-06-01

A fermionic representation is given for all the quantities entering in the generating function approach to weighted Hurwitz numbers and topological recursion. This includes: KP and 2 D Toda {τ} -functions of hypergeometric type, which serve as generating functions for weighted single and double Hurwitz numbers; the Baker function, which is expanded in an adapted basis obtained by applying the same dressing transformation to all vacuum basis elements; the multipair correlators and the multicurrent correlators. Multiplicative recursion relations and a linear differential system are deduced for the adapted bases and their duals, and a Christoffel-Darboux type formula is derived for the pair correlator. The quantum and classical spectral curves linking this theory with the topological recursion program are derived, as well as the generalized cut-and-join equations. The results are detailed for four special cases: the simple single and double Hurwitz numbers, the weakly monotone case, corresponding to signed enumeration of coverings, the strongly monotone case, corresponding to Belyi curves and the simplest version of quantum weighted Hurwitz numbers.

Electric Double Layer electrostatics of spherical polyelectrolyte brushes with pH-dependent charge density

NASA Astrophysics Data System (ADS)

Li, Hao; Chen, Guang; Sinha, Shayandev; Das, Siddhartha; Soft Matter, Interfaces,; Energy Laboratory (Smiel) Team

Understanding the electric double layer (EDL) electrostatics of spherical polyelectrolyte (PE) brushes, which are spherical particles grafted with PE layers, is essential for appropriate use of PE-grfated micro-nanoparticles for targeted drug delivery, oil recovery, water harvesting, emulsion stabilization, emulsion breaking, etc. Here we elucidate the EDL electrostatics of spherical PE brushes for the case where the PE exhibits pH-dependent charge density. This pH-dependence necessitates the consideration of explicit hydrogen ion concentration, which in turn dictates the distribution of monomers along the length of the grafted PE. This monomer distribution is shown to be a function of the nature of the sphere (metallic or a charged or uncharged dielectric or a liquid-filled sphere). All the calculations are performed for the case where the PE electrostatics can be decoupled from the PE elastic and excluded volume effects. Initial predictions are also provided for the case where such decoupling is not possible.

Physical properties of a resin system for filling the inter-space in the ITER TF coil casing

NASA Astrophysics Data System (ADS)

Evans, D.; Baynahm, E.; Canfer, S.; Foussat, A.

2014-01-01

Each of the eighteen ITER Toroidal Field (TF) coils will consist of seven double pancakes. Each double pancake will have been individually vacuum impregnated and then the seven units assembled together, over-wrapped with glass fabric based insulation and finally vacuum impregnated again to form the TF coil winding pack [1]. The winding pack (WP) will be finally assembled into the coil casing (CC) and to allow for manufacturing tolerances and final geometric definition, a nominal 10 mm gap will exist between the winding pack and the coil case but in practice, this gap may vary between 3 and 15 mm. After assembly, the final step will be to fill the gap with a material that will maintain the final position of the WP and to uniformly transfer load from WP to CC. This paper deals with the selection of materials and techniques to fill the gap and details some of the properties of the chosen material.

Double breast contour in primary aesthetic breast augmentation: incidence, prevention and treatment.

PubMed

Médard de Chardon, Victor; Balaguer, Thierry; Chignon-Sicard, Bérengère; Lebreton, Elisabeth

2010-04-01

The goal of this study was to define the incidence of double breast contour in primary aesthetic breast augmentation and to analyze its risk factors. An independent plastic surgeon analyzed the data of 200 patients who had a primary aesthetic breast augmentation with silicone gel implant and with a minimum 12-month follow-up. All patients had pre and postoperative standardized photography. Mastopexy-augmentations, breast reconstructions, breast malformations (tuberous breasts and Poland syndrome), and patients with incomplete data were excluded from the study. Assessment was achieved using an original standardized evaluation form (preoperative breast morphology, surgical options, postoperative aesthetic results). Patients were also asked to complete an exhaustive satisfaction form. A double breast contour was assessed clinically using Massiha's classification. The mean follow-up was 36 months. The double breast contour incidence was 7%. All of them were type I (the so called waterfall deformity). There was no type II (double inframammary crease). They were minor for 6.5% and major for 0.5%. They were related to a preoperative breast ptosis, subpectoral placement, and implant upper malposition. The rate of the type I was 10.5% of submuscular augmentation and 15% of preoperative breast ptosis. A double breast contour was primitive for 6% and secondary for 1% (pregnancy and breast-feeding postaugmentation). It was bilateral for 4.5% (3 cases of upper malposition, 1 case of medial malposition, 2 cases of pregnancy with breast-feeding postaugmentation and 1 patient refused a mastopexy-augmentation). It was unilateral for 2.5% related to a preoperative breast asymmetry with ptosis asymmetry and skin quality asymmetry. The satisfaction rate in the group "double contour" (14 patients) was 85.7% (vs. 91.9%). One patient had revision surgery (upper malposition). These types of deformities are fundamentally different with consideration on their clinical aspects, physiopathogeny, prevention and treatment. Type I major risk factor is subpectoral augmentation of ptotic breasts (with medium to bad skin quality and loses muscle to gland attachments). The muscle at the inferior pole of the breast is a "brake" preventing implant to fill the envelope. This risk is increased with implant malposition, constitutional ptosis asymmetry with symmetrical implant placement and selection of an insufficient implant projection or dimensions. This deformity can be avoided with selection of a subglandular or dual plane (type II or III) placement, a sufficient implant volume or projection and anatomic prosthesis. Type II is related to a lowering of a well-defined submammary fold more commonly in constricted and dens glandular breasts. This deformity can be avoided with respecting the inframammary fold, radial incisions on the gland's posterior surface, and selection of anatomic implants.

The Understanding Words Reading Intervention: Evidence from a Case Series Design

ERIC Educational Resources Information Center

Wright, Craig; Conlon, Elizabeth G.; Wright, Michalle

2012-01-01

Using a case-series design with double baseline and 10-week maintenance phase, 5 struggling readers from middle- to high-income families (age range 6.4-7.9 years) completed a 5-times-weekly intervention (96 sessions) administered by a parent. All participants completed the intervention with phonological decoding, text-reading accuracy and reading…

26 CFR 1.665(a)-0A - Excess distributions by trusts; scope of subpart D.

Code of Federal Regulations, 2010 CFR

2010-04-01

...” for the preceding year is also deemed distributed. To prevent double taxation, however, the...., an accumulation trust), in most cases, as if the income had been currently distributed to the...” of the trust, which, in the case of distributions made for a taxable year beginning after December 31...

The Design of Secondary Schools--A Case Study, Singapore.

ERIC Educational Resources Information Center

Liew Kok-Pun, Michael; And Others

Land scarcity dominates the thinking of school planners in Singapore. Techniques for optimizing the use of land for schools include (1) the construction of multi-storied or high-rise schools; (2) operation of a double-shift system and, in some cases, a triple-shift system; (3) multiple use of educational spaces; and (4) construction of several…

Sequential double photodetachment of He- in elliptically polarized laser fields

NASA Astrophysics Data System (ADS)

Génévriez, Matthieu; Dunseath, Kevin M.; Terao-Dunseath, Mariko; Urbain, Xavier

2018-02-01

Four-photon double detachment of the helium negative ion is investigated experimentally and theoretically for photon energies where the transient helium atom is in the 1 s 2 s 3S or 1 s 2 p P3o states, which subsequently ionize by absorption of three photons. Ionization is enhanced by intermediate resonances, giving rise to series of peaks in the He+ spectrum, which we study in detail. The He+ yield is measured in the wavelength ranges from 530 to 560 nm and from 685 to 730 nm and for various polarizations of the laser light. Double detachment is treated theoretically as a sequential process, within the framework of R -matrix theory for the first step and effective Hamiltonian theory for the second step. Experimental conditions are accurately modeled, and the measured and simulated yields are in good qualitative and, in some cases, quantitative agreement. Resonances in the double detachment spectra can be attributed to well-defined Rydberg states of the transient atom. The double detachment yield exhibits a strong dependence on the laser polarization which can be related to the magnetic quantum number of the intermediate atomic state. We also investigate the possibility of nonsequential double detachment with a two-color experiment but observe no evidence for it.

Hohlraum-Driven Ignition-Like Double-Shell Implosion Experiments on Omega: Analysis and Interpretation

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

Amendt, P; Robey, H F; Park, H-S

2003-08-22

An experimental campaign to study hohlraum-driven ignition-like double-shell target performance using the Omega laser facility has begun. These targets are intended to incorporate as many ignition-like properties of the proposed National Ignition Facility (NIF) double-shell ignition design [1,2] as possible, given the energy constraints of the Omega laser. In particular, this latest generation of Omega double-shells is nominally predicted to produce over 99% of the (clean) DD neutron yield from the compressional or stagnation phase of the implosion as required in the NIF ignition design. By contrast, previous double-shell experience on Omega [3] was restricted to cases where a significantmore » fraction of the observed neutron yield was produced during the earlier shock convergence phase where the effects of mix are deemed negligibly small. These new targets are specifically designed to have optimized fall-line behavior for mitigating the effects of pusher-fuel mix after deceleration onset and, thereby, providing maximum neutron yield from the stagnation phase. Experimental results from this recent Omega ignition-like double-shell implosion campaign show favorable agreement with two-dimensional integrated hohlraum simulation studies when enhanced (gold) hohlraum M-band (2-5 keV) radiation is included at a level consistent with observations.« less

Comparison of Clinical Efficacy of Lateral and Lateral and Medial Double-plating Fixation of Distal Femoral Fractures.

PubMed

Bai, Zhibiao; Gao, Shichang; Hu, Zhenming; Liang, Anlin

2018-03-20

The present study was performed to compare the clinical efficacy of lateral plate and lateral and medial double-plating fixation of distal femoral fractures and explore the indication of lateral and medial double-plating fixation of the distal femoral fractures. From March 2006 to April 2014, 48 and 12 cases of distal femoral fractures were treated with lateral plate (single plate) and lateral and medial plates (double plates), respectively. During the surgery, after setting the lateral plate for the distal femoral fractures, if the varus stress test of the knee was positive and the lateral collateral ligament rupture was excluded, lateral and medial double-plating fixation was used for the stability of the fragments. All the patients were followed up at an average period of 15.9 months. The average operation time, the intraoperative hemorrhage and the fracture union time of the two groups were compared. One year after operation, knee function was evaluated by the Kolmert's standard. There was no significant difference in the average operation time, intraoperative hemorrhage, fracture healing time and excellent and good rates of postoperative knee function between two groups. Positive Varus stress test during operation can be an indication for lateral and medial double-plating fixation of distal femoral fractures.

Laser Energy Monitor for Double-Pulsed 2-Micrometer IPDA Lidar Application

NASA Technical Reports Server (NTRS)

Refaat, Tamer F.; Petros, Mulugeta; Remus, Ruben; Yu, Jirong; Singh, Upendra N.

2014-01-01

Integrated path differential absorption (IPDA) lidar is a remote sensing technique for monitoring different atmospheric species. The technique relies on wavelength differentiation between strong and weak absorbing features normalized to the transmitted energy. 2-micron double-pulsed IPDA lidar is best suited for atmospheric carbon dioxide measurements. In such case, the transmitter produces two successive laser pulses separated by short interval (200 microseconds), with low repetition rate (10Hz). Conventional laser energy monitors, based on thermal detectors, are suitable for low repetition rate single pulse lasers. Due to the short pulse interval in double-pulsed lasers, thermal energy monitors underestimate the total transmitted energy. This leads to measurement biases and errors in double-pulsed IPDA technique. The design and calibration of a 2-micron double-pulse laser energy monitor is presented. The design is based on a high-speed, extended range InGaAs pin quantum detectors suitable for separating the two pulse events. Pulse integration is applied for converting the detected pulse power into energy. Results are compared to a photo-electro-magnetic (PEM) detector for impulse response verification. Calibration included comparing the three detection technologies in single-pulsed mode, then comparing the pin and PEM detectors in double-pulsed mode. Energy monitor linearity will be addressed.

Primary intestinal lymphangiectasia diagnosed by double-balloon enteroscopy and treated by medium-chain triglycerides: a case report

PubMed Central

2013-01-01

Introduction Primary intestinal lymphangiectasia is a disorder characterized by exudative enteropathy resulting from morphologic abnormalities of the intestinal lymphatics. Intestinal lymphangiectasia can be primary or secondary, so the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A double-balloon enteroscopy and biopsy, as well as the pathology can be used to confirm the diagnosis of intestinal lymphangiectasia. A polymeric diet containing medium-chain triglycerides and total parenteral nutrition may be a useful therapy. Case presentation A 17-year-old girl of Mongoloid ethnicity was admitted to our hospital with a history of diarrhea and edema. She was diagnosed with protein-losing enteropathy caused by intestinal lymphangiectasia. This was confirmed by a double-balloon enteroscopy and multi-dot biopsy. After treatment with total parenteral nutrition in hospital, which was followed by a low-fat and medium-chain triglyceride diet at home, she was totally relieved of her symptoms. Conclusion Intestinal lymphangiectasia can be diagnosed with a double-balloon enteroscopy and multi-dot biopsy, as well as the pathology of small intestinal tissue showing edema of the submucosa and lymphangiectasia. Because intestinal lymphangiectasia can be primary or secondary, the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A positive clinical response to the special diet therapy, namely a low-fat and medium-chain triglyceride diet, can further confirm the diagnosis of primary intestinal lymphangiectasia. PMID:23316917

Epidemiological Transition and the Double Burden of Disease in Accra, Ghana

PubMed Central

de-Graft Aikins, Ama

2010-01-01

It has long been recognized that as societies modernize, they experience significant changes in their patterns of health and disease. Despite rapid modernization across the globe, there are relatively few detailed case studies of changes in health and disease within specific countries especially for sub-Saharan African countries. This paper presents evidence to illustrate the nature and speed of the epidemiological transition in Accra, Ghana’s capital city. As the most urbanized and modernized Ghanaian city, and as the national center of multidisciplinary research since becoming state capital in 1877, Accra constitutes an important case study for understanding the epidemiological transition in African cities. We review multidisciplinary research on culture, development, health, and disease in Accra since the late nineteenth century, as well as relevant work on Ghana’s socio-economic and demographic changes and burden of chronic disease. Our review indicates that the epidemiological transition in Accra reflects a protracted polarized model. A “protracted” double burden of infectious and chronic disease constitutes major causes of morbidity and mortality. This double burden is polarized across social class. While wealthy communities experience higher risk of chronic diseases, poor communities experience higher risk of infectious diseases and a double burden of infectious and chronic diseases. Urbanization, urban poverty and globalization are key factors in the transition. We explore the structures and processes of these factors and consider the implications for the epidemiological transition in other African cities. PMID:20803094

Clinical success of implant-supported and tooth-implant-supported double crown-retained dentures.

PubMed

Bernhart, Gunda; Koob, Andreas; Schmitter, Marc; Gabbert, Olaf; Stober, Thomas; Rammelsberg, Peter

2012-08-01

The objective of this retrospective study was to compare biological and technical complications of implant-supported and tooth-implant-supported double crown-retained dentures (DCRDs) with those of tooth-supported DCRDs. Sixty-three DCRDs were monitored. One study group included 16 prostheses with a combination of implants and natural teeth as double crowns (ti group), whereas in the second study group, 19 dentures were retained exclusively on implants (ii group); a third study group with 28 exclusively tooth-supported dentures served as controls (tt group). Tooth loss, implant failure, and technical complications (loss of retention of primary crown, abutment screw loosening, loss of facing, fracture of resin denture teeth and fracture of saddle resin) were analysed. During the observation period of 24 months, no implants or teeth were lost in the ti group and three technical complications were recorded. In the ii group, two implants were lost, two cases of peri-implantitis occurred and four technical complications were observed. In the tt group, two cases of tooth loss and seven technical complications were observed. At the time of the last examination, all prostheses of the ti group and the ii group were functional. Patients of these two study groups reported high satisfaction with both function and aesthetics with no significant difference between the two groups. Treatment with DCRDs showed comparable results in the three study groups. The 2-year results indicate that double crowns can be recommended for implant and combined tooth-implant-retained dentures.

Double-bundle PCL reconstruction using autologous hamstring tendons: outcome with a minimum 2-year follow-up.

PubMed

Cury, Ricardo de Paula Leite; Castro Filho, Rômulo Neves; Sadatsune, Daniel Akira; do Prado, Davi Ribeiro; Gonçalves, Ricardo José Peruzzo; Mestriner, Marcos Barbieri

2017-01-01

To present the outcomes of posterior cruciate ligament (PCL) double-bundle reconstruction using autologous hamstring tendons, with a minimum follow-up of two years. Evaluation of 16 cases of PCL injury that underwent double-bundle reconstruction with autogenous hamstring tendons, between 2011 and 2013. The final sample consisted of 16 patients, 15 men and one woman, with a mean age of 31 years (21-49). The predominant mechanism was motorcycle accident in half of the cases. There was a mean interval of 15 months between the time of lesion and the surgery (three to 52 months). Five lesions were isolated and 11, associated. Clinical evaluation, application of validated scores, and measurements with use of the KT-1000 were performed. The analysis showed a mean preoperative Lysholm score of 50 points (28-87), progressing to 94 points (85-100) postoperatively. The IKDC score also demonstrated improvement. In the preoperative evaluation, four and 12 patients were respectively classified as C (abnormal) and D (very unusual), and in the postoperative evaluation six as A (normal) and ten as B (close to normal). In the post-operative evaluation by KT1000 arthrometer, 13 patients showed difference between 0-2 mm and 3 between 3 and 5 mm, when compared with the contralateral side. Autologous hamstring tendons are a viable option in double-bundle reconstruction of the PCL, with good clinical results in a minimum follow-up of two years.

Femtosecond-assisted keratopigmentation double tunnel technique in the management of a case of Urrets-Zavalia syndrome.

PubMed

Alio, Jorge L; Rodriguez, Alejandra E; Toffaha, Bader T; El Aswad, A

2012-09-01

To describe the successful use of a double intrastromal tunnel femtosecond-assisted keratopigmentation technique to manage a case of unilateral Urrets-Zavalia syndrome. A 33-year-old man was referred with a history of trauma in his right eye due to a labor-related accident. Because of myopic anisometropia, he had been previously implanted with an angle-supported phakic intraocular lens. The patient presented iris atrophy and a fixed dilated pupil. He complained of severe and incapacitating photophobia, glare, and decreased vision. To obtain a complete iris replica, the surgery involved creation of double keratopigmented intrastromal tunnels using femtosecond laser and micronized mineral pigments. The deepest layer was stained black first and then the superficial layer was stained with a contoured greenish blue-gray color, which matched the contralateral eye. In the immediate postoperative period, the patient reported a complete elimination of photophobia associated with the corrected distance visual acuity improvement. A very adequate cosmetic outcome was also achieved. Stability was observed during the 12-month follow-up. A femtosecond-assisted keratopigmentation technique using 2 pigmented intrastromal tunnels to achieve an intracorneal pigmented replica of the iris was effective in improving the patient's severe visual function disability and cosmetic appearance. To the best of our knowledge, this is the first report of severe visual function disability caused by atrophic iris and a fixed dilated pupil treated with double intrastromal layers of keratopigmentation by means of femtosecond-created tunnels.

Accuracy of the lattice-Boltzmann method using the Cell processor

NASA Astrophysics Data System (ADS)

Harvey, M. J.; de Fabritiis, G.; Giupponi, G.

2008-11-01

Accelerator processors like the new Cell processor are extending the traditional platforms for scientific computation, allowing orders of magnitude more floating-point operations per second (flops) compared to standard central processing units. However, they currently lack double-precision support and support for some IEEE 754 capabilities. In this work, we develop a lattice-Boltzmann (LB) code to run on the Cell processor and test the accuracy of this lattice method on this platform. We run tests for different flow topologies, boundary conditions, and Reynolds numbers in the range Re=6 350 . In one case, simulation results show a reduced mass and momentum conservation compared to an equivalent double-precision LB implementation. All other cases demonstrate the utility of the Cell processor for fluid dynamics simulations. Benchmarks on two Cell-based platforms are performed, the Sony Playstation3 and the QS20/QS21 IBM blade, obtaining a speed-up factor of 7 and 21, respectively, compared to the original PC version of the code, and a conservative sustained performance of 28 gigaflops per single Cell processor. Our results suggest that choice of IEEE 754 rounding mode is possibly as important as double-precision support for this specific scientific application.

Impact of Tropopause Structures on Deep Convective Transport Observed during MACPEX

NASA Astrophysics Data System (ADS)

Mullendore, G. L.; Bigelbach, B. C.; Christensen, L. E.; Maddox, E.; Pinkney, K.; Wagner, S.

2016-12-01

Deep convection is the most efficient method of transporting boundary layer mass to the upper troposphere and stratosphere (UTLS). The Mid-latitude Airborne Cirrus Properties Experiment (MACPEX) was conducted during April of 2011 over the central U.S. With a focus on cirrus clouds, the campaign flights often sampled large cirrus anvils downstream from deep convection and included an extensive observational suite of chemical measurements on a high altitude aircraft. As double-tropopause structures are a common feature in the central U.S. during the springtime, the MACPEX campaign provides a good opportunity to gather cases of deep convective transport in the context of both single and double tropopause structures. Sampling of chemical plumes well downstream from convection allows for sampling in relatively quiescent conditions and analysis of irreversible transport. The analysis presented includes multiple methods to assess air mass source and possible convective processing, including back trajectories and ratios of chemical concentrations. Although missions were flown downstream of deep convection, recent processing by convection does not seem likely in all cases that high altitude carbon monoxide plumes were observed. Additionally, the impact of single and double tropopause structures on deep convective transport is shown to be strongly dependent on high stability layers.

Mosaic Double Aneuploidy of X and G Chromosomes

ERIC Educational Resources Information Center

And Others; Singh, D. N.

1975-01-01

Reported are case histories of three severely retarded adolescents with typical Down's Syndrome features but whose cytogenetic analysis revealed a rare chromosomal anomaly of mosaicism of Down's and Turner's syndromes. (CL)

Double-wells and double-layers in dusty Fermi-Dirac plasmas: Comparison with the semiclassical Thomas-Fermi counterpart

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

Akbari-Moghanjoughi, M.

Based on the quantum hydrodynamics (QHD) model, a new relationship between the electrostatic-potential and the electron-density in the ultradense plasma is derived. Propagation of arbitrary amplitude nonlinear ion waves is, then, investigated in a completely degenerate dense dusty electron-ion plasma, using this new energy relation for the relativistic electrons, in the ground of quantum hydrodynamics model and the results are compared to the case of semiclassical Thomas-Fermi dusty plasma. Based on the standard pseudopotential approach, it is remarked that the Fermi-Dirac plasma, in contrast to the Thomas-Fermi counterpart, accommodates a wide variety of nonlinear excitations such as positive/negative-potential ion solitarymore » and periodic waves, double-layers, and double-wells. It is also remarked that the relativistic degeneracy parameter which relates to the mass-density of plasma has significant effects on the allowed matching-speed range in Fermi-Dirac dusty plasmas.« less

Bronchial lumen is the safer route for an airway exchange catheter in double-lumen tube replacement: preventable complication in airway management for thoracic surgery.

PubMed

Wu, Hsiang-Ling; Tai, Ying-Hsuan; Wei, Ling-Fang; Cheng, Hung-Wei; Ho, Chiu-Ming

2017-10-01

There is no current consensus on which lumen an airway exchange catheter (AEC) should be passed through in double-lumen endotracheal tube (DLT) to exchange for a single-lumen endotracheal tube (SLT) after thoracic surgery. We report an unusual case to provide possible solution on this issue. A 71-year-old man with lung adenocarcinoma had an event of a broken exchange catheter used during a DLT replacement with a SLT, after a video-assisted thoracic surgery. The exchange catheter was impinged at the distal tracheal lumen and snapped during manipulation. All three segments of the catheter were retrieved without further airway compromises. Placement of airway tube exchanger into the tracheal lumen of double-lumen tube is a potential contributing factor of the unusual complication. We suggest an exchange catheter be inserted into the bronchial lumen in optimal depth with the adjunct of video laryngoscope, as the safe method for double-lumen tube exchange.

Multiple parton interactions and forward double pion production in pp and dA scattering

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

Strikman, M.; Vogelsang, W.

2011-02-01

We estimate the contributions by double-parton interactions to the cross sections for pp{yields}{pi}{sup 0}{pi}{sup 0}X and dA{yields}{pi}{sup 0}{pi}{sup 0}X at the Relativistic Heavy Ion Collider (RHIC). We find that such contributions become important at large forward rapidities of the produced pions. This is, in particular, the case for dA scattering, where they strongly enhance the azimuthal-angular independent pedestal component of the cross section, providing a natural explanation of this feature of the RHIC dA data. We argue that the discussed processes open a window to studies of double quark distributions in nucleons. We also briefly address the roles of shadowingmore » and energy loss in dA scattering, which we show to affect the double-inclusive pion cross section much more strongly than the single-inclusive one. We discuss the implications of our results for the interpretation of pion azimuthal correlations.« less

Vacuum aspiration with the IPAS Modified Gynecologic Syringe.

PubMed

Balogh, S A

1983-01-01

The IPAS Modified Gynecologic Syringe was compared with the electric pump and standard hand pump in a clinical trial of 1227 women undergoing vacuum aspiration. This modified double-valve syringe was designed to fit larger 8 mm, 10 mm and 12 mm cannulae, which are more suitable for late first trimester procedures. The study was conducted at four centers in which the double-valve syringe was used alternately with the vacuum source normally used at each clinic. Although there were notable inter-center differences with respect to certain outcome variables, results were similar for procedures performed at the same center. The only significant finding was the lower proportion of women requiring D & C to complete uterine evacuation among double-valve syringe patients than among hand pump cases at one center. The data indicate that the double-valve syringe is safe and effective for uterine aspiration in women up to 14 weeks' gestation and may be preferable for use in clinics with limited facilities.

Can Multiple Cropping Help to Avoid the Impacts of Heat Extremes? The Case of Winter Wheat/Soybean Double Cropping in the United States

NASA Astrophysics Data System (ADS)

Seifert, C.; Lobell, D. B.

2014-12-01

In adapting U.S. agriculture to the climate of the 21st century, multiple cropping presents a unique opportunity to help offset projected negative trends in agricultural production while moving critical crop yield formation periods outside of the hottest months of the year. Critical constraints on this practice include moisture availability, and, more importantly, growing season length. We review evidence that this last constraint has decreased in the previous quarter century, allowing for more winter wheat/soybean double cropping in previously phenologically constrained areas. We also carry this pattern forward to 2100, showing a 126% to 211% increase in the area phenologically suitable for double cropping under the RCP45 and RCP85 scenarios respectively. These results suggest that climate change will relieve phenological constraints on wheat-soy double cropping systems over much of the United States, changing production patterns and crop rotations as areas become suitable for the practice.

Minimizing donor-site morbidity following bilateral pedicled TRAM breast reconstruction with the double mesh fold over technique.

PubMed

Bharti, Gaurav; Groves, Leslie; Sanger, Claire; Thompson, James; David, Lisa; Marks, Malcolm

2013-05-01

Transverse rectus abdominus muscle flaps (TRAM) can result in significant abdominal wall donor-site morbidity. We present our experience with bilateral pedicle TRAM breast reconstruction using a double-layered polypropylene mesh fold over technique to repair the rectus fascia. A retrospective study was performed that included patients with bilateral pedicle TRAM breast reconstruction and abdominal reconstruction using a double-layered polypropylene mesh fold over technique. Thirty-five patients met the study criteria with a mean age of 49 years old and mean follow-up of 7.4 years. There were no instances of abdominal hernia and only 2 cases (5.7%) of abdominal bulge. Other abdominal complications included partial umbilical necrosis (14.3%), seroma (11.4%), partial wound dehiscence (8.6%), abdominal weakness (5.7%), abdominal laxity (2.9%), and hematoma (2.9%). The TRAM flap is a reliable option for bilateral autologous breast reconstruction. Using the double mesh repair of the abdominal wall can reduce instances of an abdominal bulge and hernia.

Effects of Doubled CO2 on Tropical Sea-Surface Temperature (SSTs) for Onset of Deep Convection and Maximum SST-GCM Simulations Based Inferences

NASA Technical Reports Server (NTRS)

Sud, Y. C.; Walker, G. K.; Zhou, Y. P.; Schmidt, Gavin A.; Lau, K. M.; Cahalan, R. F.

2008-01-01

A primary concern of CO2-induced warming is the associated rise of tropical (10S-10N) seasurface temperatures (SSTs). GISS Model-E was used to produce two sets of simulations-one with the present-day and one with doubled CO2 in the atmosphere. The intrinsic usefulness of model guidance in the tropics was confirmed when the model simulated realistic convective coupling between SSTs and atmospheric soundings and that the simulated-data correlations between SSTs and 300 hPa moiststatic energies were found to be similar to the observed. Model predicted SST limits: (i) one for the onset of deep convection and (ii) one for maximum SST, increased in the doubled C02 case. Changes in cloud heights, cloud frequencies, and cloud mass-fractions showed that convective-cloud changes increased the SSTs, while warmer mixed-layer of the doubled CO2 contained approximately 10% more water vapor; clearly that would be conducive to more intense storms and hurricanes.

Duplication cyst of the small intestine found by double-balloon endoscopy: A case report

PubMed Central

Ogino, Haruei; Ochiai, Toshiaki; Nakamura, Norimoto; Yoshimura, Daisuke; Kabemura, Teppei; Kusumoto, Tetsuya; Matsuura, Hiroshi; Nakashima, Akihiko; Honda, Kuniomi; Nakamura, Kazuhiko

2008-01-01

A 35-year-old man was admitted due to bloody stool and anemia. The bleeding source could not be detected by esophagogastroduodenoscopy or colonoscopy. Double balloon endoscopy (DBE) revealed a diverticulum-like hole in which coagula stuck in the ileum at 1 meter on the oral side from the ileocecal valve. The adjacent mucosa just to the oral side of the hole was elevated like a submucosal tumor. The lesion was considered the source of bleeding and removed surgically. It was determined to be a cyst with an ileal structure on the mesenteric aspect accompanying gastric mucosa. The diagnosis was a duplication cyst of the ileum, which is a rare entity that can cause gastrointestinal bleeding. In the present case, DBE was used to find the hemorrhagic duplication cyst in the ileum. PMID:18609722

Improving the Ability of Image Sensors to Detect Faint Stars and Moving Objects Using Image Deconvolution Techniques

PubMed Central

Fors, Octavi; Núñez, Jorge; Otazu, Xavier; Prades, Albert; Cardinal, Robert D.

2010-01-01

In this paper we show how the techniques of image deconvolution can increase the ability of image sensors as, for example, CCD imagers, to detect faint stars or faint orbital objects (small satellites and space debris). In the case of faint stars, we show that this benefit is equivalent to double the quantum efficiency of the used image sensor or to increase the effective telescope aperture by more than 30% without decreasing the astrometric precision or introducing artificial bias. In the case of orbital objects, the deconvolution technique can double the signal-to-noise ratio of the image, which helps to discover and control dangerous objects as space debris or lost satellites. The benefits obtained using CCD detectors can be extrapolated to any kind of image sensors. PMID:22294896

Improving the ability of image sensors to detect faint stars and moving objects using image deconvolution techniques.

PubMed

Fors, Octavi; Núñez, Jorge; Otazu, Xavier; Prades, Albert; Cardinal, Robert D

2010-01-01

In this paper we show how the techniques of image deconvolution can increase the ability of image sensors as, for example, CCD imagers, to detect faint stars or faint orbital objects (small satellites and space debris). In the case of faint stars, we show that this benefit is equivalent to double the quantum efficiency of the used image sensor or to increase the effective telescope aperture by more than 30% without decreasing the astrometric precision or introducing artificial bias. In the case of orbital objects, the deconvolution technique can double the signal-to-noise ratio of the image, which helps to discover and control dangerous objects as space debris or lost satellites. The benefits obtained using CCD detectors can be extrapolated to any kind of image sensors.

Distributed finite-time containment control for double-integrator multiagent systems.

PubMed

Wang, Xiangyu; Li, Shihua; Shi, Peng

2014-09-01

In this paper, the distributed finite-time containment control problem for double-integrator multiagent systems with multiple leaders and external disturbances is discussed. In the presence of multiple dynamic leaders, by utilizing the homogeneous control technique, a distributed finite-time observer is developed for the followers to estimate the weighted average of the leaders' velocities at first. Then, based on the estimates and the generalized adding a power integrator approach, distributed finite-time containment control algorithms are designed to guarantee that the states of the followers converge to the dynamic convex hull spanned by those of the leaders in finite time. Moreover, as a special case of multiple dynamic leaders with zero velocities, the proposed containment control algorithms also work for the case of multiple stationary leaders without using the distributed observer. Simulations demonstrate the effectiveness of the proposed control algorithms.

Pathologic Remodeling of Endoneurial Tubules in Human Neuromas.

PubMed

Karsy, Michael; Palmer, Cheryl A; Mahan, Mark A

2018-01-18

Laminins are extracellular matrix proteins that participate in endoneurial tubule formation and are important in the regeneration of nerves after injury. They act as scaffolds to guide nerves to distal targets and play a key role in neurite outgrowth. Because there is evidence that laminin architecture affects nerve regeneration, we evaluated endoneurial tubules by examining the laminin structure in clinical samples from patients with nerve injuries. In a retrospective review of eight nerve injury cases, we evaluated nerve histology in relation to clinical history and injury type. The immunohistochemical delineation of the laminin structure in relationship with the neuroma type was performed. Five cases of upper-trunk stretch injuries-four from childbirth injury and one from a motorcycle accident-and three cases of nerve laceration leading to neuroma formation were examined. In the upper-trunk stretch injuries, avulsed nerves demonstrated no neuroma formation with a linear laminin architecture and a regular Schwann cell arrangement, but increased fibrous tissue deposition. For neuromas-in-continuity after a stretch injury, laminin immunohistochemistry demonstrated a double-lumen laminin tubule, with encapsulation of the Schwann cells and axonal processes. Nerve laceration leading to stump neuroma formation had a similar double-lumen laminin tubule, but less severe fibrosis. In nerve injuries with regenerative capacity, endoneurial tubules become pathologically disorganized. A double-lumen endoneurial tubule of unclear significance develops. The consistency of this pattern potentially suggests a reproducible pathophysiologic process. Further exploration of this pathophysiologic healing may provide insight into the failure of programmed peripheral nerve regeneration after injury.

Our ultrasonographic experience in the management of symptomatic hydronephrosis during pregnancy.

PubMed

Dell'Atti, Lucio

2016-03-01

The aim of the present study was to document the role of ultrasound in the diagnosis and management of symptomatic hydronephrosis during pregnancy. In this study, we reviewed 36 consecutive cases of pregnant women whose pregnancy was complicated by symptomatic hydronephrosis. In all patients, management was initially conservative (analgesics and fluids) after hospitalization. The following criteria were used to indicate double-J stent placement under US guidance rather than a conservative treatment: persistent pain with no improvement after conservative treatment, progressive hydronephrosis (>2 cm dilatation of the renal pelvis) or presence of uterine contractions. The mean patient's age was 25 years (17-35) and gestational age at clinical presentation was 24 weeks (13-37). 81 % of cases had a renal pelvis dilatation >2 cm, while in only 19 % of cases there was a hydronephrosis between 1 and 2 cm in diameter; however, calculi were confirmed only in 25 patients. 28 patients required an invasive management with double-J stent insertion under US guidance. The sensitivity and specificity of US in the etiological diagnosis of hydronephrosis during pregnancy was 83 and 91 %, respectively. Conservative management with medical therapy and observation should be the first-line treatment approach. In our opinion a rapid ureteral decompression with the insertion of a ureteral double-J stent, under US visualization, is the safest method in the treatment of pregnant women with obstructed renal systems.

Prenatal and accurate perinatal diagnosis of type 2 H or ductular duplicate gallbladder.

PubMed

Maggi, Umberto; Farris, Giorgio; Carnevali, Alessandra; Borzani, Irene; Clerici, Paola; Agosti, Massimo; Rossi, Giorgio; Leva, Ernesto

2018-02-07

Double gallbladder is a rare biliary anomaly. Perinatal diagnosis of the disorder has been reported in only 6 cases, and in 5 of them the diagnosis was based on ultrasound imaging only. However, the ultrasound technique alone does not provide a sufficiently precise description of cystic ducts and biliary anatomy, an information that is crucial for a correct classification and for a possible future surgery. At 21 weeks of gestational age of an uneventful pregnancy in a 38 year old primipara mother, a routine ultrasound screening detected a biliary anomaly in the fetus suggestive of a double gallbladder. A neonatal abdominal ultrasonography performed on postnatal day 2 confirmed the diagnosis. On day 12 the newborn underwent a Magnetic Resonance Cholangiopancreatography (MRCP) that clearly characterized the anatomy of the anomaly: both gallbladders had their own cystic duct and both had a separate insertion in the main biliary duct. We report a case of early prenatal suspected duplicate gallbladder that was confirmed by a neonatal precise diagnosis of a Type 2, H or ductular duplicate gallbladder, using for the first time 3D images of Magnetic resonance cholangiopancreatography in a newborn. An accurate anatomical diagnosis is mandatory in patients undergoing a possible future cholecystectomy, to avoid surgical complications or reoperations. Therefore, in case of a perinatal suspicion of a double gallbladder, neonates should undergo a Magnetic resonance cholangiopancreatography. A review of the Literature about this variant is included.

Double uterus with obstructed hemivagina and ipsilateral renal agenesis: pelvic anatomic variants in 87 cases.

PubMed

Fedele, L; Motta, F; Frontino, G; Restelli, E; Bianchi, S

2013-06-01

What are the anatomic variants (and their frequencies) of double uterus, obstructed hemivagina and ipsilateral renal agenesis? Most cases examined (72.4%) were of the classic anatomic variant of the Herlyn-Werner-Wunderlich syndrome (with didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis) but the 27.6% of cases are of a rare variant of the syndrome (with uterus septum or cervical agenesis), showing relevant clinical and surgical implications. The extreme variability of anatomic structures involved in this syndrome (both uterus, cervico-vaginal and renal anomalies) is well known, even if a complete and uniform analysis of all its heterogeneous presentations in a large series is lacking. This is a retrospective study with 87 patients referred to our third level referral center between 1981 and 2011. We analyzed the laparoscopic and chart records of 87 women, who referred to our institute with double uterus, unilateral cervico-vaginal obstruction and ipsilateral renal anomalies. Sixty-three of 87 patients had the more classic variant of didelphys uterus with obstructed hemivagina; 10/87 patients had septate bicollis uterus with obstructed hemivagina; 9/87 patients had bicornuate bicollis uterus with obstructed hemivagina; 4/87 patients had didelphys uterus with unilateral cervical atresia; 1/87 patients had bicornuate uterus with one septate cervix and unilateral obstructed hemivagina. This is a retrospective study with a long enrolling period (30 years). New insights in the anatomic variants of this rare syndrome with their relevant surgical implications.

Oromandibular reconstruction with chimeric double-skin paddle flap based on peroneal vessel axis for synchronous opposite double oral cancer.

PubMed

Huang, Shih-Tsai; Liu, Wen-Chung; Chen, Lee-Wei; Yang, Kuo-Chung

2015-05-01

Synchronous double oral cancer represents the minority of cases of head and neck cancer. After tumor ablation, 2 separate oromandibular defects, even combined with a through-and-through oral defect, pose a serious reconstructive challenge. The ideal method for reconstruction remains controversial. Based on the peroneal vessel axis, a chimeric double-skin paddle peroneal fasciocutaneous or fibular osteomyocutaneous flap could be designed to accomplish the difficult reconstruction. Six male patients, each with 2 separate oromandibular defects after tumor ablation of synchronous double oral cancer, received double-skin paddle flap reconstruction with 3 peroneal fasciocutaneous and 3 fibular osteomyocutaneous flaps. All 6 flaps survived; however, complications included 1 skin paddle lost due to insufficient perfusion of a visible perforator, and 1 superficial necrosis occurring over the tip of a longer skin paddle. One postoperative intraoral infection and 1 donor site infection were also reported. During follow-up, 3 months later, 1 patient succumbed to local recurrence and bony metastasis. One patient developed a new cancer in the maxillary gingiva, and another had osteoradionecrosis 8 months later. Four patients gained acceptable cosmesis with good oral competence. A chimeric flap based on the peroneal artery could provide a segment of fibular bone, 1 or 2 skin paddles, and a cuff of the flexor hallucis longus muscle simultaneously. For 1-stage reconstruction of separate oromandibular defects after tumor ablation of synchronous double oral cancer, this design could provide all components at 1 transfer.

Forensic, Cultural, and Systems Issues in Child Sexual Abuse Cases--Part 2: Research and Practitioner Issues

ERIC Educational Resources Information Center

Tishelman, Amy C.; Geffner, Robert

2010-01-01

This article introduces the second issue of the special double issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. We briefly review the articles, which include a discussion of child sexual abuse myths, an empirical analysis of extended child sexual abuse evaluations, an article on the role of the medical provider…

An Examination of Resource Allocation Strategies That Promote Student Achievement: Case Studies of Rural Elementary Schools in Hawaii

ERIC Educational Resources Information Center

Acopan-Tuasivi, C. K.

2012-01-01

This study presents case studies of rural elementary schools in Hawaii that examine resource allocation strategies that promote student achievement. The combined frame work of the Evidence Based Model (Odden & Picus, 2008) and the 10 Strategies for Doubling Student Performance (Odden, 2009) were utilized to compare actual school resources and…

Energy transfer, orbital angular momentum, and discrete current in a double-ring fiber array

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

Alexeyev, C. N.; Volyar, A. V.; Yavorsky, M. A.

We study energy transfer and orbital angular momentum of supermodes in a double-ring array of evanescently coupled monomode optical fibers. The structure of supermodes and the spectra of their propagation constants are obtained. The geometrical parameters of the array, at which the energy is mostly confined within the layers, are determined. The developed method for finding the supermodes of concentric arrays is generalized for the case of multiring arrays. The orbital angular momentum carried by a supermode of a double-ring array is calculated. The discrete lattice current is introduced. It is shown that the sum of discrete currents over themore » array is a conserved quantity. The connection of the total discrete current with orbital angular momentum of discrete optical vortices is made.« less

Periodic and rational solutions of the reduced Maxwell-Bloch equations

NASA Astrophysics Data System (ADS)

Wei, Jiao; Wang, Xin; Geng, Xianguo

2018-06-01

We investigate the reduced Maxwell-Bloch (RMB) equations which describe the propagation of short optical pulses in dielectric materials with resonant non-degenerate transitions. The general Nth-order periodic solutions are provided by means of the Darboux transformation. The Nth-order degenerate periodic and Nth-order rational solutions containing several free parameters with compact determinant representations are derived from two different limiting cases of the obtained general periodic solutions, respectively. Explicit expressions of these solutions from first to second order are presented. Typical nonlinear wave patterns for the four components of the RMB equations such as single-peak, double-peak-double-dip, double-peak and single-dip structures in the second-order rational solutions are shown. This kind of the rational solutions correspond to rogue waves in the reduced Maxwell-Bloch equations.

Rain Reevaporation, Boundary Layer Convection Interactions, and Pacific Rainfall Patterns in an AGCM

NASA Technical Reports Server (NTRS)

Bacmeister, Julio T.; Suarez, Max J.; Robertson, Franklin R.

2004-01-01

Sensitivity experiments with an atmospheric general circulation model (AGCM) show that parameterized rain re-evaporation has a large impact on simulated precipitation patterns in the tropical Pacific, especially on the configuration of the model s intertropical convergence zone (ITCZ). Weak re-evaporation leads t o the formation of a "double ITCZ" during the northern warm season. The double ITCZ is accompanied by strong coupling between precipitation and high-frequency vertical motion in the planetary boundary layer (PBL). Strong reevaporation leads to a better overall agreement of simulated precipitation with observations. The model s double ITCZ bias is reduced. At the same time, correlation between high-frequency vertical motion in the PBL and precipitation is reduced. Experiments with modified physics suggest that evaporative cooling by rain near the PBL top weakens the coupling between precipitation and vertical motion. This may reduce the model s tendency to form double ITCZs. The strength of high-frequency vertical motions in the PBL was also reduced directly through the introduction of a diffusive cumulus momentum transport (DCMT) parameterization. The DCMT had a visible impact on simulated precipitation in the tropics, but did not reduce the model s double bias in all cases.

Compression member response of double steel angles on truss structure with member length variation

NASA Astrophysics Data System (ADS)

Hasibuan, Purwandy; Panjaitan, Arief; Haiqal, Muhammad

2018-05-01

One type of structures that implements steel angles as its members is truss system of telecommunication tower. For this structure, reinforcements on tower legs are also needed when antennas and microwaves installation placed on the peak of tower increases in quantity. One type of reinforcement methods commonly used is by increasing areas section capacity, where tower leg consisted of single angle section will be reinforced to be double angle sections. Regarding this case, this research discussed behavior two types of double angle steel section 2L 30.30.3 that were designed identically in area section but vary in length: 103 cm and 83 cm. At the first step, compression member together with tension member was formed to be a truss system, where compression and tension member were met at the joint plate. Schematic loading was implemented by giving tension loading on the joint plate, and this loading was terminated when each specimen reached its failure. Research findings showed that implementing shorter double angle (83 cm) sections, increased compression strength of steel angle section up to 13 %. Significant deformation occurring only on the flange for both of specimens indicated that implementing double angle is effective to prevent lateral-torsional buckling.

Effect of cancellation in neutrinoless double beta decay

NASA Astrophysics Data System (ADS)

Mitra, Manimala; Pascoli, Silvia; Wong, Steven

2014-11-01

In light of recent experimental results, we carefully analyze the effects of interference in neutrinoless double beta decay, when more than one mechanism is operative. If a complete cancellation is at work, the half-life of the corresponding isotope is infinite, and any constraint on it will automatically be satisfied. We analyze this possibility in detail assuming a cancellation in Xe 136 , and find its implications on the half-life of other isotopes, such as Ge 76 . For definiteness, we consider the role of light and heavy sterile neutrinos. In this case, the effective Majorana mass parameter can be redefined to take into account all contributions, and its value gets suppressed. Hence, larger values of neutrino masses are required for the same half-life. The canonical light neutrino contribution cannot saturate the present limits of half-lives or the positive claim of observation of neutrinoless double beta decay, once the stringent bounds from cosmology are taken into account. For the case of cancellation, where all the sterile neutrinos are heavy, the tension between the results from neutrinoless double beta decay and cosmology becomes more severe. We show that the inclusion of light sterile neutrinos in this setup can resolve this issue. Using the recent results from GERDA, we derive upper limits on the active-sterile mixing angles and compare them with the case of no cancellation. The required values of the mixing angles become larger, if a cancellation is at work. A direct test of destructive interference in Xe 136 is provided by the observation of this process in other isotopes, and we study in detail the correlation between their half-lives. Finally, we discuss the model realizations which can accommodate light and heavy sterile neutrinos and the cancellation. We show that sterile neutrinos of few hundred MeV or GeV mass range, coming from an Extended seesaw framework or a further extension, can satisfy the required cancellation.

Some observations on mesh refinement schemes applied to shock wave phenomena

NASA Technical Reports Server (NTRS)

Quirk, James J.

1995-01-01

This workshop's double-wedge test problem is taken from one of a sequence of experiments which were performed in order to classify the various canonical interactions between a planar shock wave and a double wedge. Therefore to build up a reasonably broad picture of the performance of our mesh refinement algorithm we have simulated three of these experiments and not just the workshop case. Here, using the results from these simulations together with their experimental counterparts, we make some general observations concerning the development of mesh refinement schemes for shock wave phenomena.

Double charmonia production in exclusive Z-boson decays

NASA Astrophysics Data System (ADS)

Likhoded, A. K.; Luchinsky, A. V.

2018-05-01

This paper is devoted to systematic analysis of double charmonium production in exclusive Z-boson decays in the framework of non-relativistic quantum chromodynamics (NRQCD) and leading twist light-cone (LC) models. Theoretical predictions for branching fractions of all considered decays are presented. According to the obtained results in the case of the allowed helicity suppression rule processes, the effect of internal quark motion increases the branching fractions by a factor 1.5, while for forbidden reactions the LC predictions are strictly zero, while NRQCD ones are significantly smaller than for allowed.

Secondary lymphangiectasia of the small bowel: utility of double balloon enteroscopy for diagnosis and management.

PubMed

Safatle-Ribeiro, Adriana Vaz; Iriya, Kiyoshi; Couto, Décio Sampaio; Kawaguti, Fábio Shiguehiss; Retes, Felipe; Ribeiro, Ulysses; Sakai, Paulo

2008-01-01

Sporadic lymphangiectasias are commonly found throughout the small bowel and are considered to be normal. Not uncommonly, lymphangiectasias are pathologic and can lead to mid-gastrointestinal bleeding, abdominal pain and protein-losing enteropathy. Pathologic lymphangiectasias of the small bowel include primary lymphangiectasia, secondary lymphangiectasia and lymphaticovenous malformations. In this report we present three different cases of small bowel lymphangiectasia detected by double balloon enteroscopy. The patients were diagnosed with South American blastomycosis, tuberculosis and primary small bowel lymphangioma. 2009 S. Karger AG, Basel

The Column Strength of Two Extruded Aluminum-Alloy H-Sections

NASA Technical Reports Server (NTRS)

Osgood, William R; Holt, Marshall

1939-01-01

Extruded aluminum-alloy members of various cross sections are used in aircraft as compression members either singly or as stiffeners for aluminum-alloy sheet. In order to design such members, it is necessary to know their column strength or, in the case of stiffeners, the value of the double modulus, which is best obtained for practical purposes from column tests. Column tests made on two extruded h-sections are described, and column formulas and formulas for the ratio of the double modulus to Young's modulus, based on the tests, are given.

Double- and multi-carbapenemase-producers: the excessively armored bacilli of the current decade.

PubMed

Meletis, G; Chatzidimitriou, D; Malisiovas, N

2015-08-01

Multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative nosocomial pathogens commonly carry one carbapenemase gene conferring resistance to carbapenems and other beta-lactam antibiotics. However, increasing reports show that double-carbapenemase-producing (DCP) and even multi-carbapenemase-producing (MCP) bacteria are emerging in some parts of the world, diminishing further, in some cases, the already limited treatment options. In the present review, the up-to-date reports of DCP and MCP isolates are summarized and concerns regarding their emergence are discussed.

Single and double diffractive dissociation and the problem of extraction of the proton-Pomeron cross-section

NASA Astrophysics Data System (ADS)

Petrov, V. A.; Ryutin, R. A.

2016-04-01

Diffractive dissociation processes are analyzed in the framework of covariant reggeization. We have considered the general form of hadronic tensor and its asymptotic behavior for t → 0 in the case of conserved tensor currents before reggeization. Resulting expressions for differential cross-sections of single dissociation (SD) process (pp → pM), double dissociation (DD) (pp → M1M2) and for the proton-Pomeron cross-section are given in detail, and corresponding problems of the approach are discussed.

Phase correlation of laser waves with arbitrary frequency spacing.

PubMed

Huss, A F; Lammegger, R; Neureiter, C; Korsunsky, E A; Windholz, L

2004-11-26

The theoretically predicted correlation of laser phase fluctuations in Lambda-type interaction schemes is experimentally demonstrated. We show that the mechanism of correlation in a Lambda scheme is restricted to high-frequency noise components, whereas in a double-Lambda scheme, due to the laser phase locking in a closed-loop interaction, it extends to all noise frequencies. In this case the correlation is weakly sensitive to coherence losses. Thus the double-Lambda scheme can be used to correlate electromagnetic fields with carrier frequency differences beyond the GHz regime.

Recurrent clot anuria following laparoscopic pyeloplasty in a solitary functioning kidney: managing with double guide wire technique

PubMed Central

Kumar, Santosh; Singh, Shivanshu; Parmar, Kalpesh Mahesh; Garg, Nitin

2014-01-01

Clot anuria in a solitary functioning kidney is an emergency situation. Haematuria with clot anuria in an early postoperative period represents a challenge, as treatment options are limited. Manipulation of the anastomotic site may lead to anastomotic disruption and urinoma while use of thrombolytic therapy poses the danger of increasing haematuria. We report a case of anuria due to clot retention in the upper tract following laparoscopic dismembered pyeloplasty in a solitary functioning kidney, managed successfully with double guide wire technique. PMID:25540210

Comparison of light and x-ray sensitometric responses of double-emulsion films for different processing conditions.

PubMed

Blendl, C; Buhr, E

2001-12-01

The effects of different film processing conditions on light and x-ray sensitometric responses were compared for a variety of double-emulsion x-ray films. The processing conditions were altered by changes of the developer temperature. Three different exposure variants were applied: x-ray sensitometry using two stepped neutral density attenuators between film and screens, simultaneous double-sided light sensitometry, and single-sided light sensitometry. 13 different types of double-emulsion x-ray films were investigated, among them three asymmetric films. In the special case of exposing the asymmetric films with the single-sided light sensitometer, a method was investigated where each side of the film is exposed at different locations and the sum effect is analyzed. From each sensitometric curve shape two parameters, the logarithmic speed (logS) and the average gradient (G), were evaluated. The results of this study can be summarized as follows: (1) Single-sided and double-sided light sensitometers revealed almost equal changes of logS when the processing conditions are altered. Thus, single-sided light sensitometers can serve as a substitute for double-sided light sensitometers provided that suited exposure methods are used and appropriate sensitometric parameters are evaluated. (2) Light sensitometry quantitatively indicated changes of the film processing that affect the x-ray speed. Hence, light sensitometry is a useful method to monitor changes in film processing.

Characterization of circulating CD4+ CD8+ double positive and CD4- CD8- double negative T-lymphocyte in children with β-thalassemia major.

PubMed

Zahran, Asmaa M; Saad, Khaled; Elsayh, Khalid I; Alblihed, Mohamd A

2017-03-01

Infectious complications represent the second most common cause of mortality and a major cause of morbidity in β-thalassemia major (BTM), with a prevalence of 12-13%. The data on unconventional T-lymphocyte subsets in BTM children are limited. The aim of the present study was to investigate and evaluate phenotypic alterations in CD4 + CD8 + double positive (DP), CD4 - CD8 - double negative (DN), and natural killer T-lymphocytes (NKT) in BTM children in comparison to healthy controls. Our case control study included 80 children with BTM and 40 healthy children as controls. Assessment of unconventional T-lymphocyte populations was done using sensitive four-color flow cytometry (FACSCalibur). Our analysis of the data showed a significantly higher frequency CD4 + CD8 + (double-positive) T cells, CD4 - CD8 - (double negative) T cells, and natural killer T cells in the peripheral blood of both BTM groups (splenectomized and non-splenectomized) as compared to healthy controls, suggesting that these cells may play a role in the clinical course of BTM. The relationship of the unconventional T-lymphocytes to immune disorders in BTM children remains to be determined. Further longitudinal study with a larger sample size is warranted to elucidate the role these cells in BTM. TRIAL NUMBER: UMIN000018950.

Visual performance on detection tasks with double-targets of the same and different difficulty.

PubMed

Chan, Alan H S; Courtney, Alan J; Ma, C W

2002-10-20

This paper reports a study of measurement of horizontal visual sensitivity limits for 16 subjects in single-target and double-targets detection tasks. Two phases of tests were conducted in the double-targets task; targets of the same difficulty were tested in phase one while targets of different difficulty were tested in phase two. The range of sensitivity for the double-targets test was found to be smaller than that for single-target in both the same and different target difficulty cases. The presence of another target was found to affect performance to a marked degree. Interference effect of the difficult target on detection of the easy one was greater than that of the easy one on the detection of the difficult one. Performance decrement was noted when correct percentage detection was plotted against eccentricity of target in both the single-target and double-targets tests. Nevertheless, the non-significant correlation found between the performance for the two tasks demonstrated that it was impossible to predict quantitatively ability for detection of double targets from the data for single targets. This indicated probable problems in generalizing data for single target visual lobes to those for multiple targets. Also lobe area values obtained from measurements using a single-target task cannot be applied in a mathematical model for situations with multiple occurrences of targets.

Rotator Cuff Calcific Tendinopathy: Randomized Comparison of US-guided Percutaneous Treatments by Using One or Two Needles.

PubMed

Orlandi, Davide; Mauri, Giovanni; Lacelli, Francesca; Corazza, Angelo; Messina, Carmelo; Silvestri, Enzo; Serafini, Giovanni; Sconfienza, Luca Maria

2017-11-01

Purpose To determine whether the use of one or two needles influences procedure performance and patient outcomes for ultrasonography (US)-guided percutaneous irrigation of calcific tendinopathy. Materials and Methods Institutional review board approval and written informed patient consent were obtained. From February 2012 to December 2014, 211 patients (77 men and 134 women; mean age, 41.6 years ± 11.6; range, 24-69 years) with painful calcific tendinopathy diagnosed at US were prospectively enrolled and randomized. Operators subjectively graded calcifications as hard, soft, or fluid according to their appearance at US. US-guided percutaneous irrigation of calcific tendinopathy (local anesthesia, needle lavage, intrabursal steroid injection) was performed in 100 patients by using the single-needle procedure and in 111 patients by using the double-needle procedure. Calcium dissolution was subjectively scored (easy = 1; intermediate = 2; difficult = 3). Procedure duration was recorded. Clinical evaluation was performed by using the Constant score up to 1 year after the procedure. The occurrence of postprocedural bursitis was recorded. Mann-Whitney U, χ 2 , and analysis of variance statistics were used. Results No difference in procedure duration was seen overall (P = .060). Procedure duration was shorter with the double-needle procedure in hard calcifications (P < .001) and with the single-needle procedure in fluid calcifications (P = .024). Ease of calcium dissolution was not different between single- and double-needle procedures, both overall and when considering calcification appearance (P > .089). No clinical differences were found (Constant scores for single-needle group: baseline, 55 ± 7; 1 month, 69 ± 7; 3 month, 90 ± 5; 1 year, 92 ± 4; double-needle group: 57 ± 6; 71 ± 9; 89 ± 7; 92 ± 4, respectively; P = .241). In the single-needle group, nine of 100 cases (9%) of postprocedural bursitis were seen, whereas four of 111 cases (3.6%) were seen in the double-needle group (P = .180). Conclusion The only difference between using the single- or double-needle procedure when performing US-guided percutaneous irrigation of calcific tendinopathy is procedure duration in hard and fluid calcifications. Clinical outcomes are similar up to 1 year. © RSNA, 2017.

Emerging Trends in the Volume and Format of Outside Examinations Submitted for Secondary Interpretation

PubMed Central

Hunt, Christopher H.; Wood, Christopher P.; Diehn, Felix E.; Eckel, Laurence J.; Schwartz, Kara M.; Erickson, Bradley J.

2014-01-01

OBJECTIVE The purpose of this article is to describe the trends of secondary interpretations, including the total volume and format of cases. MATERIALS AND METHODS This retrospective study involved all outside neuroradiology examinations submitted for secondary interpretation from November 2006 through December 2010. This practice utilizes consistent criteria and includes all images that cover the brain, neck, and spine. For each month, the total number of outside examinations and their format (i.e., hard-copy film, DICOM CD-ROM, or non-DICOM CD-ROM) were recorded. RESULTS There was no significant change in the volume of cases (1043 ± 131 cases/month; p = 0.46, two-sided Student t test). There was a significant decrease in the volume of hard-copy films submitted, with the mean number of examinations submitted per month on hard-copy film declining from 297 in 2007 to 57 in 2010 (p < 0.0001, Student t test). This decrease was mirrored by an increase in the mean number of cases submitted on CD-ROM (753 cases/month in 2007 and 1036 cases/month in 2010; p < 0.0001). Although most were submitted in DICOM format, there was almost a doubling of the volume of cases submitted on non-DICOM CD-ROM (mean number of non-DICOM CD-ROMs, nine cases/month in 2007 and 17 cases/month in 2010; p < 0.001). CONCLUSION There has been a significant decrease in the number of hard-copy films submitted for secondary interpretation. There has been almost a doubling of the volume of cases submitted in non-DICOM formats, which is unfortunate, given the many advantages of the internationally derived DICOM standard, including ease of archiving, standardized display, efficient review, improved interpretation, and quality of patient care. PMID:22451538

Emerging trends in the volume and format of outside examinations submitted for secondary interpretation.

PubMed

Hunt, Christopher H; Wood, Christopher P; Diehn, Felix E; Eckel, Laurence J; Schwartz, Kara M; Erickson, Bradley J

2012-04-01

The purpose of this article is to describe the trends of secondary interpretations, including the total volume and format of cases. This retrospective study involved all outside neuroradiology examinations submitted for secondary interpretation from November 2006 through December 2010. This practice utilizes consistent criteria and includes all images that cover the brain, neck, and spine. For each month, the total number of outside examinations and their format (i.e., hard-copy film, DICOM CD-ROM, or non-DICOM CD-ROM) were recorded. There was no significant change in the volume of cases (1043 ± 131 cases/month; p = 0.46, two-sided Student t test). There was a significant decrease in the volume of hard-copy films submitted, with the mean number of examinations submitted per month on hard-copy film declining from 297 in 2007 to 57 in 2010 (p < 0.0001, Student t test). This decrease was mirrored by an increase in the mean number of cases submitted on CD-ROM (753 cases/month in 2007 and 1036 cases/month in 2010; p < 0.0001). Although most were submitted in DICOM format, there was almost a doubling of the volume of cases submitted on non-DICOM CD-ROM (mean number of non-DICOM CD-ROMs, nine cases/month in 2007 and 17 cases/month in 2010; p < 0.001). There has been a significant decrease in the number of hard-copy films submitted for secondary interpretation. There has been almost a doubling of the volume of cases submitted in non-DICOM formats, which is unfortunate, given the many advantages of the internationally derived DICOM standard, including ease of archiving, standardized display, efficient review, improved interpretation, and quality of patient care.

Importance of double-pole CFS-PML for broad-band seismic wave simulation and optimal parameters selection

NASA Astrophysics Data System (ADS)

Feng, Haike; Zhang, Wei; Zhang, Jie; Chen, Xiaofei

2017-05-01

The perfectly matched layer (PML) is an efficient absorbing technique for numerical wave simulation. The complex frequency-shifted PML (CFS-PML) introduces two additional parameters in the stretching function to make the absorption frequency dependent. This can help to suppress converted evanescent waves from near grazing incident waves, but does not efficiently absorb low-frequency waves below the cut-off frequency. To absorb both the evanescent wave and the low-frequency wave, the double-pole CFS-PML having two poles in the coordinate stretching function was developed in computational electromagnetism. Several studies have investigated the performance of the double-pole CFS-PML for seismic wave simulations in the case of a narrowband seismic wavelet and did not find significant difference comparing to the CFS-PML. Another difficulty to apply the double-pole CFS-PML for real problems is that a practical strategy to set optimal parameter values has not been established. In this work, we study the performance of the double-pole CFS-PML for broad-band seismic wave simulation. We find that when the maximum to minimum frequency ratio is larger than 16, the CFS-PML will either fail to suppress the converted evanescent waves for grazing incident waves, or produce visible low-frequency reflection, depending on the value of α. In contrast, the double-pole CFS-PML can simultaneously suppress the converted evanescent waves and avoid low-frequency reflections with proper parameter values. We analyse the different roles of the double-pole CFS-PML parameters and propose optimal selections of these parameters. Numerical tests show that the double-pole CFS-PML with the optimal parameters can generate satisfactory results for broad-band seismic wave simulations.

Patients double-seropositive for ANCA and anti-GBM antibodies have varied renal survival, frequency of relapse, and outcomes compared to single-seropositive patients.

PubMed

McAdoo, Stephen P; Tanna, Anisha; Hrušková, Zdenka; Holm, Lisa; Weiner, Maria; Arulkumaran, Nishkantha; Kang, Amy; Satrapová, Veronika; Levy, Jeremy; Ohlsson, Sophie; Tesar, Vladimir; Segelmark, Mårten; Pusey, Charles D

2017-09-01

Co-presentation with both ANCA and anti-GBM antibodies is thought to be relatively rare. Current studies of such 'double-positive' cases report small numbers and variable outcomes. To study this further we retrospectively analyzed clinical features and long-term outcomes of a large cohort of 568 contemporary patients with ANCA-associated vasculitis, 41 patients with anti-GBM disease, and 37 double-positive patients with ANCA and anti-GBM disease from four European centers. Double-positive patients shared characteristics of ANCA-associated vasculitis (AAV), such as older age distribution and longer symptom duration before diagnosis, and features of anti-GBM disease, such as severe renal disease and high frequency of lung hemorrhage at presentation. Despite having more evidence of chronic injury on renal biopsy compared to patients with anti-GBM disease, double-positive patients had a greater tendency to recover from being dialysis-dependent after treatment and had intermediate long-term renal survival compared to the single-positive patients. However, overall patient survival was similar in all three groups. Predictors of poor patient survival included advanced age, severe renal failure, and lung hemorrhage at presentation. No single-positive anti-GBM patients experienced disease relapse, whereas approximately half of surviving patients with AAV and double-positive patients had recurrent disease during a median follow-up of 4.8 years. Thus, double-positive patients have a truly hybrid disease phenotype, requiring aggressive early treatment for anti-GBM disease, and careful long-term follow-up and consideration for maintenance immunosuppression for AAV. Since double-positivity appears common, further work is required to define the underlying mechanisms of this association and define optimum treatment strategies. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Double Uvula in a Fifty-Six-Year-Old Woman

PubMed Central

Catli, Tolgahan

2014-01-01

Introduction: Deformities of the uvula are considered as the dark area of otorhinolaryngology practice. This little and plain part of the human organism has various functions and its abnormalities might cause serious disabilities. Case Presentation: In our case report, we present a unique deformity of the uvula in a 56-year-old woman. Discussion: The aim of this report was to present a very rare condition, unique case “polyuvula”, and to review the literature regarding other uvula abnormalities. PMID:25763232

[Terata catydidymus dicephalus: description of a case].

PubMed

Alò, P L; Trombetta, G; Marcone, P; De Quarto, A; Memeo, L; Di Tondo, U

1997-10-01

Conjoined twinning is the result of an abnormal developmental process of "twinning" in which two similar weighted and sized twins are partially conjoined and show a total symmetry independently from the pattern of conjunction. They are classified in three groups: Terata Catydidymus, Terata Anadidyma and Terata Anacatadidyma. Among Terata Catydidymus the dicephalus subtype is a rare abnormality with a severe prognosis compared to other subtypes as: diprosopus, pyophagus and ischiopagus. We report the case of a fetus at the 15th weeks of pregnancy. The external examination revealed severe diffuse somatic malformations consisting of dicephalia with a double neck in conjunction to a single chest, a single abdomen, a double spine conjoined distally near the sacrum, buds of ribs in between the two spines with mid clavicular and scapular fusion following the major axis of the two bones. Arms and legs revealed no abnormalities. Central nervous system structures were normally developed and the two hemispheres seemed completely separated and independent one to the other. We believe that the case described is interesting being Terata Catydidymus a rare phenomenon, being the dicephalus subtype still lesser frequent and its occurrence in males quite exceptional.

The dynamics of double slab subduction

NASA Astrophysics Data System (ADS)

Holt, A. F.; Royden, L. H.; Becker, T. W.

2017-04-01

We use numerical models to investigate the dynamics of two interacting slabs with parallel trenches. Cases considered are: a single slab reference, outward dipping slabs (out-dip), inward dipping slabs (in-dip) and slabs dipping in the same direction (same-dip). Where trenches converge over time (same-dip and out-dip systems), large positive dynamic pressures in the asthenosphere are generated beneath the middle plate and large trench-normal extensional forces are transmitted through the middle plate. This results in slabs that dip away from the middle plate at depth, independent of trench geometry. The single slab, the front slab in the same-dip case and both out-dip slabs undergo trench retreat and exhibit stable subduction. However, slabs within the other double subduction systems tend to completely overturn at the base of the upper mantle, and exhibit either trench advance (rear slab in same-dip), or near-stationary trenches (in-dip). For all slabs, the net slab-normal dynamic pressure at 330 km depth is nearly equal to the slab-normal force induced by slab buoyancy. For double subduction, the net outward force on the slabs due to dynamic pressure from the asthenosphere is effectively counterbalanced by the net extensional force transmitted through the middle plate. Thus, dynamic pressure at depth, interplate coupling and lithospheric stresses are closely linked and their effects cannot be isolated. Our results provide insights into both the temporal evolution of double slab systems on Earth and, more generally, how the various components of subduction systems, from mantle flow/pressure to interplate coupling, are dynamically linked.

3D Printing in Surgical Management of Double Outlet Right Ventricle.

PubMed

Yoo, Shi-Joon; van Arsdell, Glen S

2017-01-01

Double outlet right ventricle (DORV) is a heterogeneous group of congenital heart diseases that require individualized surgical approach based on precise understanding of the complex cardiovascular anatomy. Physical 3-dimensional (3D) print models not only allow fast and unequivocal perception of the complex anatomy but also eliminate misunderstanding or miscommunication among imagers and surgeons. Except for those cases showing well-recognized classic surgical anatomy of DORV such as in cases with a typical subaortic or subpulmonary ventricular septal defect, 3D print models are of enormous value in surgical decision and planning. Furthermore, 3D print models can also be used for rehearsal of the intended procedure before the actual surgery on the patient so that the outcome of the procedure is precisely predicted and the procedure can be optimally tailored for the patient's specific anatomy. 3D print models are invaluable resource for hands-on surgical training of congenital heart surgeons.

Design and implementation of relational databases relevant to the diverse needs of a tuberculosis case contact study in the Gambia.

PubMed

Jeffries, D J; Donkor, S; Brookes, R H; Fox, A; Hill, P C

2004-09-01

The data requirements of a large multidisciplinary tuberculosis case contact study are complex. We describe an ACCESS-based relational database system that meets our rigorous requirements for data entry and validation, while being user-friendly, flexible, exportable, and easy to install on a network or stand alone system. This includes the development of a double data entry package for epidemiology and laboratory data, semi-automated entry of ELISPOT data directly from the plate reader, and a suite of new programmes for the manipulation and integration of flow cytometry data. The double entered epidemiology and immunology databases are combined into a separate database, providing a near-real-time analysis of immuno-epidemiological data, allowing important trends to be identified early and major decisions about the study to be made and acted on. This dynamic data management model is portable and can easily be applied to other studies.

Anisotropic magnetotail equilibrium and convection

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

Hau, L.N.

This paper reports on self-consistent two-dimensional equilibria with anisotropic plasma pressure for the Earth's magnetotail. These configurations are obtained by numerically solving the generalized Grad-Shafranov equation, describing anisotropic plasmas with p[parallel] [ne] p[perpendicular], including the Earth's dipolar field. Consistency between these new equilibria and the assumption of steady-state, sunward convection, described by the double-adiabatic laws, is examined. As for the case of isotropic pressure [Erickson and Wolf, 1980], there exists a discrepancy between typical quite-time magnetic field models and the assumption of steady-state double-adiabatic lossless plasma sheet convection. However, unlike that case, this inconsistency cannot be removed by the presencemore » of a weak equatorial normal magnetic field strength in the near tail region: magnetic field configurations of this type produce unreasonably large pressure anisotropies, p[parallel] > p[perpendicular], in the plasma sheet. 16 refs., 5 figs.« less

Double-lumen catheter in the right jugular vein induces two sub-endothelial abscesses in an unusual place, the transition between the superior vena cava and the right atrium: a case report

PubMed Central

2014-01-01

Endocarditis is a type of infection that is common in internal medicine wards and in haemodialysis clinics. The location that is most affected are the heart valves. Herein, we report a case of an uncommon abscess, a sub-endothelial abscess between the transition of the superior vena cava and the right atrium. There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter. Usually, this type of abscess is located in valves, either the tricuspid valve if related to catheters or injection drug use or the mitral valve if related to other causes. An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection. PMID:25110520

Equation-of-motion coupled cluster method for high spin double electron attachment calculations

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

Musiał, Monika, E-mail: musial@ich.us.edu.pl; Lupa, Łukasz; Kucharski, Stanisław A.

The new formulation of the equation-of-motion (EOM) coupled cluster (CC) approach applicable to the calculations of the double electron attachment (DEA) states for the high spin components is proposed. The new EOM equations are derived for the high spin triplet and quintet states. In both cases the new equations are easier to solve but the substantial simplification is observed in the case of quintets. Out of 21 diagrammatic terms contributing to the standard DEA-EOM-CCSDT equations for the R{sub 2} and R{sub 3} amplitudes only four terms survive contributing to the R{sub 3} part. The implemented method has been applied tomore » the calculations of the excited states (singlets, triplets, and quintets) energies of the carbon and silicon atoms and potential energy curves for selected states of the Na{sub 2} (triplets) and B{sub 2} (quintets) molecules.« less

[Report of a case of poisoning by double snake bite with neurotrope venom at the National Donka Hospital, Conakry (Guinea)].

PubMed

Sako, F B; Sow, M S; Bangoura, E F; Guilavogui, F

2011-12-01

Poisoning by snake bites remains an important cause of death in developing countries and in Africa in particular. Positive diagnosis is mostly easy because of the interrogation of the family and the local reactions that occur in the bite area. However, it is easy to know the type of the snake because the description by the victim is often unclear. We report a case of poisoning due to double bite by an unidentified snake that led to a clinical picture dominated by neurological and respiratory signs, suggestive of a neurotoxin poisoning in a young man living in rural area. Despite the delay in the management due to the ritual traditional treatment, the symptoms improved after the administration of polyvalent anti-venom. This observation raises the delicate problem of identification of snakes from the clinical symptomatology observed, considering their variety

Double-lumen balloon for Onyx® embolization via extracranial arteries in transverse sigmoid dural arteriovenous fistulas: initial experience.

PubMed

Clarençon, Frédéric; Di Maria, Federico; Gabrieli, Joseph; Carpentier, Alexandre; Pistochi, Silvia; Bartolini, Bruno; Zeghal, Chiheb; Chiras, Jacques; Sourour, Nader-Antoine

2016-10-01

Transverse-sigmoid dural arteriovenous fistulas (TS DAVFs) can be challenging to treat by endovascular means. Indeed, a total cure of the fistula can only be achieved when complete occlusion of the fistulous point(s) is obtained by penetration of the embolic agent. However, in some cases, especially for transosseous branches from extracranial arteries like the occipital artery (OcA) or the superficial temporal artery (STA), such penetration is usually poor, leading to major proximal reflux and incomplete fistula obliteration. We present three cases of embolization in two patients with TS DAVF through the OcA and/or the STA with Onyx® using a double-lumen balloon (Microvention, Tustin, CA, USA). This technique allows the penetration of the embolic agent in the transosseous branches by forming a counter-pressure with the inflated balloon. This technique may be useful to achieve complete occlusion of TS DAVFs by endovascular means.

Endoscopic removal of a tablespoon lodged within the duodenum

PubMed Central

Watanabe, Takashi; Aoyagi, Kunihiko; Tomioka, Yoshitaka; Ishibashi, Hideki; Sakisaka, Shotaro

2015-01-01

Here we report the case of a 34-year-old man who underwent endoscopic removal of a tablespoon from the stomach that was lodged within the duodenum. Removal required the use of a two-channel upper endoscope and polypectomy snares. Using the double-snare technique, the spoon was grasped at the proximal and distal parts of the handle. The double-snare was first pulled unsuccessfully and then pulled with simultaneous manual abdominal compression of the bulbus from the body surface. Compression was gently applied towards the stomach. As a result, the head of the spoon prolapsed from the bulbus, and was easily retracted from the stomach without any complications. In cases of foreign body lodging within the duodenum, the manual abdominal compression technique may help clinicians pull out the object and avoid surgery. The usefulness of manual compression is dependent on the foreign body’s sharpness and the location. PMID:25945026

Elastic-plastic finite-element analyses of thermally cycled double-edge wedge specimens

NASA Technical Reports Server (NTRS)

Kaufman, A.; Hunt, L. E.

1982-01-01

Elastic-plastic stress-strain analyses were performed for double-edge wedge specimens subjected to thermal cycling in fluidized beds at 316 and 1088 C. Four cases involving different nickel-base alloys (IN 100, Mar M-200, NASA TAZ-8A, and Rene 80) were analyzed by using the MARC nonlinear, finite element computer program. Elastic solutions from MARC showed good agreement with previously reported solutions obtained by using the NASTRAN and ISO3DQ computer programs. Equivalent total strain ranges at the critical locations calculated by elastic analyses agreed within 3 percent with those calculated from elastic-plastic analyses. The elastic analyses always resulted in compressive mean stresses at the critical locations. However, elastic-plastic analyses showed tensile mean stresses for two of the four alloys and an increase in the compressive mean stress for the highest plastic strain case.

The Role Of Staphylococcus Haemolyticus In Men Infertility

NASA Astrophysics Data System (ADS)

AL-Ghizzawi, Ghaed’a. J.; Jomaa, Zahraa K.

2018-05-01

A total of 80 samples of seminal fluid from infertile men who were admitted to clinics and attended laboratories in Omara City during the period from 1 June 2016 to 1 December 2016, samples were subjected to semen analysis as recommended by WHO. The age of patients was from 20 – 59 year. Another 25 semen samples were collected from fertilized men considered as the control group. For this purpose seminal fluid were cultured on MacConkey agar, Blood agar, Chocolate agar. Within the 80 samples recorded S. haemolyticus appeared in 14 cases and the rate of infection was 18%, all strains was diagnosed by Vitek system 2 Double. The highest percent (64%) was recorded in the age group 30 – 39. Primary infertility recorded 94% while 6% was recorded for secondary infertility. Also, different species of bacterial isolates were identified in 32 cases by Vitek system 2 Double. The bacterial infection of the male genital system affected fertility.

A double hit model for the distribution of time to AIDS onset

NASA Astrophysics Data System (ADS)

Chillale, Nagaraja Rao

2013-09-01

Incubation time is a key epidemiologic descriptor of an infectious disease. In the case of HIV infection this is a random variable and is probably the longest one. The probability distribution of incubation time is the major determinant of the relation between the incidences of HIV infection and its manifestation to Aids. This is also one of the key factors used for accurate estimation of AIDS incidence in a region. The present article i) briefly reviews the work done, points out uncertainties in estimation of AIDS onset time and stresses the need for its precise estimation, ii) highlights some of the modelling features of onset distribution including immune failure mechanism, and iii) proposes a 'Double Hit' model for the distribution of time to AIDS onset in the cases of (a) independent and (b) dependent time variables of the two markers and examined the applicability of a few standard probability models.

Experimental and theoretical studies of the He(2+)-He system - Differential cross sections for direct, single-, and double-charge-transfer scattering at keV energies

NASA Technical Reports Server (NTRS)

Gao, R. S.; Dutta, C. M.; Lane, N. F.; Smith, K. A.; Stebbings, R. F.; Kimura, M.

1992-01-01

Measurements and calculations of differential cross sections for direct scattering, single-charge transfer, and double-charge transfer in collisions of 1.5-, 2.0-, 6.0-, and 10.0-keV (He-3)2+ with an He-4 target are reported. The measurements cover laboratory scattering angles below 1.5 deg with an angular resolution of about 0.03 deg. A quantum-mechanical molecular-state representation is employed in the calculations; in the case of single-charge transfer a two-state close-coupling calculation is carried out taking into account electron-translation effects. The theoretical calculations agree well with the experimental results for direct scattering and double-charge transfer. The present calculation identifies the origins of oscillatory structures observed in the differential cross sections.

Ablation enhancement of silicon by ultrashort double-pulse laser ablation

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

Zhao, Xin; Shin, Yung C.

In this study, the ultrashort double-pulse ablation of silicon is investigated. An atomistic simulation model is developed to analyze the underlying physics. It is revealed that the double-pulse ablation could significantly increase the ablation rate of silicon, compared with the single pulse ablation with the same total pulse energy, which is totally different from the case of metals. In the long pulse delay range (over 1 ps), the enhancement is caused by the metallic transition of melted silicon with the corresponding absorption efficiency. At ultrashort pulse delay (below 1 ps), the enhancement is due to the electron excitation by the first pulse.more » The enhancement only occurs at low and moderate laser fluence. The ablation is suppressed at high fluence due to the strong plasma shielding effect.« less

Double-Balloon-Assisted n-Butyl-2-Cyanoacrylate Embolization of Intrahepatic Arterioportal Shunt Prior to Chemoembolization of Hepatocellular Carcinoma

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

Takao, Hidemasa, E-mail: takaoh-tky@umin.ac.jp; Shibata, Eisuke; Ohtomo, Kuni

A case of multiple hepatocellular carcinomas with a severe intrahepatic arterioportal shunt that was successfully embolized with n-butyl-2-cyanoacrylate with coaxial double-balloon occlusion prior to transcatheter arterial chemoembolization is presented. A proximal balloon positioned at the proper hepatic artery was used for flow control, and a coaxial microballoon, positioned in the closest of three arterial feeding branches to the arterioportal shunt, was used to control the delivery of n-butyl-2-cyanoacrylate. This coaxial double-balloon technique can prevent proximal embolization and distal migration of n-butyl-2-cyanoacrylate and enable precise control of the distribution of n-butyl-2-cyanoacrylate. It could also be applicable to n-butyl-2-cyanoacrylate embolization for othermore » than intrahepatic arterioportal shunt.« less

Nonlinear low frequency electrostatic structures in a magnetized two-component auroral plasma

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

Rufai, O. R., E-mail: rajirufai@gmail.com; Scientific Computing, Memorial University of Newfoundland, St John's, Newfoundland and Labrador A1C 5S7; Bharuthram, R., E-mail: rbharuthram@uwc.ac.za

2016-03-15

Finite amplitude nonlinear ion-acoustic solitons, double layers, and supersolitons in a magnetized two-component plasma composed of adiabatic warm ions fluid and energetic nonthermal electrons are studied by employing the Sagdeev pseudopotential technique and assuming the charge neutrality condition at equilibrium. The model generates supersoliton structures at supersonic Mach numbers regime in addition to solitons and double layers, whereas in the unmagnetized two-component plasma case only, soliton and double layer solutions can be obtained. Further investigation revealed that wave obliqueness plays a critical role for the evolution of supersoliton structures in magnetized two-component plasmas. In addition, the effect of ion temperaturemore » and nonthermal energetic electron tends to decrease the speed of oscillation of the nonlinear electrostatic structures. The present theoretical results are compared with Viking satellite observations.« less

Double-reconnected magnetic structures driven by Kelvin-Helmholtz vortices at the Earth's magnetosphere

NASA Astrophysics Data System (ADS)

Faganello, Matteo; Borgogno, Dario; Califano, Francesco; Pegoraro, Francesco

2015-11-01

In an almost collisionless MagnetoHydrodynamic plasma in a relatively strong magnetic field, stresses can be conveyed far from the region where they are exerted e.g., through the propagation of Alfvèn waves. The forced dynamics of line-tied magnetic structures in solar and stellar coronae is a paradigmatic case. We investigate how this action at a distance develops from the equatorial region of the Kelvin-Helmholtz unstable flanks of the Earth's magnetosphere leading to the onset, at mid latitude in both hemispheres, of correlated double magnetic field line reconnection events that can allow the solar wind plasma to enter the Earth's magnetosphere. This mid-latitude double reconnection process, first investigated in, has been confirmed here by following a large set of individual field lines using a method similar to a Poincarè map.

Double Aneuploidy Detected by Cell-Free DNA Testing and Confirmed by Fetal Tissue Analysis.

PubMed

Echague, Charlene G; Petersen, Scott M

2016-06-01

Double aneuploidies account for 0.21-2.8% of spontaneous abortions resulting from chromosomal abnormalities. Rarely, cell-free DNA testing detects multiple aneuploidies; however, to discern among maternal, placental, and fetal origin, further evaluation is required. A 49-year-old woman, gravida 5 para 0, underwent cell-free DNA testing at 11 4/7 weeks of gestation, which revealed a fetus that was high risk for trisomies 18 and 21. On ultrasonography at 14 weeks of gestation, she was diagnosed with a missed abortion and underwent surgical management. Fetal and placental tissues were sent for analysis and were positive for trisomies 18 and 21, confirming the results of cell-free DNA testing. Our case highlights the ability of cell-free DNA testing to recognize a double aneuploidy confirmed by fetal tissue analysis.

Megavolt parallel potentials arising from double-layer streams in the Earth's outer radiation belt.

PubMed

Mozer, F S; Bale, S D; Bonnell, J W; Chaston, C C; Roth, I; Wygant, J

2013-12-06

Huge numbers of double layers carrying electric fields parallel to the local magnetic field line have been observed on the Van Allen probes in connection with in situ relativistic electron acceleration in the Earth's outer radiation belt. For one case with adequate high time resolution data, 7000 double layers were observed in an interval of 1 min to produce a 230,000 V net parallel potential drop crossing the spacecraft. Lower resolution data show that this event lasted for 6 min and that more than 1,000,000 volts of net parallel potential crossed the spacecraft during this time. A double layer traverses the length of a magnetic field line in about 15 s and the orbital motion of the spacecraft perpendicular to the magnetic field was about 700 km during this 6 min interval. Thus, the instantaneous parallel potential along a single magnetic field line was the order of tens of kilovolts. Electrons on the field line might experience many such potential steps in their lifetimes to accelerate them to energies where they serve as the seed population for relativistic acceleration by coherent, large amplitude whistler mode waves. Because the double-layer speed of 3100  km/s is the order of the electron acoustic speed (and not the ion acoustic speed) of a 25 eV plasma, the double layers may result from a new electron acoustic mode. Acceleration mechanisms involving double layers may also be important in planetary radiation belts such as Jupiter, Saturn, Uranus, and Neptune, in the solar corona during flares, and in astrophysical objects.

Accuracy and reading time for six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts.

PubMed

Tagliafico, Alberto Stefano; Calabrese, Massimo; Bignotti, Bianca; Signori, Alessio; Fisci, Erica; Rossi, Federica; Valdora, Francesca; Houssami, Nehmat

2017-12-01

To compare six strategies using digital breast tomosynthesis in women with mammographically negative dense breasts. This is a substudy of the 'ASTOUND' trial. 163 women who underwent tomosynthesis with synthetically reconstructed projection images (S-2D) inclusive of 13 (7.9%) cases diagnosed with breast cancer at histopathology after surgery were evaluated. Accuracy measures and screen-reading time of six reading strategies were assessed: (A) Single reading of S-2D alone, (B) single reading of tomosynthesis alone, (C) single reading of joint interpretation of tomosynthesis + S-2D, (D) double-reading of S-2D alone, (E) double reading of tomosynthesis alone, (F) double reading of joint interpretation of tomosynthesis + S-2D. The median age of the patients was 53 years (range, 36-88 years). The highest global accuracy was obtained with double reading of tomosynthesis + S2D (F) with an AUC of 0.979 (p<0.001) and a mean reading time of 154 s versus 34 s for the fastest strategy (single reading of S-2D alone). The AUCs for the other five strategies did not differ from each other. Double reading of tomosynthesis+ S2D had the best accuracy of six screen-reading strategies although it had the longest reading time. • Tomosynthesis acquisitions are progressively implemented with reconstructed synthesized 2D images • Double reading using S-2D plus tomosynthesis had the highest global accuracy (p<0.001). • Double reading of S-2D plus tomosynthesis increased reading time.

Fluoroscopic guidance for placing a double lumen endotracheal tube in adults.

PubMed

Calenda, Emile; Baste, Jean Marc; Hajjej, Ridha; Rezig, Najiba; Moriceau, Jerome; Diallo, Yaya; Sghaeir, Slim; Danielou, Eric; Peillon, Christophe

2014-09-01

The aim of this study was to assess the right placement of the double lumen endotracheal tube with fluoroscopic guidance, which is used in first intention prior to the fiberscope in our institution. This was a prospective observational study. The study was conducted in vascular and thoracic operating rooms. We enrolled 205 patients scheduled for thoracic surgery, with ASA physical statuses of I (n = 37), II (n = 84), III (n = 80), and IV (n = 4). Thoracic procedures were biopsy (n = 20), wedge (n = 34), culminectomy (n = 6), lobectomy (n = 82), pneumonectomy (n = 4), sympathectomy (n = 9), symphysis (n = 47), and thymectomy (n = 3). The intubation with a double lumen tube was performed with the help of a laryngoscope. Tracheal and bronchial balloons were inflated and auscultation was performed after right and left exclusions. One shot was performed to locate the position of the bronchial tube and the hook. Fluoroscopic guidance was used to relocate the tube in case of a wrong position. When the fluoroscopic guidance failed to position the tube, a fiberscope was used. Perioperative collapse of the lung was assessed by the surgeon during the surgery. Correct fluoroscopic image was obtained after the first attempt in 58.5% of patients therefore a misplaced position was encountered in 41.5%. The fluoroscopic guidance allowed an exact repositioning in 99.5% of cases, and the mean duration of the procedure was 8 minutes. A fiberscope was required to move the hook for one patient. We did not notice a moving of the double lumen endotracheal tube during the surgery. The surgeon satisfaction was 100%. The fluoroscopy evidenced the right position of the double lumen tube and allowed a right repositioning in 99.5% of patients with a very simple implementation. Copyright © 2014. Published by Elsevier B.V.

[Analysis on the long-term effects of modified double endobutton technique in the treatment of Tossy type III acromioclavicular joint dislocations].

PubMed

Yan, Rui-Jian; Lu, Jian-Wei; Zhang, Chun

2014-01-01

To investigate the long-term clinical effects of modified double Endobutton technique for the treatment of acromioclavicular joint dislocations of Tossy type III. A retrospective study was done in 42 patients with acromioclavicular joint dislocations of Tossy type III treated with modified double Endobutton technique from December 2008 to December 2010. There were 24 males and 18 females, ranging in age from 21 to 56 years old (averaged, 32.5 years old). All the patients were treated with open reduction, coracoclavicular ligament reconstruction using double Endobutton technique, and repair of acromioclavicular ligament. The Karlsson system was used to evaluate therapeutic effects. The distance from coracoid to clavicle was measured to evaluate reduction loss. All the patients were followed up, and the duration ranged from 2.0 to 3.2 years (averaged,2.4 years). According to Karlsson system, 32 patients got an A degree and 10 patients got a B degree at three months post-operatively; 26 patients got an A degree and 16 patients got a B degree at the latest follow-up; 6 patients got an A degree at 3 months after operation lowered to B degree at the latest follow-up. The coracoid-clavicle distance increased from (26.91 +/- 0.91) mm at 3 months after operation to (27.41 +/- 1.10) mm at the latest follow-up. Te patients treated with over-reduction during operation or with heavy physical labour work after operation had obvious widened coracoid-clavicle distance. Bone absorption was found around the plate in most cases, mainly in the clavicular side. Treatment for acromioclavicular joint dislocations of Tossy type III with modified double Endobutton technique has satisfactory early clinical results. But with time passing, loss of reduction and bone absorption around the plate could be observed, and clinical outcomes of some cases downgrade during the long-term follow-up.

Immature MEF2C-dysregulated T-cell leukemia patients have an early T-cell precursor acute lymphoblastic leukemia gene signature and typically have non-rearranged T-cell receptors

PubMed Central

Zuurbier, Linda; Gutierrez, Alejandro; Mullighan, Charles G.; Canté-Barrett, Kirsten; Gevaert, A. Olivier; de Rooi, Johan; Li, Yunlei; Smits, Willem K.; Buijs-Gladdines, Jessica G.C.A.M.; Sonneveld, Edwin; Look, A. Thomas; Horstmann, Martin; Pieters, Rob; Meijerink, Jules P.P.

2014-01-01

Three distinct immature T-cell acute lymphoblastic leukemia entities have been described including cases that express an early T-cell precursor immunophenotype or expression profile, immature MEF2C-dysregulated T-cell acute lymphoblastic leukemia cluster cases based on gene expression analysis (immature cluster) and cases that retain non-rearranged TRG@ loci. Early T-cell precursor acute lymphoblastic leukemia cases exclusively overlap with immature cluster samples based on the expression of early T-cell precursor acute lymphoblastic leukemia signature genes, indicating that both are featuring a single disease entity. Patients lacking TRG@ rearrangements represent only 40% of immature cluster cases, but no further evidence was found to suggest that cases with absence of bi-allelic TRG@ deletions reflect a distinct and even more immature disease entity. Immature cluster/early T-cell precursor acute lymphoblastic leukemia cases are strongly enriched for genes expressed in hematopoietic stem cells as well as genes expressed in normal early thymocyte progenitor or double negative-2A T-cell subsets. Identification of early T-cell precursor acute lymphoblastic leukemia cases solely by defined immunophenotypic criteria strongly underestimates the number of cases that have a corresponding gene signature. However, early T-cell precursor acute lymphoblastic leukemia samples correlate best with a CD1 negative, CD4 and CD8 double negative immunophenotype with expression of CD34 and/or myeloid markers CD13 or CD33. Unlike various other studies, immature cluster/early T-cell precursor acute lymphoblastic leukemia patients treated on the COALL-97 protocol did not have an overall inferior outcome, and demonstrated equal sensitivity levels to most conventional therapeutic drugs compared to other pediatric T-cell acute lymphoblastic leukemia patients. PMID:23975177

Measuring nuclear reaction cross sections to extract information on neutrinoless double beta decay

NASA Astrophysics Data System (ADS)

Cavallaro, M.; Cappuzzello, F.; Agodi, C.; Acosta, L.; Auerbach, N.; Bellone, J.; Bijker, R.; Bonanno, D.; Bongiovanni, D.; Borello-Lewin, T.; Boztosun, I.; Branchina, V.; Bussa, M. P.; Calabrese, S.; Calabretta, L.; Calanna, A.; Calvo, D.; Carbone, D.; Chávez Lomelí, E. R.; Coban, A.; Colonna, M.; D'Agostino, G.; De Geronimo, G.; Delaunay, F.; Deshmukh, N.; de Faria, P. N.; Ferraresi, C.; Ferreira, J. L.; Finocchiaro, P.; Fisichella, M.; Foti, A.; Gallo, G.; Garcia, U.; Giraudo, G.; Greco, V.; Hacisalihoglu, A.; Kotila, J.; Iazzi, F.; Introzzi, R.; Lanzalone, G.; Lavagno, A.; La Via, F.; Lay, J. A.; Lenske, H.; Linares, R.; Litrico, G.; Longhitano, F.; Lo Presti, D.; Lubian, J.; Medina, N.; Mendes, D. R.; Muoio, A.; Oliveira, J. R. B.; Pakou, A.; Pandola, L.; Petrascu, H.; Pinna, F.; Reito, S.; Rifuggiato, D.; Rodrigues, M. R. D.; Russo, A. D.; Russo, G.; Santagati, G.; Santopinto, E.; Sgouros, O.; Solakci, S. O.; Souliotis, G.; Soukeras, V.; Spatafora, A.; Torresi, D.; Tudisco, S.; Vsevolodovna, R. I. M.; Wheadon, R. J.; Yildirin, A.; Zagatto, V. A. B.

2018-02-01

Neutrinoless double beta decay (0vββ) is considered the best potential resource to access the absolute neutrino mass scale. Moreover, if observed, it will signal that neutrinos are their own anti-particles (Majorana particles). Presently, this physics case is one of the most important research “beyond Standard Model” and might guide the way towards a Grand Unified Theory of fundamental interactions. Since the 0vββ decay process involves nuclei, its analysis necessarily implies nuclear structure issues. In the NURE project, supported by a Starting Grant of the European Research Council (ERC), nuclear reactions of double charge-exchange (DCE) are used as a tool to extract information on the 0vββ Nuclear Matrix Elements. In DCE reactions and ββ decay indeed the initial and final nuclear states are the same and the transition operators have similar structure. Thus the measurement of the DCE absolute cross-sections can give crucial information on ββ matrix elements. In a wider view, the NUMEN international collaboration plans a major upgrade of the INFN-LNS facilities in the next years in order to increase the experimental production of nuclei of at least two orders of magnitude, thus making feasible a systematic study of all the cases of interest as candidates for 0vββ.

Conditional punishment is a double-edged sword in promoting cooperation.

PubMed

Huang, Feng; Chen, Xiaojie; Wang, Long

2018-01-11

Punishment is widely recognized as an effective approach for averting from exploitation by free-riders in human society. However, punishment is costly, and thus rational individuals are unwilling to take the punishing action, resulting in the second-order free-rider problem. Recent experimental study evidences that individuals prefer conditional punishment, and their punishing decision depends on other members' punishing decisions. In this work, we thus propose a theoretical model for conditional punishment and investigate how such conditional punishment influences cooperation in the public goods game. Considering conditional punishers only take the punishing action when the number of unconditional punishers exceeds a threshold number, we demonstrate that such conditional punishment induces the effect of a double-edged sword on the evolution of cooperation both in well-mixed and structured populations. Specifically, when it is relatively easy for conditional punishers to engage in the punishment activity corresponding to a low threshold value, cooperation can be promoted in comparison with the case without conditional punishment. Whereas when it is relatively difficult for conditional punishers to engage in the punishment activity corresponding to a high threshold value, cooperation is inhibited in comparison with the case without conditional punishment. Moreover, we verify that such double-edged sword effect exists in a wide range of model parameters and can be still observed in other different punishment regimes.

The steady-state tangential contact problem for a falling drop type of contact area on corrugated rail by simplified theory of rolling contact

NASA Astrophysics Data System (ADS)

Piotrowski, Jerzy

1991-10-01

Investigation of contact mechanical nonlinearities of a mathematical model of corrugation revealed that the typical shape of contact patch resembles a falling drop of water. A contact patch of that shape was approximated with a figure composed of two parts of ellipses with different eccentricities. The contact pressure distribution was assumed as a smoothing ensemble of two paraboloidal distributions. The description of a general case of double half elliptical contact area was given but a special case of double half elliptical contact is more interesting as it possesses some Hertzian properties. It was shown how three geometrical parameters of double half elliptical contact can be chosen when actual, non-Hertzian contact is known. A linear theory was written which indicates that the lateral vibrations of the rail may be excited only due to shape variation on corrugation even if any other cause for these vibrations does not exist. For nonlinear theory a computer program, based on FASTSIM algorithm by Kalker, was written. The aim is to calculate the creep forces and frictional power density distribution over the contact area. Also, a graphic program visualizing the solution was written. Numerical results are not provided; unattended and unsolved problems relevant for this type of contact are listed.

Reduced Capillary Length Scale in the Application of Ostwald Ripening Theory to the Coarsening of Charged Colloidal Crystals in Electrolyte Solutions

NASA Astrophysics Data System (ADS)

Rowe, Jeffrey D.; Baird, James K.

2007-06-01

A colloidal crystal suspended in an electrolyte solution will ordinarily exchange ions with the surrounding solution and develop a net surface charge density and a corresponding double layer. The interfacial tension of the charged surface has contributions arising from: (a) background interfacial tension of the uncharged surface, (b) the entropy associated with the adsorption of ions on the surface, and (c) the polarizing effect of the electrostatic field within the double layer. The adsorption and polarization effects make negative contributions to the surface free energy and serve to reduce the interfacial tension below the value to be expected for the uncharged surface. The diminished interfacial tension leads to a reduced capillary length scale. According to the Ostwald ripening theory of particle coarsening, the reduced capillary length will cause the solute supersaturation to decay more rapidly and the colloidal particles to be smaller in size and greater in number than in the absence of the double layer. Although the length scale for coarsening should be little affected in the case of inorganic colloids, such as AgI, it should be greatly reduced in the case of suspensions of protein crystals, such as apoferritin, catalase, and thaumatin.

Distal biceps tendon rupture reconstruction using muscle-splitting double-incision approach

PubMed Central

Tarallo, Luigi; Mugnai, Raffaele; Zambianchi, Francesco; Adani, Roberto; Catani, Fabio

2014-01-01

AIM: To evaluate the clinical and functional results after repair of distal biceps tendon tears, following the Morrey’s modified double-incision approach. METHODS: We retrospectively reviewed 47 patients with distal rupture of biceps brachii treated between 2003 and 2012 in our Orthopedic Department with muscle-splitting double-incision technique. Outcome measures included the Mayo elbow performance, the DASH questionnaire, patient’s satisfaction, elbow and forearm motion, grip strength and complications occurrence. RESULTS: At an average 18 mo follow-up (range, 7 mo-10 years) the average Mayo elbow performance and DASH score were respectively 97.2 and 4.8. The elbow flexion range was 94%, extension was -2°, supination was 93% and pronation 96% compared with the uninjured limb. The mean grip strength, expressed as percentage of respective contralateral limb, was 83%. The average patient satisfaction rating on a Likert scale (from 0 to 10) was 9.4. The following complications were observed: 3 cases of heterotopic ossification (6.4%), one (2.1%) re-rupture of the tendon at the site of reattachment and 2 cases (4.3%) of posterior interosseous nerve palsy. No complication required further surgical treatment. CONCLUSION: This technique allows an anatomic reattachment of distal biceps tendon at the radial tuberosity providing full functional recovery with low complication rate. PMID:25133147

Pathologic Remodeling of Endoneurial Tubules in Human Neuromas

PubMed Central

Karsy, Michael; Palmer, Cheryl A

2018-01-01

Background: Laminins are extracellular matrix proteins that participate in endoneurial tubule formation and are important in the regeneration of nerves after injury. They act as scaffolds to guide nerves to distal targets and play a key role in neurite outgrowth. Because there is evidence that laminin architecture affects nerve regeneration, we evaluated endoneurial tubules by examining the laminin structure in clinical samples from patients with nerve injuries. Methods: In a retrospective review of eight nerve injury cases, we evaluated nerve histology in relation to clinical history and injury type. The immunohistochemical delineation of the laminin structure in relationship with the neuroma type was performed. Results: Five cases of upper-trunk stretch injuries—four from childbirth injury and one from a motorcycle accident—and three cases of nerve laceration leading to neuroma formation were examined. In the upper-trunk stretch injuries, avulsed nerves demonstrated no neuroma formation with a linear laminin architecture and a regular Schwann cell arrangement, but increased fibrous tissue deposition. For neuromas-in-continuity after a stretch injury, laminin immunohistochemistry demonstrated a double-lumen laminin tubule, with encapsulation of the Schwann cells and axonal processes. Nerve laceration leading to stump neuroma formation had a similar double-lumen laminin tubule, but less severe fibrosis. Conclusions: In nerve injuries with regenerative capacity, endoneurial tubules become pathologically disorganized. A double-lumen endoneurial tubule of unclear significance develops. The consistency of this pattern potentially suggests a reproducible pathophysiologic process. Further exploration of this pathophysiologic healing may provide insight into the failure of programmed peripheral nerve regeneration after injury. PMID:29560300

The Ultimate Strength of Double Hull Oil Tanker Due to Grounding and Collision

NASA Astrophysics Data System (ADS)

Izaak Latumahina, Samuel; Zubair Muis Alie, Muhammad; Sitepu, Ganding

2018-02-01

The damaged tanker by grounding and collision may totally collapse if loss its buoyancy, stability and suffer structural failure. The objective of the present study is to investigate the ultimate strength of double hull oil tanker under vertical bending moments due to grounding and collision. The damages are modelled by removing the elements consist of stiffened and unstiffened plates from the damages part. One-frame space of the double hull oil tanker is taken to be analysed. Two damages cases are considered in the analyses those are grounding and collision. The transversal damage extent for grounding are 10%, 25%, 40% and 55%. The groundings are placed at symmetric position on the outer bottom part. For the case of collision, the vertical damage extent are taken as 10%, 20%, 40% and 60%. The transversal damages extent is taken to be B/16 and it is constant for all collision damages. The investigation of the ultimate strength is performed by the Non-Linear Finite Element Analysis method under moment control. The boundary condition is applied with fully constrained on all nodes at the aft-end, while the rigid linked on all nodes is attached at the fore-end with respect to the reference point on the neutral axis. The initial imperfection, welding residual stress and crack are not considered in the analyses. The results obtained by Non-Linear Finite Element Analyses for the ultimate strength are compared with the in-house program using Smith’s method implemented in HULLST. The stress distribution and deformation for every case of damages including intact are also discussed in the present study.

Double-diffusive instabilities in ancient seawater

NASA Astrophysics Data System (ADS)

Pawlowicz, Rich; Scheifele, Ben; Zaloga, Artem; Wuest, Alfred; Sommer, Tobias

2015-04-01

Powell Lake, British Columbia, Canada is a geothermally heated lake about 350m deep with a saline lower layer that was isolated from the ocean by coastal uplift about 11000 years ago, after the last ice age. Careful temperature and conductivity profiling measurements show consistent, stable, and spatially/temporally coherent steps resulting from double-diffusive processes in certain ranges of depth, vertically interspersed with other depth ranges where these signatures are not present. These features are quasi-stable for at least several years. Although molecular diffusion has removed about half the salt from the deepest waters and biogeochemical processes have slightly modified the water composition, the lack of tidal processes and shear-driven mixing, as well as an accurate estimate of heat flux from both sediment heat flux measurements and gradient measurements in a region not susceptible to diffusive instabilities, makes this a unique geophysical laboratory to study double diffusion. Here we present a detailed picture of the structure of Powell Lake and its double-diffusive stair cases, and suggest shortcomings with existing parameterizations for fluxes through such staircases.

Posterior Double Vertebral Column Resections Combined with Satellite Rod Technique to Correct Severe Congenital Angular Kyphosis.

PubMed

Sun, Xu; Zhu, Ze-Zhang; Chen, Xi; Liu, Zhen; Wang, Bin; Qiu, Yong

2016-08-01

This paper presents a highly challenging technique involving posterior double vertebral column resections (VCRs) and satellite rods placement. This was a young adult case with severe angular thoracolumbar kyphosis of 101 degrees, secondary to anterior segmentation failure from T11 to L1 . There were hemivertebrae at T11 and T12 , and a wedged vertebra at L1 . He received double VCRs at T12 and T11 and instrumented fusion from T6 to L4 via a posterior only approach. Autologous grafts and a cage were placed between the bony surfaces of the osteotomy gap. Once closure of osteotomy was achieved, bilateral permanent CoCr rods were placed with addition of satellite rods. Postoperative X-ray demonstrated marked correction of kyphosis. On the 10(th) days after surgery, the patient was able to walk without assistance. In conclusion, double VCRs are effective to correct severe angular kyphosis, and addition of satellite rods may be imperative to enhance instrumentation strength and thus prevent correction loss. © 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Enhanced long-distance transport of periodic electron beams in an advanced double layer cone-channel target

NASA Astrophysics Data System (ADS)

Ji, Yanling; Duan, Tao; Zhou, Weimin; Li, Boyuan; Wu, Fengjuan; Zhang, Zhimeng; Ye, Bin; Wang, Rong; Wu, Chunrong; Tang, Yongjian

2018-02-01

An enhanced long-distance transport of periodic electron beams in an advanced double layer cone-channel target is investigated using two-dimensional particle-in-cell simulations. The target consists of a cone attached to a double-layer hollow channel with a near-critical-density inner layer. The periodic electron beams are generated by the combination of ponderomotive force and longitudinal laser electric field. Then a stable electron propagation is achieved in the double-layer channel over a much longer distance without evident divergency, compared with a normal cone-channel target. Detailed simulations show that the much better long-distance collimation and guidance of energetic electrons is attributed to the much stronger electromagnetic fields at the inner wall surfaces. Furthermore, a continuous electron acceleration is obtained by the more intense laser electric fields and extended electron acceleration length in the channel. Our investigation shows that by employing this advanced target, both the forward-going electron energy flux in the channel and the energy coupling efficiency from laser to electrons are about threefold increased in comparison with the normal case.

2H{ 19F} REDOR for distance measurements in biological solids using a double resonance spectrometer

NASA Astrophysics Data System (ADS)

Grage, Stephan L.; Watts, Jude A.; Watts, Anthony

2004-01-01

A new approach for distance measurements in biological solids employing 2H{ 19F} rotational echo double resonance was developed and validated on 2H, 19F- D-alanine and an imidazopyridine based inhibitor of the gastric H +/K +-ATPase. The 2H- 19F double resonance experiments presented here were performed without 1H decoupling using a double resonance NMR spectrometer. In this way, it was possible to benefit from the relatively longer distance range of fluorine without the need of specialized fluorine equipment. A distance of 2.5 ± 0.3 Å was measured in the alanine derivative, indicating a gauche conformation of the two labels. In the case of the imidazopyridine compound a lower distance limit of 5.2 Å was determined and is in agreement with an extended conformation of the inhibitor. Several REDOR variants were compared, and their advantages and limitations discussed. Composite fluorine dephasing pulses were found to enhance the frequency bandwidth significantly, and to reduce the dependence of the performance of the experiment on the exact choice of the transmitter frequency.

The abundance of homoeologue transcripts is disrupted by hybridization and is partially restored by genome doubling in synthetic hexaploid wheat.

PubMed

Hao, Ming; Li, Aili; Shi, Tongwei; Luo, Jiangtao; Zhang, Lianquan; Zhang, Xuechuan; Ning, Shunzong; Yuan, Zhongwei; Zeng, Deying; Kong, Xingchen; Li, Xiaolong; Zheng, Hongkun; Lan, Xiujin; Zhang, Huaigang; Zheng, Youliang; Mao, Long; Liu, Dengcai

2017-02-10

The formation of an allopolyploid is a two step process, comprising an initial wide hybridization event, which is later followed by a whole genome doubling. Both processes can affect the transcription of homoeologues. Here, RNA-Seq was used to obtain the genome-wide leaf transcriptome of two independent Triticum turgidum × Aegilops tauschii allotriploids (F1), along with their spontaneous allohexaploids (S1) and their parental lines. The resulting sequence data were then used to characterize variation in homoeologue transcript abundance. The hybridization event strongly down-regulated D-subgenome homoeologues, but this effect was in many cases reversed by whole genome doubling. The suppression of D-subgenome homoeologue transcription resulted in a marked frequency of parental transcription level dominance, especially with respect to genes encoding proteins involved in photosynthesis. Singletons (genes where no homoeologues were present) were frequently transcribed at both the allotriploid and allohexaploid plants. The implication is that whole genome doubling helps to overcome the phenotypic weakness of the allotriploid, restoring a more favourable gene dosage in genes experiencing transcription level dominance in hexaploid wheat.

Similarity of PSR J1906+0746 TO PSR J0737-3039: A Candidate of a New Double Pulsar System?

NASA Astrophysics Data System (ADS)

Yang, Yi-Yan; Zhang, Cheng-Min; Li, Di; Wang, De-Hua; Pan, Yuan-Yue; Lingfu, Rong-Feng; Zhou, Zhu-Wen

2017-02-01

PSR J1906+0746 is a nonrecycled strong magnetic field neutron star (NS), sharing the properties of the secondary-formed NS PSR J0737-3039B in the double pulsar system PSR J0737-3039AB. By comparing the orbital parameters of PSR J1906+0746 with those of PSR J0737-3039AB, we conclude that both systems have a similar origin and evolution history, involving an e-capture process for forming the second-born NS, like in the case of PSR J0737-3039B. We expect the companion of PSR J1906+0746 to be a long-lived recycled pulsar with radio beams that currently cannot be observed from Earth. We suggest possible ways to detect its presence. To compare PSR J1906+0746 with PSR J0737-3039, we also present the mass distribution of eight pairs of double NSs and find that in double NSs the mass of the recycled pulsar is usually larger than that of the nonrecycled one, which may be the result of accretion.

Double-peaked breakthrough curves as a consequence of solute transport through underground lakes: a case study of the Furfooz karst system, Belgium

NASA Astrophysics Data System (ADS)

Dewaide, Lorraine; Collon, Pauline; Poulain, Amaël; Rochez, Gaëtan; Hallet, Vincent

2018-03-01

The existence of double-peaked breakthrough curves (BTC), which are the result of the transport of a dye tracer through underground lakes, is reported. Investigations were undertaken on the Furfooz karst system in southern Belgium. In this system, the River Lesse sinks partially into a swallow hole. The water follows a solitary conduit leading to an underground lake that is directly connected to a second underground lake. Double-peaked BTCs were detected in the resurgent water, downstream of this second lake. The report first describes field data (tracer tests in various hydrologic conditions) which point towards the double peak being linked to a nonlinear process that originates within the lakes. Complementary investigations within the lakes show a complex behavior of the dye tracer related to a specific hydrodynamic feature that leads to the separation of the solute plume. A conceptual model of the solute transport within the lakes is proposed. This model emphasizes the physical effect of the lakes on the dye flow-through process.

Effect of cation ordering on oxygen vacancy diffusion pathways in double perovskites

DOE PAGES

Uberuaga, Blas Pedro; Pilania, Ghanshyam

2015-07-08

Perovskite structured oxides (ABO 3) are attractive for a number of technological applications, including as superionics because of the high oxygen conductivities they exhibit. Double perovskites (AA’BB’O 6) provide even more flexibility for tailoring properties. Using accelerated molecular dynamics, we examine the role of cation ordering on oxygen vacancy mobility in one model double perovskite SrLaTiAlO 6. We find that the mobility of the vacancy is very sensitive to the cation ordering, with a migration energy that varies from 0.6 to 2.7 eV. In the extreme cases, the mobility is both higher and lower than either of the two endmore » member single perovskites. Further, the nature of oxygen vacancy diffusion, whether one-dimensional, two-dimensional, or three-dimensional, also varies with cation ordering. We correlate the dependence of oxygen mobility on cation structure to the distribution of Ti 4+ cations, which provide unfavorable environments for the positively charged oxygen vacancy. The results demonstrate the potential of using tailored double perovskite structures to precisely control the behavior of oxygen vacancies in these materials.« less

Paraesthesia during the needle-through-needle and the double segment technique for combined spinal epidural anaesthesia.

PubMed

Ahn, H J; Choi, D H; Kim, C S

2006-07-01

Paraesthesia during regional anaesthesia is an unpleasant sensation for patients and, more importantly, in some cases it is related to neurological injury. Relatively few studies have been conducted on the frequency of paraesthesia during combined spinal epidural anaesthesia. We compared two combined spinal epidural anaesthesia techniques: the needle-through-needle technique and the double segment technique in this respect. We randomly allocated 116 parturients undergoing elective Caesarean section to receive anaesthesia using one of these techniques. Both techniques were performed using a 27G pencil point needle, an 18G Tuohy needle, and a 20G multiport epidural catheter from the same manufacturer. The overall frequency of paraesthesia was higher in the needle-through-needle technique group (56.9% vs. 31.6%, p = 0.011). The frequency of paraesthesia at spinal needle insertion was 20.7% in the needle-through-needle technique group and 8.8% in the double segment technique group; whereas the frequency of paraesthesia at epidural catheter insertion was 46.6% in the needle-through-needle technique group and 24.6% in the double segment technique group.

Pre- and post-head processing for single- and double-scrambled sentences of a head-final language as measured by the eye tracking method.

PubMed

Tamaoka, Katsuo; Asano, Michiko; Miyaoka, Yayoi; Yokosawa, Kazuhiko

2014-04-01

Using the eye-tracking method, the present study depicted pre- and post-head processing for simple scrambled sentences of head-final languages. Three versions of simple Japanese active sentences with ditransitive verbs were used: namely, (1) SO₁O₂V canonical, (2) SO₂O₁V single-scrambled, and (3) O₁O₂SV double-scrambled order. First pass reading times indicated that the third noun phrase just before the verb in both single- and double-scrambled sentences required longer reading times compared to canonical sentences. Re-reading times (the sum of all fixations minus the first pass reading) showed that all noun phrases including the crucial phrase before the verb in double-scrambled sentences required longer re-reading times than those required for single-scrambled sentences; single-scrambled sentences had no difference from canonical ones. Therefore, a single filler-gap dependency can be resolved in pre-head anticipatory processing whereas two filler-gap dependencies require much greater cognitive loading than a single case. These two dependencies can be resolved in post-head processing using verb agreement information.

Transition region response of the symmetric double probe and its application in the lower ionosphere

NASA Technical Reports Server (NTRS)

Szuszczewicz, E. P.

1972-01-01

The technique is discussed of the symmetric double-probe which readily lends itself to the in situ measurement of plasma temperature in the ionospheric D-region because it can lead to meaningful results under relatively high collision frequencies where the Langmuir probe has been observed to fail. It is shown that the modification to the original collision-free double-probe theory of Johnson and Malter for the determination of electron temperature is never greater than + or - 12%, with a value of (8 + or - 2)% nominally applicable in the case of D-region diagnostics. This technique was successfully operated on a Nike-Cajun payload flown at mid-day from White Sands, New Mexico to an apogee of 78.5 km. The associated electronics and deployed double-probe configuration are presented, and a current-voltage characteristic collected in the ascent stage at 73.7 km is briefly discussed. The values of electron temperature indicated by the sampled data are approximately 30% higher than those predicted by theory for the anticipated state of thermal equilibrium with the ambient neutrals.

Using large spectroscopic surveys to test the double degenerate model for Type Ia supernovae

NASA Astrophysics Data System (ADS)

Breedt, E.; Steeghs, D.; Marsh, T. R.; Gentile Fusillo, N. P.; Tremblay, P.-E.; Green, M.; De Pasquale, S.; Hermes, J. J.; Gänsicke, B. T.; Parsons, S. G.; Bours, M. C. P.; Longa-Peña, P.; Rebassa-Mansergas, A.

2017-07-01

An observational constraint on the contribution of double degenerates to Type Ia supernovae requires multiple radial velocity measurements of ideally thousands of white dwarfs. This is because only a small fraction of the double degenerate population is massive enough, with orbital periods short enough, to be considered viable Type Ia progenitors. We show how the radial velocity information available from public surveys such as the Sloan Digital Sky Survey can be used to pre-select targets for variability, leading to a 10-fold reduction in observing time required compared to an unranked or random survey. We carry out Monte Carlo simulations to quantify the detection probability of various types of binaries in the survey and show that this method, even in the most pessimistic case, doubles the survey size of the largest survey to date (the SPY Survey) in less than 15 per cent of the required observing time. Our initial follow-up observations corroborate the method, yielding 15 binaries so far (eight known and seven new), as well as orbital periods for four of the new binaries.

The electrostatic properties of Fiber-Reinforced-Plastics double wall underground storage gasoline tanks

NASA Astrophysics Data System (ADS)

Li, Yipeng; Liu, Quanzhen; Meng, He; Sun, Lifu; Zhang, Yunpeng

2013-03-01

At present Fiber Reinforced Plastics (FRP) double wall underground storage gasoline tanks are wildly used. An FRP product with a resistance of more than 1011 Ω is a static non-conductor, so it is difficult for the static electricity in the FRP product to decay into the earth. In this paper an experimental system was built to simulate an automobile gasoline filling station. Some electrostatic parameters of the gasoline, including volume charge density, were tested when gasoline was unloaded into a FRP double wall underground storage tank. Measurements were taken to make sure the volume charge density in the oil-outlet was similar to the volume charge density in the tank. In most cases the volume charge density of the gasoline was more than 22.7 μC m-3, which is likely to cause electrostatic discharge in FRP double wall underground storage gasoline tanks. On the other hand, it would be hard to ignite the vapor by electrostatic discharge since the vapor pressure in the tanks is over the explosion limit. But when the tank is repaired or re-used, the operators must pay attention to the static electricity and some measurements should be taken to avoid electrostatic accident. Besides the relaxation time of charge in the FRP double wall gasoline storage tanks should be longer.

The Comparison of Double J Stent Insertion and Conservative Treatment Alone in Severe Pure Gestational Hydronephrosis: A Case Controlled Clinical Study

PubMed Central

Çeçen, Kürşat; Ülker, Kahraman

2014-01-01

Objective. Management options of gestational hydronephrosis are based on the coexisting stone disease, pyelonephritis, and renal disease. However, the management option and its consequences in the absence of a coexisting disease state are not clear. In this study we aimed to compare the effectiveness of conservative treatment and double J insertion in symptomatic pure gestational hydronephrosis. Material and Methods. The data of the women with severe pure gestational hydronephrosis over a nine-year period was collected retrospectively. The included women were grouped into two according to receiving double J stent insertion or conservative treatments. Results. Double J insertion and conservative treatment groups included 24 and 29 women, respectively. Hydronephrosis was demonstrated on the right, left, or both kidneys in 37 (70%), 13 (24%), and 3 (6%) women, respectively. None of the participants gave birth prior to the 37th week. The demographics, initial pain scores, the severity of the hydronephrosis during first admission, and pain scores one week after the interventions did not differ significantly between groups (P > 0.05). Similarly, the rates of complications, postpartum pain scores, and permanent hydronephrosis did not differ between groups (P > 0.05). Conclusion. Double J insertion in symptomatic pure gestational hydronephrosis adds no benefit to conservative treatment. PMID:24574939

Diameter of the useful diffraction halo in double-exposure speckle photographs recorded under various conditions

NASA Astrophysics Data System (ADS)

Alejo, A.; Marti, L.; Moreno, A.; Ostrovskii, Iu. I.; Serra, R.

1985-06-01

Consideration is given to the relationship between the diffraction halo radius Theta(h) and the displacement (Delta) of the object in double exposed speckle photographs taken in various conditions. The numerical values of Theta(h)/Delta were obtained for several speckle recordings having exposure times in the range 0.5-3.8 s. It is shown that long exposure times did not significantly decrease the minimum measureable displacement of the object. The radii of the diffraction halo were the same in the case of both long and short exposure times.

Double valve replacement in a patient with implantable cardioverter defibrillator with severe left ventricular dysfunction.

PubMed

Manjunath, Girish; Rao, Prakash; Prakash, Nagendra; Shivaram, B K

2016-01-01

Recent data from landmark trials suggest that the indications for cardiac pacing and implantable cardioverter defibrillators (ICDs) are set to expand to include heart failure, sleep-disordered breathing, and possibly routine implantation in patients with myocardial infarction and poor ventricular function.[1] This will inevitably result in more patients with cardiac devices undergoing surgeries. Perioperative electromagnetic interference and their potential effects on ICDs pose considerable challenges to the anesthesiologists.[2] We present a case of a patient with automatic ICD with severe left ventricular dysfunction posted for double valve replacement.

Sequential two-photon double ionization of noble gases by circularly polarized XUV radiation

NASA Astrophysics Data System (ADS)

Gryzlova, E. V.; Grum-Grzhimailo, A. N.; Kuzmina, E. I.; Strakhova, S. I.

2014-10-01

Photoelectron angular distributions (PADs) and angular correlations between two emitted electrons in sequential two-photon double ionization (2PDI) of atoms by circularly polarized radiation are studied theoretically. In particular, the sequential 2PDI of the valence n{{p}6} shell in noble gas atoms (neon, argon, krypton) is analyzed, accounting for the first-order corrections to the dipole approximation. Due to different selection rules in ionization transitions, the circular polarization of photons causes some new features of the cross sections, PADs and angular correlation functions in comparison with the case of linearly polarized photons.

Occurrence of Double Monoclonal Bands on Protein Electrophoresis: An Unusual Finding.

PubMed

Srinivasan, Vishrut K; Bhagat, Priyanka; Bansal, Frainey; Chhabra, Seema

2016-06-01

Various techniques of protein electrophoresis are used for detection of monoclonal proteins/paraproteins in serum and/or urine of patients with monoclonal gammopathies. These are detected as the so-called 'M' bands (monoclonal bands) on serum protein electrophoresis and/or immunofixation electrophoresis. In most cases, a single M-band is detected. However, more than one M-band can be detected in the samples of a minor proportion of patients. This condition is termed as 'double gammopathy' or 'biclonal gammopathy'. A knowledge of such an unusual occurrence is essential for recognition and appropriate interpretation of this entity.

Analytical solutions to the free vibration of a double-walled carbon nanotube carrying a bacterium at its tip

NASA Astrophysics Data System (ADS)

Storch, Joel A.; Elishakoff, Isaac

2013-11-01

We calculate the natural frequencies and mode shapes of a cantilevered double-walled carbon nanotube carrying a rigid body—representative of a bacterium or virus—at the tip of the outer nanotube. By idealizing the nanotubes as Bernoulli-Euler beams, we are able to obtain exact expressions for both the mode shapes and characteristic frequency equation. Separate analyses are performed for the special case of a concentrated tip mass and the more complicated situation where the tip body also exhibits inertia and mass center offset from the beam tip.

[Research of gestrinone-related abnormal uterine bleeding and the intervention in the treatment: a multi-center, randomized, controlled clinical trial].

PubMed

Duan, H; Wang, S; Hao, M; Chen, L; Tang, J; Wang, X; Peng, Y Z; Zhang, S C; Cao, L R; Yu, J J

2016-02-01

To investigate the incidence, influencing factors and intervention of gestrinone-related abnormal uterine bleeding at different dosage of gestrinone in the clinical treatment. This was a multicenter, randomized, control study of 195 Chinese women with endometriosis or adenomyosis from June 2011 to November 2013. The subjects were randomized into three groups with oral administration of gestrinone, 2.5 mg dose at one time; twice a week group: 67 cases with oral administration twice a week last three months; double dose first month group: 67 cases with oral administration triple times a week at first month, then twice a week for two months; three times a week group: 61 cases with oral administration three times a week last three months. The improvement of the abnormal uterine bleeding, the changes in estrogen, liver function and blood coagulation were evaluated. At the same time, B-ultrasound examination evaluation were performed. (1) Three months later, the incidence of abnormal uterine bleeding in twice a week group was 30% (20/67), in double dose first month group and three times a week group were 7%(5/67) and 16% (10/61) respectively, there were significant difference between three groups (P<0.05). The incidence in double dose first month group was the most lower. (2) Univariate analysis showed that the dosage and ovarian size were the significant factors for abnormal uterine bleeding (OR=0.461,P= 0.003;OR=0.303,P=0.016); logistic regression analysis demonstrated that the risk of abnormal uterine bleeding in double dose first month group was the lowest when compared with twice a week group and three times a week group, the risk in twice a week group was 5-fold higher than that in double dose first month group (OR=0.211,P=0.011). The incidence of abnormal uterine bleeding in participants with abnormal ovarian volume results from ovarian cyst or ovarian surgery was significantly lower than those with normal ovarian volume (OR=0.304,P=0.018). (3) After the treatment of three months, there were no significant difference in alanine transaminase level between the groups (P>0.05). The body mass index significantly increased in three group (P<0.05), but there were no significant differences between the groups (P>0.05). As for blood coagulation, there were also no significant differences between the groups (P>0.05). Double dose of gestrinone in the first month could significantly decrease the incidence of gestrinone-related abnormal uterine bleeding. It is a more optimied dosage of gestrinone and without severe side effects. Chinese Clinical Trial Registry, registration number: ChiCTR-TRC-12002327.

Four new cases of double heterozygosity for BRCA1 and BRCA2 gene mutations: clinical, pathological, and family characteristics.

PubMed

Zuradelli, Monica; Peissel, Bernard; Manoukian, Siranoush; Zaffaroni, Daniela; Barile, Monica; Pensotti, Valeria; Cavallari, Ugo; Masci, Giovanna; Mariette, Frederique; Benski, Anne Caroline; Santoro, Armando; Radice, Paolo

2010-11-01

Double heterozygosity (DH) for BRCA1 and BRCA2 mutations is a very rare finding, particularly in non-Ashkenazi individuals, and only a few cases have been reported to date. In addition, little is known on the pathological features of the tumors that occur in DH cases and on their family history of cancer. Four carriers of pathogenic mutations in both BRCA1 and BRCA2 were identified among women who underwent genetic counseling for hereditary susceptibility to breast and ovarian carcinoma at three different Italian institutions. Clinical, pathological, and family history data were collected from medical records and during genetic counseling sessions. All identified DH cases developed breast carcinoma and three of them were also diagnosed with ovarian carcinoma. Mean ages of breast and ovarian cancer diagnosis were 42.7 and 48.6 years, respectively. The majority of breast cancers showed a BRCA1-related phenotype, being negative for hormone receptors and HER2. Two cases reported different gastrointestinal tumors among relatives. Although the individuals described in this study show more severe clinical features in comparison to previously reported BRCA1 and BRCA2 DH cases, our observations support the hypothesis of a non specific phenotype of DH cases in terms of age of disease onset. In addition, our observations indicate that in DH patients breast carcinogenesis appears to be driven mainly by the mutations in BRCA1. The possible association of DH for BRCA gene mutations with gastrointestinal tumors is in keeping with previous reports, but needs to be confirmed by further analyses.

Automated microaneurysm detection method based on double ring filter in retinal fundus images

NASA Astrophysics Data System (ADS)

Mizutani, Atsushi; Muramatsu, Chisako; Hatanaka, Yuji; Suemori, Shinsuke; Hara, Takeshi; Fujita, Hiroshi

2009-02-01

The presence of microaneurysms in the eye is one of the early signs of diabetic retinopathy, which is one of the leading causes of vision loss. We have been investigating a computerized method for the detection of microaneurysms on retinal fundus images, which were obtained from the Retinopathy Online Challenge (ROC) database. The ROC provides 50 training cases, in which "gold standard" locations of microaneurysms are provided, and 50 test cases without the gold standard locations. In this study, the computerized scheme was developed by using the training cases. Although the results for the test cases are also included, this paper mainly discusses the results for the training cases because the "gold standard" for the test cases is not known. After image preprocessing, candidate regions for microaneurysms were detected using a double-ring filter. Any potential false positives located in the regions corresponding to blood vessels were removed by automatic extraction of blood vessels from the images. Twelve image features were determined, and the candidate lesions were classified into microaneurysms or false positives using the rule-based method and an artificial neural network. The true positive fraction of the proposed method was 0.45 at 27 false positives per image. Forty-two percent of microaneurysms in the 50 training cases were considered invisible by the consensus of two co-investigators. When the method was evaluated for visible microaneurysms, the sensitivity for detecting microaneurysms was 65% at 27 false positives per image. Our computerized detection scheme could be improved for helping ophthalmologists in the early diagnosis of diabetic retinopathy.

Two-point derivative dispersion relations

NASA Astrophysics Data System (ADS)

Ferreira, Erasmo; Sesma, Javier

2013-03-01

A new derivation is given for the representation, under certain conditions, of the integral dispersion relations of scattering theory through local forms. The resulting expressions have been obtained through an independent procedure to construct the real part and consist of new mathematical structures of double infinite summations of derivatives. In this new form the derivatives are calculated at the generic value of the energy E and separately at the reference point E = m that is the lower limit of the integration. This new form may be more interesting in certain circumstances and directly shows the origin of the difficulties in convergence that were present in the old truncated forms called standard-derivative dispersion relations (DDR). For all cases in which the reductions of the double to single sums were obtained in our previous work, leading to explicit demonstration of convergence, these new expressions are seen to be identical to the previous ones. We present, as a glossary, the most simplified explicit results for the DDR's in the cases of imaginary amplitudes of forms (E/m)λ[ln (E/m)]n that cover the cases of practical interest in particle physics phenomenology at high energies. We explicitly study the expressions for the cases with λ negative odd integers, that require identification of cancelation of singularities, and provide the corresponding final results.

Homoclinic behaviors and chaotic motions of double layered viscoelastic nanoplates based on nonlocal theory and extended Melnikov method.

PubMed

Wang, Yu; Li, Feng-Ming; Wang, Yi-Ze

2015-06-01

The nonlinear dynamical equations are established for the double layered viscoelastic nanoplates (DLNP) subjected to in-plane excitation based on the nonlocal theory and von Kármán large deformation theory. The extended high dimensional homoclinic Melnikov method is employed to study the homoclinic phenomena and chaotic motions for the parametrically excited DLNP system. The criteria for the homoclinic transverse intersection for both the asynchronous and synchronous buckling cases are proposed. Lyapunov exponents and phase portraits are obtained to verify the Melnikov-type analysis. The influences of structural parameters on the transverse homoclinic orbits and homoclinic bifurcation sets are discussed for the two buckling cases. Some novel phenomena are observed in the investigation. It should be noticed that the nonlocal effect on the homoclinic behaviors and chaotic motions is quite remarkable. Hence, the small scale effect should be taken into account for homoclinic and chaotic analysis for nanostructures. It is significant that the nonlocal effect on the homoclinic phenomena for the asynchronous buckling case is quite different from that for the synchronous buckling case. Moreover, due to the van der Walls interaction between the layers, the nonlocal effect on the homoclinic behaviors and chaotic motions for high order mode is rather tiny under the asynchronous buckling condition.

Ultra-wideband polarization conversion metasurface and its application cases for antenna radiation enhancement and scattering suppression.

PubMed

Zheng, Yuejun; Zhou, Yulong; Gao, Jun; Cao, Xiangyu; Yang, Huanhuan; Li, Sijia; Xu, Liming; Lan, Junxiang; Jidi, Liaori

2017-11-23

A double-layer complementary metasurface (MS) with ultra-wideband polarization conversion is presented. Then, we propose two application cases by applying the polarization conversion structures to aperture coupling patch antenna (ACPA). Due to the existence of air-filled gap of ACPA, air substrate and dielectric substrate are used to construct the double-layer MS. The polarization conversion bandwidth is broadened toward low-frequency range. Subsequently, two application cases of antenna are proposed and investigated. The simultaneous improvement of radiation and scattering performance of antenna is normally considered as a contradiction. Gratifyingly, the contradiction is addressed in these two application cases. According to different mechanism of scattering suppression (i.e., polarization conversion and phase cancellation), the polarization conversion structures are utilized to construct uniform and orthogonal arrangement configurations. And then, the configurations are integrated into ACPA and two different kinds of metasurface-based (MS-based) ACPA are formed. Radiation properties of the two MS-based ACPAs are improved by optimizing the uniform and orthogonal arrangement configurations. The measured results suggest that ultra-wideband polarization conversion properties of the MS are achieved and radiation enhancement and scattering suppression of the two MS-based ACPAs are obtained. These results demonstrate that we provide novel approach to design high-performance polarization conversion MS and MS-based devices.

Can facilitated aid in dying be permitted by 'double effect'? Some reflections from a recent New Zealand case.

PubMed

Gavaghan, Colin; King, Mike

2016-06-01

While the Doctrine of Double Effect (DDE) remains controversial in ethical circles, it continues to be recognised in common law courts. In 2015, the High Court of New Zealand became the latest to acknowledge the existence of the DDE, in a case that challenged the prohibition on physician assisted dying. In so doing, the possibility was raised that the DDE could potentially be used in an untraditional way to provide a prima facie justification of "facilitated aid in dying" (FAID) in some cases.In this article, we develop and offer justification for this line of reasoning. If it can be shown that FAID sometimes satisfies the conditions for DDE, this, we suggest, may have significant implications for the aid in dying debate, not only in New Zealand, but more widely. Even if all of the elements of the DDE are not met in such cases, though, we suggest that one of those elements - the doctor's intent in providing FAID - may not always be such as to attract moral blame or criminal culpability. 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/

Homoclinic behaviors and chaotic motions of double layered viscoelastic nanoplates based on nonlocal theory and extended Melnikov method

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

Wang, Yu; Wang, Yi-Ze; Li, Feng-Ming, E-mail: fmli@bjut.edu.cn

2015-06-15

The nonlinear dynamical equations are established for the double layered viscoelastic nanoplates (DLNP) subjected to in-plane excitation based on the nonlocal theory and von Kármán large deformation theory. The extended high dimensional homoclinic Melnikov method is employed to study the homoclinic phenomena and chaotic motions for the parametrically excited DLNP system. The criteria for the homoclinic transverse intersection for both the asynchronous and synchronous buckling cases are proposed. Lyapunov exponents and phase portraits are obtained to verify the Melnikov-type analysis. The influences of structural parameters on the transverse homoclinic orbits and homoclinic bifurcation sets are discussed for the two bucklingmore » cases. Some novel phenomena are observed in the investigation. It should be noticed that the nonlocal effect on the homoclinic behaviors and chaotic motions is quite remarkable. Hence, the small scale effect should be taken into account for homoclinic and chaotic analysis for nanostructures. It is significant that the nonlocal effect on the homoclinic phenomena for the asynchronous buckling case is quite different from that for the synchronous buckling case. Moreover, due to the van der Walls interaction between the layers, the nonlocal effect on the homoclinic behaviors and chaotic motions for high order mode is rather tiny under the asynchronous buckling condition.« less

The burden of community-acquired pneumonia in the elderly: the Spanish EVAN-65 study.

PubMed

Ochoa-Gondar, Olga; Vila-Córcoles, Angel; de Diego, Cinta; Arija, Victoria; Maxenchs, Monica; Grive, Montserrat; Martin, Enrique; Pinyol, Josep L

2008-06-27

Community-acquired pneumonia (CAP) is generally considered a major cause of morbidity and mortality in the elderly. However, population-based data are very limited and its overall burden is unclear. This study assessed incidence and mortality from CAP among Spanish community-dwelling elderly. Prospective cohort study that included 11,240 individuals aged 65 years or older, who were followed from January 2002 until April 2005. Primary endpoints were all-cause CAP (hospitalised and outpatient) and 30-day mortality after the diagnosis. All cases were radiographically proved and validated by checking clinical records. Incidence rate of overall CAP was 14 cases per 1,000 person-year (95% confidence interval: 12.7 to 15.3). Incidence increased dramatically by age (9.9 in people 65-74 years vs 29.4 in people 85 years or older), and it was almost double in men than in women (19.3 vs 10.1). Hospitalisation rate was 75.1%, with a mean length-stay of 10.4 days. Overall 30-days case-fatality rate was 13% (15% in hospitalised and 2% in outpatient cases). CAP remains as a major health problem in older adults. Incidence rates in this study are comparable with rates described in Northern Europe and America, but they largely doubled prior rates reported in other Southern European regions.

The effect of double nursing, an alternative nursing strategy for the hyper-prolific sow herd, on herd performance.

PubMed

Houben, Manon A M; Tobias, Tijs J; Holstege, Manon M C

2017-01-01

Hyper-prolific sows produce more piglets than they can suckle, as the number of milk producing teats of the sow is lower (twelve to sixteen) than the number of live born piglets per litter. Farmers and farm workers are struggling to feed this surplus of piglets. To minimize suckling piglet mortality, litter size at 24 hours after parturition should not exceed the number of functional teats of the sow. Strategies to adequately nurse or feed the surplus of piglets after 24 hours are limited and mostly restricted to either fostering piglets by other sows, supplying milk replacers (formula) or early weaning and rearing on formula. In this case report we describe the design and application of a so called 'double nursing' strategy, for which one sow simultaneously nurses two litters from birth to weaning. Piglet mortality and reproductive parameters of sows that have nursed two litters are compared, over a three year period, with those that nursed one litter. In this herd, the double nursing strategy appeared to be a successful strategy. Double nursing sows experienced a lower piglet mortality, despite the double nursing strategy. The negative effects on reproduction proved to be limited, there was a negative effect on litter size in subsequent litters, but no significant effect on the interval weaning to next conception. It has to be noted though that not all characteristics on which double nursing selection takes place, could be taken into account during statistical analyses.

Kinematics and design of a class of parallel manipulators

NASA Astrophysics Data System (ADS)

Hertz, Roger Barry

1998-12-01

This dissertation is concerned with the kinematic analysis and design of a class of three degree-of-freedom, spatial parallel manipulators. The class of manipulators is characterized by two platforms, between which are three legs, each possessing a succession of revolute, spherical, and revolute joints. The class is termed the "revolute-spherical-revolute" class of parallel manipulators. Two members of this class are examined. The first mechanism is a double-octahedral variable-geometry truss, and the second is termed a double tripod. The history the mechanisms is explored---the variable-geometry truss dates back to 1984, while predecessors of the double tripod mechanism date back to 1869. This work centers on the displacement analysis of these three-degree-of-freedom mechanisms. Two types of problem are solved: the forward displacement analysis (forward kinematics) and the inverse displacement analysis (inverse kinematics). The kinematic model of the class of mechanism is general in nature. A classification scheme for the revolute-spherical-revolute class of mechanism is introduced, which uses dominant geometric features to group designs into 8 different sub-classes. The forward kinematics problem is discussed: given a set of independently controllable input variables, solve for the relative position and orientation between the two platforms. For the variable-geometry truss, the controllable input variables are assumed to be the linear (prismatic) joints. For the double tripod, the controllable input variables are the three revolute joints adjacent to the base (proximal) platform. Multiple solutions are presented to the forward kinematics problem, indicating that there are many different positions (assemblies) that the manipulator can assume with equivalent inputs. For the double tripod these solutions can be expressed as a 16th degree polynomial in one unknown, while for the variable-geometry truss there exist two 16th degree polynomials, giving rise to 256 solutions. For special cases of the double tripod, the forward kinematics problem is shown to have a closed-form solution. Numerical examples are presented for the solution to the forward kinematics. A double tripod is presented that admits 16 unique and real forward kinematics solutions. Another example for a variable geometry truss is given that possesses 64 real solutions: 8 for each 16th order polynomial. The inverse kinematics problem is also discussed: given the relative position of the hand (end-effector), which is rigidly attached to one platform, solve for the independently controlled joint variables. Iterative solutions are proposed for both the variable-geometry truss and the double tripod. For special cases of both mechanisms, closed-form solutions are given. The practical problems of designing, building, and controlling a double-tripod manipulator are addressed. The resulting manipulator is a first-of-its kind prototype of a tapered (asymmetric) double-tripod manipulator. Real-time forward and inverse kinematics algorithms on an industrial robot controller is presented. The resulting performance of the prototype is impressive, since it was to achieve a maximum tool-tip speed of 4064 mm/s, maximum acceleration of 5 g, and a cycle time of 1.2 seconds for a typical pick-and-place pattern.

Medicaid prospective payment: Case-mix increase

PubMed Central

Baker, Samuel L.; Kronenfeld, Jennie J.

1990-01-01

South Carolina Medicaid implemented prospective payment by diagnosis-related group (DRG) for inpatient care. The rate of complications among newborns and deliveries doubled immediately. The case-mix index for newborns increased 66.6 percent, which increased the total Medicaid hospital expenditure 5.5 percent. Outlier payments increased total expenditure further. DRG distribution change among newborns has a large impact on spending because newborn complication DRGs have high weights. States adopting a DRG-based payment system for Medicaid should anticipate a greater increase in case mix than Medicare experienced. PMID:10113463

Effect of Anharmonicity on the Kondo Phenomena of a Magnetic Ion Vibrating in a Confinement Potential

NASA Astrophysics Data System (ADS)

Yashiki, Satoshi; Ueda, Kazuo

2011-08-01

Effect of anharmonicity of a cage potential for a magnetic ion vibrating in a metal is investigated by the numerical renormalization group method. The cage potential is assumed to be one-dimensional and of the double-well type. In the absence of the Coulomb interaction, we find continuous crossover among the three limiting cases: Yu--Anderson-type Kondo regime, the double-well-type Kondo one, and the renormalized Fermi chain one. In the entire parameter space of the double-well potential, the ground state is described by a local Fermi liquid. In the Yu--Anderson-type Kondo regime, a quantum phase transition to the ground state with odd parity takes place passing through the two-channel Kondo fixed point when the Coulomb interaction increases. Therefore, the vibration of a magnetic ion in an oversized cage structure is a promising route to the two-channel Kondo effect.

Recombination energy in double white dwarf formation

NASA Astrophysics Data System (ADS)

Nandez, J. L. A.; Ivanova, N.; Lombardi, J. C.

2015-06-01

In this Letter, we investigate the role of recombination energy during a common envelope event. We confirm that taking this energy into account helps to avoid the formation of the circumbinary envelope commonly found in previous studies. For the first time, we can model a complete common envelope event, with a clean compact double white dwarf binary system formed at the end. The resulting binary orbit is almost perfectly circular. In addition to considering recombination energy, we also show that between 1/4 and 1/2 of the released orbital energy is taken away by the ejected material. We apply this new method to the case of the double white dwarf system WD 1101+364, and we find that the progenitor system at the start of the common envelope event consisted of an ˜1.5 M⊙ red giant star in an ˜30 d orbit with a white dwarf companion.

HR 7578 - A K dwarf double-lined spectroscopic binary with peculiar abundances

NASA Technical Reports Server (NTRS)

Fekel, F. C., Jr.; Beavers, W. I.

1983-01-01

The number of double-lined K and M dwarf binaries which is currently known is quite small, only a dozen or less of each type. The HR 7578 system was classified as dK5 on the Mount Wilson system and as K2 V on the MK ystem. A summary of radial-velocity measurements including the observatory and weight of each observation is given in a table. The star with the stronger lines has been called component A. The final orbital element solution with all observations appropriately weighted was computed with a differential corrections computer program described by Barker et al. (1967). The program had been modified for the double-lined case. Of particular interest are the very large eccentricity of the system and the large minimum masses for each component. These large minimum masses suggest that eclipses may be detectable despite the relatively long period and small radii of the stars.

On the Accuracy of Double Scattering Approximation for Atmospheric Polarization Computations

NASA Technical Reports Server (NTRS)

Korkin, Sergey V.; Lyapustin, Alexei I.; Marshak, Alexander L.

2011-01-01

Interpretation of multi-angle spectro-polarimetric data in remote sensing of atmospheric aerosols require fast and accurate methods of solving the vector radiative transfer equation (VRTE). The single and double scattering approximations could provide an analytical framework for the inversion algorithms and are relatively fast, however accuracy assessments of these approximations for the aerosol atmospheres in the atmospheric window channels have been missing. This paper provides such analysis for a vertically homogeneous aerosol atmosphere with weak and strong asymmetry of scattering. In both cases, the double scattering approximation gives a high accuracy result (relative error approximately 0.2%) only for the low optical path - 10(sup -2) As the error rapidly grows with optical thickness, a full VRTE solution is required for the practical remote sensing analysis. It is shown that the scattering anisotropy is not important at low optical thicknesses neither for reflected nor for transmitted polarization components of radiation.

Folding control in cyclic peptides through N-methylation pattern selection: formation of antiparallel beta-sheet dimers, double reverse turns and supramolecular helices by 3alpha,gamma cyclic peptides.

PubMed

Amorín, Manuel; Castedo, Luis; Granja, Juan R

2008-01-01

Peptide foldamers constitute a growing class of nanomaterials with potential applications in a wide variety of chemical, medical and technological fields. Here we describe the preparation and structural characteristics of a new class of cyclic peptide foldamers (3alpha,gamma-CPs) that, depending on their backbone N-methylation patterns and the medium, can either remain as flat rings that dimerize through arrays of hydrogen bonds of antiparallel beta-sheet type, or can fold into twisted double reverse turns that, in the case of double gamma-turns, associate in nonpolar solvents to form helical supramolecular structures. A 3alpha,gamma-CP consists of a number of multiples of a repeat unit made up of four amino acid residues of alternating chirality: three corresponding to alpha-amino acids and one to a gamma-amino acid (a cis-3-aminocycloalkanecarboxylic acid).

Double jeopardy: the impact of neoliberalism on care workers in the United States and South Africa.

PubMed

Abramovitz, Mimi; Zelnick, Jennifer

2010-01-01

Many researchers have explored how neoliberal restructuring of the workplace has reduced the standard of living and increased workplace stress among private sector employees. However, few have focused on how neoliberal restructuring of public policy has had similar effects on the public sector workforce. Using original case study research, the authors examine how two iconic pieces of neoliberal policy--the 1996 welfare reform bill in the United States and the GEAR macroeconomic policy in South Africa--affected public/nonprofit human service workers in New York City, United States, and public sector nurses in KwaZulu-Natal, South Africa. The authors argue that in both situations, despite national differences, these policies created a "double jeopardy," in which patients/clients and care workers are adversely affected by neoliberal public policy. This "double jeopardy" creates significant hardship, but also the opportunity for new social movements.

Double stellate tongue reduction: a new method of treatment for macroglossia in patients with Beckwith-wiedemann syndrome.

PubMed

Hettinger, Patrick C; Denny, Arlen D

2011-09-01

Although multiple methods of tongue reduction have been described, recent literature suggests that the central reductions may be more favorable in patients with Beckwith-Wiedemann syndrome (BWS). In this case series, we review our experience with macroglossia associated with BWS, and we offer a new technique of central tongue reduction. Between 1993 and 2007, a retrospective chart review was conducted to include all patients with a diagnosis of BWS who have undergone stellate or double stellate tongue reduction at the Children's Hospital of Wisconsin. A total of 7 patients met all inclusion criteria. All patients had good tongue mobility at 1-year follow-up. One patient required speech therapy for persistent articulation errors postoperatively. A total of 2 patients required secondary procedures for recurrent macroglossia. There were no complaints of abnormal taste or sensation. The stellate and double stellate tongue reductions provide effective treatment in macroglossia associated with BWS.

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

Kundu, Sourav, E-mail: sourav.kundu@saha.ac.in; Karmakar, S. N., E-mail: sachindranath.karmakar@saha.ac.in

We present a tight-binding study of conformation dependent electronic transport properties of DNA double-helix including its helical symmetry. We have studied the changes in the localization properties of DNA as we alter the number of stacked bases within every pitch of the double-helix keeping fixed the total number of nitrogen bases within the DNA molecule. We take three DNA sequences, two of them are periodic and one is random and observe that in all the cases localization length increases as we increase the radius of DNA double-helix i.e., number of nucleobases within a pitch. We have also investigated the effectmore » of backbone energetic on the I-V response of the system and found that in presence of helical symmetry, depending on the interplay of conformal variation and disorder, DNA can be found in either metallic, semiconducting and insulating phases, as observed experimentally.« less

Ozone response to a CO2 doubling - Results from a stratospheric circulation model with heterogeneous chemistry

NASA Technical Reports Server (NTRS)

Pitari, G.; Palermi, S.; Visconti, G.; Prinn, R. G.

1992-01-01

A spectral 3D model of the stratosphere has been used to study the sensitivity of polar ozone with respect to a carbon dioxide increase. The lower stratospheric cooling associated with an imposed CO2 doubling may increase the probability of polar stratospheric cloud (PSC) formation and this affect ozone. The ozone perturbation obtained with the inclusion of a simple parameterization for heterogeneous chemistry on PSCs is compared to that relative to a pure homogeneous chemistry. In both cases the temperature perturbation is determined by a CO2 doubling, while the total chlorine content is kept at the present level. It is shown that the lower temperature may increase the depth and the extension of the ozone hole by extending the area amenable to PSC formation. It may be argued that this effect, coupled with an increasing amount of chlorine, may produce a positive feedback on the ozone destruction.

Fixation of comminuted midshaft clavicle fractures with bone fragments separated by soft tissue using a novel double ligature technique

PubMed Central

Ju, Wei-Na; Wang, Cheng-Xue; Wang, Tie-Jun; Qi, Bao-Chang

2017-01-01

Abstract Rationale: Clavicle fractures are common, and mostly occur in the midshaft. Methods for operative treatment of midshaft clavicle fractures are evolving, as they improve clinical outcomes compared with traditional conservative management. However, fixation of comminuted midshaft clavicle fractures with bone fragments separated by soft tissue remains a challenge. Patient concerns: Here, we present a case of comminuted midshaft clavicle fracture with a bone fragment separated from the main fracture by soft tissue. Diagnosis: Left comminuted midshaft clavicle fracture. Interventions: We treated this patient with a novel double ligature technique using absorbable suturing. Outcomes: In the past 7 years, we have treated >50 patients with this technique. We have achieved good clinical outcomes with no complications. Lessons: We recommend widespread use of our novel double ligature technique for treating comminuted midshaft clavicle fractures with bone fragments separated by soft tissue. PMID:29137088

Hydrodynamics of the double-wave structure of insect spermatozoa flagella

PubMed Central

Pak, On Shun; Spagnolie, Saverio E.; Lauga, Eric

2012-01-01

In addition to conventional planar and helical flagellar waves, insect sperm flagella have also been observed to display a double-wave structure characterized by the presence of two superimposed helical waves. In this paper, we present a hydrodynamic investigation of the locomotion of insect spermatozoa exhibiting the double-wave structure, idealized here as superhelical waves. Resolving the hydrodynamic interactions with a non-local slender body theory, we predict the swimming kinematics of these superhelical swimmers based on experimentally collected geometric and kinematic data. Our consideration provides insight into the relative contributions of the major and minor helical waves to swimming; namely, propulsion is owing primarily to the minor wave, with negligible contribution from the major wave. We also explore the dependence of the propulsion speed on geometric and kinematic parameters, revealing counterintuitive results, particularly for the case when the minor and major helical structures are of opposite chirality. PMID:22298815

Metric of two balancing Kerr particles in physical parametrization

NASA Astrophysics Data System (ADS)

Manko, V. S.; Ruiz, E.

2015-11-01

The present paper aims at elaborating a completely physical representation for the general 4-parameter family of the extended double-Kerr spacetimes describing two spinning sources in gravitational equilibrium. This involved problem is solved in a concise analytical form by using the individual Komar masses and angular momenta as arbitrary parameters, and the simplest equatorially symmetric specialization of the general expressions obtained by us yields the physical representation for the well-known Dietz-Hoenselaers superextreme case of two balancing identical Kerr constituents. The existence of the physically meaningful "black-hole-superextreme-object" equilibrium configurations permitted by the general solution may be considered as a clear indication that the spin-spin repulsion force might actually be by far stronger than expected earlier, when only the balance between two superextreme Kerr sources was thought possible. We also present the explicit analytical formulas relating the equilibrium states in the double-Kerr and double-Reissner-Nordström configurations.

Single Versus Double Ureteral Stent Placement After Laser Endoureterotomy for the Management of Benign Ureteral Strictures: A Randomized Clinical Trial.

PubMed

Ibrahim, Hamdy M; Mohyelden, Khaled; Abdel-Bary, Ahmed; Al-Kandari, Ahmed M

2015-10-01

Endoureterotomy is a viable option for treating patients with benign ureteral stricture. We compared the efficacy and safety of double versus single ureteral stent placement after laser endoureterotomy. This study included 55 patients with benign ureteral strictures; all patients underwent retrograde laser endoureterotomy. Patients were randomized either to single or double ureteral stents. Single stents were placed in 27 ureters while double stents were placed in 28 ureters. The stent diameter used was 7 F, and stents were indwelling for 8 weeks. Imaging was performed 1 month after stent removal and repeated regularly every 3 months. Clinical characteristics, operative results, and functional outcomes were compared for strictures managed in both groups. Success was evaluated both subjectively and objectively. Fifty-five patients with a mean age of 46 (16-75) years had benign ureteral strictures; the mean stricture length was 1.92 (1-3) cm. The mean follow-up was 25.7 (9-42) months. The overall success rate was 67.3% (37 patients) with no radiologic evidence of obstruction, 6 (10.9%) patients showed symptomatic improvement while 12 (21.8%) patients underwent surgical reconstruction. Success was significantly higher for ureteral strictures (>1.5 cm) managed with double stent placement (82.4%), compared with single stent placement (38.9%) with a P value of 0.009. Double stent placement of the ureter after laser endoureterotomy achieved a higher success rate compared with single stent placement in cases of benign ureteral strictures. Although ureteral strictures (≤1.5 cm) achieved better outcome after laser endoureterotomy, strictures (>1.5 cm) favored better with double stent versus single stent placement.

The Double Opposing Z-Plasty Plus or Minus Buccal Flap Approach for Repair of Cleft Palate: A Review of 505 Consecutive Cases.

PubMed

Mann, Robert J; Martin, Matthew D; Eichhorn, Mitchell G; Neaman, Keith C; Sierzant, Charles G; Polley, John W; Girotto, John A

2017-03-01

Standard methods of cleft palate repair rely on existing palatal tissue to achieve closure. These procedures often require relaxing incisions, causing scars and growth restriction, and may result in insufficient palatal length and suboptimal positioning of the velar musculature. The Furlow double opposing Z-plasty improves palatal length and repositions the velar musculature; however, relaxing incisions may still be needed. The addition of buccal flaps to the Furlow repair obviates the need for relaxing incisions and allows the Furlow repair to be used in wide clefts. A retrospective review was performed on 505 patients; all patients were treated with the double opposing Z-plasty plus or minus buccal flap approach. Outcomes included nasal resonance, secondary speech surgery, and postoperative complications. A comparison was made between patients treated with double opposing Z-plasty alone and those treated with double opposing Z-plasty plus buccal flaps. The average nasal resonance score was 1.38 and was equivalent in both the double opposing Z-plasty alone and with buccal flap groups, despite significantly more wide clefts in the buccal flap group (56 percent versus 8 percent). The secondary surgery rate for velopharyngeal insufficiency was 6.6 percent and the fistula rate was 6.1 percent. The large fistula rate (>2 mm) was 2.7 percent. The double opposing Z-plasty plus or minus buccal flap approach is a useful alternative to standard palate repairs. Speech outcomes were excellent, even in wider clefts, and postoperative complications were minimal. Buccal flaps allow the benefits of the Furlow repair to be applied to any size cleft, without the need for relaxing incisions. Therapeutic, III.

An efficient algorithm for double-difference tomography and location in heterogeneous media, with an application to the Kilauea volcano

USGS Publications Warehouse

Monteiller, V.; Got, J.-L.; Virieux, J.; Okubo, P.

2005-01-01

Improving our understanding of crustal processes requires a better knowledge of the geometry and the position of geological bodies. In this study we have designed a method based upon double-difference relocation and tomography to image, as accurately as possible, a heterogeneous medium containing seismogenic objects. Our approach consisted not only of incorporating double difference in tomography but also partly in revisiting tomographic schemes for choosing accurate and stable numerical strategies, adapted to the use of cross-spectral time delays. We used a finite difference solution to the eikonal equation for travel time computation and a Tarantola-Valette approach for both the classical and double-difference three-dimensional tomographic inversion to find accurate earthquake locations and seismic velocity estimates. We estimated efficiently the square root of the inverse model's covariance matrix in the case of a Gaussian correlation function. It allows the use of correlation length and a priori model variance criteria to determine the optimal solution. Double-difference relocation of similar earthquakes is performed in the optimal velocity model, making absolute and relative locations less biased by the velocity model. Double-difference tomography is achieved by using high-accuracy time delay measurements. These algorithms have been applied to earthquake data recorded in the vicinity of Kilauea and Mauna Loa volcanoes for imaging the volcanic structures. Stable and detailed velocity models are obtained: the regional tomography unambiguously highlights the structure of the island of Hawaii and the double-difference tomography shows a detailed image of the southern Kilauea caldera-upper east rift zone magmatic complex. Copyright 2005 by the American Geophysical Union.

Double-inversion mechanisms of the X⁻ + CH₃Y [X,Y = F, Cl, Br, I] SN2 reactions.

PubMed

Szabó, István; Czakó, Gábor

2015-03-26

The double-inversion and front-side attack transition states as well as the proton-abstraction channels of the X(-) + CH3Y [X,Y = F, Cl, Br, I] reactions are characterized by the explicitly correlated CCSD(T)-F12b/aug-cc-pVTZ(-PP) level of theory using small-core relativistic effective core potentials and the corresponding aug-cc-pVTZ-PP bases for Br and I. In the X = F case the double-inversion classical(adiabatic) barrier heights are 28.7(25.6), 15.8(13.4), 13.2(11.0), and 8.6(6.6) kcal mol(-1) for Y = F, Cl, Br, and I, respectively, whereas the barrier heights are in the 40-90 kcal mol(-1) range for the other 12 reactions. The abstraction channels are always above the double-inversion saddle points. For X = F, the front-side attack classical(adiabatic) barrier heights, 45.8(44.8), 31.0(30.3), 24.7(24.2), and 19.5(19.3) kcal mol(-1) for Y = F, Cl, Br, and I, respectively, are higher than the corresponding double-inversion ones, whereas for the other systems the front-side attack saddle points are in the 35-70 kcal mol(-1) range. The double-inversion transition states have XH···CH2Y(-) structures with Cs point-group symmetry, and the front-side attack saddle points have either Cs (X = F or X = Y) or C1 symmetry with XCY angles in the 78-88° range. On the basis of the previous reaction dynamics simulations and the minimum energy path computations along the inversion coordinate of selected XH···CH2Y(-) systems, we suggest that the double inversion may be a general mechanism for SN2 reactions.

EBV-associated but HHV8-unrelated double-hit effusion-based lymphoma.

PubMed

Chen, Bo-Jung; Chen, David Yen-Ting; Kuo, Chun-Chi; Chuang, Shih-Sung

2017-03-01

Effusion-based lymphoma is a rare and unique type of large B-cell lymphoma presenting in effusion without a mass lesion. It shares many clinicopathological features with primary effusion lymphoma (PEL), but is distinct from PEL by the absence of HHV8 association. Double hit lymphoma (DHL) is an aggressive B-cell lymphoma, defined by concurrent rearrangement of MYC and BCL2 or BCL6. DHL often presents as lymphadenopathy or an extranodal mass, but rarely occurs in effusion. Here we report a 61-year-old male with alcoholic cirrhosis presenting as massive ascites and left pleural effusion. He has no HIV, HBV or HCV infection and no mass lesion by CT scans. Cytology of both pleural effusion and ascites show large lymphoma cells with plasmablastic morphology characterized by pleomorphic and eccentric nuclei, prominent nucleoli and frequent mitoses. Immunohistochemical study with cell block shows that the lymphoma cells express plasma cell-related markers (CD138, MUM-1 and EMA), but not CD3, CD30, CD45, B-cell markers (CD19, CD20, CD79a, and PAX5), HHV8, ALK or cytokeratin. EBER is positive in most lymphoma cells. Fluorescence in situ hybridization reveals rearrangement at the IGH, BCL2, and MYC loci, but not at BCL6. It is diagnosed as an EBV-associated but HHV8-unrelated double hit effusion-based lymphoma with plasmablastic features. The patient passed away soon after diagnosis without chemotherapy. This is the first reported case of double-hit effusion-based lymphoma with MYC and BCL2 rearrangement. This case illustrates the importance of integrating clinical, cytological, immunophenotypical, and molecular findings to reach a correct diagnosis. Diagn. Cytopathol. 2017;45:257-261. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A double-helix and cross-patterned solenoid used as a wirelessly powered receiver for medical implants

NASA Astrophysics Data System (ADS)

Mao, Shitong; Wang, Hao; Mao, Zhi-Hong; Sun, Mingui

2018-05-01

Many medical implants need to be designed in the shape of a cylinder (rod), a cuboid or a capsule in order to adapt to a specific site within the human body or facilitate the implantation procedure. In order to wirelessly power these types of implants, a pair of coils, one is located inside the human body and one is outside, is often used. Since most organs such as major muscles, blood vessels, and nerve bundles are anatomically parallel to the body surface, the most desired wireless power transfer (WPT) direction is from the external power transmission pad (a planar coil) to the lateral surface of the implant. However, to obtain optimal coupling, the currently used solenoid coil requires being positioned perpendicular to the body surface, which is often medically or anatomically unacceptable. In this research, a concentric double-helix (DH) coil with an air core is presented for use in implantable devices. Two helical coils are tilted at opposite angles (±45 degrees) to form a cross pattern. The WPT system is designed using the magnetic resonance concept for wireless power transfer (MR-WPT). The power transfer efficiency (PTE) relies on the near-field magnetic coupling which is closely related to the location and orientation of the DH coil. We explain how the novel structure of the DH solenoid magnifies the mutual inductance with the widely adopted circular planner coil and how the PTE is improved in comparison to the case of the conventional solenoid coil. We also study an important case where the double-helix power reception coil is laterally and angularly misaligned with the transmitter. Finally, our computational study using the finite element method and experimental study with actually constructed prototypes are presented which have proven our new double-helix coil design.

[Double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament at stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V].

PubMed

Hu, Wen-yue; Yu, Chong; Huang, Zhong-ming; Han, Lei

2015-06-01

To explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V . From January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects. All patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up. Double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Transverse correlations in triphoton entanglement: Geometrical and physical optics

NASA Astrophysics Data System (ADS)

Wen, Jianming; Xu, P.; Rubin, Morton H.; Shih, Yanhua

2007-08-01

The transverse correlation of triphoton entanglement generated within a single crystal is analyzed. Among many interesting features of the transverse correlation, they arise from the spectral function F of the triphoton state produced in the parametric processes. One consequence of transverse effects of entangled states is quantum imaging, which is theoretically studied in photon counting measurements. Klyshko’s two-photon advanced-wave picture is found to be applicable to the multiphoton entanglement with some modifications. We found that in the two-photon coincidence counting measurement by using triphoton entanglement, although the Gaussian thin lens equation (GTLE) holds, the imaging shown in coincidences is obscure and has a poor quality. This is because of tracing the remaining transverse modes in the untouched beam. In the triphoton imaging experiments, two kinds of cases have been examined. For the case that only one object with one thin lens is placed in the system, we found that the GTLE holds as expected in the triphoton coincidences and the effective distance between the lens and imaging plane is the parallel combination of two distances between the lens and two detectors weighted by wavelengths, which behaves as the parallel combination of resistors in the electromagnetism theory. Only in this case, a point-point correspondence for forming an image is well-accomplished. However, when two objects or two lenses are inserted in the system, though the GTLEs are well-satisfied, in general a point-point correspondence for imaging cannot be established. Under certain conditions, two blurred images may be observed in the coincidence counts. We have also studied the ghost interference-diffraction experiments by using double slits as apertures in triphoton entanglement. It was found that when two double slits are used in two optical beams, the interference-diffraction patterns show unusual features compared with the two-photon case. This unusual behavior is a destructive interference between two amplitudes for two photons crossing two double slits.

Arrhythmias after transcatheter closure of perimembranous ventricular septal defects with a modified double-disk occluder: early and long-term results.

PubMed

Li, Pan; Zhao, Xian-xian; Zheng, Xing; Qin, Yong-wen

2012-07-01

With the development of interventional techniques and devices, transcatheter closure of perimembranous ventricular septal defect has been widely performed. However, there has been a lack of long-term follow-up results about postoperative ECG changes of PmVSD patients. We report our experience of early and late arrhythmias after transcatheter closure of PmVSD with a modified double-disk occluder (MDVO). We performed a retrospective review of 79 patients (47 males, 32 females) between September 2002 and May 2007 who underwent transcatheter closure of perimembranous ventricular septal defect. Symmetric and asymmetric PmVSD occluders were used. The diameter of the evaluated defects ranged from 3 to 12 mm, as measured by TTE and 3 to 15 mm by left ventriculography. Most cases of PmVSD were treated successfully with a single procedure, resulting in a successful closure rate of 97% (77/79 patients). There was no death in any of the patients. After the operation, 79 patients were followed-up for a range of 10-76 months (35.3 ± 17.4 months). In this series, 11 cases of incomplete right bundle branch block and five cases of complete right bundle branch block occurred during the early period after operation. During long-term follow-up, these issues declined in prevalence to five and four cases, respectively. Moreover, reversible third-degree AVB occurred during closure or after the procedure, and two of the three patients with reversible AVB received a temporary heart pacemaker implantation. These patients recovered 1 h, 6 days, and 9 days later, respectively. During 10-76 months of follow-up, no complications occurred in any of the patients, including residual shunt, severe aortic valve, or tricuspid valve regurgitation. Device closure of perimembranous ventricular septal defects with a modified double-disk occluder (MDVO) resulted in excellent closure rates and acceptably low arrhythmia rates.

Semitendinosus Tendon Transfer Associated With Distal Alignment for Patella Alta in a Patient With Recurrent Dislocations.

PubMed

Calderazzi, Filippo; Pellegrini, Andrea; Coviello, Gianluca; Groppi, Giulia; Ceccarelli, Francesco

2015-10-01

Patellofemoral instability is characterized by pain during normal daily activities and frequent dislocation events. In the reported case, an adolescent girl, aged 15 years, affected by left patellofemoral instability, underwent surgery with a double technique comprising tibial tubercle distalization and medial patellofemoral ligament reconstruction. In case of patella alta associated with patellofemoral instability, surgical treatment should focus on medial patellofemoral ligament repair and on recurrent instability prevention.

[Usher syndrome: about a case].

PubMed

Daoudi, Chama; Boutimzine, Noureddine; Haouzi, Samia El; Lezrek, Omar; Tachfouti, Samira; Lezrek, Mounir; Laghmari, Mina; Daoudi, Rajae

2017-01-01

Usher syndrome is a genetic disease resulting in double sensory deprivation (auditory and visual) called deafblindness. We report the case of a 50-year old patient, born to consanguineous parents, presenting with congenital deafness associated with normal vestibular function and pigmentary retinopathy responsible for decreased bilateral visual acuity occurred at the age of 16 years. This association composes Usher syndrome type 2, a rare autosomal recessive disorder. Cataract surgery allowed visual acuity improvement in this patient.

Anemia in patient with primary hyperoxaluria and bone marrow involvement by oxalate crystals.

PubMed

Mykytiv, Vitaliy; Campoy Garcia, Fiz

2018-06-01

We present a rare case of anaemia secondary to bone marrow infiltration by oxalate crystals and renal failure in a patient diagnosed with primary hyperoxaluria. In our case, the anaemia was recovered after the double liver and kidney transplantation, the latter was performed on two occasions after the failure of the first graft. Copyright © 2017 King Faisal Specialist Hospital & Research Centre. Published by Elsevier Ltd. All rights reserved.

Incidence of double ovulation during the early postpartum period in lactating dairy cows.

PubMed

Kusaka, Hiromi; Miura, Hiroshi; Kikuchi, Motohiro; Sakaguchi, Minoru

2017-03-15

In lactating cattle, the incidence of twin calving has many negative impacts on production and reproduction in dairy farming. In almost all cases, natural twinning in dairy cattle is the result of double ovulation. It has been suggested that the milk production level of cows influences the number of ovulatory follicles. The objective of the present study was to investigate the incidence of double ovulations during the early postpartum period in relation to the productive and reproductive performance of dairy cows. The ovaries of 43 Holstein cows (26 primiparous and 17 multiparous) were ultrasonographically scanned throughout the three postpartum ovulation sequences. The incidence of double ovulation in the unilateral ovaries was 66.7%, with a higher incidence in the right ovary than in the left, whereas that in bilateral ovaries was 33.3%. When double ovulations were counted dividing into each side ovary in which ovulations occurred, the total frequency of ovulations deviated from a 1:1 ratio (60.3% in the right side and 39.7% in the left side, P < 0.05). In multiparous cows, double ovulation occurred more frequently than in primiparous cows (58.8% vs. 11.5% per cow and 30.0% vs. 3.8% per ovulation, respectively P < 0.01). The double ovulators experienced more anovulatory repeated waves of follicles before their first ovulations than the single ovulators, which resulted in an extension of the period from parturition to third ovulation (81.5 days vs. 64.2 days, P < 0.05). In the multiparous cows, the double ovulators exhibited higher peak milk yield (P < 0.01) with lower milk lactose concentration (P < 0.05), indicating the prevalence of a more severe negative energy balance during the postpartum 3-month compared to the multiparous single ovulators. Our results showed that, regardless of their parity, double ovulation had no impact on the reproductive performance of the cows. Two multiparous cows that experienced double ovulation during the early postpartum period subsequently conceived twin fetuses. It can be speculated that the incidence of double ovulations during the early postpartum period partly contributes to the increased incidence of undesirable twin births in multiparous dairy cows. Copyright © 2016. Published by Elsevier Inc.

Corpus luteum function following single and double ovulation during estrous cycle in Sanjabi ewes.

PubMed

Shabankareh, H Karami; Habibizad, J; Torki, M

2009-09-01

This study compared the effect of double and single ovulation on serum progesterone concentrations and luteal characteristics in Sanjabi ewes at different days of the estrous cycle. The estrous cycles of 197 Sanjabi ewes were synchronized by a 12-day treatment with intravaginal sponges (Chronogest). Estrus was detected in 144 ewes 27-39 h after sponge removal. Daily blood samples were taken every morning and analyzed for serum progesterone (P4). Ewes were then transported to a local abattoir, where nine ewes were slaughtered on each experimental day (days 1-16 after estrus) for ovary collection. The ovarian follicles were measured and categorized by size (very small <2mm; small 2-3.5mm; medium 3.5-5mm; large >5mm). On each slaughter day, the number of corpora lutea per ewe was classified as single and double ovulation. The results show that the effect of dominant follicles was less during the mid-luteal phase. Ovulation rate of right, left and both ovaries were (54.9%), (23.6%) and (21.5%), respectively. The incidence of double ovulations was 40.2%. In the case of ewes exhibiting double ovulation, 46.6% occurred unilateral (ewes exhibited both ovulations on the right ovary); whereas 53.4% occurred bilateral (ewes exhibited ovulations on the right and left ovaries). Unilateral double ovulation was not observed in the left ovary. The right ovary appeared to play a significantly greater role in ewes showing single and double ovulations than the left ovary (P<0.05). Serum progesterone concentration showed minimum and maximum levels of 0.29+/-0.15 and 5.51+/-0.75 ng/ml on days 16 and 11 post-estrous, respectively (P<0.001). The mean volume of individual corpus lutea in ewes with single ovulations was significantly higher than in ewes with double ovulations (P<0.01). However, the total volume of corpus lutea in ewes with single ovulation was significantly lower than in ewes with double ovulations in some days of estrous cycle (P<0.01). The serum progesterone concentration was significantly higher in double than single ovulating animals on days 1-16 of the estrous cycle (P<0.001). These results indicated a relatively high incidence of double ovulation in ewes associated with increasing total luteal volume and high circulating concentrations of progesterone.

Double bifurcation optimization stent system technique for left main stenosis.

PubMed

Vassilev, D; Mateev, H; Alexandrov, A; Karamfiloff, K; Gil, R J

2014-12-01

We present a first-in-man case with implantation in culottes' fashion of two dedicated coronary bifurcation stents (BiOSS Lim) in distal left main stenosis. The immediate procedural and very short-term result was excellent. © 2014, Wiley Periodicals, Inc.

Simultaneous measurement of position and momentum: Naimark embeddings and projections

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

Levine, R.Y.; Tucci, R.R.

1989-02-01

Single and double meter simultaneous measurements of a harmonic oscillator are reviewed and compared. Naimark extensions are constructed and relevant projection properties are exhibited for both cases. The theory is extended to the simultaneous measurement of squeezed position and momentum measurements.

PubMed Central

Marchand, R.

1993-01-01

Three recent articles are examined in which research using the double-blind randomised clinical trial, the case control study, and the quasi-cohort study is described. Understanding the advantages and disadvantages of these methods makes it easier to grasp the pneumococcal vaccine controversy and make an informed choice. PMID:8499794

Helium in double-detonation models of type Ia supernovae

NASA Astrophysics Data System (ADS)

Boyle, Aoife; Sim, Stuart A.; Hachinger, Stephan; Kerzendorf, Wolfgang

2017-03-01

The double-detonation explosion model has been considered a candidate for explaining astrophysical transients with a wide range of luminosities. In this model, a carbon-oxygen white dwarf star explodes following detonation of a surface layer of helium. One potential signature of this explosion mechanism is the presence of unburned helium in the outer ejecta, left over from the surface helium layer. In this paper we present simple approximations to estimate the optical depths of important He I lines in the ejecta of double-detonation models. We use these approximations to compute synthetic spectra, including the He I lines, for double-detonation models obtained from hydrodynamical explosion simulations. Specifically, we focus on photospheric-phase predictions for the near-infrared 10 830 Å and 2 μm lines of He I. We first consider a double detonation model with a luminosity corresponding roughly to normal SNe Ia. This model has a post-explosion unburned He mass of 0.03 M⊙ and our calculations suggest that the 2 μm feature is expected to be very weak but that the 10 830 Å feature may have modest opacity in the outer ejecta. Consequently, we suggest that a moderate-to-weak He I 10 830 Å feature may be expected to form in double-detonation explosions at epochs around maximum light. However, the high velocities of unburned helium predicted by the model ( 19 000 km s-1) mean that the He I 10 830 Å feature may be confused or blended with the C I 10 690 Å line forming at lower velocities. We also present calculations for the He I 10 830 Å and 2 μm lines for a lower mass (low luminosity) double detonation model, which has a post-explosion He mass of 0.077 M⊙. In this case, both the He I features we consider are strong and can provide a clear observational signature of the double-detonation mechanism.

Wave-optics simulation of the double-pass beam propagation in modulating retro-reflector FSO systems using a corner cube reflector.

PubMed

Yang, Guowei; You, Shengzui; Bi, Meihua; Fan, Bing; Lu, Yang; Zhou, Xuefang; Li, Jing; Geng, Hujun; Wang, Tianshu

2017-09-10

Free-space optical (FSO) communication utilizing a modulating retro-reflector (MRR) is an innovative way to convey information between the traditional optical transceiver and the semi-passive MRR unit that reflects optical signals. The reflected signals experience turbulence-induced fading in the double-pass channel, which is very different from that in the traditional single-pass FSO channel. In this paper, we consider the corner cube reflector (CCR) as the retro-reflective device in the MRR. A general geometrical model of the CCR is established based on the ray tracing method to describe the ray trajectory inside the CCR. This ray tracing model could treat the general case that the optical beam is obliquely incident on the hypotenuse surface of the CCR with the dihedral angle error and surface nonflatness. Then, we integrate this general CCR model into the wave-optics (WO) simulation to construct the double-pass beam propagation simulation. This double-pass simulation contains the forward propagation from the transceiver to the MRR through the atmosphere, the retro-reflection of the CCR, and the backward propagation from the MRR to the transceiver, which can be realized by a single-pass WO simulation, the ray tracing CCR model, and another single-pass WO simulation, respectively. To verify the proposed CCR model and double-pass WO simulation, the effective reflection area, the incremental phase, and the reflected beam spot on the transceiver plane of the CCR are analyzed, and the numerical results are in agreement with the previously published results. Finally, we use the double-pass WO simulation to investigate the double-pass channel in the MRR FSO systems. The histograms of the turbulence-induced fading in the forward and backward channels are obtained from the simulation data and are fitted by gamma-gamma (ΓΓ) distributions. As the two opposite channels are highly correlated, we model the double-pass channel fading by the product of two correlated ΓΓ random variables (RVs).

Double talon cusps on supernumerary tooth fused to maxillary central incisor: Review of literature and report of case

PubMed Central

2014-01-01

Human tooth development is a continuous process begin at the sixth weeks in utero and extends to about sixth months after birth for the primary dentition and from sixteenth week in utero to late adolescence for permanent dentition. There is no other organ of the human body which takes so long to attain its ultimate morphology as dentition. Several physiologic growth processes participate in the progressive development of the teeth including: initiation, proliferation, histodifferentiation, morphodifferentiation, apposition, calcification, and eruption. Aberrations in different stages of tooth development can result in unique manifestations both in primary and permanent dentitions. The fact that premaxilla is the predilection site for the occurrence of supernumerary teeth, talon cusp, dens invaginatus, and geminated teeth may suggest that the embryological development of premaxilla differ from other sites of the jaws. The dental abnormalities presented in this review are of great concern to dentist and parents because they create clinical, pathological and esthetic problems. Dental practitioner should be aware of the clinical sign, associated problems and treatment options for a given case. Key words:Double talon cusps, fusion, supernumerary, case report. PMID:25593664

New telemedicine techniques in dermatology - evaluation with reflectance confocal microscopy via cloud-based platform.

PubMed

Łudzik, Joanna; Witkowski, Alexander Michael; Roterman-Konieczna, Irena

Dermoscopically equivocal skin lesions may present a diagnostic challenge in daily clinical practice and are regularly sent for second expert opinion. We present a new approach to handling these cases in a consultation referral system that enables communication between the initial doctor at the image upload site and dermatology experts at a distance via cloud-based telemedicine. In our study we retrospectively evaluated 100 equivocal cases with complete digital dermoscopy-reflectance confocal microscopy image sets and compared suggested management of the initial doctor to a second expert confocal reader. We evaluated the effect of reader concordance on final management of these lesions resulting in a single reader overall sensitivity of 89% and specificity of 66% and double reader concordance method sensitivity of 98% and specificity of 54%. In conclusion, we found that application of double reader evaluation of these image sets with automatic referral of lesions for removal in the case of discordant diagnosis between two doctors improved the sensitivity of diagnosis in this subset of lesions and may increase the safety threshold of management choice reducing potential misdiagnosis in telemedicine settings. This paper concerns the application of telemedicine in practical medicine.

Online media report on a Hungarian double suicide case: comparison of consecutively published articles.

PubMed

Balázs, Judit; Keresztény, Agnes; Pelbát, Gergely; Sinka, Lea; Szilvás, Fanni; Torzsa, Tímea

2013-09-01

Certain types of news coverage can increase the likelihood of suicide. This study explores, how media covered a suicide case in a country, where there was no available guideline, though it was among the leading countries in suicide statistics. The specific aim was to compare the first and second waves of reporting on suicide from the same website. In 2011, two young women committed double suicide in Budapest, Hungary. We analyzed the first and second waves of the reported articles about this double suicide case, in online daily newspapers, news portals and also the readers' comments. Provocative aspects were present in 38.9-100.0% of the articles, while preventive aspects were found in 0-22.2% of the articles. Readers commented in 49.6% "Other Aspects" (comments about all other aspects not belonging to any other category, i.e. Risk Behavior, Family Relations, Suicide Place and Methods, Prevention, Media Style Reporting) and in 25.4% "Without Content" (comments without a specific content: e.g. chatting), while "Prevention" (comments about possible safety preventive measures) was mentioned only in 1.5% of the comments. In 34.1% the emotional tonality of the comments was "Neutral" (indifferent comments: e.g. chatting). Though articles published for the second time were significantly longer than the firstly published ones, the preventive aspects of reporting were not added to the second articles either, but significantly more provocative aspects were found in them. The suicide reports, both in the first and second waves of reporting, were not in line with the recommendation of the international guidelines on suicide reporting. It draws the attention of professionals to the importance of developing national guidelines on media suicide coverage.

Immediate occlusal loading of double acid-etched surface titanium implants in 41 consecutive full-arch cases in the mandible and maxilla: 6- to 74-month results.

PubMed

Ibañez, Juan C; Tahhan, Marcelo J; Zamar, Juan A; Menendez, Alicia B; Juaneda, Agustina M; Zamar, Nicolas J; Monqaut, Jose L

2005-11-01

The high success rate of dental implants has changed the quality of life for many patients. Immediate loading finds its application in some clinical cases and certainly adds another modality of treatment for the implant patient. Starting with a few implants immediately loaded with a bar overdenture in the mandible, the concept of immediate loading evolved to loading multiple implants in both the maxilla and mandible. In this investigation, 41 consecutive patients who needed full-arch restorations were treated with 343 double acid-etched surface implants between May 1998 and March 2004. The sample included smokers and bruxers. Twenty-three mandibular and 26 maxillary cases were treated, loading the implants within 48 hours, by using resin provisional prostheses, metal-reinforced provisional prostheses, or definitive prostheses (metal-acrylic or metal-ceramic). All implants were followed for 12 to 74 months. Follow-up consisted of clinical as well as radiographic examination. Furthermore, resonance frequency analysis was done in most of the implants during the last 2 years. The success rate obtained was 99.42% (only two mandibular implants that are still surviving were considered failures). The bone level was measured every year. The average radiographic bone level change was 0.56 mm at 12, 0.76 mm at 24, 0.84 mm at 36, 0.82 mm at 48, 0.83 mm at 60, and 0.94 mm at 72 months. A high success rate can be achieved when double acid-etched surface implants are immediately loaded with fixed full-arch restorations in the maxilla and mandible.

Evaluation of the IgE cross-reactions among vespid venoms. A possible approach for the choice of immunotherapy.

PubMed

Caruso, B; Bonadonna, P; Severino, M G; Manfredi, M; Dama, A; Schiappoli, M; Rizzotti, P; Senna, G; Passalacqua, G

2007-05-01

Hymenoptera venom allergy can be effectively cured with specific immunotherapy, thus the correct identification of the allergen is essential. In the case of multiple skin and serum positivities it is important to know if a cross-reaction among venoms is present. We studied by CAP-inhibition assays the degree of cross-reactivity between Vespula vulgaris and Polistes dominulus. Serum samples were obtained from consecutive patients with a clinical history of grade III-IV reactions to hymenoptera sting and with nondiscriminative skin/CAP positivity to both Vespula and Polistes. Inhibition assays were carried out with a CAP method, incubating the sera separately with both venoms and subsequently measuring the specific immunoglobulin E (IgE) to venoms themselves. Forty-five patients (33 male, mean age 40 years, age range 12-74, total serum IgE 242 +/- 168 kU/l) were included. Their specific IgE to Vespula and Polistes were 12.03 +/- 5.70 kU/l and 10.7 +/- 2.0 kU/l (P = NS), respectively. At the CAP-inhibition assays, in 25 patients a >75% heterologous inhibition by P. dominulus venom against V. vulgaris-specific IgE was found. In six subjects V. vulgaris venom effectively inhibited the P. dominulus-specific IgE. In the remaining 14 cases the CAP-inhibition test provided intermediate and not discriminative results. In 31/45 patients, the double sensitizations to venoms were probably the result of cross-reactions and the CAP-inhibition allowed identifying the true double sensitizations. This approach may be helpful for the correct prescription of immunotherapy in the case of V. vulgaris and P. dominulus double positivity.

[Open repair of gluteus medius and minimus tendons tears with double-row technique : Clinical and radiological results].

PubMed

Schröder, J H; Geßlein, M; Schütz, M; Perka, C; Krüger, D

2018-03-01

Operative refixation is a new therapeutic option in cases of failed conservative treatment for trochanteric pain syndrome (TPS) and lesions of the hip abductors in magnetic resonance imaging (MRI). Evaluation of the clinical and radiological results after open gluteus medius and minimus tendon reconstruction with a double-row technique was carried out. Patients with failed conservative treatment for TPS and confirmed lesions of the hip abductors in MRI were treated by open hip abductor tendon reconstruction with a double-row technique. The patients were evaluated preoperatively and postoperatively (minimum follow-up 12 months) using the modified Harris hip score (mHHS) and a subjective score (subjective hip value, SHV). Preoperative and postoperative MRI evaluation included measurement of hip abductor muscle diameter and cross-sectional area as well as fatty degeneration. In this study 12 consecutive cases of open reconstruction of the hip abductor tendons were included. There was a significant improvement in the mHHS. In one case the patient showed an atraumatic rupture in the proximal anchor row. The MRI showed a significant improvement in muscle diameter and cross-sectional area for the gluteus medius muscle of the affected and the contralateral side, while the degree of fatty degeneration did not improve. The fatty degeneration showed a significant correlation with the postoperative results in the mHHS and the SHV. Operative reconstruction of lesions in the hip abductor tendons is a therapy option with significant improvement of patient satisfaction and functional scores as well as muscle diameter and cross-sectional area for the gluteus medius. The degree of fatty degeneration and possible differential diagnoses need to be taken into consideration.

Clinical study of double dose of valsartan combined with tacrolimus in treatment of diabetic nephropathy.

PubMed

Jin, H; Zhang, H-N; Hou, X-L; Zhang, B; Wu, J; Zhang, H-B

2016-01-01

To investigate the clinical effect of double dose of valsartan combined with tacrolimus in the treatment of diabetic nephropathy (DN). HA total of 86 cases diagnosed with DN were selected from October 2013 to October 2014 in Zaozhuang Municipal Hospital, China. The study was approved by our hospital Ethics Committee and written consent was obtained from patients and their family members. Patients were randomly divided into three groups according to the sequence of admission, group A (conventional dose of valsartan group, n = 28 cases), group B (double dose of valsartan group, n = 29 cases) and group C (double dose of valsartan combined with tacrolimus group, n = 29). Clinical effects were compared by analyzing the renal function tests after 8 weeks. 24h urine protein, serum creatinine level of patients in group B and group C were significantly lower than that of group A. Those in group C was much lower. The glomerular filtration rates were significantly higher for group B and C than that of group A, and those in group C were much higher. The difference is statistically significant (p < 0.05). High-sensitivity C-reactive protein (hs CRP) and adiponectin levels of patients in group B and C of were significantly lower than that of group A and those in group C were much lower. The difference is statistically significant (p < 0.05). The high mobility group protein 1 (HMGB1) and renal tubular and interstitial damage index (TDI) of patients in B and C groups were significantly lower than those in the A group, and those in C group were significantly lower. The difference was statistically significant p < 0.05). The clinical effective rates of patients in group B and C were significantly higher than that in group A, and those of group C were much higher. The difference is statistically significant (p < 0.05). The recurrence rates of patients in group B and group C were significantly lower than those of group A and those in group C were much lower. The difference is statistically significant (p < 0.05). Patients in three groups showed no obvious drug complications. Double dose of valsartan combined with tacrolimus treatment of DN patients can improve clinical symptoms, reducing inflammation, inhibiting or even reversing the interstitial fibrosis, which will improve the curative effect and reduce the recurrence, as to provide a new theoretical basis for the clinical treatment of the disease.

Multi-electrode double layer capacitor having single electrolyte seal and aluminum-impregnated carbon cloth electrodes

DOEpatents

Farahmandi, C. J.; Dispennette, J. M.; Blank, E.; Kolb, A. C.

1999-05-25

A single cell, multi-electrode high performance double layer capacitor includes first and second flat stacks of electrodes adapted to be housed in a closeable two-part capacitor case which includes only a single electrolyte seal. Each electrode stack has a plurality of electrodes connected in parallel, with the electrodes of one stack being interleaved with the electrodes of the other stack to form an interleaved stack, and with the electrodes of each stack being electrically connected to respective capacitor terminals. A porous separator sleeve is inserted over the electrodes of one stack before interleaving to prevent electrical shorts between the electrodes. The electrodes are made by folding a compressible, low resistance, aluminum-impregnated carbon cloth, made from activated carbon fibers, around a current collector foil, with a tab of the foils of each electrode of each stack being connected in parallel and connected to the respective capacitor terminal. The height of the interleaved stack is somewhat greater than the inside height of the closed capacitor case, thereby requiring compression of the interleaved electrode stack when placed inside of the case, and thereby maintaining the interleaved electrode stack under modest constant pressure. The closed capacitor case is filled with an electrolytic solution and sealed. A preferred electrolytic solution is made by dissolving an appropriate salt into acetonitrile (CH[sub 3]CN). In one embodiment, the two parts of the capacitor case are conductive and function as the capacitor terminals. 32 figs.

Method of making a multi-electrode double layer capacitor having single electrolyte seal and aluminum-impregnated carbon cloth electrodes

DOEpatents

Farahmandi, C. Joseph; Dispennette, John M.; Blank, Edward; Kolb, Alan C.

2002-09-17

A single cell, multi-electrode high performance double layer capacitor includes first and second flat stacks of electrodes adapted to be housed in a closeable two-part capacitor case which includes only a single electrolyte seal. Each electrode stack has a plurality of electrodes connected in parallel, with the electrodes of one stack being interleaved with the electrodes of the other stack to form an interleaved stack, and with the electrodes of each stack being electrically connected to respective capacitor terminals. A porous separator is positioned against the electrodes of one stack before interleaving to prevent electrical shorts between the electrodes. The electrodes are made by folding a compressible, low resistance, aluminum-impregnated carbon cloth, made from activated carbon fibers, around a current collector foil, with a tab of the foils of each electrode of each stack being connected in parallel and connected to the respective capacitor terminal. The height of the interleaved stack is somewhat greater than the inside height of the closed capacitor case, thereby requiring compression of the interleaved electrode stack when placed inside of the case, and thereby maintaining the interleaved electrode stack under modest constant pressure. The closed capacitor case is filled with an electrolytic solution and sealed. A preferred electrolytic solution is made by dissolving an appropriate salt into acetonitrile (CH.sub.3 CN). In one embodiment, the two parts of the capacitor case are conductive and function as the capacitor terminals.

Multi-electrode double layer capacitor having single electrolyte seal and aluminum-impregnated carbon cloth electrodes

DOEpatents

Farahmandi, C Joseph [San Diego, CA; Dispennette, John M [Oceanside, CA; Blank, Edward [San Diego, CA; Kolb, Alan C [Rancho Santa Fe, CA

1999-05-25

A single cell, multi-electrode high performance double layer capacitor includes first and second flat stacks of electrodes adapted to be housed in a closeable two-part capacitor case which includes only a single electrolyte seal. Each electrode stack has a plurality of electrodes connected in parallel, with the electrodes of one stack being interleaved with the electrodes of the other stack to form an interleaved stack, and with the electrodes of each stack being electrically connected to respective capacitor terminals. A porous separator sleeve is inserted over the electrodes of one stack before interleaving to prevent electrical shorts between the electrodes. The electrodes are made by folding a compressible, low resistance, aluminum-impregnated carbon cloth, made from activated carbon fibers, around a current collector foil, with a tab of the foils of each electrode of each stack being connected in parallel and connected to the respective capacitor terminal. The height of the interleaved stack is somewhat greater than the inside height of the closed capacitor case, thereby requiring compression of the interleaved electrode stack when placed inside of the case, and thereby maintaining the interleaved electrode stack under modest constant pressure. The closed capacitor case is filled with an electrolytic solution and sealed. A preferred electrolytic solution is made by dissolving an appropriate salt into acetonitrile (CH.sub.3 CN). In one embodiment, the two parts of the capacitor case are conductive and function as the capacitor terminals.

Multi-electrode double layer capacitor having single electrolyte seal and aluminum-impregnated carbon cloth electrodes

DOEpatents

Farahmandi, C. Joseph; Dispennette, John M.; Blank, Edward; Kolb, Alan C.

1999-01-19

A single cell, multi-electrode high performance double layer capacitor includes first and second flat stacks of electrodes adapted to be housed in a closeable two-part capacitor case which includes only a single electrolyte seal. Each electrode stack has a plurality of electrodes connected in parallel, with the electrodes of one stack being interleaved with the electrodes of the other stack to form an interleaved stack, and with the electrodes of each stack being electrically connected to respective capacitor terminals. A porous separator sleeve is inserted over the electrodes of one stack before interleaving to prevent electrical shorts between the electrodes. The electrodes are made by folding a compressible, low resistance, aluminum-impregnated carbon cloth, made from activated carbon fibers, around a current collector foil, with a tab of the foils of each electrode of each stack being connected in parallel and connected to the respective capacitor terminal. The height of the interleaved stack is somewhat greater than the inside height of the closed capacitor case, thereby requiring compression of the interleaved electrode stack when placed inside of the case, and thereby maintaining the interleaved electrode stack under modest constant pressure. The closed capacitor case is filled with an electrolytic solution and sealed. A preferred electrolytic solution is made by dissolving an appropriate salt into acetonitrile (CH.sub.3 CN). In one embodiment, the two parts of the capacitor case are conductive and function as the capacitor terminals.

Pre-operative rectal indomethacin for reduction of postoperative nausea and vomiting after laparoscopic cholecystectomy: a double-blind randomized clinical trial.

PubMed

Pazouki, Abdolreza; Cheraghali, Roozbeh; Saeedimotahhar, Hossein; Jesmi, Fatemeh; Jangjoo, Ali; Pishgahroudsari, Mohadeseh

2015-01-01

To evaluate the effect of pre-operative indomethacin suppository on postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. A double blind placebo-controlled randomized clinical trial. Hazrat Rasoul Akram Hospital, Tehran, Iran, from February 2010 to September 2012. One hundred and thirty patients, scheduled for laparoscopic cholecystectomy, were randomly divided into case and control groups. Sixty-five patients received indomethacin suppository and 70 patients received rectal placebo in the case and control groups respectively. All patients underwent the same protocol in laparoscopic surgery and anesthesia, then nausea and vomiting was recorded after 1, 6, 12 and 24 hours postoperatively and compared between the two groups. Independent-sample t test or Mann-Whitney tests were used for statistical analysis. Level of statistical significance was set at P ² 0.05. Patients' nausea was statistically lower in the case group at the 1st hour (43.1 vs. 92.9%), 6th hour (20.0 vs. 68.6%) and 12th hour (7.7 vs. 24.3%) after surgery (for all periods, P < 0.001). Fewer patients in the case group experienced vomiting at the first (13.8 vs. 51.4%) and 6th hour (0 vs. 20%) after surgery (for both P < 0.001). The use of pethidine was also statistically less in the case group in the same hours after surgery (for all of them, P < 0.001). Rectal indomethacin before laparoscopic cholecystectomy led to lower postoperative nausea and vomiting.

Multi-electrode double layer capacitor having single electrolyte seal and aluminum-impregnated carbon cloth electrodes

DOEpatents

Farahmandi, C.J.; Dispennette, J.M.; Blank, E.; Kolb, A.C.

1999-01-19

A single cell, multi-electrode high performance double layer capacitor includes first and second flat stacks of electrodes adapted to be housed in a closeable two-part capacitor case which includes only a single electrolyte seal. Each electrode stack has a plurality of electrodes connected in parallel, with the electrodes of one stack being interleaved with the electrodes of the other stack to form an interleaved stack, and with the electrodes of each stack being electrically connected to respective capacitor terminals. A porous separator sleeve is inserted over the electrodes of one stack before interleaving to prevent electrical shorts between the electrodes. The electrodes are made by folding a compressible, low resistance, aluminum-impregnated carbon cloth, made from activated carbon fibers, around a current collector foil, with a tab of the foils of each electrode of each stack being connected in parallel and connected to the respective capacitor terminal. The height of the interleaved stack is somewhat greater than the inside height of the closed capacitor case, thereby requiring compression of the interleaved electrode stack when placed inside of the case, and thereby maintaining the interleaved electrode stack under modest constant pressure. The closed capacitor case is filled with an electrolytic solution and sealed. A preferred electrolytic solution is made by dissolving an appropriate salt into acetonitrile (CH{sub 3}CN). In one embodiment, the two parts of the capacitor case are conductive and function as the capacitor terminals. 32 figs.

Method of making a multi-electrode double layer capacitor having single electrolyte seal and aluminum-impregnated carbon cloth electrodes

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

Farahmandi, C. Joseph; Dispennette, John M.; Blank, Edward

A method of making a double layer capacitior includes first and second flat stacks of electrodes adapted to be housed in a closeable two-part capacitor case which includes only a single electrolyte seal. Each electrode stack has a plurality of electrodes connected in parallel, with the electrodes of one stack being interleaved with the electrodes of the other stack to form an interleaved stack, and with the electrodes of each stack being electrically connected to respective capacitor terminals. A porous separator is positioned against the electrodes of one stack before interleaving to prevent electrical shorts between the electrodes. The electrodesmore » are made by folding a compressible, low resistance, aluminum-impregnated carbon cloth, made from activated carbon fibers, around a current collector foil, with a tab of the foils of each electrode of each stack being connected in parallel and connected to the respective capacitor terminal. The height of the interleaved stack is somewhat greater than the inside height of the closed capacitor case, thereby requiring compression of the interleaved electrode stack when placed inside of the case, and thereby maintaining the interleaved electrode stack under modest constant pressure. The closed capacitor case is filled with an electrolytic solution and sealed. A preferred electrolytic solution is made by dissolving an appropriate salt into acetonitrile (CH.sub.3 CN). In one embodiment, the two arts of the capacitor case are conductive and function as the capacitor terminals.« less

Semiempirical modeling of Ag nanoclusters: New parameters for optical property studies enable determination of double excitation contributions to plasmonic excitation

DOE PAGES

Gieseking, Rebecca L.; Ratner, Mark A.; Schatz, George C.

2016-06-03

Quantum mechanical studies of Ag nanoclusters have shown that plasmonic behavior can be modeled in terms of excited states where collectivity among single excitations leads to strong absorption. However, new computational approaches are needed to provide understanding of plasmonic excitations beyond the single-excitation level. We show that semiempirical INDO/CI approaches with appropriately selected parameters reproduce the TD-DFT optical spectra of various closed-shell Ag clusters. The plasmon-like states with strong optical absorption comprise linear combinations of many singly excited configurations that contribute additively to the transition dipole moment, whereas all other excited states show significant cancellation among the contributions to themore » transition dipole moment. The computational efficiency of this approach allows us to investigate the role of double excitations at the INDO/SDCI level. The Ag cluster ground states are stabilized by slight mixing with doubly excited configurations, but the plasmonic states generally retain largely singly excited character. The consideration of double excitations in all cases improves the agreement of the INDO/CI absorption spectra with TD-DFT, suggesting that the SDCI calculation effectively captures some of the ground-state correlation implicit in DFT. Furthermore, these results provide the first evidence to support the commonly used assumption that single excitations are in many cases sufficient to describe the optical spectra of plasmonic excitations quantum mechanically.« less

Single and Double ITCZ in Aqua-Planet Models with Globally Uniform Sea Surface Temperature and Solar Insolation: An Interpretation

NASA Technical Reports Server (NTRS)

Chao, Winston C.; Chen, Baode; Einaudi, Franco (Technical Monitor)

2001-01-01

It has been known for more than a decade that an aqua-planet model with globally uniform sea surface temperature and solar insolation angle can generate ITCZ (intertropical convergence zone). Previous studies have shown that the ITCZ under such model settings can be changed between a single ITCZ over the equator and a double ITCZ straddling the equator through one of several measures. These measures include switching to a different cumulus parameterization scheme, changes within the cumulus parameterization scheme, and changes in other aspects of the model design such as horizontal resolution. In this paper an interpretation for these findings is offered. The latitudinal location of the ITCZ is the latitude where the balance of two types of attraction on the ITCZ, both due to earth's rotation, exists. The first type is equator-ward and is directly related to the earth's rotation and thus not sensitive to model design changes. The second type is poleward and is related to the convective circulation and thus is sensitive to model design changes. Due to the shape of the attractors, the balance of the two types of attractions is reached either at the equator or more than 10 degrees away from the equator. The former case results in a single ITCZ over the equator and the latter case a double ITCZ straddling the equator.

MYC protein expression and genetic alterations have prognostic impact in patients with diffuse large B-cell lymphoma treated with immunochemotherapy

PubMed Central

Valera, Alexandra; López-Guillermo, Armando; Cardesa-Salzmann, Teresa; Climent, Fina; González-Barca, Eva; Mercadal, Santiago; Espinosa, Íñigo; Novelli, Silvana; Briones, Javier; Mate, José L.; Salamero, Olga; Sancho, Juan M.; Arenillas, Leonor; Serrano, Sergi; Erill, Nadina; Martínez, Daniel; Castillo, Paola; Rovira, Jordina; Martínez, Antonio; Campo, Elias; Colomo, Luis

2013-01-01

MYC alterations influence the survival of patients with diffuse large B-cell lymphoma. Most studies have focused on MYC translocations but there is little information regarding the impact of numerical alterations and protein expression. We analyzed the genetic alterations and protein expression of MYC, BCL2, BCL6, and MALT1 in 219 cases of diffuse large B-cell lymphoma. MYC rearrangement occurred as the sole abnormality (MYC single-hit) in 3% of cases, MYC and concurrent BCL2 and/or BCL6 rearrangements (MYC double/triple-hit) in 4%, MYC amplifications in 2% and MYC gains in 19%. MYC single-hit, MYC double/triple-hit and MYC amplifications, but not MYC gains or other gene rearrangements, were associated with unfavorable progression-free survival and overall survival. MYC protein expression, evaluated using computerized image analysis, captured the unfavorable prognosis of MYC translocations/amplifications and identified an additional subset of patients without gene alterations but with similar poor prognosis. Patients with tumors expressing both MYC/BCL2 had the worst prognosis, whereas those with double-negative tumors had the best outcome. High MYC expression was associated with shorter overall survival irrespectively of the International Prognostic Index and BCL2 expression. In conclusion, MYC protein expression identifies a subset of diffuse large B-cell lymphoma with very poor prognosis independently of gene alterations and other prognostic parameters. PMID:23716551

MYC protein expression and genetic alterations have prognostic impact in patients with diffuse large B-cell lymphoma treated with immunochemotherapy.

PubMed

Valera, Alexandra; López-Guillermo, Armando; Cardesa-Salzmann, Teresa; Climent, Fina; González-Barca, Eva; Mercadal, Santiago; Espinosa, Iñigo; Novelli, Silvana; Briones, Javier; Mate, José L; Salamero, Olga; Sancho, Juan M; Arenillas, Leonor; Serrano, Sergi; Erill, Nadina; Martínez, Daniel; Castillo, Paola; Rovira, Jordina; Martínez, Antonio; Campo, Elias; Colomo, Luis

2013-10-01

MYC alterations influence the survival of patients with diffuse large B-cell lymphoma. Most studies have focused on MYC translocations but there is little information regarding the impact of numerical alterations and protein expression. We analyzed the genetic alterations and protein expression of MYC, BCL2, BCL6, and MALT1 in 219 cases of diffuse large B-cell lymphoma. MYC rearrangement occurred as the sole abnormality (MYC single-hit) in 3% of cases, MYC and concurrent BCL2 and/or BCL6 rearrangements (MYC double/triple-hit) in 4%, MYC amplifications in 2% and MYC gains in 19%. MYC single-hit, MYC double/triple-hit and MYC amplifications, but not MYC gains or other gene rearrangements, were associated with unfavorable progression-free survival and overall survival. MYC protein expression, evaluated using computerized image analysis, captured the unfavorable prognosis of MYC translocations/amplifications and identified an additional subset of patients without gene alterations but with similar poor prognosis. Patients with tumors expressing both MYC/BCL2 had the worst prognosis, whereas those with double-negative tumors had the best outcome. High MYC expression was associated with shorter overall survival irrespectively of the International Prognostic Index and BCL2 expression. In conclusion, MYC protein expression identifies a subset of diffuse large B-cell lymphoma with very poor prognosis independently of gene alterations and other prognostic parameters.

Convergence of Legendre Expansion of Doppler-Broadened Double Differential Elastic Scattering Cross Section

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

Arbanas, Goran; Dunn, Michael E; Larson, Nancy M

2012-01-01

Convergence properties of Legendre expansion of a Doppler-broadened double-differential elastic neutron scattering cross section of {sup 238}U near the 6.67 eV resonance at temperature 10{sup 3} K are studied. A variance of Legendre expansion from a reference Monte Carlo computation is used as a measure of convergence and is computed for as many as 15 terms in the Legendre expansion. When the outgoing energy equals the incoming energy, it is found that the Legendre expansion converges very slowly. Therefore, a supplementary method of computing many higher-order terms is suggested and employed for this special case.

A unique case of "double-orifice aortic valve"-comprehensive assessment by 2-, 3-dimensional, and color Doppler echocardiography.

PubMed

Stirrup, James E; Cowburn, Peter J; Pousios, Dimitrios; Ohri, Sunil K; Shah, Benoy N

2016-09-01

Transesophageal echocardiography (TEE) is a powerful imaging tool for the comprehensive assessment of valvular structure and function. TEE may be of added benefit when anatomy is difficult to delineate accurately by transthoracic echocardiography. In this article, we present 2-, 3-dimensional, and color Doppler TEE images from a male patient with aortic stenosis. A highly unusual and complex pattern of valvular calcification created a functionally "double-orifice" valve. Such an abnormality may have implications for the accuracy of continuous-wave Doppler echocardiography, which assumes a single orifice valve in native aortic valves. © 2016, Wiley Periodicals, Inc.

[One-stage Operation through the Same Skin Incision for Synchronous Double Primary Breast and Lung Cancer;Report of a Case].

PubMed

Takahashi, Noriyuki; Kuga, Yoko; Uno, Satoko; Saito, Keita

2018-02-01

A 75-year-old woman noticed a small mass in the right side breast and consulted our hospital. The results of the detailed examination indicated the synchronous double primary right breast cancer and the same side lung cancer (rS5). One-stage operation from the same skin incision was scheduled. Volume rendering (VR) of computed tomography (CT)-scan was very useful in deciding the position and the length of the skin incision. The breast tumor resection and the right middle lobe resection were successfully performed through 6.5 cm skin incision.

Search for neutrinoless double beta decay

NASA Astrophysics Data System (ADS)

Ostrovskiy, Igor; O'Sullivan, Kevin

2016-06-01

We review current experimental efforts to search for neutrinoless double beta decay (0νββ). A description of the selected leading experiments is given and the strongest recent results are compared in terms of achieved background indexes (BI) and limits on effective Majorana mass. A combined limit is also shown. The second part of the review covers next generation experiments, highlighting the challenges and new technologies that may be necessary to achieve a justifiable discovery potential. A potential synergy with direct dark matter searches, which could be an especially prudent strategy in case the axial vector coupling constant is quenched in 0νββ decay, is emphasized.

Role of bilateral inferior petrosal sinus sampling (BIPSS) in the diagnosis of Cushing’s disease in a patient with double superior vena cava

PubMed Central

Tashi, Sonam; Ng, Keng Sin

2015-01-01

Cushing’s syndrome is known to have a wide spectrum of clinical presentation with debilitating consequences and morbidity if not diagnosed and treated in time. Sometimes the diagnosis of Cushing’s syndrome can be challenging to the endocrinologist, especially when the usual battery of biochemical tests and advanced cross-sectional imaging is negative or inconclusive. We described a case in which the use of bilateral inferior petrosal sinus sampling (BIPSS) was conclusive albeit being technically challenging (due to a rare incidental finding of double superior vena cava) and invasive in nature. PMID:26629301

Double external jugular vein and other rare venous variations of the head and neck.

PubMed

Shenoy, Varsha; Saraswathi, Perumal; Raghunath, Gunapriya; Karthik, Jayakumar Sai

2012-12-01

Superficial veins of the head and neck are utilised for central venous cannulation, oral reconstruction and parenteral nutrition in debilitated patients. Clinical and sonological examinations of these veins may provide clues toward underlying cardiac pathology. Hence, although variations in these vessels are common, a sound knowledge of such variations becomes clinically important to surgeons, radiologists and interventional anaesthetists. We report a rare case of a left-sided double external jugular vein where the common facial vein continued as the second external jugular vein, and where there was a communicating channel between the internal jugular vein on the same side and the anterior jugular vein.

Analytical performance assessment of orbital configurations

NASA Astrophysics Data System (ADS)

Hitzl, D. L.; Krakowski, D. C.

1981-08-01

The system analysis of an orbital communication network of N satellites has been conducted. Specifically, the problem of connecting, in an optimal way, a set of ground-based laser transmitters to a second set of ground receivers on another part of the earth via a number of relay satellites fitted with retroreflectors has been addressed. A computer program has been developed which can treat either the so-called 'single-bounce' or 'double-bounce' cases. Sample results included in this paper consider a double-bounce orbital network composed of 12 relay satellites in 6 hour elliptical orbits together with 16 transceiver (delivery) satellites in 4.8 hour elliptical orbits.

Prevalence of Atherosclerotic Coronary Stenosis in Asymptomatic North Indian Population: A Post-mortem Coronary Angiography Study.

PubMed

Bansal, Yogender Singh; Mandal, Shatrugan Prasad; Kumar, Senthil; Setia, Puneet

2015-09-01

A preliminary study of coronaries using post-mortem angiography was undertaken to see the prevalence of atherosclerotic coronary stenosis in non-cardiac unnatural deaths. This study was conducted in a tertiary care centre located in Chandigarh. A total of 128 medico-legal cases were studied comprising 88 males and 40 females. Post-mortem examinations of these MLC cases were conducted in the Department of Forensic Medicine, PGIMER, Chandigarh. All hearts were visually screened by post-mortem coronary angiography first and then grossly examined using serial transverse incision technique in positive screening cases to find the degree of narrowing. Of the study group, 34% males and 20% females showed evidence of narrowing on angiography. Of the males showing coronary stenosis, 83% had single vessel disease and 13% had double vessel disease, while only one individual had triple vessel disease. In cases of female, all the cases of coronary stenosis were single vessel disease. Left anterior descending coronary artery (LAD) was the most common vessel involved, followed by right coronary artery (RCA) & Left circumflex artery (LCX) and in cases of double vessel disease, LAD in combination with LCX was responsible for 75% of the cases. Remarkably 23.6% of study population in the age group of less than 40 years showed appreciable narrowing in at least one of the coronaries. In general, the prevalence of CAD is on the rise, particularly in younger population owing to the changes in their lifestyle and food habits. This preliminary study revealed evidence of narrowing of at least one coronary in 34% male and 20% female population and 23.6% subjects were less than 40 years old. Further detailed studies are needed especially in younger age group and to support the need for preventive cardiology in the early years of life.

Double reading.

PubMed

Kopans, D B

2000-07-01

Clearly, the cost of double reading varies with the approach used. The Massachusetts General Hospital method can only lead to an increase in recalls and the costs that these engender (anxiety for the women recalled, trauma from any biopsies obtained, and the actual monetary costs of additional imaging and interventions). It is of interest that one potential cost, the concern that women recalled may be reluctant to participate again in screening, does not seem to be the case. Women who are recalled appear to be more likely to participate in future screening. Double interpretation where there must be a consensus between the interpreting radiologists, and if this cannot be reached a third arbiter, is the most labor intensive, but can reduce the number of recalls in a double reading system. Computer systems have been developed to act as a second reader. The films must be digitized and then fed through the reader, but studies suggest that the computer can identify cancers that may be overlooked by a human reader. The challenge is to do this without too many false-positive calls. If the radiologist finds the false-positives are too numerous and distracting, then the system is not used. As digital mammographic systems proliferate, and computer algorithms become more sophisticated, the second human reader will likely be replaced by a computer-aided detection system and double reading will become the norm.

[Characteristics of Crohn's disease under 
double balloon enteroscopy].

PubMed

Jia, Jia; Liu, Rui; Liu, Xiangjie; Shen, Shourong; Guo, Qin

2018-05-28

To observe ulcer characteristics of Crohn's disease under double balloon enteroscopy, and to evaluate the correlation between endoscopic severity and clinical manifestations.
 Methods: A prospective, observational study from July 2015 to December 2016 in the Third Xiangya Hospital, Central South University, we selected 45 patients with positive double-balloon enteroscopy (DBE) and confirmed Crohn's disease. Two digestive internal physician observed the ulcer characteristics of Crohn's disease under double balloon enteroscopy, and gave a simple endoscopic score for CD (SES-CD). We analyzed the correlation between SES-CD and Crohn's disease activity index (CDAI).
 Results: DBE indicated 24 patient ulcers (53.33%) locating at the end of the ileum, 5 (11.11%) locating at ileocolon, 16 (35.56%) locating at upper gatrointestinal tract and they did not affect the end of the ileum. Among them, 8 cases (17.78%) affected only jejunum. Thirty-two patients with longitudinal ulcers in Crohn's disease, accounting for 71.11%. There was no correlation between SES-CD score and CDAI score (r=0.237, P=0.136).
 Conclusion: The ulcerative appearance in Crohn's disease were diverse under double balloon enteroscopy. Crohn's disease could only affect the upper gastrointestinal tract or jejunum. The unwounded ileum and ileocecal valve couldn't be a sign to exclude Crohn's disease. CDAI score couldn't fully assess the prognosis of Crohn's disease.

Seismic moment tensor for anisotropic media: implication for Non-double-couple earthquakes

NASA Astrophysics Data System (ADS)

Cai, X.; Chen, X.; Chen, Y.; Cai, M.

2008-12-01

It is often found that the inversion results of seismic moment tensor from real seismic recorded data show the trace of seismic moment tensor M is not zero, a phenomenon called non-double-couple earthquake sources mechanism. Recently we have derived the analytical expressions of M in transversely isotropic media with the titled axis of symmetry and the results shows even only pure shear-motion of fault can lead to the implosive components determined by several combined anisotropic elastic constants. Many non-double-couple earthquakes from observations often appear in volcanic and geothermal areas (Julian, 1998), where there exist a mount of stress-aligned fluid-saturated parallel vertical micro-cracks identical to transversely isotropic media (Crampin, 2008), this stress-aligned crack will modify the seismic moment tensor. In another word, non-double-couple earthquakes don't mean to have a seismic failure movement perpendicular to the fault plane, while traditional research of seismic moment tensor focus on the case of isotropy, which cannot provide correct interpretation of seismic source mechanism. Reference: Julian, B.R., Miller, A.D. and Foulger, G.R., 1998. Non-double-couple earthquakes,1. Theory, Rev. Geophys., 36, 525¨C549. Crampin,S., Peacock,S., 2008, A review of the current understanding of seismic shear-wave splitting in the Earth's crust and common fallacies in interpretation, wave motion, 45,675-722

Utility of the Anterior Oblique-Viewing Endoscope and the Double-Balloon Enteroscope for Endoscopic Retrograde Cholangiopancreatography in Patients with Billroth II Gastrectomy

PubMed Central

Sen-yo, Manabu; Kaino, Seiji; Suenaga, Shigeyuki; Uekitani, Toshiyuki; Yoshida, Kanako; Harano, Megumi; Sakaida, Isao

2012-01-01

Background/Purpose. The difficulties of endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy have been reported. We evaluated the usefulness of an anterior oblique-viewing endoscope and a double-balloon enteroscope for endoscopic retrograde cholangiopancreatography in such patients. Methods. From January 2003 to December 2011, 65 patients with Billroth II gastrectomy were enrolled in this study. An anterior oblique-viewing endoscope was used for all patients. From February 2007, a double-balloon enteroscope was used for the failed cases. The success rate of procedures was compared with those in 20 patients with Billroth II gastrectomy using forward-viewing endoscope or side-viewing endoscope from March 1996 to July 2002 as historical controls. Results. In all patients in whom the papilla was reached (60/65), selective cannulation was achieved. The success rate of selective cannulation and accomplishment of planned procedures in the anterior oblique-viewing endoscope group were both significantly higher than that in the control group (100% versus 70.1%, 100 versus 58.8%, resp.). A double-balloon enteroscope was used in 2 patients, and the papilla could be reached and the planned procedures completed. Conclusions. An anterior oblique-viewing endoscope and double-balloon enteroscope appear to be useful in performing endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy. PMID:23056039

Modelling of Lunar Laser Ranging in the Geocentric Frame and Comparison with the Common-View Double-Difference Lunar Laser Ranging Approach

NASA Astrophysics Data System (ADS)

Svehla, D.; Rothacher, M.

2016-12-01

Is it possible to process Lunar Laser Ranging (LLR) measurements in the geocentric frame in a similar way SLR measurements are modelled for GPS satellites and estimate all global reference frame parameters like in the case of GPS? The answer is yes. We managed to process Lunar laser measurements to Apollo and Luna retro-reflectors on the Moon in a similar way we are processing SLR measurements to GPS satellites. We make use of the latest Lunar libration models and DE430 ephemerides given in the Solar system baricentric frame and model uplink and downlink Lunar laser ranges in the geocentric frame as one way measurements, similar to SLR measurements to GPS satellites. In the first part of this contribution we present the estimation of the Lunar orbit as well as the Earth orientation parameters (including UT1 or UT0) with this new formulation. In the second part, we form common-view double-difference LLR measurements between two Lunar retro-reflectors and two LLR telescopes to show the actual noise of the LLR measurements. Since, by forming double-differences of LLR measurements, all range biases are removed and orbit errors are significantly reduced (the Lunar orbit is much farther away than the GPS orbits), one can consider double-difference LLR as an "orbit-free" and "bias-free" differential approach. In the end, we make a comparison with the SLR double-difference approach with Galileo satellites, where we already demonstrated submillimeter precision, and discuss possible combination of LLR and SLR to GNSS satellites using double-difference approach.

Numerical Comparison of Active Acoustic and Structural Noise Control in a Stiffened Double Wall Cylinder

NASA Technical Reports Server (NTRS)

Grosveld, Ferdinand W.

1996-01-01

The active acoustic and structural noise control characteristics of a double wall cylinder with and without ring stiffeners were numerically evaluated. An exterior monopole was assumed to acoustically excite the outside of the double wall cylinder at an acoustic cavity resonance frequency. Structural modal vibration properties of the inner and outer shells were analyzed by post-processing the results from a finite element analysis. A boundary element approach was used to calculate the acoustic cavity response and the coupled structural-acoustic interaction. In the frequency region of interest, below 500 Hz, all structural resonant modes were found to be acoustically slow and the nonresonant modal response to be dominant. Active sound transmission control was achieved by control forces applied to the inner or outer shell, or acoustic control monopoles placed just outside the inner or outer shell. A least mean square technique was used to minimize the interior sound pressures at the nodes of a data recovery mesh. Results showed that single acoustic control monopoles placed just outside the inner or outer shells resulted in better sound transmission control than six distributed point forces applied to either one of the shells. Adding stiffeners to the double wall structure constrained the modal vibrations of the shells, making the double wall stiffer with associated higher modal frequencies. Active noise control obtained for the stiffened double wall configurations was less than for the unstiffened cylinder. In all cases, the acoustic control monopoles controlled the sound transmission into the interior better than the structural control forces.

Contracts.

ERIC Educational Resources Information Center

Gellert, Shepard D.; Wilson, Grace

1977-01-01

This paper reviews experimental psychology goal research and its implications for the therapist doing contract therapy. Clinical examples of various levels of contracts give illustrations, and a technique, the therapeutic double bind, as a form of contract, is detailed. A case study is presented to illustrate the use of the theory. Three…