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Sample records for early concurrent conventional

  1. Liver enzyme abnormalities during concurrent use of herbal and conventional medicines in Korea: a retrospective study.

    PubMed

    Kim, Na-Hee; Jung, Hwan-Yong; Cho, Seung-Yeon; Park, Seong-Uk; Park, Jung-Mi; Ko, Chang-Nam

    2011-11-15

    Concurrent use of herbal medicine (HM) and conventional medicine (CM) is increasing. However, little is known about the prevalence of drug-induced liver injury (DILI) related to this concurrent use. In order to investigate changes in liver enzymes during concurrent use of HM and CM and to assess the prevalence of DILI related to their concurrent use, we screened for liver injury among inpatients at our institution who were administered both HM and CM for at least 14 days while hospitalized between 2006 and 2010. We used the Council for International Organization of Medical Science (CIOMS) laboratory criteria to define liver injury. Of the 892 patients included in the study, 34 (3.81%) had liver injury on admission and 21 (2.35%) had liver injury at discharge. Of the 48 cases that fulfilled the CIOMS laboratory criteria for liver injury, 34 had preexisting liver injury. The remaining 14 were analyzed, and five were concluded to have DILI, resulting in a prevalence of 5/892 (0.56%, with a 95% confidence interval of 0.07-1.05%). Overall, clinical symptoms of liver injury were mild. We thus contend that concurrent use of HM and CM is relatively safe. Copyright © 2011 Elsevier GmbH. All rights reserved.

  2. CAM Use in Pediatric Neurology: An Exploration of Concurrent Use with Conventional Medicine

    PubMed Central

    Galicia-Connolly, Elaine; Adams, Denise; Bateman, Justin; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W. James; Vohra, Sunita

    2014-01-01

    Background Previous studies have found that up to 60% of children with neurologic conditions have tried complementary and alternative medicine (CAM). Objective To assess the use of CAM among patients presenting to neurology clinics at two academic centers in Canada. Methods A survey instrument was developed to inquire about use of CAM products and therapies, including reasons for use, perceived helpfulness, and concurrent use with conventional medicine, and administered to patients or their parents/guardians at the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa. Results Overall CAM use at the Stollery was 78%, compared to 48% at CHEO. The most common CAM products used were multi-vitamins (84%), vitamin C (37%), homeopathic remedies (24%), and fish oil/omega 3 s (22%). The most common CAM practices used were massage (47%), chiropractic (37%), faith healing (18%), aromatherapy (16%), homeopathy (16%), and relaxation (16%). Many patients used CAM products at the same time as conventional medicine but just over half (57%) discussed this concurrent use with their physician. Conclusion CAM use is common in pediatric neurology patients and most respondents felt that it was helpful, with few or no harms associated. However, this use is often undisclosed, increasing possibility of interactions with conventional drugs. We urge clinicians to inquire about CAM use during routine history taking at every patient visit. Parents would clearly like more information about CAM from their specialty clinics; such information would be easier to share if more primary data were available about the safety and effectiveness of commonly used therapies. PMID:24736474

  3. Concurrent Complementary and Alternative Medicine CAM and Conventional Rehabilitation Therapy in the Management of Children with Developmental Disorders

    PubMed Central

    Kim, Soo Yeon; Nam, Sang-Ook; Lee, Chang-Hyung; Shin, Yong Beom; Ko, Hyun-Yoon; Yun, Young-Ju

    2013-01-01

    Background. We investigated the concurrent use of conventional rehabilitations and complementary and alternative medicine (CAM) therapies for the long-term management of children with developmental disorders (DDs). Methods. The parents or caregivers of 533 children with DDs (age range, 1–19 years) who visited the rehabilitation centers were surveyed using in depth face-to-face interviews. Results. Of the 533 patients enrolled, 520 completed the questionnaire (97% response rate). A total of 292 (56%) children were receiving multiple therapies, more than two conventional rehabilitations and CAM, at the time of the interview. A total of 249 (48%) children reported lifetime CAM use, 23% used CAM at the time of the interview, and 62% of the patients planned to use CAM therapy in the future. Conventional rehabilitation therapies used at the time of the interview included physical therapy (30%), speech therapy (28%), and occupational therapy (19%), and the CAM therapies included herbal medicine (5%) and acupuncture or moxibustion (3%). The respondents indicated that in the future they planned to use acupuncture or moxibustion (57%), occupational therapy (18%), cognitive behavioral therapy (16%), speech therapy (10%), and physical therapy (8%). Conclusion. Concurrent management as conventional rehabilitations and CAM therapies is widely used by children with DDs. PMID:24324519

  4. Clinic Function and Computerized Ambulatory Records: A Concurrent Study with Conventional Records

    PubMed Central

    Campbell, James R.; Givner, Nathaniel; Seelig, Charles B.; Patil, Kashinath; Wigton, Robert S.; Tape, Thomas G.

    1988-01-01

    Controlled studies of computerized ambulatory information systems are rare. As part of an evaluation of the effects of COSTAR on clinic function, we divided our resident teaching clinic into a study group with access to COSTAR and a control group allowed access only to conventional medical records. We sampled staff attitudes toward use of the computer and did detailed time studies of clinic patient flow. Staff attitudes reflected a high degree of acceptance, favoring COSTAR over conventional records. This was primarily related to improvement in telephone management and demand care. House staff never became facile users of COSTAR because of infrequent clinic sessions. Clinics assigned to COSTAR experienced somewhat longer waiting times due to an increased workload and training effects. Installation of computerized records should prompt a careful evaluation of expected benefits.

  5. Broad CTL Response in Early HIV Infection Drives Multiple Concurrent CTL Escapes.

    PubMed

    Leviyang, Sivan; Ganusov, Vitaly V

    2015-10-01

    Recent studies have highlighted the ability of HIV to escape from cytotoxic T lymphocyte (CTL) responses that concurrently target multiple viral epitopes. Yet, the viral dynamics involved in such escape are incompletely understood. Previous analyses have made several strong assumptions regarding HIV escape from CTL responses such as independent or non-concurrent escape from individual CTL responses. Using experimental data from evolution of HIV half genomes in four patients we observe concurrent viral escape from multiple CTL responses during early infection (first 100 days of infection), providing confirmation of a recent result found in a study of one HIV-infected patient. We show that current methods of estimating CTL escape rates, based on the assumption of independent escapes, are biased and perform poorly when CTL escape proceeds concurrently at multiple epitopes. We propose a new method for analyzing longitudinal sequence data to estimate the rate of CTL escape across multiple epitopes; this method involves few parameters and performs well in simulation studies. By applying our novel method to experimental data, we find that concurrent multiple escapes occur at rates between 0.03 and 0.4 day(-1), a relatively broad range that reflects uncertainty due to sparse sampling and wide ranges of parameter values. However, we show that concurrent escape at rates 0.1-0.2 day(-1) across multiple epitopes is consistent with our patient datasets.

  6. Concurrent Data Elicitation Procedures, Processes, and the Early Stages of L2 Learning: A Critical Overview

    ERIC Educational Resources Information Center

    Leow, Ronald P.; Grey, Sarah; Marijuan, Silvia; Moorman, Colleen

    2014-01-01

    Given the current methodological interest in eliciting direct data on the cognitive processes L2 learners employ as they interact with L2 data during the early stages of the learning process, this article takes a critical and comparative look at three concurrent data elicitation procedures currently employed in the SLA literature: Think aloud (TA)…

  7. Concurrent Data Elicitation Procedures, Processes, and the Early Stages of L2 Learning: A Critical Overview

    ERIC Educational Resources Information Center

    Leow, Ronald P.; Grey, Sarah; Marijuan, Silvia; Moorman, Colleen

    2014-01-01

    Given the current methodological interest in eliciting direct data on the cognitive processes L2 learners employ as they interact with L2 data during the early stages of the learning process, this article takes a critical and comparative look at three concurrent data elicitation procedures currently employed in the SLA literature: Think aloud (TA)…

  8. Concurrent Cyclophosphamide, Methotrexate, and 5-Fluorouracil Chemotherapy and Radiotherapy for Early Breast Carcinoma

    SciTech Connect

    Livi, Lorenzo Saieva, Calogero; Borghesi, Simona; Paoletti, Lisa; Meattini, Icro; Rampini, Andrea; Petrucci, Alessia; Scoccianti, Silvia; Paiar, Fabiola; Cataliotti, Luigi; Leonulli, Barbara Grilli; Bianchi, Simonetta; Biti, Gian Paolo

    2008-07-01

    Purpose: The optimal sequencing of adjuvant chemotherapy (CT) and radiation therapy (RT) in patients with early-stage breast cancer remains unclear. Patients and Methods: We retrospectively compared 485 patients treated with conservative breast surgery and postoperative whole-breast RT and six courses of CMF (cyclophosphamide 600 mg/m{sup 2}, methotrexate 40 mg/m{sup 2}, and 5-fluorouracil 600 mg/m{sup 2}) with 300 patients who received postoperative CMF only and with 509 patients treated with postoperative whole-breast RT only. The mean radiation dose delivered was 50 Gy (range, 46-52 Gy) with standard fractionation. The boost dose was 6-16 Gy according to resection margins and at the discretion of the radiation oncologist. Acute and late RT toxicity were scored using respectively the Radiation Therapy Oncology Group and the Late Effects in Normal Tissues Subjective, Objective, Management and Analytic scale. Results: A slightly higher Grade 2 acute skin toxicity was recorded in the concurrent group (21.2% vs. 11.2% of the RT only group, p < 0.0001). RT was interrupted more frequently in the CMF/RT group respective to the RT group (8.5% vs. 4.1%; p = 0.006). There was no difference in late toxicity between the two groups. All patients in the concurrent group successfully received the planned dose of RT and CT. Local recurrence rate was 7.6% in CT/RT group and 9.8% in RT group; this difference was not statistically significant at univariate analysis (log-rank test p = 0.98). However, at multivariate analysis adjusted also for pathological tumor, pathological nodes, and age, the CT/RT group showed a statistically lower rate of local recurrence (p = 0.04). Conclusions: Whole-breast RT and concurrent CMF are a safe adjuvant treatment in terms of toxicity.

  9. Concurrent and longitudinal associations of basal and diurnal cortisol with mental health symptoms in early adolescence.

    PubMed

    Shirtcliff, Elizabeth A; Essex, Marilyn J

    2008-11-01

    Recent biosocial theories postulate that both biological risk and the social context influence the development of mental health problems [Boyce and Ellis (2005) Development and Psychopathology, 17(2), 271-301]. Guided by this framework, we examined whether basal cortisol and its diurnal rhythm were associated with mental health symptoms in early adolescence. Because cross-sectional and longitudinal investigations sometimes reveal different cortisol-mental health associations, we examined the association both concurrently and longitudinally when children transition to middle school, a time which entails a major change in social context from single to multiple teachers, classrooms, and sets of classmates. Salivary cortisol was measured three times a day (waking, afternoon, and bedtime) across 3 days when adolescents were 5th graders. Mental health was measured when adolescents were in 5th and 7th grades, just before and after the transition to middle school. To deal with the substantial comorbidity of internalizing and externalizing symptoms at this developmental stage, mental health measures distinguished overall symptom severity from the preponderance of internalizing versus externalizing symptoms (i.e., directionality). A three-level Hierarchical Linear Model was used to extract basal cortisol and its diurnal rhythm separate from the day-to-day and within-the-day fluctuations in cortisol in response to daily experiences. Results were specific to symptom severity, suggesting that cortisol is a nonspecific risk factor for mental health symptoms in young adolescents. At 5th grade, low basal cortisol was associated with concurrent symptom severity. However, longitudinally, it was adolescents with high cortisol at 5th grade who were at risk for increasing mental health symptoms by 7th grade. Flat diurnal rhythms in 5th grade were related to levels of symptom severity at both 5th and 7th grades. Considering the change in social context, as defined by the transition to

  10. Combination of concurrent endoscopic submucosal dissection and modified peroral endoscopic myotomy for an achalasia patient with synchronous early esophageal neoplasms

    PubMed Central

    Shi, Sha; Fu, Kuangi; Dong, Xin-Qian; Hao, Yu-Jing; Li, Sen-Lin

    2017-01-01

    Achalasia is generally accepted as a condition associated with an increased risk for developing esophageal squamous cell carcinoma. In our paper, we introduced an achalasia patient combined with synchronous early esophageal neoplasms. We performed a combination of concurrent endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM). No complications other than postoperative pain that needed morphine treatment for two days had occurred. Dysphagia was significantly improved. Neither reflux nor cough occurred. The short-term efficacy and safety of our case is favorable and suggests that concurrent ESD and POEM could be a treatment option to such patients. PMID:28250904

  11. Early auditory change detection implicitly facilitated by ignored concurrent visual change during a Braille reading task.

    PubMed

    Aoyama, Atsushi; Haruyama, Tomohiro; Kuriki, Shinya

    2013-09-01

    Unconscious monitoring of multimodal stimulus changes enables humans to effectively sense the external environment. Such automatic change detection is thought to be reflected in auditory and visual mismatch negativity (MMN) and mismatch negativity fields (MMFs). These are event-related potentials and magnetic fields, respectively, evoked by deviant stimuli within a sequence of standard stimuli, and both are typically studied during irrelevant visual tasks that cause the stimuli to be ignored. Due to the sensitivity of MMN/MMF to potential effects of explicit attention to vision, however, it is unclear whether multisensory co-occurring changes can purely facilitate early sensory change detection reciprocally across modalities. We adopted a tactile task involving the reading of Braille patterns as a neutral ignore condition, while measuring magnetoencephalographic responses to concurrent audiovisual stimuli that were infrequently deviated either in auditory, visual, or audiovisual dimensions; 1000-Hz standard tones were switched to 1050-Hz deviant tones and/or two-by-two standard check patterns displayed on both sides of visual fields were switched to deviant reversed patterns. The check patterns were set to be faint enough so that the reversals could be easily ignored even during Braille reading. While visual MMFs were virtually undetectable even for visual and audiovisual deviants, significant auditory MMFs were observed for auditory and audiovisual deviants, originating from bilateral supratemporal auditory areas. Notably, auditory MMFs were significantly enhanced for audiovisual deviants from about 100 ms post-stimulus, as compared with the summation responses for auditory and visual deviants or for each of the unisensory deviants recorded in separate sessions. Evidenced by high tactile task performance with unawareness of visual changes, we conclude that Braille reading can successfully suppress explicit attention and that simultaneous multisensory changes can

  12. Early diagnostic of concurrent gear degradation processes progressing under time-varying loads

    NASA Astrophysics Data System (ADS)

    Guilbault, Raynald; Lalonde, Sébastien

    2016-08-01

    This study develops a gear diagnostic procedure for the detection of multi- and concurrent degradation processes evolving under time-varying loads. Instead of a conventional comparison between a descriptor and an alarm level, this procedure bases its detection strategy on a descriptor evolution tracking; a lasting descriptor increase denotes the presence of ongoing degradation mechanisms. The procedure works from time domain residual signals prepared in the frequency domain, and accepts any gear conditions as reference signature. To extract the load fluctuation repercussions, the procedure integrates a scaling factor. The investigation first examines a simplification assuming a linear connection between the load and the dynamic response amplitudes. However, while generally valuable, the precision losses associated with large load variations may mask the contribution of tiny flaws. To better reflect the real non-linear relation, the paper reformulates the scaling factor; a power law with an exponent value of 0.85 produces noticeable improvements of the load effect extraction. To reduce the consequences of remaining oscillations, the procedure also includes a filtering phase. During the validation program, a synthetic wear progression assuming a commensurate relation between the wear depth and friction assured controlled evolutions of the surface degradation influence, whereas the fillet crack growth remained entirely determined by the operation conditions. Globally, the tested conditions attest that the final strategy provides accurate monitoring of coexisting isolated damages and general surface deterioration, and that its tracking-detection capacities are unaffected by severe time variations of external loads. The procedure promptly detects the presence of evolving abnormal phenomena. The tests show that the descriptor curve shapes virtually describe the constant wear progression superimposed on the crack length evolution. At the tooth fracture, the mean values of

  13. Impact of the early detection of esophageal neoplasms in hypopharyngeal cancer patients treated with concurrent chemoradiotherapy.

    PubMed

    Watanabe, Shigenobu; Ogino, Ichiro; Inayama, Yoshiaki; Sugiura, Madoka; Sakuma, Yasunori; Kokawa, Atsushi; Kunisaki, Chikara; Inoue, Tomio

    2017-04-01

    We examined the risk factors and prognostic factors for synchronous esophageal neoplasia (SEN) by comparing the characteristics of hypopharyngeal cancer (HPC) patients with and without SEN. We examined 183 patients who were treated with definitive radiotherapy for HPC. Lugol chromoendoscopy screening of the esophagus was performed in all patients before chemoradiotherapy. Thirty-six patients had SEN, 49 patients died of HPC and two died of esophageal cancer. The patients with SEN exhibited significantly higher alcohol consumption than those without SEN (P = 0.018). The 5-year overall survival (OS) rate of the 36 patients with SEN was lower than that of the other patients (36.2% vs 63.4%, P = 0.006). The SEN patients exhibited significantly shorter HPC cause-specific survival than the other patients (P = 0.039). Both the OS (P = 0.005) and the HPC cause-specific survival (P = 0.026) of the patients with SEN were significantly shorter than those of the patients without SEN in multivariate analysis. Category 4/T1 stage esophageal cancer was treated with concurrent chemoradiotherapy (CCRT), endoscopic treatment or chemotherapy. The 5-year survival rates for esophageal cancer recurrence for CCRT, endoscopic treatment and chemotherapy were 71.5, 43.7 and 0%, respectively. The median (range) survival time (months) of CCRT, endoscopic treatment and chemotherapy was 22.7 (7.5-90.6), 46.44 (17.3-136.7) and 7.98 (3.72-22.8), respectively. Advanced HPC patients with SEN might have a poorer prognosis than those without SEN even when the esophageal cancer is detected early and managed appropriately. © 2014 Wiley Publishing Asia Pty Ltd.

  14. A matter of timing: early, not chronic phase intestinal nematode infection restrains control of a concurrent enteric protozoan infection.

    PubMed

    Rausch, Sebastian; Held, Josephin; Stange, Joerg; Lendner, Matthias; Hepworth, Matthew R; Klotz, Christian; Lucius, Richard; Pogonka, Thomas; Hartmann, Susanne

    2010-10-01

    Infections with parasitic worms are often long lasting and associated with modulated immune responses. We analyzed the influence of the nematode Heligmosomoides polygyrus bakeri dwelling in the small intestine on concurrent protozoan infection with Eimeria falciformis residing in the cecum. To dissect the effects of a nematode infection in the early versus chronic phase, we infected animals with E. falciformis 6 or 28 days post H. p. bakeri infection. Only a concurrent early nematode infection led to an increased replication of the protozoan parasite, whereas a chronic worm infection had no influence on the control of E. falciformis. Increased protozoan replication correlated with the reduced production of IFN-γ, IL-12/23, CCL4, CXCL9 and CXCL10, reduced migration of T cells and increased expression of Foxp3 at the site of protozoan infection. This was accompanied by a stronger nematode-specific Th2 response in gut-draining LN. Protection of mice against challenge infections with the protozoan parasite was not altered. Hence, the detrimental effect of a nematode infection on the control of a concurrent protozoan infection is transient and occurs only in the narrow time window of the early phase of infection.

  15. Accelerated versus conventional radiation fractionation in early stage carcinoma larynx.

    PubMed

    Alam, M S; Perween, R; Siddiqui, S A

    2016-01-01

    In our study, we have treated cases of early glottic carcinoma by two different dose-fractionation schedules in relation to overall treatment time. This is an analysis of 29 patients with invasive, previously untreated T1and T2squamous cell carcinoma of true vocal cord that was treated by radical radiation therapy. All patients were treated with a continuous course of radiation therapy with once-daily fractionation. All the patients were treated 5 days a week from Monday to Friday. The fractionation regime was either: (1) 62.5 Gy/25fractions/5 weeks at 2.5 Gy fractions (Regimen 1), (2) 70 Gy/35 fractions/7 weeks at 2 Gy/fraction (Regimen 2). Regimen 1 included 15/29 patients (51.72%) and Regimen 2 included 14/29 patients (48.27%). Patients were evaluated for: (1) Locoregional control, (2) acute and late radiation toxicities, (3) quality of voice. There was no significant difference in terms of locoregional control rate, acute and late radiation toxicities in both groups. Voice quality during and after radiation was comparable in both arms. Use of high dose per fraction schedule with shorter duration of treatment results in comparable local control as well as the quality of voice to the protracted course of radiotherapy without increase in treatment-related toxicities. Shorter overall treatment time can be of great advantage in terms of time, cost, comfort, and acceptability by the patients.

  16. Concurrent conventionally factionated radiotherapy and weekly docetaxel in the treatment of stage IIIb non-small-cell lung carcinoma

    PubMed Central

    Koukourakis, M I; Bahlitzanakis, N; Froudarakis, M; Giatromanolaki, A; Georgoulias, V; Koumiotaki, S; Christodoulou, M; Kyrias, G; Skarlatos, J; Kostantelos, J; Beroukas, K

    1999-01-01

    Docetaxel has shown remarkable radiosensitizing in vitro properties. In a previous phase I/II dose escalation study in non- small-cell lung cancer (NSCLC) we observed a high response rate after concomitant boost radiotherapy and weekly docetaxel. The maximum tolerated dose was 30 mg m−2 week−1. In the present phase II study we evaluated whether weekly docetaxel and conventionally fractionated radiotherapy could be better tolerated and equally effective in the treatment of locally advanced NSCLC. Thirty-five patients with T3, T4/N2, T3/M0-staged disease were recruited. Docetaxel (30 mg m−2) was given as a 30 min infusion once a week. Asthenia and radiation-induced oesophagitis were the main side-effects of the regimen enforcing 2-week treatment delay in 6/35 (17%) patients and minor delay (3–7 days) in another 11/35 (31%) patients. Neutrophil, platelet and haemoglobin toxicity was minimal, but pronounced lymphocytopenia was observed. Complete response (CR) of the chest disease was observed in 12/35 (34%) patients and partial response in 16/35 (46%). Although not statistically significant (P = 0.19), a higher CR rate (8/18; 44%) was observed in patients who accomplished their therapy within the scheduled treatment time (44–47 days) as compared to patients that interrupted their treatment for several days due to treatment-related toxicity (CR 4/17; 23%). The overall survival and the local progression-free survival at 1 year was 48% and 60% respectively. We conclude that docetaxel combination with radiotherapy is a promising approach for the management of locally advanced NSCLC that results in high CR rate. Further trials with docetaxel-based radiochemotherapy should integrate accelerated radiotherapy together with cytoprotection. © 1999 Cancer Research Campaign PMID:10468298

  17. Long-Term Results of Early Surgery versus Conventional Treatment for Infective Endocarditis Trial.

    PubMed

    Kang, Duk-Hyun; Lee, Sahmin; Kim, Yong-Jin; Kim, Sung-Han; Kim, Dae-Hee; Yun, Sung-Cheol; Song, Jong-Min; Chung, Cheol-Hyun; Song, Jae-Kwan; Lee, Jae-Won

    2016-11-01

    Compared with conventional treatment, early surgery significantly reduced the composite end point of all-cause death and embolic events during hospitalization, but long-term data in this area are lacking. This study sought to compare long-term outcomes of early surgery with a conventional treatment strategy in patients with infective endocarditis (IE) and large vegetations. The Early Surgery versus Conventional Treatment in Infective Endocarditis (EASE) trial randomly assigned patients with left-sided IE, severe valve disease and large vegetation to early surgery (37 patients) or conventional treatment groups (39 patients). The pre-specified end points were all-cause death, embolic events, recurrence of IE and repeat hospitalizations due to the development of congestive heart failure occurring during follow-up. There were no significant differences between the early surgery and the conventional treatment group in all-cause mortality at 4 years (8.1% and 7.7%, respectively; hazard ratio [HR] 1.04; 95% CI, 0.21 to 5.15; p=0.96). The rate of the composite end point of death from any cause, embolic events or recurrence of IE at 4 years was 8.1% in the early surgery group and 30.8% in the conventional treatment group (HR, 0.22; 95% CI, 0.06-0.78; p=0.02). The estimated actuarial rate of end points at 7 years was significantly lower in the early surgery group than in the conventional treatment group (log-rank p=0.007). There was a substantial benefit in having early surgery for patients with IE and large vegetations whose health was sustained up to 7 years, and late clinical outcome after surgery was excellent in survivors of IE. (EASE clinicaltrials.gov identifier: NCT00750373).

  18. Concurrent and Predictive Relations between Hormone Levels and Social-Emotional Functioning in Early Adolescence.

    ERIC Educational Resources Information Center

    Nottelmann, Editha D.; And Others

    Hormone levels and changes in hormone levels were evaluated three times across a 1-year period as concurrent and predictive correlates of the socio-emotional functioning of 56 boys 10- to 14-years-old and 52 girls 9- to 14-years-old who represented the five stages of Tanner's criteria of pubertal development. The hormone measures were serum levels…

  19. Clinical Outcome in Posthysterectomy Cervical Cancer Patients Treated With Concurrent Cisplatin and Intensity-Modulated Pelvic Radiotherapy: Comparison With Conventional Radiotherapy

    SciTech Connect

    Chen, M.-F.; Tseng, C.-J.; Tseng, C.-C.; Kuo, Y.-C.; Yu, C.-Y.; Chen, W.-C. . E-mail: rto_chen@yahoo.com.tw

    2007-04-01

    Purpose: To assess local control and acute and chronic toxicity with intensity-modulated radiation therapy (IMRT) as adjuvant treatment of cervical cancer. Methods and Materials: Between April 2002 and February 2006, 68 patients at high risk of cervical cancer after hysterectomy were treated with adjuvant pelvic radiotherapy and concurrent chemotherapy. Adjuvant chemotherapy consisted of cisplatin (50 mg/m{sup 2}) for six cycles every week. Thirty-three patients received adjuvant radiotherapy by IMRT. Before the IMRT series was initiated, 35 other patients underwent conventional four-field radiotherapy (Box-RT). The two groups did not differ significantly in respect of clinicopathologic and treatment factors. Results: IMRT provided compatible local tumor control compared with Box-RT. The actuarial 1-year locoregional control for patients in the IMRT and Box-RT groups was 93% and 94%, respectively. IMRT was well tolerated, with significant reduction in acute gastrointestinal (GI) and genitourinary (GU) toxicities compared with the Box-RT group (GI 36 vs. 80%, p = 0.00012; GU 30 vs. 60%, p = 0.022). Furthermore, the IMRT group had lower rates of chronic GI and GU toxicities than the Box-RT patients (GI 6 vs. 34%, p = 0.002; GU 9 vs. 23%, p = 0.231). Conclusion: Our results suggest that IMRT significantly improved the tolerance to adjuvant chemoradiotherapy with compatible locoregional control compared with conventional Box-RT. However, longer follow-up and more patients are needed to confirm the benefits of IMRT.

  20. Conventional Tests and Testing for Early Intervention Eligibility: Is There an Evidence Base?

    ERIC Educational Resources Information Center

    Macy, Marisa; Bagnato, Stephen J.; Macy, Robert S.; Salaway, Jen

    2015-01-01

    Conventional tests and testing procedures are used predominately to determine eligibility for early intervention and early childhood special education programs and services. Such traditional tests must have critical attributes to ensure accurate and representative measurements of the capabilities of infants, toddlers, and preschool children who…

  1. The effects of anodal-tDCS on corticospinal excitability enhancement and its after-effects: conventional vs. unihemispheric concurrent dual-site stimulation

    PubMed Central

    Vaseghi, Bita; Zoghi, Maryam; Jaberzadeh, Shapour

    2015-01-01

    Previous researchers have approved the ability of anodal transcranial direct current stimulation (a-tDCS) of the primary motor cortex (M1) to enhance corticospinal excitability (CSE). The primary aim of the current study was to investigate the effect of concurrent stimulation of M1 and a functionally connected cortical site of M1 on CSE modulation. This new technique is called unihemispheric concurrent dual-site a-tDCS (a-tDCSUHCDS). The secondary aim was to investigate the mechanisms underlying the efficacy of this new approach in healthy individuals. In a randomized crossover study, 12 healthy right-handed volunteers received a-tDCS under five conditions: a-tDCS of M1, a-tDCSUHCDS of M1-dorsolateral prefrontal cortex (DLPFC), a-tDCSUHCDS of M1-primary sensory cortex (S1), a-tDCSUHCDS of M1-primary visual cortex (V1), and sham a-tDCSUHCDS. Peak-to-peak amplitude of transcranial magnetic stimulation (TMS) induced MEPs, short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) were assessed before and four times after each condition. A-tDCSUHCDS conditions induced larger MEPs than conventional a-tDCS. The level of M1 CSE was significantly higher following a-tDCSUHCDS of M1-DLPFC than other a-tDCSUHCDS conditions (p < 0.001), and lasted for over 24 h. The paired-pulse TMS results after a-tDCS of M1-DLPFC showed significant facilitatory increase and inhibitory change. A-tDCSUHCDS of M1-DLPFC increases M1 CSE twofold that of conventional a-tDCS. A-tDCSUHCDS of M1-DLPFC enhances the activity of glutamergic mechanisms for at least 24 h. Such long-lasting M1 CSE enhancement induced by a-tDCSUHCDS of M1-DLPFC could be a valuable finding in clinical scenarios such as learning, motor performance, or pain management. The present study has been registered on the Australian New Zealand Clinical Trial at http://www.anzctr.org.au/ with registry number of ACTRN12614000817640. PMID:27242498

  2. Early escharectomy and concurrent composite skin grafting over human acellular dermal matrix scaffold for covering deep facial burns.

    PubMed

    Tang, Bing; Zhu, Bin; Liang, Yue-Ying; Bi, Liang-Kuan; Chen, Bin; Hu, Zhi-Cheng; Zhang, Kai; Zhu, Jia-Yuan

    2011-04-01

    Although escharectomy and full-thickness skin autografting have been widely used to treat deep facial burns, the clinical outcomes remain unacceptable. Composite razor-thin skin grafting over acellular dermal matrix scaffold has been used successfully in repairing burns of the trunk and limbs, but its use in covering deep facial burns has rarely been reported. In this study, the authors investigated the clinical outcomes of early escharectomy and concurrent composite razor-thin skin autografting and acellular dermal matrix scaffold for treating deep facial burns. Patients with deep facial burns (n = 16) involving 8 to 30 percent of the total body surface area received early escharectomy by postburn day 3 and concurrent, one-stage, large, razor-thin skin autografting on top of human acellular dermal matrix scaffold. Wound dressings were changed on postoperative days 7, 9, and 12 to examine the survival of skin autografts. Patients were followed up for 12 months to evaluate their facial profiles. The take rate of composite skin autografts was 97.3 percent at postoperative day 12. At the follow-up visit, the skin autografts appeared normal in color, with soft texture and good elasticity. The skin junctures showed little scarring. The patients exhibited a chubby facial appearance and abundant expression, except for one patient with microstomia and two patients with ectropion who required further plastic surgical interventions. Early escharectomy and concurrent composite razor-thin skin autografting on top of acellular dermal matrix scaffold constitute an effective and favorable option for covering deep facial burns, especially for patients with limited donor sites.

  3. Did the addition of concurrent chemotherapy to conventional radiotherapy improve survival for patients with HPV+ve and HPV-ve Oropharynx cancer? A population-based study.

    PubMed

    Hall, Stephen F; Liu, Fei-Fei; O'Sullivan, Brian; Shi, Willa; Rohland, Susan; Griffiths, Rebecca; Groome, Patti

    2017-10-10

    In the absence of clear evidence on the efficacy of concurrent chemoradiotherapy (CRT) over conventional radiotherapy (RT) for HPV+ve and for HPV-ve oropharyngeal cancer (OPC), this study compares the treatments and outcomes from pre-CRT years to post-CRT years. A population-based retrospective treatment-effectiveness study based on all patients with OPC treated in Ontario Canada in 1998, 1999, 2003 and 2004. Charts were reviewed, tissue samples were requested and tissue was tested for p16 or in situ hybridisation. Overall survival (OS) and disease-specific survival (DSS) were compared by treatment era and by treatment type for all 1028 patients, for 865 treated for cure and for 610 with HPV status. There was no improvement in OS comparing pre-CRT to post-CRT eras for the HPV+ve patients (P=0.147) or for the HPV-ve patients (P=0.362). There was no difference in OS comparing CRT to RT for the HPV+ve cohort (HR=0.948 (0.642-1.400)) or for the HPV-ve patients (HR=1.083 (0.68-1.727)). In these 'real-world' patients what appeared to be improvements in OS with CRT in clinical trials were confounded by HPV status in Ontario. CRT did not improve outcomes for HPV+ve or for HPV-ve patients.

  4. Simultaneous Integrated Boost Using Intensity-Modulated Radiotherapy Compared With Conventional Radiotherapy in Patients Treated With Concurrent Carboplatin and 5-Fluorouracil for Locally Advanced Oropharyngeal Carcinoma

    SciTech Connect

    Clavel, Sebastien; Nguyen, David H.A.; Fortin, Bernard; Despres, Philippe; Khaouam, Nader; Donath, David; Soulieres, Denis; Guertin, Louis; Nguyen-Tan, Phuc Felix

    2012-02-01

    Purpose: To compare, in a retrospective study, the toxicity and efficacy of simultaneous integrated boost using intensity-modulated radiotherapy (IMRT) vs. conventional radiotherapy (CRT) in patients treated with concomitant carboplatin and 5-fluorouracil for locally advanced oropharyngeal cancer. Methods and Materials: Between January 2000 and December 2007, 249 patients were treated with definitive chemoradiation. One hundred patients had 70 Gy in 33 fractions using IMRT, and 149 received CRT at 70 Gy in 35 fractions. Overall survival, disease-free survival, and locoregional control were estimated using the Kaplan-Meier method. Results: Median follow-up was 42 months. Three-year actuarial rates for locoregional control, disease-free survival, and overall survival were 95.1% vs. 84.4% (p = 0.005), 85.3% vs. 69.3% (p = 0.001), and 92.1% vs. 75.2% (p < 0.001) for IMRT and CRT, respectively. The benefit of the radiotherapy regimen on outcomes was also observed with a Cox multivariate analysis. Intensity-modulated radiotherapy was associated with less acute dermatitis and less xerostomia at 6, 12, 24, and 36 months. Conclusions: This study suggests that simultaneous integrated boost using IMRT is associated with favorable locoregional control and survival rates with less xerostomia and acute dermatitis than CRT when both are given concurrently with chemotherapy.

  5. Clinical efficacy of early loading versus conventional loading of dental implants

    PubMed Central

    Zhu, Yanfei; Zheng, Xinyi; Zeng, Guanqi; Xu, Yi; Qu, Xinhua; Zhu, Min; Lu, Eryi

    2015-01-01

    The aim of this study was to determine the clinical differences between early and conventional loading protocols for dental implants. A comprehensive search of the Medline, Embase, and OVID databases for studies published through January 10, 2015 was conducted. Fourteen studies were included in our analysis. We found that early loading imposed a significantly higher risk of implant failure than did conventional loading (risk ratio = 2.09, 95% confidence interval [CI] [1.18, 3.69], P = 0.01), while no significant differences between the methods were found with regards to the marginal bone loss (weighted mean differences [WMD] = 0.11, 95% CI [−0.07, 0.28], P = 0.23), periotest value (WMD = 0.02, 95% CI [−0.83, 0.87], P = 0.96), or implant stability quotient (WMD = 0.79, 95% CI [−0.03, 1.62], P = 0.06). As for the health status of the peri-implant tissue, conventionally loaded implants demonstrated better performance than did early loaded implants. Subgroup analyses demonstrated that the sample size, time of publication, loading definition, implant position, extent, and restoration type influenced the results. Although early implant loading is convenient and comfortable for patients, this method still cannot achieve the same clinical outcomes as the conventional loading method. PMID:26542097

  6. Presence and Quality of Kindergarten Children's Friendships: Concurrent and Longitudinal Associations with Child Adjustment in the Early School Years.

    PubMed

    Engle, Jennifer M; McElwain, Nancy L; Lasky, Nicole

    2011-07-01

    The presence and quality of friendships are posited to have developmental significance, yet little is known about the extent to which children without friends versus low-quality friendships compare on socioemotional adjustment. The current study utilized data from a subsample of 567 children (289 boys) participating in the NICHD Study of Early Child Care and Youth Development. Based on maternal reports at kindergarten, four friendship groups were formed: no friends, low quality, average quality, and high quality, and these groups were used to predict teacher-reported behavior problems and social skills concurrently (in kindergarten) and longitudinally (in first and third grade). Concurrently, low-quality friendships were associated with greater externalizing behavior, whereas high-quality friendships were associated with greater social skills. Longitudinally, having no friends in kindergarten was associated with higher levels of externalizing behavior for boys, but lower levels for girls. Children without friends also showed more internalizing problems at first grade. Lastly, having a high-quality friendship in kindergarten was associated with greater social skills in first and third grades, but only for boys. Results underscore high-quality friendship as a context for the development of social skills and indicate different trajectories of problem behavior for kindergarten children with no friends versus low-quality friendships.

  7. A comparative evaluation of early stent occlusion among biliary conventional versus wing stents.

    PubMed

    Khashab, Mouen A; Hutfless, Susan; Kim, Katherine; Lennon, Anne Marie; Canto, Marcia I; Jagannath, Sanjay B; Okolo, Patrick I; Shin, Eun Ji; Singh, Vikesh K

    2012-06-01

    Conventional plastic stents with a lumen typically have limited patency. The lumenless wing stent was engineered to overcome this problem. The objective of this study was to compare the incidence of early stent occlusion (symptomatic occlusion/cholangitis necessitating re-insertion within 90 days) for wing stents and conventional plastic stents. Patients with biliary pathology treated with plastic biliary stenting during the period 2003-2009 comprised the study cohort. Patients who had at least one biliary wing stent placed comprised the wing stent group, whereas patients who underwent only conventional stent plastic placement comprised the conventional stent group. Patients were stratified by indication: benign biliary strictures (group 1), malignant biliary strictures (group 2), or benign biliary non-stricture pathology (group 3). The association of stent type with the occurrence of primary outcome by indication was analyzed by use of multivariable logistic regression. Three-hundred and forty-six patients underwent 612 ERCP procedures with placement of plastic biliary stent(s). On multivariate analysis, early stent occlusion did not differ between the wing and conventional groups in groups 1, 2, and 3. Among patients who achieved primary outcome in group 2, significantly fewer patients in the wing group had cholangitis (6.7% vs. 39.1%, P = 0.03). Among patients who achieved primary outcome in group 3, significantly fewer patients in the wing group had cholangitis (10% vs. 50%, P = 0.03). Early stent occlusion was similar for wing stents and conventional plastic stents. Wing stents, however, were associated with a lower incidence of cholangitis in patients with malignant biliary obstruction and benign non-stricturing biliary pathology.

  8. Concurrent Validity and Feasibility of Short Tests Currently Used to Measure Early Childhood Development in Large Scale Studies

    PubMed Central

    Rubio-Codina, Marta; Araujo, M. Caridad; Attanasio, Orazio; Muñoz, Pablo; Grantham-McGregor, Sally

    2016-01-01

    In low- and middle-income countries (LIMCs), measuring early childhood development (ECD) with standard tests in large scale surveys and evaluations of interventions is difficult and expensive. Multi-dimensional screeners and single-domain tests (‘short tests’) are frequently used as alternatives. However, their validity in these circumstances is unknown. We examined the feasibility, reliability, and concurrent validity of three multi-dimensional screeners (Ages and Stages Questionnaires (ASQ-3), Denver Developmental Screening Test (Denver-II), Battelle Developmental Inventory screener (BDI-2)) and two single-domain tests (MacArthur-Bates Short-Forms (SFI and SFII), WHO Motor Milestones (WHO-Motor)) in 1,311 children 6–42 months in Bogota, Colombia. The scores were compared with those on the Bayley Scales of Infant and Toddler Development (Bayley-III), taken as the ‘gold standard’. The Bayley-III was given at a center by psychologists; whereas the short tests were administered in the home by interviewers, as in a survey setting. Findings indicated good internal validity of all short tests except the ASQ-3. The BDI-2 took long to administer and was expensive, while the single-domain tests were quickest and cheapest and the Denver-II and ASQ-3 were intermediate. Concurrent validity of the multi-dimensional tests’ cognitive, language, and fine motor scales with the corresponding Bayley-III scale was low below 19 months. However, it increased with age, becoming moderate-to-high over 30 months. In contrast, gross motor scales’ concurrence was high under 19 months and then decreased. Of the single-domain tests, the WHO-Motor had high validity with gross motor under 16 months, and the SFI and SFII expressive scales showed moderate correlations with language under 30 months. Overall, the Denver-II was the most feasible and valid multi-dimensional test and the ASQ-3 performed poorly under 31 months. By domain, gross motor development had the highest concurrence

  9. Simplified spacecraft vulnerability assessments at component level in early design phase at the European Space Agency's Concurrent Design Facility

    NASA Astrophysics Data System (ADS)

    Kempf, Scott; Schäfer, Frank K.; Cardone, Tiziana; Ferreira, Ivo; Gerené, Sam; Destefanis, Roberto; Grassi, Lilith

    2016-12-01

    During recent years, the state-of-the-art risk assessment of the threat posed to spacecraft by micrometeoroids and space debris has been expanded to the analysis of failure modes of internal spacecraft components. This method can now be used to perform risk analyses for satellites to assess various failure levels - from failure of specific sub-systems to catastrophic break-up. This new assessment methodology is based on triple-wall ballistic limit equations (BLEs), specifically the Schäfer-Ryan-Lambert (SRL) BLE, which is applicable for describing failure threshold levels for satellite components following a hypervelocity impact. The methodology is implemented in the form of the software tool Particle Impact Risk and vulnerability Analysis Tool (PIRAT). During a recent European Space Agency (ESA) funded study, the PIRAT functionality was expanded in order to provide an interface to ESA's Concurrent Design Facility (CDF). The additions include a geometry importer and an OCDT (Open Concurrent Design Tool) interface. The new interface provides both the expanded geometrical flexibility, which is provided by external computer aided design (CAD) modelling, and an ease of import of existing data without the need for extensive preparation of the model. The reduced effort required to perform vulnerability analyses makes it feasible for application during early design phase, at which point modifications to satellite design can be undertaken with relatively little extra effort. The integration of PIRAT in the CDF represents the first time that vulnerability analyses can be performed in-session in ESA's CDF and the first time that comprehensive vulnerability studies can be applied cost-effectively in early design phase in general.

  10. Early Clinical Outcome With Concurrent Chemotherapy and Extended-Field, Intensity-Modulated Radiotherapy for Cervical Cancer

    SciTech Connect

    Beriwal, Sushil . E-mail: beriwals@upmc.edu; Gan, Gregory N.; Heron, Dwight E.; Selvaraj, Raj N.; Kim, Hayeon; Lalonde, Ron; Kelley, Joseph L.; Edwards, Robert P.

    2007-05-01

    Purpose: To assess the early clinical outcomes with concurrent cisplatin and extended-field intensity-modulated radiotherapy (EF-IMRT) for carcinoma of the cervix. Methods and Materials: Thirty-six patients with Stage IB2-IVA cervical cancer treated with EF-IMRT were evaluated. The pelvic lymph nodes were involved in 19 patients, and of these 19 patients, 10 also had para-aortic nodal disease. The treatment volume included the cervix, uterus, parametria, presacral space, upper vagina, and pelvic, common iliac, and para-aortic nodes to the superior border of L1. Patients were assessed for acute toxicities according to the National Cancer Institute Common Toxicity Criteria for Adverse Events, version 3.0. All late toxicities were scored with the Radiation Therapy Oncology Group late toxicity score. Results: All patients completed the prescribed course of EF-IMRT. All but 2 patients received brachytherapy. Median length of treatment was 53 days. The median follow-up was 18 months. Acute Grade {>=}3 gastrointestinal, genitourinary, and myelotoxicity were seen in 1, 1, and 10 patients, respectively. Thirty-four patients had complete response to treatment. Of these 34 patients, 11 developed recurrences. The first site of recurrence was in-field in 2 patients (pelvis in 1, pelvis and para-aortic in 1) and distant in 9 patients. The 2-year actuarial locoregional control, disease-free survival, overall survival, and Grade {>=}3 toxicity rates for the entire cohort were 80%, 51%, 65%, and 10%, respectively. Conclusion: Extended-field IMRT with concurrent chemotherapy was tolerated well, with acceptable acute and early late toxicities. The locoregional control rate was good, with distant metastases being the predominant mode of failure. We are continuing to accrue a larger number of patients and longer follow-up data to further extend our initial observations with this approach.

  11. Evaluating Assistive Technology in Early Childhood Education: The Use of a Concurrent Time Series Probe Approach

    ERIC Educational Resources Information Center

    Parette, Howard P.; Blum, Craig; Boeckmann, Nichole M.

    2009-01-01

    As assistive technology applications are increasingly implemented in early childhood settings for children who are at risk or who have disabilities, it is critical that teachers utilize observational approaches to determine whether targeted assistive technology-supported interventions make a difference in children's learning. One structured…

  12. Evaluating Assistive Technology in Early Childhood Education: The Use of a Concurrent Time Series Probe Approach

    ERIC Educational Resources Information Center

    Parette, Howard P.; Blum, Craig; Boeckmann, Nichole M.

    2009-01-01

    As assistive technology applications are increasingly implemented in early childhood settings for children who are at risk or who have disabilities, it is critical that teachers utilize observational approaches to determine whether targeted assistive technology-supported interventions make a difference in children's learning. One structured…

  13. Can CT Virtual Cystoscopy Replace Conventional Cystoscopy in Early Detection of Bladder Cancer?

    PubMed Central

    Abrol, Sachin; Jairath, Ankush; Ganpule, Sanika; Ganpule, Arvind; Mishra, Shashikant; Sabnis, Ravindra; Desai, Mahesh

    2015-01-01

    Aim. To correlate findings of conventional cystoscopy with CT virtual cystoscopy (CTVC) in detecting bladder tumors and to evaluate accuracy of virtual cystoscopy in early detection of bladder cancer. Material and Method. From June 2013 to June 2014, 50 patients (46 males, four females) with history and investigations suggestive of urothelial cancer, with mean age 62.76 ± 10.45 years, underwent CTVC by a radiologist as per protocol and subsequently underwent conventional cystoscopy (CPE) the same day or the next day. One urologist and one radiologist, blinded to the findings of conventional cystoscopy, independently interpreted the images, and any discrepant readings were resolved with consensus. Result. CTVC detected 23 out of 25 patients with bladder tumor(s) correctly. Two patients were falsely detected as negative while two were falsely labeled as positive in CTVC. Virtual and conventional cystoscopy were comparable in detection of tumor growth in urinary bladder. The sensitivity, specificity, positive predictive value, and negative predictive value of virtual cystoscopy were 92% each. Conclusion. CTVC correlates closely with the findings of conventional cystoscopy. Bladder should be adequately distended and devoid of urine at the time of procedure. However, more studies are required to define the role of virtual cystoscopy in routine clinical practice. PMID:26600802

  14. Concurrent early-onset peripartum cardiomyopathy in a preeclampsia patient with acute pulmonary edema.

    PubMed

    Belen, Erdal; Tipi, Fahri Fatih; Helvaci, Aysen; Bayyigit, Akif

    2015-01-01

    We herein report the case of a preeclampsia patient with comorbid peripartum cardiomyopathy (PPCMP). A 22-year-old woman in the 26th week of gestation was admitted with acute pulmonary edema. Hypertension and proteinuria were detected, and echocardiography showed an ejection fraction of 33%. It is remarkable that PPCMP particularly that associated with preeclampsia was observed in the early gestational period. In conclusion, while dyspnea and pretibial edema are often noted during normal pregnancies, the potential for PPCMP should be considered if these symptoms are excessive and/or comorbid paroxysmal nocturnal dyspnea and orthopnea are present, even in patients with preeclampsia.

  15. Early Thiopurines Versus Conventional Step-Care Therapy for Modifying the Disease Course of Early Crohn's Disease

    PubMed Central

    Qiu, Yun; Chen, Bai-Li; Mao, Ren; Zhang, Sheng-Hong; He, Yao; Zeng, Zhi-Rong; Chen, Min-Hu

    2015-01-01

    Abstract The impact of thiopurines (TP) on the long-term outcome of early Crohn disease (CD) is still controversial. The present study designed as a comparison of conventional step-care to alternative treatment paradigms for disease progression. This longitudinal cohort study examined the established CD patients from a university-based inflammatory bowel disease referral center. Outcomes of mucosal healing (MH), CD-related surgery or hospitalization, and clinical remission were compared based on timing of initiation of TP therapy. The cumulative incidence of events was estimated by Kaplan–Meier method. One-hundred ninety patients with early CD were included. After a median follow-up of 57 months (interquartile range, 31.3–76.2), 29 patients undergone abdominal surgeries, 48 patients hospitalized, and 68 patients experienced clinical flares. A higher cumulative proportion of patients in the top-down (TD) group achieving MH than both the accelerated step-up (AC) group and conventional management (CM) group at month 36 (78.8% vs 39.9% and 42.2%, respectively; P = 0.001). There was a trend, albeit not significant, for an increased proportion of patients free of CD-related intestinal surgery in the TD group at month 60 (P = 0.16). However, among secondary outcomes, an early TP-based AC or TD strategy was not associated with improvement in clinical remission rates compared with a CM strategy at month 60 (P = 0.79). No significant difference was observed between early TP and CM for rates of MH, CD-related intestinal surgery or hospitalization, and clinical remission. Both AC and CM strategy were minimally effective for disease modification. TD strategy has the potential of achieving higher rates MH. Our results support the TD strategy in patients with early CD at risk for a disabling course. PMID:26252273

  16. Structural phylogenomics uncovers the early and concurrent origins of cysteine biosynthesis and iron-sulfur proteins.

    PubMed

    Zhang, Hong-Yu; Qin, Tao; Jiang, Ying-Ying; Caetano-Anollés, Gustavo

    2012-01-01

    Cysteine (Cys) has unique chemical properties of catalysis, metal chelation, and protein stabilization. While Cys biosynthesis is assumed to be very ancient, the actual time of origin of these metabolic pathways remains unknown. Here, we use the molecular clocks of protein folds and fold superfamilies to time the origin of Cys biosynthesis. We find that the tRNA-dependent biosynthetic pathway appeared ~3.5 billion years ago while the tRNA-independent counterpart emerged ~500 million years later. A deep analysis of the origins of Cys biosynthesis in the context of emerging biochemistry uncovers some intriguing features of the planetary environment of early Earth. Results suggest that iron-sulfur (Fe-S) proteins that use cysteinyl sulfur to bind iron atoms were not the first to arise in evolution. Instead, their origin coincides with the appearance of the first Cys biosynthetic pathway. It is therefore likely that Cys did not play an important role in the make up of primordial protein molecules and that Fe-S clusters were not part of active sites at the beginning of biological history.

  17. Evaluation of the margins of differentiated early gastric cancer by using conventional endoscopy

    PubMed Central

    Yoshinaga, Shigetaka; Oda, Ichiro; Abe, Seiichiro; Nonaka, Satoru; Suzuki, Haruhisa; Takisawa, Hajime; Taniguchi, Hirokazu; Saito, Yutaka

    2015-01-01

    AIM: To evaluate the determination of the margin of differentiated-type early gastric cancers by using conventional endoscopy. METHODS: We retrospectively evaluated 364 differentiated early gastric cancers that were endoscopically resected as en-bloc specimens and diagnosed pathologically in detail between November 2007 and October 2008. All procedures were done with conventional endoscopes and all endoscopic samples, before and after indigo carmine dye, were re-evaluated using a digital filing system by one endoscopist. We analyzed the incidence of lesions with unclear margins and the relationship between unclear margins and relevant clinicopathological findings. RESULTS: The rate of lesions with unclear margins was 20.6% (75/364). Multivariate regression analysis suggested that the factors that make the determination of the margin difficult were normal color, presence of components of flat area (0-IIb), a diameter ≥ 21 mm, ulceration, and components of poorly differentiated adenocarcinoma in the mucosal surface. CONCLUSION: As many as 20% of differentiated early gastric cancers show unclear margins. Consideration of the factors associated with unclear margins may help endoscopists to accurately determine the margins of the lesion. PMID:26078834

  18. Early cannulation graft Flixene™ for conventional and complex hemodialysis access creation.

    PubMed

    Hinojosa, Carlos A; Soto-Solis, Saul; Olivares-Cruz, Sandra; Laparra-Escareno, Hugo; Gomez-Arcive, Zeniff; Anaya-Ayala, Javier E

    2017-03-21

    The Flixene™ (Atrium™, Hudson, NH) is a trilaminate composite polytetrafluoroethylene (PTFE) graft that allows access within 72 hours. We evaluate our initial experience with this device for conventional and complex hemodialysis access creation. Retrospective review in end-stage renal disease (ESRD) patients who underwent access creation with Flixene from January 2013 to July 2014. For our analysis, the patients were divided in two groups: those with complex access configurations tunneled in the chest and/or abdominal wall (thoraco-abdominal wall access [TAWA]), and those tunneled in conventional sites (extremity access [EA]). Patient's demographics, indications, complications, reinterventions, patency rates and factors influencing outcomes were evaluated. In 19 patients (54% men; mean age 44 years ± 18), 24 grafts were implanted, (13 EA [54%] vs. 11 TAWA), all patent after surgery. Central venous occlusive disease (CVOD) was present in all patients with TAWA and in 7/13 (54%) EA patients (p = 0.016). Early cannulation (within 72 hours) was successful in 12 EA and 5 TAWA grafts (p = 0.044). Complication rates including infection, thrombosis, bleeding and steal syndrome were 8/11 (73%) in TAWA and 5/13 (38%) in EA (p = 0.02). At 12 months, primary patency rates for EA and TAWA were 25% and 41%; secondary patency rates were 55% and 41%, respectively. Early cannulation (EC) grafts are viable alternatives for conventional and complex access creation that allowed early cannulation (<72 hours) in 17 (70%) of our cases. Primary and secondary patency rates at 12 months were equivalent to data reported on ePTFE grafts.

  19. Two-year follow-up of early- and conventionally-placed two-stage implants supporting fixed prostheses.

    PubMed

    Bekcioglu, Burak; Sagirkaya, Elcin; Karasoy, Durdu; Cehreli, Murat

    2012-01-01

    The objective of this study was to compare the biologic and prosthetic outcomes of early- and conventionally-placed implants supporting fixed prostheses. Using inclusion/exclusion criteria, early- and conventionally-placed implant patient groups, rehabilitated with Branemark System implants supporting fixed prostheses for 2 years, were selected from the patient archives. Kaplan-Meier survival estimates, time-dependent marginal bone loss, Plaque Index, peri-implant infection, Bleeding Index scores, and prosthetic complications data of the groups were compared. A total of 212 implants were placed in early-placed (n=42, 101 implants) and conventionally-placed (n=45, 111 implants) patient groups and 5 implants failed during the 2-year follow-up. The 1- and 2-year Kaplan-Meier survival probabilities of early-placed (0.98) and conventionally-placed (0.973) groups were comparable (P=.735). The 6-month to 2-year marginal bone loss in the conventionally-placed group was higher than in the early-placed group (P<.05). There were differences between groups on soft tissue scores between the 2 years of function (P<.05). The frequency of prosthetic complications was very low and comparable in both groups (P=.476). Early- and conventionally-placed implants supporting fixed prostheses showed comparable clinical outcomes during the 2-year follow-up, although the marginal bone loss was higher in the latter group.

  20. Medical emergency team activation: performance of conventional dichotomised criteria versus national early warning score.

    PubMed

    Tirkkonen, Joonas; Olkkola, Klaus T; Huhtala, Heini; Tenhunen, Jyrki; Hoppu, Sanna

    2014-04-01

    To activate the hospital's medical emergency team (MET), either conventional dichotomised activation criteria or an early warning scoring system may be used. The relative performance of these different activation patterns to discriminate high risk patients in a heterogenic general ward population after adjustment for multiple confounding factors has not been evaluated. We aimed to evaluate the dichotomised activation criteria used at our institution and the recently published national early warning score (NEWS, United Kingdom). Prospective point prevalence study at a university hospital in Finland. On two separate days, the vital signs of all adult patients without treatment limitations were measured. Data on cumulative comorbidity (Charlson comorbidity index), age, gender, admission characteristics and subsequent mortality were collected. Univariate and multivariate logistic regression models were used for unadjusted and adjusted performance testing. The cohort consisted of 615 patients. The dichotomised activation criteria were not associated with in-hospital serious adverse events (odds ratio 1.87, 95% confidence interval 0.55-6.30) or 30-day mortality (2.13, 0.79-5.72) after adjustments. For a NEWS of seven or more (the suggested trigger level for immediate MET activation), the adjusted odds ratios for the above mentioned outcomes were 7.45 (2.39-23.3) and 11.4 (4.40-29.6), respectively. Unlike the dichotomised activation criteria, NEWS was also independently associated with a higher 60- and 180-day mortality after adjustments. NEWS discriminates high risk patients in a heterogenic general ward population independently of multiple confounding factors. The conventional dichotomised activation criteria were not able to detect high risk patients. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  1. Comparative effectiveness of early versus conventional timing of dialysis initiation in advanced CKD.

    PubMed

    Crews, Deidra C; Scialla, Julia J; Boulware, L Ebony; Navaneethan, Sankar D; Nally, Joseph V; Liu, Xiaobo; Arrigain, Susana; Schold, Jesse D; Ephraim, Patti L; Jolly, Stacey E; Sozio, Stephen M; Michels, Wieneke M; Miskulin, Dana C; Tangri, Navdeep; Shafi, Tariq; Wu, Albert W; Bandeen-Roche, Karen

    2014-05-01

    Previous observational studies examining outcomes associated with the timing of dialysis therapy initiation in the United States have often been limited by lead time and survivor bias. Retrospective cohort study comparing the effectiveness of early versus later (conventional) dialysis therapy initiation in advanced chronic kidney disease (CKD). The analysis used inverse probability weighting to account for an individual's contribution to different exposure groups over time in a pooled logistic regression model. Patients contributed risk to both exposure categories (early and later initiation) until there was a clear treatment strategy (ie, dialysis therapy was initiated early or estimated glomerular filtration rate [eGFR] decreased to <10mL/min/1.73m(2)). Patients with CKD who had at least one face-to-face outpatient encounter with a Cleveland Clinic health care provider as of January 1, 2005, and at least 3 eGFRs in the range of 20-30mL/min/1.73m(2) measured at least 180 days apart. Timing of dialysis therapy initiation as determined using model-based interpolation of eGFR trajectories over time. Timing was defined as early (interpolated eGFR at dialysis therapy initiation≥10mL/min/1.73m(2)) or later (eGFR < 10mL/min/1.73m(2)) and was time-varying. Death from any cause occurring from the time that eGFR was equal to 20mL/min/1.73m(2) through September 15, 2009. The study population consisted of 652 patients meeting inclusion criteria. Most (71.3%) of the study population did not initiate dialysis therapy during follow-up. Patients who did not initiate dialysis therapy (n=465) were older, more likely to be white, and had more favorable laboratory profiles than those who started dialysis therapy. Overall, 146 initiated dialysis early and 80 had eGFRs decrease to <10mL/min/1.73m(2). Many participants (n=426) were censored prior to attaining a clear treatment strategy and were considered undeclared. There was no statistically significant survival difference for the

  2. Neurogenic heterotopic ossification: epidemiology and morphology on conventional radiographs in an early neurological rehabilitation population.

    PubMed

    Seipel, R; Langner, S; Platz, T; Lippa, M; Kuehn, J P; Hosten, N

    2012-01-01

    To retrospectively evaluate neurogenic heterotopic ossification in an early neurological rehabilitation population (phases B and C) with respect to epidemiology and morphology on conventional radiographs. Over a 4-year period, 1,463 patients treated at a clinic for early neurological rehabilitation were evaluated for clinical symptoms of neurogenic heterotopic ossification. In case of clinical suspicion, plain radiographs of the expected sites were obtained. If heterotopic ossification was detected, the initial and subsequent radiographs were retrospectively analyzed for sites, size, and morphology. Immature lesions were categorized as small (<10 mm) or large (10-100 mm). The prevalence rate of neurogenic heterotopic ossification was 2.05%. The condition was most common in young male adults. The hip was the most common site accounting for more than half of the cases. Two or more ossifications were seen in 56.7% of the affected patients with approximately two-thirds showing bilateral symmetric involvement of corresponding joint regions. The size of ossifications strongly varied interindividually. Small immature lesions demonstrated less progression in size than large lesions during maturation (P < 0.05). Standard radiographs, as a fast and inexpensive technique, allow the expected size progression of heterotopic ossifications during maturation to be estimated, which is relevant in terms of therapeutic decisions, patient mobilization, and neurological rehabilitation.

  3. Computerised versus conventional methodology of radiographic joint destruction assessment in early rheumatoid arthritis

    PubMed Central

    Huo, Yinghe; De Hair, Maria J H; Shaib, Yasmin O; van der Heijde, Désirée; Kuchuk, Natalia O; Viergever, Max A; van Laar, Jacob M; Vincken, Koen L; Lafeber, Floris P

    2015-01-01

    Objectives To compare computerised and conventional methodology of radiographic joint destruction assessment in early rheumatoid arthritis (RA). Methods We investigated the contribution of the 3rd-to-5th carpometacarpal joints (CMC3-5, which are excluded in computerised assessment so far owing to bone overlapping) to total joint space narrowing (JSN) scores in two cohorts of patients with early RA (n=392). Next, we investigated agreement between JSN scoring using single time point individual joint-based method (individual joint of a single time point (IJSTP), reflecting computerised reading) and conventional JSN scoring using the Sharp-van der Heijde (SvdH) method in a cohort of patients with early RA (n=59). We used intraclass correlation coefficients (ICCs), Bland and Altman plots, and linear mixed modelling to analyse differences in progression between two methods. Radiographs were available at baseline, and at 1 and 2 years of follow-up. Results Of all joints affected by JSN at baseline or JSN progression during 2 years of follow-up, 3.9% and 6.6% concerned CMC3-5. Exclusion of CMC3-5 resulted in a decrease of 1.9–4.6% in JSN progression scores during 2 years of follow-up. The ICCs for JSN progression scores using IJSTP with or without CMC3-5 compared with SvdH were 0.71–0.81 and 0.69–0.78 at 1 and 2 years of follow-up. Signal-to-noise ratios for IJSTP-based and SvdH scoring were 0.51 and 0.58, respectively. The progression rate for each year was not statistically significantly different between two scoring methods (p=0.59 and 0.89). Conclusions This study showed that excluding CMC3-5 has limited influence on JSN (progression) scores and showed the feasibility of using IJSTP-based reading for computerised scoring of JSN (progression) in RA. PMID:26688750

  4. Laparoscopic radical cholecystectomy for suspected early gall bladder carcinoma: thinking beyond convention.

    PubMed

    Palanisamy, Senthilnathan; Patel, Nikunj; Sabnis, Sandeep; Palanisamy, Nalankilli; Vijay, Anand; Palanivelu, Praveenraj; Parthasarthi, R; Chinnusamy, Palanivelu

    2016-06-01

    Gall bladder cancer (GBC) is the most common and aggressive malignancy of the biliary tract with extremely poor prognosis. Radical resection remains the only potential curative treatment for operable lesions. Although laparoscopic approach is now considered as standard of care for many gastrointestinal malignancies, surgical community is still reluctant to use this approach for GBC probably because of fear of tumor dissemination, inadequate lymphadenectomy and overall nihilistic approach. Aim of this study was to share our initial experience of laparoscopic radical cholecystectomy (LRC) for suspected early GBC. From 2008 to 2013, 91 patients were evaluated for suspected GBC, of which, 14 patients had early disease and underwent LRC. Mean age of the cohort was 61.14 ± 4.20 years with male/female ratio of 1:1.33. Mean operating time was 212.9 ± 26.73 min with mean blood loss of 196.4 ± 63.44 ml. Mean hospital stay was 5.14 ± 0.86 days without any 30-day mortality. Bile leak occurred in two patients. Out of 14 patients, 12 had adenocarcinoma, one had xanthogranulomatous cholecystitis and another had adenomyomatosis of gall bladder as final pathology. Resected margins were free in all (>1 cm). Median number of lymph nodes resected was 8 (4-14). Pathological stage of disease was pT2N0 in eight, pT2N1 in three and pT3N0 in one patient. Median follow-up was 51 (14-70) months with 5-year survival 68.75 %. Laparoscopic radical cholecystectomy with lymphadenectomy can be a viable alternative for management of early GBC in terms of technical feasibility and oncological clearance along with offering the conventional advantages of minimal access approach.

  5. Early cardiac toxicity following adjuvant radiotherapy of left-sided breast cancer with or without concurrent trastuzumab

    PubMed Central

    Cao, Lu; Cai, Gang; Chang, Cai; Yang, Zhao-Zhi; Feng, Yan; Yu, Xiao-Li; Ma, Jin-Li; Wu, Jiong; Guo, Xiao-Mao; Chen, Jia-Yi

    2016-01-01

    Purpose To evaluate the influence of concurrent trastuzumab on the cardiotoxicity in patients receiving left-sided adjuvant radiotherapy. Materials and Methods Medical records of stage I-III left-sided breast cancer patients, including 64 receiving concurrent trastuzumab with radiotherapy and 73 receiving radiotherapy alone were retrospectively reviewed. All of the patients had normal LVEF after adjuvant chemotherapy. Information of doses volume to cardiac structures was collected. Cardiac events were assessed according to CTC 2.0. Results Median follow-up of LVEF and clinical assessment of cardiac function from the initiation of radiotherapy was 6.7 months (range 3–60.9) and 26 months (range 6.4–60.9), respectively. Grade 1 LVEF dysfunction occurred in 5 (7.8%) and 3 (4.1%) patients of the concurrent-trastuzumab and radiotherapy alone cohort, respectively. Trastuzumab was the only significant factor influencing absolute LVEF decrease in univariate analysis. In multivariate analysis of concurrent-trastuzumab cohort, IMC radiotherapy and start trastuzumab during radiotherapy were independent risk factors. For concurrent cohort, mean heart dose, as well as D10-D30, D50-D55, V5-V20 of the heart and D30-D45, D65-D75, V6-V15 of the LV were significantly higher in patients developing LVEF dysfunction. Conclusions Concurrent trastuzumab and left-sided radiotherapy is well tolerated in terms of cardiotoxicity in patients with normal baseline cardiac function after adjuvant chemotherapy. However, increases in mean dose and low–dose volume of cardiac structures are associated with a higher risk of acute LVEF dysfunction. PMID:26460956

  6. Effectiveness of a telemonitoring intensive strategy in early rheumatoid arthritis: comparison with the conventional management approach.

    PubMed

    Salaffi, Fausto; Carotti, Marina; Ciapetti, Alessandro; Di Carlo, Marco; Gasparini, Stefania; Farah, Sonia; Gutierrez, Marwin

    2016-04-02

    The advent of Internet and World Wide Web has created new perspectives toward interaction between patients and healthcare professionals. Telemonitoring patients with rheumatoid arthritis (RA) is an emerging concept to guide the collaborative management treatment and improve outcomes in patients. The objective of this study was to investigate whether an intensive treatment strategy, according to a telemonitoring protocol, is more effective than conventional management strategy in reaching remission and comprehensive disease control (CDC) after 1 year in early rheumatoid arthritis (ERA) patients. Forty-four ERA patients were randomly allocated into two groups: the telemonitoring intensive strategy (TIS) group (group 1) or the conventional strategy (CS) group (group 2). Three patients refused to participate. In group 1 (n = 21), a remote monitoring system of disease activity, in combination with protocolised treatment adjustments aiming for remission was applied. In group 2 (n = 20), patients were treated according to daily clinical practice, with regular evaluation of disease activity, but without protocolised treatment adjustments. A telemedical care called "REmote TElemonitoring for MAnaging Rheumatologic Condition and HEaltcare programmes" (RETE-MARCHE), was developed to perform the remote monitoring. A higher percentage of patients in the TIS group achieved CDAI remission vs patients in the CS group (38.1 % vs 25 % at year 1, p <0.01). Time to achieve remission was significantly shorter in the group 1 than in the group 2, with a median of 20 weeks vs a median over 36-weeks (p <0.001). Concordantly, the patients in group 1 showed a greater improvement (p <0.001), compared with group 2 in terms of functional impairment (71.4 % vs 35 %) and radiological damage progression (23.8 % vs 10 %), resulting in a greater rate of CDC (19.4 % vs 5 %). According to our results, an intensive treatment strategy by telemonitoring leads to more effective disease

  7. Prospective Analysis of Early Lapse to Drinking and Smoking Among Individuals in Concurrent Alcohol and Tobacco Treatment

    PubMed Central

    Holt, Laura J.; Litt, Mark D.; Cooney, Ned L.

    2012-01-01

    The aims of the current study were to examine, prospectively, 1) dynamic changes in affective state, self-efficacy, and urge in the hours before initial smoking and drinking lapses among individuals in concurrent alcohol and smoking treatment, and 2) the extent to which self-efficacy, urge to use, and/or the use of one substance predicted lapse to the other substance. Ninety-six men and women recruited for a clinical trial of concurrent alcohol and tobacco treatment were eligible for inclusion. Only data from those who experienced an initial lapse to drinking (n=29), or smoking (n=32) were included. Two outpatient substance abuse clinics provided concurrent alcohol and smoking treatment on a weekly basis for three months. Ecological Momentary Assessment (EMA) methods were employed over a 28-day monitoring period to assess antecedents to first drink and a 14-day monitoring period was examined for initial smoking lapses. Baseline and EMA measures of positive and negative affect, alcohol/smoking urge, alcohol/smoking abstinence self-efficacy, nicotine withdrawal, and quantity/frequency of alcohol and tobacco use were examined as lapse predictors. Analyses of EMA ratings controlled for the corresponding baseline measure. Smoking lapse among individuals in concurrent alcohol and tobacco treatment was foreshadowed by higher urges to smoke, lower positive mood, and lower confidence to resist smoking. Drinking lapse was preceded by lower confidence to resist smoking, but only among individuals who reported recent smoking. Concurrent alcohol and smoking treatment should focus on the enhancement of abstinence self-efficacy, positive mood, and the curbing of urges in order to offset lapse risk. PMID:22023022

  8. Numerical assessment of bone remodeling around conventionally and early loaded titanium and titanium-zirconium alloy dental implants.

    PubMed

    Akça, Kıvanç; Eser, Atılım; Çavuşoğlu, Yeliz; Sağırkaya, Elçin; Çehreli, Murat Cavit

    2015-05-01

    The aim of this study was to investigate conventionally and early loaded titanium and titanium-zirconium alloy implants by three-dimensional finite element stress analysis. Three-dimensional model of a dental implant was created and a thread area was established as a region of interest in trabecular bone to study a localized part of the global model with a refined mesh. The peri-implant tissues around conventionally loaded (model 1) and early loaded (model 2) implants were implemented and were used to explore principal stresses, displacement values, and equivalent strains in the peri-implant region of titanium and titanium-zirconium implants under static load of 300 N with or without 30° inclination applied on top of the abutment surface. Under axial loading, principal stresses in both models were comparable for both implants and models. Under oblique loading, principal stresses around titanium-zirconium implants were slightly higher in both models. Comparable stress magnitudes were observed in both models. The displacement values and equivalent strain amplitudes around both implants and models were similar. Peri-implant bone around titanium and titanium-zirconium implants experiences similar stress magnitudes coupled with intraosseous implant displacement values under conventional loading and early loading simulations. Titanium-zirconium implants have biomechanical outcome comparable to conventional titanium implants under conventional loading and early loading.

  9. Early gonadotropin-releasing hormone antagonist start improves follicular synchronization and pregnancy outcome as compared to the conventional antagonist protocol.

    PubMed

    Park, Chan Woo; Hwang, Yu Im; Koo, Hwa Seon; Kang, Inn Soo; Yang, Kwang Moon; Song, In Ok

    2014-12-01

    To assess whether an early GnRH antagonist start leads to better follicular synchronization and an improved clinical pregnancy rate (CPR). A retrospective cohort study. A total of 218 infertile women who underwent IVF between January 2011 and February 2013. The initial cohort (Cohort I) that underwent IVF between January 2011 and March 2012 included a total of 68 attempted IVF cycles. Thirty-four cycles were treated with the conventional GnRH antagonist protocol, and 34 cycles with an early GnRH antagonist start protocol. The second cohort (Cohort II) that underwent IVF between June 2012 and February 2013 included a total of 150 embryo-transfer (ET) cycles. Forty-three cycles were treated with the conventional GnRH antagonist protocol, 34 cycles with the modified early GnRH antagonist start protocol using highly purified human menopause gonadotropin and an addition of GnRH agonist to the luteal phase support, and 73 cycles with the GnRH agonist long protocol. The analysis of Cohort I showed that the number of mature oocytes retrieved was significantly higher in the early GnRH antagonist start cycles than in the conventional antagonist cycles (11.9 vs. 8.2, p=0.04). The analysis of Cohort II revealed higher but non-significant CPR/ET in the modified early GnRH antagonist start cycles (41.2%) than in the conventional antagonist cycles (30.2%), which was comparable to that of the GnRH agonist long protocol cycles (39.7%). The modified early antagonist start protocol may improve the mature oocyte yield, possibly via enhanced follicular synchronization, while resulting in superior CPR as compared to the conventional antagonist protocol, which needs to be studied further in prospective randomized controlled trials.

  10. Pretreatment performance status and nutrition are associated with early mortality of locally advanced head and neck cancer patients undergoing concurrent chemoradiation.

    PubMed

    Chang, Pei-Hung; Yeh, Kun-Yun; Huang, Jen-Seng; Lai, Chien-Hong; Wu, Tsung-Han; Lan, Yii-Jenq; Tsai, Jason Chien-Sheng; Chen, Eric Yen-Chao; Yang, Shih-Wei; Wang, Cheng-Hsu

    2013-05-01

    Unexpected fatal events in patients with head and neck cancers undergoing concurrent chemoradiation therapy are a clinical concern. Malnutrition, which is reported frequently in head and neck cancer patients, are associated with immunity derangement. The purpose of this study was to identify risk factors for early death of patients undergoing chemoradiation. We retrospectively analyzed the records of 194 stage III, IVA, and IVB head and neck cancer patients who were treated with chemoradiation between 2007 and 2009. We defined early death as death while receiving chemoradiation or within 60 days of treatment completion. Risk factors for early death were tested using univariate and multivariate analyses. Fourteen patients (7.2 %) experienced early death, 78.6 % of whom died of infection. Univariate analysis revealed significant correlations between early death and several pretreatment variables, including Eastern Cooperative Oncology Group performance status (PS) >1, hemoglobin <10 g/dL, albumin <3 g/dL, body mass index (BMI) <19 kg/m(2), and peripheral blood total lymphocyte count <700/μL. Multivariate analysis showed that PS >1, BMI <19 kg/m(2), and peripheral blood total lymphocyte count <700/μL were independent variables associated with early death. Poor performance status and malnutrition before chemoradiation independently predict early death in locally advanced head and neck cancer patients undergoing chemoradiation. Cautious management of head and neck cancer patients with these risk factors is required throughout chemoradiation period.

  11. Effect of early versus conventional epidural analgesia during labor on cytokine production.

    PubMed

    Orbach-Zinger, Sharon; Bessler, Hanna; Arnovetzky, Rosana; Levin, Yivgenia; Sulkes, Jaqueline; Bardin, Ron; Peleg, Dan; Eidelman, Leonid

    2012-03-01

    To compare the effect of early epidural analgesia (EEA) vs. conventional epidural analgesia (CEA) on cytokine production in mother and neonate. Healthy parturients with uncomplicated term pregnancies were randomized into two groups: EEA - parturients who would receive epidural analgesia before onset of pain and the control group, CEA - parturients who would receive epidural analgesia after onset of pain. Cytokines were measured in maternal blood at randomization Visual Analog Scale (VAS) < 30], 24 h postpartum, and in cord blood. Forty-one women were studied. Epidural was performed in EEA when VAS was 23 ± 10 and in CEA when VAS was77 ± 10 (p < 0.0001). Background data were similar except for ruptured membranes at admission (EEA 15%, CEA 46.6%; p = 0.03), transient hypotension (EEA 20%, CEA 0%; p = 0.03), and meconium (EEA 25%, CEA 0%; p = 0.01). No significant differences were found in cytokine levels between groups at any time. Interleukin (IL)-6 levels changed significantly only in the control group (p = 0.046). There was significant correlation between baseline maternal IL-6 level and cord blood level in CEA (r = 0.59, p = 0.005), while no significant correlation existed in EEA (r = 0.33, p = 0.16). Although there was no significant difference in cytokine levels between the groups, EEA prevented the significant increase in IL-6 during labor and interrupted IL-6 fetal-maternal dependency.

  12. High-frequency oscillatory ventilation versus conventional ventilation in a piglet model of early meconium aspiration.

    PubMed

    Hachey, W E; Eyal, F G; Curtet-Eyal, N L; Kellum, F E

    1998-03-01

    To compare the cardiopulmonary effects of high-frequency oscillatory ventilation (HFO) and conventional ventilation (CV) in a piglet model of meconium aspiration syndrome. Prospective, randomized control study. Piglets 1 to 2 wks of age. Meconium aspiration was induced in 30 piglets. They were then randomized to CV, HFO at 10 Hz, or HFO at 15 Hz. Arterial blood gas, and systemic and pulmonary hemodynamics were measured serially. Airway opening pressure (P-Flex), static lung compliance (Crs), and trapped gas volume (TGV) were derived. Meconium instillation produced similar stable decreases in Crs (6.7 +/- 0.7 [SEM] to 4.7 +/- 0.4 mL/cm) and increases in pulmonary vascular resistance (68 +/- 6.4 vs. 91.9 +/- 8.5 mm Hg/mL/kg/min). A greater proportion of animals (40%, p< .007) remained hypercarbic during HFO at 15 Hz. Oxygenation indices were similar for all groups. In regards to high-frequency support, both power and deltaP were higher in the HFO at 15 Hz group (p< .001). When compared with both CV and HFO at 10 Hz, the TGV in the HFO at 15 Hz group was significantly higher following randomization to ventilator type. P-Flex was also greatest in the 15 Hz group, followed by the 10 Hz group and the CV group. Higher airway opening pressures, given identical compliance, suggest that HFO at 15 Hz resulted in greater large airway obstruction. With HFO's inherent low tidal volumes, progression of meconium to the distal airways may be delayed. Early institution of HFO at 15 Hz in meconium aspiration may exacerbate air trapping. HFO at lower rates may be the optimal method of respiratory support in meconium aspiration syndrome. HFO may extend the window of time available for removal of meconium.

  13. Systematic Review and Meta-analysis of Conventionally Fractionated Concurrent Chemoradiotherapy versus Altered Fractionation Radiotherapy Alone in the Definitive Management of Locoregionally Advanced Head and Neck Squamous Cell Carcinoma.

    PubMed

    Gupta, T; Kannan, S; Ghosh-Laskar, S; Agarwal, J P

    2016-01-01

    Treatment intensification either by using concurrent chemoradiotherapy (CCRT) or altered fractionation radiotherapy (AFRT) improves outcomes of locoregionally advanced head and neck squamous cell carcinoma (HNSCC). The superiority of one approach over the other, however, remains to be firmly established. The aim of the present study was to compare outcomes of CCRT versus AFRT in the definitive non-surgical management of locoregionally advanced HNSCC for evidence-based decision making. An electronic search of Medline via PubMed was conducted with no language, year, or publication status restrictions. The Cochrane Central Register of Controlled Trials (CENTRAL) and Database of Abstracts of Reviews of Effectiveness (DARE) were also searched electronically. Only randomised controlled trials assigning HNSCC patients randomly to conventionally fractionated CCRT or AFRT alone were included. Data were extracted independently by two reviewers and pooled using the Cochrane methodology for meta-analysis and expressed as a hazard ratio with 95% confidence intervals. Overall survival was the primary outcome of interest, whereas disease-free survival, locoregional control and toxicity were secondary end points. Five randomised controlled trials (involving 1117 patients and 627 deaths) directly comparing conventionally fractionated CCRT with AFRT alone were included. The risk of bias in included studies was low for efficacy outcomes, but high for toxicity outcomes. The overall pooled hazard ratio of death was 0.73 (95% confidence interval = 0.62-0.86), which significantly favoured conventionally fractionated CCRT over AFRT alone (P < 0.0001). Similarly, disease-free survival (hazard ratio = 0.79, 95% confidence interval = 0.68-0.92; P = 0.002) and locoregional control (hazard ratio = 0.71, 95% confidence interval = 0.59-0.84; P < 0.0001) were significantly improved with CCRT. There were no significant differences in the incidence of severe acute toxicity (dermatitis and mucositis

  14. Early apoptotic changes in human spermatozoa and their relationships with conventional semen parameters and sperm DNA fragmentation.

    PubMed

    Zhang, Hao-Bo; Lu, Shao-Ming; Ma, Chun-Yan; Wang, Li; Li, Xiao; Chen, Zi-Jiang

    2008-03-01

    To investigate whether early apoptotic changes in spermatozoa can be significant markers for sperm quality. Two early apoptotic changes in the semen of 56 men were assessed using Annexin V (AN)/propidium iodide (PI) staining for phosphatidylserine externalization and JC-1 staining for mitochondrial membrane potential (MMP). The results were compared with conventional semen parameters and DNA fragmentation identified using the TUNEL assay. The different labeling patterns in the bivariate Annexin V/PI analysis identified four distinctive spermatozoa populations. The percentage of AN(-)/PI(-) spermatozoa positively correlated with conventional semen parameters and MMP, but negatively correlated with TUNEL (+) spermatozoa. As for the AN(-)/PI(+) fraction, we found an opposite result in comparison to AN(-)/PI(-) spermatozoa. The level of early apoptotic AN(+)/PI(+) spermatozoa negatively correlated with MMP and sperm motility. The level of late apoptotic AN+/PI+ spermatozoa negatively correlated with conventional semen parameters and MMP, and positively correlated with TUNEL (+) spermatozoa. MMP positively correlated with conventional semen parameters, but negatively correlated with TUNEL (+) spermatozoa. Although early apoptotic AN+/PI(-) spermatozoa only negatively correlates with sperm motility, the differences in proportion of each subpopulation of spermatozoa (especially, the percentage of AN(-)/PI(-) spermatozoa), and decreased MMP might be significant markers for diagnosing male infertility. They possibly bring additional information to predict the outcome of in vitro fertilization.

  15. Instrumental and Conventional Interpretations of Behavior Are Associated with Distinct Outcomes in Early Childhood

    ERIC Educational Resources Information Center

    Clegg, Jennifer M.; Legare, Cristine H.

    2016-01-01

    Four tasks (N = 191, 3- to 6-year-olds) examined the effect of instrumental versus conventional language cues on children's imitative fidelity of a necklace-making activity, their memory and transmission of the activity, and their perceptions of functional fixedness. Children in the conventional condition imitated with higher fidelity, transmitted…

  16. Instrumental and Conventional Interpretations of Behavior Are Associated with Distinct Outcomes in Early Childhood

    ERIC Educational Resources Information Center

    Clegg, Jennifer M.; Legare, Cristine H.

    2016-01-01

    Four tasks (N = 191, 3- to 6-year-olds) examined the effect of instrumental versus conventional language cues on children's imitative fidelity of a necklace-making activity, their memory and transmission of the activity, and their perceptions of functional fixedness. Children in the conventional condition imitated with higher fidelity, transmitted…

  17. Comparison of the diagnostic utility of the ultrathin endoscope and the conventional endoscope in early gastric cancer screening.

    PubMed

    Hayashi, Yuko; Yamamoto, Yorimasa; Suganuma, Takanori; Okada, Kazuhisa; Nego, Masami; Imada, Shin-Ichi; Imai, Mizuka; Yoshimoto, Kazuhito; Ueki, Nobue; Hirasawa, Toshiaki; Uragami, Naoyuki; Tsuchida, Tomohiro; Fujisaki, Junko; Hoshino, Etsuo; Takahashi, Hiroshi; Igarashi, Masahiro

    2009-04-01

    Currently, transnasal esophagogastroduodenoscopy using an ultrathin endoscope is being widely carried out as a screening test for early gastric cancer. We compared the diagnostic utility of ultrathin esophagogastroduodenoscopy with that of conventional esophagogastroduodenoscopy in detecting 42 lesions of early gastric cancer that had a diameter of conventional esophagogastroduodenoscopy in terms of screening for early gastric cancer. The disadvantages of ultrathin esophagogastroduodenoscopy should be taken carefully into consideration while examining lesions.

  18. Longitudinal patterns of poverty and health in early childhood: exploring the influence of concurrent, previous, and cumulative poverty on child health outcomes

    PubMed Central

    2012-01-01

    Background Although the links between poverty and health have often been studied , the dynamics of poverty and physical health in early childhood remain under-investigated. In particular, it is not known whether the health of young children is affected differently from that of adults by patterns of poverty unique to them. Methods We examined patterns of health from 5 to 41 months of age as a function of concurrent, lagged, and chronic exposure to insufficient income. Using data from the first four rounds of the Quebec Longitudinal Study of Child Development, we performed multilevel logistic and multilevel Poisson regressions and latent growth curve analyses to explore associations between exposure to poverty and mother-reported asthma-like attacks, and maternal perception of health status controlling for neonatal, maternal, and environmental characteristics. Results The mean number of mother-reported asthma-like attacks significantly decreased as children aged. The likelihood of being perceived in a poorer health status also decreased across time. Concurrent poverty was associated with more mother-reported asthma-like attacks and with a higher risk of being perceived in poorer health status. One-period-lagged poverty was associated with more mother-reported asthma-like attacks and this remained significant after controlling for concurrent poverty. The number of mother-reported asthma-like attacks was significantly higher among children in the chronic poverty class compared to those in the never-poor class, particularly at 17 and 29 months. Perceived health status at 5-months was significantly poorer among chronically poor children compared to never-poor children. Conclusion Exposure to poverty negatively affects two major health indicators in early childhood – maternal perception of child health and mother-reported asthma-like attacks. Patterns of the effects vary according to timing and duration of poverty exposure. Further longitudinal research is warranted

  19. Longitudinal patterns of poverty and health in early childhood: exploring the influence of concurrent, previous, and cumulative poverty on child health outcomes.

    PubMed

    Béatrice, Nikiéma; Lise, Gauvin; Victoria, Zunzunegui Maria; Louise, Séguin

    2012-09-04

    Although the links between poverty and health have often been studied , the dynamics of poverty and physical health in early childhood remain under-investigated. In particular, it is not known whether the health of young children is affected differently from that of adults by patterns of poverty unique to them. We examined patterns of health from 5 to 41 months of age as a function of concurrent, lagged, and chronic exposure to insufficient income. Using data from the first four rounds of the Quebec Longitudinal Study of Child Development, we performed multilevel logistic and multilevel Poisson regressions and latent growth curve analyses to explore associations between exposure to poverty and mother-reported asthma-like attacks, and maternal perception of health status controlling for neonatal, maternal, and environmental characteristics. The mean number of mother-reported asthma-like attacks significantly decreased as children aged. The likelihood of being perceived in a poorer health status also decreased across time. Concurrent poverty was associated with more mother-reported asthma-like attacks and with a higher risk of being perceived in poorer health status. One-period-lagged poverty was associated with more mother-reported asthma-like attacks and this remained significant after controlling for concurrent poverty. The number of mother-reported asthma-like attacks was significantly higher among children in the chronic poverty class compared to those in the never-poor class, particularly at 17 and 29 months. Perceived health status at 5-months was significantly poorer among chronically poor children compared to never-poor children. Exposure to poverty negatively affects two major health indicators in early childhood - maternal perception of child health and mother-reported asthma-like attacks. Patterns of the effects vary according to timing and duration of poverty exposure. Further longitudinal research is warranted to disentangle time-specific from

  20. A comparison of treatment modalities for nasal extranodal natural killer/T-cell lymphoma in early stages: The efficacy of CHOP regimen based concurrent chemoradiotherapy.

    PubMed

    Cao, Jianzhong; Lan, Shengmin; Shen, Liuhai; Si, Hongwei; Zhang, Ning; Li, Hongwei; Guo, Ruyuan

    2016-11-25

    This study was designed to evaluate the efficacy of several treatment modalities, including CHOP based concurrent chemoradiotherapy (CCRT), for the patients with stage IE or IIE nasal extranodal NK/T-cell lymphoma (nasal ENKL). The cases were retrieved between 2000 and 2010 (n=94), and were followed to the end of February 2016. The patients were grouped into A (chemotherapy alone; CT alone), B (sequential treatment) and C (CCRT). For those with efficacy evaluation for overall treatment (n=90), CR was attained in 60.0% (18/30), 69.8% (30/43) and 76.5% (13/17) patients in the group A, B and C, respectively. The 5-year OS rate was 35.2%, 41.9% and 70.6% in the group A, B and C, respectively. For patients with early stage diseases (IE and IIE), the ECOG performance status and the Ann Arbor stage were significant prognostic factors for both OS and PFS. Among the stage IE patients, besides the ECOG performance status, three prognostic factors which related to treatments (treatment modalities, efficacy of initial and overall treatment) were significant against OS or PFS. In conclusion, compared to chemotherapy alone and sequential treatment, nasal ENKL patients in early stages, especially stage IE, benefit the most from CHOP based concurrent chemoradiotherapy.

  1. A novel system for in-situ observations of early hydration reactions in wet conditions in conventional SEM

    SciTech Connect

    Katz, A.; Bentur, A. . E-mail: bentur@tx.technion.ac.il; Kovler, K.

    2007-01-15

    A novel system enabling wet microscopy in conventional SEM is described and its performance for in-situ study of hydration reactions is demonstrated. The technology is based on a sealed specimen capsule, which is protected from the microscope vacuum by an electron-transparent partition membrane. Thus, the wet sample can be placed and observed in a 'conventional' SEM without the need for drying or employing environmental SEM. Early hydration reactions of gypsum and cement systems were followed during the first 24 h.

  2. Concurrent white and gray matter degeneration of disease-specific networks in early-stage Alzheimer's disease and behavioral variant frontotemporal dementia.

    PubMed

    Steketee, Rebecca M E; Meijboom, Rozanna; de Groot, Marius; Bron, Esther E; Niessen, Wiro J; van der Lugt, Aad; van Swieten, John C; Smits, Marion

    2016-07-01

    This study investigates regional coherence between white matter (WM) microstructure and gray matter (GM) volume and perfusion measures in Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) using a correlational approach. WM-GM coherence, compared with controls, was stronger between cingulum WM and frontotemporal GM in AD, and temporoparietal GM in bvFTD. In addition, in AD compared with controls, coherence was stronger between inferior fronto-occipital fasciculus WM microstructure and occipital GM perfusion. In this first study assessing regional WM-GM coherence in AD and bvFTD, we show that WM microstructure and GM volume and perfusion measures are coherent, particularly in regions implicated in AD and bvFTD pathology. This indicates concurrent degeneration in disease-specific networks. Our methodology allows for the detection of incipient abnormalities that go undetected in conventional between-group analyses. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Dose-Volume Histogram Predictors of Chronic Gastrointestinal Complications After Radical Hysterectomy and Postoperative Concurrent Nedaplatin-Based Chemoradiation Therapy for Early-Stage Cervical Cancer

    SciTech Connect

    Isohashi, Fumiaki; Yoshioka, Yasuo; Mabuchi, Seiji; Konishi, Koji; Koizumi, Masahiko; Takahashi, Yutaka; Ogata, Toshiyuki; Maruoka, Shintaroh; Kimura, Tadashi; Ogawa, Kazuhiko

    2013-03-01

    concurrent nedaplatin-based chemoradiation therapy for early-stage cervical cancer.

  4. Using Behavioral Consensus to Learn about Social Conventions in Early Childhood

    PubMed Central

    Zhao, Wanying; Baron, Andrew S.; Hamlin, J. K.

    2016-01-01

    Adults make inferences about the conventionality of others’ behaviors based on their prevalence across individuals. Here, we look at whether children use behavioral consensus as a cue to conventionality, and whether this informs which cultural models children choose to learn from. We find that 2- to 5-year old children exhibit increasing sensitivity to behavioral consensus with age, suggesting that like adults, young humans use behavioral consensus to identify social conventions. However, unlike previous studies showing children’s tendencies to prefer and to learn from members of a consensus, the present study suggests that there are contexts in which children prefer and learn from unconventional individuals. The implications of these different preferences are discussed. PMID:27761119

  5. Histogram analysis of apparent diffusion coefficient for monitoring early response in patients with advanced cervical cancers undergoing concurrent chemo-radiotherapy.

    PubMed

    Meng, Jie; Zhu, Lijing; Zhu, Li; Ge, Yun; He, Jian; Zhou, Zhengyang; Yang, Xiaofeng

    2017-01-01

    Background Apparent diffusion coefficient (ADC) histogram analysis has been widely used in determining tumor prognosis. Purpose To investigate the dynamic changes of ADC histogram parameters during concurrent chemo-radiotherapy (CCRT) in patients with advanced cervical cancers. Material and Methods This prospective study enrolled 32 patients with advanced cervical cancers undergoing CCRT who received diffusion-weighted (DW) magnetic resonance imaging (MRI) before CCRT, at the end of the second and fourth week during CCRT and one month after CCRT completion. The ADC histogram for the entire tumor volume was generated, and a series of histogram parameters was obtained. Dynamic changes of those parameters in cervical cancers were investigated as early biomarkers for treatment response. Results All histogram parameters except AUClow showed significant changes during CCRT (all P < 0.05). There were three variable trends involving different parameters. The mode, 5th, 10th, and 25th percentiles showed similar early increase rates (33.33%, 33.99%, 34.12%, and 30.49%, respectively) at the end of the second week of CCRT. The pre-CCRT 5th and 25th percentiles of the complete response (CR) group were significantly lower than those of the partial response (PR) group. Conclusion A series of ADC histogram parameters of cervical cancers changed significantly at the early stage of CCRT, indicating their potential in monitoring early tumor response to therapy.

  6. Presence and Quality of Kindergarten Children’s Friendships: Concurrent and Longitudinal Associations with Child Adjustment in the Early School Years

    PubMed Central

    Engle, Jennifer M.; McElwain, Nancy L.

    2010-01-01

    The presence and quality of friendships are posited to have developmental significance, yet little is known about the extent to which children without friends versus low-quality friendships compare on socioemotional adjustment. The current study utilized data from a subsample of 567 children (289 boys) participating in the NICHD Study of Early Child Care and Youth Development. Based on maternal reports at kindergarten, four friendship groups were formed: no friends, low quality, average quality, and high quality, and these groups were used to predict teacher-reported behavior problems and social skills concurrently (in kindergarten) and longitudinally (in first and third grade). Concurrently, low-quality friendships were associated with greater externalizing behavior, whereas high-quality friendships were associated with greater social skills. Longitudinally, having no friends in kindergarten was associated with higher levels of externalizing behavior for boys, but lower levels for girls. Children without friends also showed more internalizing problems at first grade. Lastly, having a high-quality friendship in kindergarten was associated with greater social skills in first and third grades, but only for boys. Results underscore high-quality friendship as a context for the development of social skills and indicate different trajectories of problem behavior for kindergarten children with no friends versus low-quality friendships. PMID:21822401

  7. Clozapine-Induced Microseizures, Orofacial Dyskinesia, and Speech Dysfluency in an Adolescent with Treatment Resistant Early Onset Schizophrenia on Concurrent Lithium Therapy

    PubMed Central

    Haq, Ayman; Song, Michael M.; Aligeti, Manish

    2017-01-01

    Clozapine is an atypical antipsychotic used in the treatment of refractory schizophrenia. It has a well-known side effect profile, including agranulocytosis, decreased seizure threshold, and tardive dyskinesia. In addition, numerous case reports have described clozapine-induced stuttering in adults. However, there has been only one previous case report describing it in the adolescent population. In addition, concurrent lithium therapy has been shown to enhance the neurotoxic effects of antipsychotics and lower the seizure threshold. Here, we report on the development of clozapine-induced microseizures, orofacial dyskinesia, and stuttering in a 17-year-old adolescent male with treatment of refractory early onset schizophrenia on clozapine and concurrent lithium therapy. The patient's symptoms of schizophrenia responded well to the clozapine regimen. However, with the escalating dose of clozapine, the patient developed speech dysfluency in the form of stuttering and perioral twitching. An electroencephalogram confirmed seizure activity. Due to similarities with tardive dyskinesia, symptoms of microseizures induced by atypical antipsychotics may not be accurately diagnosed. A multidisciplinary treatment of speech dysfluency is of particular importance in the adolescent schizophrenic patients, who are expected to have longer duration of lifetime exposure to antipsychotics and in whom peer group interaction is crucial for normal personal and social development. PMID:28835863

  8. Reading with a Crayon: Pre-Conventional Marginalia as Reader Response in Early Childhood

    ERIC Educational Resources Information Center

    Fischer, Sarah

    2017-01-01

    Child-produced marginalia, annotations written or drawn in the margins of a text by a young reader, have been stigmatized as devaluing the book on which it was created and often dismissed as "graffiti." Recent historical studies of marginalia created by older children, those who have mastered conventional writing and drawing, have…

  9. Ada concurrent programming

    SciTech Connect

    Gehani, N.

    1984-01-01

    In this book, Narain Gehani explains the concurrent programming facilities in Ada and shows how to use them effectively in writing concurrent programs. He also surveys concurrent programming facilities in other languages, discusses issues specific to concurrent programming, and examines the limitations of the concurrent programming facilities in Ada. Topics considered include an introduction to concurrent programming, the concurrent programming model in Ada, and a survey of other concurrent programming models; tasking, i.e., concurrent programming facilities in Ada; task types; exceptions and tasking; device drivers; real-time programming; topics related to concurrent programming; more examples of concurrent programming; and synopsis of sequential programming in Ada.

  10. Early nutritional intervention improves treatment tolerance and outcomes in head and neck cancer patients undergoing concurrent chemoradiotherapy.

    PubMed

    Paccagnella, Agostino; Morello, Michela; Da Mosto, Maria C; Baruffi, Carla; Marcon, Maria L; Gava, Alessandro; Baggio, Vittorio; Lamon, Stefano; Babare, Roberta; Rosti, Giovanni; Giometto, Marta; Boscolo-Rizzo, Paolo; Kiwanuka, Edward; Tessarin, Michele; Caregaro, Lorenza; Marchiori, Carlo

    2010-07-01

    Patients with head and neck cancer (HNC) undergoing chemoradiotherapy are at high risk of malnutrition, which is related to complication rate. The aim of this study was to investigate the impact of an early intensive nutritional intervention on nutritional status and outcomes in patients undergoing chemoradiotherapy for HNC. We analysed retrospectively the clinical documentation of 33 HNC patients who were referred for early nutritional intervention (nutrition intervention group, NG) before they were submitted to chemoradiotherapy. The outcome of these patients was compared to that of 33 patients who received chemoradiotherapy without receiving a specifically designed early nutrition support programme (control group, CG). NG patients lost less weight during chemoradiotherapy compared to CG patients (-4.6 +/- 4.1% vs -8.1 +/- 4.8% of pre-treatment weight, p < 0.01, at the completion of treatment). Patients in the NG experienced fewer radiotherapy breaks (>5 days) for toxicity (30.3% vs 63.6%, p < 0.01); the mean number of days of radiation delayed for toxicity was 4.4 +/- 5.2 in NG vs 7.6 +/- 6.5 in CG (p < 0.05); a linear correlation was found between percentage of weight lost from baseline to chemoradiotherapy completion and days of radiation delays (p < 0.01). There were less patients who had an unplanned hospitalisation in the NG relative to the CG (16.1% vs 41.4%, p = 0.03). In the NG, symptoms having an effect on the nutritional status developed early and were present in the nearly totality of patients at chemotherapy completion; 60.6% of NG patients needed tube feeding. Early nutrition intervention in patients with HNC receiving chemoradiotherapy resulted in an improved treatment tolerance and fewer admissions to hospital. This result suggests that nutritional intervention must be initiated before chemoradiotherapy, and it needs to be continued after treatment completion.

  11. Early Versus Delayed Initiation of Concurrent Palliative Oncology Care: Patient Outcomes in the ENABLE III Randomized Controlled Trial

    PubMed Central

    Bakitas, Marie A.; Tosteson, Tor D.; Li, Zhigang; Lyons, Kathleen D.; Hull, Jay G.; Li, Zhongze; Dionne-Odom, J. Nicholas; Frost, Jennifer; Dragnev, Konstantin H.; Hegel, Mark T.; Azuero, Andres; Ahles, Tim A.

    2015-01-01

    Purpose Randomized controlled trials have supported integrated oncology and palliative care (PC); however, optimal timing has not been evaluated. We investigated the effect of early versus delayed PC on quality of life (QOL), symptom impact, mood, 1-year survival, and resource use. Patients and Methods Between October 2010 and March 2013, 207 patients with advanced cancer at a National Cancer Institute cancer center, a Veterans Affairs Medical Center, and community outreach clinics were randomly assigned to receive an in-person PC consultation, structured PC telehealth nurse coaching sessions (once per week for six sessions), and monthly follow-up either early after enrollment or 3 months later. Outcomes were QOL, symptom impact, mood, 1-year survival, and resource use (hospital/intensive care unit days, emergency room visits, chemotherapy in last 14 days, and death location). Results Overall patient-reported outcomes were not statistically significant after enrollment (QOL, P = .34; symptom impact, P = .09; mood, P = .33) or before death (QOL, P = .73; symptom impact, P = .30; mood, P = .82). Kaplan-Meier 1-year survival rates were 63% in the early group and 48% in the delayed group (difference, 15%; P = .038). Relative rates of early to delayed decedents' resource use were similar for hospital days (0.73; 95% CI, 0.41 to 1.27; P = .26), intensive care unit days (0.68; 95% CI, 0.23 to 2.02; P = .49), emergency room visits (0.73; 95% CI, 0.45 to 1.19; P = .21), chemotherapy in last 14 days (1.57; 95% CI, 0.37 to 6.7; P = .27), and home death (27 [54%] v 28 [47%]; P = .60). Conclusion Early-entry participants' patient-reported outcomes and resource use were not statistically different; however, their survival 1-year after enrollment was improved compared with those who began 3 months later. Understanding the complex mechanisms whereby PC may improve survival remains an important research priority. PMID:25800768

  12. Early Versus Delayed Initiation of Concurrent Palliative Oncology Care: Patient Outcomes in the ENABLE III Randomized Controlled Trial.

    PubMed

    Bakitas, Marie A; Tosteson, Tor D; Li, Zhigang; Lyons, Kathleen D; Hull, Jay G; Li, Zhongze; Dionne-Odom, J Nicholas; Frost, Jennifer; Dragnev, Konstantin H; Hegel, Mark T; Azuero, Andres; Ahles, Tim A

    2015-05-01

    Randomized controlled trials have supported integrated oncology and palliative care (PC); however, optimal timing has not been evaluated. We investigated the effect of early versus delayed PC on quality of life (QOL), symptom impact, mood, 1-year survival, and resource use. Between October 2010 and March 2013, 207 patients with advanced cancer at a National Cancer Institute cancer center, a Veterans Affairs Medical Center, and community outreach clinics were randomly assigned to receive an in-person PC consultation, structured PC telehealth nurse coaching sessions (once per week for six sessions), and monthly follow-up either early after enrollment or 3 months later. Outcomes were QOL, symptom impact, mood, 1-year survival, and resource use (hospital/intensive care unit days, emergency room visits, chemotherapy in last 14 days, and death location). Overall patient-reported outcomes were not statistically significant after enrollment (QOL, P = .34; symptom impact, P = .09; mood, P = .33) or before death (QOL, P = .73; symptom impact, P = .30; mood, P = .82). Kaplan-Meier 1-year survival rates were 63% in the early group and 48% in the delayed group (difference, 15%; P = .038). Relative rates of early to delayed decedents' resource use were similar for hospital days (0.73; 95% CI, 0.41 to 1.27; P = .26), intensive care unit days (0.68; 95% CI, 0.23 to 2.02; P = .49), emergency room visits (0.73; 95% CI, 0.45 to 1.19; P = .21), chemotherapy in last 14 days (1.57; 95% CI, 0.37 to 6.7; P = .27), and home death (27 [54%] v 28 [47%]; P = .60). Early-entry participants' patient-reported outcomes and resource use were not statistically different; however, their survival 1-year after enrollment was improved compared with those who began 3 months later. Understanding the complex mechanisms whereby PC may improve survival remains an important research priority. © 2015 by American Society of Clinical Oncology.

  13. Changes in cerebral oxygen saturation and early postoperative cognitive function after laparoscopic gastrectomy: a comparison with conventional open surgery

    PubMed Central

    Jo, Youn Yi; Kim, Jong Yeop; Lee, Mi Geum; Lee, Seul Gi

    2016-01-01

    Background Laparoscopic gastrectomy requires a reverse-Trendelenburg position and prolonged pneumoperitoneum and it could cause significant changes in cerebral homeostasis and lead to cognitive dysfunction. We compared changes in regional cerebral oxygen saturation (rSO2), early postoperative cognitive function and hemodynamic variables in patients undergoing laparoscopic gastrectomy with those patients that underwent conventional open gastrectomy. Methods Sixty patients were enrolled in this study and the patients were distributed to receive either laparoscopic gastrectomy (laparoscopy group, n = 30) or open conventional gastrectomy (open group, n = 30). rSO2, end-tidal carbon dioxide tension, hemodynamic variables and arterial blood gas analysis were monitored during the operation. The enrolled patients underwent the mini-mental state examination 1 day before and 5 days after surgery for evaluation of early postoperative cognitive function. Results Compared to baseline value, rSO2 and end-tidal carbon dioxide tension increased significantly in the laparoscopy group after pneumoperitoneum, whereas no change was observed in the open group. No patient experienced cerebral oxygen desaturation or postoperative cognitive dysfunction. Changes in mean arterial pressure over time were significantly different between the groups (P < 0.001). Conclusions Both laparoscopic and open gastrectomy did not induce cerebral desaturation or early postoperative cognitive dysfunction in patients under desflurane anesthesia. However, rSO2 values during surgery favoured laparoscopic surgery, which was possibly related to increased cerebral blood flow due to increased carbon dioxide tension and the effect of a reverse Trendelenburg position. PMID:26885301

  14. Effects of maternal postpartum depression in a well-resourced sample: Early concurrent and long-term effects on infant cognitive, language, and motor development.

    PubMed

    Smith-Nielsen, Johanne; Tharner, Anne; Krogh, Marianne Thode; Vaever, Mette Skovgaard

    2016-12-01

    This study examined early and long-term effects of maternal postpartum depression on cognitive, language, and motor development in infants of clinically depressed mothers. Participants were 83 mothers and their full-term born children from the urban region of Copenhagen, Denmark. Of this group, 28 mothers were diagnosed with postnatal depression three to four months postpartum in a diagnostic interview. Cognitive, language, and motor development was assessed with the Bayley Scales of Infant and Toddler Development third edition, when the infants were 4 and 13 months of age. We found that maternal postpartum depression was associated with poorer cognitive development at infant age four months, the effect size being large (Cohen's d = 0.8) and with similar effects for boys and girls. At 13 months of age infants of clinical mothers did not differ from infants of non-clinical mothers. At this time most (79%) of the clinical mothers were no longer, or not again, depressed. These results may indicate that maternal depression can have an acute, concurrent effect on infant cognitive development as early as at four months postpartum. At the same time, in the absence of other risk factors, this effect may not be enduring. The main weaknesses of the study include the relatively small sample size and that depression scores were only available for 35 of the non-clinical mothers at 13 months. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  15. Concurrent validity of social subtype and IQ after early intensive behavioral intervention in children with autism: a preliminary investigation.

    PubMed

    Beglinger, Leigh; Smith, Tristram

    2005-06-01

    Three subtypes of autism based on social style have been proposed by Wing: active-but-odd, passive, or aloof. Previous research has shown evidence of an association between IQ and Wing subtype in untreated children and adults. Because IQ changes can accompany behavioral treatment, but often only for a subset of children, social subtype may be related to treatment responsiveness. We administered a social subtyping measure, the Wing Subgroups Questionnaire (WSQ), at various points in treatment to younger children than previously studied with autism in early, intensive behavioral intervention (EIBI). Thirty-seven children in EIBI (aged 39-71 months, amount of EIBI 0-44 months) were assessed to determine whether Wing's three proposed subtypes were found in this sample and whether subtypes were associated with current IQ and change in IQ after a period of EIBI. Results confirmed that all three subtypes were present and correlated with IQ after a period of intervention, as well as with change in IQ. Participants classified as aloof had significantly lower IQ scores and changes in IQ after EIBI than other children. Future studies should extend these findings by examining whether social subtype at pretreatment predicts EIBI outcome.

  16. Treating concurrent chronic low back pain and depression with low-dose venlafaxine: an initial identification of "easy-to-use" clinical predictors of early response.

    PubMed

    Rej, Soham; Dew, Mary Amanda; Karp, Jordan F

    2014-07-01

    Depression and chronic low back pain (CLBP) are both frequent and commonly comorbid in older adults seeking primary care. Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine may be effective in treating comorbid depression and CLBP. For patients with comorbid depression and CLBP, our goal was to identify "easy-to-use" early clinical variables associated with response to 6 weeks of low-dose venlafaxine pharmacotherapy that could be used to construct a clinically useful predictive model in future studies. We report data from the first 140 patients completing phase 1 of the Addressing Depression and Pain Together clinical trial. Patients aged ≥60 with concurrent depression and CLBP received 6 weeks of open-label venlafaxine 150 mg/day and supportive management. Using univariate and multivariate methods, we examined a variety of clinical predictors and their association with response to both depression and CLBP; change in depression; and change in pain scores at 6 weeks. About 26.4% of patients responded for both depression and pain with venlafaxine. Early improvement in pain at 2 weeks predicted improved response rates (P = 0.027). Similarly, positive changes in depression and pain at 2 weeks independently predicted continued improvement at 6 weeks in depression and pain, respectively (P < 0.001). An important minority of patients benefitted from 6 weeks of venlafaxine 150 mg/day. Early improvement in depression and pain at 2 weeks may predict continued improvement at week 6. Future studies must examine whether patients who have a poor initial response may benefit from increasing the SNRI dose, switching, or augmenting with other treatments after 2 weeks of pharmacotherapy. Wiley Periodicals, Inc.

  17. Treating Concurrent Chronic Low Back Pain and Depression with Low-Dose Venlafaxine: An Initial Identification of “Easy-to-Use” Clinical Predictors of Early Response

    PubMed Central

    Rej, Soham; Dew, Mary Amanda; Karp, Jordan F.

    2014-01-01

    Objective Depression and Chronic Low Back Pain (CLBP) are both frequent and commonly comorbid in older adults seeking primary care. Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) such as venlafaxine may be effective in treating comorbid depression and CLBP. For patients with comorbid depression and CLBP, our goal was to identify “easy-to-use” early clinical variables associated with response to 6 weeks of low-dose venlafaxine pharmacotherapy that could be used to construct a clinically-useful predictive model in future studies. Methods We report data from the first 140 patients completing phase 1 of the ADAPT clinical trial. Patients aged ≥60 with concurrent depression and CLBP received 6-weeks of open-label venlafaxine 150mg/day and supportive management. Using univariate and multivariate methods, we examined a variety of clinical predictors and their association with response to both depression and CLBP; change in depression; and change in pain scores at 6 weeks. Results 26.4% of patients responded for both depression and pain with venlafaxine. Early improvement in pain at 2 weeks predicted improved response rates (p=0.027). Similarly, positive changes in depression and pain at 2 weeks independently predicted continued improvement at 6 weeks in depression and pain, respectively (p<0.001). Conclusions An important minority of patients benefitted from 6 weeks of venlafaxine 150mg/day. Early improvement in depression and pain at 2 weeks may predict continued improvement at week 6. Future studies must examine whether patients who have a poor initial response may benefit from increasing the SNRI dose, switching, or augmenting with other treatments after 2 weeks of pharmacotherapy. PMID:25040462

  18. Early detection of colorectal cancer: from conventional methods to novel biomarkers.

    PubMed

    Vatandoost, Nasimeh; Ghanbari, Jahanafrooz; Mojaver, Mahboobeh; Avan, Amir; Ghayour-Mobarhan, Majid; Nedaeinia, Reza; Salehi, Rasoul

    2016-02-01

    Colorectal cancer (CRC) is one of the major health problems worldwide and is often diagnosed at late stage. There is growing body of evidence in early detection of this disease with novel screening modalities to reduce compliance and increase specificity of available methods. The aim of current review is to give an overview on currently available screening methods (e.g., fecal occult blood testing (FOBT), flexible sigmoidoscopy, and colonoscopy), with their own merits and disadvantages, and new genetic/epigenetic/protein markers, as novel screening modalities. There are several serum and fecal biomarkers that can predict CRC and polyps. Overall sensitivities for detection by fecal DNA markers ranged from 53 to 87%, while a panel of serum protein markers provides a sensitivity/specificity up to 85% for CRC. In particular, DNA methylation markers (e.g., SEPT9, SFRP2, and ALX4), circulating microRNAs (e.g., microRNA21), SNPs in microRNAs binding site (e.g., rs4596 located within a target region of the predicted miR-518a-5p and miR-527), protein markers (e.g., carcinoembryonic antigen, N-methyltransferase), or microsatellites instability in tumors with deficient mismatch repair of some genes are among the most interesting and promising biomarkers. Increasing evidence supports the use of combined fecal and serum biomarkers with sigmoidoscopy and colonoscopy screening in order to maximize the benefits and reduce the number of false-positive tests and patients undergoing invasive methods, which in turn could overcome the limitations of the current screening methods for early detection of CRC and adenomas.

  19. Concurrent changes in conduct problems and depressive symptoms in early adolescents: a developmental person-centered approach.

    PubMed

    Chen, Rusan; Simons-Morton, Bruce

    2009-01-01

    The co-occurrence of conduct problems (CP) and depressive symptoms (DS) is an important topic in developmental psychopathology; however, research in this area is still in its early stages. Using data from a school-based longitudinal sample of 2,453 adolescents with five waves from Grade 6 to 9, we examined the prevalence, etiology, and consequences of the co-occurrence of CP and DS. A person-centered approach, general growth mixture modeling, was applied to obtain CP and DS trajectory groups. The risk factors and consequences of the co-occurrence problem were examined using the trajectory groups. As hypothesized in a nonclinical sample, a small proportion of boys (8.8%) and girls (3.7%) reported to be high in both CP and DS over time. Among the adolescents with the highest level of CP, only 6.3% of the boys and 6.0% of the girls experienced the highest level of DS. However, among those with the highest level of DS trajectories, 42.9% of the boys and 10.2% of the girls reported the highest level of CP, indicating a gender-specific risk of the co-occurrence problem for depressed boys. Psychosocial and family factors were identified as vulnerable precursors to co-occurring CP and DS, a finding in line with the multiple domain risk model for CP and the transactional model for DS. The study also found that adolescents with the co-occurrence problem were more similar to those with "pure DS" than those with "pure CP" in academic adjustment at the ninth grade.

  20. [Early evaluation of anaemia in patients with acute gastrointestinal bleeding: venous blood gas analysis compared to conventional laboratory].

    PubMed

    Benítez Cantero, José Manuel; Jurado García, Juan; Ruiz Cuesta, Patricia; González Galilea, Angel; Muñoz García-Borruel, María; García Sánchez, Valle; Gálvez Calderón, Carmen

    2013-10-19

    Evaluation of patients with acute gastrointestinal bleeding (AGB) requires early clinical evaluation and analysis. The aim of this study is to evaluate early concordance of hemoglobin (Hb) and hematocrit (HTC) levels determined by conventional venous blood gas analysis (VBG) and by conventional Laboratory in Emergencies (LAB). Observational and prospective study of patients admitted in the Gastrointestinal Haemorrhage Unit with both high and low AGB. Demographic and clinical variables and simultaneous venous blood samples were obtained to determine Hb and HTC by VBG and LAB. Concordance in both methods was analysed by intra-class correlation coefficient (ICC) and Bland-Altman analysis. One hundred and thirty-two patients were included: 87 (65.9%) males, average age 66.8 years. VBG overestimated Hb in 0.49 g/dl (95% confidence interval: 0.21-0.76) with respect to LAB. Concordance was very high in Hb (ICC 0.931) and high in HTC (0.899), with the Bland-Altman graphs showing both concordance and overestimation of Hb levels determined by VBG. In 19 patients (14.39%), Hb by VBG exceeded in more than 1g/dL the final determination obtained by LAB. Early determination of Hb and HTC in patients with AGB by VBG provides reliable results in the initial evaluation of anaemia. VBG systematically overestimates Hb values by less than 0.5 g/dl, and therefore clinical and hemodynamic evaluation of the bleeding patient should prevail over analytical results. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  1. Detection of bone erosion in early rheumatoid arthritis: ultrasonography and conventional radiography versus non-contrast magnetic resonance imaging.

    PubMed

    Rahmani, Maryam; Chegini, Hosein; Najafizadeh, Seyed Reza; Azimi, Mohammad; Habibollahi, Peiman; Shakiba, Madjid

    2010-08-01

    Nowadays, there is a trend toward early diagnosis and treatment of rheumatoid arthritis (RA) especially in patients with early signs of bone erosion which can be detected by magnetic resonance imaging (MRI). The aim of following study is to compare the sensitivity and specificity of ultrasonography (US) and conventional radiography (CR) compared to MRI for early detection of bone erosion in RA patients. In 12 patients with RA diagnosis, 120 first to fifth metacarpophalangeal joints and 96 second to fifth proximal interphalangeal joints were examined. Non-contrast MRI, US and CR were performed for bone erosion evaluation. For further analysis, the patients were divided in two equal groups according to disease activity score (DAS28). The overall sensitivity and specificity of US compared to MRI in detecting bone erosion were 0.63 and 0.98, respectively with a considerable agreement (kappa = 0.68, p < 0.001). Sensitivity and specificity of CR compared to MRI in detecting bone erosion were 0.13 and 1.00, respectively (kappa = 0.20, p < 0.001). In patients with more active disease, the sensitivity and specificity were 0.67 and 0.99 (kappa = 0.74, p < 0.001) compared to 0.59 and 0.97 (kappa = 0.61, p < 0.001) for the rest of patients according to DAS28. Conclusively, these findings reveal an acceptable agreement between US and MRI for detection of bone erosion in patients with early RA but not CR. US might be considered as a valuable tool for early detection of bone erosion especially when MRI is not available or affordable. Besides, it seems the US could be more reliable when the disease is more active.

  2. Nebivolol exerts beneficial effects on endothelial function, early endothelial progenitor cells, myocardial neovascularization, and left ventricular dysfunction early after myocardial infarction beyond conventional β1-blockade.

    PubMed

    Sorrentino, Sajoscha A; Doerries, Carola; Manes, Costantina; Speer, Thimoteus; Dessy, Chantal; Lobysheva, Irina; Mohmand, Wazma; Akbar, Razma; Bahlmann, Ferdinand; Besler, Christian; Schaefer, Arnd; Hilfiker-Kleiner, Denise; Lüscher, Thomas F; Balligand, Jean-Luc; Drexler, Helmut; Landmesser, Ulf

    2011-02-01

    The aim of this study was to investigate whether nebivolol has added effects on left ventricular (LV) dysfunction and remodeling early after myocardial infarction (MI) beyond its β₁-receptor-blocking properties. Nebivolol is a third-generation selective β₁-adrenoreceptor antagonist that stimulates endothelial cell nitric oxide (NO) production and prevents vascular reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activation. Both endothelial NO synthase-derived NO production and NADPH oxidase activation are critical modulators of LV dysfunction early after MI. Mice with extensive anterior MI (n = 90) were randomized to treatment with nebivolol (10 mg/kg/day), metoprolol-succinate (20 mg/kg/day), or placebo for 30 days starting on day 1 after surgery. Infarct size was similar among the groups. Both β₁-adrenergic receptor antagonists caused a similar decrease in heart rate. Nebivolol therapy improved endothelium-dependent vasorelaxation and increased early endothelial progenitor cells 4 weeks after MI compared with metoprolol and placebo. Nebivolol, but not metoprolol, inhibited cardiac NADPH oxidase activation after MI, as detected by electron spin resonance spectroscopy analysis. Importantly, nebivolol, but not metoprolol, improved LV dysfunction 4 weeks after MI (LV ejection fraction: nebivolol vs. metoprolol vs. placebo: 32 ± 4% vs. 17 ± 6% vs. 19 ± 4%; nebivolol vs. metoprolol: p < 0.05) and was associated with improved survival 4 weeks post-MI compared with placebo. Nebivolol had a significantly more pronounced inhibitory effect on cardiomyocyte hypertrophy after MI compared with metoprolol. Nebivolol improves LV dysfunction and survival early after MI likely beyond the effects provided by conventional β₁-receptor blockade. Nebivolol induced effects on NO-mediated endothelial function, early endothelial progenitor cells and inhibition of myocardial NADPH oxidase likely contribute to these beneficial effects of nebivolol early

  3. The enhanced value of combining conventional and 'omics' analyses in early assessment of drug-induced hepatobiliary injury

    SciTech Connect

    Ellinger-Ziegelbauer, Heidrun; Adler, Melanie; Amberg, Alexander; Brandenburg, Arnd; Callanan, John J.; Connor, Susan; Fountoulakis, Michael; Gmuender, Hans; Gruhler, Albrecht; Hodson, Mark; Matheis, Katja A.; McCarthy, Diane; Raschke, Marian; Riefke, Bjoern; Schmitt, Christina S.; Sieber, Max; Sposny, Alexandra; Suter, Laura; Sweatman, Brian

    2011-04-15

    The InnoMed PredTox consortium was formed to evaluate whether conventional preclinical safety assessment can be significantly enhanced by incorporation of molecular profiling ('omics') technologies. In short-term toxicological studies in rats, transcriptomics, proteomics and metabolomics data were collected and analyzed in relation to routine clinical chemistry and histopathology. Four of the sixteen hepato- and/or nephrotoxicants given to rats for 1, 3, or 14 days at two dose levels induced similar histopathological effects. These were characterized by bile duct necrosis and hyperplasia and/or increased bilirubin and cholestasis, in addition to hepatocyte necrosis and regeneration, hepatocyte hypertrophy, and hepatic inflammation. Combined analysis of liver transcriptomics data from these studies revealed common gene expression changes which allowed the development of a potential sequence of events on a mechanistic level in accordance with classical endpoint observations. This included genes implicated in early stress responses, regenerative processes, inflammation with inflammatory cell immigration, fibrotic processes, and cholestasis encompassing deregulation of certain membrane transporters. Furthermore, a preliminary classification analysis using transcriptomics data suggested that prediction of cholestasis may be possible based on gene expression changes seen at earlier time-points. Targeted bile acid analysis, based on LC-MS metabonomics data demonstrating increased levels of conjugated or unconjugated bile acids in response to individual compounds, did not provide earlier detection of toxicity as compared to conventional parameters, but may allow distinction of different types of hepatobiliary toxicity. Overall, liver transcriptomics data delivered mechanistic and molecular details in addition to the classical endpoint observations which were further enhanced by targeted bile acid analysis using LC/MS metabonomics.

  4. Event-related potential evidence for the early activation of literal meaning during comprehension of conventional lexical metaphors.

    PubMed

    Lu, Aitao; Zhang, John X

    2012-07-01

    Among different types of metaphors, lexical metaphors are special in that they have been highly lexicalized and often suggested to be processed like non-metaphorical words. The present study examined two types of Chinese metaphorical words which are conceptualized through body parts. One has both a metaphorical meaning and a literal meaning actively in use, with the former dominant over the latter, referred to as the Met+Lit words. The other has only metaphorical meaning, referred to as Met-only words. In two experiments, lexical metaphor words were presented following a body-related picture and participants judged whether the picture and word were semantically related (Experiment 1) or made lexical decision on the word ignoring the picture (Experiment 2). The N400 ERP responses showed a clear semantic priming effect for the Met+Lit words compared with the non-ambiguous neutral words, with latencies comparable to that in Met-only words in both experiments. The results were interpreted to indicate that the literal meaning as a subordinate meaning was activated during the early comprehension of conventional lexical metaphors, supporting the notion of dual access to metaphorical meaning and literal meaning in metaphor processing. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Early-stage Node-negative (T1-T2N0) Anal Cancer Treated with Simultaneous Integrated Boost Radiotherapy and Concurrent Chemotherapy.

    PubMed

    Franco, Pierfrancesco; Arcadipane, Francesca; Ragona, Riccardo; Mistrangelo, Massimiliano; Cassoni, Paola; Rondi, Nadia; Morino, Mario; Racca, Patrizia; Ricardi, Umberto

    2016-04-01

    To report clinical outcomes of a consecutive series of patients with early-stage (T1-T1N0) anal cancer treated with intensity-modulated radiotherapy (IMRT) and a simultaneous integrated boost (SIB) approach similarly to the RTOG 05-29 trial. A cohort of 43 patients underwent SIB-IMRT employing a schedule consisting of 50.4 Gy/28 fractions to the gross tumor volume and 42 Gy/28 fractions to the elective nodal volumes for cT1N0 cases, and 54 Gy/30 fractions and 45 Gy/30 fractions to the same volumes for cT2N0 cases. Chemotherapy was administered concurrently following Nigro's regimen. The primary endpoint was colostomy-free survival (CFS). Secondary endpoints were locoregional control (LRC), disease-free (DFS), cancer-specific (CSS) and overall (OS) survival. Median follow-up was 39.7 months. The actuarial 3-year CFS was 79.4% [95% confidence interval (CI)=61.4-89.7%]. Actuarial 3-year OS and CSS were 90.8% (95% CI=74.1-96.9%) and 93.8% (95% CI=77.3-98.4%), while DFS was 75.5% (95% CI=56.4-87.1%). Actuarial 3-year LRC was 86.1% (95% CI=69.6-94%). On multivariate analysis, tumor size >3 cm showed a trend towards significance in predicting CFS [hazard ratio (HR)=8.6, 95% CI=84.7-88.1%; p=0.069]. Maximum detected adverse events included: skin (G3): 18%; gastrointestinal tract (G2): 67%; genitourinary tract (G3): 3%; genitalia (G2): 30%; anemia (G2): 7%; leukopenia (G3): 26%, leukopenia (G4):7%; neutropenia (G3): 15%; neutropenia (G4): 12%; thrombocytopenia (G3): 9%. Our clinical results support the use of SIB-IMRT in the combined modality treatment of patients with anal cancer. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  6. [Efficacy of early cerebral MR in the detection of brain lesions in high risk preterm infants compared with conventional US].

    PubMed

    Vendemmia, M; Millet, V; Simeoni, U; Girard, N; Paludetto, R

    2004-01-01

    To identify the efficacy of early cerebral MR, performed in the first month of birth, in the detection of brain lesions in high risk preterm infants, compared with conventional US, we recruited into the study a group of 30 preterm infants born at or below a gestational age of 30 weeks, who had a pathologic scan. The findings on US were compared with those of the early MR scan, performed in the same days, the results of which were considered as the final diagnosis. The value of cranial US as a predictor of MR signal intensity was assessed by calculating sensitivity, specificity, positive and negative predictive values. Agreement between two investigations was evaluated by calculating the K coefficient. US showed 33 haemorrhagic lesions in 25 preterms; MR showed 27 haemorrhagic lesions in 22 infants: in 16 cases MR gave the same results of US. Cranial US was reliable in detecting lesions such as GLH and IVH, but less sensitive in the definition of their size and distribution. Sensitivity of US for haemorrhagic lesions was 96.3%, PPV 78.8%, K coefficient 0.55 (p < 0.001). About the White Matter, cranial US demonstrated 20 lesions in 20 preterms; MR showed 16 lesions in 16 infants: in 3 cases MR was agree to US. US showed high reliability in the detection of cystic lesions, but significant limitations in the demonstration of non-cystic injury. We founded that normal WM echogenicity on US is not a good predictor of normal WM signal intensity on MR (30%). Sensitivity of US for WM lesions was 81.3%, PPV 65%, K coefficient 0.23 (p = 0.04). Finally US showed 4 lesions in other brain locations, MR confirmed 3 of them and discovered other 10. Sensitivity of US for these lesions was 23.1%, PPV 75%, K coefficient 0.21 (p = 0.11). We founded that cranial US is a good method for detecting GLH, IVH, HPI and severe WM lesions (cystic PVL), but it can miss non-cystic PVL, punctate haemorrhages, WMD and lesions in other brain locations, that, on the other hand, MR detects clearly.

  7. Concurrent programming and robotics

    SciTech Connect

    Cox, I.J.; Gehani, N.H.

    1989-04-01

    Many current robot systems exhibit a significant degree of concurrency, doing many activities in parallel. Future sensor-based robots are expected to exhibit even more concurrency. Programs to control such robots are characterized by the need to wait for external events and/or handle interrupts, deal with concurrent activities, synchronize actions with external events, and communicate with other robots and processes. In this paper, the authors focus on the advantages of concurrent programming for robotics and suggest that a general-purpose language with the right facilities is a good vehicle for robot programming. In this context they discuss Concurrent C, an upward-compatible extension of the C language that provides high-level concurrent programming facilities. They give an historical perspective of concurrent programming followed by a brief description of Concurrent C and how Concurrent C programs communicate with robots and devices. They show by examples how Concurrent C simplifies writing robot programs. Of specific interest are the process interaction and related interrupt handling facilities.

  8. Differences in whey protein content between cow's milk collected in late pasture and early indoor feeding season from conventional and organic farms in Poland.

    PubMed

    Kuczyńska, Beata; Puppel, Kamila; Gołebiewski, Marcin; Metera, Ewa; Sakowski, Tomasz; Słoniewski, Krzysztof

    2012-11-01

    The aim of the study was to investigate bioactive whey protein concentrations in cow's milk collected in late pasture (LP) and early indoor feeding (EIF) season from conventional and organic farms in Poland. Results showed that in the LP somatic cell count (SCC) was higher under organic farming conditions. However, percentages of protein and fat were higher under conventional farming conditions. In EIF, milk from conventional dairy farms had a higher percentage of fat and lactose and a lower concentration of protein and SCC in comparison to milk from organic farms. Organic milk in LP had higher concentrations of beneficial whey proteins than conventional milk, including β-lactoglobulin (β-Lg, 4.12 vs. 2.68 g L⁻¹), lactoferrin (Lf, 334.99 vs. 188.02 mg L⁻¹), and lysozyme (Lz, 15.68 vs. 12.56 µg L⁻¹). However, conventional milk in EIF had higher concentrations of bovine serum albumin (146.47 vs. 118.65 mg L⁻¹), Lf (49 vs. 185.27 mg L⁻¹), and Lz (16.63 vs. 13.22 µg L⁻¹). The results show significant differences in the investigated parameters between organic milk and milk from conventional system during EIF and LP. Moreover, extending the pasture season during EIF in organic farms decreases concentration of bioactive compounds of milk. Copyright © 2012 Society of Chemical Industry.

  9. Separation Logic and Concurrency

    NASA Astrophysics Data System (ADS)

    Bornat, Richard

    Concurrent separation logic is a development of Hoare logic adapted to deal with pointers and concurrency. Since its inception, it has been enhanced with a treatment of permissions to enable sharing of data between threads, and a treatment of variables as resource alongside heap cells as resource. An introduction to the logic is given with several examples of proofs, culminating in a treatment of Simpson's 4-slot algorithm, an instance of racy non-blocking concurrency.

  10. Concurrent and sequential initiation of ovarian function suppression with chemotherapy in premenopausal women with endocrine-responsive early breast cancer: an exploratory analysis of TEXT and SOFT.

    PubMed

    Regan, M M; Walley, B A; Francis, P A; Fleming, G F; Láng, I; Gómez, H L; Colleoni, M; Tondini, C; Pinotti, G; Salim, M; Spazzapan, S; Parmar, V; Ruhstaller, T; Abdi, E A; Gelber, R D; Coates, A S; Goldhirsch, A; Pagani, O

    2017-09-01

    Recent breast cancer treatment guidelines recommend that higher-risk premenopausal patients should receive ovarian function suppression (OFS) as part of adjuvant endocrine therapy. If chemotherapy is also given, it is uncertain whether to select concurrent or sequential OFS initiation. We analyzed 1872 patients enrolled in the randomized phase III TEXT and SOFT trials who received adjuvant chemotherapy for hormone receptor-positive, HER2-negative breast cancer and upon randomization to an OFS-containing adjuvant endocrine therapy, initiated gonadotropin-releasing-hormone-agonist triptorelin. Breast cancer-free interval (BCFI) was compared between patients who received OFS concurrently with chemotherapy in TEXT (n = 1242) versus sequentially post-chemotherapy in SOFT (n = 630). Because timing of trial enrollment relative to adjuvant chemotherapy differed, we implemented landmark analysis re-defining BCFI beginning 1 year after final dose of chemotherapy (median, 15.5 and 8.1 months from enrollment to landmark in TEXT and SOFT, respectively). As a non-randomized treatment comparison, we implemented comparative-effectiveness propensity score methodology with weighted Cox modeling. Distributions of several clinico-pathologic characteristics differed between groups. Patients who were premenopausal post-chemotherapy in SOFT were younger on average. The median duration of adjuvant chemotherapy was 18 weeks in both groups. There were 231 (12%) BC events after post-landmark median follow-up of about 5 years. Concurrent use of triptorelin with chemotherapy was not associated with a significant difference in post-landmark BCFI compared with sequential triptorelin post-chemotherapy, either in the overall population (HR = 1.11, 95% CI 0.72-1.72; P = 0.72; 4-year BCFI 89% in both groups), or in the subgroup of 692 women <40 years at diagnosis (HR = 1.13, 95% CI 0.69-1.84) who are less likely to develop chemotherapy-induced amenorrhea. Based on

  11. Predictive Value of Conventional Ultrasound and Contrast-Enhanced Ultrasound in Early Recurrence of Hepatocellular Carcinoma after Surgical Resection.

    PubMed

    Wang, Yibin; Liao, Jintang; Qi, Wenjun; Xie, Lulu; Li, Yueyi

    2016-05-01

    The goals of the work described here were to study the pre-operative risk factors associated with early recurrence (ER) of hepatocellular carcinoma (HCC) after surgical resection and discuss the value of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in predicting ER of HCC, so as to provide more information for optimizing clinical treatment and improving prognosis. A retrospective analysis was conducted on 59 patients who underwent both US and CEUS examinations pre-operatively and surgical resection for HCC between December 2010 and January 2014 in our hospital. The patients' clinical data, laboratory examination data and ultrasonic imaging diagnostic data were collected. Univariate analysis and logistic regression analysis were performed to determine the independent risk factors for ER of HCC after surgical resection. Diagnostic values of independent risk factors in predicting ER were further evaluated. The 59 patients were divided into the ER group (27 cases) and ER-free group (32 cases). There were no significant differences in age and sex between the two groups (p > 0.05). Univariate analysis revealed that differences in pre-operative serum α-fetoprotein level ≥400 ng/mL (p = 0.008), tumor diameter ≥5 cm (p = 0.012), macroscopic vascular invasion (p = 0.040), "fast wash-out" enhancement pattern (p = 0.006) and inhomogeneous distribution of contrast agent (p = 0.031) statistically significantly differed between the two groups. Logistic regression analysis indicated that pre-operative serum AFP level ≥400 ng/mL (p = 0.024), tumor diameter ≥5 cm (p = 0.042) and "fast wash-out" enhancement pattern (p = 0.009) were independent risk factors for ER of HCC; macrovascular invasion (p = 0.095) and inhomogeneous distribution of contrast agent (p = 0.628) did not statistically significantly differ between two groups (p = 0.628). Predictive values of the independent risk factors were further evaluated. The sensitivity of a "fast wash

  12. Early and Severe Radiation Toxicity Associated with Concurrent Sirolimus in an Organ Transplant Recipient with Head and Neck Cutaneous Squamous Cell Carcinoma: A Case Report.

    PubMed

    Manyam, Bindu V; Nwizu, Tobenna I; Rahe, Melissa L; Harr, Bridgett A; Koyfman, Shlomo A

    2015-10-01

    We present a case of a 71-year-old man with a history of liver transplantation who was treated with adjuvant radiotherapy with concurrent cisplatin for recurrent cutaneous squamous cell carcinoma of the head and neck. The patient was transitioned from tacrolimus to sirolimus for immunosuppression immediately prior to the start of radiation therapy, with the goal of reducing the risk for further skin cancer recurrence. The patient developed severe normal tissue toxicity, disproportionate to the dose delivered. He was diagnosed with Grade 4 esophagitis and mucositis after just 2,400 cGy in 12 fractions (planned 6,400 cGy in 32 fractions), requiring cessation of therapy. Six months later, the patient was diagnosed with local recurrence and distant metastases in the lung, and unfortunately passed away one month later. Randomized data have demonstrated the anti-neoplastic benefit of sirolimus. Pre-clinical studies and animal models have suggested that sirolimus may be a radiation sensitizer; however, the literature is limited regarding the clinical translation of these biologic findings. The case we presented reflects that concurrent radiation therapy with sirolimus may enhance the cytotoxic effects of radiation therapy and contribute to dose-limiting toxicity. Certainly, further study is necessary to explore this observation.

  13. Heterogeneous concurrent computing with exportable services

    NASA Technical Reports Server (NTRS)

    Sunderam, Vaidy

    1995-01-01

    Heterogeneous concurrent computing, based on the traditional process-oriented model, is approaching its functionality and performance limits. An alternative paradigm, based on the concept of services, supporting data driven computation, and built on a lightweight process infrastructure, is proposed to enhance the functional capabilities and the operational efficiency of heterogeneous network-based concurrent computing. TPVM is an experimental prototype system supporting exportable services, thread-based computation, and remote memory operations that is built as an extension of and an enhancement to the PVM concurrent computing system. TPVM offers a significantly different computing paradigm for network-based computing, while maintaining a close resemblance to the conventional PVM model in the interest of compatibility and ease of transition Preliminary experiences have demonstrated that the TPVM framework presents a natural yet powerful concurrent programming interface, while being capable of delivering performance improvements of upto thirty percent.

  14. Concurrent Software Engineering Project

    ERIC Educational Resources Information Center

    Stankovic, Nenad; Tillo, Tammam

    2009-01-01

    Concurrent engineering or overlapping activities is a business strategy for schedule compression on large development projects. Design parameters and tasks from every aspect of a product's development process and their interdependencies are overlapped and worked on in parallel. Concurrent engineering suffers from negative effects such as excessive…

  15. Concurrent Software Engineering Project

    ERIC Educational Resources Information Center

    Stankovic, Nenad; Tillo, Tammam

    2009-01-01

    Concurrent engineering or overlapping activities is a business strategy for schedule compression on large development projects. Design parameters and tasks from every aspect of a product's development process and their interdependencies are overlapped and worked on in parallel. Concurrent engineering suffers from negative effects such as excessive…

  16. Hypofractionated Radiotherapy and Stereotactic Boost with Concurrent and Adjuvant Temozolamide for Glioblastoma in Good Performance Status Elderly Patients - Early Results of a Phase II Trial.

    PubMed

    Floyd, Scott R; Kasper, Ekkehard M; Uhlmann, Erik J; Fonkem, Ekokobe; Wong, Eric T; Mahadevan, Anand

    2012-01-01

    Glioblastoma Multiforme (GBM) is an aggressive primary brain neoplasm with dismal prognosis. Based on successful phase III trials, 60 Gy involved-field radiotherapy in 30 fractions over 6 weeks [Standard radiation therapy (RT)] with concurrent and adjuvant temozolomide is currently the standard of care. In this disease, age and Karnofsky Performance Status (KPS) are the most important prognostic factors. For elderly patients, clinical trials comparing standard RT with radiotherapy abbreviated to 40 Gy in 15 fractions over 3 weeks demonstrated similar outcomes, indicating shortened radiotherapy may be an appropriate option for elderly patients. However, these trials did not include temozolomide chemotherapy, and included patients with poor KPS, possibly obscuring benefits of more aggressive treatment for some elderly patients. We conducted a prospective Phase II trial to examine the efficacy of a hypofractionated radiation course followed by a stereotactic boost with concurrent and adjuvant temozolomide chemotherapy in elderly patients with good performance status. In this study, patients 65 years and older with a KPS > 70 and histologically confirmed GBM received 40 Gy in 15 fractions with 3D conformal technique followed by a 1-3 fraction stereotactic boost to the enhancing tumor. All patients also received concurrent and adjuvant temozolomide. Patients were evaluated 1 month post-treatment and every 2 months thereafter. Between 2007 and 2010, 20 patients (9 males and 11 females) were enrolled in this study. The median age was 75.4 years (range 65-87 years). At a median follow-up of 11 months (range 7-32 months), 12 patients progressed and 5 are alive. The median progression free survival was 11 months and the median overall survival was 13 months. There was no additional toxicity. These results indicate that elderly patients with good KPS can achieve outcomes comparable to the current standard of care using an abbreviated

  17. Hypofractionated Radiotherapy and Stereotactic Boost with Concurrent and Adjuvant Temozolamide for Glioblastoma in Good Performance Status Elderly Patients – Early Results of a Phase II Trial

    PubMed Central

    Floyd, Scott R.; Kasper, Ekkehard M.; Uhlmann, Erik J.; Fonkem, Ekokobe; Wong, Eric T.; Mahadevan, Anand

    2012-01-01

    Glioblastoma Multiforme (GBM) is an aggressive primary brain neoplasm with dismal prognosis. Based on successful phase III trials, 60 Gy involved-field radiotherapy in 30 fractions over 6 weeks [Standard radiation therapy (RT)] with concurrent and adjuvant temozolomide is currently the standard of care. In this disease, age and Karnofsky Performance Status (KPS) are the most important prognostic factors. For elderly patients, clinical trials comparing standard RT with radiotherapy abbreviated to 40 Gy in 15 fractions over 3 weeks demonstrated similar outcomes, indicating shortened radiotherapy may be an appropriate option for elderly patients. However, these trials did not include temozolomide chemotherapy, and included patients with poor KPS, possibly obscuring benefits of more aggressive treatment for some elderly patients. We conducted a prospective Phase II trial to examine the efficacy of a hypofractionated radiation course followed by a stereotactic boost with concurrent and adjuvant temozolomide chemotherapy in elderly patients with good performance status. In this study, patients 65 years and older with a KPS > 70 and histologically confirmed GBM received 40 Gy in 15 fractions with 3D conformal technique followed by a 1–3 fraction stereotactic boost to the enhancing tumor. All patients also received concurrent and adjuvant temozolomide. Patients were evaluated 1 month post-treatment and every 2 months thereafter. Between 2007 and 2010, 20 patients (9 males and 11 females) were enrolled in this study. The median age was 75.4 years (range 65–87 years). At a median follow-up of 11 months (range 7–32 months), 12 patients progressed and 5 are alive. The median progression free survival was 11 months and the median overall survival was 13 months. There was no additional toxicity. These results indicate that elderly patients with good KPS can achieve outcomes comparable to the current standard of care using an abbreviated

  18. A randomized trial of early versus delayed mediastinal drain removal after cardiac surgery using silastic and conventional tubes

    PubMed Central

    Moss, Emmanuel; Miller, Corey S.; Jensen, Henrik; Basmadjian, Arsène; Bouchard, Denis; Carrier, Michel; Perrault, Louis P.; Cartier, Raymond; Pellerin, Michel; Demers, Philippe

    2013-01-01

    OBJECTIVES Mediastinal drainage following cardiac surgery with traditional large-bore plastic tubes can be painful and cumbersome. This study was designed to determine whether prolonged drainage (5 days) with a silastic tube decreased the incidence of significant pericardial effusion and tamponade following aortic or valvular surgery. METHODS One hundred and fifty patients undergoing valvular or aortic surgery in a tertiary cardiac surgery institution were randomized to receive a conventional mediastinal tube plus a silastic Blake drain (n = 75), or two conventional tubes (n = 75). Conventional drains were removed on postoperative day (POD) 1, while Blake drains were removed on POD 5. The primary end-point was the combined incidence of significant pericardial effusion (≥15 mm) or tamponade through POD 5. Secondary end-points included total mediastinal drainage, postoperative atrial fibrillation (AF) and pain. RESULTS Analysis was performed for 67 patients in the Blake group and 73 in the conventional group. There was no difference between the two groups in the combined end-point of significant effusion or tamponade (7.4 vs 8.3%, P = 0.74), or in the incidence of AF (47 vs 46%, P = 0.89). Mean 24-h drainage was greater in the Blake group than in the conventional group (749 ± 444 ml vs 645 ± 618 ml, P < 0.01). Overall incidence of significant pericardial effusion at 30 days was 12.1% (n = 17), with 5% (n = 7) requiring drainage. The Blake group had a numerically lower incidence of effusion requiring drainage at POD 30 (3.0 vs 6.8%, P = 0.44). Postoperative pain was similar between groups. CONCLUSIONS In patients undergoing ascending aortic or valvular surgery, prolonged drainage with silastic tubes is safe and does not increase postoperative pain. There was no difference between the Blake and conventional drains with regard to significant pericardial effusion or tamponade in this cohort; however, this conclusion is limited by the low overall incidence of the

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

    NASA Technical Reports Server (NTRS)

    Chattopadhyay, Debarati; Hihn, Jairus; Warfield, Keith

    2011-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Chattopadhyay, Debarati; Hihn, Jairus; Warfield, Keith

    2011-01-01

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

  1. Comparison of multi-modal early oral nutrition for the tolerance of oral nutrition with conventional care after major abdominal surgery: a prospective, randomized, single-blind trial.

    PubMed

    Sun, Da-Li; Li, Wei-Ming; Li, Shu-Min; Cen, Yun-Yun; Xu, Qing-Wen; Li, Yi-Jun; Sun, Yan-Bo; Qi, Yu-Xing; Lin, Yue-Ying; Yang, Ting; Lu, Qi-Ping; Xu, Peng-Yuan

    2017-02-10

    Early oral nutrition (EON) has been shown to improve recovery of gastrointestinal function, length of stay and mortality after abdominal surgery; however, early oral nutrition often fails during the first week after surgery. Here, a multi-modal early oral nutrition program is introduced to promote recovery of gastrointestinal function and tolerance of oral nutrition. Consecutive patients scheduled for abdominal surgery were randomized to the multimodal EON group or a group receiving conventional care. The primary endpoint was the time of first defecation. The secondary endpoints were outcomes and the cost-effectiveness ratio in treating infectious complications. The rate of infectious-free patients was regarded as the index of effectiveness. One hundred seven patients were randomly assigned to groups. Baseline characteristics were similar for both groups. In intention-to-treat analysis, the success rate of oral nutrition during the first week after surgery in the multimodal EON group was 44 (83.0%) versus 31 (57.4%) in the conventional care group (P = 0.004). Time to first defecation, time to flatus, recovery time of bowel sounds, and prolonged postoperative ileus were all less in the multimodal EON group (P < 0.05). The median postoperative length of stay in the multimodal EON group was 8 days (6, 12) versus 10 days (7, 18) in the conventional care group (P < 0.001). The total cost of treatment and nutritional support were also less in the multi-modal early oral nutrition group (P < 0.001). The effectiveness was 84.9 and 79.9% in the multimodal EON and conventional care group, respectively (P = 0.475). However, the cost-effectiveness ratio was USD 537.6 (506.1, 589.3) and USD 637.8 (593.9, 710.3), respectively (P < 0.001). The multi-modal early oral nutrition program was an effective way to improve tolerance of oral nutrition during the first week after surgery, decrease the length of stay and improve cost-effectiveness after abdominal

  2. Testing of concurrent programs and partial specifications

    SciTech Connect

    Hamlet, D.

    1982-12-01

    The testing problems of concurrent systems include those of sequential programs, but there are two additional difficulties: the scheduling of tasks may alter the behavior, making tests misleading; testing may be conducted at an early stage of development, by users who are not software experts. Concurrent process systems can be modeled by a collection of finite-state transducers, in a way that displays their unique problems. The specification languages PAISLey and Gist approach the definition of concurrent systems differently, but both permit users to execute partially defined systems. The declarative language PROLOG, although not explicitly designed for concurrent programming, exhibits similar characteristics. Prototype execution has some unexpected implications for testing, and for final implementation.

  3. Document Concurrence System

    NASA Technical Reports Server (NTRS)

    Muhsin, Mansour; Walters, Ian

    2003-01-01

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

  4. Document Concurrence System

    NASA Technical Reports Server (NTRS)

    Muhsin, Mansour; Walters, Ian

    2004-01-01

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

  5. Document Concurrence System

    NASA Technical Reports Server (NTRS)

    Muhsin, Mansour; Walters, Ian

    2003-01-01

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

  6. The early predictive value of a decrease of metabolic tumor volume in repeated (18)F-FDG PET/CT for recurrence of locally advanced non-small cell lung cancer with concurrent radiochemotherapy.

    PubMed

    Huang, Wei; Liu, Bo; Fan, Min; Zhou, Tao; Fu, Zheng; Zhang, Zicheng; Li, Hongsheng; Li, Baosheng

    2015-03-01

    The aim of this study is to investigate the value of [(18)F] fluorodeoxyglucose positron emission tomography/computed tomography ((18)F FDG PET/CT) to predict recurrence of patients with locally advanced non-small cell lung cancer (NSCLC) during the early stage of concurrent chemoradiotherapy (CCRT). A total of 53 stage III NSCLC patients without diabetics or undergoing surgery were enrolled in the prospective study. Those patients were evaluated by FDG PET before and following 40Gy radiotherapy (RT) with a concurrent cisplatin-based heterogeneous chemotherapy regimen. Semiquantitative assessment was used to determine maximum and mean SUVs (SUVmax/SUVmean) and metabolic tumor volume (MTV) of the primary tumor. The prognostic significance of PET/CT parameters and other clinical variables was assessed using Cox regression analyses. The cutoffs of PET/CT parameters which have been determined by the previous study were used to separate the groups with Kaplan-Meier curves. Recurrence rates at 1- and 2-years were 18.9% (10/53) and 50.9% (27/53) for all patients, respectively. Cox regression analysis showed that the only prognostic factor for recurrence was a decrease of MTV. Using the cutoff of 29.7%, a decrease of MTV can separate the patients into 2 groups with Kaplan-Meier curve successfully. The prospective study has reinforced the early predictive value of MTV in repeated (18)F-FDG PET/CT for recurrence in a subgroup of locally advanced NSCLC who underwent CCRT. A decrease of MTV in (18)F-FDG uptake by the primary tumor correlates with higher LRFS. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Concurrent evaluation of visual, cytological and HPV testing as screening methods for the early detection of cervical neoplasia in Mumbai, India.

    PubMed Central

    Shastri, Surendra S.; Dinshaw, Ketayun; Amin, Geetanjali; Goswami, Smriti; Patil, Sharmila; Chinoy, Roshini; Kane, S.; Kelkar, Rohini; Muwonge, Richard; Mahé, Cédric; Ajit, Dulhan; Sankaranarayanan, R.

    2005-01-01

    OBJECTIVE: Naked eye visual inspection with acetic acid (VIA), magnified VIA (VIAM), visual inspection with Lugol's iodine (VILI), cytology and human papillomavirus (HPV) testing were evaluated as screening methods for the detection of high-grade squamous intraepithelial lesions (HSIL) of the uterine cervix in a cross-sectional study in Mumbai, India. METHODS: Cytology, HPV testing, VIA, VIAM and VILI were carried out concurrently for 4039 women aged 30-65 years. All women were investigated with colposcopy and biopsies were taken from 939 women who had colposcopic abnormalities. The reference standard for final disease status was histology or negative colposcopy. The presence of HSIL was confirmed in 57 women (1.4%). The test characteristics for each method were calculated using standard formulae. RESULTS: The sensitivities of cytology, HPV testing, VIA, VIAM and VILI were 57.4%, 62.0%, 59.7%, 64.9%, and 75.4%, respectively (differences were not statistically significant). The specificities were 98.6%, 93.5%, 88.4%, 86.3%, and 84.3%, respectively. Adding a visual test to cytology or HPV testing in parallel combination resulted in a substantial increase in sensitivity, with a moderate decrease in specificity. The parallel combination of VILI and HPV testing resulted in a sensitivity of 92.0% and a specificity of 79.9%. CONCLUSION: As a single test, cytology had the best balance of sensitivity and specificity. Visual tests are promising in low-resource settings, such as India. The use of both VIA and VILI may be considered where good quality cytology or HPV testing are not feasible. The sensitivity of cytology and HPV testing increased significantly when combined with VIA or VILI. PMID:15798842

  8. A Randomized Controlled Trial of Vagus Nerve-preserving Distal Gastrectomy Versus Conventional Distal Gastrectomy for Postoperative Quality of Life in Early Stage Gastric Cancer Patients.

    PubMed

    Kim, Su Mi; Cho, Juhee; Kang, Danbee; Oh, Seung Jong; Kim, Ae Ran; Sohn, Tae Sung; Noh, Jae Hyoung; Kim, Sung

    2016-06-01

    To compare the postoperative quality of life of vagus nerve preserving distal gastrectomy (VPG) vs conventional distal gastrectomy (CG) in patients with early-stage gastric cancer. Randomized controlled clinical trial. Large tertiary comprehensive cancer center in Korea. One hundred sixty-three patients with early gastric cancer 18 years of age or older expected to undergo curative gastric resection. Patients were randomized 1:1 to VPG (n = 85) or CG (n = 78). European Organization for Research and Treatment of Cancer (EORTC) gastric module (STO22). Patients assigned to VPG showed less diarrhea 3 and 12 months after surgery (P = 0.040 and 0.048, respectively) and less appetite loss at 12 months (P = 0.011) compared with those assigned to CG. In both groups, fatigue, anxiety, eating restriction, and body image deteriorated at 3 months after surgery and did not regain baseline levels 12 months after surgery. There were no significant differences between the 2 groups in cancer recurrence and death over 5 years of follow-up. Early gastric cancer patients undergoing VPG reported significantly less diarrhea and appetite loss at 12 months postsurgery compared with those undergoing CG, with no differences in long-term clinical outcomes. VPG may improve the quality of life after gastrectomy in early gastric cancer patients compared with CG.

  9. A comparison of the clinical outcomes of embryos derived from intracytoplasmic sperm injection after early fertilization check and conventional insemination using sibling oocytes.

    PubMed

    Ohgi, Shirei; Hagihara, Chikako; Anakubo, Hisayo; Yanaihara, Atsushi

    2016-04-01

    In order to identify the real contribution of early fertilization check (EFC) for reproductive outcome, we compared the developmental potential of embryos derived from intracytoplasmic sperm injection (ICSI) after EFS with those from conventional insemination in sibling oocytes. Between April 2009 and April 2012, a total of 3249 oocytes in 386 patients were recruited following conventional insemination. Oocytes showing a second polar body (2ndPB) after an EFC were considered to be fertilized oocytes (IVF group), but, oocytes not showing a 2ndPB after EFC were placed into the ICSI group. The incidence of morphologically good embryos (MGE) on day 3, the blastocyst formation (BL), and the development of full blastocysts (full-BL) on day 5 were compared between the two groups. The clinical pregnancy rate was compared between the cycles with only conventional insemination or ICSI after EFC of the embryos being transferred. The fertilization rates in both the IVF and the ICSI groups were 48.1 and 73.9 %, respectively. The percentage of MGE in the ICSI group (40.8 %) was significantly lower than that in the IVF group (56.1 %, p < 0.01). The percentages of BL and full-BL in the ICSI group were significantly lower than those in the IVF group. The pregnancy rates were similar in both the groups. Checking fertilization earlier than the usual period contributed to an avoidance of lower fertilization. Moreover, the embryos derived from ICSI after EFC possessed a normal developmental potential.

  10. Early functional results after Hemiarthroplasty for femoral neck fracture: a randomized comparison between a minimal invasive and a conventional approach

    PubMed Central

    2012-01-01

    Background A minimal invasive approach for elective hip surgery has been implemented in our institution in the past. It is widely hypothesized that implanting artificial hips in a minimal invasive fashion decreases surgical trauma and is helpful in the rehabilitation process in elective hip surgery. Thereby geriatric patients requiring emergency hip surgery also could theoretically benefit from a procedure that involves less tissue trauma. Methods Sixty patients who sustained a fractured neck of femur were randomly assigned into two groups. In the minimal invasive arm, the so called “direct anterior approach” (DAA) was chosen, in the conventional arm the Watson-Jones-Approach was used for implantation of a bipolar hemi-arthroplasty. Primary outcome parameter was the mobility as measured by the four-item-Barthel index. Secondary outcome parameters included pain, haemoglobin-levels, complications, duration of surgery, administration of blood transfusion and external length of incision. Radiographs were evaluated. Results A statistically significant difference (p = 0,009) regarding the mobility as measured with the four-item Barthel index was found at the 5th postoperative day, favouring the DAA. Evaluation of the intensity of pain with a visual analogue scale (VAS) showed a statistically significant difference (p = 0,035) at day 16. No difference was evident in the comparison of radiographic results. Conclusions Comparing two different approaches to the hip joint for the implantation of a bipolar hemi-arthroplasty after fractured neck of femur, it can be stated that mobilization status is improved for the DAA compared to the WJA when measured by the four-item Barthel index, there is less pain as measured using the VAS. There is no radiographic evidence that a minimal invasive technique leads to inferior implant position. Level of Evidence: Level II therapeutic study. PMID:22873207

  11. Decision making processes based on social conventional rules in early adolescents with and without autism spectrum disorders

    PubMed Central

    Komeda, Hidetsugu; Osanai, Hidekazu; Yanaoka, Kaichi; Okamoto, Yuko; Fujioka, Toru; Arai, Sumiyoshi; Inohara, Keisuke; Koyasu, Masuo; Kusumi, Takashi; Takiguchi, Shinichiro; Kawatani, Masao; Kumazaki, Hirokazu; Hiratani, Michio; Tomoda, Akemi; Kosaka, Hirotaka

    2016-01-01

    Autism spectrum disorder (ASD) is characterized by problems with reciprocal social interaction, repetitive behaviours/narrow interests, and impairments in the social cognition and emotional processing necessary for intention-based moral judgements. The aim of this study was to examine the information used by early adolescents with and without ASD when they judge story protagonists as good or bad. We predicted that adolescents with ASD would use protagonists’ behaviour, while typically developing (TD) adolescents would use protagonists’ characteristics when making the judgements. In Experiment 1, we measured sentence by sentence reading times and percentages for good or bad judgements. In Experiment 2, two story protagonists were presented and the participants determined which protagonist was better or worse. Experiment 1 results showed that the adolescents with ASD used protagonist behaviours and outcomes, whereas the TD adolescents used protagonist characteristics, behaviours, and outcomes. In Experiment 2, TD adolescents used characteristics information when making “bad” judgements. Taken together, in situations in which participants cannot go back and assess (Experiment 1), and in comparable situations in which all information is available (Experiment 2), adolescents with ASD do not rely on information about individual characteristics when making moral judgements. PMID:27897213

  12. Comparison of safety and efficacy of the early injection of atropine during dobutamine stress echocardiography with the conventional protocol.

    PubMed

    Tsutsui, Jeane M; Osório, Altamiro F F; Lario, F Abio C; Fernandes, Daniela R A; Sodre, Gustavo; Andrade, José L; Ramires, José A F; Mathias, Wilson

    2004-12-01

    Although dobutamine-atropine stress echocardiography (DASE) is an established method for evaluating patients who have coronary artery disease (CAD), it can increase test duration and a patient's exposure to large doses of dobutamine. New protocols, including the early injection of atropine during dobutamine stress echocardiography (EA-DSE), have been proposed to decrease test duration. This study compared the safety, efficacy, and accuracy of EA-DSE with those of DASE. We retrospectively evaluated 3,163 patients who underwent DASE and 1,664 patients who underwent EA-DSE over a period of 12 years. In EA-DSE, atropine at a dose 50% stenosis) was assessed in patients who underwent quantitative angiography

  13. Simple and robust diagnosis of early, small and AFP-negative primary hepatic carcinomas: an integrative approach of serum fluorescence and conventional blood tests

    PubMed Central

    Wang, Ting; Zhang, Kun-He; Hu, Piao-Ping; Huang, Zeng-Yong; Zhang, Pan; Wan, Qin-Si; Huang, De-Qiang; Lv, Nong-Hua

    2016-01-01

    The diagnosis of early, small and alpha-fetoprotein (AFP)-negative primary hepatic carcinomas (PHCs) remains a significant challenge. We developed a simple and robust approach to noninvasively detect these PHCs. A rapid, high-throughput and single-tube method was firstly developed to measure serum autofluorescence and cell-free DNA (cfDNA)-related fluorescence using a real-time PCR system, and both types of serum fluorescence were measured and routine laboratory data were collected in 1229 subjects, including 353 PHC patients, 331 liver cirrhosis (LC) patients, 213 chronic hepatitis (CH) patients and 332 normal controls (NC). The results showed that fluorescence indicators of PHC differed from those of NC, CH and LC to various extents, and all of them were not associated with age, gender, or AFP level. The logistic regression models established with the fluorescence indicators alone and combined with AFP, hepatic function tests and blood cell analyses were valuable for distinguishing early, small, AFP-negative and all PHC from LC, CH, NC and all non-PHC, with areas under the receiver operating characteristic curves 0.857–0.993 and diagnostic accuracies 80.2–97.7%. Conclusively, serum autofluorescence and cfDNA-related fluorescence are able to be rapidly and simultaneously measured by our simple method and valuable for diagnosing early, small and AFP-negative PHCs, especially integrating with AFP and conventional blood tests. PMID:27590520

  14. Simple and robust diagnosis of early, small and AFP-negative primary hepatic carcinomas: an integrative approach of serum fluorescence and conventional blood tests.

    PubMed

    Wang, Ting; Zhang, Kun-He; Hu, Piao-Ping; Huang, Zeng-Yong; Zhang, Pan; Wan, Qin-Si; Huang, De-Qiang; Lv, Nong-Hua

    2016-09-27

    The diagnosis of early, small and alpha-fetoprotein (AFP)-negative primary hepatic carcinomas (PHCs) remains a significant challenge. We developed a simple and robust approach to noninvasively detect these PHCs. A rapid, high-throughput and single-tube method was firstly developed to measure serum autofluorescence and cell-free DNA (cfDNA)-related fluorescence using a real-time PCR system, and both types of serum fluorescence were measured and routine laboratory data were collected in 1229 subjects, including 353 PHC patients, 331 liver cirrhosis (LC) patients, 213 chronic hepatitis (CH) patients and 332 normal controls (NC). The results showed that fluorescence indicators of PHC differed from those of NC, CH and LC to various extents, and all of them were not associated with age, gender, or AFP level. The logistic regression models established with the fluorescence indicators alone and combined with AFP, hepatic function tests and blood cell analyses were valuable for distinguishing early, small, AFP-negative and all PHC from LC, CH, NC and all non-PHC, with areas under the receiver operating characteristic curves 0.857-0.993 and diagnostic accuracies 80.2-97.7%. Conclusively, serum autofluorescence and cfDNA-related fluorescence are able to be rapidly and simultaneously measured by our simple method and valuable for diagnosing early, small and AFP-negative PHCs, especially integrating with AFP and conventional blood tests.

  15. Instantaneous Conventions

    PubMed Central

    Misyak, Jennifer; Noguchi, Takao; Chater, Nick

    2016-01-01

    Humans can communicate even with few existing conventions in common (e.g., when they lack a shared language). We explored what makes this phenomenon possible with a nonlinguistic experimental task requiring participants to coordinate toward a common goal. We observed participants creating new communicative conventions using the most minimal possible signals. These conventions, furthermore, changed on a trial-by-trial basis in response to shared environmental and task constraints. Strikingly, as a result, signals of the same form successfully conveyed contradictory messages from trial to trial. Such behavior is evidence for the involvement of what we term joint inference, in which social interactants spontaneously infer the most sensible communicative convention in light of the common ground between them. Joint inference may help to elucidate how communicative conventions emerge instantaneously and how they are modified and reshaped into the elaborate systems of conventions involved in human communication, including natural languages. PMID:27793986

  16. Concurrent validity of the differential ability scales, second edition with the Mullen Scales of Early Learning in young children with and without neurodevelopmental disorders.

    PubMed

    Farmer, Cristan; Golden, Christine; Thurm, Audrey

    2016-01-01

    Estimates of intelligence in young children with neurodevelopmental disorders are critical for making diagnoses, in characterizing symptoms of disorders, and in predicting future outcomes. The limitations of standardized testing for children with developmental delay or cognitive impairment are well known: Tests do not exist that provide developmentally appropriate material along with norms that extend to the lower reaches of ability. Two commonly used and interchanged instruments are the Mullen Scales of Early Learning (MSEL), a test of developmental level, and the Differential Ability Scales, second edition (DAS-II), a more traditional cognitive test. We evaluated the correspondence of contemporaneous MSEL and the DAS-II scores in a mixed sample of children aged 2-10 years with autism spectrum disorder (ASD), non-ASD developmental delays, and typically developing children across the full spectrum of cognitive ability. Consistent with published data on the original DAS and the MSEL, scores on the DAS-II and MSEL were highly correlated. However, curve estimation revealed large mean differences that varied as a function of the child's cognitive ability level. We conclude that interchanging MSEL and DAS-II scores without regard to the discrepancy in scores may produce misleading results in both cross-sectional and longitudinal studies of children with and without ASD, and, thus, this practice should be implemented with caution.

  17. Tranexamic acid and early saphenous vein graft patency in conventional coronary artery bypass graft surgery: a prospective randomized controlled clinical trial.

    PubMed

    Karski, Jacek; Djaiani, George; Carroll, Jo; Iwanochko, Mark; Seneviratne, Priya; Liu, Peter; Kucharczyk, Walter; Fedorko, Ludwik; David, Tirone; Cheng, Davy

    2005-08-01

    Use of antifibrinolytic agents reduces the risk of bleeding and decreases the need for blood product use in patients undergoing cardiac surgery. The purpose of this study was to determine whether perioperative use of tranexamic acid decreases the rate of saphenous vein graft patency in the early postoperative period after conventional coronary artery bypass grafting surgery. A total of 312 patients scheduled for elective coronary artery bypass grafting surgery with cardiopulmonary bypass were randomized to receive either tranexamic acid 100 mg/kg (n = 147) or placebo (n = 165) in a double-blinded fashion before the initiation of cardiopulmonary bypass. Saphenous vein graft patency was assessed with magnetic resonance imaging 5 to 30 days after surgery. Both groups were comparable with respect to baseline demographic data and surgical characteristics. A total of 237 (76%) patients underwent magnetic resonance imaging assessment. A total of 297 saphenous vein grafts were performed and 253 (85.2%; 95% confidence interval, 83.5%-86.9%) were seen in the tranexamic acid group, and 265 saphenous vein grafts were performed and 231 (87.2%; 95% confidence interval, 85.5%-88.9%) were seen in the placebo group (P = .4969). The blood loss and blood product transfusion rates in the tranexamic acid group were significantly lower than in the placebo group. There was no difference between groups with respect to postoperative morbidity and mortality. The administration of tranexamic acid before cardiopulmonary bypass did not seem to compromise early venous graft patency rates but reduced perioperative blood product transfusion rates. Consequently, tranexamic acid could be advocated for routine use in patients undergoing conventional coronary artery bypass grafting surgery.

  18. The Bias and Signal Attenuation Present in Conventional Pollen-Based Climate Reconstructions as Assessed by Early Climate Data from Minnesota, USA

    PubMed Central

    St. Jacques, Jeannine-Marie; Cumming, Brian F.; Sauchyn, David J.; Smol, John P.

    2015-01-01

    The inference of past temperatures from a sedimentary pollen record depends upon the stationarity of the pollen-climate relationship. However, humans have altered vegetation independent of changes to climate, and consequently modern pollen deposition is a product of landscape disturbance and climate, which is different from the dominance of climate-derived processes in the past. This problem could cause serious signal distortion in pollen-based reconstructions. In the north-central United States, direct human impacts have strongly altered the modern vegetation and hence the pollen rain since Euro-American settlement in the mid-19th century. Using instrumental temperature data from the early 1800s from Fort Snelling (Minnesota), we assessed the signal distortion and bias introduced by using the conventional method of inferring temperature from pollen assemblages in comparison to a calibration set from pre-settlement pollen assemblages and the earliest instrumental climate data. The early post-settlement calibration set provides more accurate reconstructions of the 19th century instrumental record, with less bias, than the modern set does. When both modern and pre-industrial calibration sets are used to reconstruct past temperatures since AD 1116 from pollen counts from a varve-dated record from Lake Mina, Minnesota, the conventional inference method produces significant low-frequency (centennial-scale) signal attenuation and positive bias of 0.8-1.7°C, resulting in an overestimation of Little Ice Age temperature and likely an underestimation of the extent and rate of anthropogenic warming in this region. However, high-frequency (annual-scale) signal attenuation exists with both methods. Hence, we conclude that any past pollen spectra from before Euro-American settlement in this region should be interpreted using a pre-Euro-American settlement pollen set, paired to the earliest instrumental climate records. It remains to be explored how widespread this problem is

  19. The bias and signal attenuation present in conventional pollen-based climate reconstructions as assessed by early climate data from Minnesota, USA.

    PubMed

    St Jacques, Jeannine-Marie; Cumming, Brian F; Sauchyn, David J; Smol, John P

    2015-01-01

    The inference of past temperatures from a sedimentary pollen record depends upon the stationarity of the pollen-climate relationship. However, humans have altered vegetation independent of changes to climate, and consequently modern pollen deposition is a product of landscape disturbance and climate, which is different from the dominance of climate-derived processes in the past. This problem could cause serious signal distortion in pollen-based reconstructions. In the north-central United States, direct human impacts have strongly altered the modern vegetation and hence the pollen rain since Euro-American settlement in the mid-19th century. Using instrumental temperature data from the early 1800 s from Fort Snelling (Minnesota), we assessed the signal distortion and bias introduced by using the conventional method of inferring temperature from pollen assemblages in comparison to a calibration set from pre-settlement pollen assemblages and the earliest instrumental climate data. The early post-settlement calibration set provides more accurate reconstructions of the 19th century instrumental record, with less bias, than the modern set does. When both modern and pre-industrial calibration sets are used to reconstruct past temperatures since AD 1116 from pollen counts from a varve-dated record from Lake Mina, Minnesota, the conventional inference method produces significant low-frequency (centennial-scale) signal attenuation and positive bias of 0.8-1.7 °C, resulting in an overestimation of Little Ice Age temperature and likely an underestimation of the extent and rate of anthropogenic warming in this region. However, high-frequency (annual-scale) signal attenuation exists with both methods. Hence, we conclude that any past pollen spectra from before Euro-American settlement in this region should be interpreted using a pre-Euro-American settlement pollen set, paired to the earliest instrumental climate records. It remains to be explored how widespread this problem is

  20. Early clinical outcomes and toxicity of intensity modulated versus conventional pelvic radiation therapy for locally advanced cervix carcinoma: a prospective randomized study.

    PubMed

    Gandhi, Ajeet Kumar; Sharma, Daya Nand; Rath, Goura Kisor; Julka, Pramod Kumar; Subramani, Vellaiyan; Sharma, Seema; Manigandan, Durai; Laviraj, M A; Kumar, Sunesh; Thulkar, Sanjay

    2013-11-01

    To evaluate the toxicity and clinical outcome in patients with locally advanced cervical cancer (LACC) treated with whole pelvic conventional radiation therapy (WP-CRT) versus intensity modulated radiation therapy (WP-IMRT). Between January 2010 and January 2012, 44 patients with International Federation of Gynecology and Obstetrics (FIGO 2009) stage IIB-IIIB squamous cell carcinoma of the cervix were randomized to receive 50.4 Gy in 28 fractions delivered via either WP-CRT or WP-IMRT with concurrent weekly cisplatin 40 mg/m(2). Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events, version 3.0, and late toxicity was graded according to the Radiation Therapy Oncology Group system. The primary and secondary endpoints were acute gastrointestinal toxicity and disease-free survival, respectively. Of 44 patients, 22 patients received WP-CRT and 22 received WP-IMRT. In the WP-CRT arm, 13 patients had stage IIB disease and 9 had stage IIIB disease; in the IMRT arm, 12 patients had stage IIB disease and 10 had stage IIIB disease. The median follow-up time in the WP-CRT arm was 21.7 months (range, 10.7-37.4 months), and in the WP-IMRT arm it was 21.6 months (range, 7.7-34.4 months). At 27 months, disease-free survival was 79.4% in the WP-CRT group versus 60% in the WP-IMRT group (P=.651), and overall survival was 76% in the WP-CRT group versus 85.7% in the WP-IMRT group (P=.645). Patients in the WP-IMRT arm experienced significantly fewer grade ≥2 acute gastrointestinal toxicities (31.8% vs 63.6%, P=.034) and grade ≥3 gastrointestinal toxicities (4.5% vs 27.3%, P=.047) than did patients receiving WP-CRT and had less chronic gastrointestinal toxicity (13.6% vs 50%, P=.011). WP-IMRT is associated with significantly less toxicity compared with WP-CRT and has a comparable clinical outcome. Further studies with larger sample sizes and longer follow-up times are warranted to justify its use in routine clinical practice. Copyright © 2013

  1. Early Clinical Outcomes and Toxicity of Intensity Modulated Versus Conventional Pelvic Radiation Therapy for Locally Advanced Cervix Carcinoma: A Prospective Randomized Study

    SciTech Connect

    Gandhi, Ajeet Kumar; Sharma, Daya Nand; Rath, Goura Kisor; Julka, Pramod Kumar; Subramani, Vellaiyan; Sharma, Seema; Manigandan, Durai; Laviraj, M.A.; Kumar, Sunesh; Thulkar, Sanjay

    2013-11-01

    Purpose: To evaluate the toxicity and clinical outcome in patients with locally advanced cervical cancer (LACC) treated with whole pelvic conventional radiation therapy (WP-CRT) versus intensity modulated radiation therapy (WP-IMRT). Methods and Materials: Between January 2010 and January 2012, 44 patients with International Federation of Gynecology and Obstetrics (FIGO 2009) stage IIB-IIIB squamous cell carcinoma of the cervix were randomized to receive 50.4 Gy in 28 fractions delivered via either WP-CRT or WP-IMRT with concurrent weekly cisplatin 40 mg/m{sup 2}. Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events, version 3.0, and late toxicity was graded according to the Radiation Therapy Oncology Group system. The primary and secondary endpoints were acute gastrointestinal toxicity and disease-free survival, respectively. Results: Of 44 patients, 22 patients received WP-CRT and 22 received WP-IMRT. In the WP-CRT arm, 13 patients had stage IIB disease and 9 had stage IIIB disease; in the IMRT arm, 12 patients had stage IIB disease and 10 had stage IIIB disease. The median follow-up time in the WP-CRT arm was 21.7 months (range, 10.7-37.4 months), and in the WP-IMRT arm it was 21.6 months (range, 7.7-34.4 months). At 27 months, disease-free survival was 79.4% in the WP-CRT group versus 60% in the WP-IMRT group (P=.651), and overall survival was 76% in the WP-CRT group versus 85.7% in the WP-IMRT group (P=.645). Patients in the WP-IMRT arm experienced significantly fewer grade ≥2 acute gastrointestinal toxicities (31.8% vs 63.6%, P=.034) and grade ≥3 gastrointestinal toxicities (4.5% vs 27.3%, P=.047) than did patients receiving WP-CRT and had less chronic gastrointestinal toxicity (13.6% vs 50%, P=.011). Conclusion: WP-IMRT is associated with significantly less toxicity compared with WP-CRT and has a comparable clinical outcome. Further studies with larger sample sizes and longer follow-up times are warranted to justify

  2. Concurrency Among Strangers

    NASA Astrophysics Data System (ADS)

    Miller, Mark S.; Tribble, E. Dean; Shapiro, Jonathan

    Programmers write programs, expressing plans for machines to execute. When composed so that they may cooperate, plans may instead interfere with each other in unanticipated ways. Plan coordination is the art of simultaneously enabling plans to cooperate, while avoiding hazards of destructive plan interference. For sequential computation within a single machine, object programming supports plan coordination well. For concurrent computation, this paper shows how hard it is to use locking to prevent plans from interfering without also destroying their ability to cooperate.

  3. National Concurrent Enrollment Partnership Standards

    ERIC Educational Resources Information Center

    National Alliance of Concurrent Enrollment Partnerships, 2009

    2009-01-01

    The National Alliance of Concurrent Enrollment Partnerships (NACEP) is a professional organization for high schools and colleges that fosters and supports rigorous concurrent enrollment. Established in 1999 in response to the dramatic increase in concurrent enrollment courses throughout the country, NACEP serves as a national accrediting body and…

  4. Determination of value of bovine respiratory disease control using a remote early disease identification system compared with conventional methods of metaphylaxis and visual observations.

    PubMed

    White, B J; Amrine, D E; Goehl, D R

    2015-08-01

    Mitigation of the deleterious effects of bovine respiratory disease (BRD) is an important issue in the cattle industry. Conventional management of calves at high risk for BRD often includes mass treatment with antimicrobials at arrival followed by visual observation for individual clinical cases. These methods have proven effective; however, control program efficacy is influenced by the accuracy of visual observation. A remote early disease identification (REDI) system has been described that monitors cattle behavior to identify potential BRD cases. The objective of this research was to compare health and performance outcomes using either traditional BRD control (visual observation and metaphylaxis) or REDI during a 60-d postarrival phase in high-risk beef calves. The randomized controlled clinical trial was performed in 8 replicates at 3 different facilities over a 19-mo period. In each replicate, a single load of calves was randomly allocated to receive either conventional management (CONV; total = 8) or REDI (total = 8) as the method for BRD control. Cattle were monitored with each diagnostic method for the first 30 d on feed and performance variables were collected until approximately 60 d after arrival. Statistical differences ( < 0.10) were not identified in common performance (ADG) or health (morbidity, first treatment success, and mortality risk) among the treatment groups. Calves in the REDI pens had a lower ( < 0.01) average number of days on feed at first treatment (9.1 ± 1.2 d) compared with CONV pens (15.8 ± 1.2 d). There were no statistical differences ( > 0.10) in risk of BRD treatment and REDI calves were not administered antimicrobials at arrival; therefore, REDI calves had a lower ( < 0.01) average number of doses of antimicrobials/calf (0.75 ± 0.1 doses) compared with CONV calves (1.67 ± 0.1 doses). In this trial, the REDI system was comparable to conventional management with the potential advantages of earlier BRD diagnosis and decreased use

  5. Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: Initial report on a randomized controlled clinical trial

    SciTech Connect

    Pow, Edmond; Kwong, Dora; McMillan, Anne S. . E-mail: annemcmillan@hku.hk; Wong, May; Sham, Jonathan; Leung, Lucullus; Leung, W. Keung

    2006-11-15

    Purpose: To compare directly the effect of intensity-modulated radiotherapy (IMRT) vs. conventional radiotherapy (CRT) on salivary flow and quality of life (QoL) in patients with early-stage nasopharyngeal carcinoma (NPC). Methods and Materials: Fifty-one patients with T2, N0/N1, M0 NPC took part in a randomized controlled clinical study and received IMRT or CRT. Stimulated whole (SWS) and parotid (SPS) saliva flow were measured and Medical Outcomes Short Form 36 (SF-36), European Organization for Research and Treatment of Cancer (EORTC) core quetionnaire, and EORTC head-and-neck module (QLQ-H and N35) were completed at baseline and 2, 6, and 12 months after radiotherapy. Results: Forty-six patients (88%) were in disease remission 12 months after radiotherapy. At 12 months postradiotherapy, 12 (50.0%) and 20 patients (83.3%) in the IMRT group had recovered at least 25% of preradiotherapy SWS and SPS flow respectively, compared with 1 (4.8%) and 2 patients (9.5%), respectively, in the CRT group. Global health scores showed continuous improvement in QoL after both treatments (p < 0.001). However, after 12 months subscale scores for role-physical, bodily pain, and physical function were significantly higher in the IMRT group, indicating a better condition (p < 0.05). Dry mouth and sticky saliva were problems in both groups 2 months after treatment. In the IMRT group, there was consistent improvement over time with xerostomia-related symptoms significantly less common than in the CRT group at 12 months postradiotherapy. Conclusions: IMRT was significantly better than CRT in terms of parotid sparing and improved QoL for early-stage disease. The findings support the case for assessment of health-related QoL in relation to head-and-neck cancer using a site-specific approach.

  6. Early adolescent music preferences and minor delinquency.

    PubMed

    Ter Bogt, Tom F M; Keijsers, Loes; Meeus, Wim H J

    2013-02-01

    To test Music Marker Theory (MMT) positing that early adolescents' preferences for nonmainstream types of popular music indicate concurrent and later minor delinquency. MMT was tested in a 4-year longitudinal study (n = 309). The results showed that early fans of different types of rock (eg, rock, heavy metal, gothic, punk), African American music (rhythm and blues, hip-hop), and electronic dance music (trance, techno/hardhouse) showed elevated minor delinquency concurrently and longitudinally. Preferring conventional pop (chart pop) or highbrow music (classic music, jazz), in contrast, was not related to or was negatively related to minor delinquency. Early music preferences emerged as more powerful indicators of later delinquency rather than early delinquency, indicating that music choice is a strong marker of later problem behavior. The mechanisms through which music preferences are linked to minor delinquency are discussed within the framework of MMT.

  7. A Comparative Study of Daily 3-Gy Hypofractionated and 1.8-Gy Conventional Breast Irradiation in Early-Stage Breast Cancer

    PubMed Central

    Lee, Sea-Won; Kim, Yeon-Joo; Shin, Kyung Hwan; Kim, Kyubo; Chie, Eui Kyu; Han, Wonshik; Im, Seock-Ah; Jung, So-Youn; Lee, Keun Seok; Lee, Eun Sook

    2016-01-01

    Abstract We retrospectively compared accelerated hypofractionation (AHF) with conventional fractionation (CF) in the radiation therapy (RT) for early-stage breast cancer patients. Three hundred seventy-nine early-stage (pT1–2 and pN0–1a) breast cancer patients who received RT with AHF after breast-conserving surgery (BCS) were included. These patients were matched with 379 corresponding patients who received BCS and RT with CF at a different center with respect to the year BCS was performed, patient age (±3 years), and cancer stage. The AHF regimen consisted of 39 Gy in 13 fractions to the whole breast and a consecutive boost of 9 to 12 Gy in 3 to 4 fractions to the tumor bed. CF comprised whole-breast irradiation up to 50.4 Gy in 28 fractions and a boost of 9 to 14 Gy in 5 to 7 fractions to the tumor bed. The median follow-up period was 75 months (range, 3.8–110.8 months). There was no statistically significant difference between the AHF and CF groups in terms of age distribution, T and N stage, resection margin, and histologic grade. There were 5 ipsilateral breast tumor relapse (IBTR) cases in the AHF group compared with 7 cases in the CF group. Seven and eight locoregional relapse (LRR) cases were observed in the AHF and CF groups, respectively. The 7-year rates of IBTR-free survival, LRR-free survival, and disease-free survival were 98.9%, 98.4%, and 97.1% in the AHF group and 98.1%, 97.9%, and 96.0% in the CF group, respectively (P > 0.05). The incident rates of grade 3 edema, hyperpigmentation, or wet desquamation at the end of RT were higher in the CF group than in the AHF group (16.4% vs 0.2%, respectively; P < 0.01). AHF RT of 39 Gy to the whole breast plus a 9-Gy boost in 16 fractions showed excellent tumor control and tolerable skin toxicity, a finding that is comparable to CF RT in patients with early-stage breast cancer. PMID:27175630

  8. Treatment outcome of immediate, early and conventional single-tooth implants in the aesthetic zone: a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfaction.

    PubMed

    den Hartog, Laurens; Slater, James J R Huddleston; Vissink, Arjan; Meijer, Henny J A; Raghoebar, Gerry M

    2008-12-01

    This study evaluated, through a systematic review of the literature, the outcome of single-implant restorations in the aesthetic zone with natural adjacent teeth, thereby addressing immediate, early and conventional implant approaches. MEDLINE (1950-2008), EMBASE (1966-2008), and CENTRAL (1800-2008) were searched to identify eligible studies. Two reviewers independently assessed the methodological quality using specific study-design-related assessment forms. Out of 86 primarily selected articles, 19 studies fulfilled the inclusion criteria. A meta-analysis showed an overall survival rate of 95.5% [95% confidence interval: (93.0-97.1)] after 1 year. A stratified meta-analysis revealed no differences in survival between immediate, early and conventional implant strategies. Little marginal peri-implant bone resorption was found together with low incidence of biological and technical complications. No significant differences in outcome measures were reported in clinical trials comparing immediate, early or conventional implant strategies. The included literature suggested that promising short-term results could be achieved for immediate, early and conventional single-implants in the aesthetic zone. However, important parameters as aesthetic outcome, soft-tissue aspects, and patient satisfaction were clearly underexposed. The question whether immediate and early single-implant therapies would result in better treatment outcomes remained inconclusive due to lack of well-designed controlled clinical studies.

  9. Concurrent engineering research center

    NASA Technical Reports Server (NTRS)

    Callahan, John R.

    1995-01-01

    The projects undertaken by The Concurrent Engineering Research Center (CERC) at West Virginia University are reported and summarized. CERC's participation in the Department of Defense's Defense Advanced Research Project relating to technology needed to improve the product development process is described, particularly in the area of advanced weapon systems. The efforts committed to improving collaboration among the diverse and distributed health care providers are reported, along with the research activities for NASA in Independent Software Verification and Validation. CERC also takes part in the electronic respirator certification initiated by The National Institute for Occupational Safety and Health, as well as in the efforts to find a solution to the problem of producing environment-friendly end-products for product developers worldwide. The 3M Fiber Metal Matrix Composite Model Factory Program is discussed. CERC technologies, facilities,and personnel-related issues are described, along with its library and technical services and recent publications.

  10. Adjuvant Hypofractionated Versus Conventional Whole Breast Radiation Therapy for Early-Stage Breast Cancer: Long-Term Hospital-Related Morbidity From Cardiac Causes

    SciTech Connect

    Chan, Elisa K.; Woods, Ryan; McBride, Mary L.; Virani, Sean; Nichol, Alan; Speers, Caroline; Wai, Elaine S.; Tyldesley, Scott

    2014-03-15

    Purpose: The risk of cardiac injury with hypofractionated whole-breast/chest wall radiation therapy (HF-WBI) compared with conventional whole-breast/chest wall radiation therapy (CF-WBI) in women with left-sided breast cancer remains a concern. The purpose of this study was to determine if there is an increase in hospital-related morbidity from cardiac causes with HF-WBI relative to CF-WBI. Methods and Materials: Between 1990 and 1998, 5334 women ≤80 years of age with early-stage breast cancer were treated with postoperative radiation therapy to the breast or chest wall alone. A population-based database recorded baseline patient, tumor, and treatment factors. Hospital administrative records identified baseline cardiac risk factors and other comorbidities. Factors between radiation therapy groups were balanced using a propensity-score model. The first event of a hospital admission for cardiac causes after radiation therapy was determined from hospitalization records. Ten- and 15-year cumulative hospital-related cardiac morbidity after radiation therapy was estimated for left- and right-sided cases using a competing risk approach. Results: The median follow-up was 13.2 years. For left-sided cases, 485 women were treated with CF-WBI, and 2221 women were treated with HF-WBI. Mastectomy was more common in the HF-WBI group, whereas boost was more common in the CF-WBI group. The CF-WBI group had a higher prevalence of diabetes. The 15-year cumulative hospital-related morbidity from cardiac causes (95% confidence interval) was not different between the 2 radiation therapy regimens after propensity-score adjustment: 21% (19-22) with HF-WBI and 21% (17-25) with CF-WBI (P=.93). For right-sided cases, the 15-year cumulative hospital-related morbidity from cardiac causes was also similar between the radiation therapy groups (P=.76). Conclusions: There is no difference in morbidity leading to hospitalization from cardiac causes among women with left-sided early-stage breast

  11. Adjuvant hypofractionated versus conventional whole breast radiation therapy for early-stage breast cancer: long-term hospital-related morbidity from cardiac causes.

    PubMed

    Chan, Elisa K; Woods, Ryan; McBride, Mary L; Virani, Sean; Nichol, Alan; Speers, Caroline; Wai, Elaine S; Tyldesley, Scott

    2014-03-15

    The risk of cardiac injury with hypofractionated whole-breast/chest wall radiation therapy (HF-WBI) compared with conventional whole-breast/chest wall radiation therapy (CF-WBI) in women with left-sided breast cancer remains a concern. The purpose of this study was to determine if there is an increase in hospital-related morbidity from cardiac causes with HF-WBI relative to CF-WBI. Between 1990 and 1998, 5334 women ≤ 80 years of age with early-stage breast cancer were treated with postoperative radiation therapy to the breast or chest wall alone. A population-based database recorded baseline patient, tumor, and treatment factors. Hospital administrative records identified baseline cardiac risk factors and other comorbidities. Factors between radiation therapy groups were balanced using a propensity-score model. The first event of a hospital admission for cardiac causes after radiation therapy was determined from hospitalization records. Ten- and 15-year cumulative hospital-related cardiac morbidity after radiation therapy was estimated for left- and right-sided cases using a competing risk approach. The median follow-up was 13.2 years. For left-sided cases, 485 women were treated with CF-WBI, and 2221 women were treated with HF-WBI. Mastectomy was more common in the HF-WBI group, whereas boost was more common in the CF-WBI group. The CF-WBI group had a higher prevalence of diabetes. The 15-year cumulative hospital-related morbidity from cardiac causes (95% confidence interval) was not different between the 2 radiation therapy regimens after propensity-score adjustment: 21% (19-22) with HF-WBI and 21% (17-25) with CF-WBI (P=.93). For right-sided cases, the 15-year cumulative hospital-related morbidity from cardiac causes was also similar between the radiation therapy groups (P=.76). There is no difference in morbidity leading to hospitalization from cardiac causes among women with left-sided early-stage breast cancer treated with HF-WBI or CF-WBI at 15-year follow

  12. Increased Diagnostic Accuracy of Digital vs. Conventional Clock Drawing Test for Discrimination of Patients in the Early Course of Alzheimer’s Disease from Cognitively Healthy Individuals

    PubMed Central

    Müller, Stephan; Preische, Oliver; Heymann, Petra; Elbing, Ulrich; Laske, Christoph

    2017-01-01

    The conventional Clock Drawing Test (cCDT) is a rapid and inexpensive screening tool for detection of moderate and severe dementia. However, its usage is limited due to poor diagnostic accuracy especially in patients with mild cognitive impairment (MCI). The diagnostic value of a newly developed digital Clock Drawing Test (dCDT) was evaluated and compared with the cCDT in 20 patients with early dementia due to AD (eDAT), 30 patients with amnestic MCI (aMCI) and 20 cognitively healthy controls (HCs). Parameters assessed by dCDT were time while transitioning the stylus from one stroke to the next above the surface (i.e., time-in-air), time the stylus produced a visible stroke (i.e., time-on-surface) and total-time during clock drawing. Receiver-operating characteristic (ROC) curves were calculated and logistic regression analyses have been conducted for statistical analysis. Using dCDT, time-in-air was significantly increased in eDAT (70965.8 ms) compared to aMCI (54073.7 ms; p = 0.027) and HC (32315.6 ms; p < 0.001). In addition, time-in-air was significantly longer in patients with aMCI compared to HC (p = 0.003), even in the aMCI group with normal cCDT score (54141.8 ms; p < 0.001). Time-in-air using dCDT allowed discrimination of patients with aMCI from HCs with a sensitivity of 81.3% and a specificity of 72.2% while cCDT scoring revealed a sensitivity of 62.5% and a specificity of 83.3%. Most interestingly, time-in-air allowed even discrimination of aMCI patients with normal cCDT scores (80% from all aMCI patients) from HCs with a clinically relevant sensitivity of 80.8% and a specificity of 77.8%. A combination of dCDT variables and cCDT scores did not improve the discrimination of patients with aMCI from HC. In conclusion, assessment of time-in-air using dCDT yielded a higher diagnostic accuracy for discrimination of aMCI patients from HCs than the use of cCDT even in those aMCI patients with normal cCDT scores. Modern digitizing devices offer the opportunity

  13. Diagnostic performance of conventional endoscopy in the identification of submucosal invasion by early gastric cancer: the "non-extension sign" as a simple diagnostic marker.

    PubMed

    Nagahama, Takashi; Yao, Kenshi; Imamura, Kentaro; Kojima, Toshiki; Ohtsu, Kensei; Chuman, Kenta; Tanabe, Hiroshi; Yamaoka, Rino; Iwashita, Akinori

    2017-03-01

    The ability to differentiate between mucosal (M) or microinvasive submucosal (SM1: depth of less than 500 µm) and invasive submucosal (SM2: depth of 500 µm or more) cancer is paramount when choosing the method of treatment for early gastric cancer (EGC). The "non-extension sign" relates to a localized increase in thickness and rigidity due to massive submucosal invasion by a cancer. The present study sought to assess the ability of conventional endoscopy (CE) to correctly identify SM2 cancer using only the non-extension sign. This is a retrospective study based on a prospectively collected database. EGCs had been diagnosed according to invasion depth as M-SM1 or SM2. In terms of the endoscopic diagnostic criterion, lesions positive for the non-extension sign were classified as SM2 cancers, while those negative for the non-extension sign were classified as M-SM1 cancers. Histopathological findings were used as the gold standard. We examined a total of 863 lesions from 704 patients, comprising 104 true-positive, 733 true-negative, 9 false-positive, and 17 false-negative lesions. This yielded a sensitivity of 92.0 % (95 % confidence interval (CI), 87.0-97.0 %), a specificity of 97.7 % (95 % CI, 96.7-98.8 %), a positive predictive value of 85.9 % (95 % CI, 79.7-92.1 %), a negative predictive value of 98.8 % (95 % CI, 98.0-99.6 %), and a diagnostic accuracy of 96.9 % (95 % CI, 95.8-98.1 %). The non-extension sign may be useful for accurately determining the suitability of minimally invasive endoscopic treatment. Nevertheless, considering the limitations of retrospective analysis, a further prospective study is warranted to confirm the diagnostic reliability of the non-extension sign.

  14. Computational simulation for concurrent engineering of aerospace propulsion systems

    NASA Technical Reports Server (NTRS)

    Chamis, C. C.; Singhal, S. N.

    1993-01-01

    Results are summarized for an investigation to assess the infrastructure available and the technology readiness in order to develop computational simulation methods/software for concurrent engineering. These results demonstrate that development of computational simulation methods for concurrent engineering is timely. Extensive infrastructure, in terms of multi-discipline simulation, component-specific simulation, system simulators, fabrication process simulation, and simulation of uncertainties--fundamental to develop such methods, is available. An approach is recommended which can be used to develop computational simulation methods for concurrent engineering of propulsion systems and systems in general. Benefits and issues needing early attention in the development are outlined.

  15. Computational simulation of concurrent engineering for aerospace propulsion systems

    NASA Technical Reports Server (NTRS)

    Chamis, C. C.; Singhal, S. N.

    1992-01-01

    Results are summarized of an investigation to assess the infrastructure available and the technology readiness in order to develop computational simulation methods/software for concurrent engineering. These results demonstrate that development of computational simulations methods for concurrent engineering is timely. Extensive infrastructure, in terms of multi-discipline simulation, component-specific simulation, system simulators, fabrication process simulation, and simulation of uncertainties - fundamental in developing such methods, is available. An approach is recommended which can be used to develop computational simulation methods for concurrent engineering for propulsion systems and systems in general. Benefits and facets needing early attention in the development are outlined.

  16. Computational simulation of concurrent engineering for aerospace propulsion systems

    NASA Technical Reports Server (NTRS)

    Chamis, C. C.; Singhal, S. N.

    1992-01-01

    Results are summarized of an investigation to assess the infrastructure available and the technology readiness in order to develop computational simulation methods/software for concurrent engineering. These results demonstrate that development of computational simulations methods for concurrent engineering is timely. Extensive infrastructure, in terms of multi-discipline simulation, component-specific simulation, system simulators, fabrication process simulation, and simulation of uncertainties - fundamental in developing such methods, is available. An approach is recommended which can be used to develop computational simulation methods for concurrent engineering for propulsion systems and systems in general. Benefits and facets needing early attention in the development are outlined.

  17. A Comparison of 3 Ways of Conventional Pap Smear, Liquid-Based Cytology and Colposcopy vs Cervical Biopsy for Early Diagnosis of Premalignant Lesions or Cervical Cancer in Women with Abnormal Conventional Pap Test.

    PubMed

    Karimi-Zarchi, Mojgan; Peighmbari, Fateme; Karimi, Neda; Rohi, Mitra; Chiti, Zohre

    2013-12-01

    The most cost effective method of prevention and detection of cervical cancer is the Pap smear. In abnormal Pap smear, colposcopy, endocervical curettage and biopsy will be done. Gold standard method in detecting cervical lesion is biopsy. Now in two ways conventional Pap smear and liquid base are routine diagnostic technique in Iran and given easily and cost-effectiveness of this method in the detection of cervical lesions to determine the sensitivity the objective of this study was compare three methods of Pap smear and colposcopy in detection of any lesion to gold standard biopsy in the positive ASC cases who referred to gynecologic Oncology Clinic of shahid Sadoughi University of Medical Science. This study is a descriptive analytic in 2009-2010 years on 150 cases of patients with Atypical Squamose Cell (ASC) results in previous pap smear ,conventional pap smear, liquid based pap smear, colposcopy and cervical biopsy had been done for all patient and finally data were analyzed with chi-square statistical test on spss ver 16 saftware. Average age of patients in this study was, 42 ± 9.9 year and reason for referring patients in 35.4% of cases was due to follow-up of abnormal results of previous Pap smear, in 30% bleeding, 12% Pain and 2.6% percent of cases was checking-up. In final results of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy any of the methods conventional and liquid based Pap smear and colposcopy were compared with cervical biopsy as a gold standard. The conventional Pap smear method had a sensitivity 51%, specificity 66.6%, PPV 96%, NPV was 8% and accuracy was 92%, about the liquid base Pap smear method, sensitivity was 55.3%, specificity was 77.7%, PPV was 97.5%, NPV was 10% and accuracy was 56/6%. About the colposcopy, sensitivity was70/9 % specificity 44/4%, PPV was 95.2%, NPV was 8/8% and accuracy was 69.3%. The relationship between sensitivity results of conventional Pap smear and

  18. Concurrent and Longitudinal Predictors of Calculation Skills in Preschoolers

    ERIC Educational Resources Information Center

    Tobia, Valentina; Bonifacci, Paola; Marzocchi, Gian Marco

    2016-01-01

    Early calculation abilities in preschoolers are predictive of mathematics achievement in subsequent grades (e.g., Jordan et al. 2009). Two studies were conducted to evaluate concurrent and longitudinal predictors of early calculation skills. In the first study, 102 preschoolers (57.8% female; mean age?=?60.57?±?8.66 months) were given vocabulary,…

  19. Concurrent and Longitudinal Predictors of Calculation Skills in Preschoolers

    ERIC Educational Resources Information Center

    Tobia, Valentina; Bonifacci, Paola; Marzocchi, Gian Marco

    2016-01-01

    Early calculation abilities in preschoolers are predictive of mathematics achievement in subsequent grades (e.g., Jordan et al. 2009). Two studies were conducted to evaluate concurrent and longitudinal predictors of early calculation skills. In the first study, 102 preschoolers (57.8% female; mean age?=?60.57?±?8.66 months) were given vocabulary,…

  20. Estimating concurrence via entanglement witnesses

    SciTech Connect

    Jurkowski, Jacek; Chruscinski, Dariusz

    2010-05-15

    We show that each entanglement witness detecting a given bipartite entangled state provides an estimation of its concurrence. We illustrate our result with several well-known examples of entanglement witnesses and compare the corresponding estimation of concurrence with other estimations provided by the trace norm of partial transposition and realignment.

  1. Concurrent Validity and Holland's Theory

    ERIC Educational Resources Information Center

    Gaffey, Robert L.; Walsh, W. Bruce

    1974-01-01

    This study was designed to explore two areas: (1) the concurrent validity of Holland's theory for employed men using four different operational definitions of vocational orientation, and (2) the relationships among all possible combinations of same named scales across the four inventories. Findings tend to support the concurrent validity of…

  2. Concurrent Validity and Holland's Theory

    ERIC Educational Resources Information Center

    Gaffey, Robert L.; Walsh, W. Bruce

    1974-01-01

    This study was designed to explore two areas: (1) the concurrent validity of Holland's theory for employed men using four different operational definitions of vocational orientation, and (2) the relationships among all possible combinations of same named scales across the four inventories. Findings tend to support the concurrent validity of…

  3. Measuring coherence with entanglement concurrence

    NASA Astrophysics Data System (ADS)

    Qi, Xianfei; Gao, Ting; Yan, Fengli

    2017-07-01

    Quantum coherence is a fundamental manifestation of the quantum superposition principle. Recently, Baumgratz et al (2014 Phys. Rev. Lett. 113 140401) presented a rigorous framework to quantify coherence from the view of theory of physical resource. Here we propose a new valid quantum coherence measure which is a convex roof measure, for a quantum system of arbitrary dimension, essentially using the generalized Gell-Mann matrices. Rigorous proof shows that the proposed coherence measure, coherence concurrence, fulfills all the requirements dictated by the resource theory of quantum coherence measures. Moreover, strong links between the resource frameworks of coherence concurrence and entanglement concurrence is derived, which shows that any degree of coherence with respect to some reference basis can be converted to entanglement via incoherent operations. Our work provides a clear quantitative and operational connection between coherence and entanglement based on two kinds of concurrence. This new coherence measure, coherence concurrence, may also be beneficial to the study of quantum coherence.

  4. Social Development from Infancy to Adolescence: Longitudinal and Concurrent Factors in an Adoption Sample

    ERIC Educational Resources Information Center

    Jaffari-Bimmel, Nicole; Juffer, Femmie; van IJzendoorn, Marinus H.; Bakermans-Kranenburg, Marian J.; Mooijaart, Ab

    2006-01-01

    In the present longitudinal study, early adopted children (N = 160) were followed from infancy to adolescence to assess the influence of previous and concurrent factors on the children's social development. This study allowed for more conclusive evidence of the influence of early and concurrent rearing experiences and temperament on…

  5. Moon Convention

    NASA Image and Video Library

    2015-03-23

    People with similar jobs or interests hold conventions and meetings, so why shouldn't moons? Pandora, Prometheus, and Pan -- seen here, from right to left -- also appear to be holding some sort of convention in this image. Some moons control the structure of nearby rings via gravitational "tugs." The cumulative effect of the moon's tugs on the ring particles can keep the rings' edges from spreading out as they are naturally inclined to do, much like shepherds control their flock. Pan is a prototypical shepherding moon, shaping and controlling the locations of the inner and outer edges of the Encke gap through a mechanism suggested in 1978 to explain the narrow Uranian rings. However, though Prometheus and Pandora have historically been called "the F ring shepherd moons" due to their close proximity to the ring, it has long been known that the standard shepherding mechanism that works so well for Pan does not apply to these two moons. The mechanism for keeping the F ring narrow, and the roles played -- if at all -- by Prometheus and Pandora in the F ring's configuration are not well understood. This is an ongoing topic for study by Cassini scientists. This view looks toward the sunlit side of the rings from about 29 degrees above the ringplane. The image was taken in visible light with the Cassini spacecraft narrow-angle camera on Jan. 2, 2015. The view was obtained at a distance of approximately 1.6 million miles (2.6 million kilometers) from the rings and at a Sun-ring-spacecraft, or phase, angle of 86 degrees. Image scale is 10 miles (15 kilometers) per pixel. http://photojournal.jpl.nasa.gov/catalog/pia18306

  6. Symbolically Modeling Concurrent MCAPI Executions

    NASA Technical Reports Server (NTRS)

    Fischer, Topher; Mercer, Eric; Rungta, Neha

    2011-01-01

    Improper use of Inter-Process Communication (IPC) within concurrent systems often creates data races which can lead to bugs that are challenging to discover. Techniques that use Satisfiability Modulo Theories (SMT) problems to symbolically model possible executions of concurrent software have recently been proposed for use in the formal verification of software. In this work we describe a new technique for modeling executions of concurrent software that use a message passing API called MCAPI. Our technique uses an execution trace to create an SMT problem that symbolically models all possible concurrent executions and follows the same sequence of conditional branch outcomes as the provided execution trace. We check if there exists a satisfying assignment to the SMT problem with respect to specific safety properties. If such an assignment exists, it provides the conditions that lead to the violation of the property. We show how our method models behaviors of MCAPI applications that are ignored in previously published techniques.

  7. Concurrent vs. Conjoint Marital Therapy.

    ERIC Educational Resources Information Center

    Hefner, Charles W.; Prochaska, James O.

    1984-01-01

    Evaluated couples (N=27) randomly assigned to conjoint or concurrent therapy to compare treatment effectiveness with regard to intrapersonal and interpersonal problems. Results showed no differences between the two treatments on any of the outcome measures. (LLL)

  8. Concurrent Engineering Working Group White Paper Distributed Collaborative Design: The Next Step in Aerospace Concurrent Engineering

    NASA Technical Reports Server (NTRS)

    Hihn, Jairus; Chattopadhyay, Debarati; Karpati, Gabriel; McGuire, Melissa; Panek, John; Warfield, Keith; Borden, Chester

    2011-01-01

    As aerospace missions grow larger and more technically complex in the face of ever tighter budgets, it will become increasingly important to use concurrent engineering methods in the development of early conceptual designs because of their ability to facilitate rapid assessments and trades of performance, cost and schedule. To successfully accomplish these complex missions with limited funding, it is essential to effectively leverage the strengths of individuals and teams across government, industry, academia, and international agencies by increased cooperation between organizations. As a result, the existing concurrent engineering teams will need to increasingly engage in distributed collaborative concurrent design. The purpose of this white paper is to identify a near-term vision for the future of distributed collaborative concurrent engineering design for aerospace missions as well as discuss the challenges to achieving that vision. The white paper also documents the advantages of creating a working group to investigate how to engage the expertise of different teams in joint design sessions while enabling organizations to maintain their organizations competitive advantage.

  9. Concurrent Engineering Working Group White Paper Distributed Collaborative Design: The Next Step in Aerospace Concurrent Engineering

    NASA Technical Reports Server (NTRS)

    Hihn, Jairus; Chattopadhyay, Debarati; Karpati, Gabriel; McGuire, Melissa; Panek, John; Warfield, Keith; Borden, Chester

    2011-01-01

    As aerospace missions grow larger and more technically complex in the face of ever tighter budgets, it will become increasingly important to use concurrent engineering methods in the development of early conceptual designs because of their ability to facilitate rapid assessments and trades of performance, cost and schedule. To successfully accomplish these complex missions with limited funding, it is essential to effectively leverage the strengths of individuals and teams across government, industry, academia, and international agencies by increased cooperation between organizations. As a result, the existing concurrent engineering teams will need to increasingly engage in distributed collaborative concurrent design. The purpose of this white paper is to identify a near-term vision for the future of distributed collaborative concurrent engineering design for aerospace missions as well as discuss the challenges to achieving that vision. The white paper also documents the advantages of creating a working group to investigate how to engage the expertise of different teams in joint design sessions while enabling organizations to maintain their organizations competitive advantage.

  10. Comparison of human papillomavirus DNA tests, liquid-based cytology and conventional cytology for the early detection of cervix uteri cancer.

    PubMed

    Girianelli, Vania R; Thuler, Luiz Claudio S; Szklo, Moyses; Donato, Alexandre; Zardo, Lucilia M G; Lozana, José A; Almeida Neto, Olimpio F; Carvalho, Aurenice C L; Matos, Jorge H; Figueiredo, Valeska

    2006-12-01

    To compare the performance of human papillomavirus DNA tests (samples collected by a healthcare professional and self-collected) and liquid-based cytology with conventional cytology in the detection of cervix uteri cancer and its precursor lesions. A cross-sectional study was carried out in 1777 women living in poor communities in Rio de Janeiro State, Brazil. Eligibility criteria included ages 25-59 years and not having had a Papanicolau test within at least 3 years prior to the study. Cytology (conventional or liquid-based) and human papillomavirus DNA (collected by a healthcare professional or self-collected) tests were performed using samples collected in a single visit. Women with abnormalities in at least one test and a systematic sample of 70 women with negative test results were referred to a colposcopic examination. Test readings were double-masked, and the outcome of interest was high-grade squamous intraepithelial lesion or worse. The pathology report was used as the gold standard. The prevalence of high-grade squamous intraepithelial lesion or worse was 2.0%. Human papillomavirus DNA test collected by a health professional alone or combined with conventional cytology had the highest sensitivity (91.4 and 97.1%, respectively). The highest specificity was found for conventional cytology (91.6%) and for a human papillomavirus DNA test collected by a healthcare professional (90.2%). On the basis of only test performance, the use of human papillomavirus DNA tests, alone or combined with cytology, would seem to be recommended. Its population-wide implementation, however, is conditional on a cost-effectiveness analysis.

  11. Fuzzy simulation in concurrent engineering

    NASA Technical Reports Server (NTRS)

    Kraslawski, A.; Nystrom, L.

    1992-01-01

    Concurrent engineering is becoming a very important practice in manufacturing. A problem in concurrent engineering is the uncertainty associated with the values of the input variables and operating conditions. The problem discussed in this paper concerns the simulation of processes where the raw materials and the operational parameters possess fuzzy characteristics. The processing of fuzzy input information is performed by the vertex method and the commercial simulation packages POLYMATH and GEMS. The examples are presented to illustrate the usefulness of the method in the simulation of chemical engineering processes.

  12. Object-oriented concurrent programming

    SciTech Connect

    Yonezawa, A.; Tokoro, M.

    1986-01-01

    This book deals with a major theme of the Japanese Fifth Generation Project, which emphasizes logic programming, parallelism, and distributed systems. It presents a collection of tutorials and research papers on a new programming and design methodology in which the system to be constructed is modeled as a collection of abstract entities called ''objects'' and concurrent messages passing among objects. The book includes proposals for programming languages that support this methodology, as well as the applications of object-oriented concurrent programming to such areas as artificial intelligence, software engineering, music synthesis, office information systems, and system programming.

  13. Fuzzy simulation in concurrent engineering

    NASA Technical Reports Server (NTRS)

    Kraslawski, A.; Nystrom, L.

    1992-01-01

    Concurrent engineering is becoming a very important practice in manufacturing. A problem in concurrent engineering is the uncertainty associated with the values of the input variables and operating conditions. The problem discussed in this paper concerns the simulation of processes where the raw materials and the operational parameters possess fuzzy characteristics. The processing of fuzzy input information is performed by the vertex method and the commercial simulation packages POLYMATH and GEMS. The examples are presented to illustrate the usefulness of the method in the simulation of chemical engineering processes.

  14. A Comparison of Equine-Assisted Intervention and Conventional Play-Based Early Intervention for Mother-Child Dyads with Insecure Attachment

    ERIC Educational Resources Information Center

    Beetz, Andrea; Winkler, Nora; Julius, Henri; Uvnäs-Moberg, Kerstin; Kotrschal, Kurt

    2015-01-01

    Early interventions aim at promoting a good mother-child relationship as basis for a good socio-emotional development, especially in high-risk populations, and at correcting already unfavorable patterns of interaction and are common today. Insecure attachment, both of the child and of the mother, has been identified as a risk factor for early…

  15. A Comparison of Equine-Assisted Intervention and Conventional Play-Based Early Intervention for Mother-Child Dyads with Insecure Attachment

    ERIC Educational Resources Information Center

    Beetz, Andrea; Winkler, Nora; Julius, Henri; Uvnäs-Moberg, Kerstin; Kotrschal, Kurt

    2015-01-01

    Early interventions aim at promoting a good mother-child relationship as basis for a good socio-emotional development, especially in high-risk populations, and at correcting already unfavorable patterns of interaction and are common today. Insecure attachment, both of the child and of the mother, has been identified as a risk factor for early…

  16. Early development of cloned bovine embryos produced from oocytes enucleated by fluorescence metaphase II imaging using a conventional halogen-lamp microscope.

    PubMed

    Iwamoto, Daisaku; Yamagata, Kazuo; Kishi, Masao; Hayashi-Takanaka, Yoko; Kimura, Hiroshi; Wakayama, Teruhiko; Saeki, Kazuhiro

    2015-04-01

    Enucleation of a recipient oocyte is one of the key processes in the procedure of somatic cell nuclear transfer (SCNT). However, especially in bovine species, lipid droplets spreading in the ooplasm hamper identification and enucleation of metaphase II (MII) chromosomes, and thereby the success rate of the cloning remains low. In this study we used a new experimental system that enables fluorescent observation of chromosomes in living oocytes without any damage. We succeeded in visualizing and removing the MII chromosome in matured bovine oocytes. This experimental system consists of injecting fluorescence-labeled antibody conjugates that bind to chromosomes and fluorescent observation using a conventional halogen-lamp microscope. The cleavage rates and blastocyst rates of bovine embryos following in vitro fertilization (IVF) decreased as the concentration of the antibody increased (p<0.05). The enucleation rate of the conventional method (blind enucleation) was 86%, whereas all oocytes injected with the antibody conjugates were enucleated successfully. Fusion rates and developmental rates of SCNT embryos produced with the enucleated oocytes were the same as those of the blind enucleation group (p>0.05). For the production of SCNT embryos, the new system can be used as a reliable predictor of the location of metaphase plates in opaque oocytes, such as those in ruminant animals.

  17. Concurrent Resurgence and Behavioral History

    ERIC Educational Resources Information Center

    da Silva, Stephanie P.; Maxwell, Megan E.; Lattal, Kennon A.

    2008-01-01

    The contribution of past experiences to concurrent resurgence was investigated in three experiments. In Experiment 1, resurgence was related to the length of reinforcement history as well as the reinforcement schedule that previously maintained responding. Specifically, more resurgence occurred when key pecks had been reinforced on a…

  18. Visualization of Concurrent Program Executions

    NASA Technical Reports Server (NTRS)

    Artho, Cyrille; Havelund, Klaus; Honiden, Shinichi

    2007-01-01

    Various program analysis techniques are efficient at discovering failures and properties. However, it is often difficult to evaluate results, such as program traces. This calls for abstraction and visualization tools. We propose an approach based on UML sequence diagrams, addressing shortcomings of such diagrams for concurrency. The resulting visualization is expressive and provides all the necessary information at a glance.

  19. Intranasal ethmoidectomy and concurrent procedures.

    PubMed

    Taylor, J S; Crocker, P V; Keebler, J S

    1982-07-01

    In this review of 526 intranasal ethmoidectomy procedures, there was a complication rate of 2.5% with no blindness, meningitis, or deaths. The rationale for associated concurrent procedures is presented. The use of an absorbable hemostatic sinus sponge and an easily removable Telfa nasal packing made possible just a two-night hospital stay in over 90% of these patients.

  20. Visualization of Concurrent Program Executions

    NASA Technical Reports Server (NTRS)

    Artho, Cyrille; Havelund, Klaus; Honiden, Shinichi

    2007-01-01

    Various program analysis techniques are efficient at discovering failures and properties. However, it is often difficult to evaluate results, such as program traces. This calls for abstraction and visualization tools. We propose an approach based on UML sequence diagrams, addressing shortcomings of such diagrams for concurrency. The resulting visualization is expressive and provides all the necessary information at a glance.

  1. Concurrent Resurgence and Behavioral History

    ERIC Educational Resources Information Center

    da Silva, Stephanie P.; Maxwell, Megan E.; Lattal, Kennon A.

    2008-01-01

    The contribution of past experiences to concurrent resurgence was investigated in three experiments. In Experiment 1, resurgence was related to the length of reinforcement history as well as the reinforcement schedule that previously maintained responding. Specifically, more resurgence occurred when key pecks had been reinforced on a…

  2. Modular verification of concurrent systems

    SciTech Connect

    Sobel, A.E.K.

    1986-01-01

    During the last ten years, a number of authors have proposed verification techniques that allow one to prove properties of individual processes by using global assumptions about the behavior of the remaining processes in the distributed program. As a result, one must justify these global assumptions before drawing any conclusions regarding the correctness of the entire program. This justification is often the most difficult part of the proof and presents a serious obstacle to hierarchical program development. This thesis develops a new approach to the verification of concurrent systems. The approach is modular and supports compositional development of programs since the proofs of each individual process of a program are completely isolated from all others. The generality of this approach is illustrated by applying it to a representative set of contemporary concurrent programming languages, namely: CSP, ADA, Distributed Processes, and a shared variable language. In addition, it is also shown how the approach may be used to deal with a number of other constructs that have been proposed for inclusion in concurrent languages: FORK and JOIN primitives, nested monitor calls, path expressions, atomic transactions, and asynchronous message passing. These results allow argument that the approach is universal and can be used to design proof systems for any concurrent language.

  3. Dual-energy computed tomography for the assessment of early treatment effects of regorafenib in a preclinical tumor model: comparison with dynamic contrast-enhanced CT and conventional contrast-enhanced single-energy CT.

    PubMed

    Knobloch, Gesine; Jost, Gregor; Huppertz, Alexander; Hamm, Bernd; Pietsch, Hubertus

    2014-08-01

    The potential diagnostic value of dual-energy computed tomography (DE-CT) compared to dynamic contrast-enhanced CT (DCE-CT) and conventional contrast-enhanced CT (CE-CT) in the assessment of early regorafenib treatment effects was evaluated in a preclinical setting. A rat GS9L glioma model was examined with contrast-enhanced dynamic DE-CT measurements (80 kV/140 kV) for 4 min before and on days 1 and 4 after the start of daily regorafenib or placebo treatment. Tumour time-density curves (0-240 s, 80 kV), DE-CT (60 s) derived iodine maps and the DCE-CT (0-30 s, 80 kV) based parameters blood flow (BF), blood volume (BV) and permeability (PMB) were calculated and compared to conventional CE-CT (60 s, 80 kV). The regorafenib group showed a marked decrease in the tumour time-density curve, a significantly lower iodine concentration and a significantly lower PMB on day 1 and 4 compared to baseline, which was not observed for the placebo group. CE-CT showed a significant decrease in tumour density on day 4 but not on day 1. The DE-CT-derived iodine concentrations correlated with PMB and BV but not with BF. DE-CT allows early treatment monitoring, which correlates with DCE-CT. Superior performance was observed compared to single-energy CE-CT. • Regorafenib treatment response was evaluated by CT in a rat tumour model. • Dual-energy contrast-enhanced CT allows early treatment monitoring of targeted anti-tumour therapies. • Dual-energy CT showed higher diagnostic potential than conventional contrast enhanced single-energy CT. • Dual-energy CT showed diagnostic potential comparable to dynamic contrast-enhanced CT. • Dual-energy CT is a promising method for efficient clinical treatment response evaluation.

  4. An Integrated Approach to Risk Assessment for Concurrent Design

    NASA Technical Reports Server (NTRS)

    Meshkat, Leila; Voss, Luke; Feather, Martin; Cornford, Steve

    2005-01-01

    This paper describes an approach to risk assessment and analysis suited to the early phase, concurrent design of a space mission. The approach integrates an agile, multi-user risk collection tool, a more in-depth risk analysis tool, and repositories of risk information. A JPL developed tool, named RAP, is used for collecting expert opinions about risk from designers involved in the concurrent design of a space mission. Another in-house developed risk assessment tool, named DDP, is used for the analysis.

  5. An Integrated Approach to Risk Assessment for Concurrent Design

    NASA Technical Reports Server (NTRS)

    Meshkat, Leila; Voss, Luke; Feather, Martin; Cornford, Steve

    2005-01-01

    This paper describes an approach to risk assessment and analysis suited to the early phase, concurrent design of a space mission. The approach integrates an agile, multi-user risk collection tool, a more in-depth risk analysis tool, and repositories of risk information. A JPL developed tool, named RAP, is used for collecting expert opinions about risk from designers involved in the concurrent design of a space mission. Another in-house developed risk assessment tool, named DDP, is used for the analysis.

  6. Characterization of lymphoid follicles with red ring signs as first manifestation of early Crohn's disease by conventional histopathology and confocal laser endomicroscopy.

    PubMed

    Krauss, Ekaterina; Agaimy, Abbas; Neumann, Helmut; Schulz, Ulrike; Kessler, Hermann; Hartmann, Arndt; Neurath, Markus F; Raithel, Martin; Mudter, Jonas

    2012-01-01

    Clinical observations suggest that the lymphoid follicles (LFs) may play a crucial role in the pathogenesis of inflammatory bowel disease (IBD), especially in Crohn's disease (CD) as the site of initial mucosal inflammation. The aim of this study was to compare the morphology of LFs in CD, ulcerative colitis (UC) and control patients using confocal laser endomicroscopy (CLE) in correlation to histological and immunohistochemical findings of biopsies. 79 patients with IBD (46 with CD, 32 with UC and 1 patient with indeterminate colitis) and 67 controls patients were enrolled prospectively in this study. Median age was 32.5 years (range 19-65) and 37.4 years (range 20-65 years) respectively. To analyze the LFs, standardized images from the terminal ileum and the colon were taken using white-light video endoscopes. Additionally, CLE was performed to analyze subsurface structure of LFs. Targeted biopsies of LFs were analyzed using haematoxylin and eosin stain and immunohistochemistry. LFs were seen in all parts of the lower GI tract, but mostly in the terminal ileum and cecum. Endoscopy in 15 out of 17 patients with the first manifestation of CD showed LFs surrounded by red ring (so-called red ring sign, RRS). Histologically, LFs with RRS showed hypervascularization at the base of the LFs associated with numerous CD15-positive granulocytes. Similar features were not seen in LFs without RRS and in the control group. In some LFs with RRS early aphthous ulcers were seen. Using CLE, RRS showed abolished normal crypt architecture, crypt distortion, increased cellular infiltrate within the lamina propria, and dilated vessels. LFs with RRS probably represent an early sign of aphthous ulcers in early CD and, thus, may be considered as early markers of first manifestation and flares in CD.

  7. Concurrency and discrete event control

    NASA Technical Reports Server (NTRS)

    Heymann, Michael

    1990-01-01

    Much of discrete event control theory has been developed within the framework of automata and formal languages. An alternative approach inspired by the theories of process-algebra as developed in the computer science literature is presented. The framework, which rests on a new formalism of concurrency, can adequately handle nondeterminism and can be used for analysis of a wide range of discrete event phenomena.

  8. 78 FR 41078 - Acceptance of Concurrent Jurisdiction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ... accepted concurrent legislative jurisdiction from the State of Michigan over lands and waters administered by the National Park Service within the boundaries of Sleeping Bear Dunes National Lakeshore. DATES: Effective Date: Concurrent legislative jurisdiction within Sleeping Bear Dunes National Lakeshore...

  9. 36 CFR 292.69 - Concurrent reclamation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Concurrent reclamation. 292... reclamation. Plans of operations involving locatable minerals, operating plans involving outstanding mineral... practicable, that reclamation proceed concurrently with the mineral operation. ...

  10. 36 CFR 292.69 - Concurrent reclamation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Concurrent reclamation. 292... reclamation. Plans of operations involving locatable minerals, operating plans involving outstanding mineral... practicable, that reclamation proceed concurrently with the mineral operation. ...

  11. 36 CFR 292.69 - Concurrent reclamation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 2 2012-07-01 2012-07-01 false Concurrent reclamation. 292... reclamation. Plans of operations involving locatable minerals, operating plans involving outstanding mineral... practicable, that reclamation proceed concurrently with the mineral operation. ...

  12. 36 CFR 292.69 - Concurrent reclamation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Concurrent reclamation. 292... reclamation. Plans of operations involving locatable minerals, operating plans involving outstanding mineral... practicable, that reclamation proceed concurrently with the mineral operation. ...

  13. Strengthening Concurrent Enrollment through NACEP Accreditation

    ERIC Educational Resources Information Center

    Scheffel, Kent; McLemore, Yvette; Lowe, Adam

    2015-01-01

    This chapter describes how implementing the National Alliance of Concurrent Enrollment Partnerships' 17 accreditation standards strengthens a concurrent enrollment program, enhances secondary-postsecondary relations, and benefits students, their families, and secondary and postsecondary institutions.

  14. [EFFICACY AND SECURITY OF A CONVENTIONAL PROCEDURE OF PLASMAPHERESIS IN COMPLEX OF TREATMENT OF NONBILIARY ACUTE PANCREATITIS IN EARLY PHASE OF THE DISEASE].

    PubMed

    Mishalov, V G; Markulan, L Yu; Matveyev, R M

    2016-02-01

    Abstract Efficacy and security of a plasmapheresis procedure in complex of treatment of nonbiliary acute pancreatitis in early phase of the disease were established, basing on the treatment results analysis in 48 patients. The plasmapheresis results were estimated in accordance to changes revealed in the intoxication leukocytic index (ILI), a general protein (GP) content, general calcium (GC) in the blood plasm and of the activated partial thrombin time (APTHT). Application of plasmapheresis in patients, suffering purulent pancreatitis in the enzymal phase, have guaranteed a staged reduction of ILI by (34.86 ± 1.27)%, the APTHT enhancement from (35.15 ± 0.37) to (52.01 ± 0.62) sec, a trustworthy lowering of the GP by (4.35 ± 0.02) g/L at average and of GC in a blood plasmby (10.45 ± 0.38)%.

  15. Functional diffusion map as an early imaging biomarker for high-grade glioma: correlation with conventional radiologic response and overall survival.

    PubMed

    Hamstra, Daniel A; Galbán, Craig J; Meyer, Charles R; Johnson, Timothy D; Sundgren, Pia C; Tsien, Christina; Lawrence, Theodore S; Junck, Larry; Ross, David J; Rehemtulla, Alnawaz; Ross, Brian D; Chenevert, Thomas L

    2008-07-10

    Assessment of radiologic response (RR) for brain tumors utilizes the Macdonald criteria 8 to 10 weeks from the start of treatment. Diffusion magnetic resonance imaging (MRI) using a functional diffusion map (fDM) may provide an earlier measure to predict patient survival. Sixty patients with high-grade glioma were enrolled onto a study of intratreatment MRI at 1, 3, and 10 weeks. Receiver operating characteristic curve analysis was used to evaluate imaging parameters as a function of patient survival at 1 year. Both log-rank and Cox proportional hazards models were utilized to assess overall survival. Greater increases in diffusion in response to therapy over time were observed in those patients alive at 1 year compared with those who died as a result of disease. The volume of tumor with increased diffusion by fDM at 3 weeks was the strongest predictor of patient survival at 1 year, with larger fDM predicting longer median survival (52.6 v 10.9 months; log-rank, P < .003; hazard ratio [HR] = 2.7; 95% CI, 1.5 to 5.9). Radiologic response at 10 weeks had similar prognostic value (median survival, 31.6 v 10.9 months; log-rank P < .0007; HR = 2.9; 95% CI, 1.7 to 7.2). Radiologic response and fDM differed in 25% of cases. A composite index of response including fDM and RR provided a robust predictor of patient survival and may identify patients in whom RR does not correlate with clinical outcome. Compared with conventional neuroimaging, fDM provided an earlier assessment of equal predictive value, and the combination of fDM and RR provided a more accurate prediction of patient survival than either metric alone.

  16. Concurrent sexual partnerships among African American women in Philadelphia: results from a qualitative study

    PubMed Central

    Nunn, Amy; Dickman, Samuel; Cornwall, Alexandra; Kwakwa, Helena; Mayer, Kenneth H.; Rosengard, Cynthia

    2014-01-01

    Background African American women are disproportionately affected by HIV/AIDS. Concurrent sexual partnerships may contribute to racial disparities in HIV infection. Little is known about attitudes and practices related to concurrency among African American women and the social, structural and behavioral factors that influence concurrency. Methods We recruited 19 heterosexual African American women engaging in concurrent sexual partnerships from a public health clinic in Philadelphia in 2009. We conducted in-depth interviews exploring social norms, attitudes and practices about concurrency, and the structural, social and behavioral factors influencing concurrent sexual partnerships. Grounded theory guided interview protocols and data analysis. Results Seventeen women reported one main and one or more non-main partners; two reported no main partners. Many women used condoms more frequently with non-main than main partners, noting they trust main partners more than non-main partners. Social factors influencing concurrency included social normalization of concurrency, inability to negotiate partners’ other concurrent partnerships, being unmarried, and not trusting main and non-main partners. Not trusting partners and the community at large were the most commonly cited reasons that women engaged in concurrent partnerships. Structural factors included economic dependence on partners, partners’ dependence on women for economic support and housing, and incarceration that interrupted partnerships. Behavioral factors including alcohol and cocaine use influenced concurrency. Conclusions Social, structural, and behavioral factors strongly influenced these African American women’s concurrent sexual partnerships. Many evidence-based interventions (EBIs) disseminated by the US Centers for Disease Control and Prevention (CDC) focus largely on behavioral factors and may fail to address the social and structural factors influencing African American women’s sexual networks

  17. Exclusive Preference Develops Less Readily on Concurrent Ratio Schedules with Wheel-Running than with Sucrose Reinforcement

    ERIC Educational Resources Information Center

    Belke, Terry W.

    2010-01-01

    Previous research suggested that allocation of responses on concurrent schedules of wheel-running reinforcement was less sensitive to schedule differences than typically observed with more conventional reinforcers. To assess this possibility, 16 female Long Evans rats were exposed to concurrent FR FR schedules of reinforcement and the schedule…

  18. Clastic sediment source characterisation using discrete and included magnetic particles their relationship to conventional petrographic methods in early Pleistocene fluvial glacial sediments, Upper Don River Basin (Russia)

    NASA Astrophysics Data System (ADS)

    Alekseeva, Veronika A.; Hounslow, Mark W.

    Data from mineral magnetics, heavy mineral and quartz grain micromorphology analysis are compared, from early Pleistocene glacial sediments in the River Don palaeo-valley (central part of the Russian Plain). The aim was to evaluate the relative sensitivity of discrete and included magnetic particle populations to depositional processes, sediment provenance and particle size fractionation. Two size fractions from each sample were used for the magnetic measurements, 0.5-1 and 0.25-0.5 mm, on both the original fractions and after acid dissolution to isolate the magnetic inclusions. Quartz micromorphology was assessed on the 0.25-0.5 mm fraction, and is an indicator of the depositional environment and transport process. This shows three morphological groups, whose abundance in each section appears unrelated to their geographic position in the palaeo-valley. The heavy mineral data on the 0.1-0.25 mm fraction, shows a difference in the relative content of sediment derived from a Scandinavian source, mainly reflected in the epidote and amphibole content. The content of Fe-oxides reflects this Scandinavian source by its larger magnetic abundance parameters and lesser haematite content. The discriminating power of magnetic data for separating sediment provenance is not the same across the two studied grain size fractions. The discrete magnetic particles seem to be more powerful in the finer fraction and the included magnetic particles in the coarser fraction. These data show that combined discrete and included mineral magnetic approach offers potentially complementary and powerful means of characterizing glacial sediments for purposes of provenance indication.

  19. Concepts of concurrent programming. Final report

    SciTech Connect

    Bustard, D.W.

    1990-04-01

    A concurrent program is one defining actions that may be performed simultaneously. This module discusses the nature of such programs and provides an overview of the means by which they may be constructed and executed. Emphasis is given to the terminology used in this field and the underlying concepts involved. This module is largely concerned with explicit concurrency, where concurrent behavior is specified by the program designer. Particular attention is paid to programs that can be considered inherently concurrent, that is, programs that are constructed to control or model physical systems that involve parallel activity. The module also includes a brief introduction to performance-oriented concurrency, where concurrency is used to improve program performance by taking advantage of hardware support for parallel processing. The module is divided into three sections. The first deals with basic concepts in concurrent programming, covering characteristic attributes, formal properties, standard design problems, and execution details. The second section discusses the steps in constructing concurrent programs for specification to coding. The final section briefly examines concurrency from the point of view of some common application areas. The module gives a foundation for a deeper study of specific topics in concurrent programming. It also provides the preparatory material for a study of the concurrent aspects of application areas such as real-time (embedded) systems, database systems, operating systems, and many simulation systems.

  20. Conventional magnetic superconductors

    SciTech Connect

    Wolowiec, C. T.; White, B. D.; Maple, M. B.

    2015-07-01

    We discuss several classes of conventional magnetic superconductors including the ternary rhodium borides and molybdenum chalcogenides (or Chevrel phases), and the quaternary nickel-borocarbides. These materials exhibit some exotic phenomena related to the interplay between superconductivity and long-range magnetic order including: the coexistence of superconductivity and antiferromagnetic order; reentrant and double reentrant superconductivity, magnetic field induced superconductivity, and the formation of a sinusoidally-modulated magnetic state that coexists with superconductivity. We introduce the article with a discussion of the binary and pseudobinary superconducting materials containing magnetic impurities which at best exhibit short-range “glassy” magnetic order. Early experiments on these materials led to the idea of a magnetic exchange interaction between the localized spins of magnetic impurity ions and the spins of the conduction electrons which plays an important role in understanding conventional magnetic superconductors. Furthermore, these advances provide a natural foundation for investigating unconventional superconductivity in heavy-fermion compounds, cuprates, and other classes of materials in which superconductivity coexists with, or is in proximity to, a magnetically-ordered phase.

  1. Conventional magnetic superconductors

    DOE PAGES

    Wolowiec, C. T.; White, B. D.; Maple, M. B.

    2015-07-01

    We discuss several classes of conventional magnetic superconductors including the ternary rhodium borides and molybdenum chalcogenides (or Chevrel phases), and the quaternary nickel-borocarbides. These materials exhibit some exotic phenomena related to the interplay between superconductivity and long-range magnetic order including: the coexistence of superconductivity and antiferromagnetic order; reentrant and double reentrant superconductivity, magnetic field induced superconductivity, and the formation of a sinusoidally-modulated magnetic state that coexists with superconductivity. We introduce the article with a discussion of the binary and pseudobinary superconducting materials containing magnetic impurities which at best exhibit short-range “glassy” magnetic order. Early experiments on these materials led tomore » the idea of a magnetic exchange interaction between the localized spins of magnetic impurity ions and the spins of the conduction electrons which plays an important role in understanding conventional magnetic superconductors. Furthermore, these advances provide a natural foundation for investigating unconventional superconductivity in heavy-fermion compounds, cuprates, and other classes of materials in which superconductivity coexists with, or is in proximity to, a magnetically-ordered phase.« less

  2. Concurrent fractional and equilibrium crystallisation

    NASA Astrophysics Data System (ADS)

    Sha, Lian-Kun

    2012-06-01

    This paper proposes the concept of concurrent fractional and equilibrium crystallisation (CFEC) in a multi-phase magmatic system in light of experimental results on diffusivities of elements and other species in minerals and melts. A group of equations are presented to describe how the concentrations of an element or isotope change in fractionated solid, equilibrated solid, melt, liquid, and gas phases, as well as in magma, as a function of distribution coefficients and mass fractions during the CFEC process. CFEC model is a generalised and unified formulation that is valid, not only for pure fractional crystallisation (FC) and perfect equilibrium crystallisation (EC) singly, as two of its limiting end-member cases, but also for the geologically more important process of concurrent fractional and equilibrium crystallisation. The concept that both fractional and equilibrium crystallisation can operate concurrently in a magmatic system, for a given element, among different minerals, and even within different-sized crystal grains of the very same mineral phase, is of fundamental importance in deepening our current understanding of magmatic differentiation processes. CFEC probably occurs more frequently in the natural world than either pure fractional or perfect equilibrium crystallisation alone, as a result of the interplay of varying diffusivities of elements under diverse physicochemical conditions, different residence time and growth rates of mineral phases in magmas, and varying grain sizes within each phase and among different phases. The marked systematic variations in trace element concentrations in the melts of the Bishop Tuff have long been perplexing and difficult to reconcile with existing models of differentiation. CFEC, which is able to better explain the scatter trends in a systematic way than fractional crystallisation, is considered to be the cause.

  3. Concurrent engineering teams. Volume 2: Annotated bibliography

    NASA Astrophysics Data System (ADS)

    Richter, Karen J.; Dierolf, David A.

    1990-11-01

    Specific concurrent engineering practices vary among organizations. There are, however, various management practices that appear to work well for most organizations. This paper presents the reader with specific, useful examples from several defense contractors illustrating how multifunctional concurrent engineering teams are being organized and managed and how concurrent engineering team meetings are conducted and supported. The types of computer support that could be used to enhance the efficiency and effectiveness of concurrent engineering team meetings are identified. The general findings are that there exists a direct relationship between total quality management (TQM) and concurrent engineering, and that many applications of computer-aided group problem solving are possible and practical today for the concurrent engineering team meetings. Areas identified for additional research are the documentation of the decision process and rationale during the product and process definition, the capturing of lessons learned during the implementation of concurrent engineering, and the performance evaluation and training of team members.

  4. Leukocyte-poor platelet-rich plasma is more effective than the conventional therapy with acetaminophen for the treatment of early knee osteoarthritis.

    PubMed

    Simental-Mendía, Mario; Vílchez-Cavazos, José F; Peña-Martínez, Víctor M; Said-Fernández, Salvador; Lara-Arias, Jorge; Martínez-Rodríguez, Herminia Guadalupe

    2016-12-01

    Knee osteoarthritis (OA) is a degenerative and progressive articular cartilage disease. Infiltration of autologous platelet-rich plasma (PRP) has been proposed as a therapeutic alternative due to the content of biologically active cytokines in PRP. We aimed to compare the clinical response of acetaminophen and intra-articular leukocyte-poor PRP (LP-PRP) in early knee OA. A total of 65 patients with clinically and radiographically documented knee OA (grade 1-2) were analyzed. Patients were randomized into two groups: 32 were treated with acetaminophen (500 mg/8 h) over 6 weeks, and 33 received three intra-articular injections of autologous LP-PRP (once every 2 weeks). All patients were evaluated by the Visual Analogue Scale (VAS), the Western Ontario and McMaster Universities (WOMAC) score, and the SF-12 health survey at baseline and 6, 12, and 24 weeks of follow-up. All LP-PRP preparations were analyzed for the platelet, leukocyte, IL-1ra, and TGF-β concentrations. The decrease in the VAS pain level in the LP-PRP group was greater than that in the acetaminophen group (p < 0.05). Patients treated with LP-PRP showed a sustained improvement in knee function at week 24 (p < 0.01). The SF-12 results only indicated an improvement in quality-of-life in the LP-PRP group at 6, 12, and 24 weeks of follow-up (p < 0.01). Both IL-1ra and TGF-β were detected in the LP-PRP samples (313.8 ± 231.6 and 21,183.8 ± 8556.3 pg/mL, respectively). Treatment with LP-PRP injections resulted in a significantly better clinical outcome than did treatment with acetaminophen, with sustained lower EVA and WOMAC scores and improvement in quality-of-life (higher SF-12 score). Therapy with LP-PRP may positively modify the inflammatory joint environment by counteracting IL-1β action.

  5. How to Improve the Early Diagnosis of Trypanosoma cruzi Infection: Relationship between Validated Conventional Diagnosis and Quantitative DNA Amplification in Congenitally Infected Children

    PubMed Central

    Bua, Jacqueline; Volta, Bibiana J.; Perrone, Alina E.; Scollo, Karenina; Velázquez, Elsa B.; Ruiz, Andres M.; De Rissio, Ana M.

    2013-01-01

    Background According to the Chagas congenital transmission guides, the diagnosis of infants, born to Trypanosoma cruzi infected mothers, relies on the detection of parasites by INP micromethod, and/or the persistence of T. cruzi specific antibody titers at 10–12 months of age. Methodology and Principal Findings Parasitemia levels were quantified by PCR in T. cruzi-infected children, grouped according to the results of one-year follow-up diagnosis: A) Neonates that were diagnosed in the first month after delivery by microscopic blood examination (INP micromethod) (n = 19) had a median parasitemia of 1,700 Pe/mL (equivalent amounts of parasite DNA per mL); B) Infants that required a second parasitological diagnosis at six months of age (n = 10) showed a median parasitemia of around 20 Pe/mL and 500 Pe/mL at 1 and 6 months old, respectively, and C) babies with undetectable parasitemia by three blood microscopic observations but diagnosed by specific anti - T. cruzi serology at around 1 year old, (n = 22), exhibited a parasitemia of around 5 Pe/mL, 800 Pe/mL and 20 Pe/mL 1, 6 and 12 month after delivery, respectively. T. cruzi parasites were isolated by hemoculture from 19 congenitally infected children, 18 of which were genotypified as DTU TcV, (former lineage TcIId) and only one as TcI. Significance This report is the first to quantify parasitemia levels in more than 50 children congenitally infected with T. cruzi, at three different diagnostic controls during one-year follow-up after delivery. Our results show that the parasite burden in some children (22 out of 51) is below the detection limit of the INP micromethod. As the current trypanocidal treatment proved to be very effective to cure T. cruzi - infected children, more sensitive parasitological methods should be developed to assure an early T. cruzi congenital diagnosis. PMID:24147166

  6. Concurrent ultrasonic weld evaluation system

    DOEpatents

    Hood, D.W.; Johnson, J.A.; Smartt, H.B.

    1987-12-15

    A system for concurrent, non-destructive evaluation of partially completed welds for use in conjunction with an automated welder is disclosed. The system utilizes real time, automated ultrasonic inspection of a welding operation as the welds are being made by providing a transducer which follows a short distance behind the welding head. Reflected ultrasonic signals are analyzed utilizing computer based digital pattern recognition techniques to discriminate between good and flawed welds on a pass by pass basis. The system also distinguishes between types of weld flaws. 5 figs.

  7. Concurrent ultrasonic weld evaluation system

    DOEpatents

    Hood, Donald W.; Johnson, John A.; Smartt, Herschel B.

    1987-01-01

    A system for concurrent, non-destructive evaluation of partially completed welds for use in conjunction with an automated welder. The system utilizes real time, automated ultrasonic inspection of a welding operation as the welds are being made by providing a transducer which follows a short distance behind the welding head. Reflected ultrasonic signals are analyzed utilizing computer based digital pattern recognition techniques to discriminate between good and flawed welds on a pass by pass basis. The system also distinguishes between types of weld flaws.

  8. Concurrent ultrasonic weld evaluation system

    DOEpatents

    Hood, D.W.; Johnson, J.A.; Smartt, H.B.

    1985-09-04

    A system for concurrent, non-destructive evaluation of partially completed welds for use in conjunction with an automated welder. The system utilizes real time, automated ultrasonic inspection of a welding operation as the welds are being made by providing a transducer which follows a short distance behind the welding head. Reflected ultrasonic signals are analyzed utilizing computer based digital pattern recognition techniques to discriminate between good and flawed welds on a pass by pass basis. The system also distinguishes between types of weld flaws.

  9. Barriers in Concurrent Separation Logic

    NASA Astrophysics Data System (ADS)

    Hobor, Aquinas; Gherghina, Cristian

    We develop and prove sound a concurrent separation logic for Pthreads-style barriers. Although Pthreads barriers are widely used in systems, and separation logic is widely used for verification, there has not been any effort to combine the two. Unlike locks and critical sections, Pthreads barriers enable simultaneous resource redistribution between multiple threads and are inherently stateful, leading to significant complications in the design of the logic and its soundness proof. We show how our logic can be applied to a specific example program in a modular way. Our proofs are machine-checked in Coq.

  10. Randomized Trial Comparing Conventional-Dose With High-Dose Conformal Radiation Therapy in Early-Stage Adenocarcinoma of the Prostate: Long-Term Results From Proton Radiation Oncology Group/American College of Radiology 95-09

    PubMed Central

    Zietman, Anthony L.; Bae, Kyounghwa; Slater, Jerry D.; Shipley, William U.; Efstathiou, Jason A.; Coen, John J.; Bush, David A.; Lunt, Margie; Spiegel, Daphna Y.; Skowronski, Rafi; Jabola, B. Rodney; Rossi, Carl J.

    2010-01-01

    Purpose To test the hypothesis that increasing radiation dose delivered to men with early-stage prostate cancer improves clinical outcomes. Patients and Methods Men with T1b-T2b prostate cancer and prostate-specific antigen ≤ 15 ng/mL were randomly assigned to a total dose of either 70.2 Gray equivalents (GyE; conventional) or 79.2 GyE (high). No patient received androgen suppression therapy with radiation. Local failure (LF), biochemical failure (BF), and overall survival (OS) were outcomes. Results A total of 393 men were randomly assigned, and median follow-up was 8.9 years. Men receiving high-dose radiation therapy were significantly less likely to have LF, with a hazard ratio of 0.57. The 10-year American Society for Therapeutic Radiology and Oncology BF rates were 32.4% for conventional-dose and 16.7% for high-dose radiation therapy (P < .0001). This difference held when only those with low-risk disease (n = 227; 58% of total) were examined: 28.2% for conventional and 7.1% for high dose (P < .0001). There was a strong trend in the same direction for the intermediate-risk patients (n = 144; 37% of total; 42.1% v 30.4%, P = .06). Eleven percent of patients subsequently required androgen deprivation for recurrence after conventional dose compared with 6% after high dose (P = .047). There remains no difference in OS rates between the treatment arms (78.4% v 83.4%; P = .41). Two percent of patients in both arms experienced late grade ≥ 3 genitourinary toxicity, and 1% of patients in the high-dose arm experienced late grade ≥ 3 GI toxicity. Conclusion This randomized controlled trial shows superior long-term cancer control for men with localized prostate cancer receiving high-dose versus conventional-dose radiation. This was achieved without an increase in grade ≥ 3 late urinary or rectal morbidity. PMID:20124169

  11. Concurrent Image Processing Executive (CIPE)

    NASA Technical Reports Server (NTRS)

    Lee, Meemong; Cooper, Gregory T.; Groom, Steven L.; Mazer, Alan S.; Williams, Winifred I.

    1988-01-01

    The design and implementation of a Concurrent Image Processing Executive (CIPE), which is intended to become the support system software for a prototype high performance science analysis workstation are discussed. The target machine for this software is a JPL/Caltech Mark IIIfp Hypercube hosted by either a MASSCOMP 5600 or a Sun-3, Sun-4 workstation; however, the design will accommodate other concurrent machines of similar architecture, i.e., local memory, multiple-instruction-multiple-data (MIMD) machines. The CIPE system provides both a multimode user interface and an applications programmer interface, and has been designed around four loosely coupled modules; (1) user interface, (2) host-resident executive, (3) hypercube-resident executive, and (4) application functions. The loose coupling between modules allows modification of a particular module without significantly affecting the other modules in the system. In order to enhance hypercube memory utilization and to allow expansion of image processing capabilities, a specialized program management method, incremental loading, was devised. To minimize data transfer between host and hypercube a data management method which distributes, redistributes, and tracks data set information was implemented.

  12. Preparing HEP software for concurrency

    NASA Astrophysics Data System (ADS)

    Clemencic, M.; Hegner, B.; Mato, P.; Piparo, D.

    2014-06-01

    The necessity for thread-safe experiment software has recently become very evident, largely driven by the evolution of CPU architectures towards exploiting increasing levels of parallelism. For high-energy physics this represents a real paradigm shift, as concurrent programming was previously only limited to special, well-defined domains like control software or software framework internals. This paradigm shift, however, falls into the middle of the successful LHC programme and many million lines of code have already been written without the need for parallel execution in mind. In this paper we have a closer look at the offline processing applications of the LHC experiments and their readiness for the many-core era. We review how previous design choices impact the move to concurrent programming. We present our findings on transforming parts of the LHC experiment reconstruction software to thread-safe code, and the main design patterns that have emerged during the process. A plethora of parallel-programming patterns are well known outside the HEP community, but only a few have turned out to be straightforward enough to be suited for non-expert physics programmers. Finally, we propose a potential strategy for the migration of existing HEP experiment software to the many-core era.

  13. Secondary Syphilis With Hepatitis and Nephrotic Syndrome: A Rare Concurrence.

    PubMed

    Makker, Jasbir; Bajantri, Bharat; Nayudu, Suresh Kumar

    2016-07-01

    Syphilis, a chronic multisystem disease, is caused by a spirochete, Treponema pallidum. Clinical presentation may expand to several stages including primary, secondary and latent syphilis, which may present as early or late syphilis. Nephrotic syndrome and acute hepatitis are well-known complications of secondary syphilis. To the best of our knowledge, secondary syphilis with coexisting renal and hepatic complications has rarely been reported. Here we present a rare case of concurrent nephrotic syndrome and acute hepatitis in a patient with secondary syphilis.

  14. 47 CFR 61.136 - Revocation of concurrences.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Revocation of concurrences. 61.136 Section 61...) TARIFFS Concurrences § 61.136 Revocation of concurrences. A concurrence may be revoked by a revocation notice or cancelled by a new concurrence. A revocation notice or a new concurrence, if less broad...

  15. Concurrent rendezvous control of underactuated spacecraft

    NASA Astrophysics Data System (ADS)

    Muralidharan, Vijay; Reza Emami, M.

    2017-09-01

    The concurrent control of spacecraft equipped with one-axis unilateral thruster and three-axis attitude actuator is considered in this paper. The proposed control law utilizes attitude control channels along with the single thrust force concurrently, for three-dimensional trajectory tracking and rendezvous with a target object. The concurrent controller also achieves orbital transfer to low Earth orbits with long range separation. To demonstrate the orbit transfer capabilities of the concurrent controller, a smooth elliptical orbit transfer trajectory for co-planar circular orbits is designed. The velocity change and energy consumption of the designed orbit transfer trajectory is observed to be equivalent to that of Hohmann transfer.

  16. Automated Concurrent Blackboard System Generation in C++

    NASA Technical Reports Server (NTRS)

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

    1999-01-01

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

  17. Preliminary results of a randomized study (NPC-9902 Trial) on therapeutic gain by concurrent chemotherapy and/or accelerated fractionation for locally advanced nasopharyngeal carcinoma

    SciTech Connect

    Lee, Anne W.M. . E-mail: awmlee@ha.org.hk; Tung, Stewart Y.; Chan, Anthony T.C.; Chappell, Rick; Fu, Y.-T.; Lu, Tai-Xiang; Tan, Terence; Chua, Daniel T.T.; O'Sullivan, Brian; Xu, Shirley L.; Pang, Ellie S.Y.; Sze, W.-M.; Leung, T.-W.; Kwan, W.-H.; Chan, Paddy; Liu, X.-F.; Tan, E.-H.; Sham, Jonathan; Siu, Lillian; Lau, W.-H.

    2006-09-01

    Purpose: To compare the benefit achieved by concurrent chemoradiotherapy (CRT) and/or accelerated fractionation (AF) vs. radiotherapy (RT) alone with conventional fractionation (CF) for patients with T3-4N0-1M0 nasopharyngeal carcinoma (NPC). Methods and Materials: All patients were irradiated with the same RT technique to {>=}66 Gy at 2 Gy per fraction, conventional five fractions/week in the CF and CF+C (chemotherapy) arms, and accelerated six fractions/week in the AF and AF+C arms. The CF+C and AF+C patients were given the Intergroup 0099 regimen (concurrent cisplatin plus adjuvant cisplatin and 5-fluorouracil). Results: Between 1999 and April 2004, 189 patients were randomly assigned; the trial was terminated early because of slow accrual. The median follow-up was 2.9 years. When compared with the CF arm, significant improvement in failure-free survival (FFS) was achieved by the AF+C arm (94% vs. 70% at 3 years, p = 0.008), but both the AF arm and the CF+C arm were insignificant (p {>=} 0.38). Multivariate analyses showed that CRT was a significant factor: hazard ratio (HR) = 0.52 (0.28-0.97), AF per se was insignificant: HR = 0.68 (0.37-1.25); the interaction of CRT by AF was strongly significant (p = 0.006). Both CRT arms had significant increase in acute toxicities (p < 0.005), and the AF+C arm also incurred borderline increase in late toxicities (34% vs. 14% at 3 years, p = 0.05). Conclusions: Preliminary results suggest that concurrent chemoradiotherapy with accelerated fractionation could significantly improve tumor control when compared with conventional RT alone; further confirmation of therapeutic ratio is warranted.

  18. Concurrent oxytocin in women needing second dinoprostone.

    PubMed

    Sher, Zaiba; Ashraf, Mussaret; Irum, Nabila; Bashir, Shaheen; Khaliq, Nagina; Yaqub, Saima

    2015-05-01

    To reduce average induction delivery internal in patients with poor Bishop score without compromising fetomaternal outcome (in terms of birth weight, NICU admission, maternal complications and mode of delivery). A descriptive study. Department of Obstetrics and Gynaecology, Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad, from February to December 2009. All patients needing 2nd dinoprostone pessary for induction of labour were included in the study. Patients with gestation below 37 weeks, those with intra-uterine growth restriction, bad obstetric history, previous uterine scar and patients in whom Bishop score improved for amniotomy after 1st dinoprostone pessary, were excluded. Data was collected on a special proforma where all variables were defined. Out of 90 patients, 44 (48.8%) had spontaneous vertex deliveries and 12 (13.3%) had instrumental deliveries so a total vaginal deliveries occurred in 56 (62.2%) patients. Thirty four patients (37.8%) had emergency caesarean sections. Main indication for cesarean was failure to progress in 1st stage of labour followed by fetal distress. There were 3 failed inductions. Only 2 patients had hyperstimulation. NICU admission were 8 and all babies were discharged healthy from nursery with no case of early neonatal death. Concurrent oxytocin with 2nd dinoprostone in patients with poor Bishop scores (initial scores 2 and 3) resulted in more vaginal birth and comparatively shorter induction delivery time with almost negligible fetomaternal complications.

  19. Comparison of three different concurrent chemoradiation regimens for treatment of laryngeal cancer.

    PubMed

    Aydil, Utku; Akmansu, Müge; Gumusay, Özge; Bakkal, Faruk Kadri; Yazıcı, Ömer; Kızıl, Yusuf; Köybaşıoğlu, Ahmet; Yıldız, Ramazan; Büyükberber, Süleyman; İnal, Erdoğan

    2016-09-01

    During last decades, laryngeal organ preservation strategies have emerged. The data about the oncological outcomes mainly come from multi-institutional prospective studies. In this study, we aimed to determine the oncological outcomes of different organ preservation regimens applied in routine practice. Patients who had definitive concurrent chemoradiation (CRT) for treatment of laryngeal cancer between January 2001 and June 2013 were retrospectively reviewed. There were 139 subjects who met the inclusion criteria. Three groups were defined: group A (n = 59) consisted of subjects who had concurrent cisplatin and radiotherapy (RT), group B (n = 47) consisted of subjects who had cisplatin/docetaxel-based concurrent CRT, and group C (n = 33) had induction chemotherapy before concurrent cisplatin and RT. The Kaplan-Meier estimated 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence-free survival (LRFS) rates for the whole study group were 66.5, 69.2, 69.6, and 88.9 %, respectively. None of these survival rates were statistically different when the treatment arms were compared. The 3- and 5-year LRFS rates were significantly lower in subjects with a T4a tumor (p = 0.030). According to our results, the oncological outcomes of three different platinum-based concurrent chemotherapy schemes were similar and high local control rates could be achieved with the use of these protocols. Neoadjuvant chemotherapy before concurrent CRT was not superior to conventional concurrent treatment.

  20. Concurrence control for transactions with priorities

    NASA Technical Reports Server (NTRS)

    Marzullo, Keith

    1989-01-01

    Priority inversion occurs when a process is delayed by the actions of another process with less priority. With atomic transactions, the concurrency control mechanism can cause delays, and without taking priorities into account can be a source of priority inversion. Three traditional concurrency control algorithms are extended so that they are free from unbounded priority inversion.

  1. Concurrency control for transactions with priorities

    NASA Technical Reports Server (NTRS)

    Marzullo, Keith

    1989-01-01

    Priority inversion occurs when a process is delayed by the actions of another process with less priority. With atomic transations, the concurrency control mechanism can cause delays, and without taking priorities into account can be a source of priority inversion. In this paper, three traditional concurrency control algorithms are extended so that they are free from unbounded priority inversion.

  2. 29 CFR 500.141 - Concurrent actions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Concurrent actions. 500.141 Section 500.141 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS MIGRANT AND SEASONAL AGRICULTURAL WORKER PROTECTION Enforcement § 500.141 Concurrent actions. The taking of any one...

  3. Specifying the behavior of concurrent systems

    NASA Technical Reports Server (NTRS)

    Furtek, F. C.

    1984-01-01

    A framework for rigorously specifying the behavior of concurrent systems is proposed. It is based on the view of a concurrent system as a collection of interacting processes but no assumptions are made about the mechanisms for process synchronization and communication. A formal language is described that permits the expression of a broad range of logical and timing dependencies.

  4. A Concurrent Support Course for Intermediate Algebra

    ERIC Educational Resources Information Center

    Cooper, Cameron I.

    2011-01-01

    This article summarizes the creation and implementation of a concurrent support class for TRS 92--Intermediate Algebra, a developmental mathematics course at Fort Lewis College in Durango, Colorado. The concurrent course outlined in this article demonstrates a statistically significant increase in student success rates since its inception.…

  5. New concurrent iterative methods with monotonic convergence

    SciTech Connect

    Yao, Qingchuan

    1996-12-31

    This paper proposes the new concurrent iterative methods without using any derivatives for finding all zeros of polynomials simultaneously. The new methods are of monotonic convergence for both simple and multiple real-zeros of polynomials and are quadratically convergent. The corresponding accelerated concurrent iterative methods are obtained too. The new methods are good candidates for the application in solving symmetric eigenproblems.

  6. 36 CFR 292.69 - Concurrent reclamation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Concurrent reclamation. 292.69 Section 292.69 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL RECREATION AREAS Smith River National Recreation Area Other Provisions § 292.69 Concurrent...

  7. 37 CFR 2.42 - Concurrent use.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Concurrent use. 2.42 Section 2.42 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.42 Concurrent use. An application...

  8. A Concurrent Support Course for Intermediate Algebra

    ERIC Educational Resources Information Center

    Cooper, Cameron I.

    2011-01-01

    This article summarizes the creation and implementation of a concurrent support class for TRS 92--Intermediate Algebra, a developmental mathematics course at Fort Lewis College in Durango, Colorado. The concurrent course outlined in this article demonstrates a statistically significant increase in student success rates since its inception.…

  9. Reducing Concurrency Bottlenecks in Parallel I/O Workloads

    SciTech Connect

    Manzanares, Adam C.; Bent, John M.; Wingate, Meghan

    2011-01-01

    To enable high performance parallel checkpointing we introduced the Parallel Log Structured File System (PLFS). PLFS is middleware interposed on the file system stack to transform concurrent writing of one application file into many non-concurrently written component files. The promising effectiveness of PLFS makes it important to examine its performance for workloads other than checkpoint capture, notably the different ways that state snapshots may be later read, to make the case for using PLFS in the Exascale I/O stack. Reading a PLFS file involved reading each of its component files. In this paper we identify performance limitations on broader workloads in an early version of PLFS, specifically the need to build and distribute an index for the overall file, and the pressure on the underlying parallel file system's metadata server, and show how PLFS's decomposed components architecture can be exploited to alleviate bottlenecks in the underlying parallel file system.

  10. Gaudi components for concurrency: Concurrency for existing and future experiments

    NASA Astrophysics Data System (ADS)

    Clemencic, M.; Funke, D.; Hegner, B.; Mato, P.; Piparo, D.; Shapoval, I.

    2015-05-01

    HEP experiments produce enormous data sets at an ever-growing rate. To cope with the challenge posed by these data sets, experiments’ software needs to embrace all capabilities modern CPUs offer. With decreasing memory/core ratio, the one-process-per-core approach of recent years becomes less feasible. Instead, multi-threading with fine-grained parallelism needs to be exploited to benefit from memory sharing among threads. Gaudi is an experiment-independent data processing framework, used for instance by the ATLAS and LHCbexperiments at CERN's Large Hadron Collider. It has originally been designed with only sequential processing in mind. In a recent effort, the frame work has been extended to allow for multi-threaded processing. This includes components for concurrent scheduling of several algorithms - either processingthe same or multiple events, thread-safe data store access and resource management. In the sequential case, the relationships between algorithms are encoded implicitly in their pre-determined execution order. For parallel processing, these relationships need to be expressed explicitly, in order for the scheduler to be able to exploit maximum parallelism while respecting dependencies between algorithms. Therefore, means to express and automatically track these dependencies need to be provided by the framework. In this paper, we present components introduced to express and track dependencies of algorithms to deduce a precedence-constrained directed acyclic graph, which serves as basis for our algorithmically sophisticated scheduling approach for tasks with dynamic priorities. We introduce an incremental migration path for existing experiments towards parallel processing and highlight the benefits of explicit dependencies even in the sequential case, such as sanity checks and sequence optimization by graph analysis.

  11. The Concurrent Programming of Saccades

    PubMed Central

    McSorley, Eugene; McCloy, Rachel; Williams, Louis

    2016-01-01

    Sequences of saccades have been shown to be prepared concurrently however it remains unclear exactly what aspects of those saccades are programmed in parallel. To examine this participants were asked to make one or two target-driven saccades: a reflexive saccade; a voluntary saccade; a reflexive then a voluntary saccade; or vice versa. During the first response the position of a second target was manipulated. The new location of the second saccade target was found to impact on second saccade latencies and second saccade accuracy showing that some aspects of the second saccade program are prepared in parallel with the first. However, differences were found in the specific pattern of effects for each sequence type. These differences fit well within a general framework for saccade control in which a common priority map for saccade control is computed and the influence of saccade programs on one another depends not so much on the types of saccade being produced but rather on the rate at which their programs develop. PMID:28005964

  12. TEACH - A concurrent robot control language

    NASA Technical Reports Server (NTRS)

    Ruoff, C. F.

    1979-01-01

    This paper describes the TEACH robot control language and its supporting operating system. It addresses concurrency, device independence, and other issues related to manipulator control, task specification, and system operation.

  13. CilkSpec: Optimistic Concurrency for Cilk

    SciTech Connect

    Aga, Shaizeen D.; Krishnamoorthy, Sriram; Narayanasamy, Satish

    2015-11-15

    Recursive parallel programming models such as Cilk strive to simplify the task of parallel programming by enabling a simple divide-and-conquer model of programming. This model is effective in re- cursively partitioning work into smaller parts and combining their results. However, recursive work partitioning can impose additional constraints on concurrency than is implied by the true dependences in a program. In this paper, we present a speculation-based approach to alleviate the concurrency constraints imposed by such recursive parallel programs. We design a runtime infrastructure that supports speculative execution and a predictor to accurately learn and identify opportunities to relax extraneous concurrency constraints. Experimental evaluation demonstrates that speculative relaxation of concurrency constraints can deliver gains of up to 1.6× on 30 cores over baseline Cilk.

  14. Secondary Syphilis With Hepatitis and Nephrotic Syndrome: A Rare Concurrence

    PubMed Central

    Makker, Jasbir; Bajantri, Bharat; Nayudu, Suresh Kumar

    2016-01-01

    Syphilis, a chronic multisystem disease, is caused by a spirochete, Treponema pallidum. Clinical presentation may expand to several stages including primary, secondary and latent syphilis, which may present as early or late syphilis. Nephrotic syndrome and acute hepatitis are well-known complications of secondary syphilis. To the best of our knowledge, secondary syphilis with coexisting renal and hepatic complications has rarely been reported. Here we present a rare case of concurrent nephrotic syndrome and acute hepatitis in a patient with secondary syphilis. PMID:27298666

  15. Inheritance and Synchronization in Concurrent OOP

    NASA Astrophysics Data System (ADS)

    Briot, Jean-Pierre; Yonezawa, Akinori

    This paper discusses knowledge sharing (inheritance) mechanisms for Object-Oriented Programming (OOP) in the context of concurrent (distributed) languages. We review three different schemes: inheritance, delegation and copy. A fourth model, called recipe-query, is presented and all are compared and criticized. Techniques relying on the shared memory assumption are rejected. We point out the conflict between distributing knowledge among objects and the synchronization of concurrent objects.

  16. Concurrent processing in nonlinear structural stability

    NASA Technical Reports Server (NTRS)

    Darbhamulla, S. P.; Razzaq, Z.; Storaasli, O. O.

    1986-01-01

    A concurrent processing algorithm is developed for materially nonlinear stability analysis of imperfect columns with biaxial partial rotational end restraints. The algorithm for solving the governing nonlinear ordinary differential equations is implemented on a multiprocessor computer called the 'Finite Element Machine', developed at the NASA Langley Research Center. Numerical results are obtained on up to nine concurrent processors. A substantial computational gain is achieved in using the parallel processing approach.

  17. Concurrent processing in nonlinear structural stability

    NASA Technical Reports Server (NTRS)

    Darbhamulla, S. P.; Razzaq, Z.; Storaasli, O. O.

    1986-01-01

    A concurrent processing algorithm is developed for materially nonlinear stability analysis of imperfect columns with biaxial partial rotational end restraints. The algorithm for solving the governing nonlinear ordinary differential equations is implemented on a multiprocessor computer called the 'Finite Element Machine', developed at the NASA Langley Research Center. Numerical results are obtained on up to nine concurrent processors. A substantial computational gain is achieved in using the parallel processing approach.

  18. Interpretive model for a ''a concurrency method''

    SciTech Connect

    Carter, C.L.

    1986-06-01

    ''A Concurrency Method'' is a language embodying the data flow characteristics of data-drive and single-assignment. The interpreter for ''A Concurrency Method'' models a physical machine with an architecture directed toward this language. The interpreter is a complete system with scheduler, editor, load balancer and message handler. This model embraces some architectural features in other data flow machines and models and combines these features in a manner most conducive to this language. 9 refs., 5 figs.

  19. Concurrent planning and execution for autonomous robots

    NASA Technical Reports Server (NTRS)

    Simmons, Reid G.

    1992-01-01

    The Task Control Architecture (TCA) provides communication and coordination facilities to construct distributed, concurrent robotic systems. The use of TCA in a system that walks a legged robot through rugged terrain is described. The walking system, as originally implemented, had a sequential sense-plan-act control cycle. Utilizing TCA features for task sequencing and monitoring, the system was modified to concurrently plan and execute steps. Walking speed improved by over 30 percent, with only a relatively modest conversion effort.

  20. Human CD45RA(-) FoxP3(hi) Memory-Type Regulatory T Cells Show Distinct TCR Repertoires With Conventional T Cells and Play an Important Role in Controlling Early Immune Activation.

    PubMed

    Lei, H; Kuchenbecker, L; Streitz, M; Sawitzki, B; Vogt, K; Landwehr-Kenzel, S; Millward, J; Juelke, K; Babel, N; Neumann, A; Reinke, P; Volk, H-D

    2015-10-01

    Adoptive immunotherapy with regulatory T cells (Treg) is a new option to promote immune tolerance following solid organ transplantation (SOT). However, Treg from elderly patients awaiting transplantation are dominated by the CD45RA(-) CD62L(+) central memory type Treg subset (TregCM), and the yield of well-characterized and stable naïve Treg (TregN) is low. It is, therefore, important to determine whether these TregCM are derived from the thymus and express high stability, suppressive capacity and a broad antigen repertoire like TregN. In this study, we showed that TregCM use a different T cell receptor (TCR) repertoire from conventional T cells (Tconv), using next-generation sequencing of all 24 Vβ families, with an average depth of 534 677 sequences. This showed almost no contamination with induced Treg. Furthermore, TregCM showed enhanced suppressive activity on Tconv at early checkpoints of immune activation controlling activation markers expression and cytokine secretion, but comparable inhibition of proliferation. Following in vitro expansion under mTOR inhibition, TregCM expanded equally as well as TregN without losing their function. Despite relatively limited TCR repertoire, TregCM also showed specific alloresponse, although slightly reduced compared to TregN. These results support the therapeutic usefulness of manufacturing Treg products from CD45RA(-) CD62L(+) Treg-enriched starting material to be applied for adoptive Treg therapy. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  1. Concurrent and predictive validity of an early language screening program.

    PubMed

    Klee, T; Carson, D K; Gavin, W J; Hall, L; Kent, A; Reece, S

    1998-06-01

    The efficacy of screening 2-year-old children for language delay using a parent-report questionnaire was investigated in three studies. The Language Development Survey (Rescorla, 1989) was mailed to 650 families at the time of their child's second birthday. Fifty-three percent of the surveys received by parents were completed and returned. Screening outcomes were then compared, in double-blind fashion, with the results of comprehensive clinical evaluations at ages 2 (N = 64) and 3 (N = 36). Parents' report of the size of their children's expressive vocabularies was highly correlated with clinical language measures at age 2. Children who screened positive performed significantly poorer than children who screened negative on standardized language tests and on measures taken from spontaneous conversation. The screening program demonstrated excellent sensitivity and specificity for identifying language delay at age 2 but somewhat lower levels for predicting developmental status one year later.

  2. Correlates of Concurrent Sexual Partnerships Among Young, Rural African American Men

    PubMed Central

    Cho, Junhan; Barnum, Stacey C.; Brown, Geoffrey L.

    2015-01-01

    Objective We investigated the social, behavioral, and psychological factors associated with concurrent (i.e., overlapping in time) sexual partnerships among rural African American young men with a primary female partner. Methods We recruited 505 men in rural areas of southern Georgia from January 2012 to August 2013 using respondent-driven sampling; 361 reported having a primary female partner and participating only in heterosexual sexual activity. Men provided data on their demographic characteristics and HIV-related risk behaviors, as well as social, behavioral, and psychological risk factors. Results Of the 361 men with a primary female partner, 164 (45.4%) reported concurrent sexual partners during the past three months. Among the 164 men with a concurrent sexual partner, 144 (92.9%) reported inconsistent condom use with their primary partners, and 68 (41.5%) reported using condoms inconsistently with their concurrent partners. Having concurrent sexual partnerships was associated with inconsistent condom use, substance use before sex, and self-reported sexually transmitted infections (STIs). Bivariate correlates of concurrent sexual partnerships included incarceration, substance use, early onset of sexual activity, impulsive decision-making, and masculinity attitudes (i.e., men's adherence to culturally defined standards for male behavior). In a multivariate model, both masculinity ideology and impulsive decision-making independently predicted concurrent sexual partnerships independent of other risk factors. Conclusion Masculinity attitudes and impulsive decision-making are independent predictors of concurrent sexual partnerships among rural African American men and, consequently, the spread of HIV and other STIs. Developing programs that target masculinity attitudes and self-regulatory skills may help to reduce concurrent sexual partnerships. PMID:26345725

  3. Cincinnati; Our Convention City

    ERIC Educational Resources Information Center

    Borchin, Anna

    1970-01-01

    During Easter week, 1971, Cincinnati will be the hostess of the 50th anniversary convention of the Catholic Library Association. Items of historical interest concerning the city are briefly described. (NH)

  4. Minamata Convention on Mercury

    EPA Pesticide Factsheets

    On November 6, 2013 the United States signed the Minamata Convention on Mercury, a new multilateral environmental agreement that addresses specific human activities which are contributing to widespread mercury pollution

  5. A Quiet Convention.

    ERIC Educational Resources Information Center

    Suggs, Welch

    2003-01-01

    Describes how discussion of governance and academic standards dominated the proceedings at the first NCAA convention of Myles Brand's presidency. The new president also offered a qualified endorsement of Title IX. (EV)

  6. Analysis and modeling of concurrency, cycle time, and productivity in aerospace development projects

    NASA Astrophysics Data System (ADS)

    Hilscher, Richard Walter

    Engineering development projects are a key element of continued economic growth and profitability for companies that produce durable goods based on evolving technology. Today's world economy and the rapid pace of technology development necessitate a minimum development project cycle time to maximize the economic value of new products. Concurrent engineering and Integrated Product-Process Development (IPPD) evolved as an industry-wide strategy in the late 1980's and early 1990's to address the need for rapid product development and improved product quality. Rapid development of computer-based tools for communications and engineering has occurred in parallel with the emergence of concurrent engineering strategies. The combination of new computer tools and concurrent engineering practices has rendered many project management tools less effective or obsolete. New methods are needed for tracking progress and benchmarking projects employing concurrent engineering. Concurrent engineering and the resulting concurrency between specific activities within development projects has been associated with both positive and negative effects on project performance. This research applies empirical data analysis and computer simulation to evaluate these relationships using new metrics designed specifically for concurrent engineering analysis. By looking within the project at concurrency between specific activities, new insights have been gained into the nature and progress of concurrent engineering implementation. These relationships are useful tools in developing project plans with greater probability of success. A new metric for measuring concurrency is applied that uses the timing of information transactions between project activities and yields different conclusions than those related to time-based metrics. The research also applies a new methodology for comparison of project performance across product lines within aerospace. By using productivity rates and a new work content

  7. WE-D-BRE-04: Modeling Optimal Concurrent Chemotherapy Schedules

    SciTech Connect

    Jeong, J; Deasy, J O

    2014-06-15

    Purpose: Concurrent chemo-radiation therapy (CCRT) has become a more common cancer treatment option with a better tumor control rate for several tumor sites, including head and neck and lung cancer. In this work, possible optimal chemotherapy schedules were investigated by implementing chemotherapy cell-kill into a tumor response model of RT. Methods: The chemotherapy effect has been added into a published model (Jeong et al., PMB (2013) 58:4897), in which the tumor response to RT can be simulated with the effects of hypoxia and proliferation. Based on the two-compartment pharmacokinetic model, the temporal concentration of chemotherapy agent was estimated. Log cell-kill was assumed and the cell-kill constant was estimated from the observed increase in local control due to concurrent chemotherapy. For a simplified two cycle CCRT regime, several different starting times and intervals were simulated with conventional RT regime (2Gy/fx, 5fx/wk). The effectiveness of CCRT was evaluated in terms of reduction in radiation dose required for 50% of control to find the optimal chemotherapy schedule. Results: Assuming the typical slope of dose response curve (γ50=2), the observed 10% increase in local control rate was evaluated to be equivalent to an extra RT dose of about 4 Gy, from which the cell-kill rate of chemotherapy was derived to be about 0.35. Best response was obtained when chemotherapy was started at about 3 weeks after RT began. As the interval between two cycles decreases, the efficacy of chemotherapy increases with broader range of optimal starting times. Conclusion: The effect of chemotherapy has been implemented into the resource-conservation tumor response model to investigate CCRT. The results suggest that the concurrent chemotherapy might be more effective when delayed for about 3 weeks, due to lower tumor burden and a larger fraction of proliferating cells after reoxygenation.

  8. Concurrent mechatronic design approach for active control of cavity noise

    NASA Astrophysics Data System (ADS)

    de Oliveira, L. P. R.; da Silva, M. M.; Sas, P.; Van Brussel, H.; Desmet, W.

    2008-07-01

    Active control is a potential solution to many noise and vibration problems for improving the low-frequency performance. Cavity noise reduction as encountered for instance in aircraft cabins and vehicle interiors is a typical example. However, the conventional design of these active solutions may lead to suboptimal products, since the interaction between the vibro-acoustic plant dynamics and control dynamics is usually not considered. A proper way to design such active systems would be considering control and plant parameters concurrently. To cope with this approach, a methodology to derive a fully coupled mechatronic model that deals with both the vibro-acoustic plant dynamics as well as the control parameters is proposed. The inclusion of sensor and actuator models is investigated, since it contributes to the model accuracy as it can confer frequency, phase or amplitude limitations to the control performance. The proposed methodology provides a reduced state-space model derived from a fully coupled vibro-acoustic finite element model. Experimental data on a vibro-acoustic vehicle cabin mock-up are used to validate the model reduction procedure. Regarding noise reduction, optimization results are presented considering both vibro-acoustic plant features, such as thicknesses, and control parameters, such as sensor and actuator placement and control gains. A collocated sensor/actuator pair is considered in a velocity feedback control strategy. The benefits of a concurrent mechatronic design when dealing with active structural-acoustic control solutions are addressed, illustrated and experimentally validated.

  9. Characteristics of demyelinating Charcot-Marie-Tooth disease with concurrent diabetes mellitus

    PubMed Central

    Yu, Zhiliang; Wu, Xiaohua; Xie, Huijun; Han, Ying; Guan, Yangtai; Qin, Yong; Zheng, Huimin; Jiang, Jianming; Niu, Zhenmin

    2014-01-01

    Purpose: Charcot-Marie-Tooth disease (CMT) is the most common type of inherited peripheral neuropathy and has a high degree of genetic heterogeneity. CMT with concurrent diabetes mellitus (DM) is rare. The purpose of this study is to explore the genetic, clinical and pathological characteristics of the patients with CMT and concurrent DM. Methods: We investigated gene mutations (the peripheral myelin protein 22 gene, myelin protein zero gene, lipopolysaccharide-induced tumor necrosis factor-α factor gene, early growth response gene and the neurofilament light chain gene loci) of a relatively large and typical Chinese family with CMT1 and concurrent DM2. From the literature, we also retrieved all reported families and single cases with CMT and concurrent DM. We comprehensively analyzed the characteristics of total 33 patients with CMT and concurrent DM, and further compared these characteristics with those of patients of diabetic peripheral neuropathy (DPN). Results: Patients with CMT and concurrent DM had some relatively independent characteristics and pathogenic mechanisms. So we designated that kind of characteristic demyelinating CMT which accompanies DM as Yu-Xie syndrome (YXS), a new specific clinical subtype of CMT. Conclusion: CMT is an etiologic factor of DM, even though the intrinsic association between CMT and DM still remains further exploration. PMID:25120817

  10. Concurrent Multiscale Modeling of Embedded Nanomechanics

    SciTech Connect

    Rudd, R E

    2001-04-13

    We discuss concurrent multiscale simulations of dynamic and temperature-dependent processes found in nanomechanical systems coupled to larger scale surroundings. We focus on the behavior of sub-micron Micro-Electro-Mechanical Systems (MEMS), especially micro-resonators. The coupling of length scales methodology we have developed for MEMS employs an atomistic description of small but key regions of the system, consisting of millions of atoms, coupled concurrently to a finite element model of the periphery. The result is a model that accurately describes the behavior of the mechanical components of MEMS down to the atomic scale. This paper reviews some of the general issues involved in concurrent multiscale simulation, extends the methodology to metallic systems and describes how it has been used to identify atomistic effects in sub-micron resonators.

  11. Multidisciplinary Concurrent Design Optimization via the Internet

    NASA Technical Reports Server (NTRS)

    Woodard, Stanley E.; Kelkar, Atul G.; Koganti, Gopichand

    2001-01-01

    A methodology is presented which uses commercial design and analysis software and the Internet to perform concurrent multidisciplinary optimization. The methodology provides a means to develop multidisciplinary designs without requiring that all software be accessible from the same local network. The procedures are amenable to design and development teams whose members, expertise and respective software are not geographically located together. This methodology facilitates multidisciplinary teams working concurrently on a design problem of common interest. Partition of design software to different machines allows each constituent software to be used on the machine that provides the most economy and efficiency. The methodology is demonstrated on the concurrent design of a spacecraft structure and attitude control system. Results are compared to those derived from performing the design with an autonomous FORTRAN program.

  12. Concurrent behavior: Are the interpretations mutually exclusive?

    PubMed Central

    Lyon, David O.

    1982-01-01

    The experimental literature is replete with examples of behavior which occur concurrently with a schedule of reinforcement. These concurrent behaviors, often with similar topographies and occurring under like circumstances, may be interpreted as functionally autonomous, collateral, adjunctive, superstitious or mediating behavior. The degree to which the interaction of concurrent and schedule controlled behavior is used in the interpretation of behavior illustrated the importance of distinguishing among these interpretations by experimental procedure. The present paper reviews the characteristics of these interpretations, and discusses the experimental procedures necessary to distinguish among them. The paper concludes that the interpretations are mutually exclusive and refer to distinct behaviors, but that the distinction between any two of the interpretations requires more than one experimental procedure. PMID:22478568

  13. Examining the Concurrent Validity of Assessing Preschool Language and Literacy Skills

    ERIC Educational Resources Information Center

    Xu, Yaoying

    2012-01-01

    The purpose of this study was to examine the concurrent validity of the assessment for an early language and literacy project. The goal of the project was to promote a successful transition to kindergarten for preschoolers who were at risk for reading difficulties by equipping them with the necessary language and literacy skills needed for early…

  14. Multipartite concurrence for identical-fermion systems

    NASA Astrophysics Data System (ADS)

    Majtey, A. P.; Bouvrie, P. A.; Valdés-Hernández, A.; Plastino, A. R.

    2016-03-01

    We study the problem of detecting multipartite entanglement among indistinguishable fermionic particles. A multipartite concurrence for pure states of N identical fermions, each one having a d -dimensional single-particle Hilbert space, is introduced. Such an entanglement measure, in particular, is optimized for maximally entangled states of three identical fermions that play a role analogous to the usual (qubit) Greenberger-Horne-Zeilinger state. In addition, it is shown that the fermionic multipartite concurrence can be expressed as the mean value of an observable, provided two copies of the composite state are available.

  15. The concurrent common Lisp development environment

    NASA Technical Reports Server (NTRS)

    1988-01-01

    A discussion of the Concurrent Common Lisp Development Environment on the iNTEL Personal Super Computer (iPSC) is presented. The advent of AI based engineering design tools has lead to a need for increased performance of computational facilities which support those tools. Gold Hill has approached this problem by directing its efforts to the creation of a concurrent, distributed AI development environment. This discussion focuses on the development tools aspect of the CCLISP environment. The future direction of Gold Hill in the area of distributed AI support environments is also presented.

  16. Concurrent engineering of an infrared telescope system

    NASA Astrophysics Data System (ADS)

    Geis, Jason; Lang, Jeffrey; Peterson, Leslie; Roybal, Francisco; Tanzillo, Jennifer; Thomas, David; Warren, David

    2011-10-01

    A concurrent engineering approach to the design and analysis of a space-borne Electro-Optical (EO) sensor is presented. A detailed design of an infrared telescope payload is developed by an interdisciplinary team of mechanical, structural, thermal, and optical engineers using a Simulation Driven Engineering (SDE) software environment. The telescope payload design is also integrated with a conceptual level design of the space segment of a mission that incorporates the payload. The flow of the concurrent design process is described, and design outputs are provided.

  17. Concurrency and other sexual risk behaviors among Black young adults in a southeastern city

    PubMed Central

    Jolly, David H.; Mueller, Monique P.; Chen, Mario; Alston, Le’Marus; Hawley, Marcus; Okumu, Eunice; Eley, Natalie T.; Stancil, Tonya; MacQueen, Kathleen M.

    2017-01-01

    Black Americans continue to have higher rates of HIV disease than other races/ethnicities. Conventional individual-level risk behaviors do not fully account for these racial/ethnic disparities. Sexual concurrency may help explain them. Respondent-driven sampling (RDS) was used to enroll 508 sexually active 18 to 30 year old Black men and women in Durham, North Carolina in a cross-sectional survey on HIV-related topics. Consistent condom use was low for all participants, especially with steady partners. Concurrent partnerships in the past six months were relatively common for both men (38%) and women (25%). In general, men involved in concurrent relationships engaged in more risk behaviors than other men (e.g., inconsistent condom use and alcohol and drug use). A majority of concurrent partnerships involved steady partners. HIV prevention programs should address the risks of concurrency and factors that discourage condom use, especially with steady partners with whom condom use is particularly low. PMID:26829257

  18. Concurrent Engineering Teams. Volume 1: Main Text

    DTIC Science & Technology

    1990-11-01

    Delphi Processes. Scott, Foresman, and Co. Glenview, IL. Dertouzos, Michael L.; Lester, Rizhard K.; and Solow , Robert M. 1989. Made in America. Regaining...Nc:%* York. Nevins, James L. and Whitney, Daniel E. 1989. Concurrent Design of F-,oducts and Processes: a Strategy for the Next Generation in

  19. Network based high performance concurrent computing

    SciTech Connect

    Sunderam, V.S.

    1991-01-01

    The overall objectives of this project are to investigate research issues pertaining to programming tools and efficiency issues in network based concurrent computing systems. The basis for these efforts is the PVM project that evolved during my visits to Oak Ridge Laboratories under the DOE Faculty Research Participation program; I continue to collaborate with researchers at Oak Ridge on some portions of the project.

  20. SCOOP Structured Concurrent Object Oriented Prolog

    NASA Astrophysics Data System (ADS)

    Vaucher, Jean; Lapalme, Guy; Malenfant, Jacques

    SCOOP is an experimental language implemented in Prolog that tries to combine the best of logic, object-oriented and concurrent programming in a structured, natural and efficient manner. SCOOP provides hierarchies of object classes. These objects behave as independent Prolog programs with private databases which can execute goals within other objects.

  1. Concurrent Validity of Four Androgyny Instruments.

    ERIC Educational Resources Information Center

    Wilson, F. Robert; Cook, Ellen Piel

    1984-01-01

    Compares concurrent validity of four sex-role instruments administered to a group of 281 urban university students. Reports that the instruments are sufficiently different in their measurement characteristics to warrant limiting generalizations about behavior based on these instruments to a particular instrument being used. (KH)

  2. Concurrent Validity of the TONI-3

    ERIC Educational Resources Information Center

    Banks, Sandra H.; Franzen, Michael D.

    2010-01-01

    The literature pertaining to intelligence assessment reveals an ongoing discussion about the areas of intelligence captured by nonverbal tests. To date, few studies have investigated the criterion validity of the Test of Nonverbal Intelligence, Third Edition (TONI-3). The present study investigates the concurrent validity of the TONI-3 in a sample…

  3. Concurrent Validity of Four Androgyny Instruments.

    ERIC Educational Resources Information Center

    Wilson, F. Robert; Cook, Ellen Piel

    1984-01-01

    Compares concurrent validity of four sex-role instruments administered to a group of 281 urban university students. Reports that the instruments are sufficiently different in their measurement characteristics to warrant limiting generalizations about behavior based on these instruments to a particular instrument being used. (KH)

  4. 33 CFR 385.7 - Concurrency statements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Concurrency statements. 385.7 Section 385.7 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROGRAMMATIC REGULATIONS FOR THE COMPREHENSIVE EVERGLADES RESTORATION PLAN General Provisions...

  5. 33 CFR 385.7 - Concurrency statements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Concurrency statements. 385.7 Section 385.7 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROGRAMMATIC REGULATIONS FOR THE COMPREHENSIVE EVERGLADES RESTORATION PLAN General Provisions...

  6. 33 CFR 385.7 - Concurrency statements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Concurrency statements. 385.7 Section 385.7 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROGRAMMATIC REGULATIONS FOR THE COMPREHENSIVE EVERGLADES RESTORATION PLAN General Provisions...

  7. 33 CFR 385.7 - Concurrency statements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Concurrency statements. 385.7 Section 385.7 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROGRAMMATIC REGULATIONS FOR THE COMPREHENSIVE EVERGLADES RESTORATION PLAN General Provisions...

  8. 33 CFR 385.7 - Concurrency statements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Concurrency statements. 385.7 Section 385.7 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROGRAMMATIC REGULATIONS FOR THE COMPREHENSIVE EVERGLADES RESTORATION PLAN General Provisions...

  9. Concurrent Validity of the TONI-3

    ERIC Educational Resources Information Center

    Banks, Sandra H.; Franzen, Michael D.

    2010-01-01

    The literature pertaining to intelligence assessment reveals an ongoing discussion about the areas of intelligence captured by nonverbal tests. To date, few studies have investigated the criterion validity of the Test of Nonverbal Intelligence, Third Edition (TONI-3). The present study investigates the concurrent validity of the TONI-3 in a sample…

  10. Concurrent Engineering through Product Data Standards

    DTIC Science & Technology

    1991-05-01

    styles. Workmn’ Cv Grow, New forms of workplace orpnization in modem manufacturing facilities gives workers more responsibility [2. Increasingly, they must...still being defined today. In the same way. the integrated concurrent engineering environment will provide opportunities for new products that cannot... new products rather than the improvement or revolutionary changing of exsting manufacturing pracutes. As mentioned in the introduction, standards are

  11. Concurrent Cognitive Task Modulates Coordination Dynamics

    ERIC Educational Resources Information Center

    Pellecchia, Geraldine L.; Shockley, Kevin; Turvey, M. T.

    2005-01-01

    Does a concurrent cognitive task affect the dynamics of bimanual rhythmic coordination? In-phase coordination was performed under manipulations of phase detuning and movement frequency and either singly or in combination with an arithmetic task. Predicted direction-specific shifts in stable relative phase from 0 degrees due to detuning and…

  12. Concurrent Meta-Evaluation: A Critique

    ERIC Educational Resources Information Center

    Hanssen, Carl E.; Lawrenz, Frances; Dunet, Diane O.

    2008-01-01

    Meta-evaluations reported in the literature, although rare, often have focused on retrospective assessment of completed evaluations. Conducting a meta-evaluation concurrently with the evaluation modifies this approach. This method provides the opportunity for the meta-evaluators to advise the evaluators and provides the basis for a summative…

  13. Teaching Teamwork and Problem Solving Concurrently

    ERIC Educational Resources Information Center

    Goltz, Sonia M.; Hietapelto, Amy B.; Reinsch, Roger W.; Tyrell, Sharon K.

    2008-01-01

    Teamwork and problem-solving skills have frequently been identified by business leaders as being key competencies; thus, teaching methods such as problem-based learning and team-based learning have been developed. However, the focus of these methods has been on teaching one skill or the other. A key argument for teaching the skills concurrently is…

  14. Concurrent Meta-Evaluation: A Critique

    ERIC Educational Resources Information Center

    Hanssen, Carl E.; Lawrenz, Frances; Dunet, Diane O.

    2008-01-01

    Meta-evaluations reported in the literature, although rare, often have focused on retrospective assessment of completed evaluations. Conducting a meta-evaluation concurrently with the evaluation modifies this approach. This method provides the opportunity for the meta-evaluators to advise the evaluators and provides the basis for a summative…

  15. Concurrent Validity of McCarthy's Scales.

    ERIC Educational Resources Information Center

    Arinoldo, Carlo G.

    1982-01-01

    Data on the concurrent validity of the McCarthy Scales, using two Wechsler Scales for Children as criteria, were compared with those of previous studies. Significant moderate to strong correlations at preschool and school-age levels between the General Cognitive Index of the McCarthy and Wechsler IQ's were noted. (Author/RD)

  16. Lymecycline and concurrent ingestion of milk.

    PubMed

    Ericson, S; Gnarpe, H

    1979-01-01

    It has been suggested in the past that milk causes an impaired absorption of tetracycline and this paper describes a study set up to examine any inhibition of absorption of a tetracycline derivative, lymecycline (Tetralysal) with the concurrent intake of milk. The results of the study show no clinical reason for restricting a moderate intake of milk in conjunction with lymecycline therapy.

  17. Using Concurrent Verbalization to Measure Math Comprehension

    ERIC Educational Resources Information Center

    Lambeth, Cathryn Colley

    2012-01-01

    The current study investigated variability in student performance on a concurrent verbalization measure based on a grade-level sample math word problem and sought to determine to what extent the variability in verbalization scores is related to scores on a reliable measure of reading (DIBELS Next) and math (easyCBM) and to student factors (e.g.…

  18. Literary Competence beyond Conventions.

    ERIC Educational Resources Information Center

    Torell, Orjan

    2001-01-01

    Revises the concept of "literary competence" based on the texts produced by two Russian high school students. Shows that literacy competence cannot be reduced to internalized literary conventions, although these are a fundamental component of literary competence, and proposes a model of literary competence. Also explores merits and…

  19. Convention Problems - 1787.

    ERIC Educational Resources Information Center

    Hanson, Deroy L.

    Designed to motivate eighth-grade civics students in the study of the United States Constitution, this game is intended to simulate the basic problems faced by the delegates to the Philadelphia Convention of 1787. The four parts of the game introduce the governmental concepts of the bicameral legislature, the executive branch, the judicial branch,…

  20. Convention Problems - 1787.

    ERIC Educational Resources Information Center

    Hanson, Deroy L.

    Designed to motivate eighth-grade civics students in the study of the United States Constitution, this game is intended to simulate the basic problems faced by the delegates to the Philadelphia Convention of 1787. The four parts of the game introduce the governmental concepts of the bicameral legislature, the executive branch, the judicial branch,…

  1. Attentional Capacity Limits Gap Detection during Concurrent Sound Segregation.

    PubMed

    Leung, Ada W S; Jolicoeur, Pierre; Alain, Claude

    2015-11-01

    Detecting a brief silent interval (i.e., a gap) is more difficult when listeners perceive two concurrent sounds rather than one in a sound containing a mistuned harmonic in otherwise in-tune harmonics. This impairment in gap detection may reflect the interaction of low-level encoding or the division of attention between two sound objects, both of which could interfere with signal detection. To distinguish between these two alternatives, we compared ERPs during active and passive listening with complex harmonic tones that could include a gap, a mistuned harmonic, both features, or neither. During active listening, participants indicated whether they heard a gap irrespective of mistuning. During passive listening, participants watched a subtitled muted movie of their choice while the same sounds were presented. Gap detection was impaired when the complex sounds included a mistuned harmonic that popped out as a separate object. The ERP analysis revealed an early gap-related activity that was little affected by mistuning during the active or passive listening condition. However, during active listening, there was a marked decrease in the late positive wave that was thought to index attention and response-related processes. These results suggest that the limitation in detecting the gap is related to attentional processing, possibly divided attention induced by the concurrent sound objects, rather than deficits in preattentional sensory encoding.

  2. A Conventional Mean Pole

    NASA Astrophysics Data System (ADS)

    Stamatakos, N. G.; McCarthy, D. D.

    2016-12-01

    A CONVENTIONAL MEAN POLE PATH The gradual drift of the pole associated with the rotational axis of the Earth in a terrestrial reference frame is characterized by the motion of a "mean pole." The IERS Conventions (2010) does not provide a formal definition of such a "mean pole." In its glossary it defines the terminology "mean pole" in the celestial frame by using the definition "the position on the celestial sphere towards which the Earth's axis points at a particular epoch, with the oscillations due to precession-nutation removed." The need for a terrestrial mean pole is mentioned in Section 7.1.4 of the IERS Conventions, which outlines the procedure to account for the variation in terrestrial site coordinates caused by the pole tide. It states, that an estimate of the wander of the mean pole to within about 10 milliarc-seconds is needed to ensure that the geopotential field is aligned to the long term mean pole. Historically the angular coordinates of this "mean pole" were calculated by averaging the observed angular coordinates of the rotational pole over six years, the beat period of the annual and approximately 14-month Chandler motions of the rotational pole. The IERS Conventions (2010) realization of the mean pole is composed of a cubic fit of the polar coordinates valid over 1976-2010 and a linear model for extrapolation after 2010.0. Further it notes that in the future, the IERS conventional mean pole will be revised as needed with sufficient advance notice. However, this document leaves open the formal definition of a conventional terrestrial mean pole, the spectral frequency content to be expected in such a definition and a procedure to be used to realize the coordinates of the path for users. Background is provided regarding past realizations of a "mean pole," and the requirements for a realization of a mean pole path are reviewed. Possible definitions and potential mathematical models to provide mean pole coordinates in the future are outlined. In

  3. Conventional Reduced Risk Pesticide Program

    EPA Pesticide Factsheets

    Find out about the Conventional Reduced Risk Pesticide Program, which expedites the review and regulatory decision-making process of conventional pesticides that pose less risk to human health and the environment than existing conventional alternatives.

  4. Combination of DC Vaccine and Conventional Chemotherapeutics.

    PubMed

    Dong, Wei; Wei, Ran; Shen, Hongchang; Ni, Yang; Meng, Long; Du, Jiajun

    2016-01-01

    Recently mutual interactions of chemotherapy and immunotherapy have been widely accepted, and several synergistic mechanisms have been elucidated as well. Although much attention has focused on the combination of DC vaccine and chemotherapy, there are still many problems remaining to be resolved, including the optimal treatment schedule of the novel strategy. In this article, we methodically examined literature about the combination strategy of DC vaccine and conventional chemotherapy. Based on the published preclinical and clinical trials, treatment schedules of the combinational strategy can be classified as three modalities: chemotherapy with subsequent DC vaccine (post-DC therapy); DC vaccine followed by chemotherapy (pre-DC therapy); concurrent DC vaccine with chemotherapy (con-DC therapy).The safety and efficacy of this combinatorial immunotherapy strategy and its potential mechanisms are discussed. Although we could not draw conclusions on optimal treatment schedule, we summarize some tips which may be beneficial to trial design in the future.

  5. Conventional Strategic Deterrence

    SciTech Connect

    Latter, A.L.; Martinelli, E.A.; Speed, R.D.

    1992-08-01

    The Bush Administration argues that the US, as the world's only remaining superpower, must be prepared to intervene militarily in regional conflicts. However, the traditional American way of fighting-relying on ground forces with heavy equipment, supported by naval and air forces--could prove too expensive, both monetarily and in terms of expected American casualties, to garner the support of the American public or Congress. This paper argues that the revolution in conventional weaponry demonstrated in the Persian Gulf War opens up the possibility of a new strategy--called Conventional Strategic Deterrence--that could reduce both financial costs and casualties (if it were necessary to implement the strategy) while still being a strong and credible deterrent to regional conflict.

  6. IERS Conventions (2003)

    DTIC Science & Technology

    2004-01-01

    3), are the respective resonance frequencies associated with the Chandler wobble (CW), the retrograde free core nutation (FCN), and the pro- grade...Soc., 64, pp. 747–765. Zschau, J., 1983, “Rheology of the Earth’s mantle at tidal and Chandler Wobble periods,” Proc. Ninth Int. Symp. Earth Tides, New...Reference Frame CTRS Conventional Terrestrial Reference System CW Chandler Wobble DOMES Directory Of MERIT Sites DORIS Doppler Orbit determination

  7. Laparoscopic versus conventional appendectomy.

    PubMed Central

    Vallina, V L; Velasco, J M; McCulloch, C S

    1993-01-01

    OBJECTIVE: The goal of this study was to prospectively define the impact of laparoscopy on the management of patients with a presumed diagnosis of appendicitis. SUMMARY BACKGROUND DATA: While the role of laparoscopy in the management of cholelithiasis is well established, its impact on the management of acute appendicitis needs to be objectively defined and compared to that of conventional management. Several authors have predicted that laparoscopic appendectomy will become the preferred treatment for appendicitis. METHODS: Two groups of consecutive patients with similar clinical characteristics of acute appendicitis were compared. Data on the laparoscopic group were compiled prospectively on standardized forms; data on the conventional group were collected retrospectively. Operative time, hospital stay, analgesia, cost, and return to normal activities were noted. RESULTS: Seventeen consecutive patients who underwent appendectomy were compared to 18 consecutive patients who underwent laparoscopy (16 of these 18 had laparoscopic appendectomy). There was no significant difference between the two groups in terms of clinical characteristics and appendiceal histopathology. The mean operative times were 61 +/- 4.1 minutes and 46 +/- 2.9 minutes for the laparoscopy and conventional groups, respectively (p < 0.01). Hospital stay was significantly shorter in the laparoscopic appendectomy group, with 81% of patients being discharged on their first postoperative day (p < 0.001). The laparoscopic appendectomy patients required significantly less narcotic analgesia (p < 0.02). Return to normal activity was not significantly different between the two groups. The average total cost of laparoscopic appendectomy was 30% greater than that of conventional appendectomy. CONCLUSIONS: Laparoscopy is a useful adjunct to the management of patients with a presumed clinical diagnosis of acute appendicitis. PMID:8239785

  8. Convention, Confirmation, and Credibility

    DTIC Science & Technology

    1989-01-01

    4 It was Pierre Duhem , a physicist, who made the strongest claim regarding the conventionality of what most people think of as empirical theory near...Mach, op. cit. p. 306. 5. Pierre Duhem , The Aim and Structure of Physical Theory Princeton University Press, Princeton, 1954. In French, it appeared as...examine in detail the ideas of Mach, Poincare, and Duhem . That they had the idea that it could be philosophically respectable to regard scientific

  9. [Neonatal conventional ventilation guidelines].

    PubMed

    2001-09-01

    Respiratory pathology is a frequent problem in Neonatal Intensive Care Units; the last few years, our knowledge about its management has improved enormously. Conventional Ventilatory support is a high-specialized technique that maintains a correct alveolar gas exchange while the primary aetiology is to present some clinical guidelines for every professional working with newborns who have respiratory failure improves. The aim of this document is to present some clinical guidelines for every professional working with newborns who have respiratory pathology

  10. Cross-domain interference costs during concurrent verbal and spatial serial memory tasks are asymmetric.

    PubMed

    Morey, Candice C; Mall, Jonathan T

    2012-01-01

    Some evidence suggests that memory for serial order is domain-general. Evidence also points to asymmetries in interference between verbal and visual-spatial tasks. We confirm that concurrently remembering verbal and spatial serial lists provokes substantial interference compared with remembering a single list, but we further investigate the impact of this interference throughout the serial position curve, where asymmetries are indeed apparent. A concurrent verbal order memory task affects spatial memory performance throughout the serial positions of the list, but performing a spatial order task affects memory for the verbal serial list only for early list items; in the verbal task only, the final items are unaffected by a concurrent task. Adding suffixes eliminates this asymmetry, resulting in impairment throughout the list for both tasks. These results suggest that domain-general working memory resources may be supplemented with resources specific to the verbal domain, but perhaps not with equivalent spatial resources.

  11. Concurrent Sexual Partnerships and Sexually Transmitted Diseases in Russia

    PubMed Central

    Zhan, Weihai; Krasnoselskikh, Tatiana V.; Niccolai, Linda M.; Golovanov, Sergei; Kozlov, Andrei P.; Abdala, Nadia

    2011-01-01

    Background Sexual concurrency is associated with higher prevalence of sexually transmitted diseases (STDs) including HIV. However, most studies have focused only on the concurrency of the individual participant (individual concurrency) and not on concurrency of their sexual partners (partner concurrency). Furthermore, limited concurrency information is available in Russia where HIV epidemic is growing rapidly. We therefore examine the prevalence and correlates of individual and partner concurrency, and determine whether either type of concurrency is associated with diagnosed STDs among STD clinic attendees in St. Petersburg, Russia. Methods In total, 799 attendees were recruited into a cross-sectional study between 2006 and 2008. A questionnaire collected information on demographics, medical history, sexual behaviors, and up to 3 sexual partners during the preceding year. Results The prevalence of individual and partner concurrency was 24.7% and 45.4%, respectively. Both were correlated with marital status, weekly alcohol consumption, age at first sex, and number of lifetime sexual partners. Partner concurrency was significantly associated with diagnosed STDs (odds ratio = 2.06; 95% confidence interval = 1.35–3.15). No significant association between individual concurrency and STDs was observed. Conclusions Partner concurrency, not individual concurrency, is independently associated with increased odds of having an STD in the studied population. PMID:21258270

  12. Concurrent sexual partnerships and sexually transmitted diseases in Russia.

    PubMed

    Zhan, Weihai; Krasnoselskikh, Tatiana V; Niccolai, Linda M; Golovanov, Sergei; Kozlov, Andrei P; Abdala, Nadia

    2011-06-01

    Sexual concurrency is associated with higher prevalence of sexually transmitted diseases (STDs) including HIV. However, most studies have focused only on the concurrency of the individual participant (individual concurrency) and not on concurrency of their sexual partners (partner concurrency). Furthermore, limited concurrency information is available in Russia where HIV epidemic is growing rapidly. We therefore examine the prevalence and correlates of individual and partner concurrency, and determine whether either type of concurrency is associated with diagnosed STDs among STD clinic attendees in St. Petersburg, Russia. In total, 799 attendees were recruited into a cross-sectional study between 2006 and 2008. A questionnaire collected information on demographics, medical history, sexual behaviors, and up to 3 sexual partners during the preceding year. The prevalence of individual and partner concurrency was 24.7% and 45.4%, respectively. Both were correlated with marital status, weekly alcohol consumption, age at first sex, and number of lifetime sexual partners. Partner concurrency was significantly associated with diagnosed STDs (odds ratio = 2.06; 95% confidence interval = 1.35-3.15). No significant association between individual concurrency and STDs was observed. Partner concurrency, not individual concurrency, is independently associated with increased odds of having an STD in the studied population.

  13. Personality and Career Success: Concurrent and Longitudinal Relations

    PubMed Central

    Sutin, Angelina R.; Costa, Paul T.; Miech, Richard; Eaton, William W.

    2009-01-01

    The present research addresses the dynamic transaction between extrinsic (occupational prestige, income) and intrinsic (job satisfaction) career success and the Five-Factor Model of personality. Participants (N = 731) completed a comprehensive measure of personality and reported their job title, annual income, and job satisfaction; a subset of these participants (n = 302) provided the same information approximately 10 years later. Measured concurrently, emotionally stable and conscientious participants reported higher incomes and job satisfaction. Longitudinal analyses revealed that, among younger participants, higher income at baseline predicted decreases in Neuroticism and baseline Extraversion predicted increases in income across the 10 years. Results suggest that the mutual influence of career success and personality is limited to income and occurs early in the career. PMID:19774106

  14. Concurrent, parallel, multiphysics coupling in the FACETS project

    NASA Astrophysics Data System (ADS)

    Cary, J. R.; Candy, J.; Cobb, J.; Cohen, R. H.; Epperly, T.; Estep, D. J.; Krasheninnikov, S.; Malony, A. D.; McCune, D. C.; McInnes, L.; Pankin, A.; Balay, S.; Carlsson, J. A.; Fahey, M. R.; Groebner, R. J.; Hakim, A. H.; Kruger, S. E.; Miah, M.; Pletzer, A.; Shasharina, S.; Vadlamani, S.; Wade-Stein, D.; Rognlien, T. D.; Morris, A.; Shende, S.; Hammett, G. W.; Indireshkumar, K.; Pigarov, A. Yu; Zhang, H.

    2009-07-01

    FACETS (Framework Application for Core-Edge Transport Simulations), is now in its third year. The FACETS team has developed a framework for concurrent coupling of parallel computational physics for use on Leadership Class Facilities (LCFs). In the course of the last year, FACETS has tackled many of the difficult problems of moving to parallel, integrated modeling by developing algorithms for coupled systems, extracting legacy applications as components, modifying them to run on LCFs, and improving the performance of all components. The development of FACETS abides by rigorous engineering standards, including cross platform build and test systems, with the latter covering regression, performance, and visualization. In addition, FACETS has demonstrated the ability to incorporate full turbulence computations for the highest fidelity transport computations. Early indications are that the framework, using such computations, scales to multiple tens of thousands of processors. These accomplishments were a result of an interdisciplinary collaboration among computational physics, computer scientists and applied mathematicians on the team.

  15. Aerospace concurrent engineering: a modern global approach

    NASA Astrophysics Data System (ADS)

    Imbert, Mariano; Li, Xiaoxing

    2009-12-01

    System engineering aspects, like concurrent engineering (CE) in the aerospace sector, has been studied by many authors. The change and evolution in this regard is continually influenced by the information technology advances. But global cooperation is only discussed by developed countries and high technology corporations. A review of CE and its ramifications in the aerospace industry is presented. Based on the current literature, the general lifecycle of a spacecraft and its phases are explained as well as the tools that are implemented in today's industry. In this paper we propose a new approach for the product development process in the spacecraft production industry the Aerospace Concurrent Engineering (ACE), which is mainly focused in the technology itself, its optimal design and environment impact rather than costs and marketing impact. And the potential of globally oriented research and implementation of space programs is discussed for its consideration.

  16. Nautilus: A Concurrent Anticipatory Programming Language

    NASA Astrophysics Data System (ADS)

    Menezes, P. Blauth; Costa, Simone A.; Machado, Júlio P.; Ramos, Jaime

    2002-09-01

    Nautilus is a concurrent anticipatory programming language based on the object-oriented language GNOME which is a simplified and revised version of OBLOG. A semantics for Nautilus is given by Nonsequencial Automata, that is a categorial semantic domain based on labeled transition system with full concurrency, where a class of morphisms stands for anticipation. The semantics of an object in Nautilus is given by an anticipation morphism, which is viewed as a special automaton morphism where target automata, called base, is determined by the computations of a freely generated automata able to simulate any object specified over the involved attributes, and the source automata is a relabelled restriction of the base. In order to introduce the anticipation of Nautilus, some examples are presented depicting the features of the language.

  17. Enabling communication concurrency through flexible MPI endpoints

    DOE PAGES

    Dinan, James; Grant, Ryan E.; Balaji, Pavan; ...

    2014-09-23

    MPI defines a one-to-one relationship between MPI processes and ranks. This model captures many use cases effectively; however, it also limits communication concurrency and interoperability between MPI and programming models that utilize threads. Our paper describes the MPI endpoints extension, which relaxes the longstanding one-to-one relationship between MPI processes and ranks. Using endpoints, an MPI implementation can map separate communication contexts to threads, allowing them to drive communication independently. Also, endpoints enable threads to be addressable in MPI operations, enhancing interoperability between MPI and other programming models. Furthermore, these characteristics are illustrated through several examples and an empirical study thatmore » contrasts current multithreaded communication performance with the need for high degrees of communication concurrency to achieve peak communication performance.« less

  18. Enabling communication concurrency through flexible MPI endpoints

    SciTech Connect

    Dinan, James; Grant, Ryan E.; Balaji, Pavan; Goodell, David; Miller, Douglas; Snir, Marc; Thakur, Rajeev

    2014-09-23

    MPI defines a one-to-one relationship between MPI processes and ranks. This model captures many use cases effectively; however, it also limits communication concurrency and interoperability between MPI and programming models that utilize threads. Our paper describes the MPI endpoints extension, which relaxes the longstanding one-to-one relationship between MPI processes and ranks. Using endpoints, an MPI implementation can map separate communication contexts to threads, allowing them to drive communication independently. Also, endpoints enable threads to be addressable in MPI operations, enhancing interoperability between MPI and other programming models. Furthermore, these characteristics are illustrated through several examples and an empirical study that contrasts current multithreaded communication performance with the need for high degrees of communication concurrency to achieve peak communication performance.

  19. Interpretive model for ''A Concurrency Method''

    SciTech Connect

    Carter, C.L.

    1987-01-01

    This paper describes an interpreter for ''A Concurrency Method,'' in which concurrency is the inherent mode of operation and not an appendage to sequentiality. This method is based on the notions of data-drive and single-assignment while preserving a natural manner of programming. The interpreter is designed for and implemented on a network of Corvus Concept Personal Workstations, which are based on the Motorola MC68000 super-microcomputer. The interpreter utilizes the MC68000 processors in each workstation by communicating across OMNINET, the local area network designed for the workstations. The interpreter is a complete system, containing an editor, a compiler, an operating system with load balancer, and a communication facility. The system includes the basic arithmetic and trigonometric primitive operations for mathematical computations as well as the ability to construct more complex operations from these. 9 refs., 5 figs.

  20. Enabling communication concurrency through flexible MPI endpoints

    SciTech Connect

    Dinan, James; Grant, Ryan E.; Balaji, Pavan; Goodell, David; Miller, Doug; Snir, Marc; Thakur, Rajeev

    2014-11-01

    MPI defines a one-to-one relationship between MPI processes and ranks. This model captures many use cases effectively; however, it also limits communication concurrency and interoperability between MPI and programming models that utilize threads. This paper describes the MPI endpoints extension, which relaxes the longstanding one-to-one relationship between MPI processes and ranks. Using endpoints, an MPI implementation can map separate communication contexts to threads, allowing them to drive communication independently. Endpoints also enable threads to be addressable in MPI operations, enhancing interoperability between MPI and other programming models. These characteristics are illustrated through several examples and an empirical study that contrasts current multithreaded communication performance with the need for high degrees of communication concurrency to achieve peak communication performance.

  1. A declarative approach to visualizing concurrent computations

    SciTech Connect

    Roman, G.C.; Cox, K.C. )

    1989-10-01

    That visualization can play a key role in the exploration of concurrent computations is central to the ideas presented. Equally important, although given less emphasis, is concern that the full potential of visualization may not be reached unless the art of generating beautiful pictures is rooted in a solid, formally technical foundation. The authors show that program verification provides a formal framework around which such a foundation can be built. Making these ideas a practical reality will require both research and experimentation.

  2. Bounds on multipartite concurrence and tangle

    NASA Astrophysics Data System (ADS)

    Wang, Jing; Li, Ming; Li, Hongfang; Fei, Shao-Ming; Li-Jost, Xianqing

    2016-10-01

    We present an analytical lower bound of multipartite concurrence based on the generalized Bloch representations of density matrices. It is shown that the lower bound can be used as an effective entanglement witness of genuine multipartite entanglement. Tight lower and upper bounds for multipartite tangles are also derived. Since the lower bounds depend on just part of the correlation tensors, the result is experimentally feasible.

  3. Concurrent Computing: Numerical Algorithms and Some Applications.

    DTIC Science & Technology

    1986-07-15

    determinant of the harmonic frequencies This result was obtained via a combination of relationships using classical trigonometric moment theory and...component, the out put management subsystem, is the most problem dependent. Current plans call for the design of basic tools for displaying results which...will be augmented as particular applications are tried. During this same time period, we plan to establish a network linking the project’s concurrent

  4. Lower bounds on concurrence and separability conditions

    SciTech Connect

    Vicente, Julio I. de

    2007-05-15

    We obtain analytical lower bounds on the concurrence of bipartite quantum systems in arbitrary dimensions related to the violation of separability conditions based on local uncertainty relations and on the Bloch representation of density matrices. We also illustrate how these results complement and improve those recently derived [Chen, Albeverio, and Fei, Phys. Rev. Lett. 95, 040504 (2005)] by considering the Peres-Horodecki and the computable cross-norm or realignment criteria.

  5. Synthesis of Efficient Structures for Concurrent Computation.

    DTIC Science & Technology

    1983-10-01

    CONTRACT OR GRANT NUMBER(a) Richard M. King and Ernst Mayr F49620-82-C-0007 9. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT, TASK...for CONCURRENT COMPUTATION by Richard M. King Ernst W. Mayrt Cordel Green Principal Investigator Kestrel Institute 1801 Page Mill Road Palo Alto, CA... Mayr , and A. Siegel ’Techniques for Solving Graph Problems in Parallel Environments’ Proceedings of the W4h Symposium on Foundation* of Computer

  6. Changes in Concurrent Precipitation and Temperature Extremes

    SciTech Connect

    Hao, Zengchao; AghaKouchak, Amir; Phillips, Thomas J.

    2013-08-01

    While numerous studies have addressed changes in climate extremes, analyses of concurrence of climate extremes are scarce, and climate change effects on joint extremes are rarely considered. This study assesses the occurrence of joint (concurrent) monthly continental precipitation and temperature extremes in Climate Research Unit (CRU) and University of Delaware (UD) observations, and in 13 Coupled Model Intercomparison Project Phase 5 (CMIP5) global climate simulations. Moreover, the joint occurrences of precipitation and temperature extremes simulated by CMIP5 climate models are compared with those derived from the CRU and UD observations for warm/wet, warm/dry, cold/wet, and cold/dry combinations of joint extremes. The number of occurrences of these four combinations during the second half of the 20th century (1951–2004) is assessed on a common global grid. CRU and UD observations show substantial increases in the occurrence of joint warm/dry and warm/wet combinations for the period 1978–2004 relative to 1951–1977. The results show that with respect to the sign of change in the concurrent extremes, the CMIP5 climate model simulations are in reasonable overall agreement with observations. The results reveal notable discrepancies between regional patterns and the magnitude of change in individual climate model simulations relative to the observations of precipitation and temperature.

  7. Symbolic Analysis of Concurrent Programs with Polymorphism

    NASA Technical Reports Server (NTRS)

    Rungta, Neha Shyam

    2010-01-01

    The current trend of multi-core and multi-processor computing is causing a paradigm shift from inherently sequential to highly concurrent and parallel applications. Certain thread interleavings, data input values, or combinations of both often cause errors in the system. Systematic verification techniques such as explicit state model checking and symbolic execution are extensively used to detect errors in such systems [7, 9]. Explicit state model checking enumerates possible thread schedules and input data values of a program in order to check for errors [3, 9]. To partially mitigate the state space explosion from data input values, symbolic execution techniques substitute data input values with symbolic values [5, 7, 6]. Explicit state model checking and symbolic execution techniques used in conjunction with exhaustive search techniques such as depth-first search are unable to detect errors in medium to large-sized concurrent programs because the number of behaviors caused by data and thread non-determinism is extremely large. We present an overview of abstraction-guided symbolic execution for concurrent programs that detects errors manifested by a combination of thread schedules and data values [8]. The technique generates a set of key program locations relevant in testing the reachability of the target locations. The symbolic execution is then guided along these locations in an attempt to generate a feasible execution path to the error state. This allows the execution to focus in parts of the behavior space more likely to contain an error.

  8. Concurrent visualization in a production supercomputing environment.

    PubMed

    Ellsworth, David; Green, Bryan; Henze, Chris; Moran, Patrick; Sandstrom, Timothy

    2006-01-01

    We describe a concurrent visualization pipeline designed for operation in a production supercomputing environment. The facility was initially developed on the NASA Ames "Columbia" supercomputer for a massively parallel forecast model (GEOS4). During the 2005 Atlantic hurricane season, GEOS4 was run 4 times a day under tight time constraints so that its output could be included in an ensemble prediction that was made available to forecasters at the National Hurricane Center. Given this time-critical context, we designed a configurable concurrent pipeline to visualize multiple global fields without significantly affecting the runtime model performance or reliability. We use MPEG compression of the accruing images to facilitate live low-bandwidth distribution of multiple visualization streams to remote sites. We also describe the use of our concurrent visualization framework with a global ocean circulation model, which provides a 864-fold increase in the temporal resolution of practically achievable animations. In both the atmospheric and oceanic circulation models, the application scientists gained new insights into their model dynamics, due to the high temporal resolution animations attainable.

  9. Changes in Concurrent Precipitation and Temperature Extremes

    DOE PAGES

    Hao, Zengchao; AghaKouchak, Amir; Phillips, Thomas J.

    2013-08-01

    While numerous studies have addressed changes in climate extremes, analyses of concurrence of climate extremes are scarce, and climate change effects on joint extremes are rarely considered. This study assesses the occurrence of joint (concurrent) monthly continental precipitation and temperature extremes in Climate Research Unit (CRU) and University of Delaware (UD) observations, and in 13 Coupled Model Intercomparison Project Phase 5 (CMIP5) global climate simulations. Moreover, the joint occurrences of precipitation and temperature extremes simulated by CMIP5 climate models are compared with those derived from the CRU and UD observations for warm/wet, warm/dry, cold/wet, and cold/dry combinations of joint extremes.more » The number of occurrences of these four combinations during the second half of the 20th century (1951–2004) is assessed on a common global grid. CRU and UD observations show substantial increases in the occurrence of joint warm/dry and warm/wet combinations for the period 1978–2004 relative to 1951–1977. The results show that with respect to the sign of change in the concurrent extremes, the CMIP5 climate model simulations are in reasonable overall agreement with observations. The results reveal notable discrepancies between regional patterns and the magnitude of change in individual climate model simulations relative to the observations of precipitation and temperature.« less

  10. Conventional and unconventional superconductivity

    NASA Astrophysics Data System (ADS)

    Fernandes, R. M.

    2012-02-01

    Superconductivity has been one of the most fruitful areas of research in condensed matter physics, bringing together researchers with distinct interests in a collaborative effort to understand from its microscopic basis to its potential for unprecedented technological applications. The concepts, techniques, and methods developed along its centennial history have gone beyond the realm of condensed matter physics and influenced the development of other fascinating areas, such as particle physics and atomic physics. These notes, based on a set of lectures given at the 2011 Advanced Summer School of Cinvestav, aim to motivate the young undergraduate student in getting involved in the exciting world of conventional and unconventional superconductors.

  11. Concurrency Control Algorithms and its Variants: A Survey

    NASA Astrophysics Data System (ADS)

    Batra, Neera; Kapil, A. K.

    2010-11-01

    This paper surveys many variants of concurrency control algorithms in database systems. We classify the different alternatives under locking, time-stamp, optimistic algorithms. Though the performance of different concurrency control algorithms have been explored extensively for database management systems but to the best of author's knowledge, the relative variants of different protocols used for concurrency control algorithms have not been reported yet.

  12. An Asian regional analysis of cost-effectiveness of early irbesartan treatment versus conventional antihypertensive, late amlodipine, and late irbesartan treatments in patients with type 2 diabetes, hypertension, and nephropathy.

    PubMed

    Annemans, Lieven; Demarteau, Nadia; Hu, Shanlian; Lee, Tae-Jin; Morad, Zaher; Supaporn, Thanom; Yang, Wu-Chang; Palmer, Andrew J

    2008-01-01

    The prevalence of type 2 diabetes, often leading to diabetic nephropathy, has increased globally, especially in Asia. Irbesartan treatment delays the progression of kidney disease at the early (microalbuminuria) and late (proteinuria) stages of nephropathy in hypertensive type 2 diabetics. This treatment has proven to be cost-effective in Western countries. This study assessed the cost-effectiveness of early irbesartan treatment in Asian settings. An existing lifetime model was reprogrammed in Microsoft Excel to compare irbesartan started at an early stage to irbesartan or amlodipine started at a late stage, and standard treatments from a health-care perspective in China, Malaysia, Thailand, South Korea, and Taiwan. The main effectiveness parameters were incidences of end-stage renal disease, time in dialysis, and life expectancy. All costs were converted to 2004 US$ using official purchasing power parity. Local data were obtained for costs, transplantation,dialysis, and mortality rates. Probabilities regarding disease progression after treatment with the investigated drugs were extracted from two published clinical trials. A probabilistic sensitivity analysis was performed. Early use of irbesartan yielded the largest clinical and economic benefits reducing need for dialysis by 61% to 63% versus the standard treatment, total costs by 9% (Thailand) to 42% (Taiwan), and increasing life expectancy by 0.31 to 0.48 years. Early irbesartan had a 66% (Thailand) to 95% (Taiwan) probability of being dominant over late irbesartan. Although the absolute results varied in different settings, reflecting differences in epidemiology, management, and costs, early irbesartan treatment was a cost-effective alternative in the Asian settings.

  13. Robot-assisted Supraomohyoid neck dissection via a modified face-lift or retroauricular approach in early-stage cN0 squamous cell carcinoma of the oral cavity: a comparative study with conventional technique.

    PubMed

    Lee, Hyoung Shin; Kim, Won Shik; Hong, Hyun Jun; Ban, Myung Jin; Lee, Dongwon; Koh, Yoon Woo; Choi, Eun Chang

    2012-11-01

    Supraomohyoid neck dissection (SOND) in clinical N0 (cN0) neck of oral cavity squamous cell carcinoma (SCC) is performed by many head and neck surgeons showing improved regional control and disease-specific survival. However, disfiguring neck scars have been accepted to be unavoidable. In this study, we sought to introduce and evaluate the feasibility of our surgical technique to hide the external scar of neck dissection using the robotic system via a modified face-lift or retroauricular approach. Twenty-six patients with cN0 oral cavity SCC were divided into two groups of robot-assisted neck dissection and conventional neck dissection via external cervical incision. The operation time, amount and duration of drainage, length of hospital stay, complications, number of retrieved lymph nodes, and satisfaction scores were compared. Mean operation time was longer in the robot-assisted group (157 ± 22 min) than the conventional group (78 ± 16 min) (P < 0.001). However, the amount and duration of drainage, hospital stay, retrieved lymph nodes, and complications were comparable. Because the postoperative scar was hidden by the auricle and hair, the satisfaction score was significantly higher in the robot-assisted group (P < 0.001). Robot-assisted SOND via a modified face-lift or retroauricular approach in cN0 oral cavity SCC was feasible compared to conventional technique and showed a clear cosmetic benefit. Longer operation time remains the drawback of this procedure. However, it could be considered for patients who require SOND and prefer to avoid external neck scar.

  14. Biodiesel from conventional feedstocks.

    PubMed

    Du, Wei; Liu, De-Hua

    2012-01-01

    At present, traditional fossil fuels are used predominantly in China, presenting the country with challenges that include sustainable energy supply, energy efficiency improvement, and reduction of greenhouse gas emissions. In 2007, China issued The Strategic Plan of the Mid-and-Long Term Development of Renewable Energy, which aims to increase the share of clean energy in the country's energy consumption to 15% by 2020 from only 7.5% in 2005. Biodiesel, an important renewable fuel with significant advantages over fossil diesel, has attracted great attention in the USA and European countries. However, biodiesel is still in its infancy in China, although its future is promising. This chapter reviews biodiesel production from conventional feedstocks in the country, including feedstock supply and state of the art technologies for the transesterification reaction through which biodiesel is made, particularly the enzymatic catalytic process developed by Chinese scientists. Finally, the constraints and perspectives for China's biodiesel development are highlighted.

  15. A measurement-based study of concurrency in a multiprocessor

    NASA Technical Reports Server (NTRS)

    Mcguire, Patrick John

    1987-01-01

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

  16. Advanced concurrent engineering environment final report

    SciTech Connect

    Jortner, J.N.; Friesen, J.A.; Schwegel, J.

    1997-08-01

    Sandia demonstrated large-scale visualization in a conference room environment. Project focused on the installation of hardware for visualization and display, and the integration of software tools for design and animation of 3-dimensional parts. Using a high-end visualization server, 3-dimensional modeling and animation software, and leading edge World Wide Web technology, and advanced concurrent engineering environment was simulated where a design team was able to work collectively, rather than as solely disjoint individual efforts. Finally, a successful animation of a Sandia part was demonstrated, and a computer video generated. This video is now accessible on a Sandia internal web server.

  17. Advanced concurrent-engineering environment. Final report

    SciTech Connect

    Jortner, J.N.; Friesen, J.A.

    1997-07-01

    Sandia demonstrated large-scale visualization in a conference room environment. Project focused in the installation of hardware for visualization and display, and the integration of software tools for design and animation of 3-dimensional parts. Using a high-end visualization server, 3-dimensional modeling and animation software, and leading edge World Wide Web technology, an advanced concurrent engineering environment was simulated where a design team was able to work collectively, rather than as solely disjoint individual efforts. Finally, a successful animation of a Sandia part was demonstrated, and a computer video generated. This video is now accessible on a Sandia internal web server.

  18. Concurrency-based approaches to parallel programming

    SciTech Connect

    Kale, L.V.; Chrisochoides, N.; Kohl, J.

    1995-07-17

    The inevitable transition to parallel programming can be facilitated by appropriate tools, including languages and libraries. After describing the needs of applications developers, this paper presents three specific approaches aimed at development of efficient and reusable parallel software for irregular and dynamic-structured problems. A salient feature of all three approaches in their exploitation of concurrency within a processor. Benefits of individual approaches such as these can be leveraged by an interoperability environment which permits modules written using different approaches to co-exist in single applications.

  19. Concurrency-based approaches to parallel programming

    NASA Technical Reports Server (NTRS)

    Kale, L.V.; Chrisochoides, N.; Kohl, J.; Yelick, K.

    1995-01-01

    The inevitable transition to parallel programming can be facilitated by appropriate tools, including languages and libraries. After describing the needs of applications developers, this paper presents three specific approaches aimed at development of efficient and reusable parallel software for irregular and dynamic-structured problems. A salient feature of all three approaches in their exploitation of concurrency within a processor. Benefits of individual approaches such as these can be leveraged by an interoperability environment which permits modules written using different approaches to co-exist in single applications.

  20. Quantification of concurrence via weak measurement

    NASA Astrophysics Data System (ADS)

    Tukiainen, Mikko; Kobayashi, Hirokazu; Shikano, Yutaka

    2017-05-01

    Since entanglement is not an observable per se, measuring its value in practice is a difficult task. Here we propose a protocol for quantifying a particular entanglement measure, namely, concurrence, of an arbitrary two-qubit pure state via a single fixed measurement setup by exploiting so-called weak measurements and the associated weak values together with the properties of the Laguerre-Gaussian modes. The virtue of our technique is that it is generally applicable for all two-qubit systems and does not involve simultaneous copies of the entangled state. We also propose an explicit optical implementation of the protocol.

  1. Aortopulmonary ectopic parathyroid gland and concurrent thymolipoma.

    PubMed

    Abu Abeeleh, Mahmoud; Bani Hani, Amjad; Ghaith, Ata; Alodwan, Tareq; Bani Ismail, Zuhair; Alshehabat, Musa

    2016-10-01

    Ectopic parathyroid adenomas are considered the main cause of primary hyperparathyroidism. However, concurrent parathyroid and thymic pathologies are rarely diagnosed in the same patient. A 47-year-old man with history of diabetes mellitus, hypertension, and myasthenia gravis presented with persistent hypercalcemia. Laboratory investigations, computed tomography, and technetium-99 m sestamibi scintigraphy revealed ectopic parathyroid glands, a mediastinal mass, and an enlarged thymus. The patient underwent thymectomy and mass excision via a median sternotomy. Histopathology was consistent with ectopic parathyroid adenoma and thymolipoma. The serum calcium and parathormone concentrations normalized within 48 hours after surgery. © The Author(s) 2016.

  2. Concurrent Kimura disease and lupus nephritis

    PubMed Central

    Wang, Haitao; Fang, Fang; Sun, Ying; Wang, Songlan; Mao, Yonghui

    2016-01-01

    Abstract Background: Kimura disease is a rare chronic inflammatory disorder with peripheral eosinophilia and elevated serum IgE and is also frequently complicated by nephropathy. Methods: We report a rare case of Kimura disease concomitant with lupus nephritis in a 72-year old male patient with recurrent unexplained lymphadenopathy, renal lesions, and immunologic abnormalities. Results: The patient was successfully managed with gamma immunoglobulin, intravenous pulse methylprednisolone therapy, hydroxychloroquine, and prednisone. Conclusion: This is the first report of a case of Kimura disease concomitant with lupus nephritis and highlights the importance of considering lupus nephritis as a possible concurrent disease in patients with Kimura disease that have immunologic abnormalities. PMID:27741124

  3. Concurrent pityriasis rosea and Bell's palsy.

    PubMed

    Voss, Vanessa; Mattox, Adam; Guo, Mary

    2017-01-23

    Pityriasis rosea is a dermatological disease with a well-documented clinical appearance, but less is known about causes and treatment. Bell's palsy is a neurological condition leading to acute idiopathic hemifacial paralysis. Recent studies indicate that human herpesvirus (HHV) 6-7 reactivation may be a contributing factor to both conditions. We report a case of the 2 concurrent diagnoses that supports a common contributing factor and suggests further awareness and research into the role HHV 6-7 may play in the aetiology of both conditions. 2017 BMJ Publishing Group Ltd.

  4. Systematic Review: Generating Evidence-Based Guidelines on the Concurrent Use of Dietary Antioxidants and Chemotherapy or Radiotherapy

    PubMed Central

    Nakayama, Akiko; Alladin, Karen P.; Igbokwe, Obianuju; White, Jeffrey D.

    2013-01-01

    The risk–benefit ratio for concurrent use of dietary antioxidants with chemotherapy or radiation therapy is a controversial topic. In this review, the medical literature on concurrent antioxidant use with chemotherapy or radiotherapy was assessed and further steps for generating evidence-based guidelines are suggested. The clinical cancer research community should cooperate and focus new studies on the use of a specific combination of antioxidant and chemotherapy or radiotherapy, and determine optimal doses for a specific cancer setting. Mechanistic studies on the interaction between antioxidants and conventional cancer therapy could lead to novel biomarkers for assessing dose adequacy. PMID:22085269

  5. Neural activity associated with distinguishing concurrent auditory objects

    NASA Astrophysics Data System (ADS)

    Alain, Claude; Schuler, Benjamin M.; McDonald, Kelly L.

    2002-02-01

    The neural processes underlying concurrent sound segregation were examined by using event-related brain potentials. Participants were presented with complex sounds comprised of multiple harmonics, one of which could be mistuned so that it was no longer an integer multiple of the fundamental. In separate blocks of trials, short-, middle-, and long-duration sounds were presented and participants indicated whether they heard one sound (i.e., buzz) or two sounds (i.e., buzz plus another sound with a pure-tone quality). The auditory stimuli were also presented while participants watched a silent movie in order to evaluate the extent to which the mistuned harmonic could be automatically detected. The perception of the mistuned harmonic as a separate sound was associated with a biphasic negative-positive potential that peaked at about 150 and 350 ms after sound onset, respectively. Long duration sounds also elicited a sustained potential that was greater in amplitude when the mistuned harmonic was perceptually segregated from the complex sound. The early negative wave, referred to as the object-related negativity (ORN), was present during both active and passive listening, whereas the positive wave and the mistuning-related changes in sustained potentials were present only when participants attended to the stimuli. These results are consistent with a two-stage model of auditory scene analysis in which the acoustic wave is automatically decomposed into perceptual groups that can be identified by higher executive functions. The ORN and the positive waves were little affected by sound duration, indicating that concurrent sound segregation depends on transient neural responses elicited by the discrepancy between the mistuned harmonic and the harmonic frequency expected based on the fundamental frequency of the incoming stimulus.

  6. Concurrent Chemoradiotherapy for Esophageal Cancer With Malignant Fistula

    SciTech Connect

    Koike, Ryuta; Nishimura, Yasumasa Nakamatsu, Kiyoshi; Kanamori, Shuichi; Shibata, Toru

    2008-04-01

    Background: We reviewed clinical results of chemoradiotherapy (CRT) in the treatment of patients with advanced esophageal cancer with fistulae that developed before or during CRT. Methods and Materials: The study group included 16 patients with fistulous esophageal cancer treated by means of CRT between 1999 and 2006. Nine patients had fistulae before CRT, whereas 7 developed fistulae during CRT. The group included 12 men and four women with a median age of 55 years (range, 37-77 years). There were 9 patients with Stage III disease and 7 with Stage IV disease. All tumors were squamous cell carcinomas. Two courses of concurrent chemotherapy were combined with radiation therapy; 60 Gy/30 fractions/7 weeks (1-week split). For 15 patients, low-dose protracted chemotherapy with 5-fluorouracil (250-300 mg/m{sup 2} x 14 days) and cisplatin (7 mg/m{sup 2} x 10 days) was administered, whereas full-dose cisplatin and 5-fluorouracil were administered to the remaining patient. Results: The planned dose of 60 Gy was delivered to 11 patients (69%), whereas radiation therapy was terminated early in 5 patients (40-58 Gy) because of acute toxicities, including two treatment-related deaths. Disappearance of fistulae was noted during or after CRT in 7 patients (44%). All three esophagomediastinal fistulae were closed, but only four of 13 esophagorespiratory fistulae were closed by CRT. For patients with Stage III, 1- and 2-year survival rates were 33% and 22%, respectively. Median survival time was 8.5 months. Conclusion: Despite significant toxicity, concurrent CRT appears effective at closing esophageal malignant fistulae.

  7. Concurrent work with parents of adolescent patients.

    PubMed

    Novick, Kerry Kelly; Novick, Jack

    2013-01-01

    Over the last ten years we have seen an increasing acceptance of the general idea of working with parents of child patients. What remains, however, as an area of controversy, conflict, and resistance, is the question of whether and how much therapists should or can work with the parents of adolescent patients. Questions cluster around how to maintain confidentiality and lead to the even larger issue of conceptualizing the developmental goals of the phase of adolescence. We see the major developmental tasks for both parents and adolescents as involving transformation of the self and the relationship, in the context of separateness rather than separation. If adolescent therapists work from the assumption that the goal of adolescence is transformation, concurrent work with parents and adolescents will move them all into a new level of relationship. Without concomitant change in parents, it is doubly hard for adolescents to progress into adulthood. In this paper we offer clinical material from five older adolescents and their parents to illustrate the techniques that follow from our model of dynamic concurrent parent work throughout the phases of treatment. Using the tasks of the therapeutic alliance as a conceptual framework, we describe working toward the dual goals of restoration to the path of progressive development and restoration of the parent-child relationship. We pay particular attention to the unfolding of conflicts between closed-system omnipotent functioning and open-system reality mastery, and the role offathers in late-adolescent development.

  8. Drug discrimination under a concurrent schedule.

    PubMed Central

    Snodgrass, S H; McMillan, D E

    1996-01-01

    Three pigeons were trained to discriminate a 5.0 mg/kg dose of pentobarbital from saline under a two-key concurrent schedule with responding on the key associated with the presession injection, under both stimulus conditions, producing four times as many reinforcers as responding on the other key. This concurrent schedule resulted in approximately 70% responding to the higher reinforcement key under the pentobarbital stimulus and approximately 30% responding to that key under the saline stimulus. During testing, then, the pigeons were able to dose-dependently emit higher (>70%) or lower (<30%) values than were established under the control conditions. Dose-response curves were determined for pentobarbital (twice), methamphetamine, phencyclidine, chlordiazepoxide, and the combination of pentobarbital and the barbiturate antagonist bemegride. The results obtained with pentobarbital and chlordiazepoxide showed that, as the dose increased, pentobarbital-appropriate responding also increased. Methamphetamine produced relatively flat dose--response curves, whereas phencyclidine administration produced inconsistent effects on responding. The combination of the training dose of pentobarbital with increasing doses of bemegride produced a decrease in pentobarbital-appropriate responding. The results also showed that the dose-response curves for pentobarbital and chlordiazepoxide, instead of being all or none, were graded functions of the drug dose. PMID:8636660

  9. Locality Aware Concurrent Start for Stencil Applications

    SciTech Connect

    Shrestha, Sunil; Gao, Guang R.; Manzano Franco, Joseph B.; Marquez, Andres; Feo, John T.

    2015-02-10

    Stencil computations are at the heart of many physical simulations used in scientific codes. Thus, there exists a plethora of optimization efforts for this family of computations. Among these techniques, tiling techniques that allow concurrent start have proven to be very efficient in providing better performance for these critical kernels. Nevertheless, with many core designs being the norm, these optimization techniques might not be able to fully exploit locality (both spatial and temporal) on multiple levels of the memory hierarchy without compromising parallelism. It is no longer true that the machine can be seen as a homogeneous collection of nodes with caches, main memory and an interconnect network. New architectural designs exhibit complex grouping of nodes, cores, threads, caches and memory connected by an ever evolving network-on-chip design. These new designs may benefit greatly from carefully crafted schedules and groupings that encourage parallel actors (i.e. threads, cores or nodes) to be aware of the computational history of other actors in close proximity. In this paper, we provide an efficient tiling technique that allows hierarchical concurrent start for memory hierarchy aware tile groups. Each execution schedule and tile shape exploit the available parallelism, load balance and locality present in the given applications. We demonstrate our technique on the Intel Xeon Phi architecture with selected and representative stencil kernels. We show improvement ranging from 5.58% to 31.17% over existing state-of-the-art techniques.

  10. An MCM/chip concurrent engineering validation

    NASA Astrophysics Data System (ADS)

    Moreno, Hector; Stark, Shuane

    1992-12-01

    We report on the MOST software system, which implements a concurrent physical design environment for Multi-Chip Modules. The system integrates the work of design teams distributed across a network and using different CAD systems. At present the following systems have been integrated: Cadence's Edge 2.1, Cadence's Allegro 6.1, AutoDesk's AutoCad 12.0, and Harris' Finesse. Software links were established allowing data from those systems to be shared through a ROSE (Rensselaer Object Storage Environment) database management developed under the sponsorship of the DICE program. The code was written in C++ and uses various methods to feed the information in and obtain it out of the design systems: IGES for Allegro, SKILL for Edge and dfile for Finesse, while the AutoCad link is a direct one. The DDR2 (Digital Drop Receiver, version 2) multi-chip module from Harris was entered into the system and routed utilizing a redundant route scheme. The exercise used a concurrent approach, the data defining parts and placement entered through Finesse, the parts modified in Edge, the route done in Allegro and the final merge and verification performed with the Edge tool.

  11. Evaluation of interaction dynamics of concurrent processes

    NASA Astrophysics Data System (ADS)

    Sobecki, Piotr; Białasiewicz, Jan T.; Gross, Nicholas

    2017-03-01

    The purpose of this paper is to present the wavelet tools that enable the detection of temporal interactions of concurrent processes. In particular, the determination of interaction coherence of time-varying signals is achieved using a complex continuous wavelet transform. This paper has used electrocardiogram (ECG) and seismocardiogram (SCG) data set to show multiple continuous wavelet analysis techniques based on Morlet wavelet transform. MATLAB Graphical User Interface (GUI), developed in the reported research to assist in quick and simple data analysis, is presented. These software tools can discover the interaction dynamics of time-varying signals, hence they can reveal their correlation in phase and amplitude, as well as their non-linear interconnections. The user-friendly MATLAB GUI enables effective use of the developed software what enables to load two processes under investigation, make choice of the required processing parameters, and then perform the analysis. The software developed is a useful tool for researchers who have a need for investigation of interaction dynamics of concurrent processes.

  12. Artificial concurrent catalytic processes involving enzymes.

    PubMed

    Köhler, Valentin; Turner, Nicholas J

    2015-01-11

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

  13. Concurrent hyperadrenocorticism and diabetes mellitus in dogs.

    PubMed

    Miceli, D D; Pignataro, O P; Castillo, V A

    2017-07-25

    Hyperadrenocorticism (HAC) and diabetes mellitus (DM) are two diseases that can occur concurrently in dogs. The objective of this study was to evaluate the coexistence of HAC and DM, and the risk factors involved that could contribute to the development of DM in dogs with HAC. A total of 235 dogs with HAC were studied and, according to their fasting glycemia, they were divided into three groups: <5.6mmol/L, between 5.6 and 10.08mmol/L and >10.08mmol/L. The following parameters were evaluated: age, gender, cause of HAC, body condition, glycemia, total cholesterol, triglycerides, urinary cortisol:creatinin ratio (UCCR) and survival time. A 13.61% concurrence of HAC and DM was observed. Dogs with a fasting glycemia >5.6mmol/L, with dislipemia, with Pituitary-Dependent Hyperadrenocorticism, UCCR >100×10(-6) and non-castrated females showed a higher risk of developing DM. The development of DM in dogs with HAC reduces the survival time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Concurrent sound segregation is enhanced in musicians.

    PubMed

    Zendel, Benjamin Rich; Alain, Claude

    2009-08-01

    The ability to segregate simultaneously occurring sounds is fundamental to auditory perception. Many studies have shown that musicians have enhanced auditory perceptual abilities; however, the impact of musical expertise on segregating concurrently occurring sounds is unknown. Therefore, we examined whether long-term musical training can improve listeners' ability to segregate sounds that occur simultaneously. Participants were presented with complex sounds that had either all harmonics in tune or the second harmonic mistuned by 1%, 2%, 4%, 8%, or 16% of its original value. The likelihood of hearing two sounds simultaneously increased with mistuning, and this effect was greater in musicians than nonmusicians. The segregation of the mistuned harmonic from the harmonic series was paralleled by an object-related negativity that was larger and peaked earlier in musicians. It also coincided with a late positive wave referred to as the P400 whose amplitude was larger in musicians than in nonmusicians. The behavioral and electrophysiological effects of musical expertise were specific to processing the mistuned harmonic as the N1, the N1c, and the P2 waves elicited by the tuned stimuli were comparable in both musicians and nonmusicians. These results demonstrate that listeners' ability to segregate concurrent sounds based on harmonicity is modulated by experience and provides a basis for further studies assessing the potential rehabilitative effects of musical training on solving complex scene analysis problems illustrated by the cocktail party example.

  15. Diffusion MRI with concurrent magnetic field monitoring.

    PubMed

    Wilm, Bertram J; Nagy, Zoltan; Barmet, Christoph; Vannesjo, S Johanna; Kasper, Lars; Haeberlin, Max; Gross, Simon; Dietrich, Benjamin E; Brunner, David O; Schmid, Thomas; Pruessmann, Klaas P

    2015-10-01

    Diffusion MRI is compromised by unknown field perturbation during image encoding. The purpose of this study was to address this problem using the recently described approach of concurrent magnetic field monitoring. Magnetic field dynamics were monitored during the echo planar imaging readout of a common diffusion-weighted MRI sequence using an integrated magnetic field camera setup. The image encoding including encoding changes over the duration of entire scans were quantified and analyzed. Field perturbations were corrected by accounting for them in generalized image reconstruction. The impact on image quality along with geometrical congruence among different diffusion-weighted images was assessed both qualitatively and quantitatively. The most significant field perturbations were found to be related to higher-order eddy currents from diffusion-weighting gradients and B0 field drift as well as gradual changes of short-term eddy current behavior and mechanical oscillations during the scan. All artifacts relating to dynamic field perturbations were eliminated by incorporating the measured encoding in image reconstruction. Concurrent field monitoring combined with generalized reconstruction enhances depiction fidelity in diffusion imaging. In addition to artifact reduction, it improves geometric congruence and thus facilitates image combination for quantitative diffusion analysis. © 2015 Wiley Periodicals, Inc.

  16. Conventional mechanical ventilation

    PubMed Central

    Tobias, Joseph D.

    2010-01-01

    The provision of mechanical ventilation for the support of infants and children with respiratory failure or insufficiency is one of the most common techniques that are performed in the Pediatric Intensive Care Unit (PICU). Despite its widespread application in the PICUs of the 21st century, before the 1930s, respiratory failure was uniformly fatal due to the lack of equipment and techniques for airway management and ventilatory support. The operating rooms of the 1950s and 1960s provided the arena for the development of the manual skills and the refinement of the equipment needed for airway management, which subsequently led to the more widespread use of endotracheal intubation thereby ushering in the era of positive pressure ventilation. Although there seems to be an ever increasing complexity in the techniques of mechanical ventilation, its successful use in the PICU should be guided by the basic principles of gas exchange and the physiology of respiratory function. With an understanding of these key concepts and the use of basic concepts of mechanical ventilation, this technique can be successfully applied in both the PICU and the operating room. This article reviews the basic physiology of gas exchange, principles of pulmonary physiology, and the concepts of mechanical ventilation to provide an overview of the knowledge required for the provision of conventional mechanical ventilation in various clinical arenas. PMID:20927268

  17. Concurrence as a measure of Markovianity: concurrence versus distinguishability and divisibility

    NASA Astrophysics Data System (ADS)

    Gao, Ze-Yu; Ren, Yu-Kun; Zeng, Hao-Sheng

    2016-07-01

    We examine the measure of Markovianity based on entanglement through two typical dynamical models in qubit systems and compare it with the measures of Markovianity based on state distinguishability and dynamical divisibility. We find that divisible dynamics always leads to the monotonic decrease in concurrence, but distinguishability does not constrain its behavior in the same way.

  18. ESD and the Rio Conventions

    ERIC Educational Resources Information Center

    Sarabhai, Kartikeya V.; Ravindranath, Shailaja; Schwarz, Rixa; Vyas, Purvi

    2012-01-01

    Chapter 36 of Agenda 21, a key document of the 1992 Earth Summit, emphasised reorienting education towards sustainable development. While two of the Rio conventions, the Convention on Biological Diversity (CBD) and the United Nations Framework Convention on Climate Change (UNFCCC), developed communication, education and public awareness (CEPA)…

  19. ESD and the Rio Conventions

    ERIC Educational Resources Information Center

    Sarabhai, Kartikeya V.; Ravindranath, Shailaja; Schwarz, Rixa; Vyas, Purvi

    2012-01-01

    Chapter 36 of Agenda 21, a key document of the 1992 Earth Summit, emphasised reorienting education towards sustainable development. While two of the Rio conventions, the Convention on Biological Diversity (CBD) and the United Nations Framework Convention on Climate Change (UNFCCC), developed communication, education and public awareness (CEPA)…

  20. Evaluation of concurrent priority queue algorithms. Technical report

    SciTech Connect

    Huang, Q.

    1991-02-01

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

  1. Concurrent multiresolution finite element: formulation and algorithmic aspects

    NASA Astrophysics Data System (ADS)

    Tang, Shan; Kopacz, Adrian M.; Chan O'Keeffe, Stephanie; Olson, Gregory B.; Liu, Wing Kam

    2013-12-01

    A multiresolution concurrent theory for heterogenous materials is proposed with novel macro scale and micro scale constitutive laws that include the plastic yield function at different length scales. In contrast to the conventional plasticity, the plastic flow at the micro zone depends on the plastic strain gradient. The consistency condition at the macro and micro zones can result in a set of algebraic equations. Using appropriate boundary conditions, the finite element discretization was derived from a variational principle with the extra degrees of freedom for the micro zones. In collaboration with LSTC Inc, the degrees of freedom at the micro zone and their related history variables have been augmented in LS-DYNA. The 3D multiresolution theory has been implemented. Shear band propagation and the large scale simulation of a shear driven ductile fracture process were carried out. Our results show that the proposed multiresolution theory in combination with the parallel implementation into LS-DYNA can capture the effects of the microstructure on shear band propagation and allows for realistic modeling of ductile fracture process.

  2. Defying cosmic convention

    NASA Image and Video Library

    2017-03-20

    Some galaxies are harder to classify than others. Here, Hubble’s trusty Wide Field Camera 3 (WFC3) has captured a striking view of two interacting galaxies located some 60 million light-years away in the constellation of Leo (The Lion). The more diffuse and patchy blue glow covering the right side of the frame is known as NGC 3447 — sometimes NGC 3447B for clarity, as the name NGC 3447 can apply to the overall duo. The smaller clump to the upper left is known as NGC 3447A. The trouble with space is that it is, to state the obvious, really, really big. Astronomers have for hundreds of years been discovering and naming galaxies, stars, cosmic clouds and more. Unifying and regulating the conventions and classifications for everything ever observed is very difficult, especially when you get an ambiguous object like NGC 3447, which stubbornly defies easy categorisation. Overall, we know NGC 3447 comprises a couple of interacting galaxies, but we’re unsure what each looked like before they began to tear one another apart. The two sit so close that they are strongly influenced and distorted by the gravitational forces between them, causing the galaxies to twist themselves into the unusual and unique shapes seen here. NGC 3447A appears to display the remnants of a central bar structure and some disrupted spiral arms, both properties characteristic of certain spiral galaxies. Some identify NGC 3447B as a former spiral galaxy, while others categorise it as being an irregular galaxy.  

  3. An international randomised controlled trial to compare TARGeted Intraoperative radioTherapy (TARGIT) with conventional postoperative radiotherapy after breast-conserving surgery for women with early-stage breast cancer (the TARGIT-A trial).

    PubMed

    Vaidya, Jayant S; Wenz, Frederik; Bulsara, Max; Tobias, Jeffrey S; Joseph, David J; Saunders, Christobel; Brew-Graves, Chris; Potyka, Ingrid; Morris, Stephen; Vaidya, Hrisheekesh J; Williams, Norman R; Baum, Michael

    2016-09-01

    following values are 5-year Kaplan-Meier rates for TARGIT compared with EBRT. There was no statistically significant difference in local recurrence between TARGIT and EBRT. TARGIT was non-inferior to EBRT overall [TARGIT 3.3%, 95% confidence interval (CI) 2.1% to 5.1% vs. EBRT 1.3%, 95% CI 0.7% to 2.5%; p = 0.04; Pnon-inferiority = 0.00000012] and in the prepathology stratum (n = 2298) when TARGIT was given concurrently with lumpectomy (TARGIT 2.1%, 95% CI 1.1% to 4.2% vs. EBRT 1.1%, 95% CI 0.5% to 2.5%; p = 0.31; Pnon-inferiority = 0.0000000013). With delayed TARGIT postpathology (n = 1153), the between-group difference was larger than 2.5% and non-inferiority was not established for this stratum (TARGIT 5.4%, 95% CI 3.0% to 9.7% vs. EBRT 1.7%, 95% CI 0.6% to 4.9%; p = 0.069; Pnon-inferiority = 0.06640]. The local recurrence-free survival was 93.9% (95% CI 90.9% to 95.9%) when TARGIT was given with lumpectomy compared with 92.5% (95% CI 89.7% to 94.6%) for EBRT (p = 0.35). In a planned subgroup analysis, progesterone receptor (PgR) status was found to be the only predictor of outcome: hormone-responsive patients (PgR positive) had similar 5-year local recurrence with TARGIT during lumpectomy (1.4%, 95% CI 0.5% to 3.9%) as with EBRT (1.2%, 95% CI 0.5% to 2.9%; p = 0.77). Grade 3 or 4 radiotherapy toxicity was significantly reduced with TARGIT. Overall, breast cancer mortality was much the same between groups (TARGIT 2.6%, 95% CI 1.5% to 4.3% vs. EBRT 1.9%, 95% CI 1.1% to 3.2%; p = 0.56) but there were significantly fewer non-breast-cancer deaths with TARGIT (1.4%, 95% CI 0.8% to 2.5% vs. 3.5%, 95% CI 2.3% to 5.2%; p = 0.0086), attributable to fewer deaths from cardiovascular causes and other cancers, leading to a trend in reduced overall mortality in the TARGIT arm (3.9%, 95% CI 2.7% to 5.8% vs. 5.3%, 95% CI 3.9% to 7.3%; p = 0.099]. Health economic analyses suggest that TARGIT was statistically significantly less costly

  4. Concurrent macular corneal dystrophy and keratoconus.

    PubMed

    Mohammad-Rabei, Hossein; Shojaei, Ahmad; Aslani, Mehdi

    2012-01-01

    A 21-year-old female presented with progressive bilateral visual loss for the past 8 years. The patient had no history of systemic disease, surgery or medications. Complete ophthalmologic examination and topography were performed. On ophthalmic examination, uncorrected visual acuity was counting fingers at 2.5 m (20/50 with pinhole) in the right and left eyes. Both corneas appeared hazy on gross examination. On slit-lamp biomicroscopy, focal grayish-white opacities with indistinct borders were noted in the superficial and deep corneal stroma of both eyes. Both corneas were thin and bulging. Corneal topography showed a pattern consistent with keratoconus. The patient underwent penetrating keratoplasty (PKP). Histopathologic studies after PKP confirmed the diagnosis of macular corneal dystrophy and keratoconus in the same eye. The patient was clinically diagnosed as a case of concurrent macular dystrophy and keratoconus, which is a very rare presentation.

  5. Concurrent remote entanglement with continuous variables

    NASA Astrophysics Data System (ADS)

    Zalys-Geller, E.; Narla, A.; Shankar, S.; Hatridge, M.; Silveri, M.; Sliwa, K. M.; Mundhada, S. O.; Girvin, S. M.; Devoret, M. H.

    A necessary ingredient for large scale quantum information processing is the ability to entangle distant qubits on demand. In the field of superconducting quantum information, this process can be achieved by entangling stationary superconducting qubits with flying coherent states of microwave light, which are then co-amplified by a Josephson Parametric Converter (JPC). The JPC also serves as a which-path information eraser, causing the probabilistic continuous measurement process to concurrently entangle the qubits. We discuss the sensitivity of the experiment to the loss of quantum information during the flight of the coherent states, as well as strategies to improve which-path information erasure and reduce information loss to the degree required for entanglement generation. Work supported by ARO, AFOSR, NSF, and YINQE.

  6. The fallacies of concurrent climate policy efforts.

    PubMed

    Radetzki, Marian

    2010-05-01

    Climate policy has assumed an extreme degree of urgency in the international debate in recent years. This article begins by taking a critical look at the scientific underpinnings of the efforts to stabilize the climate. It points to several serious question marks on the purported relationship between greenhouse gas emissions and global warming, and expresses distrust about claims of impending catastrophes related to rising sea levels, hurricanes, and spread of infectious disease. It then reviews the concurrent climate policy efforts and concludes that they are incoherent, misguided and unduly costly, and that they have so far had no perceptible impact on anthropogenic greenhouse gas emissions. The exceedingly ambitious policy plans currently under preparation suffer from similar fallacies. For these reasons, but also because of the remaining scientific doubts and the exorbitant costs that have to be incurred, skepticism is expressed about the preparedness to implement the climate policy plans currently on the table.

  7. Concurrent error detecting codes for arithmetic processors

    NASA Technical Reports Server (NTRS)

    Lim, R. S.

    1979-01-01

    A method of concurrent error detection for arithmetic processors is described. Low-cost residue codes with check-length l and checkbase m = 2 to the l power - 1 are described for checking arithmetic operations of addition, subtraction, multiplication, division complement, shift, and rotate. Of the three number representations, the signed-magnitude representation is preferred for residue checking. Two methods of residue generation are described: the standard method of using modulo m adders and the method of using a self-testing residue tree. A simple single-bit parity-check code is described for checking the logical operations of XOR, OR, and AND, and also the arithmetic operations of complement, shift, and rotate. For checking complement, shift, and rotate, the single-bit parity-check code is simpler to implement than the residue codes.

  8. Concurrent explanations can enhance visual decision making.

    PubMed

    Leisti, Tuomas; Radun, Jenni; Virtanen, Toni; Nyman, Göte; Häkkinen, Jukka

    2014-01-01

    The verbalization of one's thoughts has been shown to impair judgment and decision making in some cases, particularly when targets are perceptual. This finding has been attributed to the fact that non-verbal processes are sometimes difficult to verbalize, which may cause a shift in processing that is maladaptive to the task. The study shows that concurrent written explanations can also enhance judgment and decision making in certain visual choice tasks. This finding suggests that the effect of verbalization on perceptual tasks is not dependent on whether the targets of the judgment are verbal or perceptual but rather on whether there is adequate vocabulary to execute the task and whether the task benefits from a more analytic approach.

  9. Generalized monogamy relations of concurrence for N -qubit systems

    NASA Astrophysics Data System (ADS)

    Zhu, Xue-Na; Fei, Shao-Ming

    2015-12-01

    We present a different kind of monogamous relations based on concurrence and concurrence of assistance. For N -qubit systems A B C1...CN -2 , the monogamy relations satisfied by the concurrence of N -qubit pure states under the partition A B and C1...CN -2 , as well as under the partition A B C1 and C2...CN -2 , are established, which gives rise to a kind of restrictions on the entanglement distribution and trade off among the subsystems.

  10. 15 CFR 930.78 - State agency concurrence or objection.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND COASTAL... Continental Shelf (OCS) Exploration, Development and Production Activities § 930.78 State agency concurrence...

  11. C formal verification with unix communication and concurrency

    NASA Technical Reports Server (NTRS)

    Hoover, Doug N.

    1990-01-01

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

  12. An international randomised controlled trial to compare TARGeted Intraoperative radioTherapy (TARGIT) with conventional postoperative radiotherapy after breast-conserving surgery for women with early-stage breast cancer (the TARGIT-A trial).

    PubMed Central

    Vaidya, Jayant S; Wenz, Frederik; Bulsara, Max; Tobias, Jeffrey S; Joseph, David J; Saunders, Christobel; Brew-Graves, Chris; Potyka, Ingrid; Morris, Stephen; Vaidya, Hrisheekesh J; Williams, Norman R; Baum, Michael

    2016-01-01

    -breast-cancer mortality. RESULTS In total, 3451 patients were recruited between March 2000 and June 2012. The following values are 5-year Kaplan-Meier rates for TARGIT compared with EBRT. There was no statistically significant difference in local recurrence between TARGIT and EBRT. TARGIT was non-inferior to EBRT overall [TARGIT 3.3%, 95% confidence interval (CI) 2.1% to 5.1% vs. EBRT 1.3%, 95% CI 0.7% to 2.5%; p = 0.04; Pnon-inferiority = 0.00000012] and in the prepathology stratum (n = 2298) when TARGIT was given concurrently with lumpectomy (TARGIT 2.1%, 95% CI 1.1% to 4.2% vs. EBRT 1.1%, 95% CI 0.5% to 2.5%; p = 0.31; Pnon-inferiority = 0.0000000013). With delayed TARGIT postpathology (n = 1153), the between-group difference was larger than 2.5% and non-inferiority was not established for this stratum (TARGIT 5.4%, 95% CI 3.0% to 9.7% vs. EBRT 1.7%, 95% CI 0.6% to 4.9%; p = 0.069; Pnon-inferiority = 0.06640]. The local recurrence-free survival was 93.9% (95% CI 90.9% to 95.9%) when TARGIT was given with lumpectomy compared with 92.5% (95% CI 89.7% to 94.6%) for EBRT (p = 0.35). In a planned subgroup analysis, progesterone receptor (PgR) status was found to be the only predictor of outcome: hormone-responsive patients (PgR positive) had similar 5-year local recurrence with TARGIT during lumpectomy (1.4%, 95% CI 0.5% to 3.9%) as with EBRT (1.2%, 95% CI 0.5% to 2.9%; p = 0.77). Grade 3 or 4 radiotherapy toxicity was significantly reduced with TARGIT. Overall, breast cancer mortality was much the same between groups (TARGIT 2.6%, 95% CI 1.5% to 4.3% vs. EBRT 1.9%, 95% CI 1.1% to 3.2%; p = 0.56) but there were significantly fewer non-breast-cancer deaths with TARGIT (1.4%, 95% CI 0.8% to 2.5% vs. 3.5%, 95% CI 2.3% to 5.2%; p = 0.0086), attributable to fewer deaths from cardiovascular causes and other cancers, leading to a trend in reduced overall mortality in the TARGIT arm (3.9%, 9

  13. Concurrent Adaptive Measurement of Multiple Abilities.

    ERIC Educational Resources Information Center

    Ackerman, Terry A.; Davey, Tim C.

    An adaptive test can usually match or exceed the measurement precision of conventional tests several times its length. This increased efficiency is not without costs, however, as the models underlying adaptive testing make strong assumptions about examinees and items. Most troublesome is the assumption that item pools are unidimensional. Truly…

  14. Early related or unrelated haematopoietic cell transplantation results in higher overall survival and leukaemia-free survival compared with conventional chemotherapy in high-risk acute myeloid leukaemia patients in first complete remission.

    PubMed

    Basara, N; Schulze, A; Wedding, U; Mohren, M; Gerhardt, A; Junghanss, C; Peter, N; Dölken, G; Becker, C; Heyn, S; Kliem, C; Lange, T; Krahl, R; Pönisch, W; Fricke, H-J; Sayer, H G; Al-Ali, H; Kamprad, F; Niederwieser, D

    2009-04-01

    Between 1996 and 2004, a total of 708 patients were enrolled in the acute myeloid leukaemia (AML) '96 and '02 studies of the East German Study Group (OSHO). Of these, 138 patients (19.5%) had unfavourable cytogenetics defined as complex karyotype, del (5q)/-5, del (7q)/-7, abn (3q26) and abn (11q23). In all, 77 (56%) achieved complete remission 1 (CR1) after induction chemotherapy and were eligible for haematopoietic cell transplantation (HCT). HCT was performed after a median of two cycles of consolidation chemotherapy (CT) in the AML '96 and one cycle in the AML '02 study (P=0.03). After a median follow-up of 19 months, overall survival (OS) at two years was significantly better in the donor group (52+/-9%) versus the no-donor group (24+/-8%; P=0.005). Differences in outcomes were mainly because of a lower relapse incidence in patients after HCT (39+/-11%) compared with a higher relapse incidence in patients undergoing CT (77+/-10%; P=0.0005). Treatment-related mortality was low and not statistically significantly different between the two treatment groups (15+/-7 and 5+/-5% for HCT and chemotherapy, respectively; P=0.49).We conclude that early HCT from related or unrelated donors led to significantly better OS and leukaemia-free survival compared with chemotherapy in patients with unfavourable karyotype.

  15. Concurrent performances: stimulus-control gradients during schedules of signalled and unsignalled concurrent reinforcement1

    PubMed Central

    Catania, A. Charles; Silverman, Philip J.; Stubbs, D. Alan

    1974-01-01

    On one key, pigeons' pecks were reinforced according to a variable-interval schedule in the presence of vertical lines, and were not reinforced in the presence of oblique lines. On a second key, pecks were reinforced according to a variable-interval schedule in the presence of blue, according to a signalled variable-interval schedule in the presence of red, and were not reinforced in the presence of white. Subsequently, during extinction, stimulus-control gradients were obtained by presenting eight different line orientations on the first key concurrent with each of the three colors on the second key. On the first key, line-orientation gradients tended to be lower, narrower, and less shifted in peak or area when the second-key stimulus was blue or red, the stimuli respectively correlated with unsignalled and signalled reinforcement, than when it was white, the stimulus correlated with extinction. Thus, the effect on first-key line-orientation gradients depended on second-key stimuli correlated with concurrent reinforcement, whether or not these stimuli were also correlated with concurrent responding. As a function of first-key line orientation, an inverted gradient was obtained on the second key during blue; during both red and white, rates of pecking on the second key were near zero. PMID:16811737

  16. Concurrent or Sequential Hormonal and Radiation Therapy in Breast Cancer: A Literature Review

    PubMed Central

    Yu, Edward; Potvin, Kylea; D'souza, David; Lock, Michael

    2015-01-01

    Background and objectives: Adjuvant hormonal therapy is frequently used in the treatment of women with estrogen receptor (ER)/progesterone receptor (PR) positive breast cancer. When radiotherapy is given, hormone therapy may be delivered in a concurrent or sequential manner. Hormonal blockade with tamoxifen or aromatase inhibitors is thought to arrest hormonally dependent cancer cells in the early G1 phase of the cell cycle. This has been theorized to reduce the efficacy of radiation, which is known to be more effective in cells that are actively dividing. Therefore, there has been a reluctance by many to treat with concurrent hormonal and radiation therapy. Methods: We performed a search of the Medline database that led to the identification of 39 studies. Abstract and full-text review of these studies led to the identification of seven English non-review studies in peer-reviewed literature between 1995 and 2015 that addressed the question of timing of radiation and hormonal therapy. Outcome measures were captured from each of the studies. Results: No difference in survival or local-regional recurrence was identified between concurrent versus sequential treatment. Furthermore, no difference in cosmetic outcome or adverse effects was noted for either approach. However, when comparing radiation alone or radiation and hormonal therapy, there was an increased risk of breast and lung fibrosis with combined treatment. Conclusions: Hormone therapy, concurrent or sequential, with radiation results in comparable disease-related outcomes, including survival and recurrence. However, given the theoretical reduction in efficacy and increased rates of fibrosis with concurrent use, it is reasonable to support the use of sequential therapy. PMID:26623219

  17. Product design simplification system for concurrent engineering environment

    NASA Astrophysics Data System (ADS)

    Lin, Grier C. I.; Hsu, Hung-Yao

    1995-08-01

    Product design is the most important stage in the course of product development. All the important decision-making regarding manufacturing and assembly is made during this period. Concurrent engineering (CE) has been proposed to facilitate the whole development processes by using multi-disciplinary team-work. Under the concept of CE there is a need to provide the designers an expert system to investigate their design in the early stage of design. In this paper the construction of a product design simplification system has been explored and a prototype system has been developed. The system can be used to evaluate product design on the basis of design for assembly (DFA) principles. Design simplification can be accomplished by three approaches. The first uses the three criteria of Boothroyd and Dewhurst's Methodology, the second examines the functional implication of parts and the third considers if a part is secured after assembly. The system will give the designer advice according to the evaluation results. All the rules in the rule-base are derived from the expertise in DFA field. On the basis of the implementation of this prototype system further research directions are also suggested.

  18. Gender differences in psychotic disorders with concurrent substance use.

    PubMed

    Caton, Carol L M; Xie, Haiyi; Drake, Robert E; McHugo, Gregory

    2014-01-01

    We conducted a comparative analysis of gender differences in patients with primary psychotic disorders with concurrent substance use and in those with substance-induced psychoses. A total of 385 individuals admitted to psychiatric emergency departments with early-onset psychosis and recent substance use were interviewed at baseline and at six-month intervals for two years. Using a standardized research diagnostic assessment instrument, we classified patients at baseline into primary and substance-induced psychosis groups and analyzed the effects of gender on demographic, family, and clinical characteristics at baseline, the interaction of gender and diagnosis, and gender main effects on illness course, adjustment, and service use over the two-year follow-up period. Women had better premorbid adjustment, less misattribution of symptoms, and a later age at onset of regular drug use compared to men. Women, however, showed greater depression and histories of abuse compared to men. Men had greater arrest histories. No interactions between gender and diagnosis were significant. Both genders in the primary and substance-induced psychosis groups showed clinical and functional improvement over the follow-up period despite the overall minimal use of mental health and substance abuse treatment services. Women and men with psychosis and substance use differ on several dimensions. Our findings suggest the need for gender-specific treatment programming across both diagnostic groups.

  19. A Model-Driven Approach to Teaching Concurrency

    ERIC Educational Resources Information Center

    Carro, Manuel; Herranz, Angel; Marino, Julio

    2013-01-01

    We present an undergraduate course on concurrent programming where formal models are used in different stages of the learning process. The main practical difference with other approaches lies in the fact that the ability to develop correct concurrent software relies on a systematic transformation of formal models of inter-process interaction (so…

  20. 18 CFR 131.52 - Certificate of concurrence.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... concurrence. 131.52 Section 131.52 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY APPROVED FORMS, FEDERAL POWER ACT AND PUBLIC UTILITY REGULATORY POLICIES ACT OF 1978 FORMS § 131.52 Certificate of concurrence. (See §§ 35.1 through 35.21 of this chapter.)...

  1. 18 CFR 131.52 - Certificate of concurrence.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... concurrence. 131.52 Section 131.52 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY APPROVED FORMS, FEDERAL POWER ACT AND PUBLIC UTILITY REGULATORY POLICIES ACT OF 1978 FORMS § 131.52 Certificate of concurrence. (See §§ 35.1 through 35.21 of this chapter.)...

  2. 18 CFR 131.52 - Certificate of concurrence.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... concurrence. 131.52 Section 131.52 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY APPROVED FORMS, FEDERAL POWER ACT AND PUBLIC UTILITY REGULATORY POLICIES ACT OF 1978 FORMS § 131.52 Certificate of concurrence. (See §§ 35.1 through 35.21 of this chapter.)...

  3. 18 CFR 131.52 - Certificate of concurrence.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... concurrence. 131.52 Section 131.52 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY APPROVED FORMS, FEDERAL POWER ACT AND PUBLIC UTILITY REGULATORY POLICIES ACT OF 1978 FORMS § 131.52 Certificate of concurrence. (See §§ 35.1 through 35.21 of this chapter.)...

  4. Industrial Insights on the DoD Concurrent Engineering Program

    DTIC Science & Technology

    1988-10-01

    improvements in: 1) concurrent engineering -related technologies; 2) industrial structural approaches to product design and production process development ; 3... industry in DoD-specific manufacturing design and process development ; and 3) sponsorship and support of manufacturing engineering education and...implementation of the Concurrent Engineering Program will take place principally in the design and development laboratories of industry and on the production

  5. School Concurrency: Lessons Learned from Broward County, Florida. Revised.

    ERIC Educational Resources Information Center

    Stroud, Nancy E.

    This paper presents an overview of the intergovernmental planning and cooperation in a failed effort to defend a regulatory program for school concurrence in Florida's Broward County public school system. A detailed description of the proposed concurrency system is provided along with the critiques of the system that resulted from the…

  6. 28 CFR 0.56 - Exclusive or concurrent jurisdiction.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exclusive or concurrent jurisdiction. 0.56 Section 0.56 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Criminal Division § 0.56 Exclusive or concurrent jurisdiction. The Assistant Attorney General...

  7. 39 CFR 273.7 - Concurrence of Attorney General.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Concurrence of Attorney General. 273.7 Section 273... PROGRAM FRAUD CIVIL REMEDIES ACT § 273.7 Concurrence of Attorney General. (a) The Attorney General is... the Attorney General or his designee approves such action in a written statement which specifies:...

  8. A Model-Driven Approach to Teaching Concurrency

    ERIC Educational Resources Information Center

    Carro, Manuel; Herranz, Angel; Marino, Julio

    2013-01-01

    We present an undergraduate course on concurrent programming where formal models are used in different stages of the learning process. The main practical difference with other approaches lies in the fact that the ability to develop correct concurrent software relies on a systematic transformation of formal models of inter-process interaction (so…

  9. Partner Concurrency and the STD/HIV Epidemic.

    PubMed

    Aral, Sevgi O

    2010-03-01

    Conceptually and theoretically, it is easy to see how short gaps and concurrent partnerships fuel the spread of sexually transmitted infections (STI) and HIV in populations. The consequences of concurrency are bounded by the duration of the infectious period and by the relationships between concurrent partnerships and other dimensions of sexual behavior. Consequently, it is difficult to predict how concurrent partnerships or short gaps may be related to the spread of STI and HIV in a particular epidemiologic context in empirical reality. In recent years, analyses of sexual behavior data collected through nationally representative surveys revealed similar prevalences of concurrent sexual partnerships in Western populations. The association between concurrent sexual partnerships and STI/HIV risk is complicated. At the population level, recent findings suggest that the ecological association between polygyny and HIV prevalence is negative at the country level and at the sub-national level. To address the need for agreed-upon standard definitions and measures of concurrent sexual partnerships, which will facilitate comparisons across time and settings, the Joint United Nations Program on HIV/AIDS (UNAIDS) Reference Group on Estimates, Modelling, and Projections convened a meeting in April 2009. The recommendations developed at this meeting include suggestions for a definition, indicators, and measures of concurrency.

  10. Concurrent Schedules of Positive and Negative Reinforcement: Differential-Impact and Differential-Outcomes Hypotheses

    PubMed Central

    Magoon, Michael A; Critchfield, Thomas S

    2008-01-01

    Considerable evidence from outside of operant psychology suggests that aversive events exert greater influence over behavior than equal-sized positive-reinforcement events. Operant theory is largely moot on this point, and most operant research is uninformative because of a scaling problem that prevents aversive events and those based on positive reinforcement from being directly compared. In the present investigation, humans' mouse-click responses were maintained on similarly structured, concurrent schedules of positive (money gain) and negative (avoidance of money loss) reinforcement. Because gains and losses were of equal magnitude, according to the analytical conventions of the generalized matching law, bias (log b ≠ 0) would indicate differential impact by one type of consequence; however, no systematic bias was observed. Further research is needed to reconcile this outcome with apparently robust findings in other literatures of superior behavior control by aversive events. In an incidental finding, the linear function relating log behavior ratio and log reinforcement ratio was steeper for concurrent negative and positive reinforcement than for control conditions involving concurrent positive reinforcement. This may represent the first empirical confirmation of a free-operant differential-outcomes effect predicted by contingency-discriminability theories of choice. PMID:18683609

  11. Concurrent schedules of positive and negative reinforcement: differential-impact and differential-outcomes hypotheses.

    PubMed

    Magoon, Michael A; Critchfield, Thomas S

    2008-07-01

    Considerable evidence from outside of operant psychology suggests that aversive events exert greater influence over behavior than equal-sized positive-reinforcement events. Operant theory is largely moot on this point, and most operant research is uninformative because of a scaling problem that prevents aversive events and those based on positive reinforcement from being directly compared. In the present investigation, humans' mouse-click responses were maintained on similarly structured, concurrent schedules of positive (money gain) and negative (avoidance of money loss) reinforcement. Because gains and losses were of equal magnitude, according to the analytical conventions of the generalized matching law, bias (log b (double dagger) 0) would indicate differential impact by one type of consequence; however, no systematic bias was observed. Further research is needed to reconcile this outcome with apparently robust findings in other literatures of superior behavior control by aversive events. In an incidental finding, the linear function relating log behavior ratio and log reinforcement ratio was steeper for concurrent negative and positive reinforcement than for control conditions involving concurrent positive reinforcement. This may represent the first empirical confirmation of a free-operant differential-outcomes effect predicted by contingency-discriminability theories of choice.

  12. Radiotherapy associated with concurrent bevacizumab in patients with non-metastatic breast cancer.

    PubMed

    Pernin, Victor; Belin, Lisa; Cottu, Paul; Bontemps, Patrick; Lemanski, Claire; De La Lande, Brigitte; Baumann, Pierre; Missohou, Fernand; Levy, Christelle; Peignaux, Karine; Bougnoux, Pierre; Denis, Fabrice; Bollet, Marc; Dendale, Rémi; Vago, Nora Ady; Campana, François; Fourquet, Alain; Kirova, Youlia M

    2014-12-01

    The purpose of this multicenter prospective and descriptive study was to determine late toxicities and outcomes among patients with non-metastatic breast cancer receiving concurrent bevacizumab (BV) and radiation therapy (RT) in the clinical trials. Early and late toxicities were assessed and evaluation was available for 63 patients (pts) at 12 months. Acute radiation dermatitis was observed in 48 (76%): grade 1 for 27, grade 2 for 17 and grade 3 for 4 pts. Grade 2 acute oesophagitis was observed in one patient (2%). Little toxicity was described 1 year after the completion of RT: 7 pts (12%): grade 1-2 pain, 3 (5%) presented grade 1 fibrosis, and 2 pts (4%) - telangiectasia. One patient (2%) experienced grade 1 dyspnoea. Five grade 1-2 lymphoedema occurred. Only one patient experienced a LEVF value less than 50% one year after the end of RT. In conclusion, the concurrent BV with locoregional RT provides acceptable toxicities.

  13. Toxic epidermal necrolysis in a patient receiving concurrent phenytoin and whole brain and thoracic radiotherapy.

    PubMed

    Ahmed, Imtiaz; Biswas, Ahitagni; Krishnamurthy, Sapna; Julka, Pramod K

    2014-11-01

    Toxic epidermal necrolysis (TEN) is a severe drug induced type IV hypersensitivity syndrome that can be caused by anticonvulsant drugs, especially the aromatic anticonvulsants such as phenytoin. Most patients with brain metastasis receive whole brain radiotherapy along with anti-edema measures and anticonvulsants either as prophylactic or for symptom control; phenytoin being the most commonly used drug. In a subset of patients, cranial irradiation may act as a precipitating factor along with anticonvulsants for the development of TEN. We report a 54-year-old patient with metastatic non-small cell lung cancer treated with palliative whole brain and mediastinal radiotherapy with concurrent phenytoin-developing TEN, which started within the radiation portals with subsequent generalization. Though a rare, but serious complication, avoidance of the use of phenytoin concurrent with radiotherapy, replacing phenytoin with newer anticonvulsants, early recognition, aggressive management and awareness of this possible complication has been implied upon in this report.

  14. Hypofractionated radiation therapy in the treatment of early-stage breast cancer.

    PubMed

    Freedman, Gary M

    2012-02-01

    Hypofractionated radiation refers to the use of fewer, larger-dose radiation treatments that are usually given over a shorter time period compared to conventional radiation fraction sizes. Randomized trials of hypofractionated whole breast irradiation (WBI) have demonstrated comparable outcomes as conventional fractionation. For a higher-risk population for local recurrence, a phase 3 trial by the Radiation Therapy Oncology Group (RTOG) is currently studying hypofractionated WBI with a concurrent tumor bed boost over 3 weeks. Accelerated partial breast irradiation limits radiation to the region of the tumor bed for 1-3 weeks and is the subject of an ongoing randomized trial by the National Surgical Breast and Bowel Project and RTOG. Questions remain for hypofractionation about optimal patient selection, radiation techniques, and the risk of late toxicity. But results from current trials could make hypofractionation more widely accepted for patients with early-stage breast cancer.

  15. The Emergence of Conventional Writing.

    ERIC Educational Resources Information Center

    Epstein, Maria

    Children in the emergent writing stage write in pre-conventional or emergent forms (scribbling, drawing, non-phonetic letterings, and phonetic spelling) before they write conventionally. A special education teacher in a kindergarten inclusion setting in the Bronx, New York, noticing that her students did not particularly like to write, decided and…

  16. Changes in Concurrent Droughts and Heatwaves in the United States

    NASA Astrophysics Data System (ADS)

    Mazdiyasni, O.; Aghakouchak, A.

    2015-12-01

    A combination of climate events (e.g., low precipitation and high temperatures) may cause a significant impact on the ecosystem and society, though individual events involved may not be severe extremes themselves. Analyzing historical changes in concurrent climate extremes is critical to preparing for and mitigating the negative effects of climatic change and variability. This study focuses on the changes in concurrences of heatwaves and meteorological droughts from 1960 - 2010. Despite an apparent hiatus in rising temperature and no significant trend in droughts, we show a substantial increase in concurrent droughts and heatwaves across most parts of the United States, and a statistically significant shift in the distribution of concurrent extremes. While commonly used trend analysis methods do not show any trend in concurrent droughts and heatwaves, a unique statistical approach discussed in this study exhibits a statistically significant change in the distribution of the data.

  17. Developing Concurrency Messages for the Black Community in Seattle, Washington

    PubMed Central

    Chapman, Caitlin Hughes; Clad, Rachel; Murray, Kate; Foster, Jennifer; Morris, Martina; Parks, Malcolm R.; Kurth, Ann Elizabeth

    2013-01-01

    In the United States, Blacks are disproportionately impacted by HIV/AIDS. Sexual networks and concurrent relationships have emerged as important contributors to the heterosexual transmission of HIV. To date, Africa is the only continent where an understanding of the impact of sexual concurrency has been conveyed in HIV prevention messaging. This project was developed by researchers and members of the Seattle, WA African American and African-Born communities, using the principles of community-based participatory research (CBPR). Interest in developing concurrency messaging came from the community and resulted in the successful submission of a community-academic partnership proposal to develop and disseminate HIV prevention messaging around concurrency. We describe: (a) the development of concurrency messaging through the integration of collected formative data and findings from the scientific literature; (b) the process of disseminating the message in the local Black community; and (c) important factors to consider in the development of similar campaigns. PMID:23206202

  18. Creatine and Caffeine: Considerations for Concurrent Supplementation.

    PubMed

    Trexler, Eric T; Smith-Ryan, Abbie E

    2015-12-01

    Nutritional supplementation is a common practice among athletes, with creatine and caffeine among the most commonly used ergogenic aids. Hundreds of studies have investigated the ergogenic potential of creatine supplementation, with consistent improvements in strength and power reported for exercise bouts of short duration (≤ 30 s) and high intensity. Caffeine has been shown to improve endurance exercise performance, but results are mixed in the context of strength and sprint performance. Further, there is conflicting evidence from studies comparing the ergogenic effects of coffee and caffeine anhydrous supplementation. Previous research has identified independent mechanisms by which creatine and caffeine may improve strength and sprint performance, leading to the formulation of multi-ingredient supplements containing both ingredients. Although scarce, research has suggested that caffeine ingestion may blunt the ergogenic effect of creatine. While a pharmacokinetic interaction is unlikely, authors have suggested that this effect may be explained by opposing effects on muscle relaxation time or gastrointestinal side effects from simultaneous consumption. The current review aims to evaluate the ergogenic potential of creatine and caffeine in the context of high-intensity exercise. Research directly comparing coffee and caffeine anhydrous is discussed, along with previous studies evaluating the concurrent supplementation of creatine and caffeine.

  19. Stimulus effects on concurrent performance in transition

    PubMed Central

    Hanna, Elenice S.; Blackman, Derek E.; Todorov, João Claudio

    1992-01-01

    Six experimentally naive pigeons were exposed to concurrent variable-interval variable-interval schedules in a three-key procedure in which food reinforcement followed pecks on the side keys and pecks on the center key served as changeover responses. In Phase 1, 3 birds were exposed to 20 combinations of five variable-interval values, with each variable-interval value consistently associated with a different color on the side keys. Another 3 pigeons were exposed to the same 20 conditions, but with a more standard procedure that used a nondifferential discriminative stimulus on the two side keys throughout all conditions. In Phase 2, the differential and nondifferential stimulus conditions were reversed for each pigeon. Each condition lasted for one 5-hr session and one subsequent 1-hr session. In the last 14 conditions of each phase, the presence of differential discriminative stimuli decreased the time necessary for differential responding to develop and increased the sensitivity of behavior to reinforcement distribution in the 1st hr of training; during the last hours of training in each condition, however, the effects of the differential discriminative stimuli could not be distinguished from the effects of reinforcement distribution per se. These results show the importance of studying transitions in behavior as well as final performance. They may also be relevant to discrepancies in the results of previous experiments that have used nonhuman and human subjects. PMID:16812669

  20. Concurrent implementation of quality improvement programs.

    PubMed

    Nyström, Monica Elisabeth; Garvare, Rickard; Westerlund, Anna; Weinehall, Lars

    2014-01-01

    Competing activities and projects can interfere with implementing new knowledge and approaches. The purpose, therefore, was to investigate processes and impact related to implementing two concurrent quality initiatives in a Swedish hospital. These were a regionally initiated, system-wide organizational learning programme called the Dynamic and Viable Organization (DVO) and a national initiative on stopping healthcare-associated and hospital-acquired infections (SHAI). Both undertakings aspired to increase staff competence in systematic improvement approaches. Multiple methods were applied including surveys, observations, interviews, process diaries, documents and organizational measurements. Respondents were unit managers, change facilitators and improvement team members. Even though both initiatives shared the same improvement approach, there was no strong indication that they were strategically combined to benefit each other. The initiatives existed side by side with some coordination and some conflict. Despite absent management strategies to utilize the national SHAI initiative, positive developments in QI culture and communication were reported. The current study illustrates the inherent difficulties coordinating change initiatives, even in favourable circumstances. This article addresses the lesser studied but common situation of coinciding and competing projects in organizations.

  1. Navigational conversation impairs concurrent distance judgments.

    PubMed

    Patrick, Regan E; Elias, Lorin J

    2009-01-01

    Dual-task performance as it relates to driving, such as tuning a radio or manipulating a cellular phone, forces drivers to divide their attention between the traffic demands and the in-car task. The present study investigated how concurrent spatial or non-spatial cognitive distractions mediated proximity judgments using vehicular stimuli. Utilizing a modified version of the task employed by [Elias, L.J., Robinson, B. in press. Drive on the right side of the road: perceptual asymmetries for judgments of automobile proximity. International Journal of Neuroscience.] the current study examined how mental navigation (spatial distraction) affected accuracy and response time for depth judgments on vehicular stimuli in each visual field. These were compared to a control condition in which no distraction was present, as well as when a semantic (non-spatial) distraction was present. We found that conversation of a navigational nature (i.e., spatial distraction) most negatively impacted accuracy and response time when processing dynamically changing vehicle proximity. Further, these deleterious effects appeared to be uniform throughout the visual field. Findings are related to driving while being distracted, with particular emphasis on the role of cerebral lateralization in dual-task performance.

  2. Concurrent use of methotrexate and acitretin revisited.

    PubMed

    Lowenthal, Kate E; Horn, Pamela J; Kalb, Robert E

    2008-01-01

    According to Food and Drug Administration (FDA)-approved prescribing information, combination therapy with acitretin and methotrexate (MTX) is contraindicated. This is based on company data suggesting increased hepatotoxicity in patients who received concomitant methotrexate and etretinate, the prodrug of acitretin. We reviewed the clinical data of 18 patients with psoriasis who received methotrexate and acitretin concurrently. Patients received 25 mg of acitretin once daily or alternating days and 7.5-25 mg methotrexate weekly. Baseline metabolic panels, including lipids, and complete blood counts (CBC) were drawn prior to therapy and every 4-12 weeks while on therapy. The average length of treatment was 9 months. Two patients discontinued treatment after refusal to abstain from alcohol. Seven patients discontinued treatment due to a lack of response. Two patients discontinued treatment after clearing. One patient discontinued treatment secondary to hair loss. Six patients are currently continuing therapy. In this series of patients, combination therapy with acitretin and methotrexate was well tolerated and often effective. There were no new or unusual adverse events noted, including significant hepatotoxicity. In patients who would benefit from the use of acitretin, the concomitant use of methotrexate is not an absolute contraindication.

  3. Differences between conventional and non-conventional MRI techniques in Parkinson’s disease

    PubMed Central

    Baglieri, Annalisa; Marino, Maria Adele; Morabito, Rosa; Di Lorenzo, Giuseppe; Bramanti, Placido; Marino, Silvia

    2013-01-01

    Summary Magnetic resonance imaging (MRI) provides an in vivo assessment of cortical and subcortical regions affected in Parkinson’s disease (PD). This review summarizes the most important conventional and non-conventional MRI techniques applied in this field. Standard neuroimaging techniques have played a marginal role in the diagnosis and follow-up of PD, essentially being used only to discriminate atypical syndromes from PD, to exclude secondary causes such as vascular lesions, and to confirm the absence of specific imaging features found in atypical parkinsonisms. However, non-conventional MRI techniques, i.e. new neuroimaging approaches such as magnetic resonance spectroscopy, diffusion tensor imaging, and functional MRI, may allow the detection of structural, functional and metabolic changes useful not only for differential diagnosis, but also for early diagnosis and outcome and treatment monitoring in PD. In addition, we illustrate the advantages of high-field MRI over lower magnetic fields, highlighting the great potential of advanced neuroimaging techniques. PMID:24125556

  4. Climate Monitoring Satellite Designed in a Concurrent Engineering Process

    NASA Astrophysics Data System (ADS)

    Bauer, Waldemar; Braukhane, A.; Quantius, D.; Dumont, E.; Grundmann, J. T.; Romberg, O.

    An effective method of detecting Green House Gases (GHG CO2 and CH4) is using satellites, operating in Low Earth Orbit (LEO). Satellite based greenhouse gas emissions monitoring is challenging and shows an ambitions level of requirements. Until now for corresponding scientific payload it is common to use a purpose-built satellite bus, or to install the payload on board of a larger conventional satellite. These approaches fulfils all customer requirements but could be critical from a financial point of view. Between 2014 and 2020, no space-based CH4 detection and if at all limited CO2 detection capabilities are planned internationally. In order to fill this gap the Institute for Environmental Physics (IUP) of the University of Bremen plans a GHG satellite mission with near-surface sensitivity called "CarbonSat". It shall perform synchronous global atmospheric CO2 and CH4 observations with the accuracy, precision and coverage needed to significantly advance our knowledge about the sources and sinks of Green House Gases. In order to verify technical and financial opportunities of a small satellite a Concurrent Engi-neering Study (CE-study) has been performed at DLR Bremen, Germany. To reuse knowledge in compact satellite design, the Compact/SSB (Standard Satellite Bus) was chosen as baseline design. The SSB has been developed by DLR and was already used for BIRD (Bispectral Infra-Red Detection) mission but also adapted to the ongoing missions like TET (Technologie-Erprobungs-Trüger) or AsteroidFinder. This paper deals with the highly effective design process a within the DLR-CE-Facility and with the outcomes of the CE-study. It gives an overview of the design status as well as an outlook for comparable missions.

  5. Concurrent Chemoradiotherapy Improves Survival in Patients With Hypopharyngeal Cancer

    SciTech Connect

    Paximadis, Peter; Yoo, George; Lin, Ho-Sheng; Jacobs, John; Sukari, Ammar; Dyson, Greg; Christensen, Michael; Kim, Harold

    2012-03-15

    Purpose: To retrospectively review our institutional experience with hypopharyngeal carcinoma with respect to treatment modality. Methods and Materials: A total of 70 patients with hypopharyngeal cancer treated between 1999 and 2009 were analyzed for functional and survival outcomes. The treatments included surgery alone (n = 5), surgery followed by radiotherapy (RT) (n = 3), surgery followed by chemoradiotherapy (CRT) (n = 13), RT alone (n = 2), CRT alone (n = 22), induction chemotherapy followed by RT (n = 3), and induction chemotherapy followed by CRT (n = 22). Results: The median follow-up was 18 months. The median overall survival and disease-free survival for all patients was 28.3 and 17.6 months, respectively. The 1- and 2-year local control rate for all patients was 87.1% and 80%. CRT, given either as primary therapy or in the adjuvant setting, improved overall survival and disease-free survival compared with patients not receiving CRT. The median overall survival and disease-free survival for patients treated with CRT was 36.7 and 17.6 months vs. 14.0 and 8.0 months, respectively (p < .01). Of the patients initially treated with an organ-preserving approach, 4 (8.2%) required salvage laryngectomy for local recurrence or persistent disease; 8 (16.3%) and 12 (24.5%) patients were dependent on a percutaneous gastrostomy and tracheostomy tube, respectively. The 2-year laryngoesophageal dysfunction-free survival rate for patients treated with an organ-preserving approach was estimated at 31.7%. Conclusions: Concurrent CRT improves survival in patients with hypopharyngeal cancer. CRT given with conventional radiation techniques yields poor functional outcomes, and future efforts should be directed at determining the feasibility of pharyngeal-sparing intensity-modulated radiotherapy in patients with hypopharyngeal tumors.

  6. Concurrent engineering solution for the design of ship and offshore bracket parts and fabrication process

    NASA Astrophysics Data System (ADS)

    Kim, Tae-Won; Lim, Sang-Sub; Seok, Ho-Hyun; Kang, Chung-Gil

    2013-09-01

    Brackets in ships and offshore structures are added structures that can endure stress concentrations. In this study, a concurrent engineering solution was proposed, and a high strength low carbon cast steel alloy applicable to offshore structures was designed and developed. The yield strength and ultimate tensile strength of the designed steel were 480 and 600 MPa, respectively. The carbon equivalent of the steel was 0.446 with a weld crack susceptibility index of 0.219. The optimal structural design of the brackets for offshore structures was evaluated using ANSYS commercial software. The possibility of replacing an assembly of conventional built-up brackets with a single casting bulb bracket was verified. The casting process was simulated using MAGMAsoft commercial software, and a casting fabrication process was designed. For the proposed bulb bracket, it was possible to reduce the size and weight by approximately 30% and 50%, respectively, compared to the conventional type of bracket.

  7. Microsurgical management of complex fingertip injuries: comparison to conventional skin grafting.

    PubMed

    Rose, E H; Norris, M S; Kowalski, T A

    1988-01-01

    In selected cases of severe fingertip injuries, an aggressive approach using microvascular and microneural techniques can yield functional results equal or superior to conventional methods of treatment in less severe injuries. A series of 20 patients were treated microsurgically from 1983 to 1986 for severe acute distal finger injuries or their early sequelae--five distal replantations, eight neurovascular free tissue transfers, and nine distal neurorrhaphies/nerve grafts with or without vascular conduit. Concurrently, 33 simpler tip avulsions were treated with full-thickness skin grafts for comparison. In the microsurgical series, one replant and the distal 1 cm of a free toe flap necrosed. Replants averaged two-point discrimination of 9.8 mm and pulp pinch 65 percent of normal; free toe transfers, two-point of 6 mm, pulp pinch 58 percent; distal nerve reconstruction, two-point 6 mm. Operating time per digit averaged 5.0 hours for replants, 4.3 hours for toe flaps, and 1.5 hours for nerve repair/grafts. All patients returned to full pre-injury employment within six months. None required revisional surgery for dysesthetic fingertips. In the conventional skin graft series, greater than six months follow-up is available in 17 patients. Average two-point was 7 mm (range: 3 to greater than 15 mm) and pulp pinch 83 percent of normal. There were seven poor results with cold intolerance, numbness, and paresthesias, three of which required revisional surgery. The data suggest that microsurgical management of fingertip injuries achieves results comparable to skin grafts, despite the greater complexity of the initial injury. This approach has resulted in fewer secondary tip revisions. Operative times are acceptable. Parameters of sensory return are similar, although pulp pinch is slightly less. Disability times are comparable to the average in major pulp losses. Of importance, final permanent partial factors of disability are diminished in rating, due to retained digital

  8. Feasibility evaluation of hypofractionated radiotherapy with concurrent temozolomide in elderly patients with glioblastoma.

    PubMed

    Uto, Megumi; Mizowaki, Takashi; Ogura, Kengo; Arakawa, Yoshiki; Mineharu, Yohei; Miyamoto, Susumu; Hiraoka, Masahiro

    2016-12-01

    Although hypofractionated radiotherapy (HFRT) is preferred to conventionally fractionated radiotherapy when treating elderly patients with glioblastoma, the benefits and tolerability of HFRT with concurrent temozolomide (TMZ) remain unknown for such patients. We assessed the feasibility and outcomes of elderly patients with glioblastoma treated with HFRT and concurrent TMZ. We retrospectively reviewed the medical records of 11 patients aged ≥70 years who were treated with HFRT and concurrent TMZ. All patients had newly diagnosed and histologically confirmed glioblastoma and were treated at our institution between October 2011 and April 2015. The median age was 74 years (range, 70-85 years). Total resection/subtotal resection/biopsy were performed in 2/5/4 patients, respectively. The planning target volume included the T1-enhancing tumor and the resection cavity plus 2-cm margins, and all surrounding edema. The median prescription dose was 35 Gy (range, 35-42.5 Gy), delivered in 10 fractions. Seven patients received TMZ at 150 mg/m(2) for 5 days and 4 received TMZ at 75 mg/m(2) during HFRT. Overall survival (OS) was defined as the time from surgery to death or the last follow-up. The median follow-up period was 13.2 months. The median OS and progression-free survival (PFS) times were 13.2 and 7.0 months, respectively. One patient experienced grade 4 neutropenia, lymphocytopenia, and thrombocytopenia. No grade 3 or higher nonhematological adverse event was noted. Our analysis demonstrated the feasibility of HFRT with concurrent TMZ used to treat elderly patients with glioblastoma. Further prospective clinical trials are needed to define therapies that balance efficacy with tolerability.

  9. Clinical outcomes after implantation of a centrifugal flow left ventricular assist device and concurrent cardiac valve procedures.

    PubMed

    Milano, Carmelo; Pagani, Francis D; Slaughter, Mark S; Pham, Duc Thinh; Hathaway, David R; Jacoski, Mary V; Najarian, Kevin B; Aaronson, Keith D

    2014-09-09

    Cardiac valve procedures are commonly performed concurrently during implantation of left ventricular assist devices, but the added procedural risk has not been studied in detail. Data from patients receiving the HeartWare Ventricular Assist Device in the ADVANCE bridge to transplant (BTT) trial and continued access protocol were reviewed. Of 382 consecutive patients who completed follow-up between August 2008 and June 2013 (mean time on support 389 days, median 271 days), 262 (68.6%) underwent isolated HeartWare Ventricular Assist Device implantation, 75 (19.6%) a concurrent valve procedure, and 45 (11.8%) concurrent nonvalvular procedures. Of the concurrent valve procedures, 56 were tricuspid, 13 aortic, and 6 mitral. Survival was similar between groups (79% for concurrent valve procedures and 85% for HeartWare Ventricular Assist Device only at 1 year; P=0.33). Concurrent valve procedures were also associated with increased unadjusted early right heart failure (RHF). A multivariable analysis for death and RHF (121 total events) identified female sex (odds ratio=2.0 [95% confidence interval, 1.2-3.3; P=0.0053]) and preimplant tricuspid regurgitation severity (odds ratio=2.9 [95% confidence interval, 1.8-4.8, P<0.0001]) as independent predictors while concurrent tricuspid valve procedures (TVP) were not predictors. Furthermore, patients with significant preimplant tricuspid regurgitation who did not receive a TVP experienced an increased rate of late RHF compared with those who received TVP (0.19 versus 0.05 events per patient-year, respectively; P=0.024). Compared with HeartWare Ventricular Assist Device alone, survival was equivalent for the concurrent valve procedure group. Tricuspid regurgitation severity was the most important predictor of increased postoperative RHF, and concurrent TVP was not an independent predictor of RHF overall. Concurrent TVP may reduce the rate of late RHF for patients with significant preimplant tricuspid insufficiency. http

  10. Concurrent Chemoradiotherapy in Resected Extrahepatic Cholangiocarcinoma

    SciTech Connect

    Nelson, John W.; Ghafoori, A. Paiman; Willett, Christopher G.; Tyler, Douglas S.; Pappas, Theodore N.; Clary, Bryan M.; Hurwitz, Herbert I.; Bendell, Johanna C.; Morse, Michael A.; Clough, Robert W.; Czito, Brian G.

    2009-01-01

    Purpose: Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials: A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results: Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, respectively. The median survival was 34 months. No patient died perioperatively. Patient age {<=}60 years and perineural involvement adversely affected survival on univariate analysis. Patients undergoing R0 resection had a significantly improved rate of local control but no survival advantage. Despite having more advanced disease at presentation, patients treated neoadjuvantly had a longer survival (5-year survival 53% vs. 23%, p = 0.16) and similar rates of Grade 2-3 surgical morbidity (16% vs. 33%, p = 0.24) compared with those treated in the postoperative setting. Conclusion: These study results suggest a possible local control benefit from chemoradiotherapy combined with surgery in patients with advanced, resected biliary cancer. Furthermore, our results suggest that a treatment strategy that includes preoperative chemoradiotherapy might result in improved tumor resectability with similar surgical morbidity compared with patients treated postoperatively, as well as potentially improved survival outcomes. Distant failure remains a significant failure pattern, suggesting the need for more effective systemic

  11. CONCURRENT CHEMORADIOTHERAPY IN RESECTED EXTRAHEPATIC CHOLANGIOCARCINOMA

    PubMed Central

    Nelson, John W.; Ghafoori, A. Paiman; Willett, Christopher G.; Tyler, Douglas S.; Pappas, Theodore N.; Clary, Bryan M.; Hurwitz, Herbert I.; Bendell, Johanna C.; Morse, Michael A.; Clough, Robert W.; Czito, Brian G.

    2014-01-01

    Purpose Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy. Methods and Materials A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors. Results Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, respectively. The median survival was 34 months. No patient died perioperatively. Patient age ≤60 years and perineural involvement adversely affected survival on univariate analysis. Patients undergoing R0 resection had a significantly improved rate of local control but no survival advantage. Despite having more advanced disease at presentation, patients treated neoadjuvantly had a longer survival (5-year survival 53% vs. 23%, p = 0.16) and similar rates of Grade 2–3 surgical morbidity (16% vs. 33%, p = 0.24) compared with those treated in the postoperative setting. Conclusion These study results suggest a possible local control benefit from chemoradiotherapy combined with surgery in patients with advanced, resected biliary cancer. Furthermore, our results suggest that a treatment strategy that includes preoperative chemoradiotherapy might result in improved tumor resectability with similar surgical morbidity compared with patients treated postoperatively, as well as potentially improved survival outcomes. Distant failure remains a significant failure pattern, suggesting the need for more effective systemic

  12. Discriminability between alternatives in a switching-key concurrent schedule

    PubMed Central

    Alsop, Brent; Davison, Michael

    1992-01-01

    Six pigeons were trained to discriminate between two intensities of white light in a symbolic matching-to-sample procedure. These stimuli were then used to signal which schedule was available on the main key in a switching-key concurrent schedule. The concurrent schedules led to a symbolic matching-to-sample phase in which the subject identified the concurrent schedule to which it last responded before a reinforcer could be obtained. The concurrent schedules were varied across conditions. Discriminability, measured during the symbolic matching-to-sample performance, was high throughout and did not differ across the two procedures. Performance in the concurrent schedules was like that typically obtained using these schedules. Delays were then arranged between completion of the concurrent schedules and presentations of the symbolic matching-to-sample phase. A series of conditions with an intervening delay of 10 s showed that both concurrent-schedule performance and symbolic matching-to-sample performance were affected by the delay in a similar way; that is, choice responding was closer to indifference. PMID:16812649

  13. Phase I trial of escalating-dose cisplatin with 5-fluorouracil and concurrent radiotherapy in Chinese patients with esophageal cancer.

    PubMed

    Lin, Qiang; Gao, Xian-Shu; Qiao, Xue-Ying; Zhou, Zhi-Guo; Zhang, Ping; Chen, Kun; Zhao, Yan-Nan; Asaumi, Junichi

    2008-02-01

    We defined the maximum-tolerated dose (MTD) of chemoradiotherapy (cisplatin (CDDP) with 5-fluorouracil (5-FU) and concurrent chemoradiotherapy) for Chinese patients with esophageal cancer. Twenty-one previously untreated patients with primary esophageal cancer were entered into this study. Escalating doses of CDDP with 5-FU were administered in a modified Fibonacci sequence, with concurrent conventional fractionation radiotherapy (CFR) of 60 Gy or 50 Gy. The starting doses were CDDP 37.5 mg/m2 on day 1, and 5-FU 500 mg/m2 on days 1-5, respectively. The regimen was repeated 4 times every 28 days. If no dose-limiting toxicity (DLT) was observed, the next dose level was applied. The procedures were repeated until DLT appeared. The MTD was declared to be 1 dose level below the level at which DLT appeared. DLT was grade 3 radiation-induced esophagitis at a dose level of CDDP 60 mg/m2 with 5-FU 700 mg/m2 and concurrent 60 Gy CFR. MTD was defined as CDDP 52.5 mg/m2 with 5-FU 700 mg/m2 and concurrent 50 Gy CFR. The MTD of CDDP with 5-FU and in concurrent chemoradiotherapy for Chinese patients with esophageal cancer is CDDP 52.5 mg/m2 on day 1 and 5FU 700 mg/m2 on days 1-5, repeated 4 times every 28 days, and concurrent 50 Gy CFR. Further evaluation of this regimen in a prospective phase II trial is ongoing.

  14. Quantum Photonics Beyond Conventional Computing

    DTIC Science & Technology

    2015-07-10

    computational task making it a key application of quantum technology for chemistry , biology and material science. In contrast to a digital simulation on a...AFRL-AFOSR-UK-TR-2015-0045 Quantum Photonics Beyond Conventional Computing Jeremy OBrien THE UNIVERSITY OF BRISTOL 07/10/2015 Final Report...2015 2. REPORT TYPE Final 3. DATES COVERED (From – To) 15 Mar 2012 – 15 Mar 2015 4. TITLE AND SUBTITLE Quantum Photonics Beyond Conventional

  15. TMBean: Optimistic Concurrency in Application Servers Using Transactional Memory

    NASA Astrophysics Data System (ADS)

    Charles, Lucas; Felber, Pascal; Gête, Christophe

    In this experience report, we present an evaluation of different techniques to manage concurrency in the context of application servers. Traditionally, using entity beans is considered as the only way to synchronize concurrent access to data in Jave EE and using mechanism such as synchronized blocks within EJBs is strongly not recommended. In our evaluation we consider the use of software transactional memory to enable concurrent accesses to shared data across different session beans. We are also comparing our approach with using (1) entity beans and (2) session beans synchronized by a global lock.

  16. A Concurrent Distributed System for Aircraft Tactical Decision Generation

    NASA Technical Reports Server (NTRS)

    McManus, John W.

    1990-01-01

    A research program investigating the use of artificial intelligence (AI) techniques to aid in the development of a Tactical Decision Generator (TDG) for Within Visual Range (WVR) air combat engagements is discussed. The application of AI programming and problem solving methods in the development and implementation of a concurrent version of the Computerized Logic For Air-to-Air Warfare Simulations (CLAWS) program, a second generation TDG, is presented. Concurrent computing environments and programming approaches are discussed and the design and performance of a prototype concurrent TDG system are presented.

  17. Potential interactions between complementary/alternative products and conventional medicines in a Medicare population.

    PubMed

    Elmer, Gary W; Lafferty, William E; Tyree, Patrick T; Lind, Bonnie K

    2007-10-01

    Despite the high prevalence of complementary and alternative medicine (CAM) product use among the elderly, little is known about the extent of concurrent CAM-conventional medicine use and the potential for adverse reactions. To determine the prevalence of CAM product use concurrent with conventional medications, prescription and nonprescription, in a Medicare population and assess the risk for adverse interactions. Retrospective analysis was performed on Cardiovascular Health Study interview data from 1994, 1995, 1997, and 1999. The prevalence of concurrent combinations of CAM products and conventional drugs was tabulated. The adverse interaction risks were categorized as unknown, theoretical, and significant. Of 5052 participants, the median age was 75, 60.2% were female, 16.6% were African American, and 83.4% were white. The percent using CAM products during the 4 time periods was 6.3%, 6.7%, 12.8%, and 15.1%. The percent using both CAM products and conventional drugs was 6.0%, 6.2%, 11.7%, and 14.4%. Of these, 294 (5.8%) individuals took combinations considered to have a significant risk for an adverse interaction. Combinations with risk were observed on 393 separate interviews. Most (379) involved a risk of bleeding due to use of ginkgo, garlic, or ginseng together with aspirin, warfarin, ticlopidine, or pentoxifylline. An additional 786 observations of combinations were considered to have some, albeit theoretical or uncertain, risk for an adverse interaction. Concurrent use of CAM products and conventional medicines in a Medicare population was found to be common. Research to define the risks of combining ginkgo and garlic supplements with aspirin should be of high priority.

  18. Concurrent Engineering Teams. Volume 2: Annotated Bibliography

    DTIC Science & Technology

    1990-11-01

    publishles. They normally embody restilts of major projects which (a) have a direct bearing am decisionse affecting major program , III) addrnss...D., "What Processes do You Own? How are They Doing?," Program Manager, Journal of the Defense Systems Management College, September-October 1989, pp...216. The key ingredient to any successful TQM program is top management commitment and involvement. The early top management involvement reflects

  19. Concurrence of Grave's disease and Hashimoto's thyroiditis.

    PubMed Central

    Sato, T; Takata, I; Taketani, T; Saida, K; Nakajima, H

    1977-01-01

    Early histological changes in the thyroid gland were examined in 30 patients with juvenile thyrotoxicosis, by means of needle biopsy. Based on the degree of lymphocytic infiltration and degenerative changes in follicular epithelium, results were classified into four groups. A: hyperplastic changes without cellular infiltration (6 patients, 20%); B: hyperplastic changes with areas of focal thyroiditis less than 30% of specimen (10 patients, 33%); C: those with 30 to 60% areas ot thyroiditis (10 patients, 33%); D: almost diffuse thyroiditis (4 patients, 13%). Moderate to severe lymphocytic thyroiditis was frequently present in the early stage of hyperplastic thyroid glands. The clinical significance of the 4 histological groups was evaluated. Neither clinical signs nor routine laboratory tests could differentiate these groups except group D, in which thyrotoxic signs were mild and transient. However, serum antithyroid antibodies tended to increase in accordance with severity of thyroiditis. The rate of remission was high in groups C and D, whereas relapse was frequent in group A. These results suggest that Grave's disease and chronic lymphocytic thyroiditis are closely related in the early stage of thyrotoxicosis in children, and that the clinical course may be considerably altered by the degree of associated thyroiditis. Images Fig. 1 Fig. 2 Fig. 3 Fig. 3 PMID:580172

  20. The Multidimensional Card Selection Task: A new way to measure concurrent cognitive flexibility in preschoolers.

    PubMed

    Podjarny, Gal; Kamawar, Deepthi; Andrews, Katherine

    2017-07-01

    Most executive function research examining preschoolers' cognitive flexibility, the ability to think about something in more than one way, has focused on preschoolers' facility for sequentially switching their attention from one dimension to another (e.g., sorting bivalent cards first by color and then by shape). We know very little about preschoolers' ability to coordinate more than one dimension simultaneously (concurrent cognitive flexibility). Here we report on a new task, the Multidimensional Card Selection Task, which was designed to measure children's ability to consider two dimensions, and then three dimensions, concurrently (e.g., shape and size, and then shape, size, and color). More than half of the preschoolers in our sample of 107 (50 3-year-olds and 57 4-year-olds) could coordinate three dimensions simultaneously and consistently across three test trials. Furthermore, performance on the Multidimensional Card Selection Task was related, but not identical, to performance on other cognitive tasks, including a widely used measure of switching cognitive flexibility (the Dimensional Change Card Sort). The Multidimensional Card Selection Task provides a new way to measure concurrent cognitive flexibility in preschoolers, and opens another avenue for exploring the emergence of early cognitive flexibility development. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Temporal orienting of attention is interfered by concurrent working memory updating.

    PubMed

    Capizzi, Mariagrazia; Correa, Angel; Sanabria, Daniel

    2013-01-01

    A previous dual-task study (Capizzi, Sanabria, & Correa, 2012) showed that temporal orienting of attention was disrupted by performing a concurrent working memory task, while sequential effects were preserved. Here, we recorded event related potentials (ERPs) during single- and dual-task performance to investigate how this behavioural dissociation would be expressed in neural activity measures. The single-task condition required participants to respond to a visual target stimulus that could be anticipated on the basis of a highly predictive temporal cue. The dual-task condition introduced a concurrent working memory task, in which colour information had to be updated on every trial. The behavioural results replicated our previous findings of impaired temporal orienting, but preserved sequential effects, under dual-task relative to single-task conditions. The ERPs results showed that temporal orienting and sequential effects both modulated the cue-locked preparatory contingent negative variation (CNV) and the target-locked N2 amplitude and P3 latency under single-task, but not under dual-task conditions. In contrast to temporal orienting, sequential effects were also observed at the early target-locked P1 and N1 potentials. Crucially, only the P1 modulation survived dual-task interference. These findings provide novel electrophysiological evidence that performance of a concurrent working memory task may interfere in a selective way with neural activity specifically linked to temporal orienting of attention. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Surprise responses in the human brain demonstrate statistical learning under high concurrent cognitive demand

    NASA Astrophysics Data System (ADS)

    Garrido, Marta Isabel; Teng, Chee Leong James; Taylor, Jeremy Alexander; Rowe, Elise Genevieve; Mattingley, Jason Brett

    2016-06-01

    The ability to learn about regularities in the environment and to make predictions about future events is fundamental for adaptive behaviour. We have previously shown that people can implicitly encode statistical regularities and detect violations therein, as reflected in neuronal responses to unpredictable events that carry a unique prediction error signature. In the real world, however, learning about regularities will often occur in the context of competing cognitive demands. Here we asked whether learning of statistical regularities is modulated by concurrent cognitive load. We compared electroencephalographic metrics associated with responses to pure-tone sounds with frequencies sampled from narrow or wide Gaussian distributions. We showed that outliers evoked a larger response than those in the centre of the stimulus distribution (i.e., an effect of surprise) and that this difference was greater for physically identical outliers in the narrow than in the broad distribution. These results demonstrate an early neurophysiological marker of the brain's ability to implicitly encode complex statistical structure in the environment. Moreover, we manipulated concurrent cognitive load by having participants perform a visual working memory task while listening to these streams of sounds. We again observed greater prediction error responses in the narrower distribution under both low and high cognitive load. Furthermore, there was no reliable reduction in prediction error magnitude under high-relative to low-cognitive load. Our findings suggest that statistical learning is not a capacity limited process, and that it proceeds automatically even when cognitive resources are taxed by concurrent demands.

  3. Comparison of two different radiation fractionation schedules with concurrent chemotherapy in head and neck malignancy.

    PubMed

    Alam, M S; Perween, R; Siddiqui, S A

    2016-01-01

    The worldwide incidence of head and neck malignancy exceeds half a million cases annually. In radiotherapy (RT), conventional fractionation comprises giving five fractions per week from Monday to Friday. Accelerated RT includes administration of six fractions per week is being advocated. It gives better locoregional control and the median overall treatment time is 39 days as compared to 46 days in conventional group. Our study involved comparison of conventional versus accelerated RT with concurrent chemotherapy, in evaluation of local control and toxicity in the two arms. Sixty patients of locally advanced squamous cell carcinoma head and neck region were studied. All the patients received cisplatin (30 mg/m2) weekly during the therapy. The patients received RT dose of 70 Gray (Gy) in 35 fractions (#). The patients were randomly assorted into two groups: Group 1 - Study group (n = 30) - Six fractions RT per week (Monday-Saturday). Group 2 - Control group (n = 30) - Five fractions RT per week (Monday-Friday). During and after the treatment, locoregional control, acute and late radiation toxicity were assessed. Results and Observation: There was no significant difference between the two schedules regarding locoregional control rate. The Grade 3 or higher acute toxicities were significantly higher in the accelerated arm although there was no significant difference in late toxicities between the two arms. Accelerated fractionation regimen was not more efficacious than conventional fractionation in the treatment of previously untreated head and neck carcinoma.

  4. Evolution of the ATLAS Software Framework towards Concurrency

    NASA Astrophysics Data System (ADS)

    Jones, R. W. L.; Stewart, G. A.; Leggett, C.; Wynne, B. M.

    2015-05-01

    The ATLAS experiment has successfully used its Gaudi/Athena software framework for data taking and analysis during the first LHC run, with billions of events successfully processed. However, the design of Gaudi/Athena dates from early 2000 and the software and the physics code has been written using a single threaded, serial design. This programming model has increasing difficulty in exploiting the potential of current CPUs, which offer their best performance only through taking full advantage of multiple cores and wide vector registers. Future CPU evolution will intensify this trend, with core counts increasing and memory per core falling. Maximising performance per watt will be a key metric, so all of these cores must be used as efficiently as possible. In order to address the deficiencies of the current framework, ATLAS has embarked upon two projects: first, a practical demonstration of the use of multi-threading in our reconstruction software, using the GaudiHive framework; second, an exercise to gather requirements for an updated framework, going back to the first principles of how event processing occurs. In this paper we report on both these aspects of our work. For the hive based demonstrators, we discuss what changes were necessary in order to allow the serially designed ATLAS code to run, both to the framework and to the tools and algorithms used. We report on what general lessons were learned about the code patterns that had been employed in the software and which patterns were identified as particularly problematic for multi-threading. These lessons were fed into our considerations of a new framework and we present preliminary conclusions on this work. In particular we identify areas where the framework can be simplified in order to aid the implementation of a concurrent event processing scheme. Finally, we discuss the practical difficulties involved in migrating a large established code base to a multi-threaded framework and how this can be achieved

  5. Concurrency-Induced Transitions in Epidemic Dynamics on Temporal Networks

    NASA Astrophysics Data System (ADS)

    Onaga, Tomokatsu; Gleeson, James P.; Masuda, Naoki

    2017-09-01

    Social contact networks underlying epidemic processes in humans and animals are highly dynamic. The spreading of infections on such temporal networks can differ dramatically from spreading on static networks. We theoretically investigate the effects of concurrency, the number of neighbors that a node has at a given time point, on the epidemic threshold in the stochastic susceptible-infected-susceptible dynamics on temporal network models. We show that network dynamics can suppress epidemics (i.e., yield a higher epidemic threshold) when the node's concurrency is low, but can also enhance epidemics when the concurrency is high. We analytically determine different phases of this concurrency-induced transition, and confirm our results with numerical simulations.

  6. Divided representation of concurrent goals in the human frontal lobes.

    PubMed

    Charron, Sylvain; Koechlin, Etienne

    2010-04-16

    The anterior prefrontal cortex (APC) confers on humans the ability to simultaneously pursue several goals. How does the brain's motivational system, including the medial frontal cortex (MFC), drive the pursuit of concurrent goals? Using brain imaging, we observed that the left and right MFC, which jointly drive single-task performance according to expected rewards, divide under dual-task conditions: While the left MFC encodes the rewards driving one task, the right MFC concurrently encodes those driving the other task. The same dichotomy was observed in the lateral frontal cortex, whereas the APC combined the rewards driving both tasks. The two frontal lobes thus divide for representing simultaneously two concurrent goals coordinated by the APC. The human frontal function seems limited to driving the pursuit of two concurrent goals simultaneously.

  7. Selective impairment of auditory selective attention under concurrent cognitive load.

    PubMed

    Dittrich, Kerstin; Stahl, Christoph

    2012-06-01

    Load theory predicts that concurrent cognitive load impairs selective attention. For visual stimuli, it has been shown that this impairment can be selective: Distraction was specifically increased when the stimulus material used in the cognitive load task matches that of the selective attention task. Here, we report four experiments that demonstrate such selective load effects for auditory selective attention. The effect of two different cognitive load tasks on two different auditory Stroop tasks was examined, and selective load effects were observed: Interference in a nonverbal-auditory Stroop task was increased under concurrent nonverbal-auditory cognitive load (compared with a no-load condition), but not under concurrent verbal-auditory cognitive load. By contrast, interference in a verbal-auditory Stroop task was increased under concurrent verbal-auditory cognitive load but not under nonverbal-auditory cognitive load. This double-dissociation pattern suggests the existence of different and separable verbal and nonverbal processing resources in the auditory domain.

  8. The Revised UCLA Loneliness Scale: Concurrent and Discriminant Validity Evidence.

    ERIC Educational Resources Information Center

    Russell, Dan; And Others

    1980-01-01

    Two studies provide methodogical refinement in the measurement of loneliness, using a revised version of the self-report UCLA Loneliness Scale. Investigates response bias, concurrent validity, and correlated measures. (Author/SS)

  9. Finite Element Analysis in Concurrent Processing: Computational Issues

    NASA Technical Reports Server (NTRS)

    Sobieszczanski-Sobieski, Jaroslaw; Watson, Brian; Vanderplaats, Garrett

    2004-01-01

    The purpose of this research is to investigate the potential application of new methods for solving large-scale static structural problems on concurrent computers. It is well known that traditional single-processor computational speed will be limited by inherent physical limits. The only path to achieve higher computational speeds lies through concurrent processing. Traditional factorization solution methods for sparse matrices are ill suited for concurrent processing because the null entries get filled, leading to high communication and memory requirements. The research reported herein investigates alternatives to factorization that promise a greater potential to achieve high concurrent computing efficiency. Two methods, and their variants, based on direct energy minimization are studied: a) minimization of the strain energy using the displacement method formulation; b) constrained minimization of the complementary strain energy using the force method formulation. Initial results indicated that in the context of the direct energy minimization the displacement formulation experienced convergence and accuracy difficulties while the force formulation showed promising potential.

  10. A Concurrent Multiple Negotiation Protocol Based on Colored Petri Nets.

    PubMed

    Niu, Lei; Ren, Fenghui; Zhang, Minjie; Bai, Quan

    2016-06-21

    Concurrent multiple negotiation (CMN) provides a mechanism for an agent to simultaneously conduct more than one negotiation. There may exist different interdependency relationships among these negotiations and these interdependency relationships can impact the outcomes of these negotiations. The outcomes of these concurrent negotiations contribute together for the agent to achieve an overall negotiation goal. Handling a CMN while considering interdependency relationships among multiple negotiations is a challenging research problem. This paper: 1) comprehensively highlights research problems of negotiations at concurrent negotiation level; 2) provides a graph-based CMN model with consideration of the interdependency relationships; and 3) proposes a colored Petri net-based negotiation protocol for conducting CMNs. With the proposed protocol, a CMN can be efficiently and concurrently processed and negotiation agreements can be efficiently achieved. Experimental results indicate the effectiveness and efficiency of the proposed protocol in terms of the negotiation success rate, the negotiation time and the negotiation outcome.

  11. Hematologic Toxicity of Concurrent Administration of Radium-223 and Next-generation Antiandrogen Therapies.

    PubMed

    Dan, Tu D; Eldredge-Hindy, Harriet B; Hoffman-Censits, Jean; Lin, Jianqing; Kelly, William K; Gomella, Leonard G; Lallas, Costas D; Trabulsi, Edouard J; Hurwitz, Mark D; Dicker, Adam P; Den, Robert B

    2017-08-01

    Radium-223 is a first-in-class radiopharmaceutical recently approved for the treatment of castration-resistant prostate cancer in patients with symptomatic bone metastases. Initial studies investigating Radium-223 primarily used nonsteroidal first-generation antiandrogens. Since that time, newer antiandrogen therapies have demonstrated improved survival in patients with castration-resistant prostate cancer. It has been suggested that the rational combination of these newly approved agents with Radium-223 may lead to improved response rates and clinical outcomes. Currently, there is lack of information regarding the safety of concurrent administration of these agents with radiopharmaceuticals. Here, we report on hematologic toxicity findings from our institution in patients receiving concurrent Radium-223 and next-generation antiandrogen therapies with either enzalutamide or abiraterone. In a retrospective study, we analyzed patients who received Radium-223 as part of an early-access trial, and following FDA approval in May 2013, patients receiving Radium-223 as part of standard care. Radium-223 was given at standard dosing of 50 kBq/kg each month for 6 total cycles. Complete blood counts were performed before treatment monthly and following each injection. Blood counts from patients receiving Radium alone and concurrently with next-generation antiandrogens were compared. To date, 25 total patients were analyzed, with a median of 5 monthly doses received per patient. Fourteen patients received concurrent therapy during monthly Radium-223 with either enzalutamide (n=8) or abiraterone (n=6). Six patients expired due to disease progression. Two patients discontinued treatment due to grade 3 myelosuppression. For patients receiving either Radium alone and with concurrent next-generation antiandrogen therapy, there did not appear to be any statistically significant differences between initial and nadir blood counts. Mean change from initial neutrophil count to nadir was

  12. Time concurrency/phase-time synchronization in digital communications networks

    NASA Technical Reports Server (NTRS)

    Kihara, Masami; Imaoka, Atsushi

    1990-01-01

    Digital communications networks have the intrinsic capability of time synchronization which makes it possible for networks to supply time signals to some applications and services. A practical estimation method for the time concurrency on terrestrial networks is presented. By using this method, time concurrency capability of the Nippon Telegraph and Telephone Corporation (NTT) digital communications network is estimated to be better than 300 ns rms at an advanced level, and 20 ns rms at final level.

  13. Actors: A Model of Concurrent Computation in Distributed Systems.

    DTIC Science & Technology

    1985-06-01

    RD-A157 917 ACTORS: A MODEL OF CONCURRENT COMPUTATION IN 1/3- DISTRIBUTED SY𔃿TEMS(U) MASSACHUSETTS INST OF TECH CRMBRIDGE ARTIFICIAL INTELLIGENCE...EmmmmmmEmmmmmE mmmmmmmmmmmmmmlfllfllf EEEEEEEmmmmmEE Sa~WNVS AO nflWl ,VNOIJVN 27 n- -o :1 ~ili0 Technical Report 844 Actors: A Model Of Concurrent...Computation In Distributed Systems Gui A. Aghai MIT Artificial Intelligence Laboratory Thsdocument ha. been cipp -oved I= pblicrelease and sale; itsI

  14. Dating Concurrent Objects: Real-Time Modeling and Schedulability Analysis

    NASA Astrophysics Data System (ADS)

    de Boer, Frank S.; Jaghoori, Mohammad Mahdi; Johnsen, Einar Broch

    In this paper we introduce a real-time extension of the concurrent object modeling language Creol which is based on duration statements indicating best and worst case execution times and deadlines. We show how to analyze schedulability of an abstraction of real-time concurrent objects in terms of timed automata. Further, we introduce techniques for testing the conformance between these behavioral abstractions and the executable semantics of Real-Time Creol in Real-Time Maude.

  15. Single-channel in-ear-EEG detects the focus of auditory attention to concurrent tone streams and mixed speech

    NASA Astrophysics Data System (ADS)

    Fiedler, Lorenz; Wöstmann, Malte; Graversen, Carina; Brandmeyer, Alex; Lunner, Thomas; Obleser, Jonas

    2017-06-01

    Objective. Conventional, multi-channel scalp electroencephalography (EEG) allows the identification of the attended speaker in concurrent-listening (‘cocktail party’) scenarios. This implies that EEG might provide valuable information to complement hearing aids with some form of EEG and to install a level of neuro-feedback. Approach. To investigate whether a listener’s attentional focus can be detected from single-channel hearing-aid-compatible EEG configurations, we recorded EEG from three electrodes inside the ear canal (‘in-Ear-EEG’) and additionally from 64 electrodes on the scalp. In two different, concurrent listening tasks, participants (n  =  7) were fitted with individualized in-Ear-EEG pieces and were either asked to attend to one of two dichotically-presented, concurrent tone streams or to one of two diotically-presented, concurrent audiobooks. A forward encoding model was trained to predict the EEG response at single EEG channels. Main results. Each individual participants’ attentional focus could be detected from single-channel EEG response recorded from short-distance configurations consisting only of a single in-Ear-EEG electrode and an adjacent scalp-EEG electrode. The differences in neural responses to attended and ignored stimuli were consistent in morphology (i.e. polarity and latency of components) across subjects. Significance. In sum, our findings show that the EEG response from a single-channel, hearing-aid-compatible configuration provides valuable information to identify a listener’s focus of attention.

  16. Concurrent recall of serially learned visual discrimination problems in dwarf goats (Capra hircus).

    PubMed

    Langbein, J; Siebert, K; Nuernberg, G

    2008-11-01

    Studies of cognitive ability in farm animals are valuable, not only because they provide indicators of the commonality of comparative influence, but understanding farm animal cognition may also aid in management and treatment procedures. Here, eight dwarf goats (Capra hircus) learned a series of 10 visual four-choice discriminations using an automated device that allowed individual ad lib. access to the test setup while staying in a familiar environment and normal social setting. The animals were trained on each problem for 5 days, followed by concurrent testing of the current against the previous problem. Once all 10 problems had been learned, they were tested concurrently over the course of 9 days. In initial training, all goats achieved criterion learning levels on nearly all problems within 2 days and under 200 trials. Concurrently presenting the problems trained in adjacent sessions did not impair performance on either problem relative to single-problem learning. Upon concurrent presentation of all 10 previously learned problems, at least half were well-remembered immediately. Although this test revealed a recency effect (later problems were better remembered), many early-learned problems were also well-retained, and 10-item relearning was quite quick. These results show that dwarf goats can retain multiple-problem information proficiently and can do so over periods of several weeks. From an ecological point of view, the ability to form numerous associations between visual cues offered by specific plants and food quality is an important pre-grazing mechanism that helps goats exploit variation in vegetation and graze selectively.

  17. NULL Convention Floating Point Multiplier

    PubMed Central

    Ramachandran, Seshasayanan

    2015-01-01

    Floating point multiplication is a critical part in high dynamic range and computational intensive digital signal processing applications which require high precision and low power. This paper presents the design of an IEEE 754 single precision floating point multiplier using asynchronous NULL convention logic paradigm. Rounding has not been implemented to suit high precision applications. The novelty of the research is that it is the first ever NULL convention logic multiplier, designed to perform floating point multiplication. The proposed multiplier offers substantial decrease in power consumption when compared with its synchronous version. Performance attributes of the NULL convention logic floating point multiplier, obtained from Xilinx simulation and Cadence, are compared with its equivalent synchronous implementation. PMID:25879069

  18. NULL convention floating point multiplier.

    PubMed

    Albert, Anitha Juliette; Ramachandran, Seshasayanan

    2015-01-01

    Floating point multiplication is a critical part in high dynamic range and computational intensive digital signal processing applications which require high precision and low power. This paper presents the design of an IEEE 754 single precision floating point multiplier using asynchronous NULL convention logic paradigm. Rounding has not been implemented to suit high precision applications. The novelty of the research is that it is the first ever NULL convention logic multiplier, designed to perform floating point multiplication. The proposed multiplier offers substantial decrease in power consumption when compared with its synchronous version. Performance attributes of the NULL convention logic floating point multiplier, obtained from Xilinx simulation and Cadence, are compared with its equivalent synchronous implementation.

  19. Genetic algorithm guided population pharmacokinetic model development for simvastatin, concurrently or non-concurrently co-administered with amlodipine.

    PubMed

    Chaturvedula, Ayyappa; Sale, Mark E; Lee, Howard

    2014-02-01

    An automated model development was performed for simvastatin, co-administered with amlodipine concurrently or non-concurrently (i.e., 4 hours later) in 17 patients with coexisting hyperlipidemia and hypertension. The single objective hybrid genetic algorithm (SOHGA) was implemented in the NONMEM software by defining the search space for structural, statistical and covariate models. Candidate models obtained from the SOHGA runs were further assessed for biological plausibility and the precision of parameter estimates, followed by traditional backward elimination process for model refinement. The final population pharmacokinetic model shows that the elimination rate constant for simvastatin acid, the active form by hydrolysis of its lactone prodrug (i.e., simvastatin), is only 44% in the concurrent amlodipine administration group compared with the non-concurrent group. The application of SOHGA for automated model selection, combined with traditional model selection strategies, appears to save time for model development, which also can generate new hypotheses that are biologically more plausible.

  20. Concurrent bias correction in hemodynamic data assimilation.

    PubMed

    Hu, Zhenghui; Liu, Huafeng; Shi, Pengcheng

    2012-10-01

    Low-frequency drift in fMRI datasets can be caused by various sources and are generally not of interest in a conventional task-based fMRI experiment. This feature complicates the assimilation approach that is always under specific assumption on statistics of system uncertainties. In this paper, we present a novel approach to the assimilation of nonlinear hemodynamic system with stochastic biased noise. By treating the drift variation as a random-walk process, the assimilation problem was translated into the identification of a nonlinear system in the presence of time-varying bias. We developed a bias aware unscented Kalman estimator to efficiently handle this problem. In this framework, the estimates of bias-free states and drift are separately carried out in two parallel filters, the optimal estimates of the system states then are corrected from bias-free states with drift estimates. The approach can simultaneously deal with the fMRI responses and drift in an assimilation cycle in an on-line fashion. It makes no assumptions of the structure and statistics of the drift, thereby is particularly suited for fMRI imaging where the formulation of real drift remains difficult to acquire. Experiments with synthetic data and real fMRI data are performed to demonstrate feasibility of our approach and to explore its potential advantages over classic polynomial approach. Moreover, we include the comparison of the variability of observables from the scanner and of normalized signal used in assimilation procedure in Appendix.

  1. Toxicity of concurrent radiochemotherapy for locally advanced non--small-cell lung cancer: a systematic review of the literature.

    PubMed

    Koning, Caro C; Wouterse, Sanne J; Daams, Joost G; Uitterhoeve, Lon L; van den Heuvel, Michel M; Belderbos, José S

    2013-09-01

    Concurrent radiochemotherapy (RCT) is the treatment of choice for patients with locally advanced non-small-cell lung cancer (NSCLC). Two meta-analyses were inconclusive in an attempt to define the optimal concurrent RCT scheme. Besides efficacy, treatment toxicity will influence the appointed treatment of choice. A systematic review of the literature was performed to record the early and late toxicities, as well as overall survival, of concurrent RCT regimens in patients with NSCLC. The databases of PubMed, Ovid, Medline, and the Cochrane Library were searched for articles on concurrent RCT published between January 1992 and December 2009. Publications of phase II and phase III trials with ≥ 50 patients per treatment arm were selected. Patient characteristics, chemotherapy regimen (mono- or polychemotherapy, high or low dose) and radiotherapy scheme, acute and late toxicity, and overall survival data were compared. Seventeen articles were selected: 12 studies with cisplatin-containing regimens and 5 studies using carboplatin. A total of 13 series with mono- or polychemotherapy schedules--as single dose or double or triple high-dose or daily cisplatin-containing (≤ 30 mg/m(2)/wk) chemotherapy were found. Acute esophagitis ≥ grade 3 was observed in up to 18% of the patients. High-dose cisplatin regimens resulted in more frequent and severe hematologic toxicity, nausea, and vomiting than did other schemes. The toxicity profile was more favorable in low-dose chemotherapy schedules. From phase II and III trials published between 1992 and 2010, it can be concluded that concurrent RCT with monochemotherapy consisting of daily cisplatin results in favorable acute and late toxicity compared with concurrent RCT with single high-dose chemotherapy, doublets, or triplets.

  2. Hydrogen storage: beyond conventional methods.

    PubMed

    Dalebrook, Andrew F; Gan, Weijia; Grasemann, Martin; Moret, Séverine; Laurenczy, Gábor

    2013-10-09

    The efficient storage of hydrogen is one of three major hurdles towards a potential hydrogen economy. This report begins with conventional storage methods for hydrogen and broadly covers new technology, ranging from physical media involving solid adsorbents, to chemical materials including metal hydrides, ammonia borane and liquid precursors such as alcohols and formic acid.

  3. Use of conventional and novel smokeless tobacco products among US adolescents.

    PubMed

    Agaku, Israel T; Ayo-Yusuf, Olalekan A; Vardavas, Constantine I; Alpert, Hillel R; Connolly, Gregory N

    2013-09-01

    To assess the prevalence and correlates of use of conventional and novel smokeless tobacco products among a national sample of US middle and high school students. Data from the 2011 National Youth Tobacco Survey were analyzed to determine national estimates of current use of conventional ("chewing tobacco", "snuff," or "dip"), novel ("snus" and "dissolvable tobacco products"), and any smokeless tobacco products (novel and/or conventional products) within the past 30 days. The overall prevalence of current use of any smokeless tobacco product was 5.6% (n = 960). Among all students, 5.0% used chewing tobacco, snuff, or dip; 1.9% used snus; and 0.3% used dissolvable tobacco products. Among users of any smokeless tobacco, 64.0% used only conventional products, 26.8% were concurrent users of novel plus conventional products, whereas 9.2% exclusively used novel products. Approximately 72.1% of current any smokeless tobacco users concurrently smoked combustible tobacco products, and only 40.1% expressed an intention to quit all tobacco use. Regression analyses indicated that peer (adjusted odds ratio [aOR]: 9.56; 95% confidence interval [CI]: 7.14-12.80) and household (aOR: 3.32; 95% CI: 2.23-4.95) smokeless tobacco use were associated with smokeless tobacco use, whereas believing that all forms of tobacco are harmful was protective (aOR: 0.55; 95% CI: 0.38-0.79). Conventional smokeless tobacco products remain the predominant form of smokeless tobacco use. Most users of novel smokeless tobacco products also concurrently smoked combustible tobacco products. Smokeless tobacco use was associated with lower perception of harm from all tobacco products and protobacco social influences, indicating the need to change youth perceptions about the use of all tobacco products and to engage pediatricians in tobacco use prevention and cessation interventions.

  4. Socioeconomic Inequality in Concurrent Tobacco and Alcohol Consumption

    PubMed

    Intarut, Nirun; Pukdeesamai, Piyalak

    2017-07-27

    Background: Whilst several studies have examined inequity of tobacco use and inequity of alcohol drinking individually, comparatively little is known about concurrent tobacco and alcohol consumption. The present study therefore investigated inequity of concurrent tobacco and alcohol consumption in Thailand. Methods: The 2015 Health and Welfare Survey was obtained from Thailand’s National Statistical Office and used as a source of national representative data. Concurrent tobacco and alcohol consumption was defined as current and concurrent use of both tobacco and alcohol. The wealth assets index was used as an indicator of socioeconomic inequity. Socioeconomic status included 5 groups ranging from poorest (Q1) to richest (Q5). A total of 55,920 households and 113,705 participants aged 15 years or over were included and analyzed. A weighted multiple logistic regression was performed. Results: The prevalence of concurrent tobacco and alcohol consumption, tobacco consumption only, and alcohol consumption only were 15.2% (95% CI: 14.9, 15.4), 4.7% (95% CI: 4.5, 4.8), and 18.9% (95% CI: 18.7, 19.1), respectively. Weighted multiple logistic regression showed that concurrent tobacco and alcohol consumption was high in the poorest socioeconomic group (P for trend: <0.001), and tobacco consumption only was also high in the poorest group (P for trend: <0.001). A high prevalence of alcohol consumption was observed in the richest group (P for trend: <0.001). Conclusions: These findings suggest that tobacco and alcohol consumption prevention programs would be more effective if they considered socioeconomic inequities in concurrent tobacco and alcohol consumption rather than focusing on single drug use. Creative Commons Attribution License

  5. Classes of Oppositional-Defiant behaviour: Concurrent and predictive validity

    PubMed Central

    Althoff, Robert R.; Kuny-Slock, Ana V.; Verhulst, Frank C.; Hudziak, James J.; van der Ende, Jan

    2014-01-01

    Background Oppositional Defiant Disorder (ODD) has components of both irritability and defiance. It remains unclear whether children with variation in these domains have different adult outcomes. This study examined the concurrent and predictive validity of classes of oppositional defiant behavior. Methods Latent Class Analysis was performed on the Oppositional Defiant Problems scale of the Child Behavior Checklist in two samples, one in the U.S. (the Achenbach Normative Sample, N=2029) and one in The Netherlands (the Zuid-Holland Study, N=2076). A third sample of American children (The Vermont Family Study, N=399) was examined to determine concurrent validity with DSM diagnoses. Predictive validity over 14 years was assessed using the Zuid-Holland Study. Results 4 classes of oppositional defiant problems were consistent in the two latent class analyses: No Symptoms, All Symptoms, Irritable, and Defiant. Individuals in the No Symptoms Class were rarely diagnosed concurrently with ODD or any future disorder. Individuals in the All Symptoms Class had an increased frequency of concurrent childhood diagnosis of ODD and of violence in adulthood. Subjects in the Irritable Class had low concurrent diagnosis of ODD, but increased odds of adult mood disorders. Individuals in the Defiant Class had low concurrent diagnosis of ODD, but had increased odds of violence as adults. Conclusions Only children in the All Symptoms class were likely to have a concurrent diagnosis of ODD. Although not diagnosed with ODD, children in the Irritable Class were more likely to have adult mood disorders and children in the Defiant Class were more likely to engage in violent behavior. PMID:24673629

  6. Classes of oppositional-defiant behavior: concurrent and predictive validity.

    PubMed

    Althoff, Robert R; Kuny-Slock, Ana V; Verhulst, Frank C; Hudziak, James J; van der Ende, Jan

    2014-10-01

    Oppositional defiant disorder (ODD) has components of both irritability and defiance. It remains unclear whether children with variation in these domains have different adult outcomes. This study examined the concurrent and predictive validity of classes of oppositional defiant behavior. Latent class analysis was performed on the oppositional defiant problems scale of the Child Behavior Checklist in two samples, one in the US (the Achenbach Normative Sample, N = 2029) and one in the Netherlands (the Zuid-Holland Study, N = 2076). A third sample of American children (The Vermont Family Study, N = 399) was examined to determine concurrent validity with DSM diagnoses. Predictive validity over 14 years was assessed using the Zuid-Holland Study. Four classes of oppositional defiant problems were consistent in the two latent class analyses: No Symptoms, All Symptoms, Irritable, and Defiant. Individuals in the No Symptoms Class were rarely diagnosed concurrently with ODD or any future disorder. Individuals in the All Symptoms Class had an increased frequency of concurrent childhood diagnosis of ODD and of violence in adulthood. Subjects in the Irritable Class had low concurrent diagnosis of ODD, but increased odds of adult mood disorders. Individuals in the Defiant Class had low concurrent diagnosis of ODD, but had increased odds of violence as adults. Only children in the All Symptoms class were likely to have a concurrent diagnosis of ODD. Although not diagnosed with ODD, children in the Irritable Class were more likely to have adult mood disorders and children in the Defiant Class were more likely to engage in violent behavior. © 2014 The Authors. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

  7. Concurrent heroin use among methadone maintenance clients in China.

    PubMed

    Li, Li; Lin, Chunqing; Wan, Dai; Zhang, Linglin; Lai, Wenhong

    2012-03-01

    The study examined concurrent illicit heroin use among methadone maintenance clients in China and its association with clients' demographic characteristics, treatment experience, and personal social network. Face-to-face surveys were conducted with 178 clients randomly recruited from six methadone maintenance treatment (MMT) clinics in Sichuan, China. Concurrent heroin use was measured based on self-report of heroin use during the past 30 days and a confirmatory urine morphine test. The participants' demographic characteristics and treatment factors were measured and examined. The drug use status of their family members and friends was also assessed. A total of 80 participants (44.9%) who either reported illicit heroin use in the past 30 days or had a positive urine test were defined as using heroin concurrently. Having drug-using friends was significantly associated with increased concurrent heroin use. Longer length of treatment (2 years or longer) was associated with increased concurrent heroin use. Among those who had both drug-using family members and friends, more women (71.4%) than men (50.0%) used heroin. For those who had no drug-using family members or friends, more men (34.8%) than women (20.8%) used heroin. Study findings indicate an urgent need to address concurrent illicit heroin use among MMT clients. Further examination of the influence of social networks on concurrent drug abuse behavior is encouraged. Results also highlight the importance of understanding gender differences in treatment seeking and behavioral changes, which is crucial to the development of gender-specific treatment strategies. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Selected Convention Papers: Perspectives in Theory and Practice.

    ERIC Educational Resources Information Center

    Council for Exceptional Children, Arlington, VA.

    Presented are 59 short, selected convention papers (conference reports) on different aspects of educational needs for handicapped children. Representative topics include the Warren Project on effectiveness and feasibility of early admission to school for mentally advanced children, sheltered workshops for the trainable mentally handicapped, the…

  9. Concurrent Stereotactic Radiosurgery and Bevacizumab in Recurrent Malignant Gliomas: A Prospective Trial

    SciTech Connect

    Cabrera, Alvin R.; Cuneo, Kyle C.; Desjardins, Annick; Sampson, John H.; McSherry, Frances; Herndon, James E.; Peters, Katherine B.; Allen, Karen; Hoang, Jenny K.; Chang, Zheng; Craciunescu, Oana; Vredenburgh, James J.; Friedman, Henry S.; Kirkpatrick, John P.

    2013-08-01

    Purpose: Virtually all patients with malignant glioma (MG) eventually recur. This study evaluates the safety of concurrent stereotactic radiosurgery (SRS) and bevacizumab (BVZ), an antiangiogenic agent, in treatment of recurrent MG. Methods and Materials: Fifteen patients with recurrent MG, treated at initial diagnosis with surgery and adjuvant radiation therapy/temozolomide and then at least 1 salvage chemotherapy regimen, were enrolled in this prospective trial. Lesions <3 cm in diameter were treated in a single fraction, whereas those 3 to 5 cm in diameter received 5 5-Gy fractions. BVZ was administered immediately before SRS and 2 weeks later. Neurocognitive testing (Mini-Mental Status Exam, Trail Making Test A/B), Functional Assessment of Cancer Therapy-Brain (FACT-Br) quality-of-life assessment, physical exam, and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) were performed immediately before SRS and 1 week and 2 months following completion of SRS. The primary endpoint was central nervous system (CNS) toxicity. Secondary endpoints included survival, quality of life, microvascular properties as measured by DCE-MRI, steroid usage, and performance status. Results: One grade 3 (severe headache) and 2 grade 2 CNS toxicities were observed. No patients experienced grade 4 to 5 toxicity or intracranial hemorrhage. Neurocognition, quality of life, and Karnofsky performance status did not change significantly with treatment. DCE-MRI results suggest a significant decline in tumor perfusion and permeability 1 week after SRS and further decline by 2 months. Conclusions: Treatment of recurrent MG with concurrent SRS and BVZ was not associated with excessive toxicity in this prospective trial. A randomized trial of concurrent SRS/BVZ versus conventional salvage therapy is needed to establish the efficacy of this approach.

  10. Concurrent apatinib and local radiation therapy for advanced gastric cancer

    PubMed Central

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

    2017-01-01

    Abstract Rationale: Apatinib is a novel anti-angiogenic agent targeting vascular endothelial growth factor receptor-2, which is effective in patients with chemotherapy-refractory gastric cancer. There are no reports of concurrent apatinib with local radiation therapy in elderly patients with advanced gastric cancer. Patient concerns and Diagnoses: we present the first published report of a 70-year-old male patient with advanced gastric cancer who received concurrent apatinib and local radiation therapy after failure of oxaliplatin and S-1 chemotherapy. Interventions and Outcomes: The patient received concurrent apatinib and local radiation therapy and was followed up 7 months after therapy without disease progress, 14 months later indicated extensive metastasis and this patient died of pulmonary infection. Lessons: Elderly patients with advanced gastric cancer may benefit from concurrent apatinib with local radiation therapy when chemotherapy is not tolerated or successful. Further studies are needed to investigate the clinical outcomes and toxicities associated with concurrent apatinib and radiation therapy in gastric cancer. PMID:28248891

  11. Predicting Early Sexual Activity with Behavior Problems Exhibited at School Entry and in Early Adolescence

    ERIC Educational Resources Information Center

    Schofield, Hannah-Lise T.; Bierman, Karen L.; Heinrichs, Brenda; Nix, Robert L.

    2008-01-01

    Youth who initiate sexual intercourse in early adolescence (age 11-14) experience multiple risks, including concurrent adjustment problems and unsafe sexual practices. The current study tested two models describing the links between childhood precursors, early adolescent risk factors, and adolescent sexual activity: a cumulative model and a…

  12. The Differential Effects of Concurrent Planning Practice Elements on Reunification and Adoption

    ERIC Educational Resources Information Center

    D'Andrade, Amy C.

    2009-01-01

    Objective: The child welfare practice of concurrent planning attempts to shorten children's stays in foster care. There is very little quantitative research on concurrent planning's effects. This study examines the influence of concurrent planning practice elements (reunification prognosis, concurrent plan, full disclosure, and discussion of…

  13. Prevalence and predictors of concurrent sexual partnerships in a predominantly African American population in Jackson, Mississippi.

    PubMed

    Nunn, Amy; MacCarthy, Sarah; Barnett, Nancy; Rose, Jennifer; Chan, Philip; Yolken, Annajane; Cornwall, Alexandra; Chamberlain, Nicholas; Barnes, Arti; Riggins, Reginald; Moore, Elya; Simmons, Dantrell; Parker, Sharon; Mena, Leandro

    2014-12-01

    Concurrent sexual partnerships, or sexual partnerships that overlap in time, have been associated with HIV and sexually transmitted infections (STI). How best to measure concurrency and the personal characteristics and predictors of concurrency are not yet well understood. We compared two frequently used concurrency definitions, including a self-reported measure based on participant response regarding overlapping sex with partners, and the UNAIDS measure based on overlapping dates of last sex and intention to have sex again. We performed multivariable logistic regression analyses to identify socio-demographic, behavioral, and structural predictors of concurrency among 1,542 patients at an urban STI clinic in Jackson, Mississippi. Nearly half (44 %) reported concurrency based on self-reported sex with other partners, and 26 % reported concurrency according to the UNAIDS concurrency measure. Using the self-reported concurrency measure, the strongest predictors of concurrency were perceived partner concurrency, drug use at last sex, having more than 10 lifetime partners, and being recently incarcerated. Strongest predictors of concurrency using the UNAIDS measure were lifetime number of partners and perceived partner concurrency. Concurrency is highly prevalent in this population in the Deep South and social, structural and behavioral factors were important predictors of concurrency for both measures. Future research should use time anchored data collection methods and biomarkers to assess whether both definitions of concurrency are associated with HIV outcomes.

  14. Prevalence and predictors of concurrent sexual partnerships in a predominantly African American population in Jackson, Mississippi

    PubMed Central

    Nunn, Amy; MacCarthy, Sarah; Barnett, Nancy; Rose, Jennifer; Chan, Philip; Yolken, Annajane; Cornwall, Alexandra; Chamberlain, Nicholas; Barnes, Arti; Riggins, Reginald; Moore, Elya; Simmons, Dantrell; Parker, Sharon; Mena, Leandro

    2014-01-01

    Concurrent sexual partnerships, or sexual partnerships that overlap in time, have been associated with HIV and sexually transmitted infections (STI) infection. How best to measure concurrency and the personal characteristics and predictors of concurrency are not yet well understood. We compared two frequently used concurrency definitions, including a self-reported measure based on participant response regarding overlapping sex with partners, and the UNAIDS measure based on overlapping dates of last sex and intention to have sex again. We performed multivariable logistic regression analyses to identify socio-demographic, behavioral, and structural predictors of concurrency among 1,542 patients at an urban STI clinic in Jackson, Mississippi. Nearly half (44%) reported concurrency based on self-reported sex with other partners, and 26% reported concurrency according to the UNAIDS concurrency measure. Using the self-reported concurrency measure, the strongest predictors of concurrency were perceived partner concurrency, drug use at last sex, having more than 10 lifetime partners, and being recently incarcerated. Strongest predictors of concurrency using the UNAIDS measure were lifetime number of partners and perceived partner concurrency. Concurrency is highly prevalent in this population in the Deep South and social, structural and behavioral factors were important predictors of concurrency for both measures. Future research should use time anchored data collection methods and biomarkers to assess whether both definitions of concurrency are associated with HIV outcomes. PMID:24803130

  15. Design and Analysis Techniques for Concurrent Blackboard Systems. Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Mcmanus, John William

    1992-01-01

    Blackboard systems are a natural progression of knowledge-based systems into a more powerful problem solving technique. They provide a way for several highly specialized knowledge sources to cooperate to solve large, complex problems. Blackboard systems incorporate the concepts developed by rule-based and expert systems programmers and include the ability to add conventionally coded knowledge sources. The small and specialized knowledge sources are easier to develop and test, and can be hosted on hardware specifically suited to the task that they are solving. The Formal Model for Blackboard Systems was developed to provide a consistent method for describing a blackboard system. A set of blackboard system design tools has been developed and validated for implementing systems that are expressed using the Formal Model. The tools are used to test and refine a proposed blackboard system design before the design is implemented. My research has shown that the level of independence and specialization of the knowledge sources directly affects the performance of blackboard systems. Using the design, simulation, and analysis tools, I developed a concurrent object-oriented blackboard system that is faster, more efficient, and more powerful than existing systems. The use of the design and analysis tools provided the highly specialized and independent knowledge sources required for my concurrent blackboard system to achieve its design goals.

  16. A Concurrent Product-Development Approach for Friction-Stir Welded Vehicle-Underbody Structures

    NASA Astrophysics Data System (ADS)

    Grujicic, M.; Arakere, G.; Hariharan, A.; Pandurangan, B.

    2012-04-01

    High-strength aluminum and titanium alloys with superior blast/ballistic resistance against armor piercing (AP) threats and with high vehicle light-weighing potential are being increasingly used as military-vehicle armor. Due to the complex structure of these vehicles, they are commonly constructed through joining (mainly welding) of the individual components. Unfortunately, these alloys are not very amenable to conventional fusion-based welding technologies [e.g., gas metal arc welding (GMAW)] and to obtain high-quality welds, solid-state joining technologies such as friction-stir welding (FSW) have to be employed. However, since FSW is a relatively new and fairly complex joining technology, its introduction into advanced military-vehicle-underbody structures is not straight forward and entails a comprehensive multi-prong approach which addresses concurrently and interactively all the aspects associated with the components/vehicle-underbody design, fabrication, and testing. One such approach is developed and applied in this study. The approach consists of a number of well-defined steps taking place concurrently and relies on two-way interactions between various steps. The approach is critically assessed using a strengths, weaknesses, opportunities, and threats (SWOT) analysis.

  17. Definitive high-dose radiotherapy with concurrent chemotherapy for locally advanced rectal cancer

    PubMed Central

    Kim, Min-Jeong; Kim, Eun Seok; Yeo, Seung-Gu

    2016-01-01

    Abstract Background: Standard management for locally advanced rectal cancer (LARC) involves preoperative chemoradiotherapy (CRT) and radical surgery. However, this level of treatment may be unnecessary for a subgroup of LARC patients. Previous reports have shown that approximately 20% of LARC patients experience a complete tumor response to preoperative CRT. Post-CRT nonoperative management of these patients may prevent morbidities associated with radical surgery. To our knowledge, this case report firstly presents the favorable long-term outcomes of a LARC patient who underwent definitive aim CRT. Methods: The patient was 73 years’ old, and staging workups revealed T3N2bM0 rectal adenocarcinoma. He agreed to receive CRT, but refused surgery. A radiotherapy (RT) dose of 64.8 Gy was prescribed, which was higher than conventional (50.4 Gy) preoperative aim RT. The regimen of concurrent chemotherapy was the same as that used in preoperative aim CRT: 2 cycles of 5-fluorouracil and leucovorin. Results: Three months after CRT completion, a complete tumor response was identified clinically. Colonoscopic biopsy after 1 year showed no tumor cells. This patient is alive after 4 years with no evidence of recurrence or severe toxicity. Conclusion: The long-term outcomes of this case indicate the feasibility of definitive high-dose RT with concurrent chemotherapy for LARC. PMID:27749573

  18. Cetuximab concurrent with IMRT versus cisplatin concurrent with IMRT in locally advanced nasopharyngeal carcinoma

    PubMed Central

    Wu, Xin; Huang, Jingwen; Liu, Lei; Li, Hongmei; Li, Ping; Zhang, Jing; Xie, Li

    2016-01-01

    Abstract To evaluate the treatment efficacies and toxicities of concurrent cetuximab-based bioradiotherapy (BRT) or cisplatin-based chemoradiotherapy (CRT) in locally advanced nasopharyngeal carcinoma. :Patients with previously untreated locally advanced nasopharyngeal carcinoma were matched into pairs, and enrolled into the study. All patients were given either BRT or CRT. Survival outcomes, toxicities, and prognostic factors were evaluated. :A total of 112 patients were enrolled. The 5-year overall survival was 79.3% and 79.5% in CRT and BRT arm, respectively (P = 0.797) and the 5-year DFS was 73.5% and 74.6%, respectively (P = 0.953). In toxicity analysis, CRT arm had more significant decrease in white blood cell, platelet, hemoglobin, and severe vomiting, while more severe skin reactions and mucositis were shown in BRT arm. :BRT was not less efficacious than traditional CRT. They lead to different aspects of toxicities. If patients cannot stand more severe toxicities caused by CRT, BRT could be an ideal alternative. PMID:27684830

  19. Concurrent performances: rate constancies without changeover delays1

    PubMed Central

    Catania, A. Charles

    1976-01-01

    Pigeons' pecks on two keys were maintained, without changeover delays, by independent variable-interval schedules of food reinforcement. Four regularly cycling 2-min components scheduled reinforcement respectively for both keys, left key only, both keys, and right key only. Initially, reinforcement scheduled for one key alone produced more responding on that key than reinforcement scheduled concurrently for both keys. Continued sessions reduced this difference; response rate on a given key approached constancy, or invariance with respect to the performance on and schedule for the other key. When extinction replaced the reinforcement schedule on either key, responding on that key decreased more during components that scheduled reinforcement for the other key than during those that did not. This demonstration that responses on one key were not supported by reinforcers on the other key suggested that the alternation of concurrent responding and either-key-alone responding prevented concurrent superstitions from developing. PMID:16811922

  20. Concurrent algorithms for autonomous robot navigation in an unexplored terrain

    SciTech Connect

    Rao, S.V.N.; Iyengar, S.S.; Jorgensen, C.C.; Weisbin, C.R.

    1986-01-01

    Navigation planning is one of the vital aspects of any autonomous mobile robot. In this paper, we present concurrent algorithms for an autonomous robot navigation system that does not require a pre-learned obstacle terrain model. The terrain model is gradually built by integrating the information from multiple journeys. The available information is used to the maximum extent in navigation planning, and global optimality is gradually achieved. It is shown that these concurrent algorithms are free from deadlocks and starvation. The performance of the concurrent algorithms is analyzed in terms of the planning time, travel time, scanning time, and update time. A modified adjacency list is proposed as the data structure for the spatial graph that represents an obstacle terrain. The time complexities of various algorithms that access, maintain, and update the spatial graph are estimated, and the effectiveness of the implementation is illustrated.

  1. Charge recovery during concurrent stimulation for a vision prosthesis.

    PubMed

    Addi, M Mohd; Dokos, S; Preston, P J; Dommel, N; Wong, Y T; Lovell, N H

    2008-01-01

    Parallel or concurrent stimulation in an epiretinal neuroprosthesis is likely necessary in order to deliver sufficient phosphenes for effective vision. Important issues with concurrent stimulation are the effect of current distribution which introduces current leakage or 'cross talk' between adjacent electrodes and charge recovery which determines balanced charge being delivered/recovered at each electrode from the previous phase. In this paper, we present the effect of concurrent stimulation of two hexagonally arranged platinum electrode arrays on charge recovery. Balanced and imbalanced (unequal) currents were delivered to the hexagonal arrays when they were immersed in physiological saline. Both simulation and experimental results revealed that charge was not recovered at individual electrodes, particularly when imbalanced currents were delivered. However, total charge injected to both hexagonal arrays was recovered.

  2. How Formal Dynamic Verification Tools Facilitate Novel Concurrency Visualizations

    NASA Astrophysics Data System (ADS)

    Aananthakrishnan, Sriram; Delisi, Michael; Vakkalanka, Sarvani; Vo, Anh; Gopalakrishnan, Ganesh; Kirby, Robert M.; Thakur, Rajeev

    With the exploding scale of concurrency, presenting valuable pieces of information collected by formal verification tools intuitively and graphically can greatly enhance concurrent system debugging. Traditional MPI program debuggers present trace views of MPI program executions. Such views are redundant, often containing equivalent traces that permute independent MPI calls. In our ISP formal dynamic verifier for MPI programs, we present a collection of alternate views made possible by the use of formal dynamic verification. Some of ISP’s views help pinpoint errors, some facilitate discerning errors by eliminating redundancy, while others help understand the program better by displaying concurrent even orderings that must be respected by all MPI implementations, in the form of completes-before graphs. In this paper, we describe ISP’s graphical user interface (GUI) capabilities in all these areas which are currently supported by a portable Java based GUI, a Microsoft Visual Studio GUI, and an Eclipse based GUI whose development is in progress.

  3. Concurrent negotiation and coordination for grid resource coallocation.

    PubMed

    Sim, Kwang Mong; Shi, Benyun

    2010-06-01

    Bolstering resource coallocation is essential for realizing the Grid vision, because computationally intensive applications often require multiple computing resources from different administrative domains. Given that resource providers and consumers may have different requirements, successfully obtaining commitments through concurrent negotiations with multiple resource providers to simultaneously access several resources is a very challenging task for consumers. The impetus of this paper is that it is one of the earliest works that consider a concurrent negotiation mechanism for Grid resource coallocation. The concurrent negotiation mechanism is designed for 1) managing (de)commitment of contracts through one-to-many negotiations and 2) coordination of multiple concurrent one-to-many negotiations between a consumer and multiple resource providers. The novel contributions of this paper are devising 1) a utility-oriented coordination (UOC) strategy, 2) three classes of commitment management strategies (CMSs) for concurrent negotiation, and 3) the negotiation protocols of consumers and providers. Implementing these ideas in a testbed, three series of experiments were carried out in a variety of settings to compare the following: 1) the CMSs in this paper with the work of others in a single one-to-many negotiation environment for one resource where decommitment is allowed for both provider and consumer agents; 2) the performance of the three classes of CMSs in different resource market types; and 3) the UOC strategy with the work of others [e.g., the patient coordination strategy (PCS )] for coordinating multiple concurrent negotiations. Empirical results show the following: 1) the UOC strategy achieved higher utility, faster negotiation speed, and higher success rates than PCS for different resource market types; and 2) the CMS in this paper achieved higher final utility than the CMS in other works. Additionally, the properties of the three classes of CMSs in

  4. Assessment, Intervention, and Training Needs of Service Providers for Children with Intellectual Disabilities or Autism Spectrum Disorders and Concurrent Problem Behaviours

    ERIC Educational Resources Information Center

    Rivard, Mélina; Morin, Diane; Dionne, Carmen; Mello, Catherine; Gagnon, Marc-André

    2015-01-01

    This study documented the perceived needs of therapists, specialists, and managers who work with children with intellectual disabilities (ID) and/or autism spectrum disorders (ASD) and concurrent problem behaviours (PBs). Seventy-five respondents from specialized PB and early childhood programs within eight public rehabilitation centres were…

  5. Concurrent Algorithm For Particle-In-Cell Simulations

    NASA Technical Reports Server (NTRS)

    Liewer, Paulett C.; Decyk, Viktor K.

    1990-01-01

    Separate decompositions used for particle-motion and field calculations. General Concurrent Particle-in-Cell (GCPIC) algorithm used to implement motions of individual plasma particles (ions and electrons) under influence of particle-in-cell (PIC) computer codes on concurrent processors. Simulates motions of individual plasma particles under influence of electromagnetic fields generated by particles themselves. Performed to study variety of nonlinear problems in plasma physics, including magnetic and inertial fusion, plasmas in outer space, propagation of electron and ion beams, free-electron lasers, and particle accelerators.

  6. Implementing Concurrency Control in Reliable Distributed Object-Oriented Systems

    NASA Astrophysics Data System (ADS)

    Parrington, Graham D.; Shrivastava, Santosh K.

    One of the key concepts available in many object-oriented programming languages is that of type-inheritance, which permits new types to be derived from, and inherit the capabilities of, old types. This paper describes how to exploit this property in a very simple fashion to implement object-oriented concurrency control. We show how by using type-inheritance, objects may control their own level of concurrency in a type-specific manner. Simple examples demonstrate the applicability of the approach. The implementation technique described here is being used to develop Arjuna, a fault-tolerant distributed programming system supporting atomic actions.

  7. Sequential and Concurrent Chemoradiation: State of the Art.

    PubMed

    Chau, Nicole G; Haddad, Robert I

    2015-12-01

    Most patients diagnosed with head and neck cancer have locally advanced disease. Sequential and concurrent chemoradiation are standard, nonsurgical, curative-intent treatment options. Controversy remains regarding the superiority of one approach to another. Definitive management strategies are evolving with increasing efforts to pursue deintensification of therapy for low-risk patients, and to pursue therapeutic intensification for high-risk patients. Both sequential therapy and concurrent chemoradiation play important roles in shaping treatment paradigms because both approaches may be used to investigate deintensification or intensification strategies. This article examines the latest evidence and state-of-the-art approaches, highlighting ongoing controversies and future directions.

  8. Concurrent engineering: Spacecraft and mission operations system design

    NASA Technical Reports Server (NTRS)

    Landshof, J. A.; Harvey, R. J.; Marshall, M. H.

    1994-01-01

    Despite our awareness of the mission design process, spacecraft historically have been designed and developed by one team and then turned over as a system to the Mission Operations organization to operate on-orbit. By applying concurrent engineering techniques and envisioning operability as an essential characteristic of spacecraft design, tradeoffs can be made in the overall mission design to minimize mission lifetime cost. Lessons learned from previous spacecraft missions will be described, as well as the implementation of concurrent mission operations and spacecraft engineering for the Near Earth Asteroid Rendezvous (NEAR) program.

  9. Lower bound on concurrence for arbitrary-dimensional tripartite quantum states

    NASA Astrophysics Data System (ADS)

    Chen, Wei; Fei, Shao-Ming; Zheng, Zhu-Jun

    2016-09-01

    In this paper, we study the concurrence of arbitrary-dimensional tripartite quantum states. An explicit operational lower bound of concurrence is obtained in terms of the concurrence of substates. A given example shows that our lower bound may improve the well-known existing lower bounds of concurrence. The significance of our result is to get a lower bound when we study the concurrence of arbitrary m⊗ n⊗ l-dimensional tripartite quantum states.

  10. 10 CFR 429.23 - Conventional cooking tops, conventional ovens, microwave ovens.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 false Conventional cooking tops, conventional ovens, microwave... Conventional cooking tops, conventional ovens, microwave ovens. (a) Sampling plan for selection of units for testing. (1) The requirements of § 429.11 are applicable to conventional cooking tops, conventional ovens...

  11. 10 CFR 429.23 - Conventional cooking tops, conventional ovens, microwave ovens.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Conventional cooking tops, conventional ovens, microwave... Conventional cooking tops, conventional ovens, microwave ovens. (a) Sampling plan for selection of units for testing. (1) The requirements of § 429.11 are applicable to conventional cooking tops, conventional ovens...

  12. Conventional Radiology in Rheumatoid Arthritis.

    PubMed

    Llopis, Eva; Kroon, Herman M; Acosta, Jose; Bloem, Johan L

    2017-09-01

    In clinical practice, the conventional radiography is still the radiologic method for the diagnosis of rheumatoid arthritis (RA). Moreover, it provides a quick overview of the symptomatic joints to narrow the differential diagnosis and to evaluate progression. RA is a polyarticular disease with bilateral and symmetric involvement of the peripheral joints, especially small joints, and less frequently, the cervical spine. The radiologic features are soft tissue swelling, periarticular osteoporosis, erosions, loss of joint space, and in advanced disease, osteolysis and typical subluxations or deformities, such as ulnar deviation. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Dilution Confusion: Conventions for Defining a Dilution

    ERIC Educational Resources Information Center

    Fishel, Laurence A.

    2010-01-01

    Two conventions for preparing dilutions are used in clinical laboratories. The first convention defines an "a:b" dilution as "a" volumes of solution A plus "b" volumes of solution B. The second convention defines an "a:b" dilution as "a" volumes of solution A diluted into a final volume of "b". Use of the incorrect dilution convention could affect…

  14. Dilution Confusion: Conventions for Defining a Dilution

    ERIC Educational Resources Information Center

    Fishel, Laurence A.

    2010-01-01

    Two conventions for preparing dilutions are used in clinical laboratories. The first convention defines an "a:b" dilution as "a" volumes of solution A plus "b" volumes of solution B. The second convention defines an "a:b" dilution as "a" volumes of solution A diluted into a final volume of "b". Use of the incorrect dilution convention could affect…

  15. Concurrent Formative Evaluation: Guidelines and Implications for Multimedia Designers.

    ERIC Educational Resources Information Center

    Northrup, Pamela Taylor

    1995-01-01

    Discusses formative evaluation for multimedia instruction and presents guidelines for formatively evaluating multimedia instruction concurrent with analysis, design, and development. Data collection criteria that include group involvement, data collection strategies, and information to be gathered are presented, and rapid prototypes and…

  16. Bidirectional Interference between Timing and Concurrent Memory Processing in Children

    ERIC Educational Resources Information Center

    Rattat, Anne-Claire

    2010-01-01

    This study investigated the nature of resources involved in duration processing in 5- and 8-year-olds. The children were asked to reproduce the duration of a visual or auditory stimulus. They performed this task either alone or concurrently with an executive task (Experiment 1) or with a digit or visuospatial memory task (Experiment 2). The…

  17. Concurrent signal combining and channel estimation in digital communications

    DOEpatents

    Ormesher, Richard C.; Mason, John J.

    2011-08-30

    In the reception of digital information transmitted on a communication channel, a characteristic exhibited by the communication channel during transmission of the digital information is estimated based on a communication signal that represents the digital information and has been received via the communication channel. Concurrently with the estimating, the communication signal is used to decide what digital information was transmitted.

  18. Rapid Acquisition in Concurrent Chains: Evidence for a Decision Model

    ERIC Educational Resources Information Center

    Grace, Randolph C.; McLean, Anthony P.

    2006-01-01

    Pigeons' choice in concurrent chains can adapt to rapidly changing contingencies. Grace, Bragason, and McLean (2003) found that relative initial-link response rate was sensitive to the immediacy ratio in the current session when one of the terminal-link fixed-interval schedules was changed daily according to a pseudorandom binary sequence (e.g.,…

  19. Contingency Discriminability and Peak Shift in Concurrent Schedules

    ERIC Educational Resources Information Center

    Krageloh, Christian U.; Elliffe, Douglas M.; Davison, Michael

    2006-01-01

    We investigated the effects of discriminative stimuli on choice in a highly variable environment using a procedure in which multiple two-key concurrent VI VI components changed every 10 reinforcers and were signaled by differential flashes of red and yellow keylights. Across conditions, five pigeons were exposed to a number of different…

  20. Concurrent Validity of Holland's Theory for College Degreed Working Women

    ERIC Educational Resources Information Center

    Horton, Joseph A.; Walsh, W. Bruce

    1976-01-01

    The study was designed to explore two areas: (1) the concurrent validity of Holland's theory for employed college degreed women using two different operational definitions (Vocational Preference Inventory and the Self-Directed Search) of vocational orientation; and (2) the relationships among same named scales across the VPI and the SDS. (Author)

  1. Apparatus for the concurrent inspection of partially completed welds

    DOEpatents

    Smartt, Herschel B.; Johnson, John A.; Larsen, Eric D.; Bitsoi, Rodney J.; Perrenoud, Ben C.; Miller, Karen S.; Pace, David P.

    2002-01-01

    An apparatus for the concurrent inspection of partially completed welds is described in which is utilized in combination with a moveable welder for forming a partially completed weld, and an ultrasonic generator mounted on a moveable welder in which is reciprocally moveable along a path of travel which is laterally disposed relative to the partially completed weld.

  2. MultiLogo: A Study of Children and Concurrent Programming.

    ERIC Educational Resources Information Center

    Resnick, Mitchel

    1990-01-01

    Discusses concurrent, or parallel, programming languages; explains the design of the MultiLogo programming language; and describes a study of fourth and fifth graders that used MultiLogo to control robotic devices built out of Lego bricks. Three categories of MultiLogo programming bugs are described, and implications for changes in design and…

  3. Concurrent Movement Impairs Incidental but Not Intentional Statistical Learning

    ERIC Educational Resources Information Center

    Stevens, David J.; Arciuli, Joanne; Anderson, David I.

    2015-01-01

    The effect of concurrent movement on incidental versus intentional statistical learning was examined in two experiments. In Experiment 1, participants learned the statistical regularities embedded within familiarization stimuli implicitly, whereas in Experiment 2 they were made aware of the embedded regularities and were instructed explicitly to…

  4. Network based high performance concurrent computing. Progress report, [FY 1991

    SciTech Connect

    Sunderam, V.S.

    1991-12-31

    The overall objectives of this project are to investigate research issues pertaining to programming tools and efficiency issues in network based concurrent computing systems. The basis for these efforts is the PVM project that evolved during my visits to Oak Ridge Laboratories under the DOE Faculty Research Participation program; I continue to collaborate with researchers at Oak Ridge on some portions of the project.

  5. Temporal Context in Concurrent Chains: I. Terminal-Link Duration

    ERIC Educational Resources Information Center

    Grace, Randolph C.

    2004-01-01

    Two experiments are reported in which the ratio of the average times spent in the terminal and initial links ("Tt/Ti") in concurrent chains was varied. In Experiment 1, pigeons responded in a three-component procedure in which terminal-link variable-interval schedules were in constant ratio, but their average duration increased across components…

  6. Threaded Cognition: An Integrated Theory of Concurrent Multitasking

    ERIC Educational Resources Information Center

    Salvucci, Dario D.; Taatgen, Niels A.

    2008-01-01

    The authors propose the idea of threaded cognition, an integrated theory of concurrent multitasking--that is, performing 2 or more tasks at once. Threaded cognition posits that streams of thought can be represented as threads of processing coordinated by a serial procedural resource and executed across other available resources (e.g., perceptual…

  7. CONCURRENT INJECTION OF COSOLVENT AND AIR FOR ENHANCED PCE REMOVAL

    EPA Science Inventory

    The goal of this study was to use preferential flow of air to improve the dynamics of cosolvent displacement in order to enhance DNAPL displacement and dissolution. The concurrent injection of cosolvent and air was evaluated in a glass micromodel for a DNAPL remediation technolog...

  8. MultiLogo: A Study of Children and Concurrent Programming.

    ERIC Educational Resources Information Center

    Resnick, Mitchel

    1990-01-01

    Discusses concurrent, or parallel, programming languages; explains the design of the MultiLogo programming language; and describes a study of fourth and fifth graders that used MultiLogo to control robotic devices built out of Lego bricks. Three categories of MultiLogo programming bugs are described, and implications for changes in design and…

  9. Bidirectional Interference between Timing and Concurrent Memory Processing in Children

    ERIC Educational Resources Information Center

    Rattat, Anne-Claire

    2010-01-01

    This study investigated the nature of resources involved in duration processing in 5- and 8-year-olds. The children were asked to reproduce the duration of a visual or auditory stimulus. They performed this task either alone or concurrently with an executive task (Experiment 1) or with a digit or visuospatial memory task (Experiment 2). The…

  10. Increasing Communication in Children with Concurrent Vision and Hearing Loss

    ERIC Educational Resources Information Center

    Brady, Nancy C.; Bashinski, Susan M.

    2008-01-01

    Nine children with complex communication needs and concurrent vision and hearing losses participated in an intervention program aimed at increasing intentional prelinguistic communication. The intervention constituted a pilot, descriptive study of an adapted version of prelinguistic milieu teaching, hence referred to as A-PMT. In A-PMT, natural…

  11. CONCURRENT INJECTION OF COSOLVENT AND AIR FOR ENHANCED PCE REMOVAL

    EPA Science Inventory

    The goal of this study was to use preferential flow of air to improve the dynamics of cosolvent displacement in order to enhance DNAPL displacement and dissolution. The concurrent injection of cosolvent and air was evaluated in a glass micromodel for a DNAPL remediation technolog...

  12. Concurrent and Predictive Validity of the Galician CDI

    ERIC Educational Resources Information Center

    Perez-Pereira, Miguel; Resches, Mariela

    2011-01-01

    This paper explores the concurrent and predictive validity of the long and short forms of the Galician version of the MacArthur-Bates CDI (IDHC). Forty-two Galician-speaking children were longitudinally evaluated at age 1 ; 6, 2 ; 0 and 4 ; 0. On the first two occasions, the subjects' vocabulary and grammar skills were assessed through the IDHC.…

  13. Partnership duration, concurrency, and HIV in sub-Saharan Africa.

    PubMed

    Sawers, Larry; Isaac, Alan

    2017-07-01

    A widely accepted explanation for the exceptionally high HIV prevalence in sub-Saharan Africa is the practice of long-term overlapping heterosexual partnering. This article shows that long-duration concurrent partnering can be protective against HIV transmission rather than promoting it. Monogamous partnering prevents sexual transmission to anyone outside the partnership and, in an initially concordant-seronegative partnership, prevents sexual acquisition of HIV by either partner. Those protections against transmission and acquisition last as long as the partnership persists without new outside partnerships. Correspondingly, these two protective effects characterise polygynous partnerships, whether or not the polygyny is formal or informal, until a partner initiates a new partnership. Stable and exclusive unions of any size protect against HIV transmission, and more durable unions provide a longer protective effect. Survey research provides little information on partnership duration in sub-Saharan Africa and sheds no light on the interaction of duration, concurrency, and HIV. This article shows how assumptions about partnership duration in individual-based sexual-network models affect the contours of simulated HIV epidemics. Longer mean partnership duration slows the pace at which simulated epidemics grow. With plausible assumptions about partnership duration and at levels of concurrency found in the region, simulated HIV epidemics grow slowly or not at all. Those results are consistent with the hypothesis that long-duration partnering is protective against HIV and inconsistent with the hypothesis that long-term concurrency drives the HIV epidemics in sub-Saharan Africa.

  14. Selective Impairment of Auditory Selective Attention under Concurrent Cognitive Load

    ERIC Educational Resources Information Center

    Dittrich, Kerstin; Stahl, Christoph

    2012-01-01

    Load theory predicts that concurrent cognitive load impairs selective attention. For visual stimuli, it has been shown that this impairment can be selective: Distraction was specifically increased when the stimulus material used in the cognitive load task matches that of the selective attention task. Here, we report four experiments that…

  15. Unruptured sinus of Valsalva aneurysm presenting with concurrent Morgagni hernia

    PubMed Central

    Davis, S. Scott; Chen, Edward P.; Henry, Travis S.; Book, Wendy M.

    2015-01-01

    We describe a patient with dyspnea and intermittent cyanosis who was found to have concurrent right diaphragmatic and right atrial masses, initially thought to have advanced vascular sarcoma. She was ultimately diagnosed with an unruptured sinus of Valsalva aneurysm, a Morgagni hernia, and a patent foramen ovale. Her dyspnea and cyanosis resolved after sequential surgical correction of these defects. PMID:26424953

  16. A C++ Thread Package for Concurrent and Parallel Programming

    SciTech Connect

    Jie Chen; William Watson

    1999-11-01

    Recently thread libraries have become a common entity on various operating systems such as Unix, Windows NT and VxWorks. Those thread libraries offer significant performance enhancement by allowing applications to use multiple threads running either concurrently or in parallel on multiprocessors. However, the incompatibilities between native libraries introduces challenges for those who wish to develop portable applications.

  17. Threaded Cognition: An Integrated Theory of Concurrent Multitasking

    ERIC Educational Resources Information Center

    Salvucci, Dario D.; Taatgen, Niels A.

    2008-01-01

    The authors propose the idea of threaded cognition, an integrated theory of concurrent multitasking--that is, performing 2 or more tasks at once. Threaded cognition posits that streams of thought can be represented as threads of processing coordinated by a serial procedural resource and executed across other available resources (e.g., perceptual…

  18. Temporal Context in Concurrent Chains: I. Terminal-Link Duration

    ERIC Educational Resources Information Center

    Grace, Randolph C.

    2004-01-01

    Two experiments are reported in which the ratio of the average times spent in the terminal and initial links ("Tt/Ti") in concurrent chains was varied. In Experiment 1, pigeons responded in a three-component procedure in which terminal-link variable-interval schedules were in constant ratio, but their average duration increased across components…

  19. Aging and Concurrent Task Performance: Cognitive Demand and Motor Control

    ERIC Educational Resources Information Center

    Albinet, Cedric; Tomporowski, Phillip D.; Beasman, Kathryn

    2006-01-01

    A motor task that requires fine control of upper limb movements and a cognitive task that requires executive processing--first performing them separately and then concurrently--was performed by 18 young and 18 older adults. The motor task required participants to tap alternatively on two targets, the sizes of which varied systematically. The…

  20. 38 CFR 21.7673 - Measurement of concurrent enrollments.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Educational Assistance for Members of the Selected Reserve Course Assessment § 21.7673 Measurement of concurrent enrollments. (a) Conversion of units of... in the program of education which the reservist is pursuing at the primary institution. This...

  1. 38 CFR 21.7172 - Measurement of concurrent enrollments.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational Assistance Program (Montgomery GI Bill-Active Duty) Course Assessment § 21.7172 Measurement of concurrent enrollments. (a... of education which the veteran is pursuing at the primary institution. This conversion will be...

  2. The Role of Concurrent Engineering in Weapons System Acquisition

    DTIC Science & Technology

    1988-12-01

    poter ’ "- rost savings. One of the workshop participants related an experience where the use of concurrent engineering methods of muitifunction...York Umverniy Conference on Making Statistics More Effective in Schools of Busin=s (19-20 June, 1987), Harry V. Roberts of the Graduate School of

  3. Human Operant Learning under Concurrent Reinforcement of Response Variability

    ERIC Educational Resources Information Center

    Maes, J. H. R.; van der Goot, M.

    2006-01-01

    This study asked whether the concurrent reinforcement of behavioral variability facilitates learning to emit a difficult target response. Sixty students repeatedly pressed sequences of keys, with an originally infrequently occurring target sequence consistently being followed by positive feedback. Three conditions differed in the feedback given to…

  4. Concurrent chemoradiation for high-risk prostate cancer.

    PubMed

    Cooper, Benjamin T; Sanfilippo, Nicholas J

    2015-08-10

    There are estimated to be 220800 cases of prostate cancer diagnosed in 2015, making up 26% of all cancer diagnoses. Fortunately, adenocarcinoma of the prostate is often a highly treatable malignancy. Even though the majority of prostate cancer patients present with localized disease, prostate cancer still accounts for over 27000 deaths a year. There is a subset of patients that are likely to recur after locoregional treatment that is thought of as a "high-risk" population. This more aggressive subset includes patients with clinical stage greater than T2b, Gleason score greater than 7, and prostate specific antigen greater than 20 ng/dL. The rate of biochemical relapse in this high risk group is 32%-70% within five years of definitive focal therapy. Given these discouraging outcomes, attempts have been made to improve cure rates by radiation dose escalation, addition of androgen depravation therapy, and addition of chemotherapy either sequentially or concurrently with radiation. One method that has been shown to improve clinical outcomes is the addition of chemotherapy to radiotherapy for definitive treatment. Concurrent chemoradiation with 5-fluorouracil, estramustine phosphate, vincristine, docetaxel, and paclitaxel has been studied in the phase I and/or II setting. These trials have identified the maximum tolerated dose of chemotherapy and radiation that can be safely delivered concurrently and established the safety and feasibility of this technique. This review will focus on the addition of concurrent chemotherapy to radiotherapy in the definitive management of high-risk prostate cancer.

  5. Concurrent materials and process selection in conceptual design

    SciTech Connect

    Kleban, S.D.

    1998-07-01

    The sequential manner in which materials and processes for a manufactured product are selected is inherently less than optimal. Designers` tendency to choose processes and materials with which they are familiar exacerbate this problem. A method for concurrent selection of materials and a joining process based on product requirements using a knowledge-based, constraint satisfaction approach is presented.

  6. Validating Timed Models of Deployment Components with Parametric Concurrency

    NASA Astrophysics Data System (ADS)

    Broch Johnsen, Einar; Owe, Olaf; Schlatte, Rudolf; Tapia Tarifa, Silvia Lizeth

    Many software systems today are designed without assuming a fixed underlying architecture, and may be adapted for sequential, multicore, or distributed deployment. Examples of such systems are found in, e.g., software product lines, service-oriented computing, information systems, embedded systems, operating systems, and telephony. Models of such systems need to capture and range over relevant deployment scenarios, so it is interesting to lift aspects of low-level deployment concerns to the abstraction level of the modeling language. This paper proposes an abstract model of deployment components for concurrent objects, extending the Creol modeling language. The deployment components are parametric in the amount of concurrency they provide; i.e., they vary in processing resources. We give a formal semantics of deployment components and characterize equivalence between deployment components which differ in concurrent resources in terms of test suites. Our semantics is executable on Maude, which allows simulations and test suites to be applied to a deployment component with different concurrent resources.

  7. 18 CFR 131.52 - Certificate of concurrence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... concurrence. 131.52 Section 131.52 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY APPROVED FORMS, FEDERAL POWER ACT AND PUBLIC UTILITY REGULATORY POLICIES ACT... schedule (rate schedule supplement) described below, which the (Name of public utility filing rate...

  8. Concurrent Pre-Service Teachers: An Analysis of Values

    ERIC Educational Resources Information Center

    Ryan, Thomas G.; Schruder, Courtney R.; Robinson, Stephanie

    2013-01-01

    Our investigation of axiology (study of values) allowed us to ascertain a hierarchy of values of pre-service education students concurrently enrolled in two degree programs. We discovered homogeneity which may be a consequence of the discipline (education) investigated and/or sampling, as 87% were female, which reflected the female dominance of…

  9. Concurrent Pre-Service Teachers: An Analysis of Values

    ERIC Educational Resources Information Center

    Ryan, Thomas G.; Schruder, Courtney R.; Robinson, Stephanie

    2013-01-01

    Our investigation of axiology (study of values) allowed us to ascertain a hierarchy of values of pre-service education students concurrently enrolled in two degree programs. We discovered homogeneity which may be a consequence of the discipline (education) investigated and/or sampling, as 87% were female, which reflected the female dominance of…

  10. Concurrent Movement Impairs Incidental but Not Intentional Statistical Learning

    ERIC Educational Resources Information Center

    Stevens, David J.; Arciuli, Joanne; Anderson, David I.

    2015-01-01

    The effect of concurrent movement on incidental versus intentional statistical learning was examined in two experiments. In Experiment 1, participants learned the statistical regularities embedded within familiarization stimuli implicitly, whereas in Experiment 2 they were made aware of the embedded regularities and were instructed explicitly to…

  11. Selective Impairment of Auditory Selective Attention under Concurrent Cognitive Load

    ERIC Educational Resources Information Center

    Dittrich, Kerstin; Stahl, Christoph

    2012-01-01

    Load theory predicts that concurrent cognitive load impairs selective attention. For visual stimuli, it has been shown that this impairment can be selective: Distraction was specifically increased when the stimulus material used in the cognitive load task matches that of the selective attention task. Here, we report four experiments that…

  12. The Stay/Switch Model of Concurrent Choice

    ERIC Educational Resources Information Center

    MacDonall, James S.

    2009-01-01

    This experiment compared descriptions of concurrent choice by the stay/switch model, which says choice is a function of the reinforcers obtained for staying at and for switching from each alternative, and the generalized matching law, which says choice is a function of the total reinforcers obtained at each alternative. For the stay/switch model…

  13. Ethanol reinforced behavior assessed with a concurrent schedule.

    PubMed

    Roehrs, T A; Samson, H H

    1981-10-01

    Oral ethanol (5% v/v) reinforced responding was studied in three rats using a concurrent fixed ratio (FR) schedule with water available at a second lever. First, concurrent (FR8 FR8) responding on both levers for water presentation was established. Then a concurrent (FR8 FR8) water-ethanol presentation schedule was introduced and a food ration was placed in the chamber at the beginning of the session. Within 12 sessions, ethanol responding developed and within-session feeding was discontinued. When stable concurrent water-ethanol performance was achieved, average ethanol responding was 11 times greater than water responding, even when ethanol availability switched from one level to the other. During the one hour session, in some cases, sufficient ethanol was ingested to produce blood ethanol levels between 30 and 50 mg/100 ml. As the ethanol FR requirement was increased for four sessions each to FR10, 12, 14, 16, 18, 20, 40 and 50, rats continued to respond for ethanol, and in some rats, ethanol preference was maintained even when the ethanol FR was 50 while the water FR remained at 8.

  14. Limited Matching on Concurrent-Schedule Reinforcement of Academic Behavior.

    ERIC Educational Resources Information Center

    Mace, F. Charles; And Others

    1994-01-01

    Three adolescent students with special educational needs were given reinforcers (nickels) according to three different concurrent variable-interval schedules. Time allocated to the assigned tasks was in linear relationship to the reinforcement rate. However, changes in reinforcement schedules were not followed by changes in allocation patterns…

  15. 37 CFR 2.73 - Amendment to recite concurrent use.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Amendment to recite concurrent use. 2.73 Section 2.73 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE RULES OF PRACTICE IN TRADEMARK CASES Amendment of Application § 2.73...

  16. 37 CFR 2.73 - Amendment to recite concurrent use.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Amendment to recite concurrent use. 2.73 Section 2.73 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE RULES OF PRACTICE IN TRADEMARK CASES Amendment of Application § 2.73...

  17. The Concurrent Development of Spelling Skills in Two Languages

    ERIC Educational Resources Information Center

    Joy, Rhonda

    2011-01-01

    The study reported on in this paper investigated the concurrent development of spelling in children learning two languages. The study compared over time and between languages the types of spelling errors made in English as a first language and French as a second. Fortyseven grade one English-speaking children completed an English and French…

  18. 36 CFR 14.56 - Concurrence by Federal Highway Administration.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Concurrence by Federal Highway Administration. 14.56 Section 14.56 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Under Title 23, U.S.C. (Interstate and Defense Highway System) § 14...

  19. 36 CFR 14.56 - Concurrence by Federal Highway Administration.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Concurrence by Federal Highway Administration. 14.56 Section 14.56 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Under Title 23, U.S.C. (Interstate and Defense Highway System) § 14...

  20. 36 CFR 14.56 - Concurrence by Federal Highway Administration.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Concurrence by Federal Highway Administration. 14.56 Section 14.56 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Under Title 23, U.S.C. (Interstate and Defense Highway System) § 14...

  1. 36 CFR 14.56 - Concurrence by Federal Highway Administration.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Concurrence by Federal Highway Administration. 14.56 Section 14.56 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Under Title 23, U.S.C. (Interstate and Defense Highway System) § 14...

  2. 36 CFR 14.56 - Concurrence by Federal Highway Administration.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Concurrence by Federal Highway Administration. 14.56 Section 14.56 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Under Title 23, U.S.C. (Interstate and Defense Highway System) § 14...

  3. Concurrent Think-Aloud Protocol as a Socially Situated Construct

    ERIC Educational Resources Information Center

    Sasaki, Tomomi

    2008-01-01

    Verbal report protocols have been considered as direct representations of individual cognitive processes. The present study examined the social nature of verbal reports, particularly focusing on whether and in what ways concurrent think-aloud (TA) protocol data are recipient-designed. The results of this study suggest that verbal reports elicited…

  4. Human Operant Learning under Concurrent Reinforcement of Response Variability

    ERIC Educational Resources Information Center

    Maes, J. H. R.; van der Goot, M.

    2006-01-01

    This study asked whether the concurrent reinforcement of behavioral variability facilitates learning to emit a difficult target response. Sixty students repeatedly pressed sequences of keys, with an originally infrequently occurring target sequence consistently being followed by positive feedback. Three conditions differed in the feedback given to…

  5. Contingency Discriminability and Peak Shift in Concurrent Schedules

    ERIC Educational Resources Information Center

    Krageloh, Christian U.; Elliffe, Douglas M.; Davison, Michael

    2006-01-01

    We investigated the effects of discriminative stimuli on choice in a highly variable environment using a procedure in which multiple two-key concurrent VI VI components changed every 10 reinforcers and were signaled by differential flashes of red and yellow keylights. Across conditions, five pigeons were exposed to a number of different…

  6. Towards PCC for Concurrent and Distributed Systems (Work in Progress)

    NASA Technical Reports Server (NTRS)

    Henriksen, Anders S.; Filinski, Andrzej

    2009-01-01

    We outline some conceptual challenges in extending the PCC paradigm to a concurrent and distributed setting, and sketch a generalized notion of module correctness based on viewing communication contracts as economic games. The model supports compositional reasoning about modular systems and is meant to apply not only to certification of executable code, but also of organizational workflows.

  7. 48 CFR 9903.304 - Concurrent full and modified coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... modified coverage. 9903.304 Section 9903.304 Federal Acquisition Regulations System COST ACCOUNTING... AND COST ACCOUNTING STANDARDS CONTRACT COVERAGE CAS Rules and Regulations 9903.304 Concurrent full and... may compel the use of cost accounting practices that are not required under modified coverage....

  8. Concurrent split cord malformation and teratoma: dysembryology, presentation, and treatment.

    PubMed

    Babu, Ranjith; Reynolds, Renee; Moreno, Jessica R; Cummings, Thomas J; Bagley, Carlos A

    2014-02-01

    Split cord malformation (SCM) is a rare form of spinal dysraphism in which the spinal cord is divided in the sagittal plane, forming a double neural tube. In addition to being associated with a variety of malformations, SCM may occur with spinal cord tumors, with only exceptional cases involving teratomas. As only eight patients with a teratoma associated with SCM have been reported, their presentation characteristics and treatment are currently unclear. We review the literature of all patients with SCM with concurrent spinal teratoma, discuss the potential dysembryology, and report the first case of SCM with concurrent spinal teratoma in an elderly patient. The mean age of those with concurrent SCM and teratomas was 39.4 years, with 55.6% occurring in females. The lumbar spine was the most frequent location for teratomas (66.7%), with the Type II malformation more commonly occurring with these tumors (75%). The duration of symptoms varied widely, ranging from 1 month to 5 years, with the average duration being nearly 2 years. Back pain (87.5%) and lower extremity weakness (75%) were the most common presenting symptoms. As SCM may be associated with progressive neurological deterioration and teratomas can contain immature or malignant components, surgery should be attempted with the goal of gross total resection. Nonetheless, in patients with a concurrent tumor and spinal dysraphism, spinal teratomas should be considered in the differential diagnosis. Gross total resection of these lesions may be safely achieved even in the presence of SCM using intraoperative electrophysiologic monitoring.

  9. Concurrence of dermatological and ophthalmological morbidity in onchocerciasis.

    PubMed

    Coffeng, L E; Fobi, G; Ozoh, G; Bissek, A C; Nlatté, B O; Enyong, P; Olinga, J M Olinga; Zouré, H G M; Habbema, J D F; Stolk, W A; de Vlas, S J; Boussinesq, M; Noma, M

    2012-04-01

    Prevalence of skin and eye disorders in African onchocerciasis (river blindness) is well documented. However, less is known about their joint occurrence. Information on concurrence may improve our understanding of disease pathogenesis and is required to estimate the disease burden of onchocerciasis. We analysed data from 765 individuals from forest villages in the Kumba and Ngambe Health districts, Cameroon. These data were collected in 1998, as baseline data for the evaluation of the African Programme for Onchocerciasis Control. Concurrence of symptoms was assessed using logistic regression. Onchocerciasis was highly endemic in the study population (63% nodule prevalence among males aged ≥20). Considerable overall prevalences of onchocercal visual impairment (low vision or blindness: 4%), troublesome itch (15%), reactive skin disease (19%), and skin depigmentation (25%) were observed. The association between onchocercal visual impairment and skin depigmentation (OR 9.0, 95% CI 3.9-20.8) was partly explained by age and exposure to infection (OR 3.0, 95% CI 1.2-7.7). The association between troublesome itch and reactive skin disease was hardly affected by adjustment (adjusted OR 6.9, 95% CI 4.2-11.1). Concluding, there is significant concurrence of morbidities within onchocerciasis. Our results suggest a possible role of host characteristics in the pathogenesis of depigmentation and visual impairment. Further, we propose a method to deal with concurrence when estimating the burden of disease.

  10. Conventional and Non-Conventional Drosophila Toll Signaling

    PubMed Central

    Lindsay, Scott A.; Wasserman, Steven A.

    2013-01-01

    The discovery of Toll in Drosophila and of the remarkable conservation in pathway composition and organization catalyzed a transformation in our understanding of innate immune recognition and response. At the center of that picture is a cascade of interactions in which specific microbial cues activate Toll receptors, which then transmit signals driving transcription factor nuclear localization and activity. Experiments gave substance to the vision of pattern recognition receptors, linked phenomena in development, gene regulation, and immunity into a coherent whole, and revealed a rich set of variations for identifying non-self and responding effectively. More recently, research in Drosophila has illuminated the positive and negative regulation of Toll activation, the organization of signaling events at and beneath membranes, the sorting of information flow, and the existence of non-conventional signaling via Toll-related receptors. Here, we provide an overview of the Toll pathway of flies and highlight these ongoing realms of research. PMID:23632253

  11. Concurrent and longitudinal associations between diurnal cortisol and body mass index across adolescence.

    PubMed

    Ruttle, Paula L; Javaras, Kristin N; Klein, Marjorie H; Armstrong, Jeffrey M; Burk, Linnea R; Essex, Marilyn J

    2013-06-01

    Childhood and adolescent obesity have reached epidemic levels; however, little is known about the psychobiological underpinnings of obesity in youth and whether these differ from the mechanisms identified in adults. The current study examines concurrent (i.e., measured at the same point in time) and longitudinal (i.e., using earlier cortisol measures to predict later body mass index [BMI]) associations between diurnal cortisol and BMI across adolescence. Adolescent diurnal cortisol was measured over 3 days at each 11, 13, and 15 years. Hierarchical linear modeling was used to extract average measures of predicted morning, afternoon, evening levels of cortisol and the diurnal slope at each assessment. Adolescent BMI (kg/m(2)) was measured at 11, 13, 15, and 18 years. Sex, family socioeconomic status, mother's BMI, pubertal status, and adolescent mental health were examined as possible confounding variables. Linear regressions revealed that blunted patterns of adolescent cortisol were associated with increased measures of BMI across adolescence both concurrently and longitudinally, particularly when examining measures of cortisol in early adolescence. Multinomial logistic regressions extended the linear regression findings beyond BMI scores to encompass categories of obesity. The current study builds on previous research documenting diurnal cortisol-obesity findings in adults by demonstrating similar findings exist both concurrently and longitudinally in adolescents. Findings suggest the association between cortisol and BMI is developmentally influenced and that blunted diurnal cortisol patterns can be identified in overweight individuals at a younger age than previously thought. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. Determinants of overweight with concurrent stunting among Ghanaian children.

    PubMed

    Atsu, Benedicta K; Guure, Chris; Laar, Amos K

    2017-07-27

    Malnutrition (undernutrition and overnutrition) is a major public health problem in Ghana -affecting growth and development of individuals and the nation. Stunting and overweight are of particular interest, as recent national surveys show a rising trend of overnutrition and stubbornly high burden of stunting among Ghanaian children. There are currently no data on the simultaneous occurrence of overweight and stunting within individuals in Ghana. This paper presents the burden, the individual-level, and contextual determinants of overweight with concurrent stunting among Ghanaian children. This study analyzed data set of the fourth round of the Ghana Multiple Indicator Cluster Survey (MICS4). Bivariate analyses were used to describe selected characteristics of survey respondents and their children. Hierarchical modelling approach facilitated identification of significant distal, intermediate and proximal factors/determinants of concurrent stunting and overweight. Both crude and adjusted prevalence ratios via a multivariable Poison regression model with their corresponding 95% Confidence Intervals (CI) are reported. Variables with p ≤ 0.25 at the bivariate level were included in the multivariable analysis. An alpha value of 5% was used to indicate significance. Of 7550 cases (children) analyzed, the prevalence of stunting was 27.5%; underweight was 17.3%; and wasting was 7.7%. The prevalence of overweight and concurrent overweight and stunting were respectively 2.4% and 1.2%. Children who belonged to the fourth wealth quintile, were more likely to be overweight and concurrently stunted as against children belonging to the poorest quintile (aPR = 1.010; 95% CI, 1.003-1.017). Compared to religious (Christians/Muslim/Traditionalist) household heads, children whose household heads did not belong to any religion had 2 times the rates of the Overweight with concurrent stunting (PR = 2.024; 95% CI, 1.016-4.034). Children with mothers aged 20-34 and 35-49 had an

  13. Implementing the chemical weapons convention

    SciTech Connect

    Kellman, B.; Tanzman, E. A.

    1999-12-07

    In 1993, as the CWC ratification process was beginning, concerns arose that the complexity of integrating the CWC with national law could cause each nation to implement the Convention without regard to what other nations were doing, thereby causing inconsistencies among States as to how the CWC would be carried out. As a result, the author's colleagues and the author prepared the Manual for National Implementation of the Chemical Weapons Convention and presented it to each national delegation at the December 1993 meeting of the Preparatory Commission in The Hague. During its preparation, the Committee of CWC Legal Experts, a group of distinguished international jurists, law professors, legally-trained diplomats, government officials, and Parliamentarians from every region of the world, including Central Europe, reviewed the Manual. In February 1998, they finished the second edition of the Manual in order to update it in light of developments since the CWC entered into force on 29 April 1997. The Manual tries to increase understanding of the Convention by identifying its obligations and suggesting methods of meeting them. Education about CWC obligations and available alternatives to comply with these requirements can facilitate national response that are consistent among States Parties. Thus, the Manual offers options that can strengthen international realization of the Convention's goals if States Parties act compatibly in implementing them. Equally important, it is intended to build confidence that the legal issues raised by the Convention are finite and addressable. They are now nearing competition of an internet version of this document so that interested persons can access it electronically and can view the full text of all of the national implementing legislation it cites. The internet address, or URL, for the internet version of the Manual is http: //www.cwc.ard.gov. This paper draws from the Manual. It comparatively addresses approximately thirty

  14. Combined versus monotherapy or concurrent therapy for treatment of thalassaemia.

    PubMed

    Song, Ta-Shu; Hsieh, Yow-Wen; Peng, Ching-Tien; Chen, Tai-Lin; Lee, Hong-Zin; Chung, Jing-Gung; Hour, Mann-Jen

    2014-01-01

    A combined deferasirox (DFX) and deferiprone (DFP) treatment protocol for relieving thalassemia patients' iron-overload was designed and the pharmacokinetic study was performed by LC-MS/MS. For this open-label, randomized trial, eight patients were recruited and randomly allocated to different treatment regimens: (A) monotherapy with single oral dose of DFX 30 mg/kg, (B) monotherapy with DFP 80 mg/kg/day, twice daily, (C) combined therapy with DFX and DFP (DFX 30 mg/kg for first dose, DFP 40 mg/kg 7 hours later, and DFP 40 mg/kg after another 7 h) and (D) concurrent therapy with DFX 30 mg/kg and DFP 80 mg/kg. Descriptive statistics evaluated pharmacokinetic parameters, AUC0-t, AUC0-inf, Cmax, Tmax, T1/2 and MRT. A positive pharmacokinetic drug interaction was observed in combined therapy. In case of DFX, combined therapy tallied about 2-fold larger than monotherapy in AUC, 1.5-fold larger in Cmax, 1 h longer in Tmax, but 1 h shorter in T1/2. Regarding DFP, most such parameters of combined therapy concurred with monotherapy. Conversely, negative drug interaction was observed in concurrent therapy. With DFX, concurrent therapy attained 1.2- to 2.2-fold lower than monotherapy in AUC0-t and Cmax, 0.6-h shorter in Tmax, and 3-fold longer in T1/2. With DFP, concurrent therapy proved approximately 2-fold larger than monotherapy in AUC and Cmax, 2.5-fold longer in T1/2, and 1.4-fold longer in MRT. Follow-up of subjects' clinical examinations and subjective symptoms showed no adverse events. Our findings showed the combined therapy had advantages, safe, convenient and painless for patients, over the existing concurrent therapy with deferoxamine (DFO) and DFX. Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  15. A comparison of piezosurgery with conventional techniques for internal osteotomy.

    PubMed

    Koçak, I; Doğan, R; Gökler, O

    2017-06-01

    To compare conventional osteotomy with the piezosurgery medical device, in terms of postoperative edema, ecchymosis, pain, operation time, and mucosal integrity, in rhinoplasty patients. In this prospective study, 49 rhinoplasty patients were randomly divided into two groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. For all patients, the total duration of the operation was recorded, and photographs were taken and scored for ecchymosis and edema on postoperative days 2, 4, and 7. In addition, pain level was evaluated on postoperative day 2, and mucosal integrity was assessed on day 4. All scoring and evaluation was conducted by a physician who was blinded to the osteotomy procedure. In the piezosurgery group, edema scores on postoperative day 2 and ecchymosis scores on postoperative days 2, 4, and 7 were significantly lower than in the conventional osteotomy group (p < 0.05). On postoperative day 2, the pain level was lower in the piezosurgery group than in the conventional osteotomy group (p < 0.05). In an endoscopic examination on postoperative day 4, while 24% of the patients in the conventional osteotomy group had mucosal damage, no such damage was observed in the piezosurgery group. When total operation duration was compared, there was no significant difference between the groups (p > 0.05). Piezosurgery is a safe osteotomy method, with less edema (in the early postoperative period) and ecchymosis compared with conventional osteotomy, as well as less pain, a similar operation duration, and no mucosal damage.

  16. Effect of accounting for multiple concurrent catheters on central line-associated bloodstream infection rates: practical data supporting a theoretical concern.

    PubMed

    Aslakson, Rebecca A; Romig, Mark; Galvagno, Samuel M; Colantuoni, Elizabeth; Cosgrove, Sara E; Perl, Trish M; Pronovost, Peter J

    2011-02-01

    Central line-associated bloodstream infection (CLABSI) rates are gaining importance as they become publicly reported metrics and potential pay-for-performance indicators. However, the current conventional method by which they are calculated may be misleading and unfairly penalize high-acuity care settings, where patients often have multiple concurrent central venous catheters (CVCs). We compared the conventional method of calculating CLABSI rates, in which the number of catheter-days is used (1 patient with n catheters for 1 day has 1 catheter-day), with a new method that accounts for multiple concurrent catheters (1 patient with n catheters for 1 day has n catheter-days), to determine whether the difference appreciably changes the estimated CLABSI rate. Cross-sectional survey. Academic, tertiary care hospital. Adult patients who were consecutively admitted from June 10 through July 9, 2009, to a cardiac-surgical intensive care unit and a surgical intensive and surgical intermediate care unit. Using the conventional method, we counted 485 catheter-days throughout the study period, with a daily mean of 18.6 catheter-days (95% confidence interval, 17.2-20.0 catheter-days) in the 2 intensive care units. In contrast, the new method identified 745 catheter-days, with a daily mean of 27.5 catheter-days (95% confidence interval, 25.6-30.3) in the 2 intensive care units. The difference was statistically significant (P < .001). The new method that accounted for multiple concurrent CVCs resulted in a 53.6% increase in the number of catheter-days; this increased denominator decreases the calculated CLABSI rate by 36%. The undercounting of catheter-days for patients with multiple concurrent CVCs that occurs when the conventional method of calculating CLABSI rates is used inflates the CLABSI rate for care settings that have a high CVC burden and may not adjust for underlying medical illness. Additional research is needed to validate and generalize our findings.

  17. Conventional power sources for colliders

    SciTech Connect

    Allen, M.A.

    1987-07-01

    At SLAC we are developing high peak-power klystrons to explore the limits of use of conventional power sources in future linear colliders. In an experimental tube we have achieved 150 MW at 1 ..mu..sec pulse width at 2856 MHz. In production tubes for SLAC Linear Collider (SLC) we routinely achieve 67 MW at 3.5 ..mu..sec pulse width and 180 pps. Over 200 of the klystrons are in routine operation in SLC. An experimental klystron at 8.568 GHz is presently under construction with a design objective of 30 MW at 1 ..mu..sec. A program is starting on the relativistic klystron whose performance will be analyzed in the exploration of the limits of klystrons at very short pulse widths.

  18. Conventionalism and integrable Weyl geometry

    NASA Astrophysics Data System (ADS)

    Pucheu, M. L.

    2015-03-01

    Since the appearance of Einstein's general relativity, gravitation has been associated to the space-time curvature. This theory introduced a geometrodynamic language which became a convenient tool to predict matter behaviour. However, the properties of space-time itself cannot be measurable by experiments. Taking Poincaré idea that the geometry of space-time is merely a convention, we show that the general theory of relativity can be completely reformulated in a more general setting, a generalization of Riemannian geometry, namely, the Weyl integrable geometry. The choice of this new mathematical language implies, among other things, that the path of particles and light rays should now correspond to Weylian geodesies. Such modification in the dynamic of bodies brings a new perception of physical phenomena that we will explore.

  19. High-temperature conventional superconductivity

    NASA Astrophysics Data System (ADS)

    Eremets, M. I.; Drozdov, A. P.

    2017-02-01

    Conventional superconductors are described well by the Bardeen – Cooper – Schrieffer (BCS) theory (1957) and its related theories, all of which importantly put no explicit limit on transition temperature Tc. While this allows, in principle, room-temperature superconductivity, no such phenomenon has been observed. Since the discovery of superconductivity in 1911, the measured critical temperature of BCS superconductors has not until recently exceeded 39 K. In 2014, hydrogen sulfide under high pressure was experimentally found to exhibit superconductivity at Tc = 200 K, a record high value which greatly exceeds that of the previous class of high-temperature superconductors, the cuprates. The superconductivity mechanism in cuprates has not yet been explained. Over a period of 25 years, the critical temperature of cuprates has not been increased above 164 K. The paper reviews research on record-high Tc superconductivity in hydrogen sulphide and other hydrides. Prospects for increasing Tc to room temperature are also discussed.

  20. High-temperature conventional superconductivity

    NASA Astrophysics Data System (ADS)

    Eremets, M. I.; Drozdov, A. P.

    2016-11-01

    Conventional superconductors are described well by the Bardeen - Cooper - Schrieffer (BCS) theory (1957) and its related theories, all of which importantly put no explicit limit on transition temperature T_c. While this allows, in principle, room-temperature superconductivity, no such phenomenon has been observed. Since the discovery of superconductivity in 1911, the measured critical temperature of BCS superconductors has not until recently exceeded 39 K. In 2014, hydrogen sulfide under high pressure was experimentally found to exhibit superconductivity at T_c=200 K, a record high value which greatly exceeds that of the previous class of high-temperature superconductors, the cuprates. The superconductivity mechanism in cuprates has not yet been explained. Over a period of 25 years, the critical temperature of cuprates has not been increased above 164 K. The paper reviews research on record-high T_c superconductivity in hydrogen sulphide and other hydrides. Prospects for increasing T_c to room temperature are also discussed.