A review of ride comfort studies in the United Kingdom

NASA Technical Reports Server (NTRS)

Griffin, M. J.

1975-01-01

United Kingdom research which is relevant to the assessment of vehicle ride comfort was reviewed. The findings reported in approximately 80 research papers are outlined, and an index to the areas of application of these studies is provided. The data obtained by different research groups are compared, and it is concluded that, while there are some areas of general agreement, the findings obtained from previous United Kingdom research are insufficient to define a general purpose ride comfort evaluation procedure. The degree to which United Kingdom research supports the vibration evaluation procedure defined in the current International Standard on the evaluation of human exposure to whole-body vibration is discussed.

A Rapid Assessment of Instructional Strategies to Teach Auditory-Visual Conditional Discriminations to Children with Autism

ERIC Educational Resources Information Center

Kodak, Tiffany; Clements, Andrea; LeBlanc, Brittany

2013-01-01

The purpose of the present investigation was to evaluate a rapid assessment procedure to identify effective instructional strategies to teach auditory-visual conditional discriminations to children diagnosed with autism. We replicated and extended previous rapid skills assessments (Lerman, Vorndran, Addison, & Kuhn, 2004) by evaluating the effects…

Evaluation of a novel high-resolution mapping technology for ablation of recurrent scar-related atrial tachycardias.

PubMed

Anter, Elad; McElderry, Thomas H; Contreras-Valdes, Fernando M; Li, Jianqing; Tung, Patricia; Leshem, Eran; Haffajee, Charles I; Nakagawa, Hiroshi; Josephson, Mark E

2016-10-01

Rhythmia is a new technology capable of rapid and high-resolution mapping. However, its potential advantage over existing technologies in mapping complex scar-related atrial tachycardias (ATs) has not yet been evaluated. The purpose of this study was to examine the utility of Rhythmia for mapping scar-related ATs in patients who had failed previous ablation procedure(s). This multicenter study included 20 patients with recurrent ATs within 2 years after a previous ablation procedure (1.8 ± 0.7 per patient). In all cases, the ATs could not be adequately mapped during the index procedure because of scar with fractionated electrograms, precluding accurate time annotation, frequent change in the tachycardia in response to pacing, and/or degeneration into atrial fibrillation. These patients underwent repeat mapping and ablation procedure with Rhythmia. From a total of 28 inducible ATs, 24 were successfully mapped. Eighteen ATs (75%) terminated during radiofrequency ablation and 4 (16.6%) with catheter pressure or entrainment from the site of origin or isthmus. Two ATs that were mapped to the interatrial septum slowed but did not terminate with ablation. In 21 of 24 ATs the mechanism was macroreentry, while in 3 of 24 the mechanism was focal. Interestingly, in 5 patients with previously failed ablation of an allegedly "focal" tachycardia, high-resolution mapping demonstrated macroreentrant arrhythmia. The mean mapping time was 28.6 ± 17 minutes, and the mean radiofrequency ablation time to arrhythmia termination was 3.2 ± 2.6 minutes. During a mean follow-up of 7.5 ± 3.1 months, 15 of 20 patients (75%) were free of AT recurrences. The Rhythmia mapping system may be advantageous for mapping complex scar-related ATs. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Procedures For Continuing Metropolitan Planning: Final Research Report

DOT National Transportation Integrated Search

1974-01-01

This report marks the conclusion of the third phase of the : Metropolitan Plan Evaluation Project. Findings of both phases two : and three are summarized here. More detailed and technical results : have been reported previously. : The continuing metr...

QUANTITATIVE PROCEDURES FOR NEUROTOXICOLOGY RISK ASSESSMENT

EPA Science Inventory

In this project, previously published information on biologically based dose-response model for brain development was used to quantitatively evaluate critical neurodevelopmental processes, and to assess potential chemical impacts on early brain development. This model has been ex...

Intracytoplasmic sperm injection for treatment of the infertile male.

PubMed

Kim, E D; Lamb, D J; Lipshultz, L I

1997-07-01

Intracytoplasmic sperm injection (ICSI) with in vitro fertilization represents one of the most significant advances in fertility technology. In this relatively new procedure, a single viable sperm is microinjected into an oocyte that has been extracted transvaginally. After fertilization occurs, the embryo is transferred into the uterus. This procedure now affords men who were previously thought to be irreversibly infertile the chance to initiate their own biologic pregnancy. However, because of the procedure's significant costs and its potential risk to the mother, careful selection of couples following a thorough male factor evaluation is mandatory.

Co-evaluation of plant extracts as petrochemical substitutes and for biologically active compounds

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

McChesney, J.D.; Adams, R.P.

Recent efforts to discover phytochemicals that could substitute for petroleum-derived fuels and industrial feedstocks have not given much attention to the potential of these same phytochemicals to provide sources of biologically active compounds. The suitability of extraction products made to assess specific plants as potential botanochemical sources has been evaluated for use in screening procedures for evidence of biologically active compounds. Screening procedures for antibacterial, antifungal and toxic properties are discussed. Screening results are presented for extracts of nearly 80 species of plants from the southeastern United States and southern Great Plains that had previously been evaluated as sources ofmore » botanochemicals.« less

Risk Predictors for Postcontrast Acute Kidney Injury.

PubMed

Krause, Trudy Millard; Ukhanova, Maria; Lee Revere, Frances; Finkel, Kevin W

2018-05-22

To evaluate risk predictors of acute kidney injury (AKI) after contrast-media procedures in a broader cohort of patients than previously reported. Comprehensive medical and pharmacy commercial claims data from 2012 to 2014. Claims associated with contrast-media procedures for 2,737,020 persons between January 1, 2012 and November 30, 2014, were reviewed. The overall incidence of AKI after a contrast-media procedure was 0.85%. AKI occurred in 26% of cases that had two or more contrast procedures within 30 days, compared with 9% of non-AKI cases. Although the incidence of postcontrast AKI was low, 10% of patients who developed AKI had a recent previous episode of AKI. In cases when AKI had occurred within 180 days of contrast administration, the odds of subsequent kidney injury was 9.39. Overall, there is a low risk (0.85%) of developing an AKI after a procedure with contrast-media consistent with several recent studies. However, in adults with a recent history of AKI, physicians must consider this history as a risk factor for subsequent AKI. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Hearing disability and communication handicap for compensation purposes based on self-assessment and audiometric testing.

PubMed

Salomon, G; Parving, A

1985-01-01

It is reasoned that for compensation or epidemiological studies an evaluation of hearing disability and the concomitant handicap must include the ability to perceive visual cues. A scaling procedure for hearing- and audiovisual communication handicap is presented. The procedure deviates in two ways from previous handicap assessments: (1) It is based on individual self-assessment of semantic speech perception but can be implemented by means of professional audiological test procedures. (2) The system does not make use of pure-tone auditory thresholds as a predominant audiological principle, but is based on speech perception. The interrelationship between auditory and audiovisual handicap is evaluated. A total score including audio- and audiovisual perception handicap is proposed and a suggestion for disability percentages is presented.

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

Evans, J.H.; Chipley, K.K.; Nelms, H.A.

An evaluation of the ORNL loop transport cask demonstrating its compliance with the regulations governing the transportation of radioactive and fissile materials is presented. A previous review of the cask is updated to demonstrate compliance with current regulations, to present current procedures, and to reflect the more recent technology.

Statistical evaluation of rainfall-simulator and erosion testing procedure : final report.

DOT National Transportation Integrated Search

1977-01-01

The specific aims of this study were (1) to supply documentation of statistical repeatability and precision of the rainfall-simulator and to document the statistical repeatabiity of the soil-loss data when using the previously recommended tentative l...

Efficacy of adrenal venous sampling is increased by point of care cortisol analysis

PubMed Central

Viste, Kristin; Grytaas, Marianne A; Jørstad, Melissa D; Jøssang, Dag E; Høyden, Eivind N; Fotland, Solveig S; Jensen, Dag K; Løvås, Kristian; Thordarson, Hrafnkell; Almås, Bjørg; Mellgren, Gunnar

2013-01-01

Primary aldosteronism (PA) is a common cause of secondary hypertension and is caused by unilateral or bilateral adrenal disease. Treatment options depend on whether the disease is lateralized or not, which is preferably evaluated with selective adrenal venous sampling (AVS). This procedure is technically challenging, and obtaining representative samples from the adrenal veins can prove difficult. Unsuccessful AVS procedures often require reexamination. Analysis of cortisol during the procedure may enhance the success rate. We invited 21 consecutive patients to participate in a study with intra-procedural point of care cortisol analysis. When this assay showed nonrepresentative sampling, new samples were drawn after redirection of the catheter. The study patients were compared using the 21 previous procedures. The intra-procedural cortisol assay increased the success rate from 10/21 patients in the historical cohort to 17/21 patients in the study group. In four of the 17 successful procedures, repeated samples needed to be drawn. Successful sampling at first attempt improved from the first seven to the last seven study patients. Point of care cortisol analysis during AVS improves success rate and reduces the need for reexaminations, in accordance with previous studies. Successful AVS is crucial when deciding which patients with PA will benefit from surgical treatment. PMID:24169597

[The conversion of a modified Fontan procedure to a total extracardiac cavo-pulmonary conduit. The Medico-Surgical Cardiology Group].

PubMed

Abella, R F; Marianeschi, S M; De la Torre, T; Smedile, G; Masetti, P; Cipriani, A; Magherini, A; Meli, M; Iorio, F S; Marcelletti, C F

1998-06-01

After a modified Fontan procedure with atriopulmonary or atrioventricular conduit, some patients present stress intolerance, supraventricular arrhythmia, recurrent pleuropericardial or ascitic effusions, and protein-losing enteropathy, all of which are signs that the previous procedure has failed. The aim of this study was to evaluate the midterm outcome after surgical therapy for this condition. Between August 1994 and December 1997, nine patients (6 males and 3 females), age 10 to 39 (mean 21.5) years, underwent conversion of previous modified Fontan procedure to total extracardiac cavo-pulmonary connection. Time from the previous procedure was 6 to 18 years (mean 10). Diagnosis was tricuspid atresia with pulmonary stenosis (n = 2), double-inlet left ventricle and concordant ventriculoarterial connection (n = 3), double-inlet left ventricle and discordant ventriculoarterial connection (n = 3), Holmes heart (n = 1). Nine patients presented decreased stress tolerance, seven had arrhythmia, five had pleuropericardial effusions and two had protein-losing enteropathy. In all but one patient, right atrial pressure was higher than 15 mmHg, while in six patients the cardiac index was less than 2 l/min/m2. A polytetrafluoroethylene non-valved conduit was interposed between the inferior vena cava and the right pulmonary artery for conversion in all patients. A bidirectional cavo-pulmonary anastomosis (modified Glenn) was associated in all patients. Evaluation was done by NYHA Class and by an arbitrary score assigned to patients based on 7 parameters. There was no perioperative mortality. All patients were clinically improved at a mean follow-up of 24 months (range: 3 to 46). No patient had effusions, and the arrhythmias disappeared in 4 patients and were controlled by medical therapy in one. The two patients with protein-losing enteropathy improved markedly within 30 days and the score dropped below 10 points. The conversion of the modified Fontan procedure to total extracardiac cavo-pulmonary connection improves clinical condition by decreasing the right atrium-pulmonary gradient and right atrial preload, and by providing a laminar cavo-pulmonary flow without any need for intracardiac anastomoses. This procedure should be undertaken early in this subset of patients, before ventricular failure ensues.

AM2 Brickwork Pattern Evaluation

DTIC Science & Technology

2016-12-01

pavement applications. Designation : D 6951. West Consho- hocken, PA: ASTM International. ASTM International. 2010a. Standard test method for in-place... design . This report provides test results for each evaluation and discussions comparing their perfor- mance to previous tests conducted under similar... designated by other authorized documents. DESTRUCTION NOTICE - For classified documents, follow the procedures in DOD5200.22-M, Industrial Security Manual

Use of a Picture Exchange Communication System for preventive procedures in individuals with autism spectrum disorder: pilot study.

PubMed

Zink, Adriana Gledys; Diniz, Michele Baffi; Rodrigues Dos Santos, Maria Teresa Botti; Guaré, Renata Oliveira

2016-09-01

The aim of the present study was to evaluate the use of the Picture Exchange Communication System (PECS) in individuals with autism spectrum disorder (ASD) in order to facilitate patient-professional communication during preventive procedures. In this study, 26 patients with ASD, between 5 and 19 years of age (10±3.3 y), were divided into two groups: G1 (n = 13) with no previous experience of dental treatment, and G2 (n = 13), with such previous experience. The initial approach followed the principles of the Son-Rise Program®. The seven PECSs presented the routine of the dental office: "room," "ground," "chair," "dentist," "mouth," "low," and "triple." Each PEC was used up to three times in order to acquire the skill proposed. It was verified that G2 required a greater number of times to achieve the acceptance of PECS "ground," "dentist," "mouth," and "triple" (p < .05). We concluded that PECS facilitated patient-professional communication during preventive procedures, including for ASD patients with previous dental experience. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

NASA Task Load Index (TLX). Volume 1.0; Paper and Pencil Package

NASA Technical Reports Server (NTRS)

Hart, Sandra G.

1986-01-01

This booklet contains the materials necessary to collect subjective workload assessments with the NASA Task Load Index. This procedure for collecting workload ratings was developed by the Human Performance Group at NASA Ames Research Center during a three year research effort that involved more than 40 laboratory. simulation. and inflight experiments. Although the technique is still undergoing evaluation. this booklet is being distributed to allow other researchers to use it in their own experiments. Comments or suggestions about the procedure would be greatly appreciated. This package is intended to fill a "nuts and bolts" function of describing the procedure. A bibliography provides background information about previous empirical findings and the logic that supports the procedure.

Acquisition of mands and tacts with concurrent echoic training.

PubMed

Kodak, Tiffany; Clements, Andrea

2009-01-01

Previous studies have identified a number of effective teaching procedures to increase verbal behavior in individuals with developmental disabilities. However, few studies have evaluated modifications of treatment procedures when children fail to acquire communication skills. In the present investigation, a 4-year-old boy with autism failed to acquire unprompted mands and tacts during mand-only and tact-only training. Results indicated that combining echoic training with mand or tact training increased unprompted manding and tacting.

ACQUISITION OF MANDS AND TACTS WITH CONCURRENT ECHOIC TRAINING

PubMed Central

Kodak, Tiffany; Clements, Andrea

2009-01-01

Previous studies have identified a number of effective teaching procedures to increase verbal behavior in individuals with developmental disabilities. However, few studies have evaluated modifications of treatment procedures when children fail to acquire communication skills. In the present investigation, a 4-year-old boy with autism failed to acquire unprompted mands and tacts during mand-only and tact-only training. Results indicated that combining echoic training with mand or tact training increased unprompted manding and tacting. PMID:20514191

The Effects of Evaluating Video Examples of Staffs' Own versus Others' Performance on Discrete-Trial Training Skills in a Human Service Setting

ERIC Educational Resources Information Center

Williams, W. Larry; Gallinat, Julianne

2011-01-01

Many studies have been conducted evaluating the use of feedback in staff training in organizational settings. Central to this literature has been the use of a variety of forms of feedback, including videotaped feedback. A distinction is outlined between video modeling and a variety of possible video feedback procedures. Previous studies have…

Habitat Suitability Index Models: Black-shouldered kite

USGS Publications Warehouse

Faanes, Craig A.; Howard, Rebecca J.

1987-01-01

A review and synthesis of existing information were used to develop a model for evaluating black-shouldered kite habitat quality. The model is scaled to produce an index between 0 (unsuitable habitat) to 1.0 (optimal habitat). Habitat suitability index models are designed for use with the Habitat Evaluation Procedures previously developed by the U.S. Fish and Wildlife Service. Guidelines for model application are provided.

Improved staff procedure skills lead to improved managment skills: an observational study in an educational setting.

PubMed

Rüter, Anders; Vikstrom, Tore

2009-01-01

Good staff procedure skills in a management group during incidents and disasters are believed to be a prerequisite for good management of the situation. However, this has not been demonstrated scientifically. Templates for evaluation results from performance indicators during simulation exercises have previously been tested. The aim of this study was to demonstrate the possibility that these indicators can be used as a tool for studying the relationship between good management skills and good staff procedure skills. Good and structured work (staff procedure skills) in a hospital management group during simulation exercises in disaster medicine is related to good and timely decisions (good management skills). Results from 29 consecutive simulation exercises in which staff procedure skills and management skills were evaluated using quantitative measurements were included. The statistical analysis method used was simple linear regression with staff procedure skills as the response variable and management skills as the predictor variable. An overall significant relationship was identified between staff procedure skills and management skills (p(2)0.05). This study suggests that there is a relationship between staff procedure skills and management skills in the educational setting used. Future studies are needed to demonstrate if this also can be observed during actual incidents.

[Evolution of methodical approaches to solve problem of evaluating and predicting the thermal status of cosmonauts in the real flight].

PubMed

Kuznets, E I; Bobrov, A F; Bekreneva, L N; Mikhailova, L I; Utekhin, B A; Pruzhinina, T I; Iakovleva, E V; Chadov, V I

1996-01-01

The problem of evaluating and predicting the thermal status of a cosmonaut in the long-term space mission is a pressing one and remains to be solved. The previous studies indicated that the best plan to be followed is to evaluate the thermal status of a cosmonaut during his egress into outer space with the use of the procedure of parotid thermometry of the mean body temperature.

Evaluating Patient-Centered Outcomes in Clinical Trials of Procedural Sedation, Part 2 Safety: Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research Recommendations.

PubMed

Ward, Denham S; Williams, Mark R; Berkenbosch, John W; Bhatt, Maala; Carlson, Douglas; Chappell, Phillip; Clark, Randall M; Constant, Isabelle; Conway, Aaron; Cravero, Joseph; Dahan, Albert; Dexter, Franklin; Dionne, Raymond; Dworkin, Robert H; Gan, Tong J; Gozal, David; Green, Steven; Irwin, Michael G; Karan, Suzanne; Kochman, Michael; Lerman, Jerrold; Lightdale, Jenifer R; Litman, Ronald S; Mason, Keira P; Miner, James; O'Connor, Robert E; Pandharipande, Pratik; Riker, Richard R; Roback, Mark G; Sessler, Daniel I; Sexton, Anne; Tobin, Joseph R; Turk, Dennis C; Twersky, Rebecca S; Urman, Richard D; Weiss, Mark; Wunsch, Hannah; Zhao-Wong, Anna

2018-05-17

The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research, established by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks, a public-private partnership with the US Food and Drug Administration, convened a second meeting of sedation experts from a variety of clinical specialties and research backgrounds to develop recommendations for procedural sedation research. The previous meeting addressed efficacy and patient- and/or family-centered outcomes. This meeting addressed issues of safety, which was defined as "the avoidance of physical or psychological harm." A literature review identified 133 articles addressing safety measures in procedural sedation clinical trials. After basic reporting of vital signs, the most commonly measured safety parameter was oxygen saturation. Adverse events were inconsistently defined throughout the studies. Only 6 of the 133 studies used a previously validated measure of safety. The meeting identified methodological problems associated with measuring infrequent adverse events. With a consensus discussion, a set of core and supplemental measures were recommended to code for safety in future procedural clinical trials. When adopted, these measures should improve the integration of safety data across studies and facilitate comparisons in systematic reviews and meta-analyses.

Transition between free-space Helmholtz equation solutions with plane sources and parabolic wave equation solutions.

PubMed

Mahillo-Isla, R; Gonźalez-Morales, M J; Dehesa-Martínez, C

2011-06-01

The slowly varying envelope approximation is applied to the radiation problems of the Helmholtz equation with a planar single-layer and dipolar sources. The analyses of such problems provide procedures to recover solutions of the Helmholtz equation based on the evaluation of solutions of the parabolic wave equation at a given plane. Furthermore, the conditions that must be fulfilled to apply each procedure are also discussed. The relations to previous work are given as well.

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2012-10-01 2012-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2013-10-01 2013-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2014-10-01 2014-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2011-10-01 2011-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

42 CFR 488.30 - Revisit user fee for revisit surveys.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., or substantiated complaint survey and that is designed to evaluate the extent to which previously... 42 Public Health 5 2010-10-01 2010-10-01 false Revisit user fee for revisit surveys. 488.30... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES General...

DEVELOPING RELATIVE POTENCY FACTORS FOR PESTICIDE MIXTURES: BIOSTATISTICAL ANALYSES OF JOINT DOSE-RESPONSE

EPA Science Inventory

The 1996 Food Quality Protection Act (FQPA) and the 1996 Safe Drinking Water Act Amendments (SDWAA) reaffirm previous Acts that mandate the EPA to evaluate risks posed by environmental chemical mixtures. The current report develops biological concepts and statistical procedures f...

Laboratory performance evaluation of CIR-emulsion and its comparison against CIR-foam test results from phase III.

DOT National Transportation Integrated Search

2009-12-01

Currently, no standard mix design procedure is available for CIR-emulsion in Iowa. The CIR-foam mix : design process developed during the previous phase is applied for CIR-emulsion mixtures with varying : emulsified asphalt contents. Dynamic modulus ...

The AME2016 atomic mass evaluation (I). Evaluation of input data; and adjustment procedures

NASA Astrophysics Data System (ADS)

Huang, W. J.; Audi, G.; Wang, Meng; Kondev, F. G.; Naimi, S.; Xu, Xing

2017-03-01

This paper is the first of two articles (Part I and Part II) that presents the results of the new atomic mass evaluation, AME2016. It includes complete information on the experimental input data (also including unused and rejected ones), as well as details on the evaluation procedures used to derive the tables of recommended values given in the second part. This article describes the evaluation philosophy and procedures that were implemented in the selection of specific nuclear reaction, decay and mass-spectrometric results. These input values were entered in the least-squares adjustment for determining the best values for the atomic masses and their uncertainties. Details of the calculation and particularities of the AME are then described. All accepted and rejected data, including outweighted ones, are presented in a tabular format and compared with the adjusted values obtained using the least-squares fit analysis. Differences with the previous AME2012 evaluation are discussed and specific information is presented for several cases that may be of interest to AME users. The second AME2016 article gives a table with the recommended values of atomic masses, as well as tables and graphs of derived quantities, along with the list of references used in both the AME2016 and the NUBASE2016 evaluations (the first paper in this issue). AMDC: http://amdc.impcas.ac.cn/ Contents The AME2016 atomic mass evaluation (I). Evaluation of input data; and adjustment proceduresAcrobat PDF (1.2 MB) Table I. Input data compared with adjusted valuesAcrobat PDF (1.3 MB)

Effects of computer-based training on procedural modifications to standard functional analyses.

PubMed

Schnell, Lauren K; Sidener, Tina M; DeBar, Ruth M; Vladescu, Jason C; Kahng, SungWoo

2018-01-01

Few studies have evaluated methods for training decision-making when functional analysis data are undifferentiated. The current study evaluated computer-based training to teach 20 graduate students to arrange functional analysis conditions, analyze functional analysis data, and implement procedural modifications. Participants were exposed to training materials using interactive software during a 1-day session. Following the training, mean scores on the posttest, novel cases probe, and maintenance probe increased for all participants. These results replicate previous findings during a 1-day session and include a measure of participant acceptability of the training. Recommendations for future research on computer-based training and functional analysis are discussed. © 2017 Society for the Experimental Analysis of Behavior.

Remote Excavation System technology evaluation report: Buried Waste Robotics Program

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

Not Available

1993-09-01

This document describes the results from the Remote Excavation System demonstration and testing conducted at the Idaho National Engineering Laboratory during June and July 1993. The purpose of the demonstration was to ascertain the feasibility of the system for skimming soil and removing various types of buried waste in a safe manner and within all regulatory requirements, and to compare the performances of manual and remote operation of a backhoe. The procedures and goals of the demonstration were previously defined in The Remote Excavation System Test Plan, which served as a guideline for evaluating the various components of the systemmore » and discussed the procedures used to conduct the tests.« less

NASA Task Load Index (TLX). Volume 1.0; Computerized Version

NASA Technical Reports Server (NTRS)

Hart, Sandra G.

1986-01-01

This booklet and the accompanying diskette contain the materials necessary to collect subjective workload assessments with the NASA Task Load Index on IBM PC compatible microcomputers. This procedure for collecting workload ratings was developed by the Human Performance Group at NASA Ames Research Center during a three year research effort that involved more than 40 laboratory, simulation, and inflight experiments Although the technique is still undergoing evaluation, this package is being distributed to allow other researchers to use it in their own experiments Comments or suggestions about the procedure would be greatly appreciated This package is intended to fill a "nuts and bolts" function of describing the procedure. A bibliography provides background information about previous empirical findings and the logic that supports the procedure.

Soundwalk approach to identify urban soundscapes individually.

PubMed

Jeon, Jin Yong; Hong, Joo Young; Lee, Pyoung Jik

2013-07-01

This study proposes a soundwalk procedure for evaluating urban soundscapes. Previous studies, which adopted soundwalk methodologies for investigating participants' responses to visual and acoustic environments, were analyzed considering type, evaluation position, measurement, and subjective assessment. An individual soundwalk procedure was then developed based on asking individual subjects to walk and select evaluation positions where they perceived any positive or negative characteristics of the urban soundscape. A case study was performed in urban spaces and the results were compared with those of the group soundwalk to validate the individual soundwalk procedure. Thirty subjects (15 architects and 15 acousticians) participated in the soundwalk. During the soundwalk, the subjects selected a total of 196 positions, and those were classified into 4 groups. It was found that soundscape perceptions were dominated by acoustic comfort, visual images, and openness. It was also revealed that perceived elements of the acoustic environment and visual image differed across classified soundscape groups, and there was a difference between architects and acousticians in terms of how they described their impressions of the soundscape elements. The results show that the individual soundwalk procedure has advantages for measuring diverse subjective responses and for obtaining the perceived elements of the urban soundscape.

Evaluation of a Pre-Treatment Assessment to Select Mand Topographies for Functional Communication Training

ERIC Educational Resources Information Center

Ringdahl, Joel E.; Falcomata, Terry S.; Christensen, Tory J.; Bass-Ringdahl, Sandie M.; Lentz, Alison; Dutt, Anuradha; Schuh-Claus, Jessica

2009-01-01

Recent research has suggested that variables related to specific mand topographies targeted during functional communication training (FCT) can affect treatment outcomes. These include effort, novelty of mands, previous relationships with problem behavior, and preference. However, there is little extant research on procedures for identifying which…

Poorly Performing Physicians: Does the Script Concordance Test Detect Bad Clinical Reasoning?

ERIC Educational Resources Information Center

Goulet, Francois; Jacques, Andre; Gagnon, Robert; Charlin, Bernard; Shabah, Abdo

2010-01-01

Introduction: Evaluation of poorly performing physicians is a worldwide concern for licensing bodies. The College des Medecins du Quebec currently assesses the clinical competence of physicians previously identified with potential clinical competence difficulties through a day-long procedure called the Structured Oral Interview (SOI). Two peer…

Information Acquisition in Children Undergoing Medical Procedures.

ERIC Educational Resources Information Center

Melamed, Barbara G.; And Others

In order to evaluate how individual characteristics of hospitalized children influence their acquisition of information presented in a film depicting preparation for surgery, 42 children between the ages of 4 to 17 were assigned to experimental and control groups that were matched for age, sex, race, type of surgery and previous hospital…

20171130_Ind Ergo Report_631 DI Water Movement Process.

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

Rivera, Cynthia R.

Perform an industrial ergonomic assessment to evaluate the new procedures for filling, lifting, and delivering high purity de-ionized water to building 9925. The goal was to improve on the previous method by minimizing/eliminating as much lifting and bending as possible to reduce the potential for overexertion-related injuries.

30 CFR 250.285 - How do I submit revised and supplemental EPs, DPPs, and DOCDs?

Code of Federal Regulations, 2011 CFR

2011-07-01

..., DPPs, and DOCDs? 250.285 Section 250.285 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT..., including information on changes in expected environmental impacts. (c) Procedures. All supplemental EPs... likely to result in a significant change in the impacts previously identified and evaluated, are subject...

An Evaluation of a Stimulus Preference Assessment of Auditory Stimuli for Adolescents with Developmental Disabilities

ERIC Educational Resources Information Center

Horrocks, Erin; Higbee, Thomas S.

2008-01-01

Previous researchers have used stimulus preference assessment (SPA) methods to identify salient reinforcers for individuals with developmental disabilities including tangible, leisure, edible and olfactory stimuli. In the present study, SPA procedures were used to identify potential auditory reinforcers and determine the reinforcement value of…

Establishment of QC/QA procedures for open-graded mixes : final report.

DOT National Transportation Integrated Search

1998-09-01

The State of Oregon has employed the use of porous concrete surfaces (E- and F-mixes) since the 1970s. The use of porous mixes has increased substantially in the past five years. Previously, no work had been done to evaluate whether the quality contr...

Single-operator cholangioscopy in patients requiring evaluation of bile duct disease or therapy of biliary stones (with videos).

PubMed

Chen, Yang K; Parsi, Mansour A; Binmoeller, Kenneth F; Hawes, Robert H; Pleskow, Douglas K; Slivka, Adam; Haluszka, Oleh; Petersen, Bret T; Sherman, Stuart; Devière, Jacques; Meisner, Søren; Stevens, Peter D; Costamagna, Guido; Ponchon, Thierry; Peetermans, Joyce A; Neuhaus, Horst

2011-10-01

The feasibility of single-operator cholangioscopy (SOC) for biliary diagnostic and therapeutic procedures was previously reported. To confirm the utility of SOC in more widespread clinical use. Prospective clinical cohort study. Fifteen endoscopy referral centers in the United States and Europe. Two hundred ninety-seven patients requiring evaluation of bile duct disease or biliary stone therapy. SOC examination and, as indicated, SOC-directed stone therapy or forceps biopsy. Procedural success defined as ability to (1) visualize target lesions and, if indicated, collect biopsy specimens adequate for histological evaluation or (2) visualize biliary stones and initiate fragmentation and removal. The overall procedure success rate was 89% (95% CI, 84%-92%). Adequate tissue for histological examination was secured in 88% of 140 patients who underwent biopsy. Overall sensitivity in diagnosing malignancy was 78% for SOC visual impression and 49% for SOC-directed biopsy. Sensitivity was higher (84% and 66%, respectively) for intrinsic bile duct malignancies. Diagnostic SOC procedures altered clinical management in 64% of patients. Procedure success was achieved in 92% of 66 patients with stones and complete stone clearance during the study SOC session in 71%. The incidence of serious procedure-related adverse events was 7.5% for diagnostic SOC and 6.1% for SOC-directed stone therapy. The study was observational in design with no control group. Evaluation of bile duct disease and biliary stone therapy can be safely performed with a high success rate by using the SOC system. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Evaluation of ridesharing programs in Michigan

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

Kulp, G.; Tsao, H.J.; Webber, R.E.

1982-10-01

The design, implementation, and results of a carpool and vanpool evaluation are described. Objectives of the evaluation were: to develop credible estimates of the energy savings attributable to the ridesharing program, to provide information for improving the performance of the ridesharing program, and to add to a general understanding of the ridesharing process. Previous evaluation work is critiqued and the research methodology adopted for this study is discussed. The ridesharing program in Michigan is described and the basis for selecting Michigan as the evaluation site is discussed. The evaluation methodology is presented, including research design, sampling procedure, data collection, andmore » data validation. Evaluation results are analyzed. (LEW)« less

Risk Factors for 30-Day Hospital Re-Admission with an Infectious Complication after Lower-Extremity Vascular Procedures.

PubMed

Melvin, Joseph C; Smith, Jamie B; Kruse, Robin L; Vogel, Todd R

2017-04-01

Lowering the 30-d re-admission rate after vascular surgery offers the potential to improve healthcare quality. This study evaluated re-admission associated with infections after open and endovascular lower extremity (LE) procedures for peripheral artery disease (PAD). Patients admitted for elective LE procedures for PAD were selected from the Cerner Health Facts ® database. Chi-square analysis evaluated the characteristics of the index admission associated with infection at 30-d re-admission. Multivariable logistic models were created to examine the association of patient and procedural characteristics with infections at re-admission. The microbiology data available at the time of re-admission were evaluated also. A total of 7,089 patients underwent elective LE procedures, of whom 770 (10.9%) were re-admitted within 30 d. A total of 289 (37.5%) had a diagnosis of infection during the re-admission. These infections included surgical site (14.8%), cellulitis (13.6%), sepsis (8.8%), urinary tract (4.9%), and pneumonia (4.9%). Index stay factors associated with infection at re-admission were fluid and electrolyte disorders, kidney disease, diabetes, previous infection, and chronic anemia. Laboratory results associated with an infection during re-admission were post-operative hemoglobin <8 g/dL, blood urea nitrogen >20 mg/dL, platelet counts >400 × 10 3 /mcL, glucose >180 mg/dL, and white blood cell count >11.0 × 10 3 /mcL. Adjusted models demonstrated longer stay, chronic anemia, previous infection, treatment at a teaching hospital, and hemoglobin <8 g/dL to be risk factors for re-admission with infection. Infective organisms isolated during the re-admission stay included Staphylococcus, Enterococcus, Escherichia, Pseudomonas, Proteus, and Klebsiella. Infectious complications were associated with more than one-third of all re-admissions after LE procedures. Predictors of re-admission within 30 d with an infectious complication were longer stay, greater co-morbidity burden, hospitalization in teaching facilities, hemoglobin <8 g/dL, and an infection during the index stay. Microbiology examination at re-admission demonstrated gram-negative bacteria in more than 40% of infections. Further evaluation of high-risk vascular patients prior to discharge and consideration of antibiotic administration for gram-negative organisms at the time of re-admission may improve outcomes.

[Apheresis in children: procedures and outcome].

PubMed

Tummolo, Albina; Colella, Vincenzo; Bellantuono, Rosa; Giordano, Mario; Messina, Giovanni; Puteo, Flora; Sorino, Palma; De Palo, Tommaso

2012-01-01

Apheresis procedures are used in children to treat an increasing number of conditions by removing different types of substances from the bloodstream. In a previous study we evaluated the first results of our experience in children, emphasizing the solutions adopted to overcome technical difficulties and to adapt adult apheresis procedures to a pediatric population. The aim of the present study is to present data on a larger number of patients in whom apheresis was the main treatment. Ninety-three children (50 m, 43 f) affected by renal and/or extrarenal diseases were included. They were treated with LDL apheresis, protein A immunoadsorption, or plasma exchange. Our therapeutic protocol was the same as described in the previous study. Renal diseases and immunological disorders remained the most common conditions requiring this therapeutic approach. However, hemolytic uremic syndrome (HUS) was no longer the most frequent renal condition to be treated, as apheresis is currently the first treatment option only in cases of atypical HUS. In this series we also treated small children, showing that low weight should no longer be considered a contraindication to apheresis procedures. The low rate of complications and the overall satisfactory clinical results with increasingly advanced technical procedures make a wider use of apheresis in children realistic in the years to come.

Surgical Management of Dural Arteriovenous Fistula After Craniotomy: Case Report and Review of Literature.

PubMed

Pabaney, Aqueel H; Robin, Adam M; Basheer, Azam; Malik, Ghaus

2016-05-01

Development of dural arteriovenous fistula (dAVF) with cortical venous drainage at the site of previous craniotomy is a rare manifestation of nontraumatic subarachnoid hemorrhage (SAH). The authors present a case of postcraniotomy dAVF formation and discuss plausible underlying mechanisms of fistula formation and treatment options as well as review the literature. A 62-year-old man, who had undergone craniotomy 2 decades previously, presented with SAH. Workup revealed a low-flow dAVF with leptomeningeal venous drainage at the posterior margin of the craniotomy. Surgical resection of fistula was undertaken that resulted in cure. Spontaneous SAH in patients with a previous history of an intracranial procedure (e.g., craniotomy, ventriculostomy) should prompt detailed imaging evaluation. In the absence of vascular disease, meticulous review of the angiogram must be undertaken to rule out dAVF at the procedure site and it should be treated definitively. Copyright © 2016 Elsevier Inc. All rights reserved.

Caesarean section greatly increases risk of scar endometriosis.

PubMed

Nominato, Nilo Sérgio; Prates, Luis Felipe Victor Spyer; Lauar, Isabela; Morais, Jaqueline; Maia, Laura; Geber, Selmo

2010-09-01

To estimate the incidence of scar endometriosis after different surgical procedures. A retrospective study of 72 patients diagnosed with scar endometriosis between 1978 and 2003 was performed. Patient age, site of endometriosis, previous operations, time-gap between last surgery and onset of symptoms, nodule characteristics, and recurrence were evaluated. Age ranged from 16 to 48 years. Location varied according to the previous surgery: 46 caesarean section, one hysterectomy, one in abdominal surgery, 19 episiotomy, one was a relapse and two pelvic floor procedures, two women with no previous surgery. The incidence of scar endometriosis after caesarean section was significantly higher than after episiotomy (0.2 and 0.06%, respectively: p<0.00001) with a relative risk of 3.3. Pain was the most frequent symptom. The mean time between surgery and onset of symptoms was 3.7 years. Our findings confirm that scar endometriosis is a rare condition and indicate, probably for the first time, that caesarean section greatly increases the risk of developing scar endometriosis. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Evaluation of the clinical benefit of an electromagnetic navigation system for CT-guided interventional radiology procedures in the thoraco-abdominal region compared with conventional CT guidance (CTNAV II): study protocol for a randomised controlled trial.

PubMed

Rouchy, R C; Moreau-Gaudry, A; Chipon, E; Aubry, S; Pazart, L; Lapuyade, B; Durand, M; Hajjam, M; Pottier, S; Renard, B; Logier, R; Orry, X; Cherifi, A; Quehen, E; Kervio, G; Favelle, O; Patat, F; De Kerviler, E; Hughes, C; Medici, M; Ghelfi, J; Mounier, A; Bricault, I

2017-07-06

Interventional radiology includes a range of minimally invasive image-guided diagnostic and therapeutic procedures that have become routine clinical practice. Each procedure involves a percutaneous needle insertion, often guided using computed tomography (CT) because of its availability and usability. However, procedures remain complicated, in particular when an obstacle must be avoided, meaning that an oblique trajectory is required. Navigation systems track the operator's instruments, meaning the position and progression of the instruments are visualised in real time on the patient's images. A novel electromagnetic navigation system for CT-guided interventional procedures (IMACTIS-CT®) has been developed, and a previous clinical trial demonstrated improved needle placement accuracy in navigation-assisted procedures. In the present trial, we are evaluating the clinical benefit of the navigation system during the needle insertion step of CT-guided procedures in the thoraco-abdominal region. This study is designed as an open, multicentre, prospective, randomised, controlled interventional clinical trial and is structured as a standard two-arm, parallel-design, individually randomised trial. A maximum of 500 patients will be enrolled. In the experimental arm (navigation system), the procedures are carried out using navigation assistance, and in the active comparator arm (CT), the procedures are carried out with conventional CT guidance. The randomisation is stratified by centre and by the expected difficulty of the procedure. The primary outcome of the trial is a combined criterion to assess the safety (number of serious adverse events), efficacy (number of targets reached) and performance (number of control scans acquired) of navigation-assisted, CT-guided procedures as evaluated by a blinded radiologist and confirmed by an expert committee in case of discordance. The secondary outcomes are (1) the duration of the procedure, (2) the satisfaction of the operator and (3) the irradiation dose delivered, with (4) subgroup analysis according to the expected difficulty of the procedure, as well as an evaluation of (5) the usability of the device. This trial addresses the lack of published high-level evidence studies in which navigation-assisted CT-guided interventional procedures are evaluated. This trial is important because it addresses the problems associated with conventional CT guidance and is particularly relevant because the number of interventional radiology procedures carried out in routine clinical practice is increasing. ClinicalTrials.gov identifier: NCT01896219 . Registered on 5 July 2013.

Consulting report on the NASA technology utilization network system

NASA Technical Reports Server (NTRS)

Hlava, Marjorie M. K.

1992-01-01

The purposes of this consulting effort are: (1) to evaluate the existing management and production procedures and workflow as they each relate to the successful development, utilization, and implementation of the NASA Technology Utilization Network System (TUNS) database; (2) to identify, as requested by the NASA Project Monitor, the strengths, weaknesses, areas of bottlenecking, and previously unaddressed problem areas affecting TUNS; (3) to recommend changes or modifications of existing procedures as necessary in order to effect corrections for the overall benefit of NASA TUNS database production, implementation, and utilization; and (4) to recommend the addition of alternative procedures, routines, and activities that will consolidate and facilitate the production, implementation, and utilization of the NASA TUNS database.

Expanding the boundaries of evaluative learning research: How intersecting regularities shape our likes and dislikes.

PubMed

Hughes, Sean; De Houwer, Jan; Perugini, Marco

2016-06-01

Over the last 30 years, researchers have identified several types of procedures through which novel preferences may be formed and existing ones altered. For instance, regularities in the presence of a single stimulus (as in the case of mere exposure) or 2 or more stimuli (as in the case of evaluative conditioning) have been shown to influence liking. We propose that intersections between regularities represent a previously unrecognized class of procedures for changing liking. Across 4 related studies, we found strong support for the hypothesis that when environmental regularities intersect with one another (i.e., share elements or have elements that share relations with other elements), the evaluative properties of the elements of those regularities can change. These changes in liking were observed across a range of stimuli and procedures and were evident when self-report measures, implicit measures, and behavioral choice measures of liking were employed. Functional and mental explanations of this phenomenon are offered followed by a discussion of how this new type of evaluative learning effect can accelerate theoretical, methodological, and empirical development in attitude research. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

20 CFR 220.21 - Initial evaluation of a previous occupational disability.

Code of Federal Regulations, 2013 CFR

2013-04-01

... his left leg in an automobile accident which occurred on June 16, 1982. For a period of 18 months following the accident the claimant underwent 2 surgical procedures which restored the functional use of his... facts disclosed above, beginning June 16, 1982 (the date of the automobile accident). The claimant files...

20 CFR 220.21 - Initial evaluation of a previous occupational disability.

Code of Federal Regulations, 2014 CFR

2014-04-01

... his left leg in an automobile accident which occurred on June 16, 1982. For a period of 18 months following the accident the claimant underwent 2 surgical procedures which restored the functional use of his... facts disclosed above, beginning June 16, 1982 (the date of the automobile accident). The claimant files...

20 CFR 220.21 - Initial evaluation of a previous occupational disability.

Code of Federal Regulations, 2011 CFR

2011-04-01

... his left leg in an automobile accident which occurred on June 16, 1982. For a period of 18 months following the accident the claimant underwent 2 surgical procedures which restored the functional use of his... facts disclosed above, beginning June 16, 1982 (the date of the automobile accident). The claimant files...

20 CFR 220.21 - Initial evaluation of a previous occupational disability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... his left leg in an automobile accident which occurred on June 16, 1982. For a period of 18 months following the accident the claimant underwent 2 surgical procedures which restored the functional use of his... facts disclosed above, beginning June 16, 1982 (the date of the automobile accident). The claimant files...

20 CFR 220.21 - Initial evaluation of a previous occupational disability.

Code of Federal Regulations, 2012 CFR

2012-04-01

... his left leg in an automobile accident which occurred on June 16, 1982. For a period of 18 months following the accident the claimant underwent 2 surgical procedures which restored the functional use of his... facts disclosed above, beginning June 16, 1982 (the date of the automobile accident). The claimant files...

An Exploration of Definition and Procedural Fluency in Integral Calculus

ERIC Educational Resources Information Center

Grundmeier, Todd A.; Hansen, Jennifer; Sousa, Emily

2006-01-01

A survey was administered to calculus students who had previously been exposed to a course on integral calculus. The purpose of the survey was to explore students' understanding of the definition of a definite integral, their abilities to evaluate definite integrals, and their graphical interpretations of definite integrals. The analysis of…

[Utility of digital thoracotomy in chest trauma].

PubMed

Vélez, Sebastián E; Sarquis, Guillermo

2006-01-01

toracostomy in thoracic trauma is a good opportunity for the digital exploration of pleural cavity. To evaluate the utility of digital exploration during chest tube insertion in thoracic trauma. Hospital de Urgencias. Córdoba. patients with blunt and penetrating chest trauma by stab wound, who need chest tube insertion and treated by only one surgeon, were evaluated from July 10 to December 31st 2000. Previously to the thoracostomy with 24 french tube in 5th intercostal space, at the affected side, a digital exploration of pleural cavity was done, attempting to find intrathoracic injuries. in a six months period, 36 thoracostomy tubes were placed, due thoracic trauma (11 blunt trauma and 25 penetrating, by stab wound). Three patients had positive findings in the digital exploration, which forced to do another diagnostic or therapeutic procedures. digital thoracotomy is not considered a formal procedure, but as a part of a technique, in which, the previous exploration with the finger before chest tube insertion, allows to reach a diagnosis of the pleural space situation, to confirm suspicions, to modify a conduct, and to avoid greater morbidity to patients.

Reward, cost, and self-evaluation procedures for disruptive adolescents in a psychiatric hospital school1

PubMed Central

Kaufman, Kenneth F.; O'Leary, K. Daniel

1972-01-01

Sixteen pupils in a psychiatric hospital were assigned to two tutorial reading classes and balanced on six pupil characteristics and teacher preferences for the children. The effects of reward and cost procedures in a token program were assessed using both within- and between-subject comparisons in the following phases: (1) Baseline; (2) Token I, teacher evaluated and reinforced children for appropriate behavior; (3) Withdrawal of Tokens; (4) Token II, same as Token I; (5) Token III, same as Token I and II, but switched order of class meeting time; and (6) Self-Evaluation, students rated their own behavior and received prizes based on their rating, rather than the teacher's rating. The token program was markedly successful in reducing disruptive behavior and in increasing reading skills in both the Reward and Cost Classes, but there were no significant differences in the effects of the reward versus the cost procedure. While cost may be seen as a punishment procedure, there were no adverse side effects observed in the Cost Class at any time when the token program was in effect. The order of the classes was unrelated to the level of disruptive behavior or academic progress. The Self-Evaluative Phase, in which the students rated their own behavior, was included as an alternative to the abrupt withdrawal of tokens. In this phase, disruptive behavior remained at the previous low level. PMID:16795351

The AME2016 atomic mass evaluation (I). Evaluation of input data; and adjustment procedures

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

Huang, W. J.; Audi, G.; Wang, Meng

This paper is the first of two articles (Part I and Part II) that presents the results of the new atomic mass evaluation, Ame2016. It includes complete information on the experimental input data (also including unused and rejected ones), as well as details on the evaluation procedures used to derive the tables of recommended values given in the second part. This article describes the evaluation philosophy and procedures that were implemented in the selection of specific nuclear reaction, decay and mass-spectrometric results. These input values were entered in the least-squares adjustment for determining the best values for the atomic massesmore » and their uncertainties. Details of the calculation and particularities of the Ame are then described. All accepted and rejected data, including outweighted ones, are presented in a tabular format and compared with the adjusted values obtained using the least-squares fit analysis. Differences with the previous Ame2012 evaluation are discussed and specific information is presented for several cases that may be of interest to Ame users. The second Ame2016 article gives a table with the recommended values of atomic masses, as well as tables and graphs of derived quantities, along with the list of references used in both the Ame2016 and the Nubase2016 evaluations (the first paper in this issue). Amdc: http://amdc.impcas.ac.cn/« less

Evaluation of the localization auditory screening test in children 6-18 months of age.

PubMed

Tillis, C H; Grimm, W A

1978-01-01

The present paper is a report of a project to develop an automated auditory screening test for infants six to 18 months of age. The first year of the project was devoted to developing equipment and test procedures; the second year was concerned with testing the effectiveness of the equipment and procedures on an actual population of six to 18 month old infants. Two-hundred and fifty infants were screened auditorily as part of a county health department child development clinic. The pass/fail results of the screening test were evaluated in terms of physical and developmental examination following the screening and by means of a case review of the child's previous history. The results indicate that the procedure under investigation can be used to differentiate the normal hearing infant from the infant with possible hearing problems. It is shown by the test environment in which this study was conducted that the procedure reported can be successfully incorporated into a public health program, i.e., child development clinics or EPSDT programs.

Individual and population pharmacokinetic compartment analysis: a graphic procedure for quantification of predictive performance.

PubMed

Eksborg, Staffan

2013-01-01

Pharmacokinetic studies are important for optimizing of drug dosing, but requires proper validation of the used pharmacokinetic procedures. However, simple and reliable statistical methods suitable for evaluation of the predictive performance of pharmacokinetic analysis are essentially lacking. The aim of the present study was to construct and evaluate a graphic procedure for quantification of predictive performance of individual and population pharmacokinetic compartment analysis. Original data from previously published pharmacokinetic compartment analyses after intravenous, oral, and epidural administration, and digitized data, obtained from published scatter plots of observed vs predicted drug concentrations from population pharmacokinetic studies using the NPEM algorithm and NONMEM computer program and Bayesian forecasting procedures, were used for estimating the predictive performance according to the proposed graphical method and by the method of Sheiner and Beal. The graphical plot proposed in the present paper proved to be a useful tool for evaluation of predictive performance of both individual and population compartment pharmacokinetic analysis. The proposed method is simple to use and gives valuable information concerning time- and concentration-dependent inaccuracies that might occur in individual and population pharmacokinetic compartment analysis. Predictive performance can be quantified by the fraction of concentration ratios within arbitrarily specified ranges, e.g. within the range 0.8-1.2.

Correlation, evaluation, and extension of linearized theories for tire motion and wheel shimmy

NASA Technical Reports Server (NTRS)

Smiley, Robert F

1957-01-01

An evaluation is made of the existing theories of a linearized tire motion and wheel shimmy. It is demonstrated that most of the previously published theories represent varying degrees of approximation to a summary theory developed in this report which is a minor modification of the basic theory of Von Schlippe and Dietrich. In most cases where strong differences exist between the previously published theories and summary theory, the previously published theories are shown to possess certain deficiencies. A series of systematic approximations to the summary theory is developed for the treatment of problems too simple to merit the use of the complete summary theory, and procedures are discussed for applying the summary theory and its systematic approximations to the shimmy of more complex landing-gear structures than have previously been considered. Comparisons of the existing experimental data with the predictions of the summary theory and the systematic approximations provide a fair substantiation of the more detailed approximate theories.

40 CFR 80.131 - Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously...

Code of Federal Regulations, 2010 CFR

2010-07-01

..., certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline... Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline, and butane blenders. (a) Attest procedures for GTAB. The following are...

40 CFR 80.131 - Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously...

Code of Federal Regulations, 2011 CFR

2011-07-01

..., certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline... Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline, and butane blenders. (a) Attest procedures for GTAB. The following are...

40 CFR 80.131 - Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously...

Code of Federal Regulations, 2013 CFR

2013-07-01

..., certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline... Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline, and butane blenders. (a) Attest procedures for GTAB. The following are...

40 CFR 80.131 - Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously...

Code of Federal Regulations, 2012 CFR

2012-07-01

..., certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline... Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline, and butane blenders. (a) Attest procedures for GTAB. The following are...

40 CFR 80.131 - Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously...

Code of Federal Regulations, 2014 CFR

2014-07-01

..., certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline... Agreed upon procedures for GTAB, certain conventional gasoline imported by truck, previously certified gasoline used to produce gasoline, and butane blenders. (a) Attest procedures for GTAB. The following are...

An evaluation of the hemiplegic subject based on the Bobath approach. Part III. A validation study.

PubMed

Arsenault, A B; Dutil, E; Lambert, J; Corriveau, H; Guarna, F; Drouin, G

1988-01-01

Sixty-two hemiplegic subjects were treated with the Bobath approach for a period of three months. During this time they were evaluated on three occasions. The testing battery consisted of a Bobath evaluation, the Brunnstrom scale, the Fugl-Meyer test, the Upper Extremity Functional Test (UEFT) and the Present Pain Intensity (PPI) of the McGill pain questionnaire. A Friedman analysis of variance showed that, except for pain, all the protocols used disclosed significant progress (p less than 0.001) over time in terms of motor recovery. Except for pain, the results of the Bobath evaluation were significantly correlated (Spearman's Rho, p less than 0.001) with the results of the other testing procedures. It is concluded that the new Bobath evaluation proposed in a previous paper is as sensitive in depicting progress in motor recovery over time as are the other testing procedures used. Furthermore, this new evaluation seems to be measuring similar properties to the other tests. However, pain (PPI) appears not to be an important dependent variable.

Item Response Modeling: An Evaluation of the Children's Fruit and Vegetable Self-Efficacy Questionnaire

ERIC Educational Resources Information Center

Watson, Kathy; Baranowski, Tom; Thompson, Debbe

2006-01-01

Perceived self-efficacy (SE) for eating fruit and vegetables (FV) is a key variable mediating FV change in interventions. This study applies item response modeling (IRM) to a fruit, juice and vegetable self-efficacy questionnaire (FVSEQ) previously validated with classical test theory (CTT) procedures. The 24-item (five-point Likert scale) FVSEQ…

Effects of Film Modeling on the Reduction of Anxiety-Related Behaviors in Individuals Varying in Level of Previous Experience in the Stress Situation.

ERIC Educational Resources Information Center

Melamed, Barbara G.; And Others

1978-01-01

Evaluated influence of film preparation on children undergoing dental sessions with respect to peer modeling v demonstration of procedures and amount of information. Children exposed to peer-model videotaped presentations immediately preceding their restorative treatment exhibited fewer disruptive behaviors and less apprehension than those…

A Proposal Comparing a Clinician-Guided Patient Information Module to Standard Patient Information Evaluating Treatment Expectations of Dermal Fillers

ERIC Educational Resources Information Center

Warren, Hermine

2014-01-01

In 2011, nearly 13 million nonsurgical cosmetic procedures were performed, representing a 6% increase from the previous year. Patients often present with unrealistic treatment expectations based on beauty industry standards and misinformation. In addition, due to the lack of competency standardization in this area, providers frequently deliver…

Aortic operation after previous coronary artery bypass grafting: management of patent grafts for myocardial protection.

PubMed

Nakajima, Masato; Tsuchiya, Koji; Fukuda, Shoji; Morimoto, Hironobu; Mitsumori, Yoshitaka; Kato, Kaori

2006-04-01

Aortic surgery for progressive aortic valve disease or aortic aneurysm after previous coronary artery bypass grafting (CABG) is a challenging procedure. We report the outcome of aortic reoperation after previous CABG and evaluate our management of patent grafts and our methods for obtaining myocardial protection. From February 2001 to July 2003, 6 patients with progressive aortic valve disease and aneurysm of the thoracic aorta were operated on. The group comprised 3 men and 3 women with a mean age of 67.6 years. There were 4 patients with an aneurysm of the aortic arch, 1 with chronic ascending aortic dissection, and 1 with progressive aortic valve stenosis. The interval between previous CABG and aortic surgery was 74.0 +/- 44.2 months. All reoperations were performed via median resternotomy. Myocardial protection was obtained by hypothermic perfusion of patent in-situ arterial grafts following cold-blood cardioplegia administration via the aortic root under aortic cross clamping. The operative procedure was aortic arch replacement in 4 patients, ascending aortic replacement with double CABG in 1, and aortic valve replacement in 1. All patients survived the reoperation. Postoperative maximum creatine kinase-MB was 49.2 +/- 29.8 and no new Q-waves occurred in the electrocardiogram nor were any new wall motion abnormalities recognized on echocardiography. There were no late deaths during a follow-up of 30.7 months. Reoperative aortic procedures after CABG can be performed safely with myocardial protection via hypothermic perfusion of a patent in-situ arterial graft.

A simplified procedure for correcting both errors and erasures of a Reed-Solomon code using the Euclidean algorithm

NASA Technical Reports Server (NTRS)

Truong, T. K.; Hsu, I. S.; Eastman, W. L.; Reed, I. S.

1987-01-01

It is well known that the Euclidean algorithm or its equivalent, continued fractions, can be used to find the error locator polynomial and the error evaluator polynomial in Berlekamp's key equation needed to decode a Reed-Solomon (RS) code. A simplified procedure is developed and proved to correct erasures as well as errors by replacing the initial condition of the Euclidean algorithm by the erasure locator polynomial and the Forney syndrome polynomial. By this means, the errata locator polynomial and the errata evaluator polynomial can be obtained, simultaneously and simply, by the Euclidean algorithm only. With this improved technique the complexity of time domain RS decoders for correcting both errors and erasures is reduced substantially from previous approaches. As a consequence, decoders for correcting both errors and erasures of RS codes can be made more modular, regular, simple, and naturally suitable for both VLSI and software implementation. An example illustrating this modified decoding procedure is given for a (15, 9) RS code.

Preparation and characterization of electrodes for the NASA Redox storage system

NASA Technical Reports Server (NTRS)

Reid, M. A.; Gahn, R. F.; Ling, J. S.; Charleston, J.

1980-01-01

Electrodes for the Redox energy storage system based on iron and chromium chloride reactants is discussed. The physical properties of several lots of felt were determined. Procedures were developed for evaluating electrode performance in lab scale cells. Experimental procedures for evaluating electrodes by cyclic voltammetry are described which minimize the IR losses due to the high internal resistance in the felt (distributed resistance). Methods to prepare electrodes which reduced the coevolution of hydrogen at the chromium electrode and eleminate the drop in voltage on discharge occasionally seen with previous electrodes were discussed. Single cells of 0.3329 ft area with improved membranes and electrodes are operating at over 80% voltage efficiency and coulombic efficiencies of over 98% at current densities of 16 to 20 amp % ft.

Greater physician involvement improves coding outcomes in endobronchial ultrasound-guided transbronchial needle aspiration procedures.

PubMed

Pillai, Anilkumar; Medford, Andrew R L

2013-01-01

Correct coding is essential for accurate reimbursement for clinical activity. Published data confirm that significant aberrations in coding occur, leading to considerable financial inaccuracies especially in interventional procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Previous data reported a 15% coding error for EBUS-TBNA in a U.K. service. We hypothesised that greater physician involvement with coders would reduce EBUS-TBNA coding errors and financial disparity. The study was done as a prospective cohort study in the tertiary EBUS-TBNA service in Bristol. 165 consecutive patients between October 2009 and March 2012 underwent EBUS-TBNA for evaluation of unexplained mediastinal adenopathy on computed tomography. The chief coder was prospectively electronically informed of all procedures and cross-checked on a prospective database and by Trust Informatics. Cost and coding analysis was performed using the 2010-2011 tariffs. All 165 procedures (100%) were coded correctly as verified by Trust Informatics. This compares favourably with the 14.4% coding inaccuracy rate for EBUS-TBNA in a previous U.K. prospective cohort study [odds ratio 201.1 (1.1-357.5), p = 0.006]. Projected income loss was GBP 40,000 per year in the previous study, compared to a GBP 492,195 income here with no coding-attributable loss in revenue. Greater physician engagement with coders prevents coding errors and financial losses which can be significant especially in interventional specialties. The intervention can be as cheap, quick and simple as a prospective email to the coding team with cross-checks by Trust Informatics and against a procedural database. We suggest that all specialties should engage more with their coders using such a simple intervention to prevent revenue losses. Copyright © 2013 S. Karger AG, Basel.

[The most effective dosage in the administration of PGF2-alpha for interruption of pregnancy during the 2d trimester].

PubMed

Herczeg, J; Szontágh, F

1974-06-23

Artificial interruption of pregnancy contains too many risks from the 12th week of pregnancy. The authors have been working at finding the most suitable and effective dosage of prostaglandin for the interruption of pregnancy during the 2nd trimester. The new dosage experimented was 25 mg of prostaglandin F2alpha, followed by another 25 mg 6 hours later. The clinical efficiency of this dosage was tested. This procedures was used in 45 cases. The efficiency of the method was compared to the efficiency of the previously used dosage, which was 25 mg of prostaglandin F2alpha, followed by 25 mg 24 hours later. The new dosage was evaluated 91% efficient, while the previous dosage was found to be 75% efficient. The side effects were rated as acceptable by the patients. There was no case of infection. Two undeniable advantages were found with this new dosage: the duration of the actual procedure is considerably reduced, and the method appears to be much safer. The authors conclude that this new procedure offers numerous clinical advantages.

A Mapmark method of standard setting as implemented for the National Assessment Governing Board.

PubMed

Schulz, E Matthew; Mitzel, Howard C

2011-01-01

This article describes a Mapmark standard setting procedure, developed under contract with the National Assessment Governing Board (NAGB). The procedure enhances the bookmark method with spatially representative item maps, holistic feedback, and an emphasis on independent judgment. A rationale for these enhancements, and the bookmark method, is presented, followed by a detailed description of the materials and procedures used in a meeting to set standards for the 2005 National Assessment of Educational Progress (NAEP) in Grade 12 mathematics. The use of difficulty-ordered content domains to provide holistic feedback is a particularly novel feature of the method. Process evaluation results comparing Mapmark to Anghoff-based methods previously used for NAEP standard setting are also presented.

24 CFR 200.213 - Applicability of procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Previous Participation Review and Clearance Procedure § 200.213 Applicability of procedure. The Previous Participation Review and Clearance procedure set forth in this part is administered by the Assistant Secretary... 887, which are tenant-based programs); (d) Sales of projects by the Secretary, including “all cash...

[The complex origin of ventricular tachycardia after the total correction of tetralogy of Fallot].

PubMed

Ressia, L; Graffigna, A; Salerno-Uriarte, J A; Viganò, M

1993-09-01

Two patients underwent surgical treatment of ventricular tachycardia after repair of tetralogy of Fallot. Both patients had right bundle branch block, moderate pulmonary valve incompetence and right ventricular dilatation, and were refractory to electrophysiologically guided drug therapy. Both patients underwent intraoperative epicardial mapping, which located the arrhythmogenic focus on the right ventricular outflow tract, on the border of the previous ventriculotomy. In one patient removal of the previous scar and endocardial cryoablation was successful in ablating the arrhythmia. In the other, the same procedure was only temporarily effective. VT recurred and was subsequently identified at the superior border of the closed ventricular septal defect. It was ablated by means of transcatheter radiofrequency. While VT from foci located on the right ventricular free wall can be easily detected and ablated, septal origin of VT requires extensive preoperative and intraoperative electrophysiological evaluation and may necessitate combined surgical and transcatheter procedures.

Current Performance Characteristics of NASA Langley Research Center's Cockpit Motion Base and Standardized Test Procedure for Future Performance Characterization

NASA Technical Reports Server (NTRS)

Cowen, Brandon; Stringer, Mary T.; Hutchinson, Brian K.; Davidson, Paul C.; Gupton, Lawrence E.

2014-01-01

This report documents the updated performance characteristics of NASA Langley Research Center's (LaRC) Cockpit Motion Base (CMB) after recent revisions that were made to its inner-loop, feedback control law. The modifications to the control law will be briefly described. The performance of the Cockpit Motion Facility (CMF) will be presented. A short graphical comparison to the previous control law can be found in the appendix of this report. The revised controller will be shown to yield reduced parasitic accelerations with respect to the previous controller. Metrics based on the AGARD Advisory Report No. 144 are used to assess the overall system performance due to its recent control algorithm modification. This report also documents the standardized simulator test procedure which can be used in the future to evaluate potential updates to the control law.

Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies.

PubMed

Hulme, Paul A; Krebs, Jörg; Ferguson, Stephen J; Berlemann, Ulrich

2006-08-01

Systematic literature review. To evaluate the safety and efficacy of vertebroplasty and kyphoplasty using the data presented in published clinical studies, with respect to patient pain relief, restoration of mobility and vertebral body height, complication rate, and incidence of new adjacent vertebral fractures. Vertebroplasty and kyphoplasty have been gaining popularity for treating vertebral fractures. Current reviews provide an overview of the procedures but are not comprehensive and tend to rely heavily on personal experience. This article aimed to compile all available data and evaluate the clinical outcome of the 2 procedures. This is a systematic review of all the available data presented in peer-reviewed published clinical trials. The methodological quality of included studies was evaluated, and data were collected targeting specific standard measurements. Where possible, a quantitative aggregation of the data was performed. A large proportion of subjects had some pain relief, including 87% with vertebroplasty and 92% with kyphoplasty. Vertebral height restoration was possible using kyphoplasty (average 6.6 degrees ) and for a subset of patients using vertebroplasty (average 6.6 degrees ). Cement leaks occurred for 41% and 9% of treated vertebrae for vertebroplasty and kyphoplasty, respectively. New fractures of adjacent vertebrae occurred for both procedures at rates that are higher than the general osteoporotic population but approximately equivalent to the general osteoporotic population that had a previous vertebral fracture. The problem with stating definitely that vertebroplasty and kyphoplasty are safe and effective procedures is the lack of comparative, blinded, randomized clinical trials. Standardized evaluative methods should be adopted.

Comparison of acceptance, preference and efficacy between pressure anesthesia and classical needle infiltration anesthesia for dental restorative procedures in adult patients

PubMed Central

Makade, Chetana Sachin; Shenoi, Pratima R; Gunwal, Mohit K

2014-01-01

Introduction: Intraoral local anesthesia is essential for delivering dental care. Needless devices have been developed to provide anesthesia without injections. Little controlled research is available on its use in dental restorative procedures in adult patients. The aims of this study were to compare adult patients acceptability and preference for needleless jet injection with classical local infiltration as well as to evaluate the efficacy of the needleless anesthesia. Materials and Methods: Twenty non fearful adults with no previous experience of dental anesthesia were studied using split-mouth design. The first procedure was performed with classical needle infiltration anesthesia. The same amount of anesthetic solution was administered using MADA jet needleless device in a second session one week later, during which a second dental restorative procedure was performed. Patients acceptance was assessed using Universal pain assessment tool while effectiveness was recorded using soft tissue anesthesia and pulpal anesthesia. Patients reported their preference for the anesthetic method at the third visit. The data was evaluated using chi square test and student's t-test. Results: Pressure anesthesia was more accepted and preferred by 70% of the patients than traditional needle anesthesia (20%). Both needle and pressure anesthesia was equally effective for carrying out the dental procedures. Conclusion: Patients experienced significantly less pain and fear (p<0.01) during anesthetic procedure with pressure anesthesia. However, for more invasive procedures needle anesthesia will be more effective. PMID:24778516

Dermal and inhalation acute toxic class methods: test procedures and biometric evaluations for the Globally Harmonized Classification System.

PubMed

Holzhütter, H G; Genschow, E; Diener, W; Schlede, E

2003-05-01

The acute toxic class (ATC) methods were developed for determining LD(50)/LC(50) estimates of chemical substances with significantly fewer animals than needed when applying conventional LD(50)/LC(50) tests. The ATC methods are sequential stepwise procedures with fixed starting doses/concentrations and a maximum of six animals used per dose/concentration. The numbers of dead/moribund animals determine whether further testing is necessary or whether the test is terminated. In recent years we have developed classification procedures for the oral, dermal and inhalation routes of administration by using biometric methods. The biometric approach assumes a probit model for the mortality probability of a single animal and assigns the chemical to that toxicity class for which the best concordance is achieved between the statistically expected and the observed numbers of dead/moribund animals at the various steps of the test procedure. In previous publications we have demonstrated the validity of the biometric ATC methods on the basis of data obtained for the oral ATC method in two-animal ring studies with 15 participants from six countries. Although the test procedures and biometric evaluations for the dermal and inhalation ATC methods have already been published, there was a need for an adaptation of the classification schemes to the starting doses/concentrations of the Globally Harmonized Classification System (GHS) recently adopted by the Organization for Economic Co-operation and Development (OECD). Here we present the biometric evaluation of the dermal and inhalation ATC methods for the starting doses/concentrations of the GHS and of some other international classification systems still in use. We have developed new test procedures and decision rules for the dermal and inhalation ATC methods, which require significantly fewer animals to provide predictions of toxicity classes, that are equally good or even better than those achieved by using the conventional LD(50)/LC(50) methods. In order to cope with rather narrow dose/concentration classes of the GHS we have, as in our previous publications, combined the outcome of all results that can be obtained during testing for the allocation to one of the defined toxicity classes of the GHS. Our results strongly recommend the deletion of the dermal LD(50) and the inhalation LC(50) test as regulatory tests and the adoption of the dermal and inhalation ATC methods as internationally accepted alternatives.

Assisted reproductive technologies: medical safety issues in the older woman.

PubMed

Segev, Yakir; Riskin-Mashiah, Shlomit; Lavie, Ofer; Auslender, Ron

2011-06-01

Abstract Previous study has shown that in the United States, most maternal deaths and severe obstetric complications due to chronic disease are potentially preventable through improved medical care before conception. Many women who need assisted reproductive technology (ART) because of infertility are older than the average pregnant woman. Risks for such chronic diseases as obesity, diabetes mellitus, chronic hypertension, cardiovascular disease (CVD), and malignancy greatly increase with maternal age. Chronic illness increases the risk of the in vitro fertilization (IVF) procedure and is also associated with increased obstetric risk and even death. The objective of this review is to outline the potential risks for older women who undergo ART procedures and pregnancy and to characterize guidelines for evaluation before enrollment in ART programs. A PubMed search revealed that very few studies have related to pre-ART medical evaluation. Therefore, we suggest a pre-ART medical assessment, comparable to the recommendations of the American Heart Association before noncompetitive physical activity and the American Society of Anesthesiologists before elective surgery. This assessment should include a thorough medical questionnaire and medical examination. Further evaluation and treatment should follow to ensure the safety of ART procedures and of ensuing pregnancies.

Enhanced automated platform for 2D characterization of RFID communications

NASA Astrophysics Data System (ADS)

Vuza, Dan Tudor; Vlǎdescu, Marian

2016-12-01

The characterization of the quality of communication between an RFID reader and a transponder at all expected positions of the latter on the reader antenna is of primal importance for the evaluation of performance of an RFID system. Continuing the line of instruments developed for this purpose by the authors, the present work proposes an enhanced version of a previously introduced automated platform for 2D evaluation. By featuring higher performance in terms of mechanical speed, the new version allows to obtain 2D maps of communication with a higher resolution that would have been prohibitive in terms of test duration with the previous version. The list of measurement procedures that can be executed with the platform is now enlarged with additional ones, such as the determination of the variation of the magnetic coupling between transponder and antenna across the antenna surface and the utilization of transponder simulators for evaluation of the quality of communication.

Estimation of descriptive statistics for multiply censored water quality data

USGS Publications Warehouse

Helsel, Dennis R.; Cohn, Timothy A.

1988-01-01

This paper extends the work of Gilliom and Helsel (1986) on procedures for estimating descriptive statistics of water quality data that contain “less than” observations. Previously, procedures were evaluated when only one detection limit was present. Here we investigate the performance of estimators for data that have multiple detection limits. Probability plotting and maximum likelihood methods perform substantially better than simple substitution procedures now commonly in use. Therefore simple substitution procedures (e.g., substitution of the detection limit) should be avoided. Probability plotting methods are more robust than maximum likelihood methods to misspecification of the parent distribution and their use should be encouraged in the typical situation where the parent distribution is unknown. When utilized correctly, less than values frequently contain nearly as much information for estimating population moments and quantiles as would the same observations had the detection limit been below them.

Selection for Higher Education in Developing Countries--the Use of Tests in Admission for Pre-Entry Science Upgrading Courses in Botswana, Swaziland and Lesotho.

ERIC Educational Resources Information Center

Altink, Wieby M. M.

The degree of predictive validity and the relationship with previous learning conditions were studied for measures used in admission procedures for upgrading courses in science and mathematics in Botswana, Lesotho, and Swaziland. School results, achievement tests, aptitude tests, and ability tests were evaluated for students leaving secondary…

Real-time intraprocedural 18F-FDG PET/CT-guided biopsy using automated robopsy arm (ARA) in the diagnostic evaluation of thoracic lesions with prior inconclusive biopsy results: initial experience from a tertiary health care centre.

PubMed

Radhakrishnan, Renjith Kalathoorakathu; Mittal, Bhagwant Rai; Gorla, Arun Kumar Reddy; Basher, Rajender Kumar; Sood, Ashwani; Bal, Amanjit; Kalra, Naveen; Khandelwal, Niranjan; Singh, Navneet; Behera, Digambar

2017-12-01

The aim of this study was to assess the feasibility and appraise the diagnostic utility of real time 18 F-FDG PET/CT-guided biopsy under automated robopsy arm (ARA) guidance for the evaluation of thoracic lesions with prior inconclusive biopsy results. PET/CT-guided biopsy of thoracic lesions was performed in patients who had at least one previous inconclusive biopsy. A total of 25 patients (male:female-18 males, 7 females; age: range, 13-75; mean, 53.7) were included in this study. All these patients underwent percutaneous needle biopsies under real-time PET/CT guidance using ARA (ROBIO-EX, Perfint healthcare Pvt Ltd, Chennai, India) needle navigation technique. Histopathology and clinical follow-up results were reviewed for assessing the accuracy of procedures. Adequate representative tissue sample could be retrieved in all the patients. No major procedure-related complications were encountered in any patient. Of the 25 procedures, 21 lesions were positive for malignancy and benign findings were observed in the other 4 lesions on histopathology. None of the patients required further biopsy in arriving at a final diagnosis. Overall diagnostic yield of the procedure was 100%. Real time 18 F-FDG PET/CT guidance for percutaneous biopsies of lung and mediastinal lesions is a feasible technique with potential utility in patients with previous inconclusive biopsy results. Advances in knowledge: 18 F-FDG PET/CT guidance reduces the sampling errors by specifically targeting areas of viability and avoiding necrosis/atelectasis. A navigational tool like ARA is thought to help in accurately targeting these areas.

Accelerated Return to Sport After Osteochondral Autograft Plug Transfer

PubMed Central

Werner, Brian C.; Cosgrove, Chris T.; Gilmore, C. Jan; Lyons, Matthew L.; Miller, Mark D.; Brockmeier, Stephen F.; Diduch, David R.

2017-01-01

Background: Previous studies have reported varying return-to-sport protocols after knee cartilage restoration procedures. Purpose: To (1) evaluate the time for return to sport in athletes with an isolated chondral injury who underwent an accelerated return-to-sport protocol after osteochondral autograft plug transfer (OAT) and (2) evaluate clinical outcomes to assess for any consequences from the accelerated return to sport. Study Design: Case series; Level of evidence, 4. Methods: An institutional cohort of 152 OAT procedures was reviewed, of which 20 competitive athletes met inclusion and exclusion criteria. All patients underwent a physician-directed accelerated rehabilitation program after their procedure. Return to sport was determined for all athletes. Clinical outcomes were assessed using International Knee Documentation Committee (IKDC) and Tegner scores as well as assessment of level of participation on return to sport. Results: Return-to-sport data were available for all 20 athletes; 13 of 20 athletes (65%) were available for clinical evaluation at a mean 4.4-year follow-up. The mean time for return to sport for all 20 athletes was 82.9 ± 25 days (range, 38-134 days). All athletes were able to return to sport at their previous level and reported that they were satisfied or very satisfied with their surgical outcome and ability to return to sport. The mean postoperative IKDC score was 84.5 ± 9.5. The mean Tegner score prior to injury was 8.9 ± 1.7; it was 7.7 ± 1.9 at final follow-up. Conclusion: Competitive athletes with traumatic chondral defects treated with OAT managed using this protocol had reduced time to preinjury activity levels compared with what is currently reported, with excellent clinical outcomes and no serious long-term sequelae. PMID:28451623

Training for percutaneous renal access on a virtual reality simulator.

PubMed

Zhang, Yi; Yu, Cheng-fan; Liu, Jin-shun; Wang, Gang; Zhu, He; Na, Yan-qun

2013-01-01

The need to develop new methods of surgical training combined with advances in computing has led to the development of virtual reality surgical simulators. The PERC Mentor(TM) is designed to train the user in percutaneous renal collecting system access puncture. This study aimed to validate the use of this kind of simulator, in percutaneous renal access training. Twenty-one urologists were enrolled as trainees to learn a fluoroscopy-guided percutaneous renal accessing technique. An assigned percutaneous renal access procedure was immediately performed on the PERC Mentor(TM) after watching instruction video and an analog operation. Objective parameters were recorded by the simulator and subjective global rating scale (GRS) score were determined. Simulation training followed and consisted of 2 hours daily training sessions for 2 consecutive days. Twenty-four hours after the training session, trainees were evaluated performing the same procedure. The post-training evaluation was compared to the evaluation of the initial attempt. During the initial attempt, none of the trainees could complete the appointed procedure due to the lack of experience in fluoroscopy-guided percutaneous renal access. After the short-term training, all trainees were able to independently complete the procedure. Of the 21 trainees, 10 had primitive experience in ultrasound-guided percutaneous nephrolithotomy. Trainees were thus categorized into the group of primitive experience and inexperience. The total operating time and amount of contrast material used were significantly lower in the group of primitive experience versus the inexperience group (P = 0.03 and 0.02, respectively). The training on the virtual reality simulator, PERC Mentor(TM), can help trainees with no previous experience of fluoroscopy-guided percutaneous renal access to complete the virtual manipulation of the procedure independently. This virtual reality simulator may become an important training and evaluation tool in teaching fluoroscopy-guided percutaneous renal access.

The effect of limb amputation on standing weight distribution in the remaining three limbs in dogs.

PubMed

Cole, Grayson Lee; Millis, Darryl

2017-01-16

Despite the fact that limb amputation is a commonly performed procedure in veterinary medicine, quantitative data regarding outcomes are lacking. The intention of this study was to evaluate the effect of limb amputation on weight distribution to the remaining three limbs at a stance in dogs. Ten dogs with a prior forelimb amputation and ten dogs with a prior hindlimb amputation; all of which had no history of orthopaedic or neural disease in the remaining three limbs were included in the study. Standing weight bearing was evaluated with a commercial stance analyzer in all dogs. Five valid trials were obtained and a mean percentage of weight bearing was calculated for each remaining limb. The dogs with a previous forelimb amputation, and also those with a previous hindlimb amputation, had the largest mean increase in weight bearing in the contralateral forelimb. In conclusion, proactive monitoring of orthopaedic disease in the contralateral forelimb may be advisable in dogs with a previous limb amputation. In addition, when determining candidacy for a limb amputation, disease of the contralateral forelimb should be thoroughly evaluated.

Assessment of simple colorimetric procedures to determine smoking status of diabetic subjects.

PubMed

Smith, R F; Mather, H M; Ellard, G A

1998-02-01

The performance of a simple colorimetric assay for urinary nicotine metabolites to assess smoking status in diabetic subjects (n = 251) was investigated. Several variations of the colorimetric assay and a qualitative extraction procedure were evaluated in comparison with a cotinine immunoassay as the "gold standard." Among these, the best overall performance was achieved with the qualitative test (sensitivity 95%; specificity 100%). The quantitative measurement of total nicotine metabolites performed less well (sensitivity 92%; specificity 97%) but could be improved by incorporating a blank extraction (sensitivity 98%; specificity 98%). Allowance for diuresis appeared to offer no advantage over the other methods. These results support previous findings regarding the use of these colorimetric procedures in nondiabetic subjects and, contrary to other recent observations, their performance was not impaired in diabetic patients.

Transfemoral aortic valve implantation in severe aortic stenosis patients with prior mitral valve prosthesis

PubMed Central

Sarı, Cenk; Baştuğ, Serdal; Kasapkara, Hacı Ahmet; Durmaz, Tahir; Keleş, Telat; Akçay, Murat; Aslan, Abdullah Nabi; Bayram, Nihal Akar; Bozkurt, Engin

2015-01-01

Introduction Transcatheter aortic valve implantation for severe symptomatic aortic stenosis in patients with a previous mitral valve prosthesis is technically challenging, and pre-procedural comprehensive assessment of these patients before transcatheter aortic valve implantation is vital for an uncomplicated and successful procedure. Aim We want to share our experience with transcatheter aortic valve implantation in patients with a preexisting functional mitral valve prosthesis and describe a series of important technical and pre-procedural details. Material and methods At our center, 135 patients with symptomatic severe aortic stenosis were treated with transcatheter aortic valve implantation. Six of them with a preexisting mitral valve prosthesis received an Edwards SAPIEN XT valve through the transfemoral route. Results Transcatheter aortic valve implantation was performed successfully in all 6 patients without any deformation of the cobalt-chromium/steel stents of the aortic valve bioprosthesis. Also no distortion or malfunction in the mitral valve prosthesis was observed after the procedure. There were no complications during the hospitalization period. Post-procedural echocardiography revealed no or mild aortic paravalvular regurgitation and normal valve function in all the patients. In addition, serial echocardiographic examination demonstrated that both the stability and function of the aortic and mitral prosthetic valves were normal without any deterioration in the gradients and the degree of the regurgitation at long-term follow-ups. Conclusions Our experience confirms that transcatheter aortic valve implantation is technically feasible in patients with previous mitral valve replacement but comprehensive evaluation of patients by multimodal imaging techniques such as transesophageal echocardiography and multislice computed tomography is mandatory for a successful and safe procedure. PMID:26677380

Prospective clinical observational study evaluating gender-associated differences of preoperative pain intensity.

PubMed

Tafelski, Sascha; Kerper, Léonie F; Salz, Anna-Lena; Spies, Claudia; Reuter, Eva; Nachtigall, Irit; Schäfer, Michael; Krannich, Alexander; Krampe, Henning

2016-07-01

Previous studies reported conflicting results concerning different pain perceptions of men and women. Recent research found higher pain levels in men after major surgery, contrasted by women after minor procedures. This trial investigates differences in self-reported preoperative pain intensity between genders before surgery.Patients were enrolled in 2011 and 2012 presenting for preoperative evaluation at the anesthesiological assessment clinic at Charité University hospital. Out of 5102 patients completing a computer-assisted self-assessment, 3042 surgical patients with any preoperative pain were included into this prospective observational clinical study. Preoperative pain intensity (0-100 VAS, visual analog scale) was evaluated integrating psychological cofactors into analysis.Women reported higher preoperative pain intensity than men with median VAS scores of 30 (25th-75th percentiles: 10-52) versus 21 (10-46) (P < 0.001). Adjusted multiple regression analysis showed that female gender remained statistically significantly associated with higher pain intensity (P < 0.001). Gender differences were consistent across several subgroups especially with varying patterns in elderly. Women scheduled for minor and moderate surgical procedures showed largest differences in overall pain compared to men.This large clinical study observed significantly higher preoperative pain intensity in female surgical patients. This gender difference was larger in the elderly potentially contradicting the current hypothesis of a primary sex-hormone derived effect. The observed variability in specific patient subgroups may help to explain heterogeneous findings of previous studies.

Feasibility and safety of general anesthesia for bronchial thermoplasty: a description of early 10 treatments.

PubMed

Aizawa, Mariko; Ishihara, Satoshi; Yokoyama, Takeshi; Katayama, Katsuyuki

2018-03-20

Bronchial thermoplasty (BT) is a recently introduced bronchoscopic treatment for patients with asthma refractory to pharmacotherapy. Intraprocedural sedation management is important for successful performance of BT. However, the results of general anesthesia in patients undergoing BT have not been well described. The aim of this study was to evaluate the feasibility and safety of general anesthesia in patients undergoing BT. We retrospectively reviewed the records of 10 consecutive BT treatments performed under general anesthesia in 4 patients. The feasibility outcomes were coughing and body movement during the procedure, procedure abandonment, and the relative frequency of thermal activation failure. The safety outcomes were bronchospasm and hypoxemia during the procedure, respiratory symptoms, and the need for oxygen after the procedure. Coughing occurred in two treatments. Neither body movement nor procedure abandonment occurred in any treatments. Neither intraprocedural bronchospasm nor hypoxemia occurred in any treatments. Respiratory symptoms occurred in 7 of 10 treatments within 1 day after the procedure and resolved within 4 days, which is comparable with a previous report. These results indicate that general anesthesia is feasible and safe for patients undergoing BT.

Evaluation of Hands-Free Devices for the Display of Maintenance Procedures

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Hoffman, Ronald B.; Litaker, Harry, Jr.; Solem, Jody; Holden, Kritina; Twyford, Evan; Conlee, Carl

2007-01-01

Over the past year, NASA's focus has turned to crewed long duration and exploration missions. On these journeys, crewmembers will be required to execute thousands of procedures to maintain life support systems, check out space suits, conduct science experiments, and perform medical exams. To support the many complex tasks crewmembers undertake in microgravity, NASA is interested in providing crewmembers a hands-free work environment to promote more efficient operations. The overarching objective is to allow crewmembers to use both of their hands for tasks related to their mission, versus holding a paper manual or interacting with a display. The use of advanced, hands-free tools will undoubtedly make the crewmembers task easier, but they can also add to overall task complexity if not properly designed. A leading candidate technology for supporting a hands-free environment is the Head-Mounted Display (HMD). A more recent technology (e-book reader) that could be easily temp-stowed near the work area is also a potential hands-free solution. Previous work at NASA involved the evaluation of several commercially available HMDs for visual quality, comfort, and fit, as well as suitability for use in microgravity. Based on results from this work, three HMDs were selected for further evaluation (along with an e-book reader), using International Space Station (ISS)-like maintenance procedures. Two evaluations were conducted in the Space Station Mockup and Trainer Facility (SSMTF) located at the NASA Johnson Space Center (building 9). The SSMTF is a full scale, medium fidelity replica of the pressurized portions of the ISS. It supports crew training such as ingress and egress, habitability, and emergency procedures. In each of the two evaluations, the participants performed two maintenance procedures. One maintenance procedure involved inspecting air filters in a life support system and replacing them with a clean filter if one were found to be contaminated. The second maintenance procedure focused on working in a confined space; specifically, pulling down a rack to inspect wiring configurations, and rewiring in a different pattern. The maintenance procedures were selected to assess mobility, tool use, and access to multiple document sources during task performance. That is, the participant had to move from rack to rack, use a wrench, a camera, etc., replace components, and refer to diagrams to complete tasks. A constraint was imposed that the ISS-like format of the procedures was to be retained, and not modified or optimized for the electronic device ("plug and play" approach). This was based on future plans to test with real procedures on ISS.

Prospective Study of Combined Colon and Endometrial Cancer Screening in Women With Lynch Syndrome: A Patient-Centered Approach

PubMed Central

Huang, Marilyn; Sun, Charlotte; Boyd-Rogers, Stephanie; Burzawa, Jennifer; Milbourne, Andrea; Keeler, Elizabeth; Yzquierdo, Rebecca; Lynch, Patrick; Peterson, Susan K.; Lu, Karen

2011-01-01

Background: Endometrial and colorectal cancers are the most common cancers in Lynch syndrome. Consensus guidelines recommend annual endometrial biopsy (EMB) and regular colonoscopies. We assessed the feasibility of concurrently performing EMB and colonoscopy and evaluated women's perception of pain, satisfaction, and acceptability. Methods: From July 2002 to December 2009, women who had a gene mutation for Lynch syndrome, met the Amsterdam II criteria, or had a high-risk situation that required screening were prospectively enrolled. After conscious sedation, the procedures were sequentially performed. Patients completed pre- and postprocedure questionnaires assessing pain, level of satisfaction, and acceptability. The Wilcoxon rank test and Mann-Whitney test were used to compare pain scores. Results: Forty-two women completed the study. Median age was 37 years (range, 25 to 73). Nineteen had previously had an EMB in the office setting. Women reported significantly lower median levels of pain in the combined procedure compared with previous office setting biopsies (P < .001). Regardless of parity, women reported significantly less pain for an EMB as part of the combined screen compared with an office EMB (parous, P = .003; nulliparous, P = .026). Women also reported a high level of satisfaction and more convenience in the combined procedure. All participants preferred combined to separately scheduled procedures and would recommend the combined procedure to their relatives. Conclusion: Combined colon and endometrial cancer screening is a patient-centered approach that is feasible, acceptable, and may improve adherence to Lynch syndrome screening recommendations. PMID:21532810

Trans-catheter aortic valve implantation after previous aortic homograft surgery.

PubMed

Drews, Thorsten; Pasic, Miralem; Buz, Semih; Unbehaun, Axel

2011-12-01

In patients with previous heart surgery, the operative risk is elevated during conventional aortic valve re-operations. Trans-catheter aortic valve implantation is a new method for the treatment of high-risk patients. Nevertheless, this new procedure carries potential risks in patients with previous homograft implantation in aortic position. Between April 2008 and February 2011, 345 consecutive patients (mean EuroSCORE (European System for Cardiac Operative Risk Evaluation): 38 ± 20%; mean Society of Thoracic Surgeons (STS) Mortality Score: 19 ± 16%; mean age: 80 ± 8 years; 111 men and 234 women) underwent trans-apical aortic valve implantation. In three patients, previous aortic homograft implantation had been performed. Homograft degeneration causing combined valve stenosis and incompetence made re-operation necessary. In all three patients, the aortic valve could be implanted using the trans-apical approach, and the procedure was successful. In two patients, there was slight paravalvular leakage of the aortic prosthesis and the other patient had slight central leakage. Neither ostium obstruction nor mitral valve damage was observed. Trans-catheter valve implantation can be performed successfully after previous homograft implantation. Particular care should be taken to achieve optimal valve positioning, not to obstruct the ostium of the coronary vessels due to the changed anatomic situation and not to cause annulus rupture. Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

DIRAC: A new version of computer algebra tools for studying the properties and behavior of hydrogen-like ions

NASA Astrophysics Data System (ADS)

McConnell, Sean; Fritzsche, Stephan; Surzhykov, Andrey

2010-03-01

During recent years, the DIRAC package has proved to be an efficient tool for studying the structural properties and dynamic behavior of hydrogen-like ions. Originally designed as a set of MAPLE procedures, this package provides interactive access to the wave and Green's functions in the non-relativistic and relativistic frameworks and supports analytical evaluation of a large number of radial integrals that are required for the construction of transition amplitudes and interaction cross sections. We provide here a new version of the DIRAC program which is developed within the framework of MATHEMATICA (version 6.0). This new version aims to cater to a wider community of researchers that use the MATHEMATICA platform and to take advantage of the generally faster processing times therein. Moreover, the addition of new procedures, a more convenient and detailed help system, as well as source code revisions to overcome identified shortcomings should ensure expanded use of the new DIRAC program over its predecessor. New version program summaryProgram title: DIRAC Catalogue identifier: ADUQ_v2_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADUQ_v2_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC license, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 45 073 No. of bytes in distributed program, including test data, etc.: 285 828 Distribution format: tar.gz Programming language: Mathematica 6.0 or higher Computer: All computers with a license for the computer algebra package Mathematica (version 6.0 or higher) Operating system: Mathematica is O/S independent Classification: 2.1 Catalogue identifier of previous version: ADUQ_v1_0 Journal reference of previous version: Comput. Phys. Comm. 165 (2005) 139 Does the new version supersede the previous version?: Yes Nature of problem: Since the early days of quantum mechanics, the "hydrogen atom" has served as one of the key models for studying the structure and dynamics of various quantum systems. Its analytic solutions are frequently used in case studies in atomic and molecular physics, quantum optics, plasma physics, or even in the field of quantum information and computation. Fast and reliable access to functions and properties of the hydrogenic systems are frequently required, in both the non-relativistic and relativistic frameworks. Despite all the knowledge about one-electron ions, providing such an access is not a simple task, owing to the rather complicated mathematical structure of the Schrödinger and especially Dirac equations. Moreover, for analyzing experimental results as well as for performing advanced theoretical studies one often needs (apart from the detailed information on atomic wave- and Green's functions) to be able to calculate a number of integrals involving these functions. Although for many types of transition operators these integrals can be evaluated analytically in terms of special mathematical functions, such an evaluation is usually rather involved and prone to mistakes. Solution method: A set of Mathematica procedures is developed which provides both the non-relativistic and relativistic solutions of the "Hydrogen atom model". It facilitates, moreover, the symbolic evaluation of integrals involved in the calculations of cross sections and transition amplitudes. These procedures are based on a large number of relations among special mathematical functions, information about their integral representations, recurrence formulae and series expansions. Based on this knowledge, the DIRAC tools provide a fast and reliable algebraic (and if necessary, numeric) manipulation of functions and properties of one-electron systems, thus helping to obtain further insight into the behavior of quantum physical systems. Reasons for new version: The original version of the DIRAC program was developed as a toolbox of Maple procedures and was submitted to the CPC library in 2004 (cf. Ref. [1]). Since then DIRAC has found its niche in advanced theoretical studies carried out in realm of heavy ion physics. With the help of this program detailed analysis has been performed, in particular, for the various excitation and ionization processes occurring in relativistic ion-atom collisions [2], the polarization of the characteristic X-ray radiation following radiative electron capture [3], the correlation properties of the two-photon emission from few-electron heavy ions [4], the spin entanglement phenomena in atomic photoionization [5] and even for exploring the vibrational excitations of the heavy nuclei [6]. Although these studies have conclusively proven the potential of the program, they have also illuminated routes for its further enhancement. Apart from certain source code revisions, demand has grown for a new version of DIRAC compatible with the Mathematica platform. The version presented here includes a wider ranging and more user friendly interactive help system, a number of new procedures and reprogramming for greater computational efficiency. Summary of revisions: The most important new capabilities of the DIRAC program since the previous version are: The utilization of the Mathematica (version 6.0) platform. The addition of a number of new procedures. Since the complete list of the new (and updated) procedures can be found in the interactive help library of the program, we mention here only the most important ones: DiracGlobal[] - Displays a list of the current global settings which specify the framework, nuclear charge and the units which are to be used by the DIRAC program. DiracRadialOrbitalMomentum[] - Returns a non-relativistic radial orbital in momentum space for both, the bound and free electron states. DiracSlaterRadial[] - Evaluates the radial Slater integral both, with the non-relativistic and relativistic wavefunctions. In the previous version of the program this procedure was restricted to the non-relativistic framework only. DiracGreensIntegralRadial[] - Evaluates the two-dimensional radial integrals with the wave- and Green's functions both in non-relativistic and relativistic frameworks. DiracAngularMatrixElement[] - Calculates the angular matrix elements for various irreducible tensor operators. The elimination of some redundant procedures. In particular, the previous version supported evaluation of the spherical Bessel functions, Wigner 3j symbols, Clebsch-Gordan coefficients and spherical harmonics functions. These tools are now superseded by in-built procedures of Mathematica. The development of a full featured interactive help system which follows the style of the Mathematica Help Pages. Extensive revision of the source code in order to correct a number of bugs and inconsistencies that have been identified during use of the previous version of Dirac. The DIRAC package is distributed as a compressed tar file from which the DIRAC root directory can be (re-)generated. The root directory contains the source code and help libraries, a "Readme" file, Dirac_Installation_Instructions, as well as the notebook DemonstrationNotebook.nb that includes a number of test cases to illustrate the use of the program. These test cases, which concern the theoretical analysis of wavefunctions and the fine-structure of hydrogen-like ions, has already been discussed in detail in Ref. [1] and are provided here in order to underline the continuity between the previous (Maple) and new (Mathematica) versions of the DIRAC program. Unusual features: Even though all basic features of the previous Maple version have been retained in as close to the original form as possible, some small syntax changes became necessary in the new version of DIRAC in order to follow Mathematica standards. First of all, these changes concern naming conventions for DIRAC's procedures. As was discussed in Ref. [1], previously rather long names were employed in which each word was separated by an underscore. For example, when running the Maple version of the program one had to call the procedure Dirac_Slater_radial() in order to evaluate the Slater integral. Such a naming convention however, cannot be used in the Mathematica framework where the underscore character is reserved to represent Blank, a built-in symbol. In the new version of DIRAC we therefore follow the Mathematica convention of delimiting each word in a procedure's name by capitalization. Evaluation of the Slater determinant can be accomplished now simply by entering DiracSlaterRadial[]. Besides procedure names, a new convention is introduced to represent fundamental physical constants. In this version of DIRAC the group of (preset) global variables has changed to resemble their conventional symbols, specifically α, a, e, m, c and ℏ, being the fine structure constant, Bohr radius, electron charge, electron mass, speed of light and the Planck constant respectively. If the numerical evaluator N is wrapped around any of these constants, their numerical values are returned. Running time: Although the program replies promptly upon most requests, the running time also depends on the particular task. For example, computation of (radial) matrix elements involving components of relativistic wavefunctions might require a few seconds of a runtime. A number of test calculations performed regarding this and other tasks clearly indicate that the new version of Dirac requires up to 90% less evaluation time compared to its predecessor. References:A. Surzhykov, P. Koval, S. Fritzsche, Comput. Phys. Comm. 165 (2005) 139. H. Ogawa, et al., Phys. Rev. A 75 (2007) 1. A.V. Maiorova, et al., J. Phys. B: At. Mol. Opt. Phys. 42 (2009) 125003. L. Borowska, A. Surzhykov, Th. Stöhlker, S. Fritzsche, Phys. Rev. A 74 (2006) 062516. T. Radtke, S. Fritzsche, A. Surzhykov, Phys. Rev. A 74 (2006) 032709. A. Pálffy, Z. Harman, A. Surzhykov, U.D. Jentschura, Phys. Rev. A 75 (2007) 012712.

Habitat Suitability Index Models: Red king crab

USGS Publications Warehouse

Jewett, Stephen C.; Onuf, Christopher P.

1988-01-01

A review and synthesis of existing information were used to develop a Habitat Suitability Index (HSI) model for evaluating habitat of different life stages of red king crab (Paralithodes camtschatica). A model consolidates habitat use information into a framework appropriate for field application, and is scaled to produce an index between 0.0 (unsuitable habitat) and 1.0 (optimum habitat) in Alaskan coastal waters, especially in the Gulf of Alaska and the southeastern Bering Sea. HSI models are designed to be used with Habitat Evaluation Procedures previously developed by the U.S. Fish and Wildlife Service.

Limited experience, high body mass index and previous urethral surgery are risk factors for failure in open urethroplasty due to penile strictures.

PubMed

Ekerhult, Teresa O; Lindqvist, Klas; Peeker, Ralph; Grenabo, Lars

2015-01-01

The aim of this study was to evaluate outcomes and possible risk factors for failure of open urethroplasty due to penile urethral strictures. A retrospective chart review was undertaken of 90 patients with penile stricture undergoing 109 open urethroplasties between 2000 and 2011. In 80 urethroplasties, a one-stage procedure was performed: 68 of these had a pediculated penile skin flap, nine had a free buccal mucosal graft and three had a free skin graft. A two-stage procedure using buccal mucosa was performed in 29 urethroplasties. Failure was defined as when further urethral instrumentation was needed. The mean age in the one-stage and two-stage groups were 50 and 54 years, respectively. The success rates in the corresponding groups were 65% and 72%, with follow-up times of 63 and 40 months, respectively. Multivariable analyses disclosed body mass index (BMI) and previous urethral surgery to be significant risk factors for failure in the one-stage group. Failure over time significantly decreased during the study period. Both one- and two-stage penile urethroplasty demonstrated success rates in line with previous reports. Limited experience, high BMI and previous urethral surgery appear to be associated with less favourable outcome.

The Case for Use of Simple Difference Scores to Test the Significance of Differences in Mean Rates of Change in Controlled Repeated Measurements Designs

ERIC Educational Resources Information Center

Overall, John E.; Tonidandel, Scott

2010-01-01

A previous Monte Carlo study examined the relative powers of several simple and more complex procedures for testing the significance of difference in mean rates of change in a controlled, longitudinal, treatment evaluation study. Results revealed that the relative powers depended on the correlation structure of the simulated repeated measurements.…

Revisiting the southern pine growth decline: Where are we 10 years later?

Treesearch

Gary L. Gadbury; Michael S. Williams; Hans T. Schreuder

2004-01-01

This paper evaluates changes in growth of pine stands in the state of Georgia, U.S.A., using USDA Forest Service Forest Inventory and Analysis (FIA) data. In particular, data representing an additional 10-year growth cy-cle has been added to previously published results from two earlier growth cycles. A robust regression procedure is combined with a bootstrap technique...

Entropy of mixing calculations for compound forming liquid alloys in the hard sphere system

NASA Astrophysics Data System (ADS)

Singh, P.; Khanna, K. N.

1984-06-01

It is shown that the semi-empirical model proposed in a previous paper for the evaluation of the entropy of mixing of simple liquid metals alloys leads to accurate results for compound forming liquid alloys. The procedure is similar to that described for a regular solution. Numerical applications are made to NaGa, KPb and KT1 alloys.

An Evaluation of a Progressive High-Probability Instructional Sequence Combined with Low-Probability Demand Fading in the Treatment of Food Selectivity

ERIC Educational Resources Information Center

Penrod, Becky; Gardella, Laura; Fernand, Jonathan

2012-01-01

Few studies have examined the effects of the high-probability instructional sequence in the treatment of food selectivity, and results of these studies have been mixed (e.g., Dawson et al., 2003; Patel et al., 2007). The present study extended previous research on the high-probability instructional sequence by combining this procedure with…

Multicenter clinical trial of high-intensity focused ultrasound treatment in glaucoma patients without previous filtering surgery.

PubMed

Aptel, Florent; Denis, Philippe; Rouland, Jean-François; Renard, Jean-Paul; Bron, Alain

2016-08-01

To evaluate the efficacy and safety of the ultrasonic circular cyclocoagulation procedure in patients with open-angle glaucoma naïve of previous filtering surgery. Prospective non-comparative interventional clinical study conducted in five French University Hospitals. Thirty eyes of 30 patients with open-angle glaucoma, intra-ocular pressure (IOP) > 21 mmHg and with no previous filtering glaucoma surgeries were sonicated with a probe comprising six piezoelectric transducers. The six transducers were activated with a 6-s exposure time. Complete ophthalmic examinations were performed before the procedure and at 1 day, 1 week, 1, 2, 3, 6 and 12 months after the procedure. Primary outcomes were qualified surgical success (defined as IOP reduction from baseline ≥20% and IOP > 5 mmHg with possible re-intervention and without hypotensive medication adjunction) and complete surgical success (defined as IOP reduction from baseline ≥20%, IOP > 5 mmHg and IOP < 21 mmHg with possible re-intervention and without hypotensive medication adjunction) at the last follow-up visit and vision-threatening complications. Secondary outcomes were mean IOP at each follow-up visit compared with baseline, medication use, complications and re-interventions. Intra-ocular pressure was significantly reduced (p < 0.05) from a mean pre-operative value of 28.2 ± 7.2 mmHg (n = 3.6 hypotensive medications) to 19.6 ± 7.9 mmHg at 12 months (n = 3.1 hypotensive medications and n = 1.1 procedures) (mean IOP reduction of 30%). Qualified success was achieved in 63% of eyes (19/30) (mean IOP reduction of 37% in these eyes) and complete success in 46.7% of eyes (14/30) (mean IOP reduction of 37% in these eyes) at the last follow-up. No major intra- or post-operative complications occurred. The UC(3) procedure seems to be an effective and well-tolerated method to reduce IOP in patients with open-angle glaucoma without previous filtering surgery. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

[Local approval procedures act as a brake on RCTs].

PubMed

van der Stok, E P; Huiskens, J; Hemmes, B; Grünhagen, D J; van Gulik, T M; Verhoef, C; Punt, C J A

2016-01-01

Large multicentre randomised controlled trials (RCTs) in the Netherlands are increasingly being impeded by major differences between local approval procedures. However, no national agenda exists as yet to improve this situation. The existence of major local differences in processing time and documentation required has been reported previously but little is known about the costs incurred and whether or not specific certifications and research contracts are mandatory. The current study evaluated these aspects of local procedures for obtaining approval of two oncological multicentre RCTs. Retrospective, descriptive. All local procedures for obtaining approval of two randomised clinical trials were evaluated: the CAIRO5 and CHARISMA trials initiated by the Dutch Colorectal Cancer Group (DCCG). We objectified time between approval by the Medical Ethics Review Committee (METC) and final approval by the Board of Directors (RvB), the type and number of documents needed, and costs charged. The median time interval between the approval by the Medical Ethics Review Committee and the approval by the Board of Directors was 90 days (range 4-312). The number of documents required per centre ranged from 6-20. The costs charged ranged from € 0-€ 1750, and amounted to € 8575 for all procedures combined. No costs were charged by the majority of the centres. The approval procedures for multicentre clinical trials in the Netherlands demonstrate major differences. Processing times, documentation required and costs are unpredictable; greater uniformity is highly desirable in this context.

Are all metal-on-metal hip revision operations contributing to the National Joint Registry implant survival curves? : a study comparing the London Implant Retrieval Centre and National Joint Registry datasets.

PubMed

Sabah, S A; Henckel, J; Koutsouris, S; Rajani, R; Hothi, H; Skinner, J A; Hart, A J

2016-01-01

The National Joint Registry for England, Wales and Northern Ireland (NJR) has extended its scope to report on hospital, surgeon and implant performance. Data linkage of the NJR to the London Implant Retrieval Centre (LIRC) has previously evaluated data quality for hip primary procedures, but did not assess revision records. We analysed metal-on-metal hip revision procedures performed between 2003 and 2013. A total of 69 929 revision procedures from the NJR and 929 revised pairs of components from the LIRC were included. We were able to link 716 (77.1%) revision procedures on the NJR to the LIRC. This meant that 213 (22.9%) revision procedures at the LIRC could not be identified on the NJR. We found that 349 (37.6%) explants at the LIRC completed the full linkage process to both NJR primary and revision databases. Data completion was excellent (> 99.9%) for revision procedures reported to the NJR. This study has shown that only approximately one third of retrieved components at the LIRC, contributed to survival curves on the NJR. We recommend prospective registry-retrieval linkage as a tool to feedback missing and erroneous data to the NJR and improve data quality. Prospective Registry - retrieval linkage is a simple tool to evaluate and improve data quality on the NJR. ©2016 Sabah et al.

Genotoxic activity of 4,4',5'-trimethylazapsoralen on plasmid DNA.

PubMed

Lagatolla, C; Dolzani, L; Granzotto, M; Monti-Bragadin, C

1998-01-01

The genotoxic activities of 8-methoxypsoralen (8-MOP) and 4,4',5'-trimethylazapsoralen (4,4',5'-TMAP) on plasmid DNA have been compared. In a previous work, 4,4',5'-TMAP, a methyl derivative of a psoralen isoster, had shown potential photochemotherapeutic activity. The mutagenic activity of mono- and bifunctional lesions caused by these compounds was evaluated both after UVA irradiation, which causes the formation of both kinds of lesions, and after a two-step irradiation procedure of the psoralen-plasmid DNA complex, which allowed monoadducts and interstrand crosslinks to be studied separately. Furthermore, we used a procedure that allowed us to evaluate both the mutagenic and recombinogenic activity of the two compounds. Results indicate that the most important difference between 8-MOP and 4,4',5'-TMAP consists in their mode of photoreaction with DNA rather than in their mutagenic potential. In fact, in all of the experimental procedures, 4,4',5'-TMAP shows a lower ability than 8-MOP to generate interstrand crosslinks. However, when comparable toxicity levels are reached, the two compounds show the same mutagenic potentiality.

Evaluating the Utility of Web-Based Consumer Support Tools Using Rough Sets

NASA Astrophysics Data System (ADS)

Maciag, Timothy; Hepting, Daryl H.; Slezak, Dominik; Hilderman, Robert J.

On the Web, many popular e-commerce sites provide consumers with decision support tools to assist them in their commerce-related decision-making. Many consumers will rank the utility of these tools quite highly. Data obtained from web usage mining analyses, which may provide knowledge about a user's online experiences, could help indicate the utility of these tools. This type of analysis could provide insight into whether provided tools are adequately assisting consumers in conducting their online shopping activities or if new or additional enhancements need consideration. Although some research in this regard has been described in previous literature, there is still much that can be done. The authors of this paper hypothesize that a measurement of consumer decision accuracy, i.e. a measurement preferences, could help indicate the utility of these tools. This paper describes a procedure developed towards this goal using elements of rough set theory. The authors evaluated the procedure using two support tools, one based on a tool developed by the US-EPA and the other developed by one of the authors called cogito. Results from the evaluation did provide interesting insights on the utility of both support tools. Although it was shown that the cogito tool obtained slightly higher decision accuracy, both tools could be improved from additional enhancements. Details of the procedure developed and results obtained from the evaluation will be provided. Opportunities for future work are also discussed.

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

Beavin, P. Jr.

A previously published method for determining zirconium in antiperspirant aerosols was collaboratively studied by 7 laboratories. The method consists of 2 procedures: a rapid dilution procedure for soluble zirconium compounds or a lengthier fusion procedure for total zirconium followed by colorimetric determination. The collaborators were asked to perform the following: Spiking materials representing 4 levels of soluble zirconium were added to weighed portions of a zirconium-free cream base concentrate and the portions were assayed by the dilution procedure. Spiking materials representing 4 levels of zirconium in either the soluble or the insoluble form (or as a mixture) were also addedmore » to portions of the same concentrate and these portions were assayed by the fusion procedure. They were also asked to concentrate and assay, by both procedures, 2 cans each of 2 commercial aerosol antiperspirants containing zirconyl hydroxychloride. The average percent recoveries and standard deviations for spiked samples were 99.8-100.2 and 1.69-2.71, respectively, for soluble compounds determined by the dilution procedure, and 93.8-97.4 and 3.09-4.78, respectively, for soluble and/or insoluble compounds determined by the fusion procedure. The average perent zirconium found by the dilution procedure in the 2 commercial aerosol products was 0.751 and 0.792. Insufficient collaborative results were received for the fusion procedure for statistical evaluation. The dilution procedure has been adopted as official first action.« less

Spinal cord stimulation for patients with refractory angina and previous coronary surgery.

PubMed

Lapenna, Elisabetta; Rapati, Dino; Cardano, Paola; De Bonis, Michele; Lullo, Francesca; Zangrillo, Alberto; Alfieri, Ottavio

2006-11-01

Refractory angina pectoris is an exceptionally debilitating condition affecting patients who have typically failed multiple percutaneous and surgical revascularizations and optimal medical therapy and who are not amenable for further revascularization procedures. Spinal cord stimulation (SCS) has been adopted in this context at our institution and midterm mortality, anginal status, and quality of life have been evaluated. From 1998 to 2004, 51 patients with refractory class III-IV angina, who were not considered candidates for revascularization procedures, underwent SCS. All patients had already undergone previous surgical revascularization and a median of two percutaneous procedures. Transmyocardial laser revascularization had been previously performed in 8 cases (15.6%). Most of the patients (70.5%) had experienced a myocardial infarction. Mean ejection fraction was 0.42 +/- 0.121, Canadian Cardiovascular Society class 3.5 +/- 0.5, quality of life (Spitzer index) 4.5 +/- 1.2, and the median frequency of weekly angina episodes was 10. There were no SCS implantation-related complications. At follow-up (100% complete, mean 24 +/- 18 months), a significant improvement of anginal symptoms (>50% reduction of weekly anginal episodes) occurred in 45 patients (88.2%). In those patients (Responders), the quality of life improved significantly (6.8 +/- 1.5; p < 0.0001), CCS class decreased to 2 +/- 0.7 (p < 0.0001), and the median frequency of weekly angina episodes to 3 (p < 0.0001). At 3 years, Responders' survival was 91.8 +/- 4.6% and the freedom from cardiac events 72.6 +/- 8.42%. Spinal cord stimulation is a safe and effective procedure in truly no-option patients affected by refractory angina. A midterm sustained improvement of symptoms and quality of life have been documented with a satisfactory 3-year survival rate.

Metallurgical evaluation of factors influencing the ductility of aged T-111

NASA Technical Reports Server (NTRS)

Gold, R. E.

1972-01-01

The metallurgical factors influencing the ductility of T-111 (Ta-8W-2Hf) alloy following long-time exposures of GTA welds and tubing in the temperature range 982 C (1800 F) through 1316 C (2400 F) were evaluated by means of scanning and transmission electron microscopy, Auger electron emission spectroscopy, and optical metallographic procedures. No classical aging response occurs in the alloy over the temperature range studied. The ductility impairment implied by previous investigations is not the result of microstructural response of the alloy to thermal exposures. Intergranular failure in the GTA sheet welds appears the result of random contamination by silicon, potassium, and/or fluorine at the grain boundaries of the fusion zones. Exposure to lithium at high temperatures had no adverse effects on the ductility of T-111 tubing. These materials were, however, sensitive to post-age handling and testing procedures.

A variationally coupled FE-BE method for elasticity and fracture mechanics

NASA Technical Reports Server (NTRS)

Lu, Y. Y.; Belytschko, T.; Liu, W. K.

1991-01-01

A new method for coupling finite element and boundary element subdomains in elasticity and fracture mechanics problems is described. The essential feature of this new method is that a single variational statement is obtained for the entire domain, and in this process the terms associated with tractions on the interfaces between the subdomains are eliminated. This provides the additional advantage that the ambiguities associated with the matching of discontinuous tractions are circumvented. The method leads to a direct procedure for obtaining the discrete equations for the coupled problem without any intermediate steps. In order to evaluate this method and compare it with previous methods, a patch test for coupled procedures has been devised. Evaluation of this variationally coupled method and other methods, such as stiffness coupling and constraint traction matching coupling, shows that this method is substantially superior. Solutions for a series of fracture mechanics problems are also reported to illustrate the effectiveness of this method.

[Comparison of the Bologna and Ingelman-Sundberg procedures for stress incontinence associated with genital prolapse: ten-year follow-up of a prospective randomized study].

PubMed

Debodinance, P

2000-04-01

Our purpose was to evaluate and compare the long-term results of the Bologna and the Ingelman-Sundberg procedures for the treatment of stress urinary incontinence in women with genital prolapse. Forty-seven women underwent surgery at the gynecologic division at Dunkirk Hospital, France between January 1989 and August 1990. All patients presented a genital prolapse with a cystocele of at least degree 2 associated with urinary stress incontinence. The subjects were randomly allocated to one of the two procedures. In the clinical incontinence group (28 patients), 12 procedures were Bologna operations and 16 were Ingelman-Sundberg operations. In the potential incontinence group (19 patients), 11 procedures were Bologna operations and 8 were Ingelman-Sundberg operations. Physical examination and urodynamic explorations were performed preoperatively, and 3 months and 1 year postoperatively. A questionnaire was sent to all participating women during the tenth year of follow-up. We obtained 46 answers. Mean follow-up was 9.7 years. The result of the 1-year postoperative evaluation has been previously published. At 1 year, complete cure was achieved in 91.7% of the patients who underwent the Bologna procedure and 93.7% in those who had the Ingelman-Sundberg procedure. At 10 years, the cure rate was 72.7% and 56.2% (p<0.05) respectively. After the first year, the decline in cure rate was twice as fast with the Ingelman-Sundberg procedure than with the Bologna operation. The longevity of the Bologna procedure is greater than that of the Ingelman-Sundberg procedure. Recovery rate declines by 20% in 9 years. All results of urinary stress incontinence surgery were good after the first year. One has to wait 5 to 10 years before reliable informative results can be obtained. This fact should be taken into consideration before accepting to use of new procedures.

Inactivation of the Hutchinson strain of non-A, non-B hepatitis virus by combined use of beta-propiolactone and ultraviolet irradiation

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

Prince, A.M.; Stephan, W.; Dichtelmueller, H.B.

1985-06-01

A beta-propiolactone/ultraviolet irradiation procedure (beta PL/UV) has been evaluated for its ability to inactivate 30,000 chimpanzee infectious doses of the Hutchinson strain of non-A, non-B (NANB) virus. The chimpanzees were inoculated with plasma to which this dose of the titrated virus had been added prior to application of the beta PL/UV process in accordance with a procedure used for licensed blood derivatives in Germany. Neither animal developed hepatitis. When subsequently challenged with the same contaminated plasma, which had not been sterilized, both animals promptly developed typical NANB hepatitis. This study extends the high (approximately 10(7)-fold) process efficiency of the betamore » PL/UV procedure previously reported for hepatitis B virus to a blood-borne NANB virus.« less

Minimally Invasive Transtubular Endoscopic Decompression for L5 Radiculopathy Induced by Lumbosacral Extraforaminal Lesions

PubMed Central

Kitamura, Takahiro; Masuda, Keigo; Hotta, Kensuke; Senba, Hideyuki; Shidahara, Satoshi

2018-01-01

Study Design Retrospective study. Purpose This study aimed to evaluate the efficacy of minimally invasive transtubular endoscopic decompression for the treatment of lumbosacral extraforaminal lesion (LSEFL). Overview of Literature Conventional procedures for surgical decompression for the treatment of LSEFL involve certain technical challenges because the lumbosacral extraforaminal region has unique anatomical features. Moreover, the efficacy of minimally invasive procedures performed via the posterolateral approach for LSEFL has been reported. Methods Twenty-five patients who had undergone minimally invasive transtubular endoscopic decompression for the treatment of LSEFL and could be followed up for at least 1 year postoperatively were enrolled. Five of these patients had a history of lumbar surgery, and seven had concomitant adjacent-level spinal stenosis. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) lumbar score, numeric rating scale (NRS), and the JOA Back Pain Evaluation Questionnaire (JOABPEQ). The mean postoperative follow-up (FU) duration was 3.8 years. Results All procedures could be completed without any severe surgical complications, and all patients could resume their previous activity level within 1 month postoperatively. The JOA score significantly increased from 14.1±4.0 at baseline to 23.1±3.7 at the 1-year FU and 22.1±3.8 at the last FU. Similarly, there were significant improvements in the postoperative NRS and JOABPEQ scores. An additional surgery was performed in two patients (8%) during the FU period. Patients with degenerative scoliosis exhibited significantly poorer outcomes compared with those without this condition. Conclusions Transtubular endoscopic decompression can overcome certain technical challenges involved in the conventional procedures for LSEFL treatment; therefore, it can be recommended as a useful procedure for treating LSEFL. This procedure can provide some benefits to LSEFL patients and offer a well-illuminated surgical field and high surgical safety for the surgeon. However, the procedure should be carefully adapted for LSEFL patients with concomitant degenerative scoliosis. PMID:29713405

Local heterogeneities in early batches of EBT2 film: a suggested solution.

PubMed

Kairn, T; Aland, T; Kenny, J

2010-08-07

To enhance the utility of radiochromic films for high-resolution dosimetry of small and modulated radiotherapy fields, we propose a means to negate the effects of heterogeneities in EBT2 (and other) films. The results of using our simple procedure for evaluating radiation dose in EBT2 film are compared with the results of using the manufacturer's recommended procedure as well as a procedure previously established for evaluating dose in older EBT film. It is shown that Newton's ring-like scanning artefacts can be avoided through the use of a plastic frame, to elevate the film above the scanner's surface. The effects of film heterogeneity can be minimized by evaluating net optical density, pixelwise, as the logarithm of the ratio of the red-channel pixel value in each pixel of each irradiated film to the red-channel pixel value in the same pixel in the same film prior to irradiation. The application of a blue-channel correction was found to result in increased noise. It is recommended that, when using EBT2 film for radiotherapy quality assurance, the films should be scanned before and after irradiation and analysed using the method proposed herein, without the use of the blue-channel correction, in order to produce dose images with minimal film heterogeneity effects.

Grindability determination of torrefied biomass materials using the Hybrid Work index

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

Van Essendelft, D.T.; Zhou, X.; Kang, B.S.-J.

2012-01-01

The grindability of torrefied biomass materials is a difficult parameter to evaluate due to its inhomogeneous character and non-uniform morphology. However, it is necessary to develop a grinding test that is representative of the wide ranging character of biomass and torrefied biomass materials. Previous research has shown that Resistance to Impact Milling (RIM) can be linearly correlated to thermally driven weight loss in biomass. In particular, the RIM equipment was found to supply the right energy level to physically break down structurally deficient biomass materials while leaving the un-touched material relatively intact [1–3]. However, the RIM procedure was not designedmore » to extract the comminution energy. Alternatively, the Bond Work Index (BWI) procedure was developed to accurately assess the grinding energy of brittle materials [4,5]. However, the milling energy is too low to be effective for biomass comminution. In this research, the BWI procedure was utilized with the ball–mill approach in the RIM test to evaluate torrefied biomass materials. The hybridized procedure has been shown to be both highly correlated to energy consumption and sensitive to degree of torrefaction. The proposed Hybrid Work Index (HWI) is certainly useful for assessing torrefaction in a laboratory environment, but it may also be correlated to grinding energy at industrial scales.« less

Endoscopic submucosal dissection for locally recurrent colorectal lesions after previous endoscopic mucosal resection.

PubMed

Zhou, Pinghong; Yao, Liqing; Qin, Xinyu; Xu, Meidong; Zhong, Yunshi; Chen, Weifeng

2009-02-01

The objective of this study was to determine the efficacy and safety of endoscopic submucosal dissection for locally recurrent colorectal cancer after previous endoscopic mucosal resection. A total of 16 patients with locally recurrent colorectal lesions were enrolled. A needle knife, an insulated-tip knife and a hook knife were used to resect the lesion along the submucosa. The rate of the curative resection, procedure time, and incidence of complications were evaluated. Of 16 lesions, 15 were completely resected with endoscopic submucosal dissection, yielding an en bloc resection rate of 93.8 percent. Histologic examination confirmed that lateral and basal margins were cancer-free in 14 patients (87.5 percent). The average procedure time was 87.2 +/- 60.7 minutes. None of the patients had immediate or delayed bleeding during or after endoscopic submucosal dissection. Perforation in one patient (6.3 percent) was the only complication and was managed conservatively. The mean follow-up period was 15.5 +/- 6.8 months; none of the patients experienced lesion residue or recurrence. Endoscopic submucosal dissection appears to be effective for locally recurrent colorectal cancer after previous endoscopic mucosal resection, making it possible to resect whole lesions and provide precise histologic information.

Outcomes of LASIK and PRK in previous penetrating corneal transplant recipients.

PubMed

Kovoor, Timmy A; Mohamed, Engy; Cavanagh, H Dwight; Bowman, R Wayne

2009-09-01

To evaluate the safety and efficacy of excimer laser refractive surgery in correcting refractive error in eyes that have undergone previous penetrating keratoplasty (PK). Twenty-three keratorefractive procedures on 16 eyes from 16 consecutive subjects were evaluated between 2002 and 2008. Each patient presented a previous history of a PK with subsequent postoperative myopia and astigmatism. Keratometric value, manifest refraction, best-corrected visual acuity, uncorrected visual acuity, and complications were determined. There were a total of 14 photorefractive keratectomy (PRK) procedures performed on 11 eyes and 9 laser in situ keratomileusis (LASIK) procedures performed on 5 eyes. In the PRK group, the preoperative post-PK manifest refractive spherical equivalent and cylindrical error were -6.22 +/- 6.23 diopter and 5.23 +/- 2.26 D, respectively. The PRK postoperative manifest refractive spherical equivalent and cylindrical error were -3.61 +/- 4.23 D (P=0.25) and 3.21 +/- 1.78 D (P=0.02), respectively. In the LASIK group, the preoperative post-PK manifest refractive spherical equivalent and cylindrical error were -3.05 +/- 3.29 D and 4.11 +/- 2.38 D, respectively. The LASIK postoperative manifest refractive spherical equivalent and cylindrical error were -1.51 +/- 2.02 D (P=0.24) and 2.08 +/- 1.26 D (P=0.03), respectively. There was a 2-line or greater improvement of uncorrected visual acuity in 8 of the 14 PRK treatments and 5 of the 9 LASIK treatments. There were two episodes of acute graft rejection. One of the episodes resolved with topical and oral corticosteroids, and the other episode required a repeat corneal transplantation. PRK and LASIK are effective tools in reducing surgically induced astigmatism after penetrating corneal transplantation in most patients in this case series. The reduction of astigmatism may allow improved contact lens or spectacle fitting to achieve best-corrected binocular visual acuity.

Habitat Suitability Index Models: Muskellunge

USGS Publications Warehouse

Cook, Mark F.; Solomon, R. Charles

1987-01-01

A review and synthesis of existing information were used to develop a Habitat Suitability Index (HSI) model for the muskellunge (Esox masquinongy Mitchell). The model consolidates habitat use information into a framework appropriate for field application, and is scaled to produce an index between 0.0 (unsuitable habitat) to 1.0 (optimum habitat). HSI models are designed to be used with Habitat Evaluation Procedures previously developed by the U.S. Fish and Wildlife Service.

Post-Loop Electrosurgical Excision Procedure Complications in Srinagarind Hospital.

PubMed

Maleerat, Pimjai; Chumworathayi, Bandit; Kietpeerakool, Chumnan; Luanratanakorn, Sanguanchoke; Temtanakitpaisan, Amornrat

2016-01-01

The purpose of this study was to evaluate the prevalence and predictors of post-Loop Electrosurgical Excision Procedure (LEEP) complications in Srinagarind Hospital, Khon Kaen, Thailand. Retrospective chart review was performed for 200 patients undergoing LEEP during January 2012 to February 2013. Their mean age was 45 years-old. Fifty-three (26.5%) were menopausal. The three most common preceding abnormal cervical cytology were high-grade squamous intraepithelial lesion (HSIL; 50%), atypical squamous cell cannot exclude HSIL (ASC-H; 10.5%), and low-grade squamous intraepithelial lesion (LSIL; 10%). The overall complications prevalence rate was 16.5% (95%CI, 11.4-21.6). Complications included bleeding (11%; 95%CI, 6.66-15.3), offensive discharge (4%; 95%CI, 1.28-6.72), and pelvic inflammatory disease (1.5%; 95%CI, 0.18-3.18). Only mode of delivery was an independent predictor of post-LEEP complications. Women with previous caesarean sections carried an increased risk of complications by 3.9 times (95%CI, 1.21-12.56) compared with vaginal delivery. In conclusion, LEEP is generally safe with an acceptable complication rate. Previous caesarean section was the only independent predictor for post-LEEP complications. However, this predictor still needs prudent evaluation as no clear cause-effect relationship was identified.

Data analysis of response interruption and redirection as a treatment for vocal stereotypy.

PubMed

Wunderlich, Kara L; Vollmer, Timothy R

2015-12-01

Vocal stereotypy, or repetitive, noncontextual vocalizations, is a problematic form of behavior exhibited by many individuals with autism spectrum disorder (ASD). Recent research has evaluated the efficacy of response interruption and redirection (RIRD) in the reduction of vocal stereotypy. Research has indicated that RIRD often results in reductions in the level of vocal stereotypy; however, many previous studies have only presented data on vocal stereotypy that occurred outside RIRD implementation. The current study replicated the procedures of previous studies that have evaluated the efficacy of RIRD and compared 2 data-presentation methods: inclusion of only data collected outside RIRD implementation and inclusion of all vocal stereotypy data from the entirety of each session. Subjects were 7 children who had been diagnosed with ASD. Results indicated that RIRD appeared to be effective when we evaluated the level of vocal stereotypy outside RIRD implementation, but either no reductions or more modest reductions in the level of vocal stereotypy during the entirety of sessions were obtained for all subjects. Results suggest that data-analysis methods used in previous research may overestimate the efficacy of RIRD. © Society for the Experimental Analysis of Behavior.

Modelling of wildlife migrations and its economic impacts

NASA Astrophysics Data System (ADS)

Myšková, Kateřina; Žák, Jaroslav

2013-10-01

Natural wildlife migrations are often disrupted by the construction of line structures, especially freeways. Various overpasses and underpasses (migration objects) are being designed to enable species to pass through line structures. The newly developed original procedure for the quantification of the utility of migration objects (migration potentials) and sections of line structures retrieves the deficiencies of the previous ones. The procedure has been developed under bulk information obtained by monitoring migrations using camera system and spy games. The log-normal distribution functions are used. The procedure for the evaluation of the probability of the permeability of the line structures sectors is also presented. The above mentioned procedures and algorithms can be used while planning, preparing, constructing or verifying the measures to assure the permeability of line structures for selected feral species. Using the procedures can significantly reduce financial costs and improve the permeability. When the migration potentials are correctly determined and the whole sector is taken into account for the migrations, some originally designed objects may be found to be redundant and not building them will bring financial savings.

Guidelines and standard procedures for continuous water-quality monitors: Station operation, record computation, and data reporting

USGS Publications Warehouse

Wagner, Richard J.; Boulger, Robert W.; Oblinger, Carolyn J.; Smith, Brett A.

2006-01-01

The U.S. Geological Survey uses continuous water-quality monitors to assess the quality of the Nation's surface water. A common monitoring-system configuration for water-quality data collection is the four-parameter monitoring system, which collects temperature, specific conductance, dissolved oxygen, and pH data. Such systems also can be configured to measure other properties, such as turbidity or fluorescence. Data from sensors can be used in conjunction with chemical analyses of samples to estimate chemical loads. The sensors that are used to measure water-quality field parameters require careful field observation, cleaning, and calibration procedures, as well as thorough procedures for the computation and publication of final records. This report provides guidelines for site- and monitor-selection considerations; sensor inspection and calibration methods; field procedures; data evaluation, correction, and computation; and record-review and data-reporting processes, which supersede the guidelines presented previously in U.S. Geological Survey Water-Resources Investigations Report WRIR 00-4252. These procedures have evolved over the past three decades, and the process continues to evolve with newer technologies.

Development and applications of algorithms for calculating the transonic flow about harmonically oscillating wings

NASA Technical Reports Server (NTRS)

Ehlers, F. E.; Weatherill, W. H.; Yip, E. L.

1984-01-01

A finite difference method to solve the unsteady transonic flow about harmonically oscillating wings was investigated. The procedure is based on separating the velocity potential into steady and unsteady parts and linearizing the resulting unsteady differential equation for small disturbances. The differential equation for the unsteady velocity potential is linear with spatially varying coefficients and with the time variable eliminated by assuming harmonic motion. An alternating direction implicit procedure was investigated, and a pilot program was developed for both two and three dimensional wings. This program provides a relatively efficient relaxation solution without previously encountered solution instability problems. Pressure distributions for two rectangular wings are calculated. Conjugate gradient techniques were developed for the asymmetric, indefinite problem. The conjugate gradient procedure is evaluated for applications to the unsteady transonic problem. Different equations for the alternating direction procedure are derived using a coordinate transformation for swept and tapered wing planforms. Pressure distributions for swept, untaped wings of vanishing thickness are correlated with linear results for sweep angles up to 45 degrees.

Surgical Instrument Restraint in Weightlessness

NASA Technical Reports Server (NTRS)

Campbell, Mark R.; Dawson, David L.; Melton, Shannon; Hooker, Dona; Cantu, Hilda

2000-01-01

Performing a surgical procedure during spaceflight will become more likely with longer duration missions in the near future. Minimal surgical capability has been present on previous missions as the definitive medical care time was short and the likelihood of surgical events too low to justify surgical hardware availability. Early demonstrations of surgical procedures in the weightlessness of parabolic flight indicated the need for careful logistical planning and restraint of surgical hardware. The consideration of human ergonomics also has more impact in weightlessness than in the conventionall-g environment. Three methods of surgical instrument restraint - a Minor Surgical Kit (MSK), a Surgical Restraint Scrub Suit (SRSS), and a Surgical Tray (ST) were evaluated in parabolic flight surgical procedures. The Minor Surgical Kit was easily stored, easily deployed, and demonstrated the best ability to facilitate a surgical procedure in weightlessness. Important factors in this surgical restraint system include excellent organization of supplies, ability to maintain sterility, accessibility while providing secure restraint, ability to dispose of sharp items and biological trash, and ergonomical efficiency.

Frontal and Parietal Cortices Show Different Spatiotemporal Dynamics across Problem-solving Stages.

PubMed

Tschentscher, Nadja; Hauk, Olaf

2016-08-01

Arithmetic problem-solving can be conceptualized as a multistage process ranging from task encoding over rule and strategy selection to step-wise task execution. Previous fMRI research suggested a frontal-parietal network involved in the execution of complex numerical and nonnumerical tasks, but evidence is lacking on the particular contributions of frontal and parietal cortices across time. In an arithmetic task paradigm, we evaluated individual participants' "retrieval" and "multistep procedural" strategies on a trial-by-trial basis and contrasted those in time-resolved analyses using combined EEG and MEG. Retrieval strategies relied on direct retrieval of arithmetic facts (e.g., 2 + 3 = 5). Procedural strategies required multiple solution steps (e.g., 12 + 23 = 12 + 20 + 3 or 23 + 10 + 2). Evoked source analyses revealed independent activation dynamics within the first second of problem-solving in brain areas previously described as one network, such as the frontal-parietal cognitive control network: The right frontal cortex showed earliest effects of strategy selection for multistep procedural strategies around 300 msec, before parietal cortex activated around 700 msec. In time-frequency source power analyses, memory retrieval and multistep procedural strategies were differentially reflected in theta, alpha, and beta frequencies: Stronger beta and alpha desynchronizations emerged for procedural strategies in right frontal, parietal, and temporal regions as function of executive demands. Arithmetic fact retrieval was reflected in right prefrontal increases in theta power. Our results demonstrate differential brain dynamics within frontal-parietal networks across the time course of a problem-solving process, and analyses of different frequency bands allowed us to disentangle cortical regions supporting the underlying memory and executive functions.

A preregistered, direct replication attempt of the retrieval-extinction effect in cued fear conditioning in rats.

PubMed

Luyten, Laura; Beckers, Tom

2017-10-01

In 2009, Monfils and colleagues proposed a behavioral procedure that was said to result in a permanent attenuation of a previously established fear memory, thereby precluding a possible return of fear after extinction (Monfils, Cowansage, Klann, & LeDoux, 2009). By presenting a single retrieval trial one hour before standard extinction training, they found an enduring reduction of fear. The retrieval-extinction procedure holds great clinical potential, particularly for anxiety patients, but the findings are not undisputed, and several conceptual replications have failed to reproduce the effect. These failures have largely been attributed to small procedural differences. This preregistered study is the first endeavor to exactly replicate three key experiments of the original report by Monfils et al. (2009), thereby gauging the robustness of their seminal findings. Despite adhering to the original procedures as closely as possible, we did not find any evidence for reduced return of fear with the retrieval-extinction procedure relative to regular extinction training, as assessed through spontaneous recovery, reinstatement and renewal. Behavior of animals in the control condition (extinction only) was comparable to that in the original studies and provided an adequate baseline to reveal differences with the retrieval-extinction condition. Our null findings indicate that the effect sizes in the original paper may have been inflated and question the legitimacy of previously proposed moderators of the retrieval-extinction effect. We argue that direct experimental evaluation of purported moderators of the retrieval-extinction effect will be key to shed more light on its nature and prerequisites. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of automatic procedures in the selection of peaks over threshold in flood frequency analysis: A Canadian case study in the context of climate change

NASA Astrophysics Data System (ADS)

Durocher, M.; Mostofi Zadeh, S.; Burn, D. H.; Ashkar, F.

2017-12-01

Floods are one of the most costly hazards and frequency analysis of river discharges is an important part of the tools at our disposal to evaluate their inherent risks and to provide an adequate response. In comparison to the common examination of annual streamflow maximums, peaks over threshold (POT) is an interesting alternative that makes better use of the available information by including more than one flood event per year (on average). However, a major challenge is the selection of a satisfactory threshold above which peaks are assumed to respect certain conditions necessary for an adequate estimation of the risk. Additionally, studies have shown that POT is also a valuable approach to investigate the evolution of flood regimes in the context of climate change. Recently, automatic procedures for the selection of the threshold were suggested to guide that important choice, which otherwise rely on graphical tools and expert judgment. Furthermore, having an automatic procedure that is objective allows for quickly repeating the analysis on a large number of samples, which is useful in the context of large databases or for uncertainty analysis based on a resampling approach. This study investigates the impact of considering such procedures in a case study including many sites across Canada. A simulation study is conducted to evaluate the bias and predictive power of the automatic procedures in similar conditions as well as investigating the power of derived nonstationarity tests. The results obtained are also evaluated in the light of expert judgments established in a previous study. Ultimately, this study provides a thorough examination of the considerations that need to be addressed when conducting POT analysis using automatic threshold selection.

[The application of vector analysis for evaluation of astigmatism correction in the corneal refractive surgery].

PubMed

Zhang, Jiamei; Wang, Yan

2016-01-01

Since sixty percent of ametropes obtain astigmatism, which has influence on the visual quality, correcting the astigmatism is always the focus of concerns during visual correction procedures especially for the corneal refractive surgery. The postoperative spherical equivalent or residual cylindrical dioptors was used as quantitative index to evaluate the correction of astigmatism previously; however, such results neglect the effect of astigmatic axis shift on the treatment. Taking astigmatism as a vector parameter could describe the magnitude and direction of astigmatism accurately, thus it was increasingly applied in the evaluation of astigmatism correction. This paper reviews the present vector analysis methods, evaluation indexes and its application for the correction of astigmatism in the corneal refractive surgery.

A Randomized Prospective Study Of The Use Of Ipads In Reducing Anxiety During Cast Room Procedures

PubMed Central

Ko, Justine S.; Whiting, Zachariah; Nguyen, Cynthia; Liu, Raymond W; Gilmore, Allison

2016-01-01

Background Cast room procedures can be a source of anxiety for children. Various techniques, including music therapy, have been evaluated as a way to ease this anxiety. The use of iPads as a form of distraction during cast room procedures has not previously been evaluated and was the purpose of the current study. Methods 146 children and adolescents who underwent cast room procedures during June- August 2015 were randomly assigned to one of three groups: no-iPad, iPad with video, or iPad with game. Patient heart rates were measured using a pulse oximeter in the waiting room, before the procedure, during the procedure, and after the procedure. Mean values for each group were calculated at each time interval and compared both between groups and within groups over time. Results There were no significant differences in baseline (waiting room) heart rate between the no-iPad and iPad groups. When compared with the no-iPad group, there was a trend toward decreased heart rate in the video group (p=0.13) and a significant increase in heart rate in the game group (p=0.026) before the procedure. There were no significant decreases in heart rate within any of the groups when comparing the waiting room heart rates with the during procedure heart rates. There was a significant difference between the no-iPad and video groups (p=0.047) when comparing the change in heart rate from baseline to before the procedure, with a decreased heart rate observed in the video group. Conclusions The results of this study show a significant decrease in heart rate when transitioning from the waiting room to the cast room while watching videos on the iPad. iPad-based video delivery appears to decrease anxiety prior to cast room procedures. iPad-based game play is difficult to assess as elevations in heart rate prior to the procedure are presumed to be related to game play and confound the observed effect it may have on anxiety related to the procedure. PMID:27528849

Separator Materials Used in Secondary Alkaline Batteries Characterized and Evaluated

NASA Technical Reports Server (NTRS)

1996-01-01

Nickel-cadmium (Ni/Cd) and nickel-hydrogen (Ni/H2) secondary alkaline batteries are vital to aerospace applications. Battery performance and cycle life are significantly affected by the type of separators used in those batteries. A team from NASA Lewis Research Center's Electrochemical Technology Branch developed standardized testing procedures to characterize and evaluate new and existing separator materials to improve performance and cycle life of secondary alkaline batteries. Battery separators must function as good electronic insulators and as efficient electrolyte reservoirs. At present, new types of organic and inorganic separator materials are being developed for Ni/Cd and Ni/H2 batteries. The separator material previously used in the NASA standard Ni/Cd was Pellon 2505, a 100-percent nylon-6 polymer that must be treated with zinc chloride (ZnCl2) to bond the fibers. Because of stricter Environmental Protection Agency regulation of ZnCl2 emissions, the battery community has been searching for new separators to replace Pellon 2505. As of today, two candidate separator materials have been identified; however, neither of the two materials have performed as well as Pellon 2505. The separator test procedures that were devised at Lewis are being implemented to expedite the search for new battery separators. The new test procedures, which are being carried out in the Separator Laboratory at Lewis, have been designed to guarantee accurate evaluations of the properties that are critical for sustaining proper battery operation. These properties include physical and chemical stability, chemical purity, gas permeability, electrolyte retention and distribution, uniformity, porosity, and area resistivity. A manual containing a detailed description of 12 separator test procedures has been drafted and will be used by the battery community to evaluate candidate separator materials for specific applications. These standardized procedures will allow for consistent, uniform, and reliable results that will ensure that separator materials have the desired properties for long life and good performance in secondary alkaline cells.

Exploring multicriteria decision strategies in GIS with linguistic quantifiers: A case study of residential quality evaluation

NASA Astrophysics Data System (ADS)

Malczewski, Jacek; Rinner, Claus

2005-06-01

Commonly used GIS combination operators such as Boolean conjunction/disjunction and weighted linear combination can be generalized to the ordered weighted averaging (OWA) family of operators. This multicriteria evaluation method allows decision-makers to define a decision strategy on a continuum between pessimistic and optimistic strategies. Recently, OWA has been introduced to GIS-based decision support systems. We propose to extend a previous implementation of OWA with linguistic quantifiers to simplify the definition of decision strategies and to facilitate an exploratory analysis of multiple criteria. The linguistic quantifier-guided OWA procedure is illustrated using a dataset for evaluating residential quality of neighborhoods in London, Ontario.

Assessing residents' operative skills for external ventricular drain placement and shunt surgery in pediatric neurosurgery.

PubMed

Aldave, Guillermo; Hansen, Daniel; Briceño, Valentina; Luerssen, Thomas G; Jea, Andrew

2017-04-01

OBJECTIVE The authors previously demonstrated the use of a validated Objective Structured Assessment of Technical Skills (OSATS) tool for evaluating residents' operative skills in pediatric neurosurgery. However, no benchmarks have been established for specific pediatric procedures despite an increased need for meaningful assessments that can either allow for early intervention for underperforming trainees or allow for proficient residents to progress to conducting operations independently with more passive supervision. This validated methodology and tool for assessment of operative skills for common pediatric neurosurgical procedures-external ventricular drain (EVD) placement and shunt surgery- was applied to establish its procedure-based feasibility and reliability, and to document the effect of repetition on achieving surgical skill proficiency in pediatric EVD placement and shunt surgery. METHODS A procedure-based technical skills assessment for EVD placements and shunt surgeries in pediatric neurosurgery was established through the use of task analysis. The authors enrolled all residents from 3 training programs (Baylor College of Medicine, Houston Methodist Hospital, and University of Texas-Medical Branch) who rotated through pediatric neurosurgery at Texas Children's Hospital over a 26-month period. For each EVD placement or shunt procedure performed with a resident, the faculty and resident (for self-assessment) completed an evaluation form (OSATS) based on a 5-point Likert scale with 7 categories. Data forms were then grouped according to faculty versus resident (self) assessment, length of pediatric neurosurgery rotation, postgraduate year level, and date of evaluation ("beginning of rotation," within 1 month of start date; "end of rotation," within 1 month of completion date; or "middle of rotation"). Descriptive statistical analyses were performed with the commercially available SPSS statistical software package. A p value < 0.05 was considered statistically significant. RESULTS Five attending evaluators (including 2 fellows who acted as attending surgeons) completed 260 evaluations. Twenty house staff completed 269 evaluations for self-assessment. Evaluations were completed in 562 EVD and shunt procedures before the surgeons left the operating room. There were statistically significant differences (p < 0.05) between overall attending (mean 4.3) and junior resident (self; mean 3.6) assessments, and between overall attending (mean 4.8) and senior resident (self; mean 4.6) assessment scores on general performance and technical skills. The learning curves produced for the residents demonstrate a stereotypical U- or V-shaped curve for acquiring skills, with a significant improvement in overall scores at the end of the rotation compared with the beginning. The improvement for junior residents (Δ score = 0.5; p = 0.002) was larger than for senior residents (Δ score = 0.2; p = 0.018). CONCLUSIONS The OSATS is an effective assessment tool as part of a comprehensive evaluation of neurosurgery residents' performance for specific pediatric procedures. The authors observed a U-shaped learning curve, contradicting the idea that developing one's surgical technique and learning a procedure represents a monotonic, cumulative process of repetitions and improvement.

Prime-, Stress- and Cue-Induced Reinstatement of Extinguished Drug-Reinforced Responding in Rats: Cocaine as the Prototypical Drug of Abuse

PubMed Central

Beardsley, Patrick M.; Shelton, Keith L.

2012-01-01

This unit describes the testing of rats in prime-, footshock- and cue-induced reinstatement procedures. Evaluating rats in these procedures enables the assessment of treatments on behavior thought to model drug relapse precipitated by re-contact with an abused drug (prime-induced), induced by stress (footshock-induced), or by stimuli previously associated with drug administration (cue-induced). For instance, levels of reinstatement under the effects of test compound administration could be compared to levels under vehicle administration to help identify potential treatments for drug relapse, or reinstatement levels of different rat strains could be compared to identify potential genetic determinants of perseverative drug-seeking behavior. Cocaine is used as a prototypical drug of abuse, and relapse to its use serves as the model in this unit, but other self-administered drugs could readily be substituted with little modification to the procedures. PMID:23093352

Standardised evaluation of the performance of a simple membrane filtration-elution method to concentrate bacteriophages from drinking water.

PubMed

Méndez, Javier; Audicana, Ana; Isern, Ana; Llaneza, Julián; Moreno, Belén; Tarancón, María Luisa; Jofre, Juan; Lucena, Francisco

2004-04-01

The bacteriophage elution procedure described further after adsorption to acetate-nitrate cellulose membrane filters allows better recovery of phages concentrated from 1l of water than elution procedures used previously. The improvement is due to the combined effect of the eluent (3% (w/v) beef extract, 3% (v/v) Tween 80, 0.5M NaCl, pH 9.0) and the application of ultrasound instead of agitation or swirling. Average recovery of somatic coliphages, 82 +/- 7%, was the greatest, and that of phages infecting Bacteroides fragilis, 56 +/- 8%, the lowest, with intermediate values for F-specific and F-specific RNA bacteriophages. Thus, the method allowed recovery of over 56% for all the phages suggested as surrogate indicators. The method was then validated according to an International Standardisation Organisation validation standard procedure and implemented in routine laboratories, which obtained reproducible results.

Intravascular US-Guided Portal Vein Access: Improved Procedural Metrics during TIPS Creation.

PubMed

Gipson, Matthew G; Smith, Mitchell T; Durham, Janette D; Brown, Anthony; Johnson, Thor; Ray, Charles E; Gupta, Rajan K; Kondo, Kimi L; Rochon, Paul J; Ryu, Robert K

2016-08-01

To evaluate transjugular intrahepatic portosystemic shunt (TIPS) outcomes and procedure metrics with the use of three different image guidance techniques for portal vein (PV) access during TIPS creation. A retrospective review of consecutive patients who underwent TIPS procedures for a range of indications during a 28-month study period identified a population of 68 patients. This was stratified by PV access techniques: fluoroscopic guidance with or without portography (n = 26), PV marker wire guidance (n = 18), or intravascular ultrasound (US) guidance (n = 24). Procedural outcomes and procedural metrics, including radiation exposure, contrast agent volume used, procedure duration, and PV access time, were analyzed. No differences in demographic or procedural characteristics were found among the three groups. Technical success, technical success of the primary planned approach, hemodynamic success, portosystemic gradient, and procedure-related complications were not significantly different among groups. Fluoroscopy time (P = .003), air kerma (P = .01), contrast agent volume (P = .003), and total procedural time (P = .02) were reduced with intravascular US guidance compared with fluoroscopic guidance. Fluoroscopy time (P = .01) and contrast agent volume (P = .02) were reduced with intravascular US guidance compared with marker wire guidance. Intravascular US guidance of PV access during TIPS creation not only facilitates successful TIPS creation in patients with challenging anatomy, as suggested by previous investigations, but also reduces important procedure metrics including radiation exposure, contrast agent volume, and overall procedure duration compared with fluoroscopically guided TIPS creation. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

Aortic valve replacement for stenosis with or without coronary artery bypass grafting after 2 previous isolated coronary artery bypass grafting operations

PubMed Central

Lee Henry, Christopher; Ko, Jong Mi; Henry, Albert Carl; Matter, Gregory John

2011-01-01

Aortic valve replacement following an earlier coronary artery bypass grafting (CABG) procedure is fairly common. When this situation occurs, the type of valve dysfunction is usually stenosis (with or without regurgitation), and whether it was missed at the time of the earlier CABG or developed subsequently is usually unclear. We attempted to determine the survival in patients who had had aortic valve replacement after 2 previous CABG procedures. We describe 12 patients who had aortic valve replacement for aortic stenosis; rather than one previous CABG operation, all had had 2 previous CABG procedures. Only one patient died in the early postoperative period after aortic valve replacement, and the remaining 11 were improved substantially: all have lived at least 11 months, and one is still alive at over 101 months after aortic valve replacement. Aortic valve replacement remains beneficial for most patients even after 2 previous CABG procedures. PMID:21307968

Habitat Suitability Index Models: Hairy woodpecker

USGS Publications Warehouse

Sousa, Patrick J.

1987-01-01

A review and synthesis of existing information were used to develop a Habitat Suitability Index (HSI) model for the hairy woodpecker (Picoides villosus). The model consolidates habitat use information into a framework appropriate for field application, and is scaled to produce an index between 0.0 (unsuitable habitat) to 1.0 (optimum habitat). HSI models are designed to be used with Habitat Evaluation Procedures previously developed by the U.S. Fish and Wildlife Service.

Habitat Suitability Index Models: Diamondback terrapin (nesting) - Atlantic coast

USGS Publications Warehouse

Palmer, William M.; Cordes, Carroll L.

1988-01-01

A review and synthesis of existing information were used to develop a Habitat Suitability Index (HSI) model for the diamondback terrapin (Malaclemys terrapin). The model consolidates habitat use information into a framework appropriate for field application, and is scaled to produce an index between 0.0 (unsuitable habitat) to 1.0 (optimum habitat). HSI models are designed to be used with Habitat Evaluation Procedures previously developed by the U.S. Fish and Wildlife Service.

Habitat Suitability Index Models: Snapping turtle

USGS Publications Warehouse

Graves, Brent M.; Anderson, Stanley H.

1987-01-01

A review and synthesis of existing information were used to develop a Habitat Suitability Index (HSI) model for the snapping turtle (Chelydra serpentina). The model consolidates habitat use information into a framework appropriate for field application, and is scaled to produce an index between 0.0 (unsuitable habitat) and 1.0 (optimum habitat). HSI models are designed to be used with Habitat Evaluation Procedures previously developed by the U.S. Fish and Wildlife Service.

Habitat Suitability Index Models: Red-winged blackbird

USGS Publications Warehouse

Short, Henry L.

1985-01-01

A review and synthesis of existing information were used to develop a Habitat Suitability Index (HSI) model for the red-winged blackbird (Agelaius phoeniceus L.). The model consolidates habitat use information into a framework appropriate for field application, and is scaled to produce an index between 0.0 (unsuitable habitat) to 1.0 (optimum habitat). HSI models are designed to be used with Habitat Evaluation Procedures previously developed by the U.S. Fish and Wildlife Service.

Habitat Suitability Index Models: Spotted owl

USGS Publications Warehouse

Laymon, Stephen A.; Salwasser, Hal; Barrett, Reginald H.

1985-01-01

A review and synthesis of existing information were used to develop a Habitat Suitability Index (HSI) model for the spotted owl (Strix occidentalis). The model consolidates habitat use information into a framework appropriate for field application, and is scaled to produce an index between 0.0 (unsuitable habitat) to 1.0 (optimum habitat). HSI models are designed to be used with Habitat Evaluation Procedures previously developed by the U.S. Fish and Wildlife Service.

Short- and long-term need for permanent pacemaker after transcatheter implantation of the Edwards Sapien aortic valve prosthesis.

PubMed

Moreno, Raúl; Calvo, Luis; Sánchez-Recalde, Angel; Galeote, Guillermo; Jiménez-Valero, Santiago; López, Teresa; Plaza, Ignacio; González-Davia, Rosa; Ramírez, Ulises; Mesa, Jose Maria; Moreno-Gomez, Isidro; López-Sendón, José-Luis

2015-11-01

A permanent pacemaker is frequently needed after transcatheter aortic valve implantation, but the available data are mainly on the CoreValve system. To evaluate the need for new permanent pacemaker after implantation of the Edwards Sapien device, as well as related factors. We included the first 100 patients treated with the Edwards Sapien device at our institution. Of these, 12 had a permanent pacemaker before the procedure, and thus our study population was the remaining 88 patients. A permanent pacemaker was indicated in eight patients (9.1%) during hospitalization or at 30 days. After discharge, another four patients needed a pacemaker (at 42 days and three, 18, and 30 months). Two variables were associated with the need for pacemaker during hospitalization: previous dialysis (13% vs. 1%, p=0.042) and complete right bundle branch block before the procedure (25% vs. 5%, p=0.032). More than one month after the procedure, the characteristics associated with the need for pacemaker were plasma creatinine level (2.5±1.7 vs. 1.3±0.6 mg/dl, p=0.001) and previous myocardial infarction (50% vs. 10%, p=0.013). The rate of pacemaker implantation with the Edwards Sapien device was 9.1%. Right bundle branch block and dialysis were associated with this complication.

EVA Development and Verification Testing at NASA's Neutral Buoyancy Laboratory

NASA Technical Reports Server (NTRS)

Jairala, Juniper C.; Durkin, Robert; Marak, Ralph J.; Sipila, Stepahnie A.; Ney, Zane A.; Parazynski, Scott E.; Thomason, Arthur H.

2012-01-01

As an early step in the preparation for future Extravehicular Activities (EVAs), astronauts perform neutral buoyancy testing to develop and verify EVA hardware and operations. Neutral buoyancy demonstrations at NASA Johnson Space Center's Sonny Carter Training Facility to date have primarily evaluated assembly and maintenance tasks associated with several elements of the International Space Station (ISS). With the retirement of the Shuttle, completion of ISS assembly, and introduction of commercial players for human transportation to space, evaluations at the Neutral Buoyancy Laboratory (NBL) will take on a new focus. Test objectives are selected for their criticality, lack of previous testing, or design changes that justify retesting. Assembly tasks investigated are performed using procedures developed by the flight hardware providers and the Mission Operations Directorate (MOD). Orbital Replacement Unit (ORU) maintenance tasks are performed using a more systematic set of procedures, EVA Concept of Operations for the International Space Station (JSC-33408), also developed by the MOD. This paper describes the requirements and process for performing a neutral buoyancy test, including typical hardware and support equipment requirements, personnel and administrative resource requirements, examples of ISS systems and operations that are evaluated, and typical operational objectives that are evaluated.

Effects of High-Flux versus Low-Flux Membranes on Pulmonary Function Tests in Hemodialysis Patients.

PubMed

Momeni, Ali; Rouhi, Hamid; Kiani, Glareh; Amiri, Masoud

2013-01-01

Several studies have been carried out to evaluate the effects of dialysis on pulmonary function tests (PFT). Dialysis procedure may reduce lung volumes and capacities or cause hypoxia; however, to the best of our knowledge, there is no previous study evaluating the effects of membrane type (high flux vs. low flux) on PFT in these patients. The aim of this study was the evaluation of this relationship. In this cross-sectional study, 43 hemodialysis patients without pulmonary disease were enrolled. In these patients dialysis was conducted by low-and high-flux membranes and before and after the procedure, spirometry was done and the results were evaluated by t-test and chi square test. The mean age of patients was 56.34 years. Twenty-three of them were female (53.5%). Type of membrane (high flux vs. low flux) had no effect on spirometry results of patients despite the significant decrease in the body weight during the dialysis session. High flux membrane had no advantage over low flux membrane in terms of improvement in spirometry findings; thus, we could not offer these expensive membranes for this purpose.

Interprofessional and interdisciplinary simulation-based training leads to safe sedation procedures in the emergency department.

PubMed

Sauter, Thomas C; Hautz, Wolf E; Hostettler, Simone; Brodmann-Maeder, Monika; Martinolli, Luca; Lehmann, Beat; Exadaktylos, Aristomenis K; Haider, Dominik G

2016-08-02

Sedation is a procedure required for many interventions in the Emergency department (ED) such as reductions, surgical procedures or cardioversions. However, especially under emergency conditions with high risk patients and rapidly changing interdisciplinary and interprofessional teams, the procedure caries important risks. It is thus vital but difficult to implement a standard operating procedure for sedation procedures in any ED. Reports on both, implementation strategies as well as their success are currently lacking. This study describes the development, implementation and clinical evaluation of an interprofessional and interdisciplinary simulation-based sedation training concept. All physicians and nurses with specialised training in emergency medicine at the Berne University Department of Emergency Medicine participated in a mandatory interdisciplinary and interprofessional simulation-based sedation training. The curriculum consisted of an individual self-learning module, an airway skill training course, three simulation-based team training cases, and a final practical learning course in the operating theatre. Before and after each training session, self-efficacy, awareness of emergency procedures, knowledge of sedation medication and crisis resource management were assessed with a questionnaire. Changes in these measures were compared via paired tests, separately for groups formed based on experience and profession. To assess the clinical effect of training, we collected patient and team satisfaction as well as duration and complications for all sedations in the ED within the year after implementation. We further compared time to beginning of procedure, time for duration of procedure and time until discharge after implementation with the one year period before the implementation. Cohen's d was calculated as effect size for all statistically significant tests. Fifty staff members (26 nurses and 24 physicians) participated in the training. In all subgroups, there is a significant increase in self-efficacy and knowledge with high effect size (d z  = 1.8). The learning is independent of profession and experience level. In the clinical evaluation after implementation, we found no major complications among the sedations performed. Time to procedure significantly improved after the introduction of the training (d = 0.88). Learning is independent of previous working experience and equally effective in raising the self-efficacy and knowledge in all professional groups. Clinical outcome evaluation confirms the concepts safety and feasibility. An interprofessional and interdisciplinary simulation-based sedation training is an efficient way to implement a conscious sedation concept in an ED.

Expanding endourology for biliary stone disease: the efficacy of intracorporeal lithotripsy on refractory biliary calculi.

PubMed

Sninsky, Brian C; Sehgal, Priyanka D; Hinshaw, J Louis; McDermott, John C; Nakada, Stephen Y

2014-07-01

We evaluated the efficacy of ureteroscopic therapy (electrohydraulic lithotripsy [EHL] and intraductal laser lithotripsy [ILL]) in patients with challenging biliary stones secondary to anatomic variations resulting from a previous surgical procedure, including liver transplantation. A retrospective chart review was performed for all patients with previous surgical alteration of the gastrointestinal (GI) tract who underwent EHL or ILL via peroral or percutaneous access for choledocholithiasis by a single surgeon at our institution from 2000 to 2012. A database containing clinical and surgical variables was created, and long-term follow-up was conducted (3-138 months; median, 99 months). Thirteen patients (51.7±20.0 years; M:F, 10:3) in whom endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTHC), or both failed were identified. Failure of ERCP/PTHC was because of inaccessibility of the calculi in all cases. Stone clearance was achieved in 12/13 (93%) patients; 8/12 (62%) after one procedure, and 4/12 (31%) after two procedures. One patient with biliary cast syndrome needed four interventions over 9 years. Major complications were low, with only one patient with hypotension and cholangitis that resolved with 24 hours of administration of intravenous fluids and antibiotics. Both endoscopic and percutaneous lithotripsies are effective treatments for refractory biliary calculi resulting from the post-surgical GI tract. Although a staged second procedure may be necessary in patients with significant stone burden, this is significantly better than extensive open surgery.

Flexible and rigid cystoscopy in women.

PubMed

Gee, Jason R; Waterman, Bradley J; Jarrard, David F; Hedican, Sean P; Bruskewitz, Reginald C; Nakada, Stephen Y

2009-01-01

Previous studies have evaluated the tolerability of rigid versus flexible cystoscopy in men. Similar studies, however, have not been performed in women. We sought to determine whether office-based flexible cystoscopy was better tolerated than rigid cystoscopy in women. Following full IRB approval, women were prospectively randomized in a single-blind manner. Patients were randomized to flexible or rigid cystoscopy and draped in the lithotomy position to maintain blinding of the study. Questionnaires evaluated discomfort before, during, and after cystoscopy. Thirty-six women were randomized to flexible (18) or rigid (18) cystoscopy. Indications were surveillance (16), hematuria (15), recurrent UTIs (2), voiding dysfunction (1), and other (2). All questionnaires were returned by 31/36 women. Using a 10-point visual analog scale (VAS), median discomfort during the procedure for flexible and rigid cystoscopy were 1.4 and 1.8, respectively, in patients perceiving pain. Median recalled pain 1 week later was similar at 0.8 and 1.15, respectively. None of these differences were statistically significant. Flexible and rigid cystoscopy are well tolerated in women. Discomfort during and after the procedure is minimal in both groups. Urologists should perform either procedure in women based on their preference and skill level.

Compound estimation procedures in reliability

NASA Technical Reports Server (NTRS)

Barnes, Ron

1990-01-01

At NASA, components and subsystems of components in the Space Shuttle and Space Station generally go through a number of redesign stages. While data on failures for various design stages are sometimes available, the classical procedures for evaluating reliability only utilize the failure data on the present design stage of the component or subsystem. Often, few or no failures have been recorded on the present design stage. Previously, Bayesian estimators for the reliability of a single component, conditioned on the failure data for the present design, were developed. These new estimators permit NASA to evaluate the reliability, even when few or no failures have been recorded. Point estimates for the latter evaluation were not possible with the classical procedures. Since different design stages of a component (or subsystem) generally have a good deal in common, the development of new statistical procedures for evaluating the reliability, which consider the entire failure record for all design stages, has great intuitive appeal. A typical subsystem consists of a number of different components and each component has evolved through a number of redesign stages. The present investigations considered compound estimation procedures and related models. Such models permit the statistical consideration of all design stages of each component and thus incorporate all the available failure data to obtain estimates for the reliability of the present version of the component (or subsystem). A number of models were considered to estimate the reliability of a component conditioned on its total failure history from two design stages. It was determined that reliability estimators for the present design stage, conditioned on the complete failure history for two design stages have lower risk than the corresponding estimators conditioned only on the most recent design failure data. Several models were explored and preliminary models involving bivariate Poisson distribution and the Consael Process (a bivariate Poisson process) were developed. Possible short comings of the models are noted. An example is given to illustrate the procedures. These investigations are ongoing with the aim of developing estimators that extend to components (and subsystems) with three or more design stages.

Procedures to evaluate the efficiency of protective clothing worn by operators applying pesticide.

PubMed

Espanhol-Soares, Melina; Nociti, Leticia A S; Machado-Neto, Joaquim Gonçalves

2013-10-01

The evaluation of the efficiency of whole-body protective clothing against pesticides has already been carried out through field tests and procedures defined by international standards, but there is a need to determine the useful life of these garments to ensure worker safety. The aim of this article is to compare the procedures for evaluating efficiency of two whole-body protective garments, both new and previously used by applicators of herbicides, using a laboratory test with a mannequin and in the field with the operator. The evaluation of the efficiency of protective clothing used both quantitative and qualitative methodologies, leading to a proposal for classification according to efficiency, and determination of the useful life of protective clothing for use against pesticides, based on a quantitative assessment. The procedures used were in accordance with the standards of the modified American Society for Testing and Materials (ASTM) F 1359:2007 and International Organization for Standardization 17491-4. The protocol used in the field was World Health Organization Vector Biology and Control (VBC)/82.1. Clothing tested was personal water repellent and pesticide protective. Two varieties of fabric were tested: Beige (100% cotton) and Camouflaged (31% polyester and 69% cotton). The efficiency in exposure control of the personal protective clothing was measured before use and after 5, 10, 20, and 30 uses and washes under field conditions. Personal protective clothing was worn by workers in the field during the application of the herbicide glyphosate on weed species in mature sugar cane plantations using a knapsack sprayer. The modified ASTM 1359:2007 procedure was chosen as the most appropriate due to its greater repeatability (lower coefficient of variation). This procedure provides quantitative evaluation needed to determine the efficiency and useful life of individual protective clothing, not just at specific points of failure, but according to dermal protection as a whole. The qualitative assessment, which is suitable for verification of garment design and stitching flaws, does not aid in determining useful life, but does complement the quantitative evaluation. The proposed classification is appropriate and accurate for determining the useful life of personal protective clothing against pesticide materials relative to number of uses and washes after each use. For example, the Beige garment had a useful life of 30 uses and washes, while the Camouflaged garment had a useful life of 5 uses and washes. The quantitative evaluation aids in determining the efficiency and useful life of individual protective clothing according to dermal protection as a whole, not just at specific points of failure.

Single-trial evaluative conditioning can be moderated by instructed forgetting.

PubMed

Gast, Anne; Kattner, Florian

2016-09-01

Evaluative conditioning (EC) is a change in the valence of a conditioned stimulus (CS) due to previous pairing with an affective unconditioned stimulus (US). Several previous studies indicate that EC is related to memory of the CS-US pairs. Previous studies, however, typically cannot distinguish between the influence of CS-US knowledge during measurement and during encoding. In addition, by measuring rather than manipulating memory, they do not test the causal effect of memory on EC. The present study employed a "directed forgetting" procedure to the EC paradigm instructing participants to either forget or remember certain CS-US pairs. We found that EC effects after single learning trials were stronger for to-be-remembered than for to-be-forgotten pairs. Manipulation checks showed that the forgetting manipulation also successfully modulated memory for the target pairs and reduced both retroactive and proactive interference on memory for other pairs. Item-based analyses further demonstrated that the size of EC depended on CS-US memory. The results suggest that EC relies on available memory during measurement of the EC effect.

Brain measures of nociception using near-infrared spectroscopy in patients undergoing routine screening colonoscopy.

PubMed

Becerra, Lino; Aasted, Christopher M; Boas, David A; George, Edward; Yücel, Meryem A; Kussman, Barry D; Kelsey, Peter; Borsook, David

2016-04-01

Colonoscopy is an invaluable tool for the screening and diagnosis of many colonic diseases. For most colonoscopies, moderate sedation is used during the procedure. However, insufflation of the colon produces a nociceptive stimulus that is usually accompanied by facial grimacing/groaning while under sedation. The objective of this study was to evaluate whether a nociceptive signal elicited by colonic insufflation could be measured from the brain. Seventeen otherwise healthy patients (age 54.8 ± 9.1; 6 female) undergoing routine colonoscopy (ie, no history of significant medical conditions) were monitored using near-infrared spectroscopy (NIRS). Moderate sedation was produced using standard clinical protocols for midazolam and meperidine, titrated to effect. Near-infrared spectroscopy data captured during the procedure was analyzed offline to evaluate the brains' responses to nociceptive stimuli evoked by the insufflation events (defined by physician or observing patients' facial responses). Analysis of NIRS data revealed a specific, reproducible prefrontal cortex activity corresponding to times when patients grimaced. The pattern of the activation is similar to that previously observed during nociceptive stimuli in awake healthy individuals, suggesting that this approach may be used to evaluate brain activity evoked by nociceptive stimuli under sedation, when there is incomplete analgesia. Although some patients report recollection of procedural pain after the procedure, the effects of repeated nociceptive stimuli in surgical patients may contribute to postoperative changes including chronic pain. The results from this study indicate that NIRS may be a suitable technology for continuous nociceptive afferent monitoring in patients undergoing sedation and could have applications under sedation or anesthesia.

Brain Measures of Nociception using Near Infrared Spectroscopy in Patients Undergoing Routine Screening Colonoscopy

PubMed Central

Boas, David A.; George, Edward; Yücel, Meryem A.; Kussman, Barry D.; Kelsey, Peter; Borsook, David

2015-01-01

Colonoscopy is an invaluable tool for screening and diagnosis of many colonic diseases. For most colonoscopies, moderate sedation is used during the procedure. However, insufflation of the colon produces a nociceptive stimulus that is usually accompanied by facial grimacing/groaning while under sedation. The objective of the current study was to evaluate whether a nociceptive signal elicited by colonic insufflation could be measured from the brain. Seventeen otherwise healthy patients (age 54.8±9.1; 6 female) undergoing routine colonoscopy (i.e., no history of significant medical conditions) were monitored using near-infrared spectroscopy (NIRS). Moderate sedation was produced using standard clinical protocols for midazolam and meperidine, titrated to effect. NIRS data captured during the procedure was analyzed offline to evaluate the brains’ responses to nociceptive stimuli evoked by the insufflation events (defined by physician or observing patients’ facial responses). Analysis of NIRS data revealed a specific, reproducible prefrontal cortex activity corresponding to times when patients grimaced. The pattern of the activation is similar to that previously observed during nociceptive stimuli in awake healthy individuals, suggesting that this approach may be used to evaluate brain activity evoked by nociceptive stimuli under sedation, when there is incomplete analgesia. While some patients report recollection of procedural pain following the procedure, the effects of repeated nociceptive stimuli in surgical patients may contribute to postoperative changes including chronic pain. The results from this study indicate that NIRS may be a suitable technology for continuous nociceptive afferent monitoring in patients undergoing sedation and could have applications under sedation or anesthesia. PMID:26645550

Nomarski differential interference contrast microscopy for surface slope measurements: an examination of techniques

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

Hartman, J.S.; Gordon, R.L.; Lessor, D.L.

1981-08-01

Alternate measurement and data analysis procedures are discussed and compared for the application of reflective Nomarski differential interference contrast microscopy for the determination of surface slopes. The discussion includes the interpretation of a previously reported iterative procedure using the results of a detailed optical model and the presentation of a new procedure based on measured image intensity extrema. Surface slope determinations from these procedures are presented and compared with results from a previously reported curve fit analysis of image intensity data. The accuracy and advantages of the different procedures are discussed.

A Social Evaluation of Perception on Body Contouring Surgery by Turkish Male Aesthetic Surgery Patients.

PubMed

Ozel, Bora; Sezgin, Billur; Guney, Kirdar; Latifoglu, Osman; Celebi, Cemallettin

2015-02-01

Although aesthetic procedures are known to have a higher impact on women, men are becoming more inclined toward such procedures since the last decade. To determine the reason behind the increase in demand for male aesthetic procedures and to learn about the expectations and inquietude related to body contouring surgery, a prospective questionnaire study was conducted on 200 Turkish males from January 1, 2011-May 31, 2012. Demographic information, previous aesthetic procedures and thoughts on body contouring procedures with given reasons were questioned. The results of the study showed that 53 % of all participants considered undergoing body contouring surgery with the given reason that they believed their current body structure required it. For those who did not consider contouring operations, 92.5 % said they felt that they did not need such a procedure. The results of the statistical analysis showed that BMI was a significant factor in the decision making process for wanting to undergo body contouring procedures. The results of the study showed that men's consideration for aesthetic operations depends mainly on necessity and that the most considered region was the abdominal zone in regard to contouring. We can conclude that men are becoming more interested in body contouring operations and therefore different surgical procedures should be refined and re-defined according to the expectations of this new patient group.

Robust tracking of a virtual electrode on a coronary sinus catheter for atrial fibrillation ablation procedures

NASA Astrophysics Data System (ADS)

Wu, Wen; Chen, Terrence; Strobel, Norbert; Comaniciu, Dorin

2012-02-01

Catheter tracking in X-ray fluoroscopic images has become more important in interventional applications for atrial fibrillation (AF) ablation procedures. It provides real-time guidance for the physicians and can be used as reference for motion compensation applications. In this paper, we propose a novel approach to track a virtual electrode (VE), which is a non-existing electrode on the coronary sinus (CS) catheter at a more proximal location than any real electrodes. Successful tracking of the VE can provide more accurate motion information than tracking of real electrodes. To achieve VE tracking, we first model the CS catheter as a set of electrodes which are detected by our previously published learning-based approach.1 The tracked electrodes are then used to generate the hypotheses for tracking the VE. Model-based hypotheses are fused and evaluated by a Bayesian framework. Evaluation has been conducted on a database of clinical AF ablation data including challenging scenarios such as low signal-to-noise ratio (SNR), occlusion and nonrigid deformation. Our approach obtains 0.54mm median error and 90% of evaluated data have errors less than 1.67mm. The speed of our tracking algorithm reaches 6 frames-per-second on most data. Our study on motion compensation shows that using the VE as reference provides a good point to detect non-physiological catheter motion during the AF ablation procedures.2

Pediatric endocanalicular diode laser dacryocystorhinostomy: results of a minimally invasive surgical technique.

PubMed

Uysal, Ismail Onder; Ozçimen, Muammer; Yener, Halil Ibrahim; Kal, Ali

2011-09-01

The purpose of this study was to evaluate the effectiveness of endocanalicular diode laser dacryocystorhinostomy (DCR), which is a minimally invasive surgical technique, in pediatric patients with congenital nasolacrimal duct obstruction (NLDO). A retrospective study was carried out on patients treated between October 2008 and August 2009 for nasolacrimal duct obstruction with an endocanalicular diode laser procedure. Patients diagnosed as having nasolacrimal duct obstruction were included in this study and an endocanalicular diode laser procedure was performed. The main outcome measures were patients' previous treatments, clinical presentation, operative and postoperative complications, postoperative follow-up and resolution of epiphora. Eighteen children (10 girls, 8 boys) with a mean age of 6.11 ± 2.08 years (range, 4-10) underwent 20 endocanalicular laser DCR operations for congenital NLDO. In all eyes (100%), there was a history of epiphora and chronic dacryocystitis; two (10%) presented with acute dacryocystitis. Previous procedures included probing and irrigation of all eyes (100%) and silicone tube intubation in nine eyes (45%). None of the patients underwent any previous DCR operations. During a mean postoperative follow-up period of 20.50 ± 3.24 months (range, 14-24 months), the anatomical success rate (patency of ostium on nasal endoscopy) was 100%, and the clinical success rate (resolution of epiphora) was 85%. Endocanalicular diode laser DCR is an effective treatment modality for pediatric patients with congenital NLDO that compares favorably with the reported success rates of external and endoscopic endonasal DCR. Moreover, it has an added advantage of shorter operative time, less morbidity and avoidance of overnight admission.

Further development of LLNA:DAE method as stand-alone skin-sensitization testing method and applied for evaluation of relative skin-sensitizing potency between chemicals.

PubMed

Yamashita, Kunihiko; Shinoda, Shinsuke; Hagiwara, Saori; Itagaki, Hiroshi

2015-04-01

To date, there has been no well-established local lymph node assay (LLNA) that includes an elicitation phase. Therefore, we developed a modified local lymph node assay with an elicitation phase (LLNA:DAE) to discriminate true skin sensitizers from chemicals that gave borderline positive results and previously reported this assay. To develop the LLNA:DAE method as a useful stand-alone testing method, we investigated the complete procedure for the LLNA:DAE method using hexyl cinnamic aldehyde (HCA), isoeugenol, and 2,4-dinitrochlorobenzene (DNCB) as test compounds. We defined the LLNA:DAE procedure as follows: in the dose-finding test, four concentrations of chemical applied to dorsum of the right ear on days 1, 2, and 3 and dorsum of both ears on day 10. Ear thickness and skin irritation score were measured on days 1, 3, 5, 10, and 12. Local lymph nodes were excised and weighed on day 12. The test dose for the primary LLNA:DAE study was selected as the dose that gave the highest left ear lymph node weight in the dose-finding study, or the lowest dose that produced a left ear lymph node of over 4 mg. This procedure was validated using nine different chemicals. Furthermore, qualitative relationship was observed between the degree of elicitation response in the left ear lymph node and the skin sensitizing potency of 32 chemicals tested in this study and the previous study. These results indicated that LLNA:DAE method was as first LLNA method that was able to evaluate the skin sensitizing potential and potency in elicitation response.

Planetary Candidates Observed by Kepler. VII. The First Fully Uniform Catalog Based on the Entire 48-month Data Set (Q1-Q17 DR24)

NASA Astrophysics Data System (ADS)

Coughlin, Jeffrey L.; Mullally, F.; Thompson, Susan E.; Rowe, Jason F.; Burke, Christopher J.; Latham, David W.; Batalha, Natalie M.; Ofir, Aviv; Quarles, Billy L.; Henze, Christopher E.; Wolfgang, Angie; Caldwell, Douglas A.; Bryson, Stephen T.; Shporer, Avi; Catanzarite, Joseph; Akeson, Rachel; Barclay, Thomas; Borucki, William J.; Boyajian, Tabetha S.; Campbell, Jennifer R.; Christiansen, Jessie L.; Girouard, Forrest R.; Haas, Michael R.; Howell, Steve B.; Huber, Daniel; Jenkins, Jon M.; Li, Jie; Patil-Sabale, Anima; Quintana, Elisa V.; Ramirez, Solange; Seader, Shawn; Smith, Jeffrey C.; Tenenbaum, Peter; Twicken, Joseph D.; Zamudio, Khadeejah A.

2016-05-01

We present the seventh Kepler planet candidate (PC) catalog, which is the first catalog to be based on the entire, uniformly processed 48-month Kepler data set. This is the first fully automated catalog, employing robotic vetting procedures to uniformly evaluate every periodic signal detected by the Q1-Q17 Data Release 24 (DR24) Kepler pipeline. While we prioritize uniform vetting over the absolute correctness of individual objects, we find that our robotic vetting is overall comparable to, and in most cases superior to, the human vetting procedures employed by past catalogs. This catalog is the first to utilize artificial transit injection to evaluate the performance of our vetting procedures and to quantify potential biases, which are essential for accurate computation of planetary occurrence rates. With respect to the cumulative Kepler Object of Interest (KOI) catalog, we designate 1478 new KOIs, of which 402 are dispositioned as PCs. Also, 237 KOIs dispositioned as false positives (FPs) in previous Kepler catalogs have their disposition changed to PC and 118 PCs have their disposition changed to FPs. This brings the total number of known KOIs to 8826 and PCs to 4696. We compare the Q1-Q17 DR24 KOI catalog to previous KOI catalogs, as well as ancillary Kepler catalogs, finding good agreement between them. We highlight new PCs that are both potentially rocky and potentially in the habitable zone of their host stars, many of which orbit solar-type stars. This work represents significant progress in accurately determining the fraction of Earth-size planets in the habitable zone of Sun-like stars. The full catalog is publicly available at the NASA Exoplanet Archive.

A COMPARISON OF TWO PAIRING PROCEDURES TO ESTABLISH PRAISE AS A REINFORCER

PubMed Central

Dozier, Claudia L.; Iwata, Brian A.; Thomason-Sassi, Jessica; Worsdell, April S.; Wilson, David M.

2012-01-01

Some individuals with intellectual disabilities do not respond to praise as a reinforcer, which may limit their ability to learn. We evaluated 2 procedures (stimulus pairing and response–stimulus pairing), both of which involved pairing previously neutral praise statements with preferred edible items, to determine their usefulness in establishing praise as a reinforcer. Results of Study 1 indicated that stimulus pairing was not effective in conditioning praise as a reinforcer for 3 of 4 subjects; results were inconclusive for the 4th subject. Results of Study 2 indicated that response–stimulus pairing was effective in conditioning praise as a reinforcer for 4 of 8 subjects. After conditioning, praise also increased the occurrence of additional target responses for these 4 subjects. PMID:23322928

Novel anatomic variation: heptafurcation of the celiac trunk.

PubMed

Rusu, M C; Manta, B A

2018-04-01

We report here anatomic variants which were found during a retrospective study of a male patient, 54 years old, evaluated in computed tomography: heptafurcation of the celiac trunk (CT) and bilateral double renal arteries. The seven branches of the heptafurcated CT were the (1) left and (2) right inferior phrenic arteries, the (3) splenic and (4) left gastric artery, the (5) common hepatic artery, further sending off the (a) proper, continued as left, hepatic artery and (b) the gastroduodenal artery, (6) a replaced right hepatic artery and (7) the dorsal pancreatic artery. To our knowledge, heptafurcation of the CT was not reported previously. The arterial variants have great importance during various surgical and interventional procedures and should be documented prior to respective procedures.

Abdominoplasty: Risk Factors, Complication Rates, and Safety of Combined Procedures.

PubMed

Winocour, Julian; Gupta, Varun; Ramirez, J Roberto; Shack, R Bruce; Grotting, James C; Higdon, K Kye

2015-11-01

Among aesthetic surgery procedures, abdominoplasty is associated with a higher complication rate, but previous studies are limited by small sample sizes or single-institution experience. A cohort of patients who underwent abdominoplasty between 2008 and 2013 was identified from the CosmetAssure database. Major complications were recorded. Univariate and multivariate analysis was performed evaluating risk factors, including age, smoking, body mass index, sex, diabetes, type of surgical facility, and combined procedures. The authors identified 25,478 abdominoplasties from 183,914 procedures in the database. Of these, 8,975 patients had abdominoplasty alone and 16,503 underwent additional procedures. The number of complications recorded was 1,012 (4.0 percent overall rate versus 1.4 percent in other aesthetic surgery procedures). Of these, 31.5 percent were hematomas, 27.2 percent were infections and 20.2 percent were suspected or confirmed venous thromboembolism. On multivariate analysis, significant risk factors (p < 0.05) included male sex (relative risk, 1.8), age 55 years or older (1.4), body mass index greater than or equal to 30 (1.3), multiple procedures (1.5), and procedure performance in a hospital or surgical center versus office-based surgical suite (1.6). Combined procedures increased the risk of complication (abdominoplasty alone, 3.1 percent; with liposuction, 3.8 percent; breast procedure, 4.3 percent; liposuction and breast procedure, 4.6 percent; body-contouring procedure, 6.8 percent; liposuction and body-contouring procedure, 10.4 percent). Abdominoplasty is associated with a higher complication rate compared with other aesthetic procedures. Combined procedures can significantly increase complication rates and should be considered carefully in higher risk patients. Risk, II.

Improving DoD Logistics: Perspectives from Rand Research, Volume 1,

DTIC Science & Technology

1995-01-01

strategic lift, and a more dynamic environment in which plans and priorities rapidly changed and units frequently moved. As in the previous chart...legislation, regulations, or local procedures.5 4 Many of these limits are imposed on DoD by Congress, with the explicit or implicit intent to protect DoD...propagate process improvements more widely. This chart lists elements of some of these programs. The intent is not to evaluate or to be exhaustive but to

B-1 Systems Approach to Training. Simulation Technology Assessment Report (STAR)

DTIC Science & Technology

1975-07-01

Psychology in the Air Force, 1974. Creelman , J.A., Evaluation of Approach Training Procedures, U.S. Naval School of Aviation Med., Proj. No. NM001-109-107...training. 3.2 PHYSICAL VERSUS PSYCHOLOGICAL SIMULATION In the previous section, the term "physical simulation" was used to represent the case where... psychology that there is no "step function" threshold. Rather, detection capability plotted against phys- ical parameter strength results in an ogival

Joint Test and Evaluation Procedures Manual.

DTIC Science & Technology

1980-09-01

offices within 0oD such as ODDTE may allot funds to individual JTFs for purchasing goods and services. 1-12 Service support to JT&E is usually drawn...on underlying assumptions about the "real world," and that a good operational scenario may conflict with the assumptions for a specific statistical...Learned Since a good Data Management Plan is critical to the success of a joint test, some situations which have occurred in previous tests are listed

Laparoscopic completion cholecystectomy and common bile duct exploration for retained gallbladder after single-incision cholecystectomy.

PubMed

Kroh, Matthew; Chalikonda, Sricharan; Chand, Bipan; Walsh, R Matthew

2013-01-01

Recent enthusiasm in the surgical community for less invasive surgical approaches has resulted in widespread application of single-incision techniques. This has been most commonly applied in laparoscopic cholecystectomy in general surgery. Cosmesis appears to be improved, but other advantages remain to be seen. Feasibility has been demonstrated, but there is little description in the current literature regarding complications. We report the case of a patient who previously underwent single-incision laparoscopic cholecystectomy for symptomatic gallstone disease. After a brief symptom-free interval, she developed acute pancreatitis. At evaluation, imaging results of ultrasonography and magnetic resonance cholangiopancreatography demonstrated a retained gallbladder with cholelithiasis. The patient was subsequently referred to our hospital, where she underwent further evaluation and surgical intervention. Our patient underwent 4-port laparoscopic remnant cholecystectomy with transcystic common bile duct exploration. Operative exploration demonstrated a large remnant gallbladder and a partially obstructed cystic duct with many stones. Transcystic exploration with balloon extraction resulted in duct clearance. The procedure took 75 minutes, with minimal blood loss. The patient's postoperative course was uneventful. Final pathology results demonstrated a remnant gallbladder with cholelithiasis and cholecystitis. This report is the first in the literature to describe successful laparoscopic remnant cholecystectomy and transcystic common bile duct exploration after previous single-port cholecystectomy. Although inadvertent partial cholecystectomy is not unique to this technique, single-port laparoscopic procedures may result in different and significant complications.

TRACON Aircraft Arrival Planning and Optimization Through Spatial Constraint Satisfaction

NASA Technical Reports Server (NTRS)

Bergh, Christopher P.; Krzeczowski, Kenneth J.; Davis, Thomas J.; Denery, Dallas G. (Technical Monitor)

1995-01-01

A new aircraft arrival planning and optimization algorithm has been incorporated into the Final Approach Spacing Tool (FAST) in the Center-TRACON Automation System (CTAS) developed at NASA-Ames Research Center. FAST simulations have been conducted over three years involving full-proficiency, level five air traffic controllers from around the United States. From these simulations an algorithm, called Spatial Constraint Satisfaction, has been designed, coded, undergone testing, and soon will begin field evaluation at the Dallas-Fort Worth and Denver International airport facilities. The purpose of this new design is an attempt to show that the generation of efficient and conflict free aircraft arrival plans at the runway does not guarantee an operationally acceptable arrival plan upstream from the runway -information encompassing the entire arrival airspace must be used in order to create an acceptable aircraft arrival plan. This new design includes functions available previously but additionally includes necessary representations of controller preferences and workload, operationally required amounts of extra separation, and integrates aircraft conflict resolution. As a result, the Spatial Constraint Satisfaction algorithm produces an optimized aircraft arrival plan that is more acceptable in terms of arrival procedures and air traffic controller workload. This paper discusses the current Air Traffic Control arrival planning procedures, previous work in this field, the design of the Spatial Constraint Satisfaction algorithm, and the results of recent evaluations of the algorithm.

Ecological Momentary Assessments and Automated Time Series Analysis to Promote Tailored Health Care: A Proof-of-Principle Study.

PubMed

van der Krieke, Lian; Emerencia, Ando C; Bos, Elisabeth H; Rosmalen, Judith Gm; Riese, Harriëtte; Aiello, Marco; Sytema, Sjoerd; de Jonge, Peter

2015-08-07

Health promotion can be tailored by combining ecological momentary assessments (EMA) with time series analysis. This combined method allows for studying the temporal order of dynamic relationships among variables, which may provide concrete indications for intervention. However, application of this method in health care practice is hampered because analyses are conducted manually and advanced statistical expertise is required. This study aims to show how this limitation can be overcome by introducing automated vector autoregressive modeling (VAR) of EMA data and to evaluate its feasibility through comparisons with results of previously published manual analyses. We developed a Web-based open source application, called AutoVAR, which automates time series analyses of EMA data and provides output that is intended to be interpretable by nonexperts. The statistical technique we used was VAR. AutoVAR tests and evaluates all possible VAR models within a given combinatorial search space and summarizes their results, thereby replacing the researcher's tasks of conducting the analysis, making an informed selection of models, and choosing the best model. We compared the output of AutoVAR to the output of a previously published manual analysis (n=4). An illustrative example consisting of 4 analyses was provided. Compared to the manual output, the AutoVAR output presents similar model characteristics and statistical results in terms of the Akaike information criterion, the Bayesian information criterion, and the test statistic of the Granger causality test. Results suggest that automated analysis and interpretation of times series is feasible. Compared to a manual procedure, the automated procedure is more robust and can save days of time. These findings may pave the way for using time series analysis for health promotion on a larger scale. AutoVAR was evaluated using the results of a previously conducted manual analysis. Analysis of additional datasets is needed in order to validate and refine the application for general use.

One repetition maximum bench press performance: a new approach for its evaluation in inexperienced males and females: a pilot study.

PubMed

Bianco, Antonino; Filingeri, Davide; Paoli, Antonio; Palma, Antonio

2015-04-01

The aim of this study was to evaluate a new method to perform the one repetition maximum (1RM) bench press test, by combining previously validated predictive and practical procedures. Eight young male and 7 females participants, with no previous experience of resistance training, performed a first set of repetitions to fatigue (RTF) with a workload corresponding to ⅓ of their body mass (BM) for a maximum of 25 repetitions. Following a 5-min recovery period, a second set of RTF was performed with a workload corresponding to ½ of participants' BM. The number of repetitions performed in this set was then used to predict the workload to be used for the 1RM bench press test using Mayhew's equation. Oxygen consumption, heart rate and blood lactate were monitored before, during and after each 1RM attempt. A significant effect of gender was found on the maximum number of repetitions achieved during the RTF set performed with ½ of participants' BM (males: 25.0 ± 6.3; females: 11.0x± 10.6; t = 6.2; p < 0.001). The 1RM attempt performed with the workload predicted by Mayhew's equation resulted in females performing 1.2 ± 0.7 repetitions, while males performed 4.8 ± 1.9 repetitions. All participants reached their 1RM performance within 3 attempts, thus resulting in a maximum of 5 sets required to successfully perform the 1RM bench press test. We conclude that, by combining previously validated predictive equations with practical procedures (i.e. using a fraction of participants' BM to determine the workload for an RTF set), the new method we tested appeared safe, accurate (particularly in females) and time-effective in the practical evaluation of 1RM performance in inexperienced individuals. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ecological Momentary Assessments and Automated Time Series Analysis to Promote Tailored Health Care: A Proof-of-Principle Study

PubMed Central

Emerencia, Ando C; Bos, Elisabeth H; Rosmalen, Judith GM; Riese, Harriëtte; Aiello, Marco; Sytema, Sjoerd; de Jonge, Peter

2015-01-01

Background Health promotion can be tailored by combining ecological momentary assessments (EMA) with time series analysis. This combined method allows for studying the temporal order of dynamic relationships among variables, which may provide concrete indications for intervention. However, application of this method in health care practice is hampered because analyses are conducted manually and advanced statistical expertise is required. Objective This study aims to show how this limitation can be overcome by introducing automated vector autoregressive modeling (VAR) of EMA data and to evaluate its feasibility through comparisons with results of previously published manual analyses. Methods We developed a Web-based open source application, called AutoVAR, which automates time series analyses of EMA data and provides output that is intended to be interpretable by nonexperts. The statistical technique we used was VAR. AutoVAR tests and evaluates all possible VAR models within a given combinatorial search space and summarizes their results, thereby replacing the researcher’s tasks of conducting the analysis, making an informed selection of models, and choosing the best model. We compared the output of AutoVAR to the output of a previously published manual analysis (n=4). Results An illustrative example consisting of 4 analyses was provided. Compared to the manual output, the AutoVAR output presents similar model characteristics and statistical results in terms of the Akaike information criterion, the Bayesian information criterion, and the test statistic of the Granger causality test. Conclusions Results suggest that automated analysis and interpretation of times series is feasible. Compared to a manual procedure, the automated procedure is more robust and can save days of time. These findings may pave the way for using time series analysis for health promotion on a larger scale. AutoVAR was evaluated using the results of a previously conducted manual analysis. Analysis of additional datasets is needed in order to validate and refine the application for general use. PMID:26254160

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

Farina, R.; Brandao-Mello, C.E.; Oliveira, A.R.

In September 1987, the Goiania radiological accident involving a source of {sup 137}Cs culminated in about 140 victims who presented internal and/or external contamination and/or external exposure to radiation and/or radiation burns. Internal contamination was verified through analysis of urine and fecal samples. Internal contamination was also evaluated by measurements performed at the whole-body counter installed in Goiania in November 1987. To enhance the decorporation of 137Cs, patients were treated with the following: (1) Prussian Blue, oral administration, in 46 patients; (2) diuretics, oral administration, in 17 patients; (3) induced perspiration, increasing {sup 137}Cs elimination. These procedures were done undermore » rigorous clinical evaluation and considering the data from assay of excreta and data obtained from the whole-body counter. The doses of Prussian Blue exceeded about 6.5 times the dose previously indicated in the literature. It was the first time diuretics were used in humans to treat {sup 137}Cs internal contamination. The results of these procedures are discussed.« less

Design and Outcomes of a Comprehensive Care Experience Level System to Evaluate and Monitor Dental Students' Clinical Progress.

PubMed

Teich, Sorin T; Roperto, Renato; Alonso, Aurelio A; Lang, Lisa A

2016-06-01

A Comprehensive Care Experience Level (CCEL) system that is aligned with Commission on Dental Accreditation (CODA) standards, promotes comprehensive care and prevention, and addresses flaws observed in previous Relative Value Units (RVU)-based programs has been implemented at the School of Dental Medicine, Case Western Reserve University since 2011. The purpose of this article is to report on the design, implementation, and preliminary outcomes of this novel clinical evaluation system. With the development of the CCEL concept, it was decided not to award points for procedures performed on competency exams. The reason behind this decision was that exams are not learning opportunities and are evaluated with summative tools. To determine reasonable alternative requirements, production data from previous classes were gathered and translated into CCEL points. These RVU points had been granted selectively only for restorative procedures completed after the initial preparation stage of the treatment plan, and achievement of the required levels was checked at multiple points during the clinical curriculum. Results of the CCEL system showed that low performing students increased their productivity, overall production at graduation increased significantly, and fluoride utilization to prevent caries rose by an order of magnitude over the RVU system. The CCEL program also allowed early identification and remediation of students having difficulty in the clinic. This successful implementation suggests that the CCEL concept has the potential for widespread adoption by dental schools. This method also can be used as a behavior modification tool to achieve specific patient care or clinical educational goals as illustrated by the way caries prevention was promoted through the program.

48 CFR 45.202 - Evaluation procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Evaluation procedures. 45... MANAGEMENT GOVERNMENT PROPERTY Solicitation and Evaluation Procedures 45.202 Evaluation procedures. (a) The... evaluation purposes only, a rental equivalent evaluation factor. (b) The contracting officer shall ensure the...

Effects of victim presence and coercion in restorative justice: An experimental paradigm.

PubMed

Saulnier, Alana; Sivasubramaniam, Diane

2015-08-01

There is little experimental work examining the ways in which particular procedural features of restorative justice impact offenders. This research describes a new experimental paradigm designed to advance knowledge about causal relationships in restorative justice settings. Apologizing is a core component of restorative procedures, and can result in beneficial outcomes, but previous research suggests that coercion to apologize and the absence of victims in restorative procedures may negatively impact these outcomes. The experimental procedure elicited confessions and apologies for a transgression from participants (N = 101) in a deceptive paradigm. We manipulated coercion (coerced, not coerced) and victim presence (direct, surrogate, ambiguous) to test their effects on offenders' subjective experiences of offering an apology, as well as their effects on the quality of offenders' apologies. Findings indicated that the victim presence and coercion manipulations significantly impacted some of the subjective perceptions of apologizers, including perceptions of accountability and transgression finality. In addition, independent raters evaluated the degree to which the transgressor's apologies conveyed remorse, acceptance of guilt, and potential for dispute resolution. Victim presence and coercion consistently affected the ability of transgressors to convey high quality apologies. Implications for future research and restorative procedures are discussed. (c) 2015 APA, all rights reserved).

Proficiency-based cervical cancer brachytherapy training.

PubMed

Zhao, Sherry; Francis, Louise; Todor, Dorin; Fields, Emma C

2018-04-25

Although brachytherapy increases the local control rate for cervical cancer, there has been a progressive decline in its use. Furthermore, the training among residency programs for gynecologic brachytherapy varies considerably, with some residents receiving little to no training. This trend is especially concerning given the association between poor applicator placement and decline in local control. Considering the success of proficiency-based training in other procedural specialties, we developed and implemented a proficiency-based cervical brachytherapy training curriculum for our residents. Each resident placed tandem and ovoid applicators with attending guidance and again alone 2 weeks later using a pelvic model that was modified to allow for cervical brachytherapy. Plain films were taken of the pelvic model, and applicator placement quality was evaluated. Other evaluated metrics included retention of key procedural details, the time taken for each procedure and presession and postsession surveys to assess confidence. During the initial session, residents on average met 4.5 of 5 placement criteria, which improved to 5 the second session. On average, residents were able to remember 7.6 of the 8 key procedural steps. Execution time decreased by an average of 10.5%. Resident confidence with the procedure improved dramatically, from 2.6 to 4.6 of 5. Residents who had previously never performed a tandem and ovoid procedure showed greater improvements in these criteria than those who had. All residents strongly agreed that the training was helpful and wanted to participate again the following year. Residents participating in this simulation training had measurable improvements in the time to perform the procedure, applicator placement quality, and confidence. This curriculum is easy to implement and is of great value for training residents, and would be particularly beneficial in programs with low volume of cervical brachytherapy cases. Simulation programs could also be created for other technically challenging radiation oncology procedures. Copyright © 2018 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Cluster analysis as a tool for evaluating the exploration potential of Known Geothermal Resource Areas

DOE PAGES

Lindsey, Cary R.; Neupane, Ghanashym; Spycher, Nicolas; ...

2018-01-03

Although many Known Geothermal Resource Areas in Oregon and Idaho were identified during the 1970s and 1980s, few were subsequently developed commercially. Because of advances in power plant design and energy conversion efficiency since the 1980s, some previously identified KGRAs may now be economically viable prospects. Unfortunately, available characterization data vary widely in accuracy, precision, and granularity, making assessments problematic. In this paper, we suggest a procedure for comparing test areas against proven resources using Principal Component Analysis and cluster identification. The result is a low-cost tool for evaluating potential exploration targets using uncertain or incomplete data.

Cluster analysis as a tool for evaluating the exploration potential of Known Geothermal Resource Areas

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

Lindsey, Cary R.; Neupane, Ghanashym; Spycher, Nicolas

Although many Known Geothermal Resource Areas in Oregon and Idaho were identified during the 1970s and 1980s, few were subsequently developed commercially. Because of advances in power plant design and energy conversion efficiency since the 1980s, some previously identified KGRAs may now be economically viable prospects. Unfortunately, available characterization data vary widely in accuracy, precision, and granularity, making assessments problematic. In this paper, we suggest a procedure for comparing test areas against proven resources using Principal Component Analysis and cluster identification. The result is a low-cost tool for evaluating potential exploration targets using uncertain or incomplete data.

Reducing bias and analyzing variability in the time-left procedure.

PubMed

Trujano, R Emmanuel; Orduña, Vladimir

2015-04-01

The time-left procedure was designed to evaluate the psychophysical function for time. Although previous results indicated a linear relationship, it is not clear what role the observed bias toward the time-left option plays in this procedure and there are no reports of how variability changes with predicted indifference. The purposes of this experiment were to reduce bias experimentally, and to contrast the difference limen (a measure of variability around indifference) with predictions from scalar expectancy theory (linear timing) and behavioral economic model (logarithmic timing). A control group of 6 rats performed the original time-left procedure with C=60 s and S=5, 10,…, 50, 55 s, whereas a no-bias group of 6 rats performed the same conditions in a modified time-left procedure in which only a single response per choice trial was allowed. Results showed that bias was reduced for the no-bias group, observed indifference grew linearly with predicted indifference for both groups, and difference limen and Weber ratios decreased as expected indifference increased for the control group, which is consistent with linear timing, whereas for the no-bias group they remained constant, consistent with logarithmic timing. Therefore, the time-left procedure generates results consistent with logarithmic perceived time once bias is experimentally reduced. Copyright © 2015 Elsevier B.V. All rights reserved.

Movement suppression time-out for undesirable behavior in psychotic and severely developmentally delayed children.

PubMed

Rolider, A; Van Houten, R

1985-01-01

The effects of a movement suppression time-out, which involved punishing any movement or verbalization while a client is in the time-out area, were evaluated in four experiments. The first experiment examined the effects of a DRO procedure and movement suppression plus DRO in suppressing self-injurious behavior in a psychotic child in three different situations. In Experiment 2, the results of the previous experiment were replicated with two dangerous behaviors in a second psychotic child. In a third experiment, movement suppression plus DRO was compared with contingent restraint in reducing inappropriate poking behavior in two settings. The movement suppression procedure eliminated poking whereas contingent restraint had little effect. In the final experiment, movement suppression time-out alone was compared with exclusionary time-out alone and simple corner time-out alone. Self-stimulation occurred at high levels during the exclusionary and simple corner time-out procedures. Self-stimulation was either suppressed or reduced during movement suppression time-out. The movement suppression time-out procedure produced a larger reduction in the target behavior in all three children. The effectiveness of the movement suppression procedure was explained in terms of the suppression of self-stimulation while the time-out procedure was being applied.

Endoscopic removal of laser-cut covered self-expandable metallic biliary stents: A report of six cases.

PubMed

Tanisaka, Yuki; Ryozawa, Shomei; Kobayashi, Masanori; Harada, Maiko; Kobatake, Tsutomu; Omiya, Kumiko; Iwano, Hirotoshi; Arai, Shin; Nonaka, Kouichi; Mashimo, Yumi

2018-02-01

Covered self-expandable metallic stents (CSEMS) may provide palliative drainage for unresectable distal malignant biliary strictures. Laser-cut CSEMS allows easy positioning due to its characteristic of minimal stent shortening. Endoscopic stent removal is sometimes recommended for recurrent biliary obstruction (RBO). However, there are no previous reports of endoscopic removal of laser-cut CSEMS. The current study presents data from 6 patients who were placed a laser-cut CSEMS for unresectable distal malignant biliary strictures, and later endoscopic stent removal was attempted for RBO at the present institute. The duration of stent placement, the procedural success rate, the procedural duration, and accidental complications were evaluated. The mean duration of stent placement was 156±37.9 days (range, 117-205). The procedural success rate was 100%. The mean procedural duration was 11.8±7.5 min (range, 5-24). No complications were reported. Laser-cut CSEMS were safely removed from all patients. The present case report is the first to demonstrate that Endoscopic stent removal of laser-cut CSEMS was safely performed.

Registration of planar bioluminescence to magnetic resonance and x-ray computed tomography images as a platform for the development of bioluminescence tomography reconstruction algorithms.

PubMed

Beattie, Bradley J; Klose, Alexander D; Le, Carl H; Longo, Valerie A; Dobrenkov, Konstantine; Vider, Jelena; Koutcher, Jason A; Blasberg, Ronald G

2009-01-01

The procedures we propose make possible the mapping of two-dimensional (2-D) bioluminescence image (BLI) data onto a skin surface derived from a three-dimensional (3-D) anatomical modality [magnetic resonance (MR) or computed tomography (CT)] dataset. This mapping allows anatomical information to be incorporated into bioluminescence tomography (BLT) reconstruction procedures and, when applied using sources visible to both optical and anatomical modalities, can be used to evaluate the accuracy of those reconstructions. Our procedures, based on immobilization of the animal and a priori determined fixed projective transforms, should be more robust and accurate than previously described efforts, which rely on a poorly constrained retrospectively determined warping of the 3-D anatomical information. Experiments conducted to measure the accuracy of the proposed registration procedure found it to have a mean error of 0.36+/-0.23 mm. Additional experiments highlight some of the confounds that are often overlooked in the BLT reconstruction process, and for two of these confounds, simple corrections are proposed.

Stiffness after knee arthrotomy: evaluation of prevalence and results after manipulation under anaesthesia.

PubMed

Ipach, I; Schäfer, R; Lahrmann, J; Kluba, T

2011-05-01

The aim of the present study was to determine the prevalence and the effect of manipulation under anaesthesia in patients with Total Knee Arthroplasty (TKA), "revision-knee" and all forms of other intra-articular surgical procedures. We aimed to determine differences in the outcome according to the number of previous surgeries and according to time of manipulation under anaesthesia (MUA). One thousand three hundred and forty-four elective intra-articular surgeries (no trauma cases) were performed at our institution between 2004 and 2009. Fifty-two of them underwent MUA because of postoperative knee stiffness with a flexion less than 90°. The prevalence for stiffness after primary TKA was 4.54%, for revision-knee procedures 5.11%, and for other forms of intra-articular surgery 1.29%. Flexion was statistically significantly improved directly after MUA in the group after primary TKA with a mean gain of 35.13°±17.03°, in the group with revision procedures of 41.31°±9.08° and in the group with other forms of intra-articular surgery of 24.37°±5.21°. Patients with more than two previous operations showed significantly worse results (P=0.039). No statistically significant difference (P=0.307) was seen according to time (>/<30 days) of MUA. MUA is a valuable technique to increase ROM after TKA in patients with stiff knees, for "revision-knees" and all other patients with reduced flexion after different forms of intra-articular knee surgical procedures (excluding trauma cases). The results were similar for early and delayed MUA relative to the last surgery. The patients can therefore undergo conservative treatment (e.g. physiotherapy) before the MUA without the risk of poorer outcome. The results after MUA in patients with many previous operations were significantly worse and so an open/arthroscopic arthrolysis should be discussed earlier for this subgroup. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Trephine Transverse Colostomy Is Effective for Patients Who Have Previously Undergone Rectal Surgery

PubMed Central

Yeom, Seung-Seop; Jung, Sung Woo; Oh, Se Heon; Lee, Jong Lyul; Yoon, Yong Sik; Park, In Ja; Lim, Seok-Byung; Yu, Chang Sik; Kim, Jin Cheon

2018-01-01

Purpose Colostomy creation is an essential procedure for colorectal surgeons, but the preferred method of colostomy varies by surgeon. We compared the outcomes of trephine colostomy creation with open those for the (laparotomy) and laparoscopic methods and evaluated appropriate indications for a trephine colostomy and the advantages of the technique. Methods We retrospectively evaluated 263 patients who had undergone colostomy creation by trephine, open and laparoscopic approaches between April 2006 and March 2016. We compared the clinical features and the operative and postoperative outcomes according to the approach used for stoma creation. Results One hundred sixty-three patients (62%) underwent colostomy surgery for obstructive causes and 100 (38%) for fistulous problems. The mean operative time was significantly shorter with the trephine approach (trephine, 46.0 ± 1.9 minutes; open, 78.7 ± 3.9 minutes; laparoscopic, 63.5 ± 5.0 minutes; P < 0.001), as was the time to flatus (1.8 ± 0.1 days, 2.1 ± 0.1 days, 2.2 ± 0.3 days, P = 0.025). Postoperative complications (<30 days) were not different among the 3 approaches (trephine, 4.3%; open, 1.2%; laparoscopic, 0%; P = 0.828). In patients who underwent rectal surgery, a trephine colostomy was feasible for a diversion colostomy (P < 0.001). Conclusion The trephine colostomy is safe and can be implemented quickly in various situations, and compared to other colostomy procedures, the patient’s recovery is faster. Previous laparotomy history was not a contraindication for a trephine colostomy, and a trephine transverse colostomy is feasible for patients who have undergone previous rectal surgery. PMID:29742862

Factor analysis in optimization of formulation of high content uniformity tablets containing low dose active substance.

PubMed

Lukášová, Ivana; Muselík, Jan; Franc, Aleš; Goněc, Roman; Mika, Filip; Vetchý, David

2017-11-15

Warfarin is intensively discussed drug with narrow therapeutic range. There have been cases of bleeding attributed to varying content or altered quality of the active substance. Factor analysis is useful for finding suitable technological parameters leading to high content uniformity of tablets containing low amount of active substance. The composition of tabletting blend and technological procedure were set with respect to factor analysis of previously published results. The correctness of set parameters was checked by manufacturing and evaluation of tablets containing 1-10mg of warfarin sodium. The robustness of suggested technology was checked by using "worst case scenario" and statistical evaluation of European Pharmacopoeia (EP) content uniformity limits with respect to Bergum division and process capability index (Cpk). To evaluate the quality of active substance and tablets, dissolution method was developed (water; EP apparatus II; 25rpm), allowing for statistical comparison of dissolution profiles. Obtained results prove the suitability of factor analysis to optimize the composition with respect to batches manufactured previously and thus the use of metaanalysis under industrial conditions is feasible. Copyright © 2017 Elsevier B.V. All rights reserved.

Sonographically guided percutaneous needle release of the carpal tunnel for treatment of carpal tunnel syndrome: preliminary report.

PubMed

McShane, John M; Slaff, Samantha; Gold, Judith E; Nazarian, Levon N

2012-09-01

The purpose of this study was to evaluate the effectiveness of a novel treatment procedure, sonographically guided percutaneous needle release of the carpal tunnel, for individuals with carpal tunnel syndrome. Seventeen patients (89% female; mean age, 62 years; SD, 13.6 years) with a clinical diagnosis of carpal tunnel syndrome who had undergone a sonographically guided percutaneous needle release of the carpal tunnel at least 6 months before follow-up evaluation were retrospectively reviewed. At the follow-up evaluation, to ascertain previous and current symptoms as well as functional impairment, the patients filled out a hand diagram and a questionnaire. In addition, medical records were reviewed, and patients were queried regarding complications such as infection or nerve damage. Median nerve sonographic measurements and a physical evaluation were performed on a subset of 13 patients who came to the office for evaluation. Postprocedure sonography showed that patients had a significantly smaller (P = .03) cross-sectional area of the median nerve compared to pretreatment values. In addition, patients had significantly fewer symptoms (P < .0001), less functional impairment (P = .0002), and an improved hand diagram score (P < .0001). Postprocedure patients had grip strength that was 12 lb below average (≈1 SD below) compared to grip strength norms. However, most patients (84.6%) had negative clinical diagnostic test results for carpal tunnel syndrome, and 86% said they were satisfied with the procedure. There were no procedure-related infections or nerve injuries. Of the patients with carpal tunnel syndrome who agreed to participate in this study, most had favorable symptomatic and functional outcomes. Sonographically guided percutaneous needle release of the carpal tunnel may be an alternative option to traditional surgical treatment of carpal tunnel syndrome.

Indirect latex glove contamination and its inhibitory effect on vinyl polysiloxane polymerization.

PubMed

Kimoto, Katsuhiko; Tanaka, Kinya; Toyoda, Minoru; Ochiai, Kent T

2005-05-01

The inhibitory effect of indirect latex contamination on the polymerization of vinyl polysiloxane (VPS) impression material has been previously reported. However, the transfer of specific elements that cause inhibition has not been confirmed, nor has the removal of such contaminants been reported. This study examined the surfaces of materials commonly used in restorative procedures that were contaminated by indirect latex glove contact and then evaluated for inhibition of polymerization of VPS. The effect of selected cleansing procedures was then studied. Four experimental groups (n = 8) were prepared: (1) clean vinyl gloves (control), (2) clean gingival retraction cords (control), (3) contaminated vinyl gloves, and (4) contaminated gingival retraction cord. Microscopic evaluation of the appearance and the characterization of surface particulate contamination were performed for each. Three cleansing protocols were then evaluated for efficacy in cleaning vinyl glove surfaces contaminated by latex contact (n = 10): (1) brushing with water, (2) brushing with soap/rinsing with water, (3) cleansing with rubbing alcohol. The subsequent degree of VPS polymerization inhibition was evaluated subjectively. A chi-square test was used for data analysis (alpha=.05). Particulate sulfur elements and sulfur-chloride compounds were present on the contaminated substrates. None of the 3 cleansing procedures eliminated polymerization inhibition (P =.33). Residual elemental sulfur remained on all tested surfaces. Particulate sulfur and sulfur-chloride compounds were identified as the particulate contamination that resulted in polymerization inhibition of the tested VPS dental impression material. Removal of these contaminants from the tested vinyl gloves and gingival retraction cord was not possible with the 3 cleansing protocols tested in this study.

What Is the Risk of Anastomotic Leak After Repeat Intestinal Resection in Patients With Crohn's Disease?

PubMed

Johnston, W Forrest; Stafford, Caitlin; Francone, Todd D; Read, Thomas E; Marcello, Peter W; Roberts, Patricia L; Ricciardi, Rocco

2017-12-01

Approximately half of Crohn's patients require intestinal resection, and many need repeat resections. The purpose of this study was to evaluate the increased risk of clinical anastomotic leak in patients with a history of previous intestinal resection undergoing repeat resection with anastomosis for Crohn's disease. This was a retrospective analysis of prospectively collected departmental data with 100% capture. The study was conducted at the department of colorectal surgery in a tertiary care teaching hospital between July 2007 and March 2016. A cohort of consecutive patients with Crohn's disease who were treated with intestinal resection and anastomosis, excluding patients with proximal fecal diversion, were included. The cohort was divided into 2 groups, those with no previous resection compared with those with previous resection. Clinical anastomotic leak within 30 days of surgery was measured. Of the 206 patients who met criteria, 83 patients had previous intestinal resection (40%). The 2 groups were similar in terms of patient factors, immune-suppressing medication use, and procedural factors. Overall, 20 clinical anastomotic leaks were identified (10% leak rate). There were 6 leaks (5%) detected in patients with no previous intestinal resection and 14 leaks (17%) detected in patients with a history of previous intestinal resection (p < 0.005). The OR of anastomotic leak in patients with Crohn's disease with previous resection compared with no previous resection was 3.5 (95% CI, 1.3-9.4). Patients with 1 previous resection (n = 53) had a leak rate of 13%, whereas patients with ≥2 previous resections (n = 30) had a leak rate of 23%. The number of previous resections correlated with increasing risk for clinical anastomotic leak (correlation coefficient = 0.998). This was a retrospective study with limited data to perform a multivariate analysis. Repeat intestinal resection in patients with Crohn's disease is associated with an increased rate of anastomotic leakage when compared with initial resection despite similar patient, medication, and procedural factors. See Video Abstract at http://links.lww.com/DCR/A459.

Habitat Suitability Index Models: Laughing gull

USGS Publications Warehouse

Zale, Alexander V.; Mulholland, Rosemarie

1985-01-01

A review and synthesis of existing information were used to develop a habitat model for laughing gull (Larus atricilla). The model is scaled to produce an index of habitat suitability between 0 (unsuitable habitat) and 1.0 (optimally suitable habitat) for areas along the Gulf of Mexico coast. Habitat suitability indices are designed for use with the Habitat Evaluation Procedures previously developed by the U.S. Fish and Wildlife Service. Guidelines for application of the model and techniques for measuring model variables are described.

Qualitative and quantitative analysis of women's perceptions of transvaginal surgery.

PubMed

Bingener, Juliane; Sloan, Jeff A; Ghosh, Karthik; McConico, Andrea; Mariani, Andrea

2012-04-01

Prior surveys evaluating women's perceptions of transvaginal surgery both support and refute the acceptability of transvaginal access. Most surveys employed mainly quantitative analysis, limiting the insight into the women's perspective. In this mixed-methods study, we include qualitative and quantitative methodology to assess women's perceptions of transvaginal procedures. Women seen at the outpatient clinics of a tertiary-care center were asked to complete a survey. Demographics and preferences for appendectomy, cholecystectomy, and tubal ligation were elicited, along with open-ended questions about concerns or benefits of transvaginal access. Multivariate logistic regression models were constructed to examine the impact of age, education, parity, and prior transvaginal procedures on preferences. For the qualitative evaluation, content analysis by independent investigators identified themes, issues, and concerns raised in the comments. The completed survey tool was returned by 409 women (grouped mean age 53 years, mean number of 2 children, 82% ≥ some college education, and 56% with previous transvaginal procedure). The transvaginal approach was acceptable for tubal ligation to 59%, for appendectomy to 43%, and for cholecystectomy to 41% of the women. The most frequently mentioned factors that would make women prefer a vaginal approach were decreased invasiveness (14.4%), recovery time (13.9%), scarring (13.7%), pain (6%), and surgical entry location relative to organ removed (4.4%). The most frequently mentioned concerns about the vaginal approach were the possibility of complications/safety (14.7%), pain (9%), infection (5.6%), and recovery time (4.9%). A number of women voiced technical concerns about the vaginal approach. As in prior studies, scarring and pain were important issues to be considered, but recovery time and increased invasiveness were also in the "top five" list. The surveyed women appeared to actively participate in evaluating the technical components of the procedures.

Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014.

PubMed

Angrisani, L; Santonicola, A; Iovino, P; Vitiello, A; Zundel, N; Buchwald, H; Scopinaro, N

2017-09-01

Several bariatric surgery worldwide surveys have been previously published to illustrate the evolution of bariatric surgery in the last decades. The aim of this survey is to report an updated overview of all bariatric procedures performed in 2014.For the first time, a special section on endoluminal techniques was added. The 2014 International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) survey form evaluating the number and the type of surgical and endoluminal bariatric procedures was emailed to all IFSO societies. Trend analyses from 2011 to 2014 were also performed. There were 56/60 (93.3%) responders. The total number of bariatric/metabolic procedures performed in 2014 consisted of 579,517 (97.6%) surgical operations and 14,725 (2.4%) endoluminal procedures. The most commonly performed procedure in the world was sleeve gastrectomy (SG) that reached 45.9%, followed by Roux-en-Y gastric bypass (RYGB) (39.6%), and adjustable gastric banding (AGB) (7.4%). The annual percentage changes from 2013 revealed the increase of SG and decrease of RYGB in all the IFSO regions (USA/Canada, Europe, and Asia/Pacific) with the exception of Latin/South America, where SG decreased and RYGB represented the most frequent procedure. There was a further increase in the total number of bariatric/metabolic procedures in 2014 and SG is currently the most frequent surgical procedure in the world. This is the first survey that describes the endoluminal procedures, but the accuracy of provided data should be hopefully improved in the next future. We encourage the creation of further national registries and their continuous updates taking into account all new bariatric procedures including the endoscopic procedures that will obtain increasing importance in the near future.

Evaluating a restrictive formulary system by assessing nonformulary-drug requests.

PubMed

Green, J A; Chawla, A K; Fong, P A

1985-07-01

Nonformulary-drug requests were used to evaluate a restrictive formulary system in a large university hospital, and a telephone survey of eight similar hospitals was conducted to assess the restrictiveness of their formulary systems. Nonformulary-drug requests were evaluated by two drug information pharmacists over a 12-month period (January-December 1984) to assess the frequency with which nonformulary items were ordered, the costs associated with the procurement of nonformulary drug products, and the rationales given by physicians when ordering nonformulary products. Of all nonformulary requests, 65% were for drugs previously evaluated by the pharmacy and therapeutics committee and denied admission to the formulary. A cost savings of $1887 would have resulted if formulary alternates had been used instead of nonformulary products. Excluding 22% of nonformulary items that were requested for the continuation of preadmission drug therapy, only 13% of the rationales for the remaining requests were appropriate. Although the eight other hospitals surveyed said they had restrictive formularies, all had frequent requests and procedures for procuring nonformulary items and some formularies included most available drugs. The formulary system at the study hospital was considered restrictive, but procedures for nonformulary-drug requests limited the effectiveness of the system. If any benefit is to result from formulary systems, hospitals must strengthen their enforcement of formulary restrictions.

An efficient matrix-matrix multiplication based antisymmetric tensor contraction engine for general order coupled cluster.

PubMed

Hanrath, Michael; Engels-Putzka, Anna

2010-08-14

In this paper, we present an efficient implementation of general tensor contractions, which is part of a new coupled-cluster program. The tensor contractions, used to evaluate the residuals in each coupled-cluster iteration are particularly important for the performance of the program. We developed a generic procedure, which carries out contractions of two tensors irrespective of their explicit structure. It can handle coupled-cluster-type expressions of arbitrary excitation level. To make the contraction efficient without loosing flexibility, we use a three-step procedure. First, the data contained in the tensors are rearranged into matrices, then a matrix-matrix multiplication is performed, and finally the result is backtransformed to a tensor. The current implementation is significantly more efficient than previous ones capable of treating arbitrary high excitations.

How can activity-based costing methodology be performed as a powerful tool to calculate costs and secure appropriate patient care?

PubMed

Lin, Blossom Yen-Ju; Chao, Te-Hsin; Yao, Yuh; Tu, Shu-Min; Wu, Chun-Ching; Chern, Jin-Yuan; Chao, Shiu-Hsiung; Shaw, Keh-Yuong

2007-04-01

Previous studies have shown the advantages of using activity-based costing (ABC) methodology in the health care industry. The potential values of ABC methodology in health care are derived from the more accurate cost calculation compared to the traditional step-down costing, and the potentials to evaluate quality or effectiveness of health care based on health care activities. This project used ABC methodology to profile the cost structure of inpatients with surgical procedures at the Department of Colorectal Surgery in a public teaching hospital, and to identify the missing or inappropriate clinical procedures. We found that ABC methodology was able to accurately calculate costs and to identify several missing pre- and post-surgical nursing education activities in the course of treatment.

Laser versus scalpel cleaning of crustose lichens on granite

NASA Astrophysics Data System (ADS)

Rivas, T.; Pozo-Antonio, J. S.; López de Silanes, M. E.; Ramil, A.; López, A. J.

2018-05-01

This paper addresses the evaluation of the cleaning of crustose lichens developing on granite. The evaluation was performed considering the effectiveness of the cleanings and harmfulness exerted on the granite. The laser cleaning of lichen was compared with the most conventional procedure, scalpel. The combination of both procedures was also tested. The study, which was carried out with two different species of crustose lichen, was also focused on the influence of the intrinsic characteristics of the lichen on the effectiveness. The cleanings were evaluated by optic and electronic microscopies, FTIR and colour spectrophotometry. A previous characterization of the lichen and its interaction with the granite using those analytical techniques were also performed. The laser cleaning effectiveness depends on the coverage and the colour of the lichen; also, the prior mechanical weakening of the lichen by scalpel seemed to improve the laser cleaning. The darkest lichen was satisfactorily removed by laser and with the combined cleaning. Conversely, the lightest lichen was more difficult to extract with laser than the darkest lichen, being necessary to apply both methods sequentially. Despite laser and the combination of methods cleaned satisfactorily the surface, they were unable to eliminate the thalli into fissures.

Automatic detection of sleep macrostructure based on a sensorized T-shirt.

PubMed

Bianchi, Anna M; Mendez, Martin O

2010-01-01

In the present work we apply a fully automatic procedure to the analysis of signal coming from a sensorized T-shit, worn during the night, for sleep evaluation. The goodness and reliability of the signals recorded trough the T-shirt was previously tested, while the employed algorithms for feature extraction and sleep classification were previously developed on standard ECG recordings and the obtained classification was compared to the standard clinical practice based on polysomnography (PSG). In the present work we combined T-shirt recordings and automatic classification and could obtain reliable sleep profiles, i.e. the sleep classification in WAKE, REM (rapid eye movement) and NREM stages, based on heart rate variability (HRV), respiration and movement signals.

Drawbar Pull (DP) Procedures for Off-Road Vehicle Testing

NASA Technical Reports Server (NTRS)

Creager, Colin; Asnani, Vivake; Oravec, Heather; Woodward, Adam

2017-01-01

As NASA strives to explore the surface of the Moon and Mars, there is a continued need for improved tire and vehicle development. When tires or vehicles are being designed for off-road conditions where significant thrust generation is required, such as climbing out of craters on the Moon, it is important to use a standard test method for evaluating their tractive performance. The drawbar pull (DP) test is a way of measuring the net thrust generated by tires or a vehicle with respect to performance metrics such as travel reduction, sinkage, or power efficiency. DP testing may be done using a single tire on a traction rig, or with a set of tires on a vehicle; this report focuses on vehicle DP tests. Though vehicle DP tests have been used for decades, there are no standard procedures that apply to exploration vehicles. This report summarizes previous methods employed, shows the sensitivity of certain test parameters, and provides a body of knowledge for developing standard testing procedures. The focus of this work is on lunar applications, but these test methods can be applied to terrestrial and planetary conditions as well. Section 1.0 of this report discusses the utility of DP testing for off-road vehicle evaluation and the metrics used. Section 2.0 focuses on test-terrain preparation, using the example case of lunar terrain. There is a review of lunar terrain analogs implemented in the past and a discussion on the lunar terrain conditions created at the NASA Glenn Research Center, including methods of evaluating the terrain strength variation and consistency from test to test. Section 3.0 provides details of the vehicle test procedures. These consist of a review of past methods, a comprehensive study on the sensitivity of test parameters, and a summary of the procedures used for DP testing at Glenn.

Can evaluation of a dental procedure at the outset of learning predict later performance at the preclinical level? A pilot study.

PubMed

Polyzois, Ioannis; Claffey, Noel; McDonald, Albhe; Hussey, David; Quinn, Frank

2011-05-01

The purpose of this study was to examine the effectiveness of conventional pre-clinical training in dentistry and to determine if evaluation of a dental procedure at the beginning of dental training can be a predictor for future performance. A group of second year dental students with no previous experience in operative dentistry were asked to prepare a conventional class I cavity on a lower first molar typodont. Their first preparation was carried out after an introductory lecture and a demonstration and their second at the end of conventional training. The prepared typodonts were coded and blindly scored for the traditional assessment criteria of outline form, retention form, smoothness, cavity depth and cavity margin angulation. Once the codes were broken, a paired t-test was used to compare the difference between the means of before and after scores (P<0.0001) and a Pearson's linear correlation to test the association (r=0.4). From the results of this study, we could conclude that conventional preclinical training results in a significant improvement in the manual skills of the dental students and that the dental procedure used had only a limited predictive value for later performance at the preclinical level. © 2011 John Wiley & Sons A/S.

Topical anesthesia in phacoemulsification.

PubMed

Waheeb, Saad

2010-09-01

To evaluate the efficacy of topical anesthesia; topical Benoxinate 0.4% (Oxybuprocaine) and Xylocaine (Lidocaine) gel, in selected cataract patients as an alternative to peribulbar or retrobulbar block anesthesia during cataract surgery. Prospective non-comparative evaluation of patients' and surgeon's satisfaction at the end of the procedure. Three hundred patients (300 eyes) were included in the study. The procedure was explained to patients with details regarding what will happen and what to expect during surgery. All patients received topical anesthesia with Benoxinate 0.4% eye drops and Xylocaine gel 2%. All surgeries were done by the same surgeon using the same machine (updated LEGACY phacoemulsifier, Alcon) and approach (clear corneal incision) and followed by a foldable intraocular lens (IOL) implantation. None of the patients had severe pain during the procedure; only 2% (six of 300) required use of intravenous sedation (Propofol), both the surgeon's and the patients' satisfaction were high. Eye movements and blepharospasm were not significant problems, and no serious complications occurred. Rate of vitreous loss due to posterior capsule tear/rupture was within literature reported range and not different from our previous experience. Topical anesthesia is a satisfactory and safe alternative to retrobulbar and peribulbar anesthesia for clear corneal phacoemulsification and intraocular lens implantation in selected cataract patients in the hands of experienced cataract surgeon.

Topical anesthesia in phacoemulsification

PubMed Central

Waheeb, Saad

2010-01-01

Purpose: To evaluate the efficacy of topical anesthesia; topical Benoxinate 0.4% (Oxybuprocaine) and Xylocaine (Lidocaine) gel, in selected cataract patients as an alternative to peribulbar or retrobulbar block anesthesia during cataract surgery. Materials and Methods: Prospective non-comparative evaluation of patients’ and surgeon’s satisfaction at the end of the procedure. Three hundred patients (300 eyes) were included in the study. The procedure was explained to patients with details regarding what will happen and what to expect during surgery. All patients received topical anesthesia with Benoxinate 0.4% eye drops and Xylocaine gel 2%. All surgeries were done by the same surgeon using the same machine (updated LEGACY phacoemulsifier, Alcon) and approach (clear corneal incision) and followed by a foldable intraocular lens (IOL) implantation. Results: None of the patients had severe pain during the procedure; only 2% (six of 300) required use of intravenous sedation (Propofol), both the surgeon’s and the patients’ satisfaction were high. Eye movements and blepharospasm were not significant problems, and no serious complications occurred. Rate of vitreous loss due to posterior capsule tear/rupture was within literature reported range and not different from our previous experience. Conclusion: Topical anesthesia is a satisfactory and safe alternative to retrobulbar and peribulbar anesthesia for clear corneal phacoemulsification and intraocular lens implantation in selected cataract patients in the hands of experienced cataract surgeon. PMID:21120050

An enhanced rheometer inertia correction procedure (ERIC) for the study of gelling systems using combined motor-transducer rheometers

NASA Astrophysics Data System (ADS)

Hudson, R. E.; Holder, A. J.; Hawkins, K. M.; Williams, P. R.; Curtis, D. J.

2017-12-01

The rheological characterisation of viscoelastic materials undergoing a sol-gel transition at the Gel Point (GP) has important applications in a wide range of industrial, biological, and clinical environments and can provide information regarding both kinetic and microstructural aspects of gelation. The most rigorous basis for identifying the GP involves exploiting the frequency dependence of the real and imaginary parts of the complex shear modulus of the critical gel (the system at the GP) measured under small amplitude oscillatory shear conditions. This approach to GP identification requires that rheological data be obtained over a range of oscillatory shear frequencies. Such measurements are limited by sample mutation considerations (at low frequencies) and, when experiments are conducted using combined motor-transducer (CMT) rheometers, by instrument inertia considerations (at high frequencies). Together, sample mutation and inertia induced artefacts can lead to significant errors in the determination of the GP. Overcoming such artefacts is important, however, as the extension of the range of frequencies available to the experimentalist promises both more accurate GP determination and the ability to study rapidly gelling samples. Herein, we exploit the frequency independent viscoelastic properties of the critical gel to develop and evaluate an enhanced rheometer inertia correction procedure. The procedure allows acquisition of valid GP data at previously inaccessible frequencies (using CMT rheometers) and is applied in a study of the concentration dependence of bovine gelatin gelation GP parameters. A previously unreported concentration dependence of the stress relaxation exponent (α) for critical gelatin gels has been identified, which approaches a limiting value (α = 0.7) at low gelatin concentrations, this being in agreement with previous studies and theoretical predictions for percolating systems at the GP.

Fetal and maternal dose assessment for diagnostic scans during pregnancy

NASA Astrophysics Data System (ADS)

Rafat Motavalli, Laleh; Miri Hakimabad, Hashem; Hoseinian Azghadi, Elie

2016-05-01

Despite the concerns about prenatal exposure to ionizing radiation, the number of nuclear medicine examinations performed for pregnant women increased in the past decade. This study attempts to better quantify radiation doses due to diagnostic nuclear medicine procedures during pregnancy with the help of our recently developed 3, 6, and 9 month pregnant hybrid phantoms. The reference pregnant models represent the adult female international commission on radiological protection (ICRP) reference phantom as a base template with a fetus in her gravid uterus. Six diagnostic scintigraphy scans using different radiopharmaceuticals were selected as typical diagnostic nuclear medicine procedures. Furthermore, the biokinetic data of radioiodine was updated in this study. A compartment representing iodide in fetal thyroid was addressed explicitly in the biokinetic model. Calculations were performed using the Monte Carlo transport method. Tabulated dose coefficients for both maternal and fetal organs are provided. The comparison was made with the previously published fetal doses calculated for stylized pregnant female phantoms. In general, the fetal dose in previous studies suffers from an underestimation of up to 100% compared to fetal dose at organ level in this study. A maximum of difference in dose was observed for the fetal thyroid compared to the previous studies, in which the traditional models did not contain the fetal thyroid. Cumulated activities of major source organs are primarily responsible for the discrepancies in the organ doses. The differences in fetal dose depend on several other factors including chord length distribution between fetal organs and maternal major source organs, and anatomical differences according to gestation periods. Finally, considering the results of this study, which was based on the realistic pregnant female phantoms, a more informed evaluation of the risks and benefits of the different procedures could be made.

Neural-Net Processed Characteristic Patterns for Measurement of Structural Integrity of Pressure Cycled Components

NASA Technical Reports Server (NTRS)

Decker, A. J.

2001-01-01

A neural-net inspection process has been combined with a bootstrap training procedure and electronic holography to detect changes or damage in a pressure-cycled International Space Station cold plate to be used for cooling instrumentation. The cold plate was excited to vibrate in a normal mode at low amplitude, and the neural net was trained by example to flag small changes in the mode shape. The NDE (nondestructive-evaluation) technique is straightforward but in its infancy; its applications are ad-hoc and uncalibrated. Nevertheless previous research has shown that the neural net can detect displacement changes to better than 1/100 the maximum displacement amplitude. Development efforts that support the NDE technique are mentioned briefly, followed by descriptions of electronic holography and neural-net processing. The bootstrap training procedure and its application to detection of damage in a pressure-cycled cold plate are discussed. Suggestions for calibrating and quantifying the NDE procedure are presented.

[Evaluation of mass spectrometry: MALDI-TOF MS for fast and reliable yeast identification].

PubMed

Relloso, María S; Nievas, Jimena; Fares Taie, Santiago; Farquharson, Victoria; Mujica, María T; Romano, Vanesa; Zarate, Mariela S; Smayevsky, Jorgelina

2015-01-01

The matrix-assisted laser desorption/ionization time-of-flight mass spectrometry technique known as MALDI-TOF MS is a tool used for the identification of clinical pathogens by generating a protein spectrum that is unique for a given species. In this study we assessed the identification of clinical yeast isolates by MALDI-TOF MS in a university hospital from Argentina and compared two procedures for protein extraction: a rapid method and a procedure based on the manufacturer's recommendations. A short protein extraction procedure was applied in 100 isolates and the rate of correct identification at genus and species level was 98.0%. In addition, we analyzed 201 isolates, previously identified by conventional methods, using the methodology recommended by the manufacturer and there was 95.38% coincidence in the identification at species level. MALDI TOF MS showed to be a fast, simple and reliable tool for yeast identification. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

Delay Discounting of Video Game Players: Comparison of Time Duration Among Gamers

PubMed Central

Sprong, Matthew E.; Lloyd, Daniel P.; Cutter, Christopher J.; Printz, Destiny M.B.; Sullivan, Ryan M.; Moore, Brent A.

2017-01-01

Abstract Video game addiction or Internet game disorder, as proposed by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), has similar criterion characteristics to other impulse control disorders. There is limited research examining video game addiction within a behavioral economic framework using delay discounting. The current study evaluated delay-discounting patterns of money and video game play by usual weekly hours of video game play. A total of 104 participants were split into 1 of 3 groups of video game players (low, medium, and high) and were asked to complete a monetary and video game discounting procedure through an online survey. Results showed significant differences between groups within both the monetary (p = 0.003) and video game discounting procedures (p = 0.004). Additionally, a positive linear relationship was noted between the groups across both procedures. The results of the current article reinforce previous findings that more hours of video game use are associated with greater impulsivity and provide implications for future research. PMID:28118044

Delay Discounting of Video Game Players: Comparison of Time Duration Among Gamers.

PubMed

Buono, Frank D; Sprong, Matthew E; Lloyd, Daniel P; Cutter, Christopher J; Printz, Destiny M B; Sullivan, Ryan M; Moore, Brent A

2017-02-01

Video game addiction or Internet game disorder, as proposed by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), has similar criterion characteristics to other impulse control disorders. There is limited research examining video game addiction within a behavioral economic framework using delay discounting. The current study evaluated delay-discounting patterns of money and video game play by usual weekly hours of video game play. A total of 104 participants were split into 1 of 3 groups of video game players (low, medium, and high) and were asked to complete a monetary and video game discounting procedure through an online survey. Results showed significant differences between groups within both the monetary (p = 0.003) and video game discounting procedures (p = 0.004). Additionally, a positive linear relationship was noted between the groups across both procedures. The results of the current article reinforce previous findings that more hours of video game use are associated with greater impulsivity and provide implications for future research.

Osteochondral repair in hemophilic ankle arthropathy: from current options to future perspectives

PubMed Central

BUDA, ROBERTO; CAVALLO, MARCO; CASTAGNINI, FRANCESCO; FERRANTI, ENRICO; NATALI, SIMONE; GIANNINI, SANDRO

2015-01-01

Young hemophilic patients are frequently affected by ankle arthropathy. At the end stage of the disease, the current treatments are arthrodesis and arthroplasty, which have significant drawbacks. Validated procedures capable of slowing down or even arresting the progression towards the end stage are currently lacking. This review aims to discuss the rationale for and feasibility of applying, in mild hemophilic ankle arthropathy, the main techniques currently used to treat osteochondral defects, focusing in particular on ankle distraction, chondrocyte implantation, mesenchymal stem cell transplantation, allograft transplantation and the use of growth factors. To date, ankle distraction is the only procedure that has been successfully used in hemophilic ankle arthropathy. The use of mesenchymal stem cells have recently been evaluated as feasible for osteochondral repair in hemophilic patients. There may be a rationale for the use of growth factors if they are combined with the previous techniques, which could be useful to arrest the progression of the degeneration or delay end-stage procedures. PMID:26904526

Newborn screening healthcare information system based on service-oriented architecture.

PubMed

Hsieh, Sung-Huai; Hsieh, Sheau-Ling; Chien, Yin-Hsiu; Weng, Yung-Ching; Hsu, Kai-Ping; Chen, Chi-Huang; Tu, Chien-Ming; Wang, Zhenyu; Lai, Feipei

2010-08-01

In this paper, we established a newborn screening system under the HL7/Web Services frameworks. We rebuilt the NTUH Newborn Screening Laboratory's original standalone architecture, having various heterogeneous systems operating individually, and restructured it into a Service-Oriented Architecture (SOA), distributed platform for further integrity and enhancements of sample collections, testing, diagnoses, evaluations, treatments or follow-up services, screening database management, as well as collaboration, communication among hospitals; decision supports and improving screening accuracy over the Taiwan neonatal systems are also addressed. In addition, the new system not only integrates the newborn screening procedures among phlebotomy clinics, referral hospitals, as well as the newborn screening center in Taiwan, but also introduces new models of screening procedures for the associated, medical practitioners. Furthermore, it reduces the burden of manual operations, especially the reporting services, those were heavily dependent upon previously. The new system can accelerate the whole procedures effectively and efficiently. It improves the accuracy and the reliability of the screening by ensuring the quality control during the processing as well.

Evaluation of fast green FCF dye for non-lethal detection of integumental injuries in juvenile chinook salmon oncorhynchus tshawytscha

USGS Publications Warehouse

Elliott, D.G.; Conway, C.M.; Applegate, L.M.J.

2009-01-01

A rapid staining procedure for detection of recent skin and fin injuries was tested in juvenile Chinook salmon Oncorhynchus tshawytscha. Immersion of anesthetized fish for 1 min in aerated aqueous solutions of the synthetic food dye fast green FCF (Food Green 3) at concentrations of 0.1 to 0.5% produced consistent and visible staining of integumental injuries. A 0.1% fast green concentration was satisfactory for visual evaluation of injuries, whereas a 0.5% concentration was preferable for digital photography. A rinsing procedure comprised of two 30 s rinses in fresh water was most effective for removal of excess stain after exposure of fish. Survival studies in fresh water and seawater and histopathological analyses indicated that short exposures to aqueous solutions of fast green were non-toxic to juvenile Chinook salmon. In comparisons of the gross and microscopic appearance of fish exposed to fast green at various times after injury, the dye was observed only in areas of the body where epidermal disruption was present as determined by scanning electron microscopy. No dye was observed in areas where epidermal integrity had been restored. Further comparisons showed that fast green exposure produced more consistent and intense staining of skin injury sites than a previously published procedure using trypan blue. Because of its relatively low cost, ease of use and the rapid and specific staining of integumental injuries, fast green may find widespread application in fish health and surface injury evaluations. ?? Inter-Research 2009.

A Cohort Analysis of Postbariatric Panniculectomy--Current Trends in Surgeon Reimbursement.

PubMed

Aherrera, Andrew S; Pandya, Sonal N

2016-01-01

The overall number of patients undergoing body contouring procedures after massive weight loss (MWL) has progressively increased over the past decade. The purpose of this study was to evaluate the charges and reimbursements for panniculectomy after MWL at a large academic institution in Massachusetts. A retrospective review was performed and included all identifiable panniculectomy procedures performed at our institution between January 2008 and January 2014. The annual number of patients undergoing panniculectomy, the type of insurance coverage and reimbursement method of each patient, and the amounts billed and reimbursed were evaluated. During our study period, 114 patients underwent a medically necessary panniculectomy as a result of MWL. The average surgeon fee billed was $3496 ± $704 and the average amount reimbursed was $1271 ± $589. Ten cases (8.8%) had no reimbursements, 31 cases (21.8%) reimbursed less than $1000, 66 cases (57.9%) reimbursed between $1000 and $2000, and no cases reimbursed the full amount billed. When evaluated by type of insurance coverage, collection ratios were 37.4% ± 17.4% overall, 41.7% ± 16.4% for private insurance, and 24.0% ± 13.0% for Medicare/Medicaid insurance (P < 0.001). Reimbursements for panniculectomy are remarkably low, and in many instances, absent, despite obtaining previous preauthorization of medical necessity. Although panniculectomy is associated with improvements in quality of life and high levels of patient satisfaction, poor physician reimbursement for this labor intensive procedure may preclude access to appropriate care required by the MWL patient population.

A scalable architecture for incremental specification and maintenance of procedural and declarative clinical decision-support knowledge.

PubMed

Hatsek, Avner; Shahar, Yuval; Taieb-Maimon, Meirav; Shalom, Erez; Klimov, Denis; Lunenfeld, Eitan

2010-01-01

Clinical guidelines have been shown to improve the quality of medical care and to reduce its costs. However, most guidelines exist in a free-text representation and, without automation, are not sufficiently accessible to clinicians at the point of care. A prerequisite for automated guideline application is a machine-comprehensible representation of the guidelines. In this study, we designed and implemented a scalable architecture to support medical experts and knowledge engineers in specifying and maintaining the procedural and declarative aspects of clinical guideline knowledge, resulting in a machine comprehensible representation. The new framework significantly extends our previous work on the Digital electronic Guidelines Library (DeGeL) The current study designed and implemented a graphical framework for specification of declarative and procedural clinical knowledge, Gesher. We performed three different experiments to evaluate the functionality and usability of the major aspects of the new framework: Specification of procedural clinical knowledge, specification of declarative clinical knowledge, and exploration of a given clinical guideline. The subjects included clinicians and knowledge engineers (overall, 27 participants). The evaluations indicated high levels of completeness and correctness of the guideline specification process by both the clinicians and the knowledge engineers, although the best results, in the case of declarative-knowledge specification, were achieved by teams including a clinician and a knowledge engineer. The usability scores were high as well, although the clinicians' assessment was significantly lower than the assessment of the knowledge engineers.

The use of standard operating procedures in day case anterior cruciate ligament reconstruction.

PubMed

Khan, T; Jackson, W F; Beard, D J; Marfin, A; Ahmad, M; Spacie, R; Jones, R; Howes, S; Barker, K; Price, A J

2012-08-01

The current rate of day-case anterior cruciate ligament reconstruction (ACLR) in the UK remains low. Although specialised care pathways with standard operating procedures (SOPs) have been effective in reducing length of stay following some surgical procedures, this has not been previously reported for ACLR. We evaluate the effectiveness of SOPs for establishing day-case ACLR in a specialist unit. Fifty patients undergoing ACLR between May and September 2010 were studied prospectively ("study group"). SOPs were designed for pre-operative assessment, anaesthesia, surgical procedure, mobilisation and discharge. We evaluated length of stay, readmission rates, patient satisfaction and compliance to SOPs. A retrospective analysis of 50 patients who underwent ACLR prior to implementation of the day-case pathway was performed ("standard practice group"). Eighty percent of patients in the study group were discharged on the day of surgery (mean length of stay=5.3h) compared to 16% in the standard practice group (mean length of stay=21.6h). This difference was statistically significant (p<0.05, Mann-Whitney U test). All patients were satisfied with the day case pathway. Ninety-two percent of the study group were discharged on the day of surgery when all SOPs were followed and 46% where they were not. High rates of day-case ACLR with excellent patient satisfaction can be achieved with the use of a specialised patient pathway with SOPs. Copyright © 2011 Elsevier B.V. All rights reserved.

Impact of operator experience and training strategy on procedural outcomes with leadless pacing: Insights from the Micra Transcatheter Pacing Study.

PubMed

El-Chami, Mikhael; Kowal, Robert C; Soejima, Kyoko; Ritter, Philippe; Duray, Gabor Z; Neuzil, Petr; Mont, Lluis; Kypta, Alexander; Sagi, Venkata; Hudnall, John Harrison; Stromberg, Kurt; Reynolds, Dwight

2017-07-01

Leadless pacemaker systems have been designed to avoid the need for a pocket and transvenous lead. However, delivery of this therapy requires a new catheter-based procedure. This study evaluates the role of operator experience and different training strategies on procedural outcomes. A total of 726 patients underwent implant attempt with the Micra transcatheter pacing system (TPS; Medtronic, Minneapolis, MN, USA) by 94 operators trained in a teaching laboratory using a simulator, cadaver, and large animal models (lab training) or locally at the hospital with simulator/demo model and proctorship (hospital training). Procedure success, procedure duration, fluoroscopy time, and safety outcomes were compared between training methods and experience (implant case number). The Micra TPS procedure was successful in 99.2% of attempts and did not differ between the 55 operators trained in the lab setting and the 39 operators trained locally at the hospital (P = 0.189). Implant case number was also not a determinant of procedural success (P = 0.456). Each operator performed between one and 55 procedures. Procedure time and fluoroscopy duration decreased by 2.0% (P = 0.002) and 3.2% (P < 0.001) compared to the previous case. Major complication rate and pericardial effusion rate were not associated with case number (P = 0.755 and P = 0.620, respectively). There were no differences in the safety outcomes by training method. Among a large group of operators, implantation success was high regardless of experience. While procedure duration and fluoroscopy times decreased with implant number, complications were low and not associated with case number. Procedure and safety outcomes were similar between distinct training methodologies. © 2017 Wiley Periodicals, Inc.

Hypocalcemia after thyroidectomy in patients with a history of bariatric surgery.

PubMed

Chereau, Nathalie; Vuillermet, Cindy; Tilly, Camille; Buffet, Camille; Trésallet, Christophe; du Montcel, Sophie Tezenas; Menegaux, Fabrice

2017-03-01

Hypocalcemia is a common complication after total thyroidectomy. Previous bariatric surgery could be a higher factor risk for hypocalcemia due to alterations in calcium absorption and vitamin D deficiency. To evaluate incidence and factors involved in the risk of hypocalcemia (transient and permanent) and the postoperative outcomes of these patients after total thyroidectomy. University hospital in Paris, France. All patients who had previously undergone obesity surgery (i.e., Roux-en-Y gastric bypass, sleeve gastrectomy, or adjustable gastric band) who had a total thyroidectomy from 2006 to 2015 were included. No patient was lost to follow-up. Each patient was matched 1:1 with a patient who had no previous bariatric surgery for age, gender, body mass index, and year of surgery. Forty-eight patients were identified (43 female; mean age 48.9±9.2 yr). Nineteen patients (40%) had a postoperative hypocalcemia: transient in 14 patients (29.2%) and permanent in 5 patients (10.4%). No significant predictive clinical or biochemical factors were found for hypocalcemia risk, except for the type of bariatric procedure: Bypass surgery had a 2-fold increased risk of hypocalcemia compared to others procedures (60% versus 30%, P = .05). In the matched pair analysis, the risk of hypocalcemia was significantly higher in patients with previous bariatric surgery than in the matched cohort (40% versus 15%, P = .006). Patients with previous bariatric surgery have an increased risk for hypocalcemia after total thyroidectomy, especially after Roux-en-Y gastric bypass. Careful and prolonged follow-up of calcium, vitamin D, and parathyroid hormone levels should be suggested for these patients. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Postauthorization safety surveillance of ADVATE [antihaemophilic factor (recombinant), plasma/albumin-free method] demonstrates efficacy, safety and low-risk for immunogenicity in routine clinical practice.

PubMed

Oldenburg, J; Goudemand, J; Valentino, L; Richards, M; Luu, H; Kriukov, A; Gajek, H; Spotts, G; Ewenstein, B

2010-11-01

  Postauthorization safety surveillance of factor VIII (FVIII) concentrates is essential for assessing rare adverse event incidence. We determined safety and efficacy of ADVATE [antihaemophilic factor (recombinant), plasma/albumin-free method, (rAHF-PFM)] during routine clinical practice. Subjects with differing haemophilia A severities and medical histories were monitored during 12 months of prophylactic and/or on-demand therapy. Among 408 evaluable subjects, 386 (95%) received excellent/good efficacy ratings for all on-demand assessments; the corresponding number for subjects with previous FVIII inhibitors was 36/41 (88%). Among 276 evaluable subjects receiving prophylaxis continuously in the study, 255 (92%) had excellent/good ratings for all prophylactic assessments; the corresponding number for subjects with previous FVIII inhibitors was 41/46 (89%). Efficacy of surgical prophylaxis was excellent/good in 16/16 evaluable procedures. Among previously treated patients (PTPs) with >50 exposure days (EDs) and FVIII≤2%, three (0.75%) developed low-titre inhibitors. Two of these subjects had a positive inhibitor history; thus, the incidence of de novo inhibitor formation in PTPs with FVIII≤2% and no inhibitor history was 1/348 (0.29%; 95% CI, 0.01-1.59%). A PTP with moderate haemophilia developed a low-titre inhibitor. High-titre inhibitors were reported in a PTP with mild disease (following surgery), a previously untreated patient (PUP) with moderate disease (following surgery) and a PUP with severe disease. The favourable benefit/risk profile of rAHF-PFM previously documented in prospective clinical trials has been extended to include a broader range of haemophilia patients, many of whom would have been ineligible for registration studies. © 2010 Blackwell Publishing Ltd.

[µCT analysis of mandibular molars before and after instrumentation by Reciproc files].

PubMed

Ametrano, Gianluca; Riccitiello, Francesco; Amato, Massimo; Formisano, Anna; Muto, Massimo; Grassi, Roberta; Valletta, Alessandra; Simeone, Michele

2013-01-01

Cleaning and shaping are important section for the root canal treatment. A number of different methodologies have been developed to overcome these problems, including the introduction of rotary instruments nickel-titanium (NiTi). In endodontics NiTi have been shown to significantly reduce procedural errors compared to manual techniques of instrumentation. The efficiency of files is related to many factor. Although previous investigations that have used µCT analysis were hampered by insufficient resolution or projection incorrect. The new generation of μCT performance best offer, as micron resolution and accurate measurement software for evaluating the accurate anatomy of the root canal. The aim the paper was to evaluate the efficiency of Reciproc files in root canal treatment, evaluated before and after instrumentation by using μ-CT analysis.

Comparison of 1997 Medicare relative value units for gender-specific procedures: is Adam still worth more than Eve?

PubMed

Goff, B A; Muntz, H G; Cain, J M

1997-08-01

On January 1, 1992, Congress implemented a Medicare payment system based on relative value units (RVUs). The total RVU (which is made up of work, practice, and malpractice RVUs) is multiplied by a dollar conversion factor to set the reimbursement for all procedures covered by Medicare. In a previous study, we found that significant gender bias exists in Medicare reimbursement for female-specific services. Recently, HCFA approved increases (beginning January 1997) in the work RVU for many gynecologic procedures. This study was undertaken to compare work and total RVUs for gender-specific procedures effective January 1, 1997. Using the May 1996 Federal Register, we compared work and total RVUs for 24 pairs of gender-specific procedures. The groups were matched so that the amount of work and level of difficulty would be similar, if not identical. We validated our selection of procedures for comparison by also evaluating the average time required to perform these procedures. Comparison of work RVUs for the 24 paired procedures revealed that in 19 cases (80%), male-specific procedures had a higher RVU; in 3 cases (12%), female-specific procedures were higher; and in 2 cases, there was no difference. On average, work RVUs were 49% higher for urologic procedures than for gynecologic procedures. Comparison of total RVUs revealed that in 20 cases (83%), urologic procedures had a higher total RVU and in 3 cases (12%), gynecologic procedures were higher. On average, male-specific surgeries are reimbursed at an amount which is 37% higher than that for female-specific surgeries. Recent increases in work RVUs for many gynecologic procedures have resulted in improved reimbursement. However, even with these improvements, significant gender bias still exists in the Medicare reimbursement of female-specific procedures. This gender bias is further magnified as more private insurance carriers use the system to set reimbursement.

Contemporary Surgical Trends in the Management of Symptomatic Meniscal Tears among United States Military Servicemembers from 2010 to 2015.

PubMed

Pekari, Timothy B; Wang, Kevin C; Cotter, Eric J; Kusnezov, Nicholas; Waterman, Brian R

2018-03-07

The purpose of this investigation is to report on trends over time in the treatment of meniscal pathology among military orthopaedic surgeons, as well as to evaluate the impact of patient demographics and concomitant procedure on the type of meniscal procedure performed. We performed a retrospective analysis of all active-duty United States military servicemembers who underwent a meniscal procedure from 2010 to 2015 within the Military Health System. Patient demographics and surgical variables were extracted from the electronic medical record. Treatments were categorized by location and by type of intervention (i.e., repair or debridement). Chi-square and linear regression analyses were performed to identify temporal trends in meniscal procedures and factors that were correlated with the type of meniscal procedure performed. Out of 29,571 meniscal procedures analyzed, partial meniscectomy was performed in 81.3% ( n  = 24,343) of cases, meniscal repair in 20.3% ( n  = 6,073), and meniscus allograft transplantation (MAT) in 0.7% ( n  = 206). The rates of debridement, repair, and concomitant surgeries did not demonstrate any significant temporal trends, whereas MAT demonstrated a significant decrease in overall utilization. Nearly two-thirds of all meniscal procedures were performed in the medial compartment. MAT occurred equally between the medial and lateral compartments. Lateral meniscal lesions demonstrated significantly higher rates of debridement. With each year of advancing age, there was a 3.7% increasing likelihood of meniscectomy and 6.5% decreasing likelihood of repair. Females were more likely to undergo meniscal repair than males. Patients in the military population were more likely to undergo meniscal repair compared with previously reported rates in the civilian population. In this physically active cohort of nearly 30,000 military patients, 1 in 5 meniscal tears were treated with meniscal repair. Meniscal repairs were performed at a higher rate for all age groups compared with previously reported rates in the civilian population. Further research is required to elucidate the causative factors behind these differences and the effect on postoperative outcomes. IV, cross-sectional study. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

29 CFR 1956.22 - Procedures for evaluation and monitoring.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Procedures for evaluation and monitoring. 1956.22 Section 1956.22 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION..., Change, Evaluation and Withdrawal of Approval Procedures § 1956.22 Procedures for evaluation and...

Cortical spreading depression occurs during elective neurosurgical procedures.

PubMed

Carlson, Andrew P; William Shuttleworth, C; Mead, Brittany; Burlbaw, Brittany; Krasberg, Mark; Yonas, Howard

2017-01-01

OBJECTIVE Cortical spreading depression (CSD) has been observed with relatively high frequency in the period following human brain injury, including traumatic brain injury and ischemic/hemorrhagic stroke. These events are characterized by loss of ionic gradients through massive cellular depolarization, neuronal dysfunction (depression of electrocorticographic [ECoG] activity) and slow spread (2-5 mm/min) across the cortical surface. Previous data obtained in animals have suggested that even in the absence of underlying injury, neurosurgical manipulation can induce CSD and could potentially be a modifiable factor in neurosurgical injury. The authors report their initial experience with direct intraoperative ECoG monitoring for CSD. METHODS The authors prospectively enrolled patients undergoing elective craniotomy for supratentorial lesions in cases in which the surgical procedure was expected to last > 2 hours. These patients were monitored for CSD from the time of dural opening through the time of dural closure, using a standard 1 × 6 platinum electrode coupled with an AC or full-spectrum DC amplifier. The data were processed using standard techniques to evaluate for slow potential changes coupled with suppression of high-frequency ECoG propagating across the electrodes. Data were compared with CSD validated in previous intensive care unit (ICU) studies, to evaluate recording conditions most likely to permit CSD detection, and identify likely events during the course of neurosurgical procedures using standard criteria. RESULTS Eleven patients underwent ECoG monitoring during elective neurosurgical procedures. During the periods of monitoring, 2 definite CSDs were observed to occur in 1 patient and 8 suspicious events were detected in 4 patients. In other patients, either no events were observed or artifact limited interpretation of the data. The DC-coupled amplifier system represented an improvement in stability of data compared with AC-coupled systems. Compared with more widely used postoperative ICU monitoring, there were additional challenges with artifact from saturation during bipolar cautery as well as additional noise peaks detected. CONCLUSIONS CSD can occur during elective neurosurgical procedures even in brain regions distant from the immediate operative site. ECoG monitoring with a DC-coupled full-spectrum amplifier seemed to provide the most stable signal despite significant challenges to the operating room environment. CSD may be responsible for some cases of secondary surgical injury. Though further studies on outcome related to the occurrence of these events is needed, efforts to decrease the occurrence of CSD by modification of anesthetic regimen may represent a novel target for study to increase the safety of neurosurgical procedures.

Long-term follow-up of a randomized clinical trial comparing Beger with pylorus-preserving Whipple procedure for chronic pancreatitis.

PubMed

Müller, M W; Friess, H; Martin, D J; Hinz, U; Dahmen, R; Büchler, M W

2008-03-01

Duodenum-preserving pancreatic head resection according to Beger and the pylorus-preserving Whipple (ppWhipple) procedure were compared in patients with chronic pancreatitis (CP) in a randomized clinical trial. Perioperative data and short-term outcome have been reported previously. The present study evaluated long-term follow-up. Forty patients were enrolled originally, 20 in each group. Long-term follow-up included mortality, morbidity, pain status, occupational rehabilitation, quality of life (QoL), and endocrine and exocrine function at median follow-up of 7 and 14 years. One patient who had a ppWhipple procedure was lost to follow-up. There were five late deaths in each group. No differences were noted in pain status and exocrine pancreatic function. Loss of appetite was significantly worse in the ppWhipple group at 14 years' follow-up, but there were no other differences in QoL parameters examined. After 14 years, diabetes mellitus was present in seven of 15 patients who had the Beger procedure and 11 of 14 patients after ppWhipple resection (P = 0.128). After long-term follow-up of up to 14 years early advantages of the Beger procedure were no longer present. 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

A 20-year period of orthotopic liver transplantation activity in a single center: a time series analysis performed using the R Statistical Software.

PubMed

Santori, G; Andorno, E; Morelli, N; Casaccia, M; Bottino, G; Di Domenico, S; Valente, U

2009-05-01

In many Western countries a "minimum volume rule" policy has been adopted as a quality measure for complex surgical procedures. In Italy, the National Transplant Centre set the minimum number of orthotopic liver transplantation (OLT) procedures/y at 25/center. OLT procedures performed in a single center for a reasonably large period may be treated as a time series to evaluate trend, seasonal cycles, and nonsystematic fluctuations. Between January 1, 1987 and December 31, 2006, we performed 563 cadaveric donor OLTs to adult recipients. During 2007, there were another 28 procedures. The greatest numbers of OLTs/y were performed in 2001 (n = 51), 2005 (n = 50), and 2004 (n = 49). A time series analysis performed using R Statistical Software (Foundation for Statistical Computing, Vienna, Austria), a free software environment for statistical computing and graphics, showed an incremental trend after exponential smoothing as well as after seasonal decomposition. The predicted OLT/mo for 2007 calculated with the Holt-Winters exponential smoothing applied to the previous period 1987-2006 helped to identify the months where there was a major difference between predicted and performed procedures. The time series approach may be helpful to establish a minimum volume/y at a single-center level.

Transfascial vaginal tape (TFT): a simple, safe and cost-effective procedure for stress urinary incontinence. A preliminary study.

PubMed

Foglia, Giovanni; Mistrangelo, Emanuela; Lijoi, Davide; Alessandri, Franco; Ragni, Nicola

2007-07-01

To analyse prospectively the effectiveness of a new simple, minimally invasive, and cost-effective technique for the treatment of female urinary stress incontinence: the transfascial vaginal tape (TFT). In a prospective study, we enrolled 45 women undergoing TFT with or without hysterectomy and/or another pelvic reconstructive procedure between 1st December 2003 and 31st December. TFT consists of a tension-free urethrosuspension using a sling located at the mid-urethral level and placed laterally in the endopelvic fascia previously perforated. Follow-up evaluations were established at 3 and 6 months and at 1 year after the operation. During each follow-up, women underwent cough stress test and they answered to the "Incontinence quality of life questionnaire" (I-QOL), to the Patient Global Impression of Severity (PGI-S) and of Improvement (PGI-I) questions. Thirty-nine patients (88.9%) had a follow-up examination 1 year after surgery. Of these, 30 (76.9%) were defined cured, 6 (15.4%) improved and 3 (7.7%) failed. TFT procedure can be considered a simple, safe and cost-effective procedure for the treatment of stress urinary incontinence and can be an alternative to tension-free vaginal tape or transobturator route for sub-urethral tape procedures.

Precise Haptic Device Co-Location for Visuo-Haptic Augmented Reality.

PubMed

Eck, Ulrich; Pankratz, Frieder; Sandor, Christian; Klinker, Gudrun; Laga, Hamid

2015-12-01

Visuo-haptic augmented reality systems enable users to see and touch digital information that is embedded in the real world. PHANToM haptic devices are often employed to provide haptic feedback. Precise co-location of computer-generated graphics and the haptic stylus is necessary to provide a realistic user experience. Previous work has focused on calibration procedures that compensate the non-linear position error caused by inaccuracies in the joint angle sensors. In this article we present a more complete procedure that additionally compensates for errors in the gimbal sensors and improves position calibration. The proposed procedure further includes software-based temporal alignment of sensor data and a method for the estimation of a reference for position calibration, resulting in increased robustness against haptic device initialization and external tracker noise. We designed our procedure to require minimal user input to maximize usability. We conducted an extensive evaluation with two different PHANToMs, two different optical trackers, and a mechanical tracker. Compared to state-of-the-art calibration procedures, our approach significantly improves the co-location of the haptic stylus. This results in higher fidelity visual and haptic augmentations, which are crucial for fine-motor tasks in areas such as medical training simulators, assembly planning tools, or rapid prototyping applications.

Pain perception of children undergoing nasendoscopy for investigation of voice and resonance disorders.

PubMed

Hay, Imogen; Oates, Jennifer; Giannini, Alessandra; Berkowitz, Robert; Rotenberg, Brian

2009-05-01

The primary objective of this descriptive and correlational study was to determine the level of pain and discomfort perceived by children undergoing nasendoscopy for investigation of voice and resonance disorders. The secondary objective was to explore whether gender, age, previous experience of painful or distressing medical procedures, and previous experience of nasendoscopy influenced the perception of pain during nasendoscopy. Twenty-three children self-reported the degree of pain perceived during nasendoscopy using the Wong-Baker Faces Pain Rating Scale. Parents also used this scale to rate their child's perceived pain. Otolaryngologists and speech pathologists rated the intensity and frequency of observed pain-related behaviors using the Child-Adult Medical Procedure Interaction Scale-Revised and the Procedure Behavior Checklist. Children perceived the procedure, on average, to be moderately painful, as did their parents. Only two children reported perceiving no pain during the procedure. The most frequently observed pain-related behaviors were muscle tension (86.96%), physical resistance (69.57%), requiring physical restraint (60.87%), crying (43.48%), and expressions of verbal pain (39.13%). No significant correlations were found between self-reported pain or observed pain and the variables of age, gender, previous experience of nasendoscopy, and previous experience of painful or distressing medical procedures, although children aged 4-7 years reported significantly more pain than children aged 8-18 years. Most children perceive nasendoscopy to be painful to some degree. This perceived pain occurred in conjunction with several observable pain-related behaviors that have the potential to interfere with the success of the procedure.

Use of repeat anterior maxillary distraction to correct residual midface hypoplasia in cleft patients.

PubMed

Richardson, Sunil; Krishna, Shreya; Bansal, Avi

2017-12-01

The study was designed to evaluate the efficacy of performing a second, repeat anterior maxillary distraction (AMD) to treat residual cleft maxillary hypoplasia. Five patients between the ages of 12 to 15 years with a history of AMD and with residual cleft maxillary hypoplasia were included in the study. Inclusion was irrespective of gender, type of cleft lip and palate, and the amount of advancement needed. Repeat AMD was executed in these patients 4 to 5 years after the primary AMD procedure to correct the cleft maxillary hypoplasia that had developed since the initial procedure. Orthopantomogram (OPG) and lateral cephalograms were taken for evaluation preoperatively, immediately after distraction, after consolidation, and one year postoperatively. The data obtained was tabulated and a Mann Whitney U-test was used for statistical comparisons. At the time of presentation, a residual maxillary hypoplasia was observed with a well maintained distraction gap on the OPG which ruled out the occurrence of a relapse. Favorable movement of the segments without any resistance was seen in all patients. Mean maxillary advancement of 10.56 mm was achieved at repeat AMD. Statistically significant increases in midfacial length, SNA angle, and nasion perpendicular to point A distance was achieved ( P =0.012, P =0.011, and P =0.012, respectively). Good profile was achieved for all patients. Minimal transient complications, for example anterior open bite and bleeding episodes, were managed. Addressing the problem of cleft maxillary hypoplasia at an early age (12-15 years) is beneficial for the child. Residual hypoplasia may develop in some patients, which may require additional corrective procedures. The results of our study show that AMD can be repeated when residual deformity develops with the previous procedure having no negative impact on the results of the repeat procedure.

34 CFR 300.304 - Evaluation procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Educational Placements Evaluations and Reevaluations § 300.304 Evaluation procedures. (a) Notice. The public... conducting the evaluation, the public agency must— (1) Use a variety of assessment tools and strategies to... evaluation procedures. Each public agency must ensure that— (1) Assessments and other evaluation materials...

Surgical staging and prognosis in serous borderline ovarian tumours (BOT): A subanalysis of the AGO ROBOT study

PubMed Central

Trillsch, F; Mahner, S; Vettorazzi, E; Woelber, L; Reuss, A; Baumann, K; Keyver-Paik, M-D; Canzler, U; Wollschlaeger, K; Forner, D; Pfisterer, J; Schroeder, W; Muenstedt, K; Richter, B; Fotopoulou, C; Schmalfeldt, B; Burges, A; Ewald-Riegler, N; de Gregorio, N; Hilpert, F; Fehm, T; Meier, W; Hillemanns, P; Hanker, L; Hasenburg, A; Strauss, H-G; Hellriegel, M; Wimberger, P; Kommoss, S; Kommoss, F; Hauptmann, S; du Bois, A

2015-01-01

Background: Incomplete surgical staging is a negative prognostic factor for patients with borderline ovarian tumours (BOT). However, little is known about the prognostic impact of each individual staging procedure. Methods: Clinical parameters of 950 patients with BOT (confirmed by central reference pathology) treated between 1998 and 2008 at 24 German AGO centres were analysed. In 559 patients with serous BOT and adequate ovarian surgery, further recommended staging procedures (omentectomy, peritoneal biopsies, cytology) were evaluated applying Cox regression models with respect to progression-free survival (PFS). Results: For patients with one missing staging procedure, the hazard ratio (HR) for recurrence was 1.25 (95%-CI 0.66–2.39; P=0.497). This risk increased with each additional procedure skipped reaching statistical significance in case of two (HR 1.95; 95%-CI 1.06–3.58; P=0.031) and three missing steps (HR 2.37; 95%-CI 1.22–4.64; P=0.011). The most crucial procedure was omentectomy which retained a statistically significant impact on PFS in multiple analysis (HR 1.91; 95%-CI 1.15–3.19; P=0.013) adjusting for previously established prognostic factors as FIGO stage, tumour residuals, and fertility preservation. Conclusion: Individual surgical staging procedures contribute to the prognosis for patients with serous BOT. In this analysis, recurrence risk increased with each skipped surgical step. This should be considered when re-staging procedures following incomplete primary surgery are discussed. PMID:25562434

Surgical staging and prognosis in serous borderline ovarian tumours (BOT): a subanalysis of the AGO ROBOT study.

PubMed

Trillsch, F; Mahner, S; Vettorazzi, E; Woelber, L; Reuss, A; Baumann, K; Keyver-Paik, M-D; Canzler, U; Wollschlaeger, K; Forner, D; Pfisterer, J; Schroeder, W; Muenstedt, K; Richter, B; Fotopoulou, C; Schmalfeldt, B; Burges, A; Ewald-Riegler, N; de Gregorio, N; Hilpert, F; Fehm, T; Meier, W; Hillemanns, P; Hanker, L; Hasenburg, A; Strauss, H-G; Hellriegel, M; Wimberger, P; Kommoss, S; Kommoss, F; Hauptmann, S; du Bois, A

2015-02-17

Incomplete surgical staging is a negative prognostic factor for patients with borderline ovarian tumours (BOT). However, little is known about the prognostic impact of each individual staging procedure. Clinical parameters of 950 patients with BOT (confirmed by central reference pathology) treated between 1998 and 2008 at 24 German AGO centres were analysed. In 559 patients with serous BOT and adequate ovarian surgery, further recommended staging procedures (omentectomy, peritoneal biopsies, cytology) were evaluated applying Cox regression models with respect to progression-free survival (PFS). For patients with one missing staging procedure, the hazard ratio (HR) for recurrence was 1.25 (95%-CI 0.66-2.39; P=0.497). This risk increased with each additional procedure skipped reaching statistical significance in case of two (HR 1.95; 95%-CI 1.06-3.58; P=0.031) and three missing steps (HR 2.37; 95%-CI 1.22-4.64; P=0.011). The most crucial procedure was omentectomy which retained a statistically significant impact on PFS in multiple analysis (HR 1.91; 95%-CI 1.15-3.19; P=0.013) adjusting for previously established prognostic factors as FIGO stage, tumour residuals, and fertility preservation. Individual surgical staging procedures contribute to the prognosis for patients with serous BOT. In this analysis, recurrence risk increased with each skipped surgical step. This should be considered when re-staging procedures following incomplete primary surgery are discussed.

Fitting hidden Markov models of protein domains to a target species: application to Plasmodium falciparum

PubMed Central

2012-01-01

Background Hidden Markov Models (HMMs) are a powerful tool for protein domain identification. The Pfam database notably provides a large collection of HMMs which are widely used for the annotation of proteins in new sequenced organisms. In Pfam, each domain family is represented by a curated multiple sequence alignment from which a profile HMM is built. In spite of their high specificity, HMMs may lack sensitivity when searching for domains in divergent organisms. This is particularly the case for species with a biased amino-acid composition, such as P. falciparum, the main causal agent of human malaria. In this context, fitting HMMs to the specificities of the target proteome can help identify additional domains. Results Using P. falciparum as an example, we compare approaches that have been proposed for this problem, and present two alternative methods. Because previous attempts strongly rely on known domain occurrences in the target species or its close relatives, they mainly improve the detection of domains which belong to already identified families. Our methods learn global correction rules that adjust amino-acid distributions associated with the match states of HMMs. These rules are applied to all match states of the whole HMM library, thus enabling the detection of domains from previously absent families. Additionally, we propose a procedure to estimate the proportion of false positives among the newly discovered domains. Starting with the Pfam standard library, we build several new libraries with the different HMM-fitting approaches. These libraries are first used to detect new domain occurrences with low E-values. Second, by applying the Co-Occurrence Domain Discovery (CODD) procedure we have recently proposed, the libraries are further used to identify likely occurrences among potential domains with higher E-values. Conclusion We show that the new approaches allow identification of several domain families previously absent in the P. falciparum proteome and the Apicomplexa phylum, and identify many domains that are not detected by previous approaches. In terms of the number of new discovered domains, the new approaches outperform the previous ones when no close species are available or when they are used to identify likely occurrences among potential domains with high E-values. All predictions on P. falciparum have been integrated into a dedicated website which pools all known/new annotations of protein domains and functions for this organism. A software implementing the two proposed approaches is available at the same address: http://www.lirmm.fr/∼terrapon/HMMfit/ PMID:22548871

Fitting hidden Markov models of protein domains to a target species: application to Plasmodium falciparum.

PubMed

Terrapon, Nicolas; Gascuel, Olivier; Maréchal, Eric; Bréhélin, Laurent

2012-05-01

Hidden Markov Models (HMMs) are a powerful tool for protein domain identification. The Pfam database notably provides a large collection of HMMs which are widely used for the annotation of proteins in new sequenced organisms. In Pfam, each domain family is represented by a curated multiple sequence alignment from which a profile HMM is built. In spite of their high specificity, HMMs may lack sensitivity when searching for domains in divergent organisms. This is particularly the case for species with a biased amino-acid composition, such as P. falciparum, the main causal agent of human malaria. In this context, fitting HMMs to the specificities of the target proteome can help identify additional domains. Using P. falciparum as an example, we compare approaches that have been proposed for this problem, and present two alternative methods. Because previous attempts strongly rely on known domain occurrences in the target species or its close relatives, they mainly improve the detection of domains which belong to already identified families. Our methods learn global correction rules that adjust amino-acid distributions associated with the match states of HMMs. These rules are applied to all match states of the whole HMM library, thus enabling the detection of domains from previously absent families. Additionally, we propose a procedure to estimate the proportion of false positives among the newly discovered domains. Starting with the Pfam standard library, we build several new libraries with the different HMM-fitting approaches. These libraries are first used to detect new domain occurrences with low E-values. Second, by applying the Co-Occurrence Domain Discovery (CODD) procedure we have recently proposed, the libraries are further used to identify likely occurrences among potential domains with higher E-values. We show that the new approaches allow identification of several domain families previously absent in the P. falciparum proteome and the Apicomplexa phylum, and identify many domains that are not detected by previous approaches. In terms of the number of new discovered domains, the new approaches outperform the previous ones when no close species are available or when they are used to identify likely occurrences among potential domains with high E-values. All predictions on P. falciparum have been integrated into a dedicated website which pools all known/new annotations of protein domains and functions for this organism. A software implementing the two proposed approaches is available at the same address: http://www.lirmm.fr/~terrapon/HMMfit/

Evaluation of cleansing methods for previously worn prostheses.

PubMed

Glass, R Thomas; Conrad, Robert S; Bullard, James W; Goodson, Leigh B; Mehta, Naresh; Lech, Stanley J; Loewy, Zvi G

2011-04-01

Although there are many product claims that address the issue of denture sanitization, controlled scientific studies on previously worn dentures have not been performed. The purpose of this study was to evaluate procedures directed at sanitizing previously worn contaminated dentures from two regions of the United States. This study examined 51 previously worn dentures from two regions. An established method of denture retrieval, sectioning, and culturing was used, including isolation of anaerobes. Evaluation of microbial contamination posttreatment was used to determine the effects of soaking dentures in Polident (US and European formulations) for varying periods of times/temperatures, microwaving dentures with varying temperatures, sonicating dentures, and immersing the dentures while using a vacuum. A combination of analysis of variance (ANOVA) and general linear model (GLM) of the SPSS was used to analyze the data with P < .05 being considered statistically significant when using a two-tailed test. While all Polident treatments were found to significantly reduce microorganism loads in dentures, extended soaking (8 hours) and 65 degrees C (5 minutes) were the most effective. Microwaving was slightly more effective than either sonication or vacuum. Regardless the treatment, dentures underwent sanitization rather than sterilization. Denture-borne microorganisms can be significantly reduced by using a Polident solution for 8 hours at room temperature or for 5 minutes at 65 degrees C. Microwaving, sonication, and use of a vacuum were less effective. ClLINICAL IMPLICATIONS The importance of daily use of Polident solution for 8 hours or for 5 minutes at 65 degrees C to sanitize worn prostheses must be stressed.

Prospective Comparison of Live Evaluation and Video Review in the Evaluation of Operator Performance in a Pediatric Emergency Airway Simulation

PubMed Central

House, Joseph B.; Dooley-Hash, Suzanne; Kowalenko, Terry; Sikavitsas, Athina; Seeyave, Desiree M.; Younger, John G.; Hamstra, Stanley J.; Nypaver, Michele M.

2012-01-01

Introduction Real-time assessment of operator performance during procedural simulation is a common practice that requires undivided attention by 1 or more reviewers, potentially over many repetitions of the same case. Objective To determine whether reviewers display better interrater agreement of procedural competency when observing recorded, rather than live, performance; and to develop an assessment tool for pediatric rapid sequence intubation (pRSI). Methods A framework of a previously established Objective Structured Assessment of Technical Skills (OSATS) tool was modified for pRSI. Emergency medicine residents (postgraduate year 1–4) were prospectively enrolled in a pRSI simulation scenario and evaluated by 2 live raters using the modified tool. Sessions were videotaped and reviewed by the same raters at least 4 months later. Raters were blinded to their initial rating. Interrater agreement was determined by using the Krippendorff generalized concordance method. Results Overall interrater agreement for live review was 0.75 (95% confidence interval [CI], 0.72–0.78) and for video was 0.79 (95% CI, 0.73–0.82). Live review was significantly superior to video review in only 1 of the OSATS domains (Preparation) and was equivalent in the other domains. Intrarater agreement between the live and video evaluation was very good, greater than 0.75 for all raters, with a mean of 0.81 (95% CI, 0.76–0.85). Conclusion The modified OSATS assessment tool demonstrated some evidence of validity in discriminating among levels of resident experience and high interreviewer reliability. With this tool, intrareviewer reliability was high between live and 4-months' delayed video review of the simulated procedure, which supports feasibility of delayed video review in resident assessment. PMID:23997874

LAPAROSCOPIC UNCINATECTOMY: A MORE CONSERVATIVE APPROACH TO THE UNCINATE PROCESS OF THE PANCREAS.

PubMed

Surjan, Rodrigo Cañada; Basseres, Tiago; Makdissi, Fabio Ferrari; Machado, Marcel Autran Cesar; Ardengh, José Celso

2017-01-01

The isolate resection of the uncinate process of the pancreas is a rarely described procedure but is an adequate surgery to treat benign and low grade malignancies of the uncinate process of the pancreas. To detail laparoscopic uncinatectomy technique and present the initial results. Patient is placed in supine position with the surgeon between legs. Three 5-mm, one 10-mm and one 12-mm trocars were used to perform the isolated resection of the uncinate process of the pancreas. Parenchymal transection is performed with harmonic scalpel. A hemostatic absorbable tissue is deployed over the area previously occupied by the uncinate process. A Waterman drain is placed. This procedure was applied to an asymptomatic 62-year-old male with biopsy proven low grade neuroendocrine tumor of the pancreatic uncinate process. A laparoscopic pancreaticoduodenectomy was proposed. During the initial surgical evaluation, intraoperative sonography was performed and disclosed that the lesion was a few millimeters away from the Wirsung. The option was to perform a laparoscopic uncinatectomy. Postoperative period until full recovery was swift and uneventful. Laparoscopic uncinatectomy is a safe and efficient procedure when performed by surgical teams with large experience in minimally invasive biliopancreatic procedures.

Antegrade Ureteral Stenting is a Good Alternative for the Retrograde Approach.

PubMed

van der Meer, Rutger W; Weltings, Saskia; van Erkel, Arian R; Roshani, Hossain; Elzevier, Henk W; van Dijk, Lukas C; van Overhagen, Hans

2017-07-01

Double J (JJ) stents for treating obstructive ureteral pathology are generally inserted through a retrograde route with cystoscopic guidance. Antegrade percutaneous insertion using fluoroscopy can be performed alternatively but is less known. Indications, success rate and complications of antegrade ureteral stenting were evaluated. Data of consecutive patients in which antegrade ureteral stenting was performed were retrospectively analysed using the radiology information system and patient records. Patient characteristics, details of the antegrade JJ stent insertion procedure and registered complications were collected. Furthermore, it was investigated if prior to the antegrade procedure a retrograde attempt for JJ stent insertion was performed. Total 130 attempts for antegrade JJ stent insertion were performed in 100 patients. A percutaneous nephrostomy catheter had already been placed in the majority of kidneys (n = 109) for initial treatment of hydronephrosis. Most prevelant indication for a JJ stent was obstructive ureteral pathology due to malignancy (n = 63). A JJ stent was successfully inserted in 125 of 130 procedures. In 21 cases, previous retrograde ureteral stenting had failed but, subsequent antegrade ureteral stenting was successful. There were 8 procedure related complications; 6 infections, 1 false tract and 1 malposition. Antegrade percutaneous insertion of a JJ stent is a good alternative for retrograde insertion.

Experience with diagnostic laparoscopy for gynecological indications.

PubMed

Ikechebelu, J I

2013-01-01

Diagnostic laparoscopy is an endoscopy procedure, which has become indispensable in the evaluation of the female reproductive organs especially in infertility. Experience with conversion to open laparotomy is presented and ways of averting this complication are discussed. A retrospective study was performed. All the 1654 diagnostic laparoscopies performed at a private fertility center over a 10-year period (January 2000 to December 2009) were analyzed for indications, cases of conversion to open laparotomy, and measures taken to prevent this complication. Simple percentage method was used. Infertility was the commonest indication for 1627 (98.4%) procedures, while primary amenorrhoea and chronic pelvic pain were responsible for 20 (1.2%) and 7 (0.4%) procedures, respectively. There was no mortality in this series. There was conversion to open laparotomy due to hemorrhage in only 2 (0.12%) procedures and this happened at the first year of practice. The low rate of conversion was attributed to the surgeons experience, proper patient selection, and the use of Palmers point for insufflation in some patients with previous pelvic surgeries and use of supraumbilical access in patients with pelvic masses. Diagnostic laparoscopy for gynecological indications is safe and wider application of this modern technology is recommended for our practice.

A Comparison of Multivariable Control Design Techniques for a Turbofan Engine Control

NASA Technical Reports Server (NTRS)

Garg, Sanjay; Watts, Stephen R.

1995-01-01

This paper compares two previously published design procedures for two different multivariable control design techniques for application to a linear engine model of a jet engine. The two multivariable control design techniques compared were the Linear Quadratic Gaussian with Loop Transfer Recovery (LQG/LTR) and the H-Infinity synthesis. The two control design techniques were used with specific previously published design procedures to synthesize controls which would provide equivalent closed loop frequency response for the primary control loops while assuring adequate loop decoupling. The resulting controllers were then reduced in order to minimize the programming and data storage requirements for a typical implementation. The reduced order linear controllers designed by each method were combined with the linear model of an advanced turbofan engine and the system performance was evaluated for the continuous linear system. Included in the performance analysis are the resulting frequency and transient responses as well as actuator usage and rate capability for each design method. The controls were also analyzed for robustness with respect to structured uncertainties in the unmodeled system dynamics. The two controls were then compared for performance capability and hardware implementation issues.

Complete supine percutaneous nephrolithotomy with GoPro®. Ten steps for success.

PubMed

Vicentini, Fabio Carvalho; Dos Santos, Hugo Daniel Barone; Batagello, Carlos Alfredo; Amundson, Julia Rothe; Oliveira, Evaristo Peixoto; Marchini, Giovanni Scala; Srougi, Miguel; Nahas, Willian Carlos; Mazzucchi, Eduardo

2018-03-15

To show a video of a complete supine Percutaneous Nephrolithotomy (csPCNL) performed for the treatment of a staghorn calculus, from the surgeon's point of view. The procedure was recorded with a GoPro® camera, demonstrating the ten essential steps for a successful procedure. The patient was a 38 years-old woman with 2.4cm of left kidney lower pole stone burden who presented with 3 months of lumbar pain and recurrent urinary tract infections. She had a previous diagnosis of polycystic kidney disease and chronic renal failure stage 2. CT scan showed two 1.2cm stones in the lower pole (Guy's Stone Score 2). She had a previous ipsilateral double J insertion due to an obstructive pyelonephritis. The csPCNL was uneventful with a single access in the lower pole. The surgeon had a Full HD GoPro Hero 4 Session® camera mounted on his head, controlled by the surgical team with a remote control. All of the mains steps were recorded. Informed consent was obtained prior to the procedure. The surgical time was 90 minutes. Hemoglobin drop was 0.5g/dL. A post-operative CT scan was stone-free. The patient was discharged 36 hours after surgery. The camera worked properly and didn't cause pain or muscle discomfort to the surgeon. The quality of the recorded movie was excellent. GoPro® camera proved to be a very interesting tool to document surgeries without interfering with the procedure and with great educational potential. More studies should be conducted to evaluate the role of this equipment. Copyright® by the International Brazilian Journal of Urology.

Development of an Internet-Administered Cognitive Behavior Therapy Program (ENGAGE) for Parents of Children Previously Treated for Cancer: Participatory Action Research Approach.

PubMed

Wikman, Anna; Kukkola, Laura; Börjesson, Helene; Cernvall, Martin; Woodford, Joanne; Grönqvist, Helena; von Essen, Louise

2018-04-18

Parenting a child through cancer is a distressing experience, and a subgroup of parents report negative long-term psychological consequences years after treatment completion. However, there is a lack of evidence-based psychological interventions for parents who experience distress in relation to a child's cancer disease after end of treatment. One aim of this study was to develop an internet-administered, cognitive behavior therapy-based, psychological, guided, self-help intervention (ENGAGE) for parents of children previously treated for cancer. Another aim was to identify acceptable procedures for future feasibility and efficacy studies testing and evaluating the intervention. Participatory action research methodology was used. The study included face-to-face workshops and related Web-based exercises. A total of 6 parents (4 mothers, 2 fathers) of children previously treated for cancer were involved as parent research partners. Moreover, 2 clinical psychologists were involved as expert research partners. Research partners and research group members worked collaboratively throughout the study. Data were analyzed iteratively using written summaries of the workshops and Web-based exercises parallel to data collection. A 10-week, internet-administered, cognitive behavior therapy-based, psychological, guided, self-help intervention (ENGAGE) was developed in collaboration with parent research partners and expert research partners. The content of the intervention, mode and frequency of e-therapist support, and the individualized approach for feedback were modified based on the research partner input. Shared solutions were reached regarding the type and timing of support from an e-therapist (eg, initial video or telephone call, multiple methods of e-therapist contact), duration and timing of intervention (eg, 10 weeks, 30-min assessments), and the removal of unnecessary support functions (eg, removal of chat and forum functions). Preferences for study procedures in future studies testing and evaluating the intervention were discussed; consensus was not reached for all aspects. To the best of our knowledge, this study is the first use of a participatory action research approach to develop a psychological intervention for parents of children previously treated for cancer and to identify acceptable study procedures. Involvement of parents with lived experience was vital in the development of a potentially relevant and acceptable intervention for this population. ©Anna Wikman, Laura Kukkola, Helene Börjesson, Martin Cernvall, Joanne Woodford, Helena Grönqvist, Louise von Essen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.04.2018.

A new software for prediction of femoral neck fractures.

PubMed

Testi, Debora; Cappello, Angelo; Sgallari, Fiorella; Rumpf, Martin; Viceconti, Marco

2004-08-01

Femoral neck fractures are an important clinical, social and economic problem. Even if many different attempts have been carried out to improve the accuracy predicting the fracture risk, it was demonstrated in retrospective studies that the standard clinical protocol achieves an accuracy of about 65%. A new procedure was developed including for the prediction not only bone mineral density but also geometric and femoral strength information and achieving an accuracy of about 80% in a previous retrospective study. Aim of the present work was to re-engineer research-based procedures and develop a real-time software for the prediction of the risk for femoral fracture. The result was efficient, repeatable and easy to use software for the evaluation of the femoral neck fracture risk to be inserted in the daily clinical practice providing a useful tool for the improvement of fracture prediction.

Endovascular therapy of acute ischemic stroke: report of the Standards of Practice Committee of the Society of NeuroInterventional Surgery.

PubMed

Blackham, K A; Meyers, P M; Abruzzo, T A; Albuquerque, F C; Alberquerque, F C; Fiorella, D; Fraser, J; Frei, D; Gandhi, C D; Heck, D V; Hirsch, J A; Hsu, D P; Hussain, M Shazam; Jayaraman, M; Narayanan, S; Prestigiacomo, C; Sunshine, J L

2012-03-01

To summarize and classify the evidence for the use of endovascular techniques in the treatment of patients with acute ischemic stroke. Recommendations previously published by the American Heart Association (AHA) (Guidelines for the early management of adults with ischemic stroke (Circulation 2007) and Scientific statement indications for the performance of intracranial endovascular neurointerventional procedures (Circulation 2009)) were vetted and used as a foundation for the current process. Building on this foundation, a critical review of the literature was performed to evaluate evidence supporting the endovascular treatment of acute ischemic stroke. The assessment was based on guidelines for evidence based medicine proposed by the Stroke Council of the AHA and the University of Oxford, Centre for Evidence Based Medicine (CEBM). Procedural safety, technical efficacy and impact on patient outcomes were specifically examined.

A theoretical method for selecting space craft and space suit atmospheres.

PubMed

Vann, R D; Torre-Bueno, J R

1984-12-01

A theoretical method for selecting space craft and space suit atmospheres assumes that gas bubbles cause decompression sickness and that the risk increases when a critical bubble volume is exceeded. The method is consistent with empirical decompression exposures for humans under conditions of nitrogen equilibrium between the lungs and tissues. Space station atmospheres are selected so that flight crews may decompress immediately from sea level to station pressure without preoxygenation. Bubbles form as a result of this decompression but are less than the critical volume. The bubbles are absorbed during an equilibration period after which immediate transition to suit pressure is possible. Exercise after decompression and incomplete nitrogen equilibrium are shown to increase bubble size, and limit the usefulness of one previously tested stage decompression procedure for the Shuttle. The method might be helpful for evaluating decompression procedures before testing.

The Effect of Radiation on Selected Photographic Film

NASA Technical Reports Server (NTRS)

Slater, Richard; Kinard, John; Firsov, Ivan

2000-01-01

We conducted this film test to evaluate several manufacturers' photographic films for their ability to acquire imagery on the International Space Station. We selected 25 motion picture, photographic slide, and negative films from three different film manufacturers. We based this selection on the fact that their films ranked highest in other similar film tests, and on their general acceptance by the international community. This test differed from previous tests because the entire evaluation process leading up to the final selection was based on information derived after the original flight film was scanned to a digital file. Previously conducted tests were evaluated entirely based on 8 x 10s that were produced from the film either directly or through the internegative process. This new evaluation procedure provided accurate quantitative data on granularity and contrast from the digital data. This test did not try to define which film was best visually. This is too often based on personal preference. However, the test results did group the films by good, marginal, and unacceptable. We developed, and included in this report, a template containing quantitative, graphical, and visual information for each film. These templates should be sufficient for comparing the different films tested and subsequently selecting a film or films to be used for experiments and general documentation on the International Space Station.

A New Approach for Resolving Conflicts in Actionable Behavioral Rules

PubMed Central

Zhu, Dan; Zeng, Daniel

2014-01-01

Knowledge is considered actionable if users can take direct actions based on such knowledge to their advantage. Among the most important and distinctive actionable knowledge are actionable behavioral rules that can directly and explicitly suggest specific actions to take to influence (restrain or encourage) the behavior in the users' best interest. However, in mining such rules, it often occurs that different rules may suggest the same actions with different expected utilities, which we call conflicting rules. To resolve the conflicts, a previous valid method was proposed. However, inconsistency of the measure for rule evaluating may hinder its performance. To overcome this problem, we develop a new method that utilizes rule ranking procedure as the basis for selecting the rule with the highest utility prediction accuracy. More specifically, we propose an integrative measure, which combines the measures of the support and antecedent length, to evaluate the utility prediction accuracies of conflicting rules. We also introduce a tunable weight parameter to allow the flexibility of integration. We conduct several experiments to test our proposed approach and evaluate the sensitivity of the weight parameter. Empirical results indicate that our approach outperforms those from previous research. PMID:25162054

Applicant Personality and Procedural Justice Perceptions of Group Selection Interviews.

PubMed

Bye, Hege H; Sandal, Gro M

2016-01-01

We investigated how job applicants' personalities influence perceptions of the structural and social procedural justice of group selection interviews (i.e., a group of several applicants being evaluated simultaneously). We especially addressed trait interactions between neuroticism and extraversion (the affective plane) and extraversion and agreeableness (the interpersonal plane). Data on personality (pre-interview) and justice perceptions (post-interview) were collected in a field study among job applicants ( N  = 97) attending group selection interviews for positions as teachers in a Norwegian high school. Interaction effects in hierarchical regression analyses showed that perceptions of social and structural justice increased with levels of extraversion among high scorers on neuroticism. Among emotionally stable applicants, however, being introverted or extraverted did not matter to justice perceptions. Extraversion did not impact on the perception of social justice for applicants low in agreeableness. Agreeable applicants, however, experienced the group interview as more socially fair when they were also extraverted. The impact of applicant personality on justice perceptions may be underestimated if traits interactions are not considered. Procedural fairness ratings for the group selection interview were high, contrary to the negative reactions predicted by other researchers. There was no indication that applicants with desirable traits (i.e., traits predictive of job performance) reacted negatively to this selection tool. Despite the widespread use of interviews in selection, previous studies of applicant personality and fairness reactions have not included interviews. The study demonstrates the importance of previously ignored trait interactions in understanding applicant reactions.

Ureteroscopic treatment of larger renal calculi (>2 cm).

PubMed

Bagley, Demetrius H; Healy, Kelly A; Kleinmann, Nir

2012-09-01

To evaluate the current status of ureteroscopic lithotripsy (UL) for treating renal calculi of >2 cm, as advances in flexible ureteroscope design, accessory instrumentation and lithotrites have revolutionised the treatment of urinary calculi. While previously reserved for ureteric and small renal calculi, UL has gained an increasing role in the selective management of larger renal stone burdens. We searched the available databases, including PubMed, Google Scholar, and Scopus, for relevant reports in English, and the article bibliographies to identify additional relevant articles. Keywords included ureteroscopy, lithotripsy, renal calculi, and calculi >2 cm. Retrieved articles were reviewed to consider the number of patients, mean stone size, success rates, indications and complications. In all, nine studies (417 patients) were eligible for inclusion. After one, two or three procedures the mean (range) success rates were 68.2 (23-84)%, 87.1 (79-91)% and 94.4 (90.1-96.7)%, respectively. Overall, the success rate was >90% with a mean of 1.2-2.3 procedures per patient. The overall complication rate was 10.3%, including six (1.4%) intraoperative and 37 (8.9%) postoperative complications, most of which were minor. The most common indications for UL were a failed previous treatment (46%), comorbidities (18.2%), and technical and anatomical factors (12.3%). UL is safe and effective for treating large renal calculi. While several procedures might be required for total stone clearance, UL should be considered a standard approach in the urologist's options treating renal calculi of >2 cm.

Derived Relational Responding: A Comparison of Match-to-Sample and the Relational Completion Procedure

ERIC Educational Resources Information Center

Dymond, Simon; Whelan, Robert

2010-01-01

Previous research suggests that the Relational Completion Procedure may be an effective alternative procedure for studying derived relational responding. However, the parameters that make it effective, relative to traditional match-to-sample, remain to be determined. The present experiment compared the Relational Completion Procedure and…

40 CFR 444.12 - Monitoring Requirements

Code of Federal Regulations, 2011 CFR

2011-07-01

... requirements to monitor, according to EPA-approved test procedures, each pollutant limited in the permit, the... test procedures listed in the table to this paragraph. Most of these test procedures have previously been incorporated by reference at 40 CFR 136.3(a), Table IB. The test procedures for the regulated...

40 CFR 444.12 - Monitoring Requirements

Code of Federal Regulations, 2012 CFR

2012-07-01

... requirements to monitor, according to EPA-approved test procedures, each pollutant limited in the permit, the... test procedures listed in the table to this paragraph. Most of these test procedures have previously been incorporated by reference at 40 CFR 136.3(a), Table IB. The test procedures for the regulated...

40 CFR 444.12 - Monitoring Requirements

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements to monitor, according to EPA-approved test procedures, each pollutant limited in the permit, the... test procedures listed in the table to this paragraph. Most of these test procedures have previously been incorporated by reference at 40 CFR 136.3(a), Table IB. The test procedures for the regulated...

Habitat Suitability Index Models: Beaver

USGS Publications Warehouse

Allen, Arthur W.

1982-01-01

Habitat preferences of the beaver (Castor canadensis) are described in this publication, which is one of a series of Habitat Suitability Index (HSI) models. Habitat use information is presented in a synthesis of the literature on the species-habitat requirements of the beaver, followed by the development of the HSI model. The model is designed to provide information for use in impact assessment and habitat management activities, and should be used in conjunction with habitat evaluation procedures previously developed by the Fish and Wildlife Service. This revised model updates the original publication dated September 1982.

An evaluation of two methods for increasing self-initiated verbalizations in autistic children.

PubMed Central

Matson, J L; Sevin, J A; Box, M L; Francis, K L; Sevin, B M

1993-01-01

Three children with autism and mental retardation were treated for deficits in self-initiated speech. A novel treatment package employing visual cue fading was compared with a graduated time-delay procedure previously shown to be effective for increasing self-initiated language. Both treatments included training multiple self-initiated verbalizations using multiple therapists and settings. Both treatments were effective, with no differences in measures of acquisition of target phrases, maintenance of behavioral gains, acquisition with additional therapists and settings, and social validity. PMID:8407687

Symptomatic retention of the Agile® patency capsule.

PubMed

Egea Valenzuela, Juan; Estrella Díez, Esther; Alberca de Las Parras, Fernando

2017-06-01

The Agile® capsule has shown to be useful when evaluating the patency of the small bowel in patients prior to capsule endoscopy studies. It is a safe tool and a low rate of complications have been reported, highlighting symptomatic retention, although references in literature are scarce and it is only observed in 1.2% of the procedures. We present the case of a symptomatic retention of this device in a patient with previously known colonic Crohn's disease in who a small bowel study was indicated and was sent for prior patency test.

34 CFR 300.304 - Evaluation procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Placements Evaluations and Reevaluations § 300.304 Evaluation procedures. (a) Notice. The public agency must... evaluation, the public agency must— (1) Use a variety of assessment tools and strategies to gather relevant... procedures. Each public agency must ensure that— (1) Assessments and other evaluation materials used to...

Evaluation and refinement of a field-portable drinking water toxicity sensor utilizing electric cell-substrate impedance sensing and a fluidic biochip.

PubMed

Widder, Mark W; Brennan, Linda M; Hanft, Elizabeth A; Schrock, Mary E; James, Ryan R; van der Schalie, William H

2015-07-01

The US Army's need for a reliable and field-portable drinking water toxicity sensor was the catalyst for the development and evaluation of an electric cell-substrate impedance sensing (ECIS) device. Water testing technologies currently available to soldiers in the field are analyte-specific and have limited capabilities to detect broad-based water toxicity. The ECIS sensor described here uses rainbow trout gill epithelial cells seeded on fluidic biochips to measure changes in impedance for the detection of possible chemical contamination of drinking water supplies. Chemicals selected for testing were chosen as representatives of a broad spectrum of toxic industrial compounds. Results of a US Environmental Protection Agency (USEPA)-sponsored evaluation of the field portable device were similar to previously published US Army testing results of a laboratory-based version of the same technology. Twelve of the 18 chemicals tested following USEPA Technology Testing and Evaluation Program procedures were detected by the ECIS sensor within 1 h at USEPA-derived human lethal concentrations. To simplify field-testing methods further, elimination of a procedural step that acclimated cells to serum-free media streamlined the test process with only a slight loss of chemical sensitivity. For field use, the ECIS sensor will be used in conjunction with an enzyme-based sensor that is responsive to carbamate and organophosphorus pesticides. Copyright © 2014 John Wiley & Sons, Ltd.

Evaluation of a Jugular Venipuncture Alpaca Model to Teach the Technique of Blood Sampling in Adult Alpacas.

PubMed

Rousseau, Marjolaine; Beauchamp, Guy; Nichols, Sylvain

The effectiveness of teaching aids in veterinary medical education is not often assessed rigorously. The objective in the present study was to evaluate the effectiveness of a commercially available jugular venipuncture alpaca model as a complementary tool to teach veterinary students how to perform venipuncture in adult alpacas. We hypothesized that practicing on the model would allow veterinary students to draw blood in alpacas more rapidly with fewer attempts than students without previous practice on the model. Thirty-six third-year veterinary students were enrolled and randomly allocated to the model (group M; n=18) or the control group (group C; n=18). The venipuncture technique was taught to all students on day 0. Students in group M practiced on the model on day 2. On day 5, an evaluator blinded to group allocation evaluated the students' venipuncture skills during a practical examination using live alpacas. Success was defined as the aspiration of a 6-ml sample of blood. Measured outcomes included number of attempts required to achieve success (success score), total procedural time, and overall qualitative score. Success scores, total procedural time, and overall scores did not differ between groups. Use of restless alpacas reduced performance. The jugular venipuncture alpaca model failed to improve jugular venipuncture skills in this student population. Lack of movement represents a significant weakness of this training model.

Motion estimation using point cluster method and Kalman filter.

PubMed

Senesh, M; Wolf, A

2009-05-01

The most frequently used method in a three dimensional human gait analysis involves placing markers on the skin of the analyzed segment. This introduces a significant artifact, which strongly influences the bone position and orientation and joint kinematic estimates. In this study, we tested and evaluated the effect of adding a Kalman filter procedure to the previously reported point cluster technique (PCT) in the estimation of a rigid body motion. We demonstrated the procedures by motion analysis of a compound planar pendulum from indirect opto-electronic measurements of markers attached to an elastic appendage that is restrained to slide along the rigid body long axis. The elastic frequency is close to the pendulum frequency, as in the biomechanical problem, where the soft tissue frequency content is similar to the actual movement of the bones. Comparison of the real pendulum angle to that obtained by several estimation procedures--PCT, Kalman filter followed by PCT, and low pass filter followed by PCT--enables evaluation of the accuracy of the procedures. When comparing the maximal amplitude, no effect was noted by adding the Kalman filter; however, a closer look at the signal revealed that the estimated angle based only on the PCT method was very noisy with fluctuation, while the estimated angle based on the Kalman filter followed by the PCT was a smooth signal. It was also noted that the instantaneous frequencies obtained from the estimated angle based on the PCT method is more dispersed than those obtained from the estimated angle based on Kalman filter followed by the PCT method. Addition of a Kalman filter to the PCT method in the estimation procedure of rigid body motion results in a smoother signal that better represents the real motion, with less signal distortion than when using a digital low pass filter. Furthermore, it can be concluded that adding a Kalman filter to the PCT procedure substantially reduces the dispersion of the maximal and minimal instantaneous frequencies.

An improved procedure for El Nino forecasting: Implications for predictability

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

Chen, D.; Zebiak, S.E.; Cane, M.A.

A coupled ocean-atmosphere data assimilation procedure yields improved forecasts of El Nino for the 1980s compared with previous forecasting procedures. As in earlier forecasts with the same model, no oceanic data were used, and only wind information was assimilated. The improvement is attributed to the explicit consideration of air-sea interaction in the initialization. These results suggest that El Nino is more predictable than previously estimated, but that predictability may vary on decadal or longer time scales. This procedure also eliminates the well-known spring barrier to El Nino prediction, which implies that it may not be intrinsic to the real climatemore » system. 24 refs., 5 figs., 1 tab.« less

Local denoising of digital speckle pattern interferometry fringes by multiplicative correlation and weighted smoothing splines.

PubMed

Federico, Alejandro; Kaufmann, Guillermo H

2005-05-10

We evaluate the use of smoothing splines with a weighted roughness measure for local denoising of the correlation fringes produced in digital speckle pattern interferometry. In particular, we also evaluate the performance of the multiplicative correlation operation between two speckle patterns that is proposed as an alternative procedure to generate the correlation fringes. It is shown that the application of a normalization algorithm to the smoothed correlation fringes reduces the excessive bias generated in the previous filtering stage. The evaluation is carried out by use of computer-simulated fringes that are generated for different average speckle sizes and intensities of the reference beam, including decorrelation effects. A comparison with filtering methods based on the continuous wavelet transform is also presented. Finally, the performance of the smoothing method in processing experimental data is illustrated.

AgRISTARS: Foreign commodity production forecasting. The 1980 US/Canada wheat and barley exploratory experiment

NASA Technical Reports Server (NTRS)

Payne, R. W. (Principal Investigator)

1981-01-01

The crop identification procedures used performed were for spring small grains and are conducive to automation. The performance of the machine processing techniques shows a significant improvement over previously evaluated technology; however, the crop calendars require additional development and refinements prior to integration into automated area estimation technology. The integrated technology is capable of producing accurate and consistent spring small grains proportion estimates. Barley proportion estimation technology was not satisfactorily evaluated because LANDSAT sample segment data was not available for high density barley of primary importance in foreign regions and the low density segments examined were not judged to give indicative or unequvocal results. Generally, the spring small grains technology is ready for evaluation in a pilot experiment focusing on sensitivity analysis to a variety of agricultural and meteorological conditions representative of the global environment.

Comparison of treatment outcomes of transnasal vocal fold polypectomy versus microlaryngoscopic surgery.

PubMed

Wang, Chi-Te; Liao, Li-Jen; Huang, Tsung-Wei; Lo, Wu-Chia; Cheng, Po-Wen

2015-05-01

Office-based procedures have been proposed for the treatment of vocal polyps, including indirect laryngoscopic surgery and angiolytic laser photocoagulation. Our previous report documented good treatment outcomes by combining the two aforementioned procedures. This study was intended to further compare the treatment outcomes of office transnasal vocal fold polypectomy (VFP) with those of microlaryngoscopic surgery (MLS). A matched cohort study. This study retrospectively enrolled 50 age-, gender-, and size-matched patients with vocal polyps treated by VFP or MLS at a tertiary teaching hospital from January 2012 to October 2013. Treatment outcomes were evaluated before, 2 weeks, and 6 weeks after the procedures via perceptual rating of voice quality, acoustic measurement of the speech signal, 10-item voice-handicap index, maximal phonation time, subjective rating of voice quality, and videolaryngostroboscopic evaluation. Both VFP and MLS resulted in significant clinical improvements 2 and 6 weeks postoperatively. Study results exhibited similar objective outcomes between VFP and MLS, whereas patients who received VFP reported higher subjective voice quality than those receiving MLS 2 weeks postoperatively. Six weeks after the procedures, the objective and subjective treatment outcomes were not significantly different between the two treatment groups. This study shows that transnasal VFP may be used as an effective alternative treatment for small vocal polyps. Patients who received office VFP experienced rapid symptomatic relief with a higher degree of subjective effectiveness than MLS 2 weeks postoperatively, whereas the overall treatment outcomes showed a comparable level of effectiveness for both modalities. 3B. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Preoperative transcutaneous electrical nerve stimulation for localizing superficial nerve paths.

PubMed

Natori, Yuhei; Yoshizawa, Hidekazu; Mizuno, Hiroshi; Hayashi, Ayato

2015-12-01

During surgery, peripheral nerves are often seen to follow unpredictable paths because of previous surgeries and/or compression caused by a tumor. Iatrogenic nerve injury is a serious complication that must be avoided, and preoperative evaluation of nerve paths is important for preventing it. In this study, transcutaneous electrical nerve stimulation (TENS) was used for an in-depth analysis of peripheral nerve paths. This study included 27 patients who underwent the TENS procedure to evaluate the peripheral nerve path (17 males and 10 females; mean age: 59.9 years, range: 18-83 years) of each patient preoperatively. An electrode pen coupled to an electrical nerve stimulator was used for superficial nerve mapping. The TENS procedure was performed on patients' major peripheral nerves that passed close to the surgical field of tumor resection or trauma surgery, and intraoperative damage to those nerves was apprehensive. The paths of the target nerve were detected in most patients preoperatively. The nerve paths of 26 patients were precisely under the markings drawn preoperatively. The nerve path of one patient substantially differed from the preoperative markings with numbness at the surgical region. During surgery, the nerve paths could be accurately mapped preoperatively using the TENS procedure as confirmed by direct visualization of the nerve. This stimulation device is easy to use and offers highly accurate mapping of nerves for surgical planning without major complications. The authors conclude that TENS is a useful tool for noninvasive nerve localization and makes tumor resection a safe and smooth procedure. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

One Size Fits All: Evaluation of the Transferability of a New "Learning" Histologic Image Analysis Application.

PubMed

Arlt, Janine; Homeyer, André; Sänger, Constanze; Dahmen, Uta; Dirsch, Olaf

2016-01-01

Quantitative analysis of histologic slides is of importance for pathology and also to address surgical questions. Recently, a novel application was developed for the automated quantification of whole-slide images. The aim of this study was to test and validate the underlying image analysis algorithm with respect to user friendliness, accuracy, and transferability to different histologic scenarios. The algorithm splits the images into tiles of a predetermined size and identifies the tissue class of each tile. In the training procedure, the user specifies example tiles of the different tissue classes. In the subsequent analysis procedure, the algorithm classifies each tile into the previously specified classes. User friendliness was evaluated by recording training time and testing reproducibility of the training procedure of users with different background. Accuracy was determined with respect to single and batch analysis. Transferability was demonstrated by analyzing tissue of different organs (rat liver, kidney, small bowel, and spleen) and with different stainings (glutamine synthetase and hematoxylin-eosin). Users of different educational background could apply the program efficiently after a short introduction. When analyzing images with similar properties, accuracy of >90% was reached in single images as well as in batch mode. We demonstrated that the novel application is user friendly and very accurate. With the "training" procedure the application can be adapted to novel image characteristics simply by giving examples of relevant tissue structures. Therefore, it is suitable for the fast and efficient analysis of high numbers of fully digitalized histologic sections, potentially allowing "high-throughput" quantitative "histomic" analysis.

Evaluating flow cytometer performance with weighted quadratic least squares analysis of LED and multi-level bead data

PubMed Central

Parks, David R.; Khettabi, Faysal El; Chase, Eric; Hoffman, Robert A.; Perfetto, Stephen P.; Spidlen, Josef; Wood, James C.S.; Moore, Wayne A.; Brinkman, Ryan R.

2017-01-01

We developed a fully automated procedure for analyzing data from LED pulses and multi-level bead sets to evaluate backgrounds and photoelectron scales of cytometer fluorescence channels. The method improves on previous formulations by fitting a full quadratic model with appropriate weighting and by providing standard errors and peak residuals as well as the fitted parameters themselves. Here we describe the details of the methods and procedures involved and present a set of illustrations and test cases that demonstrate the consistency and reliability of the results. The automated analysis and fitting procedure is generally quite successful in providing good estimates of the Spe (statistical photoelectron) scales and backgrounds for all of the fluorescence channels on instruments with good linearity. The precision of the results obtained from LED data is almost always better than for multi-level bead data, but the bead procedure is easy to carry out and provides results good enough for most purposes. Including standard errors on the fitted parameters is important for understanding the uncertainty in the values of interest. The weighted residuals give information about how well the data fits the model, and particularly high residuals indicate bad data points. Known photoelectron scales and measurement channel backgrounds make it possible to estimate the precision of measurements at different signal levels and the effects of compensated spectral overlap on measurement quality. Combining this information with measurements of standard samples carrying dyes of biological interest, we can make accurate comparisons of dye sensitivity among different instruments. Our method is freely available through the R/Bioconductor package flowQB. PMID:28160404

Extemporaneous procedures for dissolving risedronate tablets for oral administration and for feeding tubes.

PubMed

Dansereau, Richard J; Crail, Debbie J

2005-01-01

Risedronate (Actonel, Procter & Gamble Pharmaceuticals) is commercially available only as film-coated tablets. Extemporaneous procedures for dissolving tablets for feeding tubes and for preparation of an oral liquid have not previously been evaluated. To evaluate procedures for dissolving risedronate sodium tablets for administration in liquid form and drug recovery following dissolution in cups and following passage through different types of feeding tubes. Tablets (5 and 35 mg) were individually dispersed in 2 oz of water. After 2 minutes, the solution was stirred for 30 seconds, dispensed, and rinsed with an additional 4 oz of water. The sample was filtered and analyzed by HPLC. Ten replicates were performed using the various cups. Gastrostomy and nasoenteric tubes were flushed with 1 oz of water. Individual tablets were dispersed in 2 oz of water; after 2 minutes, the solution was stirred for 30 seconds and poured through the tube and flushed with 1 oz of water. Samples were filtered and analyzed by HPLC. Ten replicates were performed for each type of feeding tube. For cups, the mean amount of drug recovered ranged from 95.7% to 100.5% of the label claim, with a relative standard deviation (RSD) range of 1.1-6.3%. For gastrostomy and nasoenteric tubes, the mean amount of drug recovered ranged from 98.3% to 101.9% of label claim, with an RSD range of 0.9-3.3%. A simple and accurate procedure was developed for dissolving risedronate tablets in water to prepare a liquid formulation for administration orally or through feeding tubes.

Demographic and psychological variables affecting test subject evaluations of ride quality

NASA Technical Reports Server (NTRS)

Duncan, N. C.; Conley, H. W.

1975-01-01

Ride-quality experiments similar in objectives, design, and procedure were conducted, one using the U.S. Air Force Total In-Flight Simulator and the other using the Langley Passenger Ride Quality Apparatus to provide the motion environments. Large samples (80 or more per experiment) of test subjects were recruited from the Tidewater Virginia area and asked to rate the comfort (on a 7-point scale) of random aircraft motion typical of that encountered during STOL flights. Test subject characteristics of age, sex, and previous flying history (number of previous airplane flights) were studied in a two by three by three factorial design. Correlations were computed between one dependent measure, the subject's mean comfort rating, and various demographic characteristics, attitudinal variables, and the scores on Spielberger's State-Trait Anxiety Inventory. An effect of sex was found in one of the studies. Males made higher (more uncomfortable) ratings of the ride than females. Age and number of previous flights were not significantly related to comfort ratings. No significant interactions between the variables of age, sex, or previous number of flights were observed.

Parameter sensitivity analysis of the mixed Green-Ampt/Curve-Number method for rainfall excess estimation in small ungauged catchments

NASA Astrophysics Data System (ADS)

Romano, N.; Petroselli, A.; Grimaldi, S.

2012-04-01

With the aim of combining the practical advantages of the Soil Conservation Service - Curve Number (SCS-CN) method and Green-Ampt (GA) infiltration model, we have developed a mixed procedure, which is referred to as CN4GA (Curve Number for Green-Ampt). The basic concept is that, for a given storm, the computed SCS-CN total net rainfall amount is used to calibrate the soil hydraulic conductivity parameter of the Green-Ampt model so as to distribute in time the information provided by the SCS-CN method. In a previous contribution, the proposed mixed procedure was evaluated on 100 observed events showing encouraging results. In this study, a sensitivity analysis is carried out to further explore the feasibility of applying the CN4GA tool in small ungauged catchments. The proposed mixed procedure constrains the GA model with boundary and initial conditions so that the GA soil hydraulic parameters are expected to be insensitive toward the net hyetograph peak. To verify and evaluate this behaviour, synthetic design hyetograph and synthetic rainfall time series are selected and used in a Monte Carlo analysis. The results are encouraging and confirm that the parameter variability makes the proposed method an appropriate tool for hydrologic predictions in ungauged catchments. Keywords: SCS-CN method, Green-Ampt method, rainfall excess, ungauged basins, design hydrograph, rainfall-runoff modelling.

Sub-barrier radioactive ion beam investigations using a new methodology and analysis for the stacked target technique

NASA Astrophysics Data System (ADS)

Fisichella, M.; Shotter, A. C.; Di Pietro, A.; Figuera, P.; Lattuada, M.; Marchetta, C.; Privitera, V.; Romano, L.; Ruiz, C.; Zadro, M.

2015-12-01

For low energy reaction studies involving radioactive ion beams, the experimental reaction yields are generally small due to the low intensity of the beams. For this reason, the stacked target technique has been often used to measure excitation functions. This technique offers considerable advantages since the reaction cross-section at several energies can be simultaneously measured. In a further effort to increase yields, thick targets are also employed. The main disadvantage of the method is the degradation of the beam quality as it passes through the stack due to the statistical nature of energy loss processes and any nonuniformity of the stacked targets. This degradation can lead to ambiguities of associating effective beam energies to reaction product yields for the targets within the stack and, as a consequence, to an error in the determination of the excitation function for the reaction under study. A thorough investigation of these ambiguities is reported, and a best practice procedure of analyzing data obtained using the stacked target technique with radioactive ion beams is recommended. Using this procedure a re-evaluation is reported of some previously published sub-barrier fusion data in order to demonstrate the possibility of misinterpretations of derived excitation functions. In addition, this best practice procedure has been used to evaluate, from a new data set, the sub-barrier fusion excitation function for the reaction 6Li+120Sn .

Reversed-phase liquid chromatography column testing: robustness study of the test.

PubMed

Le Mapihan, K; Vial, J; Jardy, A

2004-12-24

Choosing the right RPLC column for an actual separation among the more than 600 commercially available ones still represents a real challenge for the analyst particularly when basic solutes are involved. Many tests dedicated to the characterization and the classification of stationary phases have been proposed in the literature and some of them highlighted the need of a better understanding of retention properties to lead to a rational choice of columns. However, unlike classical chromatographic methods, the problem of their robustness evaluation has often been left unaddressed. In the present study, we present a robustness study that was applied to the chromatographic testing procedure we had developed and optimized previously. A design of experiment (DoE) approach was implemented. Four factors, previously identified as potentially influent, were selected and subjected to small controlled variations: solvent fraction, temperature, pH and buffer concentration. As our model comprised quadratic terms instead of a simple linear model, we chose a D-optimal design in order to minimize the experiment number. As a previous batch-to-batch study [K. Le Mapihan, Caractérisation et classification des phases stationnaires utilisées pour l'analyse CPL de produits pharmaceutiques, Ph.D. Thesis, Pierre and Marie Curie University, 2004] had shown a low variability on the selected stationary phase, it was then possible to split the design into two parts, according to the solvent nature, each using one column. Actually, our testing procedure involving assays both with methanol and with acetonitrile as organic modifier, such an approach enabled to avoid a possible bias due to the column ageing considering the number of experiments required (16 + 6 center points). Experimental results were computed thanks to a Partial Least Squares regression procedure, more adapted than the classical regression to handle factors and responses not completely independent. The results showed the behavior of the solutes in relation to their physico-chemical properties and the relevance of the second term degree of our model. Finally, the robust domain of the test has been fairly identified, so that any potential user precisely knows to which extend each experimental parameter must be controlled when our testing procedure is to be implemented.

Design and synthesis of chalcone derivatives as potential non-purine xanthine oxidase inhibitors.

PubMed

Bui, Trung Huu; Nguyen, Nhan Trung; Dang, Phu Hoang; Nguyen, Hai Xuan; Nguyen, Mai Thanh Thi

2016-01-01

Based on some previous research, the chalcone derivatives exhibited potent xanthine oxidase inhibitory activity, e.g. sappanchalcone ( 7 ), with IC 50 value of 3.9 μM, was isolated from Caesalpinia sappan . Therefore, objectives of this research are design and synthesis of 7 and other chalcone derivatives by Claisen-Schmidt condensation and then evaluate their XO inhibitory activity. Fifteen chalcone derivatives were synthesized by Claisen-Schmidt condensation, and were evaluated for XO inhibitory activity. Nine out of 15 synthetic chalcones showed inhibitory activity ( 3 ; 5 - 8 ; 10 - 13 ). Sappanchalcone derivatives ( 11 ) (IC 50 , 2.5 μM) and a novel chalcone ( 13 ) (IC 50 , 2.4 μM) displayed strong xanthine oxidase inhibitory activity that is comparable to allopurinol (IC 50 , 2.5 μM). The structure-activity relationship of these chalcone derivatives was also presented. It is the first research on synthesis sappanchalcone ( 7 ) by Claisen-Schmidt condensation. The overall yield of this procedure was 6.6 %, higher than that of reported procedure (4 %). Design, synthesis, and evaluation of chalcone derivatives were carried out. This result suggests that the chalcone derivative can be used as potential non-purine XO inhibitors.Graphical abstractThe chalcone derivatives as potential non-purine xanthine oxidase inhibitors.

Volume-dependent hemodynamic effects of blood collection in canine donors - evaluation of 13% and 15% of total blood volume depletion.

PubMed

Ferreira, Rui R F; Gopegui, Rafael R; De Matos, Augusto J F

2015-03-01

There is no consensus regarding the blood volume that could be safely donated by dogs, ranging from 11 to 25% of its total blood volume (TBV). No previous studies evaluated sedated donors. To evaluate the hemodynamic effects of blood collection from sedated and non-sedated dogs and to understand if such effects were volume-dependent. Fifty three donations of 13% of TBV and 20 donations of 15% TBV were performed in dogs sedated with diazepam and ketamine. Additionally, a total of 30 collections of 13% TBV and 20 collections of 15% TBV were performed in non-sedated dogs. Non-invasive arterial blood pressures and pulse rates were registered before and 15 min after donation. Post-donation pulse rates increased significantly in both sedated groups, with higher differences in the 15% TBV collections. Systolic arterial pressures decreased significantly in these groups, while diastolic pressures increased significantly in 13% TBV donations. Non-sedated groups revealed a slight, but significant, SBP decrease. No clinical signs related to donations were registered. These results suggest that the collection of 15% TBV in sedated donors induces hemodynamic variations that may compromise the harmlessness of the procedure, while it seems to be a safe procedure in non-sedated dogs.

Tubal anastomosis after previous sterilization: a systematic review.

PubMed

van Seeters, Jacoba A H; Chua, Su Jen; Mol, Ben W J; Koks, Carolien A M

2017-05-01

Female sterilization is one of the most common contraceptive methods. A small number of women, however, opt for reversal of sterilization procedures after they experience regret. Procedures can be performed by laparotomy or laparoscopy, with or without robotic assistance. Another commonly utilized alternative is IVF. The choice between surgery and IVF is often influenced by reimbursement politics for that particular geographic location. We evaluated the fertility outcomes of different surgical methods available for the reversal of female sterilization, compared these to IVF and assessed the prognostic factors for success. Two search strategies were employed. Firstly, we searched for randomized and non-randomized clinical studies presenting fertility outcomes of sterilization reversal up to July 2016. Data on the following outcomes were collected: pregnancy rate, ectopic pregnancy rate, cost of the procedure and operative time. Eligible study designs included prospective or retrospective studies, randomized controlled trials, cohort studies, case-control studies and case series. No age restriction was applied. Exclusion criteria were patients suffering from tubal infertility from any other reason (e.g. infection, endometriosis and adhesions from previous surgery) and studies including <10 participants. The following factors likely to influence the success of sterilization reversal procedures were then evaluated: female age, BMI and duration and method of sterilization. Secondly, we searched for randomized and non-randomized clinical studies that compared reversal of sterilization to IVF and evaluated them for pregnancy outcomes and cost effectiveness. We included 37 studies that investigated a total of 10 689 women. No randomized controlled trials were found. Most studies were retrospective cohort studies of a moderate quality. The pooled pregnancy rate after sterilization reversal was 42-69%, with heterogeneity seen from the different methods utilized. The reported ectopic pregnancy rate was 4-8%. The only prognostic factor affecting the chance of conception was female age. The surgical approach (i.e. laparotomy [microscopic], laparoscopy or robotic) had no impact on the outcome, with the exception of the macroscopic laparotomic technique, which had inferior results and is not currently utilized. For older women, IVF could be a more cost-effective alternative for the reversal of sterilization. However, direct comparative data are lacking and a cut-off age cannot be stated. In sterilized women who suffer regret, surgical tubal re-anastomosis is an effective treatment, especially in younger women. However, there is a need for randomized controlled trials comparing the success rates and costs of surgical reversal with IVF. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Preliminary evaluation of the effect of a dynamic preferential runway system upon community noise disturbance

NASA Technical Reports Server (NTRS)

Patterson, H. P.; Edmiston, R. P.; Connor, W. K.

1972-01-01

A dynamic preferential runway system (DPRS) was developed for John F. Kennedy International Airport for the purpose of controlling short term noise exposure in the neighboring communities. The DPRS is a computer-aided procedure for optimum selection of runways from the standpoint of noise and is based upon a community disturbance model which takes into account flyover levels, size of exposed populations, time of day and week, and persistence of overflights. A preliminary evaluation of the DPRS is presented on the basis of social survey data and telephone complaint records, for the trial period of August and September, 1971. Comparative use is made of data taken in a previous survey of the same community areas in 1969.

22 CFR 96.100 - Procedures for evaluating applicants for temporary accreditation.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Procedures and Standards Relating to Temporary Accreditation § 96.100 Procedures for evaluating applicants... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Procedures for evaluating applicants for... entity must: (1) Review the agency's written application and supporting documentation; and (2) Verify the...

Declining operative experience for junior level residents: Is this an unintended consequence of minimally invasive surgery?

PubMed Central

Mullen, Matthew G.; Salerno, Elise P.; Michaels, Alex D.; Hedrick, Traci L.; Sohn, Min-Woong; Smith, Philip W.; Schirmer, Bruce D.; Friel, Charles M.

2016-01-01

Introduction Our group has previously demonstrated an upward shift from junior to senior resident participation in common general surgery operations, traditionally performed by junior level residents. The objective of this study was to evaluate if this trend would correct over time. We hypothesized that junior resident case volume would improve. Methods A sample of essential laparoscopic and open general surgery procedures (appendectomy, inguinal herniorrhaphy, cholecystectomy, and partial colectomy) was chosen for analysis. The ACS NSQIP Participant Use Files were queried for these procedures between 2005–2012. Cases were stratified by participating resident post-graduate year (PGY) with ‘junior resident’ defined as PGY1–3. Logistic regression was performed to determine change in junior resident participation for each type of procedure over time. Results 185,335 cases were included in the study. For three of the operations we considered, the prevalence of laparoscopic surgery increased from 2005–2012 (all p<0.001). Cholecystectomy was an exception, which showed an unchanged proportion of cases performed laparoscopically across the study period (p=0.119). Junior resident participation decreased by 4.5%/year (p<0.001) for laparoscopic procedures and by 6.2%/year (p<0.001) for open procedures. The proportion of laparoscopic surgeries performed by junior level residents decreased for appendectomy by 2.6%/year (p<0.001) and cholecystectomy by 6.1%/year (p<0.001), whereas it was unchanged for inguinal herniorrhaphy (p=0.75) and increased for partial colectomy by 3.9%/year (p=0.003). A decline in junior resident participation was seen for all open surgeries, with appendectomy decreasing by 9.4%/year (p<0.001), cholecystectomy by 4.1%/year (p<0.002), inguinal herniorrhaphy by 10%/year (p<0.001) and partial colectomy by 2.9%/year (p<0.004). Conclusions Along with the proliferation of laparoscopy for common general surgical procedures there has been a concomitant reduction in the participation of junior level residents. As previously thought, familiarity with laparoscopy has not translated to redistribution of basic operations from senior to junior residents. This trend has significant implications for general surgery resident education. PMID:27066854

Major System Source Evaluation and Selection Procedures.

DTIC Science & Technology

1987-04-02

A-RIBI I" MAJOR SYSTEM SOURCE EVALUATION AND SELECTION PROCEDURES / (U) BUSINESS MANAGEMENT RESEARCH ASSOCIATES INC ARLINGTON VA 02 APR 6? ORMC-5...BRMC-85-5142-1 0 I- MAJOR SYSTEM SOURCE EVALUATION AND SELECTION PROCEDURES o I Business Management Research Associates, Inc. 1911 Jefferson Davis...FORCE SOURCE EVALUATION AND SELECTI ON PROCEDURES Prepared by Business Management Research Associates, Inc., 1911 Jefferson Davis Highway, Arlington

Sizing Single Cantilever Beam Specimens for Characterizing Facesheet/Core Peel Debonding in Sandwich Structure

NASA Technical Reports Server (NTRS)

Ratcliffe, James G.

2010-01-01

This technical publication details part of an effort focused on the development of a standardized facesheet/core peel debonding test procedure. The purpose of the test is to characterize facesheet/core peel in sandwich structure, accomplished through the measurement of the critical strain energy release rate associated with the debonding process. Following an examination of previously developed tests and a recent evaluation of a selection of these methods, a single cantilever beam (SCB) specimen was identified as being a promising candidate for establishing such a standardized test procedure. The objective of the work described here was to begin development of a protocol for conducting a SCB test that will render the procedure suitable for standardization. To this end, a sizing methodology was developed to ensure appropriate SCB specimen dimensions are selected for a given sandwich system. Application of this method to actual sandwich systems yielded SCB specimen dimensions that would be practical for use. This study resulted in the development of a practical SCB specimen sizing method, which should be well-suited for incorporation into a standardized testing protocol.

New technologies in treatment of atrial fibrillation in cardiosurgical patients

NASA Astrophysics Data System (ADS)

Evtushenko, A. V.; Evtushenko, V. V.; Bykov, A. N.; Sergeev, V. S.; Syryamkin, V. I.; Kistenev, Yu. V.; Anfinogenova, Ya. D.; Smyshlyaev, K. A.; Kurlov, I. O.

2015-11-01

The article is devoted to the evaluation of the results of clinical application of penetrating radiofrequency ablation techniques on atrial myocardium. Total operated on 241 patients with valvular heart disease and coronary heart disease complicated with atrial fibrillation. All operations were performed under cardiopulmonary bypass and cardioplegia. The main group consists of 141 patients which were operated using penetrating technique radiofrequency exposure. The control group consisted of 100 patients who underwent surgery with the use of "classical" monopolar RF-ablation technique. Both groups were not significantly different on all counts before surgery. Patients with previous heart surgery were excluded during the selection of candidates for the procedure, due to the presence of adhesions in the pericardium, that do not allow good visualization of left atrium, sufficient to perform this procedure. Penetrating technique has significantly higher efficiency compared to the "classic" technique in the early and long-term postoperative periods. In the early postoperative period, its efficiency is 93%, and in the long term is 88%. The efficacy of "classical" monopolar procedure is below: 86% and 68% respectively.

Submucosal surgery: novel interventions in the third space.

PubMed

Teitelbaum, Ezra N; Swanstrom, Lee L

2018-02-01

Traditional surgeries involve accessing body cavities, such as the abdomen and thorax, via incisions that divide skin and muscle. These operations result in postoperative pain and convalescence, and a risk of complications such as wound infection and hernia. The development of flexible endoscopy allowed diseases as varied as gastrointestinal bleeding and colon adenomas to be treated without incisions, but this technique is restricted by its endoluminal nature. A novel category of surgical endoscopic procedures has recently been developed that uses flexible endoscopic techniques to enter and access the submucosa of the gastrointestinal tract. Through this approach, the advantages of incisionless endoscopy can be applied to areas of the body that previously could only be reached with surgery. This Review introduces this new class of interventions by describing two examples of such submucosal surgeries for the treatment of benign gastrointestinal disease: per-oral endoscopic myotomy and per-oral pyloromyotomy. The approach to pre-procedure patient evaluation, operative technique, and the published outcomes are discussed, as well as potential future applications of similar techniques and procedures in this so-called third space. Copyright © 2018 Elsevier Ltd. All rights reserved.

Initial experience with hysteroscopic tubal occlusion (Essure®)

PubMed Central

Depes, Daniella De Batista; Pereira, Ana Maria Gomes; Lippi, Umberto Gazi; Martins, João Alfredo; Lopes, Reginaldo Guedes Coelho

2016-01-01

ABSTRACT Objective To evaluate results of early tubal occlusions performed by hysteroscopy (Essure®). Methods This prospective study included 38 patients, 73.7% of them were white, mean age 34.5 years, they have had on average 3 pregnancies and 2.7 of deliveries. A total of 86.8% of patients previously prepared the endometrium. All procedures were carried out at outpatient unit without anesthesia. Results Insertion rate of the device was 100% at a mean time of 4 minutes and 50 seconds. Based on the analogical visual scale, average pain reported was three, and 55.3% of women did not report pain after the procedure. After 3 months, 89.5% of patients were very satisfied with the method. Simple radiographs of the pelvis showed 92.1% of topical devices, and one case of unilateral expulsion had occurred. A four years follow-up did not show failure in the method. Conclusions Tubal occlusion through hysteroscopy at outpatient unit and without anesthesia was a quickly and well-tolerated procedure. No serious complications were seen, the success rate was high, and patients were satisfied. PMID:27462885

Self-motion perception: assessment by real-time computer-generated animations

NASA Technical Reports Server (NTRS)

Parker, D. E.; Phillips, J. O.

2001-01-01

We report a new procedure for assessing complex self-motion perception. In three experiments, subjects manipulated a 6 degree-of-freedom magnetic-field tracker which controlled the motion of a virtual avatar so that its motion corresponded to the subjects' perceived self-motion. The real-time animation created by this procedure was stored using a virtual video recorder for subsequent analysis. Combined real and illusory self-motion and vestibulo-ocular reflex eye movements were evoked by cross-coupled angular accelerations produced by roll and pitch head movements during passive yaw rotation in a chair. Contrary to previous reports, illusory self-motion did not correspond to expectations based on semicircular canal stimulation. Illusory pitch head-motion directions were as predicted for only 37% of trials; whereas, slow-phase eye movements were in the predicted direction for 98% of the trials. The real-time computer-generated animations procedure permits use of naive, untrained subjects who lack a vocabulary for reporting motion perception and is applicable to basic self-motion perception studies, evaluation of motion simulators, assessment of balance disorders and so on.

NASA DOE POD NDE Capabilities Data Book

NASA Technical Reports Server (NTRS)

Generazio, Edward R.

2015-01-01

This data book contains the Directed Design of Experiments for Validating Probability of Detection (POD) Capability of NDE Systems (DOEPOD) analyses of the nondestructive inspection data presented in the NTIAC, Nondestructive Evaluation (NDE) Capabilities Data Book, 3rd ed., NTIAC DB-97-02. DOEPOD is designed as a decision support system to validate inspection system, personnel, and protocol demonstrating 0.90 POD with 95% confidence at critical flaw sizes, a90/95. The test methodology used in DOEPOD is based on the field of statistical sequential analysis founded by Abraham Wald. Sequential analysis is a method of statistical inference whose characteristic feature is that the number of observations required by the procedure is not determined in advance of the experiment. The decision to terminate the experiment depends, at each stage, on the results of the observations previously made. A merit of the sequential method, as applied to testing statistical hypotheses, is that test procedures can be constructed which require, on average, a substantially smaller number of observations than equally reliable test procedures based on a predetermined number of observations.

The effects of previous open renal stone surgery types on PNL outcomes.

PubMed

Ozgor, Faruk; Kucuktopcu, Onur; Ucpinar, Burak; Sarilar, Omer; Erbin, Akif; Yanaral, Fatih; Sahan, Murat; Binbay, Murat

2016-01-01

Our aim was to demonstrate the effect of insicion of renal parenchyma during open renal stone surgery (ORSS) on percutaneous nephrolithotomy (PNL) outcomes. Patients with history of ORSS who underwent PNL operation between June 2005 and June 2015 were analyzed retrospectively. Patients were divided into two groups according to their type of previous ORSS. Patients who had a history of ORSS with parenchymal insicion, such as radial nephrotomies, anatrophic nephrolithotomy, lower pole resection, and partial nephrectomy, were included in Group 1. Other patients with a history of open pyelolithotomy were enrolled in Group 2. Preoperative characteristics, perioperative data, stone-free status, and complications were compared between the groups. Stone-free status was defined as complete clearance of stone(s) or presence of residual fragments smaller than 4 mm. The retrospective nature of our study, different experience level of surgeons, and lack of the evaluation of anesthetic agents and cost of procedures were limitations of our study. 123 and 111 patients were enrolled in Groups 1 and 2, respectively. Preoperative characteristics were similar between groups. In Group 1, the mean operative time was statistically longer than in Group 2 (p=0.013). Stone-free status was significantly higher in Group 2 than in Group 1 (p=0.027). Complication rates were similar between groups. Hemorrhage requiring blood transfusion was the most common complication in both groups (10.5% vs. 9.9%). Our study demonstrated that a history of previous ORSS with parenchymal insicion significantly reduces the success rates of PNL procedure.

Successful outcome of modified quad surgical procedure in preteen and teen patients with brachial plexus birth palsy.

PubMed

Nath, Rahul K; Somasundaram, Chandra

2012-01-01

To evaluate the outcome of modified Quad procedure in preteen and teen patients with brachial plexus birth palsy. We have previously demonstrated a significant improvement in shoulder abduction, resulting from the modified Quad procedure in children (mean age 2.5 years; range, 0.5-9 years) with obstetric brachial plexus injury. We describe in this report the outcome of 16 patients (6 girls and 10 boys; 7 preteen and 9 teen) who have undergone the modified Quad procedure for the correction of the shoulder function, specifically abduction. The patients underwent transfer of the latissimus dorsi and teres major muscles, release of contractures of subscapularis pectoralis major and minor, and axillary nerve decompression and neurolysis (the modified Quad procedure). Mean age of these patients at surgery was 13.5 years (range, 10.1-17.9 years). The mean preoperative total Mallet score was 14.8 (range, 10-20), and active abduction was 84° (range, 20°-140°). At a mean follow-up of 1.5 years, the mean postoperative total Mallet score increased to 19.7 (range, 13-25, P < .0001), and the mean active abduction improved to 132° (range, 40°-180°, P < .0003). The modified Quad procedure greatly improves not only the active abduction but also other shoulder functions in preteen and teen patients, as this outcome is the combined result of decompression and neurolysis of the axillary nerve and the release of the contracted internal rotators of the shoulder.

Electromagnetic information transfer through aqueous system.

PubMed

Foletti, Alberto; Ledda, Mario; Lolli, Maria Grazia; Grimaldi, Settimio; Lisi, Antonella

2017-01-01

Several beneficial effects of the electromagnetic information transfer through aqueous system (EMITTAS) procedure have previously been reported in vitro. The clinical potential of this procedure has also started to be evaluated. Information flow in biological systems can be investigated through chemical and molecular approaches or by a biophysical approach focused on endogenous electrodynamic activities. Electromagnetic signals are endogenously generated at different levels of the biological organization and, likely, play an active role in synchronizing internal cell function or local/systemic adaptive response. Consequently, each adaptive response can be described by its specific electromagnetic pattern and, therefore, correlates with a unique and specific electromagnetic signature. A biophysical procedure synchronously integrating the EMITTAS procedure has already been applied for the treatment of articular pain, low-back pain, neck pain and mobility, fluctuating asymmetry, early-stage chronic kidney disease, refractory gynecological infections, minor anxiety and depression disorders. This clinical strategy involves a single treatment, since the EMITTAS procedure allows the patient to continue his/her own personal treatment at home by means of self-administration of the recorded aqueous system. A significant and long-lasting improvement has been reported, showing a potential beneficial use of this biophysical procedure in the management of common illnesses in an efficient, effective and personalized way. Data from recent studies suggest that aqueous systems may play a key role in providing the basis for recording, storing, transferring and retrieving clinically effective quanta of biological information. These features likely enable to trigger local and systemic self-regulation and self-regeneration potential of the organism.

Teaching Palatoplasty Using a High-Fidelity Cleft Palate Simulator.

PubMed

Cheng, Homan; Podolsky, Dale J; Fisher, David M; Wong, Karen W; Lorenz, H Peter; Khosla, Rohit K; Drake, James M; Forrest, Christopher R

2018-01-01

Cleft palate repair is a challenging procedure for cleft surgeons to teach. A novel high-fidelity cleft palate simulator has been described for surgeon training. This study evaluates the simulator's effect on surgeon procedural confidence and palatoplasty knowledge among learners. Plastic surgery trainees attended a palatoplasty workshop consisting of a didactic session on cleft palate anatomy and repair followed by a simulation session. Participants completed a procedural confidence questionnaire and palatoplasty knowledge test immediately before and after the workshop. All participants reported significantly higher procedural confidence following the workshop (p < 0.05). Those with cleft palate surgery experience had higher procedural confidence before (p < 0.001) and after (p < 0.001) the session. Palatoplasty knowledge test scores increased in 90 percent of participants. The mean baseline test score was 28 ± 10.89 percent and 43 ± 18.86 percent following the workshop. Those with prior cleft palate experience did not have higher mean baseline test scores than those with no experience (30 percent versus 28 percent; p > 0.05), but did have significantly higher scores after the workshop (61 percent versus 35 percent; p < 0.05). All trainees strongly agreed or agreed that the simulator should be integrated into training and they would use it again. This study demonstrates the effective use of a novel cleft palate simulator as a training tool to teach palatoplasty. Improved procedural confidence and knowledge were observed after a single session, with benefits seen among trainees both with and without previous cleft experience.

Endoscopic biliary stent insertion through specialized duodenal stent for combined malignant biliary and duodenal obstruction facilitated by stent or PTBD guidance.

PubMed

Lee, Jong Jin; Hyun, Jong Jin; Choe, Jung Wan; Lee, Dong-Won; Kim, Seung Young; Jung, Sung Woo; Jung, Young Kul; Koo, Ja Seol; Yim, Hyung Joon; Lee, Sang Woo

2017-11-01

Endoscopic stenting for combined malignant biliary and duodenal obstruction is technically demanding. However, this procedure can be facilitated when there is guidance from previously inserted stent or PTBD tube. This study aimed to evaluate the feasibility and clinical success rate of endoscopic placement of biliary self-expandable metal stent (SEMS) through duodenal SEMS in patients with combined biliary and duodenal obstruction due to inoperable or metastatic periampullary malignancy. A total of 12 patients with combined malignant biliary and duodenal stricture underwent insertion of biliary SEMS through the mesh of specialized duodenal SEMS from July 2012 to October 2016. Technical and clinical success rate, adverse events and survival after completion of SEMS insertion were evaluated. The duodenal strictures were located in the first portion of the duodenum in four patients (Type I), in the second portion in three patients (Type II), and in the third portion in five patients (Type III). Technical success rate of combined metallic stenting was 91.7%. Insertion of biliary SEMS was guided by previously inserted biliary SEMS in nine patients, plastic stent in one patient, and PTBD in two patients. Clinical success rate was 90.9%. There were no early adverse events after the procedure. Mean survival period after combined metallic stenting was 91.9 days (range: 15-245 days). Endoscopic placement of biliary SEMS through duodenal SEMS is feasible with high success rates and relatively easy when there is guidance. This method can be a good alternative for palliation in patients with combined biliary and duodenal obstruction.

Effectiveness of an immunohistochemical protocol for Leishmania detection in different clinical forms of American tegumentary leishmaniasis.

PubMed

Marques, Fernanda A; Soares, Rodrigo P; Almeida, Gregório G; Souza, Carolina C; Melo, Maria N; Pinto, Sebastião A; Quixabeira, Valeria B; Pereira, Ledice I; Dorta, Miriam L; Ribeiro-Dias, Fatima; Silveira, Fernando T; Silva, Sydnei M; Gontijo, Celia M; Tafuri, Wagner L

2017-02-01

American tegumentary leishmaniasis (ATL) is a neglected disease widely distributed in Latin America. In Brazil, it is caused by different Leishmania species belonging to the Subgenera Viannia and Leishmania. ATL diagnosis is routinely based on clinical, epidemiological, parasitological and immunological (delayed-type hypersensitivity skin test-DTH) evidences. The main objective of this work was to determine the efficacy of a previous immunohistochemical (IHC) method developed by our group. Seventy eight skin biopsies from patients with different ATL clinical forms and origins were evaluated. The method was previously standardized in ATL patients from the municipality of Caratinga, Minas Gerais, Brazil, all infected with Leishmania (V.) braziliensis. Here, it is evaluated in patients from the North, Southeast and Midwest regions of Brazil. Clinical, parasitological (biopsy PCR) and immunological (Montenegro skin test-MST) diagnosis were performed prior to IHC procedure. The IHC procedure detected 70.5% of the cases having a high agreement with MST diagnosis (kappa=0.84). A distinguished contribution of this work is that IHC succeed in diagnosing some negative DTH patients. Those were infected with Leishmania (L.) amazonensis, commonly causing the anergic form of the disease. In conclusion, IHC succeed in detecting ATL caused by different Leishmania species from various geographic regions and clinical status. Although it was not able to detect ATL in all patients, it was better than MST providing an additional tool for the diagnosis of ATL patients. There was no significant correlation between clinical forms and histological features including the presence of necrosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Rate of new findings in diagnostic office bronchoscopy.

PubMed

Soldatova, Liuba; DeSilva, Brad W; Matrka, Laura A

2017-06-01

Awake Flexible Tracheobronchoscopy (FTB) is an alternative to rigid bronchoscopy or sedated flexible bronchoscopy and allows an awake examination of the tracheobronchial tree. We hypothesized that the ability to perform office bronchoscopy as the need arises during a clinic visit would lead to a high rate of previously undiagnosed and clinically relevant findings. This study reports the rate and nature of such findings for this procedure at our institution. Retrospective chart review. The records of 127 adult patients evaluated at the voice and swallowing disorders clinic between June of 2012 and January of 2015 were reviewed. New findings were defined as new pathology visualized during FTB exam that was not previously diagnosed by means of other diagnostic modalities. A total of 233 scope procedures (84 transnasal bronchoscopies and 149 tracheoscopies) were reviewed, 232 of which were completed and one of which was incomplete due to severe subglottic stenosis. New, clinically relevant findings were seen in 57% of transnasal bronchoscopies (48 of 84) and 21% of tracheoscopies (32 of 149). All of these findings provided additional information directing workup or resulted in a change in patient management. Office-based evaluation of the tracheobronchial tree yields a high rate of new findings. In our study, office bronchoscopy had a 57% rate of new findings and was performed without complications. The utility of tracheoscopy was also apparent in its ability to quickly and safely examine the trachea, with a 21% rate of new findings. 4. Laryngoscope, 127:1376-1380, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Spectrum of use and effectiveness of endoscopic and surgical therapies for chronic pancreatitis in the United States.

PubMed

Glass, Lisa M; Whitcomb, David C; Yadav, Dhiraj; Romagnuolo, Joseph; Kennard, Elizabeth; Slivka, Adam A; Brand, Randall E; Anderson, Michelle A; Banks, Peter A; Lewis, Michele D; Baillie, John; Sherman, Stuart; Alkaade, Samer; Amann, Stephen T; Disario, James A; O'Connell, Michael; Gelrud, Andres; Forsmark, Christopher E; Gardner, Timothy B

2014-05-01

This study aims to describe the frequency of use and reported effectiveness of endoscopic and surgical therapies in patients with chronic pancreatitis treated at US referral centers. Five hundred fifteen patients were enrolled prospectively in the North American Pancreatitis Study 2, where patients and treating physicians reported previous therapeutic interventions and their perceived effectiveness. We evaluated the frequency and effectiveness of endoscopic (biliary or pancreatic sphincterotomy, biliary or pancreatic stent placement) and surgical (pancreatic cyst removal, pancreatic drainage procedure, pancreatic resection, surgical sphincterotomy) therapies. Biliary and/or pancreatic sphincterotomy (42%) were the most common endoscopic procedure (biliary stent, 14%; pancreatic stent, 36%; P < 0.001). Endoscopic procedures were equally effective (biliary sphincterotomy, 40.0%; biliary stent, 40.8%; pancreatic stent, 47.0%; P = 0.34). On multivariable analysis, the presence of abdominal pain (odds ratio, 1.82; 95% confidence interval, 1.15-2.88) predicted endoscopy, whereas exocrine insufficiency (odds ratio, 0.63; 95% confidence interval, 0.42-0.94) deterred endoscopy. Surgical therapies were attempted equally (cyst removal, 7%; drainage procedure, 10%; resection procedure, 12%) except for surgical sphincteroplasty (4%; P < 0.001). Surgical sphincteroplasty was the least effective (46%; P < 0.001) versus cyst removal (76% drainage [71%] and resection [73%]). Although surgical therapies were performed less frequently than endoscopic therapies, they were more often reported to be effective.

29 CFR 1956.22 - Procedures for evaluation and monitoring.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Change, Evaluation and Withdrawal of Approval Procedures § 1956.22 Procedures for evaluation and... enforcement authority under section 18(e) of the Act is not relevant to Phase II and III monitoring under...

Ensemble-based prediction of RNA secondary structures.

PubMed

Aghaeepour, Nima; Hoos, Holger H

2013-04-24

Accurate structure prediction methods play an important role for the understanding of RNA function. Energy-based, pseudoknot-free secondary structure prediction is one of the most widely used and versatile approaches, and improved methods for this task have received much attention over the past five years. Despite the impressive progress that as been achieved in this area, existing evaluations of the prediction accuracy achieved by various algorithms do not provide a comprehensive, statistically sound assessment. Furthermore, while there is increasing evidence that no prediction algorithm consistently outperforms all others, no work has been done to exploit the complementary strengths of multiple approaches. In this work, we present two contributions to the area of RNA secondary structure prediction. Firstly, we use state-of-the-art, resampling-based statistical methods together with a previously published and increasingly widely used dataset of high-quality RNA structures to conduct a comprehensive evaluation of existing RNA secondary structure prediction procedures. The results from this evaluation clarify the performance relationship between ten well-known existing energy-based pseudoknot-free RNA secondary structure prediction methods and clearly demonstrate the progress that has been achieved in recent years. Secondly, we introduce AveRNA, a generic and powerful method for combining a set of existing secondary structure prediction procedures into an ensemble-based method that achieves significantly higher prediction accuracies than obtained from any of its component procedures. Our new, ensemble-based method, AveRNA, improves the state of the art for energy-based, pseudoknot-free RNA secondary structure prediction by exploiting the complementary strengths of multiple existing prediction procedures, as demonstrated using a state-of-the-art statistical resampling approach. In addition, AveRNA allows an intuitive and effective control of the trade-off between false negative and false positive base pair predictions. Finally, AveRNA can make use of arbitrary sets of secondary structure prediction procedures and can therefore be used to leverage improvements in prediction accuracy offered by algorithms and energy models developed in the future. Our data, MATLAB software and a web-based version of AveRNA are publicly available at http://www.cs.ubc.ca/labs/beta/Software/AveRNA.

Life threatening bleeding from duodenal ulcer after Roux-en-Y gastric bypass: Case report and review of the literature.

PubMed

Ivanecz, Arpad; Sremec, Marko; Ceranić, Davorin; Potrč, Stojan; Skok, Pavel

2014-12-16

Acute upper gastrointestinal bleeding is a rare, but serious complication of gastric bypass surgery. The inaccessibility of the excluded stomach restrains postoperative examination and treatment of the gastric remnant and duodenum, and represents a major challenge, especially in the emergency setting. A 59-year-old patient with previous history of peptic ulcer disease had an upper gastrointestinal bleeding from a duodenal ulcer two years after having a gastric bypass procedure for morbid obesity. After negative upper endoscopy finding, he was urgently evaluated for gastrointestinal bleeding. At emergency laparotomy, the bleeding duodenal ulcer was identified by intraoperative endoscopy through gastrotomy. The patient recovered well after surgical hemostasis, excision of the duodenal ulcer and completion of the remnant gastrectomy. Every general practitioner, gastroenterologist and general surgeon should be aware of growing incidence of bariatric operations and coherently possible complications after such procedures, which modify patient's anatomy and physiology.

Chitosan-based microcapsules containing grapefruit seed extract grafted onto cellulose fibers by a non-toxic procedure.

PubMed

Alonso, Diana; Gimeno, Miquel; Sepúlveda-Sánchez, José D; Shirai, Keiko

2010-04-19

A novel non-toxic procedure is described for the grafting of chitosan-based microcapsules containing grapefruit seed oil extract onto cellulose. The cellulose was previously UV-irradiated and then functionalized from an aqueous emulsion of the chitosan with the essential oil. The novel materials are readily attained with durable fragrance and enhanced antimicrobial properties. The incorporation of chitosan as determined from the elemental analyses data was 16.08+/-0.29 mg/g of sample. Scanning electron microscopy (SEM) and gas chromatography-mass spectroscopy (GC-MS) provided further evidence for the successful attachment of chitosan microcapsules containing the essential oil to the treated cellulose fibers. The materials thus produced displayed 100% inhibition of Escherichia coli and Staphylococcus epidermidis up to 48 h of incubation. Inhibition of bacteria by the essential oil was also evaluated at several concentrations. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Feasibility studies of time-like proton electromagnetic form factors at $$\\overline{\\rm P}$$ANDA at FAIR

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

Singh, B.; Erni, W.; Krusche, B.

Simulation results for future measurements of electromagnetic proton form factors atmore » $$\\overline{\\rm P}$$ANDA (FAIR) within the PandaRoot software framework are reported. The statistical precision with which the proton form factors can be determined is estimated. The signal channel p¯p → e +e – is studied on the basis of two different but consistent procedures. The suppression of the main background channel, i.e. p¯p → π +π –, is studied. Furthermore, the background versus signal efficiency, statistical and systematical uncertainties on the extracted proton form factors are evaluated using two different procedures. The results are consistent with those of a previous simulation study using an older, simplified framework. Furthermore, a slightly better precision is achieved in the PandaRoot study in a large range of momentum transfer, assuming the nominal beam conditions and detector performance.« less

Determination of element affinities by density fractionation of bulk coal samples

USGS Publications Warehouse

Querol, X.; Klika, Z.; Weiss, Z.; Finkelman, R.B.; Alastuey, A.; Juan, R.; Lopez-Soler, A.; Plana, F.; Kolker, A.; Chenery, S.R.N.

2001-01-01

A review has been made of the various methods of determining major and trace element affinities for different phases, both mineral and organic in coals, citing their various strengths and weaknesses. These include mathematical deconvolution of chemical analyses, direct microanalysis, sequential extraction procedures and density fractionation. A new methodology combining density fractionation with mathematical deconvolution of chemical analyses of whole coals and their density fractions has been evaluated. These coals formed part of the IEA-Coal Research project on the Modes of Occurrence of Trace Elements in Coal. Results were compared to a previously reported sequential extraction methodology and showed good agreement for most elements. For particular elements (Be, Mo, Cu, Se and REEs) in specific coals where disagreement was found, it was concluded that the occurrence of rare trace element bearing phases may account for the discrepancy, and modifications to the general procedure must be made to account for these.

Feasibility studies of time-like proton electromagnetic form factors at $$\\overline{\\rm P}$$ANDA at FAIR

DOE PAGES

Singh, B.; Erni, W.; Krusche, B.; ...

2016-10-28

Simulation results for future measurements of electromagnetic proton form factors atmore » $$\\overline{\\rm P}$$ANDA (FAIR) within the PandaRoot software framework are reported. The statistical precision with which the proton form factors can be determined is estimated. The signal channel p¯p → e +e – is studied on the basis of two different but consistent procedures. The suppression of the main background channel, i.e. p¯p → π +π –, is studied. Furthermore, the background versus signal efficiency, statistical and systematical uncertainties on the extracted proton form factors are evaluated using two different procedures. The results are consistent with those of a previous simulation study using an older, simplified framework. Furthermore, a slightly better precision is achieved in the PandaRoot study in a large range of momentum transfer, assuming the nominal beam conditions and detector performance.« less

Laparoscopic donor nephrectomy increases the supply of living donor kidneys: a center-specific microeconomic analysis.

PubMed

Kuo, P C; Johnson, L B

2000-05-27

A tenet of microeconomics is that new technology will shift the supply curve to the right. Laparoscopic donor nephrectomy (LDN) is a new technique for removal of living donor kidneys. Centers performing this procedure have noted an increased number of patients presenting for donor evaluation. This has not been previously studied. The records of all LDN performed from May 1998 to February 1999 were reviewed. The following variables were examined: sex, age, related vs. unrelated donation, estimated blood loss, i.v. analgesia, length of stay, and time out of work. Donors undergoing traditional open donor nephrectomy during January 1997 to May 1998 served as the control group. A composite cost index was constructed. LDN significantly decreased length of stay, pain, and time out of work; the supply function shifted to the right. Telephone interviews revealed that 47% donated solely because of the LDN procedure. LDN increases the supply of living donor kidneys.

Performance evaluation of a LYSO-based PET scanner for monitoring of dose delivery in hadrontherapy

NASA Astrophysics Data System (ADS)

Fabbiani, E.; Belcari, N.; Camarlinghi, N.; Del Guerra, A.; Ferretti, S.; Kraan, A.; Panetta, D.; Sportelli, G.; Rosso, V.

2015-12-01

The DoPET scanner is a compact positron emission tomography (PET) device. It has been developed for monitoring the range of charged particles during therapy with hadron beams. Previous works have focused on the development and upgrade of the device and on data analysis. In this paper, a full performance characterization of the DoPET system in terms of the energy resolution, spatial resolution, sensitivity, uniformity, and noise equivalent count rate is reported. All measurements refer to an adapted version of the National Electrical Manufacturers Association (NEMA) NU 4 - 2008 protocol, which was written originally for small animal PET systems. Since DoPET is a dual head planar system, it requires a modified characterisation procedure with respect to those described for ring geometries as in the NEMA NU 4 - 2008 protocol. The presented procedure may be of interest for any other PET system with a similar geometry as DoPET.

A Multi-Start Evolutionary Local Search for the Two-Echelon Location Routing Problem

NASA Astrophysics Data System (ADS)

Nguyen, Viet-Phuong; Prins, Christian; Prodhon, Caroline

This paper presents a new hybrid metaheuristic between a greedy randomized adaptive search procedure (GRASP) and an evolutionary/iterated local search (ELS/ILS), using Tabu list to solve the two-echelon location routing problem (LRP-2E). The GRASP uses in turn three constructive heuristics followed by local search to generate the initial solutions. From a solution of GRASP, an intensification strategy is carried out by a dynamic alternation between ELS and ILS. In this phase, each child is obtained by mutation and evaluated through a splitting procedure of giant tour followed by a local search. The tabu list, defined by two characteristics of solution (total cost and number of trips), is used to avoid searching a space already explored. The results show that our metaheuristic clearly outperforms all previously published methods on LRP-2E benchmark instances. Furthermore, it is competitive with the best meta-heuristic published for the single-echelon LRP.

An updated systematic review of the evolution of ALPPS and evaluation of its advantages and disadvantages in accordance with current evidence.

PubMed

Cai, Yu-Long; Song, Pei-Pei; Tang, Wei; Cheng, Nan-Sheng

2016-06-01

The main obstacle to achieving an R0 resection after a major hepatectomy is inability to preserve an adequate future liver remnant (FLR) to avoid postoperative liver failure (PLF). Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel technique for resecting tumors that were previously considered unresectable, and this technique results in a vast increase in the volume of the FLR in a short period of time. However, this technique continues to provoke heated debate because of its high mortality and morbidity.The evolution of ALPPS and its advantages and disadvantages have been systematically reviewed and evaluated in accordance with current evidence. Electronic databases (PubMed and Medline) were searched for potentially relevant articles from January 2007 to January 2016.ALPPS has evolved into various modified forms. Some of these modified techniques have reduced the difficulty of the procedure and enhanced its safety. Current evidence indicates that the advantages of ALPPS are rapid hypertrophy of the FLR, the feasibility of the procedure, and a higher rate of R0 resection in comparison to other techniques. However, ALPPS is associated with worse major complications, more deaths, and early tumor recurrence.Hepatobiliary surgeons should carefully consider whether to perform ALPPS. Some modified forms of ALPPS have reduced the mortality and morbidity of the procedure, but they cannot be recommended over the original procedure currently. Portal vein embolization (PVE) is still the procedure of choice for patients with a tumor-free FLR, and ALPPS could be used as a salvage procedure when PVE fails. More persuasive evidence needs to be assembled to determine whether ALPPS or two-stage hepatectomy (TSH) is better for patients with a tumor involving the FLR. Evidence with regard to long-term oncological outcomes is still limited. More meticulous comparative studies and studies of the 5-year survival rate of ALPPS could ultimately help to determine the usefulness of ALPPS. Indications and patient selection for the procedure need to be determined.

An updated systematic review of the evolution of ALPPS and evaluation of its advantages and disadvantages in accordance with current evidence

PubMed Central

Cai, Yu-Long; Song, Pei-Pei; Tang, Wei; Cheng, Nan-Sheng

2016-01-01

Abstract The main obstacle to achieving an R0 resection after a major hepatectomy is inability to preserve an adequate future liver remnant (FLR) to avoid postoperative liver failure (PLF). Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel technique for resecting tumors that were previously considered unresectable, and this technique results in a vast increase in the volume of the FLR in a short period of time. However, this technique continues to provoke heated debate because of its high mortality and morbidity. The evolution of ALPPS and its advantages and disadvantages have been systematically reviewed and evaluated in accordance with current evidence. Electronic databases (PubMed and Medline) were searched for potentially relevant articles from January 2007 to January 2016. ALPPS has evolved into various modified forms. Some of these modified techniques have reduced the difficulty of the procedure and enhanced its safety. Current evidence indicates that the advantages of ALPPS are rapid hypertrophy of the FLR, the feasibility of the procedure, and a higher rate of R0 resection in comparison to other techniques. However, ALPPS is associated with worse major complications, more deaths, and early tumor recurrence. Hepatobiliary surgeons should carefully consider whether to perform ALPPS. Some modified forms of ALPPS have reduced the mortality and morbidity of the procedure, but they cannot be recommended over the original procedure currently. Portal vein embolization (PVE) is still the procedure of choice for patients with a tumor-free FLR, and ALPPS could be used as a salvage procedure when PVE fails. More persuasive evidence needs to be assembled to determine whether ALPPS or two-stage hepatectomy (TSH) is better for patients with a tumor involving the FLR. Evidence with regard to long-term oncological outcomes is still limited. More meticulous comparative studies and studies of the 5-year survival rate of ALPPS could ultimately help to determine the usefulness of ALPPS. Indications and patient selection for the procedure need to be determined. PMID:27311006

Constant and Progressive Time Delay Procedures for Teaching Children with Autism: A Literature Review

ERIC Educational Resources Information Center

Walker, Gabriela

2008-01-01

A review of 22 empirical studies examining the use of constant (CTD) and progressive (PTD) time delay procedures employed with children with autism frames an indirect analysis of the demographic, procedural, methodological, and outcome parameters of existing research. None of the previous manuscripts compared the two response prompting procedures.…

Ten-year experience of recombinant activated factor VII use in surgical patients with congenital haemophilia with inhibitors or acquired haemophilia in Japan.

PubMed

Takedani, H; Shima, M; Horikoshi, Y; Koyama, T; Fukutake, K; Kuwahara, M; Ishiguro, N

2015-05-01

Patients with congenital haemophilia with inhibitors or acquired haemophilia are at risk of bleeding complications during surgery. In these patients, replacement therapy for the missing coagulation factor is ineffective, and a bypassing agent such as recombinant activated factor VII (rFVIIa) is required to manage bleeding. To evaluate the safety and haemostatic efficacy of rFVIIa treatment in Japanese patients with congenital haemophilia with inhibitors to FVIII/FIX or acquired haemophilia undergoing surgery. Postmarketing surveillance data from May 2000 to March 2010 were analysed to assess the haemostatic efficacy of 38 procedures in 22 patients with congenital haemophilia A, 13 procedures in seven patients with congenital haemophilia B, and five procedures in five patients with acquired haemophilia. Postoperative bleeding control was judged to be effective (bleeding was stopped completely or reduced considerably) for 34/38 procedures (89%) in patients with congenital haemophilia A, 10/13 procedures (77%) in patients with congenital haemophilia B, and 4/5 procedures (80%) in patients with acquired haemophilia. Tranexamic acid was used concomitantly for 36/56 procedures (64%). Safety was analysed for 66 procedures in 37 patients. Adverse effects potentially related to rFVIIa treatment included mild superficial thrombophlebitis, mild decrease in platelet count, and mild elevation of the serum alanine transaminase level in one patient each. All adverse effects resolved without treatment. Administration of rFVIIa provided adequate haemostasis without serious adverse effects in the majority of cases. The efficacy and safety data in Japanese patients were similar to previously published data from other countries. © 2014 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

Historical patterns in the types of procedures performed and radiation safety practices used in nuclear medicine from 1945–2009

PubMed Central

Van Dyke, Miriam E.; Drozdovitch, Vladimir; Doody, Michele M.; Lim, Hyeyeun; Bolus, Norman E.; Simon, Steven L.; Alexander, Bruce H.; Kitahara, Cari M.

2016-01-01

We evaluated historical patterns in the types of procedures performed in diagnostic and therapeutic nuclear medicine and the associated radiation safety practices used from 1945–2009 in a sample of U.S. radiologic technologists. In 2013–2014, 4,406 participants from the U.S. Radiologic Technologists (USRT) Study who previously reported working with medical radionuclides completed a detailed survey inquiring about the performance of 23 diagnostic and therapeutic radionuclide procedures and the use of radiation safety practices when performing radionuclide procedure-related tasks during five time periods: 1945–1964, 1965–1979, 1980–1989, 1990–1999, and 2000–2009. We observed an overall increase in the proportion of technologists who performed specific diagnostic or therapeutic procedures across the five time periods. Between 1945–1964 and 2000–2009, the median frequency of diagnostic procedures performed substantially increased (5 per week to 30 per week), attributable mainly to an increasing frequency of cardiac and non-brain PET scans, while the median frequency of therapeutic procedures performed modestly decreased (from 4 per month to 3 per month). We also observed a notable increase in the use of most radiation safety practices from 1945–1964 to 2000–2009 (e.g., use of lead-shielded vials during diagnostic radiopharmaceutical preparation increased from 56 to 96%), although lead apron use dramatically decreased (e.g., during diagnostic imaging procedures, from 81 to 7%). These data describe historical practices in nuclear medicine and can be used to support studies of health risks in nuclear medicine technologists. PMID:27218293

A framework for assessing the adequacy and effectiveness of software development methodologies

NASA Technical Reports Server (NTRS)

Arthur, James D.; Nance, Richard E.

1990-01-01

Tools, techniques, environments, and methodologies dominate the software engineering literature, but relatively little research in the evaluation of methodologies is evident. This work reports an initial attempt to develop a procedural approach to evaluating software development methodologies. Prominent in this approach are: (1) an explication of the role of a methodology in the software development process; (2) the development of a procedure based on linkages among objectives, principles, and attributes; and (3) the establishment of a basis for reduction of the subjective nature of the evaluation through the introduction of properties. An application of the evaluation procedure to two Navy methodologies has provided consistent results that demonstrate the utility and versatility of the evaluation procedure. Current research efforts focus on the continued refinement of the evaluation procedure through the identification and integration of product quality indicators reflective of attribute presence, and the validation of metrics supporting the measure of those indicators. The consequent refinement of the evaluation procedure offers promise of a flexible approach that admits to change as the field of knowledge matures. In conclusion, the procedural approach presented in this paper represents a promising path toward the end goal of objectively evaluating software engineering methodologies.

Evaluation of standardized sample collection, packaging, and ...

EPA Pesticide Factsheets

Journal Sample collection procedures and primary receptacle (sample container and bag) decontamination methods should prevent contaminant transfer between contaminated and non-contaminated surfaces and areas during bio-incident operations. Cross-contamination of personnel, equipment, or sample containers may result in the exfiltration of biological agent from the exclusion (hot) zone and have unintended negative consequences on response resources, activities and outcomes. The current study was designed to: (1) evaluate currently recommended sample collection and packaging procedures to identify procedural steps that may increase the likelihood of spore exfiltration or contaminant transfer; (2) evaluate the efficacy of currently recommended primary receptacle decontamination procedures; and (3) evaluate the efficacy of outer packaging decontamination methods. Wet- and dry-deposited fluorescent tracer powder was used in contaminant transfer tests to qualitatively evaluate the currently-recommended sample collection procedures. Bacillus atrophaeus spores, a surrogate for Bacillus anthracis, were used to evaluate the efficacy of spray- and wipe-based decontamination procedures.

Increased prevalence of preeclampsia among women undergoing procedural intervention for renal artery fibromuscular dysplasia.

PubMed

Vance, Chardonnay J; Taylor, Robert N; Craven, Timothy E; Edwards, Matthew S; Corriere, Matthew A

2015-08-01

Renal artery fibromuscular dysplasia (RA-FMD) has a higher prevalence among women and a presumed hormonal etiology. Although preeclampsia has a clinical presentation similar to symptomatic RA-FMD and occurs exclusively in women, associations between these 2 diseases have not been characterized. To explore epidemiologic associations between RA-FMD and preeclampsia, we administered a validated screening instrument for preeclampsia to a cohort of women with a history of pregnancy who had previously been treated with procedural intervention for symptomatic RA stenosis. Women with a history of pregnancy who had previously undergone procedural intervention (including angioplasty and/or bypass) for symptomatic RA stenosis were identified from a prospectively maintained operative registry and screened for remote history of preeclampsia using a validated survey instrument. Univariable associations between RA-FMD and preeclampsia among participants with a history of pregnancy were evaluated using t-tests for continuous factors and chi-squared tests for dichotomous factors. Multivariable associations were evaluated using logistic regression models. A total of 144 women were identified who met the study inclusion criteria, including 94 with atherosclerotic RA stenosis and 50 with RA-FMD. Sixty-nine patients were contacted, 59 consented to participate, and 52 had a history of pregnancy (and therefore were at risk for preeclampsia). Participants completed the survey instrument at a mean of 7.1 ± 3.1 vs. 6.9 ± 3.6 years after RA procedural intervention, respectively. Survey responses indicated a history of preeclampsia in 19/52 (36.5%) of participants overall, including 14/27 (51.9%) with RA-FMD versus 5/20 (20.0%) with RA atherosclerosis (P = 0.02). Preeclampsia remained associated with FMD in a multivariable model adjusting for smoking status, age at time of surgery, and estimated glomerular filtration rate (odds ratio [OR] 9.51, 95% confidence interval [CI] 1.49-60.6, P = 0.017); age at the time of surgery (OR 2.78, 95% CI 1.04-7.42, P = 0.041) and estimated glomerular filtration rate (OR 3.31, 95% CI 1.29-8.52, P = 0.013) were also associated with FMD in the multivariable model. Women with a history of procedural intervention for symptomatic RA stenosis have an overall prevalence of preeclampsia which greatly exceeds that expected in the general population, and our results suggest that preeclampsia is specifically associated with RA-FMD. Further investigation is needed to characterize the mechanistic relationships between FMD and preeclampsia and may have potential to decrease related cardiovascular morbidity and mortality. Copyright © 2015 Elsevier Inc. All rights reserved.

A decision support system-based procedure for evaluation and monitoring of protected areas sustainability for the Mediterranean region

NASA Astrophysics Data System (ADS)

Pediaditi, K.; Buono, F.; Pompigna, F.; Bogliotti, C.; Nurlu, E.; Ladisa, G.; Petropoulos, G. P.

2011-10-01

Despite common acknowledgement of the value of protected areas as instruments in ensuring sustainability, and their promotion for the achievement of policies on halting the loss of biodiversity, there is no common approach today for monitoring and evaluating them. This paper presents a novel integrated nature conservation management procedure developed to monitor and evaluate the sustainability of Mediterranean protected areas. This procedure was successfully implemented and formally evaluated by protected area managers in six Mediterranean countries, results of which are presented here together with an overview of the web-based Decision Support System (DSS) developed to facilitate its wide adoption. The DSS and procedure has been designed and evaluated by managers as a useful tool, which facilitates and provides needed procedural guidance for protected area monitoring whilst minimizing input requirements to do so. The procedure and DSS were developed following a review of existing protected area assessment tools and a detailed primary investigation of the needs and capacity of its intended users. Essentially, the procedure and DSS guides provide the facilities for protected area managers, in following a participatory approach to develop a context-specific sustainability monitoring strategy, for their protected area. Consequently, the procedure is, by design, participatory, context specific, holistic and relevant to protected area management and institutional procedures. The procedure was piloted and formally evaluated in Greece, Italy, Turkey, Egypt, Malta and Cyprus. Feedback collected from the pilot evaluations is also summarised herein.

Evaluation of site plan review procedures.

DOT National Transportation Integrated Search

1988-01-01

The site plan review procedures of the Virginia Department of Transportation (VDOT) were evaluated. The objectives of the evaluation were to recommend (1) a set of site plan review procedures including a checklist, (2) definitions of the roles and re...

An Interlaboratory Validation of the Radiation Dose Response Relationship (DRR) for H-ARS in the Rhesus Macaque.

PubMed

Thrall, Karla D; Love, Ruschelle; OʼDonnell, Kyle C; Farese, Ann M; Manning, Ronald; MacVittie, Thomas J

2015-11-01

The Medical Countermeasures against Radiological Threats (MCART) consortium has established a dose response relationship for the hematopoietic acute radiation syndrome (HARS) in the rhesus macaque conducted under an individualized supportive care protocol, including blood transfusions. Application of this animal model as a platform for demonstrating efficacy of candidate medical countermeasures is significantly strengthened when the model is independently validated at multiple institutions. The study reported here describes implementation of standard operating procedures at an institute outside the consortium in order to evaluate the ability to establish an equivalent radiation dose response relationship in a selected species. Validation of the animal model is a significant component for consideration of the model protocol as an FDA-recommended drug development tool in the context of the "Animal Rule." In the current study, 48 male rhesus macaques (4-8 kg) were exposed to total-body irradiation (TBI) using 6 MV photon energy at a dose rate of approximately 0.8 Gy min. Results show that onset and duration of the hematological response, including anemia, neutropenia, and thrombocytopenia, following TBI ranging from 6.25 to 8.75 Gy correlate well with previously reported findings. The lethality values at 60 d following TBI were estimated to be 6.88 Gy (LD30/60), 7.43 Gy (LD50/60), and 7.98 Gy (LD70/60). These values are equivalent to those published previously of 7.06 Gy (LD30/60), 7.52 Gy (LD50/60), and 7.99 Gy (LD70/60); the DRR slope (p = 0.68) and y-intercepts show agreement along the complete dose range for HARS. The ability to replicate the previously established institutional lethality profile (PROBIT) and model outcomes through careful implementation of defined procedures is a testament to the robustness of the model and highlights the need for consistency in procedures.

Survival Prediction in Patients Undergoing Open-Heart Mitral Valve Operation After Previous Failed MitraClip Procedures.

PubMed

Geidel, Stephan; Wohlmuth, Peter; Schmoeckel, Michael

2016-03-01

The objective of this study was to analyze the results of open heart mitral valve operations for survival prediction in patients with previously unsuccessful MitraClip procedures. Thirty-three consecutive patients who underwent mitral valve surgery in our institution were studied. At a median of 41 days, they had previously undergone one to five futile MitraClip implantations. At the time of their operations, patients were 72.6 ± 10.3 years old, and the calculated risk, using the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, was a median of 26.5%. Individual outcomes were recorded, and all patients were monitored postoperatively. Thirty-day mortality was 9.1%, and the overall survival at 2.2 years was 60.6%. Seven cardiac-related and six noncardiac deaths occurred. Univariate survival regression models demonstrated a significant influence of the following variables on survival: EuroSCORE II (p = 0.0022), preoperative left ventricular end-diastolic dimension (p = 0.0052), left ventricular ejection fraction (p = 0.0249), coronary artery disease (p = 0.0385), and severe pulmonary hypertension (p = 0.0431). Survivors showed considerable improvements in their New York Heart Association class (p < 0.0001), left ventricular ejection fraction (p = 0.0080), grade of mitral regurgitation (p = 0.0350), and mitral valve area (p = 0.0486). Survival after mitral repair was not superior to survival after replacement. Indications for surgery after failed MitraClip procedures must be considered with the greatest of care. Variables predicting postoperative survival should be taken into account regarding the difficult decision as to whether to operate or not. Our data suggest that replacement of the pretreated mitral valve is probably the more reasonable concept rather than complex repairs. When the EuroSCORE II at the time of surgery exceeds 30%, conservative therapy is advisable. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Improved False Discovery Rate Estimation Procedure for Shotgun Proteomics.

PubMed

Keich, Uri; Kertesz-Farkas, Attila; Noble, William Stafford

2015-08-07

Interpreting the potentially vast number of hypotheses generated by a shotgun proteomics experiment requires a valid and accurate procedure for assigning statistical confidence estimates to identified tandem mass spectra. Despite the crucial role such procedures play in most high-throughput proteomics experiments, the scientific literature has not reached a consensus about the best confidence estimation methodology. In this work, we evaluate, using theoretical and empirical analysis, four previously proposed protocols for estimating the false discovery rate (FDR) associated with a set of identified tandem mass spectra: two variants of the target-decoy competition protocol (TDC) of Elias and Gygi and two variants of the separate target-decoy search protocol of Käll et al. Our analysis reveals significant biases in the two separate target-decoy search protocols. Moreover, the one TDC protocol that provides an unbiased FDR estimate among the target PSMs does so at the cost of forfeiting a random subset of high-scoring spectrum identifications. We therefore propose the mix-max procedure to provide unbiased, accurate FDR estimates in the presence of well-calibrated scores. The method avoids biases associated with the two separate target-decoy search protocols and also avoids the propensity for target-decoy competition to discard a random subset of high-scoring target identifications.

Multiparameter optimization of mammography: an update

NASA Astrophysics Data System (ADS)

Jafroudi, Hamid; Muntz, E. P.; Jennings, Robert J.

1994-05-01

Previously in this forum we have reported the application of multiparameter optimization techniques to the design of a minimum dose mammography system. The approach used a reference system to define the physical imaging performance required and the dose to which the dose for the optimized system should be compared. During the course of implementing the resulting design in hardware suitable for laboratory testing, the state of the art in mammographic imaging changed, so that the original reference system, which did not have a grid, was no longer appropriate. A reference system with a grid was selected in response to this change, and at the same time the optimization procedure was modified, to make it more general and to facilitate study of the optimized design under a variety of conditions. We report the changes in the procedure, and the results obtained using the revised procedure and the up- to-date reference system. Our results, which are supported by laboratory measurements, indicate that the optimized design can image small objects as well as the reference system using only about 30% of the dose required by the reference system. Hardware meeting the specification produced by the optimization procedure and suitable for clinical use is currently under evaluation in the Diagnostic Radiology Department at the Clinical Center, NH.

Analytic tests and their relation to jet fuel thermal stability

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

Heneghan, S.P.; Kauffman, R.E.

1995-05-01

The evaluation of jet fuel thermal stability (TS) by simple analytic procedures has long been a goal of fuels chemists. The reason is obvious: if the analytic chemist can determine which types of material cause his test to respond, the refiners will know which materials to remove to improve stability. Complicating this quest is the lack of an acceptable quantitative TS test with which to compare any analytic procedures. To circumvent this problem, we recently compiled the results of TS tests for 12 fuels using six separate test procedures. The results covering a range of flow and temperature conditions showmore » that TS is not as dependent on test conditions as previously thought. Also, comparing the results from these tests with several analytic procedures shows that either a measure of the number of phenols or the total sulfur present in jet fuels is strongly indicative of the TS. The phenols have been measured using a cyclic voltammetry technique and the polar material by gas chromatography (atomic emission detection) following a solid phase extraction on silica gel. The polar material has been identified as mainly phenols (by mass spectrometry identification). Measures of the total acid number or peroxide concentration have little correlation with TS.« less

Improved False Discovery Rate Estimation Procedure for Shotgun Proteomics

PubMed Central

2016-01-01

Interpreting the potentially vast number of hypotheses generated by a shotgun proteomics experiment requires a valid and accurate procedure for assigning statistical confidence estimates to identified tandem mass spectra. Despite the crucial role such procedures play in most high-throughput proteomics experiments, the scientific literature has not reached a consensus about the best confidence estimation methodology. In this work, we evaluate, using theoretical and empirical analysis, four previously proposed protocols for estimating the false discovery rate (FDR) associated with a set of identified tandem mass spectra: two variants of the target-decoy competition protocol (TDC) of Elias and Gygi and two variants of the separate target-decoy search protocol of Käll et al. Our analysis reveals significant biases in the two separate target-decoy search protocols. Moreover, the one TDC protocol that provides an unbiased FDR estimate among the target PSMs does so at the cost of forfeiting a random subset of high-scoring spectrum identifications. We therefore propose the mix-max procedure to provide unbiased, accurate FDR estimates in the presence of well-calibrated scores. The method avoids biases associated with the two separate target-decoy search protocols and also avoids the propensity for target-decoy competition to discard a random subset of high-scoring target identifications. PMID:26152888

Antegrade Ureteral Stenting is a Good Alternative for the Retrograde Approach

PubMed Central

van der Meer, Rutger W.; Weltings, Saskia; van Erkel, Arian R.; Roshani, Hossain; Elzevier, Henk W.; van Dijk, Lukas C.; van Overhagen, Hans

2017-01-01

Background/Aims Double J (JJ) stents for treating obstructive ureteral pathology are generally inserted through a retrograde route with cystoscopic guidance. Antegrade percutaneous insertion using fluoroscopy can be performed alternatively but is less known. Indications, success rate and complications of antegrade ureteral stenting were evaluated. Methods Data of consecutive patients in which antegrade ureteral stenting was performed were retrospectively analysed using the radiology information system and patient records. Patient characteristics, details of the antegrade JJ stent insertion procedure and registered complications were collected. Furthermore, it was investigated if prior to the antegrade procedure a retrograde attempt for JJ stent insertion was performed. Results Total 130 attempts for antegrade JJ stent insertion were performed in 100 patients. A percutaneous nephrostomy catheter had already been placed in the majority of kidneys (n = 109) for initial treatment of hydronephrosis. Most prevelant indication for a JJ stent was obstructive ureteral pathology due to malignancy (n = 63). A JJ stent was successfully inserted in 125 of 130 procedures. In 21 cases, previous retrograde ureteral stenting had failed but, subsequent antegrade ureteral stenting was successful. There were 8 procedure related complications; 6 infections, 1 false tract and 1 malposition. Conclusion Antegrade percutaneous insertion of a JJ stent is a good alternative for retrograde insertion. PMID:28785193

Quality-assurance plan for groundwater activities, U.S. Geological Survey, Washington Water Science Center

USGS Publications Warehouse

Kozar, Mark D.; Kahle, Sue C.

2013-01-01

This report documents the standard procedures, policies, and field methods used by the U.S. Geological Survey’s (USGS) Washington Water Science Center staff for activities related to the collection, processing, analysis, storage, and publication of groundwater data. This groundwater quality-assurance plan changes through time to accommodate new methods and requirements developed by the Washington Water Science Center and the USGS Office of Groundwater. The plan is based largely on requirements and guidelines provided by the USGS Office of Groundwater, or the USGS Water Mission Area. Regular updates to this plan represent an integral part of the quality-assurance process. Because numerous policy memoranda have been issued by the Office of Groundwater since the previous groundwater quality assurance plan was written, this report is a substantial revision of the previous report, supplants it, and contains significant additional policies not covered in the previous report. This updated plan includes information related to the organization and responsibilities of USGS Washington Water Science Center staff, training, safety, project proposal development, project review procedures, data collection activities, data processing activities, report review procedures, and archiving of field data and interpretative information pertaining to groundwater flow models, borehole aquifer tests, and aquifer tests. Important updates from the previous groundwater quality assurance plan include: (1) procedures for documenting and archiving of groundwater flow models; (2) revisions to procedures and policies for the creation of sites in the Groundwater Site Inventory database; (3) adoption of new water-level forms to be used within the USGS Washington Water Science Center; (4) procedures for future creation of borehole geophysics, surface geophysics, and aquifer-test archives; and (5) use of the USGS Multi Optional Network Key Entry System software for entry of routine water-level data collected as part of long-term water-level monitoring networks.

Computer program to minimize prediction error in models from experiments with 16 hypercube points and 0 to 6 center points

NASA Technical Reports Server (NTRS)

Holms, A. G.

1982-01-01

A previous report described a backward deletion procedure of model selection that was optimized for minimum prediction error and which used a multiparameter combination of the F - distribution and an order statistics distribution of Cochran's. A computer program is described that applies the previously optimized procedure to real data. The use of the program is illustrated by examples.

33 CFR 277.5 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... has established implementing procedures based on those previously adopted and utilized by the Chief of Engineers prior to 15 October 1966. This regulation adapts these cost apportionment procedures, found in...

33 CFR 277.5 - General.

Code of Federal Regulations, 2011 CFR

2011-07-01

... has established implementing procedures based on those previously adopted and utilized by the Chief of Engineers prior to 15 October 1966. This regulation adapts these cost apportionment procedures, found in...

The Evaluation of Foreign-Language-Teacher Education Programmes

ERIC Educational Resources Information Center

Peacock, Matthew

2009-01-01

This article presents a new procedure for the evaluation of EFL teacher-training programmes based on principles of programme evaluation and foreign-language-teacher (FLT) education. The procedure focuses on programme strengths and weaknesses and how far the programme meets the needs of students. I tested the procedure through an evaluation of a…

Simultaneous bilateral robotic partial nephrectomy: Case report and critical evaluation of the technique.

PubMed

Giberti, Claudio; Gallo, Fabrizio; Schenone, Maurizio; Cortese, Pierluigi

2014-06-16

We report our first simultaneous bilateral robot assisted partial nephrectomy (RAPN) in order to show and critically discuss the feasibility of this procedure. Materials and methods A 69-year-old male patient visited our department due to incidental finding of bilateral mesorenal small masses (2.5 cm on the right and 3.5 cm on the left) suspicious for malignancy. We started from the right side with patient in flank position. Port placement: 12-mm periumbilical camera port, two 8-mm robotic ports in wide ''V''configuration, additional 12 mm assistant port on the midline between the umbilicus and symphysis pubis. A right unclamping RAPN with sliding clip renorrhaphy was performed. The trocars were removed and the robot undocked. Without interrupting the anesthesiological procedures, the patient was reported in supine position and, after 180 degrees rotation of the surgical bed, was newly placed in contralateral flank position. Using both the previous periumbilical and midline ports, two other 8-mm robotic trocars were placed. The robot was then redocked and RAPN was also performed on the left side using the same previously reported technique. Results Total time: 285 min. Estimated blood losses: 150 cc. Postoperative period: uneventful. Pathological examination: bilateral renal cell carcinoma, negative surgical margins. Conclusions Our experience was encouraging and confirmed the feasibility and safety of this procedure. The planning of our technique was time and cost effective with cosmetic benefit for the patient. However, we think that an appropriate selection of the patients and a skill in robotic renal surgery are advisable before approaching this type of surgery.

Ureteroscopic treatment of larger renal calculi (>2 cm)

PubMed Central

Bagley, Demetrius H.; Healy, Kelly A.; Kleinmann, Nir

2012-01-01

Objectives To evaluate the current status of ureteroscopic lithotripsy (UL) for treating renal calculi of >2 cm, as advances in flexible ureteroscope design, accessory instrumentation and lithotrites have revolutionised the treatment of urinary calculi. While previously reserved for ureteric and small renal calculi, UL has gained an increasing role in the selective management of larger renal stone burdens. Methods We searched the available databases, including PubMed, Google Scholar, and Scopus, for relevant reports in English, and the article bibliographies to identify additional relevant articles. Keywords included ureteroscopy, lithotripsy, renal calculi, and calculi >2 cm. Retrieved articles were reviewed to consider the number of patients, mean stone size, success rates, indications and complications. Results In all, nine studies (417 patients) were eligible for inclusion. After one, two or three procedures the mean (range) success rates were 68.2 (23–84)%, 87.1 (79–91)% and 94.4 (90.1–96.7)%, respectively. Overall, the success rate was >90% with a mean of 1.2–2.3 procedures per patient. The overall complication rate was 10.3%, including six (1.4%) intraoperative and 37 (8.9%) postoperative complications, most of which were minor. The most common indications for UL were a failed previous treatment (46%), comorbidities (18.2%), and technical and anatomical factors (12.3%). Conclusions UL is safe and effective for treating large renal calculi. While several procedures might be required for total stone clearance, UL should be considered a standard approach in the urologist’s options treating renal calculi of >2 cm. PMID:26558040

14CO2 analysis of soil gas: Evaluation of sample size limits and sampling devices

NASA Astrophysics Data System (ADS)

Wotte, Anja; Wischhöfer, Philipp; Wacker, Lukas; Rethemeyer, Janet

2017-12-01

Radiocarbon (14C) analysis of CO2 respired from soils or sediments is a valuable tool to identify different carbon sources. The collection and processing of the CO2, however, is challenging and prone to contamination. We thus continuously improve our handling procedures and present a refined method for the collection of even small amounts of CO2 in molecular sieve cartridges (MSCs) for accelerator mass spectrometry 14C analysis. Using a modified vacuum rig and an improved desorption procedure, we were able to increase the CO2 recovery from the MSC (95%) as well as the sample throughput compared to our previous study. By processing series of different sample size, we show that our MSCs can be used for CO2 samples of as small as 50 μg C. The contamination by exogenous carbon determined in these laboratory tests, was less than 2.0 μg C from fossil and less than 3.0 μg C from modern sources. Additionally, we tested two sampling devices for the collection of CO2 samples released from soils or sediments, including a respiration chamber and a depth sampler, which are connected to the MSC. We obtained a very promising, low process blank for the entire CO2 sampling and purification procedure of ∼0.004 F14C (equal to 44,000 yrs BP) and ∼0.003 F14C (equal to 47,000 yrs BP). In contrast to previous studies, we observed no isotopic fractionation towards lighter δ13C values during the passive sampling with the depth samplers.

40 CFR 444.12 - Monitoring requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... must include requirements to monitor, according to EPA-approved test procedures, each pollutant limited... be accomplished using approved test procedures listed in the table to this paragraph. Most of these test procedures have previously been incorporated by reference at 40 CFR 136.3(a), Table IB. The test...

40 CFR 444.12 - Monitoring requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... must include requirements to monitor, according to EPA-approved test procedures, each pollutant limited... be accomplished using approved test procedures listed in the table to this paragraph. Most of these test procedures have previously been incorporated by reference at 40 CFR 136.3(a), Table IB. The test...

Effect of local endometrial injury on pregnancy outcomes in ovum donation cycles.

PubMed

Dain, Lena; Ojha, Kamal; Bider, David; Levron, Jacob; Zinchenko, Viktor; Walster, Sharon; Dirnfeld, Martha

2014-10-01

To evaluate the effect of local endometrial injury (LEI) on clinical outcomes in ovum donation recipients. Retrospective cohort analysis of ovum donation cycles conducted from 2005 to 2012. Two private IVF centers. Total 737 ovum donation cycles. LEI by endometrial "scratch" with the use of a Pipelle catheter. Clinical pregnancy and live birth rates. No statistically significant differences were found in clinical pregnancy rates and live birth rates in cycles subjected to LEI compared with those without. Combination of LEI with fibroid uterus resulted with significantly higher clinical pregnancy rates compared with LEI in normal uterine anatomy. This is the first study done in ovum recipients who underwent LEI by a "scratch" procedure after failed implantation. Unlike most previous reports, which found improved pregnancy rates with the use of "scratch effect" or "minor endometrial injury" after repeated implantation failures in standard IVF with own eggs, we did not find any changes in implantation rates in a population of egg recipients following this procedure. In view of a possible positive effect of LEI in cycles with a previous four or more failures, prospective randomized controlled studies are warranted to better define the target population who may benefit from this intervention. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Comparison of speech perception performance between Sprint/Esprit 3G and Freedom processors in children implanted with nucleus cochlear implants.

PubMed

Santarelli, Rosamaria; Magnavita, Vincenzo; De Filippi, Roberta; Ventura, Laura; Genovese, Elisabetta; Arslan, Edoardo

2009-04-01

To compare speech perception performance in children fitted with previous generation Nucleus sound processor, Sprint or Esprit 3G, and the Freedom, the most recently released system from the Cochlear Corporation that features a larger input dynamic range. Prospective intrasubject comparative study. University Medical Center. Seventeen prelingually deafened children who had received the Nucleus 24 cochlear implant and used the Sprint or Esprit 3G sound processor. Cochlear implantation with Cochlear device. Speech perception was evaluated at baseline (Sprint, n = 11; Esprit 3G, n = 6) and after 1 month's experience with the Freedom sound processor. Identification and recognition of disyllabic words and identification of vowels were performed via recorded voice in quiet (70 dB [A]), in the presence of background noise at various levels of signal-to-noise ratio (+10, +5, 0, -5) and at a soft presentation level (60 dB [A]). Consonant identification and recognition of disyllabic words, trisyllabic words, and sentences were evaluated in live voice. Frequency discrimination was measured in a subset of subjects (n = 5) by using an adaptive, 3-interval, 3-alternative, forced-choice procedure. Identification of disyllabic words administered at a soft presentation level showed a significant increase when switching to the Freedom compared with the previously worn processor in children using the Sprint or Esprit 3G. Identification and recognition of disyllabic words in the presence of background noise as well as consonant identification and sentence recognition increased significantly for the Freedom compared with the previously worn device only in children fitted with the Sprint. Frequency discrimination was significantly better when switching to the Freedom compared with the previously worn processor. Serial comparisons revealed that that speech perception performance evaluated in children aged 5 to 15 years was superior with the Freedom than previous generations of Nucleus sound processors. These differences are deemed to ensue from an increased input dynamic range, a feature that offers potentially enhanced phonemic discrimination.

Clinical evaluation of a confocal microendoscope system for imaging the ovary

NASA Astrophysics Data System (ADS)

Tanbakuchi, Anthony A.; Rouse, Andrew R.; Hatch, Kenneth D.; Sampliner, Richard E.; Udovich, Josh A.; Gmitro, Arthur F.

2008-02-01

We have developed a mobile confocal microendoscope system that provides live cellular imaging during surgery to aid in diagnosing microscopic abnormalities including cancer. We present initial clinical trial results using the device to image ovaries in-vivo using fluorescein and ex-vivo results using acridine orange. The imaging catheter has improved depth control and localized dye delivery mechanisms than previously presented. A manual control now provides a simple way for the surgeon to adjust and optimize imaging depth during the procedure while a tiny piezo valve in the imaging catheter controls the dye delivery.

Body mass index is not associated with sperm-zona pellucida binding ability in subfertile males.

PubMed

Sermondade, Nathalie; Dupont, Charlotte; Faure, Céline; Boubaya, Marouane; Cédrin-Durnerin, Isabelle; Chavatte-Palmer, Pascale; Sifer, Christophe; Lévy, Rachel

2013-09-01

Lifestyle factors, such as weight and nutritional status may affect male fertility, including sperm fertilization ability. The objective of this retrospective study was to evaluate the association between body mass index (BMI) and sperm-zona pellucida binding ability assessed according to the zona binding (ZB) test, which has been described to be a relevant diagnostic tool for the prediction of in vitro fertilization (IVF) ability. Three hundred and six male patients from couples diagnosed with primary idiopathic or mild male factor infertility were included. Correlations between BMI and semen parameters according to ZB test indices were assessed, together with frequencies of positive and negative tests across the BMI categories. In this selected population, BMI was not related to conventional semen parameters or sperm quality assessed according to the ability of spermatozoa to bind to the zona pellucida. The previously described poor outcomes of IVF procedures in cases of male obesity could be due to other sperm defects, such as alterations of sperm capacitation or acrosome reaction. The link between male BMI and biological outcomes during IVF procedures, such as fertilization rates, should be further evaluated.

Evaluation of mitral valve replacement anchoring in a phantom

NASA Astrophysics Data System (ADS)

McLeod, A. Jonathan; Moore, John; Lang, Pencilla; Bainbridge, Dan; Campbell, Gordon; Jones, Doug L.; Guiraudon, Gerard M.; Peters, Terry M.

2012-02-01

Conventional mitral valve replacement requires a median sternotomy and cardio-pulmonary bypass with aortic crossclamping and is associated with significant mortality and morbidity which could be reduced by performing the procedure off-pump. Replacing the mitral valve in the closed, off-pump, beating heart requires extensive development and validation of surgical and imaging techniques. Image guidance systems and surgical access for off-pump mitral valve replacement have been previously developed, allowing the prosthetic valve to be safely introduced into the left atrium and inserted into the mitral annulus. The major remaining challenge is to design a method of securely anchoring the prosthetic valve inside the beating heart. The development of anchoring techniques has been hampered by the expense and difficulty in conducting large animal studies. In this paper, we demonstrate how prosthetic valve anchoring may be evaluated in a dynamic phantom. The phantom provides a consistent testing environment where pressure measurements and Doppler ultrasound can be used to monitor and assess the valve anchoring procedures, detecting pararvalvular leak when valve anchoring is inadequate. Minimally invasive anchoring techniques may be directly compared to the current gold standard of valves sutured under direct vision, providing a useful tool for the validation of new surgical instruments.

A simple analytical method for determining the atmospheric dispersion of upward-directed high velocity releases

NASA Astrophysics Data System (ADS)

Palazzi, E.

The evaluation of atmospheric dispersion of a cloud, arising from a sudden release of flammable or toxic materials, is an essential tool for properly designing flares, vents and other safety devices and to quantify the potential risk related to the existing ones or arising from the various kinds of accidents which can occur in chemical plants. Among the methods developed to treat the important case of upward-directed jets, Hoehne's procedure for determining the behaviour and extent of flammability zone is extensively utilized, particularly concerning petrochemical plants. In a previous study, a substantial simplification of the aforesaid procedure was achieved, by correlating the experimental data with an empirical formula, allowing to obtain a mathematical description of the boundaries of the flammable cloud. Following a theoretical approach, a most general model is developed in the present work, applicable to the various kinds of design problems and/or risk evaluation regarding upward-directed releases from high velocity sources. It is also demonstrated that the model gives conservative results, if applied outside the range of the Hoehne's experimental conditions. Moreover, with simple modifications, the same approach could be easily applied to deal with the atmospheric dispersion of anyhow directed releases.

Hemodynamic Parameters during Laryngoscopic Procedures in the Office and in the Operating Room.

PubMed

Tierney, William S; Chota, Rebecca L; Benninger, Michael S; Nowacki, Amy S; Bryson, Paul C

2016-09-01

Previous research has shown that office-based laryngoscopic procedures can induce hemodynamic changes, including tachycardia and severe hypertension, calling into question the safety of these procedures. However, comparison between office and operating room (OR) procedures has not been carried out. Therefore, we prospectively measured hemodynamic variables in both settings to compare hemodynamic changes between office and OR procedures. Prospective cohort study. Single academic center. Subjects undergoing office and OR laryngoscopic procedures were prospectively identified, and 92 OR and 70 office subjects were included. Heart rate and blood pressure were measured at established time points before, during, and after the procedures. Descriptive and comparative statistical analyses were conducted. Severe hemodynamic events, either tachycardia or severe hypertension (blood pressure >180 mm Hg systolic or >110 mm Hg diastolic), occurred significantly more frequently in OR than office procedures (41% vs 20%; P = .006). OR severe hemodynamic events occurred more commonly than previously reported rates in the office (41% vs 28%; P = .012). Regression analyses showed that the odds of having a severe hemodynamic event were 3.66 times higher in OR versus office procedures. Severe hemodynamic events are more likely to occur in the OR than in the office during laryngologic procedures. While larger studies will be required to establish rates of dangerous cardiovascular events in laryngoscopic procedures, hemodynamic parameters indicate that office-based procedures have a safety benefit for procedures that can be conducted in either setting. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Evaluating flow cytometer performance with weighted quadratic least squares analysis of LED and multi-level bead data.

PubMed

Parks, David R; El Khettabi, Faysal; Chase, Eric; Hoffman, Robert A; Perfetto, Stephen P; Spidlen, Josef; Wood, James C S; Moore, Wayne A; Brinkman, Ryan R

2017-03-01

We developed a fully automated procedure for analyzing data from LED pulses and multilevel bead sets to evaluate backgrounds and photoelectron scales of cytometer fluorescence channels. The method improves on previous formulations by fitting a full quadratic model with appropriate weighting and by providing standard errors and peak residuals as well as the fitted parameters themselves. Here we describe the details of the methods and procedures involved and present a set of illustrations and test cases that demonstrate the consistency and reliability of the results. The automated analysis and fitting procedure is generally quite successful in providing good estimates of the Spe (statistical photoelectron) scales and backgrounds for all the fluorescence channels on instruments with good linearity. The precision of the results obtained from LED data is almost always better than that from multilevel bead data, but the bead procedure is easy to carry out and provides results good enough for most purposes. Including standard errors on the fitted parameters is important for understanding the uncertainty in the values of interest. The weighted residuals give information about how well the data fits the model, and particularly high residuals indicate bad data points. Known photoelectron scales and measurement channel backgrounds make it possible to estimate the precision of measurements at different signal levels and the effects of compensated spectral overlap on measurement quality. Combining this information with measurements of standard samples carrying dyes of biological interest, we can make accurate comparisons of dye sensitivity among different instruments. Our method is freely available through the R/Bioconductor package flowQB. © 2017 International Society for Advancement of Cytometry. © 2017 International Society for Advancement of Cytometry.

Different matrix evaluation for the bone regeneration of rats' femours using time domain optical coherence tomography

NASA Astrophysics Data System (ADS)

Rusu, Laura-Cristina; Negrutiu, Meda Lavinia; Sinescu, Cosmin; Hoinoiu, Bogdan; Zaharia, Cristian; Ardelean, Lavinia; Duma, Virgil-Florin; Podoleanu, Adrian G.

2014-01-01

The osteoconductive materials are important in bone regeneration procedures. Three dimensional (3D) reconstructions were obtained from the analysis. The aim of this study is to investigate the interface between the femur rat bone and the new bone that is obtained using a method of tissue engineering that is based on two artificial matrixes inserted in previously artificially induced defects. For this study, under strict supervision 20 rats were used in conformity with ethical procedures. In all the femurs a round defect was induced by drilling with a 1 mm spherical Co-Cr surgical drill. The matrixes used were IngeniOss (for ten samples) and 4Bone(for the other ten samples). These materials were inserted into the induced defects. The femurs were investigated at 1 month, after the surgical procedures. The interfaces were examined using Time Domain (TD) Optical Coherence Tomography (OCT) combined with Confocal Microscopy (CM). The scanning procedure is similar to that used in any CM, where the fast scanning is en-face (line rate) and the scanning in depth is much slower (at the frame rate). The optical configuration uses two single mode directional couplers with a superluminiscent diode as the source centered at 1300 nm. The results showed open interfaces due to the insufficient healing process, as well as closed interfaces due to a new bone formation inside the defect. The conclusion of this study is that TD-OCT can act as a valuable tool in the investigation of the interface between the old bone and the one that has been newly created due to the osteoinductive process. The TD-OCT has proven a valuable tool for the non-invasive evaluation of the matrix bone interfaces.

Appropriate interpretation of aerobic capacity: allometric scaling in adult and young soccer players

PubMed Central

Chamari, K; Moussa-Chamari, I; Boussaidi, L; Hachana, Y; Kaouech, F; Wisloff, U

2005-01-01

Objective: To compare aerobic capacity of young and adult elite soccer players using appropriate scaling procedures. Methods: Twenty four male adult (mean (SD) age 24 (2) years, weight 75.7 (7.2) kg, VO2MAX 66.6 (5.2) ml/lbm/min, where lbm is lean body mass in kg) and 21 youth (14 (0.4) years, 60.2 (7.3) kg, 66.5 (5.9) ml/lbm/min) elite soccer players took part in the study. Allometric equations were used to determine the relation between maximal and submaximal oxygen cost of running (running economy) and body mass. Results: Maximal and submaximal oxygen uptake increased in proportion to body mass raised to the power of 0.72 (0.04) and 0.60 (0.06) respectively. The VO2MAX of adult players was similar to that of the youth players when expressed in direct proportion to body mass—that is, ml/kg/min—but 5% higher (p<0.05) when expressed using appropriate procedures for scaling. Conversely, compared with seniors, youth players had 13% higher (p<0.001) energy cost of running—that is, poorer running economy—when expressed as ml/kg/min but not when expressed according to the scaling procedures. Conclusions: Compared with the youth soccer players, VO2MAX in the seniors was underestimated and running economy overestimated when expressed traditionally as ml/lbm/min. The study clearly shows the pitfalls in previous studies when aerobic capacity was evaluated in subjects with different body mass. It further shows that the use of scaling procedures can affect the evaluation of, and the resultant training programme to improve, aerobic capacity. PMID:15665205

Atrial fibrillation ablation using remote magnetic navigation and the risk of atrial-esophageal fistula: international multicenter experience.

PubMed

Danon, Asaf; Shurrab, Mohammed; Nair, Krishnakumar Mohanan; Latcu, Decebal Gabriel; Arruda, Mauricio S; Chen, Xu; Szili-Torok, Tamas; Rossvol, Ole; Wissner, Eric E; Lashevsky, Ilan; Crystal, Eugene

2015-08-01

Remote magnetic navigation (RMN) has been used in various electrophysiological procedures, including atrial fibrillation (AF) ablation. Atrial-esophageal fistula (AEF) is one of most disastrous complications of AF ablation. We aimed to evaluate the incidence of AEF during AF ablation using RMN in comparison to manual ablation. We conducted the first international survey among RMN operators for assessment of the prevalence of AEF and procedural parameters affecting the risk. Data from parallel survey of AEF among Canadian interventional electrophysiologists (CIE) using only manual catheters served as control. Fifteen RMN operators (who performed 3637 procedures) and 25 manual CIE operators (7016 procedures) responded to the survey. RMN operators were more experienced than CIE operators (16.3 ± 8.3 vs. 9.2 ± 5.4 practice years in electrophysiology, p = 0.007). The maximal energy output in the posterior wall was higher in the operator using RMN (33 ± 5 vs. 28.6 ± 4.9 W; p = 0.02). Other parameters including use of preprocedural images, irrigated catheter, pump flow rate, esophageal temperature monitoring, intracardiac echocardiography (ICE), and general anesthesia were similar. CIE operators administered proton-pump inhibitors postoperatively significantly more than RMN operators (76 vs. 35%, p = 0.01). AEF was reported in 5 of the 7016 patients in the control group (0.07%) but in none of the RMN group (p = 0.11). AEF is a rare complication and its evaluation necessitates large-scale studies. Although no AEF case with RMN was reported in this large study or previously on the literature, the rarity of this complication prevents firm conclusion about the risk.

Validation of a Dry Model for Assessing the Performance of Arthroscopic Hip Labral Repair.

PubMed

Phillips, Lisa; Cheung, Jeffrey J H; Whelan, Daniel B; Murnaghan, Michael Lucas; Chahal, Jas; Theodoropoulos, John; Ogilvie-Harris, Darrell; Macniven, Ian; Dwyer, Tim

2017-07-01

Arthroscopic hip labral repair is a technically challenging and demanding surgical technique with a steep learning curve. Arthroscopic simulation allows trainees to develop these skills in a safe environment. The purpose of this study was to evaluate the use of a combination of assessment ratings for the performance of arthroscopic hip labral repair on a dry model. Cross-sectional study; Level of evidence, 3. A total of 47 participants including orthopaedic surgery residents (n = 37), sports medicine fellows (n = 5), and staff surgeons (n = 5) performed arthroscopic hip labral repair on a dry model. Prior arthroscopic experience was noted. Participants were evaluated by 2 orthopaedic surgeons using a task-specific checklist, the Arthroscopic Surgical Skill Evaluation Tool (ASSET), task completion time, and a final global rating scale. All procedures were video-recorded and scored by an orthopaedic fellow blinded to the level of training of each participant. The internal consistency/reliability (Cronbach alpha) using the total ASSET score for the procedure was high (intraclass correlation coefficient > 0.9). One-way analysis of variance for the total ASSET score demonstrated a difference between participants based on the level of training ( F 3,43 = 27.8, P < .001). A good correlation was seen between the ASSET score and previous exposure to arthroscopic procedures ( r = 0.52-0.73, P < .001). The interrater reliability for the ASSET score was excellent (>0.9). The results of this study demonstrate that the use of dry models to assess the performance of arthroscopic hip labral repair by trainees is both valid and reliable. Further research will be required to demonstrate a correlation with performance on cadaveric specimens or in the operating room.

Setting priorities for space research: An experiment in methodology

NASA Technical Reports Server (NTRS)

1995-01-01

In 1989, the Space Studies Board created the Task Group on Priorities in Space Research to determine whether scientists should take a role in recommending priorities for long-term space research initiatives and, if so, to analyze the priority-setting problem in this context and develop a method by which such priorities could be established. After answering the first question in the affirmative in a previous report, the task group set out to accomplish the second task. The basic assumption in developing a priority-setting process is that a reasoned and structured approach for ordering competing initiatives will yield better results than other ways of proceeding. The task group proceeded from the principle that the central criterion for evaluating a research initiative must be its scientific merit -- the value of the initiative to the proposing discipline and to science generally. The group developed a two-stage methodology for priority setting and constructed a procedure and format to support the methodology. The first of two instruments developed was a standard format for structuring proposals for space research initiatives. The second instrument was a formal, semiquantitative appraisal procedure for evaluating competing proposals. This report makes available complete templates for the methodology, including the advocacy statement and evaluation forms, as well as an 11-step schema for a priority-setting process. From the beginning of its work, the task group was mindful that the issue of priority setting increasingly pervades all of federally supported science and that its work would have implications extending beyond space research. Thus, although the present report makes no recommendations for action by NASA or other government agencies, it provides the results of the task group's work for the use of others who may study priority-setting procedures or take up the challenge of implementing them in the future.

Evaluation of standardized sample collection, packaging, and decontamination procedures to assess cross-contamination potential during Bacillus anthracis incident response operations

PubMed Central

Calfee, M. Worth; Tufts, Jenia; Meyer, Kathryn; McConkey, Katrina; Mickelsen, Leroy; Rose, Laura; Dowell, Chad; Delaney, Lisa; Weber, Angela; Morse, Stephen; Chaitram, Jasmine; Gray, Marshall

2016-01-01

Sample collection procedures and primary receptacle (sample container and bag) decontamination methods should prevent contaminant transfer between contaminated and non-contaminated surfaces and areas during bio-incident operations. Cross-contamination of personnel, equipment, or sample containers may result in the exfiltration of biological agent from the exclusion (hot) zone and have unintended negative consequences on response resources, activities and outcomes. The current study was designed to: (1) evaluate currently recommended sample collection and packaging procedures to identify procedural steps that may increase the likelihood of spore exfiltration or contaminant transfer; (2) evaluate the efficacy of currently recommended primary receptacle decontamination procedures; and (3) evaluate the efficacy of outer packaging decontamination methods. Wet- and dry-deposited fluorescent tracer powder was used in contaminant transfer tests to qualitatively evaluate the currently-recommended sample collection procedures. Bacillus atrophaeus spores, a surrogate for Bacillus anthracis, were used to evaluate the efficacy of spray- and wipe-based decontamination procedures. Both decontamination procedures were quantitatively evaluated on three types of sample packaging materials (corrugated fiberboard, polystyrene foam, and polyethylene plastic), and two contamination mechanisms (wet or dry inoculums). Contaminant transfer results suggested that size-appropriate gloves should be worn by personnel, templates should not be taped to or removed from surfaces, and primary receptacles should be selected carefully. The decontamination tests indicated that wipe-based decontamination procedures may be more effective than spray-based procedures; efficacy was not influenced by material type but was affected by the inoculation method. Incomplete surface decontamination was observed in all tests with dry inoculums. This study provides a foundation for optimizing current B. anthracis response procedures to minimize contaminant exfiltration. PMID:27362274

Evaluation of standardized sample collection, packaging, and decontamination procedures to assess cross-contamination potential during Bacillus anthracis incident response operations.

PubMed

Calfee, M Worth; Tufts, Jenia; Meyer, Kathryn; McConkey, Katrina; Mickelsen, Leroy; Rose, Laura; Dowell, Chad; Delaney, Lisa; Weber, Angela; Morse, Stephen; Chaitram, Jasmine; Gray, Marshall

2016-12-01

Sample collection procedures and primary receptacle (sample container and bag) decontamination methods should prevent contaminant transfer between contaminated and non-contaminated surfaces and areas during bio-incident operations. Cross-contamination of personnel, equipment, or sample containers may result in the exfiltration of biological agent from the exclusion (hot) zone and have unintended negative consequences on response resources, activities and outcomes. The current study was designed to: (1) evaluate currently recommended sample collection and packaging procedures to identify procedural steps that may increase the likelihood of spore exfiltration or contaminant transfer; (2) evaluate the efficacy of currently recommended primary receptacle decontamination procedures; and (3) evaluate the efficacy of outer packaging decontamination methods. Wet- and dry-deposited fluorescent tracer powder was used in contaminant transfer tests to qualitatively evaluate the currently-recommended sample collection procedures. Bacillus atrophaeus spores, a surrogate for Bacillus anthracis, were used to evaluate the efficacy of spray- and wipe-based decontamination procedures. Both decontamination procedures were quantitatively evaluated on three types of sample packaging materials (corrugated fiberboard, polystyrene foam, and polyethylene plastic), and two contamination mechanisms (wet or dry inoculums). Contaminant transfer results suggested that size-appropriate gloves should be worn by personnel, templates should not be taped to or removed from surfaces, and primary receptacles should be selected carefully. The decontamination tests indicated that wipe-based decontamination procedures may be more effective than spray-based procedures; efficacy was not influenced by material type but was affected by the inoculation method. Incomplete surface decontamination was observed in all tests with dry inoculums. This study provides a foundation for optimizing current B. anthracis response procedures to minimize contaminant exfiltration.

Training gastroenterology fellows to perform gastric polypectomy using a novel ex vivo model

PubMed Central

Chen, Ming-Jen; Lin, Ching-Chung; Liu, Chia-Yuan; Chen, Chih-Jen; Chang, Chen-Wang; Chang, Ching-Wei; Lee, Chien-Wei; Shih, Shou-Chuan; Wang, Horng-Yuan

2011-01-01

AIM: To evaluate the effect of hands-on training of gastroenterology fellows in gastric polypectomy using an ex vivo simulator. METHODS: Eight gastroenterology fellows at Mackay Memorial Hospital, Taipei were evaluated in gastric polypectomy techniques using a pig stomach with artificial polyps created by a rubber band ligation device. The performance of four second year (year-2) fellows who had undergone one year of clinical training was compared with that of four first year (year-1) fellows both before and after a 4-h workshop using the ex vivo simulator. The workshop allowed for hands-on training in the removal of multiple artificial polyps and the placement of hemoclips at the excision site. Evaluation included observation of technical skills, procedure time, and the fellows’ confidence scale. RESULTS: One week after the workshop, the year-1 fellows were re-evaluated and had significantly improved mean performance scores (from 17.9 ± 1.8 to 22.5 ± 0.7), confidence scale (from 4.5 ± 1.0 to 7.8 ± 0.5) and procedure time (from 615.0 ± 57.4 s to 357.5 ± 85.0 s) compared with their baseline performance. After 4 h of training using the ex vivo simulator, the skills of the year-1 fellows were statistically similar to those of the year-2 fellows. CONCLUSION: Use of this ex vivo simulator significantly improved the endoscopic gastric polypectomy skills of gastroenterology fellows who had not had previous clinical training in gastric polypectomy. PMID:22147969

Dermatological Feasibility of Multimodal Facial Color Imaging Modality for Cross-Evaluation of Facial Actinic Keratosis

PubMed Central

Bae, Youngwoo; Son, Taeyoon; Nelson, J. Stuart; Kim, Jae-Hong; Choi, Eung Ho; Jung, Byungjo

2010-01-01

Background/Purpose Digital color image analysis is currently considered as a routine procedure in dermatology. In our previous study, a multimodal facial color imaging modality (MFCIM), which provides a conventional, parallel- and cross-polarization, and fluorescent color image, was introduced for objective evaluation of various facial skin lesions. This study introduces a commercial version of MFCIM, DermaVision-PRO, for routine clinical use in dermatology and demonstrates its dermatological feasibility for cross-evaluation of skin lesions. Methods/Results Sample images of subjects with actinic keratosis or non-melanoma skin cancers were obtained at four different imaging modes. Various image analysis methods were applied to cross-evaluate the skin lesion and, finally, extract valuable diagnostic information. DermaVision-PRO is potentially a useful tool as an objective macroscopic imaging modality for quick prescreening and cross-evaluation of facial skin lesions. Conclusion DermaVision-PRO may be utilized as a useful tool for cross-evaluation of widely distributed facial skin lesions and an efficient database management of patient information. PMID:20923462

Filling cystoureterography facilitates stone visualization in patients with previously inserted double-J ureteral stents.

PubMed

Kravchick, Sergey George; Shumalinsky, Dmitry; Jeshurun-Koren, Michael; Stepnov, Eugen; Cytron, Shmuel

2005-06-01

In our study, we assessed the ability of a filling cystogram to induce vesicoureteral reflux (VUR) and to evaluate its role in stone targeting during ESWL in the presence of a double-J ureteral stent (JJ-S). Filling cystoureterography was performed during ESWL in 17 patients with previously inserted 4.7 F JJ-S. The examination ended with stone localization. In every procedure, 3,500 shock waves were delivered with an energy range of 18-23 kV. Patients were evaluated 4 weeks after ESWL. A stone-free result was defined as no evidence of calculi in the first or second visits. Because contrast material was employed in this study, we also evaluated its possible interference with the results of lithotripsy. All radiolucent or poorly calcified stones were successfully localized. In four patients, rhythmic suprapubic manual pressure was performed to initiate VUR. Reflux was low grade in 35% and high grade in 65% of renal units. The efficiency quotient reached 59%. In vitro artificial stones were successfully disintegrated both in water and solutions of Ultravist. In the presence of a JJ-S, filling cystography can easily localize radiolucent stones during SWL. No special catheters or stents are required for this technique. Ultravist in particular does not affect the results of ESWL unfavorably.

Comparison of ventricular and lumbar cerebrospinal fluid T cells in non-inflammatory neurological disorder (NIND) patients.

PubMed

Provencio, J Javier; Kivisäkk, Pia; Tucky, Barbara H; Luciano, Mark G; Ransohoff, Richard M

2005-06-01

The aim of the present study was to define the cellular composition of ventricular, as compared with lumbar, cerebrospinal fluid (CSF) in patients with non-inflammatory neurological disorders (NIND). We addressed this issue by determining the cellular composition of lumbar CSF from patients with normal pressure hydrocephalus (NPH) who were undergoing lumbar CSF drainage during evaluation for shunting procedures, and evaluating ventricular CSF from a subset of these who underwent subsequent placement of ventriculoperitoneal shunts. We determined the cellular composition of lumbar CSF from 18 patients with NPH, and found that the leukocyte differentials, and relative proportions of CD4+ and CD8+ central memory (TCM), effector memory (TEM) and naive cell (TNaive) populations, were equivalent to those found previously in studies of CSF from patients with NIND. We further evaluated cells in the ventricular CSF of five patients who had previously undergone lumbar drainage. Leukocyte differential counts, as well as CD4+ and CD8+ TCM, TEM, and TNaive proportions, were equivalent in matched ventricular and lumbar CSF samples. These observations support the hypothesis that leukocytes enter the CSF in a selective fashion, at its site of formation in the choroid plexus. The results implicate CSF T cells in the immune surveillance of the central nervous system.

Comments on using absolute spectrophotometry of Wolf-Rayet stars

NASA Technical Reports Server (NTRS)

Underhill, A. B.

1986-01-01

Garmany et al. (1984) have conducted a study involving spectrophotometric scans of 13 Wolf-Rayet stars. They have found that the application of a 'standard' reddening law to the observed data gives spurious results in many cases. They concluded also that previous attempts to determine the intrinsic continua and the effective temperatures of Wolf-Rayet stars are inadequate. In the present study the conclusions of Garmany et al. are evaluated. According to this evaluation, it has not been demonstrated by Garmany et al., beyond a reasonble doubt, that the interstellar extinction law varies greatly from Wolf-Rayet star to Wolf-Rayet star. The procedure followed by Garmany et al. to find the apparent shape of the ultraviolet continuum of a Wolf-Rayet star is unsatisfactory for a number of reasons.

Monitoring Items in Real Time to Enhance CAT Security

ERIC Educational Resources Information Center

Zhang, Jinming; Li, Jie

2016-01-01

An IRT-based sequential procedure is developed to monitor items for enhancing test security. The procedure uses a series of statistical hypothesis tests to examine whether the statistical characteristics of each item under inspection have changed significantly during CAT administration. This procedure is compared with a previously developed…

42 CFR 422.502 - Evaluation and determination procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Application Procedures and Contracts for Medicare Advantage Organizations § 422.502 Evaluation and determination procedures. (a) Basis for...

Rotary powered device for bone marrow aspiration and biopsy yields excellent specimens quickly and efficiently.

PubMed

Swords, Ronan T; Kelly, Kevin R; Cohen, Stephen C; Miller, Larry J; Philbeck, Thomas E; Hacker, Sander O; Spadaccini, Cathy J; Giles, Francis J; Brenner, Andrew J

2010-06-01

Recently, a new FDA-cleared battery powered bone marrow biopsy system was developed to allow operators access to the bone marrow space quickly and efficiently. A pre-clinical evaluation of the device (OnControl, Vidacare Corporation, San Antonio, TX, USA) on anesthetized pigs was conducted, in addition to a clinical evaluation in hematology clinic patients requiring a bone marrow biopsy. Twenty-six samples were collected from the swine model. No cellular artifact or thermal damage was reported in any of the samples obtained. For the clinical evaluation of the device, 16 patients were recruited. Mean time from needle contact with skin to needle removal was 38.5 +/- 13.94 seconds. No complications were reported. In this study, the manual and powered samples were equivalent in specimen quality. In the patients evaluated, the device was safe, easy to use and the mean procedural time was significantly faster than previously reported with a manual technique.

The 1980 US/Canada wheat and barley exploratory experiment, volume 1

NASA Technical Reports Server (NTRS)

Bizzell, R. M.; Prior, H. L.; Payne, R. W.; Disler, J. M.

1983-01-01

The results from the U.S./Canada Wheat and Barley Exploratory Experiment which was completed during FY 1980 are presented. The results indicate that the new crop identification procedures performed well for spring small grains and that they are conductive to automation. The performance of the machine processing techniques shows a significant improvement over previously evaluated technology. However, the crop calendars will require additional development and refinements prior to integration into automated area estimation technology. The evaluation showed the integrated technology to be capable of producing accurate and consistent spring small grains proportion estimates. However, barley proportion estimation technology was not satisfactorily evaluated. The low-density segments examined were judged not to give indicative or unequivocal results. It is concluded that, generally, the spring small grains technology is ready for evaluation in a pilot experiment focusing on sensitivity analyses to a variety of agricultural and meteorological conditions representative of the global environment. It is further concluded that a strong potential exists for establishing a highly efficient technology or spring small grains.

Evaluation of the toxic properties of naturally weathered Exxon Valdez crude oil to surrogate wildlife species

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

Stubblefield, W.A.; Hancock, G.A.; Ford, W.H.

1995-12-31

The toxic properties of naturally weathered Exxon Valdez crude oil (WEVC) to avian and mammalian wildlife species were evaluated using the surrogate species, mallard duck, Anas platyrhynchos, and European ferret, Mustela putorius. This study was conducted to evaluate the potential for toxic (rather than physical) injury to wildlife species that may have been exposed to WEVC, either through external contact or through dietary uptake. Previous studies have assessed the toxicity of unweathered crude oils, including Alaska North Slope Crude, but little information exists regarding the toxicity of a naturally weathered crude oil, typical of that encountered following a spill. Amore » battery of laboratory toxicity tests was conducted, in compliance with standard and published test procedures, to evaluate acute and subchronic toxicity of WEVC. These included tests of food avoidance, reproductive effects, and direct eggshell application toxicity. Naturally weathered EVC, recovered postspill from Prince William Sound, was used as the test material. 36 refs., 7 figs., 4 tabs.« less

Implications of cost-effectiveness analysis of medical technology. background paper number 5. four common x-ray procedures: problems and prospects for economic evaluation

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

Wagner, J.L.; Krieger, M.J.

This paper is about the economic evaluation of diagnostic procedures. The issue of economic evaluation is explored in the context of four common diagnostic X-ray procedures: the chest X-ray, the skull X-ray, the barium enema study, and the excretory urogram. The paper is divided into two parts. The first part summarizes the different evaluative models underlying studies of the four diagnostic X-ray procedures and to lay out the strengths and weaknesses of each method. The second part contains four separate chapters summarizing what is known about the utilization, costs, risks, and benefits of each procedure, with particular emphasis on themore » evaluative methods employed.« less

Is the frozen elephant trunk procedure superior to the conventional elephant trunk procedure for completion of the second stage?

PubMed

Rustum, Saad; Beckmann, Erik; Wilhelmi, Mathias; Krueger, Heike; Kaufeld, Tim; Umminger, Julia; Haverich, Axel; Martens, Andreas; Shrestha, Malakh

2017-10-01

Our goal was to compare the results and outcomes of second-stage completion in patients who had previously undergone the elephant trunk (ET) or the frozen elephant trunk (FET) procedure for the treatment of complex aortic arch and descending aortic disease. Between August 2001 and December 2014, 53 patients [mean age 61 ± 13 years, 64% (n = 34) male] underwent a second-stage completion procedure. Of these patients, 32% (n = 17) had a previous ET procedure and 68% (n = 36) a previous FET procedure as a first-stage procedure. The median times to the second-stage procedure were 7 (0-78) months in the ET group and 8 (0-66) months in the FET group. The second-stage procedure included thoracic endovascular aortic repair in 53% (n = 28) of patients and open surgical repair in 47% (n = 25). More endovascular interventions were performed in FET patients (61%, n = 22) than in the ET group (35%, n = 6, P = 0.117). The in-hospital mortality rate was significantly lower in the FET (8%, n = 3) group compared with the ET group (29%, n = 5, P = 0.045). The median follow-up time after the second-stage operation for the entire cohort was 4.6 (0.4-10.4) years. The 5-year survival rate was 76% in the ET patients versus 89% in the FET patients (log-rank: P = 0.11). We observed a significantly lower in-hospital mortality rate in the FET group compared to the ET group. This result might be explained by the higher rate of endovascular completion in the FET group. We assume that the FET procedure offers the benefit of a more ideal landing zone, thus facilitating endovascular completion. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Cumulative uncertainty in measured streamflow and water quality data for small watersheds

USGS Publications Warehouse

Harmel, R.D.; Cooper, R.J.; Slade, R.M.; Haney, R.L.; Arnold, J.G.

2006-01-01

The scientific community has not established an adequate understanding of the uncertainty inherent in measured water quality data, which is introduced by four procedural categories: streamflow measurement, sample collection, sample preservation/storage, and laboratory analysis. Although previous research has produced valuable information on relative differences in procedures within these categories, little information is available that compares the procedural categories or presents the cumulative uncertainty in resulting water quality data. As a result, quality control emphasis is often misdirected, and data uncertainty is typically either ignored or accounted for with an arbitrary margin of safety. Faced with the need for scientifically defensible estimates of data uncertainty to support water resource management, the objectives of this research were to: (1) compile selected published information on uncertainty related to measured streamflow and water quality data for small watersheds, (2) use a root mean square error propagation method to compare the uncertainty introduced by each procedural category, and (3) use the error propagation method to determine the cumulative probable uncertainty in measured streamflow, sediment, and nutrient data. Best case, typical, and worst case "data quality" scenarios were examined. Averaged across all constituents, the calculated cumulative probable uncertainty (??%) contributed under typical scenarios ranged from 6% to 19% for streamflow measurement, from 4% to 48% for sample collection, from 2% to 16% for sample preservation/storage, and from 5% to 21% for laboratory analysis. Under typical conditions, errors in storm loads ranged from 8% to 104% for dissolved nutrients, from 8% to 110% for total N and P, and from 7% to 53% for TSS. Results indicated that uncertainty can increase substantially under poor measurement conditions and limited quality control effort. This research provides introductory scientific estimates of uncertainty in measured water quality data. The results and procedures presented should also assist modelers in quantifying the "quality"of calibration and evaluation data sets, determining model accuracy goals, and evaluating model performance.

Da Vinci robot error and failure rates: single institution experience on a single three-arm robot unit of more than 700 consecutive robot-assisted laparoscopic radical prostatectomies.

PubMed

Zorn, Kevin C; Gofrit, Ofer N; Orvieto, Marcelo A; Mikhail, Albert A; Galocy, R Matthew; Shalhav, Arieh L; Zagaja, Gregory P

2007-11-01

Previous reports have suggested that a 2% to 5% device failure rate (FR) be quoted when counseling patients about robot-assisted laparoscopic radical prostatectomy (RLRP). We sought to evaluate our FR on the da Vinci system. Since February 2003, more than 800 RLRPs have been performed at our institution using a single three-armed robotic unit. A prospective database was analyzed to determine the device FR and whether it resulted in case abortion or open conversion. Intuitive Surgical Systems provided data concerning the system's performance, including its fault rate. Error messages were classified as recoverable and non-recoverable faults. Between February 2003 and November 2006, 725 RLRP cases were available for evaluation. There were no intraoperative device failures that resulted in a case conversion. Technical errors resulting in surgeon handicap occurred in 3 cases (0.4%). Four patients (0.5%) had their procedures aborted secondary to system failure at initial set-up prior to patient entrance to the operating room. Data analysis retrieved from the da Vinci console reported on a total of 807 procedures since 2003. Only 4 cases (0.4%) were reported from the Intuitive Surgical database to result in either an aborted or a converted case, which compares favorably with our results. Since the last computer system upgrade (September 2005), the mean recoverable and non-recoverable fault rates per procedure were 0.21 and 0.05, respectively. For all the advanced features the da Vinci system offers, it is surprisingly reliable. Throughout our RLRP experience, device failure resulted in case conversion, procedure abortion, and surgeon handicap in 0, 0.5%, and 0.4% of procedures, respectively. As such, a lowered device FR of 0.5% should be used when counseling patients undergoing RLRP. To avoid futile general anesthesia, a policy should be enforced to ensure that the da Vinci system is completely set up before the patient enters the operating room.

Use of repeat anterior maxillary distraction to correct residual midface hypoplasia in cleft patients

PubMed Central

2017-01-01

Objectives The study was designed to evaluate the efficacy of performing a second, repeat anterior maxillary distraction (AMD) to treat residual cleft maxillary hypoplasia. Materials and Methods Five patients between the ages of 12 to 15 years with a history of AMD and with residual cleft maxillary hypoplasia were included in the study. Inclusion was irrespective of gender, type of cleft lip and palate, and the amount of advancement needed. Repeat AMD was executed in these patients 4 to 5 years after the primary AMD procedure to correct the cleft maxillary hypoplasia that had developed since the initial procedure. Orthopantomogram (OPG) and lateral cephalograms were taken for evaluation preoperatively, immediately after distraction, after consolidation, and one year postoperatively. The data obtained was tabulated and a Mann Whitney U-test was used for statistical comparisons. Results At the time of presentation, a residual maxillary hypoplasia was observed with a well maintained distraction gap on the OPG which ruled out the occurrence of a relapse. Favorable movement of the segments without any resistance was seen in all patients. Mean maxillary advancement of 10.56 mm was achieved at repeat AMD. Statistically significant increases in midfacial length, SNA angle, and nasion perpendicular to point A distance was achieved (P=0.012, P=0.011, and P=0.012, respectively). Good profile was achieved for all patients. Minimal transient complications, for example anterior open bite and bleeding episodes, were managed. Conclusion Addressing the problem of cleft maxillary hypoplasia at an early age (12–15 years) is beneficial for the child. Residual hypoplasia may develop in some patients, which may require additional corrective procedures. The results of our study show that AMD can be repeated when residual deformity develops with the previous procedure having no negative impact on the results of the repeat procedure. PMID:29333371

[Benefits of the classical approach in surgery for pulmonary metastases].

PubMed

Horák, P; Pospísil, R; Poloucek, P

2011-03-01

Distant metastases remain a significant problem in the treatment of malignancies. Surgical management of pulmonary metastases is considered valuable from the oncological view only on condition that R0 resection can be achieved. The whole spectrum of resection procedures can be used, however most commonly, extraanatomic lung resections are employed. It has not been fully evaluated whether the same efficacy can be obtained with thoracoscopic procedures. The aim was to compare the study complication rates with literature data. The secondary aim was to evaluate the benefit of intraoperative lung palpation examination. The authors present a retrospective study in a group of subjects operated for secondary pulmonary malignancies in the Motol Charles University 2nd Medical Faculty and Faculty Hospital Surgical Clinic, from 2003 to 2007. The authors compared the patient group's morbidity and 30-day mortality rates with literature data. Preoperative CT findings, intraoperative palpation findings and histological examination findings were assessed. Postoperative morbidity of the operated subjects was 16.5%, postoperative 30-day mortality was 0%. The authors compared the preoperative diagnostic data based on CT, the intraoperative findings and histological findings. During the total of 77 surgical procedures, including open and VATS procedures, the authors performed intraoperative palpation examination and detected 60 foci (24.6% out of the total removed foci) previously undetected on CT. All of the foci were of less than 5mm and in 55 cases, the foci were proved metastases. The outcome data showing low postoperative morbidity rates and nul 30-day mortality have confirmed that pulmonary metastasectomy is a safe method, a part of the complex oncological management. A surgeon's palpation finding is considered unsubstitutable in the detection of all lung foci and for necessary orientation in order to identify the safety margin in wedge resections. Therefore, the authors prefer the open or videoassissted approach to purely miniinvasive procedures.

Magnetic compression ostomy for simple tube colostomy in rats--magnacolostomy.

PubMed

Uygun, Ibrahim; Okur, Mehmet H; Arayici, Yilmaz; Keles, Aysenur; Ozturk, Hayrettin; Otcu, Selcuk

2012-01-01

Magnetic compression anastomoses (magnamosis) have been previously described for gastrointestinal, biliary, urinary, and vascular anastomoses. Objectives. Herein, the authors report the creation of a magnetic compression colostomy (magnacolostomy) using a simple technique in rats. Animals were randomized into two groups (n = 8, each): a magnetic colostomy (MC) group and a control surgical tube colostomy (SC) group. In the MC group, the first magnetic ball (3 mm) was rectally introduced into the rat colon. The second magnetic ball (4 mm) was placed subcutaneously into the left quadrant, and the two magnetic balls strongly coupled. On postoperative day 20 for the MC group and postoperative day 10 in the SC group, the rats were sacrificed and the colostomies evaluated macroscopically, histopathologically, and for mechanical burst testing. From the macroscopic evaluation, two rats failed to form the colostomy canal due to colostomy catheter and magnetic ball removal. In the remaining rats, evidence of complications were not observed. Two rats in the MC group displayed mild adhesion and all rats in the SC group displayed moderate adhesion. No significant differences between the burst pressures were observed. However, a significant difference (p < 0.001) between the procedure times of the MC (4.13 +/- 1.00 minutes) and SC groups (14.25 +/- 2.05 minutes) was evident. Magnacolostomy is an easy and effective procedure in the rat model and presents a safe, minimally invasive alternative to current tube colostomy procedures such as antegrade continence enemas, percutaneous endoscopic, and colostomy/cecostomy in humans.

Biclustering of gene expression data using reactive greedy randomized adaptive search procedure.

PubMed

Dharan, Smitha; Nair, Achuthsankar S

2009-01-30

Biclustering algorithms belong to a distinct class of clustering algorithms that perform simultaneous clustering of both rows and columns of the gene expression matrix and can be a very useful analysis tool when some genes have multiple functions and experimental conditions are diverse. Cheng and Church have introduced a measure called mean squared residue score to evaluate the quality of a bicluster and has become one of the most popular measures to search for biclusters. In this paper, we review basic concepts of the metaheuristics Greedy Randomized Adaptive Search Procedure (GRASP)-construction and local search phases and propose a new method which is a variant of GRASP called Reactive Greedy Randomized Adaptive Search Procedure (Reactive GRASP) to detect significant biclusters from large microarray datasets. The method has two major steps. First, high quality bicluster seeds are generated by means of k-means clustering. In the second step, these seeds are grown using the Reactive GRASP, in which the basic parameter that defines the restrictiveness of the candidate list is self-adjusted, depending on the quality of the solutions found previously. We performed statistical and biological validations of the biclusters obtained and evaluated the method against the results of basic GRASP and as well as with the classic work of Cheng and Church. The experimental results indicate that the Reactive GRASP approach outperforms the basic GRASP algorithm and Cheng and Church approach. The Reactive GRASP approach for the detection of significant biclusters is robust and does not require calibration efforts.

Progression following neoadjuvant systemic chemotherapy may not be a contraindication to a curative approach for colorectal carcinomatosis.

PubMed

Passot, Guillaume; Vaudoyer, Delphine; Cotte, Eddy; You, Benoit; Isaac, Sylvie; Noël Gilly, François; Mohamed, Faheez; Glehen, Olivier

2012-07-01

The objective of this retrospective study was to evaluate the influence of neoadjuvant systemic chemotherapy on patients with colorectal carcinomatosis before a curative procedure. Peritoneal carcinomatosis (PC) from colorectal cancer may be treated with a curative intent by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The role of perioperative systemic chemotherapy for this particular metastatic disease remains unclear. One hundred twenty patients with PC from colorectal cancer were consecutively treated by 131 procedures combining CRS with HIPEC. The response to neoadjuvant systemic chemotherapy was assessed on data from previous explorative surgery and/or radiological imaging. Ninety patients (75%) were treated with neoadjuvant systemic chemotherapy in whom 32 (36%) were considered to have responded, 19 (21%) had stable disease, and 19 (21%) developed diseases progression. Response could not be evaluated in 20 patients (22%). On univariate analysis, the use of neoadjuvant systemic chemotherapy had a significant positive prognostic influence (P = 0.042). On multivariate analysis, the completeness of CRS and the use of adjuvant systemic chemotherapy were the only significant prognostic factors (P < 0.001 and P = 0.049, respectively). Response to neoadjuvant systemic chemotherapy had no significant prognostic impact with median survival of 31.4 months in patients showing disease progression. In patients with PC from colorectal cancer without extraperitoneal metastases, failure of neoadjuvant systemic chemotherapy should not constitute an absolute contraindication to a curative procedure combining CRS and HIPEC.

(GTG)5 MSP-PCR fingerprinting as a technique for discrimination of wine associated yeasts?

PubMed

Ramírez-Castrillón, Mauricio; Mendes, Sandra Denise Camargo; Inostroza-Ponta, Mario; Valente, Patricia

2014-01-01

In microbiology, identification of all isolates by sequencing is still unfeasible in small research laboratories. Therefore, many yeast diversity studies follow a screening procedure consisting of clustering the yeast isolates using MSP-PCR fingerprinting, followed by identification of one or a few selected representatives of each cluster by sequencing. Although this procedure has been widely applied in the literature, it has not been properly validated. We evaluated a standardized protocol using MSP-PCR fingerprinting with the primers (GTG)5 and M13 for the discrimination of wine associated yeasts in South Brazil. Two datasets were used: yeasts isolated from bottled wines and vineyard environments. We compared the discriminatory power of both primers in a subset of 16 strains, choosing the primer (GTG)5 for further evaluation. Afterwards, we applied this technique to 245 strains, and compared the results with the identification obtained by partial sequencing of the LSU rRNA gene, considered as the gold standard. An array matrix was constructed for each dataset and used as input for clustering with two methods (hierarchical dendrograms and QAPGrid layout). For both yeast datasets, unrelated species were clustered in the same group. The sensitivity score of (GTG)5 MSP-PCR fingerprinting was high, but specificity was low. As a conclusion, the yeast diversity inferred in several previous studies may have been underestimated and some isolates were probably misidentified due to the compliance to this screening procedure.

(GTG)5 MSP-PCR Fingerprinting as a Technique for Discrimination of Wine Associated Yeasts?

PubMed Central

Inostroza-Ponta, Mario; Valente, Patricia

2014-01-01

In microbiology, identification of all isolates by sequencing is still unfeasible in small research laboratories. Therefore, many yeast diversity studies follow a screening procedure consisting of clustering the yeast isolates using MSP-PCR fingerprinting, followed by identification of one or a few selected representatives of each cluster by sequencing. Although this procedure has been widely applied in the literature, it has not been properly validated. We evaluated a standardized protocol using MSP-PCR fingerprinting with the primers (GTG)5 and M13 for the discrimination of wine associated yeasts in South Brazil. Two datasets were used: yeasts isolated from bottled wines and vineyard environments. We compared the discriminatory power of both primers in a subset of 16 strains, choosing the primer (GTG)5 for further evaluation. Afterwards, we applied this technique to 245 strains, and compared the results with the identification obtained by partial sequencing of the LSU rRNA gene, considered as the gold standard. An array matrix was constructed for each dataset and used as input for clustering with two methods (hierarchical dendrograms and QAPGrid layout). For both yeast datasets, unrelated species were clustered in the same group. The sensitivity score of (GTG)5 MSP-PCR fingerprinting was high, but specificity was low. As a conclusion, the yeast diversity inferred in several previous studies may have been underestimated and some isolates were probably misidentified due to the compliance to this screening procedure. PMID:25171185

[From data entry to data presentation at a clinical workstation--experiences with Anesthesia Information Management Systems (AIMS)].

PubMed

Benson, M; Junger, A; Quinzio, L; Michel, A; Sciuk, G; Fuchs, C; Marquardt, K; Hempelmannn, G

2000-09-01

Anesthesia Information Management Systems (AIMS) are required to supply large amounts of data for various purposes such as performance recording, quality assurance, training, operating room management and research. It was our objective to establish an AIMS that enables every member of the department to independently access queries at his/her work station and at the same time allows the presentation of data in a suitable manner in order to increase the transfer of different information to the clinical workstation. Apple Macintosh Clients (Apple Computer, Inc. Cupertino, California) and the file- and database servers were installed into the already partially existing hospital network. The most important components installed on each computer are the anesthesia documenting software NarkoData (ProLogic GmbH, Erkrath), HIS client software and a HTML browser. More than 250 queries for easy evaluation were formulated with the software Voyant (Brossco Systems, Espoo, Finland). Together with the documentation they are the evaluation module of the AIMS. Today, more than 20,000 anesthesia procedures are recorded each year at 112 decentralised workstations with the AIMS. In 1998, 90.8% of the 20,383 performed anesthetic procedures were recorded online and 9.2% entered postopeatively into the system. With a corresponding user access it is possible to receive all available patient data at each single anesthesiological workstation via HIS (diagnoses, laboratory results) anytime. The available information includes previous anesthesia records, statistics and all data available from the hospitals intranet. This additional information is of great advantage in comparison to previous working conditions. The implementation of an AIMS allowed to greatly enhance the quota but also the quality of documentation and an increased flow of information at the anesthesia workstation. The circuit between data entry and the presentation and evaluation of data, statistics and results directly available at the clinical workstation was put into practice.

Comparison study of two procedures for the determination of emamectin benzoate in medicated fish feed.

PubMed

Farer, Leslie J; Hayes, John M

2005-01-01

A new method has been developed for the determination of emamectin benzoate in fish feed. The method uses a wet extraction, cleanup by solid-phase extraction, and quantitation and separation by liquid chromatography (LC). In this paper, we compare the performance of this method with that of a previously reported LC assay for the determination of emamectin benzoate in fish feed. Although similar to the previous method, the new procedure uses a different sample pretreatment, wet extraction, and quantitation method. The performance of the new method was compared with that of the previously reported method by analyses of 22 medicated feed samples from various commercial sources. A comparison of the results presented here reveals slightly lower assay values obtained with the new method. Although a paired sample t-test indicates the difference in results is significant, this difference is within the method precision of either procedure.

Successful Outcome of Modified Quad Surgical Procedure in Preteen and Teen Patients with Brachial Plexus Birth Palsy

PubMed Central

Nath, Rahul K.; Somasundaram, Chandra

2012-01-01

Objective: To evaluate the outcome of modified Quad procedure in preteen and teen patients with brachial plexus birth palsy. Background: We have previously demonstrated a significant improvement in shoulder abduction, resulting from the modified Quad procedure in children (mean age 2.5 years; range, 0.5–9 years) with obstetric brachial plexus injury. Methods: We describe in this report the outcome of 16 patients (6 girls and 10 boys; 7 preteen and 9 teen) who have undergone the modified Quad procedure for the correction of the shoulder function, specifically abduction. The patients underwent transfer of the latissimus dorsi and teres major muscles, release of contractures of subscapularis pectoralis major and minor, and axillary nerve decompression and neurolysis (the modified Quad procedure). Mean age of these patients at surgery was 13.5 years (range, 10.1–17.9 years). Results: The mean preoperative total Mallet score was 14.8 (range, 10–20), and active abduction was 84° (range, 20°–140°). At a mean follow-up of 1.5 years, the mean postoperative total Mallet score increased to 19.7 (range, 13–25, P < .0001), and the mean active abduction improved to 132° (range, 40°–180°, P < .0003). Conclusion: The modified Quad procedure greatly improves not only the active abduction but also other shoulder functions in preteen and teen patients, as this outcome is the combined result of decompression and neurolysis of the axillary nerve and the release of the contracted internal rotators of the shoulder. PMID:23308301

The child's perspective on discomfort during medical research procedures: a descriptive study.

PubMed

Staphorst, Mira S; Benninga, Marc A; Bisschoff, Margriet; Bon, Irma; Busschbach, Jan J V; Diederen, Kay; van Goudoever, Johannes B; Haarman, Eric G; Hunfeld, Joke A M; Jaddoe, Vincent V W; de Jong, Karin J M; de Jongste, Johan C; Kindermann, Angelika; Königs, Marsh; Oosterlaan, Jaap; Passchier, Jan; Pijnenburg, Mariëlle W; Reneman, Liesbeth; Ridder, Lissy de; Tamminga, Hyke G; Tiemeier, Henning W; Timman, Reinier; van de Vathorst, Suzanne

2017-08-01

The evaluation of discomfort in paediatric research is scarcely evidence-based. In this study, we make a start in describing children's self-reported discomfort during common medical research procedures and compare this with discomfort during dental check-ups which can be considered as a reference level of a 'minimal discomfort' medical procedure. We exploratory study whether there are associations between age, anxiety-proneness, gender, medical condition, previous experiences and discomfort. We also describe children's suggestions for reducing discomfort. Cross-sectional descriptive study. Paediatric research at three academic hospitals. 357 children with and without illnesses (8-18 years, mean=10.6 years) were enrolled: 307 from paediatric research studies and 50 from dental care. We measured various generic forms of discomfort (nervousness, annoyance, pain, fright, boredom, tiredness) due to six common research procedures: buccal swabs, MRI scans, pulmonary function tests, skin prick tests, ultrasound imaging and venepunctures. Most children reported limited discomfort during the research procedures (means: 1-2.6 on a scale from 1 to 5). Compared with dental check-ups, buccal swab tests, skin prick tests and ultrasound imaging were less discomforting, while MRI scans, venepunctures and pulmonary function tests caused a similar degree of discomfort. 60.3% of the children suggested providing distraction by showing movies to reduce discomfort. The exploratory analyses suggested a positive association between anxiety-proneness and discomfort. The findings of this study support the acceptability of participation of children in the studied research procedures, which stimulates evidence-based research practice. Furthermore, the present study can be considered as a first step in providing benchmarks for discomfort of procedures in paediatric research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The child's perspective on discomfort during medical research procedures: a descriptive study

PubMed Central

Staphorst, Mira S; Benninga, Marc A; Bisschoff, Margriet; Bon, Irma; Busschbach, Jan J V; Diederen, Kay; van Goudoever, Johannes B; Haarman, Eric G; Hunfeld, Joke A M; Jaddoe, Vincent V W; de Jong, Karin J M; de Jongste, Johan C; Kindermann, Angelika; Königs, Marsh; Oosterlaan, Jaap; Passchier, Jan; Pijnenburg, Mariëlle W; Reneman, Liesbeth; de Ridder, Lissy; Tamminga, Hyke G; Tiemeier, Henning W; Timman, Reinier; van de Vathorst, Suzanne

2017-01-01

Objective The evaluation of discomfort in paediatric research is scarcely evidence-based. In this study, we make a start in describing children's self-reported discomfort during common medical research procedures and compare this with discomfort during dental check-ups which can be considered as a reference level of a ‘minimal discomfort’ medical procedure. We exploratory study whether there are associations between age, anxiety-proneness, gender, medical condition, previous experiences and discomfort. We also describe children's suggestions for reducing discomfort. Design Cross-sectional descriptive study. Setting Paediatric research at three academic hospitals. Patients 357 children with and without illnesses (8–18 years, mean=10.6 years) were enrolled: 307 from paediatric research studies and 50 from dental care. Main outcome measures We measured various generic forms of discomfort (nervousness, annoyance, pain, fright, boredom, tiredness) due to six common research procedures: buccal swabs, MRI scans, pulmonary function tests, skin prick tests, ultrasound imaging and venepunctures. Results Most children reported limited discomfort during the research procedures (means: 1–2.6 on a scale from 1 to 5). Compared with dental check-ups, buccal swab tests, skin prick tests and ultrasound imaging were less discomforting, while MRI scans, venepunctures and pulmonary function tests caused a similar degree of discomfort. 60.3% of the children suggested providing distraction by showing movies to reduce discomfort. The exploratory analyses suggested a positive association between anxiety-proneness and discomfort. Conclusions The findings of this study support the acceptability of participation of children in the studied research procedures, which stimulates evidence-based research practice. Furthermore, the present study can be considered as a first step in providing benchmarks for discomfort of procedures in paediatric research. PMID:28765130

Financial Impact of Allogeneic Hematopoietic Cell Transplantation on Patients and Families over 2-years: Results from a Multicenter Pilot Study

PubMed Central

Denzen, Ellen M.; Thao, Viengneesee; Hahn, Theresa; Lee, Stephanie J.; McCarthy, Philip L.; Rizzo, J. Douglas; Ammi, Monique; Drexler, Rebecca; Flesch, Susan; James, Heather; Omondi, Nancy; Murphy, Elizabeth; Pederson, Kate; Majhail, Navneet S.

2016-01-01

Hematopoietic cell transplantation (HCT) is a procedure that can significantly influence the socioeconomic wellbeing of patients, caregivers and their families. Among 30 allogeneic HCT recipients and their caregivers enrolled on a pilot study evaluating the feasibility of studying financial impact of HCT, 16 agreed to participate in the long-term phase, completed a baseline questionnaire and received phone interviews at 6, 12, 18 and 24 months post-HCT. Analyses showed that by 2-years post-HCT, 54% of patients who previously contributed to household earnings had not returned to work and 80% of patients/caregivers reported transplant as having moderate to great impact on household income. However, patients’ level of confidence in their ability to meet household financial obligations increased from baseline to 2-years. A relatively large proportion of patients reported inability to pay for medical care through this time period. Case studies demonstrated patient individual perception of financial impact of HCT varies considerably, regardless of actual income. We demonstrate the feasibility of conducting a study to evaluate financial impact of allogeneic HCT through 2-years post-transplantation. Some patients/caregivers continue to experience significant long-term financial burden after this procedure. Our study lays the foundation for a larger evaluation of patient/caregiver financial burden associated with HCT. PMID:27088381

Validation of Universal Scale in Oral Surgery (USOS) for Patient's Psycho-emotional Status Rating.

PubMed

Astramskaite, Inesa; Pinchasov, Ginnady; Gervickas, Albinas; Sakavicius, Dalius; Juodzbalys, Gintaras

2017-01-01

There aren't any objective methods that may help in standard evaluation of oral surgery patient's psycho-emotional status. Without any standardized evaluation, two main problems appear: heterogeneity between studies and ineffective patient's evaluation. Therefore, Universal Scale in Oral Surgery (USOS) for patient's psycho-emotional status rating has previously been proposed by authors. The aim of present study is to assess the clinical effectivity and validate the Universal Scale in Oral Surgery in case of outpatient tooth extraction for adult healthy patients. Clinical trial to validate the USOS for patient's psycho-emotional status rating was performed. In total 90 patients, that came for outpatient dental extraction to Lithuanian University of Health Sciences Oral and Maxillofacial Surgery Department ambulatory, were enrolled in clinical trial. Patients filled self-reported questionnaires before the procedure. Operating surgeon rated USOS for patient's psycho-emotional status rating doctor's part questionnaire after the procedure. 4 - 6 weeks later all patients were asked to fill USOS for patient's psycho-emotional status rating questionnaire retrospectively. According to the statistical analysis, the final composition of USOS for patient's psycho-emotional status rating that would fit to reliability coefficient should be composed from 6 patient part questions and 3 general doctor part questions. Universal Scale in Oral Surgery for patient's psycho-emotional status rating is a novel, doctor and patient rated scale which is suitable for clinical and scientific usage.

Financial impact of allogeneic hematopoietic cell transplantation on patients and families over 2 years: results from a multicenter pilot study.

PubMed

Denzen, E M; Thao, V; Hahn, T; Lee, S J; McCarthy, P L; Rizzo, J D; Ammi, M; Drexler, R; Flesch, S; James, H; Omondi, N; Murphy, E; Pederson, K; Majhail, N S

2016-09-01

Hematopoietic cell transplantation (HCT) is a procedure that can significantly influence the socioeconomic wellbeing of patients, caregivers and their families. Among 30 allogeneic HCT recipients and their caregivers enrolled on a pilot study evaluating the feasibility of studying financial impact of HCT, 16 agreed to participate in the long-term phase, completed a baseline questionnaire and received phone interviews at 6, 12, 18 and 24 months post HCT. Analyses showed that by 2 years post HCT, 54% of patients who previously contributed to household earnings had not returned to work and 80% of patients/caregivers reported transplant as having moderate to great impact on household income. However, patients' levels of confidence in their abilities to meet household financial obligations increased from baseline to 2 years. A relatively large proportion of patients reported inability to pay for medical care through this time period. Case studies demonstrated that patients' individual perceptions of the financial impact of HCT varies considerably, regardless of actual income. We demonstrate the feasibility of conducting a study to evaluate the financial impact of allogeneic HCT through 2 years post transplantation. Some patients/caregivers continue to experience a significant long-term financial burden after this procedure. Our study lays the foundation for a larger evaluation of patient/caregiver financial burden associated with HCT.

Systematic Evaluation of Professional Performance: Legally Supported Procedure and Process.

ERIC Educational Resources Information Center

Kerl, Stella Beatriz; Garcia, John L.; McCullough, C. Sue; Maxwell, Melissa Elaine

2002-01-01

Legal challenges to counseling students' dismissal that are based on interpersonal or clinical incompetence require sound systematic academic evaluation and adherence to procedural and substantive due process. Presents an examination of professional competency from counselor education and legal perspectives, an evaluation procedure and process,…

28 CFR 104.31 - Procedure for claims evaluation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Procedure for claims evaluation. 104.31 Section 104.31 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) SEPTEMBER 11TH VICTIM... any required documents. (b) Procedural tracks. Each claim will be placed on a procedural track...

28 CFR 104.31 - Procedure for claims evaluation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Procedure for claims evaluation. 104.31 Section 104.31 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) SEPTEMBER 11TH VICTIM... any required documents. (b) Procedural tracks. Each claim will be placed on a procedural track...

Assessment of CAPRI predictions in rounds 3-5 shows progress in docking procedures.

PubMed

Méndez, Raúl; Leplae, Raphaël; Lensink, Marc F; Wodak, Shoshana J

2005-08-01

The current status of docking procedures for predicting protein-protein interactions starting from their three-dimensional (3D) structure is reassessed by evaluating blind predictions, performed during 2003-2004 as part of Rounds 3-5 of the community-wide experiment on Critical Assessment of PRedicted Interactions (CAPRI). Ten newly determined structures of protein-protein complexes were used as targets for these rounds. They comprised 2 enzyme-inhibitor complexes, 2 antigen-antibody complexes, 2 complexes involved in cellular signaling, 2 homo-oligomers, and a complex between 2 components of the bacterial cellulosome. For most targets, the predictors were given the experimental structures of 1 unbound and 1 bound component, with the latter in a random orientation. For some, the structure of the free component was derived from that of a related protein, requiring the use of homology modeling. In some of the targets, significant differences in conformation were displayed between the bound and unbound components, representing a major challenge for the docking procedures. For 1 target, predictions could not go to completion. In total, 1866 predictions submitted by 30 groups were evaluated. Over one-third of these groups applied completely novel docking algorithms and scoring functions, with several of them specifically addressing the challenge of dealing with side-chain and backbone flexibility. The quality of the predicted interactions was evaluated by comparison to the experimental structures of the targets, made available for the evaluation, using the well-agreed-upon criteria used previously. Twenty-four groups, which for the first time included an automatic Web server, produced predictions ranking from acceptable to highly accurate for all targets, including those where the structures of the bound and unbound forms differed substantially. These results and a brief survey of the methods used by participants of CAPRI Rounds 3-5 suggest that genuine progress in the performance of docking methods is being achieved, with CAPRI acting as the catalyst.

Integrated Test and Evaluation Flight Test 3 Flight Test Plan

NASA Technical Reports Server (NTRS)

Marston, Michael Lawrence

2015-01-01

The desire and ability to fly Unmanned Aircraft Systems (UAS) in the National Airspace System (NAS) is of increasing urgency. The application of unmanned aircraft to perform national security, defense, scientific, and emergency management are driving the critical need for less restrictive access by UAS to the NAS. UAS represent a new capability that will provide a variety of services in the government (public) and commercial (civil) aviation sectors. The growth of this potential industry has not yet been realized due to the lack of a common understanding of what is required to safely operate UAS in the NAS. NASA's UAS Integration into the NAS Project is conducting research in the areas of Separation Assurance/Sense and Avoid Interoperability, Human Systems Integration (HSI), and Communication to support reducing the barriers of UAS access to the NAS. This research is broken into two research themes namely, UAS Integration and Test Infrastructure. UAS Integration focuses on airspace integration procedures and performance standards to enable UAS integration in the air transportation system, covering Sense and Avoid (SAA) performance standards, command and control performance standards, and human systems integration. The focus of Test Infrastructure is to enable development and validation of airspace integration procedures and performance standards, including the integrated test and evaluation. In support of the integrated test and evaluation efforts, the Project will develop an adaptable, scalable, and schedulable relevant test environment capable of evaluating concepts and technologies for unmanned aircraft systems to safely operate in the NAS. To accomplish this task, the Project will conduct a series of Human-in-the-Loop and Flight Test activities that integrate key concepts, technologies and/or procedures in a relevant air traffic environment. Each of the integrated events will build on the technical achievements, fidelity and complexity of the previous tests and technical simulations, resulting in research findings that support the development of regulations governing the access of UAS into the NAS.

UAS Integration in the NAS Project: Integrated Test and Evaluation (IT&E) Flight Test 3. Revision E

NASA Technical Reports Server (NTRS)

Marston, Michael

2015-01-01

The desire and ability to fly Unmanned Aircraft Systems (UAS) in the National Airspace System (NAS) is of increasing urgency. The application of unmanned aircraft to perform national security, defense, scientific, and emergency management are driving the critical need for less restrictive access by UAS to the NAS. UAS represent a new capability that will provide a variety of services in the government (public) and commercial (civil) aviation sectors. The growth of this potential industry has not yet been realized due to the lack of a common understanding of what is required to safely operate UAS in the NAS. NASA's UAS Integration into the NAS Project is conducting research in the areas of Separation Assurance/Sense and Avoid Interoperability, Human Systems Integration (HSI), and Communication to support reducing the barriers of UAS access to the NAS. This research is broken into two research themes namely, UAS Integration and Test Infrastructure. UAS Integration focuses on airspace integration procedures and performance standards to enable UAS integration in the air transportation system, covering Sense and Avoid (SAA) performance standards, command and control performance standards, and human systems integration. The focus of Test Infrastructure is to enable development and validation of airspace integration procedures and performance standards, including the integrated test and evaluation. In support of the integrated test and evaluation efforts, the Project will develop an adaptable, scalable, and schedulable relevant test environment capable of evaluating concepts and technologies for unmanned aircraft systems to safely operate in the NAS. To accomplish this task, the Project will conduct a series of Human-in-the-Loop and Flight Test activities that integrate key concepts, technologies and/or procedures in a relevant air traffic environment. Each of the integrated events will build on the technical achievements, fidelity and complexity of the previous tests and technical simulations, resulting in research findings that support the development of regulations governing the access of UAS into the NAS.

The effects of previous open renal stone surgery types on PNL outcomes

PubMed Central

Ozgor, Faruk; Kucuktopcu, Onur; Ucpinar, Burak; Sarilar, Omer; Erbin, Akif; Yanaral, Fatih; Sahan, Murat; Binbay, Murat

2016-01-01

Introduction: Our aim was to demonstrate the effect of insicion of renal parenchyma during open renal stone surgery (ORSS) on percutaneous nephrolithotomy (PNL) outcomes. Methods: Patients with history of ORSS who underwent PNL operation between June 2005 and June 2015 were analyzed retrospectively. Patients were divided into two groups according to their type of previous ORSS. Patients who had a history of ORSS with parenchymal insicion, such as radial nephrotomies, anatrophic nephrolithotomy, lower pole resection, and partial nephrectomy, were included in Group 1. Other patients with a history of open pyelolithotomy were enrolled in Group 2. Preoperative characteristics, perioperative data, stone-free status, and complications were compared between the groups. Stone-free status was defined as complete clearance of stone(s) or presence of residual fragments smaller than 4 mm. The retrospective nature of our study, different experience level of surgeons, and lack of the evaluation of anesthetic agents and cost of procedures were limitations of our study. Results: 123 and 111 patients were enrolled in Groups 1 and 2, respectively. Preoperative characteristics were similar between groups. In Group 1, the mean operative time was statistically longer than in Group 2 (p=0.013). Stone-free status was significantly higher in Group 2 than in Group 1 (p=0.027). Complication rates were similar between groups. Hemorrhage requiring blood transfusion was the most common complication in both groups (10.5% vs. 9.9%). Conclusions: Our study demonstrated that a history of previous ORSS with parenchymal insicion significantly reduces the success rates of PNL procedure. PMID:28255416

Use of Hawaii Analog Sites for Lunar Science and In-Situ Resource Utilization

NASA Astrophysics Data System (ADS)

Sanders, G. B.; Larson, W. E.; Picard, M.; Hamilton, J. C.

2011-10-01

In-Situ Resource Utilization (ISRU) and lunar science share similar objectives with respect to analyzing and characterizing the physical, mineral, and volatile materials and resources at sites of robotic and human exploration. To help mature and stress instruments, technologies, and hardware and to evaluate operations and procedures, space agencies have utilized demonstrations at analog sites on Earth before use in future missions. The US National Aeronautics and Space Administration (NASA), the Canadian Space Agency (CSA), and the German Space Agency (DLR) have utilized an analog site on the slope of Mauna Kea on the Big Island of Hawaii to test ISRU and lunar science hardware and operations in two previously held analog field tests. NASA and CSA are currently planning on a 3rd analog field test to be held in June, 2012 in Hawaii that will expand upon the successes from the previous two field tests.

Sequence of eruptive events in the Vesuvio area recorded in shallow-water Ionian Sea sediments

NASA Astrophysics Data System (ADS)

Taricco, C.; Alessio, S.; Vivaldo, G.

2008-01-01

The dating of the cores we drilled from the Gallipoli terrace in the Gulf of Taranto (Ionian Sea), previously obtained by tephroanalysis, is checked by applying a method to objectively recognize volcanic events. This automatic statistical procedure allows identifying pulse-like features in a series and evaluating quantitatively the confidence level at which the significant peaks are detected. We applied it to the 2000-years-long pyroxenes series of the GT89-3 core, on which the dating is based. The method confirms the dating previously performed by detecting at a high confidence level the peaks originally used and indicates a few possible undocumented eruptions. Moreover, a spectral analysis, focussed on the long-term variability of the pyroxenes series and performed by several advanced methods, reveals that the volcanic pulses are superimposed to a millennial trend and a 400 years oscillation.

Evolution of mechanical response of sodium montmorillonite interlayer with increasing hydration by molecular dynamics.

PubMed

Schmidt, Steven R; Katti, Dinesh R; Ghosh, Pijush; Katti, Kalpana S

2005-08-16

The mechanical response of the interlayer of hydrated montmorillonite was evaluated using steered molecular dynamics. An atomic model of the sodium montmorillonite was previously constructed. In the current study, the interlayer of the model was hydrated with multiple layers of water. Using steered molecular dynamics, external forces were applied to individual atoms of the clay surface, and the response of the model was studied. The displacement versus applied stress and stress versus strain relationships of various parts of the interlayer were studied. The paper describes the construction of the model, the simulation procedure, and results of the simulations. Some results of the previous work are further interpreted in the light of the current research. The simulations provide quantitative stress deformation relationships as well as an insight into the molecular interactions taking place between the clay surface and interlayer water and cations.

Use of Hawaii Analog Sites for Lunar Science and In-Situ Resource Utilization

NASA Technical Reports Server (NTRS)

Sanders, G. B.; Larson, W. E.; Picard, M.; Hamilton, J. C.

2011-01-01

In-Situ Resource Utilization (ISRU) and lunar science share similar objectives with respect to analyzing and characterizing the physical, mineral, and volatile materials and resources at sites of robotic and human exploration. To help mature and stress instruments, technologies, and hardware and to evaluate operations and procedures, space agencies have utilized demonstrations at analog sites on Earth before use in future missions. The US National Aeronautics and Space Administration (NASA), the Canadian Space Agency (CSA), and the German Space Agency (DLR) have utilized an analog site on the slope of Mauna Kea on the Big Island of Hawaii to test ISRU and lunar science hardware and operations in two previously held analog field tests. NASA and CSA are currently planning on a 3rd analog field test to be held in June, 2012 in Hawaii that will expand upon the successes from the previous two field tests.

Student Services Program Planning and Evaluation: Responsibility, Procedures, Instrument, and Guidelines.

ERIC Educational Resources Information Center

Repp, Charles A.; Brach, Ronald C.

The manual provides a rationale, procedural guidelines, time-schedules, instruments, and supporting documentation for student services program evaluation at SUNY Agricultural and Technical College, Delhi. Six procedural guidelines include: (1) all programs and services should be evaluated at least once every four years, with provision for annual…

Automatic procedure for stable tetragonal or hexagonal structures: application to tetragonal Y and Cd

NASA Astrophysics Data System (ADS)

Marcus, P. M.; Jona, F.

2005-05-01

A simple effective procedure (MNP) for finding equilibrium tetragonal and hexagonal states under pressure is described and applied. The MNP procedure finds a path to minima of the Gibbs free energy G at T=0 K (G=E+pV, E=energy per atom, p=pressure, V=volume per atom) for tetragonal and hexagonal structures by using the approximate expansion of G in linear and quadratic strains at an arbitrary initial structure to find a change in the strains which moves toward a minimum of G. Iteration automatically proceeds to a minimum within preset convergence criteria on the calculation of the minimum. Comparison is made with experimental results for the ground states of seven metallic elements in hexagonal close-packed (hcp), face- and body-centered cubic structures, and with a previous procedure for finding minima based on tracing G along the epitaxial Bain path (EBP) to a minimum; the MNP is more easily generalized than the EBP procedure to lower symmetry and more atoms in the unit cell. Comparison is also made with a molecular-dynamics program for crystal equilibrium structures under pressure and with CRYSTAL, a program for crystal equilibrium structures at zero pressure. Application of MNP to the elements Y and Cd, which have hcp ground states at zero pressure, finds minima of E at face-centered cubic (fcc) structure for both Y and Cd. Evaluation of all the elastic constants shows that fcc Y is stable, hence a metastable phase, but fcc Cd is unstable.

Efficacy and adverse events of cold vs hot polypectomy: A meta-analysis.

PubMed

Fujiya, Mikihiro; Sato, Hiroki; Ueno, Nobuhiro; Sakatani, Aki; Tanaka, Kazuyuki; Dokoshi, Tatsuya; Fujibayashi, Shugo; Nomura, Yoshiki; Kashima, Shin; Gotoh, Takuma; Sasajima, Junpei; Moriichi, Kentaro; Watari, Jiro; Kohgo, Yutaka

2016-06-21

To compare previously reported randomized controlled studies (RCTs) of cold and hot polypectomy, we systematically reviewed and clarify the utility of cold polypectomy over hot with respect to efficacy and adverse events. A meta-analysis was conducted to evaluate the predominance of cold and hot polypectomy for removing colon polyps. Published articles and abstracts from worldwide conferences were searched using the keywords "cold polypectomy". RCTs that compared either or both the effects or adverse events of cold polypectomy with those of hot polypectomy were collected. The patients' demographics, endoscopic procedures, No. of examined lesions, lesion size, macroscopic and histologic findings, rates of incomplete resection, bleeding amount, perforation, and length of procedure were extracted from each study. A forest plot analysis was used to verify the relative strength of the effects and adverse events of each procedure. A funnel plot was generated to assess the possibility of publication bias. Ultimately, six RCTs were selected. No significant differences were noted in the average lesion size (less than 10 mm) between the cold and hot polypectomy groups in each study. Further, the rates of complete resection and adverse events, including delayed bleeding, did not differ markedly between cold and hot polypectomy. The average procedural time in the cold polypectomy group was significantly shorter than in the hot polypectomy group. Cold polypectomy is a time-saving procedure for removing small polyps with markedly similar curability and safety to hot polypectomy.

Construction of mammographic examination process ontology using bottom-up hierarchical task analysis.

PubMed

Yagahara, Ayako; Yokooka, Yuki; Jiang, Guoqian; Tsuji, Shintarou; Fukuda, Akihisa; Nishimoto, Naoki; Kurowarabi, Kunio; Ogasawara, Katsuhiko

2018-03-01

Describing complex mammography examination processes is important for improving the quality of mammograms. It is often difficult for experienced radiologic technologists to explain the process because their techniques depend on their experience and intuition. In our previous study, we analyzed the process using a new bottom-up hierarchical task analysis and identified key components of the process. Leveraging the results of the previous study, the purpose of this study was to construct a mammographic examination process ontology to formally describe the relationships between the process and image evaluation criteria to improve the quality of mammograms. First, we identified and created root classes: task, plan, and clinical image evaluation (CIE). Second, we described an "is-a" relation referring to the result of the previous study and the structure of the CIE. Third, the procedural steps in the ontology were described using the new properties: "isPerformedBefore," "isPerformedAfter," and "isPerformedAfterIfNecessary." Finally, the relationships between tasks and CIEs were described using the "isAffectedBy" property to represent the influence of the process on image quality. In total, there were 219 classes in the ontology. By introducing new properties related to the process flow, a sophisticated mammography examination process could be visualized. In relationships between tasks and CIEs, it became clear that the tasks affecting the evaluation criteria related to positioning were greater in number than those for image quality. We developed a mammographic examination process ontology that makes knowledge explicit for a comprehensive mammography process. Our research will support education and help promote knowledge sharing about mammography examination expertise.

Evaluation of questionnaire-based information on previous physical work loads. Stockholm MUSIC 1 Study Group. Musculoskeletal Intervention Center.

PubMed

Torgén, M; Winkel, J; Alfredsson, L; Kilbom, A

1999-06-01

The principal aim of the present study was to evaluate questionnaire-based information on past physical work loads (6-year recall). Effects of memory difficulties on reproducibility were evaluated for 82 subjects by comparing previously reported results on current work loads (test-retest procedure) with the same items recalled 6 years later. Validity was assessed by comparing self-reports in 1995, regarding work loads in 1989, with worksite measurements performed in 1989. Six-year reproducibility, calculated as weighted kappa coefficients (k(w)), varied between 0.36 and 0.86, with the highest values for proportion of the workday spent sitting and for perceived general exertion and the lowest values for trunk and neck flexion. The six-year reproducibility results were similar to previously reported test-retest results for these items; this finding indicates that memory difficulties was a minor problem. The validity of the questionnaire responses, expressed as rank correlations (r(s)) between the questionnaire responses and workplace measurements, varied between -0.16 and 0.78. The highest values were obtained for the items sitting and repetitive work, and the lowest and "unacceptable" values were for head rotation and neck flexion. Misclassification of exposure did not appear to be differential with regard to musculoskeletal symptom status, as judged by the calculated risk estimates. The validity of some of these self-administered questionnaire items appears sufficient for a crude assessment of physical work loads in the past in epidemiologic studies of the general population with predominantly low levels of exposure.

Evaluation of a technique to simplify depictions of visually complex aeronautical procedures for NextGen

DOT National Transportation Integrated Search

2013-10-04

Performance based navigation supports the design of more precise flight procedures. However, these new procedures can be visually complex, which may impact the usability of charts that depict the procedures. The purpose of the study was to evaluate w...

Designing Flightdeck Procedures

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Mauro, Robert; Degani, Asaf; Loukopoulou, Loukia

2016-01-01

The primary goal of this document is to provide guidance on how to design, implement, and evaluate flight deck procedures. It provides a process for developing procedures that meet clear and specific requirements. This document provides a brief overview of: 1) the requirements for procedures, 2) a process for the design of procedures, and 3) a process for the design of checklists. The brief overview is followed by amplified procedures that follow the above steps and provide details for the proper design, implementation and evaluation of good flight deck procedures and checklists.

TVT-O for the treatment of pure urodynamic stress incontinence: efficacy, adverse effects, and prognostic factors at 5-year follow-up.

PubMed

Serati, Maurizio; Bauer, Ricarda; Cornu, Jean Nicolas; Cattoni, Elena; Braga, Andrea; Siesto, Gabriele; Lizée, Daphné; Haab, François; Torella, Marco; Salvatore, Stefano

2013-05-01

Inside-out tension-free vaginal transobturator tape (TVT-O) is currently one of the most effective and popular procedures for the surgical treatment of female stress urinary incontinence (SUI), but data reporting long-term outcomes are scarce. To evaluate the efficacy and safety of TVT-O 5-yr implantation for management of pure SUI in women. A prospective observational study was conducted in four tertiary reference centers. Consecutive women presenting with urodynamically proven, pure SUI treated by TVT-O were included. Patients with mixed incontinence and/or anatomic evidence of pelvic organ prolapse were excluded. TVT-O implantation without any associated procedure. Data regarding subjective outcomes (International Consultation on Incontinence-Short Form [ICIQ-SF], Patient Global Impression of Improvement, patient satisfaction scores), objective cure (stress test) rates, and adverse events were collected during follow-up. Multivariable analyses were performed to investigate outcomes. Of the 191 women included, 21 (11.0%) had previously undergone a failed anti-incontinence surgical procedure. Six (3.1%) patients were lost to follow-up. The 5-yr subjective and objective cure rates were 90.3% and 90.8%, respectively. De novo overactive bladder (OAB) was reported by 24.3% of patients at 5-yr follow-up. Median ICIQ-SF score significantly improved from 17 (interquartile range [IQR]:16-17) preoperatively to 0 (IQR: 0-2) (p<0.0001). Failure of a previous anti-incontinence procedure was the only independent predictor of subjective recurrence of SUI (hazard ratio [HR]: 4.4; p = 0.009) or objective (HR: 3.7; p = 0.02). No predictive factor of de novo OAB was identified. TVT-O implantation is a highly effective option for the treatment of women with pure SUI, showing a very high cure rate and a low incidence of complications after 5-yr follow-up. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Double-balloon endoscopy for retrograde cholangiography in patients with choledochojejunostomy and Roux-en-Y reconstruction.

PubMed

Pohl, J; May, A; Aschmoneit, I; Ell, C

2009-02-01

Choledochojejunal anastomoses with Roux-en-Y reconstruction excludes the biliary tract from conventional endoscopic retrograde cholangiography (ERC) with standard endoscopes due to the length of the interposed small bowel segment. Double-balloon enteroscopy (DBE) facilitates deep insertion into the small bowel and may be used to perform ERC in these patients. In the present case series we report our experience with diagnostic and therapeutic double-balloon ERC in patients with choledochojejunostomy to a long Roux-en-Y loop previously unavailable for standard length endoscopes. Between December 2004 and May 2008 15 patients (mean age: 60.2 years) with choledochojejunal anastomosis underwent a total of 25 DBE-ERC procedures. Cannulation of the bile ducts was achieved in 22 / 25 procedures (84 %). Twenty-one therapeutic interventions, including stone removal, biliary duct dilation, stent placement and removal of previously placed stents were performed during 16 procedures in 8 patients. The mean total duration time of the procedures was 74.6 +/- 25.0 minutes. Postinterventional self-limiting fever occurred after 4 procedures in 3 patients with cholangitis. After therapeutic interventions all patients had a significant drop of bilirubin levels and all except one patient were free of complaints (follow-up 10.4 +/- 8.6 months). The DBE system permits diagnostic and therapeutic ERC in surgically modified anatomy, previously unavailable for endoluminal access. In our experience this procedure is safe and has a high success rate with a favourable patient outcome.

A Comparison of Error-Correction Procedures on Skill Acquisition during Discrete-Trial Instruction

ERIC Educational Resources Information Center

Carroll, Regina A.; Joachim, Brad T.; St. Peter, Claire C.; Robinson, Nicole

2015-01-01

Previous research supports the use of a variety of error-correction procedures to facilitate skill acquisition during discrete-trial instruction. We used an adapted alternating treatments design to compare the effects of 4 commonly used error-correction procedures on skill acquisition for 2 children with attention deficit hyperactivity disorder…

Quantitative evaluation for accumulative calibration error and video-CT registration errors in electromagnetic-tracked endoscopy.

PubMed

Liu, Sheena Xin; Gutiérrez, Luis F; Stanton, Doug

2011-05-01

Electromagnetic (EM)-guided endoscopy has demonstrated its value in minimally invasive interventions. Accuracy evaluation of the system is of paramount importance to clinical applications. Previously, a number of researchers have reported the results of calibrating the EM-guided endoscope; however, the accumulated errors of an integrated system, which ultimately reflect intra-operative performance, have not been characterized. To fill this vacancy, we propose a novel system to perform this evaluation and use a 3D metric to reflect the intra-operative procedural accuracy. This paper first presents a portable design and a method for calibration of an electromagnetic (EM)-tracked endoscopy system. An evaluation scheme is then described that uses the calibration results and EM-CT registration to enable real-time data fusion between CT and endoscopic video images. We present quantitative evaluation results for estimating the accuracy of this system using eight internal fiducials as the targets on an anatomical phantom: the error is obtained by comparing the positions of these targets in the CT space, EM space and endoscopy image space. To obtain 3D error estimation, the 3D locations of the targets in the endoscopy image space are reconstructed from stereo views of the EM-tracked monocular endoscope. Thus, the accumulated errors are evaluated in a controlled environment, where the ground truth information is present and systematic performance (including the calibration error) can be assessed. We obtain the mean in-plane error to be on the order of 2 pixels. To evaluate the data integration performance for virtual navigation, target video-CT registration error (TRE) is measured as the 3D Euclidean distance between the 3D-reconstructed targets of endoscopy video images and the targets identified in CT. The 3D error (TRE) encapsulates EM-CT registration error, EM-tracking error, fiducial localization error, and optical-EM calibration error. We present in this paper our calibration method and a virtual navigation evaluation system for quantifying the overall errors of the intra-operative data integration. We believe this phantom not only offers us good insights to understand the systematic errors encountered in all phases of an EM-tracked endoscopy procedure but also can provide quality control of laboratory experiments for endoscopic procedures before the experiments are transferred from the laboratory to human subjects.

Quantification of hyaluronan (HA) using a simplified fluorophore-assisted carbohydrate electrophoresis (FACE) procedure.

PubMed

Midura, Ronald J; Cali, Valbona; Lauer, Mark E; Calabro, Anthony; Hascall, Vincent C

2018-01-01

Hyaluronan (HA) exhibits numerous important roles in physiology and pathologies, and these facts necessitate an ability to accurately and reproducibly measure its quantities in tissues and cell cultures. Our group previously reported a rigorous and analytical procedure to quantify HA (and chondroitin sulfate, CS) using a reductive amination chemistry and separation of the fluorophore-conjugated, unsaturated disaccharides unique to HA and CS on high concentration acrylamide gels. This procedure is known as fluorophore-assisted carbohydrate electrophoresis (FACE) and has been adapted for the detection and quantification of all glycosaminoglycan types. While this previous FACE procedure is relatively straightforward to implement by carbohydrate research investigators, many nonglycoscience laboratories now studying HA biology might have difficulties establishing this prior FACE procedure as a routine assay for HA. To address this need, we have greatly simplified our prior FACE procedure for accurate and reproducible assessment of HA in tissues and cell cultures. This chapter describes in detail this simplified FACE procedure and, because it uses an enzyme that degrades both HA and CS, investigators will also gain additional insight into the quantities of CS in the same samples dedicated for HA analysis. © 2018 Elsevier Inc. All rights reserved.

Chimpanzees' (Pan troglodytes) use of gaze cues in object-choice tasks: different methods yield different results.

PubMed

Barth, Jochen; Reaux, James E; Povinelli, Daniel J

2005-04-01

To assess the influence of different procedures on chimpanzees' performance in object-choice tasks, five adult chimpanzees were tested using three experimenter-given cues to food location: gazing, glancing, and pointing. These cues were delivered to the subjects in an identical fashion but were deployed within the context of two distinct meta-procedures that have been previously employed with this species with conflicting results. In one procedure, the subjects entered the test unit and approached the experimenter (who had already established the cue) on each trial. In the other procedure, the subjects stayed in the test unit throughout a session, witnessed the hiding procedure, and waited for a delay of 10 s during which the cue was provided. The subjects scored at high levels far exceeding chance in response to the gaze cue only when they approached the experimenter for each trial. They performed at chance levels when they stayed inside the test unit throughout the session. They scored at chance levels on all other cues irrespective of the procedure. These findings imply that (a) chimpanzees can immediately exploit social gaze cues, and (b) previous conflicting findings were likely due to the different meta-procedures that were used.

Attenuation-emission alignment in cardiac PET∕CT based on consistency conditions

PubMed Central

Alessio, Adam M.; Kinahan, Paul E.; Champley, Kyle M.; Caldwell, James H.

2010-01-01

Purpose: In cardiac PET and PET∕CT imaging, misaligned transmission and emission images are a common problem due to respiratory and cardiac motion. This misalignment leads to erroneous attenuation correction and can cause errors in perfusion mapping and quantification. This study develops and tests a method for automated alignment of attenuation and emission data. Methods: The CT-based attenuation map is iteratively transformed until the attenuation corrected emission data minimize an objective function based on the Radon consistency conditions. The alignment process is derived from previous work by Welch et al. [“Attenuation correction in PET using consistency information,” IEEE Trans. Nucl. Sci. 45, 3134–3141 (1998)] for stand-alone PET imaging. The process was evaluated with the simulated data and measured patient data from multiple cardiac ammonia PET∕CT exams. The alignment procedure was applied to simulations of five different noise levels with three different initial attenuation maps. For the measured patient data, the alignment procedure was applied to eight attenuation-emission combinations with initially acceptable alignment and eight combinations with unacceptable alignment. The initially acceptable alignment studies were forced out of alignment a known amount and quantitatively evaluated for alignment and perfusion accuracy. The initially unacceptable studies were compared to the proposed aligned images in a blinded side-by-side review. Results: The proposed automatic alignment procedure reduced errors in the simulated data and iteratively approaches global minimum solutions with the patient data. In simulations, the alignment procedure reduced the root mean square error to less than 5 mm and reduces the axial translation error to less than 1 mm. In patient studies, the procedure reduced the translation error by >50% and resolved perfusion artifacts after a known misalignment for the eight initially acceptable patient combinations. The side-by-side review of the proposed aligned attenuation-emission maps and initially misaligned attenuation-emission maps revealed that reviewers preferred the proposed aligned maps in all cases, except one inconclusive case. Conclusions: The proposed alignment procedure offers an automatic method to reduce attenuation correction artifacts in cardiac PET∕CT and provides a viable supplement to subjective manual realignment tools. PMID:20384256

Test Operations Procedure (TOP) 08-2-188 Chemical Point Detector Vapor Testing

DTIC Science & Technology

2018-04-27

Evaluation Command 6617 Aberdeen Boulevard Aberdeen Proving Ground, MD 21005-5001 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S...AND EVALUATION COMMAND TEST OPERATIONS PROCEDURE *Test Operations Procedure 08-2-188 27 April 2018 DTIC AD No. CHEMICAL POINT DETECTOR VAPOR...188 27 April 2018 2 1. SCOPE. This Test Operations Procedure (TOP), which has been endorsed by the Test and Evaluation Capabilities and

Isolation of carbohydrate-metabolizing, extremely halophilic bacteria.

NASA Technical Reports Server (NTRS)

Tomlinson, G. A.; Hochstein, L. I.

1972-01-01

Four previously unrecognized strains of extremely halophilic bacteria that utilize carbohydrates have been isolated. Gas production proved an unreliable index of carbohydrate metabolism; therefore, carbohydrate utilization was measured by determining acid formation and sugar disappearance during growth. By these procedures, carbohydrate utilization was readily detected. The results suggest that carbohydrate dissimilation by extremely halophilic bacteria may be more common than previously thought and that the apparent rarity of carbohydrate-metabolizing halophiles may be an artifact of the isolation procedures used.

Risk factors for postoperative urinary tract infection following midurethral sling procedures.

PubMed

Doganay, Melike; Cavkaytar, Sabri; Kokanali, Mahmut Kuntay; Ozer, Irfan; Aksakal, Orhan Seyfi; Erkaya, Salim

2017-04-01

To identify the potential risk factors for urinary tract infections following midurethral sling procedures. 556 women who underwent midurethral sling procedure due to stress urinary incontinence over a four-year period were reviewed in this retrospective study. Of the study population, 280 women underwent TVT procedures and 276 women underwent TOT procedures. Patients were evaluated at 4-8 weeks postoperatively and were investigated for the occurrence of a urinary tract infection. Patients who experienced urinary tract infection were defined as cases, and patients who didn't were defined as controls. All data were collected from medical records. Multivariate logistic regression model was used to identify the risk factors for urinary tract infection. Of 556 women, 58 (10.4%) were defined as cases while 498 (89.6%) were controls. The mean age of women in cases (57.8±12.9years) was significantly greater than in controls (51.8±11.2years) (p<0.001). The presence of menopausal status, previous abdominal surgery, preoperative antibiotic treatment due to urinary tract infection, concomitant vaginal hysterectomy and cystocele repair, TVT procedure and postoperative postvoiding residual bladder volume ≥100ml were more common in cases than in controls. However, in multivariate regression analysis model presence of preoperative urinary tract infection [OR (95% CI)=0.1 (0.1-0.7); p=0.013], TVT procedure [OR (95% CI)=8.4 (3.1-22.3); p=0.000] and postoperative postvoiding residual bladder volume ≥100ml [OR (95% CI)=4.6 (1.1-19.2); p=0.036] were significant independent risk factors for urinary tract infection following midurethral slings CONCLUSION: Urinary tract infection after midurethral sling procedures is a relatively common complication. The presence of preoperative urinary tract infection, TVT procedure and postoperative postvoiding residual bladder volume ≥100ml may increase the risk of this complication. Identification of these factors could help surgeons to minimize this complicationby developing effective strategies. Copyright © 2017. Published by Elsevier B.V.

A framework for the evaluation of new interventional procedures.

PubMed

Lourenco, Tania; Grant, Adrian M; Burr, Jennifer M; Vale, Luke

2012-03-01

The introduction of new interventional procedures is less regulated than for other health technologies such as pharmaceuticals. Decisions are often taken on evidence of efficacy and short-term safety from small-scale usually observational studies. This reflects the particular challenges of evaluating interventional procedures - the extra facets of skill and training and the difficulty defining a 'new' technology. Currently, there is no framework to evaluate new interventional procedures before they become available in clinical practice as opposed to new pharmaceuticals. This paper proposes a framework to guide the evaluation of a new interventional procedure. A framework was developed consisting of a four-stage progressive evaluation for a new interventional procedure: Stage 1: Development; Stage 2: Efficacy and short-term safety; Stage 3: Effectiveness and cost-effectiveness; and Stage 4: Implementation. The framework also suggests the types of studies or data collection methods that can be used to satisfy each stage. This paper makes a first step on a framework for generating evidence on new interventional procedures. The difficulties and limitations of applying such a framework are discussed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Genitourinary Surgical Workload at Deployed U.S. Facilities in Iraq and Afghanistan, 2002-2016.

PubMed

Turner, Caryn A; Orman, Jean A; Stockinger, Zsolt T; Hudak, Steven J

2018-06-13

Genitourinary surgery constitutes approximately 1.15% of procedures performed for combat injuries. During forward deployment, surgeons usually deploy without urology support. To better understand the training and skills maintenance needs for genitourinary procedures by describing in detail the genitourinary surgical workload during 15 years of combat operations and compare our findings with those from previously published articles. A retrospective analysis of the Department of Defense Trauma Registry (DoDTR) was performed for all Roles 2 and 3 medical treatment facilities in Iraq and Afghanistan, from January 2002 to May 2016. The 177 ICD-9-CM procedure codes identified as genitourinary procedures were grouped into 15 anatomic categories by subject matter experts. Select groups were further subdivided by procedure types. Descriptive analyses were performed and stratified workload percentiles were calculated for the 10th, 50th, and 90th percentiles. Data analysis was performed using Stata Version 14 (College Station, TX, USA). This quality improvement project was deemed exempt from institutional review board review by the U.S. Army Institute of Surgical Research. A total of 3,963 genitourinary surgical procedures were identified, the majority occurring at Role 3 medical treatment facilities (3,512, 88.6%). The most common procedure groups were testis (20.6%), bladder (18.8%), scrotum (17.7%), and kidney (13.5%). The single most common individual procedures performed were unilateral orchiectomy (394, 9.9%), suture of laceration of scrotum and tunica vaginalis (373, 9.4%), nephroureterectomy (360, 9.1%), and other suprapubic cystostomy (268, 6.8%). Of the 77 gynecological procedures, 15 were C-sections. Genitourinary caseload per facility was low, never exceeding nine procedures per month. All deploying surgeons may be required to evaluate, stage, and surgically manage genitourinary, gynecologic, and obstetrical conditions. Surgery on the male genitalia, bladder, and kidney were the most commonly required genitourinary operative procedures in deployed facilities; therefore, non-urological surgeons should receive pre-deployment training in these techniques. The workload data from our study can be used to help guide the development of pre-deployment training to ensure military surgeons have the skills to perform the specialty procedures required while deployed.

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

Bae, Wookeun; Shin, Eung Bai; Lee, Kil Chul

The potential hazard of landfill wastes was previously evaluated by examining the extraction procedures for individual waste, although various wastes were co-disposed of in actual landfills. This paper investigates the reduction of extraction-procedure toxicity by co-disposing various combinations of two wastes. When two wastes are mixed homogeneously, the extraction of heavy metals from the waste mixture is critically affected by the extract pH. Thus, co-disposal wastes will have a resultant pH between the pH values of its constituent. The lower the resultant pH, the lower the concentrations of heavy metals in the extract. When these wastes are extracted sequentially, themore » latter extracted waste has a stronger influence on the final concentration of heavy metals in the extract. Small-scale lysimeter experiments confirm that when heavy-metal-bearing leachates Generated from hazardous-waste lysimeters are passed through a nonhazardous-waste lysimeter filled with compost, briquette ash, or refuse-incineration ashes, the heavy-metal concentration in the final leachates decreases significantly. Thus, the heavy-metal leaching could be attenuated if a less extraction-procedure-toxic waste were placed at the bottom of a landfill. 3 refs., 4 figs., 5 tabs.« less

Group Sequential Testing of the Predictive Accuracy of a Continuous Biomarker with Unknown Prevalence

PubMed Central

Koopmeiners, Joseph S.; Feng, Ziding

2015-01-01

Group sequential testing procedures have been proposed as an approach to conserving resources in biomarker validation studies. Previously, Koopmeiners and Feng (2011) derived the asymptotic properties of the sequential empirical positive predictive value (PPV) and negative predictive value curves, which summarize the predictive accuracy of a continuous marker, under case-control sampling. A limitation of their approach is that the prevalence can not be estimated from a case-control study and must be assumed known. In this manuscript, we consider group sequential testing of the predictive accuracy of a continuous biomarker with unknown prevalence. First, we develop asymptotic theory for the sequential empirical PPV and NPV curves when the prevalence must be estimated, rather than assumed known in a case-control study. We then discuss how our results can be combined with standard group sequential methods to develop group sequential testing procedures and bias-adjusted estimators for the PPV and NPV curve. The small sample properties of the proposed group sequential testing procedures and estimators are evaluated by simulation and we illustrate our approach in the context of a study to validate a novel biomarker for prostate cancer. PMID:26537180

Empowerment evaluation of a Swedish gender equity plan

PubMed Central

Gavriilidis, Georgios; Gavriilidou, Nivetha Natarajan; Pettersson, Erika; Renhammar, Eva; Balkfors, Anna; Östergren, Per-Olof

2014-01-01

Background Empowerment is essential for gender equity and health. The city of Malmö, Sweden, has formulated a development plan for gender equity integration (GEIDP). A ‘Policy Empowerment Index’ (PEI) was previously developed to assess the empowerment potential of policies. Objectives To pilot-evaluate the GEIDP’s potential for empowerment and to test the PEI for future policy evaluations. Design The GEIDP was analyzed and scored according to electronically retrieved evidence on constituent opinion, participation, capacity development, evaluation–adaptation, and impact. Results The plan’s PEI score was 64% (CI: 48–78) and was classified as ‘enabling’, ranging between ‘enabling’ and ‘supportive’. The plan’s strengths were: 1) constituent knowledge and concern; 2) peripheral implementation; 3) protection of vulnerable groups; and 4) evaluation/adaptation procedures. It scored average on: 1) policy agenda setting; 2) planning; 3) provisions for education; 4) network formation; 5) resource mobilization. The weakest point was regarding promotion of employment and entrepreneurship. Conclusions The PEI evaluation highlighted the plan’s potential of constituency empowerment and proposed how it could be augmented. PMID:24993349

External cephalic version among women with a previous cesarean delivery: report on 36 cases and review of the literature.

PubMed

Abenhaim, Haim A; Varin, Jocelyne; Boucher, Marc

2009-01-01

Whether or not women with a previous cesarean section should be considered for an external cephalic version remains unclear. In our study, we sought to examine the relationship between a history of previous cesarean section and outcomes of external cephalic version for pregnancies at 36 completed weeks of gestation or more. Data on obstetrical history and on external cephalic version outcomes was obtained from the C.H.U. Sainte-Justine External Cephalic Version Database. Baseline clinical characteristics were compared among women with and without a history of previous cesarean section. We used logistic regression analysis to evaluate the effect of previous cesarean section on success of external cephalic version while adjusting for parity, maternal body mass index, gestational age, estimated fetal weight, and amniotic fluid index. Over a 15-year period, 1425 external cephalic versions were attempted of which 36 (2.5%) were performed on women with a previous cesarean section. Although women with a history of previous cesarean section were more likely to be older and para >2 (38.93% vs. 15.0%), there were no difference in gestational age, estimated fetal weight, and amniotic fluid index. Women with a prior cesarean section had a success rate similar to women without [50.0% vs. 51.6%, adjusted OR: 1.31 (0.48-3.59)]. Women with a previous cesarean section who undergo an external cephalic version have similar success rates than do women without. Concern about procedural success in women with a previous cesarean section is unwarranted and should not deter attempting an external cephalic version.

Declining Operative Experience for Junior-Level Residents: Is This an Unintended Consequence of Minimally Invasive Surgery?

PubMed

Mullen, Matthew G; Salerno, Elise P; Michaels, Alex D; Hedrick, Traci L; Sohn, Min-Woong; Smith, Philip W; Schirmer, Bruce D; Friel, Charles M

2016-01-01

Our group has previously demonstrated an upward shift from junior to senior resident participation in common general surgery operations, traditionally performed by junior-level residents. The objective of this study was to evaluate if this trend would correct over time. We hypothesized that junior resident case volume would improve. A sample of essential laparoscopic and open general surgery procedures (appendectomy, inguinal herniorrhaphy, cholecystectomy, and partial colectomy) was chosen for analysis. The American College of Surgeons National Surgical Quality Improvement Program Participant Use Files were queried for these procedures between 2005 and 2012. Cases were stratified by participating resident post-graduate year with "junior resident" defined as post-graduate year1-3. Logistic regression was performed to determine change in junior resident participation for each type of procedure over time. A total of 185,335 cases were included in the study. For 3 of the operations we considered, the prevalence of laparoscopic surgery increased from 2005-2012 (all p < 0.001). Cholecystectomy was an exception, which showed an unchanged proportion of cases performed laparoscopically across the study period (p = 0.119). Junior resident participation decreased by 4.5%/y (p < 0.001) for laparoscopic procedures and by 6.2%/y (p < 0.001) for open procedures. The proportion of laparoscopic surgeries performed by junior-level residents decreased for appendectomy by 2.6%/y (p < 0.001) and cholecystectomy by 6.1%/y (p < 0.001), whereas it was unchanged for inguinal herniorrhaphy (p = 0.75) and increased for partial colectomy by 3.9%/y (p = 0.003). A decline in junior resident participation was seen for all open surgeries, with appendectomy decreasing by 9.4%/y (p < 0.001), cholecystectomy by 4.1%/y (p < 0.002), inguinal herniorrhaphy by 10%/y (p < 0.001) and partial colectomy by 2.9%/y (p < 0.004). Along with the proliferation of laparoscopy for common general surgical procedures there has been a concomitant reduction in the participation of junior-level residents. As previously thought, familiarity with laparoscopy has not translated to redistribution of basic operations from senior to junior residents. This trend has significant implications for general surgery resident education. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Amniotic membrane transplantation for ocular disease: a review of the first 233 cases from the UK user group

PubMed Central

Saw, Valerie P J; Minassian, Darwin; Dart, John K G; Ramsay, Andrew; Henderson, Hugo; Poniatowski, Stefan; Warwick, Ruth M; Cabral, Suzanne

2007-01-01

Background Amniotic membrane transplantation (AMT), as a new tool in the armamentarium of therapies available for ocular surface problems, became widely available in the UK in 1998. This study evaluates the indications for treatment, the surgical procedures used, and the results of a subset of the first AMT cases carried out by the group using this nationally available supply. This user group model provides data which is different from that obtained from uncontrolled case series, or clinical trials, and may be more representative of the outcomes that can be expected when a procedure becomes widely available. Methods The first 233 AMTs, performed by the UK user group, were evaluated by audit and outcomes were assessed at 3 months. Results Of the 233 transplants, there were 126 (54.1%) valid outcome returns: the outcome for persistent epithelial defects was a healed and stable surface in 11/35 (31.4%, 95% CI 16.9 to 49.3); for chemical/thermal injuries, a healed uninflamed eye with clear cornea in 5/18 (27.8%, 95% CI 9.7 to 53.4); for bullous keratopathy a pain‐free, stable surface without bullae in 4/18 (22.2%, 95% CI 6.4 to 47.6); for ocular surface reconstruction, an epithelialised uninflamed conjunctiva without scarring in 12/23 (52.2%, 95% CI 30.6 to 73.2); and for limbal stem cell deficiency, a corneal phenotype in 4/7 (57.1%). The operative technique least associated with failure was use of a bandage contact lens at the end of the procedure (OR 0.19, 95% CI 0.06 to 0.59, p = 0.004). Previous treatment with topical steroids was significantly associated with failure (OR 5.70, 95% CI 1.77 to 18.43, p = 0.004). Conclusion Although the outcome criteria used in this study were stringent, and the follow‐up duration was short, the results of AMT by this user group were generally less favourable than those of previously reported case series. Controlled clinical trials would improve the quality of evidence for use of amniotic membrane in ocular disease. PMID:17314154

Isolated and combined medial patellofemoral ligament reconstruction in revision surgery for patellofemoral instability: a prospective study.

PubMed

Kohn, Ludwig M; Meidinger, Gebhart; Beitzel, Knut; Banke, Ingo J; Hensler, Daniel; Imhoff, Andreas B; Schöttle, Philip B

2013-09-01

Persistent pain and redislocations after surgical treatment of patellofemoral instability are described in up to 40% of patients. However, prospective outcome data about revision surgery are missing. To evaluate the clinical outcome after revision medial patellofemoral ligament (MPFL) reconstruction using isolated and combined procedures, with a follow-up of 24 months. Case series; Level of evidence, 4. Study participants were 42 patients (median age, 22 years; range, 13-46 years) who underwent revision surgery between January 2007 and December 2009 because of persistent patellofemoral instability after a mean of 1.8 previous failed surgical interventions (lateral release, medial imbrication/vastus medialis obliquus distalization, medialization of the tuberosity). An isolated MPFL reconstruction was performed in 15 cases, while a combination procedure was performed in 27 cases. The clinical results were evaluated preoperatively and 24 months postoperatively using the International Knee Documentation Committee (IKDC), Kujala, and Tegner scores as well as a subjective questionnaire. Patellar shift, tilt, and height, as well as level of degeneration, were defined preoperatively and at the latest follow-up on plain radiographs and magnetic resonance imaging. At 24-month follow-up, 87% of the patients were satisfied or very satisfied with the treatment. No apprehension or redislocation was reported at follow-up, and there was a significant decrease in pain during daily activities. There were significant improvements (P < .001) in IKDC (from 50 to 80), Kujala (from 51 to 85), and Tegner scores (from 2.4 to 4.9). Patellar shift, tilt, and height decreased significantly (P < .05) to anatomic values, and there was no aggravation to the level of pre-existing degeneration. No significant difference was noticed between the isolated and combined procedures. As patellofemoral instability is a multifactorial problem, revision surgery should be indicated only after a comprehensive examination. The results of this study show that MPFL reconstruction, alone or in combination, seems to be an effective treatment for recurrent patellar dislocations after a failed previous surgery, leading to significant increases in stability and functionality as well as a reduction in pain.

Sutureless circumcision using 2-Octyl cyanoacrylate results in more rapid and less painful procedures with excellent cosmetic satisfaction.

PubMed

Van Haute, C; Tailly, T; Klockaerts, K; Ringoir, Y

2015-06-01

Circumcision is the most common surgical procedure in male children in the world and is performed because of cultural, religious or medical reasons. Traditionally, interrupted sutures are used to close the wound, but 2-Octyl cyanoacrylate (2-OCA) tissue glue can be used as an alternative method to close the circumcision wound. To compare the use of 2-OCA with absorbable sutures in circumcision wound closure in prepubescent patients in terms of operative time, complication rate, postoperative pain and cosmetic results. We retrospectively evaluated 662 circumcision procedures using sutures and 609 procedures using 2-OCA for wound closure in prepubescent boys. All circumcision procedures were performed by 2 surgeons in a single centre. Operative time was collected from the hospital surgical software system. 62% of the patients in the suture group and 59% of the patients in the 2-OCA group presented for a postoperative check-up 6 weeks after the circumcision. Data regarding postoperative pain, need for analgesia, cosmetic satisfaction and the ease of wound care were collected through questionnaires completed by 25% of the boy's parents in the suture group and 53% of the parents in the 2-OCA group. Mean operative time was significantly shorter in the 2-OCA group (13 min) than in the suture group (17 min). Complications were comparable and mostly minor. Reintervention was only required in 3 cases. According to the parents, the degree of postoperative pain and the postoperative need for analgesics was significantly lower in the 2-OCA group. Wounds closed with 2-OCA were easier to care for. The cosmetic results after 1 day, after 1 week and after 1 month in the 2-OCA group were significantly superior than in the suture group, according to the parents' evaluation. The use of 2-OCA in circumcision wound closure has been reported before. Previous studies with mainly limited patient numbers report less pain, shorter procedure times and a higher surgeon satisfaction in terms of cosmetic results. This study is the largest study comparing the use of 2-OCA and interrupted sutures in circumcision wound closure. The retrospective character of the study, the lack of a validated questionnaire tool for the cosmetic evaluation and the use of the parent's evaluation are the limitations of this study. The use of 2-OCA in circumcision wound closure results in a shorter operative time, in less postoperative pain, in easy postoperative wound care and in excellent cosmesis when compared to interrupted absorbable sutures. 2-OCA is our current technique of choice in circumcision wound closure. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Evaluation of Bias-Variance Trade-Off for Commonly Used Post-Summarizing Normalization Procedures in Large-Scale Gene Expression Studies

PubMed Central

Qiu, Xing; Hu, Rui; Wu, Zhixin

2014-01-01

Normalization procedures are widely used in high-throughput genomic data analyses to remove various technological noise and variations. They are known to have profound impact to the subsequent gene differential expression analysis. Although there has been some research in evaluating different normalization procedures, few attempts have been made to systematically evaluate the gene detection performances of normalization procedures from the bias-variance trade-off point of view, especially with strong gene differentiation effects and large sample size. In this paper, we conduct a thorough study to evaluate the effects of normalization procedures combined with several commonly used statistical tests and MTPs under different configurations of effect size and sample size. We conduct theoretical evaluation based on a random effect model, as well as simulation and biological data analyses to verify the results. Based on our findings, we provide some practical guidance for selecting a suitable normalization procedure under different scenarios. PMID:24941114

Hardware Testing and System Evaluation: Procedures to Evaluate Commodity Hardware for Production Clusters

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

Goebel, J

2004-02-27

Without stable hardware any program will fail. The frustration and expense of supporting bad hardware can drain an organization, delay progress, and frustrate everyone involved. At Stanford Linear Accelerator Center (SLAC), we have created a testing method that helps our group, SLAC Computer Services (SCS), weed out potentially bad hardware and purchase the best hardware at the best possible cost. Commodity hardware changes often, so new evaluations happen periodically each time we purchase systems and minor re-evaluations happen for revised systems for our clusters, about twice a year. This general framework helps SCS perform correct, efficient evaluations. This article outlinesmore » SCS's computer testing methods and our system acceptance criteria. We expanded the basic ideas to other evaluations such as storage, and we think the methods outlined in this article has helped us choose hardware that is much more stable and supportable than our previous purchases. We have found that commodity hardware ranges in quality, so systematic method and tools for hardware evaluation were necessary. This article is based on one instance of a hardware purchase, but the guidelines apply to the general problem of purchasing commodity computer systems for production computational work.« less

Incomplete colonoscopy: Maximizing completion rates of gastroenterologists

PubMed Central

Brahmania, Mayur; Park, Jei; Svarta, Sigrid; Tong, Jessica; Kwok, Ricky; Enns, Robert

2012-01-01

BACKGROUND Cecal intubation is one of the goals of a quality colonoscopy; however, many factors increasing the risk of incomplete colonoscopy have been implicated. The implications of missed pathology and the demand on health care resources for return colonoscopies pose a conundrum to many physicians. The optimal course of action after incomplete colonoscopy is unclear. OBJECTIVES: To assess endoscopic completion rates of previously incomplete colonoscopies, the methods used to complete them and the factors that led to the previous incomplete procedure. METHODS: All patients who previously underwent incomplete colonoscopy (2005 to 2010) and were referred to St Paul’s Hospital (Vancouver, British Columbia) were evaluated. Colonoscopies were re-attempted by a single endoscopist. Patient charts were reviewed retrospectively. RESULTS: A total of 90 patients (29 males) with a mean (± SD) age of 58±13.2 years were included in the analysis. Thirty patients (33%) had their initial colonoscopy performed by a gastroenterologist. Indications for initial colonoscopy included surveillance or screening (23%), abdominal pain (15%), gastrointestinal bleeding (29%), change in bowel habits or constitutional symptoms (18%), anemia (7%) and chronic diarrhea (8%). Reasons for incomplete colonoscopy included poor preparation (11%), pain or inadequate sedation (16%), tortuous colon (30%), diverticular disease (6%), obstructing mass (6%) and stricturing disease (10%). Reasons for incomplete procedures in the remaining 21% of patients were not reported by the referring physician. Eighty-seven (97%) colonoscopies were subsequently completed in a single attempt at the institution. Seventy-six (84%) colonoscopies were performed using routine manoeuvres, patient positioning and a variable-stiffness colonoscope (either standard or pediatric). A standard 160 or 180 series Olympus gastroscope (Olympus, Japan) was used in five patients (6%) to navigate through sigmoid diverticular disease; a pediatric colonoscope was used in six patients (7%) for similar reasons. Repeat colonoscopy on the remaining three patients (3%) failed: all three required surgery for strictures (two had obstructing malignant masses and one had a severe benign obstructing sigmoid diverticular stricture). CONCLUSION: Most patients with previous incomplete colonoscopy can undergo a successful repeat colonoscopy at a tertiary care centre with instruments that are readily available to most gastroenterologists. Other modalities for evaluation of the colon should be deferred until a second attempt is made at an expert centre. PMID:22993727

Visual Contrast Sensitivity Functions Obtained from Untrained Observers Using Tracking and Staircase Procedures. Final Report.

ERIC Educational Resources Information Center

Geri, George A.; Hubbard, David C.

Two adaptive psychophysical procedures (tracking and "yes-no" staircase) for obtaining human visual contrast sensitivity functions (CSF) were evaluated. The procedures were chosen based on their proven validity and the desire to evaluate the practical effects of stimulus transients, since tracking procedures traditionally employ gradual…

Establishing Arbitrarily Applicable Relations of Same and Opposite with the Relational Completion Procedure: Selection-Based Feedback

ERIC Educational Resources Information Center

Dymond, Simon; Ng, Tsz Ching; Whelan, Robert

2013-01-01

Research suggests that the relational completion procedure (RCP) is effective for studying derived relations of same and opposite. Previously, procedural parameters, such as the presence or absence of a confirmatory response requirement, were found to have a facilitative effect on the number of training trials to criterion and overall arbitrary…

Exploring the Efficacy of Behavioral Skills Training to Teach Basic Behavior Analytic Techniques to Oral Care Providers

ERIC Educational Resources Information Center

Graudins, Maija M.; Rehfeldt, Ruth Anne; DeMattei, Ronda; Baker, Jonathan C.; Scaglia, Fiorella

2012-01-01

Performing oral care procedures with children with autism who exhibit noncompliance can be challenging for oral care professionals. Previous research has elucidated a number of effective behavior analytic procedures for increasing compliance, but some procedures are likely to be too time consuming and expensive for community-based oral care…

Training with Differential Outcomes Enhances Discriminative Learning and Visuospatial Recognition Memory in Children Born Prematurely

ERIC Educational Resources Information Center

Martinez, Lourdes; Mari-Beffa, Paloma; Roldan-Tapia, Dolores; Ramos-Lizana, Julio; Fuentes, Luis J.; Estevez, Angeles F.

2012-01-01

Previous studies have demonstrated that discriminative learning is facilitated when a particular outcome is associated with each relation to be learned. When this training procedure is applied (the differential outcome procedure; DOP), learning is faster and more accurate than when the more common non-differential outcome procedure is used. This…

The Effects of Rationales, Differential Reinforcement, and a Guided Compliance Procedure to Increase Compliance among Preschool Children

ERIC Educational Resources Information Center

Wilder, David A.; Myers, Kristin; Nicholson, Katie; Allison, Janelle; Fischetti, Anthony T.

2012-01-01

Previous research suggests that rationales, or statements describing why a child should comply with a caregiver-delivered instruction, are ineffective at increasing compliance. In the current study, we compared the effects of rationales to a differential reinforcement procedure and a guided compliance procedure. The results indicated that…

Routine conventional karyotyping of lymphoma staging bone marrow samples does not contribute clinically relevant information.

PubMed

Nardi, Valentina; Pulluqi, Olja; Abramson, Jeremy S; Dal Cin, Paola; Hasserjian, Robert P

2015-06-01

Bone marrow (BM) evaluation is an important part of lymphoma staging, which guides patient management. Although positive staging marrow is defined as morphologically identifiable disease, such samples often also include flow cytometric analysis and conventional karyotyping. Cytogenetic analysis is a labor-intensive and costly procedure and its utility in this setting is uncertain. We retrospectively reviewed pathological reports of 526 staging marrow specimens in which conventional karyotyping had been performed. All samples originated from a single institution from patients with previously untreated Hodgkin and non-Hodgkin lymphomas presenting in an extramedullary site. Cytogenetic analysis revealed clonal abnormalities in only eight marrow samples (1.5%), all of which were positive for lymphoma by morphologic evaluation. Flow cytometry showed a small clonal lymphoid population in three of the 443 morphologically negative marrow samples (0.7%). Conventional karyotyping is rarely positive in lymphoma staging marrow samples and, in our cohort, the BM karyotype did not contribute clinically relevant information in the vast majority of cases. Our findings suggest that karyotyping should not be performed routinely on BM samples taken to stage previously diagnosed extramedullary lymphomas unless there is pathological evidence of BM involvement by lymphoma. © 2015 Wiley Periodicals, Inc.

Pulmonary function evaluation during the Skylab and Apollo-Soyuz missions.

PubMed

Sawin, C F; Nicogossian, A E; Rummel, J A; Michel, E L

1976-02-01

Previous experience during Apollo postflight exercise testing indicated no major changes in pulmonary function. Pulmonary function has been studied in detail following exposure to hypoxic and hyperoxic normal gravity environments, but no previous study has reported on men exposed to an environment that was both normoxic at 258 torr total pressure and at null gravity as encountered in Skylab. Forced vital capacity (FVC) was measured during the preflight and postflight periods of the Skylab 2 mission. Inflight measurements of vital capacity (VC) were obtained during the last 2 weeks of the second manned mission (Skylab 3). More detailed pulmonary function screening was accomplished during the Skylab 4 mission. The primary measurements made during Skylab 4 testing included residual volume determination (RV), closing volume (CV), VC, FVC and its derivatives. In addition, VC was measured in flight at regular intervals during the Skylab 4 mission. Vital capacity was decreased slightly (-10%) in flight in all Skylab 4 crewmen. No major preflight-to-postflight changes were observed. The Apollo-Soyuz Test Project (ASTP) crewmen were studied using equipment and procedures similar to those employed during Skylab 4. Postflight evaluation of the ASTP crewmen was complicated by their inadvertent exposure to nitrogen tetroxide gas fumes upon reentry.

Selecting the "Best" Factor Structure and Moving Measurement Validation Forward: An Illustration.

PubMed

Schmitt, Thomas A; Sass, Daniel A; Chappelle, Wayne; Thompson, William

2018-04-09

Despite the broad literature base on factor analysis best practices, research seeking to evaluate a measure's psychometric properties frequently fails to consider or follow these recommendations. This leads to incorrect factor structures, numerous and often overly complex competing factor models and, perhaps most harmful, biased model results. Our goal is to demonstrate a practical and actionable process for factor analysis through (a) an overview of six statistical and psychometric issues and approaches to be aware of, investigate, and report when engaging in factor structure validation, along with a flowchart for recommended procedures to understand latent factor structures; (b) demonstrating these issues to provide a summary of the updated Posttraumatic Stress Disorder Checklist (PCL-5) factor models and a rationale for validation; and (c) conducting a comprehensive statistical and psychometric validation of the PCL-5 factor structure to demonstrate all the issues we described earlier. Considering previous research, the PCL-5 was evaluated using a sample of 1,403 U.S. Air Force remotely piloted aircraft operators with high levels of battlefield exposure. Previously proposed PCL-5 factor structures were not supported by the data, but instead a bifactor model is arguably more statistically appropriate.

Pulmonary function evaluation during the Skylab and Apollo-Soyuz missions

NASA Technical Reports Server (NTRS)

Sawin, C. F.; Nicogossian, A. E.; Rummel, J. A.; Michel, E. L.

1976-01-01

Previous experience during Apollo postflight exercise testing indicated no major changes in pulmonary function. Pulmonary function has been studied in detail following exposure to hypoxic and hyperoxic normal gravity environments, but no previous study has reported on men exposed to an environment that was both normoxic at 258 torr total pressure and at null gravity as encountered in Skylab. Forced vital capacity (FVC) was measured during the preflight and postflight periods of the Skylab 2 mission. Inflight measurements of vital capacity (VC) were obtained during the last 2 weeks of the second manned mission (Skylab 3). More detailed pulmonary function screening was accomplished during the Skylab 4 mission. The primary measurements made during Skylab 4 testing included residual volume determination (RV), closing volume (CV), VC, FVC and its derivatives. In addition, VC was measured in flight at regular intervals during the Skylab 4 mission. Vital capacity was decreased slightly (-10%) in flight in all Skylab 4 crewmen. No major preflight-to-postflight changes were observed. The Apollo-Soyuz Test Project (ASTP) crewmen were studied using equipment and procedures similar to those employed during Skylab 4. Postflight evaluation of the ASTP crewmen was complicated by their inadvertent exposure to nitrogen tetroxide gas fumes upon reentry.

Pressing movements and perceived force and displacement are influenced by object stiffness.

PubMed

Endo, Hiroshi

2016-09-01

Despite many previous studies on stiffness perception, few have investigated the exploratory procedures involved. This study evaluated whether stiffness range influences pressing movements and perception of force and displacement during stiffness discrimination tasks. Force and displacement data were obtained from 30 participants. Peak values of force and displacement, pressing duration and number of presses were analyzed. Two kinds of subjective evaluations were also recorded: perceived difference in force/displacement used to discriminate between specimens, and perceived effort. Although the number of presses and pressing duration were constant across a wide stiffness range, pressing strength was adjusted for the stiffness of objects, with harder specimens pressed more strongly. Further, even if the stiffnesses of two compared specimens were different, the pressing forces applied to the specimens approached the same magnitude at a higher stiffness range. Differences in force were most easily perceived at lower stiffness ranges, while displacement differences were perceived more readily at higher stiffness ranges. These results were consistent with those of previous studies. Finally, the reasons why stiffness range influenced pressing movements and perceived differences in force/displacement are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Selecting wool-type fabrics for sensorial comfort in women office clothing for the cold season, using the multi-criteria decision analysis

NASA Astrophysics Data System (ADS)

Harpa, Rodica

2017-10-01

This article presents the strategy and the procedure used to achieve the declared goal: fabrics selection, pursuing sensorial comfort of a specific women-clothing item, by using the multi-criteria decision analysis. First, the objective evaluation of seven wool-type woven fabrics, suitable to the quality profile expected for the defined destination, was accomplished. Then, a survey was conducted on a sample of 187 consumers, women aged between 18 to 60 years old, with a background in the textile field, regarding both the preferences manifested in purchasing products, and the importance of various sensory perceptions through handling materials used in clothing products. Finally, the MCDM applied through the implementation of previous accomplished software STAT-ADM, allowed choosing the preferred wool-type fabric in order to get the expected sensorial comfort of women office trousers for the cold season, according to the previously established criteria. This overall approach showed good results in fabrics selection for assuring the sensorial comfort in women’s clothing, by using the multicriteria decision analysis based on a rating scale delivered by customers with knowledge in the textile field, but non-experts in the fabrics hand evaluation topic.

Inter-rater reliability of select physical examination procedures in patients with neck pain.

PubMed

Hanney, William J; George, Steven Z; Kolber, Morey J; Young, Ian; Salamh, Paul A; Cleland, Joshua A

2014-07-01

This study evaluated the inter-rater reliability of select examination procedures in patients with neck pain (NP) conducted over a 24- to 48-h period. Twenty-two patients with mechanical NP participated in a standardized examination. One examiner performed standardized examination procedures and a second blinded examiner repeated the procedures 24-48 h later with no treatment administered between examinations. Inter-rater reliability was calculated with the Cohen Kappa and weighted Kappa for ordinal data while continuous level data were calculated using an intraclass correlation coefficient model 2,1 (ICC2,1). Coefficients for categorical variables ranged from poor to moderate agreement (-0.22 to 0.70 Kappa) and coefficients for continuous data ranged from slight to moderate (ICC2,1 0.28-0.74). The standard error of measurement for cervical range of motion ranged from 5.3° to 9.9° while the minimal detectable change ranged from 12.5° to 23.1°. This study is the first to report inter-rater reliability values for select components of the cervical examination in those patients with NP performed 24-48 h after the initial examination. There was considerably less reliability when compared to previous studies, thus clinicians should consider how the passage of time may influence variability in examination findings over a 24- to 48-h period.

Specific LED-based red light photo-stimulation procedures improve overall sperm function and reproductive performance of boar ejaculates

PubMed Central

Yeste, Marc; Codony, Francesc; Estrada, Efrén; Lleonart, Miquel; Balasch, Sam; Peña, Alejandro; Bonet, Sergi; Rodríguez-Gil, Joan E.

2016-01-01

The present study evaluated the effects of exposing liquid-stored boar semen to different red light LED regimens on sperm quality and reproductive performance. Of all of the tested photo-stimulation procedures, the best pattern consisted of 10 min light, 10 min rest and 10 min of further light (10-10-10 pattern). This pattern induced an intense and transient increase in the majority of motility parameters, without modifying sperm viability and acrosome integrity. While incubating non-photo-stimulated sperm at 37 °C for 90 min decreased all sperm quality parameters, this reduction was prevented when the previously-described light procedure was applied. This effect was concomitant with an increase in the percentage of sperm with high mitochondrial membrane potential. When sperm were subjected to ‘in vitro’ capacitation, photo-stimulation also increased the percentage of sperm with capacitation-like changes in membrane structure. On the other hand, treating commercial semen doses intended for artificial insemination with the 10-10-10 photo-stimulation pattern significantly increased farrowing rates and the number of both total and live-born piglets for parturition. Therefore, our results indicate that a precise photo-stimulation procedure is able to increase the fertilising ability of boar sperm via a mechanism that could be related to mitochondrial function. PMID:26931070

[Clinical features of non-small cell lung cancer cases].

PubMed

Atici, Atilla G; Erkan, Levent; Findik, Serhat; Uzun, Oğuz; Kandemir, Bedri

2004-01-01

The aim of this study was to evaluate the clinical features of non-small cell lung cancer (NSCLC) cases that were diagnosed in our clinic. The patients who were diagnosed as NSCLC in our clinic between January 1988 and January 1999 were comprised the study group. The files and records of the study group were retrospectively reviewed to identify patients and all the data including demographic characteristics, history, physical examination findings, laboratory values, diagnostic procedures, radiologic findings and staging procedures. The study group included 564 patients (506 male, 58 female). The mean age was 60 years (28-97). 87% of the patients were current smokers or ex-smokers. The most frequent symptoms on admission were cough, sputum, and dyspnea. The most common radiologic finding was a central mass with a diameter of more than 4 cm with an irregular border. The diagnosis was established by histopathologic examination of biopsy specimens obtained by various means, in which bronchoscopy was the sole means of diagnosis in 83% of the patients. Histopathologic examination of the biopsy specimens resulted as follows: 85.8% squamous cell carcinoma, 10.3% adenocarcinoma, 1.4% large cell carcinoma, 0.45% adenosquamous carcinoma, and 2.1% undifferentiated NSCLC. Staging procedures that were done in all patients revealed that 85% of the patients were diagnosed at the stage IIIB and IV. Metastasis was most frequently to the bones followed by brain and liver. In our study squamous cell carcinoma was the most common histopathologic type with a higher percentage than the previous reports in the literature. The percentages of stage IIIB and IV were also higher in our study than previous papers in the literature.

Automated solid-phase extraction-liquid chromatography-tandem mass spectrometry analysis of 11-nor-Delta9-tetrahydrocannabinol-9-carboxylic acid in human urine specimens: application to a high-throughput urine analysis laboratory.

PubMed

Robandt, P V; Klette, K L; Sibum, M

2009-10-01

An automated solid-phase extraction coupled with liquid chromatography and tandem mass spectrometry (SPE-LC-MS-MS) method for the analysis of 11-nor-Delta(9)-tetrahydrocannabinol-9-carboxylic acid (THC-COOH) in human urine specimens was developed. The method was linear (R(2) = 0.9986) to 1000 ng/mL with no carryover evidenced at 2000 ng/mL. Limits of quantification and detection were found to be 2 ng/mL. Interrun precision was evaluated at the 15 ng/mL level over nine batches spanning 15 days (n = 45). The coefficient of variation (%CV) was found to be 5.5% over the course of the validation. Intrarun precision of a 15 ng/mL control (n = 5) ranged from 0.58% CV to 7.4% CV for the same set of analytical batches. Interference was tested using (+/-)-11-hydroxy-Delta(9)-tetrahydrocannabinol, cannabidiol, (-)-Delta(8)-tetrahydrocannabinol, and cannabinol. One hundred and nineteen specimens previously found to contain THC-COOH by a previously validated gas chromatographic mass spectrometry (GC-MS) procedure were compared to the SPE-LC-MS-MS method. Excellent agreement was found (R(2) = 0.9925) for the parallel comparison study. The automated SPE procedure eliminates the human factors of specimen handling, extraction, and derivatization, thereby reducing labor costs and rework resulting from human error or technique issues. Additionally, method runtime is greatly reduced (e.g., during parallel studies the SPE-LC-MS-MS instrument was often finished with analysis by the time the technician finished the offline SPE and derivatization procedure prior to the GC-MS analysis).

Research and development for a ground-based hydrogen-maser system

NASA Technical Reports Server (NTRS)

1972-01-01

The results of a joint experiment aimed primarily at the determination of the frequency of the H(1) hyperfine transition are reported. The transition frequency value for Cs-133 hyperfine transition is found. The result is the mean of two independent evaluations against the cesium reference, which differ by 0.002 Hz. The one-sigma uncertainty of the value nu sub H is also estimated to be 0.002 Hz. One evaluation is based on wall shift experiments at Harvard University; the other is a result of new wall shift measurement using many storage bulbs of different sizes at the National Bureau of Standards. The experimental procedures and the applied corrections are described. Results for the wall shift and for the frequency of hydrogen are compared with previously published values, and error limits of the experiments are discussed.

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

Ellis, Sebastian A. R.; Quevillon, Jérémie; You, Tevong

Recently, a general result for evaluating the path integral at one loop was obtained in the form of the Universal One-Loop Effective Action. It may be used to derive effective field theory operators of dimensions up to six, by evaluating the traces of matrices in this expression, with the mass dependence encapsulated in the universal coefficients. In this study we show that it can account for loops of mixed heavy–light particles in the matching procedure. Our prescription for computing these mixed contributions to the Wilson coefficients is conceptually simple. Moreover it has the advantage of maintaining the universal structure ofmore » the effective action, which we illustrate using the example of integrating out a heavy electroweak triplet scalar coupling to a light Higgs doublet. Finally we also identify new structures that were previously neglected in the universal results.« less

Fabrication of light water reactor tritium targets

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

Pilger, J.P.

1991-11-01

The mission of the Fabrication Development Task of the Tritium Target Development Project is: to produce a documented technology basis, including specifications and procedures for target rod fabrication; to demonstrate that light water tritium targets can be manufactured at a rate consistent with tritium production requirements; and to develop quality control methods to evaluate target rod components and assemblies, and establish correlations between evaluated characteristics and target rod performance. Many of the target rod components: cladding tubes, end caps, plenum springs, etc., have similar counterparts in LWR fuel rods. High production rate manufacture and inspection of these components has beenmore » adequately demonstrated by nuclear fuel rod manufacturers. This summary describes the more non-conventional manufacturing processes and inspection techniques developed to fabricate target rod components whose manufacturability at required production rates had not been previously demonstrated.« less

Radiological pitfalls of age estimation in adopted children: a case report.

PubMed

Gibelli, D; De Angelis, D; Cattaneo, C

2015-04-01

Age estimation has a relevant importance in assessing adopted children, also in cases where the age of the minor seems unquestioned, since pathological conditions may radically alter bodily growth. This may lead to an incorrect age evaluation, with consequent social and psychological problems linked to an inadequate collocation in public school. This study aims at exposing a case report concerning age estimation for a newly adopted child from Cambodia; previous clinical documentation reported information suggesting possible malnutrition, which was verified by the observation of a general disalignment of bone and dental structures. This example shows the importance of a thorough forensic evaluation of adopted children from other countries in order to verify the possible environmental modification of physiological growth even where it seems not to be needed, and represents a caveat for clinical and social personnel dealing with adoption procedures.

49 CFR Appendix C to Part 242 - Procedures for Obtaining and Evaluating Motor Vehicle Driving Record Data

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Procedures for Obtaining and Evaluating Motor Vehicle Driving Record Data C Appendix C to Part 242 Transportation Other Regulations Relating to... CERTIFICATION OF CONDUCTORS Pt. 242, App. C Appendix C to Part 242—Procedures for Obtaining and Evaluating Motor...

49 CFR Appendix C to Part 242 - Procedures for Obtaining and Evaluating Motor Vehicle Driving Record Data

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Procedures for Obtaining and Evaluating Motor Vehicle Driving Record Data C Appendix C to Part 242 Transportation Other Regulations Relating to... CERTIFICATION OF CONDUCTORS Pt. 242, App. C Appendix C to Part 242—Procedures for Obtaining and Evaluating Motor...

Accuracy limitations of range-range (spherical) multilateration systems.

DOT National Transportation Integrated Search

1973-10-11

This report presents a novel procedure for determining the accuracy of range-range (or spherical) multilateration systems. The procedure is a generalization of one previously described for hyperbolic multilateration systems. A central result is a dem...

A procedural method for express bus-fringe parking transit planning.

DOT National Transportation Integrated Search

1976-01-01

The report illustrates a procedural method for planning express bus-fringe parking transit services - a method built upon the findings from previous research, including disaggregate travel choice models and planning guidelines. The methodology addres...

Evaluation of a procedure for reducing vehicle-tree accidents.

DOT National Transportation Integrated Search

1987-01-01

A procedure for reducing vehicle-tree accidents was evaluated. The procedure, developed by the Michigan Department of Transportation, consists of five steps: (1) preparing a base map and plotting roadway information, (2) assigning priorities for fiel...

Using Telemedicine to Conduct Behavioral Assessments

PubMed Central

Barretto, Anjali; Wacker, David P; Harding, Jay; Lee, John; Berg, Wendy K

2006-01-01

We describe the use of telemedicine by the Biobehavioral Service at the University of Iowa Hospitals and Clinics to conduct brief functional analyses for children with developmental and behavioral disorders who live in rural areas of Iowa. Instead of being served at our outpatient facility, participants received initial behavioral assessments in their local schools or social service agencies via videoconference. Case descriptions for 2 participants whose evaluations were conducted via telemedicine, and a brief summary of all outpatient assessments conducted over a 4-year period by the Biobehavioral Service, are provided. This report extends previous applications of functional analysis procedures by examining brief behavioral assessments conducted via telemedicine. PMID:17020213

Effects of weak electromagnetic fields on Escherichia coli and Staphylococcus aureus

NASA Astrophysics Data System (ADS)

Smith, Derek A.

Previous studies of electromagnetic field effects on bacteria are examined, and new experimental procedures and their results are discussed. Experimental samples of Escherichia coli and Staphylococcus aureus were prepared in different conditions, and measurements of optical density were used to track growth rates after removing the samples from their associated experimental environments. Experimental environments varied in magnetic field intensities and frequencies, including a control environment of minimal field intensity. Plots of experimental data sets and their associated averages are used to visualize the experimental outcomes, and differences in growth patterns are evaluated. Results are then used to hypothesize the mechanisms and consequences of the potentially observed field effects.

Effect of training different classes of verbal behavior to decrease aberrant verbal behavior.

PubMed

Vandbakk, Monica; Arntzen, Erik; Gisnaas, Arnt; Antonsen, Vidar; Gundhus, Terje

2012-01-01

Inappropriate verbal behavior that is labeled "psychotic" is often described as insensitive to environmental contingencies. The purpose of the current study was to establish different classes of rational or appropriate verbal behavior in a woman with developmental disabilities and evaluate the effects on her psychotic or aberrant vocal verbal behavior. Similar to a previous study (Arntzen, Ro Tonnessen, & Brouwer, 2006), the results of the current study suggested that the procedure helped to establish a repertoire of appropriate functional vocal verbal behavior in the participant. Overall, the results suggested the effectiveness of an intervention based on training various classes of verbal behavior in decreasing aberrant verbal behavior.

Problems in the evaluation of day hospitals.

PubMed

Guy, W; Gross, G M

1967-06-01

The day hospital has been utilized as a means both to maintain and improve remission status of previously hospitalized patients and, more recently, as an alternative to inpatient treatment. Although uniformly encouraging, the reports of treatment success are ambiguous and complicated by the recency and diversity of the programs. Proposals to reduce confusion in the areas of identification of population, definition of treatment, treatment effects, and assessment procedures are discussed. The concept of therapeutic community with its emphasis on socialization processes makes symptom reduction alone an insufficient criterion of treatment success. More comprehensive measures of the permanency of remission and quality of social adjustment are advocated.

Early learning effect of residents for laparoscopic sigmoid resection.

PubMed

Bosker, Robbert; Groen, Henk; Hoff, Christiaan; Totte, Eric; Ploeg, Rutger; Pierie, Jean-Pierre

2013-01-01

To evaluate the effect of learning the laparoscopic sigmoid resection procedure on resident surgeons; establish a minimum number of cases before a resident surgeon could be expected to achieve proficiency with the procedure; and examine if an analysis could be used to measure and support the clinical evaluation of the surgeon's competence with the procedure. Retrospective analysis of data which was prospective entered in the database. From 2003 to 2007 all patients who underwent a laparoscopic sigmoid resection carried out by senior residents, who completed the procedure as the primary surgeon proctored by an experienced surgeon, were included in the study. A cumulative sum control chart (CUSUM) analysis was used evaluate performance. The procedure was defined as a failure if major intra-operative complications occurred such as intra abdominal organ injury, bleeding, or anastomotic leakage; if an inadequate number of lymph nodes (<12 nodes) were removed; or if conversion to an open surgical procedure was required. Thirteen residents performed 169 laparoscopic sigmoid resections in the period evaluated. A significant majority of the resident surgeons were able to consistently perform the procedure without failure after 11 cases and determined to be competent. One resident was not determined to be competent and the CUSUM score supported these findings. We concluded that at least 11 cases are required for most residents to obtain necessary competence with the laparoscopic sigmoid resection procedure. Evaluation with the CUSUM analysis can be used to measure and support the clinical evaluation of the resident surgeon's competence with the procedure. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Efficacy Outcome Measures for Procedural Sedation Clinical Trials in Adults: An ACTTION Systematic Review.

PubMed

Williams, Mark R; McKeown, Andrew; Dexter, Franklin; Miner, James R; Sessler, Daniel I; Vargo, John; Turk, Dennis C; Dworkin, Robert H

2016-01-01

Successful procedural sedation represents a spectrum of patient- and clinician-related goals. The absence of a gold-standard measure of the efficacy of procedural sedation has led to a variety of outcomes being used in clinical trials, with the consequent lack of consistency among measures, making comparisons among trials and meta-analyses challenging. We evaluated which existing measures have undergone psychometric analysis in a procedural sedation setting and whether the validity of any of these measures support their use across the range of procedures for which sedation is indicated. Numerous measures were found to have been used in clinical research on procedural sedation across a wide range of procedures. However, reliability and validity have been evaluated for only a limited number of sedation scales, observer-rated pain/discomfort scales, and satisfaction measures in only a few categories of procedures. Typically, studies only examined 1 or 2 aspects of scale validity. The results are likely unique to the specific clinical settings they were tested in. Certain scales, for example, those requiring motor stimulation, are unsuitable to evaluate sedation for procedures where movement is prohibited (e.g., magnetic resonance imaging scans). Further work is required to evaluate existing measures for procedures for which they were not developed. Depending on the outcomes of these efforts, it might ultimately be necessary to consider measures of sedation efficacy to be procedure specific.

Subliminal presentation of emotionally negative vs positive primes increases the perceived beauty of target stimuli.

PubMed

Era, Vanessa; Candidi, Matteo; Aglioti, Salvatore Maria

2015-11-01

Emotions have a profound influence on aesthetic experiences. Studies using affective priming procedures demonstrate, for example, that inducing a conscious negative emotional state biases the perception of abstract stimuli towards the sublime (Eskine et al. Emotion 12:1071-1074, 2012. doi: 10.1037/a0027200). Moreover, subliminal happy facial expressions have a positive impact on the aesthetic evaluation of abstract art (Flexas et al. PLoS ONE 8:e80154, 2013). Little is known about how emotion influences aesthetic perception of non-abstract, representational stimuli, especially those that are particularly relevant for social behaviour, like human bodies. Here, we explore whether the subliminal presentation of emotionally charged visual primes modulates the explicit subjective aesthetic judgment of body images. Using a forward/backward masking procedure, we presented subliminally positive and negative, arousal-matched, emotional or neutral primes and measured their effect on the explicit evaluation of perceived beauty (high vs low) and emotion (positive vs negative) evoked by abstract and body images. We found that negative primes increased subjective aesthetic evaluations of target bodies or abstract images in comparison with positive primes. No influence of primes on the emotional dimension of the targets was found, thus ruling out an unspecific arousal effect and strengthening the link between emotional valence and aesthetic appreciation. More specifically, that subliminal negative primes increase beauty ratings compared to subliminal positive primes indicates a clear link between negative emotions and positive aesthetic evaluations and vice versa, suggesting a possible link between negative emotion and the experience of sublime in art. The study expands previous research by showing the effect of subliminal negative emotions on the subjective aesthetic evaluation not only of abstract but also of body images.

Minimally-invasive Laser Ablation Inductively Coupled Plasma Mass Spectrometry analysis of model ancient copper alloys

NASA Astrophysics Data System (ADS)

Walaszek, Damian; Senn, Marianne; Wichser, Adrian; Faller, Markus; Wagner, Barbara; Bulska, Ewa; Ulrich, Andrea

2014-09-01

This work describes an evaluation of a strategy for multi-elemental analysis of typical ancient bronzes (copper, lead bronze and tin bronze) by means of laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS).The samples originating from archeological experiments on ancient metal smelting processes using direct reduction in a ‘bloomery’ furnace as well as historical casting techniques were investigated with the use of the previously proposed analytical procedure, including metallurgical observation and preliminary visual estimation of the homogeneity of the samples. The results of LA-ICPMS analysis were compared to the results of bulk composition obtained by X-ray fluorescence spectrometry (XRF) and by inductively coupled plasma mass spectrometry (ICPMS) after acid digestion. These results were coherent for most of the elements confirming the usefulness of the proposed analytical procedure, however the reliability of the quantitative information about the content of the most heterogeneously distributed elements was also discussed in more detail.

Life threatening bleeding from duodenal ulcer after Roux-en-Y gastric bypass: Case report and review of the literature

PubMed Central

Ivanecz, Arpad; Sremec, Marko; Ćeranić, Davorin; Potrč, Stojan; Skok, Pavel

2014-01-01

Acute upper gastrointestinal bleeding is a rare, but serious complication of gastric bypass surgery. The inaccessibility of the excluded stomach restrains postoperative examination and treatment of the gastric remnant and duodenum, and represents a major challenge, especially in the emergency setting. A 59-year-old patient with previous history of peptic ulcer disease had an upper gastrointestinal bleeding from a duodenal ulcer two years after having a gastric bypass procedure for morbid obesity. After negative upper endoscopy finding, he was urgently evaluated for gastrointestinal bleeding. At emergency laparotomy, the bleeding duodenal ulcer was identified by intraoperative endoscopy through gastrotomy. The patient recovered well after surgical hemostasis, excision of the duodenal ulcer and completion of the remnant gastrectomy. Every general practitioner, gastroenterologist and general surgeon should be aware of growing incidence of bariatric operations and coherently possible complications after such procedures, which modify patient’s anatomy and physiology. PMID:25512773

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

Hagen, E.W.

This report reviews and evaluates the performance of the compressed-air and pressurized-nitrogen gas systems in commercial nuclear power units. The information was collected from readily available operating experiences, licensee event reports, system designs in safety analysis reports, and regulatory documents. The results are collated and analyzed for significance and impact on power plant safety performance. Under certain circumstances, the fail-safe philosophy for a piece of equipment or subsystem of the compressed-air systems initiated a series of actions culminating in reactor transient or unit scram. However, based on this study of prevailing operating experiences, reclassifying the compressed-gas systems to a highermore » safety level will neither prevent (nor mitigate) the reoccurrences of such happenings nor alleviate nuclear power plant problems caused by inadequate maintenance, operating procedures, and/or practices. Conversely, because most of the problems were derived from the sources listed previously, upgrading of both maintenance and operating procedures will not only result in substantial improvement in the performance and availability of the compressed-air (and backup nitrogen) systems but in improved overall plant performance.« less

Black-hole kicks from numerical-relativity surrogate models

NASA Astrophysics Data System (ADS)

Gerosa, Davide; Hébert, François; Stein, Leo C.

2018-05-01

Binary black holes radiate linear momentum in gravitational waves as they merge. Recoils imparted to the black-hole remnant can reach thousands of km /s , thus ejecting black holes from their host galaxies. We exploit recent advances in gravitational waveform modeling to quickly and reliably extract recoils imparted to generic, precessing, black-hole binaries. Our procedure uses a numerical-relativity surrogate model to obtain the gravitational waveform given a set of binary parameters; then, from this waveform we directly integrate the gravitational-wave linear momentum flux. This entirely bypasses the need for fitting formulas which are typically used to model black-hole recoils in astrophysical contexts. We provide a thorough exploration of the black-hole kick phenomenology in the parameter space, summarizing and extending previous numerical results on the topic. Our extraction procedure is made publicly available as a module for the Python programming language named surrkick. Kick evaluations take ˜0.1 s on a standard off-the-shelf machine, thus making our code ideal to be ported to large-scale astrophysical studies.

An assessment of differential reinforcement procedures for learners with autism spectrum disorder.

PubMed

Johnson, Kate A; Vladescu, Jason C; Kodak, Tiffany; Sidener, Tina M

2017-04-01

Differential reinforcement procedures may promote unprompted correct responding, resulting in a quicker transfer of stimulus control than nondifferential reinforcement. Recent studies that have compared reinforcement arrangements have found that the most effective arrangement may differ across participants. The current study conducted an assessment of differential reinforcement arrangements (i.e., quality, schedule, and magnitude) and nondifferential reinforcement to identify the most effective arrangement for each participant. The assessment phase showed that the quality arrangement was the most efficient for all participants during auditory-visual matching. Next, a validation phase was conducted to evaluate whether the assessment would predict the most effective arrangement across multiple skills. The results from the assessment phase were validated for all participants for the same skill. However, the results were only validated for one participant during the other skills (i.e., tact and intraverbal). The results are discussed in light of previous research and future areas of research. © 2017 Society for the Experimental Analysis of Behavior.

Delayed benefit of naps on motor learning in preschool children.

PubMed

Desrochers, Phillip C; Kurdziel, Laura B F; Spencer, Rebecca M C

2016-03-01

Sleep benefits memory consolidation across a variety of domains in young adults. However, while declarative memories benefit from sleep in young children, such improvements are not consistently seen for procedural skill learning. Here we examined whether performance improvements on a procedural task, although not immediately observed, are evident after a longer delay when augmented by overnight sleep (24 h after learning). We trained 47 children, aged 33-71 months, on a serial reaction time task and, using a within-subject design, evaluated performance at three time points: immediately after learning, after a daytime nap (nap condition) or equivalent wake opportunity (wake condition), and 24 h after learning. Consistent with previous studies, performance improvements following the nap did not differ from performance improvements following an equivalent interval spent awake. However, significant benefits of the nap were found when performance was assessed 24 h after learning. This research demonstrates that motor skill learning is benefited by sleep, but that this benefit is only evident after an extended period of time.

Heuristic algorithms for the minmax regret flow-shop problem with interval processing times.

PubMed

Ćwik, Michał; Józefczyk, Jerzy

2018-01-01

An uncertain version of the permutation flow-shop with unlimited buffers and the makespan as a criterion is considered. The investigated parametric uncertainty is represented by given interval-valued processing times. The maximum regret is used for the evaluation of uncertainty. Consequently, the minmax regret discrete optimization problem is solved. Due to its high complexity, two relaxations are applied to simplify the optimization procedure. First of all, a greedy procedure is used for calculating the criterion's value, as such calculation is NP-hard problem itself. Moreover, the lower bound is used instead of solving the internal deterministic flow-shop. The constructive heuristic algorithm is applied for the relaxed optimization problem. The algorithm is compared with previously elaborated other heuristic algorithms basing on the evolutionary and the middle interval approaches. The conducted computational experiments showed the advantage of the constructive heuristic algorithm with regards to both the criterion and the time of computations. The Wilcoxon paired-rank statistical test confirmed this conclusion.

Private sector surgical training: feasibility through the lens of appendicectomy.

PubMed

Yap, Raymond; Cullinan, Mark

2017-12-01

Training in medicine and surgery has been a public hospital responsibility in Australia. Increasing specialist training needs has led to pressure on speciality societies to find additional training posts, with one utilized solution being the establishment of private hospital training. This growing use has been despite no previously published evaluations of private hospital training in Australia. This article seeks to evaluate the feasibility of surgical training in private hospitals in appendicectomy. Data were prospectively collected on registrar involvement in appendicectomy cases at a single private tertiary institution over 1 year. These data were divided into groups according to registrar involvement and analysed, looking at training caseload, operating theatre time and complications. A total of 122 cases were analysed over the study period. Registrars were more likely to have increased primary operator responsibility if they were an accredited versus unaccredited registrar (P = 0.04) and if the case was open versus laparoscopic (P < 0.001). There was an increase of 15% in total procedure time when the registrar was involved (P = 0.04). There was no significant difference in complications whether the registrar was involved or not. Training in the private sector in Australia appears feasible, with a small loss of efficiency and no increase in complications. This article hopes to further encourage implementation and evaluation of private sector training programs to expand current training positions. Further studies, in different specialty and procedural domains, are needed to assess and evaluate the ongoing feasibility of private sector training. © 2016 Royal Australasian College of Surgeons.

Defining Autism: Variability in State Education Agency Definitions of and Evaluations for Autism Spectrum Disorders

PubMed Central

Pennington, Malinda L.; Cullinan, Douglas; Southern, Louise B.

2014-01-01

In light of the steady rise in the prevalence of students with autism, this study examined the definition of autism published by state education agencies (SEAs), as well as SEA-indicated evaluation procedures for determining student qualification for autism. We compared components of each SEA definition to aspects of autism from two authoritative sources: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and Individuals with Disabilities Education Improvement Act (IDEA-2004). We also compared SEA-indicated evaluation procedures across SEAs to evaluation procedures noted in IDEA-2004. Results indicated that many more SEA definitions incorporate IDEA-2004 features than DSM-IV-TR features. However, despite similar foundations, SEA definitions of autism displayed considerable variability. Evaluation procedures were found to vary even more across SEAs. Moreover, within any particular SEA there often was little concordance between the definition (what autism is) and evaluation procedures (how autism is recognized). Recommendations for state and federal policy changes are discussed. PMID:24987527

48 CFR 42.1503 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 42.1503 Procedures. (a) Agency procedures for the past performance evaluation system shall generally provide for input to the.... Those individuals identified may obtain information for the evaluation of performance from the program...

Using simulators to teach pediatric airway procedures in an international setting.

PubMed

Schwartz, Marissa A; Kavanagh, Katherine R; Frampton, Steven J; Bruce, Iain A; Valdez, Tulio A

2018-01-01

There has been a growing shift towards endoscopic management of laryngeal procedures in pediatric otolaryngology. There still appears to be a shortage of pediatric otolaryngology programs and children's hospitals worldwide where physicians can learn and practice these skills. Laryngeal simulation models have the potential to be part of the educational training of physicians who lack exposure to relatively uncommon pediatric otolaryngologic pathology. The objective of this study was to assess the utility of pediatric laryngeal models to teach laryngeal pathology to physicians at an international meeting. Pediatric laryngeal models were assessed by participants at an international pediatric otolaryngology meeting. Participants provided demographic information and previous experience with pediatric airways. Participants then performed simulated surgery on these models and evaluated them using both a previously validated Tissue Likeness Scale and a pre-simulation to post-simulation confidence scale. Participants reported significant subjective improvement in confidence level after use of the simulation models (p < 0.05). Participants reported realistic representations of human anatomy and pathology. The models' tissue mechanics were adequate to practice operative technique including the ability to incise, suture, and suspend models. The pediatric laryngeal models demonstrate high quality anatomy, which is easy manipulated with surgical instruments. These models allow both trainees and surgeons to practice time-sensitive airway surgeries in a safe and controlled environment. Copyright © 2017 Elsevier B.V. All rights reserved.

Dual PECCS: a cognitive system for conceptual representation and categorization

NASA Astrophysics Data System (ADS)

Lieto, Antonio; Radicioni, Daniele P.; Rho, Valentina

2017-03-01

In this article we present an advanced version of Dual-PECCS, a cognitively-inspired knowledge representation and reasoning system aimed at extending the capabilities of artificial systems in conceptual categorization tasks. It combines different sorts of common-sense categorization (prototypical and exemplars-based categorization) with standard monotonic categorization procedures. These different types of inferential procedures are reconciled according to the tenets coming from the dual process theory of reasoning. On the other hand, from a representational perspective, the system relies on the hypothesis of conceptual structures represented as heterogeneous proxytypes. Dual-PECCS has been experimentally assessed in a task of conceptual categorization where a target concept illustrated by a simple common-sense linguistic description had to be identified by resorting to a mix of categorization strategies, and its output has been compared to human responses. The obtained results suggest that our approach can be beneficial to improve the representational and reasoning conceptual capabilities of standard cognitive artificial systems, and - in addition - that it may be plausibly applied to different general computational models of cognition. The current version of the system, in fact, extends our previous work, in that Dual- PECCS is now integrated and tested into two cognitive architectures, ACT-R and CLARION, implementing different assumptions on the underlying invariant structures governing human cognition. Such integration allowed us to extend our previous evaluation.

A novel method for analysing key corticosteroids in polar bear (Ursus maritimus) hair using liquid chromatography tandem mass spectrometry.

PubMed

Weisser, Johan J; Hansen, Martin; Björklund, Erland; Sonne, Christian; Dietz, Rune; Styrishave, Bjarne

2016-04-01

This paper presents the development and evaluation of a methodology for extraction, clean-up and analysis of three key corticosteroids (aldosterone, cortisol and corticosterone) in polar bear hair. Such a methodology can be used to monitor stress biomarkers in polar bears and may provide as a useful tool for long-term and retrospective information. We developed a combined pressurized liquid extraction (PLE)-solid phase extraction (SPE) procedure for corticosteroid extraction and clean-up followed by high pressure liquid chromatography tandem mass spectrometry (HPLC-MS/MS) analysis. This procedure allows for the simultaneous determination of multiple steroids, which is in contrast to previous polar bear studies based on ELISA techniques. Absolute method recoveries were 81%, 75% and 60% for cortisol, corticosterone and aldosterone, respectively. We applied the developed method on a hair sample pooled from four East Greenland polar bears. Herein cortisol and corticosterone were successfully determined in levels of 0.32±0.02ng/g hair and 0.13±0.02ng/g hair, respectively. Aldosterone was below limit of detection (LOD<0.17ng/g). The cortisol hair concentration found in these East Greenland polar bears was consistent with cortisol levels previously determined in the Southern Hudson Bay and James Bay in Canada using ELISA kits. Copyright © 2016 Elsevier B.V. All rights reserved.

The Bookmark Procedure for Setting Cut-Scores and Finalizing Performance Standards: Strengths and Weaknesses

ERIC Educational Resources Information Center

Lin, Jie

2006-01-01

The Bookmark standard-setting procedure was developed to address the perceived problems with the most popular method for setting cut-scores: the Angoff procedure (Angoff, 1971). The purposes of this article are to review the Bookmark procedure and evaluate it in terms of Berk's (1986) criteria for evaluating cut-score setting methods. The…

Implementation of a near-zero fluoroscopy approach in interventional electrophysiology: impact of operator experience.

PubMed

Wannagat, Severin; Loehr, Lena; Lask, Sebastian; Völk, Katharina; Karaköse, Tamer; Özcelik, Cemil; Mügge, Andreas; Wutzler, Alexander

2018-04-01

Catheter ablation is performed under fluoroscopic guidance. Reduction of radiation dose for patients and staff is emphasized by current recommendations. Previous studies have shown that lower operator experience leads to increased radiation dose. On the other hand, less experienced operators may depend even more on fluoroscopic guidance. Our study aimed to evaluate feasibility and efficacy of a non-fluoroscopic approach in different training levels. From January 2017, a near-zero fluoroscopy approach was established in two centers. Four operators (beginner, 1st year fellow, 2nd year fellow, expert) were instructed to perform the complete procedure with the use of a 3-D mapping system without fluoroscopy. A historical cohort that underwent procedures with fluoroscopy use served as control group. Dose area product (DPA), procedure duration, acute procedural success, and complications were compared between the groups and for each operator. Procedures were performed in 157 patients. The first 100 patients underwent procedures with fluoroscopic guidance, the following 57 procedures were performed with the near-zero fluoroscopy approach. The results show a significant reduction in DPA for all operators immediately after implementation of the near-zero fluoroscopy protocol (control 637 ± 611 μGy/m 2 ; beginner 44.1 ± 79.5 μGy/m 2 , p = 0.002; 1st year fellow 24.3 ± 46.4.5 μGy/m 2 , p = 0.001; 2nd year fellow 130.3 ± 233.3 μGy/m 2 , p = 0.003; expert 9.3 ± 37.4 μGy/m 2 , P < 0.001). Procedure duration, acute success, and complications were not significantly different between the groups. Our results show a 90% reduction of DPA shortly after implementation of a near-zero fluoroscopy approach in interventional electrophysiology even in operators in training.

[Classification and choice of surgical procedures for chronic pancreatitis].

PubMed

Yang, Yin-Mo; Wan, Yuan-Lian; Zhuang, Yan; Wang, Wei-Min; Yan, Zhong-Yu; Huang, Yan-Ting

2005-02-01

To explore the classification, choice of surgical procedures and the clinical outcome of surgical management for chronic pancreatitis. 54 patients with chronic pancreatitis undergoing operation in our hospital from 1983 to 2004 were analyzed retrospectively, who were divided into chronic calcifying pancreatitis and chronic obstructive pancreatitis according to the clinical manifestations. There were 41 men (76%) and 13 women (24%) with a mean age of 54 years. The cause of chronic pancreatitis was alcohol related in 25 cases (46%), cholelithiasis in 21 (39%), and previous episodes of acute pancreatitis in 18 (33%). Clinical manifestations included abdominal pain in 38 cases (70%), obstructive jaundice in 27 cases (50%). There existed a significant difference in some clinical materials between the two groups of chronic calcifying pancreatitis and chronic obstructive pancreatitis, which might mean the different pathologic basis in the two kinds of chronic pancreatitis. A total of 34 patients underwent nine different operations without perioperative deaths. Both the Puestow procedure and the pancreatoduodenectomy was safe and achieved pain relief in a large percentage of patients, which could also improve the exocrine function whereas the endocrine function remained unchanged. Addition of biliary bypass to the Puestow procedure was suitable for the patients with stenosis of common bile duct. Jaundice was the main manifestation in the patients with the inflammatory mass in the head of the pancreas and Whipple's procedure or other resectional procedures should be performed for them. Only drainage of bile duct had a better outcome for the relief of jaundice, but its effect to pancreas need to be further evaluated. The clinicopathologic characteristics of obstructive chronic pancreatitis was more variable and the surgical management should be also different for individuals.

Navigational ultrasound imaging: A novel imaging tool for aiding interventional therapies of equine musculoskeletal injuries.

PubMed

Lustgarten, M; Redding, W R; Schnabel, L V; Prange, T; Seiler, G S

2016-03-01

Navigational ultrasound imaging, also known as fusion imaging, is a novel technology that allows real-time ultrasound imaging to be correlated with a previously acquired computed tomography (CT) or magnetic resonance imaging (MRI) study. It has been used in man to aid interventional therapies and has been shown to be valuable for sampling and assessing lesions diagnosed with MRI or CT that are equivocal on ultrasonography. To date, there are no reports of the use of this modality in veterinary medicine. To assess whether navigational ultrasound imaging can be used to assist commonly performed interventional therapies for the treatment of equine musculoskeletal injuries diagnosed with MRI and determine the appropriateness of regional anatomical landmarks as registration sites. Retrospective, descriptive clinical study. Horses with musculoskeletal injuries of the distal limb diagnosed with MRI scheduled for ultrasound-guided interventional therapies were evaluated (n = 17 horses with a total of 29 lesions). Anatomical landmarks used for image registration for the navigational procedure were documented. Accuracy of lesion location and success of the procedure were assessed subjectively and described using a grading scale. All procedures were accurately registered using regional anatomical landmarks and considered successful based on our criteria. Anatomical landmarks were described for each lesion type. The addition of navigational imaging was considered to greatly aid the procedures in 59% of cases and added information to the remainder of the procedures. The technique was considered to improve the precision of these interventional procedures. Navigational ultrasound imaging is a complementary imaging modality that can be used for the treatment of equine soft tissue musculoskeletal injuries diagnosed with MRI. © 2015 EVJ Ltd.

A Quantitative Analysis of the Relationship between Medicare Payment and Service Volume for Glaucoma Procedures from 2005 through 2009.

PubMed

Gong, Dan; Jun, Lin; Tsai, James C

2015-05-01

To calculate the association between Medicare payment and service volume for 6 commonly performed glaucoma procedures. Retrospective, longitudinal database study. A 100% dataset of all glaucoma procedures performed on Medicare Part B beneficiaries within the United States from 2005 to 2009. Fixed-effects regression model using Medicare Part B carrier data for all 50 states and the District of Columbia, controlling for time-invariant carrier-specific characteristics, national trends in glaucoma service volume, Medicare beneficiary population, number of ophthalmologists, and income per capita. Payment-volume elasticities, defined as the percent change in service volume per 1% change in Medicare payment, for laser trabeculoplasty (Current Procedural Terminology [CPT] code 65855), trabeculectomy without previous surgery (CPT code 66170), trabeculectomy with previous surgery (CPT code 66172), aqueous shunt to reservoir (CPT code 66180), laser iridotomy (CPT code 66761), and scleral reinforcement with graft (CPT code 67255). The payment-volume elasticity was nonsignificant for 4 of 6 procedures studied: laser trabeculoplasty (elasticity, -0.27; 95% confidence interval [CI], -1.31 to 0.77; P = 0.61), trabeculectomy without previous surgery (elasticity, -0.42; 95% CI, -0.85 to 0.01; P = 0.053), trabeculectomy with previous surgery (elasticity, -0.28; 95% CI, -0.83 to 0.28; P = 0.32), and aqueous shunt to reservoir (elasticity, -0.47; 95% CI, -3.32 to 2.37; P = 0.74). Two procedures yielded significant associations between Medicare payment and service volume. For laser iridotomy, the payment-volume elasticity was -1.06 (95% CI, -1.39 to -0.72; P < 0.001): for every 1% decrease in CPT code 66761 payment, laser iridotomy service volume increased by 1.06%. For scleral reinforcement with graft, the payment-volume elasticity was -2.92 (95% CI, -5.72 to -0.12; P = 0.041): for every 1% decrease in CPT code 67255 payment, scleral reinforcement with graft service volume increased by 2.92%. This study calculated the association between Medicare payment and service volume for 6 commonly performed glaucoma procedures and found varying magnitudes of payment-volume elasticities, suggesting that the volume response to changes in Medicare payments, if present, is not uniform across all Medicare procedures. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

9 CFR 147.16 - Procedure for the evaluation of mycoplasma reactors by in vivo bio-assay (enrichment).

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Procedure for the evaluation of mycoplasma reactors by in vivo bio-assay (enrichment). 147.16 Section 147.16 Animals and Animal Products... the evaluation of mycoplasma reactors by in vivo bio-assay (enrichment). This procedure has been shown...

Human memory reconsolidation: A guiding framework and critical review of the evidence.

PubMed

Elsey, James W B; Van Ast, Vanessa A; Kindt, Merel

2018-05-24

Research in nonhuman animals suggests that reactivation can induce a transient, unstable state in a previously consolidated memory, during which the memory can be disrupted or modified, necessitating a process of restabilization in order to persist. Such findings have sparked a wave of interest into whether this phenomenon, known as reconsolidation, occurs in humans. Translating research from animal models to human experiments and even to clinical interventions is an exciting prospect, but amid this excitement, relatively little work has critically evaluated and synthesized existing research regarding human memory reconsolidation. In this review, we formalize a framework for evaluating and designing studies aiming to demonstrate human memory reconsolidation. We use this framework to shed light on reconsolidation-based research in human procedural memory, aversive and appetitive memory, and declarative memory, covering a diverse selection of the most prominent examples of this research, including studies of memory updating, retrieval-extinction procedures, and pharmacological interventions such as propranolol. Across different types of memory and procedure, there is a wealth of observations consistent with reconsolidation. Moreover, some experimental findings are already being translated into clinically relevant interventions. However, there are a number of inconsistent findings, and the presence of alternative explanations means that we cannot conclusively infer the presence of reconsolidation at the neurobiological level from current evidence. Reconsolidation remains a viable but hotly contested explanation for some observed changes in memory expression in both humans and animals. Developing effective and efficient new reconsolidation-based treatments can be a goal that unites researchers and guides future experiments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Development of an apparatus and methodology for conducting functional magnetic resonance imaging (fMRI) with pharmacological stimuli in conscious rhesus monkeys.

PubMed

Murnane, Kevin Sean; Howell, Leonard Lee

2010-08-15

Functional magnetic resonance imaging (fMRI) is a technique with significant potential to advance our understanding of multiple brain systems. However, when human subjects undergo fMRI studies they are typically conscious whereas pre-clinical fMRI studies typically utilize anesthesia, which complicates comparisons across studies. Therefore, we have developed an apparatus suitable for imaging conscious rhesus monkeys. In order to minimize subject stress and spatial motion, each subject was acclimated to the necessary procedures over several months. The effectiveness of this process was then evaluated, in fully trained subjects, by quantifying objective physiological measures. These physiological metrics were stable both within and across sessions and did not differ from when these same subjects were immobilized using standard primate handling procedures. Subject motion and blood oxygenation level dependent (BOLD) fMRI measurements were then evaluated by scanning subjects under three different conditions: the absence of stimulation, presentation of a visual stimulus, or administration of intravenous (i.v.) cocaine (0.3mg/kg). Spatial motion differed neither by condition nor along the three principal axes. In addition, maximum translational and rotational motion never exceeded one half of the voxel size (0.75 mm) or 1.5 degrees, respectively. Furthermore, the localization of changes in blood oxygenation closely matched those reported in previous studies using similar stimuli. These findings document the feasibility of fMRI data collection in conscious rhesus monkeys using these procedures and allow for the further study of the neural effects of psychoactive drugs. (c) 2010 Elsevier B.V. All rights reserved.

Biclustering of gene expression data using reactive greedy randomized adaptive search procedure

PubMed Central

Dharan, Smitha; Nair, Achuthsankar S

2009-01-01

Background Biclustering algorithms belong to a distinct class of clustering algorithms that perform simultaneous clustering of both rows and columns of the gene expression matrix and can be a very useful analysis tool when some genes have multiple functions and experimental conditions are diverse. Cheng and Church have introduced a measure called mean squared residue score to evaluate the quality of a bicluster and has become one of the most popular measures to search for biclusters. In this paper, we review basic concepts of the metaheuristics Greedy Randomized Adaptive Search Procedure (GRASP)-construction and local search phases and propose a new method which is a variant of GRASP called Reactive Greedy Randomized Adaptive Search Procedure (Reactive GRASP) to detect significant biclusters from large microarray datasets. The method has two major steps. First, high quality bicluster seeds are generated by means of k-means clustering. In the second step, these seeds are grown using the Reactive GRASP, in which the basic parameter that defines the restrictiveness of the candidate list is self-adjusted, depending on the quality of the solutions found previously. Results We performed statistical and biological validations of the biclusters obtained and evaluated the method against the results of basic GRASP and as well as with the classic work of Cheng and Church. The experimental results indicate that the Reactive GRASP approach outperforms the basic GRASP algorithm and Cheng and Church approach. Conclusion The Reactive GRASP approach for the detection of significant biclusters is robust and does not require calibration efforts. PMID:19208127

Evaluation of the heat transfer module (FAHT) of Failure Analysis Nonlinear Thermal And Structural Integrated Code (FANTASTIC)

NASA Technical Reports Server (NTRS)

Keyhani, Majid

1989-01-01

The heat transfer module of FANTASTIC Code (FAHT) is studied and evaluated to the extend possible during the ten weeks duration of this project. A brief background of the previous studies is given and the governing equations as modeled in FAHT are discussed. FAHT's capabilities and limitations based on these equations and its coding methodology are explained in detail. It is established that with improper choice of element size and time step FAHT's temperature field prediction at some nodes will be below the initial condition. The source of this unrealistic temperature prediction is identified and a procedure is proposed for avoiding this phenomenon. It is further shown that the proposed procedure will converge to an accurate prediction upon mesh refinement. Unfortunately due to lack of time FAHT's ability to accurately account for pyrolysis and surface ablation has not been verified. Therefore, at the present time it can be stated with confidence that FAHT can accurately predict the temperature field for a transient multi-dimensional, orthotropic material with directional dependence, variable property, with nonlinear boundary condition. Such a prediction will provide an upper limit for the temperature field in an ablating decomposing nozzle liner. The pore pressure field, however, will not be known.

Dissociative symptoms in individuals with gender dysphoria: is the elevated prevalence real?

PubMed

Colizzi, Marco; Costa, Rosalia; Todarello, Orlando

2015-03-30

This study evaluated dissociative symptomatology, childhood trauma and body uneasiness in 118 individuals with gender dysphoria, also evaluating dissociative symptoms in follow-up assessments after sex reassignment procedures were performed. We used both clinical interviews (Dissociative Disorders Interview Schedule) and self-reported scales (Dissociative Experiences Scale). A dissociative disorder of any kind seemed to be greatly prevalent (29.6%). Moreover, individuals with gender dysphoria had a high prevalence of lifetime major depressive episode (45.8%), suicide attempts (21.2%) and childhood trauma (45.8%), and all these conditions were more frequent in patients who fulfilled diagnostic criteria for any kind of dissociative disorder. Finally, when treated, patients reported lower dissociative symptoms. Results confirmed previous research about distress in gender dysphoria and improved mental health due to sex reassignment procedures. However, it resulted to be difficult to ascertain dissociation in the context of gender dysphoria, because of the similarities between the two conditions and the possible limited application of clinical instruments which do not provide an adequate differential diagnosis. Therefore, because the body uneasiness is common to dissociative experiences and gender dysphoria, the question is whether dissociation is to be seen not as an expression of pathological dissociative experiences but as a genuine feature of gender dysphoria. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A procedure for the assessment of the toxicity of intermediates and products formed during the accidental thermal decomposition of a chemical species.

PubMed

Di Somma, Ilaria; Pollio, Antonino; Pinto, Gabriele; De Falco, Maria; Pizzo, Elio; Andreozzi, Roberto

2010-04-15

The knowledge of the substances which form when a molecule undergoes chemical reactions under unusual conditions is required by European legislation to evaluate the risks associated with an industrial chemical process. A thermal decomposition is often the result of a loss of control of the process which leads to the formation of many substances in some cases not easily predictable. The evaluation of the change of an overall toxicity passing from the parent compound to the mixture of its thermal decomposition products has been already proposed as a practical approach to this problem when preliminary indications about the temperature range in which the molecule decomposes are available. A new procedure is proposed in this work for the obtainment of the mixtures of thermal decomposition products also when there is no previous information about the thermal behaviour of investigated molecules. A scanning calorimetric run that is aimed to identify the onset temperature of the decomposition process is coupled to an isoperibolic one in order to obtain and collect the products. An algal strain is adopted for toxicological assessments of chemical compounds and mixtures. An extension of toxicological investigations to human cells is also attempted. 2009 Elsevier B.V. All rights reserved.

Evaluation of Pharmacist-Initiated Discharge Medication Reconciliation and Patient Counseling Procedures.

PubMed

Choi, Sebastian; Babiak, Jaime

2018-04-01

To evaluate a recently implemented procedure of discharge medication reconciliation and patient counseling completed by pharmacists at a nursing facility. This is a 138-bed nursing facility that houses long-term care residents as well as patients for subacute rehabilitation. Discharge process involves the medical team (geriatrician, medical resident, medical students), social workers, and nurse coordinators. Pharmacists are incorporated in the discharge process by completing medication reconciliation, patient counseling, and telephone follow-up, to improve patient understanding and satisfaction. Medication discrepancies identified by pharmacists via medication reconciliation, number of patients who were counseled by pharmacist, and number of patients encountered for telephone follow-up. Fifty-four patients were discharged during the study period. A total of 200 discrepancies were identified after discharge medication reconciliation by the pharmacist. On average, we found that there were 4 discrepancies per patient (range 0 to 16). Most of the discrepancies that were found were medication additions and omissions. Forty-five patients (83.3%) agreed to counseling and were then counseled by a pharmacist. Patients were often not counseled because of last-minute discharge, and no encounter was made. Involving pharmacists in patient transitions of care may be beneficial as previous studies have demonstrated; however, additional studies in a nursing facility setting are needed to validate these benefits.

Cloud Screening and Quality Control Algorithm for Star Photometer Data: Assessment with Lidar Measurements and with All-sky Images

NASA Technical Reports Server (NTRS)

Ramirez, Daniel Perez; Lyamani, H.; Olmo, F. J.; Whiteman, D. N.; Navas-Guzman, F.; Alados-Arboledas, L.

2012-01-01

This paper presents the development and set up of a cloud screening and data quality control algorithm for a star photometer based on CCD camera as detector. These algorithms are necessary for passive remote sensing techniques to retrieve the columnar aerosol optical depth, delta Ae(lambda), and precipitable water vapor content, W, at nighttime. This cloud screening procedure consists of calculating moving averages of delta Ae() and W under different time-windows combined with a procedure for detecting outliers. Additionally, to avoid undesirable Ae(lambda) and W fluctuations caused by the atmospheric turbulence, the data are averaged on 30 min. The algorithm is applied to the star photometer deployed in the city of Granada (37.16 N, 3.60 W, 680 ma.s.l.; South-East of Spain) for the measurements acquired between March 2007 and September 2009. The algorithm is evaluated with correlative measurements registered by a lidar system and also with all-sky images obtained at the sunset and sunrise of the previous and following days. Promising results are obtained detecting cloud-affected data. Additionally, the cloud screening algorithm has been evaluated under different aerosol conditions including Saharan dust intrusion, biomass burning and pollution events.

Summary of the British Transplantation Society UK Guidelines for Living Donor Liver Transplantation.

PubMed

Manas, Derek; Burnapp, Lisa; Andrews, Peter Antony

2016-06-01

The British Transplantation Society Guidelines for Living Donor Liver Transplantation was published in July 2015 and is the first national guideline in the field of living donor liver transplantation. The guideline aims to review the evidence relating to the evaluation process of both recipient and donor candidates; address the moral and ethical issues surrounding the procedure; outline the technical aspects of the procedure, including the middle hepatic vein controversy and the "small for size syndrome"; review donor and recipient outcomes and complications including donor mortality; and examine evidence relating to the advantages and disadvantages of living donor liver transplantation. In line with previous guidelines published by the BTS, the guideline has used the Grading of Recommendations Assessment, Development and Evaluation system to rate the strength of evidence and recommendations. This article summarizes the Statements of Recommendation contained in the guideline, which provide a framework for the delivery of living liver donation in the United Kingdom and may be of wide international interest. It is recommended that the full guideline document is consulted for details of the relevant references and evidence base. This may be accessed at http://www.bts.org.uk/BTS/Guidelines_Standards/Current/BTS/Guidelines_Standards/Current_Guidelines.aspx?hkey=e285ca32-5920-4613-ac08-fa9fd90915b5.

Subjective evaluation of H.265/HEVC based dynamic adaptive video streaming over HTTP (HEVC-DASH)

NASA Astrophysics Data System (ADS)

Irondi, Iheanyi; Wang, Qi; Grecos, Christos

2015-02-01

The Dynamic Adaptive Streaming over HTTP (DASH) standard is becoming increasingly popular for real-time adaptive HTTP streaming of internet video in response to unstable network conditions. Integration of DASH streaming techniques with the new H.265/HEVC video coding standard is a promising area of research. The performance of HEVC-DASH systems has been previously evaluated by a few researchers using objective metrics, however subjective evaluation would provide a better measure of the user's Quality of Experience (QoE) and overall performance of the system. This paper presents a subjective evaluation of an HEVC-DASH system implemented in a hardware testbed. Previous studies in this area have focused on using the current H.264/AVC (Advanced Video Coding) or H.264/SVC (Scalable Video Coding) codecs and moreover, there has been no established standard test procedure for the subjective evaluation of DASH adaptive streaming. In this paper, we define a test plan for HEVC-DASH with a carefully justified data set employing longer video sequences that would be sufficient to demonstrate the bitrate switching operations in response to various network condition patterns. We evaluate the end user's real-time QoE online by investigating the perceived impact of delay, different packet loss rates, fluctuating bandwidth, and the perceived quality of using different DASH video stream segment sizes on a video streaming session using different video sequences. The Mean Opinion Score (MOS) results give an insight into the performance of the system and expectation of the users. The results from this study show the impact of different network impairments and different video segments on users' QoE and further analysis and study may help in optimizing system performance.

The Impact of Procedural and Epistemological Knowledge on Conceptual Understanding: The Case of Density and Floating-Sinking Phenomena

ERIC Educational Resources Information Center

Zoupidis, Anastasios; Pnevmatikos, Dimitrios; Spyrtou, Anna; Kariotoglou, Petros

2016-01-01

The aim of the present study was twofold. First, we aimed to replicate the findings of previous studies which had showed a substantial improvement on procedural and epistemological knowledge after direct instruction and their maintenance in time. Second, we aimed to examine the dynamic relationships of the procedural (control of variables…

47 CFR 1.2202 - Competitive bidding design options.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Section 1.2202 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Grants...) Procedures that utilize mathematical computer optimization software, such as integer programming, to evaluate... evaluating bids using a ranking based on specified factors. (B) Procedures that combine computer optimization...

Educational and evaluation strategies in the training of physician specialists

PubMed

Gaona-Flores, Verónica Alejandra; Campos-Navarro, Luz Arcelia; Arenas-Osuna, Jesús; Alcalá-Martínez, Enrique

2017-01-01

Teaching strategies have been defined as procedures, means or resources that teachers used to promote meaningful learning. Identify teaching strategies and evaluation used by the professor with residents in tertiary hospitals health care. This is a cross-sectional study conducted with full, associate and assistant professors of various medical specialties. A questionnaire was applied to evaluate the strategies used by professors to teach and evaluate students. We included a sample of 90 professors in 35 medical specialties. The most frequent teaching activities were: organizing students to develop presentations on specific subjects, followed by asking questions on previously reviewed subjects, In terms of the strategies employed, the most frequent "always" option was applied to case analyses. The most frequent methods used for the evaluation of theoretical knowledge were: participation in class, topic presentation and exams. Teaching activities were primarily based on the presentation of specific topics by the residents. The most commonly used educational strategies were clinical case analyses followed by problem-based learning and the use of illustrations. Evaluation of the residents' performance in theory knowledge, hinged on class participation, presentation of assigned topics and exams. Copyright: © 2017 SecretarÍa de Salud

Hydrocarbon- and rubber-producing crops: evaluation of 100 US plant species

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

Buchanan, R.T.; Cull, I.M., Otey, F.H.; Russell, C.R.

1978-01-01

Agricultural production of rubber and other hydrocarbons in the United States may be compatible with increased food and fiber production if entire plants are harvested and processed for fiber, protein, and carbohydrate as well. Procedures and criteria have been established for the preliminary evaluation of plant species as potential multi-use hydrocarbon-producing crops. Previously, 106 species representing 44 families and 81 genera were evaluated. Now an additional 100 species respresenting 13 additional families and 60 additional genera have been evaluated, and some of these species also offer promise as future crops. Several Labiatae are high in natural rubber (NR) content: Pycnanthemummore » incanum (Mountain Mint) and Teucrium canadense (American Germander) were evaluated as promising species. Three Compositae, Cacalia atriplicifolia (Pale Indian-Plant), Solidago graminifolia (Grass-leafed Golden-rod, and Solidago rigida (Stiff Golden-rod) were also evaluated as promising species for NR. Campanuala americana (Tall Bellflower, Campanulaceae) has potential as a source of both oil and NR. Euphorbia dentata (Euphorbiaceae) does not produce NR but is very high in protein and oil contents. Sassafras albudim (Sassafras, Lauraceae) is of interest for its rapid growth rate in combination with a high oil content. A few other species offer some promise.« less