Predicted extracapsular invasion of hilar lymph node metastasis by fusion positron emission tomography/computed tomography in patients with lung cancer

PubMed Central

MAKINO, TAKASHI; HATA, YOSHINOBU; OTSUKA, HAJIME; KOEZUKA, SATOSHI; ISOBE, KAZUTOSHI; TOCHIGI, NOBUMI; SHIRAGA, NOBUYUKI; SHIBUYA, KAZUTOSHI; HOMMA, SAKAE; IYODA, AKIRA

2015-01-01

Intraoperative detection of hilar lymph node metastasis, particularly with extracapsular invasion, may affect the surgical procedure in patients with lung cancer, as the preoperative estimation of hilar lymph node metastasis is unsatisfactory. The aim of this study was to investigate whether fusion positron emission tomography/computed tomography (PET/CT) is able to predict extracapsular invasion of hilar lymph node metastasis. Between April, 2007 and April, 2013, 509 patients with primary lung cancer underwent surgical resection at our institution, among whom 28 patients exhibiting hilar lymph node metastasis (at stations 10 and 11) were enrolled in this study. A maximum lymph node standardized uptake value of >2.5 in PET scans was interpreted as positive. A total of 17 patients had positive preoperative PET/CT findings in their hilar lymph nodes, while the remaining 11 had negative findings. With regard to extracapsular nodal invasion, the PET/CT findings (P=0.0005) and the histological findings (squamous cell carcinoma, P=0.05) were found to be significant predictors in the univariate analysis. In the multivariate analysis, the PET/CT findings were the only independent predictor (P=0.0004). The requirement for extensive pulmonary resection (sleeve lobectomy, bilobectomy or pneumonectomy) was significantly more frequent in the patient group with positive compared with the group with negative PET/CT findings (76 vs. 9%, respectively, P=0.01). Therefore, the PET/CT findings in the hilar lymph nodes were useful for the prediction of extracapsular invasion and, consequently, for the estimation of possible extensive pulmonary resection. PMID:26623046

Predicted extracapsular invasion of hilar lymph node metastasis by fusion positron emission tomography/computed tomography in patients with lung cancer.

PubMed

Makino, Takashi; Hata, Yoshinobu; Otsuka, Hajime; Koezuka, Satoshi; Isobe, Kazutoshi; Tochigi, Nobumi; Shiraga, Nobuyuki; Shibuya, Kazutoshi; Homma, Sakae; Iyoda, Akira

2015-09-01

Intraoperative detection of hilar lymph node metastasis, particularly with extracapsular invasion, may affect the surgical procedure in patients with lung cancer, as the preoperative estimation of hilar lymph node metastasis is unsatisfactory. The aim of this study was to investigate whether fusion positron emission tomography/computed tomography (PET/CT) is able to predict extracapsular invasion of hilar lymph node metastasis. Between April, 2007 and April, 2013, 509 patients with primary lung cancer underwent surgical resection at our institution, among whom 28 patients exhibiting hilar lymph node metastasis (at stations 10 and 11) were enrolled in this study. A maximum lymph node standardized uptake value of >2.5 in PET scans was interpreted as positive. A total of 17 patients had positive preoperative PET/CT findings in their hilar lymph nodes, while the remaining 11 had negative findings. With regard to extracapsular nodal invasion, the PET/CT findings (P=0.0005) and the histological findings (squamous cell carcinoma, P=0.05) were found to be significant predictors in the univariate analysis. In the multivariate analysis, the PET/CT findings were the only independent predictor (P=0.0004). The requirement for extensive pulmonary resection (sleeve lobectomy, bilobectomy or pneumonectomy) was significantly more frequent in the patient group with positive compared with the group with negative PET/CT findings (76 vs. 9%, respectively, P=0.01). Therefore, the PET/CT findings in the hilar lymph nodes were useful for the prediction of extracapsular invasion and, consequently, for the estimation of possible extensive pulmonary resection.

Management of extra-capsular temporo-mandibular joint ankylosis: does conservative approach to treatment have a role?

PubMed

Anyanechi, C E; Osunde, O D; Bassey, G O

2015-06-01

The conventional management of fibrous extracapsular temporo-mandibular joint (TMJ) ankylosis, a debilitating disease, is associated with surgical complications and financial burden on the patients. To assess the outcome of conservative approach to the management of fibrous extracapsular TMJ ankylosis. This is a prospective study of patients who presented at the Dental and Maxillofacial Surgery Clinic of the University of Calabar Teaching Hospital, Nigeria, during the period from January 1999 to December 2012 with a history of inability to open the mouth diagnosed as fibrous extracapsular TMJ ankylosis. Twenty-one subjects were treated and their ages ranged from 11 to 22 years with mean at 15.0 years. There were 13 (61.9 %) males and 8 (38.1 %) females with male: female ratio of 1.6:1. The aetiological factor that predisposed to formation of extracapsular TMJ ankylosis was facial trauma. There was no facial asymmetry and the side distribution of the affliction showed that 1 (4.8 %) was bilateral while 20 (95.2 %) were unilateral. Eight cases (38.1 %) were incomplete ankylosis while the rest (n = 13, 61.9 %) were complete. The shorter the duration of fibrous ankylosis and the greater the initial inter-incisal distance before treatment, the better the treatment outcome. The outcome of treatment suggests that the conservative approach to management of this condition was beneficial to these patients because they presented early. However, randomized controlled clinical trials are needed to validate this treatment option.

Eye health care in the Czech Republic.

PubMed

Kocur, Ivo; Kuchynka, Pavel

2002-01-01

An analysis of eye health care in the Czech Republic as of 1998 was performed. A questionnaire was used to obtain information from all 59 in-patient eye departments. The number of ophthalmologists per 1 million inhabitants was 95. The number of cataract operations per 1 million inhabitants was 4,209: phaco-emulsification (36,926 surgeries, 85.2%), extracapsular extraction (6,094 surgeries, 14.1%) and intracapsular extraction (90 surgeries, 0.2%). Intra-ocular lenses were implanted in 99% of cases; 404 corneal transplantations and 1,220 operations for retinal detachment were performed. The number of pars plana vitrectomies for diabetic eye complications was 661. Selected regional clinical centres should be equipped and preferred by health insurance companies to provide comprehensive eye health care services and training. Copyright 2002 S. Karger AG, Basel

Treatment of medial shoulder joint instability in dogs by extracapsular stabilization with a prosthetic ligament: 39 cases (2008-2013).

PubMed

O'Donnell, Erica M; Canapp, Sherman O; Cook, James L; Pike, Fred

2017-11-01

OBJECTIVE To investigate clinical outcomes for dogs surgically treated for medial shoulder joint instability (MSI) by extracapsular stabilization with a prosthetic ligament. DESIGN Retrospective multicenter case series. ANIMALS 39 client-owned dogs. PROCEDURES Medical records of 3 veterinary medical centers were searched to identify dogs with MSI diagnosed by clinical examination and arthroscopic assessment and treated by extracapsular stabilization with a prosthetic ligament. A minimum 6-month follow-up period was required for study inclusion. Signalment, function or use of the dog, duration of clinical signs, clinical and diagnostic imaging data, MSI grade (1 [mild] to 4 [complete luxation]), follow-up duration, complications, and outcome data were recorded. RESULTS All grades of MSI were represented. Implants were placed successfully in all dogs. Complications (4 major and 2 minor) were recorded for 6 of 39 (15%) dogs; all were treated successfully. Function at the time of last follow-up (6 to 68 months) was deemed full in 30 of 39 (77%) dogs and acceptable in 9 (23%). CONCLUSIONS AND CLINICAL RELEVANCE Surgical treatment of MSI in dogs by extracapsular stabilization with a prosthetic ligament was associated with a complication rate considered acceptable for orthopedic procedures. All patient outcomes were considered successful.

An outbreak of endophthalmitis after extracapsular cataract surgery probably caused by endotoxin contaminated distilled water used to dissolve acetylcholine.

PubMed

Boks, T; van Dissel, J T; Teterissa, N; Ros, F; Mahmut, M H; Utama, E D; Rol, M; van Asdonk, P; Airiani, S; van Meurs, J C

2006-09-01

To study possible causes of an outbreak of severe endophthalmitis after planned extracapsular cataract surgery in Medan, Indonesia. In a 3 week period in November 2001, 17 of 43 patients developed signs of endophthalmitis after planned extracapsular cataract surgery. A search for possible causes was undertaken 4 months later. In autoclaved stored distilled water used to dissolve acetylcholine (used in 16 of 17 patients with endophthalmitis) a high amount of endotoxin was detected in a human blood essay, as well as a small number of non-typeable Pseudomonas spp. These findings suggest that distilled water used as solvent for acetylcholine was responsible for this outbreak of endophthalmitis. As a consequence, we now rely on solvents that are regularly checked for impurities such as an intravenous infusion fluid, rather than on vials with distilled water that is presumed to be sterile and kept for some time.

Pleomorphic adenoma of the accessory parotid gland: case report and reappraisal of intraoral extracapsular dissection for management.

PubMed

Tsegga, Tibebu M; Britt, Jennifer D; Ellwanger, Aragon R

2015-03-01

Pleomorphic adenoma is the most common tumor of the major and minor salivary glands. Rarely is it found evolving from an ectopic location of major salivary glandular tissue in the mid cheek. A healthy 56-year-old woman presented to our institution with a 20-year duration of a slowly growing right cheek soft tissue mass that was causing facial asymmetry. No significant functional or neurosensory dysfunction was appreciated. Radiologic examination showed a heterogeneous, hyperintense, well-delineated mass within the region of the right buccal fat pad. Fine-needle aspiration biopsy showed benign salivary gland elements consistent with pleomorphic adenoma. The decision was made to perform intraoral extracapsular dissection for removal. Discussion of the clinical assessment and magnetic resonance imaging evaluation with an emphasis on intraoral extracapsular dissection for definitive surgical therapy of longstanding benign salivary gland tumors is emphasized. Published by Elsevier Inc.

Correlation between obesity and prognostic/predictive parameters with emphasis on the importance of lymph node metastases in patients with invasive breast carcinoma.

PubMed

Hankó-Bauer, Orsolya; Georgescu, Rares; Coros, Marius F; Boros, Monica; Barsan, Iulia; Stolnicu, Simona

We aimed to evaluate whether obese women experience more advanced invasive breast carcinoma (IBC) with a higher number of involved lymph nodes, higher range of axillary lymph node ratio (LNR) and presence and size of extracapsular extension as it may have an impact on prognosis and management. 245 patients diagnosed with IBC were divided into normal weight (NW), overweight (OW) and obese (OB) groups. Patients were divided into high range of LNR (LNR over or equal to 0.2) and low LNR (LNR less than 0.2). The extracapsular extension dimensions were measured on the original slides of each case and grouped into ≤ 1 mm and > 1 mm. 84 patients (33.07%) were OW, 72 (29.38%) OB and 91 (37.14%) NW. 45.7% of cases had macrometastasis in the axillary lymph nodes. NW patients had significantly fewer metastatic lymph nodes (p = 0.05) than in the OW/OB groups. There was no statistically significant difference between BMI groups according to the LNR (p = 0.66). Out of 111 cases with macrometastasis, 58 cases (52.25%) had extracapsular extension (ECE) (11.7% NW, 24.32% OW and 16.22% OB). Significantly more OW patients presented extranodal invasion (p = 0.04). We found no statistically significant relationship between the extracapsular extension diameter and BMI groups (p = 0.1).

Can Prostate-Specific Antigen Kinetics before Prostate Biopsy Predict the Malignant Potential of Prostate Cancer?

PubMed

Kim, Sang Jin; Jeong, Tae Yoong; Yoo, Dae Seon; Park, Jinsung; Cho, Seok; Kang, Seok Ho; Lee, Sang Hyub; Jeon, Seung Hyun; Lee, Tchun Yong; Park, Sung Yul

2015-11-01

To predict the malignant potential of prostate cancer (PCa) according to prostate-specific antigen velocity (PSAV), PSA density (PSAD), free/total PSA ratio (%fPSA), and digital rectal examination (DRE). From January 2009 to December 2012, 548 adult male patients were diagnosed with PCa by prostate biopsy at four hospitals in Korea. We retrospectively analyzed 155 adult male patients with an initial PSA level≤10 ng/mL and whose PSA levels had been checked more than two times at least 6 months before they had been diagnosed with PCa, with test intervals of more than 3 months. Patients with a urinary tract infection, and patients who had previously undergone cystoscopy or surgery of the prostate were excluded. We separated patients into two groups according to Gleason sum [Gleason sum≤7 (n=134) or Gleason sum≥8 (n=21)] and the presence of extracapsular invasion [organ confined (n=129) or extracapsular invasion (n=26)]. Differences between the groups were compared. The group with a Gleason sum≥8 or extracapsular invasion of PCa showed high PSAV and significantly lower %fPSA. There were no significant differences in PSAD and the presence of an abnormality on DRE between two groups. In PCa patients treated with other therapies besides prostatectomy, a high PSA velocity and a low %fPSA may predict high grade PCa with a Gleason sum≥8 or the presence of extracapsular invasion.

Preliminary study of a new intraocular method in the diagnosis and treatment of Propionibacterium acnes endophthalmitis following cataract extraction.

PubMed

Owens, S L; Lam, S; Tessler, H H; Deutsch, T A

1993-04-01

Late endophthalmitis, due to Propionibacterium acnes, developed in three patients following uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens (PC-IOL) insertion. Cultures from the capsular bag yielded P. acnes in all three. With topical anesthesia and through an anterior chamber paracentesis, culture specimens were taken from and clindamycin irrigated into the capsular bag. Filtered 100% oxygen was introduced into the anterior chamber in two; the third also received an injection of gentamicin and dexamethasone into the capsular bag. After treatment, two patients received oral antibiotics; one received hyperbaric oxygen therapy. Visual acuity was improved and inflammation reduced in all three. However, after treatment, ocular toxic effects due to clindamycin were suspected in one. This approach offers several clear advantages, including topical anesthesia, outpatient management, elimination of the need for vitrectomy, and retention of the intraocular lens (IOL).

An outbreak of endophthalmitis after extracapsular cataract surgery probably caused by endotoxin contaminated distilled water used to dissolve acetylcholine

PubMed Central

Boks, T; van Dissel, J T; Teterissa, N; Ros, F; Mahmut, M H; Utama, E D; Rol, M; van Asdonk, P; Airiani, S; van Meurs, J C

2006-01-01

Aim To study possible causes of an outbreak of severe endophthalmitis after planned extracapsular cataract surgery in Medan, Indonesia. Methods In a 3 week period in November 2001, 17 of 43 patients developed signs of endophthalmitis after planned extracapsular cataract surgery. A search for possible causes was undertaken 4 months later. Results In autoclaved stored distilled water used to dissolve acetylcholine (used in 16 of 17 patients with endophthalmitis) a high amount of endotoxin was detected in a human blood essay, as well as a small number of non‐typeable Pseudomonas spp. Conclusions These findings suggest that distilled water used as solvent for acetylcholine was responsible for this outbreak of endophthalmitis. As a consequence, we now rely on solvents that are regularly checked for impurities such as an intravenous infusion fluid, rather than on vials with distilled water that is presumed to be sterile and kept for some time. PMID:16687451

Translations on North Korea, Number 612

DTIC Science & Technology

1978-08-31

Superintendent of Documents, U.S. Government Printing Office Washington, D.C. 20402. Indexes to this report (by keyword, author, personal names, title and...GOVERNMENTAL AFFAIRS Appearance Lists for DPRK Personalities 1 Japanese Journal Gives Background on Youth League (KITA CHOSEN KENKHJ,, Apr 78) 11...GOVERNMENTAL AFFAIRS APPEARANCE LISTS FOR DPRK PERSONALITIES [The following lists of DPRK government and KWP officials have been extracted from Korean

Extracapsular cataract extraction training: junior ophthalmology residents' self-reported satisfaction level with their proficiency and initial learning barrier.

PubMed

Ting, Daniel Shu Wei; Tan, Sarah; Lee, Shu Yen; Rosman, Mohamad; Aw, Ai Tee; Yeo, Ian Yew San

2015-07-01

To investigate residents' self-reported satisfaction level with their proficiency in extracapsular cataract extraction (ECCE) surgery and the initial barriers to learning the procedure. This is a single-centre prospective descriptive case series involving eight first-year ophthalmology residents in Singapore National Eye Center. We recorded the demographics, frequency of review by the residents of their own surgical videos and their satisfaction level with their proficiency at each of the ECCE steps using a 5-point Likert scale. All ECCE surgical videos between October 2013 and May 2014 were collected and analysed for the overall time taken for the surgery and the time taken to perform the individual steps of the procedure. The mean age of the residents was 27.6 ± 1.5 years and 62.5% (5/8) were women. More than half (62.5%, 5/8) reviewed their own surgical videos while 37.5% (3/8) discussed the surgical videos with their peers or supervisors. Of the ECCE steps, the residents were most dissatisfied with their proficiency in performing irrigation and aspiration (87.5%, 7/8), followed by suturing (62.5%, 5/8), intraocular lens insertion (62.5%, 5/8) and tin can capsulotomy (62.5%, 5/8). The average time taken for each ECCE case was 55.0 ± 12.2 min and, of all the steps, most time was spent on suturing (20.5 ± 6.8 min), followed by irrigation and aspiration (5.5 ± 3.6 min) and tin can capsulotomy (3.3 ± 1.8 min). The first-year ophthalmology residents were most dissatisfied with their proficiency in irrigation/aspiration, suturing and tin can capsulotomy. More training needs to be directed to these areas during teaching sessions in the operating room, wet laboratory or cataract simulation training sessions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Results after planned extracapsular cataract extraction with the Klöti stripper and implantation of UV light-absorbent Simcoe lenses with a 10-degree loop tilt].

PubMed

Gnad, H D; Skorpik, C; Paroussis, P

1985-08-09

Planned ECCE remains a valuable alternative to phacoemulsification due to its protection of the endothelial cells of the cornea. In contrast to the most commonly used infusion-aspiration systems, Kloeti's vitreous stripper provides, in addition, an excellent cutting mechanism enabling the removal of hard parts of the parenchyma or capsular remnants. The aspheric shaped UV light absorbing Simcoe lenses with a 10 grade loop angle used as lens replacement over the past 2 years in 300 cases did not cause any noteworthy complications. In 94% of cases a visual acuity of at least 0.5 was achieved; no case of cystoid macular edema has been observed so far.

A new technique of extracapsular restoration with a tie made of ethylene tetrafluoroethylene (ETFE) for rupture of the cranial cruciate ligament in dogs.

PubMed

Yamada, E; Imayama, Y; Katano, S; Nagashima, F; Shibata, T

1996-06-01

A new extracapsular technique for repair of canine cranial cruciate ligament rupture using an ethylene tetrafluoroethylene (ETFE) tie was presented. Eighteen dogs (body weight: 6.0-46 kg) with this problem were used for this study. The advantages of this method were 1) the operation was easily performed. 2) Joint could be stabilized by proper fixation with microadjustment during operation. 3) This method presented less surgical invasion than the intracapsular one, since wide incision was not conducted over peripheral tissue of the stifle joint.

Serial corneal endothelial cell loss with lathe-cut and injection-molded posterior chamber intraocular lenses.

PubMed

Kraff, M C; Sanders, D R; Lieberman, H L

1983-01-01

We compared endothelial cell loss of patients implanted with lathe-cut posterior chamber lenses and those implanted with injection-molded lenses over a three-year postoperative period. Results were based on more than 2,500 measurements of corneal endothelial density. Although the technique of cataract extraction (anterior chamber phacoemulsification, posterior chamber phacoemulsification, or planned extracapsular extraction) significantly affected cell loss (P less than .01), the type of implant (lathe-cut or injection-molded) did not. Significant continuing endothelial cell loss did not occur during the first three postoperative years with injection-molded lenses. There was, however, a statistically significant 7% to 15% additional cell loss after surgery over the first two to three postoperative years with lathe-cut implants. There have been no cases of corneal endothelial decompensation developing after implantation of injection-molded or lathe-cut lenses. Because a standard field clinical specular microscope was used in this study, cell counting errors cannot be ruled out as a cause of these findings.

The First Cataract Surgeons in Anglo-America

PubMed Central

Leffler, Christopher T.; Schwartz, Stephen G.; Grzybowski, Andrzej; Braich, Puneet S.

2014-01-01

We tried to identify the earliest cataract surgeons in the English-speaking areas of America. In 1751, couching was performed on the Caribbean island of Montserrat by John Morphy. William Stork of England, who couched cataracts, practiced in Jamaica in 1760 and then in cities from Annapolis to Boston between 1761 and 1764. Frederick William Jericho of Germany, upon completion of his training at Utrecht, published his 1767 treatise on his preferred surgical technique of extracapsular cataract extraction. Jericho had practiced in the Leeward Islands by 1776 and then in cities from Charleston to Boston between 1783 and 1785. The French surgeon Lewis Leprilete was the first to advertise cataract extraction in the United States in 1782 and probably passed on the skill to his protégé, Nathaniel Miller of Massachusetts. Leprilete was also the first to publicize Benjamin Franklin's invention of bifocals.. These pioneers exposed American doctors and the public to cataract surgery. Shortly after their arrival, evidence emerges of other surgeons performing these procedures in America. PMID:25444521

Extracapsular dissection for warthin tumors despite the risk of ipsilateral metachronous occurrence.

PubMed

Mantsopoulos, Konstantinos; Goncalves, Miguel; Koch, Michael; Iro, Heinrich

2018-03-24

The ideal extent of surgical intervention for cystadenolymphomas of the parotid gland remains a matter of controversy. The aim of our study was to assess the surgical outcome after extracapsular dissection for cystadenolymphomas of the parotid gland. A further purpose of this study was to examine how the number of primary cystadenolymphomas or the size of the primary lesion influences the possibility of an ipsilateral metachronous tumor occurrence. Retrospective clinical study. A retrospective evaluation of the records was carried out for all patients treated for cystadenolymphomas of the parotid gland by means of extracapsular dissection at a tertiary referral center between 2000 and 2012. Three hundred twenty-seven patients were included in the study. Our analysis detected an overall occurrence rate of ipsilateral metachronous tumors of 3.1% (10/327) with a mean follow-up of 108.4 months. A significant difference in the rate of metachronous lesions between unilocular (1.7%) and multilocular (11.6%) tumors could be detected (χ 2 (1) = 7.342, P < .001). Our analysis was not able to find any significant influence of the maximal tumor size on the rate of metachronous tumors (χ 2 (1) = 0.634, P = .426). One of the most controversial issues in the treatment of cystadenolymphomas of the parotid gland concerns the question of which is the best therapeutic approach to be taken in such patients. Our analysis was able to demonstrate the benefits of extracapsular dissection in the management of solitary as well as carefully selected multicentric cystadenolymphomas with a consistently acceptable surgical outcome. 4. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

Predicting extracapsular involvement in prostate cancer through the tumor contact length and the apparent diffusion coefficient.

PubMed

Granja, M F; Pedraza, C M; Flórez, D C; Romero, J A; Palau, M A; Aguirre, D A

To evaluate the diagnostic performance of the length of the tumor contact with the capsule (LTC) and the apparent diffusion coefficient (ADC) map in the prediction of microscopic extracapsular extension in patients with prostate cancer who are candidates for radical prostatectomy. We used receiver operating curves to retrospectively study the diagnostic performance of the ADC map and the LTC as predictors of microscopic extracapsular extension in 92 patients with prostate cancer and moderate to high risk who were examined between May 2011 and December 2013. The optimal cutoff for the ADC map was 0.87× 10 -3 mm 2 /s, which yielded an area under the ROC curve of 72% (95% CI: 57%-86%), corresponding to a sensitivity of 83% and a specificity of 61%. The optimal cutoff for the LTC was 17.5mm, which yielded an area under the ROC curve of 74% (95% CI: 61%-87%), corresponding to a sensitivity of 91% and a specificity of 57%. Combining the two criteria improved the diagnostic performance, yielding an area under the ROC curve of 77% (95% CI: 62%-92%), corresponding to a sensitivity of 77% and a specificity of 61%. We elaborated a logistic regression model, obtaining an area under the ROC curve of 82% (95% CI: 73%-93%). Using quantitative measures improves the diagnostic accuracy of multiparametric magnetic resonance imaging in the staging of prostate cancer. The values of the ADC and LTC were predictors of microscopic extracapsular extension, and the best results were obtained when both values were used in combination. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Ability of preoperative 3.0-Tesla magnetic resonance imaging to predict the absence of side-specific extracapsular extension of prostate cancer.

PubMed

Hara, Tomohiko; Nakanishi, Hiroyuki; Nakagawa, Tohru; Komiyama, Motokiyo; Kawahara, Takashi; Manabe, Tomoko; Miyake, Mototaka; Arai, Eri; Kanai, Yae; Fujimoto, Hiroyuki

2013-10-01

Recent studies have shown an improvement in prostate cancer diagnosis with the use of 3.0-Tesla magnetic resonance imaging. We retrospectively assessed the ability of this imaging technique to predict side-specific extracapsular extension of prostate cancer. From October 2007 to August 2011, prostatectomy was carried out in 396 patients after preoperative 3.0-Tesla magnetic resonance imaging. Among these, 132 (primary sample) and 134 patients (validation sample) underwent 12-core prostate biopsy at the National Cancer Center Hospital of Tokyo, Japan, and at other institutions, respectively. In the primary dataset, univariate and multivariate analyses were carried out to predict side-specific extracapsular extension using variables determined preoperatively, including 3.0-Tesla magnetic resonance imaging findings (T2-weighted and diffusion-weighted imaging). A prediction model was then constructed and applied to the validation study sample. Multivariate analysis identified four significant independent predictors (P < 0.05), including a biopsy Gleason score of ≥8, positive 3.0-Tesla diffusion-weighted magnetic resonance imaging findings, ≥2 positive biopsy cores on each side and a maximum percentage of positive cores ≥31% on each side. The negative predictive value was 93.9% in the combination model with these four predictors, meanwhile the positive predictive value was 33.8%. Good reproducibility of these four significant predictors and the combination model was observed in the validation study sample. The side-specific extracapsular extension prediction by the biopsy Gleason score and factors associated with tumor location, including a positive 3.0-Tesla diffusion-weighted magnetic resonance imaging finding, have a high negative predictive value, but a low positive predictive value. © 2013 The Japanese Urological Association.

Effect of oxybuprocaine 0.4% in preventing surgically induced miosis.

PubMed Central

van Rij, G; Renardel de Lavalette, J G; Baarsma, G S; Jansen, J T

1984-01-01

In a group of 68 patients a double-blind study was performed to assess the effect of preoperative oxybuprocaine 0.4% (Dorsacaine, Novesin) eye drops in comparison with a placebo in preventing surgically induced miosis during extracapsular cataract extraction. One drop of oxybuprocaine 0.4% or placebo was instilled 10 and 5 minutes preoperatively. The pupil diameter was recorded at different stages of the operation. It was found that oxybuprocaine reduced the amount of pupil constriction during the operation significantly as compared with the placebo group, facilitating the removal of lens material and the implantation of an intraocular lens. The effect of oxybuprocaine is considered to be due to anaesthetic action on sensory nerves in the eye, which may inhibit the release of a miotic substance. PMID:6367812

Effect of oxybuprocaine 0.4% in preventing surgically induced miosis.

PubMed

van Rij, G; Renardel de Lavalette, J G; Baarsma, G S; Jansen, J T

1984-04-01

In a group of 68 patients a double-blind study was performed to assess the effect of preoperative oxybuprocaine 0.4% (Dorsacaine, Novesin) eye drops in comparison with a placebo in preventing surgically induced miosis during extracapsular cataract extraction. One drop of oxybuprocaine 0.4% or placebo was instilled 10 and 5 minutes preoperatively. The pupil diameter was recorded at different stages of the operation. It was found that oxybuprocaine reduced the amount of pupil constriction during the operation significantly as compared with the placebo group, facilitating the removal of lens material and the implantation of an intraocular lens. The effect of oxybuprocaine is considered to be due to anaesthetic action on sensory nerves in the eye, which may inhibit the release of a miotic substance.

Linguine sign in musculoskeletal imaging: calf silicone implant rupture.

PubMed

Duryea, Dennis; Petscavage-Thomas, Jonelle; Frauenhoffer, Elizabeth E; Walker, Eric A

2015-08-01

Imaging findings of breast silicone implant rupture are well described in the literature. On MRI, the linguine sign indicates intracapsular rupture, while the presence of silicone particles outside the fibrous capsule indicates extracapsular rupture. The linguine sign is described as the thin, wavy hypodense wall of the implant within the hyperintense silicone on T2-weighted images indicative of rupture of the implant within the naturally formed fibrous capsule. Hyperintense T2 signal outside of the fibrous capsule is indicative of an extracapsular rupture with silicone granuloma formation. We present a rare case of a patient with a silicone calf implant rupture and discuss the MRI findings associated with this condition.

An eleven gene molecular signature for extra-capsular spread in oral squamous cell carcinoma serves as a prognosticator of outcome in patients without nodal metastases.

PubMed

Wang, Weining; Lim, Weng Khong; Leong, Hui Sun; Chong, Fui Teen; Lim, Tony K H; Tan, Daniel S W; Teh, Bin Tean; Iyer, N Gopalakrishna

2015-04-01

Extracapsular spread (ECS) is an important prognostic factor for oral squamous cell carcinoma (OSCC) and is used to guide management. In this study, we aimed to identify an expression profile signature for ECS in node-positive OSCC using data derived from two different sources: a cohort of OSCC patients from our institution (National Cancer Centre Singapore) and The Cancer Genome Atlas (TCGA) head and neck squamous cell carcinoma (HNSCC) cohort. We also sought to determine if this signature could serve as a prognostic factor in node negative cancers. Patients with a histological diagnosis of OSCC were identified from an institutional database and fresh tumor samples were retrieved. RNA was extracted and gene expression profiling was performed using the Affymetrix GeneChip Human Genome U133 Plus 2.0 microarray platform. RNA sequence data and corresponding clinical data for the TCGA HNSCC cohort were downloaded from the TCGA Data Portal. All data analyses were conducted using R package and SPSS. We identified an 11 gene signature (GGH, MTFR1, CDKN3, PSRC1, SMIM3, CA9, IRX4, CPA3, ZSCAN16, CBX7 and ZFP3) which was robust in segregating tumors by ECS status. In node negative patients, patients harboring this ECS signature had a significantly worse overall survival (p=0.04). An eleven gene signature for ECS was derived. Our results also suggest that this signature is prognostic in a separate subset of patients with no nodal metastasis Further validation of this signature on other datasets and immunohistochemical studies are required to establish utility of this signature in stratifying early stage OSCC patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

Scanning electron microscopy analysis of a sputnik-like intraocular lens 28 years after implantation.

PubMed

Ferrer, Consuelo; Abu-Mustafa, Sabat K; Alió, Jorge L

2009-09-01

To report a pupil-supported, iris-clip intraocular lens (IOL) that was explanted more than 28 years after implantation. A pupil-supported, iris-clip, Sputnik-like IOL was implanted in the left eye of a 33-year-old man to correct aphakia after extracapsular cataract extraction due to trauma. Twenty-eight years after implantation, the patient was referred to our center with loss of vision. Clinical examination showed dislocation of the IOL, which was subsequently explanted. Scanning electron microscopic examination showed a transparent, polymethylmethacrylate (PMMA), pupil-supported, iris-clip IOL with melanosomes and cell deposits (foreign-body reaction) on its surface. This case demonstrates the inertness of PMMA material and reports that a foreign body reaction can be induced following IOL dislocation 28 years after implantation. Copyright 2009, SLACK Incorporated.

Extraoral approach to mandibular condylar fractures: our experience with 100 cases.

PubMed

Colletti, Giacomo; Battista, Valeria Marinella Augusta; Allevi, Fabiana; Giovanditto, Federica; Rabbiosi, Dimitri; Biglioli, Federico

2014-07-01

Mandibular condylar fractures are very common. The current literature contains many indications and methods of treatment. Extraoral approaches are complicated by the need to avoid injury to the facial nerve. On the other hand intraoral approaches can make fracture reduction and/or fixation difficult. The mini-retromandibular approach provides an excellent view of the surgical field, minimises the risk of injury to the facial nerve, and allows rapid and easy management of condylar fractures. We have collected and reviewed our first 100 condylar fractures treated by means of a mini-retromandibular approach. Between June 2006 and June 2012, Eighty-seven patients with extracapsular condylar fractures underwent open reduction and rigid fixation for 100 extracapsular condylar fractures via a mini-retromandibular approach. Dental occlusion and anatomic reduction were restored in all 100 condylar fractures. Postoperative infection developed in three patients. There was one sialocele and one case of plate fracture. Four patients experienced transient palsy of the buccal branch of the facial nerve. No permanent deficit of any facial nerve branch was observed. No patient showed condylar head resorption. Our experience with the treatment of the first 100 condylar fractures using the mini-retromandibular approach has demonstrated that this technique has allowed the Authors to safely manage extracapsular condylar fractures at all levels. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Tibial anatomy in normal small breed dogs including anisometry of various extracapsular stabilizing suture attachment sites.

PubMed

Witte, P G

2015-01-01

To investigate proximal tibial anatomy and its influence on anisometry of extracapsular stabilizing sutures in small dog breeds. Mediolateral radiographs of the femora, stifles, and tibiae of 12 small breed dogs were acquired with the stifles positioned at various angles. Measurements taken included tibial plateau angle (TPA), diaphyseal: proximal tibial angle (DPA), patellar tendon angle (PTA), Z-angle, relative tibial tuberosity width (rTTW), and the distance between six combinations of two femoral and three tibial extra-capsular stabilizing suture (ECS) attachment sites. Theoretical strain through stifle range-of-motion was recorded. The TPA (32° ± 5.8°), DPA (10.2° ± 7.3°), PTA (103.7° ± 6.2°), and Z-angle (70.4° ± 9.0°) were positively correlated with one another (R >0.7), but none were correlated with rTTW (0.93 ± 0.10). The F2-T1 combination of ECS attachment sites had lowest strain for nine stifles. The shortest attachment site separation was at a stifle flexion of 50° for nine stifles. Proximal tibial anatomy measurements could not predict optimal attachment site combination, optimal stifle angle for suture placement, or ECS strain. There is individual variation in the optimal attachment site combination and stifle angle for suture placement, which may influence consistency of outcomes with ECS.

The effect of extracapsular injuries on growth and development of the mandible condyle: an experimental study in growing dogs.

PubMed

Liu, Siying; Tian, Lei; Ding, Mingchao; Liu, Yanpu; Li, Guiyu; Chen, Jinwu; Ding, Yin

2016-11-01

To investigate the effects of condylar extracapsular injuries on the development of the mandibular condyle and try to find a way to treat condylar hyperplasia by electively using such injuries to restrict the overdeveloped mandibular condyle. Sixty 6-month-old beagle puppies were divided randomly into five groups: blank control; unilateral fracture to the condylar neck; unilateral fracture to the condylar neck treated with rigid internal fixation; unilateral periosteum injury; unilateral decortication of the condylar neck. Computed tomography, 99 m Tc single-photon emission computed tomography, and tetracycline-calcein double-labeling were performed after surgery. The puppies were sacrificed 12 and 24 weeks after surgery. Morphologic analyses and examination of growth activity were done. Unilateral fracture of the condylar neck without fixation caused local morphologic changes during the early postoperative period, but compensatory growth of the condyle altered such changes after healing. The other types of injury failed to inhibit the growth of the condyle and the mandible, whereas functional deviation of the chin was found after unilateral fracture of the condylar neck with or without fixation. The four types of extracapsular injury described here failed to inhibit the growth of the mandibular condyle and could not be selected as alternatives to treat condylar hyperplasia. Copyright © 2016 Elsevier Inc. All rights reserved.

Femoral neck-shaft angle in extra-capsular proximal femoral fracture fixation; does it make a TAD of difference?

PubMed

Walton, N P; Wynn-Jones, H; Ward, M S; Wimhurst, J A

2005-11-01

The effect of femoral neck-shaft angle and implant type on the accuracy of lag screw placement in extra-capsular proximal femoral fracture fixation was investigated. Radiographs of all extra-capsular proximal femoral fractures seen in one unit over 18 months were reviewed. Of 399 cases, 307 (237 female, 70 male) were included in the study as they had no contra-lateral proximal femoral metal work. Femoral neck-shaft angle (NSA) of the uninjured hip and magnification adjusted tip-apex distance (TAD) of femoral head lag screw were measured. Type of fixation implant was 135 degrees classic hip screw (CHS) (n=144) or 130 degrees intra-medullary hip screw (IMHS) (n=163). Mean contra-lateral NSA was 130.2 degrees (112.9--148 degrees ) and 64 patients (58 female, 6 male) had a NSA <125 degrees . Mean adjusted TAD was 18.7 mm (5.8--43.8mm) and 88.9% of cases had a TAD of less than 25 mm. TAD values were significantly greater using an IMHS if NSA was <125 degrees than if NSA was >125 degrees (p=0.028). This was not the case with the CHS. The use of the 130 degrees -IMHS in patients with a NSA <125 degrees leads to poorer lag screw placement than if NSA >125 degrees and caution is advocated when using this device in such cases.

Traumatic lenticular abscess: clinical description and outcome.

PubMed

Rajaraman, Revathi; Lalitha, Prajna; Raghavan, Anita; Palanisamy, Manikandan; Prajna, Namperumalsamy Venkatesh

2007-07-01

To analyze cases with posttraumatic lenticular abscess and study the etiology, clinical presentation, management, and outcome. Retrospective case series. Seventeen eyes of 17 patients with traumatic lenticular abscesses were managed with extracapsular cataract extraction after aspirating the abscess. The mean age of the patients was 40.3 years, and males constituted 82%. The mean time to presentation after injury was 14.35 days (range, one to 60 days), and the patients had a mean follow-up of 125.94 days (range, 21 to 300 days). Culture of the lenticular abscess revealed bacterial growth in eight cases (47%) and fungi in four cases (23.5%). In five (29.4%) cases, culture was negative. Staphylococcus epidermidis grew in seven cases (41%). Thirteen eyes (77%) had best-corrected visual acuity better than 20/120. Surgical removal of the abscess, with systemic and local antimicrobial treatment is effective in cases of posttraumatic intralenticular abscess.

Classification of parotidectomies: a proposal of the European Salivary Gland Society.

PubMed

Quer, M; Guntinas-Lichius, O; Marchal, F; Vander Poorten, V; Chevalier, D; León, X; Eisele, D; Dulguerov, P

2016-10-01

The objective of this study is to provide a comprehensive classification system for parotidectomy operations. Data sources include Medline publications, author's experience, and consensus round table at the Third European Salivary Gland Society (ESGS) Meeting. The Medline database was searched with the term "parotidectomy" and "definition". The various definitions of parotidectomy procedures and parotid gland subdivisions extracted. Previous classification systems re-examined and a new classification proposed by a consensus. The ESGS proposes to subdivide the parotid parenchyma in five levels: I (lateral superior), II (lateral inferior), III (deep inferior), IV (deep superior), V (accessory). A new classification is proposed where the type of resection is divided into formal parotidectomy with facial nerve dissection and extracapsular dissection. Parotidectomies are further classified according to the levels removed, as well as the extra-parotid structures ablated. A new classification of parotidectomy procedures is proposed.

Multi-procedure management in an eyeglasses-related open globe injury

PubMed Central

Skopiński, Piotr; Langwińska-Wośko, Ewa; Korwin, Magdalena; Kołodziejczyk, Wojciech; Ambroziak, Anna Maria

2014-01-01

We present a case of successful multi-procedure management of a patient with an open globe injury. A 47-year-old man sustained an injury to his left eye caused by glass fragments of his own spectacles shattered while he was protecting an unknown woman from physical assault at a bus stop. Over a span of 65 months the patient underwent multiple procedures including primary wound repair, penetrating keratoplasty combined with extracapsular cataract extraction, neodymium: YAG laser capsulotomy, and laser-assisted subepithelial keratectomy (LASEK), and had a successfully treated episode of corneal graft rejection. This sequence of treatment substantially improved his left eye vision from hand movements at the time of admission to 0.9–0.5 × 90 at the last follow-up nearly 10 years after the trauma. Proper initial surgical management of an open globe injury can create the possibility for virtually complete vision restoration. PMID:24729818

Intraocular pressure variation following retrobulbar anaesthesia among the different sex, age and ethnic groups in Malaysia.

PubMed

Lee, F N; Kong, V Y; Lee, G P; Ho, K H; Choon, S C; Hoh, H B

1999-12-01

A total of 114 patients (48 Chinese, 34 Malay and 32 Indian) undergoing extracapsular cataract extraction (ECCE) with intraocular lens implantation, were enrolled. All were given 3 ml of local anaesthetic (combination of equal amounts of lignocaine 2% and bupivacaine 0.5%) using retrobulbar technique. Intraocular pressure (IOP) was measured at different time intervals; before, immediately after and 5 minutes after injection with Honan balloon compression. Mean IOP increased by 5.0 mmHg immediately after injection (p < 0.001) and reduced to baseline level after 5 minutes of external compression. Although there were no statistical difference in terms of IOP variation between sex and age groups, Chinese patients demonstrated the highest IOP rise following retrobulbar anaesthesia. This is the first study to demonstrate the influence of race in the IOP response with Chinese subjects having the highest IOP rise.

Outcomes of Patients With Head-and-Neck Cancer of Unknown Primary Origin Treated With Intensity-Modulated Radiotherapy

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

Shoushtari, Asal; Saylor, Drew; Kerr, Kara-Lynne

2011-11-01

Purpose: To analyze survival, failure patterns, and toxicity in patients with head-and-neck carcinoma of unknown primary origin (HNCUP) treated with intensity-modulated radiotherapy (IMRT). Methods and materials: Records from 27 patients with HNCUP treated during the period 2002-2008 with IMRT were reviewed retrospectively. Nodal staging ranged from N1 to N3. The mean preoperative dose to gross or suspected disease, Waldeyer's ring, and uninvolved bilateral cervical nodes was 59.4, 53.5, and 51.0 Gy, respectively. Sixteen patients underwent neck dissection after radiation and 4 patients before radiation. Eight patients with advanced nodal disease (N2b-c, N3) or extracapsular extension received chemotherapy. Results: With amore » median follow-up of 41.9 months (range, 25.3-93.9 months) for nondeceased patients, the 5-year actuarial overall survival, disease-free survival, and nodal control rates were 70.9%, 85.2%, and 88.5%, respectively. Actuarial disease-free survival rates for N1, N2, and N3 disease were 100%, 94.1%, and 50.0%, respectively, at 5 years. When stratified by nonadvanced (N1, N2a nodal disease without extracapsular spread) vs. advanced nodal disease (N2b, N2c, N3), the 5-year actuarial disease-free survival rate for the nonadvanced nodal disease group was 100%, whereas for the advanced nodal disease group it was significantly lower at 66.7% (p = 0.017). Three nodal recurrences were observed: in 1 patient with bulky N2b disease and 2 in patients with N3 disease. No nodal failures occurred in patients with N1 or N2a disease who received only radiation and surgery. Conclusion: Definitive IMRT to 50-56 Gy followed by neck dissection results in excellent nodal control and overall and disease-free survival, with acceptable toxicity for patients with T0N1 or nonbulky T0N2a disease without extracapsular spread. Patients with extracapsular spread, advanced N2 disease, or N3 disease may benefit from concurrent chemotherapy, targeted therapeutic agents, or accelerated radiation regimens in addition to surgery.« less

Arthroscopy of the Nondistractable Hip: A Novel Extracapsular Approach

PubMed Central

Doron, Ran; Amar, Eyal; Rath, Ehud; Sampson, Thomas; Ochiai, Derek; Matsuda, Dean K.

2014-01-01

Adequate traction to achieve hip joint distraction is essential for avoiding iatrogenic injury to the joint during hip arthroscopy. An inability to distract the joint is a relative contraindication for hip arthroscopy. This report describes a novel technique involving an extracapsular approach to gain safe access to a hip joint that fails a trial of traction during positioning for hip arthroscopy. The anterolateral portal is established under fluoroscopic guidance. The arthroscope is positioned on the lateral rim of the acetabulum. A shaver, introduced through a modified anterior portal, is used to facilitate capsular exposure. An arthroscopic capsular incision is made proximal to the lateral acetabular rim and extended anteriorly with a radiofrequency probe. Osteoplasty of the anterolateral acetabular rim is carried out with a burr while protecting the labrum. Distraction of the hip is then possible, allowing safe central-compartment access and subsequent chondrolabral procedures. PMID:25685682

Extracapsular local infiltration analgesia in hip arthroscopy: a retrospective study

PubMed Central

Kahn, Timothy L; Adeyemi, Temitope F; Maak, Travis G

2018-01-01

ABSTRACT Many hip arthroscopy patients experience significant pain in the immediate postoperative period. Although peripheral nerve blocks have demonstrated efficacy in alleviating some of this pain, they come with significant costs. Local infiltration analgesia (LIA) may be a significantly cheaper and efficacious treatment modality. Although LIA has been well studied in hip and knee arthroplasty, its efficacy in hip arthroscopy is unclear. The purpose of this retrospective study is to determine the efficacy of a single extracapsular injection of bupivacaine–epinephrine during hip arthroscopy in reducing the rate of elective postoperative femoral nerve blocks. A retrospective review of 100 consecutive patients who underwent primary hip arthroscopy at a single medical center was performed. The control group consisted of 50 patients before the implementation of the current LIA protocol, whereas another 50 patients received a 20-ml extracapsular injection of 0.25% bupivacaine–epinephrine under direct arthroscopic visualization after capsular closure. In the post-anesthesia care unit (PACU), patients were offered a femoral nerve block for uncontrolled pain. The rate of femoral nerve block, and total opioid consumption, was compared between groups. The proportion of patients receiving elective femoral nerve blocks was significantly less in the LIA group (34%) as compared with the control group (56%; P = 0.027). There was no significant difference in total PACU opioid consumption between groups (P = 0.740). The decreased utilization of postoperative nerve blocks observed in the LIA group suggests that LIA may improve postoperative pain management and should be considered as a potentially cost-effective tool in pain management in hip arthroscopy patients. Level of Evidence: III PMID:29423252

A prospective study about the preoperative total blood loss in older people with hip fracture.

PubMed

Wu, Jie-Zhou; Liu, Peng-Cheng; Ge, Wei; Cai, Ming

2016-01-01

Our study is to confirm that hemoglobin (Hb) level is significantly reduced before operation in elderly patients with hip fracture and to specify potential amounts of bleeding and Hb decline in different types of fractures. A prospective analysis was made on the clinical data of 349 patients with both a diagnosis of hip fracture and an operative delay of greater than 72 hours between April 2014 and February 2016. Hb concentration was measured on a daily basis before the surgery. Patients were grouped according to the type of fracture (intracapsular and extracapsular) for calculation of the total blood loss (TBL). All data analyses were done by SPSS version 21 software. There was a significant decrease preoperatively in the Hb concentration of nearly 21.55 g/L (standard error of the mean [SEM] 7.67) in patients with extracapsular hip fractures and nearly 15.63 g/L (SEM 6.01) in patients with intracapsular hip fractures. The preoperative TBL in patients with extracapsular fracture was significantly larger compared to that in patients with intracapsular fracture (790.3 mL and 581.7 mL, respectively, P <0.05 using Student's t -test). We found no significant difference in the preoperative TBL between the male and female groups. Hip fracture patients have an obvious blood loss after the injury, yet prior to the surgery the Hb levels were found to be normal. Anesthetic and orthopedic staff should pay additional attention to the problem of low preoperative Hb concentration, even if the initial Hb level was apparently normal.

Predictors and Patterns of Local, Regional, and Distant Failure in Squamous Cell Carcinoma of the Vulva.

PubMed

Bogani, Giorgio; Cromi, Antonella; Serati, Maurizio; Uccella, Stefano; Donato, Violante Di; Casarin, Jvan; Naro, Edoardo Di; Ghezzi, Fabio

2017-06-01

To identify factors predicting for recurrence in vulvar cancer patients undergoing surgical treatment. We retrospectively evaluated data of consecutive patients with squamous cell vulvar cancer treated between January 1, 1990 and December 31, 2013. Basic descriptive statistics and multivariable analysis were used to design predicting models influencing outcomes. Five-year disease-free survival (DFS) and overall survival (OS) were analyzed using the Cox model. The study included 101 patients affected by vulvar cancer: 64 (63%) stage I, 12 (12%) stage II, 20 (20%) stage III, and 5 (5%) stage IV. After a mean (SD) follow-up of 37.6 (22.1) months, 21 (21%) recurrences occurred. Local, regional, and distant failures were recorded in 14 (14%), 6 (6%), and 3 (3%) patients, respectively. Five-year DFS and OS were 77% and 82%, respectively. At multivariate analysis only stromal invasion >2 mm (hazard ratio: 4.9 [95% confidence interval, 1.17-21.1]; P=0.04) and extracapsular lymph node involvement (hazard ratio: 9.0 (95% confidence interval, 1.17-69.5); P=0.03) correlated with worse DFS, although no factor independently correlated with OS. Looking at factors influencing local and regional failure, we observed that stromal invasion >2 mm was the only factor predicting for local recurrence, whereas lymph node extracapsular involvement predicted for regional recurrence. Stromal invasion >2 mm and lymph node extracapsular spread are the most important factors predicting for local and regional failure, respectively. Studies evaluating the effectiveness of adjuvant treatment in high-risk patients are warranted.

A multicenter study shows PTEN deletion is strongly associated with seminal vesicle involvement and extracapsular extension in localized prostate cancer.

PubMed

Troyer, Dean A; Jamaspishvili, Tamara; Wei, Wei; Feng, Ziding; Good, Jennifer; Hawley, Sarah; Fazli, Ladan; McKenney, Jesse K; Simko, Jeff; Hurtado-Coll, Antonio; Carroll, Peter R; Gleave, Martin; Lance, Raymond; Lin, Daniel W; Nelson, Peter S; Thompson, Ian M; True, Lawrence D; Brooks, James D; Squire, Jeremy A

2015-08-01

Loss of the phosphatase and tensin homolog (PTEN) tumor suppressor gene is a promising marker of aggressive prostate cancer. Active surveillance and watchful waiting are increasingly recommended to patients with small tumors felt to be low risk, highlighting the difficulties of Gleason scoring in this setting. There is an urgent need for predictive biomarkers that can be rapidly deployed to aid in clinical decision-making. Our objectives were to assess the incidence and ability of PTEN alterations to predict aggressive disease in a multicenter study. We used recently developed probes optimized for sensitivity and specificity in a four-color FISH deletion assay to study the Canary Retrospective multicenter Prostate Cancer Tissue Microarray (TMA). This TMA was constructed specifically for biomarker validation from radical prostatectomy specimens, and is accompanied by detailed clinical information with long-term follow-up. In 612 prostate cancers, the overall rate of PTEN deletion was 112 (18.3%). Hemizygous PTEN losses were present in 55/612 (9.0%) of cancers, whereas homozygous PTEN deletion was observed in 57/612 (9.3%) of tumors. Significant associations were found between PTEN status and pathologic stage (P < 0.0001), seminal vesicle invasion (P = 0.0008), extracapsular extension (P < 0.0001), and Gleason score (P = 0.0002). In logistic regression analysis of clinical and pathological variables, PTEN deletion was significantly associated with extracapsular extension, seminal vesicle involvement, and higher Gleason score. In the 406 patients in which clinical information was available, PTEN homozygous (P = 0.009) deletion was associated with worse post-operative recurrence-free survival (number of events = 189), pre-operative prostate specific antigen (PSA) (P < 0.001), and pathologic stage (P = 0.03). PTEN status assessed by FISH is an independent predictor for recurrence-free survival in multivariate models, as were seminal vesicle invasion, extracapsular extension, and Gleason score, and preoperative PSA. Furthermore, these data demonstrate that the assay can be readily introduced at first diagnosis in a cost effective manner analogous to the use of FISH for analysis of HER2/neu status in breast cancer. Combined with published research beginning 17 years ago, both the data and tools now exist to implement a PTEN assay in the clinic. © 2015 The Authors. The Prostate, published by Wiley Periodicals, Inc.

Comparison of the effects of intraocular irrigating solutions on the corneal endothelium in intraocular lens implantation.

PubMed Central

Matsuda, M; Kinoshita, S; Ohashi, Y; Shimomura, Y; Ohguro, N; Okamoto, H; Omoto, T; Hosotani, H; Yoshida, H

1991-01-01

We conducted a randomised prospective controlled study to determine the effects of a glucose glutathione bicarbonate solution (BSS Plus) and a citrate acetate bicarbonate solution (S-MA2) on the corneal endothelium in patients undergoing extracapsular cataract extraction with posterior chamber lens implantation. One eye of each patient was randomly assigned to receive BSS Plus, and the other eye to receive S-MA2. BSS Plus caused significantly less corneal swelling on the first postoperative day than did S-MA2. There was no difference between the two solutions in their effect on corneal thickness one week and one month postoperatively. Computer assisted morphometric analysis of wide-field specular microscopic photographs demonstrated minimal changes in endothelial morphological characteristics in the eyes irrigated with BSS Plus. By comparison S-MA2, caused a significant loss of endothelial cells and a marked reduction in the figure coefficient. These results indicated that BSS Plus has a clinical advantage over S-MA2 with respect to the corneal endothelium. PMID:1873266

Is anterior chamber lens implantation after intracapsular cataract extraction safe in rural black patients in Africa? A pilot study in KwaZulu-Natal, South Africa.

PubMed

Cook, C D; Evans, J R; Johnson, G J

1998-01-01

There are an estimated 16 million people blind from cataract world-wide. In many areas the routine operation is intracapsular cataract extraction (ICCE). The role of modern anterior chamber (AC) intraocular lenses (IOLs) is being explored, and they have been shown to be safe and successful in Asia. Are they equally safe in rural black African populations? One hundred black patients aged 50 years and over who attended Edendale Hospital were enrolled in a pilot study of insertion of AC IOLs after ICCE. They were followed up for 6 months. With financial remuneration, the follow-up rate at 8 weeks increased from the usual 30% to 72%. At 6 months, 67% of eyes achieved a correlated visual acuity of 6/18 or better. Thirty per cent had persistent uveitis, 16% had peripheral anterior synechiae beyond the points of haptic contact, and 5% had an intraocular pressure greater than 21 mmHg. A randomised trial comparing ICCE with AC IOL and extracapsular cataract extraction with posterior chamber IOL is probably not justified at this time in this population. However, there may be wide variations in the reaction of the eyes of different African ethnic groups to IOLs. In view of the successful use of AC IOLs in Asian eyes, further pilot studies of AC IOLs may be warranted in other parts of Africa where ICCE is the routine procedure.

Extracapsular extension of pelvic lymph node metastases is of prognostic value in carcinoma of the cervix uteri.

PubMed

Horn, Lars-Christian; Hentschel, Bettina; Galle, Dana; Bilek, Karl

2008-01-01

Pelvic lymph node involvement is a well-recognized prognostic factor in cervical carcinoma (CX). Limited knowledge exists about extranodal extension of the tumor outside the lymph node capsule, i.e. extracapsular spread (ECS). Two hundred fifty-six cases of surgically treated CX (FIGO stage IB1 to IIB) with pelvic lymph node involvement were evaluated regarding the occurrence of extranodal spread of the metastatic deposits outside the lymph node capsule (ECS), determined on standardized handled lymphadenectomy specimens, regarding their impact of recurrent disease and overall survival during a median follow-up time of 62 months (95% CI 51-73 months). ECS was seen in 30.9% (79/256) of the cases. The occurrence of ECS showed a significant correlation to advanced stage disease (p=0.02), the number of involved nodes (p<0.001) and the size of metastatic deposits (p<0.01). The 5-year recurrence-free survival rate in patients with ECS was significant lower compared to patients without ECS (59.7% [95% CI: 46.3%-73.2%] versus 67.2% [95% CI: 58.9%-75.5%]; (p=0.04). The 5-year overall survival rate was significant lower in patients with ECS (33.5% [95% CI: 20.6%-46.3%] vs. 60.5% [95% CI: 52.3%-68.6%]; p<0.001). In multivariate analysis, tumor stage, number of involved pelvic nodes, tumor differentiation and ECS were independent prognostic factors. The results indicate that extracapsular spread (ECS) of pelvic lymph node metastases is of prognostic impact in cervical carcinomas. A revised FIGO/TNM classification system for pelvic lymph node disease is recommended: ECS 0 = lymph node involvement without extranodal spread of the metastatic deposits and ECS 1 = lymph node involvement with extranodal spread of the metastatic deposits.

Solid Lymph Nodes as an Imaging Biomarker for Risk Stratification in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma.

PubMed

Rath, T J; Narayanan, S; Hughes, M A; Ferris, R L; Chiosea, S I; Branstetter, B F

2017-07-01

Human papillomavirus-related oropharyngeal squamous cell carcinoma is associated with cystic lymph nodes on CT and has a favorable prognosis. A subset of patients with aggressive disease experience treatment failure. Our aim was to determine whether the extent of cystic lymph node burden on staging CT can serve as an imaging biomarker to predict treatment failure in human papillomavirus-related oropharyngeal squamous cell carcinoma. We identified patients with human papilloma virus-related oropharyngeal squamous cell carcinoma and staging neck CTs. Demographic and clinical variables were recorded. We retrospectively classified the metastatic lymph node burden on CT as cystic or solid and assessed radiologic extracapsular spread. Biopsy, subsequent imaging, or clinical follow-up was the reference standard for treatment failure. The primary end point was disease-free survival. Cox proportional hazard regression analyses of clinical, demographic, and anatomic variables for treatment failure were performed. One hundred eighty-three patients were included with a mean follow-up of 38 months. In univariate analysis, the following variables had a statistically significant association with treatment failure: solid-versus-cystic lymph nodes, clinical T-stage, clinical N-stage, and radiologic evidence of extracapsular spread. The multivariate Cox proportional hazard model resulted in a model that included solid-versus-cystic lymph nodes, T-stage, and radiologic evidence of extracapsular spread as independent predictors of treatment failure. Patients with cystic nodal metastasis at staging had significantly better disease-free survival than patients with solid lymph nodes. In human papilloma virus-related oropharyngeal squamous cell carcinoma, patients with solid lymph node metastases are at higher risk for treatment failure with worse disease-free survival. Solid lymph nodes may serve as an imaging biomarker to tailor individual treatment regimens. © 2017 by American Journal of Neuroradiology.

Magnitude of benefit for adjuvant radiotherapy following minimally invasive surgery in intermediate to high risk HPV-positive oropharyngeal squamous cell carcinoma.

PubMed

Pasalic, Dario; Funk, Ryan K; García, Joaquín J; Price, Daniel L; Price, Katharine A; Harmsen, William S; Patel, Samir H; Young, Geoffrey D; Foote, Robert L; Moore, Eric J; Ma, Daniel J

2018-07-01

To determine the outcomes and toxicities of minimally-invasive surgery with adjuvant intensity-modulated radiotherapy +/- chemotherapy (AT) compared to definitive surgical therapy (ST) in a contemporary cohort of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). From 2005 to 2013, a consecutive cohort of 190 HPV-positive OPSCC patients was retrospectively reviewed from multi-institutional databases maintained by the Departments of Otorhinolaryngology and Radiation Oncology. A total of 116 AT patients and 42 ST patients with intermediate or high risk pathologic features were included in the final analysis. All patients received minimally invasive surgery. Time to recurrence and time to death from the onset of surgery were evaluated. Toxicity data collected included dysphagia or xerostomia requiring feeding tube placement >6 months, or mandibular osteonecrosis requiring surgery or hyperbaric oxygen. All AT patients received IMRT to a median dose of 60 Gy. Chemotherapy delivered to 67.2% of AT patients. AT group included more high-risk patients given higher nodal classification (p = 0.005) and extracapsular extension (p = 0.0005). AT improved disease-free survival (HR 2.77, CI 1.22-6.28; p = 0.02) and local-regional control (HR 14.83, CI 3.240-67.839; p = 0.001). Disease-free survival with AT and tumor extracapsular extension was improved when compared to ST (HR of 4.34, CI 1.540-12.213; p = 0.006). Dysphagia or mandibular osteonecrosis toxicity after AT vs. ST of 19.0% vs. 2.4%. AT improved local-regional control and disease-free survival but was associated with greater toxicity. The recurrence benefit was most pronounced in tumors with extracapsular extension. Copyright © 2018 Elsevier Ltd. All rights reserved.

A multicenter study shows PTEN deletion is strongly associated with seminal vesicle involvement and extracapsular extension in localized prostate cancer

PubMed Central

Troyer, Dean A; Jamaspishvili, Tamara; Wei, Wei; Feng, Ziding; Good, Jennifer; Hawley, Sarah; Fazli, Ladan; McKenney, Jesse K; Simko, Jeff; Hurtado-Coll, Antonio; Carroll, Peter R; Gleave, Martin; Lance, Raymond; Lin, Daniel W; Nelson, Peter S; Thompson, Ian M; True, Lawrence D; Brooks, James D; Squire, Jeremy A

2015-01-01

BACKGROUND Loss of the phosphatase and tensin homolog (PTEN) tumor suppressor gene is a promising marker of aggressive prostate cancer. Active surveillance and watchful waiting are increasingly recommended to patients with small tumors felt to be low risk, highlighting the difficulties of Gleason scoring in this setting. There is an urgent need for predictive biomarkers that can be rapidly deployed to aid in clinical decision-making. Our objectives were to assess the incidence and ability of PTEN alterations to predict aggressive disease in a multicenter study. METHODS We used recently developed probes optimized for sensitivity and specificity in a four-color FISH deletion assay to study the Canary Retrospective multicenter Prostate Cancer Tissue Microarray (TMA). This TMA was constructed specifically for biomarker validation from radical prostatectomy specimens, and is accompanied by detailed clinical information with long-term follow-up. RESULTS In 612 prostate cancers, the overall rate of PTEN deletion was 112 (18.3%). Hemizygous PTEN losses were present in 55/612 (9.0%) of cancers, whereas homozygous PTEN deletion was observed in 57/612 (9.3%) of tumors. Significant associations were found between PTEN status and pathologic stage (P < 0.0001), seminal vesicle invasion (P = 0.0008), extracapsular extension (P < 0.0001), and Gleason score (P = 0.0002). In logistic regression analysis of clinical and pathological variables, PTEN deletion was significantly associated with extracapsular extension, seminal vesicle involvement, and higher Gleason score. In the 406 patients in which clinical information was available, PTEN homozygous (P = 0.009) deletion was associated with worse post-operative recurrence-free survival (number of events = 189), pre-operative prostate specific antigen (PSA) (P < 0.001), and pathologic stage (P = 0.03). CONCLUSION PTEN status assessed by FISH is an independent predictor for recurrence-free survival in multivariate models, as were seminal vesicle invasion, extracapsular extension, and Gleason score, and preoperative PSA. Furthermore, these data demonstrate that the assay can be readily introduced at first diagnosis in a cost effective manner analogous to the use of FISH for analysis of HER2/neu status in breast cancer. Combined with published research beginning 17 years ago, both the data and tools now exist to implement a PTEN assay in the clinic. Prostate 75: 1206–1215, 2015. © 2015 The Authors. The Prostate, published by Wiley Periodicals, Inc. PMID:25939393

A natural language processing program effectively extracts key pathologic findings from radical prostatectomy reports.

PubMed

Kim, Brian J; Merchant, Madhur; Zheng, Chengyi; Thomas, Anil A; Contreras, Richard; Jacobsen, Steven J; Chien, Gary W

2014-12-01

Natural language processing (NLP) software programs have been widely developed to transform complex free text into simplified organized data. Potential applications in the field of medicine include automated report summaries, physician alerts, patient repositories, electronic medical record (EMR) billing, and quality metric reports. Despite these prospects and the recent widespread adoption of EMR, NLP has been relatively underutilized. The objective of this study was to evaluate the performance of an internally developed NLP program in extracting select pathologic findings from radical prostatectomy specimen reports in the EMR. An NLP program was generated by a software engineer to extract key variables from prostatectomy reports in the EMR within our healthcare system, which included the TNM stage, Gleason grade, presence of a tertiary Gleason pattern, histologic subtype, size of dominant tumor nodule, seminal vesicle invasion (SVI), perineural invasion (PNI), angiolymphatic invasion (ALI), extracapsular extension (ECE), and surgical margin status (SMS). The program was validated by comparing NLP results to a gold standard compiled by two blinded manual reviewers for 100 random pathology reports. NLP demonstrated 100% accuracy for identifying the Gleason grade, presence of a tertiary Gleason pattern, SVI, ALI, and ECE. It also demonstrated near-perfect accuracy for extracting histologic subtype (99.0%), PNI (98.9%), TNM stage (98.0%), SMS (97.0%), and dominant tumor size (95.7%). The overall accuracy of NLP was 98.7%. NLP generated a result in <1 second, whereas the manual reviewers averaged 3.2 minutes per report. This novel program demonstrated high accuracy and efficiency identifying key pathologic details from the prostatectomy report within an EMR system. NLP has the potential to assist urologists by summarizing and highlighting relevant information from verbose pathology reports. It may also facilitate future urologic research through the rapid and automated creation of large databases.

The Effects of Governmental Protected Areas and Social Initiatives for Land Protection on the Conservation of Mexican Amphibians

PubMed Central

Ochoa-Ochoa, Leticia; Urbina-Cardona, J. Nicolás; Vázquez, Luis-Bernardo; Flores-Villela, Oscar; Bezaury-Creel, Juan

2009-01-01

Traditionally, biodiversity conservation gap analyses have been focused on governmental protected areas (PAs). However, an increasing number of social initiatives in conservation (SICs) are promoting a new perspective for analysis. SICs include all of the efforts that society implements to conserve biodiversity, such as land protection, from private reserves to community zoning plans some of which have generated community-protected areas. This is the first attempt to analyze the status of conservation in Latin America when some of these social initiatives are included. The analyses were focused on amphibians because they are one of the most threatened groups worldwide. Mexico is not an exception, where more than 60% of its amphibians are endemic. We used a niche model approach to map the potential and real geographical distribution (extracting the transformed areas) of the endemic amphibians. Based on remnant distribution, all the species have suffered some degree of loss, but 36 species have lost more than 50% of their potential distribution. For 50 micro-endemic species we could not model their potential distribution range due to the small number of records per species, therefore the analyses were performed using these records directly. We then evaluated the efficiency of the existing set of governmental protected areas and established the contribution of social initiatives (private and community) for land protection for amphibian conservation. We found that most of the species have some proportion of their potential ecological niche distribution protected, but 20% are not protected at all within governmental PAs. 73% of endemic and 26% of micro-endemic amphibians are represented within SICs. However, 30 micro-endemic species are not represented within either governmental PAs or SICs. This study shows how the role of land conservation through social initiatives is therefore becoming a crucial element for an important number of species not protected by governmental PAs. PMID:19721719

Identification of Differentially Expressed Proteins in Direct Expressed Prostatic Secretions of Men with Organ-confined Versus Extracapsular Prostate Cancer*

PubMed Central

Kim, Yunee; Ignatchenko, Vladimir; Yao, Cindy Q.; Kalatskaya, Irina; Nyalwidhe, Julius O.; Lance, Raymond S.; Gramolini, Anthony O.; Troyer, Dean A.; Stein, Lincoln D.; Boutros, Paul C.; Medin, Jeffrey A.; Semmes, O. John; Drake, Richard R.; Kislinger, Thomas

2012-01-01

Current protocols for the screening of prostate cancer cannot accurately discriminate clinically indolent tumors from more aggressive ones. One reliable indicator of outcome has been the determination of organ-confined versus nonorgan-confined disease but even this determination is often only made following prostatectomy. This underscores the need to explore alternate avenues to enhance outcome prediction of prostate cancer patients. Fluids that are proximal to the prostate, such as expressed prostatic secretions (EPS), are attractive sources of potential prostate cancer biomarkers as these fluids likely bathe the tumor. Direct-EPS samples from 16 individuals with extracapsular (n = 8) or organ-confined (n = 8) prostate cancer were used as a discovery cohort, and were analyzed in duplicate by a nine-step MudPIT on a LTQ-Orbitrap XL mass spectrometer. A total of 624 unique proteins were identified by at least two unique peptides with a 0.2% false discovery rate. A semiquantitative spectral counting algorithm identified 133 significantly differentially expressed proteins in the discovery cohort. Integrative data mining prioritized 14 candidates, including two known prostate cancer biomarkers: prostate-specific antigen and prostatic acid phosphatase, which were significantly elevated in the direct-EPS from the organ-confined cancer group. These and five other candidates (SFN, MME, PARK7, TIMP1, and TGM4) were verified by Western blotting in an independent set of direct-EPS from patients with biochemically recurrent disease (n = 5) versus patients with no evidence of recurrence upon follow-up (n = 10). Lastly, we performed proof-of-concept SRM-MS-based relative quantification of the five candidates using unpurified heavy isotope-labeled synthetic peptides spiked into pools of EPS-urines from men with extracapsular and organ-confined prostate tumors. This study represents the first efforts to define the direct-EPS proteome from two major subclasses of prostate cancer using shotgun proteomics and verification in EPS-urine by SRM-MS. PMID:22986220

PIP breast implants: rupture rate and correlation with breast cancer

PubMed Central

MOSCHETTA, M.; TELEGRAFO, M.; CORNACCHIA, I.; VINCENTI, L.; RANIERI, V.; CIRILLI, A.; RELLA, L.; IANORA, A.A. STABILE; ANGELELLI, G.

2014-01-01

Aim To evaluate the incidence of Poly Implant Prosthése (PIP) rupture as assessed by magnetic resonance imaging (MRI), the prevalence of the detected signs and the potential correlation with breast carcinoma. Patients and methods 67 patients with silicone breast implants and clinical indications for breast MRI were evaluated for a total of 125 implants: 40 (32%) PIP in 21 patients and 85 non-PIP in 46 patients (68%), the latest considered as control group. A 1.5-T MR imaging device was used in order to assess implant integrity with dedicated sequences and in 6 cases a dynamic study was performed for characterizing breast lesions. Two radiologists with more than 5 years’ experience in the field of MRI evaluated in consensus all MR images searching for the presence of clear signs of intra or extra-capsular implant rupture. Results 20/40 (50%) PIP implants presented signs of intra-capsular rupture: linguine sign in 20 cases (100%), tear-drop sign in 6 (30%). In 12/20 cases (60%), MRI signs of extra-capsular rupture were detected. In the control group, an intra-capsular rupture was diagnosed in 12/85 cases (14%) associated with extra-capsular one in 5/12 cases (42%). Among the six cases with suspected breast lesions, in 2/21 patients with PIP implants (10%) a breast carcinoma was diagnosed (mucinous carcinoma, n=1; invasive ductal carcinoma, n=1). In 4/46 patients (9%) with non-PIP implants, an invasive ductal carcinoma was diagnosed. Conclusion The rupture rate of PIP breast implants is significantly higher than non-PIP (50% vs 14%). MRI represents the most accurate imaging tool for evaluating breast prostheses and the linguine sign is the most common MRI sign to be searched. The incidence of breast carcinoma does not significantly differ between the PIP and non-PIP implants and a direct correlation with breast cancer can not been demonstrated. PMID:25644728

PIP breast implants: rupture rate and correlation with breast cancer.

PubMed

Moschetta, M; Telegrafo, M; Cornacchia, I; Vincenti, L; Ranieri, V; Cirili, A; Rella, L; Stabile Ianora, A A; Angelelli, G

2014-01-01

To evaluate the incidence of Poly Implant Prosthése (PIP) rupture as assessed by magnetic resonance imaging (MRI), the prevalence of the detected signs and the potential correlation with breast carcinoma. 67 patients with silicone breast implants and clinical indications for breast MRI were evaluated for a total of 125 implants: 40 (32%) PIP in 21 patients and 85 non-PIP in 46 patients (68%), the latest considered as control group. A 1.5-T MR imaging device was used in order to assess implant integrity with dedicated sequences and in 6 cases a dynamic study was performed for characterizing breast lesions. Two radiologists with more than 5 years' experience in the field of MRI evaluated in consensus all MR images searching for the presence of clear signs of intra or extra-capsular implant rupture. 20/40 (50%) PIP implants presented signs of intra-capsular rupture: linguine sign in 20 cases (100%), tear-drop sign in 6 (30%). In 12/20 cases (60%), MRI signs of extra-capsular rupture were detected. In the control group, an intra-capsular rupture was diagnosed in 12/85 cases (14%) associated with extra-capsular one in 5/12 cases (42%). Among the six cases with suspected breast lesions, in 2/21 patients with PIP implants (10%) a breast carcinoma was diagnosed (mucinous carcinoma, n=1; invasive ductal carcinoma, n=1). In 4/46 patients (9%) with non-PIP implants, an invasive ductal carcinoma was diagnosed. The rupture rate of PIP breast implants is significantly higher than non-PIP (50% vs 14%). MRI represents the most accurate imaging tool for evaluating breast prostheses and the linguine sign is the most common MRI sign to be searched. The incidence of breast carcinoma does not significantly differ between the PIP and non-PIP implants and a direct correlation with breast cancer can not been demonstrated.

Risk Factors for Central Neck Lymph Node Metastases in Micro- Versus Macro- Clinically Node Negative Papillary Thyroid Carcinoma.

PubMed

Sessa, Luca; Lombardi, Celestino Pio; De Crea, Carmela; Tempera, Serena Elisa; Bellantone, Rocco; Raffaelli, Marco

2018-03-01

Tumor size has been advocated as possible risk factors for occult central lymph node metastases (CNM) in papillary thyroid carcinoma (PTC) patients. This prospective study evaluated factors that could identify patients at higher risk of occult CNM, especially comparing micro-PTC and macro-PTC. One hundred and eighty-six patients were recruited. All the patients had cN0 clinically unifocal PTC and underwent total thyroidectomy and bilateral prophylactic central neck dissection. Risk factors for occult CNM in micro- and macro-PTC patients were evaluated. Eighty-two patients showed CNM. The rate of CNM did not differ among different sizes cut off (≤20 mm, ≤10 mm, ≤5 mm P = NS). Significantly more pN1a than pN0 patients had pT3 tumors (35/82 vs. 26/104) (P < 0.05), extracapsular invasion (35/82 vs. 22/104) (P < 0.01) and microscopic multifocal disease (50/82 vs. 47/104) (P < 0.05). Independent risk factors for CNM were extracapsular invasion and multifocality at multivariate analysis. Risk factors for CNM in 77 micro-PTC were extracapsular invasion (16/31 pN1 vs. 10/46 pN0, P < 0.05) and multifocality (21/31 pN1 vs. 16/46 pN0, P < 0.01). Among 109 macro-PTC, risk factors for CNM were angioinvasion (15/51 pN1 vs. 7/58 pN0, P < 0.05) and classic PTC at the final histology (PTC vs. tall cell variant vs. follicular variant PTC) (P < 0.05). Risk factors for CNM can differ between micro- and macro-PTC, but no preoperatively known clinical parameter is predictor of CNM in cN0 clinically unifocal PTC.

Can extracapsular lymph node involvement be a tool to fine-tune pN1 for adenocarcinoma of the oesophagus and gastro-oesophageal junction in the Union Internationale contre le Cancer (UICC) TNM 7th edition?†.

PubMed

Nafteux, Philippe; Lerut, Toni; De Hertogh, Gert; Moons, Johnny; Coosemans, Willy; Decker, Georges; Van Veer, Hans; De Leyn, Paul

2014-06-01

The current (7th) International Union Against Cancer (UICC) pN staging system is based on the number of positive lymph nodes but does not take into consideration the characteristics of the metastatic lymph nodes itself. In particular, it has been suggested that tumour penetration beyond the lymph node capsule in metastatic lymph nodes, which is also called extracapsular lymph node involvement, has a prognostic impact. The aim of the current study was to assess the prognostic value of extracapsular (EC) and intracapsular (IC) lymph node involvement (LNI) in adenocarcinoma of the oesophagus and gastro-oesophageal junction (GOJ) and to assess its potential impact on the 7th edition of the UICC TNM manual. From 2000 to 2010, all consecutive adenocarcinoma patients with primary R0-resection (n = 499) were prospectively included for analysis. The number of resected lymph nodes, number of positive lymph nodes and number of EC-LNI/IC-LNI were determined. Extracapsular spread was defined as infiltration of cancer cells beyond the capsule of the positive lymph node. Two hundred and eighteen (43%) patients had positive lymph nodes. Cancer-specific 5-year survival in lymph node-positive patients was significantly (P < 0.0001) worse compared with lymph node-negative patients, being 88.3 vs 28.7%, respectively. In 128 (58.7%) cases EC-LNI was detected. EC-LNI showed significantly worse cancer-specific 5-year survival compared with IC-LNI, 19.6 vs 44.0% (P < 0.0001). In the pN1 category (1 or 2 positive LN's-UICC stages IIB and IIIA), this was 30.4% vs 58%; (P = 0.029). In higher pN categories, this effect was no longer noticed. Integrating these findings into an adapted TNM classification resulted in improved homogeneity, monotonicity of gradients and discriminatory ability indicating an improved performance of the staging system. EC-LNI is associated with worse survival compared with IC-LNI. EC-LNI patients show survival rates that are more closely associated with the current TNM stage IIIB, while IC-LNI patients have a survival more similar to TNM stage IIB. Incorporating the EC-IC factor in the TNM classification results in an increased performance of the TNM model. Further confirmation from other centres is required within the context of future adaptations of the UICC/AJCC (American Joint Committee on Cancer) staging system for oesophageal cancer. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

A bill to require that, in the questionnaires used in the taking of any decennial census of population, a checkbox or other similar option be included so that respondents may indicate Dominican extraction or descent.

THOMAS, 111th Congress

Sen. Gillibrand, Kirsten E. [D-NY

2009-05-20

Senate - 06/09/2009 Committee on Homeland Security and Governmental Affairs referred to Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Water contamination from oil extraction activities in Northern Peruvian Amazonian rivers.

PubMed

Yusta-García, Raúl; Orta-Martínez, Martí; Mayor, Pedro; González-Crespo, Carlos; Rosell-Melé, Antoni

2017-06-01

Oil extraction activities in the Northern Peruvian Amazon have generated a long-standing socio-environmental conflict between oil companies, governmental authorities and indigenous communities, partly derived from the discharge of produced waters containing high amounts of heavy metals and hydrocarbons. To assess the impact of produced waters discharges we conducted a meta-analysis of 2951 river water and 652 produced water chemical analyses from governmental institutions and oil companies reports, collected in four Amazonian river basins (Marañon, Tigre, Corrientes and Pastaza) and their tributaries. Produced water discharges had much higher concentrations of chloride, barium, cadmium and lead than are typically found in fresh waters, resulting in the widespread contamination of the natural water courses. A significant number of water samples had levels of cadmium, barium, hexavalent chromium and lead that did not meet Peruvian and international water standards. Our study shows that spillage of produced water in Peruvian Amazon rivers placed at risk indigenous population and wildlife during several decades. Furthermore, the impact of such activities in the headwaters of the Amazon extended well beyond the boundaries of oil concessions and national borders, which should be taken into consideration when evaluating large scale anthropogenic impacts in the Amazon. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of pelvic phased-array versus endorectal coil magnetic resonance imaging at 3 Tesla for local staging of prostate cancer.

PubMed

Kim, Bum Soo; Kim, Tae-Hwan; Kwon, Tae Gyun; Yoo, Eun Sang

2012-05-01

Several studies have demonstrated the superiority of endorectal coil magnetic resonance imaging (MRI) over pelvic phased-array coil MRI at 1.5 Tesla for local staging of prostate cancer. However, few have studied which evaluation is more accurate at 3 Tesla MRI. In this study, we compared the accuracy of local staging of prostate cancer using pelvic phased-array coil or endorectal coil MRI at 3 Tesla. Between January 2005 and May 2010, 151 patients underwent radical prostatectomy. All patients were evaluated with either pelvic phased-array coil or endorectal coil prostate MRI prior to surgery (63 endorectal coils and 88 pelvic phased-array coils). Tumor stage based on MRI was compared with pathologic stage. We calculated the specificity, sensitivity and accuracy of each group in the evaluation of extracapsular extension and seminal vesicle invasion. Both endorectal coil and pelvic phased-array coil MRI achieved high specificity, low sensitivity and moderate accuracy for the detection of extracapsular extension and seminal vesicle invasion. There were statistically no differences in specificity, sensitivity and accuracy between the two groups. Overall staging accuracy, sensitivity and specificity were not significantly different between endorectal coil and pelvic phased-array coil MRI.

Single- and double- lumen silicone breast implant integrity: prospective evaluation of MR and US criteria.

PubMed

Berg, W A; Caskey, C I; Hamper, U M; Kuhlman, J E; Anderson, N D; Chang, B W; Sheth, S; Zerhouni, E A

1995-10-01

To evaluate the accuracy of magnetic resonance (MR) and ultrasound (US) criteria for breast implant integrity. One hundred twenty-two single-lumen silicone breast implants and 22 bilumen implants were evaluated with surface coil MR imaging and US and surgically removed. MR criteria for implant failure were a collapsed implant shell ("linguine sign"), foci of silicone outside the shell ("noose sign"), and extracapsular gel, US criteria were collapsed shell, low-level echoes within the gel, and "snowstorm" echoes of extracapsular silicone. Among single-lumen implants, MR imaging depicted 39 of 40 ruptures, 14 of 28 with minimal leakage; 49 of 54 intact implants were correctly interpreted. US depicted 26 of 40 ruptured implants, four of 28 with minimal leakage, and 30 of 54 intact implants. Among bilumen implants, MR imaging depicted four of five implants with rupture of both lumina and nine of 10 as intact; US depicted one rupture and helped identify two of 10 as intact. Mammography accurately depicted the status of 29 of 30 bilumen implants with MR imaging correlation. MR imaging depicts implant integrity more accurately than US; neither method reliably depicts minimal leakage with shell collapse. Mammography is useful in screening bilumen implant integrity.

Perspective of ophthalmology residents in the United States about residency programs and competency in relation to the International Council of Ophthalmology guidelines.

PubMed

Abdelfattah, Nizar Saleh; Radwan, Ahmed E; Sadda, Srinivas R

2016-09-01

To evaluate the perspective of ophthalmology residents in the US about their residency programs and compare the competency of residency programs to international competency levels set by the International Council of Ophthalmology (ICO). A cross-sectional web-based survey extracted from the ICO published competency standards was sent to program directors of ophthalmology residency programs in the US to forward it to current PGY-3, 4 residents, and residency graduates from 2011 to 2014. Eighty-seven responses were received, comprising 61 residents and 26 graduates. Most respondents were highly satisfied with their programs (93.6%). Clinic-based training was rated satisfactorily. Insufficient exposure to low-vision rehabilitation (38.5%), refraction and contact lenses prescription (38.5%), and vitreo-retinal surgeries (38.5%) was reported. Respondents were satisfied with their overall surgical experiences, with the vast majority (>83%) rating case volume, complexity, and variety as satisfactory or better. A significant group stated they had insufficient exposure to extra-capsular cataract extraction (26.3%), refractive surgery (19.7%), and orbital surgery (64.5%). All graduates surveyed passed their Ophthalmic Knowledge Assessment Program (OKAP) examinations, and 72% felt their residency programs adequately prepared them for the examinations. All respondents reported insufficient training in certain nonclinical areas, such as practice management, staffing, and administration skills. Ophthalmology residents in the US express high levels of satisfaction with their residency training programs. While most programs adequately address most ICO core objectives, certain curriculum modifications should be considered.

A 20-Year Review of 75 Cases of Salivary Duct Carcinoma.

PubMed

Gilbert, Mark R; Sharma, Arun; Schmitt, Nicole C; Johnson, Jonas T; Ferris, Robert L; Duvvuri, Umamaheswar; Kim, Seungwon

2016-05-01

Salivary duct carcinoma is a rare, aggressive malignancy of the salivary glands. Owing to its rare nature, clinical data are limited, and only a few clinical studies comprise more than 50 patients. To review the University of Pittsburgh Medical Center's experience with salivary duct carcinoma over a 20-year period, focusing on demographics, presentation, treatment, and outcome. This investigation was a retrospective cohort study in a multihospital institution with tertiary referral. A pathology database was reviewed for all cases of histopathologically diagnosed salivary duct carcinoma from January 1, 1995, to October 20, 2014. Patients who were referrals for pathology review only and were never seen at the institution were excluded. In total, 75 study patients were identified. The electronic medical record was reviewed for details regarding demographics, presentation, treatment, and outcome, including overall survival (OS) and disease-free survival (DFS). This study was supplemented with a review of the institution's Head and Neck Oncology Database for further clinical details. Primary outcome measures consisted of OS and DFS. The study sample comprised 75 participants with a mean age at diagnosis of 66.0 years (age range, 33-93 years), and 29% (n = 22) were female. Most primary tumors were from the parotid gland (83%), with the next most frequent site being the submandibular gland (12%). Overall, 41% of the cases were carcinoma ex pleomorphic adenoma. Rates of other histologic features included the following: perineural invasion (69%), extracapsular spread (58%), ERBB2 (formerly HER2) positivity (31%) (62% of those who were tested), and vascular invasion (61%). The median OS was 3.1 years, and the median DFS was 2.7 years. Univariate Kaplan-Meier survival analyses demonstrated that facial nerve sacrifice and extracapsular spread were associated with lower OS (2.38 vs 5.11 years and 2.29 vs 6.56 years, respectively) and DFS (2.4 vs 3.88 years and 1.44 vs 4.5 years, respectively). Although underpowered, multivariable analysis demonstrated significantly worse OS in patients with N2 and N3 disease (hazard ratio [HR] 8.42, 95% CI, 1.84-38.5) but did not show significantly worse DFS or OS for facial nerve sacrifice or extracapsular spread. There was no association between ERBB2 positivity and survival and no difference in survival between patients receiving radiation therapy vs radiation therapy plus chemotherapy. No patients had recurrence or distant metastasis after 5 disease-free years. Salivary duct carcinoma is an aggressive disease. A large number of cases in this review were carcinoma ex pleomorphic adenoma and had classic negative prognostic indicators, such as perineural invasion, vascular invasion, and extracapsular spread. ERBB2 positivity was not associated with any difference in survival. Facial nerve involvement appears to indicate worse prognosis, as does nodal stage higher than N1. Recurrence and metastasis after 5 years are rare.

Evaluation of antioxidants and argpyrimidine in normal and cataractous lenses in north Indian population

PubMed Central

Mynampati, Bharani K; Ghosh, Sujata; Muthukumarappa, Thungapathra; Ram, Jagat

2017-01-01

AIM To assess the level of glutathione, thioltransferase, and argpyrimidine in nuclear and cortical cataractous lenses as well as in the clear lenses in the north Indian population. METHODS Human cataractous lenses were collected from the patients who underwent extracapsular cataract extraction surgery; clear lenses were collected from the freshly donated eye bank eyes. Antioxidant molecules such as glutathione and thioltransferase enzyme activity were measured; simultaneously in these lenses a blue fluorophore argpyrimidine, an advanced glycation end (AGE) product level was assessed using high performance liquid chromatography (HPLC). RESULTS The protein concentration was found to be present at higher levels in the control lenses compared to cataract lenses. A significant decrease in the glutathione level was observed in the nuclear cataractous lenses compared to cortical cataractous (P=0.004) and clear lenses (P≤0.005), but no significant change in the level of antioxidant enzyme thioltransferase was observed. Further, argpyrimidine a blue fluorophore (AGE) was found to be significantly higher in the nuclear cataract (P=0.013) compared to cortical cataract lenses. CONCLUSION Antioxidants such as glutathione significantly decrease in age-related nuclear and cortical cataract and an AGE, argpyrimidine are present at significantly higher levels in nuclear cataract. PMID:28730112

Using 3 Tesla magnetic resonance imaging in the pre-operative evaluation of tongue carcinoma.

PubMed

Moreno, K F; Cornelius, R S; Lucas, F V; Meinzen-Derr, J; Patil, Y J

2017-09-01

This study aimed to evaluate the role of 3 Tesla magnetic resonance imaging in predicting tongue tumour thickness via direct and reconstructed measures, and their correlations with corresponding histological measures, nodal metastasis and extracapsular spread. A prospective study was conducted of 25 patients with histologically proven squamous cell carcinoma of the tongue and pre-operative 3 Tesla magnetic resonance imaging from 2009 to 2012. Correlations between 3 Tesla magnetic resonance imaging and histological measures of tongue tumour thickness were assessed using the Pearson correlation coefficient: r values were 0.84 (p < 0.0001) and 0.81 (p < 0.0001) for direct and reconstructed measurements, respectively. For magnetic resonance imaging, direct measures of tumour thickness (mean ± standard deviation, 18.2 ± 7.3 mm) did not significantly differ from the reconstructed measures (mean ± standard deviation, 17.9 ± 7.2 mm; r = 0.879). Moreover, 3 Tesla magnetic resonance imaging had 83 per cent sensitivity, 82 per cent specificity, 82 per cent accuracy and a 90 per cent negative predictive value for detecting cervical lymph node metastasis. In this cohort, 3 Tesla magnetic resonance imaging measures of tumour thickness correlated highly with the corresponding histological measures. Further, 3 Tesla magnetic resonance imaging was an effective method of detecting malignant adenopathy with extracapsular spread.

Germline PRKACA amplification leads to Cushing syndrome caused by 3 adrenocortical pathologic phenotypes.

PubMed

Carney, J Aidan; Lyssikatos, Charalampos; Lodish, Maya B; Stratakis, Constantine A

2015-01-01

We describe the pathology of 5 patients with germline PRKACA copy number gain and Cushing syndrome: 4 males and 1 female, aged 2 to 43 years, including a mother and son. Imaging showed normal or slightly enlarged adrenal glands in 4 patients and a unilateral mass in the fifth. Biochemically, the patients had corticotropin-independent hypercortisolism. Four underwent bilateral adrenalectomy; unilateral adrenalectomy was performed in the patient with the adrenal mass. Pathologically, 3 patients, including the 1 with the tumor (adenoma), had primary pigmented nodular adrenocortical disease with extranodular cortical atrophy and mild intracapsular and extracapsular extension of cortical cells. The other 2 patients had cortical hyperplasia and prominent capsular and extracapsular micronodular cortical hyperplasia. Immunoperoxidase staining revealed differences for synaptophysin, inhibin-A, and Ki-67 (nuclei) in the atrophic cortices (patients 1, 2, and 3) and hyperplastic cortices (patients 4 and 5) and for Ki-67 (nuclei) and vimentin in the extracortical nodules in the 2 groups of patients. β-Catenin stained the cell membrane, cytoplasm, and nuclei of the adenoma. The patients were well at follow-up (1-23 years); 24-hour urinary cortisol excretion was elevated in the patient who had unilateral adrenalectomy. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparison of Pelvic Phased-Array versus Endorectal Coil Magnetic Resonance Imaging at 3 Tesla for Local Staging of Prostate Cancer

PubMed Central

Kim, Bum Soo; Kim, Tae-Hwan; Kwon, Tae Gyun

2012-01-01

Purpose Several studies have demonstrated the superiority of endorectal coil magnetic resonance imaging (MRI) over pelvic phased-array coil MRI at 1.5 Tesla for local staging of prostate cancer. However, few have studied which evaluation is more accurate at 3 Tesla MRI. In this study, we compared the accuracy of local staging of prostate cancer using pelvic phased-array coil or endorectal coil MRI at 3 Tesla. Materials and Methods Between January 2005 and May 2010, 151 patients underwent radical prostatectomy. All patients were evaluated with either pelvic phased-array coil or endorectal coil prostate MRI prior to surgery (63 endorectal coils and 88 pelvic phased-array coils). Tumor stage based on MRI was compared with pathologic stage. We calculated the specificity, sensitivity and accuracy of each group in the evaluation of extracapsular extension and seminal vesicle invasion. Results Both endorectal coil and pelvic phased-array coil MRI achieved high specificity, low sensitivity and moderate accuracy for the detection of extracapsular extension and seminal vesicle invasion. There were statistically no differences in specificity, sensitivity and accuracy between the two groups. Conclusion Overall staging accuracy, sensitivity and specificity were not significantly different between endorectal coil and pelvic phased-array coil MRI. PMID:22476999

Complications of hip fractures: A review

PubMed Central

Carpintero, Pedro; Caeiro, Jose Ramón; Carpintero, Rocío; Morales, Angela; Silva, Samuel; Mesa, Manuel

2014-01-01

Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections (alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum -a major contributor to fracture healing- in the femoral neck. In extracapsular fractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients. PMID:25232517

Is arthroplasty preferable to internal fixation for the treatment of extracapsular fracture of the upper femur in the elderly?

PubMed

Duriez, P; Devaux, T; Chantelot, C; Baudrier, N; Hery, J-Y; Mainard, D; Favier, T; Massin, P

2016-10-01

Although internal fixation is the reference treatment for extracapsular fracture of the upper femur, indications for arthroplasty are broadening, especially in unstable comminutive fracture in fragile bone. The present study hypothesis was that arthroplasty reduces early mortality and morbidity and provides better recovery of autonomy in over-80 year-old patients than does internal fixation. A prospective multicenter study was conducted on 8 sites. Internal fixation was systematically used in 5 centers; arthroplasty was used systematically in 1 center, and reserved for unstable fracture in 2 centers. A total of 697 patients aged over 80 years (mean age, 85±5 years), presenting with extracapsular fracture, were included; 521 were treated by internal fixation and 176 by arthroplasty. Results were studied on multivariate analysis of ASA score, blood loss, transfusion, and also of treatment modality as an independent factor for early (first 6 months) mortality and morbidity (mechanical, general and nutritional complications) and functional outcome (autonomy and dependence). Overall mortality was 19.2%. Autonomy deteriorated in 56% of patients alive at 6 months and dependence worsened in 44%. Two percent of those managed by internal fixation underwent revision for disassembly (n=8) or infection (n=1). Eight percent of those managed by arthroplasty underwent revision for dislocation (n=4), implant loosening (n=3) or infection (n=7). On univariate analysis, mortality was higher in the arthroplasty group (25%) than with internal fixation (17%; P=0.002), as were blood loss (425±286mL versus 333±223mL; P<0.0001), transfusion rate (61% versus 32%; P<0.0001) and infection (4% versus 0.2%; P<0.001). On multivariate analysis, however, treatment modality no longer showed impact on mortality or on morbidity and autonomy at 6 months. Nutritional status was better conserved at 6 months following arthroplasty, but dependence worsened. Poor preoperative autonomy, ASA score, and nutritional status and time to treatment were independent factors for mortality. Transfusion, associated with onset of mechanical complications, significantly increased dependence. Type of treatment had little impact on mortality, morbidity or functional outcome. Differences seemed more related to preoperative functional and nutritional status. III, prospective case-control study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Surgical Non-governmental Organizations: Global Surgery's Unknown Nonprofit Sector.

PubMed

Ng-Kamstra, Joshua S; Riesel, Johanna N; Arya, Sumedha; Weston, Brad; Kreutzer, Tino; Meara, John G; Shrime, Mark G

2016-08-01

Charitable organizations may play a significant role in the delivery of surgical care in low- and middle-income countries (LMICs). However, in order to quantify their collective contribution, to account for the care they provide in national surgical plans, and to maximize coordination between organizations, a comprehensive database of these groups is required. We aimed to create such a database using web-available data. We searched for organizations that meet the United Nations Rule of Law definition of non-governmental organizations and provide surgery in LMICs. We termed these surgical non-governmental organizations (s-NGOs). We screened multiple sources including a listing of disaster relief organizations, medical volunteerism databases, charity commissions, and the results of a literature search. We performed a secondary review of each eligible organization's website to verify inclusion criteria and extracted data. We found 403 s-NGOs providing surgery in all 139 LMICs, with most (61 %) incorporating surgery into a broader spectrum of health services. Over 80 % of s-NGOs had an office in the USA, the UK, Canada, India, or Australia, and they most commonly provided surgery in India (87 s-NGOs), Haiti (71), Kenya (60), and Ethiopia (55). The most common specialties provided were general surgery (184), obstetrics and gynecology (140), and plastic surgery (116). This new catalog includes the largest number of s-NGOs to date, but this is likely to be incomplete. This list will be made publicly available to promote collaboration between s-NGOs, national health systems, and global health policymakers.

Small size of metastatic lymph nodes with extracapsular spread greatly impacts treatment outcomes in oral squamous cell carcinoma patients.

PubMed

Michikawa, C; Izumo, T; Sumino, J; Morita, T; Ohyama, Y; Michi, Y; Uzawa, N

2018-07-01

Extracapsular spread (ECS) of metastatic lymph nodes from oral carcinoma is the most significant prognostic predictor of a poor treatment outcome. However, only a few reports on prognostic factors in ECS-positive cases have been investigated. To address this problem, a detailed examination of ECS pathology was conducted to determine the prognostic factors of oral squamous cell carcinoma (OSCC) with ECS of metastatic lymph nodes. This study involved 63 OSCC patients with at least one pathologically metastatic node with ECS. Among the 229 metastatic lymph nodes, 149 exhibited ECS. Univariate analysis revealed that a poor outcome and recurrence were significantly associated with the number of ECS-positive nodes, density of ECS, and the minor axis of the smallest ECS-positive node. However, multivariate analysis identified only small size of ECS-positive nodes as a significant and independent factor predicting recurrence and a poor outcome. Thus, small size of ECS-positive nodes is the most important prognostic indicator for OSCC with ECS in metastatic lymph nodes. The classification of ECS status using the minor axis of ECS-positive nodes may be useful for further prediction of a poorer prognosis in OSCC cases. Standardization of ECS diagnosis and multicenter prospective studies will be required to confirm and refine these findings. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Management of well-differentiated thyroid cancer in 2010: perspectives of a head and neck surgical oncologist.

PubMed

Urken, Mark L

2010-01-01

To review the terminology and controversy regarding the performance of prophylactic lymph node dissection for patients without evidence suggestive of pathologic adenopathy. Terminology of lymph node levels in the neck and chest, and the issues regarding lymph node dissection, are reviewed. In addition, differences between lymph nodes are reviewed and discussed. Management of lymph nodes in this disease process has become the most contentious aspect of surgical decision-making due to the ambiguity of their prognostic significance and the prevalence of nodal metastases in very early primary tumors. Performance of prophylactic central compartment node dissection is not technically any more difficult than therapeutic node dissection when clinically significant nodes are encountered. It is therefore reasonable to consider this technique as an important adjunct to a total thyroidectomy for the purpose of enhanced disease staging, prevention of nodal recurrence, and avoidance of having to re-enter the previously operated central compartment. A recent study is reviewed and discussed in detail. The literature regarding the prognostic significance of extracapsular spread in lymph nodes is also presented. Morphologic characteristics of metastatic lymph nodes in thyroid cancer vary greatly. However, the reporting of these differences is lacking. The presence of extracapsular extension in a lymph node has prognostic significance. The clinician should be aware of these variations and the impact that they may have on recurrence risk and disease-specific survival.

Laser-assisted corneal welding in cataract surgery: retrospective study.

PubMed

Menabuoni, Luca; Pini, Roberto; Rossi, Francesca; Lenzetti, Ivo; Yoo, Sonia H; Parel, Jean-Marie

2007-09-01

To evaluate the efficacy of laser welding to close corneal wounds in cataract surgery. Department of Ophthalmology, Hospital of Misericordia e Dolce, Prato, Italy. This retrospective nonrandomized interventional case series included 20 eyes of 20 patients. All eyes had cataract with visual acuity worse than 20/200. Ten patients had phacoemulsification surgery, and 10 had extracapsular cataract extraction (ECCE). Surgeries were followed by laser-assisted closure of the corneal wounds by diode laser welding of the stroma using a technique established in animal models. Preoperative and postoperative (1, 3, 7, 30, and 90 days) astigmatism, level of inflammation, Seidel testing, and endothelial cell counts were obtained. There were minor differences in preoperative and postoperative astigmatism except in 1 eye in the ECCE group. The Seidel test showed no wound leakage during the follow-up examinations, and endothelial cell loss was similar to that published for standard surgical cataract procedures. No collateral effects of the laser welding were detected, nor was postoperative inflammation. Astigmatism was slightly affected by the use of laser welding for corneal wound closure after phacoemulsification and ECCE. The laser-assisted corneal sealing procedure was rapid and safe and could serve as an alternative to corneal suturing, with significant potential applications for the closure of longer incisions, such as those used in penetrating keratoplasty.

Eye healthcare services in eastern Europe: Part 1. Cataract surgery.

PubMed

Kocur, I; Resnikoff, S; Foster, A

2002-08-01

To describe cataract surgical services in 1998 in 12 eastern European countries and to identify their needs to reduce cataract blindness. All inpatient eye departments in the 12 countries received a standardised questionnaire; the data obtained were further processed at the coordinating centre in Prague. All 458 eye departments in the region were involved. The response rate was 100%, except for Bulgaria (93%) and Romania (93%). The total number of cataract surgeries per one million inhabitants in 1998 was calculated: Belarus (800), Federation of Bosnia and Herzegovina (1275), Bulgaria (1730), the Czech Republic (4210), Estonia (2530), Hungary (3530), Latvia (1860), Lithuania (1550), Trans-Dniester Moldova (1300), Poland (1475), Romania (1260), and Slovakia (2430). Cataracts were mostly operated on by the extracapsular technique. Intracapsular extractions were frequently performed in Federation of Bosnia and Herzegovina (47%), Belarus (46%), Bulgaria (18%), and Romania (14.3%). Phacoemulsification was uncommonly used in 1998, except for the Czech Republic (86%), Estonia (50%), Slovakia (38%), and Hungary (16%). An IOL was implanted in more than 90% of patients in the Czech Republic, Estonia, Hungary, Latvia, Lithuania, and Slovakia. Conditions for cataract surgery in the eastern European region differ. The main barriers to cataract surgery were state budget limitations, insufficient supply of consumables, underutilisation of operating theatres, and poor detection of patients requiring surgery.

Design and optimization of a semicontinuous hot-cold extraction of polyphenols from grape pomace.

PubMed

Monrad, Jeana K; Srinivas, Keerthi; Howard, Luke R; King, Jerry W

2012-06-06

Grape pomace contains appreciable amounts of polyphenolic compounds such as anthocyanins and procyanidins which can be recovered for use as food supplements. The extraction of these polyphenols from the pomace is usually accomplished at slightly elevated temperatures, frequently employing hydroethanolic solvents. Due to governmental regulations and the cost involved in using ethanol as a solvent, as well as the loss in polyphenolics due to thermal degradation, improved extraction techniques are required. In this study, a semicontinuous extraction apparatus employing only water was developed to maximize the recovery of anthocyanins and procyanidins from red grape pomace (Vitis vinifera). Water is preheated prior to its entry to the extraction cell containing the grape pomace sample, where it is allowed to then flow continuously through the unheated extraction vessel prior to its collection at ambient conditions. Extraction variables that impacted the polyphenolic recovery included pomace moisture content (crude or dried), sample mass, water flow rate, and extraction temperature. A response surface method was used to analyze the results from the extraction, and the optimal conditions were found to be 140 °C and 9 mL/min water flow rate. These conditions can produce an extract containing 130 mg/100 g DW of anthocyanins and 2077 mg/100 g DW of procyanidins. Higher yields of polyphenolics were observed using crude (wet) rather than dried pomace, hence avoiding the need to dry the pomace prior to extraction. The described semicontinuous extraction method using only water as the extraction solvent under subcritical conditions allowed the efficient extraction of polyphenols from red grape pomace without the attendant loss of polyphenolic content due to having to heat the extraction vessel prior to commencement of extraction.

An Analysis of Ethical Issues in Governmental Communication.

ERIC Educational Resources Information Center

Turner, John R.

A research review examined the ethical responsibilities of a communicator in contemporary American society, particularly in governmental communication. Various scholars have suggested standards of ethical governmental communication and have questioned the ethics of governmental officials in several cases. Ethical analysis of President Ronald…

75 FR 23247 - International Whaling Commission; 62nd Annual Meeting; Nominations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-03

... representing the positions of non-governmental organizations. Generally, only one non-governmental position is... representing the positions of non-governmental organizations. Generally, only one non-governmental position is... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XV73 International...

46 CFR 67.41 - Governmental entity.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Governmental entity. 67.41 Section 67.41 Shipping COAST... DOCUMENTATION OF VESSELS Citizenship Requirements for Vessel Documentation § 67.41 Governmental entity. A governmental entity is a citizen for the purpose of obtaining a vessel document if it is an entity of the...

46 CFR 67.41 - Governmental entity.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 2 2011-10-01 2011-10-01 false Governmental entity. 67.41 Section 67.41 Shipping COAST... DOCUMENTATION OF VESSELS Citizenship Requirements for Vessel Documentation § 67.41 Governmental entity. A governmental entity is a citizen for the purpose of obtaining a vessel document if it is an entity of the...

Guidelines for the Analysis of Responsibility in Governmental Communication.

ERIC Educational Resources Information Center

Gouran, Dennis S.

This paper discusses specific issues involving governmental conduct in communication with the public, outlines a set of conditions that frequently stimulate social interest in governmental responsibility, and develops a corresponding set of guidelines for use in the evaluation of instances of questionable governmental conduct in communication.…

Behavior of squamous cell carcinoma of the floor of the mouth. Is supraomohyoid neck dissection sufficiently safe to manage clinically N0 patients?

PubMed

Cariati, Paolo; Cabello Serrano, Almudena; Roman Ramos, Maria; Sanchez Lopez, Dario; Fernandez Solis, Jose; Martinez Lara, Ildefonso

2018-05-11

The main aim of the present report is to study the behavior of SCC of the floor of the mouth. A retrospective analysis was conducted using the records of patients diagnosed with squamous cell carcinoma of the floor of the mouth between 2000 and 2012 in the HUVN. Ninety-three patients with squamous cell carcinoma of the floor of the mouth treated with tumourectomy and selective neck dissection were included in the study. The pattern of distribution of cervical metastases and numerous histological features such as T-stage, N stage, surgical margins, tumor thickness, ECS (extracapsular spread) and vascular invasion were analyzed. Level I was the most affected level, followed by Level II. T stage, tumor thickness, and surgical margins showed a strong relationship with the risk of developing a local or cervical failure at follow-up. Overall survival was 52.7%. T stage, tumor thickness, N stage, recurrence, extracapsular spread, and vascular invasion were also associated with a poor prognosis. SCC of the floor of the mouth is an aggressive disease even at early stages. Due to the low rate of positive nodes observed at level IV and V in clinically N0 patients, supraomohyoid neck dissection might be considered sufficiently safe in this group. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Prognostic impact of perineural invasion and lymphovascular invasion in advanced stage oral squamous cell carcinoma.

PubMed

Jardim, J F; Francisco, A L N; Gondak, R; Damascena, A; Kowalski, L P

2015-01-01

Perineural invasion (PNI) and lymphovascular invasion (LVI) have been associated with the risk of local recurrences and lymph node metastasis. The aim of this study was to evaluate the prognostic impact of PNI and LVI in patients with advanced stage squamous cell carcinoma of the tongue and floor of the mouth. One hundred and forty-two patients without previous treatment were selected. These patients underwent radical surgery with neck dissection and adjuvant treatment. Clinicopathological data were retrieved from the medical charts, including histopathology and surgery reports. Univariate analysis was performed to assess the impact of studied variables on survival. Overall survival was negatively influenced by six tumour-related factors: increasing T stage (P = 0.003), more than two clinically positive nodes (P = 0.002), extracapsular spread of lymph node metastasis (P < 0.001), tumour thickness (P = 0.04), PNI (P < 0.001), and LVI (P = 0.012). Disease-free survival was influenced by PNI (P = 0.04), extracapsular spread of lymph node metastasis (P = 0.008), and N stage (P = 0.006). Multivariate analysis showed PNI to be an independent predictor for overall survival (P = 0.01) and disease-free survival (P = 0.03). Thus the presence of PNI in oral carcinoma surgical specimens has a significant impact on survival outcomes in patients with advanced stage tumours submitted to radical surgery and adjuvant radiotherapy/radiochemotherapy. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

22 CFR 140.9 - Other non-governmental entities and individuals.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... Section 140.9 applies to private voluntary agencies, educational institutions, for-profit firms, other non-governmental entities and private individuals. A non-governmental entity that is not organized under the laws... suspect that a proposed U.S. non-governmental entity or a key individual of such entity may be or may have...

22 CFR 140.9 - Other non-governmental entities and individuals.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... Section 140.9 applies to private voluntary agencies, educational institutions, for-profit firms, other non-governmental entities and private individuals. A non-governmental entity that is not organized under the laws... suspect that a proposed U.S. non-governmental entity or a key individual of such entity may be or may have...

22 CFR 140.9 - Other non-governmental entities and individuals.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... Section 140.9 applies to private voluntary agencies, educational institutions, for-profit firms, other non-governmental entities and private individuals. A non-governmental entity that is not organized under the laws... suspect that a proposed U.S. non-governmental entity or a key individual of such entity may be or may have...

Non-Governmental Religious Schools in Germany--Increasing Demand by Decreasing Religiosity?

ERIC Educational Resources Information Center

Scheunpflug, Annette

2015-01-01

This paper addresses the situation of non-governmental religious schools in Germany. The available empirical data demonstrate an increasing demand for these schools in recent decades. In this paper, possible causes of this development are discussed. First, the given constitutional framework for religion in governmental and non-governmental schools…

45 CFR 146.180 - Treatment of non-Federal governmental plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Treatment of non-Federal governmental plans. 146... § 146.180 Treatment of non-Federal governmental plans. (a) Requirements subject to exemption—(1) Basic rule. A sponsor of a non-Federal governmental plan may elect to exempt its plan, to the extent that the...

45 CFR 146.180 - Treatment of non-Federal governmental plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Treatment of non-Federal governmental plans. 146... § 146.180 Treatment of non-Federal governmental plans. (a) Requirements subject to exemption—(1) Basic rule. A sponsor of a non-Federal governmental plan may elect to exempt its plan, to the extent that the...

Flavonoid detection in hydroethanolic extract of Pouteria torta (Sapotaceae) leaves by HPLC-DAD and the determination of its mutagenic activity.

PubMed

Costa, Daryne L M G; Rinaldo, Daniel; Varanda, Eliana A; de Sousa, Juliana F; Nasser, Ana L M; Silva, Ana C Z; Baldoqui, Débora C; Vilegas, Wagner; dos Santos, Lourdes Campaner

2014-10-01

It is well known that phytotherapy has grown in popularity in recent years. Because a drug cannot be administered without ensuring its effectiveness and safety, the standardization and regulation of phytotherapeutic drugs are required by the global market and governmental authorities. This article describes a simple and reliable high-performance liquid chromatography-diode array detection analysis method for the simultaneous detection of myricetin-3-O-β-D-galactopyranoside, myricetin-3-O-α-L-arabinopyranoside, and myricetin-3-O-α-L-rhaminopyranoside present in the hydroethanolic extract (ethanol/H2O, 7:3, v/v) of Pouteria torta. The mutagenic activity of the extract was evaluated on Salmonella typhimurium and by an in vivo micronucleus test on the peripheral blood cells of Swiss mice. The linearity, sensitivity, selectivity, repeatability, accuracy, and precision of the assay were evaluated. The analytical curves were linear and exhibited good repeatability (with a deviation of less than 5%) and demonstrated good recovery (within the 83-107% range). The results demonstrate that the hydroethanolic extract exhibited a mutagenic activity in both assays, suggesting caution in the use of this plant in folk medicine.

Flavonoid Detection in Hydroethanolic Extract of Pouteria torta (Sapotaceae) Leaves by HPLC-DAD and the Determination of Its Mutagenic Activity

PubMed Central

Costa, Daryne L.M.G.; Rinaldo, Daniel; Varanda, Eliana A.; de Sousa, Juliana F.; Nasser, Ana L.M.; Silva, Ana C.Z.; Baldoqui, Débora C.; Vilegas, Wagner

2014-01-01

Abstract It is well known that phytotherapy has grown in popularity in recent years. Because a drug cannot be administered without ensuring its effectiveness and safety, the standardization and regulation of phytotherapeutic drugs are required by the global market and governmental authorities. This article describes a simple and reliable high-performance liquid chromatography–diode array detection analysis method for the simultaneous detection of myricetin-3-O-β-D-galactopyranoside, myricetin-3-O-α-L-arabinopyranoside, and myricetin-3-O-α-L-rhaminopyranoside present in the hydroethanolic extract (ethanol/H2O, 7:3, v/v) of Pouteria torta. The mutagenic activity of the extract was evaluated on Salmonella typhimurium and by an in vivo micronucleus test on the peripheral blood cells of Swiss mice. The linearity, sensitivity, selectivity, repeatability, accuracy, and precision of the assay were evaluated. The analytical curves were linear and exhibited good repeatability (with a deviation of less than 5%) and demonstrated good recovery (within the 83–107% range). The results demonstrate that the hydroethanolic extract exhibited a mutagenic activity in both assays, suggesting caution in the use of this plant in folk medicine. PMID:25055245

Cataract, ocular surgery, aphakia, and the chromatic expression of the painter Jovan Bijelić.

PubMed

Nikolić, Ljubiša; Jovanović, Vesna

2016-11-01

Approaching art from the standpoint of optics and the artist’s eye pathology can sometimes explain the shift of the spectral colors in the work of some artists with cataract and aphakia. This may not be obvious in the paintings of other artists with the same eye pathology. The aim of this study was to create a timeline from the recently obtained details of the cataract surgery, his best corrected aphakic visual acuity, and the last paintings of the artist Jovan Bijelić. The research included primary and secondary source material: Bijelić’s paintings from all stages of his career, interviews with Bijelić and his eye surgeon, art criticism, sources with the description of Bijelić’s symptoms, hospital archives, discussion with art historians, comparison of his palette from different periods. Jovan Bijelić was nearly blind from cataract in 1957. He underwent an unsuccessful cataract surgery in 1956, followed by enucleation of the operated eye. In 1958, 20/25–20/20 vision was regained, after the extracapsular cataract extraction and sector iridectomy in his right eye, with the posterior lens capsule discision afterwards. Xanthopsia and cyanopsia are not present in his art, which is not a representation of visualized objects. The response of Jovan Bijelić to cataract and aphakia was predominantly a change of his style.

Role of intraocular lens parameters in visual rehabilitation of patients after extracapsular cataract extraction

NASA Astrophysics Data System (ADS)

Bakutkin, Valery V.; Galanzha, Vladimir A.

2001-01-01

The main method of cataract treatment is micro surgical removing of the opaque lens from the eye with implantation of an intra ocular lens. We performed the comparative study of using various IOL models differing in its materials, index of refraction, spectral properties, configuration, shape, size and other features. Before and after the IOL implantation we performed the following test: visual acuity measuring, refractometry, keratometry, laser interferometric retinometry, color perception assessment, digital photo- and videorecording of the eye with image processing and some others. We found a number of correlations between the IOL properties and some characteristics of the patient's vision. The decentration of the IOL optical part more than 1,5 mm conduced to the non-corneal astigmatism and the prismatic effect. A small diameter of the IOL optical part and high index of refraction promotes to the appearance of the optical aberrations. Leucosapphire IOLs revealed the high degree of light reflection and the minimal adhesive ability of the IOL surface. Leucosapphire IOL revealed the high degree of light reflection and the minimal adhesive ability of the IOL surface. PMMA IOL revealed the low reflective power and the high adhesive ability. The best color vision was revealed in patients with PMMA IOL with an additional compound absorbing not only UV light but also short-wave blue light.

The epigenetic landscape of oral squamous cell carcinoma

PubMed Central

Jithesh, P V; Risk, J M; Schache, A G; Dhanda, J; Lane, B; Liloglou, T; Shaw, R J

2013-01-01

Background: There is relatively little methylation array data available specifically for oral squamous cell carcinoma (OSCC). This study aims to compare the DNA methylome across a large cohort of tumour/normal pairs. Methods: DNA was extracted from 44 OSCCs and paired normal mucosa. DNA methylation analysis employed the Illumina GoldenGate high-throughput array comprising 1505 CpG loci selected from 807 epigenetically regulated genes. This data was correlated with extracapsular spread (ECS), human papilloma virus (HPV) status, recurrence and 5-year survival. Results: Differential methylation levels of a number of genes distinguished the tumour tissue sample from the matched normal. Putative methylation signatures for ECS and recurrence were identified. The concept of concordant methylation or CpG island methylator phenotype (CIMP) in OSCC is supported by our data, with an association between ‘CIMP-high' and worse prognosis. Epigenetic deregulation of NOTCH4 signalling in OSCC was also observed, as part of a possible methylation signature for recurrence, with parallels to recently discovered NOTCH mutations in HNSCC. Differences in methylation in HPV-driven cases were seen, but are less significant than that has been recently proposed in other series. Conclusion: Although OSCC seems as much an ‘epigenetic' as a genetic disease, the translational potential of cancer epigenetics has yet to be fully exploited. This data points to the application of epigenetic biomarkers and targets available to further the development of therapy in OSCC. PMID:23287992

Eye healthcare services in eastern Europe: Part 1 Cataract surgery

PubMed Central

Kocur, I; Resnikoff, S; Foster, A

2002-01-01

Aim: To describe cataract surgical services in 1998 in 12 eastern European countries and to identify their needs to reduce cataract blindness. Methods: All inpatient eye departments in the 12 countries received a standardised questionnaire; the data obtained were further processed at the coordinating centre in Prague. Results: All 458 eye departments in the region were involved. The response rate was 100%, except for Bulgaria (93%) and Romania (93%). The total number of cataract surgeries per one million inhabitants in 1998 was calculated: Belarus (800), Federation of Bosnia and Herzegovina (1275), Bulgaria (1730), the Czech Republic (4210), Estonia (2530), Hungary (3530), Latvia (1860), Lithuania (1550), Trans-Dniester Moldova (1300), Poland (1475), Romania (1260), and Slovakia (2430). Cataracts were mostly operated on by the extracapsular technique. Intracapsular extractions were frequently performed in Federation of Bosnia and Herzegovina (47%), Belarus (46%), Bulgaria (18%), and Romania (14.3%). Phacoemulsification was uncommonly used in 1998, except for the Czech Republic (86%), Estonia (50%), Slovakia (38%), and Hungary (16%). An IOL was implanted in more than 90% of patients in the Czech Republic, Estonia, Hungary, Latvia, Lithuania, and Slovakia. Conclusions: Conditions for cataract surgery in the eastern European region differ. The main barriers to cataract surgery were state budget limitations, insufficient supply of consumables, underutilisation of operating theatres, and poor detection of patients requiring surgery. PMID:12140200

Prospective evaluation of external ocular microbial growth and aqueous humor contamination during cataract surgery.

PubMed

Tervo, T; Ljungberg, P; Kautiainen, T; Puska, P; Lehto, I; Raivio, I; Järvinen, E; Kuusela, P; Tarkkanen, A

1999-01-01

To analyze the route of aqueous humor contamination leading to the development of postoperative endophthalmitis. Department of Ophthalmology, University of Helsinki, Finland. Forty-nine eyes of 49 patients (31 having phacoemulsification and 18 extracapsular cataract extraction [ECCE]) participated in the study. Four bacterial cultures were taken: preoperative conjunctival swab, lid margin culture, intraoperative lacrimal lake sample, and immediate postoperative anterior chamber fluid sample. Preoperative lid margin cultures were positive in 59.2% of eyes, conjunctival cultures in 69.4%, and lacrimal lake cultures in 24.9%. Four aqueous humor samples (8.2%) showed bacterial growth in the anterior chamber aspirate: 3 in the phacoemulsification and 1 in the ECCE group. The bacteria isolated in this study, Staphylococcus epidermidis and Propionibacterium acnes (2 positive isolates each) were sensitive to the preoperative topical antibiotics used. No aqueous humor sample or any from other locations showed gram-negative microbe growth. The most frequently recovered microbes in all samples collected from the 3 other sources were S epidermidis and other coagulase-negative staphylococcus species, followed by P acnes and other propionibacterium species. Staphylococcus aureus, and diptheroids. The ocular surface significantly contributed to the transmission of microbes into the eye during cataract surgery. These microbes could not be eradicated by topical preoperative antibiotics. However, no patient developed postoperative endophthalmitis. Natural defense mechanisms appear to fend off a minor inoculum with these microbes of relatively low pathogenicity.

Surgical management and histologic and immunohistochemical features of a cataract and retrolental plaque secondary to persistent hyperplastic tunica vasculosa lentis/persistent hyperplastic primary vitreous (PHTVL/PHPV) in a Bloodhound puppy.

PubMed

Gemensky-Metzler, Anne J; Wilkie, David A

2004-01-01

The objective of this study was to describe the clinical, histologic and immunohistochemical features, the surgical treatment, and outcome of a cataract secondary to persistent hyperplastic tunica vasculosa lentis/persistent hyperplastic primary vitreous (PHTVL/PHPV) in a dog. A 4-month-old male Bloodhound dog presented for evaluation of a cataract. A complete ophthalmic examination and ocular ultrasonography were performed. A resorbing cataract with intralenticular hemorrhage, lens induced uveitis, and PHTVL/PHPV were diagnosed. Extracapsular cataract extraction using phacoemulsification was performed. A primary posterior capsulectomy was performed to remove a retrolental plaque with the posterior capsule; the excised plaque was submitted for histopathology and immunohistochemical staining. A 41-Diopter intraocular lens (IOL) was implanted. Functional vision was maintained postoperatively during the 21-month follow-up period. Histologically, the posterior capsule was coiled and exhibited duplication. The retrolental plaque was comprised of dense fibrous connective tissue, blood vessels, free red blood cells, hemosiderin-laden macrophages, a pocket of neural tissue and numerous perivascular mast cells. With immunohistochemical staining, the neural elements were determined to be glial cells compatible with astrocytes. Cataract secondary to PHTVL/PHPV can be successfully treated using phacoemulsification and planned posterior capsulectomy. Posterior lens capsule duplication, mast cells and astrocytic glial cells may be normal components of the fibrovascular retrolental plaque associated with PHTVL/PHPV.

Outcomes of oral cavity cancer patients treated with surgery followed by postoperative intensity modulated radiation therapy.

PubMed

Quinlan-Davidson, Sean R; Mohamed, Abdallah S R; Myers, Jeffrey N; Gunn, Gary B; Johnson, Faye M; Skinner, Heath; Beadle, Beth M; Gillenwater, Ann M; Phan, Jack; Frank, Steven J; William, William N; Wong, Andrew J; Lai, Stephen Y; Fuller, Clifton D; Morrison, William H; Rosenthal, David I; Garden, Adam S

2017-09-01

Although treatment paradigms have not changed significantly, radiotherapy, surgery, and imaging techniques have improved, leading us to investigate oncologic and survival outcomes for oral cavity squamous cell cancer (OCSCC) patients treated with surgery followed by postoperative IMRT. Records of patients with pathological diagnosis of OCSCC treated between 2000 and 2012 were retrospectively reviewed. Patients' demographic, disease, and treatment criteria were extracted. Kaplan-Meier method was used to calculate survival curves. Two hundred eighty-nine patients were analyzed. Median follow-up was 35months. Two hundred sixty-eight had neck dissections (93%), of which 66% had nodal involvement, and 51% of those positive dissections had extracapsular extension. Forty patients received induction chemotherapy and 107 received concurrent chemotherapy. Median dose to high risk clinical target volume was 60Gy/30 fractions. The 5-year locoregional control and overall survival rates were 76% and 57%, respectively. Tumors with >1.5cm depth of invasion had significantly higher risk of local failure compared with ≤1.5cm (p<0.001). In multivariate analysis, positive and no neck dissection (p=0.01), positive lymphovascular invasion (p=0.006) and >1.5cm depth of invasion (p=0.003) were independent predictors of poorer survival. Disease outcomes were consistent with historical data and did not appear compromised by the use of IMRT. Copyright © 2017 Elsevier Ltd. All rights reserved.

Outcomes of oral cavity cancer patients treated with surgery followed by postoperative intensity modulated radiation therapy

PubMed Central

Quinlan-Davidson, Sean R.; Mohamed, Abdallah S. R.; Myers, Jeffrey N.; Gunn, Gary B.; Johnson, Faye M.; Skinner, Heath; Beadle, Beth M; Gillenwater, Ann M.; Phan, Jack; Frank, Steven J.; William, William N.; Wong, Andrew J.; Lai, Stephen Y.; Fuller, Clifton D.; Morrison, William H.; Rosenthal, David I.; Garden, Adam S.

2018-01-01

Objectives Although treatment paradigms have not changed significantly, radiotherapy, surgery, and imaging techniques have improved, leading us to investigate oncologic and survival outcomes for oral cavity squamous cell cancer (OCSCC) patients treated with surgery followed by postoperative IMRT. Material and Methods Records of patients with pathological diagnosis of OCSCC treated between 2000–2012 were retrospectively reviewed. Patients’ demographic, disease, and treatment criteria were extracted. Kaplan-Meier method was used to calculate survival curves. Results Two hundred eighty-nine patients were analyzed. Median follow-up was 35 months. Two hundred sixty-eight had neck dissections (93%), of which 66% had nodal involvement, and 51% of those positive dissections had extracapsular extension. Forty patients received induction chemotherapy and 107 received concurrent chemotherapy. Median dose to high risk clinical target volume was 60 Gy/30 fractions. The 5-year locoregional control and overall survival rates were 76% and 57%, respectively. Tumors with >1.5 cm depth of invasion had significantly higher risk of local failure compared with ≤1.5 cm (p<0.001). In multivariate analysis, positive and no neck dissection (p=0.01), positive lymphovascular invasion (p=0.006) and >1.5 cm depth of invasion (p=0.003) were independent predictors of poorer survival. Conclusions Disease outcomes were consistent with historical data and did not appear compromised by the use of IMRT. PMID:28797467

The role of health policy in the burden of breast cancer in Brazil.

PubMed

Figueiredo, Francisco Winter Dos Santos; Almeida, Tábata Cristina do Carmo; Cardial, Débora Terra; Maciel, Érika da Silva; Fonseca, Fernando Luiz Affonso; Adami, Fernando

2017-11-28

Breast cancer affects millions of women worldwide, particularly in Brazil, where public healthcare system is an important model in health organization and the cost of chronic disease has affected the economy in the first decade of the twenty-first century. The aim was to evaluate the role of health policy in the burden of breast cancer in Brazil between 2004 and 2014. Secondary analysis was performed in 2017 with Brazilian Health Ministry official data, extracted from the Department of Informatics of the National Health System. Age-standardized mortality and the age-standardized incidence of hospital admission by breast cancer were calculated per 100,000 people. Public healthcare costs were converted to US dollars. Regression analysis was performed to estimate the trend of breast cancer rates and healthcare costs, and principal component analysis was performed to estimate a cost factor. Stata® 11.0 was utilized. Between 2004 to 2014, the age-standardized rates of breast cancer mortality and the incidence of hospital admission and public healthcare costs increased. There was a positive correlation between breast cancer and healthcare public costs, mainly influenced by governmental strategies. Governmental strategies are effective against the burden of breast cancer in Brazil.

34 CFR Appendix A to Subpart B of... - Standards for Audit of Governmental Organizations, Programs, Activities, and Functions (GAO)

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false Standards for Audit of Governmental Organizations... Programs Pt. 668, Subpt. B, App. A Appendix A to Subpart B of Part 668—Standards for Audit of Governmental... standard for governmental auditing is: In matters relating to the audit work, the audit organization and...

Oil for health in sub-Saharan Africa: health systems in a 'resource curse' environment.

PubMed

Calain, Philippe

2008-10-21

In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomized by oil extraction in sub-Saharan Africa. Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan), I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments) are further examined. Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalized and instrumentalized toward economic and corporate interests in resource curse settings. From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components) and more open perspectives on causal mechanisms.

Performance indicators for maternity care in a circumpolar context: a scoping review

PubMed Central

Rich, Rebecca; D'Hont, Thomsen; Linton, Janice; Murphy, Kellie E.; Veillard, Jeremy; Chatwood, Susan

2016-01-01

Background In circumpolar regions, harsh climates and scattered populations have prompted the centralization of care and reduction of local maternity services. The resulting practice of routine evacuation for birth from smaller towns to larger urban centres points to a potential conflict between the necessity to ensure patient safety and the importance of delivering services that are responsive to the health needs and values of populations served. Objective To identify recommended performance/quality indicators for use in circumpolar maternity care systems. Methods We searched Scopus, Ebscohost databases (including Academic Search Complete and CINAHL), the Global Health Database, High North Research Documents, and online grey literature. Articles were included if they focused on maternal health indicators in the population of interest (Indigenous women, women receiving care in circumpolar or remote regions). Articles were excluded if they were not related to pregnancy, birth or the immediate post-partum or neonatal periods. Two reviewers independently reviewed articles for inclusion and extracted relevant data. Results Twenty-six documents were included. Twelve were government documents, seven were review articles or indicator compilations, four were indicator sets recommended by academics or non-governmental organizations and three were research papers. We extracted and categorized 81 unique health indicators. The majority of indicators reflected health systems processes and outcomes during the antenatal and intra-partum periods. Only two governmental indicator sets explicitly considered the needs of Indigenous peoples. Conclusions This review demonstrates that, although most circumpolar health systems engage in performance reporting for maternity care, efforts to capture local priorities and values are limited in most regions. Future work in this area should involve northern stakeholders in the process of indicator selection and development. PMID:27938636

Performance indicators for maternity care in a circumpolar context: a scoping review.

PubMed

Rich, Rebecca; D'Hont, Thomsen; Linton, Janice; Murphy, Kellie E; Veillard, Jeremy; Chatwood, Susan

2016-01-01

In circumpolar regions, harsh climates and scattered populations have prompted the centralization of care and reduction of local maternity services. The resulting practice of routine evacuation for birth from smaller towns to larger urban centres points to a potential conflict between the necessity to ensure patient safety and the importance of delivering services that are responsive to the health needs and values of populations served. To identify recommended performance/quality indicators for use in circumpolar maternity care systems. We searched Scopus, Ebscohost databases (including Academic Search Complete and CINAHL), the Global Health Database, High North Research Documents, and online grey literature. Articles were included if they focused on maternal health indicators in the population of interest (Indigenous women, women receiving care in circumpolar or remote regions). Articles were excluded if they were not related to pregnancy, birth or the immediate post-partum or neonatal periods. Two reviewers independently reviewed articles for inclusion and extracted relevant data. Twenty-six documents were included. Twelve were government documents, seven were review articles or indicator compilations, four were indicator sets recommended by academics or non-governmental organizations and three were research papers. We extracted and categorized 81 unique health indicators. The majority of indicators reflected health systems processes and outcomes during the antenatal and intra-partum periods. Only two governmental indicator sets explicitly considered the needs of Indigenous peoples. This review demonstrates that, although most circumpolar health systems engage in performance reporting for maternity care, efforts to capture local priorities and values are limited in most regions. Future work in this area should involve northern stakeholders in the process of indicator selection and development.

Performance indicators for maternity care in a circumpolar context: a scoping review.

PubMed

Rich, Rebecca; D'Hont, Thomsen; Linton, Janice; Murphy, Kellie E; Veillard, Jeremy; Chatwood, Susan

2016-01-01

Background In circumpolar regions, harsh climates and scattered populations have prompted the centralization of care and reduction of local maternity services. The resulting practice of routine evacuation for birth from smaller towns to larger urban centres points to a potential conflict between the necessity to ensure patient safety and the importance of delivering services that are responsive to the health needs and values of populations served. Objective To identify recommended performance/quality indicators for use in circumpolar maternity care systems. Methods We searched Scopus, Ebscohost databases (including Academic Search Complete and CINAHL), the Global Health Database, High North Research Documents, and online grey literature. Articles were included if they focused on maternal health indicators in the population of interest (Indigenous women, women receiving care in circumpolar or remote regions). Articles were excluded if they were not related to pregnancy, birth or the immediate post-partum or neonatal periods. Two reviewers independently reviewed articles for inclusion and extracted relevant data. Results Twenty-six documents were included. Twelve were government documents, seven were review articles or indicator compilations, four were indicator sets recommended by academics or non-governmental organizations and three were research papers. We extracted and categorized 81 unique health indicators. The majority of indicators reflected health systems processes and outcomes during the antenatal and intra-partum periods. Only two governmental indicator sets explicitly considered the needs of Indigenous peoples. Conclusions This review demonstrates that, although most circumpolar health systems engage in performance reporting for maternity care, efforts to capture local priorities and values are limited in most regions. Future work in this area should involve northern stakeholders in the process of indicator selection and development.

Factors influencing the development of primary care data collection projects from electronic health records: a systematic review of the literature.

PubMed

Gentil, Marie-Line; Cuggia, Marc; Fiquet, Laure; Hagenbourger, Camille; Le Berre, Thomas; Banâtre, Agnès; Renault, Eric; Bouzille, Guillaume; Chapron, Anthony

2017-09-25

Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and durability of such projects. A systematic review was conducted using the PubMed database to identify worldwide current primary care data collection projects. The gray literature was also searched via official project websites and their contact person was emailed to obtain information on the project managers. Data were retrieved from the included studies using a standardized form, screening four aspects: projects features, technological infrastructure, GPs' roles, data collection network organization. The literature search allowed identifying 36 routine data collection networks, mostly in English-speaking countries: CPRD and THIN in the United Kingdom, the Veterans Health Administration project in the United States, EMRALD and CPCSSN in Canada. These projects had in common the use of technical facilities that range from extraction tools to comprehensive computing platforms. Moreover, GPs initiated the extraction process and benefited from incentives for their participation. Finally, analysis of the literature data highlighted that governmental services, academic institutions, including departments of general practice, and software companies, are pivotal for the promotion and durability of primary care data collection projects. Solid technical facilities and strong academic and governmental support are required for promoting and supporting long-term and wide-range primary care data collection projects.

Oil for health in sub-Saharan Africa: health systems in a 'resource curse' environment

PubMed Central

Calain, Philippe

2008-01-01

Background In a restricted sense, the resource curse is a theory that explains the inverse relationship classically seen between dependence on natural resources and economic growth. It defines a peculiar economic and political environment, epitomised by oil extraction in sub-Saharan Africa. Methods Based on secondary research and illustrations from four oil-rich geographical areas (the Niger Delta region of Nigeria, Angola, southern Chad, Southern Sudan), I propose a framework for analysing the effects of the resource curse on the structure of health systems at sub-national levels. Qualitative attributes are emphasised. The role of the corporate sector, the influence of conflicts, and the value of classical mitigation measures (such as health impact assessments) are further examined. Results Health systems in a resource curse environment are classically fractured into tripartite components, including governmental health agencies, non-profit non-governmental organisations, and the corporate extractive sector. The three components entertain a range of contractual relationships generally based on operational considerations which are withdrawn from social or community values. Characterisation of agencies in this system should also include: values, operating principles, legitimacy and operational spaces. From this approach, it appears that community health is at the same time marginalised and instrumentalised toward economic and corporate interests in resource curse settings. Conclusion From a public health point of view, the resource curse represents a fundamental failure of dominant development theories, rather than a delay in creating the proper economy and governance environment for social progress. The scope of research on the resource curse should be broadened to include more accurate or comprehensive indicators of destitution (including health components) and more open perspectives on causal mechanisms. PMID:18939986

U.S. Governmental Information Operations and Strategic Communications: A Discredited Tool or User Failure? Implications for Future Conflict

DTIC Science & Technology

2013-12-01

U.S. GOVERNMENTAL INFORMATION OPERATIONS AND STRATEGIC COMMUNICATIONS : A DISCREDITED TOOL OR USER FAILURE? IMPLICATIONS FOR FUTURE CONFLICT Steve...TYPE 3. DATES COVERED 00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE U.S. Governmental Information Operations and Strategic Communications : A ...GOVERNMENTAL INFORMATION OPERATIONS AND STRATEGIC COMMUNICATIONS : A DISCREDITED TOOL OR USER FAILURE? IMPLICATIONS FOR FUTURE CONFLICT Steve Tatham

Predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia.

PubMed

Guber, Ivo; Rémont, Laurent; Bergin, Ciara

2015-01-01

To evaluate the predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia. This is a retrospective review of all ISBCS performed at Kantonsspital Winterthur, Switzerland, between April 2000 and September 2013. The case notes of 250 patients were reviewed. Patients having full refraction reported (110 patients/220 eyes) were included. 210 (95 %) eyes had a straight forward phacoemulsification with posterior chamber intraocular lens implantation, seven eyes had a planned extracapsular cataract extraction (ECCE); three eyes had an intracapsular cataract extraction. Both eyes of 110 patients (64 women, 46 men) with a mean age of 79.0 years, standard deviation (SD) ±11.4 (range 26 to 97 years) were included. Median preoperative best corrected visual acuity (BCVA) was 0.5 LogMAR in the first eye, the interquartile range (IQR) was [0.4, 1.2]; 0.7 LogMAR in the second eye with IQR [0.4, 1.8]. At one month, the median BCVA was 0.2 LogMAR, IQR [0.1, 0.3] in the first eye, median BCVA was 0.1 LogMAR and IQR [0.0, 0.5] in the second eye. There were 3 eyes (3 %) that lost 3 lines or more in BCVA at one month (control vs. pre-operatively). In all three cases, poor visual acuity had been recorded pre-operatively (>1 LogMAR). Achieved refraction was within ±1.0 D of the target in 83 % of eyes. There were only 5 % (n = 6) of cases where if delayed sequential bilateral extraction had been performed could potentially intraocular lens (IOL) choice have been adjusted, in four of these cases, target refraction was within ±1.0 D in the second eye. ISBCS performed under general anaesthesia achieves target refraction in 83 % of eyes after consideration of complications, ocular co-morbidities and systemic restrictions. In the majority of cases where IOL power calculation could be considered, the achieved refraction of the second surgical eye was within ±1.0 D of intended refraction. This undermines the utility of IOL power adjustments in the second surgical eye.

Two-Phase Helical Computed Tomography Study of Salivary Gland Warthin Tumors: A Radiologic Findings and Surgical Applications

PubMed Central

Joo, Yeon Hee; Kim, Jin Pyeong; Park, Jung Je

2014-01-01

Objectives The goal of this study was to define the radiologic characteristics of two-phase computed tomography (CT) of salivary gland Warthin tumors and to compare them to pleomorphic adenomas. We also aimed to provide a foundation for selecting a surgical method on the basis of radiologic findings. Methods We prospectively enrolled 116 patients with parotid gland tumors, who underwent two-phase CT preoperatively. Early and delayed phase scans were obtained, with scanning delays of 30 and 120 seconds, respectively. The attenuation changes and enhancement patterns were analyzed. In cases when the attenuation changes were decreased, we presumed Warthin tumor preoperatively and performed extracapsular dissection. When the attenuation changes were increased, superficial parotidectomy was performed on the parotid gland tumors. We analyzed the operation times, incision sizes, complications, and recurrence rates. Results Attenuation of Warthin tumors was decreased from early to delayed scans. The ratio of CT numbers in Warthin tumors was also significantly different from other tumors. Warthin tumors were diagnosed with a sensitivity of 96.1% and specificity of 97% using two-phase CT. The mean operation time was 38 minutes and the mean incision size was 36.2 mm for Warthin tumors. However, for the other parotid tumors, the average operation time was 122 minutes and the average incision size was 91.8 mm (P<0.05). Conclusion Salivary Warthin tumor has a distinct pattern of contrast enhancement on two-phase CT, which can guide treatment decisions. The preoperative diagnosis of Warthin tumor made extracapsular dissection possible instead of superficial parotidectomy. PMID:25177439

Two-phase helical computed tomography study of salivary gland warthin tumors: a radiologic findings and surgical applications.

PubMed

Joo, Yeon Hee; Kim, Jin Pyeong; Park, Jung Je; Woo, Seung Hoon

2014-09-01

The goal of this study was to define the radiologic characteristics of two-phase computed tomography (CT) of salivary gland Warthin tumors and to compare them to pleomorphic adenomas. We also aimed to provide a foundation for selecting a surgical method on the basis of radiologic findings. We prospectively enrolled 116 patients with parotid gland tumors, who underwent two-phase CT preoperatively. Early and delayed phase scans were obtained, with scanning delays of 30 and 120 seconds, respectively. The attenuation changes and enhancement patterns were analyzed. In cases when the attenuation changes were decreased, we presumed Warthin tumor preoperatively and performed extracapsular dissection. When the attenuation changes were increased, superficial parotidectomy was performed on the parotid gland tumors. We analyzed the operation times, incision sizes, complications, and recurrence rates. Attenuation of Warthin tumors was decreased from early to delayed scans. The ratio of CT numbers in Warthin tumors was also significantly different from other tumors. Warthin tumors were diagnosed with a sensitivity of 96.1% and specificity of 97% using two-phase CT. The mean operation time was 38 minutes and the mean incision size was 36.2 mm for Warthin tumors. However, for the other parotid tumors, the average operation time was 122 minutes and the average incision size was 91.8 mm (P<0.05). Salivary Warthin tumor has a distinct pattern of contrast enhancement on two-phase CT, which can guide treatment decisions. The preoperative diagnosis of Warthin tumor made extracapsular dissection possible instead of superficial parotidectomy.

[Extracapsular hepatic adenoma. Case report and literature review].

PubMed

Vargas-Flores, Edgar; Pérez-Aguilar, Francisco; Valdez-Mendieta, Yanet

Hepatic adenomas are uncommon epithelial tumours. They usually appear in women between 20 and 44 years old. They are commonly located in the right hepatic lobe and are typically solitary masses. Multiple adenomas can present in patients with prolonged use of oral contraceptive pills, glycogen storage diseases and hepatic adenomatosis. A 35 year-old woman without any significant past medical history, with a chief complaint that started in December 2012 with oppressive, mild intensity abdominal pain located in right upper quadrant in the abdomen on deep palpation. With an abdominal ultrasound showing a mass of 91×82×65cm located in the right flank, isoechogenic with internal vascularity. Contrast computed tomography scan showing an ovoid tumour with circumscribed borders, with heterogenic intense reinforcement and displacement of adjacent structures with dimensions of 88×71×80cm. In laparotomy, excision of the tumour and cholecystectomy with the trans surgical findings of an 8cm tumour with a pedicle containing one artery and one vein coming from the hepatic free border with strong adhesions to the gallbladder. Pathologic diagnosis: Extracapsular hepatic adenoma. Incidence of hepatic adenomas has increased in the last decades, in a parallel fashion with the introduction of oral contraceptive pills, showing association with glycogen storage diseases and to a lesser degree with diabetes and pregnancy. Diagnosis is clinical with the aid of imaging studies. Prognosis of hepatic adenomas is not well established, therefore, management depends on symptoms, size, number, location and certainty of diagnosis. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

External validation of a nomogram for prediction of side-specific extracapsular extension at robotic radical prostatectomy.

PubMed

Zorn, Kevin C; Gallina, Andrea; Hutterer, Georg C; Walz, Jochen; Shalhav, Arieh L; Zagaja, Gregory P; Valiquette, Luc; Gofrit, Ofer N; Orvieto, Marcelo A; Taxy, Jerome B; Karakiewicz, Pierre I

2007-11-01

Several staging tools have been developed for open radical prostatectomy (ORP) patients. However, the validity of these tools has never been formally tested in patients treated with robot-assisted laparoscopic radical prostatectomy (RALP). We tested the accuracy of an ORP-derived nomogram in predicting the rate of extracapsular extension (ECE) in a large RALP cohort. Serum prostate specific antigen (PSA) and side-specific clinical stage and biopsy Gleason sum information were used in a previously validated nomogram predicting side-specific ECE. The nomogram-derived predictions were compared with the observed rate of ECE, and the accuracy of the predictions was quantified. Each prostate lobe was analyzed independently. As complete data were available for 576 patients, the analyses targeted 1152 prostate lobes. Median age and serum PSA concentration at radical prostatectomy were 60 years and 5.4 ng/mL, respectively. The majority of side-specific clinical stages were T(1c) (993; 86.2%). Most side-specific biopsy Gleason sums were 6 (572; 49.7%). The median side-specific percentages of positive cores and of cancer were, respectively, 20.0% and 5.0%. At final pathologic review, 107 patients (18.6%) had ECE, and side-specific ECE was present in 117 patients (20.3%). The nomogram was 89% accurate in the RALP cohort v 84% in the previously reported ORP validation. The ORP side-specific ECE nomogram is highly accurate in the RALP population, suggesting that predictive and possibly prognostic tools developed in ORP patients may be equally accurate in their RALP counterparts.

Computed tomography detection of extracapsular spread of squamous cell carcinoma of the head and neck in metastatic cervical lymph nodes.

PubMed

Carlton, Joshua A; Maxwell, Adam W; Bauer, Lyndsey B; McElroy, Sara M; Layfield, Lester J; Ahsan, Humera; Agarwal, Ajay

2017-06-01

Background and purpose In patients with squamous cell carcinoma of the head and neck (HNSCC), extracapsular spread (ECS) of metastases in cervical lymph nodes affects prognosis and therapy. We assessed the accuracy of intravenous contrast-enhanced computed tomography (CT) and the utility of imaging criteria for preoperative detection of ECS in metastatic cervical lymph nodes in patients with HNSCC. Materials and methods Preoperative intravenous contrast-enhanced neck CT images of 93 patients with histopathological HNSCC metastatic nodes were retrospectively assessed by two neuroradiologists for ECS status and ECS imaging criteria. Radiological assessments were compared with histopathological assessments of neck dissection specimens, and interobserver agreement of ECS status and ECS imaging criteria were measured. Results Sensitivity, specificity, positive predictive value, and accuracy for overall ECS assessment were 57%, 81%, 82% and 67% for observer 1, and 66%, 76%, 80% and 70% for observer 2, respectively. Correlating three or more ECS imaging criteria with histopathological ECS increased specificity and positive predictive value, but decreased sensitivity and accuracy. Interobserver agreement for overall ECS assessment demonstrated a kappa of 0.59. Central necrosis had the highest kappa of 0.74. Conclusion CT has moderate specificity for ECS assessment in HNSCC metastatic cervical nodes. Identifying three or more ECS imaging criteria raises specificity and positive predictive value, therefore preoperative identification of multiple criteria may be clinically useful. Interobserver agreement is moderate for overall ECS assessment, substantial for central necrosis. Other ECS CT criteria had moderate agreement at best and therefore should not be used individually as criteria for detecting ECS by CT.

Accuracy of high resolution (1.5 tesla) pelvic phased array magnetic resonance imaging (MRI) in staging prostate cancer in candidates for radical prostatectomy: results from a prospective study.

PubMed

Renard-Penna, Raphaële; Rouprêt, Morgan; Comperat, Eva; Ayed, Amine; Coudert, Mathieu; Mozer, Pierre; Xylinas, Evanguelos; Bitker, Marc-Olivier; Grenier, Philippe

2013-05-01

To evaluate the role of pelvic phased array MRI in staging prostate cancer (CaP). We prospectively collected data over 12 months on CaP patients who underwent preoperative MR imaging with a pelvic phased array before radical prostatectomy. MR images were analyzed prospectively by 2 radiologists. MR imaging findings were then correlated with pathologic findings. Overall, 101 patients were included with a mean PSA level of 8 (range 1.8-30). Reader 1 (AUC 0.895, 95% CI 0.791-0.999) had a higher performance than reader 2 (AUC 0.687, 95% CI, 0.555-0.819) and than DRE (AUC 0.728, 95% CI, 0.599-0.857) in discriminating T2 from T3 CaP (P = 0.01). The κ-index of inter-observer agreement was 0.56. A model that combines MRI findings, DRE, PSA, and Gleason score was the most competitive for staging (AUC 0.895, 95% CI, 0.791-0.999). For the multivariate analysis, 3 criteria were significantly associated with extracapsular extension: asymmetry of the neuro-vascular bundles (P = 0.001), asymmetric enhancement of neurovascular bundles (P = 0.02), and bulging of the capsule (P = 0.0003). Pelvic phased array MRI presented satisfying results in its ability to adequately stage CaP and notably in detecting the extracapsular extension of tumors. It is likely to provide reliable information but rather in the hands of an experienced radiologist. Copyright © 2013 Elsevier Inc. All rights reserved.

Pathological upgrading in prostate cancer patients eligible for active surveillance: Does prostate-specific antigen density matter?

PubMed

Jin, Byung-Soo; Kang, Seok-Hyun; Kim, Duk-Yoon; Oh, Hoon-Gyu; Kim, Chun-Il; Moon, Gi-Hak; Kwon, Tae-Gyun; Park, Jae-Shin

2015-09-01

To evaluate prospectively the role of prostate-specific antigen (PSA) density in predicting Gleason score upgrading in prostate cancer patients eligible for active surveillance (T1/T2, biopsy Gleason score≤6, PSA≤10 ng/mL, and ≤2 positive biopsy cores). Between January 2010 and November 2013, among patients who underwent greater than 10-core transrectal ultrasound-guided biopsy, 60 patients eligible for active surveillance underwent radical prostatectomy. By use of the modified Gleason criteria, the tumor grade of the surgical specimens was examined and compared with the biopsy results. Tumor upgrading occurred in 24 patients (40.0%). Extracapsular disease and positive surgical margins were found in 6 patients (10.0%) and 8 patients (17.30%), respectively. A statistically significant correlation between PSA density and postoperative upgrading was found (p=0.030); this was in contrast with the other studied parameters, which failed to reach significance, including PSA, prostate volume, number of biopsy cores, and number of positive cores. Tumor upgrading was also highly associated with extracapsular cancer extension (p=0.000). The estimated optimal cutoff value of PSA density was 0.13 ng/mL(2), obtained by receiver operating characteristic analysis (area under the curve=0.66; p=0.020; 95% confidence interval, 0.53-0.78). PSA density is a strong predictor of Gleason score upgrading after radical prostatectomy in patients eligible for active surveillance. Because tumor upgrading increases the potential for postoperative pathological adverse findings and prognosis, PSA density should be considered when treating and consulting patients eligible for active surveillance.

Long Term Functional Outcome of Tibial Tuberosity Advancement vs. Tibial Plateau Leveling Osteotomy and Extracapsular Repair in a Heterogeneous Population of Dogs.

PubMed

Krotscheck, Ursula; Nelson, Samantha A; Todhunter, Rory J; Stone, Marisa; Zhang, Zhiwu

2016-02-01

To determine a long term function of tibial tuberosity advancement (TTA) for treatment of ruptured cranial cruciate ligament (CCL) in dogs, and to compare this to the long term function of previously reported tibial plateau leveling osteotomy (TPLO), extracapsular reconstruction (ECR), and a population of normal dogs. Prospective clinical trial. Dogs with unilateral ruptured CCL treated with TTA (n = 14), TPLO (n = 15), and ECR (n = 23), and normal adult dogs (control, n = 80). Force plate gait analysis was performed at 1 time point for the normal control group and preoperatively, and at 2 and 8 weeks and 6 and 12 months postoperatively for the treatment groups. Using serial force plates, symmetry indices (SI) were calculated between the operated and unoperated pelvic limbs for peak vertical force (PVF), contact time (CT), and vertical impulse (VI). Ground reaction forces (GRF) of the treatment and control group were compared using a general linear model. Walk SI for dogs with TTA were not significantly different from the control group at 12 months postoperatively. At the trot, neither TTA nor ECR achieved normal GRF. SI of the TPLO group were not different from the normal control group by 6-12 months postoperatively. At the walk, TTA achieves normal function by 12 months; however, at the trot TTA is indistinguishable from ECR. TPLO resulted in operated limb function that was similar to the control population by 6-12 months postoperatively at the walk and the trot. © Copyright 2016 by The American College of Veterinary Surgeons.

78 FR 66684 - Atlantic Highly Migratory Species; Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-06

...) representation of a private, non-governmental, regional, national, or international organization representing... industries, environmental community, academia, and non-governmental organizations are considered for... from commercial and recreational fishing interests, and the environmental/non-governmental organization...

76 FR 34209 - International Whaling Commission; 63rd Annual Meeting; Nominations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-13

... Commissioner representing the positions of non-governmental organizations. Generally, only one non-governmental... recommendations to the U.S. IWC Commissioner representing the positions of non-governmental organizations... International Whaling Commission; 63rd Annual Meeting; Nominations AGENCY: National Marine Fisheries Service...

77 FR 19646 - International Whaling Commission; 64th Annual Meeting; Nominations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-02

... Commissioner representing the positions of non-governmental organizations. Generally, only one non-governmental... the U.S. IWC Commissioner representing the positions of non-governmental organizations. Generally... International Whaling Commission; 64th Annual Meeting; Nominations AGENCY: National Marine Fisheries Service...

Governmentality--Neoliberalism--Education: The Risk Perspective

ERIC Educational Resources Information Center

Kašcák, Ondrej; Pupala, Branislav

2011-01-01

This paper understands the basic elements of neoliberalism in education and governmentality to be the technologies for the neoliberal government of education. It outlines Foucault's methodology for analysing governmentality and shows how neoliberalism is a discursive formation which homogenises apparently unrelated language games and…

75 FR 48625 - Amendment to the International Traffic in Arms Regulations: Dual Nationals and Third-Country...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-11

..., including technical data, within a foreign business entity, foreign governmental entity, or international..., directly employed by the foreign business entity, foreign governmental entity, or international... any defense article, any foreign business entity, foreign governmental entity, or international...

77 FR 13996 - Determination of Governmental Plan Status; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-08

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [REG-157714-06] RIN 1545-BG43 Determination of Governmental Plan Status; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...) relating to the determination of governmental plans. FOR FURTHER INFORMATION CONTACT: Concerning the...

76 FR 76633 - Indian Tribal Governmental Plans; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-08

... Indian Tribal Governmental Plans; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... are considering proposing relating to the determination of whether a plan of an Indian Tribal government is a governmental plan within the meaning of section 414(d) and contains an appendix that includes...

What's New: Update on GASB and Accounting Standards.

ERIC Educational Resources Information Center

Marrone, Robert S.; Scharle, Robert E.

1996-01-01

Updates the Governmental Accounting Standards Board (GASB) statements, which pronounce upon and provide guidance in accounting and financial reporting for state and local governmental entities. Describes the development of GASB's governmental finance-reporting model project and identifies five components of internal control. One figure and two…

77 FR 12514 - Determination of Governmental Plan Status; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [REG-157714-06] RIN 1545-BG43 Determination of Governmental Plan Status; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... governmental plans. FOR FURTHER INFORMATION CONTACT: Concerning the proposed regulations, Pamela Kinard at (202...

45 CFR 150.313 - Market conduct examinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

45 CFR 150.313 - Market conduct examinations.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

39 CFR 3002.15 - Office of Public Affairs and Governmental Relations. [Reserved

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Office of Public Affairs and Governmental Relations. [Reserved] 3002.15 Section 3002.15 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL ORGANIZATION §§ 3002.15 Office of Public Affairs and Governmental Relations. [Reserved...

47 CFR 76.1505 - Public, educational and governmental access.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Open Video Systems § 76.1505 Public, educational and governmental access. (a) An open video system operator shall be subject to public, educational and... video system operator must ensure that all subscribers receive any public, educational and governmental...

47 CFR 76.1505 - Public, educational and governmental access.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Open Video Systems § 76.1505 Public, educational and governmental access. (a) An open video system operator shall be subject to public, educational and... video system operator must ensure that all subscribers receive any public, educational and governmental...

47 CFR 76.1505 - Public, educational and governmental access.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Open Video Systems § 76.1505 Public, educational and governmental access. (a) An open video system operator shall be subject to public, educational and... video system operator must ensure that all subscribers receive any public, educational and governmental...

47 CFR 76.1505 - Public, educational and governmental access.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Open Video Systems § 76.1505 Public, educational and governmental access. (a) An open video system operator shall be subject to public, educational and... video system operator must ensure that all subscribers receive any public, educational and governmental...

47 CFR 76.1505 - Public, educational and governmental access.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Open Video Systems § 76.1505 Public, educational and governmental access. (a) An open video system operator shall be subject to public, educational and... video system operator must ensure that all subscribers receive any public, educational and governmental...

5 CFR 919.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-01-01

... foreign government or foreign governmental entity; (2) A public international organization; (3) An entity... wholly or partially of one or more foreign governments or foreign governmental entities. (b) A benefit to... governmental operations. (g) Any other transaction if the application of an exclusion to the transaction is...

31 CFR 19.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-07-01

... governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or... foreign governments or foreign governmental entities. (b) A benefit to an individual as a personal... results from ordinary governmental operations. (g) Any other transaction if the application of an...

76 FR 28174 - International Traffic in Arms Regulations: Dual Nationals and Third-Country Nationals Employed by...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... territories of the governmental end-user or international organization. For example, such would be required to.... Furthermore, companies, international organizations, and foreign governmental entities bear significantly more...), to or within a foreign business entity, foreign governmental entity, or international organization...

41 CFR 105-68.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-07-01

... foreign government or foreign governmental entity; (2) A public international organization; (3) An entity... wholly or partially of one or more foreign governments or foreign governmental entities. (b) A benefit to... incidental benefit that results from ordinary governmental operations. (g) Any other transaction if the...

29 CFR 1471.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-07-01

... governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or... foreign governments or foreign governmental entities. (b) A benefit to an individual as a personal... transaction. (f) An incidental benefit that results from ordinary governmental operations. (g) Any other...

10 CFR 2.309 - Hearing requests, petitions to intervene, requirements for standing, and contentions.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., local governmental body, and affected, Federally-recognized Indian Tribe. (i) A State, local governmental body (county, municipality or other subdivision), and any affected Federally-recognized Indian... contention requirements in paragraph (f) of this section), except that a State, local governmental body or...

10 CFR 2.309 - Hearing requests, petitions to intervene, requirements for standing, and contentions.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., local governmental body, and affected, Federally-recognized Indian Tribe. (i) A State, local governmental body (county, municipality or other subdivision), and any affected Federally-recognized Indian... contention requirements in paragraph (f) of this section), except that a State, local governmental body or...

Governmental Surveillance of Three Progressive Educators.

ERIC Educational Resources Information Center

Nelson, Murry R.; Singleton, H. Wells

Governmental interference with academic freedom is illustrated by F.B.I. surveillance of and unauthorized distribution of information about progressive educators John Dewey, George Counts, and Harold Rugg. These three educators attracted the attention of governmental agencies and special interest groups during the 1930s and 1940s because they…

26 CFR 1.892-4T - Commercial activities (temporary regulations).

Code of Federal Regulations, 2010 CFR

2010-04-01

... current or future production of income or gain are commercial activities. An activity may be considered a... railroad is not a non-profit activity. (4) Governmental functions. Governmental functions are not commercial activities. The term “governmental functions” shall be determined under U.S. standards. In general...

26 CFR 1.892-4T - Commercial activities (temporary regulations).

Code of Federal Regulations, 2011 CFR

2011-04-01

... current or future production of income or gain are commercial activities. An activity may be considered a... railroad is not a non-profit activity. (4) Governmental functions. Governmental functions are not commercial activities. The term “governmental functions” shall be determined under U.S. standards. In general...

26 CFR 1.892-4T - Commercial activities (temporary regulations).

Code of Federal Regulations, 2014 CFR

2014-04-01

... current or future production of income or gain are commercial activities. An activity may be considered a... railroad is not a non-profit activity. (4) Governmental functions. Governmental functions are not commercial activities. The term “governmental functions” shall be determined under U.S. standards. In general...

26 CFR 1.892-4T - Commercial activities (temporary regulations).

Code of Federal Regulations, 2013 CFR

2013-04-01

... current or future production of income or gain are commercial activities. An activity may be considered a... railroad is not a non-profit activity. (4) Governmental functions. Governmental functions are not commercial activities. The term “governmental functions” shall be determined under U.S. standards. In general...

26 CFR 1.892-4T - Commercial activities (temporary regulations).

Code of Federal Regulations, 2012 CFR

2012-04-01

... current or future production of income or gain are commercial activities. An activity may be considered a... railroad is not a non-profit activity. (4) Governmental functions. Governmental functions are not commercial activities. The term “governmental functions” shall be determined under U.S. standards. In general...

7 CFR 1205.337 - Influencing governmental action.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Influencing governmental action. 1205.337 Section... RESEARCH AND PROMOTION Cotton Research and Promotion Order Expenses and Assessments § 1205.337 Influencing governmental action. No funds collected by the Board under this subpart shall in any manner be used for the...

7 CFR 1205.337 - Influencing governmental action.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Influencing governmental action. 1205.337 Section... RESEARCH AND PROMOTION Cotton Research and Promotion Order Expenses and Assessments § 1205.337 Influencing governmental action. No funds collected by the Board under this subpart shall in any manner be used for the...

7 CFR 1250.351 - Influencing governmental action.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Influencing governmental action. 1250.351 Section... RESEARCH AND PROMOTION Egg Research and Promotion Order Expenses and Assessments § 1250.351 Influencing governmental action. No funds collected by the Board under this subpart shall in any manner be used for the...

7 CFR 1250.351 - Influencing governmental action.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Influencing governmental action. 1250.351 Section... RESEARCH AND PROMOTION Egg Research and Promotion Order Expenses and Assessments § 1250.351 Influencing governmental action. No funds collected by the Board under this subpart shall in any manner be used for the...

Engaging Education Policies through Governmentality Studies

ERIC Educational Resources Information Center

Brass, Jory

2015-01-01

This article offers a brief introduction to governmentality studies and the conceptual tools that it provides to help English educators recognise the ideas and practices that education policies mobilise to steer our professions towards particular values, norms and outcomes. After a short overview of governmentality, it offers a short discussion of…

77 FR 3202 - Determination of Governmental Plan Status

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [REG-157714-06] RIN 1545-BG43 Determination of Governmental Plan Status AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... regulations, (REG-157714-06) relating to the determination of governmental plans. DATES: The public hearing is...

77 FR 5442 - Determination of Governmental Plan Status

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-03

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [REG-157714-06] RIN 1545-BG43 Determination of Governmental Plan Status AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... governmental plans. This notice supersedes the notice of public hearing published in the Federal Register on...

Residency Evaluation and Adherence Design Study III: Ophthalmology residency training in India: Then and now-Improving with time?

PubMed

Biswas, Partha; Gogate, Parikshit Madhav; Maskati, Quresh Badr; Natarajan, Sundaram; Verma, Lalit; Bansal, Payal K

2018-06-01

To gauge the differences in ophthalmology residency training, academic, clinical and surgical, in the last three decades of the 20 th century and the first decade of the 21 st century. A survey was conducted by the Academic and Research Committee of the All India Ophthalmological Society, in 2014-2016, using a prevalidated questionnaire, which was circulated to ophthalmologists to gauge the practicality of the teaching protocols of clinical and surgical skills during postgraduate residency program. Of the 1005 respondents, 320 ophthalmologists who completed residency between 1967 and 2002 (20 th century trained) and 531 who completed a residency in 2003-2012 (21 st century trained) fulfilled the inclusion criteria. The average age was 49.2 years (standard deviation [SD] 4) and 32.6 years (SD 4), respectively. Twenty-first century trained ophthalmologists rated their training significantly better than the 20 th century trained ophthalmologists for slit lamp examination (P = 0.001), indirect ophthalmoscopy, gonioscopy, automated perimetry, optical coherence tomography, and fundus photography (all having P < 0.001), while the 20 th century trained rated their teaching of refraction, synoptophore, diplopia charting better (all P < 0.001). The range of grading was 0-10 in all categories. The median number of surgeries performed independently by 20 th century and 21 st century trained (during their training period) were: intracapsular cataract extraction (ICCE) 10, 0; extracapsular cataract extraction (ECCE) 43, 18; small incision cataract surgery (SICS) 5, 55; phacoemulsification (Phaco) 0, 1; pterygium excision 20, 15; dacryocystectomy 11, 4; dacryocystorhinostomy 11, 2; chalazion 35, 30; trabeculectomies 5, 0; strabismus correction 0, 0; vitrectomy 0, 0; keratoplasty 0, 0; eyelid surgery 6, 2; and ocular emergencies 18, 20. Teaching of many clinical skills had improved over decades. Cataract surgery training has shifted from ICCE and ECCE to SICS and Phaco, but other surgeries were still taught sparingly. There was an enormous variation across the country in residency training which needs immediate attention.

Strategic issues in preventing cataract blindness in developing countries.

PubMed Central

Ellwein, L. B.; Kupfer, C.

1995-01-01

Cataract blindness is a public health problem of major proportions in developing countries. Intracapsular cataract extraction with aphakic spectacles has been the standard surgical technique for restoring sight. Because of image magnification in the operated eye, however, the result in unilaterally blind patients is less than satisfactory. Fortunately, with the availability of low-cost intraocular lenses (IOL) and ophthalmologists trained in extracapsular surgery, it is now practical to intervene successfully in the unilateral case. The need for increased attention on the quality of the visual high prevalence of cataract blindness in developing countries and an increasing cataract incidence due to an aging population require substantial increases in surgical volume. The third issue relates to cost. If significant increases in surgical volume and quality of outcomes are to be realized without an increased need for external funding, service delivery must be made more efficient. The expansion of IOL surgery for unilateral blindness is a favourable trend in ensuring financial sustainability of delivery systems; patients can be operated on while still economically productive and able to pay rather than waiting for bilateral blindness and a less favourable economic and social impact. If the quality, volume, and cost issues are to be successfully addressed, operational and structural changes to eye care delivery systems are necessary. These changes can be effected through training, technology introduction, management of facilities, social marketing, organizational partnerships, and evaluation. With improved understanding of the critical factors in successful models their widespread replication will be facilitated. PMID:8846495

Postoperative staging of the neck dissection using extracapsular spread and lymph node ratio as prognostic factors in HPV-negative head and neck squamous cell carcinoma patients.

PubMed

Majercakova, Katarina; Valero, Cristina; López, Montserrat; García, Jacinto; Farré, Nuria; Quer, Miquel; León, Xavier

2018-02-01

The presence of nodes with extracapsular spread (ECS) and the lymph node ratio (LNR) have prognostic competence in the pathologic evaluation of patients with a head and neck squamous cell carcinoma (HNSCC) treated with a neck dissection. The purpose of this study is to assess the effect of ECS & LNR on prognosis of HPV negative HNSCC patients treated with neck dissection and to compare to 8th edition TNM/AJCC classification. We carried out a retrospective study of 1383 patients with HNSCC treated with a neck dissection between 1985 and 2013. We developed a classification of the patients according to the presence of nodes with ECS and the LNR value with a recursive partitioning analysis (RPA) model. We obtained a classification tree with four terminal nodes: for patients without ECS (including patients pN0) the cut-off point for LNR was 1.6%, while for patients with lymph nodes with ECS it was 11.4%. The 5-year disease-specific survival for patients without ECS/LNR < 1.6% was 83.3%; for patients without ECS/LNR ≥ 1.6% it was 61.5%; for patients with ECS/LNR < 11.4% it was 33.7%; and for patients with ECS/LNR ≥ 11.4% it was 18.5%. The classification obtained with RPA had better discrimination between categories than the 8th edition of the TNM/AJCC classification. ECS status and LNR value proved high prognostic capacity in the pathological evaluation of the neck dissection. The combination of ECS and LNR improved the predictive capacity of the 8th edition of the TNM/AJCC classification in HPV-negative HNSCC patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Outcome Analysis of Patients With Oral Cavity Cancer and Extracapsular Spread in Neck Lymph Nodes

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

Liao, Chun-Ta, E-mail: liaoct@adm.cgmh.org.tw; Department of Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; Lee, Li-Yu

Purpose: Extracapsular spread (ECS) in neck lymph nodes is a major adverse prognostic factor in patients with oral cavity squamous cell carcinoma (OSCC). We conducted a retrospective analysis of prognostic factors in this patient group and tried to identify a subset of patients with a worse prognosis suitable for more aggressive therapeutic interventions. Methods and Materials: Enrolled in the study were 255 OSCC patients with ECS in neck nodes and without evidence of distant metastasis. All participants were followed-up for at least 2 years or censored at last follow-up. The 5-year rates of control, distant metastasis, and survival were themore » main outcome measures. Results: Level IV/V lymph node metastases and tumor depth {>=}12 mm were independent predictors of 5-year survival and identified three prognostic groups. In the low-risk group (no level IV/V metastases and tumor depth <12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 60%, 66%, and 50%, respectively. In the intermediate-risk group (no level IV/V metastases and tumor depth {>=}12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 39%, 41%, and 28%, respectively. In the high-risk group (evidence of level IV/V metastases), the 5-year disease-free, disease-specific, and overall survival rates were 14%, 12%, and 10%, respectively. Conclusions: Among OSCC patients with ECS, those with level IV/V metastases appear to have the worst prognosis followed by without level IV/V metastases and tumor depth {>=}12 mm. An aggressive therapeutic approach may be suitable for intermediate- and high-risk patients.« less

Depth of invasion, size and number of metastatic nodes predicts extracapsular spread in early oral cancers with occult metastases.

PubMed

Mair, Manish D; Shetty, Rathan; Nair, Deepa; Mathur, Yash; Nair, Sudhir; Deshmukh, Anuja; Thiagarajan, Shiva; Pantvaidya, Gouri; Lashkar, Sarbani; Prabhash, Kumar; Chaukar, Devendra; Pai, Prathmesh; Cruz, Anil D; Chaturvedi, Pankaj

2018-06-01

Presence of extracapsular spread (ECS) significantly decreases survival in oral cancer patients. Considering its prognostic impact, we have studied the incidence and factors predicting ECS in clinically node negative early oral cancers. We performed a retrospective chart review of 354 treatment naïve clinically node negative early oral cancer patients operated between 2012 and 2014. Chi-square test and logistic regression were used for identifying predictors of ECS, while cox-regression test was used for survival analysis. The incidence of occult nodal metastasis was 28.5% (101/354). Among them, ECS was seen in 15.3%(54/354) patients. The incidence of ECS in T1 and T2 lesion was 13.4% (21/157) and 16.8% (33/197), respectively. The overall incidence of ECS was 48% and 29% in lymph nodes smaller than 10 mm and 5 mm respectively. We found that tumor depth of invasion (>5 mm; p-0.027) and node (metastatic) size >15 mm (p-0.018) were significant predictors of ECS. p N2b disease was seen in 41/354 (11.6%) of which 31/354 (8.7%) had ECS, i.e. 75.6% of pN2b patients been ECS positive (p-0.000). The 3-year OS of patients without nodal metastasis, nodal metastasis without ECS and nodal metastasis with ECS was 88.4%, 66.9% and 59.2% (p-0.000) respectively. A significant number of patients with metastatic nodal size less than 1 cm have ECS which suggests aggressive behavior of the primary tumor. Thus, elective neck dissection is the only way of detecting ECS in these patients which may warrant treatment intensification. Copyright © 2018 Elsevier Ltd. All rights reserved.

Predicting Likelihood of Having Four or More Positive Nodes in Patient With Sentinel Lymph Node-Positive Breast Cancer: A Nomogram Validation Study

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

Unal, Bulent; Gur, Akif Serhat; Beriwal, Sushil

2009-11-15

Purpose: Katz suggested a nomogram for predicting having four or more positive nodes in sentinel lymph node (SLN)-positive breast cancer patients. The findings from this formula might influence adjuvant radiotherapy decisions. Our goal was to validate the accuracy of the Katz nomogram. Methods and Materials: We reviewed the records of 309 patients with breast cancer who had undergone completion axillary lymph node dissection. The factors associated with the likelihood of having four or more positive axillary nodes were evaluated in patients with one to three positive SLNs. The nomogram developed by Katz was applied to our data set. The areamore » under the curve of the corresponding receiver operating characteristics curve was calculated for the nomogram. Results: Of the 309 patients, 80 (25.9%) had four or more positive axillary lymph nodes. On multivariate analysis, the number of positive SLNs (p < .0001), overall metastasis size (p = .019), primary tumor size (p = .0001), and extracapsular extension (p = .01) were significant factors predicting for four or more positive nodes. For patients with <5% probability, 90.3% had fewer than four positive nodes and 9.7% had four or more positive nodes. The negative predictive value was 91.7%, and sensitivity was 80%. The nomogram was accurate and discriminating (area under the curve, .801). Conclusion: The probability of four or more involved nodes is significantly greater in patients who have an increased number of positive SLNs, increased overall metastasis size, increased tumor size, and extracapsular extension. The Katz nomogram was validated in our patients. This nomogram will be helpful to clinicians making adjuvant treatment recommendations to their patients.« less

Intra- and extra-capsular hip fractures in the elderly: Two different pathologies?

PubMed

Dinamarca-Montecinos, J L; Prados-Olleta, N; Rubio-Herrera, R; Castellón-Sánchez del Pino, A; Carrasco-Buvinic, A

2015-01-01

To compare intracapsular (IC) and extracapsular (EC) hip fractures (HIF) in elderly patients in order to determine if they are different pathologies. Longitudinal, observational, descriptive, analytical prospective design, using a non-probabilistic sample from a full sample collection with 647 subjects (male and female), of 60 or more years old, admitted with HIF to the Department of Orthopedics and Traumatology of the Hospital, between January 1, 2010 and December 31, 2012. Follow-up was for 1 year post HIF. Socio-demographic, etiological, developmental, therapeutic and prognostic variables are compared. This is the first study on this subject with Latin American population. EC HIF incidence was superior to IC, contrary to that published in European/American populations. There are significant differences in etiological variables (χ(2)=6.34, p<0.042), with traumatic etiology in EC and non-traumatic in IC. There are also differences in therapeutic interventions performed (osteosynthesis for EC, arthroplasty for IC), with the decision on not to operate being lower in IC (both p<0.0000). The variables associated with the decision on not to perform surgery are age, etiology and postoperative mortality. The results are similar to other studies, adding the IC association with non-traumatic origin, in particular the trend of statistical association between IC and non-primary osteoporotic pathology (neoplasms, renal osteodystrophy, primary hyperparathyroidism). A further analysis was performed on the differences between Latin American and European/American populations in the incidence of either type of HIF. There are important etiological and therapeutic differences between IC and EC HIF; therefore it would be advisable to consider them as distinct disease entities. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

Determining Which Patients Require Irradiation of the Supraclavicular Nodal Area After Surgery for N1 Breast Cancer

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

Yu, Jeong Il; Park, Won, E-mail: wonp68@skku.ed; Huh, Seung Jae

2010-11-15

Purpose: We designed this study to determine which patients have a high risk of supraclavicular node recurrence in N1 breast cancer previously treated with surgery but not having received supraclavicular radiation therapy (SCRT) and to identify which patients needed SCRT. Methods and Materials: We performed a retrospective review of 448 pathologic N1 breast cancer patients treated with mastectomy or breast-conserving treatment, but without SCRT, between 1994 and 2003. Mastectomy was performed in 302 patients (67.4%). The median number of axillary nodes dissected was 17 (range, 5-53). Systemic chemotherapy was administered in 443 patients (98.9%), and 144 patients received radiation aftermore » breast-conserving surgery. The median follow-up was 88 months (range, 15-170 months). Results: At follow-up, the treatment failed in 101 patients (22.5%), and 39 patients (8.7%) had supraclavicular node recurrence. Prognostic factors in supraclavicular node recurrence included lymphovascular invasion (p < 0.0001), extracapsular extension (p < 0.0001), the number of involved axillary nodes (p = 0.0003), and the level of involved axillary nodes (p = 0.012) in univariate and multivariate analyses. The total number of prognostic factors correlated well with supraclavicular node recurrence. In the analysis of 5-year supraclavicular node recurrence-free survival, patients with two or more factors showed a significantly higher recurrence rate than did patients with fewer than two factors (96.8% and 72.9%, respectively; p < 0.0001). Conclusions: The prognostic factors associated with supraclavicular node recurrence were lymphovascular invasion, extracapsular extension, and the number and level of involved axillary nodes. Patients with two or more prognostic factors might benefit from SCRT.« less

Evolution of the patient characteristics of candidates for radical prostatectomy and the results obtained with the technique.

PubMed

Sanchís-Bonet, A; Arribas-Gómez, I; Sánchez-Rodríguez, C; Sánchez-Chapado, M

2015-03-01

To evaluate the oncological profile and risk of biochemical recurrence of patients with prostate cancer who underwent radical prostatectomy based on the time period in which the patients were operated. To evaluate the differences in prostate-specific antigen (PSA) at diagnosis of patients with or without biochemical recurrence based on these time periods. Observation carried forward study of a cohort of 972 radical prostatectomies performed during 3 time periods (1994-2000, 2001-2006, 2007-2011). The importance of PSA at diagnosis on the time periods and on biochemical recurrence was assessed using a generalized linear model. The independent predictive behavior of biochemical recurrence was analyzed using Cox regression. The median follow-up was 38 (16-76) months. PSA levels at diagnosis were higher in the period 1994-2000 (12.97ng/mL, P<.001). Seventy-two percent of the patients from the period 2007-2011 were diagnosed as clinical stage T1c (P<.001), compared with 55% from the period 1994-2000. The percentage of extracapsular extension in the specimen decreased from 27% to 18% from the period 1994-2000 to the period 2007-2011 (p<.001). The percentage of patients with biochemical recurrence went from 38% to 14% from the first to the third period (P>.001). The difference between PSA levels at diagnosis for the patients with or without biochemical recurrence was independent of the period (P=.84). The period during which surgery was performed was not an independent predictive factor for biochemical recurrence (P=.09). Patients from the 2007-2011 period had less extracapsular disease in the radical prostatectomy. The period was not an independent predictive factor for biochemical recurrence. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

MUC1 Expression by Immunohistochemistry Is Associated with Adverse Pathologic Features in Prostate Cancer: A Multi-Institutional Study.

PubMed

Eminaga, Okyaz; Wei, Wei; Hawley, Sarah J; Auman, Heidi; Newcomb, Lisa F; Simko, Jeff; Hurtado-Coll, Antonio; Troyer, Dean A; Carroll, Peter R; Gleave, Martin E; Lin, Daniel W; Nelson, Peter S; Thompson, Ian M; True, Lawrence D; McKenney, Jesse K; Feng, Ziding; Fazli, Ladan; Brooks, James D

2016-01-01

The uncertainties inherent in clinical measures of prostate cancer (CaP) aggressiveness endorse the investigation of clinically validated tissue biomarkers. MUC1 expression has been previously reported to independently predict aggressive localized prostate cancer. We used a large cohort to validate whether MUC1 protein levels measured by immunohistochemistry (IHC) predict aggressive cancer, recurrence and survival outcomes after radical prostatectomy independent of clinical and pathological parameters. MUC1 IHC was performed on a multi-institutional tissue microarray (TMA) resource including 1,326 men with a median follow-up of 5 years. Associations with clinical and pathological parameters were tested by the Chi-square test and the Wilcoxon rank sum test. Relationships with outcome were assessed with univariable and multivariable Cox proportional hazard models and the Log-rank test. The presence of MUC1 expression was significantly associated with extracapsular extension and higher Gleason score, but not with seminal vesicle invasion, age, positive surgical margins or pre-operative serum PSA levels. In univariable analyses, positive MUC1 staining was significantly associated with a worse recurrence free survival (RFS) (HR: 1.24, CI 1.03-1.49, P = 0.02), although not with disease specific survival (DSS, P>0.5). On multivariable analyses, the presence of positive surgical margins, extracapsular extension, seminal vesicle invasion, as well as higher pre-operative PSA and increasing Gleason score were independently associated with RFS, while MUC1 expression was not. Positive MUC1 expression was not independently associated with disease specific survival (DSS), but was weakly associated with overall survival (OS). In our large, rigorously designed validation cohort, MUC1 protein expression was associated with adverse pathological features, although it was not an independent predictor of outcome after radical prostatectomy.

Tumor cell anaplasia and multinucleation are predictors of disease recurrence in oropharyngeal squamous cell carcinoma, including among just the human papillomavirus-related cancers.

PubMed

Lewis, James S; Scantlebury, Juliette B; Luo, Jingqin; Thorstad, Wade L

2012-07-01

Oropharyngeal squamous cell carcinoma (SCC) is frequently related to high risk human papillomavirus. This tumor expresses p16, frequently has a nonkeratinizing morphology, and has improved outcomes. Despite having a good prognosis, tumors can have focal or diffuse nuclear anaplasia or multinucleation, the significance of which is unknown. From a database of 270 oropharyngeal SCCs with known histologic typing (using our established system) and p16 immunohistochemistry, all surgically resected cases (149) were reviewed. Anaplasia was defined as any × 40 field with ≥ 3 tumor nuclei with diameters ≥ 5 lymphocyte nuclei (~25 μm), and multinucleation was defined as any × 40 field with ≥ 3 tumor cells with multiple nuclei. p16 was positive in 128 cases (85.9%), 64 cases (43.0%) showed anaplasia, and 71 (47.7%) showed multinucleation. Anaplasia and multinucleation were highly related (P<0.001), and both also correlated with histologic type (P<0.001 and P=0.01, respectively), p16 status (P=0.09 and 0.03, respectively), and partially with nodal extracapsular extension. There was no correlation with any of the other variables. In univariate analysis, cases showing anaplasia or multinucleation had worse overall, disease-specific, and disease-free survival (P<0.006 for all). Higher T-stage, keratinizing histologic type, extracapsular extension, and smoking also all correlated with worse survival. In multivariate analysis, anaplasia and multinucleation both predicted worse disease-specific survival (hazard ratio 9.9, P=0.04; and hazard ratio 11.9, P=0.02, respectively) independent of the other variables. In summary, among surgically resectable oropharyngeal SCC (including among just the p16-positive cohort), tumor cell anaplasia and multinucleation independently correlated with disease recurrence and poorer survival.

Tumor Cell Anaplasia and Multinucleation Are Predictors of Disease Recurrence in Oropharyngeal Squamous Cell Carcinoma, Including Among Just the Human Papillomavirus-Related Cancers

PubMed Central

Lewis, James S.; Scantlebury, Juliette B.; Luo, Jingqin; Thorstad, Wade L.

2013-01-01

Oropharyngeal squamous cell carcinoma (SCC) is frequently related to high risk human papillomavirus. This tumor expresses p16, frequently has a nonkeratinizing morphology, and has improved outcomes. Despite having a good prognosis, tumors can have focal or diffuse nuclear anaplasia or multinucleation, the significance of which is unknown. From a database of 270 oropharyngeal SCCs with known histologic typing (using our established system) and p16 immunohistochemistry, all surgically resected cases (149) were reviewed. Anaplasia was defined as any ×40 field with ≥ 3 tumor nuclei with diameters ≥ 5 lymphocyte nuclei (~25 μm), and multinucleation was defined as any ×40 field with ≥ 3 tumor cells with multiple nuclei. p16 was positive in 128 cases (85.9%), 64 cases (43.0%) showed anaplasia, and 71 (47.7%) showed multinucleation. Anaplasia and multinucleation were highly related (P < 0.001), and both also correlated with histologic type (P < 0.001 and P = 0.01, respectively), p16 status (P = 0.09 and 0.03, respectively), and partially with nodal extracapsular extension. There was no correlation with any of the other variables. In univariate analysis, cases showing anaplasia or multinucleation had worse overall, disease-specific, and disease-free survival (P < 0.006 for all). Higher T-stage, keratinizing histologic type, extracapsular extension, and smoking also all correlated with worse survival. In multivariate analysis, anaplasia and multinucleation both predicted worse disease-specific survival (hazard ratio 9.9, P = 0.04; and hazard ratio 11.9, P = 0.02, respectively) independent of the other variables. In summary, among surgically resectable oropharyngeal SCC (including among just the p16-positive cohort), tumor cell anaplasia and multinucleation independently correlated with disease recurrence and poorer survival. PMID:22743286

MR imaging of silicone breast implants: evaluation of prospective and retrospective interpretations and interobserver agreement.

PubMed

Quinn, S F; Neubauer, N M; Sheley, R C; Demlow, T A; Szumowski, J

1996-01-01

MR imaging was used to evaluate the integrity of silicone breast implants in 54 women with 108 implants. MR images were interpreted by relatively inexperienced readers who tried to reproduce the experiences reported in the literature. The study examines the interobserver agreement using different diagnostic signs and the influence of experience on interpretation errors. Prospective and retrospective interpretations were compared with surgical findings at the time of explanation. Diagnostic indicators, including the linguine sign, the inverted tear drop sign, the C sign, water droplets mixed with silicone, and extracapsular globules of silicone, were evaluated for diagnostic efficacy and interobserver agreement. The prospective sensitivity and specificity were 87% and 78%, respectively. With the retrospective interpretations, the sensitivity and specificity increased to 93% and 92%, respectively. Most of the prospective false-positive interpretations were due to misinterpreting radial folds as signs of implant rupture. Six implants interpreted retrospectively as false positives had gross amounts of silicone around the implants at surgery but there were no obvious rents in the implant shells. There was fair to excellent interobserver agreement with the individual diagnostic signs except for extracapsular globules of silicone. All of the signs had specificities of greater than 90%. The sensitivities of the individual signs were less than the overall retrospective sensitivity. With experience, the sensitivity improved from 87% to 93% and the specificity improved from 78% to 92%. This study helps substantiate the use of diagnostic signs used by other authors to detect silicone loss from breast implants by MR imaging; however, questions remain as to the clinical role of MR imaging in evaluating implants for silicone loss.

Factors influencing the indication for tonsillectomy: a historical overview and current concepts.

PubMed

Hultcrantz, Elisabeth; Ericsson, Elisabeth

2013-01-01

Tonsil surgery has been performed for more than 3,000 years. During the 19th century when anesthesia became available, techniques were refined and the number of procedures performed increased. Repeated throat infections often causing big tonsils was the reason why parents asked for the procedure. During the preantibiotic era, scarlet fever was feared since potential heart or kidney complications were life-threatening. The technique used before 1900 was tonsillotomy since neither a fingernail, snare nor the later 'guillotine' were used extracapsularly. Bleeding was small and the surgery ambulatory. Extracapsular tonsillectomy developed around the turn of the 20th century with the purpose of avoiding remnants - the 'focal infection theory' was prevailing. The whole tonsil was now extirpated with good visibility of the tonsillar area in a deeply anesthetized patient. During the first half of the 20th century, the two methods competed, but by 1950, total tonsillectomy had become the only 'correct' tonsil surgery. The indication was still recurrent infections. The risk for serious bleeding increased; therefore large clinics arose where patients remained for at least a week after tonsillectomy. When oral penicillin for children became available during the 1960s, the threat of throat infection decreased and the number of tonsillectomies declined. The awareness of obstructive problems in children rose at the same time when obstructive sleep apnea syndrome became a disease for adults (1970s). Tonsillotomy was revived during the 1990s and is today used increasingly in many countries. The indication is mainly obstructive sleep apnea syndromeor sleep-disordered breathing, especially in small children. Total tonsillectomy is still preferred for recurrent infections, which include periodic fever/adenitis/pharyngitis/aphthous ulcer syndrome and recurrent peritonsillitis. Copyright © 2013 S. Karger AG, Basel.

A survey of perceived training differences between ophthalmology residents in Hong Kong and China.

PubMed

Young, Alvin L; Jhanji, Vishal; Liang, Yuanbo; Congdon, Nathan; Chow, Simon; Wang, Fenghua; Zhang, Xiujuan; Man, Xiaofei; Yang, Mingming; Lin, Zhong; Yuen, Hunter G L; Lam, Dennis S C

2015-09-28

To study the differences in ophthalmology resident training between China and the Hong Kong Special Administrative Region (HKSAR). Training programs were selected from among the largest and best-known teaching hospitals. Ophthalmology residents were sent an anonymous 48-item questionnaire by mail. Work satisfaction, time allocation between training activities and volume of surgery performed were determined. 50/75 residents (66.7 %) from China and 20/26 (76.9 %) from HKSAR completed the survey. Age (28.9 ± 2.5 vs. 30.2 ± 2.9 years, p = 0.15) and number of years in training (3.4 ± 1.6 vs. 2.8 ± 1.5, p = 0.19) were comparable between groups. The number of cataract procedures performed by HKSAR trainees (extra-capsular, median 80.0, quartile range: 30.0, 100.0; phacoemulsification, median: 20.0, quartile range: 0.0, 100.0) exceeded that for Chinese residents (extra-capsular: median = 0, p < 0.0001; phacoemulsification: median = 0, p < 0.0001). Chinese trainees spent more time completing medical charts (>50 % of time on charts: 62.5 % versus 5.3 %, p < 0.0001) and received less supervision (≥90 % of training supervised: 4.4 % versus 65 %, p < 0.0001). Chinese residents were more likely to feel underpaid (96.0 % vs. 31.6 %, p < 0.0001) and hoped their children would not practice medicine (69.4 % vs. 5.0 %, p = 0.0001) compared HKSAR residents. In this study, ophthalmology residents in China report strikingly less surgical experience and supervision, and lower satisfaction than HKSAR residents. The HKSAR model of hands-on resident training might be useful in improving the low cataract surgical rate in China.

The epidemiology and functional outcomes of operative fixation of extracapsular proximal femoral fractures (AO 31-A) in young adults.

PubMed

Ramoutar, D N; Kodumuri, P; Rodrigues, J N; Olewicz, S; Moran, C G; Ollivere, B J; Forward, D P

2017-02-01

Proximal femoral fractures in adults under 50 years are not as common as in the elderly, but may have just as significant an impact. There is little in the literature describing the functional outcomes of fixation in this age group. Our aim was to assess the clinical and functional outcomes of operative management of extracapsular proximal femoral fractures (AO 31-A) in the young adult (<50 years). Consecutive skeletally mature patients <50 years undergoing operative fixation of these fractures were obtained from a prospective database over a 12-year period. Complications and mortality data were obtained from this database and case note review. Outcome scores were obtained via postal questionnaires. Eighty-eight patients were included in the study of which 74 (84%) had fixation with the dynamic hip screw. The mean age was 39 years (range 17-50) with a male preponderance (73.8%). Mean hospital stay was 14 days (range 2-94). Seventeen (19.3%) patients had died at a mean of 40 months from their operation date. The 1-year mortality was 4.5%. There were five complications (5.7%). SF-36 and EuroQol 5D scores showed that 5-10% had severe problems with a 20% decrease in quality of life compared to population norms. The biggest differences were in the physical function modalities. One-third had fair to poor hip function as assessed by the Oxford Hip Score. Though these injuries are relatively rare in this age group, they do have significant mortality and functional impairment reflecting a higher energy of injury rather than the frailty seen in the elderly.

Role of sentinel lymph node biopsy in oral cancer.

PubMed

Calabrese, L; Bruschini, R; Ansarin, M; Giugliano, G; De Cicco, C; Ionna, F; Paganelli, G; Maffini, F; Werner, J A; Soutar, D

2006-12-01

Squamous cell carcinoma of the oral cavity represents about 2% of all malignant neoplasms and 47% of those developing in the head and neck area. The tongue is the most common site involved, and this incidence is increasing mainly in young people, possibly related to human papilloma virus infections. Prognosis depends on the stage: the 5-year survival rate of tongue squamous cell carcinoma, whatever the T stage, is 73% in pN0 cases, 40% in patients with positive nodes without extracapsular spread (pNl ECS-), and 29% when nodes are metastatic with extracapsular spread (pNl ECS+: p > or = 0.0001). Nodal micrometastases (cN0 pN1) are found in up to 50% of cN0 tongue squamous cell carcinoma patients operated on the neck. At present, no clinical, imaging staging modalities or biological markers are available to diagnose nodal micrometastases. The sentinel node biopsy has been tested since 1996 in order to find a solution to this problem. The sentinel node is the first node reached by the lymphatic stream, assuming an orderly and sequential drainage from the tumour site, and should be predictive of the nodal stage. According to the literature, sentinel node biopsy is a reliable technique in selected cN0 cases, but the procedure is still experimental and should not be performed outside validation trials. Successful application of sentinel node biopsy in the head and neck region requires surgical experience and specific technical devices, including pre-operative lymphoscintigraphy and intra-operative gamma-probe. Moreover, dynamic lymphoscintigraphy seems to be able to show the lymphatic stream from the primary tumour and could allow a selective neck dissection to be tailored thus reducing the related morbidity.

Comparison of the Walz Nomogram and Presence of Secondary Circulating Prostate Cells for Predicting Early Biochemical Failure after Radical Prostatectomy for Prostate Cancer in Chilean Men.

PubMed

Murray, Nigel P; Reyes, Eduardo; Orellana, Nelson; Fuentealba, Cynthia; Jacob, Omar

2015-01-01

To determine the utility of secondary circulating prostate cells for predicting early biochemical failure after radical prostatectomy for prostate cancer and compare the results with the Walz nomagram. A single centre, prospective study of men with prostate cancer treated with radical prostatectomy between 2004 and 2014 was conducted, with registration of clinical-pathological details, total serum PSA pre-surgery, Gleason score, extracapsular extension, positive surgical margins, infiltration of lymph nodes, seminal vesicles and pathological stage. Secondary circulating prostate cells were obtained using differential gel centrifugation and assessed using standard immunocytochemistry with anti-PSA. Biochemical failure was defined as a PSA >0.2ng/ml, predictive values werecalculated using the Walz nomagram and CPC detection. A total of 326 men participated, with a median follow up of 5 years; 64 had biochemical failure within two years. Extracapsular extension, positive surgical margins, pathological stage, Gleason score ≥ 8, infiltration of seminal vesicles and lymph nodes were all associated with higher risk of biochemical failure. The discriminative value for the nomogram and circulating prostate cells was high (AUC >0.80), predictive values were higher for circulating prostate cell detection, with a negative predictive value of 99%, sensitivity of 96% and specificity of 75%. The nomagram had good predictive power to identify men with a high risk of biochemical failure within two years. The presence of circulating prostate cells had the same predictive power, with a higher sensitivity and negative predictive value. The presence of secondary circulating prostate cells identifies a group of men with a high risk of early biochemical failure. Those negative for secondary CPCs have a very low risk of early biochemical failure.

Surgical treatment of scapulohumeral subluxation in an alpaca (Vicugna pacos) using osteotomy of the acromion, open reduction and extracapsular tension sutures.

PubMed

Kofler, J; Eberspächer, E; Fischl, K; Vidoni, B

2016-05-01

A 3.3-year-old male alpaca, weighing 60 kg was referred for investigation of a severe left forelimb lameness of 4 weeks duration. A scapulohumeral subluxation had been diagnosed radiographically by the referring veterinarian. Based on clinical, ultrasonographic and radiographic findings the diagnosis of cranio-lateral subluxation of the left humeral head was confirmed. In addition, a full thickness lesion (approximately 1×1 cm) of the articular cartilage on the caudomedial aspect of the humeral head was diagnosed by arthroscopy. Treatment included open reduction with internal fixation. Severe muscle contraction and local tissue fibrosis around the scapulohumeral joint (SHJ) required osteotomy of the acromion 3 cm proximal to the distal acromial edge, to allow adequate access. Internal stabilisation was achieved by placing tension band sutures between one cortical screw in the scapular neck and two cortical screws, with washers, craniolaterally on the greater tubercle of the humerus. Post-surgery, a carpal flexion sling was applied with the carpus maintained in 70° flexion for 4 weeks to avoid postoperative weight-bearing. An exercise programme was started 8 days after surgery and continued for 12 weeks. The alpaca had an uneventful postsurgical recovery and showed no lameness after 8 weeks. The long-term outcome was excellent; 21 months after surgery the alpaca was sound and the range of movement of the left SHJ was equal to the right SHJ. Even in this chronic case of subluxation of the SHJ of 4 weeks duration, surgical treatment using osteotomy of the acromion, open reduction and internal fixation with extracapsular scapulohumeral tension sutures resulted in an excellent long-term outcome in this alpaca, despite the presence of a cartilage lesion.

Can computerized tomography accurately stage childhood renal tumors?

PubMed

Abdelhalim, Ahmed; Helmy, Tamer E; Harraz, Ahmed M; Abou-El-Ghar, Mohamed E; Dawaba, Mohamed E; Hafez, Ashraf T

2014-07-01

Staging of childhood renal tumors is crucial for treatment planning and outcome prediction. We sought to identify whether computerized tomography could accurately predict the local stage of childhood renal tumors. We retrospectively reviewed our database for patients diagnosed with childhood renal tumors and treated surgically between 1990 and 2013. Inability to retrieve preoperative computerized tomography, intraoperative tumor spillage and nonWilms childhood renal tumors were exclusion criteria. Local computerized tomography stage was assigned by a single experienced pediatric radiologist blinded to the pathological stage, using a consensus similar to the Children's Oncology Group Wilms tumor staging system. Tumors were stratified into up-front surgery and preoperative chemotherapy groups. The radiological stage of each tumor was compared to the pathological stage. A total of 189 tumors in 179 patients met inclusion criteria. Computerized tomography staging matched pathological staging in 68% of up-front surgery (70 of 103), 31.8% of pre-chemotherapy (21 of 66) and 48.8% of post-chemotherapy scans (42 of 86). Computerized tomography over staged 21.4%, 65.2% and 46.5% of tumors in the up-front surgery, pre-chemotherapy and post-chemotherapy scans, respectively, and under staged 10.7%, 3% and 4.7%. Computerized tomography staging was more accurate in tumors managed by up-front surgery (p <0.001) and those without extracapsular extension (p <0.001). The validity of computerized tomography staging of childhood renal tumors remains doubtful. This staging is more accurate for tumors treated with up-front surgery and those without extracapsular extension. Preoperative computerized tomography can help to exclude capsular breach. Treatment strategy should be based on surgical and pathological staging to avoid the hazards of inaccurate staging. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

"Languaging the Worker: Globalized Governmentalities in/of Language in Peripheral Spaces"

ERIC Educational Resources Information Center

Dlaske, Kati; Barakos, Elisabeth; Motobayashi, Kyoko; McLaughlin, Mireille

2016-01-01

In the introduction to the special issue "Languaging the worker: globalized governmentalities in/of language in peripheral spaces", we take up the notion of governmentality as a means to interrogate the complex relationship between language, labor, power, and subjectivity in peripheral multilingual spaces. Our aim here is to argue for…

Interagency and Commercial Collaboration During an Investigation of Chikungunya and Dengue Among Returning Travelers to the United States

PubMed Central

Jentes, Emily S.; Millman, Alexander J.; Decenteceo, Michelle; Klevos, Andrew; Biggs, Holly M.; Esposito, Douglas H.; McPherson, Heidi; Sullivan, Carmen; Voorhees, Dayton; Watkins, Jim; Anzalone, Fanancy L.; Gaul, Linda; Flores, Sal; Brunette, Gary W.; Sotir, Mark J.

2017-01-01

Public health investigations can require intensive collaboration between numerous governmental and nongovernmental organizations. We describe an investigation involving several governmental and nongovernmental partners that was successfully planned and performed in an organized, comprehensive, and timely manner with several governmental and nongovernmental partners. PMID:27601520

Justifying Compulsory Environmental Education in Liberal Democracies

ERIC Educational Resources Information Center

Schinkel, Anders

2009-01-01

The need for education for (as opposed to about) sustainability is urged from many sides. Initiatives in this area tend to focus on formal education. Governmental, supra-governmental and non-governmental bodies all expect much of this kind of education, which is to transform children--and through them society--in the direction of sustainability.…

76 FR 69172 - Determination of Governmental Plan Status

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

...The Treasury Department and IRS anticipate issuing regulations under section 414(d) of the Internal Revenue Code (Code) to define the term ``governmental plan.'' This document describes the rules that the Treasury Department and IRS are considering proposing relating to the determination of whether a plan is a governmental plan within the meaning of section 414(d) and contains an appendix that includes a draft notice of proposed rulemaking on which the Treasury Department and IRS invite comments from the public. This document applies to sponsors of, and participants and beneficiaries in, employee benefit plans that are determined to be governmental plans.

Accident at the Fukushima Dai-ichi nuclear power stations of TEPCO--outline & lessons learned.

PubMed

Tanaka, Shun-ichi

2012-01-01

The severe accident that broke out at Fukushima Dai-ichi nuclear power stations on March 11, 2011, caused seemingly infinite damage to the daily life of residents. Serious and wide-spread contamination of the environment occurred due to radioactive materials discharged from nuclear power stations (NPSs). At the same time, many issues were highlighted concerning countermeasures to severe nuclear accidents. The accident is outlined, and lessons learned are extracted with respect to the safety of NPSs, as well as radiation protection of residents under the emergency involving the accident. The materials of the current paper are those released by governmental agencies, academic societies, interim reports of committees under the government, and others.

Timeliness of Nongovernmental versus Governmental Global Outbreak Communications

PubMed Central

Mondor, Luke; Brownstein, John S.; Chan, Emily; Madoff, Lawrence C.; Pollack, Marjorie P.; Buckeridge, David L.

2012-01-01

To compare the timeliness of nongovernmental and governmental communications of infectious disease outbreaks and evaluate trends for each over time, we investigated the time elapsed from the beginning of an outbreak to public reporting of the event. We found that governmental sources improved the timeliness of public reporting of infectious disease outbreaks during the study period. PMID:22709741

Filling the Gaps: The Role and Impact of International Non-Governmental Organisations in "Education for All"

ERIC Educational Resources Information Center

Tota, Pasqua Marina

2014-01-01

This article discusses the involvement of international non-governmental organisations (INGOs) in transnational education policy-making, with particular reference to the global initiative Education for All (EFA). EFA is a policy process carried out by international governmental organisations (IGOs) with the main aim to achieve basic education for…

Genealogies of Governmentality: Producing and Managing Young Children and Their Education

ERIC Educational Resources Information Center

Ailwood, Jo

2004-01-01

Genealogies, or histories of the present, create critical spaces to remind us of the non-necessity of that which we consider necessary to our lives (Burchell 1993). Further, genealogies of governmentality attempt to create this space with a focus on how conduct is conducted. In this paper I suggest that genealogies of governmentality are one way…

Governmental Forest Policy for Sustainable Forest Management in Costa Rica, Guatemala, and Nicaragua: Regulation, Implementation, and Impact

Treesearch

Kathleen A. McGinley; Frederick W. Cubbage

2012-01-01

We evaluated how governmental forest regulation in Costa Rica, Guatemala, and Nicaragua has succeeded or failed in fostering changes in forest owner and user behavior that enhance the sustainability of tropical forest management. As expected, sufficient resources and capacity for forest policy implementation are crucial for attaining governmental forest policy...

36 CFR 1275.50 - Restriction of materials related to abuses of governmental power.

Code of Federal Regulations, 2010 CFR

2010-07-01

... related to abuses of governmental power. 1275.50 Section 1275.50 Parks, Forests, and Public Property... § 1275.50 Restriction of materials related to abuses of governmental power. (a) The Archivist will... power, as defined in § 1275.16(c), when: (1) The Archivist, in accordance with § 1275.44, is in the...

5 CFR 581.306 - Lack of moneys due from, or payable by, a governmental entity served with legal process.

Code of Federal Regulations, 2010 CFR

2010-01-01

... governmental entity served with legal process. 581.306 Section 581.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PROCESSING GARNISHMENT ORDERS FOR CHILD SUPPORT AND/OR ALIMONY Compliance With Process § 581.306 Lack of moneys due from, or payable by, a governmental entity...

5 CFR 581.306 - Lack of moneys due from, or payable by, a governmental entity served with legal process.

Code of Federal Regulations, 2013 CFR

2013-01-01

... governmental entity served with legal process. 581.306 Section 581.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PROCESSING GARNISHMENT ORDERS FOR CHILD SUPPORT AND/OR ALIMONY Compliance With Process § 581.306 Lack of moneys due from, or payable by, a governmental entity...

5 CFR 581.306 - Lack of moneys due from, or payable by, a governmental entity served with legal process.

Code of Federal Regulations, 2011 CFR

2011-01-01

... governmental entity served with legal process. 581.306 Section 581.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PROCESSING GARNISHMENT ORDERS FOR CHILD SUPPORT AND/OR ALIMONY Compliance With Process § 581.306 Lack of moneys due from, or payable by, a governmental entity...

5 CFR 581.306 - Lack of moneys due from, or payable by, a governmental entity served with legal process.

Code of Federal Regulations, 2014 CFR

2014-01-01

... governmental entity served with legal process. 581.306 Section 581.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PROCESSING GARNISHMENT ORDERS FOR CHILD SUPPORT AND/OR ALIMONY Compliance With Process § 581.306 Lack of moneys due from, or payable by, a governmental entity...

5 CFR 581.306 - Lack of moneys due from, or payable by, a governmental entity served with legal process.

Code of Federal Regulations, 2012 CFR

2012-01-01

... governmental entity served with legal process. 581.306 Section 581.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PROCESSING GARNISHMENT ORDERS FOR CHILD SUPPORT AND/OR ALIMONY Compliance With Process § 581.306 Lack of moneys due from, or payable by, a governmental entity...

A Legal Analysis of Litigation against Oklahoma Educators and School Districts under the Oklahoma Governmental Tort Claims Act

ERIC Educational Resources Information Center

Lacefield, Kevin Lee

2010-01-01

This dissertation analyzed public court decisions in cases against Oklahoma school districts and their employees involving sovereign immunity claims filed under Oklahoma's Governmental Tort Claims Act. The questions addressed were: (1) How have the Oklahoma courts interpreted the Governmental Tort Claims Act, (Okla. Stat. tit. 51 Section 151 et…

[Which relationships between civilian-military actions(CMA), civilian and military cooperation (CIMIC)and non-governmental organizations(NGO)?].

PubMed

Grünewald, F; de Geoffroy, V

2002-01-01

This article questions the existence of "governmental humanitarianism" in opposition to "non-governmental" humanitarianism. The authors report the growing implication of civilian and military actors representing governments in responding to crises and express their concern that this tendency could ultimately lead to use of humanitarian action for diplomatic and economic purposes. They stress that unlike non-governmental organizations, state-run humanitarian agencies are subject to political, economic, and geographic factors. In the context of increasingly frequent application of the CMA doctrine, the authors analyze the role of non-governmental organizations in the field during post-crisis reconstruction. They underline the growing problem of organizing bilateral and multilateral assistance operations. They restate the hope expressed by many humanitarian organizations for a return of the rule of law and conclude on the need to develop complementary activities in the field.

Interagency and Commercial Collaboration During an Investigation of Chikungunya and Dengue Among Returning Travelers to the United States.

PubMed

Jentes, Emily S; Millman, Alexander J; Decenteceo, Michelle; Klevos, Andrew; Biggs, Holly M; Esposito, Douglas H; McPherson, Heidi; Sullivan, Carmen; Voorhees, Dayton; Watkins, Jim; Anzalone, Fanancy L; Gaul, Linda; Flores, Sal; Brunette, Gary W; Sotir, Mark J

2017-02-08

Public health investigations can require intensive collaboration between numerous governmental and nongovernmental organizations. We describe an investigation involving several governmental and nongovernmental partners that was successfully planned and performed in an organized, comprehensive, and timely manner with several governmental and nongovernmental partners. © The American Society of Tropical Medicine and Hygiene.

Russia’s Reactions to the Color Revolutions

DTIC Science & Technology

2017-03-01

Democratic Institute NGO non -governmental organization ODIHR Office for Democratic Institutions and Human Rights OSCE Organization for Security and...as the United States and other Western partners continue their tradition of promoting democracy and encouraging non -governmental organization (NGO...Ukraine as genuinely popular and indigenous upheavals, largely ignoring the role of U.S. funding and U.S. non -governmental organisations in

International non-governmental actors in HIV/AIDS prevention in China.

PubMed

Wu, Feng Shi

2005-01-01

International non-governmental organizations were among the first international actors that responded to the emergence of AIDS crisis in China. Since 1994, the number of international non-governmental organizations and charitable foundations working in AIDS related issue areas in China has grown steadily and substantially. Despite their organizational differences, most of these non-governmental actors present the characteristics of independent mission, localized practice and diverse working focus. Even though they are constrained by financial and other factors compared with multilateral and bilateral official assistance agencies, they have still played a unique role in fighting against AIDS in China as technical experts, public educators, and civil society supporters.

Research and in situ conservation of owl monkeys enhances environmental law enforcement at the Colombian-Peruvian border.

PubMed

Maldonado, Angela M; Peck, Mika R

2014-07-01

This study reports on impacts of illegal trade in owl monkeys (Aotus nancymaae, A. vociferans) for the biomedical research market in the Colombian-Peruvian Amazonian border. Through freedom of information requests and interviews with hunters we found that 912 owl monkeys, including A. nancymaae captured in Peru, were trapped over a 3-month period in 2012 to supply a malaria research facility based in Leticia, Colombia, which had trapping permits for the use of only 800 A. vociferans annually yet experimentation took place using A. nancymaae. High levels of extraction in Peru have had population-level impacts with significantly lower densities of Aotus spp. (3-24 individuals/km(2)) compared to Colombian sites with low hunting pressure (26-44 individuals/km(2)). Post-experimental release of this species in Colombian territory has created a new distribution whose status and impacts on resident populations of A. vociferans remain unknown. The trapping method has also had environmental impact, with loss of over 65,000 trees (including sleeping sites), annually. As Aotus species are registered under the Convention of International Trade in Endangered Species of Wild Fauna and Flora (CITES) Appendix II, international trade requires official permission and evidence that extraction does not impact wild populations. However, no official records exist and CITES legislation has failed, due principally to a lack of appropriate monitoring by national authorities responsible for compliance. Of further concern is that we had previously documented and reported the illegal trade to the appropriate governmental authorities yet still no action was taken-as demonstrated by the continuing trade in 2013. Enforcement eventually occurred when a non-governmental organization initiated legal action against organizations responsible. A successful second instance ruling by the Colombian State's Council in 2013 revoked trapping permits. Using the trade in owl monkeys as a case study we consider implementation, compliance, and enforcement of CITES in the border area to identify mechanisms to improve enforcement of environmental legislation. © 2014 Wiley Periodicals, Inc.

Hurricane Katrina: Utilization of Private, Non-Governmental Health Professionals Time for New Strategies

DTIC Science & Technology

2006-09-01

governmental employees specific to workers compensation and death compensation. Potential long-term financial drain on federal budgets. 48 • Health ...coverage for identified/verified and pre-credentialed health professionals to be made “emergency state employees ” to provide liability and workers ...governmental health professionals for workers compensation and death benefits. A review of the potential deployment mechanisms provides insight to the

Saudi Governmental Structure and Foreign Policy

DTIC Science & Technology

1993-01-21

goNrUnent Igeny. SAUDI GOVERNMENTAL STRUCTURE AND FOREIGN POLICY BY COLONEL AL-MUTAIRI NAIF Saudi National Guard DISTRI1BUTION STATEMENT A: Approved for...TASK IWOX UNIT ELEMENT NO. NO. NO. AE NO. 11. TITLE (Include Security Classification) Saudi Governmental Structure and Foreign Policy - Uncl 12... STRUCTURE AND FOREIGN POLICY AN INDIVIDUAL STUDY PROJECT by Colonel al-Mutairi Naif Saudi National Guard Mr. James J. Coyle (Project Adviser) IL

Role of governmental and non-governmental organizations in mitigation of stigma and discrimination among HIV/AIDS persons in Kibera, Kenya.

PubMed

Odindo, Margaret A; Mwanthi, Mutuku A

2008-04-01

This study assessed the role of governmental and non-governmental organizations in mitigation of stigma and discrimination among people infected and affected by HIV/AIDS in informal settlements of Kibera. This was a descriptive cross-sectional study and used a multi stage stratified sampling method. The study was conducted in Kibera, an informal settlement with a population of over one million people which makes it the largest slum not only in Kenya but in sub-Saharan Africa. The study targeted infected individuals, non-infected community members, managers of the organizations implementing HIV/AIDS programmes and service providers. In the process 1331 households were interviewed using qualitative and quantitative data collection instruments. Statistical Package for Social Sciences (SPSS) and Nudist 4 packages were used to analyze the quantitative and qualitative data respectively. More than 61% of the respondents had patients in their households. Fifty five percent (55%) of the households received assistance from governmental and non-governmental organizations in taking care of the sick. Services provided included awareness, outreach, counseling, testing, treatment, advocacy, home based care, assistance to the orphans and legal issues. About 90% of the respondents perceived health education, counseling services and formation of post counseling support groups to combat stigma and discrimination to be helpful. Stigma and discrimination affects the rights of People Living with HIV/AIDS (PLWHAs). Such stigmatization and discrimination goes beyond and affects those who care for the PLWHAs, and remains the biggest impediment in the fight against HIV/AIDS in Kibera. Governmental and non-governmental organizations continue to provide key services in the mitigation of stigma and discrimination in Kibera. However, personal testimonies by PLWHAs showed that HIV positive persons still suffer from stigma and discrimination. Approximately 43% of the study population experienced stigma and discrimination.

Accident at the Fukushima Dai-ichi Nuclear Power Stations of TEPCO —Outline & lessons learned—

PubMed Central

TANAKA, Shun-ichi

2012-01-01

The severe accident that broke out at Fukushima Dai-ichi nuclear power stations on March 11, 2011, caused seemingly infinite damage to the daily life of residents. Serious and wide-spread contamination of the environment occurred due to radioactive materials discharged from nuclear power stations (NPSs). At the same time, many issues were highlighted concerning countermeasures to severe nuclear accidents. The accident is outlined, and lessons learned are extracted with respect to the safety of NPSs, as well as radiation protection of residents under the emergency involving the accident. The materials of the current paper are those released by governmental agencies, academic societies, interim reports of committees under the government, and others. PMID:23138450

National and Governmental Advisory Committees: Meetings

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Meetings and Teleconference Information for the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation,

[Social organizations and governmental institutions: perspectives on partnerships in children's health care through volunteers and the Pastoral da Criança].

PubMed

Andrade, Raquel Dully; de Mello, Débora Falleiros

2006-03-01

The aim of this research is to present perspectives on partnerships between social organizations and governmental institutions in children's health care. This study reflects on social participation and relations between governmental and non-governmental services in constructing the consolidation of the Sistema Unico de Saúde (Unified Health System), highlighting the role of volunteers and health professionals in this process. In child care, these associations are potential, due to the wide range and prominence of social organizations oriented towards children, particularly the Pastoral da Criança (the Catholic Church's Child Pastoral), which makes it important to discuss public policies aimed at establishing and strengthening these links in the local and national spheres.

[Outcome of cataract surgery in patients with pigmentary retinal degeneration].

PubMed

Grześk, Magdalena; Kałuzny, Józef; Malukiewicz-Wiśniewska, Grazyna

2007-01-01

To evaluate the results of cataract surgery in patients with RP because retinitis pigmentosa is one of the disease entities that belongs to tapeto-retinal degenerations. The occurrence of RP appearance is 1:4000 to 1:3000. Twenty patients with RP (7 women and 13 men, 33 eyes), who underwent cataract surgery were examined retrospectively. Average age in our group was 46.6 years. Visual acuity, intraocular pressure, slip lamp examination, fundus examination, cataract morphology, visual field were taken before surgery and on discharge, on the basis of medical documentation. Control examination was taken, on average, eighty one months after cataract surgery. Nine eyes were operated by phacoemulsification, 24 eyes by means of extracapsular cataract extraction. In the same way control group of 18 patients who underwent cataract surgery without RP (33 eyes) was examined. In RP group in 63.6% patients on discharge from the hospital and in 60.6% patients during the control examination, improvement of visual acuity was revealed. Deterioration was noted in 18.2% of patients on discharge from hospital and in 24.2% of patients during the control examination. In the control group improvement of visual acuity was revealed in 90.9% of patients on discharge and in 97% patients during the control examination, whereas deterioration of visual acuity occurred in 6.1% patients on discharge and in 3% patients during the check examination. In patients with retinitis pigmentosa cataract occurs earlier then in the control group. Cataract surgery for relatively minor opacities is beneficial in patients with RP, and causes improvement of visual acuity in most of eyes undergoing surgery.

Reliable intraocular pressure measurement using automated radio-wave telemetry.

PubMed

Paschalis, Eleftherios I; Cade, Fabiano; Melki, Samir; Pasquale, Louis R; Dohlman, Claes H; Ciolino, Joseph B

2014-01-01

To present an autonomous intraocular pressure (IOP) measurement technique using a wireless implantable transducer (WIT) and a motion sensor. The WIT optical aid was implanted within the ciliary sulcus of a normotensive rabbit eye after extracapsular clear lens extraction. An autonomous wireless data system (AWDS) comprising of a WIT and an external antenna aided by a motion sensor provided continuous IOP readings. The sensitivity of the technique was determined by the ability to detect IOP changes resulting from the administration of latanoprost 0.005% or dorzolamide 2%, while the reliability was determined by the agreement between baseline and vehicle (saline) IOP. On average, 12 diurnal and 205 nocturnal IOP measurements were performed with latanoprost, and 26 diurnal and 205 nocturnal measurements with dorzolamide. No difference was found between mean baseline IOP (13.08±2.2 mmHg) and mean vehicle IOP (13.27±2.1 mmHg) (P=0.45), suggesting good measurement reliability. Both antiglaucoma medications caused significant IOP reduction compared to baseline; latanoprost reduced mean IOP by 10% (1.3±3.54 mmHg; P<0.001), and dorzolamide by 5% (0.62±2.22 mmHg; P<0.001). Use of latanoprost resulted in an overall twofold higher IOP reduction compared to dorzolamide (P<0.001). Repeatability was ±1.8 mmHg, assessed by the variability of consecutive IOP measurements performed in a short period of time (≤1 minute), during which the IOP is not expected to change. IOP measurements in conscious rabbits obtained without the need for human interactions using the AWDS are feasible and provide reproducible results.

Altered mitochondrial genome content signals worse pathology and prognosis in prostate cancer.

PubMed

Kalsbeek, Anton M F; Chan, Eva K F; Grogan, Judith; Petersen, Desiree C; Jaratlerdsiri, Weerachai; Gupta, Ruta; Lyons, Ruth J; Haynes, Anne-Maree; Horvath, Lisa G; Kench, James G; Stricker, Phillip D; Hayes, Vanessa M

2018-01-01

Mitochondrial genome (mtDNA) content is depleted in many cancers. In prostate cancer, there is intra-glandular as well as inter-patient mtDNA copy number variation. In this study, we determine if mtDNA content can be used as a predictor for prostate cancer staging and outcomes. Fresh prostate cancer biopsies from 115 patients were obtained at time of surgery. All cores underwent pathological review, followed by isolation of cancer and normal tissue. DNA was extracted and qPCR performed to quantify the total amount of mtDNA as a ratio to genomic DNA. Differences in mtDNA content were compared for prostate cancer pathology features and disease outcomes. We showed a significantly reduced mtDNA content in prostate cancer compared with normal adjacent prostate tissue (mean difference 1.73-fold, P-value <0.001). Prostate cancer with increased mtDNA content showed unfavorable pathologic characteristics including, higher disease stage (PT2 vs PT3 P-value = 0.018), extracapsular extension (P-value = 0.02) and a trend toward an increased Gleason score (P-value = 0.064). No significant association was observed between changes in mtDNA content and biochemical recurrence (median follow up of 107 months). Contrary to other cancer types, prostate cancer tissue shows no universally depleted mtDNA content. Rather, the change in mtDNA content is highly variable, mirroring known prostate cancer genome heterogeneity. Patients with high mtDNA content have an unfavorable pathology, while a high mtDNA content in normal adjacent prostate tissue is associated with worse prognosis. © 2017 Wiley Periodicals, Inc.

Surgical intervention and accommodative responses, I: centripetal ciliary body, capsule, and lens movements in rhesus monkeys of various ages.

PubMed

Croft, Mary Ann; McDonald, Jared P; James, Rebecca J; Heatley, Gregg A; Lin, Ting-Li; Lütjen-Drecoll, Elke; Kaufman, Paul L

2008-12-01

To determine how surgically altering the normal relationship between the lens and the ciliary body in rhesus monkeys affects centripetal ciliary body and lens movement. In 18 rhesus monkey eyes (aged 6-27 years), accommodation was induced before and after surgery by electrical stimulation of the Edinger-Westphal nucleus. Accommodative amplitude was measured by coincidence refractometry. Goniovideography was performed before and after intra- and extracapsular lens extraction (ICLE, ECLE) and anterior regional zonulolysis (ARZ). Centripetal lens/capsule movements, centripetal ciliary process (CP) movements, and circumlental space were measured by computerized image analysis of the goniovideography images. Centripetal accommodative CP and capsule movement increased in velocity and amplitude after, compared with before, ECLE regardless of age (n = 5). The presence of the lens substance retarded capsule movement by approximately 21% in the young eyes and by approximately 62% in the older eyes. Post-ICLE compared with pre-ICLE centripetal accommodative CP movement was dampened in all eyes in which the anterior vitreous was disrupted (n = 7), but not in eyes in which the anterior vitreous was left intact (n = 2). After anterior regional zonulolysis (n = 4), lens position shifted toward the lysed quadrant during accommodation. The presence of the lens substance, capsule zonular attachments, and Wieger's ligament may play a role in centripetal CP movement. The capsule is still capable of centripetal movement in the older eye (although at a reduced capacity) and may have the ability to produce approximately 6 D of accommodation in the presence of a normal, young crystalline lens or a similar surrogate.

OPTICAL PRINCIPLES, BIOMECHANICS, AND INITIAL CLINICAL PERFORMANCE OF A DUAL-OPTIC ACCOMMODATING INTRAOCULAR LENS (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

PubMed Central

McLeod, Stephen D.

2006-01-01

Purpose To design and develop an accommodating intraocular lens (IOL) for endocapsular fixation with extended accommodative range that can be adapted to current standard extracapsular phacoemulsification technique. Methods Ray tracing analysis and lens design; finite element modeling of biomechanical properties; cadaver eye implantation; initial clinical evaluation. Results Ray tracing analysis indicated that a dual-optic design with a high plus-power front optic coupled to an optically compensatory minus posterior optic produced greater change in conjugation power of the eye compared to that produced by axial movement of a single-optic IOL, and that magnification effects were unlikely to account for improved near vision. Finite element modeling indicated that the two optics can be linked by spring-loaded haptics that allow anterior and posterior axial displacement of the front optic in response to changes in ciliary body tone and capsular tension. A dual-optic single-piece foldable silicone lens was constructed based on these principles. Subsequent initial clinical evaluation in 24 human eyes after phacoemulsification for cataract indicated mean 3.22 diopters of accommodation (range, 1 to 5 D) based on defocus curve measurement. Accommodative amplitude evaluation at 1- and 6-month follow-up in all eyes indicated that the accommodative range was maintained and that the lens was well tolerated. Conclusions A dual-optic design increases the accommodative effect of axial optic displacement, with minimal magnification effect. Initial clinical trials suggest that IOLs designed on this principle might provide true pseudophakic accommodation following cataract extraction and lens implantation. PMID:17471355

Trust in government and support for governmental regulation: the case of electronic health records.

PubMed

Herian, Mitchel N; Shank, Nancy C; Abdel-Monem, Tarik L

2014-12-01

This paper presents results from a public engagement effort in Nebraska, USA, which measured public opinions about governmental involvement in encouraging the use of electronic health records (EHRs). We examine the role of trust in government in contributing to public support for government involvement in the development of EHR technologies. We hypothesize that trust in government will lead to support for federal and state governmental encouragement of the use of EHRs among doctors and insurance companies. Further, because individual experiences with health-care professionals will reduce perceptions of risk, we expect that support for governmental involvement will be tempered by greater personal experience with the health-care industry. Examining a small survey of individuals on the issue, we find general support for both of our hypotheses. The findings suggest that trust in government does have a positive relationship with support for government involvement in the policy domain, but that the frequency of personal experiences with health-care providers reduces the extent to which the public supports governmental involvement in the development of EHR technology. This inquiry contributes to our understanding of public attitudes towards government involvement in EHRs in the United States specifically and contributes to social science examining links between trust in government and support for governmental activity in the emerging policy domain regarding electronic health records systems. © 2012 John Wiley & Sons Ltd.

Analyzing privacy requirements: A case study of healthcare in Saudi Arabia.

PubMed

Ebad, Shouki A; Jaha, Emad S; Al-Qadhi, Mohammed A

2016-01-01

Developing legally compliant systems is a challenging software engineering problem, especially in systems that are governed by law, such as healthcare information systems. This challenge comes from the ambiguities and domain-specific definitions that are found in governmental rules. Therefore, there is a significant business need to automatically analyze privacy texts, extract rules and subsequently enforce them throughout the supply chain. The existing works that analyze health regulations use the U.S. Health Insurance Portability and Accountability Act as a case study. In this article, we applied the Breaux and Antón approach to the text of the Saudi Arabian healthcare privacy regulations; in Saudi Arabia, privacy is among the top dilemmas for public and private healthcare practitioners. As a result, we extracted and analyzed 2 rights, 4 obligations, 22 constraints, and 6 rules. Our analysis can assist requirements engineers, standards organizations, compliance officers and stakeholders by ensuring that their systems conform to Saudi policy. In addition, this article discusses the threats to the study validity and suggests open problems for future research.

Fragmentation in Australian Commonwealth and South Australian State policy on mental health and older people: A governmentality analysis

PubMed Central

Oster, Candice; Henderson, Julie; Lawn, Sharon; Reed, Richard; Dawson, Suzanne; Muir-Cochrane, Eimear; Fuller, Jeffrey

2016-01-01

Mental health care for older people is a significant and growing issue in Australia and internationally. This article describes how older people’s mental health is governed through policy discourse by examining Australian Commonwealth and South Australian State government policy documents, and commentaries from professional groups, advocacy groups and non-governmental organisations. Documents published between 2009 and 2014 were analysed using a governmentality approach, informed by Foucault. Discourses of ‘risk’, ‘ageing as decline/dependence’ and ‘healthy ageing’ were identified. Through these discourses, different neo-liberal governmental strategies are applied to ‘target’ groups according to varying risk judgements. Three policy approaches were identified where older people are (1) absent from policy, (2) governed as responsible, active citizens or (3) governed as passive recipients of health care. This fragmented policy response to older people’s mental health reflects fragmentation in the Australian policy environment. It constructs an ambiguous place for older people within neo-liberal governmental rationality, with significant effects on the health system, older people and their carers. PMID:27147440

Object-based image analysis for the assessment of mineral extraction in conflict regions - a case study in the Democratic Republic of the Congo

NASA Astrophysics Data System (ADS)

Kranz, Olaf; Schoepfer, Elisabeth; Spröhnle, Kristin; Lang, Stefan

2016-06-01

In this study object-based image analysis (OBIA) techniques were applied to assess land cover changes related to mineral extraction in a conflict-affected area of the eastern Democratic Republic of the Congo (DRC) over a period of five years based on very high resolution (VHR) satellite data of different sensors. Object-based approaches explicitly consider spatio-temporal aspects which allow extracting important information to document mining activities. The use of remote sensing data as an independent, up-to-date and reliable data source provided hints on the general development of the mining sector in relation to socio-economic and political decisions. While in early 2010, the situation was still characterised by an intensification of mineral extraction, a mining ban between autumn 2010 and spring 2011 marked the starting point for a continuous decrease of mining activities. The latter can be substantiated through a decrease in the extend of the mining area as well as of the number of dwellings in the nearby settlement. A following demilitarisation and the mentioned need for accountability with respect to the origin of certain minerals led to organised, more industrialized exploitation. This development is likewise visible on satellite imagery as typical clearings within forested areas. The results of the continuous monitoring in turn facilitate non-governmental organisations (NGOs) to further foster the mentioned establishment of responsible supply chains by the mining industry throughout the entire period of investigation.

15 CFR 50.60 - Request for certification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... set cost of the product (one certificate). Certification fees may increase somewhat if the customer.... These governmental units include a variety of legally defined general- and special-purpose governmental...

National and Governmental Advisory Committee Advice Letters for 2014

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Advice Letters produced for and/or by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation

National and Governmental Advisory Committee Advice Letters for 2015

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Advice Letters produced for and/or by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation

Consideration of environmental noise effects in transportation planning by governmental entities

NASA Technical Reports Server (NTRS)

Mayo, L. H.

1975-01-01

Environmental concerns are reviewed with respect to major transportation systems: the interstate highway system and commercial air transportation. The type of planning that was done for interstate highway systems is described, and the shift in social value emphasis that has become apparent since the interstate system was authorized is considered. Other topics discussed include the constitutional framework for the allocation of governmental power with respect to transportation systems planning, governmental assessment of the aircraft noise problem, and evaluating the social benefit of noise abatement.

Destruction of public and governmental experiments of GMO in Europe.

PubMed

Kuntz, Marcel

2012-01-01

The purpose of this article is to compile the destruction of GMO trials from academic or governmental research institutes in Europe, in a factual manner and to highlight their main characteristics. About 80 acts of vandalism against academic or governmental research on GMOs are identified, mainly in 4 countries; namely France, Germany, the United Kingdom and Switzerland. Examples are also provided for Italy and Belgium. The general conclusions that can be drawn from these acts are also discussed.

National and Governmental Advisory Committee Advice Letters for 2016

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Advice Letters and produced by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation, and EPA responses

National and Governmental Advisory Committee Meetings Documents for 2017

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Meetings materials,Teleconference Information produced for and/or by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation

National and Governmental Advisory Committee Meetings Documents for 2015

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Meetings materials,Teleconference Information produced for and/or by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation

75 FR 27981 - Codex Alimentarius Commission: Meeting of the Codex Alimentarius Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... undertaken by international governmental and non- governmental organizations. The CAC will finalize standards... Nations organizations, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO...

National and Governmental Advisory Committee Meetings Documents for 2016

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Meetings materials,Teleconference Information produced for and/or by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation

40 CFR 142.72 - Requirements for Tribal eligibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Requirements for Tribal eligibility. The Administrator is authorized to treat an Indian tribe as eligible to... substantial governmental duties and powers” over a defined area, (i.e., is currently performing governmental...

National and Governmental Advisory Committee Meetings Documents for 2018

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Meetings materials,Teleconference Information produced for and/or by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation

Development and internal validation of a side-specific, multiparametric magnetic resonance imaging-based nomogram for the prediction of extracapsular extension of prostate cancer.

PubMed

Martini, Alberto; Gupta, Akriti; Lewis, Sara C; Cumarasamy, Shivaram; Haines, Kenneth G; Briganti, Alberto; Montorsi, Francesco; Tewari, Ashutosh K

2018-04-19

To develop a nomogram for predicting side-specific extracapsular extension (ECE) for planning nerve-sparing radical prostatectomy. We retrospectively analysed data from 561 patients who underwent robot-assisted radical prostatectomy between February 2014 and October 2015. To develop a side-specific predictive model, we considered the prostatic lobes separately. Four variables were included: prostate-specific antigen; highest ipsilateral biopsy Gleason grade; highest ipsilateral percentage core involvement; and ECE on multiparametric magnetic resonance imaging (mpMRI). A multivariable logistic regression analysis was fitted to predict side-specific ECE. A nomogram was built based on the coefficients of the logit function. Internal validation was performed using 'leave-one-out' cross-validation. Calibration was graphically investigated. The decision curve analysis was used to evaluate the net clinical benefit. The study population consisted of 829 side-specific cases, after excluding negative biopsy observations (n = 293). ECE was reported on mpMRI and final pathology in 115 (14%) and 142 (17.1%) cases, respectively. Among these, mpMRI was able to predict ECE correctly in 57 (40.1%) cases. All variables in the model except highest percentage core involvement were predictors of ECE (all P ≤ 0.006). All variables were considered for inclusion in the nomogram. After internal validation, the area under the curve was 82.11%. The model demonstrated excellent calibration and improved clinical risk prediction, especially when compared with relying on mpMRI prediction of ECE alone. When retrospectively applying the nomogram-derived probability, using a 20% threshold for performing nerve-sparing, nine out of 14 positive surgical margins (PSMs) at the site of ECE resulted above the threshold. We developed an easy-to-use model for the prediction of side-specific ECE, and hope it serves as a tool for planning nerve-sparing radical prostatectomy and in the reduction of PSM in future series. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

[Oncological results of active surveillance in prostate cancer: A retrospective multicentric cohort].

PubMed

Mortier, P; Bastide, C; Lechevallier, E; Walz, J; Fournier, R; Savoie, P-H; Ben Othman, K; Giorgi, R; André, M; Giusiano, S; Rossi, D

2017-01-01

To report oncological outcomes of patients with prostate cancer undergoing active surveillance according to SURACAP criteria. This multicentric study included patients who were initially treated with active surveillance for localized prostate cancer according to the SURACAP criteria. The duration of active surveillance as well as the causes of discontinuing the protocol and the definitive pathological results of patients who further underwent radical prostatectomy were retrospectively evaluated. The predictors of discontinuing active surveillance were assessed using a univariable Cox Model. In addition, the predictive value of initial MRI was assessed for patients who performed such imagery. Between 2007 and 2013, 80 patients were included, with a median age of 64 years [47-74]. Median follow-up was 52.9 months [24-108]. At 5 years follow-up, 43.4% patients were still under surveillance. Among patients that underwent surgery, 17.8% had an extra-capsular extension. The risk of discontinuing was not significantly greater for patients with tumor size of 2 or 3mm versus 1mm (HR=0.9 [0.46-1.75], P=0.763), 2 positives cores versus 1 (HR=0.98 [0.48-2.02], P=0.967), T2a vs. T1c stage (HR=2.18 [0.77-6.18], P=0.133), increased PSA level (HR=1 [0.96-1.15], P=0.975) or the patient's age (HR=1 [0.93-1.16], P=0.966). Among the 50 patients who performed initial MRI, the results of such imagery was not significantly associated to the risk of discontinuing active surveillance MRI (HR=1.49 [0.63-3.52], P=0.36). Although this study reveals a high rate of release from active surveillance at 5 years, the rate of extra-capsular tumors reported in the group of patients that underwent surgery is among the lowest in literature. 4. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Analysis of 30 breast implant rupture cases.

PubMed

Tark, Kwan Chul; Jeong, Hii Sun; Roh, Tae Suk; Choi, Jong Woo

2005-01-01

Breast implants used for augmentation mammoplasty or breast reconstruction could rupture from various causes such as trauma or spontaneous failure. The objectives of this study were to investigate the relationships between the causes of implant rupture and the degree of capsular contracture, and then to evaluate the relative efficacies of specific signs on magnetic resonance imaging (MRI) known to be beneficial for diagnosing the rupture. A retrospective review identified patients with prosthetic implant rupture or impending rupture treated by the senior author. The 30 cases of implant rupture available for review were classified into two groups: intracapsular and extracapsular ruptures. The 30 cases of breast implant ruptures were analyzed with respect to the clinical symptoms and signs, the causes of rupture, the degree of capsular contracture, and therapeutic plans. Among the 30 cases, 14 patients who had undergone MRI during the diagnostic period were analyzed with respect to the relationships between MRI readings and operative findings. Spontaneous rupture of membranes was most common (80%), followed by failure because of trauma (7%) and valve or implant base (4%). The symptoms during implant rupture were contour deformity, palpated mass-like lesions, pain, and focal inflammation. According to the analysis of specific MRI signs, the sensitivity and specificity of the linguine sign were 87% and 100%, respectively, for intracapsular rupture. For extracapsular rupture, the sensitivity and specificity of the linguine sign were, respectively, 67% and 75%. The sensitivity and specificity of the rat-tail sign and tear drop sign were 14% and 50%, respectively. Breast implant rupture was correlated with the degree of capsular contracture in our study. Among the various specific MRI signs used in diagnosing the rupture, the linguine sign was reliable and had a high sensitivity and specificity, especially in cases of intracapsular rupture. On the other hand, the rat-tail and tear drop signs were nonspecific signs for diagnosing the rupture of breast implant.

Once-Daily Radiation Therapy for Inflammatory Breast Cancer

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

Brown, Lindsay; Harmsen, William; Blanchard, Miran

2014-08-01

Purpose: Inflammatory breast cancer (IBC) is a rare and aggressive breast cancer variant treated with multimodality therapy. A variety of approaches intended to escalate the intensity and efficacy of radiation therapy have been reported, including twice-daily radiation therapy, dose escalation, and aggressive use of bolus. Herein, we examine our outcomes for patients treated with once-daily radiation therapy with aggressive bolus utilization, focusing on treatment technique. Methods and Materials: A retrospective review of patients with nonmetastatic IBC treated from January 1, 2000, through December 31, 2010, was performed. Locoregional control (LRC), disease-free survival (DFS), overall survival (OS) and predictors thereof weremore » assessed. Results: Fifty-two women with IBC were identified, 49 (94%) of whom were treated with neoadjuvant chemotherapy. All underwent mastectomy followed by adjuvant radiation therapy. Radiation was delivered in once-daily fractions of 1.8 to 2.25 Gy (median, 2 Gy). Patients were typically treated with daily 1-cm bolus throughout treatment, and 33 (63%) received a subsequent boost to the mastectomy scar. Five-year Kaplan Meier survival estimates for LRC, DFS, and OS were 81%, 56%, and 64%, respectively. Locoregional recurrence was associated with poorer OS (P<.001; hazard ratio [HR], 4.1). Extracapsular extension was associated with worse LRC (P=.02), DFS (P=.007), and OS (P=.002). Age greater than 50 years was associated with better DFS (P=.03). Pathologic complete response was associated with a trend toward improved LRC (P=.06). Conclusions: Once-daily radiation therapy with aggressive use of bolus for IBC results in outcomes consistent with previous reports using various intensified radiation therapy regimens. LRC remains a challenge despite modern systemic therapy. Extracapsular extension, age ≤50 years, and lack of complete response to chemotherapy appear to be associated with worse outcomes. Novel strategies are needed in IBC, particularly among these subsets of patients.« less

Accuracy of Computed Tomography for Predicting Pathologic Nodal Extracapsular Extension in Patients With Head-and-Neck Cancer Undergoing Initial Surgical Resection

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

Prabhu, Roshan S., E-mail: roshansprabhu@gmail.com; Winship Cancer Institute, Emory University, Atlanta, Georgia; Magliocca, Kelly R.

2014-01-01

Purpose: Nodal extracapsular extension (ECE) in patients with head-and-neck cancer increases the loco-regional failure risk and is an indication for adjuvant chemoradiation therapy (CRT). To reduce the risk of requiring trimodality therapy, patients with head-and-neck cancer who are surgical candidates are often treated with definitive CRT when preoperative computed tomographic imaging suggests radiographic ECE. The purpose of this study was to assess the accuracy of preoperative CT imaging for predicting pathologic nodal ECE (pECE). Methods and Materials: The study population consisted of 432 consecutive patients with oral cavity or locally advanced/nonfunctional laryngeal cancer who underwent preoperative CT imaging before initialmore » surgical resection and neck dissection. Specimens with pECE had the extent of ECE graded on a scale from 1 to 4. Results: Radiographic ECE was documented in 46 patients (10.6%), and pECE was observed in 87 (20.1%). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 43.7%, 97.7%, 82.6%, and 87.3%, respectively. The sensitivity of radiographic ECE increased from 18.8% for grade 1 to 2 ECE, to 52.9% for grade 3, and 72.2% for grade 4. Radiographic ECE criteria of adjacent structure invasion was a better predictor than irregular borders/fat stranding for pECE. Conclusions: Radiographic ECE has poor sensitivity, but excellent specificity for pECE in patients who undergo initial surgical resection. PPV and NPV are reasonable for clinical decision making. The performance of preoperative CT imaging increased as pECE grade increased. Patients with resectable head-and-neck cancer with radiographic ECE based on adjacent structure invasion are at high risk for high-grade pECE requiring adjuvant CRT when treated with initial surgery; definitive CRT as an alternative should be considered where appropriate.« less

Improving consent in patients undergoing surgery for fractured neck of femur.

PubMed

Thiruchandran, Gajendiran; McKean, Andrew R; Rudran, Branavan; Imam, Mohamed A; Yeong, Keefai; Hassan, Abdel

2018-05-02

Background Neck of femur fractures and their subsequent operative fixation are associated with high rates of perioperative morbidity and mortality. Consenting in this setting is suboptimal with the Montgomery court ruling changing the perspective of consent. This quality improvement project assessed the adequacy of consenting against British Orthopaedic Association-endorsed guidance and implemented a series of changes to improve the documentation of risks associated with surgery for fractured neck of femur. Methods Seventy consecutive patients who underwent any operative fixation of a neck of femur fracture were included over a 6-month period at a single centre. Patients unable to consent or without electronic notes were excluded. Consent forms were analysed and the documented potential risks or complications associated with surgery were compared to British Orthopaedic Association-endorsed guidance. A series of changes (using the plan, do study, act (PDSA) approach) was implemented to improve the adequacy of consent. Results Documentation of four out of 12 potential risks or complications was recorded in <50% of cases for patients with intracapsular fractures (n=35), and documentation of seven out of 12 potential risks or complications was recorded in <50% of cases for patients with extracapsular fractures (n=35). Re-audit following raising awareness and attaching consent guidance showed 100% documentation of potential risks or complications in patients with intracapsular and extracapsular fractures (n=70). A neck of femur fracture-specific consent form has been implemented which will hopefully lead to sustained improvement. Conclusions Consenting patients with fractured neck of femur for surgery in the authors' unit was suboptimal when compared to British Orthopaedic Association-endorsed consent guidance. This project has shown that ensuring such guidance is readily available has improved the adequacy of consent. The authors hope that introduction of a neck of femur fracture-specific consent form within their unit will lead to sustained adequate documentation of risks associated with surgery.

40 CFR 35.917-6 - Acceptance by implementing governmental units.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.917-6 Acceptance by implementing governmental units. A facilities plan submitted for...

40 CFR 35.917-6 - Acceptance by implementing governmental units.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.917-6 Acceptance by implementing governmental units. A facilities plan submitted for...

40 CFR 35.917-6 - Acceptance by implementing governmental units.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.917-6 Acceptance by implementing governmental units. A facilities plan submitted for...

40 CFR 35.917-6 - Acceptance by implementing governmental units.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.917-6 Acceptance by implementing governmental units. A facilities plan submitted for...

National and Governmental Advisory Committee Advice Letters and EPA Responses for 2017

EPA Pesticide Factsheets

Advice Letters and produced by the National Advisory Committee and Governmental Advisory Committee to the United States Representative to the North American Commission for Environmental Cooperation, and EPA responses

Thailand Momentum on Policy and Practice in Local Legislation on Dengue Vector Control

PubMed Central

Bhumiratana, Adisak; Intarapuk, Apiradee; Chujun, Suriyo; Kaewwaen, Wuthichai; Sorosjinda-Nunthawarasilp, Prapa; Koyadun, Surachart

2014-01-01

Over a past decade, an administrative decentralization model, adopted for local administration development in Thailand, is replacing the prior centralized (top-down) command system. The change offers challenges to local governmental agencies and other public health agencies at all the ministerial, regional, and provincial levels. A public health regulatory and legislative framework for dengue vector control by local governmental agencies is a national topic of interest because dengue control program has been integrated into healthcare services at the provincial level and also has been given priority in health plans of local governmental agencies. The enabling environments of local administrations are unique, so this critical review focuses on the authority of local governmental agencies responsible for disease prevention and control and on the functioning of local legislation with respect to dengue vector control and practices. PMID:24799896

Legislation affecting governmental assistance for children of parents with substance use: a policy analysis of social justice.

PubMed

Raynor, Phyllis; Williams, Pamela Holtzclaw

2012-11-01

There is legislation that withdraws governmental assistance where parents are using drugs. Social justice is an important consideration in any policy that modifies governmental assistance that benefits vulnerable children. The purpose of this policy analysis is to analyze identified legislation that effect governmental assistance for children in response to parents' substance misuse. A selective review of data-driven studies examined findings describing actual or potential effects on children of legislation targeting parental substance misuse. Challenges in design, processes, and implementation contribute to poor child outcomes. Identifiable constructs of social justice were missing in the reviewed legislation. Social injustice is a potential outcome for children when legislative intent focuses solely on addressing parental drug behaviors. Legislative alternatives to withdrawing support can address substance abuse while maintaining health promotion for these vulnerable children.

Limitations in small artisanal gold mining addressed by educational components paired with alternative mining methods.

PubMed

Zolnikov, Tara R

2012-03-01

Current solutions continue to be inadequate in addressing the longstanding, worldwide problem of mercury emissions from small artisanal gold mining. Mercury, an inexpensive and easily accessible heavy metal, is used in the process of extracting gold from ore. Mercury emissions disperse, affecting human populations by causing adverse health effects and environmental and social ramifications. Many developing nations have sizable gold ore deposits, making small artisanal gold mining a major source of employment in the world. Poverty drives vulnerable, rural populations into gold mining because of social and economic instabilities. Educational programs responding to this environmental hazard have been implemented in the past, but have had low positive results due to lack of governmental support and little economic incentive. Educational and enforced intervention programs must be developed in conjunction with governmental agencies in order to successfully eliminate this ongoing problem. Industry leaders offered hopeful suggestions, but revealed limitations when trying to develop encompassing solutions to halt mercury emissions. This research highlights potential options that have been attempted in the past and suggests alternative solutions to improve upon these methods. Some methods include buyer impact recognition, risk assessment proposals exposing a cost-benefit analysis and toxicokinetic modeling, public health awareness campaigns, and the education of miners, healthcare workers, and locals within hazardous areas of mercury exposure. These methods, paired with the implementation of alternative mining techniques, propose a substantial reduction of mercury emissions. Copyright © 2011 Elsevier B.V. All rights reserved.

Conflict minerals from the Democratic Republic of the Congo: global tungsten processing plants, a critical part of the tungsten supply chain

USGS Publications Warehouse

Bermúdez-Lugo, Omayra

2014-01-01

The U.S. Geological Survey (USGS) analyzes supply chains to identify and define major components of mineral and material flows from ore extraction, through intermediate forms, to a final product. Two major reasons necessitate these analyses: (1) to identify risks associated with the supply of critical and strategic minerals to the United States and (2) to provide greater supply chain transparency so that policymakers have the information necessary to ensure domestic legislation compliance. This fact sheet focuses on the latter. The USGS National Minerals Information Center has been asked by governmental and non-governmental organizations to provide information on tin, tantalum, tungsten, and gold (collectively known as “3TG minerals”) processing facilities worldwide in response to U.S. legislation aimed at removing the link between the trade in these minerals and civil unrest in the Democratic Republic of the Congo. Post beneficiation processing plants (smelters and refineries) of 3TG mineral ores and concentrates were identified by company and industry association representatives as being the link in the 3TG mineral supply chain through which these minerals can be traced to their source of origin (mine); determining the point of origin is critical to establishing a transparent conflict mineral supply chain. This fact sheet, the first in a series of 3TG mineral fact sheets, focuses on the tungsten supply chain by listing plants that consume tungsten concentrates to produce ammonium paratungstate and ferrotungsten worldwide.

13 CFR 400.109 - Government-wide debarment and suspension (nonprocurement).

Code of Federal Regulations, 2010 CFR

2010-01-01

... Government; (ii) Direct awards to foreign governments or public international organizations, or transactions with foreign governments or foreign governmental entities, public international organizations, foreign... public international organizations, or transactions with foreign governments or foreign governmental...

Child abuse and neglect in Turkey: professional, governmental and non-governmental achievements in improving the national child protection system.

PubMed

Akco, Seda; Dagli, Tolga; Inanici, Mehmet Akif; Kaynak, Hatice; Oral, Resmiye; Sahin, Figen; Sofuoglu, Zeynep; Ulukol, Betul

2013-11-01

Since ratification of the United Nations Convention on the Rights of the Child in 1995, significant efforts were made in Turkey to improve protection of children from abuse and neglect. The government took steps to amend relevant laws. Several state departments recognized the need for professional in-service training of relevant governmental agency staff. University hospitals established numerous hospital-based multidisciplinary child protection centres. The government established an Interministerial Higher Council, which has been overseeing the foundation of 13 child advocacy centres for a multidisciplinary and interagency response to child sexual abuse. In addition to undertaking research, non-governmental organizations contributed to this process by instituting professional and public education. These ground-breaking developments in the last decade give promise of even further improvement in the national child protection system from investigative, child protective and rehabilitative perspectives.

[Acute traumatic and especially neglected traumatic hip dislocations are very rare in children].

PubMed

Fernandez, F F; Wirth, T; Eberhardt, O

2012-09-01

We report about the first hip arthroscopies of extracapsular neglected hip dislocations with concomitant injuries in two children (2 and 4 years old). The major problem of traumatic hip dislocation is avascular necrosis. Further problems are possible concomitant injuries. It is important not to cause further damage by therapeutic procedures. In a 4-year-old child the hip could be reduced under visualization and in a 2-year-old child with epiphyseal fracture the extent of the operation could be reduced. In both children large avulsion injuries of the ligamentum capitis femoris could be resected via hip arthroscopy. Hip arthroscopy can reduce surgical morbidity considerably and can possibly contribute to prevention of the feared avascular necrosis of the femoral head.

Screening of a Combinatorial Library of Organic Polymers for the Solid-Phase Extraction of Patulin from Apple Juice

PubMed Central

Giovannoli, Cristina; Spano, Giulia; Di Nardo, Fabio; Anfossi, Laura; Baggiani, Claudio

2017-01-01

Patulin is a water-soluble mycotoxin produced by several species of fungi. Governmental bodies have placed it under scrutiny for its potential negative health effects, and maximum residue limits are fixed in specific food matrices to protect consumers’ health. Confirmatory analysis of patulin in complex food matrices can be a difficult task, and sample clean-up treatments are frequently necessary before instrumental analyses. With the aim of simplifying the clean-up step, we prepared a 256-member combinatorial polymeric library based on 16 functional monomers, four cross-linkers and four different porogenic solvents. The library was screened for the binding towards patulin in different media (acetonitrile and citrate buffer at pH 3.2), with the goal of identifying polymer formulations with good binding properties towards the target compound. As a proof of concept, a methacrylic acid-co-pentaerithrytole tetraacrylate polymer prepared in chloroform was successfully used as a solid-phase extraction material for the clean-up and extraction of patulin from apple juice. Clean chromatographic patterns and acceptable recoveries were obtained for juice spiked with patulin at concentration levels of 25 (64 ± 12%), 50 (83 ± 5.6%) and 100 μg L−1 (76 ± 4.5%). The within-day and between-day reproducibility evaluated at a concentration level of 25 μg L−1 were 5.6 and 7.6%, respectively. PMID:28531103

GASB's Basis of Accounting Project.

ERIC Educational Resources Information Center

Kovlak, Daniel L.

1986-01-01

In July 1984, the Governmental Accounting Standards Board began its "Measurement Focus/Basis of Accounting" project, which addresses measurement issues and revenue and expenditure recognition problems involving governmental funds. This article explains the project's background, alternatives discussed by the board, and tentative…

Aviation security : vulnerabilities in, and alternatives for, pre-board screening security operations

DOT National Transportation Integrated Search

2001-09-25

This is the statement of Gerald L. Dillingham, Director, Physical Infrastructure Issues before the Committee on Governmental Affairs and Its Subcommittee on Oversight of Governmental Management, Restructuring and the District of Columbia, U.S. Senate...

Aviation security : vulnerabilities in, and alternatives for, preboard screening security operations

DOT National Transportation Integrated Search

2001-09-25

This is the statement of Gerald L. Dillingham, Director, Physical Infrastructure Issues before the Committee on Governmental Affairs and Its Subcommittee on Oversight of Governmental Management, Restructuring and the District of Columbia, U.S. Senate...

18 CFR 801.0 - Introduction.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Commission. The Commission is a regional governmental agency whose purpose is to effect comprehensive multiple purpose planning for the conservation, utilization, development, management, and control of the... fulfill its statutory regional governmental role. (c) The objectives of the Commission are to: (1) Develop...

48 CFR 1307.503 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the statement of work are inherently governmental. This policy applies to all services other than... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Policy. 1307.503 Section... PLANNING ACQUISITION PLANNING Inherently Governmental Functions 1307.503 Policy. All procurement request...

GASB Achieves Standardization, Recognition.

ERIC Educational Resources Information Center

Bissell, George E.

1986-01-01

In 1984 the Governmental Accounting Standards Board, created to solidify accounting principles for government entities, enumerated Generally Accepted Accounting Principles endorsed by the American Institute of Certified Public Accountants and the National Council on Governmental Accounting. These principles have recently been approved for school…

78 FR 5707 - Lavatory Oxygen Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-28

... scale of the businesses, organizations, and governmental jurisdictions subject to regulation.'' To... organizations, and small governmental jurisdictions. Agencies must perform a review to determine whether a rule... developing U.S. standards, the Trade Act requires agencies to consider international standards and, where...

13 CFR 500.109 - Government-wide debarment and suspension (nonprocurement).

Code of Federal Regulations, 2010 CFR

2010-01-01

... international organizations, or transactions with foreign governments or foreign governmental entities, public international organizations, foreign government owned (in whole or in part) or controlled entities, entities... foreign governmental entities, public international organizations, foreign government owned (in whole or...

The Role of Law in Adaptive Governance

EPA Science Inventory

The term “governance” encompasses both governmental and nongovernmental participation in collective choice and action. Law dictates the structure, boundaries, rules, and processes within which governmental action takes place, and in doing so becomes one of the focal points for an...

10 CFR 851.27 - Reference sources.

Code of Federal Regulations, 2011 CFR

2011-01-01

....nfpa.org. (v) American Conference of Governmental Industrial Hygienist (ACGIH), 1330 Kemper Meadow...) American Society of Mechanical Engineers (ASME), P.O. Box 2300 Fairfield, NJ 07007. Telephone: 800-843-2763...) American Conference of Governmental Industrial Hygienists, “Threshold Limit Values for Chemical Substances...

7 CFR 281.2 - Administration.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE... ITO is presumed to exercise governmental jurisdiction, unless otherwise determined by FNS: (2) The... show to FNS: (i) That the ITO exercises governmental jurisdiction over a geographic area(s) which...

10 CFR 51.123 - Charges for environmental documents; distribution to public; distribution to governmental agencies.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Charges for environmental documents; distribution to public; distribution to governmental agencies. 51.123 Section 51.123 Energy NUCLEAR REGULATORY COMMISSION.... 10, 2003] Commenting ...

Reliable intraocular pressure measurement using automated radio-wave telemetry

PubMed Central

Paschalis, Eleftherios I; Cade, Fabiano; Melki, Samir; Pasquale, Louis R; Dohlman, Claes H; Ciolino, Joseph B

2014-01-01

Purpose To present an autonomous intraocular pressure (IOP) measurement technique using a wireless implantable transducer (WIT) and a motion sensor. Methods The WIT optical aid was implanted within the ciliary sulcus of a normotensive rabbit eye after extracapsular clear lens extraction. An autonomous wireless data system (AWDS) comprising of a WIT and an external antenna aided by a motion sensor provided continuous IOP readings. The sensitivity of the technique was determined by the ability to detect IOP changes resulting from the administration of latanoprost 0.005% or dorzolamide 2%, while the reliability was determined by the agreement between baseline and vehicle (saline) IOP. Results On average, 12 diurnal and 205 nocturnal IOP measurements were performed with latanoprost, and 26 diurnal and 205 nocturnal measurements with dorzolamide. No difference was found between mean baseline IOP (13.08±2.2 mmHg) and mean vehicle IOP (13.27±2.1 mmHg) (P=0.45), suggesting good measurement reliability. Both antiglaucoma medications caused significant IOP reduction compared to baseline; latanoprost reduced mean IOP by 10% (1.3±3.54 mmHg; P<0.001), and dorzolamide by 5% (0.62±2.22 mmHg; P<0.001). Use of latanoprost resulted in an overall twofold higher IOP reduction compared to dorzolamide (P<0.001). Repeatability was ±1.8 mmHg, assessed by the variability of consecutive IOP measurements performed in a short period of time (≤1 minute), during which the IOP is not expected to change. Conclusion IOP measurements in conscious rabbits obtained without the need for human interactions using the AWDS are feasible and provide reproducible results. PMID:24531415

A retrospective study on the incidence of post-cataract surgery Descemet's membrane detachment and outcome of air descemetopexy.

PubMed

Odayappan, Annamalai; Shivananda, Narayana; Ramakrishnan, Seema; Krishnan, Tiruvengada; Nachiappan, Sivagami; Krishnamurthy, Smitha

2018-02-01

To study the anatomic and functional outcome of air descemetopexy in postcataract surgery Descemet's membrane detachment (DMD). Retrospective study. Setting: Institutional. Records of 112 patients who underwent air descemetopexy for postcataract surgery sight-threatening DMD at Aravind Eye Hospital, Pondicherry, between January 2013 and December 2015 were studied. Anatomical outcome refers to reattachment of the Descemet's membrane (DM). Functional outcome was given by the best-corrected visual acuity. The mean age was 66.47±8.46 (SD) years, the male to female ratio was 45:67. The incidence of DMD was more in extracapsular cataract extraction (0.26%) and manual small incision cataract surgery (0.11%) than phacoemulsification (0.04%) (p=0.005 and p<0.0001). DMD was more common among surgical trainees (0.17%) than consultants (0.07%) (p≤0.0001). After primary air descemetopexy, 78 (71%) out of the 110 patients had DM reattachment. The complications noted after descemetopexy include persistent DMD (21.8%), corneal decompensation (7.3%), appositional angle closure (18%), pupillary block with air (2.7%) and uveitis (2.7%). Age, sex and timing of intervention did not influence the reattachment rate. Fifteen patients underwent repeat air descemetopexy for persistent DMD among whom nine (60%) had successful reattachment. Almost 75% of patients had vision better than 6/18 1 month after anatomically successful descemetopexy. Air descemetopexy is a safe and efficient modality of treatment of DMD and should be tried even in patients with severe DMD before planning a major surgery like endothelial keratoplasty. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

SURGICAL INTERVENTION AND ACCOMMODATIVE RESPONSES: I. CENTRIPETAL CILIARY BODY, CAPSULE AND LENS MOVEMENT IN RHESUS MONKEYS OF VARYING AGE

PubMed Central

Croft, Mary Ann; Mcdonald, Jared P.; James, Rebecca J.; Heatley, Gregg A.; Lin, Ting-Li; Lütjen-Drecoll, Elke; Kaufman, Paul L.

2009-01-01

Purpose To determine how surgically altering the normal relationship between the lens and the ciliary body in rhesus monkeys affects centripetal ciliary body and lens movement. Methods In 18 rhesus monkey eyes (aged 6–27 years), accommodation was induced before and after surgery by electrical stimulation of the Edinger-Westphal (E–W) nucleus. Accommodative amplitude was measured by coincidence refractometry. Goniovideography was performed before and after intra- and extra-capsular lens extraction (ICLE, ECLE) and anterior regional zonulolysis. Centripetal lens/capsule movements, centripetal ciliary process (CP) movements, and circumlental space were measured by computerized image analysis of the goniovideography images. Results Centripetal accommodative CP and capsule movement increased in velocity and amplitude post-ECLE compared to pre-ECLE regardless of age (n=5). The presence of the lens substance retarded capsule movement by ~21% in the young eyes and by ~62% in the older eyes. Post-ICLE compared to pre-ICLE centripetal accommodative CP movement was dampened in all eyes in which the anterior vitreous was disturbed (n=7), but not in eyes in which the anterior vitreous was left intact (n=2). Following anterior regional zonulolysis (n=4), lens position shifted toward the lysed quadrant during accommodation. Conclusions The presence of the lens substance, capsule zonular attachments, and Wiegers ligament may play a role in centripetal CP movement. The capsule is still capable of centripetal movement in the older eye (although at a reduced capacity) and may have the ability to produce ~6 diopters of accommodation in the presence of a normal young crystalline lens or a similar surrogate. PMID:18552393

Solar Energy Now.

ERIC Educational Resources Information Center

Rose, Harvey, Ed.

Twenty articles addressing different aspects of solar energy are compiled in this book. They represent the views of different governmental and non-governmental organizations, members of congress, and other individuals including, for example, Barry Commoner and Amory Lovins. Topics discussed include the need for federal support, passive solar…

78 FR 26665 - Excepted Service

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... Organization name Position title No. Effective date Department of Commerce Office of White House Deputy... Assistant for DD130034 2/8/2013 Assistant Secretary Middle East Affairs. of Defense (International Security... Transportation...... Assistant Secretary Associate Director DT130011 2/27/2013 for Governmental for Governmental...

75 FR 7254 - International Whaling Commission; 2010 Intersessional Meetings; Nominations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-18

... recommendations to the U.S. IWC Commissioner representing the positions of non-governmental organizations... recommendations to the U.S. IWC Commissioner representing the positions of non-governmental organizations... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration RIN 0648-XU28 International...

36 CFR 1275.48 - Transfer of materials.

Code of Federal Regulations, 2010 CFR

2010-07-01

... be neither related to abuses of governmental power nor otherwise of general historical significance... identified as private or personal. (b) Materials determined to be neither related to abuses of governmental power nor otherwise of general historical significance, and transferred pursuant to paragraph (a) of...

48 CFR 37.114 - Special acquisition requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... attention to ensure that they do not result in performance of inherently governmental functions by the... those that involve support of government policy or decision making. During performance of service... contracting for functions that are not inherently governmental but closely support the performance of...

Management Issues & Innovation. Chapter 10.

ERIC Educational Resources Information Center

Acampora, Alfonso P., Ed.; Nebelkopf, Ethan, Ed.

This document contains 11 papers from the ninth World Conference of Therapeutic Communities (TCs) that deal with management issues and innovations within TCs. Papers include: (1) "Support or Restriction of TCs: Governmental Interation vs. Self-Reliance" (Richard Pruss); (2) "Governmental Support: A Swedish Perspective" (Lars…

The Goals for Regulating College Tuition

ERIC Educational Resources Information Center

Zeng, Xiaodong

2009-01-01

Regulation refers to governmental restrictions over enterprise in order to protect public interest. Research on governmental regulation in China primarily focuses on public utility, and inadequate attention has been paid to regulating college tuition. Currently, although the educational administrative agencies have successfully kept college…

Vegetation extraction from high-resolution satellite imagery using the Normalized Difference Vegetation Index (NDVI)

NASA Astrophysics Data System (ADS)

AlShamsi, Meera R.

2016-10-01

Over the past years, there has been various urban development all over the UAE. Dubai is one of the cities that experienced rapid growth in both development and population. That growth can have a negative effect on the surrounding environment. Hence, there has been a necessity to protect the environment from these fast pace changes. One of the major impacts this growth can have is on vegetation. As technology is evolving day by day, there is a possibility to monitor changes that are happening on different areas in the world using satellite imagery. The data from these imageries can be utilized to identify vegetation in different areas of an image through a process called vegetation detection. Being able to detect and monitor vegetation is very beneficial for municipal planning and management, and environment authorities. Through this, analysts can monitor vegetation growth in various areas and analyze these changes. By utilizing satellite imagery with the necessary data, different types of vegetation can be studied and analyzed, such as parks, farms, and artificial grass in sports fields. In this paper, vegetation features are detected and extracted through SAFIY system (i.e. the Smart Application for Feature extraction and 3D modeling using high resolution satellite ImagerY) by using high-resolution satellite imagery from DubaiSat-2 and DEIMOS-2 satellites, which provide panchromatic images of 1m resolution and spectral bands (red, green, blue and near infrared) of 4m resolution. SAFIY system is a joint collaboration between MBRSC and DEIMOS Space UK. It uses image-processing algorithms to extract different features (roads, water, vegetation, and buildings) to generate vector maps data. The process to extract green areas (vegetation) utilize spectral information (such as, the red and near infrared bands) from the satellite images. These detected vegetation features will be extracted as vector data in SAFIY system and can be updated and edited by end-users, such as governmental entities and municipalities.

32 CFR 169a.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING COMMERCIAL ACTIVITIES... Department of Defense. DoD governmental function. A function that is related so intimately to the public... Department of Defense. Services or products in support of Governmental functions such as those listed in...

32 CFR 169a.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING COMMERCIAL ACTIVITIES... Department of Defense. DoD governmental function. A function that is related so intimately to the public... Department of Defense. Services or products in support of Governmental functions such as those listed in...

32 CFR 169a.3 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING COMMERCIAL ACTIVITIES... Department of Defense. DoD governmental function. A function that is related so intimately to the public... Department of Defense. Services or products in support of Governmental functions such as those listed in...

Major Changes in Governmental GAAP.

ERIC Educational Resources Information Center

Piotrowski, Craig L.

1988-01-01

The Governmental Accounting Standards Board (GASB) is the standard-setting body for establishing generally accepted accounting principles for school systems and all state and local governments. A brief summary of a statement prepared by GASB's staff outlines the proposed changes in school accounting and financial reporting. (MLF)

Quality Management in Hungarian Higher Education: Organisational Responses to Governmental Policy

ERIC Educational Resources Information Center

Csizmadia, Tibor; Enders, Jurgen; Westerheijden, Don F.

2008-01-01

This article focuses on responses of higher education institutions to governmental policy. We investigate the influence of organisational characteristics on the implementation of quality management in Hungarian higher education institutions. Our theoretical framework is based on organisational theories (resource dependency and…

77 FR 63217 - Use of Additional Portable Oxygen Concentrators on Board Aircraft

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-16

..., organizations, and governmental jurisdictions subject to regulation. To achieve this principle, agencies are... small entities, including small businesses, not-for-profit organizations, and small governmental... manufacturer's names. In this final rule, the FAA will add those previous manufacturer's names (International...

78 FR 76779 - Proposed Modification of the Philadelphia, PA, Class B Airspace Area

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-19

... regulatory and informational requirements to the scale of the businesses, organizations, and governmental... businesses, not-for-profit organizations, and small governmental jurisdictions. Agencies must perform a... southeast than intended from the Philadelphia International Airport. This was caused by the miscalculation...

76 FR 30174 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... and consultation to domestic and international governmental and non-governmental organizations on... Organization, Functions, and Delegations of Authority Part C (Centers for Disease Control and Prevention) of the Statement of Organization, Functions, and Delegations of Authority of the Department of Health and...

48 CFR 52.203-16 - Preventing Personal Conflicts of Interest.

Code of Federal Regulations, 2014 CFR

2014-10-01

... this clause— Acquisition function closely associated with inherently governmental functions means... means an individual who performs an acquisition function closely associated with inherently governmental functions and is— (1) An employee of the contractor; or (2) A subcontractor that is a self-employed...

48 CFR 52.203-16 - Preventing Personal Conflicts of Interest.

Code of Federal Regulations, 2012 CFR

2012-10-01

... this clause— Acquisition function closely associated with inherently governmental functions means... means an individual who performs an acquisition function closely associated with inherently governmental functions and is— (1) An employee of the contractor; or (2) A subcontractor that is a self-employed...

48 CFR 52.203-16 - Preventing Personal Conflicts of Interest.

Code of Federal Regulations, 2013 CFR

2013-10-01

... this clause— Acquisition function closely associated with inherently governmental functions means... means an individual who performs an acquisition function closely associated with inherently governmental functions and is— (1) An employee of the contractor; or (2) A subcontractor that is a self-employed...

Is There Scientific Consensus on Acid Rain? -- Excerpts from Six Governmental Reports.

ERIC Educational Resources Information Center

Environmental Education Report and Newsletter, 1986

1986-01-01

Compiles a series of direct quotations from six governmental reports that reflect a scientific consensus on major aspects of acid deposition. Presents the statements in a question and answer format. Also reviews the sources, extent, and effects of acid rain. (ML)

49 CFR 266.15 - Requirements for State Rail Plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... regional governmental bodies to review and comment on appropriate elements of the State Rail Plan...) Describe the State's methodology for determining the ratio of benefits to the costs of proposed projects...) Describe the planning process participation of local and regional governmental bodies, the railroads...

49 CFR 266.15 - Requirements for State Rail Plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... regional governmental bodies to review and comment on appropriate elements of the State Rail Plan...) Describe the State's methodology for determining the ratio of benefits to the costs of proposed projects...) Describe the planning process participation of local and regional governmental bodies, the railroads...

49 CFR 266.15 - Requirements for State Rail Plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... regional governmental bodies to review and comment on appropriate elements of the State Rail Plan...) Describe the State's methodology for determining the ratio of benefits to the costs of proposed projects...) Describe the planning process participation of local and regional governmental bodies, the railroads...

49 CFR 266.15 - Requirements for State Rail Plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... regional governmental bodies to review and comment on appropriate elements of the State Rail Plan...) Describe the State's methodology for determining the ratio of benefits to the costs of proposed projects...) Describe the planning process participation of local and regional governmental bodies, the railroads...

Serving Migrant Families.

ERIC Educational Resources Information Center

North Carolina State Advisory Committee on Services to Migrants, Raleigh.

The third edition of the annual report by the North Carolina State Advisory Committee on Services to Migrants has the same purpose as previous reports--to improve state services to migrant families. Grouping responsible governmental and non-governmental programs by agency, the descriptions include eligibility requirements and names of contact…

31 CFR 315.87 - Payment to governmental agencies, units, or their officers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... REGULATIONS GOVERNING U.S. SAVINGS BONDS, SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES... officer's authority. (b) Officers. A bond registered in the official title of an officer of a governmental...

Perceptions of government knowledge and control over contributions of aid organizations and INGOs to health in Nepal: a qualitative study.

PubMed

Giri, Aditi; Khatiwada, Prashant; Shrestha, Bikram; Chettri, Radheshyam Khatri

2013-01-18

Almost 50% of the Nepali health budget is made up of international aid. International Non-Governmental Organizations working in the field of health are able to channel their funds directly to grass root level. During a 2010 conference, the Secretary of Population stated that the government has full knowledge and control over all funds and projects coming to Nepal. However, there are no documents to support this. The study aims to assess government and partner perceptions on whether Government of Nepal currently has full knowledge of contributions of international aid organizations and International Non-Governmental Organizations to health in Nepal and to assess if the government is able to control all foreign contributions to fit the objectives of Second Long Term Health Plan (1997-2017). A qualitative study was performed along with available literature review. Judgmental and snowball sampling led to 26 in depth interviews with key informants from the government, External Development Partners and International Non-Governmental Organizations. Results were triangulated based on source of data. Representatives of the Department of Health Services declined to be interviewed. Data collection was done until researchers felt data saturation had been reached with each group of key informants. While Ministry of Health and Population leads the sector wide approach that aims to integrate all donor and International Non-Governmental Organization contributions to health and direct them to the government's priority areas, questions were raised around its capacity to do so. Similarly, informants questioned the extent to which Social Welfare Council was able to control all International Non-Governmental Organizations contributions. Political tumult, corruption in the government, lack of human resources in the government, lack of coordination between government bodies, convoluted bureaucracy, and unreliability of donor and International Non-Governmental Organization contributions were identified as the main reasons for difficulties in aid integration. Despite its commitment to coordinate and control development assistance to the health sector, and its leadership position of the Sector Wide Approach, complete knowledge and effective coordination of all international contributions remains a challenge and is hampered by issues within the government as well as among External Development Partners and International Non-Governmental Organizations.

Getting to Know Governmental GAAP.

ERIC Educational Resources Information Center

Bissell, George E.

1987-01-01

Presents the history and an overview of how generally accepted accounting principles (GAAP) are established and by what process the standards are created. School business officials are invited to participate in the Governmental Accounting Standards Board (GASB), established as the standard setting body for state and local governments. (MLF)

State, Governmentality and Education--the Nordic Experience.

ERIC Educational Resources Information Center

Kivinen, Osmo; Rinne, Risto

1998-01-01

Interrogates the prevailing concept of the state as a regulative idea. Introduces Michel Foucault's notion of "governmentality" and investigates how it has historically been linked to education and to the Scandinavian "Caring State." Explores changing tasks of education and the nature of social contracts that could correspond…

Brownfields Davis Bacon for Revolving Loan Fund Grants: RLF Grants to Governmental/Quasi-Governmental Organizations

EPA Pesticide Factsheets

Terms & conditions specify how Recipients will assist EPA in meeting its Davis Bacon responsibilities when DB applies to EPA awards of financial assistance under the Recovery Act or any other statute which makes DB applicable to EPA financial assistance.

24 CFR 583.5 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... COMMUNITY FACILITIES SUPPORTIVE HOUSING PROGRAM General § 583.5 Definitions. As used in this part: Applicant... definition, governmental entities include those that have general governmental powers (such as a city or... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Definitions. 583.5 Section 583.5...

Strategies for Sustainable Business Models for Open Educational Resources

ERIC Educational Resources Information Center

de Langen, F. H. T.

2013-01-01

For several years, the importance of continuous education has been stressed by several governmental and non-governmental institutions (Janssen & Schuwer, 2012; Marshall & Casserly, 2006). Education is seen as important both for personal growth and empowerment for one's personal wellbeing and for developing the professional capabilities…

Radiotherapy on hidradenocarcinoma.

PubMed

Lalya, Issam; Hadadi, Khalid; Tazi, El Mehdi; Lalya, Ilham; Bazine, Amine; Andaloussy, Khalid; Elmarjany, Mohamed; Sifat, Hassan; Hassouni, Khalid; Kebdani, Tayeb; Mansouri, Hamid; Benjaafar, Noureddine; Elgueddari, Brahim Khalil

2011-01-01

Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. POST OPERATIVE RADIOTHERAPY ALLOWS BETTER LOCAL CONTROL AND SHOULD BE MANDATORY WHEN HISTOLOGICAL FEATURES PREDICTIVE OF RECURRENCE ARE PRESENT: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread.

Anterior Cruciate Ligament Injury, Reconstruction, and the Optimization of Outcome

PubMed Central

Bliss, James Philip

2017-01-01

Anterior cruciate ligament reconstruction (ACLR) provides an established surgical intervention to control pathological tibiofemoral translational and rotational movement. ACLR is a safe and reproducible intervention, but there remains an underlying rate of failure to return to preinjury sporting activity levels. Postoperative pathological laxity and graft reinjury remain concerns. Previously, unrecognized meniscal lesions, disruption of the lateral capsule, and extracapsular structures offer potential avenues to treat and to therefore improve kinematic outcome and functional results, following reconstruction. Addressing laterally based injuries may also improve the durability of intraarticular ACLR. Improving the anterior cruciate ligament (ACL) graft replication of the normal ACL attachment points on the femur and the tibia, using either double bundle or anatomical single bundle techniques, improves kinematics, which may benefit outcome and functionality, following reconstruction. PMID:28966384

The Structures of Centralized Governmental Privacy Protection: Approaches, Models, and Analysis.

ERIC Educational Resources Information Center

Jaeger, Paul T.; McClure, Charles R.; Fraser, Bruce T.

2002-01-01

Asserts that the federal government should adopt a centralized governmental structure for the privacy protection of personal information and data. Discusses the roles of federal law, federal agencies, and the judiciary; the concept of information privacy; the impact of current technologies; and models of centralized government structures for…

Tips for School Districts: GASB's New Fund Balance Standards

ERIC Educational Resources Information Center

Mead, Dean Michael

2010-01-01

In March 2009, the Governmental Accounting Standards Board (GASB) issued Statement No. 54, "Fund Balance Reporting and Governmental Fund Type Definitions." School districts that prepare financial reports based on generally accepted accounting principles are required to implement this standard no later than the first fiscal year that starts after…

Making Citizens Governable? The Crick Report as Governmental Technology

ERIC Educational Resources Information Center

Pykett, Jessica

2007-01-01

This paper considers the recent introduction of Citizenship Education in England from a governmental perspective, drawing on the later work of Foucault to offer a detailed account of the political rationalities, technologies and subjectivities implicated in contemporary education policy in the formation and governance of citizen-subjects. This is…

77 FR 72709 - Prohibition Against Certain Flights Within the Territory and Airspace of Iraq

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... requirements to the scale of the businesses, organizations, and governmental jurisdictions subject to... organizations, and small governmental jurisdictions. Agencies must perform a review to determine whether a rule... International Airports in Northern Iraq by any United States (U.S.) air carrier or commercial operator, any...

78 FR 17993 - Request for Nominations for the General Advisory Committee and the Scientific Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-25

...-governmental conservation organizations. Members of the Committee shall be invited to attend all non-executive... from the public and private sectors, including non- governmental conservation organizations. The... the International Dolphin Conservation Program (AIDCP). The United States Section to the IATTC is...

76 FR 33397 - 60-Day Notice of Proposed Information Collection: DS-4131 Advance Notification Form: Tourist and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... Advance Notification Form: Tourist and Other Non-Governmental Activities in the Antarctic Treaty Area... of Information Collection: Advance Notification Form: Tourist and Other Non-Governmental Activities... proposed information collection is necessary for the proper performance of our functions. Evaluate the...

Governmentality in Environmental Education Policy Discourses: A Qualitative Study of Teachers in Botswana

ERIC Educational Resources Information Center

Ketlhoilwe, M. J.

2013-01-01

International environmental education policy discourses have influenced policy construction in Botswana and how teachers conduct themselves and teaching in environmental learning. The researcher uses Foucault's notion of governmentality to understand the effects of power/knowledge relations in policy. The analysis is taken further through a…

40 CFR 35.917-6 - Acceptance by implementing governmental units.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Acceptance by implementing governmental units. 35.917-6 Section 35.917-6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean...

Regional Meeting of Pacific Islands Women's Non-Governmental Organizations.

ERIC Educational Resources Information Center

South Pacific Commission, Noumea (New Caledonia).

Papers presented at a 1985 regional conference of the Pacific Islands Women's Non-Governmental Organizations are provided in this document. Each paper reports on a different country and discusses developmental issues relating to women's role, such as medical programs, health, social status and welfare, education, employment, and other subjects.…

Afghanistan Narcotics: The Bigger Battle Toward Stabilization

DTIC Science & Technology

2009-04-01

Development of economic opportunities coupled with effective governmental reform is necessary for the nation to become prosperous, stable, and secure. 15...without marginalizing narcotics production and narco-trafficking. Effective security, strong governance, judicial capability...introduce the possibility of meaningful alternative livelihoods. Development of these economic opportunities coupled with effective governmental

Governmental Immunity for Public Education: A Shield of Legal Protection.

ERIC Educational Resources Information Center

Aitken, Joan E.

The American tradition of sovereign immunity and the Eleventh Amendment of the United States Constitution have provided certain legal protection to government personnel, including leaders of public elementary, secondary, and post-secondary institutions, but the concept of governmental immunity may be difficult to understand as it applies to…

44 CFR 64.4 - Effect on community eligibility resulting from boundary changes, governmental reorganization, etc.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Effect on community... HAZARD MITIGATION National Flood Insurance Program COMMUNITIES ELIGIBLE FOR THE SALE OF INSURANCE § 64.4 Effect on community eligibility resulting from boundary changes, governmental reorganization, etc. (a...

44 CFR 64.4 - Effect on community eligibility resulting from boundary changes, governmental reorganization, etc.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Effect on community... HAZARD MITIGATION National Flood Insurance Program COMMUNITIES ELIGIBLE FOR THE SALE OF INSURANCE § 64.4 Effect on community eligibility resulting from boundary changes, governmental reorganization, etc. (a...

27 CFR 479.104 - Registration of firearms by certain governmental entities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... § 479.104 Registration of firearms by certain governmental entities. Any State, any political subdivision thereof, or any official police organization of such a government entity engaged in criminal.... This section shall not apply to a firearm merely being held for use as evidence in a criminal...

Governmentality of Youth: Managing Risky Subjects

ERIC Educational Resources Information Center

Besley, Tina A. C.

2010-01-01

This article poses the question: How do understandings of governmentality play out in discourses of youth? In the twenty-first-century neoliberal contexts of consumer capitalist societies, discourses of youth need now to move beyond the valuable earlier understandings based on psychological and cultural/subcultural studies to harness Foucault's…

It's Time to Implement GASB Statement 54

ERIC Educational Resources Information Center

Heinfeld, Gary; Nuehring, Bert

2012-01-01

In February 2009, the Governmental Accounting Standards Board (GASB) issued Statement No. 54, "Find Balance Reporting and Governmental Fund Type Definitions." This statement changes how a fund balance is classified on the face of the government fund financial statements and refines the definitions for government fund types. The statement's…

A Survey of Golf Courses as a Source of Invasive C3 Grasses

USDA-ARS?s Scientific Manuscript database

Creeping bentgrass (Agrostis stolonifera L.; CBG), Kentucky bluegrass (Poa pratensis L.; KBG), and fine fescue species (Festuca spp.; FF) are commonly used as turf on golf courses. All have been identified as invasive species by governmental or non-governmental groups. We hypothesized that abundan...

World Peace News. Volume 2, Number 6.

ERIC Educational Resources Information Center

1971

The purpose of this independent monthly newsletter is to report what universities, non-governmental organizations, governmental agencies, the United Nations, religious groups, and concerned individuals do and think about peace and the development of enforceable world law. Main articles in this issue are on the following: 1) pollution as a…

9 CFR 329.4 - Notification of governmental authorities having jurisdiction over article or livestock detained...

Code of Federal Regulations, 2010 CFR

2010-01-01

... authorities having jurisdiction over article or livestock detained; form of written notification. 329.4... governmental authorities having jurisdiction over article or livestock detained; form of written notification. Within 48 hours after the detention of any livestock or article pursuant to this part, an authorized...

Enhancing English Language Planning Strategy Using a WebQuest Model

ERIC Educational Resources Information Center

Al-Sayed, Rania Kamal Muhammad; Abdel-Haq, Eman Muhammad; El-Deeb, Mervat Abou-Bakr; Ali, Mahsoub Abdel-Sadeq

2016-01-01

The present study aimed at developing English language planning strategy of second year distinguished governmental language preparatory school pupils using the a WebQuest model. Fifty participants from second year at Hassan Abu-Bakr Distinguished Governmental Language School at Al-Qanater Al-Khairia (Qalubia Governorate) were randomly assigned…

Schoolchildren, Governmentality and National E-Safety Policy Discourse

ERIC Educational Resources Information Center

Hope, Andrew

2015-01-01

The introduction of widespread school Internet access in industrialised countries has been accompanied by the materialisation of what can be labelled as a national school e-safety agenda. Drawing upon Foucault's notions of discourse and governmentality, this paper explores how e-safety policy documents serve to constrain the conceptual…

The Neoliberal Racial Project: The Tiger Mother and Governmentality

ERIC Educational Resources Information Center

Rhee, Jeong-eun

2013-01-01

Combining the conceptual approach of racial formation and racial projects with the Foucauldian concept of governmentality, Jeong-eun Rhee theorizes the "neoliberal racial project" (NRP) and examines contemporary meanings and operations of race and racism in relation to neoliberalism. She analyzes Amy Chua's popular parenting memoir,…

The Search for Stability: Provincial Reconstruction Teams in Afghanistan

DTIC Science & Technology

2004-03-07

7 WORKING WITH NGOS ...Governmental Organisations (IGOs) and Non Governmental Organisations ( NGOs ), has made significant progress. However, the extremities of the country remained...plethora of NGOs and the US and NATO led military. To facilitate cooperation, initial PRT locations were deliberately chosen to be co-located (in the

The New Zealand Experiment: Assessment-Driven Curriculum--Managing Standards, Competition and Performance to Strengthen Governmentality

ERIC Educational Resources Information Center

O'Neill, Anne-Marie

2015-01-01

Following the Tomorrow's Schools administrative restructuring, a second wave of educational change installed globalised discourses as governmentality policies in Aotearoa New Zealand. Drawing on Foucault's "toolkit", this genealogical policy chronology traces the transformation of curriculum and assessment into a specific political…

The Suppression of Ethical Dispositions through Managerial Governmentality: A Habitus Crisis in Australian Higher Education

ERIC Educational Resources Information Center

Zipin, Lew; Brennan, Marie

2003-01-01

"Fiscal" and other so-called "crises" in Australian universities are more fundamentally, it is argued in this article, crises of government decision and "governmentality". Using an illustrative "morality tale" drawn from their working knowledge of the Australian university sector, the authors take a…

9 CFR 381.213 - Notification of governmental authorities having jurisdiction over article detained; form of...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Notification of governmental authorities having jurisdiction over article detained; form of written notification. 381.213 Section 381.213 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY...

Effects of the Oil Spill on Alaskan Education.

ERIC Educational Resources Information Center

Oldaker, Lawrence Lee

Oil-industry-produced revenues, help finance Alaskan state and local governmental services including education. Capital losses incurred by the Exxon Corporation and by commerical fisheries as a consequence of the Exxon Valdez oil spill caused an economic recession, the result being diminished financing for a number of governmental programs and…

The Rhetorical Icon: Toward an Iconological Theory of U.S. Foreign Policy.

ERIC Educational Resources Information Center

Hamlett, Ralph A.

American foreign policy must operate within the parameters of public opinion, and governmental and non-governmental actors must educate the characteristically alienated citizenry concerning policy issues. Since rational discourse is of limited benefit in the process, advocates instead use verbal representations or metaphor to instill within the…

Shark cartilage, cancer and the growing threat of pseudoscience.

PubMed

Ostrander, Gary K; Cheng, Keith C; Wolf, Jeffrey C; Wolfe, Marilyn J

2004-12-01

The promotion of crude shark cartilage extracts as a cure for cancer has contributed to at least two significant negative outcomes: a dramatic decline in shark populations and a diversion of patients from effective cancer treatments. An alleged lack of cancer in sharks constitutes a key justification for its use. Herein, both malignant and benign neoplasms of sharks and their relatives are described, including previously unreported cases from the Registry of Tumors in Lower Animals, and two sharks with two cancers each. Additional justifications for using shark cartilage are illogical extensions of the finding of antiangiogenic and anti-invasive substances in cartilage. Scientific evidence to date supports neither the efficacy of crude cartilage extracts nor the ability of effective components to reach and eradicate cancer cells. The fact that people think shark cartilage consumption can cure cancer illustrates the serious potential impacts of pseudoscience. Although components of shark cartilage may work as a cancer retardant, crude extracts are ineffective. Efficiencies of technology (e.g., fish harvesting), the power of mass media to reach the lay public, and the susceptibility of the public to pseudoscience amplifies the negative impacts of shark cartilage use. To facilitate the use of reason as the basis of public and private decision-making, the evidence-based mechanisms of evaluation used daily by the scientific community should be added to the training of media and governmental professionals. Increased use of logical, collaborative discussion will be necessary to ensure a sustainable future for man and the biosphere.

Career Decision-Making Self-Efficacy, Integration, and the Likelihood of Managerial Retention in Governmental Agencies

ERIC Educational Resources Information Center

Peterson, Shari

2009-01-01

Results based on responses from 679 managers in three governmental agencies confirmed that career-related organizational practices and relationships impacted their staying in the organization. Specifically, managers who scored higher in career decision-making self efficacy, a relatively new variable to the turnover literature, career integration,…

75 FR 51812 - The Consumer and Governmental Affairs Bureau Seeks Comment on the Commission's Policies and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-23

... FEDERAL COMMUNICATIONS COMMISSION [CG Docket No. 10-162; DA 10-1325] The Consumer and Governmental... 504 of the Rehabilitation Act of 1973 AGENCY: Federal Communications Commission. ACTION: Notice... can be sent by hand or messenger delivery, by commercial overnight courier, or by first-class or...

26 CFR 301.7701(i)-4 - Special rules for certain entities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the debt obligations in the performance of a governmental purpose; and (iii) The entity holds the... packaging of debt obligations for re-sale on the secondary market even if any profits from the sale are used in the performance of an essential governmental function. (3) Determinations by the Commissioner. If...

Neo-Liberal "Governmentality" in the English and Japanese Higher Education Systems

ERIC Educational Resources Information Center

Yokoyama, Keiko

2008-01-01

The purpose of this paper is to identify common patterns in central authorities' steering of universities and the institutional power in neo-liberal higher education regimes. The paper examines the regulatory mechanisms of England and Japan through Foucault's idea of "governmentality" and utilises the concept of autonomy to identify the…

Medical loss ratio rebate requirements for non-federal governmental plans. Interim final rule with request for comments.

PubMed

2011-12-07

This interim final rule with comment period revises the regulations implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act in order to establish rules governing the distribution of rebates by issuers in group markets for non-Federal governmental plans.

Public School District Immunity Status in the United States.

ERIC Educational Resources Information Center

Kemper Insurance Group, Chicago, IL.

This paper compiles results of a State-by-State survey of public school district immunity. The survey sought to discover if (1) school districts in each State have governmental immunity for liability, (2) this immunity applies only to governmental activities or to proprietary activities also, (3) board members and employees have immunity, (4) the…

34 CFR Appendix B to Subpart B of... - Appendix I, Standards for Audit of Governmental Organizations, Programs, Activities, and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... shall be conducted * * * by independent certified public accountants or by independent licensed public... provide for the continuing licensing of public accountants and which are prescribed by the Secretary in... expression of an opinion on financial reports of governmental organizations, only fully qualified public...

34 CFR 85.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-07-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... governmental entities. (b) A benefit to an individual as a personal entitlement without regard to the...

78 FR 49756 - Renewal of Charter for the National Vaccine Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-15

...) identifies annually for the Director of the NVP the most important areas of governmental and non-governmental... Health Organization (PAHO) to serve as a non-voting liaison representative member of the Committee. PAHO is an international public health agency with over 110 years of experience working to improve health...

21 CFR 1404.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-04-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... governmental entities. (b) A benefit to an individual as a personal entitlement without regard to the...

29 CFR 98.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-07-01

... award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or (4) Any other entity consisting wholly or partially of one or more foreign governments or foreign governmental entities...

22 CFR 1006.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-04-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... governmental entities. (b) A benefit to an individual as a personal entitlement without regard to the...

2 CFR 180.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-01-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... governmental entities. (b) A benefit to an individual as a personal entitlement without regard to the...

22 CFR 1508.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-04-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... governmental entities. (b) A benefit to an individual as a personal entitlement without regard to the...

The Governmentality of Childhood Obesity: Coca-Cola, Public Health and Primary Schools

ERIC Educational Resources Information Center

Powell, Darren; Gard, Michael

2015-01-01

In this paper, we examine the emergence of what might seem an unexpected policy outcome--a large multinational corporation, frequently blamed for exacerbating childhood obesity, operating as an officially sanctioned driver of anti-obesity initiatives in primary schools across the globe. We draw on Foucault's notion of governmentality to examine…

77 FR 72889 - Aerotest Operations, Inc., Consideration of Indirect Transfer and Conforming Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... previously available; and (iii) the filing has been submitted in a timely fashion based on the availability of the subsequent information. A State, local governmental body, Federally-recognized Indian tribe... under 2.309(h)(2) a State, local governmental body, or Federally-recognized Indian tribe does not need...

10 CFR 51.123 - Charges for environmental documents; distribution to public; distribution to governmental agencies.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Charges for environmental documents; distribution to public; distribution to governmental agencies. 51.123 Section 51.123 Energy NUCLEAR REGULATORY COMMISSION... National Environmental Policy Act-Regulations Implementing Section 102(2) Public Notice of and Access to...

10 CFR 51.123 - Charges for environmental documents; distribution to public; distribution to governmental agencies.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Charges for environmental documents; distribution to public; distribution to governmental agencies. 51.123 Section 51.123 Energy NUCLEAR REGULATORY COMMISSION... National Environmental Policy Act-Regulations Implementing Section 102(2) Public Notice of and Access to...

10 CFR 51.123 - Charges for environmental documents; distribution to public; distribution to governmental agencies.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Charges for environmental documents; distribution to public; distribution to governmental agencies. 51.123 Section 51.123 Energy NUCLEAR REGULATORY COMMISSION... National Environmental Policy Act-Regulations Implementing Section 102(2) Public Notice of and Access to...

10 CFR 51.123 - Charges for environmental documents; distribution to public; distribution to governmental agencies.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Charges for environmental documents; distribution to public; distribution to governmental agencies. 51.123 Section 51.123 Energy NUCLEAR REGULATORY COMMISSION... National Environmental Policy Act-Regulations Implementing Section 102(2) Public Notice of and Access to...

Young People, Education and Unlawful Non-Citizenship: Spectral Sovereignty and Governmentality in Australia

ERIC Educational Resources Information Center

Rasmussen, Mary Lou; Harwood, Valerie

2009-01-01

This paper considers Judith Butler's discussion of the intersections between governmentality and sovereign power in "Precarious life: the powers of mourning and violence." We consider this interrelationship with a view to considering how this might enable us to expand our understanding of contemporary discourses governing young people…

Disability and Democracy in Cambodia: An Integrative Approach to Community Building and Civic Engagement

ERIC Educational Resources Information Center

Zook, Darren C.

2010-01-01

The political framework through which the various communities of disabled persons in Cambodia advocate for and claim their rights is complex and confusing. Both governmental and non-governmental actors engage this political framework through the mobilization of persons from the various disabled communities, competing in the civic sphere through…

Schooling Entrepreneurs: Entrepreneurship, Governmentality and Education Policy in Sweden at the Turn of the Millennium

ERIC Educational Resources Information Center

Dahlstedt, Magnus; Hertzberg, Fredrik

2012-01-01

Departing from Michel Foucault's concept of governmentality, the focus of this article is the introduction of entrepreneurial education in Swedish education policy at the turn of the millennium. We analyze the various meanings attached to the concepts of "entrepreneur" and "entrepreneurship" in education policy documents, as…

Special Education in America: Its Legal and Governmental Foundations.

ERIC Educational Resources Information Center

Ballard, Joseph, Ed.; And Others

The text presents six chapters on the legal and governmental bases of special education. In the Introduction, F. Weintraub and J. Ballard cite the legislative and litigative history of P.L. 94-142, the Education for All Handicapped Children Act, and briefly address information sources on such policy issues as procedural safeguards, underserved…

Career Development among Undergraduate Students of Madda Walabu University, South East Ethiopia

ERIC Educational Resources Information Center

Getachew, Abera; Daniel, Gobena

2016-01-01

Career guidance and counselling is a vaguely implemented concept in most educational institutions, governmental and non-governmental organisations. The severity of the problem and scarcity of relevant information among university students have prompted the undertaking of this study the aim of which was to assess career development among…

Encouraging Educational Intra-Communications: Governmental Support for Educational Cooperation.

ERIC Educational Resources Information Center

Stoloff, David L.

1990-01-01

A survey of governmental support of school-university collaborations, both national and international, is reported. Examples are viewed within the models of J. I. Goodland (1988) and P. C. Schlechty and B. Whitford (1988) and reviewed in terms of the implications for educational intracommunications and development of lifelong learning strategies.…

A Conceptual Model for Supporting Para-Teacher Learning in an Indian Non-Governmental Organization (NGO)

ERIC Educational Resources Information Center

Raval, Harini; McKenney, Susan; Pieters, Jules

2010-01-01

Non-governmental organizations (NGOs) are being recognized globally for their influential role in realizing the UN Millennium Development Goal of education for all in developing countries. NGOs mostly employ untrained para-educators for grassroots activities. The professional development of these teachers is critical for NGO effectiveness, yet…

76 FR 76595 - Medical Loss Ratio Rebate Requirements for Non-Federal Governmental Plans

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-07

..., Department of Health and Human Services, Attention: CMS-9998-IFC2, P.O. Box 8010, Baltimore, MD 21244-8010... for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-9998-IFC2... premium paid by subscribers of non-Federal governmental plans for the benefit of subscribers, ensuring...

Neoliberal and Disciplinary Environmentality and "Sustainable Seafood" Consumption: Storying Environmentally Responsible Action

ERIC Educational Resources Information Center

Lloro-Bidart, Teresa

2017-01-01

This article invokes a neoliberal and disciplinary governmentality lens in a political ecology of education framework to analyze educational programming at Long Beach, California's Aquarium of the Pacific. I begin by briefly describing governmentality as Foucault and neo-Foucauldian scholars have theorized the concept, followed by a discussion of…

Staffing for Unmanned Aircraft Systems (UAS) Operations

DTIC Science & Technology

2016-06-01

Service’s staffing determination . Using these business rules and observations enabled the follow-on assessment of individual UAS mission elements... Determination Framework ......................................................13  B.  Inherently Governmental (IG...authorities, and the determination of inherently governmental (IG) activities. Table 1. Delta between Rank/Pay Grades Annual Total Cost O-4 O-3 W-3 W-2

Acts of Negotiation: Governmentality and Medium of Instruction in an Eastern Ukrainian University

ERIC Educational Resources Information Center

Goodman, Bridget

2018-01-01

This study investigates language policy and language choices at a university in Ukraine, a country of evolving national governance and shifting language policy. Ethnographic data interpreted through the lenses of governmentality, language planning and policy, and conversation analysis show that (1) the institution rather than the national…

29 CFR 510.24 - Governmental entities eligible for minimum wage phase-in.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... 510.24 Section 510.24 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION... FAIR LABOR STANDARDS ACT IN PUERTO RICO Classification of Industries § 510.24 Governmental entities... engaged in one or more of the “traditional” functions listed in § 510.24 (a) or (b). All other employees...

From Governing through Data to Governmentality through Data: Artefacts, Strategies and the Digital Turn

ERIC Educational Resources Information Center

Souto-Otero, Manuel; Beneito-Montagut, Roser

2016-01-01

The article argues that current discussions about governance through data in education can be fruitfully extended through: (1) the establishment of connections with wider debates about the role of commensuration processes and governmentality in the recreation of education systems; (2) greater emphasis on the "artefacts" through which…

Inter-Institutional Relations in the Governance of England's National Parks: A Governmentality Perspective

ERIC Educational Resources Information Center

Thompson, Nicola

2005-01-01

Using Foucault's governmentality approach this paper analyses recent developments in power relations between different levels of government. Taking as its empirical focus the relationship between England's National Park Authorities (NPAs) and the UK government, the paper argues that there are two competing imperatives at work in the governance of…

Equal Employment Opportunity: What We Believe, What We Know, What Research Can Show.

ERIC Educational Resources Information Center

Burstein, Paul

Some Americans believe that governmental attempts to end discrimination in employment have gone too far, leading to reverse discrimination and excessive governmental power. Others believe that the government has not gone far enough. Evidence shows that discrimination against women and members of minority groups has declined, even though it is…

Responses to Climate Change: Exploring Organisational Learning across Internationally Networked Organisations for Development

ERIC Educational Resources Information Center

Boyd, Emily; Osbahr, Henny

2010-01-01

Drawing from the organisational learning and governance literature, this paper assesses four internationally networked governmental and non-governmental organisations in the UK addressing climate change. We analyse how those concerned understand the climate change crisis, what mechanisms are put in place to address information flows, and what…

Developing Governmentality: Conduct [to the third power] and Education Policy

ERIC Educational Resources Information Center

Gillies, Donald

2008-01-01

This article examines education policy and the policy process in the light of two key concepts. The first is the concept of "governmentality" from the work of Michel Foucault (1991). The second is the concept of "political spectacle" from the work of Murray Edelman (1985, 1988). Taking note, further, of recent work by…

Governmental Reform and Education for the Gifted in Japan: A Current Analysis

ERIC Educational Resources Information Center

Bugaj, Stephen J.

2009-01-01

Though targeted for governmental reform since 2002, services envisioned for gifted and talented students have not materialized in Japan. From the perspective of his personal experience as a Japan Fulbright Memorial Fund participant in 2005 and an extensive review of available literature and contacts with the Japanese Ministry of Education,…

45 CFR 150.301 - General rule regarding the imposition of civil money penalties.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REQUIREMENTS RELATING TO HEALTH CARE ACCESS CMS ENFORCEMENT IN GROUP AND INDIVIDUAL INSURANCE MARKETS CMS... to CMS's enforcement authority under § 150.101(b)(2), or any non-Federal governmental plan (or employer that sponsors a non-Federal governmental plan) that is subject to CMS's enforcement authority...

Scratching the First Teflon Presidency: Frank Kent vs. Franklin Roosevelt.

ERIC Educational Resources Information Center

Olasky, Marvin N.

While the typical pantheon of journalism history heroes is made up almost entirely of individuals who campaigned for more governmental regulation and increased social liberalism, there is also an opposing tradition in American journalism, one based on the premise that governmental cures are in most cases worse than the diseases they are designed…

Civic and Political Education of Women.

ERIC Educational Resources Information Center

United Nations, New York, NY. Dept. of Economic and Social Affairs.

"This pamphlet was produced at the request of the United Nations Commission on the Status of Women and the Economic and Social Council (of the United Nations)...It was written primarily for the use of leaders responsible for the civic and political education of women, whether governmental or non-governmental, and is intended as a basic…

78 FR 37216 - Sabine River Authority of Texas and Sabine River Authority, State of Louisiana; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-20

... Environmental Impact Statement for the Toledo Bend Hydroelectric Project In accordance with the National... Office of Energy Projects has reviewed the application for license for the Toledo Bend Hydroelectric... the Toledo Bend Project. The draft EIS documents the views of governmental agencies, non- governmental...

Changing Regimes: Governmentality and Education Policy in Post-Apartheid South Africa

ERIC Educational Resources Information Center

Christie, Pam

2006-01-01

This article applies Foucault's notion of governmentality to educational restructuring in post-apartheid South Africa. It argues that the nature of government in a modern state entails engaging with particular practices and domains of knowledge, which themselves constrain the changes that are conceivable and credible. Using Foucault's concepts of…

The Invisible Hand: Governmental Influences on the Field of Play During the Production and Diffusion of Mobile TV

NASA Astrophysics Data System (ADS)

Lin, Su-Yi; Chiasson, Mike W.

The purpose of this paper is to examine how government agencies alter the context around the production and diffusion of technologies, and how this strengthens or weakens particular ICT trajectories. An embedded case is conducted to address this question in Taiwan, as governmental actions affected the early production and diffusion of DVB-H technology and WiMAX technology, both of which enable mobile TV services. The context around and across these two technologies are analyzed from an institutional perspective, including the framework proposed by King et al (1994). The key lesson of this paper is that government agencies are capable of influencing the diffusion of nomadic technologies through their legitimating powers, specific national policies, the allocation of radio frequency spectrum, the implementation of regulations, and the allocation of financial resources. However, the ultimate effects are determined by mixed institutional factors and sometimes contradictory governmental interventions, stemming from historical differences and conflicts across the various government agencies involved. The implications for ICT diffusion research and governmental policy makers are discussed.

Causes and treatment of mandibular and condylar fractures in children and adolescents: a review of 104 cases.

PubMed

Shi, Jun; Chen, Zhibiao; Xu, Bing

2014-03-01

There are no uniform treatments, standards, and specifications for conservative and surgical management of mandibular fractures in children and adolescents. To review the management of mandibular fractures in children and adolescents at our institution. The medical records of 104 children and adolescents (60 male and 44 female) treated for mandibular fractures from 2005 to 2012 at the Ninth People's Hospital, Shanghai, China, were retrospectively reviewed. The participants were classified as having deciduous dentition (age ≤6 years), mixed dentition (age >6 but <12 years), and permanent dentition (age ≥12 but ≤16 years). Conservative treatment and surgical management. Helkimo clinical dysfunction and anamnestic indices. Condylar process fractures accounted for 55.7% of the fractures (112 fractures of 201 total fracture sites), and symphysis fractures, parasymphysis fractures, fractures of the body, and fractures of the angle accounted for 20.9%, 11.9%, 7.0%, and 3.5% of the fractures, respectively. A total of 83 cases with 159 fracture sites with complete follow-up data were included in the treatment analysis. In these 83 patients, 77 fractures were dentigerous bone fractures, 46 were intracapsular fractures, and 36 were extracapsular fractures. Dentigerous bone fractures of the mandible were managed by closed or open reduction in children younger than 12 years and were managed more often by open reduction and fixation in those between ages 12 and 16 years. Closed treatment was performed for 22 condylar process fractures (28.6%), and open reduction was carried out for 55 condylar process fractures (71.4%). In patients with intracapsular fractures, there was no significant relationship between dentation age and treatment method (P = .06). Most patients with extracapsular fractures with permanent dentition underwent surgical fixation (73.3%), whereas most with deciduous dentition received conservative treatment (87.5%). In patients with condylar process fractures, there was no significant difference in Ai and Di based on treatment method (P = .49 and P = .76, respectively). The treatment of mandibular fractures in children and adolescents should be determined by clinical factors including age, location, and type of fracture.

Clinical comparison of a novel extracapsular stabilization procedure and tibial plateau leveling osteotomy for treatment of cranial cruciate ligament deficiency in dogs.

PubMed

Cook, James L; Luther, Jill K; Beetem, Jodi; Karnes, Josh; Cook, Cristi R

2010-04-01

To develop and test a novel extracapsular technique, TightRope CCL technique (TR), and compare its 6-month clinical outcomes to tibial plateau leveling osteotomy (TPLO) in dogs with cranial cruciate ligament (CCL) deficiency. Prospective clinical cohort study. Medium, large, and giant breed dogs (n=47) with CCL deficiency. Before clinical use, TR was evaluated by mechanical testing and the surgical technique was developed and evaluated in canine cadavers. For the clinical study, dogs were assigned to either TR (n=24) or TPLO (n=23) groups and the assigned technique performed after arthroscopic assessment and treatment of joint pathology. Postoperative management was standardized for both groups. Outcome measures were performed immediately postoperatively and up to 6 months after surgery and included complication types and rate, subjective measurement of cranial drawer and tibial thrust, subjective assessment of radiographic progression of osteoarthritis (OA), and function using a validated client questionnaire (6 months only). TR with a fiber tape suture had superior mechanical properties for creep, stiffness, yield load, and load at failure. Duration of anesthesia, total surgical time, and stabilization procedure (TR versus TPLO) were all significantly (P<.001) shorter for TR compared with TPLO. Complications requiring further treatment occurred in 12.5% of TR cases and 17.4% of TPLO cases. No significant differences were noted between groups for cranial tibial thrust, but cranial drawer was significantly (P<.05) lower in TR stifles at all postoperative time points. No significant differences were noted between groups for radiographic OA scores. No statistically or clinically significant differences were noted between TR and TPLO for scores for each of the client questionnaire categories. TR resulted in 6-month outcomes that were not different than TPLO in terms of radiographic progression of OA and client-evaluated level of function. TR was associated with shorter anesthesia and surgery times as well as a lower complication rate. The TR technique is safe and effective and can be considered an appropriate surgical option as part of the overall treatment plan for CCL deficiency in dogs.

Augmented reality fluoroscopy simulation of the guide-wire insertion in DHS surgery: A proof of concept study.

PubMed

van Duren, B H; Sugand, K; Wescott, R; Carrington, R; Hart, A

2018-05-01

Hip fractures contribute to a significant clinical burden globally with over 1.6 million cases per annum and up to 30% mortality rate within the first year. Insertion of a dynamic hip screw (DHS) is a frequently performed procedure to treat extracapsular neck of femur fractures. Poorly performed DHS fixation of extracapsular neck of femur fractures can result in poor mobilisation, chronic pain, and increased cut-out rate requiring revision surgery. A realistic, affordable, and portable fluoroscopic simulation system can improve performance metrics in trainees, including the tip-apex distance (the only clinically validated outcome), and improve outcomes. We developed a digital fluoroscopic imaging simulator using orthogonal cameras to track coloured markers attached to the guide-wire which created a virtual overlay on fluoroscopic images of the hip. To test the accuracy with which the augmented reality system could track a guide-wire, a standard workshop femur was used to calibrate the system with a positional marker fixed to indicate the apex; this allowed for comparison between guide-wire tip-apex distance (TAD) calculated by the system to be compared to that physically measured. Tests were undertaken to determine: (1) how well the apex could be targeted; (2) the accuracy of the calculated TAD. (3) The number of iterations through the algorithm giving the optimal accuracy-time relationship. The calculated TAD was found to have an average root mean square error of 4.2 mm. The accuracy of the algorithm was shown to increase with the number of iterations up to 20 beyond which the error asymptotically converged to an error of 2 mm. This work demonstrates a novel augmented reality simulation of guide-wire insertion in DHS surgery. To our knowledge this has not been previously achieved. In contrast to virtual reality, augmented reality is able to simulate fluoroscopy while allowing the trainee to interact with real instrumentation and performing the procedure on workshop bone models. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

Prostate Postbrachytherapy Seed Distribution: Comparison of High-Resolution, Contrast-Enhanced, T1- and T2-Weighted Endorectal Magnetic Resonance Imaging Versus Computed Tomography: Initial Experience

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

Bloch, B. Nicolas; Department of Radiology, General Hospital Vienna, Medical University Vienna, Vienna; Lenkinski, Robert E.

2007-09-01

Purpose: To compare contrast-enhanced, T1-weighted, three-dimensional magnetic resonance imaging (CEMR) and T2-weighted magnetic resonance imaging (T2MR) with computed tomography (CT) for prostate brachytherapy seed location for dosimetric calculations. Methods and Materials: Postbrachytherapy prostate MRI was performed on a 1.5 Tesla unit with combined surface and endorectal coils in 13 patients. Both CEMR and T2MR used a section thickness of 3 mm. Spiral CT used a section thickness of 5 mm with a pitch factor of 1.5. All images were obtained in the transverse plane. Two readers using CT and MR imaging assessed brachytherapy seed distribution independently. The dependency of datamore » read by both readers for a specific subject was assessed with a linear mixed effects model. Results: The mean percentage ({+-} standard deviation) values of the readers for seed detection and location are presented. Of 1205 implanted seeds, CEMR, T2MR, and CT detected 91.5% {+-} 4.8%, 78.5% {+-} 8.5%, and 96.1% {+-} 2.3%, respectively, with 11.8% {+-} 4.5%, 8.5% {+-} 3.5%, 1.9% {+-} 1.0% extracapsular, respectively. Assignment to periprostatic structures was not possible with CT. Periprostatic seed assignments for CEMR and T2MR, respectively, were as follows: neurovascular bundle, 3.5% {+-} 1.6% and 2.1% {+-} 0.9%; seminal vesicles, 0.9% {+-} 1.8% and 0.3% {+-} 0.7%; periurethral, 7.1% {+-} 3.3% and 5.8% {+-} 2.9%; penile bulb, 0.6% {+-} 0.8% and 0.3% {+-} 0.6%; Denonvillier's Fascia/rectal wall, 0.5% {+-} 0.6% and 0%; and urinary bladder, 0.1% {+-} 0.3% and 0%. Data dependency analysis showed statistical significance for the type of imaging but not for reader identification. Conclusion: Both enumeration and localization of implanted seeds are readily accomplished with CEMR. Calculations with MRI dosimetry do not require CT data. Dose determinations to specific extracapsular sites can be obtained with MRI but not with CT.« less

UNESCO, "universal bioethics," and state regulation of health risks: a philosophical critique.

PubMed

Cherry, Mark J

2009-06-01

The United Nations Educational, Scientific, and Cultural Organization's (UNESCO) Universal Declaration on Bioethics and Human Rights announces a significant array of welfare entitlements--to personal health and health care, medicine, nutrition, water, improved living conditions, environmental protection, and so forth--as well as corresponding governmental duties to provide for such public health measures, though the simple expedient of announcing that such entitlements are "basic human rights." The Universal Declaration provides no argument for the legitimacy of the sweeping governmental authority, taxation, and regulation to create and impose such "rights." As this paper explores that some action promotes a purported good, such as "health," does not thereby make the action morally permissible. Just as there are moral limits on legitimate personal actions, there are also moral limits on legitimate governmental actions to promote purported goods, including health. A core question of any governmental regulation, therefore, is whether it is a legitimate application of moral political authority or an unauthorized act of state coercion. Pace UNESCO's wide-ranging assertions, this paper argues that promoting health only falls within the legitimate authority of governments in very narrowly defined circumstances. As the paper critically explores, at stake are foundational moral and political questions concerning the limits of governmental authority to intervene in the consensual interaction of persons. Imposing such duties on others, including citizens of a state through regulatory activity and taxation, must be justified, nonarbitrary, and demonstrably within the limits of moral political authority. UNESCO's assertions do not meet this burden of proof.

Perceptions of government knowledge and control over contributions of aid organizations and INGOs to health in Nepal: a qualitative study

PubMed Central

2013-01-01

Background Almost 50% of the Nepali health budget is made up of international aid. International Non-Governmental Organizations working in the field of health are able to channel their funds directly to grass root level. During a 2010 conference, the Secretary of Population stated that the government has full knowledge and control over all funds and projects coming to Nepal. However, there are no documents to support this. The study aims to assess government and partner perceptions on whether Government of Nepal currently has full knowledge of contributions of international aid organizations and International Non-Governmental Organizations to health in Nepal and to assess if the government is able to control all foreign contributions to fit the objectives of Second Long Term Health Plan (1997–2017). Methods A qualitative study was performed along with available literature review. Judgmental and snowball sampling led to 26 in depth interviews with key informants from the government, External Development Partners and International Non-Governmental Organizations. Results were triangulated based on source of data. Representatives of the Department of Health Services declined to be interviewed. Data collection was done until researchers felt data saturation had been reached with each group of key informants. Results While Ministry of Health and Population leads the sector wide approach that aims to integrate all donor and International Non-Governmental Organization contributions to health and direct them to the government’s priority areas, questions were raised around its capacity to do so. Similarly, informants questioned the extent to which Social Welfare Council was able to control all International Non-Governmental Organizations contributions. Political tumult, corruption in the government, lack of human resources in the government, lack of coordination between government bodies, convoluted bureaucracy, and unreliability of donor and International Non-Governmental Organization contributions were identified as the main reasons for difficulties in aid integration. Conclusions Despite its commitment to coordinate and control development assistance to the health sector, and its leadership position of the Sector Wide Approach, complete knowledge and effective coordination of all international contributions remains a challenge and is hampered by issues within the government as well as among External Development Partners and International Non-Governmental Organizations. PMID:23327564

Aerospace management techniques: Commercial and governmental applications

NASA Technical Reports Server (NTRS)

Milliken, J. G.; Morrison, E. J.

1971-01-01

A guidebook for managers and administrators is presented as a source of useful information on new management methods in business, industry, and government. The major topics discussed include: actual and potential applications of aerospace management techniques to commercial and governmental organizations; aerospace management techniques and their use within the aerospace sector; and the aerospace sector's application of innovative management techniques.

Directory of Early Childhood Care and Education Organization in Asia and the Pacific.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

The care and education of children is a primary task of all societies, and the role of parents, families, and communities is essential in this process. This directory describes the major activities of 360 non-governmental and governmental organizations, based in 30 countries in Asia and the Pacific region (Australia; Bangladesh; Bhutan; Cambodia;…

Governmental Immunity: Legal Basis and Implications for Public Education.

ERIC Educational Resources Information Center

Connors, Eugene T.

The concept of sovereign immunity in English law originated in both early canon law and the feudal system, became formalized in case law under King Henry II, and as the royal prerogative, became established into statutory law under King Henry VIII. This concept of governmental immunity was adopted by the states when the union was founded. The case…

Barriers to the Implementation of Electronic Learning in Governmental Organizations: Case of Iran

ERIC Educational Resources Information Center

Jahromi, Gelayol Safavi; Nikabadi, Mohsen Shafiei; Maleki, Morteza

2017-01-01

New developments in technology, particularly the information technology, have changed the perception of learning. These changes have made distance learning an important part of education. However, it seems that this technology does not have a strong position in governmental organizations yet. Therefore, the main goal of this research is to present…

The Role of International Non-Governmental Organisations in Promoting Adult Education for Social Change: A Research Agenda

ERIC Educational Resources Information Center

Hoff, Lutz; Hickling-Hudson, Anne

2011-01-01

This paper explores the role of International Non-Governmental Organisations (INGOs) in adult education as one instrument of global civil society to effect social change. Postcolonial theory is utilized to explore the complex relationships between the concepts of "globalisation", "global civil, society", and "adult education for social change". In…

Training Needs of Governmental Schools' Principals Hosting Kindergartens Classes: The Case for Jordan

ERIC Educational Resources Information Center

Ashraah, Mamdouh M.; Al-Olaimat, Ali M.; Takash, Hanan M.

2015-01-01

This study aimed at identifying the training needs of governmental schools' principals with kindergarten classes. The sample of the study consisted of a random sample of (62) female principal. The instrument of the study was developed by the researchers and included 60 items distributed on four domains (planning, organizing, guidance, and…

International Organizations, Changing Governance and China's Policy Making in Higher Education: An Analysis of the World Bank and the World Trade Organization

ERIC Educational Resources Information Center

Yang, Rui

2010-01-01

In a context of intensified globalization, the importance of international governmental organizations and non-governmental organizations as influencers and shapers of the global environment is becoming prominent. Participation in international organizations leads to active incorporation of nation-states with worldwide connotations. In higher…

Perspectives in Higher Education: Background Papers on Governmental and Economic Affairs.

ERIC Educational Resources Information Center

Arkansas Univ., Little Rock.

Three papers are presented from a conference on governmental and economic affairs held at the University of Arkansas at Little Rock. In "Federal Legislation and Higher Education," John P. Mallan pointed out that the major portion of funds is channeled through student aid programs, and research and development funds are concentrated in a…

In the Name of Liberation: Notes on Governmentality, Entrepreneurial Education, and Lifelong Learning

ERIC Educational Resources Information Center

Dahlstedt, Magnus; Hertzberg, Fredrik

2014-01-01

The focus of this article is the growing importance of entrepreneurship in the context of Swedish education policy. Departing from Foucault's concept of governmentality, this article analyzes some of the main ideas in the discourse on entrepreneurship education in Sweden and points out its specifics, as an instance of the broader educational and…

What Can International Comparisons Teach Us about School Choice and Non-Governmental Schools in Europe?

ERIC Educational Resources Information Center

Dronkers, Jaap; Avram, Silvia

2015-01-01

All European states have a primary obligation to establish and maintain governmental schools everywhere, but as the result of political struggle and constitutional guarantees, they have also allowed and often financed non-state schools based on special pedagogical, religious or philosophical ideas. Depending on the level of state grants for…

Metaphors of Teacher Candidates' Regarding the Concept of "Non-Governmental Organizations" (NGOs)

ERIC Educational Resources Information Center

Selanik-Ay, Tugba

2016-01-01

In this study, a learning area in social studies curriculum called "Groups, institutions and social organizations" was used. It can be seen that an important role for teachers in a social studies programme is to benefit from non-governmental organizations. The aim of this study is to investigate primary school teacher candidates' social…

Working with or against the Stores?: A Non-Governmental Organization Working with Alcohol Purchase Attempts

ERIC Educational Resources Information Center

Geidne, Susanna; Eriksson, Charli

2009-01-01

Purpose: The purpose of this paper is to describe and analyse the implementation by a non-governmental organization (NGO) of an intervention with two different strategies--one employing confrontational approaches, the other cooperative ones--aiming to reduce the rate of successful purchase attempts (PAs) of medium-strength beer in Sweden.…

Supreme Court Agrees to Review Case of Nevada Coach; Will Focus on Role of the NCAA as a Governmental Body.

ERIC Educational Resources Information Center

Lederman, Douglas

1987-01-01

The Supreme Court agreed to review a ruling by the Nevada Supreme Court that the NCAA had violated Jerry Tarkanian's constitutional right to due process. The Court will focus on whether the NCAA acts as a governmental body when it regulates college sports. (MLW)

Governmentality as a Genealogical Toolbox in Historical Analysis

ERIC Educational Resources Information Center

Andersson, Janicke

2014-01-01

The aim of this article is to show how governmentality may be used to analyze historical events and discourses, and how this historical analysis can be used as a perspective to problematize contemporary discourses. The example used in this article is from my research on life-extension handbooks published in Sweden 1700-1930, and by this I stress…

Governmentality in Higher Education: A Critical Analysis of the National Survey of Student Engagement (NSSE)

ERIC Educational Resources Information Center

Gorman, Bonnie B.

2012-01-01

In this dissertation, the National Survey of Student Engagement (NSSE) serves as a nodal point through which to examine the power relations shaping the direction and practices of higher education in the twenty-first century. Theoretically, my analysis is informed by Foucault's concept of governmentality, briefly defined as a technology of power…

Role of Non-Governmental Organizations for the Development of Basic Education in Punjab, Pakistan

ERIC Educational Resources Information Center

Iqbal, Javed

2010-01-01

The purpose of the study was to investigate the general working structure of non-governmental organizations (NGOs) and to examine the services and facilities provided by NGOs for basic education in Punjab, Pakistan. The population comprised 112 NGOs working for the promotion of basic education in Punjab, 3980 teachers working in basic education…

The Intractability of Information: Non-Governmental Development Organizations and the Uses of Knowledge

ERIC Educational Resources Information Center

Reiter, Jordan

2006-01-01

The globalization of information has led to increased optimism about the increasing role of global civil society. However, the underdeveloped have been left out of this information explosion. Through development, non-governmental organizations (NGOs) seek to empower the poor so that they have the resources and abilities to join the rest of the…

22 CFR 140.10 - Intermediate credit institutions.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... 1603(a) and made applicable by § 140.5) whether the ICI will be treated as a non-governmental entity or... ICI's treatment as a non-governmental entity or a foreign government entity, a clause shall be included in agreements with all ICIs requiring that any loan greater than $1,000 provided by the ICI to an...

22 CFR 140.10 - Intermediate credit institutions.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... 1603(a) and made applicable by § 140.5) whether the ICI will be treated as a non-governmental entity or... ICI's treatment as a non-governmental entity or a foreign government entity, a clause shall be included in agreements with all ICIs requiring that any loan greater than $1,000 provided by the ICI to an...

22 CFR 140.10 - Intermediate credit institutions.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... 1603(a) and made applicable by § 140.5) whether the ICI will be treated as a non-governmental entity or... ICI's treatment as a non-governmental entity or a foreign government entity, a clause shall be included in agreements with all ICIs requiring that any loan greater than $1,000 provided by the ICI to an...

My Brother as "Problem": Neoliberal Governmentality and Interventions for Black Young Men and Boys

ERIC Educational Resources Information Center

Dumas, Michael J.

2016-01-01

In this article, the author argues that the Obama Administration's My Brother's Keeper (MBK) initiative serves as an exemplar of neoliberal governmentality, in which Black young men and boys are constructed as essentially damaged, as problems in need of a technocratic public--private solution. More than simply an ideological imposition from above…

From Policies to Implementation of Open Distance Learning in Rwanda: A Genealogical and Governmentality Analysis

ERIC Educational Resources Information Center

Mukama, Evode

2018-01-01

The purpose of this paper is to analyse the interplay between policy formulation and implementation in terms of the historical practices of open distance learning (ODL) in Rwanda. This paper draws on the Foucauldian genealogical and governmentality analysis. The paper examines government aspirations as depicted in policy statements starting from…

Directory of Early Childhood Care and Education Organizations in the Arab States.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

The care and education of children is a primary task of all societies, and the role of parents, families, and communities is essential in this process. This directory describes the major activities of 64 non-governmental and governmental organizations, based on 12 Arab countries (Algeria, Djibouti, Egypt, Jordan, Kuwait, Lebanon, Mauritania,…

Governmental Professionalism: Re-Professionalising or De-Professionalising Teachers in England?

ERIC Educational Resources Information Center

Beck, John

2008-01-01

This paper draws on recent work by John Clarke and Janet Newman and their colleagues to analyse a relatively coherent governmental project, spanning the decades of Conservative and New Labour government in England since 1979, that has sought to render teachers increasingly subservient to the state and agencies of the state. Under New Labour this…

Prognostic factors and relative risk for survival in N1-3 oral squamous cell carcinoma: a multivariate analysis using Cox's hazard model.

PubMed

Noguchi, M; Kido, Y; Kubota, H; Kinjo, H; Kohama, G

1999-12-01

The records of 136 patients with N1-3 oral squamous cell carcinoma treated by surgery were investigated retrospectively, with the aim of finding out which factors were predictive of survival on multivariate analysis. Four independent factors significantly influenced survival in the following order: pN stage; T stage; histological grade; and N stage. The most significant was pN stage, the five-year survival for patients with pN0 being 91% and for patients with pN1-3 41%. A further study was carried out on the 80 patients with pN1-3 to find out their prognostic factors for survival and the independent factors identified by multivariate analysis were T stage and presence or absence of extracapsular spread to metastatic lymph nodes.

Magnetic resonance imaging of breast implants.

PubMed

Shah, Mala; Tanna, Neil; Margolies, Laurie

2014-12-01

Silicone breast implants have significantly evolved since their introduction half a century ago, yet implant rupture remains a common and expected complication, especially in patients with earlier-generation implants. Magnetic resonance imaging is the primary modality for assessing the integrity of silicone implants and has excellent sensitivity and specificity, and the Food and Drug Administration currently recommends periodic magnetic resonance imaging screening for silent silicone breast implant rupture. Familiarity with the types of silicone implants and potential complications is essential for the radiologist. Signs of intracapsular rupture include the noose, droplet, subcapsular line, and linguine signs. Signs of extracapsular rupture include herniation of silicone with a capsular defect and extruded silicone material. Specific sequences including water and silicone suppression are essential for distinguishing rupture from other pathologies and artifacts. Magnetic resonance imaging provides valuable information about the integrity of silicone implants and associated complications.

Radiotherapy on hidradenocarcinoma

PubMed Central

Lalya, Issam; Hadadi, Khalid; Tazi, El Mehdi; Lalya, Ilham; Bazine, Amine; Andaloussy, Khalid; Elmarjany, Mohamed; Sifat, Hassan; Hassouni, Khalid; Kebdani, Tayeb; Mansouri, Hamid; Benjaafar, Noureddine; Elgueddari, Brahim Khalil

2011-01-01

Context: Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. Case Report: We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. Conclusion: Post operative radiotherapy allows better local control and should be mandatory when histological features predictive of recurrence are present: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread. PMID:22540063

Simultaneous detection of ricin and abrin DNA by real-time PCR (qPCR).

PubMed

Felder, Eva; Mossbrugger, Ilona; Lange, Mirko; Wölfel, Roman

2012-09-01

Ricin and abrin are two of the most potent plant toxins known and may be easily obtained in high yield from the seeds using rather simple technology. As a result, both toxins are potent and available toxins for criminal or terrorist acts. However, as the production of highly purified ricin or abrin requires sophisticated equipment and knowledge, it may be more likely that crude extracts would be used by non-governmental perpetrators. Remaining plant-specific nucleic acids in these extracts allow the application of a real-time PCR (qPCR) assay for the detection and identification of abrin or ricin genomic material. Therefore, we have developed a duplex real-time PCR assays for simultaneous detection of ricin and abrin DNA based on the OmniMix HS bead PCR reagent mixture. Novel primers and hybridization probes were designed for detection on a SmartCycler instrument by using 5'-nuclease technology. The assay was thoroughly optimized and validated in terms of analytical sensitivity. Evaluation of the assay sensitivity by probit analysis demonstrated a 95% probability of detection at 3 genomes per reaction for ricin DNA and 1.2 genomes per reaction for abrin DNA. The suitability of the assays was exemplified by detection of ricin and abrin contaminations in a food matrix.

Collaborative outreach

NASA Astrophysics Data System (ADS)

Sanmarti-Vila, Lydia; García-Matos, Marta; Beduini, Federica; Carrasco, Silvia

2016-09-01

Many research projects and scientific initiatives multiple their impact and relevance through collaborations. It is the contact and exchange with others that often brings a scientist's work to the next level. The same happens with outreach: sharing activities, concepts, materials and knowhow may lead to greater impact, more innovative, inspirational ideas with enough potential to create pioneering outreach activities. A good example for this is the FP7 European project "GoPhoton!", an initiative of ECOP (European Centres of Outreach in Photonics) that ran through 2014 and 2015 and finished at the beginning of 2016 and was directed at the general public, young minds as well as current and future entrepreneurs. This project was based on the idea of sharing activities - which is at the core of ECOP's identity- already existing in other nodes (institutions within the project), or created within GoPhoton! The main concept was the effective leverage of local links such as the networks of educators and professionals in general, industrial clusters, museums, universities, governmental and non-governmental organizations, all from a Pan-European perspective possible through ECOP. This has resulted in over 200 events impacting over two million people. The sharing of activities across institutions that have different resources, facilities, and cultural environments is not straightforward. One of the biggest challenges for the consortium was to be able to extract the concept and identity of each activity, so that it could be realistically adapted to each local context. A crucial point was being able to effectively use the knowhow gained from a partner's activity, in a way that the essence of the activity remained untainted across the participating nodes, while still triggering innovation locally.

Drivers for animal welfare policies in Europe.

PubMed

Dalla Villa, P; Matthews, L R; Alessandrini, B; Messori, S; Migliorati, G

2014-04-01

The European region has been, and remains, a global leader in the development of animal welfare policies. The region has a great diversity of cultures and religions, different levels of socio-economic development, and varied legislation, policies and practices. Nevertheless, there are common drivers for animal welfare policy based on a history of animal welfare ethics and obligations to animal users and society in general. A unifying goal of countries in the region is to achieve sustainable compliance with the World Organisation for Animal Health (OIE) standards on animal health and welfare. Ethics isthe overarching driver, supported by the actions of governmental, inter-governmental and non-governmental activities, markets and trade, science and knowledge. Historically, organisations involved in promoting animal welfare have tended to act in isolation. For example, non-governmental organisations (NGOs) have run campaigns to influence retailers and the welfare policies of their farmer suppliers. Increasingly, different organisations with common or complementary goals are working together. For example, competent authorities, inter-governmental bodies and NGOs have combined their efforts to address dog population control across several countries in the region. Also, animal welfare is becoming integrated into the corporate social responsibility targets of private companies. Science and knowledge, as drivers and tools, are assisting with the harmonisation of welfare standards, e.g. by providing a common basis for measuring welfare impacts through animal-based measures and widespread sharing of this information. Current trends suggest that there will be greater collaboration among the organisations driving change, and increasing convergence of animal welfare strategies and welfare assessment tools. The result will be increased harmonisation of animal welfare standards throughout the region.

[Local food production for school feeding programmes in Spain].

PubMed

Soares, Panmela; Martínez-Mián, Maria Asunción; Caballero, Pablo; Vives-Cases, Carmen; Davó-Blanes, Mari Carmen

To identify and characterize initiatives that promote the purchase of locally-sourced foods to supply schools and the school centres carrying out the initiatives. Exploratory, descriptive study based on secondary data and key informant reports. A search of governmental and non-governmental initiatives was carried out at the autonomous community level. Government initiatives were located through school feeding programmes in the different autonomous communities, their nutritional guides and representatives of the councils for education and agriculture. Non-governmental initiatives were found through their own websites and the snowball technique. Initiatives were analysed by their geographic distribution, organizational area (government vs. non-government), number of school centres carrying out the initiatives, management style and organic food purchase. A descriptive analysis of the data was carried out. 12 initiatives carried out by 318 schools (2.16% of all the schools with food service in Spain) were identified. Among these, 6 are governmental initiatives with a scope of 274 schools (1.86%), and 6 are non-governmental initiatives with a scope of 44 schools (0.30%). Most of these schools have a public management system in place (n=284). All the initiatives provide for the purchase of organic food. Local food purchase initiatives in Spain have a limited reach. However, the existence of a state directive could support and strengthen the development of such initiatives, given that school commitment is greater when initiatives are driven by the public sector. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Non-Governmental Organizations in Africa: The Leonenet Street Children Project in Sierra Leone

ERIC Educational Resources Information Center

Hinton, Samuel

2005-01-01

The purpose of this paper is to provide snapshots of observations, interventions, and processes in the day to day working of a child charity in Sierra Leone. There were 114 local and 49 overseas funded Non Governmental Organizations (NGOs) in Sierra Leone in 2002. The Leonenet Street Children Project was founded in 1996 by the membership of the…

Neoliberal Governmentality, Schooling and the City: Conceptual and Empirical Notes on and from the Global South

ERIC Educational Resources Information Center

Gulson, Kalervo N.; Fataar, Aslam

2011-01-01

This paper applies ideas that emanate from the Global North, concerning neoliberalism and neoliberal governmentality, to the case of marketisation in South Africa. It also attends to the limits of Northern ideas that are both intellectual undertakings and policy manifestations. In the first part of the paper, we identify how rationales for school…

People's Participation in Development and the Management of Natural Resources. Report on the Caribbean Regional Workshop (Vieux Fort, St. Lucia, April 15-19, 1985).

ERIC Educational Resources Information Center

Vukasin, Helen L., Ed.

This Caribbean Regional Workshop was organized to bring together representatives of private, voluntary, and community development organizations, governmental agencies, and other non-governmental organizations in the Eastern Caribbean who were concerned with environmental quality. The conference was intended to improve the level of citizen…

An Assessment of the Readiness of King Fahad Medical City, Saudi Arabia, in Adopting Effective Online Staff Development Programs

ERIC Educational Resources Information Center

Alwadie, Adnan D.

2011-01-01

Internet access has grown in Saudi Arabia between 2000 and 2005 by more than 1000% and many governmental organizations are starting to provide part of their services using the internet. In addition, the Ministry of Higher Education has provided funding to all governmental universities to start developing strategies and guidelines for online…

Wall-papering Fog: How the United States’ Africa Command (AFRICOM) Can Counter the Threat of Radical Islamic Fundamentalism in North Africa

DTIC Science & Technology

2008-05-22

of the primary issues that AFRICOM will have to address in North Africa such as governmental structure, finance reform, the disputed Western Sahara...will have to address in North Africa such as governmental structure, finance reform, the disputed Western Sahara region, the availability of equal...30 Finance Reform ......................................................................................................................... 32

Fostering the Memoir Writing Skills as a Creative Non-Fiction Genre Using a WebQuest Model

ERIC Educational Resources Information Center

Al-Sayed, Rania Kamal Muhammad; Abdel-Haq, Eman Muhammad; El-Deeb, Mervat Abou-Bakr; Ali, Mahsoub Abdel-Sadeq

2016-01-01

The present study aimed at developing the memoir writing skills as a creative non-fiction genre of second year distinguished governmental language preparatory school pupils using the a WebQuest model. Fifty participants from second year at Hassan Abu-Bakr Distinguished Governmental Language School at Al-Qanater Al-Khairia(Qalubia Governorate) were…

Analysing the Accreditation of Engineering Education in South Africa through Foucault's Panopticon and Governmentality Lenses

ERIC Educational Resources Information Center

Mutereko, Sybert

2018-01-01

Using Foucault's power concepts of the panopticon and governmentality as analytic and heuristic tools, this study reveals insights into how accreditation creates power networks in the quality assurance of higher education graduates in South Africa. The study draws on 11 in-depth interviews with academics from the Faculty of Engineering at a…

75 FR 37803 - Consumer & Governmental Affairs Bureau Seeks Comment on a Petition for Expedited Clarification...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... FEDERAL COMMUNICATIONS COMMISSION [CG Docket No. 02-278; DA 10-997] Consumer & Governmental... Notice DA 10-997, which seeks comment on Global Tel's petition. Pursuant to 47 CFR 1.415 and 1.419 of the... 1.1206(b). The full text of document DA 10-997 and any subsequently filed documents in this matter...

Directory of Early Childhood Care and Education Organizations in Latin America and the Caribbean. First Edition.

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France).

The care and education of children is a primary task of all societies, and the role of parents, families, and communities is essential in this process. This directory describes the major activities of 218 non-governmental and governmental organizations, based in 38 Latin American and Caribbean countries, involved in early childhood care and…

American Families; Trends and Pressures, 1973. Hearings Before the Subcommittee on Children and Youth of the Committee on Labor and Public Welfare.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Public Welfare.

This report contains the processings of three days of subcommittee hearings examining the influence that governmental policies have on American families. In order to look at the pressures and trends affecting American families, the hearings studied governmental policies in areas such as work, institutionalization, mobility, taxes, welfare,…

Design for Partnership. Proceedings of the Consultation on Government and Non-Governmental Organisations Partnership in Child Care (12th, Madras, India, November 3-4, 1995).

ERIC Educational Resources Information Center

M.S. Swaminathan Research Foundation, Madras (India).

Non-governmental organizations (NGOs) have demonstrated effectiveness in a spectrum of activities, including outreach to the poor, action against gender discrimination, and relief services. Partnerships between government and NGOs offer unique opportunities for progress toward sustainable development. In the context of some recent government…

A Discussion on Governmental Research Grants.

PubMed

Fang, Hui

2015-10-01

Governmental research grants are financially supported by taxpayers to meet financial requirements of research, particularly research that is unlikely to be supported by private funds. Researchers reward donors by producing knowledge. Publishing research results in an academic journal reflects achievement by researchers; however, receiving a grant award does not. The latter only provides the researcher with the capacity to perform his/her research. Applicants may receive more financial support than they actually need because there is no strict audit on the amount of money requested by each research proposal. There are fewer opportunities to apply for a governmental grant than there are for publishing an academic article, and the application process for governmental grants is not flexible. Some potentially innovative research may be impeded by the intense competition among scientific researchers applying for financial support. Researchers face stiffer competition at this stage than at the stage of publishing results. This paper suggests that scientific foundations can improve their efficiency by giving funding preference to economic proposals. Methods for estimating the efficiency of grants are proposed. The practice followed by the Small Grants for Exploratory Research programme of the National Science Foundation validates my analysis and recommendations.

Investigating and profiling the leadership behaviours of Jordanian nursing leaders.

PubMed

Mrayyan, Majd; Khasawneh, Israa

Leadership' is a social process in which a member or members of a group influence the interpretation of events, choice of goals/outcomes, organization of work activities, motivation, abilities, power relations, and shared orientations. This study identifies leadership behaviours of Jordanian nursing leaders. A descriptive comparative design was used to collect data from four governmental and three private hospitals. Data were collected during April 2005. The total number of recruited nursing leaders was 140 with a 70% response rate. T-tests and chi-squares were performed to compare the phenomenon of interest. The mean reported leadership behaviours were slightly higher in private hospitals than those in governmental hospitals. However, more than half of the time, leaders in both types of hospitals used supportive leadership behaviours. There were significant differences between governmental and private hospitals in most demographics of the sample. Based on types of hospitals and gender, differences in leadership behaviours were advantageous for nursing leaders in private hospitals, while differences based on units and wards were advantageous for nursing leaders in governmental hospitals. In general, Jordanian nursing leaders used supportive leadership behaviours. Differences in leadership behaviours have implications for nursing practice, research, and education.

Challenges to the rapid identification of children who have been trafficked for commercial sexual exploitation.

PubMed

Rafferty, Yvonne

2016-02-01

Child trafficking for commercial sexual exploitation (CSE) is a complex phenomenon, requiring multifaceted programs and policies by various stakeholders. A number of publications have focused on preventing this heinous crime. Less attention, however, has been paid to the recovery and rehabilitation of children who have been traumatized as a result of being trafficked for CSE. This article focuses on the first step in the protection and recovery process, which is to ensure that procedures are in place for their identification, so that they might access timely and appropriate assistance. It highlights three situational and two child-related challenges to identification. In addition, it describes the additional victimization experienced by children who are wrongly arrested for crimes associated with prostitution or illegal border crossings, rather than being identified as victims. An extensive literature review was conducted, and included academic publications, as well as governmental and non-governmental reports. In addition, field-based qualitative research was undertaken in South and Southeast Asia, and involved interviews with representatives from United Nations and governmental agencies, non-governmental organizations (NGOs), and aftercare recovery programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

How sustainable is government-sponsored desertification rehabilitation in China? Behavior of households to changes in environmental policies.

PubMed

Liu, Ning; Zhou, Lihua; Hauger, J Scott

2013-01-01

This paper undertakes a direct, comprehensive assessment of the long-term sustainability of desertification rehabilitation in China under a plausible but worst case scenario where governmental interventions, in the form of payments for environmental services (PES), will cease. The analysis is based on household behavior as well as experimental data. Our econometric results highlight the main obstacles to the sustainability of rehabilitation programs subsequent to cessation of government intervention, including specific shortfalls in households' preference for a free ride, budget constraints, attitudes, tolerance of and responsibility for desertification, and dissatisfaction with governmental actions. We conclude that desertification rehabilitation is not sustainable in China without continued governmental intervention. The results of this study are intended to support policy makers as they consider future directions for rehabilitation sustainability.

Governmental regulation and nongovernmental certification of forests in the tropics: policy, execution, uptake, and overlap in Costa Rica, Guatemala, and Nicaragua

Treesearch

Kathleen McGinley; F.W. Cubbage

2011-01-01

We analyzed how and why governmental forest regulation and nongovernmental forest certification in Costa Rica, Guatemala, and Nicaragua and their execution lead to, or fail to produce desired changes in forest owner and user behavior toward the enhanced sustainability of tropical forests. The findings confirmed not only that sufficient resources and capacity for...

Travelling Policies and Global Buzzwords: How International Non-Governmental Organizations and Charities Spread the Word about Early Childhood in the Global South

ERIC Educational Resources Information Center

Penn, Helen

2011-01-01

This article is based on a web-search commissioned by an international charity to review the work of international non-governmental organizations (INGOs) and charities which promote and support early childhood education and care (ECEC) in the global South. The article examines examples of such initiatives. It is suggested that there is…

Frictions That Activate Change: Dynamics of Global to Local Non-Governmental Organizations for Female Education and Empowerment in China, India, and Pakistan

ERIC Educational Resources Information Center

Seeberg, Vilma; Baily, Supriya; Khan, Asima; Ross, Heidi; Wang, Yimin; Shah, Payal; Wang, Lei

2017-01-01

This article examines how non-governmental organizations create resources and spaces for girls and women's education and empowerment in China, India and Pakistan--in the context of global expectations and local state relations as well as cultural norms. We examine the dynamics that foster female empowerment associated with educational attainment.…

20 CFR 645.125 - What are the roles of the local and State governmental partners in the governance of the WtW...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the roles of the local and State governmental partners in the governance of the WtW program? 645.125 Section 645.125 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROVISIONS GOVERNING WELFARE-TO-WORK GRANTS Scope...

Clan and Islamic Identities in Somali Society

DTIC Science & Technology

2011-11-01

governmental and non-governmental contacts as far away as Australia, South Africa , Kenya, Israel, and all over Europe and North America. Government of...9] Africa Watch Committee (1990). Somalia – a government at war with its own people: Testimonies about the killings and conflict in the North . New...Nairobi/Brussels. [118] International Crisis Group (2005a). Understanding Islamism. Middle East/ North Africa Report no.37. Cairo/Brussels. [119

Shifting Discourses of Migrant Incorporation at a Time of Crisis: Understanding the Articulation of Language and Labour in the Catalan Non-Governmental Sector

ERIC Educational Resources Information Center

Codó, Eva; Garrido, Maria Rosa

2014-01-01

In this article, we investigate the discursive transformations that occurred at a migrant-support non-governmental organisation (NGO) located in the outskirts of Barcelona (Catalonia, Spain) and how they intersect with broader sociopolitical and economic processes. In particular, we focus on the revamping of the key notions of language and labour…

Constructing a Criterion Reference Test to Measure the Research and Statistical Competencies of Graduate Students at the Jordanian Governmental Universities

ERIC Educational Resources Information Center

Al-Habashneh, Maher Hussein; Najjar, Nabil Juma

2017-01-01

This study aimed at constructing a criterion-reference test to measure the research and statistical competencies of graduate students at the Jordanian governmental universities, the test has to be in its first form of (50) multiple choice items, then the test was introduced to (5) arbitrators with competence in measurement and evaluation to…

Geospatial Informational Security Risks and Concerns of the U.S. Air Force GeoBase Program

DTIC Science & Technology

2007-03-01

multiple governmental directives such as the Government Performance and Results Act (GPRA), Paperwork Reduction Act (PRA), and Office of Management and... governments , non- governmental organizations (NGOs), universities, and commercial sector contractors (Lachman, 2006). One command noted that over...Defense, or the United States Government . AFIT/GEM/ENV/07-M1 GEOSPATIAL INFORMATIONAL SECURITY RISKS AND CONCERNS OF THE UNITED STATES

Interest of Grade Ten Students toward Physics among Other Science Subjects, Case of Wolaita Soddo Town Governmental Secondary Schools, Ethiopia

ERIC Educational Resources Information Center

Hamelo, Shewangzaw

2016-01-01

This paper has proposed to investigate the interest in students towards physics among other science subjects. The investigation was carried out with 490 samples of grade ten students in Wolaita Soddo town governmental schools. Thus, overall result indicates that the interest in students towards physics is low and students hate to learn physics in…

Assessment of safety culture in isfahan hospitals (2010).

PubMed

Raeisi, Ahmed Reza; Nazari, Maryam; Bahmanziari, Najme

2013-01-01

Many internal and external risk factors in health care organizations make safety important and it has caused the management to consider safety in their mission statement. One of the most important tools is to establish the appropriate organizational structure and safety culture. The goal of this research is to inform managers and staff about current safety culture status in hospitals in order to improve the efficiency and effectiveness of health services. This is a descriptive-survey research. The research population was selected hospitals of Isfahan, Iran. Research tool was a questionnaire (Cronbach alpha 0.75). The questionnaire including 93 questions (Likert scale) classified in 12 categories: Demographic questions, Individual attitude, management attitude, Safety Training, Induced stress, pressure and emotional conditions during work, Consultation and participation, Communications, Monitoring and control, work environment, Reporting, safety Rules, procedures and work instructions that distributed among 45 technicians, 208 Nurses and 62 Physicians. All data collected from the serve was analysis with statistical package of social science (SPSS). In this survey Friedman test, Spearman correlation, analysis of variance (ANOVA) and factor analysis have been used for data analyzing. The score of safety culture dimensions was 2.90 for Individual attitude, 3.12 for management attitude, 3.32 for Safety Training, 3.14 for Induced stress, pressure and emotional conditions during work, 3.31 for Consultation and participation, 2.93 for Communications, 3.28 for Monitoring and control, 3.19 for work environment, 3.36 for Reporting, 3.59 safety Rules, procedures and work instructions that Communication and individual attitude were in bad condition. Safety culture among different hospitals: governmental and educational, governmental and non-educational and non-governmental and different functional groups (physicians, nurses, diagnostic) of studied hospitals showed no significant differences. There was no relationship between safety culture and demographic data. It was concluded that is no different among governmental and educational, governmental and non-educational and non-governmental in level of safety culture, all of them were on intermediate level so it is essential to attention to the safety culture in hospitals and planning to improve it.

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

Holt, Jeffrey W.

The Tribe is working to reduce energy consumption and expense in Tribally-owned governmental buildings and low income housing sites. In 2009, the Tribe applied to the U. S. Department of Energy for funding to conduct energy audits of Tribally-owned governmental buildings. Findings from the energy audits would define the extent and types of energy efficiency improvements needed, establish a basis for energy priorities, strategies and action plans, and provide a benchmark for measuring improvements from energy efficiency implementations. In 2010, the DOE awarded a grant in the amount of $95,238 to the Tribe to fund the energy audits of ninemore » governmental buildings and to pay for travel expenses associated with attendance and participation at the DOE annual program reviews. In 2011, the Tribe applied for and was awarded a DOE grant in the amount of $75,509 to conduct energy audits of the remaining 30 Tribally-owned governmental buildings. Repeating mobilization steps performed during the first DOE energy audits grant, the Tribe initiated the second round of governmental building energy audits by completing energy auditor procurement. The selected energy auditor successfully passed DOE debarment and Sault Tribe background clearances. The energy audits contract was awarded to U. P. Engineers and Architects, Inc. of Sault Ste. Marie, Michigan. The Tribe continued mobilizing for the energy audits by providing the energy auditor with one year of electric, gas and water utility invoice copies per building, as well as supplemental building information, such as operating hours. The Tribe also contacted building occupants to coordinate scheduling for the on-site energy audit inspections and arranged for facilities management personnel to guide the energy auditor through the buildings and answer questions regarding building systems.« less

Health technology assessment agencies: an international overview of organizational aspects.

PubMed

Martelli, Francesco; La Torre, Giuseppe; Di Ghionno, Elena; Staniscia, Tommaso; Neroni, Massimo; Cicchetti, Americo; Von Bremen, Konrade; Ricciardi, Walter

2007-01-01

The aim of the study is to make an international comparison of Health Technology Assessment (HTA) Agencies, to show their similarities and differences. An e-mail questionnaire was sent to thirty HTA agencies internationally. Questions related to the structure of the agency, the relationship with health-related institutions, the prescriptiveness of the decisions taken, the main core and the modalities to spread the assessment, and the type of funding. Twenty-four HTA Agencies answered the questionnaire: 25 percent in America, 4.2 percent in Australia, and 70.8 percent in Europe. Fifty-four percent of HTA Agencies are governmental institutions (83.3 percent have central government funding), while 62.5 percent have relationships with health-related governmental institutions. Of the agencies, 87 percent reported that their decisions are not prescriptive, while for 20.8 percent and 8.3 percent of them stated that this was the case totally or partially, respectively, especially for the governmental and American Agencies. Seventeen agencies (70.8 percent) declared their work on multiannual programs (77 percent of the governmental HTA Agencies and 100 percent of the American ones). The assessments mainly addressed diagnostic procedures (85.7 percent) and pharmaceuticals (25 percent). The most common way to disseminate results is by means of paper report (91.7 percent), followed by the Internet (16.7 percent), and seminars to expert audiences (12.5 percent). The comparative analysis of HTA Agencies showed that governmental and American Agencies have a profound impact on the prescriptiveness of their assessment, and this could be linked to the fact that these types of Agencies work on multiannual programs. European and American HTA Agencies have many similarities in terms of type of assessment, funding, and dissemination of results.

How Sustainable Is Government-Sponsored Desertification Rehabilitation in China? Behavior of Households to Changes in Environmental Policies

PubMed Central

Liu, Ning; Zhou, Lihua; Hauger, J. Scott

2013-01-01

This paper undertakes a direct, comprehensive assessment of the long-term sustainability of desertification rehabilitation in China under a plausible but worst case scenario where governmental interventions, in the form of payments for environmental services (PES), will cease. The analysis is based on household behavior as well as experimental data. Our econometric results highlight the main obstacles to the sustainability of rehabilitation programs subsequent to cessation of government intervention, including specific shortfalls in households’ preference for a free ride, budget constraints, attitudes, tolerance of and responsibility for desertification, and dissatisfaction with governmental actions. We conclude that desertification rehabilitation is not sustainable in China without continued governmental intervention. The results of this study are intended to support policy makers as they consider future directions for rehabilitation sustainability. PMID:24204849

The Role of Non-Governmental Organisations and Faith-Based Organisations in Achieving Education for All: The Case of Sierra Leone

ERIC Educational Resources Information Center

Nishimuko, Mikako

2009-01-01

Sierra Leone, one of the world's poorest countries, experienced a civil war from 1991 to 2002. The government's capacity to provide educational services remains weak, and still over 30% of children in the country are hard to reach and do not have access to primary education. This paper discusses the role of non-governmental organisations (NGOs)…

Toward an Integrated System for Command and Control Net-Centric Web Services and Sustainment: Application to Homland Security

DTIC Science & Technology

2010-08-01

the public and for first responders to access disaster information and services provided by government agencies and non- governmental organizations...thereby reducing the performance gap for a single federal disaster-management site. DMIS provides government and non- governmental organizations...NIMS) and Na- tional Response Framework (NRF): a. First responders b. Local governments and agencies c. Regional and federal agencies 2

Recruiting Trends, 1997-98: A National Study of Job Market Trends for New College Graduates among 477 Businesses, Industries, and Governmental Agencies. 27th Edition.

ERIC Educational Resources Information Center

Scheetz, L. Patrick

This report of job recruiting trends affecting 1997-98 college graduates is based on survey results from 477 businesses, industries, and governmental agencies. It notes that employers anticipate an increase of 27.5 percent in job prospects for new college graduates and that there is a high demand for technical graduates, including majors in…

Analyzing Collaborative Governance Through Social Network Analysis: A Case Study of River Management Along the Waal River in The Netherlands.

PubMed

Fliervoet, J M; Geerling, G W; Mostert, E; Smits, A J M

2016-02-01

Until recently, governmental organizations played a dominant and decisive role in natural resource management. However, an increasing number of studies indicate that this dominant role is developing towards a more facilitating role as equal partner to improve efficiency and create a leaner state. This approach is characterized by complex collaborative relationships between various actors and sectors on multiple levels. To understand this complexity in the field of environmental management, we conducted a social network analysis of floodplain management in the Dutch Rhine delta. We charted the current interorganizational relationships between 43 organizations involved in flood protection (blue network) and nature management (green network) and explored the consequences of abolishing the central actor in these networks. The discontinuation of this actor will decrease the connectedness of actors within the blue and green network and may therefore have a large impact on the exchange of ideas and decision-making processes. Furthermore, our research shows the dependence of non-governmental actors on the main governmental organizations. It seems that the Dutch governmental organizations still have a dominant and controlling role in floodplain management. This challenges the alleged shift from a dominant government towards collaborative governance and calls for detailed analysis of actual governance.

Analyzing Collaborative Governance Through Social Network Analysis: A Case Study of River Management Along the Waal River in The Netherlands

NASA Astrophysics Data System (ADS)

Fliervoet, J. M.; Geerling, G. W.; Mostert, E.; Smits, A. J. M.

2016-02-01

Until recently, governmental organizations played a dominant and decisive role in natural resource management. However, an increasing number of studies indicate that this dominant role is developing towards a more facilitating role as equal partner to improve efficiency and create a leaner state. This approach is characterized by complex collaborative relationships between various actors and sectors on multiple levels. To understand this complexity in the field of environmental management, we conducted a social network analysis of floodplain management in the Dutch Rhine delta. We charted the current interorganizational relationships between 43 organizations involved in flood protection (blue network) and nature management (green network) and explored the consequences of abolishing the central actor in these networks. The discontinuation of this actor will decrease the connectedness of actors within the blue and green network and may therefore have a large impact on the exchange of ideas and decision-making processes. Furthermore, our research shows the dependence of non-governmental actors on the main governmental organizations. It seems that the Dutch governmental organizations still have a dominant and controlling role in floodplain management. This challenges the alleged shift from a dominant government towards collaborative governance and calls for detailed analysis of actual governance.

Sexual behaviour of commercial sex workers and their clients in Cambodia. Japan-Cambodia Collaborating Research Group.

PubMed

Morio, S; Soda, K; Tajima, K; Leng, H B; Kitamura, K; Mizushima, S; Ohshige, K; Tan, F; Suyama, A; Sopheab, H; Phalla, T

1999-06-01

This study surveyed the sexual behaviour of commercial sex workers and their clients in an attempt to identify factors of transmission of STDs (including HIV/AIDS) and to control their epidemics in Cambodia and South-East Asia. Cross-sectional study. Trained questioners asked items of the questionnaires to each objective subject in December 1996. Data were analysed to show the descriptive status by risk group of each person. 200 direct commercial sex workers, 220 indirect commercial sex workers, and 211 clients in Phnom Penh. Prostitution was widely accepted by both young males and females, and this was an easy way for young girls to obtain money. Although commercial sex workers and clients were knowledgeable about prevention methods against STDs, they seldom used condoms. Some commercial sex workers had been infected with STDs many times, and many of them incompletely treated the diseases by themselves. Social support from governmental and non-governmental organisation was poor. It is very important to support both commercial sex workers in practicing preventive methods against STDs and also visiting physicians when they notice symptoms of STDs. It is strongly recommended that not only governmental but also non-governmental organisations should be more active in this area.

[Original method of extracapsule fragmentation of the lens nucleus during phacoemulsification].

PubMed

Avetisov, S E; Iusef, Iusef Naim; Mamikonian, V R; Vvedenskiĭ, A S; Iusef, Said Naim; Mutonen, N V

2002-01-01

Clinical estimation of different modifications of phacoemulsification revealed the formation of the second tunnel in the nucleus for its division into quadrants in "four-quadrant phaco" increases the required duration of ultrasonography (US) and irrigation, which causes greater endothelial losses associated with the use of nuclear breakdown by means of a chopper tunnel. When the authors used their own methods of "extracapsular half-nuclei" fragmentation, endothelial losses are rather greater than those with the similar method "stop & "chop", which is associated with closer disposition of the US tip to the posterior corneal surface. At the same time nuclear breakdown by means a chapper in the capsular sac by the "stop & chop" method causes dilation of Zinn's ligaments, fraught by their rupture, particularly if latent derangement or defects of the zonular apparatus, and increases the risk of damage to the posterior capsule by the chopper.

Is Ki67 prognostic for aggressive prostate cancer? A multicenter real-world study.

PubMed

Fantony, Joseph J; Howard, Lauren E; Csizmadi, Ilona; Armstrong, Andrew J; Lark, Amy L; Galet, Colette; Aronson, William J; Freedland, Stephen J

2018-06-15

To test if Ki67 expression is prognostic for biochemical recurrence (BCR) after radical prostatectomy (RP). Ki67 immunohistochemistry was performed on tissue microarrays constructed from specimens obtained from 464 men undergoing RP at the Durham and West LA Veterans Affairs Hospitals. Hazard ratios (HR) for Ki67 expression and time to BCR were estimated using Cox regression. Ki67 was associated with more recent surgery year (p < 0.001), positive margins (p = 0.001) and extracapsular extension (p < 0.001). In center-stratified analyses, the adjusted HR for Ki67 expression and BCR approached statistical significance for west LA (HR: 1.54; p = 0.06), but not Durham (HR: 1.10; p = 0.74). This multi-institutional 'real-world' study provides limited evidence for the prognostic role of Ki67 in predicting outcome after RP.

Targeted proteomics identifies liquid-biopsy signatures for extracapsular prostate cancer

PubMed Central

Kim, Yunee; Jeon, Jouhyun; Mejia, Salvador; Yao, Cindy Q; Ignatchenko, Vladimir; Nyalwidhe, Julius O; Gramolini, Anthony O; Lance, Raymond S; Troyer, Dean A; Drake, Richard R; Boutros, Paul C; Semmes, O. John; Kislinger, Thomas

2016-01-01

Biomarkers are rapidly gaining importance in personalized medicine. Although numerous molecular signatures have been developed over the past decade, there is a lack of overlap and many biomarkers fail to validate in independent patient cohorts and hence are not useful for clinical application. For these reasons, identification of novel and robust biomarkers remains a formidable challenge. We combine targeted proteomics with computational biology to discover robust proteomic signatures for prostate cancer. Quantitative proteomics conducted in expressed prostatic secretions from men with extraprostatic and organ-confined prostate cancers identified 133 differentially expressed proteins. Using synthetic peptides, we evaluate them by targeted proteomics in a 74-patient cohort of expressed prostatic secretions in urine. We quantify a panel of 34 candidates in an independent 207-patient cohort. We apply machine-learning approaches to develop clinical predictive models for prostate cancer diagnosis and prognosis. Our results demonstrate that computationally guided proteomics can discover highly accurate non-invasive biomarkers. PMID:27350604

Pyomyositis of tensor fascia lata: a case report

PubMed Central

Ozkan, Korhan; Unay, Koray; Ugutmen, Ender; Eren, Abdullah; Eceviz, Engin; Saygý, Baransel

2008-01-01

Introduction Pyomyositis is a disease in which an abscess is formed deep within large striated muscles. Case presentation We report the case of a 10-year-old boy who presented with fever and a painful hip and was subsequently diagnosed with pyomyositis of the tensor fascia lata. In children with clinical and laboratory findings of inflammation in the vicinity of the hip joint, the differential diagnosis includes transient synovitis, an early stage of Legg-Calvé-Perthes disease, infectious arthritis of the hip, rheumatologic diseases and extracapsular infection such as osteomyelitis. Conclusion To the best of the authors' knowledge, this is the first report of pyomyositis of the tensor fascia lata. Although pyomyositis is a rare disease and the differential diagnosis includes a variety of other commonly observed diseases, pyomyositis should be considered in cases where children present with fever, leukocytosis and localized pain. PMID:18652647

Sushruta-samhitA - A critical Review Part-1 : Historical glimpse

PubMed Central

Sharma, Hari S.; Sharma, Hiroe I.; Sharma, Hemadri A.

2012-01-01

In the history of Ayurveda, Sushruta stands before Caraka. He practically applied Vaidika culture for treatment. His treatise translated into nine foreign languages apart from various Indian languages like Hindi, Bengali, Malayalam, etc., Sushruta is the most celebrated physician and surgeon in India. Though he practiced during the 5th century BC, many of his contributions to medicine and surgery preceded similar discoveries in the western world. Sushruta devotes a complete volume of his experiences to ophthalmologic diseases. In the Uttara Tantram, Sushruta enumerates a sophisticated classification of eye diseases complete with signs, symptoms, prognosis, and medical/surgical interventions. In particular, Sushruta describes what may have been the first extracapsular cataract surgery using a sharply pointed instrument with a handle fashioned into a trough. His ability to manage many common eye conditions of the time with limited diagnostic aids is a testament to his virtuosity. PMID:23559784

Contracting out to improve the use of clinical health services and health outcomes in low- and middle-income countries.

PubMed

Odendaal, Willem A; Ward, Kim; Uneke, Jesse; Uro-Chukwu, Henry; Chitama, Dereck; Balakrishna, Yusentha; Kredo, Tamara

2018-04-03

Contracting out of governmental health services is a financing strategy that governs the way in which public sector funds are used to have services delivered by non-governmental health service providers (NGPs). It represents a contract between the government and an NGP, detailing the mechanisms and conditions by which the latter should provide health care on behalf of the government. Contracting out is intended to improve the delivery and use of healthcare services. This Review updates a Cochrane Review first published in 2009. To assess effects of contracting out governmental clinical health services to non-governmental service provider/s, on (i) utilisation of clinical health services; (ii) improvement in population health outcomes; (iii) improvement in equity of utilisation of these services; (iv) costs and cost-effectiveness of delivering the services; and (v) improvement in health systems performance. We searched CENTRAL, MEDLINE, Embase, NHS Economic Evaluation Database, EconLit, ProQuest, and Global Health on 07 April 2017, along with two trials registers - ClinicalTrials.gov and the International Clinical Trials Registry Platform - on 17 November 2017. Individually randomised and cluster-randomised trials, controlled before-after studies, interrupted time series, and repeated measures studies, comparing government-delivered clinical health services versus those contracted out to NGPs, or comparing different models of non-governmental-delivered clinical health services. Two authors independently screened all records, extracted data from the included studies and assessed the risk of bias. We calculated the net effect for all outcomes. A positive value favours the intervention whilst a negative value favours the control. Effect estimates are presented with 95% confidence intervals. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of the evidence and we prepared a Summary of Findings table. We included two studies, a cluster-randomised trial conducted in Cambodia, and a controlled before-after study conducted in Guatemala. Both studies reported that contracting out over 12 months probably makes little or no difference in (i) immunisation uptake of children 12 to 24 months old (moderate-certainty evidence), (ii) the number of women who had more than two antenatal care visits (moderate-certainty evidence), and (iii) female use of contraceptives (moderate-certainty evidence).The Cambodia trial reported that contracting out may make little or no difference in the mortality over 12 months of children younger than one year of age (net effect = -4.3%, intervention effect P = 0.36, clustered standard error (SE) = 3.0%; low-certainty evidence), nor to the incidence of childhood diarrhoea (net effect = -16.2%, intervention effect P = 0.07, clustered SE = 19.0%; low-certainty evidence). The Cambodia study found that contracting out probably reduces individual out-of-pocket spending over 12 months on curative care (net effect = $ -19.25 (2003 USD), intervention effect P = 0.01, clustered SE = $ 5.12; moderate-certainty evidence). The included studies did not report equity in the use of clinical health services and in adverse effects. This update confirms the findings of the original review. Contracting out probably reduces individual out-of-pocket spending on curative care (moderate-certainty evidence), but probably makes little or no difference in other health utilisation or service delivery outcomes (moderate- to low-certainty evidence). Therefore, contracting out programmes may be no better or worse than government-provided services, although additional rigorously designed studies may change this result. The literature provides many examples of contracting out programmes, which implies that this is a feasible response when governments fail to provide good clinical health care. Future contracting out programmes should be framed within a rigorous study design to allow valid and reliable measures of their effects. Such studies should include qualitative research that assesses the views of programme implementers and beneficiaries, and records implementation mechanisms. This approach may reveal enablers for, and barriers to, successful implementation of such programmes.

[Intraocular pressure after ND: YAG laser capsulotomy in pseudophakic patients with glaucoma].

PubMed

Sesar, Antonio; Petric, Irena; Sesar, Ivanka; Lacmnovic-Loncar, Valentina; Jurisić, Darija; Tomić, Zeljka; Mandić, Zdravko

2006-01-01

The aim of the study was to analyze changes in intraocular pressure after Nd: YAG laser capsulotomy in pseudophakic patients with glaucoma. Intraocular pressure was recorded before, and 1 and 3 hours after YAG laser capsulotomy in 69 pseudophakic patients with glaucoma. Twenty eight patients received no therapy before capsulotomy, 21 patients received topical brimonidine 0.2%, and 20 patients received topical dorzolamide 2% 1 hour before laser capsulotomy. All patients received topical tropicamide 1% and tetracaine 0.5%. Nd: YAG laser posterior capsulotomy was performed using inverted-U technique to make a 3-4 mm diameter capsulotomy. After capsulotomy, all eyes received topical fluorometholone for 10 days. A pressure rise was greater in patients without any therapy before YAG laser capsulotomy. Eight patients with glaucoma showed intraocular pressure rise of 5 mm Hg, and 2 patients pressure rise of 10 mm Hg after laser capsulotomy. A reduction of intraocular pressure rise was found in patients who received dorzolamide 2% or brimonidine 0.2%, only 1 patient in each group developed a pressure rise of 5 mm Hg. In all patients a significant pressure rise developed within the first hour. It is difficult to compare different studies due to different techniques of cataract surgery and different intraocular lense material and design. Barnes showed that 6 of 29 (21%) developed a pressure rise of 5 mm Hg, and 1 of 29 (3%) patients a pressure rise of 10 mm Hg. In our study, 29% of patients had a pressure rise of > or =5 mm Hg, and 7% of patients had a rise of > or =10 mm Hg after laser capsulotomy. These results may be associated with a large proportion of extracapsular cataract extraction (71%) versus phacoemulsification (29%) in our patients. Pretreatment with dorzolamide 2% or brimonidine 0.2% reduce the intraocular pressure rise after Nd: YAG laser capsulotomy in pseudophakic patients with glaucoma.

Effect of H-7 on secondary cataract after phacoemulsification in the live rabbit eye.

PubMed

Tian, Baohe; Heatley, Gregg A; Filla, Mark S; Kaufman, Paul L

2010-12-01

This study is aimed to determine if the serine-threonine kinase inhibitor H-7 inhibits secondary cataract after phacoemulsification in the live rabbit eye. Eighteen rabbits underwent extracapsular lens extraction by phacoemulsification in 1 eye. The eye was treated with intravitreal H-7 (300 or 1,200 μM; n = 6 or 5) or balanced salt solution (BSS) (n = 7) immediately after the surgery and twice weekly for 10 weeks. Each eye received slit lamp biomicroscopy once a week, during which posterior capsule opacification (PCO) was evaluated. The eye was then enucleated and the lens capsule was prepared, fixed, and imaged. PCO was evaluated again on the isolated lens capsule under a phase microscope. Soemmering's ring area (SRA) and the entire lens capsule area were measured from capsule images on a computer and the percentage of SRA (PSRA) in the entire capsule area was calculated. Wet weight of the capsule (WW) was determined on a balance. No significant difference in PCO was observed in any comparison. No significant differences in SRA, PSRA, and WW were observed between the 300 μM H-7-treated eye and the BSS-treated eye. However, SRA, PSRA, and WW in the 1,200 μM H-7-treated eye were significantly smaller than those in the BSS-treated eye [28.3 ± 16.2 vs. 61.4 ± 8.86 mm(2) (P = 0.001), 33% ± 20% vs. 65% ± 15% (P = 0.01), and 65.6 ± 27.9 vs. 127.0 ±37.3 mg (P = 0.01)]. Intravitreal H-7 (1,200 μM) significantly inhibits Soemmering's ring formation in the live rabbit eye, suggesting that agents that inhibit the actomyosin system in cells may prevent secondary cataract after phacoemulsification.

Cost-Effectiveness Analysis of Chemoradiation Therapy Versus Transoral Robotic Surgery for Human Papillomavirus–Associated, Clinical N2 Oropharyngeal Cancer

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

Sher, David J., E-mail: david.sher@utsouthwestern.edu; Fidler, Mary Jo; Tishler, Roy B.

Purpose: To perform a cost-effectiveness analysis of primary chemoradiation therapy (CRT) versus transoral robotic surgery (TORS) for clinical N2, human papillomavirus (HPV)-positive oropharyngeal carcinoma. Methods and Materials: We developed a Markov model to describe the health states after treatment with CRT or TORS, followed by adjuvant radiation therapy or CRT in the presence of high-risk pathology (positive margins or extracapsular extension). Outcomes, toxicities, and costs were extracted from the literature. One-way sensitivity analyses (SA) were performed over a wide range of parameters, as were 2-way SA between the key variables. Probabilistic SA and value of information studies were performed over keymore » parameters. Results: The expected quality-adjusted life years (QALYs)/total costs for CRT and TORS were 7.31/$50,100 and 7.29/$62,200, respectively, so that CRT dominated TORS. In SA, primary CRT was almost always cost-effective up to a societal willingness-to-pay of $200,000/QALY, unless the locoregional recurrence risk after TORS was 30% to 50% lower, at which point it became cost effective at a willingness-to-pay of $50-100,000/QALY. Probabilistic SA confirmed the importance of locoregional recurrence risk, and the value of information in precisely knowing this parameter was more than $7M per year. If the long-term utility after TORS was 0.03 lower than CRT, CRT was cost-effective over nearly any assumption. Conclusions: Under nearly all assumptions, primary CRT was the cost-effective therapy for HPV-associated, clinical N2 OPC. However, in the hypothetical event of a large relative improvement in LRR with surgery and equivalent long-term utilities, primary TORS would become the higher-value treatment, arguing for prospective, comparative study of the 2 paradigms.« less

How to Certify Learning in a Country Split into Two by a Civil War: Governmental and Non-Governmental Initiatives in Cote d'Ivoire, 2002-06

ERIC Educational Resources Information Center

Hamer, Magali Chelpi-den

2007-01-01

Following political turmoil and rising socio-economic difficulties, Cote d'Ivoire has been split into two since September 2002. The rebellion controls the northern part of the country and the main towns of Bouake, Korhogo and Man, while the government controls the southern part with Abidjan, Yamoussoukro, Daloa and all the ports in the coastal…

The Factors Influencing the Achievement of a U.S. Governmentally-Sponsored International Education Exchange Program's Objectives: Reflections of Alumni from the Kyrgyz Republic

ERIC Educational Resources Information Center

Timlin, Kevin

2017-01-01

The purpose of this study is to determine which factors influence the achievement of program objectives for Kyrgyz Republic alumni of the U.S. governmentally sponsored UGRAD program. The UGRAD program was designed to provide university students from the former Soviet Union an opportunity to study at an institute of higher education in the United…

A comprehensive survey of the relationship between self-efficacy and performance for the governmental auditors.

PubMed

Su, Jau-Ming; Lee, Shue-Ching; Tsai, Sang-Bing; Lu, Tzu-Li

2016-01-01

As governmental auditing is involved in evaluating the legitimacy, economy, efficiency, and effectiveness of how the various administrative branches use their allocated resources to optimize the government's functions, it is expected that the performance of the auditors in charge are strongly influenced by their respective qualities such as self-efficacy and experience, etc. To further understand the factors that may enhance their performance and to ultimately provide practical recommendations for the audit authorities, we have surveyed about 50 % of all the governmental auditors in Taiwan. The result showed that any auditing experience and professionalization do positively influence the professional awareness, and acquired knowledge and skillset of an auditor can effectively improve his or her professional judgment. We also found that perceived ability, problem-solving skills, and resource sharing may significantly impact any performance involved. Our study provides a workable management guidelines for strengthening the self-efficacy of audit authorities in Taiwan.

Occupational disease among non-governmental employees in Malaysia: 2002-2006.

PubMed

Abas, Adinegara Bin Lutfi; Said, Abdul Razzak Bin Mohd; Mohammed, Mohammed Azman Bin Aziz; Sathiakumar, Nalini

2008-01-01

In the absence of systematic occupational disease surveillance, other data collected by governmental agencies or industry is useful in the identification of occupational diseases and their control. We examined data on occupational diseases reported by non-governmental employees to the national workers' social security organization in Malaysia, 2002-2006. The overall incidence rate of occupational disease was 2.8 per 100,000 workers. There was an increase in the annual number and rates of occupational disease over time. The most frequently reported conditions were hearing impairment (32%) and musculoskeletal disorders (28%). Workers in the non-metallic manufacturing industry had the highest average incidence rate of hearing impairment (12.7 per 100,000 workers) and musculoskeletal disorders (3.5 per 100,000 workers), compared to all other industries. Preventive measures should focus on safety education, engineering control and workplace ergonomics. Enforcing workplace standards and incorporating an ongoing surveillance system will facilitate the control and reduction of occupational disease.

Will Catholic hospitals survive without government reimbursements?

PubMed

Archer, David L

2017-02-01

This brief essay will begin to address the feasibility of operating a Catholic healthcare system without reimbursement from government healthcare programs such as Medicare and Medicaid. This question stems from the recent ACA/HHS "Nondiscrimination in Health Programs and Activities" final rule. Summary : The average hospital in the United States receives 40-50 percent of its net revenues from governmental sources. Participation in Medicare is contingent upon the hospital having a Medicare provider agreement. Participation in other governmental programs (Medicaid) as well as most commercial insurance is also contingent upon that agreement. Hospitals, including "Catholic" hospitals, cannot survive without a Medicare provider agreement. That agreement may be terminated for non-compliance with Medicare and other governmental regulations such as the recent ACA/HHS "Nondiscrimination in Health Programs and Activities" final rule, which could require "Catholic" hospitals to provide services which violate moral principals of the Church.

The World Hypertension League: where now and where to in salt reduction

PubMed Central

Lackland, Daniel T.; Lisheng, Liu; Zhang, Xin-Hua; Nilsson, Peter M.; Niebylski, Mark L.

2015-01-01

High dietary salt is a leading risk for death and disability largely by causing increased blood pressure. Other associated health risks include gastric and renal cell cancers, osteoporosis, renal stones, and increased disease activity in multiple sclerosis, headache, increased body fat and Meniere’s disease. The World Hypertension League (WHL) has prioritized advocacy for salt reduction. WHL resources and actions include a non-governmental organization policy statement, dietary salt fact sheet, development of standardized nomenclature, call for quality research, collaboration in a weekly salt science update, development of a process to set recommended dietary salt research standards and regular literature reviews, development of adoptable power point slide sets to support WHL positions and resources, and critic of weak research studies on dietary salt. The WHL plans to continue to work with multiple governmental and non-governmental organizations to promote dietary salt reduction towards the World Health Organization (WHO) recommendations. PMID:26090335

The role of microcredit in reducing women's vulnerabilities to multiple disasters.

PubMed

Ray-Bennett, Nibedita S

2010-01-01

This article explores the relationship between microcredit and vulnerability reduction for women-headed households in'multiple disasters'. Here multiple disasters are understood as disasters that occur in one specific place and cause severe devastation. The case study covers the super-cyclone in 1999, floods in 2001 and 2003, and drought in 2002 in Orissa, India. The study entailed eight months fieldwork and interviews with several governmental and non-governmental officials and 12 women-headed households from different social castes. The findings suggest that microcredit is a useful tool to replace women's livelihood assets that have been lost in multiple disasters. But inefficient microcredit delivery can cause microdebts and exacerbate caste, class and gender inequalities. It is posited that microcredit delivery cannot achieve vulnerability reduction for women in multiple disasters unless it is complemented by effective financial services, integrated policy planning and disaster management between government, non-governmental organisations and the community.

A STUDY ON A COOPERATIVE RELATIONSHIP TO THE IMPROVEMENT OF THE REGIONAL FIRE FIGHTING VALIDITY -Case Study in Bangkok, Thailand-

NASA Astrophysics Data System (ADS)

Sripramai, Keerati; Oikawa, Yasushi; Watanabe, Hiroshi; Katada, Toshitaka

Generally, in order to improve some regional fire fighting validity, indispensable strategies are not only a reinforcement of the governmental fire fighting ability, but also a strengthening of the cooperative relationship between governmental and non-governmental fire fighting ability. However, for practical purposes, the effective strategy should be different depending on the actual situationin the subject area. So, in this study, we grasp the actual state and background of the problems that need to be solved for the improvement of the regional fire fighting validity in Bangkok as a case study, and examine the appropriate solution focusing on the relationship between official and voluntary fire fighting. Through some practicable activities such as interviews, investigati ons, and making the regional fire fighting validity map, it became clear that the problems of uncooperative relationship and the lack of trust between stakeholders should be solved first and foremost.

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

Not Available

The Public Health Assessment of Sola Optical USA, Inc. is based on a review of the Remedial Investigation report and the Public Health Risk Assessment. The Sola Optical USA, Inc. (Sola) site, located in Petaluma, Sonoma County, California, was placed on the National Priorities List by the EPA on June, 1988. The EPA is the lead governmental agency for the cleanup at the Sola site. Spillage associated with six underground solvent storage tanks resulted in volatile organic contaminants (VOCs) leaking into the subsurface soils and groundwater. These underground tanks and some of the surrounding contaminated soil have been excavated andmore » removed from the site. Various VOCs have been detected in on-site groundwater at levels of human health concern; however the contaminated groundwater is not currently a source of drinking water. An on-site groundwater extraction and treatment system has been in operation since 1987. Based on information reviewed, ATSDR and CDHS have concluded that the Sola site poses no apparent public health hazard.« less

Water pollution in Pakistan and its impact on public health--a review.

PubMed

Azizullah, Azizullah; Khattak, Muhammad Nasir Khan; Richter, Peter; Häder, Donat-Peter

2011-02-01

Water pollution is one of the major threats to public health in Pakistan. Drinking water quality is poorly managed and monitored. Pakistan ranks at number 80 among 122 nations regarding drinking water quality. Drinking water sources, both surface and groundwater are contaminated with coliforms, toxic metals and pesticides throughout the country. Various drinking water quality parameters set by WHO are frequently violated. Human activities like improper disposal of municipal and industrial effluents and indiscriminate applications of agrochemicals in agriculture are the main factors contributing to the deterioration of water quality. Microbial and chemical pollutants are the main factors responsible exclusively or in combination for various public health problems. This review discusses a detailed layout of drinking water quality in Pakistan with special emphasis on major pollutants, sources of pollution and the consequent health problems. The data presented in this review are extracted from various studies published in national and international journals. Also reports released by the government and non-governmental organizations are included. Copyright © 2010 Elsevier Ltd. All rights reserved.

Iranian entrepreneur nurses' perceived barriers to entrepreneurship: A qualitative study.

PubMed

Jahani, Simin; Abedi, Heidarali; Elahi, Nasrin; Fallahi-Khoshknab, Masoud

2016-01-01

To respond efficiently to the increasing and new needs of people in health issues, it is necessary for nurses to develop their knowledge from hospital to society and to be equipped to play entrepreneur role in different levels of care. The present study was conducted to describe Iranian entrepreneur nurses' perceived barriers to entrepreneurship, in order to identify the existing barriers. This is a qualitative study in which Graneheim and Lundman's content analysis method was employed. Thirteen entrepreneur nurses were chosen purposively, and data were gathered by unstructured interviews. As a result of the data analysis, five major themes were extracted: Traditional nursing structure, legal limitations, traditional attitudes of governmental managers, unprofessional behaviors of colleagues, and immoral business. The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity.

Community-company relations in gold mining in Ghana.

PubMed

Garvin, Theresa; McGee, Tara K; Smoyer-Tomic, Karen E; Aubynn, Emmanuel Ato

2009-01-01

As a result of Structural Adjustment Programme from the 1980s, many developing countries have experienced an increase in resource extraction activities by international and transnational corporations. The work reported here examines the perceived impacts of gold mining at the community level in the Wassa West District of Ghana, Africa and discusses those perceived impacts in the context of globalization processes and growing multinational corporate interest in Corporate Social Responsibility (CSR). Interview data compared community members' perceptions with those of company representatives in three communities. The results indicate that communities held companies responsible for a series of economic, social, and environmental changes. While recognizing some of the benefits brought by the mines, communities felt that the companies did not live up to their responsibility to support local development. Companies responded by denying, dismissing concerns, or shifting blame. Findings from this work show that lack of engagement and action by government agencies at all levels resulted in companies acting in a surrogate governmental capacity. In such situations, managing expectations is key to community-company relations.

Warfare in the 21st Century. A Selected Bibliography

DTIC Science & Technology

2003-07-01

2002) Also available from <http://www.carlisle.army.mil/ssi/pubs/2002/afghan/afghan.htm>. Internet. Accessed 20 June 2003. Brooks, David R ., and...Future Wars. Portland, OR: Frank Cass, 2003. 208pp. (UA10.5 N65 2003) Cerami, Joseph R ., and James F. Holcomb, eds. U.S. Army War College Guide to...also includes "current news searches and policy-like documents from other governmental and non-governmental sources." Schilling, William R ., ed

Review of the Burden of Esophageal Cancer in Malaysia.

PubMed

Siti-Azrin, Ab Hamid; Wan-Nor-Asyikeen, Wan Adnan; Norsa'adah, Bachok

2016-01-01

Esophageal cancer is one of the top leading causes of cancer-related deaths in Malaysia. To date, neither the prevalence nor incidence of esophageal cancer nationally have been recorded. Esophageal cancer remains a major and lethal health problem even if it is not common in Malaysia. The late presentation of esophageal cancer makes it a difficult and challenging medical problem. Therefore, more governmental and non-governmental organizations of Malaysia should emphasize primary and secondary prevention strategies.

Environmental Impact Statement. Small Intercontinental Ballistic Missile Program. Malmstrom Air Force Base, Montana

DTIC Science & Technology

1987-12-01

Study for Sun River Electr’: Cooperative, Inc. Fairfield, Montana. Butler, G.C., C. Hyslop , and 0. Huntzinger (editors) 1980 Anthroposenic Compounds...Counties, Montana, 1980 -1984 3.1.3-2 Actual and Projected Population of Selected Montana ................ 3-7 Counties and Cities, the State of...by Grade Level 3.1.3-4 City of Great Falls Revenues and Expenditures, All Governmental .... 3-18 Governmental Funds, FY 1980 -2000 3.1.3-5 Cascade

Career Oriented Curriculum of the D.C. School System. Hearing before the Subcommittee on Governmental Efficiency and the District of Columbia of the Committee on Governmental Affairs. United States Senate, Ninety-Eighth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Governmental Affairs.

The subject of this hearing was the partnership between the District of Columbia's public schools and several private companies. This partnership resulted in the establishment of a school curriculum giving high school students exposure to specific career training and also orientation to the workplace. The training was in the fields of…

How Governmental Policies Regarding Strategic and Critical Materials Affect the Acquisition of Major Weapon Systems.

DTIC Science & Technology

1981-09-01

L. Bollman S. MERPORMINO ORGANIZATION NAME ANO0 *003355 10. PRGRAM CLEWEIT . PROJECT, T ASK AREA A WORK UNIT NUN111E10iS Naval Postgraduate School...8217investigations concerning the development, mining, preparation, treatment, and utilization of domestic ores and other mineral substances . The...many cases, however, only been an instrument used and abused by other governmental agencies. One area severely censured has been use of the Stock

Coffee Beans and Rice Paddies - War on the Cheap: American Advisors in El Salvador and Vietnam

DTIC Science & Technology

2014-05-19

some interesting correlations between the effectiveness of a governmental counterinsurgent force, and the echelon of a host governance upon which U.S...advisory forces placed the most emphasis. There is a correlation that can be drawn from the research: the higher the echelon in a host country...interesting correlations between the effectiveness of a governmental counterinsurgent force, and the echelon of a host governance upon which U.S

JPRS Report, East Asia, Southeast Asia, The Decisive Years: Memoirs of Vietnamese Senior General Hoang Van Thai

DTIC Science & Technology

1987-06-23

governmental system , in order to maintain and develop the forces of the revolution in the governmental administration and the mass organizations, build... operatinal modes in order to, in future years, form three strong fists (the rural areas, the urban areas, and the main-force units). When the strategic...opportunity arose, when the comparison of forces between ourselves and the enemy underwent a_ fundamental change, when the United States was

Economic value of in vitro fertilization in Ukraine, Belarus, and Kazakhstan.

PubMed

Mandrik, Olena; Knies, Saskia; Severens, Johan L

2015-01-01

An economic value calculation was performed to estimate the lifetime net present value of in vitro fertilization (IVF) in Ukraine, Belarus, and Kazakhstan. Net lifetime tax revenues were used to represent governmental benefits accruing from a hypothetical cohort of an IVF population born in 2009 using the methodology of generational accounting. Governmental expenses related to this population included social benefits, education and health care, unemployment support, and pensions. Where available, country-specific data referencing official sources were applied. The average health care cost needed to achieve one additional birth from the governmental perspective varied from $2,599 in Ukraine to $5,509 in Belarus. The net present value from the population born using IVF was positive in all countries: for Ukraine ($9,839), Belarus ($21,702), and Kazakhstan ($2,295). The break-even costs of drugs and supplies per IVF procedure is expected to be $3,870, $8,530, and $1,780, respectively. Probabilistic sensitivity analyses based on 5,000 simulations show that the average net present value per person remains positive: $1,894±$7,619, $27,925±$12,407, and $17,229±$24,637 in Ukraine, Belarus, and Kazakhstan, respectively. Financing IVF may represent a good investment in terms of governmental financial returns, even in lower-income countries with state-financed health care systems such as Ukraine, Belarus, and Kazakhstan.

Economic value of in vitro fertilization in Ukraine, Belarus, and Kazakhstan

PubMed Central

Mandrik, Olena; Knies, Saskia; Severens, Johan L

2015-01-01

Background An economic value calculation was performed to estimate the lifetime net present value of in vitro fertilization (IVF) in Ukraine, Belarus, and Kazakhstan. Methods Net lifetime tax revenues were used to represent governmental benefits accruing from a hypothetical cohort of an IVF population born in 2009 using the methodology of generational accounting. Governmental expenses related to this population included social benefits, education and health care, unemployment support, and pensions. Where available, country-specific data referencing official sources were applied. Results The average health care cost needed to achieve one additional birth from the governmental perspective varied from $2,599 in Ukraine to $5,509 in Belarus. The net present value from the population born using IVF was positive in all countries: for Ukraine ($9,839), Belarus ($21,702), and Kazakhstan ($2,295). The break-even costs of drugs and supplies per IVF procedure is expected to be $3,870, $8,530, and $1,780, respectively. Probabilistic sensitivity analyses based on 5,000 simulations show that the average net present value per person remains positive: $1,894±$7,619, $27,925±$12,407, and $17,229±$24,637 in Ukraine, Belarus, and Kazakhstan, respectively. Conclusion Financing IVF may represent a good investment in terms of governmental financial returns, even in lower-income countries with state-financed health care systems such as Ukraine, Belarus, and Kazakhstan. PMID:26109873

Health promotion activities in annual reports of local governments: 'Health for All' targets as a tool for content analysis.

PubMed

Andersson, Camilla M; Bjärås, Gunilla E M; Tillgren, Per; Ostenson, Claes-Göran

2003-09-01

This article presents an instrument to study the annual reporting of health promotion activities in local governments within the three intervention municipalities of the Stockholm Diabetes Prevention Program (SDPP). The content of health promotion activities are described and the strengths, weaknesses and relevance of the method to health promotion discussed. A content analysis of local governmental reports from 1995-2000 in three Swedish municipalities. A matrix with WHO's 38 'Health for All' (HFA) targets from 1991 was used when coding the local health promotion activities. There are many public health initiatives within the local governmental structure even if they are not always addressed as health promotion. The main focuses in the local governmental reports were environmental issues, unemployment, social care and welfare. Local governmental reports were found to be a useful source of information that could provide knowledge about the priorities and organizational capacities for health promotion within local authorities. Additionally the HFA targets were an effective tool to identify and categorize systematically local health promotion activities in the annual reports of local governments. Identifying local health promotion initiatives by local authorities may ease the development of a health perspective and joint actions within the existing political and administrative structure. This paper provides a complementary method of attaining and structuring information about the local community for developments in health promotion.

Tillandsia stricta Sol (Bromeliaceae) leaves as monitors of airborne particulate matter-A comparative SEM methods evaluation: Unveiling an accurate and odd HP-SEM method.

PubMed

de Oliveira, Martha Lima; de Melo, Edésio José Tenório; Miguens, Flávio Costa

2016-09-01

Airborne particulate matter (PM) has been included among the most important air pollutants by governmental environment agencies and academy researchers. The use of terrestrial plants for monitoring PM has been widely accepted, particularly when it is coupled with SEM/EDS. Herein, Tillandsia stricta leaves were used as monitors of PM, focusing on a comparative evaluation of Environmental SEM (ESEM) and High-Pressure SEM (HPSEM). In addition, specimens air-dried at formaldehyde atmosphere (AD/FA) were introduced as an SEM procedure. Hydrated specimen observation by ESEM was the best way to get information from T. stricta leaves. If any artifacts were introduced by AD/FA, they were indiscernible from those caused by CPD. Leaf anatomy was always well preserved. PM density was determined on adaxial and abaxial leaf epidermis for each of the SEM proceedings. When compared with ESEM, particle extraction varied from 0 to 20% in air-dried leaves while 23-78% of particles deposited on leaves surfaces were extracted by CPD procedures. ESEM was obviously the best choice over other methods but morphological artifacts increased in function of operation time while HPSEM operation time was without limit. AD/FA avoided the shrinkage observed in the air-dried leaves and particle extraction was low when compared with CPD. Structural and particle density results suggest AD/FA as an important methodological approach to air pollution biomonitoring that can be widely used in all electron microscopy labs. Otherwise, previous PM assessments using terrestrial plants as biomonitors and performed by conventional SEM could have underestimated airborne particulate matter concentration. © 2016 Wiley Periodicals, Inc.

Shoreline Erosion and Slope Failure Detection over Southwest Lakeshore Michigan using Temporal Radar and Digital Elevation Model

NASA Astrophysics Data System (ADS)

Sataer, G.; Sultan, M.; Yellich, J. A.; Becker, R.; Emil, M. K.; Palaseanu, M.

2017-12-01

Throughout the 20th century and into the 21st century, significant losses of residential, commercial and governmental property were reported along the shores of the Great Lakes region due to one or more of the following factors: high lake levels, wave actions, groundwater discharge. A collaborative effort (Western Michigan University, University of Toledo, Michigan Geological Survey [MGS], United States Geological Survey [USGS], National Oceanographic and Atmospheric Administration [NOAA]) is underway to examine the temporal topographic variations along the shoreline and the adjacent bluff extending from the City of South Haven in the south to the City of Saugatuck in the north within the Allegan County. Our objectives include two main tasks: (1) identification of the timing of, and the areas, witnessing slope failure and shoreline erosion, and (2) investigating the factors causing the observed failures and erosion. This is being accomplished over the study area by: (1) detecting and measuring slope subsidence rates (velocities along line of site) and failures using radar interferometric persistent scatter (PS) techniques applied to ESA's European Remote Sensing (ERS) satellites, ERS-1 and -2 (spatial resolution: 25 m) that were acquired in 1995 to 2007, (2) extracting temporal high resolution (20 cm) digital elevation models (DEM) for the study area from temporal imagery acquired by Unmanned Aerial Vehicles (UAVs), and applying change detection techniques to the extracted DEMs, (3) detecting change in elevation and slope profiles extracted from two LIDAR Coastal National Elevation Database (CoNED) DEMs (spatial resolution: 0.5m), acquired on 2008 and 2012, and (4) spatial and temporal correlation of the detected changes in elevation with relevant data sets (e.g., lake levels, precipitation, groundwater levels) in search of causal effects.

An improved automated procedure for informal and temporary dwellings detection and enumeration, using mathematical morphology operators on VHR satellite data

NASA Astrophysics Data System (ADS)

Jenerowicz, Małgorzata; Kemper, Thomas

2016-10-01

Every year thousands of people are displaced by conflicts or natural disasters and often gather in large camps. Knowing how many people have been gathered is crucial for an efficient relief operation. However, it is often difficult to collect exact information on the total number of the population. This paper presents the improved morphological methodology for the estimation of dwellings structures located in several Internally Displaced Persons (IDPs) Camps, based on Very High Resolution (VHR) multispectral satellite imagery with pixel sizes of 1 meter or less including GeoEye-1, WorldView-2, QuickBird-2, Ikonos-2, Pléiades-A and Pléiades-B. The main topic of this paper is the approach enhancement with selection of feature extraction algorithm, the improvement and automation of pre-processing and results verification. For the informal and temporary dwellings extraction purpose the high quality of data has to be ensured. The pre-processing has been extended by including the input data hierarchy level assignment and data fusion method selection and evaluation. The feature extraction algorithm follows the procedure presented in Jenerowicz, M., Kemper, T., 2011. Optical data are analysed in a cyclic approach comprising image segmentation, geometrical, textural and spectral class modeling aiming at camp area identification. The successive steps of morphological processing have been combined in a one stand-alone application for automatic dwellings detection and enumeration. Actively implemented, these approaches can provide a reliable and consistent results, independent of the imaging satellite type and different study sites location, providing decision support in emergency response for the humanitarian community like United Nations, European Union and Non-Governmental relief organizations.

Cost-effectiveness of Haemophilus influenzae type b vaccine in Vietnam

PubMed Central

Le, Phuc; Griffiths, Ulla K.; Anh, Dang Duc; Franzini, Luisa; Chan, Wenyaw; Swint, J. Michael

2015-01-01

Background With GAVI support, Vietnam introduced Haemophilus influenzae type b (Hib) vaccine in 2010 without evidence on cost-effectiveness. We aimed to analyze the cost-effectiveness of Hib vaccine from societal and governmental perspectives. Method We constructed a decision-tree cohort model to estimate the costs and effectiveness of Hib vaccine versus no Hib vaccine for the 2011 birth cohort. The disease burden was estimated from local epidemiologic data and literature. Vaccine delivery costs were calculated from governmental reports and 2013 vaccine prices. A prospective cost-of-illness study was conducted to estimate treatment costs. The human capital approach was employed to estimate productivity loss. The incremental costs of Hib vaccine were divided by cases, deaths, and disability-adjusted life years (DALY) averted. We used the WHO recommended cost-effectiveness thresholds of an intervention being highly cost-effective if incremental costs per DALY were below GDP per capita. Result From the societal perspective, incremental costs per discounted case, death and DALY averted were US$ 6,252, US$ 26,476 and US$ 1,231, respectively; the break-even vaccine price was US$ 0.69/dose. From the governmental perspective, the results were US$ 6,954, US$ 29,449, and US$ 1,373, respectively; the break-even vaccine price was US$ 0.48/dose. Vietnam's GDP per capita was US$ 1,911 in 2013. In deterministic sensitivity analysis, morbidity and mortality parameters were among the most influential factors. In probabilistic sensitivity analysis, Hib vaccine had an 84% and 78% probability to be highly cost-effective from the societal and governmental perspectives, respectively. Conclusion Hib vaccine was highly cost-effective from both societal and governmental perspectives. However, with GAVI support ending in 2016, the government will face a six-fold increase in its vaccine budget at the 2013 vaccine price. The variability of vaccine market prices adds an element of uncertainty. Increased government commitment and improved resource allocation decision making will be necessary to retain Hib vaccine. PMID:26044493

205 Allergy Training and Immunotherapy in Latin America: How Survey-Results Lead to a Regional Overview

PubMed Central

Gomez, R. Maximiliano; Linnemann, Désirée Larenas; Passalacqua, Giovanni; González-Díaz, Sandra; Coce, Victor H.; Canonica, Giorgio Walter; Baena-Cagnani, Carlos E.

2012-01-01

Background In April 2011 a group of Latin American (LA) allergy experts, leaders in their countries in the area of immunotherapy, met in Cordoba, Argentina, to discuss how allergy and allergen-specific immunotherapy (ASIT) can be improved in the region. The need for a situational sketch was expressed. Methods A questionnaire on allergy training (AT), ASIT, extracts and legislation was sent out to 22 leaders in the field of nine LA countries to obtain an overview of the LA situation. Results Results are presented with descriptive statistics. All 22 questionnaires were returned (9 countries). AT in 56% of the surveyed LA countries is at the third-level of medical care, after a core-training of 2 to 3 years internal medicine or pediatrics; in 3 countries it is a second-level career and in one country there is no AT. Board certification with exam is only mandatory in a third of the countries; recertification being obtained without exam. Mostly, training is in general allergy; pediatric AT only exists in 2 countries. Both sublingual (SLIT, only in the form of drops) and subcutaneous (SCIT) immunotherapy are practiced in all countries, from the age of 3 years (mean, range 1–5 years) onward. As no strict legislation exists IT can be managed by non-allergists in 7/9 countries. Mixed extracts are used with mostly 3 to 5 allergens/vial (range 2 to 6-10 allergens/vial) and all countries have bacterial vaccine. SCIT extracts come from US and European (89%) and 56% local providers. SLIT extracts are almost exclusively from Europe (Spain), but in Argentine, Brazil, and Mexico also local SLIT extracts exist. There is rudimentary regulation concerning extract potency in 2 countries. IT is generally paid for by private patients. Insurance companies reimburse IT in 56% of the countries, the social security system in 33% and in one country selected third level governmental hospitals supply IT. Publications on adverse events with IT are starting to appear (3 countries) and 3 countries have their own guidelines on IT (one only in pediatrics). Conclusions A clearer picture where and how to improve AT and ASIT in LA has been obtained; however, unmet needs on ASIT are still pending.

Population and the Future: From Bucharest (1974) to Mexico City (1984). Summary Report of the United Nations Fund for Population Activities Briefing for Non-Governmental Organizations in New York (2nd, New York, New York, February 16, 1983).

ERIC Educational Resources Information Center

De Vel Muller, Robert

The major objectives of this briefing are to inform non-governmental organizations (NGOs) of population problems and progress worldwide and to provide information on the International Conference on Population to be held in Mexico City in 1984. The bulk of the report summarizes the group meetings and followup discussions held to examine four major…

Institutional environmental impact statement, Michoud Assembly Facility, New Orleans, Louisiana

NASA Technical Reports Server (NTRS)

1978-01-01

A description and analysis of Michoud Assembly Facility as an operational base for both NASA and NASA-related programs and various government tenant-agencies and their contractors is given. Tenant-agencies are governmental agencies or governmental agency contractors which are not involved in a NASA program, but utilize office or manufacturing space at the Michoud Assembly Facility. The statements represent the full description of the likely environmental effects of the facility and are used in the process of making program and project decisions.

The Iranian Islamic Clergy: Governmental Politics and Theocracy,

DTIC Science & Technology

1984-03-05

7 AD-A141 942 THE IRANIAN ISLAMIC CLERGY GOVERNMENTAL POLITCS AND THEOCRAC(U) MIDDLE EAST NST WASHINGTON DC IJCARJOMAND ET AL 05 MAR 84 MDA908-83...chey had destroyed the well-organized and highly dedicated Islamic radicals, the Mujahedin. They had also succeeded in putting an end to the presence of...ability to forgive, were als;o associated with thne qu=rters. But the luti band. had the potential, it iiot supervised, - 7 C aeop :n ru; gangb : v

Title I Preschool Education: More Children Served, but Gauging Effect on School Readiness Difficult. Report to the Chairman, Subcommittee on Oversight of Government Management, Restructuring and the District of Columbia, Committee on Governmental Affairs, U.S. Senate.

ERIC Educational Resources Information Center

Shaul, Marnie S.

At the request of the Committee on Governmental Affairs of the U.S. Senate, this report presents findings of a study to determine the extent to which Title I funds are used to support education or developmentally appropriate activities for preschoolers, and what is known about the effectiveness of Title I-funded programs in preparing preschoolers…

Navigating the profits and pitfalls of governmental partnerships: the ICRC and intergovernmental relief, 1918-23.

PubMed

Lowe, Kimberly A

2015-10-01

The International Committee of the Red Cross (ICRC) is today a staunch proponent of the need for humanitarian organisations to remain independent of state interests, yet it deliberately solicited intergovernmental intervention in international relief after the First World War of 1914-18. This paper examines why an organisation committed to upholding the independence and impartiality of humanitarian action might still choose to partner with governmental bodies. It also highlights the historical beginnings of a linkage between international aid and geopolitics. To secure governmental funding for refugee relief during the 1920s, the ICRC argued that the humanitarian crises of the post-war years were a threat to the political and social stability of Europe. While this has become axiomatic, the interwar history of the ICRC demonstrates that the perceived connection between relief and geopolitical stability is historically constructed, and that it must continue to be asserted persuasively to be effective. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

Soft System Methodology as a Tool to Understand Issues of Governmental Affordable Housing Programme of India: A Case Study Approach

NASA Astrophysics Data System (ADS)

Ghosh, Sukanya; Roy, Souvanic; Sanyal, Manas Kumar

2016-09-01

With the help of a case study, the article has explored current practices of implementation of governmental affordable housing programme for urban poor in a slum of India. This work shows that the issues associated with the problems of governmental affordable housing programme has to be addressed to with a suitable methodology as complexities are not only dealing with quantitative data but qualitative data also. The Hard System Methodologies (HSM), which is conventionally applied to address the issues, deals with real and known problems which can be directly solved. Since most of the issues of affordable housing programme as found in the case study are subjective and complex in nature, Soft System Methodology (SSM) has been tried for better representation from subjective points of views. The article explored drawing of Rich Picture as an SSM approach for better understanding and analysing complex issues and constraints of affordable housing programme so that further exploration of the issues is possible.

Quantitative proteomics analysis by iTRAQ in human nuclear cataracts of different ages and normal lens nuclei.

PubMed

Zhou, Hai Yan; Yan, Hong; Wang, Li Li; Yan, Wei Jia; Shui, Ying Bo; Beebe, David C

2015-08-01

The goal of this study was to quantitatively identify the differentially expressed proteins in nuclear cataracts of different ages and normal lens nuclei in humans. Forty-eight human lens nucleus samples with hardness grades III, IV were obtained during cataract surgery by extracapsular cataract extraction. Seven normal transparent human lens nuclei were obtained from fresh normal cadaver eyes during corneal transplantation surgery. Lens nuclei were divided into seven groups according to age and optic axis: Group A (average age 80.8 ± 1.2 years), Group B (average age 57.0 ± 4.0 years), Group C average age 80.3 ± 4.5 years), Group D (average age 56.9 ± 4.2 years), Group E (average age 78.1 ± 2.5 years), Group F (average age 57.6 ± 3.3 years) and Group G (seven normal transparent human lenses from normal cadaver eyes, average age 34.7 ± 4.2 years). Water-soluble, water-insoluble, and water-insoluble-urea-soluble protein fractions were extracted from samples. The three-part protein fractions from the individual lenses were combined to form the total proteins of each sample. The proteomic profiles of each group were further analyzed using 8-plex iTRAQ labeling combined with 2D-LC-MS/MS. The data were analyzed with the ProteinPilot software for peptide matching, protein identification, and quantification. Differentially expressed proteins were validated by Western blotting. We employed biological and technical replicates and selected the intersection of the two results, which included 80 proteins. Nine proteins were differentially expressed among the 80 proteins identified using proteomic techniques. In age-related nuclear cataracts (ARNC), the expression levels of fatty acid-binding protein and pterin-4-alpha-carbinolamine dehydratase were upregulated, whereas the levels of alpha-crystallin B chain (CRYAB), GSH synthetase, phakinin, gamma-crystallin C, phosphoglycerate kinase 1, betaine-homocysteine S-methyltransferase 1 (BHMT1), and spectrin beta chain were downregulated. These proteins may be associated with abnormal protein aggregation and oxidative stress. GSH synthetase and CRYAB expression levels in the nuclear cataract decreased with age. The mass spectrometric analysis results were consistent with the Western blot validation. The results indicate that CRYAB and GSH synthetase may be involved in ARNC pathogenesis. iTRAQ combined with 2D-LC-MS/MS provides new methods for future studies of pathological mechanisms and protective drug development for ARNC. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A multistage crucible of revision and approval shapes IPCC policymaker summaries.

PubMed

Mach, Katharine J; Freeman, Patrick T; Mastrandrea, Michael D; Field, Christopher B

2016-08-01

Intergovernmental Panel on Climate Change (IPCC) member governments approve each report's summary for policymakers (SPM) by consensus, discussing and agreeing on each sentence in a plenary session with scientist authors. A defining feature of IPCC assessment, the governmental approval process builds joint ownership of current knowledge by scientists and governments. The resulting SPM revisions have been extensively discussed in anecdotes, interviews, and perspectives, but they have not been comprehensively analyzed. We provide an in-depth evaluation of IPCC SPM revisions, establishing an evidential basis for understanding their nature. Revisions associated with governmental review and approval generally expand SPMs, with SPM text growing by 17 to 53% across recent assessment reports. Cases of high political sensitivity and failure to reach consensus are notable exceptions, resulting in SPM contractions. In contrast to recent claims, we find that IPCC SPMs are as readable, for multiple metrics of reading ease, as other professionally edited assessment summaries. Across reading-ease metrics, some SPMs become more readable through governmental review and approval, whereas others do not. In an SPM examined through the entire revision process, most revisions associated with governmental review and approval occurred before the start of the government-approval plenary session. These author revisions emphasize clarity, scientific rigor, and explanation. In contrast, the subsequent plenary revisions place greater emphasis especially on policy relevance, comprehensiveness of examples, and nuances of expert judgment. Overall, the value added by the IPCC process emerges in a multistage crucible of revision and approval, as individuals together navigate complex science-policy terrain.

On medicine and politics.

PubMed Central

Krakauer, E.

1992-01-01

This paper explores the relationship between medicine and politics, between medical management of the human body and governmental management of the body politic. It argues that the increasing complexity both of society and of governmental administration of society in the modern age has made it impossible completely to separate medicine from politics. It demonstrates that, along with great potential for social benefit, "medico-politics" brought with it great danger; much harm has been done purportedly to heal the body politic. The paper concludes by suggesting a way for physicians to minimize this danger. Images FIG. 1 PMID:1285451

Egyptian women in physics: Progress and challenges

NASA Astrophysics Data System (ADS)

Mohsen, M.; Hosni, Hala; Mohamed, Hadeer; Gadalla, Afaf; Kahil, Heba; Hashem, Hassan

2015-12-01

The present study shows a progressive increase in the number of female physicists as undergraduates and postgraduates in several governmental universities. For instance, in Ain Shams University, the percentage of women who selected physics as a major course of study increased from 7.2% in 2012 to 10.8% in 2013 and 15.7% in 2014. The study also provides the current gender distribution in the various positions among the teaching staff in seven governmental universities. The data supports the fact that female teaching assistants are increasing in these universities.

INFOMAT: The international materials assessment and application centre's internet gateway

NASA Astrophysics Data System (ADS)

Branquinho, Carmen Lucia; Colodete, Leandro Tavares

2004-08-01

INFOMAT is an electronic directory structured to facilitate the search and retrieval of materials science and technology information sources. Linked to the homepage of the International Materials Assessment and Application Centre, INFOMAT presents descriptions of 392 proprietary databases with links to their host systems as well as direct links to over 180 public domain databases and over 2,400 web sites. Among the web sites are associations/unions, governmental and non-governmental institutions, industries, library holdings, market statistics, news services, on-line publications, standardization and intellectual property organizations, and universities/research groups.

Unmanned aircraft systems integration into the national airspace

NASA Astrophysics Data System (ADS)

Wolf, H. G.

This paper examines the Federal Aviation Administration (FAA) Regulation Roadmap as set forth in the FAA Modernization and Reform Act of 2012 as well as the evolutionary process of relative legal framework. The paper will also explore the role of industry stakeholders and semi-governmental, advisory groups such as the RTCA SC-203 to show the involvement of non-governmental organizations. Leveraging the author's involvement with RTCA on the Safety Work Group of Special Committee 203, two processes within the context of safety will be explained and problems identified.

Nd: YAG photodisruptors. American Academy of Ophthalmology

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

Not Available

Nd: YAG laser surgery can cut lens capsule, vitreous and capsular membranes, strands, and adhesions, and the iris within the surgically unopened eye, thereby avoiding infection, wound leaks, and other complications of conventional intraocular surgery. The technique has found its most widespread use in performing posterior capsulotomies after extracapsular cataract surgery. It has an extremely low complication rate when used in the anterior segment and is a preferred alternative to surgical discission. The uncertainties regarding its safety in creating iridotomies in phakic eyes have lessened with its extensive use in patients with pupillary-block glaucoma. However, caution is urged in othermore » applications in phakic eyes. Following each Nd: YAG laser procedure, the eye should be monitored for elevation of intraocular pressure during the first two hours, and for retinal tears, retinal detachment, or cystoid macular edema during the first month after the procedure. Uncertainties persist regarding the circumstances under which the laser in its current configuration should be used in the vitreous cavity.« less

Definitive diagnosis of breast implant rupture using magnetic resonance imaging.

PubMed

Ahn, C Y; Shaw, W W; Narayanan, K; Gorczyca, D P; Sinha, S; Debruhl, N D; Bassett, L W

1993-09-01

Breast implant rupture is an important complication of augmented and reconstructed breasts. Although several techniques such as mammography, xeromammography, ultrasound, thermography, and computed tomographic (CT) scanning have been proven to be useful to detect implant rupture, they have several disadvantages and lack specificity. In the current study, we have established magnetic resonance imaging (MRI) as a definitive, reliable, and reproducible technique to diagnose both intracapsular and extracapsular ruptures. The study was conducted in 100 symptomatic patients. Our imaging parameters were able to identify ruptures in implants with silicone shells. All the ruptures showed the presence of wavy lines, free-floating silicone shell within the gel ("free-floating loose-thread sign" or "linguine sign"). We had a 3.75 percent incidence of false-positive and false-negative results. The sensitivity for detection of silicone implant rupture was 76 percent, with a specificity of 97 percent. In addition, we also were able to identify the artifacts that may interfere with the definitive diagnosis of implant rupture.

Immunocompromised patients with metastatic cutaneous nodal squamous cell carcinoma of the head and neck: Poor outcome unrelated to the index lesion.

PubMed

Lam, Johnson K S; Sundaresan, Puma; Gebski, Val; Veness, Michael J

2018-05-01

Immunocompromised patients with metastatic cutaneous nodal head and neck squamous cell carcinoma (HNSCC) have worse outcomes compared to the immunocompetent. The purpose of this study was to investigate the characteristics of the primary cutaneous squamous cell carcinoma (SCC), nodal pathology, and outcome between these 2 groups. Analysis of a prospective database was performed. A 2:1 pooled analysis selected 46 immunocompetent patients matched with 23 immunocompromised patients. Overall survival (OS) and relapse-free survival (RFS) were calculated using the Kaplan-Meier method. No significant difference was found in the primary tumor characteristics between the 2 groups. In the immunocompromised group, RFS (hazard ratio [HR] 2.70; P = .01) and OS (HR 2.32; P = .04) were significantly worse. Extracapsular spread was present in 100% of the immunocompromised patients. No significant difference was identified in the primary cutaneous SCC between the immunocompetent and immunocompromised patients. Immunosuppression predicted worse outcome. © 2018 Wiley Periodicals, Inc.

A rare presentation of haematuria: hip prosthesis in the bladder.

PubMed

Phan, Yih Chyn; Eli, Nnaemeka; Pillai, Praveen; O'Dair, Jonathan

2018-03-22

An 80-year-old woman presented to our department with visible haematuria and stage II acute kidney injury (AKI). She had stage IIB cervical cancer, for which she received chemotherapy and external beam radiotherapy in 2003. Four years later, she had a left dynamic hip screw for an extracapsular neck of femur fracture following a fall. In 2010, she underwent a right total hip replacement owing to osteoarthritis, and it was subsequently revised in 2012 owing to a right acetabular component failure. In this admission, her AKI improved with intravenous fluid administration and her haematuria settled following catheterisation with a three-way catheter and bladder irrigation with saline. She underwent a flexible cystoscopy which revealed that a part of her right hip prosthesis was in the bladder, having eroded through the right bony pelvis. However, she declined any surgical interventions. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.